Background: Despite the fact that pacing at the right ventricular apex acutely and chronically decreases left ventricular contractile function, this pacing site is still conventionally used in adults and children. Because animal studies showed beneficial effects of left ventricular pacing, we compared the hemodynamic performance of left ventricular apex, left ventricular free wall, and right ventricular apex pacing in children.
Methods: Studies were performed in 10 children (median age, 2.5 years; range, 2 months to 17 years) undergoing surgery for congenital heart disease with normal systemic left ventricular anatomy and intraventricular conduction. High-fidelity left ventricular and arterial pressure measurements were performed during epicardial right ventricular apex and left ventricular apex and free wall pacing.
Results: Left ventricular apex pacing increased the maximum rate of rise of left ventricular pressure and pulse pressure significantly relative to right ventricular apex pacing (by 7.7% +/- 7.2% and 7.7% +/- 7.0%, respectively) without changes in end-diastolic left ventricular pressure. Left ventricular free wall pacing did not significantly improve hemodynamics as compared with right ventricular apex pacing. The QRS duration was not different among pacing at the three sites.
Conclusions: In this short-term study left ventricular apex pacing is hemodynamically superior to right ventricular apex and left ventricular free wall pacing in children. Therefore, the left ventricular apex appears a favorable pacing site after pediatric cardiac surgery.
Undifferentiated pleomorphic sarcoma, an exceedingly rare and aggressive primary cardiac tumor arising from mesenchymal stem cells, is associated with poor prognosis and high mortality despite adequate treatment. A 52-year-old female presented with a 2-month history of angina and dyspnea on exertion. Her clinical history included severe acute respiratory syndrome coronavirus 2 myocarditis and iron deficiency anemia.
The benefits of permanent cardiac pacing have been widely demonstrated. However, the literature on complications remains inconsistent. We lack precise information about the frequency of complications and their predictive factors in our center.
Objective: The present study aimed to investigate the correlation between lipoprotein(a) (Lp-a) and coronary artery disease (CAD) complicated by type I cardiorenal syndrome (CRS).
Methods: We conducted a retrospective analysis of patients diagnosed with CAD admitted to the Department of Cardiovascular Medicine at Shaoxing Central Hospital from January 2021 to December 2022, with chief complaints of "chest distress and dyspnea." Patient demographic data, biochemical indicators (including blood lipid levels and serum creatinine), cardiac function markers (such as pro-brain natriuretic peptide, pro-BNP), echocardiography, and coronary angiography results were collected.
Department of Medical and Surgical Specialties, Radiological Science and Public Health, Institute of Cardiology, ASST Spedali Civili, University of Brescia, Brescia, Italy.
Aims: Few data are available regarding the role of tricuspid annulus plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP), a measurement of right ventricular to pulmonary artery coupling, in patients with chronic heart failure and left ventricular systolic dysfunction.
Methods And Results: This retrospective single-centre study included outpatients with left ventricular systolic dysfunction (ejection fraction ≤ 50%) evaluated between January 2022 and December 2022. TAPSE/PASP was evaluated as a continuous variable and as tertiles according to its value on the first visit.
Background: Oral treatment with the exogenous ketone body 3-hydroxybutyrate improves cardiac function in patients with heart failure with reduced ejection fraction, but ketosis is limited to 3 to 4 hours. Treatment with (R)-1,3-butanediol (BD) provides prolonged ketosis in healthy controls, but the hemodynamic and metabolic profile is unexplored in patients with heart failure with reduced ejection fraction.
Methods And Results: This was a randomized, single-blind, placebo-controlled, crossover study.
