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2.
Echocardiography ; 36(11): 2122-2125, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31573705

RESUMO

We report the case of a 74-year-old male, with a medical history of cor triatriatum, admitted with a 10-day history of intermittent fever. Three sets of blood cultures were positive for Providencia rettgeri. Transthoracic and transesophageal echocardiogram excluded infective endocarditis, but revealed a congenital accessory tissue adhering to the mitral valve, causing supravalvular mitral stenosis. Cor triatriatum sinistrum is a rare congenital cardiac anomaly, even more uncommon in adults, and quite exceptional when associated with mitral valve disease. Because the patient had no symptoms related to the heart valve disease, no surgical indication was given and he was managed conservatively.


Assuntos
Anormalidades Múltiplas , Coração Triatriado/diagnóstico , Ecocardiografia Tridimensional/métodos , Ecocardiografia Transesofagiana/métodos , Ventrículos do Coração/diagnóstico por imagem , Estenose da Valva Mitral/diagnóstico , Valva Mitral/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Humanos , Masculino , Valva Mitral/anormalidades , Estenose da Valva Mitral/congênito , Doenças Raras
3.
PLoS One ; 14(1): e0210320, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30657767

RESUMO

Irisin, a recently discovered myokine, has been considered a prognostic factor in several cardiovascular diseases. Nevertheless, no data are available on the role of irisin in patients with heart failure (HF), both with preserved (HFpEF) or reduced (HFrEF) ejection fraction. We have therefore evaluated the circulating irisin levels in HFpEF and HFrEF patients, correlating them with metabolic parameters and total antioxidant capacity (TAC), as index of oxidative stress. Irisin was significantly higher in HFpEF than in HFrEF patients (7.72 ± 0.76 vs 2.77 ± 0.77 ng/ml, respectively). An inverse correlation between irisin and TAC was found in HFpEF, but not in HFrEF. Conversely, no correlation was present with HOMA index. These data support the hypothesis that a different pathophysiological mechanism is involved in the two HF subtypes, and oxidative stress modulates irisin secretion.


Assuntos
Fibronectinas/sangue , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/fisiopatologia , Volume Sistólico/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Resistência à Insulina , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo , Projetos Piloto
4.
Medicine (Baltimore) ; 94(43): e1365, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26512552

RESUMO

Erdheim-Chester disease (ECD) is a rare, multiorgan, non-Langerhans cell histiocytosis of uncertain origin, characterized by systemic xanthogranulomatous infiltration from CD68+CD1a- histiocytes. Skeletal involvement is present in up to 96% of cases with bilateral osteosclerosis of meta-diaphysis of long bones. Furthermore, in more than 50% of cases there is 1 extraskeletal manifestation. In this case report, we describe an interesting case of ECD with an extensive pan-cardiac and vascular involvement, in addition to skeletal, retro-orbital, and retroperitoneum one.A 44-year-old woman with a long history of exophthalmos referred to our hospital for elective surgical orbital decompression. At preoperative examinations a large pericardial effusion was discovered. Echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) described an inhomogeneous mass involving pericardium and the right heart, abdominal aorta and its main branches and the retroperitoneum, suggestive for a systemic inflammatory disorder. Histological examination on a biopsy sample confirmed the diagnosis of ECD. Radiology showed the pathognomonic long-bone involvement. Surgical orbital decompression was performed and medical therapy with interferon-α (INF-α) was started.Among extraskeletal manifestations of ECD, cardiovascular involvement is often asymptomatic and thus under-diagnosed but linked to poor prognosis. This is why clinician should always look for it when a new case of ECD is diagnosed.


Assuntos
Sistema Cardiovascular/patologia , Doença de Erdheim-Chester/patologia , Adulto , Doença de Erdheim-Chester/complicações , Feminino , Humanos , Derrame Pericárdico/etiologia
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