scholarly journals AUTOLOGICAL CELL THERAPY AND ITS ROLE IN THE TREATMENT OF REFRACTORY ANGINA

2021 ◽  
Vol 19 (4) ◽  
Author(s):  
S.I. Эстрин ◽  
T.V. Kravchenko ◽  
A.R. Pechenenko
Keyword(s):  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Medical Science ◽  
State Institution ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
P Value ◽  
Cell Transplant ◽  
Refractory Angina ◽  
Ventricular Ejection Fraction

The first clinical studies dedicated to the use of autological mesenchymal stem сells(MSCs) for the treatment of angina by means of their intravenous and transendocardialinjection is carried out in State Institution «Institute of Urgent and Recovery Surgerynamed after V.K. Gusak of National Academy of Medical Science of Ukraine» since 2007.The effectiveness of autological mesenchymal stem cells (MSCs) was researched in 60patients, and it was established that injection of 50 million of cells per a person withrefractory angina is an effective and a safe method of treatment. The results of clinicalresearch have shown that the delivery of MSCs to the lesion provides restoring ofmyocardial function and influences on the left ventricular remodeling.Objective – to substantiate the effectiveness of autological MSCs in the treatment ofrefractory angina.Material and methods. The results of examination, treatment and observation of 60patients with refractory angina (52 men and 8 women aged from 46 to 70 years) since2007 to 2012 are performed in the article.Results. We obtained the following data while studying of the dynamics of left ventricularend diastolic volume (LVEDV), which is a prognostic factor of the course of heart failure(HF). The decrease of LVEDV from 248.5 ± 22.3 to 194.3 ± 26.4 ml was observed inthe group of patients 3 months later after endocardial injection. This rate was stable 6months later after an injection, but lower than the initial one (p value > 0.05). A similartrend was observed in the group of intravenous injection . LVEDV decreased from 244.1± 24.3 to 193.4 ± 18.9 ml within 3 months and remained stable up to 6 months but lowerto the rate that was observed before the treatment with a trend to increasing to the initiallevel. Ultrasound studying of the left ventricular ejection fraction (LVEF) in patients of transendocardial injection of cell transplant showed an increasing of LVEF from 41.3 ±3.2 to 49.3 ± 4.6% 3 months later after the procedure and it was stable up to 6 months ofthe posttransplant period. LVEF is also increased in the group of intravenous transplantadmission (from 33.8 ± 3.6 to 42.8 ± 4.8%) after procedure, with its gradually decreasingin terms of 3 months, LVEF approaches the starting values up to 6 months after celltransplantation.Conclusions. The received clinical data have shown that MSCs facilitate the restoringof mechanical myocardial function and influence left ventricular remodeling aftertheir admission to the lesion zone. This effect has been confirmed according to cardiacechocardiography, treadmill-test, electromechanical mapping of the LV. The positiveeffect was remaining for 6 months. The received data allows to recommend the clinicaluse of biotechnology in ischemic heart disease treatment.

Circulating MicroRNA-146a and MicroRNA-21 Predict Left Ventricular Remodeling after ST-Elevation Myocardial Infarction

Cardiology ◽  
2015 ◽  
Vol 132 (4) ◽  
pp. 233-241 ◽  
Author(s):  
Xiaoxia Liu ◽  
Yumei Dong ◽  
Song Chen ◽  
Guangde Zhang ◽  
Mingyu Zhang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Circulating Microrna ◽  
Ventricular Ejection Fraction ◽  
Creatine Kinase Mb ◽  
Acute Mi

Objectives: MicroRNA (miR)-146a and miR-21 have been reported to participate in inflammatory reactions and fibrosis. Excessive inflammation and cardiac fibrosis may play important roles in the development of left ventricular remodeling (LVR). This study assessed whether miR-146a, miR-21 and other biomarkers could predict LVR after myocardial infarction (MI). Methods: Circulating miR-146a, miR-21 and other biomarker levels were measured in 198 patients with acute MI 5 days after primary percutaneous coronary intervention (PCI). All patients were assessed by transthoracic echocardiography on day 5 and 1 year after primary PCI. Results: Concentrations of circulating miR-146a, miR-21, C-reactive protein, creatine kinase MB type and troponin I, as well as estimated glomerular filtration rate (eGFR) and left ventricular ejection fraction (LVEF), were significantly higher in patients with than in those without LVR (p < 0.05). Multivariate logistic regression analysis showed that circulating miR-146a (odds ratio, OR = 2.127, p < 0.0001), miR-21 (OR = 1.119, p < 0.0001), eGFR (OR = 0.939, p = 0.0137) and LVEF (OR = 0.802, p = 0.0048) were independent predictors of LVR development. The area under the curve for the combination of miR-146a and miR-21 was significantly higher than for either alone. Conclusion: Circulating miR-146a and miR-21 may be novel biomarkers predictive of LVR after acute MI. Their combination may better predict LVR than either alone.

scholarly journals Cardiac fibroblast activation detected by Ga-68 FAPI PET imaging as a potential novel biomarker of cardiac injury/remodeling

2020 ◽  
Author(s):  
J. Siebermair ◽  
M. I. Köhler ◽  
J. Kupusovic ◽  
S. G. Nekolla ◽  
L. Kessler ◽  
...  
Keyword(s):  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Tumor Staging ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Specific Marker ◽  
Myocardial Uptake ◽  
Ventricular Ejection Fraction ◽  
Fibroblast Activation ◽  
Standardized Uptake Values

Abstract Background Fibroblast activation protein (FAP) as a specific marker of activated fibroblasts can be visualized by positron emission tomography (PET) using Ga-68-FAP inhibitors (FAPI). Gallium-68-labeled FAPI is increasingly used in the staging of various cancers. In addition, the first cases of theranostic approaches have been reported. In this work, we describe the phenomenon of myocardial FAPI uptake in patients who received a Ga-68 FAPI PET for tumor staging. Method and results Ga-68 FAPI PET examinations for cancer staging were retrospectively analyzed with respect to cardiac tracer uptake. Standardized uptake values (SUV) were correlated to clinical covariates in a univariate regression model. From 09/2018 to 11/2019 N = 32 patients underwent FAPI PET at our institution. Six out of 32 patients (18.8%) demonstrated increased localized myocardial tracer accumulation, with remote FAPI uptake being significantly higher in patients with vs without localized focal myocardial uptake (SUVmax 2.2 ± .6 vs 1.5 ± .4, P < .05 and SUVmean 1.6 ± .4 vs 1.2 ± .3, P < .05, respectively). Univariate regression demonstrated a significant correlation of coronary artery disease (CAD), age and left ventricular ejection fraction (LVEF) with remote SUVmean uptake, the latter with a very strong correlation with remote uptake (R2 = .74, P < .01). Conclusion Our study indicates an association of CAD, age, and LVEF with FAPI uptake. Further studies are warranted to assess if fibroblast activation can be reliably measured and may be used for risk stratification regarding early detection or progression of CAD and left ventricular remodeling.

scholarly journals Acute Kidney Injury Increase Risk of Left Ventricular Remodeling: A Cohort of 1,573 Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Qiang Li ◽  
Weihua Chen ◽  
Shanshan Shi ◽  
Haozhang Huang ◽  
Wenguang Lai ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Kidney Injury ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Absolute Increase ◽  
Ventricular Ejection Fraction ◽  
Lv Remodeling ◽  
Increase Risk

Background: Acute kidney injury (AKI) is a common complication after coronary angiography (CAG) and associated with heart failure (HF). Left ventricular (LV) remodeling is a vital process in the progression of HF. However, few studies investigate the relationship between AKI and LV remodeling.Methods: We included consecutive patients undergoing CAG from January 2007 to December 2018 at Guangdong Provincial People’s Hospital (NCT04407936). AKI was defined as an absolute increase in serum creatinine (Scr) of ≥ 0.3mg/dl or a ≥ 50% increase in Scr from baseline within the first 48–72 h after the procedure. LV remodeling was defined as: (1) an absolute decrease in left ventricular ejection fraction (LVEF) of ≥ 10% compared to baseline, or (2) a follow-up LVEF &lt; 40%. Univariate and multivariate logistical regressions were used to assess the association between AKI and LV remodeling.Results: Of the 1,573 patients (62.2 ± 9.7 years, female 36.7%) included in the study, 231 (14.7%) had AKI. The incidence of LV remodeling was higher in patients with AKI than in those without AKI (24.7% vs. 14.5%). After adjusting for confounding, multivariate logistic regression showed that AKI was associated with a significantly higher risk of LV remodeling [adjusted odds ratio (aOR) 1.87; 95% CI, 1.30–2.66; p &lt; 0.001]. In addition, LV remodeling patients had higher all-cause mortality compared to non-LV remodeling patients (9.7% vs. 19.1%).Conclusion: Our data suggested that AKI is present in up to 15% of patients after CAG and that nearly a quarter of AKI patients suffered LV remodeling and AKI patients have a two-fold risk of developing LV remodeling than non-AKI patients. Our findings suggest that more active measures be taken not only to prevent AKI patient developing into LV remodeling, but to prevent patients undergoing CAG from developing AKI.

Towards a Personalized and Dynamic CRT-D

2012 ◽  
Vol 51 (06) ◽  
pp. 495-506 ◽  
Author(s):  
L. Santini ◽  
G. B. Forleo ◽  
V. Minni ◽  
K. Mafhouz ◽  
D. G. Della Rocca ◽  
...  
Keyword(s):  
Numerical Model ◽  
Cardiovascular System ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Aortic Pressure ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

SummaryBackground: In spite of cardiac resynchronization therapy (CRT) benefits, 25 – 30% of patients are still non responders. One of the possible reasons could be the non optimal atrioventricular (AV) and interventricular (VV) intervals settings. Our aim was to exploit a numerical model of cardiovascular system for AV and VV intervals optimization in CRT.Methods: A numerical model of the cardiovascular system CRT-dedicated was previously developed. Echocardiographic parameters, Systemic aortic pressure and ECG were collected in 20 consecutive patients before and after CRT. Patient data were simulated by the model that was used to optimize and set into the device the intervals at the baseline and at the follow up. The optimal AV and VV intervals were chosen to optimize the simulated selected variable/s on the base of both echocardiographic and electrocardiographic parameters.Results: Intervals were different for each patient and in most cases, they changed at follow up. The model can well reproduce clinical data as verified with Bland Altman analysis and T-test (p > 0.05). Left ventricular remodeling was 38.7% and left ventricular ejection fraction increasing was 11% against the 15% and 6% reported in literature, respectively.Conclusions: The developed numerical model could reproduce patients conditions at the baseline and at the follow up including the CRT effects. The model could be used to optimize AV and VV intervals at the baseline and at the follow up realizing a personalized and dynamic CRT. A patient tailored CRT could improve patients outcome in comparison to literature data.

scholarly journals DOES THE CORRECTION OF THE ANXIETY-DEPRESSIVE DISORDERS INFLUENCE ON THE PROCESSES OF THE LEFT VENTRICULAR REMODELING IN PATIENTS WITH ACUTE CORONARY SYNDROME?

2019 ◽  
Vol 33 (4) ◽  
pp. 98-102
Author(s):  
T. M. Poponina ◽  
K. I. Gunderina ◽  
Yu. S. Poponina ◽  
M. V. Soldatenko
Keyword(s):  
Acute Coronary Syndrome ◽  
Depressive Disorders ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Study Groups ◽  
Left Ventricular ◽  
Anxiety Reduction ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome

Aim:to study the dynamic of echocardiographic parameters in patients with acute coronary syndrome associated with anxiety and depressive disorders during the therapy by innovative Russian drug containing release-active antibodies to the brain-specific protein S-100 (Tenoten) in-hospital and during six months of treatment.Material and Methods. 54 patients with acute coronary syndrome associated with anxiety and depressive disorders were randomized into 2 groups: patients of group 1 were administered with anti-anxiety medicament Tenoten, 6 tablets per day in addition to the therapy for acute coronary syndrome; group 2 received placebo. All patients underwent echocardiography at inpatient and outpatient stages six months after randomization.Results. Clinically significant anxiety and subclinical depression were detected in patients of both study groups. The intake of anti-anxiety drug Tenoten for six months contributed to anxiety reduction, myocardial contractility improvement, and a decrease in the left ventricular volume indices. Negative changes were observed in comparison group: a decrease in the left ventricular ejection fraction, increase in volume indices, and decline in the left ventricular relaxation.Conclusion. Administration of Tenoten at a dose of six tablets per day to patients with acute coronary syndrome in combination with affective disorders resulted not only in improvement of a mental status, but it also contributed to suppression of the left ventricular remodeling processes.

scholarly journals Role of speckle tracking echocardiography in patients with myocardial infarction

Pathologia ◽  
2021 ◽  
Vol 18 (1) ◽  
pp. 117-124
Author(s):  
A. V. Kobets ◽  
M. P. Kopytsia ◽  
N. V. Tytarenko ◽  
Yu. V. Rodionova
Keyword(s):  
Myocardial Infarction ◽  
Transthoracic Echocardiography ◽  
Speckle Tracking ◽  
Ventricular Remodeling ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular Remodeling ◽  
Radial Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

All over the world cardiovascular diseases are one of the main reason of morbidity and mortality in the structure of non-communicable diseases, and myocardial infarction has a leading role. Markers of modern advanced ultrasound techniques, speckle tracking echocardiography, play significant role in the detection and assessment of cardiovascular disease. Deviation of them can detect myocardial ischemia, hypertrophy, dystrophy and infiltration, severe systemic diseases, cardiotoxicity of the drugs, etc. This technology significantly improves diagnostic capabilities of transthoracic echocardiography, it allows to assess myocardial function in all three planes (longitudinal, circumferential and radial), in which myocardium moves during cardiac cycle. Speckle tracking echocardiography can determine the volume of myocardial damage, differentiate subendocardial and transmural myocardial infarction, identify viable and fibrous areas of the myocardium, that is confirmed by the results of magnetic resonance imaging. Besides, this method helps to detect and assess mechanical dyssynchrony and also predict the risk of pathological left ventricular remodeling and life-threatening adverse cardiovascular events (arrhythmias, increasing of heart failure, recurrent myocardial infarction, stroke, death, etc.), that is important for patients with acute myocardial infarction to identify high-risk patients. The most studied markers of this technique are longitudinal, circumferential and radial strain, mechanical dispersion and postsystolic shortening. Markers of this ultrasound technique significantly complete other markers of transthoracic echocardiography, such as left ventricular ejection fraction, to assess risk stratification of cardiovascular complications. The value of speckle-tracking echocardiography markers has been demonstrated alone or in combination with other markers.

Bendopnea as a risk factor for the incidence of COVID-19 in patients with CHF

2021 ◽  
Vol 2 (2) ◽  
pp. 26-34
Author(s):  
Dmitry O. Dragunov ◽  
Anna V. Sokolova ◽  
Aminat D. Gasanova ◽  
Timofey V. Latyshev ◽  
Grigoriy P. Arutyunov
Keyword(s):  
Risk Factor ◽  
Left Ventricular Ejection Fraction ◽  
Statistical Processing ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
P Value ◽  
Chronic Patients ◽  
Software Environment ◽  
Ventricular Ejection Fraction ◽  
R Language

Purpose. Analysis of the incidence of COVID-19 in patients from the register «Management of chronic patients with multiple diseases» with a previously established CHF diagnosis, depending on the presence or absence of a symptom of bendopnea. Materials and methods. Retrospective analysis of electronic outpatient records of 121 patients with CHF with and without bendopnea symptom, with an assessment of the incidence of COVID-19. For statistical processing of the data obtained, we used the R language and the RStudio software environment. Results. The average age of the patients was 74.38±9.83 years. Bendopnea symptom occurred in 60,3% (n = 73) of the studied patients. The incidence of COVID-19 was 14% (n = 17), of which 88% were patients with the symptom of bendopnea (p-value = 0.023, Х2 = 5.17). The chance of COVID-19 in patients with bendopnea was higher than in patients without symptom of bendopnea (OR 5.8 (1.2; 26.7), p = 0.013). Conclusion. The presence of a symptom of bendopnea in patients with CHF increases the risk of COVID-19. A statistically significant relationship was established between the presence of a symptom of bendopnea, the level of left ventricular ejection fraction and the incidence of COVID-19.

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