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dilated cardiomyopathy guidelines

Junichi Ishida, Masaaki Konishi, Stephan von Haehling
Heart failure is a major public issue, and dilated cardiomyopathy (DCM) is one of the common etiologies of heart failure. DCM is generally progressive, and some patients with DCM need heart transplant despite optimal medical and mechanical therapy. Current guidelines recommend inhibitors of renin-angiotensin-aldosterone system, namely angiotensin-converting-enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB), and mineralocorticoid receptor antagonist as well as beta-blockers for the medical treatment of heart failure with reduced ejection fraction, including DCM...
December 2015: ESC Heart Failure
ByungSu Yoo
Hypertension is the most common risk factor for systolic and diastolic heart failure. Based on population-attributable risks, hypertension has the greatest impact on the development of heart failure, accounting for 39% of HF events in men and 59% in women. Higher blood pressure, longer duration of hypertension and older age are associated with higher incidence of heart failure however, long term control of hypertension reduces the risk of heart failure. Thus current guideline pointed the hypertension as the single most important modifiable risk factor for heart failure...
September 2016: Journal of Hypertension
Makoto Sano, Hiroshi Satoh, Kenichiro Suwa, Masao Saotome, Tsuyoshi Urushida, Hideki Katoh, Hideharu Hayashi, Takeji Saitoh
Cardiac involvement of sarcoid lesions is diagnosed by myocardial biopsy which is frequently false-negative, and patients with cardiac sarcoidosis (CS) who have impaired left ventricular (LV) systolic function are sometimes diagnosed with dilated cardiomyopathy (DCM). Late gadolinium enhancement (LE) in magnetic resonance imaging is now a critical finding in diagnosing CS, and the novel Japanese guideline considers myocardial LE to be a major criterion of CS. This article describes the value of LE in patients with CS who have impaired LV systolic function, particularly the diagnostic and clinical significance of LE distribution in comparison with DCM...
September 26, 2016: World Journal of Cardiology
Kaushik Guha, Christopher J Allen, Sumir Chawla, Hayley Pryse-Hawkins, Laura Fallon, Vicki Chambers, Ali Vazir, Alex R Lyon, Martin R Cowie, Rakesh Sharma
The National Institute for Health and Care Excellence (NICE) updated its guidelines for chronic heart failure (HF) in 2010. This re-audit assessed interim improvement as compared with an audit in 2011. Patients with HF (preserved and reduced ejection fraction) attending a tertiary cardiac centre over a 2-year period (January 2013-December 2014) were audited. The data collected included demographics, HF aetiology, medications, clinical parameters and cardiac rehabilitation. In total, 513 patients were audited...
October 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
Yuki Ikeda, Takayuki Inomata, Teppei Fujita, Yuichiro Iida, Toyoji Kaida, Takeru Nabeta, Shunsuke Ishii, Emi Maekawa, Tomoyoshi Yanagisawa, Tomohiro Mizutani, Takashi Naruke, Toshimi Koitabashi, Ichiro Takeuchi, Junya Ako
We aimed to elucidate the relationship between glycated hemoglobin (HbA1c), cardiac systolic/diastolic function, and heart failure (HF) prognosis during guideline-directed medical therapy in patients with nonischemic dilated cardiomyopathy (NIDCM). We evaluated 283 hospitalized NIDCM patients, who were grouped according to baseline (BL) and 1-year (1Y) levels of HbA1c (<6.0, 6.0-6.9, and ≥7.0 %). The primary endpoint was defined as either readmission for HF worsening or cardiac death. Approximately half of the patients had BL- or 1Y-HbA1c ≥6...
September 26, 2016: Heart and Vessels
Joachim Seegers, Leonard Bergau, Tobias Tichelbäcker, Marek Malik, Markus Zabel
BACKGROUND AND RATIONALE: In patients with ischemic or non-ischemic cardiomyopathy and impaired left ventricular ejection fraction, treatment with implantable cardioverter-defibrillator (ICD) has been shown to improve survival and guidelines recommend their use for primary prevention of sudden cardiac death. Experts disagree regarding the validity of decade-old trial results as the basis for this recommendation, therefore, reconsideration of prophylactic ICD treatment is needed. EU-CERT-ICD, DANISH-ICD AND DO-IT: In order to update the evidence on prophylactic ICD treatment, several prospective studies are underway in Europe...
August 26, 2016: Journal of Electrocardiology
Mary Sweet, Matthew R G Taylor, Luisa Mestroni
INTRODUCTION: Dilated cardiomyopathy (DCM) is the most common cardiomyopathy and occurs often in families. As an inherited disease, understanding the significance of diagnostic procedures and genetic screening within families is of utmost importance. AREAS COVERED: Genetic studies have shown that in 30-40% of familial DCM (FDC) cases a causative genetic mutation can be identified. Successful genetic analysis is highly dependent on close examination of patient and family history, and clinical guidelines exist recommending genetic testing to aid in the evaluation of family members at risk of developing FDC...
2015: Expert Opinion on Orphan Drugs
R Brian Sommerville, Margherita Guzzi Vincenti, Kathleen Winborn, Anne Casey, Nathan O Stitziel, Anne M Connolly, Douglas L Mann
Genetic disorders that disrupt the structure and function of the cardiovascular system and the peripheral nervous system are common enough to be encountered in routine cardiovascular practice. Although often these patients are diagnosed in childhood and come to the cardiologist fully characterized, some patients with hereditary neuromuscular disease may not manifest until adulthood and will present initially to the adult cardiologist for an evaluation of an abnormal ECG, unexplained syncope, LV hypertrophy, and or a dilated cardiomyopathy of unknown cause...
June 14, 2016: Trends in Cardiovascular Medicine
Jakob A Hauser, Svitlana Demyanets, Krisztina Rusai, Clara Goritschan, Michael Weber, Dilveer Panesar, Lisa Rindler, Andrew M Taylor, Rodrig Marculescu, Michael Burch, Johann Wojta, Ina Michel-Behnke
OBJECTIVE: Biomarkers play a pivotal role in heart failure (HF) management. Reference values and insights from studies in adults cannot be extrapolated to the paediatric population due to important differences in pathophysiology and compensatory reserve. We assessed the diagnostic utility of four novel biomarkers in paediatric HF. METHODS: Midregional (MR) pro-atrial natriuretic peptide (proANP), soluble ST2 (sST2), growth differentiation factor-15 (GDF-15), MR-pro-adrenomedullin (proADM) and N-terminal pro-B natriuretic peptide (NT-proBNP) were measured in 114 patients and 89 controls...
October 15, 2016: Heart: Official Journal of the British Cardiac Society
Bert Vandenberk, Christophe Garweg, Gabor Voros, Vincent Floré, Thomas Marynissen, Christian Sticherling, Markus Zabel, Joris Ector, Rik Willems
BACKGROUND: Clinical guidelines on implantable cardioverter defibrillator (ICD) therapy changed significantly in the last decades with potential inherent effects on therapy efficacy. We aimed to study therapy rates in time and the association between therapies and mortality. METHODS: All patients receiving an ICD, primary and secondary prevention, were included in a single-center retrospective registry. Information on first appropriate and inappropriate therapies was documented...
August 2016: Pacing and Clinical Electrophysiology: PACE
Seon Young Hwang, JinShil Kim
AIMS AND OBJECTIVES: Maintaining adequate ratios of sodium-to-potassium requires heart failure patients to be adherent to recommended dietary guidelines. A potential deterrent to adherence is poor cognitive functioning. The aims of this study were to (1) estimate dietary sodium and potassium intake and sodium-to-potassium ratios and (2) examine the associations between cognitive functioning and sodium-to-potassium ratios. BACKGROUND: Cognitive impairment may impact levels of adherence and subsequently sodium-to-potassium ratios; however, little is known about the relationship of cognitive functioning, adherence to dietary restrictions and sodium-to-potassium ratios...
June 2016: Journal of Clinical Nursing
Josef Finsterer, Claudia Stöllberger
Little is known regarding cardiac involvement (CI) by neuromuscular disorders (NMDs). The purpose of this review is to summarise and discuss the major findings concerning the types, frequency, and severity of cardiac disorders in NMDs as well as their diagnosis, treatment, and overall outcome. CI in NMDs is characterized by pathologic involvement of the myocardium or cardiac conduction system. Less commonly, additional critical anatomic structures, such as the valves, coronary arteries, endocardium, pericardium, and even the aortic root may be involved...
March 2016: Korean Circulation Journal
Ying-Han R Hsu, Haran Yogasundaram, Nirmal Parajuli, Lucas Valtuille, Consolato Sergi, Gavin Y Oudit
Heart failure remains an important clinical burden, and mitochondrial dysfunction plays a key role in its pathogenesis. The heart has a high metabolic demand, and mitochondrial function is a key determinant of myocardial performance. In mitochondrial disorders, hypertrophic remodeling is the early pattern of cardiomyopathy with progression to dilated cardiomyopathy, conduction defects and ventricular pre-excitation occurring in a significant proportion of patients. Cardiac dysfunction occurs in approximately a third of patients with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome, a stereotypical example of a mitochondrial disorder leading to a cardiomyopathy...
January 2016: Heart Failure Reviews
Bharat Malhotra, Ahmad K Rahal, Hussam Farhoud, Dennis F Moore, K James Kallail
Background. Posttransplant lymphoproliferative disorders (PTLDs) occur after solid organ transplantation. Treatment guidelines include reduction in immunosuppression (RIS), radiation, rituximab, chemotherapy, and immunological agents. We present a rare case of recurrent diffuse large B-cell lymphoma presenting as a PTLD in a heart transplant patient treated with autologous blood stem cell transplant (ASCT) after failure of conventional therapy. Case Presentation. A 66-year-old male presented with a neck mass...
2015: Case Reports in Transplantation
Mohammed Abdullahi Talle, Faruk Buba, Charles Oladele Anjorin
Objectives. We sought to determine the prevalence and aetiology of LVT among patients undergoing echocardiography. Methods. We reviewed case notes and echocardiographic data of patient diagnosed with LVT using noncontrast transthoracic echocardiography. Definition of various conditions was made using standard guidelines. Mean ± SD were derived for continuous variables and comparison was made using Student's t-test. Results. Total of 1302 transthoracic echocardiograms were performed out of which 949 adult echocardiograms were considered eligible...
2014: Advances in Medicine
Maurizio Brighenti, Andrea Donti, Maria Giulia Gagliardi, Nicola Maschietto, Davide Marini, Maristella Lombardi, Ugo Vairo, Gabriella Agnoletti, Ornella Milanesi, Giacomo Pongiglione, Marco Bonvicini
OBJECTIVES: The objective of this investigation is to evaluate the safety, the impact of endomyocardial biopsy (EMB) results in myocarditis management and the incidence of different etiologies of myocarditis in a pediatric population. BACKGROUND: Although EMB is an established diagnostic tool to evaluate suspected myocarditis, there is lack of clear diagnostic and management guidelines for myocarditis in pediatric patients, particularly in infants. METHODS: We performed a retrospective database review and subsequent outcomes analysis from five Italian pediatric cardiology centers to identify patients aged 0-18 years who underwent EMB for suspected myocarditis or inflammatory cardiomyopathy (ICMP) between 2009 and 2011...
March 2016: Catheterization and Cardiovascular Interventions
Loon Yee Louis Teo, Rocio T Moran, W H Wilson Tang
The understanding of the genetic basis of cardiomyopathy has expanded significantly over the past 2 decades. The increasing availability, shortening diagnostic time, and lowering costs of genetic testing have provided researchers and physicians with the opportunity to identify the underlying genetic determinants for thousands of genetic disorders, including inherited cardiomyopathies, in effort to improve patient morbidities and mortality. As such, genetic testing has advanced from basic scientific research to clinical application and has been incorporated as part of patient evaluations for suspected inherited cardiomyopathies...
December 2015: Current Heart Failure Reports
Nasim Naderi, Mona Heidarali, Fatemeh Barzegari, Behshid Ghadrdoost, Ahmad Amin, Sepideh Taghavi
BACKGROUND: There is increasing evidence that endocrine system may be dysfunctional in patients with heart failure. OBJECTIVES: In the present study, we investigated hormonal abnormalities in heart failure and the effect of disturbed hormonal balance on prognostic outcomes of patients with systolic heart failure. PATIENTS AND METHODS: Among patients followed in Heart Failure and Transplantation Clinic, 33 men with a diagnosis of idiopathic dilated cardiomyopathy receiving guidelines-directed medical therapies and with New York Heart Association Class II-III were enrolled...
August 2015: Research in Cardiovascular Medicine
Kaspar Broch, Klaus Murbræch, Arne Kristian Andreassen, Einar Hopp, Svend Aakhus, Lars Gullestad
Outcome is better in patients with idiopathic dilated cardiomyopathy (IDC) than in ischemic heart failure (HF), but morbidity and mortality are nevertheless presumed to be substantial. Most data on the prognosis in IDC stem from research performed before the widespread use of current evidence-based treatment, including implantable devices. We report outcome data from a cohort of patients with IDC treated according to current HF guidelines and compare our results with previous figures: 102 consecutive patients referred to our tertiary care hospital with idiopathic IDC and a left ventricular ejection fraction <40% were included in a prospective cohort study...
September 15, 2015: American Journal of Cardiology
Misato Chimura, Kunihiko Kiuchi, Katsunori Okajima, Akira Shimane, Takahiro Sawada, Tetsuari Onishi, Shinichiro Yamada, Yasuyo Taniguchi, Yoshinori Yasaka, Hiroya Kawai
BACKGROUND: Current guidelines recommend the implantation of an implantable cardioverter-defibrillator (ICD) for primary prevention of sudden cardiac death (SCD) in a subgroup of patients with nonishcemic cardiomyopathy (NICM) who have a left ventricular ejection fraction (LVEF) ≤30% to 35%, and are NYHA functional class Ⅱ or Ⅲ. However, the majority of patients with an ICD implantation for primary prevention did not receive appropriate ICD therapy. The purpose of this study was to evaluate the association between myocardial fibrosis detected by cardiovascular magnetic resonance (CMR) imaging and life-threatening ventricular arrhythmic events in NICM patients...
July 29, 2015: Journal of Cardiovascular Electrophysiology
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