scholarly journals The Prevalence of Left Ventricular Thrombus among Heart Failure Patients Admitted to Kuwait Teaching Hospital in Sana’a City between January 2014 -2017

2019 ◽  
pp. 30-35
Author(s):  
Alaghbari Khaled ◽  
Askar Faiza
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Teaching Hospital ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ischemic Heart ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Ventricular Thrombus

Background: Heart failure is a major Public Health problem due to its high morbidity and mortality rates .The Left Ventricular Thrombus (LVT) is more frequently seen in acute heart failure as a complication of Left Ventricular (LV) systolic dysfunction. Objectives: The objective of this study was to determine the prevalence of LVT and its outcome among Yemeni patients presented with heart failure to Kuwait teaching hospital in Sana’a. This cross sectional retrospective study made during the period of January 2014-January 2017 study for all patients admitted to the hospital with Heart Failure (HF). Results: During study period 1856 patients with cardiac diseases were admitted to the hospital. Of this 217 were in (F. Among patient which 61(28.1%) had LVT. The mean age of patient presented with LVT was 51 years ± 8.1 Most cases were male (90%) while only (10%), were females. Ischemic Heart Disease (IHD), Dilated Cardiac Myopathy (DCMP) and Hypertension, found to be an associated risk factors of LVT represented (51%, 34.2% and 34.2%) respectively. However 8 (13%) of patients with LVT had embolic complications. The mortality rate during hospitalization was 4 (6.6%). Conclusion: The Ischemic heart disease was the leading cause of left ventricular thrombus.

scholarly journals The Prevalence of Left Ventricular Thrombus among Heart Failure Patients Admitted to Kuwait Teaching Hospital in Sanaa City between January 2014 -2017

2019 ◽  
pp. 29-34
Author(s):  
Alaghbari Khaled ◽  
Askar Faiza
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Teaching Hospital ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ischemic Heart ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Ventricular Thrombus

Background: Heart failure is a major Public Health problem due to its high morbidity and mortality rates. The Left Ventricular Thrombus (LVT) is more frequently seen in acute heart failure as a complication of Left Ventricular (LV) systolic dysfunction. Objectives: The objective of this study was to determine the prevalence of LVT and its outcome among Yemeni patients presented with heart failure to Kuwait teaching hospital in Sanaa. This cross sectional retrospective study made during the period of January 2014-January 2017 study for all patients admitted to the hospital with Heart Failure (HF). Results: During study period 1856 patients with cardiac diseases were admitted to the hospital. Of this 217 were in (F. Among patient which 61(28.1%) had LVT. The mean age of patient presented with LVT was 51 years ± 8.1 Most cases were male (90%) while only (10%), were females. Ischemic Heart Disease (IHD), Dilated Cardiac Myopathy (DCMP) and Hypertension, found to be an associated risk factors of LVT represented (51%, 34.2% and 34.2%) respectively. However 8 (13%) of patients with LVT had embolic complications. The mortality rate during hospitalization was 4 (6.6%). Conclusion: The Ischemic heart disease was the leading cause of left ventricular thrombus.

scholarly journals Routine Revascularization Versus Initial Medical Therapy for Stable Ischemic Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (9) ◽  
pp. 841-857 ◽  
Author(s):  
Sripal Bangalore ◽  
David J. Maron ◽  
Gregg W. Stone ◽  
Judith S. Hochman
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Unstable Angina ◽  
Medical Therapy ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Cochrane Central Register ◽  
Stable Ischemic Heart Disease

Background: Revascularization is often performed in patients with stable ischemic heart disease. However, whether revascularization reduces death and other cardiovascular outcomes is uncertain. Methods: We conducted PUBMED/EMBASE/Cochrane Central Register of Controlled Trials searches for randomized trials comparing routine revascularization versus an initial conservative strategy in patients with stable ischemic heart disease. The primary outcome was death. Secondary outcomes were cardiovascular death, myocardial infarction (MI), heart failure, stroke, unstable angina, and freedom from angina. Trials were stratified by percent stent use and by percent statin use to evaluate outcomes in contemporary trials. Results: Fourteen randomized clinical trials that enrolled 14 877 patients followed up for a weighted mean of 4.5 years with 64 678 patient-years of follow-up fulfilled our inclusion criteria. Most trials enrolled patients with preserved left ventricular systolic function and low symptom burden, and excluded patients with left main disease. Revascularization compared with medical therapy alone was not associated with a reduced risk of death (relative risk [RR], 0.99 [95% CI, 0.90–1.09]). Trial sequential analysis showed that the cumulative z-curve crossed the futility boundary, indicating firm evidence for lack of a 10% or greater reduction in death. Revascularization was associated with a reduced nonprocedural MI (RR, 0.76 [95% CI, 0.67–0.85]) but also with increased procedural MI (RR, 2.48 [95% CI, 1.86–3.31]) with no difference in overall MI (RR, 0.93 [95% CI, 0.83–1.03]). A significant reduction in unstable angina (RR, 0.64 [95% CI, 0.45–0.92]) and increase in freedom from angina (RR, 1.10 [95% CI, 1.05–1.15]) was also observed with revascularization. There were no treatment-related differences in the risk of heart failure or stroke. Conclusions: In patients with stable ischemic heart disease, routine revascularization was not associated with improved survival but was associated with a lower risk of nonprocedural MI and unstable angina with greater freedom from angina at the expense of higher rates of procedural MI. Longer-term follow-up of trials is needed to assess whether reduction in these nonfatal spontaneous events improves long-term survival.

scholarly journals The Use of Selective Inhibitor of If-Channels Ivabradine in Patients with Ischemic Heart Disease, Heart Failure with High Heart Rate

Kardiologiia ◽  
2019 ◽  
Vol 59 (10) ◽  
pp. 60-65 ◽  
Author(s):  
Yu. N. Belenkov ◽  
I. S. Ilgisonis ◽  
Yu. I. Naymann ◽  
E. A. Privalova ◽  
A. V. Zhito
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
High Heart Rate ◽  
Ventricular Ejection Fraction

Ischemic heart disease (IHD) and chronic heart failure (CHF) belong to leading causes of death among patients with cardiovascular diseases (CVD). Modern medical approaches to the treatment of patients with CHF do not always provide a significant improvement in the quality of life, a decrease in the frequency of CHF exacerbations and hospitalizations, and an improvement of the long-term prognosis. According to the neurohumoral theory of IHD and CHF development, the blockade of the sympathoadrenal system with β-adrenoblockers (β-AB) is pathogenetically substantiated, and preparations of this group are recommended as one of the main classes of drugs for the treatment of patients with CHF. However, selection of heart rhythm slowing therapy in patients with CHF of ischemic genesis is often difficult due to the development of undesirable side effects of β-AB, intolerance and/or due to the presence of contraindications for their use. Randomized studies have shown that prescribing a combination of β-AB and If-channel blocker ivabradine for heart rate (HR) reduction or solely ivabradine when use of β-AB is impossible in complex CHF therapy, improves the left ventricle (LV) diastolic function, reducing mortality from CHF decompensation. However, the prognostic significance of the use of ivabradine in patients with CHF with preserved left ventricular ejection fraction of ischemic genesis with heart rate higher than 70 beats/min receiving maximum tolerated doses of β-AB remains not fully investigated.

scholarly journals The natural history of myocardial disease in dialysis patients.

1991 ◽  
Vol 2 (1) ◽  
pp. 2-12 ◽  
Author(s):  
P S Parfrey ◽  
J D Harnett ◽  
P E Barre
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Natural History ◽  
Ischemic Heart Disease ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Dialysis Patients

Among dialysis patients, only 23% have a normal echocardiogram, about 10% have recurrent or chronic congestive heart failure, and 17% have asymptomatic ischemic heart disease. The predisposing factors for congestive heart failure are dilated cardiomyopathy, hypertrophic hyperkinetic disease, and ischemic heart disease. Dilated cardiomyopathy, a disorder of systolic function, includes among its risk factors age, hyperparathyroidism, and smoking. Hypertrophic disease results in diastolic dysfunction, and its predictors include age, hypertension, aluminum accumulation, anemia, and, perhaps, hyperparathyroidism. Ischemic heart disease is due to the presence of coronary artery disease and also to nonatherosclerotic disease caused by the reduction in coronary vasodilator reserve and altered myocardial oxygen delivery and use. The clinical outcome of congestive heart failure is comparable to that of nonrenal patients with medically refractory heart failure. Left ventricular hypertrophy is an important independent determinant of survival. A subset have hyperkinetic disease with severe hypertrophy and have a bad survival, as low as 43% have a 2-yr survival after the first admission to hospital with cardiac failure. The prognosis for those with dilated cardiomyopathy is less severe but is worse than those with normal echocardiogram. The survival of patients with symptomatic ischemic heart disease was little different from that of patients without symptoms, suggesting that the underlying cardiomyopathies had an adverse impact on survival independent of ischemic disease. Much research needs to be undertaken on the risk factors, natural history, and therapy of the various types of cardiac disease prevalent in dialysis patients.

Abstract 11749: Prognostic Value of Left Ventricular Global Longitudinal Strain and Ejection Fraction in Patients With Non-ischemic and Ischemic Heart Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Tetsuari Onishi ◽  
Yasue Tsukishiro ◽  
Hiroya Kawai
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Ischemic Heart Disease ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Lv Function

Background: Both Left ventricular (LV) global longitudinal strain (GLS) and LV ejection fraction (LVEF) are useful parameters for assessment of LV function. The aim of this study is to confirm the prognostic value of them in patients with non-ischemic and ischemic heart disease. Methods: We studied 179 patients (DCM group: Age 61±15 years, 70 females, LVEF 33±9%) with non-ischemic dilated cardiomyopathy and heart failure symptom, and 97 patients (MI group: Age 66±13 years, 18 females, LVEF 45±7%) who were successfully treated with percutaneous coronary intervention for acute anteroseptal myocardial infarction. Echocardiography was used for LV GLS derived from 2D speckle-tracking method and LVEF with modified Simpson’s method. Outcome was assessed according to death and re-hospitalization with heart failure in the follow-up period. Results: 40 patients in DCM group and 10 patients in MI group experienced at least one event. In these 2 groups, significant differences in GLS and LVEF were found between patients with and without cardiac events (p<0.05). Kaplan-Meier analysis showed patients with worse GLS had an unfavorable outcome in both DCM and MI groups (p<0.05), but LVEF did not associated with outcome. Conclusion: LV GLS has the potential to predict the outcome with higher sensitivity than LVEF in patients with heart disease regardless of ischemic etiology.

scholarly journals The prevalence of left ventricular thrombus among patients with low ejection fraction by trans-thoracic echocardiography

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Nouradden Noman Aljaber ◽  
Zohoor Ali Mattash ◽  
Sultan Abdulwadoud Alshoabi ◽  
Fahad Hassan Alhazmi
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus ◽  
The Mean ◽  
Low Ejection Fraction

Background and objectives: Ejection fraction (EF) is a measurement of heart function that reflects the portion of pumped out blood from the filled left ventricle per each heartbeat. The current study aimed to investigate the prevalence of left ventricular thrombus in patients with EF lower than 35% by using Transthoracic Echocardiography (TTE). Methods: In this prospective study, 82 cardiac patients underwent TTE procedure in order to assess the presence of left ventricular thrombus (LVT) from January 1st to December 31st 2017 at the Military Cardiac Centre in Sana’a, Yemen. Results: Out of 82 patients enrolled in this study, the mean age was 49.13 ± 14.8 years and 87.8% were male. The mean of EF was 31.16% and LVT was found in 6.1%. The spontaneous contrast was seen in 25.6% of patients indicating strong relationship with low EF (p < 0.001). Among patients with low EF, ischemic heart disease (IHD) was identified in 50%, hypertension in 30.5%, diabetes mellitus (DM) type 2 in 23.2%, and hyperlipidemia 12.2%. Exactly 80% of LVT were detected in IHD patients with dilated cardiomyopathy (DCMP) and 80% of detected LVT were apical in site. Conclusion: Cardiac patients with low ejection fraction developed left ventricular thrombosis, and most of the affected patients were ischemic heart disease with dilated cardiomyopathy. Interestingly, spontaneous contrast was found high significantly in these patients, which may reflect the continuous process of thrombus formation. Abbreviations:EF: ejection fraction, ASE: American society of echocardiography, EACVI: European association of cardiovascular imaging, LV: left ventricle, LVEF: left ventricular ejection fraction, HFpEF: heart failure with preserved ejection fraction, HFrEF: heart failure with reduced ejection fraction, MI: myocardial infarction, DCMP: dilated cardiomyopathy, AF: atrial fibrillation, TTE: Transthoracic echocardiography, TEE: trans-esophageal echocardiography, RHD: rheumatic heart disease, HTN: hypertension, DM: diabetes mellitus, CHF: congestive heart failure, JVP: jugular venous pressure, CBC: complete blood count, LFT: liver function tests, RFT: renal function test, LVT: left ventricular thrombus, ECG: electrocardiography, LVT: left ventricular thrombus, EDV: end diastolic volume, ESV: end systolic volume, SPSS: statistical package for the social sciences, IBM: international business machines, SD: standard deviation. doi: https://doi.org/10.12669/pjms.36.4.1972 How to cite this:Aljaber NN, Mattash ZA, Alshoabi SA, Alhazmi FA. The prevalence of left ventricular thrombus among patients with low ejection fraction by trans-thoracic echocardiography. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1972 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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