المؤلفون: Gloria Santangelo, Gabriele Tumminello, Lucia Barbieri, Giulio Pio Federico Mallardi, Andrea Faggiano, Silvia Moscardelli, Andrea Rossi, Fabiana Cozza, Stefano Carugo, Pompilio Faggiano

المصدر: Journal of Clinical Medicine, Vol 13, Iss 12, p 3478 (2024)

مصطلحات موضوعية: moderate aortic valve stenosis, left ventricular disfunction, discordant moderate aortic stenosis, aortic valve replacement, iPCSK9, Medicine

الوصف: According to current guidelines, only clinical surveillance is recommended for patients with moderate aortic valve stenosis (AS), while aortic valve replacement may be considered in patients undergoing surgery for other indications. Recent studies have shown that moderate AS is associated with a high risk of adverse cardiovascular events, including death, especially in patients with left ventricular dysfunction. In this context, multimodality imaging can help to improve the accuracy of moderate AS diagnosis and to assess left ventricular remodeling response. This review discusses the natural history of this valve disease and the role of multimodality imaging in the diagnostic process, summarizes current evidence on the medical and non-medical management, and highlights ongoing trials on valve replacement.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2077-0383/13/12/3478Test; https://doaj.org/toc/2077-0383Test

الوصول الحر: https://doaj.org/article/4af5be106a5f4b8cbc5a3a5f9e7bc70aTest

المؤلفون: Melendo-Viu, María, Dobarro Pérez, David, Raposeiras Roubin, Sergio, Llamas Pernas, Carmen, Moliz Cordón, Candela, Vázquez Lamas, Miriam, Piñón Esteban, Miguel, Varela Martínez, María Ángela, Abu Assi, Emad, Pita Romero, Rafael, Legarra Calderón, Juan José, Íñiguez Romo, Andrés

مصطلحات موضوعية: 616.12, Left ventricular assist device, destination therapy, patient selection, frailty, comorbidities, right ventricular disfunction, Cardiología, 2410.02 Anatomía Humana

الوصف: 2023 Descuento MDPI ; Advanced heart failure is a growing problem for which the best treatment is cardiac transplantation. However, the shortage of donors’ hearts made left ventricular assist devices as destination therapy (DT-LVAD) a highly recommended alternative: they improved mid-term prognosis as well as patients’ quality of life. Current intracorporeal pumps with a centrifugal continuous flow evolved in the last few years. Since 2003, when first LVAD was approved for long-term support, smaller device sizes with better survival and hemocompatibility profile were reached. The most important difficulty lies in the moment of the implant. Recent indications range from INTERMACS class 2 to 4, with close monitoring in intermediate cases. Moreover, a large multiparametric study is needed for considering the candidacy: basal situation, with a special interest in frailty, comorbidities, including renal and hepatic dysfunction, and medical background, considering every prior cardiac condition, must be evaluated. In addition, some clinical risk scores can be helpful to measure the possibility of right heart failure or morbi-mortality. With this review, we sought to summarize all the device improvements, with their updated clinical results, as well as to focus on all the patient selection criteria. ; Depto. de Medicina ; Fac. de Medicina ; TRUE ; pub ; Descuento UCM

وصف الملف: application/pdf

العلاقة: https://hdl.handle.net/20.500.14352/104902Test; Melendo-Viu M, Dobarro D, Raposeiras Roubin S, Llamas Pernas C, Moliz Cordón C, Vazquez Lamas M, et al. Left Ventricular Assist Device as a Destination Therapy: Current Situation and the Importance of Patient Selection. Life 2023;13:1065. https://doi.org/10.3390/life13041065Test.; https://doi.org/10.3390/life13041065Test; https://www.mdpi.com/2075-1729/13/4/1065Test

الإتاحة: https://doi.org/20.500.14352/10490210.3390/life13041065Test
https://hdl.handle.net/20.500.14352/104902Test
https://www.mdpi.com/2075-1729/13/4/1065Test

المؤلفون: María Melendo-Viu, David Dobarro, Sergio Raposeiras Roubin, Carmen Llamas Pernas, Candela Moliz Cordón, Miriam Vazquez Lamas, Miguel Piñón Esteban, Maria Ángela Varela Martínez, Emad Abu Assi, Rafael Pita Romero, Juan José Legarra Calderón, Andrés Íñiguez Romo

المصدر: Life, Vol 13, Iss 4, p 1065 (2023)

مصطلحات موضوعية: left ventricular assist device, destination therapy, patient selection, frailty, comorbidities, right ventricular disfunction, Science

الوصف: Advanced heart failure is a growing problem for which the best treatment is cardiac transplantation. However, the shortage of donors’ hearts made left ventricular assist devices as destination therapy (DT-LVAD) a highly recommended alternative: they improved mid-term prognosis as well as patients’ quality of life. Current intracorporeal pumps with a centrifugal continuous flow evolved in the last few years. Since 2003, when first LVAD was approved for long-term support, smaller device sizes with better survival and hemocompatibility profile were reached. The most important difficulty lies in the moment of the implant. Recent indications range from INTERMACS class 2 to 4, with close monitoring in intermediate cases. Moreover, a large multiparametric study is needed for considering the candidacy: basal situation, with a special interest in frailty, comorbidities, including renal and hepatic dysfunction, and medical background, considering every prior cardiac condition, must be evaluated. In addition, some clinical risk scores can be helpful to measure the possibility of right heart failure or morbi-mortality. With this review, we sought to summarize all the device improvements, with their updated clinical results, as well as to focus on all the patient selection criteria.

العلاقة: https://www.mdpi.com/2075-1729/13/4/1065Test; https://doaj.org/toc/2075-1729Test; https://doaj.org/article/2df7bbd5093f4f7ca05defe37c11ed37Test

الإتاحة: https://doi.org/10.3390/life13041065Test
https://doaj.org/article/2df7bbd5093f4f7ca05defe37c11ed37Test

المؤلفون: Rodrigues, Ronaldo Campos, Azevedo, Katia Martins Lopes de, Moscavitch, Samuel Datum, Setubal, Sergio, Mesquita, Claudio Tinoco

المصدر: Arquivos Brasileiros de Cardiologia. October 2019 113(4)

مصطلحات موضوعية: Acquired Immunodeficiency Syndrome, HIV, Ventricular Disfunction,Left, Echocardiography, Doppler, Antiretroviral Therapy, Highly Active, Strain, Speckle Tracking

الوصف: Background: Most cardiovascular abnormalities in patients infected with the human immunodeficiency virus (HIV) have been associated with myocardial damage directly caused by the virus. Some cases, however, may be associated with adverse effects from antiretroviral therapy (ART). New ventricular function assessment techniques are capable of detecting early changes in the cardiac function of HIV-infected patients using or not using ART. The usefulness of these techniques has been little employed in these patients. Objectives: To investigate the potential influence of antiretroviral therapy (ART) on the occurrence of subclinical left ventricular systolic dysfunction evaluated by myocardial strain rate analysis using two-dimensional speckle tracking echocardiography (2-D Echo) in treated HIV patients compared to untreated patients and healthy individuals. Methods: Sixty-eight HIV-infected patients with no cardiovascular symptoms, normal left ventricular (LV) ejection fraction (> 0.55 on 2-D Echo) were divided into three groups: 11 patients not using antiretroviral therapy (NT), 24 using protease inhibitor (PI) and 33 using non-nucleoside reverse transcriptase inhibitor (NNRTI). We also studied 30 normal non-HIV infected individuals (Ctrl). Demographic, clinical, biochemical and anthropometric data were collected. Preliminary transthoracic echocardiography included study of myocardial strain using two-dimensional speckle tracking. We studied strain and strain rate in the seventeen left ventricular (LV) myocardial segments in the longitudinal, circumferential and radial axes. Statistical analysis of the data was done with IBM SPSS - version 20 for Windows. Upon analysis of the data, namely the normality of independent variables in the different groups and the homogeneity of the variances between the groups, Kruskal-Wallis’ non-parametric test was done, followed by Dunn’s multiple comparison tests to test the significance of the differences between the values measured in the study groups. A significance level of 5% was adopted for decision-making on statistical tests. Results: The mean age of HIV patients was 40 ± 8.65 years and the mean age of controls was 50 ± 11.6 years (p < 0.001). Median LV global longitudinal strain (GLS) of NT patients (-17.70%), PI patients (-18.27%) and NNRTIs (-18.47%) were significantly lower than that of the Ctrl group (-20.77%; p = 0.001). There was no significant difference in mean SLG between treated patients (PI, NNRTI) and untreated (NT) patients. No significant differences were observed in mean circumferential and radial strain, nor on circumferential and radial strain rates between the NT, PI, NNRTI and Ctrl groups. Conclusion: The data suggest that HIV patients present, on myocardial strain measured by speckle tracking, signs of early LV systolic dysfunction that seem to be unrelated to the presence of ART. The prognostic significance of this condition in these patients deserves further studies.

وصف الملف: text/html

الوصول الحر: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019001000737Test

المؤلفون: Zanobetti, Maurizio, Converti, Cristiano, Conti, Alberto, Viviani, Gabriele, Guerrini, Elisa, Boni, Vanessa, Vicidomini, Sonia, Poggioni, Claudio, Guzzo, Aurelia, Coppa, Alessandro, Bigiarini, Sofia, Innocenti, Francesca, Pini, Riccardo

المصدر: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health. 14(5)

مصطلحات موضوعية: Pulmonary Embolism, Echocardiography, Emergency Department, Right Ventricular Disfunction, Thrombolytic therapy, Emergency Medicine, Cardiology

الوصف: Introduction: Pulmonary embolism (PE) is a life-threatening illness with high morbidity and mortality. Echocardiography (ECG) plays an important role in the early identification of right ventricular (RV) dysfunction, making it a helpful tool in identifying hemodynamically stable patients affected by PE with a higher mortality risk. The purpose of this study was to evaluate if one or more ECG indexes could predict a short-term evolution towards RV dysfunction.Methods: We selected all patients consecutively admitted to the Careggi Hospital Emergency Department with the clinical suspicion of PE, confirmed by computed tomography angiography prior to enrollment. Subsequently, properly trained emergency physicians acquired a complete ECG to measure RV morphological and functional indices. For each patient, we recorded if he or she received a fibrinolytic treatment, a surgical embolectomy or heparin therapy during the emergency department (ED) stay. Then, every patient was re-evaluated with ECG, by the same physician, after 1 week in our intensive observation unit and 1 month as outpatient in our ED regional referral center for PE.Results: From 2002 to 2007, 120 consecutive patients affected by PE were evaluated by echocardiography at the Careggi Hospital ED. Nine patients (8%) were treated with thrombolytic therapy. Six died within 1 week and 4 abandoned the study, while the remaining 110 survived and were re-evaluated by ECG after 1 week and 1 month. The majority of the echocardiographic RV indexes improve mostly in the first 7 days: Acceleration Time (AT) from 78±14 ms to 117±14 ms (p

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/0k25z8rkTest

المؤلفون: Santellano-Juárez,Brenda, González-Islas,Dulce, Contreras-Ramírez,Edna, Orea-Tejeda,Arturo, Pineda-Juárez,Juan, Peláez-Hernández,Viridiana, Keirns-Davies,C., Herrera-Saucedo,Raúl, Elizondo-Montes,Marcela, Pérez-Cortes,Guillermo

المصدر: Neumología y cirugía de tórax v.76 n.3 2017

مصطلحات موضوعية: Right heart failure, prognosis, chronic obstructive pulmonary disease, hospital mortality, right ventricular disfunction

الوصف: Background: Patients with chronic obstructive pulmonary disease (COPD) have a high prevalence of heart failure (HF). Patients with concurrent HF and COPD have worse prognosis. However, the impact of Right Heart Failure (RHF) on hospital mortality has not been explored. Objective: to evaluate the association between of right heart failure (RHF) and hospital mortality in COPD patients. Methods: An analytical cross-sectional study was performed in hospitalized COPD patients. The patients hospitalized between 2014 and 2015 were including in study. Results: Ninety-five patients diagnosed with COPD were analyzed: COPD alone (n = 25), COPD and HF with preserved ejection fraction (HFpEF) (n = 29), COPD and RHF (n = 41) and COPD and HF with reduced ejection fraction (HFrEF) (n = 0). The variables associated with risk of hospital mortality were RHF (OR: 10.91, 95% CI: 1.28 to 92.65, p = 0.029), stroke (OR: 14.4, 95% CI: 2.64 to 78.37, p 0.002), pulmonary thromboembolism (OR: 2.09, 95% CI: 1.47-2.98, <0.001) and chronic renal disease (OR: 4.08, 95% CI: 3.36 to 7.01, p < 0.001). Finally, RHF with COPD subjects has 9.42 times more risk of hospital mortality (OR: 9.42, 95% CI: 1.00 to 88.31, p = 0.049) than COPD without RHF adjusted by confusing variables. Conclusion: RHF is a independient risk factor for hospital mortality in COPD patients.

وصف الملف: text/html

الإتاحة: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0028-37462017000300253Test

المؤلفون: Maurizio Zanobetti, Cristiano Converti, Alberto Conti, Gabriele Viviani, Elisa Guerrini, Vanessa Boni, Sonia Vicidomini, Claudio Poggioni, Aurelia Guzzo, Alessandro Coppa, Sofia Bigiarini, Francesca Innocenti, Riccardo Pini

المصدر: Western Journal of Emergency Medicine, Vol 14, Iss 5, Pp 509-517 (2013)

مصطلحات موضوعية: pulmonary embolism, echocardiography, emergency department, right ventricular disfunction, thrombolytic therapy, emergency medicine, cardiology, Medicine, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9

الوصف: Introduction: Pulmonary embolism (PE) is a life-threatening illness with high morbidity and mortality. Echocardiography (ECG) plays an important role in the early identification of right ventricular (RV) dysfunction, making it a helpful tool in identifying hemodynamically stable patients affected by PE with a higher mortality risk. The purpose of this study was to evaluate if one or more ECG indexes could predict a short-term evolution towards RV dysfunction.Methods: We selected all patients consecutively admitted to the Careggi Hospital Emergency Department with the clinical suspicion of PE, confirmed by computed tomography angiography prior to enrollment. Subsequently, properly trained emergency physicians acquired a complete ECG to measure RV morphological and functional indices. For each patient, we recorded if he or she received a fibrinolytic treatment, a surgical embolectomy or heparin therapy during the emergency department (ED) stay. Then, every patient was re-evaluated with ECG, by the same physician, after 1 week in our intensive observation unit and 1 month as outpatient in our ED regional referral center for PE.Results: From 2002 to 2007, 120 consecutive patients affected by PE were evaluated by echocardiography at the Careggi Hospital ED. Nine patients (8%) were treated with thrombolytic therapy. Six died within 1 week and 4 abandoned the study, while the remaining 110 survived and were re-evaluated by ECG after 1 week and 1 month. The majority of the echocardiographic RV indexes improve mostly in the first 7 days: Acceleration Time (AT) from 78±14 ms to 117±14 ms (p

وصف الملف: electronic resource

العلاقة: http://escholarship.org/uc/item/0k25z8rkTest#; https://doaj.org/toc/1936-900XTest; https://doaj.org/toc/1936-9018Test

الوصول الحر: https://doaj.org/article/eb8af320deef4a8f870ee5756fb05e98Test

المؤلفون: Riccardo Raddino, Ivano Bonadei, Melissa Teli, Federica Chieppa, Giorgio Caretta, Debora Robba, Gregoriana Zanini, Enrico Vizzardi, Livio Dei Cas

المصدر: Monaldi Archives for Chest Disease, Vol 70, Iss 1 (2016)

مصطلحات موضوعية: peripartum cardiomyopathy, left ventricular disfunction, heart failure, Medicine

الوصف: which left ventricular dysfunction and symptoms of heart failure occur in the peripartum period in previously healthy women. Incidence of PPCM ranges from 1 in 1300 to 1 in 15,000 pregnancies. The etiology of PPCM is unknown, but viral, autoimmune, and idiopathic causes may contribute. The diagnostic criteria are onset of heart failure in the last month of pregnancy or in the first 5 months postpartum, absence of determinable cause for cardiac failure, and absence of a demonstrable heart disease before the last month of pregnancy. Risk factors for PPCM include advanced maternal age, multiparity, African race, twinning, gestational hypertension, and long-term tocolysis. The clinical presentation of patients with PPCM is similar to that of patients with dilated cardiomyopathy. Echocardiography is central to diagnosis. Early diagnosis and initiation of treatment are essential to optimize pregnancy outcome. Treatment is similar to medical therapy for other forms of dilated cardiomyopathy. About half the patients of PPCM recover without complications. The prognosis is poor in patients with persistent cardiomyopathy. Persistence of disease after 6 months indicates irreversible cardiomyopathy and portends worse survival.

وصف الملف: electronic resource

العلاقة: https://www.monaldi-archives.org/index.php/macd/article/view/431Test; https://doaj.org/toc/1122-0643Test; https://doaj.org/toc/2532-5264Test

الوصول الحر: https://doaj.org/article/2bfeaf7cc9e54bb9b487e4d9957c2214Test

المؤلفون: Nikolić Aleksandra, Jovović Ljiljana, Tomić Slobodan, Vuković Milan

المصدر: Vojnosanitetski Pregled, Vol 69, Iss 1, Pp 32-36 (2012)

مصطلحات موضوعية: heart defects, congenital, ventricular disfunction, echocardiography, diagnosis, prevalence, Medicine (General), R5-920

الوصف: Background/Aim. Left ventricular noncompaction (LVNC) is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies) or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System). Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ± 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/0042-8450Test

الوصول الحر: https://doaj.org/article/095aadec82e64d2eaffb3f066474b834Test

المؤلفون: Santangelo, Gloria, Tumminello, Gabriele, Barbieri, Lucia, Mallardi, Giulio Pio Federico, Faggiano, Andrea, Moscardelli, Silvia, Rossi, Andrea, Cozza, Fabiana, Carugo, Stefano, Faggiano, Pompilio

المصدر: J Clin Med ; ISSN:2077-0383 ; Volume:13 ; Issue:12

مصطلحات موضوعية: aortic valve replacement, discordant moderate aortic stenosis, iPCSK9, left ventricular disfunction, moderate aortic valve stenosis

الوصف: According to current guidelines, only clinical surveillance is recommended for patients with moderate aortic valve stenosis (AS), while aortic valve replacement may be considered in patients undergoing surgery for other indications. Recent studies have shown that moderate AS is associated with a high risk of adverse cardiovascular events, including death, especially in patients with left ventricular dysfunction. In this context, multimodality imaging can help to improve the accuracy of moderate AS diagnosis and to assess left ventricular remodeling response. This review discusses the natural history of this valve disease and the role of multimodality imaging in the diagnostic process, summarizes current evidence on the medical and non-medical management, and highlights ongoing trials on valve replacement.

العلاقة: https://doi.org/10.3390/jcm13123478Test; https://pubmed.ncbi.nlm.nih.gov/38930005Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11204855Test/

الإتاحة: https://doi.org/10.3390/jcm13123478Test
https://pubmed.ncbi.nlm.nih.gov/38930005Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11204855Test/