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1.
Rev Cardiovasc Med ; 22(2): 445-452, 2021 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-34258911

RESUMEN

Left ventricular (LV) aneurysm following acute myocardial infarction (MI) represents a less common complication, but with worse clinical outcomes. Ventricular surgical reconstruction is not always the intervention of choice due to high surgical risk. There were proposed less invasive LV aneurysm exclusion techniques such as the less invasive ventricular enhancement (LIVE) procedure. Our paper represents the first systematic approach to investigate the efficacy and safety of LIVE procedure using Revivent TCTM anchor system for LV aneurysm exclusion. Studies were considered if they reported original data regarding LIVE procedure's efficacy and/or safety using the Revivent TCTM system in patients with LV aneurysms. Five studies met the inclusion criteria. The procedure is associated with a reduction in LV volumes and an improvement in LV ejection fraction (LVEF). The means of preoperative LVEF varied between 22.8% and 35.6%, while postoperative LVEF means ranged between 34% and 45.9% (P < 0.005) across studies. All included papers reported a significant difference between preoperative and postoperative LV end-systolic volume index (P ≤ 0.001) and LV end-diastolic volume index (P ≤ 0.001). Three out of four studies achieved statistical significance (P ≤ 0.001) when comparing preoperative (means range: 2.6-3.4) and postoperative (means range: 1.4-1.9) New York Heart Association (NYHA) class. One study reported a survival rate of 90.6 (95% CI, 84.6-97.0) at 12 months following the procedure. LIVE appears to be a promising and appropriate treatment strategy for a complex condition, which could extend the indication of LV aneurysm exclusion in the future.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Aneurisma Cardíaco , Disfunción Ventricular Izquierda , Aneurisma Cardíaco/diagnóstico por imagen , Aneurisma Cardíaco/etiología , Aneurisma Cardíaco/cirugía , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/cirugía , Humanos , Volumen Sistólico , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/etiología , Función Ventricular Izquierda
2.
Vasa ; 46(3): 227-230, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28102772
3.
N Engl J Med ; 367(14): 1297-309, 2012 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-22920930

RESUMEN

BACKGROUND: The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated. METHODS: In this double-blind, randomized trial, in a primary analysis involving 7243 patients under the age of 75 years receiving aspirin, we evaluated up to 30 months of treatment with prasugrel (10 mg daily) versus clopidogrel (75 mg daily). In a secondary analysis involving 2083 patients 75 years of age or older, we evaluated 5 mg of prasugrel versus 75 mg of clopidogrel. RESULTS: At a median follow-up of 17 months, the primary end point of death from cardiovascular causes, myocardial infarction, or stroke among patients under the age of 75 years occurred in 13.9% of the prasugrel group and 16.0% of the clopidogrel group (hazard ratio in the prasugrel group, 0.91; 95% confidence interval [CI], 0.79 to 1.05; P=0.21). Similar results were observed in the overall population. The prespecified analysis of multiple recurrent ischemic events (all components of the primary end point) suggested a lower risk for prasugrel among patients under the age of 75 years (hazard ratio, 0.85; 95% CI, 0.72 to 1.00; P=0.04). Rates of severe and intracranial bleeding were similar in the two groups in all age groups. There was no significant between-group difference in the frequency of nonhemorrhagic serious adverse events, except for a higher frequency of heart failure in the clopidogrel group. CONCLUSIONS: Among patients with unstable angina or myocardial infarction without ST-segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.).


Asunto(s)
Síndrome Coronario Agudo/tratamiento farmacológico , Angina Inestable/tratamiento farmacológico , Infarto del Miocardio/tratamiento farmacológico , Piperazinas/uso terapéutico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Tiofenos/uso terapéutico , Ticlopidina/análogos & derivados , Anciano , Aspirina/uso terapéutico , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/prevención & control , Clopidogrel , Método Doble Ciego , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Piperazinas/efectos adversos , Inhibidores de Agregación Plaquetaria/efectos adversos , Clorhidrato de Prasugrel , Antagonistas del Receptor Purinérgico P2/efectos adversos , Antagonistas del Receptor Purinérgico P2/uso terapéutico , Accidente Cerebrovascular/epidemiología , Tiofenos/efectos adversos , Ticlopidina/efectos adversos , Ticlopidina/uso terapéutico
4.
Am Heart J ; 168(4): 446-56, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25262253

RESUMEN

OBJECTIVE: The objective of this study is to compare the effects of 2 types of diuretics, indapamide and hydrochlorothiazide, added to an angiotensin-converting enzyme inhibitor, on ventricular and arterial functions in patients with hypertension and diabetes. METHODS: This is a prospective, randomized, active-controlled, PROBE design study in 56 patients (57 ± 9 years, 52% men) with mild-to-moderate hypertension and type 2 diabetes, with normal ejection fraction, randomized to either indapamide (1.5 mg Slow Release (SR)/day) or hydrochlorothiazide (25 mg/d), added to quinapril (10-40 mg/d). All patients had conventional, tissue Doppler and speckle tracking echocardiography and assessment of endothelial and arterial functions and biomarkers, at baseline and after 6 months. RESULTS: Baseline characteristics were similar between groups; systolic and diastolic blood pressures decreased similarly, by 15% and 9% on indapamide and by 17% and 10% on hydrochlorothiazide (P < .05). Mean longitudinal systolic velocity and longitudinal strain increased by 7% and 14% on indapamide (from 5.6 ± 1.8 to 6.0 ± 1.1 cm/s and from 16.2% ± 1.8% to 18.5% ± 1.1%, both P < .05), but did not change on hydrochlorothiazide (P < .05 for intergroup differences), whereas ejection fraction and radial systolic function did not change. Similarly, mean longitudinal early diastolic velocity increased by 31% on indapamide (P < .05), but did not change on hydrochlorothiazide (P < .05 for intergroup differences). These changes were associated with improved endothelial and arterial functions on indapamide, but not on hydrochlorothiazide. CONCLUSION: Indapamide was found to improve measures of endothelial and arterial functions and to increase longitudinal left ventricular function compared with hydrochlorothiazide in patients with hypertension and diabetes, after 6 months of treatment. This study suggests that indapamide, a thiazide-like diuretic, has important vascular effects that can improve ventriculoarterial coupling.


Asunto(s)
Arterias Carótidas/fisiopatología , Diabetes Mellitus Tipo 2/complicaciones , Hidroclorotiazida/administración & dosificación , Hipertensión/tratamiento farmacológico , Indapamida/administración & dosificación , Resistencia Vascular/efectos de los fármacos , Función Ventricular/efectos de los fármacos , Presión Sanguínea/efectos de los fármacos , Arterias Carótidas/diagnóstico por imagen , Arterias Carótidas/efectos de los fármacos , Diuréticos/uso terapéutico , Relación Dosis-Respuesta a Droga , Ecocardiografía Doppler , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/complicaciones , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Método Simple Ciego , Resultado del Tratamiento , Ultrasonografía Doppler en Color
5.
Echocardiography ; 29(3): 326-33, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22066959

RESUMEN

AIMS: In asymptomatic patients with severe primary mitral regurgitation (PMR), early detection of left ventricular (LV) dysfunction indicates the optimal timing of mitral valve surgery; however, normal ejection fraction (EF) and end-systolic diameter (ESD) can mask significant LV impairment. METHODS: We studied 28 asymptomatic patients (59 ± 13 years, 18 male) with severe PMR, EF > 60%, and ESD < 45 mm, and 10 age-matched healthy subjects. All underwent echocardiography with tissue velocity imaging to assess LV geometry, EF, and longitudinal systolic function; and two-dimensional speckle tracking to assess longitudinal strain (LS) and longitudinal strain rate (LSR), and radial strain (RS) and radial strain rate (RSR). Patients were reevaluated 14 days after successful mitral valve repair and divided in: IA, with a postoperative EF reduction >10% (13 patients) and IB, with an EF reduction <10% (15 patients). RESULTS: Patients with PMR had longitudinal dysfunction and decreased radial systolic deformation, by comparison with controls, although EF and ESD were similar. Subgroup IA had significantly lower S(TVI) , LS, and RS than IB (7.3 ± 0.9 vs 10.8 ± 1.5 m/s; -16.0 ± 4.2% vs -21.7 ± 2.1%; and 37.4 ± 2.5% vs 41.6 ± 2.4%; all p < 0.001) although preoperative LV mass index, LV diameters, and EF were similar. Multiple stepwise regression analysis showed that S(TVI) and the combination of S(TVI) and LS represent the main independent predictors for a postoperative EF reduction >10% (r(2) = 0.52, p < 0.001; and r(2) = 0.70, p < 0.001, respectively). CONCLUSION: Myocardial systolic velocities as well as radial and longitudinal LV deformation assessed by speckle tracking can detect subclinical LV dysfunction and predict impaired postoperative LV function in asymptomatic patients with severe PMR.


Asunto(s)
Ecocardiografía/métodos , Insuficiencia de la Válvula Mitral/complicaciones , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/etiología , Humanos
6.
Maedica (Bucur) ; 17(1): 4-13, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35733741

RESUMEN

Aim: Left atrium (LA) assessment has gained significant interest in recent years because of its diagnostic and prognostic role in cardiovascular diseases. We aimed to assess the feasibility and reproducibility of three-dimensional echocardiography (3DE) versus two-dimensional echocardiography (2DE) for LA volumes (LAV) when measurements were performed by users with different levels of expertise in 3DE. Method:We prospectively recruited 35 consecutive patients referred to our echocardiography laboratory. Subjects underwent two separate 2DE and 3DE acquisitions of the LA in the same day by different users. Left atrial volumes were measured by the two users, who had similar levels of training in 2DE but different levels of training in 3DE - one advanced user and one beginner user. Results: Our results showed a good intra-observer reproducibility for 2DE (r=0.98) and an equally good reproducibility for 3DE LAVs when measured by the beginner user (r=0.97). Similarly, there was a good inter-observer reproducibility for the 2DE LAVs when measured by observers with similar levels of expertise in 2DE (r=0.98). However, similarly reproducible results were obtained for the 3DE LAVs when measured by users with significantly different levels of training in 3DE (r=0.98). Furthermore, there was a lower, yet acceptable (r>0.8), reproducibility for the 2DE LAVs when measured on separately acquired datasets by users who acquired the respective datasets, both with advanced level of training in 2DE. However, reproducibility was superior for 3DE LAVs when measured by the beginner and advanced users in 3DE (r=0.97). Conclusion: We conclude that 3DE is a technique that promises to improve patients' overall assessment, showing a good feasibility and better reproducibility than 2DE for the measurement of LAVs, regardless of level of training in the method.

7.
Echocardiography ; 27(6): 659-67, 2010 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-20412268

RESUMEN

OBJECTIVE: Athlete's heart is associated with left ventricular (LV) hypertrophy (LVH), and "supranormal" cardiac function, suggesting that this is a physiological process. Hypertrophy alone cannot explain increase in cardiac function, therefore, other mechanisms, such as better ventriculo-arterial coupling might be involved. METHODS: We studied 60 male (21 +/- 3 years) subjects: 27 endurance athletes, and a control group of 33 age-matched sedentary subjects. We assessed global systolic and diastolic LV function, short- and long-axis myocardial velocities, arterial structure and function and ventriculo-arterial coupling, endothelial function by flow-mediated dilatation, and amino-terminal pro-brain natriuretic peptide (NT-proBNP) and biological markers of myocardial fibrosis and of oxidative stress. RESULTS: Athletes had "supranormal" LV longitudinal function (12.4 +/- 1.0 vs 10.1 +/- 1.4 cm/s for longitudinal systolic velocity, and 17.4 +/- 2.6 vs 15.1 +/- 2.4 cm/s for longitudinal early diastolic velocity, both P < 0.01), whereas ejection fraction and short-axis function were similar to controls. Meanwhile, they had better endothelial function (16.7 +/- 7.0 vs 13.3 +/- 5.3%, P < 0.05) and lower arterial stiffness (pulse wave velocity 7.1 +/- 0.6 vs 8.8 +/- 1.1 m/s, P = 0.0001), related to lower oxidative stress (0.259 +/- 0.71 vs 0.428 +/- 0.88 nmol/mL, P = 0.0001), with improved ventriculo-arterial coupling (37.1 +/- 21.5 vs 15.5 +/- 13.4 mmHg.m/s(3)x 10(3), P = 0.0001). NT-proBNP and markers of myocardial fibrosis were not different from controls. LV longitudinal function was directly related to ventriculo-arterial coupling, and inversely related to arterial stiffness and to oxidative stress. CONCLUSIONS: "Supranormal" cardiac function in athletes is due to better endothelial and arterial function, related to lower oxidative stress, with optimized ventriculo-arterial coupling; athlete's heart is purely a physiological phenomenon, associated with "supranormal" cardiac function, and there are no markers of myocardial fibrosis.


Asunto(s)
Vasos Coronarios/fisiopatología , Endotelio Vascular/fisiopatología , Ventrículos Cardíacos/fisiopatología , Deportes/fisiología , Función Ventricular Izquierda/fisiología , Vasos Coronarios/diagnóstico por imagen , Endotelio Vascular/diagnóstico por imagen , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Hipertrofia Ventricular Izquierda/diagnóstico por imagen , Hipertrofia Ventricular Izquierda/fisiopatología , Masculino , Ultrasonografía , Adulto Joven
8.
Maedica (Bucur) ; 15(4): 532-535, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33603913

RESUMEN

The following case report and literature review will emphasize the individualized therapeutic management of a complex prothrombotic pathology. The onset of acute portal vein thrombosis in a patient with atrial fibrillation and good compliance to anticoagulation with a direct oral anticoagulant, who associates significant thrombocytosis, after excluding predisposing inflammations, infections or solid neoplasia, raises the diagnostic suspicion of myeloproliferative disorder, and imposes a complex interdisciplinary approach.

9.
Cardiovasc Ther ; 2020: 9241081, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31969934

RESUMEN

INTRODUCTION: Including healthcare professionals dealing with cardiovascular diseases, Heart Team is a concept/structure designed for selecting diagnostic strategies, facilitating therapeutic decisions, and improving cardiovascular outcomes in patients with complex heart pathologies, requiring input from different subspecialties and the necessity of a multidisciplinary approach. The aim of this narrative review is to search for and to summarize current evidence regarding Heart Team and to underline the future directions for the development of this concept. METHODS: We searched the electronic database of PubMed, SCOPUS, and Cochrane CENTRAL for studies including Heart Team. Forty-eight studies were included, if reference was made to Heart Team structure and functionality. RESULTS: We depicted the structure and the timeline of Heart Team, along with actual evidence-based recommendations from European Guidelines. We underlined the importance of quality of knowledge-sharing and decision-making inside the Team, analyzing bad decisions which did not reflect members' true beliefs due to "uniformity pressure, closed mindedness, and illusion of invulnerability." The observation that Guidelines' indications regarding Heart Team carry a level C indication underlines the very future of this Team: randomized controlled trials proving solid benefits in an evidence-based world. CONCLUSIONS: Envisioned as a tool for optimizing the management of various complex cardiovascular pathologies, Heart Team should simplify and facilitate the activity in the cardiovascular ward. Finally, these facts should be translated into better cardiovascular outcomes and a lower psychological distress among Team participants. Despite all future changes, there must always be a constant part: the patient should remain at the very center of the Team.


Asunto(s)
Enfermedades Cardiovasculares/terapia , Prestación Integrada de Atención de Salud/tendencias , Medicina Basada en la Evidencia/tendencias , Grupo de Atención al Paciente/tendencias , Atención Dirigida al Paciente/tendencias , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/historia , Enfermedades Cardiovasculares/fisiopatología , Conducta Cooperativa , Prestación Integrada de Atención de Salud/historia , Difusión de Innovaciones , Medicina Basada en la Evidencia/historia , Predicción , Historia del Siglo XXI , Humanos , Comunicación Interdisciplinaria , Grupo de Atención al Paciente/historia , Atención Dirigida al Paciente/historia
10.
CMAJ ; 180(12): 1207-13, 2009 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-19506280

RESUMEN

BACKGROUND: We describe the clinical characteristics, treatments and in-hospital case-fatality rates in an unselected population of patients admitted for acute myocardial infarction. METHODS: From January 2000 to June 2007, we tracked consecutive patients who were admitted to 7 tertiary referral and 21 county hospitals in Romania for medical treatment of ST-segment elevation acute myocardial infarction. These patients were enrolled in the Romanian Registry for ST-segment Elevation Myocardial Infarction. For this prospective study, we collected data on demographic characteristics, cardiovascular risk factors, various aspects of treatment for myocardial infarction, and in-hospital death. RESULTS: The 9186 patients in the study group had a mean age of 63.8 years. The median time from onset of symptoms to thrombolysis was 230 (interquartile range 120-510) minutes. Of the 9186 patients, 4986 (54.3%) had hypertension, 1974 (21.5%) had diabetes mellitus, 3545 (38.6%) had lipid disorders and 4653 (50.7%) were smokers. The in-hospital mortality rate was 12.7% (1170 deaths). The study group consisted of 2893 women and 6293 men. The women were older than the men and had higher rates of hypertension and diabetes mellitus but were less likely to be smokers. A smaller proportion of women than men presented within 2 hours after onset of symptoms (23.1% v. 34.4%, p < 0.001). Smaller proportions of women received thrombolytics (40.8% v. 53.5%, p < 0.001), anticoagulants (93.4% v. 95.2%; p = 0.001), antiplatelet agents (88.3% v. 91.2%, p < 0.001) and primary percutaneous coronary interventions (1.5% v. 2.2%, p = 0.030). The risk of in-hospital death was greater for women, even after adjustment for confounders (odds ratio 1.33, 95% confidence interval 1.13-1.56; p < 0.001). INTERPRETATION: The rates of reperfusion therapy for patients with acute myocardial infarction were low, and in-hospital case-fatality rates were high in this study. Excess in-hospital mortality was more pronounced among women.


Asunto(s)
Mortalidad Hospitalaria , Infarto del Miocardio/mortalidad , Anciano , Angioplastia Coronaria con Balón/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/terapia , Pautas de la Práctica en Medicina , Estudios Prospectivos , Calidad de la Atención de Salud , Sistema de Registros , Rumanía/epidemiología , Terapia Trombolítica/estadística & datos numéricos
11.
J Clin Ultrasound ; 37(6): 369-73, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19253356

RESUMEN

We report a case of aorto-pulmonary fistula following multiple valve surgery in a patient with colon carcinoma who had had recurrent episodes of Streptococcus Bovis endocarditis. Diagnosis was made by transesophageal echocardiography and aortography. Patient underwent emergency percutaneous implantation of an aortic endoprosthesis, but he continued to deteriorate and the fatal outcome could not be changed. This case underscores the importance of examination of gastrointestinal tract in patients with Streptococcus Bovis endocarditis.


Asunto(s)
Válvula Aórtica/diagnóstico por imagen , Fístula Arterio-Arterial/etiología , Endocarditis Bacteriana/complicaciones , Prótesis Valvulares Cardíacas/efectos adversos , Infecciones Relacionadas con Prótesis/complicaciones , Arteria Pulmonar/diagnóstico por imagen , Adenocarcinoma/complicaciones , Fístula Arterio-Arterial/diagnóstico por imagen , Neoplasias del Colon/complicaciones , Ecocardiografía Transesofágica , Resultado Fatal , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico por imagen , Infecciones Estreptocócicas/complicaciones , Streptococcus bovis
12.
Maedica (Bucur) ; 19(1): 1-3, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38736919
13.
Europace ; 10(12): 1454-5, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18948364

RESUMEN

Persistent left superior vena cava (LSVC) is a rare congenital anomaly which can add difficulties in placing defibrillation leads and achieving good defibrillation thresholds. Previous reports described placement of leads at or near the right ventricular apex. We hereby report the first case of a dual-coil, active fixation defibrillation lead, successfully implanted into the anterior-septal right ventricular outflow tract, through a persistent LSVC.


Asunto(s)
Desfibriladores , Electrodos Implantados , Ventrículos Cardíacos/cirugía , Implantación de Prótesis/métodos , Vena Cava Superior/anomalías , Vena Cava Superior/cirugía , Anciano , Humanos , Masculino
14.
Am J Emerg Med ; 26(7): 839.e3-6, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18774061

RESUMEN

We present a rare case of noncardiogenic pulmonary edema (NCPE) associated with sudden coma due to severe hypoglycemia. We suggest that in every case of NCPE associated with coma, a rapid determination of glycemia should be provided because delays in diagnosis can lead to adverse outcome.


Asunto(s)
Hipoglucemia/complicaciones , Edema Pulmonar/etiología , Electrocardiografía , Escala de Coma de Glasgow , Humanos , Hipoglucemia/inducido químicamente , Hipoglucemiantes/efectos adversos , Insulina/efectos adversos , Masculino , Persona de Mediana Edad , Edema Pulmonar/diagnóstico , Edema Pulmonar/fisiopatología
15.
Maedica (Bucur) ; 18(2): 171-173, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37588836
16.
Maedica (Bucur) ; 18(3): 387-388, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38023765
17.
Maedica (Bucur) ; 18(4): 545-546, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38348078
18.
Maedica (Bucur) ; 13(2): 147-151, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30069243

RESUMEN

Carney complex (CNC) is a rare autosomal dominant syndrome. Spotty skin pigmentation is the major clinical manifestation of CNC, followed by cardiac myxomas, benign tumors that usually present with features from the classical triad of obstructive cardiac, embolic and non-specific constitutional symptoms (NCS). NCS are caused by the overproduction of interleukin-6 (IL-6), a pro-inflammatory cytokine which mediates the induction of intercellular adhesion molecule 1 (ICAM-1) and promotes endothelial dysfunction and atherosclerosis. Thus, myxomas may be directly linked to an increased risk of atherosclerotic events. We report here a case of a 74-year-old woman with left atrial myxoma, skin pigmentary abnormalities, thyroid disorder and extensive atherosclerosis, with non-embolic occlusion of infrarenal abdominal aorta.

19.
Sci Rep ; 8(1): 3300, 2018 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-29459794

RESUMEN

Multiple sclerosis (MS), neurologic disease affecting young population, may cause cardiovascular dysfunction, due to autonomous nervous dysfunction, physical invalidity, increased oxidative stress, and systemic inflammatory status. However, cardiovascular function is rarely evaluated in these patients. We assessed left and right ventricular (LV and RV) function by 2D, 3D, tissue Doppler, and speckle tracking echocardiography, and vascular function by remodeling, stiffness, and endothelial dysfunction parameters in patients with MS, compared to control subjects. 103 subjects (35 ± 10 years,70 women) were studied: 67 patients with MS and 36 control subjects. Patients with MS had decreased LV systolic function, confirmed by lower 2D and 3D ejection fraction, mitral annular plane systolic excursion, longitudinal myocardial systolic velocities, and 2D and 3D global longitudinal strain. The RV function was also decreased, as demonstrated by lower fractional area change, tricuspid annular plane systolic excursion, longitudinal systolic velocities, and longitudinal strain. Additionally, LV diastolic and left atrial (LA)  function were decreased compared to controls. The parameters of arterial and endothelial function were similar between groups. Patients with MS have impaired biventricular function by comparison with normal subjects, with reduced LA function, but normal arterial and endothelial function. The noninvasive echocardiographic techniques might help to determine patients with MS at risk of developing cardiovascular dysfunction.


Asunto(s)
Enfermedades Cardiovasculares/diagnóstico , Insuficiencia Cardíaca/diagnóstico , Esclerosis Múltiple/diagnóstico , Adolescente , Adulto , Anciano , Enfermedades Cardiovasculares/diagnóstico por imagen , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/fisiopatología , Ecocardiografía , Ecocardiografía Doppler , Diagnóstico por Imagen de Elasticidad , Femenino , Insuficiencia Cardíaca/diagnóstico por imagen , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/fisiopatología , Humanos , Interpretación de Imagen Asistida por Computador , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/diagnóstico por imagen , Esclerosis Múltiple/fisiopatología , Volumen Sistólico , Ultrasonografía Doppler , Función Ventricular Izquierda/fisiología , Función Ventricular Derecha/fisiología , Adulto Joven
20.
Maedica (Bucur) ; 17(1): 3, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35733750
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