Academic literature on the topic 'Global ejection fraction'
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Journal articles on the topic "Global ejection fraction"
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Soslow, Jonathan H., Emem Usoro, Li Wang, and David A. Parra. "Evaluation of tricuspid annular plane systolic excursion measured with cardiac MRI in children with tetralogy of Fallot." Cardiology in the Young 26, no. 4 (August 17, 2015): 718–24. http://dx.doi.org/10.1017/s1047951115001456.
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AbstractBackgroundAneurysmal dilation of the right ventricular outflow tract complicates assessment of right ventricular function in patients with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is commonly used to estimate ejection fraction. We hypothesised that tricuspid annular plane systolic excursion measured by cardiac MRI approximates global and segmental right ventricular function, specifically right ventricular sinus ejection fraction, in children with repaired tetralogy of Fallot.MethodsTricuspid annular plane systolic excursion was measured retrospectively on cardiac MRIs in 54 patients with repaired tetralogy of Fallot. Values were compared with right ventricular global, sinus, and infundibular ejection fractions. Tricuspid annular plane systolic excursion was indexed to body surface area, converted into a fractional value, and converted into published paediatric Z-scores.ResultsTricuspid annular plane systolic excursion measurements had good agreement between observers. Right ventricular ejection fraction did not correlate with the absolute or indexed tricuspid annular plane systolic excursion and correlated weakly with fractional tricuspid annular plane systolic excursion (r=0.41 and p=0.002). Segmental right ventricular function did not appreciably improve correlation with any of the tricuspid annular plane systolic excursion measures. Paediatric Z-scores were unable to differentiate patients with normal and abnormal right ventricular function.ConclusionsTricuspid annular plane systolic excursion measured by cardiac MRI correlates poorly with global and segmental right ventricular ejection fraction in children with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is an unreliable approximation of right ventricular function in this patient population.
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Grapsa, Julia. "Left Ventricular Ejection Fraction and Global Longitudinal Strain." Journal of the American College of Cardiology 72, no. 9 (August 2018): 1065–66. http://dx.doi.org/10.1016/j.jacc.2018.05.070.
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Naing, Pyi, Douglas Forrester, Nadarajah Kangaharan, Aruna Muthumala, Su Mon Myint, and David Playford. "Heart failure with preserved ejection fraction: A growing global epidemic." Australian Journal of General Practice 48, no. 7 (July 1, 2019): 465–71. http://dx.doi.org/10.31128/ajgp-03-19-4873.
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Standke, R., R. P. Baum, S. Tezak, D. Mildenberger, F. D. Maul, G. Hör, M. Kaltenbach, and H. Klepzig. "Vergleich von Belastungs- EKG und Radionuklid- Ventrikulographie bezüglich des Nachweises einer Myokardischämie bei isolierten Stenosen des Ramus interventricularis anterior." Nuklearmedizin 27, no. 02 (1988): 57–62. http://dx.doi.org/10.1055/s-0038-1628908.
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21 patients with LAD-stenoses of at least 70% and 21 patients with LAD- stenoses and additional intramural anterior wall infarctions were studied. 20 patients without heart disease or after successful transluminal coronary angioplasty and 18 patients with intramural anterior wall infarction after successful transluminal dilatation of the LAD (remaining stenosis maximal 30%) served as controls. The normal range of global and regional left ventricular ejection fraction response to exercise was defined based on the data of 25 further patients without relevant coronary heart disease. Thus, a decrease in global ejection fraction and regional wall motion abnormalities were judged pathological. All patients were comparable with respect to age, ejection fraction at rest and work load. Myocardial ischemia could be detected by the exercise ECG in 81 % of all patients without infarction and in 71 % of patients with infarction. The corresponding values for global left ventricular ejection fraction were 76% and 81 %, respectively, and for regional ejection fraction 95% in both groups. No false-positive exercise ECGs were observed in the healthy controls and 2 (11 %) in the corresponding group with intramural infarction. The global ejection fraction was pathological in 1 (5%) healthy subject without infarction and in 3 (17%) corresponding patients with infarction. Sectorial analysis revealed 5 and 22%, respectively. Our findings suggest that the exercise ECG has a limited sensitivity to detect myocardial ischemia in patients with isolated LAD-stenoses and intramural myocardial infarction. Radionuclide ventriculography yields pathological values more often; however, false-positive results also occur more frequently.
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Clemmensen, Tor Skibsted, Hans Eiskjær, Pernille B. Kofoed-Nielsen, Søren Høyer, and Steen Hvitfeldt Poulsen. "Case of Acute Graft Failure during Suspected Humoral Rejection with Preserved Ejection Fraction, but Severely Reduced Longitudinal Deformation Detected by 2D-Speckle Tracking." Case Reports in Transplantation 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/173589.
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This case displays limited utility of left ventricular ejection fraction to detect acute graft failure due to microvascular vasculopathy and suspected humoral rejection. Despite severe and progressive graft failure, clinically and by right heart catheterizations, left ventricular ejection fraction remained unchanged, indicating need of more reliable noninvasive methods for graft function surveillance. Global longitudinal strain relates to clinical heart failure, filling pressure, and cardiac index during suspected humoral rejection and microvascular dysfunction in this HTX patient. We suggest routine monitoring of graft function by global longitudinal strain as supplement to routine left ventricular ejection fraction and diastolic Doppler measurements.
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Borlaug, Barry A., Thomas P. Olson, Carolyn S. P. Lam, Kelly S. Flood, Amir Lerman, Bruce D. Johnson, and Margaret M. Redfield. "Global Cardiovascular Reserve Dysfunction in Heart Failure With Preserved Ejection Fraction." Journal of the American College of Cardiology 56, no. 11 (September 2010): 845–54. http://dx.doi.org/10.1016/j.jacc.2010.03.077.
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Chen, Yei-Tsung, Lee Lee Wong, Oi Wah Liew, and Arthur Mark Richards. "Heart Failure with Reduced Ejection Fraction (HFrEF) and Preserved Ejection Fraction (HFpEF): The Diagnostic Value of Circulating MicroRNAs." Cells 8, no. 12 (December 16, 2019): 1651. http://dx.doi.org/10.3390/cells8121651.
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Circulating microRNAs offer attractive potential as epigenetic disease biomarkers by virtue of their biological stability and ready accessibility in liquid biopsies. Numerous clinical cohort studies have revealed unique microRNA profiles in different disease settings, suggesting utility as markers with diagnostic and prognostic applications. Given the complex network of microRNA functions in modulating gene expression and post-transcriptional modifications, the circulating microRNA landscape in disease may reflect pathophysiological status, providing valuable information for delineating distinct subtypes and/or stages of complex diseases. Heart failure (HF) is an increasingly significant global health challenge, imposing major economic liability and health care burden due to high hospitalization, morbidity, and mortality rates. Although HF is defined as a syndrome characterized by symptoms and findings on physical examination, it may be further differentiated based on left ventricular ejection fraction (LVEF) and categorized as HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). The presenting clinical syndromes in HFpEF and HFrEF are similar but mortality differs, being somewhat lower in HFpEF than in HFrEF. However, while HFrEF is responsive to an array of therapies, none has been shown to improve survival in HFpEF. Herein, we review recent HF cohort studies focusing on the distinct microRNA profiles associated with HF subtypes to reveal new insights to underlying mechanisms and explore the possibility of exploiting these differences for diagnostic/prognostic applications.
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Sunthankar, Sudeep, David A. Parra, Kristen George-Durrett, Kimberly Crum, Joshua D. Chew, Jason Christensen, Frank J. Raucci, Meng Xu, James C. Slaughter, and Jonathan H. Soslow. "Tissue characterisation and myocardial mechanics using cardiac MRI in children with hypertrophic cardiomyopathy." Cardiology in the Young 29, no. 12 (November 26, 2019): 1459–67. http://dx.doi.org/10.1017/s1047951119002397.
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AbstractIntroduction:Distinguishing between hypertrophic cardiomyopathy and other causes ofleft ventricular hypertrophy can be difficult in children. We hypothesised that cardiac MRI T1 mapping could improve diagnosis of paediatric hypertrophic cardiomyopathy and that measures of myocardial function would correlate with T1 times and extracellular volume fraction.Methods:Thirty patients with hypertrophic cardiomyopathy completed MRI with tissue tagging, T1-mapping, and late gadolinium enhancement. Left ventricular circumferential strain was calculated from tagged images. T1, partition coefficient, and synthetic extracellular volume were measured at base, mid, apex, and thickest area of myocardial hypertrophy. MRI measures compared to cohort of 19 healthy children and young adults. Mann–Whitney U, Spearman’s rho, and multivariable logistic regression were used for statistical analysis.Results:Hypertrophic cardiomyopathy patients had increased left ventricular ejection fraction and indexed mass. Hypertrophic cardiomyopathy patients had decreased global strain and increased native T1 (−14.3% interquartile range [−16.0, −12.1] versus −17.3% [−19.0, −15.7], p < 0.001 and 1015 ms [991, 1026] versus 990 ms [972, 1001], p = 0.019). Partition coefficient and synthetic extracellular volume were not increased in hypertrophic cardiomyopathy. Global native T1 correlated inversely with ejection fraction (ρ = −0.63, p = 0.002) and directly with global strain (ρ = 0.51, p = 0.019). A logistic regression model using ejection fraction and native T1 distinguished between hypertrophic cardiomyopathy and control with an area under the receiver operating characteristic curve of 0.91.Conclusion:In this cohort of paediatric hypertrophic cardiomyopathy, strain was decreased and native T1 was increased compared with controls. Native T1 correlated with both ejection fraction and strain, and a model using native T1 and ejection fraction differentiated patients with and without hypertrophic cardiomyopathy.
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ITO, Koji, Azusa FUKUMITSU, Kikuko AKIMITSU, Machiko MURATA, Tomoyo OKUDA, Kayo KUROKAWA, Aki OGAWA, Masahiro MOHRI, and Hideo YAMAMOTO. "Increase in global function index in subjects with preserved left ventricular ejection fraction." Choonpa Igaku 44, no. 5 (2017): 439–45. http://dx.doi.org/10.3179/jjmu.jjmu.a.90.
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Patel, Jay, Rishi Rikhi, Muzna Hussain, Chadi Ayoub, Alan Klein, Patrick Collier, and Rohit Moudgil. "Global longitudinal strain is a better metric than left ventricular ejection fraction." Current Opinion in Cardiology 35, no. 2 (March 2020): 170–77. http://dx.doi.org/10.1097/hco.0000000000000716.
Full textDissertations / Theses on the topic "Global ejection fraction"
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Wright, Gabriel J. T. "Automated 3D echocardiography analysis : advanced methods and their evaluation on clinical data." Thesis, University of Oxford, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275378.
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Jonsson, Åsa. "How to create and analyze a Heart Failure Registry with emphasis on Anemia and Quality of Life." Doctoral thesis, Linköpings universitet, Avdelningen för kardiovaskulär medicin, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-137351.
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Background and aims Heart failure (HF) is a major cause of serious morbidity and death in the population and one of the leading medical causes of hospitalization among people older than 60 years. The aim of this thesis was to describe how to create and how to analyze a Heart Failure Registry with emphasis on Anemia and Quality of Life. (Paper I) We described the creation of the Swedish Heart Failure Registry (SwedeHF) as an instrument, which may help to optimize the handling of HF patients and show how the registry can be used to improve the management of patients with HF. (Paper II) In order to show how to analyze a HF registry we investigated the prevalence of anemia, its predictors, and its association with mortality and morbidity in a large cohort of unselected patients with HFrEF included in the SwedeHF, and to explore if there are subgroups of HF patients identifying high--‐risk patients in need of treatment. (Paper III) In order to show another way of analyzing a HF registry we assessed the prevalence of, associations with, and prognostic impact of anemia in patients with HFmrEF and HFpEF. (Paper IV) Finally we examined the usefulness of EQ--‐ 5D as a measure of patient--‐reported outcomes among HF patients using different analytical models and data from the SwedeHF, and comparing results about HRQoL for patients with HFpEF and HFrEF. Methods An observational study based on the SwedeHF database, consisting of about 70 variables, was undertaken to describe how a registry is created and can be used (Paper I). One comorbidity (anemia) was applied to different types of HF patients, HFrEF (EF <40%) (II) and HFmrEF (EF 40--‐49% ) or HFpEF (> 50%) (III) analyzing the data with different statistical methods. The usefulness of EQ--‐5D as measure of patient--‐ reported outcomes was studied and the results about HRQoL were compared for patients with HFpEF and HFrEF (IV). Results In the first paper (Paper I) we showed how to create a HF registry and presented some characteristics of the patients included, however not adjusted since this was not the purpose of the study. In the second paper (Paper II) we studied anemia in patients with HFrEF and found that the prevalence of anemia in HFrEF were 34 % and the most important independent predictors were higher age, male gender and renal dysfunction. One--‐year survival was 75 % with anemia vs. 81 % without (p<0,001). In the matched cohort after propensity score the hazard ratio associated with anemia was for all--‐cause death 1.34. Anemia was associated with greater risk with lower age, male gender, EF 30--‐39%, and NYHA--‐class I--‐II. In the third paper (Paper III) we studied anemia in other types of HF patients and found that the prevalence in the overall cohort in patients with EF > 40% was 42 %, in HFmrEF 38 % and in HFpEF (45%). Independent associations with anemia were HFpEF, male sex, higher age, worse New York Heart Association class and renal function, systolic blood pressure <100 mmHg, heart rate ≥70 bpm, diabetes, and absence of atrial fibrillation. One--‐year survival with vs. without anemia was 74% vs. 89% in HFmrEF and 71% vs. 84% in HFpEF (p<0.001 for all). Thus very similar results in paper II and III but in different types of HF patients. In the fourth paper (Paper IV) we studied the usefulness of EQ--‐5D in two groups of patients with HF (HFpEF and HFrEF)) and found that the mean EQ--‐5D index showed small reductions in both groups at follow--‐up. The patients in the HFpEF group reported worsening in all five dimensions, while those in the HFrEF group reported worsening in only three. The Paretian classification showed that 24% of the patients in the HFpEF group and 34% of those in the HFrEF group reported overall improvement while 43% and 39% reported overall worsening. Multiple logistic regressions showed that treatment in a cardiology clinic affected outcome in the HFrEF group but not in the HFpEF group (Paper IV). Conclusions The SwedeHF is a valuable tool for improving the management of patients with HF, since it enables participating centers to focus on their own potential for improving diagnoses and medical treatment, through the online reports (Paper I). Anemia is associated with higher age, male gender and renal dysfunction and increased risk of mortality and morbidity (II, III). The influence of anemia on mortality was significantly greater in younger patients in men and in those with more stable HF (Paper II, III). The usefulness of EQ--‐5D is dependent on the analytical method used. While the index showed minor differences between groups, analyses of specific dimensions showed different patterns of change in the two groups of patients (HFpEF and HFrEF). The Paretian classification identified subgroups that improved or worsened, and can therefore help to identify needs for improvement in health services (Paper IV).
Books on the topic "Global ejection fraction"
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Moonen, Marie, Nico Van de Veire, and Erwan Donal. Heart failure: risk stratification and follow-up. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0027.
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An increasing number of two- and three-dimensional echocardiographic, Doppler, and speckle imaging-derived parameters and values can be related to prognosis in heart failure with left ventricular (LV) systolic dysfunction. This chapter discusses both conventional and new indices, including their advantages and potential limitations. There is increasing evidence for the use of new indices, including three-dimensional LV ejection fraction and global longitudinal strain. The follow-up and monitoring of heart failure patients using two-dimensional transthoracic echocardiography is also discussed in this chapter, including how to estimate the LV filling pressures and quantify LV reverse remodelling.
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Lancellotti, Patrizio, and Bernard Cosyns. The Standard Transthoracic Echo Examination. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713623.003.0002.
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Functional imaging by modern echocardiography offers a variety of methods to assess regional and global myocardial function beyond classic dimension, volume and ejection fraction measurements. This chapter shows how various modalities of Doppler echocardiography can be used for assessment of valves, haemodynamics, and coronary flow reserve. It also provides information on myocardial function can be extracted from echo images using a tissue Doppler or speckle tracking approach. 3Dechocardiography provides real-time 3D images of the heart in motion. Various types of examination and quantification are also shown. A brief explanation of contrast imaging is included as well as practical considerations such as administration protocols and the safety of ultrasound contrast.
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Galderisi, Maurizio, Juan Carlos Plana, Thor Edvardsen, Vitantonio Di Bello, and Patrizio Lancellotti. Cardiac oncology. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0064.
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Cancer therapeutics may induce cardiac damage in the left and the right ventricle. Radiotherapy most frequently induces valvular damage, carotid stenosis, and coronary artery disease. Pericardial disease may be due to both chemo- and radiotherapy. The manifestations of both chemo- and radiotherapy can develop acutely but also become overt years after their performance, in particular after radiotherapy. The main cardiac damage of cancer therapeutics-related cardiac dysfunction (CTRCD) corresponds to the reduction of left ventricular (LV) systolic function. The Expert Consensus document from ASE and EACVI has defined CTRCD as a decrease in LV ejection fraction (LVEF) of greater than 10 percentage points, to a value less than 53%. The accurate calculation of LVEF at baseline and during follow-up is extremely important. The assessment of LV longitudinal function, in particular of speckle tracking-derived global longitudinal strain (GLS), can provide additional information, allowing early, subclinical detection of CTRCD. The ideal strategy could be to compare the measurements of GLS obtained during chemotherapy, with the one obtained at baseline. An integrated approach with the use of echocardiography at standardized, clinical preselected intervals with biomarker (ultrasensitive troponin) assessment prior to each chemotherapy cycle could be suggested in patients at high risk of CTRCD. Follow-up after therapy should depend on the type of chemotherapy/radiotherapy and the presence/absence of on-therapy CTRCD. Long-term follow-up should be planned after radiotherapy.
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AlJaroudi, Wael. Risk Assessment in Acute Coronary Syndromes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0013.
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Acute coronary syndromes (ACS) include unstable angina pectoris (UAP), non-ST elevation (NSTEMI), and ST elevation acute myocardial infarction (STEMI). Each year, more than 2 million people are hospitalized with ACS in the United States. The initial treatment has evolved over the last few decades from conservative management to early reperfusion therapy. Medical therapy has also significantly changed with the use of newer more potent antiplatelet agents, beta-blockers, angiotensin converting enzyme inhibitors, statins, and anti-anginal drugs, which have resulted in improvement of patient care and survival. There is no role for stress myocardial perfusion imaging (MPI) in the acute presentation; however, rest MPI may be used to identify the culprit lesion and risk stratify patients if injected during chest pain. In stable patients for ACS, submaximal exercise or vasodilator MPI can be performed as early as 48 hours after the event. Several gated MPI-derived variables such as left ventricular (LV) ejection fraction (EF), LV volumes, infarct size, mechanical dyssynchrony, and residual ischemic burden can risk stratify patients and provide prognostic data incremental to validated clinical risk scores such as GRACE (Global Registry of Acute Coronary Syndrome) and TIMI (Thrombolysis in Myocardial Infarction). Patients with depressed LVEF, remodeled LV, and large perfusion defects are at particularly high- risk for subsequent cardiac death or recurrent myocardial infarction. In such setting, MPI plays a pivotal role in the management of patients and guiding therapeutic decisions. The current chapter will review the clinical and MPI predictors of outcomes in patients presenting with ACS according to updated guidelines and a proposed algorithm integrating the role of MPI in guiding therapeutic decisions and management.
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Rigo, Fausto, Covadonga Fernández-Golfín, and Bruno Pinamonti. Dilated cardiomyopathy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0043.
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Dilated cardiomyopathy (DCM) is characterized by a globally dilated and dysfunctioning left ventricle (LV). Therefore, echocardiographic diagnostic criteria for DCM are a LV end-diastolic diameter greater than 117% predicted value corrected for age and body surface area and a LV ejection fraction less than 45% (and/or fractional shortening less than 25%). Usually, the LV is also characterized by a normal or mildly increased wall thickness with eccentric hypertrophy and increased mass, a spherical geometry (the so-called LV remodelling), a dyssynchronous contraction (typically with left bundle branch block), and diastolic dysfunction with elevated LV filling pressure. Other typical echocardiographic features of DCM include functional mitral and tricuspid regurgitation, right ventricular dysfunction, atrial dilatation, and secondary pulmonary hypertension. Several echocardiographic parameters, measured both at baseline and at follow-up, are valuable for prognostic stratification of DCM patients. Furthermore, re-evaluation of echocardiographic parameters during the disease course under optimal medical therapy is valuable for tailoring medical treatment and confirming indications for invasive treatments at follow-up. The stress echo can play a pivotal role in the different phases of DCM helping us in stratifying the prognosis of these patients. Finally, familial screening is an important tool for early diagnosis of DCM in asymptomatic patients.
Book chapters on the topic "Global ejection fraction"
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Hoffmann, Rainer, and Frank A. Flachskampf. "Evaluation of systolic LV function and LV mechanics." In The ESC Textbook of Cardiovascular Imaging, edited by José Luis Zamorano, Jeroen J. Bax, Juhani Knuuti, Patrizio Lancellotti, Fausto J. Pinto, Bogdan A. Popescu, and Udo Sechtem, 497–506. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198849353.003.0034.
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Analysis of global and regional left ventricular (LV) function is the most frequent indication to perform echocardiography. While visual assessment based on 2D images is the basis for analysis of LV function, it may be supplemented by quantitative techniques to obtain parameters of global or regional function. 2D echocardiography tends to underestimate LV volumes compared to cardiac magnetic resonance (CMR), 3D echocardiography results in less volume underestimation and high accuracy in the analysis of ejection fraction. Visual analysis of regional function is limited by significant interobserver variability. Another approach to systolic LV function is the assessment of LV mechanics, typically by measuring global longitudinal deformation (strain) by speckle-tracking echocardiography. Alternatively, information on deformation can be obtained from CMR (currently, mostly by feature tracking). Deformation parameters detect early impairment of LV systolic function with higher sensitivity than ejection fraction. While echocardiography continues to be the first-choice modality for ejection fraction, CMR has become the gold standard for quantification of LV volumes and ejection fraction. Nuclear imaging should be applied to assess LV function only if simultaneous assessment of myocardial perfusion is requested.
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Sidebotham, David, Alan Merry, Malcolm Legget, and Gavin Wright. "Left ventricular systolic function." In Practical Perioperative Transoesophageal Echocardiography. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198759089.003.0006.
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Chapter 6 is subdivided into three sections: global LV systolic function, regional LV systolic function, and cardiomyopathies. In Section 1, commonly used indices of global systolic function, such as fractional area change and ejection fraction, are reviewed, along with their limitations related to oesophageal imaging. The relationship between stroke volume and ejection fraction is explored. Newer techniques such as quantitative 3D imaging and strain-rate imaging are described. In Section 2, the causes of regional systolic dysfunction are reviewed, along with the different aetiologies of real and apparent segmental wall motion abnormalities. Complications of myocardial infarction such as mitral regurgitation, true and false LV aneurysms, and ventricular septal rupture are also dealt with in this section. Section 3 provides an overview of the echocardiographic findings associated with various cardiomyopathies: dilated, hypertrophic, restrictive, acute myocarditis, LV non-compaction, and Takotsubo.
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Zannad, Faiez, João Pedro Ferreira, and Theresa McDonagh. "Heart failure." In The ESC Handbook on Cardiovascular Pharmacotherapy, edited by Theresa McDonagh, Joao Pedro Ferreira, and Faiez Zannad, 143–64. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198759935.003.0009_update_001.
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Heart failure (HF) is a global pandemic affecting nearly 30 million people worldwide and is increasing in prevalence. Chronic heart failure with reduced left ventricular ejection fraction (HFrEF) results from impaired systolic dysfunction and represents about half of HF cases. The commonest aetiology is myocardial ischaemia. Chronic heart failure with preserved left ventricular ejection fraction (HFpEF) is symptoms and/or signs of heart failure, with left ventricular ejection fraction in the normal range. Acute HF is characterized by a rapid onset of signs and symptoms of HF, requiring urgent treatment. Acute HF may present as a first occurrence (de novo) or, more frequently, as a consequence of acute decompensation of chronic HF and may be caused by primary cardiac dysfunction or precipitated by extrinsic factors, often in patients with chronic HF. The diagnostic, workup, and treatment options for these conditions will be summarized in the chapter.
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Lund, Lars H., and Gianluigi Savarese. "Definition, epidemiology, and burden of disease: HFpEF." In ESC CardioMed, 1748–54. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0403.
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Heart failure with preserved ejection fraction (HFpEF) is a global pandemic, affecting half of the heart failure population and with an incidence and prevalence expected to increase further with an ageing population. With no therapy to reduce morbidity or mortality, HFpEF has been defined as the single largest unmet need in cardiovascular medicine. As compared with heart failure with reduced ejection fraction (HFrEF), patients with HFpEF are more likely to be older and female, to have a higher prevalence of cardiovascular risk factors (i.e. obesity, hypertension, and diabetes), other cardiovascular co-morbidities (i.e. atrial fibrillation and valvular disease) and non-cardiovascular co-morbidities (i.e. anaemia, chronic pulmonary disease, and chronic kidney disease), but a lower prevalence of ischaemic heart disease. In non-selective cohorts and registries, crude but not adjusted mortality is higher in HFpEF vs. HFrEF, with risk of cardiovascular events lower in HFpEF, especially in clinical trial populations. A novel category, heart failure with mid-range ejection fraction (HFmrEF) has been introduced for an ejection fraction in the 40–49% range, to emphasize that this range is not normal but also has no evidence-based interventions. HFmrEF appears similar to HFrEF with regard to ischaemic heart disease prevalence and outcomes, but is intermediate between HFpEF and HFrEF in many other aspects.
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Voigt, Jens-Uwe. "Left ventricular function, heart failure, and resynchronization therapy." In ESC CardioMed, edited by Frank Flachskampf, 450–54. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0092.
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Left ventricular cavity size is commonly described using linear internal dimensions and volumes. Measurements are regularly reported for end-diastole and frequently also for end-systole. Indexing to body surface area allows a comparison among individuals with different body sizes. Ejection Fraction and Global Longitudinal Strain are used to measure global left ventricular function. Regional function is described semi-quantitatively per LV segment. Stress tests can reveal viable myocardium and inducible ischemia. Diastolic function assessment is complex and requires several parameters. All patients with symptoms of heart failure should be evaluated by echocardiography. Echocardiography also plays a critical role in identifying candidates for cardiac resynchronization. Specific motion and deformation patterns can identify patients where CRT may improve heart failure symptoms and lead to reverse remodelling.
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Hoffmann, Rainer, and Paolo Colonna. "Evaluation of left ventricular systolic function and mechanics." In The ESC Textbook of Cardiovascular Imaging, 315–22. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198703341.003.0023.
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Analysis of left ventricular (LV) systolic function is the most frequent indication to perform echocardiography and an integral part of cardiac magnetic resonance (CMR) or radionuclide studies. Visual estimation of LV function may be supplemented by quantitative analysis of 2D images to obtain parameters of global or regional function. Administration of contrast agents to improve identification of myocardium–blood interface has been demonstrated to improve the reproducibility of 2D-echocardiography-based analysis of LV function and should be applied in cases of insufficient endocardial border definition (more than two LV segments not adequately visualized). 2D-echocardiography-based analysis of LV volumes results in underestimation of end-systolic and end-diastolic LV volumes compared to CMR. 3D-echocardiography results in significantly less volume underestimation and higher accuracy in the analysis of ejection fraction. Analysis of regional wall motion is mainly based on subjective visual assessment, which is limited by significant inter-observer variability. Doppler tissue imaging and speckle tracking echocardiography have become validated methods for quantitative analysis of regional LV function. Similarly, tagging, strain-encoded cardiac magnetic resonance (SENC) and feature tracking are modalities to quantify regional LV function based on CMR. Echocardiography should be used as a primary technique to assess systolic LV function as it is the cheapest, widely available and can be applied without the use of ionizing radiation or nephrotoxic contrast material. CMR has become the clinical gold standard for quantification of LV function and may be applied if other information achievable best by CMR is required. Similarly, nuclear techniques should be applied to assess LV function only if simultaneous assessment of myocardial perfusion is requested.
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Becker, Richard C., and Frederick A. Spencer. "Facilitated Percutaneous Coronary Intervention." In Fibrinolytic and Antithrombotic Therapy. Oxford University Press, 2006. http://dx.doi.org/10.1093/oso/9780195155648.003.0018.
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The failure of fibrinolytic therapy to restore physiologic myocardial perfusion in upward of 40% of patients supports the development of strategies to improve response rates to percutaneous coronary intervention (PCI) in those requiring early procedures. The construct of facilitated PCI (pharmacoinvasive therapy) provides a platform for utilizing the strengths of existing therapies and treatment modalities. The Heparin in Early Patency (HEAP) trial (Zijlstra et al., 2002) included 1,702 patients treated with primary PCI for myocardial infarction (MI); 860 patients received aspirin (500 mg IV) and UFH (≥5,000 U IV) before being transported to the hospital and 842 patients received the same antithrombotic therapy in the hospital. TIMI 2 or 3 flow rates were higher in the pretreated group (31% vs. 20%; p = .001), and patients with TIMI 2 or 3 flow initially had a higher PCI success rate (94% vs. 89%; p <.001) and a lower 30-day mortality (1.6% vs. 3.4%; p = .04). The Plasminogen Activator Angioplasty Compatibility Trial (PACT) randomized 606 patients to receive a 50-mg bolus of alteplase or placebo, followed by immediate angiography and angioplasty if needed (Ross et al., 1999). TIMI flow rates on arrival to the catheterization laboratory were 33% and 15%, respectively. Facilitated PCI and primary PCI restored TIMI 3 flow in occluded vessels equally (77% and 79%, respectively). There were no differences in major bleeding. Left ventricular ejection fraction was highest in those with TIMI 3 flow on arrival to the catheterization laboratory or following PCI within 1 hour of alteplase administration. Full-dose fibrinolytic therapy with alteplase or reteplase followed by coronary angiography and PCI (if no clinical evidence of reperfusion) was evaluated retrospectively in the Global Use of Strategies to Open Occluded Arteries (GUSTO) III trial (Miller et al., 1999). Among those undergoing PCI (n = 392), 87 patients received in-laboratory abciximab. A trend toward reduced mortality was observed in abciximab-treated patients, but at a higher cost of hemorrhagic complications. In the Strategies for Patency Enhancement in the Emergency Department (SPEED) trial (Herrmann et al., 2000), 323 patients who underwent PCI had an 88% procedural success rate and a 30-day composite of death, reinfarction, or revascularization of 5.6%.
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Posner, Richard A. "Introduction." In Catastrophe. Oxford University Press, 2004. http://dx.doi.org/10.1093/oso/9780195178135.003.0003.
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You wouldn’t see the asteroid, even though it was several miles in diameter, because it would be hurtling toward you at 15 to 25 miles a second. At that speed, the column of air between the asteroid and the earth’s surface would be compressed with such force that the column’s temperature would soar to several times that of the sun, incinerating everything in its path. When the asteroid struck, it would penetrate deep into the ground and explode, creating an enormous crater and ejecting burning rocks and dense clouds of soot into the atmosphere, wrapping the globe in a mantle of fiery debris that would raise surface temperatures by as much as 100 degrees Fahrenheit and shut down photosynthesis for years. The shock waves from the collision would have precipitated earthquakes and volcanic eruptions, gargantuan tidal waves, and huge forest fires. A quarter of the earth’s human population might be dead within 24 hours of the strike, and the rest soon after. But there might no longer be an earth for an asteroid to strike. In a high-energy particle accelerator, physicists bent on re-creating conditions at the birth of the universe collide the nuclei of heavy atoms, containing large numbers of protons and neutrons, at speeds near that of light, shattering these particles into their constituent quarks. Because some of these quarks, called strange quarks, are hyperdense, here is what might happen: A shower of strange quarks clumps, forming a tiny bit of strange matter that has a negative electric charge. Because of its charge, the strange matter attracts the nuclei in the vicinity (nuclei have a positive charge), fusing with them to form a larger mass of strange matter that expands exponentially. Within a fraction of a second the earth is compressed to a hyperdense sphere 100 meters in diameter, explodes in the manner of a supernova, and vanishes. By then, however, the earth might have been made uninhabitable for human beings and most other creatures by abrupt climate changes.
Conference papers on the topic "Global ejection fraction"
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Oakland, H. T., P. Joseph, A. Elassal, M. Cullinan, P. M. Heerdt, and I. Singh. "Characteristic Impedance Affects Global Right Ventricular Function in Pulmonary Arterial Hypertension and Heart Failure with Preserved Ejection Fraction." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3690.
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Farrar, G. E., G. T. Gullberg, and A. I. Veress. "Full Cardiac Cycle Strain Measurement Using Hyperelastic Warping, Application to Detecting Myocardial Dysfunction in Rat microPET Images." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53654.
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Assessments of regional heart wall deformation (wall motion, thickening, strain) are commonly used to evaluate left ventricular wall function in the clinical setting. Nuclear based imaging modalities such as PET and SPECT are commonly used to localize ischemic myocardial disease, and can identify impairment of cardiac function due to hypertrophic or dilated cardiomyopathies. Regional wall motion analysis in conjunction with global left ventricular (LV) ejection fraction is commonly used to assess systolic and diastolic function. The quantification of ventricular strains throughout the entire cardiac cycle provides valuable information that could be used to more effectively differentiate between diastolic and systolic dysfunction, as well as a more complete picture of overall cardiac performance.
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Pathak, Soumi. "An acute cardiac complication of HIPEC." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685385.
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Recently, cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) has been described for both treatment and prevention of locoregional cancer of various origin. As this procedure involves large amount of blood and fluid loss during the CRS phase, and haemodynamic, metabolic, and coagulation changes during the HIPEC phase, thus thorough study and evaluation is needed to reduce the morbidity and mortality associated with this newer modality in treatment of cancer patients. We hereby describe a case report where a patient developed acute cardiac dysfunction in the immediate postoperative period following CRS with HIPEC. A 65 years old patient weighing 62 kg had undergone CRS with HIPEC for ovarian carcinoma. She had a blood loss of 1.5 L and ascetic fluid drainage of 1.5 L. Intraoperatively fluid was given according to stroke volume variation and two pack cell was transfused to maintain haemoglobin above 10 g. Two hours postoperatively she suddenly developed severe hypotension and an echocardiography done revealed a global left ventricular dysfunction with a 28% ejection fraction. She was intubated and put on inotropic support. Utrasound abdomen revealed fluids and features suggestive of intestinal perforation. So she was reopened on the 3rd postoperative day and primary closure of the intestinal perforation was done. Thereafter she became haemodynamically stable and we were able to extubate her on the fourth post operative day. Thus we conclude that goal directed fluid therapy with advanced monitoring, thorough evaluation, skeptical vigilance and preemtive thinking is required to deal with the challenges posed by CRS with HIPEC.
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Lochan, R., S. Tyagi, B. S. Yadav, D. K. M. Rao, A. Bhat, and M. Khalilullah. "EFFICACY OF INTRAVENOUS STREPTOKINASE IN ACUTE MYOCARDIAL INFARCTION: ACUTE AND FOLLOW UP STUDY." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642993.
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The efficacy of intravenous streptokinase on recanalization of the 'infarct vessel' and its effect on left ventricular function was assessed in two groups of patients. Group I consisted of 90 consecutive patients (age 32-75 years, mean 56 years) received 500,000 units of intravenous streptokinase (STK) over 30 minutes within 6 hours of onset of acute myocardial infarction (MI). Forty-eight patients had anterior MI and forty-two had inferior MI. The control group consisted of forty survivors of acute MI comparable in age and site of infarction. In Group I, ten patients were administered STK after baseline coronary angiogram demonstrated total occlusion of infarct related coronary artery. In these patients, serial coronary angiogram were done at intervals of 30 minutes after STK infusion upto a period of 3 hours. Recanalization was seen in all cases within 75-135 minutes (average 120 minutes). Seventy-nine of STK group and all of the control group underwent selective coronary arteriography and contrast left ventriculography within 48 to 72 hours of acute MI. Recanalization of infarct related artery was demonstrated in 72 out of 79 patients (91%) in STK group while 8 (20%) in control group had spontaneous recanalization. Left ventricular ejection fraction (LVEF) was higher in STK group (58%) as compared to control group (49%). Among patients with anterior MI, LVEF was significantly better in STK compared to control group (59% Vs. 44%, p > 0.01)while in inferior MI the difference was not significant (63% Vs. 59.4%, p > 0.05) in the two groups. Follow up study in 20 STK patients at 6 months revealed a decrease in residual stenosis from 75 ± 8% to 60 ± 6% and improvement in LVEF from 59 ± 8% to 68 ± 12% (p > 0.01). In conclusion, intravenous STK in acute MI results in high rate of infarct vessel patency and improved global left ventricular function during both early and late follow up period.
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Villemant, D., P. Barriot, and P. Bodenan. "THROMBOLYSIS AND ACUTE MYOCARDIAL INFARCTION (AMI)." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642981.
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AMI is a major cause of morbidity and mortality in modern society Conventional treatment has no benefic effect on the size of infarct, alteration of left ventricular (LV) function and mortality. Intravenous (IV) thrombolysis reduces in hospital mortality by 23 % if infused within 3 hours of ischemia, 47 % if within 1 hour. It reduces the size of infarct by 51 % if reperfusion occurs within 1 hour of ischemia, 31 % if between 1 and 2 hours and 13 % if between 2 and 4 hours. The preservation of LV function is of 28 to 42%. These benefic effects, thanks to IV thrombolysis, can be obtained only if reperfusion occurs within 3 or 4 hours of ischemia. Unfortunately, a french prospective study “ENIM 84” estimates that the mean delay between onset of chest pain and arrival at hospital is 10,3 hours.Goals of the study were to show that “at home” thrombolysis: 1) is a feasible and a safe technique, 2) is responsible of a significant saving of time, 3) preserves LV function according to the precocity of treatment.Two groups of patients (pts) are compared : group A : 62 pts had “at home” thrombolysis by a trained medical staff aboard a mobile emergency care unit. Group B : 53 pts had thrombolysis at arrival at CCU. Protocol is simular in both groups : An IV infusion of 1 5 M iu of streptokinase over 45 to 60 min after an IV bolus of 100 mg Hydrocortisone. Criteriae and contra-indications are those usually used for thrombolysis. Radionuclide angiography was performed 4 days and 1 month after AMI to evaluate global and regional ejection fraction (EF). Only 1 hemorrhagic complication (a mild melaena) and 2 reversible ventricular fibrillations were reported. Reperfusion arrythmias were frequent (55 %) but do not need treatment. The number of candidates for thrombolysis is then increased. The saving of time is 73 min. Difference between the 4 days and 1 month EF is not significant in pts with conventional treatment or if reperfusion occurs after 4 hours of ischemia 48 ± 11 % vs 51 ± 13 %.But it is significant if before 4 hours 49 ± 11 % vs 56 ± 12 % and highly significant if before 2 hours 48 ± 12 % vs 59 ± 10 %.