The Effect of Acute Allergic Reactions on Diastolic Heart Function

Purpose: Diastolic heart failure is characterized by the presence of heart failure symptoms despite preserved systolic function. Cytokines released during allergic reactions may impair diastolic heart function, either through their direct toxic effects or by inducing coronary artery spasm. The purpose of this study was to examine the effects of acute allergic reactions on diastolic heart function. Methods: Fifty patients, randomly selected from those who were admitted to the emergency room between May 2010 and December 2010 with the complaints of rash and itching, and who were subsequently diagnosed with allergic reactions based on the clinical and laboratory findings, were included in the study as the allergy group. Thirty healthy volunteers, in whom the diagnosis of allergy was ruled out based on the clinical and laboratory data, were use as the control group. Diastolic heart functions were evaluated in patients presenting with allergic reaction as well as in control subjects. Results: There was no significant difference between the two groups in terms of basal systolic functions, diameters of the cavities and wall thicknesses, and biochemical parameters. Color M mode flow progression velocities, E ratios, E/A ratios and mitral lateral annulus tissue Doppler velocities measured by echocardiography at Day 0 and Day 5 were significantly altered in the allergy group (p < 0.05). Conclusion: Impairment in diastolic functions was observed following acute allergic reactions. Acute allergic reactions could be a cause of mortality and morbidity if they lead to the development of diastolic heart failure.

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Effect of Levosimendan on the short-term clinical efficacy of patients with acute decompensated heart failure

Tobacco Regulatory Science ◽

10.18001/trs.7.6.131 ◽

2021 ◽

Vol 7 (6) ◽

pp. 6572-6584

Author(s):

Wang Huping ◽

Wang Shidong ◽

Rong A ◽

Xie Xueliang

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Clinical Efficacy ◽

Adverse Reactions ◽

Heart Function ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Control Group ◽

Clinical Effects ◽

Significant Difference

OBJECTIVE To observe the effect of levosimendan on the clinical efficacy of patients with acute decompensated heart failure (ADHF). METHODS Collected 124 patients with acute decompensated heart failure who were admitted to the cardiology department of our hospital from October 2019 to October 2020. According to the random number table method, they were divided into control group and levosimendan group. The control group was given traditional anti-heart failure treatment, and the levosimendan group was added with levosimendan injection on the basis of the control group. The clinical efficacy indicators, functional indicators, incidence of adverse reactions, mortality during hospitalization, rehospitalization rates and combined endpoint events within 3 months of follow-up were compared before and after treatment. RESULT The results of clinical efficacy comparison showed that the number of significant effective number in the controlgroup was less than that of the levosimendan group, and there was no difference in the number of effective, ineffective and total effective groups; the improvement of dyspnea after treatment in the levosimendan group was better than that of the control group; cardiac color Doppler ultrasound LVEF in control group is higher than Levosimendan group, LVEDV and LVESV are lower than control group; The BNP control group was higher than the levosimendan group. There was no significant difference in renal function between the two groups.The urine output of the control group was less than that of the levosimendan group.There was no statistically significant difference in adverse reactions, rehospitalization rates within 3 months, and mortality between the two groups of patients, and the combined endpoint event (death or rehospitalization) was significantly lower than that of the control group. CONCLUSION Levosimendan in the treatment of patients with acute decompensated heart failure can achieve significant clinical effects, and effectively improve the patient's hemodynamic indicators and increase renal perfusion.With the deepening of the aging of the population in China, the incidence of decompensated heart failure in the elderly population is higher, which seriously affects the normal life. Acute decompensated heart failure (ADHF), a kind of heart disease, is a clinical syndrome characterized by dyspnea with sudden onset and rapid peak based on abnormal heart function (11. It is typical of the late stage of heart disease, usually on the basis of chronic heart failure. The disease is complex and difficult to treat. In addition, the mortality rate of patients is high [2], which endangers the health of patients and threatens their life safety, and is the key disease of current clinical attention. At present, drug therapy is mainly adopted in the clinical treatment to stabilize the hemodynamic level of patients. Clinical practice shows that it is not significantthe to adopt conventional symptomatic treatment effect/which demands a new effective treatment scheme. Levosimendan .a new type of positive inotropic drug, -can increase myocardial contractility and has significant effects in improving heart failure which will reduce mortality, improve the incidence of arrhythmia and bring hope to patients [3]. This study took 124 cases admitted to our hospital as the research object, and analyzed the therapeutic effect of levosimendan. The report are as follows.

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Abstract P233: Diabetic Cardiomyopathy is Reversed by Increased Mitochondrial Bioenergetics Due to PGC-1α Activation by EET Treatment of Obese Mice

Hypertension ◽

10.1161/hyp.68.suppl_1.p233 ◽

2016 ◽

Vol 68 (suppl_1) ◽

Author(s):

Jian Cao ◽

John A McClung ◽

Shailendra P Singh ◽

Lars Bellner ◽

Maayan Waldman ◽

...

Keyword(s):

Heart Failure ◽

Insulin Resistance ◽

Oxidative Phosphorylation ◽

Mitochondrial Dysfunction ◽

Diabetic Cardiomyopathy ◽

Cardiac Fibrosis ◽

Systolic Function ◽

Control Group ◽

Protein Markers ◽

Obesity And Diabetes

Introduction: Obesity and diabetes are associated with progressive cardiac fibrosis that, sequentially, results in diastolic dysfunction, reduced contractility, and ultimately heart failure. Contributing factors include hyperglycemia, insulin resistance, mitochondrial dysfunction, and a reduction in AMPK signaling. PGC-1α activates mitochondrial biogenesis and oxidative phosphorylation and is decreased in patients with diabetes mellitus (DM). We hypothesize that an epoxyeicosatrienoic acids (EETs) agonist (EET-A) will increase PGC-1α levels in a db mouse model of DM attenuate cardiomyopathy, and prevent heart failure. Methods: Db mice (4-wks), were allowed to acclimatize for 16-wks and were then divided into 3 treatment groups for an additional 16 wks: A) control, B) EET-A 1.5mg/100g BW 2 weeks and C) EET-A-Ln-PGC-1α shRNA. Ln-PGC-1α shRNA suppressed PGC-1α protein in heart tissue by 40-50%. Oxygen consumption (VO 2 ), and blood glucose was determined. Heart tissues were harvested to measure PGC-1α, HO-1, pAMPK, PGC-1α, echocardiographic fractional shortening, mitochondrial oxidative phosphorylation (OXPHOS) and mitofusion protein markers. Results: All mice developed heart failure by the end of 16 weeks and were characterized by a decrease in myocardial contractility, an increase in insulin resistance and blood pressure, decreased VO 2 , the appearance of mitochondria dysfunction and a decrease in AMPK and downstream PGC-1α signaling. Mice treated with EET-A demonstrated an increase in PGC-1α levels, improved mitochondrial function and oxidative phosphorylation (p<0.01 vs control), increased NO bioavailability (p<0.05 vs control), and normalization of glucose metabolism, insulin levels, VO 2 and LV systolic function (p<0.05 vs control). All of these findings were suppressed by PGC-1α inhibition which was accompanied by the onset of even more severe LV dysfunction than in the control group. Conclusion: Increased EET levels result in activation of PGC-1α-HO-1 which reverses diabetes induced insulin resistance, mitochondrial dysfunction, and cardiomyopathy. EET may have potential as a powerful agent for therapeutic application in the treatment of diabetic cardiomyopathy.

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INCREASED TISSUE TRANSGLUTAMINASE LEVELS ARE ASSOCIATED WITH INCREASED EPILEPTIFORM ACTIVITY IN ELECTROENCEPHALOGRAPHY AMONG PATIENTS WITH CELIAC DISEASE

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000400005 ◽

2015 ◽

Vol 52 (4) ◽

pp. 272-277 ◽

Cited By ~ 3

Author(s):

Sedat IŞIKAY ◽

Şamil HIZLI ◽

Serkan ÇOŞKUN ◽

Kutluhan YILMAZ

Keyword(s):

Celiac Disease ◽

Tissue Transglutaminase ◽

Pearson Correlation ◽

Epileptiform Activity ◽

Control Group ◽

Healthy Children ◽

Newly Diagnosed ◽

Laboratory Findings ◽

Significant Difference ◽

Medical Histories

Background - Celiac disease is an autoimmune systemic disorder in genetically predisposed individuals precipitated by gluten ingestion. Objective - In this study, we aimed to determine asymptomatic spike-and-wave findings on electroencephalography in children with celiac disease. Methods - A total of 175 children with the diagnosis of celiac disease (study group) and 99 age- and sex-matched healthy children as controls (control group) were included in the study. In order to determine the effects of gluten free diet on laboratory and electroencephalography findings, the celiac group is further subdivided into two as newly-diagnosed and formerly-diagnosed patients. Medical histories of all children and laboratory findings were all recorded and neurologic statuses were evaluated. All patients underwent a sleep and awake electroencephalography. Results - Among 175 celiac disease patients included in the study, 43 were newly diagnosed while 132 were formerly-diagnosed patients. In electroencephalography evaluation of patients the epileptiform activity was determined in 4 (9.3%) of newly diagnosed and in 2 (1.5%) of formerly diagnosed patients; on the other hand the epileptiform activity was present in only 1 (1.0%) of control cases. There was a statistically significant difference between groups in regards to the presence of epileptiform activity in electroencephalography. Pearson correlation analysis revealed that epileptiform activity in both sleep and awake electroencephalography were positively correlated with tissue transglutaminase levels (P=0.014 and P=0.019, respectively). Conclusion - We have determined an increased epileptiform activity frequency among newly-diagnosed celiac disease patients compared with formerly-diagnosed celiac disease patients and control cases. Moreover the tissue transglutaminase levels were also correlated with the presence of epileptiform activity in electroencephalography. Among newly diagnosed celiac disease patients, clinicians should be aware of this association and be alert about any neurological symptoms.

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Reduced myocardial reserve in cirrhotic patients: an evaluation by dobutamine stress speckle tracking and tissue Doppler imaging (TDI) echocardiography

Journal of Cardiovascular and Thoracic Research ◽

10.15171/jcvtr.2019.22 ◽

2019 ◽

Vol 11 (2) ◽

pp. 127-131 ◽

Cited By ~ 4

Author(s):

Mahmood Zamirian ◽

Forough Afsharizadeh ◽

Alireza Moaref ◽

Firoozeh Abtahi ◽

Fatemeh Amirmoezi ◽

...

Keyword(s):

Heart Failure ◽

Strain Rate ◽

Speckle Tracking ◽

Systolic Function ◽

Peak Stress ◽

Tissue Doppler ◽

Doppler Imaging ◽

Control Group ◽

Basal Segment ◽

Cirrhotic Patients

Introduction: Despite the normal systolic function at rest, cirrhotic patients often suffer from volume overload and symptoms of heart failure as they face stressful situations. This study investigated the myocardial reserve in cirrhotic patients at resting condition and peak stress by dobutamine speckle tracking echocardiography (STE) and tissue Doppler imaging (TDI). Methods: Twenty cirrhotic patients and 10 normal individuals aged 30-50 were selected randomly. For all of the participants, complete echocardiographic study of 2D, STE and TDI was done at rest and peak stress status with dobutamine. The following parameters were assessed: ejection fraction (EF), global longitudinal LV strain (GLS), strain rate in the septal basal segment and lateral wall and E’ in the septal basal segment by color-coded method. Results: At baseline, EF was higher than 55% in both groups. GLS was higher (-22.6±2.4%) in the case group than the control group (-19.2±1.9%) at resting condition. After stress, it showed a greater increase (-22.5±1.7%) in the controls compared to cirrhotic patients (-22.6±3.3%; mean difference = 2.6 ± 2.03, P = 0.02). In cirrhotic patients, the average strain rate in the basal septal segment decreased after stress (-1.2 ± 0.3/s to-1.1 ± 0.3/s), but it increased in the control group (-1.1 ± 0.2/s to -1.8 ± 0.2/s). Conclusion: Despite the presence of normal resting systolic function in cirrhotic patients, there was insufficient increase or even a decrease in myocardial function with stress; this may indicate the absence of sufficient myocardial reserve in cirrhotic patients. These findings would help to explain the reason for occurrence of heart failure or hemodynamic changes in cirrhotic patients.

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The Effect of an Educational Plan Based on the Roy Adaptation Model for Fatigue and Activities of Daily Living of Patients with Heart Failure Disease

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v30i4.11 ◽

2020 ◽

Vol 30 (4) ◽

Author(s):

Mahdieh Abdolahi ◽

Mohammad Mahdi Doustmohamadi ◽

Hojjat Sheikhbardsiri

Keyword(s):

Heart Failure ◽

Intervention Group ◽

Nursing Intervention ◽

Daily Activities ◽

Control Group ◽

Roy Adaptation Model ◽

Educational Plan ◽

Significant Difference ◽

Patients With Heart Failure ◽

Adaptation Model

BACKGROUND: Cardiac failure is one of the most common chronic diseases with high rate of morbidity and mortality. Fatigue and decreased ability to perform daily activities are of the most common complications of this disease. The purpose of this study was to determine the effect of an educational plan based on Roy adaptation model on fatigue and daily activities in patients with heart failure.METHODS: This experimental study was performed on 60 heart failure patients admitted in two educational hospitals supervised by the Kerman University of Medical Sciences in 2019. Sample was randomly assigned into two intervention and control groups. The intervention group received the care plan through a face-toface and group training program in 6 sessions at one month. Interval followed by a follow-up period for 4 weeks later. Fatigue level was calculated based on piper fatigue scale, and daily activities were calculated by Barthes scale.RESULTS: The finding indicated that there was a significant difference between the two groups (control and intervention) after the intervention. The result showed that the intervention group had significantly lower mean scores in fatigue and higher mean scores in daily activities compared to the control group after intervention P ≤ .05. There was a significant relationship between fatigue and daily activities of life with frequency of hospitalization and duration of disease in both groups, P ≤ .05.CONCLUSION: Implementation of Roy model-based education program as a low-cost, effective, and non-aggressive nursing intervention can reduce fatigue, and improve daily activities in patients with heart failure.

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CORRELATION BETWEEN VAS OPRESSIN CONCENTRATION AND CHRONIC HEART FAILURE SEVE RITY: CHARAC TERISTICS OF PA TIENTS WITH TERMINAL AND DECOMPE NSA TED HEART FAILURE

The Clinician ◽

10.17650/1818-8338-2018-12-1-36-42 ◽

2018 ◽

Vol 12 (1) ◽

pp. 36-42

Author(s):

E. S. Trofimov ◽

A. S. Poskrebysheva ◽

N. А. Shostak

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Clinical Symptoms ◽

Left Ventricular ◽

Stage Iii ◽

Left Ventricular Ejection ◽

Control Group ◽

Ventricular Ejection Fraction ◽

Significant Difference ◽

Functional Classes

Objective: to evaluate vasopressin (VP) concentration in patients with varying severity of chronic heart failure (CHF), intensity of clinical symptoms, and decreased level of left ventricular ejection fraction (LVEF). Materials and methods. In total, 120 patients (44 males, 76 females) with CHF of varying genesis (mean age 72.12 ± 10.18 years) and 30 clinically healthy individuals (18 males, 12 females) as a control group (mean age 33.4 ± 6.23 years) were examined. All patients underwent comprehensive clinical and instrumental examination in accordance with the standards for patients with CHF. The VP level was determined using ELISA. Statistical analysis was performed using the IBM SPSS Statistics v. 23 software.Results. The patients with CHF had significantly higher blood VP levels compared to the control group (72.91 ± 53.9 pg/ml versus 6.6 ± 3.2 pg/ml respectively; p <0.01). At the same time, patients with stage III CHF had significantly lower VP levels than patients with stages IIВ and IIА (35.61 ± 21.53 pg/ml versus 71.67 ± 48.31 pg/ml and 86.73 ± 59.78 pg/ml respectively; p<0.01). A similar picture was observed for the functional classes (FC). For instance, for CHF FC II and III, the VP level was 91.93 ± 67.13 pg/ml and 77.95 ± 54.01 pg/ml respectively, while for FC IV it decreased to 50.49 ± 28.18 pg/ml (p <0.01). The VP concentration in patients who subsequently perished was significantly lower than in patients who survived (48.79 ± 26.30 pg/ml versus 79.72 ± 57.73 pg/ml; p = 0.012). Moreover, in patients with LVEF <50 %, the VP level was significantly lower than in patients with LVEF >50 % (59.43 ± 42.51 pg/ml versus 86.43 ± 62.46 pg/ml respectively; p <0.05).Conclusion. The observed significant differences in VP in patients with stage III and IV CFH can indicate depletion of neurohumoral mediators in this patient category. However, a correlation between the VP level and the level of LVEF decrease can indicate a significant difference in the role of VP in CHF pathogenesis in patients with preserved and decreased LVEF. This observation requires further research.

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Contractile protein phosphorylation predicts human heart disease phenotypes

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00957.2012 ◽

2013 ◽

Vol 304 (12) ◽

pp. H1644-H1650 ◽

Cited By ~ 12

Author(s):

Lori A. Walker ◽

David A. Fullerton ◽

Peter M. Buttrick

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Protein Phosphorylation ◽

Protein Phosphatase ◽

Human Heart ◽

Troponin I ◽

Systolic Function ◽

Left Ventricular ◽

Control Group ◽

Lv Function

Human heart failure has been associated with a low level of thin-filament protein phosphorylation and an increase in calcium sensitivity of contraction relative to both “control” human heart tissue and tissue from small animal models. However, diverse strategies of human tissue procurement and the reliance on tissue obtained from subjects with end-stage heart failure suggest this may be an incomplete characterization. Therefore, we evaluated cardiac left ventricular (LV) biopsy samples from patients with aortic stenosis undergoing valve replacement who presented either with LV hypertrophy and preserved systolic function (Hyp) or with LV dilation and reduced ejection fraction (Dil). In Hyp, total troponin I (TnI) phosphorylation was markedly increased and myosin light chain 2 (MLC2) phosphorylation was unchanged relative to a control group of patients with normal LV function. Conversely, in Dil, total TnI phosphorylation was significantly reduced compared with control subjects and MLC2 phosphorylation was increased. Site-specific analysis of TnI phosphorylation revealed phenotype-specific differences such that Hyp samples demonstrated significant increases in phosphorylation at serine 22/23 and Dil samples had significant decreases at serine 43. The ratio of phosphorylation at the two sites was biased toward serine 22/23 in Hyp and toward serine 43/45 in Dil. Western blot analysis showed that protein phosphatase-1 was reduced in Hyp and protein phosphatase-2 was reduced in Dil. These data suggest that posttranslational modifications of sarcomeric proteins, both singly and in combination, are stage specific. Defining these changes in progressive heart disease may provide important diagnostic and treatment information.

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Results of initial lymph node biopsy in homosexual men with generalized lymphadenopathy.

Journal of Clinical Oncology ◽

10.1200/jco.1986.4.2.165 ◽

1986 ◽

Vol 4 (2) ◽

pp. 165-169 ◽

Cited By ~ 9

Author(s):

A M Levine ◽

P R Meyer ◽

P S Gill ◽

R L Burkes ◽

M Krailo ◽

...

Keyword(s):

Lymph Node ◽

Laboratory Data ◽

Clinical Parameter ◽

Lymph Node Biopsy ◽

Homosexual Men ◽

Laboratory Findings ◽

Node Biopsy ◽

Significant Difference ◽

Generalized Lymphadenopathy ◽

Persistent Generalized Lymphadenopathy

Persistent, generalized lymphadenopathy (PGL) is considered part of the acquired immunodeficiency syndrome (AIDS)-related complex. The clinical course is usually benign, although some patients may evolve to AIDS. Characteristic features on lymph node biopsy have been described. Recently, large series of PGL have been reported in which many study patients have not undergone initial diagnostic biopsy. The value of such biopsy has been questioned. We report the clinical, pathologic, and laboratory findings in six homosexual men initially considered as potential candidates for study of the natural history of PGL. They were excluded by initial lymph node biopsy, which revealed small-cleaved lymphoma in two, focal Kaposi's sarcoma in two, disseminated mycobacterium tuberculosis in one, and histoplasma encapsulatum in one. The clinical and laboratory data from these six patients were compared with those from 34 patients with biopsy-proven PGL; no statistically significant difference in any prebiopsy clinical parameter was found. We conclude that initial lymph node biopsy may reveal changes other than reactive hyperplasia in homosexual men with generalized lymphadenopathy.

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