The effect of myocardial fibrosis on left ventricular torsion and twist in patients with non-ischemic dilated cardiomyopathy

Background: Left ventricular (LV) rotation, twist, and torsion are important aspects of thecardiac performance. Myocardial fibrosis can be identified as the late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR). In this study, we investigated the associationbetween myocardial fibrosis and LV rotational parameters in patients with nonischemic dilated cardiomyopathy (NDC).Methods: Twenty-two NDC patients were enrolled. LV dimensions, volumes and ejection fraction (EF) were measured, conventional tissue Doppler imaging data was acquired. Speckletracking imaging was performed to measure LV deformation, LV rotational parameters. Bloodsamples were obtained for NT-proBNP. Late gadolinium enhanced cardiac magnetic resonance (LGE-CMR) was used to assess cardiac fibrosis index.Results: Myocardial deformation was similar between LGE+ and LGE– groups. LGE+patients have significantly higher basal and lower apical systolic rotation, lower twist andtorsion when compared to LGE– patients. However, untwisting rate was similar between thegroups. Torsion was significantly correlated with LVEF and MR-index. Patients with reversedapical systolic rotation had significantly greater NT-proBNP values, basal systolic rotation andsignificantly lower apical systolic rotation, torsion, and MR-index.Conclusions: Cardiac fibrosis index is closely related with myocardial torsion and LV systolicfunction and may be used for the evaluation of cardiac condition. Reversed apical systolicrotation indicated more extensive cardiac fibrosis as it may reflect severe LV dyssynchrony andpoor LV performance

Impairment of the left ventricular systolic and diastolic function in patients with non-alcoholic fatty liver disease

Background: Non-alcoholic fatty liver disease (NAFLD) is considered the liver component of the metabolic syndrome. We investigated the diastolic and systolic functional parameters of patients with NAFLD and the impact of metabolic syndrome on these parameters. Methods: Thirty-five non-diabetic, normotensive NAFLD patients, and 30 controls, were included in this study. Each patient underwent transthoracic conventional and tissue Doppler echocardiography (TDI) for the assessment of left ventricular (LV) diastolic and systolic function. Study patients were also evaluated with 24-hour ambulatory blood pressure monitoring. Results: NAFLD patients had higher blood pressures, increased body mass indices, and more insulin resistance than controls. TDI early diastolic velocity (E&#8217; on TDI) values were lower in NAFLD patients than the controls (11.1 &#177; 2.1 vs 15.3 &#177; 2.7; p < 0.001). TDI systolic velocity (S&#8217; on TDI) values were lower in NAFLD patients than the controls (9.34 &#177; 1.79 vs 10.6 &#177; 1.52; p = 0.004). E&#8217; on TDI and S&#8217; on TDI values were moderately correlated with night-systolic blood pressure, night-diastolic blood pressure, and night-mean blood pressure in NAFLD patients. Conclusions: Patients with NAFLD have impaired LV systolic and diastolic function even in the absence of morbid obesity, hypertension, or diabetes. (Cardiol J 2010; 17, 5: 457-463

Consensus Report of the 4th International Forum for Gadolinium-Ethoxybenzyl-Diethylenetriamine Pentaacetic Acid Magnetic Resonance Imaging

This paper reports on issues relating to the optimal use of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging (Gd-EOB-DTPA MR imaging) together with the generation of consensus statements from a working group meeting, which was held in Seoul, Korea (2010). Gd-EOB-DTPA has been shown to improve the detection and characterization of liver lesions, and the information provided by the hepatobiliary phase is proving particularly useful in differential diagnoses and in the characterization of small lesions (around 1-1.5 cm). Discussion also focused on advances in the role of organic anion-transporting polypeptide 8 (OATP8) transporters. Gd-EOB-DTPA is also emerging as a promising tool for functional analysis, enabling the calculation of post-surgical liver function in the remaining segments. Updates to current algorithms were also discussed

Nonalcoholic fatty liver disease as a multi-systemic disease

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. NAFLD includes a wide spectrum of liver conditions ranging from simple steatosis to nonalcoholic steatohepatitis and advanced hepatic fibrosis. NAFLD has been recognized as a hepatic manifestation of metabolic syndrome linked with insulin resistance. NAFLD should be considered not only a liver specific disease but also an early mediator of systemic diseases. Therefore, NAFLD is usually associated with cardiovascular disease, chronic kidney disease, type 2 diabetes, obesity, and dyslipidemia. NAFLD is highly prevalent in the general population and is associated with increased cardiovascular morbidity and mortality. The underlying mechanisms and pathogenesis of NAFLD with regard to other medical disorders are not yet fully understood. This review focuses on pathogenesis of NAFLD and its relation with other systemic diseases

Multiple Anterior Mitral Valve Perforation After Deep Transfemoral Aortic Valve Implantation

Transcatheter aortic valve implantation (TAVI) is an alternative for high-risk aortic valve replacement. There are limited data related to the late complications of TAVI. Deep aortic prosthetic valve implantation can cause direct erosive perforation of anterior mitral leaflet or erosive endothelial lesion which predisposes the tissue to infective endocarditis. Our report emphasizes anterior mitral leaflet perforation after TAVI, which may be seen especially in patients exposed to sepsis

Reliability of multi-vessel off-pump coronary artery by-pass surgery in patients who have low risk profile

We investigated the reliability of multi-vessel off-pump coronary artery by-pass surgery in patients who have low risk profile. This study included 53 patients who undergone off-pump coronary artery by-pass surgery. Patients have been allocated two groups in terms of graft count. 1 and 2 vessel patients were defined as Group A and 3,4,5 vessel patients as Group B. Baseline and serial post-operative CK-MB values were obtained. Ejection fraction (LVEF), mitral-myocardial systolic velocities (lateral S and septal S), mean E, left ventricle filling pressure index (E/E ratio) and tricuspid-S were calculated at pre and postoperative period. Intensive care unit stay time was moderately correlated with pre mean E (r = -0.32, p=0.020) and pre E/E ratio (r = 0.34, p=0.013). &#8710; CK-MB values were similar between two groups (p=0.263). There are no differences between groups in terms of &#8710; LVEF, &#8710; mean E, &#8710; lateral S and &#8710; tricuspid S. &#8710; E/ E ratio was mildly in favour of group A patients (-2.31 ± 2.70 vs. -0.29 ± 2.89, p=0.007). Furthermore, &#8710; septal S was slightly in favour of group A patients (0.71 ± 2.39 cm/s vs. -0.66 ± 1.73 cm/s, p=0.017). Multi-vessel off-pump coronary artery by-pass surgery seems as safe as 1 and 2 vessels despite small differences in terms of cardiac function alterations in patients who have low risk profile. [Med-Science 2019; 8(1.000): 42-7

Nonalcoholic fatty liver disease as a multi-systemic disease

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. NAFLD includes a wide spectrum of liver conditions ranging from simple steatosis to nonalcoholic steatohepatitis and advanced hepatic fibrosis. NAFLD has been recognized as a hepatic manifestation of metabolic syndrome linked with insulin resistance. NAFLD should be considered not only a liver specific disease but also an early mediator of systemic diseases. Therefore, NAFLD is usually associated with cardiovascular disease, chronic kidney disease, type 2 diabetes, obesity, and dyslipidemia. NAFLD is highly prevalent in the general population and is associated with increased cardiovascular morbidity and mortality. The underlying mechanisms and pathogenesis of NAFLD with regard to other medical disorders are not yet fully understood. This review focuses on pathogenesis of NAFLD and its relation with other systemic diseases

Coronary calcium score, albuminuria and inflammatory markers in type 2 diabetic patients: Associations and prognostic implications

WOS: 000311026100018PubMed ID: 22595190Aims: To investigate the relationship of coronary artery calcium (CAC) scores with common carotid artery intima media thickness (CCA-IMT), albuminuria and inflammatory factors in type 2 diabetes. Methods and results: 128 asymptomatic type 2 diabetic patients, with at least one cardiovascular risk factor in addition to diabetes, were included in the study. CAC scores, carotid arteries plaque formation and CCA-IMT were assessed. The patients were followed for a mean period of 36.6 +/- 3.3 months. Linear regression analysis identified the logarithmically transformed (Ln) albuminuria (beta = 0.32, P = 0.007), age (beta = 0.04, P = 0.001) and the uric acid (beta = 0.13, P = 0.04) as independent determinants of the CAC score. During follow-up period, cardiovascular events occurred in 18 out of 46 patients with CAC score >= 100 compared with 5 out of 82 patients with CAC score <100 (log rank, P < 0.0001). Multivariate Cox proportional hazards analysis identified LnCAC score (P < 0.0001), LnAlbuminuria (P = 0.01) and uric acid (P = 0.03) as independent predictors for cardiovascular events. Conclusions: There was a significant relationship between CAC score, albuminuria and inflammation in patients with type 2 diabetes. LnCAC score together with LnAlbuminuria and uric acid were identified as independent predictors of cardiovascular events in these patients