Background Recurrence of takotsubo cardiomyopathy （TTC） is a well-known complication. However, current literature lists only a few isolated cases. We aimed to determine the incidence and clinical significance of rec...Background Recurrence of takotsubo cardiomyopathy （TTC） is a well-known complication. However, current literature lists only a few isolated cases. We aimed to determine the incidence and clinical significance of recurrent TTC. Methods ＆ Results Our institutional database constituted a collective of 114 patients diagnosed with TTC since 2003. Close follow-up of these patients revealed a recurrence of TTC in seven of these （6.1%）. The time interval between the index event and its recurrence varied between six months and six years. Arterial hypertension was more revealed in the recurrence group of TTC compared to non-recurrence group, （P = 0.02）. Chronic obstructive pulmo- nary disease and/or asthma was more diagnosed in the recurrence group, （P = 0.04）. Clinical events like fight ventficular involvement, TTC related complications such as life-threatening arrhythmias, pulmonary congestion and in hospital death were observed more frequently in the recurrent episode. Over a mean follow-up of one year the mortality rate was similar in both groups. Conclusions Recurrence of TTC within six years after index event is not an uncommon phenomenon. In the event of right ventricular involvement in the relapse phase, it might be associated with a higher complication rate. TTC recurrence should be the first differential diagnosis in patients with a past history of TTC.展开更多
Objectives To establish a cost-effective and reproducible procedure for induction of chronic left ventricular aneurysm （LVA） in rabbits. Methods Acute myocardial infarction （AMI） was induced in 35 rabbits via conc...Objectives To establish a cost-effective and reproducible procedure for induction of chronic left ventricular aneurysm （LVA） in rabbits. Methods Acute myocardial infarction （AMI） was induced in 35 rabbits via concomitant ligation of the left anterior descending （LAD） coronary artery and the circumflex （Cx） branch at the middle portion. Development of AMI was co n-firmed by ST segment elevation and akinesis of the occluded area. Echocardiography, pathological evaluation, and agar i n-tra-chamber casting were utilized to validate the formation of LVA four weeks after the surgery. Left ventricular end systolic pressure （LVESP） and diastolic pressure （LVEDP） were measured before, immediately after and four weeks after ligation. D i-mensions of the ventricular chamber, thickness of the interventricular septum （IVS） and the left ventricular posterior wall （LVPW） left ventricular end diastolic volume （LVEDV） and systolic volume （LVESV）, and ejection fraction （EF） were recorded by echo-cardiography. Results Thirty one （88.6%） rabbits survived myocardial infarction and 26 of them developed aneurysm （83.9%）. The mean area of aneurysm was 33.4% ＆#177; 2.4% of the left ventricle. LVEF markedly decreased after LVA formation, whereas LVEDV, LVESV and the thickness of IVS as well as the dimension of ventricular chamber from apex to mitral valve annulus significantly increased. LVESP immediately dropped after ligation and recovered to a small extent after LVA formation. LVEDP progressively increased after ligation till LVA formation. Areas in the left ventricle （LV） that underwent fibrosis included the apex, anterior wall and lateral wall but not IVS. Agar intra-chamber cast showed that the bulging of LV wall was prominent in the area of aneurysm. Conclusions Ligation of LAD and Cx at the middle portion could induce develo pment of LVA at a mean area ratio of 33.4%＆#177;2.4%which involves the apex, anterior wall and lateral wall of the LV.展开更多
Objectives To assess the regional diastolic function in patients with hypertrophic cardiomyopathy （HCM） by using single-beat, real-time, three-dimensional echocardiography （RT-3DE）. Methods Sixty-five patients wit...Objectives To assess the regional diastolic function in patients with hypertrophic cardiomyopathy （HCM） by using single-beat, real-time, three-dimensional echocardiography （RT-3DE）. Methods Sixty-five patients with HCM in sinus rhythm together with fifty age- and gender-matched normal controls were studied by two dimensional echocardiography （2DE） and RT-3DE. The parameters analyzed by RT-3DE included： left ventrieular （LV） volumes, left ventricular ejection fraction （LVEF）, end diastolic sphericity index （EDSI）, diastolic dyssynchrony index （DDI）, dispersion end diastole （DISPED）, and normalized 17 segmental volume-time curves. Results Evaluated by RT-3DE, LVEF was slightly lower compared with 2DE （63.2 ± 6.8% vs. 59.1 ± 6.4%, P 〈 0.0001）. Normal subjects had relatively uniform volumetric curves for all LV segments. In HCM patients, the segmental volumetric curves were dyssynchronous. Increased DDI and DISPED in end diastole were observed in patients with HCM （9.95 ± 3.75, 41.76 ± 17.19, P 〈 0.0001）, and not all abnormal volumetric segments occurred in the hypertrophic regions. Conclusions Patients with HCM have presented regional diastolic dyssynchrony in the diastole phase, and this preclinical lesion can be recognized by single-beat RT-3DE.展开更多
To the Editor The interesting report by Redfors, et aL[1] in the June issue of the Journal of Geriatric Cardiology, about an 88-year-old woman who presented with chest pain, found on echocardiography （ECHO） to have...To the Editor The interesting report by Redfors, et aL[1] in the June issue of the Journal of Geriatric Cardiology, about an 88-year-old woman who presented with chest pain, found on echocardiography （ECHO） to have transient left ventricular apical akinesis with a hypercontractile base, and an occluded first diagonal coronary branch with suspected acute plaque rupture, on coronary angiography, treated with a percutaneous coronary intervention, for which the authors concluded that the observed extent of akinesis was disproportionally large for the occluded coronary lesion, letting them to deduce that the acute myocardial infarction （AMI） caused the episode of Takotsubo syndrome （TTS）, reminds me of a similar case of an AMI due to stent thrombosis and a resultant associated TTS.展开更多
We present a computational framework for the study of cardiac motion.The bio-mechanical model captures the passive and active properties of the cardiac tissue as well as the fiber architecture.We focus on the analysis...We present a computational framework for the study of cardiac motion.The bio-mechanical model captures the passive and active properties of the cardiac tissue as well as the fiber architecture.We focus on the analysis of deformations of a beating left ventricle(LV),comparing numerical simulations with real data acquired by echocardiography.The goal is to determine the clinical relevance of the LV strains pattern and to investigate the relationships between that pattern and the arrangement of myocardial fibers.The proposed framework could in principle be used for a wide range of clinical applications.展开更多
文摘Background Recurrence of takotsubo cardiomyopathy （TTC） is a well-known complication. However, current literature lists only a few isolated cases. We aimed to determine the incidence and clinical significance of recurrent TTC. Methods ＆ Results Our institutional database constituted a collective of 114 patients diagnosed with TTC since 2003. Close follow-up of these patients revealed a recurrence of TTC in seven of these （6.1%）. The time interval between the index event and its recurrence varied between six months and six years. Arterial hypertension was more revealed in the recurrence group of TTC compared to non-recurrence group, （P = 0.02）. Chronic obstructive pulmo- nary disease and/or asthma was more diagnosed in the recurrence group, （P = 0.04）. Clinical events like fight ventficular involvement, TTC related complications such as life-threatening arrhythmias, pulmonary congestion and in hospital death were observed more frequently in the recurrent episode. Over a mean follow-up of one year the mortality rate was similar in both groups. Conclusions Recurrence of TTC within six years after index event is not an uncommon phenomenon. In the event of right ventricular involvement in the relapse phase, it might be associated with a higher complication rate. TTC recurrence should be the first differential diagnosis in patients with a past history of TTC.
文摘Objectives To establish a cost-effective and reproducible procedure for induction of chronic left ventricular aneurysm （LVA） in rabbits. Methods Acute myocardial infarction （AMI） was induced in 35 rabbits via concomitant ligation of the left anterior descending （LAD） coronary artery and the circumflex （Cx） branch at the middle portion. Development of AMI was co n-firmed by ST segment elevation and akinesis of the occluded area. Echocardiography, pathological evaluation, and agar i n-tra-chamber casting were utilized to validate the formation of LVA four weeks after the surgery. Left ventricular end systolic pressure （LVESP） and diastolic pressure （LVEDP） were measured before, immediately after and four weeks after ligation. D i-mensions of the ventricular chamber, thickness of the interventricular septum （IVS） and the left ventricular posterior wall （LVPW） left ventricular end diastolic volume （LVEDV） and systolic volume （LVESV）, and ejection fraction （EF） were recorded by echo-cardiography. Results Thirty one （88.6%） rabbits survived myocardial infarction and 26 of them developed aneurysm （83.9%）. The mean area of aneurysm was 33.4% ＆#177; 2.4% of the left ventricle. LVEF markedly decreased after LVA formation, whereas LVEDV, LVESV and the thickness of IVS as well as the dimension of ventricular chamber from apex to mitral valve annulus significantly increased. LVESP immediately dropped after ligation and recovered to a small extent after LVA formation. LVEDP progressively increased after ligation till LVA formation. Areas in the left ventricle （LV） that underwent fibrosis included the apex, anterior wall and lateral wall but not IVS. Agar intra-chamber cast showed that the bulging of LV wall was prominent in the area of aneurysm. Conclusions Ligation of LAD and Cx at the middle portion could induce develo pment of LVA at a mean area ratio of 33.4%＆#177;2.4%which involves the apex, anterior wall and lateral wall of the LV.
文摘Objectives To assess the regional diastolic function in patients with hypertrophic cardiomyopathy （HCM） by using single-beat, real-time, three-dimensional echocardiography （RT-3DE）. Methods Sixty-five patients with HCM in sinus rhythm together with fifty age- and gender-matched normal controls were studied by two dimensional echocardiography （2DE） and RT-3DE. The parameters analyzed by RT-3DE included： left ventrieular （LV） volumes, left ventricular ejection fraction （LVEF）, end diastolic sphericity index （EDSI）, diastolic dyssynchrony index （DDI）, dispersion end diastole （DISPED）, and normalized 17 segmental volume-time curves. Results Evaluated by RT-3DE, LVEF was slightly lower compared with 2DE （63.2 ± 6.8% vs. 59.1 ± 6.4%, P 〈 0.0001）. Normal subjects had relatively uniform volumetric curves for all LV segments. In HCM patients, the segmental volumetric curves were dyssynchronous. Increased DDI and DISPED in end diastole were observed in patients with HCM （9.95 ± 3.75, 41.76 ± 17.19, P 〈 0.0001）, and not all abnormal volumetric segments occurred in the hypertrophic regions. Conclusions Patients with HCM have presented regional diastolic dyssynchrony in the diastole phase, and this preclinical lesion can be recognized by single-beat RT-3DE.
文摘To the Editor The interesting report by Redfors, et aL[1] in the June issue of the Journal of Geriatric Cardiology, about an 88-year-old woman who presented with chest pain, found on echocardiography （ECHO） to have transient left ventricular apical akinesis with a hypercontractile base, and an occluded first diagonal coronary branch with suspected acute plaque rupture, on coronary angiography, treated with a percutaneous coronary intervention, for which the authors concluded that the observed extent of akinesis was disproportionally large for the occluded coronary lesion, letting them to deduce that the acute myocardial infarction （AMI） caused the episode of Takotsubo syndrome （TTS）, reminds me of a similar case of an AMI due to stent thrombosis and a resultant associated TTS.
基金the Italian Minister for Education,Research,and University(Grant No.2017KL4EF3)“Sapienza”Universiti di Roma(Grant No.RM120172A77FB346)。
文摘We present a computational framework for the study of cardiac motion.The bio-mechanical model captures the passive and active properties of the cardiac tissue as well as the fiber architecture.We focus on the analysis of deformations of a beating left ventricle(LV),comparing numerical simulations with real data acquired by echocardiography.The goal is to determine the clinical relevance of the LV strains pattern and to investigate the relationships between that pattern and the arrangement of myocardial fibers.The proposed framework could in principle be used for a wide range of clinical applications.
