Evaluation Of Cardiac Function Research Articles

Maternal Left Ventricular Diastolic and Systolic Function during Normal Pregnancy in Saint Bernard Dogs.

This study aimed to evaluate maternal left ventricular (LV) systo-diastolic function using conventional and TDI echocardiography and included 10 healthy Saint-Bernard pregnant bitches. M-mode, peak transmitral flow velocities during early diastole (E) and atrial contraction (A), aortic and pulmonic flow, myocardial performance index (MPI), TDI studies (peak myocardial velocities during early diastole (E’), atrial contraction (A’) and peak systole (S’)), and blood pressure were measured at 21 to 28 (T1), 40 (T2) and 60 (T3) days of gestation and four to eight weeks postpartum (T4). Cardiac output and heart rate were 20% and 9% higher at T3, respectively, compared to T4 (p < 0.01). Lateral S’ was 36% higher at T3 than at T1 (p < 0.05). Changes in diastolic function were demonstrated by 10% lower E wave and 15% A wave at T1, compared to T4 (p < 0.05). E’ and A’ were 23% and 42% higher at T3 compared to T4 (p < 0.01). Both lateral E/E’ and E’/A’ were 6% and 19% lower at T3 compared to T1 (p < 0.01 and p < 0.05, respectively). At T3, MPI was 51% and 34% lower when compared to T1 or T2 (p < 0.05). The echocardiographic evaluation of maternal cardiac function is important, as structural, and functional changes occur throughout pregnancy.

The role of maternal serum catestatin in the evaluation of preeclampsia and fetal cardiac functions

Objective:To compare the maternal serum catestatin (CST) levels in pregnant women with preeclampsia (PE) and with normal blood pressure and evaluate the relationship between the maternal serum CST levels and fetal cardiac functions.Materials and Methods:This cross-sectional study was conducted on 27 women with early-onset PE (EOPE), 28 women with late-onset PE (LOPE), and 28 healthy pregnant women. Maternal serum CST levels were measured using the enzyme-linked immunosorbent assay kits. Fetal cardiac functions were evaluated using the cardiac Doppler.Results:Maternal serum CST levels were lower in the EOPE group; however, no statistically significant difference was found between the groups. Compared with the other two groups, a statistically significant difference was found in the fetal E/A ratio and myocardial performance index (MPI) values of the EOPE group (p=0.013, p=0.002, p=0.005, p<0.001, respectively). The fetal E/A ratio was positively correlated with the maternal serum CST levels in both the PE and control groups (p<0.001, p<0.001). The fetal isovolumetric relaxation time and MPI values were negatively correlated with maternal serum CST levels in both the PE and control groups (p<0.001, p=0.001, p<0.001, and p=0.002, respectively).Conclusion:Lower CST levels are associated with fetal cardiovascular dysfunction, thus CST can be a critical biochemical marker in fetal cardiac function evaluation.

Abstract 14452: Echocardiographic Evaluation of Donor Cardiac Structure and Function Following Reanimation Using Normothermic Regional Perfusion in Donation After Circulatory Death

Introduction: As heart transplantation from donation after circulatory death (DCD) continues to increase, preliminary results suggest outcomes comparable to donation after brain death. It is unknown if the obligatory period of warm ischemia experienced during DCD withdrawal process causes immediate changes in cardiac allograft function. Methods: We retrospectively reviewed and compared pre-donation with post reanimation echocardiographic findings in all DCD donors at our institution from Jan to March 2021. All DCD donor organs were reanimated with in-situ thoracoabdominal normothermic regional perfusion (NRP) after circulatory death. Echocardiographic assessment included: a) 2-dimensional and speckle-tracking measures of chamber size and function; b) ejection fraction (EF); c) fractional area change (FAC); and d) global longitudinal strain (GLS). Results: Altogether 3 DCD heart donations were performed during the study period. Basic demographics and withdrawal ischemic time periods are depicted in Table 1. There were no changes in LV EF and RV FAC when comparing the pre-donation and the post-reanimation echocardiogram. There was a minimal decrease in LV GLS and RV free-wall systolic strain in 2 of the 3 donors following reanimation (Table 2). Conclusions: DCD cardiac allografts reanimated with NRP demonstrated no change in echocardiographic parameters used for a standard donor heart evaluation and were successfully transplanted. Findings suggest donor cardiac function is not clinically different from the pre-donation in DCD hearts reanimated after a relatively short functional ischemic time and without need for inotropic support.

Abstract 10080: Myocardial Physiological Responses to the Third Trimester of Healthy Pregnancy

Background: Pregnancy requires significant cardiometabolic adaptation and is therefore considered a “stress test” for future cardiovascular disease. Cardiovascular magnetic resonance (CMR) allows evaluation of cardiac structure, function and tissue characteristics with excellent reproducibility. There is scarcity of CMR data on pregnancy-associated cardiovascular adaptive changes. Moreover, no studies to date assessed the physiological impact of pregnancy on cardiac high energy phosphate metabolism, measured as the phosphocreatine (PCr)/ATP ratio, using 31 Phosphorus magnetic resonance spectroscopy ( 31 P-MRS). Objectives: We aimed to investigate the physiological effects of pregnancy in women in the third trimester of a healthy singleton pregnancy on cardiac energetics, function and tissue characteristics using 31 P-MRS and CMR at 3T. Methods: Thirty pregnant women and fifteen age-matching nulliparous healthy female controls were recruited. Results: Clinical characteristics and CMR/ 31 P-MRS results are provided in Table1.Resting heart rates and cardiac output were higher in pregnancy, with no significant differences in left-ventricular volumes, mass or ejection fraction, diastolic function (mitral in-flow E/A), global longitudinal strain or MAPSE. There were subtle reductions in cardiac PCr/ATP in pregnancy. Compared to non-pregnant controls, myocardial T1 was 2% higher in pregnant women, whilst T2 was 5% lower. Conclusions: Healthy pregnancy was associated with no significant changes in cardiac size, mass or function. Consistent with the haemodynamic changes in pregnancy, subtle reductions in cardiac energetics were detected, though these remained within normal range.CMR is well tolerated in pregnancy and may play a role in assessing cardiac involvement in women at risk of perinatal complications, offering the opportunity of early initiation of risk modifying treatment and prevention of adverse maternal cardiovascular outcomes.

Ultrasonographic assessment of cardiac function and disease severity in coronary heart disease

BACKGROUNDCoronary heart disease (CHD) causes many adverse cardiovascular events and poses a threat to the patient’s health and quality of life. AIMTo evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD.METHODSA total of 106 patients with CHD (study group) and 106 healthy individuals (control group) in our hospital from March 2019 to September 2020 were selected for this study. All subjects were examined by ultrasound, and the mitral orifice’s early-to-late diastolic blood flow velocity ratio (E/A), left ventricular end-diastolic volume (LVDd), and left atrial diameter (LAD) were measured. Values were compared between the study group and healthy group, and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed. In addition, the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo.RESULTSE/A (1.46 ± 0.34) of the study group was smaller than that of the control group (1.88 ± 0.44), while LVDd (58.24 ± 5.05 mm) and LAD (43.31 ± 4.38 mm) were larger (48.15 ± 3.93 and 34.94 ± 2.81, respectively; P < 0.05). E/A for patients with grade III disease (1.41 ± 0.43) was smaller and their LVDd (60.04 ± 4.21 mm) and LA (44.16 ± 2.79 mm) were larger than those in patients with grade II disease (1.71 ± 0.48, 52.18 ± 3.67 mm, and 39.68 ± 2.37, respectively; P < 0.05). Patients with grade IV disease had smaller E/A (1.08 ± 0.39) and larger LVDd (66.81 ± 5.39 mm) and LAD (48.81 ± 3.95 mm) than patients with grade II and III disease (P < 0.05). In patients with moderate disease, E/A (1.44 ± 0.41) was smaller and LVDd (59.95 ± 4.14 mm) and LAD (45.15 ± 2.97 mm) were larger than in patients with mild disease (1.69 ± 0.50, 51.97 ± 3.88 and 38.81 ± 2.56 mm, respectively; P < 0.05). In patients with severe disease, E/A (1.13 ± 0.36) was smaller and LVDd (67.70 ± 6.11 mm) and LAD (49.09 ± 4.05 mm) were larger than in patients with moderate disease (P < 0.05). E/A was negatively correlated with cardiac function classification and disease severity, while LVDd and LAD were positively correlated with cardiac function classification and disease severity (P < 0.05). E/A (1.83 ± 0.51) for patients with good prognosis was higher than that for those with poor prognosis (1.39 ± 0.32), while LVDd (49.60 ± 4.39 mm) and LAD (36.13 ± 3.05 mm) were lower (P < 0.05).CONCLUSIONThe ultrasonic parameters of patients with CHD are abnormal, and differ significantly in patients with different cardiac function grades, lesion degree, and prognosis.

Comparison of impedance cardiography and cardiac magnetic resonance imaging for the evaluation of cardiac function in early-stage breast cancer patients

Objective. Breast cancer treatment can negatively impact cardiac function in some breast cancer patients. Current methods (MUGA, echocardiography) used in clinical practice to detect abnormal cardiac changes as a result of treatment suffer from important limitations. Use of alternative techniques that would offer safe, inexpensive and non-invasive cardiac function assessment in this population would be highly advantageous. The aim of this study was to examine the agreement between impedance cardiography (ICG) and cardiac magnetic resonance imaging (CMR) in quantifying stroke volume (SV), cardiac output (CO) and end-diastolic volume (EDV) in this population. Approach. Sixteen breast cancer patients underwent ICG and CMR assessments at three time-points (before treatment, immediately after chemotherapy, and four months after chemotherapy). Bland–Altman analysis was used to quantify the accuracy and precision of ICG (relative to CMR) in estimating absolute values of SV, CO and EDV. Four methods (concordance rate, polar concordance rate, clinical concordance rate and trend interchangeability rate) were also used to assess ICG performance in tracking changes in these variables. Main results. Bland–Altman analysis showed that the accuracy of ICG relative to CMR was −3.1 ml (SV), 0.2 l·min−1 (CO) and −26.0 ml (EDV) and precision was 13.2 ml (SV), 1.1 l·min−1 (CO) and 20.1 ml (EDV), respectively. Trending ability assessment showed that (1) the concordance rate was 87% (SV), 73% (CO) and 73% (EDV), (2) the polar concordance rate was 67% (SV), 53% (CO) and 33% (EDV), (3) the clinical concordance rate was 33% (SV), 40% (CO) and 20% (EDV) and (4) the trend interchangeability rate was 29% (SV), 43% (CO) and 17% (EDV), respectively. Significance. Our findings show that, although ICG showed good accuracy for absolute SV and CO measurements and for CO and EDV changes, precision was poor for all variables in terms of both absolute measurements and trend tracking performance. This suggests that ICG cannot be used interchangeably with CMR in breast cancer patients.

Echocardiographic Normal Reference of Left Ventricular Contractile Reserve During Treadmill Exercise Stress Echocardiography in Healthy Chinese Adults - New Non-Sex-Specific Parameter for Left Ventricular Contractile Reserve Evaluation.

PurposeLeft ventricular (LV) contractile reserve is commonly used for LV systolic function assessment, while data on normal LV contractile reserve to exercise and the effect of gender on it are contradictory and limited, especially in Chinese adults. The aims of the present study are to clarify echocardiographic normal reference of LV contractile reserve during treadmill exercise stress echocardiography in healthy Chinese adults and to evaluate the sex-specific impact on it.Patients and MethodsThe study population consisted of 157 healthy Chinese adults. All subjects underwent comprehensive echocardiographic assessment at rest and immediately after a symptom-limited treadmill stress test. The impact of gender on LV contractile reserve was analyzed.ResultsThe study population consisted of 157 healthy Chinese adults. All subjects underwent comprehensive echocardiographic assessment at rest and immediately after a symptom-limited treadmill stress test. The impact of gender on LV contractile reserve was analyzed.ConclusionTraditional LV contractile reserve of men was much higher than that of women in a healthy Chinese population. The difference might be because of higher BSA in men. ΔGLS was less influenced by METs and CI at rest compared to ΔEF. ΔGLS, and especially the ΔGLS index, might be considered as a more preferable contractile reserve parameter for clinical cardiac function evaluation.

Evaluation of subclinical cardiovascular risk and cardiac function in children with vesicoureteral reflux: a prospective study.

Vesicoureteral reflux is a prominent congenital anomaly of the kidney and the urinary tract. Further, renal scarring is known to be related to chronic inflammation. However, there have been limited studies to date regarding the cardiovascular consequences of vesicoureteral reflux. The aim of this study is to evaluate the possible subclinical atherosclerosis and cardiovascular complications in children with vesicoureteral reflux. Patients with vesicoureteral reflux and age matched healthy controls were prospectively included in this case-control study. Patients were divided into two groups concerning renal scarring status. To assess cardiac functions, carotid artery intima media, epicardial adipose tissue, and periaortic adipose tissue thicknesses were evaluated. There were 50 patients with vesicoureteral reflux; 26 patients without renal scarring and 24 patients with renal scarring, as well as 40 healthy controls. Myocardial performance indexes (Tei indexes) measured by tissue Doppler echocardiography from septum and left ventricle were significantly increased in study group (for all, p < 0.001). Also, intima media, epicardial adipose tissue, and periaortic adipose tissue thicknesses of the study groups were significantly higher than the control group (for all, p < 0.001). However, no statistical difference was observed between renal scarring (-) and renal scarring (+) groups. Results of our study showed early deterioration of cardiac systolic and diastolic functions in children with vesicoureteral reflux regardless of renal scarring. Also, diagnosis of vesicoureteral reflux is an important risk factor for subclinical atherosclerosis, independent of renal scarring, which should be considered in the follow-up of these patients.

Visit-to-Visit Fasting Glucose Variability in Young Adulthood and Cardiac Structure and Function at Midlife: The CARDIA Study.

Glycemic variability was found associated with left ventricular structure and function in type 2 diabetes. But it is still unclear that whether the greater visit-to-visit fasting glucose (FG) variability in young adulthood among the community population is associated with cardiac function alteration and cardiac remodeling at midlife. The community-based prospective cohort study of Coronary Artery Risk in Young Adult (CARDIA) recruited young participants at the baseline age of 18–30 years during the period of 1985–1986 (Year 0). FG was measured at Year 0, 2, 10, 15, 20, and 25. The echocardiographic evaluation of cardiac structure and function was conducted at year 25. A total of 2,600 young adults mean (SD) aged at 24.9 years (3.6) of which 57.3% were women and 46.7% were African Americans had been included in the study. After multivariable adjusted, higher SD of mean FG (SDFG) is associated with lower early peak diastolic septal mitral annular velocity (e') (β [SE], −0.214 [0.080], P < 0.01) and higher E/e' (β [SE], 0.307 [0.094], P < 0.01), and higher coefficient of variation of the mean FG (CVFG) is also associated with lower e' (β [SE], −0.141[0.066], P < 0.05) and higher E/e' (β [SE], 0.204 [0.078], P < 0.01). The higher average real variation of mean FG (ARVFG) is associated with higher E/e' (β [SE], 0.178 [0.085], P < 0.05) and higher left ventricular mass index (LVMI) (β [SE], 1.240 [0.618], P < 0.05). The higher FG variability in young adulthood is associated with the subclinical change of left ventricular (LV) diastolic function at midlife.

Role of Strain Imaging for Guiding Management of Valvular Heart Disease

Echocardiographic strain imaging allows more precise evaluation of cardiac function and provides new insights into the complex cardiac mechanics. Global longitudinal strain is found to be clinically useful in various valvular heart diseases. It provides additional diagnostic and prognostic information besides standard echocardiographic and clinical parameters. In this review, a summary of current clinical applications, limitations, and future of strain echocardiography in patients with valvular heart diseases is discussed.

18F-sodium fluoride PET/MRI myocardial imaging in patients with suspected cardiac amyloidosis

BackgroundWe evaluated the diagnostic performance of 18F-NaF PET/MRI in patients with suspected cardiac amyloidosis (CA). MethodsTwenty-seven consecutive patients underwent myocardial PET 1 hour after injection of 4 MBq/kg 18F-NaF with simultaneous MRI including cine-MRI, T1 and T2 mapping, first-pass and late gadolinium enhancement (LGE). 18F-NaF uptake was measured visually and semi-quantitatively by calculating myocardium-to-blood pool (M/B) ratios. CA was confirmed histologically. ResultsTransthyretin (TTR)-CA was diagnosed in 16 patients, light-chain (AL)-CA in 7, and no-CA in 4. Visual interpretation of 18F-NaF images revealed a relative increase in myocardial uptake in only 3 patients, all with TTR CA, and a relative decrease in 13, including 7 AL CA, 3 no-CA, and 3 TTR CA. M/B ratios were significantly higher in TTR CA (1.00 ± 0.12) than in AL CA (0.81 ± 0.06, P = 0.001) or in no-CA (0.73 ± 0.16, P = 0.006). The optimal M/B cut-off to distinguish TTR CA from AL CA was ≥ 0.90 (Fischer, P = 0.0005). By comparison, classification of patients using 99mTc-HMDP heart-to-mediastinum ratios with the previously published cut-off ≥ 1.21 reached higher significance (P < 0.0001). Among MRI parameters, myocardial T1, LGE score, and extracellular volume were higher in CA than in no-CA patients, 1409 ± 76 vs 1278 ± 35 ms (P = 0.004), 10.35 ± 5.30 vs 3.50 ± 3.42 (P = 0.03), and 46 ± 10 vs 33 ± 8 % (P = 0.01), respectively. Conclusion18F-NaF PET/MRI shows good diagnostic performance when semi-quantification is used. However, contrast is low and visual interpretation may be challenging in routine. PET/MRI could constitute a one-stop-shop evaluation of amyloid load and cardiac function in patients needing rapid work-up.

Evaluation of fetal cardiac functions in the setting of maternal diabetes: Application of the global spherical index, global strain and fractional area change by the speckle tracking technique

ObjectiveTo evaluate ventricular contractility and profile heart deformations in fetuses of hyperglycemic mothers using the Speckle tracking imaging (STI). The fractional area change (FAC), global longitudinal strain (GLS) and global sphericity index (GSI) of the 4-chamber view (4-CV) were computed. Study DesignDynamic 4-CV images of 60 fetuses exposed to maternal diabetes (MD) and 60 controls were retrospectively collected between 19 and 37 weeks of gestation. Speckle-tracking analysis was used to compute and compare GSI, GLS and FAC of the right ventricle (RV) and the left ventricle (LV) between the groups. By definition, GSI was the ratio of the epicardial basal–apical length in end-diastole (BAL) to the overall transverse length of RV and LV in end-diastole (TL). The FAC was calculated by dividing the difference between end-diastolic area and end-systolic area by the end-diastolic area. Similarly, the GLS of the RV and LV was obtained by dividing the difference between the endocardial length in end-systole and endocardial length in end-diastole to the endocardial length in end-diastole. Data for conventional echocardiographic parameters, standard biological measurements of fetus and maternal baseline characteristics were also recorded and compared between the groups. Linear regression analysis was performed to assess the association between age, BMI and the inter-ventricular septum thickness (IVST). ResultsGestational age at the time of examination did not differ significantly between the control and gestational diabetes group (p = 0.74). In fetuses exposed to MD, the thickness of the IVS was higher while the FAC of RV, GLS of RV and the GSI were all significantly lower. The FAC and global strain of LV generally decreased with progress in gestation but the difference between the two groups was not statistically significant. Conventional echocardiography in fetuses exposed to MD revealed a lower mitral E/A ratio and a larger myocardial performance index (MPI) of the RV and LV. Although the annular plane systolic excursion (MAPSE), tricuspid annular plane systolic excursion (TAPSE) and septal annular plane systolic excursion (SAPSE) were also lower in this group, the difference was not statistically significant compared to fetuses of the control group. No regression relationship between age, BMI and IVST were noticed in any group. ConclusionThis study found that diastolic dysfunction among fetuses of gestational diabetic mothers is accompanied by global cardiac deformation and functional decrease of the RV in systole in the second and third trimester. The GSI, global strain and FAC acquired by SRI can be used as convenient and reliable quantitative parameters in the assessment of cardiac function in fetuses exposed to gestational diabetes.

A case report of an infant after episodes of paroxysmal supraventricular tachycardia with left ventricular thrombosis and cerebral infarction

Left ventricular thrombosis and cerebral infarction caused by recurrent episodes of paroxysmal supraventricular tachycardia (PSVT) are uncommon in infants. We present the case of a 23-month-old girl whose echocardiography revealed a left ventricular thrombus, which resolved after sinus rhythm was restored. The girl had experienced repeated systemic convulsions and high muscular tension of the left limb accompanied by movement disorder. Soon afterward, cranial magnetic resonance imaging (MRI) revealed scattered lacunar cerebral infarctions in the right lateral ventricle. The symptoms, signs, and laboratory examination satisfied the diagnosis of left ventricular thrombosis and cerebral infarction caused by recurrent episodes of PSVT. The girl was given antiarrhythmic drugs, including propranolol, esmolol, and amiodarone, intracranial pressure decreasing treatment (mannitol), heart and brain cell nutritional therapy, anticoagulant therapy, and her condition gradually improved. This case report highlights the importance of pediatric PSVT patients' clinical management and that more emphasis should be placed on early recognition and prevention of severe complications. Pediatricians should be trained early recognition of the nonspecific clinical manifestations of PSVT, make effectively and quickly diagnosis by electrocardiogram, evaluation of cardiac function and thrombosis by echocardiography, and termination PSVT as rapidly as possible. Thromboprophylaxis therapy might be considered for recurrent episodes of PSVT.

Functional Cardiac Ct In Pediatric And Adult Patients With Congenital And Acquired Heart Diseases.

Introduction: The aim of the study was to assess the utility of the functional Cardiac CT in evaluating the cardiac function and morphology in patients with congenital and acquired heart diseases. Cardiac anatomy is well delineated by CT as compared to other available imaging modalities. Evaluation of cardiac function by CT has been a challenge. However with latest generation 320 detectors/640-multi slice CT machine it is now possible to assess cardiac anatomy and cardiac function.

Left Ventricular Strain Rate for Intraoperative Evaluation of Cardiac Diastolic Function by Transesophageal Echocardiography: The Correlation Between Late Diastolic Peak Longitudinal Strain Rate and the Severity of Diastolic Dysfunction

Speckle-tracking echocardiography is a promising tool for evaluating cardiac diastolic dysfunction. A correlation between left atrial strain rate during atrial contraction and the severity of diastolic dysfunction previously has been demonstrated. Because visualization of the left atrial walls is difficult with transesophageal echocardiography, the authors evaluated the use of left ventricular strain rate during atrial contraction as a substitute for left atrial strain rate to intraoperatively measure the extent of cardiac diastolic dysfunction. Retrospective clinical study. Single institutional study. Sixty-six patients who underwent cardiac surgery between January 2018 and January 2021. None. Preoperative echocardiographic reports and intraoperative echocardiographic images of the participants were studied. The correlation of cardiac diastolic dysfunction stage with the peak longitudinal strain rate during late diastole and the time to peak value were evaluated. The late diastolic peak longitudinal strain rate was correlated significantly with the stage of diastolic dysfunction (r=-0.64, p < 0.0001). There was no significant correlation between the stage of diastolic dysfunction and the time to peak value (r=-0.17, p=0.18). A late diastolic peak longitudinal strain rate <0.68 1/s had a sensitivity of 80% and specificity of 81% for predicting grade 2 or 3 diastolic dysfunction. The late diastolic peak longitudinal strain rate correlates with the severity of diastolic dysfunction in patients undergoing cardiac surgery.

Evaluation of Relationship between Serum Ferritin Level and Cardiac Complications in Thalassemia Patients in Pasteur Hospital of Bam City in 2018

Introduction and objective: Cardiac complications are the most common cause of mortality in beta thalassemia patients. Hence, this study was conducted with the aim of evaluating the relationship between serum ferritin level and cardiac complications in Thalassemia patients at Specific Diseases Center in Bam city in 2018. Methodology: This is a descriptive-analytical study. Fifty-five patients with thalassemia major in Bam city were selected using a convenient sampling method. They were examined in terms of the prevalence of cardiac complications and their relationship with serum ferritin level was evaluated using SPSS 23 software and descriptive and inferential statistical tests. The significance level was considered p-value&lt; 0.05 in this study. Results: The mean age of the patients was 17.84 ± 6.72. The mean serum ferritin level was 3674.07 ± 2192.21 mg / dl. Only 3 out of 29 patients (5.8%) had an ejection fraction (EF) reduction in echocardiography. In other echocardiographic studies, 13.7% of patients had MILD MR Heart valve dysfunction and 3.9% had MILD TR heart valve dysfunction and 1 person (1.9%) had both dysfunctions simultaneously. Moreover, 13 patients (25.5%) had diastolic cardiac dysfunction. There was no statistically significant relationship between the serum ferritin level of the studied people and echocardiographic findings (p-value &lt;0.05). Discussion and Conclusion: Based on the results of this study and other studies, serum ferritin may not be relied as a definitive indicator for the evaluation of cardiac function. However, it is recommended that the importance of iron removal to be considered in patients’ training programs and different indicators to be used to evaluate the cardiac complications as the most important complication in thalassemia patients. Keywords: Thalassemia, Ferritin, Cardiac complications

Quantitative Proteomics Reveal That Metabolic Improvement Contributes to the Cardioprotective Effect of T89 on Isoproterenol-Induced Cardiac Injury.

BackgroundT89, a traditional Chinese medicine, has passed phase II, and is undergoing phase III clinical trials for treatment of ischemic cardiovascular disease by the US FDA. However, the role of T89 on isoproterenol (ISO)-induced cardiac injury is unknown. The present study aimed to explore the effect and underlying mechanism of T89 on ISO-induced cardiac injury.MethodsMale Sprague-Dawley rats received subcutaneous injection of ISO saline solution at 24 h intervals for the first 3 days and then at 48 h intervals for the next 12 days. T89 at dose of 111.6 and 167.4 mg/kg was administrated by gavage for 15 consecutive days. Rat survival rate, cardiac function evaluation, morphological observation, quantitative proteomics, and Western blotting analysis were performed.ResultsT89 obviously improved ISO-induced low survival rate, attenuated ISO-evoked cardiac injury, as evidenced by myocardial blood flow, heart function, and morphology. Quantitative proteomics revealed that the cardioprotective effect of T89 relied on the regulation of metabolic pathways, including glycolipid metabolism and energy metabolism. T89 inhibited the enhancement of glycolysis, promoted fatty acid oxidation, and restored mitochondrial oxidative phosphorylation by regulating Eno1, Mcee, Bdh1, Ces1c, Apoc2, Decr1, Acaa2, Cbr4, ND2, Cox 6a, Cox17, ATP5g, and ATP5j, thus alleviated oxidative stress and energy metabolism disorder and ameliorated cardiac injury after ISO. The present study also verified that T89 significantly restrained ISO-induced increase of HSP70/HSP40 and suppressed the phosphorylation of ERK, further restored the expression of CX43, confirming the protective role of T89 in cardiac hypertrophy. Proteomics data are available via ProteomeXchange with identifier PXD024641.ConclusionT89 reduced mortality and improves outcome in the model of ISO-induced cardiac injury and the cardioprotective role of T89 is correlated with the regulation of glycolipid metabolism, recovery of mitochondrial function, and improvement of myocardial energy.

Cardiac autonomic function evaluation during the COVID-19 pandemic: A frugal innovation for Valsalva manoeuvre

Cardiac autonomic function evaluation during the COVID-19 pandemic: A frugal innovation for Valsalva manoeuvre

Validation of using cardioplegic solutions for preserving cardiac function in isolated rabbit heart assays

IntroductionCardioplegic solutions were first developed to preserve heart function during cardiac surgeries and heart transplants but have application in the nonclinical setting. Due to lack of lab space in the vivarium, cardioplegic solution was used to conserve cardiac function for ex-vivo studies performed in a separate building. All studies in this report were conducted with isolated female rabbit hearts (IRHs) via retrograde perfusion using the Langendorff apparatus to investigate if cardioplegia usage affects cardiac function. MethodsCardioplegia was achieved with a hyperkalemia (27 mM KCL) solution kept at 4 °C. Cardiac function was assessed by measuring ECG parameters, left ventricular contractility, and coronary flow under constant perfusion pressure. IRHs were cannulated with Krebs Henseleit buffer (KH) either fresh or after cardioplegic solution storage (C-IRH). Three comparisons were performed with and without cardioplegia; (i) direct side-by side studies of cardiac function; (ii) pharmacological responses to typical ion channels blockers, dofetilide, flecainide, and diltiazem; (iii) retrospective evaluation of cardiac functions in a large sample of hearts. ResultsIn the side-by-side comparisons, cardioplegia-stored IRHs (C-IRH; storage time 90 min) had similar electrocardiographic (ECG) and hemodynamic parameters to fresh-cannulated hearts with KH buffer (KH-IRH). In addition, responses to dofetilide, flecainide, and diltiazem, were similar for C-IRH and KH-IRH hearts. Over the years (2006–2011), baseline data was collected from 79 hearts without cardioplegia and 100 hearts with cardioplegia (C-IRH; storage time 15 min), which showed no meaningful differences in a retrospective analysis. DiscussionCardiac function was preserved after cardioplegic treatment, however, coronary flow rates were decreased (−19.3%) in C-IRH hearts which indicated an altered coronary vascular tone. In conclusion, storage in cardioplegic solution preserves rabbit cardiac function, a practice that enables heart tissues to be collected at one site (e.g., vivarium) and transported to a laboratory in a separate location.

MO547ASSOCIATION BETWEEN SERUM INDICES OF IRON METABOLISM AND CARDIOVASCULAR MORBIDITY IN PATIENTS WITH PREDIALYSIS CHRONIC KIDNEY DISEASE

Abstract Background and Aims Patients with predialysis chronic kidney disease (CKD) have a greater risk of developing cardiovascular disease (CVD) events than the general population. Anaemia is the most frequent comorbidity in pre-dialysis CKD patients and is associated with an increase in CVD events. Iron deficiency is the most frequent cause of erythropoiesis-stimulating agents (ESAs) resistant anaemia in CKD patients and is modifiable by therapeutic intervention. However, the optimal ranges of iron markers are uncertain in predialysis CKD patients. Therefore, we aimed to investigate the association between serum indices of iron metabolism and the incidence of CVD events in patients with predialysis CKD using the CKD-Japan Cohort (CKD-JAC) data. Method We prospectively followed 1550 CKD patients aged 20-75 years with an estimated glomerular filtration rate (eGFR) &amp;lt;60 mL/min/1.73 m2 for a mean of 4.21 years. We set serum transferrin saturation (TSAT) and ferritin levels as the main exposures to be tested. Our main outcome measures were any of the CVD events including fatal or non-fatal myocardial infarction, congestive heart failure (CHF), angina pectoris, arrhythmia, aorta dissection, cerebrovascular disorder, and peripheral artery diseases identified at each facility and adjudicated by the independent cardiac function evaluation committee. Multivariable Cox proportional hazards regression models were employed to examine the association between serum TSAT or ferritin levels with time to events. Death was considered as a competing risk with the Fine and Gray model. All models were stratified by facilities and adjusted for potential confounders as follows: age, sex, systolic blood pressure, diabetes mellitus, history of CHF, haemoglobin, serum calcium, serum phosphorus, intact parathyroid hormone, eGFR, proteinuria, ESAs, iron supplementation, renin-angiotensin system inhibitors, and beta-blockers. We also applied the multivariable fractional polynomial interaction (MFPI) approach to investigate whether TSAT levels are the effect modifier of the association between iron supplementation and the outcomes. Results In the overall cohort, 208 (13.4 %) patients developed CVD events (including 97 CHF) during the follow-up period (26.6 events/1000 person-year). The incidence rate of CVD events was the highest in the TSAT &amp;lt; 20% category (33.0 events/1000 person-year). Compared to patients in the TSAT &amp;gt; 40% category, those in the TSAT &amp;lt; 20% category demonstrated an increased risk of CVD events (adjusted hazard ratio (AHR): 1.86, 95% confidence interval (CI): 1.06-3.26) and CHF events (AHR: 2.82, 95% CI: 1.15-6.89), respectively. Meanwhile, there was no association between serum ferritin levels and the risk of developing CVD or CHF events. MFPI analyses showed a reduced risk of CVD in patients receiving iron supplementation only in patients with TSAT &amp;lt;20% (P for interaction=0.02). Conclusion Maintaining TSAT &amp;gt;20% could be effective to reduce the risk of developing CVD events (especially CHF) in patients with predialysis CKD. Our analyses also suggest that iron-deficient patients with predialysis CKD may benefit from iron supplementation for reduced risk of CVD events.