1/14. Rapid progression of cardiomyopathy in mitochondrial diabetes.Cardiac involvement and its clinical course in a diabetic patient with a mitochondrial tRNA(Leu)(UUR) mutation at position 3243 is reported in a 54-year-old man with no history of hypertension. At age 46, an electrocardiogram showed just T wave abnormalities. At age 49, it fulfilled SV1 RV5 or 6>35 mm with strain pattern. At age 52, echocardiography revealed definite left ventricular (LV) hypertrophy, and abnormally increased mitochondria were shown in biopsied endomyocardial specimens. He was diagnosed as having developed hypertrophic cardiomyopathy associated with the mutation. However, at age 54, SV1 and RV5,6 voltages were decreased, and echocardiography showed diffuse decreased LV wall motion and LV dilatation. Because he had mitochondrial diabetes, the patient's heart rapidly developed hypertrophic cardiomyopathy, and then it seemed to be changing to a dilated LV with systolic dysfunction. Rapid progression of cardiomyopathy can occur in mitochondrial diabetes.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/14. Myocardial perfusion and metabolic changes induced by biventricular pacing in dilated cardiomyopathy and left bundle branch block: description of a case evaluated by positron emission tomography.The effects of biventricular pacing on myocardial wall function are well known, but, at the moment, its real effects on myocardial metabolism are unclear. In patients affected by left bundle branch block, at positron emission tomography a septal defect of the uptake of 18F-fluorodeoxyglucose (FDG) was referred. There were no alterations in myocardial perfusion, suggesting possible metabolic damage. In this paper we report the case of a patient affected by dilated cardiomyopathy and left bundle branch block treated with a biventricular device. Biventricular pacing resolved both the wall motion alterations as well as the defect in FDG uptake present in the septal area. On the contrary, during biventricular pacing there were no modifications in myocardial perfusion as compared to basal evaluation.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/14. A case of cardiomyopathy induced by premature ventricular complexes.tachycardia-induced cardiomyopathy is a well-known and reversible condition, but the left ventricular dysfunction caused by frequent isolated premature ventricular complexes (PVCs) has been rarely reported. Apparent dilated cardiomyopathy was resolved in a patient after the focal source of PVCs was eliminated by radiofrequency catheter ablation. echocardiography showed progressive improvement of the abnormal wall motion. Frequent PVCs could be the cause of left ventricular dysfunction in a subset of patients with dilated cardiomyopathy and radiofrequency ablation should be the choice of therapy in those patients.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/14. Impedance cardiography and quantitative tissue Doppler echocardiography for evaluating the effect of cardiac resynchronization therapy: a case report.An 83-year-old woman presented with dilated cardiomyopathy. cardiac resynchronization therapy was performed. Two weeks later, cardiac output and ventricular wall motion were estimated using impedance cardiography and tissue Doppler echocardiography with and without pacing. cardiac output increased from 3.5 to 4.5 l/min during biventricular pacing with a 120 msec atrioventricular interval. Intraventricular phase difference for contraction decreased from 190 to 150 msec. When the atrioventricular interval was 180 msec, cardiac output and phase difference became 4.6 l/min and 170 msec. These assessments were performed rapidly and non-invasively. New impedance cardiography and tissue Doppler echocardiography are useful to evaluate the effect of cardiac resynchronization therapy.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/14. Partial left ventriculectomy for end-stage cardiomyopathy: report of a case.Cardiac transplantation is an established treatment for end-stage heart failure, but its use is very limited. Partial left ventriculectomy has been reported as an alternative treatment for end-stage dilated cardiomyopathy. However, it has been well recognized that emergency partial left ventriculectomy for intractable decompensation is associated with poor survival. We report a case of a 68-year-old man with a left ventricular end-diastolic diameter of 108 mm, who underwent emergency extended partial left ventriculectomy, without papillary muscle resection, and mitral valve replacement with chordae preservation to deal with ongoing cardiogenic shock caused by end-stage dilated cardiomyopathy. The patient's cardiac status and general condition improved after the operation, and he survived the crisis. This operation should be considered as an alternative strategy for patients with septal motion and very large left ventricle. Thus, we report a successful extended partial left ventriculectomy and mitral valve replacement for end-stage dilated cardiomyopathy with very large left ventricular end-diastolic diameter.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/14. Reversible left ventricular hypertrophy after tako-tsubo-like cardiomyopathy.Tako-tsubo-like cardiomyopathy is a newly-recognized enigmatic disease characterized by transient left ventricular dysfunction of a broad area of the apex with a hyperkinetic area around the cardiac base. There is ST-segment elevation with no coronary stenosis. The exact mechanism for this entity remains unknown. Here, we report a case of tako-tsubo-like cardiomyopathy that showed a marked left ventricular hypertrophy (LVH) when the wall motion returned to normal. LVH was normalized at 10 months. The cause of LVH remains unknown.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/14. Insights from continued use of a Novacor Left Ventricular Assist System for a period of 6 years.We report a patient supported with the Novacor Left Ventricular Assist System for more than 6 years and chronicle his progress as an illustration of the clinical, practical, and emotional challenges of this therapy and the benefits of an intervention that can return a morbidly ill patient to an essentially normal lifestyle. This experience underlines the importance of patient selection, optimal timing of intervention, and the potential impact of psychologic issues on outcome.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/14. Efficacy of biventricular pacing for dialysis-related hypotension due to idiopathic dilated cardiomyopathy.A 45-year-old man who had been undergoing maintenance hemodialysis for end-stage renal failure, caused by chronic glomerulonephritis 4 years before, was admitted to our hospital for biventricular pacemaker implantation (BVP). Ten years ago, he was diagnosed with idiopathic dilated cardiomyopathy, and had been suffering from dialysis-related hypotension (DRH) due to low cardiac function over the past year. An electrocardiogram revealed complete left bundle branch block with a QRS duration of 180 ms, and echocardiography showed moderate hypokinesis of the left ventricular wall and systolic asynchronized motion of the septum and free wall. After BVP, the left ventricular ejection fraction had increased from 29% to 40%, and the transmitral rapid left ventricular filling (E wave) and atrial contraction (A wave) ratio (E/A) had improved from 1.3 to 1.0. Before and after BVP, we measured hemodynamic parameters during hemodialysis by successive echocardiography. Before BVP, systemic vascular resistance had decreased, cardiac output had not changed, and hypotension was noted. In contrast, after BVP, cardiac output had increased and systemic vascular resistance had not changed, which caused an increase in blood pressure. We conclude that BVP improved the cardiac function which resulted in an improvement in dialysis-related hypotension (DRH).- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/14. perfusion and mechanical analysis with technetium-99m 2-methoxy-isobutyl-isonitrile in a case of dilated cardiomyopathy.With technetium-99m 2-methoxy-isobutyl-isonitrile (99mTc-MIBI), regional wall thickening in a patient with dilated cardiomyopathy was analyzed by the first component Fourier method. The regional wall thickening was compared with thallium-201 and 99mTc-MIBI SPECT imaging. thallium-201 SPECT images showed mildly reduced perfusion in the posterior wall and redistribution in the septum, whereas 99mTc-MIBI images showed heterogeneous accumulation around the left ventricular circumference. By means of phase analysis, diffusely decreased wall thickening and discontinuity of percent wall thickening in neighboring segments were observed throughout the left ventricle. Regional wall motion and wall thickening correlated roughly. However, discrepancies between the mechanical function and myocardial perfusion, and discrepancies in regional myocardial perfusion between thallium-201 and 99mTc-MIBI were observed.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/14. Angiographic long-term follow-up of primary apical ballooning of the left ventricle.Acute and reversible left ventricular apical wall motion abnormalities presenting with chest pain, electrocardiographic (EKG) changes and cardiac markers release, in the absence of coronary artery stenosis, have already been identified as a possible distinct clinical entity: the so-called Tako-Tsubo syndrome. A 65-year-old man with history of hypertension, hypercholesterolemia and smoking, was admitted at the emergency room of a secondary referral institution with a severe and prolonged (45 min) chest pain, irradiated to the left arm, associated with neurovegetative syndrome. The clinical presentation suggested an acute myocardial infarction (AMI). Interestingly no coronary artery stenoses or vasospasm reaction to administration of acetylcholine could be detected. A slow flow phenomenon was present. The left ventricle angiography confirmed a mild depression of left ventricle systolic function (EF 45%), with akinesia of antero-lateral wall and the typical apical ballooning-like profile. At 3-month follow-up, the patient continued to be asymptomatic and the echocardiogram showed a progressive normalization of left ventricle segmental motion and ejection fraction with a complete restoration only after 6 months. At 1 year the coronary angiography confirmed the absence of coronary stenosis, with complete regression of the ventricular apical ballooning at left ventricle catheterization. At two-year follow-up the patient is still asymptomatic. A slow resolution of the syndrome should be included in the diagnostic criteria for apical ballooning.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
| | Next -> |