Doppler tissue imaging unmasks right ventricular function abnormalities in HIV-infected patients

Background: We sought to investigate right ventricular (RV) function with Doppler tissue imaging (DTI) in human immunodeficiency virus (HIV)-infected patients receiving highly-active antiretroviral treatment, without any heart-related symptoms. Methods: We studied 38 asymptomatic HIV patients (aged 44.5 ± 9.2 years, 22 of them men) and 25 age-matched and sex-matched controls. All subjects underwent conventional and DTI estimation of left ventricular (LV) systolic and diastolic function, measuring peak systolic and diastolic myocardial velocities at the mitral annulus (Sm, Em, Am). Two-dimensional (2-D) echocardiographic study of the right ventricle (RV) was performed from the four-chamber view, and RV end-diastolic dimensions were measured. DTI recordings from the RV free wall at the tricuspid annulus were used to determine systolic (SmRV) and diastolic function (EmRV and AmRV). Results: HIV-infected patients compared to controls exhibited significantly lower peak systolic velocities at the septal-SmIVS (7.9 ± 1.3 vs 9.1 ± 1.4 cm/s, p = 0.002) and lateral mitral annulus - SmLAT (9.8 ± 1.7 vs 11.2 ± 1.3 cm/s, p = 0.025); no difference was observed regarding conventional 2-D examination of LV systolic and diastolic function and DTI-derived Em and Am. No significant difference occurred between HIV patients and controls regarding RV end-diastolic dimensions and pulmonary artery systolic pressure. However, SmRV (13.8 ± 1.6 vs 14.9 ± 2.2 cm/s, p = 0.040), EmRV (11.6 ± 3 vs 13.5 ± 2.6 cm/s, p = 0.028) and AmRV (10.9 ± 2.5 vs 13.8 ± 4 cm/s, p = 0.003) were significantly reduced in HIV patients as compared to controls. Conclusions: DTI unmasks subtle and otherwise undetectable abnormalities of the longitudinal LV systolic function and both RV systolic and diastolic function, in asymptomatic HIV patients receiving highly-active antiretroviral treatment. (Cardiol J 2010; 17, 6: 587-593

Short-term depressive symptoms and 30-day prognosis of hospitalized patients with Acute Coronary Syndromes; the Greek Study of Acute Coronary Syndromes (GREECS)

Aims - We evaluated whether short-term depressive symptoms are associated with the 30-day prognosis of hospitalized patients presented with acute coronary syndromes (ACS). Methods - A sample of 6 hospitals located in Greek urban and rural regions was selected. From October 2003 to September 2004, we recorded the non-fatal admissions of ACS. Assessment of depressive symptoms, during past month, was based on the CES-D scale (Radloff S., 1977). Results - 2172 patients were included in the study (1649, 76% were males). The mean CES-D score was 13.5 +/- 12 in male patients and 13.6 +/- 12 in females (p=0.89). Compared to patients with angina those who had non-Q-wave MI or Q-wave MI had higher CES-D score (12.3 +/- 11.6 vs. 15.3 +/- 12.8 vs. 13.2 +/- 11.9, p=0.001). The number of events during the first 30-day following discharge was 9.2% in males and 9.7% in females. Multivariable logistic regression analysis revealed that 1-unit increase in CES-D was associated with 10% higher odds (95% CI 1.09-1.12) of re-current events (death or re-hospitalization), after adjusting for various socio-demographic, lifestyle and clinical factors. Conclusion - We revealed that short-term depressive symptoms are related to more severe disease and a worsen 30-day prognosis of patients hospitalized for ACS. Declaration of Interest: None

Effects of functional electrical stimulation on quality of life and emotional stress in patients with chronic heart failure secondary to ischaemic or idiopathic dilated cardiomyopathy: A randomised, placebo-controlled trial

Objective: Functional electrical stimulation (FES) improves exercise capacity and endothelial function in chronic heart failure (CHF) patients. This study evaluates the impact of FES on quality of life and emotional stress in patients with moderate to severe CHF. Methods: Thirty patients with stable CHF (24 men; NYHA class II-III; left ventricular ejection fraction < 35%) were randomly assigned (2: 1) to a 6-week FES training program (n = 20) or placebo (n = 10). Questionnaires addressing quality of life [Kansas City Cardiomyopathy Questionnaire (KCCQ), functional and overall], and emotional stress [Zung self-rating depression scale (SDS), Beck Depression Inventory (BDI)], as well as plasma B-type natriuretic peptide (BNP) and 6-min walking distance test (6MWT) were assessed at baseline and after completion of training protocol. Results: A significant improvement in KCCQ functional (F= 76.666, p < 0.00 1), KCCQ overall (F - 41.508, p < 0.00 1), BDI (F = 17.768, p < 0.00 1) and Zung SDS (F = 27.098, p < 0.00 1) was observed in the FES group compared to placebo. Patients in the FES group had also a significant increase in 6MWT (F = 19.413, p < 0.00 1) and a trend towards reduction in plasma BNP (F = 4.252, p = 0.053) compared to placebo. Conclusion: FES seems to have a beneficial effect on quality of life, exercise capacity and emotional stress in patients with moderate to severe CHE (c) 2008 European Society of Cardiology. Published by Elsevier B.V. All rights reserved