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1.
Article | IMSEAR | ID: sea-234271

ABSTRACT

Cardiomyopathy is defined as a heterogeneous group of myocardial disorders wherein the cardiac muscle is functionally and structurally abnormal, without the presence of any congenital heart disease (CHD), coronary artery disease (CAD), valvular disease, and hypertension sufficient enough to lead to abnormality of the myocardium. Based on etiology, cardiomyopathies are classified into primary (acquired, mixed, or genetic) and secondary, which results in different phenotypes like hypertrophic, restrictive, dilated, etc. patterns. Hypertrophic cardiomyopathy is the most common type of primary cardiomyopathy among all cardiomyopathies usually presenting as exertional dyspnea, heart failure, atypical chest pain, syncope, and sudden cardiac death (SCD). Dilated cardiomyopathy is genetic or acquired, causing classic symptoms of heart failure with reduced ejection fraction. Restrictive cardiomyopathy is mostly associated with systemic disease and is rare. Diagnosis of cardiomyopathy includes a detailed evaluation of history, and physical examination followed by a workup including blood test, genetic testing, electrocardiography, and echocardiography testing. Treatment includes initially staging the therapy for heart failure, restriction of physical activity, evaluation of the need for implantable cardioverter-defibrillators, optimization of drugs, and consideration of heart transplantation in refractory cases. Genetic testing of families is now available as an emerging modality for early diagnosis and prevention in relatives of diagnosed cases. This review evaluates the causes, early diagnosis, and early treatment and prevention modalities for cardiomyopathies to reduce morbidity and mortality caused by it.

2.
Article | IMSEAR | ID: sea-232791

ABSTRACT

The prevalence of dilated cardiomyopathy (DCM) is 1:2500 among the women of childbearing age. DCM often develops during second trimester or may be present prior pregnancy. We report a successful pregnancy outcome in a young pre-eclamptic woman with DCM who presented with cardiac failure. Multidisciplinary team involved. Anti-failure drugs, antihypertensives and thromboprophylaxis administered. Caesarean section was performed at 30 weeks because of spontaneous onset of labour to avoid undue stress on failing heart. Intra operative and post-operative recovery was uneventful. Follow up showed improvement in ejection fraction. Counselling prior pregnancy, stable cardiac status, regular monitoring, personalised care ensures safe maternal and foetal outcome.

3.
Rev. Fac. Med. Hum ; 24(3): 148-153, jul.-set. 2024. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1583224

ABSTRACT

RESUMEN La insuficiencia cardíaca con fracción de eyección recuperada se define como la mejoría de la función sistólica del ventrículo izquierdo (FEVI) hasta valores ≥ 40%, después de haber presentado una FEVI reducida (< 40%) en un momento previo y con un incremento absoluto de la FEVI ≥10%. Es una condición crónica y dinámica con alto riesgo de recaída y deterioro, por lo que, el seguimiento estrecho y la terapia médica óptima son fundamentales para su manejo. Se presenta el caso de un paciente varón joven con cardiopatía dilatada con grave disfunción sistólica del ventrículo izquierdo, que con terapia neurohormonal de falla cardiaca, presenta una rápida recuperación clínica y mejoría de la fracción de eyección y remodelado ventricular izquierdo. Se requieren más estudios para comprender mejor esta condición y su tratamiento a largo plazo.


ABSTRACT Heart failure with recovered ejection fraction is defined as the improvement of left ventricular systolic function (LVEF) to values ≥ 40%, after having presented a reduced LVEF (< 40%) at a previous time and ≥10% absolute improvement in LVEF. It is a chronic and dynamic condition with a high risk of relapse and deterioration, so close monitoring and optimal medical therapy are essential for its management. A case is presented of a young male patient with dilated cardiomyopathy with severe left ventricular systolic dysfunction, who with neurohormonal therapy for heart failure, showed rapid clinical recovery and improvement of ejection fraction and left ventricular remodeling. Further studies are needed to better understand this condition and its long-term treatment.

4.
Article | IMSEAR | ID: sea-241266

ABSTRACT

Dilated Cardiomyopathy (DCM) is defined by a left ventricle (LV) with reduced systolic function (<45%) and dilation (LV volume > 90 ml/m²), excluding coronary artery disease or sufficient load conditions to explain it. The etiologies are multiple and increasingly well-known. We conducted a single-centre, retrospective observational study within the cardiology department of the CHU IBN ROCHD in Casablanca, Morocco, over one year. The main objective was to describe the characteristics and particularities of patients followed for DCM. The diagnosis is based only on echocardiography, after exclusion of an ischemic cause, severe valvular disease, and congenital heart disease. During the study, 44 patients were included, with a male predominance of 63.6% versus 36.4%. The average age was 60 ± 16.8 years. The initial presentation of cardiomyopathy showed that 73% of patients were admitted with heart failure (HF). The mean left ventricular ejection fraction (LVEF) was 30.2 ± 7.9%. Among the attributed etiologies, idiopathic DCM was the main cause reported in 59% of cases, followed by systemic lupus erythematosus (14%) and myocarditis (14%). In our sample, treatment was based on HF management, including beta-blockers, renin-angiotensin system blockers, SGLT2 inhibitors, and aldosterone antagonists. Implantation of a defibrillator for primary prevention concerned only one patient (3%) of the 33 patients for whom the theoretical indication was retained.

6.
Article | IMSEAR | ID: sea-241239

ABSTRACT

Meadows syndrome is a rare entity, defined as systolic heart failure occurring peripartum in the absence of underlying heart disease. Thromboembolic manifestations can complicate this syndrome but are rarely revealing. We report the case of a 30-year-old patient, without a history of cardiac, multiparous, who presented 3 months after delivery, acute dyspnea. Distal pulmonary embolism was objectified by pulmonary angiography. But the final diagnosis after an analysis of clinical, ultrasound and etiological data was peripartum cardiomyopathy complicated by embolism pulmonary. The evolution under medical treatment was hardly favorable with a worsening of systolic function complicated by a new episode of bilateral proximal pulmonary embolism after 1 month in a context of covid 19 infection.

7.
Article | IMSEAR | ID: sea-241235

ABSTRACT

This case report details the clinical presentation, diagnosis, and multidisciplinary management of a 68-year-old man with cardiac thyrotoxicosis mimicking an acute coronary syndrome (ACS). The patient presented with persistent anginal chest pain, systemic symptoms, and electrocardiographic abnormalities suggestive of ACS. Despite presenting with persistent chest pain and ACS-like symptoms, a thorough examination, including the calculation of the thyrotoxicosis storm (StPRM) score, revealed thyrotoxicosis-induced dilated cardiomyopathy, challenging the initial diagnosis. This specific scoring for thyrotoxicosis severity played a crucial role in accurately identifying the thyrotoxic crisis. The case highlights the intricate relationship between thyroid dysfunction and cardiovascular manifestations, emphasizing the need for a multidisciplinary approach. Management included standard ACS protocols, careful titration of antithyroid medications, and the transition from intravenous to oral heart failure medications. Follow-up assessments demonstrated the success of personalized treatment strategies, with the normalization of thyroid function and complete resolution of the patient's symptoms. Nevertheless, the enduring impairment of left ventricular function following treatment prompts intriguing inquiries into the lasting impact of cardiac thyrotoxicosis on myocardial recovery. However, the persistence of impaired left ventricular function post-treatment raises intriguing questions about the lingering effects of cardiac thyrotoxicosis on myocardial recovery. This case underscores the importance of considering diverse cardiac presentations in hyperthyroid patients and the effectiveness of individualized management approaches in navigating the complexities of thyroid-cardiac interactions.

8.
Article in Chinese | WPRIM | ID: wpr-1006291

ABSTRACT

Dilated cardiomyopathy (DCM) is characterized by the main pathological changes of global cardiac enlargement, especially left ventricular enlargement. Clinical manifestations include decreased heart function, arrhythmia, thromboembolism, and even sudden death. It is one of the refractory cardiovascular diseases. Conservative drug treatment is still the main approach in clinical practice, but due to its unavoidable side effects such as low blood pressure, it is often difficult to achieve a satisfactory prognosis. The combination of traditional Chinese medicine and Western medicine can effectively improve side effects and enhance efficacy. The research has found that nuclear transcription factors-κB (NF-κB), adenylate activated protein kinase (AMPK)/mammalian rapamycin target protein (mTOR), transforming growth factor-β (TGF-β)/Smads, Toll like receptors (TLR) 4/c-Jun amino terminal kinase (JNK), mitogen activated protein kinase (MAPK), phosphatidylinositol 3-kinase (PI3K)/protein kinase (Akt), and other signaling pathways play a crucial regulatory role in the occurrence and development of DCM. Traditional Chinese medicine can improve myocardial fibrosis, reverse ventricular remodeling, alleviate oxidative stress, and achieve anti-inflammatory and other effects by regulating the above signaling pathways, thus improving DCM. Due to its multi-target and multi-mechanism characteristics, it has the advantages of high safety and good tolerance and has become an important part of current clinical treatment.

9.
China Pharmacy ; (12): 1374-1379, 2024.
Article in Chinese | WPRIM | ID: wpr-1031716

ABSTRACT

OBJECTIVE To observe the efficacy of vericiguat in the treatment of acute decompensated heart failure (HF) and its effect on left ventricular ejection fraction (LVEF) in patients with different left ventricular end-diastolic internal diameters (LVDd). METHODS A total of 52 patients with acute decompensated HF who were hospitalized in Anqing Municipal Hospital from September 2022 to May 2023 and were stabilized by intravenous injection of diuretics or vasodilators and then given vericiguat orally were selected. Clinical baseline data were collected, and blood creatinine (Scr), estimated glomerular filtration rate (eGFR), N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiographic indexes(LVEF, LVDd), and Kansas City cardiomyopathy questionnaire (KCCQ) scores and so on were recorded and analyzed at 1 and 6 months after treatment. The patients were divided into two subgroups according to whether they had dilated cardiomyopathy or not, the baseline data were compared between the two subgroups, and the changes in the above follow-up indexes for the entire population and two subgroups of patients were analyzed by using mixed effect model. RESULTS Patients in the dilated cardiomyopathy group were significantly younger than those in the nondilated cardiomyopathy group, while the former had a lower proportion of patients with combined coronary artery disease, longer LVDd, lower LVEF levels, and more HF patients with reduced ejection fraction (P<0.05). Compared with baseline values, KCCQ scores were significantly higher in patients in the whole population, non-dilated cardiomyopathy group and dilated cardiomyopathy group at 1 month after treatment (P<0.001). The difference between the whole population in terms of elevated KCCQ scores and decreased lg(NT-proBNP) levels was statistically significant at 6 months after treatment (P<0.05); the levels of lg(NT-proBNP)of two subgroups were significantly decreased and KCCQ scores were significantly increased (P<0.05), but the difference was not statistically significant (P>0.05); LVEF levels of the patients E-mail:guangf4-508@163.com in both subgroups were significantly elevated (P<0.05) and the difference between the subgroups amounted to 7.52% (P=0.030). Mixed effect model result showed that whether patients had coronary artery disease and different baseline levels of LVDd were likely to affect follow-up LVEF levels, with coronary artery disease contributing to follow-up LVEF elevation (P=0.043), but the coronary artery disease subgroup × time interaction was not significant (P>0.05);compared with patients with baseline LVDd ≥62 mm, patients with baseline LVDd≤61 mm had a faster LVEF improvement (P<0.05). CONCLUSIONS Vericiguat is able to improve cardiac function and quality of life in patients with acute decompensated HF without negatively affecting their renal function. The drug is able to significantly improve LVEF levels in patients with baseline LVDd ≤61 mm.

10.
China Pharmacy ; (12): 1374-1379, 2024.
Article in Chinese | WPRIM | ID: wpr-1031738

ABSTRACT

OBJECTIVE To observe the efficacy of vericiguat in the treatment of acute decompensated heart failure (HF) and its effect on left ventricular ejection fraction (LVEF) in patients with different left ventricular end-diastolic internal diameters (LVDd). METHODS A total of 52 patients with acute decompensated HF who were hospitalized in Anqing Municipal Hospital from September 2022 to May 2023 and were stabilized by intravenous injection of diuretics or vasodilators and then given vericiguat orally were selected. Clinical baseline data were collected, and blood creatinine (Scr), estimated glomerular filtration rate (eGFR), N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiographic indexes(LVEF, LVDd), and Kansas City cardiomyopathy questionnaire (KCCQ) scores and so on were recorded and analyzed at 1 and 6 months after treatment. The patients were divided into two subgroups according to whether they had dilated cardiomyopathy or not, the baseline data were compared between the two subgroups, and the changes in the above follow-up indexes for the entire population and two subgroups of patients were analyzed by using mixed effect model. RESULTS Patients in the dilated cardiomyopathy group were significantly younger than those in the nondilated cardiomyopathy group, while the former had a lower proportion of patients with combined coronary artery disease, longer LVDd, lower LVEF levels, and more HF patients with reduced ejection fraction (P<0.05). Compared with baseline values, KCCQ scores were significantly higher in patients in the whole population, non-dilated cardiomyopathy group and dilated cardiomyopathy group at 1 month after treatment (P<0.001). The difference between the whole population in terms of elevated KCCQ scores and decreased lg(NT-proBNP) levels was statistically significant at 6 months after treatment (P<0.05); the levels of lg(NT-proBNP)of two subgroups were significantly decreased and KCCQ scores were significantly increased (P<0.05), but the difference was not statistically significant (P>0.05); LVEF levels of the patients E-mail:guangf4-508@163.com in both subgroups were significantly elevated (P<0.05) and the difference between the subgroups amounted to 7.52% (P=0.030). Mixed effect model result showed that whether patients had coronary artery disease and different baseline levels of LVDd were likely to affect follow-up LVEF levels, with coronary artery disease contributing to follow-up LVEF elevation (P=0.043), but the coronary artery disease subgroup × time interaction was not significant (P>0.05);compared with patients with baseline LVDd ≥62 mm, patients with baseline LVDd≤61 mm had a faster LVEF improvement (P<0.05). CONCLUSIONS Vericiguat is able to improve cardiac function and quality of life in patients with acute decompensated HF without negatively affecting their renal function. The drug is able to significantly improve LVEF levels in patients with baseline LVDd ≤61 mm.

11.
Article in Chinese | WPRIM | ID: wpr-1017869

ABSTRACT

Objective To investigate the relationship between serum stem cell factor receptor(c-kit)and myocardial fibrosis,cardiac function and prognosis in patients with dilated cardiomyopathy(DCM)complicat-ed with heart failure.Methods A total of 77 patients with DCM complicated with heart failure who were trea-ted in 3201 Hospital from May 2020 to June 2022 were enrolled in the study as study group,and 70 DCM pa-tients without heart failure were enrolled as the control group.The levels of serum c-kit mRNA and three my-ocardial fibrosis markers[α-smooth muscle actin(α-SMA),collagen type Ⅰ and collagen type Ⅲ]were detec-ted in the two groups.Cardiac function parameters were obtained by echocardiography.The relationship be-tween serum c-kit mRNA level and myocardial fibrosis and cardiac function was analyzed.According to the oc-currence of major adverse cardiovascular events(MACE),the patients were divided into poor prognosis group and good prognosis group.Multivariate Logistic regression analysis was used to analyze the factors affecting the prognosis of DCM patients complicated with heart failure.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum c-kit mRNA level in predicting the prognosis of DCM patients.Results The serum c-kit mRNA level in the study group was lower than that in the control group(P<0.05).The levels of three myocardial fibrosis indicators in the study group were higher than those in the con-trol group(P<0.05).The left ventricular ejection fraction(LVEF)in the study group was lower than that in the control group(P<0.05),and the left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)in the study group were higher than those in the control group(P<0.05).Pearson correlation analysis showed that serum c-kit mRNA level was positively correlated with LVEF(r=0.677,P<0.05),while negatively correlated with α-SMA,collagen type Ⅰ,collagen type Ⅲ,LVEDV and LVESV(r=-0.725,-0.748,-0.744,-0.745,-0.662,P<0.05).Multivariate Logistic regression analysis showed that serum c-kit mRNA level is an independent factor for the prognosis of DCM patients with heart failure.ROC curve analysis showed that serum c-kit mRNA level had a sensitivity of 82.80%,a specificity of 81.80%,and an area under the curve of 0.829(95%CI:0.745-0.912,P<0.001)for evaluating the progno-sis of DCM patients complicated with heart failure.Conclusion The serum c-kit mRNA level is significantly decreased in patients with DCM complicated with heart failure,and the serum c-kit mRNA level is correlated with myocardial fibrosis and cardiac function.The detection of serum c-kit mRNA level has a high efficacy in evaluating the prognosis of patients with DCM complicated with heart failure.

12.
Chongqing Medicine ; (36): 512-516, 2024.
Article in Chinese | WPRIM | ID: wpr-1017489

ABSTRACT

Objective To study the therapeutic effect of Xuefu Zhuyu Capsule combined with sacubitril valsartan on dilated cardiomyopathy.Methods A total of 70 patients with dilated cardiomyopathy who were hospitalized in the Hospital from January to December 2020 were selected as the research objects and random-ly divided into control group and experimental group,with 35 cases in each group.The control group was only treated with sacubitril valsartan,and the experimental group was treated with Xuefu Zhuyu Capsule combined with sacubitril valsartan.According to the patient's blood pressure and renal function,sacubitril valsartan was titrated from a small dose to the maximum dose.Xuefu Zhuyu Capsule was uesd 2.4 g each time,twice a day,and the treatment time was three months.The symptoms of heart failure,glycosylated hemoglobin(HbA1c),low density lipoprotein(LDL),total cholesterol(TC),triglyceride(TG),ALT,AST,N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular end-systolic diameter(LVEDd),left ventricular end-dias-tolic diameter(LVEDs),ejection fraction(EF)and the incidence of arrhythmia were observed in the two groups after treatment.Results After treatment,the level of NT-proBNP in the experimental group was sig-nificantly lower than that in the control group(P<0.05).There was no significant difference in LDL,TC,TG,LVEDd,LVEDs and EF between the two groups(P>0.05).The incidence of atrial tachycardia and ven-tricular premature beat in the experimental group was higher than that in the control group(P<0.05).Con-clusion Xuefu Zhuyu Capsule combined with sacubitril valsartan can significantly improve the symptoms of patients with heart failure and reduce the level of NT-proBNP,but it may increase the proportion of patients with atrial tachycardia and ventricular premature beats.

13.
Article in Chinese | WPRIM | ID: wpr-1036500

ABSTRACT

Objective @#To explore the risk factors for intracardiac thrombosis in dilated cardiomyopathy (DCM) pa- tients and to construct , validate , and evaluate a nomogram prediction model based on these factors .@*Methods @#88 patients diagnosed with DCM and complicated with intracardiac thrombus , and 544 patients without intracardiac thrombus were included . The participants were randomly divided into training and validation sets at a ratio of 7 ∶ 3 . U sing both univariate and multivariate Logistic regression analyses , independent risk factors for intracardiac thrombosis in DCM patients were identified . A nomogram prediction model was constructed using R software . The model ’s validity and performance were assessed using the receiver operating characteristic (ROC) curve , the Hos- mer-Lemeshow goodness-of-fit test , calibration curve , and decision curve . @*Results @#The binary Logistic regression analysis showed that age , atrial fibrillation , left ventricular end-diastolic diameter ( LVEDD) , brain natriuretic peptide ( BNP) , and β-blockers were independently associated with intracardiac thrombosis in DCM patients . Based on these five factors , a nomogram was constructed and validated . The area under the ROC curve for the training set was 0. 823 (95% CI: 0. 760 ~ 0. 887) and 0 . 803 (95% CI: 0 . 705 ~ 0 . 901) for the validation set , in- dicating a good discriminative ability. The Hosmer-Lemeshow test results for the calibration curve were ( χ2 = 6. 679 , P = 0. 572) for the training set and ( χ2 = 2 . 588 , P = 0. 958) for the validation set , indicating a good fit between predicted and ob served outcomes . The decision curve showed a high net clinical benefit in the threshold range of 0. 05 ~ 0. 92 . @*Conclusion @#Based on age , atrial fibrillation , LVEDD , BNP , and β-blockers , the nomo- gram prediction model exhibits good discriminative and calibration abilities , and high clinical benefit. It can effec- tively guide clinicians in early intervention of risk factors , reducing the risk of intracardiac thrombosis in DCM pa- tients .

15.
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;39(5): e20230394, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1575982

ABSTRACT

ABSTRACT Introduction: Heart transplantation is the gold standard for advanced heart failure treatment. This study examines the survival rates and risk factors for early mortality in adult heart transplant recipients at a Brazilian center. Methods: This retrospective cohort study involved 255 adult heart transplant patients from a single center in Brazil. Data were collected from medical records and databases including three defined periods (2012-2015, 2016-2019, and 2020-2022). Statistical analysis employed Kaplan-Meier survival curves, Cox proportional hazards analysis for 30-day mortality risk factors, and Log-rank tests. Results: The recipients were mostly male (74.9%), and the mean age was 46.6 years. Main causes of heart failure were idiopathic dilated cardiomyopathy (33.9%), Chagas cardiomyopathy (18%), and ischemic cardiomyopathy (14.3%). The study revealed an overall survival of 68.1% at one year, 58% at five years, and 40.8% at 10 years after heart transplantation. Survivalimproved significantly over time, combining the most recent periods (2016 to 2022) it was 73.2% in the first year and 63% in five years. The main risk factors for 30-day mortality were longer time on cardiopulmonary bypass, the initial period of transplants (2012 to 2015), older age of the donor, and nutritional status of the donor (overweight or obese). The main causes of death within 30 days post-transplant were infection and primary graft dysfunction. Conclusion: The survival analysis by period demonstrated that the increased surgical volume, coupled with the team's experience and modifications to the immunosuppression protocol, contributed to the improved early and mid-term outcomes.

16.
Article | IMSEAR | ID: sea-228419

ABSTRACT

Background: Objective was to analyse the clinical profile of children diagnosed with Dilated cardiomyopathy and to correlate the same with the severity and functional status on 2-D echocardiography.Methods: It was a prospective, retrospective and observational study. A total of 150 subjects were selected from patients visiting the cardiology OPD, admitted in medical wards, paediatric Intensive Care Unit of a tertiary care referral centre. The demographic profile, symptomatology, heart functions and compliance were recorded. The cases were evaluated by detailed history, general and cardiovascular examination and laboratory investigations along with 2D echocardiography.Results: The demographic profile is significant as the age at diagnosis predicts the risk of mortality with older children having the worst outcome. A significant association observed between decreasing ejection fraction and increasing mortality with a p value (p=0.02). Signs of pedal edema and hepatomegaly are associated with unfavourable outcome with a significant p value of (p=0.03). The overall prognosis of children with Dilated cardiomyopathy steadily improved with timely use of appropriate medications. Only 1 patient in this study had undergone orthotopic heart transplant at the age of 15 years (case of chemotherapy induced Dilated cardiomyopathy).Conclusions: Dilated cardiomyopathy is a difficult entity to treat in children as most cases are idiopathic and the therapy remains mostly supportive. Hypovitaminosis-D and hypocalcemia are common treatable causes of dilated cardiomyopathy in children and must be ruled out in all cases of dilated cardiomyopathy. Patients refractory to medical therapy should be considered for ventricular assist devices and orthotopic heart transplantation.

17.
Article | IMSEAR | ID: sea-233613

ABSTRACT

Background: Dilated cardiomyopathy can be treated using cardiac resynchronisation therapy (CRT) effectively. In our study, we compared the clinical and biochemical profile of responders and non-responders to CRT device (CRTD) implantation suffering from DCM. Methods: A cross-sectional observational study was performed in 47 patients with dilated cardiomyopathy for CRTD implantation for a period of 18 months. The tools used for the study include electrocardiography 12 lead, echocardiography: 2D, M mode, Doppler, strain echo, Holter monitoring, coronary angiography and CRTD implantation. Statistical analysis was performed using Epi Info (TM) 7.2.2.2. Results: The proportion of responders (68.1%) was significantly higher than non-responder (31.9%). Almost 60% of patients in non-responder group had smoking as a risk factor. Around 60% were suffering from hypertension and 33% from T2DM in non-respondent group. Parameters of dyssynchrony has significantly improved in responder group than in non-responder group. LVEDV, LVESV has shown an increase and EF has decreased considerably in DCM patients. Many patients in non-responder category have shown mitral and tricuspid regurgitation. Strain echocardiography parameters-GLS, GRS and GCS were significantly decreased. Post CRTD echocardiographic parameter has improved considerably and LVESV was reduced in more than 15% of responders. Conclusions: The CRTD implantation improves patients’ clinical and Echocardiographic data which can help in better patient management, improving quality of life and decreased healthcare cost. By this study we can improve patients’ selection and predict accordingly for CRT responders and non-responders and can take necessary measures for better patient’s management.

18.
Arch. argent. pediatr ; 121(4): e202202775, ago. 2023. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1443050

ABSTRACT

La hemocromatosis es una enfermedad caracterizada por el excesivo depósito de hierro en múltiples órganos, entre ellos hígado, páncreas, piel y corazón. La infiltración de este último es un importante factor en morbilidad y mortalidad. Presentamos un caso de un paciente pediátrico con insuficiencia cardíaca terminal que ameritó trasplante cardíaco, que resultó sin complicaciones. Posterior a la cirugía, mostró mejoría bioquímica y clínica, lo que influyó positivamente en su calidad de vida y prolongó su supervivencia.


Hemochromatosis is a disease characterized by excess iron stores in multiple organs, including the liver, pancreas, skin, and heart. The infiltration of the heart is an important factor in morbidity and mortality. Here we describe the case of a pediatric patient with end-stage heart failure who required a heart transplantation, with no complications. After the surgery, she showed biochemical and clinical improvement, with a positive impact on her quality of life and a prolonged survival.


Subject(s)
Humans , Female , Child , Heart Transplantation , Iron Overload/complications , Hemochromatosis/complications , Hemochromatosis/diagnosis , Quality of Life , Liver
19.
Article | IMSEAR | ID: sea-220293

ABSTRACT

Behcet’s disease is a systemic vasculitis of the vessels for all calibers, touching arterial and venous territories. The causes of disease are unknow. BD reaches young age subjects from 10 to 45 years and affects both men and women. BD is ubiquitous but more frequent in patients from Mediterranean basin, the middle East and Asia. The diagnosis of BD is essentially clinical. The diagnostic criteria make it possible to carry the diagnosis with good sensitivity and specifity. BD evolves by recurrent inflammatory attack. BD can affect all of the organs; cardiacs manifestations are dominated by intracardiac thrombosis, the damage of three tunics, coronaryarteritis with or without myocardial infarction, coronaries aneurysms and endomyocardial fibrosis. The vascular manifestations are dominated by arterial or venous thrombosis. The presence of dilated cardiomyopathy with reduced left ventricular ejection fraction is rare. It can be explained by ischemic or inflammatory origin by cytokines. We report a case of young woman aged of 33 years to the history of 3 episodes of bipolar aphtae which presented dilated cardiomyopathy with reduced left ventricular function, biventricular thrombosis, bilateral distal pulmonary embolism with pulmonary infarction.

20.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1432171

ABSTRACT

Exponemos la experiencia del Instituto Nacional de Cardiología de una serie de casos de pacientes sometidos a trasplante cardiaco entre mayo de 2016 y junio 2022. Se realizaron 14 trasplantes, 13 fueron del sexo masculino. La edad osciló entre 19 y 62 años. Las etiologías fueron cardiopatías de tipo idiopática en 57% y valvular en 21%. El 50% se trasplantó en INTERMACS 4 (Interagency Registry for Mechanically Assisted Circulatory Support), 21% INTERMACS 3 y solo 28% en INTERMACS 2. Tres pacientes se trasplantaron con asistencia circulatoria tipo membrana circulación extracorpórea. Las complicaciones más frecuentes fueron las infecciosas. La mortalidad hospitalaria fue 35,7%. Hubo un fallecido en el seguimiento tras 5 años de trasplante.


We present the experience of the National Institute of Cardiology of a series of cases of patients undergoing heart transplantation between May 2016 and June 2022. Fourteen transplants were performed, 13 of the patients were male. The age ranged between 19 and 62 years. The etiologies were idiopathic heart disease in 57% and valvular heart disease in 21%. Fifty percent was transplanted in INTERMACS 4 (Interagency Registry for Mechanically Assisted Circulatory Support), 21% in INTERMACS 3 and only 28% in INTERMACS 2. Three patients were transplanted with membrane type extracorporeal circulation circulatory support. The most frequent complications were infectious. Hospital mortality was 35.7%. There was one patient who died during follow-up after 5 years of transplantation.

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