European journal of clinical investigation
-
Eur. J. Clin. Invest. · Feb 2021
Secondary Mitral Regurgitation - Insights from MicroRNA Assessment.
While secondary mitral regurgitation (sMR) is associated with adverse outcome in heart failure with reduced ejection fraction (HFrEF), key pathophysiologic mechanisms remain poorly understood and might be elucidated by microRNAs (miRNA/miR), that were recently related to cardiac remodelling. This study sought to assess (i) the differences of miRNA profiles in patients with severe sMR compared to matched disease controls, (ii) the correlation between circulating miRNAs and surrogates of sMR severity as well as (iii) the prognostic implications of miRNA levels in severe sMR. ⋯ This study unveils distinct pathophysiologic maladaptions at a cellular level in patients with severe sMR compared to no/mild sMR by showing significant differences in miRNA profiles and correlations with sMR severity, supporting the concept that sMR drives cardiac remodelling in heart failure. Moreover, the increased risk for adverse outcome in HFrEF patients with severe sMR conveyed by miR-133a might indicate irreversible myocardial damage.
-
Eur. J. Clin. Invest. · Feb 2021
Predictors for Adverse Outcomes of Patients With Recanalized Chronic Total Occlusion Lesion.
It is ill-defined which factors affect the prognosis of patients with recanalized chronic total occlusion (CTO). This study sought to investigate predictors for adverse outcome in such a cohort with long-time follow-up. ⋯ Advanced age, left ventricular dysfunction and residual SYNTAX score were predictors for composite cardiovascular events in patients with CTO after revascularization. Those with non-LAD CTO, high J-CTO and residual SYNTAX score had higher risk for revascularization.
-
Eur. J. Clin. Invest. · Feb 2021
Concordance among diagnostic criteria for metabolic syndrome is inconsistent in spanish adolescents.
The metabolic syndrome (MetS), although more frequent in adults, is a growing health problem in adolescent population. There are different criteria for the diagnosis, however without a consensus of which is the best to be used in this population. The heterogeneity of the different diagnostic criteria makes it necessary to carry out more studies that analyse the degree of agreement among these criteria. The present study was aimed to evaluate the agreement between different criteria for diagnosis of MetS in adolescents. ⋯ The variability observed in the agreement among the existing criteria suggests the need to validate uniform criteria for the diagnosis of MetS in adolescents.
-
Eur. J. Clin. Invest. · Feb 2021
High-Dose Methylprednisolone in Nonintubated Patients with Severe COVID-19 Pneumonia.
Recent trials with dexamethasone and hydrocortisone have demonstrated benefit in patients with coronavirus disease 2019 (COVID-19). Data on methylprednisolone are limited. ⋯ In nonintubated patients with severe COVID-19 pneumonia, methylprednisolone was associated with reduced need for mechanical ventilation and less-intensive care resource utilization without excess complications.
-
The clustering of arterial stiffness with microvascular disease (MD) and their effects on the clinical outcome of patients with type 2 diabetes (T2D) remains not fully clarified. ⋯ These findings support that screening for arterial stiffness and MD in the routine clinical assessment of patients with T2D may enhance prognostication and cardiovascular risk reclassification.