scholarly journals Endothelial Function as a Possible Significant Determinant of Cardiac Function during Exercise in Patients with Structural Heart Disease

2009 ◽  
Vol 2009 ◽  
pp. 1-8 ◽  
Author(s):  
Bonpei Takase ◽  
Takashi Akima ◽  
Akimi Uehata ◽  
Masayuki Ishihara ◽  
Akira Kurita
Keyword(s):  
Heart Disease ◽  
Endothelial Function ◽  
Cardiac Function ◽  
Brachial Artery ◽  
Stress Testing ◽  
Structural Heart Disease ◽  
Output Flow ◽  
Study Population ◽  
The Mean ◽  
Flow Mediated Vasodilation

This study was investigated the role that endothelial function and systemic vascular resistance (SVR) play in determining cardiac function reserve during exercise by a new ambulatory radionuclide monitoring system (VEST) in patients with heart disease. The study population consisted of 32 patients. The patients had cardiopulmonary stress testing using the treadmill Ramp protocol and the VEST. The anaerobic threshold (AT) was autodetermined using the V-slope method. The SVR was calculated by determining the mean blood pressure/cardiac output. Flow-mediated vasodilation (FMD) was measured in the brachial artery to evaluate endotheilial function. FMD and the percent change f'rom rest to AT in SVR correlated with those from rest to AT in ejection fraction and peak ejection ratio by VEST, respectively. Our findings suggest that FMD in the brachial artery and the SVR determined by VEST in patients with heart disease can possibly reflect cardiac function reserve during aerobic exercise.

Endothelial function state following repair of cyanotic congenital heart diseases

2013 ◽  
Vol 25 (2) ◽  
pp. 222-227 ◽  
Author(s):  
Mohammad Reza Sabri ◽  
Hooman Daryoushi ◽  
Mojgan Gharipour
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Endothelial Function ◽  
Tetralogy Of Fallot ◽  
Congenital Heart ◽  
Cyanotic Congenital Heart Disease ◽  
Vascular Endothelial ◽  
Vascular Endothelial Function ◽  
Flow Mediated Dilatation ◽  
The Mean

AbstractBackgroundRepairing cyanotic congenital heart disease may be associated with preserving endothelial function. The present study aimed to evaluate vascular endothelial function in patients with repaired cyanotic congenital heart disease.MethodsIn a case–control study conducted in 2012 in Isfahan, Iran, 42 consecutive patients aged <35 years who had suffered from different types of cyanotic congenital heart disease and had undergone complete repair of their congenital heart defect were assessed in regard to their endothelial function state by measuring flow-mediated dilatation and other cardiac function indices. They were paired with 42 sex- and age-matched healthy controls.ResultsThe mean flow-mediated dilatation was lower in patients with repaired cyanotic congenital heart disease than in the controls [6.14±2.78 versus 8.16±1.49 respectively (p<0.001)]. Significant adverse correlations were found between flow-mediated dilatation, age, and body mass indexes, in those who underwent repair surgery. In addition, flow-mediated dilatation had a positive association with the shortening fraction, ejection fraction, and tricuspid annular plane systolic excursion value, and it was also inversely associated with carotid intima-media thickness and the myocardial performance index. The mean of the flow-mediated dilatation was significantly higher in the group with tetralogy of Fallot along with complete repair before the age of 2.5 years and also in those patients with total anomalous pulmonary venous connection or transposition of the great arteries repaired with an arterial switch operation before 6 months of age, compared with the other two subgroups. This includes patients with a tetralogy of Fallot defect repaired after 4 years of age and those with complex cyanotic congenital heart disease that was repaired after 2.5 years of age (mean age at repair 9±6.1 years).ConclusionEarly repair of a cyanotic defect can result in the protection of vascular endothelial function and prevent the occurrence of vascular accidents at an older age.

scholarly journals Study of endothelial function in pregnant women with gestational diabetes mellitus by flow mediated dilation of brachial artery

2020 ◽  
Vol 9 (6) ◽  
pp. 2377
Author(s):  
Nidhi Pandey ◽  
Poonam Goel ◽  
Anita Malhotra ◽  
Reeti Mehra ◽  
Navjot Kaur
Keyword(s):  
Gestational Diabetes ◽  
Endothelial Function ◽  
Pregnant Women ◽  
Brachial Artery ◽  
Vascular Function ◽  
Post Partum ◽  
Control Group ◽  
Flow Mediated Dilation ◽  
The Mean ◽  
The Difference

Background: The objective of the study was to assess vascular function in normal pregnant women and women with gestational diabetes and to study its temporal relationship with gestational age at 24-28-week POG and at 36-38-week POG and changes in FMD in postpartum period.Methods: Assessment of vascular function was done at 24-28-week POG, 36-38-week POG and at 6-12-week postpartum by flow mediated dilation of brachial artery in 37 healthy pregnant women and 37 pregnant women with GDM.Results: In GDM group mean FMD at 24-28 weeks of POG, at 36-38 weeks POG was lower as compared to the control group (11.225±6.20,8.464±6.09 versus 14.49±5.21, 10.898±4.12) although the difference in mean FMD in two groups was not statistically significant. It was found that the decrease in FMD at 36-38-week POG as compared to 24-28 weeks POG was statistically significant in both the groups (p<0.001).Conclusions: This study revealed that when endothelial function as assessed by FMD was compared at different period of gestation, the mean decrease in FMD at 36-38-week POG as compared to 24-28-week POG and 6-week post-partum was statistically significant in patients with GDM and as well as the control group, however this trend of change was same in both the groups and was not statistically significant when compared between the two group (GDM versus control). A negative correlation of FMD was found with BMI, and HBA1c, that was stronger in GDM group.

scholarly journals Diurnal variation of flow-mediated vasodilation in healthy premenopausal women

2000 ◽  
Vol 279 (6) ◽  
pp. H2720-H2725 ◽  
Author(s):  
Åsa Ringqvist ◽  
Kenneth Caidahl ◽  
Ann-Sofi Petersson ◽  
Åke Wennmalm
Keyword(s):  
Endothelial Function ◽  
Urinary Excretion ◽  
Diurnal Variation ◽  
Brachial Artery ◽  
Plasma Levels ◽  
Plasma Concentrations ◽  
Premenopausal Women ◽  
Parallel Patterns ◽  
Period 2 ◽  
Flow Mediated Vasodilation

The present study was designed to test the hypothesis of a diurnal variation of endothelial function. Sixteen healthy, nonsmoking women were studied, each on four occasions during one 24-h period (2:00 PM, 8:00 PM, 2:00 AM, and 8:00 AM). Endothelial function was assessed by ultrasound determinations of flow-mediated vasodilation (FMD%) in the brachial artery. FMD% was contrasted with endothelium-independent vasodilation, i.e., nitroglycerine-induced vasodilation (NTG%). Additionally, plasma concentrations and urinary excretion of nitrate and cGMP were analyzed. FMD% and NTG% displayed diurnal, albeit not parallel, patterns of variation. Whereas FMD% gradually increased from 2:00 PM and peaked at 2:00 AM (means ± SE: 3.1 ± 0.4, 4.4 ± 0.4, 5.1 ± 0.9, and 3.9 ± 0.8%), the NTG% demonstrated a nadir at 2:00 AM. Plasma levels and urinary excretion of nitrate and cGMP did not display diurnal variation and no clear association with the variations seen in FMD% and NTG%. This study demonstrates a diurnal variation in both endothelium-dependent and -independent vasodilation in the brachial artery of healthy women. The background and possible implication of such a variation require further studies.

scholarly journals Flow-Mediated Vasodilation Is Not Attenuated in Hypertensive Pregnancies Despite Biochemical Signs of Inflammation

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Heli Saarelainen ◽  
Henna Kärkkäinen ◽  
Pirjo Valtonen ◽  
Kari Punnonen ◽  
Tomi Laitinen ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Brachial Artery ◽  
Normal Pregnancy ◽  
Hypertensive Disorder ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Tnf Α ◽  
Factor Α ◽  
Artery Flow ◽  
Flow Mediated Vasodilation

Background. Our objective was to evaluate endothelial function and markers of inflammation during and after pregnancy in normal pregnancies compared to pregnancies complicated with hypertension or preeclampsia (PE). Methods and Results. We measured endothelium-dependent brachial artery flow-mediated vasodilation (FMD) and high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α) in 32 women with normal pregnancy and in 28 women whose pregnancy was complicated with hypertensive disorder in the second half of pregnancy and minimum 3-month postpartum. Enhancement of endothelial function was greater in hypertensive than normal pregnancies, the mean FMD% being 11.0% versus 8.8% during pregnancy (P=0.194) and 8.0% versus 7.9% postpartum (P=0.978). Concentrations of markers of inflammation were markedly increased in pregnant hypertensive group compared to those after delivery (hsCRP 4.5 versus 0.80 mg/L, P=0.023, IL-6 2.1 versus 1.2 pg/mL, P=0.006; TNF-α 1.9 versus 1.5 pg/mL, P=0.030). There were no statistically significant associations between the markers of inflammation and FMD. Conclusions. Brachial artery FMD was not attenuated in the third trimester hypertensive pregnancies compared to normal pregnancies, whereas circulating concentrations of hsCRP and IL-6 and TNF-α reacted to hypertensive complications.

scholarly journals Sudden death in the young adult: An autopsy-based series

2020 ◽  
Author(s):  
Said Saadi ◽  
Sami Ben Jomaa ◽  
Mariem Bel Hadj ◽  
Dorra Oualha ◽  
Nidhal Haj Salem
Keyword(s):  
Heart Disease ◽  
Young Adult ◽  
Sudden Death ◽  
Clinical Information ◽  
Structural Heart Disease ◽  
Underlying Disease ◽  
Sudden Unexplained Death ◽  
Structural Abnormalities ◽  
Autopsy Data ◽  
The Mean

Abstract Background: We aim to study the profile, and pathological characteristics of sudden death in young in purpose of recommendations for prevention. Methods: We performed a retrospective cohort study using autopsy data from the Department of Forensic Medicine of Monastir (Tunisia). A review of all autopsies performed for 28 years was done. In each case, clinical information, and circumstances of death were obtained. A complete forensic autopsy and histological, and toxicological investigations were performed. We have included all sudden death in persons aged between 18 years and 35 years.Results: We collected 137 cases of sudden death during the studied period. The mean age of the studied population was 26.47 years. Almost 72% deaths were classified as cardiac death, and was due to ischemic heart disease in 32.32%. Sudden death was attributed to a pleuropulmonary cause in 7.4%, an abdominal cause in 6%, and from a neurological origin in 4.5%. The cause of sudden death in this group was not established by 9.5%.Conclusion: There are several potential causes of sudden unexplained death such as structural abnormalities, ion channel abnormalities. Unexplained deaths, presumed to result from sudden primary arrhythmogenic causes, occur in a young adult with structurally normal hearts. That underlying disease-causing genetic defects may be involved has clinical implications for family members. Our findings suggest that prevention of sudden death among young adults under the age of 35 years should also focus on evaluation for causes not associated with structural heart disease.

scholarly journals Evaluation of children with cardiac murmur using Nadas criteria

2018 ◽  
Vol 5 (2) ◽  
pp. 363 ◽  
Author(s):  
Mary James ◽  
Poornima K. N. ◽  
Praveen Jacob Ninan
Keyword(s):  
Heart Disease ◽  
Screening Test ◽  
Structural Heart Disease ◽  
Age Group ◽  
Cardiac Murmur ◽  
Medical College ◽  
Intercurrent Illness ◽  
History Of ◽  
Study Population ◽  
Minor Criteria

Background: Pediatricians often encounter children with heart murmurs during routine follow up visits or while assessment of intercurrent illness. Clinical differentiation between pathologic and innocent murmurs would be important. It is important to identify those children who need further evaluation. The aim of the study was to evaluate whether Nadas criteria can be applied as a screening test to decide on further workup.Methods: This was a prospective descriptive study done in Government T. D. Medical College, Alappuzha over a period of 12 months from July 2013 to June 2014. All children in the age group one month to 12 years, attending the outpatient department were screened for presence of murmur of grade 2 and more. They were further evaluated carefully. They were also studied for association of variables like maternal age, birthweight, dysmorphism and family history of heart disease. Nadas criteria was then applied to the study population. A score of 2 and 1 were given to major and minor criteria respectively.Results: 3070 children were screened. 150 children were detected to have murmur of grade2 and more.66 children were detected to have a structural heart disease by an echo study.74% of the study population in the age group <1 year had a heart disease.8 out of 78 children with a Nadas score of 1 and 10 out of 24 with a score of 2 had a heart disease. All with a score 3 and more had congenital heart disease (CHD).Conclusions: Nadas criteria can be used as screening test with a sensitivity of 87% and specificity of 83%. 

scholarly journals ASSESSMENT OF FLOW MEDIATED DILATATION OF BRACHIAL ARTERY BY ANGIODEFENDER DEVICE AS COMPARED TO BRACHIAL ARTERY ULTRASOUND IMAGING.

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Mukesh Kumar Sharma ◽  
Chandra Bhanu Chandan ◽  
Abhishek Shukla ◽  
Deepak Ameta ◽  
Pradeep Kurmi
Keyword(s):  
Correlation Coefficient ◽  
Ultrasound Imaging ◽  
Brachial Artery ◽  
Statistical Difference ◽  
P Value ◽  
Positive Correlation ◽  
Significant Statistical Difference ◽  
Flow Mediated Dilatation ◽  
The Mean ◽  
Flow Mediated Vasodilation

Aims & Objectives: To demonstrate, Angiodefender device, is comparable to “Brachial artery ultrasound imaging” (BAUI) in their abilities to quantify percentage flow mediated vasodilation (FMD) of the brachial artery. Methods: Study was conducted on 100 patients, flow mediated vasodilation was measured by BAUI as well as by the Angiodefender device and the results were compared. Results: The mean %FMD measured by the BAUI was found to be 7.46 ±  4.21 whereas mean %FMD measured by the Angiodefender was 8.24 ±  2.46, (p value 0.113). Positive correlation was found between both the tests with correlation coefficient of 0.65, p value < 0.0001 which is highly significant. Conclusion: Results obtained by both the methods were comparable there was no significant statistical difference. Positive correlation was highly significant between both the tests with correlation coefficient of 0.65. Keywords: Brachial artery ultrasound imaging, Angiodefender, Flow mediated vasodilation

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