The aim of the study is to quantify ventricular interactions by comparing tissue and spectral systolic echocardiographic parameters to allow the early identification of ventricular dysfunction. Clinical, paraclinical, electrocardiographic and echocardiographic evaluations were performed. Right ventricular hypertrophy was diagnosed in the M mode subcostal echocardiographic section. RV hypertrophy was defined by a right ventricular free wall thickness of ] 5 mm in diastole. We assessed the following RV and LV tissue and spectral systolic indices: apical systolic excursion of the lateral mitral ring (MAPSE), apical systolic excursion of the lateral tricuspid ring (TAPSE), left (Svs) and right (Svd) ventricular tissue systolic velocities, and RV and LV ejection times. We calculated the following to assess systolic ventricular interdependence: MAPSE/TAPSE, the normal value of which was considered as 0.66 � 0.14, and Svs/Svd, the normal value of which was considered as 0.76 � 0.21. The study group was compared to a control group with the same clinical features but without ventricular hypertrophy. Twenty-one patients were included in the study: 13 men (62%) and eight women (38%) with a mean age of 56 � 3.8 years. We compared the values between the study group and control group, with the following results: TAPSE = 20.4 � 0.9 vs. 24.1 � 0.76 and MAPSE/TAPSE = 0.74 � 0.06 vs. 0.75 � 0.04. MAPSE was comparable between the groups. Svs was comparable between the groups (0.09 � 0.01 vs. 0.12 � 0.02), whereas Svd was different between the groups (0.11 � 0.03 vs 0.16 � 0.03). Svs/Svd was 0.81 � 0.05 in the study group and 0.75 � 0.08 in the control group. LV ejection time was comparable between the two groups (299.8 � 23.6 ms vs. 303.3 � 28 ms), whereas, RV ejection time differed between the groups (275 � 17 ms vs. 245.5 � 28.5). Changes in TAPSE and MAPSE/TAPSE, in addition to Svd and Svs/Svd, are related to right ventricular dysfunction and suggest pathological changes in the interdependence mechanism of the ventricles in patients with RV hypertrophy. In addition, RV free wall thickness was strongly correlated with ventricular interdependence parameters, with the exception of MAPSE. Assessing these parameters and proportions in clinical practice will facilitate the early detection and appropriate treatment of right ventricular dysfunction.
Hypertension is one of the main risk factors for developing left ventricle failure. The study was conducted at outpatient Clinic – Medlife, Memorial Hospital. It was an observational study. We analyzed the exercise-induced secretion of NT-pro BNP in hypertensive patients with normal ejection fraction and no symptoms or signs of heart failure. Comparing the levels of NT-pro BNP before and after exercise proved to be a good mean for diagnosing left ventricular dysfunction (LVD) in hypertensive patients with left ventricular remodeling.
Cardiac rehabilitation is an individualized outpatient program of physical exercises and medical education designed to accelerate recovery and improve health status in heart disease patients. In this study, we aimed for assessment of patients’ perception of the involvement of technology and remote monitoring devices in cardiac recovery. During the Living Lab Phase of the Virtual Coaching Activities for Rehabilitation in Elderly (vCare) project, we evaluated eleven patients (five heart failure patients and six ischemic heart disease patients). Patient admission in the UMFCD cardiology clinical department served as a shared inclusion criterion for both study groups. In addition, the presence of II or III heart failure NYHA stage status was considered an inclusion criterion for the heart failure study group and patients diagnosed with ischemic heart disease for the second one. We conducted a system usability survey to assess the patients’ perception of the system’s technical and medical functions. The survey had excellent preliminary results in the heart failure study group and good results in the ischemic heart disease group. The limited access of patients to cardiac rehabilitation in Romania has led to increased interest and motivation in this study. The final version of the product is designed to adapt to patient needs and necessities; therefore, patient perception is necessary.
Background: The association between hypertension (HTN) and type 2 diabetes mellitus (DM) frequently leads to left ventricular diastolic dysfunction (DD). Methods: We aim to test whether DD can readily be unveiled as early as in the subclinical stage in diabetic hypertensive asymptomatic patients, even before echocardiography can do so. We compared the values of NT-pro BNP (as a marker of increased filling pressures) before and after the treadmill stress test in hypertensive patients with and without diabetes mellitus (DM) and normal subjects. All had normal systolic and diastolic functions at rest and after the stress test, according to the recommendations of the ESC. Results: The results from our study showed a significant increase inNT-pro BNP after the stress test, but only in hypertensive patients with diabetes. Conclusion: Compared with echocardiography, measuring the changes inNT-pro BNP after the stress test in hypertensive and diabetic patients with class A heart failure could be a tool for diagnosing DD much earlier in the evolution of the disease. This is an important finding because these patients are difficult to distinguish from those with normal left ventricle function, based only on restingNT-pro BNP or echocardiography. In this way, they can benefit much earlier from specific therapies to mitigate future cardiovascular events.
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