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Abstract Background Pulmonary arterial hypertension (PAH) in the setting of end-stage renal disease (ESRD) has important prognostic and therapeutic consequences. We estimated the prevalence of PAH among patients with ESRD treated with automated peritoneal dialysis (APD), investigated the effect of different variables and compared pulmonary artery pressure and cardiac function at the beginning and end of the study. Methods This is a 5-year study in which 31 ESRD patients on APD were recruited after fulfilling inclusion criteria. Blood samples were collected from all patients for the biochemical and hematological data at the beginning of the study and every month and at the study termination. Total body water (TBW) and extracellular water (ECW) were calculated using Watson’s and Bird’s calculation methods. All patients were followed-up at 3-month interval for cardiac evaluation. Logistic regression analysis was used to assess the relation between different variables and PAH. Results The mean age of the study population (n = 31) was 51.23 ± 15.24 years. PAH was found in 24.2% of the patients. Mean systolic pulmonary artery pressure (sPAP) and mean pulmonary artery pressure (mPAP) were significantly higher in the APD patients at study initiation than at the end of the study (40.75 + 10.61 vs 23.55 + 9.20 and 29.66 + 11.35 vs 18.24 + 6.75 mmHg respectively, p = 0.001). The median ejection fraction was significantly lower in patients with PAH at zero point than at study termination [31% (27-34) vs 50% (46-52), p = 0.002]. Hypervolemia decreased significantly at the end of study (p 1 years) seemed to decrease pulmonary arterial pressure, right atrial pressure and improve left ventricular ejection fraction (LVEF). Risk factors for PAH in ESRD were hypervolemia, abnormal ECHO findings and low hemoglobin levels. Clinical and echocardiographic abnormalities and complications are not uncommon among ESRD patients with PAH. Identification of those patients on transthoracic echocardiography may warrant further attention to treatment with APD.

Background: Pulmonary arterial hypertension (PAH) in the setting of end-stage renal disease (ESRD) has important prognostic and therapeutic consequences. We estimated the prevalence of PAH among patients with ESRD treated with automated peritoneal dialysis (APD), investigated the effect of different variables and compared pulmonary artery pressure and cardiac function at the beginning and end of the study.Methods: This is a 5-year study in which 31 ESRD patients on APD were recruited after fulfilling inclusion criteria. Blood samples were collected from all patients for the biochemical and hematological data at the beginning of the study and every month and at the study termination. Total body water (TBW) and extracellular water (ECW) were calculated using Watson's and Bird's calculation methods. All patients were followed-up at 3-month interval for cardiac evaluation. Logistic regression analysis was used to assess the relation between different variables and PAH.Results: The mean age of the study population (n = 31) was 51.23 ± 15.24 years. PAH was found in 24.2% of the patients. Mean systolic pulmonary artery pressure (sPAP) and mean pulmonary artery pressure (mPAP) were significantly higher in the APD patients at study initiation than at the end of the study (40.75 + 10.61 vs 23.55 + 9.20 and 29.66 + 11.35 vs 18.24 + 6.75 mmHg respectively, p = 0.001). The median ejection fraction was significantly lower in patients with PAH at zero point than at study termination [31% (27-34) vs 50% (46-52), p = 0.002]. Hypervolemia decreased significantly at the end of study (p <  0.001) and correlated positively with the PAP (r = 0.371 and r = 0.369), p = 0.002). sPAP correlated with left ventricular mass index, hemoglobin level, and duration on APD.Conclusions: Long term APD (> 1 years) seemed to decrease pulmonary arterial pressure, right atrial pressure and improve left ventricular ejection fraction (LVEF). Risk factors for PAH in ESRD were hypervolemia, abnormal ECHO findings and low hemoglobin levels. Clinical and echocardiographic abnormalities and complications are not uncommon among ESRD patients with PAH. Identification of those patients on transthoracic echocardiography may warrant further attention to treatment with APD. [ABSTRACT FROM AUTHOR]

Objective: Investigating structural and geometrical parameters, specifics of LV remodeling, as well as daily BP profiles in young and middle-aged service members dealing with hypertension Stage 1 and Stage 2. A group of 86 male subjects has been researched, including 52 young (26-44 y/o) and 34 middle-aged (45- 55 y/o) subjects with AH. The cardiac function has been evaluated through echo cardiography, and daily BP monitoring has been carried out. The results of the study have shown that young and middle-aged servicemen with AH have a normal LV geometry (59.6% of young subjects (31), 55.9% of middle-aged subjects (19)), and concentric LV remodeling has been observed in 40.4% of young subjects (21) and in 22.1% of middle-aged (15) subjects with AH. According to data obtained during 24-hr BPM,as compared to the normal LV geometry group, in the concentric LV remodeling groups the occurrence of the dipper AH profile has decreased both in young (28.5% vs. 39%) and middle-aged (40% vs. 47.7%) subjects. [ABSTRACT FROM AUTHOR]

To study the value of echocardiography, plasma brain natriuretic peptide (BNP), peptide hormones and hypersensitive C- reactive protein (hs-CRP) in the evaluation of heart function in patients with chronic heart failure (CHF). 100 patients with CHF who were admitted to our hospital from March 2017 to March 2020 were included in the study. According to the American heart association of New York (NYHA) classification standard, they were divided into 33 cases of gradeI, 21 cases of grade II, 25 cases of grade III, 21 cases of grade IV. Echocardiography was performed on all subjects, the differences in relevant parameter levels were analyzed. Plasma BNP, peptide and hs-CRP levels were measured and compared in all patients. Pearsn correlation was used to analyze the correlation parameters of echocardiography with plasma BNP, peptide and hs-CRP levels. The cardiac function classI~IV in patients with left ventricular ejection fraction (LVEF) showed a trend of gradually reduce, while the left atrial diameter (LAD) and left ventricular end-diastolic diameter (LVEDD) showed a trend of increased (P<0.05), plasma BNP, and peptide hormones and hs-CRP levels showed a trend of increased (P<0.05). According to Pears on correlationan alysis, LVEF in patients with CHF were negatively correlated with plasma BNP, peptide hormones and hs-CRP (r=-0.621,-0.534,-0.635, P<0.05), while LAD and LVEDD were positively correlated with plasma BNP, peptide hormones and hs-CRP (r=0.582, 0.602,0.511, r=0.547,0.592, 0.615, P<0.05). Echocardiography, plasma BNP, peptide hormones and hs-CRP were all effective in evaluating cardiac function in patients with CHF, and the combined detectionhad a synergistic and complementary effect, and it can achieve a more accurate assessment of the severity of CHF. [ABSTRACT FROM AUTHOR]

Background: Echocardiographic evaluations of the longitudinal axis of the left ventricular (LV) function have been used in the diagnosis and assessment of heart failure with normal ejection fraction (HFNEF). The evaluation of the global and segmental peak systolic longitudinal strains (PSLSs) by two-dimensional speckle tracking echocardiography (STE) may correlate with conventional echocardiography findings. We aimed to use STE to evaluate the longitudinal function of the LV in patients with HFNEF. Methods: In this study, 126 patients with HFNEF and diastolic dysfunction and 60 normal subjects on conventional echocardiography underwent STE evaluations, including LV end-diastolic and end-systolic dimensions; interventricular septal thickness; posterior wall thickness; LV volume; LV ejection fraction; left atrial volume index; early diastolic peak flow velocity (E); late diastolic peak flow velocity (A); E/A ratio; deceleration time of E; early diastolic myocardial velocity (e′); late diastolic myocardial velocity (A′); systolic myocardial velocity (S); and global, basal, mid, and apical PSLSs. The correlations between these methods were assessed. Results: The mean age was 57.50 ± 10.07 years in the HFNEF patients and 54.90 ± 7.17 years in the control group. The HFNEF group comprised 69.8% males and 30.2% females, and the normal group consisted of 70% males and 30% females. The global, basal, mid, and apical PSLSs were significantly lower in the HFNEF group (p value < 0.001 for all). There was a significant positive correlation between the global PSLS and the septal e’ (p value < 0.001). There was a negative correlation between the global PSLS and the E/e’ ratio (p value = 0.001). There was a significant negative correlation between the E/e’ ratio and the mid PSLS (p value = 0.002) and the basal PSLS (p value = 0.001). There was a weak positive correlation between the septal e’ and the mid PSLS (p value = 0.001) and the basal PSLS (p value < 0.001). There were also weak negative correlations between the isovolumic relaxation time and the global PSLS (p value = 0.022) and the mid PSLS (p value = 0.018) and also between the New York Heart Association functional class and the mid PSLS (p value = 0.041) and the basal PSLS (p value = 0.009). Conclusion: Our HFNEF patients on conventional echocardiography had different STE findings compared to our normal subjects, which is indicative of diastolic dysfunction. The longitudinal systolic function of the LV, which was measured by STE, was reduced in all the segments, denoting some degree of subclinical systolic dysfunction in these patients. [ABSTRACT FROM AUTHOR]

Acute mitral regurgitation (AMR), a known complication of acute coronary syndromes, is usually associated with posterior papillary muscle dysfunction/rupture. In severe cases, management of AMR requires surgical intervention. Reversible severe AMR in patients in the absence of left ventricular systolic dysfunction and coronary artery stenosis may result from processes which cause transient subendocardial ischemia, such as intermittent episodes of hypotension or coronary artery vasospasm. We present two cases of reversible transient AMR due to subendocardial and/or endocardial ischemia, both of which offer insight into the mechanism of transient severe AMR. [ABSTRACT FROM PUBLISHER]