We conducted a prospective study of the clinical outcomes and health-related quality of life after implantation of the CorCap support device (Acorn Cardiovascular Inc, St Paul, MN) for dilated cardiomyopathy. The criteria adopted for CorCap implantation were dilated cardiomyopathy (left ventricular [LV] end-diastolic diameter ≥ 60 mm, LV ejection fraction ...

Thymic infarcts are rare, and mainly occur following an occlusive event of stromal vessels. Distinguishing thymic infarcts from anterior mediastinal masses is important due to different treatment plans and prognoses. We describe an unusual case of a thymic infarct in a patient with the sudden onset of chest pain. In ...

The aim of this study was to evaluate the relation of basal and hyperemic coronary flow with myocardial functional improvement in patients with previous myocardial infarction undergoing elective percutaneous coronary intervention (PCI). Coronary flow was measured using transthoracic Doppler echocardiography in 50 patients (41 men; mean age, 53 ± 8 ...

Assessment and management of heart failure (HF) in older adults may be simplified and structured by the mnemonic DEFEAT-HF: Diagnosis, Etiology, Fluid volume, Ejection fraction, And Treatment of Heart Failure. A clinical diagnosis and etiology of HF can often be established during history and physical examination. Fluid volume status must be assessed ...

Seven cases are reported of acute right coronary artery occlusion and predominantly right ventricular myocardial infarction with typical ST-segment elevation in the precordial leads resembling acute anterior wall myocardial infarction. These electrocardiograms were compared with those of 5 unselected patients who had combined inferior and anterior ST-segment elevation due to ...

Because of the shortage of donors for heart transplantation, surgical ventricular reconstruction (SVR) has been under development to treat end-stage heart failure due to a dilated left ventricle. The operative procedures have been developed and modified based on the clinical results and preoperative findings of several examinations. SVR is performed ...

Myocardial ischemia is a strong trigger of B-type natriuretic peptide (BNP) release. As ischemia precedes necrosis in acute myocardial infarction, we hypothesized that BNP might be useful in the early diagnosis and risk stratification of patients with acute chest pain. In a prospective, international multicenter study, BNP was measured in ...

PURPOSE: Here, we describe the efficiency of interventional electrophysiology therapy in a critically ill patient with heart failure because of incessant AV node reentrant tachycardia after surgical port implantation. METHODS: Electrophysiology diagnostic and radio frequency ablation were utilized in the study. RESULT: We presented a 78-year-old patient with colorectal cancer, ...

A congenital left ventricular diverticulum is a rare cardiac malformation. It is a developmental anomaly that occurs during embryogenesis. Presentations vary from asymptomatic patients to sudden death. To date, the treatment described has been surgical correction. The authors report the first transcatheter closure of an isolated congenital left ventricular diverticulum ...

Cardiac arrest is classified based on whether it is treatable using defibrillation or not. It is classified as shockable rhythm (ventricular fibrillation and pulseless ventricular tachycardia, or non-shockable (asystole and pulseless electrical activity). We present a case of a 72-year-old male Saudi patient not known to have any medical illness ...

Aims: The aim of the present study was to examine the impact of the transradial approach (TRA), in comparison to the transfemoral approach (TFA), on PCI-related bleeding and patient outcomes in acute coronary syndrome patients who underwent PCI in the OASIS-5 trial. Methods and results: The primary outcome (death, myocardial ...

Aims: The relationship between stent design and periprocedural myocardial infarction is unclear. The newest type of drug-eluting stent (DES), the everolimus-eluting stent (EES), has thinner strut and polymer thickness and a small amount of drug. EES use, therefore, could be related to less myocardial necrosis post-percutaneous coronary intervention (PCI). This ...

Background Gastrointestinal bleeding is a hemorrhagic complication after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI). Objectives To determine predictors of gastrointestinal bleeding and the impact of gastrointestinal bleeding on outcomes in STEMI patients undergoing primary percutaneous coronary intervention. Methods and Results: Gastrointestinal bleeding occurred in ...

The adoption of invasive coronary physiologic lesion assessment before percutaneous coronary intervention has become routine in many catheterization laboratories. In the last decade, numerous studies have demonstrated favorable outcomes for revascularization decisions based on in-lab coronary physiology in many patients. The use of coronary physiology in the laboratory has been ...

BACKGROUND: The Myocardial Infarction Network Essen was initiated in order to establish a standardized procedure with immediate reopening of the infarcted vessel for patients with ST-elevation myocardial infarction (STEMI) in the city of Essen, Germany. The present study aims to evaluate gender-related differences in presentation of disease and clinical outcome. ...

Evidence obtained in multiple experimental models has revealed that cardiac 'conditioning' strategies - including ischaemic preconditioning, postconditioning, remote conditioning and administration of pharmacological conditioning mimetics - are profoundly protective and significantly attenuate myocardial ischaemia-reperfusion injury. As a result, there is considerable interest in translating these cardioprotective paradigms from the laboratory ...

The outcomes for patients undergoing percutaneous coronary interventions (PCI) with drug-eluting stents (DESs) and bare metal stents (BMSs) have been compared in many studies for patients with ST-segment elevation myocardial infarction. However, little is known about the relative outcomes for patients with non-ST-segment elevation myocardial infarction (NSTEMI). The aim of ...

Evaluation of: Tang AS, Wells GA, Talajic M et al. Cardiac-resynchronization therapy for mild-to-moderate heart failure. N. Engl. J. Med. 363(25), 2385-2395 (2010). Cardiac resynchronization therapy (CRT) is recognized as a class I indication according to American and European practice guidelines since 2005 in selected patients with systolic heart failure ...

Population-based studies indicate the risk of acute myocardial infarction (AMI) is greatest in the morning, during the initial hours of diurnal activity. The aim of this pilot study was to determine whether chronotype, i.e., morningness and eveningness, impacts AMI onset time. The sample comprised 63 morning- and 40 evening-type patients ...

Aims: To assess the impact of reperfusion after primary percutaneous coronary intervention (PCI) on myocardial salvage and outcome of patients with acute ST-segment elevation myocardial infarction (STEMI). Methods and results: This study included 1,406 patients with STEMI undergoing primary PCI. Blood flow restoration at epicardial and tissue levels was assessed ...

Cardiac resynchronization therapy is a key non-pharmacological treatment strategy for drug-refractory moderate-to-severe symptomatic heart failure in the presence of compromised left ventricular function and ventricular conduction delay. Because not all patients with conventional criteria benefit from CRT, continuous efforts have been directed toward improving patient selection; in particular, emerging echocardiographic ...

We report a surgical case of prosthetic valve obstruction after mitral valve replacement by a St. Jude Medical valve. A 66-year-old woman was admitted because of congestive heart failure. Prosthetic valve obstruction was diagnosed by transthoracic echocardiography and cine-fluoroscopy. Re-do cardiac surgery was indicated after a week of heparinization. Circumferential ...

Stent-based techniques may allow rapid arterial recanalization in acute stroke. We present our experience using a self-expanding stent to achieve transient bypass, and then as a thrombectomy device, with no permanent stent implantation, in acute stroke. Six patients (mean age 55, range 35-71) presented with major ischemic stroke secondary to ...

BACKGROUND: Door-to-balloon (D2B) time is conceived as a crucial parameter for evaluating the quality of acute ST-segment elevation myocardial infarction (STEMI) care. Ideally, primary percutaneous intervention should be performed within 90 min of hospital arrival. OBJECTIVES: We sought to determine the impact of emergency physician-activated "Code STEMI" protocol on door-to-balloon ...

BACKGROUND: We aimed to compare conventional echocardiographic versus speckle tracking-derived parameters in predicting postoperative left ventricular (LV) dysfunction and clinical outcomes after successful mitral valve repair in patients with mitral regurgitation. METHODS: In 147 consecutive patients in sinus rhythm with severe MR, two-dimensional echocardiography and speckle-tracking imaging for global longitudinal, ...

Background: Duty-cycled radiofrequency (DCRF) is increasingly used for ablation of atrial fibrillation (AF). Many patients also have atrial flutter (AFL). Recently, a linear multielectrode has been shown to create linear block at the cavotricuspid isthmus and in the left atrium (LA). Objective: To map and ablate atypical AFL and atrial ...

Aims Right ventricular apex (RVA) pacing may have deleterious effects on left ventricular (LV) systolic function, but its impact on LV diastolic function has not been explored. Methods and results Ninety-seven patients with sinus node dysfunction and ejection fraction (EF) ≥50% with permanent RVA pacing were randomly programmed to V-sense ...

Occurrence of supraventricular tachycardia is a common cause of clinical impairment for patients implanted with CRT devices. We report the case of atrial activity oversensing by the left ventricular (LV) lead during typical flutter, which led to LV pacing inhibition. Temporary reprogramming of the LV detection from standard bipolar to ...

BACKGROUND AND PURPOSE: Intravenous tissue-type plasminogen activator (IV tPA) frequently fails to recanalize proximal middle cerebral artery (MCA-M1) obstructions, preventing favorable outcomes. Only neurointerventional procedures prevail in these cases, but well-equipped centers remain scarce. A new therapeutic strategy consisting of a second IV thrombolysis with low-dose tenecteplase was applied. METHODS: ...

A 47-year-old man was referred because of an acute anterolateral ST-segment elevation myocardial infarction. Coronary angiography showed marked ectasia of the coronary arteries, with no obstructive lesions. Ventriculography strongly suggested severe left ventricular hypertrophy, later confirmed by cardiovascular magnetic resonance imaging. Complete clinical investigation showed that the patient also had ...

Background: By and large, prior registries and randomized trials have not distinguished between acute heart failure (AHF) associated with acute coronary syndrome (ACS) versus other causes. Aims: To examine whether the treatments and outcomes of ACS-associated AHF are different from non-ACS-associated AHF. Methods: We examined in a prospective, nationwide hospital-based ...

There are no parameters predicting the individual probability of "full response" to cardiac resynchronization therapy (CRT). The aim of this work was to find prognostic factors of full clinical and echocardiographic responses (i.e., ≥50% left ventricular ejection fraction [LVEF] and New York Heart Association class I) after 1 year of ...

Left ventricular (LV) remodeling represents an important determinant in the progression to heart failure in patients after myocardial infarction. The aim of the present study was to evaluate in patients with first ST-segment elevation acute myocardial infarction who were successfully and completely reperfused whether the control of cholesterol is predictive ...

Independent no-reflow predictors should be evaluated in female patients with ST-segment elevation acute myocardial infarction (STEMI) and successfully treated with primary percutaneous coronary intervention (PPCI) in the current interventional equipment and techniques, thus to be constructed a no-reflow predicting model. In this study, 320 female patients with STEMI were successfully ...

Conventional analysis of vascular prevention trials assigns equal weight to disparate vascular events in a composite end point at variance with the public's perception of their differential impact on health outcome. This study sought to apply the disability-adjusted life-year (DALY) metric to differential weighting individual vascular end points in trial ...

The endothelial progenitor cell (EPC)-capture stent promotes endothelialization and preliminary studies have suggested its safety and feasibility in ST-elevation myocardial infarction (STEMI). Detailed late clinical follow-up and angiographic analyses are, however, limited. We sought to determine late angiographic and clinical outcomes of the Genous EPC-capture stent in primary angioplasty. EPC-capture ...

OBJECTIVE: Aortic arch repair (AAR) on the beating heart may reduce cross-clamping times and offer improved postoperative cardiac function. METHODS: A single-center review of all patients (n = 24) who underwent surgical AAR during biventricular repair between 01/2006 and 01/2008 was done. All patients were operated on under cardiopulmonary bypass ...

In this study, we examined the effects of castration and testosterone replacement on β-adrenoceptor and G protein expression in rats subjected to doxorubicin-induced heart failure. Five groups were included in this report: control, sham-castration with heart failure, castration with heart failure, castration+testosterone replacement with heart failure and castration+testosterone replacement and ...

The circadian clock influences a number of cardiovascular (patho)physiological processes including the incidence of acute myocardial infarction. A circadian variation in infarct size has recently been shown in rodents, but there is no clinical evidence of this finding. To determine the impact of time-of-day onset of ST segment elevation myocardial ...

BACKGROUND: Cardiotoxicity of aggressive chemotherapeutic regimens includes cardiomyopathy and arrhythmias. Although cardiomyopathy is a well-recognized entity, arrhythmias are poorly studied. HYPOTHESIS: Certain chemotherapeutic regimes are associated with supraventricular arrhythmias, particularly atrial fibrillation. METHODS: We retrospectively reviewed the data on patients who received hematopoietic stem cell transplant (bone marrow transplant; BMT) ...

Left main coronary artery (LMCA) percutaneous coronary intervention (PCI) has emerged as an appealing alternative to bypass surgery for significant LMCA disease, especially in high-risk candidates. PCI for unprotected LMCA stenosis is currently designated a class IIb indication. Direct comparisons between unprotected LMCA PCI and multivessel PCI are lacking. We ...

The new high-sensitivity cardiac troponin T assay (hs-cTnT) assay seems to provide important prognostic information in patients with stable cardiovascular disease. To understand the merit of hs-cTnT more closely in stable cardiovascular disease, we performed extensive echocardiographic characterization of 57 patients with aortic stenosis and myocardial hypertrophy and related hs-cTnT ...

OBJECTIVE: Early invasive strategy, defined as early coronary angiography and subsequent revascularization, when appropriate, is recommended by current guidelines for the management of patients with moderate- to high-risk acute coronary syndromes. We sought to compare the outcomes of patients with acute coronary syndromes undergoing surgical revascularization with an on-pump versus ...

Although there have been important advances in our understanding of the mechanisms underlying the development and progression of heart failure and its treatment over the last 3 decades, heart failure remains one of the most common cardiovascular conditions and a major cause of morbidity and mortality. Unfortunately, more recently progress ...

Stent thrombosis and restenosis remain drawbacks of drug-eluting stents in patients with acute myocardial infarction (AMI). Intravascular ultrasound (IVUS) guidance for stent deployment helps optimize its results in stable patients. The aim of this study was to examine the utility of routine IVUS guidance in patients with AMI undergoing percutaneous ...

BACKGROUND: Coronary artery disease (CAD) is commonly cited as a mechanism underlying diastolic dysfunction. However, the association of CAD without ischemia and left ventricular (LV) diastolic dysfunction has not been convincingly demonstrated in asymptomatic patients. The objective of this study was to determine if such a relation exists using coronary ...

We sought to evaluate the prognostic significance of ST-segment elevation (STE) in lead aVR in unselected patients with non-STE acute coronary syndrome (NSTE-ACS). We enrolled 1,042 consecutive patients with NSTE-ACS. Patients were divided into 5 groups according to the following electrocardiographic (ECG) patterns on admission: (1) normal electrocardiogram or no ...

Aims Although electrocardiographic and echocardiographic findings with right ventricular (RV) pacing mimic intrinsic left bundle branch block (LBBB), left ventricular (LV) mechanical activation pattern may differ. We compared mechanical activation pattern of the LV in RV-pacing-induced LBBB with intrinsic LBBB in symptomatic chronic heart failure patients. Methods and results We ...

Of patients who present with ischemic-type chest pain and a negative cardiac troponin T (cTnT) at first medical contact, there are patients at a very early stage of infarction. The aim of this research was to assess heart fatty acid-binding protein (H-FABP), a novel marker of myocyte necrosis, in combination ...

Background:  Despite significant advances in stent technology and pharmacotherapy, drug-eluting stent thrombosis (DES-ST) remains a major complication of percutaneous coronary intervention (PCI) and commonly presents as ST-elevation myocardial infarction (STEMI). There are currently little data comparing the in-hospital outcomes of patients presenting with STEMI due to DES-ST with those due ...