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3.
Open Heart ; 9(1)2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35649574

RESUMO

BACKGROUND: There are limited data on structural heart disease among people living with HIV in southern Africa, where the success of antiretroviral therapy (ART) has drastically improved life expectancy and where risk factors for cardiovascular disease are prevalent. METHODS: We performed a cross-sectional study of screening echocardiography among adults (≥18 years) with HIV in Malawi presenting for routine ART care. We used univariable and multivariable logistic regression to evaluate correlates of abnormal echocardiogram. RESULTS: A total of 202 individuals were enrolled with a median age of 45 years (IQR 39-52); 52% were female, and 27.7% were on antihypertensive medication. The most common clinically significant abnormality was left ventricular hypertrophy (LVH) (12.9%, n=26), and other serious structural heart lesions were rare (<2% with ejection fraction less than 40%, moderate-severe valve lesions or moderate-severe pericardial effusion). Characteristics associated with abnormal echocardiogram included older age (OR 1.04, 95% CI 1.01 to 1.08), higher body mass index (OR 1.09, 95% CI 1.02 to 1.17), higher mean systolic blood pressure (OR 1.03, 95% CI 1.02 to 1.05) and higher mean diastolic blood pressure (OR 1.03, 95% CI 1.01 to 1.05). In a multivariable model including age, duration on ART, body mass index, and systolic and diastolic blood pressure, only mean body mass index (adjusted OR 1.10, 95% CI 1.02 to 1.19), systolic blood pressure (aOR 1.05, 95% CI 1.03 to 1.08) and diastolic blood pressure (aOR 0.96, 95% CI 0.92 to 1.00) remained associated with abnormal echocardiogram. CONCLUSIONS: LVH was common in this population of adults on ART presenting for routine care and was associated with elevated blood pressure. Further research is needed to characterise the relationship between chronic hypertension, LVH and downstream consequences, such as diastolic dysfunction and heart failure in people living with HIV.


Assuntos
Infecções por HIV , Hipertrofia Ventricular Esquerda , Adulto , Estudos Transversais , Ecocardiografia , Feminino , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/epidemiologia , Hipertrofia Ventricular Esquerda/etiologia , Malaui/epidemiologia , Masculino , Pessoa de Meia-Idade
4.
Crit Care ; 26(1): 160, 2022 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-35659340

RESUMO

BACKGROUND: We determine the predictive value of transthoracic echocardiographic (TTE) metrics for clinical deterioration within 5 days in adults with intermediate-risk pulmonary embolism (PE). METHODS: This was a prospective observational study of intermediate-risk PE patients. To determine associations of TTE and clinical predictors with clinical deterioration, we used univariable analysis, Youden's index for optimal thresholds, and multivariable analyses to report odds ratios (ORs) or area under the curve (AUC). RESULTS: Of 306 intermediate-risk PE patients, 115 (37.6%) experienced clinical deterioration. PE patients who had clinical deterioration within 5 days had greater baseline right ventricle (RV) dilatation and worse systolic function than the group without clinical deterioration as indicated by the following: RV basal diameter 4.46 ± 0.77 versus 4.20 ± 0.77 cm; RV/LV basal width ratio 1.14 ± 0.29 versus 1.02 ± 0.24; tricuspid annular plane systolic excursion (TAPSE) 1.56 ± 0.55 versus 1.80 ± 0.52 cm; and RV systolic excursion velocity 10.40 ± 3.58 versus 12.1 ± 12.5 cm/s, respectively. Optimal thresholds for predicting clinical deterioration were: RV basal width 3.9 cm (OR 2.85 [1.64, 4.97]), RV-to-left ventricle (RV/LV) ratio 1.08 (OR 3.32 [2.07, 5.33]), TAPSE 1.98 cm (OR 3.3 [2.06, 5.3]), systolic excursion velocity 10.10 cm/s (OR 2.85 [1.75, 4.63]), and natriuretic peptide 190 pg/mL (OR 2.89 [1.81, 4.62]). Significant independent predictors were: transient hypotension 6.1 (2.2, 18.9), highest heart rate 1.02 (1.00, 1.03), highest respiratory rate 1.02 (1.00, 1.04), and RV/LV ratio 1.29 (1.14, 1.47). By logistic regression and random forest analyses, AUCs were 0.80 (0.73, 0.87) and 0.78 (0.70, 0.85), respectively. CONCLUSIONS: Basal RV, RV/LV ratio, and RV systolic function measurements were significantly different between intermediate-risk PE patients grouped by subsequent clinical deterioration.


Assuntos
Deterioração Clínica , Embolia Pulmonar , Disfunção Ventricular Direita , Adulto , Ecocardiografia , Humanos , Embolia Pulmonar/diagnóstico por imagem , Disfunção Ventricular Direita/diagnóstico por imagem , Função Ventricular Direita
9.
Curr Opin Crit Care ; 28(3): 331-339, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35653255

RESUMO

PURPOSE OF REVIEW: Right ventricular dysfunction has an important impact on the perioperative course of cardiac surgery patients. Recent advances in the detection and monitoring of perioperative right ventricular dysfunction will be reviewed here. RECENT FINDINGS: The incidence of right ventricular dysfunction in cardiac surgery has been associated with unfavorable outcomes. New evidence supports the use of a pulmonary artery catheter in cardiogenic shock. The possibility to directly measure right ventricular pressure by transducing the pacing port has expanded its use to track changes in right ventricular function and to detect right ventricular outflow tract obstruction. The potential role of myocardial deformation imaging has been raised to detect patients at risk of postoperative complications. SUMMARY: Perioperative right ventricular function monitoring is based on echocardiographic and extra-cardiac flow evaluation. In addition to imaging modalities, hemodynamic evaluation using various types of pulmonary artery catheters can be achieved to track changes rapidly and quantitatively in right ventricular function perioperatively. These monitoring techniques can be applied during and after surgery to increase the detection rate of right ventricular dysfunction. All this to improve the treatment of patients presenting early signs of right ventricular dysfunction before systemic organ dysfunction ensue.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Disfunção Ventricular Direita , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Cuidados Críticos , Ecocardiografia , Humanos , Disfunção Ventricular Direita/diagnóstico por imagem , Disfunção Ventricular Direita/etiologia , Função Ventricular Direita
10.
Can Vet J ; 63(6): 627-632, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35656527

RESUMO

Although breed-specific vertebral heart size (VHS) reference ranges have been reported, the relationship between VHS and severity of cardiac enlargement has not been clarified. The objective was to assess the influence of cardiac enlargement on VHS in Chihuahuas with myxomatous mitral valve disease (MMVD). Ten clinically normal Chihuahuas (Normal) and 97 Chihuahuas with MMVD were recruited. Chihuahuas with MMVD were classified according to the values of left atrium to aorta ratio (LA/AO) and left ventricular internal dimension in diastole normalized (LVIDDN). These dogs were allocated into 3 groups: LA1 (LA/AO < 1.6), LA2 (1.6 ≤ LA/AO < 2.0), LA3 (LA/AO ≥ 2.0), and into 2 groups: LV1 (LVIDDN < 1.7), LV2 (LVIDDN ≥ 1.7). Vertebral heart sizes, measured as mean ± SD, were compared among groups. Optimal cutoff values of VHS were determined for mild (LA/AO ≥ 1.6, LVIDDN ≥ 1.7) and severe (LA/AO ≥ 2.0, LVIDDN ≥ 1.7) cardiac enlargement. Vertebral heart sizes (mean ± SD) were Normal: 9.66 ± 0.36, LA1: 10.13 ± 0.64, LA2: 10.87 ± 0.71, LA3: 11.71 ± 0.78, LV1: 10.04 ± 0.71, LV2: 11.21 ± 0.78. LA2-3 had significantly greater VHS than Normal and LA1, whereas LA3 had the greatest VHS. LV2 had significantly greater VHS than Normal and LV1 and a VHS of 10.5 and 11.1 had optimal diagnostic accuracy for identifying mild and severe cardiac enlargement, respectively. In conclusion, VHS increased according to cardiac enlargement in Chihuahuas with MMVD; a VHS of 10.5 and 11.1 might be useful in evaluating the extent of cardiac enlargement.


La taille du coeur vertébral est associée à une hypertrophie cardiaque chez les Chihuahuas atteints d'une maladie valvulaire mitrale myxomateuse. Bien que des plages de référence de taille du coeur vertébral (VHS) spécifiques à la race aient été rapportées, la relation entre le VHS et la gravité de l'hypertrophie cardiaque n'a pas été clarifiée. L'objectif était d'évaluer l'influence de l'hypertrophie cardiaque sur le VHS chez des Chihuahuas atteints de maladie myxomateuse de la valve mitrale (MMVD). Dix Chihuahuas cliniquement normaux (Normal) et 97 Chihuahuas avec MMVD ont été recrutés. Les Chihuahuas avec MMVD ont été classés selon les valeurs du rapport oreillette gauche sur aorte (LA/AO) et de la dimension interne ventriculaire gauche en diastole normalisée (LVIDDN). Ces chiens ont été répartis en trois groupes : LA1 (LA/AO < 1,6), LA2 (1,6 ≤ LA/AO < 2,0), LA3 (LA/AO ≥ 2,0), et en deux groupes : LV1 (LVIDDN < 1,7), LV2 (LVIDDN ≥ 1,7). Les tailles du coeur vertébral, mesurées comme la moyenne ± SD, ont été comparées entre les groupes. Les valeurs seuil optimales de VHS ont été déterminées pour l'hypertrophie cardiaque légère (LA/AO ≥ 1,6, LVIDDN ≥ 1,7) et sévère (LA/AO ≥ 2,0, LVIDDN ≥ 1,7). Les tailles du coeur vertébral (moyenne ± SD) étaient normales : 9,66 ± 0,36, LA1 : 10,13 ± 0,64, LA2 : 10,87 ± 0,71, LA3 : 11,71 ± 0,78, LV1 : 10,04 ± 0,71, LV2 : 11,21 ± 0,78. LA2­3 avait un VHS significativement plus élevé que Normal et LA1, tandis que LA3 avait le plus grand VHS. LV2 avait un VHS significativement plus élevé que Normal et LV1 et un VHS de 10,5 et 11,1 avait une précision diagnostique optimale pour identifier l'hypertrophie cardiaque légère et sévère, respectivement. En conclusion, le VHS a augmenté en fonction de l'hypertrophie cardiaque chez les Chihuahuas avec MMVD; un VHS de 10,5 et 11,1 pourrait être utile pour évaluer l'étendue de l'hypertrophie cardiaque.(Traduit par Dr Serge Messier).


Assuntos
Doenças do Cão , Doenças das Valvas Cardíacas , Valva Mitral , Animais , Cães , Ecocardiografia/veterinária , Átrios do Coração/diagnóstico por imagem , Doenças das Valvas Cardíacas/veterinária , Ventrículos do Coração
12.
Circ Cardiovasc Imaging ; 15(6): e014415, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35727874

RESUMO

Cardiovascular magnetic resonance has been utilized in the management and care of pediatric patients for nearly 40 years. It has evolved to become an invaluable tool in the assessment of the littlest of hearts for diagnosis, pre-interventional management and follow-up care. Although mentioned in a number of consensus and guidelines documents, an up-to-date, large, stand-alone guidance work for the use of cardiovascular magnetic resonance in pediatric congenital 36 and acquired 35 heart disease endorsed by numerous Societies involved in the care of these children is lacking. This guidelines document outlines the use of cardiovascular magnetic resonance in this patient population for a significant number of heart lesions in this age group and although admittedly, is not an exhaustive treatment, it does deal with an expansive list of many common clinical issues encountered in daily practice.


Assuntos
Cardiologia , Cardiopatias , Radiologia , American Heart Association , Criança , Ecocardiografia , Cardiopatias/diagnóstico por imagem , Humanos , Espectroscopia de Ressonância Magnética , América do Norte , Sociedades Médicas , Estados Unidos
13.
Circ Cardiovasc Imaging ; 15(6): e014159, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35727876

RESUMO

BACKGROUND: Left ventricular noncompaction (LVNC) is characterized by excessive trabeculations of the LV and may be associated with reduced systolic function or severe adverse outcomes. Several aspects remain to be elucidated; there is controversy to whether LVNC cardiomyopathy is a distinct cardiomyopathy caused by failure of the spongy fetal myocardium to condense during fetal development or acquired later in life as a morphological trait associated with other types of cardiomyopathy; the prevalence in unselected populations is unknown and the distinction between normal variation and pathology remains to be defined. In this study, we aimed to determine the prevalence of LVNC and the association to LV systolic function in a large, population-based cohort of neonates. In addition, we assessed the normal ratio of noncompact to compact (NC:C) myocardium in 150 healthy neonates. METHODS: Echocardiographic data were prospectively collected in the population study Copenhagen Baby Heart Study. The ratio of NC:C was measured in 12 ventricular segments. LVNC was defined as NC:C ≥2 in at least one segment. Neonates with LVNC were matched 1:10 to controls on sex, gestational age, and weight and age at the examination day. RESULTS: In total, 25 590 neonates (52% males, median age 11 [interquartile range, 7-15] days) underwent echocardiography. Among 21 133 with satisfactory visualization of ventricular segments, we identified a prevalence of LVNC of 0.076% (95% CI, 0.047-0.123). LV ejection fraction was lower in neonates with LVNC compared with matched controls (median 49.5 versus 59.0%; P<0.0001). In neonates with otherwise healthy hearts, the median NC:C ratio ranged from 0.0 to 0.7 and the 99th percentiles from 1.0 to 1.9 for each of the 12 segments. CONCLUSIONS: The prevalence of LVNC based on neonatal echocardiography was 0.076%. LVNC was associated with lower LV systolic function. The findings in normal newborns support the cutoff NC:C ≥2 as an appropriate diagnostic criterion. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02753348.


Assuntos
Cardiomiopatias , Cardiopatias Congênitas , Miocárdio Ventricular não Compactado Isolado , Cardiomiopatias/complicações , Cardiomiopatias/diagnóstico por imagem , Cardiomiopatias/epidemiologia , Criança , Ecocardiografia , Feminino , Cardiopatias Congênitas/complicações , Humanos , Recém-Nascido , Miocárdio Ventricular não Compactado Isolado/complicações , Miocárdio Ventricular não Compactado Isolado/diagnóstico por imagem , Miocárdio Ventricular não Compactado Isolado/epidemiologia , Masculino , Prevalência , Função Ventricular Esquerda
14.
J Cardiovasc Magn Reson ; 24(1): 37, 2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35725473

RESUMO

Cardiovascular magnetic resonance (CMR) has been utilized in the management and care of pediatric patients for nearly 40 years. It has evolved to become an invaluable tool in the assessment of the littlest of hearts for diagnosis, pre-interventional management and follow-up care. Although mentioned in a number of consensus and guidelines documents, an up-to-date, large, stand-alone guidance work for the use of CMR in pediatric congenital 36 and acquired 35 heart disease endorsed by numerous Societies involved in the care of these children is lacking. This guidelines document outlines the use of CMR in this patient population for a significant number of heart lesions in this age group and although admittedly, is not an exhaustive treatment, it does deal with an expansive list of many common clinical issues encountered in daily practice.


Assuntos
Cardiologia , Cardiopatias , Radiologia , American Heart Association , Criança , Ecocardiografia , Cardiopatias/diagnóstico por imagem , Humanos , Espectroscopia de Ressonância Magnética , América do Norte , Valor Preditivo dos Testes , Estados Unidos
15.
J Investig Med High Impact Case Rep ; 10: 23247096221104469, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35726863

RESUMO

Lipoma of the interventricular septum involving the tricuspid valve is a rare entity. A 50-year-old woman presented with exertional dyspnea. She was found to have a large right interventricular septal mass in the initial transthoracic echocardiography. This mass was further investigated by transesophageal echocardiography, cardiac gated CT, and cardiac magnetic resonance imaging. It was found to be lipomatous and embedded into the septal leaflet of the tricuspid valve. The diagnosis was confirmed by biopsy. Surgical exploration revealed that the mass was deeply embedded in the interventricular septum and septal leaflet of the tricuspid valve. The mass was resected along with sections of the interventricular septum and tricuspid valve. She underwent bioprosthetic tricuspid valve placement and patch reconstruction of the interventricular septum. We also searched case reports from MEDLINE and studied pathological and epidemiological characteristics of the published cases of cardiac masses in the past year. Cardiac lipoma although a benign tumor can cause serious hemodynamic complications. Initial transthoracic echocardiography followed by multimodality imaging is the cornerstone of the diagnosis.


Assuntos
Neoplasias Cardíacas , Lipoma , Ecocardiografia/métodos , Ecocardiografia Transesofagiana , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Pessoa de Meia-Idade , Valva Tricúspide/diagnóstico por imagem
16.
Eur Rev Med Pharmacol Sci ; 26(11): 3903-3910, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35731059

RESUMO

OBJECTIVE: We aimed to conduct a review of the literature relevant to cardiac imaging techniques and summarize the use of different non-invasive imaging modalities in the assessment of ventricular size, function, and mechanics. The current review emphasizes the benefits of speckle tracking imaging (STI), highlighting its use in demonstrating myocardial strain. This robust technique is a recent addition to the existing imaging techniques that are used to assess the myocardium. In terms of effectively determining the left ventricle ejection fraction, it is a comparable technique to cardiac magnetic resonance. The use of STI method for image acquisition relies on semiautomatic identification of the border and deformation of the region of interest, and is also independent of the angle of insonation, thus it increases the inter-and intra-observer reproducibility in contrast to the conventional tissue doppler imaging. MATERIALS AND METHODS: The databases of PubMed, Scopus, and Embase were thoroughly searched for the following keywords: 2- dimensional/ two-dimensional/ 2-D, speckle/strain tracking, systolic dysfunction, and heart failure. The studies selected described image acquisition techniques and the application of this imaging modality in various clinical settings. The selected journal articles were perused to provide the best possible analysis of STI. RESULTS: Our comparative analysis demonstrated that the STI, when compared with the conventional echocardiography, is a more sensitive image acquiring technique for detecting subclinical myocardial dysfunction. Based on the analysis it can be stated that the STI can provide valuable information on both regional and global myocardial function, and it can also quantify cardiac synchronicity and rotation. Additionally, it serves as a better prognostic indicator. CONCLUSIONS: The change in longitudinal strain can serve as an early marker of the left ventricular systolic dysfunction, and therefore, monitoring via STI has both diagnostic and prognostic value in heart failure, ischemic heart disease, valvulopathies, chemotherapy-induced cardiotoxicity, and cardiac resynchronization therapy. Despite the lack of standardization, the method is also effective in assessing the right ventricle and left atrial function and arterial rigidity.


Assuntos
Ecocardiografia , Insuficiência Cardíaca , Ecocardiografia/métodos , Insuficiência Cardíaca/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Prognóstico , Reprodutibilidade dos Testes
17.
Diving Hyperb Med ; 52(2): 136-148, 2022 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-35732286

RESUMO

Ultrasound monitoring, both in the form of Doppler and 2D echocardiography, has been used post-dive to detect decompression bubbles circulating in the bloodstream. With large variability in both bubble time course and loads, it has been hypothesised that shorter periods between imaging, or even continuous imaging, could provide more accurate post-dive assessments. However, while considering applications of ultrasound imaging post-decompression, it may also be prudent to consider the possibility of ultrasound-induced bioeffects. Clinical ultrasound studies using microbubble contrast agents have shown bioeffect generation with acoustic powers much lower than those used in post-dive monitoring. However, to date no studies have specifically investigated potential bioeffect generation from continuous post-dive echocardiography. This review discusses what can be drawn from the current ultrasound and diving literature on the safety of bubble sonication and highlights areas where more studies are needed. An overview of the ultrasound-bubble mechanisms that lead to bioeffects and analyses of ultrasound contrast agent studies on bioeffect generation in the pulmonary and cardiovascular systems are provided to illustrate how bubbles under ultrasound can cause damage within the body. Along with clinical ultrasound studies, studies investigating the effects of decompression bubbles under ultrasound are analysed and open questions regarding continuous post-dive monitoring safety are discussed.


Assuntos
Doença da Descompressão , Mergulho , Embolia Aérea , Doença da Descompressão/etiologia , Ecocardiografia/efeitos adversos , Embolia Aérea/etiologia , Humanos , Ultrassonografia/efeitos adversos
18.
Biosensors (Basel) ; 12(6)2022 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-35735522

RESUMO

Accelerometer-based devices have been employed in seismocardiography fiducial point detection with the aid of quasi-synchronous alignment between echocardiography images and seismocardiogram signals. However, signal misalignments have been observed, due to the heartbeat cycle length variation. This paper not only analyzes the misalignments and detection errors but also proposes to mitigate the issues by introducing reference signals and adynamic time warping (DTW) algorithm. Two diagnostic parameters, the ratio of pre-ejection period to left ventricular ejection time (PEP/LVET) and the Tei index, were examined with two statistical verification approaches: (1) the coefficient of determination (R2) of the parameters versus the left ventricular ejection fraction (LVEF) assessments, and (2) the receiver operating characteristic (ROC) classification to distinguish the heart failure patients with reduced ejection fraction (HFrEF). Favorable R2 values were obtained, R2 = 0.768 for PEP/LVET versus LVEF and R2 = 0.86 for Tei index versus LVEF. The areas under the ROC curve indicate the parameters that are good predictors to identify HFrEF patients, with an accuracy of more than 92%. The proof-of-concept experiments exhibited the effectiveness of the DTW-based quasi-synchronous alignment in seismocardiography fiducial point detection. The proposed approach may enable the standardization of the fiducial point detection and the signal template generation. Meanwhile, the program-generated annotation data may serve as the labeled training set for the supervised machine learning.


Assuntos
Insuficiência Cardíaca , Função Ventricular Esquerda , Computadores , Ecocardiografia , Humanos , Volume Sistólico
19.
Saudi Med J ; 43(6): 587-591, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35675931

RESUMO

OBJECTIVES: To analyze the clinical and echocardiographic changes in individuals with morbid obesity who underwent bariatric surgery. METHODS: In total, 59 obese patients with body mass index >35 kg/m2 were prospectively enrolled. We assessed baseline pre-operative and a 6-month post-operative lipid profile, hemoglobin A1c, echocardiography, lifetime, and a 10-year risks of atherosclerotic disease for all patients. RESULTS: The mean patients' age was 37±12 years, with 40 (67.8%) women. We found that the pre-operative total cholesterol (4.2±1.1 vs. 4.4±1.1, p=0.014) and triglyceride levels (1.4±0.7 vs. 1.8±0.8, p<0.0001) were significantly lower than post-operative levels, while post-operative high-density lipoprotein levels were significantly higher (1.5±0.5 vs. 1.2±0.3, p<0.0001). The calculated 10-year risk of atherosclerotic cardiovascular disease was significantly lower post-operatively (1.1±1.6% vs. 1.6±1.8%, p<0.0001). Echocardiography follow-up revealed that diastolic dysfunction was more prevalent pre-operatively than that post-operatively (41% vs. 10%, p<0.0001). Post-operative left ventricular (LV) mass was significantly lesser than the pre-operative mass (168±252 g vs. 187±255 g, p=0.019), whereas the post-operative LV diastolic (46.5±7 mm vs. 38.5±18 mm, p=0.002) and systolic dimensions (31±5 mm vs. 25±11 mm, p=0.001) were significantly smaller. CONCLUSION: Bariatric surgery resulted in a significant amelioration in lipid profile, reduction in LV mass, and LV cavity dimensions.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Adulto , Ecocardiografia , Feminino , Humanos , Lipídeos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Função Ventricular Esquerda
20.
Pan Afr Med J ; 42: 7, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35685384

RESUMO

There is a paucity of detailed descriptions of echocardiographic features of the dying heart in the literature. A 64-year-old man on chronic hemodialysis presented with cardiac arrest after missing dialysis for three weeks. He received resuscitation efforts but died while his last heartbeats were fortuitously recorded by echocardiography. Rapid echo image acquisition during pulse check of a cardiopulmonary resuscitation attempt provided a unique opportunity for documenting the echocardiographic features of a dying heart. There was a rapid progressive dense echogenicity first in the left ventricular chamber and subsequently in all other chambers, which coincided with the final heartbeats. There is no prior documentation of this observation in the literature. We hereby illustrate and characterize this observation we term as Hemostatic Instantaneous Coagulation on Echo (HICE). HICE may be the defining feature of the dying heart and may guide the decision to discontinue resuscitation interventions.


Assuntos
Reanimação Cardiopulmonar , Parada Cardíaca , Hemostáticos , Reanimação Cardiopulmonar/métodos , Ecocardiografia , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade
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