Journal of cardiovascular medicine
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J Cardiovasc Med (Hagerstown) · Jun 2010
Case ReportsTako-tsubo cardiomyopathy after successful resuscitation of out-of-hospital cardiac arrest.
A 69-year-old woman and a 29-year-old man were admitted to our hospital after successful resuscitation of out-of hospital cardiac arrest. In the first case, electrocardiogram showed mild ST-segment elevation in leads V3-V5. Coronary angiography did not show any obstructive coronary artery disease, and left ventriculography showed apical ballooning of the left ventricular chamber. ⋯ In both cases, left ventricular function returned to normal, but they died of multiple organ failure. In conclusion, cardiologists should recognize that takotsubo cardiomyopathy can occur even after successful resuscitation of cardiac arrest. Early diagnosis and appropriate intensive care are essential in these critically ill patients.
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J Cardiovasc Med (Hagerstown) · Apr 2010
Comparative StudyPreoperative creatinine clearance as a predictor of short-term outcomes after cardiac surgery: a cohort study for the comparison between the Cockroft-Gault and modification of diet in renal disease formulae.
Preoperative renal function is an important risk factor in cardiac surgery for long-term and short-term outcomes. Renal function is best assessed by measuring or calculating the glomerular filtration rate (GFR). Several algorithms using the endogenous marker serum creatinine have been developed to estimate renal function. These include the Cockcroft and Gault and the modification of diet in renal disease (MDRD) formulae. The aim of this study was to compare the predictive power of the two formulae towards short-term outcomes after cardiac surgery, such as the length of intensive care unit (ICU) stay, the length of mechanical ventilation time, and the length of in-hospital stay. ⋯ There is an indication that the Cockcroft and Gault formula could be more powerful than the MDRD formula for the preoperative prediction of early postoperative clinical outcomes in cardiac surgery, in patients not affected by renal failure. Further research is needed to confirm this result.
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J Cardiovasc Med (Hagerstown) · Apr 2010
Prognostic value of stable troponin T elevation in patients discharged from emergency department.
Troponin elevation in the absence of myocardial infarction is a challenging diagnostic problem in the emergency department (ED). Elevated troponin levels have a short-term negative prognostic value in critically ill patients hospitalized for all causes. No data are available about the short-term prognostic value of elevated troponin in ED patients discharged from hospital without clinical evidence of acute diseases. The aim of the study was to evaluate the short-term prognostic value of elevated stable troponin T (TnT) in ED patients discharged from hospital. ⋯ The patients discharged from ED with stable elevated TnT levels, but without acute diseases, had a short-term prognosis worse than that of patients with similar clinical presentation but with normal TnT values.
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J Cardiovasc Med (Hagerstown) · Mar 2010
Echo/Doppler-derived time intervals are able to predict left ventricular reverse remodeling after cardiac resynchronization therapy.
We evaluated the predictive value of echo/Doppler derived indices, which reflect the duration of the isovolumic phases of the cardiac cycle, in identifying cardiac resynchronization therapy (CRT) responders. ⋯ Echo/Doppler derived indices, describing physiologic abnormalities of the isovolumic contraction and relaxation phase, are able to predict CRT-induced reverse remodeling.