TY  - JOUR
A1  - Liu, Dan
A1  - Hu, Kai
A1  - Niemann, Markus
A1  - Herrmann, Sebastian
A1  - Cikes, Maja
A1  - Störk, Stefan
A1  - Beer, Meinrad
A1  - Gaudron, Philipp Daniel
A1  - Morbach, Caroline
A1  - Knop, Stefan
A1  - Geissinger, Eva
A1  - Ertl, Georg
A1  - Bijnens, Bart
A1  - Weidemann, Frank
T1  - Impact of Regional Left Ventricular Function on Outcome for Patients with AL Amyloidosis
JF  - PLoS ONE
N2  - Objectives
The aim of this study was to explore the left ventricular (LV) deformation changes and the potential impact of deformation on outcome in patients with proven light-chain (AL) amyloidosis and LV hypertrophy.

Background
Cardiac involvement in AL amyloidosis patients is associated with poor outcome. Detecting regional cardiac function by advanced non-invasive techniques might be favorable for predicting outcome.

Methods
LV longitudinal, circumferential and radial peak systolic strains (Ssys) were assessed by speckle tracking imaging (STI) in 44 biopsy-proven systemic AL amyloidosis patients with LV hypertrophy (CA) and in 30 normal controls. Patients were divided into compensated (n = 18) and decompensated (n = 26) group based on clinical assessment and followed-up for a median period of 345 days.

Results
Ejection fraction (EF) was preserved while longitudinal Ssys (LSsys) was significantly reduced in both compensated and decompensated groups. Survival was significantly reduced in decompensated group (35% vs. compensated 78%, P = 0.001). LSsys were similar in apical segments and significantly reduced in basal segments between two patient groups. LSsys at mid-segments were significantly reduced in all LV walls of decompensated group. Patients were further divided into 4 subgroups according to the presence or absence of reduced LSsys in no (normal), only basal (mild), basal and mid (intermediate) and all segments of the septum (severe). This staging revealed continuously worse prognosis in proportion to increasing number of segments with reduced LSsys (mortality: normal 14%, mild 27%, intermediate 67%, and severe 64%). Mid-septum LSsys<11% suggested a 4.8-fold mortality risk than mid-septum LSsys≥11%. Multivariate regression analysis showed NYHA class and mid-septum LSsys were independent predictors for survival.

Conclusions
Reduced deformation at mid-septum is associated with worse prognosis in systemic amyloidosis patients with LV hypertrophy.
KW  - regression analysis
KW  - ejection fraction
KW  - echocardiography
KW  - cardiac transplantation
KW  - deformation
KW  - amyloidosis
KW  - prognosis
KW  - stem cell transplantation
Y1  - 2013
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-130293
VL  - 8
IS  - 3
ER  - 
TY  - JOUR
A1  - Gassenmaier, Tobias
A1  - Gorski, Armin
A1  - Aleksic, Ivan
A1  - Deubner, Nikolas
A1  - Weidemann, Frank
A1  - Beer, Meinrad
T1  - Impact of cardiac magnet resonance imaging on management of ventricular septal rupture after acute myocardial infarction
JF  - World Journal of Cardiology
N2  - A 74-year-old man was admitted to the cardiac catheterization laboratory with acute myocardial infarction. After successful angioplasty and stent implantation into the right coronary artery, he developed cardiogenic shock the following day. Echocardiography showed ventricular septal rupture. Cardiac magnet resonance imaging (MRI) was performed on the critically ill patient and provided detailed information on size and localization of the ruptured septum by the use of fast MRI sequences. Moreover, the MRI revealed that the ventricular septal rupture was within the myocardial infarction area, which was substantially larger than the rupture. As the patient’s condition worsened, he was intubated and had intra-aortic balloon pump implanted, and extracorporeal membrane oxygenation was initiated. During the following days, the patient’s situation improved, and surgical correction of the ventricular septal defect could successfully be performed. To the best of our knowledge, this case report is the first description of postinfarction ventricular septal rupture by the use of cardiac MRI in an intensive care patient with cardiogenic shock and subsequent successful surgical repair.
KW  - Cardiac magnetic resonance imaging
KW  - Ventricular septal rupture
KW  - Myocardial infarction
KW  - surgical repair
KW  - Extracorporeal membrane oxygenation
Y1  - 2013
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-96562
ER  -