Objective To evaluate the efficacy and safety of long-term treatment with arotinolol in patients with idiopathic dilated cardiomyopathy(IDCM).Methods Sixty-three patients with IDCM were evaluated at baseline and after...Objective To evaluate the efficacy and safety of long-term treatment with arotinolol in patients with idiopathic dilated cardiomyopathy(IDCM).Methods Sixty-three patients with IDCM were evaluated at baseline and after 12-month therapy with arotinolol.The conventional therapy for congestive heart failure was continued throughout the study with arotinolol as the only β-blocker.Left ventricular function was assessed with the New York Heart Association functional class and two-dimensional echocardiography.Results After 12-month arotinolol treatment,there was a significant improvement in left ventricular systolic function.Left ventricular end-systolic dimension significantly decreased from 59.52±8.83 mm to 50.89±8.17 mm(P<0.001).Left ventricular ejection fraction significantly increased from 27.39%±7.94% to 41.13%±9.45%(P<0.001).Left ventricular mass index decreased from 150.47±42.42 g/m2 to 141.58±34.36 g/m2(P<0.01).No adverse events leading to premature discontinuation of study drug occurred.Conclusion In this preliminary study,12-month arotinolol treatment has a favorable effect on left ventricular function in patients with IDCM,and it is safe and well tolerated.展开更多
Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial vo...Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial volume index in patients with dilated cardiomyopathy. Materials and Methods: This was an observational, single centre study conducted in India. A total of 50 patients who were admitted to department of cardiology from July, 2008 to February, 2009 with diagnosis of dilated cardiomyopathy and an ejection fraction of <40% were included. Results: Of the 50 patients, 34 (68%) were males. 27 (54%) patients were in NYHA class II and 23 (46%) patients were in NYHA class III. LA volume was found to be ≥40 ml in all patients. LV function and LA volume were found to be correlated (r = -0.789, p < 0.01). Similarly, there was a correlation between LV function and LA volume index (r = -0.826, p < 0.01). There was no correlation between LA volume index and duration of symptoms (r = 0.04). Conclusion: It can be concluded that there is a strong inverse correlation between LA volume and left ventricular function and also between LA volume index and left ventricular function. The patients with NYHA class III were having larger left atrial volume than those with NYHA class II. Moreover, the duration of symptoms has no correlation with left atrial volume index.展开更多
Objective: To study the correlation between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) content and left ventricular remodeling in patients with dilated cardiomyopathy (DCM). Methods: The patients diagn...Objective: To study the correlation between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) content and left ventricular remodeling in patients with dilated cardiomyopathy (DCM). Methods: The patients diagnosed with DCM in our hospital between September 2014 and February 2018 were selected as the DCM group, and volunteers receiving physical examination in our hospital during the same period were selected as the control group. Serum NT-proBNP, N-terminal propeptide of procollagen type I (PINP), C-terminal telopeptide of collagen type I (CITP) and matrix metalloproteinase 1 (MMP1) contents as well as echocardiography parameters left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF) and left ventricular mass index (LVMI) were determined. Results: Serum NT-proBNP, PINP, CITP and MMP1 contents as well as LVMI, LVEDV and LVESV levels of DCM group were significantly higher than those of control group while LVEF level was significantly lower than that of control group;serum NT-proBNP content of DCM group was positively correlated with LVMI, LVEDV and LVESV levels as well as serum PINP, CITP and MMP1 contents, and negatively correlated with LVEF level. Conclusion: The increase of serum NT-proBNP in DCM patients is correlated with left ventricular remodeling and NT-proBNP content can be used to evaluate the degree of left ventricular remodeling.展开更多
Isolated left ventricular non-compaction is recently described as a rare form of cardiomyopathy that is associated with a heart failure, life threatening cardiac arrhythmia and thromboembolic complications. The diagno...Isolated left ventricular non-compaction is recently described as a rare form of cardiomyopathy that is associated with a heart failure, life threatening cardiac arrhythmia and thromboembolic complications. The diagnosis is based on echocardiography demonstration of spongy myocardium. Here we report a case of 74 years old female patient diagnosed as an isolated left ventricular non-compaction with congestive heart failure, intramural thrombus and hypertension. There is no specific treatment for LVNC;therapeutic measures are directed towards the patient’s symptom (heart failure, arrhythmia and thrombotic events) and consideration of an implantable cardioverter defibrillator and cardiac transplantation.展开更多
Malignant ventricular arrhythmias are a major adverse event and worsen the prognosis of patients affected by ischemic and non-ischemic dilated cardiomyopathy.The main parameter currently used to stratify arrhythmic ri...Malignant ventricular arrhythmias are a major adverse event and worsen the prognosis of patients affected by ischemic and non-ischemic dilated cardiomyopathy.The main parameter currently used to stratify arrhythmic risk and guide decision making towards the implantation of a cardioverter defibrillator is the evaluation of the left ventricular ejection fraction.However,this strategy is characterized by several limitations and consequently additional parameters have been suggested in order to improve arrhythmic risk stratification.The aim of this review is to critically revise the prognostic significance of non-invasive diagnostic tools in order to better stratify the arrhythmic risk prognosis of dilated cardiomyopathy patients.展开更多
The surgical indications for dilated cardiomyopathy (DCM) remain controversial, not including cardiac transplantation and mechanical circulatory support. We describe a case of idiopathic DCM that underwent successful ...The surgical indications for dilated cardiomyopathy (DCM) remain controversial, not including cardiac transplantation and mechanical circulatory support. We describe a case of idiopathic DCM that underwent successful surgical treatment using a modified left ventriculectomy, modification of the Batista procedure. The patient was a 63-year-old man who suffered from heart failure, New York Heart Association (NYHA) Class IV. Heart failure was derived from idiopathic DCM with a severely compromised left ventricular function complicated by left ventricular thrombosis. He underwent successful surgical treatment, specifically partial left ventriculectomy combined with the papillary muscle approximation, and the postoperative course was uneventful. He has been well with NYHA Class I for 3 years after the operation without heart failure.展开更多
Importance:Pathogenic variants in theRBM20 gene are associated with aggressive dilated cardiomyopathy(DCM).Recently,RBM20 was found to be associated with left ventricular non-compaction cardiomyopathy(LVNC).Thus far,o...Importance:Pathogenic variants in theRBM20 gene are associated with aggressive dilated cardiomyopathy(DCM).Recently,RBM20 was found to be associated with left ventricular non-compaction cardiomyopathy(LVNC).Thus far,only five families with LVNC have been reported to carry variants inRBM20.It remains unknown whether the variants inRBM20 associated with DCM can also cause LVNC.Objective:To elucidate the causativeRBM20 variant in two unrelated patients with both LVNC and DCM,and to identify the clinical characteristics associated with variants inRBM20.Methods:Trio whole-exome sequencing(WES)was performed.Variants were filtered and classified in accordance with the guidelines of the American College of Medical Genetics and Genomics(ACMG).Results:We identified two distinctde novo variants inRBM20(one per patient)in these two patients with LVNC.Both variants have been reported in patients with DCM,without the LVNC phenotype.Patient 1 was an 11-year-old girl who had DCM,LVNC,and heart failure;the ratio of noncompacted-to-compacted myocardium was 2.7:1.Ade novo heterozygous variant c.1907G>A(p.Arg636His)in exon 9 was identified in this patient.Patient 2 was a 13-year-old boy who had clinical phenotypes identical to those of Patient 1;the ratio of noncompacted-to-compacted myocardium was 3.2:1 in this patient.WES revealed ade novo heterozygous variant c.1909A>G(p.Ser637Gly)in exon 9.Both variants were previously characterized as pathogenic,and our study classified them as pathogenic variants based on the ACMG guidelines.Interpretation:We found that two patients with LVNC had variants inRBM20.Our results extended the clinical spectrum of the twoRBM20 variants and illustrated that the same variant inRBM20 can cause DCM,with or without the LVNC phenotype.展开更多
To assess the left ventricle regional systolic and diastolic function, left ventricle geometry and left venticle sphericity indexes in patients with dilated cardiomyopathy （DCM） by quantitative tissue velocity imagi...To assess the left ventricle regional systolic and diastolic function, left ventricle geometry and left venticle sphericity indexes in patients with dilated cardiomyopathy （DCM） by quantitative tissue velocity imaging （QTVI）. Methods Thirty normal subjects and 52 DCM patients underwent QTVI and colour Doppler flow imaging study in order to measure the left ventricular regional function along left ventricle apical long-axis view and the left ventricle geometry. Peak tissue velocities of left venticle regional muscular tissue during systole （ Vs）, systolic acceleration （ a）, early diastole（Ve） and left atrium contraction（Va） along left venticle apical long axis view were measured. The indexes of left ventricular regional systolic and diastolic function were mearsured at the same time. The left ventricle geometry shape was reflected from the systolic and diastolic sphericity index （Sis and Sid）, the left ventricular ejection fraction （LVEF） and D wave / A wave （PVd/PVa） of pulmonary veins flowing spectrum reflected the global left ventricular systolic and diastolic function. The Vs, Ve, Va, a, PVd/PVa ratio, LVEF, Sis, Sid and their correlations between normal subjects and patients with DCM were compared and analyzed. Results Vs, Ve, Va, a, PVd/PVa, Sis and Sid in patients with DCM were lower than those in normal persons. There were significant relations between Sis and a （ r = 0. 6142, P 〈 0. 05）, Ve/Va and Sid （ r = 0. 6271, P 〈 0. 05 ）. Conclusions QTVI offer a newer method which has a higher sensitivity and accuracy in evaluating the left venticle regional systolic and diastolic function in DCM patients. There was significant relation between regional cardiac function and left venticle sphericity. （ S Chin J Cardiol 2009; 10（1） ： 9 -14）展开更多
Background Heart failure is one of the main causes of death due to progressive muscular dystrophy of Duchenne muscular dystrophy （DMD） in the majority of the cases. There is high incidence of arterial thromboembolis...Background Heart failure is one of the main causes of death due to progressive muscular dystrophy of Duchenne muscular dystrophy （DMD） in the majority of the cases. There is high incidence of arterial thromboembolism in DMD patients with severe heart failure. However, it has been receiving little attention whether anticoagulative therapy in DMD patients with severe heart failure in sinus rhythm should be performed. Herein we present a case of DMD patients, with severe heart failure in sinus rhythm, who presents a large mural thrombus formation at left ventricular anterior wall.展开更多
目的探讨左室射血分数(left ventricular ejection fraction,LVEF)降低的扩张型心肌病(dilated cardiomyopathy,DCM)治疗后生存的影响因素。方法选取2020年6月至2023年6月于湖州市第一人民医院治疗的158例LVEF降低的DCM患者,根据生存状...目的探讨左室射血分数(left ventricular ejection fraction,LVEF)降低的扩张型心肌病(dilated cardiomyopathy,DCM)治疗后生存的影响因素。方法选取2020年6月至2023年6月于湖州市第一人民医院治疗的158例LVEF降低的DCM患者,根据生存状况将其分为死亡组(n=40)和生存组(n=118)。统计两组患者的临床资料,采用Cox比例风险回归模型分析影响LVEF降低的DCM患者治疗后生存的因素。结果死亡组患者的年龄显著大于生存组,合并高血压、纽约心脏病协会(New York Heart Association,NYHA)心功能分级Ⅳ级、室性心律失常占比、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)、脑钠肽(brain natriuretic peptide,BNP)水平均显著高于生存组,左室整体纵向应变(global longitudinal strain,GLS)、RR间期标准差(standard deviation of RR interval,SDNN)、RR间期平均值标准差(standard deviation of the average RR interval,SDANN)、RR间期标准差平均值(the average standard deviation of RR interval,SDNNindex)、RR间期差值均方根(root mean square of RR interval difference,rMSSD)、相邻RR间期>50ms总数占总心跳数的百分比(the percentage of total number of adjacent RR intervals>50ms to total heart rate,pNN50)、舒张末期室间隔厚度(end diastolic interventricular septal thickness,IVSd)、左心室后壁舒张期厚度(left ventricular posterior wall diastolic thickness,LVPWD)、每搏输出量(stroke volume,SV)、心输出量(cardiac output,CO)均显著低于生存组(P<0.05)。Cox回归分析显示,年龄、合并高血压、NYHA心功能分级、室性心律失常、GLS、SDNN、SDANN、SDNNindex、rMSSD、pNN50、LVEDD、LVESD、BNP是影响LVEF降低的DCM患者治疗后生存率的危险因素,IVSd、LVPWD是保护因素(P<0.05)。结论LVEF降低的DCM患者死亡率较高,且受年龄、高血压、NYHA心功能分级、室性心律失常、GLS、心率变异性、LVEDD、LVESD、BNP、IVSd、LVPWD等多种因素的影响,临床应早期给予针对性干预以提高患者治疗后生存率。展开更多
文摘Objective To evaluate the efficacy and safety of long-term treatment with arotinolol in patients with idiopathic dilated cardiomyopathy(IDCM).Methods Sixty-three patients with IDCM were evaluated at baseline and after 12-month therapy with arotinolol.The conventional therapy for congestive heart failure was continued throughout the study with arotinolol as the only β-blocker.Left ventricular function was assessed with the New York Heart Association functional class and two-dimensional echocardiography.Results After 12-month arotinolol treatment,there was a significant improvement in left ventricular systolic function.Left ventricular end-systolic dimension significantly decreased from 59.52±8.83 mm to 50.89±8.17 mm(P<0.001).Left ventricular ejection fraction significantly increased from 27.39%±7.94% to 41.13%±9.45%(P<0.001).Left ventricular mass index decreased from 150.47±42.42 g/m2 to 141.58±34.36 g/m2(P<0.01).No adverse events leading to premature discontinuation of study drug occurred.Conclusion In this preliminary study,12-month arotinolol treatment has a favorable effect on left ventricular function in patients with IDCM,and it is safe and well tolerated.
文摘Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial volume index in patients with dilated cardiomyopathy. Materials and Methods: This was an observational, single centre study conducted in India. A total of 50 patients who were admitted to department of cardiology from July, 2008 to February, 2009 with diagnosis of dilated cardiomyopathy and an ejection fraction of <40% were included. Results: Of the 50 patients, 34 (68%) were males. 27 (54%) patients were in NYHA class II and 23 (46%) patients were in NYHA class III. LA volume was found to be ≥40 ml in all patients. LV function and LA volume were found to be correlated (r = -0.789, p < 0.01). Similarly, there was a correlation between LV function and LA volume index (r = -0.826, p < 0.01). There was no correlation between LA volume index and duration of symptoms (r = 0.04). Conclusion: It can be concluded that there is a strong inverse correlation between LA volume and left ventricular function and also between LA volume index and left ventricular function. The patients with NYHA class III were having larger left atrial volume than those with NYHA class II. Moreover, the duration of symptoms has no correlation with left atrial volume index.
基金Natural Science Foundation of Hebei Province No:C2014001262.
文摘Objective: To study the correlation between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) content and left ventricular remodeling in patients with dilated cardiomyopathy (DCM). Methods: The patients diagnosed with DCM in our hospital between September 2014 and February 2018 were selected as the DCM group, and volunteers receiving physical examination in our hospital during the same period were selected as the control group. Serum NT-proBNP, N-terminal propeptide of procollagen type I (PINP), C-terminal telopeptide of collagen type I (CITP) and matrix metalloproteinase 1 (MMP1) contents as well as echocardiography parameters left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF) and left ventricular mass index (LVMI) were determined. Results: Serum NT-proBNP, PINP, CITP and MMP1 contents as well as LVMI, LVEDV and LVESV levels of DCM group were significantly higher than those of control group while LVEF level was significantly lower than that of control group;serum NT-proBNP content of DCM group was positively correlated with LVMI, LVEDV and LVESV levels as well as serum PINP, CITP and MMP1 contents, and negatively correlated with LVEF level. Conclusion: The increase of serum NT-proBNP in DCM patients is correlated with left ventricular remodeling and NT-proBNP content can be used to evaluate the degree of left ventricular remodeling.
文摘Isolated left ventricular non-compaction is recently described as a rare form of cardiomyopathy that is associated with a heart failure, life threatening cardiac arrhythmia and thromboembolic complications. The diagnosis is based on echocardiography demonstration of spongy myocardium. Here we report a case of 74 years old female patient diagnosed as an isolated left ventricular non-compaction with congestive heart failure, intramural thrombus and hypertension. There is no specific treatment for LVNC;therapeutic measures are directed towards the patient’s symptom (heart failure, arrhythmia and thrombotic events) and consideration of an implantable cardioverter defibrillator and cardiac transplantation.
文摘Malignant ventricular arrhythmias are a major adverse event and worsen the prognosis of patients affected by ischemic and non-ischemic dilated cardiomyopathy.The main parameter currently used to stratify arrhythmic risk and guide decision making towards the implantation of a cardioverter defibrillator is the evaluation of the left ventricular ejection fraction.However,this strategy is characterized by several limitations and consequently additional parameters have been suggested in order to improve arrhythmic risk stratification.The aim of this review is to critically revise the prognostic significance of non-invasive diagnostic tools in order to better stratify the arrhythmic risk prognosis of dilated cardiomyopathy patients.
文摘The surgical indications for dilated cardiomyopathy (DCM) remain controversial, not including cardiac transplantation and mechanical circulatory support. We describe a case of idiopathic DCM that underwent successful surgical treatment using a modified left ventriculectomy, modification of the Batista procedure. The patient was a 63-year-old man who suffered from heart failure, New York Heart Association (NYHA) Class IV. Heart failure was derived from idiopathic DCM with a severely compromised left ventricular function complicated by left ventricular thrombosis. He underwent successful surgical treatment, specifically partial left ventriculectomy combined with the papillary muscle approximation, and the postoperative course was uneventful. He has been well with NYHA Class I for 3 years after the operation without heart failure.
文摘Importance:Pathogenic variants in theRBM20 gene are associated with aggressive dilated cardiomyopathy(DCM).Recently,RBM20 was found to be associated with left ventricular non-compaction cardiomyopathy(LVNC).Thus far,only five families with LVNC have been reported to carry variants inRBM20.It remains unknown whether the variants inRBM20 associated with DCM can also cause LVNC.Objective:To elucidate the causativeRBM20 variant in two unrelated patients with both LVNC and DCM,and to identify the clinical characteristics associated with variants inRBM20.Methods:Trio whole-exome sequencing(WES)was performed.Variants were filtered and classified in accordance with the guidelines of the American College of Medical Genetics and Genomics(ACMG).Results:We identified two distinctde novo variants inRBM20(one per patient)in these two patients with LVNC.Both variants have been reported in patients with DCM,without the LVNC phenotype.Patient 1 was an 11-year-old girl who had DCM,LVNC,and heart failure;the ratio of noncompacted-to-compacted myocardium was 2.7:1.Ade novo heterozygous variant c.1907G>A(p.Arg636His)in exon 9 was identified in this patient.Patient 2 was a 13-year-old boy who had clinical phenotypes identical to those of Patient 1;the ratio of noncompacted-to-compacted myocardium was 3.2:1 in this patient.WES revealed ade novo heterozygous variant c.1909A>G(p.Ser637Gly)in exon 9.Both variants were previously characterized as pathogenic,and our study classified them as pathogenic variants based on the ACMG guidelines.Interpretation:We found that two patients with LVNC had variants inRBM20.Our results extended the clinical spectrum of the twoRBM20 variants and illustrated that the same variant inRBM20 can cause DCM,with or without the LVNC phenotype.
文摘To assess the left ventricle regional systolic and diastolic function, left ventricle geometry and left venticle sphericity indexes in patients with dilated cardiomyopathy （DCM） by quantitative tissue velocity imaging （QTVI）. Methods Thirty normal subjects and 52 DCM patients underwent QTVI and colour Doppler flow imaging study in order to measure the left ventricular regional function along left ventricle apical long-axis view and the left ventricle geometry. Peak tissue velocities of left venticle regional muscular tissue during systole （ Vs）, systolic acceleration （ a）, early diastole（Ve） and left atrium contraction（Va） along left venticle apical long axis view were measured. The indexes of left ventricular regional systolic and diastolic function were mearsured at the same time. The left ventricle geometry shape was reflected from the systolic and diastolic sphericity index （Sis and Sid）, the left ventricular ejection fraction （LVEF） and D wave / A wave （PVd/PVa） of pulmonary veins flowing spectrum reflected the global left ventricular systolic and diastolic function. The Vs, Ve, Va, a, PVd/PVa ratio, LVEF, Sis, Sid and their correlations between normal subjects and patients with DCM were compared and analyzed. Results Vs, Ve, Va, a, PVd/PVa, Sis and Sid in patients with DCM were lower than those in normal persons. There were significant relations between Sis and a （ r = 0. 6142, P 〈 0. 05）, Ve/Va and Sid （ r = 0. 6271, P 〈 0. 05 ）. Conclusions QTVI offer a newer method which has a higher sensitivity and accuracy in evaluating the left venticle regional systolic and diastolic function in DCM patients. There was significant relation between regional cardiac function and left venticle sphericity. （ S Chin J Cardiol 2009; 10（1） ： 9 -14）
文摘Background Heart failure is one of the main causes of death due to progressive muscular dystrophy of Duchenne muscular dystrophy （DMD） in the majority of the cases. There is high incidence of arterial thromboembolism in DMD patients with severe heart failure. However, it has been receiving little attention whether anticoagulative therapy in DMD patients with severe heart failure in sinus rhythm should be performed. Herein we present a case of DMD patients, with severe heart failure in sinus rhythm, who presents a large mural thrombus formation at left ventricular anterior wall.
文摘目的探讨左室射血分数(left ventricular ejection fraction,LVEF)降低的扩张型心肌病(dilated cardiomyopathy,DCM)治疗后生存的影响因素。方法选取2020年6月至2023年6月于湖州市第一人民医院治疗的158例LVEF降低的DCM患者,根据生存状况将其分为死亡组(n=40)和生存组(n=118)。统计两组患者的临床资料,采用Cox比例风险回归模型分析影响LVEF降低的DCM患者治疗后生存的因素。结果死亡组患者的年龄显著大于生存组,合并高血压、纽约心脏病协会(New York Heart Association,NYHA)心功能分级Ⅳ级、室性心律失常占比、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)、脑钠肽(brain natriuretic peptide,BNP)水平均显著高于生存组,左室整体纵向应变(global longitudinal strain,GLS)、RR间期标准差(standard deviation of RR interval,SDNN)、RR间期平均值标准差(standard deviation of the average RR interval,SDANN)、RR间期标准差平均值(the average standard deviation of RR interval,SDNNindex)、RR间期差值均方根(root mean square of RR interval difference,rMSSD)、相邻RR间期>50ms总数占总心跳数的百分比(the percentage of total number of adjacent RR intervals>50ms to total heart rate,pNN50)、舒张末期室间隔厚度(end diastolic interventricular septal thickness,IVSd)、左心室后壁舒张期厚度(left ventricular posterior wall diastolic thickness,LVPWD)、每搏输出量(stroke volume,SV)、心输出量(cardiac output,CO)均显著低于生存组(P<0.05)。Cox回归分析显示,年龄、合并高血压、NYHA心功能分级、室性心律失常、GLS、SDNN、SDANN、SDNNindex、rMSSD、pNN50、LVEDD、LVESD、BNP是影响LVEF降低的DCM患者治疗后生存率的危险因素,IVSd、LVPWD是保护因素(P<0.05)。结论LVEF降低的DCM患者死亡率较高,且受年龄、高血压、NYHA心功能分级、室性心律失常、GLS、心率变异性、LVEDD、LVESD、BNP、IVSd、LVPWD等多种因素的影响,临床应早期给予针对性干预以提高患者治疗后生存率。
