International journal of cardiology
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Randomized Controlled Trial
One year outcomes after glucose-insulin-potassium in ST elevation myocardial infarction. The Glucose-insulin-potassium study II.
There are conflicting data concerning the effect of treatment with glucose-insulin-potassium (GIK) in ST segment elevation myocardial infarction (STEMI). Early studies showed beneficial effects of GIK, however, recent large sample size trials did not confirm this, or suggested only benefits in patients without heart failure. We aimed to evaluate long-term effects of GIK in patients with STEMI without signs of heart failure, all treated with reperfusion therapy. ⋯ In patients with STEMI without signs of heart failure treated with reperfusion therapy, GIK therapy offers no clinical benefit at 1 year.
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Letter Case Reports
Multiple papillary fibroelastomas of the aortic valve: case report.
Papillary fibroelastoma is the third most common primary tumor of the heart and most commonly involve the cardiac valves. Most papillary fibroelastomas do not cause symptoms and they are usually incidental findings by routine echocardiography or at autopsy. ⋯ Upon surgery, a tumor was found on each aortic cusp. Pathological findings of these tumors were consistent with those of papillary fibroelastoma.
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Editorial Comment
Mutation-specific effects of lidocaine in Brugada syndrome.
Brugada syndrome (BrS) is a hereditary cardiac disease characterized by right bundle-branch block, an elevation of the ST-segment in leads V1 through V3 on the electrocardiogram, and ventricular fibrillation that can lead to sudden cardiac death. Mutations in the cardiac sodium channel gene SCN5A, which encodes the alpha-subunit of the human cardiac voltage-dependent Na+ channel (Na(v)1.5), are identified in 15-30% of patients with BrS. Most SCN5A mutations lead to a 'loss-of-function' phenotype, reducing the Na+ current during the early phases of the action potential. ⋯ However, the N406S mutation in SCN5A causes distinct gating defects and enhanced intermediate inactivation of Na+ channels, which led to unexpected pharmacological effects of lidocaine in a patient carrying this mutation. In the presence of the N406S mutation, use-dependent block by lidocaine is reduced and recovery from intermediate inactivation is hastened by lidocaine. These findings suggest that lidocaine may improve the Brugada phenotype in patients with N406S by increasing the availability of Na+ channels.
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Comparative Study
Plasma brain natriuretic peptide levels, right ventricular volume overload and exercise capacity in adolescents after surgical repair of tetralogy of Fallot.
Right ventricular (RV) volume overload secondary to pulmonary regurgitation contributes to long-term morbidities in patients after tetralogy of Fallot (TOF) repair. We tested the hypothesis that plasma brain natriuretic peptide (BNP) levels relate to RV volume overload, pulmonary regurgitation, and exercise capacity in adolescents after TOF repair. ⋯ In adolescent patients after TOF repair, plasma BNP levels relate to RV volume overload, pulmonary regurgitation and exercise capacity.
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Preliminary data have shown that colchicine may be considered for the prevention of the postpericardiotomy syndrome (PPS). The COlchicine for the Prevention of Post-pericardiotomy Syndrome (COPPS) study is a multicenter, double blind, placebo-controlled, randomized trial that will enroll 360 patients after cardiac surgery. The primary end point will be the PSS rate at 12 months. The study will be the first large randomized placebo-controlled trial in this area, and will provide important evidence regarding the possible benefit of colchicine for the primary prevention of the PPS.