Abstract 13099: Evaluation of Right Ventricular Myocardial Mechanics by 2D-and 3D-STE in Patients With End-stage Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yuman Li ◽  
Fangyan Tian ◽  
Mingxing XIE
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Systolic Function ◽  
Normal Subjects ◽  
Myocardial Mechanics ◽  
Systolic Volume ◽  
Significant Difference ◽  
End Stage Heart Failure ◽  
End Stage ◽  
2D And 3D

Background: Speckle-tracking echocardiography (STE) has emerged as a more accurate tool for assessing the right ventricular (RV) function.We aimed to assess RV myocardial mechanics by 2D- and 3D-STE in patients with end-stage heart failure (HF). Methods: We enrolled 105 patients with end-stage HF and 50 normal subjects. The results of coronary artery angiography divided these patients into two subgroups : ischaemic cardiomyopathies (ICM, n=23) and non-ischaemic cardiomyopathies subgroups (NICM, n=82). RV end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF) were measured by 3D-STE. RV free wall longitudinal strain (RVLS-fre),and RV septal wall LS (RVLS-sep) were also determined by 3D-and 2D-STE. The conventional RV function parameters (fractional area change [FAC], tricuspid annular plane systolic excursion [TAPSE]) were obtained. We compared these parameters between patients and normal subjects. RVLS-fre and RVLS-sep obtained by 3D- and 2D-STE were compared between ICM and NICM. Results: Compared with controls, patients had higher RVEDV, RVESV(P<0.001),and lower RVLS-fre, RVLS-spe, RVEF, RVSV, FAC, TAPSE(P<0.001).In 105 patients, 3D-RVLS-fre was lower than 2D-RVLS-fre (-11.43±3.83% VS -12.30±3.95%;P=0.003); whereas 3D-RVLS-sep was not different from 2D-RVLS-sep. Patients with NICM had significant lower 3D-RVLS-fre(-10.68±3.55% VS -14.06±3.70%;P<0.001)and 3D-RVLS-sep (-6.68±2.76% VS -8.26±2.64%;P=0.006)than patients with ICM. There was no difference in 2D-STE between the two subgroups. Conclusions: End-stage HF patients present significant difference in RVLS values between 3D- and 2D-STE. 3D-STE is superior to 2D-STE for RV systolic function assessment in end-stage HF patients with different pathologies.

Right Ventricular Proteome in End-Stage Heart Failure

2012 ◽  
Vol 18 (8) ◽  
pp. S33
Author(s):  
Yan Ru Su ◽  
David Friedman ◽  
Chee Lim ◽  
Thomas G. Di Salvo
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
End Stage Heart Failure ◽  
End Stage

scholarly journals Mortality and long-term outcomes of palliative inotropes in ischemic and non-ischemic cardiomyopathy

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Tolia ◽  
M Khan ◽  
S Khan ◽  
D Alexander ◽  
M Soltys ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Ischemic Cardiomyopathy ◽  
Circulatory Support ◽  
Complication Rates ◽  
Number Of Patients ◽  
Significant Difference ◽  
History Of ◽  
End Stage Heart Failure ◽  
End Stage

Abstract Background Palliative inotropes are frequently utilized for symptom management in patients with end stage heart failure who are unable to undergo durable advanced heart failure therapies. With the advent of improved medical management and early intervention, palliative inotropes may allow for improved patient outcomes than seen previously. In this study, we aim to investigate the survival and outcomes of palliative inotrope therapy and its impacts on ischemic versus non-ischemic cardiomyopathy. Methods We retrospectively analyzed 220 patients with American Heart Association Stage D heart failure who were discharged with palliative inotrope therapy after January 1, 2010. Patients who underwent mechanical circulatory support (MCS) or those who underwent heart transplant were excluded. Those with a history of coronary artery disease, myocardial infarction, history of percutaneous intervention, or coronary artery bypass grafting were assigned to ischemic cardiomyopathy (ICM), while patients without these findings were assigned to non-ischemic cardiomyopathy (NICM). Statistical analysis was completed using Chi-Square and Student's t-tests, wherein p&lt;0.05 was considered statistically significant. Results Of the 220 patients, 87 had NICM as opposed to 133 with ICM. Mean age was found to be higher among patients with ICM (70 [62–79]) compared to NICM (65 [55–72], p-value &lt;0.01). No significant difference was seen in total days on inotrope therapy (p=0.6). While more patients in both groups were placed on milrinone as opposed to dobutamine, there was no difference between patients with ischemic and NICM (p=0.66 and 0.51 respectively). Although a greater number of patients with NICM had been lost to follow up, admitted to hospice, or expired at 2 years (p&lt;0.01), survival at 3 months, 1 year, and 2 years showed no difference between both groups. No difference was seen in number of hospitalizations or clinic visits in one year. Both groups had similar complication rates with intravenous-access related PICC line infections and new arrhythmias. (See Table). Conclusion Despite more frequent use of durable mechanical support devices, many patients who are deemed unsuitable for invasive measures are treated with palliative inotrope therapy. We have found that there is no significant difference in survival, complications, and outcomes of patients on palliative inotropes among ischemic and NICM. These findings show the versatility of palliative inotrope therapy in end stage heart failure. Further studies with larger populations need to be evaluated. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Outcomes of temporary mechanical circulatory support in cardiogenic shock due to end-stage heart failure

2021 ◽  
pp. 175114372098870
Author(s):  
Hoong Sern Lim ◽  
Aaron Ranasinghe ◽  
David Quinn ◽  
Colin Chue ◽  
Jorge Mascaro
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Organ Dysfunction ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Number Of Patients ◽  
Significant Difference ◽  
End Stage Heart Failure ◽  
Baseline Characteristics ◽  
End Stage

Background There are few reports of mechanical circulatory support (MCS) in patients with cardiogenic shock (CS) due to end-stage heart failure (ESHF). We evaluated our institutional MCS strategy and compared the outcomes of INTERMACS 1 and 2 patients with CS due to ESHF. Methods Retrospective analysis of prospectively collected data (November 2014 to July 2019) from a single centre. ESHF was defined by a diagnosis of HF prior to presentation with CS. Other causes of CS (eg: acute myocardial infarction) were excluded. We compared the clinical course, complications and 90-day survival of patients with CS due to ESHF in INTERMACS profile 1 and 2. Results We included 60 consecutive patients with CS due to ESHF Differences in baseline characteristics were consistent with the INTERMACS profiles. The duration of MCS was similar between INTERMACS 1 and 2 patients (14 (10–33) vs 15 (7–23) days, p = 0.439). There was no significant difference in the number of patients with complications that required intervention. Compared to INTERMACS 2, INTERMACS 1 patients had more organ dysfunction on support and significant lower 90-day survival (66% vs 34%, p = 0.016). Conclusion Our temporary MCS strategy, including earlier intervention in patients with CS due to ESHF at INTERMACS 2 was associated with less organ dysfunction and better 90-day survival compared to INTERMACS 1 patients.

scholarly journals Right Ventricular Protein Expression Profile in End-Stage Heart Failure

2015 ◽  
Vol 5 (3) ◽  
pp. 481-497 ◽  
Author(s):  
Yan Ru Su ◽  
Manuel Chiusa ◽  
Evan Brittain ◽  
Anna R. Hemnes ◽  
Tarek S. Absi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Protein Expression ◽  
Right Ventricular ◽  
Expression Profile ◽  
Protein Expression Profile ◽  
End Stage Heart Failure ◽  
End Stage

METABOLIC SIGNATURE OF HUMAN RIGHT VENTRICULAR MYOCARDIUM IN END STAGE HEART FAILURE

2020 ◽  
Vol 75 (11) ◽  
pp. 1043
Author(s):  
Giovanni Davogustto ◽  
Jean Wassenaar ◽  
Fan Run ◽  
Haocan Song ◽  
Fei Ye ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Ventricular Myocardium ◽  
Human Right ◽  
Metabolic Signature ◽  
End Stage Heart Failure ◽  
End Stage
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