No abstract

High-dose mitoxantrone therapy is associated with an excellent remission rate but with a significantly increased risk of clinical and subclinical early cardiotoxicity and heart failure. Mitoxantrone-induced systolic dysfunction is evident from reduction in EF, increase in Tei index, and significant reduction in GLS and GCS. Baseline impaired ventricular relaxation evident from higher E/e' ratio and lower E/A ratio independently predicts increased risk of mitoxantrone-induced early cardiotoxicity.

Aims Despite three decades of study, it is still challenging to discriminate acute apical variant stress cardiomyopathy (AVSCM) from acute left anterior descending‐myocardial infarction (LAD‐MI) at the time of presentation. A biomarker or practical imaging modality that can differentiate these two entities is highly desirable. Our objective was to characterize left ventricular (LV) mechanical deformation using 2‐dimensional (2D) echocardiographic strain imaging in an attempt to discriminate AVSCM from LAD‐MI at presentation. Methods and Results We studied 108 women (60 AVSCM, 48 ST segment elevation LAD‐MI). All underwent echocardiography within 48 hours of presentation. 2D longitudinal strain (LS) from an 18‐segment LV model was performed, with global LS (GLS) taken as the average of all 18 segments. GLS was abnormal, but did not differentiate AVSCM from LAD‐MI. Mean LS of the basal and mid‐anterior, basal, and mid‐anteroseptum segments were significantly lower in LAD‐MI vs AVSCM group (−14 ± 9% vs −20 ± 8%; −11 ± 7% vs −14 ± 6%; −9 ± 8% vs −14 ± 8%; −9 ± 7% vs −13 ± 5%, respectively, all P ≤ .05). Mean LS of the basal inferior and inferolateral segments was significantly higher in the LAD‐MI vs. AVSCM group (−19 ± 9% vs −13 ± 7%; −23 ± 11% vs −18 ± 7%, respectively, all P ≤ .05). Using ROC curve analysis, segmental strain ratio of average basal inferior and inferolateral segments LS to average mid‐ and basal anterior and anteroseptum segments LS of ≥1.58 was 90% specific for LAD‐MI [area under the curve (AUC) 0.87; P < .001]. Conclusion Longitudinal strain patterns are useful in discriminating AVSCM from LAD‐MI patients at presentation and may be valuable in stratifying patients for invasive evaluation.

Carrion's disease (CD), is a human bartonellosis, that is, endemic in the Andes of Peru, Ecuador, and Colombia. Bartonella bacilliformis, a native hemotrophic bacteria, is the causative agent of CD, and the interaction with the host could have produced changes in the gene frequencies of erythrocyte antigens. The goal here is to investigate the relationship between allele frequencies of blood group systems MNS, Diego, and Duffy and the clinical phases of CD, within a genetic context. In this associative and analytical study, 76 individuals from Bagua Grande, the province of Utcubamba, and the department of Amazonas in Peru, were enrolled. Forty of them resided in Tomocho-Collicate-Vista Hermosa area (high prevalence of cases in chronic phase, verrucous, or eruptive phase, without previous acute phase). Thirty-six individuals were from the area of Miraflores (high prevalence of cases in acute phase only) and were evaluated for blood group systems MNS, Diego, and Duffy. This study constitutes one of the first attempts at evaluating the genetic factors and clinical phases of CD. No significant statistical differences (P > 0.05) between allele frequencies of blood groups MNS, Diego, and Duffy and the prevalence of chronic and acute phases were detected in the two areas of Amazonas, Peru.