Left atrial function and NT-proANP as markers of AF progression and impaired outcome in patients with heart failure with preserved ejection fraction |
Usefulness of strain imaging echocardiography in arrhythmogenic right ventricular cardiomyopathy: clinical perspectiveAbstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare, but severe disease that predisposes patients to ventricular arrhythmias, heart failure, and increased risk of sudden cardiac death. Because of the broad spectrum of phenotypic expressions, diagnostic assessment is often challenging. Speckle-tracking echocardiography has emerged as an alternative technique enhancing the performance of standard echocardiography in ARVC patients, leading to an early detection of subtle ventricular abnormalities and potentially identifying predictors of adverse clinical outcome.
|
Challenges of recognizing bicuspid aortic valve in elderly patients undergoing TAVRAbstract
Recognition of bicuspid aortic valve (BAV) may be challenging in elderly patients with heavily calcified aortic valves undergoing transcatheter aortic valve replacement (TAVR). In this subset, the diagnostic value of pre-procedural echocardiography in clinical routine is unknown. From a total of 2583 patients undergoing TAVR in our center, we determined the rate of BAV detected by routine echocardiography as documented in the medical records. Pre-procedural multidetector computed tomography (MDCT) images were retrospectively analyzed for the presence of BAV and served as reference standard. Using MDCT criteria, BAV was found in 235 (9.1%) (age 80.1 years [interquartile range 76.4; 83.4], 44.3% female). Of these, only 27/235 (11.5%) had been identified as BAV according to echocardiography reports, whereas 6/2348 (0.3%) with TAV had been wrongly diagnosed as BAV (p < 0.001; sensitivity 11.5%, specificity 99.7%). Correct diagnosis of BAV by echocardiography was more likely when transesophageal echocardiography was available (odds ratio (OR) 5.12 [95% confidence interval (CI) 2.22; 11.80]; p < 0.001) and the reader was experienced (OR 5.28 [95% CI 1.55; 18.04]; p = 0.008). Furthermore, correct diagnosis of BAV was more likely in bicommissural-type BAV (OR 2.22 [95% CI 0.90; 5.48]; p = 0.08), whereas heavy aortic valve calcification lead to misdiagnosis (OR 0.39 [95% CI 0.14; 1.06]; p = 0.07). In elderly patients with severe aortic stenosis that are candidates for TAVR, the presence of BAV may be considerably underestimated when relying solely on routine echocardiography. This underlines the value of MDCT for the screening of BAV in this patient population.
|
Endothelial dysfunction, subclinical atherosclerosis and LDL cholesterol are the independent predictors of left atrial functions in hypertensionAbstract
Left atrial function has an important role in determining optimal performance of the heart. Increase of left atrial dysfunction and volume are poor prognostic factors. In this study, we investigated independent determinants of left atrial function in non-diabetic patients with de novo hypertension. The study included 124 consecutive non-diabetic patients with de novo hypertension. Brachial artery flow-mediated dilatation, carotid intima-media thickness, transthoracic echocardiography, 24-h rhythm holter, and aortic stiffness measurements were recorded. In echocardiography, left atrial maximum (LAMaV) and minimum (LAMiV) volumes were calculated. Left atrium total emptying fraction (LATEF) and total emptying volume (LATEV) were divided into two groups according to the mean levels. Multivariate analysis was performed after correlation analysis for LATEV and LATEF mean levels. By logistic regression analysis, systolic blood pressure (OR 0.882, 95% CI 0.784–0.992, p = 0.036), percent of flow-mediated dilation (OR 0.747, 95% CI 0.595–0.938, p = 0.012), and presence of carotid plaque (OR 0.014, 95% CI 0.001–0.188, p = 0.001) were found as independent variables that determine LATEF. Age (OR 0.879, 95% CI 0.795–0.972, p = 0.012), smoking (OR 23.739, 95% CI 2.699–208.810, p = 0.004), left ventricular mass index (OR 1.052, 95% CI 1.012–1.094, p = 0.011), mitrale E-wave velocity (OR 1.108, 95% CI 1.031–1.191, p = 0.005) and LDL (low-density lipoprotein) cholesterol (OR 0.942, 95% CI 0.911–0.974, p = 0.001) were independent predictors of LATEV. In non-diabetic patients with de novo hypertension endothelial dysfunction, subclinical atherosclerosis and LDL cholesterol levels independently affect left atrial function.
|
Echocardiographic evaluation of the effects of sacubitril–valsartan on vascular properties in heart failure patientsAbstract
Increased vascular stiffness is known to be an independent predictor of mortality in patients with heart failure with reduced ejection fraction (HFrEF). The effects of sacubitril–valsartan on vascular structure and function have not been systematically studied in this patient population. We hypothesized that aortic distensibility (AD) and fractional area change (AFAC), as assessed by 2D transthoracic echocardiography (TTE), would improve over time in HFrEF patients on sacubitril–valsartan therapy, due to the vasodilatory properties of the medication. We prospectively studied 30 patients with HFrEF (25 < EF < 40%) on optimal guideline-directed medical therapy who were subsequently started on sacubitril–valsartan. Patients underwent serial 2D TTE imaging at baseline, 3 and 6 months following therapy initiation. Ascending aortic diameters were measured 3 cm above the aortic valve in the parasternal long-axis view and used to calculate AD and AFAC, two markers of vascular compliance. For reference, we also measured AD and AFAC in 30 healthy, age and gender-matched controls at a single time point. Normal controls had significantly higher values of AD and AFAC than HFrEF patients at baseline (AD: 4.0 ± 1.1 vs. 2.2 ± 0.9 cm2dyne−110−3, p < 0.0001 and AFAC: 18.8 ± 3.7% vs. 10.3 ± 4.3%, p < 0.0001). In HFrEF patients on sacubitril–valsartan, both indices of aortic compliance progressively improved towards normal from baseline to 6 months: AD from 2.2 ± 0.9 to 3.6 ± 1.5 cm2dyne−110−3 (p < 0.0001) and AFAC from 10.3 ± 4.3 to 13.7 ± 4.1% (p < 0.0001). In conclusion, AD and AFAC are decreased in patients with HFrEF and gradually improve with sacubitril–valsartan treatment. The echocardiographic markers used in this study may become a useful tool to assess the effectiveness of sacubitril–valsartan therapy in HFrEF patients.
|
Correction to: Paclitaxel-coated balloon treatment for functionally nonsignificant residual coronary lesions after balloon angioplasty
In the original publication of the article Fig. 1 was published incorrectly. The corrected Fig. 1 is given in this correction.
|
Very early in-stent neoatherosclerosis assessed by optical coherence tomography |
Plaque erosion or coronary artery embolism? Findings from clinical presentation, optical coherence tomographic and histopathological analysis in a case with acute coronary syndrome |
Vascular response to paclitaxel-eluting nitinol self-expanding stent in superficial femoral artery lesions: post-implantation angioscopic findings from the SHIMEJI trial (Suppression of vascular wall Healing after IMplantation of drug Eluting peripheral stent in Japanese patients with the Infra inguinal lesion: serial angioscopic observation)Abstract
The aim of this study was to elucidate the vascular responses to paclitaxel-eluting stent (Zilver PTX stent) in superficial femoral artery lesion at different elapsed times using angioscopy. Patients who received Zilver PTX stent implantation from five centers were enrolled. We performed angioscopic examinations at 2, 6, and 12 months after implantation and evaluated neointimal coverage (NIC) grade, intra-stent thrombus (IS-Th) grade, and presence of yellow plaque. NIC grade 0 was defined as stent struts exposed; grade 1, struts transparently visible although covered; grade 2, struts embedded in the neointima, but translucent; and grade 3, struts fully embedded and invisible. IS-Th was graded as follows: grade 0 (none), 1 (focal), and 2 (diffusely spread). Angioscopic follow-up evaluation was performed at 2 months (25 patients, 42 lesions), 6 months (18 patients, 23 stents), and 12 months (14 patients, 24 stents) after stent implantation. Dominant NIC grade significantly increased over time; however, 16.3% of the cases had NIC grade 1 or 2 at 12 months. IS-Th grade decreased; however IS-Th and yellow plaque were persistently observed in 62.5% and 83.3% cases, respectively, at 12 months. An ongoing healing response was observed at 12 months after implantation; however, thrombogenic findings were noted. Prolonged dual antiplatelet therapy could potentially enhance the clinical utility of Zilver PTX.
|
Left atrial stiffness is superior to volume and strain parameters in predicting elevated NT-proBNP levels in systemic sclerosis patientsAbstract
Heart failure with preserved ejection fraction (HFpEF) is common in systemic sclerosis (SSc) and implies a worse prognosis therefore non-invasive assessment of left ventricular (LV) filling pressure is pivotal. Besides E/eʹ the use of maximal left atrial volume (LA Vmax index) is recommended. LA reservoir strain was also reported to be useful. The utility of LA stiffness, however, was never investigated in SSc. Thus we aimed to compare the diagnostic power of LA Vmax index, reservoir strain and stiffness in predicting elevated LV filling pressure in SSc patients. 72 SSc patients (age: 57 ± 11 years) were investigated. LA stiffness was calculated as ratio of E/eʹ to LA reservoir strain. Elevated LV filling pressure was defined as NT-proBNP > 220 pg/ml. Receiver-operating characteristic (ROC) curves were used to estimate the diagnostic performance of the investigated parameters. Average NT-proBNP level was 181 ± 154 pg/ml. NT-proBNP > 220 pg/ml was found in 21 SSc patients. LA stiffness showed the highest diagnostic performance in predicting NT-pro-BNP > 220 pg/ml, with a cut off value of 0.314 (Area under the curve: 0.719, specificity: 89.4%, sensitivity: 42.1%). AUC values for LA reservoir strain and Vmax index were 0.595 and 0.521, respectively. LA stiffness was superior to Vmax index and reservoir strain in predicting elevated NT-proBNP levels in SSc patients. Although invasive validation studies on larger samples are required, our data suggest, that the use of LA stiffness may significantly contribute to diagnostic precision in populations with a high suspicion of HFpEF.
|
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
Πληροφορίες
Ετικέτες
Κυριακή 6 Οκτωβρίου 2019
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Αρχειοθήκη ιστολογίου
-
►
2023
(276)
- ► Φεβρουαρίου (133)
- ► Ιανουαρίου (143)
-
►
2022
(1976)
- ► Δεκεμβρίου (116)
- ► Σεπτεμβρίου (158)
- ► Φεβρουαρίου (165)
- ► Ιανουαρίου (161)
-
►
2021
(3661)
- ► Δεκεμβρίου (161)
- ► Σεπτεμβρίου (274)
- ► Φεβρουαρίου (64)
- ► Ιανουαρίου (368)
-
►
2020
(4554)
- ► Δεκεμβρίου (400)
- ► Σεπτεμβρίου (381)
- ► Φεβρουαρίου (638)
- ► Ιανουαρίου (691)
-
▼
2019
(4999)
- ► Δεκεμβρίου (924)
-
▼
Οκτωβρίου
(1087)
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- Children, Vol. 6, Pages 119: Chest Compressi...
- Antibiotics, Vol. 8, Pages 203: Nursing St...
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- Cancer,
- Plants, Vol. 8, Pages 462: Effect of Oxygen ...
- Otology & Neurotology - Published Ahead-of-Pr...
- Hindawi Publishing Corporation,
- International Journal of Cancer,
- eCAM Evidence-Based Complementary and Alterna...
- Clinical Otolaryngology,
- A Study to Test Different Doses of BI 891065...
- Are BI-RADS 3 findings tracked effectively? ...
- The ROS-KRAS-Nrf2 axis in the control of the...
- Disseminated mucormycosis with cerebellum in...
- Definition of a Good Death, Attitudes Toward...
- Prognostic impact of the Controlling Nutriti...
- Peanut-allergy therapy 'protection not a cur...
- Applied Sciences, Vol. 9, Pages 4605: A Plan...
- Autophagy in Cancer Cell Death
- Remote Sensing, Vol. 11, Pages 2544: Suppres...
- IJMS, Vol. 20, Pages 5396: A Novel Claudinop...
- Agronomy, Vol. 9, Pages 694: Analysis of Fac...
- 3DPrint.com,
- Safety Profile of Sclerosing AgentsNo abstract a...
- Missed Study Visits and Subsequent HIV Incidence...
- What Are Our Opportunities in Preparing the Next...
- Comparison of drug-eluting balloon with repeat d...
- An unusual case of loperamide anaphylaxisPublica...
- Erreger, Resistenzmechanismen und etablierte The...
- Determination of Acrolein-Associated T 1 and T 2...
- Ovid and Titian 2012 The article Ovid and Titian...
- Endoscopic submucosal dissection of distal intes...
- The effect of transcutaneous electrical nerve sti...
- Assessment of post-operative healing following en...
- A comment on postmortem interrogation of cardiac...
- MR urethrography compared with operative finding...
- Understanding the Association Between Perceived ...
- Development of multiplex PCR to detect slow rust...
- Sicherheitsabstand von 2 cm ist bei Exzision von...
- Neonatal myocardial infarction: substantial impr...
- Diagnostic criteria should be considered when re...
- Predicting Psychiatric Rehospitalization in Adol...
- Robust protocol for feeder-free adaptation of cr...
- Molecular cloning and characterization of genes ...
- Therapeutic observation of Tui-pushing Wujing pl...
- Sitting time among adolescents across 26 Asia–Pa...
- Detection and measurements of apical lesions in ...
- Cortisol, oxytocin, and quality of life in major...
- Pharmaceutical applications of 3D printing techn...
- Sleep Med. 2019 Jun 8;63:142-150. doi: 10.1016/j...
- Med Educ. 2019 Oct 28. doi: 10.1111/medu.13998. ...
- Transl Androl Urol. 2019 Sep;8(Suppl 4):S436-S44...
- Biomed Chromatogr. 2019 Oct 28:e4727. doi: 10.10...
- The dental anomaly: how and why dental carie...
- Five decades of urologic pathology: the acce...
- [Diagnostic value of digital breast tomosynth...
- Tick-borne encephalitis virus detected in tic...
- Understanding and addressing social determina...
- The impact of targeted cathodal transcranial ...
- Anthropometric Analysis of the Human Skull f...
- Cancers, Vol. 11, Pages 1684: NEDD9 Inhibiti...
- Annexin A6 modulates TBC1D15/Rab7/StARD3 axi...
- Journal of Esthetic and Restorative Dentistry...
- Latest Results for Thyroid Research,
- NeuroImage,
- Trials -
- Latest Results for European Journal of Pediat...
- Journal of Oral and Maxillofacial Surgery,
- Milled versus moulded mock-ups based on the ...
- Phys.org: Cell & Microbiology News,
- Health sciences :
- American Journal of Epidemiology -
- Καλλιεργώντας ευγνωμοσύνη,
- American Journal of Otolaryngology,
- Formosan Journal of Surgery :
- Relaciones entre el factor-1α inducido por hipoxia...
- Medical News Today: What to know about press...
- Atmosphere, Vol. 10, Pages 660: Investigat...
- ScienceDirect Publication: Journal of Genetic...
- MedWorm Allergy & Immunology News,
- GEO series ,
- AUDIOLOGY,
- Latest Results for Conflict and Health,
- Modern Pathology -
- Latest Results for Der Chirurg,
- Latest Results for Pediatric Cardiology,
- Latest Results for Current Microbiology,
- BMJ Open recent issues,
- Plastic Surgery,
- American Society for Stereotactic and Functio...
- Latest Results for Maternal and Child Health ...
- ► Σεπτεμβρίου (845)
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου