scholarly journals Tako-tsubo cardiomyopathy observed in a patient with sepsis and transient hyperthyroidism

2016 ◽  
Vol 72 (1) ◽  
Author(s):  
Filippo M. Sarullo ◽  
Luigi Americo ◽  
Salvatore Accardo ◽  
Sergio Cicero ◽  
Rossella Schicchi ◽  
...  
Keyword(s):  
Troponin T ◽  
Systolic Function ◽  
Significant Coronary Artery Disease ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Blood Analysis ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Creatine Kinase Mb ◽  
Tako Tsubo Cardiomyopathy

ischemic stroke with residual left hemiparesis, was admitted to our hospital because of dyspnoea with clinical evidence of acute pulmonary edema. She was found to have a sinus tachycardia with ST-elevation in leads D1, aVL and V1-V4 in the electrocardiogram, and akinesis of the left ventricular apex with overall left ventricular systolic function being severely impaired and an ejection fraction of 28% on echocardiography. Orotracheal intubation was performed and mechanical ventilation was immediately started. Emergency cardiac catheterization was performed 2 h after the symptom onset. Coronary angiography showed no significant coronary artery disease. Blood analysis revealed an increase in the creatine kinase MB fraction, a significant positive detection in troponin T, a white blood cell count of 35000 per microliter, C-reactive protein of 59,9 mg/dl, and transient elevation in the concentration of free triiodothyronine, free thyroxine, thyroid globulin antibody, and thyroid peroxidase antibody. The symptoms improved during the next days, and follow-up echocardiography 18 days later showed complete resolution of the left ventricular dysfunction. These data suggest that tako-tsubo cardiomyopathy may be induced in patients with sepsis and transient hyperthyroidism.

The effects of dexrazoxane on cardiac status and second malignant neoplasms (SMN) in doxorubicin-treated patients with osteosarcoma (OS).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9503-9503 ◽  
Author(s):  
Lisa M. Kopp ◽  
Mark L. Bernstein ◽  
Cindy L. Schwartz ◽  
David Ebb ◽  
Mark D. Krailo ◽  
...  
Keyword(s):  
Troponin T ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
European Medicines Agency ◽  
Malignant Neoplasms ◽  
Secondary Malignancies ◽  
Her2 Positive ◽  
Pilot Studies ◽  
Second Malignant Neoplasms

9503 Background: Anthracyclines are highly efficacious in OS but associated with risk of cardiotoxicity. We conducted two studies using dexrazoxane as a cardioprotectant: i) AOST0121, a phase II study for metastatic OS and ii) P9754, a series of pilot studies including doxorubicin dose intensification in patients with localized OS. Methods: Patients on AOST0121 received methotrexate, doxorubicin (375 mg/m2), cisplatin, ifosfamide and etoposide (MAPIE). Those with HER2-positive tumors also received trastuzumab (4 mg/kg loading dose, 2 mg/kg weekly). On P9754, patients received MAP in Pilot 1, MAPI or MAPIE in Pilots 2 and 3. Total doxorubicin was 450 mg/m2 or 600 mg/m2 with each dose preceded by dexrazoxane (10:1 ratio). Etoposide was never given simultaneously with dexrazoxane. Measurements of left ventricular systolic function by echocardiography, serum troponin-T (cTnT, a myocardial injury marker) and N-terminal pro-brain natriuretic peptide (NT-proBNP, a cardiomyopathy marker) were obtained at baseline and repeated during therapy. Secondary malignancies were reported to the NCI. Results: None of the 47 patients (17 receiving trastuzumab) evaluated for cardiac toxicity on AOST0121 had significant changes in left ventricular fractional shortening, measurable cTnT, elevation of NT-proBNP or clinical evidence of cardiotoxicity (CTCv2.0). In P9754, 242 patients were evaluated for cardiotoxicity. Only 1 patient had CTCv2.0 grade 3 toxicity and 1 patient had a measurable cTnT. Three of 96 patients treated on AOST0121 and two of 272 patients on P9754 developed AML. Combining both studies: 5/398 or 1.4%. Conclusions: This large group of OS patients demonstrates that dexrazoxane is an effective cardioprotectant for doxorubicin alone (375-600 mg/m2), and in combination with trastuzumab. Dexrazoxane did not lead to an increase in secondary malignancies in OS patients treated with these regimens as compared to historical rates of 1-2%. Our results do not support the findings of a recent European Medicines Agency safety review that concluded dexrazoxane was unsafe for use in children and adolescents due to risk of SMN.

Differences in the clinical characteristics and long-term outcome of peripartum tako-tsubo cardiomyopathy and peripartum cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Kim ◽  
S.R Kim ◽  
S Park ◽  
J Seo ◽  
E.K Kim ◽  
...  
Keyword(s):  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Complete Recovery ◽  
Tertiary Hospital ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Tako Tsubo Cardiomyopathy

Abstract Background Some peripartum-associated cardiomyopathy patients present similarly to those of tako-tsubo cardiomyopathy (TCM), little is known about the clinical course of peripartum TCM. Purpose To know clinicial characteristics and outcomes of peripartum TCM, in comparison with peripartum cardiomyopathy (PPCM) Methods and results Of 31 pregnancy-associated cardiomyopathy patients in a tertiary hospital, 10 cases of peripartum TCM and 21 cases of PPCM were found. Maternal near-missed death was significantly more common in the peripartum TCM group than in the PPCM group (100.0% vs. 76.2%, p=0.030). Complete recovery was observed with all peripartum TCM cases, while 23.8% of the PPCM cases had residual left ventricle (LV) dysfunction. LV ejection fraction greater than 30% on the initial echocardiogram independently predicted early echocardiographic recovery of left ventricular systolic function (odds ratio 331.33, 95% confidence interval 3.87–28402.60, p=0.011). There was no difference between the two groups in terms of the rate of adverse clinical events at 3 years of follow-up (PPCM group: 26.3% [5/19] vs. TCM group: 33.3% [3/9], p=0.750). Conclusions One-third of pregnancy-associated cardiomyopathy patients had peripartum TCM. With contemporary supportive care, both PPCM and peripartum TCM patients had a low mortality rate and excellent long-term outcomes. Kaplan-Meier survival curves for death, Funding Acknowledgement Type of funding source: None

scholarly journals GSK-3β heterozygous knockout is cardioprotective in a knockin mouse model of familial dilated cardiomyopathy

2016 ◽  
Vol 310 (11) ◽  
pp. H1808-H1815 ◽  
Author(s):  
Rasha M. S. M. Mohamed ◽  
Sachio Morimoto ◽  
Islam A. A. E.-H. Ibrahim ◽  
Dong-Yun Zhan ◽  
Cheng-Kun Du ◽  
...  
Keyword(s):  
Mouse Model ◽  
Dilated Cardiomyopathy ◽  
Glycogen Synthase ◽  
Troponin T ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Myosin Heavy Chain Isoform ◽  
Familial Dilated Cardiomyopathy ◽  
Gsk 3Β

Glycogen synthase kinase-3β (GSK-3β) plays a central role in both cardiac physiology and pathology. Herein we want to clarify the role of GSK-3β in familial dilated cardiomyopathy. We generated a mouse model carrying a heterozygous knockout mutation of GSK-3β (GSK-3β+/− KO), together with a ΔK210 knockin mutation in cardiac troponin T (ΔK210 cTnT KI), which was proved to be one of the genetic causes of familial dilated cardiomyopathy (DCM). GSK-3β+/− KO prevented the slow and rapid deterioration in left ventricular systolic function accompanying heart failure (HF) in DCM mice with heterozygous and homozygous ΔK210 cTnT KI mutations, respectively. GSK-3β+/− KO also prevented cardiac enlargement, myocardial fibrosis, and cardiomyocyte apoptosis and markedly reduced the expression of cardiac β-myosin heavy chain isoform, indicative of HF, in DCM mice with homozygous ΔK210 cTnT KI mutation. GSK-3β+/− KO also extended the life span of these DCM mice. This study suggests that the inhibition of GSK-3β is cardioprotective in familial DCM associated with ΔK210 cTnT mutation.

scholarly journals Effects of Liraglutide on Myocardial Function After Cardiac Surgery: A Secondary Analysis of the Randomised Controlled GLOBE Trial

2020 ◽  
Vol 9 (3) ◽  
pp. 673
Author(s):  
Abraham H. Hulst ◽  
Maarten J. Visscher ◽  
Thomas G. V. Cherpanath ◽  
Lieke van de Wouw ◽  
Marc B. Godfried ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Myocardial Function ◽  
Systolic Function ◽  
Secondary Analysis ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Receptor Agonists ◽  
Beneficial Effects ◽  
Intention To Treat ◽  
Creatine Kinase Mb

Introduction: Previous studies demonstrated the cardioprotective properties of glucagon-like peptide-1 receptor agonists in patients with diabetes or cardiac disease. We investigated whether preoperative subcutaneous liraglutide improves myocardial function after cardiac surgery. Methods: We performed a pre-planned secondary analysis of adult patients undergoing cardiac surgery included in the GLOBE trial. Patients were randomised to receive 0.6 mg subcutaneous liraglutide on the evening before surgery and 1.2 mg after induction of anaesthesia, or matching placebo. Perioperative echocardiographic assessments, haemodynamic parameters, doses of vasoactive inotropic support and postoperative measurements of troponin, Creatine Kinase-MB , creatinine and lactate were compared between groups. Results: The study population consisted of the entire intention-to-treat cohort of the GLOBE trial. In this study, 129 patients received liraglutide and 132 patients placebo. Baseline characteristics were comparable between groups. Postoperatively, 170 (65%) patients underwent echocardiography. In the liraglutide group, more patients had a normal left ventricular systolic function (68%, 59 patients) compared to placebo (53%, 44 patients), difference = 15%, 95%CI = 0–30, p = 0.049. Assessment of the right ventricle revealed no difference in function. Conclusions: Patients receiving short-term preoperative liraglutide treatment better maintained normal myocardial function after cardiac surgery. This study warrants further evaluation of the potential beneficial effects of GLP-1 receptor agonists in cardiac surgery patients.

An Atypical Presentation of Acute Coronary Syndrome

2012 ◽  
Vol 8 (1) ◽  
pp. 67
Author(s):  
Syed Khurram Mushtaq Gardezi ◽  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Systolic Function ◽  
Artery Bypass ◽  
Left Ventricular Systolic Function ◽  
Regional Wall Motion ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Ventricular Systolic Function ◽  
Coronary Syndrome

A 61-year-old man was admitted to hospital with severe occipital headache and weakness and numbness of the left arm. His electrocardiograms showed changes hinting at acute coronary syndrome (ACS). However, in view of his clinical presentation, he underwent tests for likely subarachnoid haemorrhage, but this was ruled out. The next day, he was referred to cardiology. A transthoracic echocardiogram showed reduced left ventricular systolic function along with regional wall motion abnormalities involving inferoposterior walls. The patient was treated as per the protocol for ACS. A dobutamine stress echocardiogram confirmed inferior myocardial infarction with evidence of myocardial viability in the affected left ventricular segments. Subsequent investigations confirmed three-vessel coronary artery disease and reduced left ventricular systolic function. The patient underwent successful coronary artery bypass grafting.

160-OR: Acute Changes in Plasma Glucose Have Impact on Left Ventricular Systolic Function in Insulin-Treated Patients with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 160-OR
Author(s):  
ANDREAS ANDERSEN ◽  
PETER G. JØRGENSEN ◽  
JONATAN I. BAGGER ◽  
MARIA POMPEA ANTONIA BALDASSARRE ◽  
MIKKEL B. CHRISTENSEN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Plasma Glucose ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Ventricular Systolic Function ◽  
Acute Changes
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