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Stereotactic arrhythmia radioablation for intramural basal septal ventricular tachycardia originating near the His bundle.

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… Two separate LV summit origin VTs were induced with programmed stimulation and successfully treated with radiofrequency (RF) ablation at the LV endocardium directly adjacent to the aortic valve ( Figures 1 B–D). … Extensive pace mapping was performed from the RV and LV endocardium, and from the intramural septal perforator coronary arteries. …

Detection of viral SARS-CoV-2 genomes and histopathological changes in endomyocardial biopsies.

AIMS: Since December 2019, the novel coronavirus SARS-CoV-2 has spread rapidly throughout China and keeps the world in suspense. Cardiovascular complications with myocarditis and embolism due to COVID-19 have been reported. SARS-CoV-2 genome detection in the heart muscle has not been demonstrated so far, and the underlying pathophysiological mechanisms remain to be investigated. METHODS AND RESULTS: Endomyocardial biopsies (EMBs) of 104 patients (mean age: 57.90 ± 16.37 years; left ventricular ejection fraction: 33.7 ± 14.6%, sex: n = 79 male/25 female) with suspected myocarditis or unexplain

Systemic activation of integrin alphaVbeta3 in donors with spontaneous intracerebral hemorrhage is associated with subsequent development of vasculopathy in the heart transplant recipient.

BACKGROUND: Recipients of hearts from donors with spontaneous intracerebral hemorrhage (ICH) are at increased risk of allograft vasculopathy compared with trauma donors. We have recently shown that the vitronectin receptor (integrin alpha(V)beta3) is upregulated in transplant vasculopathy. We hypothesized that donor ICH is associated with systemic activation of alpha(V)beta3 in the donor before transplantation. METHODS: We evaluated mRNA expressions of alpha(V)beta3 (TaqMan PCR) in endomyocardial biopsy samples at 1-week post-transplant in 20 recipients from ICH donors and 20 recipients from

Effects of oral pretreatment with metoprolol on left ventricular wall motion, infarct size, hemodynamics, and regional myocardial blood flow in anesthetized dogs during thrombotic coronary artery occlusion and reperfusion.

OBJECTIVES: To study the effects of oral pretreatment with metoprolol over 3 days on hemodynamics, left ventricular function, regional myoca … 16, 0.08 +/- 0.06, and 0.06 +/- 0.07 (p > or = 0.04) in the placebo-treated dogs. The ratio of flow endocardium/epicardium was higher (p > or = 0.02) in the active treatment group during the control period, both in the area at risk and circumflex territory; this was also the case in the circumflex territory at the end of the experiment (p = 0.003). Thirty min …

Paroxysmal beta-adrenergic receptor-mediated alterations in ventricular repolarization at rapid heart rates during inhibition of delayed rectifier currents.

The contribution of the slow component of the delayed rectifier current (IKs) to ventricular repolarization is increased during rapid heart rates and prolonged repolarization. The objective was to characterize physiologically relevant paroxysmal beta-adrenergic receptor-mediated alterations on ventricular repolarization under these conditions. Paced guinea pig hearts were perfused with (1) control, (2) sparfloxacin (IKr inhibitor), or (3) sparfloxacin and HMR 1556 (IKs inhibitor). The mean +/- standard error of the mean epicardial action potential duration at 90% repolarization (APD90) increas

Successful treatment of cardiogenic shock caused by humoral cardiac allograft rejection.

The progress of immunosuppressive therapy has made heart transplantation the standard therapy for end-stage heart failure. However, humoral rejection of the cardiac allograft is still a challenging problem associated with high incidence of graft loss and patient mortality. The present patient developed profound cardiogenic shock requiring extracorporeal life support on the 8th day after heart transplantation. Endomyocardial biopsy revealed no cellular rejection, and complement component C4d was positively stained on the capillary endothelium. The patient was successfully treated with repeated

Diagnosis, surveillance, and epidemiologic evaluation of viral infections in pediatric cardiac transplant recipients with the use of the polymerase chain reaction.

BACKGROUND: Viral infections, particularly those caused by cytomegalovirus, are a major cause of postoperative morbidity and mortality in heart transplant recipients. These infections have classically been diagnosed by history, physical examination, peripheral viral cultures, and serologic studies. These methods are often time-consuming and lack sensitivity. Positive viral cultures from the heart are rarely obtained, and viral myocarditis and acute cellular rejection are unable to be differentiated histologically. We have therefore used the polymerse chain reaction to diagnose possible viral i

The heart in Anderson Fabry disease.

Anderson Fabry disease is a life threatening, X-linked inborn metabolic defect of the lysosomal enzyme áalpha-galactosidase A. The deficiency of alpha-galactosidase A leads to a progressive accumulation of globotriaosylceramide (Gb(3)), the major glycosphingolipid substrate of the enzyme, within vulnerable cells, tissues, and organs, including the cardiovascular system. Cardiac involvement is frequent and patients with cardiac affection develop progressive hypertrophic infiltrative cardiomyopathy, valvular abnormalities, arrhythmias, and conduction abnormalities and may develop coronary heart

Clinical impact of myocardial mTORC1 activation in nonischemic dilated cardiomyopathy.

BACKGROUND: Activity of mTOR complex 1 (mTORC1) has been shown to be up-regulated in animal models of heart failure. Here, we investigated the change and role of mTORC1 in human nonischemic dilated cardiomyopathy (NICM). METHODS: Endomyocardial biopsy specimens were obtained from patients with NICM (n=52) and from Brugada syndrome patients with normal LVEF as controls (n=10). The specimens were stained for phospho-ribosomal protein S6 (p-Rps6) and phospho-p70S6K (p-p70S6K), and the area with p-Rps6 signal was used as an index of mTORC1 activity. Using median mTORC1 activity, patients were div

Фульминантный внематочный рецидив множественной миэломы с редким сердцем, сосудистым и многовизорным участием: отчет о деле.

Множественная миелома (ММ) — плазменная злокачественная клетка, которая, как правило, проходит длительный клинический курс. Внешняя болезнь (ЭМД) представляет собой агрессивное проявление MM с относительно низким уровнем заболеваемости, которое традиционно затрагивает кожу и мягкие ткани. В то время как MM, как правило, безжалостно прогрессирует, мощное развитие болезней, характеризующееся обширной многовизорной и сосудистой инфильтрацией, является исключительно редким явлением и редко документируется в медицинской литературе. Этот случай иллюстрирует 64-летнюю женщину, у которой были обнаруже

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… Survival Present Case 65/F Abdominal mass Heart, Liver, Spleen, Lungs Chemotherapy, radiotherapy Died Xuan Guan 12 44/F Chest pain LV,pulmonary artery, aortic arch,brachiocephalic artery Chemotherapy, ASCT Alive at 7 mo Shuzhen Wang 13 57/M Dyspnea, facial and bilateral upper limb swelling RA; endocardium … Survival Present Case 65/F Abdominal mass Heart, Liver, Spleen, Lungs Chemotherapy, radiotherapy Died Xuan Guan 12 44/F Chest pain LV,pulmonary artery, aortic arch,brachiocephalic artery Chemotherapy, ASCT Alive at 7 mo Shuzhen Wang 13 57/M Dyspnea, facial and bilateral upper limb swelling RA; endocardium …

Valve repair after infective endocarditis secondary to perforation caused by Streptococcus gordonii: A case report.

BackgroundWe report a case of infective endocarditis (IE) in a patient with congenital heart valve lesions accompanied by IE, which was diagnosed based on blood culture analysis that revealed the presence of a gram-negative bacterium, Streptococcus gordonii.Case summaryThe patient had a history of precordial valve disease diagnosed by cardiac ultrasound, as well as a 4-mo history of fever. He was subjected to comprehensive anti-infection and anti-heart failure treatment in the internal medicine department. Further examination revealed sudden dislodgement from and perforation through the aortic

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… The disease is caused by a pathogenic microorganism that directly infects heart valves, the endocardium of the ventricular wall or the endocardium of the adjacent aorta via the bloodstream, often leading to superfluous organisms. …

[Establishment of porcine model of prolonged cardiac arrest and cardiopulmonary resuscitation electrically induced by ventricular fibrillation].

OBJECTIVE: To investigate the optimal injury time point of cardiac arrest (CA) induced electrically, and establish a reproducible prolonged CA and cardiopulmonary resuscitation (CPR) model in pigs. METHODS: Forty healthy domestic male pigs were randomly divided into four groups, which were ventricular fibrillation (VF) 8, 10, 11, and 12 minutes groups, each group for 10 animals. In these groups, VF was induced by alternating current delivered to right ventricular endocardium and untreated for 8, 10, 11, and 12 minutes, respectively, followed by 6 minutes of CPR procedure. The resuscitation an…

Endocardial fibroelastosis is caused by aberrant endothelial to mesenchymal transition.

RATIONALE: Endocardial fibroelastosis (EFE) is a unique form of fibrosis, which forms a de novo subendocardial tissue layer encapsulating the myocardium and stunting its growth, and which is typically associated with congenital heart diseases of heterogeneous origin, such as hypoplastic left heart syndrome. Relevance of EFE was only recently highlighted through the establishment of staged biventricular repair surgery in infant patients with hypoplastic left heart syndrome, where surgical removal of EFE tissue has resulted in improvement in the restrictive physiology leading to the growth of th

Artificial intelligence-derived left ventricular strain in echocardiography in patients treated with chemotherapy.

Global longitudinal strain (GLS) is an echocardiographic measure to detect chemotherapy-related cardiovascular dysfunction. However, its limited availability and the needed expertise may restrict its generalization. Artificial intelligence (AI)-based GLS might overcome these challenges. Our aims are to explore the agreements between AI-based GLS and conventional GLS, and to assess whether the agreements were influenced by expertise levels, cardiac remodeling and cardiovascular diseases/risks. Echocardiographic images in the apical four-chamber view of left ventricle were retrospectively analyz

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… The neural network is trained specifically for LV endocardium segmentation using standardized echocardiographic views (e.g., apical 4 chamber view). … Nevertheless, the utilization of an AI-based methodology might offer a solution to the challenge of precisely delineating the endocardium. …

Cardiac amyloidosis-A review of current literature for the practicing physician.

The amyloidoses are a family of diseases in which misfolded precursor proteins aggregate to form amyloid and deposit in body tissues. A very serious yet underrecognized form of this disease is cardiac amyloidosis, in which amyloid deposits into the extracellular space of the myocardium, resulting in thickening and stiffening of ventricular walls with resultant heart failure and conductive dysfunction. This review provides a discussion of the pathogenesis and clinical presentation of cardiac amyloidosis subtypes, as well as an up-to-date approach to diagnosis and treatment. Significant progress

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… Furthermore, secondary amyloidosis usually affects the kidneys, and myocardial involvement is rare. 4 CARDIOVASCULAR MANIFESTATIONS OF AMYLOIDOSIS Amyloid can deposit into any cardiac structures, including the endocardium, valves, myocardium, epicardium, and parietal pericardium. 6 The main pathology … consequence of amyloid infiltration into the myocardium which causes changes in calcium transport, receptor modulation, cellular metabolism, and cardiomyocyte oedema. 11 FIGURE 2 (A) An enlarged heart with a firm and slightly translucent myocardium (black arrows) and a granular appearance to the left atrial endocardium …

Сердечно-сосудистые заболевания

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… Other valves or the endocardium adjacent to valves may also occasionally be the site of infection ( Fig. 3.26 ). … The echocardiographic examination should be performed mindful of the fact that endocarditis involves the valvular endocardium in more than 98% of reported cases; mural lesions being extremely rare. …

AL type cardiac amyloidosis: a devastating fatal disease.

IntroductionCardiac amyloidosis is a rare entity with a grave prognosis. Due to the low index of suspicion secondary to non-specific symptoms, it is often diagnosed at an advanced stage with multi-organ involvement.MethodsWe report a case of systemic AL amyloidosis with predominant cardiac and renal involvement associated with multiple myeloma.Case summaryA 60-year-old male presented with progressive anasarca, orthopnea and weight gain over 8 months. On clinical examination, 3+ pitting edema was found in bilateral extremities and scrotum. Serum N-type proBNP and troponin T were elevated, and E

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… Amyloid can deposit anywhere in the heart, including the myocardium, valves, endocardium, endothelium, and pericardium, and this geographic diversity is the cause of the condition’s wide array of clinical presentations. …

Abstracts from the World Congress of Cardiology/Brazilian Congress of Cardiology 2022

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