Early Predictive Biochemical, Electrocardiographic and Echocardiographic Markers for Cardiac Damage in Patients with Pulmonic Silicosis

2019 ◽  
Vol 70 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Venera Cristina Dinescu ◽  
Ileana Puiu ◽  
Sorin Nicolae Dinescu ◽  
Diana Rodica Tudorascu ◽  
Elena Catalina Bica ◽  
...  

The aim of this study was to identify correlations between electrocardiographic and echocardiographic changes in patients with silicosis prior to the occurrence of chronic pulmonary heart disease. We conducted a prospective, descriptive, analytical study, in which we included a group of 67 patients consecutively admitted to the Health Promotion and Occupational Medicine Clinic between December 2016 and January 2018, aged 47 to 78 years.There was a biochemical and electrocardiographic evaluation for each patient as well as a right ventricle echocardiographic evaluation (diameters, volumes, function). A control group, including 25 patients with benign minor diseases that required a cardiologist consultation, was also used. From the electrocardiographic point of view, slight changes were observed regarding the waves of electrical activity of the right ventricle. Taking into account the degree of ventilatory dysfunction (depending on FEV1), changes in right heart echocardiographic parameters were identified. Thus, in what the most important right ventricular parameters, including the tricuspid annular plane systolic excursion (TAPSE) or the RV index of myocardial performance (RVMPI) were concerned, values at the upper limit of normality were recorded in most patients with moderate and severe ventilatory dysfunction. Values of echocardiographic parameters of the right heart at the upper limit of normality, correlated with the degree of ventilatory dysfunction, are early markers for cardiovascular damage in patients with pulmonary silicosis prior to the occurrence of chronic pulmonary heart disease also known ascor pulmonale.

2017 ◽  
Vol 8 (1) ◽  
pp. 204589321775312 ◽  
Author(s):  
Kewal Asosingh ◽  
Serpil Erzurum

Current dogma is that pathological hypertrophy of the right ventricle is a direct consequence of pulmonary vascular remodeling. However, progression of right ventricle dysfunction is not always lung-dependent. Increased afterload caused by pulmonary vascular remodeling initiates the right ventricle hypertrophy, but determinants leading to adaptive or maladaptive hypertrophy and failure remain unknown. Ischemia in a hypertrophic right ventricle may directly contribute to right heart failure. Rapidly enlarging cardiomyocytes switch from aerobic to anaerobic energy generation resulting in cell growth under relatively hypoxic conditions. Cardiac muscle reacts to an increased afterload by over-activation of the sympathetic system and uncoupling and downregulation of β-adrenergic receptors. Recent studies suggest that β blocker therapy in PH is safe, well tolerated, and preserves right ventricle function and cardiac output by reducing right ventricular glycolysis. Fibrosis, an evolutionary conserved process in host defense and wound healing, is dysregulated in maladaptive cardiac tissue contributing directly to right ventricle failure. Despite several mechanisms having been suggested in right heart disease, the causes of maladaptive cardiac remodeling remain unknown and require further research.


2021 ◽  
Vol 2 (3 2021) ◽  
pp. 22-26
Author(s):  
Larysa Bodretska ◽  
Iryna Shapovalenko ◽  
Ivanna Antonyuk-Shcheglova ◽  
Olena Bondarenko ◽  
Svitlana Naskalova ◽  
...  

Abstract. Purpose of the work: to study the indicators characterizing heart lesions in elderly patients who had carried COVID-19. Materials and methods: 86 patients older than 60 years old, were examined, of whom 56 (32 women and 24 men) who have carried COVID-19 between 3 and 6 months before the study, and 30 patients (12 men and 18 women) who did not have COVID - 19 in the anamnesis. The patients have been examined clinically, electro and echocardiography have been performed. The results. Elderly patients during the post-covid period have complaints of shortness of breath, pain in the heart, swelling, coughing, weakness, which are more stable and intense than before the infection. Patients who have carried COVID-19 demonstrate the signs of a chronic pulmonary heart disease: increase in the size of a right ventricle and decrease of its contractile ability, increase in pressure in a pulmonary artery. Signs of a statistically significant moderate decrease of the contractility in the left ventricular were also identified. Conclusions. The statistically significant changes in the right departments of the heart among the patients with carried COVID-19 with persistent symptoms after infection were defined. Patients who have carried COVID-19 but have no symptoms did not differ statistically from the control group. Key words: COVID-19, old age, post- COVID period, right departments of the heart.


2021 ◽  
Vol 21 (2) ◽  
pp. 1127-1134
Author(s):  
Jin Li ◽  
Shirong Dong ◽  
Ningning Xing ◽  
Fei Jin ◽  
Lingqun Lu ◽  
...  

Chronic pulmonary heart disease is a common respiratory disease. Helicobacter pylori infection can lead to the occurrence of chronic pulmonary heart disease. However, most drugs for chronic pulmonary heart disease caused by helicobacter pylori are lack of tissue specificity. At the same time, due to the blocked blood circulation in the ischemic area, the distribution of drugs in the ischemic area is often not ideal. The gastroscope technology of nano carbon can make the drug release in the focus as much as possible, and can achieve the goal of targeted treatment. This paper mainly studies the application of the gastroscope technology based on nano carbon in the remedy of chronic pulmonary heart disease caused by helicobacter pylori. After 8 weeks of treatment, the indexes of right heart function in the two groups: TAPSE and RVMPI were better than before treatment, and the improvement degree in the remedy group was more obvious than that in the control group (P < 0.05). The improvement degree of E/A and PASP was not statistically significant, the difference between the two groups was not significant (P > 0.05). In addition, the gastroscope of nano carbon can also reduce UA and TG in blood. The overall response rate was 93.75% in the remedy group, which was higher than that in the control group (P < 0.05).


2016 ◽  
Vol 97 (3) ◽  
pp. 400-404
Author(s):  
N E Aidargalieva ◽  
A Zh Teleusheva

Chronic pulmonary heart disease is a common pathology and has become one of the leading causes of disability and death in recent years [15]. According to the literature, two-thirds of patients with chronic obstructive pulmonary disease die during the period from 15 months to 5 years after the circulatory decompensation onset, which occupies the third place after hypertension and coronary heart disease among causes of death in the age group older than 50 years [14]. Pulmonary hypertension is considered to be the main pathogenetic mechanism of chronic pulmonary heart disease [11]. The mortality rate in patients with chronic pulmonary heart disease is directly related to the level of pulmonary artery systolic blood pressure. Thus, according to literature data, at the pulmonary artery systolic pressure from 30 to 50 mm Hg 4-5-year survival rate is 30%, and at the level of more than 50 mm Hg 5-year survival rate is zero [1]. Thus, pulmonary hypertension is a poor prognostic factor. Furthermore, it is known that the changes identified in the right ventricle amid the pulmonary hypertension are survival predictors in patients with chronic obstructive pulmonary disease [18]. Literature review showed that the hemodynamics feature in patients with chronic pulmonary heart disease is increased pressure in the pulmonary artery, which leads to both ventricles remodeling and in particular to the right heart enlargement, rise of both right and left ventricles diastolic dysfunction, reduced stroke volume and cardiac output. Furthermore, the review describes that such drug classes as angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers and selective β-blockers are successfully used for the revealed disorders correction in patients with chronic pulmonary heart disease.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nadya Al-Wakeel-Marquard ◽  
Tiago Ferreira da Silva ◽  
Sarah Jeuthe ◽  
Sanaz Rastin ◽  
Frédéric Muench ◽  
...  

AbstractThe right ventricle´s (RV) characteristics—thin walls and trabeculation—make it challenging to evaluate extracellular volume (ECV). We aimed to assess the feasibility of RV ECV measurements in congenital heart disease (CHD), and to introduce a novel ECV analysis tool. Patients (n = 39) and healthy controls (n = 17) underwent cardiovascular magnetic resonance T1 mapping in midventricular short axis (SAX) and transverse orientation (TRANS). Regions of interest (ROIs) were evaluated with regard to image quality and maximum RV wall thickness per ROI in pixels. ECV from plane ROIs was compared with values obtained with a custom-made tool that derives the mean T1 values from a “line of interest” (LOI) centered in the RV wall. In CHD, average image quality was good (no artifacts in the RV, good contrast between blood/myocardium), and RV wall thickness was 1–2 pixels. RV ECV was not quantifiable in 4/39 patients due to insufficient contrast or wall thickness < 1 pixel. RV myocardium tended to be more clearly delineated in SAX than TRANS. ECV from ROIs and corresponding LOIs correlated strongly in both directions (SAX/TRANS: r = 0.97/0.87, p < 0.001, respectively). In conclusion, RV ECV can be assessed if image quality allows sufficient distinction between myocardium and blood, and RV wall thickness per ROI is ≥ 1 pixel. T1 maps in SAX are recommended for RV ECV analysis. LOI application simplifies RV ECV measurements.


Heart ◽  
2012 ◽  
Vol 98 (Suppl 2) ◽  
pp. E286.3-E286
Author(s):  
Jin Xiaoli ◽  
Li Hui ◽  
Li Xin ◽  
Liu Jianbo ◽  
Jin Xiaoli

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Rodriguez Garcia ◽  
A Pijuan Domenech ◽  
J Perez Rodon ◽  
B Benito Villabriga ◽  
J Francisco Pascual ◽  
...  

Abstract Introduction Patients with repaired tetralogy of Fallot (rTF) and severe pulmonary regurgitation frequently progress to dilation and dysfunction of the right ventricle (RV). It has been documented in the literature that there is a correlation between the duration of the QRS in the surface electrocardiogram and the hemodynamic parameters of the RV of these patients, suggesting the presence of a mechanical-electrical interaction. Purpose To determine if there is an association between the contraction delay in certain areas of the RV measured in M-mode echocardiography and the delay in electrical activation measured in the electroanatomic map (EAM) of RV in patients with rTF. Methods Unicentric and observational study of all patients with rTF undergoing EAM, echocardiography with study of RV asynchrony and cardiac magnetic resonance imaging (MRI). Activation delay in the antero-basal area and in the RV outflow tract (RVOT) in the EAM were both analysed (Figure 1A). The shortening delay in the same areas in M-mode echocardiography was also evaluated (Figure 1B, C). MRI data regarding volume and ejection fraction was also collected. Results 64 patients were included (36.7±10.6 years, 65% men). The mean total activation time of the RV (RV-TAT) was 127.3±42.4 ms. Activation mapping showed a recurrent pattern with beginning in the interventricular septum and ending in RV antero-basal region and/or RVOT. A linear positive correlation was observed between RV-TAT and the activation delay in both regions analysed (ρ=0.60 and ρ=0.52, respectively; p&lt;0.001) and also between the electrical and mechanical delay in the anterior wall (ρ=0.41; p=0.001). On the other hand, it was observed a negative correlation between RV ejection fraction (RVEF), measured on MRI, and the RV-TAT (ρ=−0.41, p=0.002) and also between RVEF and the activation delay in the RV antero-basal region and in the RVOT (ρ=−0.32, p=0.016 and ρ=−0.36, p=0.007, respectively). Conclusions There is a mechanical-electrical interaction in the RV of patients with rTF, with a negative correlation between the activation delay and RVEF and between mechanical and electrical activation delay in specific anatomical regions (regional mechanical-electrical interaction). These results may guide future studies on resynchronization in this heart disease. Figure 1. EAM and echocardiographic measures Funding Acknowledgement Type of funding source: None


2017 ◽  
Vol 136 (3) ◽  
pp. 262-265 ◽  
Author(s):  
Turgut Karabag ◽  
Caner Arslan ◽  
Turab Yakisan ◽  
Aziz Vatan ◽  
Duygu Sak

ABSTRACT CONTEXT: Obstruction of the right ventricular outflow tract due to metastatic disease is rare. Clinical recognition of cardiac metastatic tumors is rare and continues to present a diagnostic and therapeutic challenge. CASE REPORT: We present the case of a patient who had severe respiratory insufficiency and whose clinical examinations revealed a giant tumor mass extending from the right ventricle to the pulmonary artery. We discuss the diagnostic and therapeutic options. CONCLUSION: In patients presenting with acute right heart failure, right ventricular masses should be kept in mind. Transthoracic echocardiography appears to be the most easily available, noninvasive, cost-effective and useful technique in making the differential diagnosis.


2020 ◽  
Vol 19 (2) ◽  
pp. 32-37
Author(s):  
I. N. Shanaev

Aim. Study of heart function in the patients with CVD. Materials and methods. 46 patients with varicosity (VD) and 34 patients with post-thrombotic disease (PTD) were examined; the control group was represented by 15 healthy volunteers. The diagnosis was established using the CEAP basic classification. The study did not include patients with a diagnosed arterial hypertension, diabetes mellitus, chronic lung disease, significant hemodynamic heart defects, coronary heart disease. Ultrasound examination of the heart and veins of the lower extremities was performed on a Saote My Lab Alpha, Acuson Sequoia 512 apparatus. In addition to the standard protocol of heart ultrasound examination, the parameters of the right heart were calculated: sizes of the right ventricle (RV), right atrium, thickness of the anterior wall of the pancreas; to assess the ejection fraction (EF) of the pancreas the mobility of the lateral edge of the tricuspid ring was calculated, and the pressure on the tricuspid valve (TV) was measured. Diastolic ventricular function was studied by spectrograms of tricuspid and mitral blood flow. Results. Most of the indicators of cardiac activity in patients with VD were within normal limits, but a tendency to increase increasing of the right heart size was noted. In addition, the thickness of the interventricular septum and the right ventricle (RV) anterior wall was found to increase from 0.8 to 1.1 cm and from 0.3 to 0.5 cm, respectively, according clinical classes from C2 to C6 (CEAP). Eject fraction (EF) of both the RV and the left ventricle (LV) were also within normal limits, but with a tendency to decrease (67.8 % – C2, to 62 % – C6). The growth of the clinical class is followed by the increasing of percentage of non-restrictive blood flow through the tricuspid valve (TV). The restrictive type of blood flow in patients with VD had not been identified. Patients with PTD also showed a tendency to increase the right heart. However, whereas the size of the RV, as a rule, did not exceed 3.0 cm, the size of the right atrium was slightly higher than normal one in the clinical class C4 and C5.6. All the patients had EF of LV within normal limits, but it slightly decreased by the growth of class. Only patient classes C3 and C4 had EF of RV within the normal range. The 18 % of patient class C5.6 had EF lower than normal with value 48%. Diastolic dysfunction (DD) of the RV was detected in 73.3% of patients with class C3 and 100% with classes C4 and C5.6. Moreover, a restrictive type of blood flow through TV appeared from class C4 and the percentage increased up to 27.2% (class C5,6). Conclusions. DD of the RV was the main hemodynamic disorder.


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