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2.
Arq. bras. cardiol ; 117(4): 690-698, Oct. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1345226

ABSTRACT

Resumo Fundamento A ressonância magnética cardíaca (RMC) é o método de escolha para avaliar as dimensões e a função do ventrículo direito (VD), e a insuficiência pulmonar (IP). Objetivos Avaliar a acurácia da ecocardiografia bidimensional (ECO 2D) em estimar a função e as dimensões do VD e o grau de IP, e comparar os resultados obtidos pela ECO 2D com os da RMC. Métodos Comparamos os relatórios de ECO e RMC de pacientes cuja indicação para RMC havia sido para avaliar VD e IP. Um valor de p < 0,05 foi considerado estatisticamente significativo. Resultados Incluímos 51 pacientes com cardiopatia congênita com idade mediana de 9,3 anos (7-13,3 anos). Observou-se uma baixa concordância entre ECO 2D e RMC quanto à classificação da dimensão (Kappa 0,19; IC 95% 0,05 a 0,33, p 0,004) e da função do VD (Kappa 0,16; IC 95% -0,01 a +0,34; p 0,034). O tamanho do VD foi subestimado pela ECO 2D em 43% dos casos, e a função do VD foi superestimada pela ECO 2D em 29% dos casos. O grau de concordância entre os métodos quanto à classificação da IP não foi significativo (Kappa 0,014; IC 95% -0,03 a +0,06; p 0,27). Houve uma tendência de a ECO 2D superestimar o grau da IP. Conclusões A ECO 2D mostrou baixa concordância com a RMC quanto às dimensões e função do VD, e grau de IP. Em geral, a ECO subestimou as dimensões do VD e superestimou a função do VD e o grau de IP quando comparada à RMC.


Abstract Background Cardiac magnetic resonance (CMR) is the method of choice for assessing right ventricular (RV) dimensions and function, and pulmonary insufficiency (PI). Objectives To assess the accuracy of two-dimensional echocardiography (2D ECHO) in estimating RV function and dimensions, and the degree of PI, and compare the 2D ECHO and CMR findings. Methods We compared ECHO and CMR reports of patients whose indication for CMR had been to assess RV and PI. A p-value < 0.05 was considered statistically significant. Results We included 51 congenital heart disease patients, with a median age of 9.3 years (7-13.3 years). There was poor agreement between 2D ECHO and CMR for classification of the RV dimension (Kappa 0.19; 95% CI 0.05 to 0.33, p 0.004) and function (Kappa 0.16; 95% CI -0.01 to +0.34; p 0.034). The RV was undersized by 2D ECHO in 43% of the cases, and RV function was overestimated by ECHO in 29% of the cases. The degree of agreement between the methods in the classification of PI was not significant (Kappa 0.014; 95% CI -0.03 to +0.06, p 0.27). 2D ECHO tended to overestimate the degree of PI. Conclusions The 2D ECHO showed a low agreement with CMR regarding the RV dimensions and function, and degree of PI. In general, ECHO underestimated the dimensions of the RV and overestimated the function of the RV and the degree of PI as compared with CMR.


Subject(s)
Humans , Child , Ventricular Dysfunction, Right/diagnostic imaging , Echocardiography, Three-Dimensional , Heart Defects, Congenital , Stroke Volume , Echocardiography , Magnetic Resonance Spectroscopy , Reproducibility of Results , Ventricular Function, Right , Magnetic Resonance Imaging, Cine , Heart Ventricles/diagnostic imaging
4.
Arch. cardiol. Méx ; 91(3): 315-320, jul.-sep. 2021. tab, graf
Article in English | LILACS | ID: biblio-1345170

ABSTRACT

Abstract Objective: Right ventricle (RV) function plays an important role during fetal and neonatal transitional circulation. Despite the published echocardiography guidelines in children including neonates, there is scare evidence on RV assessment using echocardiography in Mexican neonates. This study was aimed at assessing RV function and anatomical measures in healthy term newborns and defines normal values in this cohort of patients. Methods: A prospective study involving healthy term newborns in a single center were enrolled in the study to assess RV, all patients were recruited within 24-72 h after birth. The right ventricular assessment was performed as per American Society of Echocardiography's guidelines. Results: Seventy healthy term newborns with a median gestational age of 38 (38.5 ± 2.7) weeks had RV function assessment and anatomical structures measures with a predefined ten echocardiographic parameters protocol. The mean values for: tricuspid valve diameter was 13 mm ± 1.8, basal diameter of the RV 16.7 mm ± 2, RV length 27.8 mm ± 2.2, mid cavity diameter 14.3 mm ± 1.7, RV-anteroinferior basal diameter 21.5 mm ± 2.5, tricuspid regurgitation gradient 13.3 mmHg ± 5.9, tricuspid annular plane systolic excursion 8.7 mm, right ventricular fractional area change (RVFAC) 4 chamber (%) 40.6 ± 7.5, tricuspid E/A 0.7 ± 0.5, myocardial velocities (cm/s) E´ 8 ± 2.7, A´ 9.6 ± 2.4, S´ 6.9 ± 1.2, myocardial performance index 0.5 ± 0.1, RVFAC 3 chamber (%) 37.8 ± 15.8, and pulmonary acceleration time mean value 58.8 ± 14.9. Flattening of interventricular septum was seen in 13% infants. Conclusions: This study describes echocardiographic parameters for anatomical structures and assessment of RV function in healthy term newborns during transitional circulation. We reported novel anatomical measures of the RV; this information can provide normal reference range values and be referenced while assessing RV function in normal and sick newborns during transitional circulation.


Resumen Objetivo: Realizar una valoración ecocardiográfica de parámetros anatómicos y funcionales del ventrículo derecho (VD) en recién nacidos de término (RNT) sanos durante el periodo transicional. Método: Estudio prospectivo en RNT sanos de la Unidad de Cuidados Intensivos Neonatales del Hospital Español. Todos los pacientes fueron estudiados en las primeras 24-72 horas de vida, con base en las guías de la American Society of Echocardiography. Resultados: Se estudiaron 70 RNT sanos con una media de edad gestacional de 38 semanas de gestación (38.5 ± 2.7); en estos pacientes se obtuvieron 10 parámetros ecocardiográficos. El valor medio obtenido para la válvula tricúspide fue de 13 ± 1.8 mm, diámetro basal del VD 16.7 ± 2 mm, longitud 27.8 ± 2.2 mm, cavidad media del VD 14.3 ± 1.7 mm, diámetro basal anteroinferior 21.5 ± 2.5 mm, gradiente de insuficiencia tricuspídea 13.3 ± 5.9 mmHg, tricuspid annular plane systolic excursion (TAPSE) 8.7 mm, Fracción de acortamiento del VD (FAVD) 4 cámaras (%) 40.6 ± 7.5, E/A tricuspídeo 0.7 ± 0.5, velocidades miocárdicas (cm/s) E´ 8 ± 2.7, A´ 9.6 ± 2.4, S´ 6.9 ± 1.2, índice de rendimiento miocárdico 0.5 ± 0.1, FAVD 3 cámaras (%) 37.8 ± 15.8, tiempo de aceleración pulmonar 58.8 ± 14.9. Conclusiones: Este estudio describe parámetros anatómicos y funcionales del VD en RNT sanos durante el periodo de transición. Se reportan valores de normalidad que pueden servir como referencia.


Subject(s)
Humans , Male , Infant, Newborn , Child , Echocardiography/methods , Ventricular Function, Right/physiology , Heart Ventricles/anatomy & histology , Heart Ventricles/diagnostic imaging , Reference Values , Prospective Studies , Mexico
5.
Medicina (B.Aires) ; 81(4): 624-636, ago. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346516

ABSTRACT

Resumen La hipertensión arterial pulmonar (HAP) requiere procesos estructurados de diagnóstico y estratificación de riesgo, siendo la función del ventrículo derecho (VD) un marcador pronóstico central. Los principales objetivos terapéuticos en la HAP son mejorar y/o intentar revertir la disfunción del VD y mantener condición de bajo riesgo. Actualmente existen múltiples fármacos con diferentes mecanismos de acción cuya combinación en doble o triple terapia ha mostrado mejores resultados que la monoterapia. Evidencia actual demuestra la importancia de incorporar tempranamente prostanoides parenterales al esquema, mejorando la funcionalidad del VD y la supervivencia. En esta revisión se refleja el papel de la función del VD en el diagnós tico, pronóstico y seguimiento de la HAP. Se recomienda la evaluación sistemática y estandarizada del VD, así como el inicio temprano de tratamiento combinado en riesgo intermedio-alto para obtener las metas de alcanzar y mantener un riesgo bajo y/o evitar la progresión de la HAP.


Abstract Pulmonary arterial hypertension (PAH) requires structured processes of diagnosis and risk stratifica tion, being the function of the right ventricle (RV) a hallmark prognosis determinant. The main therapeutic goals in PAH are to improve and try to revert RV dysfunction and maintaining a low risk. Currently, there are multiple treatments with different mechanisms of action, the combination of which in double or triple therapy has shown improved results compared to monotherapy. Recent clinical evidence shows the importance of early incorpora tion of parenteral prostanoids to the scheme, improving RV function and survival. In this review, we discuss the role of the RV function in the diagnosis, prognosis, and follow-up of PAH. We recommend the systematic and standardised evaluation of the RV as well as the early initiation of combined treatment in cases of intermediate-high risk to try to reach and keep the patient with PAH at a low risk and / or avoid the progression of PAH.


Subject(s)
Humans , Ventricular Dysfunction, Right , Pulmonary Arterial Hypertension , Hypertension, Pulmonary/diagnosis , Hypertension, Pulmonary/drug therapy , Ventricular Function, Right , Heart Ventricles/diagnostic imaging
7.
Arq. bras. cardiol ; 116(4): 806-811, abr. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1285197

ABSTRACT

Resumo Fundamento: A síndrome dos ovários policísticos (SOP) é a doença endócrino-metabólica mais comum em mulheres em idade reprodutiva, e ocorre em uma a cada 10 mulheres. A doença inclui irregularidade menstrual e excesso de hormônios masculinos e é a causa mais comum de infertilidade em mulheres. A dispneia é um sintoma frequente e muitas vezes acredita-se que seja decorrente da obesidade, mas não se sabe se é decorrente de disfunção cardíaca. Objetivo: Avaliar o acoplamento ventrículo-arterial (VDAP) e a rigidez arterial pulmonar em pacientes com SOP. Métodos: Foram incluídos 44 pacientes com SOP e 60 controles; amostras de sangue venoso foram coletadas para exames laboratoriais e ecocardiograma transtorácico 2-D, Modo-M e com Doppler tecidual foram realizados em todos os participantes. Um valor de p<0,05 foi considerado estatisticamente significativo. Resultados: Quando comparadas ao grupo controle, as pacientes com SOP apresentaram valores maiores de rigidez da artéria pulmonar (p = 0,001), que se correlacionaram positivamente com o índice HOMA-IR (r = 0,545 e p <0,001). O acoplamento VDAP também estava comprometido em 34% dos pacientes do estudo. Conclusão: A rigidez da artéria pulmonar está aumentada e o acoplamento VDAP está comprometido em pacientes com SOP. (Arq Bras Cardiol. 2021; 116(4):806-811)


Abstract Background: Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disease in women in reproductive age, and occurs in one of 10 women. The disease includes menstrual irregularity and excess of male hormones and is the most common cause of female infertility. Dyspnea is a frequent symptom and is often thought to be due to obesity, and whether it is due to cardiac dysfunction is unknown. Objective: To evaluate right ventricle-pulmonary artery (RV-PA) coupling and pulmonary arterial stiffness in patients with PCOS. Methods: 44 PCOS patients and 60 controls were included; venous blood samples were taken for laboratory tests and 2-D, m-mode and tissue doppler transthoracic echocardiography were performed for all the participants. P<0,05 was considered as statistically significant. Results: When compared to the control group, PCOS patients had higher pulmonary artery stiffness values (p=0,001), which were positively correlated with HOMA-IR (r=0,545 and p<0,001). RV-PA coupling was also impaired in 34% of the study patients. Conclusion: Pulmonary artery stiffness is increased and RV-PA coupling is impaired in patients with PCOS. (Arq Bras Cardiol. 2021; 116(4):806-811)


Subject(s)
Humans , Male , Female , Polycystic Ovary Syndrome/complications , Vascular Stiffness , Pulmonary Artery/diagnostic imaging , Heart Ventricles/diagnostic imaging , Obesity
9.
Article in Chinese | WPRIM | ID: wpr-879814

ABSTRACT

This article summarizes and analyzes the clinical features and gene mutation characteristics of children with noncompaction of the ventricular myocardium (NVM). For the 6 children with NVM (4 boys and 2 girls), the age of onset ranged from 3 months to 12 years. Of the 6 children, 5 had arrhythmia, 3 had cardiac insufficiency, 1 had poor mental state, and 1 had chest distress and sighing. NVM-related gene mutations were detected in 4 children, among whom 2 had


Subject(s)
Cardiomyopathies , Child , Child, Preschool , Echocardiography , Female , Heart Ventricles/diagnostic imaging , Humans , Infant , Male , Mutation , Myocardium
11.
Rev. bras. cir. cardiovasc ; 35(5): 844-846, Sept.-Oct. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1137318

ABSTRACT

Abstract Submitral left ventricular aneurysm is a rare cardiac pathology with very few cases reported in the literature. These are nonischemic aneurysms mostly reported from Africa. Patients with submitral aneurysm exhibit varied clinical manifestations. We report a case of calcified submitral aneurysm and its successful surgical management through a transaneurysmal approach.


Subject(s)
Humans , Male , Middle Aged , Heart Aneurysm/surgery , Heart Aneurysm/diagnostic imaging , Heart Ventricles/surgery , Heart Ventricles/diagnostic imaging , Pericardium/transplantation , Calcinosis/diagnostic imaging , Echocardiography , Tomography, X-Ray Computed , Cardiac Surgical Procedures/methods
12.
Arch. cardiol. Méx ; 90(2): 116-123, Apr.-Jun. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131019

ABSTRACT

Abstract Background: Echocardiographic cardiac parameters in the prone position are usually obtained with an esophageal probe. The feasibility of obtaining them by means of a transthoracic approach is unknown. Objective: Estimating the feasibility to obtain parameters of the right ventricle by transthoracic echocardiography in prone position on the subject. Methods: Pilot design of consecutive case series without cardiopulmonary disease. Demographic, vital signs and echocardiographic variables were defined in the ventral initial, prone and ventral final decubitus positions. The data are shown with averages and standard deviations, and frequencies and percentages according to the variable. The differences between the positions were calculated with ANOVA of repeated samples and adjustment of Bonferroni test. Intra-subject variability was obtained by the Bland-Altman procedure and its 95% confidence interval. Results: We studied 50 subjects, 44 (88%) males, age 30 ± 6 years and body mass index 25.65 ± 2.71 kg/m2. Tricuspid annular plane systolic excursion (TAPSE) and S'-wave were measured 100% of the time. The vital signs and echocardiographic variables according to the position had differences in: heart rate (74 ± 9 vs. 77 ± 9 vs. 75 ± 8 beats/min), partial oxygen saturation (94.40 ± 1.70 vs. 96.64 ± 1.79 vs. 95.32 ± 1.36%) and mean systemic blood pressure (65.33 ± 5.38 vs. 67.69 ± 6.31 vs. 65.29 ± 5.62 mmHg); TAPSE (19.74 ± 3.24 vs. 21.60 ± 2.97 vs. 19.44 ± 2.84 mm), mean difference (bias) 0 (2, -2.0) and S'-wave (13.52 ± 1.87 vs. 15.02 ± 2.09 vs. 13.46 ± 1.55 cm/s), mean difference (bias) -0.46 (1.21, -2.14) respectively. Conclusions: Obtaining right ventricle parameters by transthoracic ecocardiopraphy is feasible in the prone position.


Resumen Introducción: Los parámetros cardiacos ecocardiográficos en posición de decúbito prono usualmente se obtienen con sonda esofágica. Se desconoce la factibilidad de obtenerlos mediante aproximación transtorácica. Objetivo: Estimar la factibilidad para obtener parámetros del ventrículo derecho mediante ecocardiografía transtorácica en el sujeto en posición de decúbito prono. Métodos: Diseño piloto de serie de casos consecutivos sin enfermedad cardiopulmonar. Se acotaron variables demográficas, signos vitales y ecocardiográficas en posición decúbito ventral inicial, prono y ventral final. Los datos se muestran con promedios y desviaciones estándar, y frecuencias y porcentajes de acuerdo con la variable. La diferencia entre las posiciones se calculó con ANOVA de muestras repetidas y ajuste de Bonferroni. Se obtuvo la variabilidad intrasujetos mediante el procedimiento de Bland-Altman y su intervalo de confianza al 95%. Resultados: Se estudiaron 50 sujetos, 44 (88%) masculinos, edad 30 ± 6 años e índice de masa corporal 25.65 ± 2.71 kg/m2. El TAPSE (excursión sistólica del plano del anillo tricuspídeo) y la onda S' se midieron en el 100% de las veces. Los signos vitales y variables ecocardiográficas de acuerdo con la posición tuvieron diferencias en: frecuencia cardiaca (74 ± 9 vs. 77 ± 9 vs. 75 ± 8 lpm), saturación parcial de oxígeno (94.40 ± 1.70 vs. 96.64 ± 1.79 vs. 95.32 ± 1.36%) y la presión arterial sistémica media (65.33 ± 5.38 vs. 67.69 ± 6.31 vs. 65.29 ± 5.62 mmHg); TAPSE (19.74 ± 3.24 vs. 21.60 ± 2.97 vs. 19.44 vs. 2.84 mm), diferencia media (sesgo) 0 (2, -2.0) y onda S' (13.52 ± 1.87 vs. 15.02 ± 2.09 vs. 13.46 ± 1.55 cm/s), diferencia media (sesgo) -0.46 (1.21, -2.14) respectivamente. Conclusión: En posición de decúbito prono es factible obtener parámetros del ventrículo derecho por ecocardiografía transtorácica.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Echocardiography/methods , Prone Position , Heart Ventricles/diagnostic imaging , Pilot Projects , Feasibility Studies
13.
Rev. chil. cardiol ; 39(1): 49-54, abr. 2020. graf
Article in Spanish | LILACS | ID: biblio-1115450

ABSTRACT

A 20-year-old woman, without known pre-existent conditions presented with a history of dyspnea on exertion, and palpitations for 6 months. Vital signs, as well as cardiac and pulmonary examinations were normal. Routine blood tests were normal. The ECG showed nonspecific ST-T changes. The echocardiogram showed a left ventricle of normal size and function. A cystic image was shown in relation to the right ventricle, with displacement of the interventricular septum. These findings were confirmed on computed tomography. Additional cystic images on the liver or lungs were ruled out. On surgery, a cardiac hydatic cyst adhered to the pericardium next to the right ventricle was found. Puncture, drainage of the mass and surgical removal of cystic membranes were performed. The clinical course was uneventful. A four year follow up revealed no recurrence of the cyst.


Subject(s)
Humans , Female , Young Adult , Echinococcosis/surgery , Echinococcosis/diagnostic imaging , Heart Ventricles/surgery , Heart Ventricles/diagnostic imaging , Cardiac Surgical Procedures
15.
Rev. habanera cienc. méd ; 19(1): 76-91, ene.-feb. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1099147

ABSTRACT

Introducción: La adaptación del corazón humano al acondicionamiento físico ha sido un tema de interés médico-científico, pues el remodelado cardíaco que comprende variación en el tamaño, forma, grosor de las paredes, y masa ventricular responde al tipo de actividad física. Objetivo: Determinar las modificaciones anatómicas del ventrículo izquierdo en kayacistas y canoístas femeninos y masculinos de alto rendimiento. Material y Métodos: Se realizó un estudio prospectivo, descriptivo de corte transversal en deportistas de canotaje de alto rendimiento que acudieron al Instituto de Medicina del Deporte durante la preparación especial con vistas a participar en los Juegos Olímpicos de Rio de Janeiro 2016. La muestra se conformó con 20 deportistas que cumplieron los criterios de inclusión establecidos, se recogieron los resultados de los diferentes parámetros ecocardiográficos que fueron estudiados para comprobar si existía modificación anatómica del ventrículo izquierdo (MAVI). Se empleó la estadística descriptiva e inferencial. Resultados: Edad promedio 20,9 ± 1,18 años, predominio del sexo masculino (65 por ciento); kayak (60 por ciento) y velocidad (55 por ciento) fueron las disciplinas deportivas y modalidades competitivas predominantes , fue frecuente la hipertrofia concéntrica en ambos sexos (65 por ciento), la edad deportiva de igual o menos de 10 años (60 por ciento), espesor relativo de la pared aumentado (65 por ciento), el índice AKS mayor se encontró en la hipertrofia excéntrica (1,3 por ciento) y el porciento de grasa predominante fue en la hipertrofia concéntrica para un (7,9 por ciento). Conclusiones: El espesor relativo de la pared ventricular tuvo una relación significativa con la modalidad competitiva(AU)


Introduction: The adaptation of the human heart to physical conditioning has been a medical and scientific topic of interest where cardiac remodeling involving changes in size, form, thickness of the walls and ventricular mass responds to the type of physical activity. Objective: To determine the anatomical modifications of the left ventricle in high performance male and female canoeing and kayaking athletes. Material and methods: A prospective, descriptive, cross-sectional study was conducted in high performance canoeing athletes that attended the Instituto de Medicina del Deporte during the special training in view of the preparation for the Olympic Games in Rio de Janeiro, 2016. The sample was composed of 20 athletes that fulfilled the established inclusion criteria. The results of the different echocardiographic parameters were collected and analyzed in order to check whether there were anatomical modifications of the left ventricle (AMLV). Differential and descriptive statistics were used. Results: The average age was 20, 9 ± 1, 18 years, the male sex predominated in the study (65 percent), kayak (60 percent) and velocity (55 percent) were the predominant sports disciplines and competitive modalities, respectively. Concentric hypertrophy in both sexes (65 percent), sporting age of 10 years or less (60 percent), and increase in relative wall thickness (65 percent) were frequent; the highest AKS index was found in eccentric hypertrophy (1,3 percent) and predominant fat percentage was observed in concentric hypertrophy (7,9 percent). Conclusions: The relative thickness of the ventricular wall had a significant relationship with the competitive modalities(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Water Sports/injuries , Heart Ventricles/physiopathology , Heart Ventricles/diagnostic imaging , Echocardiography/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Prospective Studies
16.
J. bras. pneumol ; 46(6): e20190136, 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1134924

ABSTRACT

RESUMO Objetivo Verificar a associação entre massa e espessura do ventrículo esquerdo (VE) e presença de hipoxemia noturna significativa em pacientes portadores de DPOC com hipoxemia diurna leve. Métodos Estudo transversal realizado em pacientes ambulatoriais, clinicamente estáveis, portadores de DPOC e hipoxemia leve (saturação de oxigênio ≥ 90 a ≤ 94%, identificados por oximetria não invasiva) em um centro clínico especializado no atendimento de doenças respiratórias em Goiânia (GO). Todos foram submetidos a avaliação clínica, espirometria, polissonografia, ecocardiografia, gasometria arterial, teste de caminhada de 6 minutos e radiografia de tórax. Resultados Foram avaliados 64 pacientes com DPOC e hipoxemia noturna. Pacientes com hipoxemia noturna significativa apresentaram parâmetros ecocardiográficos associados a mais quantidade de musculatura do VE quando comparados a pacientes com hipoxemia noturna leve. A relação entre volume/massa do VE foi significativamente menor no grupo com hipoxemia noturna significativa (0,64 ± 0,13 versus 0,72 ± 0,12; p = 0,04) e a espessura diastólica do septo interventricular e a espessura diastólica da parede posterior do VE foram significativamente maiores nesse grupo (9,7 ± 0,92 versus 9,1 ± 0,90; p = 0,03) (9,7 ± 1,0 versus 8,9 ± 1,0; p = 0,01). O tempo de sono REM com saturação abaixo de 85% prediz significativamente a espessura do septo (ajuste para índice de massa corporal [IMC], idade e pressão arterial média; r2 = 0,20; p = 0,046). Conclusão Em indivíduos portadores de DPOC e hipoxemia noturna significativa, foi observada associação entre hipoxemia severa no sono REM e parâmetros ecocardiográficos que indicam aumento da massa do VE. Tal fato sugere que esse subgrupo de indivíduos pode se beneficiar de uma avaliação ecocardiográfica do VE.


ABSTRACT Objective To verify association between left ventricular (LV) mass and thickness and the presence of significant nocturnal hypoxemia in patients with COPD with mild diurnal hypoxemia. Methods A cross-sectional study carried out in clinically stable outpatients with COPD and mild hypoxemia (oxygen saturation ≥90 to ≤94%, identified by noninvasive oximetry) in a clinic specialized in the treatment of respiratory diseases in Goiânia-GO. All patients were submitted to clinical evaluation, spirometry, polysomnography, echocardiography, arterial blood gas analysis, 6-minute walk test and chest X-ray. Results Patients with significant nocturnal hypoxemia had echocardiographic parameters associated with increase of LV musculature when compared to patients with mild nocturnal hypoxemia. The LV volume/mass ratio was significantly lower in the group with significant nocturnal hypoxemia (ratio 0.64 ± 0.13 versus 0.72 ± 0.12, p = 0.04), the thickness diastolic diameter of the interventricular septum and the diastolic thickness of the LV posterior wall were significantly higher in this group (9.7 ± 0.92 versus 9.1 ± 0.90 p = 0.03), (9.7 ± 1.0 versus 8.9 ± 1.0, p = 0.01. The time in REM sleep with saturation below 85% significantly predicted septum thickness (adjustment for BMI, age and mean blood pressure, r2 = 0.20; p = 0.046). Conclusion We observed association between severe REM sleep hypoxemia and echocardiographic parameters indicating increased LV mass in individuals with COPD and significant nocturnal hypoxemia. This suggests that this subgroup of individuals may benefit from an echocardiographic evaluation of the left ventricle.


Subject(s)
Middle Aged , Aged , Aged, 80 and over , Echocardiography/methods , Polysomnography/adverse effects , Hypertrophy, Left Ventricular/etiology , Pulmonary Disease, Chronic Obstructive/physiopathology , Heart Ventricles/diagnostic imaging , Hypoxia/physiopathology , Sleep Apnea Syndromes/physiopathology , Spirometry , Cross-Sectional Studies , Pulmonary Disease, Chronic Obstructive/complications , Heart Ventricles/anatomy & histology , Hypoxia/etiology
17.
Rev. bras. cir. cardiovasc ; 34(6): 772-774, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057492

ABSTRACT

Abstract The most common cardiac tumour in the pediatric age group is rhabdomyoma. These are usually located in the ventricles, either in the ventricular septum or free wall. Cardiac tumours in early infancy may lead to severely compromised blood flow due to inflow or outflow tract obstruction. The diagnosis of cardiac rhabdomyoma can be established by transthoracic echocardiography (TTE). Rhabdomyomas have a natural history of spontaneous regression; surgical intervention is reserved for patients with symptoms of severe obstruction or hemodynamic instability. In this study, a case of two-year old child who presented with failure to thrive and underwent excision of pedunculated mass from the right ventricular outflow tract was reported.


Subject(s)
Humans , Child, Preschool , Rhabdomyoma/surgery , Ventricular Outflow Obstruction/surgery , Heart Neoplasms/surgery , Rhabdomyoma/diagnostic imaging , Magnetic Resonance Imaging , Ventricular Outflow Obstruction/diagnostic imaging , Echocardiography , Heart Neoplasms/diagnostic imaging , Heart Ventricles/diagnostic imaging
19.
Arch. cardiol. Méx ; 89(3): 222-232, jul.-sep. 2019. tab
Article in Spanish | LILACS | ID: biblio-1149071

ABSTRACT

Resumen Objetivo: El propósito de este estudio fue evaluar los cambios tempranos en la función miocárdica en niños con sobrepeso y obesidad, sin hipertensión arterial. Métodos: Estudio transversal en el que se incluyeron 150 participantes de ambos sexos entre 6 y 15 años. Se realizaron evaluaciones antropométricas, bioquímicas y de función ventricular mediante métodos ecocardiográficos convencionales y análisis de deformación miocárdica con ecocardiografía bidimensional speckle tracking. La comparación global entre los grupos de estudio (niños con peso normal, sobrepeso y obesidad) se llevó a cabo con la prueba de análisis de varianza (ANOVA) de una vía y análisis post hoc con corrección de Bonferroni para las comparaciones múltiples, y se consideró a los niños con peso normal como grupo de referencia. Resultados: La muestra final fue de 142 participantes, 50 (35%) con peso normal, 39 (28%) con sobrepeso y 53 (37%) con obesidad. El diámetro diastólico del ventrículo izquierdo (VI) y el septum interventricular, y el diámetro de la aurícula izquierda (AI) y la masa del VI fueron significativamente más altos en el grupo con obesidad en comparación con el grupo con peso normal. No se observaron diferencias significativas en los indicadores convencionales de la función sistólica y diastólica ventricular izquierda. Se observaron diferencias significativas en la deformación miocárdica regional entre los tres grupos. La media de deformación miocárdica longitudinal global fue más baja en los pacientes con obesidad (−20.9% vs. −23.5%; p menor 0.05) en comparación con los niños con peso normal. Conclusiones: La obesidad infantil se asoció a alteraciones en la deformación miocárdica, incluso en presencia de fracción de expulsión normal. La evaluación de la deformación miocárdica es relevante en los pacientes pediátricos con obesidad.


Abstract Objective: The purpose of this study was to evaluate early changes in myocardial function in overweight and obese children without hypertension. Methods: Cross-sectional study involving 150 participants of both sexes between 6 and 15 years old. Anthropometric and biochemical evaluations were performed. Ventricular function was assessed by conventional echocardiographic methods and myocardial deformation analysis by two-dimensional speckle tracking echocardiography. One-way analysis of variance was employed for the global comparison of study variables between groups (children with normal weight, overweight and obesity), and post hoc analysis with Bonferroni correction was used for multiple comparison, considering normal-weight children as the reference category. Results: Overall, 142 participants were included, 50 (35%) with normal weight, 39 (28%) overweight and 53 (37%) obesity. Diastolic diameter of the left ventricular (LV) and interventricular septum, diameter of the left atrium and LV mass were significantly higher in children with obesity compared to those with normal weight. No significant differences in the conventional indicators of LV systolic and diastolic function were found between groups. Significant differences in the regional myocardial deformation between the three groups were observed. Mean global longitudinal myocardial deformation was smaller in patients with obesity (−20.9% vs. −23.5%, p less 0.05) compared to children with normal weight. Conclusions: The childhood obesity was associated with altered myocardial deformation, even in the presence of normal ejection fraction. Myocardial deformation evaluation is relevant in the assessment of pediatric patients with obesity.


Subject(s)
Humans , Male , Female , Child , Adolescent , Echocardiography , Pediatric Obesity/complications , Heart/diagnostic imaging , Myocardium/pathology , Cross-Sectional Studies , Pediatric Obesity/epidemiology , Heart Ventricles/diagnostic imaging
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