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Right ventricular dysfunction

Wail Alkashkari, Amani Alsubei, Ziyad M Hijazi
PURPOSE OF REVIEW: The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction...
March 15, 2018: Current Cardiology Reports
Stanimir Georgiev, Daniel Tanase, Peter Ewert, Christian Meierhofer, Alfred Hager, Jelena Pabst von Ohain, Andreas Eicken
BACKGROUND: To investigate the feasibility and mid-term results of percutaneous pulmonary valve implantation (PPVI) in patients with conduit free or "native" right ventricular outflow tracts (RVOT). METHODS AND RESULTS: We identified all 18 patients with conduit free or "native" right ventricular outflow tract, who were treated with percutaneous pulmonary valve implantation (PPVI) in our institution. They were divided into two groups - these in whom the central pulmonary artery was used as an anchoring point for the preparation of the landing zone (n=10) for PPVI and these, in whom a pulmonary artery branch was used for this purpose (n=8)...
May 1, 2018: International Journal of Cardiology
Luke S Howard
Acute pulmonary embolism (PE) is a relatively common cardiopulmonary emergency that is a major cause of hospitalization and morbidity and is the primary cause of mortality associated with venous thromboembolism (VTE). During the last decade, one of the biggest changes in the management of PE has been the approval of four non-vitamin K antagonist oral anticoagulants (NOACs; apixaban, dabigatran, edoxaban and rivaroxaban) for the treatment of PE and deep vein thrombosis and secondary prevention of VTE. Areas covered: This article reviews the evolving management of PE in the NOAC era and addresses three fundamental questions: who should receive NOACs over conventional heparin/vitamin K antagonist regimens for the treatment of acute PE; whether patients should be treated as inpatients or outpatients; and how long patients should be treated to reduce the risk of recurrence? Expert commentary: The management of PE is changing...
March 15, 2018: Expert Review of Respiratory Medicine
Yuchi Han, Paul R Forfia, Anjali Vaidya, Jeremy A Mazurek, Myung H Park, Gautam Ramani, Stephen Y Chan, Aaron B Waxman
Introduction: A major determining factor on outcomes in patients with pulmonary arterial hypertension (PAH) is right ventricular (RV) function. Ranolazine, which is currently approved for chronic stable angina, has been shown to improve RV function in an animal model and has been shown to be safe in small human studies with PAH. We aim to study the effect of ranolazine on RV function using cardiovascular magnetic resonance (CMR) in patients with pulmonary hypertension (non-group 2 patients) and monitor the effect of ranolazine on metabolism using metabolic profiling and changes of microRNA...
2018: Open Heart
Sophie Malekzadeh-Milani, Ali Houeijeh, Zakaria Jalal, Sébastien Hascoet, Mohamed Bakloul, Philippe Aldebert, Jean-François Piéchaud, François Heitz, Helene Bouvaist, Claire Dauphin, Patrice Guérin, Olivier Villemain, Jérome Petit, François Godart, Jean-Benoit Thambo, Younes Boudjemline
BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) is a routine treatment for dysfunctional right ventricular outflow tract. Infective endocarditis (IE) is a major concern. AIM: To report French experience with the Melody™ valve (Medtronic Inc., Minneapolis, MN, USA). METHODS: All patients who underwent PPVI were recorded in a multicentre French national survey. Demographic and procedural data were collected from patients with IE...
March 9, 2018: Archives of Cardiovascular Diseases
Frederik Helsen, Pieter De Meester, Alexander Van De Bruaene, Charlien Gabriels, Béatrice Santens, Mathias Claeys, Guido Claessen, Kaatje Goetschalckx, Roselien Buys, Marc Gewillig, Els Troost, Jens-Uwe Voigt, Piet Claus, Jan Bogaert, Werner Budts
BACKGROUND: To evaluate the relationship between right ventricular (RV) systolic dysfunction at rest and reduced exercise capacity in patients with a systemic RV (sRV). METHODS: All patients with congenitally corrected transposition of the great arteries (ccTGA) or complete TGA after atrial switch (TGA-Mustard/Senning) followed in our institution between July 2011 and September 2017 who underwent cardiac imaging within a six-month time period of cardiopulmonary exercise testing (CPET) were analyzed...
March 8, 2018: International Journal of Cardiology
Mark Dennis, Irina Kotchetkova, Rachael Cordina, David S Celermajer
BACKGROUND: The atrial switch operation for transposition of the Great Arteries (TGA) (Mustard or Senning Procedure) provides excellent short-term survival. Significant long-term concerns exist for these patients, however, including the ability of the right ventricle to maintain systemic perfusion and the risk of arrhythmia. We seek to describe long-term mortality and morbidity of this group of adult patients. METHODS: Consecutive patients who had undergone an atrial switch procedure, who were aged over 16 years and who were followed up at our tertiary level adult congenital heart disease (ACHD) service in Sydney, Australia since 2000 were included...
October 31, 2017: Heart, Lung & Circulation
Vasiliki V Georgiopoulou, Arash Velayati, Greg Burkman, Song Li, Kanwal Farooq, Ayman Samman-Tahhan, Lampros Papadimitriou, Javed Butler, Andreas P Kalogeropoulos
Patients with heart failure and preserved ejection fraction (HFpEF) tend to be older and have a high co-morbidity burden. The impact of co-morbid conditions and sociodemographic risk factors on outcomes in these patients has not been quantified. We evaluated 445 consecutive outpatients with HFpEF, defined as established diagnosis of heart failure (HF) with left ventricular ejection fraction at presentation >40% and no previous left ventricular ejection fraction ≤40%. Patients with specific cardiomyopathies, congenital heart disease, primary right-sided disease, valvular disease, or previous advanced HF therapies were excluded...
February 12, 2018: American Journal of Cardiology
Eoin Donnellan, Dermot Phelan
PURPOSE OF THE REVIEW: Markers of myocardial stress, including troponin, creatine kinase, and brain natriuretic peptide are frequently elevated after endurance athletic pursuits. Here, we summarize the current literature pertaining to the potential mechanism of cardiac enzyme release in athletes and seek to determine the clinical implications of these findings. RECENT FINDINGS: Recent studies have highlighted the potential adverse cardiac effects of long-term extreme endurance exercise...
March 8, 2018: Current Heart Failure Reports
Emilie Jean-St-Michel, James M Meza, Jonathon Maguire, John Coles, Brian W McCrindle
Ventricular dysfunction affects survival in patients with single right ventricle (RV), and remains one of the primary indications for heart transplantation. Since it is challenging to predict the capacity of patients with ventricular dysfunction to proceed to the stage II procedure, we sought to identify factors that would be associated with death or heart transplantation without achieving stage II for single RV patients with ventricular dysfunction after Norwood procedure. The Single Ventricle Reconstruction (SVR) trial public-use database was used...
March 8, 2018: Pediatric Cardiology
M Barczuk-Falęcka, Ł A Małek, D Roik, K Werys, B Werner, M Brzewski
AIM: To assess the accuracy of simple cardiovascular magnetic resonance imaging (CMR) parameters for first-line analysis of right ventricle (RV) dysfunction in children to identify those who require in-depth analysis and those in whom simple assessment is sufficient. MATERIALS AND METHODS: Sixty paediatric CMR studies were analysed. The following CMR parameters were measured: RV end-diastolic and end-systolic area (4CH EDA and 4CH ESA), fractional area change (FAC), RV diameter in end-diastole (RVD1), tricuspid annular plane systolic excursion (TAPSE), and RV outflow tract diameter in end-diastole (RVOT prox)...
March 6, 2018: Clinical Radiology
Shaolei Ma, Yujie Wang, Xiangrong Zuo, Jing Yao, Quan Cao
OBJECTIVE: To explore the effect of acute respiratory distress syndrome (ARDS) induced by endotoxin on the right ventricular function in rats. METHODS: Sixty male Sprague-Dawley (SD) rats were randomly divided into normal saline (NS) control group and lipopolysaccharide (LPS) model group with 30 rats in each group. The rat model of ARDS was reproduced by intratracheal instillation of LPS 10 mg/kg after tracheotomy, and the rats in NS control group was intratracheally given the same volume of NS instead of LPS...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Indranee Rajapreyar, Deepak Acharya, José Tallaj, Lauren Hornbuckle, Jessica Sharpton, Joanna Joly, Salpy Pamboukian
Ventricular arrhythmias occurs in 20-50% of patients supported with left ventricular assist devices (LVAD). Ventricular arrhythmias are well tolerated with LVAD support but long-term consequences include worsening right ventricular function. Management of ventricular arrhythmias in LVAD patients includes use of antiarrhythmic agents or ablation. Amiodarone has been used a first-line agent to treat ventricular arrhythmias post-LVAD implantation. Chronic treatment with amiodarone for arrhythmias can result in hyperthyroidism and hypothyroidism in 5-10% of patients...
March 5, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Michal Hulman, Panagiotis Artemiou, Matej Ondrusek, Vladan Hudec, Ivo Gasparovic, Martin Bena, Ivan Glonek
OBJECTIVES: Primary graft dysfunction (PGD) is a devastating complication and the most common cause of early death following a heart transplant. The goal of this study was to report our experience of using mechanical circulatory support to manage severe PGD. METHODS: Following 208 heart transplants performed between January 2007 and May 2017, 14 (6.7%) patients presented with severe PGD. We provided haemodynamic support using the following approaches: a venoarterial extracorporeal membrane oxygenation device, left ventricular assist device, right ventricular assist device and biventricular assist device...
March 5, 2018: Interactive Cardiovascular and Thoracic Surgery
Louise Kezerle, Iftach Sagy, Leah Shalev, Offer Erez, Leonid Barski
OBJECTIVES: Peripartum cardiomyopathy (PPCM) is a serious complication of pregnancy. Studies investigating the risk factors that worsen outcomes have yielded conflicting results. The goals of this study were to describe the clinical and echocardiographic characteristics of PPCM in a single tertiary center and to determine the prognostic factors associated with persistence of left ventricular (LV) dysfunction in these women. STUDY DESIGN: This retrospective cross-sectional population-based cohort study included all patients with PPCM confirmed by echocardiography who delivered at our center from 2004 to 2014...
February 1, 2018: Rambam Maimonides Medical Journal
Takeshi Yamamoto
High-risk pulmonary embolism (PE) is a life-threatening disorder associated with high mortality and morbidity. Most deaths in patients with shock occur within the first few hours after presentation, and rapid diagnosis and treatment is therefore essential to save patients' lives. The main manifestations of major PE are acute right ventricular (RV) failure and hypoxia. RV pressure overload is predominantly related to the interaction between the mechanical pulmonary vascular obstruction and the underlying cardiopulmonary status...
2018: Journal of Intensive Care
Jovana Jeremic, Tamara Nikolic Turnic, Vladimir Zivkovic, Nevena Jeremic, Isidora Milosavljevic, Ivan Srejovic, Radmila Obrenovic, Snezana Jancic, Milena Rakocevic, Stevan Matic, Dragan Djuric, Vladimir Jakovljevic
This research is designed to test the hypothesis that elevated homocysteine (Hcy) levels in vivo, caused by a deficit in vitamin B complex, promote changes in cardiac function and redox status that lead to heart failure. In order to conduct the study, we used adult male Wistar albino rats (n=30; 4 weeks old; 100±15 g body weight). Hyperhomocysteinemia (HHcy) in these animals was achieved by dietary manipulation. For 4 weeks, the animals were fed with a standard rodent chow (control - CF), a diet enriched in methionine with no deficiency in B vitamins (i...
March 6, 2018: Clinical and Experimental Pharmacology & Physiology
Adalena Tsatsopoulou, Eduardo Bossone
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is the most common phenotype described within the spectrum of arrhythmogenic cardiomyopathies. It usually presents in early adolescence with severe ventricular arrhythmias along with cardiac structural and functional alterations mainly of the right ventricular myocardium. Though the estimated prevalence of ARVC in the general population is only 1:5000, it represents one of the most common causes of juvenile sudden death. However, detection of early RV dysfunction in ARVC may be challenging requiring high clinical suspicion and an algorithmic approach...
April 15, 2018: International Journal of Cardiology
Shuang Liu, Zhengyu Guan, Xianfeng Zheng, Pingping Meng, Yonghuai Wang, Yang Li, Yan Zhang, Jun Yang, Dalin Jia, Chunyan Ma
AIMS: To assess LA diastolic and systolic function and atrial dyssynchrony in patients with heart failure with preserved ejection fraction (HFpEF) and to examine whether LA dysfunction and dyssynchrony account for the patients' symptoms of HFpEF. METHODS: Fifty-five patients with HFpEF, 31 asymptomatic patients with left ventricular diastolic dysfunction (LVDD) and 33 healthy individuals were enrolled in the study. The LA active ejection fraction (LAAEF) was calculated...
April 15, 2018: International Journal of Cardiology
Mazen S Albaghdadi, David M Dudzinski, Nicholas Giordano, Christopher Kabrhel, Brian Ghoshhajra, Michael R Jaff, Ido Weinberg, Aaron Baggish
BACKGROUND: Little data exist regarding the functional capacity of patients following acute pulmonary embolism. We sought to characterize the natural history of symptom burden, right ventricular (RV) structure and function, and exercise capacity among survivors of massive and submassive pulmonary embolism. METHODS AND RESULTS: Survivors of submassive or massive pulmonary embolism (n=20, age 57±13.3 years, 8/20 female) underwent clinical evaluation, transthoracic echocardiography, and cardiopulmonary exercise testing at 1 and 6 months following hospital discharge...
March 3, 2018: Journal of the American Heart Association
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