scholarly journals Analyses for Prevalence and Outcome of Tricuspid Regurgitation in China: An Echocardiography Study of 134,874 Patients

Cardiology ◽  
2019 ◽  
Vol 142 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Lifan Yang ◽  
Haiyan Chen ◽  
Wenzhi Pan ◽  
Lihua Guan ◽  
Xiaochun Zhang ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Tricuspid Regurgitation ◽  
Odds Ratio ◽  
Survival Rates ◽  
Positive Association ◽  
Pulmonary Artery Hypertension ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Heart Center

Background: The aim of this study is to investigate the prevalence and outcome of tricuspid regurgitation (TR) in the Chinese population. Methods: The echocardiography database, including 134,874 patients at our heart center from 2010 to 2012, was retrospectively analyzed. Results: The rates of mild, moderate, and severe TR were 2.96, 2.22, and 1.39%, respectively. Of these patients, 4.86% had primary TR, 91.41% had functional TR, and 3.73% had unexplained TR. The rate of TR was increased in elders (odds ratio: 1.038 for 1 year’s increment; 95% confidence interval: 1.037–1.040; p < 0.001) and females (odds ratio: 1.386; 95% confidence interval: 1.327–1.448, p < 0.001). The major etiologies of TR were left-sided valve heart disease (VHD) and dilated cardiomyopathy. The survival rate of severe TR patients with pulmonary artery hypertension (PAH) was lower than in those without PAH (p < 0.0001). There was a positive association between the prevalence of TR and impaired left ventricular ejection fraction. Compared to the non-left-sided VHD group, the left-sided VHD group had a better prognosis among severe TR patients. The 5-year survival rates were 79.69, 71.12, and 77.01% in the groups of left-sided VHD, non-left-sided VHD, and all patients. Conclusions: Patients with severe TR have a bad prognosis, especially those with non-left-sided VHD and those with PAH.

Efficacy of Vitamin D on Chronic Heart Failure Among Adults

2020 ◽  
Vol 90 (1-2) ◽  
pp. 49-58 ◽  
Author(s):  
Wang Chunbin ◽  
Wang Han ◽  
Cai Lin
Keyword(s):  
Heart Failure ◽  
Vitamin D ◽  
Chronic Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Confidence Interval ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Controlled Trials ◽  
Ventricular Ejection Fraction ◽  
Randomized Controlled

Abstract. Vitamin D deficiency commonly occurs in chronic heart failure. Whether additional vitamin D supplementation can be beneficial to adults with chronic heart failure remains unclear. We conducted a meta-analysis to derive a more precise estimation. PubMed, Embase, and Cochrane databases were searched on September 8, 2016. Seven randomized controlled trials that investigated the effects of vitamin D on cardiovascular outcomes in adults with chronic heart failure, and comprised 592 patients, were included in the analysis. Compared to placebo, vitamin D, at doses ranging from 2,000 IU/day to 50,000 IU/week, could not improve left ventricular ejection fraction (Weighted mean difference, WMD = 3.31, 95% confidence interval, CL = −0.93 to 7.55, P < 0.001, I2 = 92.1%); it also exerts no beneficial effects on the 6 minute walk distance (WMD = 18.84, 95% CL = −24.85 to 62.52, P = 0.276, I2 = 22.4%) and natriuretic peptide (Standardized mean difference, SMD = −0.39, 95% confidence interval CL = −0.48 to 0.69, P < 0.001, I2 = 92.4%). However, a dose-response analysis from two studies demonstrated an improved left ventricular ejection fraction with vitamin D at a dose of 4,000 IU/day (WMD = 6.58, 95% confidence interval CL = −4.04 to 9.13, P = 0.134, I2 = 55.4%). The results showed that high dose vitamin D treatment could potentially benefit adults with chronic heart failure, but more randomized controlled trials are required to confirm this result.

scholarly journals Baseline global longitudinal strain predictive of anthracycline-induced cardiotoxicity

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Raquel Araujo-Gutierrez ◽  
Kalyan R. Chitturi ◽  
Jiaqiong Xu ◽  
Yuanchen Wang ◽  
Elizabeth Kinder ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Therapy ◽  
Confidence Interval ◽  
Longitudinal Strain ◽  
Proportional Hazards ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Cox Proportional Hazards ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Abstract Background Cancer therapy-related cardiac dysfunction (CTRD) is a major source of morbidity and mortality in long-term cancer survivors. Decreased GLS predicts decreased left ventricular ejection fraction (LVEF) in patients receiving anthracyclines, but knowledge regarding the clinical utility of baseline GLS in patients at low-risk of (CTRD) is limited. Objectives The purpose of this study was to investigate whether baseline echocardiographic assessment of global longitudinal strain (GLS) before treatment with anthracyclines is predictive of (CTRD) in a broad cohort of patients with normal baseline LVEF. Methods Study participants comprised 188 patients at a single institution who underwent baseline 2-dimensional (2D) speckle-tracking echocardiography before treatment with anthracyclines and at least one follow-up echocardiogram 3 months after chemotherapy initiation. Patients with a baseline LVEF <55% were excluded from the analysis. The primary endpoint, (CTRD), was defined as an absolute decline in LVEF > 10% from baseline and an overall reduced LVEF <50%. Potential and known risk factors were evaluated using univariable and multivariable Cox proportional hazards regression analysis. Results Twenty-three patients (12.23%) developed (CTRD). Among patients with (CTRD), the mean GLS was -17.51% ± 2.77%. The optimal cutoff point for (CTRD) was -18.05%. The sensitivity was 0.70 and specificity was 0.70. The area under ROC curve was 0.70. After adjustment for cardiovascular and cancer therapy related risk factors, GLS or decreased baseline GLS ≥-18% was predictive of (CTRD) (adjusted hazards ratio 1.17, 95% confidence interval 1.00, 1.36; p = 0.044 for GLS, or hazards ratio 3.54; 95% confidence interval 1.34, 9.35; p = 0.011 for decreased GLS), along with history of tobacco use, pre-chemotherapy systolic blood pressure, and cumulative anthracycline dose. Conclusions Baseline GLS or decreased baseline GLS was predictive of (CTRD) before anthracycline treatment in a cohort of cancer patients with a normal baseline LVEF. This data supports the implementation of strain-protocol echocardiography in cardio-oncology practice for identifying and monitoring patients who are at elevated risk of (CTRD).

Clinical staging versus laparotomy and combined modality with MOPP versus ABVD in early-stage Hodgkin's disease: the H6 twin randomized trials from the European Organization for Research and Treatment of Cancer Lymphoma Cooperative Group.

1993 ◽  
Vol 11 (11) ◽  
pp. 2258-2272 ◽  
Author(s):  
P Carde ◽  
A Hagenbeek ◽  
M Hayat ◽  
M Monconduit ◽  
J Thomas ◽  
...  
Keyword(s):  
Early Stage ◽  
Survival Rates ◽  
Left Ventricular ◽  
Clinical Staging ◽  
Left Ventricular Ejection ◽  
Tumor Control ◽  
European Organization ◽  
Ventricular Ejection Fraction ◽  
Staging Laparotomy ◽  
Negative Laparotomy

PURPOSE To compare (1) clinical staging and irradiation alone versus staging laparotomy and treatment adaptation in patients with a favorable prognosis (H6F); (2) two combined modalities in patients with an unfavorable prognosis (H6U). PATIENTS AND METHODS The H6F trial (n = 262) consisted of randomization to clinical staging plus subtotal nodal irradiation (STNI) or to staging laparotomy plus treatment adaptation (adjuvant chemotherapy [CT] only in the 33% with negative laparotomy). The H6U trial (n = 316) consisted of no laparotomy, randomization to mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) or doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), and mantle irradiation. RESULTS In the H6F trial, 6-year freedom from progression (FFP) rates (78% v 83%; P = .27) were similar in clinical and laparotomy stagings, respectively. Survival rates were 93% and 89%, due to laparotomy-related deaths. In the H6U trial, the ABVD arm had superior results (6-year FFP rate, 88% v 76%; P = .01), but they were not significant for survival (91% v 85%; P = .22). CT discontinuation due to hematologic intolerance occurred more often with MOPP (14.5% v 7.3%). Decrease of the pulmonary vital capacity ([VC] < 70% of the theoretic value) was observed more frequently after ABVD than after MOPP (12% v 2%; P = .08), with two lethal pulmonary insufficiencies occurring in the ABVD arm. No modification of the isotopic left ventricular ejection fraction (LVEF) occurred. Gonadal toxicity was less in the ABVD arm. CONCLUSION Early-stage patients benefit from treatment adaptation to initial characteristics in terms of tumor control and late toxicities. Staging laparotomy before STNI may be deleted even in favorable patients at no cost to survival or FFP. In unfavorable patients, ABVD achieved better results than MOPP, at lower hematologic and gonadal cost. Therefore, despite its pulmonary toxicity, ABVD is the best choice to design improved CT regimens associated with mantle irradiation.

scholarly journals Antibody-mediated rejection with detection of de novo donor-specific anti-human leucocyte antigen Class II antibodies 3 years after heart transplantation: a case report

2020 ◽  
Vol 4 (1) ◽  
pp. 1-4
Author(s):  
Bernd Ludwig ◽  
Johanna Schneider ◽  
Daniela Föll ◽  
Qian Zhou
Keyword(s):  
Heart Transplantation ◽  
De Novo ◽  
Survival Rates ◽  
Graft Function ◽  
Left Ventricular ◽  
Cardiac Allograft ◽  
Left Ventricular Ejection ◽  
High Dose ◽  
Ventricular Ejection Fraction ◽  
Antibody Mediated Rejection

Abstract Background Antibody-mediated rejection (AMR) in cardiac transplantation may manifest early within the first weeks after transplantation but also late after months to years following transplantation resulting in mild heart failure to cardiogenic shock. While patients with early cardiac AMR are less affected and seem to have survival rates comparable to transplant recipients without AMR, late cardiac AMR is frequently associated with graft dysfunction, fulminant forms of cardiac allograft vasculopathy, and a high mortality rate. Nevertheless, AMR of cardiac allografts remains difficult to diagnose and to treat. Case summary We report the case of a 47-year-old male patient with late AMR of the cardiac allograft 3 years after heart transplantation. Antibody-mediated rejection was confirmed by endomyocardial biopsy and the presence of donor-specific antibodies (DSA). The patient was treated with high dose of prednisolone, plasmapheresis, intravenous Gamma Globulin, rituximab, immunoadsorption, and bortezomib. Under this treatment regimen left ventricular ejection fraction and pro B-type natriuretic peptide recovered, and the patient improved to New York Heart Association Class I. Currently, 3 years after the diagnosis of cardiac AMR, graft function continues to be nearly normal, and there is no evidence for transplant vasculopathy. Discussion This case illustrates that AMR can occur at any time after transplantation. Although graft function fully recovered after treatment in our patient, the level of DSA remained high, suggesting that DSA may not be a reliable parameter to determine the intensity and duration of the therapy.

scholarly journals Exercise Interventions and Cardiovascular Health in Childhood Cancer: A Meta-analysis

2020 ◽  
Vol 41 (03) ◽  
pp. 141-153 ◽  
Author(s):  
Javier S. Morales ◽  
Pedro L. Valenzuela ◽  
Alba M. Herrera-Olivares ◽  
Antonio Baño-Rodrigo ◽  
Adrián Castillo-García ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Meta Analysis ◽  
Childhood Cancer Survivors ◽  
Left Ventricular ◽  
Mean Difference ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Exercise Interventions

AbstractThis study analyzed the effects of physical exercise interventions on cardiovascular endpoints in childhood cancer survivors. Relevant articles were systematically searched in PubMed, CINAHL, and Web of Science databases (since inception to 11th September 2019). We performed a meta-analysis (random effects) to determine the mean difference (expressed together with 95% confidence intervals) between pre- and post-intervention values for those cardiovascular endpoints reported in more than three studies. Twenty-seven studies (of which 16 were controlled studies) comprising 697 participants were included. Only three studies reported adverse events related to exercise interventions. Exercise resulted in an increased performance on the 6-minute walk distance test (mean difference=111 m, 95% confidence interval=39–183, p=0.003) and a non-significant trend (mean difference=1.97 ml∙kg−1∙min−1, 95% confidence interval=−0.12–4.06, p=0.065) for improvement in peak oxygen uptake. Furthermore, left ventricular ejection fraction was preserved after exercise interventions (mean difference=0.29%, 95% confidence interval=−1.41–1.99, p=0.738). In summary, exercise interventions might exert a cardioprotective effect in childhood cancer survivors by improving – or attenuating the decline of – physical capacity and cardiovascular function. Further studies, particularly randomized controlled trials, are needed to confirm these benefits.

Effect of Donor Selection on the Early Outcome of Heart Transplant Recipients

2005 ◽  
Vol 15 (1) ◽  
pp. 24-26 ◽  
Author(s):  
Alexia Michaelides ◽  
Willie Koen
Keyword(s):  
Ejection Fraction ◽  
Survival Rates ◽  
Left Ventricular ◽  
Permanent Pacemaker ◽  
Inotropic Support ◽  
Left Ventricular Ejection ◽  
Donor Age ◽  
Ventricular Ejection Fraction ◽  
Ischemic Time ◽  
Cold Ischemic Time

Recipients receiving heart transplants from 83 donors from 1995 to 2002 were analyzed to evaluate the effect of various donor factors on recipient outcomes. The 83 donors (13 women and 70 men; 2–51 years old) had cold ischemic times ranging between 55 and 287 minutes. Donor age, cause of death, inotropic support, and cold ischemic times of the hearts were compared to 1-year left ventricular ejection fraction, permanent pacemaker dependency, 30-day mortality, and 1-year survival in the recipients. Donors receiving low-dose inotropic support resulted in recipients with permanent pacemaker dependency in 14.8%, and 30-day mortality and 1-year survival rates of 7.4% and 70.3%, respectively. Donors not receiving inotropic support resulted in recipients with permanent pacemaker dependency in 3.5%, and 30-day mortality and 1-year survival of 3.5% and 83.9%, respectively. Cold ischemic times less than or equal to 120 minutes showed 30-day mortality and 1-year survival rates of 0% and 90.9%, respectively. Cold ischemic times equal to or more than 121 minutes showed 30-day mortality and 1-year survival rates of 8% and 76%, respectively. Increased donor age ( P=.22) and cold ischemic time showed an increase in mortality without affecting mean ejection fraction in survivors. Use of inotropic support in donors ( P=.95) showed an increase in mortality without affecting mean ejection fraction in survivors.

scholarly journals Amiodarone-Induced Thyrotoxicosis Is a Predictor of Adverse Cardiovascular Outcome

2009 ◽  
Vol 94 (1) ◽  
pp. 109-114 ◽  
Author(s):  
Kai-Hang Yiu ◽  
Man-Hong Jim ◽  
Chung-Wah Siu ◽  
Chi-Ho Lee ◽  
Michele Yuen ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Cardiovascular Events ◽  
Ventricular Arrhythmias ◽  
Clinical Characteristics ◽  
Left Ventricular ◽  
Hazard Ratio ◽  
Left Ventricular Ejection ◽  
Amiodarone Therapy ◽  
Ventricular Ejection Fraction ◽  
Increased Risk

Abstract Background: Amiodarone-induced thyrotoxicosis (AIT) is a clinical condition that is notoriously difficult to manage; the relative risk of adverse cardiovascular events in these patients compared with euthyroid patients is largely unknown. Objective: We compared the clinical characteristics and major adverse cardiovascular events (MACE) in AIT and euthyroid patients. Method: Patients at a tertiary referral center who had been prescribed amiodarone for at least 3 months were retrospectively analyzed. Baseline clinical characteristics, laboratory parameters, and outcome events were evaluated. MACE was defined as cardiovascular mortality, myocardial infarction, stroke and heart failure, or ventricular arrhythmias that required hospitalization. Results: A total of 354 patients (61.8 ± 14.1 yr; 64.7% male) with a mean follow-up of 48.6 ± 26.7 months were studied. AIT, euthyroid status, and amiodarone-induced hypothyroidism were identified in 57 (16.1%), 224 (63.3%), and 73 (20.6%) patients, respectively. No differences in baseline clinical characteristics were observed between AIT and euthyroid patients. Nonetheless AIT patients demonstrated a higher MACE rate (31.6 vs. 10.7%, P &lt; 0.01), mostly driven by a higher rate of ventricular arrhythmias that required admission (7.0 vs. 1.3%, P = 0.03). Cox-regression multivariate analysis revealed that AIT (hazard ratio 2.68; confidence interval 1.53–4.68; P &lt; 0.01) and left ventricular ejection fraction less than 45% (hazard ratio 2.52; confidence interval 1.43–4.42; P &lt; 0.01) were independent predictors of MACE. Conclusion: In patients prescribed long-term amiodarone therapy, occurrence of AIT is associated with a 2.7-fold increased risk of MACE. Regular and close biochemical surveillance is thus advisable to identify and treat this high-risk group of patients.

scholarly journals Prognostic value of MELD-XI score in patients referring to the emergency department with acute ST elevation myocardial infarction

2020 ◽  
pp. 102490792090419
Author(s):  
Olgun Çelik ◽  
Orçun Çiftci ◽  
İbrahim Haldun Müderrisoğlu
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Confidence Interval ◽  
Hospital Mortality ◽  
Odds Ratio ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Left Ventricular Ejection ◽  
Operating Characteristics ◽  
St Elevation

Objective: We aimed to evaluate Model for End-stage Liver Disease excluding international normalized ratio (MELD-XI) score for prediction of 30-day in-hospital mortality in a cohort of patients with ST elevation myocardial infarction. Methods: The medical records of a total of 256 patients admitted with ST elevation myocardial infarction to the emergency department between January 2015 and January 2019 were retrospectively reviewed. A total of 111 patients were found eligible for the study. MELD-XI score was analyzed and compared on the basis of survival status. Results: A total of 111 patients with a mean age of 62.5 ± 2.55 years were included in the study. In total, 81% (n = 90) of the patients were male and 19% (n = 21) were female. The mean MELD-XI score of the patients was 10.1 ± 1.1. A total of 12 patients (12.9%) died within 30 days after hospitalization. The median MELD-XI score of the patients who died in the hospital was significantly higher than the patients survived (11.0 (10.5–11.6) vs 9.5 (9.4–13.8); p < 0.01). However, Gensini score was not significantly different between the surviving and deceased patients (p > 0.05). MELD-XI score was significantly correlated to left ventricular ejection fraction (r = −232, p < 0.01), and both parameters and age were significant independent predictors of in-hospital mortality (odds ratio: 1.73, 95% confidence interval: 1.25–2.39, p < 0.05; odds ratio: 0.89, 95% confidence interval: 0.81–0.99, p < 0.05; and odds ratio: 1.07, 95% confidence interval: 0.99–1.15, p < 0.05, respectively). A MELD-XI cut-off point of 10 had a sensitivity of 100% and a specificity of 78.8% for in-hospital mortality (area under receiver operating characteristics curve: 0.92, 95% confidence interval: 0.87–0.97, p < 0.05). A survival analysis based on a MELD-XI threshold of 10 revealed that the patients in the high-MELD-XI group had a significantly worse in-hospital survival (log rank test p < 0.001). Conclusion: MELD-XI score is a useful tool for in-hospital mortality prediction in patients referring to emergency medicine with acute ST elevation myocardial infarction.

scholarly journals Long-term outcomes of pericardial strip versus prosthetic ring annuloplasty for secondary tricuspid regurgitation by a minimally invasive approach

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Giuseppe Nasso ◽  
Nicola Di Bari ◽  
Giuseppe Santarpino ◽  
Marco Moscarelli ◽  
Mario Siro Brigiani ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Tricuspid Regurgitation ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Minimally Invasive Approach ◽  
Ventricular Ejection Fraction ◽  
Invasive Approach ◽  
Functional Tricuspid Regurgitation ◽  
Prosthetic Ring

Abstract Background This study was conducted to compare the outcomes of prosthetic ring versus autologous pericardial strip for the treatment of functional tricuspid regurgitation during left-sided valve surgery by minimally invasive approach. Methods From January 2008 and July 2016, autologous pericardial strip (group P-TAP) was used in 109 patients, and prosthetic ring (group R-TAP) in 115 patients. The primary outcomes were long-term overall survival, development of patch degeneration, and significant tricuspid regurgitation recurrence. The second outcome was the assessment of right ventricular functional parameters. Results Operative mortality was 1 case (0.9%) in the R-TAP group. At the time of hospital discharge only one patient (0.9%) in the R-TAP group had grade III+ tricuspid regurgitation, and none had grade IV+. Mean follow-up was 94.1 ± 24.5 months. Mild and moderate tricuspid regurgitation recurrence was 3.7% and 4.5% (P-TAP vs. R-TAP groups, p = 0.99). Severe regurgitation was observed in 1.8% of cases only in the R-TAP group (p = 0.49). There were no reoperations. Late mortality was 3.7% and 5.4% (P-TAP vs. R-TAP groups, p = 0.75). Freedom from death, all causes, were comparable among groups (log-rank p = 0.45). There were no statistically significant differences between two groups in TAPSE, left ventricular end-diastolic diameter, left ventricular ejection fraction, and left atrial diameter. Conclusions Tricuspid annuloplasty using an autologous pericardial strip in patients undergoing minimally invasive surgery is associated to similar long results (survival, late tricuspid regurgitation, and functional echocardiographic parameters) than annuloplasty with a prosthetic ring. In particular, the pericardial strip over time does not develop any degeneration or retraction.

Sign in / Sign up

Export Citation Format

Share Document