Reduced glucose transporter GLUT4 in skeletal muscle predicts insulin resistance in non-diabetic chronic heart failure patients independently of body composition.

Background: In chronic heart failure (CHF) skeletal muscle insulin resistance occurs independently of etiology and contributes to impaired energy metabolism. GLUT4, the predominant glucose transporter in the skeletal muscle promotes the rate-limiting step of glucose utilization in skeletal muscle. The significance of skeletal muscle GLUT4 in patients with CHF has not been studied in detail.

Cardiotrophin-1 induces interleukin-6 synthesis in human monocytes.

Background: Patients with congestive heart failure (CHF) show increased serum concentrations of cytokines like interleukin-6 (IL-6) and cardiotrophin-1 (CT-1). Additionally, monocyte function is modulated in CHF. The aim of this study was to examine if CT-1 is able to induce IL-6 in human monocytes and to investigate the underlying pathway.

Improvement of the primary success rate of recanalization of chronic total coronary occlusions with the Safe-Cross system after failed conventional wire attempts.

Background: In view of the improved long-term patency with drug-eluting stents, the challenge with chronic total coronary occlusion (CTO) remains the low primary success rate. Improved guide wires have increased this rate, but alternative devices may be of additional value. The goal of the present study was to determine the additional benefit of a new penetration device in CTOs after an extensive conventional wire approach.

Cardiotrophin-1 induces interleukin-6 synthesis in human umbilical vein endothelial cells.

In patients with chronic heart failure (CHF) increased plasma concentrations of proinflammatory cytokines are found. For example, the plasma interleukin-6 (IL-6) concentration correlates with disease severity. Beside IL-6 cardiotrophin-1 (CT-1), a member of the IL-6 superfamily, is also increased in CHF.

Analysis of location and pattern of target vessel failure in chronic total occlusions after stent implantation and its potential for the efficient use of drug-eluting stents.

Objectives: The recanalization of chronic total occlusions (CTOs) is a complex procedure with high rates of target vessel failure (TVF), i.e., restenosis or reocclusion.

No association between transmembrane protein-tyrosine phosphatase receptor type C (CD45) exon A point mutation (77C>G) and idiopathic dilated cardiomyopathy.

To investigate whether a 77C>G polymorphism in exon A of the CD45 gene causing a variant CD45RA expression pattern is associated with the development of idiopathic dilated cardiomyopathy (DCM), we studied a total of 414 individuals (104 patients and 310 controls). CD45RA expression pattern on lymphocytes was examined by flow cytometric analysis and subsequently the CD45 77C>G polymorphism was genotyped by polymerase chain reaction-allele specific restriction enzyme analysis (PCR-ASRA). We found 5 patients and 8 control individuals displaying the variant CD45RA expression pattern.

Paclitaxel-eluting stents for the treatment of chronic total coronary occlusions: a strategy of extensive lesion coverage with drug-eluting stents.

The recanalization of a chronic total coronary occlusion (CTO) is hampered by a high rate of lesion recurrence. The goal of the present study is to assess the effect of paclitaxel-eluting stents in CTOs in a strategy of extensive stent coverage and the optional use of additional bare metal stents (BMSs). In 82 consecutive patients, a CTO (duration > 2 weeks) was successfully recanalized with implantation of one or more Taxus stents.

Treatment with granulocyte colony-stimulating factor for mobilization of bone marrow cells in patients with acute myocardial infarction.

Background: This study was undertaken to evaluate the hypothesis that treatment with granulocyte colony-stimulating factor (G-CSF) to mobilize bone marrow cells (BMCs) is feasible and safe and promotes neovascularization and myocardial function in patients with acute myocardial infarction.

Methods: Fourteen patients in the treatment group and 9 patients in the control group were enrolled in this prospective, nonrandomized, open-label study. Forty-eight hours after successful recanalization and stent implantation, the patients of the treatment group received 10 microg/kg body weight per day G-CSF subcutaneously for mean treatment duration of 7.

The importance of the gastrointestinal system in the pathogenesis of heart failure.

Chronic heart failure (CHF) is a multi-organ disease with increasing evidence for the involvement of the gastrointestinal (GI) system in this syndrome. In recent research, the gut has received very little attention from cardiologists as its role in the pathogenesis of cardiovascular disease is poorly understood. Intestinal ischaemia may play an important role in bacterial translocation by increasing bowel permeability.

Outcome after cardiac arrest: predictive values and limitations of the neuroproteins neuron-specific enolase and protein S-100 and the Glasgow Coma Scale.

Background And Purpose: Patients resuscitated from cardiac arrest are at risk of subsequent death or poor neurological outcome up to a persistent vegetative state. We investigated the prognostic value of several epidemiological and clinical markers and two neuroproteins, neuron-specific enolase (NSE) and S-100 protein (S-100), in 97 patients undergoing cardiopulmonary resuscitation (CPR) after non-traumatic cardiac arrest between 1998 and 2002.

Results: 52.

Prevention of lesion recurrence in chronic total coronary occlusions by paclitaxel-eluting stents.

Objectives: The aim of this research was to assess the efficacy of paclitaxel-eluting stents in chronic total coronary occlusions (CTO).

Background: Percutaneous coronary interventions for CTOs are characterized by a high target vessel failure rate.

Methods: In 48 consecutive patients, paclitaxel-eluting stents (Taxus, Boston Scientific Corp.

Sirolimus-eluting stents for the prevention of restenosis in a worst-case scenario of diffuse and recurrent in-stent restenosis.

For recurrent in-stent restenosis (ISR), surgical revascularization or brachytherapy is still the principal therapeutic options. The present investigation explores the efficacy of a sirolimus-eluting stent to prevent restenosis in these lesions with a high risk of recurrence. In 22 consecutive patients with a recurrent and diffuse ISR, a sirolimus-eluting stent was implanted to cover the restenotic lesion.

Growth factors in the collateral circulation of chronic total coronary occlusions: relation to duration of occlusion and collateral function.

Background: Despite extensive animal experimental evidence, there are few data on the relation of growth factors and collateral function in humans.

Methods And Results: In 104 patients with a chronic total coronary occlusion (CTO; >2 weeks' duration), collateral function was assessed invasively during recanalization by intracoronary Doppler and pressure recordings. A collateral resistance index, R(Coll), was calculated.

Iohexol contrast medium induces QT prolongation in amiodarone patients.

Aims: Amiodarone is widely used in ventricular tachyarrhythmias and atrial fibrillation, known to prolong QT-intervals. Concurrent administration of drugs prolonging QT- time can induce life-threatening ventricular tachyarrhythmia.

Methods: QT-interval changes following use of Iohexol contrast-medium for coronarangiography were observed comparing 21 patients taking long-term amiodarone therapy with 21 controls not taking amiodarone or QT-prolonging drugs retrospectively.

Studies on intragastric PCO2 at rest and during exercise as a marker of intestinal perfusion in patients with chronic heart failure.

Aims: The aim of this study was to investigate mesenteric ischaemia by determining intragastric PCO(2) (iPCO(2)) with gastric tonometry during rest and exercise stress testing in patients with chronic heart failure (CHF). In CHF inflammatory immune activation is hypothesized to result from a chronic endotoxin challenge due to bacterial translocation of hypoperfused intestinal mucosa.

Methods And Results: In 10 patients with CHF and ten healthy controls a tonometry catheter was inserted into the stomach.

Carvedilol inhibits platelet-derived growth factor-induced signal transduction in human cardiac fibroblasts.

In the current study, first the platelet-derived growth factor (PDGF)-induced stimulation of the PDGF-beta receptor kinase in human cardiac fibroblasts was examined, and then the possibility of counterbalancing this signal transduction by carvedilol, a beta-blocker with alpha1-blocking properties, was investigated. Human cardiac fibroblasts were cultured from myocardial biopsy samples taken from patients with idiopathic dilated cardiomyopathy. The stimulation of the PDGF-beta receptor kinase by recombinant human PDGF (BB) in the cells and the inhibitory effect of carvedilol (1, 5, 10, and 20 microM) were investigated by analyzing PDGF-induced PDGF receptor tyrosine phosphorylation using Western blotting and by measuring DNA synthesis with a colorimetric assay.