scholarly journals Correlation between Serum Level of Matrix Metalloproteinase-2 with Left Ventricular End-diastolic Volume in Children with Heart Failure

2020 ◽  
Vol 8 (B) ◽  
pp. 973-977
Author(s):  
Bagus Ngurah Mahakrishna ◽  
Eka Gunawijaya ◽  
I Wayan Dharma Artana ◽  
Ni Putu Veny Kartika Yantie ◽  
Made Kardana ◽  
...  
Keyword(s):  
Heart Failure ◽  
Serum Level ◽  
Matrix Metalloproteinase ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Matrix Metalloproteinase 2 ◽  
Cross Sectional ◽  
Positive Correlation ◽  
End Diastolic Volume ◽  
Moderate Positive Correlation

BACKGROUND: Left ventricular end-diastolic volume (LVEDV) on echocardiography is one of the tests performed on heart failure. This refers to the volume of the left ventricle at the end of the diastolic phase, which would be increased when there is a disturbance in preload, afterload, and contractility factors. Matrix metalloproteinase-2 (MMP2) is a marker of congestive heart failure that can be examined through laboratory examinations. AIM: The objective of the study was to provide evidence of the association between MMP and inflammatory process as well as its correlation with LVEDV in children with heart failure. METHODS: This was a cross-sectional study conducted on children aged 3 months–12 years old with heart failure, who visited Sanglah Hospital, Denpasar, Indonesia from May 2017 to March 2018. Echocardiographic examination (LVEDV) and blood samples were taken to measure the serum level of MMP2 on day 1 after the subjects were diagnosed with heart failure. RESULTS: A total of 32 subjects with heart failure were analyzed in this study. Acyanotic congenital heart defect (CHD) was the most common cause of heart failure, as observed in 23 subjects (71.9%). Characteristics data revealed that 24 subjects (75%) were underweight, 23 (71.9%) had cardiomegaly, and 22 (68.8%) had mild heart failure. Data analysis showed a moderate positive correlation between MMP2 levels with LVEDV after controlling for the influence of age (p = 0.02; r = 0.425). CONCLUSION: There was a moderate positive correlation between MMP2 level and LVEDV after controlling for the age factor.

scholarly journals Correlation Between Docosahexaenoic Acid Intake and It’s Content in Breast Milk of Lactating Mothers in Jakarta

2020 ◽  
Vol 3 (2) ◽  
pp. 45
Author(s):  
Raphael Kosasih ◽  
Ninik Mudjihartini ◽  
Saptawati Bardosono
Keyword(s):  
Breast Milk ◽  
Docosahexaenoic Acid ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Food And Agriculture ◽  
Food And Agriculture Organization ◽  
Lactating Mothers ◽  
Moderate Positive Correlation

Objective: Docosahexaenoic acid (DHA) is the predominant structural fatty acid in the brain and crucial for cognitive development in early life. Newborn DHA intake completely depends on preformed DHA in mother’s breast milk. In advancing years, globalization has been declining the fish intake of Asian countries. This study aims to determine DHA intake among lactating mothers in Jakarta and its association with breast milk’s DHA.Method: This cross-sectional study was conducted in Grogol Petamburan and Cilincing Public Health Centers, Jakarta. Eighty healthy lactating mothers aged 20–35 years old in 1–6 months postpartum were taken using consecutive sampling method. Characteristics data were taken by interviews and DHA intake was assessed with the semiquantitative food frequency questionnaire. Breast milk specimens were collected in the morning and its DHA content was analyzed using Gas Chromatography with Mass Spectrometry. Descriptive analyses and Spearman rho test were used with a 95% confidence level.Result: This study showed the median of subjects’ DHA intake was 158.5(13.9–719.7) mg/day, i.e., 67.5% of the subjects was below Food and Agriculture Organization (FAO) recommendation. The median of breast milk DHA was 51.7(19–184.7) mg/day, only 42.5 % of the subjects had breast milk DHA to meet the minimal requirement of their infant. A moderate positive correlation was found between maternal DHA intake with breast milk DHA (r = 0.478, p < 0.001). Conclusion:  Maternal DHA intake has moderate positive correlation with breast milk DHA, more than half of the subject had DHA intake below FAO recommendation.

Algorithm for diagnosis and typing of ALCAPA syndrome

2021 ◽  
Vol 3 (2) ◽  
pp. 01-07
Author(s):  
Mariela Céspedes Almira ◽  
Adel Eladio González Morejón ◽  
Giselle Serrano Ricardo ◽  
Tania Rosa González Rodríguez ◽  
Judith Escobar Bermúdez
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Left Coronary Artery ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Volume Index ◽  
Cross Sectional ◽  
End Diastolic Volume ◽  
Congenital Origin ◽  
Diagnostic Modalities

ALCAPA syndrome was characterized by anomalous origin of left coronary artery from pulmonary artery. Its clinical presentation is varied and although it is an anomaly of congenital origin, it is not exclusive to pediatric ages. Its epidemiological documentation is difficult. We aimed to make the non-invasive diagnosis of the ALCAPA syndrome and its variants. An observational, prospective and cross-sectional study was conducted with 31 patients with a positive echocardiographic diagnosis of ALCAPA syndrome at Pediatric Cardio Center “William Soler” from 2005 to 2018. The variables with significance for diagnosis were the echocardiographic visualization of the anomalous connection and the reversed flow in the left coronary artery. The variables with significance for typing were age at diagnosis, ischemia in the electrocardiogram, echocardiographic visualization of left ventricle papillary muscles fibrosis, presence of severe mitral regurgitation, left ventricle spheroidal remodeling, left ventricle ejection fraction, left ventricular end-diastolic volume index, and left ventricular end-diastolic diameter index. An algorithm integrated by various diagnostic modalities associated with echocardiography as a tool for the detection of ALCAPA was developed. The documentation of the diagnostic and classificatory aspects of the syndrome is possible by detecting echocardiographic elements in conjunction with electrocardiographic and radiological aspects.

scholarly journals Intracoronary delivery of recombinant TIMP-3 after myocardial infarction: effects on myocardial remodeling and function

2017 ◽  
Vol 313 (4) ◽  
pp. H690-H699 ◽  
Author(s):  
Shayne C. Barlow ◽  
Heather Doviak ◽  
Julia Jacobs ◽  
Lisa A. Freeburg ◽  
Paige E. Perreault ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Matrix Metalloproteinase ◽  
Reperfusion Injury ◽  
Targeted Delivery ◽  
Ischemia Reperfusion ◽  
Left Ventricular ◽  
Myocardial Remodeling ◽  
Myocardial Ischemia And Reperfusion ◽  
End Diastolic Volume

Ischemia-reperfusion (IR) and myocardial infarction (MI) cause adverse left ventricular (LV) remodeling and heart failure and are facilitated by an imbalance in matrix metalloproteinase (MMP) activation and the endogenous tissue inhibitors of metalloproteinase (TIMPs). We have identified that myocardial injections of recombinant TIMP-3 (rTIMP-3; human full length) can interrupt post-MI remodeling. However, whether and to what degree intracoronary delivery of rTIMP-3 post-IR is feasible and effective remained to be established. Pigs (25 kg) underwent coronary catheterization and balloon occlusion of the left anterior descending coronary artery (LAD) for 90 min whereby at the final 4 min, rTIMP-3 (30 mg, n = 9) or saline was infused in the distal LAD. LV echocardiography was performed at 3–28 days post-IR, and LV ejection fraction (EF) and LV end-diastolic volume were measured. LV EF fell and LV end-diastolic volume increased from baseline (pre-IR) values (66 ± 1% and 40 ± 1 ml, respectively, means ± standard deviation) in both groups; however, the extent of LV dilation was reduced in the rTIMP-3 group by 40% at 28 days post-IR ( P < 0.05) and the fall in LV EF was attenuated. Despite equivalent plasma troponin levels (14 ± 3 ng/ml), computed MI size at 28 days was reduced by over 45% in the rTIMP-3 group ( P < 0.05), indicating that rTIMP-3 treatment abrogated MI expansion post-IR. Plasma NH2-terminal pro-brain natriuretic peptide levels, an index of heart failure progression, were reduced by 25% in the rTIMP-3 group compared with MI saline values ( P < 0.05). Although the imbalance between MMPs and TIMPs has been recognized as a contributory factor for post-MI remodeling, therapeutic strategies targeting this imbalance have not been forthcoming. This study is the first to demonstrate that a relevant delivery approach (intracoronary) using rTIMP can alter the course of post-MI remodeling. NEW & NOTEWORTHY Myocardial ischemia and reperfusion injury remain significant causes of morbidity and mortality whereby alterations in the balance between matrix metalloproteinase and tissue inhibitor of metalloproteinase have been identified as contributory biological mechanisms. This novel translational study advances the concept of targeted delivery of recombinant proteins to modify adverse myocardial remodeling in ischemia-reperfusion injury.

scholarly journals Relationship between physician financial incentives and clinical pathway compliance: a cross-sectional study of 18 public hospitals in China

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027540
Author(s):  
Jie Bai ◽  
Kate Bundorf ◽  
Fei Bai ◽  
Huiqin Tang ◽  
Di Xue
Keyword(s):  
Heart Failure ◽  
Financial Incentives ◽  
Clinical Pathways ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Public Hospitals ◽  
Sectional Study ◽  
Cross Sectional ◽  
Physician Compliance ◽  
The Relationship

ObjectivesMany strategies have been either used or recommended to promote physician compliance with clinical practice guidelines and clinical pathways (CPs). This study examines the relationship between hospitals’ use of financial incentives to encourage physician compliance with CPs and physician adherence to CPs.DesignA retrospectively cross-sectional study of the relationship between the extent to which patient care was consistent with CPs and hospital’s use of financial incentives to influence CP compliance.SettingEighteen public hospitals in three provinces in China.ParticipantsStratified sample of 2521 patients discharged between 3 January 2013 and 31 December 2014.Primary outcome measuresThe proportion of key performance indicators (KPIs) met for patients with (1) community-acquired pneumonia (pneumonia), (2) acute myocardial infarction (AMI), (3) acute left ventricular failure (heart failure), (4) planned caesarean section (C-section) and (5) gallstones associated with acute cholecystitis and associated cholecystectomy (cholecystectomy).ResultsThe average implementation rate of CPs for five conditions (pneumonia, AMI, heart failure, C-section and cholecystectomy) based on 2521 cases in 18 surveyed hospitals was 57% (ranging from 44% to 67%), and the overall average compliance rate for the KPIs for the five conditions was 69.48% (ranging from 65.07% to 77.36%). Implementation of CPs was associated with greater compliance within hospitals only when hospitals adopted financial incentives directed at physicians to promote compliance.ConclusionCPs are viewed as important strategies to improve medical care in China, but they have not been widely implemented or adhered to in Chinese public hospitals. In addition to supportive resources, education/training and better administration in general, hospitals should provide financial incentives to encourage physicians to adhere to CPs.

scholarly journals Left ventricular longitudinal shortening: relation to stroke volume and ejection fraction in ageing, blood pressure, body size and gender in the HUNT3 study

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001243
Author(s):  
Asbjørn Støylen ◽  
Håvard Dalen ◽  
Harald Edvard Molmen
Keyword(s):  
Blood Pressure ◽  
Body Size ◽  
Ejection Fraction ◽  
Stroke Volume ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Health Study ◽  
Cross Sectional ◽  
Relative Contribution ◽  
End Diastolic Volume

BackgroundAims of this cross-sectional study were to assess: the relative contribution of left ventricular (LV) systolic long-axis shortening (mean mitral annular plane systolic excursion, MAPSE) to stroke volume (SV), the mechanisms for preserved ejection fraction (EF) despite reduced MAPSE, the age dependency of myocardial volume and myocardial systolic compression.MethodsLinear dimensions and longitudinal and cross-sectional M-modes were acquired in 1266 individuals without history of heart disease, diabetes or known hypertension from the third wave of the Nord-Trøndelag Health Study. Measurements were entered into a half-ellipsoid LV model for volume calculations, and volumes were related to age, body size (body surface area, BSA), sex and blood pressure (BP).ResultsMean BP and proportion with hypertensive values increased with increasing age. MAPSE contributed to 75% of SV, with no relation to age or BSA as both MAPSE and SV decreased with increasing age. LV end-diastolic volume (LVEDV) and SV increased with BSA and decreased with higher age; EF was not related to age or BSA. Myocardial volume increased with higher age and BSA, with an additional gender dependency. The association of age with myocardial volume was not significant when corrected for BP, while both systolic and diastolic BP were significant associated with myocardial volume. Myocardial compression was less than 3%.ConclusionsMAPSE contributes approximately 75% and short axis shortening 25% to SV. Both decline with age, but their percentage contributions to SV are unchanged. EF is preserved by the simultaneous decrease in LVEDV and SV. Myocardial volume is positively associated with age, but this is only related to higher BP, which may have implications for BP treatment in ageing. The myocardium is near incompressible.

scholarly journals Screening for asymptomatic heart failure with preserved ejection fraction in mongolian population at high risk

Kardiologiia ◽  
2020 ◽  
Vol 60 (4) ◽  
pp. 86-90
Author(s):  
Ts. Unurjargal ◽  
Ch. Khorloo ◽  
G. Ulziisaikhan ◽  
N. Sodovsuren ◽  
A. Khasag
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
High Risk ◽  
Ejection Fraction ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Cross Sectional ◽  
High Prevalence

Objective The goals of the present study were to assess the prevalence of asymptomatic heart failure with preserved ejection fraction (HFpEF) in subjects at high risk of developing HF and to define the diagnostic accuracy of NT-pro BNP assay compared with echocardiography in this setting.Material and methods This cross-sectional study included subjects aged from 35 to 64 years, with high risk of HF, who had no clinical symptoms of HF. Risk factors of HF were detected by clinical examinations. NT-pro BNP determination was performed using immunoassay analyzer (FIA8000, Getein Bio Medical Inc, China),. The cut-off point for NT-pro BNP was 125 pg/ml. Diagnosis of HFpEF was based on criteria recommended by 2016 ESC heart failure guidelines. Diastolic dysfunction was assessed according to the algorithm proposed in the joint recommendations of the ASE/EACVI.Results 602 patients with risk factors of HF were included in the study, of which 256 (42.5 %) were males and 346 (57.5 %) females. The mean age was 51.71±8.07 years. 83 patients (13.8 %) showed elevated NT-pro BNP levels of ≥125 pg / ml. Our study has shown that NT-pro BNP concentration was positively correlating with age, both systolic and diastolic blood pressure, left ventricular mass and E / e’ ratio and negatively correlating with waist circumference, body mass index, left ventricular EF and E / A ratio in asymptomatic population. The likelihood of positive NT-pro BNP test was independently (p<0.05) associated with age, hypertension and diabetes. The diagnosis of asymptomatic HFpEF was confirmed in 12.3 % of studied population. A cutoff value of 125 pg / ml for NT-proBNP concentration showed the following diagnostic re-abilities in identifying asymptomatic HFpEF: sensitivity 85.0 %, specificity 88.6 % and area under curve 0.92 (95 % CI 0.86–0.98).Conclusion Subjects with raised NT-pro BNP level (≥125 pg/ml) were more likely to have a confirmed diagnosis of asymptomatic HFpEF after screening. In summary, in at-risk population, natriuretic peptide based screening combined with echocardiography identifies high prevalence of asymptomatic HFpEF.

scholarly journals Comparison of tools for assessing fatigue in patients with heart failure

2018 ◽  
Vol 71 (5) ◽  
pp. 2404-2410 ◽  
Author(s):  
Eliane Nepomuceno ◽  
Luma Nascimento Silva ◽  
Débora Cristine Prévide da Cunha ◽  
Rejane Kiomi Furuya ◽  
Marcus Vinicius Simões ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Heart Association ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
Significance Level ◽  
Patients With Heart Failure

ABSTRACT Objective: To compare the distributions of measurements of the Dutch Fatigue Scale (DUFS), Dutch Exertion Fatigue Scale (DEFS), and Fatigue Pictogram tools, according to the New York Heart Association (NYHA) Functional Classification and left ventricular ejection fraction (LVEF). Method: Methodological, cross-sectional study with 118 patients with heart failure. Variance analysis, Pearson's correlation, and Fisher's exact tests were carried out, with a significance level of 0.05. Results: There was an increase in the DUFS and DEFS means with worsening of the NYHA-FC (p<0.001, for both tools). Correlations among the LVEF resulted in positive and weak magnitude for the DEFS (r=0.18; p=0.05) and for the DUFS (r=0.16; p=0.08). Just the item A on the Fatigue Pictogram had an association with the NYHA-FC (p<0.001) and the LVEF (p=0.03). Conclusion: Three tools detected worsening in fatigue levels according to the illness severity assessed by the NYHA-FC.

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