International journal of cardiology
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In transposition of the great arteries (TGA), the right ventricle (RV) is subaortic and abnormal aortic structure or function could adversely affect the capacity of the RV to supply the systemic circulation. Our aim was to assess aortic dimensions and distensibility and RV function in patients with palliated TGA using cardiovascular magnetic resonance imaging (CMR). ⋯ The aortic root dilates and the ascending aorta stiffens in TGA, during young adult life. Although these proximal aortic changes did not show adverse effects on the RV in our young TGA sample, they might have important long-term physiopathological consequences in these patients.
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The identification of patients at risk for worse outcome is still a challenge. We hypothesized that cystatin C, a marker of renal function, and neutrophil gelatinase-associated lipocalin (NGAL), a marker of acute renal injury, would have a role in the prognostic stratification of these patients. ⋯ Serum NGAL, a marker of acute renal injury, is an independent predictor of worse short term prognosis in patients with acute HF. This suggests a role of renal damage, apart from renal function, in the prognosis of these patients.
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Recently, a chronic total occlusion (CTO) in the non-infarct-related artery (non-IRA) was reported as an independent predictor of clinical outcome in patients with acute ST-segment elevation myocardial infarction (STEMI). The aim of this study was to investigate the clinical significance of staged revascularization for a CTO in the non-IRA for patients with STEMI. ⋯ Successful revascularization of a CTO in the non-IRA is associated with improved clinical outcomes in patients with STEMI undergoing primary PCI.
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Prevalence of patent foramen ovale and its impact on oxygen desaturation in obstructive sleep apnea.
A possible association between patent foramen ovale (PFO) and obstructive sleep apnea has been suggested (OSA), whereby right-to-left shunting may exacerbate the severity of nocturnal oxygen desaturation. However, the interaction between these two conditions has not been well characterised. ⋯ A higher prevalence of PFO is found in OSA subjects. However, the degree of right-to-left shunting, characterised by Valsalva provocation, is not associated with an increased severity of nocturnal oxygen desaturation.