With the alarming rise in prevalence of nonalcoholic fatty liver disease (NAFLD) in the world, there is an increasing need to recognize the strong association between NAFLD and cardiovascular disease (CVD). NAFLD is dynamically involved in the pathogenesis of CVD through the processes that include increased oxidative stress, endothelial dysfunction, accelerated progression of atherosclerosis, and irregular fatty acid, glucose, and lipoprotein metabolism. By reviewing and understanding the mechanisms, the aim of this review is to introduce the association between NAFLD and CVD to health care providers and the importance of statin therapy and mortality benefits. More importantly, we discuss the role of statins as a treatment strategy and possible future directions.
Stress-induced cardiomyopathy (SIC) is associated with varying etiologies. We present a case of a 65-yearold female with recurrent SIC secondary to seizures who presented in cardiogenic shock requiring mechanical circulatory support using an Impella CP via the right axillary approach.
Background
Transcatheter aortic valve replacement (TAVR) is increasingly utilized for most patients with symptomatic severe aortic stenosis. TAVR is linked to enhanced long-term cardiac hemodynamics, reversal of left ventricle (LV) hypertrophy, and improved aortic valve gradients. We present a retrospective observational study assessing cardiac remodeling and valvular flow patterns post-TAVR.
Methods
Retrospective echocardiographic data were collected, evaluating cardiac function and valvular flow patterns before and after TAVR at a single institution. Data was compiled and statistically analyzed using a paired t-test evaluating variations at approximately 30 days and one-year post-TAVR.
Results
On echocardiogram 30 days and one-year post-TAVR, there was a reduction in LV mass index from 132 g/m² to 110 g/m² (95%CI: 98-122; p=0.01) and 118 g/m² (95%CI: 102-133; p=0.03), and a reduction in relative wall thickness from 0.54 to 0.49 (95%CI: 0.46-0.52; p=0.05) and 0.44 (95%CI: 0.38-0.49; p=0.03), respectively. Doppler velocity indices (DVI) increased from 0.24 to 0.61 (95%CI: 0.49-0.73; p<0.001) and 0.57 (95%CI: 0.48-0.65; p<0.001). Expected improvement in aortic valve velocities and gradients were observed post-TAVR.
Conclusions
Following TAVR, LV remodeling can be observed as early as 30 days. This is demonstrated by a reduction in LV mass index and relative wall thickness in conjugation with an anticipated improvement in valvular flow patterns and flow across the aortic valve.
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