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Endothelin (ET) is a potent vasoconstrictor peptide implicated in numerous human diseases, including ischemic cardiomyopathy (ICM). ET binds to receptors ET A and ET B . Specific ET receptors were characterized in left atria of patients with end-stage heart failure due to ischemic cardiomyopathy (ICM) ( n = 9) and healthy controls ( n = 9). Saturation assays revealed a K d and B max of 28 ± 8 pM and 87 ± 22 fmol mg −1 of protein, respectively, from healthy atria and 50 ± 9 pM and 162 ± 19 fmol mg −1 of protein, respectively, from diseased atria ( p A receptors using BQ123, 55% ± 5 and 66% ± 4 in healthy and diseased atria, respectively ( p B using BQ3020 was 55% ± 14 in healthy and 59% ± 10 in diseased atria. Microautoradiography studies showed a greater number of ET receptors, predominately ET A , existed in the myocardial layer of diseased atria compared with healthy atria. The percentage of occupied area was greater in the endocardium than the epicardium in diseased atria. These results showed an increase in the ET A /ET B receptor system in the failing human heart compared with the non-failing human heart.

Background. Standard orthotopic heart transplantation produces important anatomic and functional atrial alterations with subsequent thrombotic risk. Therefore the aim of this study was to analyze the prevalence and evolution of spontaneous echocardiography, atrial thrombi and embolic events. Patients and method. 52 consecutive transplanted patients were analyzed with transesophageal echocardiography and hemodynamic studies performed at 15 days and one year after transplantation. Results. Spontaneous echocardiography contrast was present in 27 patients (52%). Ten atrial thrombi were observed (19.2%), 9 with spontaneous echocardiography contrast. Six atrial thrombi appeared on day 15 and 4 after one year (with spontaneous echocardiography contrast on the previous study). Using multiple logistic regression analysis left atrial size was the only independent predictor factor for spontaneous echocardiography contrast (OR = 1.27; 95% CI, 1.09-1.54) and was an important predictor factor of atrial thrombi formation (OR = 1.19; 95% CI, 1.04-1.42). Likewise, the main predictor of atrial thrombi was the presence of spontaneous echocardiography contrast (OR = 116; 95% CI, 8.4-999). The hemodynamic pattern did not predict either the presence of spontaneous echocardiography contrast or atrial thrombi. The global incidence of embolic events was 4% less than previously described. Conclusions. The incidence of atrial thrombi and spontaneous echocardiographic contrast after standard orthotopic heart transplantation was 19.2% and 52%, respectively. An enlarged atrium and/or spontaneous echocardiography contrast was found to increase the risk of atrial thrombi. Considering the dynamic nature of atrial thrombi formation, periodical transesophageal echocardiography studies are recommended after heart transplantation.

We report a case of myocardial tuberculosis in an 18-year-old male. He had been diagnosed with isolated asymmetrical septal hypertrophy cardiomyopathy and presented severe congestive heart failure for 4 months. Echocardiography and magnetic resonance studies showed localized echodense shadows and cavities in the thickness of the left ventricle myocardium with severe myocardial dysfunction. No contraindications for cardiac transplantation were found and this was planned and performed. Histology of the myocardium was consistent with the diagnosis of myocardial tuberculosis. The patient's post-operative course was uneventful, and he was discharged with anti-tuberculosis medication.