Introduction: Peripartum cardiomyopathy is a rare disease that is difficult to diagnose and treat. Clinical findings are similar with heart failure. New treatments are needed in addition to the treatment of heart failure.
Case Report: A 32-year-old woman presented with symptoms of heart failure 4 days after first delivery. Chest X-ray showed cardiomegaly. Serum BNP level was high. Transthoracic echocardiography (TTE) indicated dilated left atrium and left ventricle, severe mitral regurgitation and ventricular dysfunction. The global longitudinal strain was – 9.1%. Cardiac magnetic resonance imaging (MRI) revealed mid-myocardial staining detected in late phase images. Concomitant bromocriptine (2,5 mg po twice a day for 15 days and then 2,5 mg po once a day for 15 days) was used with standard heart failure therapy. At 6 months, TTE and cardiac MRI revealed normal biventricular function and size. Global longitudinal strain was –14%.
Conclusion: Patients with peripartum cardiomyopathy may benefit from bromocriptine.
Cardiac sarcoidosis is symptomatic in only 5% of patients, and it is an independent predictor of mortality and carries a very poor prognosis. In our study, we aimed to assess left ventricle (LV) systolic and diastolic functions with tissue Doppler imaging (TDI) in patients with early grade pulmonary sarcoidosis.The study population included 55 patients with Grade I-II sarcoidosis (41 females, 14 males, mean age: 47.9 ± 10.1) and 22 healthy subjects. LV lateral and septal wall early myocardial peak velocity (E(m)), late myocardial peak velocity (A(m)), E(m) to A(m) ratio, myocardial relaxation time (RT(m)), myocardial systolic wave (S(m)) velocity, isovolumic acceleration (IVA), myocardial pre-contraction time (PCT(m)), contraction time (CT(m)), and the PCT(m) to CT(m) ratio were measured. No statistically significant difference was detected between the groups according to age, gender, body mass index, systolic and diastolic blood pressure, or heart rate. LV systolic parameters, LV septal, and lateral wall IVA, were significantly lower, and the PCT(m) to CT(m) ratio (P = 0.026) was higher at the septal annulus as compared with control group. E(m), a LV diastolic parameter, was significantly lower at the septal annulus.Cardiac sarcoid involvement is not rare and is treatable. It should be identified at an early stage. TDI, especially IVA, may be a suitable tool for the early detection of subclinical LV sarcoid involvement.
Objectives: Kidney transplantation recipients (KTRs) have higher cardiovascular complications risk compared to the general population. Cardiovascular risk factors (CVRF, Traditional and non-traditional) are widely studied to understand the causes of increased cardiovascular disease (CVD) risk in KTRs. Fetuin-A prevents from vascular calcification (VC) by inhibiting production and collapsing of apatite crystals to the vascular wall. The relationship between fetuin-A levels and CVRF in KTRs was investigated in this study. Methods: Sixty-two KTRs with no prior CVD history participated. Anthropometrical, laboratory (fetuin-A, inflammation markers, antioxidants, lipid peroxidation products) and cardiological (echocardiographic, pulse wave velocity) measurements were performed. Participants were divided into two groups according to normal (≥ 0.5 g/L, n = 32, NFA) and low (< 0.5 g/L, n = 30, LFA) fetuin-A levels according to manufacturer’s reference range, and the results were compared. Results: No significant difference was observed in demographic features, body mass index, systolic and diastolic blood pressures, left ventricle mass index, waist and hip circumferences, left ventricle hypertrophy and waist-hip ratios between the two groups (p > 0.05). The ratios of drug usage such as immunosuppressives, anti-hypertensives and statin were comparable between two groups. Parathormone levels were significantly higher in the NFA group (p = 0.015) and glomerular filtration rate was calculated significantly higher in LFA group (p = 007). The comparison of other CVRF reveals no significant difference (p > 0.05). Conclusions: Although many CVRF improved in KTRs, subclinical inflammation markers were still higher than the healthy population. Identification and early recognition of CVRF in high-risk individuals may contribute to the reduction of cardiovascular mortality. In our study, we observed no significant relationship between fetuin-A levels and CVRFs. We evaluated the relationship between serum fetuin-A levels on cardiovascular risk factors by its role in pathophysiology.
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