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European Journal of Heart Failure Aug 2011The aim of this study was to evaluate myocarditis as a precipitating factor for heart failure using cardiovascular magnetic resonance (CMR) and endomyocardial biopsy.
AIMS
The aim of this study was to evaluate myocarditis as a precipitating factor for heart failure using cardiovascular magnetic resonance (CMR) and endomyocardial biopsy.
METHODS AND RESULTS
Eighty-five patients with suspected myocarditis and 20 controls were evaluated. Seventy-one patients with positive CMR were referred for endomyocardial biopsy and re-evaluation after 1 year. Cardiovascular magnetic resonance was performed using STIR T2-weighted (T2W), early T1-weighted (EGE), and late gadolinium-enhanced (LGE) images. Immunohistological and polymerase chain reaction (PCR) analysis of myocardial specimens was employed. In patients with myocarditis, T2 and EGE were increased compared with controls (2.6 ± 0.9 vs. 1.57 ± 0.13, P < 0.001 and 7.9 ± 5.5 vs. 3.59 ± 0.08, P < 0.001, respectively). Late gadolinium enhancement was found in all myocarditis patients. Endomyocardial biopsy performed in 50 of 71 patients with positive CMR showed positive immunohistology in 48% and presence of infectious genomes in 80% (mainly Chlamydia, Herpes, and Parvovirus B19). Left ventricular ejection fraction (LVEF) was significantly decreased compared with controls (47.7 ± 19.2 vs. 64 ± 0.2, P < 0.001). After 1 year, CMR showed normalization of T2 and EGE, and decreased LGE. Left ventricular ejection fraction increased in 36.5% of patients, remained stable in 56.5% and decreased in 7% of patients, in whom biopsy showed persistence of the initial infective agents. A negative correlation was identified between EGE, LGE, and LVEF. Patients with positive biopsies had lower LVEFs.
CONCLUSION
In a Greek population with myocarditis, Chlamydia with viruses was a common finding. Cardiovascular magnetic resonance and PCR proved useful for the detection of myocarditis; EGE and LGE had the best correlation for the development of heart failure. Persistence of the initially detected infective agents was identified in patients who deteriorated further.
Topics: Adult; Biopsy, Needle; Follow-Up Studies; Gadolinium; Heart Failure; Humans; Magnetic Resonance Imaging; Myocarditis; Myocardium; Precipitating Factors; Radiopharmaceuticals
PubMed: 21632580
DOI: 10.1093/eurjhf/hfr052 -
Current Pain and Headache Reports Apr 2024In this narrative review, we aim to summarize recent insights into the complex interplay between environmental and genetic factors affecting the etiology, development,... (Review)
Review
PURPOSE OF REVIEW
In this narrative review, we aim to summarize recent insights into the complex interplay between environmental and genetic factors affecting the etiology, development, and progression of chronic migraine (CM).
RECENT FINDINGS
Environmental factors such as stress, sleep dysfunction, fasting, hormonal changes, weather patterns, dietary compounds, and sensory stimuli are critical triggers that can contribute to the evolution of episodic migraine into CM. These triggers are particularly influential in genetically predisposed individuals. Concurrently, genome-wide association studies (GWAS) have revealed over 100 genetic loci linked to migraine, emphasizing a significant genetic basis for migraine susceptibility. In CM, environmental and genetic factors are of equal importance and contribute to the pathophysiology of the condition. Understanding the bidirectional interactions between these elements is crucial for advancing therapeutic approaches and preventive strategies. This balanced perspective encourages continued research into the complex gene-environment nexus to improve our understanding and management of CM.
Topics: Humans; Genome-Wide Association Study; Migraine Disorders; Genetic Predisposition to Disease; Precipitating Factors; Sleep Wake Disorders
PubMed: 38363449
DOI: 10.1007/s11916-024-01228-4 -
International Journal of Clinical... Jul 2012To describe the relation between emotional stress and cardiovascular events, and review the literature on the cardiovascular effects of emotional stress, in order to... (Review)
Review
AIMS
To describe the relation between emotional stress and cardiovascular events, and review the literature on the cardiovascular effects of emotional stress, in order to describe the relation, the underlying pathophysiology, and potential therapeutic implications.
MATERIALS AND METHODS
Targeted PUBMED searches were conducted to supplement the authors' existing database on this topic.
RESULTS
Cardiovascular events are a major cause of morbidity and mortality in the developed world. Cardiovascular events can be triggered by acute mental stress caused by events such as an earthquake, a televised high-drama soccer game, job strain or the death of a loved one. Acute mental stress increases sympathetic output, impairs endothelial function and creates a hypercoagulable state. These changes have the potential to rupture vulnerable plaque and precipitate intraluminal thrombosis, resulting in myocardial infarction or sudden death.
CONCLUSION
Therapies targeting this pathway can potentially prevent acute mental stressors from initiating plaque rupture. Limited evidence suggests that appropriately timed administration of beta-blockers, statins and aspirin might reduce the incidence of triggered myocardial infarctions. Stress management and transcendental meditation warrant further study.
Topics: Cardiovascular Diseases; Disasters; Earthquakes; Humans; Meditation; Precipitating Factors; Residence Characteristics; Risk Factors; Sports; Stress, Psychological
PubMed: 22698415
DOI: 10.1111/j.1742-1241.2012.02920.x -
Sao Paulo Medical Journal = Revista... Jan 2003Scarcely reported in the literature, crying seems to be an important precipitating factor for both migraine and tension-type headache in daily practice.
CONTEXT
Scarcely reported in the literature, crying seems to be an important precipitating factor for both migraine and tension-type headache in daily practice.
OBJECTIVE
To evaluate the role of crying as a precipitating factor for migraine and tension-type headache.
TYPE OF STUDY
Prospective evaluation.
PARTICIPANTS
163 workers or students from the Universidade Metropolitana de Santos, who presented at least one attack a month, for at least one year, of either migraine or tension-type headache.
PROCEDURES
Interview by means of questionnaires and personal evaluations. Details of precipitating factors for the attacks were assessed.
RESULTS
From the total group of 163 individuals, 90 (55.2%) considered crying to be a potential factor for triggering headache attacks. Of this group of 90 persons, 62 presented migraine (6 males, 56 females) and 28 presented tension-type headache (5 males, 23 females). Only stress, anxiety and menstrual periods rated higher or equal to crying as triggering factors for both types of headache.
CONCLUSIONS
The physiology of crying is not well documented or understood. The act of crying seems to be an important precipitating factor for primary headaches and it should be studied further. The authors welcome comments on the matter and would like to work in collaboration with other groups interested in this subject.
Topics: Adolescent; Adult; Aged; Crying; Female; Humans; Male; Middle Aged; Migraine Disorders; Precipitating Factors; Prospective Studies; Tension-Type Headache
PubMed: 12751342
DOI: 10.1590/s1516-31802003000100008 -
Critical Care Clinics Oct 2002CAPS is characterized by development of widespread microvascular thrombosis. Patients at risk are those with positive aCL or LA factor. Precipitating events, such as... (Review)
Review
CAPS is characterized by development of widespread microvascular thrombosis. Patients at risk are those with positive aCL or LA factor. Precipitating events, such as infection, trauma, surgical procedures, or reduction in anticoagulation therapy, may contribute to the development of CAPS. Presentation to the ICU can be dramatic, with progressive multiorgan failure and need for rapid institution of life-supporting measures. Cardiopulmonary failure has been the major contributor to mortality. A variety of therapeutic modalities have been used in an attempt to offset the widespread thrombosis and organ damage from high aCL levels. Anticoagulation therapy and high dosages of steroids seem to have a positive effect on survival.
Topics: Antiphospholipid Syndrome; Critical Care; Diagnosis, Differential; Humans; Multiple Organ Failure; Plasmapheresis; Precipitating Factors
PubMed: 12418442
DOI: 10.1016/s0749-0704(02)00026-x -
International Journal of Cardiology Jul 2018
Topics: Death, Sudden, Cardiac; Heart Arrest; Humans; Precipitating Factors
PubMed: 29754915
DOI: 10.1016/j.ijcard.2018.03.101 -
Current Psychiatry Reports Jun 2004Subtle developmental (motor, emotional, cognitive, and behavioral) abnormalities are often present in apparently healthy individuals who later develop psychosis,... (Review)
Review
Subtle developmental (motor, emotional, cognitive, and behavioral) abnormalities are often present in apparently healthy individuals who later develop psychosis, suggesting that some aspects of causation are established before overt psychosis. These impairments may restrict information processing and social achievements years before manifesting psychosis. The main known risk factors in the development of schizophrenic psychosis are genetic factors, pregnancy and delivery complications, slow neuromotor development, and deviant cognitive and academic performance. However, their effect size and predictive power are small. Developmental precursors are not necessarily specific to schizophrenia, but also common to other psychotic disorders. No powerful risk factor, premorbid sign, or risk indicator has been identified that is useful for prediction of psychoses in the general population.
Topics: Adolescent; Adolescent Development; Blood Glucose; Child; Child Development; Cognition; Cognition Disorders; Creativity; Delivery, Obstetric; Educational Status; Family; Female; Genetic Predisposition to Disease; Humans; Lipids; Motor Skills; Precipitating Factors; Predictive Value of Tests; Pregnancy; Pregnancy Complications, Infectious; Prenatal Exposure Delayed Effects; Psychotic Disorders; Risk Factors; Schizophrenia; Schizophrenic Psychology; Sex Factors
PubMed: 15142469
DOI: 10.1007/s11920-004-0061-5 -
European Journal of Heart Failure Feb 2017Several clinical conditions may precipitate acute heart failure (AHF) and influence clinical outcome. In this study we hypothesized that precipitating factors are... (Observational Study)
Observational Study
AIMS
Several clinical conditions may precipitate acute heart failure (AHF) and influence clinical outcome. In this study we hypothesized that precipitating factors are independently associated with 90-day risk of death in AHF.
METHODS AND RESULTS
The study population consisted of 15 828 AHF patients from Europe and Asia. The primary outcome was 90-day all-cause mortality according to identified precipitating factors of AHF [acute coronary syndrome (ACS), infection, atrial fibrillation (AF), hypertension, and non-compliance]. Mortality at 90 days was 15.8%. AHF precipitated by ACS or by infection showed increased 90-day risk of death compared with AHF without identified precipitants [hazard ratio (HR) 1.69, 95% confidence interval (CI) 1.44-1.97, P < 0.001; and HR 1.51, 95% CI 1.18-1.92, P = 0.001), while AHF precipitated by AF showed lower 90-day risk of death (HR 0.56, 95% CI 0.42-0.75, P < 0.001), after multivariable adjustment. The risk of death in AHF precipitated by ACS was the highest during the first week after admission, while in AHF precipitated by infection the risk of death had a delayed peak at week 3. In AHF precipitated by AF, a trend toward reduced risk of death during the first weeks was shown. At weeks 5-6, AHF precipitated by ACS, infection, or AF showed similar risk of death to that of AHF without identified precipitants.
CONCLUSIONS
Precipitating factors are independently associated with 90-day mortality in AHF. AHF precipitated by ACS or infection is independently associated with higher, while AHF precipitated by AF is associated with lower 90-day risk of death.
Topics: Acute Coronary Syndrome; Acute Disease; Aged; Aged, 80 and over; Asia; Atrial Fibrillation; Cause of Death; Europe; Female; Heart Failure; Humans; Hypertension; Infections; Male; Middle Aged; Mortality; Patient Compliance; Precipitating Factors; Prognosis; Proportional Hazards Models; Prospective Studies; Registries
PubMed: 27790819
DOI: 10.1002/ejhf.682 -
Cleveland Clinic Journal of Medicine 1991According to widely accepted theory, migraine is a self-limited neurogenic sterile inflammation characterized by initial cerebral vasoconstriction, subsequent... (Review)
Review
According to widely accepted theory, migraine is a self-limited neurogenic sterile inflammation characterized by initial cerebral vasoconstriction, subsequent extracranial and intracranial vasodilation, sterile inflammation, and secondary muscle contraction. It is characterized by recurrent attacks of headache, usually unilateral and accompanied by nausea, vomiting, and, often, other symptoms. Frequency, duration, and intensity of attacks are widely variable. Migraine affects more women than men, and is often related to menses. Patients with classic migraine experience visual or neurologic prodromes, but vague "premonitions" occur in both classic and common migraine. Precipitating factors include foods, alcohol, medications, visual stimuli, changes in routine, and stress. The first-line agent for abortive therapy is ergotamine; corticosteroids are indicated for prolonged headache. Propranolol is recommended for daily prophylactic therapy, and alternatives include calcium channel blockers, nonsteroidal anti-inflammatory agents, and tricyclic antidepressants.
Topics: Combined Modality Therapy; Female; Humans; Migraine Disorders; Precipitating Factors; Pregnancy
PubMed: 1893557
DOI: 10.3949/ccjm.58.3.257 -
Journal of Gastroenterology and... Dec 2002Hepatic encephalopathy (HE) is seen as a clinical manifestation of low grade chronic cerebral edema, which is accompanied by alterations in glioneural communication.... (Review)
Review
Hepatic encephalopathy (HE) is seen as a clinical manifestation of low grade chronic cerebral edema, which is accompanied by alterations in glioneural communication. Different factors such as ammonia, inflammatory cytokines, benzodiazepines and electrolyte imbalances may precipitate or aggravate glia edema, thereby explaining precipitation of HE episodes by a variety of unrelated factors. Recognition and rigorous treatment of these precipitating factors is the most important measure in HE therapy which may be augmented by dietary and medical approaches. Among these approaches, evidence for proven therapeutical efficacy in HE on the basis of placebo-controlled trials is existing only for transplantation, protein restriction, administration of vegetable proteins, ornithine-aspartate, oral branched-chain amino acid treatment as well as lactulose enemas. The efficacy of oral lactulose has not been demonstrated on the basis of placebo-controlled trials.
Topics: Ammonia; Hepatic Encephalopathy; Humans; Precipitating Factors
PubMed: 12472947
DOI: 10.1046/j.1440-1746.17.s3.11.x