scholarly journals Cardioprotective properties of leptin in patients with excessive body mass

2020 ◽  
Vol 189 (4) ◽  
pp. 1259-1265 ◽  
Author(s):  
Aleksandra Paduszyńska ◽  
Agata Sakowicz ◽  
Maciej Banach ◽  
Marek Maciejewski ◽  
Marek Dąbrowa ◽  
...  
Keyword(s):  
Body Mass ◽  
Peak Systolic Velocity ◽  
Hdl Cholesterol ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Overweight And Obesity ◽  
Doppler Imaging ◽  
Normal Body Mass Index ◽  
Diastolic Velocity ◽  
Significant Difference

Abstract Background Adipose tissue is producing adipokines that play different roles in the pathophysiology of cardiovascular disease. Aims The study aimed to assess the role of selected biomarkers in hypertensive patients with overweight and obesity compared with those with normal body-mass index (BMI). Methods A total of 62 patients with BMI < 25 kg/m2 (median age 54 (46–58) yrs., 57% males) and 51 with BMI ≥ 25 kg/m2 (median age 53 (48–59) yrs., 37% males) were enrolled. Biochemical parameters, leptin, adiponectin, and resistin; asymmetric dimethylarginine; interleukin 6; and N-terminal propeptide of type III procollagen, were assessed in plasma. The evaluation of hemodynamic parameters was performed using SphygmoCor 9.0 tonometer. Echocardiography was performed using AlokaAlpha 10 Premier device. Results Overweight and obese patients had significantly higher concentration of leptin (34 vs 18 ng/ml; p = 0.03), ADMA (0.43 vs 0.38 μmol/l, p = 0.04), and lower concentration of adiponectin (5.3 vs 7 μg/ml, p = 0.01). The only significant difference in tonometry analysis was higher aortic pulse pressure (mmHg) in patients with BMI ≥ 25 kg/m2 group (34 vs 30; p = 0.03). These patients had also significantly lower peak systolic velocity and early diastolic velocity in tissue Doppler imaging of the right ventricle free wall at the level of the tricuspid annulus compared with controls (p = 0.02 and p = 0.001, respectively). The level of leptin is correlated negatively with the left ventricular mass index (LVMI) (R Spearman = − 0.5; p = 0.002) and PWV (R = − 0.4; p = 0.01) and ADMA with total and LDL cholesterol (R = − 0.42; p = 0.008), and adiponectin is correlated positively with HDL cholesterol (R = 0.67; p = 0.0001). Conclusions Leptin concentrations were inversely proportional to LVMI and PWV in patients with BMI < 25 kg/m2. Trial registration Clinicaltrials.gov study ID: NCT04175080.

scholarly journals Difference in Time to Peak Systolic Velocity in Left Ventricular Basal Segments by Tissue Doppler Imaging Predicts Clinical Responders

2007 ◽  
Vol 13 (6) ◽  
pp. S141
Author(s):  
Suman S. Kuppahally ◽  
David Liang ◽  
Randall Vagelos ◽  
Paul Wang ◽  
Amin Al-Ahmad ◽  
...  
Keyword(s):  
Tissue Doppler Imaging ◽  
Peak Systolic Velocity ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Time To Peak

scholarly journals Correlation of QRS duration with intraventricular mechanical dyssynchrony on tissue Doppler imaging in heart failure

2018 ◽  
Vol 5 (2) ◽  
pp. 46-51
Author(s):  
Sanjaya Kumar Shrestha
Keyword(s):  
Heart Failure ◽  
Tissue Doppler Imaging ◽  
Tissue Doppler ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Cardiac Resynchronization ◽  
Time To Peak ◽  
Significant Difference ◽  
Qrs Duration

Introductions: Wide QRS complex with left bundle branch block morphology is one of the three criteria for cardiac resynchronization therapy (CRT) in heart failure (HF) patients who do not improve on medical management. Approximately 30% of patients do not respond to CRT. This study investigates to find out to what extent the wide QRS duration correlates with the intraventricular mechanical dyssynchrony (IVMD) as measured by Tissue Doppler Imaging (TDI) echocardiography. Methods: The HF patients of dilated or ischemic cardiomyopathy with ejection fraction £35% admitted in the medical ward of Patan Hospital, Nepal from March to August 2017 were enrolled in the study. They were divided into two groups, narrow QRS duration of <120ms (Gr1) and wide QRS duration of ³120ms (Gr2). TDI was performed to measure time to peak systolic velocity of the left ventricular walls. The IVMD, defined as 60 ms (millisecond) or greater difference in time to peak velocity between any two points of the left ventricular walls, was compared in both groups. Results: There were 26 patients, 18 in group-1, and eight in Gr2.In Gr1, IVMD was observed 13/18 (72%) patients and in group-2 in 7/8 (87%) patients, (χ2 = 0.70, p = 0.403). There was no significant difference of IVMD between Gr1 and Gr2 (73±36ms vs 97±38ms, t = 1.54, p = 0.136).   Conclusions: Assessment of intraventricular mechanical dyssynchrony (IVMD) by Tissue Doppler Imaging (TDI) is probably superior to QRS duration in heart failure patients.

scholarly journals Impact of Overweight and Obesity on Left Ventricular Diastolic Function and Value of Tissue Doppler Echocardiography

2013 ◽  
Vol 7 ◽  
pp. CMC.S11156 ◽  
Author(s):  
Antoine Kossaify ◽  
Nayla Nicolas
Keyword(s):  
Body Mass Index ◽  
Waist Circumference ◽  
Diastolic Function ◽  
Body Mass ◽  
Left Ventricular Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Overweight And Obesity ◽  
Obese Patients ◽  
Ventricular Diastolic Function

Background Diastolic dysfunction is a common cause of heart failure with preserved systolic function in obese patients. Objective To assess diastolic function in a series of overweight and obese patients using conventional and tissue Doppler echocardiography. Setting and Method University hospital; left ventricular diastolic function was evaluated in 99 patients (mean age 61.59 ± 13.9 years); body mass index and waist circumference were assessed, and patients were subdivided into three groups according to their body mass index (kg/m2): [normal, (18.5-24.9); overweight, (25-29.9); obese, (> 29.9)]. Peak early (E) and late (A) transmural flow and peak early (E′) diastolic mitral annulus velocities were measured. Results Diastolic dysfunction was significantly higher in the overweight/obese groups compared to the normal body mass index group. The analysis was made with regard to waist circumference and other clinical characteristics, and multivariate regression analysis showed a direct and independent effect of body mass index on diastolic function [OR: 2.75; CI: 1.34-5.67; P = 0.006]. Discussion was made in view of the latest clinical data. Also, an insight into normal weight obesity is presented and discussed. Conclusion Overweight and obesity are found to have an independent negative impact on diastolic function as assessed by tissue Doppler imaging.

scholarly journals Cardiac dysfunction in acromegaly: evidence by pulsed wave tissue Doppler imaging

2000 ◽  
pp. 363-369 ◽  
Author(s):  
G Mercuro ◽  
S Zoncu ◽  
P Colonna ◽  
P Cherchi ◽  
S Mariotti ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Tissue Doppler Imaging ◽  
Systolic Function ◽  
Lateral Wall ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Control Group ◽  
Diastolic Velocity ◽  
Acromegalic Cardiomyopathy

OBJECTIVE: To verify whether the accuracy of data on myocardial function provided by pulsed-wave tissue Doppler imaging (PWTDI), a new echocardiographic application that allows quantitative measurements of myocardial wall velocities, could help towards a better understanding of the natural history of acromegalic cardiomyopathy. DESIGN: Eighteen patients with active acromegaly (ten men and eight women; mean age 48.0+/-15.0 years) with no other detectable cause of heart disease underwent PWTDI. Thirteen healthy individuals matched for age and body mass index acted as a control group. METHODS: Ejection fraction (EF), transmitral early/late diastolic velocity (E/A) ratio and isovolumic relaxation time (IVRT) were measured by conventional echocardiography; systolic peak (Sv) and early (Ev) and late (Av) diastolic peak velocities, Ev/Av ratio and regional IVRT (IVRTs) were obtained by PWTDI. RESULTS: All patients showed appreciably abnormal left ventricular global diastolic function represented by prolongation of the IVRT (P<0.001). Using PWTDI we found a prolongation of IVRTs and inversion of the Ev/Av ratio. In addition, the Ev/Av ratio proved to be significantly negatively correlated with IVRT; this correlation was not present in the case of the E/A ratio. Furthermore, a decrease in Sv was detected in the basal segment of the lateral wall (P<0.01), which had the greatest degree of diastolic dysfunction. CONCLUSIONS: PWTDI confirmed the acknowledged diastolic dysfunction that accompanies acromegalic cardiomyopathy and highlighted the greater sensitivity of regional PWTDI with respect to global Doppler diastolic indexes. Furthermore, by revealing an impairment of regional systolic function in presence of a normal EF, the findings with PWTDI contradicted the largely accepted theory that systolic function remains normal for several years in patients affected by acromegalic cardiomyopathy.

scholarly journals THE DIAGNOSTIC VALUE OF PULSED WAVE TISSUE DOPPLER IMAGING IN ASYMPTOMATIC BETA- THALASSEMIA MAJOR CHILDREN AND YOUNG ADULTS ; RELATION TO CHEMICAL BIOMARKERS OF LEFT VENTRICULAR FUNCTION AND IRON OVERLOAD .

2015 ◽  
Vol 7 ◽  
pp. e2015051 ◽  
Author(s):  
Seham Ragab
Keyword(s):  
Iron Overload ◽  
Serum Ferritin ◽  
Tissue Doppler Imaging ◽  
Mitral Annulus ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Beta Thalassemia ◽  
Ejection Time ◽  
Diastolic Velocity

Background: Cardiac iron toxicity is the leading cause of death among  β-halassaemia major (TM)  patients.  Once  heart failure becomes overt , it will be  difficult to reverse . Objectives: To investigate non overt cardiac dysfunctions  in TM patients using  pulsed wave Tissue Doppler  Imaging (TD I) and its relation to the iron overload and brain natruritic peptide (BNP). Methods: Thorough  clinical , conventional echo and  pulsed  wave TDI  parameters were compared between  asymtomatic 25 β-TM  patients  and 20 age and gender matched individuals. Serum ferritin and plasma BNP  levels were assayed by  ELISA .  Results: TM patients had significant higher mitral inflow early diastolic (E) wave and  non significant other conventional echo  parameters. Pulsed wave TDI revealed systolic and diastolic dysfunctions in the form of significant higher  isovolumetric contraction time (ICT) , ejection time ( E T) and  isovolumetric relaxation time (IRT) with significantly lower  mitral annulus  early diastolic velocity E` (12.07 ±2.06 vs 15.04±2.65 ,P= 0.003)  in patients compared to  controls. Plasma BNP was higher in patients compared to the controls.  Plasma BNP and serum ferritin had significant correlation with each other and with pulsed wave conventional and TDI indices of systolic and diastolic functions.  Patients with E/E` ≥ 8 had  significant higher  serum ferritin  and plasma BNP levels compared to those with E/E` ratio < 8 without difference in Hb levels .Conclusion:  Pulsed wave TDI  is an  important diagnostic tool for latent cardiac dysfunction in iron loaded TM patients and is related to iron overload and BNP .    

scholarly journals Diastolic function in Steinert’s disease

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Abdallah Fayssoil ◽  
Olivier Nardi ◽  
Djillali Annane ◽  
David Orlikowski
Keyword(s):  
Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Control Group ◽  
Diastolic Velocity ◽  
Echocardiography Doppler ◽  
Steinert's Disease ◽  
Steinert’S Disease ◽  
Deceleration Time

Myotonic dystrophy type 1 (MD) is the most common autosomal dominant muscular dystrophy in adults. Cardiac involvement is mainly characterized by conduction abnormalities and arrhythmias. We sought to assess diastolic function in MD patients. Echocardiography-Doppler was performed in Steinert’s patients and in a control group completed by tissue Doppler imaging (TDI). Twenty-six patients with Steinert’s disease were included in the study and were compared to a control group. Mean age was similar in the 2 groups (45.1 years ±10.9 in Steinert’s patients <em>vs</em> 42.1 years ±11 in control group P 0.4). 6 /26 patients with Steinert’s disease disclosed a left ventricular (LV) ejection fraction &lt;50%. Mean left atrial (LA) diameter was statistically different between Steinert‘s patients and patients in group control (27.8 mm ±8.5 <em>vs</em> 19.7 mm ±4; P=0.0018). Mean peak E/A mitral ratio was 1.29±0.45 in Steinert’s patients <em>vs</em> 1.36±0.4 in control group (P=0.6). We found an increase of the mitral E deceleration time in Steinert’s patients in comparison with patients in control group (219 ms ±53 vs 176 ms ±29; P=0.013). Mean peak lateral early diastolic velocity Ea was similar in the 2 groups (12.3 cm/s ±3 <em>vs</em> 13.1 cm/s ±3.8; P=0.50). Mean peak septal early diastolic velocity was sim- ilar in the 2 groups (11.2 cm/s ±2 <em>vs</em> 10.4±2; P=0.51). We found an increase of the LA diameter and an increase of the mitral deceleration time in Steinert’s patients that suggest diastolic abnormalities.

scholarly journals Echocardiographic evaluation of cardiac structure and function in obese Egyptian adolescents

2011 ◽  
Vol 22 (4) ◽  
pp. 410-416 ◽  
Author(s):  
Hanan M. Kamal ◽  
Hoda A. Atwa ◽  
Omar M. Saleh ◽  
Faten A. Mohamed
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Ventricular Hypertrophy ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Obese Group ◽  
Doppler Imaging ◽  
Hip Circumference ◽  
The Right ◽  
Diastolic Functions

AbstractObjectiveThe objective of this study was to detect structural and functional changes in the left and right ventricles in obese Egyptian adolescents.Methods and resultsAnthropometric and echocardiographic parameters, including tissue Doppler imaging, were obtained from 70 obese adolescents with average body mass index of 34 plus or minus 3.8 and compared with 50 age- and sex-matched controls, with a body mass index of 21.6 plus or minus 1.9. Cardiac dimensions, stroke volume, left ventricular and right ventricular systolic and diastolic functions were evaluated. The obese group had a higher end-diastolic septal and posterior wall thickness and left ventricular mass index than the non-obese group. Body mass index, mid-arm and hip circumference values showed significant correlations with these echocardiographic variables. Systolic and diastolic functions of the left ventricle were normal in both groups, although stroke volume was high in the obese group. The right ventricle tissue Doppler parameters were similar in both groups. However, the S wave of the septal/lateral tricuspid valve annulus was reduced in the obese group, but not to the level reflecting systolic dysfunction. This was inversely correlated with hip, waist, and mid-arm circumference. Stepwise multiple regression analysis showed that the mid-arm and hip circumference followed by the body mass index are significant predictors of these early cardiac abnormalities.ConclusionLeft ventricular hypertrophy is present in obese children, although both systolic and diastolic functions are normal. Tissue Doppler imaging revealed a minor, but still significant, reduction in the right ventricular systolic function. Mid-arm and hip circumference are predictors of left ventricular hypertrophy.

Effects of lowered dialysate sodium on left ventricle function and brain natriuretic peptide in maintenance of hemodialysis patients

2016 ◽  
Vol 36 (2) ◽  
pp. 128-134 ◽  
Author(s):  
A Akyol ◽  
S Akdag ◽  
M Asker ◽  
HA Gumrukcuoglu ◽  
R Duz ◽  
...  
Keyword(s):  
Natriuretic Peptide ◽  
Tissue Doppler ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Doppler Velocity ◽  
Transmitral Flow ◽  
Mitral Inflow ◽  
Diastolic Velocity ◽  
Significant Difference ◽  
Dialysate Sodium

Introduction: Impaired diastolic flow is characterized by decreased left ventricular (LV) filling diastole, abnormal LV distensibility, or delayed relaxation. B-Type natriuretic peptide (BNP) is an indicator of various cardiovascular diseases and body volume status. The aim of this study was to determine whether the lowering of dialysate sodium (Na) levels is effective on LV systolic and diastolic parameters and BNP in the maintenance of hemodialysis patients. Materials and Methods: The study included 49 chronic hemodialysis patients. Left atrium (LA) diameter and LV ejection fraction, LV systolic and diastolic diameter, deceleration time (DT), pulmonary artery pressure (PAP), inferior vena cava diameter (IVCD), early diastolic transmitral flow ( E) and late diastolic transmitral flow ( A) velocities, E/ A ratio, isovolumic relaxation time, peak early diastolic velocity ( E′), late diastolic velocity ( A′) of tissue Doppler mitral annulus, and flow propagation velocity of mitral inflow ( Vp) were measured before and 6 months after hemodialysis with low Na dialysate. Results: Six months after low Na hemodialysis, a decrease was observed in echocardiographic parameters such as PAP and IVCD ( p < 0.05, p < 0.001, and p < 0.001, respectively). However, a significant difference was not observed in LA diameter. In LV diastolic measurement of E and A waves, E/ A ratio, DT, Vp, septal E′ and A′, and lateral E′ and A′ exhibited significant improvement by low Na HD. BNP level was significantly reduced ( p < 0.001). Conclusions: Lowered dialysate Na concentration improves PAP, IVCD, and LV diastolic properties assessed by mitral inflow filling, tissue Doppler velocity, and mitral inflow velocity propagation.

Abstract 14898: Prognostic Value of Tissue Doppler Imaging for Predicting Ventricular Arrhythmias and Cardiovascular Mortality in Ischemic Cardiomyopathy

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Tor Biering-Sørensen ◽  
Flemming J Olsen ◽  
Katrine Storm ◽  
Thomas Fritz-Hansen ◽  
Niels T Olsen ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Tissue Doppler Imaging ◽  
Cardiovascular Mortality ◽  
Ventricular Arrhythmias ◽  
Ischemic Cardiomyopathy ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Left Ventricular Ejection ◽  
Diastolic Velocity

Background: Only 30% of patients receiving an implantable cardioverter defibrillator (ICD) for primary prevention respond appropriately to this therapy. The purpose of this study was to investigate the value of Tissue Doppler Imaging (TDI) Echocardiography at predicting appropriate ICD therapy and cardiovascular mortality (CVD) in patients with primary prevention ICD. Methods: In total, 151 ICD patients meeting primary prevention criteria, with no history of ventricular arrhythmias were included. All participants were examined by conventional 2D echocardiography and TDI echocardiography. Longitudinal systolic (s’), early diastolic (e’), and late diastolic (a’) myocardial velocities were measured using TDI at six mitral annular sites and averaged to provide global estimates. Results: Forty patients experienced the combined endpoint of ventricular tachycardia (VT), fibrillation (VF) or CVD during a median follow-up of 2.3 years. Neither left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), E/e’, global s’ nor global e’ were significantly impaired in patients who developed VT/VF/CVD (LVEF: 31 vs. 28 %, p=0.06; GLS: 9 vs. 9 %, p=0.85; E/e’: 16 vs. 16, p=0.80; s’: 3.8 vs. 3.7 cm/s, p=0.68; e’: 4.5 vs. 4.6 cm/s, p=0.61). In contrast, global a’ was significantly lower in patients with an unfavorable outcome compared to those without (5.7±1.8 vs. 4.8±2.0 cm/s, p=0.020). Global a’ remained an independent predictor of VT/VF/CVD after multivariable adjustment for age, gender, beta blocker therapy and deceleration time (HR=1.25 [1.02; 1.54], p=0.032). Regional analysis revealed that a depressed a’ in the inferior wall drives the predictive capability of a’ (Figure). Conclusion: Late diastolic velocity by TDI seems to be a superior echocardiographic predictor of VT/VF/CVD in ischemic cardiomyopathy. Additionally, impaired late diastolic velocity in the inferior myocardial wall seems to be a paramount marker of future VT/VF/CVD.

scholarly journals Impairment of coronary flow and left ventricular function in patients with slow coronary flow phenomenon and other types of microvascular angina

2020 ◽  
Vol 26 (2) ◽  
pp. 72-78
Author(s):  
Stefan Denchev ◽  
Niya Emilova ◽  
Mariana Gospodinova ◽  
Simeon Dimitrov
Keyword(s):  
Left Ventricular Function ◽  
Unstable Angina ◽  
Ventricular Function ◽  
Coronary Flow ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Microvascular Angina ◽  
Diastolic Velocity ◽  
Significant Difference

 Purpose: We aimed at assessing the impairment in coronary flow and left ventricular function in patients without obstructive coronary disease on anti-ischemic treatment admitted with diagnosis unstable angina. Material and methods: The epicardial coronary flow was evaluated in 71 patients with unstable angina in absence of coronary stenosis >50% applying the methods the corrected TIMI frame count and systolic arrest of coronary flow at coronary angiography. The abnormalities in the diastolic function were assessed by echocardiography using PW-Doppler of the diastolic mitral flow and tissue Doppler imaging. Results:  The early diastolic velocity of interventricular septum (E’sept) and left ventricular free wall (E’ lat) were reduced in the SFLVH group compared to SCFP and the patients with normal coronary flow. Significant difference was found in between the patients with SFLVH and SCFP regarding DT and A-wave velocity in sub-analysis. The epicardial coronary flow of the patients with SFLVH was as tendency impaired compared to SCFP. The therapy with β- blocker alone or combined with calcium channel blocker or nitrate did not influence either cardiac function or coronary flow in this analysis. Conclusion:  Slower left ventricular relaxation is typical for the patients with microvascular angina and left ventricular hypertrophy associated with hypertension on treatment compared to SCFP and patients with normal coronary flow.

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