Focus on echocardiographic right ventricular strain analysis in cystic fibrosis adults without cardiovascular risk factors: a case–control study

Sciatti, Edoardo; Vizzardi, Enrico; Bonadei, Ivano; Valentini, Francesca; Menotti, Elisa; Prati, Francesco; Dallapellegrina, Lucia; Berlendis, Marialma; Poli, Piercarlo; Padoan, Rita; Metra, Marco

doi:10.1007/s11739-019-02104-5

Cited by 10 publications

(9 citation statements)

References 29 publications

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“…Sciatti et al recently reported significantly larger RA area in CF patients than in controls [12]. RA volume was not analyzed in this study [12]. RA volume, similar to LA, gradually increased from controls to CF non-survivors.…”

Section: Discussionmentioning

confidence: 76%

“…However, RA was significantly larger in CF patients than in controls. Sciatti et al recently reported significantly larger RA area in CF patients than in controls [12]. RA volume was not analyzed in this study [12].…”

Section: Discussionmentioning

confidence: 94%

“…Most investigations about CF performed in the last three decades have been focused on RV structure, RV function, and, more recently, RV mechanics [10,12,14]. LV remodeling became an interesting topic only when an echocardiographic technique developed enough to provide information other than the LV diameters and the ejection fraction.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the adoption of strain in everyday clinical practice has enabled the detection of subtle cardiac changes in mechanics, which was not previously possible. Several studies have been published on this topic, and there has been no agreement regarding the influence of CF on left ventricular (LV) and RV mechanics [11,12,13,14,15]. These investigations have been mainly focused on the RV, but they have also demonstrated subtle LV strain changes [13,15].…”

Section: Introductionmentioning

confidence: 99%

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Biatrial Remodeling in Patients with Cystic Fibrosis

Đorđević

Genger

Schwarz

et al. 2019

JCM

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Background: Previous studies have focused on left and right ventricular remodeling in cystic fibrosis (CF), whereas atrial function has not been assessed in detail so far. We sought to investigate left and right atrial (LA and RA) function in patients with CF. Methods: This retrospective investigation included 82 CF patients (64 survivors and 18 non-survivors) who were referred to CF department over the period of four years, as well as 32 control subjects matched by age and gender. All participants underwent an echocardiographic examination including a strain analysis, which was performed offline and blinded for groups. Results: LA and RA volume indexes were significantly higher in CF patients than in controls and were particularly high in CF non-survivors. LA conduit and reservoir functions were significantly worse in CF survivors and non-survivors, compared with control subjects. RA phasic function was not different between controls, CF survivors and non-survivors. The parameters of lung function (forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1)) and the LA and RA volume indexes were predictors of mortality in CF patients. However, in a multivariate analysis, only FVC was an independent predictor of mortality in CF patients. Conclusions: Our results suggest that both atria are enlarged, but only LA function is impaired in CF patients. LA reservoir and conduit function is particularly deteriorated in CF patients. Though statistical significance was not reached due to our limited sample size, there was a trend of deterioration of LA and RA function from controls across CF survivors to CF non-survivors. LA and RA enlargement represented predictors of mortality in CF patients.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Biatrial Remodeling in Patients with Cystic Fibrosis

Đorđević

Genger

Schwarz

et al. 2019

JCM

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“…Right ventricle: Evidence of cardiac involvement in CF was reported for the first time in 1946. The report stated that hypertrophy of the RV is caused by pulmonary disease [ 33 ]. Since then, the structural and functional anomalies of RV have been evident among patients with CF, and these occur primarily due to long-standing hypoxia, progressive chronic obstructive disease, and raised pulmonary pressures [ 19 ].…”

Section: Reviewmentioning

confidence: 99%

Cardiovascular System Involvement in Cystic Fibrosis

Shah¹,

Lee²,

Salvi³

et al. 2021

Cureus

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Cystic fibrosis (CF) is an autosomal recessive disease primarily affecting the respiratory system and gastrointestinal system. The life expectancy of patients with CF has significantly improved due to medical advancement and the effective use of screening techniques. However, new challenges have emerged. Particularly those involving cardiovascular pathology. This study aims to provide a better understanding of the different mechanisms that cause cardiovascular complications in patients with CF, which would help find an efficient treatment that not only prolongs survival but also improves their quality of life. This study extensively reviews different theories such as right ventricular hypertrophy due to lung pathology, ventricular interdependence, the association of nutritional deficiencies and severe cystic fibrosis transmembrane conductance regulator (CFTR) genotypes with myocardial fibrosis, effects of hypoxia, recurrent infections, and systemic inflammation of the heart and blood vessels that explain the direct or indirect involvement of the cardiovascular system in CF. For this review, 258 articles were retrieved from PubMed and Google Scholar. Out of which, a total of 12 high-quality articles were selected using appropriate quality assessment tools and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The result of this study suggests that early detection of cardiovascular dysfunction can improve the survival rate of the patient. Furthermore, this study could aid future researchers in the exploration of various best screening modality techniques for the early detection of cardiovascular dysfunction.

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