scholarly journals Rescue and Nursing of Acute Severe Viral Myocarditis in Children

2015 ◽  
Vol 4 (4) ◽  
pp. 39
Author(s):  
Yan Zheng
Keyword(s):  
Heart Failure ◽  
Gamma Globulin ◽  
Viral Myocarditis ◽  
Myocardial Damage ◽  
Shock Therapy ◽  
Pulse Therapy ◽  
Correct Treatment ◽  
Oxygen Inhalation ◽  
Direct Current Cardioversion ◽  
Adrenal Cortical Hormone

<p><strong>Objective: </strong>To explore clinical rescue and nursing measures for children with acute severe viral myocarditis. <strong>Method: </strong>Patients in the hospital were immediately given positive anti-heart failure, anti-shock therapy and correct treatment of arrhythmia. Large doses of gamma globulin, adrenal cortical hormone, pulse therapy, direct current cardioversion, vitamin C, oxygen inhalation, ECG and other treatments were given. <strong>Results</strong><strong>: </strong>58 cases were rescued successfully and the prognosis was good. However, there were 3 cases of patients with severe myocardial damage, ECG, ventricular fibrillation, and 1 invalid death. <strong>Conclusion: </strong>In the treatment of acute severe viral myocarditis of children, timely, accurate and safe implementation of various rescue measures is the key to improving the success rate.</p>

Estimation of the Safety of Intraoperative Fluid Therapy during Great Abdominal Surgery in Patients with Coronary Heart Disease

2020 ◽  
Vol 5 (5) ◽  
pp. 158-163
Author(s):  
V. I. Lysenko ◽  
◽  
E. A. Karpenko ◽  
Ya. V. Morozova
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Fluid Therapy ◽  
Troponin I ◽  
Significant Proportion ◽  
Myocardial Damage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cardiac Complications ◽  
Fluid Regimen

The study of intraoperative fluid therapy tactics has been of great interest over the past few years, especially in people with concomitant coronary heart disease, as they make up a significant proportion of all surgical patients. The purpose of our study was to assess the risk of intraoperative myocardial damage in patients with concomitant coronary heart disease depending on the fluid regimen used based on monitoring of hemodynamic parameters, electrocardiogram and biomarkers of myocardial damage. Material and methods. The study involved 89 patients, who were divided into two groups depending on the tactics of intraoperative fluid therapy – restrictive and liberal. In order to detect cardiac complications at different stages, we assessed biomarkers of myocardial damage Troponin I, NT-proBNP by solid-phase enzyme-linked immunosorbent assay (ELISA). Results and discussion. Analysis of the obtained data showed that MINS (myocardial injury in noncardiac surgery) incidents were diagnosed in 5 patients (11.1%) in the first group and in 6 patients (13.6%) in the second. In patients of both groups there was an increase in NT-proBNP in the dynamics at all stages, and in the 2nd group, with a liberal regimen of intraoperative fluid therapy, it was more pronounced. It should be noted that the obtained values of NT-proBNP in all patients did not differ significantly from those allowed for this age group; such dynamics of NT-proBNP may indicate a relative risk of complications of liberal fluid therapy in patients with baseline heart failure. One of the important points when choosing the mode of fluid therapy in patients with high cardiac risk is the assessment of the initial volemic status and careful monitoring of water balance in the perioperative period with the desire for "zero" balance. The obtained dynamics of laboratory markers of myocardial damage indicates that in patients with a significant reduction in cardiac reserves compensated for heart failure, a restrictive fluid regimen is preferable, which is also confirmed by slight changes in the concentration of biomarkers. Conclusion. Thus, the study demonstrated the relative safety of selected fluid regimens in patients with concomitant coronary heart disease without signs of congestive heart failure

scholarly journals Peripheral Blood MicroRNAs as Potential Biomarkers of Myocardial Damage in Acute Viral Myocarditis

Genes ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 420
Author(s):  
Maria Marketou ◽  
Joanna Kontaraki ◽  
Alexandros Patrianakos ◽  
George Kochiadakis ◽  
Ioannis Anastasiou ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Troponin I ◽  
Left Ventricular Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Viral Myocarditis ◽  
Myocardial Damage ◽  
Left Ventricular ◽  
Cardiovascular Development ◽  
Acute Viral Myocarditis

Background: microRNAs (miRs) have emerged as important modulators of cardiovascular development and disease. Our aim was to determine whether cardiac-related miRs such as miR-21-5p and miR-1-3p were differentially expressed in acute viral myocarditis and whether any of them was related with the extent of myocardial damage and left ventricular dysfunction. Methods: We enrolled 40 patients with acute viral myocarditis. Blood samples were taken on admission and miRs expression levels in peripheral blood mononuclear cells were quantified by real-time reverse transcription polymerase chain reaction. Results: miR-21-5p, miR-1-3p were significantly elevated in acute myocarditis. miR-21-5p levels showed a strong correlation with global longitudinal strain (r = 0.71, p < 0.01), while miR-1-3p had significant correlations with troponin I (r = 0.79, p < 0.01). Conclusions: The expression of miR-21-5p and miR-1-3p in peripheral blood is increased in acute viral myocarditis, and this increase is correlated with myocardial damage and indicative of left ventricular systolic dysfunction in these patients.

Inappropriate Shock Therapy in a Heart Failure Defibrillator

2001 ◽  
Vol 24 (2) ◽  
pp. 238-240 ◽  
Author(s):  
TIM R. BETTS ◽  
STUART ALLEN ◽  
PAUL R. ROBERTS ◽  
JOHN M. MORGAN
Keyword(s):  
Heart Failure ◽  
Shock Therapy ◽  
Inappropriate Shock

Abstract 229: Determination of Phase-specific Biomarkers of Viral Myocarditis Induced by Theiler’s virus Using Multivariate Analyses of Viral Genome, Troponin, Transcriptome and Echocardiography Data

2013 ◽  
Vol 113 (suppl_1) ◽  
Author(s):  
Eiichiro Kawai ◽  
Seiichi Omura ◽  
Fumitaka Sato ◽  
Nicholas E Martinez ◽  
Viromi Fernando ◽  
...  
Keyword(s):  
Immune Responses ◽  
Viral Replication ◽  
Microarray Data ◽  
Viral Genome ◽  
Troponin I ◽  
Multivariate Analyses ◽  
Viral Myocarditis ◽  
Myocardial Damage ◽  
Heart Tissue ◽  
Viral Rna

Viral myocarditis has been proposed to be initiated by viral replication in the heart (acute phase), followed by immune-mediated damage (subacute phase), where each phase requires anti-viral and immunomodulatory treatments, respectively. There are no specific biomarkers to distinguish acute from subacute phases of myocarditis while serum troponin, echocardiography, and myocardial biopsy data have been used for diagnosis clinically. To determine the phase-specific biomarkers, we used a mouse model for myocarditis induced by Theiler’s murine encephalomyelitis virus (TMEV), which belongs to the genus Cardiovirus, the family Picornaviridae. We conducted multivariate analyses of viral genome, serum cardiac troponin I, echocardiography, histology, and transcriptome using microarray data of the heart tissue harvested on 4 (acute) and 7 (subacute) days post infection (dpi). The level of viral RNA semi-quantified by RT-PCR was 10-fold higher on 4 dpi (ΔCt = 2.5×10-2 ± 4.9×10-3) than 7 dpi (ΔCt = 2.6×10-3 ± 3.0×10-4) (P < 0.05). Serum troponin was undetectable in 4 of 10 mice on 4 dpi and only in 1 of 10 mice on 7 dpi; the serum troponin levels (ng/ml) on 4 dpi (42.9 ± 15.6) were significantly lower than 7 dpi (249.9 ± 62.8) (P < 0.05). The levels of viral RNA and troponin were strongly correlated on 4 dpi (r = 0.79, P < 0.05), but not 7 dpi (P = 0.12), suggesting that viral replication could be a major cause of myocardial damage only on 4 dpi. We found multiple high intensity cardiac lesions using echocardiography with histological myocarditis on 7 dpi, but not 4 dpi. Transcriptome analyses of microarray data showed upregulation of genes associated with innate immune responses in samples from 4 and 7 dpi, compared with controls. Samples from 7 dpi showed upregulation of genes associated with T, B, and antigen presenting cells and downregulation of cardiac myosin-related genes (Myl4, Myl7, and Mybphl), compared with 4 dpi, suggesting that acquired immune responses contribute to cardiomyocyte damage on 7 dpi. In summary, the chronological order of emergence of biomarker candidates was 1) viral genome and innate immunity, 2) troponin, and 3) acquired immunity and echo and histological changes.

Abstract 5700: Worsening Renal Function and Arrhythmic Event in Implantable Cardioverter Defibrillator Patients with Nonischemic Heart Failure

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Atsushi Takahashi ◽  
Tsuyoshi Shiga ◽  
Daigo Yagishita ◽  
Keisuke Futagawa ◽  
Naoki Serizawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Renal Dysfunction ◽  
Implantable Cardioverter Defibrillator ◽  
Shock Therapy ◽  
Electrical Storm ◽  
Icd Implantation ◽  
Cardioverter Defibrillator ◽  
Arrhythmic Event ◽  
Icd Shock

Purpose: Implantable Cardioverter Defibrillator (ICD) prevents sudden cardiac death in high risk patients with heart failure (HF). Worsening renal function (WRF) is associated with mortality in patients with myocardial infarction or HF, but its effect on lethal arrhythmia is unknown. We evaluated the influence of WRF on the occurrence of arrhythmic events in patients with nonischemic HF and ICD. Methods: A total of 286 nonischemic HF patients who underwent ICD implantation between 1990 and 2007 were studied. Estimated Glomerular Filtration Rate (eGFR) was calculated using the Modification of Diet in Renal Disease. Renal dysfunction was defined as eGFR <60mL/min/1.73m 2 and WRF was defined as 15mL/min/1.73m 2 per year. Differences in arrhythmia recurrences according to the eGFR and WRF were compared by Kaplan-Meier survival curves. Results: During a mean follow-up time of 2.2+/−1.0 years, 94 (33%) of 286 patients (mean age; 57+/−15 years, 72% male) experienced appropriate ICD shock therapy. There was a significantly higher cumulative rate of appropriate ICD shock therapy (p<0.05) and electrical storm (p<0.05) in patients with renal dysfunction than others. The patients with renal dysfunction at baseline experience WRF more frequently than other patients (53% vs. 23%, respectively, p<0.01). After correcting for age, sex, left ventricular ejection fraction (LVEF), indication for ICD implantation, and use of beta-blockers in a Cox regression model, WRF was still an independent predictor of the time to first appropriate shock (HR 2.21, 95% CI 1.32–3.69, p<0.05) and electrical storm (HR 2.22, 95% CI 1.19 – 4.13, p<0.05). The result of subgroup analysis of 147 patients with low LVEF (LVEF<35%) indicated that the patients with WRF experienced electrical storms more frequently (p<0.05). Conclusion: WRF is associated with increased rate of arrhythmic event in nonischemic HF patients. Especially, those patients with low LVEF and WRF experience more frequent ICD shocks.

scholarly journals Changes on Serum Troponin T Level before and after Taking Standard Therapy Medication in Heart Failure Patients

2020 ◽  
Vol 56 (1) ◽  
pp. 4
Author(s):  
Yen Yen Ari Indrawijaya ◽  
Suharjono Suharjono ◽  
Muhammad Aminuddin ◽  
Endang Retnowati ◽  
Gilang Mauladi Rahman
Keyword(s):  
Heart Failure ◽  
Cardiac Troponin ◽  
Standard Therapy ◽  
Troponin T ◽  
Severe Heart Failure ◽  
Myocardial Necrosis ◽  
Myocardial Damage ◽  
Symptom Improvement ◽  
Before And After ◽  
Difference Test

Patients with advanced heart failure (NYHA FC III and IV heart failure) had positive cardiac troponin levels in previous cohort studies. In heart failure, cardiac troponin T (cTnT) is a biomarker that is sensitive to myocardial damage, especially myocardial necrosis. However, there is still little information regarding changes in cTnT levels during standard therapy. This prospective observational study is aimed at evaluating changes in cTnT levels before and after the administration of standard therapy and evaluating symptom improvement before and after the administration of standard therapy in patients with severe heart failure. Measurement of cTnT levels and symptom improvement parameters before treatment was carried out on the first day of the inpatient and measurement after therapy was carried out on the last day of the inpatient. Sampling was done by consecutive sampling and found 30 patients in the inpatient room of the SMF Cardiovascular Disease, Dr. Soetomo Hospital, Surabaya during the months of May-July 2017. The results of the study obtained the average cTnT levels before therapy 33.48 + 31.88 pg/ml and the average cTnT levels after therapy 46.32 + 52.68 pg/ml. Based on the statistical difference test with the Wilcoxon sign-ranked test, there was no significant change in cTnT levels (p = 0.318). On the parameter of clinical symptom improvement, there was a significant decrease in pulse, respiratory rate, blood pressure, and mean arterial pressure before and after administration of therapy (p <0.05). There was no change in troponin T levels before and after the administration of therapy meant there was no worsening of myocardial necrosis.

scholarly journals Combined assessment of myocardial damage and electrical disturbance in chronic heart failure

2017 ◽  
Vol 9 (5) ◽  
pp. 457 ◽  
Author(s):  
Shinpei Kadowaki ◽  
Tetsu Watanabe ◽  
Yoichiro Otaki ◽  
Taro Narumi ◽  
Yuki Honda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Myocardial Damage
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