Right ventricle dysfunction is present in postoperative ToF patients. The psychosocial domain of HRQL is preserved after surgery. A trend for worse results was observed in the physical domain. The right ventricle function is not related to quality of life after surgical repair of ToF.
1. The role of growth hormone (GH) in cardiac remodelling and function in chronic and persistent pressure overload-induced left ventricular hypertrophy has not been defined. The aim of the present study was to assess short-term GH treatment on left ventricular function and remodelling in rats with chronic pressure overload-induced hypertrophy. 2. Twenty-six weeks after induction of ascending aortic stenosis (AAS), rats were treated with daily subcutaneous injections of recombinant human GH (1 mg/kg per day; AAS-GH group) or saline (AAS-P group) for 14 days. Sham-operated animals served as controls. Left ventricular function was assessed by echocardiography before and after GH treatment. Myocardial fibrosis was evaluated by histological analysis. 3. Before GH treatment, AAS rats presented similar left ventricular function and structure. Treatment of rats with GH after the AAS procedure did not change bodyweight or heart weight, both of which were higher in the AAS groups than in the controls. After GH treatment, posterior wall shortening velocity (PWSV) was lower in the AAS-P group than in the control group. However, in the AAS-GH group, PWSV was between that in the control and AAS-P groups and did not differ significantly from either group. Fractional collagen (% of total area) was significantly higher in the AAS-P and AAS-GH groups compared with control (10.34 +/- 1.29, 4.44 +/- 1.37 and 1.88 +/- 0.88%, respectively; P < 0.05) and was higher still in the AAS-P group compared with the AAS-GH group. 4. The present study has shown that short-term administration of GH to rats with chronic pressure overload-induced left ventricular hypertrophy induces cardioprotection by attenuating myocardial fibrosis.
Anemia is a prevalent comorbidity and marker of a poorer prognosis in patients with
heart failure (HF). Its clinical relevance, as well as its pathophysiology and the
clinical management of these patients are important subjects in the specialized
literature. In the present review, we describe the current concepts on the
pathophysiology of anemia in HF, its diagnostic criteria, and the recommendations for
iron supplementation. Also, we make a critical analysis of the major studies showing
evidences on the benefits of this supplementation. The four main components of anemia
are addressed: chronic disease, dilutional, "renal" and malabsorption. In patients
with HF, the diagnostic criteria are the same as those used in the general
population: serum ferritin levels lower than 30 mcg/L in patients without kidney
diseases and lower than 100 mcg/L or serum ferritin levels between 100-299 mcg/L with
transferring saturation lower than 20% in patients with chronic kidney diseases.
Finally, the therapeutic possibilities for anemia in this specific patient population
are discussed.
M a i l i n d A d d r e s s : K a t a s h i O k o s h i• T r a v e s s a C y r o T a r g a , 1 1 5 -1 8 6 1 0 -2 5 0 -B o t u c a t u , S P -B r a z i l E-mail: okoshi@cardiol.
OBJECTIVEThe purpose of this study was to identify echocardiographic parameters that allow distinguishing different levels of cardiac dysfunction in aortic banded rats.
METHODSWistar male rats (90-100 g) were subjected to aortic banding (n=23) or a sham operation (n=12). The following echocardiographic parameters were evaluated and used to group rats into groups with similar characteristics using cluster analysis: absolute values and after normalization to body weight of left ventricular enddiastolic diameter (LVDD) and left atrial systolic diameter; left ventricular end-systolic diameter (LVSD); LV weight to body weight ratio (LVW/BW); three indexes of left ventricular shortening (endocardial fractional shortening, EFS; midwall FS, MFS; and posterior wall shortening velocity, (PWSV).
RESULTSThe cluster analysis could group aortic banded rats into two groups: mild (n=13) and severe (n=9) stage of heart failure. There was no overlapping among the values of the 95% confi dence interval of the following parameters between the two groups: LVDD, LVSD, EFS, MFS, LVW/BW, and PWSV.
CONCLUSIONIt is feasible to distinguish two groups of aortic banded rats according to the level of cardiac dysfunction using those echocardiographic parameters. This allows to perform longitudinal studies in homogeneous groups of rats with aortic banding and cardiac dysfunction.
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