China
Africa
Explore chapters and articles related to this topic
Helper T-Lymphocytes in Cardiovascular Diseases
Published in Shyam S. Bansal, Immune Cells, Inflammation, and Cardiovascular Diseases, 2022
Vinay Kumar, Sahil Gupta, Rachel Rosenzweig, Shyam S. Bansal
Ischemic and nonischemic cardiomyopathy is characterized by chronic, low-grade inflammation. Coronary artery blockade or increased afterload initiates an early innate immune response to engulf apoptotic cardiomyocytes and facilitate wound healing. Subsequent processing of cardiac antigens and their presentation in conjunction with MHC-II then lead to CD4+ T-cell activation65. Studies have shown that T-cells undergo significant temporally regulated phenotypic changes to promote tissue clearance by pro-inflammatory subsets, followed by scar formation and neovascularization aided by anti-inflammatory subsets such as Tregs66. However, during chronic inflammation, as seen with cardiomyopathy and LV remodeling, CD4+ T-cells undergo a pathological switch and play a critical role in disease pathophysiology7 (Figure 2.2).
Cardiomyopathies in the elderly
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
John Arthur McClung, Srihari S. Naidu, Wilbert S. Aronow
Beta-blockade has now been shown unequivocally to be associated with improvement in symptoms, quality of life, exercise capacity, ejection fraction, and survival (100–104). Multivariate analysis has demonstrated that shorter duration of congestive symptoms and the use of beta-blockers are independently associated with reverse remodeling in patients older than 70 years of age with nonischemic cardiomyopathy (105). This observation has been attributed to an increase in α1-adrenergic receptor density, prolongation of the action potential with secondary increase in calcium influx, and induction of changes in gene expression (106). Beta-blockade also enhances calcium release channel function as well as increases plasma B-type natriuretic peptides in patients with heart failure (107,108). In addition, beta-blockers have been demonstrated to improve contractile dyssynchrony in patients with heart failure who have narrow QRS complexes (109).
Medical Consequences of Acute and Chronic Alcohol Abuse
Published in John Brick, Handbook of the Medical Consequences of Alcohol and Drug Abuse, 2012
It has been known for nearly 80 years that heavy drinking decreases longevity. Pearl noted that moderate drinkers lived longer than either abstainers or heavy drinkers (Pearl, 1926). Over the life span, total alcohol consumption is inversely associated with heart damage. The deterioration of heart muscle, a condition known as alcoholic cardiomyopathy, is one of the most serious consequences of chronic heavy drinking. As cardiac cells deteriorate, the unique ability of these cells to contract is impaired. This is particularly significant in the heart’s left ventricle, which pumps freshly oxygenated blood throughout the body. Compensatory mechanisms result in an enlarged heart, but any benefit from such cardiac hypertrophy is temporary. Eventually the heart is unable to meet the body’s demand for oxygen. Alcoholic cardiomyopathy is the most common cause of nonischemic cardiomyopathy in Western societies and is a major source of heart failure and death (NIAAA, 1997, 2000).
CardioMEMSTM System in the Daily Management of Heart Failure: Review of Current Data and Technique of Implantation
Published in Expert Review of Medical Devices, 2020
Muhammad Asif Mangi, Zeid Nesheiwat, Rehan Kahloon, George V. Moukarbel
A 77-year-old man with a history of systolic heart failure due to nonischemic cardiomyopathy. He was in NYHA Class III symptoms with multiple readmissions for acute systolic heart failure exacerbation. He was referred for placement of CardioMEMSTM PA sensor. Using ultrasound guidance and micropuncture technique, the internal jugular vein was accessed. A Swan-Ganz catheter was advanced and used to perform right heart catheterization and to perform selective left pulmonary arteriography. The CardioMEMSTM PA sensor device was advanced over the Command wire 0.018 into the left pulmonary artery. At that point, there was inability to advance the delivery catheter of the CardioMEMSTM device over the wire. The wire was then pulled back, but it was locked in the delivery catheter and would not advance nor pullback inside the delivery catheter. We then decided to retrieve the assembly including the wire, delivery catheter, and PA sensor. The wire was stuck and could not separate from the catheter itself. This particular device was discarded and was returned to the manufacturer for examination. A new CardioMEMSTM device and delivery catheter were then advanced over the wire to the target site and the CardioMEMSTM device was deployed at that location with no issues [Figure 3].
Continuous-flow left ventricular assist device implantation in patients with preexisting mechanical mitral valves: a systematic review
Published in Expert Review of Medical Devices, 2020
Jonathan S. Gordon, Thomas J. O’Malley, Elizabeth J. Maynes, Chelsey T. Wood, Neal Kalantri, Rohinton J. Morris, Louis E. Samuels, H. Todd Massey, Vakhtang Tchantchaleishvili
Five studies, comprising seven patients who underwent CF-LVAD with preexisting MMVs, were included. Study specifics are available in Table 1. The median age of patients was 54 [42, 61] years and 71.4% (5/7) were male. Baseline patient characteristics are available in Table 2. Nonischemic cardiomyopathy was the predominant etiology for heart failure in 83.3% (5/7) of patients, and ischemic cardiomyopathy was present in 16.7% (1/7) of patients. The majority (85%, 6/7) of patients received CF-LVAD as a bridge-to-transplant, with only one patient indicated for destination therapy. The MMVs were implanted a median of 6 [1, 15] years before CF-LVAD. The types of mechanical mitral valves in place were St Jude in 28.6% (2/7), On-X in 14.3% (1/7), Carbomedics in 14.3% (1/7), Starr Edwards in 14.3% (1/7), and 28.6% (2/7) were unspecified. Aortic valve prosthetics were present in 42.9% (3/7), of which two (66.7%) were mechanical valves and one (33.3%) was a bioprosthetic valve. Aortic valve replacement occurred a median of 13 [10, 17] years before CF-LVAD implantation.
Cardiovascular magnetic resonance imaging in heart failure
Published in Expert Review of Cardiovascular Therapy, 2018
Kihei Yoneyama, Yuki Kitanaka, Osamu Tanaka, Yoshihiro J. Akashi
Patients with HFrEF are at risk for significant morbidity and mortality, requiring specific disease management due to their distinctly different pathophysiology. In patients with nonischemic cardiomyopathy (mean LVEF, <30%) with the presence of LGE had an eightfold higher risk of an index composite outcome of HF hospitalization, appropriate implantable cardioverter defibrillator firings, and cardiac death compared with those without LGE, with a median follow up of 17 months in the USA [57]. Others studied consecutive 101 patients with nonischemic cardiomyopathy (mean LVEF, <40%) with the presence or absence of midwall fibrosis, with a follow-up of 1.8 years for events in the UK; midwall fibrosis was present in 35% of patients; the presence of the LGE was associated with a threefold increase in death or hospitalization [58]. LGE patterns obtained using CMR can provide detailed diagnostic information on myocardial viability.