The CELLWAVE double-blind, randomized, placebo-controlled trial was conducted among patients with CHF treated at Goethe University Frankfurt, Germany, between 2006 and 2011. This was a single-blind study of low-dose (n = 42), high-dose (n = 40), or placebo (n = 21) shock wave pretreatment targeted to the LV anterior wall. Twenty-four hours later, patients receiving shock wave pretreatment were randomized to receive double-blind intracoronary infusion of BMCs or placebo, and patients receiving placebo shock wave received intracoronary infusion of BMCs. The primary endpoint was change in LVEF from baseline to 4 months in the pooled groups shock wave + placebo infusion versus shock wave + BMCs; secondary endpoints included regional LV function assessed by magnetic resonance imaging and clinical events.. ...
PGD is a life-threatening complication of heart transplantation that presents as left, right or biventricular dysfunction occurring within the first 24 hours of transplant surgery for which there is no identifiable secondary cause (see Section 4.8). Severe PGD may be irreversible.. For patients who are on the heart transplant waiting list, consideration should be given to use an alternative antiarrhythmic drug as early as possible before transplant.. Section 4.8. Musculoskeletal and Connective Tissue Disorders:. ...
The diagnosis of idiopathic dilated cardiomyopathy should not be made without first performing a coronary angiogram. If the cause of heart failure is unknown this should be stated rather than attributing the cause to dilated cardiomyopathy. Severe ventricular dysfunction may improve dramatically after revascularisation in some cases of coronary disease. Preservation of R waves on the surface electrocardiogram suggests the presence of hibernating myocardium but thallium scintigraphy or positron emission tomography scanning should be employed to investigate this further.. ...
Cardiac resynchronization therapy (CRT) improves functional classification among patients with left ventricle malfunction and ventricular electric conduction disorders. and a HF group of 42 subjects (53.12 15.05 years, LVEF < 35%) were studied. The proposed classifiers had hit rates of 90%, 50%, and 80% to distinguish between absent, mild, and moderate-severe interventricular dyssynchrony, respectively. For […] ...
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Extracorporal shock wave therapy is performed prior to cell therapy for induction of therapeutic neovascularization and improvement of homing of bone marrow progenitor cells in patients with chronic ischemic heart disease following anterior myocardial infarction.. Shock waves can induce growth factor expression in the ischemic myocardium and might augment homing of autologous bone marrow mononuclear cells which are injected intracoronary 24 h following shock wave therapy ...
The cardiorenal syndrome generally focuses on left ventricular function, and the importance of the right ventricle as a determinant of renal function is described less frequently. In a cohort of critically ill patients with echocardiographic measurements obtained within 24 hours of admission to the intensive care unit, we examined the association of right ventricular function with acute kidney injury (AKI) and AKI-associated mortality. We also examined whether clinical measurement of volume overload modified the association between ventricular function and AKI in a subpopulation with documented admission physical examinations. Among 1879 critically ill patients with echocardiographic ventricular measurements, 43% (n = 807) had ventricular dysfunction-21% (n = 388), 9% (n = 167), and 13% (n = 252) with isolated left ventricular dysfunction, isolated right ventricular dysfunction, and biventricular dysfunction, respectively. Overall, ventricular dysfunction was associated with a 43% higher ...
Figure. QTc interval prolongation and an episode of polymorphic ventricular tachycardia are observed.. The biochemical parameters showed low serum potassium concentrations in 2 cases, whereas calcium and magnesium levels were normal in all patients. In addition, various toxic substances were detected in urine.. The echocardiogram showed severe biventricular dysfunction in 1 of the patients; ventricular function was normal in all others. After methadone was discontinued and magnesium sulfate, isoproterenol perfusion, and potassium supplements were started, polymorphic ventricular tachycardia disappeared within 7 hours of admission. After 2-3 days, methadone treatment was resumed at the usual doses, with the QTc interval progressively returning to normal in 3 cases; the fourth patient requested voluntary withdrawal before the study was completed.. DISCUSSION. Methadone has been widely used for the treatment of heroine addiction and chronic pain for more than 3 decades. It is generally ...
TY - JOUR. T1 - Evaluation of cardiac dyssynchrony with longitudinal strain analysisin 4-chamber cine MR imaging. AU - Kawakubo, Masateru. AU - Nagao, Michinobu. AU - Kumazawa, Seiji. AU - Chishaki, Akiko S.. AU - Mukai, Yasushi. AU - Nakamura, Yasuhiko. AU - Honda, Hiroshi. AU - Morishita, Junji. PY - 2013/12. Y1 - 2013/12. N2 - Purpose: We investigated the clinical performance of evaluation of cardiac mechanical dyssynchrony withlongitudinal strain analysis using four-chamber (4CH) cine magnetic resonance imaging (MRI).Materials and methods: We retrospectively enrolled 73 chronic heart failure patients (41 men, 32 women;mean age, 57 years, NYHA 2, 3, and 4) who underwent a cardiac MRI in the present study. The left ventricu-lar dyssynchrony (LVD) and interventricular dyssynchrony (IVD) indices were calculated by longitudinalstrain analysis using 4CH cine MRI. The LVD and IVD indices were compared by the Wilcoxon rank-sumtest between the patients with indication for cardiac resynchronization ...
Introduction: Liver disease (LD) is a known long-term complication in single ventricle patients who undergo Fontan procedures. Cardiopulmonary exercise test (CPET) variables are known to be associated with increased risk of hospitalization in Fontan patients but their association with liver disease is unknown.. Methods/Results: We retrospectively reviewed medical records from 2 tertiary academic institutions (Central Manchester University Hospitals, UK and University of California San Francisco, USA) and identified 114 adult Fontan patients (,18 years). LD was defined as grade IV fibrosis or cirrhosis on either ultrasound or computed tomographic imaging. Mean age was 30.9 ± 7.4 years, age at Fontan 7.9 ± 7.9 years, 56% were females, 63% underwent total cavopulmonary connection, 66% had New York Heart Association (NYHA) I, 42% had arrhythmias, 22% had systemic right ventricle and 35% had ventricular dysfunction. Of 81 patients with liver imaging data, 33 (41%) had LD. There were no differences ...
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A meta-analysis by Lipinski et al. (5) included 10 of these trials (7 randomized, 3 cohort studies) on intracoronary cell injection (within the first 14 days after infarction), yielding 698 patients, of which 659 were available at follow-up (median follow-up of 6 months). In 2 trials (n = 126), peripheral blood cells were used for intracoronary infusion and in 8 investigations bone marrow-derived cells were used. For the pooled population, Lipinski et al. (5) found a significantly superior improvement in LVEF of 3.0% (95% confidence interval: 1.9% to 4.1%, p , 0.00001) for subjects receiving bone marrow transplantation in comparison with control subjects. Similarly, LV end-systolic volumes were reduced in patients receiving cell therapy by -7.4 ml (95% confidence interval: -12.2 to -2.7 ml, p , 0.002) compared with control subjects. Changes in end-diastolic volumes were not significantly different between groups in this meta-analysis.. Clinical end points, such as death, target vessel ...
In patients with one anatomical or functional ventricular chamber, which encompasses a spectrum of rare and complex congenital cardiac malformations, a staged surgical approach in view of an ultimate Fontan operation has become the procedure of choice. Especially in the earlier era, perioperative mortality was the leading cause of death. However, many patients have a long and high-quality life, continuously improved by a better understanding of Fontan hemodynamics and the refinement of the surgical procedures. Nevertheless, the prospect of eventual failure of the Fontan circulation remains a major concern. More specifically, evaluation of the pulmonary circulation becomes particularly important as the failing Fontan circulation has become a common indication for cardiac transplantation. Although essential, especially in the preoperative setting, a comprehensive evaluation of the pulmonary circulation remains difficult in this patient population. Our global hypothesis is that the absence of ...
SAN REMO, Italy (VN) - Colombian rider Carlos Quintero will spend the night in an Italian hospital after suffering a concussion, but he is not facing life-threatening injuries in the wake of a nasty fall in Milan-San Remo.. For a few moments Saturday afternoon it looked like cycling was facing another worst-case scenario when the Colombia-Coldeportes rider crashed heavily on the descent of Le Mànie. Television images of doctors hurriedly treating the Coldeportes rider brought back the horrible images of last years Giro dItalia, when Wouter Weylandt died during a similar high-speed fall.. There was no official word from the team, but race officials confirmed that Quintero suffered a concussion and momentarily lost consciousness in the wake of his crash.. He was later transported to a hospital where a CT scan ruled out any serious brain injury. X-rays revealed a fracture to his left cheekbone and shoulder blade and a contusion to his left lung. Doctors are keeping him in the hospital overnight ...
Introduction: Experiments in dogs with left bundle branch block (LBBB) showed a strong relation between electrical (QRS-vector amplitude, QRSVampl) and mechanical interventricular dyssynchrony. We investigated this relation in patients with previously implanted devices for cardiac resynchronization therapy (CRT) using echocardiography and vectorcardiography.. Methods: To induce different degrees of left (LV) and right ventricular (RV) pre-excitation, single site LV pacing at many AV-delays was performed in 20 LBBB patients in sinus rhythm, and biventricular pacing at many VV-delays in 18 patients with complete AV-block. At all pacing settings 3D-vectorcardiograms and echocardiograms were recorded. QRSVampl was defined negative when the spatial vector direction differed ,90° from LBBB or RV-pacing. Interventricular mechanical dyssynchrony (IVMD) was determined from Doppler recordings and septal strain from speckle tracking. Septal systolic rebound stretch (SRS) and pre-stretch (SPS) were ...
In acute myocardial infarction (AMI), both tissue necrosis and edema are present and both might be implicated in the development of intraventricular dyssynchrony. However, their relative contribution to transient dyssynchrony is not known. Cardiovascular magnetic resonance (CMR) can detect necrosis and edema with high spatial resolution and it can quantify dyssynchrony by tagging techniques. Patients with a first AMI underwent percutaneous coronary interventions (PCI) of the infarct-related artery within 24 h of onset of chest pain. Within 5-7 days after the event and at 4 months, CMR was performed. The CMR protocol included the evaluation of intraventricular dyssynchrony by applying a novel 3D-tagging sequence to the left ventricle (LV) yielding the CURE index (circumferential uniformity ratio estimate; 1 = complete synchrony). On T2-weighted images, edema was measured as high-signal (|2 SD above remote tissue) along the LV mid-myocardial circumference on 3 short-axis images (% of circumference
To the best of our knowledge, this is the first clinical report to analyze the urinary levels of biopyrrins in patients with HF. The present study provides clinical evidence that the urinary levels of biopyrrins/creatinine are changed in association with both NYHA functional class and plasma levels of BNP.. Recently, increases in plasma biochemical markers of oxidative stress have been reported in patients with HF (17,18). There is a definitive correlation between oxidative stress and ventricular dysfunction (2,4). Furthermore, ventricular remodeling and progressive dilation leading to end-stage HF may be mediated by oxygen-derived free radicals (2,4). Therefore, it is likely that ROS are involved in not only the pathogenesis but also the active progression of HF (3-6). In an attempt to prevent the production of oxidants, as well as to ameliorate and repair oxidative tissue damage, detoxification systems are present in vivo and comprise both enzymatic and nonenzymatic antioxidant compounds. ...
Left Ventricular Dysfunction - Market Insights, Epidemiology and Market Forecast - 2025 is a market research report available at US $5750 for a Single User PDF License from RnR Market Research Reports Library.
Methods and Results:. Pre-Fontan catheterisation data and Fontan pressure measured at the completion were retrospectively collected. Pre-Fontan data were used to calculate the predicted pressure in the Fontan system. The predicted values were compared to the Fontan pressure measured at the Fontan completion and with the needs for fenestration. One hundred twenty-four Fontan patients were retrospectively enrolled (At Fontan: median age 30.73 [24.70-37.20] months, median weight 12.00 [10.98-14.15] kg). Fontan conduit was fenestrated in 78 patients. A poor correlation (r2 = 0.05128) between the measured and predicted data for non-fenestrated patients was observed. In the case of Fontan-predicted pressure ,17.59 mmHg, the formula identified a good short-term clinical outcome with a sensitivity of 92%. ...
Left ventricular dysfunction is a major determinant of outcome in coronary artery disease.1 However, not all dyssynergic areas are irreversibly damaged after infarction, as left ventricular dysfunction may be caused by myocardial stunning2 or by chronic reduction of blood flow,3 and the segments involved may show improved function after restoration of blood flow.4 Preservation of metabolism despite reduced function is the cornerstone of viable myocardium, but ultrastructural changes have been documented in viable tissue, including loss of sarcoplasmic reticulum, small scattered mitochondria, and glycogen deposition.5 These changes suggest a reduction in aerobic metabolism, but glucose uptake and utilisation are preserved and indeed have been used as a diagnostic marker of viability.6. Because of co-morbidity, myocardial revascularisation may be difficult to achieve in many patients with left ventricular dysfunction and viable myocardium. In these situations, medical treatment to improve left ...
ARLINGTON -- Astros catcher Humberto Quintero had seen enough fowl play. "It was taking too long," he said. Quintero was on deck in the ninth inning of Sundays game against the Rangers when a curious bird landed near home plate for the second time in a matter of minutes. Astros batter Chris Johnson tried to shoo it away with his bat and plate umpire Mike Reilly couldnt get it to budge, either. Thats when Quintero took over, approaching the bird and gently picking it up with both hands. He placed it in a camera well at the end of the first-base dugout, drawing cheers from the crowd. "We have birds in Venezuela," said Quintero, who likes to hunt and was wearing batting gloves. "Why were people scared? We have a lot of birds in Venezuela. I got it and put it away. I didnt want to wait 30 minutes for the bird to go away." Johnson was impressed with Quinteros bird-handling ability. "It looked like hes done that before," Johnson said. "Thats not something you see every day, so I was just trying ...
Septic myocardial dysfunction is a well recognised contributor to shock in sepsis but for many of us we assume this to be gross systolic impairment. Interestingly a recent study highlights that patients with severe sepsis and septic shock frequently have diastolic dysfunction1. They found that diastolic dysfunction was the strongest independent predictor of early mortality, even after adjusting for the APACHE-II score and other predictors of mortality.. In this study, 9.1% of severe sepsis/septic shock patients had isolated systolic dysfunction, 14.1% had combined systolic and diastolic dysfunction, and 38% had isolated diastolic dysfunction.. Importantly, the authors point out that although diastolic dysfunction is associated with age, hypertension, diabetes mellitus, and ischaemic heart disease, diastolic dysfunction is a stronger independent predictor of mortality than age and the other co-morbidities. However, a limitation of the study acknowledged by the authors is that it did not include ...
This page includes the following topics and synonyms: Systolic Dysfunction, Left Ventricular Dysfunction, Left Ventricular Failure, Systolic Heart Failure, Left Ventricular Systolic Dysfunction, Heart Failure with Reduced Ejection Fraction.
This St. Patricks Day, skip the green-tinged beer and instead drink to your health with this green smoothie created by Teresa Quintero, Wilcox Memorial Hospital clinical registered dietitian.. "Smoothies can be an easy way to get more fruits and vegetables into your diet," says Quintero. "They can be used as a snack, or they can replace a meal if youre in a rush so you dont skip it. They can even make for excellent recovery fuel post workouts.". Quintero came up with this green smoothie as a deliciously sneaky way to pack more calories and nutrients into her 7-year-olds diet.. "This green smoothie is definitely kid approved! It is an excellent source of vitamins A and C, iron, and is a good source of calcium," she says.. But be careful with your ingredients, and watch those portions!. Quintero advises using a green, leafy vegetable - such as kale, spinach or lettuce - as your base and building on with fruits, nuts, seeds and other add-ons sparingly.. A low-fat, low-sugar milk alternative, ...
Quartersnacks have re-edited a bunch of random seen and unseen footage of Zered Bassett this week featuring footage filmed by R.B. Umali, Joe Bouillot, Jason Jenkins, Steve Marino and Richard Quintero. "Just think of it as a post-State of Mind part." Press play for Edit of the Week.. ...