Fundamental Differences in Electrophysiologic and Electroanatomic Substrate Between Ischemic Cardiomyopathy Patients With and Without Clinical Ventricular Tachycardia
Objectives: The aim of this study was to compare the electrophysiologic substrate in ischemic cardiomyopathy (ICM) patients with and without sustained monomorphic ventricular tachycardia (SMVT).Background: Despite the universal presence of potentially arrhythmogenic left ventricular (LV) scarring, it is not clear why the majority of ICM patients never develop SMVT.Methods: Detailed electroanatomic mapping of the LV endocardium was performed in 17 stable control ICM patients (16 males) without clinical SMVT. They were compared with 17 ICM patients (15 males) with spontaneous SMVT. Standard definitions of low-voltage zones and fractionated, isolated, and very late potentials were used.Results: There were no significant baseline differences between the groups in terms of LV diameter, ejection......
POSTED 07/01/2009 at 10:09 AM --
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Chronobiological Patterns of Onset of Tako-Tsubo Cardiomyopathy: A Multicenter Italian Study
To the Editor: Several cardiovascular events, including acute myocardial infarction (AMI), show well-defined temporal patterns in their occurrence throughout the year and the day (). Tako-Tsubo cardiomyopathy (TTC), also called “stress cardiomyopathy” or “transient left ventricular apical ballooning syndrome,” is an acquired cardiomyopathy prevalent in elderly women presenting with a history of emotional or physical stress that mimics the clinical scenario of an AMI (). The aim of this study was to verify whether TTC could exhibit significant chronobiological patterns of onset. We analyzed data from 90 consecutive patients with TTC admitted between January 2002 and December 2007 to the coronary care unit of 7 Italian referral cardiac centers. All patients were enrolled according to......
POSTED 07/01/2009 at 10:09 AM --
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Myocardial bridging and sudden death in hypertrophic cardiomyopathy: Salome drops another veil
(Source: European Heart Journal)...
POSTED 06/30/2009 at 06:00 PM --
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Myocardial bridging, a frequent component of the hypertrophic cardiomyopathy phenotype, lacks systematic association with sudden cardiac death
Conclusion
In this morphological analysis of more than 250 hearts, CBs are a frequent component of phenotypically expressed HCM, and more common than in other disorders with or without LV hypertrophy. Although no systematic association with HCM-related sudden death is evident, our findings do not exclude the possibility that CB could contribute to increased risk in some individual patients, potentially impacting management decision-making on a case-by-case basis. (Source: European Heart Journal)...
POSTED 06/30/2009 at 06:00 PM --
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A new polymorphism in human calmodulin III gene promoter is a potential modifier gene for familial hypertrophic cardiomyopathy
Conclusion
These data suggest that the –34T>A CALM3 polymorphism is a modifier gene for FHC, potentially by affecting expression level of CALM3 and therefore Ca2+-handling and development of hypertrophy. (Source: European Heart Journal)...
POSTED 06/30/2009 at 06:00 PM --
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Effects of perindopril on cardiac remodelling and prognostic value of pre-discharge quantitative echocardiographic parameters in elderly patients after acute myocardial infarction: the PREAMI echo sub-study
Conclusion
Remodelling occurs in post-AMI in elderly patients with normal LV function. Echo-Doppler variables at baseline have prognostic implications. Treatment with perindopril reduces progressive LV remodelling that can occur even in the case of small infarct size. (Source: European Heart Journal)...
POSTED 06/30/2009 at 06:00 PM --
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Weight changes after hospitalization for worsening heart failure and subsequent re-hospitalization and mortality in the EVEREST trial
Conclusion
Increases in BW after hospitalization for worsening HF was predictive of repeat hospitalization events, but not mortality in the post-discharge period. (Source: European Heart Journal)...
POSTED 06/30/2009 at 06:00 PM --
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A genetic variants database for arrhythmogenic right ventricular dysplasia/cardiomyopathy
Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a hereditary cardiomyopathy characterized by fibrofatty replacement of cardiomyocytes, ventricular tachyarrhythmias and sudden death. ARVD/C is mainly caused by mutations in genes encoding desmosomal proteins. However, the pathogenicity of variants is not always clear. Therefore, we created an online database (), providing information on variants in ARVD/C-associated genes. We searched the literature using ARVD/C and its underlying genes as search terms. From the selected papers and our unpublished data, we collected details on the type of mutation and information provided at the protein level. A "details page" contains clinical data and references. To aid the interpretation of missense mutations, we provide data from in......
POSTED 06/30/2009 at 06:00 PM --
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[Case reports] Septal myectomy for hypertrophic obstructive cardiomyopathy: coil, boil and the role of rescue surgery
We present the history of a patient who underwent alcohol ablation and developed a life-threatening ventricular septal defect consecutively to a large myocardial infarction because of alcohol injection into the LAD. (Source: European Journal of Cardio-Thoracic Surgery)...
POSTED 06/29/2009 at 06:00 PM --
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Metabolic and cardiovascular complications of HIV
Abstract: Prior to the advent of highly active antiretroviral therapy, patients with advanced HIV disease presented with cardiovascular complications such as dilated cardiomyopathy and pericardial effusions. HIV is now a manageable chronic disease with patients more likely to present with complications related to treatment including coronary artery disease, diabetes, dyslipidaemia, lipodystrophy and osteopaenia. While complications, such as lactic acidosis, have become uncommon, others such as pulmonary hypertension have remained constant despite effective therapy. Attempts to mitigate exposure to potentially toxic drugs have revealed that the virus itself also has important pro-inflammatory effects. (Source: Medicine)...
POSTED 06/29/2009 at 11:17 AM --
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Editorial: Using a Magnet to Strike Gold
Cardiac magnetic resonance (CMR) imaging is rapidly emerging as the procedure of first choice in the management of patients who have heart failure (HF). It has been argued that all patients with newly diagnosed HF should undergo CMR to detect structural and functional abnormalities that are usually not detected by conventional imaging techniques. In HF patients, a typical approach includes the assessment of morphology and function, characterization of the nature of the cardiomyopathy, and risk stratification. (Source: Heart Failure Clinics)...
POSTED 06/29/2009 at 10:04 AM --
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Identifying the Etiology: A Systematic Approach Using Delayed-Enhancement Cardiovascular Magnetic Resonance
This article explores the use of DE-CMR in identifying ischemic and non-ischemic myopathic processes and details a systematic approach to determine the cause of cardiomyopathy. (Source: Heart Failure Clinics)...
POSTED 06/29/2009 at 10:04 AM --
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Comparative investigation of the left ventricular pressure-volume relationship in rat models of type 1 and type 2 diabetes mellitus
Diabetes mellitus (DM) is associated with characteristic structural and functional changes of the myocardium, termed diabetic cardiomyopathy. As a distinct entity independent of coronary atherosclerosis, diabetic cardiomyopathy is an increasingly recognized cause of heart failure. A detailed understanding of diabetic cardiac dysfunction, using relevant animal models, is required for the effective prevention and treatment of cardiovascular complications in diabetic patients. We investigated and compared cardiac performance in rat models of type 1 DM (streptozotocin induced) and type 2 DM (Zucker diabetic fatty rats) using a pressure-volume (P-V) conductance catheter system. Left ventricular (LV) systolic and diastolic function was evaluated in vivo at different preloads, including the slope......
POSTED 06/28/2009 at 06:00 PM --
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An internal domain of {beta}-tropomyosin increases myofilament Ca2+ sensitivity
Tropomyosin (TM) is involved in Ca2+-mediated muscle contraction and relaxation in the heart. Striated muscle -TM is the major isoform expressed in the heart. The expression of striated muscle β-TM in the murine myocardium results in a decreased rate of relaxation and increased myofilament Ca2+ sensitivity. Replacing the carboxyl terminus (amino acids 258–284) of -TM with β-TM (a troponin T-binding region) results in decreased rates of contraction and relaxation in the heart and decreased myofilament Ca2+ sensitivity. We hypothesized that the putative internal troponin T-binding domain (amino acids 175–190) of β-TM may be responsible for the increased myofilament Ca2+ sensitivity observed when the entire β-TM is expressed in the heart. To test this hypothesi......
POSTED 06/28/2009 at 06:00 PM --
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[Original articles] Cardiac resynchronisation therapy in paediatric and congenital heart disease: differential effects in various anatomical and functional substrates
Conclusion:
Heart failure associated with ventricular pacing is the largest indication for CRT in paediatric and congenital heart disease. CRT efficacy varies widely with the underlying anatomical and pathophysiological substrate. (Source: Heart)...
POSTED 06/28/2009 at 06:00 PM --
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New developments in anthracycline-induced cardiotoxicity.
Authors: Mordente A, Meucci E, Silvestrini A, Martorana GE, Giardina B
Anthracyclines are among the most effective anticancer drugs ever developed. Unfortunately, their clinical use is severely limited by the development of a progressive dose-dependent cardiomyopathy that irreversibly evolves toward congestive heart failure, usually refractory to conventional therapy. The pathophysiology of anthracycline-induced cardiomyopathy remains controversial and incompletely understood. The current thinking is that anthracyclines are toxic per se but gain further cardiotoxicity after one-electron reduction with ROS overproduction or two-electron reduction with conversion to C-13 alcohol metabolites. ROS overproduction can probably be held responsible for anthracycline acute cardiotoxicity, but n......
POSTED 06/27/2009 at 10:08 PM --
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Arrhythmogenic right ventricular cardiomyopathy.
Authors: Pike R
Arrhythmogenic right ventricular cardiomyopathy is a cardiac disorder manifested by the replacement of the ventricular myocardium by fibro fatty tissue and has been known to cause sudden cardiac death in young adults. In 30% to 50% of cases, the disease has familial links, which can have implications for the patients and families involved. Achieving a diagnosis can be taxing on all involved, and for the patient, it can mean having to go through a battery of tests. Once diagnosis has been confirmed, treatment for the disease includes implantation of an implantable defibrillator and/or pharmacotherapy to control the ventricular tachyarrhythmias.
PMID: 19517899 [PubMed - in process] (Source: Canadian Journal of Cardiovascular Nursing)...
POSTED 06/27/2009 at 02:01 PM --
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[Puerperal pathology]
Authors: Bezares B, Sanz O, Jiménez I
The puerperium is the period from the end of labour to the appearance of the first menstruation. The possible pathologies that can occur in this period of time are the most frequent cause of maternal mortality even in our setting. The pathology of lactation includes failure of breastfeeding, cracks in the nipple, mammary ingurgitation and puerperal mastitis. Puerperal infection is a frequent obstetric complication although clinical guidelines for prophylaxis have considerably reduced its incidence. The vascular pathology of the puerperium includes clinical features of great seriousness, representing one of the main causes of maternal mortality. These include deep vein thrombosis, of which pulmonary thromboembolism is the most serious complicat......
POSTED 06/27/2009 at 12:57 PM --
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Syncope from dynamic left ventricular outflow tract obstruction simulating hypertrophic cardiomyopathy in a patient with primary AL-type amyloid heart disease.
Authors: Velazquez-Ceceña JL, Lubell DL, Nagajothi N, Al-Masri H, Siddiqui M, Khosla S
Dynamic left ventricular outflow tract (LVOT) obstruction is seen classically in hypertrophic cardiomyopathy. Cardiac amyloidosis can present with asymmetric hypertrophy that resembles hypertrophic cardiomyopathy, and, in some cases, with dynamic LVOT obstruction. The occurrence of syncope in such patients is not uncommon. The syncope is usually thought to be related to mechanisms other than LVOT obstruction, such as arrhythmias, conduction disturbances, orthostatic hypotension, or vasovagal effects associated with neuropathy.Herein, we report the case of a patient who had immunocyte-derived (primary AL-type) cardiac amyloidosis with the echocardiographic appearance of hypertrophic cardiomyopath......
POSTED 06/27/2009 at 10:04 AM --
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The C-reactive Protein Levels in Left Ventricular Dysfunction of Different Etiology.
Conclusions: as shown by increment of C-reactive protein values, the immune system is activated in patients with the chronic left ventricular dysfunction. The patients with the chronic left ventricular dysfunction of an ishemic origin have higher levels of C-reactive protein than those of a non-ischemic origin. This difference could depend on the atherosclerotic process present presumably only in the first group.
PMID: 19534672 [PubMed - as supplied by publisher] (Source: Inflammation and Allergy Drug Targets)...
POSTED 06/27/2009 at 07:50 AM --
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