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VENTRICULAR DYSFUNCTION AND NORMAL CORONARY ARTERIES

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https://www.readbyqxmd.com/read/29909101/lipoprotein-apheresis-acutely-reverses-coronary-microvascular-dysfunction-in-patients-with-severe-hypercholesterolemia
#1
Melinda D Wu, Federico Moccetti, Eran Brown, Brian P Davidson, Tamara Atkinson, J Todd Belcik, George Giraud, P Barton Duell, Sergio Fazio, Hagai Tavori, Sotirios Tsimikas, Jonathan R Lindner
OBJECTIVES: The study evaluated whether lipoprotein apheresis produces immediate changes in resting perfusion in subjects with severe hypercholesterolemia, and whether there is a difference in the response between peripheral and coronary microcirculations. BACKGROUND: Lipoprotein apheresis is used in patients with severe hypercholesterolemia to reduce plasma levels of low-density lipoprotein cholesterol. METHODS: Quantitative contrast-enhanced ultrasound perfusion imaging of the myocardium at rest and skeletal muscle at rest and during calibrated contractile exercise was performed before and immediately after lipoprotein apheresis in 8 subjects with severe hypercholesterolemia, 7 of whom had a diagnosis of familial hypercholesterolemia...
June 9, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29898149/on-pump-beating-non-beating-cabg-in-stable-angina-have-similar-outcomes
#2
Victor Dayan, Juan Jose Paganini, Alvaro Marichal, Daniel Brusich
OBJECTIVE: On pump beating/non-beating coronary artery bypass grafts (CABG) has been compared in patients with unstable angina and/or severe left ventricular dysfunction. There is scarce evidence regarding the beneficial use of on-pump beating CABG in patients with stable angina and normal left ventricular function. Our aim was to study the postoperative results using both techniques in this group of patients. METHODS: One thousand one hundred and forty-five patients with stable angina underwent on-pump isolated CABG in Uruguay from 2011 to 2015...
March 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29859655/acute-coronary-syndromes-in-patients-with-angiographically-normal-or-near-normal-non-obstructive-coronary-arteries
#3
REVIEW
Antonis S Manolis, Antonis A Manolis, Theodora A Manolis, Helen Melita
Patients with acute coronary syndrome (ACS) with normal or near-normal (non-obstructive) coronary arteries (ACSNNOCA) constitute an important, albeit heterogeneous, patient subset of younger patients, more commonly females, who may have lower risk of cardiovascular events compared to patients with obstructive coronary artery disease; however this risk remains substantial, hence needing further investigation to identify the underlying cause and devise a proper therapeutic strategy. A diagnostic algorithm starts during coronary angiography with some essential additional diagnostic steps, such as a left ventricular angiogram that may readily identify the underlying cause, e...
May 23, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29849266/takotsubo-cardiomyopathy-presenting-as-wellens-syndrome
#4
R Scott Taylor, Leif Skjerli, John Ashurst
Takotsubo cardiomyopathy, also known as apical ballooning syndrome and stress cardiomyopathy, is a transient systolic and diastolic left ventricular dysfunction with a variety of cardiac wall-motion abnormalities that is increasingly being associated with significant morbidity and mortality. Wellens' syndrome is an electrocardiographic (ECG) pattern in a pain-free patient that is indicative of critical occlusion of the left anterior descending coronary artery requiring immediate cardiac catheterization. The authors report a case of a patient presenting with ECG findings consistent with Wellens' syndrome that was later found to have Takotsubo cardiomyopathy with angiographically normal coronary arteries on cardiac catheterization after a seizure...
August 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29778855/myocardial-strain-in-prediction-of-outcomes-after-surgery-for-severe-mitral-regurgitation
#5
Hyue Mee Kim, Goo-Yeong Cho, In-Chang Hwang, Hong-Mi Choi, Jun-Bean Park, Yeonyee E Yoon, Hyung-Kwan Kim
OBJECTIVES: We investigated whether global longitudinal strain (GLS) is a better predictor of clinical events after surgery for mitral regurgitation (MR) than conventional parameters. BACKGROUND: The optimal timing for surgery is guided by left ventricular (LV) dimension or left ventricular ejection fraction (LVEF), even though normal LVEF can mask depressed LV systolic function in severe mitral MR. METHODS: From 2006 to 2016, 506 patients (age 58...
May 11, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29723261/microvolt-t-wave-alternans-and-autonomic-nervous-system-parameters-can-be-helpful-in-the-identification-of-low-arrhythmic-risk-patients-with-ischemic-left-ventricular-systolic-dysfunction
#6
Ludmiła Daniłowicz-Szymanowicz, Damian Kaufmann, Katarzyna Rozwadowska, Maciej Kempa, Ewa Lewicka, Grzegorz Raczak
INTRODUCTION: The role of implantable cardioverter-defibrillator (ICD) placement in the primary prevention of sudden cardiac death (SCD) in all consecutive patients with left ventricular ejection fraction (LVEF) ≤ 35% is still a matter of hot debate due to the fact that the population of these patients is highly heterogeneous in terms of the SCD risk. Nevertheless, reduced LVEF is still the only established criterion during qualification of patients for ICD implantation in the primary prevention of SCD, therefore identification of persons with particularly high risk among patients with LVEF ≤35% is currently of lesser importance...
2018: PloS One
https://www.readbyqxmd.com/read/29685364/myocardial-repolarization-is-affected-in-patients-with-ascending-aortic-aneurysm
#7
Mustafa Topuz, Ömer Genç, Armagan Acele, Mevlüt Koc
OBJECTIVE: Ascending aortic aneurysm (AAA) is one of the major causes of ventricular diastolic dysfunction. Diastolic dysfunction can induce ventricular repolarization dispersion. Nevertheless, myocardial repolarization dispersion is not yet to be fully evaluated in patients with AAA. We aimed to evaluate ventricular repolarization using QT and Tp-Te interval and corrected (c) Tp-Te/QT ratio in patients with AAA. METHODS: One hundred-four patients with AAA without coronary artery disease (CAD) served as the aneurysm group and 82 patients having a normal aortic diameter as the control group...
February 13, 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29648692/multimodality-imaging-for-evaluation-of-chest-pain-using-strain-analysis-at-rest-and-peak-exercise
#8
Mohamad Jihad Mansour, Wael AlJaroudi, Omar Hamoui, Sarah Chaaban, Elie Chammas
BACKGROUND: Exercise stress echocardiography (SE) is commonly used for diagnosing coronary artery disease (CAD). The use of quantitative echocardiographic measures such as strain imaging is expected to improve the sensitivity of conventional SE which relies on the visual diagnosis of wall-motion abnormalities (WMAs). This study is set to demonstrate the added value of resting and exercise strain analysis to detect underlying microangiopathy and inducible myocardial ischemia during a resting and SE in comparison with the results of coronary computed tomographic angiogram (CCTA)...
April 12, 2018: Echocardiography
https://www.readbyqxmd.com/read/29629021/long-term-outcomes-of-left-atrial-reservoir-function-in-children-with-a-history-of-kawasaki-disease
#9
Soo Jung Kang, Jihyun Ha, Seo Jung Hwang, Hyo Jin Kim
Background: Decreased left atrial (LA) reservoir function is reported to be associated with elevated left ventricular (LV) end diastolic pressure and LV diastolic dysfunction. Echocardiographic parameters that reflect LA reservoir function include LA total emptying fraction [(maximum LA volume - minimum LA volume) / maximum LA volume], peak LA longitudinal strain (PLALS) at systole, and LA stiffness index (E/E´/PLALS). We aimed to investigate the long-term outcomes of LV diastolic function in children with a history of Kawasaki disease (KD) (KDHx group) by assessing LA reservoir function...
March 2018: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29576220/fusion-of-three-dimensional-echocardiographic-regional-myocardial-strain-with-cardiac-computed-tomography-for-noninvasive-evaluation-of-the-hemodynamic-impact-of-coronary-stenosis-in-patients-with-chest-pain
#10
Victor Mor-Avi, Mita B Patel, Francesco Maffessanti, Amita Singh, Diego Medvedofsky, S Javed Zaidi, Anuj Mediratta, Akhil Narang, Noreen Nazir, Nadjia Kachenoura, Roberto M Lang, Amit R Patel
BACKGROUND: Combined evaluation of coronary stenosis and the extent of ischemia is essential in patients with chest pain. Intermediate-grade stenosis on computed tomographic coronary angiography (CTCA) frequently triggers downstream nuclear stress testing. Alternative approaches without stress and/or radiation may have important implications. Myocardial strain measured from echocardiographic images can be used to detect subclinical dysfunction. The authors recently tested the feasibility of fusion of three-dimensional (3D) echocardiography-derived regional resting longitudinal strain with coronary arteries from CTCA to determine the hemodynamic significance of stenosis...
March 22, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29568331/impact-of-diabetes-mellitus-on-ischemic-cardiomyopathy-five-year-follow-up-revision-dm-trial
#11
Thiago Hueb, Mauricio S Rocha, Sergio F Siqueira, Silvana Angelina D Orio Nishioka, Giselle L Peixoto, Marcos M Saccab, Eduardo Gomes Lima, Rosa Maria Rahmi Garcia, José Antonio F Ramires, Roberto Kalil Filho, Martino Martinelli Filho
Background: Patients with ischemic cardiomyopathy and severe left ventricular dysfunction have a worse survival prognosis than patients with preserved ventricular function. The role of diabetes in the long-term prognosis of this patient group is unknown. This study investigated whether the presence of diabetes has a long-term impact on left ventricular function. Methods: Patients with coronary artery disease who underwent coronary artery bypass graft surgery, percutaneous coronary intervention, or medical therapy alone were included...
2018: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/29528421/the-outcome-of-mitral-regurgitation-after-the-repair-of-anomalous-left-coronary-artery-from-the-pulmonary-artery-in-infants-and-older-children
#12
Deepa Sasikumar, Baiju S Dharan, Priyadarshini Arunakumar, Arun Gopalakrishnan, Sivasubramonian Sivasankaran, Kavasseri M Krishnamoorthy
OBJECTIVES: Mitral regurgitation (MR) in the majority of infants with an anomalous left coronary artery from the pulmonary artery (ALCAPA) has been shown to improve without concomitant mitral valve repair. However, the outcome of MR in older children with ALCAPA is unclear. The purpose of this study was to compare the outcome of MR following the ALCAPA repair in infants and older children. METHODS: Forty-six patients (34 were younger than 1 year and 12 were aged 1-12 years) underwent the repair for ALCAPA in our institution from June 2006 to June 2016...
March 8, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29525195/advanced-age-attenuates-left-ventricular-filling-efficiency-quantified-using-vortex-formation-time-a-study-of-octogenarians-with-normal-left-ventricular-systolic-function-undergoing-coronary-artery-surgery
#13
Paul S Pagel, Lonnie Dye, Brent T Boettcher, Julie K Freed
OBJECTIVE: Blood flow across the mitral valve during early left ventricular (LV) filling produces a 3-dimensional rotational fluid body, known as a vortex ring, that enhances LV filling efficiency. Diastolic dysfunction is common in elderly patients, but the influence of advanced age on vortex formation is unknown. The authors tested the hypothesis that advanced age is associated with a reduction in LV filling efficiency quantified using vortex formation time (VFT) in octogenarians undergoing coronary artery bypass graft (CABG) surgery...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29495996/diagnosis-of-microvascular-angina-using-cardiac-magnetic-resonance
#14
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, John C Forfar, Keith M Channon, Michael Jerosch-Herold, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: In patients with angina and nonobstructive coronary artery disease (NOCAD), confirming symptoms due to coronary microvascular dysfunction (CMD) remains challenging. Cardiac magnetic resonance (CMR) assesses myocardial perfusion with high spatial resolution and is widely used for diagnosing obstructive coronary artery disease (CAD). OBJECTIVES: The goal of this study was to validate CMR for diagnosing microvascular angina in patients with NOCAD, compared with patients with obstructive CAD and correlated to the index of microcirculatory resistance (IMR) during invasive coronary angiography...
March 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29495995/gadolinium-free-cardiac-mr-stress-t1-mapping-to-distinguish-epicardial-from-microvascular-coronary-disease
#15
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, Andreas Greiser, Michael Jerosch-Herold, John C Forfar, Keith M Channon, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: Novel cardiac magnetic resonance (CMR) stress T1 mapping can detect ischemia and myocardial blood volume changes without contrast agents and may be a more comprehensive ischemia biomarker than myocardial blood flow. OBJECTIVES: This study describes the performance of the first prospective validation of stress T1 mapping against invasive coronary measurements for detecting obstructive epicardial coronary artery disease (CAD), defined by fractional flow reserve (FFR <0...
March 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29460490/evaluation-of-sex-differences-in-the-relationship-between-diastolic-dysfunction-and-thromboembolism-using-propensity-score-analysis
#16
Mi-Na Kim, Jae-Min Shim, Jong-Il Choi, Seong-Mi Park, Young Hoon Kim, Wan Joo Shim
BACKGROUND: Female sex is a risk factor for thromboembolism (TE) in atrial fibrillation (AF); however, the underlying mechanisms are unclear. We postulated that left ventricular (LV) diastolic dysfunction (LVDD) could be associated with increased thromboembolic risk in women. METHODS: From a retrospective cohort, 158 patients (female : male = 79:79) with nonvalvular AF were propensity score-matched for age, presence of diabetes, hypertension, coronary artery disease, congestive heart failure, embolic history, AF type, and AF duration...
February 20, 2018: Echocardiography
https://www.readbyqxmd.com/read/29446126/layer-specific-global-longitudinal-strain-reveals-impaired-cardiac-function-in-patients-with-reversible-ischemia
#17
Christoffer E Hagemann, Søren Hoffmann, Flemming J Olsen, Peter G Jørgensen, Thomas Fritz-Hansen, Jan S Jensen, Tor Biering-Sørensen
AIMS: Two-dimensional speckle tracking echocardiography (2DSTE) detects early signs of left ventricular dysfunction; however, it is unknown whether layer-specific global longitudinal strain (GLS) has incremental value in diagnosis of patients with reversible ischemia assessed by single photon emission computed tomography (SPECT). METHODS AND RESULTS: Eighty patients with stable angina pectoris (SAP), normal left ventricular ejection fraction (LVEF), and no history of ischemic heart disease were retrospectively identified to have been examined by 2DSTE, SPECT, and coronary angiography (CAG)...
February 15, 2018: Echocardiography
https://www.readbyqxmd.com/read/29440008/novel-%C3%AE-actin-gene-mutation-p-ala21val-causing-familial-hypertrophic-cardiomyopathy-myocardial-noncompaction-and-transmural-crypts-clinical-pathologic-correlation
#18
Andrea Frustaci, Alessandro De Luca, Valentina Guida, Tommaso Biagini, Tommaso Mazza, Carlo Gaudio, Claudio Letizia, Matteo Antonio Russo, Nicola Galea, Cristina Chimenti
BACKGROUND: Mutations of α-actin gene (ACTC1) have been phenotypically related to various cardiac anomalies, including hypertrophic cardiomyopathy and dilated cardiomyopathy and left ventricular (LV) myocardial noncompaction. A novel ACTC mutation is reported as cosegregating for familial hypertrophic cardiomyopathy and LV myocardial noncompaction with transmural crypts. METHODS AND RESULTS: In an Italian family of 7 subjects, 4 aged 10 (II-1), 14 (II-2), 43 (I-4) and 46 years (I-5), presenting abnormal ECG changes, dyspnea and palpitation (II-2, I-4, and I-5), and recurrent cerebral ischemic attack (I-5), underwent 2-dimensional echo, cardiac magnetic resonance, Holter monitoring, and next-generation sequencing gene analysis...
February 10, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29432575/multiple-common-co-morbidities-produce-left-ventricular-diastolic-dysfunction-associated-with-coronary-microvascular-dysfunction-oxidative-stress-and-myocardial-stiffening
#19
O Sorop, I Heinonen, M van Kranenburg, J van de Wouw, V J de Beer, T N Nguyen, Y Octavia, R W B van Duin, K Stam, R J van Geuns, P A Wielopolski, G P Krestin, A H van den Meiracker, R Verjans, M van Bilsen, A H J Danser, W J Paulus, C Cheng, W A Linke, J A Joles, M C Verhaar, J van der Velden, D Merkus, D J Duncker
Rationale: More than 50% of patients with heart failure have preserved ejection fraction characterized by diastolic dysfunction. The prevalance of diastolic dysfunction is higher in females and associates with multiple comorbidities such as hypertension (HT), obesity, hypercholesterolemia (HC) and diabetes mellitus (DM), although its pathophysiology remains incompletely understood. It has been proposed that the co-morbidities induce systemic inflammation, cardiac microvascular dysfunction and oxidative stress, leading to myocardial fibrosis, myocyte stiffening and ultimately, diastolic dysfunction...
February 8, 2018: Cardiovascular Research
https://www.readbyqxmd.com/read/29356392/transvenous-dual-chamber-pacemaker-after-paediatric-heart-transplantation-using-left-ventricle-pacing-through-the-coronary-sinus
#20
José Mario Baggio, Cristina Machado Camargo Afiune, Jorge Y Afiune, Alvaro V Sarabanda, Fernando A Atik
A 12-year-old child with end-stage heart failure due to restrictive cardiomyopathy was submitted to orthotopic heart transplantation. Primary graft dysfunction required venous arterial extra-corporeal membrane oxygenation. Heart function normalized, but complete atrioventricular block remained after 3 weeks. A dual-chamber pacing with transvenous left ventricle pacing through the coronary sinus was performed. At 5-year follow-up, the patient is stable with the same pacing system and with preserved ventricular function...
February 2018: ESC Heart Failure
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