Journal of Clinical and Experimental Cardiology最新文献

{"title":"Trans-catheter Aortic Valve Implantation in Patients with Previous Mitral Valve Replacement: A Case Series","authors":"M. Škafar, R. Zbačnik, J. Ambrožič, N. Lakič, S. Terseglav, M. Bunc","doi":"10.4172/2155-9880.1000563","DOIUrl":"https://doi.org/10.4172/2155-9880.1000563","url":null,"abstract":"Introduction: Transcatheter aortic valve implantation is a routine clinical method for patients with severe aortic stenosis at high surgical risk, such as previous cardiac surgery. The presence of mechanical mitral prosthesis might complicate trans-catheter aortic valve implantation because of possible interference between both prostheses. Some clinical reports have already demonstrated the feasibility of trans-catheter aortic valve implantation in such patients. \u0000Methods and results: We report 4 patients with severe symptomatic aortic stenosis who had prior mitral valve replacement that successfully underwent trans-catheter aortic valve implantation with Sapien XT (Edwards Lifesiences, Irvine, USA) and CoreValve (Medtronic, Irvine, USA) aortic prosthesis. Multi-slice computed tomographic angiography was used for the assessment of the distance between both aortic and mitral prosthesis annuli. Trans-esophageal echocardiography was introduced for precise positioning of trans-catheter aortic valve. There were no special technical tips besides precise positioning and slow opening of the valve prosthesis. In case of CoreValve the goal was the positioning close to “zero point” and in case of Edwards Sapien valve higher as a “halfon- half” position according to natural aortic valve. We observed no deformation or dysfunction of aortic and mitral prosthesis in any of the patients. Balloon aortic valvuloplasty prior to implantation is not mandatory; however it helps to observe the mutual effect of the new aortic valve and pre-existent mitral prosthesis. \u0000Conclusions: We conclude that trans-catheter aortic valve implantation can be safely and successfully performed in patients with mechanical mitral prosthesis. It is important to carefully evaluate the anatomical conditions with trans-esophageal echocardiography and computed tomographic angiography. Skillfulness and experience of the operators should not be neglected.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"6 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89695590","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 Invasive Coronary Angiography in Patients with Small Myocardial Perfusion Defects with Low Exercise Tolerance","authors":"Ehab A. El-Sayed, Ahmed K Metawa, M. Mokarrab, I. Shawky, M. A. Mousa, Mohammed E Saif","doi":"10.4172/2155-9880.1000564","DOIUrl":"https://doi.org/10.4172/2155-9880.1000564","url":null,"abstract":"Background: The diagnostic and prognostic value of stress myocardial perfusion scintigraphy is well established in literature. The sensitivity and specificity of the test depends on multiple factors. The workload achieved during treadmill exercise is one of the most important determinants. Hence, we thought to assess the coronary anatomy in a group of patients with low exercise tolerance that showed small perfusion defects on stress MPI studies. \u0000Material and methods: We prospectively enrolled 50 patients with mild perfusion defects and a poor exercise tolerance. An invasive coronary angiography was done according to the clinical decision of the treating physician. All patients were subjected to full history and clinical examination. Stress SPECT Tc99m Sestamibi scintigraphy was done on basis of a 2 day stress/rest imaging protocol (Exercise duration, age predicted maximal heart rate (APMHR %), ejection fraction (EF%), transient ischemic dilatation and duke treadmill score(DTS)) were recorded. A coronary stenosis ≥ 75% was considered significant. In the current study, APMHR 0.05 is considered significant. \u0000Results: Among the study cohort, a total of 6 patients (12%) had significant CAD. In presence of a small perfusion defect in the setting of low exercise tolerance, significant CAD was observed more frequently in patients with exercise duration ≤ 7 min, APMHR <85%, transient stress induced LV cavity dilatation and moderate/high DTS. The six patients with significant angiographic lesions demonstrated single vessel disease in the whole group. Distribution of the angiographic lesions was as follows: RCA (4 patients) 66.7%, the LAD (one patient) 16.65%, and the LCX (one patient) 16.65%. \u0000Conclusion: In the setting of low exercise tolerance, negative MPI/small sized perfusion defect may not exclude significant CAD. Several clinical, stress, and SPECT-MPI findings may help to predict high risk patients. Consideration of these factors may improve the overall assessment of the likelihood of significant CAD in patients undergoing stress SPECT- MPI.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"23 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80766725","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":"Liquiritigenin Enhances the Radiosensitivity of Nasopharyngeal Carcinoma Cell by Affecting Its Autophagy","authors":"Ke Yang, Yujie Li, M. Yu, Xujuan Sun","doi":"10.4172/2155-9880.1000561","DOIUrl":"https://doi.org/10.4172/2155-9880.1000561","url":null,"abstract":"Objective: To investigate the effect of licorice on radiosensitization of nasopharyngeal carcinoma cells and its mechanism. \u0000Methods: MTT assay was used to detect the effect of different concentrations of glycyrrhizin on the activity of nasopharyngeal carcinoma cells. The changes of autophagy were observed by transmission electron microscopy (TEM) in the treatment of nasopharyngeal carcinoma cells. Western blotting was used to detect the effect of glycyrrhizin on the level of autophagy protein in nasopharyngeal carcinoma. Flow cytometry was used to detect the changes of apoptosis rate of nasopharyngeal carcinoma cell line after radiotherapy. \u0000Results: After successfully constructing CNE-2-RR radiation resistant cell line, MTT assay was used to detect the best inhibition rate of 20 mmol/L glycyrrhizin on nasopharyngeal carcinoma (58.86 ± 5.02)%. Transmission electron microscopy showed that the number of autophagosomes increased and the mitochondria and nuclei were abnormal in the treatment of nasopharyngeal carcinoma cells. Western Blotting was used to detect the increase of LC3-II level and the decrease of LC3-I level in nasopharyngeal carcinoma cells of 20 mmol/L concentration group. \u0000Conclusion: Glycyrrhizin enhances its sensitivity to radiotherapy by influencing autophagy and DNA repair ability of nasopharyngeal carcinoma cells.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"106 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87899959","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":"Effect of Diabetes on Myocardial Infarct and No Reflow Size in an Experimental Rat Model and Clinical Trial","authors":"W. Dai, R. Kloner, Jianru Shi, Serge Korjian, Y. Daaboul, M. Gibson, M. Bouly, M. Isabelle, Juan E. Carreño","doi":"10.4172/2155-9880.1000560","DOIUrl":"https://doi.org/10.4172/2155-9880.1000560","url":null,"abstract":"Background: We determined the effect of diabetes on no reflow and myocardial infarct sizes in both an experimental rat model of diabetes and a contemporary trial of subjects with STEMI. \u0000Methods: Adult Zucker Diabetic Fatty (ZDF) and Sprague Dawley (SD) rats (n=15 each group) were subjected to left coronary artery occlusion for 30 min followed by 3 h of reperfusion. In the clinical trial, the myocardial infarct (MI) size and the zone of microvascular obstruction were assessed in 258 non-diabetic MI patient and 34 diabetic MI patients. \u0000Results: There was no difference in infarct size (median) in ZDF rats (49.9%) versus SD rats (59.6%; p=0.32); there was no difference in no-reflow size (mean ± SEM) in ZDF rats (32.5 ± 3.5%) versus SD rats (32.7 ± 4.3%; p=0.97). In the clinical study, CK-MB and Troponin I area under the curve at 72 h were comparable between the 2 groups. Infarct size by MRI on day 4 was 37.9 ± 1.8 ml in 216 non-diabetic patients and 34.8 ± 4.7 ml in 27 diabetic patients (p=0.559). The ratio of micro vascular obstruction on day 4 on the MRI was 0.179 ± 0.018 of the left ventricle in 200 non-diabetic patients and 0.220 ± 0.060 of the left ventricle in 23 diabetic patients. \u0000Conclusions: Both animal and clinical studies demonstrated no evidence for a larger infarct size, or larger area of no reflow in the diabetic compared to non-diabetic conditions.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"98 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84007708","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 aptamer BC 007 for in vivo neutralization of pathogenic autoantibodies directed against G-Protein coupled receptors present in patients with cardiomyopathy: Steps to a new treatment option","authors":"I. Schimke","doi":"10.4172/2155-9880-C1-079","DOIUrl":"https://doi.org/10.4172/2155-9880-C1-079","url":null,"abstract":"","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81357990","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":"A Serial NT-proBNP Model to Improve Prognostication in Patients with Pulmonary Arterial Hypertension","authors":"A. Wolfson, M. Maitland, Vasiliki Thomeas, C. Glassner, M. Gomberg-Maitland","doi":"10.4172/2155-9880.1000555","DOIUrl":"https://doi.org/10.4172/2155-9880.1000555","url":null,"abstract":"Background: Baseline elevation in N-terminal pro-brain natriuretic peptide (NT-proBNP) in pulmonary arterial hypertension (PAH) patients is associated with worse outcomes. Serial measurement of commonly available biomarkers could improve the precision of prognostic estimates and our understanding of PAH pathophysiology. Methods: Included were 103 PAH patients with baseline elevated NT-proBNP prior to the initiation or escalation of therapy with at least two subsequent NT-proBNP measurements. Using patients’ serial measurements, a linear mixed-effects model extrapolated a baseline NT-proBNP (intercept) and evolution (slope). These model-determined values were then used in Cox proportional hazards analysis to determine predictors of survival. Time-dependent area under the curve (AUC) analysis compared survival discrimination of serial versus single measurements of NTproBNP. Results: Subjects were 50 ± 14 years; most had idiopathic PAH, congenital heart disease, or connective tissue disease. Survivors were younger than non-survivors 47 ± 14 versus 55 ± 12 years (p=0.002). A multivariable survival model using invasive and non-invasive covariates found NT-proBNP significantly predicted mortality. Timedependent AUC was significantly greater for modeled (intercept) versus measured NT-proBNP. Conclusions: Prognostic modeling utilizing serial NT-proBNP measurements better predict survival than a single baseline value. This evidence supports the conduct of future studies of serial measurement of NT-proBNP to further clarify its role in the clinical care of PAH patients.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"97 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73612318","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":"Can Headache Help to Rule out Stroke Mimics during Stroke Alert","authors":"E. Sidorov, David Thompson, V. Pandav, Joshua Santucci, B. Bohnstedt, Bappaditya Ray","doi":"10.4172/2155-9880.1000554","DOIUrl":"https://doi.org/10.4172/2155-9880.1000554","url":null,"abstract":"Objective: When patients present to the emergency department (ED) with acute focal neurological deficit, sometimes it is hard to make a decision about IV thrombolysis. In such situations, neurologists need to make a judgment call about it. According to some studies, IV thrombolysis is safe for patients with stroke mimics; however, a small possibility of hemorrhage still exists. Furthermore, unnecessary IV thrombolysis in stroke mimics significantly increases cost of care. We aimed to determine if presence of headache in patients with focal neurological deficit during stroke alerts makes a difference in the neurologist decision about IV thrombolysis. \u0000Methods: A retrospective chart review of 326 patients who presented to The University of Oklahoma Medical Center (OUMC) as a stroke alert in 2013. \u0000Results: At OUMC, 151 patients were ineligible for IV thrombolysis. Out of the remaining 175 patients, 62 presented with and 113 without headache. Seven out of the 62 patients with headache were initially diagnosed in the ED with ischemic stroke and received IV thrombolysis. On later evaluation, all of these 62 patients turned out to be stroke mimics. Forty-five out of 113 patients without headache were initially diagnosed as ischemic stroke in the ED and received IV thrombolysis. Nine of these 45 patients were later diagnosed as stroke mimics while 36 had ischemic stroke. Out of the remaining 68 patients without headache, who were initially diagnosed with stroke mimics and did not receive IV thrombolysis, 4 were later diagnosed with ischemic stroke and 64 were confirmed stroke mimics. In general, patients with headache had much less frequent IV thrombolysis 7/62 (11%) than patients without headache 45/113 (40%) (p<0.0001). No patients with headache, compared to 40 patients (36 who had IV thrombolysis+4 who did not) without headache, were later diagnosed with ischemic stroke (p<0.0001). \u0000Conclusion: Patients with headache and acute focal neurological deficit less frequently receive IV thrombolysis and are less frequently diagnosed with ischemic stroke after completion of workup. Presence of headache may help neurologists to decide whether to do IV thrombolysis.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"52 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84010091","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":"Exercise Capacity and Quality of Life after Total Cavopulmonary Connection at Adults","authors":"Hu Xiaosng, Keming Yang, Shoujun Li, Wenxiang Jiang, Xingguo Sun","doi":"10.4172/2155-9880.1000551","DOIUrl":"https://doi.org/10.4172/2155-9880.1000551","url":null,"abstract":"Objective: The aim of this study was to evaluate the clinical and psychological profile of after total cavopulmonary connection procedure and to identify the significant determinants of quality of life. Methods: Data from 21 patients underwent total cavopulmonary connection procedure from January 2001 to December 2015 were retrospectively analyzed. Patients underwent an echocardiography and cardiopulmonary exercise testing. Used ST-36 questionnaire to perceived health status. The NT-pro BNP levels was test. Results: 21 patients aged between 19 to 36 years (mean 26.6 years) were enrolled. The mean follow-up time was 44.2 ± 29.9 months. The mean EF was 59.4 ± 6.2%, and the mean maximal oxygen consumption was 19.9 ± 3.6 ml/kg/min, predict value was 52.5 ± 8.9%. SF-36 score was well. Independent risk for impaired exercise capacity was interval time from surgery. Conclusions: The exercise capacity of total cavopulmonary connection patients was impaired. Identify more predict factors of the quality of these patients need further study.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"42 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73304387","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":"Heme, hemoglobin promotes the progression of atherosclerosis","authors":"J. Balla","doi":"10.4172/2155-9880-C1-076","DOIUrl":"https://doi.org/10.4172/2155-9880-C1-076","url":null,"abstract":"","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74662883","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":"Impact of Acarbose on the Serum YKL-40 Concentrations of Coronary Heart Disease Patients with Impaired Glucose Tolerance","authors":"Yihong Ni","doi":"10.4172/2155-9880.1000549","DOIUrl":"https://doi.org/10.4172/2155-9880.1000549","url":null,"abstract":"Background: YKL-40 is involved in inflammation and endothelial dysfunction, and associated with diabetes and atherosclerosis  disease. In the present study we investigated the effect of an alpha-glucosidase inhibitor, acarbose, on coronary heart disease patients with impaired glucose tolerance (IGT) and the impact of acarbose on the serum YKL-40 concentrations of these patients. Methods: This was a 24 weeks study in patients with established coronary artery disease (CAD) (50% stenosis on quantitative coronary angiography) who were newly diagnosed with IGT. After undergoing coronary angiography, CAD patients with IGT were randomly allocated to receive either acarbose 100 mg/d (C group) or no treatment group (B group) for 24 weeks. 30 patients with CAD and normal glucose tolerance were enrolled in control group (A group). Anthropometrical evaluation, fast blood glucose (FBG), postprandial blood glucose (PBG), serum fast insulin (FINS), lipid profile including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), HbA1c and serum YKL-40 were measured at baseline and 24 weeks end point. Results: There were no significant differences among tree groups in terms of age, gender distributions, SBP, DBP, TGTC, HDL-C, LDL-C, FBG. The levels of WHR, BMI, FINS, HOMA-IR, YKL-40 in the B group were significantly higher than A group. After 24-weeks treatment of acarbose (100 mg/d), the levels of WHR, TG, YKL-40 FINS, PBG, HbA1c and HOMA-IR were significantly reduced (p<0.05). Conclusions: After the treatment of acarbose 100 mg/d, the coronary heart disease patients with IGT had a beneficial effect in the glucose and lipid metabolism, the insulin resistance and serum YKL-40 concentrations were decreased.","PeriodicalId":15504,"journal":{"name":"Journal of Clinical and Experimental Cardiology","volume":"7 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75511156","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}