Fulminant adrenergic myocarditis complicated by pulmonary edema, cardiogenic shock and cardiac arrest.

Adrenergic myocarditis is an uncommon presentation of pheochromocytoma and extremely rare cause of de novo acute heart failure (AHF). We present a case of a 31-year-old Caucasian woman with a history of hypertension and recurrent occipital headaches who was admitted to the emergency department due to severe de novo AHF presenting as pulmonary edema and cardiogenic shock. During the hospital admission the patient experienced asystolic cardiac arrest and was successfully resuscitated, intubated, and mechanically ventilated.

The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion.

Acute heart failure and/or cardiogenic shock are frequently triggered by ischemic coronary events. Yet, there is a paucity of randomized data on the management of patients with heart failure complicating acute coronary syndrome, as acute coronary syndrome and cardiogenic shock have frequently been defined as exclusion criteria in trials and registries. As a consequence, guideline recommendations are mostly driven by observational studies, even though these patients have a particularly poor prognosis compared to heart failure patients without signs of coronary artery disease.

Where's the Noise? Key Features of Spontaneous Activity and Neural Variability Arise through Learning in a Deterministic Network.

Even in the absence of sensory stimulation the brain is spontaneously active. This background "noise" seems to be the dominant cause of the notoriously high trial-to-trial variability of neural recordings. Recent experimental observations have extended our knowledge of trial-to-trial variability and spontaneous activity in several directions: 1.

Distributed Bayesian Computation and Self-Organized Learning in Sheets of Spiking Neurons with Local Lateral Inhibition.

During the last decade, Bayesian probability theory has emerged as a framework in cognitive science and neuroscience for describing perception, reasoning and learning of mammals. However, our understanding of how probabilistic computations could be organized in the brain, and how the observed connectivity structure of cortical microcircuits supports these calculations, is rudimentary at best. In this study, we investigate statistical inference and self-organized learning in a spatially extended spiking network model, that accommodates both local competitive and large-scale associative aspects of neural information processing, under a unified Bayesian account.

The role of NT-proBNP in the diagnostics and differentiation of cardiac and reflex syncope in adults: relative importance to clinical presentation and medical examinations.

Purpose: The aim of this study was to assess the clinical significance of N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in the differentiation of patients with cardiac and reflex syncope.

Methods: The study included a group of 100 patients (56 women, 44 men), aged 18-77 years (mean 52.6 ± 16.

[Natriuretic peptides and their use in clinical practice according to the guidelines of the European Society of Cardiology].

In recent years, assay levels of natriuretic peptides are used in everyday clinical practice. The most commonly used is the assay the concentration of NT-proBNP in conjunction with the longest half-life (120 minutes) and its stability. According to the guidelines of the European Society of Cardiology determination of NT-proBNP were used in the diagnosis of acute and chronic heart failure, risk stratification in acute coronary syndromes, pulmonary embolism and in assessing the overall risk of cardiovascular patients prior to surgery.

STDP installs in Winner-Take-All circuits an online approximation to hidden Markov model learning.

In order to cross a street without being run over, we need to be able to extract very fast hidden causes of dynamically changing multi-modal sensory stimuli, and to predict their future evolution. We show here that a generic cortical microcircuit motif, pyramidal cells with lateral excitation and inhibition, provides the basis for this difficult but all-important information processing capability. This capability emerges in the presence of noise automatically through effects of STDP on connections between pyramidal cells in Winner-Take-All circuits with lateral excitation.

[Natriuretic peptides. History of discovery, chemical structure, mechanism of action and the removal routes. Basis of diagnostic and therapeutic use].

Natriuretic peptides (NP) are the group of proteins synthesized and secreted by the mammalian heart. All the NP are synthesized from prohormones and have 17-amino acid cyclic structures containing two cysteine residues linked by internal disulphide bond. They are characterized by a wide range of actions, mainly through their membrane receptors.

Bayesian computation emerges in generic cortical microcircuits through spike-timing-dependent plasticity.

The principles by which networks of neurons compute, and how spike-timing dependent plasticity (STDP) of synaptic weights generates and maintains their computational function, are unknown. Preceding work has shown that soft winner-take-all (WTA) circuits, where pyramidal neurons inhibit each other via interneurons, are a common motif of cortical microcircuits. We show through theoretical analysis and computer simulations that Bayesian computation is induced in these network motifs through STDP in combination with activity-dependent changes in the excitability of neurons.

Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol.

Background: The role of inflammatory and hemodynamic stress biomarkers in heart failure (HF) patients treated de novo with beta-blockers has been poorly studied.

Methods: A total of 86 patients (age 56 ± 9 years, 81 men) with left ventricular ejection fraction (LVEF) < 40% and previously not treated with beta-blockers were initiated on carvedilol. At baseline and 12 months later we performed echocardiography, cardiopulmonary exercise testing, and determined serum levels of B-type natriuretic peptide (BNP), endothelin-1 (ET-1), C-reactive protein (CRP), interleukin-6, and tumor necrosis factor alpha (TNF -a).

[Epidemiology of pulmonary embolism in patients with cardiac department].

Unlabelled: Pulmonary embolism (PE) is a blockage of the main artery of the lung or one of its branches by a embolic material. ZP is usually a manifestation of venous thromboembolism (VTE), which in addition to the ZP includes deep vein thrombosis. The aim of this study was to analyze the epidemiology of pulmonary embolism in patients in the cardiology department with regard to gender and age.

[Prevalence of age, gender and body weight on the frequency of hypertension and diabetes mellitus in patients hospitalized in cardiology department].

Unlabelled: Overweight and obesity are a major medical problems of the twenty-first century. According to the World Health Organization (WHO) in the world are about 1.6 billion people with overweight and at least 400 million adults are obese.

Neural dynamics as sampling: a model for stochastic computation in recurrent networks of spiking neurons.

The organization of computations in networks of spiking neurons in the brain is still largely unknown, in particular in view of the inherently stochastic features of their firing activity and the experimentally observed trial-to-trial variability of neural systems in the brain. In principle there exists a powerful computational framework for stochastic computations, probabilistic inference by sampling, which can explain a large number of macroscopic experimental data in neuroscience and cognitive science. But it has turned out to be surprisingly difficult to create a link between these abstract models for stochastic computations and more detailed models of the dynamics of networks of spiking neurons.

[Evaluation of plasma renin activity in acute myocardial infarction patients treated with primary percutaneous coronary interventions].

Unlabelled: The aim of this study was evaluation of plasma renin activity (PRA) in patients with acute ST-segement elevation myocardial infarction (STEMI) treated with primary percutaneous coronary interventions (PCI). We observed 40 patients (30 men, 10 woman) aged 29-69 yrs (mean age 53.9 SD 10.

Altered fibrin clot properties in patients with chronic heart failure and sinus rhythm: a novel prothrombotic mechanism.

Background: Thromboembolic complications occur more frequently in patients with chronic heart failure (CHF) than in the general population. Formation of a compact fibrin clot resistant to lysis has been shown in arterial and venous thrombosis.

Objective: To investigate fibrin clot properties in patients with CHF.

Reward-modulated Hebbian learning of decision making.

We introduce a framework for decision making in which the learning of decision making is reduced to its simplest and biologically most plausible form: Hebbian learning on a linear neuron. We cast our Bayesian-Hebb learning rule as reinforcement learning in which certain decisions are rewarded and prove that each synaptic weight will on average converge exponentially fast to the log-odd of receiving a reward when its pre- and postsynaptic neurons are active. In our simple architecture, a particular action is selected from the set of candidate actions by a winner-take-all operation.

Restrictive left ventricular filling pattern and its effect on the clinical course of systolic heart failure in patients receiving carvedilol.

Background: To analyze differences in brain natriuretic peptide (BNP) levels depending on mitral flow pattern (MFP) and to assess the effects of carvedilol on changes in MFP, left ventricular function and exercise capacity.

Methods And Results: The study population consisted of 73 patients with symptomatic heart failure in NYHA classes II and III and LVEF < 40% without prior beta-blockade. In all patients at baseline, before carvedilol, and then at 3 and 12 months after initiation of treatment, the following parameters were assessed: HR(s), serum BNP, echocardiographic parameters, and exercise capacity with gas monitoring during cardiopulmonary stress test.

Concentration of BNP, endothelin 1, pro-inflammatory cytokines (TNF-alpha, IL-6) and exercise capacity in patients with heart failure treated with carvedilol.

Background: Recent studies on the pathophysiology of heart failure indicate the role of neurohormones and immune and inflammatory processes as potential mechanisms involved in the pathogenesis and clinical course of chronic heart failure (CHF).

Aim: To analyse the relationship between concentrations of brain natriuretic peptide (BNP), endothelin-1 (ET-1), inflammatory cytokines (TNF-alpha, IL-6) and cardiopulmonary stress test parameters, and to evaluate their changes during carvedilol treatment.

Methods: The study included 86 patients (81 men and 5 women) aged from 35 to 70 years (56.

Sudden cardiac death risk factors in patients with heart failure treated with carvedilol.

Background: Chronic heart failure (CHF) is associated with a high risk of sudden cardiac death (SCD). Most frequently SCD occurs in patients with NYHA class II and III.

Aim: To evaluate the influence of prolonged carvedilol therapy on SCD risk in CHF patients.

[Variant angina pectoris associated with Morgagni-Adams-Stokes syndrome--case report].

We report a case of Prinzmetal angina initially manifested with short losses of consciousness in a 55-year-old man hospitalized in the Department of Coronary Artery Disease, Institute of Cardiology, Jagiellonian University Medical College in Cracow. Clinical symptomatology of the presented case, causes and mechanism of loss of consciousness in variant angina as well as treatment methods are discussed.

[Cardiac tamponade as the first symptom of oesophageal carcinoma -- a case report].

We present a case of a 56-year-old male who was admitted to our hospital due to cardiac tamponade. A 600 ml of purulent fluid was evacuated from the pericardium. The patient received antibiotics, however, due to recurrent pericardial effusion a pericardial drainage was required.

Cardiac arrest in a 17-year-old boy--a case report.

Cardiac arrest (CA) refers to abrupt cessation of cardiac pump function. Most sudden deaths in young people are of cardiac origin, at the same time most patients have unrecognised prior heart disease. We report a case of a 17-year-old boy with cardiac arrest induced by ventricular fibrillation.

Value of lead aVR in the detection of significant left main coronary artery stenosis in acute coronary syndrome.

Background: Electrocardiographic lead aVR is usually ignored in patients with chest pain. ST segment elevation in aVR may have diagnostic value in patients with acute coronary syndrome (ACS) and significant stenosis or obstruction of the left main coronary artery (LMCAS), especially when accompanied by ST segment elevation in lead V(1).

Aim: To asses the value of lead aVR and V1 for the detection of LMCAS in patients with ACS.