Assessment of right ventricular systolic and diastolic parameters in pulmonary sarcoidosis

2016 ◽  
Vol 64 (3) ◽  
pp. 759-763 ◽  
Author(s):  
Emrah Ipek ◽  
Selami Demirelli ◽  
Emrah Ermis ◽  
Erkan Yıldırım ◽  
Mustafa Öztürk ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Cardiac Involvement ◽  
Systolic Pressure ◽  
Clinical Manifestations ◽  
Tissue Doppler ◽  
Pulmonary Sarcoidosis ◽  
Control Group ◽  
Cardiac Symptoms ◽  
Echocardiographic Examination ◽  
Systolic And Diastolic Function

The clinical manifestations of cardiac involvement are seen in about 5% of patients with sarcoidosis; however, the incidence of cardiac involvement is higher in the autopsy series. About 14% of patients with pulmonary sarcoidosis (PS) without known cardiac involvement had diastolic dysfunction.We aimed to determine the role of parameters of right ventricular (RV) systolic and diastolic function in patients with PS without evidence of cardiac symptoms. Our study population consisted of 28 patients with grades 1–4 PS and 24 healthy subjects. This study was a clinical prospective cohort study. RV end-diastolic area was found to be significantly higher in the PS group (p=0.032). RV fractional area change (RVFAC) and tricuspid annular plane systolic excursion (TAPSE) were shown to be statistically lower in the PS group as compared to the control group (p<0.001). However, pulmonary arterial systolic pressure was significantly higher in the PS group (p=0.003). The tricuspid E velocity and E/A ratio were found to be significantly lower in the PS group (p=0.025 and 0.009, respectively), while the tricuspid A velocity and myocardial performance index (MPI) were found to be significantly lower in the control group (p=0.034 and 0.007, respectively). Early detection of cardiac involvement in PS is crucial because of the increased morbidity and risk of sudden cardiac death. RV diastolic Doppler parameters, tissue Doppler MPI, RVFAC and TAPSE are practical and cheap techniques in the diagnosis of cardiac involvement in patients with PS. A thorough transthorasic echocardiographic examination including RV systolic and diastolic functions and tissue Doppler MPI should constitute the mainstay of initial management and follow-up in PS.

Cardiac sarcoidosis manifestations

2020 ◽  
Vol 1 (1) ◽  
pp. 42-48
Author(s):  
Olga Karpova ◽  
◽  
Leonid Dvoretsky ◽  
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Cardiac Involvement ◽  
Cardiac Sarcoidosis ◽  
Clinical Manifestations ◽  
Pulmonary Sarcoidosis ◽  
Cardiac Lesion ◽  
Cardiac Symptoms ◽  
Heart Lesion ◽  
Possible Cause

Patient with pulmonary sarcoidosis and signs of cardiac involvement under the lung symptoms improvement: case report. The possible cause of cardiac symptoms (granulomatous inflammatory response, myocardial fibrosis) is discussed. The data on morbidity, clinical manifestations and cardiac lesion diagnosis in patients with sarcoidosis is reported. The need for the heart lesion signs thorough search for the purpose of early diagnosis and adequate therapy is emphasized.

scholarly journals Echocardiographic Pulmonary to Left Atrial Ratio (ePLAR): A Comparison Study between Ironman Athletes, Age Matched Controls and A General Community Cohort

2019 ◽  
Vol 8 (10) ◽  
pp. 1756 ◽  
Author(s):  
Tran ◽  
Kwon ◽  
Holt ◽  
Kierle ◽  
Fitzgerald ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Left Atrial ◽  
Systolic Pressure ◽  
Exercise Stress ◽  
Control Group ◽  
Right Ventricular Systolic Pressure ◽  
Ventricular Systolic Pressure ◽  
General Community

Background: During exercise there is a proportionally lower rise in systemic and pulmonary pressures compared to cardiac output due to reduced vascular resistance. Invasive exercise data suggest that systemic vascular resistance reduces more than pulmonary vascular resistance. The aim of this study was the non-invasive assessment of exercise hemodynamics in ironman athletes, compared with an age matched control group and a larger general community cohort. Methods: 20 ironman athletes (40 ± 11 years, 17 male) were compared with 20 age matched non-athlete controls (43 ± 7 years, 10 male) and a general community cohort of 230 non-athletes individuals (66 ± 11 years, 155 male), at rest and after maximal-symptom limited treadmill exercise stress echocardiography. Left heart parameters (mitral E-wave, e’-wave and E/e’) and right heart parameters (tricuspid regurgitation maximum velocity and right ventricular systolic pressure), were used to calculate the echocardiographic Pulmonary to Left Atrial Ratio (ePLAR) value of the three groups. Results: Athletes exercised for 12.2 ± 0.53 minutes, age matched controls for 10.1 ± 2.8 minutes and general community cohort for 8.3 ± 2.6 minutes. Mitral E/e’ rose slightly for athletes (0.9 ± 1.8), age matched controls (0.6 ± 3.0) and non-athletes (0.4 ± 3.2). Right ventricular systolic pressure increased significantly more in athletes than in both non-athlete cohorts (35.6 ± 17 mmHg vs. 20.4±10.8mmHg and 18 ± 9.6 mmHg). The marker of trans-pulmonary gradient, ePLAR, rose significantly more in athletes than in both non-athlete groups (0.15 ± 0.1 m/s vs. 0.07 ± 0.1 m/s). Conclusions: Pulmonary pressures increased proportionally four-fold compared with systemic pressures in ironman athletes. This increase in pulmonary vascular resistance corresponded with a two-fold increase in ePLAR. These changes were exaggerated compared with both non-ironman cohorts. Such changes have been previously suggested to lead to right ventricle dysfunction, arrhythmias and sudden cardiac death.

scholarly journals The prevalence of minor heart anomalies and characteristics of intracardiac hemodynamics in patients with connective tissue dysplasia according to tissue Doppler imaging

2015 ◽  
Vol 14 (4) ◽  
pp. 42-50
Author(s):  
E. V. Fomenko ◽  
S. B. Tkachenko ◽  
N. F. Beresten ◽  
E. S. Pavochkina
Keyword(s):  
Connective Tissue ◽  
Right Ventricle ◽  
Diastolic Function ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Control Group ◽  
Tei Index ◽  
Connective Tissue Dysplasia ◽  
Systolic And Diastolic Function ◽  
The Right

Introduction and aim. Minor heart anomalies (MHA) are the visceral form of connective tissue dysplasia (CTD) that lead to a deterioration in both systolic and diastolic function of the left ventricle (LV). Information about functional state of the myocardium of the right ventricle (RV) of patients with MHA is not available widely. The aim of the study is to evaluate the frequency of occurrence of different types of MHA and features of intracardiac hemodynamic using Tissue Doppler (TD) examination of patients with CTD. Materials and methods. Total were surveyed 1240 people, of which were selected 67 patients with SHD and control group of 27 healthy persons (average age 30.1±4.0 years). Evaluation of systolic and diastolic function of LV and RV was carried out based on results of pulse-wave tissue Doppler of lateral and medial parts of the mitral fibrous annulus (MFAlat, MFFm) and tricuspid fibrous annulus (TEA), including the calculation of the index Tei. Results and discussion. The incidence of SHD was 23 %. Patients of first and second groups both have significantly higher Tei index MFAlat, MFFm and TFA, and at the same time the maximum values of Tei index were observed of patients with multiple MHA (0.50±0.09; 0.56±0.08; 0.49±0.10 standard units respectively). Conclusions. Evaluation of central hemodynamics using TD is very useful to identify disorders of myocardial performance of both the left and right ventricle. Increased Tei index is an early marker of diastolic dysfunction of both ventricles.

scholarly journals Echocardiographic assessment of arrhythmogenic right ventricular cardiomyopathy

Heart ◽  
2001 ◽  
Vol 86 (1) ◽  
pp. 31-38
Author(s):  
L Lindström ◽  
U M Wilkenshoff ◽  
H Larsson ◽  
B Wranne
Keyword(s):  
Right Ventricular ◽  
Wall Motion ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Velocity Ratio ◽  
Tissue Doppler ◽  
Doppler Velocity ◽  
Control Group ◽  
Ventricular Cardiomyopathy ◽  
Velocity Pattern ◽  
Ventricular Dimensions

OBJECTIVETo evaluate new echocardiographic modes in the diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC).DESIGNProspective observational study.SETTINGUniversity Hospital.SUBJECTS15 patients with ARVC and a control group of 25 healthy subjects.METHODSTransthoracic echocardiography included cross sectional measurements of the right ventricular outflow tract, right ventricular inflow tract, and right ventricular body. Wall motion was analysed subjectively. M mode and pulsed tissue Doppler techniques were used for quantitative measurement of tricuspid annular motion at the lateral, septal, posterior, and anterior positions. Doppler assessment of tricuspid flow and systemic venous flow was also performed.RESULTSAssessed by M mode, the total amplitude of the tricuspid annular motion was significantly decreased in the lateral, septal, and posterior positions in the patients compared with the controls. The tissue Doppler velocity pattern showed decreased early diastolic peak annular (EA) velocity and an accompanying decrease in early (EA) to late diastolic (AA) velocity ratio in all positions; the systolic annular velocity was significantly decreased only in the lateral position. Four patients had normal right ventricular dimensions and three were judged to have normal right ventricular wall motion. The patient group had also a significantly decreased tricuspid flow E:A ratio.CONCLUSIONSTricuspid annular measurements are valuable, easy to obtain, and allow quantitative assessment of right ventricular function. ARVC patients showed an abnormal velocity pattern that may be an early but non-specific sign of the disease. Normal right ventricular dimensions do not exclude ARVC, and subjective detection of early changes in wall motion may be difficult.

Pulsed and Tissue Doppler Echocardiographic Changes in Patients with Thalassemia Major

2010 ◽  
Vol 3 ◽  
pp. CMBD.S4377 ◽  
Author(s):  
Taysir S. Garadah ◽  
Salah Kassab ◽  
Najat Mahdi ◽  
Ahmed Abu-Taleb ◽  
Anwer Jamsheer
Keyword(s):  
Left Ventricle ◽  
Diastolic Function ◽  
Wave Velocity ◽  
Tricuspid Valve ◽  
Thalassemia Major ◽  
Tissue Doppler ◽  
Control Group ◽  
Pulsed Doppler ◽  
Significant Difference ◽  
Systolic And Diastolic Function

Background Doppler echocardiographic studies of left ventricle (LV) systolic and diastolic function in patients with β-Thalassemia Major (β-TM) had shown different patterns of systolic and diastolic dysfunction. Aim This cross-sectional study was designed to study the LV systolic and diastolic function in patients with β-TM using Pulsed Doppler (PD) and Tissue Doppler (TD) echocardiography. Methods All patients were evaluated clinically and by echocardiography, The study included patients with β-TM (n = 38, age 15.7 ± 8.9 years) compared with an age-matched control group (n = 38, age 15.9 ± 8.9 years). The pulse Doppler indices were normalized for age and heart rate. Results Compared with control patients, M-Mode showed that patients with β-TM have thicker LV septal wall index (0.659 ± 0.23 vs. 0.446 ± 0.219 cm, P ≤ 0.001), posterior wall index (0.659 ± 0.235 vs. 0.437 ± 0.214 cm, P ≤ 0.01), and larger LVEDD index is (3.99 ± 0.48 vs. 2.170 ± 0.57 mm. P = 0.035). Pulsed Doppler showed high LV trans-mitral E wave velocity (70.818 ± 10.139 vs. 57.532 ± 10.139, p = 0.027) and E/A ratio (1.54 vs. 1.23, P ≤ 0.01). The duration of Deceleration time (DT) and isovolumic relaxation time (IVRT) were significantly shorter in patients with β-TM (150.234 ± 20.0.23 vs. 167.123 ± 19.143 msec, P ≤ 0.01) and (60.647 ± 6.77 vs. 75.474 ± 5.83 msec, P ≤ 0.001), respectively. The ratio of transmitral E wave velocity to the tissue Doppler E wave at the basal septal mitral annulus E/Em– was significantly higher in β-TM group (14.024 ± 2.29 vs. 12.132 ± 1.82, P ≤ 0.01). The Tissue Doppler systolic velocity (Sm) and the early diastolic velocity (Em) were significantly lower in β-TM group compared to control (4.31 ± 1.2 cm/s vs. 6.95 ± 2.1, P ≤ 0.01 and 4.31 ± 2.7 cm/s vs. 5.82 ± 2.5, P ≤ 0.01) respectively. The tricuspid valve velocity was significantly higher than controls (2.993 ± 0.569 vs. 1.93 ± 0.471 m/sec, respectively, P ≤ 0.01). However, the LVEF% and fractional shortening were normal with no significant difference in both groups. Conclusion In this study, patients with β-thalassemia major compared with controls, have significantly thicker LV wall, and larger LV cavity and LV diastolic filling indices suggestive of restrictive pattern with a higher tricuspid valve velocity. These data showed that left ventricle diastolic indices are compromised initially in patients with β-thalassemia major.

scholarly journals Correlation between ductus venosus velocity and right ventricular diastolic function in fetuses with isolated single umbilical artery in third trimester

2020 ◽  
Author(s):  
Tian-gang Li ◽  
Fang Nie ◽  
Zhen-dong Li ◽  
Ping-an Qi ◽  
Qi Li ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Umbilical Artery ◽  
Tissue Doppler ◽  
Ductus Venosus ◽  
Control Group ◽  
Third Trimester ◽  
Tei Index ◽  
Single Umbilical Artery ◽  
Systolic Peak Velocity ◽  
Diastolic Functions

Abstract Background The cardiac diastolic functions in fetuses with isolated single umbilical artery (SUA) in the third trimester were ealuated using the spectrum of blood flow in the fetal ductus venosus (DV). Methods Color Doppler was employed to visualize the spectra of the fetal DV and tricuspid orifice in 34 fetuses with isolated SUA aged 28–39 weeks and in age-matched healthy controls. The DV flow velocities and velocity ratios were measured. The E/A ratio at the tricuspid orifice and tissue Doppler Tei index of fetal right ventricular in the two groups were measured. Results During the third trimester, the DV atrial systolic peak velocity “a” was lower in the isolated SUA group than in the control group ( P < 0.05). The correlations between the velocity ratios and the E/A ratio at the tricuspid orifice in the two groups were analyzed, and the correlation between the v/D and E/A ratios was the best (R 2 of 0.520 in the isolated SUA group and 0.358 in the control group). The correlations between the velocity ratios and the tissue Doppler Tei index of fetal right ventricular in the two groups were analyzed, and the correlation between the PIV and tissue Doppler Tei index ratios was the best (R 2 of 0.865 in the isolated SUA group and 0.627 in the control group). Conclusions In the isolated SUA group, the atrial systolic peak velocity “a” decreased, which might be related to changes in fetal cardiac functions. v/D was more closely related to the E/A ratio at the tricuspid valve and could be used to identify changes earlier in the isolated and healthy fetuses’ right ventricular diastolic functions. PIV was more closely related to the tissue doppler Tei index of fetal right ventricular and could be used to identify the isolated and healthy fetuses’ right ventricular overall functions.

Abstract 2302: Adeno-associated Virus-mediated Prostaglandin I Synthase Gene Transfer Improved The Hypoxia-induced Pulmonary Hypertension In Mice

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Takashi Kawakami ◽  
Hideaki Kanazawa ◽  
Toru Satoh ◽  
Masaki Ieda ◽  
Yasuyo Ieda ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Gene Transfer ◽  
Right Ventricular ◽  
Histological Analysis ◽  
Systolic Pressure ◽  
Thigh Muscle ◽  
Control Group ◽  
Right Ventricular Systolic Pressure ◽  
Adeno Associated Virus ◽  
Ventricular Systolic Pressure

Background: Although prostaglandin I 2 and its derivatives are clinically used for the treatment of pulmonary hypertension, continuous intravenous administration is required for the effective treatment. Prostaglandin I 2 synthase (PGIS) is one of the most powerful therapeutic genes against pulmonary hypertension (PH). The purpose of this study was to investigate whether the human PGIS (hPGIS) gene transfer using adeno-associated virus (AAV) vector into the skeletal muscle was effective to the hypoxia induced-pulmonary hypertension in mice. Methods and Results: PH was induced in the mice subjected to hypoxic chamber (O2 10%) for 8 weeks. Right ventricular systolic pressure (RVSP) significantly increased in PH group compared with control group. In the gene transferred group (AAV1-hPGIS), the AAV type1-hPGIS (2.0×10 11 v.g./body) vector was injected into the left thigh muscle at 24 hour after exposure to hypoxia. Saline injected mice were served as control group. After 8 weeks, hemodynamics and histological analysis was performed. AAV1-PGIS significantly decreased right ventricular systolic pressure to 26±5 mmHg compared with PH group (40±4 mmHg). Systemic blood pressure did not significantly decrease AAV-hPGIS treated group. QT-PCR revealed that PH group increased BNP mRNA in RV by 6-fold higher, while AAV1-hPGIS group decreased to 1.3-fold compared with the control group. Histological analysis revealed that PH group showed severe medial thickening of the pulmonary artery, and increased %wall thickness to 33.3±7.3%, while AAV1-hPGIS decreased to 17±3.6 %. RT-PCR revealed that the hPGIS gene expression was detected only at the injected side, but not in the liver, kidney, heart, and the other organs. Histological analysis showed no pathological changes at the injected skeletal muscles. Finally, Kaplan-Mayer analysis revealed that PH group showed 47% survival at 12 weeks wile AAV1-hPGIS group showed 73%, indicating that AAV1-hPGIS treatment significantly increased the survival of PH. Conclusions: Our study demonstrated that the AAV1-mediaqted gene transfer of PGIS was effective to treat the hypoxia-induced pulmonary hypertension in mice, and can prolong the survival of these animals.

Sign in / Sign up

Export Citation Format

Share Document