Effect of Isoflurane on Echocardiographic Left-Ventricular Relaxation Indices in Patients With Diastolic Dysfunction Due to Concentric Hypertrophy and Ischemic Heart Disease

Diseases of the circulatory system are the most common pathology in Ukraine and cover 26,2 mln. Population 12,3 mln ukrainians suffer from hypertension (AH). Gastroesophageal reflux disease (GERD) is recognized by the World Organization of Gastroenterology disease of the XXI century. Given the common risk factors for hypertension coronary heart disease (CHD) and the question of GERD studies of the combined flow of these diseases and to optimize the treatment of these patients. The objective: to determine the characteristics of intracardiac hemodynamics in patients with hypertension combined with chronic ischemic heart disease on the background of GERD and the determination of the combined effects of antihypertensive and antireflux therapy on the structural-functional state of the left ventricular myocardium. Patients and methods. We examined 107 patients aged 44 to 78 years, with an established diagnosis of hypertension stage I and II in combination with chronic ischemic heart disease. Research methods included anthropometric studies, biochemical blood analysis, ambulatory blood pressure monitoring, the daily ECG monitoring, esophagogas-troduodenoscopy (EGD), echocardiography (echocardiography), testing. Results. Comorbidity for hypertension, chronic ischemic heart disease and GERD is associated with a higher frequency of abdominal type of obesity and the metabolic syndrome according to IDF criteria, significantly higher percentage of patients with grade II and III obesity. That in turn is reflected in the features of the structural1functional state of the left ventricle (LV), which manifests an increase in the number of patients with more severe degrees of left ventricular hypertrophy. Related GERD is associated with a large percentage of cases of concentric hypertrophy of the left ventricle, and a greater prevalence of diastolic dysfunction. The combination of antihypertensive and antireflux therapy for 12 weeks of treatment was reflected in the significant decrease in the weight of the index parameters of left ventricular myocardium (LVMI) and relative wall thickness index and reliable positive dynamics of indicators of left ventricular diastolic function. Conclusion. Patients with hypertension combined with chronic ischemic heart disease with comorbidity with GERD have a higher prevalence of factors of cardiovascular risk. Related GERD is associated with a more severe degree of left ventricular hypertrophy, with a large percentage of cases of concentric hypertrophy of the left ventricle, and a greater prevalence of diastolic dysfunction. A combination of antihypertensive and antireflux therapy for 12 weeks of treatment promoted significant reduction in myocardial mass index indicators LV (LVMI) and relative wall thickness index and had a significant impact on the normalization of LV diastolic function.

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Influence of Left Ventricular Diastolic Dysfunction on Ischemic Heart Disease in Patients with Chronic Kidney Disease

Korean Journal of Medicine ◽

10.3904/kjm.2012.83.3.328 ◽

2012 ◽

Vol 83 (3) ◽

pp. 328

Author(s):

Bo Kyung Choi ◽

Kyung Nam Lee ◽

In Hye Hwang ◽

Il Young Kim ◽

Harin Rhee ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Heart Disease ◽

Kidney Disease ◽

Ischemic Heart Disease ◽

Diastolic Dysfunction ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Ischemic Heart ◽

Ventricular Diastolic Dysfunction

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Left ventricular diastolic dysfunction in women with nonobstructive ischemic heart disease: insights from magnetic resonance imaging and spectroscopy

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00249.2017 ◽

2017 ◽

Vol 313 (4) ◽

pp. R322-R329 ◽

Cited By ~ 9

Author(s):

Michael D. Nelson

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Diastolic Dysfunction ◽

Obstructive Coronary Artery Disease ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Ischemic Heart ◽

Major Adverse Cardiovascular Events ◽

Ventricular Diastolic Dysfunction

Ischemic heart disease, in the absence of obstructive coronary artery disease, is prevalent in women and constitutes a major risk factor for developing major adverse cardiovascular events, including myocardial infarction, stroke, and heart failure. For decades, diagnosis was considered benign and often minimized; however, it is now known that this etiology carries much risk and is a significant burden to the health care system. This review summarizes the current state of knowledge on nonobstructive ischemic heart disease (NOIHD), the association between NOIHD and left ventricular diastolic dysfunction, potential links between NOIHD and the development of heart failure with preserved ejection fraction (HFpEF), and therapeutic options and knowledge gaps for patients living with NOIHD.

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Left ventricular diastolic dysfunction in primary hypertension and ischemic heart disease-evaluation by doppler echocardiography

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20212097 ◽

2021 ◽

Vol 8 (6) ◽

pp. 770

Author(s):

Rahul Kumar ◽

Sanjeev Diwakar ◽

Srinivas .

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Diastolic Dysfunction ◽

Diastolic Function ◽

Doppler Echocardiography ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Ischemic Heart ◽

Filling Fraction ◽

Ventricular Diastolic Dysfunction

Background: Congestive heart failure caused by a predominant abnormality in diastolic function is both common and causes significant morbidity and mortality. The objective of the study was to evaluate application of doppler echocardiography in determining left ventricular diastolic dysfunction in ischemic heart disease and essential hypertension.Methods: Present study is based on analysis of 75 patients of hypertension and 60 patients of IHD (UA, AMI, IMI) admitted to Bapuji and Chigateri general hospital during December 2019 to November 2020. Detailed history and physical examination were done. Every patient was subjected to ECG, CXR, routine investigations and Doppler Echo cardiography.Results: A total of 75 patients of primary hypertension were studied. 37 patients showed diastolic dysfunction with E/A ratio <1, with increased atrial filling fraction. Out of 37 patients, 24 showed LVH and 13 cases did not have LVH. A total of 60 patients of ischemic heart disease were studied. 23 patients showed diastolic dysfunction with E/A ratio <1, with increased atrial filling fraction and prolonged isovolumetric relaxation time.Conclusions: Our findings suggest that myocardial damage in patients with HTN and IHD affects diastolic dysfunction before systolic dysfunction. Doppler echocardiography is a valuable non-invasive method to detect left ventricular diastolic impairment and the intentional assessment of diastolic function is advisable for early detection of LV dysfunction before clinical symptoms appear.

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Direct results of percutaneous coronary interventions in patients with chronic ischemic heart disease and left ventricular dysfunction

Kreativnaya kardiologiya ◽

10.15275/kreatkard.2017.01.05 ◽

2017 ◽

Vol 1 (10) ◽

pp. 45-55

Author(s):

Bagrat Alekyan ◽

◽

Yurii Buziashvili ◽

Elena Golukhova ◽

Olga Bockeria ◽

...

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Left Ventricular Dysfunction ◽

Ventricular Dysfunction ◽

Left Ventricular ◽

Ischemic Heart ◽

Percutaneous Coronary Interventions ◽

Chronic Ischemic Heart Disease ◽

Percutaneous Coronary ◽

Direct Results

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Glutamine Is Cardioprotective in Patients with Ischemic Heart Disease following Cardiopulmonary Bypass

The Heart Surgery Forum ◽

10.1532/hsf98.20111074 ◽

2011 ◽

Vol 14 (6) ◽

pp. 384 ◽

Cited By ~ 17

Author(s):

Vladimir V. Lomivorotov ◽

Sergey M. Efremov ◽

Vladimir A. Shmirev ◽

Dmitry N. Ponomarev ◽

Vladimir N. Lomivorotov ◽

...

Keyword(s):

Heart Disease ◽

Placebo Group ◽

Cardiopulmonary Bypass ◽

Ischemic Heart Disease ◽

Troponin I ◽

Left Ventricular ◽

Ischemic Heart ◽

Left Ventricular Ejection ◽

Study Group ◽

Cardioprotective Effects

Background: The aim of the present study was to investigate the cardioprotective effects of the perioperative use of N(2)-L-alanyl-L-glutamine (GLN) in patients with ischemic heart disease (IHD) who undergo their operations under cardiopulmonary bypass (CPB).Methods: This double-blind, placebo-controlled, randomized study included 50 patients who underwent cardiac surgery with CPB. Exclusion criteria were a left ventricular ejection fraction <50%, diabetes mellitus, <3 months since the onset of myocardial infarction, and emergency surgery. Patients in the study group (n = 25) received 0.4 g/kg GLN (Dipeptiven, 20% solution) per day. Patients in the control group (n = 25) were administered a placebo (0.9% NaCl). The primary end point was the dynamics of troponin I at the following stages: (1) prior to anesthesia, (2) 30 minutes after CPB, (3) 6 hours after CPB, (4) 24 hours after surgery, and (5) 48 hours after surgery. Secondary end points included measurements of hemodynamics with a Swan-Ganz catheter.Results: On the first postoperative day after the surgery, the median troponin I level was significantly lower in the study group than in the placebo group: 1.280 ng/mL (interquartile range [IQR], 0.840-2.230 ng/mL) versus 2.410 ng/mL (IQR, 1.060-6.600 ng/mL) (P = .035). At 4 hours after cardiopulmonary bypass (CPB), the median cardiac index was higher in the patients in the study group: 2.58 L/min per m2 (IQR, 2.34-2.91 L/min per m2) versus 2.03 L/min per m2 (IQR, 1.76-2.32 L/min per m2) (P = .002). The median stroke index also was higher in the patients who received GLN: 32.8 mL/m2 (IQR, 27.8-36.0 mL/m2) versus 26.1 mL/m2 (IQR, 22.6-31.8 mL/m2) (P = .023). The median systemic vascular resistance index was significantly lower in the study group than in the placebo group: 1942 dyn�s/cm5 per m2 (IQR, 1828-2209 dyn�s/cm5 per m2) versus 2456 dyn�s/cm5 per m2 (IQR, 2400-3265 dyn�s/cm5 per m2) (P = .001).Conclusion: Perioperative administration of GLN during the first 24 hours has cardioprotective effects in IHD patients following CPB. This technique enhances the troponin concentration at 24 hours after surgery and is associated with improved myocardial function.

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