Early Left Ventricular Longitudinal Systolic Dysfunction and Cardiovascular Risk Factors in 1,371 Asymptomatic Subjects with Normal Ejection Fraction: A Tissue Doppler Study

Left ventricular systolic dysfunction without heart failure (HF), also known as asymptomatic left ventricular systolic dysfunction (ALVSD), is at least as prevalent in the general population as left ventricular systolic dysfunction with heart failure (HF-LVSD). However, the clinical characteristics of ALVSD have not been well defined in an elderly population. Our aim is to evaluate the clinical features of elderly community-based individuals with ALVSD. The Cardiovascular Health Study is a multicenter cohort study designed to assess cardiovascular risk factors and outcomes in a population 65 years and older. This study quantifies baseline demographic variables and cardiovascular risk factors in participants with ALVSD. Comparisons were made with two reference groups: individuals with HF-LVSD, and those with normal left ventricular systolic function without HF (NL-LVSF). ALVSD was present in 385 of 5152 participants (7.5%) at baseline, whereas HF-LVSD was present in 84 participants (1.6%). Among those with ALVSD, 251 (65.2%) had borderline ejection fraction (EF) (45–54%), and 134 (34.8%) had impaired EF (< 45%). ALVSD was associated with elevated cardiovascular risk factors and comorbidities compared to NL-LVSF but lower than those in individuals with HF-LVSD (see table ). Among participants with ALVSD, impaired EF was associated with male sex and higher prevalence of coronary disease and LVH compared with borderline LV function. ALVSD is more common than HF-LVSD in community-dwelling elderly individuals. Furthermore, it is characterized by more cardiac risk factors and comorbidities than those with NL-LVSF, but less than those with HF-LVSD. The severity of systolic dysfunction is associated with comorbid cardiovascular risk factors. ALVSD may identify an important group of individuals at high risk for heart failure and cardiovascular mortality. Comparison of Clinical Characteristics Between ALVSD, NL-LVSF, and HF-LVSD

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Soluble ST2 and CXCL-10 may serve as biomarkers of subclinical diastolic dysfunction in SLE and correlate with disease activity and damage

Lupus ◽

10.1177/0961203320947805 ◽

2020 ◽

Vol 29 (11) ◽

pp. 1430-1437

Author(s):

Ehud Chorin ◽

Aviram Hochstadt ◽

Uri Arad ◽

Eihab Ghantous ◽

Smadar Gertel ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Disease Activity ◽

Diastolic Dysfunction ◽

Cardiovascular Risk Factors ◽

Myocardial Dysfunction ◽

Damage Index ◽

Tissue Doppler ◽

Soluble St2 ◽

Doppler Study

Objective Subclinical myocardial dysfunction has been reported to occur early in systemic lupus erythematous (SLE). The study aim was to search for biomarkers of subclinical myocardial dysfunction which may correlate with disease activity in SLE patients. Methods This is a prospective, controlled, cross-sectional study of 57 consecutive patients with SLE and 18 controls. Serum samples were obtained to determine serum soluble ST2 (sST2), CXCL-10 and high-sensitivity troponin (hs-troponin) levels. All participants underwent an echocardiographic tissue Doppler study. Results sST2, CXCL-10 and hs-troponin levels were higher in patients with higher SLE disease activity (SLEDAI). sST2 and CXCL-10 levels were higher in patients with more disease damage as measured by the SLE damage index. Measures of diastolic dysfunction, as assessed by echocardiographic tissue Doppler negatively correlated with log CXCL-10: including E/A; E/e′lateral and E/e′septal, while E/e′ positively correlated with CXCL-10. Diastolic dysfunction parameters also correlated with log sST2 levels, a negative correlation was seen with E/e′lateral and a positive correlation was seen with E/e′. Systolic dysfunction parameters positively correlated with hs-troponin: LVED, LVES, IVS, LVMASS and LVMASS index. In a multivariate analysis, sST2 and CXCL-10 were found to be significantly different in SLE vs. healthy controls, independent of each other and independent of cardiovascular risk factors. Conclusions Soluble ST2 and CXCL-10 are markers of disease activity and accrued damage in SLE and may serve as sensitive biomarkers for detection of subclinical diastolic dysfunction, independent of traditional cardiovascular risk factors.

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ECHOCARDIOGRAPHIC FINDINGS IN PATIENTS WITH NORMOCALCEMIC PRIMARY HYPERPARATHYROIDISM COMPARED TO HYPERCALCEMIC PRIMARY HYPERPARATHYROID PATIENTS AND CONTROL SUBJECTS

Endocrine Practice ◽

10.4158/ep-2020-0405 ◽

2020 ◽

Author(s):

Jessica Pepe ◽

Luciano Colangelo ◽

Chiara Sonato ◽

Marco Occhiuto ◽

Carla Ferrara ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Ejection Fraction ◽

Primary Hyperparathyroidism ◽

Cardiovascular Risk Factors ◽

Urinary Calcium ◽

Left Ventricular ◽

Ionized Calcium ◽

Echocardiographic Parameters ◽

Echocardiographic Findings

Objective: There are no data regarding echocardiographic parameters in patients with normocalcemic primary hyperparathyroidism (NCPHPT). Our aim was to compare the echocardiographic findings in postmenopausal women with NCPHPT with those found in patients with hypercalcemic primary hyperparathyroidism (PHPT) and with controls. Methods: Seventeen consecutive Caucasian postmenopausal women with NCPHPT were compared to 20 hypercalcemic PHPT and 20 controls. Obesity, diabetes, kidney failure and previous cardiovascular diseases were considered exclusion criteria. Each patient underwent biochemical evaluation, bone mineral density scan and echocardiographic measurements. Patients with parathyroid disorder underwent kidney ultrasound evaluation. Results: PHPT patients had significantly mean higher total, ionized calcium, 24-hour urinary calcium, PTH and lower phosphorus compared to controls (all p <0.05). The only differences between NCPHPT and PHPT patients were significantly mean lower total, ionized calcium, 24-hour urinary calcium and higher phosphorus in NCPHPT (all p <0.05). The only biochemical difference between NCPHPT and controls was mean higher levels of PTH in patients with NCPHPT. There were no differences in cardiovascular risk factors between NCPHPT, PHPT and controls. Hypertension was the most frequent cardiovascular risk factor, diagnosed in 65% of PHPT patients. This high prevalence was not statistically different compared to that observed in NCPHT (59%) and in controls (30%). Echocardiography parameters were not different between NCPHPT, PHPT and controls subdivided according to the presence of hypertension (ANOVA followed by Bonferroni correction). Conclusions: In a population not at high cardiovascular risk, we found no differences in cardiovascular risk factors and echocardiographic parameters between NCPHPT, PHPT and controls. Abbreviations: NCPHPT = normocalcemic primary hyperparathyroidism, PHPT = hypercalcemic primary hyperparathyroidism, PTH = parathyroid hormone, PTX = parathyroidectomy, CA = total serum calcium, CA++= ionized calcium, P = phosphorus, CR = creatinine, [25(OH)D]= 25-OH-vitamin D, 24-UCa= 24- hour urinary calcium, GFR= glomerular filtration rate, HDL= lower high-density lipoprotein, LVM= left ventricular mass, LVEF= left ventricular ejection fraction LVEDD = left ventricular end-diastolic diameter, IVS= interventricular septum thickness, PWT= posterior wall thickness, LA= transverse diameter of left atrium, EF %= ejection fraction, E/A ratio= early transmitral diastolic flow (E) and flow velocity during atrial contraction (A) ratio, LVMI= left ventricular mass indexed, IVRT= isovolumetric relaxation time, DXA= dual X-ray absorptometry, BMI= body mass index, ANOVA= analysis of variance.

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Myocardial T1 mapping in asymptomatic subjects: variations according to left ventricular segments and correlation with cardiovascular risk factors

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/1532-429x-18-s1-p119 ◽

2016 ◽

Vol 18 (S1) ◽

Cited By ~ 1

Author(s):

Moon Young Kim ◽

Soo Jin Cho ◽

Yeon Hyeon Choe ◽

Hae Jin Kim ◽

Sung Mok Kim ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

T1 Mapping ◽

Left Ventricular ◽

Myocardial T1 ◽

Asymptomatic Subjects

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Disease activity is associated with reduced left ventricular systolic myocardial function in patients with rheumatoid arthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-209223 ◽

2016 ◽

Vol 76 (2) ◽

pp. 371-376 ◽

Cited By ~ 20

Author(s):

Helga Midtbø ◽

Anne Grete Semb ◽

Knut Matre ◽

Tore K Kvien ◽

Eva Gerdts

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Ejection Fraction ◽

Disease Activity ◽

Cardiovascular Risk Factors ◽

Myocardial Function ◽

Systolic Function ◽

Left Ventricular ◽

Lv Ejection Fraction ◽

Lv Systolic Function

ObjectivesDisease activity has emerged as a new, independent risk factor for cardiovascular disease in patients with rheumatoid arthritis (RA). We tested if disease activity in RA was associated with lower left ventricular (LV) systolic function independent of traditional cardiovascular risk factors.MethodsEchocardiographic assessment was performed in 78 patients with RA having low, moderate or high disease activity (Simplified Disease Activity Index (SDAI) >3.3), 41 patients in remission (SDAI ≤3.3) and 46 controls, all without known cardiac disease. LV systolic function was assessed by biplane Simpson ejection fraction, stress-corrected midwall shortening (scMWS) and global longitudinal strain (GLS).ResultsPatients with active RA had higher prevalence of hypertension and diabetes compared with patients in remission and controls (both p<0.05). LV ejection fraction (endocardial function) was normal in all three groups, while mean scMWS and GLS (myocardial function) were reduced in patients with RA with active disease compared with patients with RA in remission (95±18% vs 105±17% and −18.9±3.1% vs −20.6±3.5%, respectively, both p<0.01). Patients with RA in remission had similar scMWS and GLS as the controls. In multivariable analyses, having active RA was associated with lower GLS (β=0.21) and scMWS (β=−0.22, both p<0.05), both reflecting lower LV systolic myocardial function, independent of cardiovascular risk factors and LV ejection fraction. Classification of RA disease activity by other disease activity composite scores yielded similar results.ConclusionsActive RA is associated with lower LV systolic myocardial function despite normal ejection fraction and independent of traditional cardiovascular risk factors.

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Left Ventricular Myocardial T1 Values and Extracellular Volume Fraction in Asymptomatic Subjects: Variations According to Left Ventricular Segments and Correlation with Cardiovascular Risk Factors

10.21203/rs.3.rs-1041288/v1 ◽

2021 ◽

Author(s):

Moon Young Kim ◽

Soo Jin Cho ◽

Hae Jin Kim ◽

Sung Mok Kim ◽

Sang-Chol Lee ◽

...

Keyword(s):

Risk Factors ◽

Renal Function ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Volume Fraction ◽

Extracellular Volume ◽

Extracellular Volume Fraction ◽

Left Ventricular ◽

Myocardial T1 ◽

Asymptomatic Subjects

Abstract Purpose: To evaluate the normal range and variation in pre-contrast (preT1) and post-contrast (postT1) myocardial T1 values and extracellular volume fraction (ECV) according to left ventricular (LV) segments and to check for correlations between them and known cardiovascular risk factors.Methods: This study included 233 asymptomatic subjects (210 men and 23 women; aged 54.1±6.0 years) who underwent cardiac magnetic resonance imaging with preT1 and postT1 mapping on a 1.5-T scanner. T1 values and ECVs were compared among LV segments, age groups, and sex, and correlated with renal function. Based on the presence of hypertension (HTN) and diabetes mellitus (DM), the subjects were subdivided into the control (n=121), HTN (n=58), DM (n=25), and HTN and DM (HTN-DM) groups (n=29).Results: T1 values and ECV showed significant differences between the basal septal and lateral segments (p≤0.001) and between the mid-septal and mid-lateral segments (PreT1 p≤0.003, postT1 and ECV p<0.001). Among subgroups according to the HTN and DM status, the HTN-DM group showed a significantly higher ECV (0.260±0.023) than the control (0.240±0.021, p=0.011) and HTN (0.241±0.024, p=0.041) groups. Overall postT1 and ECV of the LV had significant correlation with the estimated glomerular filtration rate (r = 0.19, p=0.038 for postT1; r = -0.23, p=0.011 for ECV).Conclusion: Septal segments show higher preT1 and ECV but lower postT1 than lateral segments at the mid-ventricular and basal levels. ECV is significantly affected by cardiovascular risk factors such as HTN, DM, and decreased renal function, even in asymptomatic subjects.

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