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Left atrial dilatation

Shuang Wu, Yan-Min Yang, Jun Zhu, Jia-Meng Ren, Juan Wang, Han Zhang, Xing-Hui Shao
BACKGROUND AND AIMS: The prognostic role of big endothelin-1 (ET-1) in atrial fibrillation (AF) is unclear. We aimed to assess its predictive value in patients with AF. METHODS: A total of 716 AF patients were enrolled and divided into two groups based on the optimal cut-off value of big ET-1 in predicting all-cause mortality. The primary outcomes were all-cause mortality and major adverse events (MAEs). Cox regression analysis and net reclassification improvement (NRI) analysis were performed to assess the predictive value of big ET-1 on outcomes...
March 2, 2018: Atherosclerosis
Krzysztof Boczar, Agnieszka Sławuta, Andrzej Ząbek, Maciej Dębski, Jacek Gajek, Jacek Lelakowski, Barbara Małecka
CRT is a therapeutic option for patients with heart failure, sinus rhythm, prolonged QRS complex duration and reduced ejection fraction. We present a case of 71-year-old woman with dilated cardiomyopathy, NYHA functional class III and AF. We implanted CRT combined with direct His-bundle pacing. The indication for such a therapy was a left bundle branch block with a QRS complex of 178ms and a left ventricular EF of 15%, left ventricular end-diastolic diameter (LVEDD) of 75mm. After 8months of follow-up the LVEDD was 60mm with EF 35-40%...
March 2, 2018: Journal of Electrocardiology
Maria Viviana Carlino, Fiorella Paladino, Alfonso Sforza, Claudia Serra, Filomena Liccardi, Giovanni de Simone, Costantino Mancusi
BACKGROUND: Acute dyspnea is one of the main reasons for admission to Emergency Department (ED). Availability of ultraminiaturized pocket ultrasound devices (PUD) adds diagnostic power to the clinical examination. The aim of this study was to identify an integrated ultrasound approach for diagnosis of acute heart failure (acute HF), using PUD and combining evaluation from lung, heart and inferior vena cava (IVC). METHODS: We included 102 patients presenting to the ED of "Antonio Cardarelli" Hospital in Naples (Italy) for acute dyspnea (AD)...
March 9, 2018: Echocardiography
Michael Dandel, Roland Hetzer
Compared with the left ventricle (LV), the right ventricle (RV) is less suited for evaluation by echocardiography (ECHO). Nevertheless, RV ECHO-assessment has currently emerged as an important diagnostic tool with meaningful prognostic value and essential contribution to therapeutic decisions. Although significant progress has been made, including generation of higher-quality normative data, validation of several two-dimensional measurements and improvements in three-dimensional ECHO-techniques, many challenges in RV ECHO-assessment still persist...
March 9, 2018: Expert Review of Cardiovascular Therapy
Wenjiao Zhao, Guihua Lu, Li Liu, Zhishan Sun, Mingxin Wu, Wenyan Yi, Haiyan Chen, Yanhui Li, Lilong Tang, Jianping Zeng
BACKGROUND The aim of this study was to compare the use of the standard 12-lead electrocardiogram (ECG) with the SAN-Atrial-AVN-His (SAAH) ECG (Model PHS-A10), a new automated and integrated signals recognition system that detects micro-waveforms within the P, QRS, and T-wave, in a pig model of acute myocardial infarction (MI). MATERIAL AND METHODS Six medium-sized domestic Chinese pigs underwent general anesthesia, and an angioplasty balloon was placed and dilated for 120 minutes in the first diagonal coronary artery arising from the left anterior descending (LAD) coronary artery...
March 4, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Angel Lopez-Candales, Dagmar F Hernandez-Suarez, Francisco Lopez Menendez
Background: Even though left atrial (LA) size and function are intimately related to left ventricular (LV) diastolic dysfunction, the role of LA with regard to LV systolic function is less clear. Consequently, we examined the potential association that might exist between measures of longitudinal LV systolic shortening and LA dilation using LA volume index (LAVI). Methods: In this retrospective analysis, data from 75 echocardiograms (mean age 53 ± 14; range 24 - 89 years; mean body surface area (BSA) 2...
February 2018: Cardiology Research
A Rossi, F L Dini, E Agricola, P Faggiano, G Benfari, P L Temporelli, C Cucco, L Scelsi, C Vassanelli, S Ghio
BACKGROUND: The relation between systolic pulmonary pressure (sPAP) and left atrium in patients with heart failure (HF) is unclear. Diastolic dysfunction, expressed as restrictive mitral filling pattern (RMP), and functional mitral regurgitation (FMR) are associated with both LA enlargement and increased sPAP. We aimed to evaluate whether atrial dilation might modulate the consequences of RMP and FMR on the pulmonary circulation of patients with HF with reduced ejection fraction (HFrEF)...
February 23, 2018: Journal of Echocardiography
Nabeel Abdulrahman, Béatrice Jaspard Vinassa, Larry Fliegel, Ayesha Jabeen, Sadaf Riaz, Alain-Pierre Gadeau, Fatima Mraiche
Cardiovascular diseases are the leading cause of death worldwide. One in three cases of heart failure is due to dilated cardiomyopathy. The Na+ /H+ exchanger isoform 1 (NHE1), a multifunctional protein and the key pH regulator in the heart, has been demonstrated to be increased in this condition. We have previously demonstrated that elevated NHE1 activity induced cardiac hypertrophy in vivo. Furthermore, the overexpression of active NHE1 elicited modulation of gene expression in cardiomyocytes including an upregulation of myocardial osteopontin (OPN) expression...
February 23, 2018: Physiological Genomics
Sofian Johar, Nazar Luqman
A left atrial appendage occluder device (Watchman) and leadless pacemaker (Micra) was implanted from a single right femoral vein access in a 73-year-old female patient with persistent atrial fibrillation and symptomatic tachy-brady syndrome and unable to take oral anticoagulants. Standard methods of implantation were followed for both procedures. The Watchman device was implanted first followed by dilatation of the same venous access site in order to implant Micra transcatheter pacing system. The patient tolerated the procedures well and there were no complications...
February 16, 2018: BMJ Case Reports
Clara Stegmann, Cosima Jahnke, Ingo Paetsch, Sebastian Hilbert, Arash Arya, Andreas Bollmann, Gerhard Hindricks, Philipp Sommer
Aims: Presence of late gadolinium enhancement (LGE) is related to adverse cardiovascular outcome. Many patients suffering from atrial fibrillation (AF) undergo cardiovascular magnetic resonance (CMR) imaging prior to ablation. Since quantification of atrial fibrosis still lacks reproducibility, we sought to investigate risk factors for the presence of left ventricular (LV)-LGE and a possible correlation between ventricular fibrosis as defined by positive LGE and pathological atrial voltage maps evaluated by 3D mapping systems...
February 6, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Enisa Hodzic, Nermir Granov
Introduction: Excess dilatation of the left atrium >65 mm is known in the literature as gigantic atrium. This dilation is most commonly encountered in the mitral insufficiency of rheumatic etiology, but also in severe prolapses of the mitral valve, permanent atrial fibrillation, and at the left right shunt with cardiac insufficiency. Case report: In this paper is presented a case study of echocardiographically verified giant thrombus in left atrium in a 50 years old female patient aged 50 hospitalized because of tiredness, choking, heartburn and urinary tract symptoms...
December 2017: Medical Archives
Hubert Cochet, Xavier Iriart, Soumaya Sridi, Claudia Camaioni, Olivier Corneloup, Michel Montaudon, François Laurent, Wieme Selmi, Pauline Renou, Zakaria Jalal, Jean-Benoît Thambo
Aims: Transoesophageal echocardiography studies have reported frequent peri-device leaks and device-related thrombi (DRT) after percutaneous left atrial appendage (LAA) occlusion. We assessed the prevalence, characteristics and correlates of leaks and DRT on cardiac computed tomography (CT) after LAA occlusion. Methods and results: Consecutive patients underwent cardiac CT before LAA occlusion to assess left atrial (LA) volume, LAA shape, and landing zone diameter...
February 2, 2018: European Heart Journal Cardiovascular Imaging
K Terziyski, A Draganova
Characterized by periodic crescendo-decrescendo pattern of breathing alternating with central apneas, Central sleep apnea (CSA) with Cheyne-Stokes Breathing represents a highly prevalent, yet underdiagnosed comorbidity in chronic heart failure (CHF). A diverse body of evidence demonstrates increased morbidity and mortality in the presence of CSB. CSB has been described in both CHF patients with preserved and reduced ejection fraction, regardless of drug treatment. Risk factors for CSB are older age, male gender, high BMI, atrial fibrillation and hypocapnia...
February 7, 2018: Advances in Experimental Medicine and Biology
Sarah Page, Jane Hallam, Neelprada Pradhan, Brian Cowie, Tuong Phan, Desmond McGlade, Alex Rosalion, Andrew Newcomb, Michael Yii
BACKGROUND: Atrial fibrillation (AF) affects 1.5-2% of the population and is associated with a five-fold increased lifetime risk of stroke [1]. The left atrial appendage (LAA) is the source of embolic strokes in up to 90% of patients with non-valvular AF with clots in the left atrium [2]. METHODS: We reviewed the clinical notes and echocardiographic findings of 20 patients who underwent open cardiac surgery in which concurrent AtriClip (Atricure Inc, Westchester, Ohio, USA) device insertion was attempted at our institution from July 2013 to February 2015...
December 22, 2017: Heart, Lung & Circulation
Anar Mammadli, Veysel Kutay Vurgun, Onur Yıldırım, Ali Timuçin Altın, Başar Candemir, Ömer Akyürek
With the increasing number of implanted pacemakers and implantable cardioverter defibrillators, removal is required more frequently. Presently described is the transvenous extraction of a 26-year-old Accufix atrial lead using a mechanical dilator sheath. A 50-year-old male patient was admitted to the clinic with a pacemaker pocket infection. The atrial lead was an Accufix Bipolar J-Atrial active fixation lead, a model that was recalled in 1994, after reports of 2 deaths and 2 nonfatal injuries related to protrusion of the J retention wire...
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Pan Pan Xia, Lian Jing Li, Run Di Qi, Jiao Jiao Shi, Wei Zhu Ju, Ming Long Chen
OBJECTIVE: Hypertension is a significant risk factor for atrial fibrillation (AF). The role of pulmonary vein (PV) remodeling in the mechanistic association between hypertension and AF is not definitive. In this study, we aimed to identify changes in the electrophysiology and histology in PVs in two-kidney, one-clip (2K1C) hypertensive rats. METHODS: Fifty male Sprague-Dawley rats were classified into the 2K1C and sham-operated groups. The systolic blood pressure was measured every 2 weeks...
January 17, 2018: Anatolian Journal of Cardiology
Ryutaro Ikegami, Kazuyuki Ozaki, Takuaya Ozawa, Satoru Hirono, Masahiro Ito, Tohru Minamino
Left main coronary compression syndrome rarely occurs in patients with severe pulmonary hypertension. A 65-year-old woman with severe pulmonary hypertension due to an atrial septal defect suffered from angina on effort. Cardiac computed-tomography and coronary angiography revealed considerable stenosis of the left main coronary artery (LMA) caused by compression between the dilated main pulmonary artery trunk and the sinus of valsalva. Stenting of the LMA under intravascular ultrasound imaging was effective for the treatment of angina...
January 11, 2018: Internal Medicine
Robyn J Tapp, Alun D Hughes, Mika Kähönen, Tien Yin Wong, Nicholas Witt, Terho Lehtimäki, Nina Hutri-Kähönen, Pinki Sahota, Markus Juonala, Olli T Raitakari
BACKGROUND: Cardiometabolic health among adult offspring of hypertensive disorders of pregnancy (HDP) is relatively unknown. We hypothesized that offspring of HDP would have abnormalities in the retinal microvasculature and cardiac structure by midadulthood. METHODS AND RESULTS: The Cardiovascular Risk in Young Finns Study included randomly selected children from 5 Finnish university cities. The mean age of participants was 40 years (range 34-49 years) at the time of retinal photography and cardiac assessment...
January 6, 2018: Journal of the American Heart Association
Ba Hamadou, Marie Ntep Ngweth, Miriam Megueo Fotso, Liliane Mfeukeu-Kuate, Ahmadou M Jingi, Jean Jacques Noubiap, Chris Nadege Nganou, Jerome Boombhi, Sylvie Ndongo Amougou, Alain Menanga, Samuel Kingue
Background: Cardiac involvement is frequent in the course of human immunodeficiency virus (HIV) infection disease. This work aimed at studying the profile of echocardiographic and electrocardiography (ECG) abnormalities in adults living with HIV (PLHIV), compared to those not infected with HIV at the treatment unit of the Yaoundé Central Hospital. Methods: We carried out a case-control study over three months at the HIV treatment unit. We included adults of both sexes, aged ≥21 years, HIV-infected (cases), and age and sex matched controls...
December 2017: Cardiovascular Diagnosis and Therapy
Jingfeng Wang, Zhenning Nie, Haiyan Chen, Xianhong Shu, Zhaohua Yang, Ruiming Yao, Yangang Su, Junbo Ge
It is now well recognized that heart failure (HF) patients with left bundle branch block (LBBB) derive substantial clinical benefits from cardiac resynchronization therapy (CRT), and LBBB has become one of the important predictors for CRT response. The conventional tachypacing-induced HF model has several major limitations, including absence of stable LBBB and rapid reversal of left ventricular (LV) dysfunction after cessation of pacing. Hence, it is essential to establish an optimal model of chronic HF with isolated LBBB for studying CRT benefits...
December 11, 2017: Journal of Visualized Experiments: JoVE
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