Right Ventricular Free Wall Strain and Congestive Hepatopathy in Patients with Acute Worsening of Chronic Heart Failure: A CATSTAT-HF Echo Substudy

Borovac, Josip Anđelo; Glavaš, Duška; Grabovac, Zora Sušilović; Domić, Daniela Šupe; Stanišić, Lada; D’Amario, Domenico; Duplančić, Darko; Božić, Joško

doi:10.3390/jcm9051317

Cited by 10 publications

(7 citation statements)

References 46 publications

(49 reference statements)

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“…Gastrointestinal symptoms and dilated liver veins were interpreted as progressing signs of right heart congestion with beginning congestive gastritis and hepatopathy (AST 59 U/L, ALT 73 U/L, GGT 149 U/L, bilirubin 0.9 mg/dL). 17 …”

Section: Case Presentationmentioning

confidence: 99%

How exercise can deteriorate the clinical course of an ARVC patient: a case report

Lüsebrink

Binzenhöfer

Brunner

et al. 2021

European Heart Journal - Case Reports

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Background Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a genetic disease characterized by fibro-adipose degeneration of ventricular myocardium. Initial clinical presentation is variable and ranges from asymptomatic cases to chronic heart failure and sudden cardiac death due to malignant arrhythmias. Case summary Here, a 67-year-old male patient who started extensive physical training upon retirement and presented with ventricular tachycardia and progressive heart failure as a first sign of his disease. ARVC/D diagnosis was established according to the 2010 modified Task Force Criteria and supported by HRS/EHRA Consensus based genotyping. After initial discharge on optimal medical therayp and prophylactic ICD-implantation according to his individual ARVC risk score, the patient reported rapid decline in physical capacity on a regular follow-up four months later. To better understand the etiology of his clinical deterioration, we performed stress echocardiography, coronary angiogram and exercise right heart catheterization, which conclusively suggest impaired left ventricular (LV) filling secondary to RV failure as a main cause of global circulatory failure. Discussion The present case report focuses on relation of physical activity to disease onset and the concomitant advent of symptoms during exercise as well as a structured and guideline-aided diagnostic work-up in ARVC/D and staged treatment options. Continuous ARVC/D-center-oriented re-assessment and treatment planning including lifestyle intervention, psychological support, medical, surgical and interventional options are key elements of sustained long-term care for ARVC/D patients.

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Section: Case Presentationmentioning

confidence: 99%

How exercise can deteriorate the clinical course of an ARVC patient: a case report

Lüsebrink

Binzenhöfer

Brunner

et al. 2021

European Heart Journal - Case Reports

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“…Although those parameters normally should be viewed as a general indication of load dependence, the signi cance of the changes observed cannot be attributed to this only variation. Of particular interest may be the more relevant increase in the strain rates of basal and apical sections of the RV, versus the mid ones (24)(25).…”

Section: Discussionmentioning

confidence: 99%

Lipid-In, Sugar-Out: Early Results of Treatment with Additional Ketogenic Parenteral Nutrition in Left Ventricle Assist Device Patients.

Bejko

Bottio

Caraffa

et al. 2021

Preprint

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Background and Aims: Right ventricle failure (RVF) can be a fatal complication following left ventricle assist device (LVAD) implant. Careful intra and postoperative management is becoming increasingly important. Unfortunately, the attempts are limited to the prediction and not to the treatment. There are no data on Ketogenic parenteral nutrition (KPN) for the targeted treatment of RVF. The aim of our retrospective observational case-control study is to determine whether KPN may play a role as additional treatment to conventional therapy after LVAD implantation.Material and Methods: This is a retrospective single center analysis of a case series on prospectively collected data. From February 2012 to April 2021, 192 patients have been implanted with an LVAD. All the patients were managed with optimal medical and surgical therapy. One-hundred-seven patients were treated with additional KPN as adjuvant therapy against and in prevention of acute RVF (KPN-Group), defined according to International Society Heart and Lung Transplantation (ISHLT) guidelines. The remaining 85 patients, managed without KPN, constituted our control group (No-KPN-Group).Results: In KPN-Group acute-RVF occurred in 31 patients (29%), while causing death in 14 patients (13%). In the No-KPN-Group acute-RVF was observed in 32 patients (37.6%), while causing death in 20 patients (23.5%). According to echocardiographic and hemodynamic results, the majority of KPN-Group patients responded with RV function improvement (range 4-60% of TAPSE increase, p<0.05) with recovery of RV function in 85% of the patients (91/107). In No-KPN-Group RV functional recovery was observed in 65 patients (76.4%). Overall intra-hospital mortality was 23.4% (25) and 27.1% (23) in KPN-Group and No-KPN-Group, respectively (p=0.337). While Intensive Care Unit (ICU) stay was comparable (p=0.078), ward-stay was significantly shorter in KPN-Group (p=0.03).Conclusion: KPN was well tolerated. A complete recovery of the RV function was achieved in the majority of the patients and results lasted beyond the duration of KPN. Future research to understand the underlying mechanism, and identification of suitable patients and treatment duration is necessary.

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“…[13, 14]. Right ventricular dysfunction is common in both Heart failure with reduced or preserved ejection fraction and is associated with poor prognosis [15-17]. Thus, ALP as a marker of hepatic congestion and Right ventricular dysfunction is a predictor of worse prognosis in acute or chronic heart failure patients.…”

Section: Discussionmentioning

confidence: 99%

Alkaline phosphatase variability predicts new onset heart failure, cardiovascular mortality, and all-cause mortality in patients with type-2 diabetes mellitus: a population-based study

Zhou

Lee

Adhikari

et al. 2021

Preprint

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ObjectiveTo investigate the associations of alkaline phosphatase (ALP) variability measures with new onset heart failure, cardiovascular mortality, and all-cause mortality in type 2 diabetes mellitus patients with a populational-cohort study.MethodThis study included patients with type 2 diabetes mellitus who presented to ambulatory, outpatient and inpatient facilities managed by the public sector in Hong Kong between January 1st, 2000 to December 31st, 2019. Comprehensive clinical and medical data including demographics, past comorbidities, medications, and laboratory examinations of complete blood, lipid/glycemic profile and their variability were collected. ALP and its variability measures were extracted. Univariable and multiple multivariable Cox regression were used to identify the associations of alkaline phosphatase variability with new onset heart failure and mortality risks. Patients were stratified into three subgroups based on the tertiles of baseline ALP level.ResultsThe study cohort consisted of 14289 patients (52.52% males, mean age at initial drug exposure: 74.55 years old [standard deviation (SD): 12.7]). Over a mean follow up of 2513 days [interquartile range (IQR): 1151-4173]), 10182 patients suffered from all-cause mortality (incidence rate [IR]: 71.25%), 1966 patients (IR: 13.75%) died from cardiovascular causes, and 1171 patients (IR: 8.19%) developed with new onset heart failure. Higher cumulative incidences of all three outcomes were observed for the highest tertile of ALP compared to medium/low tertiles. ALP baseline and variability level predicted new onset heart failure, cardiovascular and all-cause mortality before adjusting for subclinical biomarkers (p < 0.01). Amongst the measures of ALP variability, the hazard ratio (HR) of coefficient of variation (CV) was markedly raised in particular (new onset heart failure: HR=2.73, 95% confidence interval [CI]= [1.71-4.37], p <0.0001; all-cause mortality: HR= 5.83, 95% CI= [5.01-6.79], p <0.0001; cardiovascular mortality: HR= 4.81, 95% CI= [3.36-6.88], p <0.0001).ConclusionsRaised ALP level and variability are associated with increased risks of all-cause mortality, cardiovascular mortality and new onset heart failure amongst patients with type 2 diabetes mellitus.

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Right Ventricular Free Wall Strain and Congestive Hepatopathy in Patients with Acute Worsening of Chronic Heart Failure: A CATSTAT-HF Echo Substudy

Cited by 10 publications

References 46 publications

How exercise can deteriorate the clinical course of an ARVC patient: a case report

How exercise can deteriorate the clinical course of an ARVC patient: a case report

Lipid-In, Sugar-Out: Early Results of Treatment with Additional Ketogenic Parenteral Nutrition in Left Ventricle Assist Device Patients.

Alkaline phosphatase variability predicts new onset heart failure, cardiovascular mortality, and all-cause mortality in patients with type-2 diabetes mellitus: a population-based study

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