Assessment of right ventricular function in advanced heart failure with nonischemic dilated cardiomyopathy: insights of right ventricular elastance

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 A total of 68 patients (mean age 64 ± 7 years, 82% men) were eligible. After adjustments, R-Elv and P-Ea were higher in isolated postcapillary-pulmonary hypertension (Ipc-PH) than combined-pulmonary hypertension (Cpc-PH) (P = 0.004 and P = 0.002, respectively), whereas R-V/A progressively decreased over Ipc-PH and Cpc-PH (P = 0.006). According to PAPm increment, P-Ea congruently increased (P-Trend = 0.028), R-Elv progressively decreased (P-Trend
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Heart failure Source Type: research

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In this study we aimed to evaluate management strategies in our pediatric cardiac transplantation candidates with PH and high PVR prior to OHT. METHOD: Twenty-six cardiac transplantation candidates (age: 10.2 ± 4.6, 1-17 years) underwent cardiac catheterization for the determination of PVR and pulmonary arterial pressure. They were admitted to the hospital and received 1-3 days of intravenous (IV) vasodilator therapy; 0.5-3 μg/kg/min nitroglyserin and/or 0.5-3 μg/kg/min nitroprusside, 5-15 μg/kg/min dobutamin and/or dopamin to keep systolic blood pressure above 80 mmHg. RESULTS: Thirteen patients ...
Source: The Turkish Journal of Pediatrics - Category: Pediatrics Authors: Tags: Turk J Pediatr Source Type: research
Conclusion: Mitofusin 2 promotes Parkin translocation and phosphorylation, leading to mitophagy to clear damaged mitochondria. However, the beneficial effects of MFN2 were reversed by autophagy inhibitors. Additionally, MFN2 participates in mitochondrial fusion to maintain mitochondrial quality. Thus, MFN2 participated in mitophagy and mitochondrial fusion against Ang II-induced cardiomyocyte injury. Introduction Ventricular remodeling is the core foundation for the development of heart failure (Hill and Olson, 2008). Pathological remodeling is typically due to a number of causes that result in increased pressure o...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Publication date: February 2019Source: JACC: Heart Failure, Volume 7, Issue 2Author(s): Sebhat Erqou, Bereket Tessema Lodebo, Ahmad Masri, Ahmed M. Altibi, Justin B. Echouffo-Tcheugui, Anastase Dzudie, Feven Ataklte, Gaurav Choudhary, Gerald S. Bloomfield, Wen-Chih Wu, Andre Pascal KengneAbstractObjectiveTo synthesize existing epidemiological data on cardiac dysfunction in HIV.BackgroundData on the burden and risk of human immunodeficiency virus (HIV) infection-associated cardiac dysfunction have not been adequately synthesized. We performed meta-analyses of extant literature on the frequency of several subtypes of cardiac...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
In conclusion, prolonged AI and/or LS infusions in HF are safe and beneficial even in small infants, allowing stabilization and reasonable social and family life out of the hospital. It may provi de precious time for heart transplantation or myocardial remodeling, improvement, and possible discontinuation even after long periods of support.
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
A 29-year-old female with a history of peripartum dilated cardiomyopathy with left ventricular ejection fraction 25%, hypertension, obstructive sleep apnea, and pulmonary hypertension was admitted to the hospital in acute decompensated heart failure and acute on chronic renal failure. She was initiated on dobutamine at 2.5  μg/kg/min intravenously and developed a regular narrow complex tachycardia at 210 beats per minute. This was determined to be an atrial tachycardia with 1:1 atrioventricular conduction.
Source: Journal of Electrocardiology - Category: Cardiology Authors: Source Type: research
In conclusion, HIMF has a critical role in the development of cardiac hypertrophy, and targeting HIMF may represent a potential therapeutic strategy.
Source: Hypertension - Category: Cardiology Authors: Tags: Heart Failure, Hypertrophy Original Articles Source Type: research
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
The final therapy of ‘end-stage heart failure’ is orthotopic heart, lung or heart-lung transplantation. However, these options are not available for many patients worldwide. Therefore, novel therapeutical strategies are needed. Based on pathophysiological insights regarding (1) the long-term impact of an obstructive pulmonary outflow tract in neonates with congenitally corrected transposition of the great arteries, (2) the importance of a restrictive versus a non-restrictive atrial septum in neonates born with a borderline left ventricle and (3) the significance of both, a patent foramen ovale and/or open ductu...
Source: Heart - Category: Cardiology Authors: Tags: Open access, Review articles Reviews Source Type: research
Here is all you wanted to know about alternans: Traube’s pulse, total pulsus alternans, diastolic pulsus alternans, right ventricular pulsus alternans, biventricular pulsus alternans and electrical alternans! Traube’s pulse – pulsus alternans Pulsus alternans or Traube’s pulse was described by Ludwig Traube in 1872 [1]. Pulsus alternans is nothing but alternating pulses having different volumes and is a feature of left ventricular dysfunction. It is well known that pulsus alternans can be augmented by a premature ventricular contraction [2]. A rare case of pulsus alternans due to 2:1 left bundl...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology biventricular pulsus alternans Brody's effect diastolic pulsus alternans electrical alternans right ventricular pulsus alternans total pulsus alternans Traube's pulse Source Type: blogs
Abstract In pediatric heart transplantation, the size of the donor organ is an important criterion for organ allocation. Oversized donor hearts are often accepted with good results, but some complications in relation to a high donor‐recipient ratio have been described. Our patient was transplanted for progressive heart failure in dilated cardiomyopathy. The donor‐to‐recipient weight ratio was 3 (donor weight 65 kg, recipient weight 22 kg). The intra‐operative echocardiography before chest closure showed excellent cardiac function, no tricuspid valve regurgitation, and a normal central venous pressure. Aft...
Source: Pediatric Transplantation - Category: Transplant Surgery Authors: Tags: Case Report Source Type: research
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