scholarly journals Evaluation of ventricular systolic dysfunction as a risk factor for acute kidney injury in intensive care unit

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Ahmed Aly Obiedallah ◽  
Ashraf Anwar E. L. Shazly ◽  
Noura Gamal Nasr ◽  
Essam M. Abdel Aziz
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Right Ventricular ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Systolic Dysfunction ◽  
Kidney Injury ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Ventricular Systolic Dysfunction

Abstract Background Heart failure (HF) is a major health problem. Cardiac and renal diseases interact in a complex bidirectional manner in both acute and chronic settings. Renal dysfunction in the setting of heart failure, termed the cardio renal syndrome (CRS), has been considered consequence of left ventricular dysfunction (LVD), whereby decreasing cardiac output (COP) results in renal under perfusion and consequent decreased glomerular filtration rate (GFR). Main body of the abstract This study showed that 500 patients were admitted to internal care unit (ICU), and out of them, 100 (20%) patients developed acute kidney injury (AKI) while 400 (80%) patients did not develop AKI. It is also showed that 67 (67%) of those with AKI and 100 (25%) of those with no-AKI had baseline ventricular systolic dysfunction, left ventricular dysfunction (LVD), right ventricular dysfunction (RVD), and biventricular dysfunction (BiVD)presented in 23 (23%), 16 (16%), and 28 (28%) patients of AKI group, respectively, and presented in 60 (15%), 30 (7.50%), and 10 (2.50%) patients, respectively, in patients without acute kidney injury (AKI) Short conclusion Our study revealed that AKI has highest incidence in patient with biventricular dysfunction followed by left ventricular dysfunction and lastly those with right ventricular dysfunction.

scholarly journals Right ventricular dysfunction and pulmonary hypertension: a neglected presentation of thyrotoxicosis

2018 ◽  
Vol 2018 ◽  
Author(s):  
Carolina Shalini Singarayar ◽  
Foo Siew Hui ◽  
Nicholas Cheong ◽  
Goay Swee En
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Right Heart Failure ◽  
Left Ventricular ◽  
Newly Diagnosed ◽  
Right Heart

Summary Thyrotoxicosis is associated with cardiac dysfunction; more commonly, left ventricular dysfunction. However, in recent years, there have been more cases reported on right ventricular dysfunction, often associated with pulmonary hypertension in patients with thyrotoxicosis. Three cases of thyrotoxicosis associated with right ventricular dysfunction were presented. A total of 25 other cases of thyrotoxicosis associated with right ventricular dysfunction published from 1994 to 2017 were reviewed along with the present 3 cases. The mean age was 45 years. Most (82%) of the cases were newly diagnosed thyrotoxicosis. There was a preponderance of female gender (71%) and Graves’ disease (86%) as the underlying aetiology. Common presenting features included dyspnoea, fatigue and ankle oedema. Atrial fibrillation was reported in 50% of the cases. The echocardiography for almost all cases revealed dilated right atrial and or ventricular chambers with elevated pulmonary artery pressure. The abnormal echocardiographic parameters were resolved in most cases after rendering the patients euthyroid. Right ventricular dysfunction and pulmonary hypertension are not well-recognized complications of thyrotoxicosis. They are life-threatening conditions that can be reversed with early recognition and treatment of thyrotoxicosis. Signs and symptoms of right ventricular dysfunction should be sought in all patients with newly diagnosed thyrotoxicosis, and prompt restoration of euthyroidism is warranted in affected patients before the development of overt right heart failure. Learning points: Thyrotoxicosis is associated with right ventricular dysfunction and pulmonary hypertension apart from left ventricular dysfunction described in typical thyrotoxic cardiomyopathy. Symptoms and signs of right ventricular dysfunction and pulmonary hypertension should be sought in all patients with newly diagnosed thyrotoxicosis. Thyrotoxicosis should be considered in all cases of right ventricular dysfunction or pulmonary hypertension not readily explained by other causes. Prompt restoration of euthyroidism is warranted in patients with thyrotoxicosis complicated by right ventricular dysfunction with or without pulmonary hypertension to allow timely resolution of the abnormal cardiac parameters before development of overt right heart failure.

Pathophysiology and clinical assessment of the cardiovascular system (including pulmonary artery catheter)

2015 ◽  
Author(s):  
Romain Barthélémy ◽  
Etienne Gayat ◽  
Alexandre Mebazaa
Keyword(s):  
Heart Failure ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Pulmonary Artery Catheter ◽  
Acute Heart Failure ◽  
Ventricular Dysfunction ◽  
Systolic Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Haemodynamic Instability

Haemodynamic instability in acute cardiac care may be related to various mechanisms, including hypovolaemia and heart and/or vascular dysfunction. Although acute heart failure patients are often admitted for dyspnoea, many mechanisms can be involved, including left ventricular diastolic and/or systolic dysfunction and/or right ventricular dysfunction. Many epidemiological studies show that clinical signs at admission, morbidity, and mortality differ between the main scenarios of acute heart failure: left ventricular diastolic dysfunction, left ventricular systolic dysfunction, right ventricular dysfunction, and cardiogenic shock. Although echocardiography often helps to assess the mechanism of cardiac dysfunction, it cannot be considered as a monitoring tool. In some cases (in particular, in cases of refractory shock secondary to both vascular and heart dysfunction or in cases of refractory haemodynamic instability associated with severe hypoxaemia), pulmonary artery catheter can help to assess and monitor cardiovascular status and to evaluate response to treatments. Last, macro- and microvascular dysfunctions are also important determinants of haemodynamic instability.

Pathophysiology and clinical assessment of the cardiovascular system (including pulmonary artery catheterization)

2021 ◽  
pp. 115-126
Author(s):  
Alessandro Sionis ◽  
Etienne Gayat ◽  
Alexandre Mebazaa
Keyword(s):  
Heart Failure ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Cardiovascular System ◽  
Acute Heart Failure ◽  
Ventricular Dysfunction ◽  
Systolic Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Ventricular Diastolic Dysfunction

The underlying pathophysiological derangements of the cardiovascular system in many medical conditions are often complex. Acute circulatory dysfunction can be related broadly to a cardiogenic cause leading to acute heart failure or be secondary to hypovolaemia or vascular dysfunction (e.g. sepsis). Different mechanisms may be involved, including left ventricular diastolic and/or systolic dysfunction and/or right ventricular dysfunction. Many aspects of left ventricular function are explained by considering ventricular pressure–volume characteristics. Epidemiological studies show that clinical signs at admission, morbidity, and mortality differ between the main scenarios of acute heart failure: left ventricular diastolic dysfunction, left ventricular systolic dysfunction, right ventricular dysfunction, and cardiogenic shock. Although echocardiography is usually the first investigation used to assess the mechanism of cardiac dysfunction, in selected cases (in particular, in cases of refractory shock secondary to both vascular and heart dysfunction or in cases of refractory haemodynamic instability associated with severe hypoxaemia), the pulmonary artery catheter can help to assess and monitor the cardiovascular status and evaluate response to treatments.

Sudden Cardiac Death and Heart Failure

2009 ◽  
Vol 20 (4) ◽  
pp. 356-365
Author(s):  
Brenda S. Thompson
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Left Ventricular Dysfunction ◽  
Cardiac Death ◽  
Ventricular Dysfunction ◽  
Treatment Guidelines ◽  
Systolic Dysfunction ◽  
The United States ◽  
Left Ventricular ◽  
Current Evidence

Ischemic heart disease and dilated cardiomyopathy are among the most common cardiovascular disease processes associated with heart failure that can lead to lethal arrhythmias and sudden cardiac death (SCD). With the increasing incidence of heart failure in the United States, many patients are now at risk for SCD. Nurses should understand the pathophysiology, current treatment guidelines, and the rationale for these therapies to effectively manage systolic dysfunction and to mitigate the risk of SCD. Nurses are more involved than ever with this patient population and play a key role as members of the heart failure disease management team. As a result, nurses are uniquely positioned to improve survival and reduce SCD in individuals diagnosed with left ventricular dysfunction. The purpose of this article is to increase the awareness of the risk of sudden death in patients with left ventricular dysfunction. Current evidence-based practice guidelines with rationale are reviewed.

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