BACKGROUND: -Recent studies have suggested acute mitral regurgitation (MR) as a potentially serious complication of Tako-Tsubo cardiomyopathy (TTC); however, the mechanism of acute MR in TTC remains unclear. The aim of this study was to elucidate the mechanisms of acute MR in patients with TTC. METHODS AND RESULTS: -Echocardiography was ...

Aims Cardiac resynchronization therapy (CRT) has dramatically improved the symptoms and prognosis of patients with heart failure in large randomized clinical trials. Optimization of device settings may maximize benefit on an individual basis, although the best method for this is not yet established. We evaluated the use of cardiogenic impedance ...

The need to improve the exercise testing accuracy, pushed the development of scores, whose applicability was already broadly recognized. Prognostic evaluation of stable coronary disease through a new simplified score. A new score was applied in 372 multivessel coronary patients with preserved ventricular function, 71.8% male, age: 59.5 (± 9.07) ...

Because left atrial (LA) volume plays a critical role in determining cardiovascular outcomes, it was hypothesized that this might be related to the distensibility of the left atrium and how this relates to left ventricular filling pressure (LVFP). Echocardiographic estimates of LVFP were compared to cardiac catheterization measurements in 521 ...

Mechanisms for atrial arrhythmias that occur in the context of acute myocardial infarction (AMI) have not been well characterized. AMI often leads to alterations in left ventricular (LV) filling dynamics, which may result in advanced diastolic dysfunction. Diastolic dysfunction may produce increased left atrial (LA) pressure and initiate LA remodeling, ...

ABSTRACT: BACKGROUND: Granulocyte colony-stimulating factor (G-CSF), a hematopoietic cytokine, was recently used to treat patients of acute myocardial infarction with beneficial effect. However, controversy exists as some patients developed re-stenosis and worsened condition post G-CSF delivery. This study presents a new disease model to study G-CSF induced cardiac thrombosis and ...

OBJECTIVES: The objective of this study is to develop a simple risk score to predict 30-day mortality of aortic valve replacement (AVR). METHODS: In a development set of 673 consecutive patients who underwent AVR between 1990 and 1993, four independent predictors for 30-day mortality were identified: body mass index (BMI) ...

Purpose: To assess the optimal timing for coronary magnetic resonance (MR) angiography in children with congenital heart disease by using dual cardiac phase whole-heart MR imaging. Materials and Methods: The local institutional review board approved this study, and informed consent was obtained from parents or guardians. Thirty children (13 girls; ...

Characterization of sudden cardiac death (SCD) risk remains a challenge in the application of implantable cardioverter-defibrillator (ICD) therapy. Late gadolinium enhancement cardiac MRI (LGE-CMR) can accurately identify myocardial scar. We performed a retrospective, single-center observational study to evaluate the association between the extent and distribution of left ventricular scar, quantified ...

Eur J Clin Invest 2011 ABSTRACT: Background  In models of acute ischaemia, erythropoietin (EPO) administration has been found to attenuate vascular injury largely through reduced apoptosis, suppressed inflammation and increased nitric oxide availability. We studied the association between circulating endogenous EPO and no-reflow in patients with first ST-elevation myocardial infarction ...

AIMS: Data on right ventricle (RV) regional function in adults with interatrial shunt are scarce. The aim of the study was to assess the regional RV deformation in the population of adults with uncorrected atrial left-to-right shunt and to establish a potential relationship between its magnitude and RV regional deformation. ...

OBJECTIVES: We reviewed the literature on IV stroke thrombolysis for patients with recent myocardial infarction (MI). METHODS: We searched PubMed and Ovid databases, relevant trials, and guidelines. RESULTS: Only 5 thrombolyzed stroke patients with recent MI were reported to have cardiac tamponade. Pathological studies show MI healing is completed by ...

Aims: To investigate the effects of alcohol septal ablation (ASA) on microcirculatory function and myocardial energetics in patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction. Methods and Results: In fifteen HCM patients who underwent ASA, echocardiography was performed prior to and 6 months after the procedure ...

Coronary stent implantation, particularly drug eluting stents, is now the major method of coronary revascularisation. Following drug-eluting stent implantation dual antiplatelet therapy with aspirin and thienopyridine is recommended for at least 12 months. Premature discontinuation, often at the time of noncardiac surgery, has been associated with stent thrombosis which has ...

Several lines of evidence indicate that increased inflammatory cytokine levels can be used for risk prediction in patients with acute coronary syndrome (ACS). This study therefore aimed to evaluate correlations between levels of soluble interleukin (IL)-2 receptor (sIL-2r), IL-6, and IL-8 and in-hospital incidence of acute heart failure (AHF) and ...

Objective: Because of increasing life expectancy, more patients require valve replacement for aortic stenosis. We aimed to determine perioperative and long-term outcomes, the factors associated with these and whether they have changed over time. Methods: We undertook a retrospective cohort study of all 4124 patients, who underwent isolated, primary aortic ...

Background Bivalirudin reduces bleeding events and is associated with a lower mortality than the combination of unfractionated heparin (UFH) and glycoprotein IIb/IIIa inhibitor during primary percutaneous coronary intervention (PCI). However, the effect of adding UFH in patients with ST elevation myocardial infarction (STEMI) treated with bivalirudin during primary PCI is ...

OBJECTIVE: To evaluate the diagnostic accuracy of dual-source CT (DSCT) prospective ECG-triggering coronary angiography in patients with different heart rate (HR). METHODS: 103 patients with suspected coronary artery disease underwent DSCT prospective ECG-triggered coronary angiography and invasive coronary angiography (ICA). The patients were grouped by HR during CT scans: low ...

Background The right ventricle is multicompartmental in orientation. Objective To assess the normal differential function of the right ventricular (RV) inflow, apical and outflow compartments, also their inter-relations and the response to pulmonary arterial hypertension (PAH). Methods 45 people were studied-16 controls and 29 patients with left-sided heart failure, 15 ...

BACKGROUND: Inclusion of a measure of left ventricular diastolic dysfunction (LVDD) may improve risk prediction after cardiac surgery. Current LVDD grading guidelines rely on echocardiographic variables that are not always available or aligned to allow grading. We hypothesized that a simplified algorithm involving fewer variables would enable more patients to ...

Objective To assess the prognostic value of low-dose 64-slice coronary CT angiography (CCTA) using prospective ECG triggering in a patient population with known or suspected coronary artery disease (CAD). Design Longitudinal follow-up study. Setting Tertiary referral cardiac imaging centre. Patients 434 consecutive patients who were referred for evaluation of CAD ...

Abstract Aims. We evaluated the feasibility, safety and efficacy of intra-myocardial injection of autologous mesenchymal stromal cells derived endothelial progenitor cell (MSC) in patients with stable coronary artery disease (CAD) and refractory angina in this first in man trial. Methods and results. A total of 31 patients with stable CAD, ...

PURPOSE: To investigate respiration-induced heart motion for left-sided breast irradiation using a four-dimensional computed tomography (4DCT) technique and to determine novel indications to assess heart motion and identify breast patients who may benefit from a gated treatment. METHODS AND MATERIALS: Images of 4DCT acquired during free breathing for 20 left-sided ...

Background & Aims: Serum anti-cardiolipin (aCL) antibodies are prevalent in patients with periodontal diseases. These increased aCL concentrations are identified to play a modulating role in cardiovascular diseases. The present study was aimed to explore the effect of phase-I periodontal therapy on IgM and IgG aCL antibodies in acute myocardial ...

An unusual problem associated with the use of left ventricular assist devices (LVADs) relates to malposition of the apical inflow cannula. From 2005 to 2010, we implanted 154 continuous-flow HeartMate II (Thoratec, Pleasanton, CA) LVADs at our institution. In 4 separate instances, patients appeared to have malposition of the inflow ...

BACKGROUND AND PURPOSE: Cardiac resynchronization therapy (CRT) is a beneficial strategy to improve severe cardiac dysfunction in patients with congestive heart failure (CHF). The improvement of endothelial function in CHF patients treated with CRT is reflected in the mortality risk reduction. However the precise mechanisms of the relationship between CRT ...

OBJECTIVES: Posttraumatic stress disorder (PTSD) prospectively increases the risk of incident cardiovascular disease (CVD) independent of other risk factors in otherwise healthy individuals. Between 10% and 20% of patients develop PTSD related to the traumatic experience of myocardial infarction (MI). We investigated the hypothesis that PTSD symptoms caused by MI ...

Background- Concerns persist regarding the risk of stent thrombosis in the setting of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Methods and Results- The Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial included 3602 patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary ...

Late gadolinium enhancement (LGE) and myocardial perfusion study by cardiac magnetic resonance (CMR) have a diagnostic and prognostic value in patients with suspected coronary artery disease (CAD). The purpose of this study was to determine the prognostic value of combined myocardial perfusion CMR and LGE in patients with known or ...

We found a highly inconsistent relation between the granular and reflective ultrasound ("speckling") pattern frequently observed in the ventricular septum of patients with hypertrophic cardiomyopathy and evidence of myocardial fibrosis by contrast-enhanced cardiovascular magnetic resonance imaging. Therefore, this distinctive echocardiographic appearance of the myocardium does not accurately characterize left ventricular ...

BACKGROUND: Coronary heart disease (CHD) mortality is 70% higher among Indian Asians (IA) than European whites (EW), the reasons for this excess remain unexplained. Coronary artery calcification (CAC) is highly correlated with coronary plaque burden and silent myocardial ischaemia in EW; but fails to identify excess risk in IA. We ...

Patients with recurrent acute myocardial infarction (AMI), who represent ≤35% of hospitalized patients with AMI, are at an increased risk of complications and death. Our study purpose was to compare the treatment and outcome of patients hospitalized with recurrent acute ST-segment elevation myocardial infarction (STEMI) from 1998 to 2006 with ...

ABSTRACT: BACKGROUND: The cause of tako tsubo cardiomyopathy remains unclear. We used a multidisciplinary approach to investigate if a common pathophysiological denominator could be outlined. METHODS: Within 3 days following symptom presentation and again after 3 months we investigated all patients coming to our institution and diagnosed with tako-tsubo cardiomyopathy. ...

BACKGROUND: The effect of ACE inhibitors on the prognosis of chronic heart failure patients with preserved left ventricular ejection fraction remains controversial. AIMS: To assess the impact of ACE inhibitors on the prognosis of chronic heart failure patients with preserved left ventricular ejection fraction. METHODS AND RESULTS: Seven prospective studies ...

The aim of this study was to analyze how the myocardial perfusion gated-SPECT (Single Photon Emission Computed Tomography) influences the practice of a coronary angiography in patients with ischemic cardiomyopathy (IM). A total of 120 consecutive patients (mean age: 64.9±11.5 years, 25 female) with IM (left ventricular ejection fraction ≤40%) ...

BACKGROUND: The aim of this study was to investigate the impact of acute right ventricular pressure overload (RVPO) on left ventricular (LV) function and regional uniformity using speckle-tracking displacement and strain analyses in patients with acute pulmonary embolism (PE). METHODS: Twenty-five patients with acute PE (mean age, 59 ± 16 ...

We report on a 20-year-old man who presented with an extensive acute anteroseptal myocardial infarction (from a thrombotic occlusion of the left anterior coronary artery) as the initial manifestation of hereditary protein C deficiency. This case report, along with previous reports, indicates that a diagnosis of protein C deficiency in ...

Background: Cardiomyopathy in systemic lupus erythematosus (SLE) may be secondary to myocardial inflammation (i.e. myocarditis) or to systemic complications such as hypertension. Symptomatic left ventricular dysfunction is the most common clinical presentation of cardiomyopathy and is potentially life threatening. Identifying the cause is critical as it dictates therapy. Methods: We ...

Several meta-analyses have focused on determination of the effectiveness of aspirin (acetylsalicylic acid) in primary prevention of cardiovascular (CV) events. Despite these data, the role of aspirin in primary prevention continues to be investigated. Nine randomized trials have evaluated the benefits of aspirin for the primary prevention of CV events: ...

OBJECTIVES: Restrictive cardiomyopathy (RCM) has been repeatedly reported as a cardiac manifestation of certain neuromuscular disorders, but only in single patients with myofibrillar myopathy (MFMP). CASE REPORT: In a 19-year-old woman with a history of short stature, tiptoe-walking since childhood, fixed joint contractures, severe scoliosis requiring surgical correction, elevated levels ...

Owing to their higher risk for cardiac death or ischemic complications, patients with acute coronary syndrome (ACS) must be identified from other causes of chest pain. Patients with acute coronary syndrome are divided into categories based on their electrocardiogram; those with new ST-segment elevation and those who present with ST-segment ...

Background: There is a consistent understanding that the proarrhythmic effect of linear ablation in the left atrium body for atrial fibrillation (AF) always manifests as the macroreentry tachycardia. However, its genesis of localized reentry has been underestimated. Methods: Among 90 persistent AF patients who had accepted linear ablation in the ...

Background Diagnosing early stages of heart failure with mild symptoms is difficult. B-type natriuretic peptide (BNP) has promising biochemical test characteristics, but its diagnostic yield on top of readily available diagnostic knowledge has not been sufficiently quantified in early stages of heart failure. Objectives To quantify the added diagnostic value ...

BACKGROUND: A remote magnetic navigation (MN) system is available for radiofrequency ablation of atrial fibrillation (AF), challenging the conventional manual ablation technique. The myocardial markers were measured to compare the effects of the two types of MN catheters with those of a manual-irrigated catheter in AF ablation. METHODS: AF patients ...

AIMS: Inotrope treatment is often necessary in refractory to optimal management end stage heart failure, when signs of end-organ hypoperfusion appear. The effect of specific inotropes on patient outcome remains controversial. The aim of the study was to compare the effect of levosimendan versus dobutamine, alone or in combination with ...

ABSTRACT BACKGROUND: Right ventricular function is predictive for outcome in patients with acute pulmonary embolism (PE). We assessed the possible incremental value of ventricular function with ECG-synchronized cardiac CT over pulmonary CT angiography (CTA) for predicting short term outcome in patients with suspected acute PE. METHODS: Local ethics committee approved ...

Survivors of an acute ST-elevation myocardial infarction (STEMI) remain at high risk for future cardiac events. Cardiac rehabilitation (CR) participation significantly reduces coronary artery disease (CAD) morbidity and mortality risk. Regrettably, poor utilization of CR services post STEMI is common, accentuating a critical action gap in the trajectory of CAD ...

BACKGROUND: The effects of right ventricular (RV) pacing on left ventricular (LV) diastolic function are unknown. This study aimed to test the hypothesis that right ventricular (RV) pacing is associated with LV diastolic dysfunction and impairment of LV torsion in children and young adults with congenital heart block. METHODS: Eighteen ...

BACKGROUND AND PURPOSE: Stroke is one of the leading causes of adult disability and death in developing countries. However, early diagnosis is difficult and no reliable biomarker is currently available. Thus, we applied a (1)H-NMR metabolomics approach to investigate the altered metabolic pattern in plasma and urine from patients with ...

Closure of perimembranous ventricular septal defects in patients with Down syndrome, either surgically or by Amplatzer occluders, carries a high risk of complete heart block. We report 5 closures using the transcatheter patch, a wireless bioabsorbable device without any reported heart block to date. The median defect size was 11 ...