scholarly journals Tachycardia-Induced Cardiomyopathy

2021 ◽  
Vol 31 (2) ◽  
pp. 259-267
Author(s):  
Ruxandra DANET ◽  
Andreea Elena VELCEA ◽  
Sorina MIHAILA-BALDEA ◽  
Dragos VINEREANU
Keyword(s):  
Left Ventricular ◽  
Assessment Tools ◽  
Diagnostic Process ◽  
Advanced Imaging ◽  
Adequate Treatment ◽  
Lv Dysfunction ◽  
Disease Prognosis ◽  
Lv Remodeling ◽  
Specific Assessment ◽  
Tachycardia Induced Cardiomyopathy

Tachycardia-induced cardiomyopathy (TIC) is characterized by reversible left ventricular (LV) dysfunction caused by long-standing tachycardia. The diagnosis of TIC is challenging due to lack of guidelines and specific assessment tools. Advanced imaging and endomyocardial biopsy should be taken into consideration in the future as contributors in the diagnostic process. There are numerous unknowns to TIC, the most pressing being the lack of diagnostic and prognostic tools. The presence of persistent negative LV remodeling after the normalization of the LV ejection fraction with adequate treatment of the tachycardia gives us a glimpse into the complex pathophysiologic processes at play, as well as the disease prognosis.

Heart failure progression is accelerated following myocardial infarction in type 2 diabetic rats

2007 ◽  
Vol 293 (3) ◽  
pp. H1609-H1616 ◽  
Author(s):  
Margaret P. Chandler ◽  
Eric E. Morgan ◽  
Tracy A. McElfresh ◽  
Theodore A. Kung ◽  
Julie H. Rennison ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Left Ventricular ◽  
Coronary Artery Ligation ◽  
Contractile Dysfunction ◽  
Lv Dysfunction ◽  
Lv Remodeling ◽  
Heart Failure Progression ◽  
Type 2 Diabetic

Clinical studies have shown a greater incidence of myocardial infarction in diabetic patients, and following an infarction, diabetes is associated with an increased risk for the development of left ventricular (LV) dysfunction and heart failure. The goal of this study was to determine if the progression of heart failure following myocardial infarction in type 2 diabetic (T2D) rats is accelerated compared with nondiabetic rats. Male nondiabetic Wistar-Kyoto (WKY) and T2D Goto-Kakizaki (GK) rats underwent coronary artery ligation or sham surgery to induce heart failure. Postligation (8 and 20 wk), two-dimensional echocardiography and LV pressure measurements were made. Heart failure progression, as assessed by enhanced LV remodeling and contractile dysfunction, was accelerated 8 wk postligation in the T2D animals. LV remodeling was evident from increased end-diastolic and end-systolic diameters and areas in the GK compared with the WKY infarcted group. Furthermore, enhanced LV contractile dysfunction was evident from a greater deterioration in fractional shortening and enhanced myocardial performance index (an index of global LV dysfunction) in the GK infarcted group. This accelerated progression was accompanied by greater increases in atrial natriuretic factor and skeletal α-actin (gene markers of heart failure and hypertrophy) mRNA levels in GK infarcted hearts. Despite similar decreases in metabolic gene expression (i.e., peroxisome proliferator-activated receptor-α-regulated genes associated with fatty acid oxidation) between infarcted WKY and GK rat hearts, myocardial triglyceride levels were elevated in the GK hearts only. These results, demonstrating enhanced remodeling and LV dysfunction 8 wk postligation provide evidence of an accelerated progression of heart failure in T2D rats.

Prior exercise improves survival, infarct healing, and left ventricular function after myocardial infarction

2009 ◽  
Vol 107 (3) ◽  
pp. 928-936 ◽  
Author(s):  
Monique C. de Waard ◽  
Dirk J. Duncker
Keyword(s):  
Myocardial Infarction ◽  
Exercise Intervention ◽  
Wheel Running ◽  
Interstitial Fibrosis ◽  
Left Ventricular ◽  
Voluntary Wheel Running ◽  
Lv Dysfunction ◽  
Lv Remodeling ◽  
Before And After ◽  
Voluntary Wheel

We investigated the effects of voluntary wheel running before an acute myocardial infarction (MI) on survival, left ventricular (LV) remodeling and dysfunction and whether exercise before and after MI provides superior protection compared with either exercise intervention alone. After 2 wk of voluntary wheel running or sedentary housing, MI was induced in C57Bl/6 mice, after which exercise was stopped (EX-MI-SED and SED-MI-SED groups, where EX is exercise and SED is sedentary) or continued (EX-MI-EX and SED-MI-EX groups) for a period of 8 wk. Exercise after MI in SED-MI-EX mice had no effect on survival, the area of infarction, and global LV remodeling, but attenuated fibrosis and apoptosis in the remote myocardium and blunted LV dysfunction and pulmonary congestion compared with SED-MI-SED mice. Exercise before MI in both EX-MI-SED and EX-MI-EX mice decreased post-MI mortality compared with both SED-MI-SED and SED-MI-EX mice. Furthermore, in both pre-MI exercise groups, the infarct area was thicker, whereas interstitial fibrosis and apoptosis in the remote LV myocardium were blunted. In contrast, the ameliorating effects of either pre-MI or post-MI exercise alone on LV dysfunction were lost in EX-MI-EX mice, which may in part be related to the increased daily exercise distance in the first week post-MI in EX-MI-EX versus SED-MI-EX mice. In conclusion, exercise before or after MI blunted LV dysfunction, whereas only exercise before MI improved survival. These findings suggest that even when regular physical activity fails to prevent an acute MI, it can still act to improve cardiac function and survival after MI.

Ischemic cardiomyopathy in pigs with two-vessel occlusion and viable, chronically dysfunctional myocardium

2002 ◽  
Vol 282 (4) ◽  
pp. H1370-H1379 ◽  
Author(s):  
James A. Fallavollita ◽  
John M. Canty
Keyword(s):  
Heart Failure ◽  
Ventricular Dysfunction ◽  
Right Heart Failure ◽  
Left Ventricular ◽  
Hibernating Myocardium ◽  
Triphenyl Tetrazolium Chloride ◽  
Vessel Occlusion ◽  
Tetrazolium Chloride ◽  
Lv Dysfunction ◽  
Lv Remodeling

A chronic left anterior descending coronary artery (LAD) stenosis leads to the development of hibernating myocardium with severe regional hypokinesis but normal global ventricular function after 3 mo. We hypothesized that two-vessel occlusion would accelerate the progression to hibernating myocardium and lead to global left ventricular (LV) dysfunction and heart failure. Pigs were instrumented with a fixed 1.5-mm constrictor on the proximal LAD and circumflex arteries. After 2 mo, there were no overt signs of right-heart failure and triphenyl tetrazolium chloride infarction was trivial (1.4 ± 0.1% of the LV). Compared with shams, regional function [myocardial systolic excursion (ΔWT); 2.1 ± 0.3 vs. 4.6 ± 0.4 mm, P < 0.05] and resting perfusion (0.90 ± 0.13 vs. 1.32 ± 0.09 ml · min−1 · g−1, P < 0.05) were reduced, consistent with hibernating myocardium. Pulmonary systolic (45.9 ± 3.3 vs. 36.5 ± 2.2 mmHg, P < 0.05) and wedge pressures (19.1 ± 1.6 vs. 11.2 ± 0.9 mmHg, P < 0.05) were increased with global ventricular dysfunction (ejection fraction 43 ± 2 vs. 50 ± 2%, P < 0.05). Early LV remodeling was present with increased cavity size and mass. Reductions in sarcoplasmic reticulum Ca2+-ATPase and phospholamban were confined to the dysfunctional LAD region with no change in calsequestrin. Thus combined stenoses of the LAD and circumflex arteries accelerate the development of hibernating myocardium and result in compensated heart failure.

Abstract 1764: Coapsys ® Leads to Global Reversal of Left Ventricular Remodeling: Expanded TRACE Study Analysis

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Sanjay Mittal ◽  
Yugal Mishra ◽  
Naresh Trehan
Keyword(s):  
Ventricular Remodeling ◽  
Shape Change ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Reverse Remodeling ◽  
Lv Dysfunction ◽  
Patients With Heart Failure ◽  
Lv Remodeling ◽  
Left Ventricular Dimensions ◽  
Ventricular Dimensions

Background: . We have previously reported as a part of the TRACE study that patients with LV dysfunction undergoing CABG and surgical implantation of Coapsys had significant reductions in LV size and MR at 1 year. Echo data of patients who recieved CABG with and without Coapsys, were retrospectively analyzed to determine the extent and pattern of LV reverse remodeling related to the LV shape change properties of Coapsys. Methods: Coapsys consists of anterior and posterior epicardial pads connected by a flexible chord, drawn together to affect change in valvular and ventricular geometry. Coapsys was implanted in patients whose MR remained ≥ grade 2 after CABG (Coapsys + CABG group, n=32). Patients whose MR grade reduced to 1 or less after CABG (CABG Alone group, n=35) received CABG only. Baseline age, ejection fraction, graft number, and MR grade in the Coapsys + CABG group and the CABG Alone group were 58, 35, 2.7, 3.0 and 59, 37 2.8, 2.7 respectively. Detailed echocardiographic measurements of diastolic left ventricular dimensions in 3 echo planes, 4 Chamber (4 Ch), 2 Chamber (2 Ch), and Long Axis (LAX), along with LV length and anterolateral papillary muscle (ALPM) depth were serially collected up to 12 months after surgery. Results: Comparison of baseline, 3 month and 12 month dimensions between Coapsys + CABG and CABG Alone groups are displayed in Figure 1 . Conclusions: In patients with MR and LV dysfunction undergoing implantation of Coapsys along with CABG, there is significant, global and progressive reversal of LV remodeling. This may to be related to the LV shape change properties of Coapsys and could benefit patients with heart failure.

scholarly journals Severe short-lasting left ventricular dysfunction associated with a respiratory infection

2019 ◽  
Vol 147 (1-2) ◽  
pp. 74-77
Author(s):  
Ivan Stankovic ◽  
Gojko Obradovic ◽  
Radosav Vidakovic ◽  
Ruzica Maksimovic ◽  
Ivan Ilic ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Respiratory Infection ◽  
Respiratory Infections ◽  
Multimodality Imaging ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Upper Respiratory Tract ◽  
Adequate Treatment ◽  
Lv Dysfunction ◽  
Tract Infections

Introduction. Since clinical and electrocardiographic features of various cardiac disorders may overlap, the differential diagnosis of left ventricular (LV) dysfunction may be difficult even for the most experienced physicians. Recent advances in cardiac imaging may help clinicians to establish an accurate diagnosis and initiate adequate treatment. The aim of this case report is to raise awareness of a very short-lasting LV dysfunction during respiratory infections and to underline the importance of multimodality imaging in this clinical setting. Case outline. A previously healthy 37-year-old male presented with atypical chest pain and ST-segment elevation in the inferolateral leads during severe mental stress and acute respiratory infection. Acute myocardial infarction, myocarditis, coronary vasospasm and stress cardiomyopathy were all considered as a differential diagnosis. A rapid onset of severe LV dysfunction and a complete recovery within 4 days was detected by echocardiography and further evaluated by multimodality imaging, including multislice computed tomography and cardiac magnetic resonance imaging. Conclusion. Severe, but very short-lasting LV dysfunction may be triggered by various causes, including upper respiratory tract infections. Since the symptoms of respiratory infections may obscure those of LV dysfunction, myocardial dysfunction in these patients may go undetected with possible serious consequences.

Changes in left ventricular function and remodeling after myocardial infarction in hypothyroid rats

2010 ◽  
Vol 298 (1) ◽  
pp. H259-H262 ◽  
Author(s):  
Yue-Feng Chen ◽  
Rebecca A. Redetzke ◽  
Suleman Said ◽  
April J. Beyer ◽  
A. Martin Gerdes
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular ◽  
Experimental Myocardial Infarction ◽  
Lv Function ◽  
Sprague Dawley ◽  
Lv Dysfunction ◽  
Long Term Effect ◽  
Sprague Dawley Rats ◽  
Lv Remodeling

It has been shown that hypothyroidism may lead to delayed wound healing after experimental myocardial infarction (MI) in rats and increased infarct size in dogs. However, the long-term effect of hypothyroidism on left ventricular (LV) remodeling after MI has not been determined. Adult female Sprague-Dawley rats with and without surgical thyroidectomy (TX) were used in the study. Four weeks after TX, MI or sham MI was performed on TX and non-TX rats. Rats from all groups were examined 4 wk later. Four weeks after TX, hypothyroid-induced LV dysfunction was confirmed by echocardiography. In terminal experiments 4 wk after MI, TX sham-MI rats showed smaller hearts and impaired LV function compared with non-TX sham-MI controls. TX + MI rats showed smaller hearts with bigger infarct areas, higher LV end-diastolic pressures, and greater impairment of relaxation (−dP/d t) compared with non-TX MI rats. Relative changes after MI between TX and non-TX rats for most other hemodynamic and echocardiographic indexes were similar. These results suggest that preexisting hypothyroidism exaggerates post-MI remodeling and worsens LV function, particularly diastolic function.

Abstract 5907: Development of Left Ventricular Dysfunction During Progression of Infant Right Ventricular Hypertrophy

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Kazuo Kitahori ◽  
Huamei He ◽  
Douglas B Cowan ◽  
Ingeborg Friehs ◽  
Pedro J Nido ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ex Vivo ◽  
Late Complication ◽  
Pressure Overload ◽  
Capillary Density ◽  
Left Ventricular ◽  
Lv Function ◽  
Lv Dysfunction ◽  
Lv Remodeling ◽  
Point Total

Background: Progressive left ventricular (LV) dysfunction can be a major late complication in patients with chronic right ventricular (RV) pressure overload (e.g. tetralogy of Fallot). The mechanisms remains unclear. We therefore examined LV function (serial echocardiography and ex vivo Langendorff) and histology in a model of infant pressure-load RV hypertrophy (RVH). Methods and Results: Ten-day-old rabbits (N=6 per time point, total =48) underwent pulmonary artery banding (PAB), were sacrificed at 2–8 weeks after PAB, and compared to age-matched sham controls. Both RV and LV performance (myocardial performance index, MPI; fractional area change, FAC), measured by echocardiography, decreased during the progression of RVH (Table ). In addition, RVH caused significant septal displacement, reduced septal contractility, and decreased LV end-systolic (LVDs) and diastolic (LVDd) dimensions. Significant septal and LV free wall apoptosis (myocyte-specific TUNEL and activated caspase-3), fibrosis (Masson’s Trichrome), and reduced capillary density (CD31 immunostaining) occurred in the left ventricles of the PAB group after 6 – 8 wks (all p<0.05). Conclusion: This study for the first time shows that pressure overload resulting in RVH causes LV dysfunction by both mechanical and molecular effects upon the septum and LV myocardium. In particular, the development of RVH is associated with septal and LV apoptosis, pathologic LV remodeling, and reduced LV capillary density. Potential mediators and mechanisms (e.g. paracrine vs. circulating stimuli) merit further investigation LV performance during the progression of RVH

A Survey of Speech-Language Pathologists' Approaches to Assessing Social Communication Disorders in Children

2020 ◽  
pp. 1-17
Author(s):  
Kristen Izaryk ◽  
Robin Edge ◽  
Dawn Lechwar
Keyword(s):  
Best Practices ◽  
Communication Disorders ◽  
Assessment Tools ◽  
Self Report ◽  
Speech Language Pathologists ◽  
Teacher Report ◽  
Formal Assessment ◽  
Language Sampling ◽  
Specific Assessment ◽  
Social Communication Disorders

Purpose The purpose of this article is to explore and describe the approaches and specific assessment tools that speech-language pathologists are currently using to assess social communication disorders (SCDs) in children, in relation to current best practices. Method Ninety-four speech-language pathologists completed an online survey asking them to identify which of the following approaches they use to assess children with SCD: parent/teacher report, naturalistic observation, formal assessment, language sample analysis, interviews, semistructured tasks, and peer/self-report. Participants were also asked to identify specific assessment tools they use within each approach. Results Participants most commonly assess SCDs by combining interviews, naturalistic observation, language sampling, parent/teacher report, and formal assessment. Semistructured tasks and peer/self-report tools were less frequently utilized. Several established parent/teacher report and formal assessment tools were commonly identified for assessing SCDs. Most participants use an informal approach for interviews, language sampling, and naturalistic observations in their SCD assessment process. Conclusions Generally, participants follow best practices for assessing SCDs by combining several different approaches. Some considerations for future assessment are identified, including the use of established protocols in the place of informal approaches in order to make the assessment of SCDs more systematic. Future directions for research are discussed.

Urine Albumin to Creatinine Ratio and Echocardiographic Left Ventricular Structure and Function in Patients with Essential Hypertension

2011 ◽  
Vol 9 (2) ◽  
pp. 90 ◽  
Author(s):  
Rohola Hemmati ◽  
Mojgan Gharipour ◽  
Hasan Shemirani ◽  
Alireza Khosravi ◽  
Elham Khosravi ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Peak Velocity ◽  
Left Ventricular ◽  
Lv Function ◽  
Creatinine Ratio ◽  
Uncomplicated Hypertension ◽  
Urine Albumin ◽  
Lv Dysfunction ◽  
Mitral Annulus Velocity ◽  
Lv Mass

Background:Appearance of microalbuminuria, particularly in patients with hypertension, might be associated with a higher prevalence of left ventricular (LV) dysfunction and geometric abnormalities. This study was undertaken to determine whether high urine albumin to creatinine ratio (UACR) as a sensitive marker for microalbuminuria can be associated with LV hypertrophy (LVH) and systolic and diastolic LV dysfunction.Methods:The study population consisted of 125 consecutive patients with essential uncomplicated hypertension. Urine albumin and creatinine concentration was determined by standard methods. LVH was defined as a LV mass index >100 g/m2 of body surface area in women and >130 g/m2 in men. Echocardiographic LV systolic and diastolic parameters were measured.Results:The prevalence of microalbuminuria in patients with essential hypertension was 5.6 %. UACR was significantly no different in patients with LVH than in patients with normal LV geometry (21.26 ± 31.55 versus 17.80 ± 24.52 mg/mmol). No significant correlation was found between UACR measurement and systolic and diastolic function parameters, including early to late diastolic peak velocity (E/A) ratio (R=-0.192, p=0.038), early diastolic peak velocity to early mitral annulus velocity (E/E') ratio (R=-0.025, p=0.794), LV ejection fraction (R=0.008, p=0.929), and LV mass (R=-0.132, p=0.154). According to the receiver operator characteristic (ROC) curve analysis, UACR measurement was not an acceptable indicator of LVH with areas under the ROC curves 0.514 (95 % confidence interval 0.394–0.634). The optimal cut-off value for UACR for predicting LVH was identified at 9.4, yielding a sensitivity of 51.6 % and a specificity of 48.3 %.Conclusion:In patients with uncomplicated essential hypertension, abnormal systolic and diastolic LV function and geometry cannot be effectively predicted by the appearance of microalbuminuria.

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