scholarly journals Ethnic differences in right ventricular structure and function in urbanized hypertensive patients in the Gornaya Shoriya region

2022 ◽  
Author(s):  
Alexey N. Sumin ◽  
Nina S. Gomozova ◽  
Anna V. Shcheglova ◽  
Oleg G. Arkhipov
Keyword(s):  
Arterial Hypertension ◽  
Right Ventricular ◽  
Diastolic Dysfunction ◽  
Ethnic Differences ◽  
Structure And Function ◽  
Right Heart ◽  
Hypertensive Patients ◽  
Factors Associated ◽  
The Right ◽  
And Function

Abstract Objective of this study was to compare right ventricular echocardiography parameters in urbanized hypertensive patients of the Shor and non-indigenous ethnic groups in the Mountain Shoria region. Methods The study included patients with arterial hypertension: 58 Shors and 50 non-indigenous urbanized residents, comparable in age, and divided by ethnicity and gender into 4 groups: Shors men (n = 20), Shors women (n = 38), non-indigenous men (n = 15) and non-indigenous women (n = 35). All underwent echocardiographic examination, and the right heart parameters were studied. Results Shor men with arterial hypertension had the lowest values ​​of the pulmonary artery index, the right atrium dimensions, and the highest values ​​of the blood flow velocity in the right ventricle, et' and st' in comparison with non-indigenous men. Shor women have the lowest values Et and Et/At ratios. RV diastolic dysfunction was detected mainly in women, somewhat more often in Shors. Ethnicity was one of the factors associated with the right ventricular diastolic dysfunction presence. Among the factors associated with the RV diastolic dysfunction were risk factors (smoking, obesity), blood pressure, gender, ethnicity, and left ventricular parameters (diastolic dysfunction and the myocardial mass increase). Conclusion Our study established the influence of ethnic differences on the right heart echocardiographic parameters in Shors and Caucasians with arterial hypertension. The revealed differences should improve the assessment of the right heart structure and function in patients with arterial hypertension from small ethnic groups, which will help to improve the diagnosis and treatment of such patients.

scholarly journals Genetic Analysis of Right Heart Structure and Function in 40,000 People

2021 ◽  
Author(s):  
James P. Pirruccello ◽  
Paolo Di Achille ◽  
Victor Nauffal ◽  
Mahan Nekoui ◽  
Samuel N. Friedman ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Deep Learning ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Left Ventricular ◽  
Structure And Function ◽  
Right Heart ◽  
Heart Chamber ◽  
The Right ◽  
And Function

The heart evolved hundreds of millions of years ago. During mammalian evolution, the cardiovascular system developed with complete separation between pulmonary and systemic circulations incorporated into a single pump with chambers dedicated to each circulation. A lower pressure right heart chamber supplies deoxygenated blood to the lungs, while a high pressure left heart chamber supplies oxygenated blood to the rest of the body. Due to the complexity of morphogenic cardiac looping and septation required to form these two chambers, congenital heart diseases often involve maldevelopment of the evolutionarily recent right heart chamber. Additionally, some diseases predominantly affect structures of the right heart, including arrhythmogenic right ventricular cardiomyopathy (ARVC) and pulmonary hypertension. To gain insight into right heart structure and function, we fine-tuned deep learning models to recognize the right atrium, the right ventricle, and the pulmonary artery, and then used those models to measure right heart structures in over 40,000 individuals from the UK Biobank with magnetic resonance imaging. We found associations between these measurements and clinical disease including pulmonary hypertension and dilated cardiomyopathy. We then conducted genome-wide association studies, identifying 104 distinct loci associated with at least one right heart measurement. Several of these loci were found near genes previously linked with congenital heart disease, such as NKX2-5, TBX3, WNT9B, and GATA4. We also observed interesting commonalities and differences in association patterns at genetic loci linked with both right and left ventricular measurements. Finally, we found that a polygenic predictor of right ventricular end systolic volume was associated with incident dilated cardiomyopathy (HR 1.28 per standard deviation; P = 2.4E-10), and remained a significant predictor of disease even after accounting for a left ventricular polygenic score. Harnessing deep learning to perform large-scale cardiac phenotyping, our results yield insights into the genetic and clinical determinants of right heart structure and function.

scholarly journals Existence Of Right Ventricular Structural And Functional Changes In Essential Hypertension And

2021 ◽  
Vol 17 (21) ◽  
pp. 1
Author(s):  
Ana Minashvili ◽  
Ann Rekhviashvili
Keyword(s):  
Essential Hypertension ◽  
Right Ventricle ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Prognostic Value ◽  
Structure And Function ◽  
Systemic Hypertension ◽  
Functional Changes ◽  
The Right ◽  
And Function

The structural and functional changes of left and right ventricles as well as the existence of ventricular interaction in patients with arterial hypertenison (AH) were discussed in many research papers. Therefore, published data regarding right ventricular changes under influence of AH are scarce, non-univocal, and sometimes contradictory. Furthermore, there is a significant lack of clinical trials addressing the influence of circadian BP profile on RV structure and function. The importance of right ventricular function in maintaining global cardiac performance was proven. However, the importance of the right ventricular structure and function for cardiovascular morbidity and mortality is still under debate. Despite the abundance of the study data and high vulnerability of the right ventricle under influence of AH, the world's leading contemporary guidelines of the AH management, right ventricular remodeling, its morphology, function, evaluation, predictive and prognostic value are neither discussed nor mentioned. Hence, we strongly believe that further investigations are needed to determine the exact clinical utility and prognostic value of right ventricular functional and morphological changes in patients with arterial hypertension. Moreover, standardization and improvement of diagnostic methodologies of the RV changes via echocardiography, computed tomography, and Magnetic Resonance Imaging are important, which might have a crucial meaning for professionals involved in AH management. The review article aims to discuss anatomic and physiologic aspects of the right ventricle and their discrepancies according to age, sex, and race, the prognostic meaning of RV remodeling, and review current publications regarding the influence of high blood pressure and its circadian profile on the prevalence of functional and structural changes of RV. Hence, we performed a literature search of the PUBMED database using the medical subject headings "arterial hypertension", "essential hypertension", "systemic hypertension", "circadian BP profile", "remodeling", "right ventricle", "morphology", "anatomy" and "function". A manual search for additional studies was performed using references cited in the original articles.

scholarly journals State of cardiovascular system in employees with chronic obstructive pulmonary disease in combination with arterial hypertension in terms of exposure to toxic games

2021 ◽  
Vol 38 (1) ◽  
pp. 16-28
Author(s):  
L. A. Panacheva ◽  
L. A. Shpagina
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Arterial Hypertension ◽  
Cardiovascular System ◽  
Structure And Function ◽  
Chronic Obstructive ◽  
Length Of Service ◽  
Obstructive Pulmonary Disease ◽  
The Right ◽  
And Function ◽  
Large Vessels

Objective. Identification of the features of the cardiovascular system damage in chronic obstructive pulmonary disease (COPD) combined with arterial hypertension (AH) in workers exposed to toxic gases (TG). Materials and methods. 132 house painters and paint production workers of the Novosibirsk aviation enterprise were included in 3 strata and examined: I-COPD and TG; II-COPD in combination with AH when exposed to TG; III COPD in combination with AH without exposure to TG. Employees of all strata were divided by length of service less than 10 and more than 10 years. The selection of workers in groups was carried out by a continuous method. Results. The most pronounced changes on the ECG, regardless of the length of service, were observed in workers with COPD in combination with hypertension and contact with TG (levogram and metabolic changes in the myocardium). When exposed to TG for more than 10 years, hypertrophy of the left parts of the heart was also detected. Among workers with COPD in combination with hypertension exposed to TG, the indicators of average pulmonary artery pressure (APAP) and pulmonary vascular resistance (PVR) elevated with increasing work experience; changes in the structure and function of the right and left parts of the heart and signs of remodeling of large vessels were also revealed. The same workers showed more pronounced changes in the daily blood pressure profile (DBPP) of AP with the prevalence of Non-dippers and Night-pickers. Conclusions. Among workers suffering from comorbid pathology, with increasing duration of TG exposure over 10 years, there were observed the most pronounced ECG changes (deviation of electrical axis to the left, metabolic changes in the myocardium, hypertrophy of the left heart); increased APAP and PVR 1.21 and 1.10 times; changes in the structure and function of the right and left chambers of the heart, remodeling of large vessels; increase in the frequency of variants of the DBPP of Non-dippers and Night-pickers.

scholarly journals Intracardiac hemodynamic abnormalities in patients with sarcoidosis

2018 ◽  
Vol 28 (5) ◽  
pp. 567-575
Author(s):  
E. I. Leonova ◽  
E. I. Shmelev ◽  
R. B. Amansakhedov
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Fibrosis ◽  
Right Ventricular ◽  
Diastolic Dysfunction ◽  
Systolic Function ◽  
Cor Pulmonale ◽  
Pulmonary Sarcoidosis ◽  
Right Heart ◽  
Lung Lesions ◽  
The Right

The aim of this study was to evaluate intracardiac hemodynamic abnormalities in patients with pulmonary sarcoidosis and to investigate relevant factors. Methods. The study involved 42 patients with chronic pulmonary sarcoidosis. Chest computed tomography (CT), echocardiography, body plethysmography, spirometry, 6-minute walking test, and measurements of lung diffusing capacity (DLCO), blood gases and blood C-reactive protein (CRP) were performed in all patients. Results. Chronic cor pulmonale was detected in 26.2% of patients. The right heart diastolic dysfunction was found in 14.3% of patients, the left heart diastolic dysfunction was found in 23.8% of patients, the mean pulmonary artery pressure (mPAP) was increased in 19% of patients. The right ventricular diameter was found to be related to the inspiratory bronchial resistance (Rin) (R = 0.480; p = 0.02), the intrathoracic gas volume (ITGV) (R = –0.670; p = 0.001), DLCO (R = 0.438; p = 0.013), and pulmonary fibrosis. The right heart systolic function (TAPSE) was related to DLCO (R = 0.518; p = 0.006), the total lung capacity (TLC) (R = 0.639; p = 0.001) and pulmonary fibrosis. The increased mPAP was related to the extension of disseminated lung lesions (R = 0.716; p = 0.018), blood oxygen partial pressure (R = 0.486; p = 0.017) and CRP level. The 6-min distance was related to Rin, the right ventricular diameter, parameters of the right heart diastolic function (tricuspid E / A ratio) (R = 0.486; p = 0.01), and ITGV (R = 0.494; p = 0.006). Conclusion. The development of cor pulmonale in patients with pulmonary sarcoidosis was related to DLCO, Rin and pulmonary fibrosis. The extension of disseminated lung lesions, hypoxemia and increased CRP were related to pulmonary hypertension. Different factors associated with cor pulmonale and pulmonary hypertension in sarcoidosis could prompt further investigation of different phenotypes of this disease with the intrinsic central hemodynamic abnormalities. 

scholarly journals Echocardiographic assessment of the right heart in adults: a practical guideline from the British Society of Echocardiography

2020 ◽  
Vol 7 (1) ◽  
pp. G19-G41 ◽  
Author(s):  
Abbas Zaidi ◽  
Daniel S Knight ◽  
Daniel X Augustine ◽  
Allan Harkness ◽  
David Oxborough ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Response To Therapy ◽  
British Society ◽  
Right Heart ◽  
Functional Changes ◽  
Complex Anatomy ◽  
Clinical Scenarios ◽  
Wide Range ◽  
The Right ◽  
And Function

The structure and function of the right side of the heart is influenced by a wide range of physiological and pathological conditions. Quantification of right heart parameters is important in a variety of clinical scenarios including diagnosis, prognostication, and monitoring response to therapy. Although echocardiography remains the first-line imaging investigation for right heart assessment, published guidance is relatively sparse in comparison to that for the left ventricle. This guideline document from the British Society of Echocardiography describes the principles and practical aspects of right heart assessment by echocardiography, including quantification of chamber dimensions and function, as well as assessment of valvular function. While cut-off values for normality are included, a disease-oriented approach is advocated due to the considerable heterogeneity of structural and functional changes seen across the spectrum of diseases affecting the right heart. The complex anatomy of the right ventricle requires special considerations and echocardiographic techniques, which are set out in this document. The clinical relevance of right ventricular diastolic function is introduced, with practical guidance for its assessment. Finally, the relatively novel techniques of three-dimensional right ventricular echocardiography and right ventricular speckle tracking imaging are described. Despite these techniques holding considerable promise, issues relating to reproducibility and inter-vendor variation have limited their clinical utility to date.

The right ventricle in critical illness

2017 ◽  
Author(s):  
Claire Colebourn ◽  
Jim Newton
Keyword(s):  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Heart Function ◽  
Structure And Function ◽  
Care Practice ◽  
Right Heart ◽  
Right Heart Function ◽  
Ventricular Structure ◽  
The Right ◽  
And Function

This chapter describes the unique aspects of right ventricular structure and function and relates this to the effects of an acute or chronic rise in pulmonary vascular resistance on the right heart. Assessment of pulmonary vascular resistance and right heart function is described in detail. The usage of this assessment in critical care practice is then explored, with particular reference to mechanical ventilation and pulmonary embolism.

Dehydroepiandrosterone restores right ventricular structure and function in rats with severe pulmonary arterial hypertension

2013 ◽  
Vol 304 (12) ◽  
pp. H1708-H1718 ◽  
Author(s):  
Abdallah Alzoubi ◽  
Michie Toba ◽  
Kohtaro Abe ◽  
Kealan D. O'Neill ◽  
Petra Rocic ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Contractile Function ◽  
Systolic Pressure ◽  
Structure And Function ◽  
Current Therapy ◽  
Pulmonary Arterial ◽  
Dhea Treatment ◽  
And Function

Current therapy of pulmonary arterial hypertension (PAH) is inadequate. Dehydroepiandrosterone (DHEA) effectively treats experimental pulmonary hypertension in chronically hypoxic and monocrotaline-injected rats. Contrary to these animal models, SU5416/hypoxia/normoxia-exposed rats develop a more severe form of occlusive pulmonary arteriopathy and right ventricular (RV) dysfunction that is indistinguishable from the human disorder. Thus, we tested the effects of DHEA treatment on PAH and RV structure and function in this model. Chronic (5 wk) DHEA treatment significantly, but moderately, reduced the severely elevated RV systolic pressure. In contrast, it restored the impaired cardiac index to normal levels, resulting in an improved cardiac function, as assessed by echocardiography. Moreover, DHEA treatment inhibited RV capillary rarefaction, apoptosis, fibrosis, and oxidative stress. The steroid decreased NADPH levels in the RV. As a result, the reduced reactive oxygen species production in the RV of these rats was reversed by NADPH supplementation. Mechanistically, DHEA reduced the expression and activity of Rho kinases in the RV, which was associated with the inhibition of cardiac remodeling-related transcription factors STAT3 and NFATc3. These results show that DHEA treatment slowed the progression of severe PAH in SU5416/hypoxia/normoxia-exposed rats and protected the RV against apoptosis and fibrosis, thus preserving its contractile function. The antioxidant activity of DHEA, by depleting NADPH, plays a central role in these cardioprotective effects.

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