Focusing on cardio-hepatic syndrome in heart failure and cardiovascular interventions: Is it time to update the prognostic risk scores?

Heart failure (HF) is a multifactorial, heterogeneous disease characterized by congestion and/or reduced cardiac output, leading to unmet metabolic demands of vital organs. Regardless of the etiology or phenotypic features (ischemic vs. non-ischemic, reduced or preserved ejection fraction, severe valvular stenosis or regurgitation), the “inevitable consequence” of the HF syndrome is the progressive end-organ dysfunction. Failure of one or more organ systems (heart itself, lungs, kidneys, liver, intestine, brain, skeletal muscle) has been the main determinant of survival in HF.1,2 Integration of new pharmacologic agents (saqubitril/valsartan, sodium-glucose cotransporter-2 (SGLT-2) inhibitors) into guideline-directed medical therapy and advancements in interventional and surgical procedures (complex coronary interventions, transcatheter aortic valve implantation (TAVI), Mitra-clip, left ventricular assist devices) have led to a significant improvement in HF mortality in selected patients.3-7 However, HF still remains a global health problem associated with reduced survival, frequent hospitalizations, and impaired quality of life

Miyokart infarktüsü sonrası erken dönemde gelişen akut ciddi mitral yetersizliğinin perkütan tedavisi ve kısa literatür özeti

Transcatheter edge-to-edge repair treatment is mainly used for patients with chronic heart failure concomitant severe mitral regurgitation. However, utilization of this system in the acute seting of myocardial infarction is still limited. In this case report authors aimed to show the effectiveness of the percutaneous treatment for severe acute mitral regurgitation early after myocardial infarction.Transkateter uç uca onarım temel olarak ciddi mitral yetersizliğinin eşlik ettiği kronik kalp yeter- sizliği hastalarında kullanılmaktadır. Ancak bu sistemin miyokart infarktüsünün akut fazında kullanımı henüz sınırlıdır. Yazarlar bu olgu sunumunda miyokart infarktüsü sonrası erken dönemde gelişen akut ciddi mitral yetersizliğinde perkütan tedavinin etkinliğini göstermeyi amaçlamışlardır

Which one is worse? Acute myocarditis and co-existing non-compaction cardiomyopathy in the same patient

WOS: 000422589400051PubMed ID: 26266155Non-compaction cardiomyopathy is a relatively rare cardiac condition known to be found in 0.12 per 100,000 cases characterized by increased trabeculations in the ventricular wall due to embryologic malformation predisposing malignant ventricular arrhythmias [1,2]. Although acute postviral myocarditis has been well-documented in the medical literature, co-existence of these two clinical entities is extremely uncommon [3-5]

Herniation of Bichat's Fat Tissue into the Oral Cavity Secondary to Trauma

Herniation of Bichat’s fat tissue into the oral cavity is a rare clinical entity. It is known as “traumatic pseudolipoma,” which develops within a short time after direct trauma to the buccal mucosa, especially in young children, or as “post-traumatic lipoma,” which occurs depending on the changes in the storage and differentiation of adipocytes after conditions, such as trauma and hematoma, that trigger cytokine release. In this article, herniation of Bichat’s fat tissue secondary to blunt-penetrating trauma in a 3-year-old boy is presented, and important points of diagnosis and treatment procedures are discussed in accordance with the literature

Isolated subclinical right ventricle systolic dysfunction in patients after liver transplantation

Although hemodynamic alterations in end-stage liver disease (ESLD) and its association with porto-pulmonary hypertension have been well-established, the long-term effects of ESLD on RV systolic function in patients without porto-pulmonary hypertension remain disregarded. Here we aimed to assess the long-term effect of ESLD on RV function and its relationship with the use of NSBBs and clinical, laboratory and imaging parameters in end-stage liver disease. The use of NSBBs is still controversial due to concerns about reduced cardiac contractility and the possibility of increased mortality. Thirty-four liver transplant recipients were included. Demographic characteristics, laboratory and baseline echocardiography measures were obtained. Patients were recalled for transthoracic echocardiographic evaluation after transplantation. Right ventricle dysfunction was identified by having at least one value below the reference levels of RV S', or TAPSE. Isolated subclinical RV dysfunction was observed at 20.6% of the sample population. The present study demonstrates hemodynamic circulation in cirrhosis and increased preload and afterload might have long-term effects on RV function, even the lack of porto-pulmonary hypertension. These findings underline the significance of cardiac function follow-up in cirrhotic patients after transplantation. In this study, patients treated with propranolol seemed to have better RV function and less gastrointestinal bleeding. We speculated that preoperative propranolol treatment might help preserve RV function by providing RAS suppression, improving endothelial function and hyperdynamic circulation seen in ESLD. This potential protective relationship between the use of propranolol and RV function might improve mortality or graft-failure during OLT and after liver transplantation in patients with cirrhosis

Angio-seal used as a bailout for incomplete hemostasis after dual perclose ProGlide deployment in transcatheter aortic valve implantation

Background: The failure rate of vascular closure devices remains a significant cause of major vascular complications in contemporary transcatheter aortic valve implantation practice. Methods: This research aimed to evaluate use of the Angio-Seal device in a bailout context in the setting of incomplete hemostasis following use of dual Perclose ProGlide devices in patients undergoing transfemoral transcatheter aortic valve implantation. A total of 185 patients undergoing transfemoral transcatheter aortic valve implantation with either dual Per-close ProGlide (n = 139) or a combination of dual Perclose ProGlide and Angio-Seal (n = 46) were retrospectively analyzed. The baseline, procedural characteristics, and all outcomes (defined according to Valve Academic Research Consortium-2 criteria) were compared. Results: No significant differences were seen between the dual Perclose ProGlide vs dual Perclose ProGlide+Angio-Seal groups with regard to the in-hospital Valve Academic Research Consortium-2 primary end points of major vascular complications (n = 13 [9.4%] vs n = 2 [4.3%]; P =.36), minor vascular complications (n = 13 [9.4%] vs n = 8 [14.7%]; P =.14), major bleeding (n = 16 [11.5%] vs n = 2 [4.3%]; P =.25), and minor bleeding (n = 9 [6.5%] vs n = 5 [10.9%]; P =.34), with higher rates of hematoma in the dual Perclose ProGlide+Angio-Seal group (n = 4 [2.9%] vs n = 5 [10.9%]; P =.044). Conclusion: Finding from the current study suggest that adjunctive Angio-Seal deployment may be feasible and safe, especially in patients with incomplete hemostasis following dual Perclose ProGlide use, and can be an optimal “bailout” procedure. (Tex Heart Inst J. 2022;49(6):e217684)

Factor XIII Val34Leu polymorphism in patients with cardiac syndrome X

Background: The aim of the study was to examine the frequency of factor XIII polymorphism among patients with cardiac syndrome X (CSX).Methods: This study was designed as a cross-sectional and observational study. Forty-eight female patients with CSX and 36 controls matched by age, gender, diabetes, and hypertension were studied. CSX was defined as typical chest pain during rest or effort, abnormal test result for exercise ECG, and presence of angiographically normal epicardial coronary arteries after ruling out inducible spasm. Factor XIII gene polymorphism was investigated by using CVD Strip Assay (ViennaLab Diagnostic GmbH) commercial kit.Results: The frequency of factor XIII (Val/Leu + Leu/Leu) mutation was significantly higher in patients with CSX (43%) than in controls (19%) (p = 0.02). Frequency of the Leu allele was significantly higher in the patient group (23.5% vs. 11.1%, p = 0.04). Factor XIII (Val/Leu + Leu/Leu) mutation (p = 0.01, OR = 3.42; 95% CI 1.22–9.58) and smoking (p = 0.04, OR = 3.33, 95% CI 1.05–10.58) were identified as independent predictors of the disease in multivariate regression analysis.Conclusions: This study indicates that there is an evidence for association between factor XIII Val34Leu polymorphism and CSX

Changes in electrocardiographic p wave parameters after cryoballoon ablation and their association with atrial fibrillation recurrence

Background: Changes in P wave parameters after circumferential pulmonary vein isolation (CPVI) have been previously identified. In this study, we aimed to determine the changes in P wave parameters surface electrocardiogram (ECG) after cryoballoon ablation (CBA) for atrial fibrillation (AF) and evaluate their relationship with AF recurrence. Methods: Sixty-one patients (mean age 53 ± 11 years, 50.8% male) with paroxysmal AF who underwent CBA were enrolled. A surface ECG was obtained from all patients immediately before the procedure, and repeated 12 hours after the procedure. P wave amplitude (Pamp), P wave duration (Pwd), and P wave dispersion (Pdis) values in preprocedural and postprocedural ECGs were measured and compared. Recurrence rates of AF in 3, 6, and 9 months following ablation were recorded for all patients. Changes in P wave parameters were compared between patients with and without AF recurrence. Results: Compared to preprocedural measurements, Pamp (from 0.58 ± 0.18 mV at baseline to 0.48 ± 0.17 mV, P 0.05). Conclusion: Pamp, Pwd, and Pdis parameters exhibited significant decrease after CBA compared to preprocedural measurements. Decreased Pamp was shown to be a predictor for good clinical outcomes following CBA

Tako-tsubo cardiomyopathy following catheter ablation of atrial fibrillation

WOS: 000351601600012PubMed ID: 25355779Tako-tsubo cardiomyopathy is characterized by reversible left ventricular dysfunction following emotional or surgical stress. Unlike the well-known complications of catheter ablation (CA) of atrial fibrillation (AF), Tako-tsubo cardiomyopathy has been rarely reported so far. We report a case of acute reversible left heart failure following successful CA of paroxysmal AF in a patient with a history of panic disorder

Acute left main coronary artery occlusion following transcatheter aortic valve replacement without obvious risk factors of coronary obstruction

Transcatheter aortic valve implantation (TAVI) has emerged as a prominent alternative for patients with severe aortic stenosis, who are deemed to be at a greater risk for surgical interventions (1). However, extreme caution is recommended against the lethal complications, such as coronary obstruction (CO) or annulus rupture, associated with this procedure that need to be overcome urgently (1). Herein, we report an occlusion of acute left main coronary artery (LMCA) after TAVI, which was treated with triple stenting, due to immediate stent recoils