scholarly journals Clinical case of borreliosis myocarditis

2020 ◽  
Vol 24 (2) ◽  
pp. 232-235
Author(s):  
Yu. Yu. Shushkovska ◽  
O.I. Afanasiuk ◽  
R.V. Matyash
Keyword(s):  
Heart Failure ◽  
Lyme Disease ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Ventricular Arrhythmia ◽  
Atrioventricular Block ◽  
Clinical Case ◽  
Functional Class ◽  
Preserved Ejection Fraction ◽  
Atrial Rhythm

Annotation. The purpose of the work is to demonstrate the peculiarities of its course, modern methods of diagnosis and treatment on the example of a clinical case of borreliosis myocarditis. According to the results of the patient's ECG, a transient atrio-ventricular block of the first degree was established. The results of general clinical methods of examination of the patient generally corresponded to the reference values. According to the results of Holter ECG monitoring, a diagnosis of mild myocarditis, heart failure I, functional class I, with preserved ejection fraction (50 %) of the left ventricle was made. Ventricular arrhythmia – 4th grade according to Laun. Competitive atrial rhythm, transient atrioventricular block. Because specific cardiovascular lesions occurred for no apparent reason and symptoms occurred during peak tick activity, the patient was re-interviewed for migratory erythema and tick bites. The patient confirmed being in the forest during the disease season and sucking the mite without specific skin lesions. To further search for the etiological factor that led to the identified changes, the patient was tested for antibodies to Burrelia burgdorferi by ELISA. The obtained positive result (Ig G – 3.89 IU/ml, Ig M – 33.74 IU/ml) indicated an acute period of Lyme disease. Thus, the final diagnosis was: Lyme disease, stage II (early disseminal). Subacute infectious (borreliosis) myocarditis, mild course, heart failure I, functional class I, with preserved ejection fraction (50 %) of the left ventricle. Ventricular arrhythmia – 4th grade according to Laun. Competitive atrial rhythm, transient atrioventricular block of the I degree. Treatment is prescribed: doxycycline 100 mg x 2 times/day, metoprolol 25 mg x 2 times/day, metabolic therapy and serological tests are recommended after 3, 6, 12 months and 2 years. Thus, the clinical case shows the difficulties of diagnosing “borreliosis myocarditis”, emphasizes the prospects for the development of algorithms for the diagnosis and treatment of borreliosis myocarditis.

scholarly journals Positive effect of if-channel’s blocker ivabradine therapy in a patient with ischemic chronic heart failure with preserved left ventricle ejection fraction and hereditary thrombophilia (clinical case)

2019 ◽  
Vol 10 (3) ◽  
pp. 79-84
Author(s):  
Iurii N. Belenkov ◽  
Elena V. Privalova ◽  
Irina S. Ilgisonis ◽  
Iuliia I. Naymann ◽  
Alexey V. Zhito
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Clinical Case ◽  
Preserved Ejection Fraction ◽  
First Line ◽  
Effective Administration ◽  
Causes Of Mortality ◽  
Positive Effect ◽  
Selection Of

Chronic heart failure is one of the leading causes of mortality among patients with cardiovascular diseases. Current therapeutic methods for treating patients with chronic heart failure do not always provide a significant improvement in main intermediate and final outcomes. According to the neurohumoral theory of chronic heart failure development, an antagonism of the sympathoadrenal system with b-blockers is pathogenetically substantiated, and the drugs of this group are one of the first-line treatment for chronic heart failure. The selection of heart rate-reducing therapy in patients with chronic heart failure caused by ischemia, can often be difficult due to development of b-blockers side effects, b-blockers intolerance and/or due to the presence of contraindications at severe comorbid pathology. This article presents a clinical case of an effective administration of ivabradine, a drug of if-channel inhibitors group, in combination with b-blockers to a patient with chronic heart failure with a preserved ejection fraction.

scholarly journals Arterial Stiffness and Ventricular Arterial Coupling and Pulsatative Load on the Left Ventricle in Patients with Hypertension with Initial and Fulminant Heart Failure and Preserved Ejection Fraction According to E/e’ Estimates

2018 ◽  
Vol 0 (5) ◽  
pp. 89-96
Author(s):  
К. М. Амосова ◽  
О. В. Василенко ◽  
Ю. В. Руденко ◽  
А. Б. Безродний ◽  
Г. В. Мостбауер ◽  
...  
Keyword(s):  
Heart Failure ◽  
Arterial Stiffness ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Preserved Ejection Fraction

Abstract MP228: The Role Of Gut Microbiome Secreted Short Chain Fatty Acids In The Development Of Heart Failure With Preserved Ejection Fraction HFpEF

2021 ◽  
Vol 129 (Suppl_1) ◽  
Author(s):  
Jomana Hatahet ◽  
Raiza Bonomo ◽  
Tyler Cook ◽  
Chelsea R White ◽  
Chaitanya Gavini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Fatty Acids ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Gut Microbiome ◽  
Cardiac Dysfunction ◽  
Longitudinal Strain ◽  
Preserved Ejection Fraction ◽  
Fecal Matter

More than 50% of patients with heart failure are diagnosed with heart failure with preserved ejection fraction (HFpEF), and 80% of them are obese. It is a prominent disease with no available treatments. It is characterized by diastolic dysfunction that involves increase in left ventricle stiffness and decrease in its relaxation during diastole. To better understand the pathogenesis of obesity associated HFpEF, our studies focus on the early asymptomatic changes in cardiac mechanics that occurs before the increases in intracardiac pressure. Therefore, we have developed an obesity associated mouse model that we called pre-HFpEF where mice were fed either Normal Chow or Western Diet for 14 weeks. Our echocardiography measurements indicated the presence of early cardiac dysfunction consistent with obesity associated pre-HFpEF phenotype. Mice on WD had decrease in Global Longitudinal Strain (%GLS) and Longitudinal strain rate reverse (LSRr) indicating early signs of systolic and diastolic dysfunction, as well as increase in left ventricle anterior and posterior wall thickness during diastole (LVAWd, LVPWd). Obesity is also known to cause microbiome imbalance, which plays a significant role in the development of cardiovascular diseases through changes in short chains fatty acids, which are products of dietary fiber fermentation by the gut bacteria. In order to study the association between gut microbiome imbalance and HFpEF development, we treated our obese pre-HFpEF mice with fecal matter transplantation (FMT) from either lean or obese mice, and we found that FMT from lean mice led to significant improvements in systolic and diastolic dysfunction by increasing %GLS and LSRr and preventing hypertrophy by decreasing LVAWd and LVPWd. In addition, WD reduced butyrate producing bacteria, however circulating levels of butyrate were significantly increased with lean FMT treatment. Using an in-vitro approach to mimic WD we found butyrate treatment to inhibit the activation of NLRP3 inflammasome and NF-KB. Therefore, since FMT treatment improved cardiac dysfunction in obesity associated pre-HFpEF mice, and that butyrate is increased after FMT and can play a role in metabolic homeostasis, we predict that butyrate could be an important player in FMT improvements through cardiac metabolic regulation and cardiac inflammation suppression

Effect of atorvastatin on the lipid profile, markers of immune inflammation and symptomatic severity of heart failure in patients with myocarditis

2020 ◽  
Vol 22 (3) ◽  
pp. 76-81
Author(s):  
N. N. Ryzhman ◽  
S. L. Grishaev ◽  
D. V. Cherkashin ◽  
E. V. Gladysheva ◽  
V. Yu. Filippov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Clinical Course ◽  
Systolic Function ◽  
Functional Class ◽  
Pleiotropic Effects ◽  
Preserved Ejection Fraction ◽  
Chronic Myocarditis ◽  
Patients With Heart Failure ◽  
Positive Effect

Abstract. The effect of atorvastatin on the immune system and lipid metabolism after 24-week treatment of patients with chronic myocarditis is considered. Statins have been found to improve the clinical course of heart failure with a preserved ejection fraction in patients with myocarditis: they reduce the functional class of heart failure, improve the systolic function of the heart and its arrhythmogenic potential. Despite the large amount of conflicting data in the field of statin use in heart failure, one can think about the possible influence of molecular differences in statins on their pharmacological and pleiotropic effects. In particular, atorvastatin, which has lipophilic properties, is able to penetrate cardiomyocytes in contrast to hydrophilic rosuvastatin, which may partially explain the positive cardiac effects of atorvastatin in patients with heart failure with a preserved ejection fraction. The probable basis for the positive effect of atorvastatin on morphofunctional parameters in heart failure is its positive pleiotropic effects associated with a decrease in рro-inflammatory immune markers and subsequent leveling of negative neurohumoral activation. An additional mechanism that caused the positive effect of atorvastatin on the clinical course of heart failure can be considered a factor of preservation of systolic function of the left ventricle.

scholarly journals Outcomes of heart failure with preserved ejection fraction after radiofrequency catheter ablation for atrial fibrillation

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Zolotarova ◽  
M Brynza ◽  
O Bilchenko
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Control Strategy ◽  
Rate Control ◽  
Left Ventricle Ejection Fraction ◽  
Preserved Ejection Fraction

Abstract Funding Acknowledgements Type of funding sources: None. Introduction. Recent randomized controlled trials have shown that in heart failure (HF) patients with reduced left ventricle ejection fraction (HFrEF) atrial fibrillation (AF) ablation reduces hospitalization and mortality due to HF compared to medical therapy (MT). However, only few studies have examined outcomes of catheter ablation (CA) for AF in HF patients with preserved left ventricle ejection fraction (HFpEF).  Purpose. To compare the effect of catheter ablation on the outcomes of atrial fibrillation with chronic heart failure with preserved ejection fraction. Methods. Our prospective study included the main group (136 patients with the HFpEF who underwent a single procedure of the CA for symptomatic AF) and control group (58 patients with the HFpEF patients with paroxysmal or persistent AF on MT for rhythm and rate control strategy). To be eligible for inclusion for both groups, left ventricular diastolic dysfunction had to be present and/or relevant structural heart disease according to the current guidelines had to be fulfilled within 6 months prior to AF ablation. Outpatient follow-up were performed at 6, 12, 24 months intervals thereafter baseline.  Results. At the follow-up the composite primary end point (all-cause death or worsening of HF that led to an unplanned hospitalization) appeared in significantly fewer patients in the CA group than in the MT group (18 (13,2%) patients vs. 16 (27,5%) patients; p =0,005). The secondary analyses showed there was 5 deaths in the CA group and 2 deaths in MT group, with rate of 3,7%  and 3,4% respectively that were equal in comparable groups (p = 0,362). The incidences of HF hospitalization and cardiovascular hospitalization were also significantly higher in MT group than in CA group (14 (24,1%) vs. 13 (9,6%), p = 0,005) vs. 21 (15,4%), p = 0,016, respectively). Cardiovascular death and cerebrovascular accident were equal in comparable groups. The Kaplan–Meier curve for primary end-point demonstrated significant higher survival and freedom from hospitalizations due to HF in the CA group compared to MT group (p = 0,005); the freedom from hospitalization for worsening HF and the freedom from the cardiovascular hospitalization were having higher probability in the СA group (p = 0,003 and p= 0,016 ). Conclusion. Comparing catheter ablation with medical therapy for rhythm or rate control strategy in patients with heart failure with preserved left ventricle ejection fraction and atrial fibrillation, we found that catheter ablation was associated with lower rate of deaths and hospitalization due to worsening of heart failure.

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