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1.
Curr Probl Cardiol ; 48(1): 101433, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36170908

RESUMO

Heart failure (HF) with preserved ejection fraction (HFpEF) is a heterogeneous syndrome including several morphological phenotypes and varying pathophysiological mechanisms. The conventional classification of HF based on left ventricular ejection fraction (LVEF) has created an oversimplification in diagnostic criteria. Although LVEF is a standardized parameter easy to calculate and broadly applied in the large clinical trials, but it is erroneously considered an index of left ventricular (LV) systolic function. Indeed, it is affected by preload and afterload and it has limitations related to reproducibility, reduced sensitivity and scarce prognostic values especially when above 50%. Notably, additional diagnostic parameters have been recently proposed in order to improve diagnostic accuracy and to homogenize the different HFpEF populations. Unfortunately, these algorithms comprise sophisticated measurements that are difficult to apply in the daily clinical practice. Additionally, the scarce diffusion of these diagnostic criteria may have led to neutral or negative results in interventional phase 3 trials. We propose changes to the current HFpEF diagnostic approach mainly based on LVEF stratification measurement aiming towards a more inclusive model taking into consideration an integrative approach starting from the main diseases responsible for cardiac dysfunction through to cardiac structural and functional alterations. Accordingly, with recent universal HF definitions, a stepwise model could be helpful in recognizing patients with early vs. overt HFpEF by the appraisal of specific Doppler echocardiographic variables. Thus, we would encourage the application of new criteria in order to better identify the different phenotypes and to move towards more personalized medicine.


Assuntos
Insuficiência Cardíaca , Função Ventricular Esquerda , Humanos , Volume Sistólico/fisiologia , Função Ventricular Esquerda/fisiologia , Reprodutibilidade dos Testes , Sístole , Prognóstico
2.
Sci Rep ; 12(1): 20000, 2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-36411300

RESUMO

Cardiovascular magnetic resonance T1-mapping enables myocardial tissue characterisation, and is capable of quantifying both intracellular and extracellular volume. T1-mapping is conventionally performed in diastole, however, we hypothesised that systolic readout would reduce variability due to a reduction in myocardial blood volume. This study investigated whether T1-mapping in systole alters T1 values compared to diastole and whether reproducibility alters in atrial fibrillation compared to sinus rhythm. We prospectively identified 103 consecutive patients recruited to the Mitral FINDER study who had T1 mapping in systole and diastole. These patients had moderate or severe mitral regurgitation and a high incidence of ventricular dilatation and atrial fibrillation. T1, ECV and goodness-of-fit (R2) values of the T1 times were calculated offline using Circle cvi42 and in house-developed software. Systolic T1 mapping was associated with fewer myocardial segments being affected by artefact compared to diastolic T1 mapping [217/2472 (9%) vs 515/2472 (21%)]. Mean native T1 values were not significantly different when measured in systole and diastole (985 ± 26 ms vs 988 ± 29 respectively; p = 0.061) and mean post-contrast values showed similar good agreement (462 ± 32 ms vs 459 ± 33 respectively, p = 0.052). No clinically significant differences in ECV, native T1 and post-contrast T1 were identified between diastolic and systolic T1 maps in males versus females, or in patients with permanent atrial fibrillation versus sinus rhythm. A statistically significant improvement in R2 value was observed with systolic over diastolic T1 mapping in all analysed maps (n = 411) (96.2 ± 1.4% vs 96.0 ± 1.4%; p < 0.001) and in subgroup analyses [Sinus rhythm: 96.1 ± 1.4 vs 96.3 ± 1.4 (n = 327); p < 0.001. AF: 95.5 ± 1.3 vs 95.9 ± 1.2 (n = 80); p < 0.001] [Males: 95.8 ± 1.4 vs 96.1 ± 1.3 (n = 264); p < 0.001; Females: 96.2 ± 1.3 vs 96.4 ± 1.4 (n = 143); p = 0.009]. In conclusion, myocardial T1 mapping is associated with similar T1 and ECV values in systole and diastole. Furthermore, systolic acquisition is less prone to gating artefact in arrhythmia.


Assuntos
Fibrilação Atrial , Insuficiência da Valva Mitral , Masculino , Feminino , Humanos , Sístole , Diástole , Insuficiência da Valva Mitral/diagnóstico por imagem , Reprodutibilidade dos Testes
3.
Vnitr Lek ; 68(7): 461-464, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36402573

RESUMO

Arerial hypertension is comon in subjects 65 years old and includes in majority of subjects systolic/diastolic form or isolated systolic hypertension. Basic therapeutic principles to the therapy of hypertension of elderly subjects are summarized. Slow and careful uptitration of antihypertensive therapy is recommended. Potential complications and caveats of therapy are also discussed, which are especially related to older frail subjects. Pharmacotherapy of hypertension in elderly is in vast majority of subjects highly beneficial with decrease of cardiovascular (CV) events and CV mortality.


Assuntos
Anti-Hipertensivos , Hipertensão , Idoso , Humanos , Anti-Hipertensivos/uso terapêutico , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Sístole , Diástole
4.
Sci Rep ; 12(1): 19726, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36396733

RESUMO

The expansion of the sheep model in research represents an attractive and economically beneficial academic reason for investigations in sheep echocardiography. The present study aimed to evaluate the clinical and echocardiographic parameters in Dorper lambs during the developmental period. Emphasis was placed on the use of the species in translational research for the echocardiographic diagnosis of congenital heart diseases, which can contribute to improvements in interventionist techniques. Ten Dorper lambs were evaluated at the following time points: 24 h after birth and 7, 14, 21, 30, 60, 90 and 120 days of age. Clinical parameters were compiled, and echocardiogram records were obtained without sedation. Rectal temperature was lower on the first day compared to the others. From 21 days of life, there was a reduction in HR, with differences between time points. Mean and systolic blood pressure differed, with the highest values at 90 and 120 days of age. The thickness of the interventricular septum in diastole (IVSd) increased as age progressed, with the highest value at 120 days of age, and the same occurred for LVIDd (left ventricle internal diameter in diastole), LVFWd (left ventricular free wall thickness in diastole), IVSs (interventricular septum thickness in systole), LVIDs (left ventricle internal diameter in systole) and LVFWs (left ventricular free wall thickness in systole). There were differences in the size of the LA, Ao and LA/Ao ratio, which were greater at 90 days and 120 days of age. Echocardiographic changes accompany the development of lambs, where changes in echocardiographic parameters are evident with advancing age. The echocardiographic measurements in lambs obtained in the present study are similar to those in newborns.


Assuntos
Ecocardiografia , Ventrículos do Coração , Gravidez , Feminino , Ovinos , Animais , Ecocardiografia/métodos , Ventrículos do Coração/diagnóstico por imagem , Sístole , Diástole , Parto
5.
Sci Rep ; 12(1): 19532, 2022 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-36376457

RESUMO

Electric interventions are used to terminate arrhythmia. However, myocardial injury from the electrical intervention can follow unique pathways and it is unknown how this affects regional ventricular function. This study investigated the impact of transthoracic electrical shocks on systolic and diastolic myocardial deformation. Ten healthy anaesthetized female swine received five transthoracic shocks (5 × 200 J) and six controls underwent a cardiovascular magnetic resonance exam prior to and 5 h after the intervention. Serial transthoracic shocks led to a global reduction in both left (LV, - 15.6 ± 3.3% to - 13.0 ± 3.6%, p < 0.01) and right ventricular (RV, - 16.1 ± 2.3% to - 12.8 ± 4.2%, p = 0.03) peak circumferential strain as a marker of systolic function and to a decrease in LV early diastolic strain rate (1.19 ± 0.35/s to 0.95 ± 0.37/s, p = 0.02), assessed by feature tracking analysis. The extent of myocardial edema (ΔT1) was related to an aggravation of regional LV and RV diastolic dysfunction, whereas only RV systolic function was regionally associated with an increase in T1. In conclusion, serial transthoracic shocks in a healthy swine model attenuate biventricular systolic function, but it is the acute development of regional diastolic dysfunction that is associated with the onset of colocalized myocardial edema.


Assuntos
Traumatismos Cardíacos , Disfunção Ventricular Esquerda , Feminino , Suínos , Animais , Ventrículos do Coração , Sístole , Diástole , Coração , Imageamento por Ressonância Magnética , Função Ventricular Esquerda
6.
Int J Cardiovasc Imaging ; 38(11): 2333-2343, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36434336

RESUMO

Manifest myocardial involvement is somewhat rare in patients with Behcet's disease (BD), although echocardiographic studies suggest that subclinical alterations in left ventricular (LV) contractility is rather common. Data on right ventricular (RV) involvement in BD is rather scarce. This study aims to determine whether RV systolic performance is affected in BD patients, and to understand the clinical and echocardiographic correlates of RV contractility in these patients. Forty-five patients who fulfilled criteria for BD and 45 age and gender matched controls were enrolled. All participants underwent a comprehensive echocardiographic examination, including deformation imaging, to characterize RV mechanics. Conventional morphologic and echocardiographic indicators of RV morphology and function were not different between groups, but RV apical strain and RV free wall strain (FWS) were significantly lower in BD patients as compared to the controls (P < 0.001 and P = 0.02, respectively). The only significant correlates of FWS were tricuspid regurgitation velocity and related indices in healthy controls, while FWS correlated with LV global longitudinal strain (GLS), morphologic measures of left and right atria and ventricles, and with conventional measures of right ventricular contractility. The relationship between FWS and GLS remained statistically significant after adjusting for other clinical and echocardiographic parameters (ß = 0.379, P = 0.01). In patients with BD, there is a subclinical alteration in RV contractility and the degree of alteration in the RV systolic performance paralleled that of LV. Thus, present results support the presence of RV involvement in these patients.


Assuntos
Síndrome de Behçet , Humanos , Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico por imagem , Valor Preditivo dos Testes , Ventrículos do Coração/diagnóstico por imagem , Ecocardiografia/métodos , Sístole
7.
Int J Cardiovasc Imaging ; 38(11): 2323-2331, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36434339

RESUMO

A wide range of subclinical changes in left ventricular (LV) geometry and function can be observed, even in the early course of arterial hypertension (HTN). Aim of the study was to investigate if the appearance of isolated basal septal hypertrophy (BSH, septal bulge) in asymptomatic young and middle-aged adults with HTN could be a marker of incipient LV systolic dysfunction when other measures of global LV function are still normal. A total of 138 patients with primary arterial hypertension, aged less than 65 years, with no comorbidities and with preserved LV ejection fraction (EF) were included. Complete 2D transthoracic echocardiography study was preformed according to standardized protocol, as well as deformation study using speckle tracking echocardiography. Global and regional longitudinal strain was measured in apical 4-, 2- and 3-chamber views according to 18-segments model. Global and regional circumferential and radial strains were measured in short axis view. Average was taken from each of the six basal, middle and apical LV segments. Patients were divided into two groups according to BSH presence and values were compared. Basal septal hypertrophy was found in half of the patients (53.6%). The whole cohort had altogether normal LV global systolic function, as well as global indices of radial strain (GRS 43.86 ± 10.75%) and longitudinal strain (GLS - 19.73 ± 2.19%), while global circumferential strain (GCS) was mildly reduced (GCS - 19.5 ± 2.81%). BSH patients had more expressed LV geometry changes (LV mass: 89.19 ± 24.59 g/m2 vs 109.15 ± 25.33 g/m2, p < 0.001; relative wall thickness: 0.3 ± 0.08 vs 0.38 ± 0.11, p < 0.001) and also revealed a specific pattern of longitudinal deformation impairment in three LV segments (basal and mid interventricular septum, basal anteroseptum). "Strain gradient" from LV base to apex (basal < mid < apical) was observed in the whole population for longitudinal and circumferential strain, and it was more pronounced in the BSH group. This group had more impaired basal LS, while apical CS was improved. Subendocardial longitudinal strain was also more impaired in the BSH group. This study brings new meaning to basal septal hypertrophy (BSH) occurrence in hypertensive patients with discrete global concentric remodeling. Regional systolic dysfunction of the basal and mid LV segments is found, while apical segments increase in deformation. This specific "strain gradient" pattern was found to be more pronounced in patients with BSH. The recognition of BHS in apparently healthy hypertensive patients with no impairment in global systolic function may suggest latent target organ damage with regional impairment of systolic function and the need to imply more aggressive treatment approach.


Assuntos
Hipertensão , Disfunção Ventricular Esquerda , Adulto , Pessoa de Meia-Idade , Humanos , Valor Preditivo dos Testes , Sístole , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/etiologia , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertrofia
9.
J Clin Ultrasound ; 50(8): 1026-1040, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36218206

RESUMO

A comprehensive understanding of the cardiac structure-function relationship is essential for proper clinical cardiac imaging. This review summarizes the basic heart anatomy and physiology from the perspective of a heart imager focused on myocardial mechanics. The main issues analyzed are the left ventricular (LV) architecture, the LV myocardial deformation through the cardiac cycle, the LV diastolic function basic parameters and the basic parameters of the LV deformation used in clinical practice for the LV function assessment.


Assuntos
Cardiologistas , Disfunção Ventricular Esquerda , Diástole/fisiologia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Volume Sistólico/fisiologia , Sístole/fisiologia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Função Ventricular Esquerda
10.
J Clin Ultrasound ; 50(8): 1134-1142, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36218210

RESUMO

This review summarizes current knowledge about echocardiographic modalities used to assess microvascular function and left ventricular (LV) systolic function in women with ischemia and no obstructive coronary arteries (INOCA). Although the entire pathophysiological background of this clinical entity still remains elusive, it is primarily linked to microvascular dysfunction which can be assessed by coronary flow velocity reserve. Subtle impairments of LV systolic function in women with INOCA are difficult to assess by interpretation of wall motion abnormalities. LV longitudinal function impairment is considered to be an early marker of subclinical systolic dysfunction and can be assessed by global longitudinal strain quantification.


Assuntos
Vasos Coronários , Disfunção Ventricular Esquerda , Vasos Coronários/diagnóstico por imagem , Ecocardiografia , Feminino , Humanos , Isquemia , Sístole
11.
Artigo em Inglês | MEDLINE | ID: mdl-36231610

RESUMO

Various factors may alter the risk for cardiovascular disease in adults with Down syndrome (Ds), yet few studies have examined differences in cardiac physiology in this population. Previous research suggested lower systolic and diastolic function, but inconsistent methodologies and younger samples warrant research in adults with Ds. Our aim is to compare the cardiac structure and function of adults with Ds to age- and sex-matched adults without Ds. Echocardiography was used to assess systolic function, diastolic function, and cardiac structure in n = 19 adults (Ds n = 9, control n = 10). Regarding cardiac structure, adults with Ds had increased left ventricular posterior wall thickness at end-systole compared to adults without Ds (p = 0.007). Regarding systolic and diastolic function, adults with Ds were found to have lower septal peak systolic annular velocity (S') (p = 0.026), lower lateral and septal mitral annular early diastolic velocity (E') (p = 0.007 and p = 0.025, respectively), lower lateral peak mitral annular late diastolic velocity (A') (p = 0.027), and higher lateral and septal mitral annular early systolic velocity to diastolic velocity ratios (E/e') (p = 0.001 and p = 0.001, respectively). Differences in both cardiac structure and function were found when comparing adults with Ds to matched adults without Ds. Most of the differences were indicative of worse diastolic function.


Assuntos
Síndrome de Down , Adulto , Diástole/fisiologia , Ecocardiografia/métodos , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiologia , Sístole/fisiologia , Função Ventricular Esquerda/fisiologia
12.
Int J Cardiol ; 367: 74-80, 2022 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-36064037

RESUMO

BACKGROUND: It is unclear whether afterload mismatch occurs during the initial stage of essential hypertension (EHT). Additionally, critical left ventricular hypertrophy (LVH) between preserved and reduced systolic functions in hypertension is also unclear. Thus, we aimed to clarify these points. METHODS: Forty-five normal control subjects (NCS) and 140 EHT patients participated. EHT patients were subdivided into three groups: group I, without LVH (n = 37); group II, with LVH (n = 80); and group III, with LVH and LV heart failure (LVHF) (n = 23). Routine electrocardiographic and echocardiographic parameters, V5R/V6R ratio, relative wall thickness (RWT), LV mass (LVM) index, and peak systolic wall stress (PSWS) were measured. RESULTS: In group I, LV systolic functions were preserved despite the increase of PSWS. In group II, LVH advanced, but LV systolic functions remained normal. A negative T-wave was observed in 69% of group II and 100% of group III. A significant correlation between RWT and LVM index was seen in NCS and groups I and II (r2 = 0.545, P < 0.0001) but not in group III. Afterload mismatch occurred in group III due to the decrease in V5R/V6R ratio, the increase of LV end-diastolic dimension, and the LV systolic dysfunctions, which are caused by exhaustion of preload reserve. The boundary of the LVM index between groups II and III was approximately 180 g/m2. CONCLUSION: Afterload mismatch did not occur in group I, but it was observed in group III due to the exhaustion of preload reserve.


Assuntos
Hipertensão , Remodelação Ventricular , Hipertensão Essencial , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico por imagem , Hipertrofia Ventricular Esquerda , Sístole
13.
J Clin Ultrasound ; 50(7): 873-884, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36069462

RESUMO

BACKGROUND: Right ventricular (RV) myocardial work (RVMW) is the latest method used to assess RV function. To date, correlations among RVMW indices and RV systolic and diastolic functions have not been studied. METHODS: A total of 106 healthy volunteers (median age, 34 years; 46% male) were prospectively enrolled. RVMW indices were measured using the RV pressure-strain loop using specific software. The correlations among RVMW indices and other RV functions were analyzed. RESULTS: During the multivariate analysis, the RV global work index (RVGWI) was significantly correlated with RV global longitudinal strain (RV GLS) (p < .0001), pulmonary systolic artery pressure (PASP) (p < .0001), and tricuspid annular (TA) plane systolic excursion (TAPSE) (p = .036). RV global constructive work (RVGCW) was correlated with RV GLS (p < .0001) and PASP (p < .0001). RV global wasted work (RVGWW) was correlated with RV GLS (p = .008) and TA isovolumetric acceleration (TA IVA) (p = .008). RV global work efficiency (RVGWE) was correlated with RV GLS (p < .0001) and tissue Doppler (TD) RV myocardial performance index (TD RMPI) (p = .043). CONCLUSION: RVMW indices showed good correlations with RV myocardial systolic function.


Assuntos
Disfunção Ventricular Direita , Adulto , Diástole , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Sístole , Disfunção Ventricular Direita/diagnóstico por imagem , Função Ventricular Direita
14.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 674-677, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36086297

RESUMO

Pulse arrival time (PAT), evaluated from electro-cardiogram (ECG) and photoplethysmogram (PPG) signals, has been widely used for cuff-less blood pressure (BP) estimation due to its high correlation with BP. However, the question of whether filtering the PPG signal impacts the extracted PAT values and consequently, the correlation between PAT and BP, has not been investigated before. In this paper, using data from 18 subjects, changes in the PAT values, and in the subject-specific PAT-systolic BP (SBP) correlation caused by filtering the PPG signal with variable cutoff frequencies in the range of 2 to 15 Hz are studied. For PAT extraction, three PPG characteristic points (foot, maximum slope and systolic peak) are considered. Results show that differences in the cutoff frequency can shift the PAT values and introduce a worst-case error of over 8.2 mmHg for SBP estimation, indicating that PPG signal filter settings can impact PAT-based BP estimations. Our study suggests that extracting the PAT from the maximum slope point of PPG signal filtered at 10 Hz provides the most stable correlation with SBP.


Assuntos
Determinação da Pressão Arterial , Fotopletismografia , Pressão Sanguínea , Determinação da Pressão Arterial/métodos , Frequência Cardíaca , Humanos , Fotopletismografia/métodos , Sístole
15.
BMC Public Health ; 22(1): 1733, 2022 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-36096756

RESUMO

OBJECTIVE: Effect of physical exercise on pregnant women currently has become a hot topic in prenatal health care. In this study, A meta-analysis was conducted on account of Randomized Controlled Trial (RCT). It focused on evaluating the effect of physical exercise intervention on blood pressure so that could provide certain evidence for health care during pregnancy. METHODS: Results of relevant studies were retrieved from PubMed, Embase, Web of Science and the Cochrane Library, and all of these included studies were evaluated according to the Cochrane collaboration's tool for assessing the risk of bias. Stata 15.1 was used for meta-analysis, and mean difference (MD) was used as statistic for pooled analysis. The effect values were combined by conventional meta-analysis and Bayesian meta-analysis respectively, and the consistency of pooled results was considered as well. RESULTS: A total of 18 RCT studies were included in the quantitative analysis. The conventional meta-analysis showed differences in blood pressure between intervention group and control group (P < 0.05). Systolic and diastolic blood pressures of intervention group were 3.19 mmHg (95% CI: -5.13, -1.25) and 2.14 mmHg (95% CI: -4.26, -0.03) lower than that of control group, respectively. Bayesian meta-analysis showed that both systolic and diastolic pressure among intervention group decreased by 3.34 mmHg (95% CrI: -5.15, -1.56) and 2.14 mmHg (95% CrI: -3.79, - 0.50), respectively. Subgroup analysis supported that as long as healthy pregnant women participated in exercises, their blood pressure could be slightly regulated, while hypertension susceptible pregnant women significantly lowered blood pressure. CONCLUSION: Exercise intervention during pregnancy is beneficial to lower or normalize blood pressure, and this research provides clues for follow-up studies.


Assuntos
Exercício Físico , Hipertensão , Pressão Sanguínea/fisiologia , Exercício Físico/fisiologia , Terapia por Exercício/métodos , Feminino , Humanos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Sístole
16.
Arthritis Res Ther ; 24(1): 219, 2022 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-36088383

RESUMO

BACKGROUND: Cardiac involvement in patients with idiopathic inflammatory myopathies (IIM) is associated with increased morbidity and mortality risk; however, little is known about the progression of cardiac dysfunction and long-term data are scarce. In the present work, we intended to prospectively study echocardiographic parameters in patients with IIM for 2 years. METHODS: Twenty-eight IIM patients (41.9±1.6 years) without cardiovascular symptoms were enrolled. Patients with monophasic/polyphasic disease patterns were studied separately and compared to age-matched healthy individuals. Conventional echocardiographic and tissue Doppler imaging (TDI) parameters of systolic [LV: ejection fraction (EF), mitral annulus systolic movement (MAPSE), lateral s') and diastolic left (mitral inflow velocities, lateral anulus velocities: e', a', E/e') and right ventricular function (fractional area change: FAC, tricuspid annulus plane systolic excursion: TAPSE) were measured at the time of the diagnosis and 2 years later. RESULTS: Subclinical LV systolic dysfunction is characterized by reduced lateral s' (10.4 vs. 6.4 cm/s, p<0.05), EF (62.6±0.6%, vs. 51.7±0.7%) and MAPSE (18.5±0.6 vs. 14.5±0.6 mm) could be observed in IIM patients with polyphasic disease course 2 years after diagnosis compared to controls. Furthermore, diastolic LV function showed a marked deterioration to grade I diastolic dysfunction at 2 years in the polyphasic group (lateral e': 12.9 ±0.6, vs. 7.4±0.3 cm/s; lateral a': 10.7±0.3, vs. 17.3±0.8 cm/s; p<0.05) supported by larger left atrium (32.1±0.6 vs. 37.8±0.6 mm; p<0.05]. TDI measurements confirmed subclinical RV systolic dysfunction in polyphasic patients 2 years after diagnosis (FAC: 45.6±1.8%, vs. 32.7±1.4%; TAPSE: 22.7±0.5, vs. 18.1±0.3 mm; p<0.05). Similar, but not significant tendencies could be detected in patients with monophasic disease patterns. Polyphasic patients showed significantly (p<0.05) worse results compared to monophasic patients regarding EF (51.7±0.7% vs. 58.1±0.6%), lateral s' (6.4±0.4 cm/sec vs. 8.6±0.4 cm/s,), left atrium (37.8±0.6 mm vs. 33.3±0.8 mm), FAC (32.7±1.4% vs. 41.0±1.6%) and TAPSE (18.1±0.3 mm vs. 21.3±0.7 mm). CONCLUSIONS: Significant subclinical cardiac dysfunction could be detected in IIM patients with polyphasic disease course 2 years after diagnosis, which identifies them as a high-risk population. TDI is a useful method to detect echocardiographic abnormalities in IIM complementing conventional echocardiography and can recognize the high cardiac risk.


Assuntos
Dermatomiosite , Cardiopatias , Disfunção Ventricular Esquerda , Humanos , Estudos Longitudinais , Sístole , Disfunção Ventricular Esquerda/diagnóstico por imagem
17.
Commun Biol ; 5(1): 934, 2022 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-36085302

RESUMO

There is need for a reliable in vitro system that can accurately replicate the cardiac physiological environment for drug testing. The limited availability of human heart tissue culture systems has led to inaccurate interpretations of cardiac-related drug effects. Here, we developed a cardiac tissue culture model (CTCM) that can electro-mechanically stimulate heart slices with physiological stretches in systole and diastole during the cardiac cycle. After 12 days in culture, this approach partially improved the viability of heart slices but did not completely maintain their structural integrity. Therefore, following small molecule screening, we found that the incorporation of 100 nM tri-iodothyronine (T3) and 1 µM dexamethasone (Dex) into our culture media preserved the microscopic structure of the slices for 12 days. When combined with T3/Dex treatment, the CTCM system maintained the transcriptional profile, viability, metabolic activity, and structural integrity for 12 days at the same levels as the fresh heart tissue. Furthermore, overstretching the cardiac tissue induced cardiac hypertrophic signaling in culture, which provides a proof of concept for the ability of the CTCM to emulate cardiac stretch-induced hypertrophic conditions. In conclusion, CTCM can emulate cardiac physiology and pathophysiology in culture for an extended time, thereby enabling reliable drug screening.


Assuntos
Biomimética , Coração , Cardiomegalia , Meios de Cultura , Humanos , Sístole
18.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 1398-1401, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36086633

RESUMO

Ventricular pump function is often characterized by the (non)linear end-systolic pressure-volume relationship (ESPVR). For each working point on that curve the tangent along with the intercept (Vo) reflect contractile state. Vo on the abscissa is an extrapolated point without physiological meaning, and may be negative. To obtain positive values for the intercept, investigators often choose a non-zero pressure level. Although this preference is mathematically sound, we demonstrate that statistical evaluations may yield different results, depending on the pressure level selected. Published data on 17 cardiac patients representing three diagnostic groups were analyzed, showing dicrotic notch pressure based values -14

Assuntos
Contração Miocárdica , Função Ventricular , Pressão Sanguínea , Humanos , Volume Sistólico , Sístole
19.
West Afr J Med ; 39(8): 844-851, 2022 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-36058006

RESUMO

BACKGROUND: Sickle cell anaemia (SCA) is associated with significant morbidity and mortality linked to multi-systemic complications. With recent improvements in healthcare globally, it is expected that SCA patients in Nigeria will live longer. The cardiovascular complications may thus become prevalent. SUBJECTS AND METHODS: Fifty-two patients with sickle cell anemia in steady state and 52 controls were recruited. The assessment included history, physical examination, 12-lead resting electrocardiography, 2D, M-Mode and Doppler echocardiography, six-minute walk test and NTerminal pro Brain Natriuretic Peptide (NT-pro BNP) assay. RESULTS: The mean age of the sickle cell patients was 28.87±7.89 years and most were post-secondary or tertiary institutions. They had faster pulse rates (84.69±9.48 vs75.48±10.35 beats/minute, p=0.000), lower blood pressure (Systolic 112.56 ±10.87 mmHg vs 115.42 ± 14.75mmHg; Diastolic 70.79±9.03mmHg vs 71.27±9.23 mmHg) and lower Body Mass Index (21.55±3.51 vs 24.94±4.56kg/m2; p=0.000). Mean left ventricular (LV) internal diameters in systole and diastole were (3.19 ±0.57cm vs 2.81±0.45 cm; p=0.000) and (4.99±0.69cm vs 4.29±0.56 cm; p=0.00) respectively. Left and right ventricular systolic functions were normal. None of the patients with SCA met the criteria for pulmonary hypertension while 88.89% of those screened using Natriuretic peptide were at risk of developing pulmonary hypertension (NT-proBNP levels ≥ 160pg/ml). Functional status assessed by sixminute walk test was normal (373.00 ±60.40m vs 403.83±72.87 m; but significantly lower than in controls (p= 0.021). CONCLUSION: The cardiovascular system is adversely affected in persons with sickle cell anaemia especially as they grow older. Despite the presence of left ventricular remodeling, the patients with SCA in this study maintained good functional status. Regular cardiovascular assessment is advised.


CONTEXTE: La drépanocytose (SCA) est associée à une morbidité et une mortalité importantes liées à des complications multisystémiques. Avec les récentes améliorations des soins de santé dans le monde, on s'attend à ce que les patients atteints d'ACS au Nigeria vivent plus longtemps. Les complications cardiovasculaires pourraient donc devenir prévalentes. SUJETS ET MÉTHODES: Cinquante-deux patients atteints de drépanocytose à l'état d'équilibre et 52 témoins ont été recrutés. L'éva lua tion c om prena it l'histoire, l'exa m en physique, l'électrocardiographie de repos à 12 dérivations, l'échocardiographie 2D, M-Mode et Doppler, un test de marche de six minutes et un test d'apnée du sommeil. le dosage du NTerminal pro Brain Natriuretic Peptide (NT-pro BNP). RÉSULTATS: L'âge moyen des patients drépanocytaires était de 28,87±7,89 ans et la plupart étaient issus d'établissements post-secondaires ou tertiaires. Ils avaient un pouls plus rapides (84,69±9,48 vs75,48±10,35 battements/minute, p=0,000), une pression artérielle plus basse (Systolique 112,56 ±10,87 mmHg vs 115,42 ± 14,75 mmHg ; diastolique 70,79±9,03 mmHg vs 71,27±9,23 mmHg) et un indice de masse corporelle plus faible (21,55±3,51 vs 24,94±4,56kg/m2 ; p=0,000). Les diamètres internes moyens du ventricule gauche (VG) en systole et en diastole étaient de (3,19 ±0,57 cm vs 2,81±0,45 cm ; p=0,000) et (4,99±0,69 cm vs 4,29±0,56 cm ; p=0,00) respectivement. Les fonctions systoliques des ventricules gauche et droit étaient normales. Aucun des patients atteints d'ACS ne répondait aux critères d'hypertension pulmonaire, tandis que 88,89 % des patients dépistés à l'aide du peptide natriurétique étaient à risque de développer une hypertension pulmonaire(taux de NT-proBNP ≥160pg/ml). L'état fonctionnel évalué par le test de marche de six minutes était normal (373,00 ±60,40 m vs 403,83±72,87 m ; mais significativement plus faible que chez les témoins (p= 0,021). CONCLUSION: Le système cardiovasculaire est affecté de manière négative chez personnes atteintes de drépanocytose, en particulier lorsqu'elles vieillissent. Malgré la présence d'un remodelage ventriculaire gauche, les patients atteints d'ACS dans cette étude ont conservé un bon état fonctionnel. Une évaluation cardiovasculaire régulière est conseillée. MOTS CLÉS: Fonction ventriculaire, Drépanocytaires adultes, État d'équilibre, Hypertension pulmonaire.


Assuntos
Anemia Falciforme , Hipertensão Pulmonar , Adulto , Anemia Falciforme/complicações , Eletrocardiografia , Humanos , Hipertensão Pulmonar/complicações , Nigéria/epidemiologia , Sístole , Adulto Jovem
20.
Biomed Res Int ; 2022: 2766321, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36046449

RESUMO

Purpose: Single-period segmentation is one of the important steps in time-domain analysis of pulse signals, which is the basis of time-domain feature extraction. The existing single-period segmentation methods have the disadvantages of generalization, reliability, and robustness. Method: This paper proposed a period segmentation method of pulse signals based on long short-term memory (LSTM) network. The preprocessing was performed to remove noises and baseline drift of pulse signals. Thus, LabelMe was used to label each period of the pulse signals into two parts according to the location of the starting point of main wave and the dicrotic notch, and the dataset of the pulse signal period segmentation was established. Consequently, the labeled dataset was input into the LSTM for training and testing, and the results were compared with sum slope function method. Result: The remarkable result with the whole period segmentation accuracy of 92.8% was achieved for the segmentation of seven types of pulse signals. And the segmentation accuracies of the systolic phase, diastolic phase, and whole period using this method were higher than those of the sum slope function method. Conclusion: LSTM-based pulse signal segmentation method can achieve outstanding, robust, and reliable segmentation effects of the systolic phase, diastolic phase, and whole period of pulse signals. The research provides a new idea and method for the segmentation of pulse signals.


Assuntos
Memória de Curto Prazo , Punho , Frequência Cardíaca , Reprodutibilidade dos Testes , Sístole
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