scholarly journals Association of smoking and right ventricular function in middle age: CARDIA study

Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001270
Author(s):  
Henrique T Moreira ◽  
Anderson C Armstrong ◽  
Chike C Nwabuo ◽  
Henrique D Vasconcellos ◽  
Andre Schmidt ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Ventricular ◽  
Diastolic Function ◽  
Middle Age ◽  
Systolic Function ◽  
Left Ventricular ◽  
Significant Difference ◽  
Former Smokers ◽  
Never Smokers ◽  
Diastolic Functions

ObjectiveTo evaluate the association of cigarette smoking and right ventricular (RV) systolic and diastolic functions in a population-based cohort of individuals at middle age.MethodsThis cross-sectional study included participants who answered the smoking questionnaire and underwent echocardiography at the Coronary Artery Risk Development in Young Adulthood year 25 examination. RV systolic function was assessed by echocardiographic-derived tricuspid annular plane systolic excursion (TAPSE) and by right ventricular peak systolic velocity (RVS’), while RV diastolic function was evaluated by early right ventricular tissue velocity (RVE’). Multivariable linear regression models assessed the relationship of smoking with RV function, adjusting for age, sex, race, body mass index, systolic blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, diabetes mellitus, alcohol consumption, pulmonary function, left ventricular systolic and diastolic function and coronary artery calcium score.ResultsA total of 3424 participants were included. The mean age was 50±4 years; 57% were female; and 53% were black. There were 2106 (61%) never smokers, 750 (22%) former smokers and 589 (17%) current smokers. In the multivariable analysis, current smokers had significantly lower TAPSE (β=−0.082, SE=0.031, p=0.008), RVS’ (β=−0.343, SE=0.156, p=0.028) and RVE’ (β=−0.715, SE=0.195, p<0.001) compared with never smokers. Former smokers had a significantly lower RVE’ compared with never smokers (β=−0.414, SE=0.162, p=0.011), whereas no significant difference in RV systolic function was found between former smokers and never smokers.ConclusionsIn a large multicenter community-based biracial cohort of middle-aged individuals, smoking was independently related to both worse RV systolic and diastolic functions.

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 P797 Assessment of right ventricular systolic function with 3D echocardiography following cardiac resynchronization therapy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Jenei ◽  
E Papp ◽  
M Clemens ◽  
Z Csanadi
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Right Ventricular ◽  
Systolic Function ◽  
Left Ventricular ◽  
3D Echocardiography ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
S Wave ◽  
Ventricular Systolic Function ◽  
Significant Difference

Abstract Background In approximately 30-40% of cases, the left ventricular systolic function does not improve following cardiac resynchronization therapy (CRT; non-responders). Currently, the role of right ventricular (RV) systolic function is not yet completely clear in the background. Our aim was to assess the RV systolic function with 3D echocardiography in CRT patients. Methods We selected 19 patients who received CRT in our department between May and June 2017, and whose 1-year follow-up data were available. We characterized several 2D parameters of RV systolic function, such as RV free wall strain (RV GLSFW), annular s’ wave velocity (TDI s), tricuspid annulus plane systolic excursion (TAPSE), RV fractional area change (RV FAC). A number of 3D parameters were also assessed, such as RV ejection fraction (EF), end-diastolic (EDV) and end-systolic (ESV) volumes, using a dedicated RV analysis software. Moreover, we measured the LV EF and considered the patients "responder", when the LV EF improved with at least 10% after CRT implantation. Results From 19 patients, 12 was identified as responders (R) and 7 as non-responders (NR). No significant difference was seen in the mean age of patients in the two groups (NR: 68 ± 6 year; R: 67 ± 9 year, p = 0.76), however, the proportion of male individuals was higher in the NR group (8/12 vs. 1/7). The RV EF was higher in the R group (41 ± 8% vs.29 ± 10%; p = 0.012), while the EDV or ESV did not differ between the two groups. The RV GLSFW (–21.2 ± 7% vs.–13.9 ± 7%, p = 0.045) and the TAPSE (16.8 ± 5 mm vs.11.4 ± 3 mm, P = 0.03) values were significantly different between the two groups. Based on logistic regression analysis, the RV EF was an independent predictor of non-respondence. Conclusions The lower RV EF indicates non-respondence to CRT, however, it is not associated with RV dilation, i.e.adverse remodelling. These results suggest mechanical abnormality of RV function in the background of impaired EF.

scholarly journals The Effect of Regular Physical Activity on the Left Ventricle Systolic Function in Patients With Chronic Coronary Artery Disease

2011 ◽  
pp. 869-875
Author(s):  
R. PANOVSKÝ ◽  
P. KUKLA ◽  
R. JANČÁR ◽  
J. MELUZÍN ◽  
J. JANČÍK ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Systolic Function ◽  
Left Ventricular ◽  
Maximal Load ◽  
Significant Difference ◽  
Left Ventricle Systolic Function ◽  
Artery Disease

The purpose of this study was to assess the influence of aerobic training on the left ventricular (LV) systolic function. Thirty patients with stable coronary artery disease, who had participated in the conducted 3-month physical training, were retrospectively divided into 2 cohorts. While patients in the cohort I (n=14) had continued training individually for 12 months, patients in the cohort II (n=16) had stopped training after finishing the conducted program. Rest and stress dobutamine/atropine echocardiography was performed in all patients before the training program and 1 year later. The peak systolic velocities of mitral annulus (Sa) were assessed by tissue Doppler imaging for individual LV walls. In addition, to determine global LV systolic longitudinal function, the four-site mean systolic velocity was calculated (Sa glob). According to the blood supply, left ventricular walls were divided into 5 groups: A- walls supplied by nonstenotic artery; B- walls supplied by coronary artery with stenosis ≤ 50 %; C- walls supplied by coronary artery with stenosis 51-70 %; D- walls with stenosis of supplying artery 71-99 %; and E- walls with totally occluded supplying artery. In global systolic function, the follow-up values of Sa glob in cohort I were improved by 0.23±0.36 as compared with baseline values at rest, and by 1.26±0.65 cm/s at the maximal load, while the values of Sa glob in cohort II were diminished by 0.53±0.22 (p=NS), and by 1.25±0.45 cm/s (p<0.05), respectively. Concerning the resting regional function, the only significant difference between cohorts in follow-up changes was found in walls E: 0.37±0.60 versus –1.76±0.40 cm/s (p<0.05). At the maximal load, the significant difference was found only in walls A (0.16±0.84 versus –2.67±0.87 cm/s; p<0.05). Patients with regular 12-month physical activity improved their global left ventricle systolic function mainly due to improvement of contractility in walls supplied by a totally occluded coronary artery.

scholarly journals Associations between IL-6 and Echo-Parameters in Patients with Early Onset Coronary Artery Disease

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 189 ◽  
Author(s):  
Natalia Pauli ◽  
Kamila Puchałowicz ◽  
Agnieszka Kuligowska ◽  
Andrzej Krzystolik ◽  
Violetta Dziedziejko ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Function ◽  
Right Ventricular ◽  
Early Onset ◽  
Left Ventricular ◽  
Coronary Syndrome ◽  
Coronary Artery Atherosclerosis ◽  
Significant Difference ◽  
Artery Disease

Background: Over the last two decades, many studies have investigated the association between interleukin 6 (IL-6) and pathogenesis and progression of coronary artery disease (CAD). Patients with CAD manifested at a young age are a particularly interesting group. They differ from older patients, not only in terms of the severity of coronary artery atherosclerosis, but also risk factor profiles, short- and long-term prognosis after myocardial infarction (MI). The role of IL-6 in younger patients with CAD is less well-known. Therefore, our study aimed to analyze the relationship between IL-6 level and other inflammations, atherosclerosis, and cardiac function parameters in early onset CAD patients. Methods: The study covered 100 patients with early onset CAD and a group of 50 healthy participants. Plasma levels of IL-6 and basic biochemical parameters, anthropometric, echocardiographic, and arteries Doppler ultrasound measurements were performed. Results: We did not observe a significant difference in IL-6 concentration in plasma between patients with early onset CAD and a control group, but IL-6 level was negatively correlated with echocardiographic measurements of ascending aorta diameter, left ventricular shortening fraction, and right ventricular end-diastolic diameter in our patients. Conclusions: In patients with early onset CAD, plasma IL-6 level is associated with other inflammation parameters and with cardiac function, potentially contributing to right ventricular remodeling and left ventricular systolic dysfunction. This suggests possible prognostic benefits of long-time observation of IL-6 level after the acute coronary syndrome.

scholarly journals Severity of structural and functional right ventricular remodeling depends on training load in an experimental model of endurance exercise

2017 ◽  
Vol 313 (3) ◽  
pp. H459-H468 ◽  
Author(s):  
Maria Sanz-de la Garza ◽  
Cira Rubies ◽  
Montserrat Batlle ◽  
Bart H. Bijnens ◽  
Lluis Mont ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Diastolic Function ◽  
Cardiac Remodeling ◽  
Ventricular Remodeling ◽  
Contractile Function ◽  
Systolic Function ◽  
Training Model ◽  
Left Ventricular ◽  
Physiological Adaptation ◽  
Exercise Load

Arrhythmogenic right ventricular (RV) remodeling has been reported in response to regular training, but it remains unclear how exercise intensity affects the presence and extent of such remodeling. We aimed to assess the relationship between RV remodeling and exercise load in a long-term endurance training model. Wistar rats were conditioned to run at moderate (MOD; 45 min, 30 cm/s) or intense (INT; 60 min, 60 cm/s) workloads for 16 wk; sedentary rats served as controls. Cardiac remodeling was assessed with standard echocardiographic and tissue Doppler techniques, sensor-tip pressure catheters, and pressure-volume loop analyses. After MOD training, both ventricles similarly dilated (~16%); the RV apical segment deformation, but not the basal segment deformation, was increased [apical strain rate (SR): −2.9 ± 0.5 vs. −3.3 ± 0.6 s−1, SED vs. MOD]. INT training prompted marked RV dilatation (~26%) but did not further dilate the left ventricle (LV). A reduction in both RV segments' deformation in INT rats (apical SR: −3.3 ± 0.6 vs. −3.0 ± 0.4 s−1 and basal SR: −3.3 ± 0.7 vs. −2.7 ± 0.6 s−1, MOD vs. INT) led to decreased global contractile function (maximal rate of rise of LV pressure: 2.53 ± 0.15 vs. 2.17 ± 0.116 mmHg/ms, MOD vs. INT). Echocardiography and hemodynamics consistently pointed to impaired RV diastolic function in INT rats. LV systolic and diastolic functions remained unchanged in all groups. In conclusion, we showed a biphasic, unbalanced RV remodeling response with increasing doses of exercise: physiological adaptation after MOD training turns adverse with INT training, involving disproportionate RV dilatation, decreased contractility, and impaired diastolic function. Our findings support the existence of an exercise load threshold beyond which cardiac remodeling becomes maladaptive. NEW & NOTEWORTHY Exercise promotes left ventricular eccentric hypertrophy with no changes in systolic or diastolic function in healthy rats. Conversely, right ventricular adaptation to physical activity follows a biphasic, dose-dependent, and segmentary pattern. Moderate exercise promotes a mild systolic function enhancement at the right ventricular apex and more intense exercise impairs systolic and diastolic function.

scholarly journals P316 A feasible and accurate method for the assessment of early ventricular dysfunction in children with kawasaki disease: result from the MyoWoRK (myocardial work related to kawasaki disease) study

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N S Borrelli ◽  
G Di Salvo ◽  
J Sabatino ◽  
M Avesani ◽  
E Filippini ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Systolic Function ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Unknown Etiology ◽  
Male Age ◽  
Significant Difference ◽  
Global Work ◽  
Lv Systolic Function

Abstract Funding Acknowledgements EACVI Training Grant Introduction Kawasaki disease (KD) is an acute vasculitis of unknown etiology. It is associated with high morbidity and mortality due to the development of coronary artery aneurysms and myocardial dysfunction. Purpose The aim of this study was to evaluate sensitivity and specificity of left ventricular (LV) pressure–strain loop (PSL) area, which reflects regional myocardial work and metabolic demand, in predicting subtle myocardial abnormalities in KD patients with coronaries aneurisms. Methods A total of 88 patients (59 male, age 8.95 ± 4.95 years) were included in our study. Among the children admitted in our institution with a diagnosis of KD during the study time frame, 42 patients (KDg) (29 male) with coronary artery dilatation (Z-score &gt;2.5) were selected. These cases were compared with 46 (30 male) age-matched controls (CTRg). Classical echocardiographic parameters of LV systolic function were normal in both groups, while global longitudinal strain (GLS) was decreased in 6 KD patients. Global work index (GWI) was calculated as the area of the LV PSL. From GWI, it was estimated also Global Constructive Work (GCW), Global Wasted Work (GWW) and Global Work Efficiency (GWE). We also made a subgroup analysis between KD patients with normal GLS (&gt; -19 %) and control patients. Results Despite normal LV systolic function by routine echocardiography, compared to controls, KD patients had lower GWI (1448 ± 382 mmHg% in KDg vs 1751 ± 263] mmHg% in CTRg, p = 0.00003), GCW (1904 ± 390 mmHg% in KDg vs 2174 ± 292 mmHg% in CTRg, p= 0.0004) and GWE (94 ± 5 % in KDg vs 96 ± 2 % in CTRg, p= 0.01). There was not significant difference in GWW between the KDg and CTRg. When KD patients with normal GLS were analysed separately, they preserved a significant difference in GWI, GCW and GWE in comparison with controls (GWI: 1490 ± 347 mmHg% in KDg vs 1751 ± 263 mmHg% in CTRg, p = 0.0002; GCW: 1972 ± 321 mmHg% in KDg vs 2174 ± 292 mmHg% in CTRg, p = 0.004; GWE: 95 ± 3 in KDg vs 96 ± 2 % in CTRg, p= 0.04). No association was found between GWI, GCW, GWW, GWE and number or dimension of the involved aneurysmatic coronaries. Conclusions The estimation of myocardial work by PSL is a novel tool for the evaluation of patients with KD. GWI, GCW and GWE were significantly reduced in KD patients with dilated coronaries. In KD patients with normal GLS, estimation of GWI, GCW and GWE may be a sensitive indicator of myocardial dysfunction and an adjuvant criterion to avoid delayed diagnosis of KD. Abstract P316 Figure. Myocardial work in KD and CTR.

scholarly journals A comparative analysis of British and American Society of Echocardiography recommendations for the assessment of left ventricular diastolic function

2018 ◽  
pp. 139-147 ◽  
Author(s):  
P Luke ◽  
C Eggett ◽  
I Spyridopoulos ◽  
T Irvine
Keyword(s):  
Diastolic Function ◽  
Systolic Function ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
British Society ◽  
Ventricular Diastolic Function ◽  
Primary Indication ◽  
Significant Difference ◽  
American Society ◽  
Grade One

At present there are two recognised guidelines for the echocardiographic assessment of left ventricular diastolic function provided by the British Society of Echocardiography and American Society of Echocardiography/European Association of Cardiovascular Imaging. However, no direct comparison of these guidelines has been performed to establish whether they provide similar diastolic grading. One hundred and eighty-nine consecutive patients in sinus rhythm who underwent transthoracic echocardiography for a primary indication of either heart failure assessment or assessment of left ventricular systolic function were extracted from our database (McKesson Cardiology). Left ventricular diastolic function assessment was performed using both guidelines and the results were compared. Chi-square, Kappa score and one-way ANOVA were used to evaluate the data at a level of P < 0.05. The most frequent outcome was unclassifiable diastolic function with significantly more patients being labelled unclassified with the British compared to American guidelines (47.4 vs 20.5%, P < 0.0001). Having excluded all unclassifiable patients, a significant difference still existed between the two guidelines with a higher proportion of grade one outcomes awarded by the ASE/EACVI guidelines. When grading subcategories were individually compared, there was significantly more grade one diastolic gradings awarded by American compared to the British guidelines (40.7 vs 20.1%, P < 0.0001). In 47% of patients it was not possible to grade diastolic function using the British guidelines, compared to 21% using the American guidelines. For those patients where grading was possible, there was a significant difference in patients classified with normal and grade one diastolic function when using British and American guidelines.

scholarly journals Correlation between Serum Ferritin and Heart Function In Children With Major Thalassemia At RSUD Dr. Soetomo

2019 ◽  
Vol 26 (1) ◽  
pp. 96
Author(s):  
Evisina Hanafiati Frans ◽  
Mahrus A Rahman ◽  
Teddy Ontoseno ◽  
I Dewa Gede Ugrasena ◽  
R Fatchul Wahabe
Keyword(s):  
Right Ventricular ◽  
Diastolic Function ◽  
Serum Ferritin ◽  
Heart Function ◽  
Systolic Function ◽  
Thalassemia Major ◽  
Left Ventricular ◽  
Iron Deposit ◽  
Ventricular Systolic Function ◽  
Right Ventricular Systolic Function

 Background: Cardiac hemosiderosis in major thalassemia has a high mortality rate. Serum ferritin levels are routinely performed to measure body iron deposit Early detection of cardiac dysfunction by routine echocardiography is very important to prevent complications due to hemosiderosis. Objective: To analyze correlation between serum ferritin levels and heart function in thalassemia major children. Methods: A cross-sectional study involving children of thalassemia major less than 18 years in the pediatric hematology oncology outpatient clinic at Dr. Soetomo Hospital. The subjects were children diagnosed with thalassemia major who had received more than 10 transfusions and had ferritin levels above 500 µg / L. All subjects were taken through consecutive sampling and performed echocardiography to measure right ventricular systolic function, left ventricular systolic function, and diastolic function. The factors analyzed included serum ferritin levels, TAPSE index, ejection fraction, and E / A ratio. Statistical analysis using chi square. Results: A total of 82 children were taken as the study sample that met the inclusion and exclusion criteria, 1 sample was dropped out due to pneumonia. Serum ferritin was not correlated to right ventricular systolic function (Cramer's phi constant 0.14, p = 0.209). Serum ferritin was not correlated with left heart systolic function (Cramer's phi constant 0.187, p = 0.09). Serum ferritin was not related to diastolic function (Cramer's phi constant 0.124, p = 0.264). Conclusion: Serum ferritin level in major thalassemia was not correlated with cardiac function

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