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Texas Heart Institute Journal May 2024Left main occlusion presenting as ST-segment elevation myocardial infarction is an exceedingly morbid condition. This article reports a case of cardiac arrest in a...
Left main occlusion presenting as ST-segment elevation myocardial infarction is an exceedingly morbid condition. This article reports a case of cardiac arrest in a patient after a treadmill stress test. Coronary angiography revealed 100% occlusion of the left main coronary artery. Left ventricular unloading with the Impella CP heart pump (ABIOMED/Johnson & Johnson MedTech) was used, after which epicardial blood flow was restored without angioplasty. The patient underwent surgical revascularization. Despite a prolonged revascularization time, there was no evidence of severe myocardial injury postoperatively.
Topics: Humans; Heart-Assist Devices; Coronary Angiography; ST Elevation Myocardial Infarction; Ventricular Function, Left; Male; Coronary Circulation; Middle Aged; Recovery of Function; Treatment Outcome; Pericardium; Myocardial Revascularization; Aged; Coronary Occlusion; Electrocardiography; Prosthesis Design
PubMed: 38805372
DOI: 10.14503/THIJ-23-8322 -
Scientific Reports May 2024Epicardial adipose tissue (EAT) is the cardiac visceral fat depot proposed to play a role in the etiology of various cardiovascular disease outcomes. Little is known...
Epicardial adipose tissue (EAT) is the cardiac visceral fat depot proposed to play a role in the etiology of various cardiovascular disease outcomes. Little is known about EAT determinants in a general population. We examined cardiometabolic, dietary, lifestyle and socioeconomic determinants of echocardiograpghically measured EAT in early adulthood. Data on cardiometabolic, dietary, lifestyle and socioeconomic factors were collected from participants of the Cardiovascular Risk in Young Finns Study (YFS; N = 1667; age 34-49 years). EAT thickness was measured from parasternal long axis echocardiograms. Multivariable regression analysis was used to study potential EAT determinants. Possible effect modification of sex was addressed. Mean EAT thickness was 4.07 mm (95% CI 4.00-4.17). Multivariable analysis [β indicating percentage of change in EAT(mm) per one unit increase in determinant variable] indicated female sex (β = 11.0, P < 0.0001), type 2 diabetes (β = 14.0, P = 0.02), waist circumference (cm) (β = 0.38, P < 0.0001), systolic blood pressure (mmHg) (β = 0.18, P = 0.02) and red meat intake (g/day) (β = 0.02, P = 0.05) as EAT determinants. Sex-specific analysis revealed age (year) (β = 0.59, P = 0.01), alcohol intake (drinks/day) (β = 4.69, P = 0.006), heavy drinking (yes/no) (β = 30.4, P < 0.0001) as EAT determinants in women and fruit intake (g/day) (β = -1.0, P = 0.04) in men. In the YFS cohort, waist circumference, systolic blood pressure and red meat intake were directly associated with EAT among all participants. In women, age, alcohol intake, heavy drinking and type 2 diabetes associated directly with EAT, while an inverse association was observed between fruit intake and EAT in men.
Topics: Humans; Male; Female; Adult; Middle Aged; Pericardium; Echocardiography; Adipose Tissue; Finland; Cardiovascular Diseases; Life Style; Risk Factors; Heart Disease Risk Factors; Diet; Intra-Abdominal Fat; Waist Circumference; Epicardial Adipose Tissue
PubMed: 38796541
DOI: 10.1038/s41598-024-61727-7 -
Bioengineering (Basel, Switzerland) Apr 2024The production of biomedical devices able to appropriately interact with the biological environment is still a great challenge. Synthetic materials are often employed,...
The production of biomedical devices able to appropriately interact with the biological environment is still a great challenge. Synthetic materials are often employed, but they fail to replicate the biological and functional properties of native tissues, leading to a variety of adverse effects. Several commercial products are based on chemically treated xenogeneic tissues: their principal drawback is due to weak mechanical stability and low durability. Recently, decellularization has been proposed to bypass the drawbacks of both synthetic and biological materials. Acellular materials can integrate with host tissues avoiding/mitigating any foreign body response, but they often lack sufficient patency and impermeability. The present paper investigates an innovative approach to the realization of hybrid materials that combine decellularized bovine pericardium with polycarbonate urethanes. These hybrid materials benefit from the superior biocompatibility of the biological tissue and the mechanical properties of the synthetic polymers. They were assessed from physicochemical, structural, mechanical, and biological points of view; their ability to promote cell growth was also investigated. The decellularized pericardium and the polymer appeared to well adhere to each other, and the two sides were distinguishable. The maximum elongation of hybrid materials was mainly affected by the pericardium, which allows for lower elongation than the polymer; this latter, in turn, influenced the maximum strength achieved. The results confirmed the promising features of hybrid materials for the production of vascular grafts able to be repopulated by circulating cells, thus, improving blood compatibility.
PubMed: 38790303
DOI: 10.3390/bioengineering11050436 -
Multimedia Manual of Cardiothoracic... May 2024Aortic root reconstruction during aortic root replacement for a patient with prosthetic valve endocarditis and aortic root abscess can be a difficult procedure with many...
Aortic root reconstruction during aortic root replacement for a patient with prosthetic valve endocarditis and aortic root abscess can be a difficult procedure with many possible complications. In this video case report, we describe our novel technique using a single bovine pericardial patch that avoids deep stitches or external sutures to support the friable annulus. Compared with more standard methods, this approach has shorter cross-clamp and cardiopulmonary bypass times and is less demanding technically.
Topics: Humans; Heart Valve Prosthesis; Aortic Valve; Heart Valve Prosthesis Implantation; Prosthesis-Related Infections; Male; Endocarditis; Endocarditis, Bacterial; Pericardium; Plastic Surgery Procedures; Middle Aged; Animals; Cattle
PubMed: 38787287
DOI: 10.1510/mmcts.2024.014 -
Radiology Case Reports Aug 2024Agenesis of pericardium is a rare finding resulting from alterations during embryologic formation. It is a congenital cardiac anomaly commonly asymptomatic. Cardiac...
Agenesis of pericardium is a rare finding resulting from alterations during embryologic formation. It is a congenital cardiac anomaly commonly asymptomatic. Cardiac magnetic resonance is actually considered the gold standard for diagnosis of pericardium agenesis. This report details the case of a 24-year-old woman who came to our clinic.
PubMed: 38770393
DOI: 10.1016/j.radcr.2024.04.020 -
Annals of Pediatric Cardiology 2023Ventricular interdependence, i.e., reciprocal variations in the left and right ventricle pressures with respiration, is a hallmark of the hemodynamic diagnosis of...
Ventricular interdependence, i.e., reciprocal variations in the left and right ventricle pressures with respiration, is a hallmark of the hemodynamic diagnosis of constrictive pericarditis (CP). Similarly, respiratory variations in the mitral and tricuspid valve Doppler inflow velocities on echocardiogram are very helpful in the diagnosis of CP. We document the absence of such variations in a patient with CP and associated atrial septal defect. It is important to be mindful of this intuitively obvious fact; otherwise, the diagnosis of CP might be missed.
PubMed: 38766458
DOI: 10.4103/apc.apc_148_23 -
World Journal of Clinical Cases May 2024This study presents an evaluation of the computed tomography lymphangiography (CTL) features of lymphatic plastic bronchitis (PB) and primary chylothorax to improve the...
BACKGROUND
This study presents an evaluation of the computed tomography lymphangiography (CTL) features of lymphatic plastic bronchitis (PB) and primary chylothorax to improve the diagnostic accuracy for these two diseases.
AIM
To improve the diagnosis of lymphatic PB or primary chylothorax, a retrospective analysis of the clinical features and CTL characteristics of 71 patients diagnosed with lymphatic PB or primary chylothorax was performed.
METHODS
The clinical and CTL data of 71 patients (20 with lymphatic PB, 41 with primary chylothorax, and 10 with lymphatic PB with primary chylothorax) were collected retrospectively. CTL was performed in all patients. The clinical manifestations, CTL findings, and conventional chest CT findings of the three groups of patients were compared. The chi-square test or Fisher's exact test was used to compare the differences among the three groups. A difference was considered to be statistically significant when < 0.05.
RESULTS
(1) The percentages of abnormal contrast medium deposits on CTL in the three groups were as follows: Thoracic duct outlet in 14 (70.0%), 33 (80.5%) and 8 (80.0%) patients; peritracheal region in 18 (90.0%), 15 (36.6%) and 8 (80.0%) patients; pleura in 6 (30.0%), 33 (80.5%) and 9 (90.0%) patients; pericardium in 6 (30.0%), 6 (14.6%) and 4 (40.0%) patients; and hilum in 16 (80.0%), 11 (26.8%) and 7 (70.0%) patients; and (2) the abnormalities on conventional chest CT in the three groups were as follows: Ground-glass opacity in 19 (95.0%), 18 (43.9%) and 8 (80.0%) patients; atelectasis in 4 (20.0%), 26 (63.4%) and 7 (70.0%) patients; interlobular septal thickening in 12 (60.0%), 11 (26.8%) and 3 (30.0%) patients; bronchovascular bundle thickening in 14 (70.0%), 6 (14.6%) and 4 (40.0%) patients; localized mediastinal changes in 14 (70.0%), 14 (34.1%), and 7 (70.0%) patients; diffuse mediastinal changes in 6 (30.0%), 5 (12.2%), and 3 (30.0%) patients; cystic lesions in the axilla in 2 (10.0%), 6 (14.6%), and 2 (20.0%) patients; and cystic lesions in the chest wall in 0 (0%), 2 (4.9%), and 2 (4.9%) patients.
CONCLUSION
CTL is well suited to clarify the characteristics of lymphatic PB and primary chylothorax. This method is an excellent tool for diagnosing these two diseases.
PubMed: 38765753
DOI: 10.12998/wjcc.v12.i14.2350 -
Cureus May 2024Introduction Epicardial adipose tissue (EAT) is an emerging cardiovascular biomarker. Subclinical left ventricular (LV) systolic dysfunction is common in rheumatoid...
Introduction Epicardial adipose tissue (EAT) is an emerging cardiovascular biomarker. Subclinical left ventricular (LV) systolic dysfunction is common in rheumatoid arthritis (RA). The aim of this study was to assess LV systolic function using two-dimensional speckle tracking echocardiography (2D-STE) and investigate its association with EAT in RA patients without clinical cardiovascular disease (CVD). Methods 60 RA patients without manifestations of CVD and 60 age- and gender-matched healthy controls have been recruited for the study. We assessed LV systolic function and EAT in all subjects using conventional echocardiography and 2D-STE. EAT was measured as the relative echo-free region between the free wall of the right ventricle and the visceral layer of the pericardium at end-systole. Results Global longitudinal strain (GLS) was decreased and EAT was increased in the RA group compared to the control group. GLS was reduced as EAT increased in RA patients (r=-0.273, P=0.035). After adjusting for confounders, multivariate linear regression analysis revealed a weakened correlation between EAT and GLS.Age and disease activity scores28 were independent factors influencing GLS in RA. Conclusion RA patients have significantly thickened EAT compared with controls. 2D-STE can detect early LV myocardial systolic dysfunction in RA, as shown by lower GLS. Accumulation of EAT is associated with lower GLS, but older age and higher disease activity may play a greater role in LV myocardial systolic dysfunction in RA.
PubMed: 38764705
DOI: 10.7759/cureus.60495 -
Respiratory Medicine Case Reports 2024Extrapulmonary tuberculosis could affect many organs beside lung airway and parenchyma. The mycobacterium tuberculosis can invade area such as the pleural and...
Extrapulmonary tuberculosis could affect many organs beside lung airway and parenchyma. The mycobacterium tuberculosis can invade area such as the pleural and pericardium by lymphogenic, hematogenic, or direct infection. Patient with history exposure with silica (SiO2) have a high-risk factor developing tuberculosis or extrapulmonary tuberculosis. Therefore, this study presents a rare case of pulmonary silicosis in a 38 years-old-man with tuberculosis pericarditis and pleuritis. The amount of silica particle found in bronchoalveolar lavage (BAL) was 39,95 ppm SiO2, while the ADA test from the pericardium and pleural fluids was 35.4 U/L and 40.2 U/L, respectively. The patient underwent pericardiocentesis and thoracocentesis, received first-line anti-tuberculosis drugs, and resigned from work. After one month follow-up, the pericardial as well as pleural fluid totally disappeared. This disease can mimic any other disease. Early detection of risk factor for extrapulmonary tuberculosis and perform the right diagnostic and treatment will give a better outcome for the patient.
PubMed: 38764459
DOI: 10.1016/j.rmcr.2024.102030 -
Cardio-oncology (London, England) May 2024Cardiac tamponade as the presenting manifestation of systemic lymphoma is relatively uncommon. Pericardium is the commonest site of involvement in secondary malignancies...
BACKGROUND
Cardiac tamponade as the presenting manifestation of systemic lymphoma is relatively uncommon. Pericardium is the commonest site of involvement in secondary malignancies with systemic lymphoma involving the heart in 20% of the cases.
CASE PRESENTATION
We describe a case of a 78-year-old gentleman, who presented with symptoms of new onset cardiac failure, and hemodynamic compromise. An echocardiography revealed cardiac tamponade, necessitating an emergency pericardiocentesis. With the aid of multimodality imaging, he was found to have a right atrioventricular groove mass, widespread lymph node enlargement with bone and peritoneal involvement. Ultimately, a histopathological evaluation revealed a diagnosis of Diffuse Large B Cell Lymphoma (DLBCL).
CONCLUSIONS
Our case illustrates that a patient with DLBCL may present with cardiac tamponade as a result of metastasis. This diagnosis, although rare, is likely to be missed, which can cause fatal complications, such as cardiac tamponade, fatal arrhythmias or sudden cardiac death.
PubMed: 38762476
DOI: 10.1186/s40959-024-00202-8