A Dual Challenge: Endocarditis in a Patient with Familial Thoracic Aortic Aneurysm-Case Report and Literature Review.

: Thoracic aortic aneurysms (TAAs) are potentially life-threatening medical conditions, and their etiology involves both genetic and multiple risk factors. endocarditis is one of the most frequent causes of blood culture-negative infective endocarditis (BCNIE) in patients with previous cardiac surgery. Our review aims to emphasize the importance of genetic testing in patients with thoracic aortic aneurysms but also the importance of additional testing in patients with suspected endocarditis whose blood cultures remain negative.

Genotype-Phenotype Insights of Inherited Cardiomyopathies-A Review.

: Cardiomyopathies (CMs) represent a heterogeneous group of primary myocardial diseases characterized by structural and functional abnormalities. They represent one of the leading causes of cardiac transplantations and cardiac death in young individuals. Clinically they vary from asymptomatic to symptomatic heart failure, with a high risk of sudden cardiac death due to malignant arrhythmias.

Importance of Multimodality Cardiac Imaging in the Diagnosis of Lipomatous Hypertrophy of the Interatrial Septum-A View beyond Standard Situations.

Lipomatous hypertrophy of the interatrial septum (LHIAS) represents a benign proliferation of lipoid cells at the level of the interatrial septum (IAS) inducing an important thickening of this structure. It respects the fossa ovalis (FO) region, having a typical "hourglass" echocardiographic appearance. There are certain cases though, with unusual appearances and/or with associated pathologies that may induce similar lesions in the heart, in which the differential diagnosis cannot be guaranteed using only the standard methods.

The Challenges of Cardiac Resynchronization Therapy in Patients with Dilated Cardiomyopathy and Persistent Left Superior Vena Cava: A Case Report and Concise Literature Review.

Heart failure with reduced ejection fraction (HFrEF) is a chronic and debilitating disease, which requires extensive diagnostic and treatment resources in order to achieve an acceptable quality of life for the patient. While optimal medical treatment remains at the core of the disease's management, interventional cardiology also plays a very important role. However, in very rare situations, interventionists might find cases especially challenging due to the presence of venous anomalies, such as persistent left superior vena cava (PLSVC), anomalies that may go undiscovered during the patient's lifetime until venous cannulation is necessary.

Monoamine Oxidase (MAO) Is Expressed at the Level of Mitral Valve with Severe Regurgitation in Hypertrophic Obstructive Cardiomyopathy: A Case Report.

Hypertrophic obstructive cardiomyopathy (HOCM) is one of the most common hereditary heart diseases. The severely hypertrophied interventricular septum combined with the systolic anterior movement (SAM) of the mitral valve (MV) frequently cause a significant pressure gradient in the left ventricular outflow tract associated with varying degrees of mitral regurgitation (MR). We present the case of a 64-year-old female patient who was diagnosed with HOCM two years ago and was admitted to the Institute of Cardiovascular Disease with exertion dyspnea and fatigue.

Echocardiographic Parameters as Predictors for the Efficiency of Resynchronization Therapy in Patients with Dilated Cardiomyopathy and HFrEF.

Cardiac resynchronization therapy (CRT) represents an increasingly recommended solution to alleviate symptomatology and improve the quality of life in individuals with dilated cardiomyopathy (DCM) and heart failure (HF) with reduced ejection fraction (HFrEF) who remain symptomatic despite optimal medical therapy (OMT). However, this therapy does have the desired results all cases, in that sometimes low sensing and high voltage stimulation are needed to obtain some degree of resynchronization, even in the case of perfectly placed cardiac pacing leads. Our study aims to identify whether there is a relationship between several transthoracic echocardiographic (TTE) parameters characterizing left ventricular (LV) performance, especially strain results, and sensing and pacing parameters.

Romanian Registry of Hypertrophic Cardiomyopathy - overview of general characteristics and therapeutic choices at a national level.

Introduction: Hypertrophic cardiomyopathy (HCM) is a disease with increased left ventricular (LV) wall thickness not solely explained by abnormal loading conditions, with great heterogeneity regarding clinical expression and prognosis. The aim of the present study was to collect data on HCM patients from different centres across the country, in order to assess the general characteristics and therapeutic choices in this population.

Methods: Between December 2014 and April 2017, 210 patients from 11 Romanian Cardiology centres were enrolled in the National Registry of HCM.

Risk stratification in patients with heart failure: the value of considering both global longitudinal left ventricular strain and mechanical dispersion.

In previous studies, mechanical dispersion (MD) predicted ventricular arrhythmias independently of left ventricular ejection fraction (LVEF). Moreover, the combination of MD and global longitudinal strain (GLS) increased the prediction of arrhythmic events. We investigated the prognostic value of a new 2-dimensional strain index, GLS/MD, in patients with heart failure (HF).

Monoamine Oxidases as Potential Contributors to Oxidative Stress in Diabetes: Time for a Study in Patients Undergoing Heart Surgery.

Oxidative stress is a pathomechanism causally linked to the progression of chronic cardiovascular diseases and diabetes. Mitochondria have emerged as the most relevant source of reactive oxygen species, the major culprit being classically considered the respiratory chain at the inner mitochondrial membrane. In the past decade, several experimental studies unequivocally demonstrated the contribution of monoamine oxidases (MAOs) at the outer mitochondrial membrane to the maladaptative ventricular hypertrophy and endothelial dysfunction.

The value of left ventricular global longitudinal strain assessed by three-dimensional strain imaging in the early detection of anthracyclinemediated cardiotoxicity.

Introduction: Anthracyclines are important anticancer drugs, but their use is limited by acute and chronic cardiotoxicity. Current approaches to surveillance are often inadequate to detect myocardial disease. Strain imaging might detect earlier myocardial dysfunction.

A new tissue Doppler index to predict cardiac death in patients with heart failure.

Background: It has been shown that a new tissue Doppler index, E/(E'×S'), including the ratio between early diastolic transmitral and mitral annular velocity (E/E'), and the systolic mitral annular velocity (S'), has a good accuracy to predict left ventricular filling pressure.

Objectives: We investigated the value of E/(E'×S') to predict cardiac death in patients with heart failure.

Methods: Echocardiography was performed in 339 consecutive hospitalized patients with heart failure, in sinus rhythm, after appropriate medical treatment, at discharge and after one month.

The prognostic value of a new tissue Doppler parameter in patients with heart failure.

It has been shown a good accuracy to predict high left ventricular end-diastolic pressure for a value >1.6 of a new tissue Doppler index, E/(E' × S'), including the ratio between early diastolic transmitral and mitral annulus velocity (E/E'), and the systolic mitral annulus velocity (S'). Our aim was to evaluate the prognostic value of E/(E' × S') > 1.

Q fever endocarditis in Romania: the first cases confirmed by direct sequencing.

Infective endocarditis (IE) is a serious, life-threatening disease with highly variable clinical signs, making its diagnostic a real challenge. A diagnosis is readily made if blood cultures are positive, but in 2.5 to 31% of all infective endocarditis cases, routine blood cultures are negative.

Additive value of torsion to global longitudinal left ventricular strain in patients with reduced ejection fraction.

Background: Torsional and longitudinal deformations are essential components of left ventricular (LV) performance. A precise assessment of LV function must take into account both LV torsion (LVtor) and global longitudinal strain (LVE). We compared a new 2D-strain parameter, LVtor x LVE, with several other echocardiographic parameters, with respect to their strength of association with N-terminal pro-brain natriuretic peptide (NTproBNP) in patients with reduced LV ejection fraction (LVEF).

A new tissue doppler index in predicting future atrial fibrillation in patients with heart failure.

Background: Onset of atrial fibrillation (AF) in patients with heart failure (HF) is usually associated with a high occurrence of cardiovascular complications. E/(E'×S') ratio (E=early diastolic transmitral velocity, E'=early mitral annular diastolic velocity and S'=systolic mitral annulus velocity) has been shown to reflect left ventricular filling pressure.

Objective: We investigate whether E/(E'×S') could be a predictor of new-onset AF in patients with HF.

The value of a new speckle tracking index including left ventricular global longitudinal strain and torsion in patients with dilated cardiomyopathy.

Introduction: Torsional and longitudinal deformations are essential components of left ventricular (LV) performance. We believe that a precise assessment of LV function must take into account both LV torsion (LVtor) and global longitudinal strain (LVε). Therefore, we investigated with speckle tracking echocardiography the value of a new parameter, LVtor × LVε, for assessing LV function in dilated cardiomyopathy (DCM) and validated it against N-terminal pro-brain natriuretic peptide (NTproBNP).

The influence of left bundle branch-block and cardiac dyssynchrony on 2D-strain parameters in patients with heart failure complicating ischemic cardiomyopathy.

Unlabelled: Coronary artery disease is the underlying cause in approximately two-thirds of patients with heart failure. Torsional and longitudinal deformations are essential components of left ventricular (LV) performance. Electric conduction defects can reduce LV ejection fraction (LVEF) and decrease cardiac output.

E/(EaxSa) estimates left ventricular end-diastolic pressure in patients with severe mitral regurgitation.

Background And Aim Of The Study: The early diastolic transmitral velocity/early mitral annular diastolic velocity ratio (E/Ea) reflects left ventricular (LV) filling pressure in a variety of cardiac diseases. The value of this parameter in patients with significant mitral regurgitation (MR) remains controversial. It has been hypothesized that, by combining the index of diastolic function (E/Ea) and a parameter that explores LV systolic performance (Sa, mitral annulus peak systolic velocity), a close prediction of the LV end-diastolic pressure (LVEDP) can be provided.

Analysis of the impact of early surgery on in-hospital mortality of native valve endocarditis: use of propensity score and instrumental variable methods to adjust for treatment-selection bias.

Background: The impact of early surgery on mortality in patients with native valve endocarditis (NVE) is unresolved. This study sought to evaluate valve surgery compared with medical therapy for NVE and to identify characteristics of patients who are most likely to benefit from early surgery.

Methods And Results: Using a prospective, multinational cohort of patients with definite NVE, the effect of early surgery on in-hospital mortality was assessed by propensity-based matching adjustment for survivor bias and by instrumental variable analysis.

Reduced valve replacement surgery and complication rate in Staphylococcus aureus endocarditis patients receiving acetyl-salicylic acid.

Objectives: To assess the influence of acetyl-salicylic acid (ASA) on clinical outcomes in Staphylococcus aureus infective endocarditis (SA-IE).

Methods: The International Collaboration on Endocarditis - Prospective Cohort Study database was used in this observational study. Multivariable analysis of the SA-IE cohort compared outcomes in patients with and without ASA use, adjusting for other predictive variables, including: age, diabetes, hemodialysis, cancer, pacemaker, intracardiac defibrillator and methicillin resistance.

A novel index combining diastolic and systolic Tissue Doppler parameters for the non-invasive assessment of left ventricular end-diastolic pressure.

Background: Early diastolic transmitral velocity (E)/early mitral annular diastolic velocity (Ea) ratio has been proposed as the best Doppler predictor for evaluating left ventricular (LV) filling pressure.

Purpose: To evaluate the relationship between a novel echocardiographic index, E/(EaxSa), and left ventricular end-diastolic pressure (LVEDP); Sa is the peak systolic mitral annular velocity. We measured this index at different sites of the mitral annulus and compared it with other Tissue Doppler parameters.

The relationship between tissue Doppler imaging and seric NTproBNP levels in sinus rhythm patients: a prospective study.

Unlabelled: N-terminal pro-brain natriuretic peptide (NTproBNP) correlates with left ventricular (LV) filling pressure. The ratio between early diastolic transmitral velocity and early mitral annular diastolic velocity (E/Ea) reflects LV filling pressure in a variety of cardiac diseases. However this relationship was not validated in some categories of patients.

Echocardiographic evidences of increased left ventricular pressure and atrial dilatation in patients with drug-resistant paroxystic atrial fibrillation and structurally normal heart.

Unlabelled: Global myocardial index (GMI) has been significantly related to left ventricular filling pressure. We hypothesized that GMI and echographic indicators of atrial dilatation were significantly different in pAF pts compared to normals.

Methods: 39 patients (pts) without structural heart disease, aged 52+/-10 years with pAF were compared to 36 control-matched pts aged 48+/-16 years.