International journal of cardiology
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Clinical Trial
Use of transthoracic echocardiography combined with venous ultrasonography in patients with pulmonary embolism.
The diagnosis of pulmonary embolism (PE) remains difficult. Ultrasounds allow for the exploration of the venous system to great extent and for the detection of indirect signs of PE. The aim of this study was to determine the incidence of acute cor pulmonale (ACP) and deep venous thrombosis (DVT) found by ultrasonographic techniques in a population of patients with PE. ⋯ A combined strategy using echocardiography with venous ultrasonography improves significantly the diagnostic value of venous ultrasonography in proximal and lobar PE and fails in distal PE.
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Cardiac hypertrophy has been demonstrated to decreases the ATP-sensitive potassium channels (K(ATP)), the major protective mechanism following the energy depletion, a common condition seen during the reperfusion after open heart surgery. In this study we have demonstrated the role of ischemic preconditioning (IP) in preventing the reperfusion injury of the hypertrophied heart by activation of the depleted K(ATP) channels. ⋯ The above results, therefore, suggest to us that IP by activation of K(ATP) channels can afford protection against the ischemia-reperfusion injury in the hypertrophied heart.
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Long-QT syndrome is a clinically and genetically heterogeneous syndrome characterized by lengthening of the QT interval and increased dispersion of the ventricular repolarization on surface electrocardiogram and a propensity to malignant ventricular arrhythmias, torsade de pointes and ventricular fibrillation, which may lead to sudden cardiac death. Long-QT syndrome mostly affects adolescents and young adults with structurally and functionally normal hearts and is caused by aberrations in potassium and sodium ion channels. ⋯ The potential therapies include sodium channel blockers (mexiletine, flecainide, lidocaine, pentisomide, phenytoin), potassium, potassium channel activators (nicorandil, pinacidil, cromakalim), alpha-adrenergic receptor blockers, calcium channel blockers, atropine, and protein kinase inhibitors. The purpose of this review is to outline the established therapies and update the recent advances and potential future strategies in the treatment of long-QT syndrome and torsade de pointes.
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Comparative Study
Cardiac troponin I predicts myocardial dysfunction and adverse outcome in septic shock.
The objectives of this study were to determine myocardial injury in patients with septic shock by measuring serum cardiac troponin I (cTnI), to evaluate relationship between elevated cTnI and myocardial dysfunction and to determine if cTnI is a predictor of outcome in these patients. ⋯ Myocardial injury can be determined in patients with septic shock by serum cTnI. Serum cTnI concentration correlates with myocardial dysfunction in septic shock. High serum cTnI predicts increased severity of sepsis and higher mortality. A close monitoring of patients with septic shock and elevated levels cTnI is warranted.