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84 results for “ischemic heart failure”
Elucidating the mechanisms underlying left ventricular function recovery in patients with ischemic heart failure undergoing surgical remodeling: A 3-dimensional ultrasound analysis.
<p>Dataset from Castelvecchio S, Frigelli M, Sturla F, Milani V, Pappalardo OA, Citarella M, Menicanti L, Votta E. Elucidating the mechanisms underlying left ventricular function recovery in patients with ischemic heart failure undergoing surgical remodeling: A 3-dimensional ultrasound analysis. J Thorac Cardiovasc Surg. 2021 Feb 26:S0022-5223(21)00381-0. doi: 10.1016/j.jtcvs.2021.02.067. Epub ahead of print. PMID: 33781593.</p> <p>Abstract </p> <p><strong>Objective: </strong>The study objective was to elucidate the mechanisms of left ventricle functional recovery in terms of endocardial contractility and synchronicity after surgical ventricular reconstruction.</p> <p><strong>Methods: </strong>Real-time 3-dimensional transthoracic echocardiography was performed on 20 patients with anterior left ventricle remodeling and ischemic heart failure before surgical ventricular reconstruction and at 6-month follow-up, and on 15 healthy controls matched by age and body surface area. Real-time 3-dimensional transthoracic echocardiography datasets were analyzed through TomTec software (4D LV-Analysis; TomTec Imaging Systems GmbH, Unterschleissheim, Germany): Left ventricle volumes, ejection fraction, and global longitudinal strain were computed; the time-dependent endocardial surface yielded by 3-dimensional speckle-tracking echocardiography was postprocessed through in-house software to quantify local systolic minimum principal strain as a measure of fiber shortening and mechanical dispersion as a measure of fiber synchronicity.</p> <p><strong>Results: </strong>Compared with controls, patients with heart failure before surgical ventricular reconstruction showed lower ejection fraction (P < .0001) and significantly impaired mechanical dispersion (P < .0001) and minimum principal strain (P < .0001); the latter worsened progressively from left ventricle base to apex. After surgical ventricular reconstruction, global longitudinal strain improved from -6.7% to -11.3% (P < .0001); mechanical dispersion decreased in every left ventricle region (P ≤ .017) and mostly in the basal region, where computed mechanical dispersion values were comparable to physiologic values (P ≥ .046); minimum principal strain improved mostly in the basal region, changing from -16.6% to -22.3% (P = .0027).</p> <p><strong>Conclusions: </strong>At 6-month follow-up, surgical ventricular reconstruction was associated with significant recovery in global left ventricle function, improved mechanical dispersion indicating a more synchronous left ventricle contraction, and improved left ventricle fiber shortening mostly in the basal region, suggesting the major role of the remote myocardium in enhancing left ventricle functional recovery.</p>
Long-term results of surgical ventricular reconstruction and comparison with the Surgical Treatment for Ischemic Heart Failure trial
<p>Gaudino M, Castelvecchio S, Rahouma M, Robinson NB, Audisio K, Soletti GJ, Cancelli G, Tam DY, Garatti A, Benedetto U, Doenst T, Girardi LN, Michler RE, Fremes SE, Velazquez EJ, Menicanti L. Long-term results of surgical ventricular reconstruction and comparison with the Surgical Treatment for Ischemic Heart Failure trial. J Thorac Cardiovasc Surg. 2022 Apr 26:S0022-5223(22)00493-7. doi: 10.1016/j.jtcvs.2022.04.016. Epub ahead of print. PMID: 35599207.</p> <p><strong>Abstract</strong></p> <p><strong>Objective: </strong>The role of surgical ventricular reconstruction (SVR) in patients with ischemic cardiomyopathy is controversial. Observational series and the Surgical Treatment of IsChemic Heart failure (STICH) trial reported contradictory results. SVR is highly dependent on operator experience. The aim of this study is to compare the long-term results of SVR between a high-volume SVR institution and the STICH trial using individual patient data.</p> <p><strong>Methods: </strong>Patients undergoing SVR at San Donato Hospital (Milan) were compared with patients undergoing SVR in STICH (as-treated principle) by inverse probability treatment-weighted Cox regression. The primary outcome was all-cause mortality.</p> <p><strong>Results: </strong>The San Donato cohort included 725 patients, whereas the STICH cohort included 501. Compared with the STICH-SVR cohort, San Donato patients were older (66.0, lower quartile, upper quartile [Q1, Q3: 58.0, 72.0] vs 61.9 [Q1, Q3: 55.1, 68.8], P < .001) and with lower left ventricular end-systolic volume index at baseline (LVESVI: 77.0 [Q1, Q3: 59.0, 97.0] vs 80.8 [Q1, Q3: 58.5, 106.8], P = .02). Propensity score weighting yielded 2 similar cohorts. At 4-year follow-up, mortality was significantly lower in the San Donato cohort compared with the STICH-SVR cohort (adjusted hazard ratio, 0.71; 95% confidence interval, 0.53-0.95; P = .001). Greater postoperative LVESVI was independently associated with mortality (hazard ratio, 1.02; 95% confidence interval, 1.01-1.03). At 4 to 6 months of follow-up, the mean reduction of LVESVI in the San Donato cohort was 39.6%, versus 10.7% in the STICH-SVR cohort (P < .001).</p> <p><strong>Conclusions: </strong>Patients with postinfarction LV remodeling undergoing SVR at a high-volume SVR institution had better long-term results than those reported in the STICH trial, suggesting that a new trial testing the SVR hypothesis may be warranted.</p>
Prognostic value of left atrial strain quantification from 2D ultrasound imaging in post-ischemic heart failure patients: evidence from the REMODEL-HF study.
<p>Frigelli M, Sturla F, Milani V, Ramputi L, Citarella M, Menicanti L, Votta E, Castelvecchio S. Prognostic value of left atrial strain quantification from 2D ultrasound imaging in post-ischemic heart failure patients: evidence from the REMODEL-HF study. Int J Cardiol. 2022 Sep 1;362:183-189. doi: 10.1016/j.ijcard.2022.04.071. Epub 2022 Apr 30. PMID: 35504452.</p> <p>Abstract</p> <p><strong>Background: </strong>Left atrial (LA) function can be effectively assessed by measuring longitudinal LA strain (LAS) via two-dimensional speckle tracking echocardiography (2DSTE). Here, we test 2DSTE-based LAS as marker of different left ventricle (LV) remodeling patterns and as prognostic index in ischemic heart failure (HF) candidates to surgical ventricular reconstruction.</p> <p><strong>Methods: </strong>We retrospectively considered ischemic HF patients with anterior (group A, n=130) or posterior (group P, n=48) LV remodeling. Based on 2D ultrasound, LV and LA morpho-functional parameters were quantified including reservoir (LAS<sub>Res</sub>), conduit (LAS<sub>Cond</sub>) and booster (LAS<sub>Boost</sub>) LAS. We tested their capability to discriminate between groups A and P, and their group-specific prognostic significance for the composite end-point of death or HF re-hospitalization at follow-up (mean follow-up time=40 months, range 3-101 months).</p> <p><strong>Results: </strong>Group A and group P displayed similar end-diastolic (p=0.89) and end-systolic (p=0.33) LV volume index, and LA volume index LAVi (p=0.44) corrected for the degree of mitral regurgitation. As compared to group P, group A revealed a significant reduction in LAS<sub>Boost</sub> (9.2±0.4% vs. 11.1±0.7%, p=0.04) and a non-significant reduction in LAS<sub>Res</sub> (16.9±0.7% vs. 19.3±1.1%, p=0.06). Kaplan-Meier curves showed that the median LAS<sub>Res</sub> and LAS<sub>Boost</sub> values effectively stratified patients based on their prognosis in the overall study population (Log-rank p=0.002 and Log_rank p<0.0001) and in group A, where the association was stronger for LAS<sub>Boost</sub> (Log-rank p<0.001) than for LAS<sub>Res</sub> (Log-rank p=0.013).</p> <p><strong>Conclusions: </strong>2DSTE-based LAS assessment is affordable, repeatable and non-invasive, and could add clinically-relevant mechanistic insight and prognostic value in the stratification of ischemic HF patients.</p>
Pannexin 1 Channels Control Cardiomyocyte Metabolism and Neutrophil Recruitment During Non-Ischemic Heart Failure
GEO Series GSE267693. Mus musculus. 23 samples. Type: Expression profiling by high throughput sequencing.
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