Effect of exercise training on autonomic derangement and neurohumoral activation in chronic heart failure.

Background: In chronic heart failure (CHF), persistent autonomic derangement and neurohumoral activation cause structural end-organ damage, decrease exercise capacity, and reduce quality of life. Beneficial effects of pharmacotherapy and of exercise training in CHF have been documented at various functional and structural levels. However, pharmacologic treatment can not yet reduce autonomic derangement and neurohumoral activation in CHF to a minimum.

Restrictive annuloplasty and coronary revascularization in ischemic mitral regurgitation results in reverse left ventricular remodeling.

Background: Data on combined coronary artery bypass grafting (CABG) and restrictive annuloplasty in patients with ischemic cardiomyopathy are scarce, and the effect on reverse left ventricular (LV) remodeling is unknown.

Methods And Results: 51 patients with ischemic LV dysfunction (LV ejection fraction 31+/-8%) and severe mitral regurgitation (grade 3 to 4+) underwent CABG and restrictive annuloplasty with stringent downsizing of the mitral annulus (by 2 sizes, Physio-ring, mean size 28+/-2). Serial transthoracic echocardiographic studies were performed (before surgery and within 3 months and 1.

Noninvasive and invasive evaluation of noncompaction cardiomyopathy.

Noncompaction cardiomyopathy is a recently described rare congenital cardiomyopathy; patients can be asymptomatic or develop diastolic and/or systolic left ventricular dysfunction with heart failure, systemic emboli or ventricular arrhythmias. Long-term prognosis is poor. Currently, diagnosis is based on findings on 2D echocardiography; in the current case report we demonstrate the use of MRI to diagnose noncompaction cardiomyopathy.