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.

Left Ventricular Remodeling, Systolic Function, and Diastolic Function in Young Adults With β-Thalassemia Intermedia

CHEST Journal ◽  
2002 ◽  
Vol 121 (2) ◽  
pp. 506-512 ◽  
Author(s):  
Marco Vaccari ◽  
Roberto Crepaz ◽  
Monica Fortini ◽  
Maria R. Gamberini ◽  
Sabrina Scarcia ◽  
...  
Keyword(s):  
Young Adults ◽  
Diastolic Function ◽  
Ventricular Remodeling ◽  
Systolic Function ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Thalassemia Intermedia

scholarly journals Direct cardiac versus systemic effects of inorganic nitrite on human left ventricular function

2021 ◽  
Author(s):  
Kevin O'Gallagher ◽  
Ana R Cabaco ◽  
Matthew Ryan ◽  
Ali Roomi ◽  
Haotian Gu ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Sodium Nitrite ◽  
Diastolic Pressure ◽  
Contractile Function ◽  
Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Cardiac Contractile Function ◽  
Lv Systolic Function ◽  
Lv Diastolic Function

Background Inorganic nitrite generates nitric oxide (NO) in vivo and is considered a potential therapy in settings where endogenous NO bioactivity is reduced and left ventricular (LV) function impaired. However, the effects of nitrite on human cardiac contractile function, and the extent to which these are direct or indirect, are unclear. Methods and Results We studied 40 patients undergoing diagnostic cardiac catheterisation who had normal LV systolic function and were not found to have obstructive coronary disease. They received either an intracoronary sodium nitrite infusion (8.7-26 mmol/min, n=20) or an intravenous sodium nitrite infusion (50 mg/kg/min, n=20). LV pressure-volume relations were recorded. The primary end point was LV end-diastolic pressure (LVEDP) while secondary end points included indices of LV systolic and diastolic function. Intracoronary nitrite infusion induced a significant reduction in LVEDP, LV end-diastolic pressure-volume relationship (EDPVR) and the time to LV end-systole (LVEST) but had no significant effect on measures of LV systolic function or systemic haemodynamics. Intravenous nitrite infusion induced greater effects, with significant decreases in LVEDP, EDPVR, LVEST, LV dP/dtmin, tau, and mean arterial pressure. Conclusions These results indicate that inorganic nitrite has modest direct effects on human LV diastolic function, independent of LV loading conditions and without affecting LV systolic properties. The systemic administration of nitrite has larger effects on LV diastolic function which are related to reduction in both preload and afterload. These effects of inorganic nitrite indicate a favourable profile for conditions characterized by LV diastolic dysfunction, e.g. heart failure with preserved ejection fraction.

Hyperhomocysteinemia leads to pathological ventricular hypertrophy in normotensive rats

2003 ◽  
Vol 285 (2) ◽  
pp. H679-H686 ◽  
Author(s):  
Jacob Joseph ◽  
Lija Joseph ◽  
Nawal S. Shekhawat ◽  
Sulochana Devi ◽  
Junru Wang ◽  
...  
Keyword(s):  
Cardiac Remodeling ◽  
Ventricular Hypertrophy ◽  
Ventricular Remodeling ◽  
Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Wall Thickening ◽  
Cardiovascular Morbidity And Mortality ◽  
And Function

A recent report indicated that hyperhomocysteinemia (Hhe), in addition to its atherothrombotic effects, exacerbates the adverse cardiac remodeling seen in response to hypertension, a powerful stimulus for pathological ventricular hypertrophy. The present study was undertaken to determine whether Hhe has a direct effect on ventricular remodeling and function in the absence of other hypertrophic stimuli. Male Wistar-Kyoto rats were fed either an amino acid-defined control diet or an intermediate Hhe-inducing diet. After 10 wk of dietary treatment, rats were subjected to echocardiographic assessment of left ventricular (LV) dimensions and systolic function. Subsequently, blood was collected for plasma homocysteine measurements, and the rats were killed for histomorphometric and biochemical assessment of cardiac remodeling and for in vitro cardiac function studies. Significant LV hypertrophy was detected by echocardiographic measurements, and in vitro results showed hypertrophy with significantly increased myocyte size in the LV and right ventricle (RV). LV and RV remodeling was characterized by a disproportionate increase in perivascular and interstitial collagen, coronary arteriolar wall thickening, and myocardial mast cell infiltration. In vitro study of LV function demonstrated abnormal diastolic function secondary to decreased compliance because the rate of relaxation did not differ between groups. LV systolic function did not vary between groups in vitro. In summary, in the absence of other hypertrophic stimuli short-term intermediate Hhe caused pathological hypertrophy and remodeling of both ventricles with diastolic dysfunction of the LV. These results demonstrate that Hhe has direct adverse effects on cardiac structure and function, which may represent a novel direct link between Hhe and cardiovascular morbidity and mortality, independent of other risk factors.

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.

scholarly journals Assessment of the state of intracardiac hemodynamics and myocardial remodeling in women with gonarthritis, hypertension and overweight

2021 ◽  
Vol 11 (7) ◽  
pp. 185-194
Author(s):  
A. Pidlubna
Keyword(s):  
Arterial Hypertension ◽  
Ventricular Remodeling ◽  
Contractile Function ◽  
Systolic Function ◽  
Left Ventricular Remodeling ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
City Hospital ◽  
Myocardial Remodeling

Abstract. The problem of comorbidity is one of the most pressing problems of modern medicine. The presence of arterial hypertension and overweight in patients with gonarthritis is associated with an earlier development of target organ damage and subsequent cardiovascular accidents. In order to assess intracardiac hemodynamics and types of myocardial remodeling in women with gonarthritis, hypertension and overweight, depending on their combinations, from 2018 to2021, a prospective study of 198 patients of the rheumatology department of the «City Hospital № 10» (Zaporizhzhia) was carried out. According to the results of the study, it was found that the presence of comorbid pathology in the form of arterial hypertension and overweight in female patients with gonarthritis negatively affects the contractile function of the heart, which is confirmed by a decrease in the main indicators of systolic function of the left ventricle; the specified combination of diseases leads to the formation of prognostically unfavorable types of left ventricular remodeling.

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

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.

ACCESSMENT OF RIGHT VENTRICULAR SYSTOLIC FUNCTION USING TAPSE

2011 ◽  
pp. 62-70
Author(s):  
Lien Nhut Nguyen ◽  
Anh Vu Nguyen
Keyword(s):  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Systolic Function ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: The prognostic importance of right ventricular (RV) dysfunction has been suggested in patients with systolic heart failure (due to primary or secondary dilated cardiomyopathy - DCM). Tricuspid annular plane systolic excursion (TAPSE) is a simple, feasible, reality, non-invasive measurement by transthoracic echocardiography for evaluating RV systolic function. Objectives: To evaluate TAPSE in patients with primary or secondary DCM who have left ventricular ejection fraction ≤ 40% and to find the relation between TAPSE and LVEF, LVDd, RVDd, RVDd/LVDd, RA size, severity of TR and PAPs. Materials and Methods: 61 patients (36 males, 59%) mean age 58.6 ± 14.4 years old with clinical signs and symtomps of chronic heart failure which caused by primary or secondary DCM and LVEF ≤ 40% and 30 healthy subject (15 males, 50%) mean age 57.1 ± 16.8 were included in this study. All patients and controls were underwent echocardiographic examination by M-mode, two dimentional, convensional Dopler and TAPSE. Results: TAPSE is significant low in patients compare with the controls (13.93±2.78 mm vs 23.57± 1.60mm, p<0.001). TAPSE is linearly positive correlate with echocardiographic left ventricular ejection fraction (r= 0,43; p<0,001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation was found with LVDd and PAPs. Conclusions: 1. Decreased RV systolic function as estimated by TAPSE in patients with systolic heart failure primary and secondary DCM) compare with controls. 2. TAPSE is linearly positive correlate with LVEF (r= 0.43; p<0.001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation is found with LVDd and PAPs. 3. TAPSE should be used routinely as a simple, feasible, reality method of estimating RV function in the patients systolic heart failure DCM (primary and secondary).

Regional Left Ventricular Systolic Function in Relation to the Cavity Geometry in Patients With Chronic Right Ventricular Pressure Overload

Circulation ◽  
1995 ◽  
Vol 91 (9) ◽  
pp. 2359-2370 ◽  
Author(s):  
Sheng-Jing Dong ◽  
Adrian P. Crawley ◽  
John H. MacGregor ◽  
Yael Fisher Petrank ◽  
Dale W. Bergman ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Systolic Function ◽  
Pressure Overload ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Ventricular Pressure ◽  
Ventricular Systolic Function

scholarly journals Prognostic Value of Echocardiographic Right Ventricular Function Parameters in the Presence of Severe Tricuspid Regurgitation

2021 ◽  
Vol 10 (11) ◽  
pp. 2266
Author(s):  
Matthias Schneider ◽  
Varius Dannenberg ◽  
Andreas König ◽  
Welf Geller ◽  
Thomas Binder ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Tricuspid Regurgitation ◽  
Right Ventricular Function ◽  
Prognostic Value ◽  
Large Scale ◽  
Systolic Function ◽  
Left Ventricular ◽  
Severe Tricuspid Regurgitation ◽  
Vena Contracta

Background: Presence of severe tricuspid regurgitation (TR) has a significant impact on assessment of right ventricular function (RVF) in transthoracic echocardiography (TTE). High trans-valvular pendulous volume leads to backward-unloading of the right ventricle. Consequently, established cut-offs for normal systolic performance may overestimate true systolic RVF. Methods: A retrospective analysis was performed entailing all patients who underwent TTE at our institution between 1 January 2013 and 31 December 2016. Only patients with normal left ventricular systolic function and with no other valvular lesion were included. All recorded loops were re-read by one experienced examiner. Patients without severe TR (defined as vena contracta width ≥7 mm) were excluded. All-cause 2-year mortality was chosen as the end-point. The prognostic value of several RVF parameters was tested. Results: The final cohort consisted of 220 patients, 88/220 (40%) were male. Median age was 69 years (IQR 52–79), all-cause two-year mortality was 29%, median TAPSE was 19 mm (15–22) and median FAC was 42% (30–52). In multivariate analysis, TAPSE with the cutoff 17 mm and FAC with the cutoff 35% revealed non-significant hazard ratios (HR) of 0.75 (95%CI 0.396–1.421, p = 0.38) and 0.845 (95%CI 0.383–1.867, p = 0.68), respectively. TAPSE with the cutoff 19 mm and visual eyeballing significantly predicted survival with HRs of 0.512 (95%CI 0.296–0.886, p = 0.017) and 1.631 (95%CI 1.101–2.416, p = 0.015), respectively. Conclusions: This large-scale all-comer study confirms that RVF is one of the main drivers of mortality in patients with severe isolated TR. However, the current cut-offs for established echocardiographic parameters did not predict survival. Further studies should investigate the prognostic value of higher thresholds for RVF parameters in these patients.

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