scholarly journals Role of Echocardiography for Assessment of Cardiac Remodeling in Congenitally Corrected Transposition of Great Arteries

2021 ◽  
Author(s):  
Alexander C. Egbe ◽  
William R. Miranda ◽  
Heidi M. Connolly
Keyword(s):  
Right Ventricular ◽  
Cardiac Remodeling ◽  
Cardiovascular Events ◽  
Ventricular Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Right Atrial ◽  
Transposition Of Great Arteries ◽  
Congenitally Corrected Transposition

Background: The purpose of this study was to assess the role of echocardiography for a comprehensive assessment of cardiac remodeling, and the relationship between indices of cardiac remodeling and cardiovascular events (defined as the composite end point of heart failure hospitalization, heart transplant, or cardiovascular death) in adults with congenitally corrected transposition of great arteries (cc-TGA). Methods: This is a retrospective study of adults with cc-TGA who underwent echocardiogram (2003–2020). Offline image analysis was performed in all patients. Chamber (atrial and ventricular) function and size were assessed by strain imaging and 2-dimensional echocardiography. Results: Of 233 patients with cc-TGA (40±15 years), 123 (55%) had at least one cardiac procedure before baseline echocardiogram. Of 233 patients, 76% and 61% had left atrial dysfunction and systemic right ventricular dysfunction, respectively; while 43% and 11% had right atrial dysfunction and left ventricular dysfunction, respectively. During a median follow-up of 8.9 years, 114 (49%) underwent additional cardiac procedures, and 66 (28%) had cardiovascular events. Left atrial reservoir strain, right ventricular global longitudinal strain, right atrial reservoir strain, left ventricular systolic pressure, and left ventricular global longitudinal strain were independently associated with cardiovascular events. Conclusions: In addition to the clinical importance of right ventricular systolic dysfunction in cc-TGA that is already well described, the current study demonstrated, for the first time, that biatrial dysfunction was common and was associated with clinical outcomes. Since there are currently no effective therapies for atrial and ventricular dysfunction in patients with cc-TGA, there is a need for research to identify novel strategies to prevent atrial and ventricular dysfunction in this population.

Mechanisms of hypotension produced by platelet-activating factor

1989 ◽  
Vol 66 (6) ◽  
pp. 2681-2690 ◽  
Author(s):  
F. R. Laurindo ◽  
R. E. Goldstein ◽  
N. J. Davenport ◽  
D. Ezra ◽  
G. Z. Feuerstein
Keyword(s):  
Right Ventricular ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Ventricular Dysfunction ◽  
Platelet Activating Factor ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Right Ventricular Failure ◽  
Right Atrial ◽  
Ventricular Failure

Platelet-activating factor (PAF) is a phospholipid mediator that induces cardiovascular collapse and release of the secondary mediator thromboxane A2 (TxA2). To clarify mechanisms involved in this collapse and, specifically, the relative contribution of left ventricular and right ventricular dysfunction, we studied 12 open-chest pigs. PAF infusion (0.04–0.28 nmol.kg-1.min-1) induced a 5- to 120-fold increase in pulmonary vascular resistance, a 75–98% fall in cardiac output, and systemic arterial hypotension. Right ventricular failure was indicated by chamber enlargement, decreased shortening, and increased right atrial pressures. In contrast, left ventricular dysfunction was accompanied by decreases in chamber dimensions and filling pressures that were unresponsive to volume expansion. U 46619 (a stable TxA2 analogue) and mechanical pulmonary artery constriction induced changes similar to PAF. In 11 additional closed-chest pigs, TxA2 blockade with indomethacin attenuated the PAF-induced rise in pulmonary vascular resistance, right ventricular dysfunction, and systemic hypotension. A specific TxA2 synthase inhibitor, OKY-046, also diminished hemodynamic effects of PAF in six other pigs. Tachyphylaxis was not observed in five pigs repeatedly given PAF. We conclude that acute right ventricular failure as the result of severe increase in pulmonary vascular resistance is the primary mechanism early in the course of PAF-induced shock in the pig. PAF-induced release of TxA2 may contribute significantly to these events.

In congenitally corrected transposition of great arteries following Fontan surgery, a left ventricle with suprasystemic systolic and high end-diastolic pressures paradoxically preserves right ventricular and tricuspid valve function

2019 ◽  
Vol 29 (12) ◽  
pp. 1522-1523
Author(s):  
Santosh Wadile ◽  
Ejaz A. Sheriff ◽  
Kothandam Sivakumar
Keyword(s):  
Left Ventricle ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Left Ventricular ◽  
Transposition Of Great Arteries ◽  
Valve Function ◽  
Fontan Surgery ◽  
Congenitally Corrected Transposition ◽  
Corrected Transposition

AbstractSystemic right ventricular function in congenitally corrected transposition depends on septal geometry. Suprasystemic left ventricular systolic pressures and high end-diastolic pressures after Fontan surgery paradoxically preserve right ventricular function.

scholarly journals Síndrome metabólica e disfunção ventricular esquerda subclínica

2016 ◽  
Vol 26 (3) ◽  
pp. 25584 ◽  
Author(s):  
Wilson Cañon Montañez
Keyword(s):  
Metabolic Syndrome ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Sindrome Metabolica

Recent studies using both conventional and tissue Doppler echocardiography have gathered evidence of myocardial dysfunction in individuals with metabolic syndrome. Recently, two-dimensional speckle-tracking echocardiography (2D-STE) has become a robust method for the detection of subclinical left ventricular dysfunction through quantitative assessment of myocardial deformation. Some studies suggest that metabolic syndrome is associated with longitudinal deformation of the left ventricle and that global longitudinal strain measured by 2D-STE is impaired in individuals with metabolic syndrome. It may be inferred that the early identification of subclinical left ventricular dysfunction and the determination of the role of the components of metabolic syndrome in impaired myocardial contractility can help elucidate and predict the risk of cardiovascular diseases in this syndrome.

scholarly journals Morphological changes and myocardial function assessed by traditional and novel echocardiographic methods in preadolescent athlete’s heart

2018 ◽  
Vol 25 (9) ◽  
pp. 1000-1007 ◽  
Author(s):  
Anders W Bjerring ◽  
Hege EW Landgraff ◽  
Svein Leirstein ◽  
Anette Aaeng ◽  
Hamza Z Ansari ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Left Ventricular Mass ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Athlete’S Heart ◽  
Right Atrial ◽  
End Diastolic Volume ◽  
Ventricular Mass ◽  
Athlete's Heart

Background Athlete’s heart is a term used to describe the morphological and functional changes in the hearts of athletes. Recent studies suggest that these changes may occur even in preadolescent athletes. This study aims to improve our understanding of the changes occurring in the preadolescent athlete’s heart. Design and methods Cardiac morphology and function in 76 preadolescent cross-country skiers (aged 12.1 ± 0.2 years) were compared with 25 age-matched non-competing preadolescents. Echocardiography was performed in all subjects, including 2D speckle-tracking strain echocardiography and 3D echocardiography. All participants underwent cardiopulmonary exercise testing to assess oxygen uptake and exercise capacity. Results Athletes had greater indexed VO2 max (62 ± 7 vs. 44 ± 5 mL/kg per min, p < 0.001), indexed left ventricular end-diastolic volume (79 ± 7 vs. 68 ± 7 mL/m2, p < 0.001), left ventricular mass (69 ± 12 vs. 57 ± 13 g/m2, p < 0.001), indexed right ventricular basal diameter (28.3 ± 3.0 vs. 25.4 ± 3.5 mm/m2, p < 0.001) and right atrial area (10.6 ± 1.4 vs. 9.7 ± 1.2 cm2/m2, p < 0.01). There was no difference in left ventricular ejection fraction, global longitudinal strain, and global circumferential strain and right ventricular fractional area change between the groups. Controls had higher right ventricular global longitudinal strain (−28.1 ± 3.5 vs. −31.1 ± 3.3%, p < 0.01). VO2 max was highly correlated to left ventricular end-diastolic volume ( r = 0.76, p < 0.001). Conclusion Athletes had greater left ventricular mass and greater left and right ventricular chamber dimensions compared with controls, while left ventricular function did not differ. Interestingly, right ventricular deformation was significantly lower compared with controls. This supports the notion that there is physiological, adaptive remodelling in preadolescent athlete’s heart.

scholarly journals Early detection of ventricular dysfunction in juvenile systemic sclerosis by speckle tracking echocardiography

Rheumatology ◽  
2020 ◽  
Vol 60 (1) ◽  
pp. 103-107
Author(s):  
Giovanni Civieri ◽  
Biagio Castaldi ◽  
Giorgia Martini ◽  
Alessandra Meneghel ◽  
Ornella Milanesi ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Speckle Tracking ◽  
Cardiac Involvement ◽  
Ventricular Dysfunction ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Laboratory Data ◽  
Left Ventricular ◽  
Juvenile Systemic Sclerosis

Abstract Objective Cardiac involvement is the most important cause of mortality in juvenile systemic sclerosis (JSSc). Recent reports in adult patients underline that traditional techniques of imaging are inadequate to assess the subclinical cardiac involvement, while speckle tracking echocardiography (STE) is able to identify ventricular dysfunctions in the early stages. The aim of our study was to assess the role of STE in JSSc. Methods Demographic, clinical and laboratory data were collected from patients with JSSc. Cardiac investigations performed at baseline (T0) and 18 (T18) and 36 months (T36) follow-up included electrocardiography, conventional echocardiography with measurement of the ejection fraction (EF) and STE with assessment of left and right ventricular global longitudinal strain (LV-GLS and RV-GLS). Cardiac parameters have been compared with demographic characteristics and disease severity, assessed by the Juvenile Systemic Sclerosis Severity Score (J4S). Results A total of 18 patients, 12 (67%) females, entered the study. At T0, electrocardiography was abnormal in three patients, EF was reduced in one, LV-GLS was abnormal in three (16.7%) and RV-GLS was abnormal in five (27.8%). At T18, EF remained stable while at T36 the result decreased in seven of nine patients. At the same time, LV-GLS also worsened (from −21.6% to −18.2%, P = 0.01). LV-GLS and RV-GLS at baseline showed a significant correlation with J4S (P = 0.012 and P = 0.02, respectively). Conclusion STE is more sensitive than standard echocardiography to identify cardiac involvement in JSSc. Over time, we observed a gradual worsening of LV-GLS, a sign of left ventricular dysfunction, that anticipated by several months the decrease of EF.

Reduction in Risk of Myocardial Infarction, Stroke, and Death from Cardiovascular Causes. Focus on Rampiril

2009 ◽  
Vol 1 ◽  
pp. CMT.S2095
Author(s):  
M. Khazaei ◽  
AM. Sharifi ◽  
S. Golbidi ◽  
I. Laher
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Active Metabolite ◽  
Cardiovascular Events ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Converting Enzyme ◽  
Weak Inhibitor

Several clinical studies demonstrate a beneficial role of angiotensin-converting enzyme (ACE) inhibitors in patients with myocardial infarction, hypertension and diabetes mellitus. This review focuses on the effects of ramipril, a weak inhibitor of ACE that is rapidly hydrolyzed to ramiprilat, an active metabolite. The Heart Outcome Prevention Evaluation (HOPE) study evaluated the effects of ramipril in patients with a high risk for cardiovascular events without pre-existing left ventricular dysfunction or heart failure. In this review, we summarized the effects of ramipril on myocardial infarction, death, diabetes mellitus, and stroke.

An Unusual Association: Right Atrial Myxoma and Severe Left Ventricular Dysfunction. Case Report and Review of the Literature

2015 ◽  
Vol 17 (6) ◽  
pp. 285
Author(s):  
Lucian Florin Dorobantu ◽  
Ovidiu Chioncel ◽  
Alexandra Pasare ◽  
Dorin Lucian Usurelu ◽  
Ioan Serban Bubenek-Turconi ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Ventricular Dysfunction ◽  
Left Ventricular Systolic Dysfunction ◽  
Left Ventricular ◽  
Right Atrial ◽  
Left Ventricular Ejection ◽  
Cardiac Tumors ◽  
Severe Left Ventricular Dysfunction ◽  
Ventricular Ejection Fraction ◽  
Increased Risk

Myxomas comprise 50% of all benign cardiac tumors in adults, with the right atrium as their second most frequent site of origin. Surgical resection is the only effective therapeutic option for patients with these tumors. The association between right atrial myxomas and severe left ventricular systolic dysfunction is extremely rare and makes treatment even more challenging. This was the case for our patient, a 47-year-old male with a right atrial mass and a severely impaired left ventricular function, with a 20% ejection fraction. Global enlargement of the heart was also noted, with moderate right ventricular dysfunction. The tumor was successfully excised using the on-pump beating heart technique, with an immediate postoperative improvement of the left ventricular ejection fraction to 35%. The technique proved useful, with no increased risk to the patient.

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