scholarly journals Ventricular remodeling and diastolic myocardial dysfunction in rats submitted to protein-calorie malnutrition

2002 ◽  
Vol 282 (4) ◽  
pp. H1327-H1333 ◽  
Author(s):  
José R. Fioretto ◽  
Susana S. Querioz ◽  
Carlos R. Padovani ◽  
Luiz S. Matsubara ◽  
Katashi Okoshi ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Systolic Function ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
The Body ◽  
Control Group ◽  
Myocardial Stiffness ◽  
Protein Calorie Malnutrition ◽  
Stiffness Constant ◽  
Ventricular Compliance

The effects of protein-calorie malnutrition (PCM) on heart structure and function are not completely understood. We studied heart morphometric, functional, and biochemical characteristics in undernourished young Wistar rats. They were submitted to PCM from birth (undernourished group, UG). After 10 wk, left ventricle function was studied using a Langendorff preparation. The results were compared with age-matched rats fed ad libitum (control group, CG). The UG rats achieved 47% of the body weight and 44% of the left ventricular weight (LVW) of the CG. LVW-to-ventricular volume ratio was smaller and myocardial hydroxyproline concentration was higher in the UG. Left ventricular systolic function was not affected by the PCM protocol. The myocardial stiffness constant was greater in the UG, whereas the end-diastolic pressure-volume relationship was not altered. In conclusion, the heart is not spared from the adverse effects of PCM. There is a geometric alteration in the left ventricle with preserved ventricular compliance despite the increased passive myocardial stiffness. The systolic function is preserved.

scholarly journals FEATURES OF HEART LESIONS IN PATIENTS WITH VIRAL LIVER CIRRHOSIS

2018 ◽  
Vol 14 (3) ◽  
pp. 387-392
Author(s):  
M. V. Chistyakova ◽  
A. V. Govorin
Keyword(s):  
Liver Cirrhosis ◽  
Left Ventricle ◽  
Pulmonary Artery ◽  
Antiviral Therapy ◽  
Left Atrium ◽  
Systolic Function ◽  
Systolic Pressure ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Control Group

Aim. To study the structural and functional parameters of the heart, as well as the effect of antiviral therapy on certain cardiohemodynamic parameters in patients with viral liver cirrhosis (VLC).Material and methods. 96 patients with VLC (median age 42.1 [36;44] years, median duration of the disease – 3.5 [2.8;6.7] years) were examined. Patients without ascites (n=59) were included into the 1st group, and patients with ascites (n=37) – into the 2nd group. The control group included 21 healthy volunteers. Standard and tissue echocardiography, Holter monitoring of electrocardiogram were performed in all participants.Results. Ventricular extrasystoles (class I to IVB) were found in 8 (13%) patients of the 1st group and in 12 (33%) patients in the 2nd group. The corrected interval of QT in the patients of the 1st group was 457.9 [442;468] msec, in the second group – 478 [433;502] msec, in control – 427.9 [406;438] msec (p<0.001). Supraventricular arrhythmias were represented by supraventricular extrasystoles in 15 (25%) patients of the 1st group and 18 (50%) – of the 2nd group; paroxysmal atrial fibrillation in 2 (3%) and 7 (19%) patients, respectively. The systolic velocity Sm of the lateral wall (3, 9 segments) in patients with ascites was lower by 23% and 25%, respectively, compared with the patients of the 1st group; Tei index increased in patients with ascites compared with the control group and the 1st group, p<0.001. In patients with VLC without ascites, the parameters characterizing the mass of the myocardium of the left ventricle increased, the left atrium and pulmonary artery widened. These disorders increased in patients with ascites; besides the systolic pressure in the pulmonary artery increased, and segmental and global systolic function of the left ventricle decreased. Antiviral therapy was accompanied by a decrease in the mass of the left ventricular myocardium, the index of left atrial volume and systolic pressure in the pulmonary artery.Сonclusion. The increase in the myocardium mass of left ventricle, left atrium, pulmonary artery diameter, as well as cardiac arrhythmia and prolongation of the corrected QT interval were found in patients with VLC without ascites. These changes were more pronounced in patients with ascites, and additionally they increased pressure in the pulmonary artery and decreased systolic function of the ventricles of the heart. The antiviral therapy had a positive effect on some cardiohemodynamic parameters. 

scholarly journals Non-Invasive Imaging for Evaluating Cardiovascular Involvement in Patients with Primary and Lupus Nephritis

2019 ◽  
Vol 13 (1) ◽  
pp. 86-93
Author(s):  
Marco Atteritano ◽  
Luca Visconti ◽  
Giuseppe Dattilo ◽  
Carmelo Zuppardo ◽  
Antonio Lacquaniti ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Systolic Function ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Carotid Bifurcation ◽  
Left Ventricular ◽  
Control Group ◽  
Carotid Imt ◽  
2D Echocardiography ◽  
Significant Difference

Background: Evidence suggests that proteinuric diseases, such as primary or secondary glomerulonephritis, increase cardiovascular risk, but few studies confirmed this association. Methods: This is a cross-sectional, observational study on 32 patients, 17 with Primary Glomerulonephritis (PG) and 15 with Lupus Glomerulonephritis (LG). The control group consisted of 32 healthy individuals. Intima-media thickness (IMT) of the left common carotid artery, carotid bifurcation and internal carotid artery was measured by ultrasound. Left ventricular myocardial deformation was assessed by the use of the Global Circumferential Strain (GCS) and the Global Longitudinal Strain (GLS) following 2-Dimensional (2D) echocardiography in all participants. Results: Patients with glomerulonephritis in both groups showed significantly lower GLS compared with controls (p=0.0005). There was also a significant difference in common carotid IMT values between the LG and GP group (0.45±0.09 vs. 0.58±0.17 mm, respectively; p=0.01), but there was no difference with the control group. In patient group (n=32), a significantly positive correlation was observed between C-reactive protein and proteinuria (r=0.98; p<0.0001), whereas negative correlations were found between common carotid IMT and creatinine clearance (r=-0.97; p<0.0001) and between carotid bifurcation IMT and phosphate levels (r=-0.97; p<0.0001) Conclusion: Subclinical systolic myocardial dysfunction is present early in the course of glomerular disease. The use of 2D GLS revealed that LG and PG patients with no cardiovascular symptoms or history and a preserved left ventricle ejection fraction on conventional echocardiography had subclinical reduction in LV global longitudinal systolic function compared with controls.

Diastolic Dysfunction- Anaesthesiologist’s Dilemma!

2021 ◽  
Vol 7 (1) ◽  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Independent Predictor ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Compliance

Left ventricular systolic dysfunction is well recognized and ably managed by anesthesiologists. Left ventricular diastolic function needs to be reckoned as well, every single time anaesthesia is planned in a patient with cardiac disease. This article emphasizes why one should take cognizance of diastolic dysfunction during perioperative anaesthesia management. Diastolic dysfunction(DD) is the inefficiency of the left ventricle to allow filling at lower atrial pressures.[1] In other words, it is the abnormal relaxation during diastole along with the reduction in left ventricular compliance which culminates into higher filling pressures of the left ventricle.[2] It is associated with comorbid conditions such as hypertension, diabetes and atrial fibrillation. Oftentimes it is asymptomatic at rest but can manifest in stress-induced circumstances such as acute severe hypertension, tachycardia, overzealous fluid administration or arrhythmias especially atrial fibrillation.[3] Various reciprocal changes occur over time within the systolic function due to long-standing diastolic dysfunction. Also, mild to moderate diastolic dysfunction forms an independent predictor for the risk of mortality in addition to the established risk of hypertension, diabetes, coronary artery disease and advanced age.[4] It is also an independent predictor of major adverse cardiac events (MACE). (5) Most of the patients in whom anaesthesia is given for various surgical procedures have comorbidities like hypertension, diabetes, dyslipidemia, atrial fibrillation and ischemic heart disease which endure high risk for DD. They may have associated heart failure with preserved ejection fraction (HFpEF).DD can contribute to postoperative heart failure [6] and is associated with various complications in the postoperative period.[2] The act of administration of anaesthesia, mechanical ventilation and intraoperative events like tachycardia, hypertension, inordinate fluid therapy along with the overall surgic

scholarly journals Особенности показателей ЭКГ у лиц моложе 45 лет, перенесших инфаркт миокарда

2017 ◽  
Vol 7 (4) ◽  
pp. 240-247
Author(s):  
O. V. Filatova ◽  
E. Ivanova ◽  
V. Chursina
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricle ◽  
Right Ventricle ◽  
Left Atrium ◽  
Left Ventricular ◽  
The Body ◽  
Control Group ◽  
Left Ventricular Myocardium ◽  
The Right

We conducted a retrospective study of EchoCG from 33 males who had the myocardial infarction. Patients with a diagnosis of "neurocirculatory dystonia" (30 people) entered the control group. We studied the size of the left ventricle, the left atrium, the right ventricle, their relationship to each other, the mass of the myocardium and the mass index of the myocardium of the left ventricle. The study of the morphological structures of the heart revealed a change in the size of the left ventricle, the left atrium and the right ventricle in patients who had an acute myocardial infarction, manifested by an increase in the end-diastolic and end-systolic dimensions of the left ventricle, the left atrium, and the right ventricle. In 2/3 of the patients who had an acute myocardial infarction, the normal geometry of the left ventricle was observed. Around one-quarter of the patients had a concentric remodeling (24%), an eccentric hypertrophy of the left ventricle was the least common (15%). The heart of patients who had an acute myocardial infarction demonstrates a lower functionality being compared to the subjects in the control group. In these groups, the maximum value of the DAC / DDR ratio is observed, the ejection fraction is reduced. To a greater extent, the onset of acute myocardial infarction was determined by the size and mass of the left ventricular myocardium. Important meaning had also the body weight, BMI, surface area of the body, the size of the left atrium, and the right ventricle.

scholarly journals Magnetic resonance hyperpolarization imaging detects early myocardial dysfunction in a porcine model of right ventricular heart failure

2019 ◽  
Vol 21 (1) ◽  
pp. 93-101 ◽  
Author(s):  
Peter Agger ◽  
Janus Adler Hyldebrandt ◽  
Esben Søvsø Szocska Hansen ◽  
Camilla Omann ◽  
Nikolaj Bøgh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Magnetic Resonance ◽  
Right Ventricular ◽  
Systolic Function ◽  
Myocardial Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Metabolic Imaging ◽  
Control Group ◽  
Conductance Catheter

Abstract Aims Early detection of heart failure is important for timely treatment. During the development of heart failure, adaptive intracellular metabolic processes that evolve prior to macro-anatomic remodelling, could provide an early signal of impending failure. We hypothesized that metabolic imaging with hyperpolarized magnetic resonance would detect the early development of heart failure before conventional echocardiography could reveal cardiac dysfunction. Methods and results Five 8.5 kg piglets were subjected to pulmonary banding and subsequently examined by [1-13C]pyruvate hyperpolarization, conventional magnetic resonance imaging, echocardiography, and blood testing, every 4 weeks for 16 weeks. They were compared with a weight matched, healthy control group. Conductance catheter examination at the end of the study showed impaired right ventricular systolic function along with compromised left ventricular diastolic function. After 16 weeks, we saw a significant decrease in the conversion ratio of pyruvate/bicarbonate in the left ventricle from 0.13 (0.04) in controls to 0.07 (0.02) in animals with pulmonary banding, along with a significant increase in the lactate/bicarbonate ratio to 3.47 (1.57) compared with 1.34 (0.81) in controls. N-terminal pro-hormone of brain natriuretic peptide was increased by more than 300%, while cardiac index was reduced to 2.8 (0.95) L/min/m2 compared with 3.9 (0.95) in controls. Echocardiography revealed no changes. Conclusion Hyperpolarization detected a shift towards anaerobic metabolism in early stages of right ventricular dysfunction, as evident by an increased lactate/bicarbonate ratio. Dysfunction was confirmed with conductance catheter assessment, but could not be detected by echocardiography. Hyperpolarization has a promising future in clinical assessment of heart failure in both acquired and congenital heart disease.

scholarly journals Myocardial deformation in patients with a single left ventricle using 2D cardiovascular magnetic resonance feature tracking: a case–control study

2021 ◽  
Author(s):  
Fabian Strodka ◽  
Jana Logoteta ◽  
Roman Schuwerk ◽  
Mona Salehi Ravesh ◽  
Dominik Daniel Gabbert ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Feature Tracking ◽  
Systolic Function ◽  
Radial Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Significant Difference ◽  
Lv Volumes

AbstractVentricular dysfunction is a well-known complication in single ventricle patients in Fontan circulation. As studies exclusively examining patients with a single left ventricle (SLV) are sparse, we assessed left ventricular (LV) function in SLV patients by using 2D-cardiovascular magnetic resonance (CMR) feature tracking (2D-CMR-FT) and 2D-speckle tracking echocardiography (2D-STE). 54 SLV patients (11.4, 3.1–38.1 years) and 35 age-matched controls (12.3, 6.3–25.8 years) were included. LV global longitudinal, circumferential and radial strain (GLS, GCS, GRS) and strain rate (GLSR, GCSR, GRSR) were measured using 2D-CMR-FT. LV volumes, ejection fraction (LVEF) and mass were determined from short axis images. 2D-STE was applied in patients to measure peak systolic GLS and GLSR. In a subgroup analysis, we compared double inlet left ventricle (DILV) with tricuspid atresia (TA) patients. The population consisted of 19 DILV patients, 24 TA patients and 11 patients with diverse diagnoses. 52 patients were in NYHA class I and 2 patients were in class II. Most SLV patients had a normal systolic function but median LVEF in patients was lower compared to controls (55.6% vs. 61.2%, p = 0.0001). 2D-CMR-FT demonstrated reduced GLS, GCS and GCSR values in patients compared to controls. LVEF correlated with GS values in patients (p < 0.05). There was no significant difference between GLS values from 2D-CMR-FT and 2D-STE in the patient group. LVEF, LV volumes, GS and GSR (from 2D-CMR-FT) were not significantly different between DILV and TA patients. Although most SLV patients had a preserved EF derived by CMR, our results suggest that, LV deformation and function may behave differently in SLV patients compared to healthy subjects.

scholarly journals Echocardiographic evaluation of ventricular septal defect haemodynamics

2007 ◽  
Vol 135 (9-10) ◽  
pp. 541-546
Author(s):  
Vesna Miranovic
Keyword(s):  
Ventricular Septal Defect ◽  
Pulmonary Artery ◽  
Body Surface ◽  
Septal Defect ◽  
Left Ventricular ◽  
The Body ◽  
Control Group ◽  
Healthy Children ◽  
And Control ◽  
The Relationship

Introduction Ventricular septal defect (VSD) is an opening in the interventricular septum. 30-50% of patients with congenital heart disease have VSD. Objective The aim of the study was to determine the dependence of the left ventricular diastolic dimension (LVD), left ventricular systolic dimension (LVS), shortening fraction (SF), left atrium (LA), pulmonary artery truncus (TPA) on the body surface and compare their values among experimental, control and a group of healthy children. Values of maximal systolic gradient pressure (Pvsd) of VSD were compared with children from one experimental and control group. Method Children were divided into three groups: experimental (32 children with VSD that were to go to surgery), control (20 children with VSD who did not require surgery) and 40 healthy children. Measurements of LVD, LVS, SF, LA, TPA were performed in accordance to recommendations of the American Echocardiographic Association. The value of Pvsd was calculated from the maximal flow velocity (V) in VSD using the following formula: Pvsd=4xV? (mm Hg). Results For children from the experimental group, the relationship between the body surface and the variability of the LVD was explained with 56.85%, LVS with 66.15%, SF with 4.9%, TPA with 58.92%. For children from the control group, the relationship between the body surface and the variability of LVD was explained with 88.8%, LVS with 72.5%, SF with 0.42%, PA with 58.92%. For healthy children, the relationship between the body surface and the variabilitiy of the LVD was explained with 88.8%, LVS with 88.78%, SF with 5.25% and PA with 84.75%. There was a significant statistical difference between average values of Pvsd in the experimental and control group (p<0.02). Conclusion The presence of the large VSD has an influence on the enlargement of LVD, LVS, SF, TPA. The enlargement of the size of the pulmonary artery depends on the presence of VSD and there is a direct variation in the magnitude of the shunt. There is a relationship and significant dependence of the LVS and LVD on the body surface. There is no statistically significant dependence between SF and body surface.

scholarly journals Sub-clinical Detection of Left Ventricular Myocardial Dysfunction in Valvular Heart Diseases: A State-of-the-Art Review in a Speckle Tracking Echocardiography and Myocardial Performance

2020 ◽  
pp. 1-13
Author(s):  
Galaleldin Nagib Elkilany ◽  
◽  
Sherif Baath Allah ◽  
Petras Lohana ◽  
◽  
...  
Keyword(s):  
Mitral Valve ◽  
Maximum Rate ◽  
State Of The Art ◽  
Systolic Function ◽  
Heart Diseases ◽  
Myocardial Dysfunction ◽  
Pressure Rise ◽  
Left Ventricular ◽  
Myocardial Performance ◽  
Valve Diseases

Purpose of the state-of-the-art review: Left ventricular (LV) global longitudinal strain (GLS) is recently recognized as a more sensitive measure of LV myocardial systolic function compared with LV ejection fraction (LVEF). In addition, left ventricular GLS , myocardial performance index (MPI) and maximum rate of LV pressure rise during isovolumetric contraction (LV dP/dtmax) are more reproducible than traditional assessment of LV systolic function by two dimensional echocardiography (2DE) LVEF. These underutilized techniques can detect preclinical myocardial dysfunction in patients who are at risk of LV failure in valvular-induced heart disease . Current guidelines for diagnosis and treatment of valvular heart disease (VHD) include LVEF as one of the parameters to take into consideration in the clinical decision-making. However, a large body of evidence has shown that left ventricular GLS, MPI and LV dP/dtmax have been classically considered as a sensitive marker of LV contractility and inotropic state. In turn GLS and myocardial performance may be a better prognosticator than LVEF in aortic and mitral valve heart diseases. This timely state-of-the-art review, appraised the evidence and role of GLS, MPI and dP/dT as clinical tools in patients with aortic and mitral valve disease. Recent findings: Left ventricular GLS has been shown to be prognostic in low-flow, low-gradient severe aortic stenosis with preserved LVEF. The role of left ventricular GLS, Tei index (MPI) and maximum rate of LV pressure rise (LV dP/dtmax) in patients with aortic regurgitation and mitral valve diseases (regurgitation and stenosis) is less well established. Summary: Echocardiography is considered the primary non-invasive imaging tool for valvular heart disease assessment and the cornerstone method in diagnosing and evaluating the morphology and severity of aortic and mitral valve diseases. Currently, diagnostic-cardiac catheterization is no more recommended except in very rare cases when echocardiographic image quality is suboptimal, non-diagnostic and when the results of 2DE are discrepant with clinical data. Once clinical decision-making is based on the 2DE and three dimensional echocardiographic in assessment of the severity of mitral and aortic valve diseases, it is crucial that standards should be adopted to maintain accuracy and consistency across echocardiographic laboratories. This illustrative review article assesses left ventricular systolic function (LVEF) employing two and/or three dimensional echocardiography in comparison to GLS, MPI and LV dP/dtmax, especially applied for aortic valve (AV) and mitral valve (MV) diseases. It is noteworthy that this document only provides echocardiographic standards rather than making recommendations for clinical management. Conclusion: It is concluded that GLS, MPI and maximum rate of LV pressure rise during isovolumetric contraction (LV dP/dtmax) are recommended and more so, they should be increasingly used to identify subclinical LV myocardial dysfunction in patients with mitral and aortic valve heart diseases, to identify optimal timing for surgery and prognosticate outcomes after surgery

scholarly journals Features of structural and functional remodeling of the left ventricle in patients suffering from arterial hypertension with concomitant hypothyroidism

2019 ◽  
Vol 26 (5) ◽  
pp. 43-52
Author(s):  
V. I. Tseluyko ◽  
L. M. Yakovleva ◽  
D. A. Korchagina
Keyword(s):  
Body Mass Index ◽  
Left Ventricle ◽  
Arterial Hypertension ◽  
Diastolic Dysfunction ◽  
Body Mass ◽  
Mean Value ◽  
Left Ventricular ◽  
Control Group ◽  
Functional Remodeling ◽  
The Mean

The aim – to study the features of structural and functional remodeling of the left ventricle in patients suffering from arterial hypertension with concomitant hypothyroidism and to determine clinical and past medical history and laboratory factors associated with their development. Materials and methods. 50 patients suffering from hypertension with concomitant hypothyroidism were enrolled into the study. Depending on the level of thyroid stimulating hormone in the serum the examined patients were distributed into two groups of 25 patients with the compensated and 25 with decompensated course of hypothyroidism. The control group consisted of 30 patients with hypertension in which the pathology of the thyroid gland was excluded. The comparison of the main parameters of the echocardiography study of the myocardium has been performed depending on hypothyroidism compensation. Assessment of parameters of transmitral diastolic blood flow has been performed. A regression analysis has been conducted to detect the relation of clinical and past medical history factors and echocardiographic parameters with the development of diastolic dysfunction by E/A ratio. The values of central hemodynamics have been studied for evaluation of the contractile function of the myocardium. Results and discussion. According to the results of the echocardiography of both examined groups it has been found that the final systolic and stroke volume exceeded the parameters of the control group. The mean value of the left ventricle ejection fraction was statistically significantly lower than in the control group (p=0.004). The left ventricle myocardial mass in patients with hypothyroidism was statistically significantly greater than in the control group. It was proved that in patients, who were diagnosed with decompensated hypothyroidism, the mean value of the left atrium size to growth by the degree of 2.7 was statistically significantly higher than in the control group (p=0.01), whereas the average value of the ratio of the size of the left atrium to the surface area of the body had no statistically significant differences between the groups. It has been found that in both groups the proportion of patients with diastolic dysfunction in which the E/A ratio was less than 1.0 was higher than in the control group (р=0.01 and p=0.03, respectively). The independent factors of diastolic dysfunction of the left ventricle in patients with hypertension in the presence of hypothyroidism have been found. Conclusions. In the presence of decompensated hypothyroidism in patients with arterial hypertension, both with obesity and with normal body mass index, left ventricular mass indexes were significantly higher in comparison with a control group. Regardless of the compensation of the thyroid state in patients with arterial hypertension, the ejection fraction was significantly lower. According to regression analysis, independent factors for the development of diastolic dysfunction in patients with arterial hypertension and hypothyroidism with a body mass index ≥ 30 kg/m2 is the index of mass of the left ventricular myocardium, determined by the degree of 2.7, the level of total cholesterol to statistical significance – the level of office systolic blood pressure and the duration of hormone replacement therapy for hypothyroidism; with body mass index < 30 kg/m2 – age and left atrial index, determined by body surface area. For patients with arterial hypertension and reduced thyroid gland function, violation of the left ventricular myocardial relaxation is typical as evidenced by a higher proportion of patients with a decrease in E/A to less than 0.8 in these patients.

Sign in / Sign up

Export Citation Format

Share Document