Abstract 15512: Predictors of Normalization of Left Ventricular Systolic Function After Acute Myocarditis -multicenter Observational Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ayano Yoshida ◽  
Kentaro Jujo ◽  
Eiji Shibahashi ◽  
Takuma Takada ◽  
Yuichiro Minami ◽  
...  
Keyword(s):  
Observational Study ◽  
Systolic Function ◽  
Acute Myocarditis ◽  
Area Under The Curve ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Multicenter Observational Study ◽  
Recovery Group

Introduction: The clinical presentation of acute myocarditis is highly variable, and its prognosis is occasionally unpredictable. Even the patients discharge alive, left ventricular (LV) remodeling occurs during the follow-up period in some cases, which causes the progression of dilated cardiomyopathy or sudden cardiac death. Purpose: We aimed to investigate the predictors of the recovery of LV ejection fraction (LVEF) in patients with acute myocarditis. Methods: This multicenter observational study included 20 patients [average age 38 years, 18 (90%) male] suffering acute myocarditis who were urgently hospitalized between 2007 and 2019. Enrolled patients were assigned into 2 groups depending on a recovery of LV function that was defined as LVEF ≥55% by transthoracic echocardiography (TTE) within 12 months after the onset; the Recovery group (n=8) and Non-recovery group (n=12). Results: Overall, LVEF increased from 37% to 52% (p<0.001) during the follow-up period (median interval: 180 (IQR: 42-332) days). There was no statistically differences in baseline clinical profiles or medications at discharge between the groups. However, LVEF at admission was significantly higher in the Recovery group than Non-recovery group (47±13% vs. 31±13%, p=0.014). The univariate logistic regression analysis showed that baseline LVEF was related to a recovery of LV function (odds ratio, 1.12; 95% confidence interval, 1.00-1.26). The ROC curve for a recovery of LV function revealed that the cut-off value of LVEF at admission was 42% (sensitivity: 75%, specificity: 83%, area under the curve: 0.83, Figure A ). Patients with baseline LVEF ≥42% achieved significantly higher rates of LV functional recovery after acute myocarditis than those with LVEF <42% (17% vs 75%, p=0.019, Figure B ). Conclusions: Baseline LVEF could predict a normalization of LV function in patients with acute myocarditis. Close observation and TTE follow-up should be considered in such a refractory population.

scholarly journals Prognostic value of NT-proBNP for myocardial recovery in peripartum cardiomyopathy (PPCM)

2021 ◽  
Author(s):  
J. Hoevelmann ◽  
E. Muller ◽  
F. Azibani ◽  
S. Kraus ◽  
J. Cirota ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Systolic Function ◽  
Point Of Care ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Lv Function ◽  
Myocardial Recovery ◽  
End Diastolic Volume

Abstract Introduction Peripartum cardiomyopathy (PPCM) is an important cause of pregnancy-associated heart failure worldwide. Although a significant number of women recover their left ventricular (LV) function within 12 months, some remain with persistently reduced systolic function. Methods Knowledge gaps exist on predictors of myocardial recovery in PPCM. N-terminal pro-brain natriuretic peptide (NT-proBNP) is the only clinically established biomarker with diagnostic value in PPCM. We aimed to establish whether NT-proBNP could serve as a predictor of LV recovery in PPCM, as measured by LV end-diastolic volume (LVEDD) and LV ejection fraction (LVEF). Results This study of 35 women with PPCM (mean age 30.0 ± 5.9 years) had a median NT-proBNP of 834.7 pg/ml (IQR 571.2–1840.5) at baseline. Within the first year of follow-up, 51.4% of the cohort recovered their LV dimensions (LVEDD < 55 mm) and systolic function (LVEF > 50%). Women without LV recovery presented with higher NT-proBNP at baseline. Multivariable regression analyses demonstrated that NT-proBNP of ≥ 900 pg/ml at the time of diagnosis was predictive of failure to recover LVEDD (OR 0.22, 95% CI 0.05–0.95, P = 0.043) or LVEF (OR 0.20 [95% CI 0.04–0.89], p = 0.035) at follow-up. Conclusions We have demonstrated that NT-proBNP has a prognostic value in predicting LV recovery of patients with PPCM. Patients with NT-proBNP of ≥ 900 pg/ml were less likely to show any improvement in LVEF or LVEDD. Our findings have implications for clinical practice as patients with higher NT-proBNP might require more aggressive therapy and more intensive follow-up. Point-of-care NT-proBNP for diagnosis and risk stratification warrants further investigation.

scholarly journals Distribution of left ventricular thrombus among patients with significantly impaired systolic function

2021 ◽  
Vol 02 ◽  
Author(s):  
Ibrahim Abdullah Alranini ◽  
Hatim Kheirallah ◽  
Juan Jaime Alfonso ◽  
Ahmed R. Al Fagih
Keyword(s):  
Ischemic Cardiomyopathy ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Lv Function ◽  
Variable Degree ◽  
Ventricular Thrombus ◽  
Study Results

Background: The prevalence of left ventricular (LV) thrombus as well as the distribution among patients with a variable degree of left ventricular systolic function impairment due to various etiologies is not well known. Objectives: To describe the distribution of left ventricular thrombus in relation to the underlying pathology, i.e., ischemic versus non-ischemic cardiomyopathy with ejection fraction (EF) below 45%. Methods: All echocardiography studies performed between January 2013 and September 2017 were reviewed, and only those with confirmed LV thrombus were included. The patient’s demographic, clinical characteristics, cardiac history, and echocardiographic parameters were obtained. The cohort was divided into 4 subgroups: 22 patients with EF of 36 - 45% (A), 114 with 26% - 35% (B), 99 with 16 - 25% (C) and 48 with 15% or less (D). Results: A total of 63,732 echocardiography study results were reviewed. Only 282 patients were proved to have LV thrombus with EF less than 45%. 217 (77%) patients had previous myocardial infarction, of which 212 (97.7%) were presented with anterior regional wall motion abnormality. 90 (32.7%) patients were found to have dilated left ventricle, while 41 (14.5%) were diagnosed with dilated cardiomyopathy (DCM). 37 (13.2%) patients had moderately severe to severe mitral regurgitation. It was observed that the highest distribution of LV thrombus was seen in group B (40.3%). Conclusion: The majority of LV thrombus distribution was seen in patients with EF between 26% to 35% due to ischemic cardiomyopathy. Conversely, in the cohort of non-ischemic cardiomyopathy, the majority were observed in those with severely impaired LV function.

scholarly journals Correlation between hemoglobin level and left ventricular systolic functions and dimensions in children with chronic severe anemia

2011 ◽  
Vol 51 (2) ◽  
pp. 79
Author(s):  
Erlina Masniari Napitupulu ◽  
Fera Wahyuni ◽  
Tina Christina L. Tobing ◽  
Muhammad Ali ◽  
Bidasari Lubis
Keyword(s):  
Systolic Function ◽  
Pearson Correlation ◽  
Systolic Dysfunction ◽  
Univariate Analysis ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Lv Function ◽  
Severe Anemia ◽  
Cross Sectional ◽  
Lv Systolic Function

Background Chronic severe anemia is a connnon disease. Cardiac output may increase when the hemoglobin (Hb) level decreases to < 7 g/dL for 3 months or more. Alteration of left ventricular (LV) function occurs frequently in children 'With chronic severe anemia, in the {onn of concentric LV hypertrophy, LV dilatation with or v.ithout LV hypertrophy, or systolic dysfunction. Objective To examine the correlation between Hb level and alteration of LV systolic function in children with chronic severe anemia. Methods We conducted a cross-sectional study in Adam Malik Hospital from October to December 2009. Subjects were chronic severely anemic children. Left ventricular systolic function (ejection fraction/EF, fractional shortening/FS) and dimensions (left ventricular end diastolic diameter/LVEDD and left ventricular end systolic diameter/LVESD) were measured using Hitachi EUB 5500 echocardiography unit. Univariate analysis  and Pearson correlation were performed.Results Thirty children were enrolled in the study. The mean of age was 113.5 months (SD 53.24). Hb values ranged from 2.1 to 6.9 g/dL with mean value of 4.6 g/dL (SD 1.44). Mean duration of anemia was 3.9 months (SD 0.70). Chronic severe anemia was not associated \\lith decreased LV systolic function [EF 62.2% (SD 9.16), r =0.296, P=0.112; FS 33.8% (SD 7.26), r =0.115, P=0.545], nor LV dimension changes [LVEDD 40.2 mm (SD 6.85), r = -0.192, P=0.308; LVESD 26.2 mm (SD 4.98), r=-0.266, P=0.156]. Conclusion There was no correlation between Hb level in chronically anemic children and changes in LV systolic function or dimension.

307Clinical outcomes of pacing induced cardiomyopathy in patients with preserved left ventricular systolic function and atrioventricular block

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
O Dor ◽  
M Haim ◽  
O Barrett ◽  
V Novack ◽  
Y Konstantino
Keyword(s):  
Atrioventricular Block ◽  
Systolic Function ◽  
Beta Blockers ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Rv Pacing ◽  
Baseline Characteristics ◽  
First Time ◽  
Normal Lvef

Abstract Funding Acknowledgements None Background Patients with preserved LVEF and atrioventricular block (AVB) who are anticipated for high-burden of right ventricular (RV) pacing possess a risk to develop pacing induced cardiomyopathy (PICM). Aims To evaluate the incidence and outcomes of RV-PICM in this patient"s population. Methods 1013 patients with AVB underwent first time pacemaker (PM) implantation between 2002 and 2016. A total of 203 patients with normal LVEF were included. Follow-up echocardiography was examined for a decrease in LVEF &gt; 10%. Alternative causes for cardiomyopathy were excluded. Patient"s characteristics, mortality and hospitalizations for heart failure (HF) were compared between the PICM and non-PICM groups.  Results 51 patients (25%) developed PICM, with 22 patients (11%) showing LVEF &lt; 40%. During mean follow-up of 49.2 months, the risk of HF hospitalization or all-cause mortality was significantly higher in the PICM group (35.3% vs. 19.1%, p = 0.009). LVEDD was independently associated with PICM (HR = 1.10, 95% CI: 1.03-1.17, p = 0.01) and CAD was nearly associated with PICM (HR = 2.19, 95% CI: 0.98-4.90, p = 0.06).  Conclusions The incidence of PICM in patients with normal LVEF and AVB is alarmingly high. PICM in patients with a previously normal LVEF is associated with unfavorable outcomes. Table 1 Characteristics Cohort without PICM (152) n (%) Cohort with PICM (51) n(%) p Age mean ± SD 74.6 ± 10.5 71 ± 13 0.04 Gender (male) 80 (52.6) 29 (56.9) 0.6 Pacing modeDDDVDDVVI 108 (71.1) 38 (25) 6 (3.9) 34 (66.7) 15 (29.4) 2(3.9) 0.83 Hypertension 112 (73.7) 36 (70.6) 0.67 PVD 16 (10.5) 5 (8.9) 0.88 CAD 36 (23.7) 19 (37.3) 0.01 CVA / TIA 17 (11.2) 7 (13.7) 0.63 Atrial fibrillation / flutter 18 (11.8) 9 (17.6) 0.29 COPD 15 (9.9) 2 (3.9) 0.25 Diabetes Mellitus 56 (36.8) 27 (52.9) 0.04 Chronic Kidney Disease 27 (17.9) 14 (27.5) 0.14 Statins 65 (43) 30(60) 0.04 ACE inhibitors / ARBs 52 (34.4) 18 (36) 0.84 Beta Blockers 42 (28) 10 (20) 0.26 LVEDD mm 45.13 ± 5.53 48.46 ± 5.97 &lt;0.001 LVESD mm 25.68 ± 5.28 27.72 ± 4.67 0.02 Baseline characteristics Abstract Figure. HF and Mortality outcomes

scholarly journals New Echocardiographic Findings Correlate with Intramyocardial Inflammation in Endomyocardial Biopsies of Patients with Acute Myocarditis and Inflammatory Cardiomyopathy

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Felicitas Escher ◽  
Mario Kasner ◽  
Uwe Kühl ◽  
Johannes Heymer ◽  
Ursula Wilkenshoff ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Acute Myocarditis ◽  
Left Ventricular ◽  
Inflammatory Cardiomyopathy ◽  
Lv Systolic Function ◽  
Lymphocytic Infiltrates ◽  
Fractional Shortening

Background. The diagnosis of acute myocarditis (AMC) and inflammatory cardiomyopathy (DCMi) can be difficult. Speckle tracking echocardiography with accurate assessments of regional contractility could have an outstanding importance for the diagnosis.Methods and Results.N=25patients with clinically diagnosed AMC who underwent endomyocardial biopsies (EMBs) were studied prospectively. Speckle tracking imaging was examined at the beginning and during a mean follow-up period of 6.2 months. In the acute phase patients had markedly decreased left ventricular (LV) systolic function (mean LV ejection fraction (LVEF)40.4±10.3%). At follow-up inn=8patients, inflammation persists, correlating with a significantly reduced fractional shortening (FS,21.5±6.0%) in contrast to those without inflammation in EMB (FS32.1±7.1%,P<0.05). All AMC patients showed a reduction in global systolic longitudinal strain (LS,−8.36±−3.47%) and strain rate (LSR,0.53±0.29 1/s). At follow-up, LS and LRS were significantly lower in patients with inflammation, in contrast to patients without inflammation (−9.4±1.4versus−16.8±2.0%,P<0.0001;0.78±0.4versus1.3±0.3 1/s). LSR and LS correlate significantly with lymphocytic infiltrates (for CD3r=0.7,P<0.0001, and LFA-1r=0.8,P<0.0001).Conclusion. Speckle tracking echocardiography is a useful adjunctive assisting tool for evaluation over the course of intramyocardial inflammation in patients with AMC and DCMi.

scholarly journals Best anesthetics for assessing left ventricular systolic function by echocardiography in mice

2015 ◽  
Vol 308 (12) ◽  
pp. H1525-H1529 ◽  
Author(s):  
Ronald E. Pachon ◽  
Bruce A. Scharf ◽  
Dorothy E. Vatner ◽  
Stephen F. Vatner
Keyword(s):  
Heart Rate ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Conscious State ◽  
Left Ventricular ◽  
Lv Function ◽  
The Past ◽  
Anesthetic Agents ◽  
Lv Systolic Function ◽  
Randomized Crossover Study

Our review of the literature of the major cardiovascular journals for the past three years showed that for all studies using anesthesia for mouse echocardiography, the predominant anesthetic was isoflurane, which was used in 76% of the studies. The goal of this investigation was to determine if isoflurane is indeed the best anesthetic. Accordingly, we compared isoflurane with 2,2,2-tribromoethanol (Avertin), ketamine-xylazine, and ketamine on different days in the same 14 mice, also studied in the conscious state without anesthesia. A randomized crossover study design was employed to compare the effects on left ventricular (LV) systolic function and heart rate of the four different anesthetic agents assessed by transthoracic echocardiography. As expected, each anesthetic depressed LV ejection fraction and heart rate when compared with values in conscious mice. Surprisingly, isoflurane was not the best, but actually second to last in maintaining normal LV function and heart rate. The anesthetic with the least effect on LV function and heart rate was ketamine alone at a dose of 150 mg/kg, followed by Avertin at 290 mg/kg, isoflurane at 3% induction and 1 to 2% maintenance, and lastly ketamine-xylazine at 100 and 10 mg/kg, respectively. In summary, these results indicate that ketamine alone exerts the least depressant effects on LV function and heart rate, with Avertin second, suggesting that these anesthetics should be used when it is not feasible to study the animals in the conscious state as opposed to the most commonly used anesthetic, isoflurane.

scholarly journals Impacts of Different Anesthetic Agents on Left Ventricular Systolic Function in Mice Assessed by Echocardiography

2019 ◽  
pp. 365-374 ◽  
Author(s):  
C. LI ◽  
J. DAI ◽  
F. WU ◽  
H. ZHANG
Keyword(s):  
Heart Rate ◽  
Time Trends ◽  
Chloral Hydrate ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Conscious State ◽  
Left Ventricular ◽  
Lv Function ◽  
Anesthetic Agents ◽  
Lv Systolic Function

The present experiments were performed to study the effects and time trends of different anesthetic agents on the left ventricular (LV) systolic function and heart rate by high-resolution echocardiography in mice. Ten male C57BL/6J mice were submitted to echocardiography imaging separated by 72-hour intervals under the following conditions: 1) conscious mice, 2) mice anesthetized with isoflurane (ISO, inhaled), 3) mice anesthetized with tribromoethanol (TBE, intraperitoneal), 4) mice anesthetized with chloral hydrate (CH, intraperitoneal), and 5) mice anesthetized with pentobarbital sodium (PS, intraperitoneal). The effect of ISO, TBE, CH, and PS on LV systolic function was measured at 0, 1, 2, 3, 4, 6, 8, and 10 min after anesthesia. The results showed that LV systolic function and heart rate (HR) of anesthetized mice were reduced significantly (P<0.05), compared with results in the same mice studied in the conscious state. In addition, the results indicated that the anesthetic with the least effect on LV function was CH, and followed by TBE, PS, ISO. We conclude that different anesthetic agents always depressed the HR and LV systolic function of mice, and, furthermore, the effects and time trends of different anesthetics on LV function are different. In echocardiographic experiments, we should choose proper anesthetic agents according to the experimental requirements.

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