An Alternative Approach to the Bedside Assessment of Left Ventricular Systolic Function in the Emergency Department: Displacement of the Aortic Root

Ünlüer, Erden Erol; Karagöz, Arıf; Bayata, Serdar; Akoğlu, Haldun

doi:10.1111/acem.12114

Cited by 10 publications

(9 citation statements)

References 33 publications

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“…Left ventricular end-systolic and -diastolic left dimensions (LVESD and LVEDD, respectively) were measured according the American Society of Echocardiography guidelines (18). LV end-diastolic and -systolic volumes (EDV and ESV, respectively) were calculated using the Simpson method of disks (19). Ejection fraction (EF) was determined using the formula EF (%) = (EDV-ESV)/EDVx100.…”

Section: Methodsmentioning

confidence: 99%

C-C chemokine receptor 5 signaling contributes to cardiac remodeling and dysfunction under pressure overload

Wang

Yue

et al. 2020

Mol Med Rep

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Aortic stenosis (AS) leads to chronic pressure overload, cardiac remodeling and eventually heart failure. Chemokines and their receptors have been implicated in pressure overload-induced cardiac remodeling and dysfunction. In the present study, the role of C-C chemokine receptor 5 (CCR5) in pressure overload-induced cardiac remodeling and dysfunction was investigated in mice subjected to transverse aortic constriction (TAC). Cardiac levels of CCR5 and C-C motif chemokine ligands (CCLs)3, 4 and 5 were determined by western blotting and reverse transcription-quantitative PCR, respectively. Cardiac functional parameters were evaluated by echocardiographic and hemodynamic measurements. Myocardial fibrosis was assessed by Masson's trichrome staining and α-smooth muscle actin immunostaining. Myocardial hypertrophy and inflammatory cell infiltration were evaluated by hematoxylin and eosin staining. Angiotensin II (Ang II)-induced hypertrophy of H9c2 cardiomyocytes was assessed by F-actin immunostaining. ERK1/2 and P38 phosphorylation was examined by western blotting. TAC mice exhibited higher myocardial CCL3, CCL4, CCL5 and CCR5 levels compared with sham mice. Compared with sham mice, TAC mice also exhibited impaired cardiac function along with myocardial hypertrophy, fibrosis and inflammatory cell infiltration. TAC-induced cardiac remodeling and dysfunction were effectively ameliorated by administration of anti-CCR5 but not by IgG control antibody. Mechanistically, increased ERK1/2 and P38 phosphorylation was detected in TAC hearts and Ang II-stimulated H9c2 cardiomyocytes. Treatment with anti-CCR5 antibody decreased ERK1/2 and P38 phosphorylation and attenuated Ang II-induced H9c2 cell hypertrophy. CCR5 inhibition protected against pressure overload-induced cardiac abnormality. The findings of the present study indicate that ERK1/2 and P38 signaling pathways may be involved in the cardioprotective effects of CCR5 inhibition.

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Section: Methodsmentioning

confidence: 99%

C-C chemokine receptor 5 signaling contributes to cardiac remodeling and dysfunction under pressure overload

Wang

Yue

et al. 2020

Mol Med Rep

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“…Nowadays, it has lent itself to the evaluation and management of most patients through the incorporation of multiple ultrasound examinations within a single patient encounter. [456] The information gained can provide crucial information at the bedside, which can enhance diagnostic certainty and guide management.…”

Section: Discussionmentioning

confidence: 99%

Bedside ultrasound diagnosis of intracardiac paperclip

Ünlüer

Karagöz

Topal

et al. 2014

J Emerg Trauma Shock

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Penetrating cardiac injuries are rarely reported in the literature. Foreign bodies are rarely seen in the heart and most patients with penetrating cardiac injuries die from hemorragic or pericardial tamponade before arriving at the hospital. Bedside ultrasonography is a highly valuable and readily learned tool that has expanded rapidly since its introduction more than 20 years ago. Our case was a 23-year-old convict brought to the emergency department (ED) with a history of continuous chest pain in the upper area of the left side of the chest for one week. Focused Cardiac Sonography (FOCUS) which was performed by emergency physician showed a strong echogenic linear structure with comet tail artifact, free floating in the mid-segment of the left ventricule. Exact localizations of the paperclips within the chest was obtained with multidetector computed tomography and one of them was seen in the left ventricular cavity. FOCUS plays a crucial role in these patients by diagnosing the injury and detecting the complications in emergency department.

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“…Bedside cardiac ultrasonography (BECH) is an essential tool for EPs when diagnosing and making therapeutic decisions about critically ill patients. [6][7][8] Cardiac output (CO), which is measured by BECH after passive leg raising (PLR), has been studied several times and it has been regarded as a dynamic surrogate of volume responsiveness. 4,9 PLR is a validated dynamic method to predict fluid responsiveness in different scenarios.…”

Section: Introductionmentioning

confidence: 99%

A novel prediction of simulated fluid responsiveness by echocardiography assessment of tricuspid annulus tissue velocity with passive leg raising

Ünlüer

Karagöz

Bayata

et al. 2019

Hong Kong Journal of Emergency Medicine

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Background: Fluid responsiveness can be predicted by the effect of passive leg raising on cardiac output. Objectives: This research aimed to compare the changes in cardiac output and the peak systolic velocity values of Tricuspid annulus velocity at the free wall (S’) before and after passive leg raising in healthy volunteers. Methods: The study was approved by ethical commission. The desired sample size was 28, and 57 volunteers were included after they signed informed consent. The first measurements, including vital signs, S’, and cardiac output, were taken with the participants lying supine and were performed in the morning after 12 h fast. The participants were then asked to lie in a semirecumbent position for 3 min. After 3 min, the head of the bed was lowered to the supine position and the participants’ legs were elevated at 45°. Secondary measurements were repeated in this position. The differences between vital signs, cardiac output, and S’ measurements before and after passive leg raising were statistically compared. The level of significance was set as p < 0.05. Results: The mean values of cardiac output and S’ before passive leg raising was 9.59 L/min and 11.57 cm/s, respectively; however, those increased to 11.44 L/min and 13.72 cm/s after passive leg raising. The average increases were 16.17% for cardiac output and 15.67% for S’. The changes of cardiac output and S’ were statistically significant. The changes of vital signs before and after passive leg raising were statistically insignificant. Conclusion: This study has demonstrated the concordance of rise in cardiac output with S’ change by passive leg raising in healthy subjects. Further studies are needed to validate the use of S’ values in critically ill subjects.

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An Alternative Approach to the Bedside Assessment of Left Ventricular Systolic Function in the Emergency Department: Displacement of the Aortic Root

Cited by 10 publications

References 33 publications

C-C chemokine receptor 5 signaling contributes to cardiac remodeling and dysfunction under pressure overload

C-C chemokine receptor 5 signaling contributes to cardiac remodeling and dysfunction under pressure overload

Bedside ultrasound diagnosis of intracardiac paperclip

A novel prediction of simulated fluid responsiveness by echocardiography assessment of tricuspid annulus tissue velocity with passive leg raising

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