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Echocardiography, heart failure, endomyocardial fibrosis

Siddiq Ibrahim Khalil, Suha Khalil, Salma El Tigani, Hanan A Saad
OBJECTIVE: Endomyocardial fibrosis (EMF) is a rare disease and is often an underdiagnosed and forgotten cardiomyopathy. The objective of this study was to document the current frequency of EMF in Sudan by defining and selecting cases from patients attending the echocardiography laboratory. Additionally we aimed to create an EMF registry for Sudan. METHODS: The study started in January 2007 and is on-going. All the patients attending our echocardiography clinics in four different hospitals in Khartoum, Sudan, were included...
July 2017: Cardiovascular Journal of Africa
Stephan Schürer, Karin Klingel, Marcus Sandri, Nicolas Majunke, Christian Besler, Reinhard Kandolf, Philipp Lurz, Michael Luck, Pia Hertel, Gerhard Schuler, Axel Linke, Norman Mangner
OBJECTIVES: This study aimed to assess characteristics including endomyocardial biopsy and outcome of patients with methamphetamine (MA)-associated cardiomyopathy in a series of patients treated in Germany. BACKGROUND: MA abuse is an increasing problem worldwide. METHODS: The cases of 30 consecutive MA-abusing patients with a left ventricular (LV) ejection fraction of <40% and endomyocardial biopsy performed at initial diagnosis were analyzed...
June 2017: JACC. Heart Failure
Zahra Mirfeizi, Bahram Memar, Hoorak PourZand, Mohammad Hadi Molseghi, Arash Rezaei Shahmirzadi, Nafiseh Abdolahi
A 32-year-old pregnant woman, diagnosed with Behçet's disease 6 months earlier, presented with recent mild hemoptysis and exertional dyspnea. Transthoracic echocardiography showed an enlarged dysfunctional right ventricle. A large hypoechoic triangular-shaped mass was seen attached to the inner right ventricular wall, filling the cavity. No change in the size of the mass was noted after anticoagulant administration, and right heart failure progressed. Surgery was performed to remove the mass and repair the tricuspid valve...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
Harpreet Singh Sandhu, Sampathkumar Mahadevappa Mahendrakar, Rajebali Ramzanali Pethani, Azizullah Hafizullah Khan, Yunus Shafi Loya
Endomyocardial Fibrosis (EMF) is a form of progressive restrictive cardiomyopathy of unclear aetiology prevalent in areas within 15(0) of equator including coastal areas of Kerala a few decades back. It inflicts young adults and carries a poor prognosis due to limited options for treatment. Fortunately, the incidence of cases is now declining due to improvement in health and hygiene standards. Here, we review the aetiology and pathogenesis of EMF and report a case of a young male from Mumbai (non-endemic area) presenting with progressively worsening breathlessness and signs of heart failure unresponsive to conventional medical treatment...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
Roopali Khanna, Aditya Kapoor, Neetu Soni
Massive endocardial calcification is a rare entity. We describe a rare disease endomyocardial fibrosis associated with massive calcification of the left ventricle suspected on a chest X-ray and confirmed by echocardiography and computed tomography in an 18-year-old female presenting with breathlessness and congestive heart failure.
July 2016: Heart Views: the Official Journal of the Gulf Heart Association
Suneesh Kalliath, Rajesh Gopalan Nair, Haridasan Vellani
A 48-year-old man presented with chronic right sided heart failure. 2D echocardiography revealed the classical features of left ventricular endomyocardial fibrosis with a prominent right ventricular apical aneurysm. Right ventriculography further defined the aneurysm. Cardiac magnetic resonance images revealed a thin-walled, apical aneurysm of right ventricle with multiple septations and marked obliteration of left ventricular apex. A delayed-enhancement sequence after the infusion of contrast, demonstrated a hypersignal in the subendocardium, consistent with the right ventricular involvement of endomyocardial fibrosis...
September 2016: Indian Heart Journal
Reinaldo B Bestetti, Carolina Baraldi A Restini, Lucélio B Couto
The scientific construction of chronic Chagas heart disease (CCHD) started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922...
July 2016: Arquivos Brasileiros de Cardiologia
Clovis Nkoke, Alain Menanga, Jerome Boombhi, David Chelo, Samuel Kingue
BACKGROUND: Acquired heart diseases (AHD) in children cause significant morbidity and mortality especially in low resource settings. There is limited description of acquired childhood heart diseases in Cameroon, making it difficult to estimate its current contribution to childhood morbidity and mortality. Echocardiography is the main diagnostic modality in low resource settings and has a key role in the characterization and management of these disorders. We aimed to determine the prevalence and spectrum of AHD in children in Yaoundé-Cameroon, in an era of echocardiography...
December 2015: Cardiovascular Diagnosis and Therapy
Karin A L Mueller, Iris I Mueller, David Eppler, Christine S Zuern, Peter Seizer, Ulrich Kramer, Ina Koetter, Martin Roecken, Reinhard Kandolf, Meinrad Gawaz, Tobias Geisler, Joerg C Henes, Karin Klingel
BACKGROUND: Cardiac involvement in systemic sclerosis (SSc) is associated with a variable phenotype including heart failure, arrhythmias and pulmonary hypertension. The aim of the present study was to evaluate clinical characteristics, histopathological findings and outcome of patients with SSc and a clinical phenotype suggesting cardiac involvement. METHODS AND RESULTS: 25 patients with SSc and clinical signs of cardiac involvement were included between June 2007 and December 2010...
2015: PloS One
Ana Olga Mocumbi
Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy of unknown origin, affecting predominantly the right side of the heart. Its highest prevalence is in poor regions of sub-Saharan Africa, where it is usually found in children and adolescents. In areas where it is endemic, EMF is a major cause of heart failure and premature death. EMF of the right ventricle has unique clinical, electrocardiographic, and echocardiographic signs. Several features of advanced disease are not fully understood, the most striking being the presence of severe ascites with little or no pedal edema...
September 2014: Pulmonary Circulation
Nadezhda Glezeva, Joe Gallagher, Mark Ledwidge, John O'Donoghue, Kenneth McDonald, John Chipolombwe, Chris Watson
Within Africa, the burden of heart failure is significant. This arises from the increase in cardiovascular disease and associated risk factors such as hypertension and diabetes, as well as causes of heart failure which are particular to sub-Saharan Africa, such as endomyocardial fibrosis. The lack of access to echocardiography and other imaging modalities, from a cost and technical perspective, combined with the predominantly rural nature of many countries with poor transport links, means that the vast majority of people never obtain an appropriate diagnosis...
May 2015: Tropical Medicine & International Health: TM & IH
D A Bohara, M S Ghogare, A R Taksande, A U Mahajan, P J Nathani
We report a 30 year female with rheumatic mitral stenosis, presenting with progressive right heart failure without overt leftheart symptoms. Rapid progression to severe right heart failure with moderate pericardial effusion prompted the diagnosis of associated restrictive cardiomyopathy. A MRI scan of the heart revealed diffuse subendocardial scarring of LV and RV explaining patient's rapid downhill course.
May 2014: Journal of the Association of Physicians of India
Yusuke Morita, Takao Kato, Mitsumasa Okano, Kanae Su, Masahiro Kimura, Eri Minamino, Eisaku Nakane, Toshiaki Izumi, Shoichi Miyamoto, Tetsuya Haruna, Moriaki Inoko
The mechanisms responsible for the development of apical aneurysms in cases of hypertrophic cardiomyopathy (HCM) are currently unclear but likely involve multiple factors. Here, we present a case of HCM with marked subendocardial fibrosis involving the apical and proximal portions of the left ventricle. A 71-year-old man with left ventricular hypertrophy presented with signs and symptoms of heart failure. The presence of asymmetrical left ventricular hypertrophy and bilateral, thickened ventricular walls with an apical aneurysm on transthoracic echocardiography suggested a diagnosis of HCM with ventricular dysfunction...
2014: Case Reports in Radiology
Lilia Zakhama, Iskander Slama, Elhem Boussabah, Basma Harbegue, Majdi Mimouni, Nabil Abdelaali, Sana Sioua, Moez Thameur, Soraya Benyoussef
Hypereosinophilic syndrome (HES) is defined as a prolonged, unexplained peripheral eosinophilia. Endomyocardial fibrosis and mural thrombus formation are common occurrences such that patients are exposed to lethal thromboembolic complications. The valvular damage described is mainly related to iterative valve thromboses that are amenable to surgery. Here, the case is reported of a 39-year-old woman suffering from HES with mitral valve thrombosis and mechanical prosthetic mitral valve replacement, in whom a new thrombosis of the inserted prosthesis occurred one month postoperatively, concomitant with severe hypereosinophilia and despite adequate anticoagulation...
March 2014: Journal of Heart Valve Disease
Saburo Kusumoto, Hiroaki Kawano, Tomayoshi Hayashi, Osami Satoh, Tsuyoshi Yonekura, Masamichi Eguchi, Masayoshi Takeno, Akira Tsuneto, Yuji Koide, Tatsuro Jo, Koji Maemura
A 31-year-old woman with primary mediastinal large B-cell lymphoma refractory to conventional chemotherapy was treated with high-dose chemotherapy containing cyclophosphamide (CY). Subsequently, she was treated with auto peripheral blood stem cell transplantation. Although a complete remission was obtained, heart failure developed two months later. Echocardiography showed an impaired systolic function with pericardial effusion. A biopsy of the endomyocardial region from the left ventricle demonstrated spotty myocardial hemorrhage and myocardial fibrosis with disruption and aggregation of mitochondrial cristae...
2013: Internal Medicine
Tonino Bombardini, Sonia Gherardi, Ornella Leone, Rosa Sicari, Eugenio Picano
BACKGROUND: Due to the shortage of donor hearts, the criteria for acceptance have been considerably expanded. Hearts with regional or global left ventricular dysfunction are excluded from donation, but stress echo might be useful to identify patients with reversible wall motion abnormalities, potentially eligible for donation. METHODS: Six marginal candidate donors (mean age, 40 ± 13 years; three men) were enrolled. Resting echocardiography showed in all subjects a LV ejection fraction ≥ 45% (mean 51 ± 5%), but multiple risk factors were present...
August 2, 2013: Cardiovascular Ultrasound
David Backhoff, Michael Steinmetz, Wolfgang Ruschewski, Barbara Stastny, Reinhard Kandolf, Ulrich Krause
We report on a 9-year-old girl who developed signs of congestive heart failure with significant ascites due to constrictive pericarditis. Cardiac catheterization was performed to establish the diagnosis and to rule out restrictive cardiomyopathy. Endomyocardial biopsies were positive for activated macrophages and small-vessel disease, but no viral genomes were detected. Open pericardectomy was performed and histopathologic examination of the resected thickened pericardium showed extensive fibrosis and hyaline degeneration...
2013: Pediatric Cardiology
Antonio Fiore, Antonino Massimiliano Grande, Carlo Pellegrini, Mario Viganò, Massimo Massetti
We report a successful follow-up after 28 years of a woman with obliterative restrictive endomyocardial fibrosis (EMF) that underwent complete surgical decortication with simultaneous mitral and tricuspid bioprosthetic valve replacement in 1982 and underwent successful reoperation for the structural failure of biological prostheses after 25 years.
November 2013: Journal of Cardiac Surgery
Xinfeng Wang, Yanhe Zhu, Xinghui Wang, Yubai Yang, Shaoli Cheng
BACKGROUND: Calcitriol (CAL), an active form of vitamin D, plays a vital role in controlling cardiac hypertrophy and heart failure. The aim of the present study is to explore the effects of CAL and to elucidate its underlying mechanisms on myocardial injury induced by isoproterenol (ISO). METHODS: Myocardial impairment was induced by the subcutaneous injection of ISO in adult male Sprague-Dawley rats, and the therapeutic effect of CAL was assessed. Biometric and echocardiographic parameters, interstitial fibrosis, oxidant-antioxidant status, and protein expression relevant to the mitochondrial apoptosis pathway were then measured...
July 2013: Journal of Cardiovascular Pharmacology and Therapeutics
Andrea Frustaci, Marco Francone, Nicola Petrosillo, Cristina Chimenti
AIMS: Structural abnormalities causing cardiac deterioration in hypertensive heart disease (HHD) are poorly understood. The aim of the study was to evaluate left ventricular (LV) myocardial changes in patients with HHD and cardiac failure. METHODS AND RESULTS: Among 1229 patients undergoing an LV or biventricular endomyocardial biopsy because of unexplained LV dysfunction from 2000 to 2010, 45 had HHD. The HHD population had non-invasive assessment of cardiac wall thickness, diameters, and function; endomyocardial samples were processed for histology, immunohistochemistry, and polymerase chain reaction (PCR) for cardiotropic viruses...
March 2013: European Journal of Heart Failure
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