International journal of cardiology
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To examine prospectively the effect of cardiac surgery on plasma concentration of B-type natriuretic peptide (BNP) in children with congenital heart disease. ⋯ In children with congenital heart defects plasma BNP increased immediately after cardiac surgery despite haemodynamic unloading. The correlation to cardiopulmonary bypass time and serum lactate concentration and the similarity between the pattern of BNP release after surgery and after myocardial ischaemia might be explained by a cytoprotective role for BNP after cardiac surgery.
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To prospectively validate artificial neural network (ANN)-algorithms for early diagnosis of myocardial infarction (AMI) and prediction of 'major infarct' size in patients with chest pain and without ECG changes diagnostic for AMI. ⋯ Specially designed ANN-algorithms allow diagnosis of AMI within 2 h of monitoring. These algorithms also allow early prediction of 'major AMI' size and could thus, be used as a valuable instrument for rapid assessment of chest pain patients.
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Letter Case Reports
Osborn wave in hypothermia from Vibrio vunificus sepsis unrelated to exposure.
A 58 year old man with history of cirrhosis presented with Vibrio vunificus sepsis. The patient developed multiorgan failure despite appropriate antibiotic therapy and fluid resuscitation. ⋯ Osborn wave is commonly seen in accidental hypothermia. Although sepsis is known to cause hypothermia, Osborn wave in sepsis is not widely appreciated.
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The purpose of this study was to assess the feasibility of measuring left atrial dysfunction with tissue Doppler imaging derived strain rate and to explore its role in predicting the maintenance of sinus rhythm after cardioversion for atrial fibrillation. ⋯ SR can be measured in the basal LA wall in atrial fibrillation and the magnitude of the early diastolic SR could predict the success of cardioversion and the likelihood of maintenance of sinus rhythm.
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Letter Case Reports
Kounis syndrome associated with hypersensitivity to hymenoptera stings.
Hymenoptera stings can induce acute coronary syndromes by different pathogenetic mechanisms including direct action of the venom constituents on the coronary endothelium or allergic reaction with mediators acting on the coronary vasculature. Two patients were stung by wasps and honeybees and developed Kounis syndrome as a consequence of allergic reaction. ⋯ The patients had pre-existing coronary artery disease (type II variant of Kounis syndrome) and the allergic reaction induced by hymenoptera stings seems to have triggered inflammatory mediator release. The pathophysiology and clinical implications of this association are discussed.