From Neurocardiology to Stroke-Heart Syndrome.

The Stroke-Heart syndrome is a major chapter in neurocardiology. Both brain-heart and stroke-heart correlations are based on neurophysiological studies that define and describe the relation between the central autonomic system and cardiac function and it will be presented in this narrative review. The Stroke-Heart syndrome groups the entire spectrum of cardiac changes - clinical, ECG, echocardiographic, biological, morphological - that occur in the first 30 days from the onset of stroke, especially in the first days.

Neurogenic Stunned Myocardium as Part of Stress Cardiomyopathy.

Stress cardiomyopathy (SCM), also called Takotsubo syndrome (TTS), is a topic of current interest that extends beyond cardiology. The neurological framework currently includes neurogenic stunned myocardium (NSM), an abnormal condition that shares many common features with TTS. Unlike TTS, the main triggers for NSM are mostly neurological events (e.

Amyloid Cardiopathy and Aortic Stenosis.

Cardiac amyloidosis (amyloid cardiomyopathy, CA) is an increasingly diagnosed condition which is most frequently seen in older patients with heart failure and preserved ejection fraction as well as in those with biventricular hypertrophies and tight aortic stenosis (AS). Almost 15% of patients with tight AS can also have CA ATTR, an element with diagnostic, prognostic and therapeutic significance. The CA diagnostic, associated with AS or not, is laborious and it should be made on the basis of determining the severity of the associated AS, depending on the case.

Risk of Stroke After Transcatheter Aortic Valve Implantation: Epidemiology, Mechanism, and Management.

Background: Transcatheter aortic valve implantation (TAVI) has become an established and increasingly used approach for management of severe symptomatic aortic stenosis, showing similar or even superior outcomes compared with standard surgical aortic valve replacement (SAVR). Stroke after TAVI is a relatively rare, but serious complication, associated with potential prolonged disability and increased mortality.

Areas Of Uncertainty: The overall incidence of 30-day stroke in TAVI patients is 3%-4%, but varies between different trials.

Troponins in Heart Failure - a Perpetual Challenge.

Increased troponin levels in HF are a frequent and significant finding, as it strongly correlates with the underlying pathogenic mechanisms, diagnosis and prognosis. The advent of hs-cTn testing, as opposed to conventional troponin testing, led to additional difficulties in result interpretation. Most frequently, though not exclusively, increased cTn levels in acute or chronic failure is correlated, with myocardial necrosis (AMI); the diagnosis of AMI is confirmed if other criteria are fulfilled, as described in the fourth Universal Definition of Myocardial Infarction.

Subclinical Atrial Fibrillation, Embolic Risk, and Anticoagulant Treatment.

Professor Leonida Gherasim, MD, PhD, is a member of the Romanian Academy. We invited him to write the editorial review for this issue. The subject - how to treat the silent atrial fibrillation (that fibrillation discovered only by devices) and take the decision to anti coagulate or not - is a very important clinical judgement.

Ischemic Hepatitis - Intercorrelated Pathology.

Ischemic hepatitis is an important, yet underdiagnosed pathological condition seen in either cardiology or hepatology clinics or intensive care units. The main causes are severe heart failure, circulatory and septic shock. Close monitoring of biological tests (AST, ALT, LDH) together with hemodynamic parameters (blood pressure, cardiac output and central venous pressure) allow for rapid and accurate diagnosis.

Worsening of Heart Failure after Abdominal Surgery - Can we predict it?

Background: The cardiopulmonary test has demonstrated its role in predicting long term prognostic of patients with heart failure, but only few data are available regarding its utility on short term period.

Methods: During 2011-2013, the study enrolled 55 patients over 18 years, with different cardiovascular, metabolic and/or pulmonary pathologies, and 10 control patients matched for age, sex and surgical intervention type, without an associated pathological history who underwent elective abdominal surgery with general anesthesia.

Results: The most important predictors of the heart failure worsening after abdominal surgery were peak VO2 as percent of predicted VO2 lower than 59.

Prognostic value of heart rate variability after acute myocardial infarction.

Background: Prognosis after acute myocardial infarction (AMI) may be influenced by autonomic dysfunction that can be evaluated by assessment of heart rate variability (HRV). Its predictive value resulted from studies performed prior to large scale use of reperfusion therapy. We assessed the prognostic value of HRV parameters 1 year after AMI in patients treated conventionally or by a reperfusion method in the first 12 hours from onset.