No relationship between left ventricular radial wall motion and longitudinal velocity and the extent and severity of noncompaction cardiomyopathy

<p>Abstract</p> <p>Background</p> <p>Noncompaction cardiomyopathy (NCCM) is characterized by a prominent trabecular meshwork and deep intertrabecular recesses. Although systolic dysfunction is common, limited information is available on differences in wall motion of the normal compacted and noncompacted segments. The purpose of this study was to assess radial wall motion and longitudinal wall velocity in patients with NCCM, according to the extent and severity of noncompaction.</p> <p>Methods</p> <p>The study comprised 29 patients in sinus rhythm (age 41 ± 15 years, 15 men), who fulfilled stringent diagnostic criteria for NCCM and compared to 29 age and gender matched healthy controls. Segmental radial wall motion of all compacted and noncompacted segments was assessed with the standard visual wall motion score index and longitudinal systolic (Sm) wall velocity with tissue Doppler imaging of the mitral annulus. For each LV wall a normalized Sm value was calculated. The extent and severity of NC in each LV segment was assessed both in a qualitative and quantitative manner.</p> <p>Results</p> <p>Heart failure was the primary clinical presentation in half of the patients. NCCM patients had a wall motion score index of 1.68 ± 0.43 and a normalized Sm of 82 ± 20%. The total and maximal noncompaction scores were not related to the wall motion score index and the normalized Sm. NCCM patients with and without heart failure had similar total and maximal noncompaction scores.</p> <p>Conclusions</p> <p>In NCCM patient's radial wall motion and longitudinal LV wall velocity is impaired but not related to the extent or severity of noncompaction.</p

The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures: A report from the Euro Heart Survey on Coronary Revascularisation

Objective: Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary artery disease (CAD) undergoing angiographic procedures. Methods: Data from the EHS-CR that included 5619 patients from 31 member countries of the European Society of Cardiology were used. Inclusion criteria for the current study were completion of a self-report measure of health status, the EuroQol Questionnaire (EQ-5D) at discharge and information on 1-year follow-up, resulting in a study population of 3786 patients. Results: The 1-year mortality was 3.2% (n = 120). Survivors reported fewer problems on the five dimensions of the EQ-5D as compared with non-survivors. A broad range of potential confounders were adjusted for, which reached a p<0.10 in the unadjusted analyses. In the adjusted analyses, problems with self-care (OR 3.45; 95% CI 2.14 to 5.59) and a low rating (≤ 60) on health status (OR 2.41; 95% CI 1.47 to 3.94) were the most powerful independent predictors of mortality, among the 22 clinical variables included in the analysis. Furthermore, patients who reported no problems on all five dimensions had significantly lower 1-year mortality rates (OR 0.47; 95% CI 0.28 to 0.81). Conclusions: This analysis shows that impaired health status is associated with a 2-3-fold increased risk of all-cause mortality in patients with CAD, independent of other conventional risk factors. These results highlight the importance of including patients' subjective experience of their own health status in the evaluation strategy to optimise risk stratification and management in clinical practice

Dynamic cardiomyoplasty: impact of effective pacing

Dynamic cardiomyoplasty, in which the transposed latissimus dorsi muscle is wrapped around the heart and then electrically stimulated to augment systolic dysfunction, is an alternative surgical treatment for severe cardiomyopathies. Critical to success of this operation is to provide the wrapped skeletal muscle with more fatigue-resistant structure through repetitive electrical stimulation. A cardiostimulating device is important in this regard to perform synchronised contraction contributing to symptomatic improvement. Here in, we present a case with dynamic cardiomyoplasty improving following renewal of impaired myostimulator device. (C) 2003 Elsevier Ireland Ltd. All rights reserved

hypertension in patients with acute pulmonary embolism

Introduction: Pulmonary hypertension (PH) is the most important prognostic factor after acute pulmonary embolism (PE). Therefore, determination of patients who will develop PH after acute PE is crucial. The aim of the present study was to evaluate the predictive value of the CHADS2 and CHA2DS2-VASc scores for PH in patients with acute PE.Material and methods: Seventy-nine adults who presented with acute PE, had an admission systolic pulmonary artery pressure (sPAP) measured on echocardiogram and no previous history of PE, were retrospectively identified from the computerized database. 31 patients who had sPAP 40 mm Hg were categorized as a "PH" group.Results: SPAP was > 40 mm Hg in 48 patients (60.8%), with a mean sPAP of 60.9 +/- 16.1 mm Hg (median = 60, min-max = 41-100 mm Hg). In multivariate logistic regression models adjusted for CHADS2 and CHA2DS2-VASc score components, only age was found to be related with the development of PH. SPAP was weakly positively correlated with CHADS2 (p = 0.047; r = 0.224) and CHA2DS2-VASc (p = 0.023; r = 0.256) scores. SPAP values were increasing with the severity of the scores.Conclusions: Both CHADS2 and CHA2DS2-VASc scores could be useful in the determination of which patients should be closely followed up in order to prevent the development of PH after acute PE.C1 [Yilmaz, Samet; Yaylali, Yalin Tolga; Kuyumcu, Mevlut Serdar; Senol, Hande] Pamukkale Univ Hosp, Pamukkale Denizli, Turkey.[Unal, Sefa; Tufekcioglu, Omac] Hlth Sci Univ, Bilkent City Hosp, Ankara, Turkey

Bronchogenic cyst of interatrial septum

Bronchogenic cyst, also known as inclusion cyst, is a type of congenital endodermal heterotropia derived from an abnormal development of the ventral diverticulum of the foregut or the tracheobronchial tree during embryogenesis. Its interatrial localization is extremely rare and making a final diagnosis without surgery challenges the clinician. Herein, we report a 58-year-old male patient who had an interatrial bronchogenic cyst related to transient ischemic attack. © 2011 Italian Federation of Cardiology