scholarly journals Assessment of foetal cardiac function by myocardial tissue doppler in foetal growth restriction

2017 ◽  
Vol 6 (3) ◽  
pp. 1045
Author(s):  
Barnali Basu ◽  
Ranjan Shetty ◽  
Krishnendu Gupta
Keyword(s):  
Cardiac Function ◽  
Cardiac Dysfunction ◽  
Tertiary Care ◽  
Normal Growth ◽  
Tissue Doppler ◽  
Myocardial Tissue ◽  
Third Trimester ◽  
Foetal Growth Restriction ◽  
Adverse Neonatal Outcomes ◽  
A New Technique

Background: One of the consequences of IUGR is the development of cardiac diastolic dysfunction in fetuses. Tissue doppler in echocardiography is a new technique to detect myocardial tissue function and can act as a useful tool in the identification of this complication. Hence we decided to undertake this study to assess the utility of myocardial tissue doppler in detecting foetal cardiac dysfunction in IUGR. It was a prospective case control study in a tertiary care teaching hospital.Methods: Foetal cardiac function in the third trimester of pregnancy was evaluated with the help of myocardial tissue doppler and compared between IUGR and normal growth babies and correlated with vessel doppler findings and neonatal outcomes.Results: There were sixty two IUGR and fifty eight normal growth babies in the study. In babies with IUGR, particularly the ones with severe IUGR, abnormal vessel doppler and adverse neonatal outcomes, right ventricular MPI was found to be significantly lower. However, the variable had a poor sensitivity (40%) in detecting fetuses at risk for poor neonatal outcomes.Conclusions: Myocardial tissue doppler shows right sided cardiac dysfunction in IUGR babies in comparison to normal growth babies It is however not a sensitive indicator of adverse perinatal outcome in IUGR babies.

scholarly journals Assessment of Cardiac Dysfunction in the Intrauterine Growth-restricted Fetuses from Pre-eclamptic Mothers

2014 ◽  
Vol 8 (2) ◽  
pp. 123-127
Author(s):  
Florin Stamatian ◽  
Gabriela Caracostea
Keyword(s):  
Cardiac Function ◽  
Cardiac Dysfunction ◽  
Sequential Analysis ◽  
Tissue Doppler ◽  
Severe Form ◽  
Doppler Imaging ◽  
Diastolic Filling ◽  
Intrauterine Growth ◽  
Performance Indexes ◽  
Left And Right

ABSTRACT Background Although it is known that cardiac parameters have abnormal values in severely affected fetuses with intrauterine growth restriction (IUGR), recent research suggested that subclinical cardiac dysfunction may be present from the early stages of fetal deterioration. The identification and monitoring of cardiac dysfunction may be relevant for the management of these cases. Materials and methods In this prospective observational study, we evaluated 17 IUGR fetuses from nulliparous pregnant women diagnosed with pre-eclampsia. Cardiac structural assessment was performed using segmental sequential analysis. Cardiac function was assessed by conventional echocardiography and Tissue Doppler Imaging (TDI). Results Gestational age at admittance ranged between 24 and 30 weeks. A severe form of pre-eclampsia was diagnosed in 2 of 17 cases. Conventional cardiac examination showed low left and right ventricular diastolic filling with low E and A velocities, and increased myocardial performance indexes for both ventricles. Using TDI we observed decreased myocardial velocities and impaired contractility (demonstrated by low left and right diastolic velocities, as well as increased E’/A’ ratios). Conclusion Our study confirms the presence of early cardiac dysfunction in IUGR fetuses. Further studies are warranted to confirm the utility of TDI in obstetric ultrasound routine examination for monitoring fetal cardiac function in high-risk pregnancies. How to cite this article Caracostea G, Stamatian F. Assessment of Cardiac Dysfunction in the Intrauterine Growthrestricted Fetuses from Pre-eclamptic Mothers. Donald School J Ultrasound Obstet Gynecol 2014;8(2):123-127.

scholarly journals Alterations in plasma triglycerides and ceramides: links with cardiac function in humans with type 2 diabetes

2020 ◽  
Vol 61 (7) ◽  
pp. 1065-1074 ◽  
Author(s):  
Linda R. Peterson ◽  
Xuntian Jiang ◽  
Ling Chen ◽  
Anne C. Goldberg ◽  
Marsha S. Farmer ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Diastolic Function ◽  
Cardiac Dysfunction ◽  
Tissue Doppler ◽  
Lipid Lowering ◽  
Double Blind ◽  
Stress Markers ◽  
Fenofibrate Treatment ◽  
Lipid Species ◽  
Cardiac Relaxation

Cardiac dysfunction in T2D is associated with excessive FA uptake, oxidation, and generation of toxic lipid species by the heart. It is not known whether decreasing lipid delivery to the heart can effect improvement in cardiac function in humans with T2D. Thus, our objective was to test the hypothesis that lowering lipid delivery to the heart would result in evidence of decreased “lipotoxicity,” improved cardiac function, and salutary effects on plasma biomarkers of cardiovascular risk. Thus, we performed a double-blind randomized placebo-controlled parallel design study of the effects of 12 weeks of fenofibrate-induced lipid lowering on cardiac function, inflammation, and oxidation biomarkers, and on the ratio of two plasma ceramides, Cer d18:1 (4E) (1OH, 3OH)/24:0 and Cer d18:1 (4E) (1OH, 3OH)/16:0 (i.e., “C24:0/C16:0”), which is associated with decreased risk of cardiac dysfunction and heart failure. Fenofibrate lowered plasma TG and cholesterol but did not improve heart systolic or diastolic function. Fenofibrate treatment lowered the plasma C24:0/C16:0 ceramide ratio and minimally altered oxidative stress markers but did not alter measures of inflammation. Overall, plasma TG lowering correlated with improvement of cardiac relaxation (diastolic function) as measured by tissue Doppler-derived parameter e′. Moreover, lowering the plasma C24:0/C16:0 ceramide ratio was correlated with worse diastolic function. These findings indicate that fenofibrate treatment per se is not sufficient to effect changes in cardiac function; however, decreases in plasma TG may be linked to improved diastolic function. In contrast, decreases in plasma C24:0/C16:0 are linked with worsening cardiac function.

Abstract 16330: Evaluation of Cardiac Function in Children Undergoing Liver Transplantation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Neha Bansal ◽  
Nadia Ovchinsky ◽  
Jacqueline M Lamour ◽  
Debora Kogan-Liberman ◽  
Trang Nguyen ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Liver Transplant ◽  
Cardiac Dysfunction ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Pearson Correlation ◽  
Global Longitudinal Strain ◽  
Tertiary Care ◽  
Left Ventricular ◽  
Echocardiographic Parameters

Introduction: Cirrhotic cardiomyopathy is a hemodynamic complication of cirrhosis resulting in cardiac dysfunction. It remains poorly characterized in children. Our aim was to assess cardiac function using speckle tracking echocardiography (STE), a marker of subclinical cardiac dysfunction, in patients undergoing liver transplant (LT) and correlate it with their post-operative (op) clinical course. Methods: This is a retrospective study of pre-LT echocardiograms performed on pediatric patients (pts) with cirrhosis at a single tertiary care center who received a LT. Demographic clinical and echocardiographic data was collected and STE was performed by a single observer using TomTec system. Descriptive data was expressed as mean (SD) and number (%). The relationship between clinical data and echocardiographic variables was assessed using Pearson correlation coefficient. Significance was set at P value < 0.05. Results: Twenty-three pts underwent LT between 03/2013-12/2019 with median age 7.5 (IQR 0.1, 17) years and 31 % with biliary atresia. Five patients were listed as status 1A/1B. Their mean natural pediatric/model end-stage lived disease (PELD/MELD) score was 15. Their pre-LT echocardiogram showed normal left ventricular (LV) ejection fraction and normal right ventricular (RV) fractional area change. Tricuspid annular plane systolic excursion (TAPSE) was abnormal in 50% of pts. While LV global longitudinal strain (GLS) (23 ± 3%) and LV circumferential strain (27 ± 4%) were normal, RV GLS was abnormal in 65% of pts (22 ± 3%). There was no correlation between echocardiographic parameters and post-operative LT course (length of stay, duration of mechanical ventilation, surgical complications). Conclusions: Children undergoing liver transplant have RV dysfunction as evidenced by abnormal TAPSE and RV GLS on speckle tracking echocardiography. Echocardiographic parameters do not correlate with the immediate post-LT clinical status.

Exercise cardiac MRI unmasks cardiac dysfunction in childhood and adolescent cancer survivors with reduced cardiopulmonary fitness

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Foulkes ◽  
B Costello ◽  
E.J Howden ◽  
K Janssens ◽  
H Dillon ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Function ◽  
Cancer Survivors ◽  
Pediatric Cancer ◽  
Cardiac Dysfunction ◽  
Cardiopulmonary Fitness ◽  
Cardiac Reserve ◽  
Pediatric Cancer Survivors ◽  
Increased Risk

Abstract Background Young cancer survivors are at increased risk of impaired cardiopulmonary fitness (VO2peak) and heart failure. Assessment of exercise cardiac reserve may reveal sub-clinical abnormalities that better explain impairments in fitness and long term heart failure risk. Purpose To investigate the presence of impaired VO2peak in pediatric cancer survivors with increased risk of heart failure, and to assess its relationship with resting cardiac function and cardiac reserve Methods Twenty pediatric cancer survivors (aged 8–24 years) treated with anthracycline chemotherapy underwent cardiopulmonary exercise testing to quantify VO2peak, with a value &lt;85% of predicted defined as impaired VO2peak. Resting cardiac function was assessed using 3-dimensional echocardiography, with cardiac reserve quantified from resting and peak exercise heart rate (HR), stroke volume index (SVi) and cardiac index (CI) using exercise cardiac magnetic resonance imaging. Results 12 of 20 survivors (60%) had impaired VO2peak (97±14% vs. 70±16% of age and gender predicted). There were no differences in echocardiographic or CMR measurements of resting cardiac function between survivors with normal or impaired VO2peak. However, those with reduced VO2peak had diminished cardiac reserve, with a lesser increase in CI (Fig. 1A) and SVi (Fig. 1B) during exercise (Interaction P=0.001 for both), whilst the HR response was similar (Fig. 1C; P=0.71). Conclusions Resting measures of cardiac function are insensitive to significant cardiac dysfunction amongst pediatric cancer survivors with reduced VO2peak. Measures of cardiopulmonary fitness and cardiac reserve may aid in early identification of survivors with heightened risk of long-term heart failure. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): National Heart Foundation

scholarly journals Exposure to Δ9-tetrahydrocannabinol during rat pregnancy leads to impaired cardiac dysfunction in postnatal life

2021 ◽  
Author(s):  
Kendrick Lee ◽  
Steven R. Laviolette ◽  
Daniel B. Hardy
Keyword(s):  
Body Weight ◽  
Cardiac Function ◽  
Cardiac Dysfunction ◽  
Cardiac Remodelling ◽  
Long Term Effects ◽  
Catch Up ◽  
First Time ◽  
Impaired Cardiac Function ◽  
In Pregnancy

Abstract Background Cannabis use in pregnancy leads to fetal growth restriction (FGR), but the long-term effects on cardiac function in the offspring are unknown, despite the fact that fetal growth deficits are associated with an increased risk of developing postnatal cardiovascular disease. We hypothesize that maternal exposure to Δ9-tetrahydrocannabinol (Δ9-THC) during pregnancy will impair fetal development, leading to cardiac dysfunction in the offspring. Methods Pregnant Wistar rats were randomly selected and administered 3 mg/kg of Δ9-THC or saline as a vehicle daily via intraperitoneal injection from gestational days 6 to 22, followed by echocardiogram analysis of cardiac function on offspring at postnatal days 1 and 21. Heart tissue was harvested from the offspring at 3 weeks for molecular analysis of cardiac remodelling. Results Exposure to Δ9-THC during pregnancy led to FGR with a significant decrease in heart-to-body weight ratios at birth. By 3 weeks, pups exhibited catch-up growth associated with significantly greater left ventricle anterior wall thickness with a decrease in cardiac output. Moreover, these Δ9-THC-exposed offsprings exhibited increased expression of collagen I and III, decreased matrix metallopeptidase-2 expression, and increased inactivation of glycogen synthase kinase-3β, all associated with cardiac remodelling. Conclusions Collectively, these data suggest that Δ9-THC-exposed FGR offspring undergo postnatal catch-up growth concomitant with cardiac remodelling and impaired cardiac function early in life. Impact To date, the long-term effects of perinatal Δ9-THC (the main psychoactive component) exposure on the cardiac function in the offspring remain unknown. We demonstrated, for the first time, that exposure to Δ9-THC alone during rat pregnancy results in significantly smaller hearts relative to body weight. These Δ9-THC-exposed offsprings exhibited postnatal catch-up growth concomitant with cardiac remodelling and impaired cardiac function. Given the increased popularity of cannabis use in pregnancy along with rising Δ9-THC concentrations, this study, for the first time, identifies the risk of perinatal Δ9-THC exposure on early postnatal cardiovascular health.

Cardiac Function Normalizes 1 Year After Bariatric Surgery in Half of the Obesity Patients with Subclinical Cardiac Dysfunction

2021 ◽  
Author(s):  
Sanne M. Snelder ◽  
Yaar Aga ◽  
Lotte E. de Groot-de Laat ◽  
L. Ulas Biter ◽  
Manuel Castro Cabezas ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Cardiac Function ◽  
Cardiac Dysfunction

scholarly journals OC017: Assessment of ventricular function by myocardial tissue doppler in fetuses with intrauterine growth restriction

2008 ◽  
Vol 32 (3) ◽  
pp. 248-248
Author(s):  
A. Naujorks ◽  
P. Zielinsky ◽  
P. A. Beltrame ◽  
R. Castagna ◽  
R. Petracco ◽  
...  
Keyword(s):  
Ventricular Function ◽  
Intrauterine Growth Restriction ◽  
Tissue Doppler ◽  
Growth Restriction ◽  
Myocardial Tissue ◽  
Intrauterine Growth

scholarly journals Altered decidual leucocyte populations in the placental bed in pre-eclampsia and foetal growth restriction: a comparison with late normal pregnancy

Reproduction ◽  
2009 ◽  
Vol 138 (1) ◽  
pp. 177-184 ◽  
Author(s):  
Paula J Williams ◽  
Judith N Bulmer ◽  
Roger F Searle ◽  
Barbara A Innes ◽  
Stephen C Robson
Keyword(s):  
T Lymphocytes ◽  
Elective Caesarean Section ◽  
Normal Pregnancy ◽  
Growth Restriction ◽  
Trophoblast Invasion ◽  
Third Trimester ◽  
Double Positive ◽  
Foetal Growth ◽  
Foetal Growth Restriction ◽  
Unk Cells

Alterations in the balance of leucocyte populations in uterine decidua may lead to the generation of an unfavourable cytokine environment that is associated with unsuccessful pregnancy. Single and double immunohistochemical labelling was used to examine leucocyte populations in decidua from normal third trimester, foetal growth-restricted and pre-eclamptic pregnancies. Placental bed biopsies from 12 women undergoing elective Caesarean section with no hypertension or foetal growth restriction (FGR), 8 women with FGR without maternal hypertension and 12 women with pre-eclampsia (PE) were used to quantify decidual CD56+ uterine NK cells, CD14+ macrophages, CD3+T-lymphocytes and CD8+ lymphocytes. CD3+CD56+, CD8+CD56+ and CD161+CD3+ double-labelled cells in decidua were compared in PE and control decidua. Decidual CD3+T-lymphocytes (P<0.01), CD8+ cytotoxic T-lymphocytes (P<0.05), CD14+ macrophages (P<0.0001) and CD56+ uterine natural killer (uNK) cells (P=0.01) were decreased in placental bed biopsies from women with PE compared with control third trimester decidua. By contrast, only CD56+ uNK cells were decreased in FGR decidua (P<0.05). Double-positive CD8+CD56+ cells were also decreased in PE compared with control third trimester decidua (P<0.05). The reduction in specific leucocyte subset numbers in PE and uNK cells in FGR suggests that altered local cytokine balance may be important in defective trophoblast invasion and spiral artery transformation in these pathological pregnancies.

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