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  • ISSN: 2333-6676
    Volume 4, Issue 7
    Research Article
    Ines Paola Monte*, Silvia Gentile, Margherita Stefania Rodolico, Vera Elena Bottari, Valentina Losi, Claudia Romano, and Giovanni Duro
    Cardiac involvement in Anderson-Fabry Disease, a rare X-linked genetic lysosomal storage disorder, is common and more than 50% of patients develops a concentric non-obstructive left ventricle hypertrophy.
    Aim: Aim of study was to identify early signs of myocardial involvement in patients with Fabry Disease without hypertrophy, using 2D Speckle Tracking Echocardiography to evaluate the Left Ventricle Longitudinal Strain (GLS).
    We evaluated Echocardiograms of 21 patients (7 males, 14 females) with diagnosis of Fabry Disease. For this study we reported the values of the LV mass indexed by body surface area (LVMi), E wave of mitral flow, the systolic (S') and early diastolic myocardial velocity (E') of tissue Doppler at mitral annulus, E/E' ratio and GLS. Patients were grouped according to the presence or absence of LV hypertrophy in two groups: with LVMi >115 g/m2 (LVH) and with LVMi =115 g/m2 (noLVH); the data were compared to normal group (N) matched for age and BSA. LVH pts (2M-3F, 53 ± 9y) showed: Enzyme activity 1,54 ± 1,98; LVMi g/m2150 ± 23,6; E cm/s 70,4 ± 23,7 (vs. p<0,196); S'cm/s 5,4 ± 1,1 (vs. p<0,001); E' 5,2 ± 2,7 (vs. p<0,001); E/E' 16,96 ± 11,8 (vs. p<0,0005); GLS% -11,7 ± 5,4. (vs. p<0,001).NoLVH pts (5M-11F, 33 ± 19y) showed: Enzyme activity 3,43 ± 3,03; LVMi g/m270 ± 16,4 (vs. p<0,719); E cm/s 82,1 ± 29,6 (vs. p<0,807); S' cm/s 7,2 ± 1,6 (vs. p<0,001); E' 12 ± 4,1 (vs. p<0,204); E/E' 8 ± 3 (vs. p<0,0005); GLS% - 18,4 ± 2,8 (vs. p<0,02). Our study shows that even in patients without hypertrophy, then in the pre-clinical stage, the longitudinal ventricle function, expressed by GLS is already precociously altered.
    Review Article
    Will Eysenck and Neil Sulke*
    Atrial fibrillation (AF) is the most common sustained arrhythmia, with a prevalence of approximately 1.60% in the United Kingdom [1]. AF is associated with increased rates of death, stroke and other thromboembolic events, heart failure and hospitalisations, degraded quality of life, reduced exercise capacity, and left ventricular dysfunction [1-3]. Hypertension occurs in 65-70% of AF patients, making this the most common co-morbidity found in AF registries in Europe [4]. Early detection and treatment of hypertension is a crucial component of the management of AF. However, non-invasive assessment of blood pressure (BP) in AF has traditionally proven challenging and inaccurate. Novel brachial cuffs utilising suprasystolic waveform algorithms allow accurate assessment of central BP and augmentation index, a measure of arterial stiffness. It remains to be determined whether these devices have a niche in determining authentic assessment of BP in AF.
    Case Report
    Jaime C. Morris*, B. Scott Cook, Mark S. Rasnake, and Bret A. Rogers
    An 80-year-old female with history of end stage renal disease on hemodialysis and a transcatheter aortic valve replacement (TAVR) eight months prior was transferred to our facility for treatment of acute embolic right lower extremity ischemia. A transesophageal echocardiogram performed to evaluate for the source of emboli demonstrated large mobile vegetation on the aortic valve prosthesis. Blood cultures isolated methicillin-susceptible Staphylococcus aureus. Multiple complications developed, including small cerebral infarcts contributing to acute encephalopathy, acute liver failure secondary to rifampin therapy, and coagulopathy with multiple episodes of bleeding. She was discharged to a rehabilitation facility to complete a six-week course of cefazolin followed by lifelong oral antibiotic suppression therapy with cephalexin. She ultimately required below-the knee amputation of the ischemic limb.
    Francisco Alvarez, Bart De Boeck, Katharina Glatz, Miriam Nowack, and Peiman Jamshidi
    We present a 65 year-old woman with history of exercise-induced retrosternal pain and dyspnea. Both coronary angiography and CMR-Imaging showed evidence of microvascular dysfunction. After several admissions with acute coronary syndrome and heart failure, a myocardial biopsy was performed which revealed abundant AL amyloid deposits? We present this case in detail and review articles.
    Natraj Setty HS*, Raghu TR, Jayashree Kharge, Geetha BK, Shivanand S Patil, Santhosh Jadav, Rahul Patil, and Manjunath CN
    Thracoabdominal aneurysms are an important cardiovascular disease. They are a complex disease with both genetic and environmental factors contributing to the disease process, which involves formation, growth, and rupture. Difficult surgical challenges not only because of the magnitude of the surgery but also the propensity of patients to develop renal and spinal cord dysfunction after repair. We report case of Thracoabdominal aneurysm who presented with Dyspnoea on exertion, chest pain and back pain since 4 months, Patient was planned for surgical repair of the aneurysm.
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