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1,087 results for “Chest”
INFLUENCE OF CHEST WALL CONFORMATION ON SPIROMETRY PARAMETERS AND OUTCOME IN MILD TO MODERATE IDIOPATHIC PULMONARY FIBROSIS
<p>Extrinsic causes of restrictive lung syndrome in idiopathic pulmonary fibrosis (IPF) patients have been poorly investigated. We aimed to investigate the influence of the anterior chest wall deformity, noninvasively assessed by modified Haller index (MHI), on spirometry parameters and outcome in a consecutive population of patients with mild-to-moderate IPF.</p> <p>60 consecutive IPF patients (73.8 ± 6.6 yrs, 45 males) were included in this retrospective study. All patients underwent physical examination, spirometry, blood tests, conventional transthoracic echocardiography and MHI assessment (chest transverse diameter over the distance between sternum and spine) at basal evaluation. During follow-up, we evaluated the composite endpoint of 1) pulmonary or cardiovascular hospitalizations; 2) all-cause mortality.</p> <p>IPF patients with concave-shaped chest wall (MHI >2.5) (36.7% of total) and those with normal chest shape (MHI ≤2.5) (63.3%) were separetely analyzed. In comparison to IPF patients with MHI ≤2.5, those with MHI >2.5: were less likely to be men and smokers; had a more severe restrictive pattern; had significantly smaller cardiac chamber dimensions and significantly higher systolic pulmonary artery pressure (51.9±15.1 vs 42.4±14.3 mmHg, p=0.02). Mean follow-up time was 2.5±1.4 yrs. During follow-up, 13 deaths and 16 pulmonary or cardiovascular hospitalizations were detected. At multivariate Cox regression analysis, concave-shaped chest wall (MHI>2.5) (HR 4.55, 95%CI 1.02-20.4), increased C-reactive protein (HR 1.68, 95%CI 1.08-2.61) and absence of beta-blocker therapy (HR 0.13, 95%CI 0.01-0.26) were independently associated to the investigated outcome.</p> <p>MHI assessment and implementation may help the clinician to identify, among IPF patients, those with poorer prognosis over a medium-term follow-up.</p>
Chest conformation spuriously influences strain parameters of myocardial contractile function in healthy pregnant women
<p><strong>AIMS</strong>: Left ventricular (LV) contractility during noncomplicated pregnancy has been previously investigated by two-dimensional speckle-tracking echocardiography (2D-STE), with conflicting results. Chest abnormalities might affect myocardial strain parameters, yet this issue has not been previously investigated during pregnancy. We evaluated the influence of chest conformation on myocardial strain parameters in healthy pregnant women.</p> <p><strong>METHODS</strong>: Between October 2019 and February 2020, 50 healthy pregnant women (32.3±4.0 year/old) were consecutively studied. They underwent obstetric visit, assessment of chest shape by modified Haller index (MHI; chest transverse diameter over the distance between sternum and spine), and transthoracic echocardiography implemented with 2D-STE analysis of all myocardial strain parameters in first trimester (12–14 weeks), third trimester (36–38 weeks) and 6–9 weeks after delivery.</p> <p><strong>RESULTS</strong>: LV ejection fraction remained substantially unchanged (p=0.13), while on the average all myocardial strain parameters showed a small, but significant decrease during pregnancy, and recovered postpartum (all p<0.001). Women with concave-shaped chest wall (MHI >2.5, n=29), and those with normal chest conformation (MHI ≤2.5, n=21) were then separately analyzed. Pregnant women with MHI >2.5, but not those with MHI ≤2.5, showed a progressive but reversible decrease in all myocardial strain parameters (all p<0.001). MHI was strongly correlated with LV global longitudinal strain (r= -0.87) and LV global circumferential strain (r= -0.83) in third trimester of pregnancy.</p> <p><strong>CONCLUSIONS</strong>: Myocardial strain impairment during healthy pregnancy may not reflect intrinsic myocardial dysfunction, but rather intraventricular dyssynchrony related to a narrow antero-posterior chest diameter and raise in diaphragm, with consequent extrinsic myocardial compression.</p>
Does chest wall conformation influence myocardial strain parameters in infants with pectus excavatum?
<p>Purpose: To investigate the possible influence of chest wall conformation on myocardial strain parameters in a consecutive population of infants with pectus excavatum (PE), noninvasively assessed by modified Haller index (MHI).<br> Methods: Sixteen consecutive PE infants (MHI >2.5) and 44 infants with normal chest shape (MHI ≤2.5) entered in this prospective case–control study. All infants underwent evaluation by neonatologist, transthoracic echocardiography implemented with two-<br> dimensional speckle tracking echocardiography (2D-STE) analysis of both ventricles and MHI assessment (ratio of chest transverse diameter over the distance between sternum and spine), at two time points: within 3 days and at about 40 days of life.<br> Results: At 2.1 ± 1 days of life, compared to controls (MHI =2.01 ± 0.2), PE infants (MHI = 2.76 ± 0.2) were diagnosed with significantly smaller cardiac chambers dimensions. Biventricular contractile function and hemodynamics were similar in both<br> groups of infants. Left ventricular (LV) global longitudinal strain (GLS) (-16.0 ± 2.8 vs. -1.7 ± 2.2%), LV-global circumferential strain (GCS) (-16.3 ± 2.7 vs. -24.0 ± 5.2%), LV-global radial strain (GRS) (24.2 ± 3.0 vs. 31.5 ± 6.3%), and right ventricular free<br> wall longitudinal strain (RVFWLS) (-16.0 ± 3.2 vs. -22.3 ± 4.4%) were significantly reduced in PE infants versus controls (all p < 0.001). A strong inverse correlation between MHI and the following parameters: LV-GLS (r =-0.92), LV-GCS (r =-0.88),<br> LV-GRS (r = -0.87), and RVFWLS (r = -0.88), was demonstrated in PE infants, but not in controls, in perinatal period (all p < 0.001). Analogous results were obtained at 36.8 ± 5.2 days after birth.<br> Conclusions: Abnormal chest anatomy progressively impairs myocardial strain parameters in PE infants. This impairment might reflect intraventricular dyssynchrony due to compressive phenomena rather than intrinsic myocardial dysfunction</p>
Influence of chest conformation on myocardial strain parameters in healthy subjects with mitral valve prolapse
<p>Raw data.</p> <p>Abstract<br> Chest shape might affect myocardial strain parameters. However, the relationship between myocardial strain parameters and<br> chest conformation has not been previously investigated in subjects with mitral valve prolapse (MVP). Between April 2019<br> and May 2020, 60 healthy subjects (50.1 ± 8.6 year/old, 46.6% females) with MVP and mild-to-moderate mitral regurgitation,<br> and 60 controls matched by age, sex, and cardiovascular risk factors were consecutively studied. Participants underwent<br> modified Haller index (MHI) assessment (ratio of chest transverse diameter over the distance between sternum and spine),<br> and transthoracic echocardiography implemented with 2D-speckle tracking analysis. MHI was significantly greater in MVP<br> group than controls (2.6 ± 0.35 vs 2.1 ± 0.23, p < 0.0001). Left ventricular (LV) ejection fraction was similar in MVP and<br> controls (63.5 ± 3.7% vs 64.3 ± 3.9%, p = 0.25). LV regional and global longitudinal (GLS), circumferential (GCS) and radial<br> strain (GRS) parameters and LV peak twist were all significantly lower in MVP compared to controls (all p < 0.0001). MVP<br> subjects with a tight chest (MHI > 2.5, n = 30), and those with MHI ≤ 2.5 (n = 30) were then separately analyzed. A significant<br> impairment in myocardial strain parameters and LV peak twist was documented in MVP subjects with MHI > 2.5, but not in<br> those with MHI ≤ 2.5. MHI showed a strong inverse correlation with LV-GLS (r = − 0.85), GCS (r = − 0.84), GRS (r = − 0.84)<br> and LV peak twist (r = − 0.94). In MVP subjects, impairment of myocardial strain parameters is not due to intrinsic reduction<br> of cardiac contractility function, but it appears to be related to the degree of chest deformity.</p>
Does chest shape influence exercise stress echocardiographic results in patients with suspected coronary artery disease?
<p>Raw data related to the article</p> <p>Abstract<br> Despite the good specificity of exercise stress echocardiography (ESE) for the detection of coronary artery disease (CAD),<br> false positive (FP) results may occur. We have previously reported that chest abnormalities may affect parameters of cardiac<br> contractility. The influence of chest shape on ESE results has never been previously investigated. We retrospectively analyzed<br> 160 consecutive patients (64.4 ± 13.0-year old, 91 women) who had undergone coronary angiography at our Institution<br> because of positive ESE, between June 2014 and May 2020. Modified Haller index (MHI; chest transverse diameter over<br> the distance between sternum and spine) was assessed in all patients. Obstructive CAD was diagnosed by ≥ 70% stenosis<br> in any epicardial coronary artery. Outcome was false-positivity at ESE. 80.6% of patients were diagnosed with obstructive<br> CAD, while 19.4% had no CAD (FP). We separately analyzed patients with normal chest shape (MHI ≤ 2.5) and those with<br> concave-shaped chest wall (MHI > 2.5). These latter were mostly women with small cardiac chambers, mitral valve prolapse<br> (MVP) and exercise-induced ST-segment changes. Likelihood of false-positivity was significantly higher in subjects with<br> MHI > 2.5 than those with MHI ≤ 2.5 (30.7% vs 9.4%, p = 0.001). By multivariate logistic regression analysis, MHI > 2.5<br> (OR 4.04, 95%CI 1.45–11.2, p = 0.007), MVP (OR 3.47, 95%CI 1.32–9–12, p = 0.01) and dyssynergy in the left circumflex<br> territory (OR = 3.35, 95%CI 1.26–8.93, p = 0.01) were independently associated with false-positivity. Concave-shaped chest<br> wall (MHI > 2.5) may be associated with false-positive stress echocardiographic result. Mechanisms underpinning this finding<br> need to be further explored.</p>
Influence of chest conformation on ventricular-arterial coupling during normal pregnancy
<p>Raw data related to the article</p> <p>Abstract<br> Purpose: There is still controversy regarding the changes of ventricular-arterial coupling<br> (VAC) during normal pregnancy. The possible influence of chest shape on VAC<br> during normal pregnancy has never been investigated.<br> Methods: Between October 2019 and June 2020, 59 healthy pregnant women<br> (33.7 ± 4.4 years/old) were consecutively included. They underwent obstetric visit,<br> modified Haller index (MHI) assessment, and complete echocardiographic evaluation<br> with blood pressure measurement to assess arterial elastance (Ea), end-systolic<br> elastance (Ees), and Ea/Ees as an index of VAC, at 12-14 weeks and 36-38 weeks<br> gestation, then 6-9 weeks after delivery.<br> Results: VAC progressively increased from the first to the third trimester of pregnancy,<br> then decreased in the postpartum (P < 0.0001) in the whole study population.<br> Women with concave-shaped chest wall (MHI >2.5, n = 31) but not women with normal<br> chest shape (MHI ≤2.5, n = 28) showed a progressive increase in VAC during<br> normal pregnancy. Women with MHI >2.5 showed a significantly less pronounced<br> increase in stroke volume index (SVi) from the first to the third trimester of pregnancy.<br> There was a strong linear correlation between third trimester MHI and<br> VAC (r = 0.93).<br> Conclusions: Anatomical and/or extrinsic mechanical factors rather than impaired<br> arterial elastance or reduced left ventricular contractility may contribute to changes<br> in VAC during normal pregnancy in women with concave-shaped chest wall.</p>
phase-contrast chest radiographs
<p>see <a href="https://doi.org/10.5281/zenodo.7030750">https://doi.org/10.5281/zenodo.7030750</a></p>
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