Progressive Subclinical Left Ventricular Systolic Dysfunction in Severe Aortic Regurgitation Patients with Normal Ejection Fraction: A 24 Months Follow-Up Velocity Vector Imaging Study

2011 ◽  
Vol 28 (8) ◽  
pp. 886-891 ◽  
Author(s):  
Selen Yurdakul ◽  
Yelda Tayyareci ◽  
Ozlem Yildirimturk ◽  
Fusun Behramoglu ◽  
Zeynep Colakoglu ◽  
...  
Author(s):  
N. P. Mitkovskaya ◽  
E. M. Balysh ◽  
T. V. Statkevich ◽  
N. A. Ladygina ◽  
E. B. Petrova ◽  
...  

The aim of the study was to investigate the features of clinically suspected myocarditis complicated by the left ventricular systolic dysfunction development. 93 patients with clinically suspected myocarditis were examined. The average age was 36.63 ± 1.15 years. In 43.01 % of patients the disease was accompanied by a decrease in left ventricular systolic function. In the group of patients with left ventricular systolic dysfunction in comparison with those with preserved left ventricular ejection fraction, a significantly lower proportion of men (75 % versus 81 %, respectively, χ2 = 9.3, p < 0,01) and a higher average group age (40.7 ± 1.87 versus 33.6 ± 1.3 years, respectively, p <  0,01) were revealed. The course of the disease in patients with left ventricular systolic dysfunction was characterized by a more frequent development of rhythm disturbances (65 % versus 43.3 %, respectively, χ2  = 4.3, p  < 0,05) and a higher heart rate at admission (94.5 (75‒100) and 85 (70‒89) beats per minute, respectively, p = 0.006). The structural and functional state of the heart according to echocardiography in patients with a reduced left ventricular ejection fraction versus comparison group was characterized by larger heart chambers sizes, more pronounced violations of local left ventricular contractility, more frequent involvement of the right ventricle in the pathological process (56.3  % versus 22.2  %, respectively, χ2   =  6.4, p  < 0,05). The relationships between the left ventricular ejection fraction Весці Нацыянальнай акадэміі навук Беларусі. Серыя медыцынскіх навук. 2020. Т. 17, № 4. C. 452–460 453 and the patient’s age (r = ‒0.36), the value of the heart rate at admission (r = ‒0.32), the severity of heart failure at admission, the degree of impaired local contractility of the left ventricle, the degree of right ventricular function (TAPSE, r  =  0.58), the severity of myocardial fibrosis according to cardiovascular magnetic resonance imaging (r = ‒0.32) were revealed.


2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Umut Kocabaş ◽  
Özgür Yılmaz ◽  
Volkan Kurtoğlu

Abstract Background Diabetic cardiomyopathy (DC) is defined as a ventricular diastolic and/or systolic dysfunction, which is directly related to diabetes mellitus (DM) in the absence of coronary artery disease, valvular, congenital or hypertensive heart disease, and alcoholism. In this report, we present an unusual case of a patient with DC and reversible, acute left ventricular systolic dysfunction due to cardiotoxicity of hyperosmolar hyperglycaemic state (HHS). Case summary A 20-year-old male patient presented with weakness and polyuria. Physical examination and electrocardiogram were normal. Laboratory results and arterial blood gas analysis were consistent with HHS. Baseline echocardiography showed global left ventricular hypokinesis with an ejection fraction (EF) of 36%. The patient’s clinical condition improved after blood glucose level normalization and echocardiography revealed progressive improvement in the left ventricular systolic function with an EF of 54% at the 5-day follow-up and an EF of 69% at the 15-day follow-up. Discussion Uncontrolled DM and hyperglycaemic crisis may result in cardiotoxicity, acute left ventricular systolic dysfunction, and DC. The pathophysiological mechanism of this phenomenon is still unclear. Blood glucose control is the most important strategy for the prevention of DC.


2015 ◽  
Vol 17 (1) ◽  
pp. 5
Author(s):  
A. M. Karaskov ◽  
I. I. Demin ◽  
S. I. Zheleznev ◽  
A. V. Bogachev-prokofev ◽  
R. M. Sharifulin ◽  
...  

The Ross procedure outcomes in patients with left ventricular dysfunction are presented. 20 Ross procedures were performed in patients with aortic disease complicated by severe left ventricular dysfunction. The average left ventricular ejection fraction before surgery was 31,56,57%. Aortic stenosis was found in 60% of cases. Hospital mortality rate was 5%. Heart failure prevailed among complications. It was already in the early postoperative period that significant left ventricular remodeling was observed. The patients with aortic stenosis demonstrated a 56,9 % increase in ejection fraction, while their end-systolic diameter and end-systolic volume decreased by 34,5% and 13,3% respectively. In the group with aortic insufficiency there was a statistically significant reduction in the left ventricular volume indices: left ventricular end-diastolic diameter by 20%, left ventricular end-diastolic volume by 36,5%. No reoperation due to dysfunction of the autograft and conduits in the pulmonary artery area was required. At 12 months after surgery the processes of left ventricular cavity remodeling and normalization of contractility in both groups continued. The results of this study show that the Ross procedure can be used successfully in patients with severe left ventricular systolic dysfunction.


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