Myocardial work is a predictor of exercise tolerance in patients with dilated cardiomyopathy and left ventricular dyssynchrony

AbstractThe assessment of myocardial work (MW) by pressure –strain loops is a recently introduced tool for the assessment of myocardial performance. Aim of the present study is to evaluate the relationship between myocardial work and exercise tolerance in patients with dilated cardiomyopathy (DCM). 51 patients with DCM (mean age 57 ± 13 years, left v entricular ejection fraction: 32 ± 9%) underwent cardiopulmonary exercise test (CPET) to assess exercise performance. 22 patients (43%) had left or right bundle branch block with QRS duration >  120 ms. Trans-thoracic echocardiography (TTE) was performed before CPET. The following indices of myocardial work (MW) were measured regionally and globally: constructive work (CW), wasted work (WW), and work efficiency (WE). Left ventricular dyssynchrony (LV-DYS) was defined by the presence of septal flash or apical rocking at TTE. LV-DYS was observed in 16 (31%) patients and associated with lower LV ejection fraction (LVEF), lower global and septal WE, and higher global and septal WW. In patients with LV-DYS, septal WE was the only predictor of exercise capacity at multivariable analysis (β = 0.68, p = 0.03), whereas LVEF (β = 0.47, p = 0.05) and age (β = − 0.42, p = 0.04) were predictors of exercise capacity in patients without LV-DYS. In patients with DCM, LV-DYS...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research

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Aims: One-third of DCM patients experience ventricular tachycardia (VT), but a clear biological basis for this has not been established. The purpose of this study was to identify transcriptome signatures and enriched pathways in the hearts of dilated cardiomyopathy (DCM) patients with VT.Methods and Results: We used RNA-sequencing in explanted heart tissue from 49 samples: 19 DCM patients with VT, 16 DCM patients without VT, and 14 non-failing controls. We compared each DCM cohort to the controls and identified the genes that were differentially expressed in DCM patients with VT but not without VT.
Source: Journal of Molecular and Cellular Cardiology - Category: Cytology Authors: Source Type: research
AbstractCurrent echocardiography techniques have allowed more precise assessment of cardiac structure and function of the several types of cardiomyopathies. Parameters derived from echocardiographic tissue imaging (ETI) —tissue Doppler, strain, strain rate, and others—are extensively used to provide a framework in the evaluation and management of cardiomyopathies. Generally, myocardial function assessed by ETI is depressed in all types of cardiomyopathies, non-ischemic dilated cardiomyopathy (DCM) in particular . In hypertrophic cardiomyopathy (HCM), ETI is useful to identify subclinical disease in family membe...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
We report a rare case of rhinovirus infection in a patient with myocarditis leading to dilated cardiomyopathy. Infection is an established cause of myocarditis. Prodromal “flu-like” symptoms in a young patient with unexplained heart failure should raise concern for viral myocarditis. Diagnosis is often made by clinical presentation and not by endomyocardial biopsy due to invasiveness. Polymerase chain reaction is a rapid test that supports the diagnosis and may elucidate the role of the virus in myocarditis. Defining causes and mechanisms leading to this severe cardiovascular condition may prove critical to tar...
Source: IDCases - Category: Infectious Diseases Source Type: research
We examined the correlates of R-V/A and traditional echocardiographic indices of RVSD, over the spectrum of pulmonary hypertension and tertiles of mean pulmonary artery pressures (PAPm). Methods In 2016–2017, we studied 81 consecutive patients for heart transplant/advanced heart failure. Inclusion criteria were NIDCM, reduced ejection fraction (≤40%) and sinus rhythm. R-V/A was computed as the RV/pulmonary elastances ratio (R-Elv/P-Ea), derived from a combined right heart catheterization/transthoracic- echocardiographic assessment [right heart catheterization/transthoracic-echocardiographic (RHC/TTE)]. Results...
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Heart failure Source Type: research
Conclusion: In this study, the significant difference between the electrocardiographic data of deceased and surviving dilated cardiomyopathy patients suggests that electrocardiographic data should be evaluated in detail in order to determine the low and high risk of mortality in patients with dilated cardiomyopathy.What is Known:•Previous studies on the relationship between limited electrocardiography data of adult patients diagnosed with DCM and mortality have been determinedWhat is New:•ECG data has not been investigated in such detail in child DCM patients,as in our study.
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
Conclusions: The degradation of cytokine mRNA by Regnase-1 in cardiomyocytes plays an important role in restraining sterile inflammation in failing hearts and the Regnase-1-mediated pathway might be a therapeutic target to treat patients with heart failure. PMID: 31931613 [PubMed - as supplied by publisher]
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
We examined frequency, clinical characteristics and AF‐related management and outcomes amongst this patient population.MethodsWe retrospectively studied consecutive probands with inherited cardiomyopathy (n=962) and inherited arrhythmia syndromes (n=195) evaluated between 2002 ‐2018.ResultsAF was observed in 5 ‐31% of patients, with the highest frequency in HCM. Age of AF onset was 45.8 ± 21.9 years in the inherited arrhythmia syndromes compared to 53.3 ± 15.3 years in the inherited cardiomyopathies, with 4 CPVT patients developing AF at median age of 20 years. Overall, 11% of patients with AF had a t r...
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
AbstractIndications of cardiac resynchronization therapy (CRT) do not include exercise ‐induced left bundle branch block, but functional impairment could be improved with CRT in such cases. A 57‐year‐old woman with idiopathic dilated cardiomyopathy (ejection fraction 23%) presented with New York Heart Association Class IV and recurrent hospitalizations. During heart transplant e valuation, a new onset of intermittent left bundle branch block was observed on the cardiopulmonary exercise test. CRT was implanted, and 97% resynchronization rate was achieved. In 12 month follow‐up, both clinical and prognostic exercise ...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Case Report Source Type: research
AbstractIn humans, it is acknowledged that dilated cardiomyopathy is also caused by infection-induced myocarditis. To evaluate whether the occurrence of lesions of dilated cardiomyopathy in cattle may be triggered by myocarditis, an adult Holstein-Friesian dairy cow which showed dilated cardiomyopathy associated with myocarditis was examined by histopathology. Traumatic pericarditis or idiopathic congestive heart failure was clinically suspected, and the animal was culled because of unfavorable prognosis. Histopathological examination revealed an intrinsic cardiomyopathic lesion that overlapped with myocarditis. Cardiomyoc...
Source: Comparative Clinical Pathology - Category: Pathology Source Type: research
Conditions:   Cardiomyopathy, Dilated;   Cardiomyopathy, Hypertrophic;   Insulin Resistance Intervention:   Diagnostic Test: Oral glucose tolerance test Sponsor:   Le Bonheur Children's Hospital Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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