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2.
Acta Haematol ; 118(1): 1-6, 2007.
Article in English | MEDLINE | ID: mdl-17374947

ABSTRACT

BACKGROUND: QT dispersion has been proposed to be a predictor of adverse outcomes in a variety of cardiac disease states. The objective of this study was to examine QT dispersion in patients with sickle cell disease (SCD) and to assess the effect of pulmonary hypertension (PHT) on QT dispersion. METHODS: We performed Doppler echocardiographic assessments of pulmonary artery systolic pressure in 73 (mean age 18.5 +/- 8.0 years) steady-state SCD patients and 25 (mean age 19.6 +/- 7.2 years) healthy subjects. Resting 12-lead electrocardiogram was recorded and QT dispersion was calculated as the difference between maximum and minimum QT intervals. Bazett's formula was used to obtain a rate-corrected value of the QT interval (QTc). RESULTS: Maximum QTc, minimum QTc and QTc dispersion were significantly increased in SCD patients compared to the control subjects (p < 0.0001, p < 0.05, p < 0.0001, respectively). Among SCD patients, patients with PHT had higher maximum QTc and QTc dispersion than patients without PHT (p < 0.0001). However, minimum QTc showed no significant differences between the two patient groups. CONCLUSION: QTc dispersion is significantly increased in SCD patients, especially those with PHT indicating regional inhomogeneity of ventricular repolarization.


Subject(s)
Anemia, Sickle Cell/diagnosis , Anemia, Sickle Cell/epidemiology , Hypertension, Pulmonary/diagnosis , Long QT Syndrome/diagnosis , Adolescent , Adult , Case-Control Studies , Causality , Child , Comorbidity , Echocardiography, Transesophageal , Electrocardiography , Female , Humans , Hypertension, Pulmonary/epidemiology , Long QT Syndrome/epidemiology , Male , Probability , Prognosis , Reference Values , Risk Assessment , Severity of Illness Index , Statistics, Nonparametric
3.
Acta Neurol Scand ; 114(2): 114-8, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16867034

ABSTRACT

OBJECTIVES: To investigate the left (LV) and right ventricular (RV) function in multiple sclerosis (MS) using standard echocardiography and Doppler tissue imaging (DTI). MATERIALS AND METHODS: A total of 41 patients with definite MS and 32 healthy controls were included in the study. RESULTS: LV end-systolic dimension was increased and LV ejection fraction was decreased in MS patients compared with controls (P < 0.05). LV end-diastolic dimension was increased in MS patients, however, did not reach significance. Among DTI parameters, mitral annular peak early diastolic velocity to peak late diastolic velocity ratio (Em/Am) was decreased in MS patients, but not reach statistical significance. No significant differences in tricuspid annular Em/Am ratio was found between MS patients and controls. A statistically significant increase of DTI derived LV myocardial performance index was found in MS patients as compared with controls. RV myocardial performance index showed a tendency to be increased in MS patients, however, did not reach significance. CONCLUSIONS: These findings suggest subclinical LV dysfunction and preserved RV function in patients with MS.


Subject(s)
Heart Ventricles/physiopathology , Multiple Sclerosis/complications , Multiple Sclerosis/physiopathology , Myocardium/immunology , Ventricular Dysfunction, Left/etiology , Ventricular Dysfunction, Left/physiopathology , Adult , Cardiac Output, Low/diagnostic imaging , Cardiac Output, Low/etiology , Cardiac Output, Low/physiopathology , Diastole/physiology , Echocardiography , Female , Heart Ventricles/diagnostic imaging , Humans , Male , Myocarditis/diagnostic imaging , Myocarditis/immunology , Myocarditis/physiopathology , Predictive Value of Tests , Systole/physiology , Ventricular Dysfunction, Left/diagnostic imaging
4.
Pediatr Cardiol ; 27(4): 440-6, 2006.
Article in English | MEDLINE | ID: mdl-16835804

ABSTRACT

The effects of sickle cell disease (SCD) on right ventricular (RV) and pulmonary function in SCD patients with pulmonary hypertension is not well-known. The aim of this study was to investigate RV and pulmonary functions in patients suffering from SCD with or without pulmonary hypertension using color tissue Doppler imaging and spirometry. We evaluated 48 asymptomatic patients with SCD. All patients underwent echocardiography with tissue Doppler imaging and pulmonary function test. Patients were divided into two groups: Group 1 consisted of 27 patients (age, 18.1 +/- 7.1 years) with normal pulmonary artery pressure, and group 2 consisted of 21 patients (age, 21.4 +/- 7.4 years) with pulmonary hypertension. Both groups were compared with a sex- and age-matched control group including 24 normal healthy subjects (age, 19.8 +/- 9.2 years). Tricuspid lateral annular systolic (S (m)) and early diastolic velocity (E (m)) were higher in group 1 than group 2 and the control group (p < 0.05). Tricuspid lateral annular late diastolic velocities (A (m)), isovolumetric contraction time, and myocardial performance index (MPI) were higher and the E (m)/A (m) ratio was lower in group 2 than group 1 and the control group (p < 0.05). However, no differences were found in the tricuspid lateral annular E (m) deceleration time, ejection time, and isovolumetric relaxation time between group 1, group 2, and the control group. Tricuspid lateral annular S (m) and E (m) were similar in group 2 and the control group. Forced expiratory volume in 1 second (FEV(1)), forced vital capacity (FVC), and the diffusion capacity of the lung for carbon monoxide were decreased in both groups of patients compared to the control group (p < 0.05). However, there was no difference in respiratory rate, FEV(1)/FVC ratio, peak expiratory flow, and total lung capacity between group 1, group 2, and the control group. There were no differences in any indices of lung function between the two groups of patients. MPI is useful index to evaluate RV function in patients with SCD. RV diastolic function was disturbed in only SCD patients with pulmonary hypertension. On the other hand, the restrictive pattern of pulmonary function abnormalities had developed in both groups of patients.


Subject(s)
Anemia, Sickle Cell/physiopathology , Hypertension, Pulmonary/physiopathology , Lung Volume Measurements , Pulmonary Wedge Pressure , Ventricular Function, Right , Adolescent , Adult , Anemia, Sickle Cell/diagnostic imaging , Blood Flow Velocity , Carbon Monoxide/analysis , Case-Control Studies , Child , Echocardiography, Doppler, Color , Female , Forced Expiratory Flow Rates , Forced Expiratory Volume , Heart Rate , Heart Ventricles/diagnostic imaging , Heart Ventricles/physiopathology , Humans , Hypertension, Pulmonary/diagnostic imaging , Male , Myocardial Contraction , Oxygen/analysis , Research Design , Spirometry , Stroke Volume , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/physiopathology , Ventricular Function, Left , Vital Capacity
5.
Int J Cardiovasc Imaging ; 22(6): 745-54, 2006 Dec.
Article in English | MEDLINE | ID: mdl-16705477

ABSTRACT

OBJECTIVES: To investigate right ventricular diastolic function in rheumatoid arthritis (RA) and its relationship with left ventricular and pulmonary involvement. METHODS: Thirty-five RA patients and 30 healthy subjects were submitted to conventional Doppler (CE) and tissue Doppler echocardiography (TDE) to assess left and right systolic and diastolic function and to estimate maximal arterial systolic pulmonary pressure (PAP). To detect pulmonary involvement, pulmonary function tests and high-resolution computed tomography (HRCT) scans were performed in all RA patients. RESULTS: An abnormal RV filling, as expressed byan inverted tricuspid (Tr.) E/A ratio, was detected in 12 (34%) of the 35 RA patients and in 2 (7%) of the 30 controls (P<0.004). If compared to CE findings, prevalence of RV diastolic abnormalities were found higher in patients with RA by TDE (RV annulus Em/Am ratio <1 (in 31 (89%) of 35 patients) (P = 0.002). Twenty-two (63%) of 35 patients had abnormal HRCT findings. Pulmonary involvement with pulmonary hypertension (PHT) (36+/-5 mmHg) was detected in 10 (29%) of 35 RA. In this group, increase of RV annulus and basal Am wave, decrease of Tr. E/A ratio and RV annulus Em/Am ratio were statistically significant compared to RA (12 (34%) of 35) patients with pulmonary involvement who had normal PAP (19+/-5 mmHg), (P = 0.014, P = 0.006, P = 0.015, P = 0.049, respectively). CONCLUSIONS: This study points out an impaired RV filling in a significant part of RA patients without overt heart failure. Impairment of RV diastolic function may be a predictor of subclinic myocardial and pulmonary involvement in patients with RA.


Subject(s)
Arthritis, Rheumatoid/complications , Heart Ventricles/diagnostic imaging , Hypertension, Pulmonary/physiopathology , Ventricular Dysfunction, Right/etiology , Diastole/physiology , Echocardiography, Doppler , Female , Heart Ventricles/physiopathology , Humans , Male , Middle Aged , Respiratory Function Tests , Tomography, X-Ray Computed/methods , Ventricular Dysfunction, Right/diagnostic imaging
7.
Anadolu Kardiyol Derg ; 4(3): 217-22, 2004 Sep.
Article in Turkish | MEDLINE | ID: mdl-15355823

ABSTRACT

OBJECTIVE: The aim of this study was to investigate the relationship between the myocardial performance index (MPI) and left ventricular (LV) geometry in hypertensive patients. METHODS: The MPI, which is a marker of systolic and diastolic ventricular function, was measured in 64 hypertensive patients and in 15 healthy persons (Control). According to the value of relative wall thickness (RWT) and LV mass index (LVMI), hypertensive patients were subdivided into four groups: normal (N), 17 patients (26.6%); concentric remodeling (CR), 21 patients (32.8%); concentric hypertrophy (CH), 16 patients (25%); and eccentric hypertrophy (EH), 10 patients (15.6%). RESULTS: A higher MPI was found in all patient groups (N, 0.56+/-0.11; CR, 0.59+/-0.11; CH, 0.68+/-0.19; EH, 0.57+/-0.10) compared with the controls (0.44+/-0.09) (p=0.004, p<0.001, p<0.001 and p = 0.002, respectively). In the CH group, the MPI was also higher than in N, CR and EH groups (p=0.006, p<0.03 and p=0.009, respectively). No significant difference was found among N, CR and EH groups. The MPI was correlated with LVMI (r=0.28, p=0.014), RWT (r=0.24, p=0.035) and interventricular septum diastolic thickness (r=0.32, p=0.004). CONCLUSION: The systolic and diastolic LV functions are impaired in all subgroups of hypertensive patients according to their LV geometry compared to control group. This impairment is more advanced in patients with concentric hypertrophy than in those with the other LV geometric patterns.


Subject(s)
Hypertension/physiopathology , Hypertrophy, Left Ventricular/physiopathology , Ventricular Function, Left , Case-Control Studies , Echocardiography , Female , Heart Ventricles/pathology , Humans , Hypertension/complications , Hypertrophy, Left Ventricular/complications , Hypertrophy, Left Ventricular/diagnostic imaging , Male , Middle Aged
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