High-sensitivity CRP (hsCRP) is being increasingly used as a marker for cardiac risk assessment and as a prognostic tool in acute coronary syndrome. We analyzed the relation between hsCRP values at admission and in-hospital outcomes in 98 consecutive patients with acute myocardial infarction (AMI) undergoing catheterization. Patients with cardiac events ...

We describe the baseline characteristics, management, and outcomes of acute coronary syndrome (ACS) in patients of age ≤40 in the Gulf region of the Middle East. We studied 8176 hospitalized patients (≤40 years) with ACS. Ten percent (805) of the recruited patients were ≤40 years. The mean age was 37 ...

BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a myocardial disease that predominantly affects the right ventricle (RV). Its hallmark feature is fibrofatty replacement of the RV myocardium. Apoptosis in ARVC/D has been proposed as an important process that mediates the slow, ongoing loss of heart muscle cells which is followed ...

To explore left ventricular filling patterns in patients with a history of previous myocardial infarction (MI) using time-volume curves obtained from conventional cine-cardiac magnetic resonance (CMR) examinations. Consecutive patients with a history of previous MI who were referred for CMR evaluation constituted the study population, and a consecutive cohort of ...

BACKGROUND: Atrial fibrillation (AF) is the most common sustained dysrhythmia and appears to be an independent predictor of sudden cardiac death. The irregular ventricular rhythm contains both linear and non-linear patterns; however, it remains unclear whether vagally mediated effects are present within these patterns. OBJECTIVE: We sought to determine if ...

INTRODUCTION: Inflammation and polymorphonuclear neutrophils are shown to be important in the pathogenesis of acute myocardial infarction (AMI). Neutrophil gelatinase-associated lipocalin (NGAL) is secreted from neutrophils and may increase the proteolytic activity within the atherosclerotic plaque. We aimed to investigate whether the plasma levels of NGAL are higher in patients ...

BACKGROUND: The effects of magnesium loading on the incidence of atrial fibrillation following coronary artery bypass graft surgery (CAGB) are equivocal. None of the previous studies assessed the influence of myocardial extraction of magnesium in these settings. The current trial aims to elucidate whether the incidence of atrial fibrillation following ...

Most studies have confirmed the beneficial effects of autologous bone marrow mononuclear cell (BMMC) transplantation on angina, myocardial perfusion, regional wall motion, and LV ejection fraction (LVEF). Cardiac resynchronization therapy (CRT) has also shown a beneficial effect in patients with heart failure (HF) and electrical/mechanical dyssynchrony. However, the relative contribution ...

PURPOSE: Quantification of cardiac magnetic resonance (CMR) myocardial perfusion remains time consuming since it requires manual interventions to compensate for motion. Thus, the aim of this study was to evaluate a semiautomated registration method. MATERIALS AND METHODS: A rigid edge-based registration algorithm was applied on 10 patients who had rest ...

Eur J Clin Invest 2011 ABSTRACT: Background  Hyponatremia is a known prognostic factor for mortality in patients with heart failure but has not been extensively studied in patients with myocardial infarction (MI). This study was, therefore, designed to evaluate whether plasma sodium and hyponatremia (< 135 mM) are associated with mortality risk ...

Aim We designed this study to evaluate the possibility that dyssynchrony might lead to false-positive myocardial perfusion single photon emission computed tomography myocardial perfusion image (MPS) results in stable angina patients. METHODS AND RESULTS: This study included 61 patients with both clinically diagnosed stable angina and quantitative MPS results who ...

PURPOSE: Dronedarone is a first-line drug to prevent the recurrence of atrial fibrillation according to ESC guidelines. In the recent ATHENA trial, dronedarone reduced mortality and also hospitalization for acute coronary syndrome in patients with atrial fibrillation. This beneficial effect suggests that dronedarone might have also an impact on events ...

Acute myocardial infarction (AMI) is characterized by complex neuroendocrine activation. To investigate catestatin profiles, serial catestatin levels were determined by enzyme-linked immunosorbent assay in the first week after AMI in 50 patients. Catestatin levels reduced at admission and negatively correlated with heart rates; it increased significantly on the third day ...

The importance of improvement in the ejection fraction to the prognosis of revascularized patients with ischaemic left ventricular (LV) dysfunction is uncertain. Eighty-seven patients with ischaemic LV dysfunction (mean ejection fraction 29 ± 8% by biplane Simpson's) had dobutamine echocardiography before revascularization (coronary bypass graft surgery-81, percutaneous intervention-6). Follow-up echocardiograms ...

Objectives: The aim of this study is to verify the study hypothesis of the EXCEL trial by comparing percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) in an EXCEL-like population of patients. Background: The upcoming EXCEL trial will test the hypothesis that left main patients with SYNTAX score ...

Chronotropic incompetence is associated with poorer effort tolerance and worse mortality outcomes, not only in the general cardiac population but also in patients with congenital heart disease. When present in complex patients, pacing options may be limited by difficult pacing access, and an open surgical approach for epicardial lead placement ...

Perioperative myocardial ischemia contributes to postoperative morbidity and mortality. Remote intermittent ischemia (RI) has been shown to benefit patients undergoing coronary artery bypass graft (CABG) surgery by decreasing postoperative cardiac troponin levels. In addition, there is evidence that volatile anesthetics may provide myocardial protection. In this prospective randomized controlled trial ...

Although the popularity of performing percutaneous coronary intervention (PCI) in centres without on-site cardiac surgery backup is increasing, the safety of this practice is unknown. Our goal was to perform a systematic review and meta-analysis of PCI with and without on-site cardiac surgery backup. We identified studies using computerized literature ...

Objectives: To identify predictors of survival in a retrospective multicentre cohort of patients with cardiogenic shock undergoing coronary angiography and to address whether complete revascularization is associated with improved survival in this cohort. Background: Early revascularization is the standard of care for cardiogenic shock. Coronary bypass grafting and percutaneous intervention ...

Myocardial perfusion imaging (MPI) provides highly valuable information for risk stratification and determination of optimal clinical management. The goal of the present study was to assess the prognostic value of myocardial perfusion SPECT for the prediction of future cardiac events in Asian population. Five hundred and ten consecutive patients, who ...

Endothelial progenitor cells (EPC) have a regenerative role in the vascular system. In this study, we aimed to evaluate simultaneously the effects of EPC and inflammatory cells on the presence and the extent of coronary artery disease (CAD) and the grade of coronary collateral growth in patients with clinical suspicion ...

Objective: The aim is to describe our technique of partial direct closure of the ventricular septal defect (VSD) in Tetralogy of Fallot (TOF), and assess its influence on the realignment and remodeling of the left ventricular outflow tract. Methods: Between 2004 and 2010, 32 non-consecutive patients with TOF underwent a ...

OBJECTIVE: It has been shown that the fragmented QRS (fQRS) on electrocardiogram (ECG) signifies regional myocardial scar in patients with non-Q-wave myocardial infarction (MI). We hypothesized that presence of fQRS on ECG may be related with poorly-grown collateral coronary circulation (CCC) in patients with chronic total coronary occlusion (CTO) without ...

Background: Increasing prevalence of obesity is a significant problem in Western countries. Obesity has many effects on cardiovascular structure, function, and hemodynamics. Our aim was to compare the impact of body mass index (BMI) on right ventricular (RV) functions among healthy subjects with conventional echocardiography, tissue Doppler imaging (TDI), and ...

Background: Chronic pulmonary hypertension (cPH) is known to delay pulmonic valve closure resulting in a closely split second heart sound. We decided to measure total duration of right (RV) and left ventricular (LV) outflow tract (RVOT and LVOT) spectral signals using pulsed Doppler to determine if this approach was useful ...

BACKGROUND: There is a significant association between cardiac dysfunction and ischemic stroke. The serious cardiac adverse events (SCAEs) after decompressive craniectomy for malignant cerebral infarction from ischemic stroke were studied retrospectively. METHODS: Retrospective data were collected for preexisting cardiac risk factors, baseline clinical measures, and perioperative SCAEs including life-threatening arrhythmias, ...

BACKGROUND: Recent reports suggest that early repolarization, a common electrocardiographic (ECG) pattern that has been always considered benign, could be a substrate for ventricular arrhythmias and sudden cardiac arrest. METHODS: We examined the associations between early repolarization and markers of ventricular arrhythmogenesis as defined by presence of ventricular late potentials ...

There is a paucity of literature describing the outcomes associated with the use of TandemHeart percutaneous ventricular assist device (PVAD). The literature is limited by analyzing only subsets of patients. We present the clinical outcomes and safety associated with the use of TandemHeart among a series of heterogeneous patients requiring ...

Thrombus in sinus of Valsalva is unusual reason for acute myocardial infarction. We demonstrated a case with floating thrombus in sinus of Valsalva obstructing the right coronary ostium intermittently, and causing cardiogenic shock. The patient was diagnosed with multiplane transesophageal echocardiography and treated successfully with surgical removal of mass. A ...

OBJECTIVE: To derive a model for the identification of left anterior descending (LAD) coronary artery stenoses predisposed to plaque rupture and thrombosis. METHODS: Coronary angiograms of 186 consecutive patients (original sample) with an anterior ST elevation myocardial infarction (STEMI) and a recanalized LAD were reconstructed in the three-dimensional space. Culprit ...

Primary percutaneous coronary intervention is the preferred reperfusion therapy for ST-segment elevation acute myocardial infarction patients within 12 hours of symptom-onset. Routine stent implantation during the procedure significantly reduces the rate of target vessel revascularization, although restenosis still represents a current limitation of the technique. Drug-eluting stents were developed to ...

OBJECTIVES: We sought to determine the frequency of subintimal guidewire tracking during successful percutaneous coronary intervention (PCI) for chronic coronary total occlusions (CTO), and to better understand the procedural implications of this event. BACKGROUND: Successful percutaneous coronary intervention for chronic coronary total occlusion is associated with improved outcomes in patients ...

Despite surgical advances, the Bentall procedure still carries a 2 - 6% rate of acute complications involving the coronary vessels, including ostial stenoses, kinking or pseudoaneurysm formation. We report an unusual case of a patient who developed acute cardiogenic shock within hours following a Bentall procedure, requiring urgent mechanical assist ...

Background: We hypothesized that measurement of B-type natriuretic peptide could identify patients with non-ST elevation acute coronary syndromes at high risk for complications during beta-blocker (esmolol) infusion. Methods: We reviewed the records of 340 consecutive patients admitted with a non-ST elevation acute coronary syndrome. Seventy three (47 males, aged 62 ...

Uncertainty surrounds the optimal revascularization strategy for patients with left main coronary artery disease presenting with acute coronary syndromes (ACSs), and adequately sized specific comparisons of percutaneous and surgical revascularization in this scenario are lacking. The aim of this study was to evaluate the incidence of 1-year major adverse cardiac ...

Heart Rate Turbulence in Post-MI Patients With DM. Background: Previous studies have described the clinical utility of heart rate turbulence (HRT) as an autonomic predictor in risk-stratifying patients after myocardial infarction (MI). Some reports showed that diabetes mellitus (DM) affects the prognostic value of autonomic markers. We assessed the utility of HRT ...

The prognostic role of specific biomarkers of the renin-angiotensin-aldosterone system and sympathetic activation pathways in heart failure has never been investigated in populations with current evidence-weighted treatment. To establish whether the plasma renin activity (PRA), among several neurohormonal biomarkers, is able to predict cardiac events in a population of patients ...

Despite the use of statin therapy and achieving the target for low-density lipoprotein cholesterol, a substantial number of coronary events are not prevented, and residual risk factors remain unsettled. Recently, ezetimibe has been shown to reduce not only low-density lipoprotein cholesterol but also triglyceride (TG) levels. The aim of this ...

OBJECTIVES: To evaluate the cost-effectiveness of alternative approaches to revascularization for patients with 3-vessel or left main coronary artery disease (CAD). BACKGROUND: Previous studies have demonstrated that, despite higher initial costs, long-term costs with bypass surgery (CABG) in multivessel CAD are similar to those for percutaneous coronary intervention (PCI). The ...

BACKGROUND: In the prospective randomized TRIAS pilot study, the bio-engineered Genous™ endothelial progenitor cell capturing stent was compared with the Taxus Liberté(TM) -SR paclitaxel-eluting stent. At 1 year, a statistically non-significant difference in the rates of target vessel failure (cardiac death, myocardial infarction, or target vessel revascularization) was observed. We ...

Described is a 41-year-old man who at age 6 had partial resection of an obstructed right ventricular outflow tract with insertion of a patch and closure of a ventricular septal defect (tetralogy of Fallot). At age 41, cardiac transplantation was performed because of right ventricular outflow patch aneurysm, numerous episodes ...

Brugada syndrome is characterized electrocardiographically by ST segment elevation in the right precordial leads, followed by a negative T wave unrelated to ischemia, electrolyte disturbance or drug effects and prone to rapid polymorphic ventricular tachycardia capable of degenerating into ventricular fibrillation. The ECG pattern may be dynamic and is often ...

Complex fractionated atrial electrograms (CFAE) are morphologically more uniform in persistent longstanding as compared with paroxysmal atrial fibrillation (AF). It was hypothesized that this may result from a greater degree of repetitiveness in CFAE patterns at disparate left atrial (LA) sites in longstanding AF. CFAEs were obtained from recording sites ...

Cardiac resynchronization therapy reduces mortality and morbidity in heart failure patients with wide QRS and severe impairment of left ventricular systolic function, who are symptomatic despite optimal medical therapy. However, a high percentage of patients fail to show clinical or echocardiographic response to this treatment. Beyond current selection criteria, other ...

Abstract Background: The aim of this study is to analyse the relation between red blood cells, platelets morphology and acute myocardial infarction (AMI), and to assess whether they could supplement the role of traditional cardiac biomarkers in the early identification of patients with AMI. Methods: All consecutive patients admitted to ...

BACKGROUND: While patients with coronary artery disease (CAD) and cerebrovascular disease share similar risk factor profiles, data on whether IS can be considered a "CAD equivalent" are limited. We aimed to determine whether ischemic stroke is an independent predictor of CAD by using cardiac computed tomography angiography (CTA). METHODS: We ...

The causes of coronary microvascular dysfunction (CMVD) in patients with cardiac syndrome X (CSX) are largely unknown. Common cardiovascular risk factors (CVRFs) and increased markers of inflammation have been associated with CMVD in some studies, but their role in determining CMVD in CSX patients remains poorly known. We studied 71 ...

Recognizing the etiology of patients with left ventricular dysfunction (LVD) is essential for the risk stratification and treatment selection. We report the case of a 59-year-old man suspected of ischemic LVD with non acute symptoms studied with whole-heart cardiac magnetic resonance imaging including noninvasive coronary angiography and in whom we ...

The care of cardiovascular patients experiencing a myocardial infarction (MI) has evolved from simple bed rest and relief of pain to complex interventions and multiple medications that target both the short- and long-term risks associated with atherosclerosis and ischemia. Even the terminology has changed, from MI to acute coronary syndromes ...

Background Accurate measurements for determining cardiac index can be obtained while patients are supine in bed at various backrest elevations. It is not clear if these measurements are accurate when patients are in a bedside chair. Objective To determine if cardiac index based on measurements obtained with the patient in ...