Normal Cardiac Parameters Research Articles

121 Left ventricular morphology in elite athletes with extreme anthropometry

BackgroundBody size measurements are critical in the correct assessment of cardiac adaptation to exercise in athletes. However, the impact of high body mass index (BMI) on cardiac dimensions in athletes...

Risk stratification and pattern of cardiotoxicity in pediatric Ewing sarcoma

IntroductionAnthracycline chemotherapy contributes to improved outcomes in Ewing sarcoma; however, the most feared complication is cardiotoxicity. Echocardiograms were routinely used to monitor cardiac function after anthracycline treatment. Nevertheless, indices chosen to assess cardiac toxicity vary significantly among different centers, and no uniform protocol has been accepted as ideal. MethodsThis retrospective study included children with Ewing sarcoma treated at Children’s Cancer Hospital Egypt over 4years. All echocardiograms and related clinical assessments were reviewed. ResultsIn total, 149 patients (median age 11years; range 1–18years) were included. Although all patients had a reduced ejection fraction compared with their baseline echocardiogram, only 39 patients developed cardiotoxicity (26%): 43% acute-onset, 36% chronic early-onset, and 21% chronic late-onset. There were no statistically significant association between the frequency of myocardial dysfunction and risk factors, including age, sex, follow-up duration, cumulative doxorubicin dose, and mediastinal irradiation. Over one-third (39%) of the patients with cardiac toxicity regained normal cardiac parameters, whereas seven patients died of acute cardiac toxicity. ConclusionThe routine use of echocardiography to screen for anthracycline-induced cardiac toxicity before and during chemotherapy identified myocardial dysfunction. Early medical intervention can improve cardiac parameters. Improved screening techniques with better sensitivity and predictability are needed.

Echocardiographic findings in non-hypertensive subjects in Bayelsa, Nigeria

Background : Echocardiography is one of the tools for the assessment of patients with hypertensive disease. Differences in parameters have been described based on race, gender and environment. Aim : In order to define what should be considered abnormal, we set to find out what the normal cardiac parameters are in our environment. Methods : This was a cross sectional of 80 non hypertensive adults. Transthoracic 2D echocardiography was performed with patients in the left decubitus position using standard techniques. Results : From this study, we found the left ventricular mass to be 129 ± 37.61, the ejection fraction (%) 62.77 ± 10.55 and the fractional shortening (%) to be 34.18 ± 7.49. Values for the intraventricular septal thickness, posterior wall diameter, left ventricle internal diameter (in diastole and systole) are (0.92±0.19, 1.43±0.24), (0.91±0.17, 1.47±0.23) and (4.32±0.50, 2.83±0.42) respectively. All the parameters other than relative wall thickness and ejection fraction showed statistically significant difference (P<0.05). Conclusion : We hope that the findings from this study will provide direction on what to consider as normal regarding echocardiographic findings in our environment. Key words : Echocardiography, hypertension, cardiometabolic disorder, cardiovascular disorder, BMI, ventricular mass

Determination of Normal Echocardiographic, Electrocardiographic, and Radiographic Cardiac Parameters in the Conscious New Zealand White Rabbit

An accurate diagnosis of cardiac disease requires knowledge of normal heart parameters. In total, 100 clinically healthy, unsedated New Zealand white rabbits were studied to establish well-tolerated and repeatable techniques for echocardiography (echo) and electrocardiography. In total, 50 thoracic radiographs were obtained to establish normal cardiac parameters. Electrocardiographic complexes were used to measure heart rate, rhythm, amplitude, and duration of the wave components. Cardiac structures and systolic and diastolic functions were evaluated using echo. Thoracic digital radiographs were obtained with standard radiographic techniques. A subjective analysis of the cardiac silhouette was done as well as objective measurements using the vertebral heart score. These normal values will assist in the diagnosis of cardiac disease in rabbits.

Increased fetal endocardial echogenicity mimicking endocardial fibroelastosis following maternal organophosphorus poisoning and its complete regression in utero

Fetal endocardial fibroelastosis (EFE) has been diagnosed by antenatal ultrasonography in the past few years. A typical case of isolated endocardial fibroelastosis is illustrated here, in a fetus of 22 weeks of gestational age exposed to maternal organophosphorus poisoning at 20 weeks. No other structural cardiac or other systemic anomalies were detected in this fetus. The abnormal fetal echocardiographic features mimicking endocardial fibroelastosis completely regressed after 14 weeks and a normal full-term baby was delivered. Postnatal echocardiogram showed normal cardiac parameters. The diagnostic features mimicking EFE following maternal organophosphorus poisoning at 20 weeks of gestational age and the subsequent complete reversal of these changes after 14 weeks of diagnosis are reported for the first time in the literature.

J016 Inhibition of the multidrug resistance-associated protein 4, MRP4 promotes cardiac hypertrophy

Cyclic nucleotides mediated signaling determines the regulation of many cardiac function. It is generally admitted that the cyclic nucleotides degradation is due to phosphodiesterases. Recently, cAMP and cGMP were also shown to be extruded from the cell by an active efflux transporter, called MRP4. We investigated whether inhibition of MRP4 may independently control cyclic nucleotides levels and modify functions related to cyclic nucleotides signalling pathways in cardiac myocytes. We used silencing RNA or adenovirus encoding MRP4 shRNA (Ad-ShMRP4) to inhibit MRP4 expression in rat cardiomyocytes in vitro. We then performed physiological evaluation of cardiac morphology and function in knock-out MRP4 mice. As a model of adrenergically induced cardiac hypertrophy, miniosmotic pumps containing isoproterenol delivering 20 ìg/g/day for 2 weeks were implanted subcutaneously into 3-months old MRP4 KO and wild type mice. As a model of physiological hypertrophy, animals were housed in a cage with free access to a running monitored wheel. MRP4 is present in human, mouse and rat cardiomyocytes and over-expressed in case of increased cardiac intracellular cAMP. Using a FRET technique MRP4 inhibition was shown to increase intracellular cAMP level. Adult rat cardiomyocytes infected with Ad-shMRP4 demonstrated a significant increase in the calcium current density and in cell size compared to cells infected with the negative control Ad-shLuciferase, suggesting an activation of the cAMP/PKA pathway. While unchallenged young (3 months) MRP4 KO mice displayed normal cardiac parameters, MRP4 KO mice progressively developed significant cardiac hypertrophy by 9-12 months of age (HW/BW ; 5.15 vs 4.46 in WT mice). Isoproterenol-treated MRP4 KO mice displayed a significant increase in cardiac hypertrophy compared to stimulated WT mice (HW/BW: 6±0.38 vs 5.29±0.34 ; p=0.001). In contrast to the regulation of pathological cardiac hypertrophy, MRP4 inhibition did not affect the physiological cardiac growth response associated with physical training (HW/BW: 4.83±0.01, vs 4.84±0.13, p=NS), indicating the absence of a regulatory role of MRP4 in physiological cardiac hypertrophy. These results reveal a unique and important function for MRP4 in stress-dependent cardiac growth by controlling cyclic nucleotides signalling pathways in cardiomyocytes.

Heart of Darkness: The Downside of Trastuzumab

Heart of Darkness: The Downside of Trastuzumab