Structural myocardial alterations in diabetes and hypertension: the role of galectin-3

2014 ◽  
Vol 0 (0) ◽  
Author(s):  
Jelena P. Seferovic ◽  
Nebojsa M. Lalic ◽  
Federico Floridi ◽  
Milorad Tesic ◽  
Petar M. Seferovic ◽  
...  
Keyword(s):  
Glycosylated Hemoglobin ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Lv Mass ◽  
Galectin 3 ◽  
Study Population ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease

AbstractGalectin-3 is a protein widely distributed in the heart, brain and blood vessels, and has a regulatory role in inflammation, immunology and cancer. Many studies demonstrated that the increased level of galectin-3 is associated with progressive fibrosis and stiffening of the myocardium. The aim of this study was to investigate the role of galectin-3 in patients with type 2 diabetes (T2D) and/or arterial hypertension (HT).Study population included 189 patients, with no coronary artery disease, divided into three groups: group 1 (T2D), group 2 (T2D+HT), and group 3 (HT). All subjects underwent routine laboratory tests, as well as specific biomarkers assessment [galectin-3, glycosylated hemoglobin (HbA1c), N- terminal fragment B-type natriuretic peptide (NT-proBNP)]. Cardiological evaluation included physical examination, transthoracic tissue Doppler echocardiography and stress echocardiography.The results of this study demonstrated significantly increased levels of galectin-3, blood glucose, and HbA1c in group 2. Also, echocardiographicaly, left ventricular (LV) diameters and IVS thickness were increased in this group of patients. Furthermore, in the same cohort a positive correlation between galectin-3 and NT-pro BNP, and galectin-3 and LV mass were demonstrated. In addition, a negative correlation between galectin-3 and LV end-diastolic diameter was revealed.This study revealed that levels of galectin-3 were higher in patients with both T2D and HT, and correlated with LV mass, indicating the potential role of this biomarker for early detection of myocardial structural and functional alterations.

scholarly journals Incremental Value of Left Ventricular Mechanical Dyssynchrony Assessment by Nitrogen-13 Ammonia ECG-Gated PET in Patients With Coronary Artery Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Danzha Zheng ◽  
Yanyun Liu ◽  
Lei Zhang ◽  
Fan Hu ◽  
Xubo Tan ◽  
...  
Keyword(s):  
Myocardial Viability ◽  
Diagnostic Value ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Viable Myocardium ◽  
Cardiac Events ◽  
Nitrogen 13 Ammonia ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease

Background: Phase analysis is a technique used to assess left ventricular mechanical dyssynchrony (LVMD) in nuclear myocardial imaging. Previous studies have found an association between LVMD and myocardial ischemia. We aim to assess the potential diagnostic value of LVMD in terms of myocardial viability, and ability to predict major adverse cardiac events (MACE), using Nitrogen-13 ammonia ECG-gated positron emission tomography (gPET).Methods: Patients with coronary artery disease (CAD) who underwent Nitrogen-13 ammonia and Fluorine-18 FDG myocardial gPET were enrolled, and their gPET imaging data were retrospectively analyzed. Patients were followed up and major adverse cardiac events (MACE) were recorded. The Kruskal-Wallis test and Mann-Whitney U test were performed to compare LVMD parameters among the groups. Binary logistic regression analysis, receiver operating characteristic (ROC) curve analysis, and multiple stepwise analysis curves were applied to identify the relationship between LVMD parameters and myocardial viability. Kaplan–Meier survival curves and the log-rank test were used to look for differences in the incidence of MACE.Results: In total, 79 patients were enrolled and divided into three groups: Group 1 (patients with only viable myocardium, n = 7), Group 2 (patients with more viable myocardium than scar, n = 33), and Group 3 (patients with less viable myocardium than scar, n = 39). All LVMD parameters were significantly different among groups. The median values of systolic phase standard deviation (PSD), systolic phase histogram bandwidth (PHB), diastolic PSD, and diastolic PHB between Group 1 and Group 3, and Group 2 and Group 3 were significantly different. A diastolic PHB of 204.5° was the best cut-off value to predict the presence of myocardial scar. In multiple stepwise analysis models, diastolic PSD, ischemic extent, and New York Heart Association (NYHA) classification were independent predictive factors of viable myocardium and myocardial scar. The incidence of MACE in patients with diastolic PHB > 204.5° was 25.0%, higher than patients with diastolic PHB <204.5° (11.8%), but the difference was not significant.Conclusions: LVMD generated from Nitrogen-13 ammonia ECG-gated myocardial perfusion imaging had added diagnostic value for myocardial viability assessment in CAD patients. LVMD did not show a definite prognostic value.

scholarly journals Relationship of Body Fat and Left ventricular hypertrophy with the Risk of All-cause Death in Patients with Coronary Artery Disease

2021 ◽  
Author(s):  
Baotao Huang ◽  
Lu Yang ◽  
Bosen Yang ◽  
Fangyang Huang ◽  
Qianfeng Xiao ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Body Fat ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Lower Body ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Abstract Background and aimsLeft ventricular hypertrophy (LVH) is prevalent in obese individuals. Besides, both of LVH and obesity is associated with subclinical LV dysfunction. However, little is known about the interplay between body fat and LVH in relation to all-cause death in patients with coronary artery disease (CAD).MethodsIn this retrospective cohort study, a total of 2243 patients with angiographically proven CAD were included. Body fat and LV mass were calculated using formulas. Higher body fat was defined as the percentage of body fat was greater than 75th percentile. LVH was defined according to guidelines’ definition. Patients were divided into four groups: group 1, lower body fat and no LVH; group 2, lower body fat and LVH; group 3, higher body fat and no LVH; group 4, higher body fat and LVH. Cox-proportional hazard models were used to observe the interaction effect of body fat and LVH on all-cause death.ResultsOver 2.2 years, there were 120 deaths. Patients with higher body fat and no LVH (group 3) had similar risk of death (adjusted HR 1.83, 95%CI 1.00-3.38, P = 0.054) compared to the reference group (group 1), while patients with lower body fat and LVH (group 2) had the highest risk (adjusted HR 2.15, 95%CI 1.26–3.64, P = 0.005) of death. The results were robust after different degree of adjustment.ConclusionCertain amount of BF was not associated with increased risk of all-cause death in patients with CAD, even seems protective in those concomitant with LVH.

scholarly journals COMPARISON OF ESMOLOL, LABETALOL AND LIGNOCAINE FOR ATTENUATION OF SYMPATHOMIMETIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Dr. Ankit Kumar ◽  
Dr. Arun Kumar Kulshrestha
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Stress Responses ◽  
Left Ventricular ◽  
Group Reduction ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
American Society ◽  
Group 1

INTRODUCTION: In some individual’s suffering from hypertension, coronary artery disease, cerebrovascular disease, myocardial infarction and thyrotoxicosis, these hemodynamic stress responses can turn into life-threatening conditions like left ventricular failure, myocardial ischemia, cerebral hemorrhage, and ruptured cerebral aneurysm. Different drugs like lidocaine, vasodilator agents inhibiting sympathoadrenal response, α-and β-adrenergic blockers, and opioids can be administered prior to tracheal intubation to prevent hemodynamic responses. But higher dose of lignocaine may lead to hypotension, bradycardia, and hypoxia in patients. Due to various effect of these drugs on hemodynamic changes in patients this study was carried out to evaluate the effects of IV esmolol, lignocaine, and labetalol for attenuation of hemodynamic response to laryngoscopy and intubation. MATERIAL AND METHODS: A total of 90 consecutive patients were included in the study and were grouped in to, lignocaine group, labetalol and esmolol group containing 30 patients each. Age group 21–65 years of either sex or American Society of Anesthesiologists (ASA) Grade I or II scheduled for various general surgical procedures under endotracheal anesthesia were included in this study. Patients excluded were pregnant and lactating women, morbid obesity, and hypertension. RESULTS: Mean Age in Group 1, group2 and group 3 was 40.38 ± 7.25, 43.8 ± 9.24 and 42.56 ± 8.71 respectively while weight was 62.41 ± 7.32, 63.63 ± 8.11 and 60.74 ± 6.92 respectively. There were 17 male and 13 female in group 1, 19 male and 11 female in group 2 and 16 male and 14 female in group 3. Attenuation of blood pressure was more in labetalol group. Reduction of heart rate in labetalol group was significant. It is seen that Labetalol was more effective at attenuation of diastolic blood pressure among all drugs. Mean arterial pressure was not much reduced lignocaine and esmolol group as compared to labetalol. CONCLUSION: Haemodynamic alterations are usually observed during laryngoscopy and endotracheal intubation. In our study it was found that as labetalol is a safe and effective drug, for attenuation of sympathomimetic response.

scholarly journals The Rate of Discordance between Syntax Score II and Cardiologist Decision as a Guide for Mode of Revascularization in Patients with Complex Coronary Artery Disease

2018 ◽  
Vol 59 (4) ◽  
pp. 285-290
Author(s):  
Hasan A. Farhan
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Judgment ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Clinical Decisions ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

treatment decisions for percutaneous coronary intervention (PCI) and/or coronary artery bypass graft (CABG) in patients with complex coronary artery disease (CAD) and/or unprotected left main stem disease (ULMSD).Objectives: To assess the agreement between the clinical decisions of the cardiologist and the SS II recommendation regarding the revascularization strategies in patients with complex CAD and/or ULMSD.Patients and Methods: Prospective data from patients who presented to Baghdad Medical City Catheterization Labs for coronary angiography and were followed up between January 2014 and November 2015 were analyzed. For these patients, SS II was assessed by the two anatomical variables (SS and presence of ULMSD) and six clinical variables (age, creatinine clearance, left ventricular ejection fraction, sex, chronic obstructive pulmonary disease, and peripheral vascular disease) to predict 4-year mortality after revascularization with PCI and/or CABG. These scores were then compared with the clinical decisions of cardiologists. After 1 year of data collection, we followed up the patients by phone to assess their mortality status. Patients were categorized into three groups according the interventional procedures: Group 1 (for PCI), Group 2 (for CABG), and Group 3 (for PCI vs. CABG).Results: Two hundred patients were enrolled. Their mean age was 60.23 ± 9.836 years, and 157 (78.5%) were men. Depending on the clinical judgment of the cardiologist, 71 (35.5%) patients were referred for PCI (Group 1), 119 (59.5%) patients for CABG (Group 2), and the remaining 10 (5%) patients for PCI vs. CABG (Group 3). Based on an assessment of 4-year mortality by the SS II, CABG would have been the treatment of choice in 67 (33.5%) patients, PCI in 30 (15%) patients, and both the treatments in 103 (51.5%) patients. There was a concordance between the clinical decision of the cardiologist and SS II in 67 (33.5%) patients and discordance in 133 (66.5%) patients. Six patients died within 1 year, most of whom were from the discordant group.Conclusion: There was a statistically significant discordance between the SS II recommendation and clinical judgment of the interventional cardiologist. SS II proved to be a useful objective tool to assist experienced clinical judgment in determining appropriate revascularization strategy for CAD patients. المقدمة:درجة السنتاكس ٢ تعد طريقة ارشادية لاختيار طريقة العلاج في المرضى اللذين يعانون من امراض شرايين القلب التاجية المعقدة مع او بدون امراض الشريان الايسر الرئيسي غير المحمي. الهدف: لتقييم نسبة عدم التوافق بين القرار السريري لاختصاصي القلبية وتوصيات درجة السنتاكس ٢ بالنسبة لخطة العلاج في المرضى المصابين بآمراض شرايين القلب التاجية المعقدة مع او بدون امراض الشريان الايسر الرئيسي غير المحمي.                        طرائق البحث: يتم جمع معلومات المرضى اللذين يخضعون لاجراء القسطرة التشخيصية لشرايين القلب في صالات القسطرة في مدينة الطب وتتم متابعة المرضى ايضا وتكون مدة الدراسة للفترة من شهر كانون الثاني لسنة ٢٠١٤م الى شهر تشرين الثاني لسنة ٢٠١٥م وخلال هذه الفترة يتم تقييم المرضى عن طريق درجة السنتاكس ٢ وست متغيرات سريرية للتنبؤ بآحتمالية حدوث الوفاة خلال الاربع سنوات بعد عودة التوعي ومقارنتها مع القرار السريري لاختصاصي القلبية. ثم بعد مرور سنة على جمع الداتا، نقوم بمتابعة حالة المرضى عن طريق الاتصال الهاتفي لمعرفة إذا حدثت حالات الوفاة. يتم تقسيم المرضى الى ٣ مجاميع، المجموعة الاولى والتي تخضع للتداخل القسطاري، المجموعة الثانية والتي تخضع لعملية جراحية لزرع شرايين القلب، والمجموعة الثالثة والتي لديها احتمالية للخضوع للقسطرة او للعملية الجراحية.     النتائج: تم اشراك مئتا مريض في الدراسة، معدل العمر ٦٠.٢٣ ± ٩.٨٣٦سنة، ١٥٧ (٧٨.٥٪) من المرضى ذكور. بالاعتماد على القرار السريري لاختصاصي القلبية تم تحديد ٧١ (٣٥.٥٪) من المرضى للخضوع للتداخل القسطاري (المجموعة الاولى)، ١١٩ (٥٩.٥٪) من المرضى تم ارسالهم لاجراء عملية جراحية (المجموعة الثانية) وبقية المرضى ١٠ (٥٪) تم ادراجهم تحت احتمالية خضوعهم للتداخل القسطاري او العملية الجراحية. بالنسبة لتققيم حالة الوفاة للاربع سنوات بالاعتماد على درجة السنتاكس ٢، كانت النتيجة ان العلاج المفضل هو العمليات الجراحية وبنسبة ٣٣.٥٪، في حين ان نسبة المرضى الخاضعين للتداخل القسطاري كانت ١٥٪، وكانت النسبة متوازية بالنسبة للمرضى الخاضعين للعمليات الجراحية او التداخل القسطاري ٥١.٥٪. كان هنالك توافق بين القرار السريري لاختصاصي القلبية ودرجة السنتاكس ٢ وبنسبة ٣٣.٥٪، في حين ان نسبة عدم التوافق للمرضى كانت ٦٦.٥٪. خلال سنة واحدة توفي ستة مرضى ومعضمهم كانوا من مجموعة عدم التوافق.                  الاستنتاج: هذه الدراسة اظهرت عدم توافق هام بين توصيات درجة السنتاكس ٢ والقرار السريري لاختصاصي القلبية.

scholarly journals Relationship between the Deformation Properties of the Left Ventricle and the Severity of Coronary Atherosclerosis in Patients with Coronary Artery Disease

2021 ◽  
Vol 11 (2) ◽  
pp. 131-136
Author(s):  
F. Bekmetova ◽  
Kh. Fozilov ◽  
Sh. Doniyorov ◽  
R. Alieva ◽  
M. Mukhamedova ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Syntax Score ◽  
Deformation Properties ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

The purpose of this study was to assess the properties of left ventricular myocardial deformation in patients with coronary artery disease (CAD) with various degrees of coronary lesions. Methods and Results: The study included 74 patients with stable angina pectoris Class II-IV aged between 40 and 70 years. All patients underwent the following examinations: assessment of traditional risk factors, physical examination, general clinical and laboratory blood tests, 12-lead ECG, 24-hour ABPM, transthoracic echocardiography, two-dimensional speckle tracking echocardiography (STE), and coronary angiography (CAG). The SYNTAX score was calculated retrospectively according to the SYNTAX score algorithm. All patients were divided into 3 groups: Group 1 included 21 patients with a low SYNTAX score (0–22), for whom standard drug therapy was recommended; Group 2 included 28 patients with an intermediate SYNTAX score (23–32), to whom PCI was recommended; Group 3 included 25 patients with a high SYNTAX score (≥33), to whom CABG was recommended. Left ventricular ejection fraction (LVEF) obtained using the modified biplane Simpson's method was significantly lower in Group 3 than in Groups 1 and 2 (P=0.001); it should be noted that this indicator was within the normative values in Groups 1 and 2, and belonged to the gradation “mild dysfunction.” A more objective quantitative assessment of the contractile function of the LV myocardium was obtained by assessing the GLS and SR. The comparative analysis of the LV myocardial deformation properties in the three studied groups showed that in Group 3 the GLS and SR indicators were significantly lower than in Group 1 (P=0.000 and P=0.0020). Moreover, GLS (global longitudinal strain) and SR (strain rate) were significantly higher in Group 1 than in Group 2 (P=0.0001 and P=0.0133, respectively). GLS significantly correlated with LVEF (r=0.57; P<0.05), E/A (r=0.22; P<0.05), and SYNTAX score (r=-0.63; P<0.05). SR significantly correlated with LVEF (r=0.49; P<0.05) and SYNTAX score (r=-0.37; P<0.05) Conclusion: The results obtained indicate the diagnostic value of STE with the determination of GLS and SR in a comprehensive assessment of the severity of SAD. GLS and SR significantly correlate with the clinical course of the disease, as well as indicators of LV remodeling and LV diastolic dysfunction. STE analysis of GLS and SR has incremental diagnostic value over transthoracic echocardiography in predicting significant CAD.

scholarly journals Investigation of Oxidative Stress in Antrochoanal Polyp Etiology

2019 ◽  
Vol 99 (10) ◽  
pp. 633-636
Author(s):  
Yuce Islamoglu ◽  
Gulin Gokcen Kesici ◽  
Yagmur Canan ◽  
Hayati Kale ◽  
Özmen Kara ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Venous Blood ◽  
Healthy Individuals ◽  
Benign Lesions ◽  
Total Thiol ◽  
Study Population ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Antrochoanal polyps (ACPs) are benign lesions of the paranasal sinuses. Similarities between ACPs and nasal polyps have been previously investigated. However, oxidative stress has been implicated but not investigated in terms of the etiology of ACPs. Thus, the aim of this study was to investigate oxidative stress in the etiology of ACPs. The study population comprised 93 patients divided into 3 groups. Group 1 consisted of 30 patients with ACPs. Group 2 consisted of 33 patients with nasal septal deviation. Group 3 comprised 30 healthy individuals. Venous blood was taken from all participants, and total thiol, native thiol, disulfide, and ischemic modified albumin (IMA) levels were evaluated. When the values of native thiol ( P = .097), disulfide ( P = .221), total thiol ( P = .140), and IMA ( P = .091) were compared, no significant differences were found among the 3 groups. While many studies have been conducted related to nasal pathologies and the role of oxidative stress in their etiologies, our study concluded that oxidative stress plays no role in ACP etiology.

scholarly journals COMPARISON OF ESMOLOL, LABETALOL AND LIGNOCAINE FOR ATTENUATION OF SYMPATHOMIMETIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. H. Kirankumar
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Stress Responses ◽  
Left Ventricular ◽  
Group Reduction ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
American Society ◽  
Group 1

INTRODUCTION: In some individual’s suffering from hypertension, coronary artery disease, cerebrovascular disease, myocardial infarction and thyrotoxicosis, these hemodynamic stress responses can turn into life-threatening conditions like left ventricular failure, myocardial ischemia, cerebral hemorrhage, and ruptured cerebral aneurysm. Different drugs like lidocaine, vasodilator agents inhibiting sympathoadrenal response, α-and β-adrenergic blockers, and opioids can be administered prior to tracheal intubation to prevent hemodynamic responses. But higher dose of lignocaine may lead to hypotension, bradycardia, and hypoxia in patients. Due to various effect of these drugs on hemodynamic changes in patients this study was carried out to evaluate the effects of IV esmolol, lignocaine, and labetalol for attenuation of hemodynamic response to laryngoscopy and intubation. MATERIAL AND METHODS: A total of 90 consecutive patients were included in the study and were grouped in to, lignocaine group, labetalol and esmolol group containing 30 patients each. Age group 21–65 years of either sex or American Society of Anesthesiologists (ASA) Grade I or II scheduled for various general surgical procedures under endotracheal anesthesia were included in this study. Patients excluded were pregnant and lactating women, morbid obesity, and hypertension. RESULTS: Mean Age in Group 1, group2 and group 3 was 40.38 ± 7.25, 43.8 ± 9.24 and 42.56 ± 8.71 respectively while weight was 62.41 ± 7.32, 63.63 ± 8.11 and 60.74 ± 6.92 respectively. There were 17 male and 13 female in group 1, 19 male and 11 female in group 2 and 16 male and 14 female in group 3. Attenuation of blood pressure was more in labetalol group. Reduction of heart rate in labetalol group was significant. It is seen that Labetalol was more effective at attenuation of diastolic blood pressure among all drugs. Mean arterial pressure was not much reduced lignocaine and esmolol group as compared to labetalol. CONCLUSION: Haemodynamic alterations are usually observed during laryngoscopy and endotracheal intubation. In our study it was found that as labetalol is a safe and effective drug, for attenuation of sympathomimetic response.

scholarly journals Hypertrophy of unaffected cardiomyocytes correlates with severity of cardiomyopathy in female patients with Fabry disease

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Cristina Chimenti ◽  
Romina Verardo ◽  
Andrea Frustaci
Keyword(s):  
Fabry Disease ◽  
Wall Thickness ◽  
Left Ventricular ◽  
Female Patients ◽  
Maximal Wall Thickness ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Aim To investigate the contribution of unaffected cardiomyocytes in Fabry disease cardiomyopathy. Findings Left ventricular (LV) endomyocardial biopsies from twenty-four females (mean age 53 ± 11 ys) with Fabry disease cardiomyopathy were studied. Diagnosis of FD was based on the presence of pathogenic GLA mutation, Patients were divided in four groups according with LV maximal wall thickness (MWT): group 1 MWT ≤ 10.5 mm, group 2 MWT 10.5–15 mm, group 3 MWT 16–20 mm, group 4 MWT > 20 mm. At histology mosaic of affected and unaffected cardiomyocytes was documented. Unaffected myocytes’ size ranged from normal to severe hypertrophy. Hypertrophy of unaffected cardiomyocytes correlated with severity of MWT (p < 0.0001, Sperman r 0,95). Hypertrophy of unaffected myocytes appear to concur to progression and severity of FDCM. It is likely a paracrine role from neighboring affected myocytes.

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