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https://www.readbyqxmd.com/read/29031174/dynamic-right-ventricular-outflow-obstruction-a-rare-cause-of-hypotension-during-anestesia-induction
#1
Maria Enrica Antoniucci, Christian Colizzi, Gabriella Arlotta, Maria Calabrese, Michele Corrado, Sergio Guarneri, Lorenzo Martinelli, Andrea Scapigliati, Roberto Zamparelli, Franco Cavaliere
INTRODUCTION: Dynamic obstruction of right ventricle outflow tract (RVOTO) is a rare condition that may acutely cause severe heart failure. It has been reported in some hypertrophic cardiomyopathies, after lung transplantation, and in some cases of hemodynamic instability after cardiopulmonary bypass. PRESENTATION OF CASE: We report the case of a 71-year-old man who developed severe hypotension during the induction of general anesthesia for surgical coronary revascularization...
October 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29027210/oedema-fibrosis-in-duchenne-muscular-dystrophy-role-of-cardiovascular-magnetic-resonance-imaging
#2
REVIEW
Sophie Mavrogeni, Antigoni Papavasiliou, Katerina Giannakopoulou, George Markousis-Mavrogenis, Maria Roser Pons, Evangelos Karanasios, Ioannis Nikas, George Papadopoulos, Genovefa Kolovou, George P Chrousos
Duchenne muscular dystrophy (DMD) is an X-linked muscle disorder characterized by progressive, irreversible loss of cardiac and skeletal muscular function. Muscular enlargement in DMD is attributed to oedema, due to the increased cytoplasmic Na+ concentration. The aim in this review is to present the current experience and emphasize the role of cardiovascular magnetic resonance (CMR) in the diagnosis of this condition. DMD patients' survival depends on ventilatory assistance, as respiratory muscle dysfunction was the most common cause of death in the past...
October 13, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29025576/the-prevalence-correlates-and-impact%C3%A2-on%C3%A2-cardiac-mortality-of-right%C3%A2-ventricular-dysfunction-in-nonischemic%C3%A2-cardiomyopathy
#3
Andreas Pueschner, Pairoj Chattranukulchai, John F Heitner, Dipan J Shah, Brenda Hayes, Wolfgang Rehwald, Michele A Parker, Han W Kim, Robert M Judd, Raymond J Kim, Igor Klem
OBJECTIVES: This study sought to determine the prevalence, correlates, and impact on cardiac mortality of right ventricular (RV) dysfunction in nonischemic cardiomyopathy. BACKGROUND: Current heart failure guidelines place little emphasis on RV assessment due to limited available data on determinants of RV function, mechanisms leading to its failure, and relation to outcomes. METHODS: We prospectively studied 423 patients with cardiac magnetic resonance (CMR)...
October 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29025547/contemporary-techniques-of-pericardiectomy-for-pericardial-disease
#4
REVIEW
Pouya Hemmati, Kevin L Greason, Hartzell V Schaff
Pericardiectomy is a potentially curative treatment for constrictive pericarditis. We use a median sternotomy and believe that adequate resection involves removal of the diaphragmatic pericardium and the anterior pericardium. Late outcomes depend on severity of right-sided heart failure preoperatively, the etiology of constrictive pericarditis, and adequate pericardial resection. Late results are excellent in patients with idiopathic disease or those with pericarditis secondary to prior cardiac operations. However, survival is reduced in those with radiation-induced constrictive pericarditis, primarily owing to additional secondary effects of radiation on cardiac valves, epicardial coronary arteries, and ventricular myocardium where fibrosis may cause associated restrictive cardiomyopathy...
November 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/29025545/constrictive-pericarditis
#5
REVIEW
Terrence D Welch, Jae K Oh
Constrictive pericarditis is a potentially treatable cause of diastolic heart failure that arises because a diseased, inelastic pericardium restricts ventricular diastolic expansion. Affected patients present with heart failure with predominant right-sided symptoms and signs. The key to diagnosis is identification of the unique hemodynamic properties associated with constriction: dissociation of intrathoracic and intracardiac pressures and enhanced ventricular interaction. Comprehensive echocardiography with Doppler imaging is useful, but invasive hemodynamic assessment and cross-sectional imaging may be required for confirmation...
November 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/29023958/stroke-induced-chronic-systolic-dysfunction-driven-by-sympathetic-overactivity
#6
Michael Bieber, Rudolf A Werner, Edit Tanai, Ulrich Hofmann, Takahiro Higuchi, Kai Schuh, Peter U Heuschmann, Stefan Frantz, Oliver Ritter, Peter Kraft, Christoph Kleinschnitz
OBJECTIVE: Cardiac diseases are established risk factors for ischemic stroke incidence and severity. Conversely, there is increasing evidence that brain ischemia can cause cardiac dysfunction. The mechanisms underlying this neurogenic heart disease are incompletely understood. While it is established that ischemic stroke is associated with cardiac arrhythmias, myocardial damage, elevated cardiac enzymes and plasma catecholamines in the acute phase, nothing is known about the delayed consequences of ischemic stroke on cardiovascular function...
October 10, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29023821/optimization-of-coronary-sinus-lead-placement-targeted-to-the-longest-right-to-left-delay-in-patients-undergoing-cardiac-resynchronization-therapy-the-optimal-pacing-site-2-opsite-2-acute-study-and-protocol
#7
D Oddone, D Solari, R Nangah, G Arena, R Mureddu, D Giorgi, G Allocca, N Bottoni, G Senatore, M Giaccardi, M Giammaria, E Marra, M Laffi, E Cipolla, F Di Lorenzo, R Carpi, M Brignole
AIMS: Left ventricular (LV) lead positioning at the site of delayed electrical activation is associated with better response to cardiac resynchronization therapy (CRT). We hypothesized that a long electrical conduction delay between RV and CS leads during RV pacing (RLD index) is correlated with a better clinical outcome METHODS AND RESULTS: RLD is measured intra-procedurally, during RV pacing, as the time interval between the intracardiac electrograms of RV and CS leads. Initially, we did a prove-of-concept, feasibility, acute study in 97 patients who underwent CRT implantation...
October 11, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29023250/biomechanical-determinants-of-right-ventricular-failure-in-pulmonary-hypertension
#8
Francesco Scardulla, Diego Bellavia, Patrizio Vitulo, Giuseppe Romano, Chiara Mina, Giovanni Gentile, Francesco Clemenza, Salvatore Pasta
Pulmonary hypertension (PH) is a disease characterized by progressive adverse remodeling of the distal pulmonary arteries, resulting in elevated pulmonary vascular resistance and load pressure on the right ventricle (RV), ultimately leading to RV failure. Invasive hemodynamic testing is the gold standard for diagnosing PH, and guiding patient therapy. We hypothesized that lumped-parameter and biventricular finite-element (FE) modeling may lead to noninvasive predictions of both PH-related hemodynamic and biomechanical parameters that induce PH...
October 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29022535/gender-disparities-in-pulmonary-hypertension-at-a-tertiary-centre-in-cameroon
#9
L N Aminde, A Dzudie, A P Kenge, J Ndjebet, S Mapoh, X Kuelang, F Kamdem, B H Mbatchou Ngahane, M-S Doualla, K B Ngu, K Sliwa, F Thienemann
BACKGROUND: Pulmonary hypertension (PH) is a potent cause of heart failure and has been little investigated in the African setting. OBJECTIVE: To investigate the effects of gender on the clinical presentation, echocardiographic features and outcomes of patients with PH in Douala, Cameroon. METHODS: A prospective cohort study was conducted from March 2012 to December 2013 as part of the Pan African Pulmonary Hypertension Cohort study. PH was diagnosed by echocardiography and defined as a right ventricular systolic pressure >35 mmHg in the absence of acute right heart failure...
September 22, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29021450/the-efficacy-of-a-genetic-analysis-of-the-bmpr2-gene-in-a-patient-with-severe-pulmonary-arterial-hypertension-and-an-atrial-septal-defect-treated-with-bilateral-lung-transplantation
#10
Shunsuke Tatebe, Koichiro Sugimura, Tatsuo Aoki, Saori Yamamoto, Nobuhiro Yaoita, Hideaki Suzuki, Haruka Sato, Katsuya Kozu, Ryo Konno, Kimio Satoh, Koji Fukuda, Osamu Adachi, Ryoko Saito, Norifumi Nakanishi, Hiroko Morisaki, Kotaro Oyama, Yoshikatsu Saiki, Yoshinori Okada, Hiroaki Shimokawa
Severe pulmonary arterial hypertension (PAH) rarely develops in children with an atrial septal defect (ASD), even those with a large defect. We herein report the case of a 27-year-old man with a moderate-sized secundum ASD and right ventricular failure due to severe PAH, which developed in his early teens. He was diagnosed as having a genetic mutation of the BMPR2 gene and was successfully treated with bilateral lung transplantation with ASD path closure. In patients with congenital heart disease, a genetic analysis may provide information about the lifetime risk of developing PAH...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29017930/cardiac-magnetic-resonance-imaging-using-wideband-sequences-in-patients-with-non-conditional-cardiac-implanted-electronic-devices
#11
Duc H Do, Vaughn Eyvazian, Aileen J Bayoneta, Peng Hu, J Paul Finn, Jason S Bradfield, Kalyanam Shivkumar, Noel G Boyle
BACKGROUND: Magnetic resonance imaging (MRI) has been performed safely in patients without MRI-conditional cardiac implantable electronic devices (CIED), but experience specifically with cardiac magnetic resonance imaging (CMR) is limited in this patient population. OBJECTIVE: Evaluate the safety of CMR in non-MRI-conditional CIED and the interpretability of images using wideband sequences. METHODS: We performed 114 consecutive CMR studies in 111 patients (mean age 59±14 years with 12 pacemakers, 73 implantable cardioverter defibrillators, 29 biventricular defibrillators) utilizing a wideband pulse sequence for late gadolinium enhancement (LGE) imaging...
October 7, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29017566/right-ventricular-functional-analysis-utilizing-first-pass-radionuclide-angiography-for-pre-operative-ventricular-assist-device-planning-a-multi-modality-comparison
#12
Ryan Avery, Kevin Day, Clinton Jokerst, Toshinobu Kazui, Elizabeth Krupinski, Zain Khalpey
BACKGROUND: Advanced heart failure treated with a left ventricular assist device is associated with a higher risk of right heart failure. Many advanced heart failures patients are treated with an ICD, a relative contraindication to MRI, prior to assist device placement. Given this limitation, left and right ventricular function for patients with an ICD is calculated using radionuclide angiography utilizing planar multigated acquisition (MUGA) and first pass radionuclide angiography (FPRNA), respectively...
October 10, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29016730/microrna-424-322-as-a-new-marker-of-disease-progression-in-pulmonary-arterial-hypertension-and-its-role-in-right-ventricular-hypertrophy-by-targeting-smurf1
#13
Rui Baptista, Carla Marques, Steve Catarino, Francisco J Enguita, Marina C Costa, Paulo Matafome, Mónica Zuzarte, Graça Castro, Abílio Reis, Pedro Monteiro, Mariano Pêgo, Paulo Pereira, Henrique Girão
MicroRNAs (miRNAs) have been implicated in the pathogenesis of pulmonary hypertension (PH), a multifactorial and progressive condition associated with an increased afterload of the right ventricle leading to heart failure and death. The main aim of this study was to correlate the levels of miR-424(322) with the severity and prognosis of PH and with right ventricle hypertrophy progression. Additionally, we intended to evaluate the mechanisms and signaling pathways whereby miR-424(322) secreted by pulmonary endothelial cells (PAECs) impacts cardiomyocytes...
September 12, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28994680/rising-central-venous-pressure-impending-right-sided-failure
#14
Monish S Raut, Arun Maheshwari, Vinayak Desurkar, Rajesh Bhavsar
Central venous pressure generally indicates right sided cardiac filling pressure. Although it is a static hemodynamic parameter, however trend of CVP gives important information regarding the patient's management. Patient with left ventricular assist device is prone to develop right ventricular dysfunction which can easily be suspected by trend of CVP. However rising CVP does not always imply right heart dysfunction.
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28993841/extent-of-jugular-venous-distension-and-lower-extremity-edema-are-the-best-tools-from-history-and-physical-examination-to-identify-heart-failure-exacerbation
#15
H R Omar, M Guglin
INTRODUCTION: We aimed to identify the best tools from history and physical examination that predict severity of heart failure (HF) exacerbation among patients with an ejection fraction (EF) ≤ 30%. METHODS: Patients enrolled in the ESCAPE trial were divided into tertiles according to the combined value of pulmonary capillary wedge pressure (PCWP) and right atrial pressure (RAP) which we used as a marker of volume loading of both pulmonary and systemic compartments...
October 9, 2017: Herz
https://www.readbyqxmd.com/read/28990316/non-invasive-assessment-of-left-ventricular-filling-pressure
#16
REVIEW
Sherif F Nagueh
Dyspnoea is a presenting symptom for patients with heart failure. It is often due to elevated left ventricular (LV) filling pressure but can be due to pulmonary disease or other non-cardiac reasons. While physical examination is useful, it has its limitations. Accordingly, non-invasive imaging has an important role in the diagnostic evaluation of patients with known or suspected heart failure. Echocardiography is usually the first test obtained and is used to determine LV volumes, ejection fraction and mass as well as right ventricular size and function, left and right atrial volumes, valvular lesions, and pulmonary artery pressures...
October 8, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28988444/usefulness-of-epicardial-impedance-evaluation-for-epicardial-mapping-and-determination-of-epicardial-ablation-site-for-ventricular-tachycardia-a-pilot-study
#17
Takeshi Kitamura, Seiji Fukamizu, Satoshi Miyazawa, Iwanari Kawamura, Rintaro Hojo, Yuya Aoyama, Mitsuhiro Nishizaki, Harumizu Sakurada, Masayasu Hiraoka
BACKGROUND: During epicardial mapping, determination of appropriate ablation sites in low voltage areas (LVA) is challenging because of large epicardial areas covered by adipose tissue. OBJECTIVE: To evaluate the impedance difference between epicardial fat and the epicardial LVA using multiple detector computed tomography (MDCT). METHODS: We enrolled patients who underwent ventricular tachycardia (VT) ablation via the epicardial approach after endocardial ablation failure...
October 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28985792/renal-failure-and-right-heart-failure-after-left-ventricular-assist-device-implantation-which-is-cause-and-which-is-effect
#18
EDITORIAL
Silvana Marasco
No abstract text is available yet for this article.
November 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28984631/right-ventricular-perfusion-physiology-and-clinical-implications
#19
George J Crystal, Paul S Pagel
Regulation of blood flow to the right ventricle differs significantly from that to the left ventricle. The right ventricle develops a lower systolic pressure than the left ventricle, resulting in reduced extravascular compressive forces and myocardial oxygen demand. Right ventricular perfusion has eight major characteristics that distinguish it from left ventricular perfusion: (1) appreciable perfusion throughout the entire cardiac cycle; (2) reduced myocardial oxygen uptake, blood flow, and oxygen extraction; (3) an oxygen extraction reserve that can be recruited to at least partially offset a reduction in coronary blood flow; (4) less effective pressure-flow autoregulation; (5) the ability to downregulate its metabolic demand during coronary hypoperfusion and thereby maintain contractile function and energy stores; (6) a transmurally uniform reduction in myocardial perfusion in the presence of a hemodynamically significant epicardial coronary stenosis; (7) extensive collateral connections from the left coronary circulation; and (8) possible retrograde perfusion from the right ventricular cavity through the Thebesian veins...
October 4, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28984057/echocardiographic-estimation-of-left-ventricular-and-pulmonary-pressures-in-patients-with-heart-failure-and-preserved-ejection-fraction-a-study-utilizing-simultaneous-echocardiography-and-invasive-measurements
#20
Yoran M Hummel, Licette C Y Liu, Carolyn S P Lam, Daniel F Fonseca-Munoz, Kevin Damman, Michiel Rienstra, Peter van der Meer, Stephan Rosenkranz, Dirk J van Veldhuisen, Adriaan A Voors, Elke S Hoendermis
AIMS: Although echocardiography is generally used for the diagnosis of heart failure with preserved ejection fraction (HFpEF), invasive measurements of filling pressures are the gold standard. Studies simultaneously performing echocardiography and invasive measurements in HFpEF are sparse. METHODS AND RESULTS: Invasive haemodynamic and echocardiographic measurements were simultaneously performed in 98 patients with heart failure New York Heart Association class ≥II, left ventricular ejection fraction (LVEF) ≥45%, and suspected pulmonary hypertension on a previous echocardiogram...
October 6, 2017: European Journal of Heart Failure
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