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Non-ischemic Dilated Cardiomyopathy

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https://www.readbyqxmd.com/read/28919378/sudden-death-mechanisms-in-non-ischemic-cardiomyopathies-insights-gleaned-from-clinical-implantable-cardioverter-defibrillator-trials
#1
Benjamin A Steinberg, Siva K Mulpuru, James C Fang, Bernard J Gersh
Sudden cardiac death (SCD) represents a major cause of death among patients with heart failure. While scar-based, macro-reentrant ventricular tachycardia and ventricular fibrillation (VT/VF) is the primary etiology for SCD among patients with ischemic cardiomyopathy, a more diverse set of mechanisms and substrates are likely at play for the diverse group of patients characterized by non-ischemic, dilated cardiomyopathy (NICM). These causes may include scar-based re-entry, but also neurohormonal stimulation (sympathetic, parasympathetic, renin-angiotensin-aldosterone), inflammation, and non-arrhythmic processes occurring in the context of a genetic predisposition...
September 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28861149/posttranslational-modifications-of-calcium-calmodulin-dependent-protein-kinase-ii%C3%AE-and-its-downstream-signaling-in-human-failing-hearts
#2
Tomas Rajtik, Eva Goncalvesova, Zoltan V Varga, Przemyslaw Leszek, Mariusz Kusmierczyk, Michal Hulman, Jan Kyselovic, Peter Ferdinandy, Adriana Adameova
BACKGROUND: In human failing hearts (HF) of different origin (coronary artery disease-CAD, dilated-DCM, restrictive and hypertrophic cardiomyopathy-OTHER), we investigated the active forms of Ca(2+)/calmodulin-dependent protein kinase IIδ (p-Thr(287)-CaMKIIδ, oxMet(281/282)-CaMKIIδ) and their role in phenotypes of the disease. METHODS AND RESULTS: Although basic diagnostic and clinical markers indicating the attenuated cardiac contractility and remodeling were comparable in HF groups, CaMKIIδ-mediated axis was different...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28772045/translational-registry-for-cardiomyopathies-torch-rationale-and-first-results
#3
Claudia Seyler, Benjamin Meder, Tanja Weis, Thea Schwaneberg, Kerstin Weitmann, Wolfgang Hoffmann, Hugo A Katus, Andreas Dösch
AIMS: Non-ischemic cardiomyopathies (CMPs) comprise heart muscle disorders of different causes with high variability in disease phenotypes and clinical progression. The lack of national structures for the efficient recruitment, clinical and molecular classification, and follow-up of patients with non-ischemic CMPs limit the thorough analysis of disease mechanisms and the evaluation of novel diagnostic and therapeutic strategies. This paper describes a national, prospective, multicenter registry for patients with non-ischemic CMPs...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28761607/-severe-ventricular-arrhythmias-in-a-patient-with-dilated-cardiomyopathy-and-automated-implantable-defibrillator-aid
#4
Stéphane Méo Ikama, Jospin Makani, Bertrand Ellenga-Mbolla, Louis Igor Ondze-Kafata, Thierry Raoul Gombet, Gisèle Kimbally-Kaky
Severe ventricular arrhythmias are frequent during heart failure; they are a life-threatening condition due to the increased risk of sudden death. Efficient management remains limited in sub-Saharan Africa because of the limited or unavailable medical resources as automated implantable defibrillator (AID). We report the case of a 56-year old patient with non ischemic dilated cardiomyopathy with very low left ventricular ejection fraction (LVEF)who underwent AID implantation for primary prevention of sudden cardiac death due to ventricular arrhythmias in 2012...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28756099/predictors-of-ventricular-arrhythmia-after-left-ventricular-assist-device-implantation-a-large-single-center-observational-study
#5
Elena Efimova, Julia Fischer, Livio Bertagnolli, Borislav Dinov, Simon Kircher, Sascha Rolf, Philipp Sommer, Andreas Bollmann, Sergio Richter, Anna Meyer, Jens Garbade, Gerhard Hindricks, Arash Arya
BACKGROUND: Ventricular arrhythmias (VAs) are common in patients after left ventricular assist device (LVAD) implantation. OBJECTIVE: The purpose of this study was to determine the predictors of VAs and their impact on mortality in LVAD patients. METHODS: A total of 98 consecutive patients with an implantable cardioverter-defibrillator (ICD) (86 [88%] male, mean age 57 ± 10 years), 57 [58%] with nonischemic dilated cardiomyopathy) who had received an LVAD between May 2011 and December 2013 at our institution were included in the study...
July 27, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28709811/arrhythmic-risk-stratification-in-non-ischemic-dilated-cardiomyopathy-where-do-we-stand-after-danish
#6
REVIEW
Polychronis Dilaveris, Christos-Konstantinos Antoniou, Konstantinos A Gatzoulis
Publication of the DANISH randomized trial led to considerable debate, given that it demonstrated no survival benefit stemming from current implantable cardioverter-defibrillator (ICD) allocation criteria in patients with non-ischemic dilated cardiomyopathy (NIDCM). Consequently, a thorough reconsideration of our approach to sudden cardiac death (SCD)-risk stratification appears to be in order. NIDCM encompasses a wide spectrum of disease entities, often with differing arrhythmogenicity; however, in its kernel, is still defined by the fundamentals of electrophysiology that dictate that abnormal tissue, exhibiting altered electrophysiological properties is necessary for arrhythmogenesis, but not enough, given that formation of functional circuits is required...
June 7, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28705874/automated-quantification-of-low-amplitude-abnormal-qrs-peaks-from-high-resolution-ecg-recordings-predicts-arrhythmic-events-in-patients-with-cardiomyopathy
#7
Moloy Das, Adrian M Suszko, Sachin Nayyar, Karthik Viswanathan, Danna A Spears, George Tomlinson, Arnold Pinter, Eugene Crystal, Rupin Dalvi, Sridhar Krishnan, Vijay S Chauhan
BACKGROUND: Cardiomyopathy patients are at risk of sudden death, typically from scar-related abnormalities of electrical activation that promote ventricular tachyarrhythmias. Abnormal intra-QRS peaks may provide a measure of altered activation. We hypothesized that quantification of such QRS peaks (QRSp) in high-resolution ECGs would predict arrhythmic events in implantable cardioverter-defibrillator (ICD)-eligible cardiomyopathy patients. METHODS AND RESULTS: Ninety-nine patients with ischemic or non-ischemic dilated cardiomyopathy undergoing prophylactic ICD implantation were prospectively enrolled (age 62±11 years, left ventricular ejection fraction 27±7%)...
July 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28696268/personalizing-risk-stratification-for-sudden-death-in-dilated-cardiomyopathy-the-past-present-and-future
#8
REVIEW
Brian P Halliday, John G F Cleland, Jeffrey J Goldberger, Sanjay K Prasad
Results from the DANISH Study (Danish Study to Assess the Efficacy of ICDs in Patients With Non-Ischemic Systolic Heat Failure on Mortality) suggest that for many patients with dilated cardiomyopathy (DCM), implantable cardioverter-defibrillators do not increase longevity. Accurate identification of patients who are more likely to die of an arrhythmia and less likely to die of other causes is required to ensure improvement in outcomes and wise use of resources. Until now, left ventricular ejection fraction has been used as a key criterion for selecting patients with DCM for an implantable cardioverter-defibrillator for primary prevention purposes...
July 11, 2017: Circulation
https://www.readbyqxmd.com/read/28683825/diabetic-retinopathy-is-associated-with-diastolic-dysfunction-in-type-2-diabetic-patients-with-non-ischemic-dilated-cardiomyopathy
#9
Yoo-Ri Chung, Se-Jun Park, Ka Young Moon, Seoyoung Annie Choi, Hong-Seok Lim, Sung Wook Park, Jeong Hun Kim, Kihwang Lee
BACKGROUND: To investigate the association between diabetic retinopathy (DR) and myocardial dysfunction in patients with type 2 diabetes and dilated cardiomyopathy (dCMP). METHODS: Data were collected retrospectively from 89 patients with dCMP (46 with type 2 diabetes and 43 without diabetes) and no evidence of coronary artery disease. Echocardiographic parameters and laboratory data, including lipid profiles and fundus findings, were obtained from medical records...
July 6, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28663761/clinical-outcome-of-cardiac-resynchronization-therapy-in-dilated-phase-hypertrophic-cardiomyopathy
#10
Min Gu, Han Jin, Wei Hua, Xiao-Han Fan, Hong-Xia Niu, Tao Tian, Li-Gang Ding, Jing Wang, Cong Xue, Shu Zhang
BACKGROUNDS: Clinical trials have demonstrated that cardiac resynchronization therapy (CRT) is effective in patients with "non-ischemic cardiomyopathy". However, patients with dilated-phase hypertrophic cardiomyopathy (DHCM) have been generally excluded from such trials. We aimed to compare the clinical outcome of CRT in patients with DHCM, idiopathic dilated cardiomyopathy (IDCM), or ischemic cardiomyopathy (ICM). METHODS: A total of 312 consecutive patients (DHCM: n = 16; IDCM: n = 231; ICM: n = 65) undergoing CRT in Fuwai hospital were studied respectively...
April 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28647343/alcoholic-cardiomyopathy-what-is-known-and-what-is-not-known
#11
REVIEW
Antonio Mirijello, Claudia Tarli, Gabriele Angelo Vassallo, Luisa Sestito, Mariangela Antonelli, Cristina d'Angelo, Anna Ferrulli, Salvatore De Cosmo, Antonio Gasbarrini, Giovanni Addolorato
Excessive alcohol consumption represents one of the main causes of non-ischemic dilated cardiomyopathy. Alcoholic cardiomyopathy is characterized by dilation and impaired contraction of one or both myocardial ventricles. It represents the final effect of alcohol-induced toxicity to the heart. Several pathophysiological mechanisms have been proposed at the basis of alcohol-induced damage, most of which are still object of research. Unfortunately, symptoms of alcoholic cardiomyopathy are not specific and common to other forms of heart failure and appear when dilatation and systolic dysfunction are consolidated...
June 21, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28577279/role-of-pet-to-evaluate-coronary-microvascular-dysfunction-in-non-ischemic-cardiomyopathies
#12
REVIEW
Paco E Bravo, Marcelo F Di Carli, Sharmila Dorbala
Coronary microvascular dysfunction (CMD) can result from structural and functional abnormalities at the intramural and small coronary vessel level affecting coronary blood flow autoregulation and consequently leading to impaired coronary flow reserve. CMD often co-exists with epicardial coronary artery disease but is also commonly seen in patients with various forms of heart disease, including dilated, hypertrophic, and infiltrative cardiomyopathies. CMD can go unnoticed without any symptoms, or manifest as angina, and/or dyspnea, and contribute to the development of heart failure, and even sudden death especially when co-existing with myocardial fibrosis...
June 3, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28571807/dilated-cardiomyopathy-induced-disruption-of-basement-membrane-alters-the-lever-systems-acting-on-the-heart
#13
Iman A Mohamed, Nagwa El-Badri, Amr Zaher
Dilated cardiomyopathy (DCM) is considered the most common form of non-ischemic heart diseases. DCM, occurs in response to both non-genetic and genetic factors, and has been associated with cytoskeletal protein mutations, impairing the contractile apparatus of cardiac myocytes. However, the pathology underlying the marked left ventricular dilatation remains unclear. Moreover, patients with end-stage DCM show alterations in the composition of the extracellular matrix (ECM), and myocardial fibrosis even when the cardiac myocytes are intact...
June 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28500252/transcriptome-profiling-reveals-novel-bmi-and-sex-specific-gene-expression-signatures-for-human-cardiac-hypertrophy
#14
Mackenzie S Newman, Tina Nguyen, Michael J Watson, Robert W Hull, Han-Gang Yu
How obesity or sex may affect the gene expression profiles of human cardiac hypertrophy is unknown. We hypothesized that body-mass index (BMI) and sex can affect gene expression profiles of cardiac hypertrophy. Human heart tissues were grouped according to sex (male, female), BMI (lean<25 kg/m(2), obese>30 kg/m(2)), or left ventricular hypertrophy (LVH) and non-LVH nonfailed controls (NF). We identified 24 differentially expressed (DE) genes comparing female with male samples. In obese subgroup, there were 236 DE genes comparing LVH with NF; in lean subgroup, there were seven DE genes comparing LVH with NF...
July 1, 2017: Physiological Genomics
https://www.readbyqxmd.com/read/28472305/recessive-taf1a-mutations-reveal-ribosomopathy-in-siblings-with-end-stage-pediatric-dilated-cardiomyopathy
#15
Pamela A Long, Jeanne L Theis, Yu-Huan Shih, Joseph J Maleszewski, Patrice C Abell Aleff, Jared M Evans, Xiaolei Xu, Timothy M Olson
Non-ischemic dilated cardiomyopathy (DCM) has been recognized as a heritable disorder for over 25 years, yet clinical genetic testing is non-diagnostic in >50% of patients, underscoring the ongoing need for DCM gene discovery. Here, whole exome sequencing uncovered a novel molecular basis for idiopathic end-stage heart failure in two sisters who underwent cardiac transplantation at three years of age. Compound heterozygous recessive mutations in TAF1A, encoding an RNA polymerase I complex protein, were associated with marked fibrosis of explanted hearts and gene-specific nucleolar segregation defects in cardiomyocytes, indicative of impaired ribosomal RNA synthesis...
August 1, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28439651/contrast-enhanced-t1-mapping-based-extracellular-volume-fraction-independently-predicts-clinical-outcome-in-patients-with-non-ischemic-dilated-cardiomyopathy-a-prospective-cohort-study
#16
Jong-Chan Youn, Yoo Jin Hong, Hye-Jeong Lee, Kyunghwa Han, Chi Young Shim, Geu-Ru Hong, Young Joo Suh, Jin Hur, Young Jin Kim, Byoung Wook Choi, Seok-Min Kang
OBJECTIVES: We aimed to evaluate the prognostic role of cardiac magnetic resonance imaging (CMR)-based extracellular volume fraction (ECV) in patients with non-ischemic dilated cardiomyopathy (NIDCM) and compare it with late gadolinium enhancement (LGE) parameters. METHODS: This was a single-center, prospective, cohort study of 117 NIDCM patients (71 men, 51.9 ± 16.7 years) who underwent clinical 3.0-T CMR. Myocardial ECV and LGE were quantified on the left ventricular myocardium...
September 2017: European Radiology
https://www.readbyqxmd.com/read/28414672/a-strong-and-fortuitous-case-of-dyspnea
#17
R Hammer, M Sciaudone
CASE: A 48 year-old man with no past medical history was sent to our emergency department (ED); from a primary care clinic for hypertensive urgency of 200/130. The man reported an intermittent non-productive cough of approximately one year's duration and worsening dyspnea on exertion and orthopnea over the last month with lower extremity swelling. Of note, he emigrated from Honduras twenty years ago. Blood pressure normalized with administration of Lasix in the ED. Physical exam revealed rales in lung bases bilaterally, jugular venous distension, lower extremity pitting edema with serpiginous patches of erythema and excoriation, and a cardiac gallop...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28402404/long-term-outcome-of-surgical-cryoablation-for-refractory-ventricular-tachycardia-in-patients-with-non-ischemic-cardiomyopathy
#18
Jackson J Liang, Brian P Betensky, Daniele Muser, Erica S Zado, Elad Anter, Nimesh D Desai, David J Callans, Rajat Deo, David S Frankel, Mathew D Hutchinson, David Lin, Michael P Riley, Robert D Schaller, Gregory E Supple, Pasquale Santangeli, Michael A Acker, Joseph E Bavaria, Wilson Y Szeto, Prashanth Vallabhajosyula, Francis E Marchlinski, Sanjay Dixit
Aims: Limited data exist on the long-term outcome of patients (pts) with non-ischemic cardiomyopathy (NICM) and ventricular tachycardia (VT) refractory to conventional therapies undergoing surgical ablation (SA). We aimed to investigate the long-term survival and VT recurrence in NICM pts with VT refractory to radiofrequency catheter ablation (RFCA) who underwent SA. Methods and results: Consecutive pts with NICM and VT refractory to RFCA who underwent SA were included...
April 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28390413/does-stress-perfusion-imaging-improve-the-diagnostic-accuracy-of-late-gadolinium-enhanced-cardiac-magnetic-resonance-for-establishing-the-etiology-of-heart-failure
#19
Gaurav S Gulsin, Abishek Shetye, Jeffrey Khoo, Daniel J Swarbrick, Eylem Levelt, Florence Y Lai, Iain B Squire, Jayanth R Arnold, Gerry P McCann
BACKGROUND: Late gadolinium enhanced cardiovascular magnetic resonance (LGE-CMR) has excellent specificity, sensitivity and diagnostic accuracy for differentiating between ischemic cardiomyopathy (ICM) and non-ischemic dilated cardiomyopathy (NICM). CMR first-pass myocardial perfusion imaging (perfusion-CMR) may also play role in distinguishing heart failure of ischemic and non-ischemic origins, although the utility of additional of stress perfusion imaging in such patients is unclear...
April 8, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28292197/sudden-death-risk-stratification-in-non-ischemic-dilated-cardiomyopathy-using-old-and-new-tools-a-clinical-challenge
#20
REVIEW
Antonis S Manolis
Risk stratification for sudden cardiac death in non-ischemic dilated cardiomyopathy (NIDCM) remains a clinical challenge. Areas covered: Currently, left ventricular ejection fraction (LVEF), severity of heart failure symptoms according to NYHA classification, and morphology and duration of the QRS complex guide device management in these patients with implantation of a cardioverter defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices. Recently, the results of a randomized trial stirred some controversy regarding the utility of ICD in NIDCM patients, however, a subsequent meta-analysis confirmed prior findings of the survival-prolonging benefit of device therapy...
April 2017: Expert Review of Cardiovascular Therapy
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