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https://www.readbyqxmd.com/read/28101942/the-use-of-hemodynamic-support-in-massive-pulmonary-embolism
#1
Neal Kumar Bhatia, Neal W Dickert, Habib Samady, Vasilis Babaliaros
Massive pulmonary embolism is life threatening and can present as cardiogenic shock and cardiac arrest. We report a case of a 47-year-old male who arrested during his postoperative hospitalization and was found to have a massive pulmonary embolism with bilateral involvement of the pulmonary arteries. Given his profound shock and right ventricular failure, an Impella RP was used to stabilize his acute right ventricular failure while percutaneous embolectomy and thrombolysis was used to treat the pulmonary embolism...
January 19, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28100891/reverse-right-ventricular-remodeling-after-lung-transplantation-in-patients-with-pulmonary-arterial-hypertension-under-combination-therapy-of-targeted-medical-drugs
#2
Toshihiro Sarashina, Kazufumi Nakamura, Satoshi Akagi, Takahiro Oto, Hiroki Oe, Kentaro Ejiri, Koji Nakagawa, Nobuhiro Nishii, Hiromi Matsubara, Motomu Kobayashi, Hiroshi Morimatsu, Shinichiro Miyoshi, Hiroshi Ito
BACKGROUND: Patients with pulmonary arterial hypertension (PAH) are currently treated with combination therapy of PAH-targeted drugs. Reverse right ventricular (RV) remodeling after lung transplantation (LTx) in patients with end-stage PAH despite combination therapy of PAH-targeted drugs has not been fully elucidated.Methods and Results:A total of 136 patients, including 32 with PAH, underwent LTx from 1998 to 2014. We enrolled 12 consecutive patients with PAH treated with combination therapy of PAH-targeted drugs who underwent LTx and retrospectively analyzed the temporal and serial changes in hemodynamics and echocardiography before LTx and at 3 and 12 months after LTx...
January 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28100429/right-ventricular-function-measured-by-tapse-in-obese-subjects-at-the-time-of-acute-myocardial-infarction-and-2year-outcomes
#3
Yaser S Alhamshari, Talal Alnabelsi, Ramzi Mulki, Beatriz Cepeda-Valery, Vincent M Figueredo, Abel Romero-Corral
INTRODUCTION: Obesity is associated with significantly better outcome after acute myocardial infarction (AMI), a phenomenon known as 'obesity paradox'. Tricuspid annular plane systolic excursion (TAPSE) is an echocardiographic measurement of right ventricular (RV) function and has prognostic implications at the time of AMI. METHODS: We examined the difference in RV function among patients admitted with AMI according to obesity status. In a single center cohort analysis of 105 patients admitted between 2010 and 2011 with the diagnosis of AMI...
January 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28099680/novel-putative-pharmacologic-therapies-to-protect-the-right-ventricle-in-pulmonary-hypertension-a-review-of-current-literature
#4
REVIEW
Gerald J Maarman, Rainer Schulz, Karen Sliwa, Ralph Schermuly, Sandrine Lecour
Pulmonary hypertension (PH) is defined by elevated mean pulmonary artery pressure following the pathologic remodelling of small pulmonary arteries. An increase in right ventricular (RV) afterload results in RV hypertrophy and RV failure. The pathophysiology of PH, and RV remodelling in particular, are not well understood, thus explaining, at least in part, why current PH therapies have a limited effect. Existing therapies mostly target the pulmonary circulation. Because the remodelled RV fails to support normal cardiac function, patients eventually succumb from RV failure...
January 18, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28097316/evaluation-of-structural-progression-in-arrhythmogenic-right-ventricular-dysplasia-cardiomyopathy
#5
Thomas P Mast, Cynthia A James, Hugh Calkins, Arco J Teske, Crystal Tichnell, Brittney Murray, Peter Loh, Stuart D Russell, Birgitta K Velthuis, Daniel P Judge, Dennis Dooijes, Ryan J Tedford, Jeroen F van der Heijden, Harikrishna Tandri, Richard N Hauer, Theodore P Abraham, Pieter A Doevendans, Anneline S J M Te Riele, Maarten J Cramer
Importance: Considerable research has described the arrhythmic course of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). However, objective data characterizing structural progression, such as ventricular enlargement and cardiac dysfunction, in ARVD/C are relatively scarce. Objectives: To define the extent of structural progression, identify determinants of structural progression, and determine the association between structural progression and electrocardiographic (ECG) changes in patients with ARVD/C...
January 11, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28092203/machine-learning-of-three-dimensional-right-ventricular-motion-enables-outcome-prediction-in-pulmonary-hypertension-a-cardiac-mr-imaging-study
#6
Timothy J W Dawes, Antonio de Marvao, Wenzhe Shi, Tristan Fletcher, Geoffrey M J Watson, John Wharton, Christopher J Rhodes, Luke S G E Howard, J Simon R Gibbs, Daniel Rueckert, Stuart A Cook, Martin R Wilkins, Declan P O'Regan
Purpose To determine if patient survival and mechanisms of right ventricular failure in pulmonary hypertension could be predicted by using supervised machine learning of three-dimensional patterns of systolic cardiac motion. Materials and Methods The study was approved by a research ethics committee, and participants gave written informed consent. Two hundred fifty-six patients (143 women; mean age ± standard deviation, 63 years ± 17) with newly diagnosed pulmonary hypertension underwent cardiac magnetic resonance (MR) imaging, right-sided heart catheterization, and 6-minute walk testing with a median follow-up of 4...
January 16, 2017: Radiology
https://www.readbyqxmd.com/read/28090307/hemodynamic-response-to-treatment-of-iron-deficiency-anemia-in-pulmonary-arterial-hypertension-longitudinal-insights-from-an-implantable-hemodynamic-monitor
#7
Muddassir Mehmood, Richa Agarwal, Amresh Raina, Priscilla Correa-Jaque, Raymond L Benza
Despite new therapeutic options, pulmonary arterial hypertension (PAH) remains a progressive disease associated with substantial morbidity and mortality. As such, additional strategies for monitoring and adjunctive management of this disease are important. A 59-year-old woman with scleroderma-associated PAH received an implantable hemodynamic monitor (IHM) as part of a research protocol at our institution. Pulmonary artery pressures, heart rate, and cardiac output (sensor-based algorithm) were measured on a daily basis, and parameters of right ventricular (RV) performance and afterload were calculated...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28090294/the-effects-of-pulmonary-vasodilating-agents-on-right-ventricular-parameters-in-severe-group-3-pulmonary-hypertension-a-pilot-study
#8
Takahiro Sato, Ichizo Tsujino, Ayako Sugimoto, Toshitaka Nakaya, Taku Watanabe, Hiroshi Ohira, Masaru Suzuki, Satoshi Konno, Noriko Oyama-Manabe, Masaharu Nishimura
Pulmonary arterial hypertension (PAH)-approved vasodilators improve right ventricular (RV) function in patients with PAH. However, whether PAH-approved drugs ameliorate RV morphology and function in lung disease-associated pulmonary hypertension (lung-PH) remains unclear. We aimed to prospectively evaluate the changes in RV volume and ejection fraction (RVEF) in 14 consecutive severe lung-PH patients treated with PAH-approved vasodilators. Severe lung-PH was defined as a mean pulmonary arterial pressure (MPAP) of ≥35 mmHg or an MPAP of ≥25 mmHg with a cardiac index (L/min/m(2)) of <2...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28090292/a-new-look-at-bronchopulmonary-dysplasia-postcapillary-pathophysiology-and-cardiac-dysfunction
#9
Arvind Sehgal, Andra Malikiwi, Eldho Paul, Kenneth Tan, Samuel Menahem
Pulmonary hypertension (PH) and right ventricular function are the focus of cardiovascular effects of bronchopulmonary dysplasia (BPD). We assessed cardiac indexes reflecting systemic afterload and pulmonary venous back pressure as pathophysiologic factors. Cardiac parameters were measured by conventional echocardiography in 20 preterm infants with severe BPD and compared with those of 10 preterm infants with no BPD and 20 healthy term infants. In infants with severe BPD, PH was noted in 5 (25%) by tricuspid regurgitation Doppler jet ≥2...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28090285/pulmonary-vascular-and-ventricular-dysfunction-in-the-susceptible-patient-2015-grover-conference-series
#10
REVIEW
Bradley A Maron, Roberto F Machado, Larissa Shimoda
Pulmonary blood vessel structure and tone are maintained by a complex interplay between endogenous vasoactive factors and oxygen-sensing intermediaries. Under physiological conditions, these signaling networks function as an adaptive interface between the pulmonary circulation and environmental or acquired perturbations to preserve oxygenation and maintain systemic delivery of oxygen-rich hemoglobin. Chronic exposure to hypoxia, however, triggers a range of pathogenetic mechanisms that include hypoxia-inducible factor 1α (HIF-1α)-dependent upregulation of the vasoconstrictor peptide endothelin 1 in pulmonary endothelial cells...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28090255/clinical-utility-of-echocardiography-for-the-diagnosis-and-prognosis-in-children-with-bronchopulmonary-dsyplasia
#11
Young Earl Choi, Hwa Jin Cho, Eun Song Song, In Seok Jeong, Namsik Yoon, Young Youn Choi, Jae Sook Ma, Young Kuk Cho
BACKGROUND: Bronchopulmonary dysplasia (BPD) may result in chronic pulmonary artery hypertension and right ventricular (RV) dysfunction. Various echocardiographic assessments of RV dysfunction have been used to determine whether echocardiographic measurements of premature infants with BPD could provide sensitive measures of RV function that correlates with BPD severity. METHODS: Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderate BPD, and six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspid regurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and tissue Doppler imaging (TDI) measurements...
December 2016: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28090232/efficacy-and-safety-of-thrombolytic-therapy-in-acute-submassive-pulmonary-embolism-follow-up-study
#12
Santosh Kumar Sinha, Mohit Sachan, Amit Goel, Karandeep Singh, Vikas Mishra, Mukesh Jitendra Jha, Ashutosh Kumar, Nasar Abdali, Mohammad Asif, Mahamdula Razi, Umeshwar Pandey, Ramesh Thakur, Chandra Mohan Varma, Vinay Krishna
BACKGROUND: Thrombolysis in acute submassive pulmonary embolism (PE) remains controversial. So we studied impact of thrombolytic therapy in acute submassive PE in terms of mortality, hemodynamic status, improvement in right ventricular function, and safety in terms of major and minor bleeding. METHOD: A single-center, prospective, randomized study of 86 patients was conducted at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India. Patients received thrombolysis (single bolus of tenecteplase) with unfractionated heparin (UFH, group I) or placebo with UFH (group II)...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28087519/sympathetic-modulation-of-electrical-activation-in-normal-and-infarcted-myocardium-implications-for-arrhythmogenesis
#13
Olujimi A Ajijola, Robert L Lux, Anadjeet Khahera, OhJin Kwon, Eric Aliotta, Daniel Ennis, Michael C Fishbein, Jeffrey Laurence Ardell, Kalyanam Shivkumar
: Background The influence of cardiac sympathetic innervation on electrical activation in normal and chronically infarcted ventricular myocardium is not understood. Methods and Results Yorkshire pigs with normal hearts (NL, n=12) or anterior myocardial infarction (MI, n=9) underwent high-resolution mapping of the anteroapical left ventricle, at baseline, and during left and right stellate ganglion stimulation (LSGS & RSGS, respectively). Conduction velocity (CV), activation times (AT), & directionality of propagation were measured...
January 13, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28078759/bufalin-a-bufanolide-steroid-from-the-parotoid-glands-of-the-chinese-toad-inhibits-l-type-ca-2-channels-and-contractility-in-rat-ventricular-myocytes
#14
Tao Song, Xi Chu, Xuan Zhang, Qiong Tao Song, Ying Zhang, Yuanyuan Zhang, Xue Han, Jianping Zhang, Li Chu
Bufalin is a bufanolide steroid compound in Chan Su. Chan Su is a traditional Chinese medicine prepared from the dried white secretion of the auricular and skin glands of toads, and has been used as an Oriental drug. However, the effect of bufalin on cardiac function and its underlying cellular mechanisms remain unclear. Here, we explore the cellular mechanisms of bufalin on myocardial protection via the whole-cell patch-clamp recording and video-based edge detection system. Exposure to bufalin resulted in a concentrated-dependent blockade of ICa-L , with the half-maximal inhibitory concentration (IC50 ) of 60 μM and the maximal inhibitory effect of 71...
January 11, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28077181/at-what-age-should-tetralogy-of-fallot-be-corrected
#15
Julien I E Hoffman
Tetralogy of Fallot can be corrected with very low mortality at any age, even in neonates, but this does not necessarily mean that it should be corrected in the neonatal period. Although there are many advantages to early correction, a high proportion of these neonates have residual stenosis or pulmonary regurgitation that impairs ventricular function and may require further surgery or implantation of a pulmonary valve. Before we had the ability to correct this anomaly with low mortality in small children, a variety of palliative procedures had to be performed...
January 12, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28076798/neonatal-transplantation-confers-maturation-of-psc-derived-cardiomyocytes-conducive-to-modeling-cardiomyopathy
#16
Gun-Sik Cho, Dong I Lee, Emmanouil Tampakakis, Sean Murphy, Peter Andersen, Hideki Uosaki, Stephen Chelko, Khalid Chakir, Ingie Hong, Kinya Seo, Huei-Sheng Vincent Chen, Xiongwen Chen, Cristina Basso, Steven R Houser, Gordon F Tomaselli, Brian O'Rourke, Daniel P Judge, David A Kass, Chulan Kwon
Pluripotent stem cells (PSCs) offer unprecedented opportunities for disease modeling and personalized medicine. However, PSC-derived cells exhibit fetal-like characteristics and remain immature in a dish. This has emerged as a major obstacle for their application for late-onset diseases. We previously showed that there is a neonatal arrest of long-term cultured PSC-derived cardiomyocytes (PSC-CMs). Here, we demonstrate that PSC-CMs mature into adult CMs when transplanted into neonatal hearts. PSC-CMs became similar to adult CMs in morphology, structure, and function within a month of transplantation into rats...
January 10, 2017: Cell Reports
https://www.readbyqxmd.com/read/28075037/gauging-the-response-to-cardiac-resynchronization-therapy-the-important-interplay-between-predictor-variables-and-definition-of-a-favorable-outcome
#17
Milan Petrovic, Marija Petrovic, Goran Milasinovic, Bosiljka Vujisic Tesic, Danijela Trifunovic, Olga Petrovic, Ivana Nedeljkovic, Ivana Petrovic, Marko Banovic, Marija Boricic-Kostic, Jelena Petrovic, Ross Arena, Dejana Popovic
AIMS: Selection of patients who are viable candidates for cardiac resynchronization therapy (CRT), prediction of the response to CRT as well as an optimal definition of a favorable response, all require further exploration. The purpose of this study was to evaluate the interplay between the prediction of the response to CRT and the definition of a favorable outcome. METHODS: Seventy patients who received CRT were included. All patients met current guideline criteria for CRT...
January 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/28073806/functional-tricuspid-regurgitation-caused-by-chronic-atrial-fibrillation-a-real-time-3-dimensional-transesophageal-echocardiography-study
#18
Hiroto Utsunomiya, Yuji Itabashi, Hirotsugu Mihara, Javier Berdejo, Sayuki Kobayashi, Robert J Siegel, Takahiro Shiota
BACKGROUND: Functional tricuspid regurgitation (TR) with a structurally normal tricuspid valve (TV) may occur secondary to chronic atrial fibrillation (AF). However, the clinical and echocardiographic differences according to functional TR subtypes are unclear. Therefore, characterization of functional TR because of chronic AF (AF-TR) remains undetermined. METHODS AND RESULTS: To investigate the prevalence of AF-TR, 437 patients with moderate to severe TR underwent 3-dimensional (3D) transesophageal echocardiography...
January 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28073593/integrative-cardiopulmonary-ultrasound-for-interstitial-lung-disease-assessment-correlation-between-lung-ultrasound-performance-and-cardiac-involvement
#19
Wei-Wei Zhu, Yi-Dan Li, Hong Li, Xiu-Zhang Lu, Ling-Yun Kong, Xiao-Guang Ye, Qi-Zhe Cai, Lan-Lan Sun, Wei Jiang, Li Wang
The aims of this study were to apply integrative cardiopulmonary ultrasound (thoracic ultrasound) to the evaluation of patients with interstitial lung disease (ILD) and to determine the relationship between lung ultrasound signs and echocardiographic parameters such as systolic pulmonary artery pressure (SPAP) and various right ventricular parameters. ILD patients and healthy controls underwent lung ultrasound (LUS) and echocardiographic tests. In addition to traditional echocardiographic parameters, right ventricular free wall longitudinal strain (RVLS_FW) was measured using 2-D speckle-tracking echocardiography...
January 7, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28070903/myocardial-deformation-in-pediatric-patients-with-mucopolysaccharidoses-a-two-dimensional-speckle-tracking-echocardiography-study
#20
Francesco Borgia, Enrica Pezzullo, Vincenzo Schiano Lomoriello, Regina Sorrentino, Francesco Lo Iudice, Sara Cocozza, Roberto Della Casa, Giancarlo Parenti, Pietro Strisciuglio, Bruno Trimarco, Maurizio Galderisi
BACKGROUND: Mucopolysaccharidoses (MPS) are inherited lysosomal storage disorders caused by deficiency of required glycosaminoglycans breakdown enzymes, inducing cardiac involvement. Little is known about myocardial deformation involvement in MPS. Our aim was to assess biventricular structure and function in asymptomatic children with MPS using standard echo Doppler and 2D speckle tracking (STE). METHODS: Fifteen MPS children (one type I, six type II, three type III A, one III B, three IV A, one VI), asymptomatic for cardiac symptoms, and 15 age and sex-matched healthy controls underwent echo Doppler and STE...
January 10, 2017: Echocardiography
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