P3444Overweight and obesity in a Mediterranean pediatric population: impact in cardiac chambers morphology and systolic function

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Fernandez Cabeza ◽  
C U Aristizabal Duque ◽  
I M Blancas Sanchez ◽  
M Ruiz Ortiz ◽  
M Delgado Ortega ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Right Ventricle ◽  
Systolic Function ◽  
Pediatric Population ◽  
Left Ventricular ◽  
Normal Weight ◽  
Left Ventricle Ejection Fraction ◽  
Overweight And Obesity ◽  
Age And Sex

Abstract Background Obesity is a major medical and public health problem. A high body mass index has been associated with increased mortality and cardiovascular disease morbidity. Obesity in adults is related to hypertrophy and left ventricular dilatation. Previous studies have shown that, in Spain, the prevalence of overweight and obesity in childhood is 26% and 12.6% respectively. The association between obesity and left ventricular morphology has been poorly studied in the pediatric population. Aim To investigate the relationship between childhood obesity and the dimensions of cardiac structures and systolic function in a Mediterranean pediatric population. Methods A random sample of children and adolescents in primary and secondary education was selected, stratified by age, gender and educational centers in a rural town of 2864 inhabitants in southern Spain. Children between 6 and 17 years old were included. A transthoracic echocardiogram was performed for the evaluation of cardiac chambers morphology and systolic function. Results A total of 212 children were studied (10.9±3.0 years old and 51.9% males): 106 (50%) were normal weight, 57 (26.9%) were overweight and 49 (23.1%) were obese. Results are shown in the table. Age and sex were similar in the three groups. Overweight and obesity were related to larger values of left ventricle end-diastolic diameter and volume, left atrial volume and right ventricle basal diameter, and lower values of left ventricle ejection fraction. Normal weight Overweight Obese p Age 10.9±3.2 10.7±2.7 11.0±2.8 0.79 Male (%) 50.9% 49.1% 57.1% 0.69 End-diastolic left ventricle diameter (mm) 41.1±5.5 42.8±5.4 44.2±5.5 0.003 End-diastolic left ventricle volume (mm) 57.9±18.6 64.3±18.3 78.1±22.4 <0.0005 Interventricular septum (mm) 6.3±1.4 6.7±1.3 7.0±1.7 0.01 Left ventricle mass (g) 69.3±30.1 80.9±30.2 94.8±36.5 <0.0005 Left atrium volume (mm) 19.7±6.8 22.6±6.5 27.9±7.4 0.004 Basal right ventricle diameter (mm) 27.6±4.5 28.0±3.9 30.2±4.2 0.001 Left ventricle ejection fraction (%) 65.7±3.6 63.6±4.7 61.5±4.6 <0.0005 Conclusions Overweight and obese children have larger cardiac chambers, higher left ventricular mass, and worse systolic function compared with normal weight children of similar age and sex.

scholarly journals Relationship Between Overweight and Obesity and Cardiac Dimensions and Function in a Paediatric Population.

2021 ◽  
Author(s):  
Juan Fernández Cabeza ◽  
Cristhian H Aristizábal-Duque ◽  
Isabel María Blancas Sánchez ◽  
Martín Ruíz Ortiz ◽  
Ana Rodríguez Almodóvar ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Paediatric Population ◽  
Left Ventricular ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Left Ventricular Ejection ◽  
Left Ventricle Mass ◽  
Ventricular Ejection Fraction ◽  
And Function

Abstract Obesity in adults is associated with left ventricular hypertrophy, dilatation and myocardial fibrosis, as well as heart failure and coronary heart disease. These associations have been studied to a lesser extent in the paediatric population. This study aims to investigate the relationship between obesity and cardiac structure and function in the paediatric population. In a southern Spanish town, we selected all inhabitants aged 6–17 years stratifying by age, gender, and educational centres. We performed a complete transthoracic echocardiogram evaluating all the cardiac morphological and functional parameters commonly measured in an echocardiographic study. There were 212 children and adolescents included. Of them, 48,1 % were males. The mean age was 10.9 ± 3.0 years. 106 (50%) were normal weight, 57 (26.9%) overweight and 49 (23.1%) obese. Sex and age were similar in all three groups. Overweight and obesity were associated with larger left ventricular end-diastolic and end-systolic volumes (p < 0.0005), greater left ventricular mass (p < 0.0005) and smaller ejection fraction (p < 0.0005). They were also associated with larger atrial, aortic and right ventricular size. Lateral and mean E/e' ratios were higher (p = 0.007 and p = 0.01 respectively). Body mass index was independently associated with all cavity size variables as well as left ventricular ejection fraction. Conclusion: Childhood obesity is independently associated with larger heart chambers, greater left ventricle mass, and smaller left ventricle ejection fraction.

Effect of overweight and obesity on the left ventricular systolic and diastolic functions in patients with acute myocardial infarction

2012 ◽  
Vol 35 (4) ◽  
pp. 229 ◽  
Author(s):  
Fatih Poyraz ◽  
Murat Turfan ◽  
Sinan A. Kocaman ◽  
Huseyin U. Yazici ◽  
Nihat Sen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Diastolic Function ◽  
Systolic Function ◽  
Study Groups ◽  
Left Ventricular ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Weight Group ◽  
Normal Weight Group ◽  
Diastolic Functions

Purpose: The purpose of this study was to evaluate whether a association exits among overweight and obesity and left ventricular systolic and diastolic functions in patients admitted with first ST-elevation myocardial infarction (STEMI). Methods: The present study was performed on 451 consecutive patients diagnosed with first STEMI (376 men, 75 women; mean age 56.1±10.8 years). The patients were classified into three groups based on their body mass index (BMI) as normal weight (BMI < 25 kg/m2), overweight (BMI: 25-29.9 kg/m2) and obese (BMI > 30 kg/m2). Echocardiographic features were evaluated and compared among the three groups. Results: Mitral annulus E velocities were higher in obese individuals than normal weight group (p < 0.01). In contrast, mitral A velocities were lower (p =0.03); consequently, E\A and E'\A' ratios were lower (both p =0.01) in the obese group with respect to normal weight group. When the correction of entire variations existing among the groups were performed using multivariate linear regressions analyses, it turned out that BMI was independently associated with E/A (β= -0.19, p =0.044) and with E'/A' (β= -0.016, p=0.021). Ejection fraction, wall motion score index and myocardial S velocities were comparable among the study groups (p > 0.05). Conclusion: These results suggest that while obesity has no adverse effect on the left ventricular systolic function, it has unfavorable consequences on the left ventricular diastolic function in the patients with first STEMI. In contrast, no unfavorable effects of overweight on the left ventricular systolic and diastolic function were detected.

scholarly journals Non-Invasive Assessment of Left Ventricle Ejection Fraction: Where Do We Stand?

2021 ◽  
Vol 11 (11) ◽  
pp. 1153
Author(s):  
Alessandra Scatteia ◽  
Angelo Silverio ◽  
Roberto Padalino ◽  
Francesco De Stefano ◽  
Raffaella America ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricle Ejection Fraction ◽  
Advantages And Disadvantages ◽  
Non Invasive ◽  
Lv Ejection Fraction ◽  
Lv Systolic Function ◽  
Invasive Evaluation

The left ventricular (LV) ejection fraction (EF) is the preferred parameter applied for the non-invasive evaluation of LV systolic function in clinical practice. It has a well-recognized and extensive role in the clinical management of numerous cardiac conditions. Many imaging modalities are currently available for the non-invasive assessment of LVEF. The aim of this review is to describe their relative advantages and disadvantages, proposing a hierarchical application of the different imaging tests available for LVEF evaluation based on the level of accuracy/reproducibility clinically required.

scholarly journals Determination of serum glycated albumin and high sensitivity C - reactive protein in the insight of cardiovascular complications in diabetic chronic kidney disease patients

2020 ◽  
Vol 20 (1) ◽  
pp. 308-313
Author(s):  
Bhooma Vijayaraghavan ◽  
Giri Padmanabhan ◽  
Kumaresan Ramanathan
Keyword(s):  
Blood Glucose ◽  
Cardiovascular Diseases ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Ventricular Hypertrophy ◽  
Glycated Albumin ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Left Ventricle Ejection Fraction ◽  
Group I

Background: Left ventricular hypertrophy (LVH) has been proved as one among the cardiovascular complications and pre- dominant in patients with CKD. In CKD patients, Glycated albumin (GA) express a superior marker of glycemic control than HbA1c. Nevertheless, the precision of GA for the prediction of cardiovascular diseases among the CKD population has been ineffectively reported. The present study looks at the part of GA, HbA1c in CKD to envisage vascular complications. Materials and methods: One hundred and ninety-four patients were selected in the present study. The study has a control group (Group I, N: 52) and participants were divided into two groups based on vein diseases (Group II, N: 42; two vessels and group III, N: 100; triple vessel disease). Serum glycated albumin, hsCRP and other routine parameters were estimated in all the three groups. 2-dimensional echocardiography (2D Echo) has been done by a cardiologist to all the study patients for assessing ejection fraction and distinguish the sort of vessel diseases. Results: Group I compared with group II and III shown there was a significant association among blood glucose, serum creati- nine, HbA1c, mean blood glucose, GA, ejection fraction and hsCRP. Additionally, observed that increased levels of HbA1c, GA and creatinine inversely related to the left ventricle ejection fraction. Notwithstanding, GA and hsCRP predict precisely the left ventricle ejection fraction than different parameters. Conclusion: GA alongside hsCRP might be appropriate markers for anticipating cardiovascular diseases particularly left ventricle hypertrophy in diabetic CKD population. Keywords: CKD; glycemic control; Left Ventricular Hypertrophy; GA; HbA1c. 

Maternal Obesity Affects Cardiac Remodeling and Recovery in Women with Peripartum Cardiomyopathy

2018 ◽  
Vol 36 (05) ◽  
pp. 476-483 ◽  
Author(s):  
Esa Davis ◽  
Gregory Ewald ◽  
Michael Givertz ◽  
Navin Rajagopalan ◽  
Leslie Cooper ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Cardiac Remodeling ◽  
Maternal Obesity ◽  
Left Ventricular ◽  
Normal Weight ◽  
Peripartum Cardiomyopathy ◽  
Overweight And Obesity ◽  
Obese Women ◽  
Cardiac Recovery ◽  
Lv Dysfunction

Objective To examine the association between maternal obesity on left ventricular (LV) size and recovery in women with peripartum cardiomyopathy (PPCM). Study Design This was a prospective analysis of 100 women enrolled within 13 weeks of PPCM diagnosis and followed for a year in the Investigation of Pregnancy Associated Cardiomyopathy study. Adiposity was defined by standard body mass index (BMI) definitions for under/normal weight, overweight, and obesity. Demographic, clinical, and biomarker variables were compared across weight categories. Outcomes LV end-diastolic diameter (LVEDD) and ejection fraction were measured at entry, 6, and 12 months postpartum. Multivariable regression models examined the relationship between adiposity, LV size, and leptin levels with cardiac recovery at 6 and 12 months postpartum. Results Obese and nonobese women had similar LV dysfunction at entry. Obese women had greater LV size and less LV recovery at 6 and 12 months postpartum. BMI was positively associated with leptin and ventricular diameter. Greater BMI at entry remained associated with less ventricular recovery at 6 months (p = 0.02) in adjusted race-stratified models. LVEDD at entry predicted lower ejection fraction at 6 months (p < 0.001) and similarly at 12 months. Conclusion Obese women with PPCM had greater cardiac remodeling, higher leptin levels, and diminished cardiac recovery.

Abstract 12722: Cardiac Resynchronization Therapy in Pacing Induced Cardiomyopathy: A Higher Right Ventricle Pacing Percentage Predicts Greater Improvement in Left Ventricle Ejection Fraction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sean Lacy ◽  
Jonathan Chandler ◽  
NACHIKET MADHAV APTE ◽  
Seth Sheldon ◽  
Madhu Reddy ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Cardiac Resynchronization Therapy ◽  
Left Ventricular ◽  
Left Ventricle Ejection Fraction ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Qrs Duration ◽  
Rv Pacing ◽  
The Impact

Introduction: Cardiac resynchronization therapy (CRT) upgrade is indicated for improvement of cardiac function in patients with chronic right ventricular (RV) pacing burden >40% and heart failure with reduced ejection fraction. It is uncertain whether the CRT response is different among patients with high (≥90%) versus intermediate (<90%) burden of baseline RV pacing. Hypothesis: To assess the impact of baseline RV pacing percent on ECG and echocardiographic response after CRT upgrade for pacing induced cardiomyopathy. Methods: We conducted a retrospective study of all CRT upgrades for pacing induced cardiomyopathy at our hospital from January 2017 to December 2018. Cohorts were grouped by RV pacing burden ≥90% or <90%. QRS duration, left ventricle ejection fraction (LVEF), and left ventricular internal dimension systolic (LVIDs) were assessed at baseline and 3-12 months post CRT upgrade. Results: We included 82 patients (age 74 ± 12 yr., 71% male) who underwent CRT upgrade for pacing induced cardiomyopathy. The RV pacing burden was ≥90% [median 99% (IQR 98-99%)] in 61 patients, and <90% [median 79% (IQR 69-88%)] in 21 patients. There was a trend towards greater reduction in QRS duration in the ≥90% RV pacing group (28 ± 29 ms vs. 22 ± 38 ms, p=0.5). Improvement in LVEF was greater in ≥90% vs. <90% RV pacing group (14.3 ± 10.1% vs. 6.3 ± 10.1%, p=0.003). The association persisted on multivariable adjustment for age, sex and baseline LVEF (p=0.004). There was a trend towards greater % reduction in LVIDs in the ≥90% vs. <90% RV pacing group (6.4 ± 15.5 % vs. 3.9 ± 14.3 %, p=0.5) [Figure]. Conclusions: A higher baseline RV pacing burden predicts a greater improvement in LVEF after CRT upgrade for pacing induced cardiomyopathy.

scholarly journals A Novel Approach for Detecting Abnormality in Ejection Fraction Using Transthoracic Echocardiography with Deep Learning

2020 ◽  
Vol 16 (13) ◽  
pp. 99
Author(s):  
Prattay Guha Sarkar ◽  
Vishal Chandra
Keyword(s):  
Deep Learning ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Transthoracic Echocardiography ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Systolic Function ◽  
Whole Process

<p class="0abstract">Cardiovascular diseases (CVD) are the prime cause of mortality in people worldwide. Mortality in CVD has been strongly linked to Ejection Fraction (EF) in various studies<sup>1</sup>. Left ventricular ejection fraction (LVEF) is the central measure of left ventricular systolic function. LVEF is the fraction of chamber volume ejected in systole (stroke volume) in relation to the volume of the blood in the ventricle at the end of diastole (end-diastolic volume)<sup>2</sup>. Evaluation of left ventricular systolic function by left ventricle ejection fraction (EF) using Transthoracic echocardiography is usually a first line investigation. Determination of Ejection fraction (EF) is done most commonly by a semi-automatic process in which echocardiographer segments the left ventricle in both systolic and diastolic frames to generate systolic and diastolic chamber dimensions. The whole process in time consuming and highly dependent on operator experience causing a lot of inter-observer and intra-observer variations. Our goal is to develop algorithms so as to reduce the time consumed during whole process and make it more reliable and reproducible. We have used M-Mode of Left ventricle in PLAX view to measure chamber dimensions and calculate EF by Teich method. EF &gt;50% has been categorized as normal ejection fraction. EF &lt; 50% has been categorized as reduced ejection fraction and LV systolic dysfunction. In this research we have used fine-tuned ResNet 50 and trained it with 200 cases. We observed an accuracy of 98% and a F1 score of 77% for reduced EF (&lt;50%) and 77% for normal EF (&gt;50%). Although this is a small dataset, it shows that deep learning algorithms can be applied to medical imaging. ResNet50 is a preferred choice in terms of accuracy. This research will serve as a stepping stone for future research and will determine other cardiac matrices.</p>

scholarly journals Predictors of heart failure in patients with major beta-thalassemia

2020 ◽  
Vol 8 ◽  
pp. 670-684
Author(s):  
Ionut Stanca ◽  
Mihaela Rus ◽  
Alice Albu ◽  
Simona Fica
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Right Ventricle ◽  
Diastolic Function ◽  
Systolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Beta Thalassemia ◽  
Myocardial Mass ◽  
Systolic And Diastolic Function

Cardiomyopathy by loading the myocardium with iron is the cause of heart failure in patients with major beta-thalassemia. In these patients, cardiac systolic function remains normal for a long time, but when signs of heart failure appear, death may occur in the first year, so it is necessary to identify parameters to predict the patient's progress and prognosis.Materials and methods. We enrolled 62 patients with beta-thalassemia major (30 men and 32 women), mean age 29.9 ± 7.3 years. 32.2% of patients had disorders of carbohydrate metabolism, 12.9% associated hypothyroidism, and the mean ferritin was 1060.9 ± 856.6 ng / ml. Patients were evaluated echocardiographically, using tissue doppler technique to assess systolic and diastolic function. Myocardial mass was calculated using standard formulas and the type of left ventricular remodeling (LV) was thus obtained. Depending on the ferritin level, choosing the threshold value of 1000ng / ml, a group subanalysis of the ultrasound parameters of cardiac systolic and diastolic function was performed.Results. All patients had LV ejection fraction above 50% (LVEF), but longitudinal LV systolic dysfunction was observed in 19.3% of patients. Also in patients with serum ferritin values ​​above 1000ng / ml, the parameters of longitudinal systolic function of LV are affected, paradoxically the average value of LVEF being higher in these patients. About a quarter of patients had diastolic dysfunction, but 40.3% had elevated LV filling pressures. We noticed that the batch with ferritin over 1000 ng / ml associated increased LV filling pressures. The evaluation of the function of the right ventricle by tissue Doppler (S wave at the level of the free wall VD) was statistically significantly correlated with the hemoglobin value and we obtained pathological values ​​(S VD <11.5 cm / s) especially in the group with ferritin over 1000ng / ml. We noticed the presence of morphological abnormalities of LV, by increasing myocardial mass and the appearance of LV remodeling, 31% of patients showed severe forms, especially eccentric remodeling. It was observed that there is a risk of negative remodeling of the left ventricle in the group of those with ferritin above 1000ng / ml.Conclusions. The study proves that the evaluation of the systolic and diastolic function of the left and right ventricle by tissue Doppler ultrasound is much more accurate in the early detection of myocardial dysfunction. Ferritin levels above 1000ng / ml have been associated with impaired cardiac function parameters. Also, the remodeling of the left ventricle observed in this group of patients may be the first sign of heart failure.

scholarly journals A Study of Improvement of Left Ventricle Ejection Fraction in Heart Failure Patients with Reduced Ejection Fraction with Coronary Artery Diseases after Revascularization by Percutaneous Coronary Intervention (PCI)

2021 ◽  
pp. 33-40
Author(s):  
Mostafa Hamed Mostafa Elbahnasy ◽  
Ibtsam Khairat Ibrahim ◽  
Ehab Abdel Latef El Gendy ◽  
Ehab Abdel Wahab Hamdy
Keyword(s):  
Heart Rate ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricle Ejection Fraction ◽  
Coronary Artery Diseases ◽  
Percutaneous Coronary

Background: Left ventricular dysfunction is the single strongest predictor of mortality and one of the most frequent and deadly complication following coronary artery diseases. Aim: This   work   aims   to   study   and  explore  the  left  ventricle  ejection  fraction  improvement  after revascularization  with percutaneous coronary intervention (PCI) and the predictive factors for left ventricle ejection fraction improvement. Methods: One hundred patients with ischemic (HFrEF) who had complete revascularization with percutaneous coronary intervention (PCI), had survived at least 90 days and had undergone echocardiography review. The study duration was 1 year from April 2019 to May 2020. Result: We focused on a group of the common possible predictive factors affecting left ventricular improvement. Gender (male), CKD, DM, number of affected vessel(single vessel disease), CTO lesion, heart rate, ECG findings, presence of anginal pain, presence of dyspnea , usage of medications ( ACEI and Clopidogrel),hyper urecemia and the time between presentation of complaints and PCI were correlated with improvement of left ventricular function after revascularization by PCI. Conclusion: Time between appearance of symptoms and PCI was found to be independent predictor of LV EF improvement after revascularization. Other predictors were Male gender, DM, CKD, normal ECG finding ,absence of hyper urecemia, slower heart rate ,presence of chest pain and dyspnea , absence of CTO lesion , single vessel affection and administration of ACEI and Clopidogrel.

scholarly journals Laboratory and instrumental indicators associated with decreased left ventricle ejection fraction in patients with chronic heart failure

2021 ◽  
Vol 6 (2) ◽  
pp. 43-47
Author(s):  
Olesya Yu. Aidumova ◽  
Anatolii O. Rubanenko ◽  
Natalya V. Kompanets ◽  
Yurii V. Shchukin
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricle Ejection Fraction ◽  
Volume Index ◽  
Uric Acid Concentration ◽  
Hs Crp

Objectives to evaluate laboratory and instrumental indicators, associated with decreased left ventricle ejection fraction in patients with heart failure of ischemic etiology. Material and methods. The observational study included 71 patient with coronary heart disease and chronic heart failure (CHF). All patients underwent the testing on the following parameters: uric acid concentration, C-reactive protein (hs-CRP), NT-proBNP, ST2 and cystatin C tests, glomerular filtration rate. Instrumental examination included transthoracic echocardiography and 6-minute walk test. Results. The study revealed several indicators, associated with decreased left ventricle ejection fraction less than 50% in patients with CHF: NT-proBNP level 822.2 pg/ml, ST2 38.61 ng/l, uric acid 419.9 mmol/l, hs-CRP 2.54 mg/l, end diastolic volume index 73.68 ml/m2, left ventricular mass index 127 g/m2, left ventricular contractility index 1.75, pulmonary artery pressure 29 mm Hg. and vena cava inferior diameter 20 mm.

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