Ventricular Dysfunction

IJCS

Original Article

Exploring the Link Between ITGB3 Gene Polymorphism and Diastolic Dysfunction in Arterial Hypertension Patients

Vafa Nazirova et al. Zumrud Ismibayli Ismail Gafarov Faig Guliyev Konstantinos Kyriazis

Abstract

Background:

Arterial hypertension (AH) is a significant risk factor for cardiovascular diseases (CVDs), including myocardial infarction and stroke. The ITGB3 gene polymorphism, particularly T1565C (rs5918), has been implicated in various cardiovascular conditions, suggesting a potential role in diastolic dysfunction (DD) among AH patients.

Objectives:

The clinical-genetic relationship was studied between ITGB3 gene polymorphisms and DD in Azerbaijani patients with AH, with or without ischemic heart disease (IHD) and type 2 diabetes (T2D) mellitus.

Methods:

The study included 100 Azerbaijani patients, divided into case (n = 76) and control (n = 24) groups. Echocardiography was used to assess left ventricular diastolic function. ITGB3 gene was identified using the MassArray system. Statistical analysis involved both parametric and non-parametric tests using the IBM SPSS Statistics 26.

Results:

The study reported a significant association between ITGB3 gene polymorphisms and DD in AH patients. The T/C, C/C genotypes were particularly correlated with DD. The C/C variant, while more frequent in the AH group, did not reach statistical significance. A direct correlation was observed between DD and the C allele of the ITGB3 gene, with a higher E/e’ ratio and lower e’ velocity among carriers.

Conclusion:

This study highlights a significant association between ITGB3 gene polymorphisms and DD in Azerbaijani patients with AH. These findings suggest the potential for genetic screening to identify individuals at higher risk of DD among hypertensive patients, underscoring the importance of personalized approaches in managing hypertension and its complications. Further research with larger and more diverse cohorts is needed to validate these results and explore the underlying mechanisms.

Ler artigo completo

IJCS

Original Article

Subclinical Systolic Dysfunction during Chemotherapy for Breast Cancer

Geanne Maria Holanda de Menezes Barroso et al. Júlio César Oliveira Costa Teles Paulo Victor de Jesus Silva Karin Yasmin Santos Fonseca … Vinícius Antônio Santos Aragão Marília Marques Aquino Enaldo Vieira de Melo Karina Oliveira Ferreira Ronnei José Feitosa de Assis Michel Fabiano Silva Alves Antônio Carlos Sobral Sousa Joselina Luzia Menezes Oliveira

Abstract

Background

Cardiotoxicity is the main complication related to cancer therapy. Studies indicate that global longitudinal strain is an early detector of subclinical dysfunction of the left ventricle, preceding the decline in ejection fraction (EF). However, the reproducibility of such methodology has not been tested outside specialized centers.

Objectives

To assess the frequency of subclinical cardiotoxicity and to compare global longitudinal strain and EF measurements during the clinical course of patients undergoing chemotherapy for breast cancer.

Methods

This was an observational prospective study of 78 adult women who underwent serial echocardiograms (baseline and 1, 3, and 6 months after the beginning of chemotherapy), to evaluate biplane and 3D EF and global longitudinal strain. Cardiotoxicity and subclinical dysfunction were defined according to American Society of Echocardiography/European Association of Cardiovascular Imaging criteria. Statistical significance was set at p < 0.05.

Results

The mean age of the patients was 50.1 ± 11.48 years. The frequency of subclinical cardiotoxicity (defined by global longitudinal strain) was 14.9% after 30 days of chemotherapy, 16.7% after 3 months, and 19.7% after 6 months, compared to 4.5%, 3%, and 6.6%, respectively, when clinical cardiotoxicity was determined according to EF. The group that developed subclinical cardiotoxicity by 30 days (group A) had a higher frequency of clinical cardiotoxicity at 3 months (p=0.028) and a lower mean biplane EF after 30 days (p= 0.036) than the group that showed no evidence of subclinical cardiotoxicity (group B).

Conclusion

Subclinical cardiotoxicity was frequent and began early, being associated with a drop in EF during the clinical course.

Ler artigo completo

IJCS

Original Article

The Clinical Course of Takotsubo Syndrome Diagnosed According to the InterTAK Criteria

Nelson Henrique Fantin Fundão et al. Henrique Barbosa Ribeiro Carlos de Magalhães Campos Vinicius Bocchino Seleme … Alexandre de Matos Soeiro Marcelo Luiz Campos Vieira Wilson Mathias Jr Ludhmilla Abraão Hajjar Expedito E. Ribeiro Roberto Kalil Filho

Abstract

Background

There has been an increase in the number of cases of Takotsubo syndrome (TTS) and of scientific publications on the theme over the last years. However, little is known about the status of this disease in Brazilian hospitals.

Objective

To assess mortality and major adverse cardiovascular events (MACE) during hospitalization and follow-up of TTS patients seen in a tertiary hospital in Brazil.

Methods

This was a retrospective, observational study on 48 patients. Clinical data, signs and symptoms, complementary tests, MACE and all-cause mortality were assessed on admission and during follow-up. Kaplan-Meier curves were used for analysis of all-cause mortality and risk for MACE at median follow-up. The 95% confidence interval was also calculated for a significance level of 5%.

Results

Mean age of patients was 71 years (SD±13 years), and most patients were women (n=41; 85.4%). During hospitalization, four patients (8.3%) died and five (10.4%) developed MACE. At median follow-up of 354.5 days (IQR of 81.5-896.5 days), the risk of all-cause mortality and MACE was 11.1% (95% CI= 1.8-20.3%) and 12.7% (95% CI= 3.3-22.3%), respectively.

Conclusion

TTS was associated with high morbidity and mortality rates in a tertiary hospital in Brazil, which were comparable to those observed in acute coronary syndrome. Therefore, the severity of TTS should not be underestimated, and new therapeutic strategies are required. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

Ler artigo completo

IJCS

Editorial

The Ejection Fraction Returns to Hyde Park Session's Speakers' Corner

Wolney de Andrade Martins et al. Antonio José Lagoeiro Jorge

The ejection fraction returns to Hyde Park Session’s Speakers’ Corner

About two decades ago, the Heart Failure Society of America created the Hyde Park Session at its annual meeting. The analogy with the free and innovative proposals that took place in the historic London park were transposed to that scientific event. One of the first proposals made there was the extinction of the left ventricular ejection fraction (LVEF) as if it was an absolutist tyrant determining the life of his/her subjects. The proposition took no breath. The overwhelming majority of heart failure (HF) trials used LVEF as an inclusion criterion. The cutoff points varied. Magical numbers had little pathophysiological or clinical foundation. LVEF was measured by noninvasive methods, especially echocardiography, with high intra-and inter-examiner variability, dependent on preload and afterload changes.

Later, in 2001, a clinical entity was recognized, where acute pulmonary edema of cardiogenic cause occurred despite LVEF at levels above 50%. The following years saw incredulous initial acceptance until the epidemiological and clinical characterization of what we today call “heart failure with preserved ejection fraction (HFpEF).” From rare, it became frequent, especially in primary care. Considered benign, the prognosis became almost as reserved as heart failure with reduced ejection fraction (HFrEF). There were different proposals for diagnosis, prognostic scores, but such evolution in the knowledge of HFpEF resulted in a frustrating succession of negative therapeutic trials.

[…]

Ler artigo completo

ABC

Relato de Caso

Stent de sustentação de eletrodo de seio coronariano na ressincronização cardíaca: relato de 5 casos

Jaime Giovany Arnez Maldonado et al. Carla Fank Simão Maduro Rodrigo Castro … Hernou Oliveira Andre Gomes

RELATO DE CASO

Stent de sustentação de eletrodo de seio coronariano na ressincronização cardíaca relato de 5 casos

[…]

Ler artigo completo

ABC

Original Article

Late Results of Endoventricular Patch Plasty Repair in Akinetic and Dyskinetic Areas After Acute Myocardial Infarction

Paulo R. Prates et al. Abud Homsi Neto Lucas Maynard Lovato Guaracy F. Teixeira Fº … João R. M. Sant'Anna Luiz M. Yordi Renato A. K. Kalil Ivo A. Nesralla

OBJECTIVE – To assess the surgical results of endoventricular patch plasty repair in akinetic and dyskinetic left ventricular areas. METHODS – We studied 52 patients who had undergone endoventricular patch plasty repair associated with myocardial revascularization. The preoperative functional class distribution was as follows: class I in 1 (1.9%) patient; class II in 2 (3.8%) patients; class III in 23 (44.2%) patients; and class IV in 26 (50%) patients. RESULTS – The immediate mortality rate was 7.6% (4 patients). The clinical outcome of 44 patients followed up within a mean postoperative time of 29±25 months was as follows: class I in 33 (75%) patients; class II in 7 (15.9%) patients; class III in 2 (4.5%) patients; and class IV in 2 (4.5%) patients. Comparison between pre- and postoperative catheterization in 21 patients showed that the ejection fraction increased from 46.3% to 51.3% (p=0. 17); the left ventricular systolic volume decreased from 76.4 mL to 57.5 mL, (p=0.078); and the left ventricular diastolic volume decreased from 141.2 mL to 105.8 mL (p=0.0 73). These findings showed the tendency toward improvement, but with nonsignificant results. CONCLUSION – The technique proved to be effective, to have a low mortality rate, to cause significant clinical improvement, an increase in ejection fraction, and a reduction in left ventricular volumes.

Ler artigo completo