scholarly journals Double whammy: Rheumatic heart disease associated with left ventricular noncompaction

2021 ◽  
Vol 7 (1) ◽  
pp. 83
Author(s):  
Pradyot Tiwari ◽  
Antara Banerji
MicroRNA ◽  
2020 ◽  
Vol 09 ◽  
Author(s):  
S. Justin Carlus ◽  
Fiona Hannah Carlus ◽  
Mazen Khalid Al-Harbi ◽  
Abdulhadi H Al-Mazroea ◽  
Khalid M Al- Harbi ◽  
...  

Background: Rheumatic heart disease (RHD) remains a major cause of cardiovascular diseases and the most devastating effects are on children and young adults. RHD is caused due to the interaction between microbial, environmental, immunologic, and genetic factors. The renin-angiotensin aldosterone system (RAAS) has been strongly implicated as the susceptibility pathway in the pathogenesis of cardiovascular disease. Objective: The present study investigated the modulating effect of Angiotensin II type 1 receptor (AGTR1) 1166A>C polymorphism on the RHD and its clinical features in Saudi Arabia. Methods: AGTR1 1166A>C polymorphism was genotyped in 96 echocardiographically confirmed RHD patients and 142 ethnically matched controls by TaqMan allelic discrimination method. Results: Genotype distribution of the AGTR1 1166A>C polymorphism was not significantly different between RHD and control groups. Further, AGTR1 1166A>C genotypes are not associated with the clinical features of RHD. These data support that there was no evidence for an association between AGTR1 1166A>C polymorphism and RHD in Saudi Arabia. Conclusion: To our knowledge, this is the first study that has investigated the possible association between AGTR1 1166A>C polymorphism and susceptibility to RHD and its clinical features. Even though AGTR1 gene is 1166A>C (rs5186) was reported to be associated with hypertension, left ventricular hypertrophy and coronary heart disease. Present study did not find any association between AGTR1 1166A>C polymorphism and RHD in Saudi Arabia. Further studies are needed to confirm our findings.


2019 ◽  
Vol 31 (9-10) ◽  
pp. 233-44 ◽  
Author(s):  
Sudigdo Sastroasmoro ◽  
Bambang Madiyono ◽  
Ismet N. Oesman

Electrocardiographic criteria for left ventricular hypertrophy (L VH) were examined in 84 unselected pediatric patients with rheumatic heart disease. There were 47 male and 3 7 female patients, ranging in age from 6 to 19 years. Electrocardiographic L VH was detected m 41 patients (48.8%), i.e. in 55.3% (26/47) of boys and in 36.6% (15/41) of girls. Echocardiographically determined L VH was present in 42 cases (50%) if left ventricular mass (L VM) was indexed for height, or 47 cases (56%) if L VM was indexed for body surface area (BSA). The overall sensitivity of height-indexed electrocardiographic diagnosis of LVH was 71.4% (95% confidence interval= 57.7% to 85.1%), while its sensitivity was 73.8% (95% confidence interval= 60.0% to 87.0%). For BSA indexed echocardiographic LVH, the sensitivity was 68.1% (95% confidence interval = 54.8 to 81.4%) and the specificity was 75.7% (95% confidence interval = 61.9% to 89.5%). When sex-adjustment was examined, there was no increase of sensitivity of electrocardiographic LVH. Sensitivity of the electrocardiogram for LVH increased when age-adjustment was examined with 13 years of age as a cut-off point, both for height indexed and BSA-indexed echocardiographic LVH. Reasons/or the difference between these findings and the findings in adult patients (remarkably low sensitivity and very high specificity of ECG L VH) were discussed. Electrocardiogram was a moderate diagnostic modality in the detection of L VH in our pediatric patients with rheumatic heart disease. Sex did not influence the sensitivity of ECG L VH, but older age group tended to increase its sensitivity.


2020 ◽  
Author(s):  
Bruno R Nascimento ◽  
Craig Sable ◽  
Maria Carmo P Nunes ◽  
Kaciane K B Oliveira ◽  
Juliane Franco ◽  
...  

Abstract Background Impact of heart disease (HD) on pregnancy is significant. Objective We aimed to evaluate the feasibility of integrating screening echocardiography (echo) into the Brazilian prenatal primary care to assess HD prevalence. Methods Over 13 months, 20 healthcare workers acquired simplified echo protocols, utilizing hand-held machines (GE-VSCAN), in 22 primary care centres. Consecutive pregnant women unaware of HD underwent focused echo, remotely interpreted in USA and Brazil. Major HD was defined as structural valve abnormalities, more than mild valve dysfunction, ventricular systolic dysfunction/hypertrophy, or other major abnormalities. Screen-positive women were referred for standard echo. Results At total, 1 112 women underwent screening. Mean age was 27 ± 8 years, mean gestational age 22 ± 9 weeks. Major HD was found in 100 (9.0%) patients. More than mild mitral regurgitation was observed in 47 (4.2%), tricuspid regurgitation in 11 (1.0%), mild left ventricular dysfunction in 4 (0.4%), left ventricular hypertrophy in 2 (0.2%) and suspected rheumatic heart disease in 36 (3.2%): all, with mitral valve and two with aortic valve (AV) involvement. Other AV disease was observed in 11 (10%). In 56 screen-positive women undergoing standard echo, major HD was confirmed in 45 (80.4%): RHD findings in 12 patients (all with mitral valve and two with AV disease), mitral regurgitation in 40 (14 with morphological changes, 10 suggestive of rheumatic heart disease), other AV disease in two (mild/moderate regurgitation). Conclusions Integration of echo screening into primary prenatal care is feasible in Brazil. However, the low prevalence of severe disease urges further investigations about the effectiveness of the strategy.


Author(s):  
William J. McKenna ◽  
Perry Elliott

The term cardiomyopathy is used to describe heart muscle disease unexplained by abnormal loading conditions (hypertension, valve disease, etc.), congenital cardiac abnormalities, and ischaemic heart disease. The current classification is based on the predominant phenotype, i.e. hypertrophic, dilated, arrhythmogenic right ventricular, restrictive and unclassifiable (including left ventricular noncompaction), and—where possible—incorporating inheritance and genotype. Cardiomyopathies associated with systemic diseases are described in ...


2014 ◽  
Vol 66 ◽  
pp. S141-S142
Author(s):  
Arun Gopalakrishnan ◽  
S. Panneer Selvam ◽  
T.R. Kapilamoorthy ◽  
V.K. Ajit Kumar

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Krishna Prasad ◽  
Himanshu Gupta ◽  
Bhupendra Kumar Sihag ◽  
Dinakar Bootla ◽  
Prashant Panda ◽  
...  

Abstract Background Submitral aneurysm is a rare disease initially described in the African population. It is usually considered congenital in origin, due to a defect in the posterior portion of the mitral annulus. However, it can be seen in other diseases like ischaemic heart disease, rheumatic heart disease, infective endocarditis, tuberculosis, and syphilis. Case presentation Case 1 was a 29-year-old female, hypertensive undergoing maintenance haemodialysis for chronic kidney disease and on anti-tubercular therapy. She was found to have a large submitral aneurysm with severe mitral regurgitation, moderate left ventricular dysfunction, and pericardial effusion on echocardiogram. Case 2 was a 58-year-old gentleman presented with inferior wall ST-elevation myocardial infarction and was thrombolyzed with streptokinase for the same. Echocardiogram done 6 months later for evaluation of dyspnoea showed a large inferobasal aneurysm. Case 3 was a 56-year-old hypertensive presented with dyspnoea on exertion and echocardiogram showed a large posterolateral region with transmural late gadolinium enhancement. Case 4 was a 13-year-old boy presented with fever and cerebrovascular accident. Echocardiogram revealed vegetation in the mitral valve and a small submitral aneurysm with vegetation inside it. Discussion Submitral aneurysm is usually considered congenital in origin. However, it can be due to ischaemic heart disease, rheumatic heart disease, Takayasu arteritis, and tuberculosis. Top dimensional echocardiogram is the investigation of choice. Cardiac magentic resonance imaging helps in identifying the underlying aetiology and delineating the surrounding structures.


Author(s):  
V. S. Petrov

Aim.To assess the effect of polymorphism of tumor necrosis factor-а (TNF-α) cytokines and interleukin (IL-17A, IL-17F, IL-10) on echocardiographic parameters in patients with chronic rheumatic heart disease (RHD).Material and methods. A total of 128 patients with RHD were examined, average age was 58,96±0,34 years. Echocardiography was performed on a Philips Affinity 50 machine. Genotyping was carried out using polymorphic TNF-α markers (G308A, IL-10 G1082A, IL-17A G197A, IL-17F А161Н0 by polymerase chain reaction with an electrophoretic scheme for detecting the result of “SNP-EXPRESS”.Results. RHD homozygotes for TNF-а A308A had the largest linear dimensions of the left ventricle (left ventricle end-diastolic dimension (LVED) — 5,80±0,22 cm, left ventricle end-systolic dimension (LVES) — 3,93±0,27 cm), as well as the studied homozygous for IL-17A A197A (LVED — 5,81±0,13 cm, LVES — 3,78±0,11 cm). In group of TNF-α G308G homozygotes, values of right heart (right ventricle — 2,75±0,05 cm, right atrium — 4,80±0,11 cm) were the largest and mitral valve orifice area (MVOA) was smallest — 1,52±0,04 cm2. Heterozygous patients with IL-17F Д161Н also had a greater dilatation of the ventricles compared with homozygotes of IL-17F Н161Н, in which parameters were close to normal (LVED 5,58±0,05 cm, LVES 3,68±0,04 cm). There was no statistically significant difference in linear sizes of the left and right heart in patients with IL-10 polymorphism. IL-10 polymorphism patients had statistically significant MVOA differences: minimum MVOA in G1082A heterozygotes — 1,40±0,06 cm2and maximum — 1,64±0,04 cm2in G1082G homozygotes. IL-10 G1082G homozygotes was characterized by maximum values of interventricular septum — 1,13±0,04 cm, left ventricular posterior wall — 1,10±0,03 cm.Conclusion. Homozygosity of TNF-α A308A and IL-17A A197A in RHD patients leads to the largest linear sizes of the left ventricle, and homozygosity for TNF-а G308G — to the maximum sizes of the right heart and left atrium against the background of the minimum sizes of MVOA. IL-10 polymorphism has not effect on heart linear dimensions, but IL-10 G1082G leads to maximum MVOA size.


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