Pub Date : 2019-03-19DOI: 10.4172/2155-9880.1000624
S. Ushiroda
Background: Ventricular contractile responses to β-blockers remain largely unknown in patients with AtrialFibrillation (AF) and Heart Failure (HF), despite the recommended use of β-blockers as first-line pharmacotherapyfor these patients. This study investigated β-blocker effects on ventricular contractile mechanisms, namely theFrank-Starling Mechanism (FSM), Mechanical Restitution (MR), and Postextrasystolic Potentiation (PESP), whichare closely associated with ventricular contractile function, in AF patients with HF with preserved (HFpEF) versusreduced Ejection Fraction (HFrEF). Methods: Twenty AF patients were divided into two groups based on EF: the HFpEF group (EF ≥ 50%, n=14)and the HFrEF group (EF<40%, n=6). Using impedance cardiography, an FSM-MR graph and a PESP graph werecreated by applying (dZ/dt) min values representing the peak velocity of aortic blood flow on the y-axis againstpreceding RR interval (RR1) or RR1/pre-preceding RR interval (RR2) ratio values on the x-axis at baseline and afteradministration of a β-blocker in AF patients with HFpEF versus HFrEF. Results: With the β-blocker administration, rates of increase in median (dZ/dt) min values showed a significantpositive correlation with the rates of increase in median RR1 values as the functions of the FSM-MR in AF patientswith HFpEF (ρ=0.88, P<0.001), in contrast to those with HFrEF (ρ=−0.43, P=0.40). PESP index values representingthe extent of the effect of PESP were similarly and significantly decreased after administration of the β-blocker inboth groups: AF patients with HFpEF (baseline: median 5.9 [Interquartile Range (IQR) 2.0-16.9] vs. after β-blocker:median 1.6 [IQR 0.62-7.2]; P=0.023), and AF patients with HFrEF (baseline: median 6.6 [IQR 0.66-22.6] vs. after β-blocker: median 1.2 [IQR 0.06-15.1]; P=0.028). Conclusions: From the perspective of ventricular contractile mechanisms in AF, the β-blocker may be effectiveon the Frank-Starling mechanism and mechanical restitution in AF patients with HFpEF, but not HFrEF
{"title":"A andbeta;-Blocker may be Effective on Ventricular Contractile Mechanisms in Atrial Fibrillation Patients with Heart Failure with Preserved, but not Reduced, Ejection Fraction","authors":"S. Ushiroda","doi":"10.4172/2155-9880.1000624","DOIUrl":"https://doi.org/10.4172/2155-9880.1000624","url":null,"abstract":"Background: Ventricular contractile responses to β-blockers remain largely unknown in patients with AtrialFibrillation (AF) and Heart Failure (HF), despite the recommended use of β-blockers as first-line pharmacotherapyfor these patients. This study investigated β-blocker effects on ventricular contractile mechanisms, namely theFrank-Starling Mechanism (FSM), Mechanical Restitution (MR), and Postextrasystolic Potentiation (PESP), whichare closely associated with ventricular contractile function, in AF patients with HF with preserved (HFpEF) versusreduced Ejection Fraction (HFrEF). Methods: Twenty AF patients were divided into two groups based on EF: the HFpEF group (EF ≥ 50%, n=14)and the HFrEF group (EF<40%, n=6). Using impedance cardiography, an FSM-MR graph and a PESP graph werecreated by applying (dZ/dt) min values representing the peak velocity of aortic blood flow on the y-axis againstpreceding RR interval (RR1) or RR1/pre-preceding RR interval (RR2) ratio values on the x-axis at baseline and afteradministration of a β-blocker in AF patients with HFpEF versus HFrEF. Results: With the β-blocker administration, rates of increase in median (dZ/dt) min values showed a significantpositive correlation with the rates of increase in median RR1 values as the functions of the FSM-MR in AF patientswith HFpEF (ρ=0.88, P<0.001), in contrast to those with HFrEF (ρ=−0.43, P=0.40). PESP index values representingthe extent of the effect of PESP were similarly and significantly decreased after administration of the β-blocker inboth groups: AF patients with HFpEF (baseline: median 5.9 [Interquartile Range (IQR) 2.0-16.9] vs. after β-blocker:median 1.6 [IQR 0.62-7.2]; P=0.023), and AF patients with HFrEF (baseline: median 6.6 [IQR 0.66-22.6] vs. after β-blocker: median 1.2 [IQR 0.06-15.1]; P=0.028). Conclusions: From the perspective of ventricular contractile mechanisms in AF, the β-blocker may be effectiveon the Frank-Starling mechanism and mechanical restitution in AF patients with HFpEF, but not HFrEF","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"24 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2019-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81264238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-21DOI: 10.4172/2155-9880-c8-110
pOvidio Alberto Garcia Villarrealp
{"title":"MitraClip therapy: Rules do not change; Annuloplasty ring is a must","authors":"pOvidio Alberto Garcia Villarrealp","doi":"10.4172/2155-9880-c8-110","DOIUrl":"https://doi.org/10.4172/2155-9880-c8-110","url":null,"abstract":"","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74260194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2155-9880.1000623
Waleed I. Ibraheem, O. Abbas
Background: Previous reports indicated that patients who underwent CABG operation after previous stenting had a higher incidence of early death and major adverse cardiac events.Aim of the work: In our study, we tried to evaluate the effects of previous PCI on the myocardial function as estimated by echocardiography. As improvements in myocardial functions are a necessary argument for undergoing revascularization, it is critical to conclude preoperatively all the risk factors that might hinder this improvement. By doing such evaluation, we tried to conclude if it is necessary to include previous coronary artery stenting as a part of the EUROSCORE for risk evaluation before coronary artery bypass surgery if it really had a negative impact on postoperative myocardial function following CABG revascularization surgery.Patients and methods: After approval of the ethical committee of Ain Shams University, a prospective comparative randomized study on a cohort of 100 consecutive patients who underwent CABG in the period between January 2015 and December 2017 in Ain Shams University Hospitals, Cairo, Egypt. The patients were randomly assigned to the groups according to the specified inclusion and exclusion criteria. Patients were divided into two groups, GROUP I (number=50) patients who underwent CABG without previous left anterior descending artery stenting, and GROUPII (number=50) patients who underwent CABG with previous single or multiple LAD stenting. ECHO WITH 2D STAIN (speckle tracking) was used to evaluate the cardiac functions. Echocardiography was done pre-operatively, after one week, three months and six months postoperatively in both groups.Results: The results revealed that there is no statistically significant difference between both groups in the Preoperative risk factors: age, smoking, DM, HTN, family history, dyslipidemia, liver function, renal function, and hemoglobin levels. EuroSCORE values were comparable between the two groups. However, there was a statistically significant difference in preoperative MI, as there were 78% in group II that have history of preoperative MI in the 3-months period before surgery while in group I there were only 22%. Moreover, there is a statistically significant difference in the LADcalcification and atheroma severity between the two groups as 78% in group II vs. 22% in group I had extensive LAD disease with poor vessel quality. There was a statistically significant difference between both groups regarding the incidence of postoperative arrhythmia and bleeding postoperatively with higher values in group II. More importantly, the results revealed that there was a statistically significant difference between both groups in ECHO dimensions, EF and FS which are higher and better in group I vs. group II. Also, there is a statistically significant difference between both groups in ECHO wall motion values in most of the segments especially apical anterior septum segment and apex which reflect the viability of t
背景:先前的报道表明，先前支架植入术后接受CABG手术的患者早期死亡和主要心脏不良事件的发生率较高。工作目的:在我们的研究中，我们试图通过超声心动图评估既往PCI对心肌功能的影响。由于心肌功能的改善是进行血运重建的必要理由，因此术前总结所有可能阻碍这种改善的危险因素是至关重要的。通过这样的评估，我们试图得出结论，如果冠状动脉支架置入术确实对冠状动脉搭桥术后心肌功能有负面影响，是否有必要将其纳入冠状动脉搭桥术术前风险评估的EUROSCORE。患者和方法:经艾因沙姆斯大学伦理委员会批准，对2015年1月至2017年12月在埃及开罗艾因沙姆斯大学医院连续行CABG的100例患者进行前瞻性比较随机研究。根据指定的纳入和排除标准，将患者随机分为两组。将患者分为两组，第一组(50人)为术前未行左前降支支架置入术的CABG患者，第二组(50人)为术前曾行单支或多支LAD支架置入术的CABG患者。采用ECHO WITH 2D STAIN(斑点跟踪)评估心功能。术前、术后1周、3个月、6个月分别进行超声心动图检查。结果:两组患者术前危险因素:年龄、吸烟、DM、HTN、家族史、血脂异常、肝功能、肾功能、血红蛋白水平差异无统计学意义。两组之间的EuroSCORE值具有可比性。但术前心肌梗死差异有统计学意义，II组术前3个月有心肌梗死史的患者占78%，而I组仅有22%。此外，两组之间的LAD钙化和动脉粥样硬化严重程度有统计学差异，II组78%比I组22%存在广泛的LAD病变，血管质量差。两组术后心律失常及术后出血发生率比较，差异有统计学意义，II组发生率较高。更重要的是，结果显示两组患者在ECHO维度、EF和FS方面差异有统计学意义，且I组高于II组。两组在大多数节段的ECHO壁运动值，特别是反映这些节段活力的尖前间隔节段和尖壁运动值，差异均有统计学意义。这些运动值在I组比II组更好，表明更好的血运重建。结论:既往PCI对后续CABG的预后有负面影响。这种影响与任何术前风险变量无关。超声心动图测量的EDD、ESD、EF和RSWMA等心肌功能在没有术前PCI的CABG组改善更好。因此，决定采用经皮冠状动脉介入治疗应仔细权衡其对后续冠脉搭桥的较高风险。应严格遵循干预指南，特别是有复杂冠状动脉病变的患者，其转诊行冠脉搭桥的发生率较高。我们还建议将PCI程序作为一个独立的风险类别添加到当前EuroSCORE系统中已经测量的风险因素中。
{"title":"Effects of Previous Percutaneous Coronary Artery Interventions (PCI) on Myocardial Functions Post Coronary Artery Bypass Grafting, Should Previous PCI be Included in the Euroscore?","authors":"Waleed I. Ibraheem, O. Abbas","doi":"10.4172/2155-9880.1000623","DOIUrl":"https://doi.org/10.4172/2155-9880.1000623","url":null,"abstract":"Background: Previous reports indicated that patients who underwent CABG operation after previous stenting had a higher incidence of early death and major adverse cardiac events.Aim of the work: In our study, we tried to evaluate the effects of previous PCI on the myocardial function as estimated by echocardiography. As improvements in myocardial functions are a necessary argument for undergoing revascularization, it is critical to conclude preoperatively all the risk factors that might hinder this improvement. By doing such evaluation, we tried to conclude if it is necessary to include previous coronary artery stenting as a part of the EUROSCORE for risk evaluation before coronary artery bypass surgery if it really had a negative impact on postoperative myocardial function following CABG revascularization surgery.Patients and methods: After approval of the ethical committee of Ain Shams University, a prospective comparative randomized study on a cohort of 100 consecutive patients who underwent CABG in the period between January 2015 and December 2017 in Ain Shams University Hospitals, Cairo, Egypt. The patients were randomly assigned to the groups according to the specified inclusion and exclusion criteria. Patients were divided into two groups, GROUP I (number=50) patients who underwent CABG without previous left anterior descending artery stenting, and GROUPII (number=50) patients who underwent CABG with previous single or multiple LAD stenting. ECHO WITH 2D STAIN (speckle tracking) was used to evaluate the cardiac functions. Echocardiography was done pre-operatively, after one week, three months and six months postoperatively in both groups.Results: The results revealed that there is no statistically significant difference between both groups in the Preoperative risk factors: age, smoking, DM, HTN, family history, dyslipidemia, liver function, renal function, and hemoglobin levels. EuroSCORE values were comparable between the two groups. However, there was a statistically significant difference in preoperative MI, as there were 78% in group II that have history of preoperative MI in the 3-months period before surgery while in group I there were only 22%. Moreover, there is a statistically significant difference in the LADcalcification and atheroma severity between the two groups as 78% in group II vs. 22% in group I had extensive LAD disease with poor vessel quality. There was a statistically significant difference between both groups regarding the incidence of postoperative arrhythmia and bleeding postoperatively with higher values in group II. More importantly, the results revealed that there was a statistically significant difference between both groups in ECHO dimensions, EF and FS which are higher and better in group I vs. group II. Also, there is a statistically significant difference between both groups in ECHO wall motion values in most of the segments especially apical anterior septum segment and apex which reflect the viability of t","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90786037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-04DOI: 10.4172/2155-9880-c9-112
pMalcolm J Underwoodp
{"title":"Acute aortic syndromes: What do we know?","authors":"pMalcolm J Underwoodp","doi":"10.4172/2155-9880-c9-112","DOIUrl":"https://doi.org/10.4172/2155-9880-c9-112","url":null,"abstract":"","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85439619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.4172/2155-9880.1000612
Hussam Ezzat, I. S. Abdelaziz, A. Fahmy, A. Mostafa
M.D
医学博士
{"title":"Coronary Artery Atherosclerosis Assessment Using Multi Detector Computed Tomography and its Correlation with Framingham Risk Score among Symptomatic Patients with Chest Pain","authors":"Hussam Ezzat, I. S. Abdelaziz, A. Fahmy, A. Mostafa","doi":"10.4172/2155-9880.1000612","DOIUrl":"https://doi.org/10.4172/2155-9880.1000612","url":null,"abstract":"M.D","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72829863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-11DOI: 10.4172/2155-9880.1000600
Cesar Navarro-Paredes, M. Kurth, J. Lamont, I. Menown, M. Ruddock, S. Fitzgerald, J. Mclaughlin
Background: Chest pain of suspected cardiac origin is a common complaint for presentation at the emergency department; however only 10% to 13% of patients will have acute myocardial infarction (AMI). This study examined a decision support ‘rule-out’ algorithm to stratify risk of AMI in these patients. Methods: Five hundred and forty-eight patients with chest-pain of suspected cardiac origin were recruited. Blood samples were collected at presentation (t=0) and after 1, 2, 3, 6, 12 and 24 h. Serum troponin I, heart-type fatty acidbinding protein (H-FABP), myoglobin, carbonic anhydrase III (CAIII), creatine phosphokinase MB isoenzyme (CKMB) and glycogen phosphorylase isoenzyme BB (GPBB) were measured using the Randox Cardiac Plus Array; Troponin T (cTnT), high sensitivity troponin T (hs-cTnT), high sensitivity CRP (hs-CRP), NT-pro-BNP, total cholesterol, and HDL were measured using a Modular P Analyser. Clinical and demographic information was recorded for each patient. Results: For biomarker analysis, STEMIs were excluded, leaving 360 patients at presentation (72 NSTEMI and 288 non-AMI) and 320 patients at 1 h (66 NSTEMI and 254 non-AMI). A rule-out algorithm was developed based on H-FABP and hs-cTnT. When the H-FABP hs-cTnT combination algorithm was applied to the data, 106 additional patients at presentation were identified as non-AMI compared to the standard ESC algorithm, 189/288 (65.6%) vs. 83/288 (28.8%) (p<0.0005), respectively. Furthermore, the H-FABP hs-cTnT combination algorithm, identified 71% of non-AMI patients at 1 hour with no false negatives. Conclusion: Deployment of the H-FABP hs-cTnT combination algorithm at the emergency department could assist in the identification of non-AMI patients at presentation with the potential to reduce the number of hospital admissions by 106/288 (36.8%). Using the H-FABP hs-cTnT combination algorithm would have a significant impact on patient health ensuring that the appropriate care and efficient use of resources are directed to patients identified as high risk.
{"title":"Diagnostic Performance of a Combination Biomarker Algorithm for Rule-Out of Acute Myocardial Infarction at Time of Presentation to the Emergency Department, Using Heart-Type Fatty Acid-Binding Protein and High-Sensitivity Troponin T tests","authors":"Cesar Navarro-Paredes, M. Kurth, J. Lamont, I. Menown, M. Ruddock, S. Fitzgerald, J. Mclaughlin","doi":"10.4172/2155-9880.1000600","DOIUrl":"https://doi.org/10.4172/2155-9880.1000600","url":null,"abstract":"Background: Chest pain of suspected cardiac origin is a common complaint for presentation at the emergency department; however only 10% to 13% of patients will have acute myocardial infarction (AMI). This study examined a decision support ‘rule-out’ algorithm to stratify risk of AMI in these patients. Methods: Five hundred and forty-eight patients with chest-pain of suspected cardiac origin were recruited. Blood samples were collected at presentation (t=0) and after 1, 2, 3, 6, 12 and 24 h. Serum troponin I, heart-type fatty acidbinding protein (H-FABP), myoglobin, carbonic anhydrase III (CAIII), creatine phosphokinase MB isoenzyme (CKMB) and glycogen phosphorylase isoenzyme BB (GPBB) were measured using the Randox Cardiac Plus Array; Troponin T (cTnT), high sensitivity troponin T (hs-cTnT), high sensitivity CRP (hs-CRP), NT-pro-BNP, total cholesterol, and HDL were measured using a Modular P Analyser. Clinical and demographic information was recorded for each patient. Results: For biomarker analysis, STEMIs were excluded, leaving 360 patients at presentation (72 NSTEMI and 288 non-AMI) and 320 patients at 1 h (66 NSTEMI and 254 non-AMI). A rule-out algorithm was developed based on H-FABP and hs-cTnT. When the H-FABP hs-cTnT combination algorithm was applied to the data, 106 additional patients at presentation were identified as non-AMI compared to the standard ESC algorithm, 189/288 (65.6%) vs. 83/288 (28.8%) (p<0.0005), respectively. Furthermore, the H-FABP hs-cTnT combination algorithm, identified 71% of non-AMI patients at 1 hour with no false negatives. Conclusion: Deployment of the H-FABP hs-cTnT combination algorithm at the emergency department could assist in the identification of non-AMI patients at presentation with the potential to reduce the number of hospital admissions by 106/288 (36.8%). Using the H-FABP hs-cTnT combination algorithm would have a significant impact on patient health ensuring that the appropriate care and efficient use of resources are directed to patients identified as high risk.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"63 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2018-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87401743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-02DOI: 10.4172/2155-9880-C7-106
Aless, ro Delitala
{"title":"Beta stiffness index in euthyroid subjects: The role of free thyroxin","authors":"Aless, ro Delitala","doi":"10.4172/2155-9880-C7-106","DOIUrl":"https://doi.org/10.4172/2155-9880-C7-106","url":null,"abstract":"","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73264128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-01DOI: 10.4172/2155-9880-C6-104
W. Feeman
Heart transplantation is the last careful alternative for newborn children and small kids with inherent cardiovascular breakdown after bombed ordinary fix or palliative methods. We plan to introduce our outcomes in a review and graphic investigation. Techniques: Eighteen heart transplantations on youngsters (nine females and nine guys) were performed from 1988 to 2015. The scope old enough was between 0 days and three years. Signs for a transplantation were hypoplastic left heart disorder (n=14), non-compaction-condition (n=2), Bland-White-Garland-condition (n=1) and rendering of the incredible corridors (n=1). Fourteen youngsters (78%) had a past cardiovascular medical procedure. Four patients (22%) required mechanical circulatory help for spanning: ECMO (n=2; 11%), or LVAD and ECMO (n=2; 11%). Fifteen (83%) experienced a biatrial technique, three (17%) a bicaval one. Results: The middle holding up time in the wake of posting was 68 days (min: 0 days, max: 386 days, standard deviation (SD): 102.8 days). The general endurance was 61%, 13 youngsters (72%) endure the main year. Two patients (11%) had transplantation. The middle time patients spent at emergency unit 17 days (min: 1 day; max: 121 days). They were respirated for seven days (min: 1 day; max: 91 days). Perioperative variables we broke down were: the middle myocardial ischemia time was 236 minutes. The middle aortic cinch time was 95 minutes; the middle time of circulatory capture was an hour. Three kids (17%) got a pericardial emission. Two patients (11%) endured each: dying, cardiovascular arrhythmias, diaphragmatic paresis and cerebral difficulties. Five (28%) got a lymphoproliferative sickness. Seven kids (39%) got a coronary unite vasculopathy. Two (11%) required interventional treatment. Three (17%) got a cardiovascular pace producer. As per our information, six kids had a dismissal which called for treatment. End:
{"title":"Survival of 101 year old woman on statin therapy","authors":"W. Feeman","doi":"10.4172/2155-9880-C6-104","DOIUrl":"https://doi.org/10.4172/2155-9880-C6-104","url":null,"abstract":"Heart transplantation is the last careful alternative for newborn children and small kids with inherent cardiovascular breakdown after bombed ordinary fix or palliative methods. We plan to introduce our outcomes in a review and graphic investigation. Techniques: Eighteen heart transplantations on youngsters (nine females and nine guys) were performed from 1988 to 2015. The scope old enough was between 0 days and three years. Signs for a transplantation were hypoplastic left heart disorder (n=14), non-compaction-condition (n=2), Bland-White-Garland-condition (n=1) and rendering of the incredible corridors (n=1). Fourteen youngsters (78%) had a past cardiovascular medical procedure. Four patients (22%) required mechanical circulatory help for spanning: ECMO (n=2; 11%), or LVAD and ECMO (n=2; 11%). Fifteen (83%) experienced a biatrial technique, three (17%) a bicaval one. Results: The middle holding up time in the wake of posting was 68 days (min: 0 days, max: 386 days, standard deviation (SD): 102.8 days). The general endurance was 61%, 13 youngsters (72%) endure the main year. Two patients (11%) had transplantation. The middle time patients spent at emergency unit 17 days (min: 1 day; max: 121 days). They were respirated for seven days (min: 1 day; max: 91 days). Perioperative variables we broke down were: the middle myocardial ischemia time was 236 minutes. The middle aortic cinch time was 95 minutes; the middle time of circulatory capture was an hour. Three kids (17%) got a pericardial emission. Two patients (11%) endured each: dying, cardiovascular arrhythmias, diaphragmatic paresis and cerebral difficulties. Five (28%) got a lymphoproliferative sickness. Seven kids (39%) got a coronary unite vasculopathy. Two (11%) required interventional treatment. Three (17%) got a cardiovascular pace producer. As per our information, six kids had a dismissal which called for treatment. End:","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88802832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-20DOI: 10.4172/2155-9880.1000594
Masayuki Mori, K. Sakata, C. Nakanishi, J. Yokawa, H. Okada, M. Shimojima, S. Yoshida, T. Gamou, K. Hayashi, M. Yamagishi, M. Kawashiri
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Pub Date : 2018-05-11DOI: 10.4172/2155-9880.1000587
A. Budzikowski, O. Hai, A. Beck, A. Khodak, C. Mitre
Background: Cardiac resynchronization therapy (CRT) has a proven role in improving mortality in patients with heart failure and ventricular dyssynchrony. However, the effects of biventricular pacing (CRT) on ventricular arrhythmia susceptibility have not been definitely established, and data regarding the risk of ventricular arrhythmias (VA) with CRT has been limited and conflicting.The aim of this study was to compare the burden of VA in the short term before and after an upgrade to a cardiac resynchronization device in order to avoid the long term effects of myocardial remodeling.Methods: We analyzed 44 consecutive patients with severe LV systolic dysfunction who underwent an upgrade from a single chamber defibrillator to biventricular defibrillator due to worsening heart failure status.Results: CRT was associated with a decrease in VA in patients with high arrhythmic burden, in women and in patients older than 65.Conclusion: In this study we provide convincing evidence that in patients with identical electrophysiological substrate, biventricular pacing alone is associated with a decrease in VA burden.
{"title":"The Impact of Cardiac Resynchronization Therapy on the Frequency of Ventricular Arrhythmias","authors":"A. Budzikowski, O. Hai, A. Beck, A. Khodak, C. Mitre","doi":"10.4172/2155-9880.1000587","DOIUrl":"https://doi.org/10.4172/2155-9880.1000587","url":null,"abstract":"Background: Cardiac resynchronization therapy (CRT) has a proven role in improving mortality in patients with heart failure and ventricular dyssynchrony. However, the effects of biventricular pacing (CRT) on ventricular arrhythmia susceptibility have not been definitely established, and data regarding the risk of ventricular arrhythmias (VA) with CRT has been limited and conflicting.The aim of this study was to compare the burden of VA in the short term before and after an upgrade to a cardiac resynchronization device in order to avoid the long term effects of myocardial remodeling.Methods: We analyzed 44 consecutive patients with severe LV systolic dysfunction who underwent an upgrade from a single chamber defibrillator to biventricular defibrillator due to worsening heart failure status.Results: CRT was associated with a decrease in VA in patients with high arrhythmic burden, in women and in patients older than 65.Conclusion: In this study we provide convincing evidence that in patients with identical electrophysiological substrate, biventricular pacing alone is associated with a decrease in VA burden.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"13 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89618037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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