keyword
https://read.qxmd.com/read/38401826/frequent-pocus-and-auscultation-for-an-earlier-diagnosis-of-takotsubo-syndrome-and-unraveling-of-its-pathophysiology-the-possible-crucial-role-of-lvoto
#1
REVIEW
John E Madias
There is ample literature associating LVOTO with hypertension, AMI, LV hypertrophy, sigmoid septum, HCM, and TTS, particularly in midde aged/elderly/postmenopausal women, suggestive of a causal role for LVOTO in the pathophysiology of TTS. Although there is significant evidence that TTS is triggered by a sudden autonomic sympathetic nervous system surge and/or elevated blood-ridden catecholamines, the exact pathophysiologic trajectory leading to the clinical expression of the disease is still being debated...
February 22, 2024: Current Problems in Cardiology
https://read.qxmd.com/read/38392253/takotsubo-syndrome-and-coronary-artery-disease-which-came-first-the-chicken-or-the-egg
#2
REVIEW
Mihail Celeski, Annunziata Nusca, Valeria Maria De Luca, Giorgio Antonelli, Valeria Cammalleri, Rosetta Melfi, Fabio Mangiacapra, Elisabetta Ricottini, Paolo Gallo, Nino Cocco, Raffaele Rinaldi, Francesco Grigioni, Gian Paolo Ussia
Takotsubo syndrome (TTS) is a clinical condition characterized by temporary regional wall motion anomalies and dysfunction that extend beyond a single epicardial vascular distribution. Various pathophysiological mechanisms, including inflammation, microvascular dysfunction, direct catecholamine toxicity, metabolic changes, sympathetic overdrive-mediated multi-vessel epicardial spasms, and transitory ischemia may cause the observed reversible myocardial stunning. Despite the fact that TTS usually has an acute coronary syndrome-like pattern of presentation, the absence of culprit atherosclerotic coronary artery disease is often reported at coronary angiography...
January 26, 2024: Journal of Cardiovascular Development and Disease
https://read.qxmd.com/read/38306116/effect-of-intradialytic-exercise-on-cardiovascular-outcomes-in-maintenance-hemodialysis-a-systematic-review-and-meta-analysis
#3
JOURNAL ARTICLE
Davide Verrelli, Ajaya Sharma, Jamie Alexiuk, Quinn Tays, Krista Rossum, Monica Sharma, Emilie Ford, Alla Iansavichene, Ahmed A Al-Jaishi, Reid Whitlock, Christopher W McIntyre, Amit X Garg, Clara Bohm
BACKGROUND: Cardiovascular disease is the leading cause of death among people with kidney failure on hemodialysis, for whom improving cardiovascular health is a research priority. Intradialytic myocardial stunning is common and associated with adverse cardiovascular events. Intradialytic exercise may mitigate intradialytic myocardial stunning and improve cardiovascular structure and function. This systematic review investigated the effect of intradialytic exercise on cardiovascular outcomes in adults undergoing maintenance hemodialysis (PROSPERO #CRD42018103118)...
February 2, 2024: Kidney360
https://read.qxmd.com/read/38264990/data-independent-acquisition-proteomics-and-n-terminomics-methods-reveal-alterations-in-mitochondrial-function-and-metabolism-in-ischemic-reperfused-hearts
#4
JOURNAL ARTICLE
Bridgette Hartley, Wesam Bassiouni, Andrej Roczkowsky, Richard Fahlman, Richard Schulz, Olivier Julien
Myocardial ischemia-reperfusion (IR) (stunning) injury triggers changes in the proteome and degradome of the heart. Here, we utilize quantitative proteomics and comprehensive degradomics to investigate the molecular mechanisms of IR injury in isolated rat hearts. The control group underwent aerobic perfusion, while the IR injury group underwent 20 min of ischemia and 30 min of reperfusion to induce a stunning injury. As MMP-2 activation has been shown to contribute to myocardial injury, hearts also underwent IR injury with ARP-100, an MMP-2-preferring inhibitor, to dissect the contribution of MMP-2 to IR injury...
January 24, 2024: Journal of Proteome Research
https://read.qxmd.com/read/38242191/the-spectrum-of-post-myocardial-infarction-care-from-acute-ischemia-to-heart-failure
#5
REVIEW
Khawaja Hassan Akhtar, Muhammad Shahzeb Khan, Suzanne J Baron, Shelley Zieroth, Jerry Estep, Daniel Burkhoff, Javed Butler, Marat Fudim
Heart failure (HF) is the leading cause of mortality in patients with acute myocardial infarction (AMI), with incidence ranging from 14% to 36% in patients admitted due to AMI. HF post-MI develops due to complex inter-play between macrovascular obstruction, microvascular dysfunction, myocardial stunning and remodeling, inflammation, and neuro-hormonal activation. Cardiogenic shock is an extreme presentation of HF post-MI and is associated with a high mortality. Early revascularization is the only therapy shown to improve survival in patients with cardiogenic shock...
January 17, 2024: Progress in Cardiovascular Diseases
https://read.qxmd.com/read/38228458/acute-obstructive-hydrocephalus-an-unexpected-cause-of-cardiac-arrest
#6
JOURNAL ARTICLE
Ryan Barnicle, Alexander Bracey, Alison Rosser, David Gordon
BACKGROUND: Emergency physicians are well-versed in managing cardiac arrests, including the diagnostic and therapeutic steps after return of spontaneous circulation. Neurologic emergencies are a common cause of out-of-hospital cardiac arrest and must remain high in the differential diagnosis, as such cases often require specific interventions that may deviate from more common care pathways. Performing a noncontrast head computed tomography (NCHCT) scan after cardiac arrest has been found to change management, although the optimal timing of this imaging is unclear...
July 20, 2023: Journal of Emergency Medicine
https://read.qxmd.com/read/38201409/diagnostic-methods-in-forensic-pathology-autoptic-findings-and-immunohistochemical-study-in-cases-of-sudden-death-due-to-a-colloid-cyst-of-the-third-ventricle
#7
Angelo Montana, Francesco Paolo Busardò, Giovanni Tossetta, Gaia Goteri, Pasqualina Castaldo, Giuseppe Basile, Giulia Bambagiotti
The colloid cyst is a non-malignant tumor growth made of a gelatinous material covered by a membrane of epithelial tissue. It is usually located posterior to the foramen of Monro, in the anterior aspect of the third ventricle of the brain. Due to its location, it can cause obstructive hydrocephalus, increased intracranial pressure, and sudden cardiac death, catecholamine-mediated, through hypothalamus compression. All the mechanisms are still controversial, but the role of catecholamine has been confirmed with histological findings that highlighted myocardial injury (coagulative myocytolysis and contraction band necrosis, CBN)...
January 1, 2024: Diagnostics
https://read.qxmd.com/read/38198166/home-dialysis-in-patients-with-cardiovascular-diseases
#8
JOURNAL ARTICLE
Allison C Reaves, Daniel E Weiner, Mark J Sarnak
Kidney failure with replacement therapy and cardiovascular disease are frequently comorbid. In patients with kidney failure with replacement therapy, cardiovascular disease is a major contributor to morbidity and mortality. Conventional thrice-weekly in-center dialysis confers risk factors for cardiovascular disease, including acute hemodynamic fluctuations and rapid shifts in volume and solute concentration. Home hemodialysis and peritoneal dialysis (PD) may offer benefits in attenuation of cardiovascular disease risk factors primarily through improved volume and BP control, reduction (or slowing progression) of left ventricular mass, decreased myocardial stunning, and improved bone and mineral metabolism...
February 6, 2024: Clinical Journal of the American Society of Nephrology: CJASN
https://read.qxmd.com/read/38090463/broken-heart-a-clear-case-of-takotsubo-cardiomyopathy
#9
Mohamed A Ibrahim, Moayad A Elgassim, Amro Abdelrahman, Wala Sati, Hany A Zaki, Mohamed Elgassim
Takotsubo cardiomyopathy (TC) is a recognized clinical syndrome characterized by reversible cardiomyopathy with a distinctive left ventricular apical ballooning appearance. TC is associated with risk factors such as estrogen deficiency, emotional and physical stress, and genetic factors. The clinical presentation of TC can be like that of a myocardial infarction. While catecholamine-induced myocardial stunning is suggested by current evidence, the exact pathophysiological mechanisms remain uncertain. Diagnostic criteria, including the InterTAK Diagnostic Criteria, have been established by the Takotsubo International Registry...
November 2023: Curēus
https://read.qxmd.com/read/38044153/hemodialysis-induced-myocardial-stunning-with-no-obstructive-coronary-artery-disease-pathophysiological-significance-of-coronary-microvascular-dysfunction
#10
JOURNAL ARTICLE
Masashi Yokoi, Tsuyoshi Ito, Wataru Suzuki, Junki Yamamoto, Takafumi Nakayama, Taku Ichihashi, Shohei Kikuchi, Shuichi Kitada, Toshihiko Goto, Yoshihiro Seo
Hemodialysis (HD)-induced myocardial stunning, characterized by transient left ventricular systolic dysfunction during HD, has been reported to be common and associated with a poor prognosis. However, the pathophysiology is not fully understood. We herein report a case of HD-induced myocardial stunning without obstructive coronary artery disease complicated by coronary microvascular dysfunction (CMD), suggesting that CMD plays a crucial role in the pathophysiology of this disease.
December 4, 2023: Internal Medicine
https://read.qxmd.com/read/37932606/transient-loss-of-atrial-capture-the-atrial-pacemaker-stunning-phenomenon
#11
REVIEW
S Serge Barold
Atrial loss of capture in the chronic phase after implantation may be permanent due to various causes, e.g. technical lead problems or increased scar tissue formation around the lead tip. However, it may also be transient after atrial ischemia in the context of occlusion of the right coronary artery. In this case, it may be preferable to wait for recovery, which may take up to 45 days, instead of immediately performing an atrial lead revision.
November 6, 2023: Herzschrittmachertherapie & Elektrophysiologie
https://read.qxmd.com/read/37909841/neurogenic-myocardial-dysfunction-post-craniopharyngioma-resection-a-diagnostic-dilemma
#12
Ashwini Reddy, Priya Thappa, Kiran Jangra, Sivashanmugam Dhandapani, Bhupendra Kumar Sihag
Endoscopic transsphenoidal resection of craniopharyngioma is a commonly used technique. Cerebral vasospasm may occur in nearly 10% of cases leading to adverse neurological outcomes. Cardiopulmonary dysfunction may be seen in patients with severe vasospasm. The literature describing the occurrence of neurogenic stunned myocardium following craniopharyngioma resection in pediatric patients is very sparse. Here, we describe such a case managed with a combination of milrinone (to relieve vasospasm and improve cardiac pump function), noradrenaline (to obtain target blood pressure), and vasopressin (to control urine output)...
November 1, 2023: Paediatric Anaesthesia
https://read.qxmd.com/read/37901981/-persistent-st-elevation-with-elevated-myocardial-necrosis-markers-a-case-of-myocardial-contusion
#13
JOURNAL ARTICLE
Miriam Stucchi, Michele Galasso, Lorenzo De Censi, Antonio Cirò, Patrizia Pedrotti, Cristina Giannattasio
Myocardial contusion is a rare and potentially fatal complication of chest trauma. There is no unique definition for this entity: some authors define myocardial contusion as a mild increase in cardiac biomarkers in the context of chest trauma, while for others the diagnosis requires evidence of pathologic findings at cardiac imaging. Consequently, the real incidence of myocardial contusion remains unknown, varying in reports between 8% and 71%. We describe a case of cardiac contusion secondary to a low-energy blunt chest trauma, manifesting as persistent ST-elevation associated with elevation of myocardial necrosis markers, with consequent myocardial stunning of the right ventricular free wall...
November 2023: Giornale Italiano di Cardiologia
https://read.qxmd.com/read/37898977/the-role-and-mechanisms-of-microvascular-damage-in-the-ischemic-myocardium
#14
REVIEW
Bang-Hao Zhao, Amanguli Ruze, Ling Zhao, Qiu-Lin Li, Jing Tang, Nilupaer Xiefukaiti, Min-Tao Gai, An-Xia Deng, Xue-Feng Shan, Xiao-Ming Gao
Following myocardial ischemic injury, the most effective clinical intervention is timely restoration of blood perfusion to ischemic but viable myocardium to reduce irreversible myocardial necrosis, limit infarct size, and prevent cardiac insufficiency. However, reperfusion itself may exacerbate cell death and myocardial injury, a process commonly referred to as ischemia/reperfusion (I/R) injury, which primarily involves cardiomyocytes and cardiac microvascular endothelial cells (CMECs) and is characterized by myocardial stunning, microvascular damage (MVD), reperfusion arrhythmia, and lethal reperfusion injury...
October 29, 2023: Cellular and Molecular Life Sciences: CMLS
https://read.qxmd.com/read/37799569/incidental-cerebral-aneurysm-after-takotsubo-cardiomyopathy-a-case-report
#15
Tânia Amaro, Taynara Sgarbi, Raísa Vieira, Rafael Reis Santos, Priscila Matos, Adilson Oliveira
Takotsubo syndrome (TS) is an acute heart disease that mimics the typical features of acute coronary syndrome (ACS). TS is generally reported after subarachnoid hemorrhage (SAH) due to a ruptured aneurysm, and has an incidence rate of 0.8 (17%). Here, we report a rare case of TS with unruptured intracranial aneurism. A 54-year-old woman had a history of systemic arterial hypertension and migraine. She went to a secondary hospital 2 h after sudden-onset chest pain, which irradiated to the left upper limb and back...
October 2023: Clinical Case Reports
https://read.qxmd.com/read/37753645/does-cooled-dialysate-still-have-a-role-in-reducing-intradialytic-stress-implications-of-the-mytemp-trial
#16
JOURNAL ARTICLE
Katherine L Hull, Chris McIntyre, James O Burton
PURPOSE OF REVIEW: There is an excess of cardiovascular morbidity and mortality in the maintenance haemodialysis population. Targeting traditional risk factors (e.g. hypercholesterolaemia) do not improve cardiovascular outcomes. Repeated myocardial stunning during haemodialysis is an important nontraditional risk, resulting in pathological cardiac remodelling and fibrosis. This review explores dialysate cooling as a management strategy to promote haemodynamic stability, reduce myocardial injury, and improve cardiovascular disease outcomes for individuals receiving maintenance haemodialysis...
November 1, 2023: Current Opinion in Nephrology and Hypertension
https://read.qxmd.com/read/37692621/distal-limb-ischaemia-in-association-with-takotsubo-cardiomyopathy
#17
Keng Han Yeap, Charles Badu-Boateng, Mark Lloyd
Raynaud's phenomenon (RP) is a common clinical condition associated with digital ischaemia. A 73-year-old woman with a history of RP presented with bilateral distal lower limb ischaemia. Although no chest pain was reported, her serum troponin was greater than 25,000 ng/ml with lateral lead ST-segment elevation on ECG. Her coronary angiogram was normal, but echocardiography revealed a hypokinetic apical region consistent with Takotsubo cardiomyopathy. She was treated with iloprost, but her toes became necrotic, mummified and auto-amputated over six months...
August 2023: Curēus
https://read.qxmd.com/read/37675381/non-invasive-intradialytic-percutaneous-perfusion-monitoring-a-view-to-the-heart-through-the-skin
#18
JOURNAL ARTICLE
Jarrin D Penny, Lisa Hur, Fabio R Salerno, Dickson Wong, M Hussain Jan, Christopher W McIntyre
INTRODUCTION: The life-sustaining treatment of hemodialysis (HD) induces recurrent and cumulative systemic circulatory stress resulting in cardiovascular injury. These recurrent insults compound preexisting cardiovascular sequalae leading to the development of myocardial injury and resulting in extremely high morbidity/mortality. This is largely a consequence of challenged microcirculatory flow within the myocardium (evidenced by detailed imaging-based studies). Currently, monitoring during HD is performed at the macrovascular level...
2023: Front Nephrol
https://read.qxmd.com/read/37540842/from-neurocardiology-to-stroke-heart-syndrome
#19
JOURNAL ARTICLE
Ileana Raluca Nistor, Leonida Gherasim
The Stroke-Heart Syndrome is a major chapter in neurocardiology. Both brain-heart and stroke-heart correlations are based on neurophysiological studies that define and describe the relation between the central autonomic system and cardiac function and it will be presented in this narrative review. The Stroke-Heart syndrome groups the entire spectrum of cardiac changes - clinical, ECG, echocardiographic, biological, morphological - that occur in the first 30 days from the onset of stroke, especially in the first days...
August 4, 2023: Romanian Journal of Internal Medicine
https://read.qxmd.com/read/37525758/takotsubo-cardiomyopathy-triggered-by-acute-intermittent-porphyria
#20
JOURNAL ARTICLE
Talal Alzahrani
Background Takotsubo cardiomyopathy (TC) is a reversible condition characterized by myocardial akinesis due to catecholamine-mediated myocardial stunning. Acute intermittent porphyria (AIP) is associated with a rise in catecholamine, which could trigger TC. This study aims to evaluate patients with porphyria-triggered TC. Methods Data from the National Inpatient Sample (NIS) was used to study the prevalence rate and clinical outcome of porphyria-triggered TC among patients with TC. Results Overall, 32,500 cases were admitted between 2012 and 2016 with TC...
June 2023: Curēus
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