RESUMEN

Heart failure (HF) with normal ejection fraction - the isolated diastolic heart failure, depicts increasing prevalence and health care burden in recent times. Having less mortality rate compared to systolic heart failure but high morbidity, it is evolving as a major cardiac concern. With increasing clinical use of Left atrial volume (LAV) quantitation in clinical settings, LAV has emerged as an important independent predictor of cardiovascular outcome in HF with normal ejection fraction. This article is intended to review the diastolic and systolic heart failure, their association with left atrial volume, in depth study of Left atrial function dynamics with determinants of various functional and structural changes.

Asunto(s)

Enfermedades Cardiovasculares , Insuficiencia Cardíaca Sistólica , Insuficiencia Cardíaca , Disfunción Ventricular Izquierda , Humanos , Función Ventricular Izquierda , Volumen Sistólico , Insuficiencia Cardíaca Sistólica/complicaciones , Enfermedades Cardiovasculares/complicaciones , Factores de Riesgo , Disfunción Ventricular Izquierda/etiología , Atrios Cardíacos/diagnóstico por imagen , Insuficiencia Cardíaca/complicaciones , Factores de Riesgo de Enfermedad Cardiaca , Hipertrofia/complicaciones

RESUMEN

Right ventricular (RV) systolic function is an essential but neglected component in cardiac evaluation, and its importance to the contribution to overall cardiac function is undermined. It is not only sensitive to the effect of left heart valve disease but is also more sensitive to changes in pressure overload than the left ventricle. Pulmonary Hypertension is the common and well-recognized complication of RV systolic dysfunction. It is also the leading cause of pulmonary valve disease and right ventricular dysfunction. Patients with a high pulmonary artery pressure (PAP) and a low RV ejection fraction have a seven-fold higher risk of death than heart failure patients with a normal PAP and RV ejection fraction. Furthermore, it is an independent predictor of survival in these patients. In this review, we examine the association of right ventricular systolic function with Pulmonary Hypertension by focusing on various pathological and clinical manifestations while assessing their impact. We also explore new 2022 ESC/ERS guidelines for diagnosing and treating right ventricular dysfunction in Pulmonary Hypertension.

Asunto(s)

Insuficiencia Cardíaca , Hipertensión Pulmonar , Disfunción Ventricular Derecha , Humanos , Hipertensión Pulmonar/diagnóstico , Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/terapia , Disfunción Ventricular Derecha/diagnóstico , Disfunción Ventricular Derecha/etiología , Volumen Sistólico , Ventrículos Cardíacos , Insuficiencia Cardíaca/complicaciones

RESUMEN

A once often neglected virus from common practice has been demanding the attention of all researchers for the past decade ever since it started to infect humans from its usual wild habitats. The severe acute respiratory syndrome coronavirus 2 infection in humans is now found to have frequent manifestations of thromboembolic events as a result of a hyper-coagulable state. Anti-coagulants (ACs) have been suggested to overcome such a state, and studies have been conducted to assess its role. The objective of this meta-analysis is to determine the existence of such a role and its nature, either beneficial or not, and to assess the strength of this role if it exists. We have conducted an online search in the databases such as PubMed, Google scholar, Lancet, Elsevier, JAMA, Medline, and so on and concluded ten studies among 2562 that had results which were more precise and of better quality. The results of six studies favored the use of ACs, whereas one study showed no beneficial response and four studies discussed the effects of therapeutic versus prophylactic anti-coagulation. The result of our statistical analysis was that the odds ratio for mortality reduction of ACs in coronavirus disease 2019 (COVID-19) patients is 0.6757 (95% CI; 0.5148 to 0.961) and that for benefits of therapeutic ACs versus prophylactic ACs in COVID-19 patients is 0.809 (95% CI; 0.6137 to 1.1917). AC was associated with lower mortality and intubation among hospitalised COVID-19 patients. Compared with therapeutic AC, prophylactic AC was associated with lower mortality, although not statistically significant, and lower bleeding risks.