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Anita Nguyen, Hartzell V Schaff
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March 14, 2018: Annals of Thoracic Surgery
Taichi Sakaguchi, Toshinori Totsugawa, Kentaro Tamura, Arudo Hiraoka, Genta Chikazawa, Hidenori Yoshitaka
OBJECTIVE: Despite excellent long-term results reported for a trans-aortic septal myectomy for hypertrophic obstructive cardiomyopathy (HOCM), surgery for patients with diffuse hypertrophy is very challenging. In addition, a left ventricular outflow obstruction is often aggravated by an abnormal mitral valve and subvalvular apparatus. METHODS: We performed video-assisted minimally invasive trans-mitral septal myectomy procedures in 3 patients with diffuse-type HOCM, who were highly symptomatic despite maximal medical therapy...
March 16, 2018: General Thoracic and Cardiovascular Surgery
Konstantin V Borisov
BACKGROUND: In patients with hypertrophic obstructive cardiomyopathy myocardial fibrosis is an independent predictor of adverse outcome. A new technique of HOCM surgical correction in patients with severe hypertrophy and septal myocardial fibrosis has been proposed. METHODS: The excision of the asymmetrical hypertrophied area of the interventricular septum causing obstruction was performed from the conal part of the right ventricle corresponding to the zone of obstruction of the left ventricle (LV)...
March 10, 2018: Annals of Thoracic Surgery
Jai-Sing Yang, Yan-Ru Peng, Shih-Chang Tsai, Yeu-Sheng Tyan, Chi-Cheng Lu, Hong-Yi Chiu, Yu-Jen Chiu, Sheng-Chu Kuo, Yuh-Feng Tsai, Ping-Chin Lin, Fuu-Jen Tsai
Iodinated contrast media (iodinated CM) have increased ability to absorb x-rays and to visualize structures that normally are impossible to observe in a radiological examination. The use of iodinated CM may destory renal function, commonly known as contrast-induced nephropathy (CIN), which can result in acute renal failure (ARF). This review article mainly focuses on the following areas: (1) classifications of iodinated CM: ionic or non-ionic, high-osmolarity contrast media (HOCM), low-osmolarity contrast media (LOCM) and iso-osmolarity contrast media (IOCM); (2) an introduction to the physical and chemical properties of the non-ionic iodinated CM; (3) the management of anaphylactic reaction by iodinated CM; (4) a suggested single injection of adult doses and maximum dose for non-ionic iodinated CM; (5) the molecular mechanism of contrast-induced nephropathy (CIN); (6) In vitro studies on iodinated CM...
March 2018: BioMedicine
Ikumi Nara, Takako Iino, Hiroyuki Watanabe, Wakana Sato, Kumiko Watanabe, Mai Shimbo, Yuri Umeta, Hiroshi Ito
The morphological determinants of left ventricular outflow tract (LVOT) obstruction in hypertrophic cardiomyopathy (HCM) are not completely understood. We aimed to identify the anatomical risks of the obstruction using echocardiography.Fifty patients with untreated HCM were classified into two groups: those with LVOT pressure gradient (LVOTPG) ≥ 30 mmHg (obstructive HCM [HOCM] group) and those with LVOTPG < 30 mmHg (HNCM group). The echocardiographic morphological variables were analyzed to determine whether they were predictive of LVOT obstruction...
February 23, 2018: International Heart Journal
Amelie Burghardt, Frank van Buuren, Zisis Dimitriadis, Tim Grübbel, Hubert Seggewiss, Smita Scholtz, Dieter Horstkotte, Lothar Faber
BACKGROUND AND STUDY OBJECTIVE: Different studies have shown a good long-term survival with improvement of symptoms and hemodynamics after percutaneous septal ablation (PTSMA), similar to myectomy considered to be the therapeutic "gold standard" for symptomatic hypertrophic obstructive cardiomyopathy (HOCM). Furthermore, desobliteration of left ventricular (LV) outflow may modify features of the disease considered to be risk-relevant, such as magnitude of LV hypertrophy, outflow gradient, and left atrial (LA) size...
February 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Antonio Berruezo, Markus Linhart, Angelo Auricchio, José Luis Zamorano, Pilar Santamaria, Roger Borràs, Felip Burgos, Josep Brugada
PURPOSE: Dual-chamber (DDD) pacing has been used for treatment of patients with hypertrophic obstructive cardiomyopathy (HOCM). Due to inconclusive results in prior trials, current guidelines assign DDD pacing a class IIb indication in selected patients. Prior observations indicate that lack of clinical improvement may result from suboptimal effect of DDD pacing with non-physiological AV intervals due to fusion of intrinsic and paced QRS complex. METHODS: The Triple Chamber Pacing in Hypertrophic Obstructive Cardiomyopathy Patients (TRICHAMPION) trial is a prospective, randomized, single-blinded, multicenter study to investigate the benefit of atrial synchronous biventricular pacing (CRT-P) in highly symptomatic HOCM patients with severe left ventricular outflow tract (LVOT) obstruction who are not candidates for ablative therapies...
February 3, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Yongqiang Lai, Hongchang Guo, Jinhua Li, Jiang Dai, Changwei Ren, Yang Wang
The study was conducted to evaluate the surgical results in patients with hypertrophic obstructive cardiomyopathy (HOCM) who underwent either classic Morrow septal myectomy or modified procedure.The modified Morrow septal myectomy has gained interest as a new treatment for patients with drug-refractory symptoms of HOCM; however, its benefits in comparison to the classic procedure are unknown.In all, 236 symptomatic HOCM patients underwent surgical treatment from January 2006 to January 2015. Among them, 86 patients were treated by the classic Morrow myectomy and 150 patients via the modified procedure...
December 2017: Medicine (Baltimore)
Feng Ji, Qun Liu, Zeyu Feng, Xinwei Han, Zhitong Li
Hypertrophic cardiomyopathy is a heterogeneous myocardial disorder with a broad spectrum of clinical presentation and morphologic features. Previous reports indicated that protein kinase C pathway as a major determinant of cardiac hypertrophy and heart failure. Population-based analyses of the association between PRKCH gene (encoded PKCη) and HCM has not been performed yet. The purpose of this study is to investigate the association of the nonsynonymous SNP (1425G/A) in PRKCH gene and hypertrophic cardiomyopathy in a Chinese population...
December 29, 2017: Oncotarget
H Liu, Q Wu, H W Tan, J Pang
Objective: To observe the clinical efficacy and safety of coil embolization of septal branch in the treatment of obstructive hypertrophic cardiomyopathy (HOCM). Methods: Eighteen patients with HOCM hospitalized in our department from September 2014 to October 2016 were enrolled in this study. There were 12 males and 6 females in this cohort and the age of patients ranged from 22 to 64 years old. Left ventricular outflow tract gradient (LVOTG) was derived from echocardiographic apical five-chamber view at pre-operation and at 48 hours and 6 months post operation...
December 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
Kuo Zhang, Xiangbin Meng, Wenyao Wang, Jilin Zheng, Shimin An, Siyuan Wang, Yu Qi, Chuanyu Gao, Yi-Da Tang
Context: Thyroid hormone acts as a fundamental regulator in cardiovascular homeostasis in pathophysiological conditions. Objective: This study aims to determine whether thyroid hormone could be an independent predictor of adverse events in patients with hypertrophic obstruction cardiomyopathy (HOCM). Design, patients and outcome measure: The original cohort consisted of 965 consecutive patients with HOCM who were admitted to Fuwai Hospital from October 2009 to December 2014, and 756 patients completed thyroid functionevaluations...
January 3, 2018: Journal of Clinical Endocrinology and Metabolism
Shuoyan An, Chaomei Fan, Yinjian Yang, Fei Hang, Zhimin Wang, Yuhui Zhang, Jian Zhang
OBJECTIVES: Patients with hypertrophic obstructive cardiomyopathy (HOCM) and severe left ventricular hypertrophy (maximal left ventricular wall thickness ≥30 mm) are at high risk of sudden cardiac death (SCD). In this study, we aimed to determine whether HOCM patients with severe hypertrophy had a lower incidence of SCD after myectomy. METHODS: HOCM patients with severe hypertrophy were consecutively enrolled from Fuwai Hospital in China between 2000 and 2013...
January 5, 2018: Cardiology
Y P Ruan, X W Liu, Y Zhang, J C Han, Y Q Lai, J Lü, Y H He
Objective: To compare the early clinical effect of septal myectomy and percutaneous transluminal septal myocardial ablation (PTMSA) on the left ventricular outflow obstruction and the rate of complication in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: A total of 204 patients with HOCM who received septal reduction treatment were recruited. These patients were divided into two groups, surgery group (n=135) (65 patients with modified Morrow procedure, 70 patients with non-Morrow myomectomy) and PTMSA group (n=69)...
December 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Tomoyuki Suzuki, Masaki Hata, Kazuhiro Yamaya, Takeshi Saitou, Fumiya Haba, Masahiro Matsuno
Emergent ascending aortic replacement and extended myectomy were performed in a woman with acute aortic dissection who was aged 63 years. Preoperative transthoracic echocardiography performed in the intensive care unit showed only slight left ventricular outflow tract (LVOT) obstruction, but intraoperative transesophageal echocardiography after induction of anesthesia revealed pericardial effusion, systolic anterior motion(SAM), and associated mitral regurgitation(MR). Perioperative SAM and MR are sometimes facilitated under various hemodynamic conditions, but in this case, the left ventricular wall was thick and LVOT appeared to be obstructive by a hypertrophied septum...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Marco Spaziano, Fadi J Sawaya, Thierry Lefèvre
Hypertrophic cardiomyopathy is the most common genetically transmitted heart disease. Around two-thirds of patients develop symptoms caused by the dynamic left ventricular outflow tract obstruction, either at rest or during effort. For patients with hypertrophic obstructive cardiomyopathy (HOCM) that remain symptomatic despite optimal medical treatment, septal reduction is a valuable therapeutic strategy. While surgical myomectomy was considered the gold standard until the end of the 1990s, alcohol septal ablation (ASA) has gained rapid popularity and acceptance, especially in Europe...
December 2017: Journal of Invasive Cardiology
Serkan Asil, Barış Kaya, Uğur Canpolat, Hikmet Yorgun, Levent Şahiner, Cem Çöteli, Anıl Arat, Kudret Aytemir
AIMS: Percutaneous septal reduction therapy by either alcohol or nonalcohol agents is an alternative approach to surgery in drug-refractory symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM). Nonalcohol agents have some advantages and disadvantages over alcohol during the procedure. Nowadays, a novel non-alcohol agent, named as Ethylene-vinyl alcohol (EVOH) copolymer (Onyx® and Squid® ), is used during septal ablation. Thus, in this study, we aimed to evaluate both acute and long-term efficacy and safety profile of EVOH during septal ablation in HOCM...
December 5, 2017: Catheterization and Cardiovascular Interventions
Alin Alexandru Ionescu, Bogdan Radulescu, Vlad Herlea, Ioan Miclea, Irinel Parepa, Serban Bubenek, Bogdan Alexandru Popescu, Carmen Ginghina, Ruxandra Jurcut
Papillary fibroelastomas (PFEs) are one of the most frequent primary cardiac tumors and occur more often in patients with hypertrophic obstructive cardiomyopathy (HOCM). PFEs have been linked to an increased risk of neurological events. We report a case of a 59-year-old woman with HOCM in whom echocardiography (transthoracic and transesophageal, using 2D and 3D techniques) revealed multiple masses in various locations in the left cardiac chambers. Surgical excision of the cardiac tumors and aortic valve replacement was performed and the pathologic report confirmed the diagnosis of PFEs...
November 29, 2017: Medical Ultrasonography
Rie Aoyama, Hitoshi Takano, Yasuhiro Kobayashi, Mitsunobu Kitamura, Kuniya Asai, Yasuo Amano, Shin-Ichiro Kumita, Wataru Shimizu
BACKGROUND: The purposes of this study were to assess the usefulness of myocardial 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) for evaluating myocardial metabolic status in hypertrophic cardiomyopathy (HCM) and the therapeutic efficacy of alcohol septal ablation (ASA) in hypertrophic obstructive cardiomyopathy (HOCM). METHODS: Thirty HCM patients (64.4±10.5 years, 14 male, 12 hypertrophic non-obstructive cardiomyopathy [HNCM], 16 HOCM, and 2 dilated phase of HCM) underwent 18F-FDG-PET/CT...
2017: PloS One
Hiroyuki Takei, Rie Sano, Yoichiro Takahashi, Keiko Takahashi, Yoshihiko Kominato, Hiroyuki Tokue, Takehiro Shimada, Sachiko Awata, Satoshi Hirasawa, Naoya Ohta
Coronary postmortem computed tomography angiography (coronary PMCTA) has been introduced as a routine examination procedure for autopsy at our department. Here, we reviewed eight autopsy cases in which apparent histopathological changes including acute myocardial infarction (AMI), anomalous aortic origin of a coronary artery (AAOCA), hypertrophic obstructive cardiomyopathy (HOCM) and acute myocarditis were involved in the cause of death. For investigation of the coronary artery and shape of the heart, coronary PMCTA was valuable in detecting narrowing or obstruction of coronary artery in AMI, indicating an anomalous aortic origin of the left coronary artery in AAOCA, and demonstrating septal hypertrophy and intracavitary obstruction in HOCM...
January 2018: Legal Medicine
Roland Klingenberg, Soheila Aghlmandi, Christoph Liebetrau, Lorenz Räber, Baris Gencer, David Nanchen, David Carballo, Alexander Akhmedov, Fabrizio Montecucco, Stefan Zoller, Chad Brokopp, Dik Heg, Peter Jüni, Helena Marti Soler, Pedro-Manuel Marques-Vidal, Peter Vollenweider, Oliver Dörr, Nicolas Rodondi, François Mach, Stephan Windecker, Ulf Landmesser, Arnold von Eckardstein, Christian W Hamm, Christian M Matter, Thomas F Lüscher
Aims: We aimed to identify a novel biomarker involved in the early events leading to an acute coronary syndrome (ACS) and evaluate its role in diagnosis and risk stratification. Methods and results: Biomarker identification was based on gene expression profiling. In coronary thrombi of ACS patients, cysteine-rich angiogenic inducer 61 (Cyr61, CCN1) gene transcripts were highly up-regulated compared with peripheral mononuclear cells. In a murine ischaemia-reperfusion model (I/R), myocardial Cyr61 expression was markedly increased compared with the controls...
November 16, 2017: European Heart Journal
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