scholarly journals ASSOCIATION OF PATTERN OF MYOCARDIAL FIBROSIS WITH ADVANCED AND EARLY HEART FAILURE

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Chaman Lal Kaushal ◽  
Danquale Vance Kynshikhar ◽  
Anupam Jhobta ◽  
Dimple Kaushal
Keyword(s):  
Heart Failure ◽  
Myocardial Fibrosis ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Advanced Heart Failure ◽  
Left Ventricular Ejection ◽  
P Value ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Coronary Territory

Background: The cardiomyopathies are defined as “hetrogenous group of diseases of the myocardium associated with mechanical or electrical dysfunction that usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation and are due to variety of causes that frequently are genetic. They usually present clinically with heart failure. Methods: The cross sectional hospital based study was conducted in the Department of Radiodiagnosis in patients with heart failure with LVEF (Left Ventricular Ejection Fraction) of <45% without RWM(Regional Wall Motion)  abnormality on echocardiography evaluated in department of cardiology at IGMC, Shimla over a period of one year. Results: The myocardial fibrosis was seen in the 10 (47.62%) patients of advanced heart failure and 6(35.29%) patients of early heart failure with insignificant P value of 0.52 and odd ratio of 1.64.The subendocardial myocardial fibrosis in coronary territory was seen in the 3(14.29%) patients of advanced heart failure and 2(11.76%) patients of early heart failure with insignificant P value of 1.00 and odd ratio of 1.24. Conclusion: The association of pattern of myocardial fibrosis with advanced and early heart failure was found statistically Insignificants Keywords: MRI, Myocardial,  Heart failure.

scholarly journals PATTERN OF MYOCARDIAL FIBROSIS IN ISCHEMIC AND NON ISCHEMIC CARDIOMYOPATHY

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Chaman Lal Kaushal ◽  
Danquale Vance Kynshikhar ◽  
Anupam Jhobta ◽  
Dimple Kaushal
Keyword(s):  
Myocardial Fibrosis ◽  
Ischemic Cardiomyopathy ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
P Value ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Heterogenous Group ◽  
One Year

Background: The cardiomyopathies are defined as “heterogenous group of diseases of the myocardium associated with mechanical or electrical dysfunction that usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation and are due to variety of causes that frequently are genetic. Methods: The cross sectional hospital based study was conducted in the Department of Radiodiagnosis in patients with heart failure with LVEF (Left Ventricular Ejection Fraction) of <45% without RWM (Regional Wall Motion) abnormality on echocardiography evaluated in department of cardiology at IGMC, Shimla over a period of one year. Demographics: Demographics Overall Group Male Female Mean Age (year ) ± SD 53.86  ± 16.34  54.45  ± 19.41 53.94  ± 16.36 Gender (n) 38 17 (44.73%) 21(55.26%) Results: Myocardial fibrosis was seen in 4 (100%) patients of ischemic cardiomyopathy and 3 (18.75%) patients of non ischemic cardiomyopathy with significant P value of 0.01 and odd ratio of 1.67.  The subendocardial myocardial fibrosis was seen in 3 (75%) patients of ischemic cardiomyopathy while it was not seen in non ischemic cardiomyopathy with significant P value of < 0.01 and odd ratio of 3.59. Conclusion: Cardiac MRI has important role in dilated cardiomyopathies for distinguishing ischemic and non ischemic types as well as in evaluation of various etiological types. Keywords: MRI, Myocardial, Cardiomyopathies

scholarly journals Differences in the prognoses of patients referred to an advanced heart failure center from hospitals with different bed volumes

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Koichi Narita ◽  
Eisuke Amiya ◽  
Masaru Hatano ◽  
Junichi Ishida ◽  
Hisataka Maki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Outcome ◽  
Left Ventricular ◽  
Cox Proportional Hazards ◽  
Advanced Heart Failure ◽  
Ventricular Assist Devices ◽  
Left Ventricular Ejection ◽  
Left Ventricular Assist Devices ◽  
Ventricular Ejection Fraction

AbstractFew reports have discussed appropriate strategies for patient referrals to advanced heart failure (HF) centers with available left ventricular assist devices (LVADs). We examined the association between the characteristics and prognoses of referred patients with advanced HF and the bed volume of the referring hospitals. This retrospective analysis evaluated 186 patients with advanced HF referred to our center for consultation about the indication of LVAD between January 1, 2015, and August 31, 2018. We divided the patients into two groups according to the bed volume of their referring hospital (high bed volume hospitals (HBHs): ≥ 500 beds in the hospital; low bed volume hospitals (LBHs): < 500 beds). We compared the primary outcome measure, a composite of LVAD implantation and all-cause death, between the patients referred from HBHs and patients referred from LBHs. The 186 patients with advanced HF referred to our hospital, who were referred from 130 hospitals (87 from LBHs and 99 from HBHs), had a mean age of 43.0 ± 12.6 years and a median left ventricular ejection fraction of 22% [15–33%]. The median follow-up duration of the patients was 583 days (119–965 days), and the primary outcome occurred during follow-up in 42 patients (43%) in the HBH group and 20 patients (23%) in the LBH group. Patients referred from HBHs tended to require catecholamine infusion on transfer more often than those referred from LBLs (36.5% (HBH), 20.2% (LBL), P = 0.021). Kaplan–Meier analysis indicates that the occurrence of the primary outcome was significantly higher in the HBH patients than in the LBH patients (log-rank P = 0.0022). Multivariate Cox proportional hazards analysis revealed that catecholamine support on transfer and long disease duration were statistically significant predictors of the primary outcome. Patients from HBHs had a greater risk of the primary outcome. However, the multivariate analysis did not indicate an association between referral from an HBH and the primary outcome. In contrast, catecholamine support on transfer, long duration of disease, and low blood pressure were independent predictors of the primary outcome. Therefore, these should be considered when determining the timing of a referral to an advanced HF center, irrespective of the bed volume of the referring hospital.

GENECHOC study: genetic markers of arrhythmic risk in heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Anys ◽  
S Rigade ◽  
S Rigade ◽  
E Baron ◽  
E Baron ◽  
...  
Keyword(s):  
Heart Failure ◽  
Genetic Markers ◽  
Left Ventricular ◽  
European Ancestry ◽  
Left Ventricular Ejection ◽  
P Value ◽  
Funding Source ◽  
Ventricular Ejection Fraction ◽  
Cardioverter Defibrillator ◽  
Genome Wide

Abstract Background Ventricular arrhythmic events are responsible for 50% of death in heart failure but no reliable predictive marker is known to discriminate patients at risk of fatal arrhythmia. Interestingly, familial predisposition has been reported suggesting a role of genetic factors. Purpose Identify genetic markers increasing the arrhythmic risk in heart failure population. Method We prospectively included heart failure patients with left ventricular ejection fraction (LVEF) under 35% and a cardioverter defibrillator in primary prevention in 22 French centres between 2009 and 2017. Patients were followed for 72 months and divided into two groups: cases with an arrhythmic event during follow-up and controls. A Genome Wide Association Study (GWAS) was done. Single Nucleotide Polymorphisms (SNPs) genotyping was performed on Affymetrix Axiom Precision Medicine Research Array plates. To complement the directly genotyped SNPs we performed large-scale imputation based on the Haplotype Reference Consortium European ancestry panel leading to a dataset of 7,5 million of SNPs. Results 332 cases and 567 controls were included (86% men, mean age at implantation 52±11 years). 78% of patients had ischaemic cardiopathy, 20% had dilated cardiomyopathy. Mean LVEF was 27±5%. No statistical difference was found between cases and controls on clinical parameters, biological results, electrocardiographic measures. No locus shows genome-wide significant association (p&lt;5.10–8) on the GWAS analysis. However, 16 signals with a p-value between 5.10–8 and 5.10–5 were investigated. eQTL and chromatin conformation point to 35 genes with cardiac expression previously associated with heart failure, cardiomyopathies, cardiogenesis, arrhythmias and inflammation. Variants identified point to regulatory regions of the genome and may then propose a molecular mechanism predisposing patients to arrhythmias. Conclusion No locus raises genome-wide significance, but several signals with a nominal p-value point to relevant genes and pathways. Replication of the GWAS is ongoing on a cohort of 156 new patients with a less severe cardiopathy implanted with a cardioverter defibrillator in secondary prevention. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Nantes University Hospital

Maximal Dynamic Inspiratory Pressure Evaluation in Heart Failure: A Comprehensive Reliability and Agreement Study

2020 ◽  
Vol 100 (12) ◽  
pp. 2246-2253
Author(s):  
Fabiola M F da Silva ◽  
Gerson Cipriano ◽  
Alexandra C G B Lima ◽  
Joanlise M L Andrade ◽  
Eduardo Y Nakano ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intraclass Correlation ◽  
Left Ventricular ◽  
Inspiratory Muscle ◽  
Inspiratory Pressure ◽  
Peak Oxygen Consumption ◽  
Left Ventricular Ejection ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Index Measure

Abstract Objective The purpose of this study was to analyze the reliability (interrater and intrarater) and agreement (repeatability and reproducibility) properties of tapered flow resistive loading (TFRL) measures in patients with heart failure (HF). Methods For this cross-sectional study, participants were recruited from the cardiopulmonary rehabilitation program at the University of Brasilia from July 2015 to July 2016. All patients participated in the study, and 10 were randomly chosen for intrarater and interrater reliability testing. The 124 participants with HF (75% men) were 57.6 (SD = 1.81) years old and had a mean left ventricular ejection fraction of 38.9% (SD = 15%) and a peak oxygen consumption of 13.05 (SD = 5.3) mL·kg·min−1. The main outcome measures were the maximal inspiratory pressure (MIP) measured with a standard manovacuometer (SM) and the MIP and maximal dynamic inspiratory pressure (S-Index) obtained with TFRL. The S-Index reliability (interrater and intrarater) was examined by 2 evaluators, the S-Index repeatability was examined with 10 repetitions, and the reproducibility of the MIP and S-Index was measured with SM and TFRL, respectively. Results The reliability analysis revealed high S-Index interrater and intrarater reliability values (intraclass correlation coefficients [ICCs] of 0.89 [95% CI = 0.58–0.98] and 0.97 [95% CI = 0.89–0.99], respectively). Repeatability analyses revealed that 8 maneuvers were required to reach the maximum S-Index in 75.81% (95% CI = 68.27–83.34) of the population. The reproducibility of TFRL measures (S-Index = 68.8 [SD = 32.8] cm H2O; MIP = 66 [SD = 32.3] cm H2O) was slightly lower than that of the SM measurement (MIP = 70.1 [SD = 35.9] cm H2O). Conclusions The TFRL device provided a reliable intrarater and interrater S-Index measure in patients with HF and had acceptable repeatability, requiring 8 maneuvers to produce a stable S-Index measure. The reproducibilities of the S-Index, MIP obtained with SM, and MIP obtained with TRFL were similar. Impact TRFL is a feasible method to assess both MIP and the S-index as measures of inspiratory muscle strength in patients with HF and can be used for inspiratory muscle training, making the combined testing and training capabilities important in both clinical research and the management of patients with HF.

scholarly journals Quality of Life for Saudi Patients With Heart Failure: A Cross-Sectional Correlational Study

2015 ◽  
Vol 8 (3) ◽  
pp. 49 ◽  
Author(s):  
Mohannad Eid AbuRuz ◽  
Fawwaz Alaloul ◽  
Ahmed Saifan ◽  
Rami Masa'deh ◽  
Said Abusalem
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Saudi Arabia ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Patients With Heart Failure ◽  
Saudi Patients

<p><strong>INTRODUCTION:</strong> Heart failure is a major public health issue and a growing concern in developing countries, including Saudi Arabia. Most related research was conducted in Western cultures and may have limited applicability for individuals in Saudi Arabia. Thus, this study assesses the quality of life of Saudi patients with heart failure.</p> <p><strong>MATERIALS &amp; METHODS:</strong><em> </em>A cross-sectional correlational design was used on a convenient sample of 103 patients with heart failure. Data were collected using the Short Form-36 and the Medical Outcomes Study-Social Support Survey.</p> <p><strong>RESULTS:</strong> Overall, the patients’ scores were low for all domains of Quality of Life. The Physical Component Summary and Mental Component Summary mean scores and SDs were (36.7±12.4, 48.8±6.5) respectively, indicating poor Quality of Life. Left ventricular ejection fraction was the strongest predictor of both physical and mental summaries.</p> <p><strong>CONCLUSION:</strong> Identifying factors that impact quality of life for Saudi heart failure patients is important in identifying and meeting their physical and psychosocial needs.</p>

CRT operator challenges during procedure… tips and tricks

2021 ◽  
Vol 1 (58) ◽  
pp. 21-27
Author(s):  
Tomasz Wcisło ◽  
Haval Dariusz Qawoq
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Advanced Heart Failure ◽  
Cardiac Resynchronization ◽  
Left Ventricular Ejection ◽  
Left Ventricular Dyssynchrony ◽  
Tips And Tricks ◽  
Resynchronization Therapy ◽  
Ventricular Ejection Fraction ◽  
Ventricular Dyssynchrony

In addition to pharmacological treatment, cardiac resynchronization therapy is an important method of heart failure treating. It’s indicated for patients with advanced heart failure, decreased left ventricular ejection fraction, a wide QRS syndrome, and the presence of left ventricular dyssynchrony despite optimal pharmacotherapy. The procedure is technically difficult and laden with many possible complications. Based on our own experience, this paper presents management with one of the periprocedural complications – dissection of the coronary sinus.

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