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"myocardial dysfunction"

Maude St-Onge, Kurt Anseeuw, Frank Lee Cantrell, Ian C Gilchrist, Philippe Hantson, Benoit Bailey, Valéry Lavergne, Sophie Gosselin, William Kerns, Martin Laliberté, Eric J Lavonas, David N Juurlink, John Muscedere, Chen-Chang Yang, Tasnim Sinuff, Michael Rieder, Bruno Mégarbane
OBJECTIVE: To provide a management approach for adults with calcium channel blocker poisoning. DATA SOURCES, STUDY SELECTION, AND DATA EXTRACTION: Following the Appraisal of Guidelines for Research & Evaluation II instrument, initial voting statements were constructed based on summaries outlining the evidence, risks, and benefits. DATA SYNTHESIS: We recommend 1) for asymptomatic patients, observation and consideration of decontamination following a potentially toxic calcium channel blocker ingestion (1D); 2) as first-line therapies (prioritized based on desired effect), IV calcium (1D), high-dose insulin therapy (1D-2D), and norepinephrine and/or epinephrine (1D)...
October 3, 2016: Critical Care Medicine
Anikó Ilona Nagy, Ashwin Venkateshvaran, Béla Merkely, Lars H Lund, Aristomenis Manouras
AIMS: The diastolic pulmonary pressure gradient (DPG) has recently been introduced as a specific marker of combined pre-capillary pulmonary hypertension (Cpc-PH) in left heart disease (LHD). However, its diagnostic and prognostic superiority compared with traditional haemodynamic indices has been challenged lately. Current recommendations explicitly denote that in the normal heart, DPG values are greater than zero, with DPG ≥7 mmHg indicating Cpc-PH. However, clinicians are perplexed by the frequent observation of DPG <0 mmHg (DPGNEG ), as its physiological explanation and clinical impact are unclear to date...
October 17, 2016: European Journal of Heart Failure
Wating Su, Yuan Zhang, Qiongxia Zhang, Jinjin Xu, Liying Zhan, Qiqi Zhu, Qingquan Lian, Huimin Liu, Zhong-Yuan Xia, Zhengyuan Xia, Shaoqing Lei
BACKGROUND: Patients with diabetes are prone to develop cardiac hypertrophy and more susceptible to myocardial ischemia-reperfusion (I/R) injury, which are concomitant with hyperglycemia-induced oxidative stress and impaired endothelial nitric oxide (NO) synthase (eNOS)/NO signaling. Caveolae are critical in the transduction of eNOS/NO signaling in cardiovascular system. Caveolin (Cav)-3, the cardiomyocytes-specific caveolae structural protein, is decreased in the diabetic heart in which production of reactive oxygen species are increased...
October 12, 2016: Cardiovascular Diabetology
Lygia M Malvestio, Mara Rúbia N Celes, Linda A Jelicks, Herbert B Tanowitz, Cibele M Prado
Dystrophin, an important protein of the dystrophin-glycoprotein complex, has been implicated in the pathogenesis of experimental Chagas disease. It is important for the maintenance of cell shape and contraction force transmission. Dystrophin loss has been related to end-stage cardiac myopathies and proposed as a common route for myocardial dysfunction and progression to advanced heart failure. Evidence suggests that calpains, calcium-dependent proteases, digest dystrophin when the calcium concentration is compatible with their activation...
October 11, 2016: Parasitology Research
Jin-Man Jung, Jae-Gyum Kim, Jung Bin Kim, Kyung-Hee Cho, Sungwook Yu, Kyungmi Oh, Yong-Hyun Kim, Jeong-Yoon Choi, Woo-Keun Seo
BACKGROUND AND PURPOSE: We investigated clinical and radiological characteristics of ischemic stroke patients with Takotsubo-like myocardial dysfunction. METHODS: From multicenter stroke registry database, ischemic stroke patients who underwent transthoracic echocardiography were found. Among these, patients were classified if they had specific ventricular regional wall motion abnormalities discording with coronary artery distribution, such as apical (typical pattern) or nonapical ballooning (atypical pattern), considered as echocardiographic findings of Takotsubo cardiomyopathy...
October 11, 2016: Stroke; a Journal of Cerebral Circulation
Hui Wang, Yihua Bei, Peipei Huang, Qiulian Zhou, Jing Shi, Qi Sun, Jiuchang Zhong, Xinli Li, Xiangqing Kong, Junjie Xiao
Sepsis-induced myocardial dysfunction represents a major cause of death in intensive care units. Dysregulated microRNAs (miR)-155 has been implicated in multiple cardiovascular diseases and miR-155 can be induced by lipopolysaccharide (LPS). However, the role of miR-155 in LPS-induced cardiac dysfunction is unclear. Septic cardiac dysfunction in mice was induced by intraperitoneal injection of LPS (5 mg/kg) and miR-155 was found to be significantly increased in heart challenged with LPS. Pharmacological inhibition of miR-155 using antagomiR improved cardiac function and suppressed cardiac apoptosis induced by LPS in mice as determined by echocardiography, terminal deoxynucleotidyl transferase nick-end labeling (TUNEL) assay, and Western blot for Bax and Bcl-2, while overexpression of miR-155 using agomiR had inverse effects...
October 11, 2016: Molecular Therapy. Nucleic Acids
Liu Xianchu, Professor Zheng Lan, Li Qiufang, Liu Yi, Ruan Xiangcheng, Hou Wenqi, Ding Yang
Previous research has demonstrated that lipopolysaccharide (LPS) can induce sepsis and lead to myocardial dysfunction. Naringin has various biological activities in LPS-induced sepsis. In this study, our aim was to investigate the effects of Naringin on LPS-induced cardiac injury and clarify its potential mechanism. We found that in vivo treatment with Naringin significantly ameliorated body weight loss, and attenuated cardiac histopathological changes after LPS challenge. Furthermore, Naringin inhibited LPS-induced increase of TNF-α, IL-1β and IL-6 activities to alleviate inflammatory response in heart...
September 13, 2016: Environmental Toxicology and Pharmacology
Wei-Ting Chang, Jhih-Yuan Shih, Yin-Hsun Feng, Chun-Yen Chiang, Yu Hsuan Kuo, Wei-Yu Chen, Hong-Chang Wu, Juei-Tang Cheng, Jhi-Joung Wang, Zhih-Cherng Chen
BACKGROUND: As cancer therapies have improved, patient life spans have been extended but quality of life has been threatened by chemotherapy induced cardiotoxicity. Most cardiac complications remain unobserved until specific symptoms develop. Speckle-tracking echocardiography is a sensitive imaging modality in detecting early occult myocardial dysfunction. METHODS: A total number of 35 patients newly diagnosed with breast cancer and preparing for epirubicin therapy were prospectively recruited...
September 2016: Acta Cardiol Sin
Luc Morin, Samiran Ray, Clare Wilson, Solenn Remy, Mohamed Rida Benissa, Nicolaas J G Jansen, Etienne Javouhey, Mark J Peters, Martin Kneyber, Daniele De Luca, Simon Nadel, Luregn Jan Schlapbach, Graeme Maclaren, Pierre Tissieres
PURPOSE: Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and neonatal intensive care (ESPNIC) experts' definition of paediatric RSS. METHODS: We conducted a two-round Delphi study followed by an observational multicentre retrospective study...
October 5, 2016: Intensive Care Medicine
Xiuxiu Lv, Huadong Wang
Sepsis-induced myocardial dysfunction is a common complication in septic patients and is associated with increased mortality. In the clinical setting, it was once believed that myocardial dysfunction was not a major pathological process in the septic patients, at least in part, due to the unavailability of suitable clinical markers to assess intrinsic myocardial function during sepsis. Although sepsis-induced myocardial dysfunction has been studied in clinical and basic research for more than 30 years, its pathophysiology is not completely understood, and no specific therapies for this disorder exist...
2016: Military Medical Research
Christian Cadeddu, Alessandra Piras, Mariele Dessì, Clelia Madeddu, Giovanni Mantovani, Mario Scartozzi, Andreas Hagendorff, Paolo Colonna, Giuseppe Mercuro
Trastuzumab (TZB) has been shown to be extremely effective in breast cancer patients over-expressing HER-2, but careful cardiac monitoring is required when TZB is administered with anthracyclines, since the combination can increase its toxicity. Myocardial deformation indexes associated with speckle tracking echocardiography (STE) have proven to be very sensitive in identifying early myocardial dysfunction. An observational, prospective study was designed to assess TZB-induced cardiac damage using STE in patients with HER-2 positive breast cancer who had been sequentially treated with TZB following epirubicin (EPI)...
October 1, 2016: International Journal of Cardiovascular Imaging
Srinidhi J Meera, Tomo Ando, Daniel Pu, Shivaprasad Manjappa, Cynthia C Taub
PURPOSE: The left ventricle (LV) undergoes physiologic remodeling in adaptation to the hemodynamic changes that occur in pregnancy. Speckle tracking echocardiography (STE) is a novel and reliable tool to evaluate subtle myocardial alterations that have been utilized to assess myocardial changes in patients with diabetes mellitus (DM) but not in patients with gestational DM (GDM). We seek to evaluate changes in LV function using STE in patients with GDM compared with women with normal pregnancy...
September 28, 2016: Journal of Clinical Ultrasound: JCU
J Ambrozic, K Prokselj, M Lucovnik
INTRODUCTION: The ability to judge intravascular volume is fundamental in the management of patients with severe preeclampsia. Insufficient intravascular volume can result in decreased oxygen delivery to tissues and exacerbates organ dysfunction. On the other hand, fluid excesses can lead to fluid extravasation and pulmonary edema. Outside of pregnancy, transthoracic echocardiography and lung ultrasonography have become important diagnostic and monitoring tools in critically ill patients...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Krasimira Hristova, Vera Bogdanova, Rumen Marinov
OBJECTIVE: Arterial hypertension (HTN) causes left ventricular (LV) dysfunction even if ejection function (EF) remains preserved. The objective of this study was to assess whether complex LAFI (left atrium functional index) had additional value in definition and grading of diastolic dysfunction and compare with indices of atrial deformation - longitudinal strain. DESIGN AND METHOD: Peak atrial longitudinal strain (PALS) was evaluated in 82 patients with systemic HTN and preserved EF (> = 55%) divided in 41 with diastolic dysfunction but no hypertrophy (HTNdd), and 41 with no diastolic dysfunction or hypertrophy (eHTN)...
September 2016: Journal of Hypertension
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
Gautam R Shroff, Paolo Raggi
Extensive myocardial fibrosis is known to occur in patients undergoing dialysis due to a variety of mechanisms not necessarily restricted to coronary artery disease. Fibrosis may predispose to reentry arrhythmias and long-term myocardial dysfunction, and sudden death and congestive heart failure are the most frequent causes of death in patients undergoing renal replacement therapy. Despite the high accuracy of magnetic resonance for imaging of myocardial fibrosis, its use has been restricted by the risk of inducing nephrogenic systemic sclerosis with the injection of gadolinium...
October 2016: Kidney International
Lorissa Lamoureux, Jeejabai Radhakrishnan, Thomas G Mason, Jeffrey A Kraut, Raul J Gazmuri
Major myocardial abnormalities occur during cardiac resuscitation including intracellular acidosis - partly caused by CO2 accumulation - and activation of the Na(+)-H(+) exchanger isoform-1 (NHE-1). We hypothesized that a favorable interaction may result from NHE-1 inhibition during cardiac resuscitation followed by administration of a CO2-consuming buffer upon return of spontaneous circulation (ROSC). Ventricular fibrillation was electrically induced in 24 male rats and left untreated for 8 minutes followed by defibrillation after 8 minutes of CPR...
September 15, 2016: Journal of Applied Physiology
Yingfeng Liu, Dawei Wang, Qigen Du, Guoying Che, Jiawei Tian, Yanxin Su
OBJECTIVES: To investigate the value of 2-dimensional (2D) speckle-tracking echocardiography for assessing right ventricular (RV) systolic function in patients with chronic pulmonary heart disease (CPHD) and the correlation of its parameters with the right ventricular ejection fraction (RVEF) on cardiac magnetic resonance imaging (MRI). METHODS: According to pulmonary arterial systolic pressure, 80 patients with CPHD and tricuspid regurgitation were divided into 2 groups: 42 with mild pulmonary hypertension (PH; 30-50 mm Hg) and 38 with moderate or severe PH (≥50 mm Hg); 41 control participants were recruited...
September 14, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Alice E Kane, Susan E Howlett
The incidence of cardiovascular disease is rising as the population ages. This has led to an increase in the need to perform cardiac surgery in older patients. However, aged hearts are particularly susceptible to reperfusion injury following periods of myocardial ischemia that occur during cardiac surgery. Indeed, older adults experience myocardial dysfunction and reduced survival post-surgery compared to younger people and certain groups, including older women and frail older adults, are at particular risk...
September 14, 2016: Clinical and Experimental Pharmacology & Physiology
Ying-Yan Qiao, Mu Zeng, Rong-Juan Li, Zhao-Ting Leng, Jiao Yang, Ya Yang
AIM: The purpose of the present study was to determine the characteristics of myocardial damage at different stages of diabetes mellitus (DM) using layer-specific myocardial strain. MATERIAL AND METHODS: Thirty six New Zealand white rabbits were randomly divided into either the control group (n =18) or the DM group (induced with alloxan) (n=18). For the myocardial deformation studies echocardiography and layer-specific strain were performed at baseline and after 3, 6, and 9 months in all of the rabbits...
September 2016: Medical Ultrasonography
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