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https://www.readbyqxmd.com/read/28439851/exploring-the-pathophysiology-of-takotsubo-cardiomyopathy
#1
REVIEW
Wengen Chen, Vasken Dilsizian
PURPOSE OF REVIEW: The purpose of this review is to explore the pathophysiology of Takotsubo cardiomyopathy by appraising the interplay between myocardial perfusion, function, metabolism, and, particularly, sympathetic innervation. RECENT FINDINGS: A number of hypotheses have been proposed to explain the pathogenesis of Takotsubo cardiomyopathy, which include (1) catecholamine cardiac toxicity, (2) myocardial sympathetic innervation disruption, (3) coronary vasospasm, (4) myocardial microvascular dysfunction, and (5) aborted myocardial infarction...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28409033/aborted-sudden-cardiac-death-in-a-female-patient-presenting-with-takotsubo-like-cardiomyopathy-due-to-epicardial-coronary-vasospasm
#2
Sorin Giusca, Tom Eisele, Peter Nunninger, Benedikt Münz, Grigorios Korosoglou
Takotsubo cardiomyopathy is characterized by apical ballooning of the left ventricle (LV) in the absence of relevant coronary artery stenosis, which typically occurs in elderly women after emotional stress. Catecholamine cardiotoxicity, metabolic disturbance, and coronary microvascular impairment have previously been proposed as underlying pathophysiologic mechanisms of takotsubo cardiomyopathy, whereas myocardial stunning resulting from epicardial coronary artery vasospasm is not generally accepted as a cause of takotsubo cardiomyopathy...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28376710/electrocardiographic-changes-mimicking-acute-coronary-syndrome-in-a-large-intracranial-tumour-a-diagnostic-dilemma
#3
Nilukshana Yogendranathan, H M M T B Herath, S P Pahalagamage, Aruna Kulatunga
BACKGROUND: ST elevation Myocardial infarction is a medical emergency. A variety of noncardiac conditions had been known to mimic the ECG changes that are seen in acute coronary syndrome. Although the common ECG changes that are documented with raised intracranial pressure are T inversions, prolongation of QT interval and sinus bradycardia, ST elevation or depression, arrhythmias and prominent U waves have also been recognized. However, ST elevations in association with primary intracranial tumours are rarely reported...
April 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28269446/current-distribution-in-tissues-with-conducted-electrical-weapons-operated-in-drive-stun-mode
#4
Dorin Panescu, Mark W Kroll, Michael Brave
INTRODUCTION: The TASER® conducted electrical weapon (CEW) is best known for delivering electrical pulses that can temporarily incapacitate subjects by overriding normal motor control. The alternative drive-stun mode is less understood and the goal of this paper is to analyze the distribution of currents in tissues when the CEW is operated in this mode. METHODS AND RESULTS: Finite element modeling (FEM) was used to approximate current density in tissues with boundary electrical sources placed 40 mm apart...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227692/current-distribution-in-tissues-with-conducted-electrical-weapons-operated-in-drive-stun-mode
#5
Dorin Panescu, Mark W Kroll, Michael Brave, Dorin Panescu, Mark W Kroll, Michael Brave, Dorin Panescu, Mark W Kroll, Michael Brave
INTRODUCTION: The TASER® conducted electrical weapon (CEW) is best known for delivering electrical pulses that can temporarily incapacitate subjects by overriding normal motor control. The alternative drive-stun mode is less understood and the goal of this paper is to analyze the distribution of currents in tissues when the CEW is operated in this mode. METHODS AND RESULTS: Finite element modeling (FEM) was used to approximate current density in tissues with boundary electrical sources placed 40 mm apart...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28216496/-clinical-value-of-the-evolution-of-left-ventricular-global-strain-in-anterior-myocardial-infarction-patients-treated-with-emergency-percutaneous-coronary-intervention
#6
Zurong Yang, Qichang Zhou, Zhenfei Fang, Danming Cao, Jiawei Zhou, Xiankui Tan
To investigate the evolution of left ventricular global strain in anterior myocardial infarction patients treated with emergency percutaneous coronary intervention (PCI).
 Methods: A total of 54 patients with PCI were enrolled as a PCI group. Forty healthy subjects were enrolled as a control group. Dynamic cardiac images were collected. All of these images were analyzed off-line by velocity vector imaging (VVI) software. N-terminal pro-B-type natriuretic peptide (NT-proBNP) was measured with an electrochemiluminescence immunoassay through the Elecsys 1010/2010 system...
January 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28187814/neurocardiology
#7
REVIEW
N D Osteraas, V H Lee
Neurocardiology refers to the interplay between the nervous system and the cardiovascular system. Stress-related cardiomyopathy exemplifies the brain-heart connection and occurs in several conditions with acute brain injury that share oversympathetic activation. The brain's influences on the heart can include elevated cardiac markers, arrhythmias, repolarization abnormalities on electrocardiogram, myocardial necrosis, and autonomic dysfunction. The neurogenic stunned myocardium in aneurysmal subarachnoid hemorrhage represents one end of the spectrum, and is associated with an explosive rise in intracranial pressure that results in excess catecholamine state and possibly CBN...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28122851/intradialytic-cardiac-magnetic-resonance-imaging-to-assess-cardiovascular-responses-in-a-short-term-trial-of-hemodiafiltration-and-hemodialysis
#8
Charlotte Buchanan, Azharuddin Mohammed, Eleanor Cox, Katrin Köhler, Bernard Canaud, Maarten W Taal, Nicholas M Selby, Susan Francis, Chris W McIntyre
Hemodynamic stress during hemodialysis (HD) results in recurrent segmental ischemic injury (myocardial stunning) that drives cumulative cardiac damage. We performed a fully comprehensive study of the cardiovascular effect of dialysis sessions using intradialytic cardiac magnetic resonance imaging (MRI) to examine the comparative acute effects of standard HD versus hemodiafiltration (HDF) in stable patients. We randomly allocated 12 patients on HD (ages 32-72 years old) to either HD or HDF. Patients were stabilized on a modality for 2 weeks before undergoing serial cardiac MRI assessment during dialysis...
April 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28095748/myocardial-inactivation-of-thyroid-hormones-in-patients-with-aortic-stenosis
#9
Bruno S Paolino, Pablo M Pomerantzeff, Luís Alberto O Dallan, Fabio A Gaiotto, Nailliw Z Preite, Ana Claudia Latrônico, José Carlos Nicolau, Antonio C Bianco, Roberto R C V Giraldez
OBJECTIVE: The human heart expresses the type 2 deiodinase (D2) that activates thyroxine (T4) to triiodothyronine (T3). At the same time, the inactivating type 3 deiodinase (D3) has been found in a rat model of right ventricular hypertrophy. It is not known whether the human myocardium metabolizes thyroid hormone. This study examined myocardial thyroid hormone metabolism in patients with aortic valve stenosis (AS) undergoing aortic valve replacement and in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting surgery...
April 12, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28054182/takotsubo-cardiomyopathy-fdg-myocardial-uptake-pattern-in-fasting-patients-comparison-of-pet-ct-spect-and-echo-results
#10
Malgorzata Kobylecka, Monika Budnik, Janusz Kochanowski, Radoslaw Piatkowski, Marek Chojnowski, Katarzyna Fronczewska-Wieniawska, Tomasz Mazurek, Joanna Maczewska, Michał Peller, Grzegorz Opolski, Leszek Krolicki
BACKGROUND: The aim of this study was to assess the accumulation pattern of 18F-FDG in fasting patients with takotsubo cardiomyopathy (TTC) and to correlate the results with perfusion scintigraphy and echocardiography. METHODS: 18 consecutive patients with TTC were identified by clinical symptoms, cardiac catheterization, and echocardiography. Coronary angiography (CA) and transthoracic echocardiography (TTE) were performed on the day of the onset of symptoms. An assessment of myocardial perfusion (99mTc-MIBI) and glucose metabolism (18F-FDG) was performed within 18 days...
January 4, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28045326/non-occlusive-mesenteric-ischaemia-in-out-of-hospital-cardiac-arrest-survivors
#11
Raphael Wurm, Anna Cho, Henrike Arfsten, Raphael van Tulder, Christian Wallmüller, Philipp Steininger, Fritz Sterz, Kristina Tendl, Csilla Balassy, Klaus Distelmaier, Martin Hülsmann, Gottfried Heinz, Christopher Adlbrecht
BACKGROUND AND AIM OF THE STUDY: Non-occlusive mesenteric ischaemia (NOMI) is characterised by hypoperfusion of the intestines without evidence of mechanical obstruction, potentially leading to extensive ischaemia and necrosis. Low cardiac output appears to be a major risk factor. Cardiopulmonary resuscitation aims at restoring blood flow after cardiac arrest. However, post restoration of spontaneous circulation, myocardial stunning limits immediate recovery of sufficient cardiac function...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/27941300/reperfusion-damage%C3%A3-a-story-of-success-failure-and-hope
#12
REVIEW
Roberto Ferrari, Cristina Balla, Michele Malagù, Gabriele Guardigli, Giampaolo Morciano, Matteo Bertini, Simone Biscaglia, Gianluca Campo
Tissue salvage of severely ischemic myocardium requires timely reperfusion by thrombolysis, angioplasty, or bypass. However, recovery of left ventricular function is rare. It may be absent or, even worse, reperfusion can induce further damage. Laboratory studies have shown convincingly that reperfusion can increase injury over and above that attributable to the pre-existing ischemia, precipitating arrhythmias, suppressing the recovery of contractile function ("stunning") and possibly even causing cell death in potentially salvable ischemic tissue...
January 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27875730/contemporary-review-on-the-pathogenesis-of-takotsubo-syndrome-the-heart-shedding-tears-norepinephrine-churn-and-foam-at-the-cardiac-sympathetic-nerve-terminals
#13
REVIEW
Shams Y-Hassan, Rodney De Palma
Takotsubo syndrome (TS), an increasingly recognized acute cardiac disease entity, is characterized by a unique pattern of circumferential and typically regional left ventricular wall motion abnormality resulting in a conspicuous transient ballooning of the left ventricle during systole. The mechanism of the disease remains elusive. However, the sudden onset of acute myocardial stunning in a systematic pattern extending beyond a coronary artery territory; the history of a preceding emotional or physical stress factor in two thirds of cases; the signs of sympathetic denervation at the regions of left ventricular dysfunction on sympathetic scintigraphy; the finding of myocardial edema and other signs consistent with (catecholamine-induced) myocarditis shown by cardiac magnetic resonance imaging; and the contraction band necrosis on histopathological examination all argue strongly for the involvement of the cardiac sympathetic nervous system in the pathogenesis of TS...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27866393/potentially-pathogenic-circulating-autoantibodies-to-cardiac-troponin-are-present-in-hemodialysis-patients
#14
Helen J Jefferies, Risto Tertti, Saara Wittfooth, James O Burton, Kaj Metsärinne, Kim Pettersson, Christopher W McIntyre
Introduction Repetitive dialysis-induced cardiac injury is associated with elevated troponin levels, inflammation, and longitudinal reduction in cardiac function. Pathogenic autoantibodies to cardiac troponins (cTnAAb) produce inflammatory cardiomyopathy in murine models. This study aimed to explore the possibility that analogous autoimmune processes might occur in hemodialysis (HD) patients, by initially investigating cTnAAb prevalence, and exploring potential links with HD-induced myocardial stunning. Methods In 130 prevalent HD patients from two centers (Derby, UK; Turku, Finland), cTnAAb (immunoassay) and cardiac troponins were quantified...
November 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27772642/intensive-hemodialysis-and-treatment-complications-and%C3%A2-tolerability
#15
Jose A Morfin, Richard J Fluck, Eric D Weinhandl, Sheru Kansal, Peter A McCullough, Paul Komenda
Hemodialysis (HD) treatment can be difficult to tolerate. Common complications are intradialytic hypotension (IDH) and long time to recovery after an HD session. IDH, as defined by nadir systolic blood pressure < 90mmHg and intradialytic decline > 30mmHg, occurs in almost 8% of HD sessions. IDH may be caused by aggressive ultrafiltration in response to interdialytic weight gain, can lead to myocardial stunning and cardiac arrhythmias, and is associated with increased risk for death. Long recovery time after a treatment session is also common...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27581345/impact-of-malignancies-in-the-early-and-late-time-course-of-takotsubo-cardiomyopathy
#16
Mélanie Girardey, Laurence Jesel, Umberto Campia, Nathan Messas, Sébastien Hess, Alessio Imperiale, Cyrille Blondet, Annie Trinh, Patrick Ohlmann, Olivier Morel
BACKGROUND: Although the relationship between malignancies and catecholamine-induced myocardial stunning remains largely speculative, it has been suggested that the presence of cancer may lower the threshold for stress stimuli and/or may aggravate cardiac adrenoreceptor sensitivity. We sought to investigate whether associations exist between a previous or current diagnosis of malignancy, diagnostic parameters during hospitalization and death in takotsubo. METHODS AND RESULTS: The 154 takotsubo patients were retrospectively identified between May 2008 and December 2014...
September 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27566477/prolonged-qt-and-myocardium-recovery-after-primary-pci-a-cmri-study
#17
Riccardo Ieva, Graziapia Casavecchia, Matteo Gravina, Antonio Totaro, Armando Ferraretti, Luca Macarini, Matteo Di Biase, Natale Daniele Brunetti
BACKGROUND: The presence of viable stunned myocardium recovering after primary angioplasty is not easy to identify in the early phase of acute myocardial infarction (AMI) by noninvasive bed-side methods. We therefore aimed to assess whether a simple electrocardiogram parameter may be of help in identifying the presence of stunned viable myocardium recovering after reperfusion with primary angioplasty. MATERIALS AND METHODS: A total of 14 consecutive patients with ST-elevation AMI (STEMI) were enrolled in the study and underwent QT duration assessment after admission: the difference between QT corrected (QTc) in the ischaemic areas and QTc values in nonischaemic areas was therefore calculated and compared with the presence and the extension of viable stunned myocardium, assessed by comparing akinetic/dyskinetic areas at admission echocardiography with akinetic/dyskinetic areas and extension of scar at 6-month cardiac magnetic resonance imaging (cMRI)...
October 2016: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27553912/faster-rate-of-blood-volume-change-in-pediatric-hemodialysis-patients-impairs-cardiac-index
#18
Jessica J Geer, Shweta Shah, Eric Williams, Ayse Akcan Arikan, Poyyapakkam Srivaths
BACKGROUND: Intradialytic hypotension and myocardial stunning are proposed as contributing to the pathogenesis of increased cardiovascular disease burden and death in patients receiving maintenance hemodialysis (HD). Noninvasive cardiac output measurements provide a dynamic, real-time assessment of hemodynamic parameters. We investigated intradialytic changes in hemodynamic parameters in pediatric outpatients receiving chronic HD and determined patient and treatment risk factors associated with such intradialytic changes...
February 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27522391/acute-repetitive-and-chronic-takotsubo-syndrome-in-patients-with-chronic-kidney-disease-sympathetic-reno-cardial-syndrome
#19
REVIEW
Shams Y-Hassan
Heart failure and cardiovascular death are common in patients with chronic kidney disease (CKD) and extremely prevalent in patients undergoing dialysis. It has been shown that the excess of cardiovascular mortality in this patient population is not fully accounted for by the traditional cardiovascular risk factors. Substantial evidence exists for the presence of sympathetic over-activity in patients with dialytic and non-dialytic CKD. Several studies have also been reported on reversible segmental left ventricular wall motion abnormality consistent with myocardial stunning in association with dialysis especially hemodialysis...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27468506/-autonomic-nervous-system-and-its-imbalance-in-neuro-intensive-care-unit
#20
REVIEW
K A Popugaev, A Yu Lubnin, M V Zabelin, A S Samoylov
The autonomic nervous system (ANS) provides homeostasis due to the innervation of the secretory glands, smooth muscle and cardiac muscle. Higher centers of the ANS (primarily the hypothalamus, some centers of the brain stem and limbic system) form a integrative network, which plays a key role in coordinating the functioning of the endocrine, immune system and other parts of the central nervous system. Intracranial centers of the ANS are responsible for the consciousness, behavioral, emotional, and other components of the higher nervous activity...
March 2016: Anesteziologiia i Reanimatologiia
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