Improved cardiac performance through pacing-induced diaphragmatic stimulation: a novel electrophysiological approach in heart failure management?

Aims: Pharmacological conditioning of the phrenic nerve can positively influence systolic performance, and diaphragm activation improves ventilatory function. Here we investigate whether pacing-induced diaphragmatic stimulation (PIDS) may improve left ventricular (LV) systolic function.

Methods And Results: We studied a total of 35 patients (4 females, mean age 67 +/- 9 years, ejection fraction 61 +/- 14%) within 7 days following open heart surgery.

Left ventricular mass regression following implantation of MIRA bileaflet valves in patients with severe aortic stenosis.

The aim of this study was to evaluate the factors that determine the course of left ventricular mass regression in a homogeneous group of patients following aortic valve replacement by use of the mechanical Edwards MIRA bileaflet prosthesis. Furthermore, we examined if the 19-mm valve leads to an equally good outcome when compared with larger 21- and 23-mm valves. We included 79 patients (49 men) with a mean age of 65+/-9 years operated on for isolated aortic valve replacement with the MIRA valve prosthesis.

Pulmonary Coccidioides nodule in a Swiss patient with chronic lymphatic leukaemia.

The dimorphic fungus Coccidioides immitis, causative agent of coccidioidomycosis, is endemic in semi-arid regions of the Americas. The disease is rarely encountered in Europe. We describe the case of a 61-year-old Swiss patient with chronic lymphatic leukaemia who was eventually diagnosed with an initially unnoticed pulmonary coccidioidomycosis.

Adrenal function during coronary artery bypass grafting.

Objective: To assess adrenal function in patients undergoing coronary artery bypass grafting (CABG) by means of the low-dose (1 microg) ACTH test, and to correlate the adrenal function with clinical outcome.

Methods: During a 5-Month period we prospectively included 45 patients undergoing elective CABG with cardiopulmonary bypass and without symptoms of endocrine disease. Low-dose (1 microg) ACTH tests were performed on the day before surgery (day -1), immediately after the operation (day 0), on the two subsequent days in the intensive care unit (day 1 and day 2), and on the day of discharge from the hospital.

[Intrathoracic goiter--a rare mediastinal tumor].

Intrathoracic, totally ectopic goiters are rare, but have to be considered as a diagnostic possibility in all mediastinal masses. The displacement of the thyroid tissue inferiorly in connection with the embryogenesis of the heart and the large vessels explains the aetiology of the disease. Ectopic goiters are often asymtomatic or oligosymptomatic.