scholarly journals P1359 Left ventricle hypertrophy and diastolic dysfunction in haemodialysis patients after surgical reduction of arteriovenous fistula blood flow

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Valerianova ◽  
L Kovarova ◽  
Z Hruskova ◽  
V Bednarova ◽  
V Tuka ◽  
...  
Keyword(s):  
Blood Flow ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Arteriovenous Fistula ◽  
Diastolic Function ◽  
High Flow ◽  
Volume Index ◽  
Surgical Reduction ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy

Abstract Funding Acknowledgements Grant of the Grant Agency of Charles University and grant of the Czech Health Research council Introduction Over 50% of patients treated by chronic haemodialysis programme die of cardiovascular diseases. Changes of heart structure and function can be detected by echocardiography. The most frequent changes are left ventricle hypertrophy (LVH) and its diastolic dysfunction. One of the considered contributing mechanisms is the hyperkinetic circulation. Purpose The aim of this study was to analyse the effect of high flow arteriovenous fistula (AVF) on eft ventricular hypertrophy and diastolic function. Materials and methods We included 30 patients with a high-flow arteriovenous fistula into the study, indicated for AVF blood flow reduction because of heart failure or hand ischemia. All the patients underwent echocardiographic examination and ultrasonographic measurement of AVF blood flow before and 6 weeks after the surgery. Results The AVF banding led to significant reduction of Qa (from 2977 ± 1408 to 1295 ± 610 mL/min; p ˂ 10-6, accompanied by significant decrease of cardiac index (from 4.34 ± 1.09 to 3.56 ± 0.90 L/min.m2). These findings were accompanied by significant reduction of left ventricle mass index (from 125 ± 31 to 116 ± 32 g/m2; p = 0.04) and by improvement of diastolic dysfunction grade (from 1.66 ± 0.67 to 1.14 ± 0.95; p = 0.03). The maximum velocity of tricuspid regurgitation decreased (from 3.1 ± 0.4 to 2.7 ± 0.5), and so did the left atrium volume index (from 47 ± 14 to 42 ± 15 mL/m2; p = 0.01). Conclusions LVH and diastolic dysfunction are frequent in haemodialysis patients; hyperkinetic circulation caused by high-flow arteriovenous fistula is one of the significant contributing mechanisms. Surgical reduction of AVF blood flow improved diastolic function of the left ventricle and reduced the hypertrophy in our patient population. AVF flow volume should be always considered during cardiological examination of haemodialysis patients.

[PP.29.13] LEFT VENTRICLE HYPERTROPHY AND DIASTOLIC DYSFUNCTION ARE ASSOCIATED WITH ABDOMINAL OBESITY IN HYPERTENSIVE WOMEN

2016 ◽  
Vol 34 ◽  
pp. e302
Author(s):  
A. Cunha ◽  
T. Isbele ◽  
J. D[Combining Acute Accent]El-Rei ◽  
M. Casanova ◽  
M. Trindade ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Abdominal Obesity ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy

scholarly journals Rest NT-proBNP but not MR-proANP predicts positive diastolic stress echocardiography test result in patients with preserved left ventricle ejection fraction and heart failure symptoms

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Kubicius ◽  
M Balys ◽  
Z Gasior ◽  
M Haberka
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Transthoracic Echocardiography ◽  
Stress Echocardiography ◽  
Left Ventricle Ejection Fraction ◽  
Public Institution ◽  
Volume Index

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Silesia Introduction Diastolic dysfunction and heart failure (HF) with preserved ejection fraction are diagnostic challenges in rest transthoracic echocardiography (TTE) and clinical practice. The aim of our study was to evaluate the clinical value of diastolic stress echocardiography (DSE) and its corelation with NT-proBNP and MR-proANP testing in patients with preserved left ventricle ejection fraction (LVEF) and HF symptoms. Methods: All the consecutive patients with HF symptoms, preserved LVEF and suspected diastolic dysfunction were examined with DSE with the protocol according to the EACVI 2016 recommendations. Patients with cardiomyopahties, significant valve defects or extracardiac diseases causing similar symptoms were excluded. The assessment of diastolic function was obtained at rest transthoracic echocardiography (TTE) and at peak exertion in DSE: left atrium volume index (LAVI), average E/e’ >14, peak tricuspid regurgitation velocity >2,8 m/s, septal e’ velocity <7 cm/s or lateral e’< 10cm/s (>50% positive – diastolic dysfunction). Moreover, blood samples for NT-proBNP and MR-proANP were taken just before and 30 minutes after DSE. Results The study group included 80 patients (age: 69 ± 8.3 years; 24% males) with dyspnea (NYHA IIa – 53pts; IIb – 17pts; III – 10pts) and risk factors: hypertension (77pts), diabetes (33pts), known coronary artery disease (8pts) and chronic kidney disease (21pts). The rest TTE showed preserved systolic function (LVEF 61.6 ± 8.8%) and normal or indeterminate diastolic function in all patients. DSE revealed positive result for diastolic dysfunction in 17 patients (21%). The levels of NT-proBNP :267(160-518) vs 310(172-522) (p = 0.46) and MR-proANP: 16,2(7,8-542) vs 14,7(6,1-646) p = 0,38 did not significantly change before and after DSE. The ROC analysis showed that age (AUC = 0.720; p < 0.001), LAVI rest (AUC = 0.722, p < 0.01), E/e’ rest (AUC 0.790;p < 0.001) and baseline NT-proBNP (AUC 0.770; p = 0.002) predicted positive DSE. Other parameters, including BMI, baseline E/A, DT or e’ and MR-proANP were not predictive for DSE result. There was a positive correlation between stress NTproBNP and stress LAVI (r = 0.3;p < 0.05) and stress E/e’ (r = 0.5; p < 0.05)  There wasn’t such correlation between MRproANP and stress LAVI and stress E/e’. Conclusions Diastolic stress echocardiography revealed diastolic dysfunction in 21% of study patients and improved the diagnostic value of echocardiography. Rest NT-proBNP but not rest MR-proANP predicted positive DSE.

Abstract W P250: The Impact of Acute Hypertensive Response on Mortality After Intracerebral Hemorrhage Differs Among Patients With and Without Left Ventricle Hypertrophy

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Octavio M Pontes-Neto ◽  
Sergi Martinez-Ramirez ◽  
Anand Viswanathan ◽  
Timothy C Tan ◽  
Maria C Nunes ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Left Ventricle ◽  
Acute Phase ◽  
Blood Pressure Reduction ◽  
Chronic Hypertension ◽  
Pressure Reduction ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy ◽  
Haenszel Test ◽  
Intensive Blood Pressure

Background: While acute hypertensive response (AHR) predicts worse outcome in intracerebral hemorrhage (ICH), the INTERACT-2 trial recently failed to definitively demonstrate a major benefit of intensive blood pressure reduction on these patients. A possible explanation is that the detrimental effect of AHR on outcome may differ among ICH patients with and without previous chronic hypertension. Objective: to explore whether the prognosis of patients with AHR during the acute phase of ICH differs according to the presence or absence of left ventricle hypertrophy (LVH), which is a marker of chronic hypertensive organ damage. Method: we performed a retrospective analysis of a prospective cohort of patients with primary ICH presenting to an academic hospital between January/2000 and December/2012 with age > 18 years, who had a transthoracic echocardiogram available. LVH was defined according to Penn convention. AHR was defined as systolic blood pressure > 180 mmHg on admission. Mantel-Haenszel test was initially used to assess if LVH status influenced the effect of AHR on mortality. For subsequent analyses, ICH patients were divided in 3 groups: without AHR (reference); AHR without LVH; AHR with LVH. A multivariate logistic regression model was then used to identify independent predictors of mortality at 30-days. Results: 430 patients met inclusion criteria. AHR was present in 196 (46.6%), LVH was present in 233 (54.2%); 30-day mortality was 15.6%. On Mantel-Haenszel test, we found a trend (p=0.09) suggesting that absence of LVH increased AHR effect on mortality (OR:1.64; 95% CI: 0.95-2.8; p=0.07). On multivariate analysis, patients with AHR without LVH had significantly higher mortality (OR: 2.65; 95%CI: 1.15 to 6.1; p=0.022) when compared to patients without AHR, after adjusting for baseline characteristics. There was only a trend towards increased mortality in the group of patients with AHR and LVH (OR:2.22; 95% CI: 0.99-5.0; p=0.053). Conclusions: Patients without chronic hypertension appear to be more susceptible to the detrimental effects of AHR during the acute phase of ICH. Stratification of patients with ICH may help to identify those that will have greater benefit with intensive blood pressure reduction in the acute phase of ICH.

scholarly journals ECG-based detection of left ventricle hypertrophy

2015 ◽  
Vol 31 (2) ◽  
pp. 125-132 ◽  
Author(s):  
Gabriel Tozatto Zago ◽  
Rodrigo Varejão Andreão ◽  
Sérgio Lamego Rodrigues ◽  
José Geraldo Mill ◽  
Mário Sarcinelli Filho
Keyword(s):  
Left Ventricle ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy

scholarly journals Longitudinal Mitral Annulus Velocities Are Reduced in Hypertensive Subjects With or Without Left Ventricle Hypertrophy

Hypertension ◽  
2006 ◽  
Vol 47 (5) ◽  
pp. 854-860 ◽  
Author(s):  
Maria Cândida C. Borges ◽  
Roberta C.R. Colombo ◽  
José Geraldo F. Gonçalves ◽  
José de Oliveira Ferreira ◽  
Kleber G. Franchini
Keyword(s):  
Left Ventricle ◽  
Mitral Annulus ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy

scholarly journals Analysis of NT-proBNP and uric acid due to left ventricle hypertrophy in the patients of aortic valve disease

2018 ◽  
Vol 35 (1) ◽  
Author(s):  
Muhammad Ishtiaq Jan ◽  
Riaz Anwar Khan ◽  
Aneesa Sultan ◽  
Anwar Ullah ◽  
Ayesha Ishtiaq ◽  
...  
Keyword(s):  
Uric Acid ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Aortic Stenosis ◽  
Serum Uric Acid ◽  
Aortic Valve Disease ◽  
Severe Stenosis ◽  
Valve Dysfunction ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy

Objective: To evaluate the concentration of N terminal proBNP (NT-proBNP) and partially the serum uric acid in the severe condition of aortic valve dysfunction for assessment of left ventricle hypertrophy. Methods: The study was conducted in the signal transduction lab department of biochemistry Quaid-I-Azam University, Islamabad from September 2013 to February 2017. NT-proBNP and serum uric acid were measured in one hundred patients of aortic valve dysfunction. The patients were divided into three main groups: 1) Aortic stenosis, 2) Aortic regurgitation, and 3) Aortic stenosis with Aortic regurgitation. The results were compared between disease and controls groups. Results: High level of plasma NT-proBNP was detected in all the three disease groups of aortic valve (stenosis, p<0.001), (regurgitation, p<0.001) and (stenosis with regurgitation, p<0.001). In addition, non-significantly increased level of serum uric acid was also observed in left ventricle hypertrophy in all the three respective disease groups of aortic valve. Conclusion: Increased secretion of NT-proBNP during cardiac remodeling can be related to the severity of left ventricle hypertrophy due to aortic valve abnormality in all the disease groups of severe stenosis, severe regurgitation, and combine disease condition of severe stenosis and severe regurgitation. However, non-significant increase in uric acid concentration is also identified which may be due to one of the factors involved in left ventricle hypertrophy in all the three disease groups of aortic valve. The interaction of uric acid with NT-proBNP during cardiac remolding due to aortic valve dysfunction is still not clear. How to cite this:Jan MI, Khan RA, Sultan A, Ullah A, Ishtiaq A, Murtaza I. Analysis of NT-proBNP and uric acid due to left ventricle hypertrophy in the patients of aortic valve disease. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.148 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Features of heart failure with preserved ejection fraction (HFpEF) in diabetic patients with resistant hypertension

2021 ◽  
Vol 24 (4) ◽  
pp. 304-314
Author(s):  
M. A. Manukyan ◽  
A. Y. Falkovskaya ◽  
V. F. Mordovin ◽  
T. R. Ryabova ◽  
I. V. Zyubanova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Blood Pressure ◽  
Blood Flow ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Resistant Hypertension ◽  
Diabetic Patients ◽  
Preserved Ejection Fraction

BACKGROUND: It is expected that a steady increase in the incidence of diabetes and resistant hypertension (RHTN), along with an increase in life expectancy, will lead to a noticeable increase in the proportion of patients with heart failure with preserved ejection fraction (HFpEF). At the same time, data on the frequency of HFpEF in a selective group of patients with RHTN in combination with diabetes are still lacking, and the pathophysiological and molecular mechanisms of its formation have not been yet studied sufficiently.AIM: To assess the features of the development HFpEF in diabetic and non-diabetic patients with RHTN, as well as to determine the factors associated with HFpEF.MATERIALS AND METHODS: In the study were included 36 patients with RHTN and type 2 diabetes mellitus (DM) (mean age 61.4 ± 6.4 years, 14 men) and 33 patients with RHTN without diabetes, matched by sex, age and level of systolic blood pressure (BP). All patients underwent baseline office and 24-hour BP measurement, echocardiography with assess diastolic function, lab tests (basal glycemia, HbA1c, creatinine, aldosterone, TNF-alpha, hsCRP, brain naturetic peptide, metalloproteinases of types 2, 9 (MMP-2, MMP-9) and tissue inhibitor of MMP type 1 (TIMP-1)). HFpEF was diagnosed according to the 2019 AHA/ESC guidelines.RESULTS: The frequency of HFpEF was significantly higher in patients with RHTN with DM than those without DM (89% and 70%, respectively, p=0.045). This difference was due to a higher frequency of such major functional criterion of HFpEF as E/e’≥15 (p=0.042), as well as a tendency towards a higher frequency of an increase in left atrial volumes (p=0.081) and an increase in BNP (p=0.110). Despite the comparable frequency of diastolic dysfunction in patients with and without diabetes (100% and 97%, respectively), disturbance of the transmitral blood flow in patients with DM were more pronounced than in those without diabetes. Deterioration of transmitral blood flow and pseudo-normalization of diastolic function in diabetic patients with RHTN have relationship not only with signs of carbohydrate metabolism disturbance, but also with level of pulse blood pressure, TNF-alfa, TIMP-1 and TIMP-1 / MMP-2 ratio, which, along with the incidence of atherosclerosis, were higher in patients with DM than in those without diabetes.CONCLUSIONS: Thus, HFpEF occurs in the majority of diabetic patients with RHTN. The frequency of HFpEF in patients with DN is significantly higher than in patients without it, which is associated with more pronounced impairments of diastolic function. The progressive development of diastolic dysfunction in patients with diabetes mellitus is associated not only with metabolic disorders, but also with increased activity of chronic subclinical inflammation, profibrotic state and high severity of vascular changes.

scholarly journals P2856Predictors of survival in hypertensive patients with left ventricle hypertrophy

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
B Guzik ◽  
L McCallum ◽  
K Zmudka ◽  
A Jardine ◽  
T J Guzik ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Hypertensive Patients ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy
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