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Left dilatation

Stefan Rupp, Christian Jux
While in adults major advances in heart failure therapy in patients with dilated cardiomyopathy were documented in the last two decades, research on the mechanism and therapies of heart failure in children with left ventricular dilated cardiomyopathy has lagged behind. Despite the lack of sufficient randomized prospective studies, ACE inhibitors are first line and ß-receptor antagonists are second-line strategies in children. Following the adult guidelines, without having data concerning the pediatric population, mineral corticoids are also accepted in the treatment of pediatric heart failure, while diuretics should only be used to achieve a euvolemic status...
March 22, 2018: Heart Failure Reviews
Christopher R Broda, Svetlana B Shugh, Rohan B Parikh, YunFei Wang, Tobias R Schlingmann, Cory V Noel
After an arterial switch operation (ASO), serial imaging is necessary to monitor for maladaptive changes. We compared cardiac magnetic resonance imaging (CMR) to 2-D transthoracic echocardiography (TTE) in assessing post-operative ASO patients. We performed a retrospective review of patients at a single tertiary care center who underwent an ASO and subsequently had a CMR performed from 7/2010 to 7/2016. Those with single ventricle anatomy, congenitally corrected transposition of the great arteries, or previous atrial switch operation were excluded...
March 22, 2018: Pediatric Cardiology
Natalia Lorenzo, Irene Mendez, Mikel Taibo, Gianfranco Martinis, Sara Badia, Guillermo Reyes, Rio Aguilar
BACKGROUND: Atrial fibrillation frequently affects patients with valvular heart disease. Ablation of atrial fibrillation during valvular surgery is an alternative for restoring sinus rhythm. OBJECTIVES: This study aimed to evaluate mid-term results of successful atrial fibrillation surgical ablation during valvular heart disease surgery, to explore left atrium post-ablation mechanics and to identify predictors of recurrence. METHODS: Fifty-three consecutive candidates were included...
March 19, 2018: Arquivos Brasileiros de Cardiologia
Mathieu Struyve, Geert Robaeys
Ectopic varices are dilated portosystemic venous collaterals located outside of the gastro-esophageal region. Whereas they are common endoscopic findings in patients with portal hypertension, ectopic variceal bleeding is rather rare and accounts for only 1 to 5 % of all variceal bleedings. The rectum and the duodenum are the most common sites for ectopic varices, but they can be present along the whole intestinal tract and neighborhood. At present, there is no consensus well established on diagnostic workup for ectopic variceal bleeding and their therapeutic strategies...
July 2017: Acta Gastro-enterologica Belgica
Keisuke Inui, Kuniya Asai, Masaki Tachi, Aya Yoshinaga, Yuki Izumi, Yoshiaki Kubota, Koji Murai, Yayoi Tetsuou Tsukada, Yasuo Amano, Shinichiro Kumita, Wataru Shimizu
T1 mapping using cardiac magnetic resonance (CMR) is useful for myocardial assessment. However, its prognostic value is not well defined. The aim of this study was to determine whether T1 mapping with CMR can predict reverse cardiac remodeling in patients with non-ischemic dilated cardiomyopathy (NIDCM). We also investigated the predictive prognostic value of T1 mapping with CMR in these patients. We included 33 patients with NIDCM admitted to Nippon Medical School Hospital between February 2012 and October 2015...
March 20, 2018: Heart and Vessels
Nimrod Dar, Alexander Rubowitz
Purpose: To report a unique case of pseudo-duplication of the optic disc with maculo-schisis. Observations: A 9-year-old girl presented with decreased vision in the left eye. Her measured visual acuity was 20/50. Dilated fundus examination revealed an optic disc-like lesion with a large crater-like depression, pale color and aberrant retinal vasculature arising from its lower region. Optical coherence tomography (OCT) demonstrated maculo-schisis emerging from the optic disc complex and involving the foveal region...
June 2018: American Journal of Ophthalmology Case Reports
Alicia Blackman, Wayne Mohammed
This case presents a woman in her early 20s who died after the sudden onset of chest pain. Five years earlier, she was investigated for a cardiac murmur during pregnancy and an echocardiogram revealed a 6.0×3.0 cm blood-filled sac compressing the left atrium and anterolateral aspect of the left ventricle with communication to the aortic root. She later had a CT scan of the chest with contrast, which showed aneurysmal dilatation of the left main coronary artery. She was placed on aspirin but defaulted from clinic 11 months post partum...
March 20, 2018: BMJ Case Reports
Michelle Hershman, Raymond Carmody, Unni K Udayasankar
History A 19-year-old woman with no pertinent medical history was brought to the emergency department after being found unconscious on her bathroom floor by her roommate. In the preceding weeks, she had reported intractable nausea and vomiting, for which she had been taking ondansetron. No other medications had been prescribed. The day prior to presentation, she had contacted her mother and described increasing confusion. Glasgow coma scale score on arrival in the emergency department was 4. Intravenous naloxone was administered, without immediate response...
April 2018: Radiology
Marcin Kubik, Alicja Dąbrowska-Kugacka, Ewa Lewicka, Ludmiła Daniłowicz-Szymanowicz, Grzegorz Raczak
Left ventricular noncompaction (LVNC) is a unique inherited cardiomyopathy, characterized by an increased risk of adverse cardiovascular events such as heart failure, arrhythmia or sudden cardiac death. Although in comparison to dilated cardiomyopathy, the number of clinical studies concerning LVNC is still small, it is quickly increasing, which reflects a huge effort of the cardiovascular society to develop data to improve understanding of this cardiomyopathy. However, the predictors of adverse outcomes in LVNC are not well established...
March 16, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
José Ascención Arenas-Ruiz, Horus Martinez-Maldonado, Vicente Gonzalez-Carranza, Samuel Torres-García, Fernando Chico-Ponce de Leon
INTRODUCTION: Focal hydrocephalus including trapped temporal horn (TTH), isolated lateral and fourth ventricles, is caused by obstruction and/or adhesion related to various etiologies. With the advent of the neuroendoscope, endoscopic procedures have become an alternative in selected cases. CASE REPORT: A 2-year-old male from a rural town in México was referred to our institution because of multiple supra- and infra-tentorial abscesses and hydrocephalus. The patient had progressive deterioration and developed bilateral trapped temporal horn related to multi-septated hydrocephalus, so we performed an endoscopic ventricular-cistern-ventriculostomy through a single right temporal burr hole...
March 20, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Raffaele Altara, Fouad A Zouein, Rita Dias Brandão, Saeed N Bajestani, Alessandro Cataliotti, George W Booz
Standard therapies for heart failure with preserved ejection fraction (HFpEF) have been unsuccessful, demonstrating that the contribution of the underlying diastolic dysfunction pathophysiology differs from that of systolic dysfunction in heart failure and currently is far from being understood. Complicating the investigation of HFpEF is the contribution of several comorbidities. Here, we selected three established rat models of diastolic dysfunction defined by three major risk factors associated with HFpEF and researched their commonalities and differences...
2018: Frontiers in Cardiovascular Medicine
Ge Li-Sha, Liu Li, Zhou De-Pu, Shi Zhe-Wei, Gu Xiaohong, Chen Guang-Yi, Li Jia, Lin Jia-Feng, Chu Maoping, Li Yue-Chun
This study was designed to explore the effects of ivabradine on cardiomyocyte apoptosis in a murine model of chronic viral myocarditis (CVMC). Mice were inoculated intraperitoneally with Coxsackievirus B3 at days 1, 14, and 28, respectively. On day 42, the mice were gavaged with ivabradine for 30 days until the 72nd day. The heart of infected mice was dilated and a large number of interstitial fibroblasts infiltrated into the myocardium on day 42. Compared with the untreated CVMC mice, mice treated with ivabradine showed a significant reduction in heart rate and less impairment of left ventricular function on day 72...
2018: Frontiers in Pharmacology
Samuel G Wittekind, Yvette Gerdes, Wayne Mays, Clifford Chin, John L Jefferies
Nonischemic dilated cardiomyopathy is deadly and costly, and treatment options are limited. Cardiac rehabilitation has proved safe and beneficial for adults with various types of heart failure. Therefore, we retrospectively evaluated the hypothesis that rehabilitation is safe and improves cardiometabolic health in young patients with nonischemic dilated cardiomypathy. From 2011 through 2015, 8 patients (4 males) (mean age, 20.6 ± 6.6 yr; range, 10-31 yr) underwent rehabilitation at our institution. They were in American Heart Association class C or D heart failure and were on maximal medical therapy...
February 2018: Texas Heart Institute Journal
Charlotte Spicher, Ruth Schneider, Peter Mönnings, Christiane Schneider-Gold, Dennis Kallenberg, Bilal Cevik, Carsten Lukas, Ralf Gold, Christos Krogias
Background: Duchenne muscular dystrophy (DMD) is an X-linked recessive skeletal muscle myopathy which is caused by mutations in the dystrophin gene. Lack of dystrophin also results to cardiomyopathy, which raises significantly the stroke risk in DMD-patients. However, data about therapeutic opportunities in the acute setting are scarce in literature. So far, only two cases receiving IV thrombolysis are described, one of them with fatal outcome. Method: Case report of a case of successful mechanical thrombectomy (MTE) in an acute ischemic stroke (AIS) patient with DMD and associated dilatative cardiomyopathy...
2018: Therapeutic Advances in Neurological Disorders
Katharina Huenges, Bernd Panholzer, Jochen Cremer, Assad Haneya
Left ventricular assist device (LVAD) is nowadays a routine therapy for patients with advanced heart failure. We present the case of a 74-year-old male patient who was admitted to our center with terminal heart failure in dilated cardiomyopathy and ascending aortic aneurysm with aortic valve regurgitation. The LVAD implantation with simultaneous aortic valve and supracoronary ascending aortic replacement was successfully performed.
2018: Case Reports in Medicine
Ayako Uchinaka, Maho Yoshida, Kiyoka Tanaka, Yoshinosuke Hamada, Seiji Mori, Yoshitaka Maeno, Shigeru Miyagawa, Yoshiki Sawa, Kohzo Nagata, Hirofumi Yamamoto, Naomasa Kawaguchi
OBJECTIVE: Left ventricular (LV) remodeling alters the contractile and relaxation properties and induces myocardial stiffness. As LV remodeling progresses, the amount of collagen type III (Col3) is gradually decreased, being replaced by collagen type I (Col1). We evaluated whether Col3 overexpression improved cardiac function and remodeling in a rat with ischemic cardiomyopathy (ICM). We also investigated the functional motif and mechanism of thrombin-cleaved N-terminal osteopontin (N-OPN) on cardiac remodeling...
February 21, 2018: Journal of Thoracic and Cardiovascular Surgery
Colleen M Witzenburg, Jeffrey W Holmes
The ability to predict long-term growth and remodeling of the heart in individual patients could have important clinical implications, but the time to customize and run current models makes them impractical for routine clinical use. Therefore, we adapted a published growth relation for use in a compartmental model of the left ventricle (LV). The model was coupled to a circuit model of the circulation to simulate hemodynamic overload in dogs. We automatically tuned control and acute model parameters based on experimentally reported hemodynamic data and fit growth parameters to changes in LV dimensions from two experimental overload studies (one pressure, one volume)...
March 17, 2018: Journal of Cardiovascular Translational Research
Sujith Chacko, George Joseph, Viji Thomson, Paul George, Oommen George, Debashish Danda
BACKGROUND: Use of iodinated contrast agents for angiography in patients with renal insufficiency risks further deterioration of renal function and its adverse sequelae. OBJECTIVE: To study the effectiveness and safety of carbon dioxide (CO2 ) angiography in guiding percutaneous renal-related interventions in patients with Takayasu arteritis and renal insufficiency. METHODS: Data on CO2 angiography-guided interventions were obtained from a 23-year database of 692 Takayasu arteritis patients who underwent percutaneous interventions and were analyzed retrospectively...
March 16, 2018: Cardiovascular and Interventional Radiology
M Boutsikou, D Shore, W Li, M Rubens, A Pijuan, M A Gatzoulis, S Babu-Narayan
INTRODUCTION: The diagnosis of ALCAPA syndrome is sporadic in adulthood, of the limited cases in the literature most are incidental or without symptoms. There is a broad spectrum of clinical manifestations of ALCAPA syndrome however, including sudden cardiac death. CASES: We present herewith a series of 12 consecutive patients with ALCAPA, all diagnosed in adulthood (between 18 and 73 years of age). Five patients developed symptoms (breathlessness) after the fourth decade of life, 3 were undiagnosed despite a history of previous mitral valve repair, one presented with heart failure, one with resuscitated cardiac arrest, whereas two patients were asymptomatic...
February 24, 2018: International Journal of Cardiology
Sven Persoon, Michael Paulus, Stephan Hirt, Carsten Jungbauer, Alexander Dietl, Andreas Luchner, Christof Schmid, Lars S Maier, Christoph Birner
Implantation of left ventricular assist devices (LVADs) as bridge to transplant in end-stage heart failure allows for analyzing reverse remodeling processes of the supported heart. Whether this therapy influences the cGMP-PKG signaling pathway, which is currently under thorough investigation for developing new heart failure therapeutics, is unknown. In fourteen end-stage heart failure patients (8 with dilated cardiomyopathy, DCM; 6 with ischemic cardiomyopathy, ICM) tissue specimens of left ventricles were collected at LVAD implantation and afterwards at receiver heart explantation, respectively...
March 15, 2018: Heart and Vessels
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