Cyclosporine A in Reperfused Myocardial Infarction: The Multicenter, Controlled, Open-Label CYCLE Trial.

Background: Whether cyclosporine A (CsA) has beneficial effects in reperfused myocardial infarction (MI) is debated.

Objectives: This study investigated whether CsA improved ST-segment resolution in a randomized, multicenter phase II study.

Methods: The authors randomly assigned 410 patients from 31 cardiac care units, age 63 ± 12 years, with large ST-segment elevation MI within 6 h of symptom onset, Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 to 1 in the infarct-related artery, and committed to primary percutaneous coronary intervention, to 2.

[Primary percutaneous coronary intervention and therapeutic hypothermia in comatose survivors after out-of-hospital cardiac arrest complicating acute myocardial infarction: a single-center experience].

Background: Therapeutic hypothermia (TH) is associated with improved neurologic outcomes in comatose survivors of out-of-hospital cardiac arrest (OHCA). There are currently limited data on the outcomes of patients presenting with resuscitated OHCA in the setting of acute myocardial infarction. The aim of this study was to assess the outcomes of comatose survivors of OHCA complicating acute myocardial infarction treated with primary percutaneous coronary intervention (PCI) and TH.

Outcomes following primary percutaneous coronary intervention for unprotected left main-related ST-segment elevation myocardial infarction.

Introduction: Unprotected left main (ULM) related ST-segment elevation myocardial infarction (STEMI) is a severe event, often leading to circulatory failure and/or sudden cardiac death. Although high-risk ULM thrombosis populations treated by primary percutaneous coronary intervention (PPCI) have been previously described, very little is known regarding the outcomes following PPCI for ULM-related STEMI in a hospital without on-site surgical back-up.

Methods: A retrospective cohort analysis was performed on all consecutive patients who underwent PPCI for ULM-related STEMI in a single center.

Treatment of refractory heart failure with a percutaneous circulatory support device.

End-stage heart failure refractory to medical therapy is a clinical challenge. Heart transplantation is considered the best strategy, but it remains burdened with substantial limitations due to the scanty availability of facilities with a transplant programme, donor shortage, and unpredictable waiting lists. Alternatively, assist devices may allow an improvement of the haemodynamic conditions, modifying the history of end-stage heart failure and introducing new management strategies.

Color Doppler study of mitral regurgitation during percutaneous transluminal coronary angioplasty.

Mitral regurgitation (MR) was evaluated by color Doppler echocardiography during percutaneous transluminal coronary angioplasty (PTCA) in 28 patients with one-vessel artery disease (left anterior descending artery in 11, right coronary artery in 8, and circumflex artery in 9) and normal left ventricular function. In all three groups, left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) decreased significantly during artery occlusion in comparison with baseline values (no differences among various groups). Anterior and inferior akinesia/dyskinesia was observed in all patients during left anterior descending and right coronary artery occlusion, respectively.

Doppler analysis of portal vein flow in tricuspid regurgitation.

Portal and hepatic vein flow-velocity profiles were examined by pulsed Doppler in 66 patients with tricuspid regurgitation (color Doppler grading: severe: 37, moderate: 18; mild: 11) and 20 normal subjects to determine if portal vein flow analysis is useful in the evaluation of tricuspid regurgitation. Portal vein flow was defined as one of the following categories: subcontinuous (dependent on respiration), pulsatile systolic (not inverted), inverted after systole, and continuous (not dependent on respiration). An index of portal vein flow pulsatility was also calculated.

Reproducibility in circadian rhythm of ventricular premature complexes.

To evaluate the existence and reproducibility of a circadian rhythm of ventricular premature complexes (VPCs), 38 patients (mean age 57 +/- 17 years) with greater than or equal to VPCs/hour were studied with 24-hour electrocardiogram Holter monitoring. Nineteen patients had coronary artery disease and 19 had structurally normal hearts. A second Holter electrocardiogram was recorded in all patients from 2 to 47 days (mean 11) after the first.

[rTPA and streptokinase in acute myocardial infarct. Clinical instrumental evaluation of the 2 treatments].

Fifty-four patients with acute myocardial infarction were treated with thrombolytic therapy (27 with rTPA and 27 with streptokinase). In all the subjects CK was monitored (every 3 hours) and ergometric test, echocardiogram, and 24 hours holter ecg were performed in the pre-discharge period. In 22 of the patients, coronary angiography was also performed.

Casual versus 24-hour ambulatory blood pressure recording in the evaluation of chronic administration of sustained-release verapamil.

Although ambulatory blood pressure monitoring has been used widely for the evaluation of antihypertensive treatment, little information is available regarding the comparison between this method and casual BP measurement during drug trials. In our study, we tested the efficacy of a new formulation of verapamil, 240 mg sustained-release tablets, and compared the degree of BP reduction as detected by casual (standard mercury manometer) and by 24-hour ambulatory recording (Spacelab ICR 5300). A statistically significant fall in casual BP was observed after verapamil with respect to placebo.