Echocardiography and Laboratory Factors Associated With Prolonged Postoperative Pericardial Effusion

2022 ◽  
pp. 875647932110702
Author(s):  
Rrezarta Alihajdaraj ◽  
Adem Grbolar ◽  
Xhevdet Krasniqi ◽  
Tefik Bekteshi ◽  
Aurora Bakalli
Keyword(s):  
Pericardial Effusion ◽  
Statistical Significance ◽  
Artery Bypass ◽  
Global Longitudinal Strain ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Limited Data ◽  
Cross Sectional ◽  
Frequent Finding

Objective: Pericardial effusion is a frequent finding in patients who undergo cardiac surgery. There are currently limited data providing information regarding the factors that may contribute to postoperative pericarditis. The aim was to evaluate laboratory and echocardiographic features that may influence the presence of pericardial effusion 6 to 8 weeks following coronary artery bypass grafting (CABG). Materials and Methods: This was a prospective cross-sectional study that included 90 patients after CABG operation who were divided into two groups. A total of 32 (35.56%) patients with pericardial effusion on follow-up echocardiography formed the first group and 58 patients without pericardial effusion the second group, which were compared in respect to components that were taken prior to the operation. Results: The groups did not differ regarding sex (males 65.62% vs 63.79%, P = .86) or age (59.59 ± 9.29 vs 61.69 ± 10.71, P = .35). Platelet count (184.74 ± 58.79 vs 222.62 ± 88.97, P = .03) and left ventricular (LV) global longitudinal strain (GLS) (−14.64 ± 6.86 vs −16.96 ± 4.1, P = .04) demonstrated statistical significance. Conclusion: Prolonged postoperative pericardial effusion in small amounts may be found in patients, with preoperative lower thrombocyte count and LV GLS, which could be possible predisposing factors.

The utility of strain imaging in the cardiac surveillance of bone marrow transplant patients

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319359
Author(s):  
Tejas Deshmukh ◽  
Peter Emerson ◽  
Paul Geenty ◽  
Shehane Mahendran ◽  
Luke Stefani ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Global Longitudinal Strain ◽  
Group Versus ◽  
Marrow Transplant ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Right Ventricular Free Wall ◽  
Cross Sectional ◽  
Allogenic Bone ◽  
Transplant Patients

ObjectiveTo evaluate the utility of two-dimensional multiplanar speckle tracking strain to assess for cardiotoxicity post allogenic bone marrow transplantation (BMT) for haematological conditions.MethodsCross-sectional study of 120 consecutive patients post-BMT (80 pretreated with anthracyclines (BMT+AC), 40 BMT alone) recruited from a late effects haematology clinic, compared with 80 healthy controls, as part of a long-term cardiotoxicity surveillance study (mean duration from BMT to transthoracic echocardiogram 6±6 years). Left ventricular global longitudinal strain (LV GLS), global circumferential strain (LV GCS) and right ventricular free wall strain (RV FWS) were compared with traditionl parameters of function including LV ejection fraction (LVEF) and RV fractional area change.ResultsLV GLS (−17.7±3.0% vs −20.2±1.9%), LV GCS (−14.7±3.5% vs −20.4±2.1%) and RV FWS (−22.6±4.7% vs −28.0±3.8%) were all significantly (p=0.001) reduced in BMT+AC versus controls, while only LV GCS (−15.9±3.5% vs −20.4±2.1%) and RV FWS (−23.9±3.5% vs −28.0±3.8%) were significantly (p=0.001) reduced in BMT group versus controls. Even in patients with LVEF >53%, ~75% of patients in both BMT groups demonstrated a reduction in GCS.ConclusionMultiplanar strain identifies a greater number of BMT patients with subclinical LV dysfunction rather than by GLS alone, and should be evaluated as part of post-BMT patient surveillence. Reduction in GCS is possibly due to effects of preconditioning, and is not fully explained by AC exposure.

P2485Cardiac abnormalities and vascular damage in young adults with type 1 diabetes mellitus: incidence and associations with kidney dysfunction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Medvedev ◽  
K Mahamat ◽  
N Soseliya ◽  
V Efimova ◽  
A Safarova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Arterial Stiffness ◽  
Cardiac Remodeling ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Applanation Tonometry ◽  
Cross Sectional

Abstract Background In contrast to type 2 diabetes mellitus (DM), cardiac and vascular abnormalities in type 1 DM (T1DM) are not well investigated. We aimed to evaluate occurrence of cardiac remodeling, arterial stiffness and blood pressure (BP) phenotypes in T1DM patients. Methods The cross-sectional study consecutively included T1DM patients 18–44 y.o. without known CVD, in whom 24-hour monitoring of peripheral and central BP (ABPM) with BPLab Vasotens, applanation tonometry and conventional and speckle tracking echo were performed. BP phenotypes were determined according to current guidelines, PWV and CBP - according to individual reference values. Presence of systolic dysfunction was defined as global longitudinal strain (GLS) <20%, left ventricular hypertrophy (LVH) as LV myocardial mass index (LVMI) >95/>115 g/m2 for women/men, LV remodeling (LVR) as RWT ≥0.43. P<0.05 was considered significant. Results A total of 125 patients with T1DM (mean age 29,2±7,6 years, 60% male, median duration of DM 6,9 [2; 11] years, HbA1c 9.9 [6; 12] %, mean BMI 23±3 kg/m2, smoking 39%, median GFR 100 [86; 117] ml/min/1.73 m2, GFR <60 ml/min/1.73 m2 – in 8.8%, median albuminuria 19 [8; 24] mg/g (moderate and high albuminuria in 14.6% and 2.2%) were investigated. According to office BP and ABPM hypertension (HTN) was diagnosed in 28% patients (true and masked in 4.8 and 23.2%, respectively) and true normotension in 72%. Isolated nocturnal HTN was observed in 14.4%. Majority of the patients were dippers (51.2%), non-dippers and night-peakers profiles were registered in and 43.2% and 5.6%, respectively. Central SBP and PWV elevation were observed in 17.6% and 57.6% (PWV >10 m/s - only in 2.4%). Cardiac abnormalities were revealed in 72.4% of patients: GLS<20%, LVH, LVR and diastolic dysfunction (DD) in 71.2, 12, 39.2 and 16.8% patients, respectively. Isolated GLS <20% was detected in 30%, combination of GLS<20% with LVH (or LVR) and DD in 47.2%. Patients with vs without HTN were characterized by higher PWV (7.8±1.5 vs 6.9±1.2, p<0.001), LVMI (89.9 [75; 96] vs 71.5 [64; 77] p<0.001), incidence of DD (29.6 vs 12.2%, p=0.03), LVH (28 vs 6%, p=0.002), trend towards higher rate of central SBP increase (32.7% vs 17.4%, p=0.08), lower incidence of LVR (26 vs 44%, p=0.002) and similar GLS (p=0.16). Groups with vs without nocturnal HTN did not differ by PWV, central SBP, GLS and LVMI. PWV increase was associated only with higher LVMI (88.2 [69; 95] vs 77.6 [68; 83], p=0.042). Correlations (p<0.05) with albuminuria were observed for GLS (r=−0.26), DD (r=0.22) and non-dipping state (r=−0.34). GFR correlated (p<0.05) with GLS (r=−0.32) and PWV (r=−0.32). Conclusion Incidence of prognostically unfavourable phenotypes of HTN, cardiac remodeling and arterial stiffness (even in patients without HTN) were relatively high in T1DM population. GLS and non-dipping state correlated with albuminuria, GLS and PWV with GFR

scholarly journals A Study of Echocardiographic Changes in Patients with Newly Diagnosed Primary Hypothyroidism: A Cross-sectional Study

2021 ◽  
Vol 3 (2) ◽  
pp. 23-29
Author(s):  
Prabin Khatri ◽  
Suman Sapkota ◽  
Aryan Neupane ◽  
Narayan Gautam ◽  
Saphal Subedi ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Posterior Wall ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Primary Hypothyroidism ◽  
Newly Diagnosed ◽  
Sectional Study ◽  
Cross Sectional ◽  
Septal Thickness ◽  
Posterior Wall Thickness

Background: Hypothyroidism is known to cause reversible cardiac dysfunction in humans. Thyroid hormone alters the cardiovascular hemodynamics. This study was performed to assess echocardiographic changes in untreated newly diagnosed primary hypothyroid states as such studies are scarce in our setting.Methods: This hospital based cross-sectional study was conducted among 71 patients with newly diagnosed primary hypothyroidism who presented to the medicine outpatient department, at Universal College of Medical Sciences and Teaching Hospital (UCMS-TH), Bhairahawa, Nepal from December 2018 to June 2020 after taking ethical clearance from institutional review committee (UCMS/IRC/212/18). Thyroid function test and echocardiography were carried out in patients under study. The data was analyzed with SPSS Version 16.Results: A total of 71 patients (52 females and 19 males) with primary hypothyroidism were enrolled for the study. Among these 58 cases were overt/clinical hypothyroidism, and 13 cases were subclinical hypothyroidism. Echocardiography was abnormal in 63.4% of cases with 43.7% showing diastolic dysfunction, 18.3% diastolic interventricular septal thickness abnormality, 8.5% diastolic left ventricular posterior wall thickness abnormality, and 8.4% pericardial effusion. Conclusion: Our study found diastolic dysfunction, diastolic interventricular septal thickness abnormality, diastolic left ventricular posterior wall thickness abnormality, and pericardial effusion as the common echocardiographic change in patients with newly diagnosed primary hypothyroidism. Therefore, our study highlights the need for cardiac evaluation of patients with primary hypothyroidism so that early intervention can be performed to improve the clinical outcome. 

scholarly journals Microalbuminuria among children with congenital heart disease seen in Sokoto, North-Western Nigeria

2021 ◽  
Vol 8 (3) ◽  
pp. 414
Author(s):  
Khadijat O. Isezuo ◽  
Usman M. Sani ◽  
Usman M. Waziri ◽  
Bilkisu G. Ilah ◽  
Fatima B. Jiya ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Elisa Technique ◽  
Weak Negative Correlation

Background: Congenital heart disease (CHD) especially cyanotic CHD has been associated with microalbuminuria which is an early marker of glomerular nephropathy but this has hardly been studied in African children. The aim of this study was to compare mean microalbuminuria levels and associations among children with acyanotic CHD, cyanotic CHD and normal controls.Methods: Forty-one (41) children comprising 19 acyanotic CHD, 14 cyanotic CHD and 8 without CHD aged 1 to 15 years were recruited in a cross-sectional study. Quantitative urinary microalbuminuria was measured by ELISA technique. Positive result was microalbuminuria of 30-300 mcg/mgCr. Mean levels were compared by student t-test and analysis of variance (ANOVA). Statistical significance was taken at p<0.05.Results: There were 22 (53.7%) females and 19 (46.3%) males. Mean level of microalbuminuria was highest in those with cyanotic CHD at 147.7±78.8 mcg/mgCr, followed by those with acyanotic CHD at 111.8±61.5 mcg/mgCr and lowest in those without CHD at 67.3±31.6 mcg/mgCr. There was significant difference between the groups with CHD and those without CHD (F=4.1, p=0.03) and microalbuminuria had a significant but weak negative correlation with oxygen saturation implying that microalbuminuria increased with worsening cyanosis.Conclusions: Microalbuminuria was high among the patients with CHD, though higher in cyanotic patients warranting closer follow up of these patients.

scholarly journals The relationship between the nomophobic levels of higher education students in Ghana and academic achievement

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252880
Author(s):  
Harry Barton Essel ◽  
Dimitrios Vlachopoulos ◽  
Akosua Tachie-Menson
Keyword(s):  
Higher Education ◽  
Academic Achievement ◽  
University Students ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Education Students ◽  
Cross Sectional ◽  
The Relationship ◽  
One Way Anova

There is an upsurge in the use of mobile phones among higher education students in Ghana, which may result in the nomophobia prevalence with the students. Therefore, the need to assess the influence of nomophobia within the student population in Ghana. This descriptive cross-sectional study investigated the prevalence of nomophobia and the sociodemographic variables, and the association with academic achievement of the understudied population. A self-reporting nomophobia questionnaire, composed of 20 dimensions, was answered by 670 university students to measure the nomophobia prevalence. Raw data were estimated using descriptive statistics, and one-way ANOVA and Independent T-test. While the findings showed diverse grades of nomophobia, statistical significance between academic achievement and the level of nomophobia was observed. This study concludes that there is a high nomophobia prevalence among university students in Ghana as the use of smartphones increases. However, follow-up studies should be conducted in Ghanaian universities to monitor nomophobia and its associates in order to reduce the adverse effects of habitual use of smartphones.

scholarly journals Biventricular Longitudinal Strain Predict Mortality in COVID-19 Patients

2021 ◽  
Vol 7 ◽  
Author(s):  
Yuji Xie ◽  
Lufang Wang ◽  
Meng Li ◽  
He Li ◽  
Shuangshuang Zhu ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Cardiac Injury ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Pulmonary Artery Systolic Pressure ◽  
Right Ventricular Free Wall ◽  
Cox Analysis

Background: Biventricular longitudinal strain has been recently demonstrated to be predictive of poor outcomes in various cardiovascular settings. Therefore, this study sought to investigate the prognostic implications of biventricular longitudinal strain in patients with coronavirus disease 2019 (COVID-19).Methods: We enrolled 132 consecutive patients with COVID-19. Left ventricular global longitudinal strain from the apical four-chamber views (LV GLS4CH) and right ventricular free wall longitudinal strain (RV FWLS) were obtained using two-dimensional speckle-tracking echocardiography.Results: Compared with patients without cardiac injury, those with cardiac injury had higher levels of coagulopathy and inflammatory biomarkers, higher incidence of complications, more mechanical ventilation therapy, and higher mortality. Patients with cardiac injury displayed decreased LV GLS4CH and RV FWLS, elevated pulmonary artery systolic pressure, and higher proportion of pericardial effusion. Higher biomarkers levels of inflammation and cardiac injury, and the presence of pericardial effusion were correlated with decreases in LV GLS4CH and RV FWLS. During hospitalization, 19 patients died. Compared with survivors, LV GLS4CH and RV FWLS were impaired in non-survivors. At a 3-month follow-up after discharge, significant improvements were observed in LV GLS4CH and RV FWLS. Multivariate Cox analysis revealed that LV GLS4CH [hazard ratio: 1.41; 95% confidence interval [CI]: 1.08 to 1.84; P = 0.011] and RV FWLS (HR: 1.29; 95% CI: 1.09–1.52; P = 0.003) were independent predictors of higher mortality in patients with COVID-19.Conclusions: LV GLS4CH and RV FWLS are independent and strong predictors of higher mortality in COVID-19 patients and can track improvement during the convalescent phase of their illness. Therefore, biventricular longitudinal strain may be crucial for risk stratification and serial follow-up in patients with COVID-19.

scholarly journals Factors related to the perceived stigmatization of people living with HIV

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Juliano de Souza Caliari ◽  
Sheila Araujo Teles ◽  
Renata Karina Reis ◽  
Elucir Gir
Keyword(s):  
Statistical Significance ◽  
Cross Sectional Study ◽  
Linear Regression Method ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Specialized Service ◽  
Microsoft Office ◽  
Living With Hiv ◽  
Study Development

Abstract OBJECTIVE Analyzing the factors related to perceived stigmatization of people living with HIV. METHOD A cross-sectional study conducted from September of 2014 to December 2015 with users from a specialized service in Minas Gerais. Data were collected through individual instrument application, organized in Microsoft Office Excel(r) 2010 spreadsheets and processed on IBM(r) SPSS 23.0. Descriptive statistics and multiple linear regression method were used for data analysis, adopting statistical significance set at 5.0% (p≤0.05). The study development met research ethics standards. RESULTS 258 users participated in the study. Most were males between 40 and 49 years of age, single, with low educational level and income. Being between 40 and 49 years of age and having been hospitalized for complications related to HIV were positively associated predictors to increased stigmatization; while not having comorbidities and not being aware of exposure to HIV were predictors associated to reduced stigmatization. CONCLUSION Given these results, we highlight that stigmatization can have an impact on the lives of people living with HIV, strengthening their feelings of guilt and shame, which can lead to depression, social isolation and abandoning treatment and clinical follow-up.

Hearing Outcome of Stapes Surgery in NIENT, Bangladesh

2020 ◽  
Vol 26 (1) ◽  
pp. 31-36
Author(s):  
Md Zakaria Sarkar ◽  
AHM Ferdows Nur ◽  
Utpal Kumar Dutta ◽  
Muhammad Rafiqul Islam ◽  
Debabrota Roy ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cross Sectional Study ◽  
Surgical Trauma ◽  
Group 14 ◽  
Progressive Hearing Loss ◽  
Cross Sectional ◽  
Hearing Gain ◽  
Hearing Outcome

Objective: The aim of this study was to evaluate hearing outcome after stapedotomy in patients with Otosclerosis. Methods: This cross sectional study was carried out from July 2017 to January 2019 in National Institute of ENT, Unit V. About 22 patients with Otosclerosis were included in this study. Diagnosis of Otosclerosis was based on the history, medical status with Otoscopy, Tuning fork tests and Audiometric tests. We compiled data on the pre and post operative air-bone gap (ABG) at 0.5, 1, 2 KHZ. The ABG was Calculated using AC and BC thresholds on the same audiogram. Post operative hearing gain was then Calculated from the ABG before the operation minus the ABG of the last follow up examination Results: In this study most of the cases were age group 14-30 years (72.7%), female (54.5%). Most common symptoms was progressive hearing loss, tinnitus (77.8%).The average preoperative hearing loss in this study was (AC) was 48.31±7.68. The average post opt. hearing (AC) at follow up was 28.95±10.30 with an average hearing gain of 15.40±8.53 dB which was significant. The average pre-operative ABG was 28.99 dB ± 8.10. The average post opt. ABG was analyzed at 1 follow up showed ABG 13.18±8.09 dB which was found to be significant. Conclusion: Stapedotomy is an effective surgical procedure for the treatment of otosclerosis which leads to improvement in patient’s quality of life. A favorable hearing outcome can be obtained by the combination of experienced hands with minimal surgical trauma and appropriate surgical technique. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 31-36

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>

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