Hypertrophic cardiomyopathy
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The document discusses hypertrophic cardiomyopathy (HCM) and several related topics: - It describes a case of a 22-year-old pregnant woman with an HCM mutation who had a healthy baby boy via vaginal delivery. - Animal models of HCM have provided insights but do not fully represent the human condition. Patient-specific cell models using induced pluripotent stem cells show promise for better modeling HCM. - Early intervention may be needed to prevent the development of the hypertrophic phenotype, and attenuation of disease progression has been seen with losartan treatment in mouse models. However, more research is still needed to understand the mechanisms underlying the septal hypertrophy observed in most H
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Hypertrophic cardiomyopathy (HCM) is a disease where the heart muscle becomes abnormally thickened, making it harder for the heart to pump blood. It is usually inherited and symptoms can include chest pain, shortness of breath, fainting, and palpitations. The condition makes individuals prone to arrhythmias and heart failure. While medications and procedures like implantable defibrillators can help treatment, individuals with a family history of sudden cardiac death are at highest risk of complications from HCM.
Hocm
Hypertrophic cardiomyopathy is a genetic heart condition characterized by thickened heart muscle and potential outflow tract obstruction. It affects 0.2-0.5% of the population and is caused by mutations in genes encoding sarcomere proteins. Symptoms include chest pain, dizziness, and palpitations. Diagnosis is made via echocardiogram and genetic testing. Treatment focuses on symptom relief through medications or procedures to reduce outflow tract obstruction, as well as preventing sudden cardiac death through ICD implantation in high-risk patients.
Hypertrophic cardiomyopathy
A 17-year-old male basketball player collapsed during practice and suffered cardiac arrest. An autopsy later revealed he had hypertrophic cardiomyopathy (HCM), a genetic heart condition where the heart muscle becomes abnormally thick. HCM is a leading cause of sudden cardiac death in young athletes. The patient had previously noticed some shortness of breath with exertion but it did not limit his activity. He was found to have a heart murmur as a child but it was never investigated. HCM causes the left ventricle to become thickened and stiff, which can obstruct blood flow out of the heart and cause heart failure, chest pain, arrhythmias, and sudden cardiac death.
HOCM Hypertrophic cardiomyopathy
This document discusses hypertrophic cardiomyopathy (HCM), including its definition, causes, variants, pathophysiology, clinical presentation, diagnostic workup, and management. Key points include:
- HCM is defined by left and/or right ventricular hypertrophy, usually involving the septum with a thickness over 15mm. It is commonly caused by genetic mutations affecting cardiac proteins.
- Presentation can range from being asymptomatic to symptoms of heart failure, angina, or syncope. Exams may reveal murmurs and EKGs often show abnormal patterns. Echocardiograms and cardiac catheterization are used for diagnosis and assessment.
- Management involves medications like beta-blockers to reduce
HCM Slideshow
Here\'s my project for school which we\'ll present next week I believe (week of Jan. 11). Dr. Quinn and/or Terry, it would be great if you could comment, that way I can say it has been reviewed by some medical authorities. :D Thanx!
Alcoholic septal ablation
Hypertrophic cardiomyopathy (HCM) is defined by a thickened left ventricular wall without an identifiable cause. It can range from asymptomatic to causing heart failure, arrhythmias, or sudden cardiac death. Treatment depends on whether the left ventricular outflow tract (LVOT) is obstructed. For symptomatic patients with LVOT obstruction despite maximum medical therapy, septal reduction procedures like alcohol septal ablation or surgical myectomy are recommended. Alcohol septal ablation involves injecting alcohol into a septal perforator artery to ablate tissue and reduce the gradient. Surgical myectomy directly resects septal muscle. Both procedures significantly reduce gradients and improve symptoms but surgical myectomy provides better gradient and symptom reduction with a lower risk of
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In pediatric patients with acute lymphoblastic leukemia , the Philadelphia chromosome translocation is uncommon, with a frequency of less than 5% and is associated with poor prognosis. Ph ALL with poor prednisone response is particularly at high risk of induction failure or relapse. Most transplant centers accept CR1 Ph ALL as indication for transplant,
Including both related and unrelated HSCT. Recent studies showing that combination of imatinib and intensive chemotherapy can achieve a 3-year DFS of 80% necessitate redefining need for HSTC in patients with Ph ALL in CR1.
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This document discusses new modalities for treating refractory idiopathic thrombocytopenic purpura (ITP), including splenectomy, rituximab, thrombopoietin (TPO) receptor agonists romiplostim and eltrombopag, and combinations of rituximab with TPO agonists. Splenectomy is effective in 85% of patients initially but risks include relapse and infection. Rituximab depletes B cells and has a 60% response rate but late relapses can occur. Romiplostim and eltrombopag stimulate platelet production through the TPO receptor and have response rates over 50% with weekly/daily dosing respectively. Combining ritux
Student Work Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is a disease where the heart muscle becomes abnormally thickened, making it harder for the heart to pump blood. It is usually inherited and symptoms can include chest pain, shortness of breath, fainting, and palpitations. The condition makes individuals prone to arrhythmias and heart failure. While medications and procedures like implantable defibrillators can help treatment, individuals with a family history of sudden cardiac death are at highest risk of complications from HCM.
Hocm
Hypertrophic cardiomyopathy is a genetic heart condition characterized by thickened heart muscle and potential outflow tract obstruction. It affects 0.2-0.5% of the population and is caused by mutations in genes encoding sarcomere proteins. Symptoms include chest pain, dizziness, and palpitations. Diagnosis is made via echocardiogram and genetic testing. Treatment focuses on symptom relief through medications or procedures to reduce outflow tract obstruction, as well as preventing sudden cardiac death through ICD implantation in high-risk patients.
Hypertrophic cardiomyopathy
A 17-year-old male basketball player collapsed during practice and suffered cardiac arrest. An autopsy later revealed he had hypertrophic cardiomyopathy (HCM), a genetic heart condition where the heart muscle becomes abnormally thick. HCM is a leading cause of sudden cardiac death in young athletes. The patient had previously noticed some shortness of breath with exertion but it did not limit his activity. He was found to have a heart murmur as a child but it was never investigated. HCM causes the left ventricle to become thickened and stiff, which can obstruct blood flow out of the heart and cause heart failure, chest pain, arrhythmias, and sudden cardiac death.
HOCM Hypertrophic cardiomyopathy
This document discusses hypertrophic cardiomyopathy (HCM), including its definition, causes, variants, pathophysiology, clinical presentation, diagnostic workup, and management. Key points include:
- HCM is defined by left and/or right ventricular hypertrophy, usually involving the septum with a thickness over 15mm. It is commonly caused by genetic mutations affecting cardiac proteins.
- Presentation can range from being asymptomatic to symptoms of heart failure, angina, or syncope. Exams may reveal murmurs and EKGs often show abnormal patterns. Echocardiograms and cardiac catheterization are used for diagnosis and assessment.
- Management involves medications like beta-blockers to reduce
HCM Slideshow
Here\'s my project for school which we\'ll present next week I believe (week of Jan. 11). Dr. Quinn and/or Terry, it would be great if you could comment, that way I can say it has been reviewed by some medical authorities. :D Thanx!
Alcoholic septal ablation
Hypertrophic cardiomyopathy (HCM) is defined by a thickened left ventricular wall without an identifiable cause. It can range from asymptomatic to causing heart failure, arrhythmias, or sudden cardiac death. Treatment depends on whether the left ventricular outflow tract (LVOT) is obstructed. For symptomatic patients with LVOT obstruction despite maximum medical therapy, septal reduction procedures like alcohol septal ablation or surgical myectomy are recommended. Alcohol septal ablation involves injecting alcohol into a septal perforator artery to ablate tissue and reduce the gradient. Surgical myectomy directly resects septal muscle. Both procedures significantly reduce gradients and improve symptoms but surgical myectomy provides better gradient and symptom reduction with a lower risk of
Hypertrophic Cardiomyopathy
This document summarizes a 56-year-old African American man who presented to the hospital after an abnormal stress test. He has a history of hypertension and was previously diagnosed with left ventricular hypertrophy. A recent stress test found ventricular tachycardia and imaging showed an apical aneurysm and small inferior wall ischemia. He is currently taking medications for hypertension and has a family history of coronary artery disease.
Case presentation ethan
1. This case presents a 40-year-old male with HCM experiencing progressive heart failure symptoms despite medication. Exercise echocardiograms showed provocable outflow obstruction.
2. The next steps included evaluating and managing his symptoms with disopyramide initially, then myectomy with mitral valve plication which improved his quality of life.
3. For his family screening, his 14-year-old daughter should undergo genetic testing and cardiac screening due to his positive pathogenic MYPC3 mutation.
Hypertrophic cardiomyopathy state of the art
This document summarizes research on hypertrophic cardiomyopathy (HCM) conducted by Barry Maron and colleagues. Some key points:
1. Contemporary treatments like ICDs, septal myectomy, and medications have transformed HCM into a treatable disease with low mortality and potential for normal longevity.
2. Risk stratification models utilize factors like family history, abnormal blood pressure response, and late gadolinium enhancement on MRI to predict sudden cardiac death and guide ICD placement.
3. Recent data shows current HCM mortality may be half that of earlier cohorts, demonstrating the benefits of modern management strategies in reducing deaths from sudden cardiac death and heart failure.
hypertrophic cardiomyopathy-a case report
This document discusses hypertrophic cardiomyopathy (HCM), a disease that causes thickening of the heart muscle. It reports on a case of sudden death due to HCM. Key points include:
- HCM causes thickening of the heart muscle and disrupts its electrical function. It is a leading cause of sudden cardiac death in young athletes.
- An autopsy found the deceased's heart was massively enlarged to 790g with thickened walls, consistent with HCM.
- HCM is usually inherited but can also be caused by spontaneous gene mutations. Risk factors for sudden cardiac death include family history, prior cardiac issues, and thickened heart walls over 30mm.
Debate risk stratification in hcm is feasible using a clinical score (con)
The ESC-HCM risk score for predicting sudden cardiac death (SCD) at 5 years misclassifies many patients in the study as low risk when they experienced appropriate ICD interventions or SCD. Using the ESC risk score would have left 65 patients vulnerable to SCD without ICD protection. Key risk factors like late gadolinium enhancement on cardiac MRI and left ventricular apical aneurysms are not included in the ESC model. Contemporary risk stratification guidelines are superior to relying solely on the ESC mathematical model for complex decision making around ICD implantation in hypertrophic cardiomyopathy patients.
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is a genetic heart condition characterized by thickened heart muscle. It has an autosomal dominant pattern of inheritance, with mutations in genes encoding sarcomeric proteins. HCM causes a non-dilated, hypertrophied left ventricle and can lead to heart failure, arrhythmias, and sudden cardiac death. Treatment involves medications like beta-blockers or verapamil to reduce symptoms, and interventions like septal reduction procedures or implantable cardioverter-defibrillators to reduce risk of complications. Regular screening of family members is important for early detection of HCM.
An unusual aspect of hypertrophic cardiomyopathy
This document reports on an unusual case of hypertrophic cardiomyopathy (HCM) in a 13-year old girl. Echocardiography revealed an atypical form of HCM with a large spiral recess in the inferoseptal wall and inferior left ventricular wall, along with diastolic dysfunction. While a septal myectomy was considered, the patient unfortunately died a few days after being diagnosed. The discussion notes that HCM in patients with Noonan syndrome, like this case, often shows more severe hypertrophy and diastolic issues compared to other forms of HCM in children.
2014 esc hcm
Hypertrophic cardiomyopathy
European society of cardiology guidelines,2014
Prevention of sudden cardiac death
Left ventricular outflow tract obstruction
Case Study Hypertrophic Cardiomyopathy
This case study describes a 76-year-old female patient with hypertrophic cardiomyopathy (HCM) who underwent alcohol septal ablation to treat her symptoms. The procedure successfully reduced her left ventricular outflow tract gradient from 130 mmHg to 30 mmHg. Post-operatively, the patient developed paroxysmal atrioventricular block and required a permanent pacemaker. The alcohol septal ablation was an effective treatment for her HCM, though as with any procedure, complications can occur.
HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY (HOCM)
Hypertrophic cardiomyopathy (HCM) is a genetic heart condition characterized by excessive thickening of the heart muscle. It was initially described in the 1950s and causes significant morbidity and mortality due to heart failure, arrhythmias, and sudden cardiac death. The pathophysiology involves left ventricular outflow tract obstruction, diastolic dysfunction, myocardial ischemia, and mitral regurgitation. Treatment involves medications, septal reduction procedures like myectomy or alcohol ablation, and implantable cardioverter-defibrillators in high-risk patients. Prognosis depends on symptom severity and risk factors for sudden cardiac death.
Cardiomyopathy
Cardiomyopathy is a disease of the heart muscle that weakens the heart's ability to pump blood effectively. The main types are dilated, hypertrophic, and restrictive cardiomyopathy. Dilated cardiomyopathy is the most common type and causes the heart chambers to enlarge over time. Treatment involves managing symptoms and risk factors with medications, lifestyle changes, surgery such as implantable devices or transplant, and treating any underlying causes. A heart transplant may be an option for severe cases but carries risks of organ rejection, infection, and side effects of immunosuppressant drugs.
Alcohol septal ablation for hypertrophic obstructive cardiomyopathy - 8 years...
This article summarizes the results of a study on 53 patients who underwent alcohol septal ablation for hypertrophic obstructive cardiomyopathy over 8 years of follow up. Significant reductions in left ventricular outflow tract gradients and septal thickness were observed at 6 months follow up. Symptoms improved in the majority of patients. Ten percent of patients required pacemaker implantation. There was 92% survival rate at 8 years. The study demonstrates that alcohol septal ablation is an effective and safe nonsurgical option for treating hypertrophic obstructive cardiomyopathy that provides long-term relief of symptoms.
Management of hypertrophic cardiomyopathy
The document discusses the management of hypertrophic cardiomyopathy (HCM). It covers the diagnosis of HCM using echocardiography, cardiac MRI, and genetic testing. Treatment options discussed include medical management with beta blockers and verapamil, as well as interventional strategies like alcohol septal ablation and myectomy surgery to relieve outflow tract obstruction in severe cases. The goal of treatment is to reduce symptoms from LV outflow tract obstruction and prevent sudden cardiac death through risk stratification and ICD placement if needed.
Cardiac MRI in hypertrophic cardiomyopathy
This document discusses the use of cardiac magnetic resonance (CMR) in evaluating hypertrophic cardiomyopathy (HCM). CMR provides high resolution imaging of the heart and can identify fibrosis using late gadolinium enhancement, providing useful information beyond echocardiography. CMR is now routinely performed in new HCM patients to aid diagnosis and risk stratification, and help guide treatment planning. The incremental data from CMR improves understanding of HCM's phenotypic heterogeneity and prognostic implications.
Cardiomyopathies
This document discusses the three main types of cardiomyopathy: dilated, hypertrophic, and restrictive. Dilated cardiomyopathy is the most common and is characterized by dilation of the heart chambers and reduced contractility. It has multiple potential etiologies like viruses, genetics, or toxins. Hypertrophic cardiomyopathy is usually genetic and causes abnormal thickening of the heart muscle. It can cause outflow obstruction and is a common cause of sudden death in young athletes. Restrictive cardiomyopathy is rare and causes stiff, non-compliant ventricles that impair filling. Diagnosis involves echocardiography and treatment focuses on symptoms like diuretics and transplantation.
Cardiac mri
Cardiac MRI provides concise summaries of medical documents in 3 sentences or less:
Cardiac MRI has a history dating back to the 1970s when the first MRI machine was developed and techniques for generating images were discovered, leading to the Nobel Prize. MRI uses magnetic fields and radio waves to generate detailed images of the heart and blood vessels without using ionizing radiation. Cardiac MRI is now used clinically to assess cardiac structure and function, detect ischemia and scar tissue, and evaluate various cardiomyopathies.
Cardiac MRI
Cardiac MRI provides detailed images of the heart and blood vessels without using radiation. It has advanced significantly since its introduction in the 1980s. Developments in pulse sequences have improved image quality and allowed for faster acquisition times. Techniques like T2-weighted imaging and delayed enhancement MRI can identify heart muscle damage. Perfusion MRI evaluates blood flow and identifies areas with reduced flow. Further advances may integrate sequences, allow free breathing scans, and expand MRI's clinical and research roles in cardiology.
Cardiac mri&slice anatomy
The document provides instructions for positioning and planning various cardiac MRI scans, including 2D, 3D, and 4D views of the heart. It describes how to position slices on orthogonal localizers to visualize specific anatomical structures like the ventricles, valves, and septum. Views covered include the 4-chamber view, 2-chamber left ventricular view, short axis view, 3-chamber view, and planned views of the left ventricular outflow tract, aortic valve, mitral valve, and right ventricular outflow tract.
Cardiac MRI
Myocardial viability testing is important in patients with coronary disease and severely reduced left ventricular systolic function to determine whether revascularization may improve outcomes by identifying dysfunctional but still viable myocardium. Revascularization of viable myocardium can help recover function and symptoms, whereas predominantly scarred myocardium will not benefit from revascularization.
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This randomized controlled trial compared romiplostim (a thrombopoietin mimetic) to standard of care treatments in 234 adult patients with immune thrombocytopenia who had not undergone splenectomy. It found that patients receiving romiplostim had higher platelet counts, lower rates of treatment failure and splenectomy, less bleeding, and an improved quality of life compared to the standard of care group. Adverse events occurred in 23% of the romiplostim group and 37% of the standard of care group.
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Hypertrophic Cardiomyopathy
This document summarizes a 56-year-old African American man who presented to the hospital after an abnormal stress test. He has a history of hypertension and was previously diagnosed with left ventricular hypertrophy. A recent stress test found ventricular tachycardia and imaging showed an apical aneurysm and small inferior wall ischemia. He is currently taking medications for hypertension and has a family history of coronary artery disease.
Case presentation ethan
1. This case presents a 40-year-old male with HCM experiencing progressive heart failure symptoms despite medication. Exercise echocardiograms showed provocable outflow obstruction.
2. The next steps included evaluating and managing his symptoms with disopyramide initially, then myectomy with mitral valve plication which improved his quality of life.
3. For his family screening, his 14-year-old daughter should undergo genetic testing and cardiac screening due to his positive pathogenic MYPC3 mutation.
Hypertrophic cardiomyopathy state of the art
This document summarizes research on hypertrophic cardiomyopathy (HCM) conducted by Barry Maron and colleagues. Some key points:
1. Contemporary treatments like ICDs, septal myectomy, and medications have transformed HCM into a treatable disease with low mortality and potential for normal longevity.
2. Risk stratification models utilize factors like family history, abnormal blood pressure response, and late gadolinium enhancement on MRI to predict sudden cardiac death and guide ICD placement.
3. Recent data shows current HCM mortality may be half that of earlier cohorts, demonstrating the benefits of modern management strategies in reducing deaths from sudden cardiac death and heart failure.
hypertrophic cardiomyopathy-a case report
This document discusses hypertrophic cardiomyopathy (HCM), a disease that causes thickening of the heart muscle. It reports on a case of sudden death due to HCM. Key points include:
- HCM causes thickening of the heart muscle and disrupts its electrical function. It is a leading cause of sudden cardiac death in young athletes.
- An autopsy found the deceased's heart was massively enlarged to 790g with thickened walls, consistent with HCM.
- HCM is usually inherited but can also be caused by spontaneous gene mutations. Risk factors for sudden cardiac death include family history, prior cardiac issues, and thickened heart walls over 30mm.
Debate risk stratification in hcm is feasible using a clinical score (con)
The ESC-HCM risk score for predicting sudden cardiac death (SCD) at 5 years misclassifies many patients in the study as low risk when they experienced appropriate ICD interventions or SCD. Using the ESC risk score would have left 65 patients vulnerable to SCD without ICD protection. Key risk factors like late gadolinium enhancement on cardiac MRI and left ventricular apical aneurysms are not included in the ESC model. Contemporary risk stratification guidelines are superior to relying solely on the ESC mathematical model for complex decision making around ICD implantation in hypertrophic cardiomyopathy patients.
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is a genetic heart condition characterized by thickened heart muscle. It has an autosomal dominant pattern of inheritance, with mutations in genes encoding sarcomeric proteins. HCM causes a non-dilated, hypertrophied left ventricle and can lead to heart failure, arrhythmias, and sudden cardiac death. Treatment involves medications like beta-blockers or verapamil to reduce symptoms, and interventions like septal reduction procedures or implantable cardioverter-defibrillators to reduce risk of complications. Regular screening of family members is important for early detection of HCM.
An unusual aspect of hypertrophic cardiomyopathy
This document reports on an unusual case of hypertrophic cardiomyopathy (HCM) in a 13-year old girl. Echocardiography revealed an atypical form of HCM with a large spiral recess in the inferoseptal wall and inferior left ventricular wall, along with diastolic dysfunction. While a septal myectomy was considered, the patient unfortunately died a few days after being diagnosed. The discussion notes that HCM in patients with Noonan syndrome, like this case, often shows more severe hypertrophy and diastolic issues compared to other forms of HCM in children.
2014 esc hcm
Hypertrophic cardiomyopathy
European society of cardiology guidelines,2014
Prevention of sudden cardiac death
Left ventricular outflow tract obstruction
Case Study Hypertrophic Cardiomyopathy
This case study describes a 76-year-old female patient with hypertrophic cardiomyopathy (HCM) who underwent alcohol septal ablation to treat her symptoms. The procedure successfully reduced her left ventricular outflow tract gradient from 130 mmHg to 30 mmHg. Post-operatively, the patient developed paroxysmal atrioventricular block and required a permanent pacemaker. The alcohol septal ablation was an effective treatment for her HCM, though as with any procedure, complications can occur.
HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY (HOCM)
Hypertrophic cardiomyopathy (HCM) is a genetic heart condition characterized by excessive thickening of the heart muscle. It was initially described in the 1950s and causes significant morbidity and mortality due to heart failure, arrhythmias, and sudden cardiac death. The pathophysiology involves left ventricular outflow tract obstruction, diastolic dysfunction, myocardial ischemia, and mitral regurgitation. Treatment involves medications, septal reduction procedures like myectomy or alcohol ablation, and implantable cardioverter-defibrillators in high-risk patients. Prognosis depends on symptom severity and risk factors for sudden cardiac death.
Cardiomyopathy
Cardiomyopathy is a disease of the heart muscle that weakens the heart's ability to pump blood effectively. The main types are dilated, hypertrophic, and restrictive cardiomyopathy. Dilated cardiomyopathy is the most common type and causes the heart chambers to enlarge over time. Treatment involves managing symptoms and risk factors with medications, lifestyle changes, surgery such as implantable devices or transplant, and treating any underlying causes. A heart transplant may be an option for severe cases but carries risks of organ rejection, infection, and side effects of immunosuppressant drugs.
Alcohol septal ablation for hypertrophic obstructive cardiomyopathy - 8 years...
This article summarizes the results of a study on 53 patients who underwent alcohol septal ablation for hypertrophic obstructive cardiomyopathy over 8 years of follow up. Significant reductions in left ventricular outflow tract gradients and septal thickness were observed at 6 months follow up. Symptoms improved in the majority of patients. Ten percent of patients required pacemaker implantation. There was 92% survival rate at 8 years. The study demonstrates that alcohol septal ablation is an effective and safe nonsurgical option for treating hypertrophic obstructive cardiomyopathy that provides long-term relief of symptoms.
Management of hypertrophic cardiomyopathy
The document discusses the management of hypertrophic cardiomyopathy (HCM). It covers the diagnosis of HCM using echocardiography, cardiac MRI, and genetic testing. Treatment options discussed include medical management with beta blockers and verapamil, as well as interventional strategies like alcohol septal ablation and myectomy surgery to relieve outflow tract obstruction in severe cases. The goal of treatment is to reduce symptoms from LV outflow tract obstruction and prevent sudden cardiac death through risk stratification and ICD placement if needed.
Cardiac MRI in hypertrophic cardiomyopathy
This document discusses the use of cardiac magnetic resonance (CMR) in evaluating hypertrophic cardiomyopathy (HCM). CMR provides high resolution imaging of the heart and can identify fibrosis using late gadolinium enhancement, providing useful information beyond echocardiography. CMR is now routinely performed in new HCM patients to aid diagnosis and risk stratification, and help guide treatment planning. The incremental data from CMR improves understanding of HCM's phenotypic heterogeneity and prognostic implications.
Cardiomyopathies
This document discusses the three main types of cardiomyopathy: dilated, hypertrophic, and restrictive. Dilated cardiomyopathy is the most common and is characterized by dilation of the heart chambers and reduced contractility. It has multiple potential etiologies like viruses, genetics, or toxins. Hypertrophic cardiomyopathy is usually genetic and causes abnormal thickening of the heart muscle. It can cause outflow obstruction and is a common cause of sudden death in young athletes. Restrictive cardiomyopathy is rare and causes stiff, non-compliant ventricles that impair filling. Diagnosis involves echocardiography and treatment focuses on symptoms like diuretics and transplantation.
Cardiac mri
Cardiac MRI provides concise summaries of medical documents in 3 sentences or less:
Cardiac MRI has a history dating back to the 1970s when the first MRI machine was developed and techniques for generating images were discovered, leading to the Nobel Prize. MRI uses magnetic fields and radio waves to generate detailed images of the heart and blood vessels without using ionizing radiation. Cardiac MRI is now used clinically to assess cardiac structure and function, detect ischemia and scar tissue, and evaluate various cardiomyopathies.
Cardiac MRI
Cardiac MRI provides detailed images of the heart and blood vessels without using radiation. It has advanced significantly since its introduction in the 1980s. Developments in pulse sequences have improved image quality and allowed for faster acquisition times. Techniques like T2-weighted imaging and delayed enhancement MRI can identify heart muscle damage. Perfusion MRI evaluates blood flow and identifies areas with reduced flow. Further advances may integrate sequences, allow free breathing scans, and expand MRI's clinical and research roles in cardiology.
Cardiac mri&slice anatomy
The document provides instructions for positioning and planning various cardiac MRI scans, including 2D, 3D, and 4D views of the heart. It describes how to position slices on orthogonal localizers to visualize specific anatomical structures like the ventricles, valves, and septum. Views covered include the 4-chamber view, 2-chamber left ventricular view, short axis view, 3-chamber view, and planned views of the left ventricular outflow tract, aortic valve, mitral valve, and right ventricular outflow tract.
Cardiac MRI
Myocardial viability testing is important in patients with coronary disease and severely reduced left ventricular systolic function to determine whether revascularization may improve outcomes by identifying dysfunctional but still viable myocardium. Revascularization of viable myocardium can help recover function and symptoms, whereas predominantly scarred myocardium will not benefit from revascularization.
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Debate risk stratification in hcm is feasible using a clinical score (con)
Debate risk stratification in hcm is feasible using a clinical score (con)
Alcohol septal ablation for hypertrophic obstructive cardiomyopathy - 8 years...
Alcohol septal ablation for hypertrophic obstructive cardiomyopathy - 8 years...
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This document discusses precision and personalized medicine and the role of genetics and genomics. It defines precision medicine as tailoring medical treatment to an individual's characteristics, while personalized medicine separates patients into groups based on predicted disease risk or response. The document notes there is variability between individuals and considers factors like genetics, environment, and lifestyle. It discusses the increasing availability of DNA tests and need for prioritization due to limited budgets. Barriers to implementing genetics in medicine include lack of knowledge and guidelines. The document discusses criteria for prioritizing genetic tests and conditions, including evidence of benefit, available interventions, and health need. It provides examples of conditions that could be prioritized, like hereditary cancer syndromes and familial hypercholesterole
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- Laboratory tests including complete blood count, blood smear, and osmotic fragility test were used to diagnose HS.
stem cells applications in hurler syndrome
This document discusses stem cell transplantation as a treatment for Mucopolysaccharidosis type 1 (MPS I), also known as Hurler syndrome. MPS I is caused by a deficiency of the IDUA enzyme, leading to a buildup of glycosaminoglycans. Stem cell transplantation provides a source of functional IDUA enzyme and has become the standard treatment for the most severe form, Hurler syndrome. The document reviews several studies that have examined outcomes of stem cell transplantation for MPS I and have found improved long-term survival and reduced morbidity when combined with enzyme replacement therapy prior to transplantation.
HNDM proceedings of November 2016,Singapore
The document describes a conference on biotechnology, bioinformatics, biomedical sciences and stem cell applications taking place from November 11-12, 2016 in Singapore. It provides the conference schedule, list of speakers, and abstracts of papers being presented on topics related to diabetes, hypertension, cardiovascular disease, cognitive functions and thrombogenesis. The conference will bring together researchers from various universities and institutions in Asia to present and discuss their work in healthcare, life sciences and stem cell applications.
2015 04-13 Pharma Nutrition 2015 Philadelphia Alain van Gool
Keynote lecture at the Pharma-Nutrition 2015 conference, outline global paradigm shifts and activities in pharma, personalized healthcare and pharmanutrition combination therapies.
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Advances in stem cell transplantation
This document discusses hematopoietic stem cell transplantation (HSCT) and its current state and future opportunities. HSCT is an effective treatment for hematologic, immune, metabolic and cancerous diseases. It replaces defective cells and offers high-dose therapy and graft-versus-tumor effects. While HSCT faces challenges like toxicity and costs, advances in unrelated donor matching, cord blood use, and reduced intensity regimens have expanded its applications. Standards and accreditation are needed to ensure quality, and further growth depends on expanded donor availability and combining HSCT with new cellular immunotherapies.
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This document discusses functional mitral regurgitation (FMR) in heart failure patients. It presents evidence that even mild FMR results in poor survival outcomes, and that FMR is not just a late marker but also a cause of worse prognosis. Surgical mitral repair using a small, complete, rigid ring to reduce the mitral annulus has been shown to improve survival, ventricular remodeling, and functional status compared to no repair or incomplete repairs that do not fully correct FMR. Ongoing studies are exploring newer percutaneous approaches to treating FMR, but surgical repair remains the standard treatment when anatomically feasible to fully correct FMR.
Aortic Valve Stenosis with low EF : TAVR versus Replacement
1) Patients with low ejection fraction (EF < 50%) and severe aortic stenosis who undergo transcatheter aortic valve replacement (TAVI) have similar mortality at 1 year compared to those with higher EF, despite being higher risk.
2) TAVI is associated with significant improvements in EF, symptoms, and quality of life over 1 year in patients with very low EF (≤30%). However, mortality remains higher compared to those with EF >30%.
3) Both TAVI and surgical aortic valve replacement (SAVR) are associated with improvements in EF at 3 months in propensity matched populations with low EF. Short term outcomes are similar, but TAVI is associated with more pacemakers
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The document discusses treatment options for patients with reduced ejection fraction and secondary mitral regurgitation, including the use of minimally invasive mitral valve surgery which can be considered for elderly patients or those with comorbidities. It presents a case study of a 69-year-old male with severe secondary mitral regurgitation who underwent a minimally invasive mitral valve repair which eliminated his mitral regurgitation and improved his symptoms and ejection fraction. Long-term data on isolated mitral valve surgery in patients with reduced ejection fraction shows improvement in mitral regurgitation and functional status with no difference in survival between repair and replacement
When to consider tricuspid valve repair
The document discusses when to consider tricuspid valve repair. Tricuspid regurgitation is associated with poor prognosis, especially when secondary to left-sided heart lesions, cardiomyopathy, pulmonary hypertension, or in the setting of LVAD placement or heart transplantation. Tricuspid valve repair is indicated for severe, symptomatic primary tricuspid regurgitation, and may also be considered for significant functional regurgitation concurrent with mitral valve surgery, after isolated mitral valve surgery if regurgitation is severe, or when placing a continuous-flow LVAD. Prophylactic tricuspid annuloplasty during heart transplantation reduces the severity of post-operative regurgitation and is associated with improved long-term survival
Cad and low ef does viability assessment matter
This document discusses the value of viability studies in patients with coronary artery disease (CAD) and low ejection fraction (EF). It summarizes several studies on the topic and discusses their limitations. A key trial was the STICH trial, which found no significant difference in outcomes between revascularization and medical therapy alone, challenging the belief that revascularization benefits those with viable myocardium. The document concludes that while viability concepts are biologically plausible, recent trials create confusion and there is no consensus on how to apply viability testing in practice.
Multimodality imaging.
This document discusses the conundrum of managing mitral regurgitation (MR) in patients with heart failure. It highlights the importance of using multimodality imaging to:
1) Assess the severity of MR at rest and with exercise to determine risk and need for intervention.
2) Evaluate left ventricular function, dyssynchrony, viability and ischemia to determine indications for cardiac resynchronization therapy or revascularization.
3) Assess left ventricular remodeling and mitral valve deformation to predict risk of recurrent MR after repair and determine the best repair/replacement option.
Imaging provides essential information to optimize treatment strategies for MR in heart failure.
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This document discusses the case of a 76-year-old man presenting with heart failure symptoms and recurrent cough syncope. Testing revealed cardiac amyloidosis due to a TTR gene mutation. For patients with TTR amyloidosis, treatment options include organ transplantation, TTR stabilizers in clinical trials, or enrollment in hospice. Given his age and comorbidities, the man's options included a left ventricular assist device, extended criteria transplant, or a clinical trial for TTR amyloidosis treatment. He was ultimately listed and transplanted, and has since recovered well.
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This document discusses the case of a 76-year-old man presenting with heart failure symptoms and recurrent cough syncope. Testing revealed cardiac amyloidosis due to a TTR gene mutation. For patients with TTR amyloidosis, treatment options include organ transplantation, TTR stabilizers in clinical trials, or enrollment in hospice. Given his age and comorbidities, the man's options included a left ventricular assist device, extended criteria transplant, or a clinical trial for TTR amyloidosis treatment. He was ultimately listed and transplanted within a month, and has since recovered well.
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L.B. is a 62-year-old man with a long history of coronary artery disease and heart failure who has undergone multiple coronary bypass surgeries. He now has an ejection fraction of 25% and intractable ventricular tachycardia despite medical management. Due to the risks of ablation, the team is considering options like hospice care, cardiac transplantation, VAD implantation, or VAD exchange to treat his advanced heart failure. A cardiac catheterization revealed multiple occluded arteries and stenoses. Given his medical history and surgical history, the team must determine the best treatment approach for his condition.
The road ahead.
This document discusses the management of mitral regurgitation (MR) in heart failure patients. It explores the differences between primary and functional (secondary) MR, and notes that correcting primary MR may improve outcomes but the benefits are less clear for functional MR which is primarily a ventricular problem. The document reviews potential management options for MR in heart failure including optimal medical therapy, cardiac resynchronization therapy, surgery, and percutaneous techniques such as the MitraClip system. It presents evidence from studies on the acute effects of CRT and the impact of CRT on functional MR severity. It also discusses guidelines on indications for mitral valve surgery in chronic secondary MR and barriers to surgery.
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This document discusses the treatment of mitral regurgitation in patients with heart failure. It describes the mechanisms of functional and ischemic mitral regurgitation. While medical therapy can improve symptoms and survival, cardiac resynchronization therapy may also help reduce mitral regurgitation severity and improve outcomes. Surgery to repair the mitral valve is an option but the risk of recurrence of mitral regurgitation is high, especially with more advanced left ventricular remodeling. Randomized trials are still needed to determine whether surgical correction provides clear benefits over medical therapy alone in high-risk patients. Percutaneous mitral valve repair may be a lower risk option for inoperable patients to reduce symptoms.
Devices and intervention in heart failure.
- The document discusses the speaker's receipt of honoraria and research support from numerous pharmaceutical and device companies.
- It summarizes several journal articles and studies related to left ventricular remodeling post-myocardial infarction, baroreflex activation therapy for heart failure, and the effects of bi-ventricular pacing on left ventricular ejection fraction and end-systolic volume.
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European Journal of Heart Failure's year in Cardiology
This document contains information about Prof. Fausto J. Pinto who is the Head of Cardiology at University Hospital Sta Maria-HPV and University of Lisbon in Portugal. It discloses that he has received consultancy fees and lecture fees from various pharmaceutical companies. It also contains several figures and images from various medical studies and publications related to cardiology.
The EHJ's and EJHF's Year in Cardiology
This document lists the collaborations and conflicts of interest for speakers Thomas F. Lüscher and Marco Metra. It notes that they have received research grants, educational grants, and honoraria from numerous pharmaceutical companies. The rest of the document discusses the European Heart Journal, including new associate editors, submission rates and acceptance rates, impact factors, and plans to launch new open access and supplement journals.
Acute and advanced heart failure.
This document summarizes a presentation on cardiology topics including acute and advanced heart failure. It discusses trends in heart failure hospitalizations and mortality. It describes different hemodynamic profiles in acute heart failure patients and their corresponding treatments. It also discusses topics like iron deficiency in heart failure, sleep disordered breathing, and a study showing sleep disordered breathing is common in acute heart failure and predicts mortality.
Prevention is the best treatment
This document discusses the importance of prevention in treating cardiovascular disease. It outlines stages of heart failure progression from asymptomatic left ventricular dysfunction to refractory heart failure. Clinical trials show benefits of treating hypertension and post-MI left ventricular dysfunction to prevent heart failure. Treatment with ACE inhibitors reduces mortality and morbidity from heart failure. Prevention of risk factors is emphasized as the best strategy to avoid full-blown heart disease.
Can we afford heart failure management in the future
Heart failure is a major global health problem, affecting 26 million people worldwide. It accounts for 1-3% of hospital admissions in Europe and North America. Hospitalization is the main driver of the high economic costs of heart failure management, which is estimated to rise significantly in the coming decade. To better manage heart failure costs in the future, new models of coordinated and integrated care will need to be implemented, with a focus on preventing hospitalizations and readmissions through improved education, care transitions, and treatment of comorbidities.
The deadly statistics of heart failure.
This document discusses statistics related to heart failure. It summarizes data on outcomes for hospitalized heart failure patients compared to chronic heart failure patients. Hospitalized patients generally have worse outcomes, with high 1-year mortality rates around 25-27%. Chronic heart failure patients have lower but still significant 1-year mortality rates of around 5-6%. The document also reviews real-world data showing high readmission rates after hospitalization for heart failure. It concludes that while treatments for chronic heart failure with reduced ejection fraction have improved outcomes over decades, more efforts are still needed to improve care and outcomes for hospitalized patients and those with preserved ejection fraction.
The heart failure association global awareness programme.
The Global Heart Failure Awareness Programme aims to make the prevention and management of heart failure a global health priority. It is led by the Heart Failure Association of the European Society of Cardiology and supported by educational grants. The programme's objectives are to build a common global approach to raising awareness of heart failure among targeted audiences and to call for heart failure to be a health priority in every country. It plans to achieve this through developing educational content, building advocacy coalitions, and implementing initiatives at the national and local levels between 2015 and 2017.
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Hypertrophic cardiomyopathy
- 1. HypertrohpicCardiomyopathy University Medical Center Groningen Hypertrophic Cardiomyopathy what are the mechanisms? Peter van der Meer, MD PhD cardiologist University Medical Center Groningen The Netherlands
- 2. HypertrohpicCardiomyopathy University Medical Center Groningen Declaration of Interest Consultancy fees: Vifor Pharma, ZS-pharma, Novartis, ResMed, Singulex, Servier
- 3. HypertrohpicCardiomyopathy University Medical Center Groningen Hypertrophic Cardiomyopathy • 22 year old woman • 37 weeks pregnant • Mutation in MYBPC3-gene • Gradient LVOT increased to 80mmHg • Vaginal delivery without complications • Healthy babyboy was born
- 4. HypertrohpicCardiomyopathy University Medical Center Groningen
- 5. HypertrohpicCardiomyopathy University Medical Center Groningen Several questions come up: -Why is specifically the septum affected in the majority of the cases? -What’s the implication for the baby-boy -Are there any models which truly represent the typical HCM phenotype -Can cell models be of any help; are there any?
- 6. HypertrohpicCardiomyopathy University Medical Center Groningen Science 1996 15w 30w control First animal model for HCM α-MHC mutation Homozygous is lethal. Disarray, fibrosis and hypertrophy
- 7. HypertrohpicCardiomyopathy University Medical Center Groningen Use of mouse model to investigate interventions • Effect Tgf-β on non-myocyte proliferation • Effect losartan on non-myocyte proliferation
- 8. HypertrohpicCardiomyopathy University Medical Center Groningen N= 20 Double blind: losartan 2x50mg vs placebo Age: 51 +/- 13 years
- 9. HypertrohpicCardiomyopathy University Medical Center Groningen
- 10. HypertrohpicCardiomyopathy University Medical Center Groningen Is presistent expression of the mutant protein necessary? Double transgenic mouse Cannon et al. JACC 2015
- 11. HypertrohpicCardiomyopathy University Medical Center Groningen
- 12. HypertrohpicCardiomyopathy University Medical Center Groningen • Critical role postnatal period in pathogenesis • Mutation silencing therapies unlike to be effective • Administration very early in life to prevent hypertrophy
- 13. HypertrohpicCardiomyopathy University Medical Center Groningen Rabbit heart predominantly β-MHC (comparable to human)
- 14. HypertrohpicCardiomyopathy University Medical Center Groningen
- 15. HypertrohpicCardiomyopathy University Medical Center Groningen Effects diminish - cell division and -dilution morpholinos
- 16. University Medical Center Groningen Hypertrophihccardiomyopathy Cardiac Lineage Tracing Comparable to the “blood tree” Buikema, Van der Meer et al. Stem Cells 2014
- 17. University Medical Center Groningen Hypertrophihccardiomyopathy
- 18. HypertrohpicCardiomyopathy University Medical Center Groningen Patient specific cell models hiPS technology
- 19. HypertrohpicCardiomyopathy University Medical Center Groningen Patient Specific Cell Model Hoes, …. Van der Meer, unpublished data
- 20. HypertrohpicCardiomyopathy University Medical Center Groningen
- 21. HypertrohpicCardiomyopathy University Medical Center Groningen More arrhytmogenic effects (in single cells)
- 22. HypertrohpicCardiomyopathy University Medical Center Groningen
- 23. HypertrohpicCardiomyopathy University Medical Center Groningen Conclusions • Distribution pattern of hypertrophy in HCM mostly unknown. • Ca-sensitivity?, energy depletion?, TGF-beta? Developmental disorder? • Early intervention might be necessary to reverse the phenotype • Attenuation of progression has been observed with losartan • Several animal models exist, mouse most commonly used • Patient specific disease modelling novel tool for understanding HCM