1,720,973 research outputs found
TakoTsubo secondary to acute kidney disease
Full text linkWe report the case of a 62-year-old man who was admitted to the Cardiac Department for TakoTsubo and ACC by torsades de point, secondary to acute kidney disease. We decide to discharge with a portable defibrillator. One month after cardiac magnetic resonance showed a complete recovery of left ventricular function
Rapid progression of pulmonary artery dilatation in pulmonary hypertension
No full textWe report the case of a 47-year-old woman who was admitted to the cardiac department for worsening dyspnea. The last chest computed tomography (CT) showed a rapid increase in pulmonary artery dimension (65 mm in 2019, 76 mm in 2021). The symptoms reported by the patient were due to important extrinsic compression of the left main coronary artery (LMCA). In this case, it is very difficult to choose the best therapeutic strategy. In the end, we decided to treat the left main coronary for prevention. After 3 months no new clinical symptoms have developed
Quality of life in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation: tools and evidence
No full text: Aortic stenosis is the most prevalent valvular heart disease requiring intervention, especially in the elderly population. Surgical aortic valve replacement and transcatheter aortic valve implantation (TAVI) are well established treatment options for symptomatic patients with severe aortic stenosis, as they provide a significant survival benefit. Aortic stenosis may have an important impact on patients' quality of life (QoL). However, advanced age, comorbidities and frailty may limit the beneficial effect of aortic stenosis interventions in terms of QoL. Current guidelines mention the importance of frailty and avoiding the futility of interventions, but lack specific indications about decision-making. Also, there are limited data on how to specifically assess QoL in aortic stenosis patients since the most used questionnaires are validated in different populations (i.e. heart failure). The aim of this review is to summarize all the available tools for QoL assessment in patients with aortic stenosis; to report current evidence on the impact of TAVI on QoL; and to discuss the role of frailty and comorbidities in this setting
Varicella zoster virus and cardiovascular diseases
No full textVaricella zoster virus (VZV) is a Herpesviridae family double-stranded DNA virus that only affects humans. The first clinical manifestation appears to be varicella, typical of childhood. VZV, on the other hand, becomes latent in ganglion neurons throughout the neuroaxis after primary infection. The VZV reactivates and travels along peripheral nerve fibers in the elderly and immunocompromised individuals, resulting in Zoster. It can, however, spread centrally and infect cerebral and extracranial arteries, resulting in vasculopathy, which can lead to transient ischemic attacks, strokes, aneurysms, cavernous sinus thrombosis, giant cell arteritis, and granulomatous aortitis. Although the mechanisms of virus-induced pathological vascular remodeling are not fully understood, recent research indicates that inflammation and dysregulation of ligand-1 programmed death play a significant role. Few studies, on the other hand, have looked into the role of VZV in cardiovascular disease. As a result, the purpose of this review is to examine the relationship between VZV and cardiovascular disease, the efficacy of the vaccine as a protective mechanism, and the target population of heart disease patients who could benefit from vaccination
Impact of SGLT2 inhibitors on endothelial function and echocardiographic parameters in dilated cardiomyopathy
No full textBackground: Dilated cardiomyopathy (DCM) is a common cause of heart failure with reduced ejection fraction (HFrEF) in industrialized countries and a major contributor to morbidity and mortality. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated significant benefits in HFrEF management; however, their impact on endothelial function in this patient population remains less explored. This study aims to evaluate the effects of SGLT2i on endothelial function and echocardiographic parameters in patients with DCM. Methods: This observational, longitudinal, monocentric study enrolled patients with DCM and HFrEF. Endothelial function was assessed using peripheral arterial tonometry (EndoPAT) at baseline, 6 months, and 12 months following the initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i). The enrollment period spanned from November 2021 to November 2022. The primary endpoint was the change in reactive hyperemia index (RHI) over time. In addition, a subgroup analysis was conducted to compare the effects of different SGLT2i agents (empagliflozin vs. dapagliflozin) and DCM etiology (ischemic vs. idiopathic) on endothelial function. Results: A total of 102 patients were included, predominantly male (72%), with a median age of 75 years and an average baseline left ventricular ejection fraction (LVEF) of 32.9 ± 7.9%. NYHA class II/III was observed in 76% of participants, and ischemic etiology accounted for 53% of DCM cases. The baseline RHI value was 1.15 ± 0.34. At 6 months, it significantly increased to 1.40 ± 0.34 (P < 0.0001), reflecting an absolute change of 0.25 ± 0.03 (ΔRHI baseline - 6 months). Between 6 and 12 months, the RHI showed a further significant increase to 1.69 ± 0.36 (P < 0.0001), with an additional change of 0.29 ± 0.03 (ΔRHI 6 - 12 months). The overall change in RHI from baseline to 12 months (ΔRHI baseline - 12 months) was 0.54 ± 0.04 (P < 0.0001). No significant differences in RHI were observed between patients treated with dapagliflozin and those receiving empagliflozin (P = 0.589), nor between different DCM etiologies (ischemic vs. idiopathic, P = 0.463). The enhancement in RHI was associated with a reduction in the incidence of hospitalization for heart failure (AUC 0.783, P < 0.001). Progressive improvement in left ventricular function was observed through echocardiographic parameters. Although EDV and ESV showed a decreasing trend (EDV: 176.2 ± 64.9 to 167.6 ± 31.1 ml, P = 0.335; ESV: 124.5 ± 52.7 to 116.8 ± 24.6 ml, P = 0.606), these changes were not statistically significant. LVEF improved significantly from 32.9 ± 7.9% at baseline to 36.8 ± 5.5% at 6 months and 37.1 ± 4.9% at 12 months (P < 0.001). The E/A ratio declined from 1.5 ± 0.5 to 1.1 ± 0.3 (P = 0.023) and the E/E' ratio decreased from 18.1 ± 5.1 to 11.1 ± 2.8 (P = 0.027).Left atrial volume significantly decreased from 108 to 100 ml (P = 0.041), and pulmonary artery systolic pressure dropped from 44 to 39 mmHg at 6 months and 35 mmHg at 12 months (P < 0.001). Conclusion: SGLT2i therapy significantly improves endothelial function in patients with DCM suggesting a potential vascular benefit beyond their well established cardioprotective effects
Syncopal Recurrence in Patients Treated With Dual Chamber Pacemaker for Reflex Syncope With Asystole
No full textRight ventricle assessment before tricuspid valve interventions
No full textIn the latest ESC/EACTS Guidelines for the Management of Valvular Heart Disease, right ventricular dilatation and dysfunction, severe pulmonary hypertension and tricuspid annulus dilatation were reported to be the most important parameters to consider in patient selection for tricuspid valve interventions. Indeed, comprehensive right ventricular assessment is crucial in patients with severe tricuspid regurgitation who may benefit from transcatheter or surgical procedures. However, the only guideline parameter considered for intervention has been tricuspid annular dilatation in the presence of at least mild to moderate tricuspid regurgitation, with no other right ventricular markers used in the decision-making process for invasive treatment. Notably, challenges in the assessment of right ventricular function may limit establishing thresholds for defining right ventricular dysfunction. The aim of this review is to summarize current evidence on the prognostic significance of right ventricular function in patients with tricuspid regurgitation undergoing percutaneous or surgical interventions
COVID myocarditis: a review of the literature
Full text linkMyocarditis is a potentially fatal complication of coronavirus disease 2019 (COVID‐19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) virus. COVID‐19 myocarditis appears to have distinct inflammatory characteristics that distinguish it from other viral etiologies. COVID‐19 myocarditis can present with symptoms ranging from dyspnea and chest pain to acute heart failure and death. It is critical to detect any cases of myocarditis, especially fulminant myocarditis, which can be characterized by signs of heart failure and arrhythmias. Serial troponins, echocardiography, and electrocardiograms should be performed as part of the initial workup for suspected myocarditis. The second step in detecting myocarditis is cardiac magnetic resonance imaging and endomyocardial biopsy. Treatment for COVID‐19 myocarditis is still debatable; however, combining intravenous immunoglobulins and corticosteroids may be effective, especially in cases of fulminant myocarditis. Overall, more research is needed to determine the incidence of COVID‐19 myocarditis , and the use of intravenous immunoglobulins and corticosteroids in combination requires large randomized controlled trials to determine efficacy. The purpose of this review is to summarize current evidence on the subject.
This review aims to summarise current evidence on this topic
Cardiac biomarkers and mortality in COVID-19 infection: A review
No full textLots of meta-analysis emphasize that a great number of hospitalized patients with moderate and severe forms of COVID-19 developed acute myocardial damage, defined as an increase of cardiac biomarkers, such N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), creatine kinase-myocardial band (CK-MB) and of all type of troponins. The highest mortality rate is related with progressively increasing biomarkers levels and with a history of cardiovascular disease. In fact, the biomarkers dosage should be considered as a prognostic marker in all patients with COVID-19 disease at admission, during hospitalization and in the case of clinical deterioration. The purpose of this review is to evaluate cardiovascular prognostic factors in COVID-19 disease throughout the analysis of cardiac biomarkers to early identify the most serious patients and to optimize their outcomes
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