scholarly journals Left Atrial Shape and Function after Endovascular Device and Surgical Closure of ASDs in Children

2021 ◽  
Author(s):  
Alexander Sokolov ◽  
Viktor Varvarenko ◽  
Evgeny Krivoshchekov ◽  
Andrey Smorgon
Keyword(s):  
Left Atrium ◽  
Left Atrial ◽  
Surgical Correction ◽  
Control Group ◽  
Surgical Closure ◽  
Younger Age ◽  
Asd Closure ◽  
And Function ◽  
Endovascular Device

Retrospective analysis of echocardiograms was performed in 756 children who received endovascular device or surgical ASD closure from 2006 to 2016 in the Cardiac Center in Tomsk Russia. 564 patients had an endovascular closure and 192 had surgical correction. Follow-up duration was from 1 day to 10 years, mean 3.6 yrs for the device group and 4.2 yrs for the surgery group. The control group consisted of 3393 age-matched healthy patients. In patients with endovascular closure of an ASD, 35% had a change in the shape of the left atrium in early follow-up. Changes in the shape of the left atrium at early follow-up were more often observed in the device group and in children of a younger age. The left atrial changes were a decrease in sphericity and an increase in ellipsoidy. Changes in the shape of the left atrium persisted in 22% after transcatheter correction in the long-term. The change in shape of the left atrium after the placement of ASD devices was accompanied by activation of the mechanical function of the atrium and an increase in the filling pressure of the left ventricle. These changes were not accompanied by any disturbance in the contractility and volume of the heart chambers. In the group with surgical correction of ASD, the contractility and volume of the heart chambers did not significantly differ from those in the device closure group

scholarly journals P345 Temporal changes of left atrial function after orthotopic heart transplantation in a single-center prospective study

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
Z Dohy ◽  
C Czimbalmos ◽  
A Assabiny ◽  
Z Tarjanyi ◽  
Z Szakal-Toth ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Prospective Study ◽  
Left Atrium ◽  
Left Atrial ◽  
Temporal Changes ◽  
Left Ventricular ◽  
Atrial Function ◽  
Orthotopic Heart Transplantation ◽  
Control Group ◽  
And Function

Abstract Funding Acknowledgements Project no. NVKP_16-1-2016-0017 has been implemented with the support provided from the National Research, Development and Innovation Fund of Hungary The geometry and function of the left atrium (LA) change after orthotopic heart transplantation (HTX) with bicaval technique, as the LA has a recipient part around the pulmonary veins and a donor part, and these often contract separately. Because of this altered LA function, the recognition of left ventricular diastolic dysfunction can be challenging. The standard echocardiographic diastolic parameters are often in abnormal range in HTX patients despite of normal left ventricular diastolic function. The aim of our prospective study was to investigate the LA volumes and function and their temporal changes after HTX using cardiac magnetic resonance (CMR). To better understand the cardiac characteristics of HTX patients, we started a prospective trial in January 2018. CMR was performed at one, three and six months after HTX. Left atrial contour detection was performed in 2- and 4-chamber views. Patients who had ≥Grade II allograft rejection before the CMR examination, were excluded (n = 2). In the remaining HTX patients (n = 21) and in a control group (n = 21) LA ejection fraction (EF), BSA-corrected maximum and minimum LA volume (Vi), stroke volume (SVi) were evaluated using bi-plane mode. LA global longitudinal strain (GLS) was defined with CMR based deformation imaging, called feature tracking. HTX patients had significantly higher LA volumes (maxLAVi 71 ± 22 vs. 47 ± 6 ml/m2, minLAVi 53 ± 22 vs. 18 ± 5 ml/m2) lower LASVi (19 ± 7 vs. 29 ± 4 ml/m2), LAEF (27 ± 10 vs. 62 ± 8%) and LA-GLS (8 ± 3 vs. 39 ± 10%) compared to the control group (p < 0.0001). Analysing the temporal changes in HTX patients, we found an increase in the LAEF (26 ± 8 vs. 30 ± 5%) and LA-GLS (8 ± 3 vs. 11 ± 3%) at three months (p < 0.05), there was no significant difference between the LA parameters at three and six months. Better understanding of the changes of left atrial function after HTX could help us to recognise pathological conditions. Abstract P345 Figure. Strain analysis of the left atrium

scholarly journals P1741 Echocardiographic assessment of rate versus rhythm control strategy in patients with persistent atrial fibrillation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R Piatkowski ◽  
D A Kosior ◽  
J Kochanowski ◽  
M Szulc
Keyword(s):  
Control Strategy ◽  
Rate Control ◽  
Left Atrial ◽  
Persistent Atrial Fibrillation ◽  
Left Ventricular ◽  
Rhythm Control ◽  
Control Group ◽  
And Function ◽  
Left Ventricular Morphology

Abstract BACKGROUND Patients with persistent atrial fibrillation (AF) can be managed with either rhythm or rate control strategy. The restoration and maintenance of the sinus rhythm (SR) is not superior to the rate control regarding the total mortality and the rate of thromboembolic complications. Data concerning the effect of these strategies on left ventricular morphology and function is missing. PURPOSE The objective of our prospective randomised multicenter study in patients with persistent AF was to evaluate the effect of these two approaches on left ventricular morphology and function. METHODS The study group consisted of 205 patients (F/M 71/134; mean age 60.8 ± 11.2 years), including 101 patients randomized to the rate control approach (Group I) and 104 patients randomized to SR restoration with cardioversion and subsequent antiarrhythmic drug treatment (Group II). Mean duration of AF was 231.8 ± 112.4 days. At the end of follow-up (12 months), SR was present in 64% of patients in Group II. Echocardiographic examination was performed at a baseline and at 2 and 12 months. In the rate-control group, both right (22.1 ± 4.1 vs. 23.2 ± 3.8 cm2; p < 0.05) and left atrial (25.9 ± 5.2 vs. 26.8 ± 4.6 cm2 p < 0.05) enlargement was observed during the 12 months follow-up. A significant decrease in right (21.8 ± 3.0 vs. 21.2 ± 3.5 cm2; p < 0.05) and left atrial (26.2 ± 4.6 vs. 25.5 ± 5.0 cm2; p < 0.05) size in the rhythm control arm was observed. Both strategies led to a significant increase in left ventricular fractional shortening (32.1 ± 7.3 vs. 34.2 ± 6.5% and 31.3 ± 6.7 vs. 35.5 ± 8.9%, respectively; p < 0.05). The comparison of the left ventricular end-diastolic diameter revealed no difference within and between groups (50.8 ± 5.6 mm vs. 52.2 mm ± 6.8 mm at a baseline and 50.0 ± 6.0 vs. 52.0 ± ± 7.4 mm at 12 months, respectively). In rhythm-control group such trend was observed only in pts. with successfully maintained SR. According to LV function improvement, rhythm-control strategy was preferred in pts. with hypertension (RR 2.63; 95% C.I.: 0.93-5.45; p < 0.05) or congestive heart failure in NYHA II or III class (RR 2.13; 95% C.I.: 0.98-4.42; p < 0.05). CONCLUSIONS Both strategies led to a significant increase in LV FS. Rate-control strategy led to right and left atrium enlargement, but rhythm control resulted in their decrease.

Evaluation of left atrial size and function – from M-mode to 3D speckle-tracking echocardiography

2014 ◽  
Vol 155 (41) ◽  
pp. 1624-1631 ◽  
Author(s):  
Attila Nemes ◽  
Tamás Forster
Keyword(s):  
Left Atrium ◽  
Left Atrial ◽  
Functional Characterization ◽  
Left Atrial Size ◽  
Dynamic Motion ◽  
Heart Chamber ◽  
Atrial Size ◽  
Exact Measurement ◽  
Heart Cycle ◽  
And Function

Left atrium is not a passive heart chamber, because it has a dynamic motion respecting heart cycle and, in accordance with its stretching, it releases atrial natriuretic peptides. Since in the course of certain invasive procedures the size of left atrium may change substantially, its exact measurement and functional characterization are essential. The aim of the present review is to summarize echocardiographic methods for the assessment of left atrial size and functional parameters. Orv. Hetil., 2014. 155(41), 1624–1631.

scholarly journals Procedure of complex braided wrapping of ascending aorta in her poststenotic dilation while doing correction of aortal stenosis

2020 ◽  
Vol 87 (9-10) ◽  
pp. 18-21
Author(s):  
V. V. Popov ◽  
A. A. Bolshak
Keyword(s):  
Ascending Aorta ◽  
Main Group ◽  
Surgical Correction ◽  
Control Group ◽  
Valve Prosthesis ◽  
Original Procedure ◽  
Aortal Valve ◽  
The Moment ◽  
Aorta Diameter

Objective. To study clinical possibilities of original procedure of the ascending aorta braid-like bandage for her poststenotic dilation while performance of the aortal stenosis surgical correction. Materials and methods. To the main Group 196 patients were included those, who were operated on for prevailing aortal stenosis, conjoined with poststenotic dilation of ascending aorta. In accordance to the echocardiographic investigation data the ascending aorta diameter preoperatively have constituted (47.7 ± 1.7) mm. In all the patients the aortal valve prosthesis was performed together with complex braided wrapping of ascending aorta. Into the control group 121 patients were included, in whom Bentall intervention was accomplished with vascular prosthesis of ascending aorta. Results. Hospital lethality in the main group have constituted 0.5%. Diameter of ascending aorta in the moment of hospital discharge have constituted (39.1 ± 1.5) mm, and in late follow-up period - (40.3 ± 1.1) mm. Conclusion. Basing on clinical experience gained, it is expedient to recommend the original procedure of braided wrapping of ascending aorta in presence of her poststenotic dilation while performing surgical correction of prevailing aortal stenosis.

Cardioscopic Trans-septal Cryoablation of Left Atrium in Nonmitral Cases

2005 ◽  
Vol 1 (1) ◽  
pp. 48-50 ◽  
Author(s):  
Toshiya Ohtsuka ◽  
Mikio Ninomiya ◽  
Taisei Maemura
Keyword(s):  
Coronary Artery ◽  
Left Atrium ◽  
Tricuspid Regurgitation ◽  
Left Atrial ◽  
Artery Bypass ◽  
Aortic Disease ◽  
Maze Procedure ◽  
Partial Sternotomy ◽  
The Mean ◽  
Asd Closure

Background A modified maze procedure in which trans-septal cardioscopy was used for cryoablation in the left atrium is described. Methods The technique was used in 11 consecutive patients (9 men and 2 women, 56.5 ± 19.8 years) with permanent atrial fibrillation (Af) and concomitant nonmitral cardiac or aortic disease: aortic valvular disease in 4 patients, atrial septal defect (ASD) in 2 patients, tricuspid regurgitation in 2 patients, acute aortic dissection in 1 patient, arch aneurysm in 1 patient, and coronary artery disease in 1 patient. The mean Af duration detected in 7 cases was 18.5 ± 10.1 months. Partial sternotomy was used in aortic valve replacement, ASD closure, and tricuspid valve plasty, and fullsternotomy was used in aortic graft replacement and coronary artery bypass. Cardiopulmonary bypass was established, aortic cross-clamp was performed, a right atriotomy was created, a cryoablation probe and cardioscope (3 mm) were introduced into the left atrium through a 1-cm cut at the fossa ovalis or ASD, and cardioscopic left-atrial endocardial cryoablation was performed. The right-side maze procedure was conducted directly. The atrial appendages were excised in each case. Results Left-atrial cardioscopic cryoablation required 25.0 ± 5.5 minutes, and no deaths or procedure-related morbidities occurred. The mean follow-up period was 12 ± 8.5 months. One patient with tricuspid regurgitation died of liver failure. With the exception of coronary and acute dissection cases, all patients have maintained a sinus rhythm. Conclusion Although experience is limited, videocardioscopic trans-septal left-atrial cryoablation is a viable method for nonmitral Af cases, and the partial sternotomy approach can be performed.

scholarly journals The role of left atrial strain in patients with functional tricuspid regurgitation before and after annuloplasty: a long-term follow-up study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Qing-long Meng ◽  
Hong Meng ◽  
Jia Tao ◽  
Shu Yang ◽  
Hao Wang
Keyword(s):  
Tricuspid Regurgitation ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Pearson Correlation ◽  
Characteristic Curve ◽  
Control Group ◽  
Rheumatic Mitral Stenosis ◽  
Functional Tricuspid Regurgitation

Abstract Background Functional tricuspid regurgitation (TR) is common among patients with left heart disease and may recur during the follow-up period after selective tricuspid valve annuloplasty (TVA). This study aims to analyse the relationship between left atrial (LA) strain and the degree of preoperative functional TR and to explore the role of LA strain in predicting TR recurrence. Methods This study included 63 patients with rheumatic mitral stenosis who underwent mitral valve replacement and concomitant TVA. Additionally, 20 healthy controls were enrolled. Preoperative conventional LA echocardiographic parameters and LA strain were measured. The association between LA strain and preoperative functional TR severity was analysed by Pearson correlation. Predictors of recurrent TR were determined by multivariate logistic regression analyses. Results Compared with the control group, the mitral stenosis group developed a significant impairment in terms of LA strain. The degree of preoperative functional TR exhibited moderate correlations with LA reservoir strain (r = − 0.57) and LA conduit strain (r = 0.48). During a median follow-up period of 66.4 ± 36.4 months, TR recurred in 18 patients. Preoperative LA reservoir strain and the mean transmitral gradient were predictors of postoperative TR recurrence. When the two indexes were combined to establish a prediction, the sensitivity and specificity of prediction increased. The area under the receiver operating characteristic curve of the combined indicator was higher than those of the single indicators (0.90 vs. 0.70 and 0.72). Conclusions LA strain correlates with preoperative functional TR severity in patients with rheumatic mitral stenosis. The LA reservoir strain and preoperative mean transmitral gradient are independent predictive factors for recurrent TR after TVA.

scholarly journals The Effect of Manual Therapy and Stabilizing Exercises on Forward Head and Rounded Shoulder Postures: a six-week intervention with a one-month follow-up study (Preprint)

2017 ◽  
Author(s):  
Kiana Fatholahnezhad ◽  
Amir Letafatkar ◽  
Malihe Hadadnezhad
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Combined Treatment ◽  
Control Group ◽  
Post Intervention ◽  
Before And After ◽  
Group 2 ◽  
And Function ◽  
Group 1

BACKGROUND forward head and round shoulder posture is believed to alter scapular kinematics and muscle activity placing increased stress on the shoulder, leading to shoulder pain and dysfunction. OBJECTIVE The purpose of this study was to evaluate the effect of a six-week combined treatment consisting of manual therapy and stabilizing exercises, with a one-month follow-up, on neck pain with forward head and rounded shoulder postures. METHODS A total of 60 women aged 32-42 years of age with neck pain, and forward head and rounded shoulder postures were randomized into three groups: group 1 performed stabilizing exercises and received manual therapy (n=20), group 2 performed stabilizing exercises (n=20), and group 3 (control group) performed home exercises (n=20) over six weeks.The follow-up time was one month after the post test. The craniocervical and rounded shoulder angles, pain, and function were measured before and after six-week interventions, and a one-month follow- up. RESULTS The results showed significant positive changes within the experimental groupsin all variables, but there were minor changes in the control group in all variables before and after the intervention. Also, there were significant function and pain improvement in the experimental group 1 comparing to group 2. There were no differences between post intervention and one-month follow-up on posture and function in the experimental groups. CONCLUSIONS These findings suggest that both interventions were significantly effective for reducing neck pain, and improving function and posture in patients with chronic neck pain, and forward head and rounded shoulder postures. However, the improvement in function and pain was more effective in group 1 than those of group 2 suggesting that manual therapy can be used as a supplement method to the stabilizing intervention in the treatment of neck pain. More research is needed to confirm the result of this study.

scholarly journals Cardiac Changes in Patients on Long-Term Parenteral Nutrition

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1587 ◽  
Author(s):  
Lidia Santarpia ◽  
Roberta Esposito ◽  
Andrea Vaccaro ◽  
Lucia Alfonsi ◽  
Maria Carmen Pagano ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Control Group ◽  
High Fluid ◽  
The Right ◽  
And Function

Patients with short bowel syndrome (SBS) on long-term home parenteral nutrition (HPN) chronically receive high fluid volumes directly into the right atrium (RA) through the superior vena cava. We retrospectively evaluated cardiac function measured by routine transthoracic echocardiography (TTE) in a population of 26 SBS patients on long-term HPN and compared their data on echocardiograph-derived right heart structure and function, with those of a control group of 26 patients also bearing a central venous catheter (CVC) for other reasons. Results showed that body weight and BMI were significantly higher in the control group. The echocardiographic estimate of RA pressure was higher in HPN patients than in controls (p = 0.01). An increased estimate of RA pressure indicates the need to consider TTE in the follow-up of long-term HPN patients to detect functional impairment early.

Evaluation of Left Atrial Anatomy and Function using Multidetector Computed Tomography in Patients Undergoing Catheter Ablation for Atrial Fibrillation

2017 ◽  
pp. 39-55 ◽  
Author(s):  
V. I. Gurina ◽  
E. V. Kondrat’ev ◽  
A. Sh. Revishvily ◽  
M. Z. Alimurzaeva
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Pulmonary Veins ◽  
Systemic Review ◽  
Free Access ◽  
Contrast Enhanced ◽  
Review Reports ◽  
And Function

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Сatheter ablation (CA) of arrhythmogenic foci is supposed to be an established treatment option for symptomatic  patients with AF, refractory to antiarrhythmic therapy. Pre-procedural imaging is indispensable for the assessment of left atrium,  pulmonary veins and adjacent anatomy, and facilitates selection of  the ablation strategy to achieve an optimal result and minimize the risk of complications.Purpose: to evaluate the role of contrast-enhanced MDCT in  patients with AF; also to present the prospects for further  development of this method according to the systemic review of world research data.Materials and methods. 140 free access articles requested as  “MDCT left atrium”, “MDCT pulmonary veins”, “MDCT atrial  appendage” from 01.2009 until 01.2017 were analyzed in PubMed,  as well as a number of Russianlanguage articles in eLibrary.Results.This literature review reports and systematizes available  data on epidemiology and mechanisms of AF, represents current  classification. In addition were analyzed advantages of MDCT over  other methods of visualization while planning the CA and follow-up.Conclusion.MDCT is precise, effective and accessible option, which  satisfies visualization requirements during the preparation for CA.  Moreover, using MDCT in combination with electro-mapping systems  increases safety and effectiveness of the procedure. In postoperative period MDCT can be used for complications diagnostic and results assessment.

Abstract 3420: Effects on Myocardial Perfusion at 3 and 15 Months in Recanalized Chronic Total Occlusions - Randomized Comparison of Blood-Derived Progenitor Cells and Inactive Serum

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Holger Thiele ◽  
Andreas Schuster ◽  
Sandra Erbs ◽  
Volker Adams ◽  
Karsten Lenk ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Left Ventricular Function ◽  
Infarct Size ◽  
Progenitor Cells ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Control Group ◽  
Chronic Total Occlusions ◽  
And Function

Background: MRI is an excellent diagnostic tool for serial assessment of changes in myocardial perfusion, left ventricular function, and infarct size. In chronic total occlusions (CTO) the effects of recanalization on perfusion and function are contradictory and might depend primarily on viability. Circulating progenitor cells (CPC) injected intracoronarily after successful CTO recanalization might improve perfusion and function. Methods and results: Twenty-eight patients with reperfused CTO were randomized to either CPC’s or inactive serum (control), which were infused into the target vessel. First-pass myocardial perfusion MRI at rest and stress using adenosine at standard dose revealed a significant improvement of the myocardial perfusion reserve index (MPRI) in the affected segments. The baseline MPRI in affected segments was 1.50±0.17 in CPC versus 1.46±0.16 in control (p=0.62). In CPC the MPRI improved to 1.76±0.16 (p<0.001) at 3 and 1.82±0.20 (p<0.001) at 15 months; in control the change was 1.58±0.10 (p=0.01) at 3 and 1.61±0.08 (p=0.004) at 15 months follow-up. However, the MPRI recovery was significantly better in CPC as compared to control at 3 (p=0.004) and 15 months (p=0.005). In remote myocardium the MPRI was 1.70±0.30 and 1.69±0.25 (p<0.01 versus affected segments), respectively. At follow-up there was no significant improvement for both groups. The change in MPRI at 3 and 15 months was correlated with a change in overall infarct size for CPC (3 months: r=−0.68, p<0.02; 15 months: r=−0.81, p=0.001), whereas in control there was no correlation (r=−0.38, p=0.26; 15 months: r=−0.21, p=0.56). Infarct transmurality influenced MPRI improvement at follow-up. CPC patients had a trend towards more improved segments in particular those with higher transmurality (p=0.06). Conclusions: Analysis of serial contrast-enhanced MRI suggests that intracoronary application of CPC post recanalization of CTO is associated with improved myocardial perfusion and subsequent improved recovery of left ventricular function as compared to a control group at mid- and long-term follow-up. Further investigations of the pathophysiological CPC effects on macro- and microvascular function are required.

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