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1.
Medicine (Baltimore) ; 98(32): e16642, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393361

RESUMO

RATIONALE: Tachycardia-induced cardiomyopathy (TIC) is defined as systolic and/or diastolic dysfunction of the left ventricle resulting from prolonged elevated heart rates, completely reversible upon control of the arrhythmia. Atrioventricular reentrant tachycardia (AVRT) is one of the most frequent causes of TIC. In its incessant form, it is unlikely to be controlled by pharmacological treatment, catheter ablation being the principal therapeutic option. The coexistence of left bundle branch block (LBBB) in patients with AVRT may cause difficulties in the early diagnosis and management of tachycardia because of the wide complex morphology, making it harder to localize the accessory pathway (AP). PATIENT CONCERNS: A 60-year-old woman, presented incessant episodes of palpitations and shortness of breath due to a LBBB tachycardia leading to hemodynamic instability. DIAGNOSIS: The patient had a wide QRS tachycardia, with LBBB morphology and a heart rate of 160/minute. Echocardiography showed global hypokinesia with 25% left ventricular ejection fraction (LVEF). Considering the patient's clinical picture, TIC was suspected. INTERVENTIONS: The electrophysiological study revealed a left lateral accessory pathway. Catheter ablation was successfully performed at the level of the lateral mitral ring. OUTCOMES: One week after the ablation the patient had no signs of heart failure and the LVEF normalized to 55%. During 6-months follow-up the patient presented no more episodes of tachycardia or heart failure and the LVEF remained normal. LESSONS: AVRT is rarely associated with intrinsic LBBB, being a potential cause of TIC. In these patients, it is unlikely to control the arrhythmia pharmacologically, catheter ablation being the best therapeutic option. The variation of QRS complex duration between LBBB pattern in SR and AVRT could be useful for early diagnosis of an ipsilateral AP on surface ECG.


Assuntos
Bloqueio de Ramo/cirurgia , Ablação por Cateter/métodos , Taquicardia por Reentrada no Nó Atrioventricular/cirurgia , Bloqueio de Ramo/complicações , Bloqueio de Ramo/diagnóstico , Cardiomiopatias/diagnóstico , Cardiomiopatias/etiologia , Ecocardiografia , Eletrocardiografia , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Volume Sistólico , Taquicardia por Reentrada no Nó Atrioventricular/complicações
2.
Int Heart J ; 60(4): 788-795, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31353344

RESUMO

Severe ventricular arrhythmias such as high-grade atrioventricular block and ventricular tachycardia may cause lethal conditions or sudden death in patients with cardiac sarcoidosis (CS). Physicians should examine patients carefully for these conditions and treat them appropriately. As arrhythmias are being better diagnosed and treated, physicians are increasingly aware of atrial arrhythmias, which have not been focused upon as CS-related conditions, in patients with CS. This article reports a case of atrial flutter in sarcoidosis, and discusses literature findings on atrial arrhythmias and atrial involvement of CS. It is highly likely that atrial arrhythmia and supraventricular conduction disorder associated with or caused by CS are more common than previously thought. Physicians should pay careful attention for these conditions in the diagnosis and treatment of CS.


Assuntos
Fibrilação Atrial/etiologia , Flutter Atrial/etiologia , Cardiomiopatias/complicações , Átrios do Coração/fisiopatologia , Sarcoidose/complicações , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/cirurgia , Flutter Atrial/diagnóstico , Flutter Atrial/cirurgia , Cardiomiopatias/diagnóstico , Cardiomiopatias/fisiopatologia , Ablação por Cateter , Ecocardiografia , Eletrocardiografia Ambulatorial , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Sarcoidose/diagnóstico , Sarcoidose/fisiopatologia
3.
Nihon Shokakibyo Gakkai Zasshi ; 116(7): 607-616, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31292323

RESUMO

Cirrhotic cardiomyopathy (CCM) is a chronic cardiac dysfunction in patients with cirrhosis and is characterized by altered diastolic relaxation, blunted contractile response to stress, and electrophysiological abnormalities;however, causes of CCM are unknown. Moreover, reduced cardiac afterload due to cirrhosis-related vasodilatation often masks cardiac insufficiency, whereas rapid hemodynamic overload reveals the presence of cirrhotic cardiomyopathy. Herein, we present the case of previously unrecognized cirrhotic cardiomyopathy that became overt with the development of severe acute cardiac failure. The rapidly worsening hepatic hydrothorax increased cardiac preload and intrathoracic pressure, which impaired cardiac filling. Furthermore, cardiac contractile function might have been worsened by hypoxia due to passive atelectasis and concomitant anemia.


Assuntos
Cardiomiopatias/diagnóstico , Insuficiência Cardíaca/diagnóstico , Hidrotórax/diagnóstico , Cirrose Hepática Alcoólica/diagnóstico , Cirrose Hepática , Cardiomiopatias/complicações , Insuficiência Cardíaca/complicações , Humanos , Hidrotórax/complicações , Cirrose Hepática Alcoólica/complicações
4.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(3 Supl): 320-323, jul.-set. 2019. ilus
Artigo em Português | LILACS | ID: biblio-1023248

RESUMO

A cardiomiopatia periparto é uma causa rara de insuficiência cardíaca no período entre o último mês de gestação e os cinco meses após o parto. A síndrome do QT longo caracteriza-se pelo atraso da repolarização ventricular e pode se manifestar com síncope e morte súbita devido a um tipo de taquicardia ventricular polimórfica conhecida como torsades de pointes. Descrição do caso: J.S., 26 anos, sexo feminino, natural e procedente de São Paulo. Paciente puérpera - 40º dia (G3P3A0), procurou o pronto-socorro com queixa de síncope durante amamentação e dispneia em moderados esforços. Durante a avaliação no PS, evoluiu para desconforto torácico e agitação psicomotora, sendo notada taquicardia ventricular não sustentada no monitor cardíaco ( torsades de pointes), que foi controlada com cardioversão elétrica e sulfato de magnésio intravenoso. O eletrocardiograma mostrou ritmo sinusal, alteração difusa da repolarização ventricular e intervalo QTc de 580 ms. O ecocardiograma mostrou disfunção sistólica moderada, com fração de ejeção do ventrículo esquerdo de 43% à custa de hipocinesia difusa. Após avaliação da equipe de arritmologia chegou-se ao diagnóstico de cardiomiopatia periparto associado à síndrome do QT longo. Foi iniciado tratamento otimizado para insuficiência cardíaca e implantado cardiodesfibrilador por causa de episódios recorrentes de arritmia durante a internação. Discussão: A cardiomiopatia periparto é uma doença rara, porém, tem taxa de mortalidade elevada, entre 18% e 56%. A paciente descrita satisfez os quatro critérios para o diagnóstico: sintomas de insuficiência cardíaca nos primeiros 5 meses depois do parto, ausência de cardiomiopatia prévia, etiologia desconhecida e disfunção sistólica com FEVE < 45%. A síndrome do QT longo é uma doença genética de apresentações variáveis. Os fatores que desencadeiam as taquiarritmias são situações de instabilidade elétrica por hiperatividade do sistema simpático e também situações raras, como a cardiomiopatia periparto. Em casos de arritmias ventriculares graves, o tratamento é o implante de cardiodesfibrilador. Conclusão: A associação da cardiomiopatia periparto com a síndrome do QT longo é rara. A gravidade associada a essas condições torna importante o diagnóstico precoce e tratamento imediato pelo potencial risco de morte associado a ambas as condições clínicas


Peripartum cardiomyopathy is a rare cause of heart failure during the period between the last month of pregnancy and five months after delivery. Long QT syndrome is characterized by a delay in ventricular repolarization and may manifest with syncope and sudden death due to a type of polymorphic ventricular tachycardia known as torsades de pointes. Case description: J.S., 26-years-old, female, born and residing in São Paulo, Puerperal - 40th day (G3C3A0), went to the emergency room complaining of syncope during breastfeeding and dyspnea on moderate exertion. During evaluation in the ER, the patient developed thoracic discomfort and psychomotor agitation, with non-sustained ventricular tachycardia on the cardiac monitor (torsades de pointes), which was controlled with electrical cardioversion and intravenous magnesium sulfate. The electrocardiogram showed sinus rhythm, diffuse alteration of ventricular repolarization and QTc interval of 580 ms. The echocardiogram showed moderate systolic dysfunction, with a left ventricular ejection fraction of 43% influenced by diffuse hypokinesia. After evaluation by the arrhythmology team, the diagnosis of peripartum cardiomyopathy associated with long QT syndrome was made. Optimized treatment for heart failure was initiated and a cardioverter-defibrillator was implanted due to recurrent episodes of arrhythmia during hospitalization. Discussion: Peripartum cardiomyopathy is a rare disease, but it has a high mortality rate, between 18% and 56%. The patient described met the 4 diagnostic criteria: symptoms of heart failure in the first 5 months after delivery, absence of prior cardiomyopathy, unknown etiology, and systolic dysfunction with LVEF<45%. Long QT syndrome is a genetic disease of varying presentations. The factors that trigger the tachyarrhythmias are situations of electrical instability due to sympathetic system hyperactivity and rare situations, such as peripartum cardiomyopathy. In cases of severe ventricular arrhythmias, the treatment is a cardioverter-defibrillator implant. Conclusion: The association of peripartum cardiomyopathy with long QT syndrome is rare. The severity associated with these conditions points out early diagnosis and immediate treatment important because of the potential risk of death associated with both clinical conditions


Assuntos
Humanos , Feminino , Adulto , Síndrome do QT Longo , Taquicardia Ventricular , Período Periparto , Cardiomiopatias/diagnóstico , Síncope , Fatores de Risco , Torsades de Pointes , Eletrocardiografia/métodos , Frequência Cardíaca
5.
Klin Lab Diagn ; 64(6): 337-341, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31200404

RESUMO

The article presents the results of studies of 104 patients with cardiomyopathy hospitalized in the cardiorheumatological departments of the Republican Specialized Scientific and Practical Medical Center of Pediatrics in Tashkent and the Republican Children's Multidisciplinary Medical Center of the Republic of Karakalpakstan. An analysis of the results of the study showed that in children with cardiomyopathy there is an increase in the level of tissue (LDH, CPK) and cardiospecific (CPK-MB) enzymes, regardless of the region of residence and the form of the disease, which indicate myocardial dysfunction. Therefore, these enzymes can be regarded as highly specific biochemical markers of myocardial damage, and an increase in their activity can be used as criteria for the diagnosis of heart disease. Of the biochemical parameters, a reliable prognostic criterion for the development and outcome of cardiomyopathy is a progressive increase in the level of endothelin with increasing duration of the disease.


Assuntos
Cardiomiopatias/diagnóstico , Cardiopatias/diagnóstico , Miocárdio/patologia , Biomarcadores , Criança , Creatina Quinase , Humanos
6.
Diabetes Res Clin Pract ; 154: 90-100, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31238058

RESUMO

AIM: This study was aimed to evaluate the cardiomyopathy in patients with type 2 diabetes mellitus (T2DM) who live with or without cardiovascular complications by estimating different cardiac biomarkers. METHODS: This cross-sectional study enrolled 125 participants including 25 healthy volunteers and 100 T2DM patients. After meeting all inclusion criteria, the participants were categorized into five groups (N = 25 in each) as; healthy volunteers (I), T2DM (II), T2DM with hypertension (III), T2DM with dyslipidemia (IV), T2DM with hypertension and dyslipidemia (V). Pearson's correlation analysis was performed to assess the significant association between cardiac biomarkers other biochemical parameters. P-values <0.05 were considered statistically significant. RESULTS: The average age of the participants was found to be 55.04 ±â€¯7.51 years. The positive correlation was found between HbA1c and calcium or BNP levels however, a negative association was observed with zinc level. Group V showed higher mean of BNP (pg/mL) as 86.73 ±â€¯64.49 followed by Group III (61.02 ±â€¯53.69), IV (33.88 ±â€¯33.71), II (13.49 ±â€¯11.67) and I (5.54 ±â€¯1.49) which predicts the subclinical cardiomyopathies in the respective groups. Serum zinc (µg/dL) level were significantly lower in Group V (52.72 ±â€¯12.16) followed by III (56.15 ±â€¯9.64), IV (58.10 ±â€¯10.05), II (59.49 ±â€¯11.33) and I (73.96 ±â€¯21.91). CONCLUSIONS: In summary, BNP and calcium levels were significantly elevated while zinc was significantly reduced in T2DM patients with cardiovascular complication. Results from the study also shown positive correlation between BNP, calcium, Troponin-I levels and blood pressure. However, further longitudinal studies required to confirm these findings.


Assuntos
Biomarcadores/análise , Cardiomiopatias/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Dislipidemias/fisiopatologia , Hipertensão/fisiopatologia , Cardiomiopatias/etiologia , Cardiomiopatias/metabolismo , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico
7.
Prog Cardiovasc Dis ; 62(3): 235-241, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31075279

RESUMO

Sudden cardiac death (SCD) is a major cause of mortality in patients with nonischemic cardiomyopathy (NICM). Identifying patients who are at highest risk for SCD is an ongoing challenge. At present, guidelines recommend the use of an implantable cardioverter-defibrillator (ICD) in patients with NICM with a reduced left ventricular ejection fraction (LVEF) and heart failure (HF) symptoms. Some recent data, however, suggest that ICDs may not increase longevity in this population. Conversely, community-based studies have demonstrated that many at-risk individuals who may benefit from ICD therapy remain unprotected. Current recommendations for ICD implantation are continually debated, justifying comprehensive individualized risk assessment. Various promising techniques for further risk stratification are under evaluation, including cardiac magnetic resonance imaging, electrocardiographic assessment of electrical instability, and genetic testing. However, none of these strategies has been fully adapted into guidelines. Hence, clinical risk stratification practice today depends on LVEF and HF symptoms, which have poor sensitivity and specificity for predicting SCD risk.


Assuntos
Cardiomiopatias/complicações , Morte Súbita Cardíaca/prevenção & controle , Desfibriladores Implantáveis , Cardiomiopatias/diagnóstico , Cardiomiopatias/fisiopatologia , Cardiomiopatias/terapia , Morte Súbita Cardíaca/etiologia , Ecocardiografia , Insuficiência Cardíaca/complicações , Humanos , Imagem por Ressonância Magnética , Medição de Risco , Sensibilidade e Especificidade , Função Ventricular Esquerda
8.
Rev Med Suisse ; 15(652): 1054-1059, 2019 May 22.
Artigo em Francês | MEDLINE | ID: mdl-31116519

RESUMO

Cardiac amyloidosis is an infiltrative cardiomyopathy, typically conducting to heart failure with preserved ejection fraction. There are several causes for the disease, from which two can already be seen in the young patient and are due to either genetic mutation or neoplasia. A third, non genetic cause, typically affects older patients (previously called senile amyloidosis) and appears to be much more prevalent than initially reported. A careful initial work-up and a high index of suspicion are important to detect as early as possible the disease, as it is associated with a poor prognosis in the late stage. A standardized diagnostic approach has been proposed with the use of bone scintigraphy, recently recognized as a sensitive diagnostic tool for this type of amyloidosis. With new disease modifying therapies recently becoming available, a more active diagnostic strategy is justified.


Assuntos
Amiloidose , Cardiomiopatias , Insuficiência Cardíaca , Amiloidose/diagnóstico , Cardiomiopatias/diagnóstico , Humanos , Doenças Raras
10.
Emerg Med Clin North Am ; 37(2): 339-350, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30940376

RESUMO

Cardiovascular disease has overtaken all other causes of maternal death in the United States. The physiologic changes of pregnancy place a significant amount of stress on the cardiovascular system and put pregnant women at risk for potentially catastrophic complications, such as pulmonary embolism, aortic or coronary artery dissection, myocardial infarction, and peripartum cardiomyopathy. The diagnosis of these conditions is challenging because the symptoms can mimic those experienced in normal pregnancies. There are subtle differences in the diagnosis and treatment of cardiovascular emergencies in pregnant patients that clinicians must be aware of; however, the overall management goals are similar.


Assuntos
Serviço Hospitalar de Emergência , Complicações Cardiovasculares na Gravidez/diagnóstico , Aneurisma Dissecante/complicações , Aneurisma Dissecante/diagnóstico , Aneurisma Dissecante/terapia , Aneurisma Aórtico/complicações , Aneurisma Aórtico/diagnóstico , Aneurisma Aórtico/terapia , Cardiomiopatias/complicações , Cardiomiopatias/diagnóstico , Cardiomiopatias/terapia , Feminino , Humanos , Infarto do Miocárdio/complicações , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/terapia , Período Periparto , Gravidez , Complicações Cardiovasculares na Gravidez/terapia , Tromboembolia Venosa/complicações , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/terapia
11.
Contrib Nephrol ; 198: 73-77, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30991404

RESUMO

BACKGROUND: Carnitine deficiency is a common condition in hemodialysis patients. Therefore, abnormalities in fatty acid metabolism and organic acid metabolism are also common in dialysis patients. Tandem mass spectrometry is a standard technique in pediatric and neonatal medicine. However, it could be a new powerful tool in other fields for estimating the state of intracellular fatty acid metabolism. SUMMARY: Tandem mass spectrometry has recently revealed the relationships between carnitine profile and dialysis patients' anemia, reduced physical function, and survival rate. Fatty acid and organic acid metabolism, which could previously only be evaluated qualitatively, can now be quantitatively assessed. Key Message: The applications of tandem mass spectrometry are expected to expand not only in the field of dialysis but also in clinical medicine in general.


Assuntos
Cardiomiopatias/diagnóstico , Carnitina/deficiência , Hiperamonemia/diagnóstico , Doenças Musculares/diagnóstico , Diálise Renal/efeitos adversos , Espectrometria de Massas em Tandem/métodos , Ácidos Carboxílicos/metabolismo , Cardiomiopatias/etiologia , Carnitina/sangue , Ácidos Graxos/metabolismo , Humanos , Hiperamonemia/etiologia , Doenças Musculares/etiologia
13.
Prog Cardiovasc Dis ; 62(3): 217-226, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31004608

RESUMO

Sudden cardiac death (SCD) is a devastating possible outcome of all cardiomyopathies. The risk of SCD is increased in patients with structural heart disease and continues to increase as ventricular dysfunction worsens. There is, however, a subset of cardiomyopathy, so-called "arrhythmogenic cardiomyopathy" (ACM), that carries an inherent propensity for arrhythmia in all stages of the disease, even preceding ventricular dysfunction. The aim of this review is to identify cardiomyopathies, other than ischemic and dilated cardiomyopathies, that are associated with ventricular arrhythmias (VAs) and SCD. We discuss prevalence, diagnosis, natural history and management of arrhythmogenic right ventricular dysplasia/cardiomyopathy, ACM, and exercise-induced cardiomyopathy, with emphasis on the morbidity and mortality of VAs associated with these cardiomyopathies and how they can be mitigated through lifestyle modification, medical management, and implantation of cardioverter defibrillators.


Assuntos
Arritmias Cardíacas/etiologia , Displasia Arritmogênica Ventricular Direita/complicações , Cardiomiopatias/complicações , Morte Súbita Cardíaca/etiologia , Desfibriladores Implantáveis , Arritmias Cardíacas/mortalidade , Displasia Arritmogênica Ventricular Direita/diagnóstico , Cardiomiopatias/diagnóstico , Morte Súbita Cardíaca/prevenção & controle , Exercício , Humanos , Prevalência
14.
Ann Thorac Surg ; 108(2): 443-450, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30928552

RESUMO

BACKGROUND: Atrial fibrillation (AF) is a common cause of tachycardia-induced cardiomyopathy (TIC). This study evaluated the outcomes of the Cox-Maze IV procedure in patients with TIC and significant left ventricular dysfunction. METHODS: Between January 2002 and January 2017, 37 consecutive patients with a left ventricular ejection fraction (LVEF) of 0.40 or less underwent stand-alone surgical ablation of AF. After dilated and ischemic cardiomyopathies were excluded, 34 of 37 patients met the criteria for the diagnosis of TIC. RESULTS: Patients were a mean age of 56 ± 11 years, and 24 (70%) had long-standing persistent AF. The median AF duration was 72 months (interquartile range, 9 to 276 months). Seventeen patients (50%) had at least one catheter-based ablation that failed. Mean LVEF was 0.32 ± 0.08. There were 11 patients (32%) with New York Heart Association Functional Classification III/IV symptoms. There was one (3%) 30-day mortality caused by a pulmonary embolus, despite full anticoagulation. At 12 months, freedom from atrial tachyarrhythmias on or off antiarrhythmic drugs was 94% and 89%, respectively. Postoperative echocardiograms were available for 27 of 33 patients (82%). The LVEF improved to a mean of 0.55 ± 0.08 (95% confidence interval, 0.51 to 0.58; p < 0.001). Of the 11 patients with New York Heart Association Functional Classification III/IV symptoms, 8 patients were in class I/II at the last follow-up (p = 0.02). CONCLUSIONS: Restoration of sinus rhythm with the Cox-Maze IV was associated with significant improvement in the LVEF in patients with AF and TIC. This retrospective study illustrates the efficacy of the Cox-Maze IV in this patient population both at restoring sinus rhythm and improving ventricular function. Patients with TIC and poor left ventricular function in whom other treatments have failed should be strongly considered for surgical ablation.


Assuntos
Fibrilação Atrial/cirurgia , Cardiomiopatias/etiologia , Ablação por Cateter/métodos , Sistema de Condução Cardíaco/fisiopatologia , Frequência Cardíaca/fisiologia , Volume Sistólico/fisiologia , Função Ventricular Esquerda/fisiologia , Fibrilação Atrial/complicações , Fibrilação Atrial/fisiopatologia , Biópsia , Cardiomiopatias/diagnóstico , Cardiomiopatias/fisiopatologia , Ecocardiografia , Eletrocardiografia , Feminino , Seguimentos , Humanos , Imagem Cinética por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia , Estudos Retrospectivos , Resultado do Tratamento
15.
Clin Chim Acta ; 495: 123-128, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30959043

RESUMO

Titin, encoded by the gene TTN, is the largest human protein, and plays central roles in sarcomeric structures and functions in skeletal and cardiac muscles. Mutations of TTN are causally related to specific types of muscular dystrophies and cardiomyopathies. A developed methodology of next generation sequencing has recently led to the identification of novel TTN mutations in such diseases. The clinical significance of titin is now emerging as a target for genetic strategies. Titin-related muscular dystrophies include tibial muscular dystrophy, limb-girdle muscular dystrophy, Emery-Dreifuss muscular dystrophy, hereditary myopathy with early respiratory failure, central core myopathy, centronuclear myopathies, and Salih myopathy. Truncation mutations of TTN have been identified as the most frequent genetic cause of dilated cardiomyopathy. In this review article, we highlight the role of titin and impact of TTN mutations in the pathogenesis of muscular dystrophies and cardiomyopathies. Recently, a novel sensitive sandwich enzyme-linked immunosorbent assay (ELISA) for the detection of the urinary titin N-terminal fragments (U-TN) has been established. We discuss the clinical significance of U-TN in the diagnosis of muscular dystrophies and differential diagnosis of cardiomyopathies, as well as risk stratification in dilated cardiomyopathy.


Assuntos
Cardiomiopatias/urina , Conectina/urina , Distrofias Musculares/urina , Biomarcadores/urina , Cardiomiopatias/diagnóstico , Cardiomiopatias/genética , Conectina/genética , Humanos , Distrofias Musculares/diagnóstico , Distrofias Musculares/genética , Mutação , Isoformas de Proteínas/genética , Isoformas de Proteínas/urina
16.
Diabetes Res Clin Pract ; 150: 72-80, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30844469

RESUMO

AIM: The aim of the study was to assess the extracellular volume fraction (ECV) in type 2 diabetes mellitus (T2DM) patients with different level of hemoglobin A1c (HbA1c) by cardiac magnetic resonance (CMR), and the ability of HbA1c to predict myocardial fibrosis. METHODS: In total, 80 T2DM patients and 20 age- and sex-matched controls were prospective enrolled and underwent CMR to obtain ECV value and LV function parameters. We divided all patients into a group of HbA1c < 7.0% and a group of HbA1c ≥ 7.0%. RESULTS: In the higher HbA1c group the ECV value (all p < 0.001) was higher than both lower HbA1c group (36.23% vs. 32.19%, p < 0.001) and controls (36.23% vs. 29.73%, p < 0.001). HbA1c was positively associated (ß = 0.36, p = 0.004) with ECV, and it was also an independent predictor of myocardial fibrosis (OR = 2.00, P = 0.014). The ROC analysis showed that 7.1% was the optimal cutoff value of HbA1c that predicted the risk of myocardial fibrosis with high diagnostic accuracy (area under the curve = 0.78). CONCLUSION: T1 mapping provided myocardial fibrosis information in T2DM patients. HbA1c is positively correlated with myocardial fibrosis and can be an independently predictor of myocardial fibrosis, which may be helpful for the clinical decision-making of blood glucose control.


Assuntos
Cardiomiopatias/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Fibrose/diagnóstico , Hemoglobina A Glicada/análise , Imagem Cinética por Ressonância Magnética/métodos , Cardiomiopatias/sangue , Cardiomiopatias/diagnóstico por imagem , Cardiomiopatias/etiologia , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Feminino , Fibrose/sangue , Fibrose/diagnóstico por imagem , Fibrose/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Curva ROC
17.
Arkh Patol ; 81(1): 57-64, 2019.
Artigo em Russo | MEDLINE | ID: mdl-30830107

RESUMO

Heart involvement in sarcoidosis is diagnosed in vivo in 5-7%, at autopsy in 25% of cases as a manifestation of a systemic process and an isolated one. Difficulties in the diagnosis of isolated sarcoidosis are due to the absence of known causes of the disease and to the lack of specificity of clinical manifestations. The main symptoms include cardiac conduction and rhythm disturbances, cardiomyopathy with the development of heart failure, as well as pericardial involvement. Routine techniques (ECG, EchoCG, daily ECG monitoring) and imaging of the structures of the heart and its function evaluation (MRI, PET, and scintigraphy) are used in diagnosis. A set of clinical, instrumental, and histological data obtained at endomyocardial biopsy may suggest isolated cardiac sarcoidosis with the exception of other diseases.


Assuntos
Cardiomiopatias , Insuficiência Cardíaca , Sarcoidose , Biópsia , Cardiomiopatias/complicações , Cardiomiopatias/diagnóstico , Insuficiência Cardíaca/etiologia , Humanos , Miocárdio/patologia , Sarcoidose/complicações , Sarcoidose/diagnóstico
19.
Vet Clin North Am Equine Pract ; 35(1): 139-157, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30871834

RESUMO

Pericardial, myocardial, and great vessel diseases are relatively rare in horses. The clinical signs are often nonspecific and vague, or related to the underlying cause. Physical examination usually reveals tachycardia, fever, venous distension or jugular pulsation, a weak or bounding arterial pulse, ventral edema, and abnormal cardiac auscultation such as arrhythmia, murmur, or muffled heart sounds. The prognosis depends on the underlying cause and the disease progression, and ranges from full recovery to poor prognosis for survival. This article focuses on the etiology, diagnosis, prognosis, and treatment of pericarditis, pericardial mass lesions, myocarditis, cardiomyopathy, and great vessel aneurysm or rupture.


Assuntos
Anormalidades Cardiovasculares/veterinária , Cardiopatias/veterinária , Doenças dos Cavalos/diagnóstico , Animais , Aorta/anormalidades , Cardiomiopatias/diagnóstico , Cardiomiopatias/etiologia , Cardiomiopatias/terapia , Cardiomiopatias/veterinária , Anormalidades Cardiovasculares/diagnóstico , Anormalidades Cardiovasculares/etiologia , Anormalidades Cardiovasculares/terapia , Cardiopatias/diagnóstico , Cardiopatias/etiologia , Cardiopatias/terapia , Doenças dos Cavalos/etiologia , Doenças dos Cavalos/terapia , Cavalos , Miocardite/diagnóstico , Miocardite/etiologia , Miocardite/terapia , Miocardite/veterinária , Pericardite/diagnóstico , Pericardite/etiologia , Pericardite/terapia , Pericardite/veterinária , Prognóstico
20.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(3): 378-380, 2019 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-30914106

RESUMO

OBJECTIVE: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. The early mortality of patients with sepsis-induced myocardial dysfunction (SMD) is higher than those with normal cardiac function, and the long-term prognosis is worse. Therefore, early detection of SMD and timely intervention can reduce mortality and improve prognosis. This review focused on the progress in evaluation and treatment of SMD, with a view to provide some ideas for the diagnosis and treatment of SMD.


Assuntos
Cardiomiopatias/diagnóstico , Cardiomiopatias/terapia , Sepse/complicações , Cardiomiopatias/etiologia , Humanos
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