Hemodynamic effects of levosimendan added to dobutamine in patients with decompensated advanced heart failure refractory to dobutamine alone.

A 24-hour infusion of levosimendan was added to dobutamine in 18 patients (aged 63 +/- 9 years) hospitalized for management of decompensated New York Heart Association functional class IV heart failure refractory to a continuous 24-hour infusion of dobutamine (10 microg/kg/min) and furosemide (10 mg/hour); the primary study end point was a >or=40% increase in cardiac index and a >or=25% decrease in pulmonary capillary wedge pressure compared with pretreatment measurements. The primary end point was reached in one of the patients treated with dobutamine alone versus 7 patients (39%) treated with levosimendan and dobutamine combined (p = 0.008), whereas at 24 hours, the combined treatment was associated with a 0.

A noninvasive method for the detection of dual atrioventricular node physiology in chronic atrial fibrillation.

Considering the electrophysiologic study as a reference, the RR interval distribution analysis is a sensitive (88%) and specific (80%) noninvasive method for detecting dual atrioventricular (AV) node physiology. This method may prove useful in selecting patients with atrial fibrillation who are considered appropriate candidates for radiofrequency modification of AV nodal conduction as opposed to AV nodal ablation.

Use of vibrational angioplasty for the treatment of chronic total coronary occlusions: preliminary results.

The aim of the study was to investigate the feasibility and clinical safety of vibrational angioplasty in the treatment of chronic total coronary occlusions and evaluate the clinical and angiographic factors that are predictive of the procedural success and complications of the procedure. Seventy-eight patients with chronic total occlusions (>3 months) resistant to conventional techniques were treated by vibrational angioplasty using a variety of conventional guidewires. Lesions were successfully crossed in 67 (85.

Pain intensity in nondiabetic patients with myocardial infarction or unstable angina. Its association with clinical and psychological features.

Sixty nondiabetic coronary artery disease (CAD) patients submitted to coronary angiography were asked to rate (score 0 to 20) pain intensity (RPI) during their last major anginal episode having occurred prior to coronary angiography. This parameter was examined in relation to other variables of CAD and to psychological features. Stepwise regression analysis revealed that RPI was not related to New York Heart Association (NYHA) classification of angina or to angiographic variables.

New method for placement of intracoronary stents in order to avoid their embolization in the intravascular space.

Stent dislodgment from the delivery catheter is a well-known complication of angioplasty with stent implantation. The aim of our study was to investigate the feasibility, effectiveness, and safety of a new technique of intracoronary stent implantation in order to avoid stent loss in the intravascular space. Fifty consecutive patients were candidates for angioplasty and stent placement.