PMID- 34263118
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220424
IS  - 2514-2119 (Electronic)
IS  - 2514-2119 (Linking)
VI  - 5
IP  - 6
DP  - 2021 Jun
TI  - Normalization of left ventricular filling pressure after cardiac surgery for the 
      Loeffler's endocarditis: a case report.
PG  - ytab189
LID - 10.1093/ehjcr/ytab189 [doi]
LID - ytab189
AB  - BACKGROUND: Loeffler endocarditis is a rare restrictive cardiomyopathy, 
      characterized by hypereosinophilia and fibrous thickening of the endocardium 
      causing progressive onset of heart failure and appearance of thrombi on the walls 
      of the heart chambers. CASE SUMMARY: A 72-year-old man known for hypertension and 
      dyslipidaemia consults for progressive dyspnoea up to New York Heart Association 
      (NYHA) Classes 2-3 over 3 weeks. The biological balance sheet shows a high 
      eosinophil level and an echocardiography shows a mild echodensity fixed to the 
      left apex. After exclusion of a secondary cause of hypereosinophilia, diagnosis 
      of endomyocardial fibrosis in the context of a hypereosinophilic syndrome (HES) 
      is therefore retained. The patient's clinical presentation with cardiac 
      involvement leads us to start a treatment with corticosteroids. The patient is 
      then regularly followed every 6 months with an initially stable course without 
      complications. Two years later, he develops progressive signs of heart failure. 
      Transthoracic echocardiography shows a left ventricular (LV) dilatation with a 
      normal ejection fraction, but decreased volume due to a large echodense mass in 
      the apex, and moderate aortic regurgitation caused by myocardial infiltration. In 
      view of this rapid evolution, resection of the LV mass with concomitant aortic 
      valve replacement is performed. Pathology confirms eosinophilic infiltration. The 
      clinical course is very good with a patient who remains stable with dyspnoea NYHA 
      Classes 1-2, and echocardiography at 1 year shows a normalization of LV filling 
      pressure. DISCUSSION: HES represents a heterogeneous group of disorders 
      characterized by overproduction of eosinophils. One of the major causes of 
      mortality is associated cardiac involvement. Endocardial fibrosis and mural 
      thrombosis are frequent cardiac findings. Echocardiography plays a crucial role 
      in initial diagnosis of endomyocardial fibrosis, and for regular follow-up in 
      order to adapt medical treatment and monitor haemodynamic evolution of the 
      restrictive physiology and of valvular damage caused by the disease's evolution. 
      This case also shows that surgery can normalize filling pressure and allow a 
      clear improvement on the clinical condition even at the terminal fibrotic state.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Carcaterra, Andrea
AU  - Carcaterra A
AUID- ORCID: 0000-0002-0520-5385
AD  - Department of Cardiology, University Hospital of Geneva, Rue 
      Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
FAU - Mock, Stephane
AU  - Mock S
AD  - Department of Cardiology, University Hospital of Geneva, Rue 
      Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
FAU - Muller, Hajo
AU  - Muller H
AD  - Department of Cardiology, University Hospital of Geneva, Rue 
      Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
FAU - Testuz, Ariane
AU  - Testuz A
AUID- ORCID: 0000-0002-6139-3069
AD  - Department of Cardiology, University Hospital of Geneva, Rue 
      Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
LA  - eng
PT  - Case Reports
DEP - 20210628
PL  - England
TA  - Eur Heart J Case Rep
JT  - European heart journal. Case reports
JID - 101730741
PMC - PMC8274654
OTO - NOTNLM
OT  - Case report
OT  - Filling pressure
OT  - Hypereosinophilia
OT  - LV mass
OT  - Loeffler endocarditis
OT  - Restrictive cardiomyopathy
EDAT- 2021/07/16 06:00
MHDA- 2021/07/16 06:01
PMCR- 2021/06/28
CRDT- 2021/07/15 06:26
PHST- 2020/03/22 00:00 [received]
PHST- 2020/04/15 00:00 [revised]
PHST- 2021/03/12 00:00 [accepted]
PHST- 2021/07/15 06:26 [entrez]
PHST- 2021/07/16 06:00 [pubmed]
PHST- 2021/07/16 06:01 [medline]
PHST- 2021/06/28 00:00 [pmc-release]
AID - ytab189 [pii]
AID - 10.1093/ehjcr/ytab189 [doi]
PST - epublish
SO  - Eur Heart J Case Rep. 2021 Jun 28;5(6):ytab189. doi: 10.1093/ehjcr/ytab189. 
      eCollection 2021 Jun.