Combination use of a TandemHeart with an extracorporeal oxygenator in the treatment of five patients with refractory cardiogenic shock after acute myocardial infarction.

Cardiogenic shock remains the leading cause of in-hospital death for patients admitted with acute myocardial infarction. For patients with refractory cardiogenic shock, early revascularization and intra-aortic balloon pump support are often inadequate to reverse the persistent circulatory collapse. We report 5 cases in which an extracorporeal oxygenator in series with the TandemHeart system was instituted emergently in patients with refractory cardiogenic shock from acute myocardial infarction.

A novel two-dimensional echocardiographic finding in cardiac amyloidosis.

Background: A number of echocardiographic findings characteristic of cardiac amyloidosis (CA) have been described, each with limitations.

Methods: A distinctive wall motion pattern of preserved myocardial thickening at left ventricular apex with hypokinesis in basal and midsegments was observed in two patients with biopsy proven CA. Following this observation, endomyocaradial biopsy files beginning in 2007 were reviewed.

Pulmonary arterial hypertension: pathobiology, diagnosis, treatment, and emerging therapies.

Pulmonary hypertension is a rare disorder caused by vasoconstriction of the pulmonary arteries that leads to elevation of pulmonary vascular resistance, right ventricular failure, and ultimately death. Hypertrophy and proliferation of the pulmonary vascular endothelium leads to remodeling of this vascular system, resulting in a progressive disorder. In the past decade the molecular mechanisms and pathobiology of this disorder has become clearer.

Induction of peripheral tolerance by local delivery of dendritic cell progenitors to cardiac allografts in a murine heterotopic heart transplantation model.

Objective: Systemic injection of donor-derived dendritic cell (DC) progenitors is reported to prolong cardiac allograft survival in nonimmunosuppressed hosts. Our purpose was to identify whether tolerance limited to the cardiac allograft is inducible by direct delivery of DCs to the myocardium, thus diminishing the potential for systemic side effects.

Methods: The donors were 8- to 12-week-old male B10/ H2b mice.

Epstein-Barr virus-associated multifocal leiomyosarcomas arising in a cardiac transplant recipient: autopsy case report and review of the literature.

Epstein-Barr virus (EBV) associated smooth muscle tumors (SMTs) have been described in patients with acquired immune deficiency syndrome (AIDS) and, more recently, in association with immunosuppression after solid-organ transplantation. We present the autopsy findings of multiple leiomyosarcomas (LMSs) in a 24-year old man who died 18 months after undergoing orthotopic cardiac transplantation for idiopathic cardiomyopathy. The recognition of EBV-driven LMS developing in cardiac transplant recipients in multiple unusual sites is crucial for the management of these patients and should include complete surgical removal anti-viral therapy and modulation of immunosuppression.

Myocardial expression of fas and recovery of left ventricular function in patients with recent-onset cardiomyopathy.

Objectives: This study aimed to evaluate the role of gene expression for predicting myocardial recovery in recent-onset cardiomyopathy.

Background: Apoptosis may limit ventricular recovery. We examined the myocardial expression of Fas, Fas ligand (FasL), tumor necrosis factor (TNF)-alpha, and TNF receptor 1 (TNFR1), and myocardial recovery in patients from the multicenter Intervention in Myocarditis and Acute Cardiomyopathy (IMAC) study.