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BMJ Case Rep 2021 May 6;14(5). Epub 2021 May 6.

Foundation Programme, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK

We report the case of a 57-year-old man who presented overnight to a district general hospital as a primary percutaneous coronary intervention alert for an inferior ST elevation myocardial infarction. On presentation to cardiac catheterisation lab, he had ongoing chest pain but began to complain of left-sided limb weakness and pain in his right leg. He was found to have dense hemiparesis on examination with an National Institute of Health Stroke Scale of 8 and an absent right femoral pulse. Read More

Cureus 2021 Mar 27;13(3):e14145. Epub 2021 Mar 27.

Cardiology, St. Luke's Hospital, Chesterfield, USA.

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS), most frequently occurring in young females of reproductive age, and has a high mortality rate. Currently, no guidelines are available to direct treatment. We report a case of a 29-year-old female with complications of SCAD treated with coronary artery bypass graft (CABG), resulting in a better outcome as compared to that of percutaneous coronary intervention (PCI). Read More

Circ Heart Fail 2021 Apr 30:CIRCHEARTFAILURE120008191. Epub 2021 Apr 30.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN. (M.K.M., Y.N.V.R., S.J.A., R.A.N.).

J Clin Med 2021 Apr 22;10(9). Epub 2021 Apr 22.

Department of Cardiology, Joan XXIII University Hospital, 43005 Tarragona, Spain.

Patients with severe mitral regurgitation (MR) after myocardial infarction (MI) have an increased risk of mortality. Transcatheter mitral valve repair may therefore be a suitable therapy. However, data on clinical outcomes of patients in an acute setting are scarce, especially those with reduced left ventricle (LV) dysfunction. Read More

Catheter Cardiovasc Interv 2021 Apr 19. Epub 2021 Apr 19.

The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio, USA.

Background: Among acute myocardial infarction patients with cardiogenic shock (AMICS), a number of key variables predict mortality, including cardiac arrest (CA) and shock classification as proposed by Society for Cardiovascular Angiography and Intervention (SCAI). Given this prognostic importance, we examined the frequency of reporting of high risk variables in published randomized controlled trials (RCTs) of AMICS patients.

Methods: We identified 15 RCTs enrolling 2,500 AMICS patients and then reviewed rates of CA, baseline neurologic status, right heart catheterization data, lactate levels, inotrope and vasopressor requirement, hypothermia, mechanical ventilation, left ventricular ejection fraction (LVEF), mechanical circulatory support, and specific cause of death based on the primary manuscript and Data in S1. Read More

Postepy Kardiol Interwencyjnej 2021 Mar 27;17(1):129-130. Epub 2021 Mar 27.

3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease in Zabrze, Poland.

An 83-year-old man with a history of permanent atrial fibrillation (AF) anticoagulated by dabigatran 150 b.i.d. Read More

Thorac Cardiovasc Surg 2021 Apr 16. Epub 2021 Apr 16.

Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, United States.

Background:  Severe pulmonary hypertension (PH) and left ventricular diastolic dysfunction (LVDD) are independently associated with poor outcomes in cardiac surgery. We evaluated the relationship of several measures of LVDD, PH, and hemodynamic subtypes of PH including precapillary pulmonary hypertension(pcPH) and isolated post-capillary pulmonary hypertension(ipcPH) and combined pre and post capillary pulmonary hypertension(cpcPH) capillary PH to postoperative outcomes in a cohort of patients who underwent elective isolated-AVR.

Methods:  We evaluated ( = 206) patients in our local STS database who underwent elective isolated-AVR between 2014 and 2018, with transthoracic echocardiogram ( = 177) or right heart catheterization ( = 183) within 1 year of operation (or both,  = 161). Read More

J Cardiol 2021 Apr 6. Epub 2021 Apr 6.

Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. Electronic address:

Background: Mitochondria are dynamic organelles that undergo fission or fusion. These mitochondrial dynamics are reported to be associated with pulmonary hypertension (PH). PH is divided into 5 groups, including pulmonary artery hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH), based on its pathogenesis. Read More

Rev Port Cir Cardiotorac Vasc 2021 Apr 8;28(1):69-70. Epub 2021 Apr 8.

Department of Cardiothoracic Surgery, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.

59-year-old women with permanent atrial fibrillation and previous haemorrhagic stroke was admitted for percutaneous left atrial appendage occlusion. Shortly after, AmplatzerTM device migration into the left ventricular outflow tract was confirmed. Unsuccessful transcatheter mobilization led to an emergent surgery for device retrieval and LAA closure. Read More

Kyobu Geka 2021 Mar;74(3):174-180

Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Fukuyama, Japan.

We aimed to evaluate the results of transapical transcatheter aortic valve implantation (TAVI) for aortic stenosis. Thirty patients who had aortic stenosis and underwent transapical TAVI between 2016 and 2020 were enrolled. Medical records were reviewed, and the following data were retrieved and analyzed:basic demographic data, and intraoperative data and postoperative outcomes. Read More

ESC Heart Fail 2021 Apr 8. Epub 2021 Apr 8.

Department of Internal Medicine/Cardiology, Heart Center Leipzig at the University of Leipzig and Leipzig Heart Institute, Strümpellstraße 39, Leipzig, 04289, Germany.

Aims: Establishing a diagnosis of inflammatory cardiomyopathy (iCMP) by non-invasive means remains challenging despite advances in cardiac magnetic resonance imaging. Previous studies suggested the involvement of microRNAs in the pathogenesis of iCMP. We examined the association of a predefined set of circulatory microRNAs with clinical characteristics of iCMP and evaluated their diagnostic performance in suspected iCMP. Read More

Clin Physiol Funct Imaging 2021 Apr 8. Epub 2021 Apr 8.

Department of Clinical Sciences and Cardiology, Lund University, Lund, Sweden.

Aims: Detecting changes in ventricular function after orthotopic heart transplantation (OHT) using transthoracic echocardiography (TTE) is important but interpretation of findings is complicated by lack of data on early graft adaptation. We sought to evaluate echocardiographic measures of ventricular size and function the first year following OHT including speckle tracking derived strain. We also aimed to compare echocardiographic findings to haemodynamic parameters obtained by right heart catheterization (RHC). Read More

Eur Heart J Case Rep 2021 Mar 31;5(3):ytab113. Epub 2021 Mar 31.

Cardiology Division, Sant'Andrea Hospital, Corso Mario Abbiate 21, 13100, Vercelli, Italy.

Background: Left atrial appendage (LAA) closure is an alternative to chronic oral anticoagulation for stroke prevention in patients with atrial fibrillation (AF) at high bleeding risk. Patients with a previous percutaneous closure of a patent foramen ovale (PFO) present an increased risk for developing AF during their life, and the presence of an atrial septal device renders future percutaneous left atrial access more challenging. Very few cases of LAA occlusion in patients with a preexisting PFO closure device have been previously reported. Read More

J Med Case Rep 2021 Apr 6;15(1):151. Epub 2021 Apr 6.

Department of Cardiology, NewYork-Presbyterian Queens, Flushing, USA.

Background: Pseudo-Wellens syndrome is a rare entity characterized by the presence of electrocardiogram (ECG) changes of Wellens syndrome but without the stenosis of the left anterior descending (LAD) coronary artery. In previous reports, pseudo-Wellens syndrome most commonly resulted from recreational drug use or unidentified etiologies. We present a unique case of pseudo-Wellens syndrome due to sepsis-induced cardiomyopathy and a review of the literature. Read More

Eur J Radiol 2021 Mar 26;139:109679. Epub 2021 Mar 26.

Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL, 60611, United States.

Purpose: To test the hypothesis that cine MRI can be used to characterize features of left and right ventricles in post-capillary pulmonary hypertension (PH) caused by heart failure (HF) with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF).

Methods: With the approval of institution review board (IRB), 28 consecutive post-capillary PH patients (11 males, 62.1 ± 13. Read More

Am J Med Sci 2021 Apr 2. Epub 2021 Apr 2.

Department of Cardiology, Atlantic Health System, Morristown, NJ, USA.

Takotsubo cardiomyopathy (TCM), or stress induced cardiomyopathy is being increasingly recognized as a cause of acute heart failure. Often seen in women and older individuals with acute stressors, it can cause significant hemodynamic compromise. Here we report a case of a 78 year old woman who developed sudden chest pain following radiation therapy for B-Cell lymphoma. Read More

Cureus 2021 Feb 26;13(2):e13577. Epub 2021 Feb 26.

Radiology, Aurora Health Care, Milwaukee, USA.

Objective: Pulmonary vascular resistance (PVR) is a measurement obtained with invasive right heart catheterization (RHC) that is commonly used for management of patients with pulmonary arterial hypertension (PAH). Computed tomography pulmonary angiography (CTPA) is also done as part of the workup for PAH in some cases. The aim of our study was to assess the correlation of contrast dynamic changes in the main pulmonary artery (MPA) on CTPA with PVR obtained with RHC. Read More

Eur Heart J Suppl 2021 Mar 27;23(Suppl A):A23-A26. Epub 2021 Mar 27.

Department of Anesthesia and Intensive Care, IRCCS ISMETT, UPMC Italy, Via Ernesto Tricomi, 5, 90127 Palermo, Italy.

The rationale for mechanical circulatory support (MCS) in cardiogenic shock is to restore cardiac output in selected patients when critically low or in case of refractory cardiac arrest. Furthermore, an MCS device that moves blood from either the left atrium or the left ventricle to the systemic circulation will potentially unload the ventricle. These devices are used alone or in combination with venoarterial extracorporeal membrane oxygenation (VA-ECMO). Read More

Heart Lung Circ 2021 Mar 31. Epub 2021 Mar 31.

Department of Cardiology, National University Heart Centre, Singapore.

Background: The success rate of coronary angiography (CA) after transcatheter aortic valve implantation (TAVI) is variable. Our aim was to investigate CA difficulty, outcomes, and predictors of difficult CA after TAVI.

Method: This was an international multicentric retrospective cohort study that included patients with TAVI and subsequent CA between January 2010 and December 2019. Read More

Am J Med Case Rep 2021 3;9(5):291-294. Epub 2021 Mar 3.

Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States- 11203.

Contrast-induced encephalopathy (CIE) or contrast-induced neurotoxicity is a rare, elusive, and puzzling diagnostic entity, even for most astute clinicians. Only a handful of publications have been written describing this rare phenomenon. A recent systematic review has only identified a total of 52 cases between 1970 - 2017 [1]. Read More

ASAIO J 2021 Mar 29. Epub 2021 Mar 29.

From the Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, New York.

We describe the successful transplantation of a brain-dead donor supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO) after cardiac arrest secondary to pulmonary embolism. The donor was a 50-year-old female who developed massive pulmonary embolism complicated by cardiac arrest requiring initiation of VA-ECMO. An initial echocardiogram revealed severe right ventricular dysfunction which recovered after 6 days of VA-ECMO confirmed by transthoracic echocardiogram and right heart catheterization. Read More

J Med Case Rep 2021 Mar 31;15(1):177. Epub 2021 Mar 31.

Section of Cardiology, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Background: Heart failure is usually associated with a low-cardiac-output state; however, a minority of these patients are characterized by a high-output cardiac state, described as a cardiac index of > 4 L/minute/m. Usually such circulation is associated with low systemic vascular resistance or arteriovenous malformation (AVM), resulting in depressurized circulation and a high-output cardiac state. Treating physicians should be cognizant of such pathology when investigating patients with heart failure. Read More

Eur J Cardiothorac Surg 2021 Mar 30. Epub 2021 Mar 30.

Thorax and Cardiovascular Surgery, Heart and Diabetes Center Bad Oeynhausen, NRW, Ruhr-University Bochum, Germany.

Objectives: The development of late-onset right ventricular failure (LoRVF) that occurs months after a continuous-flow left ventricular assist device (LVAD) is implanted is a clinical problem that warrants investigation. Our goal was to study the incidence, clinical manifestations and prognosis of LoRVF in a population of patients who received an LVAD as bridge to transplantation.

Methods: Data were analysed from 97 consecutive patients who received an LVAD as bridge to transplantation and underwent a right heart catheterization at least 3 months after receiving an LVAD implantation. Read More

Khirurgiia (Mosk) 2021 (4):73-77

Petrovsky Russian Scientific Center of Surgery, Moscow, Russia.

Post-infarction ventricular septal defect (VSD) is a rare but formidable complication of myocardial infarction following mortality rate up to 90% without invasive treatment. Surgical closure is preferred for VSD. The authors report successful surgical treatment of a patient with post-infarction LV aneurysm and residual post-infarction VSD in 5 years after implantation of two occluders. Read More

Sci Rep 2021 Mar 22;11(1):6498. Epub 2021 Mar 22.

Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.

In patients with cardiovascular disorders, blood total ketone body (TKB) levels increase with worsening heart failure and are consumed as an alternative fuel to fatty acid and glucose. We investigated factors contributing to the increase in the blood TKB levels in patients with cardiovascular disorders. The study population consisted of 1030 consecutive patients who underwent cardiac catheterization. Read More

J Investig Med High Impact Case Rep 2021 Jan-Dec;9:23247096211001636

Creighton University, Phoenix, AZ, USA.

Right atrial (RA) masses are rare, challenging to diagnose, and potentially life-threatening with high mortality if untreated. We present a patient presenting with diffuse large B-cell lymphoma in the brain that was incidentally found to have a large RA mass. For a better definition of the RA mass, extensive workup using multimodality imaging including chest computed tomography, transthoracic echocardiography, transesophageal echocardiography, cardiac magnetic resonance imaging, and left heart catheterization was warranted. Read More

ESC Heart Fail 2021 Mar 20. Epub 2021 Mar 20.

Inserm U1096 ENVI, Rouen Medical School, UNIROUEN, Normandy University, Rouen, France.

Aims: In post-menopausal women, incidence of heart failure with preserved ejection fraction is higher than in men. Hormonal replacement therapies did not demonstrate benefits. We tested whether the non-steroidal mineralocorticoid receptor antagonist finerenone limits the progression of heart failure in ovariectomized (OVX) mice with metabolic disorders. Read More

Open Heart 2021 03;8(1)

Queensland Cardiovascular Group, Wesley Medical Research Limited, St Andrew's War Memorial Hospital, Brisbane, Queensland, Australia.

Objective: To determine whether Computed Tomography (CT) coronary angiography (CTCA) has clinical value for the assessment of left ventricular (LV) diastolic dysfunction (DD) beyond traditional information on coronary artery anatomy.

Method: In this retrospective study, a consecutive group of 72 patients (mean age 59±13 years)-who met the eligibility criteria of sinus rhythm, no significant valvular abnormalities, and who had transthoracic echocardiogram (TTE)-were analysed. The CTCA was prospectively triggered during diastole. Read More

Eur Radiol 2021 Mar 18. Epub 2021 Mar 18.

Department of Radiology, Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin, 300052, China.

Objective: This study aimed to compare the cardiac function among different sub-types of pulmonary hypertension (PH) and to explore the independent predictors of major adverse cardiovascular events (MACE).

Methods: Eighty-seven PH patients diagnosed by right heart catheterization (RHC) were recruited. Patients underwent cardiac magnetic resonance (CMR) and RHC examination within 2 weeks. Read More

Eur Heart J Case Rep 2021 Feb 5;5(2):ytaa546. Epub 2021 Jan 5.

Department of Pathology, Nash General Hospital of University of North Carolina Health Care.

Background : ST-elevation myocardial infarction (STEMI) requires timely coronary reperfusion but localizing ST-segment elevation (STE) can develop in clinical settings other than STEMI.

Case Summary : We report a case of a 66-year-old man, with a history of diabetes mellitus and arthritis presenting with haemoptysis and chest pain. The electrocardiogram (ECG) at presentation showed marked localizing STE but emergent cardiac catheterization showed no significant coronary artery obstruction and the serial serum cardiac troponin levels were within normal limits. Read More