scholarly journals MICA and KIR: Immunogenetic Factors Influencing Left Ventricular Systolic Dysfunction and Digestive Clinical Form of Chronic Chagas Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Christiane Maria Ayo ◽  
Reinaldo Bulgarelli Bestetti ◽  
Eumildo de Campos Junior ◽  
Luiz Sérgio Ronchi ◽  
Aldenis Albaneze Borim ◽  
...  

Tissue damage observed in the clinical forms of chronic symptomatic Chagas disease seems to have a close relationship with the intensity of the inflammatory process. The objective of this study was to investigate whether the MICA (MHC class I-related chain A) and KIR (killer cell immunoglobulin-like receptors) polymorphisms are associated with the cardiac and digestive clinical forms of chronic Chagas disease. Possible influence of these genes polymorphisms on the left ventricular systolic dysfunction (LVSD) in patients with chronic Chagas heart disease was also evaluated. This study enrolled 185 patients with positive serology for Trypanosoma cruzi classified according to the clinical form of the disease: cardiac (n=107) and digestive (n=78). Subsequently, patients with the cardiac form of the disease were sub-classified as with LVSD (n=52) and without LVSD (n=55). A control group was formed of 110 healthy individuals. Genotyping was performed by polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP). Statistical analyzes were carried out using the Chi-square test and odds ratio with 95% confidence interval was also calculated to evaluate the risk association. MICA-129 allele with high affinity for the NKG2D receptor was associated to the LVSD in patients with CCHD. The haplotype MICA*008~HLA-C*06 and the KIR2DS2-/KIR2DL2-/KIR2DL3+/C1+ combination were associated to the digestive clinical form of the disease. Our data showed that the MICA and KIR polymorphisms may exert a role in the LVSD of cardiac patients, and in digestive form of Chagas disease.

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Gaosheng Zhou ◽  
Lijun Ye ◽  
Liang Zhang ◽  
Liangqing Zhang ◽  
Yuanli Zhang ◽  
...  

Objective. To investigate the correlation between TREM-1 and LPS-induced left ventricular systolic dysfunction in BALB/c mice.Methods. Male BALB/c mice were randomly divided into 3 groups: LPS, LPS/TREM-1, and control groups which were injected intraperitoneally with 25 mg/kg LPS, 5 μg TREM-1mAb 1 h after LPS challenge, and sterilized normal saline, respectively. Left ventricular systolic function was monitored by echocardiography at 6 h, 12 h, and 24 h. Meanwhile, TNF-α, IL-1β, and sTREM-1 in serum and myocardium were determined by ELISA or real-time PCR; at last left ventricles were taken for light microscopy examination.Results. FS and EF in LPS/mAbTREM-1 group, significantly declined compared with LPS and control group at 12 h, were accompanied with a markedly increase in serum IL-1β(at 6 h) and sTREM-1 (at 12 h and 24 h) expression. Myocardium TNF-α(at 6 h and 24 h) and sTREM-1 (at 6 h) were significantly higher in LPS/mAbTrem-1-treated mice than in time-matched LPS-treated mice; meanwhile myocardium TNF-αmRNA were markedly increased in comparison with LPS-treated or saline-treated mice at 24 h. Besides, mAbTREM-1 aggravated LPS-induced myocardial damage was observed.Conclusions. Our results suggest that TREM-1 is significantly associated with LPS-induced left ventricular systolic dysfunction in BALB/c mice.


2021 ◽  
Vol 14 (3) ◽  
Author(s):  
A Alavi ◽  
S Kenzhaev ◽  
I Kakharov

Objective: to study the effect of prehospital thrombolysis on left ventricular systolic dysfunction in patients with acute ST-segment elevation coronary syndrome.Material and methods: The study included 70 patients with acute coronary syndrome with ST-segment elevation. Patients were randomized into two groups: control (group A) - 35 patients receiving standard therapy, and hospital TLT. Group B included 35 patients who underwent standard therapy and prehospital TLT. All 70 patients underwent echocardiography 1 day after myocardial revascularization and 3 months later.Results: the use of early myocardial reperfusion in patients with STEMI had a positive effect on central hemodynamics, reduced the development of LV volume overload, as a result of which end-diastolic and systolic volumes did not change during 3 months of follow-up. LVEF grew in both groups, and its growth was more pronounced in group B.Conclusion: timely prehospital reperfusion reduces the severity of myocardial damage and thus prevents the development of severe systolic myocardial dysfunction LV.


Author(s):  
Farhana Yasmin ◽  
Shireen Afroz

Background: Patients with Chronic Kidney Disease (CKD) are at significantly increased risk for both morbidity and mortality from cardiovascular disease (CVD). Determining the spectrum of echocardiographic abnormalities in these patients can help in reduction of morbidity and mortality from CKD. Materials and Methods: This cross-sectional study was held on department of Pediatric Nephrology, Dhaka Shishu Hospital, Dhaka, during July 2018 to December 2018 (Six months). A total of thirty-six children with chronic kidney disease with creatinine clearance <60ml/min/1.73 m2 and age ranged from 2 to 16 years on supportive treatment and hemodialysis were included. In control group equal number of age and sex matched healthy children without any preexisting renal or cardiovascular diseases were included. Both study group and control group were assessed for cardiovascular findings by echocardiography. Results: The mean age was 9.09±3.01 years (mean±SD) in case group and 7.85±3.69 years (mean±SD) in control group. Regarding sex, 22 patients (61.1%) in the case group were male and 14 (38.9%) were female.  In this study, in CKD patients significant (p<0.001) difference was observed in following cardiac parameters, left ventricular end diastolic diameter (LVEDD) (38.34 vs 34.52), left ventricular end systolic diameter LVESD (26.64 vs 20.75), interventricular septal thickness (IVS) (9.34 vs 7.27), left ventricular posterior wall thickness (LVPWT) (8.36 vs 7.46), ejection fraction (EF) (56.68% vs 70.36%), fractional shortening (FS) (31.88% vs 38.30%) and peak early diastole velocity/peak atrial filling velocity (E/A ratio) (1.15 vs 1.45) when compared to control group. Most common cardiac abnormality in children with chronic kidney disease were left ventricular systolic dysfunction (44.4%), mild pulmonary hypertension (30.6%) and left atrial dilatation (27. 8%). Conclusion: Left ventricular systolic dysfunction was the commonest echocardiographic findings in CKD children. There was also significant difference in diastolic function between study and control group.


2021 ◽  
Vol 19 (3) ◽  
pp. 81-85
Author(s):  
Varsha Sapehia ◽  

Background: Gold standard surgical treatment for gallstone disease is Laparoscopic cholecystectomy. Over the years surgical skills have been improved and also there is better understanding of pneumoperitoneum3 Pneumoperitoneum stimulate a neuro-hormonal stress response which lead to increases heart rate, mean arterial blood pressure and systemic vascular resistance. Present study was designed to study the effect of pneumoperitoneum on hemodynamic parameters and cardiac function in patients undergoing laparoscopic cholecystectomy with and without cardiac disease. Material and Methods: Present study was prospective, comparative study, conducted in department of anaesthesiology. Study group was patients 18-65 years age, with echocardiographic findings consistent with presence of moderate to severe left ventricular systolic dysfunction, planned for laparoscopic cholecystectomy, Consented for participation, while control group was patients 18-65 years age, with normal echocardiographic finding, planned for laparoscopic cholecystectomy, Consented for participation. Results: Total 30 patients were enrolled in this prospective trial; 15 in each group. (Study and control group). The mean age of patients are 55.6 years and 36.6 years in study and control group, respectively and difference was statistically significant. Sex distribution: In control group, male: female distribution is 1:1.2; while in the study group, male: female distribution is 1:4, and difference was statistically significant. On intragroup statistical analysis, in the control group a statistically significant fall in HR is noticed at T2 and T4 from T1. Conclusion: Present study showed that laparoscopic cholecystectomy may be safely done in cardiac patients with moderate to severe left ventricular systolic dysfunction patients under the supervision of an experienced consultant anaesthesiologist.


2021 ◽  
Vol 15 (12) ◽  
pp. e0009974
Author(s):  
Bruno Oliveira de Figueiredo Brito ◽  
Zachi I. Attia ◽  
Larissa Natany A. Martins ◽  
Pablo Perel ◽  
Maria Carmo P. Nunes ◽  
...  

Background Left ventricular systolic dysfunction (LVSD) in Chagas disease (ChD) is relatively common and its treatment using low-cost drugs can improve symptoms and reduce mortality. Recently, an artificial intelligence (AI)-enabled ECG algorithm showed excellent accuracy to detect LVSD in a general population, but its accuracy in ChD has not been tested. Objective To analyze the ability of AI to recognize LVSD in patients with ChD, defined as a left ventricular ejection fraction determined by the Echocardiogram ≤ 40%. Methodology/principal findings This is a cross-sectional study of ECG obtained from a large cohort of patients with ChD named São Paulo-Minas Gerais Tropical Medicine Research Center (SaMi-Trop) Study. The digital ECGs of the participants were submitted to the analysis of the trained machine to detect LVSD. The diagnostic performance of the AI-enabled ECG to detect LVSD was tested using an echocardiogram as the gold standard to detect LVSD, defined as an ejection fraction <40%. The model was enriched with NT-proBNP plasma levels, male sex, and QRS ≥ 120ms. Among the 1,304 participants of this study, 67% were women, median age of 60; there were 93 (7.1%) individuals with LVSD. Most patients had major ECG abnormalities (59.5%). The AI algorithm identified LVSD among ChD patients with an odds ratio of 63.3 (95% CI 32.3–128.9), a sensitivity of 73%, a specificity of 83%, an overall accuracy of 83%, and a negative predictive value of 97%; the AUC was 0.839. The model adjusted for the male sex and QRS ≥ 120ms improved the AUC to 0.859. The model adjusted for the male sex and elevated NT-proBNP had a higher accuracy of 0.89 and an AUC of 0.874. Conclusion The AI analysis of the ECG of Chagas disease patients can be transformed into a powerful tool for the recognition of LVSD.


2021 ◽  
Vol 28 (2) ◽  
pp. 167-173
Author(s):  
Irina CUCIUREANU ◽  
◽  
Cristian Alexandru ION ◽  
Anamaria-Georgiana AVRAM ◽  
Maria Suzana GUBERNA ◽  
...  

Objective: The importance of the NT-proBNP value in detecting patients at risk of developing heart failure (HF) and its importance in guiding medical management to prevent the development of HF. Material and methods: The study is a prospective study and includes 314 patients who was presented at the Bagdasar-Arseni Emergency Hospital for cardiology consultation, by appointment, for a period of 3 years. The inclusion criteria were as follows: essential hypertension (diagnosed more than 5 years before), diabetes mellitus (insulin-deficient or under treatment with oral ant diabetics diagnosed more than 5 years before), ischemic heart disease, mild or moderate valvulopathy (mild or moderate mitral regurgitation and large or moderate aortic stenosis) and permanent or paroxysmal atrial fibrillation. Exclusion criteria were as follows: a previous diagnosis of heart failure or left ventricular systolic dysfunction, and the presence of signs or symptoms of heart failure at the time of enrollment in the study. Patients were randomized into 2 groups, a control group and a intervention group. Patients in the intervention group were managed according to the NT-proBNP value, and patients in the control group received the conventional intervention. Patients were monitored for 3 years and the following objectives were pursued: new diagnosis of heart failure, systolic or diastolic dysfunction of the left ventricle and hospitalization for cardiovascular pathology. Results: After 3 years, in the control group there were 40 patients (25.5%) who developed HF, compared to 28 patients (17.8%) in the intervention group. In the control group, 60 patients (38.2%) were diagnosed with left ventricular systolic dysfunction, compared to 43 patients (27.4%) in the intervention group. Regarding left ventricular diastolic dysfunction, in the control group there were 98 patients (62.4%), and in the intervention group there were 80 patients (51.0%). Also, the rate of hospitalizations for cardiovascular pathology was higher in the control group, 56 patients (35.7%), compared to 33 patients (21.0%) in the intervention group. Discussions: The incidence of heart failure, left ventricular systolic or diastolic dysfunction, or hospitalizations for cardiovascular events, was lower in the intervention group, in which patients were managed according to the NT-proBNP value, compared to patients in the control group who received conventional intervention. Conclusions: The NT-proBNP biomarker may be useful in the medical management of patients for the prevention of heart failure.


2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Pham Dang Hai ◽  
Le Lan Phuong ◽  
Nguyen Manh Dung ◽  
Le Thi Viet Hoa ◽  
Do Van Quyen ◽  
...  

Introduction. Left ventricular dysfunction is quite common in septic shock. Speckle-tracking echocardiography (STE) is a novel, highly sensitive method for assessing left ventricular function, capable of detecting subclinical myocardial dysfunction, which is not identified with conventional echocardiography. We sought to evaluate subclinical left ventricular systolic function in patients with septic shock using speckle-tracking echocardiography. Methods. From May 2017 to December 2018, patients aged ≥18 years admitted to the intensive care unit with the diagnosis of sepsis and septic shock based on the sepsis-3 definition were included. Patients with other causes of cardiac dysfunction were excluded. Transthoracic echocardiography was performed for all the patients within 24 hours of diagnosis. Left ventricular systolic function was assessed using conventional echocardiography and speckle-tracking echocardiography. Results. Patients with septic shock (n = 90) (study group) and 37 matched patients with sepsis but no septic shock (control group) were included. Left ventricular ejection fraction (LVEF) by conventional echocardiography showed no significant difference between two groups (58.2 ± 9.9 vs. 58.6 ± 8.3, p=0.804). The global longitudinal strain (GLS) by STE was significantly reduced in patients with septic shock compared with that in the control (−14.6 ± 3.3 vs. −17.1 ± 3.3, p<0.001). Based on the cutoff value of GLS ≥ −15% for the definition of subclinical left ventricular systolic dysfunction, this dysfunction was detected in 50 patients with septic shock (55.6%) and in 6 patients in the control group (16.2%) (p<0.05). Conclusions. Speckle-tracking echocardiography can detect early subclinical left ventricular systolic dysfunction via the left ventricular global longitudinal strain compared with conventional echocardiographic parameters in patients with septic shock.


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Pâmela Guimarães Reis ◽  
Christiane Maria Ayo ◽  
Luiz Carlos de Mattos ◽  
Cinara de Cássia Brandão de Mattos ◽  
Karina Mayumi Sakita ◽  
...  

The aim of this study was to investigate possible associations between genetic polymorphisms ofIL17AG197A (rs2275913) andIL17FT7488C (rs763780) with Chagas Disease (CD) and/or the severity of left ventricular systolic dysfunction (LVSD) in patients with chronic Chagas cardiomyopathy (CCC). The study with 260 patients and 150 controls was conducted in the South and Southeast regions of Brazil. The genotyping was performed by PCR-RFLP. The A allele and A/A genotype ofIL17Awere significantly increased in patients and their subgroups (patients with CCC; patients with CCC and LVSD; and patients with CCC and severe LVSD) when compared to the control group. The analysis according to the gender showed that the A/A genotype ofIL17Awas more frequent in female with LVSD and mild to moderate LVSD and also in male patients with LVSD. The frequency ofIL17FT/C genotype was higher in male patients with CCC and severe LVSD and in female with mild to moderate LVSD. The results suggest the possible involvement of the polymorphisms ofIL17AandIL17Fin the susceptibility to chronic Chagas disease and in development and progression of cardiomyopathy.


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