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Cardiovascular outcomes after cardiac resynchronization therapy in cardiac amyloidosis
2021
Abstract Aims Cardiac resynchronization therapy (CRT) is highly effective in dilated cardiomyopathy (DCM) patients with impaired left ventricular ejection fraction (LVEF) and left bundle block branch. In cardiac amyloidosis (CA) patients, left ventricular dysfunction and conduction defects are common, but the potential of CRT to improve cardiac remodelling and survival in this particular setting remains undefined. We investigated cardiovascular outcomes in CA patients after CRT implantation in terms of CRT echocardiographic response and major cardiovascular events (MACEs). Methods and results Our retrospective study included 47 CA patients implanted with CRT devices from January 2012 to Feb…
Blood pressure in chronic kidney disease stage 5D—report from a Kidney Disease: Improving Global Outcomes controversies conference
2010
Management of blood pressure (BP) in patients with chronic kidney disease receiving dialysis (stage 5D) provides a significant challenge for healthcare professionals. The association between BP and cardiovascular disease risk has been well studied in the general population; however, in dialysis patients, physiological and dialysis-related mechanisms influencing BP are complex, and the associated risk is poorly understood. In stage 5D, BP is determined by the complex interplay of fluid volume and prescription of post-dialysis target weight, sodium load, the renin–angiotensin and sympathetic nervous systems, and diverse exogenous factors, such as administration of erythropoiesis-stimulating a…
Transcatheter indirect mitral annuloplasty induces annular and left atrial remodelling in secondary mitral regurgitation
2020
Abstract Aims Mitral annuloplasty using the Carillon Mitral Contour System (CMCS) reduces secondary mitral regurgitation (SMR) and leads to reverse left ventricular remodelling. The aim of this study was to evaluate the effect of the CMCS on the mitral valve annulus (MA) and left atrial volume (LAV). Methods and results We retrospectively evaluated the data of all patients treated with the CMCS at our centre. Using transthoracic echocardiography, MA diameters were assessed by measuring the anterolateral to posteromedial extend (ALPM) and the anterior to posterior (AP) dimensions, respectively. Also, LAV and left ventricular end‐diastolic volume (LVEDV) were assessed. Patients were examined …
The Female Sex Confers Different Prognosis in Heart Failure: Same Mortality but More Readmissions
2021
Introduction: Heart failure (HF) is a major cause of morbimortality both in men and women. Differences between sex in etiopathogenesis, response to treatment, and quality of care have been found in patients with HF. Females are usually under-represented in clinical trials and there is no solid evidence demonstrating the influence of sex in the prognostic of chronic HF. The primary objective of this study was to analyse the differences in mortality and probability of hospital readmission between males and females with HF. The secondary objective was to compare mortality and probability of hospital readmission by ejection fraction (reduced vs. preserved).Methods: Patients with decompensated H…
The Relationship between the Transforming Growth Factor β1 T29C Gene Polymorphism and Left Ventricular Geometry and Function in Hypertensive Subjects
2009
The distribution of the T29C TGFβ1 gene polymorphism was analyzed in 198 hypertensives with left ventricular hypertrophy (LVH) and in 235 hypertensives without LVH. Circulating TGFβ1 levels, procollagen type III levels, microalbuminuria, and left ventricular geometry and function were evaluated in all the hypertensives with LVH subgrouped according to T29C TGFβ1 gene polymorphism. Circulating TGFβ1 was evaluated by ELISA technique, procollagen type III by a specific radioimmunoassay, microalbuminuria by radioimmunoassay, and left ventricular geometry and function by echocardiography. All groups were comparable for gender, age, and sex. Regarding T29C TGFβ1 gene polymorphism, prevalence of T…
Transcatheter Mitral Repair for Functional Mitral Regurgitation According to Left Ventricular Function: A Real-Life Propensity-Score Matched Study
2020
Background: Transcatheter mitral valve repair (TMVR) could improve survival in functional mitral regurgitation (FMR), but it is necessary to consider the influence of left ventricular ejection fraction (LVEF). Therefore, we compare the outcomes after TMVR with Mitraclip®
MRI in the Diagnosis of Right Ventricular Dysplasia
2006
ARVD is part of the group of cardiomyopathies characterised pathologically by fibrofatty replacement of the right ventricular myocardium and clinically by right ventricular arrhythmias of the LBBB pattern. Pathogenesis, prevalence, and aetiology are yet not fully known. The diagnosis of ARVD is based on the presence of structural, histological, electrocardiographic, and genetic factors. Therapeutic options include antiarrhythmic medication, catheter ablation, implantable cardioverter defibrillation, and surgery. Angiography and echocardiography lack sensitivity and specificity in the diagnosis of ARVD. MR imaging allows a three-dimensional evaluation of especially the right ventricle, and p…
Left Renal Vein Anatomical Anomalies: Radiological and Surgical Implications
1998
Objective: To emphasize the incidence and clinical, diagnostic and surgical implications of left renal vein developmental anomalies. Design: Retrospective analysis of case notes. Setting: Clinical Anatomy Department and Surgery Department, Faculty of Medicine, University of Valencia, Spain. Patients, participants: Standard radiological examinations (CT scan) performed on 745 patients; surgical findings at operation in 128 patients with aorto-iliac atherosclerotic disease, and 72 donor cadavers for transplantation. Main outcome measures: Incidence of left renal vein anomalies (retro-aortic left renal vein and peri-aortic renal venous collar), based on radiological (CT scan) and surgical obse…
Analysis of inter-atrium differences in paroxysmal and persistent atrial fibrillation using principal component analysis
2007
The pathophysiological mechanisms of atrial fibrillation (AF) are not entirely clear yet, and there is no full explanation for the development and evolution of the arrhythmia. The goal of this study is to find inter-atrium differences in electrophysiological behavior between persistent and paroxysmal AF. The database analyzed contains intra-cardiac records from 14 patients with paroxysmal AF and 10 with persistent AF. Dominant frequency and sample entropy measurements showed that in the paroxysmal group there was a left-to-right gradient. These differences were enhanced after the extraction of the main components with principal component analysis. These findings may be interpreted as a poss…
Ectasia and Aneurysm of the Right Coronary Artery Resulting From a Shunt to the Coronary Sinus
1998
A 65-year-old woman presented with a systolic-diastolic murmur. Further MRI investigations as well as angiography revealed an arteriovenous shunt to the coronary sinus via an enlarged right coronary artery (Figure 1A⇓ and 1B⇓). The distal part of this coronary artery was transformed to a large coronary aneurysm of such extent that the left atrium was compressed …