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Bonilla Jassir JC, Parra Medina R, Polo Nieto JF, Rocha Aguirre JE, Téllez Rodríguez JP, Cháves JJ, Nieto PD, Campuzano Larrea O, Sarquella Brugada G, Brugada J, Brugada Tarradellas R. Análisis clínico e histopatológico de la prevalencia de enfermedades cardiacas en muerte súbita. Estudio en autopsias. REPERTORIO DE MEDICINA Y CIRUGÍA 2022. [DOI: 10.31260/repertmedcir.01217372.1244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introducción: un evento de muerte súbita supone un gran impacto para la sociedad, siendo importante su estudio para aportar conocimiento y fortalecer estrategias de promoción y prevención. Objetivo: determinar la prevalencia de los diagnósticos anatomopatológicos cardiacos definitivos y los hallazgos histopatológicos asociados con la muerte súbita de origen cardíaco en los pacientes sometidos a autopsias clínicas realizadas en el Hospital de San José de Bogotá DC, Colombia, durante el período 2015 a 2018. Métodos: estudio descriptivo de corte transversal retrospectivo en pacientes a quienes se les realizó autopsia con diagnóstico de muerte súbita de origen cardiovascular en el servicio de patología del Hospital de San José, Bogotá DC, Colombia. Resultados: se incluyeron 178 autopsias con diagnóstico de muerte súbita cardíaca. El promedio global de edad fue 56.1 años (DE: 15.06) con una relación hombre-mujer de 3:1. El hallazgo macroscópico más frecuente fue cardiomegalia (promedio 428.1 g (DE 112.8), acompañado de la presencia de coronariopatía esclerótica (p=0.000) con obstrucción de la luz de las arterias coronarias mayores de 80% (p=0.037). Conclusiones: los diagnósticos anatomopatológicos definitivos prevalentes en la muerte súbita cardiaca fueron cardiopatía isquémica crónica complicada (65%) e infarto agudo de miocardio (16%), datos similares a los reportados a nivel mundial. La cardiomegalia es un hallazgo frecuente que debe valorarse en forma cuidadosa.
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Bouchau R, Cariou E, Deney A, Belaid S, Itier R, Blanchard V, Fournier P, Duparc A, Galinier M, Carrié D, Lairez O, Lavie-Badie Y. Sports participation and myocarditis: Influence of sport types on disease severity. IJC HEART & VASCULATURE 2021; 37:100895. [PMID: 34765717 PMCID: PMC8571161 DOI: 10.1016/j.ijcha.2021.100895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study, in the context of acute myocarditis (AM) in sportsmen, the association between the category of sport practiced and the severity of AM. DESIGN Retrospective study. SETTING Single tertiary center. PATIENTS 82 sportspeople (≥2.5 h of sport per week) who presented an AM. ASSESSMENT OF RISK FACTORS The type of sport activity before AM were collected. MAIN OUTCOME MEASURES Complicated AM was defined by a left ventricular ejection fraction <50% or the use of inotropic drugs or ventricular assist device. RESULTS Mean age was 29 ± 9 year-old, 77 (94%) were men. Sixteen (20%) had a complicated AM. Practicing sport over 6 h a week or a Mitchell's Class IIIA sport were associated with complicated AM (44 vs. 17%, p = 0.019 and 38 vs. 11%, p = 0.008, respectively). Practicing a Mitchell's Class IC sport was associated with uncomplicated AM (6 vs. 38%, p = 0.008). CONCLUSION In sportspeople's AM, the pattern of sport activity (static or dynamic component, practice intensity) is associated with the disease's severity.
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Affiliation(s)
- Robin Bouchau
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Eve Cariou
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Antoine Deney
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Slimane Belaid
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Romain Itier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Department of Cardiovascular Rehabilitation, Rangueil University Hospital, Toulouse, France
| | - Virginie Blanchard
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
- Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Alexandre Duparc
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
- Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Yoan Lavie-Badie
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
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du Long R, Fronczek J, Niessen HWM, van der Wal AC, de Boer HH. The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies. Forensic Sci Res 2021; 7:238-246. [PMID: 35784416 PMCID: PMC9245978 DOI: 10.1080/20961790.2021.1989793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Interpreting a myocardial inflammation as causal, contributory or as of no significance at all in the cause of death can be challenging, especially in cases where other pathologic and/or medico-legal findings are also present. To further evaluate the significance of myocardial inflammation as a cause of death we performed a retrospective cohort study of forensic and clinical autopsy cases. We revised the spectrum of histological inflammatory parameters in the myocardium of 79 adult autopsy cases and related these to the reported cause of death. Myocardial slides were reviewed for the distribution and intensity of inflammatory cell infiltrations, the predominant inflammatory cell type, and the presence of inflammation-associated myocyte injury, fibrosis, edema and hemorrhage. Next, the cases were divided over three groups, based on the reported cause of death. Group 1 (n = 27) consisted of all individuals with an obvious unnatural cause of death. Group 2 (n = 29) included all individuals in which myocarditis was interpreted to be one out of more possible causes of death. Group 3 (n = 23) consisted of all individuals in which myocarditis was reported to be the only significant finding at autopsy, and no other cause of death was found. Systematic application of our histological parameters showed that only a diffuse increase of inflammatory cells could discriminate between an incidental presence of inflammation (Group 1) or a potentially significant one (Groups 2 and 3). No other histological parameter showed significant differences between the groups. Our results suggest that generally used histological parameters are often insufficient to differentiate an incidental myocarditis from a (potentially) significant one.
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Affiliation(s)
- Romy du Long
- Department of Pathology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Judith Fronczek
- Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands
| | - Hans W. M. Niessen
- Department of Pathology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Allard C. van der Wal
- Department of Pathology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Hans H. de Boer
- Department of Pathology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands
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Blagova OV, Nedostup AV, Kogan EA. Long-term Results of Drug and Interventional Treatment in Patients with Morphologically Verified Idiopathic Arrhythmias. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2021. [DOI: 10.20996/1819-6446-2021-10-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To study the late results of medical and interventional treatment in patients with morphologically verified nature of idiopathic arrhythmias.Methods. The prospective study included 20 patients (mean age 43.1±11.3 years, 10 female) with atrial fibrillation (AF), supraventricular and ventricular extrasystole, supraventricular and ventricular tachycardia, conduction disturbance without structural heart changes. In addition to the standard examination, the level of anti-heart antibodies was initially determined; endomyocardial biopsy (EMB) of the right ventricle with PCR study for the viral genome; DNA diagnostics (n=4), coronary angioraphy (n=6), skin biopsy (n=1) were performed. The median follow-up was 134 [128; 138] months.Results. By EMB in the initial examination were diagnosed: active (n=8)/borderline (n=3) infectious immune myocarditis; parvovirus-positive endomyocarditis (n=1); undifferentiated vasculitis (n=2); myocardial vasculitis (n=1); Fabry disease (n=1); arrhythmogenic right ventricular dysplasia (n=1); unspecified cardiomyopathy (n=2). Anti-heart antibodies were the most important in myocarditis diagnosis and monitoring. All patients with myocarditis/vasculitis (n=15) received its basic therapy: acyclovir (n=10); immunoglobulin G 10-12.5 g (n=2); hydroxychloroquine 200 mg/day (n=15); glucocorticoids (n=14); azathioprine 150 mg/day (n=2). The late results were evaluated in all patients with myocarditis. Initially, in 62.5% of patients a resistance of AF to all antiarrhythmic drugs was noted. After treatment the average frequency of AF paroxysms decreased (from 8 [5; 8] to 3 [1,25; 7,75] points). By the end of the follow-up, six patients underwent radiofrequency ablation (RFA) for AF, the full effect was achieved once. All patients without RFA have AF partially or completely resistant to drugs. Two patients (without RFA) died from ischemic stroke/ pulmonary embolism.Conclusion. Using EMB the causes of idiopathic arrhythmias (mainly AF) were diagnosed: immune inflammatory diseases in 75% and genetic in 25% of patients. As a result of complex treatment, the general burden of arrhythmias has decreased. But the presence of myocarditis and primary cardiomyopathy, without reducing the cardiac contractility and dilatation, does not allow achieving a stable antiarrhythmic effect. Lethality for 11 years was 10%. The causes of death were thromboembolic complications.
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Affiliation(s)
- O. V. Blagova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. V. Nedostup
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - E. A. Kogan
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Palmisano A, Darvizeh F, Cundari G, Rovere G, Ferrandino G, Nicoletti V, Cilia F, De Vizio S, Palumbo R, Esposito A, Francone M. Advanced cardiac imaging in athlete's heart: unravelling the grey zone between physiologic adaptation and pathology. Radiol Med 2021; 126:1518-1531. [PMID: 34420142 PMCID: PMC8380417 DOI: 10.1007/s11547-021-01411-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/06/2021] [Indexed: 12/11/2022]
Abstract
Over the last decades, interest toward athlete’s heart has progressively increased, leading to improve the knowledge on exercise-induced heart modifications. Sport may act as a trigger for life-threatening arrhythmias in patients with structural or electrical abnormalities, hence requiring to improve the diagnostic capability to differentiate physiological from pathological remodeling. Pathological alterations are often subtle at the initial stages; therefore, the challenge is to promptly identify athletes at risk of sudden cardiac death during the pre-participation screening protocols. Advanced imaging modalities such as coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR) can non-invasively depict coronary vessels and provide a deep morpho-functional and structural characterization of the myocardium, in order to rule out pathological life threatening alterations, which may overlap with athletes’ heart remodeling. The purpose of the present narrative review is to provide an overview of most frequent diagnostic challenges, defining the boundaries between athlete's heart remodeling and pathological structural alteration with a focus on the role and importance of CCTA and CMR.
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Affiliation(s)
- Anna Palmisano
- Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Fatemeh Darvizeh
- Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Giulia Cundari
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Rovere
- Department of Radiological and Hematological Sciences -Section of Radiology, Università Cattolica Sacro Cuore, Fondazione, Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Valeria Nicoletti
- Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Cilia
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Silvia De Vizio
- Department of Radiological and Hematological Sciences -Section of Radiology, Università Cattolica Sacro Cuore, Fondazione, Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Roberto Palumbo
- School of Radiology, Campus BioMedico Univerisity, Rome, Italy
| | - Antonio Esposito
- Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. .,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
| | - Marco Francone
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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6
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Komici K, Bianco A, Perrotta F, Dello Iacono A, Bencivenga L, D’Agnano V, Rocca A, Bianco A, Rengo G, Guerra G. Clinical Characteristics, Exercise Capacity and Pulmonary Function in Post-COVID-19 Competitive Athletes. J Clin Med 2021; 10:jcm10143053. [PMID: 34300219 PMCID: PMC8304629 DOI: 10.3390/jcm10143053] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/01/2021] [Accepted: 07/06/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Limited evidence exists regarding adverse modifications affecting cardiovascular and pulmonary function in physical active adults affected by COVID-19, especially in athletic populations. We aimed to describe the clinical presentation of COVID-19 in a cohort of competitive athletes, as well as spirometry and echocardiography findings and cardio-respiratory performance during exercise. Methods: Twenty-four competitive athletes with COVID-19 were recruited for this study after ending self-isolation and confirmation of negative laboratory results. All athletes underwent clinical evaluation, spirometry, echocardiography and cardiopulmonary exercise testing (CPET). These data were compared to a group of healthy control athletes. Results: Anosmia was the most frequent symptom present in 70.83% patients, followed by myalgia, fatigue and ageusia. The most frequent persisting symptoms were anosmia 11 (45.83%) and ageusia 8 (33.33%). Compared to controls, COVID-19 patients presented lower FEV1%: 97.5 (91.5–108) vs. 109 (106–116) p = 0.007. Peak Oxygen Uptake (VO2) in COVID-19 patients was 50.1 (47.7–51.65) vs. 49 (44.2–52.6) in controls (p = 0.618). Conclusions: Reduced exercise capacity was not identified and pulmonary and cardiovascular function are not impaired during early recovery phase in a population of physical active adults except FEV1 reduction.
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Affiliation(s)
- Klara Komici
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (A.B.); (V.D.); (A.R.); (G.G.)
- Exercise and Sports Medicine Unit, “Antonio Cardarelli Hospital”, 86100 Campobasso, Italy
- Correspondence: ; Tel./Fax: +39-087-440-4710
| | - Antonio Bianco
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (A.B.); (V.D.); (A.R.); (G.G.)
- Exercise and Sports Medicine Unit, “Antonio Cardarelli Hospital”, 86100 Campobasso, Italy
| | - Fabio Perrotta
- UOC Pneumologia AORN Sant’Anna e San Sebastiano, 81100 Caserta, Italy;
| | - Antonio Dello Iacono
- School of Health and Life Sciences, University of the West of Scotland, Hamilton G72 0LH, UK;
| | - Leonardo Bencivenga
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (L.B.); (G.R.)
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | - Vito D’Agnano
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (A.B.); (V.D.); (A.R.); (G.G.)
| | - Aldo Rocca
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (A.B.); (V.D.); (A.R.); (G.G.)
| | - Andrea Bianco
- Department of Translational Medical Sciences, University of Campania “L. Vanvitelli”, 80138 Naples, Italy;
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (L.B.); (G.R.)
- Istituti Clinici Scientifici Maugeri SpA Società Benefit (ICS Maugeri SpA SB), 82037 Telese Terme, Italy
| | - Germano Guerra
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (A.B.); (V.D.); (A.R.); (G.G.)
- Exercise and Sports Medicine Unit, “Antonio Cardarelli Hospital”, 86100 Campobasso, Italy
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7
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Podzolkov VI, Tarzimanova AI. The Value of Omega-3 Fatty Acids in the Prevention of Heart Rhythm Disorders. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2020. [DOI: 10.20996/1819-6446-2020-05-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- V. I. Podzolkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. I. Tarzimanova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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8
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Eichhorn C, Bière L, Schnell F, Schmied C, Wilhelm M, Kwong RY, Gräni C. Myocarditis in Athletes Is a Challenge: Diagnosis, Risk Stratification, and Uncertainties. JACC Cardiovasc Imaging 2019; 13:494-507. [PMID: 31202742 DOI: 10.1016/j.jcmg.2019.01.039] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/10/2018] [Accepted: 01/05/2019] [Indexed: 12/12/2022]
Abstract
Presentation of myocarditis in athletes is heterogeneous and establishing the diagnosis is challenging with no current uniform clinical gold standard. The combined information from symptoms, electrocardiography, laboratory testing, echocardiography, cardiac magnetic resonance imaging, and in certain cases endomyocardial biopsy helps to establish the diagnosis. Most patients with myocarditis recover spontaneously; however, athletes may be at higher risk of adverse cardiac events. Based on scarce evidence and mainly autopsy studies and expert's opinions, current recommendations generally advise abstinence from competitive sports ranging from a minimum of 3 to 6 months. However, the dilemma poses that (un)necessary prolonged disqualification of athletes to avoid adverse cardiac events can cause considerable disruption to training schedules and tournament preparation and lead to a decline in performance and ability to compete. Therefore, better risk stratification tools are imperatively needed. Using latest available data, this review contrasts existing recommendations and presents a new proposed diagnostic flowchart putting a greater focus on the use of cardiac magnetic resonance imaging in athletes with suspected myocarditis. This may enable cardiac caregivers to counsel athletes with suspected myocarditis more systematically and furthermore allow for pooling of more unified data. To modify recommendations regarding sports behavior in athletes with myocarditis, evidence, based on large multicenter registries including cardiac magnetic resonance imaging and endomyocardial biopsy, is needed. In the future, physicians might rely on combined novel risk stratification methods, by implementing both noninvasive and invasive tissue characterization methods.
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Affiliation(s)
- Christian Eichhorn
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts
| | - Loïc Bière
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts; Institut MitoVasc, Laboratoire Cardioprotection, Remodelage et Thrombose, University of Angers, Angers, France; Department of Cardiology, University Hospital of Angers, Angers, France
| | - Frédéric Schnell
- Rennes University Health Centre, Sports Medicine Division, Physiology Laboratories, Rennes-1 University, Rennes, France
| | - Christian Schmied
- Department of Cardiology, University Heart Center, Zurich, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Swiss Cardiovascular Center, University Hospital Berne, Berne, Switzerland
| | - Raymond Y Kwong
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christoph Gräni
- Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts; Department of Cardiology, Swiss Cardiovascular Center, University Hospital Berne, Berne, Switzerland; Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
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9
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Vischer AS, Castelletti S, Syrris P, Bastiaenen R, Miles C, Akdis D, Denhaerynck K, Jacoby D, Saguner AM, Krahn AD, Behr ER, McKenna WJ, Pantazis A. Risk score for the exclusion of arrhythmic events in arrhythmogenic right ventricular cardiomyopathy at first presentation. Int J Cardiol 2019; 290:100-105. [PMID: 31104822 DOI: 10.1016/j.ijcard.2019.04.090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 01/02/2023]
Abstract
AIMS Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetically determined heart muscle disorder associated with an increased risk of life-threatening arrhythmias in some patients. Risk stratification remains challenging. Therefore, we sought a non-invasive, easily applicable risk score to predict sustained ventricular arrhythmias in these patients. METHODS Cohort of Patients who fulfilled the 2010 ARVC task force criteria were consecutively recruited. Detailed clinical data were collected at baseline and during follow up. The clinical endpoint was a composite of recurrent sustained ventricular arrhythmias and hospitalization due to ventricular arrhythmias. Multivariable logistic regression was used to develop models to predict the arrhythmic risk. A cohort including patients from other registries in UK, Canada and Switzerland was used as a validation population. RESULTS One hundred and thirty-five patients were included of whom 35 patients (31.9%) reached the endpoint. A model consisting of filtered QRS duration on signal-averaged ECG, non-sustained VT (NSVT) on 24 h-ECG, and absence of negative T waves in lead aVR on 12‑lead surface ECG was able to predict arrhythmic events with a sensitivity of 81.8%, specificity of 84.0% and a negative predictive value of 95.5% at the first presentation of the disease. This risk score was validated in international ARVC registry patients. CONCLUSION A risk score consisting of a filtered QRS duration ≥117 ms, presence of NSVT on 24 h-ECG and absence of negative T waves in lead aVR was able to predict arrhythmic events at first presentation of the disease.
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Affiliation(s)
- Annina S Vischer
- Medical Outpatient Department, University Hospital Basel, Basel, Switzerland.
| | - Silvia Castelletti
- Istituto Auxologico Italiano, IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Milan, Italy
| | - Petros Syrris
- Institute of Cardiovascular Science, University College of London, London, UK
| | - Rachel Bastiaenen
- Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK; Cardiology Clinical Academic Group, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Chris Miles
- Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK; Cardiology Clinical Academic Group, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Deniz Akdis
- Department of Cardiology, University Heart Center, Zurich, Switzerland
| | - Kris Denhaerynck
- University of Basel, Department of Public Health, Institute of Nursing Science, Basel, Switzerland
| | - Daniel Jacoby
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Ardan M Saguner
- Department of Cardiology, University Heart Center, Zurich, Switzerland
| | - Andrew D Krahn
- Division of Cardiology, University of British Columbia, Vancouver, BC, Canada
| | - Elijah R Behr
- Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK; Cardiology Clinical Academic Group, St George's University Hospitals NHS Foundation Trust, London, UK
| | - William J McKenna
- Institute of Cardiovascular Science, University College of London, London, UK
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10
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Veronese G, Cipriani M, Petrella D, Pedrotti P, Giannattasio C, Garascia A, Oliva F, Klingel K, Frigerio M, Ammirati E. Not every fulminant lymphocytic myocarditis fully recovers. J Cardiovasc Med (Hagerstown) 2019; 19:453-454. [PMID: 29889166 DOI: 10.2459/jcm.0000000000000664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Giacomo Veronese
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda.,Department of Health Science, University of Milano-Bicocca, Milan, Italy
| | - Manlio Cipriani
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda
| | - Duccio Petrella
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda
| | - Patrizia Pedrotti
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda
| | - Cristina Giannattasio
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda.,Department of Health Science, University of Milano-Bicocca, Milan, Italy
| | - Andrea Garascia
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda
| | - Fabrizio Oliva
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda
| | - Karin Klingel
- Cardiopathology, Institute for Pathology, University Hospital Tübingen, Tübingen, Germany
| | - Maria Frigerio
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda
| | - Enrico Ammirati
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda
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11
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2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Heart Rhythm 2018; 15:e73-e189. [DOI: 10.1016/j.hrthm.2017.10.036] [Citation(s) in RCA: 177] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Indexed: 02/07/2023]
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12
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Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation 2018; 138:e272-e391. [PMID: 29084731 DOI: 10.1161/cir.0000000000000549] [Citation(s) in RCA: 249] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | - William G Stevenson
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Michael J Ackerman
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - William J Bryant
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - David J Callans
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Anne B Curtis
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Barbara J Deal
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Timm Dickfeld
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Michael E Field
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Gregg C Fonarow
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Anne M Gillis
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Christopher B Granger
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Stephen C Hammill
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Mark A Hlatky
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - José A Joglar
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - G Neal Kay
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Daniel D Matlock
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Robert J Myerburg
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Richard L Page
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
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Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2018; 72:e91-e220. [PMID: 29097296 DOI: 10.1016/j.jacc.2017.10.054] [Citation(s) in RCA: 700] [Impact Index Per Article: 116.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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14
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Landry CH, Allan KS, Connelly KA, Cunningham K, Morrison LJ, Dorian P. Sudden Cardiac Arrest during Participation in Competitive Sports. N Engl J Med 2017; 377:1943-1953. [PMID: 29141175 PMCID: PMC5726886 DOI: 10.1056/nejmoa1615710] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The incidence of sudden cardiac arrest during participation in sports activities remains unknown. Preparticipation screening programs aimed at preventing sudden cardiac arrest during sports activities are thought to be able to identify at-risk athletes; however, the efficacy of these programs remains controversial. We sought to identify all sudden cardiac arrests that occurred during participation in sports activities within a specific region of Canada and to determine their causes. METHODS In this retrospective study, we used the Rescu Epistry cardiac arrest database (which contains records of every cardiac arrest attended by paramedics in the network region) to identify all out-of-hospital cardiac arrests that occurred from 2009 through 2014 in persons 12 to 45 years of age during participation in a sport. Cases were adjudicated as sudden cardiac arrest (i.e., having a cardiac cause) or as an event resulting from a noncardiac cause, on the basis of records from multiple sources, including ambulance call reports, autopsy reports, in-hospital data, and records of direct interviews with patients or family members. RESULTS Over the course of 18.5 million person-years of observation, 74 sudden cardiac arrests occurred during participation in a sport; of these, 16 occurred during competitive sports and 58 occurred during noncompetitive sports. The incidence of sudden cardiac arrest during competitive sports was 0.76 cases per 100,000 athlete-years, with 43.8% of the athletes surviving until they were discharged from the hospital. Among the competitive athletes, two deaths were attributed to hypertrophic cardiomyopathy and none to arrhythmogenic right ventricular cardiomyopathy. Three cases of sudden cardiac arrest that occurred during participation in competitive sports were determined to have been potentially identifiable if the athletes had undergone preparticipation screening. CONCLUSIONS In our study involving persons who had out-of-hospital cardiac arrest, the incidence of sudden cardiac arrest during participation in competitive sports was 0.76 cases per 100,000 athlete-years. The occurrence of sudden cardiac arrest due to structural heart disease was uncommon during participation in competitive sports. (Funded by the National Heart, Lung, and Blood Institute and others.).
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Affiliation(s)
- Cameron H Landry
- From the Faculty of Medicine (C.H.L., P.D.), Division of Emergency Medicine, Department of Medicine (L.J.M.), the Institute of Health Policy, Management and Evaluation, Faculty of Medicine (L.J.M.), and the Departments of Medicine (P.D.) and Laboratory Medicine and Pathobiology (K.C.), University of Toronto, the Division of Cardiology (K.A.C., P.D.), Rescu (L.J.M.), Li Ka Shing Knowledge Institute (K.A.C., L.J.M.), and the Keenan Research Centre (K.A.C.), St. Michael's Hospital, and the Ontario Forensic Pathology Service (K.C.), Toronto, and the School of Nursing, McMaster University, Hamilton, ON (K.S.A.) - all in Canada
| | - Katherine S Allan
- From the Faculty of Medicine (C.H.L., P.D.), Division of Emergency Medicine, Department of Medicine (L.J.M.), the Institute of Health Policy, Management and Evaluation, Faculty of Medicine (L.J.M.), and the Departments of Medicine (P.D.) and Laboratory Medicine and Pathobiology (K.C.), University of Toronto, the Division of Cardiology (K.A.C., P.D.), Rescu (L.J.M.), Li Ka Shing Knowledge Institute (K.A.C., L.J.M.), and the Keenan Research Centre (K.A.C.), St. Michael's Hospital, and the Ontario Forensic Pathology Service (K.C.), Toronto, and the School of Nursing, McMaster University, Hamilton, ON (K.S.A.) - all in Canada
| | - Kim A Connelly
- From the Faculty of Medicine (C.H.L., P.D.), Division of Emergency Medicine, Department of Medicine (L.J.M.), the Institute of Health Policy, Management and Evaluation, Faculty of Medicine (L.J.M.), and the Departments of Medicine (P.D.) and Laboratory Medicine and Pathobiology (K.C.), University of Toronto, the Division of Cardiology (K.A.C., P.D.), Rescu (L.J.M.), Li Ka Shing Knowledge Institute (K.A.C., L.J.M.), and the Keenan Research Centre (K.A.C.), St. Michael's Hospital, and the Ontario Forensic Pathology Service (K.C.), Toronto, and the School of Nursing, McMaster University, Hamilton, ON (K.S.A.) - all in Canada
| | - Kris Cunningham
- From the Faculty of Medicine (C.H.L., P.D.), Division of Emergency Medicine, Department of Medicine (L.J.M.), the Institute of Health Policy, Management and Evaluation, Faculty of Medicine (L.J.M.), and the Departments of Medicine (P.D.) and Laboratory Medicine and Pathobiology (K.C.), University of Toronto, the Division of Cardiology (K.A.C., P.D.), Rescu (L.J.M.), Li Ka Shing Knowledge Institute (K.A.C., L.J.M.), and the Keenan Research Centre (K.A.C.), St. Michael's Hospital, and the Ontario Forensic Pathology Service (K.C.), Toronto, and the School of Nursing, McMaster University, Hamilton, ON (K.S.A.) - all in Canada
| | - Laurie J Morrison
- From the Faculty of Medicine (C.H.L., P.D.), Division of Emergency Medicine, Department of Medicine (L.J.M.), the Institute of Health Policy, Management and Evaluation, Faculty of Medicine (L.J.M.), and the Departments of Medicine (P.D.) and Laboratory Medicine and Pathobiology (K.C.), University of Toronto, the Division of Cardiology (K.A.C., P.D.), Rescu (L.J.M.), Li Ka Shing Knowledge Institute (K.A.C., L.J.M.), and the Keenan Research Centre (K.A.C.), St. Michael's Hospital, and the Ontario Forensic Pathology Service (K.C.), Toronto, and the School of Nursing, McMaster University, Hamilton, ON (K.S.A.) - all in Canada
| | - Paul Dorian
- From the Faculty of Medicine (C.H.L., P.D.), Division of Emergency Medicine, Department of Medicine (L.J.M.), the Institute of Health Policy, Management and Evaluation, Faculty of Medicine (L.J.M.), and the Departments of Medicine (P.D.) and Laboratory Medicine and Pathobiology (K.C.), University of Toronto, the Division of Cardiology (K.A.C., P.D.), Rescu (L.J.M.), Li Ka Shing Knowledge Institute (K.A.C., L.J.M.), and the Keenan Research Centre (K.A.C.), St. Michael's Hospital, and the Ontario Forensic Pathology Service (K.C.), Toronto, and the School of Nursing, McMaster University, Hamilton, ON (K.S.A.) - all in Canada
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Sanchez O, Campuzano O, Fernández-Falgueras A, Sarquella-Brugada G, Cesar S, Mademont I, Mates J, Pérez-Serra A, Coll M, Pico F, Iglesias A, Tirón C, Allegue C, Carro E, Gallego MÁ, Ferrer-Costa C, Hospital A, Bardalet N, Borondo JC, Vingut A, Arbelo E, Brugada J, Castellà J, Medallo J, Brugada R. Natural and Undetermined Sudden Death: Value of Post-Mortem Genetic Investigation. PLoS One 2016; 11:e0167358. [PMID: 27930701 PMCID: PMC5145162 DOI: 10.1371/journal.pone.0167358] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 11/11/2016] [Indexed: 12/15/2022] Open
Abstract
Background Sudden unexplained death may be the first manifestation of an unknown inherited cardiac disease. Current genetic technologies may enable the unraveling of an etiology and the identification of relatives at risk. The aim of our study was to define the etiology of natural deaths, younger than 50 years of age, and to investigate whether genetic defects associated with cardiac diseases could provide a potential etiology for the unexplained cases. Methods and Findings Our cohort included a total of 789 consecutive cases (77.19% males) <50 years old (average 38.6±12.2 years old) who died suddenly from non-violent causes. A comprehensive autopsy was performed according to current forensic guidelines. During autopsy a cause of death was identified in most cases (81.1%), mainly due to cardiac alterations (56.87%). In unexplained cases, genetic analysis of the main genes associated with sudden cardiac death was performed using Next Generation Sequencing technology. Genetic analysis was performed in suspected inherited diseases (cardiomyopathy) and in unexplained death, with identification of potentially pathogenic variants in nearly 50% and 40% of samples, respectively. Conclusions Cardiac disease is the most important cause of sudden death, especially after the age of 40. Close to 10% of cases may remain unexplained after a complete autopsy investigation. Molecular autopsy may provide an explanation for a significant part of these unexplained cases. Identification of genetic variations enables genetic counseling and undertaking of preventive measures in relatives at risk.
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Affiliation(s)
- Olallo Sanchez
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Oscar Campuzano
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
- Department of Medical Sciences, School of Medicine, University of Girona, Girona (Spain)
| | - Anna Fernández-Falgueras
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
- Cardiovascular Genetics Unit, Hospital Josep Trueta, Girona (Spain)
| | | | - Sergi Cesar
- Arrhythmia Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona (Spain)
| | - Irene Mademont
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Jesus Mates
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | | | - Monica Coll
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Ferran Pico
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Anna Iglesias
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Coloma Tirón
- Cardiovascular Genetics Unit, Hospital Josep Trueta, Girona (Spain)
| | - Catarina Allegue
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Esther Carro
- Arrhythmia Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona (Spain)
| | - María Ángeles Gallego
- Forensic Pathology Service, Institut Medicina Legal Ciències Mèdiques Catalunya, Barcelona (Spain)
| | | | - Anna Hospital
- Forensic Pathology Service, Institut Medicina Legal i Ciències Forenses de Catalunya, Girona (Spain)
| | - Narcís Bardalet
- Forensic Pathology Service, Institut Medicina Legal i Ciències Forenses de Catalunya, Girona (Spain)
| | - Juan Carlos Borondo
- Histopathology Unit, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona (Spain)
| | - Albert Vingut
- Histopathology Unit, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona (Spain)
| | - Elena Arbelo
- Arrhythmia Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona (Spain)
| | - Josep Brugada
- Arrhythmia Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona (Spain)
- Arrhythmia Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona (Spain)
| | - Josep Castellà
- Forensic Pathology Service, Institut Medicina Legal Ciències Mèdiques Catalunya, Barcelona (Spain)
| | - Jordi Medallo
- Forensic Pathology Service, Institut Medicina Legal Ciències Mèdiques Catalunya, Barcelona (Spain)
| | - Ramon Brugada
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
- Department of Medical Sciences, School of Medicine, University of Girona, Girona (Spain)
- Cardiovascular Genetics Unit, Hospital Josep Trueta, Girona (Spain)
- * E-mail:
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Sosa I, Grubesic A. How could analyzing the activity of two matrix metalloproteinases unveil the cause of sudden cardiac death. Int J Immunopathol Pharmacol 2016; 29:712-714. [PMID: 27271976 DOI: 10.1177/0394632016651878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 05/05/2016] [Indexed: 01/25/2023] Open
Abstract
Sudden cardiac death is natural, unexpected death, related to cardiovascular disease. Its postmortem elucidation is significant, as the family of the deceased aspires to prevent other sudden deaths. Irrespective of the proper etiological entity, the myocardial collagen matrix remodels, associated with the progression of cardiovascular diseases. It has become evident that many mediators such as humoral factors, transforming growth factor (TGF)-β1 among them, are involved in the remodeling process. Cardiac remodeling is the balance of regenerative and eliminatory processes that include enzymes involved in the degradation of extracellular matrix (ECM) components. Enzymes capable of degrading native fibrillar collagen are interstitial collagenases, specifically matrix metalloproteinases (MMP)-1 and MMP-8. Here, we suggest a technique of visualizing turnover of collagen in cardiac tissue.
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Affiliation(s)
- Ivan Sosa
- Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Aron Grubesic
- Department of Internal Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia
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Furlanello F, Inama G, Inama L, Cappato R. Sudden unexpected cardiac death as the first symptom in young people: some useful clinical information from a systematic standardized anatomical study. J Cardiovasc Med (Hagerstown) 2016; 17:393-5. [PMID: 27116233 DOI: 10.2459/jcm.0000000000000309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Francesco Furlanello
- aArrhythmia and Electrophysiology Center, IRCCS Humanitas Research Hospital, Milan, & Humanitas Gavazzeni Hospital, Bergamo bDepartment of Cardiology, Clinical Institute Figlie di San Camillo, Cremona cCardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University and Civil Hospital of Brescia, Brescia, Italy
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Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekvål TM, Spaulding C, Van Veldhuisen DJ. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Europace 2015; 17:1601-87. [PMID: 26318695 DOI: 10.1093/europace/euv319] [Citation(s) in RCA: 217] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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19
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Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekvål TM, Spaulding C, Van Veldhuisen DJ. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J 2015; 36:2793-2867. [PMID: 26320108 DOI: 10.1093/eurheartj/ehv316] [Citation(s) in RCA: 2530] [Impact Index Per Article: 281.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
MESH Headings
- Acute Disease
- Aged
- Anti-Arrhythmia Agents/therapeutic use
- Arrhythmias, Cardiac/genetics
- Arrhythmias, Cardiac/therapy
- Autopsy/methods
- Cardiac Resynchronization Therapy/methods
- Cardiomyopathies/complications
- Cardiomyopathies/therapy
- Cardiotonic Agents/therapeutic use
- Catheter Ablation/methods
- Child
- Coronary Artery Disease/complications
- Coronary Artery Disease/therapy
- Death, Sudden, Cardiac/prevention & control
- Defibrillators
- Drug Therapy, Combination
- Early Diagnosis
- Emergency Treatment/methods
- Female
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/therapy
- Heart Transplantation/methods
- Heart Valve Diseases/complications
- Heart Valve Diseases/therapy
- Humans
- Mental Disorders/complications
- Myocardial Infarction/complications
- Myocardial Infarction/therapy
- Myocarditis/complications
- Myocarditis/therapy
- Nervous System Diseases/complications
- Nervous System Diseases/therapy
- Out-of-Hospital Cardiac Arrest/therapy
- Pregnancy
- Pregnancy Complications, Cardiovascular/therapy
- Primary Prevention/methods
- Quality of Life
- Risk Assessment
- Sleep Apnea, Obstructive/complications
- Sleep Apnea, Obstructive/therapy
- Sports/physiology
- Stroke Volume/physiology
- Terminal Care/methods
- Ventricular Dysfunction, Left/complications
- Ventricular Dysfunction, Left/therapy
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