Abstract 4375: Potential Effects of Immunoadsorption and Subsequent IgG Substitution on Cardiopulmonary Exercise in DCM Patients

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Lars R Herda ◽  
Christiane Trimpert ◽  
Astrid Hummel ◽  
Ute Nauke ◽  
Pfeiffersche Stiftungen ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Cardiopulmonary Exercise

Recent data indicate that cardiac antibodies play an active role in the pathogenesis of dilated cardiomyopathy (DCM), and may contribute to cardiac dysfunction of DCM patients. Previous studies have suggested that immunoadsorption with subsequent IgG substitution (IA/IgG) improves left ventricular function in DCM. The potential influence of this immunomodulatory therapy on cardiopulmonary exercise remains to be elucidated. 60 patients with DCM ( n = 60, NYHA II-IV, left ventricular ejection fraction ≤ 45%) underwent either IA/IgG ( n = 30), or were followed up without IA ( n = 30). IA/IgG was performed in one course of five consecutive days. After three months we compared echocardiographic assessment of left ventricular function and spiroergometric exercise parameters in both groups. Left ventricular ejection fraction (LVEF) improved significantly in the IA/IgG group from 33.0 ± 1.2% to 40.1 ± 1.5% (p < 0.001 vs. control, p < 0.001 vs. baseline). In the control group, spiroergometric exercise parameters did not change during follow-up. In contrast, patients receiving IA/IgG improved significantly in the following parameters: peak oxygen uptake (peak VO 2 ; 17.3 ± 0.9 ml/min/kg to 21.8 ± 1.0 ml/min/kg; p < 0.01 vs. control, p < 0.01 vs. baseline), oxygen pulse (10.7 ± 0.7 ml/bpm to 13.6 ± 0.7 ml/bpm; p < 0.05 vs. control, p < 0.01 vs. baseline), and anaerobic threshold (VO 2 AT; 10.3 ± 0.5 ml/min/kg to 13.2 ± 0.5 ml/min/kg; p < 0.001 vs. control, p < 0.001 vs. baseline). The ventilatory response to exercise (V E /VCO 2 slope) decreased after IA/IgG therapy from 32.3 ± 1.5 to 28.7 ± 0.9 (p = 0.18 vs. controls, p = 0.02 vs. baseline), whereas there was no significant change in the control group after 3 months. IA/IgG therapy in DCM patients may induce improvement in echocardiographic and cardiopulmonary exercise parameters.

scholarly journals Three-Dimensional Speckle Tracking Echocardiography To Evaluate Left Ventricular Function In Patients With Acute ST-Segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention Following Tongxinluo Treatment

2022 ◽  
Author(s):  
Ruimeng Tian ◽  
Jia Feng ◽  
Wenjuan Qin ◽  
Zhen Wang ◽  
Zijing Zhai ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Acute Stemi

Abstract Objective: Bying comparing the correlation between three-dimensional speckle tracking echocardiography (3D-STE) and three-dimensional left ventricular ejection fraction (LVEF), to explore the 3D-STE to evaluate the left ventricle of patients with acute ST-segment elevation myocardial infarction (acute STEMI) after percutaneous coronary intervention (PCI) following routine treatment with Tongxinluo drugs. Methods: Altogether, 60 patients with acute STEMI and 30 healthy adults were selected, and the patients were randomly divided into the routine group and the Tongxinluo group, with 30 people in each group. All patients underwent PCI, and routine echocardiography and 3D-STE assessments were performed for each group 72 h after PCI and 12 months after PCI to obtain the following left ventricular related functional parameters: left ventricular end-diastolic diameter (LVEDD), end-ventricular septal end-diastolic thickness (IVSD), left ventricular posterior wall end-diastolic thickness (LVPWD), left ventricular short axis shortening fraction (LVFS), Simpson’s left ventricular ejection fraction (Simpson’s LVEF), three-dimensional left ventricular ejection fraction (3D-LVEF), global longitudinal strain (GLS), global circumferential strain (GCS), left ventricular twist angle (LVtw), Torsion (Tor), peak strain dispersion (PSD), and myocardial comprehensive index (MCI). The same parameters were collected in the control group, the results were compared, and the correlation analysis between GCS, GLS, LVtw, Tor, and MCIF, and 3D-LVE was performed. Results: Compared with the control group, the LVFS, LVEF (Simpson), 3D-LVEF, GLS, GCS, LVtw, Tor, and MCI significantly decreased in patients with STEMI after PCI, while the PSD significantly increased ( P <0.05). Compared with the values 72 h after PCI, the LVEDD, LVFS, LVEF (Simpson), 3D-LVEF, GLS, GCS, LVtw, Tor, and MCI significantly increased at 12 m after PCI, while PSD significantly decreased ( P <0.05). No significant difference was observed between the two groups at 72 h after PCI ( P >0.05). At 12 months after PCI, the LVEF, GLS, GCS, LVtw, Tor, and MCI of the Tongxinluo group were higher than those of the routine group. The PSD was significantly lower in the Tongxinluo group ( P <0.05). MCI and 3D-LVEF have the strongest correlation and highest consistency, which can best reflect the changes in the left ventricular function in patients with acute STEMI after PCI. Conclusion: 3D-STE can be used to evaluate the protective effect of Tongxinluo on the left ventricular function in patients with acute STEMI after PCI.

Heart failure with preserved left ventricular ejection fraction

2016 ◽  
Author(s):  
Demosthenes G. Katritsis ◽  
Bernard J. Gersh ◽  
A. John Camm
Keyword(s):  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Definition, aetiology, and management of heart failure in the context of a preserved left ventricular function are discussed.

scholarly journals Image quality to estimate ventricular ejection fraction by last year medical students improves after short courses of training

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tobias Hüppe ◽  
Heinrich Volker Groesdonk ◽  
Thomas Volk ◽  
Stefan Wagenpfeil ◽  
Benedict Wallrich
Keyword(s):  
Medical Students ◽  
Ejection Fraction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Transthoracic Echocardiography ◽  
Imaging Modality ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Abstract Background Transthoracic echocardiography is the primary imaging modality for diagnosing cardiac conditions but medical education in this field is limited. We tested the hypothesis that a structured theoretical and supervised practical course of training in focused echocardiography in last year medical students results in a more accurate assessment and more precise calculation of left ventricular ejection fraction after ten patient examinations. Methods After a theoretical introduction course 25 last year medical students performed ten transthoracic echocardiographic examination blocks in postsurgical patients. Left ventricular function was evaluated both with an eye-balling method and with the calculated ejection fraction using diameter and area of left ventricles. Each examination block was controlled by a certified and blinded tutor. Bias and precision of measurements were assessed with Bland and Altman method. Results Using the eye-balling method students agreed with the tutor’s findings both at the beginning (88%) but more at the end of the course (95.7%). The variation between student and tutor for calculation of area, diameter and ejection fraction, respectively, was significantly lower in examination block 10 than in examination block 1 (each p < 0.001). Students underestimated both the length and the area of the left ventricle at the outset, as complete imaging of the left heart in the ultrasound sector was initially unsuccessful. Conclusions A structured theoretical and practical transthoracic echocardiography course of training for last year medical students provides a clear and measurable learning experience in assessing and measuring left ventricular function. At least 14 examination blocks are necessary to achieve 90% agreement of correct determination of the ejection fraction.

Intramyocardial Angiogenic Cell Precursors in Nonischemic Dilated Cardiomyopathy

2009 ◽  
Vol 17 (4) ◽  
pp. 382-388 ◽  
Author(s):  
Kitipan V Arom ◽  
Permyos Ruengsakulrach ◽  
Michael Belkin ◽  
Montip Tiensuwan
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Cell Group ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Nonischemic Dilated Cardiomyopathy

To determine the efficacy of intramyocardial injection of angiogenic cell precursors in nonischemic dilated cardiomyopathy, 35 patients with nonischemic dilated cardiomyopathy underwent injections of angiogenic cell precursors into the left ventricle (cell group). Seventeen patients with nonischemic dilated cardiomyopathy were matched from the heart failure database to form a control group that was treated medically. Angiogenic cell precursors were obtained from autologous blood, cultured in vitro, and injected into all free-wall areas of the left ventricle in the cell group. After these injections, New York Heart Association functional class improved significantly by 1.1 ± 0.7 classes at 284.7 ± 136.2 days, and left ventricular ejection fraction improved in 71.4% of patients (25/35); the mean increase in left ventricular ejection fraction was 4.4% ± 10.6% at 192.7 ± 135.1 days. Improved quality of life was demonstrated by better physical function, role-physical, general health, and vitality domains in a short-form health survey at the 3-month follow-up. In the control group, there were no significant improvements in left ventricular ejection fraction or New York Heart Association class which increased by 0.6 ± 0.8 classes. It was concluded that intramyocardial angiogenic cell precursor injection is probably effective in the treatment of nonischemic dilated cardiomyopathy. Disclosures and Freedom of Investigation Professor Michael Belkin is an advisory board member, a minor shareholder, and receives a consulting fee from TheraVitae Co. Ltd. However, the authors had full control of the study, methods used, outcome measurements, data analysis, and production of the written report.

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