We report a child with myocardial necrosis, dilated cardiomyopathy, and severe mitral valve (MV) regurgitation following neonatal enteroviral myocarditis. He underwent MV annuloplasty at 18 months and MV replacement at 3 years of age. He remains asymptomatic on medical therapy at 8 years of age. Mitral valve surgery may stabilize ...

Since the first reported use of percutaneous transluminal coronary angioplasty (PTCA), advancements in interventional cardiology arena have been fast paced. Within the last ten years, these developments have been exponential. Developers & clinicians are fast adapting from the learning curve awarded by the time course of DES evolution. In that ...

Myocardial mononuclear cell infiltrate is a spontaneous cardiac finding commonly identified in laboratory cynomolgus monkeys. The infiltrates are predominantly composed of macrophages with lesser lymphocytes and are not typically associated with histologically detectable cardiomyocyte degeneration. These infiltrates are of concern because they confound interpretation of test article-related histopathology findings in ...

Background  A spider monkey with severe dyspnea was referred to our clinic. Methods and Results  Radiographs revealed an enlarged cardiac silhouette. Ventricular tachycardia and ST segment depression were also diagnosed after an ECG. These findings coupled with the postmortem examination confirmed dilatative cardiomyopathy. Conclusions  This case is worthy of presentation ...

Apoptosis is a key feature in the progression of heart disease. Stage B heart failure is characterized by a structurally abnormal heart in which the remodeled myocardium is prone to apoptosis. Elimination of the proapoptotic stimuli or inhibition of the apoptotic cascade could presumably rescue the myocardium and halt the ...

: To review the physiology of the regulation and determinants of heart rate and the significance in the management of critically ill patients. : The MEDLINE database, references from selected articles, and the author's personal database. : This review begins with the regulation of cardiac output and heart rate during ...

Although left ventricular assist devices (LVADs) have had success in supporting severe heart failure patients, thrombus formation within these devices still limits their long term use. Research has shown that thrombosis in the Penn State pulsatile LVAD, on a polyurethane blood sac, is largely a function of the underlying fluid ...

Cardiac pacing has played a significant role in mitigating morbidity and mortality associated with bradyarrhythmias. Throughout the years, advances made in battery reliability, lead performance, and device portability have rapidly expanded the use of cardiac pacemakers in many different disease states. Despite the benefits, there has been growing awareness of ...

BACKGROUND: No reflow after primary percutaneous coronary intervention is a dynamic process and its reversibility may affect left ventricular (LV) remodeling. We aimed at assessing in-hospital evolution of angiographic no reflow, predictors of its reversibility, and its impact on LV function at follow-up (FU). METHODS: Fifty-three consecutive patients (age, 60±10 ...

Heart diseases due to myocardial ischemia, such as myocardial infarction or ischemic heart failure, are major causes of death in developed countries, and their number is unfortunately still growing. Preliminary exploration into the pathophysiology of ischemia-reperfusion injury, together with the accumulation of clinical evidence, led to the discovery of ischemic ...

The sudden evolution of catheter ablation (CA) therapy for atrial fibrillation (AF) was brought by the discovery of a new insight into the triggering mechanism of AF by Haïssaguerre et al. in 1998. This discovery opened a new era of evolution of ablation therapy of paroxysmal AF (PAF). At the ...

Mitochondria are dynamic organelles able to vary their morphology between elongated interconnected mitochondrial networks and fragmented disconnected arrays, through events of mitochondrial fusion and fission, respectively. These events allow the transmission of signaling messengers and exchange of metabolites within the cell. They have also been implicated in a variety of ...

Takotsubo (stress) cardiomyopathy may present as acute cardiovascular collapse, simulating an acute coronary syndrome or other emergencies such as pulmonary embolism or aortic dissection. The diagnosis relies on demonstration of characteristic wall motion abnormalities in the absence of obstructive coronary lesions and is typically diagnosed with cardiac catheterization. Cardiac computed ...

The aim of this study was to investigate the morphometry of branching patterns of the main trunk of the left coronary artery (MT of LCA) in nonhuman primates, and comment on the current nomenclature. The biometric study was performed using stereomicroscopic dissection of hearts of healthy and fertile nonhuman primates ...

Myocardial infarction is a leading cause for morbidity and mortality in the modern society. Rhesus monkeys are excellent animal models for experimental and translational studies of cardiovascular diseases in humans. However, some detailed characterizations of cardiovascular disease, such as myocardial infarction, in Rhesus monkeys have not been available. The present ...

Congest Heart Fail. 2011;17:220-226. © 2011 Wiley Periodicals, Inc. Despite evidence based medical and pharmacologic advances the management of heart failure remains challenging, especially in the ambulatory setting. There is an urgent need to develop strategies to reduce hospitalizations and re-admission rates for heart failure in general. This focused review ...

Cardiac rehabilitation is an interdisciplinary and multidimensional process aimed at preventing and containing cardiovascular mortality, morbidity and disability, and promoting health in subjects with cardiocirculatory pathologies. A body of scientific evidence is today available with regard to the benefits of cardiac rehabilitation in terms of the containment of the progression ...

A decade after cardiac surgery was established, transesophageal echocardiography (TEE) was developed and used to evaluate perioperative cardiac performance. It has become an invaluable tool to provide real-time information in the cardiac operating room. TEE provides practical and useful information prior to insertion as well as after placement of the ...

This study used magnetic resonance imaging (MRI) to determine the volume of the ventricular system in the brain of three adult male African elephants (Loxodonta africana). The ventricular system of the elephant has a volume of ∼240 mL, an order of magnitude larger than that seen in the adult human. ...

It has long been debated whether watershed infarcts are caused by hemodynamic or embolic mechanisms. In the present study, we investigated microembolic roles in the pathogenesis of watershed infarcts by examining MRI in a macaque monkey model of multiple microinfarcts. 50μm microbeads were injected into each internal carotid artery twice ...

Abstract In the post-reperfusion era, molecular and genetic mechanisms of cardioprotection and regeneration represent new therapeutic challenges to limit infarct size and minimize post-ischemic remodeling after acute myocardial infarction (AMI). Activation of cell survival mechanisms can be promoted by the administration of external drugs, stimulation of internal mechanisms, and genetic ...

During early ectotherm vertebrate evolution the heart was redesigned as a high pressure pump adapted to perfuse larger body sizes. To compensate the consequent higher organ complexity and heterogeneity (ventricular myoarchitecture and blood supply), conceivably the three principal cardiac cell components, the endocardium, the contractile myocardium and the epicardium recruited ...

Caseous calcification is a rare form of mitral annular calcification. Echocardiography reveals an echodense mass in the inferior mitral annulus with smooth borders and an echolucent inner core. We present a case where caseous calcification of the mitral annulus caused severe mitral regurgitation, atrial fibrillation and heart failure. Transthoracic echocardiography, ...

Background- Excitation-contraction (EC) coupling is altered in end-stage heart failure. However, spatial heterogeneity of this remodeling has not been established at the tissue level in failing human heart. The objective of this article was to study functional remodeling of excitation-contraction coupling and calcium handling in failing and nonfailing human hearts. ...

We describe 2 cases of complex coronary lesions in which the conventional 0.014-inch balloon catheters failed to cross a chronic subtotal occlusion and also failed to adequately predilate a calcified coronary lesion. The novel use of a 0.010-inch guidewire and compatible balloon catheters in both cases allowed us to perform ...

Objective: To determine the safety and efficacy of dual-axis rotational coronary angiography (DARCA) by directly comparing it to standard coronary angiography (SA). Background: Standard coronary angiography (SA) requires numerous fixed static images of the coronary tree and has multiple well-documented limitations. Dual-axis rotational coronary angiography (DARCA) is a new rotational ...

We describe the case of a 24-year-old man who presented at our emergency department with ST-elevation myocardial infarction (STEMI). The patient showed no coronary artery disease on conventional coronary angiography (CAG). Computed tomography coronary angiography (CTCA) and cardiac magnetic resonance (MR) performed thereafter allowed the highly probable diagnosis of the ...

Studies have demonstrated the presence of stress and post-traumatic stress among ambulance personnel, but no previous research has focused on the body's reaction in the form of the change in heart rate of ambulance staff in association with specific occupational stress. The purpose of this study is to investigate whether ...

We present the case of an 80-year-old female with acute right fronto-parietal stroke and an interesting neurological sign on clinical examination; the arm levitation sign. We discuss the imaging correlates of this sign and hypothesize on the possible functional etiology of the sign. We also discuss in brief, the possibility ...

Heart rate variability (HRV), the beat-to-beat variation in either heart rate or the duration of the R-R interval - the heart period, has become a popular clinical and investigational tool. The temporal fluctuations in heart rate exhibit a marked synchrony with respiration (increasing during inspiration and decreasing during expiration - ...

The new classification of heart failure in the American College of Cardiology/American Heart Association guidelines includes stage D, which is refractory severe heart failure that does not respond to medical or resynchronization therapy. Among the many treatment strategies for stage D heart failure, only heart transplantation and ventricular assist devices ...

A 73 year old female with a history coronary artery bypass grafting and coronary stents had a witnessed cardiac arrest at home. She was transferred to an outside hospital and emergency heart catheterization revealed patent LIMA to LAD, stented grafts open, and no new culprit lesions. A temporary transvenous pacing ...

In 2000, I wrote an editorial entitled, "Detecting Coronary Calcium."1 For the past several years there have been numerous publications on this subject. Recently, an article by Min et al, provided some important information about patients with a normal coronary calcium scan and the conversion from a zero calcium score ...

The value of assessing coronary artery calcium (CAC) with regard to characterizing unstable coronary artery disease remains controversial. To evaluate the amount of CAC in patients with an acute marker-positive coronary syndrome in segments containing the culprit lesion compared with the remote coronary segments. Thirty-two patients with a marker-positive acute ...

The purpose of this study was to analyze the MDCT and MRI findings in patients with unroofed coronary sinus syndrome. This retrospective study included 11 patients with unroofed coronary sinus syndrome (10 adults, one child) without persistent left superior vena cava and one adult with communication of the left atrium ...

A patient presented with a complaint of pleuritic chest discomfort with elevated cardiac biomarkers. After a cardiac magnetic resonance imaging scan for the suspicion of myopericarditis showed a potential myocardial infarct, a coronary CT scan was performed. This revealed a thrombus of the left anterior descending artery. Cardiac catheterization confirmed ...

Patients with coronary artery calcium (CAC) scores of zero are generally considered not to have atherosclerosis. Recent studies involving computed tomography coronary angiography (CTCA) challenge this assumption. This goal of the present study is to assess the frequency, morphology, location, and the prognosis of patients with plaque detected on CTCA ...

Massive cardiac calcification is rare, occurring in association with chronic diseases or more commonly with previous myocardial infarction. We present an intriguing case of massive myocardial calcification of the left ventricle in a young patient with restrictive cardiomyopathy and progressive heart failure who required transplantation. The patient's history and clinical ...

Vulnerable plaques are characterized by large lipid cores, positive remodeling and small coronary calcium deposits. Multi-detector computed tomography (MDCT) has recently been shown to be able to characterize coronary artery plaques. The aim of this study was to evaluate culprit coronary lesions for differentiating acute coronary syndrome (ACS) from stable ...

It is uncertain whether donor-transmitted coronary artery disease (DTCAD) affects heart transplant (HT) recipients. This retrospective analysis includes records of all patients who underwent a HT at our center over an 8-year period, who survived for at least 1 month, and who were examined by coronary angiography within 2 months ...

Cardiac allograft vasculopathy remains the leading cause of late morbidity and mortality in heart transplantation. The main diagnostic methods, coronary angiography or intracoronary ultrasound (when angiography is normal), are invasive. Other study methods, such as coronary computed tomography (CT) and virtual histological analysis, have not been widely assessed in this ...

Coronary artery anomalies are a rare and often occasional finding at coronary angiography. When patients with ST-elevation myocardial infarction (STEMI) undergo angiography preliminary to a primary percutaneous coronary intervention, a 'missing' coronary artery is usually ascribed to the culprit occluded vessel.Two patients with inferior STEMI were admitted to our cath ...

Patients with symptomatic multivessel coronary artery disease rejected for coronary revascularisation have adverse prognosis. We describe a 61 year-old male with non-ST-elevation myocardial infarction who was considered unsuitable for coronary revascularisation based on the conventional angiography findings. Unlike conventional angiography, computed tomography angiography visualised distal coronary segments and the patient ...

Coronary angiography has provided an unrivalled appreciation of coronary anatomy fostering a far greater appreciation of the extent of atherosclerotic disease. However, the subjectivity of coronary angiography at determining the extent of plaque has been exposed with IVUS. Indices of coronary physiology have provided valuable adjunctive information as to the ...

OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of nuclear stress imaging as compared with noninvasive coronary artery imaging using 64-detector row cardiac computed tomography. BACKGROUND: Compared with invasive coronary angiography, multidetector row cardiac computed tomographic angiography (CTA) has shown promise in the accurate detection of ...

BACKGROUND: Multidetector computed tomography-coronary angiography allows quantification of coronary stenosis with a high level of accuracy; however, the inherent inaccuracy of visual score still remains. Computed quantitative vessel analysis systems (quantitative computed tomographic angiography [QCTA]) aim to overcome this limitation. The aim of our study was to evaluate the accuracy ...

OBJECTIVE: The purpose of this article is to compare the performance of dual-energy CT with that of 3-T MRI with late enhancement for the detection of chronic myocardial infarction during first-pass coronary CT angiography (CTA). SUBJECTS AND METHODS: Thirty-six patients underwent coronary CTA for the assessment of coronary bypass graft ...

Recent advances in multidetector-row computed tomography (MDCT) technology have created new opportunities in cardiac imaging and provided new insights into a variety of disease states. Use of 64-slice coronary computed tomography angiography has been validated for the evaluation of clinically relevant coronary artery stenosis with high negative predictive values for ...

We report here a case of streaky fat deposition in the middle layer of the left ventricular myocardium, without any underlying etiology, and this was seen on computed tomography coronary angiography. This report suggests that left ventricular middle layer fat deposition should be investigated in order to determine its etiology, ...

Angiograms of cardiac transplant (HTx) recipients were to be evaluated in a ring experiment and a joint consensus on criteria of angiographic evaluation of coronary arteries of HTx patients was to be reached. Twenty-four coronary angiograms from 11 hospitals were circulated. One hundred eighty-eight blinded evaluations were returned. A joint ...