scholarly journals Benefits of Endocardial and Multisite Pacing Are Dependent on the Type of Left Ventricular Electric Activation Pattern and Presence of Ischemic Heart Disease

2012 ◽  
Vol 5 (5) ◽  
pp. 889-897 ◽  
Author(s):  
Matthew R. Ginks ◽  
Anoop K. Shetty ◽  
Pier D. Lambiase ◽  
Simon G. Duckett ◽  
Julian Bostock ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Activation Pattern ◽  
Multisite Pacing ◽  
Electric Activation

Glutamine Is Cardioprotective in Patients with Ischemic Heart Disease following Cardiopulmonary Bypass

2011 ◽  
Vol 14 (6) ◽  
pp. 384 ◽  
Author(s):  
Vladimir V. Lomivorotov ◽  
Sergey M. Efremov ◽  
Vladimir A. Shmirev ◽  
Dmitry N. Ponomarev ◽  
Vladimir N. Lomivorotov ◽  
...  
Keyword(s):  
Heart Disease ◽  
Placebo Group ◽  
Cardiopulmonary Bypass ◽  
Ischemic Heart Disease ◽  
Troponin I ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Study Group ◽  
Cardioprotective Effects

<p><b>Background:</b> The aim of the present study was to investigate the cardioprotective effects of the perioperative use of N(2)-L-alanyl-L-glutamine (GLN) in patients with ischemic heart disease (IHD) who undergo their operations under cardiopulmonary bypass (CPB).</p><p><b>Methods:</b> This double-blind, placebo-controlled, randomized study included 50 patients who underwent cardiac surgery with CPB. Exclusion criteria were a left ventricular ejection fraction <50%, diabetes mellitus, <3 months since the onset of myocardial infarction, and emergency surgery. Patients in the study group (n = 25) received 0.4 g/kg GLN (Dipeptiven, 20% solution) per day. Patients in the control group (n = 25) were administered a placebo (0.9% NaCl). The primary end point was the dynamics of troponin I at the following stages: (1) prior to anesthesia, (2) 30 minutes after CPB, (3) 6 hours after CPB, (4) 24 hours after surgery, and (5) 48 hours after surgery. Secondary end points included measurements of hemodynamics with a Swan-Ganz catheter.</p><p><b>Results:</b> On the first postoperative day after the surgery, the median troponin I level was significantly lower in the study group than in the placebo group: 1.280 ng/mL (interquartile range [IQR], 0.840-2.230 ng/mL) versus 2.410 ng/mL (IQR, 1.060-6.600 ng/mL) (<i>P</i> = .035). At 4 hours after cardiopulmonary bypass (CPB), the median cardiac index was higher in the patients in the study group: 2.58 L/min per m<sup>2</sup> (IQR, 2.34-2.91 L/min per m<sup>2</sup>) versus 2.03 L/min per m<sup>2</sup> (IQR, 1.76-2.32 L/min per m<sup>2</sup>) (<i>P</i> = .002). The median stroke index also was higher in the patients who received GLN: 32.8 mL/m<sup>2</sup> (IQR, 27.8-36.0 mL/m<sup>2</sup>) versus 26.1 mL/m<sup>2</sup> (IQR, 22.6-31.8 mL/m<sup>2</sup>) (<i>P</i> = .023). The median systemic vascular resistance index was significantly lower in the study group than in the placebo group: 1942 dyn�s/cm<sup>5</sup> per m<sup>2</sup> (IQR, 1828-2209 dyn�s/cm<sup>5</sup> per m<sup>2</sup>) versus 2456 dyn�s/cm<sup>5</sup> per m<sup>2</sup> (IQR, 2400-3265 dyn�s/cm<sup>5</sup> per m<sup>2</sup>) (<i>P</i> = .001).</p><p><b>Conclusion:</b> Perioperative administration of GLN during the first 24 hours has cardioprotective effects in IHD patients following CPB. This technique enhances the troponin concentration at 24 hours after surgery and is associated with improved myocardial function.</p>

PULMONARY VASCULAR RESISTANCE BY ECHOCARDIOGRAPHY-DOPPLER IN ISCHEMIC HEART DISEASE WITH LEFT VENTRCULAR SYSTOLIC DYSFUNCTION

2017 ◽  
pp. 89-94
Author(s):  
Ke Toan Tran ◽  
Thi Thuy Hang Nguyen
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Tricuspid Valve ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
S Wave ◽  
Echocardiography Doppler

Objective: To determine pulmonary vascular resistance (PVR) by echocardiography - Doppler and to find correlation between pulmonary vascular resistance with left ventricular EF, PAPs, TAPSE, tissue S-wave of the tricuspid valve in patients with ischemic heart disease. Subjects and Methods: We studied on 82 patients with ischemic heart disease and EF<40% including 36 females, 46 males. Patients were estimated for pulmonary vascular resistance, EF, PAPs, TAPSE, tissue S-wave of the tricuspid valve by echocardiographyDoppler. Results: 64.6% of patients are increased PVR, average of PVR is 3.91 ± 1.85 Wood units and it is increasing with NYHA severity. There are negative correlations between pulmonary vascular resistance with left ventricular ejection fraction (r = - 0.545; p <0.001), TAPSE index (r= -0.590; p <0.001) and tissue S-wave of the tricuspid valve (r = -0.420; p <0.001); positive correlation with systolic pulmonary artery pressure (r = 0.361, p = 0.001), Conclusions: Increased PVR is the primary mechanism for pulmonary hypertension and right heart failure in patients with left heart disease. Determination of PVR in patients with left ventricular dysfunction by echocardiography is important in clinical practice. Key words: Echocardiography-Doppler; Pulmonary vascular resistance; ischemic heart disease

scholarly journals Major Left Bundle Branch Block and Coronary Heart Disease—Are There Any Differences between the Sexes?

2021 ◽  
Vol 10 (11) ◽  
pp. 2284
Author(s):  
Diana Gurzău ◽  
Alexandra Dădârlat-Pop ◽  
Bogdan Caloian ◽  
Gabriel Cismaru ◽  
Horaţiu Comşa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Left Bundle Branch Block ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Bundle Branch Block ◽  
Microvascular Angina ◽  
Ventricular Ejection Fraction

Left bundle branch block is not a benign pathology, and its presence requires the identification of a pathological substrate, such as ischemic heart disease. Left bundle branch block appears to be more commonly associated with normal coronary arteries, especially in women. The objectives of our study were to describe the particularities of left bundle branch block in women compared to men with ischemic heart disease. Result: We included seventy patients with left bundle branch block and ischemic heart disease, with a mean age of 67.01 ± 8.89 years. There were no differences in the profile of risk factors, except for smoking and uric acid. The ventricular depolarization (QRS) duration was longer in men than women (136.86 ± 8.32 vs. 132.57 ± 9.19 msec; p = 0.018) and also men were observed to have larger left ventricular diameters. Left bundle branch block duration was directly associated with ventricular diameters and indirectly associated with left ventricular ejection fraction value, especially in women (R = −0.52, p = 0.0012 vs. R = −0.50, p = 0.002). In angiography, 80% of women had normal epicardial arteries compared with 65.7% of men; all these patients presented with microvascular dysfunction. Conclusion: The differences between the sexes were not so obvious in terms of the presence of risk factors; instead, there were differences in electrocardiographic, echocardiographic, and angiographic aspects. Left bundle branch block appears to be a marker of microvascular angina and systolic dysfunction, especially in women.

scholarly journals MEGASTRUCTURES IN ISCHEMIC HEART DISEASE. MASSIVE LEFT VENTRICULAR PSEUDOANEURYSM WITH SEVERE MITRAL REGURGITATION

2021 ◽  
Vol 77 (18) ◽  
pp. 2581
Author(s):  
Andrea Teira Calderon ◽  
Adrián Margarida ◽  
Ignacio Santiago ◽  
Indira Cabrera ◽  
Sofia Gonzalez Lizarbe ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Ischemic Heart Disease ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Severe Mitral Regurgitation ◽  
Left Ventricular Pseudoaneurysm

Effects of long-term xamoterol therapy on the left ventricular mechanical efficiency in patients with ischemic heart disease

1989 ◽  
Vol 84 (1) ◽  
pp. 157-162 ◽  
Author(s):  
H. Pouleur ◽  
C. Eyll ◽  
J. Etienne ◽  
H. Mechelen ◽  
A. Vuylsteke ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Mechanical Efficiency ◽  
Left Ventricular ◽  
Ischemic Heart

Abstract 16708: Cathelicidin Related Antimicrobial Peptide Treated Bone Marrow Derived Mononuclear Cells Improves Cardiac Function in a Mouse Model of Acute Myocardial Infarction: Potential Therapeutic Targets in Ischemic Heart Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yuri M Klyachkin ◽  
Prabhakara R Nagareddy ◽  
Ahmed Asfour ◽  
Shaojing Ye ◽  
Erhe Gao ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cardiac Function ◽  
Ischemic Heart Disease ◽  
Infarct Size ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
In Vivo Studies ◽  
Boyden Chamber ◽  
Acute Ischemic Heart Disease

Introduction: Limited stem cell retention following intracoronary administration for ischemic heart disease has reduced the clinical efficacy of this novel therapy. Cathelicidins have been shown to prime BMMNC migration towards low gradients of SDF-1 suggesting a potential role in BMMNC retention. We sought to assess the safety and efficacy of BMMNC pre-treatment with CRAMP for treatment of acute ischemic heart disease. METHODS: BMMNCs isolated from GFP mice were incubated with recombinant CRAMP (2.5 μg/ml) or placebo for 1 hour followed by chemotaxis studies towards low levels of SDF-1 (2 ng/ml) using a Boyden chamber in vitro. During the in vivo studies, mice were randomized into 3 groups: AMI followed by injection of phosphate buffered saline (PBS), BMMNCs alone, or BMMNCs incubated with CRAMP. Scar size, survival and retention of injected BMNNCs were examined by immunohistochemistry at 5 weeks. Left ventricular function was measured by echocardiography at baseline, 48 hours, and 5 weeks after MI. Changes in infarct size between 5 days and 5 weeks after AMI was assessed by cardiac MRI utilizing delayed gadolinium enhancement. RESULTS: Treatment of BMNNCs with CRAMP enhanced their migration towards low, yet physiological, levels of SDF-1 (Fig 1A). In vivo, a greater proportion of cell survival and retention was observed in the BMNNC+CRAMP group than in the BMNNC-alone group (Fig 1B) and this was associated with higher percentage of BrdU positive cells (Fig 1C). Moreover, BMNNC+CRAMP administration led to significantly better survival, improvement of cardiac function (Fig 1D-H) and reduction in infarct size compared with other control groups (Fig 1I). CONCLUSIONS: Cathelicidins enhance BMMNC retention after intramyocardial administration for acute ischemic heart disease resulting in enhanced recovery. Therapies employing this strategy may represent an effective method for improving cardiac recovery and survival rate after AMI in human studies.

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