Expanding benefits from cardiac resynchronization therapy to exercise ‐induced left bundle branch block in advanced heart failure
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 parameters improved. In patients with heart failure with r educed ejection fraction and no left bundle branch block at rest, exercise test can uncover electromechanical dyssynchrony that may benefit from CRT.
We present a case of recurrent ventricular tachycardia in a patient with dilated cardiomyopathy caused by a novel mutation of LMNA gene. Through electroanatomic mapping, catheter ablation and tissue pathology we provide detailed insights into this highly pathogenic inherited cardiomyopathy.
Authors: Yazaki M, Nabeta T, Inomata T, Ako J Abstract A 44-year-old man diagnosed with idiopathic dilated cardiomyopathy was admitted to our hospital with acute decompensated heart failure. Seven years before this admission, the first introduction of medication resulted in left ventricular (LV) recovery, which was sustained for several years. However, the patient stopped taking his medication, resulting in worsening of the LV function. Despite the second introduction of medication, the LV function did not improve. We performed cardiac magnetic resonance imaging and an endomyocardial biopsy, which revealed the sign...
A 41-year-old man, with a history ACC/AHA stage C heart failure with reduced ejection fraction secondary to idiopathic dilated cardiomyopathy, presented at the HF clinic for follow-up visits, status post hospitalization due to acute decompensated heart failure in March 2019. After the initiation of milrinone during the hospitalization, two attempts to wean off milrinone were made but failed due to malperfusion and symptomatic hypotension with significant drops of the cardiac index to 1.3 L/min/m2 and 1.76 L/min/m2, respectively.
AbstractBarth syndrome (BTHS) is a rare, X-linked recessive, infantile-onset debilitating disorder characterized by early-onset cardiomyopathy, skeletal muscle myopathy, growth delay, and neutropenia, with a worldwide incidence of 1/300,000 –400,000 live births. The high mortality rate throughout infancy in BTHS patients is related primarily to progressive cardiomyopathy and a weakened immune system. BTHS is caused by defects in the TAZ gene that encodes tafazzin, a transacylase responsible for the remodeling and maturation of the mi tochondrial phospholipid cardiolipin (CL), which is critical to normal mitochondrial...
Abstract The clinical presentation of idiopathic dilated cardiomyopathy (IDCM) heart failure (HF) patients who will respond to medical therapy (responders) and those who will not (non-responders) is often similar. A machine learning (ML)-based clinical tool to identify responders would prevent unnecessary surgery, while targeting non-responders for early intervention. We used regional left ventricular (LV) contractile injury patterns in ML models to identify IDCM HF non-responders. MRI-based multiparametric strain analysis was performed in 178 test subjects (140 normal subjects and 38 IDCM patients), calculating l...
We report a case of a 30-year-old man who presented with advanced heart failure secondary to dilated cardiomyopathy. The patient was diagnosed with limb girdle muscular dystrophy type 2B (LGMD2B), a rare autosomal recessive disease. Cardiomyopathy is only rarely described in dysferlinopathies.
An estimated 3.1 million cases of myocarditis/cardiomyopathy were diagnosed in 2017. Myocarditis, inflammation of the myocardium, is a leading cause of sudden death from heart failure in children and young adults worldwide. Patients can progress to dilated cardiomyopathy, heart and heart transplant. Studies have found that Vitamin D binding protein (DBP) could be instrumental in response to tissue injury and activation of the immune response. This chemotaxis activation has been shown to be due to activation of the complement cascade via C5a.
to investigate prevalence, predictors, prognostic value of left ventricular reverse remodeling (LVRR) and relapse in patients hospitalized with dilated cardiomyopathy (DCM) from the initial center of heart failure (HF) in China.
Dilated cardiomyopathy (DCM) is a common cause of heart failure (HF). Goal Directed Medical Therapy (GDMT) for HF has been shown to improve mortality and morbidity but rate of myocardial recovery is not well known.