Clinical development and proof of principle testing of new regenerative vascular endothelial growth factor-D therapy for refractory angina: rationale and design of the phase 2 ReGenHeart trial.

Background: Despite tremendous therapeutic advancements, a significant proportion of coronary artery disease patients suffer from refractory angina pectoris, that is, quality-of-life-compromising angina that is non-manageable with established pharmacological and interventional treatment options. Adenoviral vascular endothelial growth factor-D (AdVEGF-D)-encoding gene therapy (GT) holds promise for the treatment of refractory angina.

Methods: ReGenHeart is an investigator-initiated, multicentre, randomised, placebo-controlled and double-blinded phase 2 clinical trial that aims to study the safety and efficacy of intramyocardially administered angiogenic AdVEGF-D GT for refractory angina.

Extraction of a 6-year-old leadless pacemaker (MICRA transcatheter pacing system) using commercially available removal tools: A case report.

Introduction: Leadless pacemakers are associated with a low risk of infection, so indications for their removal are rare. One can expect that the dwell time of the device correlates with a more difficult removal, but it has not been proved so far.

Methods And Results: We present a case of a patient in whom MICRA transcatheter pacing system was successfully removed with nondedicated commercially available tools, 70 months after implantation.

Assessment of Myocardial Diastolic Dysfunction as a Result of Myocardial Infarction and Extracellular Matrix Regulation Disorders in the Context of Mesenchymal Stem Cell Therapy.

The decline in cardiac contractility due to damage or loss of cardiomyocytes is intensified by changes in the extracellular matrix leading to heart remodeling. An excessive matrix response in the ischemic cardiomyopathy may contribute to the elevated fibrotic compartment and diastolic dysfunction. Fibroproliferation is a defense response aimed at quickly closing the damaged area and maintaining tissue integrity.

A New Era in Epicardial Access for the Ablation of Ventricular Arrhythmias: The Epi-Co Registry.

Objectives: This multicenter registry aimed to assess the reproducibility and safety of intentional coronary vein exit and carbon dioxide insufflation to facilitate subxiphoid epicardial access in the setting of ventricular tachycardia ablation.

Background: Epicardial ablation for ventricular tachycardia is not a widespread technique due to the significant potential complications associated with subxiphoid puncture. The first experience in 12 patients showed that intentional coronary vein exit and carbon dioxide insufflation was technically feasible.

Heart Failure with Preserved Ejection Fraction-a Concise Review.

Purpose Of Review: Heart failure with preserved ejection fraction (HFpEF) is a relatively new disease entity used in medical terminology; however, both the number of patients and its clinical significance are growing. HFpEF used to be seen as a mild condition; however, the symptoms and quality of life of the patients are comparable to those with reduced ejection fraction. The disease is much more complex than previously thought.

Patients treated with bivalirudin are still at higher risk of stent thrombosis: a comprehensive meta-analysis of randomised clinical trials of bivalirudin and heparin for percutaneous coronary interventions.

Background: Although the current practice guidelines recommend using both heparin and bivalirudin for percutaneous coronary interventions (PCI), the research data are ambiguous.

Aim: The aim of the study was to compare the impact of bivalirudin and heparin on major clinical endpoints in PCI patients with particular emphasis on periprocedural stent thrombosis.

Methods: A total of 18 randomised clinical trials involving 41,752 subjects were included.

Clinical presentation, surgical management, and outcomes of patients treated for aortic stenosis and coronary artery disease. Does age matter?

Background: Aortic stenosis and coronary artery disease (CAD) sharing similar risk factors are associated with aging of the human population.

Aim: The purpose of this study was to examine whether age affects clinical presentation, intraoperative management, and outcomes of patients who undergo simultaneous operations of aortic valve replacement (AVR) and coronary artery bypass grafting (CABG).

Methods: The study involved 452 consecutive patients aged 64.

Double atrial potentials in left-sided accessory pathways are associated with paroxysmal atrial fibrillation.

Introduction: Muscular connections between the coronary sinus (CS) and left atrium probably impact distribution of electrical activity. Double atrial potentials (DP) may be their presentation. The aim was to investigate the presence of DP in CS recordings during atrioventricular reentrant tachycardia (AVRT) and its contribution to the occurrence of paroxysmal atrial fibrillation (AF).

Safety, feasibility and effectiveness of first in-human administration of muscle-derived stem/progenitor cells modified with connexin-43 gene for treatment of advanced chronic heart failure.

Aims: To assess the safety and efficacy of transendocardial delivery of muscle-derived stem/progenitor cells with connexin-43 overexpression (Cx-43-MDS/PC) in advanced heart failure (HF).

Methods And Results: Thirteen subjects with advanced HF, New York Heart Association (NYHA) class II-III were enrolled and treated with targeted injection of Cx-43-MDS/PCs and then monitored for at least 6 months. Overexpression of Cx43 (Cx43+) was significantly higher in all but one subject (Cx43-).

From primary tricuspid regurgitation to arrhythmogenic right ventricular cardiomyopathy.

Since arrhythmogenic right ventricular dysplasia is still an under-recognised clinical entity, its 'deceitful' course requires alertness of physicians, and - in particular - awareness of its less typical manifestations. Therefore, we present a case report of a 52-year-old male subject with signs and symptoms of right ventricular heart failure and marked tricuspid regurgitation.

Asymmetry of the variability of heart rate and conduction time between atria and ventricles.

Background: Heart rate asymmetry is caused by an unequal contribution of heart rate decelerations and accelerations to heart rate variability. This study evaluates the asymmetric properties of the variability of the AA, HH, VV, AH and HV intervals.

Methods And Results: We recorded 50 1-min intracardiac ECG tracings from 10 patients (18-66 years old; 8 females) during a routine electrophysiological study.

Shortening baroreflex delay in hypertrophic cardiomyopathy patients -- an unknown effect of β-blockers.

Aims: Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy and impaired diastolic and systolic function. Abnormal sympathetic-parasympathetic balance is a potential stimulus for left ventricular hypertrophy in HCM patients. β-Blockers are routinely used in HCM for their strong negative inotropic effect; however, these drugs also influence the sympathetic-parasympathetic balance.

[Radiofrequency ablation of electrical storm using an epicardial approach in a patient with ischaemic cardiomyopathy].

We describe a case of a 63 year-old male who underwent successful RF ablation of recurrent ventricular tachycardia using epicardial approach.

Exudative pericarditis in a pregnant woman as the first sign of non-Hodgkin's lymphoma.

This case report presents a 25 year-old pregnant female diagnosed with exudative pericarditis which was the first sign of cardiac lymphoma. Such a manifestation of this disease is rare and it represents a significant diagnostic and therapeutic problem in pregnant women.

Leptin and inflammation in patients with chronic heart failure.

Background: There is an increasing interest in the role of leptin in cardiovascular pathophysiology, including proinflammatory effects. Many studies have reported elevated leptin levels in non-cachectic patients with chronic heart failure (CHF), however, the role of leptin in CHF remains unclear.

Aim: To assess the relationship between leptin levels in patients with CHF and left ventricular (LV) systolic dysfunction in relation to ventilatory response to exercise and hsCRP levels.

Oxygen uptake efficiency slope correlates with brain natriuretic peptide in patients with heart failure.

Background: Cardiopulmonary exercise testing is a well-established tool for clinical and prognostic assessment of patients with chronic heart failure (CHF). Recently, a new parameter of this examination--oxygen uptake efficiency slope (OUES)--has been described and proposed as a new prognostic factor in patients with CHF. Brain natriuretic peptide (BNP) is an established prognostic factor in CHF.

Evaluation of exercise capacity with cardiopulmonary exercise testing and BNP levels in adult patients with single or systemic right ventricles.

Introduction: The aim of the study was to evaluate exercise capacity using cardiopulmonary exercise test (CpET) and serum B-type natriuretic peptide (BNP) levels in patients with single or systemic right ventricles.

Material And Methods: The study group included 40 patients (16 males) - 17 with transposition of the great arteries after Senning operation, 13 with corrected transposition of the great arteries and 10 with single ventricle after Fontan operation, aged 19-55 years (mean 28.8 ±9.