RESUMO
An 87-year-old man with heart failure was admitted to our hospital. A transthoracic echocardiography showed diffuse mild left ventricular (LV) hypokinesis and LV noncompaction at the apex. A three-dimensional transthoracic echocardiography confirmed a trabecular meshwork. After treatment for heart failure, LV end-systolic dimension decreased and trabeculae seemed to converge and became obscure in end-systole. This is a rare case suggesting mechanism of obscured LV noncompaction after treatment for heart failure.
Assuntos
Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico por imagem , Miocárdio Ventricular não Compactado Isolado/complicações , Miocárdio Ventricular não Compactado Isolado/diagnóstico por imagem , Idoso de 80 Anos ou mais , Insuficiência Cardíaca/terapia , Humanos , Masculino , Ultrassonografia , Disfunção Ventricular Esquerda/complicações , Disfunção Ventricular Esquerda/diagnóstico por imagemRESUMO
A 70-year-old man was diagnosed with mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) with apical aneurysm and paradoxic jet flow. At cardiac catheterization, pressure study showed that there was a markedly high pressure-gradient of 90 mmHg between the apex and the base in systole. Apical pressure was 350 mmHg after premature ventricular contraction. The apical aneurysm was already dilated and spherical in late systole; the absence of active relaxation was considered to be the cause of the paradoxic jet flow. In this report, we suggest the pathogenesis of left ventricular apical aneurysm and paradoxic jet flow in MVOHCM.
Assuntos
Cardiomiopatia Hipertrófica/fisiopatologia , Aneurisma Cardíaco/fisiopatologia , Ventrículos do Coração/patologia , Idoso , Pressão Sanguínea , Cateterismo Cardíaco , Cardiomiopatia Hipertrófica/complicações , Circulação Coronária , Aneurisma Cardíaco/complicações , Humanos , MasculinoRESUMO
Two male patients, one in his thirties and the other in his fifties, were admitted to different hospitals for congestive heart failure (CHF). In both patients, laboratory findings indicated high plasma B-type natriuretic peptide (BNP) levels (266.0 and 902.7 pg/mL, respectively) and echocardiography showed large left ventricular diastolic dimensions (LVDd) (67 and 73 mm, respectively) and low ejection fractions (EF) (26% and 18%, respectively). Coronary arteriography revealed no organic stenosis in either patient. Following treatment, plasma BNP levels decreased to below the limit of measurement (4 pg/mL) in both patients and echocardiography revealed improved LVDd (61 and 52 mm, respectively) and EF (41% and 45%, respectively). Because these patients are related, genetic factors might have affected low plasma BNP levels. Moreover, these results suggest that marked decrease in plasma BNP during follow up may be an indicator of preserved neurohormonal and organ systems.
