Angiogenic imbalance and residual myocardial dysfunction in women with Peripartum Cardiomyopathy and left ventricular function recovery
|
|
- Phoebe Allen
- 6 years ago
- Views:
Transcription
1 Angiogenic imbalance and residual myocardial dysfunction in women with Peripartum Cardiomyopathy and left ventricular function recovery Sorel Goland¹, Adi Zalik¹, Jan Mark Weinstein³, Liaz Zilberman¹, Rafael Kupershtein², Michael Arad²,Tuvia Ben Gal*, Jacob George¹ ¹Kaplan Medical Center, Rehovot ²Sheba Medical Center, ³Soroka Medical Center, *Rabin Medical center, Israel
2 Peripartum Cardiomyopathy (PPCM) Occurs toward the end of pregnancy or in the first postpartum months in previously healthy women. Heart failure due to LV systolic dysfunction (LVEF<45%) Recent research suggests that PPCM is a vascular disease, triggered by late-gestational hormonal changes Elkayam U. J Am Coll Cardiol. 2011; 58: Bello NA, Arany Z. Trends Cardiovasc Med Hilfiker-Kleiner D et al.cell. 2007;128: Patten IS et al. Nature. 2012;485:
3 Two-hit hypothesis : a new concept of pathophysiology of PPCM 1. A predisposed inability to resist this insult in some women (genetic predisposition? some baseline altered endothelial function?) 2. The late-gestational hormonal changes with vasotoxic effects, including sflt1 and prolactin ('angiogenic imbalance' ) Bello NA, Arany Z. Trends Cardiovasc Med. 2015;25:
4 LV function recovery (LVEF 50%) in PPCM The rates of LV recovery differ among the studies ~ 50% recovery of LV function in the US ~70% in the IPAC registry ~35% in South Africa, Haiti and Turkey Worsening of LV function during subsequent pregnancy (SSP) can occur in 20% Rare cases of spontaneous deterioration of LV function Goland S, Elkayam U. J Card Fail. 2011; 17: Fett JD et al Int J Gynaecol Obstet. 2009;104: Blauwet LA et al. Heart. 2013;99(5): McNamara D et al. J Am Coll Cardiol. 2015;66(8):
5 What are the possible reasons for deterioration of LV function Is our definition of LV recovery inappropriate? Should we use a cut-off of 55% or 60% for complete recovery? Should we use Dobutamine stress echo? The lack of contractile reserve on DSE has been showed to predict recurrence of LV dysfunction in SSP Can we use better echo techniques? Two recent developments enable a more accurate assessment of cardiac function: tissue Doppler imaging and myocardial strain are sensitive to assess subtle changes in the myocardium Lampert MB et al, AJOG 1997 ;176: Fett JD World J Cardiol. 2014; 26; 6(3):
6 Hypothesis Recent studies suggest that angiogenic imbalance during pregnancy may lead to acute PPCM We propose that angiogenic imbalance and residual cardiac dysfunction may exist even after recovery from PPCM.
7 Aim To evaluate plasma concentrations of proand anti-angiogenic factors in post-ppcm women with LV recovery To assess possible residual myocardial dysfunction using sensitive echo techniques
8 Potential contributing factors to possible residual 'angiogenic imbalance' Pro-angiogenic vascular endothelial growth factor (VEGF) plays a key role in circulating endothelial progenitor cells (EPC s) recruitment, enhancing mobilization EPCs play a critical role in endothelial homeostasis with ability to repair endothelial injury. An anti-angiogenic factor sflt-1 (mostly released by placenta) neutralizes circulating VEGF Flt1 is elevated PPCM, pre-eclampsia, atherosclerosis, CKD, DM, ANCA-associated vasculitis
9 Methods Post- PPCM women with LV recovery ( 50%) at least 12 months after clinical presentation Plasma levels VEGF and sflt1 were measured using ELISA (enzyme-linked immunosorbent assay). The number of circulating endothelial progenitor cells (EPCs) (CD34+ and CD34/KDR+) were quantified by flow cytometry All patients underwent comprehensive cardiac function assessment including TDI and 2D strain echocardiography All measures where compared to age-,parity- and time- (from last pregnancy) matched controls Stress echo was planned to assess normal LV response to exercise
10 Results 41 women post-ppcm 29 pts with LV function recovery and appropriate echo quality were included mean age 29±7 years LVEF 61.0±3.9% follow-up (mean 32 months, months) 20 pts underwent stress echo and showed good LV contractile response (increase 5% LVEF)
11 Clinical characteristics of PPCM patients at the time of diagnosis The mean LVEF at diagnosis of PPCM 33.2±11.1%. Diagnosis postpartum in 77%. Mean parity was 2.3±1.2 Twin pregnancies 15%. Gestational hypertension 17% Pre-eclampsia 17%
12 Results: comparison of echo measurements between the post-ppcm and control groups Post- PPCM Matched controls EF (%) 61.0± ± LVEDd (mm) 45.1± ± LA area (cm2) 15.6± ± PAP (mm Hg) 22.8± ± E (cm/sec) 74.5± ± DT (sec) 179.8± ± E' septal (cm/sec) 9.9± ± S septal 7.6± ± S RV 11.4± ±
13 Results: comparison 2D strain values between the post-ppcm and control groups LG Strain% Apical circ Strain%
14 Results: comparison of sflt1 and VEGF between the post-ppcm and control groups Flt1 VEGF/Flt1 VEGF
15 Results: comparison of EPC s (CD34+/KDR+) between the post PPCM and control groups Box plots of Ln-CD34+/KDR+ of PPCM and control groups. The band at the middle of each box plot represents the median, the bottom and top of the boxes represent the 25th and 75th percentiles
16 Summary A higher concentration of sflt1 with attenuated production of VEGF along with concomitant decrease in circulating EPCs in post-ppcm women suggesting that 'angiogenic imbalance' exists even after recovery from PPCM. TDI and 2D strain were able to identify residual myocardial injury in post-ppcm women with apparent recovery of LV systolic function.
17 Conclusions Both 'angiogenic imbalance' and residual myocardial injury may play an important role in the recurrence of LV dysfunction during SSP Our finding of altered endothelial function, especially increased sflt1, which persists even after recovery from PPCM, may potentially offer an opportunity to identify women prone to develop relapse in SSP and are at risk for cardiovascular events in the future. Our results have to be tested in a larger population of post-ppcm women.
18 Limitations The main of our study is a small number of patients; however, taking in account the rarity of the disease, our numbers are similar to many studies on PPCM. Despite the relatively small number of patients, we had optimally matched controls and underwent comprehensive echocardiographic assessment. The delay in time from the presentation to the study recruitment (1-5 years), however, no pts had SPP after PPCM
19 Thank you!
20 Results: comparison of endothelial function measures between the post PPCM and control groups
Use of bromocriptine for the treatment of PPCM: are we there yet?
Use of bromocriptine for the treatment of PPCM: are we there yet? Uri Elkayam, MD Professor of Medicine Professor of Obstetrics and Gynecology Director maternal cardiology University of Southern California
More informationRisk of Subsequent Pregnancy in Women with a History of Peripartum Cardiomyopathy Uri Elkayam, MD
Risk of Subsequent Pregnancy in Women with a History of Peripartum Cardiomyopathy Uri Elkayam, MD Professor of Medicine / Cardiology Professor of Obstetrics and Gynecology University of Southern California
More informationAssociation between RV Function in PPCM and LV Recovery & Clinical Outcome
Association between RV Function in PPCM and LV Recovery & Clinical Outcome Lori A Blauwet, MD, MA Associate Professor of Medicine Co-Director, Cardio-OB Clinic Mayo Clinic Rochester, MN USA 2016 MFMER
More informationBromocriptine for the treatment of PPCM A multicenter, randomized study. Results and Implication
Bromocriptine for the treatment of PPCM A multicenter, randomized study Results and Implication Denise Hilfiker-Kleiner Kardiologie & Angiologie MHH, Hannover Funding by DFG Excellence Cluster REBIRTH
More informationConsiderations on Phasing Out Medications In the Treatment of Peripartum Cardiomyopathy After Full Recovery James D. Fett, MD
Considerations on Phasing Out Medications In the Treatment of Peripartum Cardiomyopathy After Full Recovery James D. Fett, MD Co-Director, Peripartum Cardiomyopathy Network, Coordinating Center, University
More informationPeripartum Cardiomyopathy. Kyleah Bowder. Concordia University
Peripartum Cardiomyopathy 1 Peripartum Cardiomyopathy Kyleah Bowder Concordia University Peripartum Cardiomyopathy 2 Cardiomyopathy is the deterioration of the myocardium in the heart. The myocardium is
More informationPeripartum Cardiomyopathy
Peripartum Cardiomyopathy Denise Hilfiker-Kleiner Kardiologie & Angiologie MHH, Hannover Nothing to disclose Peri- or Postpartum Cardiomyopathy Peri- or postpartum cardiomyopathy (PPCM) is a disorder of
More informationUpdate on mechanisms of peripartum cardiomyopathy: New Heart Failure Association working group position statement
Update on mechanisms of peripartum cardiomyopathy: New Heart Failure Association working group position statement Denise Hilfiker-Kleiner Kardiologie & Angiologie MHH, Hannover I have nothing to declare.
More informationClinical Outcomes of Women with Peripartum Cardiomyopathy With and Without Preeclampsia: a Population-based Study
Clinical Outcomes of Women with Peripartum Cardiomyopathy With and Without Preeclampsia: a Population-based Study Isabelle Malhamé, MSc Candidate in Epidemiology, McGill University Obstetric Medicine Fellow,
More informationWhat to do when a heart failure patient becomes pregnant
BSH Heart Failure Day for Revalidation and Training 2017 What to do when a heart failure patient becomes pregnant Dr Diane Barker Consultant Cardiologist Royal Stoke Hospital Conflicts of interest - sponsorship,
More informationClinical Investigations
Clinical Investigations Shortness of Breath During Pregnancy: Could a Cardiac Factor Be Involved? Sorel Goland, MD; Sharon Perelman, MD; Nardin Asalih, MD; Sara Shimoni, MD; Osnat Walfish, MD; Mordechai
More informationCardiac Magnetic Resonance in pregnant women
Cardiac Magnetic Resonance in pregnant women Chen SSM, Leeton L, Dennis AT Royal Women s Hospital and The University of Melbourne, Parkville, Australia alicia.dennis@thewomens.org.au Quantification of
More informationPeripartum cardiomyopathy: Frequency and predictors and indicators of clinical outcome
1517 ORIGINAL ARTICLE Peripartum cardiomyopathy: Frequency and predictors and indicators of clinical outcome Shakira Perveen, 1 Jahanara Ainuddin, 2 Shazia Jabbar, 3 Khalida Soomro, 4 Arif Ali 5 Abstract
More informationECHO HAWAII. Role of Stress Echo in Valvular Heart Disease. Not only ischemia! Cardiomyopathy. Prosthetic Valve. Diastolic Dysfunction
Role of Stress Echo in Valvular Heart Disease ECHO HAWAII January 15 19, 2018 Kenya Kusunose, MD, PhD, FASE Tokushima University Hospital Japan Not only ischemia! Cardiomyopathy Prosthetic Valve Diastolic
More informationNancy Goldman Cutler, MD Beaumont Children s Hospital Royal Oak, Mi
Nancy Goldman Cutler, MD Beaumont Children s Hospital Royal Oak, Mi Identify increased LV wall thickness (WT) Understand increased WT in athletes Understand hypertrophic cardiomyopathy (HCM) Enhance understanding
More informationCardiomyopathy. ACOI IM Board Review 2018 Martin C. Burke DO, FACOI
Cardiomyopathy ACOI IM Board Review 2018 Martin C. Burke DO, FACOI No Disclosures Cardiomyopathies Definition: diseases of heart muscle 1980 WHO: unknown causes Not clinically relevant 1995 WHO: diseases
More informationStrain/Untwisting/Diastolic Suction
What Is Diastole and How to Assess It? Strain/Untwisting/Diastolic Suction James D. Thomas, M.D., F.A.C.C. Cardiovascular Imaging Center Department of Cardiology Cleveland Clinic Foundation Cleveland,
More informationHighlights from EuroEcho 2009 Echo in cardiomyopathies
Highlights from EuroEcho 2009 Echo in cardiomyopathies Bogdan A. Popescu University of Medicine and Pharmacy, Bucharest, Romania ESC Congress 2010 Hypertrophic cardiomyopathy To determine the differences
More informationOpening Ceremony. Opening Lecture: Cardiovascular physiology of pregnancy and the puerperium Uri Elkayam University of Southern California, USA
Opening Ceremony Greetings Opening Lecture, CPP 2018 Congress chairman Opening Lecture: Cardiovascular physiology of pregnancy and the puerperium Echocardiographic changes in normal pregnancy Joan Briller
More informationNovel echocardiographic modalities: 3D echo, speckle tracking and strain rate imaging. Potential roles in sports cardiology. Stefano Caselli, MD, PhD
Novel echocardiographic modalities: 3D echo, speckle tracking and strain rate imaging. Potential roles in sports cardiology. Stefano Caselli, MD, PhD Ospedale San Pietro Fatebenefratelli Rome, Italy Differential
More informationMitral Valve prolapse: What s new? Which indications of early surgery? Input of new 2017 ESC/EACTS guidelines. Christophe Tribouilloy Amiens, France
Mitral Valve prolapse: What s new? Which indications of early surgery? Input of new 2017 ESC/EACTS guidelines Christophe Tribouilloy Amiens, France I have no financial relationships to disclose related
More informationClinical Profile and Predictors of Complications in Peripartum Cardiomyopathy
Journal of Cardiac Failure Vol. 15 No. 8 2009 Clinical Investigations Clinical Profile and Predictors of Complications in Peripartum Cardiomyopathy SOREL GOLAND, MD, 1 KALGI MODI, MD, 2 FAHED BITAR, MD,
More informationHeart failure associated with pregnancy and the peripartum
Contemporary Reviews in Cardiovascular Medicine Peripartum Cardiomyopathy Zolt Arany, MD, PhD; Uri Elkayam, MD Abstract Peripartum cardiomyopathy is a potentially life-threatening pregnancy-associated
More informationPeripartum cardiomyopathy: Challenges and perspectives
Prof. Petar M. Seferović, MD, PhD, FESC, FESC Board member, Heart Failure Association of the ESC Peripartum cardiomyopathy: Challenges and perspectives Director, Department of Cardiology, Clinical Center
More informationEVALUATION OF PREGNANT PATIENTS WITH HEART DISEASE. Karen Stout, MD University of Washington Seattle Children s Seattle, WA
EVALUATION OF PREGNANT PATIENTS WITH HEART DISEASE Karen Stout, MD University of Washington Seattle Children s Seattle, WA CASE PRESENTATION 24 year old woman with aortic regurgitation referred for evaluation
More informationPERI-PARTUM CARDIOMYOPATHY:
PERI-PARTUM CARDIOMYOPATHY: Recent insights in its patho-physiology and treatment DR.AN PATNAIK [Heart Failure Association of the European Society of Cardiology Working Group on PPCM 2010] Eur J Heart
More informationAortic stenosis aetiology: morphology of calcific AS,
How to improve patient selection in aortic stenosis? Fausto J. Pinto, FESC Aortic stenosis aetiology: morphology of calcific AS, bicuspid valve, and rheumatic AS (Adapted from C. Otto, Principles of
More informationEchocardiographic assessment of the right ventricle in paediatric pulmonary hypertension.
Echocardiographic assessment of the right ventricle in paediatric pulmonary hypertension. Mark K. Friedberg, MD No disclosures Outline RV response to increased afterload Echo assessment of RV function
More informationAn Integrated Approach to Study LV Diastolic Function
An Integrated Approach to Study LV Diastolic Function Assoc. Prof. Adriana Ilieşiu, FESC University of Medicine Carol Davila Bucharest, Romania LV Diastolic Dysfunction impaired relaxation (early diastole)
More informationThe New England Journal of Medicine
The New England Journal of Medicine Copyright 2001 by the Massachusetts Medical Society VOLUME 344 M AY 24, 2001 NUMBER 21 MATERNAL AND FETAL OUTCOMES OF SUBSEQUENT PREGNANCIES IN WOMEN WITH PERIPARTUM
More informationLow Gradient Severe AS: Who Qualifies for TAVR? Andrzej Boguszewski MD, FACC, FSCAI Vice Chairman, Cardiology Mid-Michigan Health Associate Professor
Low Gradient Severe AS: Who Qualifies for TAVR? Andrzej Boguszewski MD, FACC, FSCAI Vice Chairman, Cardiology Mid-Michigan Health Associate Professor Michigan State University, Central Michigan University
More informationHYPERTROPHY: Behind the curtain. V. Yotova St. Radboud Medical University Center, Nijmegen
HYPERTROPHY: Behind the curtain V. Yotova St. Radboud Medical University Center, Nijmegen Disclosure of interest: none Relative wall thickness (cm) M 0.22 0.42 0.43 0.47 0.48 0.52 0.53 F 0.24 0.42 0.43
More informationPregnancy in Non-Peripartum Cardiomyopathy
Pregnancy in Non-Peripartum Cardiomyopathy Avraham Shotan, Lubov Vasilenco, Michael Shochat, Mark Kazatsker, David Blondheim, Yaniv Levi, Simcha Meisel, Alicia Vazan Heart Institute, Hillel Yaffe Medical
More informationCoronary Artery Bypass Graft: Monitoring Patients and Detecting Complications
Coronary Artery Bypass Graft: Monitoring Patients and Detecting Complications Madhav Swaminathan, MD, FASE Professor of Anesthesiology Division of Cardiothoracic Anesthesia & Critical Care Duke University
More informationWhen is strain assessment mandatory?
When is strain assessment mandatory? Geneviève Derumeaux University of Lyon France Presenter Disclosure Information Geneviève Derumeaux When is strain assessment mandatory? DISCLOSURE INFORMATION: None
More informationCardiac hypertrophy : differentiating disease from athlete
Cardiac hypertrophy : differentiating disease from athlete Ario Soeryo Kuncoro, MD, Cardiologist Echocardiography Division, National Cardiovascular Centre Harapan Kita-Jakarta Departement of Cardiology
More informationDelayed recovery in peripartum cardiomyopathy: an indication for long-term follow-up and sustained therapy
European Journal of Heart Failure (2012) 14, 895 901 doi:10.1093/eurjhf/hfs070 Delayed recovery in peripartum cardiomyopathy: an indication for long-term follow-up and sustained therapy Murat Biteker 1
More informationECHO HAWAII. My home. Pulmonary Hypertension and Pulmonary Embolism: Role of Echo U.S.A. Japan. Hawaii Island 1/9/2018
Pulmonary Hypertension and Pulmonary Embolism: Role of Echo ECHO HAWAII January 15 19, 2018 Kenya Kusunose, MD, PhD, FASE Tokushima University Hospital Japan My home Japan U.S.A Hawaii Island 1 Economy
More informationObjectives. Systolic Heart Failure: Definitions. Heart Failure: Historical Perspective 2/7/2009
Objectives Diastolic Heart Failure and Indications for Echocardiography in the Asian Population Damon M. Kwan, MD UCSF Asian Heart & Vascular Symposium 02.07.09 Define diastolic heart failure and differentiate
More informationMyocardial Strain Imaging in Cardiac Diseases and Cardiomyopathies.
Myocardial Strain Imaging in Cardiac Diseases and Cardiomyopathies. Session: Cardiomyopathy Tarun Pandey MD, FRCR. Associate Professor University of Arkansas for Medical Sciences Disclosures No relevant
More information22 nd Annual Conference of the Saudi Heart Association Riyadh, Saudi Arabia
22 nd Annual Conference of the Saudi Heart Association Riyadh, Saudi Arabia New Echocardiographic Modalities to Evaluate Ventricular Function in Congenital Heart Disease: Tissue Doppler & Strain Rate Imaging
More informationTissue Doppler and Strain Imaging. Steven J. Lester MD, FRCP(C), FACC, FASE
Tissue Doppler and Strain Imaging Steven J. Lester MD, FRCP(C), FACC, FASE Relevant Financial Relationship(s) None Off Label Usage None a. Turn the wall filters on and turn down the receiver gain. b. Turn
More informationPeripartum cardiomyopathy: review and practice guidelines. Hanan ALBackr Associate Professor King Saud university, King Fahad Cardaic center -Riyadh
Peripartum cardiomyopathy: review and practice guidelines Hanan ALBackr Associate Professor King Saud university, King Fahad Cardaic center -Riyadh Outlines Definition of PPCM Dignostic Critaria for peripartum
More informationECHOCARDIOGRAPHY. Patient Care. Goals and Objectives PF EF MF LF Aspirational
Patient Care Be able to: Perform and interpret basic TTE and X cardiac Doppler examinations Perform and interpret a comprehensive X TTE and cardiac Doppler examination Perform and interpret a comprehensive
More informationPERIPARTUM CARDIOMYOPATHY
PERIPARTUM CARDIOMYOPATHY Dr.T.Venkatachalam. Professor of Anaesthesiology Madras Medical College, Chennai Peripartum cardiomyopathy is defined as the onset of acute heart failure without demonstrable
More informationNew York Science Journal 2016;9(12)
Assesment of Left Ventricular Function in Preeclamptic Women with Preserved Left Ventricular Ejection Fraction Using Two Dimensional Speckle Tracking Imaging Abdel Halim Abu Al Magd, Samy Nouh, Mohammad
More informationSusan P. D Anna MSN, APRN BC February 14, 2019
Is there Equal Opportunity in Heart Failure?? Susan P. D Anna MSN, APRN BC February 14, 2019 Disclosures: I have no financial disclosures. I am not an expert on this topic, but see a lot of women with
More informationCardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures?
Keenan Research Centre Li Ka Shing Knowledge Institute Cardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures? Howard Leong-Poi, MD, FRCPC Associate Professor of Medicine St.
More informationAS with reduced LV ejection fraction: Contractile reserve should be systematically assessed: PRO
AS with reduced LV ejection fraction: Contractile reserve should be systematically assessed: PRO Jean-Luc MONIN, MD, PhD Henri Mondor University Hospital Créteil, FRANCE Potential conflicts of interest
More informationFamilial Aggregation of Dilated Cardiomyopathy in Patients with Peripartum Cardiomyopathy
Familial Aggregation of Dilated Cardiomyopathy in Patients with Peripartum Cardiomyopathy Tibazarwa K 1, Sliwa K 1, Wonkam A 2, Mayosi BM 1 1 Hatter Cardiovascular Research Institute, Department of Medicine,
More informationHow NOT to miss Hypertrophic Cardiomyopathy? Adaya Weissler-Snir, MD University Health Network, University of Toronto
How NOT to miss Hypertrophic Cardiomyopathy? Adaya Weissler-Snir, MD University Health Network, University of Toronto Introduction Hypertrophic cardiomyopathy is the most common genetic cardiomyopathy,
More informationEvaluation of the Right Ventricle and Risk Stratification for Sudden Cardiac Death
Evaluation of the Right Ventricle and Risk Stratification for Sudden Cardiac Death Presenters: Sabrina Phillips, MD FACC FASE Director, Adult Congenital Heart Disease Services The University of Oklahoma
More informationValvular Guidelines: The Past, the Present, the Future
Valvular Guidelines: The Past, the Present, the Future Robert O. Bonow, MD, MS Northwestern University Feinberg School of Medicine Bluhm Cardiovascular Institute Northwestern Memorial Hospital Editor-in-Chief,
More informationEvalua&on)of)Le-)Ventricular)Diastolic) Dysfunc&on)by)Echocardiography:) Role)of)Ejec&on)Frac&on)
Evalua&on)of)Le-)Ventricular)Diastolic) Dysfunc&on)by)Echocardiography:) Role)of)Ejec&on)Frac&on) N.Koutsogiannis) Department)of)Cardiology) University)Hospital)of)Patras)! I have no conflicts of interest
More informationDiastolic Function Assessment Practical Ways to Incorporate into Every Echo
Diastolic Function Assessment Practical Ways to Incorporate into Every Echo Jae K. Oh, MD Echo Hawaii 2018 2018 MFMER 3712003-1 Learning Objectives My presentation will help you to Appreciate the importance
More informationMultimodality Imaging in Spontaneous Coronary Artery Dissection in the Peripartum Period
Multimodality Imaging in Spontaneous Coronary Artery Dissection in the Peripartum Period Marysia Tweet, MD NASCI Annual Meeting October 18 th, 2016 2016 MFMER slide-1 DISCLOSURE No relevant financial relationship(s)
More informationStrain and Strain Rate Imaging How, Why and When?
Strain and Strain Rate Imaging How, Why and When? João L. Cavalcante, MD Advanced Cardiac Imaging Fellow Cleveland Clinic Foundation Disclosures: No conflicts of interest Movement vs Deformation Movement
More informationRestrictive Cardiomyopathy
ESC Congress 2011, Paris Imaging Unusual Causes of Cardiomyopathy Restrictive Cardiomyopathy Kazuaki Tanabe, MD, PhD Professor of Medicine Chair, Division of Cardiology Izumo, Japan I Have No Disclosures
More informationΔυναμική υπερηχοκαρδιογραφία στις μυοκαρδιοπάθειες : έχει θέση και ποια ;
Ελληνική Καρδιολογική Εταιρεία Σεμινάρια ομάδων εργασίας Θεσσαλονίκη, 8-10 Φεβρουαρίου 2018 Ομάδα εργασίας Ηχωκαρδιολογίας Δυναμική υπερηχοκαρδιογραφία στις μυοκαρδιοπάθειες : έχει θέση και ποια ; ΑΓΑΘΗ-ΡΟΖΑ
More informationLV geometric and functional changes in VHD: How to assess? Mi-Seung Shin M.D., Ph.D. Gachon University Gil Hospital
LV geometric and functional changes in VHD: How to assess? Mi-Seung Shin M.D., Ph.D. Gachon University Gil Hospital LV inflow across MV LV LV outflow across AV LV LV geometric changes Pressure overload
More informationDialysis-Dependent Cardiomyopathy Patients Demonstrate Poor Survival Despite Reverse Remodeling With Cardiac Resynchronization Therapy
Dialysis-Dependent Cardiomyopathy Patients Demonstrate Poor Survival Despite Reverse Remodeling With Cardiac Resynchronization Therapy Evan Adelstein, MD, FHRS John Gorcsan III, MD Samir Saba, MD, FHRS
More informationPREGNANCY IN PATIENTS WITH A SYSTEMIC RV
PREGNANCY IN PATIENTS WITH A SYSTEMIC RV Carole A. Warnes MD, FRCP Professor of Medicine, Mayo Clinic No disclosures 2013 MFMER slide-1 PREGNANCY : SYSTEMIC RV D - transposition after atrial switch procedure
More informationRational use of imaging for viability evaluation
EUROECHO and other imaging modalities 2011 Rational use of imaging for viability evaluation Luc A. Pierard, MD, PhD, FESC, FACC Professor of Medicine Head, Department of Cardiology, CHU Liège, Belgium
More informationGlobal left ventricular circumferential strain is a marker for both systolic and diastolic myocardial function
Global left ventricular circumferential strain is a marker for both systolic and diastolic myocardial function Toshinari Onishi 1, Samir K. Saha 2, Daniel Ludwig 1, Erik B. Schelbert 1, David Schwartzman
More informationPRESENTER DISCLOSURE INFORMATION. There are no potential conflicts of interest regarding current presentation
PRESENTER DISCLOSURE INFORMATION There are no potential conflicts of interest regarding current presentation Better synchrony and diastolic function for septal versus apical right ventricular permanent
More informationTissue Doppler and Strain Imaging
Tissue Doppler and Strain Imaging Steven J. Lester MD, FRCP(C), FACC, FASE Relevant Financial Relationship(s) None Off Label Usage None 1 Objective way with which to quantify the minor amplitude and temporal
More informationPulmonary Hypertension: Definition and Unmet Needs
Heart Failure Center Hadassah University Hospital Pulmonary Hypertension: Definition and Unmet Needs Israel Gotsman The Heart Failure Center Hadassah University Hospital I DO NOT have a financial interest/
More information3/27/2014. Introduction.
Introduction. Myocardial perfusion & contractility becomes abnormal immediately after the onset of ischaemia, even before the development of the symptoms & ST segment changes. 1 Myocardial Wall Motion
More informationPregnancy outcome in Peripartum Cardiomyopathy
Abstract Pregnancy outcome in Peripartum Cardiomyopathy Anuja Bhalerao, Richa Garg Department of Obstetrics and Gynaecology NKP Salve institute of medical sciences, Nagpur,India Email: anuja_bhalerao@yahoo.com,
More informationVelocity Vector Imaging as a new approach for cardiac magnetic resonance: Comparison with echocardiography
Velocity Vector Imaging as a new approach for cardiac magnetic resonance: Comparison with echocardiography Toshinari Onishi 1, Samir K. Saha 2, Daniel Ludwig 1, Erik B. Schelbert 1, David Schwartzman 1,
More information10/7/2013. Systolic Function How to Measure, How Accurate is Echo, Role of Contrast. Thanks to our Course Director: Neil J.
Systolic Function How to Measure, How Accurate is Echo, Role of Contrast Neil J. Weissman, MD MedStar Health Research Institute & Professor of Medicine Georgetown University Washington, D.C. No Disclosures
More informationEffect of Ventricular Pacing on Myocardial Function. Inha University Hospital Sung-Hee Shin
Effect of Ventricular Pacing on Myocardial Function Inha University Hospital Sung-Hee Shin Contents 1. The effect of right ventricular apical pacing 2. Strategies for physiologically optimal ventricular
More informationCHRONIC HEART FAILURE : WHAT ELSE COULD WE OFFER TO OUR PATIENTS? Cardiac Rehabilitation Society of Thailand
CHRONIC HEART FAILURE : WHAT ELSE COULD WE OFFER TO OUR PATIENTS? Cardiac Rehabilitation Society of Thailand ENHANCED EXTERNAL COUNTER PULSATION Piyanuj Ruckpanich, MD. Cardiac Rehabilitation Center Perfect
More informationDifferent Characteristics of Peripartum Cardiomyopathy Between Patients Complicated With and Without Hypertensive Disorders
Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp ORIGINAL ARTICLE Myocardial Disease Different Characteristics of Peripartum Cardiomyopathy Between Patients
More informationUpdate on peripartum cardiomyopathy: Pathophysiology
Update on peripartum cardiomyopathy: Pathophysiology I HAVE NOTHING TO DISCLOSE Denise Hilfiker-Kleiner Kardiologie & Angiologie MHH, Hannover Peri- or Postpartum Cardiomyopathy Peri- or postpartum cardiomyopathy
More informationWhen to ablate patients with premature ventricular complexes?
When to ablate patients with premature ventricular complexes? Nikolaos Fragakis Assistant Professor, FESC 3rd University Cardiology Department Hippokration Hospital, Thessaloniki 58 year-old female Case
More informationAdvanced imaging of the left atrium - strain, CT, 3D, MRI -
Advanced imaging of the left atrium - strain, CT, 3D, MRI - Monica Rosca, MD Carol Davila University of Medicine and Pharmacy, Bucharest, Romania Declaration of interest: I have nothing to declare Case
More informationLeft ventricular diastolic function and filling pressure in patients with dilated cardiomyopathy
Left ventricular diastolic function and filling pressure in patients with dilated cardiomyopathy Bogdan A. Popescu University of Medicine and Pharmacy Bucharest, Romania My conflicts of interest: I have
More informationLeft atrial function. Aliakbar Arvandi MD
In the clinic Left atrial function Abstract The left atrium (LA) is a left posterior cardiac chamber which is located adjacent to the esophagus. It is separated from the right atrium by the inter-atrial
More informationAcute impairment of basal left ventricular rotation but not twist and untwist are involved in the pathogenesis of acute hypertensive pulmonary oedema
Acute impairment of basal left ventricular rotation but not twist and untwist are involved in the pathogenesis of acute hypertensive pulmonary oedema A.D. Margulescu 1,2, R.C. Sisu 1,2, M. Florescu 2,
More informationFunctional Mitral Regurgitation; therapeutic continuum overview. Michele Senni. Cardiologia 1 Scompenso e Trapianti di Cuore A.O. PAPA GIOVANNI XXIII
Functional Mitral Regurgitation; therapeutic continuum overview Michele Senni Cardiologia 1 Scompenso e Trapianti di Cuore A.O. PAPA GIOVANNI XXIII Functional Mitral Regurgitation FMR is not the result
More informationTissue Doppler and Strain Imaging
Tissue Doppler and Strain Imaging Steven J. Lester MD, FRCP(C), FACC, FASE Relevant Financial Relationship(s) None Off Label Usage None 1 Objective way with which to quantify the minor amplitude and temporal
More informationCardiac Resynchronization Therapy Selection therapy Echocardiography
Cardiac Resynchronization Therapy Selection therapy Echocardiography Prof. Patrizio LANCELLOTTI CHU Sart Tilman, Liège April, 2010 Candidates for CRT : class IA NYHA Functional Class III or IV (Subjective)
More informationThe EURObservational Research Programme (EORP) Registry on Peripartum Cardiomyopathy (PPCM) CPP, Friday, 21th February, Venice
The EURObservational Research Programme (EORP) Registry on Peripartum Cardiomyopathy (PPCM) CPP, Friday, 21th February, Venice Long-Term Registry on Patients with Peripartum Cardiomyopathy Executive Committee:
More information좌심실수축기능평가 Cardiac Function
Basic Echo Review Course 좌심실수축기능평가 Cardiac Function Seonghoon Choi Cardiology Hallym university LV systolic function Systolic function 좌심실수축기능 - 심근의수축으로심실에서혈액을대동맥으로박출하는기능 실제임상에서 LV function 의의미 1Diagnosis
More informationW J C. World Journal of Cardiology. Peripartum cardiomyopathy: A puzzle closer to solution. Abstract INTRODUCTION REVIEW
W J C World Journal of Cardiology Online Submissions: http://www.wjgnet.com/esps/ bpgoffice@wjgnet.com doi:10.4330/wjc.v6.i3.87 World J Cardiol 2014 March 26; 6(3): 87-99 ISSN 1949-8462 (online) 2014 Baishideng
More informationAtrial dyssynchrony syndrome: An overlooked cause of heart failure with normal ejection fraction
Atrial dyssynchrony syndrome: An overlooked cause of heart failure with normal ejection fraction JC Eicher, G Laurent, O Barthez, A Mathé, G Bertaux, JE Wolf Heart Failure Treatment Unit, Rhythmology and
More informationHeart Failure in Women: Dr Goh Ping Ping Cardiologist Asian Heart & Vascular Centre
Heart Failure in Women: More than EF? Dr Goh Ping Ping Cardiologist Asian Heart & Vascular Centre Overview Review pathophysiology as it relates to diagnosis and management Rational approach to workup:
More informationComprehensive Echo Assessment of Aortic Stenosis
Comprehensive Echo Assessment of Aortic Stenosis Smonporn Boonyaratavej, MD, MSc King Chulalongkorn Memorial Hospital Bangkok, Thailand Management of Valvular AS Medical and interventional approaches to
More informationThe Athlete s Heart. Critical Role of Echo. Neil J. Weissman, MD MedStar Health Research Institute & Professor of Medicine Georgetown University
The Athlete s Heart Critical Role of Echo Neil J. Weissman, MD MedStar Health Research Institute & Professor of Medicine Georgetown University Washington, D.C. Disclosures Grant support (to institution)
More informationCardiovascular Images
Cardiovascular Images Pulmonary Embolism Diagnosed From Right Heart Changes Seen After Exercise Stress Echocardiography Brian C. Case, MD; Micheas Zemedkun, MD; Amarin Sangkharat, MD; Allen J. Taylor,
More informationPulmonary Hypertension Associated with Congenital Heart Disease. Amiram Nir Hadassah, Jerusalem
Pulmonary Hypertension Associated with Congenital Heart Disease Amiram Nir Hadassah, Jerusalem Disclosure Honoraria - Actelion Research grants form Actelion The Nice Classification (2013) Blok et al. Expert
More informationWhat s New in Cardiac MRI
What s New in Cardiac MRI Katie M. Hawthorne, MD Director, Cardiac MRI Main Line Health Philadelphia Cardiovascular Summit November 18, 2017 Cardiac MRI: Disclosure 2 Disclosures No financial disclosures
More informationGenotype Positive/ Phenotype Negative: Is It a Disease?
Genotype Positive/ Phenotype Negative: Is It a Disease? Michelle Michels MD, PhD Center of Inherited Cardiovascular Diseases Erasmus MC, Rotterdam, the Netherlands No disclosures What is phenotype negative
More informationL ecocardiografia nello Scompenso Cardiaco Acuto e cronico: vecchi dogmi e nuovi trends.
V SESSIONE SCOMPENSO CARDIACO 2015 Genova, 13-14 Novembre 2015 L ecocardiografia nello Scompenso Cardiaco Acuto e cronico: vecchi dogmi e nuovi trends. Gian Paolo Bezante, MD, FACC UOC Clinica di Malattie
More informationΜαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό
Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό Diastolic HF DD: Diastolic Dysfunction DHF: Diastolic HF HFpEF: HF with preserved EF DD Pathophysiologic condition: impaired relaxation, LV compliance, LV filling
More informationGENERAL PRINCIPLES FOR ECHO ASSESSMENT OF DIASTOLIC FUNCTION (For full recommendation refer to the Left Ventricular Diastolic Function Guideline)
1 THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY RECOMMENDATIONS FOR THE EVALUATION OF LEFT VENTRICULAR DIASTOLIC FUNCTION BY ECHOCARDIOGRAPHY: A QUICK REFERENCE GUIDE FROM THE ASE WORKFLOW AND LAB MANAGEMENT
More informationCardiac Resynchronization ICD Therapy: What is New?
Cardiac Resynchronization ICD Therapy: What is New? Emile Daoud, MD Section Chief, Cardiac Electrophysiology Professor of Medicine The Ohio State University Normal Activation, Narrow QRS Synchrony Abnormal
More informationValue of echocardiography in chronic dyspnea
Value of echocardiography in chronic dyspnea Jahrestagung Schweizerische Gesellschaft für /Schweizerische Gesellschaft für Pneumologie B. Kaufmann 16.06.2016 Chronic dyspnea Shortness of breath lasting
More information