International journal of cardiology
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Myoglobin, cardiac troponin-T and creatine phosphokinase are biochemical indicators of acute coronary syndromes, however, the clinical significance in myocardial ischemia is not well established. Our aim was to elucidate their release kinetics in a well-defined short-lasting myocardial ischemia. ⋯ Severe short-lasting myocardial ischemia did not enhance troponin-T or creatine phoshokinase concentrations, whereas a transient slight cardiac release of myoglobin with a delay of 1 h and a coronary sinus peak concentration after 2 h was detected. This may be due to a rapid reperfusion effect on ischemic myocardium or minor damaged single myocardial cells.
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Comparative Study
Renin-angiotensin system and haemostasis gene polymorphisms and outcome after coronary artery bypass graft surgery.
Coronary artery bypass graft surgery is associated with a considerable 2-year mortality rate. Gene polymorphisms of the renin-angiotensin system may be associated with the risk of hypertension and cardiovascular disease. The angiotensin I-converting enzyme DD genotype has recently been identified as independent predictor of the outcome after coronary artery bypass graft surgery. Genetic factors of the clotting system may be related to the risk of myocardial infarction and restenosis after coronary interventions. The aims of the present study were to investigate whether gene polymorphisms of the renin-angiotensin system (angiotensinogen 235 M/T, angiotensin II type 1 receptor 1166 A/C) or the clotting system (glycoprotein IIIa PlA1/PlA2 and factor V Leiden 1691 G/A) are associated with the outcome after coronary artery bypass grafting. ⋯ We conclude that there are interactions between the angiotensin II type 1 receptor 1166 A/C as well as the angiotensinogen 235 M/T gene polymorphism and age with respect to the outcome after coronary artery bypass graft surgery. The glycoprotein IIIa PlA1/PlA2 and the factor V Leiden 1691 G/A gene polymorphisms were not associated with mid-term mortality or cardiac morbidity after coronary artery bypass grafting.
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Letter Case Reports
Pulmonary arteriovenous fistula presenting as brain abscess.
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Comparative Study
Patient descriptions of breathlessness in heart failure.
To explore patient experience of breathlessness in heart failure. ⋯ Patients' descriptions of breathlessness are distinct from medical terminology and more clearly relate to physical adaptations to breathlessness. Further research is required to identify whether heart failure patients' descriptions of breathlessness are different to those of cancer patients, and to establish whether the categories generated from this data set are applicable to other heart failure patients in other settings.
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Occlusion of the circumflex coronary artery may present with either ST elevation typical of inferior or lateral myocardial infarction, ST depression or a normal 12-lead electrocardiogram (ECG). In patients presenting with ST depression, concomitant ST elevation in the posterior leads V7, V8 and V9 is believed to reflect ST-elevation myocardial infarction of the posterior wall. However, to be confident of this diagnosis, it is necessary to know that posterior ST depression does not occur in acute subendocardial ischaemia. ⋯ ST elevation in leads V7, V8 and V9 is uncommon in patients presenting with subendocardial ischaemia. Therefore, in patients presenting with acute chest pain and ST depression in the 12-lead ECG, concomitant posterior ST elevation may be a reliable indicator of ST elevation posterior MI. This is likely due to circumflex artery occlusion and may require thrombolytic therapy.