Ventricular Systolic Function
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2021 ◽  
Vol 8 (9) ◽  
pp. 113
Josef Auer ◽  
Claudia Pujol ◽  
Susanne J. Maurer ◽  
Nicole Nagdyman ◽  
Peter Ewert ◽  

Background: Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital heart defect (CHD). Contemporary data regarding its outcome in adults are scarce. Methods: Retrospective, single-center study of all ccTGA patients over the age of 16 years treated at our center during the time period 2006–2018. Only patients with a biventricular circulation were included. The primary endpoint was all-cause mortality. Results: Altogether, 96 patients (mean age 32.8 ± 16.0 years, female 50%) with ccTGA and a systemic right ventricle (SRV) were included in the study. An additional CHD was present in 81 patients (84.4%); most common were a ventricular septal defect (VSD) and a left ventricular outflow tract obstruction. Out of the whole cohort, 45 (46.9%) had already undergone cardiac surgery at baseline. During a median follow-up of 6.5 (IQR 2.8–12.7) years, the primary endpoint occurred in 10 patients (10.8%). Cause of death was cardiac in nine patients and suicide in one. Hospitalizations due to heart failure occurred in 48 patients (51.6%). Upon univariate Cox analysis, an NYHA class ≥III, severe tricuspid regurgitation, severe SRV systolic impairment, as well as a reduced left ventricular systolic function were predictors of the primary endpoint. Upon multivariable analysis, only NYHA class ≥ III (HR: 18.66, CI 95%: 3.01–115.80, p = 0.0017) and a reduced left ventricular systolic function (HR: 7.36, CI 95%: 1.18–45.99, p = 0.038) remained as independent predictors. Conclusions: Adults with ccTGA and an SRV are burdened with significant morbidity and mortality. Predictors for mortality are NYHA class and subpulmonary left ventricular function.

Imaging ◽  
2021 ◽  
Laura Ceriello ◽  
Antonino Scarinci ◽  
Cesare Mantini ◽  
Sabina Gallina ◽  
Filippo Cademartiri ◽  

Abstract A 27-years-old female with multiple autoimmune disorders presented to our cardiology unit for acute chest pain and worsening dyspnoea. Admission blood tests revealed increased serum levels of high-sensitive cardiac troponin, eosinophilic count and C-reactive protein. Laboratory findings, low QRS voltages by ECG, mildly reduced left ventricular systolic function in the context of pseudohypertrophy, mild and diffuse late gadolinium enhancement associated with markedly increased native T1 and T2 mapping levels assessed by echocardiography and cardiovascular magnetic resonance imaging, raised the suspicion of massive eosinophilic myocarditis, subsequently confirmed by histological examination of endomyocardial biopsy. Prompt initiation of immunosuppressive treatment allowed swift regression of myocardial inflammation and full recovery of left ventricular systolic function within one month. After ruling-out clonal myeloid disorder, lymphocyte-variant and reactive hypereosinophilia, the young lady was eventually diagnosed with idiopathic hypereosinophilic syndrome. This case report turns the spotlight on the role and importance of advanced multi-modality cardiovascular imaging for raising clinical suspicion of acute eosinophilic myocarditis, guiding diagnostic work-up and monitoring response to treatment.

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 935
Andrea Ágnes Molnár ◽  
Márton Kolossváry ◽  
Bálint Lakatos ◽  
Márton Tokodi ◽  
Ádám Domonkos Tárnoki ◽  

Background and Objectives: No data are available on whether the heritability of left ventricle (LV) systolic and diastolic parameters are independent of each other. Therefore, our aim was to assess the magnitude of common and independent genetic and environmental factors defining LV systolic and diastolic function. Materials and Methods: We analyzed 184 asymptomatic twins (65% female, mean age: 56 ± 9 years). Transthoracic echocardiography was performed to measure LV systolic (global longitudinal and circumferential strain; basal and apical rotation) and diastolic (early diastolic velocity of mitral inflow and lateral mitral annulus tissue; deceleration time and early diastolic strain rate) parameters using conventional and speckle-tracking echocardiography. Genetic structural equation models were evaluated to quantify the proportion of common and specific genetic (Ac, As) and environmental factors (Ec, Es) contributing to the phenotypes. Results: LV systolic parameters had no common genetic or environmental heritability (Ac range: 0–0%; Ec range: 0–0%; As range: 57–77%; Es range: 24–43%). Diastolic LV parameters were mainly determined by common genetic and environmental effects (Ac range: 9–40%; Ec range: 11–49%; As range: 0–29%; Es range: 0–51%). Systolic parameters had no common genetic or environmental factors (Ac = 0%; Ec = 0%) with diastolic metrics. Conclusions: Systolic LV parameters have a strong genetic predisposition to any impact. They share no common genetic or environmental factors with each other or with diastolic parameters, indicating that they may deteriorate specifically to given effects. However, diastolic functional parameters are mainly affected by common environmental influences, suggesting that pathological conditions may deteriorate them equally. Estimation of the genetic and environmental influence and interdependence on systolic and diastolic LV function may help the understanding of the pathomechanism of different heart failure classification types.

2021 ◽  
Vol 22 (16) ◽  
pp. 9052
Simon Braumann ◽  
Wibke Schumacher ◽  
Nam Gyu Im ◽  
Felix Sebastian Nettersheim ◽  
Dennis Mehrkens ◽  

Nitro-oleic acid (NO2-OA), a nitric oxide (NO)- and nitrite (NO2−)-derived electrophilic fatty acid metabolite, displays anti-inflammatory and anti-fibrotic signaling actions and therapeutic benefit in murine models of ischemia-reperfusion, atrial fibrillation, and pulmonary hypertension. Muscle LIM protein-deficient mice (Mlp−/−) develop dilated cardiomyopathy (DCM), characterized by impaired left ventricular function and increased ventricular fibrosis at the age of 8 weeks. This study investigated the effects of NO2-OA on cardiac function in Mlp−/− mice both in vivo and in vitro. Mlp−/− mice were treated with NO2-OA or vehicle for 4 weeks via subcutaneous osmotic minipumps. Wildtype (WT) littermates treated with vehicle served as controls. Mlp−/− mice exhibited enhanced TGFβ signalling, fibrosis and severely reduced left ventricular systolic function. NO2-OA treatment attenuated interstitial myocardial fibrosis and substantially improved left ventricular systolic function in Mlp−/− mice. In vitro studies of TGFβ-stimulated primary cardiac fibroblasts further revealed that the anti-fibrotic effects of NO2-OA rely on its capability to attenuate fibroblast to myofibroblast transdifferentiation by inhibiting phosphorylation of TGFβ downstream targets. In conclusion, we demonstrate a substantial therapeutic benefit of NO2-OA in a murine model of DCM, mediated by interfering with endogenously activated TGFβ signaling.

2021 ◽  
Vol Publish Ahead of Print ◽  
Bilal Albaroudi ◽  
Mahmoud Haddad ◽  
Omar Albaroudi ◽  
Manar E. Abdel-Rahman ◽  
Robert Jarman ◽  

2021 ◽  
haorou Luo ◽  
Tuli Kou ◽  
Ye Su ◽  
Lixue Yin

Abstract Background We aimed to detect the cardiac dysfunction in the early myocardial hypertrophy rat model by layered strain and to evaluate the effect of berberine on the left ventricular systolic function of myocardial hypertrophy rats. Methods 80 healthy SD rats were randomly divided into 4 groups. The last three groups(ISO group) were injected with isoproterenol intraperitoneally to establish a model of myocardial hypertrophy;After successful modeling, group A and group B were given berberine hydrochloride intragastric administration (5mg/kg; 10mg/kg), and group C was given the same amount of normal saline by intragastric administration. The left ventricular systolic function was performed at the end of each trial using the layered strain technique. The myocardial tissue of rats was taken for pathological examination, and Masson trichrome staining and hematoxylin-eosin staining were performed. The myocardial interstitial fibrosis was evaluated and the correlation analysis was performed. Results The GCS, GSCendo and GSCmid of the ISO group were lower than those of the control group, and the difference was statistically significant (− 20.46% −29.57% −19.39% vs. −15.71% −20.11% −15.35%; P < 0.05). After berberine treatment, the GSCendo in group A (5mg/kg) and group B (10mg/kg) was higher than that in group C (− 24.49% vs.−26.87% vs.−20.09%; P < 0.001); The improvement in group B was more significant (− 24.49% vs.−26.87%; P < 0.001). Pathological results showed that, compared with the control group, fibrosis was significantly increased in the ISO group. After 7 days of berberine intragastric intervention, compared with group C without intervention, the fibrosis deposition in group A and B was reduced, and the fibrosis deposition in group B was more obvious. Spearman rank correlation analysis showed that Gscendo was positively correlated with the percentage of myocardial interstitial fiber deposition. Conclusion Persistent cardiac hypertrophy leads to marked myocardial fibrosis and necrosis. Berberine can inhibit the progression of myocardial fibrosis after the formation of cardiac hypertrophy. The stratified strain technique can identify early myocardial systolic dysfunction in patients with cardiac hypertrophy and evaluate the efficacy of short-term drug intervention, which is expected to be a new method for clinical quantitative evaluation of left ventricular systolic dysfunction.

Elif Tükenmez Tigen ◽  
Alper Kepez ◽  
Murat Sünbül ◽  
Beste Özben ◽  
Buket Ertürk Şengel ◽  

Objectives: We aimed to evaluate left ventricular (LV) and right ventricular (RV) systolic performance in patients with sepsis or septic shock and possible functional alteration on in-hospital mortality. Patients and Methods: Thirty-seven consecutive patients with the diagnosis of sepsis or septic shock were included in the study. All patients underwent comprehensive transthoracic echocardiographic examination. Data of patients discharged from the intensive care unit was compared with data of patients who died in the hospital. Results: Fifteen patients (40.5%) survived, while 22 patients were died in the hospital (59.5%). A significant difference was detected between survivor and non-survivor groups regarding before discharge or death level of inflammatory markers such as CRP (p=0.05) and procalcitonin (p=0.03) besides BNP (p=0.01) and SOFA (p=0.009) score. There were two patients (5.4%) with EF value less than %50 in the study population. Eight patients (21.6%) displayed hypokinesia on the apical segment, and four patients (10.8%) had TAPSE values below 17 mm. One patient (6.6%) in the survivor group, but seven patients (31.8%) in the non-survivor group had apical hypokinesia with a trend towards significance (p=0.068). One patient in the survivor group (6.6%) and three patients (13.6%) in the non-survivor group had RV systolic dysfunction (p: 0.51). Conclusion: We found a much lower rate of LV and RV systolic dysfunction in patients with sepsis or septic shock compared with previous studies. None of the myocardial dysfunction types was associated with in-hospital mortality. Apical hypokinesia was also more prevalent in non-survivors despite borderline significance.

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