scholarly journals Back to Normal – Normalised Left Ventricular Systolic Function in Dilated Cardiomyopathy after Cardiac Contractility Modulation Therapy

2018 ◽  
Vol 04 (01) ◽  
pp. 25
Author(s):  
Laurens Bon ◽  
Bernhard M Kaess ◽  
Andre Hochgesand ◽  
Albrecht Römer ◽  
Gerd Bürkle ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Systolic Function ◽  
Combined Therapy ◽  
Cardiac Contractility ◽  
Left Ventricular Systolic Function ◽  
Cardiac Resynchronisation Therapy ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Cardiac Contractility Modulation

We present a clinical case of a patient with dilated cardiomyopathy who neither sufficiently responded to optimal medical therapy nor to cardiac resynchronisation therapy. A cardiac contractility modulation system was implanted and after ~2 years of combined therapy with medication and devices systolic left ventricular ejection fraction returned to near normal values.

scholarly journals Prevalence of non-acute ischaemic cardiomyopathy in a Pakistani cohort

Heart Asia ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. e011043
Author(s):  
Muhammad Salman Ghazni ◽  
Saba Aijaz ◽  
Rehan Malik ◽  
Asad Z Pathan
Keyword(s):  
Stress Testing ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Rank Test ◽  
Ventricular Ejection Fraction ◽  
Primary Indication ◽  
History Of ◽  
Artery Disease

Heart failure with reduced left ventricular ejection fraction (HFrEF) is a frequently encountered clinical scenario. Coronary angiography (CAG) is usually performed to assess obstructive epicardial coronary artery disease (CAD) and the resultant ischaemia as causes of HFrEF.ObjectivesTo determine the frequency of obstructive CAD (OCAD) in patients with HFrEF and its independent predictors and outcomes.MethodsRetrospective observational study in Tabba Heart Institute on patients who underwent CAG during the past 4 years. Patients with prior known CAD or revascularisation were excluded. OCAD was defined as per the criteria from Felker et al. Regression modelling was performed to evaluate the predictors of OCAD. Survival was compared between the groups using the log rank test.ResultsOut of 2235 patients who underwent CAG, 260 had HFrEF as a primary indication for CAG and, of these, 119 (45.8%) had OCAD. Major predictors of OCAD were age >50 years at presentation (OR 2.0, 95% CI 1.1 to 3.7), presence of chest pain (OR 4.3, 95% CI 2.3 to 8.1), family history of premature CAD (OR 2.8, 95% CI 1.3 to 5.9) and utilisation of non-invasive (NIV) stress testing before CAG (OR 3.6, 95% CI 1.8 to 7.1). Survival was significantly lower (log rank p<0.001) in patients with OCAD with no revascularisation compared with OCAD with revascularisation or those who had non-obstructive CAD, and the latter two groups had comparable survival.ConclusionsOCAD is detected in nearly half of the patients with reduced left ventricular systolic function undergoing CAG. Clinical judgement based on thorough history and use of NIV stress testing can help in appropriate patient selection for this test.

P370Added value changes in signal sonr in patients with = <30% left ventricular ejection fraction

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J J Garcia Guerrero ◽  
J Fernandez De La Concha Castaneda ◽  
A Chacon Pinero ◽  
J Garcia Fernandez ◽  
I Fernandez Lozano ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Hospital Admission ◽  
Dilated Cardiomyopathy ◽  
Interim Analysis ◽  
Cardiac Contractility ◽  
Inverse Correlation ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Lv Ejection Fraction

Abstract Abstract/Introduction Decompensated congestive heart failure (CHF) is a main and increasing health problem worldwide, which leads to patients’ bad outcomes and high money expenditure. Direct relationship between Brain Natriuretic Peptides (NT-proBNP) increasing levels and adverse clinical outcomes have been demonstrated in patients with CHF.  SonR signal sensor, a micro-accelerometer embedded in the tip of the atrial lead in patients implanted with devices, picks up cardiac muscle vibration. Its amplitude is a surrogate for cardiac contractility, which is found to be further reduced in patients with decompensated CHF. Purpose We sought to find a significant inverse correlation between SonR signal and NT-proBNP levels, in order to use SonR as a surrogate of NT-proBNP to anticipate worsening CHF leading to hospital admission. Methods AVCs SONR trial is a pilot, prospective, observational, multicentre study, in which patients with dilated cardiomyopathy, any aetiology, LV ejection fraction ≤ 30%, at least one recent (&lt; 1 year) hospital admission due to CHF, and implanted with CRT-D devices (used as dual-chamber, no left ventricular (LV) lead implanted) with SonR sensor feature, were enrolled. During a year, NT-proBNP and SonR values were obtained every month, and both levels compared (Pearson’s test) Results This an interim analysis of our data, 18 months after the first patient was enrolled. Twenty two patients and 116 data pairs were analysed. Most patients were men (91%) and had ischemic dilated cardiomyopathy (59%). Mean age was 61 (range 34-82) and mean LV ejection fraction was 27% (range 15-30). The mean Pearson’s correlation coefficient of the NT-proBNP values and the SonR signal was r = - 0.36 (95% CI -0.51 to -0.19), p &lt; 0.00006 (Figure) Conclusions The interim analysis of this study shows an inverse and very significant relationship between SonR signal and NT-proBNP values. This suggests SonR signal might be used as predictor of worsening CHF. Abstract Figure

scholarly journals The Failing Heart in Pediatric Dilated Cardiomyopathy Caused by Excessive Water Drinking: A Case Report and Brief Review

2021 ◽  
Vol 03 ◽  
Author(s):  
Aditya Doni Pradana ◽  
Jarot Widodo
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Acute Heart Failure ◽  
Systolic Function ◽  
Pediatric Population ◽  
Left Ventricular ◽  
Initial Assessment ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Cardiothoracic Ratio

: Acute heart failure in dilated cardiomyopathy (DCM) is a rare cardiac disease in the pediatric population. A 15- year-old boy admitted to the emergency department of Kendal Islamic Hospital, Kendal, Indonesia on June 26th, 2020 with shortness of breath, tachycardia, and oxygen desaturation. The chest X-ray showed significant cardiomegaly with a cardiothoracic ratio was 70% and signs of pulmonary congestion. Transthoracic echocardiography revealed dilation of the left atrium and left ventricle (LV), decreased global LV systolic function with reduced left ventricular ejection fraction of 22%. Subsequently, he was diagnosed with acute heart failure in dilated cardiomyopathy and discharged on day sixth of hospitalization. Focus initial assessment and time-to-therapy in acute heart failure settings needs to be understood by all clinicians especially emergency care physicians.

scholarly journals Flow Manipulation and the Association with Myocardial Systolic Function During Extracorporeal Life Support

2021 ◽  
Author(s):  
Pauline Yeung NG ◽  
Tammy Sin Kwan MA ◽  
April IP ◽  
Shu FANG ◽  
Andy Chak Cheung LI ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Rate ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Blood Flow Rate ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Systolic Function ◽  
Ventricular Ejection Fraction

Abstract Background:Peripheral veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is used to support circulatory failure refractory to conventional therapy. However, data on the heart-ECMO interaction at different levels of ECMO blood flow during the immediate period after ECMO initiation are sparse. We evaluated the effects of varying ECMO blood flow rate on left ventricular systolic function.Methods:Adult patients who were supported by peripheral V-A ECMO in a tertiary referral center were recruited. Serial hemodynamic and cardiac performance parameters were measured by transthoracic echocardiogram within the first 48 hours after implementation of V-A ECMO. Measurements at 100%, 120%, and 50% of target blood flow (TBF) were compared.Results:A total of 45 patients were included, 32 (71.1%) were male, and the median age was 57 (50-64) years. The main indications for V-A ECMO were myocardial infarction 25 (55.6%) and myocarditis 6 (13.3%). With a decrease in extracorporeal blood flow from 100% to 50% of TBF, mean arterial pressure dropped from 75±18 to 67±20 mmHg (p<0.001), but stroke volume increased from 15 (8-25) to 21 (13-34) mL (p<0.001), and cardiac index increased from 0.8 (0.5-1.3) to 1.2 (0.7-1.7) L/min/m2 (p<0.001). All indices of left ventricular contractility improved at 50% compared with 100% TBF: the global longitudinal strain improved from -2.8 (-5.4-0) to -4.7 (-8.2- -1.1)% (p<0.001); left ventricular ejection fraction increased from 16.8 (10.0-28.5) to 28.2 (18.0-35.5)% (p<0.001); and left ventricular outflow tract velocity time integral increased from 4.7 (2.7-7.8) to 7.7 (3.9-11.3) cm (p<0.001). The addition of echocardiographic parameters improved the discrimination of the SAVE score in predicting hospital mortality (AUROC 0.71 vs 0.58).Conclusions:In the initial period of V-A ECMO support, left ventricular systolic function quantified bedside echocardiography was inversely related to ECMO blood flow rate. The heart-ECMO interaction should be considered when determining goals of ECMO flow after initiation.

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