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  • 11
    Online Resource
    Online Resource
    Components of Left Ventricular Ejection and Filling in Patients With Aortic Regurgitation Assessed by Speckle-Tracking Echocardiography
    MDPI AG ; 2012
    In:  Medicina Vol. 48, No. 1 ( 2012-02-03), p. 5-
    Details
    In: Medicina, MDPI AG, Vol. 48, No. 1 ( 2012-02-03), p. 5-
    Abstract: The aim of our study was to evaluate left ventricular (LV) longitudinal, radial, and rotational function and its relationship with conventional LV parameters of systolic and diastolic function in patients with aortic regurgitation (AR) by speckle-tracking echocardiography. Material and Methods. A total of 26 asymptomatic patients with moderate AR, 34 patients with severe AR, and 28 healthy controls were included into the study. LV rotation and longitudinal and radial strain were measured offline using speckle-tracking imaging. Results. The systolic longitudinal strain (–18.3% [SD, 2.18%] vs. –21.0% [SD, 2.52%] , P 〈 0.05) and strain rate (–1.08 s–1 [SD, 0.13 s–1] vs. –1.27 s–1 [SD, 0.15 s–1] , P 〈 0.05) were significantly lower and apical rotation (11.3° [SD, 4.99°] vs. 8.30° [SD, 4.34°] , P 〈 0.05) as well as rotation rate (82.72°/s [SD, 28.24 °/s] vs. 71.00°/s [SD, 28.04 °/s] , P 〈 0.05) were significantly higher in the patients with moderate AR compared with the control patients. The LV systolic basal rotation, systolic radial strain, and diastolic radial strain rate were significantly reduced in the patients with severe AR compared with the control patients. The global longitudinal, radial strain, and LV systolic diameter were the independent predictors of LV ejection fraction in the patients with AR (R2=0.77). The LV systolic basal rotation in the control patients, diastolic longitudinal strain rate and systolic longitudinal strain in the patients with moderate and severe AR, respectively, were independent predictors of LV diastolic filling. Conclusions. LV long-axis dysfunction with an increased apical rotation was present in the patients with moderate AR, while LV radial function and systolic basal rotation were found to be reduced in more advanced disease. LV diastolic filling depended on diastolic and systolic LV strain and rotation components in the patients with AR.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina48010005
    Language: English
    Publisher: MDPI AG
    Publication Date: 2012
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  • 12
    Online Resource
    Online Resource
    Impact of Left Ventricular Diastolic Dysfunction and Biomarkers on Pulmonary Hypertension in Patients with Severe Aortic Stenosis
    MDPI AG ; 2018
    In:  Medicina Vol. 54, No. 4 ( 2018-09-04), p. 63-
    Details
    In: Medicina, MDPI AG, Vol. 54, No. 4 ( 2018-09-04), p. 63-
    Abstract: Background: Severe aortic stenosis (AS) complicated by pulmonary hypertension (PH) is associated with poor outcomes after surgical aortic valve replacement (AVR). There is still scarce information about predictors of secondary PH in this group of patients. Objectives: The aim of this study was to investigate the prognostic impact of biomarkers together with conventional Doppler echocardiographic parameters of left ventricular diastolic function on elevated pulmonary systolic pressure (PSP) in severe AS patients before surgical AVR. Methods: Sixty patients with severe isolated AS (aortic valve area 〈 1 cm2) underwent echocardiography, N-terminal pro B-type natriuretic peptide (NT-proBNP) and growth differentiation factor-15 (GDF-15) measurements before AVR. PSP, left ventricular ejection fraction (LV EF), parameters of LV diastolic function (E/E’ ratio, mitral valve deceleration time (MV DT) and left atrial (LA) volume) were evaluated. PH was defined as an estimated PSP ≥ 45 mmHg. Results: Of the 60 patients, 21.7% with severe isolated AS had PH with PSP ≥ 45 mmHg (58.5 ± 11.2 mmHg). LV EF did not differ between groups and was not related to an elevated PSP (50 ± 8 vs. 49 ± 8%, p = 0.58). Parameters of LV diastolic dysfunction (E/E’ ratio 〉 14 (OR 6.00; 95% CI, 1.41–25.48; p = 0.009), MV DT ≤ 177.5 ms (OR 9.31; 95% CI, 2.06–41.14; p = 0.001), LA volume 〉 100 mL (OR 9.70; 95% CI, 1.92–49.03; p = 0.002)) and biomarkers (NT-proBNP 〉 4060 ng/L (OR 12.54; 95% CI, 2.80–55.99; p 〈 0.001) and GDF-15 〉 3393 pg/mL (OR 18.33; 95% CI, 2.39–140.39; p = 0.001)) were significantly associated with elevated PSP in severe AS. Conclusions: Left ventricular diastolic dysfunction and elevated biomarkers levels could predict the development of pulmonary hypertension in patients with severe aortic stenosis. Elevation of biomarkers paired with worsening of LV diastolic dysfunction could help to stratify patients for earlier surgical treatment before the development of pulmonary hypertension.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina54040063
    Language: English
    Publisher: MDPI AG
    Publication Date: 2018
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  • 13
    Online Resource
    Online Resource
    Clinical forms of infective endocarditis in Kaunas University of Medicine Hospital in 2002–2005
    MDPI AG ; 2007
    In:  Medicina Vol. 43, No. 7 ( 2007-06-13), p. 523-
    Details
    In: Medicina, MDPI AG, Vol. 43, No. 7 ( 2007-06-13), p. 523-
    Abstract: Objectives. To determine the incidence and distribution of clinical forms of infective endocarditis and to compare these data with data of 1983–1993. Material and methods. A retrospective analysis of clinical data of 116 patients with infective endocarditis treated in Kaunas University of Medicine Hospital in 2002–2005 was performed. The data were compared with analogical data of 1983–1993. Results. During 2002–2005, 55 (47.4%) patients presented with classic symptoms of infective endocarditis. In 61 cases, atypical clinical manifestations were observed: 19 patients presented with heart failure symptoms, 14 patients with embolic symptoms, 9 with pulmonary manifestations, and 5 patients with septic manifestations. There were three cases of nephritic form, three cases of rheumatic form, three cases of meningoencephalitic form, and two cases of ophthalmic form. In three cases, pacemaker endocarditis was seen. During the period of 1983–1993, 15 patients with infective endocarditis were treated annually in Kaunas University of Medicine Hospital; in 2002–2005, this number increased to 29 cases per year. More cases of embolic and pulmonic clinical forms of infective endocarditis were diagnosed as compared to the data of 1983–1993 (P 〈 0.05). There were more cases of primary endocarditis in 2002–2005 than in 1983–1993 (36.2% and 23.8%, respectively, P 〈 0.05). Conclusions. Typically, infective endocarditis manifests as classical symptoms, but in more than half of cases, atypical forms were observed, the most common of which were heart failure form and embolic form. Primary infective endocarditis was detected more frequently.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina43070066
    Language: English
    Publisher: MDPI AG
    Publication Date: 2007
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