Heart : official journal of the British Cardiac Society
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Ischaemic preconditioning results in a reduction in ischaemic-reperfusion injury to the heart. This beneficial effect is seen both with direct local preconditioning of the myocardium and with remote preconditioning of easily accessible distant non-vital limb tissue. Ischaemic postconditioning with a comparable sequence of brief periods of local ischaemia, when applied immediately after the ischaemic insult, confers benefits similar to preconditioning. ⋯ Remote ischaemic postconditioning is a simple technique to reduce infarct size without the hazards and logistics of multiple coronary artery balloon inflations. This type of conditioning promises clear clinical potential.
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Randomized Controlled Trial
Protective effect of an acute oral loading dose of trimetazidine on myocardial injury following percutaneous coronary intervention.
To evaluate the effect of pre-procedural acute oral administration of trimetazidine (TMZ) on percutaneous coronary intervention (PCI)-induced myocardial injury. ⋯ Pre-procedural acute oral TMZ administration significantly reduces PCI-induced myocardial infarction.
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Severe, sustained pulmonary arterial hypertension leads to a progressive reduction in exercise capacity, right heart failure and death. Use of intravenous epoprostenol has improved survival in adults, but data are limited in children. ⋯ Epoprostenol therapy improved survival, WHO functional class, exercise tolerance and ability to thrive in children with severe pulmonary arterial hypertension. Epoprostenol represents an effective and feasible therapy even in young children.
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To investigate whether chronic clinical comorbidity, as collected from emergency medical services (EMS) reports, influences survival after out-of-hospital ventricular fibrillation (VF) cardiac arrest. ⋯ In this cohort, an increasing burden of clinical comorbidity based on a review of EMS reports was associated with a lower odds of survival after VF arrest. This finding suggests that chronic conditions influence arrest pathophysiology and in turn could help guide resuscitation care.
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Editorial Comment
Is public access to surgeon-specific data affecting practice adversely?