scholarly journals Association between Light-Induced Dynamic Dilation of Retinal Vessels and Echocardiographic Parameters of the Left Ventricular Function in Hypertensive Patients

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 704
Author(s):  
Małgorzata Peregud-Pogorzelska ◽  
Małgorzata Zielska ◽  
Miłosz Piotr Kawa ◽  
Katarzyna Babiak ◽  
Krzysztof Safranow ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Retinal Vessel ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Hypertensive Patients ◽  
Echocardiographic Parameters ◽  
Systolic And Diastolic Function

Background and Objectives: The goal was to evaluate the association of dynamic retinal vessel analysis (DVA) with echocardiographic parameters assessing systolic and diastolic function of the left ventricle in hypertension (HT) patients with preserved left ventricle ejection fraction. Materials and Methods: This observational retrospective study recruited 36 patients with HT and 28 healthy controls. Retinal vessel diameter and reactions to flicker light were examined. Each patient was examined with echocardiography to assess left ventricular systolic and diastolic function. Results: Multivariate analysis revealed that hypertension was an independent factor associated with lower flicker-induced arterial vasodilatation (β = −0.31, p = 0.029). In the HT group, there was a significant positive association between left ventricular ejection fraction and flicker-induced arterial vasodilation (Rs = +0.31, p = 0.007). Additionally, end-diastolic left ventricular diameter negatively correlated with both arterial (Rs = −0.26, p = 0.02) and venous (Rs = −0.27, p = 0.02) flicker responses. Additionally, the echocardiographic characteristics of the left atrium (LA) remodeling in the course of HT, including the area of the LA and its antero-posterior dimension, were both negatively correlated with the arterial flicker response (Rs = −0.34, p = 0.003; Rs = −0.33, p = 0.004, respectively). From tissue Doppler parameters, the left ventricular filling index E/e’ negatively correlated with AVR (arteriovenous ratio) values (Rs = −0.36, p = 0.002). Conclusions: We revealed that systolic and diastolic function of the left ventricle in hypertensive patients is associated with retinal microvascular function.

P2470The prognostic importance and inter-relationship of systolic and diastolic tissue Doppler velocities in heart failure patients with reduced ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Sengelov ◽  
P G Jorgensen ◽  
N E Bruun ◽  
T Fritz-Hansen ◽  
F J Olsen ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
P Value ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Systolic And Diastolic Function ◽  
Relationship Of

Abstract Background Tissue Doppler imaging (TDI) can be used to evaluate both the systolic and diastolic function in patients with heart failure with reduced ejection fraction (HFrEF). However, previous studies have shown important inter-relationship between these measures in other patient populations. Purpose To investigate the prognostic importance and inter-relationship of systolic and diastolic TDI measures in HFrEF. Methods Conventional echocardiographic measurements together with peak longitudinal systolic (s'), early diastolic (e'), and late diastolic (a') myocardial velocities from all 6 myocardial walls were obtained from 1065 HFrEF patients. Outcome was all-cause mortality. Results Mean age was 67 years, 74% were male and mean left ventricular ejection fraction was 27%. During a median follow-up period of 40 months, 177 (16.6%) patients died. In univariable analyses, both s' and a' were associated with mortality (p<0.001), but e' was not (p>0.05). Patients were therefore stratified into high/low groups by the mean value of s' and a' respectively. The prognostic value of s' was significantly modified by a' (p for interaction 0.035). In patients with low s', low a' was associated with an increased risk of dying; HR 1.31 (CI: 1.17–1.55, P=0.001) per 1 cm/s decrease. Patients with both impaired systolic and diastolic function as assessed by low s' and a' had over 3 times greater risk of dying compared to having both high measures of s' and a' (HR 3.39, CI: 2.1–5.1, p<0.001) (figure). Having combined impaired systolic and diastolic function as assessed by low s' and a' remained an independent predictor of mortality even after multivariable adjustment for age, gender, body mass index, mean arterial pressure, ischemic cardiomyopathy, pacemaker, heart rate, total cholesterol, diabetes and conventional echocardiographic measures (HR 1.78 (CI: 1.04–3.04, p=0.035) (table)). Uni- and multivariable Cox regressions Variable Univariable model (95% CI) Multivariable model* HR (95% CI) P value HR (95% CI) P value High s' and high a' (n=386) Ref Ref High s' and low a' (n=113) 1.48 (1.07–4.03) 0.24 1.36 (0.69–2.70) 0.37 Low s' and high a' (n=156) 2.26 (1.34–3.81) 0.002 1.55 (0.86–2.78) 0.14 Low s' and low a' (n=262) 3.29 (2.43–5.75) <0.001 1.78 (1.04–3.04) 0.035 *Multivariable model adjusted for age, gender, body mass index, mean arterial pressure, ischemic cardiomyopathy, pacemaker, heart rate, total cholesterol, diabetes, left ventricular ejection fraction, left ventricular mass index, and deceleration time. Kaplan-Meier curves depicting survival Conclusion A pattern of combined low systolic and diastolic performance as assessed by s' and a' is a significant marker of adverse prognosis for patients with HFrEF, independent of conventional echocardiographic parameters. Acknowledgement/Funding None

P1775Outcomes in patients with left ventricular non-compaction phenotype and normal left ventricular ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Rebellius ◽  
R Berzins Schoenenberger ◽  
S Anwer ◽  
S Rogler ◽  
N Kuzo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lv Function ◽  
Ventricular Ejection Fraction ◽  
Echocardiographic Parameters ◽  
Normal Lvef

Abstract Introduction Left ventricular non-compaction (LVNC) is a rare cardiomyopathy with a progressive clinical course, resulting in symptoms such as heart failure, cardiac arrhythmias, or thrombo-embolic events. Little is known about the natural course of disease, in particular in individuals with normal LV ejection fraction (EF) at diagnosis. In this study, we aim to evaluate the outcome of this group of patients. Methods 48 LVNC patients with normal LV EF at diagnosis (defined as ≥50% by Simpson) were retrospectively analysed followed-up for median duration of 3656 days (2017–4965). All outcome data and conventional echocardiographic parameters were obtained; and in 27 patients, LV and right ventricular (RV) global longitudinal strain (GLS) were also determined using TomTec Image Arena (v.4.6). Results Mean age was 25.5 years. Median LVEF was 58.5% [IQR: 52.75 - 65.25]). The localization of non-compacted segments displayed a typical distribution with apical and inferolateral midventricular segments most frequently involved. Although LVEF was normal at baseline, median LV GLS was 16.8% (IQR: 20.0 - 14.2) and RV GLS was 18.7% (23.3–15.6). Furthermore, only 30 patients (73.2%) had a normal diastolic function, while others showed impaired relaxation (19.5%; n=8) or restrictive filling pattern (7.3%; n=3). During follow-up, LVEF decreased slightly from the initial visit (59%, [53.3–65.0]) to last follow-up (56%, [53.0–61.8], p=0.0009), and LV end-systolic and end-diastolic volumes increased (p=0.009 and 0.001, respectively). The other echocardiographic parameters did not show any significant changes. During follow-up, 3 patients (7.7%) died, 5 (12.8%) were hospitalized for heart failure, 3 (7.7%) had a thromboembolic event, 5 (12.8%) a syncope, 3 (8.1%) a non-sustained ventricular tachycardia, 9 (22.5%) a supraventricular tachycardia, and 14 (35.9%) suffered other complications during follow-up. The change in LVEF and LV volumes during follow-up was not significantly associated with outcome. Conclusion Patients presenting with a LVNC phenotype and normal LVEF did not display a completely normal LV function as revealed by LV strain and LV diastolic function. LVEF decreased slightly during follow-up, but was surprisingly stable in most patients. Nevertheless, a significant number of individuals experienced a clinically relevant event. Hence, a LVNC phenotype is important even in individuals with normal LVEF and such patients should be followed-up regularly.

New Hybrid Method for Left Ventricular Ejection Fraction Assessment from Radionuclide Ventriculography Images

2020 ◽  
Vol 16 ◽  
Author(s):  
Halima Dziri ◽  
Mohamed Ali Cherni ◽  
Dorra Ben Sellem
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Positive Predictive Value ◽  
Roc Curve ◽  
Radionuclide Ventriculography ◽  
Left Ventricular ◽  
The Other ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: In this paper, we propose a new efficient method of radionuclide ventriculography image segmentation to estimate the left ventricular ejection fraction. This parameter is an important prognostic factor for diagnosing abnormal cardiac function. Methods: The proposed method combines the Chan-Vese and the mathematical morphology algorithms. It was applied to diastolic and systolic images obtained from the Nuclear Medicine Department of Salah AZAIEZ Institute.In order to validate our proposed method, we compare the obtained results to those of two methods of the literature. The first one is based on mathematical morphology, while the second one uses the basic Chan-Vese algorithm. To evaluate the quality of segmentation, we compute accuracy, positive predictive value and area under the ROC curve. We also compare the left ventricle ejection fraction estimated by our method to that of the reference given by the software of the gamma-camera and validated by the expert, using Pearson’s correlation coefficient, ANOVA test and linear regression. Results and conclusion: Static results show that the proposed method is very efficient in the detection of the left ventricle. The accuracy was 98.60%, higher than that of the other two methods (95.52% and 98.50%). Likewise, the positive predictive value was the highest (86.40% vs. 83.63% 71.82%). The area under the ROC curve was also the most important (0.998% vs. 0.926% 0.919%). On the other hand, Pearson's correlation coefficient was the highest (99% vs. 98% 37%). The correlation was significantly positive (p<0.001).

COVID-19-associated myocarditis: single center experience of pathogenetic treatment

2021 ◽  
Vol 28 (3) ◽  
pp. 9-19
Author(s):  
V. M. Kovalenko ◽  
E. G. Nesukay ◽  
N. S. Titova ◽  
S. V. Cherniuk ◽  
R. M. Kirichenko ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Proinflammatory Cytokines ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Glucocorticoid Therapy ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

The aim – to evaluate the effectiveness of glucocorticoid therapy in patients with myocarditis with reduced left ventricular ejection fraction that developed after COVID-19 infection.Materials and methods. The results of glucocorticoid therapy in 32 patients aged (35.2±2.3) years with acute myocarditis after COVID-19 infection and left ventricular ejection fraction < 40 % are presented. All patients were prescribed a 3-month course of methylprednisolone at a daily dose of 0.25 mg/kg, followed by a gradual dose reduction of 1 mg per week until complete withdrawal 6 months after the start of treatment.Results and discussion. The analysis of the results of the examinations was performed in the 1st month from the onset of myocarditis to the appointment of glucocorticoids and after 6 months of observation. Six months later, the end-diastolic volume index decreased by 18.5 %, the left ventricular ejection fraction increased by 23.8 %, and the longitudinal global systolic straine increased by 39.8 %. On cardiac MRI, the number of left ventricular segments affected by inflammatory changes decreased from 6.22±0.77 to 2.89±0.45 segments, and the number of segments with fibrotic changes did not change significantly. After 6 months of treatment, there was a significant decrease in the concentrations of proinflammatory cytokines and cardiospecific antibodies.Conclusions. The use of a 6-month course of glucocorticoid therapy in patients with myocarditis that developed after COVID-19 infection improved the contractility of the left ventricle against the background of a significant reduction in inflammatory lesions of the left ventricle and reduced concentrations of proinflammatory cytokines and cardiospecific antibodies.

scholarly journals Changes in Mitral Annular Ascent with Worsening Echocardiographic Parameters of Left Ventricular Diastolic Function

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Paula M. Hernández Burgos ◽  
Angel López-Candales
Keyword(s):  
Ejection Fraction ◽  
Diastolic Function ◽  
Electromechanical Coupling ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Clinical Indication ◽  
Ventricular Ejection Fraction ◽  
Stage 1 ◽  
Lv Diastolic Function

Background. While the mitral annular plane systolic excursion (MAPSE) has been suggested as a surrogate measurement of left ventricular ejection fraction, less is known about the relative value of mitral annular ascent (MAa).Methods. Our database was queried for complete transthoracic echocardiograms performed for any clinical indication. Baseline echocardiographic measurements were compared to determine any correlation between MAa and traditional Echo-Doppler echocardiographic measures to characterize left ventricular diastolic dysfunction (LVDD).Results. Patients with normal LV diastolic function were younger (41±13years) than patients with LVDD (stage 1:61±13years; stage 2:57±14years; and stage 3:66±17years;p=0.156). LV ejection fraction decreased in patients with stage 2 LVDD (63±17%) and was further reduced in patients with stage 3 LVDD (28±21;p=0.003).Discussion. While a vigorous MAa excursion was seen in patients with stage 1 LVDD, MAa significantly decreased in stage 2 and stage 3 LVDD patients. Our results highlight the importance of atrioventricular coupling, as MAa motion seems to reflect changes in left atrial pressure. Additional studies are now required to better examine atrioventricular interactions and electromechanical coupling that might improve our assessment of LV diastolic function.

scholarly journals Profile of Hospitalized Hypertensives with Preserved and Reduced Left Ventricular Ejection Fraction in Nigeria

2019 ◽  
Vol 14 ◽  
Author(s):  
Akinsanya Daniel Olusegun-Joseph ◽  
Kamilu M Karaye ◽  
Adeseye A Akintunde ◽  
Bolanle O Okunowo ◽  
Oladimeji G Opadijo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Teaching Hospitals ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Hypertensive Patients ◽  
The Impact

Introduction The impact of preserved and reduced left ventricular ejection fraction (LVEF) has been well studied in heart failure, but not in hypertension. We aimed to highlight the prevalence, clinical characteristics, comorbidities and outcomes of hospitalized hypertensives with preserved and reduced LVEF from three teaching hospitals in Nigeria. Methods: This is a retrospective study of hypertensives admitted in 2013 in three teaching hospitals in Lagos, Kano and Ogbomosho, who had echocardiography done while on admission. Medical records and echocardiography parameters of the patients were retrieved and analyzed. Results: 54 admitted hypertensive patients who had echocardiography were recruited, of which 30 (55.6%) had reduced left ventricular ejection fraction (RLVEF), defined as ejection fraction <50%; while 24 (44.4%) had preserved left ventricular ejection fraction (PLVEF). There were 37(61.5%) females and 17 (31.5%) males. Of the male patients 64.7% had RLVEF, while 35.3% had PLVEF. 19(51.4%) of females had RLVEF, while 48.6% had PLVEF. Mean age of patients with PLVEF was 58.83±12.09 vs 54.83± 18.78 of RLVEF; p-0.19. Commonest comorbidity was Heart failure (HF) followed by stroke (found among 59.3% and 27.8% of patients respectively). RLVEF was significantly commoner than PLVEF in HF patients (68.8% vs 31.3%; p- 0.019); no significant difference in stroke patients (46.7% vs 53.3%; p-0.44). Mortality occurred in 1 (1.85%) patient who had RLVEF.         Conclusion: RLVEF was more common than PLVEF among admitted hypertensive patients; they also have more comorbidities. In-hospital mortality is, however, very low in both groups.

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