Herz
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We evaluated our early and late outcomes after pericardiectomy in patients with constrictive pericarditis (CP). ⋯ Although early mortality after pericardiectomy remains high, the procedure provides significant improvement in functional status in the long term.
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Vasoactive drugs and inotropic agents are important for the hemodynamic management of cardiogenic shock. In this article the use of different vasoactive and ionotropic drugs in cardiogenic shock is presented. Hemodynamic management during cardiogenic shock occurs after initial moderate volume delivery by dobutamine to increase inotropism. ⋯ The daily question is whether the dose can be reduced or in the case of deterioration whether the use of an extracorporeal circulatory support system should be considered. There are currently no available data on mortality that demonstrate the benefit of hemodynamic monitoring using target criteria. The advantage, however, results from the economic use of inotropics and vasopressors by certain target criteria.
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Review Practice Guideline
[Cardiovascular prevention and regular physical exercise : Activity and training as the true "polypill"].
Guidelines for cardiovascular prevention need to be regularly revised and updated. With respect to physical activity and exercise, many studies with practical relevance have been published in recent years. They are concerned with the evidence of physical activity for prevention of many diseases and the spectrum of indications for applying physical activity for prevention, therapy and rehabilitation. ⋯ The prescription of exercise is an important approach for improving the motivation for physical activity; however, prescribing exercise needs basic knowledge in sports physiology and proper training recommendations. Furthermore, population-based interventions for physical activity are urgently needed to implement more physical activity in the daily routine. The current ESC guidelines provide a great deal of new information to be implemented in the prevention in primary care; however, with regard to physical activity, more comprehensive biological data of physical activity should be presented in order to improve physician's knowledge, thus enhancing the fight against inactivity and sedentary lifestyles as one of the most significant risk factors.
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Technological advances in computed tomography (CT) resulted in an expansion of (the spectrum of) indications and numbers of examination in cardiology. Thus, CT found it's way into cardiological clinical practice as well as in current guidelines. This article describes the state of the technology, current developments, and the clinical significance of cardiac CT. ⋯ Hence, the curriculum "Cardiac CT" for the additional qualification of cardiologists has been introduced. The conduct and interpretation of cardiac CT require the expertise of cardiologists and radiologists to ensure its diagnostic value and patient safety in the best possible way. Therefore, structures for cooperation between the two disciplines need to be established in outpatient and in inpatient care.
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Review Meta Analysis
Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure : Results of a meta-analysis of randomized controlled trials.
The guidelines of the Scientific Societies of Cardiology recommend limiting fluid intake as a nonpharmacological measure for the management of chronic heart failure (HF). However, many patients with HF may suffer from severe thirst. A meta-analysis was performed to evaluate the effect of limiting fluid consumption based on various clinical and laboratory outcomes in patients with chronic HF. ⋯ In patients with HF, liberal fluid consumption does not seem to exert an unfavorable impact on HF rehospitalizations or all-cause mortality. Further randomized controlled trials are warranted to definitively confirm the present findings.