Abstract 16673: Framingham Risk Trajectories Predict Left Ventricular Dyssynchrony as a Measure of Subclinical Myocardial Dysfunction: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ravi Sharma ◽  
Satoru Kishi ◽  
Bharath Ambale-Venkatesh ◽  
Laura Colangelo ◽  
Jared Reis ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Myocardial Dysfunction ◽  
Statistical Significance ◽  
Cumulative Risk ◽  
Left Ventricular ◽  
Left Ventricular Dyssynchrony ◽  
Parameter Estimates ◽  
Reference Trajectory ◽  
Lv Dyssynchrony ◽  
Framingham Risk

Background: Left ventricular (LV) dyssynchrony is a measure of myocardial dysfunction in heart failure patients. However, its significance as a marker of incipient myocardial dysfunction in response to cumulative risk burden among asymptomatic individuals is not known. Our objective was to evaluate the extent of LV dyssynchrony in relationship to longitudinal changes in cardiovascular risk in otherwise healthy middle age individuals. Methods & Results: We defined five distinct Framingham risk score (FRS, D’Agostino Circulation 2008) (excluding age) trajectories in the CARDIA cohort (n=4634) to estimate the pattern of cumulative cardiovascular risk exposure over 25 year. Standard deviation of time to peak systolic circumferential strain (SD-TPS) among 6 mid-ventricular segments using 2-dimensional speckle-tracking echocardiography determined the extent of LV dyssynchrony in 2718 participant (54.3% women). Using multivariate linear regression after adjustment for demographics and LV ejection fraction, we found that among women in comparison to the low-stablegroup (reference trajectory), increased burden of cardiovascular risk was associated with progressively higher values of SD-TPS; B-coefficients were 3.50msec (95%CI, 0.23 - 6.77, p=0.04) for the moderate-stable, 7.32msec (2.56 - 12.09, p=0.003) for the elevated-stable, 8.79msec (3.49 - 14.10, p=0.001) for the moderate-increasing, and 9.54msec (0.09 - 18.99, p=0.048) for the elevated-increasing groups. There was attenuation of parameter estimates after further adjustment for cumulative body-mass-index (BMI) with loss of statistical significance. These associations were not statistically significant in men. Conclusions: Women had higher values of subclinical LV dyssynchrony in response to incremental cumulative cardiovascular risk burden over 25 years. Such relationships were absent in men. Cumulative BMI was the strongest predictor of LV dyssynchrony.

Abstract 4827: Role of Left Ventricular Dyssynchrony in Functional Mitral Regurgitation in Patients with Dilated Cardiomyopathy: A Comparison Study with Geometric Parameters of Mitral Apparatus Estimated with 3d Echocardiography

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Woonggil Choi ◽  
Soohyun Kim ◽  
Seongill Woo ◽  
Deahyuk Kim ◽  
Keumsoo Park ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Multivariate Regression Analysis ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Geometric Parameters ◽  
Functional Mitral Regurgitation ◽  
Left Ventricular Dyssynchrony ◽  
Lv Dyssynchrony ◽  
Mitral Apparatus

Objective: Functional mitral regurgitation (FMR) occurs commonly in patients with dilated cardiomyopathy (DCM). The aim of this study was to compare the roles of Left Ventricle(LV) dyssynchrony and geometric parameters of mitral apparatus as determinants of FMR in patients with DCM. Methods: Fourteen DCM patients without FMR and 15 DCM patients with FMR (ERO = 0.11 ± 0.029 cm 2 ) were enrolled. Effective regurgitant orifice (ERO) area and tissue Doppler-derived dyssynchrony index (DI: the standard deviation of time to peak myocardial systolic contraction of eight segments) were measured. The estimated DIs were corrected by the cycle length (CL) of each patient (cDI (%) = DI/CL*100). Using real-time 3D echocardiogrphy, mitral tenting area (MVT) and the degrees of displacement of anterior (APMD) and posterior (PPMD) papillary muscles were estimated. All geometric measurements were corrected (c) by the height of each patient. Results: There was no significant (p > 0.05) difference in LV Ejection Fraction and cLVEDV between two patient groups. cDI, cMVT, cAPMD and cPPMD significantly (p < 0.05) increased in the patient with FMR comparing with those in patients without FMR. cDI (r = 0.42), cMVT (r = 0.74), cAPMD (r = 0.63) and cPPMD (r = 0.64) showed significant (p < 0.05) correlations with ERO. cMVT was found to the strongest independent predictor of ERO with multivariate regression analysis, whereas cDI did not enter into the model. Conclusions: The degree of MV tenting rather than LV dyssynchrony was found to be the main determinant of FMR in DCM. However LV dyssynchrony also has a minor independent association with FMR.

scholarly journals Left ventricular dyssynchrony and post-systolic shortening in young bodybuilders using anabolic-androgenic steroids

2021 ◽  
Author(s):  
Antoine Grandperrin ◽  
Iris Schuster ◽  
Thomas Rupp ◽  
Omar IZEM ◽  
Philippe Obert ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Left Ventricular Dyssynchrony ◽  
Anabolic Androgenic Steroids ◽  
Lv Function ◽  
Ventricular Dyssynchrony ◽  
Lv Dyssynchrony ◽  
2D Strain ◽  
Lv Remodeling ◽  
Androgenic Steroids ◽  
Longitudinal Strains

Background: Left ventricular (LV) remodeling, characterized by increased LV hypertrophy and depressed function, is observed in strength-trained athletes who use anabolic-androgenic steroids (AAS). Previous studies reported an increase in cardiac fibrosis in these athletes, which could promote intraventricular dyssynchrony. In this context, this study evaluated LV dyssynchrony in strength-trained athletes using AA; hypothesizing that the use of AAS leads to an increase in LV dyssynchrony with an increase in post-systolic shortening. Methods: Forty-four participants (aged 20-40 years) were divided into three age-matched groups: strength-trained athletes using AAS (users, n=14) and those who were not (non-users, n=15), and healthy sedentary men (controls, n=15),. After completing a survey, each participant was assessed with 2D-strain echocardiography. Left ventricular dyssynchrony was quantified using the standard deviation of the time to peak for longitudinal strains (SD), the longitudinal strain delay index (LSDI) and the segmental post-systolic index (PSI). Results: Users exhibited a greater LV mass index and higher systolic and diastolic functions than both controls and non-users. The decrease in LV strains in users was predominantly observed at the interventricular segments. The SD, LSDI and PSI, calculated on the basal inferoseptal, basal anteroseptal and basal inferolateral segments, were higher in users. Conclusion: The results strongly support that the specific LV remodeling observed in young AAS users was associated with an increase in LV dyssynchrony. The correlations with ejection fraction suggested that wasted energy, due to post-systolic shortenings, contributed in part to the decrease in LV function in strength-trained athletes using AAS.

scholarly journals P1779 Myocardial work is a predictor of exercise tolerance in patients with dilated cardiomyopathy and left ventricular dyssynchrony

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Galli ◽  
F Schrub ◽  
F Schnell ◽  
A Hubert ◽  
E Donal
Keyword(s):  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Exercise Performance ◽  
Exercise Tolerance ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Left Ventricular Dyssynchrony ◽  
P Value ◽  
Heterogeneous Distribution ◽  
Lv Dyssynchrony

Abstract Background the assessment of myocardial work (MW) by pressure-strain loops is a recently introduced tool for the assessment of myocardial performance. Aim of the present study is to evaluate the relationship between myocardial work and exercise tolerance in patients with dilated cardiomyopathy (DCM) Methods 51 patients with DCM (mean age 57 ± 13 years, left entricular ejection fraction : 32 ± 9%) underwent cardiopulmonary exercise test (CPET) to assess exercise performance. Trans-thoracic echocardiography (TTE) was performed CPET. The following indices of myocardial work (MW) were measured regionally and globally: constructive work (CW), wasted work (WW), and work efficiency (WE). Left ventricular (LV) dyssynchrony (DYS) was defined by the presence of septal flash or apical rocking at TTE. Results LV-DYS was observed in 16 (31%) patients and associated with lower LV ejection fraction (LVEF), GLS, global and septal WE, and higher global and septal WW (Table 1). In patients with LV-DYS, septal WE was the only predictor of exercise peak VO2max at multivariable analysis (Figure 1), whereas LVEF (β=0.47, p = 0.05) and age (β=-0.42, 47, p= 0.04) were predictors of exercise capacity in patients without LV-DYS. Conclusions In patients with DCM, LV-DYS is associated with an heterogeneous distribution of myocardial work. Septal WE is the best predictor of exercise performance in these patients. Table 1 All n = 51 No-dyssynchrony n = 35 (69%) LV-Dyssynchrony n = 16 (31%) p-value LVEF, % 32 ± 9 34 ± 10 28 ± 7 0.04 GLS, % -12 ± 3 -13 ± 3 -10 ± 3 0.001 GCW, mmHg% 1325 ± 398 1342 ± 354 1287 ± 491 0.65 GWW, mmHg% 201 ± 147 154 ± 95 304 ±191 &lt;0.0001 GWE, % 85 ± 9 88 ± 7 78 ±10 &lt;0.0001 CWsept, mmHg% 1172 ± 459 1274 ± 398 949 ± 516 0.017 CWlat, mmHg% 1518 471 1472 ± 386 1620 ± 622 0.30 WWsept, mmHg% 283 ± 275 174 ± 98 522 ±376 &lt;0.0001 WWlat, mmHg% 135 ± 88 117 ± 81 176 ± 92 0.02 WEsept, % 78 ± 16 84 ± 9 62± 18* &lt;0.0001 WElat, % 90 ± 7 91 ± 7 88 ± 7 0.16 Abstract P1779 Figure.

scholarly journals AB0159 DIASTOLIC DYSFUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1106.2-1107
Author(s):  
S. Cabrera-Villalba ◽  
V. Valinotti ◽  
L. Roman ◽  
A. Paats ◽  
P. DE Abreu Trigueros ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Diastolic Dysfunction ◽  
Cardiovascular Risk Factors ◽  
Disease Duration ◽  
Statistical Significance ◽  
Left Ventricular ◽  
Serum Biomarkers ◽  
Echocardiographic Assessment

Background:Rheumatoid arthritis (RA) presents with an elevated incidence of congestive heart failure disease, which has a strong association with diastolic dysfunction, defined by left ventricular delayed relaxation pattern assessed by echocardiography.(1,2)Objectives:To describe the frequency of left ventricular delayed relaxation pattern in patients with RA, and the relationship with its clinical and serological characteristics, as well as with traditional and non-traditional cardiovascular risk factors.Methods:Descriptive, cross sectional, prospective study, in a Paraguayan cohort of patients with RA. This study had two phases: the first one, included a standardized questionnaire according to the variables included in the Cardiovascular Risk project (PINV15-0346), from the Consejo Nacional de Ciencias y Tecnología (CONACYT), and physical examination; the second one included laboratory sample collection performed by a specialized laboratory for serum biomarkers measurement for cardiovascular risk prediction (i.e endothelin, alpha-TNF, E-selectin, t-PA, VCAM, PAI-1 and high sensitivity-CRP levels) and echocardiographic assessment with a Doppler 7 GE USA equipment at a private facility. All patients signed informed consent. SPSS Statistics v23 was used for data analysis. Quantitative variables were presented as means and qualitative variables as frequencies. Chi square test was performed for comparisons between dichotomous variables. A p value ≤ 0.05 was used for statistical significance.Results:100 patients were included, 87% women, with a mean age of 51.36 ± 11.03 years, mean disease duration of 130.9 ± 102.64 months. 84.4% had positive ACPA. 43.3% had bone erosions, with an average of DAS 28-ESR 3.42 ± 1.1. 60% of patients presented with echocardiographic left ventricular delayed relaxation pattern. Regarding traditional CV risk factors, the same ones presented more frequently HBP (40% vs 19.4%, p = 0.037), DM2 (11.7% vs 0%, p = 0.036), obesity (38.3% vs 16.7%, p = 0.025), altered glycemia (27.1% vs 6.5%, p = 0.02), altered HbA1C (50.8% vs 22.6%, p = 0.01), higher mean weight (75.9 ± 17.62 p = 0.02), higher Framingham index high (20% vs 3.2%, p = 0.03). Regarding to clinical parameters, a higher frequency of erosions was found (55.8% vs 22.2%, p = 0.004), without other significant differences for disease activity, seropositivity or disease duration. As for serum biomarkers, higher levels of fibrinogen (639.71 ± 189.84, p = 0.04), homocysteine (11.74 ± 7.81, p = 0.05) and VCAM (519, 16 ± 203.68, p = 0.02) were found.Conclusion:We found a high frequency of diastolic dysfunction in patients with RA. They presented a significant association with traditional CV risk factors, erosions, and fibrinogen, homocysteine, and VCAM biomarkers. Adequate control of cardiovascular risk factors and echocardiographic assessment of these patients is essential in order to avoid the progression of heart functional damage.References:[1]Aslam F, Bandeali SJ, Khan NA, Alam M. Diastolic Dysfunction in Rheumatoid Arthritis: A Meta-Analysis and Systematic Review. Arthritis Care & Research. 2013;65(4):534-43.[2]Liang KP, Myasoedova E, Crowson CS, Davis JM, Roger VL, Karon BL, et al. Increased prevalence of diastolic dysfunction in rheumatoid arthritis. Annals of the Rheumatic Diseases. 1 de septiembre de 2010;69(9):1665-70.Disclosure of Interests:None declared

scholarly journals Left Ventricular Dyssynchrony in Acute ST Elevated Myocardial Infarction in Patients with Normal QRS duration

2016 ◽  
Vol 30 (1) ◽  
pp. 13-21
Author(s):  
Iftekhar Alam ◽  
Tuhin Haque ◽  
Mohammad Badiuzzaman ◽  
Abdullah Al Masud ◽  
Abrar Kaiser ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Peak Systolic Velocity ◽  
Left Ventricular ◽  
Left Ventricular Dyssynchrony ◽  
Control Group ◽  
Ventricular Dyssynchrony ◽  
Acute Stemi ◽  
Lv Dyssynchrony ◽  
Qrs Duration ◽  
Ejection Phase

Background: The aim of this study was to assess left ventricular dyssynchrony after acute ST elevated myocardial infarction (STEMI) in patients with normal QRS duration. Real time 3D echocardiography (RT3DE) with triplane tissue synchronization imaging (TSI) used to identify segmental left ventricular systolic velocity in ejection phase to evaluate LV dyssynchrony in patients with STEMI and the findings were compared with control.Materials and methods: RT3DE with triplane TSI was performed within 4 days of AMI after thrombolysis or primary PCI in 31 patients and compared with 31 agematched controls. Regional myocardial velocities were assessed in 12 segments in ejection phase, and the corresponding time to peak systolic velocity (Ts) was measured. To assess LV dyssynchrony Ts-4, Ts-6, Ts- SD-6, Ts-12 and Ts-SD-12 were computed by offline dedicated software semi-automatically.Results: The dyssynchrony parameters were significantly prolonged in patients with AMI. Among the dyssynchrony parameters TS-SD-12 was better indicator of LV dyssynchrony. The Ts-SD-12 was significantly prolonged in the STEMI group when compared with controls. In patients with acute STEMI mean Ts-SD-12 was 43.2±19.1 milliseconds whereas in control group it was 23.0 ±6.5 milliseconds (p<0.05). The Ts-SD-12 was prolonged in patients with Anterior than Inferior STEMI as follows respectively 45.9± 17.6 and 40.0± 21 milliseconds.Conclusions: Triplane TSI by RT3DE is useful in evaluating LV dyssynchrony in patients with acute STEMI and even in those with normal QRS duration there is significant left ventricular dyssynchrony early after STEMI.Bangladesh Heart Journal 2015; 30(1) : 13-21

A New Method to Diagnose Left Ventricular Dyssynchrony With Analysis of Heart Wall Thickening From Cardiac CT

2008 ◽  
Author(s):  
Matthew J. Goette ◽  
Jana G. Delfino ◽  
Brandon K. Fornwalt ◽  
John N. Oshinski
Keyword(s):  
Heart Failure ◽  
Pathological Condition ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Left Ventricular Dyssynchrony ◽  
Wall Thickening ◽  
Ventricular Dyssynchrony ◽  
Refractory Heart Failure ◽  
Myocardial Wall ◽  
Lv Dyssynchrony

Left ventricular (LV) dyssynchrony is a pathological condition in which segments of the myocardial wall contract at different times. This dyssynchrony results in a decreased LV ejection fraction (EF) and an increased level of mitral regurgitation. LV dyssynchrony has been linked to higher rates of morbidity, mortality, and arrhythmic susceptibility in patients with congestive heart failure. Cardiac resynchronization therapy (CRT) with biventricular pacemakers has benefited patients with drug-refractory heart failure and signs of ventricular dyssynchrony. Patients are currently selected for CRT therapy if they have a prolonged QRS complex (> 120 msec) on a surface electrocardiogram as well as an EF of less than 35%. However, recent data suggests that these criteria are insufficient, as 30% of patients do not respond to CRT treatments.

scholarly journals Hemodynamic forces using four-dimensional flow MRI: an independent biomarker of cardiac function in heart failure with left ventricular dyssynchrony?

2018 ◽  
Vol 315 (6) ◽  
pp. H1627-H1639 ◽  
Author(s):  
Per M. Arvidsson ◽  
Johannes Töger ◽  
Gianni Pedrizzetti ◽  
Einar Heiberg ◽  
Rasmus Borgquist ◽  
...  
Keyword(s):  
Heart Failure ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Dyssynchrony ◽  
Hemodynamic Forces ◽  
Control Subjects ◽  
Lv Dyssynchrony ◽  
Force Ratio ◽  
Patients With Heart Failure ◽  
Flow Mri

Patients with heart failure with left ventricular (LV) dyssynchrony often do not respond to cardiac resynchronization therapy (CRT), indicating that the pathophysiology is insufficiently understood. Intracardiac hemodynamic forces computed from four-dimensional (4-D) flow MRI have been proposed as a new measure of cardiac function. We therefore aimed to investigate how hemodynamic forces are altered in LV dyssynchrony. Thirty-one patients with heart failure and LV dyssynchrony and 39 control subjects underwent cardiac MRI with the acquisition of 4-D flow. Hemodynamic forces were computed using Navier-Stokes equations and integrated over the manually delineated LV volume. The ratio between transverse (lateral-septal and inferior-anterior) and longitudinal (apical-basal) forces was calculated for systole and diastole separately and compared with QRS duration, aortic valve opening delay, global longitudinal strain, and ejection fraction (EF). Patients exhibited hemodynamic force patterns that were significantly altered compared with control subjects, including loss of longitudinal forces in diastole (force ratio, control subjects vs. patients: 0.32 vs. 0.90, P < 0.0001) and increased transverse force magnitudes. The systolic force ratio was correlated with global longitudinal strain and EF ( P < 0.01). The diastolic force ratio separated patients from control subjects (area under the curve: 0.98, P < 0.0001) but was not correlated to other dyssynchrony measures ( P > 0.05 for all). Hemodynamic forces by 4-D flow represent a new approach to the quantification of LV dyssynchrony. Diastolic force patterns separate healthy from diseased ventricles. Different force patterns in patients indicate the possible use of force analysis for risk stratification and CRT implantation guidance. NEW & NOTEWORTHY In this report, we demonstrate that patients with heart failure with left ventricular dyssynchrony exhibit significantly altered hemodynamic forces compared with normal. Force patterns in patients mechanistically reflect left ventricular dysfunction on the organ level, largely independent of traditional dyssynchrony measures. Force analysis may help clinical decision making and could potentially be used to improve therapy outcomes.

scholarly journals Difference in Correlation Coefficient between Heart Rate Variability and Mechanical Dispersion in Breast Cancer Patients with and without Cardiovascular Risk Factors Post Anthracycline Chemotherapy

2020 ◽  
Vol 6 (1) ◽  
pp. 23-28
Author(s):  
Evi Fatimah ◽  
Erwan Martanto ◽  
Mohammad Iqbal ◽  
Januar W. Martha ◽  
M. Rizki Akbar
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cancer Patients ◽  
Left Ventricular ◽  
Left Ventricular Dyssynchrony ◽  
Breast Cancer Patients ◽  
Group I ◽  
Group Ii

Background: Sympathetic hyperactivity is one of the several factors that influence left ventricular dyssynchrony post anthracycline. Cardiovascular risk factors affect the acceleration of left ventricular dyssynchrony. The purpose of this study is to assess the difference in correlation coefficient between HRV and mechanical dispersion in breast cancer patients with and without cardiovascular risk factors after anthracycline administration.Method: This was a cross sectional study with linear regression analysis conducted at Hasan Sadikin General Hospital Bandung between July-October 2018. Subjects were breast cancer patients who had received 6 cycles of FAS and were divided into 2 groups. Group I was patients with breast cancer who have cardiovascular risk factors and group II was without cardiovascular risk factors. Sympathetic hyperactivity was assessed using HRV baseline frequency with minimum duration of recording and left ventricular dyssynchrony was assessed using MD method by echocardiography.Result: This study involved 66 patients. Group I (n=34, age 50.3±6.3 years) and group II (n=32, age 48.5±9 years). The median of LF/HF ratio was 2.7 ms2 (group I) and 1.9 ms2 (group II). MD value in group I and group II was 52.2±13.6 ms and 45.7±8.8 ms, respectively. The result of linear regression analysis showed positive correlation between the LF/HF ratio and MD in group I (r=0.546, p=0.001) and group II (r=0.423, p=0.016) after adjusting three confounding factors (systolic blood pressure, cumulative dose of Doxorubicin, and age).Conclusion: Correlation coefficient of HRV with mechanical dispersion in post anthracycline breast cancer patients in those with cardiovascular risk factorswas worse compared to those without cardiovascular risk factors but was not statistically significant.

The Carpentier-Edwards Classic and Physio Mitral Annuloplasty Rings: A Randomized Trial

2006 ◽  
Vol 8 (5) ◽  
pp. 389 ◽  
Author(s):  
Ghada M. M. Shahin ◽  
Geert J. M. G. van der Heijden ◽  
Michiel L. Bots ◽  
Maarten-Jan Cramer ◽  
Wybren Jaarsma ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Absolute Risk ◽  
Statistical Significance ◽  
Nyha Class ◽  
Left Ventricular ◽  
Mitral Annuloplasty ◽  
Risk Of Death ◽  
Late Failure

<P>Objective: To evaluate clinical and echocardiographic outcomes for the semi-flexible Carpentier-Edwards Physio and the rigid Classic mitral annuloplasty ring. </P><P>Methods: Ninety-six patients were randomized for either a Classic (n = 53) or a Physio (n = 43) ring from October 1995 through July 1997. Mean follow-up was 5.1 years (range .1-6.6). We included standard patient characteristics at baseline and during follow-up. Analyses were adjusted for age and gender, and for factors that differed across groups at baseline. In 2002, echocardiography was performed in 74% of the survivors. </P><P>Results: We found a 16% difference in mortality: 14% in the Physio group (n = 6) and 30% in the Classic group (n = 16) (adjusted P = .41). Life table analysis shows that the absolute risk of death after 30 months is lower in the Physio group. Intra-operative repair failure occurred in 3 patients (6%) of the Classic group, and in 4 (9%) of the Physio group, resulting in mitral valve replacement. Late failure occurred in 1 patient (2%) in the Classic group, and in 4 (9%) in the Physio group. At follow-up, left ventricular function did not differ across groups (ejection fraction 45% and 48% (adjusted P = .65)). The combined NYHA class III-IV had improved for the Classic group in 42% and for the Physio group in 34%. </P><P>Conclusion: Although the 16% difference in mortality did not reach statistical significance, it is considered clinically important. No differences in morbidity, valve function, and left ventricular function were found. Further research to explain the difference in mortality is required.</P>

SURVEY OF CARDIOVASCULAR RISK FACTORS AND ELECTROCARDIGRAPHIC, ECHOCARDIOGRAPHIC ABNORMALITIES IN PATIENTS ON WAITING LIST FOR RENAL TRANSPLANTATION

2014 ◽  
pp. 26-30
Author(s):  
Huu Thinh Nguyen ◽  
Thi Thuy Hang Nguyen ◽  
Bui Bao Hoang
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Renal Transplantation ◽  
Left Ventricular Hypertrophy ◽  
Cardiovascular Risk Factors ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Valve Insufficiency ◽  
Transplant Candidates ◽  
End Stage

Background: Cardiovascular disease is the major cause of death in dialysis patients, as well as in kidney transplant patients. Assessment of cardiovascular risks of renal transplant candidates to prevent or slow the progression of cardiovascular abệnh nhânormalities. Aim: 1) Evaluating cardiovascular risk factors, electrocardiographic and echocardiographic abnormalities in renal transplant candidates. 2) Identifying the correlation between cardiac morphological parameters with a number of factors involved. Subjects and Methods: We assessed 57 patients (73.7% male, mean age 32.4±8.8) with end-stage renal disease waiting for renal transplantation at Cho Ray Hospital between Jan 2012 and Jan 2013. All patients received a physical examination, blood pressure measurement, Hb, blood glucose test, lipid profile, ECG, echocardiography. Results: The percentage of hypertension was 98.2%, smoking (69.2%), dyslipidemia 40.4% and diabetes 12.3%. All patients had sinus rhythm, left ventricular hypertrophy 61.4% in ECG. Pericardial effusion 5.3%, mitral valve insufficiency 56.1%, aortic valve insufficiency 12.3%, left ventricular hypertrophy 94.7% in echocardiography. IVSd, LVPWd, LVMI positively correlated with kidney failure time (p <0.01, p<0.001), with DBP and SBP (p <0.05) and the degree of anemia (p <0.05). Percentage the degree of hypertension associated with proportion of left ventricular hypertrophy (p <0.05). Conclusions: Identification of cardiovascular risk factors for the prevention or intervention to reduce mortality in renal transplantation. Keywords: Cardiovascular risk factors, end-stage chronic renal failure, renal transplantation.

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