9 research outputs found
Arterial stiffness in patients with heart failure with preserved ejection fraction
No full textАдрес за кореспонденция:
Д-р Десислава Петрова Сомлева;
Клиника по кардиология;
УМБАЛ „Царица Йоанна – ИСУЛ”
ул. „Бяло море” № 8;
1527 София;
tel. 02 9432 297;
tel. 02 9432 126;
e-mail: [email protected] ***** Address for correspondence:
Desislava Petrova Somleva, M. D.;
Clinic of Cardiology;
UMHAT “Tsaritsa Yoanna – ISUL”;
8, Bialo more Str.;
Bg – 1527 Sofia Address for correspondence:
Desislava Petrova Somleva, M. D.
Clinic of Cardiology
UMHAT “Tsaritsa Yoanna – ISUL”
8, Bialo more Str.
Bg – 1527 Sofia;
tel.: +359 2 9432 297
tel.: +359 2 9432 126
e-mail: [email protected]При пациентите със сърдечна недостатъчност и запазена фракция на изтласкване (СНзФИ) е установена повишена артериалната ригидност. Целта е да се изследва връзката между артериалната ригидност и степента на диастолна дисфункция при пациенти със
СНзФИ. Изследвани са 40 пациенти със СНзФИ, 40 пациенти с артериална хипертония (АХ) и 21
здрави контроли. Артериалната ригидност е определена чрез каротидо-феморалната скорост
на пулсовата вълна (СПВ). Ехокардиографски са изчислени индексираните левокамерна (ЛК) маса и обем на ляво предсърдие (ЛП). Диастолната функция е оценена с конвенционална и тъканна Doppler ехокардиография. Пациентите със СНзФИ спрямо пациентите с АХ и здравите контроли се характеризират с по-високи СПВ (11.85 ± 2.64 m/s спрямо 10.02 ± 2.39 m/s и 7.51 ± 1.20 m/s, p < 0.0001), индекс на ЛК маса (p < 0.0001), индекс на ЛП обем (р < 0.0001), съотношение на ранната митрална скорост Е към ранната диастолна скорост на медиалния митрален анулус ЕmЕ/Еm и на митрална скорост Е към ранната диастолна скорост на латералния анулус El – E/El (p < 0.0001). При контролиране за възрастта се установи сигнификантна умерена корелация на СПВ с ЛК маса (r* = 0.46, p* < 0.0001) и Е/Еm (r* = 0.45, p* < 0.0001). Повишената артериална ригидност има роля в развитието на СНзФИ и е свързана с наличието на ЛК хипертрофия и повишени налягания на ЛК пълнене.
***** Summary. The arterial stiffness has been shown to be increased in patients with heart failure with preserved
ejection fraction (HFpEF). Purpose: To determine the relation between arterial stiffness and diastolic
dysfunction in patients with HFpEF. We examined 40 patients with HFpEF, 40 patients with arterial
hypertension (AH), 21 healthy controls. Arterial stiffness was assessed by pulse wave velocity (PWV). Left
ventricular mass index (LVMI) and left atrium volume index (LAVI) were measured by 2D-echocardiography.
Diastolic function was assessed by PW- Doppler and tissue Doppler imaging. The patients with HFpEF
compared to hypertensive and healthy subjects had higher PWV (11.85 ± 2.64 m/s vs 10.02 ± 2.39 m/s and
7.51 ± 1.20 m/s, p < 0.0001), LVMI (p < 0.0001), LAVI (p < 0.0001), ratio of early mitral flow velocity E and
early diastolic medial mitral annulus velocity EmE/Em ratio, and ratio of early mitral flow velocity E and
early diastolic lateral mitral annulus velocity ElE/El ratio (p < 0.0001). Moderate significant correlation of
PWV with LVMI (r* = 0.46, p* < 0.0001, adjusted for age) and Е/Еm ratio (r* = 0.45, p* < 0.0001, adjusted for
age) was found. Increased arterial stiffness may have a role in the development of heart failure with
preserved ejection fraction and is related to LV hypertrophy and increased LV filling pressure
Вентрикуло-съдово куплиране при пациенти със сърдечна недостатъчност и запазена фракция на изтласкване
No full textДисертационен труд за прицъждане на образователна и научна степен "Доктор" /CD/ / Десислава Петрова Сомлева . - София, 2012 . - 138 с. + Автореферат /CD/ Научна специалност: Кардиология; Шифър: 03.01.47 Научен ръководител: Проф. д-р Асен Гудев, дм
Quality of Life and Mental Health in Patients with Exacerbated Heart Failure: The Role of Obstructive and Central Sleep Apnea Phenotypes
No full textBackground: Managing acute decompensated heart failure (ADHF) is complex, particularly when combined with comorbidities like sleep apnea. Effective treatment requires personalized approaches, focusing on quality of life (QoL) and mental health outcomes. Purpose: This study explored the prevalence and characteristics of sleep apnea in patients with obesity and AHF exacerbations. It assessed how different sleep apnea phenotypes impact QoL and mental health, applying personalized medicine strategies. Methods: A prospective cohort study was conducted on 150 patients admitted for AHF exacerbation. Inclusion criteria included an Apnea–Hypopnea Index (AHI) > 5, an Epworth Sleepiness Scale (ESS) > 8, NT-proBNP > 900 pg/mL and informed consent obtained prior to participation. Optimized medical treatment was provided. QoL and mental health were evaluated using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Beck Depression Inventory (BDI). Results: Among 81 patients with sleep apnea, 73% (n = 59) had obstructive sleep apnea (OSA) and 27% (n = 19) had central sleep apnea (CSA). OSA patients reported a higher QoL (61.12 ± 17.88) compared to CSA patients (37.18 ± 19.98, p < 0.001). CSA patients exhibited more severe depression (BDI: 26.18 ± 5.5 vs. 16.64 ± 4.1, p < 0.001). Significant correlations were noted between KCCQ and BDI scores (r = −0.849, p < 0.001) and central apnea events (r = −0.485, p < 0.001). Conclusions: Sleep apnea is common in ADHF patients, with CSA being linked to poorer QoL and greater depression. Personalized medicine offers promising strategies to enhance care and outcomes
Sleep disorders in patients with acute and exacerbated chronic heart failure
No full textHeart failure is often accompanied by sleep disorders. Continuous Positive Airway Pressure (CPAP) therapy has proven in the treatment of obstructive sleep apnea, but the benefits associated with comorbid patients and patients with heart failure is still under research. On the other hand, central sleep apnea is also with high frequency in these patients and more difficult to treat. The aim of the current publication is to make a brief review of acute and exacerbated chronic heart failure in patients with sleep disorders – frequency, severity, and types to treat
Sleep apnea in patients with exacerbated heart failure and overweight
No full textSleep disorders are a common concomitant comorbidity in patients with heart failure. The aims of our study are to determine the incidence and phenotypic characteristics of sleep apnea in overweight patients with exacerbated heart failure and to assess the degree of involvement of systolic and diastolic function impairment in the individual group. From 100 screened patients with heart failure in our department from 2015 to 2017, 61 met the inclusion criteria and participated in the study. 82% (n = 50) of the patients had obstructive sleep apnea (OSA), and 18% (n = 11) had central sleep apnea (CSA). The CSA group had a significantly lower left ventricular ejection fraction (LVEF) than the OSA group (EF% 49.6 ± 8.5 vs 41.8 ± 11.4; p = 0.013). A negative correlation was found between LVEF and the number of central apnea events (r = −0.52; p < 0.001). More frequent hospitalizations for heart failure (HF) and higher mortality rate were found in the CSA group. Screening for sleep apnea in patients with exacerbated heart failure and obesity is necessary for the complex treatment of these patients
Clinical and echocardiographic characteristics of patients with atrial cardiomyopathy and their impact on prognosis
No full textIntroduction: Patients with diverse demographic and clinical characteristics and comorbidities are included in the category of atrial cardiomyopathy (ACM). Aim: Our study aims to evaluate the demographic, clinical, laboratory, and echocardiographic parameters of patients with ACM and to assess their impact on prognosis. Materials and methods: Only 200 of the 724 consecutively evaluated patients with dilated left atrium who met the criteria for advanced ACM were included in the analysis. Forty age- and sex-matched controls with normal left atrial volume were also included. On enrollment, all patients received a detailed echocardiography with volumetric and speckle tracking analysis, and they were followed for 36 months for cardiovascular outcomes, including mortality. Results: The mean age of the ACM population was 73.91±9.74 years, with 58% being women. Hypertension was found in 93% of them, 79% had atrial fibrillation, 60% had heart failure, 37% were obese, and 26% had diabetes. Over a median follow-up of 20.6 months, 35 deaths were registered in the ACM group compared to 1 death in the control group (17.5% vs. 2%, p=0.011). The presence of heart failure (HR 5.2, p=0.004), cancer (HR 3.7, p=0.007), severe tricuspid regurgitation (TR) (HR 5.4, p&lt;0.001), high NT-proBNP (HR 1.4, p&lt;0.001), and low right ventricular free wall strain (RVFWLS) (HR 1.2, p=0.006) were predictors of poor outcome. Conclusion: In patients with ACM, the most prevalent comorbidities are hypertension, atrial fibrillation, heart failure, obesity, and diabetes. ACM is associated with high mortality with the best echocardiographic predictors – the presence of severe TR and RVFWLS &gt;−17 %
Telecardiology for patients with chronic heart diseases during COVID-19 pandemic
No full textBackground: Telemedicine is an alternative to the standard consultation with a specialist during COVID-19 pandemic. Though their benefits are not well studied, the phone consultations are a potential effective resource for providing medical and psycho-social help to patients with chronic diseases during social isolation. Aim: To assess the demographic and clinical characteristics of patients, who looked for cardiology help on the phone, and the most common reasons for these consultations. Material and Methods: We analyzed the data of 196 consecutive patients with chronic cardiovascular diseases, who called for cardiology consultation at the National Patients' Organization between 22.04.2020 and 31.07.2020. Results: The mean age of the included patients was 71,7 ± 11,3 years (17 ÷ 92), and 149 of them (76%) were above the age of 65 years (who we defi ned as elderly). 114 (58%) of the consulted on the phone were females. 96 patients (49%) called from Sofi a. The mean duration of the call was 8,5 minutes. The most common reasons for teleconsultation were unstable blood pressure – in 30% of the patients (n = 59) and anxiety – 17% (n = 33). Other reasons for seeking cardiology help were adjusting the therapy (different from the antihypertensive one) – 8%, chest pain – 7%, dyspnea – 7%, questions about follow-up of a chronic disease – 7%, palpitations – 6%, monitoring of INR – 4%, second opinion before an operation or a procedure – 2%, problems getting medications or protocols – 1,5%, administrative issues (TELK/LKK) – 1,5%. The most common chronic diseases of the consulted were: arterial hypertension (89%), heart failure (31%), ischemic heart disease (25%), diabetes mellitus (22%) and atrial fibrillation (15%). Conclusion: During COVID-19 pandemic the elderly and the women more often look for cardiology help on the phone. The suboptimal control of the blood pressure and the anxiety, caused by the pandemic, are the most common reasons for phone consultations of the patients with chronic cardiovascular diseases
Effect of Lactobacillus plantarum supplementation on trimethylamine-N-oxide levels in 30 patients with atherosclerotic cardiovascular disease: A double-blind randomized controlled trial
No full textIntroduction: Trimethylamine-N-oxide (TMAO) is a metabolite produced by intestinal microbiota. It is well recognized as an independent risk marker for cardiovascular and renal diseases and mortality. Aim: The aim of the present study was to investigate the effect of Lactobacillus plantarum GLP3 supplementation on TMAO levels in 30 patients with a history of atherosclerotic cardiovascular disease after 12 weeks of treatment. Materials and methods: Thirty consecutive male patients with a history of clinical atherosclerotic cardiovascular disease were randomized in the study. TMAO levels were evaluated in human plasma samples using high-performance liquid chromatography with triple quadrupole tandem mass spectrometry and results were presented as the median (interquartile range). Microbiome sequencing analysis, focusing on bacteria from the genus Lactobacillus, was performed in 21 patients. Results: Patients receiving probiotic treatment showed a significant decrease in the TMAO levels [from 284 (139) µg/L to 202.5 (96.7) µg/L; p=0.044], with no significant change apparent in the placebo group after the treatment [from 176 (120) µg/L to 178 (150) µg/L; p=0.258]. Lactobacillus spp. % in the probiotic group was significantly increased after the interventional procedures [0.6 (0.14) before and 0.79 (0.6) after the treatment; p=0.041]. Conclusion: Probiotic supplementation with Lactobacillus plantarum GLP3 reduced the TMAO levels in very high-risk patients for cardiovascular diseases
