Effect of β-Blocker Withdrawal on Functional Capacity in Heart Failure and Preserved Ejection Fraction.

Background: Chronotropic incompetence has shown to be associated with a decrease in exercise capacity in heart failure with preserved ejection fraction (HFpEF), yet β-blockers are commonly used in HFpEF despite the lack of robust evidence.

Objectives: This study aimed to evaluate the effect of β-blocker withdrawal on peak oxygen consumption (peak Vo) in patients with HFpEF and chronotropic incompetence.

Methods: This is a multicenter, randomized, investigator-blinded, crossover clinical trial consisting of 2 treatment periods of 2 weeks separated by a washout period of 2 weeks.

Intrarenal venous flow in cardiorenal syndrome: a shining light into the darkness.

The aim of this case report is to assess the potential role of intrarenal Doppler ultrasonography as a non-invasive method to evaluate intrarenal venous flow (IRVF) in acute heart failure (AHF) and concomitant renal dysfunction. We report a case of an 81-year-old woman with valvular heart disease (previous mitral valve replacement) that presented with acutely decompensated heart failure and concomitant worsening renal function (WRF). In addition to complete physical examination, laboratory analysis, and echocardiography, IRVF was assessed at baseline and 48 h after the administration of diuretic treatment.

Endo-epicardial versus only-endocardial ablation as a first line strategy for the treatment of ventricular tachycardia in patients with ischemic heart disease.

Background: Epicardial ablation has shown improvement in clinical outcomes of patients with ischemic heart disease (IHD) after ventricular tachycardia (VT) ablation. However, usually epicardial access is only performed when endocardial ablation has failed. Our aim was to compare the efficacy of endocardial+epicardial ablation versus only endocardial ablation in the first procedure in patients with IHD.

[Outcome of patients with local complications at the site of an implantable device].

Objective: The recommendations for complete lead extraction because of local complications at the site of implantable devices have changed in the last 10 years. We analyze the outcome of patients who required an intervention because of a local complication between 2002 and 2010, in our Hospital.

Methods: We retrospectively studied 83 patients with a local complication that was classified according to skin integrity: 1.

Value of early cardiovascular magnetic resonance for the prediction of adverse arrhythmic cardiac events after a first noncomplicated ST-segment-elevation myocardial infarction.

Background: Infarct size (IS) determined by cardiac magnetic resonance (CMR) has proven an additional value, on top of left ventricular ejection fraction (LVEF), in prediction of adverse arrhythmic cardiac events (AACEs) in chronic ischemic heart disease. Its value soon after an acute ST-segment-elevation myocardial infarction remains unknown. Our aim was to determine whether early CMR can improve AACE risk prediction after acute ST-segment-elevation myocardial infarction.

Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction.

Background: Heart failure with preserved ejection fraction (HFpEF) is remarkably common in elderly people with highly prevalent comorbid conditions. Despite its increasing in prevalence, there is no evidence-based effective therapy for HFpEF. We sought to evaluate whether inspiratory muscle training (IMT) improves exercise capacity, as well as left ventricular diastolic function, biomarker profile and quality of life (QoL) in patients with advanced HFpEF and nonreduced maximal inspiratory pressure (MIP).

Effects of the antiarrhythmic drug dofetilide on transmural dispersion of repolarization in ventriculum. A computer modeling study.

Dofetilide is a class-III drug that inhibits the rapid component of the delayed potassium current ( I(Kr)). Experimental studies have shown that the different layers of ventricular muscle present differences in action potential duration (APD) and different responses to class III agents. It has been suggested that it contributes to APD heterogeneity in the ventricles.

Evaluation of lead selection methods for optimal reconstruction of body surface potentials.

In this study, several methods for optimal lead selection from multilead electrocardiographic recordings are analyzed. Two different lead selection methods have been implemented. For their evaluation, a linear transformation that reconstructs nonselected leads from selected leads is computed according to the least squares optimization, and the performance is evaluated in terms of the mean square error of the derived potentials and correlation.

[Persistence of the left superior vena cava associated with aortic insufficiency: diagnostic and therapeutic considerations].

In the course of the routine evaluation of a 26-years-old male for acquired aortic valve disease the persistence of a left superior vena cava draining into the coronary sinus was detected. This is a frequent congenital malformation of the systemic venous system that has no hemodynamic consequences in itself, though it may be associated to other congenital or acquired cardiac malformations that may require surgery. The preoperatory detection of the anomaly prevents unexpected problems when connecting the cardiopulmonary bypass.

Doppler assessment of left ventricular diastolic function in marathon runners.

The possible alteration in diastolic function as a result of physiological left ventricular hypertrophy was evaluated in 28 male marathon runners (mean age 38.6 +/- 5.7 years) using Doppler echocardiography.