scholarly journals Preponderance of right ventricular dysfunction in COVID-19 patients with inflammatory heart disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S T Thodeti ◽  
D S L Lattanzio ◽  
T M K Kuraan ◽  
M U K Khalid ◽  
D D Drenic ◽  
...  
Keyword(s):  
Heart Disease ◽  
Right Ventricular ◽  
Recovery Period ◽  
Right Ventricular Dysfunction ◽  
P Value ◽  
Published Data ◽  
Mri Findings ◽  
Inflammatory Heart Disease ◽  
Significant Difference ◽  
Cmr Imaging

Abstract Introduction Recently published data suggests that inflammatory heart disease (IHD) is far more prevalent in COVID-19 patients than initially expected. Specifically, there have been reports of greater than expected right ventricular (RV) involvement in the post COVID-19 recovery period. However, there are no published data comparing RV dysfunction in COVID-19 and non-COVID-19 patient cohorts with IHD. Purpose This study was designed to assess and compare the prevalence of RV hypokinesis in 2 patient cohorts: patients with COVID-19 related IHD and patients with non-COVID-19 related IHD, based on cardiac MRI findings (CMR). Methods An institutional cardiac imaging database was queried for all patients with IHD documented by CMR. Inflammatory heart disease was defined as pericarditis and/or myocarditis using the recently modified Lake Louise criteria, including T1 and T2 relaxation mapping. The prevalence of IHD was evaluated in 2 separate patient cohorts, subjects with COVID-19 related IHD and subjects with non-COVID-19 related IHD. Further assessment of these 2 patients cohorts included the presence of RV hypokinesis. A two-tailed Z-test was used for statistical comparison of the presence of IHD and the presence of RV hypokinesis in these 2 patient cohorts. Results 62 COVID patients and 6782 non-COVID patients were identified in the imaging database. 53 of the 62 COVID patients (85.5%) had evidence of IHD on CMR study. In contrast, 1273 of the 6782 patients (18.8%) had documented IHD detected by CMR. There was a statistically significant difference between the incidence of IHD in the 2 patient groups (p-value <0.ehab724.01391). Furthermore, of the 53 COVID patients with IHD, 30 (56.6%) showed evidence of RV hypokinesis on CMR. Of the 1273 non-COVID patients with IHD, only 126 (9.9%) showed evidence of RV hypokinesis on CMR. There was a statistically significant difference between the incidence of RV hypokinesis among the 2 groups (p-value <0.ehab724.01391). Details are provided in Figure 1. Conclusion These data suggest that the prevalence of IHD in COVID-19 patients is 4 times greater than in patients with a non-COVID etiology, based on CMR imaging findings. Furthermore, the occurrence of RV hypokinesis is 5 times greater in COVID-19 patients than in IHD patients with a non-COVID etiology, also based on CMR findings. These data suggest that CMR imaging is of value in detecting both IHD and RV dysfunction, which are often difficult to detect with other imaging modalities. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals AB1093 INTEROBSERVER AGREEMENT IN MAGNETIC RESONANCE OF SACROILIAC JOINTS ABOUT ACTIVE SACROILIITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1835.1-1836
Author(s):  
A. C. Genç ◽  
F. Turkoglu Genc ◽  
A. B. Kara ◽  
Z. Ozturk ◽  
D. Karatas ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Interobserver Agreement ◽  
Corporate Strategy ◽  
Axial Spondyloarthritis ◽  
Musculoskeletal Diseases ◽  
P Value ◽  
Mri Findings ◽  
Expert Radiologist ◽  
Significant Difference ◽  
Active Sacroiliitis

Background:Axial spondyloarthritis has characteristic clinical features such as enthesitis, sacroiliitis and spondylitis, and extra-articular manifestations(1). Magnetic resonance imaging (MRI) of sacroiliac (SI) joints is used to detect early sacroiliitis(2). Health institutions in our country carry out some of the radiology reporting services by outsourcing for reasons such as high cost and insufficient number of radiologists(3).Objectives:We decided to evaluate the interobserver agreement in active MRI findings of SI between radiologist of outsourcing radiology services and local/expert radiologist in musculoskeletal diseases.Methods:Between the years of 2015 and 2019, 8100 sacroiliac MRIs were taken at our center. The MRI of 1150 patients who were reported as active or chronic sacroiliitis from these sacroiliac MRIs or whose MRI was considered by the primary physician in favor of sacroiliitis was included in the study. Concordance between Evaluation and Service Procurement was examined using Kappa (k) coefficients. Mc Nemar test was used to compare the evaluation result between two observers. A p-value <0.05 was considered significant. Analyses were performed using commercial software (IBM SPSS Statistics, Version 23.0. Armonk, NY: IBM Corp.)Results:Of the 1150 patients examined in the study, 526 (45.7%) were male and 624 (54.3%) were female. The general average age is 37.20 ± 11.65 and the average age of men and women is 34.98 ± 11.19 and 39.07 ± 11.71 respectively. A statistically significant difference was found between the expert radiologists and outsourcing radiologist reports. In other words, a high level of compatibility was not found among the evaluators (p <0.001). When the consistency between expert radiologist and outsourced radiologist reports was examined, it was observed that there was a medium level of concordance (k = 0.589).Conclusion:The diagnosis of a spondyloarthropathy may be delayed for some reasons. In addition to the insidious course of the disease, being contented with an outsourced radiologist report may delay diagnosis. If the patient’s clinic and MRI report are not consistent, the patient should not be removed from follow-up.References:[1]Braun J. ‘Axial spondyloarthritis including ankylosing spondylitis’ Rheumatology (Oxford). 2018 1;57(suppl_6):vi1-vi3[2]Jans L, Egund N, Eshed I, Sudoł-Szopińska I, Jurik AG. Sacroiliitis in Axial Spondyloarthritis: Assessing Morphology and Activity. Semin Musculoskelet Radiol. 2018;22: 180–188.[3]Quélin B, Duhamel F. Bringing Together Strategic Outsourcing and Corporate Strategy: European Management Journal. 2003. pp. 647–661. doi:10.1016/s0263-2373(03)00113-0OUTSOURCING RADIOLOGIST REPORTSTOTALpNOT ACTIVE SACROILIITISACTIVE SACROILIITISEXPERT RADIOLOGIST REPORTSNOT ACTIVE SACROILIITIS508178686<0.0010.589ACTIVE SACROILIITIS59405464TOTAL5675831150Disclosure of Interests:None declared

scholarly journals Cyanotic congenital heart disease: Impact on growth and endocrine functions.

2021 ◽  
Vol 28 (10) ◽  
pp. 1477-1483
Author(s):  
Muhammad Sohail Arshad ◽  
Waqas Imran Khan ◽  
Arif Zulqarnain ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Mudasser Adnan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pulmonary Stenosis ◽  
Tertiary Care ◽  
Cyanotic Congenital Heart Disease ◽  
P Value ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

Objective: To find out the impact of Cyanotic Congenital Heart Disease (CCHD) on growth and endocrine functions at a tertiary care child healthcare facility of South Punjab. Study Design: Case Control study. Setting: Department of Pediatric Cardiology and Department of Pediatric Endocrinology, Institute of Child’s Health (ICH), Multan, Pakistan. Period: December 2018 to March 2020. Material & Methods: During the study period, a total of 53 cases of Echocardiography confirmed CCHD were registered. Along with 53 cases, 50 controls during the study period were also enrolled. Height, weight, body mass index (BMI) along with hormonal and biochemical laboratory investigations were done. Results: There was no significant difference between gender and age among cases and controls (p value>0.05). Most common diagnosis of CCHD among cases, 24 (45.3%) were Tetralogy of Fallot (TOF) followed by 9 (17.0%) transposition of the great arteries (TGA) with Ventricular Septal Defect (VSD) with Pulmonary Stenosis (PS). Mean weight of CCHD cases was significantly lower in comparison to controls (21.19+6.24 kg vs. 26.48+8.1 kg, p value=0.0003). Blood glucose was significantly lower among cases in comparison to controls (77.58+14.58 mg/dl vs. 87.25+11.82 mg/dl, p value=0.0004). No significant difference was found in between cases and controls in terms of various hormone levels studied (p value>0.05) except Insulin-like Growth Factor-1 (IGF-1) levels (p value<0.0001). Conclusion: Children with cyanotic congenital heart disease seem to have negative effects on nutrition and growth. Change in pituitary-adrenal axis is suspected while pituitary-thyroid axis seemed to be working fine among CCHD cases. Serum glucose and IGF-1 levels were significantly decreased among CCHD cases.

scholarly journals Carcinoid Heart Disease: A Rare Cause of Right Ventricular Dysfunction Evaluation by Transthoracic 2D, Doppler and 3-D Echocardiography

2011 ◽  
Vol 19 (2) ◽  
pp. 99 ◽  
Author(s):  
Fulvio Cacciapuoti ◽  
Marco Agrusta ◽  
Gisberta Chiorazzo ◽  
Arcangelo Midolla ◽  
Federica Agrusta ◽  
...  
Keyword(s):  
Heart Disease ◽  
Right Ventricular ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Carcinoid Heart Disease

scholarly journals Diagnosis and treatment of right ventricular dysfunction in congenital heart disease

2020 ◽  
Vol 10 (5) ◽  
pp. 1625-1645
Author(s):  
Béatrice Santens ◽  
Alexander Van De Bruaene ◽  
Pieter De Meester ◽  
Michele D’Alto ◽  
Sushma Reddy ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Diagnosis And Treatment

Changes of BNP Level and Pulmonary Arterial Pressure during An Acute Sickle Cell Crisis, Comparison with Steady State

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2503-2503
Author(s):  
Aref Agheli ◽  
Chenthil Rathnasabapathy ◽  
Ashish Sangal ◽  
Zili He ◽  
William Steier ◽  
...  
Keyword(s):  
Steady State ◽  
Right Ventricular ◽  
Sickle Cell ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Acute Chest Syndrome ◽  
Cardiac Complications ◽  
Significant Difference ◽  
Sickle Cell Crisis ◽  
Pulmonary Arterial

Abstract Background: The heart is frequently involved in Sickle Cell Anemia (SCA). Cardiomegaly is a usual finding, significant arrythmias and sudden death are common, and 30% of patients with both homozygous and heterozygous SCA develop Pulmonary Arterial Hypertension (PAH), a major risk factor for higher mortality in this population. Brain Natriuretic Peptide (BNP) and echocardiographic data could provide important prognostic and diagnostic information about PAH in SCD. High levels of BNP, which is released from ventricular cardiomyocytes in response to their stretch, reflect cardiac chamber volume and pressure overload in various conditions. In patients with PAH, BNP levels correlate with the severity of Pulmonary Artery Pressure (PAP) elevation and right ventricular dysfunction. In human, the half life of BNP is 20 minutes, reflecting the fluctuation of BNP levels during different stages of any acute cardiac pathology. Methodology: The hypothesis of this prospective IRB approved study was to investigate the BNP level and PAP elevation during an acute Sickle Cell Crisis (SCC), in particular in those with intrathoracic structures involvement. Between December 2006 and July 2008, 81 patients were registered after a written informed consent was obtained. We collected the BNP levels and echocardiographic data of patients with SCD and compared them in two group; those who were admitted with Sickle Cell Crisis (SCC) and those who returned to clinic in Steady State (SS) for follow up. The data were obtained on the first day of admission in SCC group. The primary endpoint was the elevation of the BNP level and the secondary endpoint was elevation of the PAP during a SCC, which were compared with SS patients. The inclusion criterion was age above 18 and having one of the sickle cell syndromes, requiring hospital admission. Results: Forty nine patients (59%) were female, and 34 (41%) patients were male. Their ages ranged from 19 to 65, mean (SD) 30.2 (9.7) years. The mean (SD) levels of BNP were significantly higher in patients who were admitted with one of the acute complications or vaso-occlusive crisis of sickle cell, [177.3 (23.4) pg/ml], when compared with its levels in SS, [34.17 (6.1) pg/ml], (95% CI 61.4 to 225.0, p&lt;.001) (Figure 1). An elevated BNP level was defined as levels more than 100 pg/ml. A further subgroup analysis revealed that the BNP levels were even more significantly higher in patients with acute chest syndrome or other intrathoracic events [(n= 17, mean (SD) 363.6 (121.3) pg/ml], when compared with those of simple acute sickle cell crisis, [(n= 35, mean (SD) 167.7 (26.8) pg/ml] (p=.038) (Figure 1). Topographic data about heart chambers’ sizes, volumes, and pressures were obtained by Echocardiography and compared in two groups. While only 23.1% of patients in SS group had elevated PAP with a mean (SD) of 43 (2.1) mmHg, 41.1% (n=21) of patients with SCC had elevated PAP with mean (SD) 45.9 (2.1) mmHg, with no significant difference between two groups with PAH (p=.608). Conclusion: Patients with either homozygous or heterozygous forms of SCA can have cardiac complications, such systolic and diastolic dysfunction. Hypoxemia leads to raised levels of BNP production. In patients with SCA, an elevated BNP level largely reflects the severity of right ventricular dysfunction associated with PAH. Our data revealed that BNP level and PAP are increased during vaso-occlusive crisis of SCA, in particular during those life-threatening complications, such acute chest syndrome. These changes seem to be temporary and with clinical improvement, the majority of patients’ BNP levels and PAP return to the baseline, although some will never normalize. Figure Figure

Field performance of the M-44 ejector for red fox (Vulpes vulpes) control

2003 ◽  
Vol 30 (6) ◽  
pp. 601 ◽  
Author(s):  
Clive A. Marks ◽  
Frank Gigliotti ◽  
Frank Busana
Keyword(s):  
Vulpes Vulpes ◽  
Recovery Period ◽  
Field Performance ◽  
Published Data ◽  
Red Foxes ◽  
Simple Strategy ◽  
Significant Difference ◽  
Bait Station ◽  
Free Feeding ◽  
Overall Ratio

The M-44 ejector was used to recover red foxes (Vulpes vulpes) in the eastern highlands of Victoria during two summer and two winter trials in 1997–99. Two transects containing 20 devices each were established at five independent sites. Meat baits containing rhodamine B (RB) were used in a three-week free-feeding period at each site before the ejectors were loaded with cyanide capsules and set for a further six weeks. No significant correlation was found between bodyweight and the distance from the bait station that foxes were recovered. No bias was detected in the age of either sex or the overall ratio of males to females. Bait station activity in the free-feed period was not closely correlated with the recovery of foxes at the same bait station. Comparisons with published data found no significant difference in the age structure and sex ratio of foxes recovered with the M-44 and those taken by trapping or day shooting. Nearest-neighbour distances between recovered foxes were significantly smaller in summer 1997/98 than for consecutive periods (P < 0.05). Fox recoveries were contagious in their distribution in all but the winter 1998 period. The age of foxes recovered declined from summer to winter in each year (P < 0.05) and the ratio of yearlings to adults systematically increased over the four periods. Only 39.5% of the 160 foxes recovered overall had consumed a RB-marked bait used in the three-week free-feed period, and 43% of all foxes recovered in the first week were not marked. Over a six-week recovery period in summer 1997/98 and winter 1998 there was a significant inverse relationship between time and the number of foxes recovered (P < 0.05). There was no significant difference in the slopes of the regression describing the recovery of marked and unmarked foxes during summer 1997/98, suggesting that both groups were removed at the same rate. We discuss these data with reference to the use of fox age as an indicator of control performance and suggest a simple strategy to enhance baiting efficacy when fox distribution is contagious.

scholarly journals Volume load-induced right ventricular dysfunction in animal models: insights in a translational gap in congenital heart disease

2017 ◽  
Vol 20 (4) ◽  
pp. 808-812 ◽  
Author(s):  
Guido P.L. Bossers ◽  
Quint A.J. Hagdorn ◽  
Mark Jan Ploegstra ◽  
Marinus A.J. Borgdorff ◽  
Herman H.W. Silljé ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Animal Models ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Volume Load

scholarly journals Fresh Autologous Pericardium to Reconstruct the Pulmonary Valve at the Annulus When Tetralogy of Fallot Requires a Transannular Patch at Midterm

2016 ◽  
Vol 43 (3) ◽  
pp. 207-213 ◽  
Author(s):  
Shantanu Pande ◽  
Jugal K. Sharma ◽  
C.R. Siddartha ◽  
Anubhav Bansal ◽  
Surendra K. Agarwal ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Pulmonary Valve ◽  
Right Ventricular Outflow Tract ◽  
Right Ventricular Dysfunction ◽  
Pulmonary Insufficiency ◽  
Autologous Pericardium ◽  
Transannular Patch ◽  
Significant Difference

Tetralogy of Fallot often requires reconstruction of the right ventricular outflow tract with a transannular patch (TAP), but this renders the pulmonary valve incompetent and eventually leads to right ventricular dysfunction. We retrospectively evaluated the efficacy of a reconstructed pulmonary valve and annulus in 70 patients who underwent, from December 2006 through December 2010, complete correction of tetralogy of Fallot. We divided the 70 patients into 2 groups in accordance with whether they required (n=50) or did not require (n=20) a TAP. We used autologous untreated pericardium to fashion the TAP and to create both an annulus of the correct size and a competent pulmonary valve with native leaflets. We evaluated the efficiency of this procedure both functionally and anatomically. The median age of the patients was 11 years (range, 2–38 yr). There were 56 males, with no significant difference in sexual distribution between groups. The clinical follow-up was 88% for 57.5 months, and the echocardiographic follow-up was 80% for 36 months. There was no significant difference in outflow gradient or in the occurrence of pulmonary insufficiency between the TAP group (none, 31; mild, 12; moderate, 6; and severe, 1) and the No-TAP group (none, 16; moderate, 2; and severe, 2) (P=0.59). Nor was there any thickening or calcification in the constructed valves. We conclude that pulmonary valves constructed of untreated autologous pericardium performed as well as native valves after total tetralogy of Fallot correction at midterm.

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