Heart Condition in Convalescents of Hemorrhagic Fever with Renal Syndrome According to Echocardiography Data

Aim. To study the morpho-functional parameters of the heart in convalescents of hemorrhagic fever with renal syndrome (HFRS) using echocardiography.Material and methods. The study included 27 patients without any chronic diseases who had severe or moderate HFRS (the main group) within 3 weeks after their discharge from the infection diseases hospital. The reference group consisted of 19 patients comparable by age and gender, without any chronic diseases. Transthoracic echocardiography was the basic method of heart and hemodynamics investigation. The test was performed using tissue Doppler and non-Doppler assessment of left ventricle systolic deformation method (speckle-tracking method).Results. Violation of longitudinal systolic deformation of the left ventricle was observed in 15 (55.6%) patients, which was combined with diastolic left ventricle filling by the type of relaxation violation in 8 (29.6%) cases. Mitral valve insufficiency of 1 degree was identified in 11 (40.7%) HFRS patients, insufficiency of the tricuspid valve of 1 degree was identified in 4 (14.8%) patients. Pericardial effusion was detected in 2 (7.4%) patients. In 7 (25.9%) patients in the first 3 weeks after discharge from the hospital, additional floating echoes were detected on the leaves and fibrous ring of the aortic valve, which were considered as a manifestation of thromboendocarditis.Conclusion. Further investigation is necessary to assess the prognostic value (including the risk of thromboembolic complication developing) of the changes revealed in HFRS convalescents and to support the inclusion of echocardiography in the examination program during dispensary observation of HFRS-convalescents.

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Phenomenological Regularities of Assessment of Left Ventricle Function in Mitral Valve Insufficiency

Kardiologiia ◽

10.18087/cardio.2018.1.10074 ◽

2018 ◽

Vol 17 (1) ◽

pp. 32-40

Author(s):

V. A. Sandrikov ◽

◽

T. Y. Kulagina ◽

V. A. Ivanov ◽

A. S. Krylov ◽

...

Keyword(s):

Mitral Valve ◽

Left Ventricle ◽

Mitral Valve Insufficiency ◽

Left Ventricle Function ◽

Valve Insufficiency ◽

Ventricle Function

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MORPHOFUNCTIONAL FEATURES OF THE MYOCARDIUM IN ITS DIASTOLIC OVERLOAD

Medical Science of Ukraine (MSU) ◽

10.32345/2664-4738.2.2021.06 ◽

2021 ◽

Vol 17 (2) ◽

pp. 39-46

Author(s):

A.A. Balabai ◽

A.A. Krikunov ◽

P.M. Semeniv ◽

E.V. Rudenko ◽

V.P. Zakharova

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Left Ventricle ◽

Blood Volume ◽

Interstitial Fibrosis ◽

Mitral Valve Insufficiency ◽

Diastolic Filling ◽

Myocardial Oxygen Demand ◽

Statistical Research ◽

Valve Insufficiency

Relevance. Adaptation of the heart chambers to their volume overload, which increases with diastolic filling of the left ventricle (LV) or systolic regurgitation in the left atrium (LA) in case of mitral valve insufficiency leads to remodeling of the myocardium of these chambers. Longitudinal hypertrophy of cardiomyocytes (CMCs), realized by building up new sarcomeres at the end of existing myofibrils, is an adaptation mechanism in the early stages, but eventually turns into maladjustment, which leads to heart failure. Hypertrophied CMCs, damaged during decompensation, are replaced by connective tissue due to excessive activation of fibroblasts with deposition of the extracellular matrix, which is also an element of the myocardial remodeling. The progression of heart failure is also associated with a mismatch between blood supply and myocardial oxygen demand, since an increase in the size of the CMCs is accompanied by a rarefaction of the intramural network of microvessels. It is believed that the violation of the ratio of the size of the heart, angiogenesis and cardiac function are the basis for the transition of adaptive compensation of the heart to decompensation with the progression of heart failure. Objective: to study morphological changes in the myocardium of the LV and LA in patients with mitral valve insufficiency. Materials and methods. Macroscopically, the condition of the myocardium was studied on the material of 14 autopsies of patients who died of NdMK insufficiency. History of NdMK – from 3 months. up to 2.4±1.1 years. As a control, the hearts of 3 deaths without cardiopathology were studied. The material for light microscopy was pieces of myocardium from different segments of the left ventricle, as well as from the walls of the left ventricle, obtained during autopsy.Morphological (macroscopic, histological and electron microscopic), morphometric and statistical research methods were used. Results. With LV dilatation associated with chronic mitral valve insufficiency, lengthening of each CMCs provides an increase in the area of the myocardial walls, and, accordingly, the size of the cavity of the corresponding chamber of the heart, which compensates to some extent for the increase in diastolic blood volume in the LV and systolic blood volume in the LA. However, the factor limiting this compensation mechanism is the deficiency of the myocardial microvasculature associated with limited capillary growth. The contradiction between the need for the myocardium to lengthen the CMCs and the inability of capillaries to provide them with oxygen leads to a breakdown in compensation with an increase in fibrotic changes. This is a factor limiting the further increase in the volume of the cavity. Conclusions. Overloading of the myocardium with volume leads to an increase in the length of the CMCs, on average, from 57.3±9.1 µm to 93.7±12.4 µm. The increase in the length of the CMCs is due to the increase in the number of sarcomeres from 43.7±8.4 to 62.5±14.5. The diameter of the CMCs in this case does not increase reliably. Overloading of the heart cavities with volume is often accompanied by desynchronization of the CMCs contraction, which leads to disruption of the integrity of the myocytic "working syncytium" and pronounced interstitial fibrosis.

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Surgical treatment of the ischemic heart disease with lowered contractility of left ventricle and mitral valve insufficiency

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2020.9-10.22 ◽

2020 ◽

Vol 87 (9-10) ◽

pp. 22-26

Author(s):

S. A. Rudenko ◽

A. V. Rudenko ◽

Yu. V. Kaschenko ◽

V. P. Zakharova

Keyword(s):

Heart Disease ◽

Mitral Valve ◽

Left Ventricle ◽

Ischemic Heart Disease ◽

Mitral Valve Insufficiency ◽

Ischemic Heart ◽

Cardiac Insufficiency ◽

Mitral Insufficiency ◽

Valve Insufficiency ◽

The Impact

Objective. To determine the impact of the mitral valve insufficiency in patients, suffering ischemic heart disease with lowered contractility of left ventricle and methods of its treatment. Materials and methods. During 01.01.2015-31.12.2018 yrs period in the Amosov National Institute of Cardiovascular Surgery there were conducted 2267 consecutive operations of coronary shunting, of them 190 (8.4%) - in patients, suffering the ischemic heart disease with lowered contractility of left ventricle. Reduction of the output fraction of left ventricle down to 35% and lower have served as criterion of inclusion of the patients into the Group. There were 170 (89.5%) men and 20 (10.5%) women. The patients’ age have constituted 29 - 83 yrs old, (61.1 ± 8.9) yrs old at average. Results. In 47.9% of the patients the lowering of the left ventricle contractility after myocardial infarction was followed by occurrence of regurgitation on a mitral valve. At the same time it was noted, that the regurgitation value have had correlated with degree of the left ventricle contractility lowered: in reduction of values of the left ventricle output fracture down to 25% and lower a moderate regurgitation on a mitral valve was registered up to 2 times, a significant one - in 2.5 times, and the pronounced one - in 1.5 times more frequently, than in values of the left ventricle output fracture, exceeding 25%. Occurrence of a mitral insufficiency in 18.7% patients was caused by direct damage of valvular apparatus, while in 81.3% patients the consequences of the heart cavities were present in disorder of contractile function of myocardium. Presence of postinfarction mitral insufficiency enhances the risk of an acute cardiac insufficiency in 1.7 times and necessitates intraoperative correction in values of the regurgitation fraction over 30%. Conclusion. The own data obtained witness, that noncorrected mitral insufficiency in the ischemic heart disease worsens significantly the postoperative period course after performance of coronary shunting, enhancing rate of an acute cardiac, respiratory and renal insufficiency. Thus, taking into account a negative impact of concomitant mitral valve insufficiency on efficacy of surgical interventions in the lowered contractility of left ventricle the need emerges to perform complex reconstructive intervention in patients, suffering ischemic heart disease with lowered contractility of left ventricle.

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506 Systolic and diastolic function of left ventricle evaluated by tissue Doppler imaging in adult patients after total correction of coarctation of aorta

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(07)60314-2 ◽

2007 ◽

Vol 6 (1) ◽

pp. 113-113

Author(s):

O TROJNARSKA ◽

M LANOCHA ◽

Z OKOSARNOWSKA ◽

A SZYSZKA

Keyword(s):

Left Ventricle ◽

Diastolic Function ◽

Tissue Doppler Imaging ◽

Tissue Doppler ◽

Adult Patients ◽

Doppler Imaging ◽

Coarctation Of Aorta ◽

Total Correction ◽

Systolic And Diastolic Function

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A Complex Mitral Valve Reconstruction: A Case Report

The Heart Surgery Forum ◽

10.1532/hsf.648 ◽

2005 ◽

Vol 6 (2) ◽

pp. 27

Author(s):

Dimitrios Buklas ◽

Massimo Massetti ◽

Eric Saloux ◽

Eugenio Neri ◽

Olivier LePage ◽

...

Keyword(s):

Mitral Valve ◽

Surgical Techniques ◽

Mitral Valve Insufficiency ◽

Left Ventricular ◽

Mitral Valve Reconstruction ◽

Mitral Repair ◽

Valve Reconstruction ◽

Valve Insufficiency ◽

Valve Function ◽

Valvular Function

Several techniques are currently in use for mitral valve reconstruction. We report a mitral repair case in which the use of a combination of different surgical techniques resulted in the necessary correction. A 47-year-old woman underwent surgical intervention to treat severe mitral valve insufficiency due to A1/A2/A3 and P2 prolapsed valve tissue. A combination of quadrangular resection, sliding leaflet, single chordal transposition, "flip-over" leaflet, and ring annuloplasty techniques were applied, and postsurgical correct valve function was documented by results of a left ventricular saline filling test and transesophageal echocardiography control. Complex mitral valve repairing techniques can be combined to reestablish valvular function.

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The use of the standard exercise test to establish the clinical significance of mild echocardiographic changes in a Thoroughbred poor performer : clinical communication

Journal of the South African Veterinary Association ◽

10.4102/jsava.v75i2.461 ◽

2004 ◽

Vol 75 (2) ◽

Cited By ~ 1

Author(s):

C. Meyer ◽

R. Gerber ◽

A.J. Guthrie

Keyword(s):

Exercise Test ◽

Poor Performance ◽

Respiratory Alkalosis ◽

Mitral Valve Insufficiency ◽

Cardiac Insufficiency ◽

Strenuous Exercise ◽

Clinical Communication ◽

Valve Insufficiency ◽

Blood Gas Analyses ◽

Work Up

A 4-year-old Thoroughbred gelding racehorse was referred to the Onderstepoort Veterinary Academic Hospital (OVAH) with a history of post-race distress and collapse. In the absence of any obvious abnormalities in the preceding diagnostic work-up, a standard exercise test was performed to determine an underlying cause for the post-race distress reported. In this particular case oxygen desaturation became evident at speeds as slow as 6 m/s, where PO2 was measured at 82.3 mm Hg. Similarly at a blood pH of 7.28, PCO2 had dropped to 30.0mm Hg indicating a combined metabolic acidosis and respiratory alkalosis. The cause of the distress was attributed to a severe hypoxia, with an associated hypocapnoea, confirmed on blood gas analyses, where PO2 levels obtained were as low as 56.6 mm Hg with a mean PCO2 level of 25.4 mm Hg during strenuous exercise. Arterial oxygenation returned to normal immediately after cessation of exercise to 106.44 mm Hg, while the hypocapnoeic alkalosis, PCO2 25.67 mm Hg, persisted until the animal's breathing normalized. The results obtained were indicative of a dynamic cardiac insufficiency present during exercise. The combination of an aortic stenosis and a mitral valve insufficiency may have resulted in a condition similar to that described as high-altitude pulmonary oedema, with respiratory changes and compensation as for acute altitude disease. The results obtained were indicative of a dynamic cardiac insufficiency present during exercise and substantiate the fact that an extensive diagnostic regime may be required to establish a cause for poor performance and that the standard exercise test remains an integral part of this work-up.

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Cross-border mobility in European countries: associations between cross-border worker status and health outcomes

BMC Public Health ◽

10.1186/s12889-021-10564-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lucas Nonnenmacher ◽

Michèle Baumann ◽

Etienne le Bihan ◽

Philippe Askenazy ◽

Louis Chauvel

Keyword(s):

European Union ◽

Health Outcomes ◽

Chronic Diseases ◽

Reference Group ◽

Labour Force ◽

High Risk Population ◽

The European Union ◽

Health Index ◽

Cross Sectional Survey ◽

Cross Border

Abstract Background Mobility of workers living in one country and working in a different country has increased in the European Union. Exposed to commuting factors, cross-border workers (CBWs) constitute a potential high-risk population. But the relationships between health and commuting abroad are under-documented. Our aims were to: (1) measure the prevalence of the perceived health status and the physical health outcomes (activity limitation, chronic diseases, disability and no leisure activities), (2) analyse their associations with commuting status as well as (3) with income and health index among CBWs. Methods Based on the ‘Enquête Emploi’, the French cross-sectional survey segment of the European Labour Force Survey (EU LFS), the population was composed of 2,546,802 workers. Inclusion criteria for the samples were aged between 20 and 60 years and living in the French cross-border departments of Germany, Belgium, Switzerland and Luxembourg. The Health Index is an additional measure obtained with five health variables. A logistic model was used to estimate the odds ratios of each group of CBWs, taking non-cross border workers (NCBWs) as the reference group, controlling by demographic background and labour status variables. Results A sample of 22,828 observations (2456 CBWs vs. 20,372 NCBWs) was retained. The CBW status is negatively associated with chronic diseases and disability. A marginal improvement of the health index is correlated with a wage premium for both NCBWs and CBWs. Commuters to Luxembourg have the best health outcomes, whereas commuters to Germany the worst. Conclusion CBWs are healthier and have more income. Interpretations suggest (1) a healthy cross-border phenomenon steming from a social selection and a positive association between income and the health index is confirmed; (2) the existence of major health disparities among CBWs; and (3) the rejection of the spillover phenomenon assumption for CBWs. The newly founded European Labour Authority (ELA) should take into account health policies as a promising way to support the cross-border mobility within the European Union.

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