scholarly journals Echocardiographic features of acute-phase microscopic polyangiitis in Japanese patients: A single-centre retrospective study

2021 ◽  
Author(s):  
Takashi Nawata ◽  
Natsu Kinoshita ◽  
Shinichi Okuda ◽  
Makoto Kubo ◽  
Yasuaki Wada ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Acute Phase ◽  
Microscopic Polyangiitis ◽  
Japanese Patients ◽  
Left Ventricular ◽  
Volume Index ◽  
Diastolic Filling ◽  
Single Centre ◽  
Venous Flow ◽  
Protein Levels

ABSTRACT Objectives Microscopic polyangiitis (MPA) affects various organs. However, echocardiographic findings of MPA are unclear. We aimed to evaluate the echocardiographic features of acute-phase MPA in Japanese patients. Methods This single-centre retrospective study included 15 patients with MPA who underwent echocardiography within 2 weeks of commencing steroid therapy for induction or reinduction. The echocardiography parameters of thetients were compared with those of 30 age- and sex-matched controls. Results No significant differences in left ventricular (LV) diameter, LV ejection fraction, or e’ were observed between the two groups. However, the MPA group showed a significantly higher left atrial (LA) diameter and LA volume index, as well as higher early diastolic filling velocity, diastolic pulmonary venous flow velocity, and trans-tricuspid pressure gradient, and a shorter deceleration time (DCT). Serum C-reactive protein levels were positively correlated with E wave, E/A, and DCT. These results may indicate that increased LV stiffness, rather than impairment of LV relaxation, contributed to LV diastolic function, resulting in LA enlargement. Conclusions Patients with acute-phase MPA had LA dilatation associated with LV diastolic dysfunction. This finding indicates the importance of cardiac assessment in patients with MPA, especially in patients with a strong inflammatory reaction.

Abstract 15545: Exercise-stress Real-time Cardiac Magnetic Resonance Imaging for Non-invasive Characterisation of Heart Failure With Preserved Ejection Fraction: The Hfpef Stress Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Soeren Jan Backhaus ◽  
Torben Lange ◽  
Elisabeth George ◽  
Kristian Hellenkamp ◽  
Roman Gertz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Real Time ◽  
Left Ventricular ◽  
Exercise Stress ◽  
Volume Index ◽  
Diastolic Filling ◽  
Preserved Ejection Fraction ◽  
Non Invasive

Introduction: Invasive right heart catherization (RHC) using exercise-stress is the reference-standard for the diagnosis of heart failure with preserved ejection fraction (HFpEF) but carries the risk of the procedure. Real-time cardiovascular magnetic resonance (RT-CMR) imaging allows bicycle exercise CMR with unprecedented temporal and spatial resolution and may represent a novel non-invasive alternative. Methods: The HFpEF stress trial (NCT03260621) prospectively included 75 patients with echocardiographic signs of diastolic dysfunction and dyspnoea on exertion (E/E’>8, NYHA≥II) who underwent echocardiography, RHC and RT-CMR at rest and exercise-stress. HFpEF was defined according to pulmonary capillary wedge pressure (PCWP ≥15mmHg at rest or ≥25mmHg during exercise stress). RT-CMR functional assessments included time-volume-curves for total and early (1/3) diastolic left ventricular (LV) filling or left atrial (LA) emptying and LV/LA long axis strain (LAS). Results: HFpEF patients (n=34, mean PCWP rest 13mmHg, stress 27mmHg) had higher E/e’ (12.5 vs 9.15), NT-proBNP (255 vs 75ng/l) and LA volume index (43.8 vs 36.2ml/m 2 ) compared to non-HFpEF patients (n=34, rest 8mmHg, stress 18mmHg, p≤0.001 for all). There were no differences in RT-CMR LV total and early diastolic filling at rest and during exercise-stress (p≥0.164). In contrast, RT-CMR revealed impaired stress LA total (p=0.033) and early (p<0.001) diastolic emptying in HFpEF. LA LAS was the only impaired parameter at rest (p<0.001) and emerged as the best predictor for the presence of HFpEF during exercise-stress testing (AUC rest 0.82 vs stress 0.93, p=0.029). Conclusions: RT-CMR allows highly accurate identification of HFpEF during physiological exercise and may establish itself as a novel non-invasive diagnostic alternative for routine clinical use.

scholarly journals Long-term Outcome and Efficacy of Cyclophosphamide Therapy in Japanese Patients with ANCA-associated Microscopic Polyangiitis: A Retrospective Study

2013 ◽  
Vol 52 (22) ◽  
pp. 2503-2509 ◽  
Author(s):  
Izaya Nakaya ◽  
Mayumi Yahata ◽  
Satoko Takahashi ◽  
Tomomi Sasajima ◽  
Tsutomu Sakuma ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Microscopic Polyangiitis ◽  
Japanese Patients ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cyclophosphamide Therapy

scholarly journals Comparison of renal response to four different induction therapies in Japanese patients with lupus nephritis class III or IV: A single-centre retrospective study

PLoS ONE ◽  
2017 ◽  
Vol 12 (4) ◽  
pp. e0175152 ◽  
Author(s):  
Hironari Hanaoka ◽  
Tomofumi Kiyokawa ◽  
Harunobu Iida ◽  
Kana Ishimori ◽  
Yukiko Takakuwa ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Lupus Nephritis ◽  
Japanese Patients ◽  
Class Iii ◽  
Single Centre ◽  
Renal Response

Changes in Pulmonary Venous Return during Head-up Tilting in Man

1997 ◽  
Vol 93 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Marco Guazzi ◽  
Gloria Tamborini ◽  
Anna Maltagliati
Keyword(s):  
Right Ventricular ◽  
Venous Return ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Diastolic Filling ◽  
Venous Flow ◽  
Pericardial Space ◽  
Pulmonary Venous Flow ◽  
Lung Compartment ◽  
Group 2

1. In a supine position, the heart fills to close to the limits of pericardial constraint and the pericardium may act to redistribute central blood volume from the left side of the heart back to the more compliant lung. 2. We probed whether, and through which mechanisms, a redistribution of blood from the lungs to the left heart occurs during vertical displacement and compensates for reduced venous return. 3. We investigated 16 normal volunteers with Doppler-echocardiography during 20°, 40° and 60° head-up tilting. Tilting was stopped at 10 min in 10 subjects (group 1) and at 45 min in 6 subjects (group 2). 4. At 10 min we observed a reduction in right ventricular diastolic dimension and left ventricular end-diastolic pressure, as estimated by the difference between the duration of the pulmonary venous flow during atrial contraction (Z wave) and that of the mitral A wave. We also recorded a decrease during systole (X wave) and an increase during diastole (Y wave) of the pulmonary venous forward flow velocity. These variations were evident at 20° and became progressively greater with increasing degrees of tilting. In group 2, changes at 10 min and at 45 min for any degree of displacement were similar. 5. A decrease in right ventricular dimensions (ventricular interdependence) and underfilling of the lung compartment due to volume redistribution to the periphery (diminished lung contribution to pericardial constraint) augment compliance within the pericardial space, reduce downstream pressure for pulmonary venous return and move the pulmonary venous flow predominantly to ventricular diastole, allowing diastolic filling. 6. During head-up tilting a favourable interaction between heart and lungs increases compliance within the pericardial space and facilitates redistribution of blood from the lungs, resulting in a sustained compensation for the reduced venous return.

scholarly journals Left Ventricular Hypertrophy Is Associated with Diastolic Filling Alterations in Normotensive Offspring of Hypertensive Nigerians

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
P. M. Kolo ◽  
E. O. Sanya ◽  
A. B. Omotoso ◽  
A. Soladoye ◽  
J. A. Ogunmodede
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Diastolic Filling ◽  
Venous Flow ◽  
Functional Changes ◽  
Pulmonary Venous Flow ◽  
Ventricular Diastolic Dysfunction

Contribution of left ventricular diastolic dysfunction to adverse events in patients with cardiovascular diseases is increasingly being recognized and individuals with pedigree for hypertension are thought to exhibit anatomic and or functional changes in their left ventricle before they become hypertensive. This study aimed at characterizing left ventricular diastolic function in normotensive offspring of hypertensive Nigerians. Sixty-five offspring of hypertensive parents aged 15–25 years (subjects) with 65-age and sex-matched offspring of normotensive parents (controls) were studied for early makers of hypertensive cardiovascular disease using Doppler echocardiogram. Mean mitral E velocity was reduced () in the subjects ( cm/s) compared with the controls ( cm/s). Similarly, mean S velocity of pulmonary venous flow was lower () in the subjects than in the controls. Left atrial dimension and mitral E/A ratio in the subjects with left ventricular hypertrophy were higher (, 0.004 respectively) than in the subjects without this abnormality. We concluded that normotensive offspring of hypertensive Nigerians showed early alterations in indexes of left ventricular diastolic filling and these abnormalities were exaggerated in the presence of left ventricular hypertrophy.

Real‐world effectiveness and safety of dupilumab for the treatment of atopic dermatitis in Japanese patients: a single‐centre retrospective study

2019 ◽  
Vol 181 (5) ◽  
pp. 1083-1085 ◽  
Author(s):  
H. Uchida ◽  
M. Kamata ◽  
I. Mizukawa ◽  
A. Watanabe ◽  
A. Agematsu ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Retrospective Study ◽  
Real World ◽  
Japanese Patients ◽  
Single Centre

Filling characteristics of left ventricle in newborn lambs

1995 ◽  
Vol 269 (6) ◽  
pp. H2039-H2043
Author(s):  
H. Velvis ◽  
H. S. Klopfenstein
Keyword(s):  
Mitral Valve ◽  
Stroke Volume Index ◽  
Left Ventricular ◽  
Volume Index ◽  
Diastolic Filling ◽  
Flow Transducer ◽  
Pressure Transducers ◽  
Valve Opening ◽  
Filling Characteristics ◽  
Lv Diastolic Function

An integral component of increased cardiac performance during the immediate newborn period is an increased rate of left ventricular (LV) filling. To determine the factors that facilitate increased LV filling in newborns, we compared filling characteristics in chronically instrumented awake newborn (7 +/- 2 days old) and older lambs (55 +/- 5 days old). The studies were performed 4 +/- 2 days after surgery, during which pressure transducers, dimension crystals, a flow transducer, and vascular occluders were placed. Newborn lambs had an increased cardiac index (247 +/- 40 vs. 127 +/- 48 ml.kg-1.min-1; P< 0.01) due to an increased heart rate (223 +/- 24 vs. 120 +/- 9 beats/min; P < 0.01) despite a similar stroke volume index (1.1 +/- 0.1 vs. 1.1 +/- 0.5 ml/kg; not significant). In newborn lambs, indexed mean LV filling rates were more than twofold higher (10.5 +/- 2.5 vs. 4.6 +/- 1.7 ml.kg-1.s-1; P <0.01), and a much greater percentage of filling occurred in the first 35 ms after mitral valve opening (52 +/- 7 vs. 23 +/- 8%; P < 0.01). In newborn lambs, early diastolic filling was facilitated by more rapid LV relaxation (tau: 17.2 +/- 2.2 vs. 23.3 +/- 1.2 ms; P < 0.01) and a higher left atrial (LA) pressure at the time of mitral valve opening (11.6 +/- 2.4 vs. 7.2 +/- 3.2 mmHg; P < 0.05). LV filling in newborn lambs also occurred at the expense of a higher mean LA pressure (8.4 +/- 2.4 vs. 5.1 +/- 2.6 mmHg; P < 0.05). These findings improve our understanding of LV diastolic function in newborns.

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