scholarly journals The assessment of diastolic function in patients with rheumatoid arthritis

2009 ◽  
Vol 62 (11-12) ◽  
pp. 522-528 ◽  
Author(s):  
Biljana Obradovic-Tomasevic ◽  
Nada Vujasinovic-Stupar ◽  
Ratko Tomasevic
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Diastolic Function ◽  
Clinical Signs ◽  
Clinical Findings ◽  
Mortality And Morbidity ◽  
Echocardiographic Examination ◽  
Population Mortality ◽  
High Level

Introduction. Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune chronic disease. In comparison with the overall population, mortality and morbidity of RA patients are increased due to cardiovascular diseases. There is increasing evidence that autoimmunity mechanisms are included in pathogenesis of cardiovascular diseases. Isolated disorder of diastolic function can, even with normal heart contractility, lead to heart failure. The aim of this study was to assess diastolic function in RA patients and determine factors causing diastolic dysfunction. Material and methods. The study included 88 patients with RA treated at Rheumatology Department, Clinical Hospital Centre, Zemun. All the patients were thoroughly examined (clinical findings, laboratory and echocardiographic examination). All parameters of diastolic function (mitral and pulmonary flow) were measured. Results. In RA patients 98,9% had diastolic function disorder. This parameter had been changed prior to clinical signs of heart failure and decrease of ejection fraction. Indicators of diastolic function, velocities E, A and their ratio VE/VA, as well as velocities S, D and their ratio VS/VD were lower in patients with positive rheumatoid factor. The patients' age (p<0.01), duration of the disease (p<0.05), high level of cholesterol (p<0.05), triglycerides (p<0.05) and arterial hypertension (p<0.05) were significant factors considerably affecting diastolic function. Conclusion. These findings suggest subclinical myocardial disorder in a great number of RA patients. Apart from early and aggressive treatment of the chronic inflammatory process, it is also necessary to prevent further heart complications by timely recognition and treatment of 'standard' risk factors for cardiovascular diseases.

scholarly journals New risk factors for cardiovascular diseases in patients with rheumatoid arthritis

2008 ◽  
Vol 61 (11-12) ◽  
pp. 601-606 ◽  
Author(s):  
Biljana Obradovic-Tomasevic ◽  
Nada Vujasinovic-Stupar ◽  
Ratko Tomasevic
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Epidemiologic Studies ◽  
Clinical Findings ◽  
Continuous Exposure ◽  
Echocardiographic Examination ◽  
The Mean ◽  
Hs Crp ◽  
Hospital Center

Introduction In the last three decades numerous epidemiologic studies have shown the correlation between risk factors and cardiovascular diseases. Clinical research has proven that rheumatoid arthritis patients (RA) have higher prevalence of classical risk factors in relation to general population, and over the last few years there has been an emphasis on some new risk factors which can contribute to cardiovascular diseases (CVD). Material and methods This study examined risk factor values for CVD in 88 patients with RA treated at Rheumatology Department, Clinical Hospital Center, Zemun. All patients have been thoroughly examined (clinical findings, laboratory and echocardiographic examination). Apart from classical factors, 'new' risk factors have been examined in all patients: C-reactive proteine (CRP), high-sensitive C-reactive proteine (hs-CRP) and homocystein. Results It has been determined that RA patients have more frequent higher new risk factors in comparison to classical ones. 84.1% of patients had higher CRP values, 97.1% had hsCRP and 39.5% had homocystein. The mean CRP values, especially hsCRP have been higher in patients with positive rheumatoid factor finding. Discussion Rheumatoid arthritis patients may have worse 'background atherosclerosis' than even subjects matched for classical cardiovascular risk factors. Continuous exposure to high grade systemic inflammation may be linked to accelerated atherosclerosis. Conclusions Timely identification of patients with risk factors, particularly with new risk factors, enables adequate approach in prevention of and treatment for CVD in rheumatoid arthritis patients.

scholarly journals Effects of Dust Storms and Climatological Factors on Mortality and Morbidity of Cardiovascular Diseases Admitted to ED

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Behcet Al ◽  
Mustafa Bogan ◽  
Suat Zengin ◽  
Mustafa Sabak ◽  
Seval Kul ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiovascular Diseases ◽  
Dust Storm ◽  
Dust Storms ◽  
Maximum Temperature ◽  
Inpatient Hospitalization ◽  
Mortality And Morbidity ◽  
Coronary Syndrome

Objective. This study was designed to investigate the effects of Desert Dust Storms and Climatological Factors on Mortality and Morbidity of Cardiovascular Diseases admitted to emergency department in Gaziantep. Method. Hospital records, obtained between September 01, 2009 and January 31, 2014, from four state hospitals in Gaziantep, Turkey, were compared to meteorological and climatological data. Statistical analysis was performed by Statistical Package for the Social Science (SPSS) for windows version 24.0. Results. 168,467 patients were included in this study. 83% of the patients had chest pain and 17% of patients had cardiac failure (CF). An increase in inpatient hospitalization due to CF was observed and corresponded to the duration of dust storms measured by number of days. However, there was no significant increase in emergency department (ED) presentations. There was no significant association of cardiac related mortality and coinciding presence of a dust storm or higher recorded temperature. The association of increases in temperature levels and the presence of dust storms with “acute coronary syndrome- (ACS-) related emergency service presentations, inpatient hospitalization, and mortality” were statistically significant. The relationship between the increase in PM10 levels due to causes unrelated to dust storms and the outpatient application, admission, and mortality due to heart failure was not significant. The increase in particle matter 10 (PM) levels due to causes outside the dust storm caused a significant increase in outpatient application, hospitalization, and mortality originated from ACS. Conclusion. Increased number of dust storms resulted in a higher prevalence of mortality due to ACS while mortality due to heart failure remained unchanged. Admission, hospitalization, and mortality due to chest pain both dependent and independent of ACS were increased by the presence of dust storms, PM10 elevation, and maximum temperature.

scholarly journals Left ventricular noncompaction: Clinical-echocardiographic study

2012 ◽  
Vol 69 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Aleksandra Nikolic ◽  
Ljiljana Jovovic ◽  
Slobodan Tomic ◽  
Milan Vukovic
Keyword(s):  
Heart Failure ◽  
Clinical Presentation ◽  
Color Doppler ◽  
Neuromuscular Diseases ◽  
Left Ventricular ◽  
Left Ventricular Noncompaction ◽  
Ventricular Noncompaction ◽  
Mortality And Morbidity ◽  
Echocardiographic Examination ◽  
Myocardial Fibers

Background/Aim. Left ventricular noncompaction (LVNC) is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies) or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System). Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ? 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

scholarly journals Relationship of serum procalcitonin levels and c-reactive protein levels in newborns with sepsis in different types of respiratory support in intensive care unit

2021 ◽  
Vol 13 (1) ◽  
pp. 39-47
Author(s):  
Aspazija Sofijanova ◽  
Sonja Bojadzieva ◽  
Silvana Naunova- Timovska ◽  
Hristina Mandzukovska ◽  
Elizabeta Shuperliska ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Statistical Analysis ◽  
Clinical Signs ◽  
Severe Infection ◽  
Predictive Values ◽  
Mortality And Morbidity ◽  
Protein Levels ◽  
Time Period ◽  
High Level

Sepsis in newborns with RDSy and asphyxia is essential; it is a life-threatening condition and still represents an important cause of mortality and morbidity. The aim of this study was to evaluate the predictive values of procalcitonin (PCT) as an early diagnostic and prognostic biochemical marker for sepsis in newborns with RDS and asphyxia. Material and methods: The study was designed as prospective and we examined 110 newborns with proven sepsis admitted in the Intensive  Care Unit at the University Clinic of Pediatrics – Skopje in the period between December 2018 and Јanuary 2021. Procalcitonin levels were measured by using the immunoassay system Vidas based on the ELFA principles. The newborns with proven sepsis were divided into two groups. The first group comprised 55 newborns with RDS and proven sepsis and the second group included 55 newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values ​​of PCT in the analyzed time period in first group of newborns with RDS and proven sepsis, p<0.001. The highest average values (40.37±53.79) ​​were measured on admission with a high level of peak compared to the second group of newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values ​​of PCT in the analyzed time period in the first group of newborns with RDS and proven sepsis with mechanical ventilation (MV) and bubble continuous positive airway pressure (BCPAP) compared to the second group of newborns with asphyxia  and proven sepsis,  p<0.001. PCT is a promising sepsis marker in newborns with RDSy, capable of complementing clinical signs and routine laboratory parameters suggestive of severe infection at the time of ICU admission.  

scholarly journals Improved Diastolic Dysfunction is Associated with Higher Forward Flow and Better Prognosis in Chronic Heart Failure

2021 ◽  
Author(s):  
Frank L Dini ◽  
Piercarlo Ballo ◽  
Nicola Riccardo Pugliese ◽  
Ibadete Bytyçi ◽  
Andreina D'Agostino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Diastolic Function ◽  
Clinical Laboratory ◽  
Study Endpoint ◽  
Prognostic Impact ◽  
Reduced Ejection Fraction ◽  
Echocardiographic Examination ◽  
Baseline Evaluation ◽  
Systolic And Diastolic Function

Abstract Aim. In patients with chronic heart failure (HF), the benefit of repeating the assessment of left ventricle (LV) systolic and diastolic function over time remains uncertain. We assessed the prognostic value of repeated echocardiographic assessment of LV filling pressure (LVFP) and its interaction with cardiac index (CI) in ambulatory patients with chronic HF and reduced ejection fraction (HFrEF)Methods and results. We enrolled 367 patients (age 68±11 years; 22% female) with chronic HFrEF. Patients underwent a clinical and echocardiographic examination at baseline and were re-evaluated after 6±3 months. The 2016 recommendations were used to estimate normal or increased LVFP. CI was evaluated as the product of LV outflow tract area and velocity-time integral multiplied by heart rate and divided by body surface area. After the second examination, patients were followed for a median of 30 months. The study endpoint included all-cause death and hospitalization for worsening HF. Patients who normalized LVFP or showed persistently normal LVFP at the follow-up examination had a significantly lower mortality rate than those with worsening or persistently raised LVFP. After further stratification by CI, patients with elevated LVFP and CI <2.0 L/min/m2 had a further worse outcome than those with elevated LVFP and CI ≥ 2.0 L/min/m2. Multivariate survival analysis confirmed an independent prognostic impact of changes in LVFP, incremental to that of established clinical, laboratory and echocardiographic predictors. Conclusions. Repeated evaluation based on a full diastolic function assessment of LVFP and CI significantly improved risk stratification of stable HFrEF outpatients compared to baseline evaluation.

scholarly journals CHANGES IN CLINICAL MANIFESTATION OF CONGESTIVE HEART FAILURE AT THE BACKGROUND OF REGULAR RAMIPRIL INTAKE

2014 ◽  
Vol 13 (4) ◽  
pp. 41-46
Author(s):  
A. G. Kuzmin ◽  
V. V. Gorbunov ◽  
O. V. Kuzmina
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Diastolic Function ◽  
Exercise Tolerance ◽  
Clinical Signs ◽  
Life Quality ◽  
Functional Class ◽  
Functional Changes ◽  
One Year ◽  
Systolic And Diastolic Function

Aim. To study dynamics in clinical signs of congestive heart failure (CHF) while taking ramipril regularly.Material and methods. Totally 135 patients studied (124 men, 11 women), mean age 60±8,7, with Q-MI in anamnesis of different location 3 years ago, with clinical signs of CHF III NYHA. One year after hospitalization the adherence to therapy was evaluated by Moricki-Greene test. The parameters studied: life quality, signs of CHF, exercise tolerance, morphology and systolic and diastolic function of LV and RV, respiratory system parameters, and of kidneys.Results. By the Moricki-Greene test results all patients were divided into 2 groups: I group — non-adherent patients, II — compliant. In 1 year of follow-up in those of II group the positive dynamic observed. Functional class changed to II, clinical signs of CHF decreased, life quality improved, exercise tolerance increased, intra- and transventricular dyssynchrony decreased, dyspnea regressed from 3 to 2 by Modified Medical Research Council Scale, the NT-proBNP concentration, sudden death risk, BP and HR stabilized at normal values, microalbuminuria decreased, GFR increased. Also we marked the regress of LV and RV volumes, increase of EF, improvement of diastolic function, increase of heart rate variability by the decrease of sympathetic activity.Conclusion. Clinical signs of CHF after Q-MI with III NYHA are presupposed by morpho-functional changes in the heart, cardiopulmonary and cardiorenal continuum, that have common engine for progressing and showing worse outcomes. Therapy adherence with the usage of ramipril makes possible CHF compensation and decreases the chance for exacerbation and progressing of comorbidity. 

scholarly journals Clinical case report on nutritional dystrophy in goats at S. A. Quadary Veterinary Teaching Hospital, CVASU, Chittagong

2019 ◽  
Author(s):  
S. Akter ◽  
S. Akter ◽  
M. A. H. M. Kamal ◽  
M. N. Islam ◽  
M. A. Haque ◽  
...  
Keyword(s):  
Combined Therapy ◽  
Clinical Signs ◽  
Serum Levels ◽  
Clinical Findings ◽  
Small Scale ◽  
Protein Preparation ◽  
Tissue Proliferation ◽  
Long Time ◽  
High Level ◽  
Household Farm

Background: Nutritional fibrous osteodystrophy may be developed due to dietary deficiency of calcium or dietary excess of phosphorus. Fibrous osteodystrophy (FOD) provokes hyperostotic distortion of cancellous bones, conjunctive tissue proliferation, and poor mineralization of bone. The objectives of this study were to report the clinical characteristics and therapeutic management of FOD in goats. Materials and methods: Four out of 8 Jamnapari goats developed fibrous osteodystrophy in a small scale intensive household farm in Chittagong. The age range of the affected goats was 4-5 months. The feeding history of goats was primarily wheat bran, gram and pea husk. Blood sample from all affected and non-affected animals and feed sample from household farm were collected for laboratory analysis. Fibrous Osteo-dystrophy was primarily diagnosed by observing clinical signs of mandibular and maxillary enlargement, pain on pressure at the enlarged bone, protruded tongue and dyspnea which was then confirmed by high level of phosphorus in serum evaluation. Results: The calcium and phosphorus contents in the sampled gram, pea husk and bran were 0.5%, 0.3% and 0.5%, and 0.71%, 0.49% and 0.61%, respectively. Most of the affected animals had increased serum levels of phosphorus, glucose and alkaline phosphatase and decreased level of calcium. Based on the clinical findings and the laboratory report, the cases were diagnosed as fibrous osteodystrophy due to nutritional imbalance in diet. The owner was advised strictly to stop providing any bran to animals (affected and healthy). Affected animals were additionally treated with calcium preparation vitamin ADE, ketoprofen, protein, and penicillin-streptomycin combination. Conclusion: Treatment of fibrous osteodystrophy required a long time recovery along with balanced ration. A combined therapy of calcium and vitamin D and protein preparation is effective for treatment along with adequate green grass and balanced rations.

scholarly journals Cardiovascular Risk in Rheumatoid Arthritis: Literature Review

2021 ◽  
Vol 36 (3) ◽  
pp. e262-e262
Author(s):  
Suad MA Hannawi ◽  
Haifa Hannawi ◽  
Issa Al Salmi
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Heart Failure ◽  
Literature Review ◽  
Inflammatory Arthritis ◽  
Healthy Population ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Mortality And Morbidity ◽  
Underlying Inflammation

Rheumatoid arthritis (RA) is the most common inflammatory arthritis disease with a worldwide prevalence of 1–3%. RA patients are at higher risk of atherosclerosis than their matched age-sex controls. Cardiovascular diseases (CVDs) account for a 50% risk of increased mortality and morbidity in RA. The pattern of CVD in RA patients differs from that in the general population; RA patients are more likely to have silent ischemic heart disease, sudden death, heart failure, and die early. RA patients tend to have a 5–10 years reduction in their life span than their matched healthy population. Traditional (classical) CV risk factors work separately or synergistically with the underlying inflammation to increase CVD risk in RA. Moreover, inflammation is defined as an independent CVD risk factor. This literature review aims to discuss the traditional CVD risk factors and their association with inflammation in RA.

scholarly journals Targeting cardiomyocyte proliferation as a key approach of promoting heart repair after injury

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Shuainan Li ◽  
Wenya Ma ◽  
Benzhi Cai
Keyword(s):  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Treatment Strategies ◽  
Myocardial Damage ◽  
Left Ventricular ◽  
Cardiomyocyte Proliferation ◽  
Mortality And Morbidity ◽  
Neonatal Heart

AbstractCardiovascular diseases such as myocardial infarction (MI) is a major contributor to human mortality and morbidity. The mammalian adult heart almost loses its plasticity to appreciably regenerate new cardiomyocytes after injuries, such as MI and heart failure. The neonatal heart exhibits robust proliferative capacity when exposed to varying forms of myocardial damage. The ability of the neonatal heart to repair the injury and prevent pathological left ventricular remodeling leads to preserved or improved cardiac function. Therefore, promoting cardiomyocyte proliferation after injuries to reinitiate the process of cardiomyocyte regeneration, and suppress heart failure and other serious cardiovascular problems have become the primary goal of many researchers. Here, we review recent studies in this field and summarize the factors that act upon the proliferation of cardiomyocytes and cardiac repair after injury and discuss the new possibilities for potential clinical treatment strategies for cardiovascular diseases.

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