Echocardiographic Evaluation of Cardiac Remodeling After Surgical Closure of Ventricular Septal Defect in Different Age Group

2017 ◽  
Vol 2 (2) ◽  
pp. 69-74
Author(s):  
Mohammad Aminullah ◽  
Fahmida Akter Rima ◽  
Asraful Hoque ◽  
Mokhlesur Rahman Sazal ◽  
Prodip Biswas ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Ejection Fraction ◽  
Cardiac Remodeling ◽  
Septal Defect ◽  
Left Ventricular ◽  
Age Group ◽  
Surgical Closure ◽  
Group A ◽  
Group B ◽  
Fractional Shortening

Background: Cardiac remodeling is important issue after surgical closure of ventricular septal defect.Objective: The purpose of the present study was to evaluate cardiac remodeling by echocardiography by measuring the ejection fraction, fractional shortening, left ventricular internal diameter during diastole (LVIDd) and left ventricular internal diameter during systole (LVIDs) after surgical closure of ventricular septal defect in different age group. Methodology: This prospective cohort studies was conducted in the Department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Dhaka. Patient with surgical closure of VSD were enrolled into this study purposively and were divided into 3 groups according to the age. In group A (n=10), patients were within the age group of 2.0 to 6.0 years; age of group B (n=8) patients were 6.1-18.0 years and the group C (n=6) aged range was 18.1-42.0 years. Echocardiographic variables such as ejection fraction, fractional shortening, LVIDd, LVIDs were taken preoperatively and at 1st and 3rd month of postoperative values. Result: A total number of 24 patients was recruited for this study. The mean ages of all groups were 12.60±12.09. After 1 month ejection fraction were decreased by 5.97%, 6.71% and 5.66% in group A, group B and group C respectively. After 3 months ejection fraction were increased by 6.13%, 5.13% and 5.14% in group A, group B and group C respectively. After 1 month fractional shortening were decreased by 13.55%, 9.30% and 9.09% in group A, group B and group C respectively. After 3 months fractional shortening were increased by 7.23%, 7.35% and 4.55% in group A, group B and group C respectively. After 1 month LVIDd were increased by 1.97%, 1.91% and 1.32% in group A, group B and group C respectively. After 3 months LVIDd were decreased by 10.84%, 9.89% and 7.34% in group A, group B and group C respectively. After 1 month LVIDs were increased by 2.19%, 2.86% and 1.98% in group A, group B and group C respectively. After 3 months LVIDs were decreased by 11.68%, 10.97% and 8.87% in group A, group B and group C respectively.Conclusion: Cardiac remodeling occurred after surgical closure of ventricular septal defect and remodeling were more significant in younger age group. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2):69-74

scholarly journals Detection of Cardiac Remolding After Surgical Closure of Ventricular Septal Defect in Children Less Than One Year

2019 ◽  
pp. 1-4
Author(s):  
Manal Mohamed Helmy Nabo ◽  
Keyword(s):  
Ventricular Septal Defect ◽  
Ejection Fraction ◽  
Cardiac Remodeling ◽  
Septal Defect ◽  
Left Ventricular ◽  
Internal Diameter ◽  
Surgical Closure ◽  
Group A ◽  
Group B ◽  
Fractional Shortening

Background: Cardiac remodeling is an important issue after surgical closure of ventricular septal defect (VSD). Objective: The purpose of the present study was to evaluate cardiac remodeling by echocardiography by measuring the ejection fraction, fractional shortening, left ventricular internal diameter in diastole (LVIDd) and left ventricular internal diameter in systole (LVIDs) after surgical closure of VSD defect in patients less than 1 year. Methodology: This study was conducted in the department of pediatric cardiology, Maternity and Children Hospital (MCH), El Madina El Menwara, Saudi Arebia. Patients were divided into 3 groups according to the age. All patients presented with isolated perimembreanous VSD (PM-VSD) who were surgically treated at the age less than1 year. This study population was divided into 3 groups as group A from (0- 3) months, group B from (3- 6) months and group C from 6 months to 1 year. Echocardiographic variables such as ejection fraction, fractional shortening, LVIDd and LVIDs were taken pre operative and one month post operative in all groups. The echocardiography was repeated three months post operative in group B and group C. Result: A total number of 100 patients were recruited for this study. All the above parameters were normal 1 month after VSD closure in group group A. However, in both group B and group C the follow up echocardiography was indicated. In both groups the time was needed to reach the normal vlues. Conclusion: Cardiac remodeling is an important indicator of the ability of the cardiomyocyte to be changed to the normal shape and dimension. There are many factors that affect the cardiac cell. The presence of preload or afterload causes can result in delay of remodeling. As long as the patient start to take medication for anti failure cause, the suspicion of remodeling will be delayed

scholarly journals Outcomes of Posterior Wall Thickness, Interventricular Septal Thickness and LA diameter after Surgical Closure of Ventricular Septal Defect in Different Age Group

2017 ◽  
Vol 12 (1) ◽  
pp. 12-16
Author(s):  
Md Aminullah ◽  
Swadesh Ranjan Sarker ◽  
Rakibul Hasan ◽  
Mahbubur Rahman ◽  
Rezwanul Hoque
Keyword(s):  
Ventricular Septal Defect ◽  
Wall Thickness ◽  
Septal Defect ◽  
Posterior Wall ◽  
Age Group ◽  
Surgical Closure ◽  
Septal Thickness ◽  
Posterior Wall Thickness ◽  
Group A ◽  
Group B

Background: Good outcome after surgical closure of ventricular septal defect is essential. Objective: The purpose of the present study was to see the improvement of posterior wall thickness, interventricular septal thickness and LA diameter after surgical closure of ventricular septal defect in different age group.Methodology: This prospective cohort studies was conducted in the Department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Dhaka. Patient with surgical closure of VSD were enrolled into this study purposively and were divided into 3 groups according to the age. In group A (n=10), patients were within the age group of 2.0 to 6.0 years; age of group B (n=8) patients were 6.1-18.0 years and the group C (n=6) ages range was 18.1-42.0 years. Echocardiographic variables such as posterior wall thickness, interventricular septal thickness and LA diameter were taken preoperatively and at 1st and 3rd month of postoperative values.Result: Totally 24 patients were recruited for this study. The mean age was 12.60±12.09. After 1 month posterior wall thickness was increased by 12.07%, 7.02% and 5.26% in group A, group B and group C respectively. After 3 months left ventricular posterior wall thickness was decreased by 36.21%, 29.78% and 17.58% in group A, group B and group C respectively. After 1 month interventricular septal thickness was increased by 3.51%, 8.86% and 9.22% in group A, group B and group C respectively. After 3 months interventricular septal thickness was decreased by 31.58%, 25.00% and 16.67% in group A, group B and group C respectively. After 1 month LA diameter was increased by 4.81%, 4.28% and 4.75% in group A, group B and group C respectively. After 3 months LA diameter was decreased by 15.93%, 12.84% and 5.96% in group A, group B and group C respectively.Conclusion: Cardiac remodeling occurred after surgical closure of ventricular septal defect and remodeling were more significant in younger age group.University Heart Journal Vol. 12, No. 1, January 2016; 12-16

scholarly journals Evaluation of Cardiac Remodeling After Surgical Closure of Atrial Septal Defect in Different Age Groups

2019 ◽  
Vol 8 (1-2) ◽  
pp. 48-52
Author(s):  
SMG Saklayen ◽  
Laila Akter Zahan ◽  
Jubayer Ahmad ◽  
Mohammad Armane Wadud ◽  
Tarana Fariah Monalisa ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Cardiac Remodeling ◽  
Septal Defect ◽  
Early Age ◽  
Age Group ◽  
Old Patients ◽  
Adult Age ◽  
Surgical Closure ◽  
Group A ◽  
Group B

Background & objective: Cardiac remodeling manifested clinically as changes in size, shape and function of the heart. The extent of remodeling depends on initial morphological changes. So the time at which the surgical correction of atrial septal defect (ASD) done is important. Apparently surgical outcome and remodeling is better at earlier age in comparison to adult age. The aim of this study was to find whether surgical correction of ASD is beneficial at younger age (up to 18 years) in comparison to adult age (above 18 years). Methods: This prospective cohort study was carried out on a total of 70 patients who underwent surgical closure of atrial septal defect over a period of twenty three months (23) months (from February 2013 to December 2014) in the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka. The recruited patients were divided into two groups – Group-A (comprised of ≤ 18 years old patients) and Group-B (comprised of >18 years old patients) 35 patients in each. Condition of the heart was evaluated preoperatively by echocardiography and the result was compared with postoperative echocardiographic findings at follow-ups after 1 and 3 months after surgery. Results: The comparison of echocardiographic parameters between baseline (preoperative) and those at 1 and 3 months after surgery in Group-A demonstrated that statistically significant remodeling occurred after 1st month (p < 0.001) and it further improved at 3 months. In Group-B the comparison of echo parameters between baseline and at 1 month revealed that all the parameters responded significantly indicating that remodeling occurred well after 1 month. But the same parameters when compared between baseline and at months after repair revealed insignificant differences in all the parameters, except PWT indicating that remodeling that occurred at month 1 regressed at 3 months interval. Cardiac remodeling occurred in both groups, but the degree of remodeling between patients of early age (Group-A) and late age (Group-B) revealed that ASD repair at early age responded well with respect to all the echocardiographic variables of remodeling. Conclusion: Cardiac remodeling occurs after surgical closure of atrial septal defect. But the degree of remodeling is better if the closure is done at earlier age (at or below 18 years). Ibrahim Card Med J 2018; 8 (1&2): 48-52

scholarly journals Insights on the left ventricular thrombus in patients with ischemic dilated cardiomyopathy

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Elsayed M. Mehana ◽  
Abeer M. Shawky ◽  
Heba S. Abdelrahman
Keyword(s):  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Left Ventricular Ejection ◽  
Myocardial Scarring ◽  
Ventricular Thrombus ◽  
Group A ◽  
Study Population ◽  
Group B

Abstract Background Left ventricular thrombus (LVT) formation represents a common complication of dilated cardiomyopathy (DCM). LVT is usually underestimated with transthoracic echocardiography (TTE) while cardiac magnetic resonance imaging (CMRI) is promising as an alternative imaging modality for cardiac thrombus detection. The study aims to compare TTE and CMRI in their ability to detect LVT, also, to assess the clinical and imaging parameters to determine variables that may predispose for thrombus formation. The study population includes seventy-six patients with ischemic DCM. They were divided into 2 groups based on the presence of LVT as detected by delayed-enhancement CMRI (DE-CMRI) [Group A included 20 patients with a LVT and Group B included 56 patients without]. Results All of the current study population had ischemic DCM with left ventricular ejection fraction (LVEF) < 50%. DE-CMR detected thrombus in 20 cases of the studied population that represented group A. From group A, conventional TTE detected LVT only in 8 and cine-CMR detected 13 cases out of the out of 20 cases. The ejection fraction of the left ventricle as measured by functional CMRI was significantly lower in group A (P = 0.045). Interestingly, the myocardial scarring in group A was seen significantly more extensive than in group B (the P value is < 0.00001), paralleling the increased prevalence of thrombus. Conclusions DE-CMRI provides superiority for the detection of LVT compared with standard TTE or cine-CMRI and the amount of myocardial scarring detected by DE-CMRI can be considered an independent marker for thrombus presence.

Clinical Efficacy of Immediate Rehabilitation Training after Coronary Artery Intervention in Patients with AMI

2021 ◽  
Vol 7 (5) ◽  
pp. 3087-3092
Author(s):  
Youlin Fu ◽  
Zhongming Yang ◽  
Chongrong Qiu
Keyword(s):  
Coronary Artery ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Daily Living ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Rehabilitation Training ◽  
Group A ◽  
Group B

This paper investigates the effect of rehabilitation training on the clinical outcome and prognosis of patients with acute myocardial infarction after coronary artery intervention. There was no significant difference in daily living ability score and left ventricular ejection fraction between group A before intervention (P>0.05). The score of daily living ability of group A was (76.58±3.27) significantly higher than that of group B after intervention (73.7). ±3.4) (P<0.05); left ventricular ejection fraction after intervention (55.75±4.4) was significantly higher than that of group B (52.41 ±4.19) (P<0.05); total satisfaction rate of patients in group A (93.02%) was significantly higher In group B (69.77%), the difference between the groups was statistically significant (P<0.05); the total incidence of adverse reactions and mortality in group A (11.63%, 2.33%) was significantly lower than that in group B (53.49%, 16.28%).), the difference was statistically significant (P < 0.05). In patients with acute myocardial infarction, after interventional coronary artery intervention, immediate intervention with rehabilitation training can improve left ventricular ejection fraction, improve daily living ability and nursing satisfaction, and reduce postoperative adverse reactions and death. Medical staff should be used reasonably in the clinic according to the actual situation of the patient.

Effect of warm-up on left ventricular response to sudden strenuous exercise

1982 ◽  
Vol 53 (2) ◽  
pp. 380-383 ◽  
Author(s):  
C. Foster ◽  
D. S. Dymond ◽  
J. Carpenter ◽  
D. H. Schmidt
Keyword(s):  
Blood Flow ◽  
Ejection Fraction ◽  
Myocardial Blood Flow ◽  
Left Ventricular ◽  
Strenuous Exercise ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Warm Up ◽  
Group A ◽  
Group B

Sudden strenuous exercise (SSE) has been shown to produce ischemic electrocardiographic (ECG) responses, abnormalities of myocardial blood flow, and decreases in left ventricular ejection fraction. Prior exercise taken as warm-up has been shown to ameliorate the ECG and myocardial blood flow abnormalities induced by SSE. The purpose of this study was to determine whether warm-up would normalize the responses of the left ventricular ejection fraction to SSE. Twenty healthy male volunteers performed SSE (400-W bicycle exercise) either with (group A, n = 10) or without (group B, n = 10) warm-up. Ejection fraction was measured using first-pass radionuclide angiography under control conditions and during SSE. During SSE ejection fraction decreased from control values in both group A (70.5 +/- 6.3 to 64.8 +/- 8.2%) and group B (70.3 +/- 10.1 to 57.7 +/- 7.7%), although ejection fraction was significantly higher during SSE in group A. The results are consistent with the hypothesis that the abnormal responses to SSE are attributable to subendocardial ischemia secondary to a delay in autoregulation of myocardial blood flow. However, the decrease in ejection fraction during SSE even following warm-up suggests that the mechanism for the abnormal response to SSE is more complicated than previously hypothesized.

scholarly journals Comparison of the clinical effect between the lower sternal incision and the left parasternal fourth intercostal incision in the transthoracic closure of ventricular septal defect

2020 ◽  
Author(s):  
Jun Ma ◽  
Wenlin Shangguan ◽  
Liang-wan Chen ◽  
Dong-Shan Liao
Keyword(s):  
Mechanical Ventilation ◽  
Ventricular Septal Defect ◽  
Clinical Effect ◽  
Septal Defect ◽  
Operation Time ◽  
Ventilation Time ◽  
Significant Difference ◽  
Group A ◽  
Mechanical Ventilation Time ◽  
Group B

Abstract Background: To analyze the clinical effect of two different ways of minimally invasive transthoracic closure in children with ventricular septal defect (VSD) Methods: From January 2015 to July 2019, 294 children with VSD were enrolled in the Fujian Medical University Union Hospital, who underwent VSD closure through the left sternal fourth intercostal incision (group A: n = 95) and the lower sternal incision (group B: n = 129) Results: The operation time, bleeding volume, postoperative mechanical ventilation time, postoperative ICU monitoring time, postoperative hospitalization time and complication rate in group A were significantly lower than those in group B (P < 0.05). There was no significant difference between the two groups in the operation success rate, mechanical ventilation time and total hospitalization cost (P > 0.05). Conclusion : The transthoracic closure of ventricular septal defect through the left sternal fourth intercostal incision is feasible, safe, cosmetic, and worth popularizing.

Abstract 15733: CD34 + Cell Therapy is Associated With Improved Right Ventricular Function in Heart Failure With Preserved Ejection Fraction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sabina Frljak ◽  
Gregor Poglajen ◽  
Gregor Zemljic ◽  
Andraz Cerar ◽  
Francois Haddad ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cell Therapy ◽  
Right Ventricular ◽  
Cell Transplantation ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Group A ◽  
Group B ◽  
Rv Function

Introduction: Right ventricular (RV) dysfunction is an important predictor of adverse prognosis in patients with heart failure with preserved ejection fraction (HFpEF). Hypothesis: We sought to investigate the effects of transendocardial CD34 + cell therapy on RV function in HFpEF patients. Methods: We enrolled 30 patients with HFpEF who underwent transendocardial CD34 + cell transplantation. At baseline, all patients received granulocyte-colony stimulating factor; cells were collected by apheresis and immunomagnetic selection and injected transendocardialy in the left ventricle targeting the areas of local diastolic dysfunction. Patients were followed for 6 months and changes in RV function were assessed by tricuspid annular plane systolic excursion (TAPSE), peak systolic velocity of tricuspid annulus (St), and fractional area change (FAC). Impaired RV function was defined as TAPSE<1.8 cm. Results: At baseline, RV function was impaired in 11 (37%, Group A), and preserved in 19 (63%, Group B) of patients. The groups did not differ in age (64±6 years in Group A vs. 61±11 years in Group B, P=0.37), gender (male: 82% vs. 74%, P=0.61), or left ventricular E/e' (17.7±2.3 vs. 17.3±3.4, P=0.74). Patients in Group A had lower LVEF (55.6±5.1% vs. 61.3±6.5% in Group B, P=0.02), and higher NTproBNP levels (1750±1139 pg/ml vs. 1038±658 pg/ml, P=0.05). At 6 months after cell transplantation we found an overall improvement in all parameters of RV function (TAPSE: +0.21±0.37 cm, P=0.01; St: +0.7±2.1 cm/s, P=0.03; FAC: +8.5±1.9%, P=0.02). However, RV function improvement was significant in Group A (TAPSE: +0.43±0.37 cm, P=0.004; St: +1.4±2.3 cm/s; P=0.01; FAC: +9.8±2.0%, P=0.01), but not in Group B (TAPSE: +0.04±0.27 cm, P=0.65; St: +0.4±1.3 cm/s, P=0.32; FAC: +7.1±3.7%, P=0.08). In both groups we found comparable changes in E/e' (-5.1±3.0 in Group A vs. -5.9±3.2 in Group B, P=0.53), LVEF (1.2±5.7% vs. 1.9±6.5%, P=0.45) and NTproBNP (-462±410 pg/ml vs. -390±398 pg/ml, P=0.64) at 6 months after cell transplantation. Conclusions: Transendocardial CD34 + cell therapy appears to be associated with improvement of right ventricular dysfunction in patients with HFpEF.

Left Ventricular Dysfunction after Closure of Large Patent Ductus Arteriosus

2005 ◽  
Vol 13 (1) ◽  
pp. 24-29 ◽  
Author(s):  
M Omar Galal ◽  
Mohamed Amin ◽  
Arif Hussein ◽  
Amjad Kouatli ◽  
Jameel Al-Ata ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Intervention Group ◽  
Left Ventricular ◽  
Left Ventricular Performance ◽  
Ventricular Performance ◽  
Group A ◽  
Group B ◽  
Patent Ductus

Changes in left ventricular dimensions and performance were studied in 43 patients after transcatheter occlusion or surgical ligation of patent ductus arteriosus. The patients were assigned to 2 groups based on their ductal diameter: ≥ 3.1 mm to group A ( n = 27) and ≤ 3 mm to group B ( n = 16). The mean age and weight of the groups were comparable. Before intervention, group A had a significantly larger mean left ventricular end-diastolic diameter than group B, while all patients had normal shortening fraction and ejection fraction. Within 1 month after intervention, left ventricular end-diastolic diameter showed a trend towards regression while shortening fraction and ejection fraction decreased significantly in group A. There were no significant changes in these parameters in group B. Between 1 and 6 months after intervention, left ventricular performance improved in most of the group A patients who were followed up. We conclude that closure of large ductus arteriosus in children leads to significant immediate deterioration of left ventricular performance, which appears to recover within a few months. Echocardiographic study before hospital discharge is recommended in these patients. Serious deterioration of ventricular performance after closure may warrant the use of angiotensin converting enzyme inhibitors.

The effects of surgically induced right bundle branch block on left ventricular function after closure of the ventricular septal defect

2008 ◽  
Vol 18 (4) ◽  
pp. 430-436 ◽  
Author(s):  
Thais A. L. Pedersen ◽  
Niels H. Andersen ◽  
Mette R. Knudsen ◽  
Thomas D. Christensen ◽  
Keld E. Sørensen ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Left Ventricular Function ◽  
Right Bundle Branch Block ◽  
Septal Defect ◽  
Left Ventricular ◽  
Surgical Correction ◽  
Control Group ◽  
Bundle Branch Block ◽  
Surgical Closure ◽  
Control Subjects

AbstractObjectiveTo determine the long-term significance of right bundle branch block on left ventricular systolic and diastolic function in children subsequent to surgical closure of ventricular septal defect.MethodsWe studied 26 children who underwent surgical closure of a ventricular septal defect 11 ± 2 years postoperatively by use of conventional and tissue Doppler echocardiography, comparing the findings to those obtained from a control group. Of those having surgical correction 14 had postoperative right bundle branch block.ResultsIrrespective of the presence of right bundle branch block, the peak systolic velocity of the mitral ring was lower in those undergoing surgical correction, with values of 5.2 ± 1.4 cm/s in those with right bundle branch block, 5.4 ± 1.2 cm/s in those without right bundle branch block after surgical correction, and 6.6 ± 1.0 cm/s in the control subjects (p < 0.01). In terms of diastolic function, the early septal velocity of transmitral inflow divided by the early diastolic mitral annular velocity was significantly higher in children with right bundle branch block, at 12 ± 3.0 cm/s compared to 8.4 ± 1.5 cm/s in the control subjects (p < 0.01), but not significantly higher in the children without right bundle branch block after correction compared to the control group. The fractional shortening percentage was similar in both patients and control subjects. The changes noted in left ventricular function were not significantly related to age at surgery, the period of follow-up, or the surgical method.ConclusionsSystolic long axis function is significantly reduced in children after surgical closure of ventricular septal defects, irrespective of the presence of right bundle branch block. Diastolic dysfunction, in contrast, was observed primarily in children with post-operative right bundle branch block.

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