Journal of cardiac failure
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Acute dyspnea poses a diagnostic challenge for physicians, and the current methods in differentiating cardiac from non-cardiac causes have been limited to date. Recently, the brain natriuretic peptide (BNP) rapid test has been validated in the emergency room. Nevertheless, the early accumulation of fluid in the interstitial space in the body and in the lungs, which characterizes patients with ADHF, is well estimated by BIA. We investigate whether bioelectrical impedance analysis (BIA) can serve as a noninvasive diagnostic tool in the differential diagnosis of acute decompensated heart failure (ADHF) in the emergency department (ED). ⋯ Our data suggest that Seg and WB BIA are a useful, simple, rapid, and noninvasive diagnostic adjunct in the early diagnosis of dyspnea from ADHF.
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Biventricular (Biv) pacemaker optimization is underused because of time and echo skill required. We evaluated radial artery tonometry during echo-guided Biv optimization of atrioventricular (AV) and interventricular (VV) delays. ⋯ AV and VV optimization by echocardiography produces significant improvement in LV(E-dur) and RA(E-dur). Radial artery tonometry may provide a simple noninvasive method to assist in AV delay optimization.
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Electromechanical activation time (EMAT) is a systolic time interval defined as the time from Q-wave onset to the peak first heart sound. We assessed the correlation between systolic dysfunction and EMAT calculated using computerized acoustic cardiography. ⋯ An abnormal %EMAT was strongly associated with impaired LV contractility but had no association with LV filling pressures. This noninvasive, simple, point-of-care diagnostic test has potential applications when echocardiography cannot be obtained in a timely fashion to assess systolic function.
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Trastuzumab is a recombinant humanized monoclonal antibody used for the treatment of advanced breast cancer. It improves survival and increases response to chemotherapy. ⋯ The objective of this review is to summarize facts about trastuzumab-induced cardiotoxicity and to highlight the areas of future investigations. We searched PubMed for trials involving trastuzumab used as an adjuvant therapy for breast cancer, including the metastatic breast cancer setting, and focused on cardiotoxicity.
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Skeletal muscle microcirculation impairment in patients with chronic heart failure (CHF) seems to correlate with disease severity. We evaluated the microcirculation by near-infrared spectroscopy (NIRS) occlusion technique before and after inotropic infusion. ⋯ Peripheral muscle microcirculation as assessed by NIRS is impaired in patients with CHF. This impairment is partially reversed by infusion of inotropic agents in patients with ESCHF.