scholarly journals Prevalence of Pulmonary Hypertension in an Unselected Community-Based Population: A Retrospective Echocardiographic Study—RES-PH Study

2021 ◽  
Vol 11 (6) ◽  
pp. 489
Author(s):  
Egidio Imbalzano ◽  
Marco Vatrano ◽  
Alberto Lo Gullo ◽  
Luana Orlando ◽  
Alberto Mazza ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Systolic Dysfunction ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Pulmonary Artery Systolic Pressure ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Equal Distribution ◽  
Ventricular Ejection Fraction

Introduction. The actual prevalence of pulmonary hypertension (PH) in Italy is unknown. Echocardiography is useful in the screening of patients with suspected PH by estimation of the pulmonary artery systolic pressure (PASP) from the regurgitant tricuspid flow velocity evaluation, according to the simplified Bernoulli equation. Objectives. We aimed to evaluate the frequency of suspected PH among unselected patients. Methods. We conducted a retrospective cross-sectional database search of 7005 patients, who underwent echocardiography, to estimate the prevalence of PH, between January 2013 and December 2014. Medical and echocardiographic data were collected from a stratified etiological group of PH, using criteria of the European Society of Cardiology classifications. Results. The mean age of the study population was 57.1 ± 20.5 years, of which 55.3% were male. The prevalence of intermediate probability of PH was 8.6%, with nearly equal distribution between men and women (51.3 vs. 48.7%; p = 0.873). The prevalence of high probability of PH was 4.3%, with slightly but not significant higher prevalence in female patients (43.2 vs. 56.8%; p = 0.671). PH is predominant in patients with chronic obstructive pulmonary disease (COPD) or left ventricle (LV) systolic dysfunction and related with age. PASP was significantly linked with left atrial increase and left ventricular ejection fraction. In addition, an increased PASP was related to an enlargement of the right heart chamber. Conclusions. PH has a frequency of 4.3% in our unselected population, but the prevalence may be more relevant in specific subgroups. A larger epidemiological registry could be an adequate strategy to increase quality control and identify weak points in the evaluation and treatment of these patients.

scholarly journals The Circulating MicroRNA-206 Level Predicts the Severity of Pulmonary Hypertension in Patients with Left Heart Diseases

2017 ◽  
Vol 41 (6) ◽  
pp. 2150-2160 ◽  
Author(s):  
Peng Jin ◽  
Wenzhu Gu ◽  
Yayu Lai ◽  
Wei Zheng ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Heart Diseases ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Pulmonary Artery Systolic Pressure ◽  
Circulating Microrna ◽  
Left Heart ◽  
Ventricular Ejection Fraction

Background: MicroRNA-206 (miR-206), a muscle-specific miRNA, regulates the growth of cardiac myocytes and pulmonary artery smooth muscle cells. However, it remains unknown whether miR-206 is involved in pulmonary hypertension (PH) due to left heart diseases (PH-LHD). This study was designed to investigate the correlation between miR-206 and PH in patients with LHD. Methods: In 82 consecutively enrolled LHD patients, we examined the serum levels of miR-206 and analyzed its correlations with pulmonary artery systolic pressure (PASP) and cardiac function. Another 36 age- and sex-matched subjects served as healthy controls. Results: The patients were divided into the LHD group (n=47, PASP<50 mmHg) and the PH-LHD group (n=35, PASP≥50 mmHg). The level of miR-206 was significantly decreased in the PH-LHD group compared with that of the LHD and healthy control groups. In addition, the miR-206 level was correlated with PASP (r=-0.305, p<0.001) but not with systemic blood pressure. Univariate analyses showed that miR-206, brain natriuretic peptide (BNP), left ventricular ejection fraction and left atrial longitudinal diameter (LAD) were significantly related to PASP. Multivariate regression analysis identified miR-206 as an independent predictive factor for PH. MiR-206 alone (cut-off <0.66) demonstrated a sensitivity of 68.60% and a specificity of 65.80% in predicting PH. Moreover, the combination of miR-206, BNP and LAD (cut-off 0.21) showed a sensitivity of 97.10% and a specificity of 80.30% in predicting PH in LHD patients. Conclusion: A decreased circulating miR-206 level was associated with increased PASP in LHD patients. Thus, the level of miR-206, especially combined with BNP and LAD, might be helpful in the detection of PH in LHD patients.

scholarly journals Left Atrial Enlargement an Early Predictor for Development of Systolic Dysfunction – Results of a Cross-Sectional Study Conducted in Georgia

2017 ◽  
Vol 13 (33) ◽  
pp. 1
Author(s):  
Eka Rukhadze ◽  
Nino Tabagari-Bregvadze ◽  
Levan Tvildiani
Keyword(s):  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Systolic Pressure ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Early Predictor

Background and Aims: Left ventricular systolic dysfunction, even asymptomatic, is associated with the development of heart failure (HF) and all-cause mortality. Left ventricular ejection fraction (LVEF) is the most commonly used marker of left ventricular systolic function. It is well established that early detection and treatment of reduced LVEF, as well as the aggressive management of predisposing conditions, delays the manifestation of HF. Our study aimed to measure the association between LVEF and other echocardiographic variables in a population with LVEF within the normal range and without symptoms of HF. Methods: We conducted a cross-sectional study in 2008-2009. Results: We analyzed echocardiographic and clinical data of 146 patients: 66.4% were women; mean age was 55 (40 –69 years). LVEF significantly correlated only with left atrium (LA) size (Beta -0.266, p < 0.05). The correlation was inverse and remained significant after adjusting for age, gender, obesity, diabetes, arterial hypertension, left ventricular hypertrophy, pulmonary systolic pressure, mitral regurgitation, and diastolic dysfunction. Conclusions: We found that the earliest structural change associated with LVEF tendency to decrease was LA size. Further research is needed to assess the LA enlargement as an early predictor of systolic dysfunction development.

scholarly journals Heart reHeart remodeling in patients with severe systolic dysfunction due tocancer chemotherapymodeling in patients with severe systolic dysfunction due tocancer chemotherapy.

Kardiologiia ◽  
2020 ◽  
Vol 60 (3) ◽  
pp. 51-58
Author(s):  
E. I. Emelina ◽  
A. A. Ibragimova ◽  
I. I. Ganieva ◽  
G. E. Gendlin ◽  
I. G. Nikitin ◽  
...  
Keyword(s):  
Systolic Dysfunction ◽  
Systolic Pressure ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Left Ventricular Ejection ◽  
Pulmonary Artery Systolic Pressure ◽  
Ventricular Ejection Fraction ◽  
Men And Women

Objective Comparative analysis of structural and functional specific features of the heart in patients with toxic cardiomyopathy (TCMP) with a low left ventricular ejection fraction (LVEF) and severe, chronic heart failure (CHF) and in patients with idiopathic dilated cardiomyopathy (DCMP) and similar LVEF and CHF severity.Materials and Methods This observational, single-site study included 15 patients with TCMP (12 of them received treatment including anthracycline antibiotics and 3 patients received targeted therapies) and 26 patients with idiopathic DCMP. Data of echocardiography were compared for patients with TCMP and DCMP with comparably low LVEF of <40 %.Results In patients with severe heart damage associated with antitumor therapy with low LVEF, volumetric and linear indexes of left and right ventricles and the left atrium (left atrial volume index (LAVI), 33.7 (21.5–36.9) ml / m2; right ventricular end-diastolic dimension (RVDd), 2.49 (1.77–3.53) cm; and end-diastolic volume index (EDVI), 78.0 (58.7–90.0) ml / m2) were considerably less than in the DCMP group (LAVI, 67.1 (51.1–85.0) ml / m2; RVDd, 4.05 (3.6–4.4) cm; and EDVI, 117.85 (100.6–138.5) ml / m2, p<0.0001). Furthermore, LV wall thickness and pulmonary artery systolic pressure did not differ in these groups. Both in men and women with TCMP, LAVI and EDVI were significantly less than in men and women with DCMP.Conclusion The study showed significant differences in parameters of cardiac remodeling. In TCMP patients as distinct from DCMP patients, despite a pronounced decrease in LVEF, LV dilatation was absent or LV volumetric parameters were moderately increased with a more severe somatic status.

Features Associated With Pulmonary Hypertension In Splenectomized Patients With Hemoglobin E/β-Thalassemia Disease

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3457-3457
Author(s):  
Suporn Chuncharunee ◽  
Vichai Atichartakarn ◽  
Umaporn Udomsubpayakul ◽  
Napaporn Archararit
Keyword(s):  
Pulmonary Hypertension ◽  
Conflicts Of Interest ◽  
Laboratory Data ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Pulmonary Artery Systolic Pressure ◽  
Serum Lactate Dehydrogenase ◽  
Ventricular Ejection Fraction ◽  
Hemoglobin E

Abstract Introduction Pulmonary hypertension (PHT) associated with thalassemia hemoglobinopathy is now an accepted clinical entity. Due to a high prevalence of thalassemia hemoglobinpathy worldwide, it is the most common entity of PHT. Despite the commonness, its pathogenesis is not yet completely understood. Although asplenia is a known risk factor, PHT does not develop in all splenectomized patients. The present study was therefore done to search for other associated features. Patients and Methods Sixty-one clinically stable splenectomized hemoglobin E/β-thalassemia disease (E/β-Thal) adult outpatients, on no medication aside from folic acid and who received no blood transfusion in the preceding 4 weeks, were prospectively studied. All gave written informed consent, and study protocol was approved by the institution ethics committee on studies in humans (#0774/2548). Transthoracic echocardiogram was used to evaluate cardiac function and to estimate pulmonary artery systolic pressure (PASP). PHT was defined as an estimated PASP ≥36 mmHg. Clinical features and laboratory data were dichotomized according to the presence (PHT+) or absence (PHT-) of PHT, and statistical analysis was done by STATA version 10 (Stata Corp, Texas), considering a P value<0.05 as statistically significant. Results Of the 61 patients, 32 (52.5%) were PHT+, 14 of whom were female. There was no gender difference between the 2 groups (p=0.246). All had normal left ventricular ejection fraction, and none had positive serology for human immunodeficiency virus. Results expressed in mean ± SD or median (range) of the various measured parameters and their statistically significant differences are shown in the following table. Conclusions PHT was found in 52.5% of the 61 splenectomized E/β-Thal patients with no gender preponderance. Although PHT was found mostly after the first decade of splenectomy, its prevalence did not correlate with time elapsed since the procedure. Features associated with PHT in splenectomized E/β-Thal patients were greater transfusion requirement, lower RBC counts, higher serum lactate dehydrogenase (LDH) and lower serum cholesterol levels, as a reflection of more severe disease and more severe ineffective erythropoiesis; together with a higher serum soluble vascular cell adhesion molecule-1 (VCAM-1) levels, likely from chronic hypoxemia. Disclosures: No relevant conflicts of interest to declare.

scholarly journals GH Receptor Exon 3 Genotype and Echocardiographic Abnormalities in Patients With Active Acromegaly

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A643-A644
Author(s):  
Karla Serrano ◽  
Etual Espinosa ◽  
Daniel Marrero-Rodríguez ◽  
Eduardo Almeida ◽  
Gloria Silva-Roman ◽  
...  
Keyword(s):  
Systolic Dysfunction ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Genotype 3 ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Gh Receptor ◽  
Active Acromegaly

Abstract Background: The GH receptor (GHR) exon 3 polymorphism occurs at a genomic level. Approximately 50-60% of the population is homozygous for the exon-3 containing genotype (+3/+3), 30-40% are heterozygous (+3/-3) and 10-20% are homozygous for the exon-3 lacking genotype (-3/-3). Some studies suggest that children homo- and heterozygous for the GHR exon 3 lacking genotype (-more efficient 3/-3 and +3/-3, respectively) respond better to treatment with exogenous rhGH and there is also in vitro evidence showing a more efficient signal transduction through this exon 3 deleted isoform. Some studies have found that patients with acromegaly harboring the exon 3-deleted genotype may have a higher prevalence of diabetes and hypertension. Hypothesis and Objective: Patients with active acromegaly harboring the exon 3-lacking GHR genotype may have more echocardiographic abnormalities than those who are homozygous for the exon 3 containing genotype. Patients and Methods: This is a cross-sectional study of patients with active acromegaly, defined by an IGF-1 level &gt; 1.3 times the upper limit of normal (x ULN), who underwent transthoracic echocardiography. Exon-3 GHR genotype was determined by PCR using previously described sense and antisense primers. Results: The cohort consisted of 28 patients, 54% female, with a mean age of 51 ± 12 years. Mean disease duration at the time of echocardiographic examination was 4.48 ± 4.7 years; median basal GH and IGF-1 were 12 ± 26 ng/mL and 2.4 ± 1.04 x ULN. The prevalence of hypertension and diabetes were 43% and 36%, respectively. Fifty three percent of the patients were homozygous for the exon 3-containaing genotype (+3/+3), 18% were homozygous for the exon 3-lacking genotype (-3/-3) and 29% were heterozygous (+3/-3). Clinical and biochemical features did not differ between patients with the different GHR genotypes, except for hypertension that was more prevalent in the +3/+3 genotype group (60% vs 23%, p= 0.04). The frequency of the different echocardiographic parameters was similar among groups (left ventricular hypertrophy 33% vs 15%, p= 0.27; diastolic dysfunction 47% vs 31%, p= 0.39; subclinical systolic dysfunction 42% vs 54%, p= 0.54; left ventricular ejection fraction 59±10% vs 60±16%, p= 0.83); aortic valve abnormalities 19% vs 15%, p=0.63; mitral valve abnormalities 46% vs 15%, p=0.07). Conclusions: Echocardiographic abnormalities in patients with active acromegaly do not differ among patients with the different GHR exon 3 genotypes. The clinical spectrum of acromegaly varies considerably. Although such variability is usually related to the severity of the hypersomatotropinemia, in many patients this is not the case.

scholarly journals Effect of rituximab on heart involvement in systemic sclerosis

2019 ◽  
Vol 56 (6) ◽  
pp. 709-715 ◽  
Author(s):  
L. A. Garzanova ◽  
L. P. Ananyeva ◽  
O. A. Koneva ◽  
O. B. Ovsyannikova
Keyword(s):  
Systemic Sclerosis ◽  
Lung Function ◽  
Time Course ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Pulmonary Artery Systolic Pressure ◽  
Ventricular Ejection Fraction ◽  
Heart Involvement ◽  
One Year

As of now, there has been a great body of data on the use of rituximab (RTM) in systemic sclerosis (SS), mainly on its positive effect on skin fibrosis and lung injury. However, information is still scarce about the effect of RTM on other organs and systems, namely the heart affected by SS.Objective: to assess the time course of changes in the signs of heart involvement in SS patients one year after initiation of RTM therapy.Subjects and methods. The paper gives data on changes in cardiac disorders in 71 patients with SS one year after the prescription of RTM.Results and discussion. The rate of cardiac rhythm and conduction disorders and diastolic dysfunction was unchanged. At the same time, a significant increase in left ventricular ejection fraction (EF) and a reduction in the severity of dyspnea was achieved, which correlated with improved lung function (a significant rise in forced vital capacity). The results of treatment in three patients with predominant heart involvement associated with SS (coronary heart disease and hypertension were ruled out) were considered in detail. These patients displayed pronounced positive changes as increased EF, less severe cardiac arrhythmias, reduced chronic heart failure, better quality of life, as well as the synchronicity of lower disease activity, less skin induction, improved lung function, and stabilized pulmonary artery systolic pressure.Conclusion. RTM in combination with traditional therapy can be considered as a potentially effective drug for the treatment of heart involvement in SS.

scholarly journals Multimarker approach for assessing efficiency of cardiac resynchronization therapy in patients with sinus rhythm

2021 ◽  
Vol 28 ◽  
pp. 17-24
Author(s):  
V. A. Kuznetsov ◽  
T. N. Enina ◽  
A. M. Soldatova ◽  
T. I. Petelina ◽  
S. M. Dyachkov ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Sinus Rhythm ◽  
Complex Analysis ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Left Ventricular Ejection ◽  
Pulmonary Artery Systolic Pressure ◽  
Resynchronization Therapy ◽  
Ventricular Ejection Fraction

Purpose. To design a mathematical model, that can predict a positive response to cardiac resynchronization therapy (CRT) in patients with congestive heart failure (CHF) and sinus rhythm, according to complex analysis of neurohumoral and immune activation biomarkers, fibrosis, renal dysfunction, echocardiography.Methods. Parameters of echocardiography, plasma levels of NT-proBNP, interleukins-1β, 6, 10, tumor necrosis factor α, С-reactive protein (СRP), matrix metalloproteinase-9 (ММР-9), tissue inhibitors of metalloproteinase 1 and 4, cystatin С (CYSTATIN) were studied in 40 CHF patients with sinus rhythm (65% coronary artery disease patients, 75% males, mean age 54.8±10.6 years old) during the period of maximum decrease of left ventricular end-systolic volume (LVESV) (mean duration 27.5 [11.1; 46.3] months). Responders (decrease in LVESV ≥15%) and non-responders (decrease in LVESV <15%) were identified.Results. The number of responders was 26 (65%). The initial set of variables included: age, left ventricular ejection fraction (EF), pulmonary artery systolic pressure, right ventricle size and NT-proBNP, СRP, ММР-9, CYSTATIN. According to logistic regression analysis, a prediction model of positive CRT response was created. The specificity of the model was 92.9%, sensitivity - 83.3%, AUC=0.952 (р˂0.001).Conclusion. The proposed model, based on the assessment of left ventricle EF and circulating biomarkers of inflammation, fibrosis, and renal function, strongly suggests a higher possibility of response to CRT.

scholarly journals A Predictive Model for Dilated Cardiomyopathy With Pulmonary Hypertension

2021 ◽  
Author(s):  
Jiahua Liang ◽  
Ruochen Zhu ◽  
Yi Yang ◽  
Rong Li ◽  
Chuangxiong Hong ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Dilated Cardiomyopathy ◽  
Predictive Model ◽  
External Validation ◽  
Systolic Pressure ◽  
Vital Signs ◽  
Left Ventricular ◽  
Pulmonary Artery Systolic Pressure ◽  
Chronic Obstructive ◽  
The Impact

Abstract Background: Dilated cardiomyopathy (DCM) is defined as a serious cardiac disorder caused by the presence of left ventricular dilatation and contractile dysfunction in the absence of severe coronary artery disease and abnormal loading conditions. The incidence of cardiac death is markedly higher in patients with DCM with pulmonary hypertension (PH) than in DCM patients without PH. However, no previous studies have constructed a predictive model to predict PH in patients with DCM.Methods: Data from 218 DCM patients were collected. The diagnostic criterion for PH by echocardiography was a pulmonary artery systolic pressure (PASP) ≥ 40 mmHg. Basic information, vital signs, comorbidities and biochemical data of each patient were determined. The impact of each parameter on PH was analysed by univariable and multivariable analyses, the data from which were employed to establish a predictive model. Finally, the discriminability, calibration ability, and clinical efficacy of the model were verified for both the modelling group and the external validation group.Results: We successfully applied a history of chronic obstructive pulmonary disease (COPD) or chronic bronchitis, systolic murmur (SM) at the tricuspid area, SM at the apex and brain natriuretic peptide (BNP) level to establish a model for predicting PH in DCM. The model was proven to have high accuracy and good discriminability, calibration ability, and clinical application value.Conclusions: A model for predicting PH in patients with DCM was successfully established. The new model is reliable for predicting DCM with PH and has good clinical applicability.

scholarly journals Prognostic validation of partition values for quantitative parameters to grade functional tricuspid regurgitation severity by conventional echocardiography

2020 ◽  
Author(s):  
Denisa Muraru ◽  
Marco Previtero ◽  
Roberto C Ochoa-Jimenez ◽  
Andrada C Guta ◽  
Stefano Figliozzi ◽  
...  
Keyword(s):  
High Risk ◽  
Tricuspid Regurgitation ◽  
Nyha Class ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Pulmonary Artery Systolic Pressure ◽  
Threshold Values ◽  
Ventricular Ejection Fraction ◽  
Quantitative Parameters

Abstract Aims Quantitative echocardiography parameters are seldom used to grade tricuspid regurgitation (TR) severity due to relative paucity of validation studies and lack of prognostic data. To assess the relationship between TR severity and the composite endpoint of death and hospitalization for congestive heart failure (CHF); and to identify the threshold values of vena contracta width (VCavg), effective regurgitant orifice area (EROA), regurgitant volume (RegVol), and regurgitant fraction (RegFr) to define low, intermediate, and high-risk TR based on patients’ outcome data. Methods and results A cohort of 296 patients with at least mild TR underwent 2D, 3D, and Doppler echocardiography. We built statistical models (adjusted for age, NYHA class, left ventricular ejection fraction, and pulmonary artery systolic pressure) for VCavg, EROA, RegVol, and RegFr to study their relationships with the hazard of outcome. The tertiles of the derived hazard values defined the threshold values of the quantitative parameters for TR severity grading. During 47-month follow-up, 32 deaths and 72 CHF occurred. Event-free rate was 14%, 48%, and 93% in patients with severe, moderate, and mild TR, respectively. Severe TR was graded as VCavg &gt; 6 mm, EROA &gt; 0.30 cm2, RegVol &gt; 30 mL, and RegF &gt; 45%. Conclusion This outcome study demonstrates the prognostic value of quantitative parameters of TR severity and provides prognostically meaningful threshold values to grade TR severity in low, intermediate, and high risk.

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