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Myocardial recovery

H Fan, S Li, M Lu, G Yin, X Yang, T Lan, L Dai, X Chen, J Li, Y Zhang, A Sirajuddin, P Kellman, A E Arai, S Zhao
AIM: To evaluate the image quality and diagnostic agreement with a head-to-head comparison of late gadolinium enhancement (LGE) images acquired by the motion-corrected (MOCO) balanced steady-state free precession (bSSFP) phase sensitivity inversion recovery (PSIR) and conventional segmented fast low angle shot (FLASH) PSIR methods15,16 in a patient cohort with a wide spectrum of cardiovascular disease. MATERIALS AND METHODS: In 59 consecutive patients, signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs) of the normal myocardium (NM), LGE, and blood pool (BP) were pair-wise compared between the two different sequences...
March 13, 2018: Clinical Radiology
Attila Kiss, Huaqing Shu, Ouafa Hamza, David Santer, Eva Verena Tretter, Shanglong Yao, Klaus Markstaller, Seth Hallström, Bruno K Podesser, Klaus Ulrich Klein
OBJECTIVES: Previous studies demonstrated that preconditioning with argon gas provided a marked reduction in inflammation and apoptosis and increased myocardial contractility in the setting of acute myocardial ischaemia-reperfusion (IR). There is substantial evidence that myocardial IR injury following cardioplegic arrest is associated with the enhancement of apoptosis and inflammation, which is considered to play a role in cardiac functional impairment. Therefore, the present study was designed to clarify whether preconditioning with argon gas enhances recovery of cardiac function following cardioplegic arrest...
March 13, 2018: European Journal of Cardio-thoracic Surgery
Puneet Kapur, Melanie Baimel, Jordan Chenkin
Left ventricular outflow tract pseudoaneurysms are a rare but life-threatening disorder, often caused by complications of cardiac surgery or myocardial infarction. We present a case report of a patient with no prior risk factors who presented with a six-month history of progressive exertional dyspnea, bilateral leg swelling and cough. Point-of-care ultrasound revealed an unexpected outpouching of the left ventricle. He was diagnosed with a left ventricular outflow tract pseudoaneurysm and subsequently went into cardiogenic shock secondary to extension of pseudoaneurysm causing extrinsic compression of the coronary arteries...
March 16, 2018: CJEM
Tony G Walsh, Alastair W Poole
Our understanding of platelet function has traditionally focused on their roles in physiological hemostasis and pathological thrombosis, the latter being causative of vessel occlusion and subsequent ischemic damage to various tissues. In particular, numerous in vivo studies have implicated causative roles for platelets in the pathogenesis of ischemia-reperfusion (I/R) injury to the myocardium. However, platelets clearly have more complex pathophysiological roles particularly as a result of the heterogeneous nature of biologically active cargo secreted from their granules, or contained within released microparticles or exosomes...
March 16, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Philippa R P Krahn, Sheldon M Singh, Venkat Ramanan, Labonny Biswas, Nicolas Yak, Kevan J T Anderson, Jennifer Barry, Mihaela Pop, Graham A Wright
BACKGROUND: Radiofrequency (RF) ablation has become a mainstay of treatment for ventricular tachycardia, yet adequate lesion formation remains challenging. This study aims to comprehensively describe the composition and evolution of acute left ventricular (LV) lesions using native-contrast cardiovascular magnetic resonance (CMR) during CMR-guided ablation procedures. METHODS: RF ablation was performed using an actively-tracked CMR-enabled catheter guided into the LV of 12 healthy swine to create 14 RF ablation lesions...
March 15, 2018: Journal of Cardiovascular Magnetic Resonance
Goran Abdula, Jannike Nickander, Peder Sörensson, Magnus Lundin, Peter Kellman, Andreas Sigfridsson, Martin Ugander
OBJECTIVES: Late gadolinium enhancement (LGE) is the in vivo reference standard for assessing focal myocardial fibrosis. Post-contrast T1-mapping by Modified Look-Locker Inversion recovery (MOLLI) can be used to generate synthetic late gadolinium enhancement (SynLGE) images with an image contrast similar to conventional LGE images. We hypothesized that SynLGE has an accuracy that approaches conventional LGE for diagnosing focal myocardial fibrosis. METHODS: Consecutive patients (n = 109, mean ± SD age 50 ± 16 years, 63% male) referred for clinical cardiac magnetic resonance imaging underwent LGE and post-contrast MOLLI starting 10-15 and 20-25 minutes post contrast, respectively...
March 16, 2018: Scandinavian Cardiovascular Journal: SCJ
Heidi J Reich, Lawrence S C Czer, Danny Ramzy, Francisco Arabia, Jaime Moriguchi, Deborah D Ascheim, Timothy D Henry
The use of stem cell therapy in combination with a left ventricular assist device (LVAD) for patients with advanced heart failure (HF) is an attractive concept with the potential to alter the natural history of HF. Cell therapy trials for HF have demonstrated excellent safety and encouraging results, but current rates of myocardial recovery after LVAD implantation are limited. Early trials combining these 2 therapies to increase the likelihood of recovery and to potentially obviate the need for subsequent transplantation appear promising...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Jessica Schultz, Ranjit John, Cindy Martin, Forum Kamdar, Thenappan Thenappan, Rebecca Cogswell
Myocardial fibrosis identified by apical core pathology at the time of left ventricular assist device (LVAD) implantation may add information regarding myocardial recovery potential. In this analysis, we report the prevalence of myocardial fibrosis by cardiomyopathy type and its association with other known markers of left ventricular recovery. Left ventricular assist device core pathology was reviewed on 332 patients who underwent LVAD implantation at a single institution between 2005 and 2016. Baseline clinical and echocardiographic characteristics were compared among patients with and without myocardial fibrosis by cardiomyopathy type...
March 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Fabian Aus dem Siepen, Christian Baumgärtner, Matthias Müller-Henessen, Florian André, Daniel Messroghli, Marco Ochs, Johannes Riffel, Evangelos Giannitsis, Hugo A Katus, Matthias G Friedrich, Sebastian J Buss
Background: Myocardial T1 and extracellular volume (ECV) derived from cardiovascular MRIs are more and more widely accepted as important markers for diagnosis, risk prediction and monitoring of cardiac disease. Yet data regarding long-term stability of myocardial T1 mapping are lacking. The aim of this study was to investigate the long-term stability of native and postcontrast T1 mapping values in healthy volunteers. Methods: 18 strictly selected healthy volunteers (52±10 years, 12 men) were studied on a Philips Achieva 1...
2018: Open Heart
Naoko Yamaguchi, Kentaro Yamakawa, Pradeep S Rajendran, Tatsuo Takamiya, Marmar Vaseghi
BACKGROUND: Neuraxial modulation with cardiac sympathetic denervation (CSD) can potentially reduce burden of ventricular tachy-arryhthmias (VT). Despite catheter ablation and CSD, however, VT can recur in patients with cardiomyopathy and the role of vagal nerve stimulation (VNS) in this setting is unclear. OBJECTIVE: The purpose of this study was to evaluate electrophysiological effects of VNS after CSD in normal and infarcted hearts. METHODS: In 10 normal and 6 infarcted pigs, electrophysiological and hemodynamic parameters were evaluated before and during intermittent VNS pre-CSD (bilateral stellectomy and T2-T4 thoracic ganglia removal) as well as post-CSD...
March 9, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Shawn M Shah, Nicholas R Teman, Eileen Dearth, Leora T Yarboro, John A Kern
Utilization of a left ventricular assist device (LVAD) as a bridge to myocardial recovery is an established therapy for acute systolic heart failure. However, device removal can present a technical challenge with no clear consensus on preferred method. In this case report, we describe a complex patient who underwent successful explantation of an LVAD using an intraoperatively constructed apical plug. This method utilizes inexpensive and easily accessible materials, minimizes ventricular distortion during device removal, and preserves the ventricular sewing ring for future reimplantation...
March 9, 2018: Annals of Thoracic Surgery
Sourabh Aggarwal, Feng Xie, Robin High, Gregory Pavlides, Thomas R Porter
BACKGROUND: Although microvascular flow abnormalities have been observed following epicardial recanalization in acute ST-segment elevation myocardial infarction (STEMI), the prevalence and severity of these abnormalities in the current era of rapid percutaneous coronary intervention (PCI) has not been evaluated. The objective of this study was to assess microvascular perfusion (MVP) following successful primary PCI in patients with STEMI and how it affects clinical outcome. METHODS: In this single-center, retrospective study, 170 patients who successfully underwent emergent PCI for STEMI were assessed using real-time myocardial contrast echocardiography using a continuous infusion of intravenous commercial microbubbles (3% Definity)...
March 7, 2018: Journal of the American Society of Echocardiography
Carlos D Davila, James E Udelson
Among all patients referred for stress myocardial perfusion imaging (MPI), a substantial proportion in contemporary practice cannot exercise. Another group of patients are those who are thought to be able to achieve an adequate workload with treadmill (or bicycle) exercise but do not achieve at least 85% of maximum predicted heart rate without developing symptoms. There has been substantial interest and literature on the adjunctive use of vasodilator stress during the same visit to generate best-quality results for patients who do not exercise adequately...
March 2018: JACC. Cardiovascular Imaging
Yasuhiko Sakata, Kanako Tsuji, Kotaro Nochioka, Hiroaki Shimokawa
Along with a worldwide epidemiological transition and dramatic increase in the elderly population, both the incidence and prevalence of heart failure (HF) are increasing worldwide. This epidemic of HF is characterized by an increase of HF with preserved left ventricular ejection fraction (LVEF) (HFpEF) and a decrease of HF with reduced LVEF (HFrEF). Of note, transition between HFpEF and HFrEF has been recently highlighted, since it significantly relates with prognosis. Our recent studies indicated that temporary changes in LVEF are common and associated with prognosis in patients with HF...
March 8, 2018: Advances in Experimental Medicine and Biology
António Gaspar, André P Lourenço, Miguel Álvares Pereira, Pedro Azevedo, Roberto Roncon-Albuquerque, Jorge Marques, Adelino F Leite-Moreira
To test whether remote ischaemic conditioning (RIC) as adjuvant to standard of care (SOC) would prevent progression towards heart failure (HF) after ST-elevation myocardial infarction (STEMI). Single-centre parallel 1:1 randomized trial (computerized block-randomization, concealed allocation) to assess superiority of RIC (3 cycles of intermittent 5 min lower limb ischaemia) over SOC in consecutive STEMI patients (NCT02313961, clinical From 258 patients randomized to RIC or SOC, 9 and 4% were excluded because of unconfirmed diagnosis and previously unrecognized exclusion criteria, respectively...
March 7, 2018: Basic Research in Cardiology
Fumi Yanagisawa, Yasuo Amano, Masaki Tachi, Keisuke Inui, Kuniya Asai, Shinichiro Kumita
PURPOSE: We sought to use non-contrast-enhanced T1 mapping to determine the native T1 values required to identify myocardial fibrosis in patients with dilated cardiomyopathy (DCM). METHODS: A total of 25 patients with DCM and 15 healthy controls were enrolled. All subjects underwent T1 mapping using modified look-locker inversion recovery, and the patients underwent late gadolinium-enhancement (LGE) imaging. Basal and mid-ventricular levels were divided into eight segments and the T1 value was measured in each segment...
March 7, 2018: Magnetic Resonance in Medical Sciences: MRMS
Aakriti Gupta, Jose A Barrabes, Kelly Strait, Hector Bueno, Andreu Porta-Sánchez, J Gabriel Acosta-Vélez, Rosa-Maria Lidón, Erica Spatz, Mary Geda, Rachel P Dreyer, Nancy Lorenze, Judith Lichtman, Gail D'Onofrio, Harlan M Krumholz
BACKGROUND: Young women with ST-segment-elevation myocardial infarction experience reperfusion delays more frequently than men. Our aim was to determine the electrocardiographic correlates of delay in reperfusion in young patients with ST-segment-elevation myocardial infarction. METHODS AND RESULTS: We examined sex differences in initial electrocardiographic characteristics among 1359 patients with ST-segment-elevation myocardial infarction in a prospective, observational, cohort study (2008-2012) of 3501 patients with acute myocardial infarction, 18 to 55 years of age, as part of the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study at 103 US and 24 Spanish hospitals enrolling in a 2:1 ratio for women/men...
March 7, 2018: Journal of the American Heart Association
Masahiko Ando, Arthur R Garan, Hiroo Takayama, Veli K Topkara, Jiho Han, Paul Kurlansky, Melana Yuzefpolskaya, Maryjane A Farr, Paolo C Colombo, Yoshifumi Naka, Koji Takeda
BACKGROUND: The use of percutaneous mechanical circulatory support (MCS) in the treatment of cardiogenic shock has increased. However, limitations in flow capability, ventricular unloading effect, durability, and mobility remain. We reviewed our single-center experience with continuous-flow external ventricular assist devices (VADs) to determine the role of temporary VADs for cardiogenic shock in the contemporary MCS era. METHODS: We retrospectively reviewed 252 patients who underwent continuous-flow external VAD insertion between January 2007 and December 2016...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
Hannah J Whittington, Philip J Ostrowski, Debra J McAndrew, Fang Cao, Andrew Shaw, Thomas R Eykyn, Hannah Lake, Jack Tyler, Jurgen E Schneider, Stefan Neubauer, Sevasti Zervou, Craig A Lygate
Aims: Mitochondrial creatine kinase (MtCK) couples ATP production via oxidative phosphorylation to phosphocreatine in the cytosol, which acts as a mobile energy store available for regeneration of ATP at times of high demand. We hypothesised that elevating MtCK would be beneficial in ischaemia-reperfusion (I/R) injury. Methods and Results: Mice were created overexpressing the sarcomeric MtCK gene with αMHC promoter at the Rosa26 locus (MtCK-OE) and compared with wild-type (WT) littermates...
March 2, 2018: Cardiovascular Research
Santiago Roura, Carolina Gálvez-Montón, Antoni Bayes-Genis
Chronic diseases, including myocardial scar healing and heart failure remission, impose huge social and economic burdens, and novel approaches are needed. Several therapeutic modalities are currently being evaluated, including cell therapy, stem cell conditioning, and cardiac tissue engineering. Areas covered: This review discusses the restoration of cardiac function after myocardial infarction using a vascularized flap of autologous cardiac adipose tissue over an akinetic scar. It addresses the risks and benefits of using cardiac adipose progenitors and the adipose graft transposition procedure (AGTP) to ameliorate cardiac dysfunction in preclinical and clinical trials...
March 6, 2018: Expert Review of Cardiovascular Therapy
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