We sought to determine trends, predictors, in-hospital and long-term outcomes of cerebrovascular events (CVE) related to percutaneous coronary intervention (PCI) over a 16-year period. Despite a temporal increase in patient risk profile and procedural complexity, rates of PCI-related mortality and myocardial infarction have decreased. Temporal trends, characterization, and outcomes after ...

The treatment of atrial fibrillation focuses on controlling the heart rate, preventing thromboembolic events, and, depending on the symptoms, restoring and maintaining sinus rhythm. In most cases, the rate or rhythm can be quickly controlled, and a long-term plan can be started that will minimize the impact of this disorder ...

Background: QRS fragmentation (fQRS) has been shown to be a marker of scar in patients with left ventricular dysfunction. Whether fQRS is associated with progressive left ventricular remodeling and increased mortality in patients receiving cardiac resynchronization therapy (CRT) is unclear. Methods: We reviewed the preimplant and follow-up echocardiograms in 233 ...

Background: Ventricular arrhythmias are one of the main causes of sudden death in cardiac sarcoidosis (CS). Little is known about the efficacy of corticosteroid therapy for ventricular arrhythmias in CS. Methods: Thirty-one CS patients presenting premature ventricular contractions (PVCs, ≥300/day) were investigated. Fourteen patients had nonsustained ventricular tachycardia (NSVT). All ...

Abstract Background. Research in 2008 demonstrated that the majority of out-of-hospital cardiac arrests (OHCAs) occur in the home, and many important characteristics differ between private and public locations. However, the influence of the location of collapse on survival from OHCA is not well understood. Furthermore, most of the reports have ...

Introduction. Cardiovascular disease and heart failure are common in dialysis patients. Recurrent subclinical myocardial ischemia is an important event which may lead to the heart failure. We examined whether this phenomenon occurs secondary to the intradialytic hypotension in hemodialysis patients. Materials and Methods. Twelve patients prone to intradialytic hypotension who ...

We have evaluated the outcome after coronary artery bypass surgery in very high risk patients (additive EuroSCORE≥10). The impact of beating heart coronary artery bypass surgery (BHCAB) on their outcome has been evaluated. Retrospective study including 160 consecutive patients with additive EuroSCORE≥10. . The overall survival rates at 30-day, 1-year, ...

AIMS: Hypertrophic cardiomyopathy (HCM) is a frequent cause of sudden cardiac death (SCD) due to exercise-related ventricular arrhythmias (ERVA); however the pathological substrate is uncertain. The aim was to determine the prevalence of ERVA and their relation with fibrosis as determined by cardiac magnetic resonance imaging (CMR) in carriers of ...

This case demonstrates the use of QRS scoring to quantify myocardial scar in a patient with cardiac sarcoidosis and left bundle branch block who progressively received an implantable defibrillator, cardiac resynchronization therapy (CRT), left ventricular assist device and cardiac transplantation. QRS scoring has been shown to correlate with magnetic resonance ...

Background: The aim of this study was to comprehensively evaluate electrocardiographic (ECG) findings of isolated left ventricular noncompaction (IVNC) patients at initial diagnosis and to explore the correlation between them and the clinical, echocardiographic, and magnetic resonance imaging (MRI) findings. Methods: Twenty-three patients diagnosed with IVNC by echocardiography and cardiac ...

We hypothesized that older patients in a regional ST-elevation myocardial infarction (STEMI) transfer program would attain comparable treatment to younger patients. Older patients have been either excluded or underrepresented in STEMI clinical trials. Observational studies suggest that these patients are less likely to receive adjunctive pharmacologies and reperfusion therapy-thrombolysis or ...

The purpose of the present study was to investigate the association between preoperative heart rate variability and atrial fibrillation after off-pump coronary artery bypass graft surgery. Of 524 consecutive patients undergoing isolated coronary artery bypass surgery, 390 were retrospectively analyzed after excluding the following 134 cases: on-pump surgery (n = ...

Background: Heart rate (HR) turbulence lasting up to 15 beats after ventricular premature beats (VPBs) may have profound effects on HR variability measures. Aim of this study was to examine the effects of HR turbulence on HR variability measures. Methods: We developed an algorithm, which deletes 15 consecutive RR intervals ...

Risk-stratifying heart failure patients for primary prevention implantable cardioverter-defibrillators (ICDs) remains a challenge, especially for blacks, who have an increased incidence of sudden cardiac death but have been underrepresented in clinical trials. We hypothesized that the S1103Y cardiac sodium channel SCN5A variant influences the propensity for ventricular arrhythmias in black ...

Heart failure is an international health problem, the magnitude of which is expected to continue to grow. It can be broadly divided into chronic (and relatively stable) ambulatory heart failure patients and patients hospitalized for worsening heart failure, also known as acute heart failure syndromes (AHFS). In contrast to the ...

Abstract Background. A challenge for emergency medical service (EMS) is accurate identification of acute coronary syndromes (ACS) and ST-segment elevation myocardial infarction (STEMI) for immediate treatment and transport. The electrocardiograph-based acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI) and the thrombolytic predictive instrument (TPI) have been shown to improve diagnosis and ...

Over the last decades indications have broadened and techniques have been developed resulting in an increasing use of catheter ablation for different types of ventricular tachycardia (VT). Due to the high ablation success for non scar-related ventricular arrhythmia (VA) catheter ablation has become a first line therapy for symptomatic idiopathic ...

Interventions that reduce infarct size in animal models have largely failed to improve outcome in patients suffering acute myocardial infarction (MI), or 'heart attack'. Our group recently reported a reduction of infarct size by chloramphenicol treatment in a porcine in vivo model of acute MI, through a mechanism involving the ...

Although most recent investigations into sudden cardiac death prevention in heart failure patients have been focused on primary prevention, secondary indications for defibrillators and medical therapy remain vitally important in this complex patient group. Antiarrhythmic therapy is currently used primarily as adjuvant therapy to implantable defibrillators. Secondary prophylaxis defibrillator trials ...

Heart failure is a common antecedent to atrial fibrillation; both heart failure and atrial fibrillation are associated with increased myocardial oxidative stress. Chronic canine heart failure reduces atrial action potential duration and atrial refractoriness. We hypothesized that inducible nitric oxide synthase 2 (NOS2) contributes to atrial oxidative stress and electrophysiologic ...

In patients with chronic total occlusion (CTO) and multivessel coronary artery disease, the comparison of surgical and the percutaneous revascularization strategies has rarely been conducted. The aim of this study was to compare long term clinical outcomes of drug eluting stent (DES) implantation with coronary artery bypass surgery (CABG) in ...

Coronary collateral circulation maintains myocardial perfusion in coronary atherosclerotic disease. The indicators of cardiac ischemia, (Angina pectoris on exertion, during emotion, previous myocardial infarction and prior coronary intervention) are associated with presence of coronary collateral circulation. In this prospective observational cross sectional study, 128 patients with history of angina pectoris ...

INTRODUCTION: Gated myocardial perfusion scintigraphy (g-MPS) provides functional information on the left ventricle (LV) apart from the perfusion status. Computer algorithm-based LV ejection fraction (EF) calculated from resting g-MPS has been found to be reliable in patients with normal perfusion. However, its role in patients with extensive perfusion defects is ...

The aim of this study was to assess the long-term efficacy of stem cell transplantation with revascularization for patients with ischemic cardiomyopathy. We enrolled 17 patients with ischemic cardiomyopathy who had undergone autologous stem cell treatment. To assess myocardial ischemia and viability they underwent coronary angiography, stress tests with dobutamine, ...

Despite the robust evidence of the potential benefits of n-3 polyunsaturated fatty acid (PUFA) supplementation in patients with established coronary artery disease, the impact of this therapy on patients after coronary artery bypass grafting remains completely unknown. Among 2,100 patients undergoing isolated coronary artery bypass grafting in one tertiary care ...

Left Atrial Stiffness and Atrial Fibrillation. Introduction: An increased left atrial (LA) stiffness reflects the structural remodeling and deterioration of the LA function. This study was designed to estimate LA stiffness by measuring a combination of the strain and LA pressure in patients undergoing pulmonary vein isolation (PVI) of atrial ...

Tube voltage reduction has been shown to be an effective method to reduce radiation dose in nonobese patients undergoing coronary CT angiography. To date, the impact of reduced tube voltage on objective measures of diagnostic accuracy, as defined by quantitative coronary angiography (QCA), has not been established. The purpose of ...

Background: At a time when cost containment in health care is under increased scrutiny, coronary artery bypass grafting remains the most widely performed cardiac surgical procedure in the world. This study compares 30-day mortality, morbidity, and resource use for off-pump coronary artery bypass (OPCAB) versus conventional coronary artery bypass (CCAB) ...

Early recurrence of atrial fibrillation (AF) is common after electrical cardioversion (ECV). Accurate prediction of AF recurrence might allow more selective use of ECV and the targeted use of antiarrhtyhmic therapy in those at highest risk of recurrence. We have screened consecutive patients attending for cardioversion of AF and recruited ...

Despite the positive impact of medical therapy, the burden of heart failure persists, with disease progression, frequent hospitalizations, and reduced survival. Mortality related to ventricular tachyarrhythmias and/or pump failure has led to the introduction of device therapy. Implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT) have now been established as ...

Heart failure is still a large medical problem, and the European Journal of Heart Failure remains dedicated to further investigating its pathophysiology and diagnosis, as well as alleviating the symptoms and improving outcome for patients with this disorder.(1) In 2010, a large number of important studies have been published, many ...

High-risk percutaneous coronary interventions (PCI), refractory cardiogenic shock and in-lab cardiac arrest are all associated with significant mortality. Percutaneous left ventricular assist devices (pLVAD) and CPS (cardiopulmonary support) have been used to support such patients. However, the extent to which the use of these devices can improve outcomes in this ...

We sought to evaluate the diagnostic accuracy of a new prospectively electrocardiogram (ECG)-triggered high-pitch scan mode for coronary computed tomography angiography (CTA), which allows an effective dose of less than 1 mSv. Coronary CTA provides increasingly reliable image quality, but the associated radiation exposure can be high. Seventy-five patients with ...

Evaluation of: Holmqvist ME, Wedrén S, Jacobsson LT et al. Rapid increase in myocardial infarction risk following diagnosis of rheumatoid arthritis amongst patients diagnosed between 1995 and 2006. J. Intern. Med. 268(6), 578-585 (2010). There is an ongoing debate as to when increased cardiovascular risk of patients with rheumatoid arthritis ...

Ischemic heart disease (IHD) is a leading cause of mortality and morbidity in most developed countries. Many studies revealed gender differences in the presentation, prevalence, and clinical outcomes of IHD. Compared with females, ST-segment elevation myocardial infarction is more often diagnosed in men. They also have a higher prevalence of ...

To assess the association of high-sensitivity C-reactive protein (hsCRP) to adverse cardiovascular events and perioperative myocardial damage in patients after elective vascular surgery. This was a prospective observational study in a tertiary-care teaching hospital, with 239 patients undergoing elective vascular surgery. The receiver-operating characteristic (ROC) curve was calculated to assess ...

Objective: Preoperative left ventricular systolic function is an important prognostic factor in patients undergoing mitral valve surgery. Preoperative myocardial deformation may be impaired without reduction in conventional indices such as ejection fraction (EF). Strain rate (SR) imaging is very sensitive in detecting regional systolic abnormalities and might allow diagnosis of ...

BACKGROUND AND PURPOSE: Previous data have shown the feasibility of identifying ischemic penumbra in patients with acute stroke by using a semiautomated analysis of ADC maps. Here, we investigated whether the fate of ADC-defined penumbra was altered by HG. We also examined the interaction between HG and arterial recanalization on ...

We present a 68-year-old female who suffered extensive complications after severe myocardial infarction (MI) in the circumflex (CX) territory. At 24 hours after the initial event, the patient presented with a covered right ventricular free wall rupture (FWR) which was followed by a rupture of the left posterior wall ten ...

The heart is one of the organs affected by sickle cell anemia (SCA). This prospective study has aimed to evaluate myocardial perfusion and left ventricle (LV) function in children with SCA by gated myocardial perfusion scintigraphy (G-MPS) and to compare the results with echocardiographic parameters. Forty-three patients with SCA were ...

The aim of this study was to test the effects of the KIF6 Trp719Arg polymorphism (rs20455) on vascular risk and response to statin therapy in 18,348 participants from the Heart Protection Study. There have been claims that noncarriers of the KIF6 719Arg variant receive little benefit from statin therapy. Screening ...

We present a case of a 76-year-old man with ischemic cardiomyopathy. Cardiac magnetic resonance imaging demonstrated severe left ventricular (LV) impairment with possibility of scar formation. Cardiac resynchronization therapy was employed with the aid of a novel quadripolar LV lead. The quadripolar LV lead can be programmed for 10 different ...

Angiosarcoma is the most common primary cardiac malignancy with a poor prognosis. In this report, we describe a 28-year-old male patient presenting with symptoms and findings of myocardial ischaemia who has been finally diagnosed with cardiac angiosarcoma.

We evaluated the accuracy of an uncalibrated pulse contour method called Pressure Recording Analytical Method (PRAM) compared with continuous thermodilution for cardiac output (CO) monitoring in patients implanted with a pulsatile left ventricular assist device (LVAD). Twelve adult patients implanted with the HeartMate I-XVE device were studied. CO was simultaneously ...

Aims Early activation at the His bundle (HB) region or proximal coronary sinus (CS) during focal atrial tachycardias (FATs) often necessitates biatrial mapping. Analysis of CS electrograms (EGMs) consisting of a near-field (N) component from CS musculature and a far-field (F) component from left atrial (LA) myocardium can uncover LA ...

We examined the difference between self-reported and measured body size values and their impact on detection of left ventricular hypertrophy (LVH) by echocardiographic LV mass indexation. A total of 1963 subjects referred by their practitioners for routine echocardiographic examination to nine outpatient echocardiographic laboratories across Italy were included in the ...

We examined which echocardiographic parameter correlated best with plasma brain natriuteric peptide (BNP) levels in treated hypertensive patients. Enrolled in the study were 122 treated hypertensive patients (70 ± 9 y). The left ventricular mass index and left atrial dimension (LAD) were measured using echocardiography as indexes of left ventricular ...

We tested for the presence of coronary calcifications in patients with chronic renal disease not on dialysis and studied its progression in 181 consecutive non-dialyzed patients who were followed for a median of 745 days. Coronary calcifications (calcium score) were tallied in Agatston units by computed tomography, and the patients ...

AIMS: Heart failure (HF) in the elderly carries a poor prognosis. We used the SENIORS dataset of elderly HF patients aged ≥70 years in order to develop a risk model for this population. METHODS AND RESULTS: The SENIORS trial evaluated the effects of nebivolol and enrolled 2128 patients ≥70 years ...

Haemodynamic performance of bileaflet mechanical heart valves can be severely affected by the formation of thrombotic deposits. Hence, early detection of thrombi is fundamental for a prompt diagnosis and adequate therapy. This article aims at designing a novel diagnostic and prognostic tool able to detect valvular thrombosis at early stages ...