Long-term follow-up of cardiac resynchronization therapy: mechanical resynchronization and reverse left ventricular remodeling are predictive for long-term transplant-free survival.

We sought to determine whether correction of mechanical left ventricular (LV) dyssynchrony as defined by tissue Doppler imaging (TDI) is predictive for transplant-free long-term survival in patients (pts.) undergoing cardiac resynchronization therapy (CRT). In 76 CRT recipients TDI curves from the septal, lateral, anterior, and inferior basal LV were obtained at baseline and after 6 ± 4 months.

Left atrial size and left ventricular hypertrophy correlate with myocardial fibrosis in patients with hypertrophic cardiomyopathy.

Introduction: In hypertrophic cardiomyopathy (HCM) risk assessment with respect to sudden cardiac death (SCD) is currently based on the presence or absence of different risk markers (RM). Recently, myocardial fibrosis as detected by gadolinium-enhanced magnetic resonance imaging (GE-MRI) has been suggested as additional RM. We evaluated the prevalence of myocardial fibrosis and examined correlations with other risk markers in patients considered to be at increased risk.

The diagnosis and treatment of hypertrophic cardiomyopathy.

Background: Hypertrophic cardiomyopathy (HCM) is the most common hereditary disease of the heart.

Methods: In this article, we summarize the current state of the diagnosis and treatment of HCM on the basis of a selective review of recent publications with relevance to clinical practice.

Results: Several hundred mutations in more than 27 genes, most of which encode sarcomeric structures, are associated with the HCM phenotype.

Incidence of adequate ICD interventions in patients with hypertrophic cardiomyopathy supposed to be at high risk for sudden cardiac death.

Introduction: Although the incidence of sudden cardiac death (SCD) is as low as 1%/year in un-selected patients (pts) with hypertrophic cardiomyopathy (HCM), higher-risk populations may benefit from prophylactic implantation of an ICD. Risk assessment in HCM is thus important and currently based on the presence or absence of different risk markers (RM).

Study Aim: The objective of this study is to correlate the incidence of adequate ICD interventions in HCM with the presence of different RM.

Peak systolic longitudinal strain of the lateral left ventricular wall improves after septal ablation for symptomatic hypertrophic obstructive cardiomyopathy: a follow-up study using speckle tracking echocardiography.

Speckle tracking echocardiography (STE) or two-dimensional (2D) strain imaging is a novel ultrasound method to assess myocardial deformation. Peak systolic longitudinal strain (PSLS) of the basal septum (IVS) and the opposite lateral (LVFW) wall were measured in addition to standard echocardiography in 88 consecutive patients (pts) with obstructive hypertrophic cardiomyopathy (HOCM) who underwent a septal ablation procedure (PTSMA) and who were re-evaluated 12 ± 12 after months. At baseline, PSLS was substantially reduced both in basal regions.

Extracorporeal cardiac shock wave therapy ameliorates clinical symptoms and improves regional myocardial blood flow in a patient with severe coronary artery disease and refractory angina.

Different therapeutic options are being used for chronic coronary artery disease (CAD). We report about a 51-year-old female with CAD and refractory angina pectoris despite maximally tolerated medical therapy and after both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The patient received cardiac shock wave therapy (CSWT) over a period of 6 month.

Sleep-disordered breathing in heart failure with normal left ventricular ejection fraction.

Aims: In patients with systolic heart failure (SHF) a high prevalence of sleep-disordered breathing (SDB) has been documented. The purpose of this study was to investigate the prevalence and type of SDB in patients with heart failure with normal left ventricular ejection fraction (HFNEF).

Methods And Results: Two hundred and forty-four consecutive patients (87 women, aged 65.

Percutaneous septal ablation after unsuccessful surgical myectomy for patients with hypertrophic obstructive cardiomyopathy.

Objective: To evaluate the long-term outcome of percutaneous septal ablation (PTSMA) after a previous myectomy.

Background: Myectomy usually results in symptomatic improvement and reduction of dynamic obstruction in hypertrophic obstructive cardiomyopathy patients (HOCM-pts.).

Etiology of stroke after mechanical heart valve replacement--results from a ten-year prospective study.

Background And Aims Of The Study: In patients carrying mechanical valve prostheses it is assumed that cardioembolic strokes account for 70 - 90 % of clinically diagnosed thromboembolic complications. The etiology of stroke especially in older patients with mechanical heart valves may thus be multiple and not prosthetic valve-related in a substantial percentage. It was the aim of this prospective study to analyze the etiology of stroke in consecutive patients, who had mechanical heart valve replacement before.

Drug insight: an overview of current anticoagulation therapy after heart valve replacement.

Vitamin K antagonists, such as warfarin, are the gold standard approach for the long-term anticoagulant therapy of patients with mechanical heart valves. Management decisions are, however, based predominantly on expert consensus and on data from nonrandomized, follow-up studies, which have inherent limitations in their methods. Low-intensity anticoagulation therapy provides protection against thromboembolic complications in patients with most types of modern prosthetic heart valve.

Influence of two different reporting systems on counts of thromboembolic and bleeding complications after St. Jude medical valve replacement: results from the GELIA study.

Background And Aim Of The Study: Different standards for the reporting of morbid events and different follow up techniques have a profound impact on reported morbidity after prosthetic valve replacement. Most studies follow the guidelines of The American Association of Thoracic Surgery (AATS) and The Society of Thoracic Surgeons (STS); the present authors' group has now developed an adapted Karnofsky scale which allows a more precise grading of the severity of morbid events.

Methods: The AATS/STS criteria and the adapted Karnofsky criteria were applied to the database of the German Experience with Low-Intensity Anticoagulation (GELIA) study.

Thromboembolic and bleeding complications following St. Jude Medical valve replacement: results of the German Experience With Low-Intensity Anticoagulation Study.

Study Objectives: Due to their inherent thrombogenicity, mechanical cardiac valves necessitate lifelong oral anticoagulation. Less intensive oral anticoagulation than recommended earlier might result in a lower incidence of bleeding complications without increasing the embolic hazard significantly.

Design: Comparison of three different intensities of oral anticoagulation in a prospective, randomized multicenter design.

Quantitative analysis of intraprocedural myocardial contrast echocardiography during percutaneous septal ablation for hypertrophic obstructive cardiomyopathy.

Aims: We tested whether procedural success of percutaneous septal ablation for hypertrophic obstructive cardiomyopathy is related to quantitative measurements of intraprocedural myocardial contrast echocardiography.

Methods And Results: In a study group of 34 patients, the mean area of the contrast depot was 8.5+/-2.

Influence of atypical symptoms and electrocardiographic signs of left ventricular hypertrophy or ST-segment/T-wave abnormalities on the natural history of otherwise asymptomatic adults with moderate to severe aortic stenosis: preliminary communication.

Background And Aim Of The Study: Current guidelines recommend that aortic valve replacement (AVR) is deferred in asymptomatic patients with aortic stenosis until symptoms develop. Classical symptoms include exertional dyspnea, angina pectoris and syncope. The influence of atypical symptoms (dizziness, exertional intolerance, fatigue, palpitations/arrhythmias) and electrocardiographic signs of left ventricular hypertrophy or ST-segment/T-wave abnormalities on the natural course of the disease is unknown.