Prolonged QRS in Heart Failure With Preserved Ejection Fraction

Kelly, Jacob P.; Daubert, James P.

doi:10.1016/j.jchf.2016.04.007

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…This is especially true as it relates to the development of heart failure with preserved ejection fraction, which is highly associated with DM. 47 As initially outlined by Paulus and Tschöpe, 48 the dysfunction seen in ECs in a diabetic environment (ie, increased ROS, reduced NO) results in cardiomyocyte hypertrophy and rigidity, as well as subendothelial invasion by monocytes, stimulating fibroblasts, and increasing collagen deposition. In contrast, heart failure with reduced ejection fraction occurs due to a loss of functional cardiomyocytes from apoptosis and necrosis, with resultant fibrotic changes, stemming from chronic ischemia, or infarction.…”

Section: Endothelial Dysfunction In Diabetic Cardiac and Kidney Diseasementioning

confidence: 95%

Endothelial progenitor cells for diabetic cardiac and kidney disease

Raleigh,

Pasricha,

Nauth

et al. 2024

Stem Cells Translational Medicine

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The management of diabetes mellitus and its resultant end organ dysfunction represents a major challenge to global health-care systems. Diabetic cardiac and kidney disease commonly co-occur and are significant contributors to the morbidity and mortality of patients with diabetes, carrying a poor prognosis. The tight link of these parallel end organ manifestations suggests a deeper common underlying pathology. Here, we outline the mechanistic link between diabetic cardiac and kidney disease, providing evidence for the role of endothelial dysfunction in both processes and the potential for cellular therapy to correct these disorders. Specifically, we review the preclinical and clinical evidence for endothelial progenitor cell therapy in cardiac, kidney, and cardio-renal disease applications. Finally, we outline novel approaches to endothelial progenitor cell therapy through cell enhancement and the use of extracellular vesicles, discussing published and future work.

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Section: Endothelial Dysfunction In Diabetic Cardiac and Kidney Diseasementioning

confidence: 95%

Endothelial progenitor cells for diabetic cardiac and kidney disease

Raleigh,

Pasricha,

Nauth

et al. 2024

Stem Cells Translational Medicine

View full text Add to dashboard Cite

show abstract

“…Hal ini bisa terjadi selain karena faktor usia juga karena kurangnya aktifitas fisik akibat menurunnya kapasitas fungsional. (3,15) Pada penelitian ini diketahui bahwa kelompok yang mengalami KKM lebih banyak menderita infeksi pneumonia dibandingkan dengan kelompok tanpa KKM. Begitu juga dengan kadar leukosit, kelompok dengan KKM cenderung memiliki nilai leukosit yang lebih tinggi jika dibandingkan dengan kelompok tanpa KKM.…”

Section: Keteranganunclassified

Relationship Between of Lactate Clearance with Major Cardiovascular Events in Patients with Acute Decompensated Heart Failure

Ramli¹,

Syafri²,

Fadil³

et al. 2019

IJC

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ABSTRACT Background: Acute decompensated heart failure (ADHF) still a major health problem with high morbidity and mortality. The risk stratification of ADHF patients is an important factor to determine the initial management. Examination of lactic acid levels is an inexpensive tool and mostly available at primary care centers. Lactate clearance, derivation of lactic acid level, is one of the modalities that can be used to assess risk stratification. The association between lactate clearance and in-hospital major cardiovascular events (MACE) of ADHF patients has not been studied yet. Method: Observational approach with cross-sectional design. Data obtained from observations during treatment in ADHF patients at Dr. RSUP M. Djamil Padang in April-July 2018. Bivariate analysis between variables lactate clearance and KKM was carried out during the treatment using the chi-square method and the Odds ratio was obtained. Result: From 44 subjects, 22 of subjects experienced MACE. From the results were found significant differences in lactate clearance in both of groups, -11,72 ± 4,25 %, vs 26,09 ± 9,36 % (p=0,000). The association between lactate clearance and in-hospital major cardiovascular events of ADHF patients in this study obtained OR 1,16 with 95% CI 1,12 - 4,102 (p = 0.000). Conclusion: Lactate clearance is a valuable modality that can be used to make a risk stratification in ADHF patients. Keywords: Lactate clearance, ADHF, risk stratification ABSTRAK Latar Belakang: Gagal jantung dekompensata akut (ADHF) masih merupakan masalah kesehatan dengan morbiditas dan mortalitas tinggi. Stratifikasi risiko pasien ADHF merupakan faktor penting untuk menentukan managemen awal. Pemeriksaan kadar asam laktat merupakan alat yang murah dan tersedia di pusat pelayanan primer, lactate clearance merupakan salah satu modalitas untuk menilai stratifikasi risiko. Hubungan antara lactate clearance dengan kejadian kardioavaskular mayor selama perawatan pada pasien ADHF belum diteliti. Metode Penelitian: Pendekatan observasional dengan desain potong lintang. Data diperoleh dari pengamatan selama perawatan pada pasien ADHF di RSUP Dr. M. Djamil Padang bulan April-Juli 2018. Dilakukan analisis bivariat antara varibel lactate clearance dengan KKM selama perawatan dengan menggunakan metode chi-square dan didapatkan nilai Odds ratio. Hasil Penelitian : Dari 44 subyek penelitian, 22 subjek dengan ADHF tidak mengalami KKM dan 22 subjek mengalami KKM. Hasil penelitian menemukan adanya perbedaan yang bermakna variabel lactate clerance pada kedua kelompok, yakni -11,72 ± 4,25 % vs 26,09 ± 9,36 %, dengan nilai p=0,000. Hubungan antara lactate clearance dengan kejadian kardioavaskular mayor selama perawatan pada pasien ADHF pada penelitian ini didapatkan nilai OR 1,16 dengan 95% CI 1,12 - 4,102 (nilai p=0,000). Kesimpulan : Lactate clearance dapat digunakan sebagai stratifikasi risiko pada pasien ADHF. Kata kunci : Lactate clearance, ADHF, stratifikasi risiko

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“…Dapat disimpulkan bahwa semakin terganggu fungsi sistolik ventrikel kiri sebanding dengan kejadian remodeling pada ventrikel kiri yang mengakibatkan terganggu memanjangnya waktu depolarisasi ventrikel. (14,15) Begitu pula dengan penelitian Dhingra (2006) QRS durasi yang lebar memiliki OR 1, 74 pada fraksi ejeksi menurun. (16) Interval QTc yang memanjang memiliki skoring 1 dengan OR 2,18.…”

Section: Diskusiunclassified

Padang Skoring Elektrokardiografi untuk Memprediksi Fraksi Ejeksi Ventrikel Kiri pada Gagal Jantung Kronik

Erlanda

Rasyid²,

Syafri³

et al. 2019

IJC

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ABSTRAK Latar Belakang: Gagal Jantung dibagi menjadi 3 kelompok yaitu gagal jantung fraksi ejeksi menurun (HfrEF <40%), rentang tengah (HFmrEF 40-49%), dan terpelihara (HfpEF ≥50%). Ekokardiografi masih menjadi pemeriksaan standar saat ini, sayangnya pemeriksaan tersebut masih terbatas dibeberapa pusat kesehatan. Perlu pemeriksaan awal yang lebih sederhana salah satunya elektrokardiografi (EKG) yang mudah digunakan. Penentuan skoring dari EKG diharapkan dapat memudahkan memprediksi fraksi ejeksi dan memberikan terapi yang tepat. Metode Penelitian: Pendekatan observasional dengan desain potong lintang. Diambil data rekam medis pasien gagal jantung kronik (GJK) di poliklinik Jantung RSUP Dr. M.Djamil Padang bulan Januari-Agustus 2017. Dilakukan analisis bivariat pada varibel EKG terhadap fraksi ejeksi dengan metode chi-square. Analisis multivariate dengan uji regresi binari logistik untuk mendapatkan variabel pada kalkulasi skor dengan uji Hosmer-Lameshow (p<0,25). Skoring dilakukan uji sensitivitas, spesifisitas dan analisis receiver operating curve (ROC). Hasil Penelitian : 283 subjek GJK dibagi menjadi tiga kelompok. Variabel yang memenuhi persyaratan untuk dilakukan kalkulasi skor adalah pembesaran atrium kiri (LAE) (OR=6,36; p= 0.000) dengan skor 2, QRS lebar (OR=13,06; p= 0.000) dengan skor 3, interval QTc memanjang (OR=2,18; p= 0.065) dengan skor 1 dan perubahan gelombang ST-T (OR=5,05; p= 0.000) dengan skor 2. Subjek dengan HFpEF mempunyai skor <3, HFmrEF mempunyai skor 3-4, dan HFrEF mempunyai skor >4. Sistem skoring EKG memiliki sensitivitas 71,4% dan spesifisitas 88,6% dengan AUC 87,9% Kesimpulan : Sistem skoring EKG pada penelitian ini dapat digunakan sebagai pedoman awal dalam menentukan fraksi ejeksi ventrikel kiri pada pasien GJK Kata kunci : elektrokardiografi, gagal jantung kronik, fraksi ejeksi ventrikel kiri Background: Heart failure (HF) are divided into HF reduced ejection fraction (HFrEF<40%), mid range (HFmrEF 40-49%), and preserved (HFpEF ≥50%). Nowadays echocardiography is used as gold standard examination, but it is limited only in several health centers. For this reason, a preliminary examination tools is needed. Electrocardiographic (ECG) examinations tool that available almost at every health center and easy to be used. Calculating the scores from ECG variables to determine the EF will make clinician’s earlier to give initial terapi Method: An observational approach with cross sectional study design. The data was taken from patient’s medical record with chronic heart failure (CHF) who went to the Tepartement of Cardiology at Dr. M. Djamil Padang Hospital in January-August 2017. Bivariate analysis was performed on each ECG variable then correlated with LVEF by chi-square method. Multivariate analysis with logistic binary regression test was conducted to obtain variables that would go into the score calculation stage with the Hosmer-Lameshow test (p <0.25). The sensitivity, specificity test and receiver operating curve (ROC) analysis were performed. Result: 283 subjects of CHF who had been divided into three groups. Obtained variables that met the requirements for calculating scores were left atrial enlargement (LAE) (OR = 6.36; p = 0.000) score was 2, wide QRS (OR = 13.06; p = 0,000) score was 3 , prolonged QTc interval (OR = 2,18; p = 0,065) score was 1 and ST-T change (OR = 5.05; p = 0.000) score was 2. Subjects with HFpEF if the scored were <3, HFmrEF if the scored were 3-4, and HFrEF if the scored were >4. It has sensitivity 71,4%, specificity 88,6% with AUC 87,9%. Conclusion: Electrocardiography scoring system in this study can be used as an initial tools to determining LVEF in patients with CHF. Keywords: electrocardiography, chronic heart failure, left ventricular ejection fraction

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Prolonged QRS in Heart Failure With Preserved Ejection Fraction

Cited by 4 publications

References 19 publications

Endothelial progenitor cells for diabetic cardiac and kidney disease

Endothelial progenitor cells for diabetic cardiac and kidney disease

Relationship Between of Lactate Clearance with Major Cardiovascular Events in Patients with Acute Decompensated Heart Failure

Padang Skoring Elektrokardiografi untuk Memprediksi Fraksi Ejeksi Ventrikel Kiri pada Gagal Jantung Kronik

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