scholarly journals Longitudinal strain analysis allows the identification of subclinical deterioration of right ventricular function in patients with cancer therapy-related left ventricular dysfunction

Discoveries ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. e94
Author(s):  
Diana Alexandra Cherata ◽  
◽  
Ionut Donoiu ◽  
Rodica Diaconu ◽  
Adina Glodeanu ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Left Ventricular Dysfunction ◽  
Right Ventricular Function ◽  
Longitudinal Strain ◽  
Ventricular Dysfunction ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Patients With Cancer

The role of right ventricular function in paediatric idiopathic dilated cardiomyopathy

2012 ◽  
Vol 23 (3) ◽  
pp. 409-415 ◽  
Author(s):  
Abraham Groner ◽  
Jen Yau ◽  
Irene D. Lytrivi ◽  
H. Helen Ko ◽  
James C. Nielsen ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Left Ventricular Ejection ◽  
P Value

AbstractIntroductionThe prevalence of right ventricular dysfunction in idiopathic dilated cardiomyopathy is incompletely studied in children. Furthermore, right ventricular function may signal worse outcomes. We evaluated recently published right ventricular function echocardiographic indices in identifying dysfunction in children with idiopathic dilated cardiomyopathy and the impact of right ventricular dysfunction on long-term prognosis.MethodsA retrospective database review of right ventricular function indices in 30 patients with idiopathic dilated cardiomyopathy was compared with 60 age- and sex-matched controls from January, 2001 until December, 2010. Right ventricular function was assessed by Doppler tissue peak systolic S′, early and late diastolic E′ and A′ waves and isovolumic acceleration at the tricuspid valve annulus; pulsed wave Doppler tricuspid valve inflow E and A waves; right ventricular myocardial performance index; tricuspid annular plane systolic excursion; right ventricular fractional area change.ResultsRight ventricular systolic and diastolic function in idiopathic dilated cardiomyopathy was significantly impaired. All measured indices except for isovolumic acceleration and fractional area change were significantly reduced, with a p-value less than 0.05. There was no right ventricular index predictive of death or transplantation. Patients with poor outcome were significantly more likely to need inotropic support (p-value equal to 0.018), be placed on a ventricular assist device (p equal to 0.005), and have a worse left ventricular ejection fraction z-score (p-value equal to 0.002).ConclusionRight ventricular dysfunction is under-recognised in children presenting with idiopathic dilated cardiomyopathy. The need for clinical circulatory support and left ventricular ejection fraction z-score less than minus 8 were primary determinants of outcome, independent of the degree of derangement in right ventricular function.

Pre-bypass levosimendan in ventricular dysfunction-effect on right ventricle

2020 ◽  
pp. 021849232097289
Author(s):  
Dhanesh Kumar ◽  
Om Prakash Yadava ◽  
Vikas Ahlawat ◽  
Anirban Kundu ◽  
Amita Yadav ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Ventricular Dysfunction ◽  
Artery Bypass ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Severe Left Ventricular Dysfunction ◽  
Artery Disease

Background Levosimendan is an effective calcium sensitizer with complementary mechanisms of action: calcium sensitization and opening of adenosine triphosphate-dependent potassium channels, both on the sarcolemma of the smooth muscle cells in the vasculature and on the mitochondria of cardiomyocytes. Levosimendan has a long-acting metabolite with a half-life of approximately 80 h. There have been a few small studies on this drug regarding right ventricular function. In view of this, we investigated the effect of levosimendan on right ventricular function in patients with coronary artery disease. Methods This was a prospective, randomized, double-blind study on 50 patients with coronary artery disease and severe left ventricular dysfunction (left ventricular ejection fraction ≤35%) undergoing elective off-pump coronary artery bypass. Results Levosimendan had an inotropic effect on right ventricular myocardium and a vasodilatory effect on blood vessels. It caused a decline in pulmonary vascular resistance ( p < 0.018), right ventricular systolic pressure ( p < 0.001), and pulmonary artery systolic pressure ( p < 0.001), and improved right ventricular diastolic function as shown by the decrease in right ventricular Tei index ( p < 0.001), right ventricular end-diastolic pressure, and the ratio of early diastolic tricuspid inflow to tricuspid lateral annular velocity ( p < 0.006). However, we found no beneficial effects on intensive care unit or hospital stay ( p = 0.164, p = 0.349, respectively) nor a mortality benefit. Conclusions Levosimendan has salutary effects on right ventricular function in patients with severe left ventricular dysfunction undergoing coronary artery bypass, in terms of improved hemodynamic parameters.

scholarly journals P1282BODY COMPOSITION AND VENTRICULAR FUNCTION IN HEMODIALYSIS, CLOSED COMPARTMENTS?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Javier Carbayo ◽  
Soraya Abad Esttebanez ◽  
Eduardo Verde ◽  
Alejandra Muñoz de Morales ◽  
Ángela González-Rojas ◽  
...  
Keyword(s):  
Body Composition ◽  
Mortality Rate ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Volume Overload ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular

Abstract Background and Aims Right ventricular dysfunction is common among hemodialysis (HD) patients and it has been recently described as a marker of cardiovascular morbidity and mortality. Nevertheless, mechanisms responsible for have not been clearly elucidated. Volume overload, retrograde left ventricular dysfunction, pulmonary hypertension, left-right shunt and mineral bone disease have been related. Similarly, body composition and chronic fluid overload are closely linked to survival in dialysis patients. However, there are no data about correlation between body composition and echocardiographic parameters in previous studies The aim of this study was to assess the relationship between body composition and changes in right and left ventricular function in patients on maintenance hemodyalisis. Method We conducted a retrospective and longitudinal observational cohort study over a population of 78 patients on maintenance hemodyalisis at a single hospital. They were on chronic hemodyalisis program of three weekly sessions of 240 minutes duration. A transthoracic echocardiogram (TTE) and a bioimpedance (BI) were performed in the same month, in the first inter-dialysis day of the week, being the patients asymptomatic and clinically stable, at the beginning and at the end of the study. The follow-up time since the completion of first and second ETT and BI was 19.5 months, with an average total follow-up of 29.7 months. Cardiovascular and general mortality events were recorded during that period. Echocardiography data about cardiac cavities measurement, ventricular and valvular function was collected. Left ventricular ejection fraction was evaluated by Simpson’s method (LVEF, %) and right ventricular function by tricuspid annular plane systolic excursion (TAPSE, mm).We gathered information about fluid status and corporal composition. Statistical analysis was performed using SPSS Statistics, version 21 (SPSS, Inc., Chicago, IL, USA). Results Patients with RV dysfunction (35.7%), determined as TAPSE &lt; 20, experienced a higher mortality rate (20%) compared to those who maintained TAPSE ≥ 20 (63.2%), who had a mortality rate of 2.3%. These results were statistically significant in the Kaplan-Meier survival analysis (Log Rank 6.65; p = 0.010). There were not statistically significant differences regarding age, diabetes, years on dialysis and status of volume overload between patients with and without right ventricular dysfunction. No significant differences were found between any other of the echocardiography parameters and overall mortality. Equally, neither bioimpedance measure at the beginning of the study was associated with mortality. Patients who had an FTI above the average (9.20 kg / m2) suffered a greater fall in TAPSE (-1 ± 4.3 mm) (p = 0.032) and LVEF (-4.2 ± 6.8) (p = 0.045), regarding those with lower FTI: TAPSE +2.3 ± 4.3 and LVEF +3.7± 10.4. These results seems to be related to a disproportionate LTI/LTI index rather than a greater total mass of fat due to patients with FTI &gt; 9.2 kg/m2 had a mean LTI/FTI index of 1.1, meanwhile those with FTI &lt; 9.2 kg/m2 a mean LTI/FTI of 5.9. No statistically significant relationship was found with absolute or relative volume overload, nor with changes in them over time. Conclusion The results presented suggest that high fat tissue index, and an underlying lower LTI/FTI index, could be associated with a higher risk of right and left ventricular dysfunction, which has been associated with higher mortality in hemodialysis patients.

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