Echo-Doppler Evaluation of Left Ventricular Impairment in Chronic Cor Pulmonale

Schena, Miriam; Clini, Enrico; Errera, Donatella; Quadri, A

doi:10.1378/chest.109.6.1446

Cited by 88 publications

(65 citation statements)

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“…Other study shows that heart rate (HR) in the COPD patients did not significantly differ from control group. (105) In the present study, echocardiographic assessment of left ventricular systolic function in COPD patients was in the normal value range and revealed a non significant difference from control group. Similar results were obtained by other investigators (Schena M, et al and Marcus T, et al).…”

Section: Vidiscussioncontrasting

confidence: 53%

“…Some investigators, however, suggest the presence of subclinical systolic dysfunction in the COPD patients. (110) Suchon´ et al (105) found that ejection fraction, shortening fraction and lateral mitral annular peak systolic velocity in COPD patients, were in the normal value range and did not differ significantly from control group. Similar results were obtained by other investigators.…”

Section: Vidiscussionmentioning

confidence: 96%

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Assessment of Left and Right Ventricular Functions by Myocardial Performance Index in Patients with Chronic Pulmonary Disease.

Najeebsaeed¹

2016

IOSR

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Background:Development of right ventricular hypertrophy and eventual right side heart failure is common in patients with chronic obstructive pulmonary disease (COPD). However, some disturbance in left ventricular (LV) function has been observed among such patients. The co-existence between chronic obstructive pulmonary disease (COPD) and heart failure has been previously described. However, the co-existence between COPD and subclinical LV dysfunction, without the presence of heart failure symptoms, is less well understood. P=0.128), and RVMPI (Beta =1.436, p=0. 3(98.87 ± 8.41ms) 009). LV diastolic function parameters (A, E/A, and deceleration time of E) were impaired for groups 2 and 3 compared with group 1.Mitral early diastolic and late diastolic annular velocities ratio (Em/Am), were significantly lowest in COPD patients with PH(0.77±0.066), and the isovolumetric relaxation time (IVRT) was significantly longer in group 3(105.43±4.21ms) and group 2(102.27±4.45ms) in relation to control group(71.2±5.51ms). RV diastolic function, E/A ratio was higher in the control subjects compared with the patient groups. The tricuspid inflow velocities ratio (E/A) was significantly lowest value in COPD p=atients with PH (0.84 ± 0.04) and the isovolumetric relaxation time (IVRT) was significantly longer in group

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Section: Vidiscussioncontrasting

confidence: 53%

Section: Vidiscussionmentioning

confidence: 96%

Assessment of Left and Right Ventricular Functions by Myocardial Performance Index in Patients with Chronic Pulmonary Disease.

Najeebsaeed¹

2016

IOSR

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“…Although chronic pulmonary hypertension (PH) selectively overloads the right ventricle (RV), left ventricular (LV) dysfunction also manifests in the course of primary PH [32], chronic thromboembolism [13] and cor pulmonale [41]. Echocardiography-based studies carried out in PH patients suggested that one of the mechanisms contributing to LV dysfunction is ventricular interdependence and impaired LV filling [35].…”

Section: Introductionmentioning

confidence: 99%

Time course and mechanisms of left ventricular systolic and diastolic dysfunction in monocrotaline-induced pulmonary hypertension

et al. 2009

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Although pulmonary hypertension (PH) selectively overloads the right ventricle (RV), neuroendocrine activation and intrinsic myocardial dysfunction have been described in the left ventricle (LV). In order to establish the timing of LV dysfunction development in PH and to clarify underlying molecular changes, Wistar rats were studied 4 and 6 weeks after subcutaneous injection of monocrotaline (MCT) 60 mg/kg (MCT-4, n = 11; MCT-6, n = 11) or vehicle (Ctrl-4, n = 11; Ctrl-6, n = 11). Acute single beat stepwise increases of systolic pressure were performed from baseline to isovolumetric (LVPiso). This hemodynamic stress was used to detect early changes in LV performance. Neurohumoral activation was evaluated by measuring angiotensin-converting enzyme (ACE) and endothelin-1 (ET-1) LV mRNA levels. Cardiomyocyte apoptosis was evaluated by TUNEL assay. Extracellular matrix composition was evaluated by tenascin-C mRNA levels and interstitial collagen content. Myosin heavy chain (MHC) composition of the LV was studied by protein quantification. MCT treatment increased RV pressures and RV/LV weight ratio, without changing LV end-diastolic pressures or dimensions. Baseline LV dysfunction were present only in MCT-6 rats. Afterload elevations prolonged s and upward-shifted end-diastolic pressure dimension relations in MCT-4 and even more in MCT-6. MHC-isoform switch, ACE upregulation and cardiomyocyte apoptosis were present in both MCT groups. Rats with severe PH develop LV dysfunction associated with ET-1 and tenascin-C overexpression. Diastolic dysfunction, however, could be elicited at earlier stages in response to hemodynamic stress, when only LV molecular changes, such as MHC isoform switch, ACE upregulation, and myocardial apoptosis were present.

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“…VS: volume sistólico; PP: pressão de pulso; APTac: tempo de aceleração do fluxo sistólico na artéria pulmonar; AP-Tej: tempo de ejeção do fluxo sistólico na artéria pulmonar; AP-Vmax: pico de velocidade máxima do fluxo sistólico na artéria pulmonar. (Schena et al, 1996;Boussuges et al, 2000;Funk et al, 2008). Em nosso estudo não encontramos evidências de interferência do VD sobre o VE; portanto, outras manifestações sistêmicas da DPOC, como inflamação, não avaliadas no presente estudo, podem ser estar envolvidas na fisiopatologia desta alteração.…”

Section: Outras Variáveis Hemodinâmicasunclassified

“…A hipoxemia crônica induz ao remodelamento da árvore vascular pulmonar, o que desencadeia aumento na resistência vascular pulmonar e favorece a instalação de hipertensão pulmonar com subseqüente insuficiência cardíaca direita (cor pulmonale) (Bates et al, 1998;Machado et al, 1999;Weitzenblum, 2003). Mitchell & Filley (1964) Vários estudos mostram as alterações da função ventricular direita em pacientes com DPOC (Palevsky & Fishman, 1990;Schulman & Matthay, 1992;Ota & Pereira, 1998;Vizza et al, 1998;Higham et al, 2001;Hida et al, 2002;Barbera et al, 2003;Weitzenblum, 2003); entretanto, os dados sobre alterações de ventrículo esquerdo (VE) nesses pacientes são controversos (Williams et al, 1968;Render et al, 1995;Schena et al, 1996;Vonk Noordegraaf et al, 1997;Boussuges et al, 2000;Okoshi et al, 2000;Rocha et al, 2004;Vonk-Noordegraaf et al, 2005;Jörgensen et al, 2007a;Funk et al, 2008).…”

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Estudo da remodelação cardíaca em pacientes com doença pulmonar obstrutiva crônica

Coleta¹

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Silvia e ao meu pai E Elio, pelo carinho e amor irrestrito e incondicional. Pais perfeitos, amorosos, protetores e companheiros. Pai, a saudade aumenta a cada dia, assim como o meu amor por você! Mãe, obrigada por me transmitir todos os dias seu amor, apoio, carinho e sua alegria! Tenho muito orgulho por ser sua filha. Amo vocês! Ao meu marido W Wlamyr. O seu apoio e incentivo foram essenciais para a viabilização deste trabalho. Obrigada pela compreensão e por me ajudar a concretizar os meus desejos. Você é muito especial pra mim, é o meu amor, meu companheiro, meu amigo ... meu melhor amigo! Sou muito feliz ao seu lado. Eu te amo muito! A toda minha família, especialmente ao meu irmão M Marcelo, minha sobrinha P Pamela, minhas tias L Lelita e T Terezinha e minha avó N Nenê.À doutora B Beatriz, pela atenção, carinho e contribuição em todas as etapas deste trabalho, sempre com valiosas sugestões.À doutora S Suzana, pela ajuda com a análise estatística, avaliação clínica dos pacientes e pelas sugestões na finalização deste trabalho.À minha amiga D Daniela, que desempenhou seu trabalho no Serviço de Oxigenoterapia com responsabilidade e competência e se tornou uma grande amiga.À enfermeira E Eva, que marcou sua passagem no Serviço de Oxigenoterapia pela dedicação e carinho com os pacientes.Aos verdadeiros amigos de longa data e aos novos conquistados na pós-graduação, em especial, I Ilda, R Rosana, Renata, Renatinha, Laura, Cristiane, Mariane e Thiago. Aos funcionários da Seção de Pós-Graduação da Faculdade de Medicina de Botucatu: J Janete, Lílian, Nathanael e Regina.À U UNESP e à C CAPES, pelo suporte financeiro parcial.A todos os indivíduos envolvidos nessa pesquisa.Agradecimento Especial A Agradecimento EspecialAgradecimento Especial D Dra Irma de GodoyObrigada pela confiança depositada em mim, pela compreensão e pelo carinho nos momentos mais difíceis. Sua sabedoria, honestidade, dedicação e competência são estímulos para todos e grande orgulho para mim. Dr Katashi OkoshiObrigada pela paciência, dedicação, atenção a cada detalhe e pelos ensinamentos transmitidos, de maneira incansável, ao longo desta jornada. Sua competência foi fundamental para esta pesquisa.Aos meus o orientadores, toda a minha admiração e meu respeito!

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Echo-Doppler Evaluation of Left Ventricular Impairment in Chronic Cor Pulmonale

Cited by 88 publications

References 21 publications

Assessment of Left and Right Ventricular Functions by Myocardial Performance Index in Patients with Chronic Pulmonary Disease.

Assessment of Left and Right Ventricular Functions by Myocardial Performance Index in Patients with Chronic Pulmonary Disease.

Time course and mechanisms of left ventricular systolic and diastolic dysfunction in monocrotaline-induced pulmonary hypertension

Estudo da remodelação cardíaca em pacientes com doença pulmonar obstrutiva crônica

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