Progression of myocardial disease late after correction of IHSS: Importance of transaortic approach

Objective: We retrospectively evaluated the results of an edge-to-edge repair (Alfieri stitch) of the mitral valve performed via a transaortic approach in patients who were undergoing minimally invasive aortic valve replacement.Methods: From January 2010 to September 2010, 6 patients underwent minimally invasive edge-to-edge repair of the mitral valve via a transaortic approach with concomitant aortic valve replacement. The patients were considered to be candidates for this procedure if they were deemed by the surgeon to be high-risk for a double valve procedure and if on preoperative transesophageal echocardiogram the mitral regurgitation jet originated from the middle portion (A2/P2 segments) of the mitral valve.Results: There was no operative mortality. Mean cardiopulmonary bypass time was 137 minutes, and mean cross-clamp time was 111 minutes. There was a significant improvement in the mean mitral regurgitation grade, with a mean of 3.8 preoperatively and 0.8 postoperatively. The ejection fraction remained stable, with mean preoperative and postoperative ejection fractions of 43.3% and 47.5%, respectively. Follow-up transthoracic echocardiograms obtained at a mean of 33 days postoperatively (range, 8-108 days) showed no significant worsening of mitral regurgitation.Conclusion: Transaortic repair of the mitral valve is feasible in patients undergoing minimally invasive aortic valve replacement.

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Screening drugs for myocardial disease in vivo with zebrafish: an expert update

Expert Opinion on Drug Discovery ◽

10.1080/17460441.2019.1577815 ◽

2019 ◽

Vol 14 (4) ◽

pp. 343-353 ◽

Cited By ~ 3

Author(s):

Yanbin Zhao ◽

Kun Zhang ◽

Patrick Sips ◽

Calum A. MacRae

Keyword(s):

Myocardial Disease

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The value of regional myocardial function assessment in patients with acute myocarditis at baseline and mid term follow-up

European Heart Journal ◽

10.1093/ehjci/ehaa946.0136 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J Boidol ◽

M Koziel ◽

K Miszalski-Jamka ◽

J Klys ◽

Z Kalarus ◽

...

Keyword(s):

Longitudinal Strain ◽

Ventricular Remodeling ◽

Clinical Course ◽

Troponin T ◽

Global Longitudinal Strain ◽

Cardiac Resynchronization ◽

Global Improvement ◽

Myocardial Disease ◽

Mechanical Dispersion

Abstract Background The clinical course and ventricular remodeling in inflammatory myocardial disease could be unpredictable. No single functional parameter has been confirmed as a powerful predictor of clinical course and functional recovery assessment in patients with acute inflammatory myocardial disease. Purpose The aim of the study was to assess the mechanical properties of the myocardium in patients with active myocarditis at baseline and follow-up. Methods Database from a high volume, tertiary cardiology center was analysed to identify patients with active myocarditis, based on clinical presentation and ≥1 diagnostic criteria from different categories (including electrocardiography/holter, elevated troponin T/I levels, functional or structural abnormalities on cardiac imaging or tissue characterization by cardiac magnetic resonance) between 2016 and 2019. Conventional and speckle tracking echocardiography including global longitudinal strain (GLS) mechanical dispersion (MD) was completed at baseline and at 17±13 months follow-up. MD was calculated as a standard deviation of time to peak longitudinal strain derived from all left ventricle segments in 3 apical views. Results 61 consecutive patients [50 M, 11F, end-diastolic volume 212±84 ml, end-systolic volume 130±90ml, ejection fraction (EF) 42±16%] were enrolled. During the entire follow-up 1 patient died at early observation. Implantable cardioverter-defibrillator was implanted in 5 patients (primary prevention 4, secondary 1), cardiac resynchronization therapy pacemaker in 1 patient. Despite of significant global improvement (EF 42±16% vs 52±10%, p<0.001) the limited regional improvement was noticed (GLS 14±6% vs 15±4%, p = NS; MD 47±18 ms vs 45±20 ms, p=NS) in all patients at 17±13 months follow-up. There was a strong negative association between GLS and MD at baseline (Figure 1), and slightly weaker at follow-up (R=0.47, Pearson's correlation). Moreover, the GLS correlated well the change of MD in each individual patient. Conclusions Mechanical dispersion and global longitudinal strain may serve as an additional markers of myocardial damage and potential predictive markers in non ischemic cardiomyopathy patients with proven inflammatory origin. Funding Acknowledgement Type of funding source: None

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Prognostic importance of mitral e′ velocity in constrictive pericarditis

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa133 ◽

2020 ◽

Author(s):

Jeong Hoon Yang ◽

William R Miranda ◽

Rick A Nishimura ◽

Kevin L Greason ◽

Hartzell V Schaff ◽

...

Keyword(s):

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Constrictive Pericarditis ◽

Multivariable Analysis ◽

Artery Pressure ◽

Myocardial Disease ◽

Mean Pulmonary Artery Pressure ◽

Diastolic Velocity ◽

Long Term Mortality

Abstract Aims Increased medial mitral annulus early diastolic velocity (e′) plays an important role in the echocardiographic diagnosis of constrictive pericarditis (CP) and mitral e′ velocity is also a marker of underlying myocardial disease. We assessed the prognostic implication of mitral e′ for long-term mortality after pericardiectomy in patients with CP. Methods and results We studied 104 surgically confirmed CP patients who underwent echocardiography and cardiac catheterization within 7 days between 2005 and 2013. Patients were classified as primary CP (n = 45) or mixed CP (n = 59) based on the clinical history of concomitant myocardial disease. On multivariable analysis, medial e′ velocity and mean pulmonary artery pressure were independently associated with long-term mortality post-pericardiectomy. There were significant differences in survival rates among the groups divided by cut-off values of 9.0 cm/s and 29 mmHg for medial e′ and mean pulmonary artery pressure, respectively (both P < 0.001). Ninety-two patients (88.5%) had elevated pulmonary artery wedge pressure (PAWP) (≥15 mmHg); there was no significant correlation between medial E/e′ and PAWP (r = 0.002, P = 0.998). However, despite the similar PAWP between primary CP and mixed CP groups (21.6 ± 5.4 vs. 21.2 ± 5.8, P = 0.774), all primary CP individuals with elevated PAWP had medial E/e′ <15 as opposed to 34 patients (57.6%) in the mixed CP group (P < 0.001). Conclusion Increased mitral e′ velocity is associated with better outcomes in patients with CP. A paradoxical distribution of the relationship between E/e′ and PAWP is present in these patients but there is no direct inverse correlation between them.

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A 3D Network Based Shape Prior for Automatic Myocardial Disease Segmentation in Delayed-Enhancement MRI

IRBM ◽

10.1016/j.irbm.2021.02.005 ◽

2021 ◽

Author(s):

K. Brahim ◽

A. Qayyum ◽

A. Lalande ◽

A. Boucher ◽

A. Sakly ◽

...

Keyword(s):

Delayed Enhancement ◽

Shape Prior ◽

Myocardial Disease ◽

3D Network

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Myocardial disease in patients with HIV

Nature Reviews Cardiology ◽

10.1038/nrcardio.2013.107 ◽

2013 ◽

Vol 10 (9) ◽

pp. 489-489

Author(s):

Gregory B. Lim

Keyword(s):

Myocardial Disease

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Transcriptomic analysis of the cardiac left ventricle in a rodent model of diabetic cardiomyopathy: molecular snapshot of a severe myocardial disease

Physiological Genomics ◽

10.1152/physiolgenomics.00204.2006 ◽

2007 ◽

Vol 28 (3) ◽

pp. 284-293 ◽

Cited By ~ 19

Author(s):

Sarah Glyn-Jones ◽

Sarah Song ◽

Michael A. Black ◽

Anthony R. J. Phillips ◽

Soon Y. Choong ◽

...

Keyword(s):

Diabetic Cardiomyopathy ◽

Molecular Basis ◽

Cardiovascular Complications ◽

Left Ventricular ◽

Myocardial Disease ◽

Chronic Hyperglycemia ◽

Expression Of Genes ◽

Streptozotocin Induced Diabetes ◽

Quantitative Verification ◽

Disproportionate Number

Heart disease is the major cause of death in diabetes, a disorder characterized by chronic hyperglycemia and cardiovascular complications. Diabetic cardiomyopathy (DCM) is increasingly recognized as a major contributor to diastolic dysfunction and heart failure in diabetes, but its molecular basis has remained obscure, in part because of its multifactorial origins. Here we employed comparative transcriptomic methods with quantitative verification of selected transcripts by reverse transcriptase quantitative PCR to characterize the molecular basis of DCM in rats with streptozotocin-induced diabetes of 16-wk duration. Diabetes caused left ventricular disease that was accompanied by significant changes in the expression of 1,614 genes, 749 of which had functions assignable by Gene Ontology classification. Genes corresponding to proteins expressed in mitochondria accounted for a disproportionate number of those whose expression was significantly modified in DCM, consistent with the idea that the mitochondrion is a key target of the pathogenic processes that cause myocardial disease in diabetes. Diabetes also induced global perturbations in the expression of genes regulating cardiac fatty acid metabolism, whose dysfunction is likely to play a key role in the promotion of oxidative stress, thereby contributing to the pathogenesis of diabetic myocardial disease. In particular, these data point to impaired regulation of mitochondrial β-oxidation as central in the mechanisms that generate DCM pathogenesis. This study provides a comprehensive molecular snapshot of the processes leading to myocardial disease in diabetes.

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