Association between health status and sociodemographic, clinical and treatment disparities in the Patient-centered Outcomes Related to TReatment Practices in Peripheral Arterial Disease: Investigating Trajectories (PORTRAIT) registry.

Patients with peripheral artery disease (PAD) and intermittent claudication (IC) have impaired functional status and quality of life. However, little is known about which factors are associated with poorer health status at the time of initial presentation for PAD specialty care. Characterization of such features might provide insight into disparities that impact health status in this population.

Abnormal sodium channel mRNA splicing in hypertrophic cardiomyopathy.

Background: Our previous studies showed that in ischemic and nonischemic heart failure (HF), the voltage-gated cardiac Na channel α subunit (SCN5A) mRNA is abnormally spliced to produce two truncated transcript variants (E28C and D) that activate the unfolded protein response (UPR). We tested whether SCN5A post-transcriptional regulation was abnormal in hypertrophic cardiomyopathy (HCM).

Material And Methods: Human heart tissue was obtained from HCM patients.

The effects of statins on exercise and physical activity.

Objective: We sought to review studies examining the effect of statins on symptoms of exercise tolerance, markers of muscle injury and activity levels in physical active individuals.

Background: Statin therapy reduces atherosclerotic cardiovascular disease (CVD) events. Regular physical activity is also associated with reduced CVD events, but statin therapy can produce muscle complaints, which may be more frequent in physically active individuals.

Statin and Its Association With Delirium in the Medical ICU.

Objectives: To examine the association between statin use and the risk of delirium in hospitalized patients with an admission to the medical ICU.

Design: Retrospective propensity-matched cohort analysis with accrual from September 1, 2012, to September 30, 2015.

Setting: Hartford Hospital, Hartford, CT.

The Arm is Not the Leg: Pathophysiology, Diagnosis, and Management of Upper Extremity Deep Vein Thrombosis.

Upper extremity deep venous thrombosis (UEDVT) involves thrombosis of the deep veins of the arm as they enter the thorax. They are increasing in frequency, largely due to the rising use of central venous catheters and implantable cardiac devices, and represent more than 10% of all DVT cases, Upper extremity deep venous thrombosis has been historically misunderstood when compared to lower extremity deep vein thrombosis (LEDVT). Their associated disease states may carry devastating complications, with mortality rates often higher than that of LEDVT.

Extracorporeal Membrane Oxygenation as a Bridge to Surgery for Infective Endocarditis Complicated by Aorto-Atrial Fistula and Cardiopulmonary Collapse.

The timing of surgery for active infective endocarditis is challenging when patients exhibit mechanical dysfunction and hemodynamic compromise. Extracorporeal membrane oxygenation has been described in treating sepsis but not, insofar as we know, in treating the acute mechanical sequelae that arise from infective endocarditis. We report perhaps the first case that shows the usefulness of extracorporeal membrane oxygenation as a bridge to definitive treatment in a 35-year-old man who had infective endocarditis followed by aorto-atrial fistula and cardiopulmonary collapse.

Reduction of Cardiac Arrests: The Experience of a Novel Service Centric Medical Emergency Team.

Objective: To determine whether a novel, service-centric, medical emergency team (MET) model can impact cardiac arrest (CA) rates.

Methods: A retrospective pre- vs. postintervention analysis was performed on patients ≥ 18 years who had a CA between 2007 and 2012.

Normal Variant T-Wave Changes in an Athlete with Structurally Normal Cardiac Anatomy and Function.

Athletes who perform regular and intensive physical activity may undergo structural and electrical remodeling of the heart that results in electrocardiographic changes that can cause concern. Marked T-wave inversion may represent one such physiologic change. On the other hand, T-wave inversion could be a sign of inherited heart muscle disease or may be a normal variant.

Cardiac adipose tissue and its relationship to diabetes mellitus and cardiovascular disease.

Type-2 diabetes mellitus (T2DM) plays a central role in the development of cardiovascular disease (CVD). However, its relationship to epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT) in particular is important in the pathophysiology of coronary artery disease. Owing to its close proximity to the heart and coronary vasculature, EAT exerts a direct metabolic impact by secreting proinflammatory adipokines and free fatty acids, which promote CVD locally.

Tumor lysis syndrome in a nonsmall cell lung cancer.

Tumor lysis syndrome (TLS) is an oncologic emergency caused by intense tumor cell destruction resulting in profound electrolyte abnormalities. It is generally recognized as a consequence of cytotoxic therapy in particularly chemotherapy-sensitive tumors such as hematologic cancers. Despite having been primarily recognized in hematologic malignancies, TLS has been reported in solid tumors as well.

A tale of two syndromes: Lyme disease preceding postural orthostatic tachycardia syndrome.

The pathogenesis of postural orthostatic tachycardia syndrome (POTS) is poorly understood. However, it has been suggested that altered immune activity or denervation of the autonomic system following illness may be an important trigger. Patients infected with Lyme disease have a small incidence of post-Lyme disease syndrome that share similar characteristics to POTS.

A systematic review of the time course of atherosclerotic plaque regression.

Objective: We sought to determine the time required for lipid treatment to produce regression of atherosclerotic plaques.

Background: The cholesterol content of atherosclerotic plaques contributes to their instability, and most acute cardiac events including myocardial infarction and sudden death are produced by coronary plaque disruption. We systematically reviewed the literature on atherosclerosis regression to identify the time required for cholesterol egress, plaque regression, and possible plaque stabilization.

Managing the Complications of Mild Therapeutic Hypothermia in the Cardiac Arrest Patient.

Mild therapeutic hypothermia (MTH) is used to lower the core body temperature of cardiac arrest (CA) patients to 32°C from 34°C to provide improved survival and neurologic outcomes after resuscitation from in-hospital or out-of-hospital CA. Despite the improved benefits of MTH, there are potentially unforeseen complications associated during management. Although the adverse effects are transient, the clinician should be aware of the associated complications when managing the patient receiving MTH.

Microalbuminuria as a risk factor for cardiovascular disease in healthy individuals: a case report and review of the literature.

Cardiovascular disease without significant traditional risk factors is uncommon. Microalbuminuria has been linked with an increased risk of cardiovascular disease in the diabetic and hypertensive patient. However, a similar influence of microalbuminuria on risk for cardiovascular disease occurs in individuals without diabetes or hypertension, and predicts all-cause and cardiovascular disease mortality in the nondiabetic and general population.

Magnesium adjunctive therapy in atrial arrhythmias.

Magnesium (Mg) is an important intracellular ion with cardiac metabolism and electrophysiologic properties. A large percentage of patients with arrhythmias have an intracellular Mg deficiency, which is out of line with serum Mg concentrations, and this may explain the rationale for Mg's benefits as an atrial antiarrhythmic agent. A current limitation of antiarrhythmic therapy is that the potential for cardiac risk offsets some of the benefits of therapy.