American heart journal
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American heart journal · Sep 2008
Meta Analysis Comparative StudyCurrent role of sodium bicarbonate-based preprocedural hydration for the prevention of contrast-induced acute kidney injury: a meta-analysis.
The optimal hydration strategy for prevention of contrast-induced acute kidney injury (AKI) remains unknown. The purpose of this meta-analysis is to compare the effectiveness of normal saline (NS) versus sodium bicarbonate hydration (NaHCO(3)) for prevention of contrast-induced AKI. ⋯ Although sodium bicarbonate hydration was found to be superior to NS in prevention of contrast-induced AKI, these results are in the context of study heterogeneity and, likely, publication bias. An adequately powered randomized controlled trial is warranted to define the optimal hydration strategy in patients at high risk of contrast-induced AKI who are scheduled to undergo contrast administration.
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American heart journal · Sep 2008
Multicenter StudyPredictors of improved quality of life 1 year after pacemaker implantation.
Patient's health-related quality of life (HRQoL) of pacemaker (PM) patients has increasingly become an important issue of health care evaluation. Currently, knowledge of pacing performance and technology is more or less outlined. However, determinants of poor or good HRQoL of paced patients require further elucidation. ⋯ In most patients receiving a PM, HRQoL increased in the first year after PM implantation. Knowledge of the predictors of this increase may aid physicians to timely differentiate between patients who most likely will benefit most from PM implantation in terms of HRQoL.
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American heart journal · Sep 2008
Intraoperative coronary artery pulse Doppler patterns in patients with complete transposition of the great arteries undergoing the arterial switch operation.
Arterial switch operation is standard repair for complete transposition of the great arteries (TGA). Coronary artery abnormalities are the most common cause of morbidity and mortality in the acute postoperative phase. This study was designed to determine whether coronary artery pulse Doppler flow patterns obtained by transesophageal echocardiography during the arterial switch operation are correlated with acute postoperative outcomes. ⋯ Abnormalities in LMCA flow were associated with the need for surgical revision in patients with TGA undergoing the arterial switch operation. Normal coronary artery pulse Doppler flow patterns after the arterial switch operation consisted of a late systolic peak followed by low-velocity flow throughout diastole.
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American heart journal · Sep 2008
Meta Analysis Comparative StudyAn early invasive strategy versus ischemia-guided management after fibrinolytic therapy for ST-segment elevation myocardial infarction: a meta-analysis of contemporary randomized controlled trials.
Although the use of an early invasive strategy among patients with ST-segment elevation myocardial infarctions (STEMI) who are treated initially with fibrinolytic therapy is common, the safety and efficacy of this approach remains uncertain. We performed a meta-analysis to best estimate the benefits and harms of an early invasive strategy in STEMI patients treated initially with full-dose intravenous fibrinolytic therapy, as compared to a traditional strategy of ischemia-guided management. ⋯ An early invasive strategy after fibrinolytic therapy is associated with significant reductions in mortality and reinfarction. Our results suggest a potentially important role for this strategy in the management of STEMI patients but should be confirmed by large randomized trials.
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American heart journal · Sep 2008
Comparative StudyPrevalence and characteristics of left ventricular outflow tract obstruction in Tako-Tsubo syndrome.
Tako-Tsubo syndrome is a clinical entity mimicking acute coronary syndrome (ACS). Left ventricular outflow tract (LVOT) obstruction may occur in Tako-Tsubo syndrome. The aim of this study was to determine the prevalence and features of LVOT obstruction in Tako-Tsubo syndrome in a population presenting with ACS. ⋯ The present study demonstrates that the prevalence of LVOT obstruction in Tako-Tsubo syndrome is high, with specific characteristics as compared with patients without LVOT obstruction. Echocardiography should be systematically performed for all patients presenting with Tako-Tsubo syndrome for the detection of LVOT obstruction.