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1.
Rev. bras. cir. cardiovasc ; 36(1): 71-77, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1155790

ABSTRACT

Abstract Introduction: Atrial fibrillation (AF) is the most common sustained arrhythmia. Sorting nexin 10 (SNX10) has been reported to be an important regulator in embryonic development and human diseases, however, little is known about its role in cardiac disease. The aim of this study was to investigate the clinical significance of SNX10 expression in AF. Methods: Nineteen valvular heart disease patients with AF and nine valvular heart disease patients with sinus rhythm (SR) were enrolled. Atrial tissue samples from patients undergoing open heart surgery were examined. Atrial tissues of normal hearts were obtained from two cases' autopsies. The SNX10 expression and its associations with the degree of fibrosis were analyzed by immunohistochemistry and Masson's trichrome staining. Results: SNX10 expression was detected in the cytoplasm of cardiac cells in human myocardial tissue. The SNX10 expression level was higher in the SR group than in the AF group (P=0.023). SNX10 expression was negatively associated with the degree of fibrosis (P=0.017, Spearman rho=-0.447), the New York Heart Association degree (P=0.003, Spearman rho=-0.545), left atrial diameter (P=0.038, Spearman rho=-0.393), right atrial diameter (P=0.043, Spearman rho=-0.386), and the brain natriuretic peptide (BNP) level 24 hours after surgery (P=0.030, Spearman rho=-0.426), but not the BNP level before surgery and 72 hours after surgery. No statistical significance was observed between SNX10 and the level of troponin T and C-reactive protein. Conclusion: Decreased SNX10 might serve as a potential risk factor in AF of the valvular heart disease.


Subject(s)
Humans , Atrial Fibrillation/etiology , Atrial Appendage , Heart Valve Diseases/surgery , Case-Control Studies , Risk Factors , Sorting Nexins , Heart Atria
2.
ABC., imagem cardiovasc ; 34(2)2021. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1283771

ABSTRACT

Fundamento: A elevação das pressões de enchimento secundária à disfunção diastólica do ventrículo esquerdo ocupa papel central na fisiopatologia da insuficiência cardíaca. Mesmo assim, as diretrizes internacionais falham em detectar a disfunção diastólica em uma parte dos casos. Objetivo: Avaliar a função de reserva do átrio esquerdo, estimada pelo strain longitudinal de pico do átrio esquerdo, nos casos de função diastólica indeterminada. Método: Estudo observacional com indivíduos em ritmo sinusal e fração de ejeção do ventrículo esquerdo preservada, submetidos ao ecocardiograma e divididos em três grupos conforme a análise conjunta da relação E/e´ e do volume de átrio esquerdo indexado: Grupo 1, se pressões de enchimento normais; Grupo 2, se pressões de enchimento elevadas e Grupo 3, se pressões de enchimento indeterminadas. Speckle tracking bidimensional foi empregado para medir o strain longitudinal de pico do átrio esquerdo. Análise de variância, teste t Student e curva receptor-operador (ROC) foram empregados na análise estatística. Resultado: Foram incluídos 58 pacientes, com 61 ± 14 anos, sendo 57% mulheres, com fração de ejeção do ventrículo esquerdo de 62 ± 7%. Os Grupos 2 e 3 tiveram strain longitudinal de pico do átrio esquerdo menor que o Grupo 1 (20 ± 5% versus 22 ± 6% versus 30 ± 8%, respectivamente, p=0,004), mas não diferiram entre si (p=0,93). O strain longitudinal de pico do átrio esquerdo foi preditor de pressões de enchimento elevadas (p=0,026, área sob a curva=0,80), obtendo-se sensibilidade de 60% e especificidade de 80% com valor de corte ≤ 20%. Conclusão: A função de reserva do átrio esquerdo dos indivíduos com função diastólica indeterminada é similar à dos indivíduos com disfunção diastólica avançada, conferindo ao strain longitudinal de pico do átrio esquerdo o potencial de auxiliar na reclassificação da função diastólica indeterminada.(AU)


Background: Elevation of left ventricular filling pressures secondary to diastolic dysfunction plays a central role in the pathophysiology of heart failure. However, international guidelines still fail to diagnose diastolic dysfunction in some cases. Objective: To evaluate left atrial reservoir function in indeterminate diastolic function Method: Observational study with individuals in sinus rhythm and preserved left ventricular ejection fraction, submitted to echocardiogram and divided into three groups according to the combined analysis of E/e´ ratio and indexed left atrium volume: Group 1, if normal left ventricular filling pressures; Group 2, if increased left ventricular filling pressures and Group 3, if indeterminate left ventricular filling pressures. Twodimensional speckle tracking was used to measure peak left atrial strain (LAS). Analysis of variance, Student's t test and receiver-operator curve (ROC) were used in the statistical analysis. Results: We included 58 patients who had 61 ± 14 years old, 57% of whom were women, and had average left ventricular ejection fraction 62 ± 7%. Groups 2 and 3 had lower LAS than Group 1 (20 ± 5% versus 22 ± 6% versus 30 ± 8%, respectively, p = 0.004), but did not differ between them (p = 0.93). LAS was a good predictor of elevated left ventricular filling pressures (p = 0.026; area under the curve = 0.80), obtaining sensitivity of 60% and specificity of 80% with a cut-off value ≤ 20%. Conclusion: The findings suggest that the left atrial reservoir function of individuals with indeterminate diastolic function is similar to that of individuals with advanced diastolic dysfunction, rendering LAS the potential to support the reclassification of indeterminate diastolic function.(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Ventricular Dysfunction, Left/diagnostic imaging , Heart Atria/diagnostic imaging , Heart Failure/physiopathology , Echocardiography, Doppler , Comorbidity , Observational Study
8.
Rev. bras. cir. cardiovasc ; 35(6): 1010-1012, Nov.-Dec. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1143999

ABSTRACT

Abstract We report the case of a 60-year-old patient who underwent orthotopic heart transplant 14 years earlier. Routine echocardiography showed giant masses in the left atrium. There were no symptoms or thromboembolic events in the past. Magnetic resonance imaging study revealed very enlarged left atrium (8.7 × 10.6 cm) occupied by irregular smooth mass (7 × 5 × 6.1 cm) with a stalk that was attached to the posterior left atrial wall in the area of graft suture lines. Intraoperative examination revealed a massive thrombus (12 × 10 cm) that filled almost the entire left atrial area.


Subject(s)
Humans , Middle Aged , Thromboembolism , Thrombosis/diagnostic imaging , Heart Transplantation/adverse effects , Heart Diseases/surgery , Heart Diseases/etiology , Heart Diseases/diagnostic imaging , Thrombosis/etiology , Echocardiography , Heart Atria/diagnostic imaging
9.
Arch. argent. pediatr ; 118(6): e540-e544, dic 2020. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1146213

ABSTRACT

La dilatación idiopática de la aurícula derecha es una entidad poco frecuente. Estimar la verdadera incidencia es dificultoso dado que muchos pacientes son asintomáticos y los síntomas reportados, tanto en niños como en adultos, presentan un amplio espectro de manifestaciones clínicas. Pocos pacientes con diagnóstico prenatal fueron publicados.Se presenta un caso de diagnóstico prenatal de dilatación auricular derecha con un seguimiento de 3 años y 8 meses. El paciente se encuentra asintomático, sin evidencia de trombosis auricular, medicado con ácido acetilsalicílico desde su nacimiento. El seguimiento se realizó con ecocardiogramas regulares; sin embargo, la confirmación diagnóstica fue a través de la resonancia magnética nuclear cardíaca.La importancia del reporte radica en describir una enfermedad rara, potencialmente grave, y cómo el diagnóstico prenatal permite tomar conductas anticipadas, como el monitoreo cardíaco, para la detección de arritmias y el inicio temprano de profilaxis primaria antitrombótic


Idiopathic dilatation of the right atrium is a rare condition. The real incidence of the disease is difficult to estimate since most patients are asymptomatic, although a wide spectrum of symptoms have been reported in children and adults. In the literature, prenatal diagnosis has been reported in few cases.We report a case of prenatally diagnosed right atrial dilation with a 3 years and 8 months follow up. The patient is on acetylsalicylic acid since birth and remained asymptomatic without any atrial thrombosis. We performed regular transthoracic echocardiograms during follow up, however was a cardiac magnetic resonance imaging the method for achieving diagnostic confirmation.The aim of this case report is to describe a rare, potentially serious disease and how prenatal diagnosis allows anticipated actions such as monitoring for cardiac arrhythmia detection and early starting of primary thrombosis prophylaxis.


Subject(s)
Humans , Male , Infant, Newborn , Dilatation , Heart Atria , Prenatal Diagnosis , Heart Defects, Congenital , Aneurysm
13.
Rev. bras. cir. cardiovasc ; 35(5): 713-721, Sept.-Oct. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1137324

ABSTRACT

Abstract Objective: To modify the chronic atrial fibrillation of atrial tachycardia pacing in beagles with a homemade pacemaker placed outside the body and to evaluate connective tissue growth factor and fibrosis of atrial tissue in our modified atrial tachycardia pacing beagle model. Methods: Twelve adult beagles of either sex were randomly divided into an atrial tachycardia pacing group and a control group (n=6 in each group). We performed the temporary pacemaker implantation at the right atrial appendage and put the pacemaker into the pocket of dog clothing in the atrial tachycardia pacing group. After eight weeks of atrial tachycardia pacing, the electrocardiography, transthoracic echocardiography, hematoxylin-eosin staining, and Masson's staining of the right atrial appendages were performed along with the immunohistochemistry, quantitative real-time polymerase chain reaction, and Western blot analysis of connective tissue growth factor, collagen I, and collagen III. Results: In the atrial tachycardia pacing group, atrial fibrillation was induced in five beagles (83.3%); the left atrium enlarged significantly; more canines had mitral regurgitation; and the Masson's staining, quantitative real-time polymerase chain reaction, and Western blot results demonstrated more obvious fibrosis of the left atrium. Conclusion: The modified beagle model of atrial fibrillation using a right atrium pacemaker outside the body was effective, increased connective tissue growth factor and collagen I messenger ribonucleic acid overexpression, and induced atrial fibrosis.


Subject(s)
Humans , Animals , Dogs , Pacemaker, Artificial , Atrial Fibrillation/etiology , Disease Models, Animal , Heart Atria/diagnostic imaging
14.
Rev. bras. cir. cardiovasc ; 35(5): 841-843, Sept.-Oct. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1137322

ABSTRACT

Abstract Cardiac rhythm disorders are common in many patients with cancer. The management of synchronous long-standing persistent atrial fibrillation and pulmonary lesions remains a serious surgical dilemma due to the lack of clinical data and surgical guidelines. To the best of our knowledge, this is the first described case of simultaneous thoracoscopic pulmonary segmentectomy and left atrial posterior wall and pulmonary vein isolation combined with left atrial appendage resection in a patient with early-stage primary lung cancer and long-standing persistent atrial fibrillation.


Subject(s)
Humans , Female , Aged , Atrial Fibrillation/surgery , Atrial Fibrillation/complications , Catheter Ablation/methods , Adenocarcinoma, Mucinous/surgery , Adenocarcinoma, Mucinous/complications , Adenocarcinoma, Mucinous/diagnostic imaging , Pneumonectomy/methods , Pulmonary Veins/surgery , Thoracoscopy , Tomography, X-Ray Computed , Treatment Outcome , Atrial Appendage/surgery , Heart Atria/surgery , Lung Neoplasms/surgery , Lung Neoplasms/complications , Lung Neoplasms/diagnostic imaging
15.
Rev. bras. cir. cardiovasc ; 35(4): 471-476, July-Aug. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1137315

ABSTRACT

Abstract Objective: To examine the relationship between the left atrial (LA) thrombus presence and the epicardial adipose tissue (EAT) thickness. Methods: Three hundred and twelve consecutive rheumatic mitral valve stenosis (RMVS) patients with mitral valve area (MVA) < 2 cm2 were included in this cross-sectional study. Patients were divided into two groups, those with and those without LA thrombus. Routine biochemical analysis and electrocardiographic examinations were carried out. EAT was measured using transthoracic echocardiography. Results: LA thrombus was determined in 84 (26.9%) RMVS patients. In echocardiographic examinations, higher mean gradient and LA diameter as well as lower MVA were found in the group with LA thrombus (P<0.001). In this group, higher C-reactive protein (CRP) and EAT values were also determined (P<0.001). There was significant correlation between EAT and MVA, CRP, LA appendage peak flow velocity, LA anteroposterior diameter, and mean gradient (P<0.001). Higher EAT values were identified as independently associated with the presence of LA thrombus (odds ratio 59.5; 95% confidence interval 12.1-290.10; P<0.001). Conclusion: Transthoracic echocardiography, routinely used in patients with RMVS, can measure EAT to determine patients who are under risk for thrombus.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Thrombosis/complications , Thrombosis/diagnostic imaging , Mitral Valve Stenosis/etiology , Mitral Valve Stenosis/diagnostic imaging , Adipose Tissue/diagnostic imaging , Cross-Sectional Studies , Echocardiography, Transesophageal , Heart Atria/diagnostic imaging
16.
Rev. bras. cir. cardiovasc ; 35(3): 399-401, May-June 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1137256

ABSTRACT

Abstract Primary malignant neoplasms of the heart are rare. Cardiac rhabdomyosarcoma is the second most common primary sarcoma. We report a rare case of a 49-year-old woman with a huge biatrial cardiac rhabdomyosarcoma treated by performing surgical resection followed by salvage chemotherapy for local recurrence. Cardiac sarcoma that occupy both atria are extremely rare. Although the prognosis of cardiac rhabdomyosarcoma is dismal, surgical resection should be recommended as a first line therapy to clarify the diagnosis and to relieve symptoms associated with the tumor.


Subject(s)
Humans , Female , Middle Aged , Rhabdomyosarcoma/surgery , Rhabdomyosarcoma/diagnostic imaging , Heart Neoplasms/surgery , Heart Neoplasms/diagnostic imaging , Heart Atria/surgery , Heart Atria/diagnostic imaging , Neoplasm Recurrence, Local
19.
Rev. colomb. cardiol ; 27(1): 36-40, ene.-feb. 2020. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1138751

ABSTRACT

Resumen La onda P en el electrocardiograma representa exclusivamente la despolarización de las aurículas puesto que la repolarización auricular queda oculta en el QRS. Sin embargo, cuando la repolarizacón auricular se hace evidente en el electrocardiograma se convierte en un elemento clave para el diagnóstico de algunas enfermedades. Diferente sucede en la repolarización ventricular; la repolarización auricular adopta el mismo sentido de la despolarización ya que sigue un sentido cráneo-caudal y se da desde el epicardio hacia el endocardio.


Abstract The P wave on the electrocardiogram exclusively represents atrial depolarisation, since atrial repolarisation is hidden in the QRS complex. However, when atrial repolarisation becomes evident in the electrocardiogram, it is a key element for the diagnosis of some diseases. Unlike what happens in ventricular repolarisation, atrial repolarisation adopts the same direction as depolarisation since it follows a craniocaudal course and it goes from the epicardium towards the endocardium.


Subject(s)
Electrocardiography , Heart Atria , Pericardium , Elements , Endocardium
20.
Rev. méd. Chile ; 148(1): 78-82, Jan. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1094209

ABSTRACT

Background: The incidence rates of cardiac tumors are low. Aim: To report the clinical presentation of cardiac myxomas and long-term evolution after resection. Material and Methods: Review of a database of surgical patients undergoing surgical resection of a cardiac myxoma in a public hospital between 1990 and 2018. Results: Seventy-eight patients aged 53 ± 15 years (65% females) were included. The most frequent comorbidities were arterial hypertension (40.5%), hypothyroidism (15%) and diabetes mellitus (12%). The main presenting symptoms were dyspnea (33%), neurological deficit secondary to embolism (30%) and acute pulmonary edema (5%). The most common location was the left atrium, in 87%. During surgery, cardiopulmonary bypass and aortic cross-clamp times were 50.2 ± 19.6 and 33.4 ± 15.2 min, respectively. One patient died due to severe neurological involvement. Follow-up was completed in seventy-seven patients, with a mean echocardiographic follow-up time of 10.4 ± 7.7 years. Thirty-four patients were followed for more than 10 years. Six patients (7.7%) died during the follow-up and in six patients (7%) a recurrence was identified. Conclusions: Cardiac myxoma usually has nonspecific symptoms. Surgical excision offers excellent short and long-term results. Complications and recurrence rates are low in non-hereditary myxomas but obligates to perform echocardiographic follow-up for early diagnosis of recurrence.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Heart Neoplasms , Myxoma , Echocardiography , Heart Atria , Neoplasm Recurrence, Local
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