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https://www.readbyqxmd.com/read/28089095/characteristics-of-anatomy-and-function-of-the-left-atrial-appendage-and-their-relationships-in-patients-with-cardioembolic-stroke-a-3-dimensional-transesophageal-echocardiography-study
#1
Yuki Matsumoto, Yoshihiro Morino, Akiko Kumagai, Maiko Hozawa, Motoyuki Nakamura, Yasuo Terayama, Atsushi Tashiro
BACKGROUND: Increasing attention is being paid to the left atrial appendage (LAA) in the context of risk stratification in cardioembolic stroke (CES) and the requirement for meticulous planning of percutaneous closure device implantation. However, detailed systematic assessment of the LAA remains limited. METHODS: This study evaluated the anatomy and function of LAA using 3-dimensional transesophageal echocardiography (3D-TEE) on 194 consecutive patients older than 50 years old hospitalized exclusively for CES...
January 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28077818/enlargement-of-the-excluded-left-atrial-appendage-with-thrombus
#2
Shigeaki Aoyagi, Satoru Tobinaga, Hiroyuki Saisho
We report progressive enlargement of the excluded left atrial appendage (LAA) with a thrombus in a patient who had undergone valve surgery and endocardial suture closure of the LAA previously. Echocardiography and CT detected no communication between the LAA and the left atrium. Magnetic resonance imaging showed the LAA was filled with fresh and old thrombi. Coronary arteriography demonstrated small left coronary artery-LAA fistulae. At surgery, successful exclusion of the LAA was confirmed after removal of the thrombi...
January 11, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28075503/correlation-between-cardiac-rhythm-left-atrial-appendage-flow-velocity-and-cha2-ds2-vasc-score-study-based-on-transesophageal-echocardiography-and-2-dimensional-speckle-tracking
#3
Kun Zuo, Lanlan Sun, Xinchun Yang, Xiuzhang Lyu, Kuibao Li
BACKGROUND: The CHA2 DS2 -VASc score is a classic predictor of stroke in patients with atrial fibrillation (AF). Decreased left atrial appendage flow velocity (LAA-FV) reflects the blood stasis, and left atrial (LA) strain is a manifestation of atrial remodeling. This study aimed to explore the effects of AF rhythm and CHA2 DS2 -VASc score in the development of thrombogenesis and their potential correlation with LAA-FV and LA strain. HYPOTHESIS: AF rhythm and high CHA2 DS2 -VASc score correlate independently with decreased LAA-FV, which can be predicted by LA strain...
January 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28070743/cardiac-ct-angiography-ccta-predicts-left-atrial-appendage-occluder-device-size-and-procedure-outcome
#4
Orly Goitein, Noam Fink, Ilan Hay, Elio Di Segni, Victor Guetta, David Goitein, Yafim Brodov, Eli Konen, Michael Glikson
AIM: To investigate the role of cardiac CT angiography (CCTA) in predicting optimal left atrial appendage (LAA) occluder size and procedure outcome. METHODS AND RESULTS: Thirty-six patients underwent pre-procedural CCTA. CCTA and TEE LAA orifice diameters and perimeters were compared with the implanted device size. CCTA 3D configuration was correlated with procedure outcome. Watchman™ device (N = 18): diameters were 21 ± 4, 26 ± 5 and 25 ± 3 mm for TEE, CCTA and inserted device, respectively...
January 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28066659/percutaneous-epicardial-ablation-of-incessant-atrial-tachycardia-originating-from-the-left-atrial-appendage
#5
Ji-Eun Ban, Tae Young Park, Sang-Weon Park
A 38-year-old woman presented with antiarrhythmic drug-refractory atrial tachycardia (AT). Holter recording demonstrated incessant episodes of AT followed by a long sinus pause. Electrophysiologic study revealed that the earliest endocardial activation was observed at the neck of the left atrial appendage (LAA). After unsuccessful endocardial ablation, epicardial access via a percutaneous subxiphoid approach demonstrated that the earliest epicardial atrial activation was observed on the opposite site to the endocardial LAA neck suggestive of ligament of Marshall (LOM) muscle sleeve as regarding the epicardial sharp potentials under guidance of a circular mapping catheter...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28065908/ticagrelor-but-not-clopidogrel-active-metabolite-displays-antithrombotic-properties-in-the-left-atrial-endocardium
#6
Martin F Reiner, Alexander Breitenstein, Erik W Holy, Martina Glanzmann, Heidi Amstalden, Simon F Stämpfli, Nicole R Bonetti, Volkmar Falk, Stephan Keller, Gianluigi Savarese, Stefano Benussi, Francesco Maisano, Thomas F Lüscher, Jürg H Beer, Jan Steffel, Giovanni G Camici
AIMS: Oral anticoagulation is considered standard therapy for stroke prevention in atrial fibrillation (AF). Endocardial activation triggers expression of pro-thrombotic mediators including tissue factor (TF) and plasminogen activator inhibitor-1 (PAI-1), and contributes to thrombus formation in the left atrial appendage (LAA) of AF patients. Recently, pleiotropic effects of specific P2Y12 receptor antagonists were demonstrated; however, whether these drugs possess antithrombotic effects on LAA endocardial cells currently remains unknown...
January 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28055098/glial-cell-contribution-to-basal-vessel-diameter-and-pressure-initiated-vascular-responses-in-rat-retina
#7
Hui Li, Bang V Bui, Grant Cull, Fang Wang, Lin Wang
Purpose: The purpose of this study was to test the hypothesis that retinal glial cells modify basal vessel diameter and pressure-initiated vascular regulation in rat retina. Methods: In rats, L-2-aminoadipic acid (LAA, 10 nM) was intravitreally injected to inhibit glial cell activity. Twenty-four hours following injection, retinal glial intracellular calcium (Ca2+) was labeled with the fluorescent calcium indicator Fluo-4/AM (F4, 1 mM). At 110 minutes after injection, intraocular pressure (IOP) was elevated from 20 to 50 mm Hg...
January 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28025936/current-status-of-leukemia-cytotherapy-exploitation-with-immune-cells
#8
Haiyan Bao, Depei Wu
With the development of chemotherapy and hematopoietic stem cell transplantation (HSCT), the prognosis of leukemia patients has been improved greatly in the past few decades. However, relapsed and refractory leukemia is still the major cause of mortality in leukemia patients. Besides, advancing age, poor performance status and severe co-morbidities limit the applicability of cytotoxic chemotherapy in certain groups of leukemia patients. Novel agents including nucleoside analogues, kinase inhibitors targeting oncoproteins and monoclonal antibodies are under investigation for the management of leukemia...
December 26, 2016: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28017353/significance-of-residual-mitral-regurgitation-after-continuous-flow-left%C3%A2-ventricular-assist-device-implantation
#9
Hayah Kassis, Krishna Cherukuri, Richa Agarwal, Manreet Kanwar, Subbarao Elapavaluru, George G Sokos, Robert J Moraca, Stephen H Bailey, Srinivas Murali, Raymond L Benza, Amresh Raina
OBJECTIVES: This study hypothesized that the presence of residual mitral regurgitation (MR) post-continuous flow (CF) left ventricular assist device (LVAD) implantation based on quantitative assessment would be negatively associated with right ventricular (RV) size and function and clinical outcomes. BACKGROUND: MR is associated with elevated left atrial pressure, secondary pulmonary hypertension and RV dysfunction. Implantation of a LVAD leads to mechanical unloading of the left ventricle and generally improves MR...
November 30, 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/28013284/ct-sizing-for-left-atrial-appendage-closure-is-associated-with-favourable-outcomes-for-procedural-safety
#10
Adil Rajwani, Adam J Nelson, Masoumeh G Shirazi, Patrick J S Disney, Karen S L Teo, Dennis T L Wong, Glenn D Young, Stephen G Worthley
AIMS: We evaluated the utility of computerized tomography (CT) with respect to sizing work-up for percutaneous left atrial appendage (LAA) closure, and implications for procedural safety and outcomes. METHODS AND RESULTS: Contrast-enhanced multi-detector CT was routinely conducted to guide sizing for LAA closure in addition to transoesophageal echocardiography (TOE). Procedural safety and efficacy were prospectively assessed. Across 73 consecutive cases there were no device-related procedural complications, and no severe leaks...
December 24, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28012051/assessment-of-the-left-atrial-appendage-structure-and-morphology-comparison-of-real-time-three-dimensional-transesophageal-echocardiography-and-computed-tomography
#11
Wenjuan Bai, Zhongxiu Chen, Hong Tang, Hui Wang, Wei Cheng, Li Rao
In this study, the left atrial appendage (LAA) structure and morphology were assessed using real-time three-dimensional transesophageal echocardiography (RT3D-TEE) and enhanced cardiac computed tomography (CT) scanning, and the two measurements obtained using these different techniques were compared. Two hundred nonvalvular atrial fibrillation (NVAF) patients who were prepared to undergo radiofrequency ablation were enrolled, and 62 controls were enrolled prospectively. RT3D-TEE and CT were performed, and the following parameters were measured: LAA orifice diameter, area, depth, maximum volume, and emptying velocity...
December 23, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28001014/stroke-prevention-in-atrial-fibrillation-with-left-atrial-appendage-closure
#12
Chad J Zack, Erin A Fender, David R Holmes
Patients with atrial fibrillation (AF) are at risk for stroke and thromboembolism. Oral anticoagulants (OAC) are effective therapies to reduce the risk of stroke; however these agents also increase the risk of bleeding complications. Concerns over bleeding contribute to significant under treatment and leave a substantial proportion of patients at risk for a serious or life-threatening stroke. Identification of the left atrial appendage (LAA) as the major site of pathogenic thrombus formation in AF patients has led to the development of devices which exclude the appendage from systemic circulation...
December 20, 2016: Minerva Medica
https://www.readbyqxmd.com/read/27995637/active-atrial-function-and-atrial-scar-burden-after-multiple-catheter-ablations-of-persistent-atrial-fibrillation
#13
Jana M Nührich, Anne C Geisler, Daniel Steven, Boris A Hoffmann, Benjamin Schäffer, Gunnar Lund, Christian Stehning, Ulf K Radunski, Arian Sultan, Michael Schwarzl, Gerhard Adam, Stephan Willems, Kai Muellerleile
BACKGROUND: Extensive and repeated substrate modification (SM) is frequently performed as an ablation strategy in persistent atrial fibrillation (persAF). The effect of these extended ablation strategies on atrial function has not been investigated sufficiently so far. The purpose was to assess atrial function by cardiac magnetic resonance (CMR) and its association with left atrial (LA) scar burden by electroanatomical voltage-mapping after multiple persAF ablation procedures. METHODS: We included 16 persAF-patients who had ≥ 2 SM procedures and a control group (CG) of 21 persAF-patients without prior ablation...
December 20, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27994288/plasma-cathepsin-s-and-cathepsin-s-cystatin-c-ratios-are-potential-biomarkers-for-copd
#14
Takahiro Nakajima, Hidetoshi Nakamura, Caroline A Owen, Shuichi Yoshida, Keishi Tsuduki, Shotaro Chubachi, Toru Shirahata, Shuko Mashimo, Miho Nakamura, Saeko Takahashi, Naoto Minematsu, Hiroki Tateno, Seitaro Fujishima, Koichiro Asano, Bartolome R Celli, Tomoko Betsuyaku
Purpose. This study aimed to examine whether plasma levels of cathepsin S or its inhibitor, cystatin C, may serve as biomarkers for COPD. Patients and Methods. We measured anthropometrics and performed pulmonary function tests and chest CT scans on 94 patients with COPD and 31 subjects with productive cough but no airflow obstruction ("at risk"; AR). In these subjects and in 52 healthy nonsmokers (NS) and 66 healthy smokers (HS) we measured plasma concentrations of cathepsin S and cystatin C using an ELISA...
2016: Disease Markers
https://www.readbyqxmd.com/read/27993693/whole-brain-functional-connectivity-during-acquisition-of-novel-grammar-distinct-functional-networks-depend-on-language-learning-abilities
#15
Olga Kepinska, Mischa de Rover, Johanneke Caspers, Niels O Schiller
In an effort to advance the understanding of brain function and organisation accompanying second language learning, we investigate the neural substrates of novel grammar learning in a group of healthy adults, consisting of participants with high and average language analytical abilities (LAA). By means of an Independent Components Analysis, a data-driven approach to functional connectivity of the brain, the fMRI data collected during a grammar-learning task were decomposed into maps representing separate cognitive processes...
December 16, 2016: Behavioural Brain Research
https://www.readbyqxmd.com/read/27988786/association-between-the-left-atrial-and-left-atrial-appendages-systole-strain-rate-in-patients-with-atrial-fibrillation
#16
Changming Tan, Minzhi OuYang, Demiao Kong, Xinmin Zhou
BACKGROUND The aim of this research was to explore the association between the left atrial (LA) and left atrial appendages (LAA) systole strain rate (SSR) in patients with atrial fibrillation (AF), and to provide evidence to aid in the assessment of disease progression. MATERIAL AND METHODS A total of 180 patients with AF were selected for the study (130 patients with paroxysmal AF (Par AF) and 50 patients with persistence AF (PerAF).In addition, 60 healthy individuals were selected as a control group. The total and side wall SSRs were calculated...
December 18, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27986642/anatomic-characteristics-of-the-mitral-isthmus-region-the-left-atrial-appendage-isthmus-as-a-possible-ablation-target
#17
Mateusz K Hołda, Mateusz Koziej, Jakub Hołda, Kamil Tyrak, Katarzyna Piątek, Filip Bolechała, Wiesława Klimek-Piotrowska
The mitral isthmus is a part of the postero-inferior area of the lateral left atrial wall located between the mitral annulus and the left inferior pulmonary vein ostium. Linear ablation lesions are created within the mitral isthmus for the invasive treatment of left atrial arrhythmias. However, the anatomy of this region is not fully understood. The aim of this study has been to provide a detailed morphometric description of the mitral isthmus region and to propose another possible isthmus within the investigated heart area that may serve as a potential new ablation target...
December 13, 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/27979034/interventional-left-atrial-appendage-closure-vs-novel-anticoagulation-agents-in-patients-with-atrial-fibrillation-indicated-for-long-term-anticoagulation-prague-17-study
#18
Pavel Osmancik, Petr Tousek, Dalibor Herman, Petr Neuzil, Pavel Hala, Josef Stasek, Ludek Haman, Petr Kala, Martin Poloczek, Marian Branny, Jan Chovancik, Pavel Cervinka, Jiri Holy, Vlastimil Vancura, Richard Rokyta, Milos Taborsky, Tomas Kovarnik, David Zemanek, Petr Peichl, Sarka Haskova, Jiri Jarkovsky, Petr Widimsky
: Atrial fibrillation (AF), with a prevalence of 1% to 2%, is the most common cardiac arrhythmia. Without antithrombotic treatment, the annual risk of a cardioembolic event is 5% to 6%. The source of a cardioembolic event is a thrombus, which is usually formed in the left atrial appendage (LAA). Prevention of cardioembolic events involves treatment with anticoagulant drugs: either vitamin K antagonists or, recently, novel oral anticoagulants (NOAC). The other (nonpharmacologic) option for the prevention of a cardioembolic event involves interventional occlusion of the LAA...
January 2017: American Heart Journal
https://www.readbyqxmd.com/read/27967338/soluble-lectin-like-oxidized-low-density-lipoprotein-receptor-1-as-a-novel-biomarker-for-large-artery-atherosclerotic-stroke
#19
Wensi Huang, Qian Li, Xiaoli Chen, Yuanshao Lin, Jie Xue, Zhengyi Cai, Wanli Zhang, Hong Wang, Kunlin Jin, Bei Shao
Background-Serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) has been shown associated with the progression of atherosclerosis in endothelial cells. We sought to assess whether the baseline serum sLOX-1 levels are correlated with the presence and short term functional outcome of large-artery atherosclerotic (LAA) stroke. Methods-The study recruited 241 subjects, including 148 consecutive patients with acute ischemic stroke with the subtype of LAA and 93 non-stroke controls. Clinical and laboratory data, including serum concentration of sLOX-1 were collected within 24h of admission, and the severity of LAA stroke patients was evaluated by National Institutes of Health Stroke Scale (NIHSS) score...
December 14, 2016: International Journal of Neuroscience
https://www.readbyqxmd.com/read/27943538/catheter-ablation-for-atrial-fibrillation-in-patients-with-watchman%C3%A2-left-atrial-appendage-occlusion-device-results-from-a-multicenter-registry
#20
Mohit K Turagam, Madhav Lavu, Muhammad R Afzal, Venkat Vuddanda, Mohammad-Ali Jazayeri, Valay Parikh, Donita Atkins, Sudharani Bommana, Luigi DI Biase, Rodney Horton, Rong Bai, Vijay Swarup, Jie Cheng, Andrea Natale, Dhanunjaya Lakkireddy
BACKGROUND: There have been an increasing number of atrial fibrillation (AF) patients with Watchman® left atrial appendage occlusion (LAAO) device, requiring catheter ablation (CA) for maintenance of normal sinus rhythm. In this study, we describe our experience with the feasibility and safety of CA in patients with a preexisting Watchman LAAO device. METHODS: This was a retrospective multicenter AF registry of 60 patients with Watchman® LAAO device who underwent CA for AF...
December 12, 2016: Journal of Cardiovascular Electrophysiology
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