Journal of Clinical and Experimental Cardiology最新文献

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"title":"Acute Thrombogenicity and Vascular Response after Bioresorbable Vascular Scaffold Implantation: Evidenced from Porcine Coronary Model","authors":"Masayuki Mori, K. Sakata, C. Nakanishi, J. Yokawa, H. Okada, M. Shimojima, S. Yoshida, T. Gamou, K. Hayashi, M. Yamagishi, M. Kawashiri","doi":"10.4172/2155-9880.1000594","DOIUrl":"https://doi.org/10.4172/2155-9880.1000594","url":null,"abstract":"","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"37 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79274195","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}

{"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}