Value-based approach to blood pressure telemonitoring and remote counseling in hypertensive patients.

Purpose: Blood pressure telemonitoring and remote counselling (BPTM) improves blood pressure (BP) control in patients with hypertension (HTN). Studies assessing the efficacy of BPTM from a value-based perspective are lacking. We investigated whether BPTM fits all principles of the value-based approach (clinical and economic effectiveness, improvement in patient-reported outcome/experience measures (PROM/PREM)).

[Assessment of the clinical efficacy of telemonitoring and distant counseling in patients with uncontrolled hypertension].

The aim of the study was to investigate the mathematical correlation of the clinical efficacy of blood pressure telemonitoring and distant counseling (BPTM) in patients in uncontrolled hypertension (HTN). Telehealth tools are widely used in HTN management. However clinical efficacy of such interventions assessed mainly in groups investigated without its populational and attributable impact.

Release of Mitochondrial and Nuclear DNA During On-Pump Heart Surgery: Kinetics and Relation to Extracellular Vesicles.

During heart surgery with cardiopulmonary bypass (CPB), the release of mitochondrial (mtDNA) and nuclear DNA (nDNA) and their association to extracellular vesicles were investigated. In patients undergoing elective coronary artery bypass grafting (CABG, n = 12), blood was sampled before, during, and after surgery from peripheral artery, pulmonary artery, and the coronary sinus. Plasma was separated in three fractions: microvesicles, exosomes, and supernatant.

visualization and quantification of experimental myocardial infarction by indocyanine green fluorescence imaging.

The fluorophore indocyanine green accumulates in areas of ischemia-reperfusion injury due to an increase in vascular permeability and extravasation of the dye. The aim of the study was to validate an indocyanine green-based technique of in vivo visualization of myocardial infarction. A further aim was to quantify infarct size ex vivo and compare this technique with the standard triphenyltetrazolium chloride staining.

Heparinase treatment of heparin-contaminated plasma from coronary artery bypass grafting patients enables reliable quantification of microRNAs.

Background: microRNAs have recently been identified as powerful biomarkers of human disease. Reliable polymerase chain reaction (PCR)-based quantification of nucleic acids in clinical samples contaminated with polymerase inhibitor heparin requires deheparinization. However, the effects of deheparinization procedure on quantification of nucleic acids remain largely unknown.

Remote vs. local ischaemic preconditioning in the rat heart: infarct limitation, suppression of ischaemic arrhythmia and the role of reactive oxygen species.

The unmet clinical need for myocardial salvage during ischaemia-reperfusion injury requires the development of new techniques for myocardial protection. In this study the protective effect of different local ischaemic preconditioning (LIPC) and remote ischaemic preconditioning (RIPC) protocols was compared in the rat model of myocardial ischaemia-reperfusion, using infarct size and ischaemic tachyarrhythmias as end-points. In addition, the hypothesis that there is involvement of reactive oxygen species (ROS) in the protective signalling by RIPC was tested, again in comparison with LIPC.

New technique of local ischemic preconditioning induction without repetitive aortic cross-clamping in cardiac surgery.

Background: Several studies have demonstrated that local ischemic preconditioning can reduce myocardial ischemia-reperfusion injury in cardiac surgery patients; however, preconditioning has not become a standard cardioprotective intervention, primarily because of the increased risk of atheroembolism during repetitive aortic cross-clamping. In the present study, we aimed to describe and validate a novel technique of preconditioning induction.

Methods: Patients undergoing coronary artery bypass grafting (12 women and 78 men; mean age, 56 ± 11 years) were randomized into 3 groups: (1) Controls (n = 30), (2) Perfusion (n = 30), and (3) Preconditioning (n = 30).

[Recellularization of tissue engineered vascular grafts in perfusion bioreactor].

Small diameter tissue engineered vascular grafts could be a potential solution to the shortage of vascular substitutes in reconstructive cardiovascular surgery. Previously, we have developed a decellularization method for human umbilical arteries, which could be used as a scaffold in vascular tissue engineering. Objective of the study was to optimize the recellelularization of decellularized scaffolds with mesenchymal stem cells.

Myocardial protection against global ischemia with Krebs-Henseleit buffer-based cardioplegic solution.

Background: The Krebs-Henseleit buffer is the best perfusion solution for isolated mammalian hearts. We hypothesized that a Krebs-Henseleit buffer-based cardioplegic solution might provide better myocardial protection than well-known crystalloid cardioplegic solutions because of its optimal electrolyte and glucose levels, presence of buffer systems, and mild hyperosmolarity.

Methods: Isolated Langendorff-perfused rat hearts were subjected to either global ischemia without cardioplegia (controls) or cardioplegic arrest for either 60 or 180 min, followed by 120 min of reperfusion.

[Myocardial protection against global ischemia-reperfusion with use of Krebs-Henseleit buffer-based cardioplegic solution].

Improvement of myocardial protection against global ischemia-reperfusion injury during cardiopulmonary bypass remains to be of primary importance for cardiac surgery. In the present study, the effectiveness of new Krebs-Henseleit buffer-based cardioplegic solution was investigated in an isolated rat heart preparation in normo- and hypothermic states. Use of this crystalloid cardioplegic solution in the normothermic mode (37 degrees C) resulted in better myocardial protection in comparison to standard cardioplegic solutions as evidenced from both infarct size data and the patterns of left ventricular postischemic recovery.

[Cardiac autotransplantation in a patient with congestive heart failure].

Congestive heart failure with intact or moderately lowered left ventricular pump function is caused in some patients by mitral regurgitation. Consequences are dilation of the left atrium, pulmonary hypertension, tricuspid regurgitation, thromboembolic complications, rhythm disturbances, elevated risk of sudden death. Efficacy of drug treatment, electroimpulse therapy is little and surgery is the method of choice.

[Autotransplantation of the heart as the method of treatment of congestive heart failure].

Congestive heart failure with preserved or moderately lowered left ventricular pump function in some patients is caused by mitral regurgitation. Its consequences are left atrial dilation, pulmonary hypertension, tricuspid regurgitation, thromboembolic complications, disturbances of rhythm with elevated risk of sudden death. As efficacy of drug treatment and electroimpulse therapy is small surgery is the method of choice and one of alternatives - autotransplantation of the heart.

[Myocardial ischemic postconditioning: a brief ischemia causes conversion of resistent reperfusion-induced ventricular fibrillation into the normal rhythm].

Brief episodes of myocardial ischemia-reperfusion were shown to be protective against reperfusion injury when used during early reperfusion after a prolonged ischemic episode. This phenomenon has been termed myocardial ischemic postconditioning. In this study, an effect of ischemic postconditioning on persistent reperfusion-induced ventricular fibrillation was studied in the rat isolated heart.

Ischemic postconditioning: brief ischemia during reperfusion converts persistent ventricular fibrillation into regular rhythm.

Objectives: Brief episodes of myocardial ischemia-reperfusion employed during reperfusion after a prolonged ischemic insult may attenuate the total ischemia-reperfusion injury. This phenomenon has been termed ischemic postconditioning. In the present study, we studied the possible effect of postconditioning on persistent reperfusion-induced ventricular fibrillation (VF) in the isolated rat heart model.

Does nitric oxide generation contribute to the mechanism of remote ischemic preconditioning?

The protective effect of local or remote ischemic preconditioning (IPC) on subsequent 40-min ischemic and 120-min reperfusion myocardial damage was investigated. Preconditioned rats underwent one cycle of myocardial ischemia/reperfusion consisting of 5-min ischemia produced as a left coronary artery (LCA) occlusion and 5 min of reperfusion. Remote IPC was produced as 15 min of small intestinal ischemia with 15 min of reperfusion as well as 30 min of limb ischemia with 15 min of reperfusion.