Right heart function in impaired left ventricular diastolic function: 2D speckle tracking echocardiography–based and Doppler tissue imaging–based analysis of right atrial and ventricular function

Aim

The aim of our study was to describe right atrial (RA) and right ventricular (RV) function, assessed by Doppler tissue imaging and 2D speckle tracking echocardiography (2DSTE), in women with signs of early impaired left ventricular diastolic function (DD).

Methods and Results

In a cross‐sectional trial, standard parameters of diastolic and right heart function were investigated in 438 women of the Berlin Female Risk Evaluation (BEFRI) study. In a subset of women, average peak systolic RA strain (RAS), as well as the average peak systolic RV strain of the free wall (RVS free wall) and of all RV segments (average RV strain; RVS Avg), was analyzed using 2DSTE. Compared to women with normal diastolic function (DD0), RAS, RVS free wall and RVS Avg were significantly reduced in DD (43.1% ± 11.9%, ?26.7% ± 5.6%, and ?23.3% ± 3.5% in DD0; vs 35.1% ± 10.4%, ?23.9% ± 5.5%, and ?20.6% ± 3.8% in DD; P < .01). Peak RV myocardial velocity (RV‐IVV) and acceleration during isovolumetric contraction (RV‐IVA) were markedly higher in DD (15.0 ± 3.9 cm/s and 3.1 ± 1.0 m/s² in DD vs 11.9 ± 3.2 cm/s and 2.8 ± 0.8 m/s² in DD0; P < .05). RAS and RV‐IVV were significantly associated with DD after adjustment to age, BMI, and left atrial strain in multivariate regression analysis.

Conclusion

Systolic right heart function is significantly altered in DD. DTI as well as 2DSTE constitute sensitive echocardiographic tools that enable the diagnosis of impaired right heart mechanics in early‐staged DD.     

Determinants for preventive oral health care need among community‐dwelling older people: a population‐based study

The aim was to study the determinants of preventive oral health care need among community‐dwelling old people. The study population consisted of 165 participants, a subpopulation in the Geriatric Multidisciplinary Strategy for Good Care of Elderly People (GeMS) study. Fifty‐five percent of the edentate participants with full dentures and 82% of the dentate had a need for preventive oral health care. In the total study population, the need for preventive care was associated with co‐morbidity (measured by means of the Modified Functional Co‐morbidity Index) odds ratios (OR) 1.2 (confidence intervals [CI] 1.0–1.5), being pre‐frail or frail, OR 2.5 (CI 1.2–5.1), presence of natural teeth, OR 4.8 (CI 2.2–10.4), and among dentate participants, the use of a removable partial denture, OR 12.8 (CI 1.4–114.4). Primary care clinicians should be aware of the high need for preventive care and the importance of nonoral conditions as determinants of preventive oral health care need.     

Isolated Benign Primary Cutaneous Plasmacytosis in a Child

Isolated benign primary cutaneous plasmacytosis in a child is a very rare and benign disease. Herein we present a case of this condition occurring in a child who showed good response to topical corticosteroid.     

Increased number of circulating endothelial cells (CECs) in patients with psoriasis ‐ preliminary report

Background Numerous studies have demonstrated increased cardiovascular risk in psoriasis. Circulating endothelial cells (CECs) have been proposed as a new marker of endothelial dysfunction that plays an important role in pathogenesis of atherosclerosis. Objective The aim of this study was to compare the number of CECs in psoriatic patients to a control group and to analyze possible correlations between the numbers of CECs and the plasma levels of classical markers of endothelial dysfunction, such as: sICAM‐1, sE‐selectin and von Willebrand factor (vWF). Methods The number of CECs, identified as CD146 + / CD45‐ cells, were determined in peripheral blood with using flow cytometry in psoriatic patients (n = 63) and controls (n = 31). The plasma levels of: sICAM‐1, sE‐selectin, vWF were measured with ELISA. The severity of psoriasis was assessed with PASI. Results The number of CECs was significantly increased in psoriatic patients compared with controls (P < 0.00001) and positively correlated with disease severity (R = 0.360; P = 0.0037). The levels of sICAM‐1, sE‐selectin and vWF were significantly elevated in psoriatic patients (P < 0.00001; P < 0.00001; P = 0.00072, respectively). The number of CECs was significantly, positively correlated with the levels of sICAM‐1 (R = 0.393; P = 0.0014) and vWF (R = 0.314; P = 0.012) in psoriatic patients. The levels of sICAM‐1 and sE‐selectin were positively correlated with disease severity (R = 0.356; P = 0.0041 and R = 0.407; P = 0.0009, respectively). Conclusion The increased number of CECs that correlates with disease severity and plasma levels of sICAM‐1 and vWF may indicate endothelial dysfunction or injury in patients with psoriasis.