scholarly journals The research of neurohormonal biomarkers in arterial hypertension diagnosis in adolescents

2016 ◽  
Vol 63 (2) ◽  
pp. 140-147
Author(s):  
Victoria Grosu ◽  
◽  
Victoria Melnicov ◽  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Arterial Hypertension ◽  
Myocardial Hypertrophy ◽  
Myocardial Damage ◽  
Control Group ◽  
Hemodynamic Parameters ◽  
Biochemical Tests ◽  
Hypertension Diagnosis

Arterial hypertension (AHT) is currently considered one of the most common pathologies of the cardiovascular system and one of the risk factors of atherosclerosis and chronic myocardial dysfunctions. Essential hypertension is accompanied by metabolic disorders, hypercatecholaminemia, hypertriglyceridemia, hyperinsulinemia, excessive fat storage in adipocytes in obese patients as well as other factors. To assess the degree and prognosis of arterial hypertension, it is important to use early diagnosis, first of all the signs of heart remodeling, metabolic and neurohormonal disorders, and changes in the arterial wall. Objectives of the study. Indices evaluation of neurohormonal biomarkers in arterial hypertension diagnosis in adolescents. Material and methods. The hemodynamic parameters of cardiac performance and neurohormonal biomarkers have been evaluated in this study of 113 children, divided in two groups. The first group included 52 patients, having chronic heart failure secondary to arterial hypertension and the second control group included 85 children. Obtained results. The EcoCG parameters in patients with arterial hypertension detected left myocardial hypertrophy and the septum myocardial hypertrophy, and the modification of the LVEF, LVSF. The determination of specific biochemical tests assessing myocardial damage biomarkers in patients with congestive heart failure secondary to arterial hypertension confirmed a statistically significant increase in serum content epinephrine in comparison with the control group (p<0.001), of the conclusive norepinephrine the control (p<0.05) and increase in urine content catecholamine in activity significance compared to the control group (p<0.001), with further increase concentration level in the dynamic therapy (p<0.001). Conclusions. The investigation performed shows that the patients with chronic heart failure develop hypoxic and ischemic processes, that lead to modified of hemodynamic parameters and metabolic and neurohormonal biomarkers.

scholarly journals The role of hemodynamic parameters in chronic heart failure diagnosis in children

2016 ◽  
Vol 11 (2) ◽  
pp. 187-193
Author(s):  
Victoria GROSU ◽  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Arterial Hypertension ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Myocardial Dysfunction ◽  
Clinical Manifestations ◽  
Heart Association ◽  
Left Ventricular ◽  
Hemodynamic Parameters

Despite the achievements in this field in recent years, concerning the chronic myocardial dysfunctions, pathogenesis, diagnosis and treatment management, the chronic heart failure continues to hold preeminence in the structure of cardiovascular complications and remains now one of the leading causes of invalidity of young contingent and infant mortality, presenting one of the most pressing public health problems. This requires looking for new methods of noninvasive early diagnosis with application of modern laboratory and investigational tests facilitating the identification in preclinical stages of chronic myocardial dysfunctions (CMD) by assessment of new biomarkers of myocardial injury. Objectives of the study. Hemodynamic parameters changes estimation in the evolution of chronic heart failure in children. Material and methods. The study included 233 patients with chronic heart failure, of which 78 were children and adolescents aged 10-17 years with CMD secondary to arterial hypertension. The diagnosis of arterial hypertension was established according to the ESA (European Society of Cardiology, 2009) recommendations, but the assessment of clinical manifestations of chronic heart failure was evaluated according to NYHA (New York Heart Association classification). The estimation of hemodynamic parameters was performed using echocardiography method using “Ultramark-8” (US device A) under Mand Doppler. Obtained results. In patients with arterial hypertension the types of concentric hypertrophy of left ventricular myocardial index mass (IMMVS) -59.2±14.2 and relative LV wall thickness (GRPVS) -0.46±0.22 cm were assessed. It is important to note that the study assessed the type of eccentric hypertrophy with IMMVS 66.4±7.6 and 0.44±0.25 cm GRPVS. Concentric geometric remodeling variant noted IMMVS average value of 48.4±4.2 and GRPVS- 0.44±0.21 cm. Identification of LV hypertrophy, increased GRPVS, IMMVS increase, the MMV based on echocardiographic examination of the heart reveals the geometric performance called “pathological remodeling” which actually confirms the occurrence of chronic myocardial dysfunction in patients with CHF secondary hypertension. Conclusions. Early identification of changes of cardiac performance parameters (MMV, IMMVS, GRPVS, HVS) under the conditions of the persistent tensional over estimation, reveals the early development of types of early myocardial pathological left ventricular remodeling and facilitates the options and diagnostic criteria of the heart remodeling in children with CMD secondary arterial hypertension in order to choose a selected pathogenetic treatment.

FUNCTIONAL AND INSTRUMENTAL EXAMINATION OF ELDERLY PATIENTS WITH CARDIOVASCULAR PATHOLOGY

2021 ◽  
pp. 134-138
Author(s):  
Михаил Олегович Паршин ◽  
Антон Александрович Титов ◽  
Татьяна Игоревна Субботина ◽  
Борис Дмитриевич Жидких ◽  
Елена Ефимовна Атлас
Keyword(s):  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Chronic Heart Failure ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
The Elderly ◽  
Functional Study ◽  
Economic Damage ◽  
Control Group ◽  
Cardiovascular Pathology

Сердечно-сосудистые заболевания в пожилом возрасте представляют актуальную проблему многих стран и на протяжении ряда последних десятилетий выступают ведущей причиной преждевременной смерти, нанося значительный экономический ущерб обществу и здравоохранению. Сердечно-сосудистые заболевания и, в частности, хроническая сердечная недостаточность в сочетании с артериальной гипертензией у пожилых встречаются часто, и такая тенденция сохранится и в ближайшие годы. Рассматриваемая патология у пожилых протекает нередко атипично и поэтому выявление ее требует комплексного функционального и инструментального обследования пациентов. Цель исследования - анализ и совершенствование функционального и инструментального обследования пожилых пациентов с сердечно-сосудистой патологией. Диагностическое обследование 86 пациентов 60-74 лет включало функциональное изучение интерлейкинового статуса и эхокардиографию при наличии хронической сердечной недостаточности и артериальной гипертензии. Диагноз хронической сердечной недостаточности устанавливался с учетом критериев NYHA и в соответствии с Рекомендациями Европейского общества кардиологов по диагностике и лечению острой и хронической сердечной недостаточности. Артериальная гипертензия верифицировалась в соответствии с «Национальными рекомендациями по диагностике, профилактике и лечению артериальной гипертензии». Контрольную группу составили 42 пациента пожилого возраста с отсутствием вышеназванных сердечно-сосудистых заболеваний. В ходе исследования установлено, что развитие сочетанной сердечно-сосудистой патологии сопровождается статистически значимым изменением ряда параметров инструментального (эхокардиографического) обследования. Одновременно при развитии сердечно-сосудистой патологии наблюдались изменения в системном интерлейкиновом профиле пациентов пожилого возраста. Они сопровождались преимущественно увеличением содержания в сыворотке крови провоспалительных интерлейкинов и особенно IL-8 до 48,6±2,5 пг/мл против 6,1±1,3 нг/мл в контрольной группе и IL-1β до 78,6±1,9 нг/мл против 13,5±1,0 пг/мл. Вместе с тем наблюдалось у пожилых пациентов с сердечно-сосудистой патологией снижение противовоспалительных интерлейкинов IL-4 и IL-10. Полученные результаты свидетельствуют о важности комплексного обследования пациентов с сердечно-сосудистой патологией Cardiovascular diseases in old age are an urgent problem in many countries and over the past few decades have been the leading cause of premature death, causing significant economic damage to society and public health. Cardiovascular diseases and, in particular, chronic heart failure in combination with arterial hypertension in the elderly are common and this trend will continue in the coming years. The pathology under consideration in the elderly is often isolated, and therefore its detection requires a comprehensive functional and instrumental examination of patients. The aim of the study was to analyze and improve the functional and instrumental examination of elderly patients with cardiovascular pathology. Diagnostic examination of 86 patients aged 60-74 years included functional study of interleukin status and echocardiography in the presence of chronic heart failure and arterial hypertension. The diagnosis of chronic heart failure was established taking into account the NYHA criteria and in accordance with the Recommendations of the European Society of Cardiology for the Diagnosis and Treatment of Acute and Chronic Heart Failure. Arterial hypertension was verified in accordance with the"National guidelines for the diagnosis, prevention and treatment of arterial hypertension". The control group consisted of 42 elderly patients with the absence of the above-mentioned cardiovascular diseases. The study found that the development of combined cardiovascular pathology is accompanied by a statistically significant change in a number of parameters of the instrumental (echocardiographic) examination. At the same time, changes in the systemic interleukin profile of elderly patients were observed with the development of cardiovascular pathology. They were accompanied mainly by an increase in the serum content of proinflammatory interleukins and especially IL-8 to 48.6±2.5 pg / ml versus 6.1±1.3 ng/ml in the control group and IL-1β to 78.6±1.9 ng/ml versus 13.5±1.0 pg / ml. At the same time, a decrease in anti-inflammatory interleukins IL-4 and IL-10 was observed in elderly patients with cardiovascular pathology. The results obtained indicate the importance of a comprehensive examination of patients with cardiovascular pathology

Clinical Assistant Analysis of Color Doppler Ultrasound in Diagnosis Parameters of Chronic Heart Failure

2021 ◽  
Vol 11 (6) ◽  
pp. 1616-1622
Author(s):  
Chenwei Gao ◽  
Wei Zeng ◽  
Xueyong Li ◽  
Yingjuan Zheng ◽  
Weiliang Liu
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Treatment Effect ◽  
Predictive Value ◽  
Heart Function ◽  
Color Doppler ◽  
Myocardial Damage ◽  
Color Doppler Ultrasound ◽  
Control Group

Chronic heart failure (CHF) is a group of clinical syndromes caused by changes in myocardial structure and function caused by any reason, leading to ventricular filling and ejection disorders. It is the final stage of the development of various cardiovascular diseases. It is a progressive disease. Once it starts, even if there is no new myocardial damage, the clinic is still in a stable stage, and it can still continue to develop on its own. This article uses the comprehensive parameters of echocardiography to evaluate the overall heart function of patients with chronic heart failure, and evaluates the treatment effect of patients with chronic heart failure. A total of 160 patients with chronic heart failure were studied, including 80 cases in the follow-up group, 40 cases in the non-follow-up group, and 40 cases in the normal control group. The heart failure ultrasound index composed of the comprehensive parameters of echocardiography was used to measure brain natriureric pepride (BNP), and the heart function was graded. The results showed that when the heart failure ultrasound index value >3, the diagnosis of symptomatic chronic heart failure had a sensitivity of 94.7%, a specificity of 94.6%, a positive predictive value of 97.8%, and a negative predictive value of 80.6%. The heart failure ultrasound index was positively correlated with plasma BNP and NYHA heart function (respectively 0.68, 0.73). After 6 months of observation, the ultrasound index of heart failure in the follow-up group decreased significantly before and after treatment. The experimental results show that the heart failure ultrasound index can be used to guide the treatment of patients with chronic heart failure, evaluate the treatment effect, and evaluate the prognosis. Appropriate health education and standardized medication can improve the treatment effect of chronic heart failure and improve the quality of life of patients.

scholarly journals Efficacy of cardiac rehabilitation with motion assistance from wearable cyborg hybrid assistive limb in patients with chronic heart failure: a randomized controlled trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Watanabe ◽  
A Koike ◽  
H Kato ◽  
L Wu ◽  
K Hayashi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cardiac Rehabilitation ◽  
Exercise Therapy ◽  
Knee Extensor ◽  
Control Group ◽  
Cardiac Events ◽  
Rehabilitation Programs ◽  
Sit To Stand ◽  
Knee Extensor Strength

Abstract Background Recent Cochrane Systematic Review suggested that the participation in cardiac rehabilitation is associated with approximately 20% lower cardiovascular mortality and morbidity. Exercise therapy is the key component of cardiac rehabilitation programs. In recent years, innovative technologies have been introduced into the field of rehabilitation, and a typical example is the wearable cyborg Hybrid Assistive Limb (HAL). The wearable cyborg HAL provides motion assistance based on detection of bioelectrical signals on the skin surface when muscle forces are generated. The lumbar-type HAL is expected to expand the therapeutic options for severe cardiac patients who have difficulty in performing usual cardiac rehabilitation programs, such as bicycle pedaling or walking. Purpose We aim to compare the efficacy of exercise therapy performed with motion assistance from a lumbar-type HAL versus conventional training (sit-to-stand exercise without HAL) in patients with chronic heart failure. Methods This clinical trial is a randomized, non-blinded, and controlled study. Twenty-eight heart failure patients (73.1±13.8 years) who have difficulty in walking at the usual walking speed of healthy subjects were randomly assigned to 2 groups (HAL group or control group) with a 1:1 allocation ratio and performed sit-to stand exercise either with HAL or without HAL for 5 to 30 minutes once a day, and 6 to 10 days during the study period. The brain natriuretic peptide (BNP), isometric knee extensor strength, standing ability (30-seconds chair-stand test: CS-30), short physical performance battery (SPPB) and 6-minute walking distance (6MWD) were measured before and after the completion of cardiac rehabilitation. Cardiac events such as death, re-hospitalization, myocardial infarction and worsening of angina pectoris and heart failure during 1 year after discharge were evaluated. Results There was no significant difference in the number of days of exercise therapy between the two groups. BNP, SPPB and 6MWD were improved in both groups. In the HAL group, the isometric knee extensor strength (0.29±0.11 vs 0.35±0.11 kgf/kg, p=0.003) significantly improved and CS-30 (5.5±5.1 vs 8.2±5.3, p=0.054) tended to improve. However, in the control group, either the isometric knee extensor strength (0.35±0.11 vs 0.36±0.14 kgf/kg, p=0.424) or CS-30 (6.0±4.3 vs 9.2±6.2, p=0.075) did not significantly change. HAL group showed significantly more improvement in the isometric knee extensor strength than control group (p=0.045). Cardiac events occurred in 20% in the HAL group and 43% in the control group. Conclusion The improvement in isometric knee extensor strength with the assistance from lumbar-type HAL suggests that exercise therapy using this device may be useful in chronic heart failure patients with flail or sarcopenia, a strong poor prognostic factor in these patients. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This work was supported in part by a grant-in-aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan (JSPS KAKENHI grant number JP17K09485) and funded by the ImPACT Program of the Council for Science, Technology and Innovation (Cabinet Office, Government of Japan) (grant number 2017-PM05-03-01).

Abstract 3791: Improved Ventricular-Arterial Coupling After 4 Weeks of Exercise Training in Patients with Chronic Heart Failure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Marcus Sandri ◽  
Stephan Gielen ◽  
Norman Mangner ◽  
Volker Adams ◽  
Sandra Erbs ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Exercise Training ◽  
Endothelial Function ◽  
Training Group ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Lv Function ◽  
Ventricular Ejection Fraction

Background: The concept of ventricular-arterial coupling implies that LV-function is determined by the three factors left ventricular diastolic, left ventricular systolic and arterial elastance. We have previously documented an improvement in endothelial function and systolic LV-function in patients with chronic heart failure (CHF) after 6 months of exercise training (ET). It remains, however, unclear, how shorter ET periods may affect endothelial, systolic and diastolic ventricular function as echocardiographic parameters related to ventricular arterial coupling in patients with CHF. METHODS: In this ongoing study we randomised 43 patients with stable CHF (age 60.3 ± 2.9 years, EF 27.4 ± 1.7%, VO 2 max 14.7 ± 4.3ml/kg*min) to a training or a control group (C). Patients in the training group exercised 4 times daily at 70% of the individual heart rate reserve for 4 weeks under supervision. At baseline and after 4 weeks the E/A ratio and septal/lateral E’/A’ velocities were determined by echocardiography with tissue Doppler. Exercise capacity was measured by ergospirometry and flow-mediated dilatation (FMD) was assessed by high-resolution radial ultrasound. RESULTS: After only 4 weeks of ET oxygen uptake at peak exercise increased from 14.9 ± 3.3 to 18.1 ± 4.7 ml/min/kg, (p<0.01 vs. C) in training subjects. Left ventricular ejection fraction improved from 26.8 ± 4.6 to 33.1 ± 5.5% (p<0.05 vs. C) in patients of the training group while it remained unchanged in the control group. E/A-ratio mended from 0.63 ± 0.12 to 0.81 ± 0.22 (p<0.01 vs. C) in training patients. Septal E’ velocities increased from 5.5 ± 0.5 to 7.8 ± 1.4 cm/s in training patients (p<0.05 vs. C). FMD of the radial artery improved from 8.2 ± 2.1 to 15.2 ± 3.8% (p<0.01 vs. C) as a result of ET. CONCLUSIONS: Only 4 weeks of endurance training are highly effective with significantly improved FMD accompanied by an emended systolic and diastolic LV-function. We hypothesise that the improvement in LV-EF in training patients may be caused by a corrected ventricular-arterial coupling: ventricular diastolic relaxation and effective endothelial function are ameliorated resulting in an augmentation of stroke volume.

Abstract 17220: Effects of the Oral Adsorbent of AST-120 in Patients with both Chronic Heart Failure and Chronic Kidney Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Miki Imazu ◽  
Masanori Asakura ◽  
Takuya Hasegawa ◽  
Hiroshi Asanuma ◽  
Shin Ito ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Chronic Heart Failure ◽  
Kidney Disease ◽  
Diastolic Dysfunction ◽  
Uremic Toxins ◽  
Control Group ◽  
Blood Levels ◽  
Uremic Toxin ◽  
Oral Adsorbent

Background: One of uremic toxins, indoxyl sulfate (IS) is related to the progression of chronic kidney disease (CKD) and the worse cardiovascular outcomes. We have previously reported the relationship between IS levels and the severity of chronic heart failure (CHF), but the question arises as to whether the treatment of uremic toxin is beneficial in patients with CHF. This study aimed to elucidate whether the treatment with the oral adsorbent which reduces uremic toxin improved the cardiac function of the patients with CHF. Methods: First of all, we retrospectively enrolled 49 patients with both CHF and stage ≤3 CKD in our institute compared with the healthy subjects without CHF or CKD in the resident cohort study of Arita. Secondly, we retrospectively enrolled 16 CHF outpatients with stage 3-5 CKD. They were treated with and without the oral adsorbent of AST-120 for one year termed as the treatment and control groups, respectively. We underwent both blood test and echocardiography before and after the treatment. Results: First of all, among 49 patients in CHF patients, plasma IS levels increased to 1.38 ± 0.84 μg/ml from the value of 0.08 ± 0.06 μg/ml in Arita-cho as a community-living matched with gender and eGFR of CHF patients. We found both fractional shortening (FS) and E/e’, an index of diastolic function were decreased (25.0 ± 12.7%) and increased (13.7 ± 7.5), respectively in CHF patients compared with the value of FS and E/e’ in Arita-cho (FS: 41.8 ± 8.3%, E/e’: 8.8 ± 2.1). Secondly, in the treatment group, the plasma IS levels and the serum creatinine and brain natriuretic peptide levels decreased (1.40 ± 0.17 to 0.92 ± 0.15 μg/ml; p<0.05, 1.91 ± 0.16 to 1.67 ± 0.12 mg/dl; p<0.05, 352 ± 57 to 244 ± 49 pg/ml; p<0.05, respectively) and both FS and E/e’ were improved following the treatment with AST-120 (28.8 ± 2.8 to 32.9 ± 2.6%; p<0.05, 18.0 ± 2.0 to 11.8 ± 1.0; p<0.05). However, these parameters did not change in the control group. Conclusions: The treatment to decrease the blood levels of uremic toxins improved not only renal dysfunction but cardiac systolic and diastolic dysfunction in patients with chronic heart failure. Oral adsorbents might be a new treatment of heart failure especially with diastolic dysfunction.

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