Echocardiographic evaluation of right ventricular function

Echocardiographic accurate assessment of right ventricular function due to complex three-dimensional morphology and different from left ventricular myocardial fibers orientation remains limited. Systolic function of right ventricle has been evaluated using several parameters — tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RV FAC), right ventricle to left ventricle size comparison, myocardial Doppler tissue imaging (S’ velocity) and the Tei indexas an expression of right ventricle impairment. Echocardiographic evaluation of right ventricle diastolic function has been evaluated using Doppler of the tricuspid inflow, tissue Doppler of the lateral tricuspid annulus, and measurements of inferior vena cava size and collapsibility

Ocena prawej komory w badaniu echokardiograficznym

Echocardiographic accurate assessment of right ventricular function due to complex three-dimensional morphology and different from left ventricular myocardial fibers orientation remains limited. Systolic function of right ventricle has been evaluated using several parameters — tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RV FAC), right ventricle to left ventricle size comparison, myocardial Doppler tissue imaging (S’ velocity) and the Tei index as an expression of right ventricle impairment. Echocardiographic evaluation of right ventricle diastolic function has been evaluated using Doppler of the tricuspid inflow, tissue Doppler of the lateral tricuspid annulus, and measurements of inferior vena cava size and collapsibility

Analysis of echocardiographic parameters of cardiac function in patients with acute stroke

Introduction. Cardiologic diagnostics in stroke patients is designed to identify heart disease as a potential cause of stroke. The aim of this study was to evaluate the effect of low ejection fraction (EF) and left ventricular systolic/diastolic dysfunction (LVSD, LVDD) on the neurological state on the 1st day of stroke, as well as post-stroke functional status at 30 days after stroke. Patients and methods. For a prospective study, 162 stroke patients (mean age 74 years) were qualified. They were analysed according to neurological state on the 1st day of stroke, the results of transthoracic echocardiography, and functional status at 30 days after stroke. Results. The neurological state on the 1st day after stroke was significantly worse in patients with LVSD. In patients with reduced EF, functional status was significantly worse at 30 days after stroke. Patients with E/A 0.8–2 had a significantly worse functional status compared to patients with E/A < 0.8. Individuals with E/A 0.8–2 and segmental LVSD or EF < 50% had significantly worse functional status compared to patients without LVSD. An independent factor for moderate/severe status was identified: E/A > 0.8 (RR 3.28 [95% CI 1.15-9.37]); independent factors for poor functional status were lower EF (RR 4.68 [95% CI 1.22–18.00]) and age (RR 4.68 [95% CI 1.22–11.00]). Conclusions. One quarter of patients in the acute phase of stroke have LVSD and/or LVDD. LVSD adversely affects both neurological status in acute stroke as well as functional status in the short-term follow-up. Age at first-in-life stroke incidence and lower EF are predictors of poor functional status one month after a stroke

Ghrelin as a potential blood pressure reducing factor in obese women during weight loss treatment

Wstęp: W modelach zwierzęcych grelina powoduje zmniejszenie obciążenia następczego serca i zwiększenie rzutu serca poprzez wpływ na receptory znajdujące się w układzie sercowo-naczyniowym. Celem badania było określenie zależności między redukcją masy ciała, ciśnieniem tętniczym a stężeniem greliny w surowicy u kobiet z otyłoscią. Materiał i metody: Badaniem objęto 37 otyłych kobiet (wskaźnik masy ciała [BMI, body mass index] 36,5 &#177; 5 kg/m2) bez nadciśnienia tętniczego w wywiadzie. Ciśnienie tętnicze i stężenie greliny w surowicy oznaczono przed i po 3-miesiecznej kuracji odchudzającej, która obejmowała dietę 1000 kcal/d. i ćwiczenia fizyczne. Skład ciała określono metodą analizy impedancji z użyciem aparatu Bodystat. Wyniki: W następstwie redukcji masy ciała (średnio 8,9 &#177; 4,8 kg) nastąpiło istotne obniżenie SBP (120 &#177; 13 vs. 115 &#177; 14 mm Hg, p = 0,01) i zwiększenie stężenia greliny w surowicy (66,9 &#177; 13,7 vs. 73,9 &#177; 15,4 pg/ml; p = 0,005). Stwierdzono istotne korelacje między stężeniami greliny po redukcji masy ciała a SBP (r = -0,45, p = 0,02) i DBP (r = -0,41, p = 0,05) oraz między Dstężeń greliny a DSBP (r = 0,52, p = 0,006), DDBP (r = 0,53, p = 0,005). Wykazano dodatnią korelację między wzrostem stężenia greliny a zmniejszeniem procentowej zawartości tłuszczu w organizmie pod wpływem terapii odchudzającej (r = 0,51, p = 0,002). Wnioski: Wyniki badania dowodzą, że zmniejszenie masy ciała może spowodować obniżenie ciśnienia tętniczego u osób otyłych przez mechanizm zależny od greliny.Background: In animal models ghrelin reduces cardiac afterload and increases cardiac output via receptors in the cardiovascular system. The aim of our study was to evaluate a potential relationship between weight loss treatment, blood pressure and serum ghrelin concentrations in obese women. Material and methods: A group of 37 obese premenopausal women with no previous history of hypertension (BMI: 36.5 &#177; 5 kg/m2) were involved in the study. Blood pressure and serum ghrelin levels were assessed before and after a three-month weight reduction treatment, which consisted of a diet of 1000 kcal/day and physical exercise. Body composition was determined by impedance analysis using Bodystat. Results: Following weight loss (mean 8.9 &#177; 4.8 kg) SBP decreased (120 &#177; 13 vs. 115 &#177; 14 mm Hg, p = 0.01) and serum ghrelin levels increased significantly (66.9 &#177; 13.7 vs. 73.9 &#177; 15.4 pg/ml; p = 0.005). There were significant correlations between values for ghrelin levels after weight loss and SBP (r = -0.45, p = 0.02), DBP (r = -0.41, p < 0.05), and between Dghrelin levels and DSBP (r = 0.52, p = 0.006), DDBP (r = 0.53, p = 0.005). There was a positive correlation between an increase in ghrelin and a decrease in percentage body fat during weight loss (r = 0.51; p = 0.002). Conclusion: The results seem to provide evidence that weight loss may decrease blood pressure in obese patients via a ghrelin-dependent mechanism

The relationship between cardiovascular risk estimated by use of SCORE system and intima media thickness and flow mediated dilatation in a low risk population

Background: The SCORE system is a simple, currently recommended method of cardiovascular risk assessment. The aim of this study is to determine the relationship between SCORE risk and intima media thickness (IMT) and flow mediated dilatation (FMD) in a low risk population. Methods: 119 people (59 men) without known cardiovascular disease and estimated by means of SCORE system risk < 5%, were included in the study. The ultrasound method was used to assess brachial artery diameter (BAd), FMD, nitroglycerin mediated dilatation (NMD) of brachial artery and IMT of common carotid. FMD × BAd and FMD/NMD indexes representing hyperemia-induced vasodilatation independent of brachial artery properties were analyzed. Results: IMT measured was 0.52 &#177; 0.08 mm; FMD: 17.5 &#177; 7.8%; NMD: 27.0 &#177; 9.0%; FMD × BAd: 58.2 &#177; 22.4, FMD/NMD: 0.64 &#177; 0.19. Independent predictor for both FMD and NMD was BAd (R2 &#8211;0.31; p < 0.001; R2 &#8211;0.44; p < 0.001; respectively), for FMD × BAd index and FMD/NMD index was IMT (R2 &#8211;0.04; p = 0.02; R2 &#8211;0.04; p = 0.015) in a multivariate analysis. Risk estimated by use of the SCORE system was between 0 and 4% (median-1, 25&#8211; &#8211;75 Q: 0&#8211;2). A relationship between SCORE risk and IMT (ANOVA p < 0.001), FMD (ANOVA p < 0.001), NMD (ANOVA p < 0.001), FMD × BAd index (ANOVA p = 0.017), but not FMD/NMD index (ANOVA p = 0.27), was found. Conclusions: The association of a simple stratifying scale (SCORE system) with indices of early vascular remodeling in a low risk population supports its clinical significance