scholarly journals Major Left Bundle Branch Block and Coronary Heart Disease—Are There Any Differences between the Sexes?

2021 ◽  
Vol 10 (11) ◽  
pp. 2284
Author(s):  
Diana Gurzău ◽  
Alexandra Dădârlat-Pop ◽  
Bogdan Caloian ◽  
Gabriel Cismaru ◽  
Horaţiu Comşa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Left Bundle Branch Block ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Bundle Branch Block ◽  
Microvascular Angina ◽  
Ventricular Ejection Fraction

Left bundle branch block is not a benign pathology, and its presence requires the identification of a pathological substrate, such as ischemic heart disease. Left bundle branch block appears to be more commonly associated with normal coronary arteries, especially in women. The objectives of our study were to describe the particularities of left bundle branch block in women compared to men with ischemic heart disease. Result: We included seventy patients with left bundle branch block and ischemic heart disease, with a mean age of 67.01 ± 8.89 years. There were no differences in the profile of risk factors, except for smoking and uric acid. The ventricular depolarization (QRS) duration was longer in men than women (136.86 ± 8.32 vs. 132.57 ± 9.19 msec; p = 0.018) and also men were observed to have larger left ventricular diameters. Left bundle branch block duration was directly associated with ventricular diameters and indirectly associated with left ventricular ejection fraction value, especially in women (R = −0.52, p = 0.0012 vs. R = −0.50, p = 0.002). In angiography, 80% of women had normal epicardial arteries compared with 65.7% of men; all these patients presented with microvascular dysfunction. Conclusion: The differences between the sexes were not so obvious in terms of the presence of risk factors; instead, there were differences in electrocardiographic, echocardiographic, and angiographic aspects. Left bundle branch block appears to be a marker of microvascular angina and systolic dysfunction, especially in women.

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 N-terminal natriuretic propeptide in diagnostics of myocardial injuries after coronary artery bypass grafting on a beating heart

2015 ◽  
Vol 17 (2) ◽  
pp. 18
Author(s):  
O. V. Petrova ◽  
D. G. Tarasov ◽  
A. P. Motreva ◽  
Yu. B. Martyanova ◽  
A. V. Kadykova ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Troponin T ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Functional Class ◽  
Beating Heart ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Dynamics of N-terminal natriuretic propeptide (NT-proBNP) and troponin T in the blood of patients with ischemic heart disease after CABG on a beating heart is studied. It is found out that the level of NT-proBNP in patients with ischemic heart disease at admission correlates with their functional class, left ventricular ejection fraction and end-diastolic volume). It is also shown that the level of NT-proBNP increases in 1 day after CABG and reaches the maximum values in3 days. At the 15th day a decrease in the level of NT-proBNP is observed, however, which reaches the baseline values. The analysis of correlation between NT-proBNP and troponin Т has revealed an inverse correlation between the indicators under study, which testifies to the fact that NT-proBNP cannot be used as a myocardial injury marker in patients with ischemic heart disease after CABG.

scholarly journals Trends in Left Ventricular Ejection Fraction for Patients With a New Diagnosis of Heart Failure

2020 ◽  
Vol 13 (9) ◽  
Author(s):  
Rebecca L. Tisdale ◽  
François Haddad ◽  
Shun Kohsaka ◽  
Paul A. Heidenreich
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Ischemic Heart Disease ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: The left ventricular ejection fraction (LVEF) guides treatment of heart failure, yet this data has not been systematically collected in large data sets. We sought to characterize the epidemiology of incident heart failure using the initial LVEF. Methods: We identified 219 537 patients in the Veterans Affairs system between 2011 and 2017 who had an LVEF documented within 365 days before and 30 days after the heart failure diagnosis date. LVEF was obtained from natural language processing from imaging and provider notes. In multivariate analysis, we assessed characteristics associated with having an initial LVEF <40%. Results: Most patients were male and White; a plurality were within the 60 to 69 year age decile. A majority of patients had ischemic heart disease and a high burden of co-morbidities. Over time, presentation with an LVEF <40% became slightly less common, with a nadir in 2015. Presentation with an initial LVEF <40% was more common in younger patients, men, Black and Hispanic patients, an inpatient presentation, lower systolic blood pressure, lower pulse pressure, and higher heart rate. Ischemic heart disease, alcohol use disorder, peripheral arterial disease, and ventricular arrhythmias were associated with an initial LVEF <40%, while most other comorbid conditions (eg, atrial fibrillation, chronic obstructive pulmonary disease, malignancy) were more strongly associated with an initial LVEF >50%. Conclusions: For patients with heart failure, particularly at the extremes of age, an initial preserved LVEF is common. In addition to clinical characteristics, certain races (Black and Hispanic) were more likely to present with a reduced LVEF. Further studies are needed to determine if racial differences are due to patient or health systems issues such as access to care.

scholarly journals Effects of oxygen ozone therapy on cardiac function in a patient with a prior myocardial infarction

Ozone Therapy ◽  
2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Sergio Pandolfi ◽  
Angelo Zammitti ◽  
Marianno Franzini ◽  
Vincenzo Simonetti ◽  
William Liboni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Inguinal Hernia ◽  
Ischemic Heart Disease ◽  
Autologous Blood ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Ozone Therapy ◽  
Ventricular Ejection Fraction

Oxygen-ozone therapy has been piloted in Italy patients with ischemic heart disease or suffering from myocardial infarction since 1991. Over time, it has been observed that ozone exerts a significant anti-inflammatory and rheological activity: ozone activates the redox system, lowers the pro-inflammatory cytokines16β, TNFα, modulates the NF-KB system, reduces platelet aggregation, and stimulates the release of growth factors. It is because of these characteristics that oxygen-ozone therapy is used in the prevention and treatment of ischemic heart disease and for post-infarction rehabilitation. The case study – a critically ill patient aged 76 with acute myocardial infarction (AMI), suffering from ischemic heart disease and heart attacks, high blood pressure, renal failure, ischemic vascular pluri-infarct CNS disease, Parkinsonism, stroke, neurological bladder disease and debilitating inguinal hernia – after a year and a half of AMI with infusions of autologous blood treated with ozone (GAE), recovered the left ventricular ejection fraction from 33 to 50% and underwent a successful inguinal hernia operation. It appears evident that oxygen ozone therapy using GAE protect the hearts of patients suffering from ischemic heart disease, and is useful during the acute phase of infarctions, as well as for rehabilitating patients who have had an AMI with stenting.

scholarly journals Echocardiographic prognostication of new onset heart failure in a cohort of ischemic heart disease patients

2021 ◽  
pp. 1-17
Author(s):  
Senbeta Abdissa
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Left Ventricular Ejection Fraction ◽  
Ischemic Heart Disease ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Ventricular Dimension ◽  
New Onset

Background Echocardiographic predictors for new onset heart failure in patients with ischemic heart disease with reduced left ventricular ejection fraction (HFrEF) or with preserved left ventricular ejection fraction (HFpEF) in Ethiopian and Sub-Saharan African is not well-known. Methods Two hundred twenty-eight patients with ischemic heart disease were retrospectively recruited and followed. Analysis on baseline clinical and echocardiographic characteristics of patients, and risk factors for new onset HFpEF and new onset HFrEF were done. The exclusion criteria were known heart failure at baseline and those who did not have echocardiography data. Results During the follow up period, heart failure developed in 62.2% (61/98) of ischemic heart disease patients with preserved left ventricular ejection fraction and in 70.1% (92/130) of ischemic heart disease patients with reduced left ventricular ejection fraction. We did not find significant difference between HFrEF and HFpEF in time to new onset heart failure. Systolic blood pressure, diastolic blood pressure, diabetes, left atrium and diastolic left ventricular dimension had significant association with new onset HFrEF on univariate regression analysis. Whereas new onset HFpEF was significantly associated with age, sex, presence of hypertension, Systolic blood pressure and diastolic left ventricular dimension. On cox regression analysis diastolic left ventricular dimension was associated with both new onset HFpEF and HFrEF. Age, diabetes, and dimension of left atrium were also associated with HFrEF. Conclusion This cohort study in ischemic heart disease patients suggests a key role for the diastolic left ventricular dimension, left atrium size, diabetes, sex and age as predictors of new onset HFrEF and HFpEF. Strategies directed to prevention and early treatment of diabetes, dilatation of left ventricle and left atrium may prevent a considerable proportion of HFrEF or HFpEF.

scholarly journals Expression and predictive value of leucine rich α-2 glycoprotein in ischemic heart disease

2020 ◽  
Author(s):  
Wei Gao ◽  
Runda Wu ◽  
Jiasheng Yin ◽  
Yuanji Ma ◽  
Junjie Guo ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Hospital Stay ◽  
Predictive Value ◽  
Troponin T ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction

Abstract Background : The expression and predictive value of leucine rich α-2 glycoprotein (LRG) in ischemic heart disease, including coronary artery disease (CAD), myocardial infarction (MI) and chronic total occlusion (CTO), remain unclear.Methods : A total of 231 patients were included and divided into 4 groups: control group (N=39), CAD group (N=73), MI group (N=67) and CTO group (N=52). LRG was determined and compared within groups. MI group was then divided into 2 subgroups according to LRG expression. The association between LRG expression and clinical characteristics, peak Troponin T (TNT), left ventricular ejection fraction (LVEF) and in-hospital stay was investigated.Results : LRG expression in MI group was significantly higher than that in control group (37.9±12.8 vs 25.3±8.9, P<0.001). LRG expression in CAD and CTO group were similar with that in control group (CAD vs Con, 23.1±6.8 vs 25.3±8.9, P=0.233; CTO vs Con, 22.0±7.8 vs 25.3±8.9, P=0.082). In MI group, patients with increased LRG had higher peak TNT (4.80 (2.34-10.0) vs 2.46 (0.89-4.98), P=0.002), lower LVEF (48.7±10.2 vs 54.8±8.4, P=0.009) and longer in-hospital stay (10.4±5.4 vs 8.0±2.9, P=0.027). Linear regression showed that LRG was independently associated with in-hospital stay. ROC curve showed the area of LRG under the curve (AUC) was 0.859.Conclusions : LRG expression was elevated in MI patients compared with controls, angiography confirmed CAD and CTO patients. In the MI subgroup, patients with elevated LRG had higher peak TNT, lower LVEF and longer in-hospital stay. Whether LRG is associated with major adverse cardiovascular events and long term prognosis needs further investigation.

scholarly journals Frequency of Fibromyalgia in a Sample of Iraqi Patients in Mosul with Ischemic Heart Disease

2021 ◽  
Vol 9 (B) ◽  
pp. 1672-1676
Author(s):  
Ali Younis ◽  
Mohammad Harith Alsaaty
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Ibn Sina ◽  
American College Of Rheumatology ◽  
The Mean

BACKGROUND: Fibromyalgia is a common chronic condition characterized by widespread musculoskeletal pain together with mood and cognitive dysfunction. Data on the frequency of fibromyalgia in ischemic heart disease (IHD) are scarce. AIM: This study aimed to assess the frequency of fibromyalgia in IHD patients and to evaluate the characteristics of IHD patients with comorbid fibromyalgia. METHODS: The study was conducted in the coronary care unit, Department of Medicine in Ibn Sina Teaching Hospital in Mosul city, between March and November 2020. One hundred patients with IHD and 100 healthy controls were studied. The diagnosis of fibromyalgia was according to the 2011 modification of the 2010 American College of Rheumatology preliminary diagnostic criteria for fibromyalgia. Socio-demographic features and IHD characteristics of patients were recorded. RESULTS: The frequency of fibromyalgia was significantly higher among patients with IHD (29%) as compared to controls (7%). The mean age and proportion of women were significantly higher in IHD patients with fibromyalgia than those without fibromyalgia. It was also more common in patients with the present MI (p = 0.032) and in patients who had previous coronary angiography (p = 0.008). Patients with comorbid fibromyalgia had lower left ventricular ejection fraction (LVEF) (p = 0.0003) and higher scores on beck depression inventory (p = 0.0025). However, on multivariate logistic regression analysis, only two variables remained significant, (1) among IHD patients, fibromyalgia was more frequent in women (odds ratio [OR] = 3.839, p = 0.022) and (2) in patients having lower LVEF (OR = 0.917, p = 0.008). CONCLUSION: There is a high frequency of fibromyalgia in patients with IHD. Those IHD patients with comorbid fibromyalgia are more likely to be older, women, and with poor LVEF.

scholarly journals Evaluation of Left Ventricle Performance in Patients with Ischemic Heart Disease Using Single Photon Emission Computed Tomography (SPECT) in Comparison with Echocardiography

2021 ◽  
pp. 3871-3876
Author(s):  
Marrwa K. Mohammed ◽  
Satar M. Kadam ◽  
Samar I. Essa
Keyword(s):  
Heart Disease ◽  
Left Ventricular Ejection Fraction ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Ischemic Heart Disease ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
99Mtc Mibi

Background: Ischemic heart disease is a major cause of the diastolic heart failure. Risk of heart failures was increased with microvascular coronary disease, which is characterized by left ventricular stiffness  with impaired relaxation and reduced compliance. Aim of this study is to estimate the effect of the severity of myocardium ischemia on the left ventricle ejection fraction and left ventricular volume using SPECT with 99mTc MIBI and to compare the results  with the echocardiography. The study included 117 subjects with ischemic heart disease were examined using SPECT and echocardiography techniques. The following parameters were measured: left ventricular end systolic volume (LVESV) , left ventricular end diastolic volume (LVEDV) , and left ventricular ejection fraction (LVEF). Results show that the change difference in EDV between the two technique was (98.79%) with insignificant (p > 0.05). While the change in the LVEF% between both groups was (105.40%) with significant (p <0.05). On the other hand, the difference in ESV and EDV/ESV ratio for both groups were (95.52%), and (103.61%) respectively with insignificant (p >0.05). It was concluded that SPECT with 99mTc MIBI had a good relation with the echocardiography technique for evaluation of the left ventricular ejection fraction and the left ventricular volumes. The results showed that  LVEF was decreased in patients with severe ischemic disease.

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