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1.
Am Heart J Plus ; 13: 100081, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38560087

RESUMO

Objective: The aim of this cross-sectional, retrospective, descriptive study was to review and classify cardiac masses systematically and to determine their frequencies. Methods: The medical records of 64,862 consecutive patients were investigated within 12 years. Every patient with a cardiac mass imaged by transthoracic echocardiography (TTE) and confirmed with an advanced imaging modality such as transesophageal echocardiography (TEE), computed tomography (CT) and/or cardiac magnetic resonance imaging (CMR) was included. Acute coronary syndromes triggering thrombus formation, vegetations, intracardiac device and catheter related thrombi were excluded. Results: Data demonstrated 127 (0.195%) intracardiac masses consisting of 33 (0.050%) primary benign, 3 (0.004%) primary malignant, 20 (0.030%) secondary tumors, 3 (0.004%) hydatid cysts and 68 (0.104%) thrombi respectively. The majority of primary cardiac tumors were benign (91.67%), predominantly myxomas (78.79%), and the less malignant (8.33%). Secondary cardiac tumors were common than the primary malignant tumors (20:3), with male dominancy (55%), lymphoma and lung cancers were the most frequent. Intracardiac thrombi was the majority of the cardiac masses, thrombi accompanying malignancies were in the first range (n = 17, 25%), followed by autoimmune diseases (n = 13, 19.12%) and ischemic heart disease with low ejection fraction (n = 12, 17.65%). Conclusions: This retrospective analysis identified 127 patients with cardiac masses. The majority of benign tumors were myxoma, the most common tumors that metastasized to the heart were lymphoma and lung cancers, and the thrombi associated with malignancies and autoimmune diseases were the most frequent.

2.
Turk Kardiyol Dern Ars ; 47(8): 687-690, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31802766

RESUMO

Antiphospholipid syndrome (APS) is a clinical disorder that creates an increased risk of arterial or venous thrombotic events or pregnancy-associated complications and includes the presence of autoantibodies against negatively charged phospholipids. This syndrome is often associated with systemic autoimmune diseases, such as systemic lupus erythematosus (SLE). Libman-Sacks endocarditis is a form of non-bacterial thrombotic endocarditis and is infrequently seen in APS. There are few data documenting the echocardiographic response of APS valve disease to medical treatment. This is an unusual case of a young female patient with SLE and APS who had chorea and non-bacterial thrombotic aortic valve endocarditis. Echocardiography revealed that the vegetation had receded after a combination of warfarin and immunosuppressive therapy.


Assuntos
Endocardite/tratamento farmacológico , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Varfarina/uso terapêutico , Adulto , Ecocardiografia Transesofagiana , Endocardite/diagnóstico por imagem , Feminino , Humanos , Imunossupressores/administração & dosagem , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico por imagem , Varfarina/administração & dosagem , Adulto Jovem
3.
Anadolu Kardiyol Derg ; 10(3): 247-52, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20538560

RESUMO

OBJECTIVE: Standard echocardiographic methods reflect chamber dynamics and do not provide a direct measure of myocardial fiber shortening. Therefore we evaluated longitudinal left ventricular myocardial function by tissue Doppler echocardiography; strain (S), strain rate (SR), tissue Doppler velocity (TDV) in newly diagnosed mild to moderate hypertensive patients. METHODS: Our cross-sectional and observational study population consisted of 57 patients and 48 normotensive control subjects. Patients with obesity, diabetes mellitus, regional wall motion abnormality, secondary hypertension and a history or clinical evidence of cardiovascular disease, arrhythmias or conduction abnormalities were excluded from the study. Ejection fraction, endocardial fractional shortening (eFS), meridional end-systolic stress (mESS), stress-adjusted eFS (observed /predicted eFS) were measured by M-mode echocardiography. Relationship between the left ventricular mass index and mESS was assessed by Pearson's linear regression model. RESULTS: Hypertensive patients had significantly decreased longitudinal myocardial function compared to control subjects determined by septal (-1.25+/-0.30 vs. -1.02+/-0.33, p<0.001) and lateral (-1.20+/-0.28 vs. 1.02+/-0.41, p<0.01) SR (1/s) measurements. However, there was no significant correlation between the mESS and strain-strain rate measurements in both normal and hypertensive subjects. CONCLUSIONS: Early impairment in longitudinal left ventricular systolic function can be expected despite normal endocardial left ventricular function indicated by M-mode echocardiography in patients with newly diagnosed and never treated mild to moderate hypertension.


Assuntos
Hipertensão/fisiopatologia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia , Adulto , Estudos Transversais , Ecocardiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Valores de Referência , Estresse Mecânico , Volume Sistólico , Sístole/fisiologia , Ultrassonografia Doppler em Cores/métodos
4.
Int J Cardiovasc Imaging ; 26(4): 405-12, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20111906

RESUMO

Longitudinal myocardial function (LMF) may be impaired while systolic function is still normal. We investigated relationship between LMF and hypertensive organ damage in newly diagnosed stage I hypertensive patients. A total of 57 patient with never treated stage I hypertension and 48 matched healthy control subject were enrolled in the study. Conventional 2-D, Doppler and tissue wave Doppler imaging (TDI) echocardiography were used. LMF was evaluated by the septal and lateral strain (S) and strain rate (SR) measurements. Hypertensive complications were evaluated by the urine microalbumin levels and retinal examination. A multivariate regression analysis was perfomed to assess the relation between the variables. Ejection fraction, mid-wall fractional shortenning, systolic movement rates (TDs) in TDI were similar both in hypertensive and control groups. In patients with left ventricular hypertrophy, septal TDs (7.29 +/- 1.28 vs. 8.06 +/- 1.19 cm, P = 0.03), lateral TDs (8.46 +/- 1.83 vs. 9.87 +/- 2.42 cm, P = 0.01) and lateral S (-13.02 +/- 7.83 vs. -18.86 +/- 8.60%, P = 0.01) values were significantly lower. Septal S (-13.67 +/- 3.52 vs. -19.09 +/- 5.96%, P < 0.01) and SR (-0.83 +/- 0.29 vs. -1.22 +/- 0.28 1/S, P < 0.01) were significantly decreased in hypertensive patients with microalbuminuria. Septal S value was also significantly decreased in patients with retinopathy (-14.76 +/- 5.55 vs. -20.20 +/- 5.44%, P = 0.01). Multivariate analysis showed that only septal and lateral S values were independent factors for the retinopathy and left ventricular hypertrophy, respectively. In hypertensive patients, LMF established by the measurement of S and SR, might be impaired and also related with end organ damage while global circumferential function is preserved.


Assuntos
Albuminúria/etiologia , Ecocardiografia Doppler , Hipertensão/complicações , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Doenças Retinianas/etiologia , Adulto , Albuminúria/diagnóstico , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Técnicas de Diagnóstico Oftalmológico , Ecocardiografia Doppler de Pulso , Feminino , Humanos , Hipertensão/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Nefelometria e Turbidimetria , Valor Preditivo dos Testes , Doenças Retinianas/diagnóstico , Medição de Risco , Fatores de Risco , Função Ventricular Esquerda
5.
Turk Kardiyol Dern Ars ; 36(8): 546-8, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19223721

RESUMO

Cardiac metastasis of Ewing's sarcoma is rare. A 22-year-old woman was admitted with complaints of palpitation and fatigue on exertion. She had a seven-year history of radical right tibial resection for Ewing's sarcoma and was also receiving chemotherapy for lung metastasis of Ewing's sarcoma. Both transthoracic and transesophageal echocardiography demonstrated a single, large (3x3.5 cm) inhomogeneous mass located in the free wall of the right ventricle. To differentiate the mass from a massive thrombus, contrast-enhanced magnetic resonance imaging was performed. The mass showed partial contrast enhancement, suggesting a malignant metastatic mass. Surgical resection was not considered due to accompanying lung metastasis and potentially poor outcome of the operation.


Assuntos
Neoplasias Ósseas/patologia , Ecocardiografia/métodos , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/secundário , Sarcoma de Ewing/patologia , Neoplasias Ósseas/diagnóstico , Diagnóstico Diferencial , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundário , Metástase Neoplásica , Prognóstico , Sarcoma de Ewing/diagnóstico , Adulto Jovem
6.
Int J Cardiol ; 88(2-3): 199-206, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12714199

RESUMO

We examined the possible effect of diurnal variability of heart rate on the development of arrhythmias in patients with chronic obstructive pulmonary disease (COPD). Forty-one COPD patients (M/F: 39/2, mean age: 59+/-8.5 years) and 32 (M/F: 27/5, mean age: 57+/-11 years) healthy controls were included. Twenty-four hour ECG recordings were analyzed for atrial fibrillation (AF) or ventricular premature beats (VPB), and circadian changes in heart rate variability (HRV) were assessed by dividing the 24-h period into day-time (08:00-24:00 h) and night-time (24:00-08:00 h) periods. Night-time total (TP), low frequency (LF) and high frequency (HF) powers were similarly lower from day-time parameters in AF(-) COPD patients (HF 3.91+/-1 vs. 4.43+/-1.04 ms(2), P=0.001) and controls (HF 3.95+/-0.72 vs. 4.82+/-0.66 ms(2), P<0.001). The LF/HF ratios were also significantly reduced in the same patient groups (AF(-) COPD 1.35+/-0.21 vs. 1.27+/-0.19, P=0.04, controls 1.43+/-0.14 vs. 1.24+/-0.09, P<0.001). Night-time TP and LF were increased, HF unchanged and LF/HF significantly increased (1.11+/-0.25 vs. 1.19+/-0.27, P<0.05) in AF(+) COPD patients. Frequency of VPB was correlated with corrected QT dispersion (QTc(d)) (r=0.52, P=0.001) and the day-time/night-time HF ratio (r=0.43, P=0.02). Patients with QTc(d)>or=60 ms did not have the expected increase in night-time HF and had a statistically insignificant increase in LF/HF ratio. In COPD patients with QTc(d)<60 ms, circadian changes in HRV parameters were parallel with the controls. We concluded that COPD patients with arrhythmia had circadian HRV disturbances such as unchanged night-time parasympathetic tone and disturbed sympatho-vagal balance in favor of the sympathetic system all day long, which may explain the increased frequency of arrhythmia.


Assuntos
Arritmias Cardíacas/etiologia , Arritmias Cardíacas/fisiopatologia , Transtornos Cronobiológicos/complicações , Transtornos Cronobiológicos/fisiopatologia , Ritmo Circadiano/fisiologia , Frequência Cardíaca/fisiologia , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Idoso , Arritmias Cardíacas/sangue , Gasometria , Transtornos Cronobiológicos/sangue , Eletrocardiografia Ambulatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/sangue , Testes de Função Respiratória , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo
7.
Ann Noninvasive Electrocardiol ; 7(3): 222-7, 2002 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12167183

RESUMO

BACKGROUND: Supraventricular tachyarrhythmia is a common problem in chronic obstructive pulmonary disease (COPD) patients. The purpose of this study is to analyze the factors associated with paroxysmal atrial fibrillation (AF) in COPD patients. METHODS: Forty COPD patients (38 male, 2 female, mean age 60 +/- 9 years) and 33 healthy controls (29 male, 4 female, mean age: 58 +/- 10 years) were included in this study. Echocardiography, 24-hour ambulatory and 12-lead ECG, pulmonary function tests, arterial blood gases, and serum electrolytes were measured. On ECG, maximum (P(max)) and minimum (P(min)) duration of P wave and its difference, P-wave dispersion (PWd), were measured. RESULTS: On echocardiography, diastolic dysfunction was found in 14 of the 40 (35%) COPD patients. Heart rate variability analysis revealed that COPD patients had decreased SDANN, SDNN, SDNNIDX in time-domain, and decreased LF in frequency domain parameters. Fourteen of the 40 COPD patients (35%) had AF. Patients with AF were older (57 +/- 10 vs 64 +/- 5 years, P = 0.03) and had lower SDANN, SDNN, and LF/HF ratio as compared to patients without AF in univariate analysis. All P-wave intervals (P(max), P(min,) and PWd) were increased in COPD patients compared to controls. P-wave dispersion was significantly increased in COPD patients with AF, as compared to patients without AF (57 +/- 11 vs 44 +/- 7 ms, P = 0.001). In logistic regression analysis PWd was found to be the only factor associated with the development of AF (P = 0.04). CONCLUSIONS: The presence of AF was significantly related to the prolongation of PWd, but not with pulmonary function, arterial blood gasses, and left and right atrial function.


Assuntos
Fibrilação Atrial/diagnóstico , Eletrocardiografia , Doença Pulmonar Obstrutiva Crônica/complicações , Distribuição por Idade , Idoso , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/etiologia , Estudos de Casos e Controles , Estudos de Coortes , Intervalos de Confiança , Ecocardiografia/métodos , Eletrocardiografia Ambulatorial/métodos , Feminino , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Probabilidade , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Valores de Referência , Fatores de Risco , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Distribuição por Sexo
8.
J Am Soc Echocardiogr ; 15(3): 271-4, 2002 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11875393

RESUMO

Although diagnostic value of transthoracic echocardiography in cardiac echinococcus is well established, the role of transesophageal echocardiography in both the diagnosis and the management of this entity is not well known. We present 3 unusual cases of cardiac hydatid cyst in which transesophageal echocardiography was used. A review of the literature on the subject is also presented.


Assuntos
Cardiomiopatias/diagnóstico por imagem , Equinococose/diagnóstico por imagem , Ecocardiografia Transesofagiana , Adulto , Cardiomiopatias/parasitologia , Cardiomiopatias/terapia , Equinococose/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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