scholarly journals Right ventricular ejection fraction as predictor of outcome in acute heart failure using RV ellipsoid model: A retrospective analysis of a prospective cross-sectional study

2021 ◽  
Vol 10 ◽  
pp. 204800402110027
Author(s):  
Eshan Ashcroft ◽  
Otar Lazariashvili ◽  
Jonathan Belsey ◽  
Max Berrill ◽  
Pankaj Sharma ◽  
...  

Objectives The right ventricular (RV) function is an important prognostic factor in acute and chronic heart failure (HF). Echocardiography is an essential imaging modality with established parameters for RV function which are useful and easy to perform. However, these fail to reflect global RV volumes due to reliability on one acoustic window. It is therefore attractive to calculate RV volumes and ejection fraction (RVEF/E) using an ellipsoid geometric model which has been validated against MRI in healthy adults but not in the HF patients. Design This is a retrospective analysis of a prospective cross-sectional study enrolling 418 consecutive patients with symptoms of HF according to a predefined study protocol. All patients underwent echocardiographic assessment of RV function using Tricuspid Annular Plane Systolic Excursion (TAPSE) and RV fractional area change (RVFAC) and RVEF/E. Setting Single centre study with multiple locations for acute in-patients including high dependency units. Participants Patients with acute or exacerbation of chronic HF older than 18 y.o. Main outcome measures Ability of RVEF/E to predict patient outcomes compared with two established parameters of RV function over two-year follow-up period. Primary outcome measure was all-cause mortality. Results RVEF/E is equal to TAPSE & RVFAC in predicting outcome (p ≤ 0.01 vs p ≤ 0.01) and provides additional benefit of RV volume estimation based on standard 2D echo measurements. Conclusions In this study we have shown that RVEF/E derived from ellipsoid model is not inferior to well established measures of RV function as a prognostic indicator of outcome in the acute HF.

2020 ◽  
Author(s):  
Jérôme Boombhi ◽  
Antoin Bele ◽  
Mazou N Temgoua ◽  
Ba Hamadou ◽  
Joel Noutakdie Tochie ◽  
...  

AbstractBackgroundContrarily to past concepts, heart failure with preserved ejection fraction (HFpEF) has become more prevalent than heart failure with reduced ejection fraction (HFrEF). Our objective was to study the clinical, cardiovascular and laboratory findings and therapeutic aspects of HFpEF, compared with those of HFrEF in Yaounde, Cameroon.MethodThis was an analytical cross-sectional study carried-out at the Central Hospital, General Hospital and Military Hospital of Yaounde, from January to April 2018 (4 months). 201 patients aged at least 18 years old with an echocardiography confirmed diagnosis of heart failure were been enrolled. We excluded 12 patients because they had a congenital ventricular septal defect (2), chronic cor pulmonale (4), mitral stenosis (5), and pericarditis (1).ResultsWe found that 45.5% of our patients had HFpEF whereas 37.5% had HFrEF. Patients with HFpEF were older and had a significantly higher incidence of hypertension and obesity. HFrEF was significantly more associated with congestive symptoms than HFpEF. The S3 gallop was significantly more present in patients with HFrEF. Patients with HfpEF had significantly higher rate of atrial fibrillation. Furosemide, spironolactone and digoxin were significantly used more frequently in patients with HFrEF.ConclusionHFpEF is the most frequent form of heart failure in the hospital setting in Yaoundé, Cameroon. Patients with HFpEF were significantly older and more affected by hypertension and obesity than those with HFrEF. Cardiac ultrasound is indispensable to differentiate between the two entities for better management.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Peng Yu ◽  
Ming Liu ◽  
Xue Yang ◽  
Ying Yu ◽  
Ji Zhao ◽  
...  

Angiogenin (ANG) has been shown to be elevated in several cardiovascular diseases. To detect its levels and diagnostic capacity in coronary heart disease (CHD) patients complicating chronic heart failure (CHF), we performed this cross-sectional study and enrolled 616 CHD patients and 53 healthy controls. According to complicating CHF or not, the patients were divided into CHF group (n=203) and CHD disease controls (n=413), in which the CHF group was subdivided as heart failure with reduced ejection fraction (HFrEF) group or heart failure with preserved ejection fraction (HFpEF) group on the basis of left ventricular ejection fraction (LVEF), or as different NYHA class group. Their plasma ANG levels were detected using enzyme-linked immunosorbent assay (ELISA). Plasma ANG was 342.8 (IQR [273.9,432.9]), 304.5 (IQR [254.0,370.5]), and 279.7 (IQR [214.4,344.0]) ng/mL in the CHF group, CHD disease controls, and healthy controls, respectively, significantly higher in the CHF group compared with the others. Furthermore, among CHF group, ANG is dramatically higher in the HFrEF patients compared with the HFpEF patients. As for the diagnostic capacity of ANG, the area under the receiver operating characteristic curve was 0.71 (95% CI 0.63–0.78). We concluded that plasma ANG is elevated in CHD complicating CHF patients and may be a moderate discriminator of CHF from CHD or the healthy.


Author(s):  
Mazou N Temgoua ◽  
Jérôme Boombhi ◽  
Antoin Bele ◽  
Mazou N Temgoua ◽  
Ba Hamadou ◽  
...  

Background: Contrarily to past concepts, heart failure with preserved ejection fraction (HFpEF) has become more prevalent than heart failure with reduced ejection fraction (HFrEF). Our objective was to study the clinical, cardiovascular and laboratory findings and therapeutic aspects of HFpEF, compared with those of HFrEF in Yaounde, Cameroon. Method: This was an analytical cross-sectional study carried-out at the Central Hospital, General Hospital and Military Hospital of Yaounde, from January to April 2018 (4 months). 201 patients aged at least 18 years old with an echocardiography confirmed diagnosis of heart failure had been enrolled. We excluded 12 patients because they had a congenital ventricular septal defect (2), chronic cor pulmonale (4), mitral stenosis (5), and pericarditis (1). Results: We found that 45.5% of our patients had HFpEF whereas 37.5% had HFrEF. Patients with HFpEF were older and had a significantly higher incidence of hypertension and obesity. HFrEF was significantly more associated with congestive symptoms than HFpEF. The S3 gallop was significantly more present in patients with HFrEF. Patients with HFpEF had significantly higher rate of atrial fibrillation. Furosemide, spironolactone and digoxin were significantly used more frequently in patients with HFrEF. Conclusion: HFpEF is the most frequent form of heart failure in the hospital setting in Yaoundé, Cameroon. Patients with HFpEF were significantly older and more affected by hypertension and obesity than those with HFrEF. Cardiac ultrasound is indispensable to differentiate between the two entities for better management.


2011 ◽  
pp. 62-70
Author(s):  
Lien Nhut Nguyen ◽  
Anh Vu Nguyen

Background: The prognostic importance of right ventricular (RV) dysfunction has been suggested in patients with systolic heart failure (due to primary or secondary dilated cardiomyopathy - DCM). Tricuspid annular plane systolic excursion (TAPSE) is a simple, feasible, reality, non-invasive measurement by transthoracic echocardiography for evaluating RV systolic function. Objectives: To evaluate TAPSE in patients with primary or secondary DCM who have left ventricular ejection fraction ≤ 40% and to find the relation between TAPSE and LVEF, LVDd, RVDd, RVDd/LVDd, RA size, severity of TR and PAPs. Materials and Methods: 61 patients (36 males, 59%) mean age 58.6 ± 14.4 years old with clinical signs and symtomps of chronic heart failure which caused by primary or secondary DCM and LVEF ≤ 40% and 30 healthy subject (15 males, 50%) mean age 57.1 ± 16.8 were included in this study. All patients and controls were underwent echocardiographic examination by M-mode, two dimentional, convensional Dopler and TAPSE. Results: TAPSE is significant low in patients compare with the controls (13.93±2.78 mm vs 23.57± 1.60mm, p<0.001). TAPSE is linearly positive correlate with echocardiographic left ventricular ejection fraction (r= 0,43; p<0,001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation was found with LVDd and PAPs. Conclusions: 1. Decreased RV systolic function as estimated by TAPSE in patients with systolic heart failure primary and secondary DCM) compare with controls. 2. TAPSE is linearly positive correlate with LVEF (r= 0.43; p<0.001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation is found with LVDd and PAPs. 3. TAPSE should be used routinely as a simple, feasible, reality method of estimating RV function in the patients systolic heart failure DCM (primary and secondary).


2020 ◽  
pp. 201010582096214
Author(s):  
Tsegu Hailu Gebru ◽  
Haftea Hagos Mekonen ◽  
Kbrom Gemechu Kiros

Background: Good knowledge of self-care related to heart failure (HF) is key to improve patient outcomes. However, information regarding how much patients know about self-care is lacking in developing countries, particularly in the study setting. Objective: The objectives of this study were to assess HF patients’ knowledge about self-care and to explore predictors among HF patients in Ayder comprehensive specialised referral hospital, Tigray, Ethiopia. Methods: This hospital-based cross-sectional study design was undertaken in Ayder comprehensive specialised referral hospital, Tigray, Ethiopia. A total of 408 HF patients participated, and the study was done between February and April 2018. An interviewer-assisted structured questionnaire was used to collect data. Bivariate logistic regression and multivariable logistic regression were conducted to identify the predictors associated with knowledge about self-care. Results: The mean age of the participants was 45.4 years (standard deviation=19 years). Around 255 (62.5%) of the participants had poor self-care knowledge. Age, New York Heart Association classes, duration of the disease and previous hospitalisation were the factors associated with knowledge about self-care. Conclusion: More than half of all participants had poor knowledge about self-care. Improving existing prevention strategies and strengthening patients’ knowledge are recommended to address this knowledge deficit.


2021 ◽  
Vol 63 ◽  
pp. 102176
Author(s):  
Dhairya Shukla ◽  
Sharvil Patel ◽  
Lesley Clack ◽  
Tyler B. Smith ◽  
Michael S. Shuler

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