Ankylosing spondylitis (AS) is a type of chronic inflammation that is most prevalent in young adults and is characterized by an inflammatory enthesiopathy that gradually develops toward ossification and ankylosis. If inflammation is left unchecked, it can potentially lead to complications such as secondary amyloidosis, also known as AA amyloidosis, involving the deposition of amyloid serum A protein. Our case presents with a thyroid localization of AA amyloidosis which is secondary to this AS. Such a case has been described in only four cases in the literature. Cardiac localization of AA amyloidosis has been exceptionally described in the literature. We report the case of a young patient with severe AS complicated by secondary amyloidosis with thyroid, cardiac, and probably renal localization. He was treated with anti-TNF therapy, and his condition improved significantly. Our case presents several localizations of AA amyloidosis secondary to this AS. Although cardiac involvement is rare in secondary AA amyloidosis, it should always be screened for, even in a cardiacly asymptomatic patient.
强直性脊柱炎（AS）是一种慢性炎症，多发于青壮年，其特点是炎症性强直，逐渐发展为骨化和强直。如果炎症得不到控制，有可能导致并发症，如继发性淀粉样变性，也称为 AA 淀粉样变性，涉及淀粉样血清 A 蛋白的沉积。我们的病例是继发于这种强直性脊柱炎的甲状腺局部 AA 淀粉样变性。此类病例在文献中仅有四例。AA淀粉样变性的心脏局部病变在文献中鲜有描述。我们报告了一例年轻的重症强直性脊柱炎并发继发性淀粉样变性的病例，该病有甲状腺、心脏和可能的肾脏定位。他接受了抗肿瘤坏死因子治疗，病情明显好转。我们的病例显示了继发于这种强直性脊柱炎的 AA 淀粉样变性的几种定位。虽然心脏受累在继发性AA淀粉样变性中很少见，但即使是心脏无症状的患者也应进行筛查。
{"title":"A rare clinical case of systemic AA amyloidosis with cardiac involvement complicating ankylosing spondylitis: a case report","authors":"Leïla Barakat, Khadija Echchilali, Mina Moudatir, Hassan El Kabli, Yassine Ettagmouti, Mériem Haboub, Salim Arous, Mohamed Ghali Benouna, Abdenasser Drighil, Rachida Habbal, Meryame Azim, Asmae Mazti, Meriem Regragui, Nissrine Bennani Guebessi, Mehdi Karkouri","doi":"10.1186/s43044-024-00471-9","DOIUrl":"https://doi.org/10.1186/s43044-024-00471-9","url":null,"abstract":"Ankylosing spondylitis (AS) is a type of chronic inflammation that is most prevalent in young adults and is characterized by an inflammatory enthesiopathy that gradually develops toward ossification and ankylosis. If inflammation is left unchecked, it can potentially lead to complications such as secondary amyloidosis, also known as AA amyloidosis, involving the deposition of amyloid serum A protein. Our case presents with a thyroid localization of AA amyloidosis which is secondary to this AS. Such a case has been described in only four cases in the literature. Cardiac localization of AA amyloidosis has been exceptionally described in the literature. We report the case of a young patient with severe AS complicated by secondary amyloidosis with thyroid, cardiac, and probably renal localization. He was treated with anti-TNF therapy, and his condition improved significantly. Our case presents several localizations of AA amyloidosis secondary to this AS. Although cardiac involvement is rare in secondary AA amyloidosis, it should always be screened for, even in a cardiacly asymptomatic patient.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140316183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28DOI: 10.1186/s43044-024-00470-w
Hai Nguyen Ngoc Dang, Thang Viet Luong, Toan Thanh Tran
Type 2 diabetes mellitus (T2DM) is a metabolic disorder that detrimentally affects multiple systems in the body, with a particular emphasis on the vascular and nervous systems. Despite its significant impact, limited studies have explored the influence of this condition on the left atrial (LA) function. To address this gap, our study utilized speckle tracking echocardiography (STE) to assess LA function in patients with T2DM in Central Vietnam. The cross-sectional comparative study enrolled 134 subjects involving 66 patients with T2DM and 68 healthy individuals meeting the selection and exclusion criteria of the study. In our study, healthy individuals demonstrated higher values for LA reservoir strain (LASr), LA conduit strain (LAScd), and LA contractile strain (LASct), measuring 38.75% ± 5.43%, 19.58% ± 5.91%, and 19.16% ± 4.98%, respectively. In contrast, the T2DM group exhibited lower values for LASr, LAScd, and LASct, which measured 31.2% ± 4.56%, 14.77% ± 6.3%, and 16.36% ± 4.82%, respectively (p < 0.05). T2DM patients with normal LA volume index (LAVI) and normal left ventricular mass index (LVMI), LASr, LAScd, and LASct results were 32.07% ± 5.28%, 16.28% ± 6.95%, and 15.64% ± 5.32%. respectively. STE of the LA reveals a noteworthy reduction in reservoir, conduit, and contractile functions within the T2DM group when compared to the control group (p < 0.05). Furthermore, these impaired functions persist in T2DM patients even in the absence of increased LAVI and LVMI.
{"title":"Evaluating left atrial function changes by speckle tracking echocardiography in type 2 diabetes patients in Central Vietnam: a cross-sectional comparative study","authors":"Hai Nguyen Ngoc Dang, Thang Viet Luong, Toan Thanh Tran","doi":"10.1186/s43044-024-00470-w","DOIUrl":"https://doi.org/10.1186/s43044-024-00470-w","url":null,"abstract":"Type 2 diabetes mellitus (T2DM) is a metabolic disorder that detrimentally affects multiple systems in the body, with a particular emphasis on the vascular and nervous systems. Despite its significant impact, limited studies have explored the influence of this condition on the left atrial (LA) function. To address this gap, our study utilized speckle tracking echocardiography (STE) to assess LA function in patients with T2DM in Central Vietnam. The cross-sectional comparative study enrolled 134 subjects involving 66 patients with T2DM and 68 healthy individuals meeting the selection and exclusion criteria of the study. In our study, healthy individuals demonstrated higher values for LA reservoir strain (LASr), LA conduit strain (LAScd), and LA contractile strain (LASct), measuring 38.75% ± 5.43%, 19.58% ± 5.91%, and 19.16% ± 4.98%, respectively. In contrast, the T2DM group exhibited lower values for LASr, LAScd, and LASct, which measured 31.2% ± 4.56%, 14.77% ± 6.3%, and 16.36% ± 4.82%, respectively (p < 0.05). T2DM patients with normal LA volume index (LAVI) and normal left ventricular mass index (LVMI), LASr, LAScd, and LASct results were 32.07% ± 5.28%, 16.28% ± 6.95%, and 15.64% ± 5.32%. respectively. STE of the LA reveals a noteworthy reduction in reservoir, conduit, and contractile functions within the T2DM group when compared to the control group (p < 0.05). Furthermore, these impaired functions persist in T2DM patients even in the absence of increased LAVI and LVMI.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"129 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140316081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-26DOI: 10.1186/s43044-024-00459-5
Juana Perez Morales, Ana Spaccavento, Santiago Ordoñez, Rocío Baro, Diego Conde, Juan Pablo Costabel
Nowadays, percutaneous procedures are expanding in use, and this comes with complications associated with the procedure itself. Cardiac tamponade is rare but may be life threatening since it can involve hemodynamic instability. It is known that after pleural effusion during a percutaneous procedure, pericardiocentesis should be used as drainage of the cavity. However, that does not achieve hemostasis in some cases, and in those patients who are hemodynamically unstable, a sealing agent to promote hemostasis might be useful, like thrombin. We present a case report of 89-year-old patient with history of melanoma undergoing treatment with pembrolizumab, who attended the emergency department referring chest pain (intensity 5/10) and palpitations that have lasted hours. He had TnTUs 554/566 ng/L and an echocardiogram that showed dilated right chambers, hypertrophy and global hypokinesia of the left ventricle, increased filling pressures of the left ventricle and pulmonary hypertension. Myocarditis associated with pembrolizumab was suspected, so high dose steroids were initiated and endomyocardial biopsy was conducted, resulting in iatrogenic cardiac tamponade. To determine the etiology of the suspected myocarditis, an endomyocardial biopsy was performed. Unfortunately, an intraprocedural complication arose: pleural effusion resulting in iatrogenic cardiac tamponade, leading to hemodynamic instability. It required immediate pericardial drainage via subxiphoid puncture, obtaining a 550 mL hematic debit. Clinical manifestations raised suspicion of tamponade, prompting a bedside echocardiogram for a definitive diagnosis. Despite these efforts, the patient remained hemodynamically unstable, and due to the elevated surgical risk, intrapericardial thrombin was employed to achieve successful hemostasis. Cardiac tamponade is a life-threatening condition that can sometimes be induced iatrogenically, resulting from percutaneous interventions. Despite limited evidence regarding this therapeutic strategy, in patients experiencing iatrogenic cardiac tamponade with hemodynamic instability and high surgical risk, the administration of intra-pericardial thrombin could be contemplated.
{"title":"Intra-pericardial thrombin injection in iatrogenic cardiac tamponade: a case report","authors":"Juana Perez Morales, Ana Spaccavento, Santiago Ordoñez, Rocío Baro, Diego Conde, Juan Pablo Costabel","doi":"10.1186/s43044-024-00459-5","DOIUrl":"https://doi.org/10.1186/s43044-024-00459-5","url":null,"abstract":"Nowadays, percutaneous procedures are expanding in use, and this comes with complications associated with the procedure itself. Cardiac tamponade is rare but may be life threatening since it can involve hemodynamic instability. It is known that after pleural effusion during a percutaneous procedure, pericardiocentesis should be used as drainage of the cavity. However, that does not achieve hemostasis in some cases, and in those patients who are hemodynamically unstable, a sealing agent to promote hemostasis might be useful, like thrombin. We present a case report of 89-year-old patient with history of melanoma undergoing treatment with pembrolizumab, who attended the emergency department referring chest pain (intensity 5/10) and palpitations that have lasted hours. He had TnTUs 554/566 ng/L and an echocardiogram that showed dilated right chambers, hypertrophy and global hypokinesia of the left ventricle, increased filling pressures of the left ventricle and pulmonary hypertension. Myocarditis associated with pembrolizumab was suspected, so high dose steroids were initiated and endomyocardial biopsy was conducted, resulting in iatrogenic cardiac tamponade. To determine the etiology of the suspected myocarditis, an endomyocardial biopsy was performed. Unfortunately, an intraprocedural complication arose: pleural effusion resulting in iatrogenic cardiac tamponade, leading to hemodynamic instability. It required immediate pericardial drainage via subxiphoid puncture, obtaining a 550 mL hematic debit. Clinical manifestations raised suspicion of tamponade, prompting a bedside echocardiogram for a definitive diagnosis. Despite these efforts, the patient remained hemodynamically unstable, and due to the elevated surgical risk, intrapericardial thrombin was employed to achieve successful hemostasis. Cardiac tamponade is a life-threatening condition that can sometimes be induced iatrogenically, resulting from percutaneous interventions. Despite limited evidence regarding this therapeutic strategy, in patients experiencing iatrogenic cardiac tamponade with hemodynamic instability and high surgical risk, the administration of intra-pericardial thrombin could be contemplated.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139967702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-21DOI: 10.1186/s43044-024-00457-7
Lina N. Adam, Omar A. M. Al-Habib, Ashur Y. Oraha, Mudhir S. Shekha
Unraveling myeloperoxidase’s (MPO) correlation with coronary artery disease (CAD) and genetic variations, this study seeks to enhance diagnostic precision and therapeutic strategies. CAD patients were found to be older and more male than controls. Several clinical parameters, including glucose, total bilirubin, alkaline phosphatase, creatinine, and troponin levels, showed significant variations. Moreover, CAD patients had lower red cell distribution width (RDW%) and mean platelet volume (MPV) than controls. Serum MPO levels did not differ significantly between CAD patients and controls, and no correlation was found with other clinical parameters except for glucose, creatinine, and total bilirubin. The data suggest that serum MPO levels are not substantially related to CAD patients, as indicated by lower MPO levels in CAD patients compared to controls. While highlighting the potential of MPV and RDW% as predictors of severe atherosclerosis in CAD. Further research is needed to validate the diagnostic and prognostic value of RDW%, MPV, and MPO levels in CAD. Trial registration: 15092021-9-12. Registered 15 September 2021.
{"title":"Genetic and clinical study of myeloperoxidase's association with coronary artery disease","authors":"Lina N. Adam, Omar A. M. Al-Habib, Ashur Y. Oraha, Mudhir S. Shekha","doi":"10.1186/s43044-024-00457-7","DOIUrl":"https://doi.org/10.1186/s43044-024-00457-7","url":null,"abstract":"Unraveling myeloperoxidase’s (MPO) correlation with coronary artery disease (CAD) and genetic variations, this study seeks to enhance diagnostic precision and therapeutic strategies. CAD patients were found to be older and more male than controls. Several clinical parameters, including glucose, total bilirubin, alkaline phosphatase, creatinine, and troponin levels, showed significant variations. Moreover, CAD patients had lower red cell distribution width (RDW%) and mean platelet volume (MPV) than controls. Serum MPO levels did not differ significantly between CAD patients and controls, and no correlation was found with other clinical parameters except for glucose, creatinine, and total bilirubin. The data suggest that serum MPO levels are not substantially related to CAD patients, as indicated by lower MPO levels in CAD patients compared to controls. While highlighting the potential of MPV and RDW% as predictors of severe atherosclerosis in CAD. Further research is needed to validate the diagnostic and prognostic value of RDW%, MPV, and MPO levels in CAD. Trial registration: 15092021-9-12. Registered 15 September 2021.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139919447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Systemic-to-pulmonary artery shunt (SPAS) is a rare condition that can occur as a result of congenital heart disease or chronic pulmonary inflammation, occasionally leading to life-threatening hemoptysis. Computed tomography (CT) imaging is crucial in the diagnosis of SPAS, and the optimal management approach for SPAS remains uncertain. This case report presents a novel approach to the treatment of SPAS, consisting of transcatheter arterial embolization of the systemic artery followed by lung segmentectomy. A 42-year-old man with abnormal chest findings was referred to us and a diagnosis of SPAS was established based on the CT findings showing a blood flow regurgitation from the dilated left 4th intercostal artery to the Lt. A6. The patient was asymptomatic but we decided to treat him to prevent a risk of future hemoptysis. Transcatheter arterial embolization (TAE) of systemic arteries followed by S6 segmentectomy was successfully performed with minimal blood loss and complete removal of the dilated intra-pulmonary blood vessels. Histological analysis confirmed the diagnosis of SPAS. We reported a case of SPAS, who was successfully treated with the combination of TAE and subsequent segmentectomy. The blood loss during surgery was minimal and this strategy appeared to minimize future recanalization and hemoptysis. Further studies and long-term follow-up of SPAS patients are required to establish standardized management guidelines for this rare condition.
{"title":"Systemic-to-pulmonary artery shunt treated with transcatheter arterial embolization and subsequent lung segmentectomy","authors":"Hirotsugu Notsuda, Fumiko Tomiyama, Ken Onodera, Tatsuaki Watanabe, Yui Watanabe, Hisashi Oishi, Hiromichi Niikawa, Chihiro Inoue, Hideki Ota, Masafumi Noda, Yoshinori Okada","doi":"10.1186/s43044-023-00431-9","DOIUrl":"https://doi.org/10.1186/s43044-023-00431-9","url":null,"abstract":"Systemic-to-pulmonary artery shunt (SPAS) is a rare condition that can occur as a result of congenital heart disease or chronic pulmonary inflammation, occasionally leading to life-threatening hemoptysis. Computed tomography (CT) imaging is crucial in the diagnosis of SPAS, and the optimal management approach for SPAS remains uncertain. This case report presents a novel approach to the treatment of SPAS, consisting of transcatheter arterial embolization of the systemic artery followed by lung segmentectomy. A 42-year-old man with abnormal chest findings was referred to us and a diagnosis of SPAS was established based on the CT findings showing a blood flow regurgitation from the dilated left 4th intercostal artery to the Lt. A6. The patient was asymptomatic but we decided to treat him to prevent a risk of future hemoptysis. Transcatheter arterial embolization (TAE) of systemic arteries followed by S6 segmentectomy was successfully performed with minimal blood loss and complete removal of the dilated intra-pulmonary blood vessels. Histological analysis confirmed the diagnosis of SPAS. We reported a case of SPAS, who was successfully treated with the combination of TAE and subsequent segmentectomy. The blood loss during surgery was minimal and this strategy appeared to minimize future recanalization and hemoptysis. Further studies and long-term follow-up of SPAS patients are required to establish standardized management guidelines for this rare condition.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138826058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.1186/s43044-023-00428-4
Mohamed Laimoud, Emad Hakami, Mary Jane Maghirang, Tahir Mohamed
The left ventricular assist devices (LVADs) are increasingly used for advanced heart failure as a bridge to heart transplantation or as a destination therapy. The aim of this study was to investigate the changes of diastolic pulmonary gradient (DPG), pulmonary vascular resistance (PVR) and transpulmonary gradient (TPG) after LVAD implantation and their impact on survival after LVAD and heart transplantation. A total of 73 patients who underwent LVAD (HeartMate III) implantation between 2016 and 2022 were retrospectively studied. According to pre-LVAD catheterization, 49 (67.1%) patients had DPG < 7 mmHg and 24 (32.9%) patients had DPG ≥ 7 mmHg. The patients with a pre-VAD DPG ≥ 7 mmHg had higher frequencies of right ventricular (RV) failure (p < 0.001), RVAD insertion (p < 0.001), need for renal replacement therapy (p = 0.002), total mortality (p = 0.036) and on-VAD mortality (p = 0.04) with a longer ICU stay (p = 0.001) compared to the patients with DPG < 7 mmHg. During the follow-up period of 38 (12–60) months, 24 (32.9%) patients died. Pre-LVAD DPG ≥ 7 mmHg (adjusted HR 1.83, 95% CI 1.21–6.341, p = 0.039) and post-LVAD DPG ≥ 7 mmHg (adjusted HR 3.824, 95% CI 1.482–14.648, p = 0.002) were associated with increased risks of mortality. Neither pre-LVAD TPG ≥ 12 (p = 0.505) nor post-LVAD TPG ≥ 12 mmHg (p = 0.122) was associated with an increased risk of death. Pre-LVAD PVR ≥ 3 WU had a statistically insignificant risk of mortality (HR 2.35, 95% CI 0.803–6.848, p = 0.119) while post-LVAD PVR ≥ 3 WU had an increased risk of death (adjusted HR 2.37, 95% CI 1.241–7.254, p = 0.038). For post-transplantation mortality, post-LVAD DPG ≥ 7 mmHg (p = 0.55), post-LVAD TPG ≥ 12 mmHg (p = 0.85) and PVR ≥ 3 WU (p = 0.54) did not have statistically increased risks. The logistic multivariable regression showed that post-LVAD PVR ≥ 3 WU (p = 0.013), post-LVAD DPG ≥ 7 mmHg (p = 0.026) and RVF (p = 0.018) were the predictors of mortality after LVAD implantation. Pre-LVAD DPG ≥ 7 mmHg (p < 0.001) and pre-LVAD PVR ≥ 3 WU (p = 0.036) were the predictors of RVF after LVAD implantation. Persistently high DPG was associated with right ventricular failure and mortality after LVAD implantation rather than after heart transplantation. DPG is a better predictor of pulmonary vascular remodeling compared to TPG and PVR. Further larger prospective studies are required in this field due to the growing numbers of patients with advanced heart failure, as possible candidates for LVAD implantation, and limitations of heart transplantation.
{"title":"Impact of diastolic pulmonary gradient and pulmonary vascular remodeling on survival after left ventricular assist device implantation and heart transplantation","authors":"Mohamed Laimoud, Emad Hakami, Mary Jane Maghirang, Tahir Mohamed","doi":"10.1186/s43044-023-00428-4","DOIUrl":"https://doi.org/10.1186/s43044-023-00428-4","url":null,"abstract":"The left ventricular assist devices (LVADs) are increasingly used for advanced heart failure as a bridge to heart transplantation or as a destination therapy. The aim of this study was to investigate the changes of diastolic pulmonary gradient (DPG), pulmonary vascular resistance (PVR) and transpulmonary gradient (TPG) after LVAD implantation and their impact on survival after LVAD and heart transplantation. A total of 73 patients who underwent LVAD (HeartMate III) implantation between 2016 and 2022 were retrospectively studied. According to pre-LVAD catheterization, 49 (67.1%) patients had DPG < 7 mmHg and 24 (32.9%) patients had DPG ≥ 7 mmHg. The patients with a pre-VAD DPG ≥ 7 mmHg had higher frequencies of right ventricular (RV) failure (p < 0.001), RVAD insertion (p < 0.001), need for renal replacement therapy (p = 0.002), total mortality (p = 0.036) and on-VAD mortality (p = 0.04) with a longer ICU stay (p = 0.001) compared to the patients with DPG < 7 mmHg. During the follow-up period of 38 (12–60) months, 24 (32.9%) patients died. Pre-LVAD DPG ≥ 7 mmHg (adjusted HR 1.83, 95% CI 1.21–6.341, p = 0.039) and post-LVAD DPG ≥ 7 mmHg (adjusted HR 3.824, 95% CI 1.482–14.648, p = 0.002) were associated with increased risks of mortality. Neither pre-LVAD TPG ≥ 12 (p = 0.505) nor post-LVAD TPG ≥ 12 mmHg (p = 0.122) was associated with an increased risk of death. Pre-LVAD PVR ≥ 3 WU had a statistically insignificant risk of mortality (HR 2.35, 95% CI 0.803–6.848, p = 0.119) while post-LVAD PVR ≥ 3 WU had an increased risk of death (adjusted HR 2.37, 95% CI 1.241–7.254, p = 0.038). For post-transplantation mortality, post-LVAD DPG ≥ 7 mmHg (p = 0.55), post-LVAD TPG ≥ 12 mmHg (p = 0.85) and PVR ≥ 3 WU (p = 0.54) did not have statistically increased risks. The logistic multivariable regression showed that post-LVAD PVR ≥ 3 WU (p = 0.013), post-LVAD DPG ≥ 7 mmHg (p = 0.026) and RVF (p = 0.018) were the predictors of mortality after LVAD implantation. Pre-LVAD DPG ≥ 7 mmHg (p < 0.001) and pre-LVAD PVR ≥ 3 WU (p = 0.036) were the predictors of RVF after LVAD implantation. Persistently high DPG was associated with right ventricular failure and mortality after LVAD implantation rather than after heart transplantation. DPG is a better predictor of pulmonary vascular remodeling compared to TPG and PVR. Further larger prospective studies are required in this field due to the growing numbers of patients with advanced heart failure, as possible candidates for LVAD implantation, and limitations of heart transplantation.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138819359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19DOI: 10.1186/s43044-023-00429-3
Raul Cruz Palomera, Jose Dario Valencia Gonzalez, Juan Guzmán Olea, Rosa Elena Gutiérrez Castañeda, Juan Francisco Rodríguez Alvarado, Juan Camacho Huembes, Jorge Guillermo Arenas Fonseca, Alejandro Carcaño Cuevas, Gabriel Guzman Olea
Malignant primary cardiac tumors are infrequent and can lead to an unfavorable prognosis if not identified and treated promptly. Early detection and prompt treatment of malignant primary cardiac tumors are crucial for a better prognosis. This article presents a case of primary cardiac leiomyosarcoma and reviews the literature on this topic. Female patient that developed recurrent pericardial effusion and hemodynamic instability caused by a cardiac tumor, later identified as leiomyosarcoma. Multidisciplinary treatment was administered to the patient. The initial approach to this type of pathology should include multimodality imaging to establish a prompt diagnosis leading to complete standard treatment, to minimize risks to the patient's heart function which may include resection with complete margins of the neoplasm, otherwise the prognosis may be poor.
{"title":"A monster into the heart: an unusual presentation of cardiac leiomyosarcoma","authors":"Raul Cruz Palomera, Jose Dario Valencia Gonzalez, Juan Guzmán Olea, Rosa Elena Gutiérrez Castañeda, Juan Francisco Rodríguez Alvarado, Juan Camacho Huembes, Jorge Guillermo Arenas Fonseca, Alejandro Carcaño Cuevas, Gabriel Guzman Olea","doi":"10.1186/s43044-023-00429-3","DOIUrl":"https://doi.org/10.1186/s43044-023-00429-3","url":null,"abstract":"Malignant primary cardiac tumors are infrequent and can lead to an unfavorable prognosis if not identified and treated promptly. Early detection and prompt treatment of malignant primary cardiac tumors are crucial for a better prognosis. This article presents a case of primary cardiac leiomyosarcoma and reviews the literature on this topic. Female patient that developed recurrent pericardial effusion and hemodynamic instability caused by a cardiac tumor, later identified as leiomyosarcoma. Multidisciplinary treatment was administered to the patient. The initial approach to this type of pathology should include multimodality imaging to establish a prompt diagnosis leading to complete standard treatment, to minimize risks to the patient's heart function which may include resection with complete margins of the neoplasm, otherwise the prognosis may be poor.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138744551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-15DOI: 10.1186/s43044-022-00287-5
M. Sumerkan, S. Cetın, F. Helvacı, Sendag Yaslikaya, U. Karabay, T. Hamit, A. Gurdal, M. Agirbasli, O. Alyan
{"title":"Three-dimensional echocardiographic assessment of Chiari’s network relationship with the left ventricular false tendon","authors":"M. Sumerkan, S. Cetın, F. Helvacı, Sendag Yaslikaya, U. Karabay, T. Hamit, A. Gurdal, M. Agirbasli, O. Alyan","doi":"10.1186/s43044-022-00287-5","DOIUrl":"https://doi.org/10.1186/s43044-022-00287-5","url":null,"abstract":"","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73287471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-04DOI: 10.1186/s43044-022-00284-8
C. Umeh, Sabina Kumar, Elias Wassel, P. Barve
{"title":"Meta-analysis and systematic literature review of COVID-19 associated bradycardia as a predictor of mortality","authors":"C. Umeh, Sabina Kumar, Elias Wassel, P. Barve","doi":"10.1186/s43044-022-00284-8","DOIUrl":"https://doi.org/10.1186/s43044-022-00284-8","url":null,"abstract":"","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83112385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：