International journal of cardiology
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Comparative Study
Atrial fibrillation after cardiac surgery: risk factors and their temporal relationship in prophylactic drug strategy decision.
Postoperative atrial fibrillation (AF) is a vexing problem in cardiac surgery. Our aim was to identify risk factors between surgical procedures, all having cardiopulmonary bypass (CPB) in common, and how AF contributes to early and late mortality. ⋯ In addition to the accepted risk factors of AF, primarily age, we emphasize the importance of considering details at CPB weaning, a correlation that was coronary specific. The weaning period hides valuable information that can be useful for more specific AF-prophylactic strategies. The AF-related increase in late mortality after CABG but not after valve procedures is intriguing, and draws attention to possible AF recurrence during patient follow-up and management.
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Comparative Study
Lack of decrease in plasma N-terminal pro-brain natriuretic peptide identifies acute heart failure patients with very poor outcome.
Optimal risk stratification in heart failure patients surviving an episode of acute decompensation has not yet been established. We investigated whether a lack of significant decrease in plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) during hospital stay can identify patients at high risk of poor outcome. ⋯ The magnitude of plasma NT-proBNP decrease in patients with acute heart failure is helpful in discrimination of patients at high risk of death. Plasma NT-proBNP level monitoring is important for risk stratification in this group of patients.
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Percutaneous treatment of stenoses involving aorto-ostial lesions is technically demanding and has been associated with lower procedural success and poorer clinical and angiographic outcomes when compared with non-ostial lesions. This study evaluated the immediate and long-term (2-year) outcome of aorto-ostial stenoses treated with paclitaxel-eluting stents (PES). ⋯ Utilization of PES in this complex lesion subset is feasible and associated with favorable angiographic results at 7 months. However, the gradual increase in later events up to 2 years suggests that aorto-ostial disease remains problematic even in the era of drug-eluting stents.
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Randomized Controlled Trial Clinical Trial
Relaxation effects of lavender aromatherapy improve coronary flow velocity reserve in healthy men evaluated by transthoracic Doppler echocardiography.
It has been reported that mental stress is an independent risk factor for cardiovascular events and impairs coronary circulation. Lavender aromatherapy, one of the most popular complementary treatments, is recognized as a beneficial mental relaxation therapy. However, no study has examined the effect of this therapy on coronary circulation. We aimed to assess the effect of lavender aromatherapy on coronary circulation by measuring coronary flow velocity reserve (CFVR) with noninvasive transthoracic Doppler echocardiography (TTDE). ⋯ Lavender aromatherapy reduced serum cortisol and improved CFVR in healthy men. These findings suggest that lavender aromatherapy has relaxation effects and may have beneficial acute effects on coronary circulation.
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Letter Case Reports
"Lots of clots": multiple thromboemboli including a huge paradoxical embolus in a 29-year old man.
Paradoxical embolism occurs when a venous thrombus passes into the arterial circulation, most commonly through an intracardiac shunt. This phenomenon has been associated with catastrophic outcomes such as stroke and ischemic limb. We report the case of a 29-year old man with multiple thromboemboli including a deep venous thrombus, bilateral pulmonary emboli, and a paradoxical embolus into his left subclavian artery. We postulate the underlying predisposition and sequence of events that may have resulted in these multiple blood clots and report on his successful surgical outcome.