scholarly journals Effect of Left Ventricular Restrictive filling pattern on survival in ischemic cardiomyopathy: Implications for surgical ventricular restoration.

2021 ◽  
Author(s):  
srilakshmi adhyapak ◽  
Tinku Thomas ◽  
Tivlin Maria ◽  
Kiron Varghese
Keyword(s):  
Heart Failure ◽  
Pilot Study ◽  
Ischemic Cardiomyopathy ◽  
Left Ventricular ◽  
Advanced Heart Failure ◽  
Left Ventricular Ejection ◽  
Surgical Ventricular Restoration ◽  
Ventricular Ejection Fraction ◽  
Filling Pattern ◽  
Ventricular Restoration

Background: To evaluate the effects of baseline left ventricular restrictive filling pattern (RFP; E/A>2) in ischemic cardiomyopathy (ICM) patients on prognosis. Methods: Patient data was retrospectively analyzed over a period of 4.5 years to determine the effect of Echocardiographic factors on survival and re-admission for heart failure. Results: There were 102 ICM patients who had baseline RFP. We identified two sub-groups based on geometric phenotypes of left ventricular eccentric remodeling and dilated remodeling based on the relative wall thickness (RWT >0.34 or <0.34). The patients with preserved RWT had significantly more dilated ventricles ( LVIDd and LVIDs), greater pulmonary artery systolic pressures (PASP), greater diatolic dysfunction (E/A) and less left ventricular ejection fraction (LVEF); p<0.001. The number of deaths was higher in the reduced RWT patients, as were the number of re-admissions, although the time to survival and time to re-admission was not significant. Conclusions: In this pilot study on ICM patients in advanced heart failure with baseline RFP, the presence of preserved RWT indicative of eccentric remodelling demonstrated a better clinical outcome, leading to a hypothesis that the eccentric remodelling LV phenotype might benefit with SVR.

scholarly journals Clinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy

2021 ◽  
Vol 10 (21) ◽  
pp. 4989
Author(s):  
Mohammad Abumayyaleh ◽  
Christina Pilsinger ◽  
Ibrahim El-Battrawy ◽  
Marvin Kummer ◽  
Jürgen Kuschyk ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Ischemic Cardiomyopathy ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Tachyarrhythmias ◽  
Ventricular Ejection Fraction ◽  
One Year ◽  
The Impact

Background: The angiotensin receptor-neprilysin inhibitor (ARNI) decreases cardiovascular mortality in patients with chronic heart failure with a reduced ejection fraction (HFrEF). Data regarding the impact of ARNI on the outcome in HFrEF patients according to heart failure etiology are limited. Methods and results: One hundred twenty-one consecutive patients with HFrEF from the years 2016 to 2017 were included at the Medical Centre Mannheim Heidelberg University and treated with ARNI according to the current guidelines. Left ventricular ejection fraction (LVEF) was numerically improved during the treatment with ARNI in both patient groups, that with ischemic cardiomyopathy (n = 61) (ICMP), and that with non-ischemic cardiomyopathy (n = 60) (NICMP); p = 0.25. Consistent with this data, the NT-proBNP decreased in both groups, more commonly in the NICMP patient group. In addition, the glomerular filtration rate (GFR) and creatinine changed before and after the treatment with ARNI in both groups. In a one-year follow-up, the rate of ventricular tachyarrhythmias (ventricular tachycardia and ventricular fibrillation) tended to be higher in the ICMP group compared with the NICMP group (ICMP 38.71% vs. NICMP 17.24%; p = 0.07). The rate of one-year all-cause mortality was similar in both groups (ICMP 6.5% vs. NICMP 6.6%; log-rank = 0.9947). Conclusions: This study shows that, although the treatment with ARNI improves the LVEF in ICMP and NICMP patients, the risk of ventricular tachyarrhythmias remains higher in ICMP patients in comparison with NICMP patients. Renal function is improved in the NICMP group after the treatment. Long-term mortality is similar over a one-year follow-up.

scholarly journals Differences in the prognoses of patients referred to an advanced heart failure center from hospitals with different bed volumes

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Koichi Narita ◽  
Eisuke Amiya ◽  
Masaru Hatano ◽  
Junichi Ishida ◽  
Hisataka Maki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Outcome ◽  
Left Ventricular ◽  
Cox Proportional Hazards ◽  
Advanced Heart Failure ◽  
Ventricular Assist Devices ◽  
Left Ventricular Ejection ◽  
Left Ventricular Assist Devices ◽  
Ventricular Ejection Fraction

AbstractFew reports have discussed appropriate strategies for patient referrals to advanced heart failure (HF) centers with available left ventricular assist devices (LVADs). We examined the association between the characteristics and prognoses of referred patients with advanced HF and the bed volume of the referring hospitals. This retrospective analysis evaluated 186 patients with advanced HF referred to our center for consultation about the indication of LVAD between January 1, 2015, and August 31, 2018. We divided the patients into two groups according to the bed volume of their referring hospital (high bed volume hospitals (HBHs): ≥ 500 beds in the hospital; low bed volume hospitals (LBHs): < 500 beds). We compared the primary outcome measure, a composite of LVAD implantation and all-cause death, between the patients referred from HBHs and patients referred from LBHs. The 186 patients with advanced HF referred to our hospital, who were referred from 130 hospitals (87 from LBHs and 99 from HBHs), had a mean age of 43.0 ± 12.6 years and a median left ventricular ejection fraction of 22% [15–33%]. The median follow-up duration of the patients was 583 days (119–965 days), and the primary outcome occurred during follow-up in 42 patients (43%) in the HBH group and 20 patients (23%) in the LBH group. Patients referred from HBHs tended to require catecholamine infusion on transfer more often than those referred from LBLs (36.5% (HBH), 20.2% (LBL), P = 0.021). Kaplan–Meier analysis indicates that the occurrence of the primary outcome was significantly higher in the HBH patients than in the LBH patients (log-rank P = 0.0022). Multivariate Cox proportional hazards analysis revealed that catecholamine support on transfer and long disease duration were statistically significant predictors of the primary outcome. Patients from HBHs had a greater risk of the primary outcome. However, the multivariate analysis did not indicate an association between referral from an HBH and the primary outcome. In contrast, catecholamine support on transfer, long duration of disease, and low blood pressure were independent predictors of the primary outcome. Therefore, these should be considered when determining the timing of a referral to an advanced HF center, irrespective of the bed volume of the referring hospital.

Abstract 18902: Adaptive Servo-ventilation is More Effective in Dilated Cardiomyopathy Patients than Ischemic Cardiomyopathy Patients and Heart Failure with Preserved Ejection Fraction Patients

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Tatsunori Ikeda ◽  
Manabu Fujimoto ◽  
Masakazu Yamamoto ◽  
Kazuyasu Okeie ◽  
Hisayoshi Murai ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Function ◽  
Dilated Cardiomyopathy ◽  
Ischemic Cardiomyopathy ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Preserved Ejection Fraction ◽  
Ventricular Ejection Fraction ◽  
Adaptive Servo Ventilation

Introduction: Central sleep apnea (CSA) is a common complication in heart failure patients (HF) and closely associated with poor prognosis. Adaptive servo-ventilation (ASV) is a new treatment for HF with CSA. Some study indicated ASV might improve cardiac function and its prognosis. However, there was little discussion by each background disease. Methods and Results: We examined 64 HF with CSA patients (involving 15 dilated cardiomyopathy (DCM) patients, 27 ischemic cardiomyopathy (ICM) patients, and 22 heart failure with preserved ejection fraction (HFpEF) patients) treated with ASV who had not been admitted to the hospital due to worsening HF in the 6 months before initiating ASV therapy. During 1 and 6 months observation, apnia-hypopnea index and brain natriuretic peptide were decreased significantly than baseline in all groups. There was similar in left ventricular ejection fraction in ICM and HFpEF groups during observation, however, in DCM group, there was significantly improved (29.3 +/- 14.3 to 36.5 +/- 12.4, and to 40.5 +/- 14.9%, P<0.01 compared with baseline). And left ventricular end systolic diameter was significantly shortened (53.7 +/- 11.1 to 30.4 +/- 11.5, and to 47.6 +/- 12.0 mm, P<0.01 compared with baseline), in spite of left ventricular end diastolic diameter was not changed. Conclusions: These results indicate that ASV is more effective in DCM patient with modifying hemodynamics and cardiac function than ICM and HFpEF patients.

CRT operator challenges during procedure… tips and tricks

2021 ◽  
Vol 1 (58) ◽  
pp. 21-27
Author(s):  
Tomasz Wcisło ◽  
Haval Dariusz Qawoq
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Advanced Heart Failure ◽  
Cardiac Resynchronization ◽  
Left Ventricular Ejection ◽  
Left Ventricular Dyssynchrony ◽  
Tips And Tricks ◽  
Resynchronization Therapy ◽  
Ventricular Ejection Fraction ◽  
Ventricular Dyssynchrony

In addition to pharmacological treatment, cardiac resynchronization therapy is an important method of heart failure treating. It’s indicated for patients with advanced heart failure, decreased left ventricular ejection fraction, a wide QRS syndrome, and the presence of left ventricular dyssynchrony despite optimal pharmacotherapy. The procedure is technically difficult and laden with many possible complications. Based on our own experience, this paper presents management with one of the periprocedural complications – dissection of the coronary sinus.

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