scholarly journals Cardiovascular Biomarkers and Diastolic Dysfunction in Patients With Chronic Chagas Cardiomyopathy

2021 ◽  
Vol 8 ◽  
Author(s):  
Luis E. Echeverría ◽  
Sergio Alejandro Gómez-Ochoa ◽  
Lyda Z. Rojas ◽  
Karen Andrea García-Rueda ◽  
Pedro López-Aldana ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Troponin T ◽  
Global Longitudinal Strain ◽  
Doppler Imaging ◽  
Cross Sectional ◽  
Chagas Cardiomyopathy ◽  
Amino Terminal ◽  
Nyha Classification ◽  
Unit Increase ◽  
Cardiovascular Biomarkers

Background: Chronic Chagas Cardiomyopathy is a unique form of cardiomyopathy, with a significantly higher mortality risk than other heart failure etiologies. Diastolic dysfunction (DD) plays an important role in the prognosis of CCM; however, the value of serum biomarkers in identifying and stratifying DD has been poorly studied in this context. We aimed to analyze the correlation of six biochemical markers with diastolic function echocardiographic markers and DD diagnosis in patients with CCM.Methods: Cross-sectional study of 100 adults with different stages of CCM. Serum concentrations of amino-terminal pro-B type natriuretic peptide (NT-proBNP), galectin-3 (Gal-3), neutrophil gelatinase-associated lipocalin (NGAL), high-sensitivity troponin T (hs-cTnT), soluble (sST2), and cystatin-C (Cys-c) were measured. Tissue Doppler imaging was used to measure echocardiographic parameters indicating DD. Multivariate logistic regression models adjusted by age, sex, BMI, and NYHA classification were used to evaluate the association between the biomarkers and DD.Results: From the total patients included (55% male with a median age of 62 years), 38% had a preserved LVEF, but only 14% had a normal global longitudinal strain. Moreover, 64% had a diagnosis of diastolic dysfunction, with most of the patients showing a restrictive pattern (n = 28). The median levels of all biomarkers (except for sST2) were significantly higher in the group of patients with DD. Higher levels of natural log-transformed NTproBNP (per 1-unit increase, OR = 3.41, p < 0.001), Hs-cTnT (per 1-unit increase, OR = 3.24, p = 0.001), NGAL (per 1-unit increase, OR = 5.24, p =0.003), and Cys-C (per 1-unit increase, OR = 22.26, p = 0.008) were associated with increased odds of having diastolic dysfunction in the multivariate analyses. Finally, NT-proBNP had the highest AUC value (88.54) for discriminating DD presence.Conclusion: Cardiovascular biomarkers represent valuable tools for diastolic dysfunction assessment in the context of CCM. Additional studies focusing mainly on patients with HFpEF are required to validate the performance of these cardiovascular biomarkers in CCM, allowing for an optimal assessment of this unique population.

scholarly journals Highly active antiretroviral therapy and left ventricular diastolic function in children with human immunodeficiency virus infection

2019 ◽  
Vol 59 (3) ◽  
pp. 139-43
Author(s):  
Ni Made Ayu Agustini ◽  
Eka Gunawijaya ◽  
Ni Putu Venny Kartika Yantie ◽  
Ketut Dewi Kumara Wati ◽  
Komang Ayu Witarini ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Highly Active Antiretroviral Therapy ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Cross Sectional ◽  
Ventricular Diastolic Function ◽  
Highly Active

Background In the past, cardiovascular involvement did not seem to be a common complication of HIV, but in recent years it has been described more frequently. With the advent of highly active antiretroviral therapy (HAART), the symptoms of cardiac disease has changed, as the number of HIV-infected patients with abnormal diastolic parameters has increased significantly, often presenting as symptomatic rather than asymptomatic. Objective To analyze for a possible correlation between HAART duration and left ventricular diastolic function in HIV-infected children. Methods This cross-sectional study was conducted from December 2016 to December 2017 at the Cardiology and Allergy-Immunology Division/Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali. Subjects with HAART were collected using a consecutive sampling method. The following data were recorded for each subject: age, sex, current stage of HIV, CD4+ level, as well as HAART regimen and duration of use. Transthoracic echocardiography was performed for tissue doppler imaging (TDI) of diastolic function. Spearman’s test was used to analyze the strength of correlation based on normality test results. Results This study involved 53 subjects, 21 of whom had impaired diastolic function. There was no correlation between HAART duration and diastolic function in children with HIV infection (r= -0.03; P=0.82). Conclusion Diastolic dysfunction is found in children under HAART treatment, but there is no correlation between HAART treatment duration and diastolic dysfunction.

scholarly journals Cardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258622
Author(s):  
Luis E. Echeverría ◽  
Lyda Z. Rojas ◽  
Sergio Alejandro Gómez-Ochoa ◽  
Oscar L. Rueda-Ochoa ◽  
Cristian David Sosa-Vesga ◽  
...  
Keyword(s):  
Troponin T ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Cardiac Biomarkers ◽  
Ventricular Assist Devices ◽  
Composite Outcome ◽  
Left Ventricular Assist Devices ◽  
Chagas Cardiomyopathy ◽  
Amino Terminal ◽  
Increased Risk

Background Chronic Chagas Cardiomyopathy (CCM) is a unique form of cardiomyopathy compared to other etiologies of heart failure. In CCM, risk prediction based on biomarkers has not been well-studied. We assessed the prognostic value of a biomarker panel to predict a composite outcome (CO), including the need for heart transplantation, use of left ventricular assist devices, and mortality. Methods Prospective cohort study of 100 adults with different stages of CCM. Serum concentrations of amino-terminal pro-B type natriuretic peptide (NT-proBNP), galectin-3 (Gal-3), neutrophil gelatinase-associated lipocalin (NGAL), high sensitivity troponin T (hs-cTnT), soluble (sST2), and cystatin-C (Cys-c) were measured. Survival analyses were performed using Cox proportional hazard models. Results During a median follow-up of 52 months, the mortality rate was 20%, while the CO was observed in 25% of the patients. Four biomarkers (NT-proBNP, hs-cTnT, sST2, and Cys-C) were associated with the CO; concentrations of NT-proBNP and hs-cTnT were associated with the highest AUC (85.1 and 85.8, respectively). Combining these two biomarkers above their selected cut-off values significantly increased risk for the CO (HR 3.18; 95%CI 1.31–7.79). No events were reported in the patients in whom the two biomarkers were under the cut-off values, and when both levels were above cut-off values, the CO was observed in 60.71%. Conclusion The combination of NT-proBNP and hs-TnT above their selected cut-off values is associated with a 3-fold increase in the risk of the composite outcome among CCM patients. The use of cardiac biomarkers may improve prognostic evaluation of patients with CCM.

scholarly journals Diagnostic Thresholds for Pre–Diabetes Mellitus and Diabetes Mellitus and Subclinical Cardiac Disease in the General Population: Data From the ACE 1950 Study

2021 ◽  
Author(s):  
Peder L. Myhre ◽  
Magnus N. Lyngbakken ◽  
Trygve Berge ◽  
Ragnhild Røysland ◽  
Erika N. Aagaard ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiac Disease ◽  
Cardiac Troponin ◽  
Ventricular Remodeling ◽  
Troponin T ◽  
Left Ventricular Remodeling ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Cardiac Troponin T ◽  
Cardiovascular Biomarkers

Background Diabetes mellitus (DM) is associated with left ventricular remodeling and incident heart failure, but the association between glycated hemoglobin A1c (HbA1c) and subclinical cardiac disease is not established. We aimed to determine the associations between HbA1c and (1) echocardiographic measures of left ventricular structure and function, and (2) cardiovascular biomarkers: cardiac troponin T, NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), and CRP (C‐reactive protein). Methods and Results Participants (n=3688) born in 1950 from the population‐based ACE (Akershus Cardiac Examination) 1950 Study were classified as DM (HbA1c≥6.5% or self‐reported DM), pre‐DM (HbA1c 5.7%–6.5%), and no‐DM (HbA1c<5.7%). DM, pre‐DM, and no‐DM were classified in 380 (10%), 1630 (44%), and 1678 (46%) participants, respectively. Mean age was 63.9±0.7 years, mean body mass index was 27.2±4.4 kg/m 2 , and 49% were women. Higher HbA1c was associated with worse left ventricular systolic (ejection fraction and global longitudinal strain) and diastolic (E/e'‐ratio) function, myocardial injury (cardiac troponin T), inflammation (CRP), and impaired neurohormonal homeostasis (NT‐proBNP) ( P <0.001 in unadjusted and P <0.01 in adjusted analysis for all). The associations between HbA1c and cardiovascular biomarkers were independent of the echocardiographic variables, and vice versa. Associations were nonlinear ( P <0.05 for nonlinearity) and appeared stronger in the pre‐DM range of HbA1c than the no‐DM and DM range. Conclusions HbA1c was associated with indexes of subclinical cardiovascular disease, and this was more pronounced in pre‐DM. Our results suggest that cardiovascular preventive measures should be considered also in subjects with hyperglycemia and HbA1c below the established DM cutoff. Registration clinicaltrials.gov. Identifier: NCT01555411.

scholarly journals ASYMPTOMATIC DIABETICS

2016 ◽  
Vol 23 (11) ◽  
pp. 1373-1376
Author(s):  
Liaqat Ali ◽  
Naeem Asghar ◽  
Imran Khan
Keyword(s):  
Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Pulmonary Veins ◽  
Tissue Doppler ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Cross Sectional ◽  
Color Flow

Background: Diabetes mellitus (DM) is not only a significant independent riskfactor for developing of atherosclerotic ischemic heart disease or ventricular hypertrophy but itis also able to trigger a diabetic cardiomyopathy due to dysmetabolic processes resulting heartfailure. Cardiovascular complications are known to be the main cause of death and morbidity indiabetic patients. Objectives: How frequent is the diastolic dysfunction in asymptomatic diabetic?Study Design: Descriptive cross sectional. Setting: Echocardiography department FaisalabadInstitute of Cardiology Faisalabad. Patients were recruited from outpatient department ofFaisalabad institute of cardiology Faisalabad. Duration of Study: Six months from: 28-06-2015to 28-12-2015. Methodology: 200 patients were included in the study. Patient’s bio data wasrecorded and informed consent was taken. All echocardiographic studies were performed withVIVID-07 echo machine by the same operator. Detailed assessment of left ventricular systolicand diastolic function by using standard 2-dimensional, color flow Doppler and tissue Dopplerimaging (TDI) was done. Images were obtained in all patients. Each patient underwent leftventricular (LV) diastolic function assessment by conventional Doppler, tissue Doppler imaging(TDI). LV ejection fraction was calculated using conventional method. Blood flow velocities atmitral valve leaflets and pulmonary veins were recorded with averaged from 3 end-expiratorycycles at a sweep of 100 mm/s. This information was collected through a specially designedproforma by the author. Results: In our study, out of 200 cases, 52%(n=104) were between 50-55 years of age while 48%(n=96) were between 56-60 years of age, mean+sd was calculatedas 55.54+2.59 years, 49%(n=98) were male while 51%(n=102) were females, frequency ofdiastolic dysfunction in asymptomatic, normotensive patients with diabetes mellitus wasrecorded as 45.5%(n=91) while 54.5%(n=109) had no findings of the morbidity. Conclusion:We conclude that the frequency of diastolic dysfunction is quite high (45.5%) in asymptomaticdiabetics.

scholarly journals Comparison of cardiac dysfunction in thalassemia major patients using deferoxamine or deferiprone as an iron-chelating agent

2012 ◽  
Vol 52 (5) ◽  
pp. 272 ◽  
Author(s):  
Rosalina Josep ◽  
Pustika Amalia Wahidiiyat ◽  
Partini Trihono ◽  
Piprim Yanuarso
Keyword(s):  
Diastolic Dysfunction ◽  
Cardiac Dysfunction ◽  
Standard Dose ◽  
Systolic Dysfunction ◽  
Chelating Agent ◽  
Thalassemia Major ◽  
Iron Chelator ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Cross Sectional

Background In thalassemia major (TM) patients, major mortalityis due to cardiac hemosiderosis. Several types of iron chelatingagent available recently are given to overcome this problemObjective To compare cardiac dysfunction in thalassemia majorpatients who used subcutaneous deferoxamine (DFO) to thosewho used oral deferiprone (DFP) as an iron􀁆chelating agent.Methods This cross􀁆sectional study was held at the ThalassemiaCenter, Department of Child Health􀁆Cipto MangunkusumoHospital (DCH􀁆CMH), Jakarta. We included TM patients aged1O􀁆18 years Mth a mean pre􀁆transfused hemoglobin level of 2:.7g/dL in the prior year, and who had used DFO or DFP for atleast 1 year v.ith good compliance, at a standard dose of DFO at40-60 mg/kg/day for 5 days a week or DFP at 50-100 mg/kg/day.We excluded TM patients v.ith congenital heart disease or overtheart failure. Trans􀁆thoracal echocardiography was performed atthe Integrated Cardiac Service, CMH by a pediatric cardiologistusing the conventional method and tissue Doppler imaging (TD I)consecutively, and within 2 weeks of the subject's receiving apacked red blood cell (PREC) transfusion. The 57 TM subjectsconsisted of 19 DFO users and 38 DFP users.Results In our subjects, diastolic dysfunction was more commonlyseen than systolic dysfunction, especially moderate diastolicdysfunction. In the DFO group, diastolic dysfunction only wasdetected in 3/19 subjects, systolic dysfunction only in 1/19 subjects,and both diastolic and systolic dysfunction in 15/19 subjects. Noneof the DFO users had normal cardiac function. In the DFP group,diastolic dysfunction only was seen in 6/38 subjects, and bothdiastolic and systolic dysfunction in 30/38 subjects, while 2/38subjects had normal cardiac function.Conclusion Diastolic and/or systolic dysfunction was detected inthe majority of subjects, but with preserved global cardiac function.We found that cardiac dysfunction was not significantly different inthe two iron chelator groups. For all subjects, diastolic dysfunction was seen in 89% of cases, while systolic dysfunction was detectedin 77% of cases. [Paediatr Indones. 2012;52:272,9].

scholarly journals Association between myocardial mechanical dispersion and ventricular arrhythmogenicity in Chagas cardiomyopathy.

2021 ◽  
Author(s):  
Alda Cristina Alves de Azevedo ◽  
Marcio Vinicius Lins Barros ◽  
Lars Gunnar Klaboe ◽  
Thor Edvardsen ◽  
Henrique Silveira Costa ◽  
...  
Keyword(s):  
Longitudinal Strain ◽  
Univariate Analysis ◽  
Global Longitudinal Strain ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Chagas Cardiomyopathy ◽  
Mechanical Dispersion ◽  
Ventricular Extrasystoles ◽  
Peak Longitudinal Strain ◽  
Ventricular Tachycardias

Abstract Endemic Chagas diseaseis a major health concernin LatinAmerica. Ventricular arrhythmias (VA) is a hallmark of Chagas cardiomyopathy (ChC) associated with worse prognosis. To verify if there is an association between myocardial mechanical dispersion and ventricular arrhythmogenicity in CCM. This is a cross-sectional study involving 77 patients with CCM. Global longitudinal strain (GLS) and MD were evaluated by echocardiogram, derived from the speckle tracking technique. Myocardial MD was measured from the onset of the Q / R wave on electrocardiogram to the peak longitudinal strain in 16 segments of the left ventricle. Frequency and complexity of ventricular extrasystoles (VES) were assessed by dynamic electrocardiography. The density and complexity of VES and the presence of non-sustained ventricular tachycardias (NSVTs) increase as MD increases. In logistic regression, MD was the only variable associated with the presence of VES in pairs and bigeminy. In the univariate analysis, both MD and GLS were associated with the presence of NSVT (both, p < 0.01), and MD was independently associated with NSVT (OR 1.04, 95% CI: 1.004–1.201, p = 0.031). In Chagas cardiomyopathy, MD is associated with a higher density and complexity of ventricular extrasystoles, including NSVT.

P6249Markers of early myocardial damage in steinert's disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Z Kounka ◽  
B Roque Rodriguez ◽  
L E Lezcano Gort ◽  
M J Romero Castro ◽  
D A Chipayo Gonzales ◽  
...  
Keyword(s):  
Troponin T ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Myocardial Damage ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Pulsed Wave Doppler ◽  
Age Of Diagnosis ◽  
Steinert's Disease ◽  
Steinert’S Disease

Abstract Introduction Myotonic dystrophy type 1 (DM 1), also known as Steinert's disease (SD), is the most common muscular dystrophy in adults. It is characterized by multisystemic involvement and the cardiac affectation is the second leading cause of death after the respiratory one. Purpose The objective of our work was to study the cardiac involvement by transthoracic echocardiography (TTE) including systolic function, diastolic function and myocardial deformation with global longitudinal strain (GLS) by speckle tracking and trough biomarkers of myocardial damage with high-sensitive cardiac troponin T (hs-cTnT) and NT-proBNP. Methods 24 patients affected by SD were included. The TTE machine used has software to perform GLS with reference values: −20±2%. The normal values of hs-cTnT and NT-proBNP of our central laboratory are: <14 ng/L and 0–250 pg/ml, respectively. Results The mean age of patients was 52,08±12,14 years and the average age of diagnosis was 31,42 years. There was no gender predilection (12 women, 12 men). In the TTE 55% of patients had a GLS <−18% with a global average of −17,72±4,02%. The 50% of patients with LVEF >50% had a GLS <−18% and the 27,77% had a GLS between −18 and −20%. The diastolic dysfunction assessed by pulsed wave doppler and tissue doppler imaging was present in 26.82%. The 95,83% of the patients had levels of hs-cTnT≥14 ng/L with median of 34,93 ng/L (minimum 3,96 and maximum 429), however only 30,4% of these had values of NT-proBNP above 250 pg/ml with a median of 71,83 pg/ml (minimum 9,37 and maximum 8771). Conclusions According to our experience GLS and hs-cTnT could be markers of early myocardial damage in patients with SD. We therefore need to develop protocols for the follow-up including these markers in the usual cardiac assessment.

Lipophilic Statin Use and Suicidal Ideation in a Sample of Adults With Mood Disorders

Crisis ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 278-282 ◽  
Author(s):  
Karen M. Davison ◽  
Bonnie J. Kaplan
Keyword(s):  
Suicidal Ideation ◽  
Mood Disorders ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Symptom Scores ◽  
Unit Increase ◽  
Predominantly Female ◽  
Lipophilic Statin

Background: Mood disorders are associated with a high risk of suicide. Statin therapy has been implicated in this relationship. Aims: To further clarify reported associations between suicide and cholesterol in mental health conditions, we conducted an analysis of dietary, clinical, and suicidal ideation measures in community-living adults with mood disorders. Method: Data were used from a cross-sectional study of a randomly selected community-based sample (> 18 years; n = 97) with verified mood disorders. Dietary (e.g., fat, iron, vitamin intakes), clinical (e.g., current depression and mania symptoms, medications), and sociodemographic (age, sex, and income) measures were analyzed using bivariate statistics and Poisson regression with robust variance. Results: Participants were predominantly female (71.1%) with bipolar disorder (59.8%); almost one-third (28.9%) were taking lipophilic statins. The prevalence of suicidal ideation was more than 2.5 times in those taking statins, PR = 2.59, 95% CI 1.27–5.31, p < .05. The prevalence ratio for suicidal ideation was 1.10, 95% CI 1.06–1.15, p < .001, for each unit increase in mania symptom scores. No associations between suicidal ideation and dietary intake measures were identified. Conclusion: Individuals with mood disorders may be susceptible to neuropsychiatric effects of cholesterol-lowering drugs, which warrants further research.

A STUDY ON THE CORRELATION BETWEEN MORPHOLOGIC ANORMALIES AND LEFT VENTRICULAR DIASTOLIC FUNCTION IN DILATED CARDIO-MYOPATHY

2011 ◽  
pp. 137-144
Author(s):  
Thi Ngoc Ha Hoang ◽  
Anh Vu Nguyen ◽  
Minh Loi Hoang ◽  
Cuu Long Nguyen ◽  
Thi Thuy Hang Nguyen
Keyword(s):  
Pulmonary Artery ◽  
Dilated Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Pulmonary Arteries ◽  
Left Ventricular ◽  
University Hospital ◽  
Cross Sectional ◽  
X Ray ◽  
Key Words Dilated Cardiomyopathy

Purposes: Describe the morphological and diastolic function of left ventricular changes in the patients with dilated cardiomyopathy (DCM) on US, X-ray findings, and Evaluate the correlation between morphology and diastolic function of left ventricular. Materials and method: Cross sectional study from Dec 2009 to Aug 2010, on 39 patients with dilated cardiomyopathy were evaluated at the University Hospital of Hue College of Medical and Pharmaceutical. Results: 1. X-ray and US findings characteristics of DCM is significantly increased in diameter of L, H and mG; LVM, LVMI, LVDd and LAD. 2. The pression of pulmonary artery has been significantly increased with redistribution pulmonary arteries in 61.5% cases and 23.1% have reversed pulmonary artery distribution. 3. DCM have diastolic dysfunction in 100% patients, including severe disorders to 61.5%; the restrictive dysfunction has ratio E/A>2 and E/Em average was 23.89± 17.23. 4.The correlation between the morphology and function in DCM: the diameter of H and L on the X-ray, LAD and ratio LA/AO on US correlated with the level of diastolic dysfunction (p< 0.05). All three radiographic parameters on the radio standard (H, L, the index Cardio/Thoracic) and LVDd on US have negative correlated with EF and FS with p <0.05. Key words: dilated cardiomyopathy, diastolic dysfunction, cardiac tissue Doppler, reversed pulmonary artery distribution

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