RESUMO
Global Longitudinal Strain (GLS) is a useful tool to follow-up heart transplant (HT) recipients. Important inter-vendor variability of GLS measurements has been reported in healthy subjects and different conditions, but there is still limited evidence among HT patients. We assessed the reliability and validity of GLS using two vendors (General Electric and Philips) in a group of consecutive and stable adult HT recipients. Patients underwent two concurrent GLS analyses during their echocardiographic follow-up. We evaluated GLS inter-vendor reliability using Bland-Altman's limits of agreement (LOA) plots, computing its coverage probability (CP) and the intraclass correlation coefficient (ICC). Validity was assessed though receiver operating characteristics (ROC) curves, predictive values, sensitivity and specificity of GLS for each vendor to detect a normal left ventricle function. 78 pairs of GLS studies in 53 stable HT patients were analyzed. We observed a modest inter-vendor reliability with a broad LOA (less than 50% of values falling out our CP of 2% and an ICC of 0.49). ROC analyses (areas under the curve of 0.824 Vs. 0.631, p < 0.05) and diagnosis test indices (Sensitivity of 0.73 Vs. 0.64; and Specificity of 0.79 Vs. 0.50) favored GE over Philips. Inter-vendor variability for GLS analysis exceeded clinically acceptable limits in HT recipients. GLS from GE software seemed to show higher validity as compared to Philips'. The present study provides evidence to consider caution for the interpretation of GLS for clinical management in the follow-up of HT patients, especially when GLS is measured by different vendors.
Assuntos
Transplante de Coração , Função Ventricular Esquerda , Adulto , Colômbia , Transplante de Coração/efeitos adversos , Ventrículos do Coração , Humanos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Centros de Atenção TerciáriaRESUMO
INTRODUCTION: Systolic blood pressure (SBPA) and pulse pressure amplification (PPA) were quantified using different methodological and calibration approaches to analyze (1) the association and agreement between different SBPA and PPA parameters and (2) the association between these SBPA and PPA parameters and left ventricle (LV) and atrium (LA) structural and functional characteristics. METHODS: In 269 healthy subjects, LV and LA parameters were echocardiography-derived. SBPA and PPA parameters were quantified using: (1) different equations (n = 9), (2) methodological approaches (n = 3): brachial sub-diastolic (Mobil-O-Graph®) and supra-systolic oscillometry (Arteriograph®) and aortic diameter waveform re-calibration (RCD; ultrasonography), and (3) using three different calibration schemes: systo-diastolic (SD), calculated mean (CM) and oscillometric mean (OscM). RESULTS: SBPA and PPA parameters obtained with different equations, techniques, and calibration schemes show a highly variable association level (negative, non-significant, and/or positive) among them. The association between SBPA and PPA with cardiac parameters were highly variable (negative, non-significant, or positive associations). Differences in BPA parameter data between approaches were more sensitive to the calibration method than to the device used. Both, SBPA and PPA obtained with brachial sub-diastolic technique and calibrated to CM or OscM showed higher levels of association with LV and LA structural characteristics. CONCLUSIONS: Our data show that many of the parameters that assume to quantify the same phenomenon of BPA are not related to each other in the different age groups. Both, SBPA and PPA obtained with brachial sub-diastolic technique and calibrated to CM or OscM showed higher levels of association with LV and LA structural characteristics.
Assuntos
Função do Átrio Esquerdo , Determinação da Pressão Arterial/normas , Pressão Sanguínea , Coração/fisiologia , Função Ventricular Esquerda , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Determinação da Pressão Arterial/instrumentação , Calibragem , Criança , Estudos Transversais , Ecocardiografia Doppler , Feminino , Voluntários Saudáveis , Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Oscilometria , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Adulto JovemRESUMO
Background: Echocardiography provides useful additional information on cardiac dimensions including heart wall anddimension of the ventricles, atria and conditions. Rabbits have been diagnosed with cardiac diseases, and an understandingof the animals cardiac chamber dimensions is vital in assessing the diseases severity and prognoses. Changes in cardiacdimensions due to age related and body weight were determined at different animals. The increased incidence of congenitalcardiovascular anomalies makes it essential to establish the diagnosis at an early age. The aims of this study 1) establishnormal values for the commonly used two-dimensional (2D) M-mode parameters using pre anaesthetics and 2) evaluatethe effects of age, sex, and body weight on echocardiographic parameters in clinically healthy New Zealand rabbits.Materials, Methods & Results: In this study we used 49 New Zealand white rabbits (25 male, 24 female) all reared under the same conditions. A general physical and clinical examination including complete blood count was performed foreach animal. Body surface area was calculated as BSA= 0.00718 × Height 0.725 × Weight 0.425. Rabbits were sedated withmidazolam before echocardiographic examination was performed. Echocardiographic examination was performed using aDC 6-Vet® (Mindray, PRC) ultrasonographic device equipped with a micro-convex 8 MHz probe. Right parasternal shortaxis view, B-mode and two-dimensional guided M-mode parameters were measured. Echocardiographic measurementswere performed using leading-edge-to-leading-edge conventions outlined by the American Society of Echocardiography.Statistical analyses were employed using the SPSS 19.0 program. Sex had no significant effect on the measured echocardiographic parameters except in the case of interventricular septum thickness in diastole values of the three-month-oldrabbits. The increase in the left ventricular systolic and diastolic diameters...(AU)
Assuntos
Animais , Coelhos , Ecocardiografia/veterinária , Fatores Etários , Peso Corporal , Fatores Sexuais , Coração/anatomia & histologia , Ventrículos do Coração , Volume SistólicoRESUMO
Background: Echocardiography provides useful additional information on cardiac dimensions including heart wall anddimension of the ventricles, atria and conditions. Rabbits have been diagnosed with cardiac diseases, and an understandingof the animals cardiac chamber dimensions is vital in assessing the diseases severity and prognoses. Changes in cardiacdimensions due to age related and body weight were determined at different animals. The increased incidence of congenitalcardiovascular anomalies makes it essential to establish the diagnosis at an early age. The aims of this study 1) establishnormal values for the commonly used two-dimensional (2D) M-mode parameters using pre anaesthetics and 2) evaluatethe effects of age, sex, and body weight on echocardiographic parameters in clinically healthy New Zealand rabbits.Materials, Methods & Results: In this study we used 49 New Zealand white rabbits (25 male, 24 female) all reared under the same conditions. A general physical and clinical examination including complete blood count was performed foreach animal. Body surface area was calculated as BSA= 0.00718 × Height 0.725 × Weight 0.425. Rabbits were sedated withmidazolam before echocardiographic examination was performed. Echocardiographic examination was performed using aDC 6-Vet® (Mindray, PRC) ultrasonographic device equipped with a micro-convex 8 MHz probe. Right parasternal shortaxis view, B-mode and two-dimensional guided M-mode parameters were measured. Echocardiographic measurementswere performed using leading-edge-to-leading-edge conventions outlined by the American Society of Echocardiography.Statistical analyses were employed using the SPSS 19.0 program. Sex had no significant effect on the measured echocardiographic parameters except in the case of interventricular septum thickness in diastole values of the three-month-oldrabbits. The increase in the left ventricular systolic and diastolic diameters...
Assuntos
Animais , Coelhos , Coração/anatomia & histologia , Ecocardiografia/veterinária , Fatores Etários , Fatores Sexuais , Peso Corporal , Ventrículos do Coração , Volume SistólicoRESUMO
AIMS: This study aimed to investigate whether beneficial effects of thyroid hormones are comparable to those provided by the aerobic exercise training, to verify its applicability as a therapeutic alternative to reverse the pathological cardiac remodeling post-infarction. MATERIALS AND METHODS: Male rats were divided into SHAM-operated (SHAM), myocardial infarction (MI), MI subjected to exercise training (MIE), and MI who received T3 and T4 treatment (MIH) (nâ¯=â¯8/group). MI, MIE and MIH groups underwent an infarction surgery while SHAM was SHAM-operated. One-week post-surgery, MIE and MIH groups started the exercise training protocol (moderate intensity on treadmill), or the T3 (1.2⯵g/100â¯g/day) and T4 (4.8⯵g/100â¯g/day) hormones treatment by gavage, respectively, meanwhile SHAM and MI had no intervention for 9â¯weeks. The groups were accompanied until 74â¯days after surgery, when all animals were anesthetized, left ventricle echocardiography and femoral catheterization were performed, followed by euthanasia and left ventricle collection for morphological, oxidative stress, and intracellular kinases expression analysis. KEY FINDINGS: Thyroid hormones treatment was more effective in cardiac dilation and infarction area reduction, while exercise training provided more protection against fibrosis. Thyroid hormones treatment increased the lipoperoxidation and decreased GSHPx activity as compared to MI group, increased the t-Akt2 expression as compared to SHAM group, and increased the vascular parasympathetic drive. SIGNIFICANCE: Thyroid hormones treatment provided differential benefits on the LV function and autonomic modulation as compared to the exercise training. Nevertheless, the redox unbalance induced by thyroid hormones highlights the importance of more studies targeting the ideal duration of this treatment.