scholarly journals Cardiac Iodine-123 Metaiodobenzylguanidine Imaging Predicts Sudden Cardiac Death Independently of Left Ventricular Ejection Fraction in Patients With Chronic Heart Failure and Left Ventricular Systolic Dysfunction

2009 ◽  
Vol 53 (5) ◽  
pp. 426-435 ◽  
Author(s):  
Shunsuke Tamaki ◽  
Takahisa Yamada ◽  
Yuji Okuyama ◽  
Takashi Morita ◽  
Shoji Sanada ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Death ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Systolic Dysfunction ◽  
Ventricular Ejection Fraction ◽  
Iodine 123 Metaiodobenzylguanidine ◽  
Iodine 123

Drug and Drug-Device Therapy in Heart Failure Patients in the Post-COMET and SCD-HeFT Era

2005 ◽  
Vol 10 (4_suppl) ◽  
pp. S45-S58 ◽  
Author(s):  
James A. Reiffel
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Large Scale ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Device Therapy ◽  
Ventricular Ejection Fraction

Reduced left ventricular ejection fraction and heart failure are the most important risk factors for sudden cardiac death. Recent trials have contributed to the knowledge base of critical therapies for the treatment of left ventricular systolic dysfunction and heart failure as it relates to arrhythmic and sudden cardiac death. Both pharmacologic and device therapies can reduce sudden cardiac death. The trials discussed in this paper have identified the pharmacologic and device interventions that are likely to improve the length and quality of life of the patient with left ventricular dysfunction and reduce the risk of sudden cardiac death. The mortality and anti-arrhythmic effects of angiotensin-converting enzyme inhibitors and β-blockers have been confirmed in large-scale controlled clinical heart failure trials. Recent trials have evaluated which agents are most effective and which patients will derive the most benefit from device therapy in terms of the reduction in the risk of sudden cardiac death and in the amelioration of heart failure. The recent data from the Carvedilol or Metoprolol European Trial (COMET) and the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) are discussed as the latest in the series of landmark studies that have shaped the current approaches to treating patients with heart failure and that have altered the heart failure treatment paradigm.

Peripartum Cardiomyopathy

2018 ◽  
Author(s):  
Kendra M Gray ◽  
Michael R Foley
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
The United States ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Left Ventricular Ejection ◽  
Ventricular Systolic Dysfunction ◽  
Ventricular Ejection Fraction

Peripartum cardiomyopathy (PPCM) is a serious and rare disease of late pregnancy or the early postpartum period. It is defined as idiopathic, nonfamilial, nongenetic, heart failure occurring in the absence of any other identifiable causes of heart disease within the last month of pregnancy or within the first 5 months postdelivery in otherwise previously healthy woman. The incidence in the United States is 1 per 3,000 to 4,000 live births. Left ventricular systolic dysfunction develops, almost always leading to a left ventricular ejection fraction of less than 45%. PPCM is unique in its rapid medical course and propensity to spontaneously resolve within 3 to 6 months of disease onset. The mortality rate is high, up to 10%, and the risk of relapse in subsequent pregnancies is also elevated. Treatment for PPCM varies slightly based on whether the woman is pregnant or postpartum. Conventional pharmacologic treatment includes diuretics, angiotensin-converting enzyme inhibitors (postpartum only), vasodilators such as hydralazine, digoxin, β-blockers, and anticoagulants. This review contains 5 figures, 5 tables, and 36 references. Key Words: critical care obstetrics, ejection fraction, heart failure, left ventricular systolic dysfunction, management, maternal mortality, peripartum cardiomyopathy, preeclampsia, pregnancy

scholarly journals Systolic left ventricular dysfunction in patients with clinically suspected myocarditis

2020 ◽  
Vol 17 (4) ◽  
pp. 452-460
Author(s):  
N. P. Mitkovskaya ◽  
E. M. Balysh ◽  
T. V. Statkevich ◽  
N. A. Ladygina ◽  
E. B. Petrova ◽  
...  
Keyword(s):  
Heart Rate ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Systolic Dysfunction ◽  
Ventricular Ejection Fraction

The aim of the study was to investigate the features of clinically suspected myocarditis complicated by the left ventricular systolic dysfunction development. 93 patients with clinically suspected myocarditis were examined. The average age was 36.63 ± 1.15 years. In 43.01 % of patients the disease was accompanied by a decrease in left ventricular systolic function. In the group of patients with left ventricular systolic dysfunction in comparison with those with preserved left ventricular ejection fraction, a significantly lower proportion of men (75 % versus 81 %, respectively, χ2 = 9.3, p < 0,01) and a higher average group age (40.7 ± 1.87 versus 33.6 ± 1.3 years, respectively, p <  0,01) were revealed. The course of the disease in patients with left ventricular systolic dysfunction was characterized by a more frequent development of rhythm disturbances (65 % versus 43.3 %, respectively, χ2  = 4.3, p  < 0,05) and a higher heart rate at admission (94.5 (75‒100) and 85 (70‒89) beats per minute, respectively, p = 0.006). The structural and functional state of the heart according to echocardiography in patients with a reduced left ventricular ejection fraction versus comparison group was characterized by larger heart chambers sizes, more pronounced violations of local left ventricular contractility, more frequent involvement of the right ventricle in the pathological process (56.3  % versus 22.2  %, respectively, χ2   =  6.4, p  < 0,05). The relationships between the left ventricular ejection fraction Весці Нацыянальнай акадэміі навук Беларусі. Серыя медыцынскіх навук. 2020. Т. 17, № 4. C. 452–460 453 and the patient’s age (r = ‒0.36), the value of the heart rate at admission (r = ‒0.32), the severity of heart failure at admission, the degree of impaired local contractility of the left ventricle, the degree of right ventricular function (TAPSE, r  =  0.58), the severity of myocardial fibrosis according to cardiovascular magnetic resonance imaging (r = ‒0.32) were revealed.

Abstract 17860: Cardiac Iodine-123 Metaiodobenzylguanidine Imaging Predicts Poor Prognosis Even in Patients Admitted With Acute Decompensated Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Shunsuke Tamaki ◽  
Takahisa Yamada ◽  
Takashi Morita ◽  
Yoshio Furukawa ◽  
Yusuke Iwasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Washout Rate ◽  
Mibg Imaging ◽  
Ventricular Ejection Fraction ◽  
Iodine 123 Metaiodobenzylguanidine ◽  
Iodine 123

Introduction: Cardiac iodine-123 metaiodobenzylguanidine (MIBG) imaging has been shown to provide prognostic information in patients with chronic heart failure. However, little is known about the prognostic value of cardiac MIBG imaging in patients admitted with acute decompensated heart failure (ADHF). Hypothesis: We assessed the hypothesis that cardiac MIBG imaging might also be useful for the prediction of poor clinical outcome in patients admitted with ADHF. Methods: We studied 115 consecutive patients admitted for ADHF from October 2011 to January 2013 and discharged with survival (age: 74±13 years, male: 56%, NYHA class at discharge: 2.2±0.8, left ventricular ejection fraction measured by echocardiography: 47.1±15.5%). Cardiac MIBG imaging, echocardiography and venous blood sampling were performed just before discharge. The cardiac MIBG heart-to-mediastinum ratio (H/M) and washout rate were calculated from the chest anterior view images obtained at 20 and 200min after isotope injection. The endpoints were unplanned hospitalization for worsening heart failure (WHF) and pump failure death (PFD). Results: During a follow-up period of 2.0±0.8 years, 32 patients had WHF and 15 patients had PFD. At multivariate Cox analysis, out of the variables including clinical, hemodynamic, biochemical, echocardiographic and MIBG parameters, H/M on delayed image (late H/M) was independently associated with WHF (p=0.0003) and PFD (p=0.0255), although brain natriuretic peptide showed the significant association with the endpoints at univariate analysis. Kaplan-Meier analysis showed that the patients with late H/M <1.65 (mean value) had a significantly higher risk of both WHF and PFD than those with late H/M ≧1.65 (Figure). Conclusions: Cardiac MIBG imaging could predict poor outcome even in patients admitted with ADHF.

Sign in / Sign up

Export Citation Format

Share Document