BACKGROUND: -The influence of atrioventricular (AV) interaction on mitral valve closure (MVC) and left ventricular (LV) isovolumic contraction is not fully clarified. We investigated the relationship between AV delay, MVC and LV isovolumic contraction using a horse model because of the low heart rate and physiologically long AV delay. METHODS ...

BACKGROUND: -Peak atrial longitudinal strain (PALS) during the reservoir phase has been proposed as a measure of LA function in a range of cardiac conditions with the potential for added pathophysiological insight and prognostic value. However, no studies have assessed the interrelation of PALS and LV longitudinal strain (GLS) in ...

BACKGROUND: CONTRAST-INDUCED ACUTE KIDNEY INJURY (CI-AKI) AFTER PERCUTANEOUS CORONARY INTERVENTION IS ASSOCIATED WITH ADVERSE SHORT- AND LONG-TERM OUTCOMES. HOWEVER, IDENTIFICATION OF PATIENTS AT RISK FOR CI-AKI IS CHALLENGING. USING A LARGE CONTEMPORARY RANDOMIZED TRIAL DATABASE OF PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION, WE THEREFORE SOUGHT TO EXAMINE WHETHER ADMISSION B-TYPE ...

To determine which drug-eluting stents are more effective in acute myocardial infarction (MI) patients with chronic kidney disease (CKD). This study included a total of 3,566 acute MI survivors with CKD from the Korea Acute Myocardial Infarction Registry who were treated with stenting and followed up for 12 months: 1,845 ...

AIMS: To identify sex differences in risk factors, presenting symptoms and outcomes of young patients with acute myocardial infarction. METHODS: We adopted a comprehensive approach and performed two parallel studies: (1) using provincial administrative databases from Quebec, Canada from 2000 to 2007, we identified baseline characteristics and post-acute myocardial infarction ...

OBJECTIVES: To examine the prevalence of peripheral artery disease (PAD) and the relationship between PAD and cardiovascular (CV) outcomes in subjects with left ventricular systolic dysfunction, heart failure or both after acute myocardial infarction (MI). BACKGROUND: PAD is associated with poorer prognosis in patients with stable and unstable coronary heart ...

It has been found that solar and geomagnetic activity affects the cardiovascular system. Some evidence has been reported on the increase in the rate of myocardial infarction, stroke and myocardial infarction related deaths during geomagnetic storms. We investigated the association between cardiovascular characteristics of patients, admitted for myocardial infarction with ...

AimsBoth elevated inflammatory activity and sustained tachycardia reflect unfavourable cardiovascular risk profiles, and there is evidence to suggest the deleterious effects of inflammation are amplified by increased heart rate. The purpose of this study was to assess the interaction between resting heart rate and inflammation in cardiovascular mortality.Methods and resultsA ...

BACKGROUND AND PURPOSE: Metabolic syndrome (MetS) and chronic kidney disease (CKD) have both been reported as risk factors for cardiovascular events. The aim of this study was to assess the synergistic effect of MetS and CKD on atherosclerotic plaque and cardiovascular outcomes. METHODS AND SUBJECTS: A total of 545 consecutive ...

We evaluated the cross-sectional associations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) with cardiac structural and functional abnormalities in a cohort of patients with chronic kidney disease without clinical heart failure, the Chronic Renal Insufficiency Cohort (n = 3,232). The associations of NT-proBNP with echocardiographically determined left ventricular (LV) mass and ...

Objectives. Acute myocardial infarction (AMI) is a life-threatening emergency. In Africa, the increasing prevalence of cardiovascular risk factors is leading to an epidemiological transition. No data have yet been reported about AMI in Djibouti. Patients and methods. This study prospectively included all patients with acute coronary syndrome and persistent ST ...

Patients and methods: In-stent hemodynamics were studied by transesophageal echocardiography (TEE) in a group of 54 patients after left main coronary artery stenting, during a 6-month follow-up. TEE was performed within 24 hours after stenting and at 1- and 3-month follow-up. Pulsed wave and color Doppler signals were enhanced by IV ...

The pathophysiological relationship between coronary atherosclerosis and coronary microvessels remains undefined and the specific causative role of oxidatively modified low density lipoprotein (oxLDL) in human atherosclerosis is debated. The purposes of this study are to investigate whether coronary microvessels are involved in coronary atherosclerosis and whether increased myocardial oxLDL amount ...

Objectives: We report the results of a large single-center study evaluating predictors and outcomes after transcatheter aortic valve implantation (TAVI) with different devices and access routes according to the Valve Academic Research Consortium (VARC).Background: The widespread adoption of TAVI warrants a systematic analysis of outcomes. Only few comprehensive data exist ...

Although chronic lung disease (CLD) is common among patients with myocardial infarction (MI), little is known about the influence of CLD on patient management and outcomes following MI. Using the National Cardiovascular Data Registry's ACTION Registry-GWTG, demographics, clinical characteristics, treatments, processes of care, and in-hospital adverse events after acute MI ...

Complete versus culprit-only revascularization in acute ST-elevation myocardial infarction (STEMI) patients with multivessel disease is controversial. Current guidelines recommend treatment of the culprit artery alone during the primary procedure. However, with improvements in stent technique and with the use of new antiplatelet drugs (GP IIb/IIIa inhibitors), complete revascularization (CR) at ...

AIMS: The recommendation for the use of the intra-aortic balloon pump (IABP) as adjunct in patients with cardiogenic shock undergoing primary PCI in current guidelines is controversial. We sought to investigate the use and impact of the outcome of IABP in current practice of percutaneous coronary interventions in Germany. METHODS ...

QUESTION In patients with stable coronary artery disease, does fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) plus best available medical therapy (MT) reduce death, myocardial infarction (MI), or urgent revascularization compared with MT alone? METHODS DESIGN Randomized controlled trial (Fractional Flow Reserve versus Angiography for Multivessel Evaluation 2 [FAME ...

Background: In Switzerland, health policies are decided at the local level, but little is known regarding their impact on the management of acute myocardial infarction (AMI). In this study, we assessed geographical differences within Switzerland regarding management of AMI.Design: Cross-sectional study.Methods: Swiss hospital discharge database for period 2007-2008 (26,204 discharges ...

BACKGROUND: TICAGRELOR AND PRASUGREL PROVIDE STRONGER PLATELET INHIBITION COMPARED WITH CLOPIDOGREL. DIRECT PHARMACODYNAMIC COMPARISON BETWEEN THEM HAS NOT YET BEEN REPORTED IN ST ELEVATION MYOCARDIAL INFARCTION PATIENTS.METHODS AND RESULTS: IN A PROSPECTIVE, SINGLE-CENTER, SINGLE-BLIND STUDY, 55 OUT OF 117 (47%) SCREENED CONSECUTIVE ST ELEVATION MYOCARDIAL INFARCTION PATIENTS UNDERGOING PRIMARY PERCUTANEOUS ...

Chronic kidney disease (CKD) is associated with elevated cardiovascular risk even during childhood. Tissue Doppler is a sensitive technique for the assessment of ventricular dysfunction with relatively little data available in children with CKD. We report a prospective cross-sectional echocardiographic study at a tertiary center. Forty-nine patients with median (range) ...

The Resolute zotarolimus-eluting stent (R-ZES) utilizes the same metallic platform and anti-restenotic drug as the Endeavor zotarolimus-eluting stent (E-ZES) but is coated with a more biocompatible polymer with enhanced drug-release kinetics. The aim of this study was to compare the long-term clinical outcomes of 2 zotarolimus-eluting stent generations. In two ...

There are very few things in medicine which are simple. Birth and mortality are relatively straightforward to define... but after that the trouble begins. To the casual observer the etiology of myocardial infarction (MI) is relatively obvious: prolonged myocardial ischemia. However, as Aldrovandi et al(1) have taught us in this ...

Only a few studies focused on the predictors of the SYNTAX score (SS). We evaluated the independent clinical predictors of SS in 436 consecutive patients with stable angina pectoris who underwent coronary angiography. Estimated glomerular filtration rate (eGFR) was calculated. The mean SS was 25.8 ± 13.7. High-sensitivity C-reactive protein ...

Diastolic dysfunction is common in coronary artery disease (CAD). Exercise-based cardiac rehabilitation (CR) improves survival and quality of life but its effect on diastolic function is unclear. We sought to determine the impact of CR on diastolic function. We conducted a prospective study of CAD patients referred for 3-month outpatient ...

Reports from large studies using administrative data sets and event registries have characterized recent temporal trends and treatment patterns for acute myocardial infarction. However, few were population based, and fewer examined differences in patterns of treatment for patients presenting with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction ...

BACKGROUND: The study compares five-year clinical outcomes of CABG vs PCI in a real world population of diabetic patients with multivessel coronary disease since it is not clear whether to prefer surgical or percutaneous revascularization. METHODS: Between July 2002 and December 2008, 2885 multivessel coronary diabetic patients underwent revascularization (1466 ...

ABSTRACT: BACKGROUND: It's unknown whether the prognostic value of admission heart rate (HR) was different in patients with ST-segment elevation myocardial infarction (STEMI) with or without concomitant type 2 diabetes mellitus (T2DM). METHODS: Consecutive STEMI patients who presented within 12 hours of symptom onset were recruited from 274 hospitals in ...

The purpose of this phase I clinical trial was to evaluate the safety, tolerability and potential efficacy of VM202, naked DNA expressing two isoforms of hepatocyte growth factor, as an adjunct therapy to coronary artery bypass grafting (CABG) in patients with ischemic heart disease (IHD). Nine patients were assigned to ...

A 72-year-old man with severe lactose intolerance was admitted for non-ST-segment elevation myocardial infarction. The coronary angiogram revealed occlusion of the distal third of the first diagonal artery and several non-significant lesions. The pre-discharge echocardiogram revealed moderate left ventricular systolic dysfunction. Discharged on dual antiplatelet therapy, rosuvastatin, perindopril and carvedilol, ...

ABSTRACT: BACKGROUND: We evaluated the association between linear standard Heart Rate Variability (HRV) measures and vascular, renal and cardiac target organ damage (TOD). METHODS: A retrospective analysis was performed including 200 patients registered in the Regione Campania network (aged 62.4 +/- 12, male 64%). HRV analysis was performed by 24-h ...

We sought to determine how the aging left ventricle (LV) responds to sympathetic nervous system (SNS) activation. Three separate echocardiographic experiments were conducted in 11 healthy young (26 ± 1 yr) and 11 healthy older (64 ± 1 yr) adults. Tissue Doppler imaging was used to measure systolic myocardial velocity ...

PURPOSE: The active form of vitamin D (1,25(OH)(2)D) contributes to blood flow regulation in skeletal muscle. The aim of the present study was to determine whether this hormone also modulates coronary physiology, and thus whether abnormalities in its bioavailability contribute to excess cardiovascular risk in patients with disorders of mineral ...

BACKGROUND: Our objective was to reduce hands-off time during cardiopulmonary resuscitation as increased hands-off time leads to higher mortality. METHODS: The European Resuscitation Council (ERC) 2005 and ERC 2010 guidelines were compared with an alternative sequence (ALT). Pulseless ventricular tachycardia and asystole were presented randomly to all participants in a ...

INTRODUCTION: Both myocardial necrosis and ischemia can decrease the left ventricular ejection fraction (LVEF). An accurate estimate of the relative contributions of these irreversible and potentially reversible factors could lead to better decisions regarding the risk and benefit of coronary artery bypass grafting (CABG). The value of an Ischemia Index ...

OBJECTIVES: This study aims to determine whether plasma levels of matrix metalloproteinases (MMPs) and inflammatory markers can predict the long-term prognosis of coronary revascularization in patients after acute myocardial infarction (AMI). BACKGROUND: MMPs have been implicated in the development of atherosclerosis and plaque rupture in acute coronary syndrome. METHODS: Ninety-six ...

BACKGROUND: DATA FROM RANDOMIZED TRIALS HAS DEMONSTRATED THE SUPERIORITY OF BIVALIRUDIN TO GLYCOPROTEIN IIB/IIIA INHIBITORS PLUS HEPARIN IN PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION. REAL-WORLD PERFORMANCE OF BIVALIRUDIN IN PRIMARY PERCUTANEOUS CORONARY INTERVENTION AND THE BENEFIT OF BIVALIRUDIN OVER HEPARIN REMAIN UNKNOWN IN AN ERA OF ROUTINE DUAL ANTIPLATELET THERAPY.METHODS ...

Preventing expansion and dyskinetic movement of a myocardial infarction (MI) can limit left ventricular (LV) remodeling. Using a device designed to produce variable alteration of infarct stiffness and geometry, we sought to understand how these parameters affect LV function and remodeling early after MI. Ten pigs had posterolateral infarctions. An ...

BACKGROUND AND PURPOSE: Current models dictate that, depending on occurrence of early reperfusion, the ischemic penumbra either undergoes or escapes infarction (i.e., "pan-necrosis"). However, tissue outcome following temporary middle-cerebral artery occlusion (tMCAo) in rodents can also include selective neuronal loss (SNL), which even if subtle may impede functional recovery. In ...

In this study, several electrocardiogram (ECG)-derived indices corresponding to both ventricular depolarization and repolarization were evaluated during acute myocardial ischemia in an experimental model of myocardial infarction produced by 40 min coronary balloon inflation in 13 pigs. Significant changes were rapidly observed from minute 4 after the start of coronary occlusion, ...

BACKGROUND: The major cause of death in the city of São Paulo (SP) is cardiac events. At its periphery, in-hospital mortality in acute myocardial infarction is estimated to range between 15% and 20% due to difficulties inherent in large metropoles. OBJECTIVE:To describe in-hospital mortality in ST-segment elevation acute myocardial infarction ...

Objective: The positive correlation between the time from symptom onset to the appearance of an inflammatory response and erythrocyte aggregation (EA) in the peripheral blood of acute coronary syndromes (ACS) patients had been previously reported by us. We now analyze the added prognostic value of EA in ACS patients undergoing ...

We sought to determine the prognostic value of neutrophil to lymphocyte ratio (NLR) in non-ST elevation myocardial infarction (NSTEMI) and unstable angina pectoris (UAP). A total of 308 (mean age 59.22 ± 11.93) patients with NSTEMI and UAP were prospectively evaluated. The study population was divided into tertiles based on ...

Glucagonlike peptide (GLP-1) and its receptor (GLP-1R) exhibit cardioprotective effects after myocardial ischemia and reperfusion (MI/R) in both animal studies and clinical trials. However, the kinetics of GLP-1R expression in the infarcted/ischemic myocardium has not yet been explored. The purpose of this study was to monitor the presence and time ...

Otamixaban is a synthetic intravenous direct factor Xa inhibitor, with rapid onset/offset, linear kinetics, and no significant renal elimination. A phase II trial in acute coronary syndromes (ACS) showed a marked reduction in the combined end point of death or myocardial infarction (MI) and similar bleeding rates with otamixaban at ...

BACKGROUND: Ischemic mitral valve (MV) repair for patients with severe left ventricular dilation remains challenging. The objective of this study was to investigate the efficacy of papillary muscle (PM) relocation to restore physiologic MV function. METHODS: Fresh ovine MVs (n = 6) were studied in a left-heart simulator under physiologic ...

BACKGROUND: <0.001 for DM × time interaction). The adjusted odds ratio for mortality associated with DM declined from 1.24 (95% confidence interval, 1.16-1.32) in 1994 to 1.08 (95% confidence interval, 0.99-1.19) in 2006 (P<0.001 for trend). The largest improvement in hospital mortality was observed in diabetic women (17.9% in 1994 ...

A morning peak in ST-segment elevation myocardial infarction (STEMI) has been described. The authors explored the relationship between variation of symptom onset, patient characteristics, and outcomes in two worldwide fibrinolytic trials. A total of 35 492 patients with STEMI were grouped into 8-h intervals by time of symptom onset: early ...

INTRODUCTION: Atherosclerotic coronary plaques represent the main substrate for coronary artery disease (CAD), and changes in plaque volume, investigated with intravascular ultrasound (IVUS), have been used as surrogate end-points in several clinical trials. However, no conclusive data are available to support the exploitation of IVUS-based plaque changes as a measure of ...

Seventeen years ago, the National Heart, Lung, and Blood Institute issued a clinical alert(1) that coronary-artery bypass grafting (CABG) had better rates of survival than percutaneous coronary intervention (PCI) in patients with diabetes. The alert was based on the results of the Bypass Angioplasty Revascularization Investigation (BARI) trial,(2) in which ...