Objective: Liver cirrhosis is associated with several cardiovascular abnormalities including a hyperdynamic splanchnic and systemic circulation related to arterial vasodilatation, finally leading to sodium retention, central hypovolemia, and increased intravascular volume. The objective of this study was to evaluate the relationship between NT-proBNP and echocardiographic parameters and liver disease stage in patients with cirrhosis. Method: This prospective study included 82 consecutive patients diagnosed with liver cirrhosis and 120 healthy, age- and sex-matched subjects. Standard transthoracic echocardiography was performed in all patients. Plasma NT-proBNP levels were determined. Liver disease severity in patients with cirrhosis was established by Child-Pugh class, MELD score and presence/absence of ascites. Results: Plasma levels of NT-proBNP were significantly higher in cirrhotic patients than the corresponding levels in the healthy subjects. NT-proBNP levels were also significantly elevated in Child-Pugh class C patients compared to those in class B and A. Left atrium (LA) size, diastolic function, left ventricular (LV) wall thickness, and LV ejection fraction were significantly altered in cirrhotic patients compared to controls. Advanced cirrhosis and high levels of NT-proBNP were significantly associated with increased LA volume and signs of cardiac diastolic dysfunction. We also observed significant differences between quartile groups of MELD score for the following: NT-proBNP, Troponin I, LA volume, left ventricle wall thickness, lateral wall and septum systolic tissue Doppler velocities and global longitudinal strain. Conclusion: NT-proBNP is increased in patients with cirrhosis and is correlated with the severity of liver disease as established by Child-Pugh class, MELD score, and the presence of ascites.
Cardiac affectation is one of the leading causes of death in the world. Rhythmic disorders such as ventricular extrasystoles, atrial extrasysoles, atrial fibrillation, atrial flutter represent a major risk factor with a gloomy progression and prognosis. Our goal was to analyze the existing arrhythmia risk in patients with chronic hepatic disease. Being known the alteration of the somatic status of the patient with liver cirrhosis or other chronic liver disease in the presence of comorbid cardiac symptoms, we consider vital to prevent arrhythmia risk in hepatic pathology.
Left ventricular noncompaction is a primary cardiomyopathy with genetic transmission in the vast majority of autosomal dominant cases. It is characterized by the presence of excessive myocardial trabecularities that generally affect the left ventricle. In diagnosing this condition, echocardiography is the gold standard, although this method involves an increased risk of overdiagnosis and underdiagnosis. There are also uncertain cases where echocardiography is inconclusive, a multimodal approach is needed, correlating echocardiographic results with those obtained by magnetic resonance imaging. The clinical picture may range from asymptomatic patients to patients with heart failure, supraventricular or ventricular arrhythmias, thromboembolic events and even sudden cardiac death. There is no specific treatment of left ventricular noncompaction, but the treatment is aimed at preventing and treating the complications of the disease. We will present the case of a young patient with left ventricular noncompactioncardiomyopathy and highlight the essential role of transthoracic echocardiography in diagnosing this rare heart disease.
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited. ORIGINAL PAPER Alpha-lipoic acid and vitamin B complex slow down the changes in mice diabetic cardiomyopathy GEORGICĂ COSTINEL TÂRTEA 1) , DIANA RUXANDRA FLORESCU 2) , ALEXANDRU RADU MIHAILOVICI 2) , IONUŢ DONOIU 2) , OCTAVIAN ISTRĂTOAIE 2)
The tuberous sclerosis complex (TSC) is highly variable as far as its clinical presentation is concerned. For the implementation of appropriate medical surveillance and treatment, an accurate diagnosis is compulsory. TSC may affect the heart, skin, kidneys, central nervous system (epileptic seizures and nodular intracranial tumors—tubers), bones, eyes, lungs, blood vessels and the gastrointestinal tract. The aim of this paper is to report renal manifestations as first clinical signs suggestive of TSC diagnosis. A 20-year-old patient was initially investigated for hematuria, dysuria and colicky pain in the left lumbar region. The ultrasound examination of the kidney showed bilateral hyperechogenic kidney structures and pyelocalyceal dilatation, both suggestive of bilateral obstructive lithiasis, complicated by uretero-hydronephrosis. The computer tomography (CT) scan of the kidney showed irregular kidney margins layout, undifferentiated images between cortical and medullar structures, with non-homogenous round components, suggestive of kidney angiomyolipomas, bilateral renal cortical retention cysts, images of a calculous component in the right middle calyceal branches and a smaller one on the left side. The clinical manifestations and imaging findings (skull and abdominal and pelvis CT scans) sustained the diagnosis.
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