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1.
Ben-Hamouda-Chihaoui M Kanoun F Ftouhi B Lamine-Chtioui F Kamoun M Slimane H 《Annales de cardiologie et d'angeiologie》2011,60(2):71-76
Hypertension is frequently associated with type 2 diabetes and is often difficult to control.
Aim
Evaluate the frequency of controlled hypertension in our type 2 diabetic patients with known and treated hypertension and determine the factors associated with poor blood pressure control.Subjects and methods
Prospective study concerning 300 type 2 diabetic patients with a known and treated hypertension, sex-ratio: 0.64, mean age: 61.2 ± 9.1 years (37–86). All subjects underwent physical examination, biological investigations and a 24 hours ambulatory blood pressure monitoring (ABPM).Results
Hypertension was well controlled in 70 patients (23.3%). The concordance rate between clinical measure of blood pressure and ABPM was 70.3%. Subjects with uncontrolled hypertension were older (61.8 ± 8.9 vs 59.1 ± 9.3 years, P < 0.05), more frequently of male sex (sex-ratio: 0.77 vs 0.34, P < 0.01), smokers (36.4 vs 21.7%, P < 0.05) and with abdominal adiposity (P < 0.05). Duration of diabetes, body mass index and the frequency of peripheral neuropathy, retinopathy and coronary insufficiency were not different between the two groups. Diabetic nephropathy was more frequent (29.8 vs 16.1%, P < 0.05) in the group with uncontrolled hypertension. Loss of circadian blood pressure rhythm was noted in 239 patients (79.6%) and it was more frequently observed in patients with uncontrolled hypertension (84 vs 66%, P < 0.001).Conclusion
Our type 2 diabetic patients had a poorly controlled hypertension. Close monitoring of blood pressure with adjustment of antihypertensive treatment are necessary to improve cardiovascular prognosis of our patients. 相似文献2.
T. Hugues D. Ducreux F. Berthier B. Padovani 《Annales de cardiologie et d'angeiologie》2010,59(2):61-66
Introduction
The ultrasound assessment of RV structure and function is often sub-optimal. The range of excursions of the mitral or tricuspid annulus measured in millimetre by 2D or TM-mode in centimetre per second by DTI-mode echocardiography has been shown to reflect the systolic function of both ventricles.Methods
We studied a new technique based on a tissue tracking algorithm that is ultrasound beam angle independent for automated detection of tricuspid annular displacement (TAD) (QLAB, Philips Medical Imaging). Twenty-six patients (pts) referred for magnetic resonance imaging (MRI) and 44 control subjects underwent a complete transthoracic echocardiography. MRI of the right ventricular ejection fraction (RVEF) was correlated by linear regression with TAD. Sixteen pts (61.5%) exhibited right ventricular systolic dysfunction (MRI RVEF < 40%).Results
The MRI RVEF was positively correlated with TAD (R2 = 0,65; p < 0,0001). A value of TAD <14 mm predicted right ventricular dysfunction with a sensitivity of 87.5% and a specificity of 90%. Most of (90%) healthy subjects exhibited TAD values exceeding this cut-off point (mean: 16.9 ± 1.64 mm; range: 13.3 to 24.8 mm). Negative correlation was found between TAD and age (R2 = 0,36; p < 0,0001).Conclusion
Our study is the first to correlate TAD with MRI RVEF. TAD is a simple, rapid, and non-invasive tool for right ventricular systolic function assessment. 相似文献3.
Ahmed A Gondi S Cox C Zheng M Mohammed A Stupin IV Wang S Vela D Brewer A Elayda MA Buja LM Ward Casscells S Wilson JM 《Journal of cardiac failure》2011,17(11):937-943
Background
A declining amplitude of body temperature circadian rhythm (BTCR) predicts decompensation or death in cardiomyopathic hamsters. We tested the hypothesis that changes in BTCR amplitude accompany significant changes in left ventricular (LV) size and function.Methods and Results
Using intraperitoneal transmitters, we continuously monitored the temperature of 30 male BIO TO-2 Syrian dilated cardiomyopathic hamsters. Cosinor analysis was used to detect significant changes—defined as changes >1 standard deviation from the baseline amplitude for 3 consecutive days—in BTCR amplitude over each hamster’s lifespan. The Student t-test was used to compare BTCR variability and LV size and function (as assessed by 2D echocardiography) between baseline and the time that BTCR amplitude declined. All hamsters received 10 mg/kg furosemide daily. At the time of BTCR amplitude decline, functional parameters had changed significantly (P < .0001) from baseline: ejection fraction (0.31 ± 0.09% vs. 0.52 ± 0.08%), LV end-systolic volume (0.11 ± 0.03 vs. 0.05 ± 0.02 cm3), and LV end-diastolic volume (0.16 ± 0.04 vs. 0.10 ± 0.03 cm3).Conclusions
In decompensated cardiomyopathic hamsters, a decline in BTCR amplitude was associated with progression of heart failure and cardiac decompensation. Variation in BTCR warrants further investigation because of its potential implications for the diagnosis and treatment of cardiovascular disorders. 相似文献4.
Background
Biventricular pacing (BiV) therapy has recently been shown to improve systolic function and cause reverse remodeling in patients with advanced heart failure with electromechanical delay. In these patients, the benefit of right ventricular (RV)-based pacing was controversial. We compared the acute changes in systolic and diastolic function, left ventricular (LV) volume, and intraventricular synchronicity in BiV pacing, RV pacing, and without pacing (No) by means of echocardiography and tissue Doppler imaging (TDI).Methods
TDI was performed in 33 patients with heart failure after undergoing pacemaker implantation, when the device was randomized to BiV, RV, and no pacing modes.Results
Systolic function was only improved during BiV pacing, but not during RV pacing. This included ejection fraction (No vs RV vs BiV = 24% ± 12% vs 25% ± 10% vs 30% ± 14%, P = .02 vs No), +dp/dt (P = .01), myocardial performance index (P = .01), and isovolumic contraction time (P = .03). Mitral regurgitation was only reduced during BiV pacing (P = .02). LV early diastolic function was depressed in both RV and BiV pacing, as detected by transmitral flow (97 ± 34 vs 80 ± 34 vs 82 ± 32 cm/s, both P ≤ .005) and TDI (mean myocardial early diastolic velocity of 6 basal segments, 3.3 ± 1.7 vs 2.6 ± 1.0 vs 2.6 ± 1.0 cm/s, both P = .01). The LV end-diastolic (187 ± 86 vs 177 ± 84 vs 166 ± 79, P = .003) and end-systolic (146 ± 77 vs 138 ± 79 vs 122 ± 69, P = .003) volumes were only decreased during BiV pacing. For systolic synchronicity, a significant delay in peak systolic contraction in the lateral over the septal wall (171 ± 37 vs 217 ± 46 ms, P = .004) was revealed by TDI when there was no pacing. This was abolished by BiV pacing, in which septal contraction was delayed (195 ± 38 vs 201 ± 53 ms, P = not significant). However, RV pacing restored the lateral wall delay, and systolic asynchrony reappeared (190 ± 40 vs 227 ± 56 ms, P = .01). Diastolic asynchrony between the septal and lateral walls was not evident in these patients and was not affected by either pacing mode.Conclusion
Only BiV pacing, but not RV pacing, improves systolic function, and reduces mitral regurgitation and LV volumes in patients with heart failure and electromechanical delay. This is attributed to the improvement of systolic synchronicity. Diastolic synchronicity was unaffected, whereas early diastolic function could be jeopardized, by either pacing mode. 相似文献5.
Ben Salem H Ouali S Hammas S Bougmiza I Gribaa R Ghannem K Neffati E Remadi F Boughzela E 《Annales de cardiologie et d'angeiologie》2011,(2):87-91
Aim of study
To determine whether the TIMI risk score correlates with the angiographic extent and severity of coronary artery disease in patients with non-ST-elevation acute coronary syndrome undergoing cardiac catheterization.Patients and method
We conducted a retrospective review of 239 medical records of patients who underwent coronary angiography secondary to non-ST-elevation acute coronary syndrome between 2002 and 2006. Patients were classified into three groups according to TIMI risk score: TIMI scores 0 to 2 (group 1: n = 121), 3 to 4 (group 2: n = 100), and 5 to 7 (group 3: n = 18). We compared the coronary angiography findings of the three groups.Results
Patients of group 1 had a greater likelihood of normal or non significant CAD than patients of group 2 (36.3 % vs 13 %, P < 0.001) and than patients of group 3 (36.3 % vs 0 %, P = 0.002). One-vessel disease was found more often in patients with TIMI score 0 to 2 than in patients with TIMI score 5 to 7 (28.9 % vs 0 %; P = 0.01), and in patients with TIMI score 3 to 4 than in those with score 5 to 7 (35 % vs 0 %, P = 0.006). However, 1-vessel disease was found in patients of group 1 as often as in patients of group 2. The frequency of two-vessel disease was similar whatever the level of TIMI score was low, intermediate or high. Three-vessel or left main disease was more likely found in patients of group 3 than in patients of group 2 (66.7 % vs 26 %; P = 0.01), and than patients of group 1 (66.7 % vs 13.2 %; P < 0.001). Chronic coronary occlusions and coronary calcifications were also more likely found in patients with TIMI score 5 to 7.Conclusion
In patients with non-ST-elevation acute coronary syndrome undergoing cardiac catheterization, the TIMI risk score correlated with the extent and severity of coronary artery disease. 相似文献6.
Jerbi B Sahnoun M Abid L Krichene S Abid D Mallek S Triki F Hentati M Kammoun S 《Annales de cardiologie et d'angeiologie》2011,(3):127-134
Aims of the study
To study the epidemiologic, clinical, therapeutic and prognostic characteristics of the myocardial infarction (MI) in patients with chronic kidney disease (CKD). To identify the impact of CKD in hospital, mid- and long-term survival after myocardial infarction. To determine the predictive factors of hospital and midterm MACCE in patients with CKD.Patients and methods
The study population was 231 patients with a myocardial infarction admitted alive from January 2005 to December 2006. The population was divided into two groups. Group 1: glomerular filtration rate (GFR) ≥60 ml/min: 112 patients; group 2: GFR < 60 ml/min: 119 patients.Results
Patients with CKD had more history of stroke and arterial hypertension. They had received less medical therapies and urgent reperfusion. In multivariate analysis, CKD was a predictive factor of hospital (P = 0.016), at 6 months (P = 0.003), at 1 year (P = 0.004) and at 2 years MACCE (P = 0,015). The predictive factors of hospital MACCE in group 2 were: use of vasopressors (P = 0.001) and primary angioplasty (P = 0.043). In patients with CKD, only surgical coronary revascularization was MACCE predictive factor (P = 0.03).Conclusion
Baseline renal function is a powerful predictor of short- and long-term events after myocardial infarction. Our results confirm the need to include the renal function in the evaluation of the level of risk among patients admitted with acute myocardial infarction. 相似文献7.
8.
Toper C Rivaud E Daniel C Cerf C Parquin F Catherinot E Honderlick P Escande MC Dreyfus JF Stern M Couderc LJ 《Revue de pneumologie clinique》2011,67(4):191-198
Background
The increasing use of immunosuppressive and cytotoxic therapies leads to a growing number of opportunistic infections especially Pneumocystis jirovecii pneumonia (PCP). The purpose of our study was to describe the population involved, and to assess clinical, biological, and mortality data.Methods
We collected retrospectively the whole medical file of all PCP cases diagnosed in non-HIV infected patients, in two French University Hospitals in the last decade (1999–2009). Diagnosis was made on standard coloration and/or immunofluorescence analysis of bronchoalveolar lavage fluid (BAL).Results
Forty-one patients were included in the study, mean age 56 (±12.5) years, sex ratio 0.71 men/woman. Underlying diseases were as follow: 12 patients (29%) were renal transplant recipients, 13 (32%) were treated for solid cancers, and 16 (39%) suffered from various diseases (three allogenic bone-marrow transplantation, 11 hematological malignancies, one pulmonary transplantation, one vasculitis). Twelve patients died (i.e. 29%). Median lymphocyte count was 542/mm3. More than 85% patients received corticosteroids at a median cumulative 6-month dose of 2700 mg. Seven patients (17%) had a PCP prophylaxis. Clinical worsening at day 5 (P < 0.003), poor control of the underlying disease (P < 0.015), WHO performans status superior than 2 (P < 0.025), high temperature (P < 0.04), and high oxygen flow (P < 0.042) were linked to a poor prognosis.Discussion/Conclusion
The prognosis factors found are mostly linked to the patients’ clinical severity. We would like to highlight: first, near to 30% mortality rate, secondly, a lack of prophylaxis in 34 patients, reflecting the difficulty to define PCP's risk in non HIV-infected patients. 相似文献9.
Krüger S Graf J Merx MW Koch KC Kunz D Hanrath P Janssens U 《American heart journal》2004,147(1):60-65
Background
Plasma levels of brain natriuretic peptide (BNP) are increased in patients with left heart failure. In patients with severe pulmonary embolism (PE), primary right ventricular (RV) dysfunction is frequent. Little is known about BNP secretion in acute RV failure.Methods
We prospectively studied 50 consecutive patients with confirmed PE (age range, 57 ± 19 years; 36 men). PE was confirmed with pulmonary angiography, spiral computed tomography, or echocardiography and subsidiary analyses. On admission, echocardiography and BNP measurements were performed in all patients.Results
Patients without RV dysfunction had significantly lower BNP levels than patients with RV dysfunction (55 ± 69 pg/mL vs 340 ± 362 pg/mL, P <.001). There was a significant correlation between RV end-diastolic diameter and BNP (r = 0.43, P <.05). BNP discriminated patients with or without RV dysfunction (area under the receiver operating characteristic curve, 0.78; 95% CI, 0.64-0.92). A BNP >90 pg/mL was associated with a risk ratio of 28.4 (95% CI, 3.22-251.12) for the diagnosis of RV dysfunction. All patients without LV systolic dysfunction who had syncope necessitating cardiopulmonary resuscitation had normal BNP levels. Patients with RV dysfunction had significantly more in-hospital complications (cardiogenic shock, inotropic therapy, mechanical ventilation). However, BNP levels were not predictive of mortality or in-hospital complications.Conclusions
BNP levels are frequently increased in patients with PE who have RV dysfunction, whereas patients without RV dysfunction show reference range BNP levels in the absence of left ventricular dysfunction. In acute PE, BNP elevation is highly predictive of RV dysfunction, but not of in-hospital complications and mortality. 相似文献10.
Tsémo Watchueng G Mouly-Bertin C Depagne C Lantelme P Guerin JC 《Annales de cardiologie et d'angeiologie》2011,60(4):211-217
Objective
Genesis of sleep apnoea syndrome (SAS) in chronic heart failure (CHF) is not well known. The aim of our study was to find associated factors to SAS in heart failure (HF) and to look for differences between central sleep apnea (CSA) and obstructive sleep apnea (OSA).Patients and methods
We realised a cross-sectional and retrospective study. Thirty patients with stable heart failure under medical optimal therapy were included. Polygraphy, echocardiography and cardiopulmonary exercise were systematically performed.Results
Men were predominant (80%) in the group. Mean age, left ventricular ejection fraction (LVEF) were respectively 64.1 ± 13.8 years and 40 ± 9.8%. SAS was present in 60% of patients (33.3% were classified as central sleep apnoea [CSA] and 26.7% as obstructive sleep apnoea [OSA]). Body mass index, blood pressure and left ventricular pressures estimated by the E/Ea ratio were significantly higher in the group with SAS (P < 0.05) compared to the non SAS group. New York Heart Association class was significantly higher (P = 0.04) and the predicted peak VO2 was significantly lower in CSA patients compared to OSA patients.Conclusion
High left ventricular pressures estimated by the E/Ea are significantly associated with SAS in heart failure. CSA patients tend to have a worse functional state than OSA patients. 相似文献11.
Chalghoum A Noichri Y Chkioua L Gammoudi I Dandana A Chahed H Khelil S Jeridi G Baudin B Ferchichi S Miled A 《Annales de cardiologie et d'angeiologie》2011,60(3):135-140
Background
The acute coronary syndromes (ACS) are classified among the major causes of mortality in the industrialized countries. The increased angiotensin I converting enzyme (ACEI) activity related to a genetic polymorphism constitutes a hereditary predisposition to these syndromes.Aim
Evaluate the ACEI activity in Tunisian patients with coronary heart disease, and investigate the association between this activity and an intronic deletion of 287 pb on the intron 16 of the ACEI gene.Patients and methods
Seventy-two coronary patients and 34 control subjects are recruited for our study. ACEI activity was measured by kinetic method. The intronic deletion was identified by PCR technique.Results
An increased activity of ACEI was observed in patients compared with control subjects (84.38 ± 33.83 UI/L vs 59.06 ± 18.2 UI/L, P = 10−5). The molecular study showed a raised relative frequency of D/D genotype (51.4%) among patients, whereas among the witnesses, I/I genotype prevailed (62%). D/D genotype is always associated with highest ACEI activity for the patients and the control subjects.Conclusion
The molecular studies and the biochemical investigations of the various parameters of cardiovascular risk (including the ACEI) direct towards a better treatment. 相似文献12.
Marijana Tadic Cesare Cuspidi Aleksandra Sljivic Anita Andric Branislava Ivanovic Radisav Scepanovic Irena Ilic Ljilja Jozika Tamara Marjanovic Vera Celic 《The Canadian journal of cardiology》2014
Background
We sought to investigate right ventricular (RV) and right atrial (RA) deformation obtained using 3-dimensional echocardiography (3DE) and 2-dimensional (2DE) strain in subjects with the metabolic syndrome (MS).Methods
This cross-sectional study included 108 untreated subjects with the MS and 75 control subjects similar according to sex and age. The MS was defined by the presence ≥ 3 American Heart Association/National Heart, Lung, and Blood Institute criteria. All the subjects underwent adequate laboratory analyses and complete 2DE and 3DE examination.Results
2DE global longitudinal strain of the RV was significantly decreased in the MS group compared with the control subjects (−24 ± 5 vs −27 ± 5%; P < 0.001). Similar results were obtained for the RA longitudinal strain (40 ± 5 vs 44 ± 7%; P < 0.001). Systolic and early diastolic RV and RA strain rates were decreased, whereas late diastolic strain rates were increased among the MS participants compared with the control subjects. 3DE RV ejection fraction was significantly decreased in the MS subjects (55 ± 4 vs 58 ± 4%; P < 0.001). The multivariate analysis of MS criteria showed that systolic blood pressure, waist circumference, and fasting glucose were independently associated with RV and/or RA myocardial function and deformation.Conclusions
RV mechanics and RA mechanics, assessed using 3DE and 2DE strain, were significantly deteriorated in the MS subjects. Among all MS risk factors, systolic blood pressure, abdominal circumference, and fasting glucose were the most responsible for the right heart remodelling. 相似文献13.
Jana Schlangen Gunther Fischer Colin Petko Jan Hinnerk Hansen Inga Voges Carsten Rickers Hans-Heiner Kramer Anselm Uebing 《International journal of cardiology》2013
Background
Systemic right ventricular (RV) function is a major determinant of long-term outcome in patients with palliated hypoplastic left heart syndrome (HLHS). Abnormal elastic properties of the reconstructed aorta may negatively impact on ventricular function. We therefore aimed to assess arterial elastance and its relationship to systemic RV function in these patients.Methods
Fifty-six HLHS patients (median age 5.4 years; range 2.9–14.2 years) were studied at a median of 2.6 years (range 0.8–12.7 years) after completion of the Fontan circulation with the pressure–volume conductance system.Results
Arterial elastance (Ea) was abnormally high and correlated inversely with RV ejection fraction (r = − 0.42, P = 0.001). However, end systolic elastance (Ees) – a load independent measure of intrinsic systolic ventricular function – and more so end diastolic stiffness (Eed) were positively correlated with Ea (Ees vs. Ea: r = 0.44, P = 0.001: Eed vs. Ea: r = 0.62, P < 0.0001).Patients who were treated for significant aortic arch obstruction after surgical palliation showed higher Ea and Eed even four years after successful treatment compared to the remainder of the group (Ea: 3.4 ± 1.2 vs. 2.8 ± 1.0 mm Hg/ml, P = 0.04 and Eed: 0.67 ± 0.44 vs. 0.45 ± 0.3 mm Hg/ml, P = 0.04).Conclusions
Arterial elastance is abnormally high in palliated HLHS patients and negatively impacts on ejection fraction but not on intrinsic systolic RV function early after completion of the Fontan circulation. Increased arterial elastance, however, is associated with increased RV diastolic stiffness with potential adverse effects on long-term outcome. Furthermore, arterial elastance and diastolic stiffness are particularly high in patients who needed treatment for aortic arch obstruction. 相似文献14.
Antonello D’Andrea Rita Gravino Gemma Salerno Roberto Padalino Lucia Riegler Raffaella Scarafile Enrica Pezzullo Luigi Nunziata Massimo Romano Giuseppe Limongelli Eduardo Bossone Giuseppe Pacileo Pio Caso Maria G. Russo Raffaele Calabrò 《Journal of Cardiovascular Echography》2011,21(3):126-134
Objectives
The aim of the study was to detect if right ventricular (RV) ejection fraction assessed by real-time 3D echocardiography (RT3DE) could predict patients with dilated cardiomyopathy (DCM) with greater functional impairment in response to cardiopulmonary exercise.Materials and methods
55 chronic heart failure patients with DCM (56.5 ± 9.1 years; 40 males; 30 ischaemic; NYHA class III: 40) and 30 healthy controls underwent both left ventricular (LV) and RV analysis by RT3DE. Post-processing software provided data of RT3DE systolic dyssynchrony index (SDI) of 16 LV segments, and of both LV and RV ejection fraction. Cardiac magnetic resonance was performed in a subgroup of 20 DCM patients to confirm RT3DE measurements. DCM patients underwent also bicycle cardiopulmonary exercise test with evaluation of VO2 peak (percentage of the predicted value), VE/VCO2 slope and circulatory power (CP).Results
In DCM patients mean LV ejection fraction was 29.8 ± 4.6%. RT3DE LV SDI was 8.4.4 ± 4.2, and RV ejection fraction was 51.3 ± 4.6%. By cardiopulmonary test, mean VO2 peak was 15.2 ± 4.4 mL/kg/min, and mean CP was 2.1 ± 0.8. By univariable analysis, RV ejection fraction directly correlated with VO2 peak % (r = 0,55; p < 0.0001) and inversely with VE/VCO2 slope (r = –0.42; p < 0.001). By multivariable analysis, SDI (beta coefficient = –0.46; p < 0.001) and 3D RV ejection fraction (beta coefficient = 0.42; p < 0.001) emerged as the only independent determinant of VO2 peak % during cardiopulmonary test.Conclusions
Impaired RV function in DCM patients is independently associated with worse ability to perform aerobic exercise. 相似文献15.
Background
To study the long-term prognosis of anorexia nervosa (AN), 484 adult AN patients were followed on a mean duration of 13 years.Results
The mortality rate was 1.2%. Eight factors were linked to the lack of recovery at 2 years: low BMI at discharge, low energy and fat intakes, high drive for excessive exercising, high score for perfectionism, for interpersonal distrust and for anxiety, use of tube-feeding and adhesion to treatment (P < 0.02). Four factors explained the risk of the binge/purging form at 2 years: having had binge-eating disorder and overweight before AN, having had purging episodes within the first 2 years of AN; having had very high energy intakes through meals and being not treated by tube-feeding. During the 13-year follow-up, very few binge/purging patients turned out to have the restrictive form. Two main factors explained 67% of the variance of menses recovery: having a BMI > 18.5 kg/m2; and having no physical hyperactivity. The recovery rate increased with the elapsing of relapse-free time (P = 0.02). After a 13.5-year follow-up, 292 out of the 484 patients were recovered (60.3%), 25.8% had a relatively good outcome, 6.4% a bad outcome and 6.4% a severe outcome. Very few factors were identified as predictors of a good outcome (binge-eating/purging subtype, personality disorder). 相似文献16.
Blum A Tamir S Mualem K Ben-Shushan RS Keinan-Boker L Paritsky M 《The American journal of medicine》2011,(12):1171-1174
Background
Studies have shown an association between Helicobacter pylori (HP) infection and atherosclerosis. Although epidemiological studies have suggested an association between HP infection and atherosclerosis, the issue is still controversial. It is not clear whether HP eradication will reverse endothelial damage and prevent cardiovascular events.Methods
Thirty-one dyspeptic subjects (16 men, 15 women; 50.8 ± 16.7 years) were diagnosed as HP positive using histopathological evaluation. Eleven dyspeptic subjects (5 men, 6 women; 55.4 ± 9.3 years) were negative to HP (controls). Interleukin-6 level and vascular measurements (ankle brachial index and flow-mediated diameter percent change) were done twice: on entry and 3 months afterwards. HP-positive subjects were treated with the triple therapy.Results
Thirty-one HP-positive subjects (50.8 ± 16.7 years, 16 men, weight 79.6 ± 14.8 kg, height 1.70 ± 0.1 m, body mass index [BMI] 27.5 ± 4.4, waist circumference 97.6 ± 16.7 cm) were treated accordingly. There were 11 HP-negative subjects (controls) (55.4 ± 9.3 years, 5 men, weight 83.4 ± 16.8 kg, height 1.68 ± 0.1 m, BMI 29.6 ± 6.1, waist circumference 104.4 ± 13.7 cm). No difference in age (P = .27), weight (P = .51), height (P = .50), BMI (P = .30), or waist circumference (P = .20) was observed. HP-positive subjects had severe endothelial dysfunction (−1.26 ± 8.4%) that improved after treatment (8.4 ± 9.0%) (P = .001). HP-negative subjects had endothelial dysfunction (1.9 ± 9.7%) that was not improved (5.6 ± 8.3%) (P = .41). Interleukin-6 levels in serum were not elevated in HP-positive subjects before or after HP eradication (8.4 ± 17.5 vs 13.5 ± 30.7 pg/mL; P = .45).Conclusions
The novel finding of our study was that HP eradication can improve endothelial dysfunction. 相似文献17.
Benjamin C.F. Smith Gary Dobson David Dawson Athanasios Charalampopoulos Julia Grapsa Petros Nihoyannopoulos 《Journal of the American College of Cardiology》2014
Background
Quantitative assessment of right ventricular (RV) systolic function largely depends on right ventricular ejection fraction (RVEF). Three-dimensional speckle tracking (3D-ST) has been used extensively to quantify left ventricular function, but its value for RV assessment has not been established.Objectives
This study sought to prospectively assess whether 3D-ST would be a reliable method for assessing RV systolic function and whether strain values were associated with survival.Methods
Comprehensive 2-dimensional echocardiographic assessment, 3D-ST of the RV free wall, and measurement of RVEF was performed in 97 consecutive patients with established pulmonary hypertension (PHT) (RVEF 31.4 ± 9.6%, right ventricular systolic pressure [RVSP] 76.5 ± 26.2 mm Hg) and 60 healthy volunteers (RVEF 43.8 ± 9.4%, RVSP 25.9 ± 4.3 mm Hg).Results
Area strain (AS) (−24.3 ± 7.3 vs. −30.8 ± 7.2; p < 0.001), radial strain (23.2 ± 14.4 vs. 34.9 ± 18.2; p < 0.001), longitudinal strain (LS) (−15.5 ± 3.8 vs. −17.9 ± 4.4; p = 0.001), and circumferential strain (CS) (−12.2 ± 4.5 vs. −15.7 ± 6.1; p < 0.001) were all reduced in patients with PHT, compared with normal individuals. AS and CS strongly correlated to RVEF (r = 0.851, r = −0.711; p < 0.001). Systolic dyssynchrony index was greater in PHT (0.14 ± 0.06 vs. 0.11 ± 0.07; p = 0.003) and correlated to RVEF (r = −0.563, p < 0.001). AS (hazard ratio [HR]: 3.49; 95% confidence interval [CI]: 1.21 to 7.07; p = 0.017), CS (HR: 4.17; 95% CI: 1.93 to 12.97; p < 0.001), LS (HR: 7.63; 95% CI: 1.76 to 10.27; p = 0.001), and RVEF (HR: 2.43; 95 CI: 1.00 to 5.92; p = 0.050) were significant determinants of all-cause mortality. Only AS (p = 0.029) and age (p = 0.087) were predictive of death after logistic regression analysis.Conclusions
PHT patients have reduced RV strain patterns and more dyssynchronous ventricles compared with controls, which was relatable to clinical outcomes. AS best correlated with RVEF and provides prognostic information independent of other variables. 相似文献18.
O. Ben Ounis M. Elloumi H. Zouhal E. Makni G. Lac Z. Tabka M. Amri 《Annales d'endocrinologie》2011,72(1):34-41
Objectives
The aim of this study was to characterize the resting levels of cortisol and growth hormone (GH), and the substrate profile during exercise of obese children before and after an individualized training program.Patients and methods
Twenty-two obese children (13.1 ± 0.8 yrs) were included in the study. Twelve individuals (six boys and six girls; 31.1 ± 1.1 kg/m2, VO2peak = 1.92 ± 0.16 l/min) participated in a two-month endurance training program and 10 individuals (five boys and five girls; 30.9 ± 1.7 kg/m2, VO2peak = 1.98 ± 0.12 l/min) served as controls. Training was individualized and targeting at the point were fat oxidation was maximal (Lipoxmax). Substrate oxidation was evaluated by indirect calorimetry. To determine plasma cortisol and GH concentrations, blood was collected at rest before and after the two-month period.Results
Before the program, no significant differences were detected between the training group and the control group for any of the measured anthropometric, metabolic or hormonal variables. At the end of the two-month program, training group showed an increase in VO2peak and fat oxidation during exercise. After the program, resting levels of GH and cortisol were significantly increased in the training group (+ 0.9 ± 0.3 ng/mL and + 55.4 ± 10.3 ng/mL respectively, p < 0.01). Following the two-month period, there was no change in any variables measured in control group.Conclusion
The present data show that an individualized endurance training program targeting Lipoxmax improves fat oxidation during exercise and increases resting levels of GH and cortisol. 相似文献19.
Vergès B Buffier P Baillot-Rudoni S Brindisi MC Bouillet B Petit JM 《Annales d'endocrinologie》2011,(3):203-207
Objective
Ethanol injection under ultrasound (US) guidance has been proposed as an alternative to surgery in the treatment of recurrent benign thyroid cysts following aspiration. We aimed to set up a new procedure of ethanol sclerotherapy without US guidance for the treatment of pure thyroid cysts in order to make this useful treatment, available to more patients, more particularly when access to centers specialized in thyroid ultrasonography is limited.Patients and methods
Nine patients with recurrent large thyroid cysts following aspiration, and showing symptoms of compression and/or cosmetic complaints were treated by ethanol injection without US guidance and followed for up to 11 years.Results
After ethanol injection, mean cyst volume was significantly reduced (9.9 ± 13.6 vs. 31.3 ± 34.1 ml, P = 0.007) and the mean percentage volume reduction was 72.7%. A size reduction of the thyroid lesion more than 50% was achieved in eight of the nine patients (89%). Compressive symptoms and cosmetic complaints totally disappeared after sclerotherapy in all patients. During a mean follow-up of 48 months (ranging from 12 to 135 months), no recurrences were observed. The treatment was well tolerated with no major side effects.Conclusion
Non-US-guided ethanol sclerotherapy is a safe and “easy-to-use” procedure to treat benign thyroid cysts effectively. Because this new treatment does not need US-guidance, it can be performed by endocrinologists during outpatient visits. This new procedure may be useful in some areas, such as developing countries, where access to US examination is limited. 相似文献20.
Kayemba-Kay's S Epstein S Hindmarsh P Burguet A Ingrand P Hankard R 《Annales d'endocrinologie》2011,(3):218-223