scholarly journals GH Receptor Exon 3 Genotype and Echocardiographic Abnormalities in Patients With Active Acromegaly

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A643-A644
Author(s):  
Karla Serrano ◽  
Etual Espinosa ◽  
Daniel Marrero-Rodríguez ◽  
Eduardo Almeida ◽  
Gloria Silva-Roman ◽  
...  
Keyword(s):  
Systolic Dysfunction ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Genotype 3 ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Gh Receptor ◽  
Active Acromegaly

Abstract Background: The GH receptor (GHR) exon 3 polymorphism occurs at a genomic level. Approximately 50-60% of the population is homozygous for the exon-3 containing genotype (+3/+3), 30-40% are heterozygous (+3/-3) and 10-20% are homozygous for the exon-3 lacking genotype (-3/-3). Some studies suggest that children homo- and heterozygous for the GHR exon 3 lacking genotype (-more efficient 3/-3 and +3/-3, respectively) respond better to treatment with exogenous rhGH and there is also in vitro evidence showing a more efficient signal transduction through this exon 3 deleted isoform. Some studies have found that patients with acromegaly harboring the exon 3-deleted genotype may have a higher prevalence of diabetes and hypertension. Hypothesis and Objective: Patients with active acromegaly harboring the exon 3-lacking GHR genotype may have more echocardiographic abnormalities than those who are homozygous for the exon 3 containing genotype. Patients and Methods: This is a cross-sectional study of patients with active acromegaly, defined by an IGF-1 level > 1.3 times the upper limit of normal (x ULN), who underwent transthoracic echocardiography. Exon-3 GHR genotype was determined by PCR using previously described sense and antisense primers. Results: The cohort consisted of 28 patients, 54% female, with a mean age of 51 ± 12 years. Mean disease duration at the time of echocardiographic examination was 4.48 ± 4.7 years; median basal GH and IGF-1 were 12 ± 26 ng/mL and 2.4 ± 1.04 x ULN. The prevalence of hypertension and diabetes were 43% and 36%, respectively. Fifty three percent of the patients were homozygous for the exon 3-containaing genotype (+3/+3), 18% were homozygous for the exon 3-lacking genotype (-3/-3) and 29% were heterozygous (+3/-3). Clinical and biochemical features did not differ between patients with the different GHR genotypes, except for hypertension that was more prevalent in the +3/+3 genotype group (60% vs 23%, p= 0.04). The frequency of the different echocardiographic parameters was similar among groups (left ventricular hypertrophy 33% vs 15%, p= 0.27; diastolic dysfunction 47% vs 31%, p= 0.39; subclinical systolic dysfunction 42% vs 54%, p= 0.54; left ventricular ejection fraction 59±10% vs 60±16%, p= 0.83); aortic valve abnormalities 19% vs 15%, p=0.63; mitral valve abnormalities 46% vs 15%, p=0.07). Conclusions: Echocardiographic abnormalities in patients with active acromegaly do not differ among patients with the different GHR exon 3 genotypes. The clinical spectrum of acromegaly varies considerably. Although such variability is usually related to the severity of the hypersomatotropinemia, in many patients this is not the case.

scholarly journals Left Atrial Enlargement an Early Predictor for Development of Systolic Dysfunction – Results of a Cross-Sectional Study Conducted in Georgia

2017 ◽  
Vol 13 (33) ◽  
pp. 1
Author(s):  
Eka Rukhadze ◽  
Nino Tabagari-Bregvadze ◽  
Levan Tvildiani
Keyword(s):  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Systolic Pressure ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Early Predictor

Background and Aims: Left ventricular systolic dysfunction, even asymptomatic, is associated with the development of heart failure (HF) and all-cause mortality. Left ventricular ejection fraction (LVEF) is the most commonly used marker of left ventricular systolic function. It is well established that early detection and treatment of reduced LVEF, as well as the aggressive management of predisposing conditions, delays the manifestation of HF. Our study aimed to measure the association between LVEF and other echocardiographic variables in a population with LVEF within the normal range and without symptoms of HF. Methods: We conducted a cross-sectional study in 2008-2009. Results: We analyzed echocardiographic and clinical data of 146 patients: 66.4% were women; mean age was 55 (40 –69 years). LVEF significantly correlated only with left atrium (LA) size (Beta -0.266, p < 0.05). The correlation was inverse and remained significant after adjusting for age, gender, obesity, diabetes, arterial hypertension, left ventricular hypertrophy, pulmonary systolic pressure, mitral regurgitation, and diastolic dysfunction. Conclusions: We found that the earliest structural change associated with LVEF tendency to decrease was LA size. Further research is needed to assess the LA enlargement as an early predictor of systolic dysfunction development.

Evaluation of the left ventricle longitudinal deformity using myocardial-tracking signals in severely obese adolescents

2015 ◽  
Vol 26 (4) ◽  
pp. 749-753 ◽  
Author(s):  
Norma Balderrábano ◽  
Blanca Del Rio ◽  
Elsy Navarrete ◽  
Arturo Berber ◽  
Nancy Méndez
Keyword(s):  
Left Ventricle ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
The Body ◽  
School Age Children ◽  
Left Ventricular Ejection ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Obese Adolescents ◽  
Severely Obese

AbstractBackgroundThe global prevalence of obesity in school-age children and adolescents has increased in recent decades. Obesity modifies some aspects of the cardiovascular system in order to preserve the body homoeostasis. Echocardiography to study ventricular function plays an important role in the evaluation of pathological re-modelling associated with left ventricular dysfunction. The aim of this study was to evaluate the left ventricle function and structure with conventional echocardiography and to analyse the longitudinal deformity of the left ventricle using myocardial-tracking signals in a group of severely obese adolescents.Methods and resultsWe carried out a descriptive cross-sectional study. We describe the evaluation of the left ventricle using conventional bi-dimensional echocardiography and the myocardial-tracking signals in severely obese adolescents. There were 34 severely obese adolescents included in our study; 52% had a left ventricular ejection fraction<55%, the left ventricular end-diastolic diameter was increased in 70.5% of patients, and 32.3% had an increase in left ventricular mass. On average, 78.9% had abnormal values of left ventricle longitudinal deformations. The number of segments affected per patient was, on average, 5.8, with the anterior apical segment being the most commonly affected. There was a decrease in global longitudinal deformity in 79.4% of the cases.ConclusionMore than half of this group of asymptomatic severely obese adolescents showed abnormalities in left ventricular structure and function evaluated using traditional echocardiographic methods, but 100% of the cases showed abnormalities in longitudinal deformation in at least one of the 17 left ventricle segments evaluated using myocardial-tracking signals.

scholarly journals Prevalence of Pulmonary Hypertension in an Unselected Community-Based Population: A Retrospective Echocardiographic Study—RES-PH Study

2021 ◽  
Vol 11 (6) ◽  
pp. 489
Author(s):  
Egidio Imbalzano ◽  
Marco Vatrano ◽  
Alberto Lo Gullo ◽  
Luana Orlando ◽  
Alberto Mazza ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Systolic Dysfunction ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Pulmonary Artery Systolic Pressure ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Equal Distribution ◽  
Ventricular Ejection Fraction

Introduction. The actual prevalence of pulmonary hypertension (PH) in Italy is unknown. Echocardiography is useful in the screening of patients with suspected PH by estimation of the pulmonary artery systolic pressure (PASP) from the regurgitant tricuspid flow velocity evaluation, according to the simplified Bernoulli equation. Objectives. We aimed to evaluate the frequency of suspected PH among unselected patients. Methods. We conducted a retrospective cross-sectional database search of 7005 patients, who underwent echocardiography, to estimate the prevalence of PH, between January 2013 and December 2014. Medical and echocardiographic data were collected from a stratified etiological group of PH, using criteria of the European Society of Cardiology classifications. Results. The mean age of the study population was 57.1 ± 20.5 years, of which 55.3% were male. The prevalence of intermediate probability of PH was 8.6%, with nearly equal distribution between men and women (51.3 vs. 48.7%; p = 0.873). The prevalence of high probability of PH was 4.3%, with slightly but not significant higher prevalence in female patients (43.2 vs. 56.8%; p = 0.671). PH is predominant in patients with chronic obstructive pulmonary disease (COPD) or left ventricle (LV) systolic dysfunction and related with age. PASP was significantly linked with left atrial increase and left ventricular ejection fraction. In addition, an increased PASP was related to an enlargement of the right heart chamber. Conclusions. PH has a frequency of 4.3% in our unselected population, but the prevalence may be more relevant in specific subgroups. A larger epidemiological registry could be an adequate strategy to increase quality control and identify weak points in the evaluation and treatment of these patients.

scholarly journals Is High Sensitive-Troponin I A Reliable Biomarker For Cardiac Injury In Methadone Toxicity? A Prospective Cross-Sectional Study

2021 ◽  
Author(s):  
Hasan Shemirani ◽  
Masoumeh Sadeghi ◽  
Azadeh Davoudian Dehkordi ◽  
Farzad Gheshlaghi
Keyword(s):  
Troponin I ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
High Sensitivity Troponin ◽  
High Sensitive Troponin

Abstract Background: Methadone is a synthetic opioid mostly used for detoxification therapy, as its use increases; the possibility for methadone-induced cardiotoxicity may rise. The aim of this study was to determine the association of high-sensitivity troponin I levels as a predictor of cardiac injury in methadone toxicity.Methods: Sixty methadone toxicity patients included in this prospective cross-sectional study from October 2018-November 2020. High-sensitivity troponin I level and electrocardiogram were assessed in patients at admission. All patients underwent echocardiography at admission and 30 days later and compared this findings between two groups based on high-sensitivity troponin I results.Results: Mean age of the patients was 34.5±11.1 years (males: 66%). Twelve (20%) patients had positive high sensitive-troponin results. Long QT interval and inverted T in precordial leads were mostly observed in individuals with positive high-sensitivity troponin I (75% vs. 35%, P=0.013 and 83% vs. 16%, P<0.001, respectively). Patients with elevated troponin had reduced left ventricular ejection fraction in comparison to normal group during admission (43.1±15.4% vs. 55%, P<0.001) and this left ventricular ejection fraction remained abnormal after 30 days (43.7±21.6%). Patients in positive high-sensitivity troponin I group had higher regional wall motion abnormality frequency both at admission and 30 days later compared to the other group (0 day: 42% vs. 0, P<0.001, 30th days: 25% vs. 4%, P=0.020).Conclusion: Patients with simultaneous methadone toxicity and positive high-sensitivity troponin I had worse cardiac outcomes and this biomarker could be probably used for better implementation of therapeutic interventions and prognosis.

scholarly journals Comparison of tools for assessing fatigue in patients with heart failure

2018 ◽  
Vol 71 (5) ◽  
pp. 2404-2410 ◽  
Author(s):  
Eliane Nepomuceno ◽  
Luma Nascimento Silva ◽  
Débora Cristine Prévide da Cunha ◽  
Rejane Kiomi Furuya ◽  
Marcus Vinicius Simões ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Heart Association ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Significance Level ◽  
Patients With Heart Failure

ABSTRACT Objective: To compare the distributions of measurements of the Dutch Fatigue Scale (DUFS), Dutch Exertion Fatigue Scale (DEFS), and Fatigue Pictogram tools, according to the New York Heart Association (NYHA) Functional Classification and left ventricular ejection fraction (LVEF). Method: Methodological, cross-sectional study with 118 patients with heart failure. Variance analysis, Pearson's correlation, and Fisher's exact tests were carried out, with a significance level of 0.05. Results: There was an increase in the DUFS and DEFS means with worsening of the NYHA-FC (p<0.001, for both tools). Correlations among the LVEF resulted in positive and weak magnitude for the DEFS (r=0.18; p=0.05) and for the DUFS (r=0.16; p=0.08). Just the item A on the Fatigue Pictogram had an association with the NYHA-FC (p<0.001) and the LVEF (p=0.03). Conclusion: Three tools detected worsening in fatigue levels according to the illness severity assessed by the NYHA-FC.

Evaluation of inflammatory and cardiac-electrophysiological markers in patients undergoing peritoneal dialysis

2020 ◽  
Vol 14 (17) ◽  
pp. 1641-1649
Author(s):  
Junyan Fang ◽  
Haixia Su ◽  
Ahui Song ◽  
Yan Tong ◽  
Zehui Huang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
High Serum ◽  
Left Ventricular Ejection ◽  
Dialysis Patients ◽  
Related Factors ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Interval Ratio

Background: The Tp-e/QT (peak to end of T-wave duration/QT interval) ratio is a promising marker of myocardial repolarization and ventricular arrhythmogenesis. Its elevation is associated with sudden cardiac death in different clinical conditions. This study was designed to assess the possible association between increased Tp-e/QT ratio and clinical factors in peritoneal dialysis patients. Materials & methods: We devised a prospective cross-sectional study, which included 107 patients who were divided into groups according to their Tp-e/QT ratio. The association of an increased Tp-e/QT ratio with related factors was analyzed with multivariate logistic regression. Results: Thirty-one patients, who had an elevated Tp-e/QT ratio, showed higher values of IL-6, left ventricular end-systolic diameter, Tp-e, percentage of diabetes mellitus, coronary artery calcification, and left ventricular ejection fraction. Multivariate analysis revealed that IL-6 was an independent risk factor for a higher Tp-e/QT ratio after adjustments. Conclusion: Our study revealed that a high serum IL-6 level in peritoneal dialysis patients increased the risk of a higher Tp-e/QT ratio, which indicated a potentially hazardous interplay between inflammation and arrhythmogenesis.

4091Mechanical dispersion by speckle tracking echocardiography in fabry disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T F Cianciulli ◽  
M C Saccheri ◽  
A M Risolo ◽  
J A Lax ◽  
R J Mendez ◽  
...  
Keyword(s):  
Fabry Disease ◽  
Speckle Tracking ◽  
Heart Diseases ◽  
Systolic Dysfunction ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Peak Strain ◽  
Cross Sectional ◽  
Mechanical Dispersion ◽  
Group I

Abstract Background Fabry disease is a rare X-linked storage disorder caused by a deficiency of the lysosomal enzyme α-galactosidase A and generally causes multi-organ dysfunction. Heart disease is the main cause of death, due to severe left ventricular (LV) systolic dysfunction and sudden death. In several heart diseases, the LV systolic dysfunction and ventricular arrhythmias are associated with mechanical dispersion (MD). The presence of MD in patients with FD has not been studied yet. In this cross-sectional study, we investigated the prevalence of MD in patients with FD. Methods Complete echocardiographic and speckle tracking echocardiographic (STE) data were collected. MD is an index of inter-segmental discoordination of contraction which has been used to quantify LV dyssynchrony and was defined as the standard deviation (SD) of time to peak negative strain in 17 left ventricular segments. Patients were divided into two groups according to whether or not they had left ventricular hypertrophy (LVH). MD was defined as an SD >49 msec. Results We studied 108 patients with FD, 24 patients (22%) were excluded due to inadequate imaging quality or presence of comorbidities, so the final study population consisted of 84 patients (mean age 33.3±14.6 years, 60.7% women). LVH in FD appears at older ages than in patients without LVH (48±12.5 y/o vs 27.8±11.1 y/o, p<0.0001). Patients with FD without LVH (Group I) showed normal global longitudinal peak strain (GLPS) (21.2±2.5%) and no MD (32.7±8.8 msec). In Group II (n=23) patients with FD with LVH, 17 (73.9%) had MD >49 msec prolonged mechanical dispersion (73.3±20.7 msec) and reduced GLPS (13.6±4.0%). MD was more pronounced in Fabry patients with LVH than in patients without LVH (63.4±24.7 msec vs. 32.7±8.8 msec, p<0.0001). GLPS was lower in Fabry patients with LVH than in patients without LVH (15.3±4.7% vs 21.2±2.5%, p<0.0001). Figure 1 Conclusions To our knowledge, this is the first study to demonstrate the prevalence of mechanical dispersion in patients with FD. Mechanical dispersion was seen in 73.9% of patients with FD with LVH. This dyssynchrony should be taken into account in patients who develop heart failure or life-threatening ventricular tachyarrhythmias.

scholarly journals Are high NT-proBNP levels more related to inflammation than to left ventricular systolic dysfunction in acute myocarditis?

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
B Sara ◽  
JJ Monteiro ◽  
P Carvalho ◽  
C Ribeiro Carvalho ◽  
J Chemba ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Plasma Levels ◽  
Left Ventricular Systolic Dysfunction ◽  
Small Sample Size ◽  
Acute Myocarditis ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Small Sample ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Abstract Funding Acknowledgements Type of funding sources: None. Background Plasma levels and N-terminal pro B-type natriuretic peptide (NT- proBNP), a cardiac neurohormone released in response to increased ventricular stress, represent an important predictor of clinical outcomes and left ventricular (LV) dysfunction; Although, its diagnostic and prognostic role in patients with acute myocarditis is not completely established; Our aim was to evaluate the relationship of BNP levels and LV ejection fraction (LVEF) in patients with myocarditis; Methods Data from patients (pts) discharged with the diagnosis of myocarditis, from 2008 and 2018 were retrospectively analysed. Results 62 pts were included. Mean age was 39.7 17 years and 89% (58 patients) were men. Plasma levels of NT-proBNP measured at admission ranged from 24 to 3110 pg/mL (median 514, IQR 947), and exceeded upper normal levels in 51 pts (82%). This values positively correlated with C- reactive protein (CRP) (p= 0.005, r = 0.36), leucocytes (p = 0.03, r= 0.37) and neutrophil-to-lymphocyte ratio (p= 0.05, r= 0.35), but not with left ventricular ejection fraction (LVEF) (p= 0.829). Higher levels of BNP were associated with higher troponin peak levels but not with increased mortality (p = 0.811), need of inotropic support (p= 0.059) or arrhythmic events (p= 0.130). Inflammatory parameters were significantly increased when BNP&gt; 514 pg/mL vs BNP &lt;514 pg/mL (CRP 7.2 vs 4 mg/dL, p= 0.008). This relationship was maintained at BNP &gt; 900. LVEF was comparable in both groups (p = 0.938); In this population, the magnitude of recovery of the NT- proBNP values (variation between NT-proBNP at admission and discharge) strongly correlated with the magnitude of the inflammatory markers at admission (all p &lt; 0,005) Conclusion In patients with acute myocarditis, there is a significant relationship between NT-proBNP levels and inflammation (as measured by leucocytes, NLR or CRP), but not with LVEF; Despite the limitation of a small sample size, we could hypothesize that NTproBNP in this subset of patients appears to be regulated not only by hemodynamic changes but also by the underlying systemic inflammatory process and, therefore, it interpretation should take that into account;

Sign in / Sign up

Export Citation Format

Share Document