An Unexpected Finding in an Adolescent Rowing Athlete With Angina Pectoris. A Case Report.

Significant intraventricular gradient development during exercise is rare, usually occurring with left ventricular hypertrophy. The etiopathogenesis consists of the increase in nonobstructive physiological gradients; ventricular cavitary obliteration with consequent end-systolic obstruction; and midsystolic obstruction caused by systolic anterior movement of the mitral valve compromising flow. A correlation between intraventricular gradient development and various symptoms has been established.

Clinical Application of Exercise Stress Echocardiography in an Outpatient Pediatric Population.

: Exercise stress echocardiography (ESE) is commonly employed in adults, but its applicability in pediatric populations remains to be clarified. A total of 309 consecutive children (C), with a mean age of 14.1 ± 2.

Exercise-Induced Intraventricular Gradients As a Potential Cause of Sudden Cardiac Death.

A 16-year-old boy reported an episode of dizziness related to intense training six months before an episode of aborted sudden death. The screening required for competitive sports practice was normal. There were no personal or familial antecedents of sudden death or heart disease.

Microvascular Dysfunction Is Associated With Impaired Myocardial Work in Obstructive and Nonobstructive Hypertrophic Cardiomyopathy: A Multimodality Study.

Background Two-dimensional speckle tracking echocardiography has been shown to correlate with microvascular dysfunction, a hallmark of hypertrophic cardiomyopathy (HCM). We hypothesized that there is an association between myocardial work and left ventricular ischemia, with incremental value to global longitudinal strain, in patients with HCM. Methods and Results We performed a prospective assessment of patients with HCM, undergoing 2-dimensional speckle tracking echocardiography and stress perfusion cardiac magnetic resonance.

Intraventricular gradients-When we have to "exercise" our minds: A case report.

Increased intraventricular pressure gradients due to dynamic left ventricular outflow tract obstruction during exercise have long been known to cause different symptoms. Exercise stress echocardiography is fundamental in the diagnostic approach of symptoms presenting during exercise. We hypothesize on the possible pathophysiological mechanisms responsible for our patient's syncopal episodes.

Index of microcirculatory resistance in the assessment of coronary microvascular dysfunction in hypertrophic cardiomyopathy.

Introduction And Objectives: Coronary microvascular dysfunction (CMD) is one of the most important pathophysiological features in hypertrophic cardiomyopathy (HCM). The index of microcirculatory resistance (IMR) is an invasive method to assess the coronary microcirculation. The aim was to assess CMD in patients with HCM by IMR.

Associations between perfusion defects, tissue changes and myocardial deformation in hypertrophic cardiomyopathy, uncovered by a cardiac magnetic resonance segmental analysis.

Background: Microvascular dysfunction is an often overlooked feature of hypertrophic cardiomyopathy (HCM). Our aim was to assess the association between microvascular dysfunction, wall thickness, tissue characteristics and myocardial deformation in HCM patients, by analyzing individual myocardial segments.

Methods: Prospective assessment including cardiac magnetic resonance to assess wall thickness, T1 and T2 mapping, extracellular volume, late gadolinium enhancement (LGE) and stress perfusion.

Exercise stress echocardiography: Where are we now?

Exercise stress echocardiography (ESE) is a widely used diagnostic test in cardiology departments. ESE is mainly used to study patients with coronary artery disease; however, it has increasingly been used in other clinical scenarios including valve pathology, congenital heart disease, hypertrophic and dilated cardiomyopathies, athlete evaluations, diastolic function evaluation, and pulmonary circulation study. In our laboratories, we use an established methodology in which cardiac function is evaluated while exercising on a treadmill.

The Impact of Ischemia Assessed by Magnetic Resonance on Functional, Arrhythmic, and Imaging Features of Hypertrophic Cardiomyopathy.

The aim of the study is to investigate the association between the degree of ischemia due to coronary microvascular dysfunction (CMD) and the left ventricular (LV) tissue characteristics, systolic performance, and clinical manifestations in hypertrophic cardiomyopathy (HCM). This prospective study enrolled 75 patients with HCM without obstructive epicardial coronary artery disease. Each patient underwent cardiovascular magnetic resonance (CMR) including parametric mapping, perfusion imaging during regadenoson-induced hyperemia, late gadolinium enhancement (LGE) and three-dimensional longitudinal, circumferential, and radial strains analysis.

Transaxillary Approach for Surgical Repair of Simple Congenital Cardiac Lesions: Pitfalls, and Complications.

Background: In the treatment of simple congenital cardiac lesions, percutaneous and cosmetic surgical approaches have steadily gained prominence. Surgically, right vertical axillary approach is sparsely used despite superior cosmesis and less pain and blood product usage. Knowledge of potential pitfalls could lead to its more widespread acceptance.

Myocardial work is associated with significant left ventricular myocardial fibrosis in patients with hypertrophic cardiomyopathy.

Late gadolinium enhancement on cardiac magnetic resonance adds prognostic information in patients with hypertrophic cardiomyopathy. Whether Myocardial work, a new parameter on transthoracic echocardiographic, can be associated with significant fibrosis in hypertrophic cardiomyopathy patients is unknown. In a single-centre prospective evaluation of hypertrophic cardiomyopathy patients in whom transthoracic echocardiographic and cardiac magnetic resonance were performed, Myocardial work and related indices were calculated from global longitudinal strain and from estimated left ventricular pressure curves.

Tricuspid Prosthesis Malfunction Unmasked By Exercise Stress Echocardiography.

Exercise echocardiography is used mainly in the study of patients with coronary artery disease, however the technique is increasingly used in the study of other pathologies. We present the first case of use of exercise stress echocardiography for clinical decision in one patient with biological prostheses in tricuspid position. The clinical exam, the echocardiogram, the cardiac MRI, the NT proBNP were normal and the patient has been considered to have no indication for surgery.

Female Gender is not a Risk Factor for Early Mortality after Coronary Artery Bypass Grafting.

Background: The female gender is considered as a risk factor for morbidity and mortality after coronary artery bypass grafting (CABG).

Aim: In this analysis, we assessed the impact of female gender on early outcome after CABG.

Study Design: This is a retrospective analysis of data from our center situated in South India.

Modified technique for uncommon coarctation of the aorta with arch hypoplasia.

A true presubclavian coarctation of the aorta with arch hypoplasia without major intracardiac anomaly can result in a surgical dilemma. Theoretically, one can avoid repair through median sternotomy using selective cerebral perfusion and its sequelae since no major intracardiac repair is needed. Repair through thoracotomy is technically challenging if arch reconstruction is required and precise surgical planning is required to avoid spinal hypoperfusion and to maintain cerebral perfusion.

In silico and in vitro analysis of boAP3d1 protein interaction with bovine leukaemia virus gp51.

The envelope glycoprotein 51 (gp51) is essential for bovine leukaemia virus (BLV) entry to bovine B-lymphocytes. Although the bovine adaptor protein 3 complex subunit delta-1 (boAP3D1) has been proposed as the potential receptor, the specific ligand-receptor interaction has not yet been completely defined and boAP3D1 receptor and gp51 3D structures have not been determined. This study was thus aimed at a functional annotation of boAP3D1 cellular adaptor protein and BLV gp51 and, proposing a reliable model for gp51-AP3D1 interaction using bioinformatics tools.

Easy and fast method for expression and native extraction of Plasmodium vivax Duffy binding protein fragments.

Background: The Plasmodium vivax Duffy binding protein (PvDBP) has been the most studied ligand binding human reticulocytes to date. This molecule has a cysteine-rich domain in region II (RII) which has been used as control for evaluating the target cell binding activity of several parasite molecules. However, obtaining rPvDBP-RII in a soluble form using the Escherichia coli expression system usually requires laborious and time-consuming steps for recovering the molecule's structure and function, considering it is extracted from inclusion bodies.

PvGAMA reticulocyte binding activity: predicting conserved functional regions by natural selection analysis.

Background: Adhesin proteins are used by Plasmodium parasites to bind and invade target cells. Hence, characterising molecules that participate in reticulocyte interaction is key to understanding the molecular basis of Plasmodium vivax invasion. This study focused on predicting functionally restricted regions of the P.

Characterising PvRBSA: an exclusive protein from Plasmodium species infecting reticulocytes.

Background: Plasmodium vivax uses multiple ligand-receptor interactions for preferential invasion of human reticulocytes. Several of these ligands have been identified by in silico approaches based on the role displayed by their orthologs in other Plasmodium species during initial adhesion or invasion. However, the cell adhesion role of proteins that are exclusive to species that specifically invade reticulocytes (as P.

Superior Vena Cava Syndrome Caused by Pacemaker Leads.

Superior vena cava syndrome is one of the rare adverse events associated with pacemaker leads. We describe a 47-year-old woman with a pacemaker implanted 10 years earlier who presented to us with superior vena cava syndrome managed surgically. We report the presentation, diagnosis, and treatment of this patient and the causes and management options of superior vena cava obstruction associated with pacemaker leads.

Partial anomalous pulmonary venous connections: surgical management.

Partial anomalous pulmonary venous connections (PAPVCs) are a heterogeneous group of congenital heart lesions in which at least one pulmonary vein will drain into the systemic venous system. The consequences are a variable left-to-right hemodynamic shunt and more rarely pulmonary artery hypertension. Often, PAPVC occurs in association with other congenital cardiac malformations.

A new risk factor for infective endocarditis.

Body piercing has become an increasingly common practice in recent decades, especially among young people. However, it is not a completely safe procedure and may have serious complications such as infective endocarditis, which can occur in individuals with or without previous heart disease. In this paper we report a case of endocarditis after body piercing in a young woman with a pacemaker who needed surgical intervention.

[Localized fibrous tumor of the pleura: analysis of 11 new cases].

We present a retrospective revision of a pathology, rare in his incidence (5% of the pleural tumours) and singular in his characteristics, analyzing the presentation forms, surgical treatment and results. The solitary tumours of the pleura are a rare entity, whose biological behaviour is not related with immunohistochemical characteristics; although considered benign, they present sensitive recidivation index and metastization, independently of the volume that they present. he surgery is the only available treatment, and complete surgical excision is decisive.

[Cerebral protection in aortic arch surgery].

In this paper the authors proceed to a revision of the three main methods employed for cerebral protection in aortic arch surgery, namely the deep hypothermia and total circulatory arrest, the retrograde cerebral perfusion and the selective anterograde cerebral perfusion. After a deep analysis on their advantages and disadvantages, they proposed the utilization of an association of methods (integrated approach) that has proved to be extremely well succeed in their clinical practice, specially in high-risks patients.