TITLE

Cardiovascular adaptation to chronic anemia in the elderly: an echocardiographic study

AUTHOR(S)
Aessopos, Athanasios; Deftereos, Spyros; Farmakis, Dimitrios; Corovesis, Costas; Tassiopoulos, Stergios; Tsironi, Maria; Georgonikou, Dimitra; Moyssakis, John
PUB. DATE
October 2004
SOURCE
Clinical & Investigative Medicine;Oct2004, Vol. 27 Issue 5, p265
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: To study the effects of chronic severe anemia on the aging heart. Methods: We studied 41 elderly patients (mean age 69.8 yr, standard deviation [SD] 3.9 yr) suffering from chronic severe anemia (mean hemoglobin 6.3, SD 0.5 g/dL) with no history of cardiac disease, along with 63 healthy age- and sex-matched controls. Assessment included physical examination, electrocardiogram and Doppler echocardiography. Results: Although heart rates were similar between patients and controls, arterial blood pressures were significantly lower in patients (mean pressure 92.7 mm Hg, SD 7.9, v. mean 102.1 mm Hg, SD 3.5; p<0.001). No patient was found to have congestive heart failure. Patients with chronic anemia had larger diameters of the left (end-systolic 35.28, SD 4.20, v. 33.73, SD 2.08 mm, p<0.05; end-diastolic 53.33, SD 4.55, v. 50.37, SD 2.10 mm, p<0.001) and right ventricles (30.76, SD 3.98, v. 29.04, SD 2.04 mm; p <0.05), and greater left-ventricular mass (277.64, SD 62.85, v. 212.91, SD 24.87 g; p<0.001). Fractional shortening did not differ significantly (0.33, SD 0.04, v. 0.33, SD 0.03). The load-independent end-systolic index was lower in patients (2.67, SD 0.56, v. 3.87, SD 0.49 kdyn·m2/cm5 p<0.001) along with end-systolic stress and total systemic resistance (p<0.001) than controls, whereas the cardiac index was higher (4.31, SD 1.29, v. 2.73, SD 0.51 L/min/m2; p<0.001). Differences between the 2 groups in diastolic function indices and pulmonary arterial pressures were not statistically significant. Interpretation: Chronic severe anemia is well tolerated by the aging heart. Neither congestive heart failure nor clearly evident left-ventricular dysfunction were encountered. The heart exhibited an adaptive potential through remodelling by means of the Frank-Starling mechanism and afterload reduction. However, the lower end-systolic index in patients suggests that ventricular performance was marginally compromised. This state of high output was achieved mainly by increased stroke volume, with little contribution from heart rate.
ACCESSION #
14982330

 

Related Articles

  • Echocardiography "Add-On" Codes. Parman, Cindy C. // Journal of Cardiovascular Management;Jan/Feb2005, Vol. 16 Issue 1, p6 

    This article emphasizes on "Add-On" codes in echocardiography in context of Dopler pulsed waves. The "Add-On" codes are procedural codes for additional services. Echocardiography is a group of diagnostic procedures that use high-frequency sound waves to record the structure of the heart and the...

  • Left Ventricular Diastolic Filling Dynamics During Isometric Exertion in Syndrome X Assessed with Doppler Flowmetry. Mizushige, Katsufumi; Masugata, Hisashi; Morita, Hisaki; Senda, Shoichi; Matsuo, Hirohide // Angiology;Oct1997, Vol. 48 Issue 10, p871 

    To study left ventricular diastolic properties in syndrome X, we analyzed transmitral filling dynamics during handgrip exertion. In 14 normal subjects (N), 17 with syndrome X (Syn X), 16 with single-vessel disease (SVD), and 8 with multiple-vessel disease (MVD), transmitral inflow was recorded...

  • Assessment of mitral bioprostheses using cardiovascular magnetic resonance. von Knobelsdorff-Brenkenhoff, Florian; Rudolph, André; Wassmuth, Ralf; Schulz-Menger, Jeanette // Journal of Cardiovascular Magnetic Resonance (BioMed Central);2010, Vol. 12, p36 

    Background: The orifice area of mitral bioprostheses provides important information regarding their hemodynamic performance. It is usually calculated by transthoracic echocardiography (TTE), however, accurate and reproducible determination may be challenging. Cardiovascular magnetic resonance...

  • Non-Invasive Diagnosis of a Free-Floating Left Atrial Thrombus With Emphasis on Two- Dimensional Echocardiographic Features. Szkopiec, Roman L.; Torstveit, Jeremy R.; Sri Prakash, N.; Desser, Kenneth B.; Benchimol, Alberto // Angiology;Feb1983, Vol. 34 Issue 2, p102 

    Two-dimensional echocardiography permitted identification of a large free-floating left atrial thrombus in a patient with mitral stenosis. A specific pattern of motion afforded its recognition and differentiation from mural left atrial thrombosis and tumors. Phonocardiographic tracings revealed...

  • Accurate quantitation of regurgitant volume with MRI in patients selected for mitral valve repair. Westenberg, Jos J.M.; Doornbos, Joost; Versteegh, Michel I.M.; Bax, Jeroen J.; van der Geest, Rob J.; de Roos, Albert; Dion, Robert A.E.; Reiber, Johan H.C. // European Journal of Cardio-Thoracic Surgery;Mar2005, Vol. 27 Issue 3, p462 

    Abstract: Objective: Echocardiography, the currently preferred diagnostic approach for mitral valve regurgitation, cannot accurately quantify the amount of regurgitation. Flow quantification with MRI is possible, but the conventional method (1-directional velocity-encoding) acquires the flow at...

  • Groups develop 'appropriate' criteria for cardiac ultrasound. Young, Karen // Diagnostics & Imaging Week;6/21/2007, Vol. 10 Issue 25, p1 

    The article reports on the Appropriateness Criteria for cardiac ultrasonic techniques released by the American Society of Echocardiography and the American College of Cardiology Foundation. The criteria are developed for the use of transthoracic and transesophageal echocardiography. The reasons...

  • New aspects on the assessment of left ventricular dyssynchrony by tissue Doppler echocardiography: comparison of myocardial velocity vs. displacement curves. Bogunovic, N.; Hering, D.; van Buuren, F.; Welge, D.; Lamp, B.; Horstkotte, D.; Faber, L. // International Journal of Cardiovascular Imaging;Oct2009, Vol. 25 Issue 7, p699 

    The purpose of this study is to assess the incremental value of tissue Doppler (TDI) derived displacement curves (TDint) compared to TDI velocity curves (TDvel) for the evaluation of left ventricular (LV) dyssynchrony (LVD). About 25 patients (pts.) with systolic heart failure were studied by...

  • Pulsed tissue Doppler and strain imaging discloses early signs of infiltrative cardiac disease: A study on patients with familial amyloidotic polyneuropathy Lindqvist, P.; Olofsson, B.O.; Backman, C.; Suhr, O.; Waldenström, A. // European Journal of Echocardiography;Jan2006, Vol. 7 Issue 1, p22 

    Abstract: Background: Familial amyloidotic polyneuropathy (FAP) is a hereditary systemic amyloidosis with cardiac involvement. As early identification of the cardiac involvement is of major clinical interest we performed this study to test the hypothesis that tissue Doppler imaging (TDI) and...

  • Mitral Valve Prolapse: Whiplike Motion of the Posterior Mitral Leaflet Detected by Two--Dimensional Echocardiography. Kounis, Nicholas G. // Angiology;Mar1980, Vol. 31 Issue 3, p198 

    Thirty-four patients with symptoms suggesting mitral valve prolapse were evaluated by M-mode echocardiography, real time, two-dimensional, phased array echocardiography, and cardiac catheterization. Ten of these patients had unequivocal evidence of mitral valve prolapse during cardiac...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics