Distinctive left ventricular-arterial and right ventricular-pulmonary arterial coupling observed in patients with heart failure and a higher left ventricular ejection fraction range.

Aims: Higher left ventricular (LV) ejection fraction (EF) is related to unfavourable prognosis in patients with heart failure (HF) with preserved ejection fraction (HFpEF). The cause of this finding needs to be haemodynamically explained. Thus, we investigated this crucial issue from the perspective of LV-arterial (A) and right ventricular (RV)-pulmonary arterial (PA) coupling.

Unfavourable outcomes in patients with heart failure with higher preserved left ventricular ejection fraction.

Aims: Newly introduced drugs for heart failure (HF) have been reported to improve the prognosis of HF with preserved ejection fraction (HFpEF) in the lower range of left ventricular ejection fraction (LVEF). We hypothesized that a higher LVEF is related to an unfavourable prognosis in patients with HFpEF.

Methods And Results: We tested this hypothesis by analysing the data from a prospective multicentre cohort study in 255 patients admitted to the hospital due to decompensated HF (LVEF > 40% at discharge).

Left Ventricular Hypertrophic Change Indicating Poor Prognosis in Patients With Normal-Flow, Low-Gradient Severe Aortic Stenosis With Preserved Left Ventricular Ejection Fraction.

Risk stratification of normal-flow, low-gradient (NFLG) severe aortic stenosis (SAS) with preserved left ventricular (LV) ejection fraction (EF) remains unclear. Of 289 consecutive patients diagnosed with SAS by aortic valve area <1.0 cm, 66 with NFLG-SAS (stroke volume index >35 mL/m, mean pressure gradient <40 mmHg, LVEF ≥50%) were enrolled in this study; patients with bicuspid aortic valve, acute coronary syndrome, hemodialysis, or a history of aortic valve replacement (AVR) were excluded.

Infected Aortic Aneurysm Mimicking Anti-proteinase 3-Antineutrophil Cytoplasmic Antibody-associated Vasculitis.

We herein report an unusual case of an infected descending aortic pseudoaneurysm with luminal pathognomonic oscillating vegetation with serological findings and clinical features mimicking anti-proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis. The positive blood cultures and imaging findings, including a pseudoaneurysm and vegetations in the aorta, suggested the presence of an infected aortic aneurysm. The patient was successfully treated with antibiotics and endovascular aortic repair.

Double-valve replacement for mitral and aortic regurgitation in a Patient with Libman-Sacks endocarditis.

A 53-year-old woman with systemic lupus erythematosus and antiphospholipid syndrome presented with central nervous system (CNS) lupus and vegetation of the mitral and aortic valves. Her CNS lupus was relieved with methylprednisolone pulse therapy; however, her mitral regurgitation worsened, and she developed acute decompensated heart failure. The mitral and aortic valves were replaced with mechanical heart valves.

Relation of epicardial fat to central aortic pressure and left ventricular diastolic function in patients with known or suspected coronary artery disease.

The present study tested the hypothesis that epicardial fat may be associated with augmented central aortic pressure and impaired left ventricular (LV) function. We studied 134 consecutive patients undergoing left-sided cardiac catheterization for coronary artery disease (CAD) and examined the relation of epicardial fat volume measured by multi-detector computed tomography to ascending aortic pressure and LV ejection fraction determined by cardiac catheterization as well as indices of LV diastolic function assessed by Doppler echocardiography [early diastolic mitral annular velocity (e') and a ratio of early diastolic mitral inflow to annular velocities (E/e')]. Epicardial fat volume indexed to body surface area correlated positively with age (r = 0.

Midventricular ballooning Takotsubo cardiomyopathy complicated by transient complete atrioventricular block.

A 63-year-old woman had mistakenly drunk detergent stored in a plastic bottle and was transported to our hospital via ambulance due to unconsciousness. In the emergency room, the monitoring electrocardiogram showed complete atrioventricular block and temporary pacing was thus started. Left ventriculography indicated midventricular Takotsubo cardiomyopathy, although coronary angiograms showed a normal appearance.