Lower end-systolic peak longitudinal strain obtained by 2D speckle tracking was a predictor of NSVT in HCM patients. This parameter could become a useful tool in stratifying SCD risk in this population.
BackgroundHeart failure (HF) is a highly prevalent syndrome. Although the long-term
prognostic factors have been identified in chronic HF, this information is
scarcer with respect to patients with acute HF. despite available data in
the literature on long-term prognostic factors in chronic HF, data on acute
HF patients are more scarce.ObjectivesTo develop a predictor of unfavorable prognostic events in patients
hospitalized for acute HF syndromes, and to characterize a group at higher
risk regarding their clinical characteristics, treatment and outcomes.Methodscohort study of 600 patients admitted for acute HF, defined according to the
European Society of Cardiology criteria. Primary endpoint for score
derivation was defined as all-cause mortality and / or rehospitalization for
HF at 12 months. For score validation, the following endpoints were used:
all-cause mortality and / or readmission for HF at 6, 12 and 24 months. The
exclusion criteria were: high output HF; patients with acute myocardial
infraction, acute myocarditis, infectious endocarditis, pulmonary infection,
pulmonary artery hypertension and severe mitral stenosis.Results505 patients were included, and prognostic predicting factors at 12 months
were identified. One or two points were assigned according to the odds ratio
(OR) obtained (p < 0.05). After the total score value was determined, a
4-point cut-off was determined for each ROC curve at 12 months. Two groups
were formed according to the number of points, group A < 4 points, and
group B = 4 points. Group B was composed of older patients, with higher
number of comorbidities and predictors of the combined endpoint at 6, 12 and
24 months, as linearly represented in the survival curves (Log rank).ConclusionsThis risk score enabled the identification of a group with worse prognosis at
12 months.
Adults with chronic immunosuppressive conditions are at an increased risk for Streptococcus agalactiae endocarditis, which is typically characterized by acute onset, presence of large vegetations, rapid valvular destruction and frequent complications. We report a rare case of a 74 years old man presenting with fever, renal infarction, ischemic stroke and uveitis. Infective endocarditis was diagnosed and Streptococcus agalactiae was isolated in blood cultures. A multiple myeloma Ig G-K was also diagnosed. The infective endocarditis was successfully treated with a course of benzylpenicillin and gentamicin. The authors highlight the severity of vascular embolic disease present in this case and the diagnostic challenge. They also intend to remind about the association between Streptococcus agalactiae endocarditis and chronic diseases, despite its low reported prevalence.
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