scholarly journals Factors Associated With Suggestive of Pulmonary Hypertension Measured by Echocardiography in Patients With A Mediastinal Tumor: A Single-Center Study

2021 ◽  
Author(s):  
Dong Geum Shin ◽  
Min-Kyung Kang ◽  
Kun Il Kim ◽  
Hodong Yang ◽  
Donghoon Han ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Mediastinal Tumor ◽  
Malignant Tumors ◽  
Left Ventricular ◽  
Clinical Factors ◽  
Mediastinal Tumors ◽  
Factors Associated ◽  
Single Center Study ◽  
Echocardiographic Parameters ◽  
Lv Ejection Fraction

Abstract Ultrasound techniques are generally not used as a primary tool in the evaluation of mediastinal tumors and cysts. This study aimed to identify factors associated with pulmonary hypertension (PH) measured by transthoracic echocardiography (TTE) in patients with a mediastinal tumor. This retrospective, observational study was performed from January 2015 to December 2020. Fifty-five patients (mean age, 62 ± 13 years; 31 [56%] women) who had a mediastinal tumor and underwent TTE were included. Patients were classified as with PH or without PH. We analyzed clinical factors and echocardiographic parameters. PH was found in 21 (38%) patients. Twenty-two patients were asymptomatic, and none had symptoms associated with PH. Forty-seven (86%) patients underwent surgery, and 23 (42%) patients were diagnosed with malignant tumors. The presence of PH was not related with malignancy. Patients with PH were older than those without PH (67 ± 10 versus [vs.] 59 ± 14 years, p = 0.017). Small left ventricular (LV) systolic dimension (29.4 ± 3.6 vs. 31.6 ± 3.6 mm, p = 0.040) and dimension (4.2 ± 0.3 vs. 4.5 ± 0.3 mm, p = 0.004) and hyperdynamic LV ejection fraction (EF, 69 ± 6 vs. 65 ± 5%, p = 0.019) were associated with PH. Among them, older age, small LV dimension, and high EF were independently associated with PH.The presence of PH had no significant effect on patients’ clinical manifestation or malignancy.

scholarly journals Factors associated with suggestive of pulmonary hypertension measured by echocardiography in patients with a mediastinal tumor: A single-center study

2021 ◽  
Author(s):  
Dong Geum Shin ◽  
Min-Kyung Kang ◽  
Kun Il Kim ◽  
Hodong Yang ◽  
Donghoon Han ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Mediastinal Tumor ◽  
Malignant Tumors ◽  
Left Ventricular ◽  
Clinical Factors ◽  
Mediastinal Tumors ◽  
Factors Associated ◽  
Single Center Study ◽  
Echocardiographic Parameters ◽  
Lv Ejection Fraction

Background: Ultrasound techniques are generally not used as a primary tool in the evaluation of mediastinal tumors and cysts. This study aimed to identify factors associated with pulmonary hypertension (PH) measured by transthoracic echocardiography (TTE) in patients with a mediastinal tumor. Methods: This retrospective, observational study was performed from January 2015 to December 2020. Fifty-five patients (mean age, 62 ± 13 years; 31 [56%] women) who had a mediastinal tumor and underwent TTE were included. Patients were classified as with PH or without PH. We analyzed clinical factors and echocardiographic parameters. Results: PH was found in 21 (38%) patients. Twenty-two patients were asymptomatic, and none had symptoms associated with PH. Forty-seven (86%) patients underwent surgery, and 23 (42%) patients were diagnosed with malignant tumors. The presence of PH was not related with malignancy. Patients with PH were older than those without PH (67 ± 10 versus [vs.] 59 ± 14 years, p = 0.017). Small left ventricular (LV) systolic dimension (29.4 ± 3.6 vs. 31.6 ± 3.6 mm, p = 0.040) and dimension (4.2 ± 0.3 vs. 4.5 ± 0.3 mm, p = 0.004) and hyperdynamic LV ejection fraction (EF, 69 ± 6 vs. 65 ± 5%, p = 0.019) were associated with PH. Among them, older age, small LV dimension, and high EF were independently associated with PH. Conclusion: The presence of PH had no significant effect on patients’ clinical manifestation or malignancy.

scholarly journals Speckle tracking assessment of the atrial function in patients with systemic sclerosis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
G Stronati ◽  
F Ribichini ◽  
D Benfaremo ◽  
C Dichiara ◽  
M Casella ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
Mitral Valve ◽  
Speckle Tracking ◽  
Left Ventricular ◽  
Right Atrial ◽  
Contraction Function ◽  
Echocardiographic Parameters ◽  
Valve Opening ◽  
Conduit Function

Abstract Background Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by small vessel vasculopathy, autoantibodies production and exaggerated extracellular matrix deposition, leading to extensive tissue fibrosis. Cardiac involvement in SSc, albeit often asymptomatic, is frequent and represents a negative prognostic factor. Speckle tracking global longitudinal strain (GLS) has proved itself to be an effective tool to identify the presence and the progression of subclinical SSc-related cardiomyopathy. The aim of our study was to assess whether SSc-related cardiomyopathy affects not only the ventricles but also the right (RA) and left atria (LA) in patients with SSc and no overt cardiac disease nor pulmonary hypertension. Materials and methods Observational prospective study enrolling all consecutive patients with SSc age- and gender-matched 1:1 to healthy controls. Patients with structural heart disease, heart failure, atrial fibrillation and pulmonary hypertension were excluded. For every patient, standard echocardiographic parameters and speckle-tracking derived variables were registered. The reservoir function (from the end of ventricular contraction to mitral valve opening), conduit function (from mitral valve opening through the onset of atrium contraction) and contraction function (from the onset of atrium contraction to the end of ventricular diastole) were assessed via GLS. Zero strain reference was set at left ventricular end diastole. Results Fifty-two SSc patients and 52 matched controls were consecutively enrolled. Left ventricular ejection fraction (66.5%±7.4% vs. 66.1%±5.9%; p=ns) right fractional area change (49.4%±9.6% vs. 49.2%±9.2%; p=ns) and mean sPAP (29.0%±5.3% vs. 24.4%±4.1%; p=ns) were well within the normal range and similar between SSc patients and controls. Right atrial reservoir function (35.0%±7.3% vs. 42.3%±8.5%; p=.024) and contraction function (14.8%±4.3% vs. 18.5%±4.1%; p=.034) were significantly lower in SSc patients when compared to matched controls. No difference was seen in right atrial conduit function or left atrial strain. In patients with SSc, RA reservoir (r=.194; p=.033) and conduit function (r=.174; p=.036) were directly associated to right ventricular GLS. LA reservoir (r=.260; p=.008) and conduit function (r=.271; p=.006) were directly associated with left ventricular GLS. No association was observed between contraction function and GLS in both left and right chambers. Moreover, RA and LA reservoir (r=.358; p=.02), conduit (r=.525; p=.004) and contraction functions (r=.30; p=.0.18) were directly correlated. Conclusions While no significant difference was seen between cases and controls in terms of common echocardiographic parameters, RA reservoir and contraction function assessed through GLS were significantly impaired in patients with SSc. The correlation between impaired atrial and ventricular GLS in SSc may represent another indirect evidence of SSc-related heart global involvement. FUNDunding Acknowledgement Type of funding sources: None.

Heart failure with reduced, mid-range and preserved left ventricular ejection fraction in Chinese with type 2 diabetes: risk factors and prognosis from time of first index hospitalization

2021 ◽  
Author(s):  
Andrea O.Y Luk ◽  
Xinge Zhang ◽  
Erik Fung ◽  
Hongjiang Wu ◽  
Eric S.H Lau ◽  
...  
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Clinical Factors ◽  
Ventricular Ejection Fraction ◽  
Factors Associated ◽  
One Year

Abstract BackgroundThe clinical predictors and prognosis of heart failure (HF) by categories of left ventricular ejection fraction (LVEF) have not been well studied in people with diabetes. In a retrospective cohort of Chinese with type 2 diabetes, we examined 1) clinical factors associated with incident decompensated HF, and 2) mortality post-HF, stratified by LVEF.MethodsWe conducted a retrospective analysis of the Hong Kong Diabetes Register comprising 23,348 people with type 2 diabetes without history of HF enrolled between 1993–2015, followed for incident decompensated HF until 2017. Heart failure subtypes were defined according to LVEF on echocardiography. Multivariate Cox proportional hazards models were used to identify clinical factors associated with incident HF versus no HF, stratified by HF subtypes. All-cause mortality rates were compared by HF subtypes.ResultsOver median follow-up of 7.1 years from enrolment, 1,195 (5.1%) people developed decompensated HF. Among 611 (51.1%) people with echocardiography, 24.1% had HF with reduced LVEF (HFrEF) (LVEF < 40%), 15.2% had HF with mid-range LVEF (HFmrEF) (LVEF 41–49%), and 60.7% had HF with preserved LVEF (HFpEF) (LVEF ≥ 50%). Old age, low GFR, albuminuria and coronary artery disease were associated with increased hazards for all HF subtypes. During median follow-up of 2.1 years post-HF, 760 (63.6%) people died. One-year mortality rate was lower in people with HFpEF (16.2%) than those with HFmrEF (vs 26.9%,p = 0.034) and HFrEF (vs 31.3%,p < 0.001). At 10 years, mortality rates in HFpEF group (58.0%) remained lower than HFmrEF group (vs 71.0%,p = 0.38), but similar to HFrEF group (vs 55.8%,p = 0.651).ConclusionsIn Chinese with type 2 diabetes, HFpEF was the predominant HF subtype. One-year mortality following decompensated HF was lowest in HFpEF group but 10-year mortality was similar between HFpEF and HFrEF.

scholarly journals THE ROLE OF PARASTERNAL MEDIASTINOTOMY IN THE DIAGNOSIS OF MEDIASTINAL TUMORS

2019 ◽  
Vol 6 (2) ◽  
pp. 10-19
Author(s):  
O. V. Pikin ◽  
A. B. Ryabov ◽  
A. O. Alexandrov ◽  
D. A. Vursol ◽  
A. M. Amiraliev
Keyword(s):  
Lymph Node ◽  
Mediastinal Tumor ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Specific Treatment ◽  
External Respiration ◽  
Supraclavicular Lymph Node ◽  
Tumor Biopsy ◽  
Mediastinal Tumors ◽  
Oncology Research

Parasternal mediastinotomy is a surgical method of morphological verification of mediastinal tumors, widely performed in oncological clinics. The article provides information about the method of implementation and the results of parasternal mediastinotomy for malignant tumors of the mediastinum.Purpose of the study. Evaluation of the results of parasternal mediastinotomy for morphological verification of mediastinal tumors.Patients and methods. The study included 77 patients who for the period from 2008 to 2018. 80 parasternal mediastinotomies were performed with a biopsy of a mediastinal tumor in the conditions of the Department of Thoracic Surgery of the P. Hertsen Moscow Oncology Research Institute. At the stage of preoperative examination, all patients underwent standard diagnostic studies: computed tomography of the chest, abdominal cavity, and a comprehensive ultrasound. In the case of the presence of the endobronchial component of the tumor, fibrobronchoscopy was performed. MRI of the brain was performed in patients with neurological symptoms. 12-lead ECG, echocardiography, and a study of the function of external respiration were performed to assess the functional status of patients.Results. The final histological diagnosis was made in 76 of 77 (99%) patients. The clinical diagnosis of lymphoma was set in 66, thymoma — in 6 patients, lung cancer with affection of mediastinal lymph nodes — in 4 patients, mediastinal tumor — in 4 patients. In 24 patients (31%), operations were preceded by other attempts at morphological verification. In 12 patients — mediastinal tumor biopsy under ultrasound control, in 3 — parasternal mediastinotomy, in 2 — transthoracic mediastinal tumor biopsy combined with biopsy of supraclavicular lymph node under ultrasound control, 2 — biopsy of supraclavicular lymph node under ultrasound control, in 1 — mediastinum tumor biopsy under control. — chest wall biopsy, in 1 — open biopsy with thoracotomic access, in 1 — tonsil biopsy, in 1 — trachea biopsy. In all cases, the indication for performing a parasternal mediastinotomy was an insufficient amount of material for carrying out a complete immunohistochemical study.Conclusion. Parasternal mediastinotomy is a safe and reliable method of morphological verification of the formations of the anterior mediastinum and para-aortic region. In case of the ineffectiveness of transthoracic biopsy under the control of ultrasound or CT navigation, the performing of parasternal mediastinotomy allows to establish a morphological diagnosis and to begin a specific treatment in the shortest possible time.

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