Clinical significance of ischemia-like electrocardiographic finding during heart failure treatment on left ventricular recovery in patients with non-ischemic dilated cardiomyopathy

2021 ◽  
Author(s):  
Kenji Maemura ◽  
Yuki Ikeda ◽  
Takumi Oki ◽  
Mayu Yazaki ◽  
Teppei Fujita ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Clinical Significance ◽  
Left Ventricular ◽  
Heart Failure Treatment ◽  
Failure Treatment ◽  
Left Ventricular Recovery ◽  
Non Ischemic Dilated Cardiomyopathy

scholarly journals The Role of Cardiac T-Cadherin in the Indicating Heart Failure Severity of Patients with Non-Ischemic Dilated Cardiomyopathy

Medicina ◽  
2020 ◽  
Vol 56 (1) ◽  
pp. 27
Author(s):  
Vaida Baltrūnienė ◽  
Ieva Rinkūnaitė ◽  
Julius Bogomolovas ◽  
Daiva Bironaitė ◽  
Ieva Kažukauskienė ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Experimental Studies ◽  
Left Ventricular ◽  
Human Myocardium ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cox Regression Analysis ◽  
Non Ischemic Dilated Cardiomyopathy ◽  
The Mean

Background and objectives: T-cadherin (T-cad) is one of the adiponectin receptors abundantly expressed in the heart and blood vessels. Experimental studies show that T-cad sequesters adiponectin in cardiovascular tissues and is critical for adiponectin-mediated cardio-protection. However, there are no data connecting cardiac T-cad levels with human chronic heart failure (HF). The aim of this study was to assess whether myocardial T-cad concentration is associated with chronic HF severity and whether the T-cad levels in human heart tissue might predict outcomes in patients with non-ischemic dilated cardiomyopathy (NI-DCM). Materials and Methods: 29 patients with chronic NI-DCM and advanced HF were enrolled. Patients underwent regular laboratory investigations, echocardiography, coronary angiography, and right heart catheterization. TNF-α and IL6 in serum were detected by enzyme-linked immunosorbent assay (ELISA). Additionally, endomyocardial biopsies were obtained, and the levels of T-cad were assessed by ELISA and CD3, CD45Ro, CD68, and CD4- immunohistochemically. Mean pulmonary capillary wedge pressure (PCWP) was used as a marker of HF severity, subdividing patients into two groups: mean PCWP > 19 mmHg vs. mean PCWP < 19 mmHg. Patients were followed-up for 5 years. The study outcome was composite: left ventricular assist device implantation, heart transplantation, or death from cardiovascular causes. Results: T-cad shows an inverse correlation with the mean PCWP (rho = −0.397, p = 0.037). There is a tendency towards a lower T-cad concentration in patients with more severe HF, as indicated by the mean PCWP > 19 mmHg compared to those with mean PCWP ≤ 19 mmHg (p = 0.058). Cardiac T-cad levels correlate negatively with myocardial CD3 cell count (rho = −0.423, p = 0.028). Conclusions: Univariate Cox regression analysis did not prove T-cad to be an outcome predictor (HR = 1, p = 0.349). However, decreased T-cad levels in human myocardium can be an additional indicator of HF severity. T-cad in human myocardium has an anti-inflammatory role. More studies are needed to extend the role of T-cad in the outcome prediction of patients with NI-DCM.

P6452Circulating human epididymis protein 4 is a novel prognostic predictor in ambulatory patients with non-ischemic dilated cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Okumura ◽  
H Oishi ◽  
T Kondo ◽  
Y Arao ◽  
H Kato ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Cardiac Catheterization ◽  
Coronary Sinus ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Left Ventricular Ejection ◽  
Composite Event ◽  
Ambulatory Patients ◽  
Non Ischemic Dilated Cardiomyopathy

Abstract Background Myofibroblasts, which are activated fibroblasts, play an important role in interstitial fibrosis in non-ischemic dilated cardiomyopathy (NIDCM). Recently, human epididymal body protein 4 (HE4) has attracted attention as a marker specific to myofibroblasts. However, the prognostic impact of HE-4 on cardiovascular events in NIDCM patients has not been reported. Purposes The purpose of this study was to investigate the impact of circulating serum HE4 on the prognosis in patients with NIDCM. Methods Forty-four NIDCM patients underwent echocardiography, laboratory measurements, cardiac catheterization, and endomyocardial biopsy within one week under stable heart failure condition. Patients with cancer were excluded from this study. We collected blood samples from peripheral vain, ascending aorta, and coronary sinus during cardiac catheterization and measured serum HE4 level. They were divided into two groups at the median of HE4 level: High-HE4 group (HE4 >69 pmol/L); n=22, Low-HE4 group (HE4 <69 pmol/L); n=22. Cardiac composite event was defined as cardiac related deaths and hospitalization due to worsening heart failure. Results The mean age, left ventricular ejection fraction (LVEF), and plasma brain natriuretic peptide level were 56 years, 32%, and 205 pg/mL. Between two groups, there were no significant differences in age, gender, LVEF, left ventricular end-diastolic diameter, cardiac index, and pulmonary capillary wedge pressure. However, estimated glomerular filtration rate was significantly lower in the High-HE4 group (p=0.025). Kaplan-Meier survival analysis revealed that the High-HE group had a higher rate of cardiac composite event (p=0.011, see Figure). However, as for the pathological analysis, not only the peripheral HE4 level but also HE4 value subtracting coronary sinus from ascending aorta did not significantly correlate with collagen volume fraction in biopsy samples. Circulating HE4 level and prognosis Conclusion Elevated circulating HE4 is associcated with poor prognosis in ambulatory patients with NIDCM.

Left Ventricular Longitudinal Strain as a Marker for Point of No Return in Hypertensive Heart Failure Treatment

2020 ◽  
Vol 33 (2) ◽  
pp. 226-233.e1
Author(s):  
Tomoko Ishizu ◽  
Yoshihiro Seo ◽  
Mikiko Namekawa ◽  
Nobuyuki Murakoshi ◽  
Masaki Ieda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Longitudinal Strain ◽  
Left Ventricular ◽  
Heart Failure Treatment ◽  
Failure Treatment ◽  
Point Of No Return

Control of congestive heart failure with ventricular arrhytmias in a dog with dilated cardiomyopathy – case report

2020 ◽  
Vol XXV (147) ◽  
pp. 38-50
Author(s):  
Estela Dall’Agnol Gianezini ◽  
Flavio Shigueru Jojima ◽  
Ana Paula Smiderle ◽  
Vanessa Tiemi Endo ◽  
Mônica Kanashiro Oyafuso ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Dilated Cardiomyopathy ◽  
Exercise Intolerance ◽  
Acute Dyspnea ◽  
Heart Failure Treatment ◽  
Failure Treatment ◽  
Echocardiographic Examination ◽  
History Of

Abstract: We report a case of a dog, male, eleven year old, american cocker spaniel with a history of acute dyspnea and exercise intolerance. The electrocardiography examination revealed the presence of ventricular arrhytmias, and, through echocardiographic examination, the patient was diagnosed with dilated cardiomyopathy and congestive heart failure. Treatment was performed, with improvement in congestive signs and arrhytmias. Ventricular arrhytmias are difficult to control in patients treated only for underlying heart disease, without the administration of antiarrythmics. The patient survived for fifteen months, emphasizing the need for early diagnosis and treatment, in order to obtain an improvement in life expectancy of patients with heart disease.

Abstract 1951: Circulating Dendritic Cells May Play an Important Role in Pathophysiology in Heart Failure in Humans

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Yusuke Sugi ◽  
Hideo Yasukawa ◽  
Hisashi Kai ◽  
Daisuke Fukui ◽  
Nobuyoshi Futamata ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dendritic Cells ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Primary Immune Response ◽  
Left Ventricular Ejection ◽  
Heart Failure Treatment ◽  
Heart Failure Patients ◽  
Control Subjects ◽  
Failure Treatment

Dendritic cells (DCs) are the most potent antigen-presenting cells and play a central role in initiating the primary immune response. Although increasing evidence supports immune-mediated inflammation plays an important role in the pathophysiology of heart failure, little is known regarding the source and mechanism that trigger immune responses. The present study examined whether circulating DCs have any role in the pathophysiology in heart failure in humans. Methods and Results: With multi-color flow-cytometry we determined the numbers of circulating myeloid DCs (mDCs) and plasmacytoid DCs (pDCs) in decompensated heart failure patients with NYHA class III or IV on admission (n=27) and the age-matched control subjects (n=21). DC activation markers such as CD40 and CCR7 were also measured. On admission, circulating mDC and pDC counts were significantly lower in decompensated heart failure patients compared to control subjects (12417 ± 2849 versus 5394 ± 3547 and 3321 ± 1491 versus 1800 ± 1474/ml, respectively, p<0.01). Circulating DCs were activated in the decompensated heart failure patients compared to control subjects (CD40; 1.6 ± 1.8 versus 8.5 ± 9.2, CCR7; 3.5 ± 4.1 versus 13.5 ± 10.0, respectively, p<0.05). Heart failure treatment significantly restored the reduction and the activation of circulating DCs (p<0.05). The increases of circulating DCs numbers after treatment were correlated with the decreases in B-type natriuretic peptide (BNP) and troponin-T (r=0.64, p<0.01 and r=0.46, respectively, p<0.05) and with the increase in left ventricular ejection fraction (LVEF) (r=0.73, p<0.01). Furthermore, we found that patients with smaller circulating DCs numbers (less than 10000/ml) after heart failure treatment had poor prognosis compaired with those who had greater DCs numbers (more than 10000/ml) during the 6-month follow-up (p<0.01). Thus, we found that changes of circulating DCs numbers were well correlated with cardiac injury and function, and that poor recovery of the circulating DCs number after treatment predicted recurrence of decompensated heart failure. Conclusion : These findings suggest that circulating DCs may play an important role in pathophysiology in heart failure in humans.

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