CARDIOMYOPATHY

心肌病
  • 文章类型: Journal Article
    Pimobendan目前尚未被批准用于猫,尽管已提出其在猫科动物肥厚型心肌病中的有用性。报告表明,口服健康猫后,心律失常事件增加。与口服相比,静脉内给药的效力更大,可以想象,注射匹莫苯后心律失常的发生率可能会增加。因此,本研究旨在探讨匹莫苯注射液对猫的致心律失常作用。五只临床健康的猫接受了体检,超声心动图,血压测量,和24小时动态心电图之前和之后立即接受匹莫苯作为每日两次0.15mg/kg的静脉推注剂量持续3天。此外,在匹莫苯或安慰剂IV给药的第三天进行24小时动态心电图记录以评估心率,心律失常,和心率变异性。匹莫苯丹给药后,24小时总心率显著增加.超声心动图显示室间隔壁侧二尖瓣环收缩期速度(S')显著增加,表明收缩力增强。只有一只猫表现出阵发性室性心动过速和心律失常事件的频率增加。相反,剩下的猫,观察到心律失常数量呈下降趋势.这些发现表明,静脉内给予匹莫苯可能与心律失常的发作无关。然而,需要进一步的研究来探索静脉注射匹莫苯对患有心肌疾病的猫的影响。
    Pimobendan is not currently approved for use in cats, although its usefulness in feline hypertrophic cardiomyopathy has been suggested. Reports indicate an increase in arrhythmic events following oral administration to healthy cats. Given the greater potency of intravenous administration compared to oral intake, it is conceivable that the incidence of arrhythmias may be increased following pimobendan injection. Therefore, this study aimed to investigate the proarrhythmic effects of pimobendan injection in cats. Five clinically healthy cats underwent physical examination, echocardiography, blood pressure measurements, and 24-hour Holter electrocardiography immediately before and after receiving pimobendan as an intravenous bolus dose of 0.15 mg/kg twice daily for 3 days. Additionally, a 24-hour Holter electrocardiography recording was conducted on the third day of pimobendan or placebo IV administration to assess heart rate, arrhythmias, and heart rate variability. Following pimobendan administration, there was a significant increase in total 24-hour heart rate. Echocardiography revealed a significant increase in mitral valve annulus systolic velocity (S\') on the ventricular septal wall side, indicative of enhanced contractility. Only one cat exhibited paroxysmal ventricular tachycardia and an increase in the frequency of arrhythmic events. Conversely, in the remaining cats, a decreasing trend in the number of arrhythmias was observed. These findings indicate that intravenous administration of pimobendan may not be implicated in the onset of arrhythmias. Nevertheless, further research is warranted to explore the effects of intravenous pimobendan administration in cats with myocardial disease.
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    文章类型: Journal Article
    Type 2 diabetes mellitus is one of the most common non-infectious diseases in the world. Among people with type 2 diabetes, patients of the older age group. An in understanding of the early cardiovascular manifestations of diabetes occupies an important place in international research and prevention programs, given that cardiac vascular complications are the cause of death in patients with diabetes. Recent studies evaluating left ventricular diastolic dysfunction as a characteristic predictor of diabetic cardiomyopathy by echocardiography. In accordance with the recommendations for diastolic dysfunction, have shown that the algorithm of the informative algorithm is used to determine left ventricular diastolic dysfunction in patients with prognosis in predicting cardiovascular complications.
    Сахарный диабет 2-го типа (СД2) является одним из самых распространенных неинфекционных заболеваний в мире. Среди лиц с СД2 преобладают пациенты старшей возрастной группы. Углубленное понимание ранних сердечно-сосудистых проявлений диабета занимает важное место в международных исследованиях и программах профилактики, учитывая, что сердечно-сосудистые осложнения являются основной причиной смерти пациентов с диабетом. Последние исследования оценки диастолической дисфункции ЛЖ методом эхо-КГ как характерного предиктора развития кардиомиопатии показали, что обновленный алгоритм более информативен для определения диастолической дисфункции ЛЖ у пациентов при прогнозировании сердечно-сосудистых осложнений.
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  • 文章类型: Journal Article
    几年来,左心室压缩不全(LVNC)被认为是一种真正的心肌病,并且有几个定义相继出现.特别是,LVNC的特征是突出的左心室小梁与深层小梁间凹陷分离。一些超声心动图标准和心脏磁共振成像(CMR)标准已用于诊断LVNC,导致高估患有其他疾病和/或生理状况的患者的LVNC诊断。左心室过度扩张(LVH)可存在于多种心脏疾病和生理状况中:射血分数降低的心力衰竭,地中海贫血和其他血液系统疾病,怀孕,运动员的心。因此,LVH的存在并不一定表示LVNC的存在。此外,临床表现的巨大异质性引起了人们对真正的LVNC作为心肌病存在的担忧.事实上,LVNC的范围从遗传到获得性甚至瞬时条件,孤立的形式或与其他心肌病相关的形式,先天性心脏病或预后非常不同的综合征。因此,考虑到LVH是各种疾病和生理状况的表现,最近的2023年ESC心肌病指南没有包括LVNC在心肌病中,但他们建议使用术语“LVH”而不是LVNC,描述这种表型,特别是当它是短暂的或成人发作时。在这次审查中,我们的目标是在LVNC上游览,从最初的描述到现在,了解为什么当前的指南决定将LVH视为一种表型特征而不是独特的心肌病。
    For several years, left ventricular non-compaction (LVNC) was considered as a true cardiomyopathy and several definitions have followed one another. Particularly, LVNC was characterized by prominent left ventricular trabeculae separated from deep intertrabecular recesses. Several echocardiographic criteria and cardiac magnetic resonance imaging (CMR) criteria have been used to diagnose LVNC, leading to overestimate the diagnosis of LVNC in patients with other diseases and/or physiological conditions. Left ventricular hypertrabeculation (LVH) can be present in several cardiac diseases and physiological conditions: heart failure with reduced ejection fraction, thalassemia and other hematological diseases, pregnancy, athlete\'s heart. Thus, the presence of LVH does not necessarily indicate the presence of an LVNC. In addition, the great heterogeneity of clinical manifestations has raised concerns regarding the existence of a true LVNC as a cardiomyopathy. In fact, LVNC ranges from genetic to acquired and even transient conditions, isolated forms or forms associated with other cardiomyopathies, congenital heart diseases or syndromes with a very different prognosis. Thus, considering LVH as a manifestation of various diseases and physiological conditions, the recent 2023 ESC guidelines on cardiomyopathies did not include LVNC among cardiomyopathies, but they suggested using the term \"LVH\" rather than LVNC, to describe this phenotype especially when it is transient or of adult-onset. In this review, we aimed to make an excursion on LVNC, from its initial description to the present day, to understand why current guidelines decided to consider LVH as a phenotypic trait rather than a distinct cardiomyopathy.
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  • 文章类型: Journal Article
    2型糖尿病(T2DM)是一种以持续高血糖为特征的广泛存在的慢性疾病,导致严重的并发症,如糖尿病性心肌病和肾病,显著影响患者健康和生活质量。这些并发症的复杂机制包括慢性炎症,氧化应激,和代谢失调。糖尿病心肌病,以心脏结构和功能异常为特征,糖尿病肾病,以进行性肾损伤为特征,是T2DM发病率和死亡率增加的主要原因。AdipoRon,合成的脂联素受体激动剂,在临床前研究中显示了模仿内源性脂联素有益作用的潜力,减少炎症和氧化应激,改善脂质代谢和线粒体功能。这篇系统综述评估了AdipoRon的治疗潜力,关注其对糖尿病心肌病和肾病的影响。通过全面的文献检索和分析,我们强调了AdipoRon在各种动物模型和细胞系统中改善心血管和肾脏并发症的作用。这些发现强调了转化临床研究的迫切需要,以验证AdipoRon在人群中的疗效和安全性。旨在将这种有前途的治疗方法从实验模型推进到临床应用,可能为改善糖尿病并发症的管理提供新的希望。
    Type 2 diabetes mellitus (T2DM) is a widespread chronic disease characterized by persistent hyperglycemia, leading to severe complications such as diabetic cardiomyopathy and nephropathy, significantly affecting patient health and quality of life. The complex mechanisms underlying these complications include chronic inflammation, oxidative stress, and metabolic dysregulation. Diabetic cardiomyopathy, marked by structural and functional heart abnormalities, and diabetic nephropathy, characterized by progressive kidney damage, are major contributors to the increased morbidity and mortality associated with T2DM. AdipoRon, a synthetic adiponectin receptor agonist, has shown potential in preclinical studies for mimicking the beneficial effects of endogenous adiponectin, reducing inflammation and oxidative stress, and improving lipid metabolism and mitochondrial function. This systematic review evaluates the therapeutic potential of AdipoRon, focusing on its impact on diabetic cardiomyopathy and nephropathy. Through a comprehensive literature search and analysis, we highlight AdipoRon\'s role in ameliorating cardiovascular and renal complications in various animal models and cellular systems. The findings underscore the urgent need for translational clinical studies to validate AdipoRon\'s efficacy and safety in human populations, aiming to advance this promising therapeutic approach from experimental models to clinical application, potentially offering new hope for improved management of diabetic complications.
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  • 文章类型: Journal Article
    心律失常是慢性Chagasic心肌病(CCC)导致猝死的主要原因。在这里,我们研究了心肌细胞中连接蛋白43(Cx43)表达和磷酸化的变化以及与CCC中心律失常的关联。
    感染克氏锥虫的C57Bl/6小鼠在感染后6个月和12个月通过跑步机测试和EKG进行心脏评估。组织病理学,细胞因子基因表达,研究了总Cx43及其磷酸化形式Cx43S368和Cx43S325/328/330的分布。从患有CCC的受试者获得的人心脏样品进行免疫荧光分析。促炎微环境的体外模拟(IL-1β,TNF,和IFN-γ)在H9c2细胞和iPSC衍生的心肌细胞中进行评估Cx43分布,动作电位持续时间,和路西法黄染料转移。
    慢性感染克氏杆菌的小鼠表现出与炎症增加相关的心脏功能受损,纤维化和上调IL-1β,TNF,和IFN-γ基因表达。共聚焦显微镜显示CCC中总Cx43、Cx43S368和Cx43S325/328/330的定位和磷酸化模式发生了改变,在插入的椎间盘区域之外有分散的染色,即,在侧膜和细胞质中。与对照相比,在CCC小鼠心脏的插入盘中观察到总Cx43和N-钙黏着蛋白的共定位减少。在人类CCC心脏样本中获得了类似的结果,显示Cx43在插层圆盘外分布。用IL-1β刺激人iPSC来源的心肌细胞或H9c2细胞,TNF,和IFN-γ诱导的Cx43定位改变,减少动作电位持续时间和相邻细胞之间的染料转移。
    CCC中的心脏炎症影响Cx43的分布和磷酸化模式,这可能有助于恰加斯病中传导障碍的产生。
    UNASSIGNED: Cardiac arrhythmias are the main cause of sudden death due to Chronic Chagasic Cardiomyopathy (CCC). Here we investigated alterations in connexin 43 (Cx43) expression and phosphorylation in cardiomyocytes as well as associations with cardiac arrhythmias in CCC.
    UNASSIGNED: C57Bl/6 mice infected with Trypanosoma cruzi underwent cardiac evaluations at 6 and 12 months after infection via treadmill testing and EKG. Histopathology, cytokine gene expression, and distribution of total Cx43 and its phosphorylated forms Cx43S368 and Cx43S325/328/330 were investigated. Human heart samples obtained from subjects with CCC were submitted to immunofluorescence analysis. In vitro simulation of a pro-inflammatory microenvironment (IL-1β, TNF, and IFN-γ) was performed in H9c2 cells and iPSC-derived cardiomyocytes to evaluate Cx43 distribution, action potential duration, and Lucifer Yellow dye transfer.
    UNASSIGNED: Mice chronically infected with T. cruzi exhibited impaired cardiac function associated with increased inflammation, fibrosis and upregulated IL-1β, TNF, and IFN-γ gene expression. Confocal microscopy revealed altered total Cx43, Cx43S368 and Cx43S325/328/330 localization and phosphorylation patterns in CCC, with dispersed staining outside the intercalated disc areas, i.e., in lateral membranes and the cytoplasm. Reduced co-localization of total Cx43 and N-cadherin was observed in the intercalated discs of CCC mouse hearts compared to controls. Similar results were obtained in human CCC heart samples, which showed Cx43 distribution outside the intercalated discs. Stimulation of human iPSC-derived cardiomyocytes or H9c2 cells with IL-1β, TNF, and IFN-γ induced alterations in Cx43 localization, reduced action potential duration and dye transfer between adjacent cells.
    UNASSIGNED: Heart inflammation in CCC affects the distribution and phosphorylation pattern of Cx43, which may contribute to the generation of conduction disturbances in Chagas disease.
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  • 文章类型: Journal Article
    心脏收缩力调节(CCM)是食品和药物管理局批准的用于心力衰竭患者的基于设备的疗法。系统在绝对不应期期间向心室心肌递送双相电刺激以增强左心室收缩。CCM治疗促进细胞水平的急性和慢性变化,导致整个心肌的有利重塑。CCM提高了生活质量,纽约心脏协会班,左心室射血分数,峰值摄氧量,以及心血管死亡和心力衰竭住院的复合终点。这篇综述将集中在生物学基础上,适应症,和CCM的证据,以及该技术的未来应用。
    Cardiac contractility modulation (CCM) is a Food and Drug Administration-approved device-based therapy for patients with heart failure. The system delivers biphasic electric stimulation to the ventricular myocardium during the absolute refractory period to augment left ventricular contraction. CCM therapy promotes acute and chronic changes at the cellular level, leading to favorable remodeling throughout the myocardium. CCM improves quality of life, New York Heart Association class, left ventricular ejection fraction, peak oxygen uptake, and the composite end point of cardiovascular death and heart failure hospitalizations. This review will focus on the biological basis, indications, and evidence for CCM, as well as the future applications of this technology.
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  • 文章类型: Journal Article
    心房流量调节器(AFR;Occlutech)可用于在各种病理生理设置中创建具有预定直径的心房连通。在儿科人群中,经验仅限于少数病例报告。我们旨在报告先天性和后天性心脏病患儿AFR植入的初始单中心经验。
    从2021年12月到2023年6月,我们招募了10名患者(年龄6个月-16岁)。治疗适应症为:左心室收缩功能障碍(n=6),限制性心肌病伴肺动脉高压(n=2),一名12岁儿童(n=1)的原发性法洛四联症手术修复后右心室功能障碍,和失败Fontan(n=1)。所有患者均成功进行了AFR植入。8例需要进行房间隔穿刺;在其他2例中,使用先前存在的卵圆孔未闭和有孔的房间隔缺损。9例进行了球囊预扩张。在所有情况下植入8mm装置。手术的平均时间是50分钟,中位透视时间为17分钟,中位辐射暴露剂量为2.3Gy×cm2。
    术中无并发症报告。3例患者在随访期间死亡:1例由于败血症(手术后16天),1由于疾病进展(8个月后),1是由于心房通气后7天ECMO拔管失败。在剩下的病人中,LA扩张的减少,毛细血管后肺动脉高压,观察心力衰竭症状。
    AFR在儿童和危重环境中是安全可行的,允许右/左腔卸载和改善血流动力学和症状。
    UNASSIGNED: The Atrial Flow Regulator (AFR; Occlutech) can be used to create interatrial communication with a predetermined diameter in various pathophysiological settings. In the pediatric population, the experience is limited to a few case reports. We aim to report the initial single-center experience of AFR implantation in children with congenital and acquired heart disease.
    UNASSIGNED: From December 2021 to June 2023, we enrolled 10 patients (aged 6 months-16 years). Indications to treatment were: left ventricular systolic dysfunction (n = 6), restrictive cardiomyopathy with pulmonary hypertension (n = 2), postoperative right ventricle dysfunction after surgical repair of a native Tetralogy of Fallot in a 12-year-old child (n = 1), and failure Fontan (n = 1). AFR implantation was successfully performed in all patients. Transseptal puncture was needed in 8 cases; in the other 2 cases, preexisting patent foramen ovale and fenestrated atrial septal defect were used. Balloon predilation was performed in 9 cases. An 8 mm device was implanted in all cases. The mean time of the procedure was 50 minutes, the median fluoroscopy time was 17 minutes, and median radiation exposure dose was 2.3 Gy × cm2.
    UNASSIGNED: No complications were reported during the procedure. Three patients died during the follow-up: 1 due to sepsis (16 days after the procedure), 1 due to disease progression (8 months after), and 1 due to failure of ECMO decannulation 7 days after the atrial venting. In the remaining patients, a reduction of LA dilation, postcapillary pulmonary hypertension, and heart failure symptoms were observed.
    UNASSIGNED: AFR is safe and feasible in children and critical settings, allowing right/left cavities unloading and improvement of hemodynamics and symptoms.
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  • 文章类型: Journal Article
    甲基苯丙胺是一种新兴的毒品威胁。十年来,甲基苯丙胺使用者(CAHMA)与心肌病相关的住院人数差异仍然未知。
    本研究的目的是按年龄确定CAHMA的趋势和患病率,性别,种族,和地理区域。
    我们使用了来自国家住院患者样本数据库的2008年至2020年的数据。我们确定了12,845,919名心肌病相关的住院患者;其中,222,727人被诊断为甲基苯丙胺使用者。使用具有二项链接函数的广义线性模型来计算患病率和95%CI。那些与甲基苯丙胺一起使用其他物质的人被排除在分析之外。
    从2008年到2020年,CAHMA增长了231%(P趋势<0.001)。男性CAHMA增加345%(P趋势<0.001),女性增加122%(P趋势<0.001),非西班牙裔白人为271%(P趋势<0.001),非西班牙裔黑人为254%(p趋势<0.001),西班牙裔占565%(P趋势<0.001),非西班牙裔亚洲人群为645%(P趋势<0.001)。美国西部地区(530%)(P趋势<0.001)和南部地区(200%)(P趋势<0.001)的CAHMA也显著增加。男人,西班牙裔人口,年龄组26至40岁和41至64岁,西部地区的上升趋势明显高于西部地区(P<0.001)。
    CAHMA在美国显著增加。男人,西班牙裔,非西班牙裔亚洲人,年龄组41至64。西部地区显示出更高的比例增长,突出了基于性别的增长,种族/民族,以及研究期间的地区差异。
    UNASSIGNED: Methamphetamine is an emerging drug threat. The disparity in cardiomyopathy-associated hospital admissions among methamphetamine users (CAHMA) over the decade remains unknown.
    UNASSIGNED: The purpose of this study was to determine the trends and prevalence of CAHMA by age, sex, race, and geographical region.
    UNASSIGNED: We used data from 2008 to 2020 from the National Inpatient Sample database. We identified 12,845,919 cardiomyopathy-associated hospital admissions; among them, 222,727 were diagnosed as methamphetamine users. A generalized linear model with binomial link function was used to compute the prevalence ratio and 95% CI. Those who used other substances along with methamphetamine were excluded from the analysis.
    UNASSIGNED: CAHMA increased by 231% (P trend <0.001) from 2008 to 2020. CAHMA increased 345% for men (P trend <0.001) and 122% for women (P trend <0.001), 271% for non-Hispanic White (P trend <0.001), 254% for non-Hispanic Black (p trend <0.001), 565% for Hispanic (P trend <0.001), and 645% for non-Hispanic Asian (P trend <0.001) population. CAHMA also increased significantly in the West region (530%) (P trend <0.001) and South region (200%) (P trend <0.001) of the United States. Men, Hispanic population, age groups 26 to 40 and 41 to 64 years, and Western regions showed a significantly higher uptrend than their counterparts (P trend <0.001).
    UNASSIGNED: CAHMA have increased significantly in the United States. Men, Hispanics, non-Hispanic Asian, age groups 41 to 64. and western regions showed a higher proportional increase highlighting gender-based, racial/ethnic, and regional disparities over the study period.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
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