International journal of cardiology
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To describe the natural history of common heart disease incidence on a population study. ⋯ This is the first investigation to report heart disease incidence and its natural history in a quasi-extinction cohort data from Italy in a pre-cardiac surgery era.
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Observational Study
Pre-operative growth differentiation factor 15 as a novel biomarker of acute kidney injury after cardiac bypass surgery.
Pre-operative GDF-15 plasma levels significantly improve the prognostic value of the EuroSCORE for mortality after cardiac surgery. However, despite the strong correlation between GDF-15 and renal function, no data are available regarding the potential interest of pre-operative GDF-15 levels to improve the prediction of acute kidney injury (AKI) after cardiac artery bypass graft (CABG) surgery. ⋯ Pre-operative GDF-15 plasma levels are associated with post-operative AKI in CABG patients. If confirmed in larger cohorts, pre-operative GDF-15 may be of value to improve pre-operative risk stratification among candidates for surgery.
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Adipokines released by adipose tissue have been recognised as important players in the development of cardiovascular disease. Leptin is a well-studied adipokine with an important role in body metabolism and energy expenditure and leptin-deficiency or deficient leptin signalling results in excessive obesity and type 2 diabetes. ⋯ Notably, clinical studies have failed to convincingly link leptin with increased cardiovascular disease risk. We herein summarise the role of leptin in cardiovascular disease as another example of the 'adipokine paradox' and discuss the complexity in using serum adipokine levels as biomarkers in cardiovascular disease.
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Total cavopulmonary connection (TCPC) has been the preferred treatment for patients with univentricular hearts. Current TCPC-techniques are the intra-atrial lateral tunnel (ILT) and the extracardiac conduit (ECC). We aimed to determine ventricular function during rest and stress, and to compare results for both techniques and for left (LV) versus right ventricular (RV) dominance. ⋯ Ventricular function is relatively well preserved in modern-day Fontan patients. With dobutamine stress there is a decrease in EDVi. ECC patients have higher CI and EF during stress. Patients with a dominant RV have lower systolic, including impaired contractility, and diastolic function.