scholarly journals Relationship between pulmonary edema development and left atrium mechanical functions in patients with left ventricular hypertrophy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Aggul ◽  
B Korkmaz ◽  
E Vatanoglu ◽  
G Yuksel ◽  
I Avci ◽  
...  

Abstract Background Since there is no proven treatment to reduce mortality in heart failure with preserved ejection fraction patients, to identify the predictors of decompensation are important in these patients. Purpose In this study, we aimed to evaluate the left atrium (LA) mechanical functions in patients with left ventricular hypertrophy (LVH) presenting with dyspnea and to investigate the predictors of pulmonary edema (PE). Methods This study was designed as a single-center cross-sectional study. Patients with LVH who presented to the emergency department with dyspnea were divided into two groups as PE (n=30) and non-PE (n=100). Mechanical functions of the LA were evaluated by speckle-tracking echocardiography. As a statistical method, diagnostic modelling was performed to demonstrate the relationship between demographic and echocardiographic features with the diagnosis of the patient (with or without PE). First, a basal model was created consisting of age, gender, body mass index (BMI), left ventricular mass index (LVMI), creatinine (Model 0). Then, different models were created by adding reservoir strain (S) (Model 1), conduit S, pump S, reservoir strain rate (SR), conduit SR and pump SR to the basal model, respectively. It was analyzed how each model made changes in performance criteria compared to the basal model. Results When the relationship between left atrial strain parameters and PE were analyzed, LA reservoir S (OR: 1.74 (1.14–2.64); p: 0.003) and LA pump SR (OR: 1.69 (1.07–2.64); p: 0.023) had found to be significantly associated with the development of PE. Another parameter associated with PE was admission creatinine value (OR: 1.52 (1.08–2.15), p-value: 0.016). In our study, LVMI is not a predictor for PE but, when the interaction of LA reservoir S and LVMI was considered, it is observed that decreased LA reservoir S is associated with more PE, especially in individuals with higher LVMI. Conclusion In this study, we found that the LA reservoir S is significantly associated with the development of PE in patients with LVH, especially in individuals with higher LVMI. Interaction of reservoir S and LVMI Funding Acknowledgement Type of funding source: None

1998 ◽  
Vol 27 (6) ◽  
pp. 787-791 ◽  
Author(s):  
Yousuke Takemura ◽  
Shogo Kikuchi ◽  
Hirofumi Takagi ◽  
Yutaka Inaba ◽  
Katsuya Nakagawa

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Patipan Viwatrangkul ◽  
Sakda Lawanwisut ◽  
Pondfah Leekhaphan ◽  
Tatchamon Prasart-intara ◽  
Pathomphon Phiensuparp ◽  
...  

AbstractLeft ventricular hypertrophy (LVH) is considered a cardiac condition with life-threatening complications. Detected LVH is a strong predictor of cardiovascular diseases and death. This condition is normally diagnosed at offices. We aimed to determine the prevalence and associated factors of electrocardiographic-LVH (ECG-LVH) among adults in a Thai rural community. A cross-sectional study was conducted in Na-Yao rural community of Thailand in 2020. A total of 638 individuals aged ≥ 20 years were interviewed using standardized structured questionnaires related to demographic information, risk behaviors, comorbidities and anthropometric measurements. LVH was determined by Sokolov-Lyon and Cornell criteria based on the collected electrocardiograms. The prevalence of ECG-LVH among adults was 6.6%. The factors independently associated with ECG-LVH were being male (AORs 2.04, 95% CI 1.05–3.98), history of diabetes mellitus (AORs 1.01, 95% CI 1.01–1.02), and hypertensive crisis ≥ 180/110 mmHg (AORs 7.24, 95% CI 1.31–39.92). However, resting heart rate was negatively associated with ECG-LVH (p < 0.05). Our data emphasized that LVH was one of the significant health problems among adults in a rural community. This condition could lead to severe complications. Thus, effective detection and public health interventions should be provided at the community level.


2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Nafees Ahmad ◽  
Amer Hayat Khan ◽  
Irfanullah Khan ◽  
Amjad Khan ◽  
Muhammad Atif

Aim. To evaluate doctors’ knowledge, attitude, and practices and predictors of adherence to Malaysian hypertension guidelines (CPG 2008). Methods. Twenty-six doctors involved in hypertension management at Penang General Hospital were enrolled in a cross-sectional study. Doctors’ knowledge and attitudes towards guidelines were evaluated through a self-administered questionnaire. Their practices were evaluated by noting their prescriptions written to 520 established hypertensive outpatients (20 prescriptions/doctor). SPSS 17 was used for data analysis. Results. Nineteen doctors (73.07%) had adequate knowledge of guidelines. Specialists and consultants had significantly better knowledge about guidelines’ recommendations. Doctors were positive towards guidelines with mean attitude score of 23.15±1.34 points on a 30-point scale. The median number of guidelines compliant prescriptions was 13 (range 5–20). Statistically significant correlation (rs = 0.635, P<0.001) was observed between doctors’ knowledge and practice scores. A total of 349 (67.1%) prescriptions written were guidelines compliant. In multivariate analysis hypertension clinic (OR = 0.398, P=0.008), left ventricular hypertrophy (OR = 0.091, P=0.001) and heart failure (OR = 1.923, P=0.039) were significantly associated with guidelines adherence. Conclusion. Doctors’ knowledge of guidelines is reflected in their practice. The gap between guidelines recommendations and practice was seen in the pharmacotherapy of uncomplicated hypertension and hypertension with left ventricular hypertrophy, renal disease, and diabetes mellitus.


EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Raab ◽  
L Roten ◽  
M Branca ◽  
N Nozica ◽  
M Wilhelm ◽  
...  

Abstract Background Structural disarray of hypertrophied myocytes and interstitial fibrosis characterize hypertrophic cardiomyopathy (HCM). These morphological changes also affect atrial myocytes and, together with hemodynamic alterations because of HCM, may lead to atrial cardiomyopathy.  Purpose To investigate the incremental value of P-wave parameters to differentiate left ventricular hypertrophy (LVH) because of HCM from LVH in hypertensive heart disease (HHD) and athletes heart.  Methods In a prospective study, we compared electrocardiographic (including signal-averaged ECG of the P wave) and echocardiographic data of patients with HCM, HHD and athletes heart. We developed a predictive model with a simple scoring system to identify HCM. Results We compared data of 27 patients with HCM (70% males, 49.8 ± 14.5 years), 324 patients with HHD (52% males, 74.8 ± 5.5 years), and 215 subjects with athletes heart (72% males, 42.3 ± 7.5). The table shows the significant differences among the 3 groups. We included the following parameters into a predictive score to differentiate HCM from other forms of LVH: QRS width (&gt;88ms = 1 point), P-wave integral (&gt;688µVs = 1 point) and septum thickness (&gt;12mm = 2 points). A score &gt;2 (Youden index 0.626) correctly classified HCM in 81% of the cases with a sensitivity and specificity of 82% an 81%, respectively.  Conclusion Differentiation of HCM from other forms of LVH is improved by including atrial parameters. A simple scoring system including septum thickness, QRS width and P wave integral allowed identification of patients with HCM with a sensitivity and specificity of &gt;80%. This score needs to be validated prospectively. Table 1 HCM HHD Athletes P-value HCM vs HHD* HCM vs Athletes* 95%-CI P-value 95%-CI P-value P-wave duration [ms] 152.7 ± 25.8 143.9 ± 16.5 133.5 ± 14.2 &lt;0.001 -16.9 -24.6 to -9.1 &lt;0.001 -16.3 -22.7 to -9.9 &lt;0.001 P-wave integral [µVs] 850.4 ± 272.4 672.0 ± 235.4 773.1 ± 260.1 &lt;0.001 -198.6 -320.8 to -76.3 0.002 -68.2 -169.7 to 33.2 0.187 QRS [ms] 110.3 ± 27.3 96.9 ± 20.3 95.1 ± 9.8 &lt;0.001 -16.4 -24.7 to -8.1 &lt;0.001 -13.8 -20.8 to -6.9 &lt;0.001 QTc [ms] 447.9 ± 27.2 438.6 ± 24.5 414.0 ± 22.9 &lt;0.001 -21.1 -32.7 to -9.5 &lt;0.001 -30.8 -40.5 to -21.2 &lt;0.001 LVMMI [g/m2] 153.6 ± 55.5 133.5 ± 30.3 98.6 ± 19.7 &lt;0.001 -15.3 -29.7 to -0.9 0.038 -56.1 -67.7 to -44.6 &lt;0.001 IVS [ms] 16.8 ± 4.2 11.8 ± 2.2 10.3 ± 1.5 &lt;0.001 -5.2 -6.3 to -4.1 &lt;0.001 -6.4 -7.3 to -5.6 &lt;0.001 LAVI [ml/m2] 43.2 ± 13.9 30.5 ± 9.7 30.8 ± 9.5 &lt;0.001 -14.6 -20.0 to -9.3 &lt;0.001 -12.2 -16.6 to -7.9 &lt;0.001 The table shows the study result after univariate and multivariate (*; adjusting for age and sex) analysis. Abstract Figure 1


2016 ◽  
Vol 50 (6) ◽  
pp. 331
Author(s):  
Johnny Rompis ◽  
Erling David Kaunang

Background Obesity is a chronic metabolic disorder associated with cardiovascular disease (CVD) increasing morbidity-mortality rates. It is apparent that a variety of adaptations/alterations in cardiac structure and function occurs as excessive adipose tissue accumulates. This leads to a decrease in diastolic compliance, eventually resulting in an increase in left ventricular filling pressure and left ventricular enlargement.Objective To evaluate left ventricular hypertrophy (LVH) among  obese using electrocardiographic (ECG) criteria.Methods A cross-sectional study was conducted on 74 children aged 10-15 years from February 2009 to October 2009. The subjects were divided into obese and control groups. Physical examination and standard 12 lead electrocardiography (ECG) were done in both groups.Results Of 37 obese children, LVH were featured in 3 subjects, while in control group, only 1 child had LVH (P= 0.304). We found that mean RV6 in obese and control group were 9.8446 (SD 3.5854) and 11.9662 (SD 3.2857), respectively (P=0.005). As an additional findings, we found that birth weight was related to obesity in children.Conclusion There is no relation between obesity and left ventricular using ECG criteria in obese children aged 10-15 years.


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