Acta cardiologica最新文献

This study aimed to evaluate thrombosis and bleeding events in the children implanted with two types of ventricular assist devices (VAD). A total of 26 paediatric end-stage heart failure patients with the mean age of 11.32 ± 4.17 years, 15 were boys, implanted with a VAD, either the Berlin Heart EXCOR (BHE group; n = 9) or the HeartWare (HW group, n = 17), were included in this retrospective study. Follow up data on bleeding events, thrombosis events, bridge-to-transplantation rates and survival outcome were recorded. Overall, 16(33.3%) bleeding events and 32(66.7%) thrombosis events occurred, while 14(53.8%) patients had at least one thrombotic event and 8(30.8%) patients had at least one bleeding event. BHE and HW groups were similar in terms of number of patients with at least one thrombotic (33.3% vs. 64.7%, p = .218) or bleeding (22.2% vs.35.3%, p = .399) event. Mortality occurred in 9(34.6%) patients and 13(50.0%) patients achieved bridge-to-transplantation, similarly in BHE and HW groups (mortality: 44.4% vs. 29.4%, p = .667 and transplantation: 77.8% vs. 35.3%, p = .097). In conclusion, our findings revealed that VAD application in children with heart failure enables successful heart transplantation achievement with an acceptable risk of bleeding/thromboembolic events in most of cases. More advanced VAD technologies and more successful management for haematologic complications are necessary to improve the transplantation rates in children.

Background: The use of biochemical markers in ADHF is considered valuable both in the diagnosis and treatment of diseases and in follow-up. This study aimed to investigate the prognostic power of serum sST2 and NT-proBNP levels in predicting long-term mortality in patients with ADHF using serial measurement.

Methods: A total of 122 patients with ADHF were included in this prospective study. Venous blood samples were taken from the patients at the time of first admission to the emergency department and 48 h after hospitalisation. Serial measurements were performed using the same blood samples to determine NT-proBNP and sST2 levels.

Results: The 1st time sST2 value was found to be significantly higher in the deceased group than in the living group, and this increase was found to be statistically significant (p < 0.001). The cut-off value for the 1st time value of sST2 was > 56.79 ng/mL, with 91.2% sensitivity and 79.5% specificity (area under the curve (AUC): 0.902, 95% confidence interval (CI): 0.835-0.948, p < 0.001). The cut-off value for the 2nd time sST2 value was > 38.91 ng/mL, with 97.1% sensitivity and 81.8% specificity (AUC: 0.932, 95% CI: 0.872-0.970, p < 0.001).

Conclusion: In our study, sST2 gained value as a marker that should be included in panels with multiple markers. It seems more appropriate to recommend the serial measurement of sST2 in heart failure.

Limitations of our study: The sample size is relatively small and there is no standard in timing and numbers in serial measurements.

In modern oncology, despite the efficacy of chemotherapy, there is a risk of cardiotoxicity resulting in heart failure. This necessitates early diagnosis to prevent complications and improve prognosis. The study is aimed at analysing the abilities of speckle-tracking echocardiography as a modern tool in detecting cardiotoxicity in the early stages. This non-invasive method allows evaluating myocardial strain and its contractility. During a thorough analysis and extensive review of the scientific literature, it was found that the speckle-tracking echocardiography technique demonstrates an exceptionally high sensitivity to detecting early signs of cardiotoxicity, significantly outpacing conventional echocardiography methods in this aspect. This advantage makes it an invaluable tool in the early detection of potentially dangerous changes in the myocardium, which is especially important for patients at risk of developing cardiotoxic reactions as a result of chemotherapy. Speckle-tracking echocardiography has a unique ability to identify even the slightest local abnormalities in the structure and function of the myocardium, significantly before any clinical symptoms become apparent, thereby allowing doctors to take preventive measures at the earliest stages. This outstanding diagnostic ability is supported by an extensive body of scientific research and publications that unequivocally confirm the effectiveness of speckle-tracking echocardiography as an advanced tool for the early diagnosis of cardiotoxic changes. Thus, the timely application of this technique can significantly reduce the risks to the cardiac health of patients and contribute to more effective treatment of oncological diseases. Speckle-tracking echocardiography serves as an important tool in the early detection of cardiotoxicity in patients undergoing chemotherapy, allowing clinicians to timely adapt treatment protocols and prevent the development of serious cardiovascular complications, thereby improving the prognosis and quality of life of cancer patients.

Background: TTE is the main modality used to assess RV function, but conventional TTE parameters have limited diagnostic value because they may fail to detect early abnormalities in RV systolic function. Due to its ability to detect subclinical impairment of cardiac function, 2D STE has been widely used to investigate RV function. In this study, we aimed to investigate whether there are sequelae of RV function in recovered COVID-19 patients with pulmonary involvement.

Methods: This is a prospective observational cohort study of 57 healthy volunteers and 54 patients. Participants had no history of chronic illness and no evidence of respiratory or cardiac symptoms. The patients had been hospitalised with COVID-19 with pulmonary involvement but did not require intensive care unit follow-up or non-invasive mechanical ventilation support. TTE was performed. Demographic and clinical characteristics and laboratory test results were collected.

Results: LVEF, TAPSE, St and FAC were significantly lower in the patient group. LV-LS 3-chamber, LV-GLS, RV-FWS, RV-GLS were significantly lower in the patient group.

Conclusions: RV-LS and LV-GLS were shown to decrease in the patient group. Although no obvious pathological values were observed in RV parameters on conventional echocardiography, TAPSE, St and FAC values were lower in the patient group.

İntroduction: The pathophysiology of heart failure with preserved ejection fraction has not been clearly elucidated. Therefore, there is not enough information about the prediction of poor prognosis in these patients. Our aim is to investigate whether the pulmonary artery pulsatile index, derived from right heart catheterisation parameters, is associated with mortality in these patients.

Materials and methods: The study was designed retrospectively. Patients who underwent right heart catheterisation between 2016 and 2023 and were diagnosed with heart failure with preserved ejection fraction were included in the study. The patients were divided into 2 groups. Dead patients were included in the first group, and surviving patients were included in the second group. Basic characteristics, right heart catheterisation results, pre-catheter blood and echocardiography parameters, and pulmonary artery pulsatile index were compared between both groups.

Results: Pulmonary artery pulsatile index, mean pulmonary artery pressure, and body mass index were found to be independent predictors of mortality in heart failure patients with preserved ejection fraction. A PAPi value of <2.84 was found to have 76.2% sensitivity and 77% specificity in predicting mortality in heart failure patients with preserved ejection fraction.

Conclusion: This study shows how important the pulmonary artery pulsatile index is in predicting mortality in heart failure patients with preserved ejection fraction. Since low levels of pulmonary artery pulsatile index at the time of diagnosis may predict poor prognosis, importance should be given to follow-up and treatment in these patients. Routine use of this index may contribute to reducing mortality and morbidity in patients.