Acute kidney injury biomarkers for patients in a coronary care unit: a prospective cohort study.

Background: Renal dysfunction is an established predictor of all-cause mortality in intensive care units. This study analyzed the outcomes of coronary care unit (CCU) patients and evaluated several biomarkers of acute kidney injury (AKI), including neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18) and cystatin C (CysC) on the first day of CCU admission.

Methodology/principal Findings: Serum and urinary samples collected from 150 patients in the coronary care unit of a tertiary care university hospital between September 2009 and August 2010 were tested for NGAL, IL-18 and CysC.

Reversible left ventricular diastolic dysfunction on Doppler tissue imaging predicts a more favorable prognosis in chronic heart failure.

Background: Early (e')/late (a') diastolic mitral annular velocity ratio is a powerful independent predictor of poor prognosis in patients with left ventricular (LV) dysfunction. Doppler tissue imaging, however, may change over time according to intervention and medical treatment. The aim of the present study was to prospectively evaluate whether, in clinically stable patients with chronic heart failure (CHF), the decrease of an initially high e'/a' ratio on long-term therapy predicts a more favorable outcome.

A novel echocardiographic parameter for predicting the ischemic etiology of cardiomyopathy and its prognosis in patients with congestive heart failure.

Background: Although previous studies have established the ability of mitral annular velocities and velocity dispersion indices to differentiate between ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy, prospective data are lacking on both the use of heterogeneity of mitral annular velocities to predict the ischemic etiology in patients with left ventricular dysfunction and further cardiovascular prognosis.

Methods: A total of 232 patients with left ventricular ejection fractions < 40% were admitted between 2008 and 2010. Doppler tissue imaging was performed on six mitral annular sites for three consecutive beats and then averaged for each site.

Metabolic syndrome and homocysteine level as predictors of the severity of coronary artery disease in patients with carotid stenosis.

Background: Coronary artery disease (CAD) is the most important cause of mortality and morbidity in patients who have undergone carotid artery endovascular or surgical intervention. Metabolic syndrome (MetS) and hyperhomocysteinemia (HHCY) have been reported to be associated with CAD. However, no study has investigated the association between MetS or HHCY and the severity of CAD in patients with carotid stenosis.

Prognostic significance of diastolic dysfunction by tissue Doppler imaging in patients with chronic heart failure.

Background: This study assesses the prognostic values of left ventricular (LV) filling patterns, as determined by tissue Doppler imaging (TDI), on cardiac events in patients with LV systolic dysfunction. Normally observed in patients with an advanced form of cardiac disease, an abnormal diastolic pattern by Doppler echocardiography reflects a poor prognosis. Recent studies using TDI have significantly contributed to efforts to evaluate diastolic function and demonstrate the prognostic importance of TDI-derived indices of the LV function.

Increased vascular senescence and impaired endothelial progenitor cell function mediated by mutation of circadian gene Per2.

Background: Alteration of the circadian rhythm and increased vascular senescence are linked to cardiovascular disease. Per2, a circadian gene, is known to regulate endothelium-dependent vasomotion. However, the mechanism by which Per2 affects endothelial function is unknown.

Intracellular calcium dynamics and acetylcholine-induced triggered activity in the pulmonary veins of dogs with pacing-induced heart failure.

Background: Heart failure increases autonomic nerve activities and changes intracellular calcium (Ca(i)) dynamics.

Objective: The purpose of this study was to investigate the hypothesis that abnormal Ca(i) dynamics are responsible for triggered activity in the pulmonary veins (PVs) during acetylcholine infusion in a canine model of heart failure.

Methods: Simultaneous optical mapping of Ca(i) and membrane potential was performed in isolated Langendorff-perfused PV-left atrial (LA) preparations from nine dogs with ventricular pacing-induced heart failure.

Improvement in left ventricular function following coronary stenting in patients with acute myocardial infarction: 6-month and 3-year follow-up.

Background: This study assesses hemodynamic and angiographic changes in patients with a patent infarct-related artery (IRA) after acute myocardial infarction (AMI).

Methods: One hundred and seventy-seven patients with first AMI, who received a predischarge stenting to the IRA and sustained a patent IRA over 3 years, were stratified into 3 groups according to the baseline left ventricular ejection fraction (LVEF): group A included 63 patients with a LVEF of >49%, group B 73 patients with a LVEF of 40%-49%, and group C 41 patients with a LVEF of <40%. The hemodynamic and angiographic parameters were compared at baseline, 6-month and 3-year follow-up.

Characteristics and radiofrequency ablation in posteroseptal and left free-wall subepicardial accessory pathways.

Unlabelled: Accessory pathways (APs) that can only be ablated from the coronary sinus are likely to be located subepicardially. The electrocardiographic (ECG) and electrophysiological characteristics as well as the immediate radiofrequency ablation success rate and the recurrence rate were compared in 15 patients (11 posteroseptal and 4 left free-wall) with subepicardial APs and in 31 control patients with posteroseptal (15) and left free-wall (16) APs matched with age, sex, and AP location during the same study period in whom APs were successfully ablated from the endocardial approach. Patients with posteroseptal subepicardial APs had a longer tachycardia cycle length (355 +/- 32 vs 286 +/- 49 milliseconds, P < .

Electrophysiological characteristics and radiofrequency ablation of accessory pathways with slow conductive properties.

Background: Atrioventricular accessory pathways (AP) with unusually long ventriculo-atrial (VA) conduction times are present in a significant subset of patients with the Wolff-Parkinson-White (WPW) syndrome, not including patients with the permanent form of atrioventricular junctional reciprocating tachycardia.

Methods And Results: We compared the electrophysiological characteristics and outcomes after radiofrequency (RF) ablation in 34 patients with the WPW syndrome, a VA interval >80 ms, and paroxysmal tachycardia with an RP/PR ratio <1 (the slow group), vs 80 patients with WPW syndrome and a VA interval <80 ms (the fast group). AP were found in the posteroseptal region significantly more often in the slow than in the fast group.

Enhancement of quality of life with adjustment of dry weight by echocardiographic measurement of inferior vena cava diameter in patients undergoing chronic hemodialysis.

Background/aims: Ideal dry weight (DW) can serve as a marker of good quality of life (QOL) in patients receiving chronic hemodialysis. The size of the inferior vena cava (IVC) reflects the intravascular fluid status, and the diameter of IVC correlates indirectly with DW in these patients. Adjusting DW using echocardiographic measurement of the diameter of the IVC thus may be useful in maintenance of a better QOL in patients receiving chronic hemodialysis.

Effects of altered volume loading on left ventricular hemodynamics and diastolic filling during hemodialysis.

Background: Changes in the circulating volume associated with hemodialysis (HD) resulted in alternations of left ventricular (LV) filling. However, previous studies offered conflicting findings. This study thus evaluated the impact of HD on LV diastolic filling indices and hemodynamics.

Acute and long-term clinical and angiographic outcomes of coronary stenting using Palmaz-Schatz stent and ACS Multi-Link stent.

Acute and long-term (>/= 3 years) outcomes of coronary artery stenting using Palmaz-Schatz and Multi-Link stent implantations between November 1995 and October 1999 were analyzed. There were 655 Palmaz-Schatz stent implantations in 577 lesions on 477 patients (group A) and 428 Multi-Link stent implantations in 381 lesions on 326 patients (group B). The baseline characteristics were similar in the two groups.

Algorithm for differentiation of left and right posterior paraseptal accessory pathway.

We studied 196 consecutive patients with posterior paraseptal accessory pathway (AP); 124 showed manifest preexcitation and 72 were concealed AP. Successful ablation was obtained from left-sided approach in 134 patients (left posterior pasaseptal [LPS] group) and from right sided approach in 62 patients (right posterior paraseptal [RPS] group). A ventriculo-atrial (VA) interval of <50 ms recorded at LPS region (VA(LPS)) during right ventricular pacing identified 95 of the 134 patients (71%) with LPS AP with 100% specificity and positive predictive value.

Spontaneous intramyocardial hematoma mimicking a cardiac tumor of the right ventricle.

Intramyocardial hematoma is an uncommon entity and may occur after myocardial infarction, coronary balloon angioplasty, cardiac operation, or chest trauma. It has even been noted to occur spontaneously. This report describes a 62-year-old woman who presented with a recent exacerbation of exertional dyspnea and without a history of chest pain or trauma.

Time to peak velocity measurements by pulsed wave Doppler tissue imaging to quantify ischemia-related regional myocardial asynchrony.

A total of 173 patients with chest pain but without visually discernible wall-motion abnormalities by 2-dimensional echocardiography underwent pulsed wave Doppler tissue imaging examination before angiography. Segmental longest time to peak contraction velocity (Tpv) was acquired through 3 apical views. The longest time period from electrocardiographic R wave to peak velocity on segmental velocity integrals of nonapical segments was measured.

Electrocardiographic predictors of failure and recurrence in patients with idiopathic right ventricular outflow tract tachycardia and ectopy who underwent radiofrequency catheter ablation.

This study reports new electrocardiographic (ECG) predictors of radiofrequency catheter ablation failure and recurrence in idiopathic right ventricular outflow tract (RVOT) ventricular tachycardia (VT) or ectopy based on 91 consecutive patients. Procedural success and failure rates were 85% (77/91) and 15% (14/91), respectively. Twenty three percent (18/77) had recurrence during the follow-up period of 1 to 120 months (mean 56 +/- 31 months).

Evaluation of shunt flow by multiplane transesophageal echocardiography in adult patients with isolated patent ductus arteriosus.

The role of multiplane (M) transesophageal echocardiography (TEE) in the diagnosis of isolated patent ductus arteriosus (PDA) in adults and its effectiveness in the assessment of the pulmonary to systemic flow ratio were evaluated and compared with those obtained from cardiac catheterization examination. Eleven consecutive patients, ranging from 17 to 56 years old (mean of 29.5 +/- 12.