Unexplained Double-Chambered Left Ventricle Associated with Contracting Right Ventricular Aneurysm and Right Atrial Enlargement

2013 ◽  
Vol 31 (3) ◽  
pp. E80-E84 ◽  
Author(s):  
Gherardo Finocchiaro ◽  
Daniel Murphy ◽  
Aleksandra Pavlovic ◽  
Francois Haddad ◽  
Hadas Shiran ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Right Ventricular ◽  
Right Atrial ◽  
Ventricular Aneurysm ◽  
Atrial Enlargement

Chest Radiographs Fail to Detect Right Ventricular Enlargement and Right Atrial Enlargement in Patients With a Pure Restrictive Ventilatory Impairment

CHEST Journal ◽  
1994 ◽  
Vol 106 (2) ◽  
pp. 381-384 ◽  
Author(s):  
Kalyanam Shivkumar ◽  
Kumar Ravi ◽  
Jerald W. Henry ◽  
Michael S. Eichenhorn ◽  
Paul D. Stein
Keyword(s):  
Right Ventricular ◽  
Chest Radiographs ◽  
Right Atrial ◽  
Ventricular Enlargement ◽  
Atrial Enlargement

Association of right ventricular dysfuction and left ventricle dilatation in heart failure patients

2008 ◽  
Vol 7 ◽  
pp. 130-130
Author(s):  
J OREATEJEDA ◽  
L CASTILLOMARTINEZ ◽  
R SILVATINOCO ◽  
E COLINRAMIREZ ◽  
E CANSECO ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Right Ventricular ◽  
Heart Failure Patients

scholarly journals Atrial dilation as a substrate for atrial fibrillation in the canine complete chronic atrioventricular block model

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Smoczynska ◽  
H.D.M Beekman ◽  
R.W Chui ◽  
S Rajamani ◽  
M.A Vos
Keyword(s):  
Atrial Fibrillation ◽  
Atrioventricular Block ◽  
Volume Overload ◽  
Right Atrial ◽  
Funding Source ◽  
Private Company ◽  
Structural Remodeling ◽  
2D Echocardiography ◽  
Atrial Enlargement ◽  
The Right

Abstract Background Atrial fibrillation (AF) is the most common cardiac arrhythmia treated in clinical practice. Structural remodeling is characterized by atrial enlargement and contributes to the therapeutic resistance in patients with long-standing AF. Purpose To study the atrial arrhythmogenic and echocardiographic consequences induced by volume overload in the complete chronic atrioventricular block (CAVB) dog. Methods Echocardiographic and electrophysiological data was obtained in 14 anaesthetized Mongrel dogs, in acute AV-block (AAVB), after 6 weeks of CAVB (CAVB6) and CAVB10. Left atrial (LA) volume was determined with 2D echocardiography by using the biplane method. An electrocardiogram and monophasic action potentials (MAP) at the right atrial (RA) free wall were recorded. Atrial effective refractory period (AERP) was determined by continuous programmed electrical stimulation (PES) of 20 beats with a cycle length of 400 ms and an extrastimulus with decremental design until refractoriness was reached. A continuous PES protocol of 20 beats with an extrastimulus 5 ms longer than the AERP was applied for 150 seconds to trigger AF. After 5 min without arrhythmias, autonomic neuromodulation was performed by intravenous infusion (IV) of acetylcholine (1,5μg/kg/min to 6,0μg/kg/min) for 20 min followed by prompt IV infusion of isoprenaline (3μg/min) until the atrial heart rate increased by 20 bpm. PES with an extrastimulus was repeated for 150 seconds to induce AF. Results LA volume increased from 13.7±3.2 ml at AAVB to 20.5±5.9 ml* at CAVB6, and 22.7±6.0 ml* at CAVB10 (Fig. 1A). AERP was similar at AAVB, CAVB6, and CAVB10 (115.8±11.9, 117.3±11.7, and 106.8±12.1 ms respectively). Repetitive AF paroxysms of >10 seconds were induced in 1/14 (7%) dogs at AAVB, 1/11 (9%) at CAVB6, and 5/10 (50%)* at CAVB10 (*p<0.05) upon PES (Fig. 1B). Combined neuromodulation and PES did not increase the AF inducibility rate, but prolonged the longest episode of AF in the inducible dogs from 55±49 seconds to 236±202 seconds* at CAVB10 (Fig. 1C). LA volume was higher in inducible dogs 25.0±4.9 ml compared to 18.4±4.2 ml in non-inducible dogs at CAVB10. Conclusion Sustained atrial dilation forms a substrate for repetitive paroxysms of AF. Neuro-modulation prolongs AF episode duration in susceptible dogs. This animal model can be used to study structural remodeling of the atria and possible therapeutic advances in the management of AF. Figure 1 Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Amgen Research

scholarly journals External assessment of the EUROMACS right-sided heart failure risk score

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hirak Shah ◽  
Thomas Murray ◽  
Jessica Schultz ◽  
Ranjit John ◽  
Cindy M. Martin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Risk Score ◽  
Pressure Ratio ◽  
Area Under The Curve ◽  
Left Ventricular ◽  
Right Atrial ◽  
Risk Scores ◽  
External Assessment ◽  
Failure Risk

AbstractThe EUROMACS Right-Sided Heart Failure Risk Score was developed to predict right ventricular failure (RVF) after left ventricular assist device (LVAD) placement. The predictive ability of the EUROMACS score has not been tested in other cohorts. We performed a single center analysis of a continuous-flow (CF) LVAD cohort (n = 254) where we calculated EUROMACS risk scores and assessed for right ventricular heart failure after LVAD implantation. Thirty-nine percent of patients (100/254) had post-operative RVF, of which 9% (23/254) required prolonged inotropic support and 5% (12/254) required RVAD placement. For patients who developed RVF after LVAD implantation, there was a 45% increase in the hazards of death on LVAD support (HR 1.45, 95% CI 0.98–2.2, p = 0.066). Two variables in the EUROMACS score (Hemoglobin and Right Atrial Pressure to Pulmonary Capillary Wedge Pressure ratio) were not predictive of RVF in our cohort. Overall, the EUROMACS score had poor external discrimination in our cohort with area under the curve of 58% (95% CI 52–66%). Further work is necessary to enhance our ability to predict RVF after LVAD implantation.

scholarly journals Emergency sandwich patch repair via right ventricular incision for postinfarction ventricular septal defects: a case series

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Yusuke Shimahara ◽  
Satsuki Fukushima ◽  
Shin Yajima ◽  
Naoki Tadokoro ◽  
Takashi Kakuta ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Right Ventricular ◽  
Artery Bypass ◽  
Case Series ◽  
The Other ◽  
Patch Repair ◽  
Right Atrial ◽  
Residual Shunt ◽  
Low Cardiac Output Syndrome ◽  
St Segment Elevation

Abstract Background The surgical treatment for postinfarction ventricular septal defect (VSD) remains challenging, especially in emergency cases. Several authors have reported the efficacy of a sandwich patch VSD repair via a right ventricular (RV) incision. However, this procedure remains uncommon, and its efficacy is still unknown, especially when performed under an emergency. Case summary We were able to perform sandwich patch VSD repair via an RV incision on seven consecutive patients with VSD following an ST-segment elevation myocardial infarction (STEMI) from March 2017 to December 2019. Bovine pericardial patches were used for sandwich patches. Two patients developed inferior STEMI, and the other patients developed anterior STEMI. Six patients received intra-aortic balloon pump prior to surgery, and the other received extracorporeal membrane oxygenation with Impella. The interval between the diagnosis of VSD and surgery was within 1 day in all patients except one (5 days). All seven patients underwent VSD repair in the emergency status. Four patients underwent concomitant coronary artery bypass grafting. The hospital mortality rate was 14.3% (1/7). Early postoperative transthoracic echocardiography revealed that only one patient developed more than trace residual shunt. The postoperative right atrial pressure was not significantly elevated at ≤12 mmHg in all patients. No patient developed early postoperative prolonged low cardiac output syndrome. Discussion In patients with postinfarction VSD, a sandwich patch VSD repair via an RV incision is a promising procedure with a low incidence of residual shunt development and hospital mortality, even in emergency cases.

Abstract 3265: A Comparison of Echocardiographic and Electrocardiographic Characteristics of Patients with Apical Hypertrophic Cardiomyopathy

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Josepha Binder ◽  
Brandon R Grossardt ◽  
Christine Attenhofer Jost ◽  
Kyle W Klarich ◽  
Michael J Ackerman ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Right Atrial ◽  
Apical Hypertrophic Cardiomyopathy ◽  
T Wave ◽  
Atrial Enlargement ◽  
Lv Ejection Fraction ◽  
The Relationship ◽  
T Waves

Background: Apical hypertrophic cardiomyopathy (apical HCM) is a less common subtype of HCM characterized by a focal thickening in the left ventricular apex. “Classic” ECG features have been described, however, apical HCM can persist for many years without detection. We investigated the relationship between ECG findings and echocardiographic morphometry in a large referral series of patients with apical HCM. Methods: We enumerated all patients diagnosed with apical HCM prior to Sept. 30, 2006 using the Mayo Clinic HCM database. We compared echocardiographic measures separately for patients with positive status for two ECG indices of left ventricular hypertrophy (LVH); the Sokolow-Lyon index and the Romhilt-Estes (RE) point-score. We also compared echocardiographic measurements in patients with and without negative T-waves in the precordial leads. Results: Apical HCM was detected in 177 patients (111 men and 68 women). Only 51% had positive Sokolow criteria and 51% had positive RE criteria. The agreement between Sokolow and RE status was high (agreement = 75.0%; kappa = 0.50; 95% CI = 0.38 – 0.62). In particular, Sokolow positive patients had increased LV ejection fraction (P = 0.02), and decreased LV end-systolic diameter (P = 0.03) compared with Sokolow negative patients. The prevalence of right atrial enlargement (47 vs. 28%; P = 0.02) and intracavity obstruction (22 vs. 8%; P = 0.01) were more common in Sokolow positive patients. Positive RE criteria was associated with a greater thickness of the basal septal and basal posterior walls (P = 0.001 and 0.02, respectively), and with a higher frequency of intracavity obstruction (21 vs. 9%; P = 0.04). Most patients (89%) exhibited at least one negative T-wave in the precordial leads; however, only 10% of patients had a negative T-wave of greater than 1.0 mV. We found that patients with an inverted T-wave larger than 0.4 mV (median) had a significantly increased LV ejection fraction (P = 0.03) compared with patients who had smaller or no negative T-waves. Conclusions: Among patients with apical HCM, nearly half do not have ECG evidence of LVH based on classic criteria and most do not have marked T-wave inversions. However, the majority did have at least a mild expression of negative T-waves.

Effects of single- and biventricular pacing on temporal and spatial dynamics of ventricular contraction

2002 ◽  
Vol 282 (1) ◽  
pp. H372-H379 ◽  
Author(s):  
Bradley T. Wyman ◽  
William C. Hunter ◽  
Frits W. Prinzen ◽  
Owen P. Faris ◽  
Elliot R. McVeigh
Keyword(s):  
Left Ventricle ◽  
Biventricular Pacing ◽  
Spatial Dynamics ◽  
Left Ventricular ◽  
Spatiotemporal Distribution ◽  
Right Atrial ◽  
Temporal Synchrony ◽  
Temporal And Spatial ◽  
Tagged Magnetic Resonance Imaging ◽  
Activation Delay

Resynchronization is frequently used for the treatment of heart failure, but the mechanism for improvement is not entirely clear. In the present study, the temporal synchrony and spatiotemporal distribution of left ventricular (LV) contraction was investigated in eight dogs during right atrial (RA), right ventricular apex (RVa), and biventricular (BiV) pacing using tagged magnetic resonance imaging. Mechanical activation (MA; the onset of circumferential shortening) was calculated from the images throughout the left ventricle for each pacing protocol. MA width (time for 20–90% of the left ventricle to contract) was significantly shorter during RA (43.6 ± 17.1 ms) than BiV and RVa pacing (67.4 ± 15.2 and 77.6 ± 16.4 ms, respectively). The activation delay vector (net delay in MA from one side of the left ventricle to the other) was significantly shorter during RA (18.9 ± 8.1 ms) and BiV (34.2 ± 18.3 ms) than during RVa (73.8 ± 16.3 ms) pacing. Rate of LV pressure increase was significantly lower during RVa than RA pacing (1,070 ± 370 vs. 1,560 ± 300 mmHg/s) with intermediate values for BiV pacing (1,310 ± 220 mmHg/s). BiV pacing has a greater impact on correcting the spatial distribution of LV contraction than on improving the temporal synchronization of contraction. Spatiotemporal distribution of contraction may be an important determinant of ventricular function.

Assessment of Right Ventricular and Right Atrial Systolic and Diastolic Performance Using Automated Border Detection

1999 ◽  
Vol 16 (7) ◽  
pp. 643-652 ◽  
Author(s):  
KIRK T. SPENCER ◽  
MARIA J. GARCIA ◽  
LYNN WEINART ◽  
PHILIPPE VIGNON ◽  
ROBERTO LANG
Keyword(s):  
Right Ventricular ◽  
Right Atrial ◽  
Border Detection

scholarly journals Right ventricular aneurysm due to congenital muscular defect in an adult.

1988 ◽  
Vol 52 (1) ◽  
pp. 84-88 ◽  
Author(s):  
YUTAKA TAKINO ◽  
KIMIO ITOH ◽  
NOBORU KUZIRAI ◽  
MASAHARU HASHIDA ◽  
H IROSHI KANDA ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Aneurysm
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