scholarly journals Can Visceral Adiposity Predict Paradoxical Prognostic Implications on Lethal Arrhythmic Events in Chronic Heart Failure Patients with Impaired Cardiac Sympathetic Activity?

2020 ◽  
Vol 6 (1) ◽  
pp. 46-48
Author(s):  
Shu Kasama ◽  
Sang-Geon Cho
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Sympathetic Activity ◽  
Visceral Adiposity ◽  
Cardiac Sympathetic Activity ◽  
Heart Failure Patients ◽  
Prognostic Implications

scholarly journals The prognostic significance of cardiac sympathetic activity and dyssynchrony in cardiac resynchronization therapy in ischemic and non-ischemic heart failure patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Mishkina ◽  
K Zavadovsky ◽  
V Saushkin ◽  
D Lebedev ◽  
Y Lishmanov
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Sympathetic Activity ◽  
Gated Spect ◽  
Prognostic Significance ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Cardiac Sympathetic Activity ◽  
Heart Failure Patients ◽  
Crt Response

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Russian Foundation for Basic Research Introduction Impaired cardiac sympathetic activity and contractility are associated with poor prognosis in patients with heart failure after cardiac resynchronization therapy (CRT). There are few prognostic data of the cardiac sympathetic activity and dyssynchrony in patients with chronic heart failure of various etiologies. Purpose To examine the prognostic significance of scintigraphic cardiac sympathetic activity and contractility in predicting the response to CRT and to assess the differences between patients with ischemic (IHF) and non-ischemic (NIHF) heart failure. Methods This study included 38 heart failure patients (24 male; mean age of 56 ± 11 years; 16 patients with ischemic etiology), who were submitted to CRT. Before CRT all patients underwent 123I-metaiodobenzylguanidine (123I-MIBG) imaging for cardiac sympathetic activity evaluating: early and delay heart to mediastinum ratio (eH/M and dH/M), summed MIBG Score (eSMS and dSMS). Moreover all patients underwent gated SPECT with the assessments of left ventricle dyssynchrony indexes: standard deviation (SD) and histogram bandwidth (HBW). In addition, all patients underwent gated blood-pool SPECT (GBPS) to assessed ejection fraction (EF) and stroke volume (SV) of both ventricles. Results One year after CRT response defined as LV ESV decreased by≥15% and/or LV EF increase by≥5%. Baseline cardiac sympathetic activity parameters showed significant differences between responders and non-responders only in NIHF patients: eH/M: 2.27 (2.02–2.41) vs. 1.64 (1.32–2.16); dH/M: 2.18 (2.11–2.19) vs. 1.45 (1.23 – 1.61); eSMS: 7 (5-7) vs. 15.5 (10–28.5); dSMS: 10 (10–13) vs. 16.5 (15.5–29). Significant differences in baseline LV dyssynchrony indexes between responders and non-responders were in patients of both group: in NIHF patients - SD: 54.3 (43–58) degree vs. 65 (62–66) degree; HBW: 179.5 (140–198) degree vs. 211 (208-213) degree, p < 0.054 in IHF patients - HBW: 162 (115.2–180) degree vs.  115.2 (79.2–136.8) degree. Contractility of RV was significantly differed between responders and non-responders in IHF patients: RV EF: 54.5 (41-56) % vs. 44.5 (37–49.5) %; RV SV: 80 (69-101) ml vs. 55.5 (50–72.5) ml. According to univariate logistic regression analyses in IHF patients LV dyssynchrony indexes – SD (OR = 1.55; 95% CI 1.09-2.2; p < 0.5) and HBW (OR = 1.13; 95% CI 1.02-1.24; p < 0.5), as well as RV indexes – RV EF (OR = 1.11; 95% CI 1.001-1.23; p < 0.5), RV SV (OR = 1.07; 95% CI 1.003-1.138; p < 0.5) were predictors of CRT response. In the group of NIHF patients, dH/M (OR = 1.47; 95% CI 1.08-2; p < 0.5), SD (OR = 0.83; 95% CI 0.73-0.95; p < 0.5), HBW (OR = 0.96; 95% CI 0.93-0.99; p < 0.5) showed the predictive value in terms of CRT response. Conclusion  Scintigraphic methods can be used to select patients for CRT. Cardiac 123I-MIBG scintigraphy and gated SPECT may be used for predicting CRT response in NIHF patients. Whereas in IHF patients ECG-gated SPECT and GBPS may be valuable for predicting the response to CRT.

scholarly journals CARDIAC SYMPATHETIC ACTIVITY, MYOCARDIAL PERFUSION AND HEART CONTRACTILITY IN PATIENTS WITH ISCHAEMIC AND NON-ISCHAEMIC HEART FAILURE

2018 ◽  
Vol 33 (2) ◽  
pp. 35-41
Author(s):  
A. I. Mishkina ◽  
K. V. Zavadovskiy ◽  
M. O. Gulya ◽  
V. V. Saushkin ◽  
D. I. Lebedev ◽  
...  
Keyword(s):  
Heart Failure ◽  
Myocardial Perfusion ◽  
Ejection Fraction ◽  
Sympathetic Activity ◽  
Left Ventricular ◽  
Washout Rate ◽  
Ventricular Ejection Fraction ◽  
Cardiac Sympathetic Activity ◽  
Heart Failure Patients ◽  
Heart To Mediastinum Ratio

Purpose:to assess the cardiac sympathetic activity, perfusion and contractility in ischemic and nonischemic chronic heart failure patients by using a radionuclide methods.Material and Methods.The study included 33 heart failure patients with NYHA class III and ischemic (n=13.39%) and non-ischemic (n=20.61%) heart failure. All patients underwent123I-MIBG imaging, myocardial perfusion imaging with  99mTc-MIBI and gated blood-pool single-photon emission computed tomography. Based on123I-MIBG study heart to mediastinum ratio as well as123I-MIBG washout rate were calculated. According to the myocardial perfusion imaging, Summed Rest Score was evaluated. Systolic and diastolic functions and ejection fraction as well as mechanical intraventricular dyssynchrony of both ventricles were analyzed by gated blood-pool single-photon emission computed tomography.Results.There was no statistically significant difference of hemodynamic parameters between the groups. In the first group, which include patients with ischemic heart failure, there were found the following correlations: washout rate and left ventricular end-diastolic volume (0.75; p<0.05), washout rate and left ventricular end-systolic volume (0.68; p<0.05), heart to mediastinum ratio and right ventricular ejection fraction (–0.57; p<0.05). In the group of patients with non-ischemic heart failure there were the following correlation: heart to mediastinum ratio and left ventricular end-systolic volume (–0.77; p<0.05), heart to mediastinum ratio and left ventricular ejection fraction (0.77, p<0.05), heart to mediastinum ratio and right ventricular ejection fraction (0.62, p<0.05), washout rate and left ventricular interventricular dyssynchrony (0.6; p<0.05).Conclusion.It was found out that heart failure patients were characterized by a correlation between sympathetic activity and volumes, hemodynamics and contractility of heart ventricles. The relationship between the cardiac sympathetic activity and myocardial perfusion as well as contractility depend on the etiology of chronic heart failure.

Prognostic significance of cardiac sympathetic innervation and contractility in heart failure patients submitted to cardiac resynchronization therapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Mishkina ◽  
K.V Zavadovsky ◽  
V.V Saushkin ◽  
D.I Lebedev ◽  
Y.U.B Lishmanov
Keyword(s):  
Heart Failure ◽  
Sympathetic Activity ◽  
Sympathetic Innervation ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Cardiac Sympathetic Activity ◽  
Cardiac Sympathetic Innervation ◽  
Heart Failure Patients ◽  
Lv Dyssynchrony ◽  
Crt Response

Abstract Introduction In chronic heart failure patients, cardiac resynchronization therapy (CRT) does not lead to the expected result in 30% of cases. There is a lack of prognostic data related to the cardiac sympathetic activity and contractility assessment in ischemic (IHF) and non-ischemic (CHF) heart failure patients. Purpose To assess the prognostic value of radionuclide cardiac sympathetic innervation and contractility assessment in IHF and NIHF patients submitted to CRT. Methods This study included 38 HF patients (24 male; mean age of 56±11 years), who were submitted to CRT: NYHA class II/III (n=10/28), mean QRS=159.3±17.9ms. The etiology of HF was ischemic in 16 patients and non-ischemic in 22 of them. Before CRT all patients underwent 123I-metaiodobenzylguanidine (123I-MIBG) imaging for cardiac sympathetic activity evaluating. The following indexes were estimated: early and delayed heart to mediastinum ratio (eH/M and dH/M), summed MIBG Score (eSMS and dSMS). Moreover all patients underwent gated myocardial perfusion scintigraphy with the assessments of LV dyssynchrony indexes: standard deviation (SD) and histogram bandwidth (HBW). In addition, all patients underwent gated blood-pool SPECT with both ventricles ejection fraction (EF) and stroke volume (SV) assessment. Results One year after CRT all patients were divided into two groups: responders (IHF group n=11; NIHF group n=15) and non-responders (IHF group n=5; NIHF group n=7). Among baseline scintigraphic parameters the following ones showed significant differences between responders vs. non-responders. In IHF patients - HBW: 162 (115.2–180) degree vs. 115.2 (79.2–136.8) degree, p&lt;0.05; RV_EF: 54.5 (41–56)% vs. 44.5 (37–49.5)%, p&lt;0.05; RV_SV: 80 (69–101)ml vs. 55.5 (50–72.5)ml, p&lt;0.05. In group of NIHF patients responders and non-responders were significantly differed in the following preoperative parameters: eH/M: 2.27 (2.02–2.41) vs. 1.64 (1.32–2.16), p&lt;0.05; dH/M: 2.18 (2.11–2.19) vs. 1.45 (1.23–1.61), p&lt;0.05; eSMS: 7 (5–7) vs. 15.5 (10–28.5), p&lt;0.05; dSMS: 10 (10–13) vs. 16.5 (15.5–29), p&lt;0.05, SD: 54.3 (43–58) degree vs. 65 (62–66) degree, p&lt;0.05; HBW: 179.5 (140–198) degree vs. 211 (208–213) degree, p&lt;0.05. Univariate logistic regression in IHF patients showed that LV dyssynchrony indexes – SD (OR=1.55; 95% CI 1.09–2.2; p&lt;0.5) and HBW (OR=1.13; 95% CI 1.02–1.24; p&lt;0.5), as well as RV indexes – RV_EF (OR=1.11; 95% CI 1.001–1.23; p&lt;0.5), RV_SV (OR=1.07; 95% CI 1.003–1.138; p&lt;0.5) were predictors of CRT response. In the group of NIHF patients, dH/M (OR=1.47; 95% CI 1.08–2; p&lt;0.5), SD (OR=0.83; 95% CI 0.73–0.95; p&lt;0.5), HBW (OR=0.96; 95% CI 0.93–0.99; p&lt;0.5) showed the predictive value in terms of CRT response. Conclusion(s) The positive response to CRT in IHF patients showed a link with LV dyssynchrony and preserved RV contractility. Whereas in NIHF patients the functional state of cardiac sympathetic activity, as well as LV dyssynchrony, were associated with CRT response. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Russian Foundation for Basic Research

Hyponatremia in Patients with Heart Failure: a Prognostic Marker

2018 ◽  
Vol 69 (5) ◽  
pp. 1071-1074
Author(s):  
Camelia Cristina Diaconu ◽  
Maria Manea ◽  
Mihaela Adela Iancu ◽  
Ana Maria Alexandra Stanescu ◽  
Bogdan Socea ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Mortality Rate ◽  
Treatment Strategies ◽  
Developed Countries ◽  
Heart Failure Patients ◽  
Patients With Heart Failure ◽  
High Prevalence ◽  
Prognostic Implications ◽  
Internal Medicine Clinic

Due to the high prevalence of cardiovascular diseases and better treatment strategies, with increased survival, heart failure is a condition with increasing prevalence, especially in developed countries. Heart failure patients often present electrolytic disorders, the most frequent one being hyponatremia. The objective of the study was to evaluate the frequency of hyponatremia in patients with chronic heart failure hospitalized in the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest and to assess the clinical and paraclinical correlations, as well as prognostic implications of hyponatremia in these patients. We performed an observational retrospective study on 400 chronic heart failure patients hospitalized between January 1st 2014 and August 31st 2015. From these patients, 60 patients have been diagnosed with hyponatremia (defined as a serum natrium [135 mEq/L) and represented our group of study. The values of the serum natrium at admission in the study group ranged between 110-132 mmol/L. Most patients had advanced heart failure, according to NYHA classes� classification. The proportion of patients discharged with persistent hyponatremia was 48.33%, lower than the patients discharged with corrected serum sodium (51.67%), indicating an effective treatment of hyponatremia during hospitalization. The mortality rate during hospitalization in patients with corrected hyponatremia was 8.33%, smaller than the mortality rate in patients with persistent hyponatremia despite the correct administration of hydroelectrolytic rebalancing treatment (18.33%). Persistent hyponatremia may be considered a marker of a poor prognosis in hospitalized heart failure patients.

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