scholarly journals Assessment of Left Atrial Function after ST-Segment Elevation Acute Myocardial Infarction: An Application of Real Time Three-Dimensional Echocardiography

2021 ◽  
Author(s):  
yuxia Miao ◽  
min Xu ◽  
yuetao Wang ◽  
xiao Xie ◽  
fei Liu ◽  
...  
Keyword(s):  
Real Time ◽  
Acute Phase ◽  
Troponin I ◽  
Contractile Function ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Functional Change ◽  
Multiple Time ◽  
St Segment Elevation ◽  
Creatine Kinase Mb

Objective: The purpose of this study is to evaluate the changes of LA size and function by real-time 3D echocardiography (RT-3DE), and provide a better understanding about their effects on treatment and prognosis. Methods: Ten Bama miniature pigs were used for modeling STEMI. Images were obtained by RT-3DE at multiple time points. From the LA volume-time relation curve, the LA volume (LAV) and functions (storage, channel, and active emptying) at different phases were calculated. Blood samples were obtained for measurements of NT-proBNP, creatine kinase-MB(CK-MB) and cardiac Troponin-I(cTn-I). Results: (1) LAVmax, LAVmin and LAVpre-a were all increased with time. (2) The LA expansion index was the most sensitive index of LA functional change. It increased (p< .05 vs. baseline) at the 1st day after STEMI (acute phase), and was correlated with diastolic function E/E’ (p< .05), as shown by univariate correlation analysis. (3) On the 28th day after STEMI, the active emptying percentage of total emptying (AE) showed a continuously increasing trend (p< .05), and was correlated with VTILVOT (time-velocity integral of left ventricular outflow tract) (p< .05). Conclusions: During the acute phase after STEMI, LA volume changed in order to increase LV preload. After STIMI, the storage function of LA was the first to change, while active contractile function was significantly enhanced during subacute phase. With the accurate measurement of LA function with RT-3DE, our study will help improving the therapeutic target setting and pharmacologic interventions, which may enhance the clinical outcomes of STEMI patients.

scholarly journals The Prognostic Utility of Plasma NGAL Levels in ST Segment Elevation in Myocardial Infarction Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ahmet Avci ◽  
Bahadir Ozturk ◽  
Kenan Demir ◽  
Fikret Akyürek ◽  
Bulent Behlul Altunkeser
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Mortality ◽  
Troponin I ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Roc Curve Analysis ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
Plasma Ngal ◽  
Creatine Kinase Mb

Introduction. Plasma neutrophil gelatinase-associated lipocalin (NGAL) levels in acute myocardial infarction (AMI) patients are markedly higher. In addition, plasma NGAL levels were increased in patients with acute and chronic heart failure as a complication of myocardial infarction. In this study, we investigated whether there is a difference between the prognostic use of plasma NGAL levels in ST-elevation myocardial infarction (STEMI) patients with preserved and reduced left ventricular ejection fraction (LVEF). Methods. 235 consecutive STEMI patients were enrolled in the study. Patients were divided into groups according to LVEF. Plasma NGAL, troponin I, creatine kinase MB (CKMB), and C-reactive protein (CRP) were measured. Finally, the study population examined with 34 reduced LVEF and 34 preserved LVEF consisted of a total of 68 patients (12 females; mean age, 61.5 ± 14.7). All patients were followed up prospectively for 6 months. This study group was divided into two subgroups as the patients who died (n = 14) and survived (n = 34), and plasma NGAL levels of the groups were compared. Results. The median of NGAL was 190.08 ng/ml. Age, troponin I, CKMB, CRP, glomerular filtration rate, and creatinine were higher in reduced LVEF groups. Plasma NGAL levels were also higher in reduced LVEF than in preserved LVEF, but statistically not significant (p=0.07). Plasma NGAL levels were significantly higher in death patients than in survived patients (p<0.001). In ROC curve analysis, the level to detect isolated cardiovascular mortality with a sensitivity of 86% and a specificity of 77% was 190 ng/mL for NGAL. Conclusion. Plasma NGAL levels can be used to predict cardiovascular mortality in STEMI patients.

scholarly journals Serotonin increases L-type Ca2+ current and SR Ca2+ content through 5-HT4 receptors in failing rat ventricular cardiomyocytes

2007 ◽  
Vol 293 (4) ◽  
pp. H2367-H2376 ◽  
Author(s):  
Jon Arne Kro Birkeland ◽  
Fredrik Swift ◽  
Nils Tovsrud ◽  
Ulla Enger ◽  
Per Kristian Lunde ◽  
...  
Keyword(s):  
Myosin Light Chain ◽  
Troponin I ◽  
Contractile Function ◽  
Left Ventricular ◽  
Inotropic Response ◽  
Receptor Stimulation ◽  
Ventricular Cardiomyocytes ◽  
Myosin Light Chain 2 ◽  
Intracellular Ca ◽  
Male Wistar Rats

Rats with congestive heart failure (CHF) develop ventricular inotropic responsiveness to serotonin (5-HT), mediated through 5-HT2A and 5-HT4 receptors. Human ventricle is similarly responsive to 5-HT through 5-HT4 receptors. We studied isolated ventricular cardiomyocytes to clarify the effects of 5-HT on intracellular Ca2+ handling. Left-ventricular cardiomyocytes were isolated from male Wistar rats 6 wk after induction of postinfarction CHF. Contractile function and Ca2+ transients were measured in field-stimulated cardiomyocytes, and L-type Ca2+ current ( ICa,L) and sarcoplasmic reticulum (SR) Ca2+ content were measured in voltage-clamped cells. Protein phosphorylation was measured by Western blotting or phosphoprotein gel staining. 5-HT4- and 5-HT2A-receptor stimulation induced a positive inotropic response of 33 and 18% (both P < 0.05) and also increased the Ca2+ transient (44 and 6%, respectively; both P < 0.05). ICa,L and SR Ca2+ content increased only after 5-HT4-receptor stimulation (57 and 65%; both P < 0.05). Phospholamban serine16 (PLB-Ser16) and troponin I phosphorylation increased by 26 and 13% after 5-HT4-receptor stimulation ( P < 0.05). 5-HT2A-receptor stimulation increased the action potential duration and did not significantly change the phosphorylation of PLB-Ser16 or troponin I, but it increased myosin light chain 2 (MLC2) phosphorylation. In conclusion, the positive inotropic response to 5-HT4 stimulation results from increased ICa,L and increased phosphorylation of PLB-Ser16, which increases the SR Ca2+ content. 5-HT4 stimulation is thus, like β-adrenoceptor stimulation, possibly energetically unfavorable in CHF. 5-HT2A-receptor stimulation, previously studied in acute CHF, induces a positive inotropic response also in chronic CHF, probably mediated by MLC2 phosphorylation.

scholarly journals Morphofunctional cardiac changes in pregnant women: associations with biomarkers

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000850 ◽  
Author(s):  
Takeshi Umazume ◽  
Takahiro Yamada ◽  
Satoshi Yamada ◽  
Satoshi Ishikawa ◽  
Itsuko Furuta ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Natriuretic Peptide ◽  
Troponin I ◽  
Vena Cava ◽  
Left Ventricular ◽  
Volume Index ◽  
Blood Levels ◽  
Lv Mass ◽  
Creatine Kinase Mb ◽  
In Pregnancy

ObjectiveThis longitudinal study was performed to determine changes in echocardiography parameters in association with various biomarker levels in pregnancy/postpartum.MethodsFifty-one healthy pregnant women underwent echocardiography with simultaneous determination of blood levels of five biomarkers at each of the first, second and third trimesters of pregnancy, immediately postpartum within 1 week after childbirth and approximately 1 month postpartum. Data on 255 echocardiography scans (five times per woman) and biomarkers were analysed.ResultsLeft ventricular end-diastolic dimension, left atrial (LA) volume index and left ventricular (LV) mass index increased with advancing gestation and reached the maximum immediately postpartum concomitant with the highest brain natriuretic peptide (BNP), N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-TnI) and creatine kinase MB levels. The inferior vena cava diameter was significantly reduced in the third trimester compared with that in the first trimester and the peak occurred immediately after childbirth. In 255 paired measurements, hs-TnI level was significantly positively correlated with LA volume index and LV mass index; BNP and NT-proBNP were significantly positively correlated with LA volume index and estimated glomerular filtration rate (eGFR) was significantly positively correlated with the average of early diastolic septal and lateral mitral annular velocity (e′).ConclusionsMaximal cardiac changes in morphology occurred postpartum within 1 week after childbirth, not during pregnancy. BNP/NT-proBNP, hs-TnI and eGFR reflected cardiac changes in pregnancy.

scholarly journals Reversed Septal Curvature Is Associated with Elevated Troponin Level in Hypertrophic Cardiomyopathy

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Renata Rajtar-Salwa ◽  
Tomasz Tokarek ◽  
Paweł Petkow Dimitrow
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Troponin I ◽  
High Sensitivity ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Septal Thickness ◽  
Left Ventricular Outflow ◽  
Echocardiographic Parameters ◽  
Ischemic Events ◽  
Septal Curvature

The aim of study was to compare patients with hypertrophic cardiomyopathy divided according to septal configuration assessed in a 4-chamber apical window. The study group consisted of 56 consecutive patients. Reversed septal curvature (RSC) and non-RSC were diagnosed in 17 (30.4%) and 39 (69.6%) patients, respectively. Both RSC and non-RSC groups were compared in terms of the level of high-sensitivity troponin I (hs-TnI), NT-proBNP (absolute value), NT-proBNP/ULN (value normalized for sex and age), and echocardiographic parameters, including left ventricular outflow tract gradient (LVOTG). A higher level of hs-TnI was observed in RSC patients as compared to the non-RSC group (102 (29.2-214.7) vs. 8.7 (5.3-18) (ng/l), p = 0.001 ). A trend toward increased NT-proBNP value was reported in RSC patients (1279 (367.3-1186) vs. 551.7 (273-969) (pg/ml), p = 0.056 ). However, no difference in the NT-proBNP/ULN level between both groups was observed. Provocable LVOTG was higher in RSC as compared to non-RSC patients (51 (9.5-105) vs. 13.6 (7.5-31) (mmHg), p = 0.04 ). Furthermore, more patients with RSC had prognostically unfavourable increased septal thickness to left LV diameter at the end diastole ratio. Patients with RSC were associated with an increased level of hs-TnI, and the only trend observed in this group was for the higher NT-proBNP levels. RSC seems to be an alerting factor for the risk of ischemic events. Not resting but only provocable LVOTG was higher in RSC as compared to non-RSC patients.

scholarly journals Syncope in a hypertrophic heart at a wedding party: can happiness break a thick heart? Takotsubo cardiomyopathy complicated with left ventricular outflow tract obstruction in a hypertrophic heart

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Nicoletta Orphanou ◽  
Christos Eftychiou ◽  
Elias Papasavvas ◽  
Marios Ioannides ◽  
Panayiotis Avraamides
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Obstructive Coronary Artery Disease ◽  
Interventricular Septum ◽  
Hypertensive Heart Disease ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Interesting Case ◽  
St Segment Elevation ◽  
Left Ventricular Outflow ◽  
Sigmoid Septum

Abstract A 70-year-old woman with known history of hypertension presented because of a syncopal episode during dinner at a wedding party, followed by chest pain. On physical examination a systolic murmur was noted, and her electrocardiogram showed ST segment elevation in anterior leads. She had elevated troponin levels while echocardiography showed a hypertrophic interventricular septum with dyskinetic apex and left ventricular outflow (LVOT) obstruction. Emergency coronary angiography excluded obstructive coronary artery disease and confirmed the presence of LVOT obstruction with a gradient of 90 mm Hg. A left ventriculography showed hypercontractility of the basal and mid segments with apical wall dyskinesia indicating Takotsubo cardiomyopathy. Patient was discharged after 6 days of hospitalization with normalization of left ventricular function and regression of the LVOT obstruction. This is an interesting case of Takotsubo cardiomyopathy complicated with severe LVOT obstruction in a patient with hypertensive heart disease and a sigmoid septum hypertrophy.

scholarly journals Can a pneumothorax break your heart?

2015 ◽  
Vol 24 (1) ◽  
pp. 55-8 ◽  
Author(s):  
Stylianos Mavridis ◽  
Hans-Georg Gnauk ◽  
Silvio Horn ◽  
Peter Adeberg ◽  
Martina Schumacher ◽  
...  
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Ventricular Dysfunction ◽  
Troponin I ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Air Leakage ◽  
St Segment Elevation ◽  
St Segment ◽  
Electrocardiographic Findings ◽  
Significant Coronary Stenosis

Takotsubo cardiomyopathy or apical ballooning is a condition characterized by transitory left ventricular dysfunction, affecting commonly postmenopausal females after foregoing acute emotional or physical stress. We report a case of a 63 year old female presenting with severe dyspnea and right-sided secondary spontaneous pneumothorax, initially treated with tube thoracostomy. Despite the fact that pneumothorax resolved, shortness of breath persisted and due to ST-segment elevation and increased Troponin I levels, she was admitted to cardiac catheterization. A significant coronary stenosis was ruled out and the diagnosis of a Takotsubo cardiomyopathy was established. Electrocardiographic findings were normalized within three days and attributable to prolonged air leakage. A thoracoscopic apex resection followed by a partial parietal pleurectomy was performed. Although Takotsubo cardiomyopathy is a rare syndrome, it should always be considered as a potential cardiac complication of a pneumothorax.

scholarly journals Hypertrophic Cardiomyopathy: The Time-Synchronized Relationship between Ischemia and Left Ventricular Dysfunction Assessed by Highly Sensitive Troponin I and NT-proBNP

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Renata Rajtar-Salwa ◽  
Adam Gębka ◽  
Artur Dziewierz ◽  
Paweł Petkow Dimitrow
Keyword(s):  
Troponin I ◽  
Ventricular Outflow Tract ◽  
Model Analysis ◽  
Left Ventricular ◽  
Maximum Wall Thickness ◽  
Left Ventricular Outflow ◽  
Echocardiographic Parameters ◽  
The Absolute ◽  
And Gender ◽  
Highly Sensitive Troponin

The aim of this study was to compare NT-proBNP using the absolute values and NT-proBNP/ULN values that were standardized by age and gender between three subgroups: those without ischemia (negative hs-troponin I and no anginal pain (hsTnI-/AP-)), those with painless ischemia (hsTnI+/AP-), and those with painful ischemia (hsTnI+/AP+). Additionally, echocardiographic parameters were compared in these three subgroups. The absolute value of NT-proBNP was significantly higher in the painful ischemia subgroup (hsTnI-/AP- vs. hsTnI+/AP- vs. hsTnI+/AP+: 502 (174-833) vs. 969 (363-1346) vs. 2053 (323-3283) pg/ml; p=0.018 for the whole-model analysis). The standardized value of NT-proBNP/ULN was gradually increased (hsTnI-/AP- vs. hsTnI+/AP- vs. hsTnI+/AP+: 3.61+0.63 vs. 6.90+1.31 vs. 9.35+1.87; p=0.001 for the whole-model analysis). In the comparison between subgroups (hsTnI-/AP- vs. hsTnI+/AP- vs. hsTnI+/AP+), two echocardiographic parameters increased significantly. The left ventricular maximum wall thickness (LVMWT) at diastole was 1.99±0.08 cm vs. 2.28±0.13 cm vs. 2.49±0.15 cm (p=0.004 for the whole-model analysis). The maximal gradient of the provoked left ventricular outflow tract (LVOT) gradient increased significantly in only the painful-ischemia subgroup (11 (7-30) mmHg vs. 12 (9.35-31.5) mmHg vs. 100 (43-120) mmHg). In conclusion, both painless ischemia and painful ischemia are associated with a gradual, significant increase in NT-proBNP/ULN in comparison to the double-negative hsTnI/AP subgroup. In contrast, NT-proBNP is significantly higher in only the subgroup with painful ischemia.

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