Cardiac complications of secondary hyperparathyroidism in chronic hemodialysis patients

Aim: To evaluate the eff ects of intact parathormone (iPTH) on left ventricular function using transthoracicechocardiography on chronic hemodialysis (HD) patients with secondary hyperparathyroidism. In HD patients,mortality is high and is frequently due to cardiac complications. Secondary hyperparathyroidism, high levels ofphosphate (PO4), and high calcium phosphate product (Ca × PO4) are related to cardiac complications.Materials and methods: We examined 20 patients with normal iPTH levels (Group 1) and 20 patients with high iPTHlevels (Group 2). Intact parathormone levels were measured in serum with a Coat-A-Count kit (Diagnostic ProductsCorporation, Los Angeles, CA, USA) using an immunoradiometric assay. Th e normal level of iPTH was 0.8-5.2 pmol/L.In patients with end-stage renal disease, iPTH levels should be 1.5 to 3 times higher than the normal range in order tomaintain the bone mass; thus, patients with iPTH levels 4 or more times higher than the normal range (PTH ? 20.8pmol/L) were defi ned as Group 2 while patients who had normal iPTH levels were defi ned as Group 1.Results: In both groups, Doppler parameters indicated diastolic dysfunction. However, mitral annular E velocity waslower in Group 2 than in Group 1 (6.1 ± 1.1 cm/s and 7.5 ± 1.6 cm/s, respectively; P = 0.034). It is well known thatleft ventricular hypertrophy (LVH) increases mortality rates. Left ventricle mass index and relative wall thickness areparameters refl ecting LVH, and both were higher in Group 2 (294.4 ± 103.0 g/m² and 53.5 ± 11.7%) when comparedwith Group 1 (179.2 ± 104.2 g/m² and 41.8 ± 8.9%). Th ese diff erences were found to be statistically signifi cant (P <0.001).Conclusion: Th is study demonstrates that high levels of iPTH contribute to diastolic dysfunction and LVH inhemodialysis patients

Aneurysm of the basal interventricular septum secondary to turbulent flow jet from a mitral prosthetic valve

WOS: 000353739600015PubMed: 25701978Aneurysms of the muscular interventricular septum, most of which are congenital, have been rarely reported.1,2 Usually, the affected site is the mid portion of the trabecular interventricular septum, whereas aneurysms of the basal interventricular septum are rare. A 24-year-old man who underwent mitral valve replacement with a tilting disc prosthesis in 2003 applied for medical examination for a job application and transthoracic echocardiography (TTE) was ordered by his physician

A Novel Score to Predict One-Year Mortality after Transcatheter Aortic Valve Replacement, Naples Prognostic Score

Background and Objectives: Aortic stenosis (AS) is a widespread valvular disease in developed countries, primarily among the elderly. Transcatheter aortic valve replacement (TAVR) has become a viable alternative to aortic valve surgery for patients with severe AS who are deemed a high surgical risk or for whom the AS is found to be inoperable. Predicting outcomes after TAVR is essential. The Naples Prognostic Score (NPS) is a new scoring method that evaluates nutritional status and inflammation. Our study is aims to examine the relationship between the NPS and outcomes for patients receiving TAVR. Material and Methods: We conducted a retrospective study of 370 patients who underwent TAVR across three tertiary medical centres from March 2019 to March 2023. The patients were divided into two groups based on their NPS, namely, low (0, 1, and 2) and high (3 and 4). Our study is primarily aimed to determine the one-year mortality rate. Results: Within one year, the mortality rate for the entire group was 8.6%. Nonetheless, the low-NPS group had a rate of 5.0%, whereas the high-NPS group had a rate of 13%. The difference between the two groups was statistically significant, with a p-value of 0.06. Conclusions: Our results show that NPS is an independent predictor of one-year mortality in patients undergoing TAVR