scholarly journals The functional state of the heart in women prior to extracorporeal fertilization and its dynamics after stimulation of superovulation

2020 ◽  
Vol 10 (6) ◽  
pp. 59-65
Author(s):  
Victoria V. Vakareva ◽  
Marina V. Avdeeva ◽  
Larisa V. Scheglova ◽  
Varvara V. Popova ◽  
Pavel B. Voronkov
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Functional State ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Healthy Women ◽  
Myocardial Stress ◽  
Before And After

The purpose of the work to study echocardiographic parameters before and after the induction of superovulation to determine the nature of the effect of extracorporeal fertilization on the functional state of the cardiovascular system in healthy women of reproductive age. Materials and methods. The article presents the results of clinical and instrumental examination of 80 practically healthy women (mean age 32.3 3.5 years). All women were examined twice before and after induction of superovulation during extracorporeal fertilization. Results. It was established that a decrease in the stroke volume of blood (p 0.001) was accompanied by a compensatory increase in heart rate (p 0.001). These changes ensured the stability of the minute blood volume after induction of superovulation (before 51.1 1.1 ml; after 52.1 1.2 ml; p 0.05). After induction of superovulation in women, an increase in the integral systolic index of cardiac remodeling was noted (before 108.7 2.5 units; after 118.5 4.7 units; p 0.001), an indicator of myocardial stress in systole (before 111.5 6.7 dyne/cm2; after 127.3 7.4 dyne/cm2; p 0.001) and the indicator of myocardial stress in diastole (before 139.4 6.8 dyne/cm2; after 165.7 7.9 dyne/cm2; p 0.001). In practically healthy women, after induction of superovulation, the left ventricular ejection fraction increased (before 71.3 4.2%; after 74.8 4.1%; p 0.001). The revealed dynamics is regarded as a response of the myocardium to a change in the hormonal background during superovulation induction. This is evidenced by the correlation between the estradiol level and the left ventricular ejection fraction (r = 0.36; p 0.05). Conclusion. Induction of superovulation does not adversely affect systolic and diastolic function of the left ventricle. However, after these manipulations there is an increase in systolic and diastolic myocardial stress, which reflects myocardial stress in response to hemodynamic changes. Remodeling indices are more informative for evaluating maladaptive and adaptive variants of myocardial changes in healthy women than traditional echocardiographic indicators. In this regard, remodeling indices should be used as additional indicators of the functional state of the heart in women before and after the induction of superovulation in vitro fertilization.

scholarly journals Statin use can attenuate the decline in left ventricular ejection fraction during the cardiotoxic chemotherapy: a systemic review and meta-analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Kim ◽  
K Miyazaki
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Meta Analysis ◽  
Intervention Group ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Before And After

Abstract Background Antineoplastic medications such as anthracyclines and trastuzumab are effective in treating various hematologic and solid organ malignancies, however an increased risk of cardiotoxicity in patients has been reported. A decline in left ventricular ejection fraction (LVEF) is a common finding in chemotherapy-induced cardiomyopathy and is sometimes irreversible and lethal. Several agents such as beta blockers and angiotensin-converting enzyme (ACE) inhibitors have shown to reduce the chemotherapy-induced cardiotoxicity in cancer patients. The use of statins, however, to prevent chemotherapy-related cardiotoxicity is not as well studied as other cardioprotective agents. In this study, we aimed to investigate the difference in the degree of decline in the LVEF in patients who received concurrent statin during the chemotherapy compared to those who received chemotherapy alone. Methods A systematic search of MEDLINE and EMBASE databases was performed from inception to March 2021 for studies that reported the mean LVEF before and after chemotherapy in patients who received concurrent statin therapy and those who did not receive statin along with the chemotherapy. A random effects meta-analysis was performed to obtain the pooled WMD of LVEF between the intervention (statin with chemotherapy) and the control group (chemotherapy alone) before and after chemotherapy treatments using STATA 16. Results Four studies with a total of 297 patients were included in this meta-analysis. Of the 297 patients, 115 patients were in the intervention group and received statin with chemotherapy, while 182 patients were in the control group and received chemotherapy alone. Baseline mean LVEF had no statistically significant difference between the intervention (statin) and the control (no statin) group, and the WMD was −0.38% (95% CI: −1.27 to 0.51, p=0.342). Upon follow-up, the control group patients showed a significantly greater decline in LVEF, with WMD of −6.08% (95% CI: −8.55 to −3.61, p=0.013), compared to the intervention group. Conclusion Patients who did not receive statin during the chemotherapy period had a greater mean decline in LVEF from baseline compared to that of the control group after the chemotherapy treatments. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Radiofrequency Ablation Impact on the Morpho-Functional State of the Heart in Patients with Atrial Fibrillation and Chronic Heart Failure

2021 ◽  
Vol 6 (5) ◽  
pp. 169-177
Author(s):  
T. V. Zolotarova ◽  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Functional State ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

The purpose of the study was to evaluate the radiofrequency ablation impact on the morpho-functional state of the heart in patients with atrial fibrillation and chronic heart failure with preserved ejection fraction based on 2-year follow-up. Materials and methods. The study included 194 patients with an average age of 59.3±8.5 years with atrial fibrillation and concomitant heart failure with preserved left ventricular ejection fraction of I-III functional class of New York Heart Association. Patients were divided into 2 groups: 136 patients who underwent radiofrequency catheter ablation and 58 patients in the control group who did not undergo intervention and continued antiarrhythmic pharmacotherapy. Patients were comparable in terms of basic clinical and demographic indicators. In order to assess the morpho-functional state of the heart, transthoracic echocardiography was performed at the stage of inclusion in the study and 2 years after. Results and discussion. According to the results of the analysis in the radiofrequency catheter ablation group 2 years after the intervention revealed: a statistically significant decrease in the mean end-systolic diameter of the left ventricle (3.3±0.48 cm versus 3.2±0.41cm, p <0.001); decreased size of the left atrium (4.3±0.71 cm versus 4.2±0.30 cm, p <0.001); left ventricular ejection fraction increased significantly (61.9±7.14% versus 63.9±5.65%, p <0.001); the E/e' ratio decreased statistically significantly (11.9±1.65 versus 9.4±1.48; p <0.001) and the left ventricular myocardial mass index (118.3±25.04 g/m2 versus 116.4±18.04 g/m2; p=0.045). In the pharmacotherapy group there were: a statistically significant increase in the average end-systolic size of the left ventricle (3.61±0.45 cm versus 3.63±0.41, p=0.007); statistically significant increased left atrium (4.3±0.61 cm versus 4.4±0.36; p <0.001) and the right atrium (4.1±0.52 cm versus 4.2±0.26; p <0.001); decreased left ventricular ejection fraction (58.1±6.12% versus 56.6±6.11; p <0.001); increased values of the ratio E/e' (12.1±1.63 versus 12.7±1.27; p=0.002) and decreased level of the left ventricular myocardial mass index (120.5±24.05 g/m2 versus 118.3±20.13 g/m2; p=0.044). Conclusion. Radiofrequency ablation of atrial fibrillation in patients with heart failure with preserved left ventricular ejection fraction to control sinus rhythm is associated with improved morpho-functional state of the heart at the 2-year follow-up compared with antiarrhythmic pharmacotherapy strategy: the left ventricular ejection fraction increases, the left ventricular diastolic function improves according to the E/e' value, the size of the left atrium decreases

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