scholarly journals Relationship Between Overweight and Obesity and Cardiac Dimensions and Function in a Paediatric Population.

2021 ◽  
Author(s):  
Juan Fernández Cabeza ◽  
Cristhian H Aristizábal-Duque ◽  
Isabel María Blancas Sánchez ◽  
Martín Ruíz Ortiz ◽  
Ana Rodríguez Almodóvar ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Paediatric Population ◽  
Left Ventricular ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Left Ventricular Ejection ◽  
Left Ventricle Mass ◽  
Ventricular Ejection Fraction ◽  
And Function

Abstract Obesity in adults is associated with left ventricular hypertrophy, dilatation and myocardial fibrosis, as well as heart failure and coronary heart disease. These associations have been studied to a lesser extent in the paediatric population. This study aims to investigate the relationship between obesity and cardiac structure and function in the paediatric population. In a southern Spanish town, we selected all inhabitants aged 6–17 years stratifying by age, gender, and educational centres. We performed a complete transthoracic echocardiogram evaluating all the cardiac morphological and functional parameters commonly measured in an echocardiographic study. There were 212 children and adolescents included. Of them, 48,1 % were males. The mean age was 10.9 ± 3.0 years. 106 (50%) were normal weight, 57 (26.9%) overweight and 49 (23.1%) obese. Sex and age were similar in all three groups. Overweight and obesity were associated with larger left ventricular end-diastolic and end-systolic volumes (p < 0.0005), greater left ventricular mass (p < 0.0005) and smaller ejection fraction (p < 0.0005). They were also associated with larger atrial, aortic and right ventricular size. Lateral and mean E/e' ratios were higher (p = 0.007 and p = 0.01 respectively). Body mass index was independently associated with all cavity size variables as well as left ventricular ejection fraction. Conclusion: Childhood obesity is independently associated with larger heart chambers, greater left ventricle mass, and smaller left ventricle ejection fraction.

New Hybrid Method for Left Ventricular Ejection Fraction Assessment from Radionuclide Ventriculography Images

2020 ◽  
Vol 16 ◽  
Author(s):  
Halima Dziri ◽  
Mohamed Ali Cherni ◽  
Dorra Ben Sellem
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Positive Predictive Value ◽  
Roc Curve ◽  
Radionuclide Ventriculography ◽  
Left Ventricular ◽  
The Other ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: In this paper, we propose a new efficient method of radionuclide ventriculography image segmentation to estimate the left ventricular ejection fraction. This parameter is an important prognostic factor for diagnosing abnormal cardiac function. Methods: The proposed method combines the Chan-Vese and the mathematical morphology algorithms. It was applied to diastolic and systolic images obtained from the Nuclear Medicine Department of Salah AZAIEZ Institute.In order to validate our proposed method, we compare the obtained results to those of two methods of the literature. The first one is based on mathematical morphology, while the second one uses the basic Chan-Vese algorithm. To evaluate the quality of segmentation, we compute accuracy, positive predictive value and area under the ROC curve. We also compare the left ventricle ejection fraction estimated by our method to that of the reference given by the software of the gamma-camera and validated by the expert, using Pearson’s correlation coefficient, ANOVA test and linear regression. Results and conclusion: Static results show that the proposed method is very efficient in the detection of the left ventricle. The accuracy was 98.60%, higher than that of the other two methods (95.52% and 98.50%). Likewise, the positive predictive value was the highest (86.40% vs. 83.63% 71.82%). The area under the ROC curve was also the most important (0.998% vs. 0.926% 0.919%). On the other hand, Pearson's correlation coefficient was the highest (99% vs. 98% 37%). The correlation was significantly positive (p<0.001).

COVID-19-associated myocarditis: single center experience of pathogenetic treatment

2021 ◽  
Vol 28 (3) ◽  
pp. 9-19
Author(s):  
V. M. Kovalenko ◽  
E. G. Nesukay ◽  
N. S. Titova ◽  
S. V. Cherniuk ◽  
R. M. Kirichenko ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Proinflammatory Cytokines ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Glucocorticoid Therapy ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

The aim – to evaluate the effectiveness of glucocorticoid therapy in patients with myocarditis with reduced left ventricular ejection fraction that developed after COVID-19 infection.Materials and methods. The results of glucocorticoid therapy in 32 patients aged (35.2±2.3) years with acute myocarditis after COVID-19 infection and left ventricular ejection fraction < 40 % are presented. All patients were prescribed a 3-month course of methylprednisolone at a daily dose of 0.25 mg/kg, followed by a gradual dose reduction of 1 mg per week until complete withdrawal 6 months after the start of treatment.Results and discussion. The analysis of the results of the examinations was performed in the 1st month from the onset of myocarditis to the appointment of glucocorticoids and after 6 months of observation. Six months later, the end-diastolic volume index decreased by 18.5 %, the left ventricular ejection fraction increased by 23.8 %, and the longitudinal global systolic straine increased by 39.8 %. On cardiac MRI, the number of left ventricular segments affected by inflammatory changes decreased from 6.22±0.77 to 2.89±0.45 segments, and the number of segments with fibrotic changes did not change significantly. After 6 months of treatment, there was a significant decrease in the concentrations of proinflammatory cytokines and cardiospecific antibodies.Conclusions. The use of a 6-month course of glucocorticoid therapy in patients with myocarditis that developed after COVID-19 infection improved the contractility of the left ventricle against the background of a significant reduction in inflammatory lesions of the left ventricle and reduced concentrations of proinflammatory cytokines and cardiospecific antibodies.

scholarly journals 559 An analysis of myocardial efficiency in patients with severe asymptomatic mitral regurgitation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R Cetin Guvenc ◽  
E Arugaslan ◽  
T S Guvenc ◽  
F Ozpamuk Karadeniz ◽  
H Kasikcioglu ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Severe Mitral Regurgitation ◽  
External Work ◽  
Ventricular Ejection Fraction ◽  
Myocardial Efficiency

Abstract Funding Acknowledgements None declared. Background and Aims It is difficult to determine left ventricular systolic performance in patients with severe mitral regurgitation (MR) since left ventricular ejection fraction (EF) could be preserved until the end stages of the disease. Myocardial efficiency describes the amount of external work (EW) done by the left ventricle per unit of oxygen consumed (mVO2). In the present study, we aimed to investigate MEf in patients with asymptomatic severe MR using a novel echocardiographic method. Methods: A total of 27 patients with severe asymptomatic MR and 26 healthy volunteers were included in this cross-sectional study. EW was measured using stroke volume and blood pressure, while mVO2 was estimated using double product and LV mass. Results: There were no differences between the groups with regards to EF (66%±5% vs. 69%±7%), while MEf was significantly reduced in patients with severe MR (25%±11% vs. 44%±12%, p &lt; 0.001) (Table 1). This difference was maintained even after adjustment for age, gender and body surface area (adjusted :0.44, 95%CI: 0.39–0.49 for controls and adjusted :0.24, 95%CI: 0.19–0.29 for patients with severe MR). Further analysis showed that this reduction was due to an increase in total mVO2 in the severe MR group (Figure 1). Conclusions: Myocardial efficiency was significantly lower in patients with asymptomatic severe MR and preserved EF. Table 1 Parameter Control Group (n = 26) Severe Mitral Regurgitation (n = 27) P Value Age (y) 36.5 ± 8.9 41.3 ± 14.2 0.23 Gender (%Male) 9 (35%) 10 (37%) 1.0 BSA (m2) 1.82 ± 0.20 1.76 ± 0.18 0.64 LV End-Diastolic Volume (ml) 83.13 ± 18.88 121.91 ± 37.63 &lt;0.001 LV End-Systolic Volume (ml) 28.07 ± 9.57 45.30 ± 17.42 &lt;0.001 Left Ventricular Ejection Fraction (%) 0.69 ± 0.07 0.66 ± 0.05 0.29 Systolic Mitral Velocity (cm/s) 7.88 ± 1.14 8.07 ± 1.81 0.66 Stroke Work (j) 1.14 ± 0.21 1.15 ± 0.36 0.91 Minute External Work (j) 65.96 ± 14.71 70.17 ± 23.15 0.85 mVO2 (ml.min-1.100g-1) 6.79 ± 1.93 9.48 ± 4.71 0.02 Total mVO2 (j) 166.58 ± 77.14 346.46 ± 202.71 &lt;0.001 Myocardial Efficiency (%) 44 ± 12 25 ± 11 &lt;0.001 Table 1. Demographic, anthropometric, echocardiographic and mechanoenergetic data for study groups. BSA, body surface area; LV, left ventricle; mVO2, myocardial oxygen consumption. Abstract 559 Figure 1

scholarly journals Ventricular Dyssynchrony and Function Improve following Catheter Ablation of Nonseptal Accessory Pathways in Children

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Sylvia Abadir ◽  
Anne Fournier ◽  
Marc Dubuc ◽  
Georgia Sarquella-Brugada ◽  
Patrick Garceau ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Ventricular Dyssynchrony ◽  
Accessory Pathways ◽  
And Function

Introduction. Paradoxical or hypokinetic interventricular septal motion has been described in patients with septal or paraseptal accessory pathways. Data regarding nonseptal pathways is limited.Methods and Results. We quantified left ventricular dyssynchrony and function in 16 consecutive children,14.2±3.7years, weighing53 ± 17 kg, prior to and following catheter ablation of bidirectional septal (N=6) and nonseptal (N=10) accessory pathways. Following ablation, the left ventricular ejection fraction increased by4.9±2.1% (P=0.038) from a baseline value of57.0%±7.8%. By tissue Doppler imaging, the interval between QRS onset and peak systolic velocity (Ts) decreased from a median of 33.0 ms to 18.0 ms (P=0.013). The left ventricular ejection fraction increased to a greater extent following catheter ablation of nonseptal (5.9%±2.6%,P=0.023) versus septal (2.5%±4.1%,P=0.461) pathways. The four patients with an ejection fraction <50%, two of whom had left lateral pathways, improved to >50% after ablation. Similarly, the improvement in dyssynchrony was more marked in patients with nonseptal versus septal pathways (difference between septal and lateral wall motion delay before and after ablation20.6±7.1 ms (P=0.015) versus1.4±11.4 ms (P=0.655)).Conclusion. Left ventricular systolic function and dyssynchrony improve after ablation of antegrade-conducting accessory pathways in children, with more pronounced changes noted for nonseptal pathways.

Abstract 17994: Echocardiographic parameters of Left Ventricular Size and Function as Predictors of Symptomatic Heart Failure in Patients with Low Normal Ejection Fraction Treated with Anthracyclines

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Negareh Mousavi ◽  
Timothy Tan ◽  
Mohammad Ali ◽  
Elkan F. Halpern ◽  
Lin Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Symptomatic Heart Failure ◽  
Echocardiographic Parameters ◽  
And Function

Objectives: The aim of this study was to assess whether baseline echocardiographic measures of left ventricular (LV) size and function predict the development of symptomatic heart failure or cardiac death (major adverse cardiac events, MACE) in patients treated with anthracyclines who have a pre-chemotherapy left ventricular ejection fraction (LVEF) in the low normal range (between 50-59%). Background: Anthracycline-induced symptomatic heart failure and impaired LVEF are late and often irreversible manifestations of anthracycline-induced cardiotoxicity. The value of echocardiographic parameters of myocardial size and function before chemotherapy to identify patients at high-risk for development of symptomatic heart failure in patients with low normal LVEF was studied. Methods: Patients with a LVEF between 50 and 59% before anthracyclines were selected. In these patients, LV volumes, LVEF and peak longitudinal strain (GLS) were measured. Individuals were followed for MACE and all-cause mortality over a median of 659 days (range; 3-3704 days). Results: Of 2234 patients undergoing echocardiography for pre-anthracycline assessment, 158 (7%) had a resting ejection fraction of 50-59%. Their average LV end-diastolic volume (LVEDV) was 101±22ml, LVEF was 54 ±3% and global longitudinal strain (GLS) was -17.7±2.6%. Twelve patients experienced a MACE (congestive heart failure) at a median of 173 days (range; 15-530). Age, diabetes, previous coronary artery disease, LVEDV, LVESV and GLS were all-predictive of MACE (P= 0.015, 0.0043 and 0.0065 for LVEDV, LVESV, and GLS respectively). LVEDV and GLS remained predictive of MACE when adjusted for age. Age and GLS were also predictive of overall mortality (p<0.0001 and 0.0105 respectively). Conclusions: In patients treated with anthracyclines with an LVEF of 50-59%, both baseline EDV and GLS predict the occurrence of MACE. These parameters may help target patients who could bene[[Unable to Display Character: &#64257;]]t from closer cardiac surveillance and earlier initiation of cardioprotective medical therapy.

scholarly journals DOSE-DEPENDENT EFFECTS OF LEVOTHYROXINE IN HEART FAILURE IN PATIENTS WITH CONCOMITANT THYROID PATHOLOGY

2021 ◽  
pp. 100-109
Author(s):  
Sergii Pyvovar ◽  
Yurii Rudyk ◽  
Tetiana Lozik
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Autoimmune Thyroiditis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Thyroid Pathology ◽  
Patients With Heart Failure ◽  
Dose Dependent

Abstract. Currently, the use of thyroid hormones in the setting of heart failure (HF) is still an "open book". There are several unanswered questions: the regimen, doses and schedule of drug use, as well as the consequences of such therapy. Large clinical studies can provide information on the effect of these hormones on the long-term prognosis in patients with heart failure. At the same time, the presence of comorbid thyroid pathology, which requires the prescription of levothyroxine (LT), makes it possible to partially answer these questions. The aim is to study of the dose-dependent effect of LT on the course of HF in patients with autoimmune thyroiditis (AIT). Material and methods. The study included 218 patients with HF on the background of post-infarction cardiosclerosis. 109 (50.0 %) patients with AIT received LT due to hypothyreosis in the past. These patients intake LT during 2 years before included in the study and have euthyreosis. Whether the levels of thyroid stimulating hormone (TSH), free triiodthyronine (FT3) and free thyroxine (FT4) were determined. Results. Patients who used LT, comparing with patients without this drug, had smaller end-diastolic diametr (EDD) and end-systolic diametr (ESD) and end-diastolic volum (EDV) and end-systolic volum (ESV) of left ventricle (LV) and 22.9 % greater LV ejection fraction (EF) (+ 22.9 %, p = 0.0001), as well as higher low serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP) level (- 26.3 %, p = 0.009). In the subgroup of patients taking LT at a dose of 0.1 to 0.69 μg/kg, ejection fraction of left ventricle (LVEF) did not differ from patients without this tritment. At a dose of 0.7-1.19 μg/kg, LVEF is higher compared with that of patients who did not take LT (+ 37.9 %, p = 0.0001) and patients who took LT at a dose 0.1 - 0.33 μg/kg (+ 36.9 %, p = 0.0001). LVEF was the highest in patients taking LT at a dose of > 1.20 μg/kg. The use of LT for 2 years reduces the risk of re-hospitalization (RH) due to decompensation of heart failure (Odds ratio = 0.490 (0.281-0.857), p = 0.018) and a tendentious decrease in the risk of combined endpiont achieving (- 27.9 %, p = 0.074). The ROC analysis showed that the risk of RH in patients with heart failure due to decompensation of the disease decreases with the use of LT at a dose of > 0.53 μg/kg (sensitivity – 56.62 %, specificity – 60.98 %, p = 0.016). Conclusions. The use of LT in patients has a dose-dependent positive effect on LVEF. The largest LVEF is observed in patients taking the drug at a dose of > 1.2 μg/kg. The use of an LT dose of > 0.53 μg/kg leads to a significant decrease in the frequency of re-hospitalization due to decompensation of heart failure during 2 years. Keywords: heart failure, autoimmune thyroiditis, levothyroxine, left ventricular, ejection fraction.

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