scholarly journals Clinical and Echocardiographic Assessment of Patients with Dilated Cardiomyopathy

2022 ◽  
Vol 19 (1) ◽  
pp. 73-76
Author(s):  
Madhu Aryal
Keyword(s):  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Internal Diameter ◽  
Shortness Of Breath ◽  
Cross Sectional ◽  
Reduced Ejection Fraction ◽  
Medical College ◽  
Echocardiographic Findings

Introduction: Cardiomyopathy is the disorder of the heart muscles which can be dilated, hypertrophic or restrictive type. Dilated cardiomyopathy is caused by genetic and non-genetic causes but many of the causes are still not known. Echocardiography is an important imaging technique to diagnose and manage dilated cardiomyopathy. Aims: This study aims to assess the clinical and echocardiographic findings among patients with dilated cardiomyopathy. Methods: This is a cross-sectional, observational study conducted in Nepalgunj Medical College from January 2021 to June 2021. A total of 61 patients with dilated Cardiomyopathy were enrolled after obtaining written informed consent. Clinical examination and echocardiographic findings were recorded and data analysis was done using Statistical Package for Social Sciences. Results: The participants included 31 men and 30 women with dilated cardiomyopathy. The mean age of the participants was 58.49 + 15.46 years. The most common complaint was shortness of breath 84.5% and the most common clinical presentation was bilateral basal crepitation 98.4%. The patients mostly had diastolic left ventricle internal diameter of 5.5-6 cm and ejection fraction of 21-30%. Mitral regurgitation was observed among most 58(95.1%) of the patients. Conclusion: This study concludes that shortness of breath and bilateral basal crepitation are the most common presentation. Left ventricle dilation, reduced ejection fraction and mitral regurgitation are seen among majority of the patients.

scholarly journals Functional mitral regurgitation in dilated cardiomyopathy: clinical implications and prognosis

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
V Vallejo Garcia ◽  
D Gonzalez Calle ◽  
JC Castro Garay ◽  
M Garcia Monsalvo ◽  
J Borrego Rodriguez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Late Gadolinium Enhancement ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Medical Therapy ◽  
Cardiovascular Events ◽  
Functional Mitral Regurgitation ◽  
Gadolinium Enhancement

Abstract Funding Acknowledgements Type of funding sources: None. Dilated cardiomyopathy (DCM) is a complex myocardial disease, with a high burden of symptoms and decreased life expectancy. Mitral regurgitation (MR) is a frequent comorbid condition and it is thought that it deteriorates left ventricle (LV) volume and ejection fraction. Guideline directed medical therapy for heart failure improves myocardial function and decreases morbidity and mortality, and there is ongoing interest in the application of novel percutaneous techniques like mitral edge-to-edge repair or resynchronization therapy in order to decrease cardiovascular events (CVE).  Our objective was to analyze if MR is associated with late gadolinium enhancement (LGE), left ventricle (LV) or right ventricle (RV) dysfunction and cardiovascular events in patients with DCM. A retrospective, case control study was designed including 173 patients (mean age 60 years, 73% males, 36% dyslipemia, 30% diabetes, 20% hypertension, 8% current smokers) with diagnosis of DCM and cardiac magnetic resonance study in our center between 2014-2020 according to the latest European Society of Cardiology (ESC) definition and the latest updated position paper. Clinical data, use of guideline directed medical therapy and devices, cardiac imaging tests, mortality and CVE were collected and analyzed. Mitral regurgitation was calculated on CMR and was included if it was more than mild.  After a mean follow up of 18 months, 53 patients (30%) suffered a CVE (16% heart failure, 14% incident arrythmia, 0,5% stroke 8% death). Patients with MR (n= 48; 28%) had worse LV ejection fraction (-4,8% mean; p=,02), worse RV ejection fraction (-5,5% mean; p=,03), more hospitalizations due to heart failure (OR 1,78; p=,01), had a trend toward increased mortality although it was not statistically significant (p=,01) and a trend towards late gadolinium enhancement (p,13). There was no association with incident arrythmias (p=,5) or stroke (p=,9)  In multivariate analyses (log regression, multiple linear regression) MR was maintained as an independent predictor of worse RV ejection fraction (mean -3,9%; p=,03), and hospitalization for heart failure (OR 3,8; p=,043). There was also a trend toward increased mortality (p=,1) in our population. Figure.  In patients with DCM, MR is associated with decreased LV and RV ejection fraction, hospitalization due to heart failure and has a tendency to be associated with mortality. Specific treatment for mitral regurgitation, including percutaneous edge-to-edge repair or surgery according to current guidelines, might decrease the severity of MR in these patients and that could lead to an improved prognosis and less morbidity. Further studies should review the impact of an interventional strategy in mitral regurgitation in patients with DCM. Abstract Figure. Mitral regurgitation in DCM: prognosis.

scholarly journals Clinical and etiological profile of heart failure

2019 ◽  
Vol 6 (2) ◽  
pp. 439
Author(s):  
Bansari S. Mistry ◽  
Krupa Pathak ◽  
Smita K. Trivedi
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Valvular Heart Disease ◽  
Age Groups ◽  
Age Group ◽  
Cross Sectional ◽  
Reduced Ejection Fraction ◽  
Medical College ◽  
One Year

Background: The overall prevalence of heart failure (HF) is thought to be increasing, in part because current therapies for cardiac disorders such as myocardial infarction (MI), valvular heart disease and arrhythmias, are allowing patients to survive longer. Aims of the study were to know the presentation, causes, outcome of HF patients and to know the proportion of patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).Methods: This was a cross-sectional observational study of heart failure patients for duration of one year, admitted in medicine department of medical college and SSG hospital, Vadodara, Gujarat, India.Results: Males constituted more than half of patients; however, HFpEF was more common in females in all age groups. Majority of patients had HFrEF. Breathlessness was the common presenting symptom. Common aetiologies found were ischaemic heart disease (IHD), hypertension (HTN), diabetes mellitus (DM) and valvular heart disease. 50-64 year patients constituted the major age group. IHD and DM were more common in this age group. Rheumatic heart disease (RHD) was seen commonly in 20-34 year of age group. In-hospital mortality rate though low has not much changed and contributes significantly considering the prevalence.Conclusions: Like developing countries, IHD contributes a major portion of patients with HF with risk factors like DM and HTN. Though, the contribution from RHD still cannot be ignored. There is little decrease in mortality but considering prevalence the burden is still high.

scholarly journals COMPARISON OF EJECTION FRACTION AND END VOLUMES OF THE LEFT VENTRICLE AS INDICATORS OF THE SEVERITY OF HEART FAILURE

2019 ◽  
Vol 26 (3) ◽  
pp. 33-40
Author(s):  
Dinara Sh. Gazizova
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Pathological Condition ◽  
Severe Heart Failure ◽  
Volume Index ◽  
Stroke Index ◽  
Reduced Ejection Fraction

Aim. To demonstrate that the end volumes are indicative of the severity of the left ventricle pathological condition not only under preserved, but also under reduced ejection fraction. Material and methods. 32 patients with dilated cardiomyopathy and severe heart failure, as well as with complete monitor and computer and echocardiographic control were examined. Results. The sensitivity of the ejection fraction and end volumes to the severity of heart failure (stroke index from 15.3 to 57.2, average 29.5±1.6; ejection fraction from 16.5 to 48.0, average 27.4±127; heart rate from 52 tо 113, average 81.8±2.4) was established. It is shown that the percentage change (sensitivity) of the ejection fraction (55%) is much lower than that of the end diastolic volume index (190%) and that of the end systolic volume index (438%) to the severity of heart failure. Conclusion. Indices of end-diastolic and end-systolic volumes of critical patients with dilated cardiomyopathy are more sensitive to the severity of heart failure than the ejection fraction. It is advisable to use end volumes as indicators of heart failure. An adequate quantitative assessment of the severity of heart failure should include the heart rate (duration of the cardiac cycle T).

Inter-Basal and Septal Connections of Papillary Muscles - An Anatomical Rationale for Rhythmic Opening of AV Valves - A Multicentric Medical College Based Cross Sectional Study

2021 ◽  
Vol 8 (31) ◽  
pp. 2865-2869
Author(s):  
Praveen Mulki Shenoy ◽  
Amith Ramos ◽  
Narasimha Pai ◽  
Bharath Shetty ◽  
Aravind Pallipady Rao
Keyword(s):  
Left Ventricle ◽  
Papillary Muscle ◽  
Interventricular Septum ◽  
Cross Sectional Study ◽  
Papillary Muscles ◽  
Cross Sectional ◽  
Medical College ◽  
Moderator Band ◽  
Almost All ◽  
And Function

BACKGROUND The papillary muscle basal connections have significant clinical implications. Variety of studies done on its morphology and function by various specialists in different departments. A close look on these revealed the interconnections of papillary muscles to one another and to the interventricular septum of both ventricles is related to uncoordinated contractions of papillary muscles, leading to hyper or hypokinesia or prolapse or even its rupture. METHODS Our study done in 25 formalin soaked hearts revealed after the deep and meticulous dissection, reflecting the walls of ventricles laterally the numerous interconnections of papillary muscles at its bases and IVS. Ventricles are opened by inverted ‘L’ shaped incision and its reflected more laterally till all the papillary muscles is visible in one frame after incising the moderator band. The connections were noted, measured, photographed, tabulated, compared with similar studies and analysed with experts with respective fields. RESULTS Almost all the specimens did have the interconnections. Further the post mortem findings of the cardiac related deaths with involvement of papillary muscles suggest damage to such ‘bridges’. The moderator band extensions to the base of right APM, and its extension to the posterior groups is noted in all the specimens. The bridge from the IVS to bases of both the groups of papillary muscles is noted in left ventricle. In90% of specimens the one PPM is found to be loosely connected, more so in left ventricle. CONCLUSIONS We are of a conclusion that such basal interconnections and to the interventricular septum are responsible for rhythmic contractions of papillary muscles of both ventricles. Since the AV valves have to open simultaneously, interconnections becomes mandatory as the impulse has to reach it before it reaches the trabeculae carniae. One of the Posterior papillary muscles is loosely connected to other papillary muscles, may be the reason for its rupture, more so in left ventricle. KEYWORDS Papillary Muscle, Interbasal Connection, Moderator Band, Valvular Prolapse, AV Valves

scholarly journals Diagnostic Value of Left Ventricular Early Inflow-Outflow Index in Determining Severity of Mitral Regurgitation

2017 ◽  
pp. 64-71
Author(s):  
Vera Yulia ◽  
Mefri Yanni ◽  
Didik Hariyanto
Keyword(s):  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Diagnostic Value ◽  
Geometric Error ◽  
Left Ventricular ◽  
Cross Sectional ◽  
Spectral Doppler ◽  
Common Etiology ◽  
Cross Sectional Design ◽  
Sensitivity Specificity

Background: Determining severity of mitral regurgitation (MR) is very important, asit is related with prognosis and management of the disease. Currently, there is no goldstandard exists for quantification of MR severity using echocardiography. AmericanSociety of Echocardiography (ASE) guidelines recommend several parameters basedon integrative criteria using color and spectral Doppler and anatomic measurement.Left Ventricular Early Inflow Outflow Index (LVEIO Index) was proposed as one parameterto assess the severity of MR by omitting geometric error from regurgitantvolume method. Thus, LVEIO index offers a simple, easy and accurate measurementin determining severity of MR.Methods: This study was a diagnostic test research with cross-sectional design. Thesubjects were all patients with organic mitral regurgitation who underwent echocardiographyexamination to measure severity of MR using the LVEIO index as well asother parameters measurements based on parameters of ASE guidelines. Diagnostictest was used to determine the sensitivity, specificity, positive predictive value, negativepredictive value and accuracy of LVEIO index.Results: Of 49 patients in this study, 23 of them have severe MR and 26 are non-severeMR patients. The proportion of gender between two groups almost similar with an agerange from 56 to 61 years and the most common etiology finding was degenerative MR.Echocardiography examination showed the ejection fraction in severe MR was 63±4.2%and 64±3.9% in non-severe MR. The value of LAVI, MPAP, E-wave, VC, EROA andLVEIO index increased parallel with severity of MR (LAVI; 67±18.2 vs. 40±14.2 ml/m2,MPAP; 28±12.8 vs. 20±12.6 mmHg, E-wave 1.5±0.3 vs. 1±0.2 m/s, VC 0.8±0.3 vs.0.5±0.1 cm, EROA 0.4±0.1 vs 0,2±0,1cm2, LVEIO 9±2,4 vs. 5±1,8). The sensitivity,specificity, and accuracy of LVEIO index for diagnosis of severe MR were 86%, 84%,and 89%, respectively.Conclusion: LVEIO can be proposed as a relatively simple, easy and accurate methodin determining severity of MR.

scholarly journals EPIDEMILOGICAL, CLINICAL AND ECHOCARDIOGRAPHIC FEATURES OF HEART FAILURE IN MOROCCO

2021 ◽  
Vol 9 (11) ◽  
pp. 521-526
Author(s):  
A. Maliki Alaoui ◽  
◽  
Y. Fihri ◽  
A. Ben El Mekki ◽  
H. Bouzelmat ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Cross Sectional ◽  
Reduced Ejection Fraction ◽  
Cardiology Department ◽  
Common Risk Factors ◽  
The Mean

Heart failure (HF) is a major public issue taking an epidemic dimension globally. Its incidence is continuing to rise because of a growing and aging population. We held a cross-sectional retrospective studyin the cardiology department of Mohamed V military teaching hospital of Rabat in morocco fromSeptember 2019 toSeptember 2021, including 104 patients admitted with HF. The mean age was 68.5 ±10.3year. Hypertension and diabetes mellitus are the most common risk factors. HF with reduced ejection fraction represents about 49%. Forty-four percent had dilated cardiomyopathy. Ischemic heart disease is the first cause of HF.

scholarly journals An Echocardiographic Evaluation of Dilated Cardiomyopathy in a Tertiary Care Hospital

2019 ◽  
Vol 57 (215) ◽  
Author(s):  
Raj Kumar Thapa ◽  
Kanchan K.C ◽  
Rishi Khatri ◽  
Devendra Khatri ◽  
Rajeeb Kumar Deo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Tertiary Care ◽  
Left Ventricular ◽  
Care Hospital ◽  
Echocardiographic Evaluation ◽  
Significant Difference

Introduction: Cardiomyopathies are diseases of heart muscle that may originate from genetic defects, cardiac myocyte injury or infiltration of myocardial tissues. Dilated cardiomyopathy is the most common phenotype and is often a final common pathway of numerous cardiac insults. Mostly it remains unknown in the absence of echocardiography, histopathology and genetic evaluation. Though common it is underdiagnosed with not much of data available in our setup.Methods: This study was analytical cross-sectional study of hospital data on Echocardiographic findings in 65 patients of DCM visiting cardiology unit for Echocardiographic evaluation from 1st of February to 31st July 2018 for the period of six months in Shree Birendra Hospital, a tertiary care military hospital at Chhauni, Kathmandu. Pediatric age group patients and those who refused to give consent were excluded. Data obtained were entered in Microsoft Excel 2010 and analyzed by IBM SPSS 21.Results: Among 65 patients enrolled 40 (61%) were male and 25 (39%) female with male to female ratio of 1.6:1. Elderly people (61-75 years) with an average age of 65 were commonly involved and they presented mostly with congestive heart failure, 32 (49%). Echocardiographic evaluation showed 36 (55%) with mildly dilated Left Ventricle (5.6-6.0cm). Majority had reduced Left ventricular systolic function with an average Ejection fraction (EF) of 39.6%. No significant difference between male and female with the average EF% (P=0.990) and there was no significant relation between age and average EF% (P=0.091).Conclusions: Dilated Cardiomyopathy is the commonest cardiomyopathy phenotype mostly presenting with congestive heart failure. It is often underdiagnosed in our part of the world, however echocardiography will easily detect the condition. Keywords: dilated cardiomyopathy; echocardiography; ejection fraction; left ventricle.

scholarly journals Dilated Cardiomyopathy in Children and Adults: What is New?

2008 ◽  
Vol 8 ◽  
pp. 762-775 ◽  
Author(s):  
Galal E. Nagib Elkilany ◽  
Mustafa A. AL-Qbandi ◽  
Khaled A. Sayed ◽  
Ibrahim Kabbash
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Left Ventricular Ejection ◽  
Global Strain ◽  
Independent Risk Factors

Dilated cardiomyopathy (DCM) is the most common form of cardiomyopathy and cause of cardiac transplantation in children and young adults; mortality is high among this patient population. However, mortality, clinical course, and illustrative echocardiographic data of DCM in children and adults are not well established. Our objective was to provide a research article of detailed descriptions of the incidence, causes, outcomes, related risk factors, and new echocardiographic criteria of risk of death from DCM. Our results showed that independent risk factors at DCM diagnosis for subsequent death or transplantation in children cohorts were older age, congestive heart failure, lower left ventricular ejection fraction (EF ≤ 25%), low global strain, significant mitral valve incompetence, pulmonary hypertension, diastolic dysfunction, right ventricular involvement, and cause of DCM (p< 0.001 for all). In adults, low ejection fraction (<30–35%), global peak systolic strain <-7.6%, increased EDV, ESV, LBBB, diastolic dysfunction, and left ventricle dyssynchrony were the main independent risk factors for major cardiac events and need for CRT or transplantation (p< 0.001 for all). Our conclusions were that in children and adults, DCM is a diverse disorder with outcomes that depend largely on cause, age, heart failure status at presentation, and echocardiographic parameters of the heart (systolic and diastolic function of left ventricle, pulmonary artery pressure, global strain, and valvular function of the mitral valve). This study will present new findings in the diagnostic area.

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