Number Of Heart Diseases Research Articles

A Comparative study on ECG changes among normal and otherwise healthy congenitally deaf children

Background: Congenital deafness is usually seen to be associated with number of heart diseases. Screening congenitally deaf children with ECG can give us an insight on unidentified congenitally associated heart disease. Aim and objective: To study the ECG changes in congenitally deaf children and compare with normal children of the same age group. Materials and methods: We conducted a community based cross sectional analytical study with a sample size of 120 subjects out of which 60 were children from deaf school as cases and 60 were children from normal school with normal hearing as controls. Both the groups had 30 males and 30 females. 12 lead ECG was taken, studied and compared among the two groups. Results: Deaf children showed significant ECG changes like long QTc (16.7%), left axis deviation (3.3%), right axis deviation (1.6%), clockwise rotation (8.33%), anticlockwise rotation (5%), QRS complex abnormalities (45%), T wave inversions (45%). Conclusion: Our study was able to pick up numerous changes in ECG of deaf children. Yet the findings are inconclusive. Further genetic and thorough cardiac evaluation is necessary to comprehensively establish the relation between co-occurrence of ECG changes and congenital sensorineural deafness.

Prevalence of sudden cardiac death in dogs with atrial fibrillation.

BackgroundAtrial fibrillation (AF) is associated with increased risk of sudden cardiac death (SCD) in humans, independent of secondary risk factors such as thrombogenic disorders. In dogs, SCD is described in a number of heart diseases, but an association between AF and SCD is unreported.Hypothesis(a) A higher proportion of dogs with AF will experience SCD, and (b) SCD will be associated with complex ventricular arrhythmias.AnimalsOne‐hundred forty‐two dogs with AF, and 127 dogs without AF.MethodsRetrospective, multicenter, case‐control study. Dogs included in the AF group were compared to a control group of dogs in sinus rhythm, matched for echocardiographic diagnosis. Descriptive statistics were used to identify proportions of each group suffering SCD, compared using chi‐squared testing. Risk factors for SCD in dogs with AF were evaluated at the univariable and multivariable level using binary logistic regression. Significance was P < .05.ResultsA significantly higher proportion of dogs with AF suffered SCD than dogs in the control group (14.8% vs 5.5%; P = .01). Younger age at diagnosis, larger left atrial size, and a history of syncope all were independent predictors of SCD in dogs with AF (χ 2, 16.3; P = .04).Conclusions and Clinical ImportanceAtrial fibrillation was associated with a higher prevalence of SCD in dogs. A history of syncope may be a useful predictor of SCD risk.

Genetic aspects of Ebstein anomaly and related heart diseases

Ebstein anomaly is a congenital heart disease, which is characterized by the presence of atrialized portion of the right ventricle, formed as a result of displacement of the tricuspid valve leaflets into the right ventricle and their partial adherence to the underlying myocardium. Atrialized portion in the right ventricle occupies the space between the fibrous annulus of the right atrioventricular orifice and the functional annulus of tricuspid valve, which represents a zone of closure of free (non-adherent to the underlying myocardium) edges of its leaflets. Ebstein anomaly is very rarely isolated, and can be combined with a number of heart diseases and be an integral part of hereditary syndromes. Currently, the role of genetic research in the investigation of the etiology of human diseases as well as understanding of the relationship between different diseases is increasing. The review presents literature data on the combination of Ebstein anomaly with other heart diseases (congenital heart diseases, Wolf-Parkinson-White syndrome, cardiomyopathies, including left ventricular noncompaction), inter alia, within the scope of hereditary syndromes (Noonan syndrome, 8p deletion syndrome, 18q deletion syndrome, 1p36 deletion syndrome, Pierre Robin syndrome). Genetic factors (gene and chromosomal mutations) lying at the core of Ebstein anomaly, as well as heart diseases combined with it, are highlighted. The analysis of published data suggests that Ebstein anomaly is a monogenic disease, and is characterized by allelic and locus genetic heterogeneity. The combination of Ebstein anomaly with other heart diseases is based on their genetic linkage.

Towards Designing A Hierarchical Fuzzy System for Early Diagnosis of Heart Disease

Heart disease may represent a range of conditions that affect our heart. Disease under heart diseases umbrella include coronary heart disease, heart attack, congestive heart failure, and congenital heart disease, is the leading cause of death. Mor eover, heart disease not only attacks the elderly. In the present day, lots of younger people might be getting affected by the number of heart diseases. In order to decrease the mortality rate caused by heart disease, it is necessary for the disease, to be diagnosed at an early stage. In this paper, we have proposed the use of hierarchical fuzzy systems (HFSs) for early diagnosis of heart disease. However, to design the HFSs is challenging, especially for the complex system. Therefore, in this paper, we foc us on designing a hierarchical fuzzy system to handle the complex medical application. The designed HFS consists of six key main steps implemented on heart disease. The input variables of heart disease includes shortness of breath, discomfort, pressure, he aviness, or pain in the chest, arm, or below the breastbone, fatigue, nausea, difficulties in climbing stairs, swelling in ankles, difficulty to sleep at night, irregular heartbeats, fullness, sweating, take frequent break during the day, dizzy and depress ed. Additionally, the output of heart disease is to classify whether the patient is healthy or suspecting with heart disease. The study contributes to providing insight into a way of designing the HFSs, particularly for the complex medical application.

A Novel MYH6E1503V Variant in a Family with a History of Heart Disease, including Hypoplastic Left Heart Syndrome

Hypoplastic Left Heart Syndrome (HLHS) is a severe form of congenital heart disease (CHD), requiring prompt surgical intervention and eventual transplant. Despite significant advances in detection and treatment of HLHS, genetic risk factors have been identified in &lt;5% of patients. Our prior studies of 190 HLHS patients identified 19 distinct, rare variants in the gene encoding for a‐myosin heavy chain (MYH6), with variant carriers exhibiting reduced transplant‐free survival (p &lt; 1 × 10−3). In‐depth genetic analysis was performed on the family of one HLHS subject who exhibited a novel E1503V variant in the tail domain of MYH6. The variant was identified in six additional members of the family, all of whom were related to the proband via the maternal grandmother. Four of those individuals also exhibited adult heart disease, with varying ages of onset. Though MYH6 variants have been implicated in a number of heart diseases – including arrhythmias, familial cardiomyopathies, as well as various forms of CHD – to our knowledge this is the first association of a single variant with both adult heart disease and HLHS.α‐myosin heavy chain (α‐MHC) is a cardiac‐specific protein that functions as a component of the sarcomere, the major contractile unit of the heart muscle. We therefore sought to evaluate functional consequences of MYH6E1503V on a‐MHC in vitro. Using CRISPR‐Cas9 gene editing technology, we successfully introduced the variant into induced pluripotent stem cells (iPSCs) from an unrelated individual, which were then used to generate cardiomyocytes. Subsequent evaluation of these cells revealed key insights into the effect of MYH6E1503V on sarcomere organization and contractile properties in cardiomyocytes, as well as their proliferation and differentiation capacity.Support or Funding InformationChildren's Research Institute at the Children's Hospital of Wisconsin, Little Hearts for Life Foundation, M.A is a member of the Medical Scientist Training Program at MCW, which is partially supported by a training grant from NIGMS T32‐GM080202This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Comparative Evaluation of Aortic Valve Replacement Methods in Patients Over 70 with Aortic Stenosis

BackgroundAs life expectancy and quality of health improve, more and more people reach old age, and so does the number of heart diseases. One of the most urgent problems among elderly patients is degenerative stenosis of the aortic valve (AV). The conservative treatment of symptoms of chronic heart failure with AV stenosis improves the patient’s condition only for a while, whereas surgical treatment such as replacement of AV is recognized as the main effective method of treating a defect. Recently, alternative technologies for prosthetic AV have been developed, aimed at reducing adverse effects of artificial circulation (AC) in high-risk patients and minimizing the scope of surgical intervention.Aim of studyThe aim of the study was to evaluate the immediate results of surgical treatment of aortic stenosis using different methods in patients over 70.Material and methodsThe article presents the results of treatment of 64 patients over 70 with isolated AV stenosis, operated with different surgical techniques from July, 2016 to January, 2018. All patients were divided into three groups, differing in the severity of the initial condition and the method treatment. Group 1 (transcatheter implantation of the prosthetic AV, EuroSCORE II — 21.81%) consisted of 19 patients, Group 2 (non-suture implantation of a Perceval prosthetic valce under the AC, EuroSCORE II — 13.81%) consisted of 13 patients and Group 3 (“standard” prosthetics, EuroSCORE II — 9.89%) consisted of 32 patients.ResultsIn Group 1, two patients died, the hospital mortality was 10.5%. In Group 2 and Group 3, one patient died, the hospital mortality was 7.6 and 3.1%, respectively. Implantation of a permanent pacemaker was required in three patients (15.7%) from the TAVI group after installation of Medtronic Core Valve and two patients (15.3%) from the Perceval group.ConclusionThe obtained results of AV replacement by various methods allowed to expand indications for the management of AV stenosis in patients of the older age group with a high surgical risk of operation under AC conditions who had not previously been considered candidates for surgical treatment of aortic malformation due to the age and severity of the concomitant pathology.

RISK SCORE FOR PREDICTION OF DEMENTIA RISK IN 10 YEARS AMONG OLDER ADULTS: A NORDIC POPULATION-BASED STUDY WITH THREE COHORTS

The midlife CAIDE Dementia Risk Score for estimating the risk of dementia development 20 years later in middle-aged people (45–59 years) is one of the few validated risk scores that has also been used to select participants in the successful FINGER lifestyle intervention trial. The present study aims to develop and validate a late-life risk score for estimating dementia risk in older populations (60+ years). Data analysis were based on three population-based studies: the Swedish National study on Aging and Care in Kungsholmen (SNAC-K; n=2281; age ≥60 years), the Kungsholmen project in Sweden (n=987; age 75–95 years), and the Cardiovascular Risk Factors, Aging and Dementia study in Finland (CAIDE; n=744; age 65–79 years). Data on demographics, lifestyle, psychosocial factors, vascular factors, and health status were collected following similar procedures. The three Nordic studies were used to develop the late-life dementia risk score, which will be validated in the Rotterdam Study in the Netherlands (>60 years). Cox regression was used in the data analyses with a 10-year horizon. Incidence of dementia during the follow-up period (up to 10 years) was 12.7%. The predictors for dementia varied between younger-old (60–74 years) and older-old (≥75 years) individuals. In the younger-old group, future dementia was significantly predicted by higher age (70–74 years), low diastolic blood pressure (<70 mmHg), physical inactivity, cerebrovascular disease, and the number of heart diseases. In the older-old group, future dementia was significantly predicted by higher age (≥80 years), low education (<7 years), diabetes mellitus, physical inactivity, cerebrovascular diseases, self-reported depression, and subjective memory complaints. The Harrell's C statistic was 0.74 for the dementia risk score in the younger-old group, and 0.70 for the dementia risk score in the older-old group. External validation in the Rotterdam study is ongoing. This approach highlights the role of cardiovascular diseases and mental health in the development of dementia in old and very old adults, which could further benefit dementia prevention and clinical interventions. Dementia risk estimation tools are much needed for identification of at-risk individuals who may benefit most from preventive interventions.

Forensic Sciences and Growth of Cardiology

th century. Harvey’s discovery was made possible by the lift of ban on medical autopsies. Harvey was a pioneer in recognizing that clinic-pathologic correlations from postmortem findings are pivotal in gaining anatomical knowledge and recognizing the basis of clinical symptoms and signs. Andreas Vesalius, a predecessor of Harvey had noted marked differences between Galen’s teaching and the real anatomy from observations in dissected human bodies. He traced the elaborate network of the blood vessels and accurately described the anatomy of the heart [1]. The significance of the approach of these two path finders is evident from the observations that over centuries, there has been no significant decrease in the rate of unexpected findings detected in either medico-legal autopsies or postmortem studies on patients dying from natural causes in hospitals [2,3]. Autopsy studies have contributed immensely to our understanding of the anatomical basis of a number of heart diseases. A large number of heart diseases such as myocarditis, and carcinoid heart disease were first described during autopsies. Several infections that are not diagnosed clinically have been detected at autopsy for the first time as causes for cardiac symptoms and signs [4]. We recognize at present that influenza and pneumonia can trigger acute vascular events and increase the risk of myocardial infection. Studies have linked pre-eclampsia, a major cause of death due to vascular factors to maternal infection. It was through autopsy studies that Chaga’s disease was recognized as a cause for cardiomyopathy as well as for sudden death in patients with asymptomatic infection with T. Cruzi [5,6]. Pathological features of another tropical problem rheumatic heart disease were clarified through post-mortem observations. Autopsy studies aided in understanding the pathogenesis of chronic valve disease, effects of mitral valve replacement and valve repair as well as the causes for failure of such treatment in patients with rheumatic valve disease. Complex congenital heart diseases such as tetralogy of Fallot, transposition of the great vessels, tricuspid atresia, hypoplastic left heart syndrome, coarctation of the aorta, hypoplastic right heart syndrome, anomalous position of the heart, endocardial cushion defects and tricuspid valve dysplasias have all been characterized during postmortem examinations [7,8]. Post mortem studies on adults with congenital heart diseases and who have underwent surgical corrections could provide novel information and guidance for revision of present approaches to management of patients with congenital heart defects [9].

Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes — results from the BASKET PROVE trial

Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI). Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction. A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of <60 beats per minute (bpm), the adjusted hazard ratios were (95% CI) 4.5 (1.5-13.5, p=0.006) for 60-69 bpm, 3.8 (1.2-11.9, p=0.022) for 70-79 bpm, 4.3 (1.2-15.6, p=0.025) for 80-89 bpm, and 16.9 (5.2-55.0, p<0.001) for >90 bpm. For cardiovascular death/myocardial infarction, a discharge HR >90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, p<0.001) compared to a HR <60 bpm. No interaction was found for disease presentation, diabetes or betablocker use. In patients revascularized with PCI for stable angina or acute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI.

Carnitine regulates myocardial metabolism by Peroxisome Proliferator-Activated Receptor-alpha (PPARalpha) in alcoholic cardiomyopathy

SummaryBackgroundChronic alcohol intake exerts myocardial damage en route to the development of alcoholic cardiomyopathy (ACM), although the precise pathogenesis of ACM is unknown. Carnitine is known to participate in the regulation of metabolism in a number of heart diseases. This study was designed to examine the interplay between myocardial metabolism and carnitine in the development of ACM.Material/MethodsExperimental animals were divided into 3 groups: (i) group A: alcohol-fed. (ii) group B: alcohol/carnitine: (200mg/kg/d, p.o. by mixing carnitine in rat chow). (iii) group C: control. Blood levels of free fatty acid (FFA), total carnitine (TC) and free carnitine (FC) were monitored in rats receiving alcohol with or without carnitine. Mitochondrial adenine nucleotide translocator-1 (ANT1) activity, ATPase activity, high energy phosphate concentration, peroxisome proliferator-activated receptor-α (PPARα), carnitine-palmitoyl transferase I (CPT-I), medium-chain acyl-coenzyme A dehydrogenase (MCAD), ANT1 and ATPase mRNA and protein expression were also monitored in myocardial tissue.ResultsExperimental animals received alcohol with or without carnitine for six6 months. Our results indicated that FFA increased abruptly. TC and FC were significantly decreased in groups receiving alcohol at 4 months. The concentration of ATP, ADP and AMP in the myocardium decreased following 2 months of alcohol administration. mRNA and protein expression of PPARα, CPT-I, MCAD, ANT1 and ATPase expressions were gradually altered in groups following alcohol feeding.ConclusionsThese observations suggest that abnormal metabolism is present in the myocardium during the development of ACM. Carnitine may improve myocardial metabolism by elevating the content of PPARα, CPT-I and MCAD.

Prevalence of heart diseases in patients with pulmonary embolism with and without peripheral venous thrombosis: Findings from a cross-sectional survey

Background In up to 80% of patients with pulmonary embolism (PE) no peripheral symptomatic thrombosis can be identified. Whether the heart may represent a source of PE is unknown. Methods We conducted a cross-sectional survey of patients who were 60 years or older and were discharged from the hospitals of Veneto region, Italy between 2000 and 2006 with the diagnosis of PE. We compared the prevalence of several acute and chronic heart diseases in patients discharged with the diagnosis of PE alone with that of patients with co-occurring symptomatic peripheral deep venous thrombosis (PE/DVT). Results Out of 11,236 eligible patients, 9079 (81%) were discharged with the diagnosis of PE alone, and 2157 with that of PE/DVT. 3239 of the 9079 (35.7%) patients with isolated PE, and 666 of the 2157 (30.9%) with PE/DVT had at least one heart disease. The adjusted odds ratio (OR) for having at least one heart disease in patients with isolated PE as compared to those with PE/DVT was 1.26 (95% CI, 1.13–1.40). The heart diseases that significantly contributed to the study results were all-cause cardiomyopathies (adjusted OR, 2.31; 95% CI, 1.37–3.89), all-cause heart failure (1.82; 1.45–2.27), coronary heart disease (1.28; 1.08–1.52), and atrial fibrillation or flutter (1.28; 1.08–1.51). Conclusions There is an association between isolated PE and a number of heart diseases. The results of our survey generate the hypothesis that in older patients several heart diseases may directly account for the development of PE. Prospective studies are needed to confirm this hypothesis.

The Differential Diagnosis of an Elevated Amino-Terminal Pro–B-Type Natriuretic Peptide Level

Although amino-terminal pro-B-type natriuretic peptides (NT-proBNP) are useful for the diagnosis or exclusion of heart failure (HF), this marker may identify a wide range of disease processes other than HF. Indeed, elevation of NT-proBNP may occur in a number of heart diseases (including heart muscle disease, valve disease, rhythm abnormalities, pulmonary hypertension, and cytotoxic injury to the heart) and in disease processes other than primary cardiac illnesses, including gram-negative sepsis. Importantly, although NT-proBNP may increase in settings other than HF, the presence and severity of such NT-proBNP release is often significantly associated with risk for adverse outcome. Accordingly, elevation of NT-proBNP in the context of non-HF situations should not be regarded as a "false-positive" finding, and elevated NT-proBNP values should not be discarded without consideration of the serious adverse outcomes associated with the elevation. Future studies will be necessary to further understand the utility of NT-proBNP testing in states other than cardiovascular disease.