Clot Through the Heart: Paradoxical Embolism With Thrombus-in-Transit at Multidetector Computed Tomography.

We present the case of a 67-year-old man with concomitant stroke and pulmonary embolism 1 day after radiofrequency catheter ablation for refractory atrial tachycardia. A chest computed tomographic angiogram revealed "thrombus-in-transit" across a patent foramen ovale, confirming the diagnosis of paradoxical embolism. Paradoxical embolism is a rare definitive diagnosis.

Impaired pyruvate oxidation but normal glucose uptake in diabetic pig heart during dobutamine-induced work.

We tested the hypothesis that diabetes impairs myocardial glucose uptake and pyruvate oxidation under normal conditions and during a dobutamine-induced increase in work. We also tested the hypothesis that an increase in work would result in a decrease in the levels of malonyl CoA, a potent inhibitor of carnitine palmitoyltransferase I (CPT I). Streptozotocin-diabetic micropigs were compared with a nondiabetic control group (n = 8 per group).

Myocardial high-energy phosphate and substrate metabolism in swine with moderate left ventricular hypertrophy.

Background: Although left ventricular hypertrophy (LVH) is frequently associated with impaired coronary vasodilator reserve, it is uncertain whether this leads to myocardial ischemia under physiological conditions. The goal of the present study was to determine whether swine with moderate LVH exhibit metabolic evidence of ischemia when myocardial oxygen requirements are increased.

Methods And Results: Myocardial metabolism was evaluated in an open-chest anesthetized preparation at baseline and during dobutamine infusion in 13 adolescent pigs with moderate LVH induced by supravalvular aortic banding and 12 age-matched control pigs.

Dichloroacetate stimulates carbohydrate metabolism but does not improve systolic function in ischemic pig heart.

Increased carbohydrate utilization may protect the heart during ischemia and reperfusion. Dichloroacetate (DCA) stimulates pyruvate dehydrogenase, which is the rate-limiting step in oxidation of lactate and pyruvate. The purpose of this study was to determine if the myocardial metabolic changes induced by intracoronary DCA during myocardial ischemia were accompanied by improvement in systolic function.

Inhibition of fatty acid metabolism alters myocardial high-energy phosphates in vivo.

We previously observed that isoproterenol (ISO) stimulation of the in situ porcine right ventricle (RV) increases the ratio of phosphocreatine (PCr) to ATP, accompanied by marked augmentation of myocardial free fatty acid (FFA) uptake. We hypothesized that increased FFA uptake and utilization cause the increase in PCr/ATP and that inhibition of FFA metabolism during ISO would prevent such an increase. In open-chest pigs, myocardial oxygen consumption (MVO2) of the RV free wall was increased with ISO (0.