scholarly journals Cardiac macrophages prevent sudden death during heart stress

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Junichi Sugita ◽  
Katsuhito Fujiu ◽  
Yukiteru Nakayama ◽  
Takumi Matsubara ◽  
Jun Matsuda ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Gap Junctions ◽  
Adrenergic Receptor ◽  
Cardiac Death ◽  
Connexin 43 ◽  
Pressure Overload ◽  
Impulse Conduction ◽  
Cardiac Impulse ◽  
Medical Need

AbstractCardiac arrhythmias are a primary contributor to sudden cardiac death, a major unmet medical need. Because right ventricular (RV) dysfunction increases the risk for sudden cardiac death, we examined responses to RV stress in mice. Among immune cells accumulated in the RV after pressure overload-induced by pulmonary artery banding, interfering with macrophages caused sudden death from severe arrhythmias. We show that cardiac macrophages crucially maintain cardiac impulse conduction by facilitating myocardial intercellular communication through gap junctions. Amphiregulin (AREG) produced by cardiac macrophages is a key mediator that controls connexin 43 phosphorylation and translocation in cardiomyocytes. Deletion of Areg from macrophages led to disorganization of gap junctions and, in turn, lethal arrhythmias during acute stresses, including RV pressure overload and β-adrenergic receptor stimulation. These results suggest that AREG from cardiac resident macrophages is a critical regulator of cardiac impulse conduction and may be a useful therapeutic target for the prevention of sudden death.

scholarly journals Sudden Cardiac Death in Hereditary Dilated Cardiomyopathy

2020 ◽  
Author(s):  
Marianna Leopoulou ◽  
Jo Ann LeQuang ◽  
Joseph V. Pergolizzi ◽  
Peter Magnusson
Keyword(s):  
Sudden Cardiac Death ◽  
Left Ventricle ◽  
Sudden Death ◽  
Risk Stratification ◽  
Dilated Cardiomyopathy ◽  
Cardiac Death ◽  
Disease Risk ◽  
Systolic Dysfunction ◽  
Preventive Strategies ◽  
Genetic Origin

Dilated cardiomyopathy (DCM) is characterized by the phenotype of a dilated left ventricle with systolic dysfunction. It is classified as hereditary when it is deemed of genetic origin; more than 50 genes are reported to be related to the condition. Symptoms include, among others, dyspnea, fatigue, arrhythmias, and syncope. Unfortunately, sudden cardiac death may be the first manifestation of the disease. Risk stratification regarding sudden death in hereditary DCM as well as preventive management poses a challenge due to the heterogeneity of the disease. The purpose of this chapter is to present the epidemiology, risk stratification, and preventive strategies of sudden cardiac death in hereditary DCM.

2395LGE CMR predicts sudden death and VT in adults with repaired tetralogy of Fallot - a prospective study with 3500 patient follow up years

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Ghonim ◽  
M A Gatzoulis ◽  
G C Smith ◽  
E Heng ◽  
S Ernst ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Tetralogy Of Fallot ◽  
Cardiac Death ◽  
Primary Outcome ◽  
Right Atrial ◽  
Right Atrial Area ◽  
Lge Cmr ◽  
Atrial Area

Abstract Background Adults with repaired tetralogy of Fallot (rtoF) are at risk of ventricular arrhythmia and sudden cardiac death (SCD). Cross-sectional data suggest association of late gadolinium enhancement (LGE) cardiovascular magnetic resonance imaging (CMR) with adverse clinical risk factors Purpose We sought to determine prognosis related to LGE CMR. Methods In this prospective cohort study the primary composite outcome comprised the first of cardiovascular death (SCD or heart failure-related), aborted SCD (successfully resuscitated cardiac arrest or appropriate AICD shock for ventricular fibrillation), and clinical sustained ventricular tachycardia (VT>30 seconds duration). Results In 531 rtoF patients (median age 32; 23–42, 296 (56%) male, NYHA≥II 17%) followed up after LGE CMR for median 5 (1.7–8.9) years, there were 39 primary composite outcomes: 10 SCD, 11 heart failure related deaths (2 perioperative RV failure), 2 aborted SCD and 16 clinical sustained VT events. At study end, there were 28 ventricular arrhythmic events in 28 rtoF patients (10 SCD, 16 clinical sustained VT, 2 aborted VF) that were significantly predicted by RV LGE extent (HR 1.45 CI: 1.3–1.6; P<0.001). Univariable predictors of the primary outcome were RV LGE score; HR: 1.44 (1.31–1.57; p<0.001), (Figure) together with older age; HR: 1.05 (1.02–1.07; P<0.001), late repair; HR: 1.04 (1.02–1.07; p<0.001), lower RV ejection fraction; HR: 0.92 (0.89–0.95; p<0.001), larger RVOT akinetic length; HR: 1.04 (1.02–1.06; p<0.001) larger right atrial area; HR: 1.2 (1.12–1.29; p<0.001); higher BNP levels; HR: 1.01 (1–1.02; p<0.001), lower peak VO2; HR: 0.89 (0.83–0.96; p=0.001), prior atrial arrhythmia; HR: 5.3 (2.8–10.07; p<0.001), and non-sustained VT; HR: 4.1 (2.1–7.7; p<0.001). Inducible VT did not predict the primary outcome; HR: 2.1 (0.57–8; p=0.25) In multivariable analysis both RV LGE score and indexed right atrial area (RAAi) only, remained predictive of the primary outcome (HR 1.29 CI: 1.12–1.49; p<0.001 and HR 1.1 CI: 1.02–1.12; p=0.01, respectively). Patients could accordingly be stratified such that supramedian RV LGE score (≥5) and RAAi ≥16cm2/m2 had 5-year event free survival 84% vs 94% for supramedian RV LGE score (≥5) and RAAi <16cm2/m2 or 98% for inframedian RV LGE score with RAAI<16cm2/m2. Figure. Conclusions For every unit increase in CMR defined RV fibrosis score there is a 44% increased risk of sudden cardiac death and VT. LGE CMR and maximal right atrial area should therefore be incorporated into risk stratification for sudden death in adults with rTOF. Acknowledgement/Funding British heart foundation

scholarly journals Inhibition of c-Src Tyrosine Kinase Prevents Angiotensin II–Mediated Connexin-43 Remodeling and Sudden Cardiac Death

2011 ◽  
Vol 58 (22) ◽  
pp. 2332-2339 ◽  
Author(s):  
Ali A. Sovari ◽  
Shahriar Iravanian ◽  
Elena Dolmatova ◽  
Zhe Jiao ◽  
Hong Liu ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Sudden Cardiac Death ◽  
Tyrosine Kinase ◽  
Cardiac Death ◽  
Connexin 43 ◽  
Src Tyrosine Kinase

scholarly journals Prevention of sudden cardiac death by the implantable cardioverter defibrilator

2011 ◽  
Vol 64 (5-6) ◽  
pp. 291-294 ◽  
Author(s):  
Dragan Kovacevic ◽  
Anastazija Stojisic-Milosavljevic ◽  
Vasilije Topalov ◽  
Bogoljub Mihajlovic ◽  
Dejan Sakac ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Cardiac Death ◽  
Social Insurance ◽  
Heart Rhythm ◽  
Insurance Fund ◽  
Social Insurance Fund ◽  
The Usa ◽  
Rhythm Disorder ◽  
The One

Introduction. Sudden cardiac death or, as it is also called, a modern man?s killer occurs a few hours after the beginning of the disease. Sudden death is the one that happens within an hour from the onset of the subjective discomforts regardless of the existence of any previous disease. According to modern statistics, 450.000 people die suddenly in the USA and 150,000 in Germany. Causes of sudden death. The most frequent causes of sudden death are cardiologic or, in other words, a heart rhythm disorder such as ventricular tachycardia, ventricular fibrillation and bradycardiac rhythm disorder. All these reasons can be efficiently prevented by the implantation of the cardioverter defibrillators. Implantable cardioverter defibrillator. In comparison with the already known medications, the defibrillator seems to be the most efficient in prevention of sudden cardiac death. This fact has been confirmed by large multicentre studies. The implantation itself is a routine procedure. It lasts about an hour and it often passes without any complications. The patient leaves the hospital a few days after the procedure. About 150 of these procedures are performed per year at the Institute of Cardiovascular Diseases Vojvodina. The Social Insurance Fund bears medical costs and the patient only pays the participation fee, which is symbolical if compared to the value and use of the device. Owing to this fact, this device is available to every patient thus making the efficient sudden cardiac death prevention possible.

scholarly journals Sudden cardiac death in athletes

2009 ◽  
Vol 62 (1-2) ◽  
pp. 37-41
Author(s):  
Zdravko Mijailovic ◽  
Zoran Stajic ◽  
Dragan Tavciovski ◽  
Radomir Matunovic
Keyword(s):  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Cardiac Death ◽  
Ventricular Hypertrophy ◽  
Ventricular Tachyarrhythmia ◽  
Left Ventricular ◽  
Young Athletes ◽  
Physical Effort ◽  
Social Community ◽  
Esc Guidelines

The entity of sudden cardiac death in young athletes has been known since the year 490 B.C. when young Greek soldier Phidipides had run the distance from Marathon to Athens and suddenly fell down dead. In the last twenty years, sudden death of famous athletes have attracted huge attention of medical and social community; afterwards both American and European Cardiology Societies started to publish periodically guidelines for preparticipation screening. These guidelines have focused on both identifying athletes with potential cardiovascular risk for sudden death and eligibility conditions for athletes participating in competitive sports. Structural and functional abnormalities causing sudden cardiac death in young athletes have been identified by autopsy-based studies. Unrecognized congenital cardiovascular abnormalities associated with excessive physical effort create background for electrophysiological instability and occurrence of malignant ventricular tachyarrhythmia and consequent death. The most frequent causes of sudden cardiac death in young athletes include hypertrophic cardiomyopathy, anomalies of the coronary arteries and idiopathic left ventricular hypertrophy. Current ACC/AHA & ESC guidelines should be widely used in order to reduce potential sudden cardiac death in young athletes.

scholarly journals The Potential of Late Gadolinium Enhancement to Serve as a Predictor of Ventricular Arrhythmias in Hypertrophic Cardio-myopathy Patients

2016 ◽  
Vol 8 (1) ◽  
pp. 1-11
Author(s):  
Thomas D. Gossios ◽  
Georgios K. Efthimiadis ◽  
Theodoros D. Karamitsos ◽  
Thomas Zegkos ◽  
Vasilios G. Athyros ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Hypertrophic Cardiomyopathy ◽  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Cardiac Death ◽  
Large Scale ◽  
Small Subset ◽  
Gadolinium Enhancement ◽  
Inherited Cardiomyopathy ◽  
Increased Risk

Hypertrophic cardiomyopathy, the most common inherited cardiomyopathy is well known to be the leading cause of sudden cardiac death in young people. However, amongst the population of patients, a small subset bears increased risk of sudden cardiac death and would benefit from implantation of a defibrillator, currently recognized utilizing a series of established risk factors. This risk stratification model is hampered by low positive predictive value. Therefore, novel predictors of sudden death are sought. The advent of cardiac magnetic resonance and late gadolinium enhancement has allowed accurate quantification of regional fibrosis, a key element of hypertrophic cardiomyopathy, pathophysiologically linked to increased arrhythmogenicity. We sought to review currently available data on the utility of late gadolinium enhancement to serve as a novel predictor of arrhythmias and sudden death. In conclusion, significantly diverse methodological approaches and subsequent findings between available studies on the topic have hampered such use, highlighting the need for uniformly designed large scale, prospective studies in order to clarify which aspects of myocardial fibrosis could serve as predictors of arrhythmic events.

scholarly journals Artificial Intelligence Segmented Dynamic Video Images for Continuity Analysis in the Detection of Severe Cardiovascular Disease

2021 ◽  
Vol 14 ◽  
Author(s):  
Xi Zhu ◽  
Wei Xia ◽  
Zhuqing Bao ◽  
Yaohui Zhong ◽  
Yu Fang ◽  
...  
Keyword(s):  
Neural Network ◽  
Artificial Intelligence ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Cardiac Death ◽  
Deep Neural Network ◽  
Video Image ◽  
Bundle Branch Block

In this paper, an artificial intelligence segmented dynamic video image based on the process of intensive cardiovascular and cerebrovascular disease monitoring is deeply investigated, and a sparse automatic coding deep neural network with a four layers stack structure is designed to automatically extract the deep features of the segmented dynamic video image shot, and six categories of normal, atrial premature, ventricular premature, right bundle branch block, left bundle branch block, and pacing are achieved through hierarchical training and optimization. Accurate recognition of heartbeats with an average accuracy of 99.5%. It provides technical assistance for the intelligent prediction of high-risk cardiovascular diseases like ventricular fibrillation. An intelligent prediction algorithm for sudden cardiac death based on the echolocation network was proposed. By designing an echolocation network with a multilayer serial structure, an intelligent distinction between sudden cardiac death signal and non-sudden death signal was realized, and the signal was predicted 5 min before sudden death occurred, with an average prediction accuracy of 94.32%. Using the self-learning capability of stack sparse auto-coding network, a large amount of label-free data is designed to train the stack sparse auto-coding deep neural network to automatically extract deep representations of plaque features. A small amount of labeled data then introduced to micro-train the entire network. Through the automatic analysis of the fiber cap thickness in the plaques, the automatic identification of thin fiber cap-like vulnerable plaques was achieved, and the average overlap of vulnerable regions reached 87%. The overall time for the automatic plaque and vulnerable plaque recognition algorithm was 0.54 s. It provides theoretical support for accurate diagnosis and endogenous analysis of high-risk cardiovascular diseases.

scholarly journals Sudden Death Documented During 24-hour Holter Monitoring

2020 ◽  
Vol 32 (4) ◽  
pp. 252-256
Author(s):  
Kárila Scarduelli Luciano ◽  
Rafael Zoppi Campane ◽  
Rafaela Louise Sales ◽  
Alessandra Kraus ◽  
Erden Ramirez Pestana ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Ventricular Fibrillation ◽  
Sudden Death ◽  
Female Patient ◽  
Atrioventricular Block ◽  
Cardiac Death ◽  
Torsades De Pointes ◽  
Holter Monitoring

A 50-year-old female patient admitted for etiological syncope investigation. A 24-hour Holter was installed where the record showed the mechanism of sudden cardiac death. Sudden bradycardia caused by paroxysmal atrioventricular block led to torsades de pointes, ventricular fibrillation and death. This case shows the importance of Holter in the chronology of arrhythmic events that lead to sudden death and highlights a poorly reported event – the occurrence of cardiac death during 24-hour Holter monitoring.

scholarly journals Prevalence of Abnormal Heart Weight After Sudden Death in People Younger than 40 Years of Age

2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Zachary J. Schoppen ◽  
Lauren C. Balmert ◽  
Steven White ◽  
Rachael Olson ◽  
Ponni Arunkumar ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Young People ◽  
Sudden Death ◽  
Cardiac Death ◽  
Ethnically Diverse ◽  
Reference Population ◽  
Heart Weight ◽  
Medical Examiner ◽  
Multivariable Regression ◽  
No Gold Standard

Background After sudden cardiac death in people aged <40 years, heart weight is a surrogate for cardiomegaly and a marker for cardiomyopathy. However, thresholds for cardiomegaly based on heart weight have not been validated in a cohort of cases of sudden cardiac death in young people. Methods and Results We surveyed medical examiner offices to determine which tools were used to assess heart weight norms. The survey determined that there was no gold standard for cardiomegaly (52 centers reported 22 different methods). We used a collection of heart weight data from sudden deaths in the Northwestern Sudden Death Collaboration (NSDC) to test the 22 methods. We found that the methods reported in our survey had little consistency: they classified between 18% and 81% of NSDC hearts with cardiomegaly. Therefore, we obtained biometric and postmortem data from a reference population of 3398 decedents aged <40 years. The reference population was ethnically diverse and had no known cardiac pathology on autopsy or histology. We derived and validated a multivariable regression model to predict normal heart weights and a threshold for cardiomegaly (upper 95% CI limit) in the young reference population (the Chicago model). Using the new model, the prevalence of cardiomegaly in hearts from the NSDC was 19%. Conclusions Medical examiner offices use a variety of tools to classify cardiomegaly. These approaches produce inconsistent results, and many overinterpret cardiomegaly. We recommend the model proposed to classify postmortem cardiomegaly in cases of sudden cardiac death in young people.

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