TY - JOUR. T1 - A Patient Presents with Longstanding, Severe LV Dysfunction. Is There a Role for Additional Risk Stratification Before ICD?. AU - Tereshchenko, Larisa. AU - Berger, Ronald D.. PY - 2012/6. Y1 - 2012/6. N2 - Increased longevity of patients with systolic heart failure caused by the use of implantable cardioverter-defibrillators (ICDs) is one of the most successful achievements in contemporary medicine. During the last 2 decades, the scientific community has striven to increase the benefits of ICD usage by specifying indications for primary prevention ICD implantation. Left ventricular ejection fraction is neither highly specific nor is it a highly sensitive risk marker of sudden cardiac death. The authors discuss risk-stratification approaches in different patient populations with structural heart disease and systolic heart failure.. AB - Increased longevity of patients with systolic heart failure caused by the use of implantable cardioverter-defibrillators (ICDs) is one of the ...
Background We assessed left ventricular dysfunction in a population at high risk for heart failure (HF), and explored associations between ventricular function, HF risk factors and NT-proB natriuretic peptide (NT-proBNP). Methods and results 3550 subjects at high risk for incident HF (= 60 years plus = 1 HF risk factor), but without pre-existing HF or left ventricular dysfunction, were recruited. Anthropomorphic data, medical history and blood for NT-proBNP were collected. Participants at highest risk (n = 664) (NT-proBNP highest quintile; , 30.0 pmol/L) and a sample (n = 51) from the lowest NT-proBNP quintile underwent echocardiography. Participants in the highest NT-proBNP quintile, compared to the lowest, were older (74 years vs. 67 years; p , 0.001) and more likely to have coronary artery disease, stroke or renal impairment. In the top NT-proBNP quintile (n = 664), left ventricular systolic impairment was observed in 6.6% (95% CI: 4 to 8%) of participants and was associated with male gender, ...
With the development of Dyssynchrony Imaging, Toshiba is providing cardiologists with a new innovation that expands the quantification capabilities of ultrasound to aid in diagnosing cardiovascular disease," said Gordon Parhar, director, Ultrasound Business Unit, Toshiba America Medical Systems, Inc. "The DI method makes it easier for clinicians to determine the severity of dyssynchrony by having an automated detection of maximum values and a visual display of time to peak for each region. DI also will be a valuable tool in assessing patients for cardiac resynchronization therapy, providing clinicians with a pathway treatment from pre-implant to post implantation of the pacemaker ...
Left ventricular dysfunction is a major determinant of outcome in coronary artery disease.1 However, not all dyssynergic areas are irreversibly damaged after infarction, as left ventricular dysfunction may be caused by myocardial stunning2 or by chronic reduction of blood flow,3 and the segments involved may show improved function after restoration of blood flow.4 Preservation of metabolism despite reduced function is the cornerstone of viable myocardium, but ultrastructural changes have been documented in viable tissue, including loss of sarcoplasmic reticulum, small scattered mitochondria, and glycogen deposition.5 These changes suggest a reduction in aerobic metabolism, but glucose uptake and utilisation are preserved and indeed have been used as a diagnostic marker of viability.6. Because of co-morbidity, myocardial revascularisation may be difficult to achieve in many patients with left ventricular dysfunction and viable myocardium. In these situations, medical treatment to improve left ...
BACKGROUND: Cardiac magnetic resonance imaging (CMR) has been established as a powerful tool for predicting mortality. However, its application is limited by availability and various contraindications. The aim of this study was to evaluate the predictive value of layer-specific myocardial deformation analysis as assessed by strain echocardiography for cardiac events in patients with chronic ischemic left ventricular dysfunction in comparison with CMR. METHODS: Three hundred ninety patients (mean age, 63 ± 4 years; 69% men; mean left ventricular ejection fraction [LVEF], 41 ± 7%) with chronic ischemic cardiomyopathy were prospectively enrolled and underwent strain echocardiography and CMR within 3 ± 1 days ...
Background-Limited data exist on the prevalence, associations and prognosis of individuals with asymptomatic left ventricular systolic dysfunction (ALVSD), especially in populations without prior clinical cardiovascular disease (CVD). Methods and Results-Kaplan-Meier and Cox proportional hazard analyses were used to assess the association between ALVSD, defined as left ventricular ejection fraction less than 50%, and adjudicated incident congestive heart failure (CHF), all-cause mortality, and CVD events. Out of 5004 participants, 112 participants had CHF, 321 had a CVD event, and 278 died after 9 years of follow-up. The overall prevalence of ALVSD was 1.7%, with a higher prevalence in African Americans (2.6%). ALVSD had worse cardiovascular risk profile and was also associated with increased risk in unadjusted and adjusted models for incident CHF [HR (95%): 12.0(7.04-20.3), p,0.0001 and 8.69(4.89-15.45), p,0.001 respectively], CVD [HR (95%):3.32(1.98-5.58), p,0.001 and 2.21(1.30-3.73), p=0.003 ...
TY - JOUR. T1 - Subclinical Left Ventricular Dysfunction is Influenced by Genotype Severity in Patients with Cystic Fibrosis. AU - Pallin, Michael. AU - Keating, Dominic. AU - Kaye, David M.. AU - Kotsimbos, Tom. AU - Wilson, John W.. PY - 2018/8/1. Y1 - 2018/8/1. N2 - Background and objective: Over 2000 genotypes in the cystic fibrosis (CF) gene have been described. These genotypic differences result in variable clinical manifestations of CF, with severity of disease dependent on CF transmembrane conductance (CFTR) protein function. CFTR is widely distributed in nucleated cells, including cardiac myocytes, but the effect of genotype on cardiac function is not known. Methods: This retrospective review of echocardiographic data is from a single adult CF centre between 2000 and 2015. Patients were cohorted based on the functional classification of genotype. Severe patients had both CF genes from functional classification groups 1-3; mild patients had one or no gene from these groups, or in the ...
To study the mechanisms of myocardial ischemia during isometric exercise, handgrip was sustained, for 4.5 min at 25% of maximum by 11 patients with at least one significant coronary stenosis each, during cardiac catheterization. After recovery, the handgrip that was repeated with simultaneous infusion of nitroglycerin (50 micrograms over 4 min) directly into the diseased vessel. The cardiovascular response was assessed by hemodynamic and by computer-assisted measurements of stenosis. During the first handgrip test pulmonary capillary wedge pressure rose 56% (15 to 23 mm Hg; p less than .001), the heart rate-systolic pressure product rose 33% (p less than .01), and the diseased epicardial arteries constricted. Luminal area in the stenotic segment was reduced by 35% (p less than .01), resulting in a 243% increase in estimated stenotic flow resistance (30 to 103 mm Hg/ml/sec; p less than .001). During handgrip with intracoronary nitroglycerin, the pressure-rate product again increased 33%, but ...
There is increasing evidence that transient ischemia in humans can affect myocardial function in similar patterns to those described in experimental animal models. In dogs, demand ischemia triggers both stunning (reversible contractile dysfunction despite the return of normal myocardial perfusion) and ischemic preconditioning (protection against infarction caused by subsequent coronary occlusion) (1,2). In patients with angina, myocardial contractile function may remain depressed for up to 30 min after the completion of exercise, and this may represent stunning (3-5). Patients may also develop less anginal pain and electrocardiographic (ECG) evidence of ischemia during sequential exercise testing: the "warm-up" phenomenon (6). It is hypothesized that this may represent a form of ischemic preconditioning.. There are important differences of definition between the warm-up effect and ischemic preconditioning. The former involves protection against indirect markers of ischemia (chest pain and ECG ...
TY - JOUR. T1 - Impact of ventricular dyssynchrony on postexercise accommodation of systolic myocardial motion in hypertensive patients with heart failure and a normal ejection fraction. T2 - A tissue-Doppler echocardiography study. AU - Wang, Yi Chih. AU - Yu, Chih Chieh. AU - Chiu, Fu Chun. AU - Klepfer, Ruth. AU - Hilpisch, Kathryn. AU - Splett, Vincent. AU - Tsai, Chia Ti. AU - Lai, Ling Ping. AU - Hwang, Juey Jen. AU - Lin, Jiunn Lee. PY - 2012/2/1. Y1 - 2012/2/1. N2 - Background: We hypothesized left ventricular (LV) dyssynchrony would affect postexercise accommodation of regional myocardial motion in patients with heart failure and a normal ejection fraction (HFNEF). Methods and Results: Tissue-Doppler echocardiography was studied in 100 hypertensive patients with LV ejection fraction ,50%. Among them, 70 HFNEF patients were classified into the systolic dyssynchrony (Dys: ,65 ms difference of electromechanical delay between septal and lateral segments) (43 patients) and nondyssynchrony ...
Clinical trial for NIDDM , Teneligliptin on the Progressive Left Ventricular Diastolic Dysfunction With Type 2 Diabetes Mellitus Study
Exercise-induced left ventricular regional wall motion abnormalities among patients with coronary artery disease indicate myocardial ischemia due to significant coronary artery narrowing. Recovery of such stress-induced wall motion abnormalities is thought to occur within minutes after the termination of exercise. However, in some patients, persistent contractile dysfunction has been observed up to 90 minutes into recovery. Whether persistent regional wall motion abnormalities after exercise are due to stunned myocardium (prolonged but reversible postischemic dysfunction despite restoration of blood flow) or persistent ischemia due to coronary vasoconstriction (prolonged postischemic dysfunction due to persistent reduction of regional blood flow) is not well established. It is possible that persistent but reversible left ventricular dysfunction post-exercise may represent persistent reduction in regional blood flow and/or altered regional metabolic state.. In this protocol, we intend to ...
There were 376 of the total 528 patients in the Newcastle 85+ Study with echocardiography data who were included in the analysis. The mean patient age was 87.9 ± 0.4 years, 62% were female, 44% had a history of ischemic heart disease, 58% hypertension, 2.7% severe renal failure, and 13% had diabetes. LV systolic dysfunction (ejection fraction [EF] ≤50%) was present in 32% (n = 119/376) and 20% had moderate or severe LV diastolic dysfunction with a preserved LVEF. Limiting dyspnea was reported in 63% of patients (n = 57/90) with systolic dysfunction and 60% (n = 30/50) of patients with moderate or severe diastolic dysfunction. Only 10% of patients identified to have systolic heart failure (HF) or moderate/severe diastolic dysfunction carried a pre-existing diagnosis of HF; 26% of patients with limiting dyspnea had undiagnosed LVD.. ...
The aim of the present study was to measure regional ventricular function at rest and during stress in order to assess if patients with Type II diabetes have subclinical myocardial dysfunction and if it is related to risk factors. Seventy subjects (35 patients with Type II diabetes with no symptoms, signs or history of heart disease, and 35 age- and sex-matched healthy controls) had echocardiography at rest and during dobutamine stress. Myocardial velocities were measured off-line from digital loops of colour tissue Doppler. Subendocardial function was assessed from the mean longitudinal velocities of four basal segments (apical views) and radial function from the velocities of the basal posterior wall (parasternal view). Systolic functional reserve was calculated as the increase in velocity from baseline. Longitudinal peak systolic velocity was lower in patients with diabetes, at rest (5.6±1.4 compared with 6.5±1.1 cm/s) and at peak stress (10.9±2.8 compared with 14.3±2.1 cm/s) (both ...
Reversible left ventricular dysfunction after an episode of ventricular tachycardia has been reported (3). Rapid ventricular pacing in animal models has also been shown to result in transient dysfunction of the left ventricle (4). Although the specific apical ballooning has not been mentioned in these reports, the reversible character of the ventricular dysfunction is a sufficient argument for the addition of this entity to the exclusion criteria ...
Results ALVDD was associated with higher serum natriuretic peptide, matrix metalloproteinase (MMP)-2, LAVi and left ventricular mass index versus Comparators at baseline. All patients had mean ejection fraction (EF) 67 ± 8%.. Over the follow-up duration, persistent AVLDD was associated with greater increase in monocyte chemoattractant protein-1 (924.6 ± 2420.3 vs 198.5 ± 239.4 pg/ml) and aortic root diameter (0.27 ± 0.45 vs 0.06 ± 0.27 cm) with reduction in EF (-5.4 ± 5.2 vs -0.2 ± 7.0%) versus others; all p , 0.05. Despite within-group reductions in LAVi in both groups supported by increase in anti-hypertensives with blood pressure and MMP-2 lowering, there was a significant increase in interleukin-8 and tumour necrosis factor-alpha over follow-up. ...
The reasons for concentrating on the earliest stages of HF stems from the common idea that this condition is more susceptible to reversal and also from the data of the EMPAREG OUTCOME trial showing the more robust effects, both in terms of hospitalization for HF and cardiovascular death, in the patients without HF at baseline or diagnosed during the study [10]. We therefore focused on patients with normal EF without current or prior symptoms of overt HF, but at high risk for the condition for presence of T2D and allowing for arterial hypertension and structural (LV hypertrophy) or functional (diastolic dysfunction) or biochemical (NT-pro-BNP) evidence of initial myocardial disease (Stage A and B HF according to ACC/AHA guidelines). In terms of pathophysiological changes the data are essentially based on few experimental studies and speculations [49]. SGLT2 inhibitors might actually affect myocardial functions through mechanisms that can act both directly and indirectly on the myocardium. Chronic ...
Introduction Left ventricular systolic dysfunction and elevated serum interleukins (ILs) are common in septic patients. However, whether left ventricular diastolic dysfunction is related to mortality in septic patients is a matter of debate. Aim The aim of the study was to assess the effect of myocardial systolic and diastolic functions on mortality in cases of sepsis and to predict an inflammatory marker that could be clearly linked to mortality in sepsis. Patients and methods Twenty patients were prospectively studied, with measurement of the following on admission and on day 7: left ventricular end-diastolic volume, left ventricular end-systolic volume, left ventricular ejection fraction% (echocardiography), mitral annulus S-velocity, Ed/t, and serum levels of ILs (IL-1α, IL-1β, IL-6, and IL-10). Mortality on day 28 was the study endpoint. Results Twenty patients with sepsis and septic shock were studied (45% were male and 55% were female; mean age 52±17 years). The patients were divided ...
Introduction Left ventricular systolic dysfunction and elevated serum interleukins (ILs) are common in septic patients. However, whether left ventricular diastolic dysfunction is related to mortality in septic patients is a matter of debate. Aim The aim of the study was to assess the effect of myocardial systolic and diastolic functions on mortality in cases of sepsis and to predict an inflammatory marker that could be clearly linked to mortality in sepsis. Patients and methods Twenty patients were prospectively studied, with measurement of the following on admission and on day 7: left ventricular end-diastolic volume, left ventricular end-systolic volume, left ventricular ejection fraction% (echocardiography), mitral annulus S-velocity, Ed/t, and serum levels of ILs (IL-1α, IL-1β, IL-6, and IL-10). Mortality on day 28 was the study endpoint. Results Twenty patients with sepsis and septic shock were studied (45% were male and 55% were female; mean age 52±17 years). The patients were divided ...
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The effectiveness of strategies for treatment of the altered static lung volume and against the development of bronchial hyperreactivity (BHR) following a left ventricular dysfunction (LVD) induced by myocardial ischaemia was investigated in a rat model of sustained postcapillary pulmonary hypertension. Airway resistance (Raw) was identified from the respiratory system input impedance (Zrs) in four groups of rats. End-expiratory lung volume (EELV) was determined plethysmographically, and Zrs was measured under baseline conditions and following iv infusions of 2, 6 or 18 μg/kg/min methacholine. Sham surgery was performed in the rats in Group C, while the left interventricular coronary artery was ligated and Zrs and its changes following identical methacholine challenges were reassessed in the same rats 8 weeks later, during which no treatment was applied (Group I), or the animals were treated daily with a combination of an angiotensin enzyme converter inhibitor and a diuretic (enalapril and furosemide,
This page includes the following topics and synonyms: Systolic Dysfunction, Left Ventricular Dysfunction, Left Ventricular Failure, Systolic Heart Failure, Left Ventricular Systolic Dysfunction, Heart Failure with Reduced Ejection Fraction.
BACKGROUND:In patients with left ventricular dysfunction one of the aims of therapy may be to improve functional capacity. This study compared the improvement of functional capacity in response to medical therapy with that caused by revascularization. METHODS:Fifty-two patients with severe left ventricular dysfunction were divided into groups with ischemic cardiomyopathy undergoing revascularization (group A, n = 20) or incremental medical treatment (group B, n = 16) and a control group receiving maximal medical therapy at the start of the study (group C, n = 16). All patients underwent a baseline metabolic exercise test with evaluation of peak oxygen consumption and derived exercise capacity in metabolic equivalents (METS) with standard electrocardiographic and hemodynamic monitoring. Therapy was then optimized in the medical treatment group, whereas the revascularization group underwent coronary bypass grafting. All patients subsequently underwent follow-up metabolic exercise testing. ...
The objective of the project is to study clinical and prognostic value of new echocardiographic technique, so called positive preejection velocity (+VIC), in patients with chronic ischemic left ventricular (LV) dysfunction indicated for revascularization. Pilot studies has shown high accuracy of pulsed Tissue Doppler imaging (TDI)-derived resting pattern of +VIC to detect viable myocardium in patients with both acute myocardial infarction and chronically dysfunctional myocardium. The aim of the project is to test accuracy of +VIC to predict LV remodeling and long-term prognosis after revascularization in patients with chronically dysfunctional myocardium. Study population will consist of two groups of patients with stable ischemic LV dysfunction: group A- patients indicated for revascularization (n=200), group B- matched control group treated conservatively (case-control design) (n=100). All patients will be followed for 3 years. Endpoints include: 1) LV remodeling at 6 and 24 months and 2) MACE ...
Introduction. Assessing left ventricular (LV) systolic function in a rapid and reliable way can be challenging in the critically ill patient. The purpose of this study was to evaluate the feasibility and reliability of, as well as the association between, commonly used LV systolic parameters, by using serial transthoracic echocardiography (TTE).. Methods. Fifty patients with shock and mechanical ventilation were included. TTE examinations were performed daily for a total of 7 days. Methods used to assess LV systolic function were visually estimated, "eyeball" ejection fraction (EBEF), the Simpson single-plane method, mean atrioventricular plane displacement (AVPDm), septal tissue velocity imaging (TDIs), and velocity time integral in the left ventricular outflow tract (VTI).. Results. EBEF, AVPDm, TDIs, VTI, and the Simpson were obtained in 100%, 100%, 99%, 95% and 93%, respectively, of all possible examinations. The correlations between the Simpson and EBEF showed r values for all 7 days ...
Nonalcoholic fatty liver illness (NAFLD) can be a issue [[http://​robertfkennedyjr.net/​form-two-diabetes-induce-and-remedy/​,http://​www.diettalk.com]] ​ wherein the liver has as well substantially unwanted fat. Commonly it can be not deadly, but it surely may become infected. In nondiabetics it has been related to a heart disorder regarded as left ventricular diastolic dysfunction. The remaining ventricle on the heart pumps blood coming from the lungs via the still left atrium. Blood pumped through the remaining ventricle travels in the aorta, a big artery, from where by it travels throughout the body. In left ventricular diastolic dysfunction,​ LVDD, the left ventricle does not fill thoroughly involving beats. This may trigger fluid to again up in the still left atrium together with the lungs. This problem is known as heart failure. Investigators at College and Azienda Ospedaliera Universitaria Integrata of Verona and other investigate centers in Italy, executed a examine to ...
Most studies of chemotherapy-induced cardiotoxicity have focused on the treatment of patients with heart failure or LVSD (2,7,18). In these patients, the current clinical practice is to stop chemotherapy and to restart it after LV recovery and to avoid further use of anthracyclines. However, even if LVSD improves after treatment, patients with chemotherapy-induced cardiotoxicity are prone to further deterioration in their LV function when confronted with further cycles of chemotherapy or even under stress conditions (19). Hence, in patients with cancer, the main objective should be to prevent rather than to treat cardiac toxicity (20).. ACEI have been shown to be effective against chemotherapy-induced cardiotoxicity in animal models (8,9). Although their use to prevent the progression of LVSD was disappointing in a study of pediatric cancer (18), a recent study reported favorable results when administered to adult patients with chemotherapy-induced cardiac toxicity (10). Positive results have ...
Physiological effects of percutaneous interventions / Coronary stenting in challenging cases 1244 , Loss of functional recovery In regional wall motion Is predictive for restenosis of the supplying angloplasty vessel - follow-up echocardtographlc study after high-risk angloplasty Adrian C. Borges, Franz Xaver Kleber, Dorothee SchOrger, Qert Baumann, Rosa Sicari, Alessandro Plngitore, Eugenio Rcano 1 . Medical Department I, Humbotdt-Unlverslty BerSn (Charite), Germany;1 Physiologic CSnic, CNR Pisa, Italy, on behalf of the VIDA (Viability Identification with Dobutantine-CHpyiidamote Adrrfnistmtion}Study Group The prediction of functional regional recovery Is possible wtth pharmacological stress echocarcbography and has In patients with severe left ventricular dysfunction and coronary artery disease a great prognostic Impact The aim of the study was to evaluate If the loss of recovery of regional left ventricular function after successful revascuiarization can predict a restenosis of the target ...
Over the past 1.5 decades, numerous stem cell trials have been performed in patients with cardiovascular disease. Although encouraging outcome signals have been reported, these have been small, leading to uncertainty as to whether they will translate into significantly improved outcomes. A reassessment of the rationale for the use of stem cells in cardiovascular disease is therefore timely. Such a rationale should include analyses of why previous trials have not produced significant benefit and address whether mechanisms contributing to disease progression might benefit from known activities of stem cells. The present paper provides such a reassessment, focusing on patients with left ventricular systolic dysfunction, either nonischemic or ischemic. We conclude that many mechanisms contributing to progressive left ventricular dysfunction are matched by stem cell activities that could attenuate the myocardial effect of such mechanisms. This suggests that stem cell strategies may improve patient ...
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TY - JOUR. T1 - The natural history of isolated left ventricular diastolic dysfunction. AU - Brogan, Walter C.. AU - Hillis, L. David. AU - Flores, Eduardo D.. AU - Lange, Richard A.. PY - 1992. Y1 - 1992. N2 - study objective: To assess the natural history of isolated left ventricular diastolic dysfunction. materials and methods: Follow-up (average duration, 68 months) was obtained in 51 patients with isolated left ventricular diastolic dysfunction at cardiac catheterization, characterized by (1) an elevated left ventricular end-diastolic pressure; (2) normal left ventricular end-diastolic and end-systolic volumes; (3) normal left ventricular ejection fraction; (4) no coronary artery disease; and (5) no valvular disease. results: During follow-up, seven patients died, but only one died of cardiac causes. Of the 44 living subjects, 20 (45%) noted new-onset symptoms of congestive heart failure, with 11 (25%) of these requiring hospitalization, and 12 (27%) required hospitalization for recurrent ...
Cardiac-resynchronization therapy (CRT) has known benefits in patients with severe left ventricular systolic dysfunction and prolonged QRS duration (,120 ms). However, up to half of patients with systolic dysfunction appear to have left ventricular dyssynchrony by echocardiographic measures, despite a QRS duration of less than 120 ms. As a result, CRT is often used for patients with echocardiographic evidence of dyssynchrony and a narrow QRS complex, despite a lack of clear benefit to this approach. The Echocardiography Guided Cardiac Resynchronization Therapy (EchoCRT) study sought to determine the effect of CRT on patient outcomes in the setting of symptomatic heart failure, echocardiographic findings of dyssynchrony, and QRS duration ,120 ms.. In this multicenter double blind trial, patients with severe symptomatic left ventricular failure (EF,35% and NYHA class III or IV) with a QRS duration of ,130ms (mean 105ms) and evidence of dyssynchrony either on tissue Doppler or speckle tracking echo ...
TY - JOUR. T1 - Left Ventricular Diastolic Dysfunction in Peritoneal Dialysis. AU - Wu, Cho Kai. AU - Lee, Jen Kuang. AU - Wu, Yi Fan. AU - Tsai, Chia Ti. AU - Chiang, Fu Tien. AU - Hwang, Juey Jen. AU - Lin, Jiunn Lee. AU - Hung, Kuan Yu. AU - Huang, Jenq Wen. AU - Lin, Jou Wei. PY - 2015/1/1. Y1 - 2015/1/1. N2 - Left ventricular diastolic dysfunction (LVDD) is common among patients undergoing peritoneal dialysis (PD). We examined the relationship between LVDD, major adverse cardiovascular events (MACE), and mortality in PD patients. A total of 149 patients undergoing PD with preserved left ventricular systolic function were included and followed for 3.5 years. LVDD was diagnosed (according to the European Society of Cardiology guidelines) by conventional and tissue Doppler echocardiography. Serum high-sensitivity C-reactive protein (hsCRP) was measured. The location and volume of adipose tissue were assessed by computed tomography (CT) at the level of the fourth lumbar vertebra. Subjects with ...
Results Conventional echocardiographic measurements (LV end diastolic diameter, LV end systolic diameter and LV EF) were similar between the groups. Longitudinal peak systolic strain (13.20±3.5% to 20.97±4.5%, p=0.0001) and strain rate (0.23±0.18 1/s to 4.92±0.55 1/s, p=0.0001) of the LV were significantly impaired in patients with TA, compared to controls, demonstrating subclinical ventricular systolic dysfunction. Supporting these results, we revealed impaired subclinical LV systolic function in patients with SLE, when compared to the control group (14±4.53% to 20.97±4.5%, p=0.0001 for strain; 0.23±0.12 1/s to 4.92±0.55 1/s, p=0.0001 for strain rate). The mean disease duration of the patient was 5.6 years in patients with TA. The LV systolic dysfunction was negatively correlated with disease duration, but this correlation couldnt reach the statistical significance(r=-0,085, p=0,648.). ...
TY - JOUR. T1 - New-Onset Heart Failure and Mortality in Hospital Survivors of Sepsis-Related Left Ventricular Dysfunction. AU - Vallabhajosyula, Saraschandra. AU - Jentzer, Jacob C.. AU - Geske, Jeffrey B.. AU - Kumar, Mukesh. AU - Sakhuja, Ankit. AU - Singhal, Akhil. AU - Poterucha, Joseph T.. AU - Kashani, Kianoush. AU - Murphy, Joseph G.. AU - Gajic, Ognjen. AU - Kashyap, Rahul. PY - 2017/7/19. Y1 - 2017/7/19. N2 - BACKGROUND:: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS:: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72?hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction ,50% and LV diastolic dysfunction as ≥grade II. Primary composite outcome ...
TY - JOUR. T1 - Recovery from left ventricular dysfunction was associated with the early introduction of heart failure medical treatment in cancer patients with anthracycline-induced cardiotoxicity. AU - Ohtani, Kisho. AU - Fujino, Takeo. AU - Ide, Tomomi. AU - Funakoshi, Kouta. AU - Sakamoto, Ichirou. AU - Hiasa, Ken ichi. AU - Higo, Taiki. AU - Kamezaki, Kenjiro. AU - Akashi, Koichi. AU - Tsutsui, Hiroyuki. PY - 2019/6/1. Y1 - 2019/6/1. N2 - Background: Left ventricular (LV) dysfunction due to anthracycline-induced cardiotoxicity (AIC) has been believed to be irreversible. However, this has not been confirmed and standard medical treatment for heart failure (HF) including renin-angiotensin inhibitors and β-blockers may lead to its recovery. Methods and results: We thus retrospectively studied 350 cancer patients receiving anthracycline-based chemotherapy from 2001 to 2015 in our institution. Fifty-two patients (14.9%) developed AIC with a decrease in LV ejection fraction (LVEF) of 24.1% at a ...
Ethanol consumption is associated with left ventricular dysfunction in heavy ethanol drinkers. The effect of moderate ethanol intake on left ventricular function in hypertension, however, is unknown. We investigated the relationship between ethanol consumption and cardiac changes in nonalcoholic hypertensive patients. In 335 patients with primary hypertension, we assessed daily ethanol consumption by questionnaires that combined evaluation of recent and lifetime ethanol exposure and examined cardiac structure and function by echocardiography. Patients with abnormal liver tests, previous cardiovascular events, left ventricular ejection fraction ,50%, and creatinine clearance ,30 mL/min 1.72 m2 were excluded. Left ventricular hypertrophy was found in 21% of hypertensive patients and diastolic dysfunction was detected in 50% by tissue-Doppler imaging. Ethanol consumption was comparable in hypertensive patients with and without left ventricular hypertrophy, whereas patients with left ventricular ...
The CHARM study extends our knowledge of the role of ARBs in patients with CHF.. Least surprising but still important was the finding in the CHARM-Alternative study that candesartan resulted in a significant reduction in cardiovascular mortality and heart failure hospitalization. The Valsartan Heart Failure Trial (ValHeFT) (1) reached a similar conclusion, and valsartan is indicated in patients with heart failure caused by systolic left ventricular dysfunction who are not taking an ACE inhibitor. However, the result of ValHeFT was determined in a retrospective analysis and included a relatively small number of patients and events. The CHARM-Alternative study, on the other hand, was prospective and adequately powered with a significant number of events. It is likely that ARBs used at the appropriate dose, such as valsartan 160 mg twice daily or candesartan 32 mg daily, are equivalent to target doses of an ACE inhibitor, such as enalapril 10 mg twice daily. However, the therapy of choice in ...
Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004;89(6):2745-9.http://dx.doi.org/10.1210/jc.2003-032046. Hart R, Hickey M, Franks S. Definitions, prevalence and symptoms of polycystic ovaries and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2004;18(5):671-83.http://dx.doi.org/10.1016/j.bpobgyn.2004.05.001. Schannwell CM, Schneppenheim M, Perings S, Plehn G, Strauer BE. Left ventricular diastolic dysfunction as an early manifestation of diabetic cardiomyopathy. Cardiology 2002;98(1-2):33-9.http://dx.doi.org/10.1159/000064682. Brutsaert DL, Sys SU, Gillebert TC. Diastolic failure: Pathophysiology and therapeutic implications. J Am Coll Cardiol 1993;22(1):318-25.http://dx.doi.org/10.1016/0735-1097(93)90850-Z. Watts GF, Marwick TH. Ventricular dysfunction in early diabetic heart disease: Detection, mechanisms and significance. Clin Sci ...
TY - JOUR. T1 - Tissue factor deficiency causes cardiac fibrosis and left ventricular dysfunction. AU - Pawlinski, R.. AU - Fernandes, A.. AU - Kehrle, B.. AU - Pedersen, B.. AU - Parry, G.. AU - Erlich, J.. AU - Pyo, R.. AU - Gutstein, D.. AU - Zhang, J.. AU - Castellino, F.. AU - Melis, E.. AU - Carmeliet, P.. AU - Baretton, G.. AU - Luther, T.. AU - Taubman, M.. AU - Rosen, E.. AU - Mackman, N.. PY - 2002/11/26. Y1 - 2002/11/26. N2 - Exposure of blood to tissue factor (TF) activates the extrinsic (TF: FVIIa) and intrinsic (FVIIIa:FIXa) pathways of coagulation. In this study, we found that mice expressing low levels of human TF (≈1% of wild-type levels) in an mTF-/- background had significantly shorter lifespans than wild-type mice, in part, because of spontaneous fatal hemorrhages. All low-TF mice exhibited a selective heart defect that consisted of hemosiderin deposition and fibrosis. Direct intracardiac measurement demonstrated a 30% reduction (P , 0.001) in left ventricular function in ...
Linking the ceramide synthases (CerSs) 4 and 5 with apoptosis, endometrial and colon cancers. The newly designed Amplatzer vascular plug is undergoing clinical trials. SLY2 and SLY12 encode proteins with hydrophobic tails similar to synaptobrevins, integral membrane proteins of synaptic vesicles in higher eucaryotes. This prospective, randomized, single-blinded study examined 70 ASA III patients undergoing elective ambulatory varicose vein surgery. The effects of pharmacological treatment in asymptomatic left ventricular dysfunction Population data of 15 autosomal STR loci in Chinese Han population from Jiangsu Province, Eastern China.. Effects of lamivudine and thymosin alpha1 combination therapy on patients with chronic hepatitis B Costs of occupational asthma and of occupational chronic obstructive pulmonary disease. SAM recognition and conformational switching mechanism in the Bacillus subtilis yitJ S box/SAM-I riboswitch. The neutralizing capacity of these immune plasmas is relatively ...
The morbidity, mortality and health care costs associated with congestive heart failure make prevention a more attractive public health strategy than treatment. Aggressive management of etiologic factors, including hypertension, coronary artery disease, valvular disease and excessive alcohol intake, can prevent the left ventricular remodeling and dysfunction that lead to heart failure. Early intervention with angiotensin converting enzyme inhibitors in patients with chronic left ventricular dysfunction can prevent, as well as treat, the syndrome. Several intervention strategies in patients with acute myocardial infarction can slow or prevent the left ventricular remodeling process that antedates congestive heart failure. The primary care physician must be alert to the need for aggressive intervention to reduce the burden of heart failure syndrome on the patient and on society.
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Conclusion: Our findings indicate that myocardial damage in patients with diabetes affects diastolic function before systolic function.Even young patients with diabetics with normal systolic ventricular function have diastolic dysfunction, which serves as a marker of a diabetic cardiomyopathy. Diastolic impairment seems not to correlate with disease duration. HbA1c% can be a very good indicator of long term prognosis. Strong correlation exist between diastolic dysfunction and HbA1c%.. ...
TY - JOUR. T1 - Akute angiographie für alle reanimationspatienten bei aufnahme in die klinik. AU - Kern, Karl B. PY - 2012/8. Y1 - 2012/8. N2 - Any patient resuscitated from out-of-hospital cardiac arrest thought to have a cardiac etiology should have emergency coronary angiography upon arrival at the hospital. No current algorithm correctly identifies who has an acutely occluded coronary artery as their cardiac arrest trigger and who does not. However, 75% of those with ST elevation and 33% of those without ST elevation on their postresuscitation electrocardiogram have an acutely occluded coronary artery. To choose not to perform acute coronary angiography and reperfusion in all postresuscitation patients will leave at least one in three patients with significant myocardial loss, thus, resulting in chronic left ventricular dysfunction and heart failure.. AB - Any patient resuscitated from out-of-hospital cardiac arrest thought to have a cardiac etiology should have emergency coronary ...
The participants were randomly assigned to receive the usual primary care (control condition; n = 677) or screening with BNP testing (n = 697) and followed up until December 2011 (mean follow-up, 4.2 [SD, 1.2] years). Intervention-group participants, with BNP levels of 50 pg/mL Sirtinol clinical trial or higher, underwent. echocardiography and collaborative care between their primary care physician and specialist cardiovascular service. The primary end point was prevalence of asymptomatic systolic LV dysfunction, with or without newly diagnosed heart failure. Due to the slower than expected recruitment rates, the investigators extended the study period and redefined the primary endpoint to include significant LV diastolic dysfunction as determined by a ratio of mitral peak velocity. of early filling (E) to early diastolic mitral annular velocity (E) greater than 15.It is important to note that this change did not alter the validity of the study design. Secondary end points included emergency ...
Diastolic dysfunction was found to be predictive of clinical heart failure, with five-year cumulative probabilities of 36.9% in those with diastolic dysfunction and 16.8% in those without (p , 0.001). In a multivariate analysis, the hazard ratio for developing heart failure was 1.61 [1.17-2.20; p = 0.003] after adjustment for various other demographic and echocardiographic parameters. Similar trends were seen for death: five-year cumulative probabilities of 30.8% in those with diastolic dysfunction and 12.1% in those without (p , 0.001) with a corresponding hazard ratio of 2.01 [1.32-3.06; p = 0.001] in multivariate analysis. The cumulative five-year probabilities of developing atrial fibrillation were higher in diastolic dysfunction (18.7% versus 8.8%; p , 0.001) but the association was absent after adjustment for other factors. The association with clinical heart failure was found to be independent of the effects of hypertension in a subgroup analysis ...