249 Diastolic dysfunction of the left ventricle is a common finding in rheumatoid arthritis

2004 ◽  
Vol 3 (1) ◽  
pp. 59
Author(s):  
S KACZOR
Keyword(s):  
Rheumatoid Arthritis ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Common Finding

Immune-Inflammatory Predictors of Diastolic Dysfunction of Left Ventricle in Patients with Rheumatoid Arthritis Combined with Hypertension

2021 ◽  
Vol 6 (4) ◽  
pp. 83-90
Author(s):  
I. O. Daniuk ◽  
◽  
N. G. Ryndina
Keyword(s):  
Rheumatoid Arthritis ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Roc Curve ◽  
Asymmetric Dimethylarginine ◽  
Interleukin 10 ◽  
Interleukin 1Β ◽  
Optimal Distribution ◽  
Pericardial Cavity ◽  
Distribution Point

Hypertension is the most common concomitant disease in patients with rheumatoid arthritis. Diastolic dysfunction of left ventricle is an important predictor of chronic heart failure, which can be asymptomatic for a long time. Therefore, it is advisable to detect diastolic dysfunction of left ventricle as early as possible, which can slow the progression of chronic heart failure. The purpose of the study was to determine the value of lipid peroxidation, endothelial function and systemic inflammatory response markers for diagnostic of diastolic dysfunction of left ventricle and for diagnostic of pericardial effusion in patients with rheumatoid arthritis combined with hypertension. Materials and methods. 93 patients with rheumatoid arthritis in combination with stage II hypertension were studied. The ultrasound examination of heart was performed. The serum laboratory markers of lipid peroxidation, concentration of pro-inflammatory cytokines, markers of endothelial function were determined. Results and discussion. Signs of diastolic dysfunction of left ventricle were found in 79 patients and no signs of diastolic dysfunction were found in 14 patients. It was detected that there was a significant increase of concentration of asymmetric dimethylarginine by 16.3%, interleukin-1β by 35.3%, interleukin-10 by 24.3%, the ratio of interleukin-1β / interleukin-10 by 62.0%, C-reactive protein by 52.6% and there was a significant decrease of total nitric oxide metabolites by 36.9%, nitrires by 37.5% and nitrates by 37.0% in patients with signs of diastolic dysfunction of left ventricle compared to the patients without diastolic dysfunction of left ventricle (p <0.01). It was found that the levels of isolated double bonds, diene conjugates, diene ketones, schiff bases and malonic aldehyde in patients with diastolic dysfunction of left ventricle were significantly higher by 24.4%, 25.2%, 20.4%, 17.6% and 21.4% respectively compared to the corresponding markers in patients without signs of diastolic dysfunction of left ventricle (p <0.01). The levels of vitamin A, vitamin E and catalase in patients with diastolic dysfunction of left ventricle were significantly lower by 18.2%, 27.4% and 13.4% compared to the corresponding markers of patients with normal left ventricle diastolic function (p <0.01). The highest predictor value for the diagnostic of diastolic dysfunction of left ventricle was detected in interleukin-1β area under the ROC curve 0.882, sensitivity 72.15% and specificity 100%, 95% CI [0.798-0.939] at the optimal distribution point >9.67 pg/ml and in asymmetric dimethylarginine area under the ROC curve 0.879 sensitivity 75.95% and specificity of 100%, 95% CI [0.795-0.937] at the optimal distribution point >0.715 μmol/l. In 17 (18.28%) patients, the effusion in the pericardial cavity was detected. It was detected that there was a significant increase of isolated double bonds by 18.65%, diene conjugates by 19.73%, diene ketones by 25.25%, schiff bases by 20%, malonic aldehyde by 26.76% and there was a significant decrease of vitamin A by 38.4%, vitamin E by 55.4% and catalase by 37.2% in patients with effusion in the pericardial cavity. The significant increase of asymmetric dimethylarginine was detected by 25.25%, interleukin-1β – by 52.24%, interleukin-10 – by 15.76%, the ratio of interleukin-1β / interleukin-10 – by 38.86% and C-reactive protein – by 26.9% in patients with effusion in the pericardial cavity. In addition, patients with cavity effusion have significant decrease of nitric oxide metabolites by 25.0%, nitrires by 30.0% and nitrates by 11.11% compared to the patient without effusion. The highest predictor value for the detection of effusion in the pericardial cavity was found in asymmetric dimethylarginine area under the ROC curve 0.913, 95% CI area under the ROC curve [0.836-0.961] at the optimal distribution point >0.841 μmol/l, sensitivity 94.12% and specificity 85.53%. Conclusion. The markers, which have the highest prognostic value for diagnostic of diastolic dysfunction of left ventricle in patients with rheumatoid arthritis combined with hypertension, are interleukin-1β and asymmetric dimethylarginine. In addition, asymmetric dimethylarginine has the highest predictor value for detecting fluid in the pericardial cavity

scholarly journals Early signs of myocardial dysfunction in patients with rheumatoid arthritis and ankylosing spondylitis

The Clinician ◽  
2021 ◽  
Vol 14 (3-4) ◽  
pp. 36-42
Author(s):  
L. I. Feiskhanova ◽  
D. I. Abdulganieva
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Left Ventricle ◽  
Matrix Metalloproteinase ◽  
Diastolic Dysfunction ◽  
Rheumatic Diseases ◽  
Myocardial Dysfunction ◽  
Control Group ◽  
Extracellular Matrix Components ◽  
Metalloproteinase 9

The objective of the study – identify early preclinical signs of myocardial dysfunction in patients with rheumatoid arthritis and ankylosing spondylitis.Material and methods. We examined 142 people with verified rheumatic diseases. All patients were divided into 2 groups. The first group consisted of patients with rheumatoid arthritis – 95 people. The second group – patients with ankylosing spondylitis – 47 people. The control group included 70 practically healthy individuals. In addition to standard diagnostic tests, all patients underwent tissue dopplerography of the heart using the GE Vivid E9 ultrasound device using the two-dimensional deformation technique (speckle tracking) to assess the deformation and rate of myocardial deformation, as well as determining the level of matrix metalloproteinase-9 in the blood serum.Results. Among patients with rheumatoid arthritis, diastolic dysfunction of both the left ventricle and both ventricles was more common than in the control group. The same pattern was observed in the group with ankylosing spondylitis. The calculation of the relative risk showed that the presence of rheumatoid arthritis in 4,42 times increases the risk of diastolic dysfunction of the left ventricle in comparison with practically healthy people (CI 1,6–12,2). In individuals with rheumatoid arthritis also results in a deterioration of systolic function of both ventricles. The level of matrix metalloproteinase metalloproteinase-9 was highest and most often increased in patients with ankylosing spondylitis. Among patients with rheumatoid arthritis, the average level of metalloproteinase-9 was low, but the incidence was higher than in the control group. The obtained results indicate that in these rheumatic diseases there is a marked degradation of the extracellular matrix components.Conclusion. Patients with rheumatoid arthritis and ankylosing spondylitis are characterized by a deterioration in the diastolic function of the left ventricle or both ventricles simultaneously, which is accompanied by an increase in the level of metalloproteinase-9.

Estimation of Left Ventricular Wall Stiffness by Analysis of Late Diastolic Pressure Components

2011 ◽  
Author(s):  
Casandra L. Niebel ◽  
Kelley C. Stewart ◽  
Takahiro Ohara ◽  
John J. Charonko ◽  
Pavlos P. Vlachos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Wall ◽  
Ventricular Relaxation ◽  
Wall Stiffness ◽  
Ventricular Diastolic Dysfunction

Left ventricular diastolic dysfunction (LVDD) is any abnormality in the filling of the left ventricle and is conventionally evaluated by analysis of the relaxation driven phase, or early diastole. LVDD has been shown to be a precursor to heart failure and the diagnosis and treatment for diastolic failure is less understood than for systolic failure. Diastole consists of two filling waves, early and late and is primarily dependent on ventricular relaxation and wall stiffness.

scholarly journals Diastolic dysfunction in individuals with and without heart failure with preserved ejection fraction

2021 ◽  
Author(s):  
Jan-Per Wenzel ◽  
Ramona Bei der Kellen ◽  
Christina Magnussen ◽  
Stefan Blankenberg ◽  
Benedikt Schrage ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
General Population ◽  
Diastolic Dysfunction ◽  
Cardiovascular Risk Factors ◽  
Population Based ◽  
Left Ventricular ◽  
Health Study ◽  
Common Finding

Abstract Aim Left ventricular diastolic dysfunction (DD), a common finding in the general population, is considered to be associated with heart failure with preserved ejection faction (HFpEF). Here we evaluate the prevalence and correlates of DD in subjects with and without HFpEF in a middle-aged sample of the general population. Methods and results From the first 10,000 participants of the population-based Hamburg City Health Study (HCHS), 5913 subjects (mean age 64.4 ± 8.3 years, 51.3% females), qualified for the current analysis. Diastolic dysfunction (DD) was identified in 753 (12.7%) participants. Of those, 11.2% showed DD without HFpEF (ALVDD) while 1.3% suffered from DD with HFpEF (DDwHFpEF). In multivariable regression analysis adjusted for major cardiovascular risk factors, ALVDD was associated with arterial hypertension (OR 2.0, p < 0.001) and HbA1c (OR 1.2, p = 0.007). Associations of both ALVDD and DDwHFpEF were: age (OR 1.7, p < 0.001; OR 2.7, p < 0.001), BMI (OR 1.2, p < 0.001; OR 1.6, p = 0.001), and left ventricular mass index (LVMI). In contrast, female sex (OR 2.5, p = 0.006), atrial fibrillation (OR 2.6, p = 0.024), CAD (OR 7.2, p < 0.001) COPD (OR 3.9, p < 0.001), and QRS duration (OR 1.4, p = 0.005) were strongly associated with DDwHFpEF but not with ALVDD. Conclusion The prevalence of DD in a sample from the first 10,000 participants of the population-based HCHS was 12.7% of whom 1.3% suffered from HFpEF. DD with and without HFpEF showed significant associations with different major cardiovascular risk factors and comorbidities warranting further research for their possible role in the formation of both ALVDD and DDwHFpEF.

Cardiac Manifestation among Patients with Hypothyroidism - A Cross-Sectional Study in North Karnataka

2021 ◽  
Vol 8 (26) ◽  
pp. 2283-2287
Author(s):  
Swetha Rajshekar Lakshetty ◽  
Nandini Devru
Keyword(s):  
Pericardial Effusion ◽  
Diastolic Dysfunction ◽  
Cardiac Dysfunction ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Common Finding ◽  
Low Density ◽  
Sectional Study ◽  
Cross Sectional

BACKGROUND Hypothyroidism is the second most common endocrinopathy next to diabetes mellitus (DM). Hypothyroidism is associated with increased cardiovascular mortality and morbidity. Cardiovascular complications are some of the most profound, reproducible and reversible clinical findings associated with thyroid disease1 . Hence this study was undertaken to assess the cardiac dysfunction among patients with hypothyroidism by electrocardiogram (ECG) and echocardiogram (ECHO) so as to provide a proper treatment guideline even among milder cases. METHODS This was a cross sectional study carried among 50 new patients of hypothyroidism who presented to Navodaya Hospital, Raichur during 2015 to 2017. They were clinically evaluated and underwent relevant investigations, including thyroid profile estimation, cardiac evaluation using ECG and 2D ECHO. RESULTS Most cases fell in the age group of 31 - 40 years. There was an overall female preponderance (76 %) over all age groups with mean age of 42.02 years. Goiter was found in 8 % of patients, bradycardia and hypertension was seen in 30 % and 22 % respectively. Central nervous system (CNS) examination revealed delayed ankle jerk in 40 % followed by hoarseness of voice in 38 % of patients. Lipid analysis showed increase of total cholesterol (TC), low density lipoprotein (LDL), very low-density lipoprotein (VLDL), triglycerides (TGL) and decrease of highdensity lipoprotein (HDL). Normal ECG was found in 26 % of patients. Bradycardia was most common finding seen in 30 % (15) of patients. 24 % (12) of patients exhibited low voltage complexes. While, 46 % cases showed normal ECHO findings. 24 % of cases presented with pericardial effusion. 18 % cases presented with diastolic dysfunction among which majority were mild. None of the cases had severe diastolic dysfunction. Only a meagre 10 % cases showed intraventricular septum (IVS) thickness. CONCLUSIONS Pericardial effusion was seen among 24 % of patients while diastolic dysfunction was seen in 18 % patients. Thus, any unexplained pericardial effusion should be screened for hypothyroidism. KEYWORDS Hypothyroidism, Cardiac Dysfunction, 2D ECHO, ECG, Thyroid Stimulating Hormone (TSH)

scholarly journals Features of structural and functional remodeling of the left ventricle in patients suffering from arterial hypertension with concomitant hypothyroidism

2019 ◽  
Vol 26 (5) ◽  
pp. 43-52
Author(s):  
V. I. Tseluyko ◽  
L. M. Yakovleva ◽  
D. A. Korchagina
Keyword(s):  
Body Mass Index ◽  
Left Ventricle ◽  
Arterial Hypertension ◽  
Diastolic Dysfunction ◽  
Body Mass ◽  
Mean Value ◽  
Left Ventricular ◽  
Control Group ◽  
Functional Remodeling ◽  
The Mean

The aim – to study the features of structural and functional remodeling of the left ventricle in patients suffering from arterial hypertension with concomitant hypothyroidism and to determine clinical and past medical history and laboratory factors associated with their development. Materials and methods. 50 patients suffering from hypertension with concomitant hypothyroidism were enrolled into the study. Depending on the level of thyroid stimulating hormone in the serum the examined patients were distributed into two groups of 25 patients with the compensated and 25 with decompensated course of hypothyroidism. The control group consisted of 30 patients with hypertension in which the pathology of the thyroid gland was excluded. The comparison of the main parameters of the echocardiography study of the myocardium has been performed depending on hypothyroidism compensation. Assessment of parameters of transmitral diastolic blood flow has been performed. A regression analysis has been conducted to detect the relation of clinical and past medical history factors and echocardiographic parameters with the development of diastolic dysfunction by E/A ratio. The values of central hemodynamics have been studied for evaluation of the contractile function of the myocardium. Results and discussion. According to the results of the echocardiography of both examined groups it has been found that the final systolic and stroke volume exceeded the parameters of the control group. The mean value of the left ventricle ejection fraction was statistically significantly lower than in the control group (p=0.004). The left ventricle myocardial mass in patients with hypothyroidism was statistically significantly greater than in the control group. It was proved that in patients, who were diagnosed with decompensated hypothyroidism, the mean value of the left atrium size to growth by the degree of 2.7 was statistically significantly higher than in the control group (p=0.01), whereas the average value of the ratio of the size of the left atrium to the surface area of the body had no statistically significant differences between the groups. It has been found that in both groups the proportion of patients with diastolic dysfunction in which the E/A ratio was less than 1.0 was higher than in the control group (р=0.01 and p=0.03, respectively). The independent factors of diastolic dysfunction of the left ventricle in patients with hypertension in the presence of hypothyroidism have been found. Conclusions. In the presence of decompensated hypothyroidism in patients with arterial hypertension, both with obesity and with normal body mass index, left ventricular mass indexes were significantly higher in comparison with a control group. Regardless of the compensation of the thyroid state in patients with arterial hypertension, the ejection fraction was significantly lower. According to regression analysis, independent factors for the development of diastolic dysfunction in patients with arterial hypertension and hypothyroidism with a body mass index ≥ 30 kg/m2 is the index of mass of the left ventricular myocardium, determined by the degree of 2.7, the level of total cholesterol to statistical significance – the level of office systolic blood pressure and the duration of hormone replacement therapy for hypothyroidism; with body mass index < 30 kg/m2 – age and left atrial index, determined by body surface area. For patients with arterial hypertension and reduced thyroid gland function, violation of the left ventricular myocardial relaxation is typical as evidenced by a higher proportion of patients with a decrease in E/A to less than 0.8 in these patients.

scholarly journals Dilated Cardiomyopathy in Children and Adults: What is New?

2008 ◽  
Vol 8 ◽  
pp. 762-775 ◽  
Author(s):  
Galal E. Nagib Elkilany ◽  
Mustafa A. AL-Qbandi ◽  
Khaled A. Sayed ◽  
Ibrahim Kabbash
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Left Ventricular Ejection ◽  
Global Strain ◽  
Independent Risk Factors

Dilated cardiomyopathy (DCM) is the most common form of cardiomyopathy and cause of cardiac transplantation in children and young adults; mortality is high among this patient population. However, mortality, clinical course, and illustrative echocardiographic data of DCM in children and adults are not well established. Our objective was to provide a research article of detailed descriptions of the incidence, causes, outcomes, related risk factors, and new echocardiographic criteria of risk of death from DCM. Our results showed that independent risk factors at DCM diagnosis for subsequent death or transplantation in children cohorts were older age, congestive heart failure, lower left ventricular ejection fraction (EF ≤ 25%), low global strain, significant mitral valve incompetence, pulmonary hypertension, diastolic dysfunction, right ventricular involvement, and cause of DCM (p< 0.001 for all). In adults, low ejection fraction (<30–35%), global peak systolic strain <-7.6%, increased EDV, ESV, LBBB, diastolic dysfunction, and left ventricle dyssynchrony were the main independent risk factors for major cardiac events and need for CRT or transplantation (p< 0.001 for all). Our conclusions were that in children and adults, DCM is a diverse disorder with outcomes that depend largely on cause, age, heart failure status at presentation, and echocardiographic parameters of the heart (systolic and diastolic function of left ventricle, pulmonary artery pressure, global strain, and valvular function of the mitral valve). This study will present new findings in the diagnostic area.

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