scholarly journals Cardiac structure and function in patients with schizophrenia taking antipsychotic drugs: an MRI study

2019 ◽  
Author(s):  
Toby Pillinger ◽  
Emanuele F. Osimo ◽  
Antonio de Marvao ◽  
Alaine Berry ◽  
Thomas Whitehurst ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Cardiac Mri ◽  
Cardiac Fibrosis ◽  
Left Ventricular ◽  
Myocardial Inflammation ◽  
Antipsychotic Treatment ◽  
Cardiac Structure ◽  
Lv Mass ◽  
Myocardial T1 ◽  
And Function

AbstractCardiovascular disease (CVD) is a major cause of excess mortality in schizophrenia. Preclinical evidence shows antipsychotics can cause myocardial fibrosis and myocardial inflammation in murine models, but it is not known if this is the case in patients. We therefore set out to determine if there is evidence of cardiac fibrosis and/or inflammation using cardiac MRI in medicated patients with schizophrenia compared with matched healthy controls. 31 participants (14 patients and 17 controls) underwent cardiac MRI assessing myocardial markers of fibrosis/inflammation, indexed by native myocardial T1 time, and cardiac structure (left ventricular (LV) mass) and function (left/right ventricular end-diastolic and end-systolic volumes, stroke volumes, and ejection fractions). Participants were physically fit, and matched for age, gender, smoking, blood pressure, BMI, HbA1c, ethnicity, and physical activity. Compared with controls, native myocardial T1 was significantly longer in patients with schizophrenia (effect size, d=0.89; p=0.02). Patients had significantly lower LV mass, and lower left/right ventricular end-diastolic and stroke volumes (effect sizes, d=0.86-1.08; all p-values <0.05). There were no significant differences in left/right end-systolic volumes and ejection fractions between groups (p>0.05). These results suggest an early diffuse fibro-inflammatory myocardial process in patients that is independent of established CVD-risk factors and could contribute to the excess cardiovascular mortality associated with schizophrenia. Future studies are required to determine if this is due to antipsychotic treatment or is intrinsic to schizophrenia.

Abstract MP57: The Association Between Anthropometrics and Different Measures of Cardiac Structure and Function - The Echo-SOL Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Matthew A Allison ◽  
Jianwen Cai ◽  
Ankit Desai ◽  
Barry Hurwitz ◽  
Ai Ni ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Left Ventricular ◽  
Structure And Function ◽  
Health Study ◽  
Cardiac Structure ◽  
Physical Measurements ◽  
Lv Mass ◽  
The Mean ◽  
Cardiac Structure And Function ◽  
And Function

Background: The purpose of this study was to determine the magnitudes and significances of the associations between adiposity and echocardiographically determined measures of left ventricular (LV) structure and function in a diverse cohort of Hispanic/Latino adults. Methods: Subjects were 1,350 adult men and women participants of the Hispanic Communities Health Study - Study of Latinos (HCHS-SOL) who enrolled in an ancillary study to determine cardiac structure and function by echocardiography. In addition to echocardiography, subjects were evaluated by extensive survey information, relevant physical measurements (to include bioelectrical impedance) and fasting blood assays. Results: The mean age was 56.1 years and 57% were female. Twenty-six percent were Mexican American, 25% Cuban American, 18% Dominican American, 17% Puerto Rican American, 8% Central American and 7% South American. Overall, the mean ejection fraction was 60.5%, while the mean stroke volume was 70 ml, end diastolic volume 83 ml, fractional shortening 31% and cardiac output 4.5 L/min. Results of multivariable linear regression adjusted for age, gender, hypertension, diabetes, dyslipidemia, cigarette smoking, family history of coronary heart disease, C-reactive protein and chronic kidney disease revealed that each 1-unit increment in body mass index (BMI) and fat mass (FM) by impedance was associated with 0.64 and 0.25 (p < 0.01 for both) higher LV mass index (to height), while a 0.1 unit increment in the waist to hip ratio (WHR) was associated with 3.2 higher LV mass index. Concomitantly, each 1-unit increment in BMI and FM was associated with 7 and 3% (p < 0.01 for each) higher odds of LV hypertrophy, while a 0.1 unit increment in WHR was associated with 78% higher odds for LV hypertrophy (p < 0.01). On the other hand, none of these variables were significantly associated with ejection fraction. There were no significant interactions between the anthropometric variables and the different Hispanic groups for LV mass index or hypertrophy. Conclusions: Among Hispanics/Latinos from different cultural backgrounds, and by three measures of body composition (BMI, FM and WHR), higher levels of adiposity are significantly associated with higher LV mass indexed for height and the odds for hypertrophy, while not being associated with better or worse ejection fraction.

scholarly journals Changes in Cardiac Morphology and Function in Individuals With Diabetes Mellitus

2019 ◽  
Vol 12 (9) ◽  
Author(s):  
Magnus T. Jensen ◽  
Kenneth Fung ◽  
Nay Aung ◽  
Mihir M. Sanghvi ◽  
Sucharitha Chadalavada ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Left Ventricular ◽  
Right Atrial ◽  
Ventricular Ejection Fraction ◽  
End Diastolic Volume ◽  
Lv Mass ◽  
Lv Ejection Fraction ◽  
And Function

Background: Diabetes mellitus (DM) is associated with increased risk of cardiovascular disease. Detection of early cardiac changes before manifest disease develops is important. We investigated early alterations in cardiac structure and function associated with DM using cardiovascular magnetic resonance imaging. Methods: Participants from the UK Biobank Cardiovascular Magnetic Resonance Substudy, a community cohort study, without known cardiovascular disease and left ventricular ejection fraction ≥50% were included. Multivariable linear regression models were performed. The investigators were blinded to DM status. Results: A total of 3984 individuals, 45% men, (mean [SD]) age 61.3 (7.5) years, hereof 143 individuals (3.6%) with DM. There was no difference in left ventricular (LV) ejection fraction (DM versus no DM; coefficient [95% CI]: −0.86% [−1.8 to 0.5]; P =0.065), LV mass (−0.13 g/m 2 [−1.6 to 1.3], P =0.86), or right ventricular ejection fraction (−0.23% [−1.2 to 0.8], P =0.65). However, both LV and right ventricular volumes were significantly smaller in DM, (LV end-diastolic volume/m 2 : −3.46 mL/m 2 [−5.8 to −1.2], P =0.003, right ventricular end-diastolic volume/m 2 : −4.2 mL/m 2 [−6.8 to −1.7], P =0.001, LV stroke volume/m 2 : −3.0 mL/m 2 [−4.5 to −1.5], P <0.001; right ventricular stroke volume/m 2 : −3.8 mL/m 2 [−6.5 to −1.1], P =0.005), LV mass/volume: 0.026 (0.01 to 0.04) g/mL, P =0.006. Both left atrial and right atrial emptying fraction were lower in DM (right atrial emptying fraction: −6.2% [−10.2 to −2.1], P =0.003; left atrial emptying fraction:−3.5% [−6.9 to −0.1], P =0.043). LV global circumferential strain was impaired in DM (coefficient [95% CI]: 0.38% [0.01 to 0.7], P =0.045). Conclusions: In a low-risk general population without known cardiovascular disease and with preserved LV ejection fraction, DM is associated with early changes in all 4 cardiac chambers. These findings suggest that diabetic cardiomyopathy is not a regional condition of the LV but affects the heart globally.

scholarly journals Ethnic differences in childhood right and left cardiac structure and function assessed by cardiac magnetic resonance imaging

2020 ◽  
Author(s):  
Wouter J. van Genuchten ◽  
Liza Toemen ◽  
Arno A. W. Roest ◽  
Meike W. Vernooij ◽  
Romy Gaillard ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Right Ventricular ◽  
Ethnic Differences ◽  
Early Life ◽  
Left Ventricular ◽  
Structure And Function ◽  
Cardiac Structure ◽  
End Diastolic Volume ◽  
Cardiac Structure And Function ◽  
And Function

Abstract Ethnic differences in cardiovascular risk factors and disease are well-known and may originate in early-life. We examined the ethnic differences in cardiac structure and function in children using cardiac magnetic resonance imaging in a European migrant population, and whether any difference was explained by early life factors. We used a prospective population-based cohort study among 2317 children in Rotterdam, the Netherlands. We compared children from Dutch (73%), Cape Verdean (3.5%), Dutch Antillean (3.3%), Moroccan (6.1%), Surinamese-Creoles (3.9%), Surinamese-Hindustani (3.4%), and Turkish (6.4%) background. Main outcomes were cMRI-measured cardiac structures and function. Cardiac outcomes were standardized on body surface area. Cape Verdean, Surinamese-Hindustani, and Turkish children had smaller right ventricular end-diastolic volume and left ventricular end-diastolic volume relative to their body size than Dutch children (p < 0.05). These results were not fully explained by fetal and childhood factors. Right ventricular ejection fraction and left ventricular ejection fraction did not differ between ethnicities after adjustment for fetal and childhood factors. Conclusion: Right ventricular end-diastolic volume and left ventricular end-diastolic volume differ between ethnic subgroups in childhood, without affecting ejection fraction. Follow-up studies are needed to investigate whether these differences lead to ethnic differences in cardiac disease in adulthood. What is Known:• Ethnic differences in cardiovascular risk factors and disease are well-known and may originate in early-life.• The prevalence of cardiovascular disease differs between ethnic groups.What is New:• We examined ethnic differences in left and right cardiac structure and function in children using cMRI.• Right and left cardiac dimensions differ between ethnic groups in childhood and are only partly explained by fetal and childhood factors.

Abstract P247: Associations of 25-year Smoking Patterns With Year 30 Cardiac Structure and Function: Longitudinal Results From the CARDIA Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Allison J Carroll ◽  
Ravi B Patel ◽  
Laura A Colangelo ◽  
David R Jacobs ◽  
Amanda R Mathew ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Lv Mass ◽  
Dependent Relation ◽  
Smoking Patterns ◽  
Trajectory Group ◽  
Never Smokers ◽  
And Function ◽  
Heavy Smokers

Background: Smoking exposure has a strong dose-dependent relation with cardiovascular disease (CVD). Less is known about how patterns of exposure may impact CVD. In this study, we hypothesized that patterns of high or persistent smoking for 25 years would have worse myocardial structure and function at 30 years, while patterns of quitting smoking would be similar to never smokers. Methods: Data were from 5115 black and white, men and women, aged 18-30 years at baseline (1985) in the CARDIA study. Group-based trajectory modeling (SAS proc traj ) identified smoking patterns from 1985-2010 among 3178 participants with echocardiogram at year 30 (2015). Adjusted linear regression analyses assessed associations between trajectory group with left ventricular (LV) structure (LV mass, LV diastolic dimension, left atrial volume), LV function (ejection fraction, circumferential strain, global longitudinal strain), and right ventricular function (E/A, average e’, E/e’). Interactions between smoking trajectory X sex, race, and BMI with echo measures were also assessed. Results: Seven smoking trajectory groups were identified (Figure). Trajectory group was significantly associated with cardiac structure, including LV mass ( p <.001) and LV diastolic dimension ( p =.003). For example, LV mass was greater among all smoking groups (except declining heavy smokers, n=49) compared to nonsmokers (all p s<.05); moreover, compared to heavy smokers, minimal smokers ( p =.008) and quitters ( p =.047) had smaller LV mass (Figure). Trajectory group was not associated with cardiac function (all p s>.10). None of the interactions with trajectory group was significant (all p s>.05). Conclusions: Any level of smoking during young adulthood was associated with poorer cardiac structure, but not function, compared to never smokers. Patterns of minimal and declining smoking also had significantly better structure than heavy smoking. These results suggest that quitting and reducing smoking may help preserve or restore cardiac structure over time.

scholarly journals The mitral regurgitation effects of cardiac structure and function in left ventricular noncompaction

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qing Zou ◽  
Rong Xu ◽  
Xiao Li ◽  
Hua-yan Xu ◽  
Zhi-gang Yang ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Nyha Class ◽  
Left Ventricular ◽  
Structure And Function ◽  
Left Ventricular Geometry ◽  
Cardiac Structure ◽  
Left Ventricular Noncompaction ◽  
Ventricular Noncompaction ◽  
Cardiac Structure And Function ◽  
And Function

AbstractThis study evaluated the effects of mitral regurgitation (MR) on cardiac structure and function in left ventricular noncompaction (LVNC) patients. The clinical and cardiovascular magnetic resonance (CMR) data for 182 patients with noncompaction or hypertrabeculation from three institutes were retrospectively included. We analyzed the difference in left ventricular geometry, cardiac function between LVNC patients with and without MR. The results showed that patients with MR had a worse New York Heart Association (NYHA) class and a higher incidence of arrhythmia (P < 0.05). MR occurred in 48.2% of LVNC patients. Compared to LVNC patients without MR, the two-dimensional sphericity index, maximum/minimum end-diastolic ratio and longitudinal shortening in LVNC patients with MR were lower (P < 0.05), and the peak longitudinal strain (PLS) of the global and segmental myocardium were obviously reduced (P < 0.05). No significant difference was found in strain in LVNC patients with different degree of MR; end diastolic volume, end systolic volume, and global PLS were statistically associated with MR and NYHA class (P < 0.05), but the non-compacted to compacted myocardium ratio had no significant correlation with them. In conclusion, the presence of MR is common in LVNC patients. LVNC patients with MR feature more severe morphological and functional changes. Hypertrabeculation is not an important factor affecting structure and function at the heart failure stage.

scholarly journals Network analysis of the left anterior descending coronary arteries in swim-trained rats by an in situ video microscopic technique

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Marianna Török ◽  
Petra Merkely ◽  
Anna Monori-Kiss ◽  
Eszter Mária Horváth ◽  
Réka Eszter Sziva ◽  
...  
Keyword(s):  
Sex Differences ◽  
Left Ventricular ◽  
Resistance Artery ◽  
Frequency Spectra ◽  
Stress Markers ◽  
Lv Mass ◽  
Network Properties ◽  
Exercise Induced ◽  
And Function

Abstract Background We aimed to identify sex differences in the network properties and to recognize the geometric alteration effects of long-term swim training in a rat model of exercise-induced left ventricular (LV) hypertrophy. Methods Thirty-eight Wistar rats were divided into four groups: male sedentary, female sedentary, male exercised and female exercised. After training sessions, LV morphology and function were checked by echocardiography. The geometry of the left coronary artery system was analysed on pressure-perfused, microsurgically prepared resistance artery networks using in situ video microscopy. All segments over > 80 μm in diameter were studied using divided 50-μm-long cylindrical ring units of the networks. Oxidative-nitrative (O-N) stress markers, adenosine A2A and estrogen receptor (ER) were investigated by immunohistochemistry. Results The LV mass index, ejection fraction and fractional shortening significantly increased in exercised animals. We found substantial sex differences in the coronary network in the control groups and in the swim-trained animals. Ring frequency spectra were significantly different between male and female animals in both the sedentary and trained groups. The thickness of the wall was higher in males as a result of training. There were elevations in the populations of 200- and 400-μm vessel units in males; the thinner ones developed farther and the thicker ones closer to the orifice. In females, a new population of 200- to 250-μm vessels appeared unusually close to the orifice. Conclusions Physical activity and LV hypertrophy were accompanied by a remodelling of coronary resistance artery network geometry that was different in both sexes.

Abstract P135: Hyperpolarized Carbon-13 Magnetic Resonance Reveals Early- and Late-Onset Changes to Metabolism in the Failing Heart

2011 ◽  
Vol 109 (suppl_1) ◽  
Author(s):  
Marie Schroeder ◽  
Angus Z Lau ◽  
Albert P Chen ◽  
Jennifer Barry ◽  
Damian J Tyler ◽  
...  
Keyword(s):  
Heart Failure ◽  
Magnetic Resonance ◽  
Late Onset ◽  
Krebs Cycle ◽  
Left Ventricular ◽  
Cine Mri ◽  
Cardiac Structure ◽  
End Diastolic Volume ◽  
Myocardial Energetics ◽  
And Function

Disordered metabolic substrate utilisation has been implicated in the pathogenesis of heart failure (HF). Hyperpolarised (HYP) 13C magnetic resonance, a technique in which the fate of 13C-labelled metabolites can be followed using MR imaging or spectroscopy, has enabled non-invasive assessment of metabolism. The aim of this study was to monitor carbohydrate metabolism alongside cardiac structure, function, and energetics, throughout HF progression. HF was induced in pigs (n=5) by right ventricular pacing at 188 bpm for 5 weeks. Pigs were examined at weekly time points: cine MRI assessed cardiac structure and function, HYP 13C2-pyruvate was administered intravenously and 13C MRS was used to assess 13C-glutamate production via Krebs cycle, 31P MRS assessed myocardial energetics, and HYP 13C1-pyruvate was administered to enable MRI of H13CO3- production from pyruvate dehydrogenase (PDH). At baseline, pigs had a normal left ventricular (LV) cardiac index (CI) and end diastolic volume (EDVi). The PCr/ATP was 2.3 ± 0.2. The 13C-glutamate/13C2-pyruvate was 4.3 ± 0.9%, and the H13CO3-/13C1-pyruvate ratio was 1.6 ± 0.2%. After 1–2 weeks of pacing, CI decreased to 3.3 ± 0.5 l/min/m2, PCr/ATP decreased to 1.7 ± 0.1, and 13C-glutamate/13C2-pyruvate decreased to 2.1 ± 0.6%. With the onset of HF, EDVi increased to 140.3 ± 14.1 ml/m2 and H13CO3-/13C1-pyruvate decreased to 0.5 ± 0.2%. In conclusion, we observed an early defect in Krebs' cycle that occurred alongside impaired cardiac energetics and function. Carbohydrate oxidation via PDH was maintained until the onset of HF. These results encourage use of metabolic therapies to delay/prevent the onset of heart failure in patients.

Abstract 6278: Burden of Chronic Renal Insufficiency in the General Population and Added Predictive Power of GFR to BNP and NT-proBNP in Detection of Altered Ventricular Structure and Function

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Alessandro Cataliotti ◽  
Richard J Rodeheffer ◽  
Douglas W Mahoney ◽  
Carolyn S Lam ◽  
Margaret M Redfield ◽  
...  
Keyword(s):  
General Population ◽  
Renal Insufficiency ◽  
Chronic Renal Insufficiency ◽  
Predictive Power ◽  
Left Ventricular ◽  
Structure And Function ◽  
Cardiac Biomarkers ◽  
Cardiac Structure ◽  
Cardiac Structure And Function ◽  
And Function

Background: Chronic renal insufficiency (CRI) is a strong predictor of increased mortality in the presence of heart failure (HF) and its prevalence has been increasing in the US. In addition, CRI is a major contributing factor to the progression of HF as it is associated with chronic volume overload, accelerated atherosclerosis and hypertension (HTN). The first aim of the current study was to evaluate the prevalence of CRI in an adult general population. The second aim was to address whether calculated glomerular filtration rate (cGFR) adds value to the cardiac biomarkers BNP and NT-proBNP in detecting early cardiac structural and functional impairments in the general population. Methods: From 1997 to 1999 medical history, physical examination, echocardiography, BNP (Biosite) and NT-proBNP (Roche) and serum creatinine (SCr) were obtained in 1,982 randomly selected residents of Olmsted County, MN >= 45 years (range 45 – 96 years). GFR was calculated using the Cockroft Gault equation. CRI was defined as a GFR < 60 ml/min. Cardiac structure and function were evaluated by in-depth echocardiographic examination. Results: The prevalence of cardiovascular co-morbidities was coronary atherosclerosis 12%, HTN 29.5% and diabetes mellitus 7.5%. The prevalence of CRI was 22.8% when cGFR was used for its detection. Importantly, by Chi-Square model, cGFR significantly increased the ability of BNP in detecting left ventricular hypertrophy (LVH) (p=0.004), increased relative wall thickness (p=0.0036), diastolic dysfunction (DDF) (p=0.0001) and HTN (p=0.0002). Similarly, when combined with NT-proBNP, cGFR increased the predictive power of detecting DDF (p=0.0001) and HTN (p=0.0366). Conclusion: This study reports a higher than predicted prevalence of CRI in this general US population equal to 23% and closely associated with the prevalence of HTN (29.5%). Importantly, this study also demonstrates that cGFR has additive predictive power when used in combination with two cardiac biomarkers of cardiac dysfunction and remodeling, BNP and NT-proBNP. These studies underscore the increasing burden of CRI in the general population and the utility of assessing cardiorenal function by combining renal and cardiac biomarkers in assessment of cardiac structure and function.

scholarly journals Early Left Ventricular Dysfunction Detected by Speckle Tracking in Long-Term Hemodialysis Patients with Valvular Calcification

2018 ◽  
Vol 9 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Jiahui Li ◽  
Aili Li ◽  
Jiali Wang ◽  
Yu Zhang ◽  
Ying Zhou
Keyword(s):  
Wall Thickness ◽  
Speckle Tracking ◽  
Heart Function ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Subtle Change ◽  
Lv Mass ◽  
And Function

Purpose: Cardiac valve calcification (VC) is very common in patients on hemodialysis. However, the definite effect of VC on left ventricular (LV) geometry and function in this population is unknown, especially when LV ejection fraction (LVEF) is normal. The aim of this study was to determine the effect of VC on LV geometry and function in long-term hemodialysis patients by conventional echocardiography and two-dimensional speckle tracking echocardiography (2D-STE). Methods: A total of 47 hemodialysis patients (2–3 times weekly for 5 years or more) were enrolled in this study. Cardiac VC was defined as bright echoes of more than 1 mm on one or more cusps of the aortic valve or mitral valve or mitral annulus using echocardiography as the screening method. LV longitudinal global strain (GLS) was assessed on the apical four-chamber view and calculated as the mean strain of 6 segments. LV global circumferential strain was acquired on the LV short axis view at the level of papillary muscles. Results: Twenty-five patients with VC had higher mean values of interventricular septum thickness, LV posterior wall thickness, LV mass index, relative wall thickness, and LV mass/end-diastolic volume than 22 patients without VC (p < 0.05, respectively), indicating more obvious LV hypertrophy (LVH). VC patients had higher mitral annular E/E′ values, especially at the septal side representing increased LV filling pressure compatible with diastolic dysfunction, while only the E/E′ ratio of the septal side was significantly different between the 2 groups (16.7 ± 4.1 vs. 12.3 ± 4.4, p < 0.01). When assessed by GLS, LV longitudinal systolic function was also lower in in patients with VC compared with those without VC (–0.18 ± 0.03 vs. –0.25 ± 0.04; p < 0.01). Conclusions: Cardiac VC diagnosed by echocardiography when it occurs in long-term hemodialysis patients may indicate more severe LVH, myocardial damage, and worse heart function in comparison to those without VC. Tissue Doppler imaging and 2D-STE can detect the subtle change of heart function in this population in the early stage of LV dysfunction when LVEF is normal.

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