Functional Evaluation of the Heart

Eidem, Benjamin W.

doi:10.1007/978-3-030-57193-1_5

Cited by 3 publications

(17 citation statements)

References 218 publications

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“…Differences in the classification of both hypovolemia and cardiac dysfunction, namely their use of IVC collapsibility index (IVCCI), left myocardial performance index and ejection fraction, may have resulted in different interpretations. [52][53][54] Changes in IVC diameter are influenced by a host of factors including changes in intrathoracic pressures, as seen in Kussmaul breathing, which may explain why their acidotic group of patients had a higher IVCCI compared with the nonacidotic group. Additionally, patients in their study had mean CIs which were normal to elevated, arguing against volume depletion.…”

Section: Discussionmentioning

confidence: 99%

Point-of-care Ultrasound to Assess Hemodynamic Contributors to Acute Kidney Injury in Pediatric Patients With Cerebral Malaria: A Pilot Study

Rivera

Prager

Gushu

et al. 2023

Pediatric Infectious Disease Journal

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Background: Acute kidney injury is common in severe malaria and is independently associated with mortality. The pathogenesis of acute kidney injury (AKI) in severe malaria remains incompletely understood. Ultrasound-based tools such as point-of-care ultrasound (POCUS), ultrasound cardiac output monitors (USCOMs) and renal arterial resistive index (RRI) can be used to detect hemodynamic and renal blood flow abnormalities contributing to AKI in malaria. Methods: We conducted a prospective study of Malawian children with cerebral malaria to determine the feasibility of using POCUS and USCOM to characterize hemodynamic contributors to severe AKI (Kidney Disease: Improving Global Outcomes stage 2 or 3). The primary outcome was feasibility (completion rate of study procedures). We also assessed for differences in POCUS and hemodynamic variables for patients with or without severe AKI. Results: We enrolled 27 patients who had admission cardiac and renal ultrasounds and USCOM. Completion rates were high for cardiac (96%), renal (100%) and USCOM studies (96%). Severe AKI occurred in 13 of 27 patients (48%). No patients had ventricular dysfunction. Only 1 patient in the severe AKI group was determined to be hypovolemic (P = 0.64). No significant differences in USCOM, RRI or venous congestion parameters were detected among patients with and without severe AKI. Mortality was 11% (3/27) with the 3 deaths occurring in the severe AKI group (P = 0.056). Conclusions: Ultrasound-based cardiac, hemodynamic and renal blood flow measurements appear to be feasible in pediatric patients with cerebral malaria. We were unable to detect hemodynamic or renal blood flow abnormalities contributing to severe AKI in cerebral malaria. Larger studies are needed to corroborate these findings.

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Section: Discussionmentioning

confidence: 99%

Point-of-care Ultrasound to Assess Hemodynamic Contributors to Acute Kidney Injury in Pediatric Patients With Cerebral Malaria: A Pilot Study

Rivera

Prager

Gushu

et al. 2023

Pediatric Infectious Disease Journal

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“…Abnormal diastolic function was defined as E/A<1.0, e′/a′<1.0, and E/e′>8.0 (with E/e′>14.0 considered to be clinically significant). 21,22…”

Section: Methodsmentioning

confidence: 99%

“…Abnormal diastolic function was defined as E/A<1.0, e′/a′<1.0, and E/e′>8.0 (with E/e′>14.0 considered to be clinically significant). 21,22 Covariates included age, male sex, black race, body mass index (BMI) Z score, eGFR, urine protein to creatinine ratio, SBP and diastolic BP Z scores, lab markers (serum calcium, phosphorous bicarbonate, hemoglobin), and antihypertensive medications. Obesity was categorized as normal (BMI<85th percentile), overweight (BMI≥85th to 95th percentile), and obese (≥95th percentile).…”

Section: Kidneymentioning

confidence: 99%

Diastolic Function and Ambulatory Hypertension in Children With Chronic Kidney Disease

Mitsnefes

et al. 2021

Hypertension

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Diastolic dysfunction is one of the earliest cardiac abnormalities in patients with chronic kidney disease. We analyzed echocardiographic markers of left ventricular function from 786 children and adolescents (1658 person-visits) enrolled in the CKiD (Chronic Kidney Disease in Children) cohort, a large prospective observational study of children with chronic kidney disease. Primary outcome was early mitral inflow velocity-to-early mitral annular peak velocity (E/e′) ratio as a marker of left ventricular compliance. Abnormal diastolic function was defined as E/e′>8.0. Those with an abnormal E/e′ ratio were younger, had a lower estimated glomerular filtration rate and hemoglobin, and a higher prevalence of hypertension and left ventricular hypertrophy compared to children with a normal E/e′. In adjusted analysis, a higher E/e′ ratio was independently associated with ambulatory (sustained) hypertension (1.66 [95% CI, 1.15–2.42]). Other significant independent predictors were higher left ventricular mass index Z score, increased body mass index Z score, lower hemoglobin, higher phosphorus level, and younger age. Casual blood pressure was not significantly associated with higher E/e′. These data indicate that ambulatory blood pressure might better identify children with chronic kidney disease at risk for subclinical cardiac dysfunction than clinic blood pressure alone.

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“…2 , Ref. [ 10 ]). The most specific color flow sign of an interatrial shunt is continuous flow on both sides of the septum, confirmed by pulsed-wave Doppler showing a triphasic left to right flow with late systolic, mid-diastolic, and atrial peaks.…”

Section: Intracardiac and Extracardiac Shuntsmentioning

confidence: 99%

“…Abnormalities of atria and atrial septation. In [ 10 ]; used with permission of Mayo Foundation for Medical Education and Research.) (A) Echocardiography in the subcostal coronal plane showing drop-out in the interatrial septum consistent with a moderately sized secundum ASD.…”

Section: Intracardiac and Extracardiac Shuntsmentioning

confidence: 99%

Select Congenital Heart Disease: Important Echocardiographic Features and Changes during Pregnancy

Majdalany¹,

Marcotte²

2023

Rev. Cardiovasc. Med.

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Congenital heart disease (CHD), which affects 1% to 2% of all births, is the most common abnormality in women contemplating pregnancy in western countries. With diagnostic and interventional advances, most patients with CHD survive into adulthood and require lifelong cardiac follow-up with cardiac imaging, particularly echocardiography and cardiac computed tomography. Multiple hemodynamic and physiologic changes of pregnancy may predispose patients with CHD to clinical decompensation and an inability to tolerate pregnancy. This manuscript reviews common CHD lesions, their repair or palliative interventions, long-term sequelae, important features to assess on cardiac imaging, and the impact of pregnancy on these types of lesions. Moreover, the review bridges the fields of CHD, cardiac imaging, and maternal cardiology, which will aid clinicians in counseling patients and managing pregnancies.

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Functional Evaluation of the Heart

Cited by 3 publications

References 218 publications

Point-of-care Ultrasound to Assess Hemodynamic Contributors to Acute Kidney Injury in Pediatric Patients With Cerebral Malaria: A Pilot Study

Point-of-care Ultrasound to Assess Hemodynamic Contributors to Acute Kidney Injury in Pediatric Patients With Cerebral Malaria: A Pilot Study

Diastolic Function and Ambulatory Hypertension in Children With Chronic Kidney Disease

Select Congenital Heart Disease: Important Echocardiographic Features and Changes during Pregnancy

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