scholarly journals Echocardiographic Findings in Canine Model of Chagas Disease Immunized with DNA Trypanosoma cruzi Genes

Animals ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 648
Author(s):  
Olivia Rodríguez-Morales ◽  
Francisco-Javier Roldán ◽  
Jesús Vargas-Barrón ◽  
Enrique Parra-Benítez ◽  
María de Lourdes Medina-García ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Systolic Function ◽  
Ventricular Volume ◽  
Canine Model ◽  
Pathological Process ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Peak Time ◽  
Ventricular Ejection Fraction

Chagas disease (ChD) is considered an emerging disease in the USA and Europe. Trypanosoma cruzi genes encoding a trans-sialidase protein and an amastigote-specific glycoprotein were tested as vaccines in canine model. The aim for this study was determining the prophylactic effect of these genes in experimentally infected dogs by echocardiography evaluation to compare with our findings obtained by other techniques published previously. Low fractional-shortening values of non-vaccinated dogs suggested an impairment in general cardiac function. Low left ventricular ejection fraction values found in infected dogs suggested myocardial injury regardless of whether they were vaccinated. Low left ventricular diastolic/systolic diameters suggested that progressive heart damage or heart dilation could be prevented by DNA vaccination. Systolic peak time was higher in non-vaccinated groups, increasing vulnerability to malignant arrhythmias and sudden death. High left ventricular volume suggested a decrease in wall thickness that might lead to increased size of the heart cavity, except in the pBCSP plasmid-vaccinated dogs. There was an echocardiographic evidence of left ventricular dilation and reduction in systolic function in experimental chagasic dogs. Echocardiography allowed a more complete follow-up of the pathological process in the living patient than with other techniques like electrocardiography, anatomopathology, and histopathology, being the method of choice for characterizing the clinical stages of ChD.

scholarly journals Cardiovascular findings by echocardiography in canine model of Chagas disease immunized with DNA Trypanosoma cruzi genes.

2019 ◽  
Author(s):  
Olivia Rodríguez-Morales ◽  
Francisco-Javier Roldán ◽  
Jesús Vargas-Barrón ◽  
Enrique Parra-Benítez ◽  
María de Lourdes Medina-García ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Ventricular Volume ◽  
Canine Model ◽  
Pathological Process ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Peak Time ◽  
Ventricular Ejection Fraction ◽  
The Usa

Abstract Background: Chagas disease (ChD) is nowadays considered as an emerging disease in the USA and Europe. pBCSP and pBCSSP4 plasmids, containing Trypanosoma cruzi genes encoding a trans -sialidase protein and an amastigote-specific glycoprotein, respectively, were tested as vaccines in canine model. Echocardiography studies for determining the prophylactic effect of these genes in experimentally infected dogs were evaluated to compare with findings obtained by other techniques performed previously. Hemodynamic parameters after DNA-immunization were performed. Results: Low fractional-shortening values of non-vaccinated dogs suggested an impairment in general cardiac function. Low Left-Ventricular-Ejection-Fraction values found in infected dogs suggested myocardial injury regardless of whether they were vaccinated or not. Low Left-Ventricular-Diastolic/Systolic-Diameters in vaccinated dogs suggested that progressive heart damage or heart dilation could be prevented by DNA vaccination. Systolic-Peak-Time was higher in non-vaccinated groups increasing vulnerability to malignant arrhythmias and sudden death. High Left-Ventricular-Volume in infected groups suggested a decrease in wall thickness that might lead to increased size of the heart cavity, except in the pBCSP plasmid-vaccinated dogs. Conclusions: The use of echocardiography allowed a more complete follow-up the pathological process in the living patient than with other techniques like electrocardiography, anatomopathology and histopathology, being the method of choice for characterizing the clinical stages of ChD.

Incidence and Predictors of Progression to Chagas Cardiomyopathy: Long-Term Follow-Up of Trypanosoma Cruzi Seropositive Individuals

Circulation ◽  
2021 ◽  
Author(s):  
Maria Carmo P. Nunes ◽  
Lewis F. Buss ◽  
Jose Luiz P. da Silva ◽  
Larissa Natany Almeida Martins ◽  
Claudia Di Lorenzo Oliveira ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Clinical Epidemiology ◽  
Outpatient Service ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Blood Collection ◽  
Ventricular Ejection Fraction ◽  
Chagas Cardiomyopathy

Background: There are few contemporary cohorts of Trypanosoma cruzi -seropositive individuals, and the basic clinical epidemiology of Chagas disease is poorly understood. Herein, we report the incidence of cardiomyopathy and death associated with T. cruzi seropositivity. Methods: Participants were selected in blood banks at 2 Brazilian centers. Cases were defined as T. cruzi -seropositive blood donors. T. cruzi -seronegative controls were matched for age, sex, and period of donation. Patients with established Chagas cardiomyopathy were recruited from a tertiary outpatient service. Participants underwent medical examination, blood collection, electrocardiogram, and echocardiogram at enrollment (2008 to 2010) and at follow-up (2018 to 2019). The primary outcomes were all-cause mortality and development of cardiomyopathy, defined as the presence of a left ventricular ejection fraction <50% and/or QRS complex duration ≥ 120 ms. To handle loss to follow-up, a sensitivity analysis was performed using inverse probability weights for selection. Results: We enrolled 499 T. cruzi -seropositive donors (age 48 ± 10 years, 52% male), 488 T. cruzi -seronegative donors (age 49 ± 10 years, 49% male), and 101 patients with established Chagas cardiomyopathy (age 48 ± 8 years, 59% male). The mortality in patients with established cardiomyopathy was 80.9 deaths/1000 person-years (py) (54/101, 53%) and 15.1 deaths/1000py (17/114, 15%) in T. cruzi -seropositives with cardiomyopathy at baseline. Among T. cruzi -seropositive donors without cardiomyopathy at baseline mortality was 3.7 events/1000py (15/385, 4%), which was no different from T. cruzi -seronegative donors with 3.6 deaths/1000py (17/488, 3%). The incidence of cardiomyopathy in T. cruzi -seropositive donors was 13.8 (95% CI 9.5-19.6) events/1000py (32/262, 12%) compared with 4.6 (95% CI 2.3-8.3) events/1000 py (11/277, 4%) in seronegative controls, with an absolute incidence difference associated with T. cruzi seropositivity of 9.2 (95% CI 3.6 - 15.0) events/1000py. T. cruzi antibody level at baseline was associated with development of cardiomyopathy (adjusted OR of 1.4, 95% CI 1.1-1.8). Conclusions: We present a comprehensive description of the natural history of T. cruzi seropositivity in a contemporary patient population. The results highlight the central importance of anti- T. cruzi antibody titer as a marker of Chagas disease activity and risk of progression.

ACCESSMENT OF RIGHT VENTRICULAR SYSTOLIC FUNCTION USING TAPSE

2011 ◽  
pp. 62-70
Author(s):  
Lien Nhut Nguyen ◽  
Anh Vu Nguyen
Keyword(s):  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Systolic Function ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: The prognostic importance of right ventricular (RV) dysfunction has been suggested in patients with systolic heart failure (due to primary or secondary dilated cardiomyopathy - DCM). Tricuspid annular plane systolic excursion (TAPSE) is a simple, feasible, reality, non-invasive measurement by transthoracic echocardiography for evaluating RV systolic function. Objectives: To evaluate TAPSE in patients with primary or secondary DCM who have left ventricular ejection fraction ≤ 40% and to find the relation between TAPSE and LVEF, LVDd, RVDd, RVDd/LVDd, RA size, severity of TR and PAPs. Materials and Methods: 61 patients (36 males, 59%) mean age 58.6 ± 14.4 years old with clinical signs and symtomps of chronic heart failure which caused by primary or secondary DCM and LVEF ≤ 40% and 30 healthy subject (15 males, 50%) mean age 57.1 ± 16.8 were included in this study. All patients and controls were underwent echocardiographic examination by M-mode, two dimentional, convensional Dopler and TAPSE. Results: TAPSE is significant low in patients compare with the controls (13.93±2.78 mm vs 23.57± 1.60mm, p<0.001). TAPSE is linearly positive correlate with echocardiographic left ventricular ejection fraction (r= 0,43; p<0,001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation was found with LVDd and PAPs. Conclusions: 1. Decreased RV systolic function as estimated by TAPSE in patients with systolic heart failure primary and secondary DCM) compare with controls. 2. TAPSE is linearly positive correlate with LVEF (r= 0.43; p<0.001) and linearly negative correlate with RVDd (r= -0.39; p<0.01), RVDd/LVDd (r=-0.33; p<0.01), RA size (r=-0.35; p<0.01), TR (r=-0.26; p<0.05); however, no correlation is found with LVDd and PAPs. 3. TAPSE should be used routinely as a simple, feasible, reality method of estimating RV function in the patients systolic heart failure DCM (primary and secondary).

Implication of anti-angiogenic VEGF-A165b in angiogenesis and systolic function after reperfused myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Marcos Garces ◽  
C Rios-Navarro ◽  
L Hueso ◽  
A Diaz ◽  
C Bonanad ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Adjuvant Therapy ◽  
Ejection Fraction ◽  
Infarct Size ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Funding Source ◽  
Coronary Reperfusion ◽  
Ventricular Ejection Fraction

Abstract Background Angiogenesis participates in re-establishing microcirculation after myocardial infarction (MI). Purpose In this study, we aim to further understand the role of the anti-angiogenic isoform vascular endothelial growth factor (VEGF)-A165b after MI and explore its potential as a co-adjuvant therapy to coronary reperfusion. Methods Two mice MI models were formed: 1) permanent coronary ligation (non-reperfused MI), 2) transient 45-min coronary occlusion followed by reperfusion (reperfused MI); in both models, animals underwent echocardiography before euthanasia at day 21 after MI induction. Serum and myocardial VEGF-A165b levels were determined. In both experimental MI models, functional and structural implication of VEGF-A165b blockade was assessed. In a cohort of 104 ST-segment elevation MI patients, circulating VEGF-A165b levels were correlated with cardiovascular magnetic resonance-derived left ventricular ejection fraction at 6-months and with the occurrence of adverse events (death, heart failure and/or re-infarction). Results In both models, circulating and myocardial VEGF-A165b presence was increased 21 days after MI induction. Serum VEGF-A165b levels inversely correlated with systolic function evaluated by echocardiography. VEGF-A165b blockage increased capillary density, reduced infarct size, and enhanced left ventricular function in reperfused, but not in non-reperfused MI experiments. In patients, higher VEGF-A165b levels correlated with depressed ejection fraction and worse outcomes. Conclusions In experimental and clinical studies, higher serum VEGF-A165b levels associates with a worse systolic function. Its blockage enhances neoangiogenesis, reduces infarct size, and increases ejection fraction in reperfused, but not in non-reperfused MI experiments. Therefore, VEGF-A165b neutralization represents a potential co-adjuvant therapy to coronary reperfusion. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was funded by “Instituto de Salud Carlos III” and “Fondos Europeos de Desarrollo Regional FEDER” (Exp. PIE15/00013, PI17/01836, PI18/00209 and CIBERCV16/11/00486).

scholarly journals Effects of peak time of myocardial injury biomarkers on mid-term outcomes of patients undergoing OPCABG

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Hu ◽  
Fei Gao ◽  
Mengwei Lv ◽  
Ban Liu ◽  
Yu Shi ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Cox Regression ◽  
Troponin T ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Peak Time ◽  
Clinical Trial Registry ◽  
Ventricular Ejection Fraction ◽  
The Impact

Abstract Background With the development of cardiac surgery techniques, myocardial injury is gradually reduced, but cannot be completely avoided. Myocardial injury biomarkers (MIBs) can quickly and specifically reflect the degree of myocardial injury. Due to various reasons, there is no consensus on the specific values of MIBs in evaluating postoperative prognosis. This retrospective study was aimed to investigate the impact of MIBs on the mid-term prognosis of patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods Totally 564 patients undergoing OPCABG with normal courses were included. Cardiac troponin T (cTnT) and creatine kinase myocardial band (CK-MB) were assessed within 48 h before operation and at 6, 12, 24, 48, 72, 96 and 120 h after operation. Patients were grouped by peak values and peak time courses of MIBs. The profile of MIBs and clinical variables as well as their correlations with mid-term prognosis were analyzed by univariable and multivariable Cox regression models. Result Continuous assessment showed that MIBs increased first (12 h after surgery) and then decreased. The peak cTnT and peak CK-MB occurred within 24 h after operation in 76.8% and 67.7% of the patients respectively. No significant correlation was found between CK-MB and mid-term mortality. Delayed cTnT peak (peak cTnT elevated after 24 h after operation) was correlated with lower creatinine clearance rate (69.36 ± 21.67 vs. 82.18 ± 25.17 ml/min/1.73 m2), body mass index (24.35 ± 2.58 vs. 25.27 ± 3.26 kg/m2), less arterial grafts (1.24 ± 0.77 vs. 1.45 ± 0.86), higher EuroSCORE II (2.22 ± 1.12 vs.1.72 ± 0.91) and mid-term mortality (26.5 vs.7.9%). Age (HR: 1.067, CI: 1.006–1.133), left ventricular ejection fraction (HR: 0.950, CI: 0.910–0.993), New York Heart Association score (HR: 1.839, CI: 1.159–2.917), total venous grafting (HR: 2.833, CI: 1.054–7.614) and cTnT peak occurrence within 24 h (HR: 0.362, CI: 0.196–0.668) were independent predictors of mid-term mortality. Conclusion cTnT is a better indicator than CK-MB. The peak value and peak occurrence of cTnT are related to mid-term mortality in patients undergoing OPCABG, and the peak phases have stronger predictive ability. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000033850. Registered 14 June 2020, http://www.chictr.org.cn/edit.aspx?pid=55162&htm=4.

The Assessment of Left Ventricular Ejection Fraction in Patients with Ischaemic Heart Disease by Contrast Ventriculography and Nuclear Angiography

1977 ◽  
Vol 53 (1) ◽  
pp. 55-61 ◽  
Author(s):  
A. L. Muir ◽  
W. J. Hannan ◽  
H. M. Brash ◽  
V. Baldwa ◽  
H. C. Miller ◽  
...  
Keyword(s):  
Heart Disease ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Ischaemic Heart Disease ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Contrast Ventriculography

1. In 18 patients with ischaemic heart disease left ventricular ejection fraction, measured by two different nuclear angiographic methods, has been compared with ejection fraction measured by single-plane contrast angiography. 2. The first nuclear angiographic technique involves detection of variation in the radioactivity from the left ventricle during the initial passage of a bolus of 99Tcm-labelled human serum albumin injected intravenously; the second is our own modification of a ‘gated’ method, which accumulates the radioactivity detected during the continuing recirculation of the plasma bound radioisotope, so presenting an ‘averaged’ ventricular volume curve. 3. Ejection fraction, measured by the ‘bolus’ method, is lower than that measured either by contrast ventriculography or by the ‘gated’ method. This may be due to a damping effect. 4. Ejection fraction measured by the ‘gated’ method is well correlated with that measured by contrast ventriculography (r = 0·89). 5. Our modification of the ‘gated’ method, which presents the changes in ventricular volume throughout the cardiac cycle, without needing computer facilities, is a useful non-invasive means for assessment of left ventricular function.

scholarly journals EpCAM and microvascular obstruction in patients with STEMI: a cardiac magnetic resonance study

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
C Rios-Navarro ◽  
J Gavara ◽  
J Nunez ◽  
C Bonanad Lozano ◽  
E Revuelta-Lopez ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Microvascular Obstruction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
P Value ◽  
Ventricular Ejection Fraction ◽  
Systolic Volume

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This study was funded by “Instituto de Salud Carlos III” and “Fondos Europeos de Desarrollo Regional FEDER” Bachground. Microvascular obstruction (MVO) is negatively associated with cardiac structure and worse prognosis after ST-segment elevation myocardial infarction (STEMI). Epithelial cell adhesion molecule (EpCAM), involved in endothelium adhesion, is an understudied area in the MVO setting. Purpose. We aimed to evaluate whether EpCAM is associated with the appearance of cardiac magnetic resonance (CMR)-derived MVO and long-term systolic function in reperfused STEMI. Methods. We prospectively included 106 patients with a first STEMI treated with primary percutaneous coronary intervention, quantifying serum levels of EpCAM 24 hours post-reperfusion. All patients underwent CMR imaging 1 week and 6 months post-STEMI. The independent correlation of EpCAM with MVO, systolic volume indices, and left ventricular ejection fraction (LVEF) was evaluated. Results. The mean age of the sample was 59 ± 13 years and 76% were male. Patients were dichotomized according to EpCAM median (4.48 pg/mL). At 1-week CMR, lower EpCAM was related to extensive MVO (p-value = 0.02) and greater infarct size (p-value = 0.02). At presentation, only EpCAM values were significantly associated with the presence of MVO in univariate (Odds Ratio [95% confidence interval] (OR [95% CI]): 0.58 [0.38-0.88], p-value = 0.01) and multivariate logistic regression models (OR [95% CI]: 0.54 [0.34-0.85], p-value = 0.007). Although MVO tends to resolve at chronic phases, decreased EpCAM was associated with worse systolic function: depressed LVEF (p-value = 0.009) and higher left ventricular end-systolic volume (p-value = 0.04). Conclusions. EpCAM is associated with occurrence of CMR-derived MVO at acute phases and long-term adverse ventricular remodeling post-STEMI. Future studies are needed to confirm EpCAM as biomarker, and eventually biotarget in STEMI pathophysiology.

Abstract 2936: Obesity and Mortality in Patients with Heart Failure and Preserved Systolic Function

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
John R Kapoor ◽  
Paul A Heidenreich
Keyword(s):  
Heart Failure ◽  
Proportional Hazards ◽  
Systolic Function ◽  
Total Mortality ◽  
Obesity Paradox ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Heart Failure Patients ◽  
Objective Evidence

Several large cohort studies document better survival in heart failure patients with decreased left ventricular ejection fraction (EF) and higher body mass index (BMI) compared to those with a lower BMI. It is unclear, though, if this “obesity paradox” applies to heart failure patients with preserved EF or if it extends to the very obese (BMI>35). We followed 1,235 consecutive patients with a prior diagnosis of heart failure and a preserved EF (≥50%) documented on echocardiography at one of three laboratories. We determined adjusted mortality and readmission rates at 1 year following the echocardiogram. Obesity (BMI>30) was noted in 542 patients (44%). The mean age of the cohort was 71 years, but this varied depending on BMI (73 years for BMI<25, 64 years for BMI> 35, p< 0.001). In a subset of patients with complete diastolic indices and LV mass measurements (n=405), 95% had objective evidence of diastolic dysfunction. Age-adjusted all-cause mortality (Figure ) at one year decreased with increasing BMI (31% if BMI < 25, 22% if BMI 25–29, 20% if BMI 30–35 and 19% if BMI>35, p=0.003). In a proportional hazards analysis that adjusted for patient history, demographics and laboratory values, the hazard ratios for total mortality (relative to a normal BMI) were 1.47 (95% CI, 1.06–2.05) for BMI<25, 0.95 (95% CI, 0.64 –1.42) for BMI 30 –35, and 0.83 (95% CI, 0.52–1.31), for BMI >35, p=0.046). Similar findings were noted for the composite endpoint of survival free from heart failure hospitalization. These data suggest that the obesity paradox applies to heart failure patients with preserved systolic function and extends to very obese patients (BMI>35).

scholarly journals Study of Cardiac Troponin I level in Acute Coronary Syndrome and its correlation with Left Ventricular Systolic Function

2019 ◽  
Vol 12 (1) ◽  
pp. 24-29
Author(s):  
Mohammad Jakir Hossain ◽  
Khondoker Asaduzzaman ◽  
Solaiman Hossain ◽  
Muhammad Badrul Alam ◽  
Nur Hossain
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Systolic Function ◽  
Left Ventricular ◽  
Cardiac Troponin I ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome

Background: In the diagnosis of acute coronary syndrome, cardiac troponin I is highly reliable and widely available biomarker. Serum level of cardiac troponin I is related to amount of myocardial damage and also closely relates to infarct size. Our aim of the study is to find out the relationship between cardiac troponin I and left ventricular systolic function after acute coronary syndrome. Methods: Total of 132 acute coronary syndrome patients were included in this study after admission in coronary care unit of Sir Salimullah Medical College, Mitford Hospital. Troponin I level was measured at admission and left ventricular ejection fraction (LVEF) was measured by echocardiography between 12-48 hours of onset of chest pain. Results: There was negative correlation between Troponin I at 12 to 48 hours of chest pain with LVEF in these study patients. With a cutoff value of troponin I e”6.8 ng/ml in STEMI patients there is a significant negative relation between 12 to 48 hrs troponin I and LVEF (p<0.001). Sensitivity of troponin I e” 6.8 ng/ml between 12 to 48 hours of chest pain in predicting LVEF <50% in STEMI was 93.75% and specificity was 77.78%. In NSTEMI sensitivity of troponin I e” 4.5 ng/ml between 12 to 48 hours of chest pain in predicting LVEF <50% was 65% and specificity was 54.05%. Conclusion: Serum troponin I level had a strong negative correlation with left ventricular ejection fraction after acute coronary syndrome and hence can be used to predict the LVEF in this setting. Cardiovasc. j. 2019; 12(1): 24-29

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