Transient left ventricular dysfunction in Churg Strauss syndrome: a case report

A 42 year old woman was admitted to our hospital for investigation of eosinophilia. There were no findings from the physical examination of the lungs and heart. The echocardiography showed a segmental hypokinesia of the interventricular septum and the apex causing left ventricular dysfunction with an ejection fraction 45% and mild pericardial effusion. Cardiac magnetic resonance was performed, for detection of lesions associated with the underline disease, using electrocardiogram-triggered T2-weighted and T1-weighted multislice spin-echo images (before and after an intravenous bolus of gadolinium)

Correlation of levels of cardiotrophin -1 and left atrial size of the heart in patients with diastolic dysfunction of left ventricle

In the present clinical study we measured the levels of cardiotrophin-1 in patients with diastolic dysfunction and we correlate them with the left atrial size. The specific patient's population was compared with healthy people. We did not verify the correlation of levels of cardiotrophin-1 with the left atrial size , but we found that the levels of that particular biomarker were increased in asymptomatic hypertensive patients. This could be an useful biomarker in hypertensive cardiomyopathy in early stage.H παρούσα μελέτη σε πληθυσμό ασυπτωματικών υπερτασικών με διαστολική δυσλειτουργία σταδίου 1, υπολόγισε τα επίπεδα καρδιοτροφίνης -1και τα συσχέτισε με το μέγεθος του αριστερού κόλπου. Ο συγκεκριμένος πληθυσμός συγκρίθηκε με ομάδα υγιών ατόμων . Δεν διαπιστώθηκε συσχέτιση του μεγέθους του αρ. κόλπου της καρδιάς με τα επίπεδα καρδιοτροφίνης, διαπιστώθηκε όμως η αύξηση των επιπέδων του συγκεκριμένου βιοδείκτη στους ασυμπτωματικούς υπερτασικούς, το οποίο αποτελει προγνωστικό δείκτη στην αρχόμενη υπερτασική καρδιοπάθεια

Clinical Study Cigarette Smoking Is Associated with Prolongation of the QTc Interval Duration in Patients with Type 2 Diabetes Mellitus

Aims. Aim of the study was to evaluate the effect of smoking on autonomic nervous system (ANS) activity and QTc interval duration in patients with Type 2 diabetes mellitus (T2DM). Methods. A total of 70 patients with T2DM (35 chronic smokers, 35 nonsmokers) treated with oral antidiabetic medications underwent continuous ECG Holter monitoring for 24 hours and analysis of time-and frequency-domain measures of heart rate variability (HRV). HRV over short time was also assessed using the deep breathing test. In addition, baroreflex sensitivity (BRS) was evaluated using the spontaneous sequence method. The mean QTc interval was measured from the 24-hour ECG recordings. Results. Smokers had lower body mass index (BMI) and exhibited higher 24-hour mean heart rate. There was no difference regarding all measures of ANS activity between the two groups. Smokers showed increased mean QTc duration during the 24 hours (439.25 ± 26.95 versus 425.05 ± 23.03 ms, = 0.021) as well as in both day (439.14 ± 24.31 ms, = 0.042) and night periods (440.91 ± 32.30 versus 425.51 ± 24.98 ms, = 0.033). The association between smoking status and mean QTc interval persisted after adjusting for BMI. Conclusions. Cigarette smoking is associated with prolongation of the QTc interval in patients with T2DM by a mechanism independent of ANS dysfunction

Relationship between Autonomic Nervous System Function and Continuous Interstitial Glucose Measurement in Patients with Type 2 Diabetes

Aims. The Aim of the present study was to examine whether there is a relationship between autonomic nervous system function and glycemic variability (GV) in patients with type 2 diabetes (T2D). Methods. A total of 50 (29 males) patients with T2D (mean age 58.4 ± 9.9 years, median diabetes duration 5.5 [IQR 2.0–9.25] years), on oral antidiabetic agents, underwent ECG recording and subcutaneous glucose monitoring, simultaneously and continuously, for 24 hours. Results. After adjustment for HbA1c and diabetes duration, total power of heart rate variability (HRV) was inversely associated with the standard deviation of the mean interstitial tissue glucose (MITG) and with the M-value during the entire recording (r: −0.29, P=0.052; r: −0.30, P=0.047, resp.) and during the night (r: −0.29, P=0.047; r: −0.31, P=0.03, resp.). Most of the HRV time-domain indices were significantly correlated with standard deviation of the MITG and the M-value. These correlations were stronger for the HRV recordings during the night. No significant association was found between HRV parameters and MAGE. Conclusions. HRV is inversely associated with GV in patients with T2D, which might be a sign of causation between GV and autonomic dysfunction. Prospective studies are needed to further investigate the importance of GV in the pathogenesis of long-term complications of diabetes

Cigarette Smoking Is Associated with Prolongation of the QTc Interval Duration in Patients with Type 2 Diabetes Mellitus

Aims. Aim of the study was to evaluate the effect of smoking on autonomic nervous system (ANS) activity and QTc interval duration in patients with Type 2 diabetes mellitus (T2DM). Methods. A total of 70 patients with T2DM (35 chronic smokers, 35 nonsmokers) treated with oral antidiabetic medications underwent continuous ECG Holter monitoring for 24 hours and analysis of time- and frequency-domain measures of heart rate variability (HRV). HRV over short time was also assessed using the deep breathing test. In addition, baroreflex sensitivity (BRS) was evaluated using the spontaneous sequence method. The mean QTc interval was measured from the 24-hour ECG recordings. Results. Smokers had lower body mass index (BMI) and exhibited higher 24-hour mean heart rate. There was no difference regarding all measures of ANS activity between the two groups. Smokers showed increased mean QTc duration during the 24 hours (439.25±26.95 versus 425.05±23.03 ms, P=0.021) as well as in both day (439.14±24.31 ms, P=0.042) and night periods (440.91±32.30 versus 425.51±24.98 ms, P=0.033). The association between smoking status and mean QTc interval persisted after adjusting for BMI. Conclusions. Cigarette smoking is associated with prolongation of the QTc interval in patients with T2DM by a mechanism independent of ANS dysfunction

Cigarette Smoking Is Associated with Prolongation of the QTc Interval Duration in Patients with Type 2 Diabetes Mellitus

Aims. Aim of the study was to evaluate the effect of smoking on autonomic nervous system (ANS) activity and QTc interval duration in patients with Type 2 diabetes mellitus (T2DM). Methods. A total of 70 patients with T2DM(35 chronic smokers, 35 nonsmokers) treated with oral antidiabetic medications underwent continuous ECG Holter monitoring for 24 hours and analysis of time- and frequency-domain measures of heart rate variability (HRV). HRV over short time was also assessed using the deep breathing test. In addition, baroreflex sensitivity (BRS) was evaluated using the spontaneous sequence method. The mean QTc interval was measured from the 24-hour ECG recordings. Results. Smokers had lower body mass index (BMI) and exhibited higher 24-hour mean heart rate. There was no difference regarding all measures of ANS activity between the two groups. Smokers showed increased mean QTc duration during the 24 hours (439.25 +/- 26.95 versus 425.05 +/- 23.03 ms, P = 0.021) as well as in both day (439.14 +/- 24.31 ms, P = 0.042) and night periods (440.91 +/- 32.30 versus 425.51 +/- 24.98 ms, P = 0.033). The association between smoking status and mean QTc interval persisted after adjusting for BMI. Conclusions. Cigarette smoking is associated with prolongation of the QTc interval in patients with T2DM by a mechanism independent of ANS dysfunction

Relationship between Autonomic Nervous System Function and Continuous Interstitial Glucose Measurement in Patients with Type 2 Diabetes

Aims. The Aim of the present study was to examine whether there is a relationship between autonomic nervous system function and glycemic variability (GV) in patients with type 2 diabetes (T2D). Methods. A total of 50 (29 males) patients with T2D (mean age 58.4 +/- 9.9 years, median diabetes duration 5.5 [IQR 2.0-9.25] years), on oral antidiabetic agents, underwent ECG recording and subcutaneous glucose monitoring, simultaneously and continuously, for 24 hours. Results. After adjustment for HbA1c and diabetes duration, total power of heart rate variability (HRV) was inversely associated with the standard deviation of the mean interstitial tissue glucose (MITG) and with the M-value during the entire recording (r: -0.29, P = 0.052; r: -0.30, P = 0.047, resp.) and during the night (r: -0.29, P = 0.047; r: -0.31, P = 0.03, resp.). Most of the HRV time-domain indices were significantly correlated with standard deviation of the MITG and the M-value. These correlations were stronger for the HRV recordings during the night. No significant association was found between HRV parameters and MAGE. Conclusions. HRV is inversely associated with GV in patients with T2D, which might be a sign of causation between GV and autonomic dysfunction. Prospective studies are needed to further investigate the importance of GV in the pathogenesis of long-term complications of diabetes

Advanced Heart Failure: Therapeutic Options and Challenges in the Evolving Field of Left Ventricular Assist Devices

Heart Failure is a chronic and progressively deteriorating syndrome that has reached epidemic proportions worldwide. Improved outcomes have been achieved with novel drugs and devices. However, the number of patients refractory to conventional medical therapy is growing. These advanced heart failure patients suffer from severe symptoms and frequent hospitalizations and have a dismal prognosis, with a significant socioeconomic burden in health care systems. Patients in this group may be eligible for advanced heart failure therapies, including heart transplantation and chronic mechanical circulatory support with left ventricular assist devices (LVADs). Heart transplantation remains the treatment of choice for eligible candidates, but the number of transplants worldwide has reached a plateau and is limited by the shortage of donor organs and prolonged wait times. Therefore, LVADs have emerged as an effective and durable form of therapy, and they are currently being used as a bridge to heart transplant, destination lifetime therapy, and cardiac recovery in selected patients. Although this field is evolving rapidly, LVADs are not free of complications, making appropriate patient selection and management by experienced centers imperative for successful therapy. Here, we review current LVAD technology, indications for durable MCS therapy, and strategies for timely referral to advanced heart failure centers before irreversible end-organ abnormalities