Chronic ischaemic cardiomyopathy

ESC CardioMed ◽  
2018 ◽  
pp. 1419-1423
Author(s):  
Ward A. Heggermont ◽  
Marc Vanderheyden ◽  
Jozef Bartunek
Keyword(s):  
Clinical Investigation ◽  
Critical Mass ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Ischaemic Myocardium ◽  
Ventricular Geometry ◽  
Ischaemic Cardiomyopathy ◽  
Contrast Enhanced ◽  
Percutaneous Coronary

Ischaemic cardiomyopathy is the most common cause of chronic heart failure. It is associated with several diagnostic and therapeutic challenges. They include mainly the detection of viable and ischaemic tissue amenable to improvement after revascularization. Revascularization is useful in patients with a critical mass of viable ischaemic myocardium. Provided that full revascularization is possible, percutaneous coronary intervention might be a valid alternative to surgical revascularization. Contrast-enhanced cardiac magnetic resonance is an important emerging tool to adequately detect viable myocardium. Right ventricular function and functional mitral regurgitations are important prognostic factors in ischaemic cardiomyopathy. Next to reshaping surgery, dedicated devices to restore left ventricular geometry, and stem cell therapy, are under clinical investigation.

Chronic ischaemic cardiomyopathy

ESC CardioMed ◽  
2018 ◽  
pp. 1419-1423
Author(s):  
Ward A. Heggermont ◽  
Marc Vanderheyden ◽  
Jozef Bartunek
Keyword(s):  
Clinical Investigation ◽  
Critical Mass ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Ischaemic Myocardium ◽  
Ventricular Geometry ◽  
Ischaemic Cardiomyopathy ◽  
Contrast Enhanced ◽  
Percutaneous Coronary

Ischaemic cardiomyopathy is the most common cause of chronic heart failure. It is associated with several diagnostic and therapeutic challenges. They include mainly the detection of viable and ischaemic tissue amenable to improvement after revascularization. Revascularization is useful in patients with a critical mass of viable ischaemic myocardium. Provided that full revascularization is possible, percutaneous coronary intervention might be a valid alternative to surgical revascularization. Contrast-enhanced cardiac magnetic resonance is an important emerging tool to adequately detect viable myocardium. Right ventricular function and functional mitral regurgitations are important prognostic factors in ischaemic cardiomyopathy. Next to reshaping surgery, dedicated devices to restore left ventricular geometry, and stem cell therapy, are under clinical investigation.

Relationships between left ventricular geometry and remodeling in dilated cardiomyopathy

2019 ◽  
Vol 67 (4) ◽  
Author(s):  
Ewa Dziewięcka ◽  
Sylwia Wiśniowska-Śmiałek ◽  
Lusine Khachatryan ◽  
Aleksandra Karabinowska ◽  
Maria Szymonowicz ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Ventricular Geometry

Left ventricular support during complex transradial percutaneous coronary intervention for complete revascularization

2019 ◽  
Vol 67 (4) ◽  
Author(s):  
Annamaria Dachille ◽  
Amelia Focaccio ◽  
Lucio Selvetella ◽  
Giovanni Napolitano ◽  
Carlo Briguori
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Complete Revascularization ◽  
Percutaneous Coronary ◽  
Ventricular Support

Pentraxin Level is the Key to Determine Primary Percutaneous Coronary Intervention (PCI) or Fibrinolysis

2019 ◽  
Vol 19 (2) ◽  
pp. 160-168 ◽  
Author(s):  
Habib Haybar ◽  
Saeed Alipour Parsa ◽  
Isa Khaheshi ◽  
Zeinab Deris Zayeri
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Relative Advantage ◽  
Left Ventricular Ejection ◽  
Percutaneous Coronary ◽  
Ptx3 Level ◽  
Tertiary Center ◽  
Functional Advantage

<P>Aims: To examine if pentraxin can help identify patients benefitting most from primary Percutaneous Coronary Intervention (PCI) vs. fibrinolysis. </P><P> Methods: Patients with acute ST-Elevation Myocardial Infarction (STEMI) were consecutively recruited from a community center without PCI and a tertiary center with PCI facilities. Left ventricular ejection fraction (LVEF) was determined echocardiographically at baseline and 5 days after the index admission; the difference between two measurements was considered as the magnitude of improvement. We used regression models to test the hypothesis that the magnitude of the advantage of PCI over fibrinolysis in preserving LVEF 5 days after STEMI is modified by pentraxin 3 (PTX3). </P><P> Results: The functional advantage (LVEF) of the PCI over fibrinolysis has been determined by PTX3. LVEF was attenuated and even reversed as PTX3 level increased. The primary PCI of the participants with less than 7 ng.ml-1 PTX3 level, achieved a clinically significant increase in the LVEF as compared to fibrinolysis. At lower levels of PTX3, PCI shows a conspicuous advantage over fibrinolysis in terms of the probability of developing an LVEF <40%. </P><P> Conclusion: We demonstrated not only the functional advantage of PCI over fibrinolysis performed within the recommended time frames but also the relative advantage of its relevance to the baseline PTX3 levels. PTX3 can play a role in determining the choice of best therapy. More than 75% of patients with STEMI who have PTX3 levels ≤7 ng.ml-1 imply the need of PCI.</P>

scholarly journals Effect of Exercise-Based Cardiac Rehabilitation on Left Ventricular Function in Asian Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 774
Author(s):  
Yanjiao Wang ◽  
Ching-Wen Chien ◽  
Ying Xu ◽  
Tao-Hsin Tung
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Mean Difference ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Percutaneous Coronary

(1) Background: The effects of exercise-based cardiac rehabilitation (CR) on left ventricular function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) are important but poorly understood. (2) Purpose: To evaluate the effects of an exercise-based CR program (exercise training alone or combined with psychosocial or educational interventions) compared with usual care on left ventricular function in patients with AMI receiving PCI. (3) Data sources, study selection and data extraction: We searched PubMed, WEB OF SCIENCE, EMBASE, EBSCO, PsycINFO, LILACS and Cochrane Central Register of Controlled Trials databases (CENTRAL) up to 12th June 2021. Article selected were randomized controlled trials and published as a full-text article. Meta-analysis was conducted with the use of the software Review manager 5.4. (4) Data synthesis: Eight trials were included in the meta-analysis, of which three trials were rated as high risk of bias. A significant improvement was seen in the exercise-based CR group compared with the control group regarding left ventricular ejection fraction (LVEF) (std. mean difference = 1.33; 95% CI:0.43 to 2.23; p = 0.004), left ventricular end-diastolic dimension (LVEDD) (std. mean difference = −3.05; 95% CI: −6.00 to −0.09; p = 0.04) and left ventricular end-systolic volume (LVESV) (std. mean difference = −0.40; 95% CI: −0.80 to −0.01; p = 0.04). Although exercise-based CR had no statistical effect in decreasing left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic volume (LVEDV), it showed a favorable trend in relation to both. (5) Conclusions: Exercise-based CR has beneficial effects on LV function and remodeling in AMI patients treated by PCI.

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