Kardiol Pol
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Diastolic heart failure often coexists with atrial fibrillation (AF). Elevated plasma levels of natriuretic peptides are the left ventricular (LV) marker of diastolic dysfunction. ⋯ The drop in ANP and BNP plasma concentrations after conversion to sinus rhythm in patients with AF depends on the LV diastolic function. Restoration of sinus rhythm is associated with improvement of the heart's haemodynamics, especially in patients with impaired LV diastolic function, which may be inferred from the more pronounced decrease of BNP level after DC cardioversion in this subgroup, as compared to that with normal LV function.
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Mitral valve annuloplasty is frequently performed because of favourable postoperative quality of life, and improved cardiac function. The Carpentier-Edwards mitral annuloplasty ring is implanted to correct annular dilatation, improve cooptation of the valve leaflets and prevent further annular dilatation. We present two cases of mitral annuloplasty complication in the form ring detachment leading to haemolytic anaemia in the first case.
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Randomized Controlled Trial
Variability of aortic blood flow predicts fluid responsiveness in spontaneously breathing healthy volunteers.
Assessment of fluid responsiveness is an important topic in acute cardiology. Echocardiographic measurement of respiratory variations of aortic blood velocity in ventilated shock patients can accurately predict the effect of volume expansion. On the other hand, it remains unclear whether this respiratory variability is a common physiological reaction to hypovolaemia and whether its measurement is applicable also in spontaneously breathing patients. ⋯ DVpeakao and DVTIao reflect preload-dependent changes of CI in healthy spontaneously breathing volunteers and predict fluid responsiveness.
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Comparative Study
Effects of exercise testing on natriuretic peptide secretion in patients with atrial fibrillation.
Assessment of endocrine profile in patients with cardiovascular diseases has become increasingly important during the last decade. Plasma brain natriuretic peptide (BNP) levels have been used as a marker of left ventricular dysfunction. However, the role of BNP in patients with atrial fibrillation (AF) and normal left ventricular function has not yet been determined. ⋯ Neurohormonal response to exercise differs between patients with AF and those in sinus rhythm. Exercise testing may be used to assess the ability of cardiac myocytes to increase peptide secretion.