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1.
Mehmet Fatih Özlü Kemalettin Erdem Gülhanım Kırış Ali İhsan Parlar Abdullah Demirhan Selim Suzi Ayhan Alim Erdem Serkan Öztürk Ümit Yaşar Tekelioğlu Mehmet Yazıcı 《Journal of interventional cardiac electrophysiology》2013,37(1):27-33
Objective
Postoperative atrial fibrillation (POAF) complicating coronary artery bypass grafting surgery (CABG) increases morbidity and stroke risk. Total atrial conduction time (PA-TDI duration) has been identified as an independent predictor of new-onset atrial fibrillation (AF). We aimed to assess whether PA-TDI duration is a predictor of AF after CABG.Methods
In 128 patients who had undergone CABG, preoperative clinical and echocardiographic data were compared between patients with and without POAF. The PA-TDI duration was assessed by measuring the time interval between the beginning of the P wave on the surface ECG and point of the peak A wave on TDI from left atrium (LA) lateral wall just over the mitral annulus.Results
Patients with POAF (38/128, 29.6 %) were older (68.1?±?11.1 vs. 59.3?±?10.2 years; p?<?0.001), had higher LA maximum volume, had prolonged PA-TDI duration, and had lower ejection fraction compared with patients without POAF. PA-TDI duration was found to be significantly increased in POAF group (134.3?±?19.7 vs. 112.5?±?17.7 ms; p?=?0.01). On multivariate analysis, age (95 % CI?=?1.03–1.09; p?=?0.003), LA maximum volume (95 % CI?=?1.01–1.06; p?=?0.03), and prolonged PA-TDI duration (95 % CI, 1.02–1.05; p?=?0.001) were found to be the independent risk factors of POAF.Conclusions
In this study, LA maximum volume and PA-TDI duration were found to be the independent predictors of the development of POAF after CABG. Echocardiographic predictors of left atrial electromechanical dysfunction may be useful in risk stratifying of patients in terms of POAF development after CABG. 相似文献2.
Brian Cowie Roman Kluger Steffen Rex Carlo Missant 《Annals of cardiac anaesthesia》2015,18(3):312-316
Background:
The pulmonary artery catheter (PAC) has historically been used to measure cardiac filling pressures of which pulmonary capillary wedge pressure (PCWP) has been used as a surrogate of left atrial pressure (LAP) and left ventricular end-diastolic pressure. Increasingly, the use of the PAC has been questioned in the perioperative period with multiple large studies unable to clearly demonstrate benefit in any group of patients, resulting in a declining use in the perioperative period. Alternative methods for the noninvasive estimation of left-sided filling pressures are required. Echocardiography has been used to provide noninvasive estimation of PCWP and LAP, based on evaluating mitral inflow velocity with the E and A waves and looking at movement of the mitral annulus with tissue Doppler (e’).Aim:
The aim of our study was to assess the relationship between PCWP and E/e’ in cardiac surgical patients with transesophageal echocardiography (TOE).Design:
A prospective observational study.Setting:
Cardiac surgical patients in a single quaternary referral university teaching hospital.Methods:
The ratio of mitral inflow velocity (E wave) to mitral annular tissue velocity (e’) (the E/e’ ratio) and PCWP of 91 patients undergoing general anesthesia and cardiac surgery were simultaneously recorded, with the use of TOE and a PAC.Results:
The correlation between E/e’ and PCWP was modest with a Spearman rank correlation coefficient of 0.29 (P = 0.005). The area under the receiver operating characteristic curve for using E/e’ to predict elevated PCWP (≥18 mmHg) was 0.6825 (95% confidence interval: 0.57–0.80), indicating some predictive utility. The optimum threshold value of E/e’ was 10 which had 71% sensitivity and 60% specificity to predict a PCWP ≥18 mmHg.Conclusions:
Noninvasive measurements of E/e’ in general cardiac surgical patients have only a modest correlation and does not reliably estimate PCWP. 相似文献3.
Siva Subramaniyan Neeraj Pandit Ranjit Kumar Nath Ajay Raj Athar Kamal Deepankar Vatsa 《The Egyptian Heart Journal》2018,70(4)
Background
It is well established fact that acute coronary occlusion leads to diastolic dysfunction, followed by systolic dysfunction when myonecrosis occur. It is also proven that primary percutaneous coronary intervention (PPCI) is an excellent therapy for ST elevation myocardial infarction (STEMI) to improve outcomes. However there is a paucity of information on efficacy of PPCI in improving diastolic function. Evaluation of the role of PPCI in improving diastolic dysfunction is required.Methods
61 patients with first anterior wall STEMI who underwent PPCI to left anterior descending artery were included. Echocardiographic evaluation was performed within 24?h of PPCI and then on day 15, 3?months and 6?months after PPCI. We evaluated the prevalence of diastolic dysfunction after PPCI and its recovery during 6?months along with effect of duration of chest pain on diastolic function.Results
54.1% of patients had diastolic dysfunction after PPCI whereas it was only 21.3% after 6?months (p value?<?0.001). Diastolic function indices like deceleration time, isovolumic relaxation time, E wave, A wave, E/A ratio, left atrial volume and index improved statistically from baseline to 6?months except mitral E/e′ ratio. As time required to achieve reperfusion increases (chest pain duration and D to B time) the incidence of residual diastolic dysfunction also increases (p value?<?0.001). Patients with TIMI flow?<?III had more diastolic dysfunction (p value?<?0.001).Conclusions
Primary PCI improves diastolic dysfunction in patients with anterior wall STEMI over a period of 6?months. Time to achieve reperfusion and effectiveness of reperfusion have significant effect on diastolic dysfunction. 相似文献4.
Objective
Ascending aortic aneurysm (AAA) is one of the major causes of ventricular diastolic dysfunction. Diastolic dysfunction can induce ventricular repolarization dispersion. Nevertheless, myocardial repolarization dispersion is not yet to be fully evaluated in patients with AAA. We aimed to evaluate ventricular repolarization using QT and Tp-Te interval and corrected (c) Tp-Te/QT ratio in patients with AAA.Methods
One hundred-four patients with AAA without coronary artery disease (CAD) served as the aneurysm group and 82 patients having a normal aortic diameter as the control group. All patients underwent transthoracic echocardiography (TTE) for measurements of LV diastolic function and underwent electrocardiography (ECG) to calculate RR, QT, Tp-Te intervals and QT dispersion. Bazett's formula was used to calculate QTc and cTp-Te intervals. cTp-Te/QT ratio was also calculated.Results
The groups were similar according to basal characteristics. We found left ventricular diastolic properties were impaired and QT dispersion, QTc interval, and both of Tp-Te and cTp-Te intervals were significantly prolonged in the aneurysm group than the control group. There were also significant correlations between TTE and ECG parameters. On multivariate linear regression analysis, indexed ascending aortic dimension (AAoD), LA diameter and E/e′ ratio were independent predictors of ventricular repolarization dispersion in AAA patients.Conclusions
Our study results showed that patients with AAA may have an increased risk for ventricular arrhythmogenesis because of deteriorated the left ventricular diastolic function. 相似文献5.
Federico Cacciapuoti Venere Delli Paoli Anna Scognamiglio Michele Caturano Fulvio Cacciapuoti 《Journal of Cardiovascular Echography》2015,25(2):40-45
Background:
Left atrial volume (LAV) and function are connected to the left ventricular (LV) haemodynamic patterns. To define the changes of LAV and functions to counterbalance age-related LV diastolic impairment, this study was undertaken.Methods:
2D-Left Atrial Speckle Tracking Echocardiography (2D-LASTE) was used to define both LAV and functions in an aged healthy population (group II) respect to adult healthy controls (group I).Results:
Results showed an increasing of left atrial volume indices (LAVI) (maximum, minimum, pre-a) in old subjects in comparison with those obtained in adult healthy controls. On the contrary, LAVI passive emptying unchanged and LAVI passive fraction reduced with advanced age. Finally, LAVI active emptying increased with advancing age to compensate the age-dependent left ventricular diastolic dysfunction. The values of global systolic strain (S); systolic strain rate (SrS); early diastolic strain rate (SrE), and late diastolic strain rate (SrA) were also calculated. With reference to the function, our study confirmed that LA conduit function deteriorates with age while booster pump increases respect to adult controls and reservoir phase is maintained.Conclusions:
The echocardiographic findings obtained with conventional and tissue Doppler confirmed the connection between LA functions and volumes and age-related LV dysfunction. Conclusively, 2D-LASTE appears to be a reliable tool to evaluate the role of LA to compensate the derangement of left ventricle happening with ageing. 相似文献6.
Salvatore La Carrubba Maria Chiara Todaro Concetta Zito Francesco Antonini-Canterin Ines Paola Monte Pio Caso Paolo Colonna Cesare de Gregorio Antonio Pezzano Frank Benedetto Giovanni Di Salvo Scipione Carerj Vitantonio Di Bello 《Journal of Cardiovascular Echography》2013,23(4):96-101
Context:
Metabolic syndrome (MS) is a cluster of interrelated common clinical disorders, including obesity, insulin resistance, glucose intolerance, hypertension and dyslipidemia, associated with a greater risk of atherosclerotic cardiovascular disease than any of its individual components. Although MS is associated with increased cardiovascular risk (CVR), its relationship with heart failure (HF) and left ventricular (LV) dysfunction is not fully understood.Aims:
We sought to determine whether MS is associated to LV systolic and diastolic dysfunction in a sample of patients with MS and no symptoms for HF.Subjects and Methods:
We enrolled 6422 consecutive asymptomatic patients admitted to echo-lab for a routine echocardiogram. We calculated LV systolic and diastolic function, by Simpson biplane method and validated Doppler parameters, respectively. MS was diagnosed if three or more CVR factors were found.Results:
LV systolic function was evaluated in 6175 patients (96.2%). In the group of patients without MS (n = 5630), the prevalence of systolic dysfunction was 10.8% (n = 607) while in the group of patients with MS (n = 545) it was 12.5% (n = 87), (RR1.57; CI 95% 1.2-2.0; P < 0.001). Diastolic function was evaluated in 3936 patients (61.3%). In the group of patients without MS (n = 3566) the prevalence of diastolic dysfunction was 33.3% (n = 1187), while in patients with MS (n = 370) it was 45.7% (n = 169), (RR1.68; CI95% 1.3-2.0; P < 0.001). After adjustment for age and gender, MS proved to be an independent predictor of LV systolic and diastolic dysfunction.Conclusions:
Our data show that asymptomatic LV systolic and diastolic dysfunction, is correlated with MS and demonstrate that echocardiography is a useful tool to detect patients at high risk for HF. Echocardiography in asymptomatic patients with MS may lead to a therapy initiation at early stages to prevent future cardiovascular events and HF. 相似文献7.
Jaroslav Meluzin Petr Hude Jan Krejci Lenka Spinarova Helena Podrouzkova Pavel Leinveber Ladislav Dusek Vladimir Soska Josef Tomandl Petr Nemec 《Experimental & Clinical Cardiology》2013,18(2):63-72
OBJECTIVES:
At present, there are conflicting data on the ability of echocardiographic parameters to predict the exercise-induced elevation of left ventricular (LV) filling pressure. The purpose of the present study was to validate the ratio of early diastolic transmitral (E) to mitral annular velocity (e′) obtained at peak exercise in its capacity to determine the exercise-induced elevation of pulmonary capillary wedge pressure (PCWP) and to reveal new noninvasive parameters with such capacity.METHODS:
Sixty-one patients who had undergone heart transplantation with normal LV ejection fraction underwent simultaneous exercise echocardiography and right heart catheterization.RESULTS:
In 50 patients with a normal PCWP at rest, exercise E/e′ ≥8.5 predicted exercise PCWP ≥25 mmHg with a sensitivity of 64.3% and a specificity of 84.2% (area under the curve [AUC]=0.74). A comparable or slightly better prediction was achieved by exercise E/peak systolic mitral annular velocity (s′) ≥11.0 (sensitivity 79.3%; specificity 57.9%; AUC=0.75) and exercise E/LV systolic longitudinal strain rate ≤−105 cm (sensitivity 78.9%; specificity 78.6%; AUC=0.87). Combined, exercise E/s′ and exercise E/e′ resulted in a trend toward a slightly more precise prediction (sensitivity 53.6%; specificity 89.5%; AUC=0.78) than did either variable alone.CONCLUSIONS:
Exercise E/e′, used as a sole parameter, is not sufficiently precise to predict the exercise-induced elevation of PCWP. Exercise E/s′, E/LV systolic longitudinal strain rate or combinations of these parameters may represent further promising possibilities for predicting exercise PCWP elevation. 相似文献8.
Umar G Adamu Philip M Kolo Ibrahim A Katibi George O Opadijo Ayodele BO Omotosho Matthew A Araoye 《Cardiovascular journal of Africa》2009,20(3):173-177
Background
It is not known whether abnormalities of left ventricular diastolic function are influenced by the various cardiac geometric patterns in Nigerians with newly diagnosed systemic hypertension.Objective
To evaluate the relationship between the parameters of left ventricular diastolic function and the geometric patterns in this group of patients.Methods
Two-dimensional, guided M-mode echocardiography including Doppler was performed in 150 consecutive, newly diagnosed hypertensive individuals and normotensive controls aged between 35 and 74 years. Left ventricular mass index and relative wall thickness were used to classify the hypertensive individuals into four geometric patterns, and the pulsed-wave Doppler parameters obtained were used to categorise the abnormalities of diastolic function.Results
Four left ventricular geometric patterns were identified: 23 (15.3%) had normal left ventricle geometry, 33 (22%) had concentric remodelling, 37 (24.7%) were found to have eccentric hypertrophy, and concentric hypertrophy occurred in 57 (38%) of the hypertensive individuals. Left ventricular diastolic dysfunction occurred more in hypertensives with concentric left ventricular geometric pattern. Increased left ventricular mass index and relative wall thickness were found to be associated with the mitral E-wave, E/A ratio and pulmonary venous flow S-wave in the hypertensives (p < 0.001).Conclusion
In newly diagnosed Nigerian hypertensives, the abnormalities in left ventricular diastolic function varied between the different left ventricular geometric patterns, being worst in those with concentric geometry. 相似文献9.
Pulmonary Hypertension with Left Heart Disease: Prevalence,Temporal Shifts in Etiologies and Outcome
Tatyana Weitsman Giora Weisz Rivka Farkash Marc Klutstein Adi Butnaru David Rosenmann Tal Hasin 《The American journal of medicine》2017,130(11):1272-1279
Introduction
Pulmonary hypertension has many causes. While it is conventionally thought that the most prevalent is left heart disease, little information about its proportion, causes, and implications on outcome is available.Methods
Between 1993 and 2015, 12,115 of 66,949 (18%) first adult transthoracic echocardiograms were found to have tricuspid incompetence gradient ≥40 mm Hg, a pulmonary hypertension surrogate. Left heart disease was identified in 8306 (69%) and included valve malfunction in 4115 (49%), left ventricular systolic dysfunction in 2557 (31%), and diastolic dysfunction in 1776 (21%). Patients with left heart disease, as compared with those without left heart disease, were of similar age, fewer were females (50% vs 63% P <.0001), and they had higher tricuspid incompetence gradient (median 48 mm Hg [interquartile range 43, 55] vs 46 mm Hg [42, 54] P <.0001). In reviewing trends over 20 years, the relative proportions of systolic dysfunction decreased and diastolic dysfunction increased (P for trend <.001), while valve malfunction remained the most prevalent cause of pulmonary hypertension with left heart disease. Independent predictors of mortality were age (hazard ratio [HR] 1.05; 95% CI, 1.04-1.05; P <.0001), tricuspid incompetence gradient (HR 1.02; 95% CI, 1.01-1.02, P <.0001 per mm Hg increase), and female sex (HR 0.87; 95% CI, 0.83-0.91, P <.0001).Results
Overall, left heart disease was not an independent risk factor for mortality (HR 1.04; 95% CI, 0.99-1.09; P = .110), but patients with left ventricular systolic dysfunction and with combined systolic dysfunction and valve malfunction had increased mortality compared with patients with pulmonary hypertension but without left heart disease (HR 1.30; 95% CI, 1.20-1.42 and HR 1.44; 95% CI, 1.33-1.55, respectively; P <.0001 for both).Conclusions
Pulmonary hypertension was found to be associated with left heart disease in 69% of patients. Among these patients, valve malfunction and diastolic dysfunction emerged as prominent causes. Left ventricular dysfunction carries additional risk to patients with pulmonary hypertension. 相似文献10.
Background
Cardiopulmonary involvement in systemic sclerosis (SSc) is a poor prognostic factor, due to pulmonary hypertension and right ventricular dysfunction. We assessed the echocardiographic parameters of right ventricular (RV) function in SSc and correlated echocardiographic findings to clinical features of the disease.Methods
Thirty patients with SSc (cases) and 30 healthy, age-matched subjects (controls) were studied. Echocardiography, including tissue Doppler imaging, was used to evaluate cardiac function.Results
Pulmonary hypertension could be documented in only 5 cases by Doppler echo, using Bernoulli principle. RV diastolic function was significantly deranged in cases. RV systolic function and left ventricle (LV) diastolic function were also significantly deranged in the cases. RV thickness was increased in patients with SSc. There were no significant differences in the echocardiographic variables between diffuse and limited subtypes of SSc. Myocardial performance index (MPI) of both ventricles were increased in cases. We could demonstrate RV thickness as the single most important predictor of MPI of both ventricles with sensitivity of 82% and specificity of 72% for RV-MPI and 63% for LV-MPI. Diastolic function was not found to be affected by disease duration or Rodnan skin score.Conclusion
Patients with SSc exhibit abnormal RV and LV diastolic functions as well as abnormal RV systolic function. RV wall thickness was found to be simple and the single best predictor of global myocardial performance. RV dysfunction may be a response to intermittent pulmonary arterial hypertension, lung parenchymal involvement, or secondary to LV diastolic dysfunction in SSc.Abbreviations: ACE-I, angiotensin converting enzyme inhibitor; DT, deceleration time; DTI, Doppler tissue imaging; E/A ratio, early diastolic/atrial component velocity ratio; ET, ejection time; FVC, forced vital capacity; Hct, hematocrit; HRCT, high-resolution computed tomography; IVCT/ICT, isovolumic contraction time; ILD, interstitial lung disease; IVRT/IRT, isovolumic relaxation time; LV, left ventricle/ventricular; LVEDD, left ventricular end diastolic dimension; LVEDV, left ventricular end diastolic volume; LVEF, left ventricular ejection fraction; LVESD, left ventricular end systolic dimension; LVESV, left ventricular end systolic volume; MPI, myocardial performance index; PAH, pulmonary arterial hypertension; PAP, pulmonary artery pressure; PASP, pulmonary artery systolic pressure; PAT, pulmonary acceleration time; RR, electrocardiographic R–R interval; RVEF, right ventricular ejection fraction; RV, right ventricle/ventricular; SSc, systemic sclerosis 相似文献11.
Bassam Hennawy Wael El Kilany Haitham Galal Ahmed Mamdouh 《The Egyptian Heart Journal》2018,70(3):217-223
Background
Arterial hypertension adversely affects left atrial (LA) size and function, effect on function may precede effect on size. Many techniques were used to assess LA function but with pitfalls.Objectives
Early detection of left atrial dysfunction with speckle tracking echocardiography in hypertensive patients with normal left atrial size.Patients and methods
The study was conducted on 50 hypertensive patients and 50 age matched normotensive controls, all with normal LA volume index and free from any other cardiovascular disease that may affect the LA size or function. They were all subjected to history taking, clinical examination and echocardiographic study with assessment of LA functions [total LA stroke volume, LA expansion index by conventional 2D echocardiography and Global peak atrial longitudinal strain by speckle tracking (PALS)], left ventricular (LV) systolic and diastolic functions, and LV mass.Results
Different indices of LA dysfunction (Total LA stroke volume, LA expansion index and global PALS) were significantly lower in the hypertensive group despite the normal LA volume index in all the studied subjects. The presence of diabetes mellitus (DM) and higher grade of LV diastolic dysfunction were significantly associated with lower global PALS. The higher age, systolic blood pressure (BP), body mass index (BMI), LA volume index, and LV mass index and the lower LA expansion index were associated with lower global PALS.Conclusion
Speckle tracking echocardiography is a useful novel technique in detecting LA dysfunction in hypertension even before LA enlargement occurs. 相似文献12.
Sattarzadeh R Maleki M Jamalian A Amirpour A Firuzi A Samiei N Esmaeilzadeh M Ghorbani A Tavoosi A 《Cardiovascular journal of Africa》2011,22(4):182-185
Aim
This study aimed at evaluating the early effects of successful elective percutaneous coronary intervention (PCI) on systolic and diastolic function.Methods
We consecutively studied the systolic and diastolic function in 21 patients with stable coronary artery disease (CAD) and left ventricular ejection fraction (LVEF) > 40% before and 48 hours after successful elective PCI.Results
Tei index and systolic indices (LVEF, regional wall motion abnormality score, tricuspid annular plane systolic excursion and peak systolic velocity of mitral and tricuspid annulus) did not change significantly. Among the diastolic indices, only velocity propagation (Vp) improved significantly (from 42.9 ± 10.8 to 51.8 ± 10.7, p-value = 0.008) following PCI. Diastolic velocities, E/A ratio, deceleration time (DT), early and late diastolic velocities of mitral annulus in TDI, pulmonary vein systolic (PVs) and diastolic flow velocity (PVd) did not show significant improvement.Conclusion
Propagation velocity of mitral inflow was the earliest index to recover following successful PCI in patients with stable CAD. 相似文献13.
Mehmet Demir 《Experimental & Clinical Cardiology》2013,18(1):e1-e4
BACKGROUND:
The bicuspid aortic valve (BAV) represents the most common cardiac congenital malformation in adults. It is frequently associated with dilation, aneurysm and dissection of the ascending aorta.OBJECTIVE:
To evaluate left ventricular systolic and diastolic function in subjects with BAVs.METHODS:
Thirty-five subjects with BAV (mean [± SD] age 25.9±5.7 years [range 17 to 36 years]; 18 male, 17 female) with either no valvular impairment or mild valvular impairment were recruited along with 30 control subjects (24.5±4.4 years of age [range 15 to 35 years]; 15 male, 15 female) who were matched for age, sex and body surface area. Left ventricular systolic and diastolic function were evaluated using conventional and tissue Doppler echocardiography. Left ventricular systolic and diastolic parameters were compared between the two groups.RESULTS:
In subjects with BAVs, the ratio of mitral early diastolic velocity to late diastolic velocity was lower (0.95±0.4 versus 1.27±0.9; P=0.001), the ratio of mitral early diastolic velocity to myocardial early diastolic velocity was higher (10.1±3.2 versus 6.5±2.4; P=0.001) and the myocardial early diastolic velocity was lower (8.4±2.1 versus 15.3±3.6; P<0.001) compared with control subjects. In addition, the myocardial performance index was higher in subjects with BAVs than in control subjects (P=0.03). The left ventricular ejection fraction was also lower (53±11% versus 64±13%; P<0.001). No other statistically significant differences were observed between the two groups with regard to left ventricular systolic and diastolic parameters. In addition, the number of mitral valve prolapses and atrial septal aneurysms was higher in subjects with BAVs.CONCLUSION:
BAVs may be associated with left ventricular systolic and diastolic dysfunction. 相似文献14.
Al-Shimaa Mohamed Sabry Heba Abd El-Kader Mansour Tarek Helmy Abo El-Azm Shimaa Ahmed Mostafa Basant Samy Zahid 《The Egyptian Heart Journal》2017,69(4):281-288
Objectives
Detection of the echocardiographic predictors of post-operative atrial fibrillation in patients with rheumatic mitral valve disease undergoing mitral valve replacement.Methods
The study included 50 patients with rheumatic mitral valve disease undergoing mitral valve replacement. Preoperative assessment included standard two-dimensional echocardiography to assess LA diameter, volume, and emptying fraction, LV volume and ejection fraction. TDI derived velocity, strain of the left atrium and speckle tracking to assess left ventricular function then postoperative follow up for 1 month for occurrence of atrial fibrillation.Results
The incidence of postoperative AF was 44%; these patients were significantly older (P = 0.001) and show higher prevalence of DM (P = 0.001) and HTN (P = 0.001). Also, LA diameters (antero-posterior, transverse and longitudinal) and LA volumes (maximal and minimal) were increased (P < 0.001), but no difference in LA emptying fraction (P > 0.05). Systolic LA strain and left ventricular global longitudinal strain were significantly reduced in those patients (P value <0.001). Echocardiographic predictors of AF were LA systolic strain (P value <0.001) and LV global longitudinal strain (P value = 0.003). Cutoff value for systolic LA strain ≤23 had sensitivity 90.91% and specificity 93.33% in predicting POAF. While, left ventricular global longitudinal strain ≤?14.9% had sensitivity 63.6% and specificity 100.0% in predicting AF.Conclusion
LA systolic strain and LV global longitudinal strain were significant predictors of POAF. Echocardiographic parameters can identify patients at greater risk of developing POAF who can benefit from preventive measure and guide the selection of prosthesis. 相似文献15.
Piyush O. Somani Qais contractor Ajay S. Chaurasia Pravin M. Rathi 《Indian heart journal》2014,66(6):649-655
Aim
Present study aims to study the occurrence of cirrhotic cardiomyopathy and its correlation to hepatorenal syndrome by assessing the cardiac status in patients with cirrhosis of liver and healthy controls.Methods
Thirty alcoholic cirrhotic, thirty non-alcoholic cirrhotic and thirty controls were enrolled for the study. Cardiac parameters were assessed by color doppler echocardiography. Patients were followed up for twelve months period for development of hepatorenal syndrome.Results
Mild diastolic dysfunction was present in 18 cirrhotic patients (30%): grade I in fifteen patients and grade II in three. Diastolic dysfunction was unrelated to age; sex and etiology of cirrhosis. Among all the echocardiographic parameters, only deceleration time was found to be statistically significant. Echocardiographic parameters in systolic and diastolic function were not different in compensated vs decompensated patients in different Child-Pugh classes or cirrhosis aetiologies.At one year follow-up, no significant differences were found in survival between patients with or without diastolic dysfunction. Hepatorenal syndrome developed in only two patients and its correlation with diastolic dysfunction was not statistically significant.Conclusions
Present study shows that although diastolic dysfunction is a frequent event in cirrhosis, it is usually of mild degree and does not correlate with severity of liver dysfunction. There are no significant differences in echocardiographic parameters between alcoholic and non-alcoholic cirrhosis. HRS is not correlated to diastolic dysfunction in cirrhotic patients. There is no difference in survival at one year between patients with or without diastolic dysfunction. Diastolic dysfunction in cirrhosis is unrelated to circulatory dysfunction, ascites and HRS. 相似文献16.
Daniela do Carmo Rassi Marcelo Luiz Campos Vieira Ana Lúcia Martins Arruda Viviane Tiemi Hotta Rogério Gomes Furtado Danilo Teixeira Rassi Salvador Rassi 《Arquivos brasileiros de cardiologia》2014,102(3):245-252
Background
Echocardiography provides important information on the cardiac evaluation of patients with heart failure. The identification of echocardiographic parameters in severe Chagas heart disease would help implement treatment and assess prognosis.Objective
To correlate echocardiographic parameters with the endpoint cardiovascular mortality in patients with ejection fraction < 35%.Methods
Study with retrospective analysis of pre-specified echocardiographic parameters prospectively collected from 60 patients included in the Multicenter Randomized Trial of Cell Therapy in Patients with Heart Diseases (Estudo Multicêntrico Randomizado de Terapia Celular em Cardiopatias) - Chagas heart disease arm. The following parameters were collected: left ventricular systolic and diastolic diameters and volumes; ejection fraction; left atrial diameter; left atrial volume; indexed left atrial volume; systolic pulmonary artery pressure; integral of the aortic flow velocity; myocardial performance index; rate of increase of left ventricular pressure; isovolumic relaxation time; E, A, Em, Am and Sm wave velocities; E wave deceleration time; E/A and E/Em ratios; and mitral regurgitation.Results
In the mean 24.18-month follow-up, 27 patients died. The mean ejection fraction was 26.6 ± 5.34%. In the multivariate analysis, the parameters ejection fraction (HR = 1.114; p = 0.3704), indexed left atrial volume (HR = 1.033; p < 0.0001) and E/Em ratio (HR = 0.95; p = 0.1261) were excluded. The indexed left atrial volume was an independent predictor in relation to the endpoint, and values > 70.71 mL/m2 were associated with a significant increase in mortality (log rank p < 0.0001).Conclusion
The indexed left atrial volume was the only independent predictor of mortality in this population of Chagasic patients with severe systolic dysfunction. 相似文献17.
Akintunde AA Akinwusi PO Familoni OB Opadijo OG 《Cardiovascular journal of Africa》2010,21(5):252-256
Background
Hypertension is an important cardiovascular risk factor worldwide. It is associated with left ventricular hypertrophy (LVH). Both diastolic and systolic dysfunction may occur in hypertensive heart disease. The ventricles are structurally and functionally interdependent on each other. This was an echocardiographic study intended to describe the impact of left ventricular pressure overload and hypertrophy due to hypertension on right ventricular morphology and function.Methods
One hundred subjects with systemic hypertension and 50 age- and gender-matched normotensive control subjects were used for this study. Two-dimensional (2-D), M-mode and Doppler echocardiographic studies were done to evaluate the structure and function of both ventricles. Data analysis was done using the SPSS 16.0 (Chicago, Ill). Statistical significance was taken as p < 0.05.Results
Age and gender were comparable between the two groups. Hypertensive subjects had significantly increased left ventricular end-diastolic dimensions, posterior wall thickness, interventricular septal thickness, left atrial dimensions and left ventricular mass and index. The mitral valve E/A ratio was reduced among hypertensive subjects when compared to normal controls (1.15 ± 0.75 vs 1.44 ± 0.31, respectively; p < 0.05). A similar pattern was found in the tricuspid E/A ratio (1.14 ± 0.36 vs 1.29 ± 0.30, respectively; p < 0.05). Hypertensive subjects also had reduced right ventricular internal dimensions (20.7 ± 8.0 vs 23.1 ± 3.1 mm, respectively; p < 0.001) but similar peak pulmonary systolic velocity. The mitral e/a ratio correlated well with the tricuspid e/a ratio.Conclusion
Systemic hypertension is associated with right ventricular morphological and functional abnormalities. Right ventricular diastolic dysfunction may be an early clue to hypertensive heart disease. 相似文献18.
Hemodynamic Effects of Noninvasive Ventilation in Patients with
Venocapillary Pulmonary Hypertension
André Moreira Bento Luiz Francisco Cardoso Flávio Tarasoutchi Roney Orismar Sampaio Luiz Junya Kajita Pedro Alves Lemos Neto 《Arquivos brasileiros de cardiologia》2014,103(5):410-417
Background
The hemodynamic effects of noninvasive ventilation with positive pressure in patients with pulmonary hypertension without left ventricular dysfunction are not clearly established.Objectives
Analyze the impact of increasing airway pressure with continuous positive airway pressure on hemodynamic parameters and, in particular, on cardiac output in patients with variable degrees of pulmonary hypertension.Methods
The study included 38 patients with pulmonary hypertension caused by mitral stenosis without left ventricular dysfunction or other significant valvulopathy. The hemodynamic state of these patients was analyzed in three conditions: baseline, after continuous positive pressure of 7 cmH2O and, finally, after pressure of 14 cmH2O.Results
The population was composed of predominantly young and female individuals with significant elevation in pulmonary arterial pressure (mean systolic pressure of 57 mmHg). Of all variables analyzed, only the right atrial pressure changed across the analyzed moments (from the baseline condition to the pressure of 14 cmH2O there was a change from 8 ± 4 mmHg to 11 ± 3 mmHg, respectively, p = 0.031). Even though there was no variation in mean cardiac output, increased values in pulmonary artery pressure were associated with increased cardiac output. There was no harmful effect or other clinical instability associated with use application of airway pressure.Conclusion
In patients with venocapillary pulmonary hypertension without left ventricular dysfunction, cardiac output response was directly associated with the degree of pulmonary hypertension. The application of noninvasive ventilation did not cause complications directly related to the ventilation systems. 相似文献19.
Mohamed Ibrahim Maha Behairy Marwa El-Ashry Ahmad E. Mostafa 《The Egyptian Heart Journal》2018,70(1):27-33
Background
Cardiovascular diseases (CVDs) are a major cause of morbidity and mortality in patients with end stage renal disease (ESRD). Circulating endotoxins may have toxic effect on myocardial functions and are speculated as pathogens of accelerated atherosclerosis and hemodialysis (HD) patients.Objective
We aimed to assess the possible relation between circulating endotoxin levels and left ventricular functions parameters, common carotid artery intimal media thickness (CIMT) in prevalent HD patients.Patients and Methods
Forty stable prevalent HD patients with mean age (47.97 ± 14.42) year using regular conventional hemodialysis sessions in Ain shams university hemodialysis unit, Cairo, Egypt were randomly selected. Diabetics, congestive heart failure and those with history of myocardial infarction or coronary artery disease were excluded from the study. All patients were studied by CBC and routine chemistry, as well as hs CRP, Intact PTH, lipid profile and endotoxin level by ELISA before and after the HD session, Delta change of endotoxin (pre dialysis endotoxin-post dialysis endotoxin) was calculated, resting Doppler echocardiographic and carotid duplex.Results
Mean of Pre-HD session serum endotoxin level was (0.356 ± 0.090) EU/mL and the mean of post -HD endotoxin levels was (0.367 ± 0.110) EU/mL. Significant positive correlation between post dialysis endotoxin, MV E/A ratio and grades of left ventricular diastolic dysfunction (P < 0.05) and significant correlation between delta change in endotoxin and EF% (r = ?0.36,P = 0.02). By stepwise linear regression analysis for determinants of MVE/A post –HD endotoxin level independently associated with MV E/A ratio (ß = 0.350, P = 0.027). We did not detect any significant correlation between CCA atherosclerosis and neither pre nor post- HD endotoxin level nor with delta change of pre and post HD endotoxin levels.Conclusion
Acute increase in post dialytic circulating endotoxin level in prevalent HD patients may be associated with both left ventricular systolic and diastolic dysfunction and that attempts to reduce endotoxin level may have a positive impact on cardiovascular complications in HD Patients. 相似文献20.
OS Ogah RO Akinyemi JO Adesina JKL Osinfade RF Ogundipe GD Adegbite OI Udofia SB Udoh OS Ojo AA Alabi T Majekodunmi AO Falase 《Cardiovascular journal of Africa》2011,22(6):297-302