International journal of cardiology
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Randomized Controlled Trial Multicenter Study
Longer-term bosentan therapy improves functional capacity in Eisenmenger syndrome: results of the BREATHE-5 open-label extension study.
Bosentan, an oral endothelin ET(A)/ET(B) receptor antagonist, improves hemodynamics and exercise capacity in patients with Eisenmenger syndrome but longer-term effects are unknown. This study investigated the efficacy and safety of bosentan up to 40 weeks in these patients. ⋯ In conclusion, these longer follow-up data support the efficacy and safety profile reported in the preceding BREATHE-5 study of bosentan treatment of Eisenmenger syndrome, challenging the notion that pulmonary vascular disease and severe functional impairment in these patients are not amenable to therapy.
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Randomized Controlled Trial Multicenter Study
Value of right ventricular dysfunction for prognosis in pulmonary embolism.
Acute pulmonary embolism (APE) patients with right ventricular dysfunction (RVD) have a worse prognosis. We assessed RVD, deciding the indexes correlating best with prognosis. ⋯ RVD was a discriminator for a poor prognosis in normotensive patients. Early detection of RVD (especially combination of RV dilation and IVC broadening, RVED/LVED>0.67 and/or SPAP>60 mm Hg) was beneficial for identifying high-risk patients. Hemodynamic instability, 14-day clinical outcomes, and SPAP independently predicted 3-month clinical outcomes.
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The purpose of our study was to evaluate the results of endovascular treatment of symptomatic vertebro-basilar insufficiency (VBI) unresponsive to medical therapy. ⋯ Posterior fossa ischemia is an under-diagnosed condition that occurs with relative frequency in cardiac patients. Awareness of this condition and adequate non-invasive testing permits identification of these patients. Endovascular treatment using coronary wires and stents including drug eluting stents, seems to be the treatment of choice for vertebral artery revascularization due to the high technical success rate, low complication rate, and long-term durability.
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Acute pericarditis is often accompanied by some degree of myocarditis. In clinical practice both pericarditis and myocarditis coexist because they share common etiologic agents, mainly cardiotropic viruses. The term "myopericarditis" indicates a primarily "pericarditic syndrome" and it is responsible for the majority of cases. ⋯ The natural history of myopericarditis in large populations is not known with accuracy. On follow-up, the majority of these cases had objective normalization of echocardiography, electrocardiography, laboratory testing, and functional status, although up to 14% may report atypical, non-limiting chest discomfort. Unfortunately, few data have been published on myopericarditis, the paper reviews current available evidence on the presentation, management, and prognosis of myopericarditis.
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Letter Multicenter Study
Chronic pharmacological treatment in takotsubo cardiomyopathy.
Takotsubo cardiomyopathy is a disorder that has been appreciated only recently. In most of reported cases, this syndrome mimes an acute myocardial infarction. Till this moment no data are available from literature about the treatment in the acute phase of this disease. ⋯ The results of our survey suggest that a chronic treatment with beta-blockers, ACE-inhibitors, calcium channels blockers and aspirin does not provide any benefit in patients with Takotsubo cardiomyopathy. Thus, it seem to be important an early correct differential diagnosis to avoid any chronic treatment in these patients.