Predictive value of the high-sensitivity troponin T assay and the simplified Pulmonary Embolism Severity Index in hemodynamically stable patients with acute pulmonary embolism: a prospective validation study.

Background: The new, high-sensitivity troponin T (hsTnT) assay may improve risk stratification of normotensive patients with acute pulmonary embolism (PE). We externally validated the prognostic value of hsTnT, and of the simplified Pulmonary Embolism Severity Index (sPESI), in a large multicenter cohort.

Methods And Results: We prospectively examined 526 normotensive patients with acute PE; of those, 31 (5.

Electrocardiographic criteria of left ventricular hypertrophy in patients with morbid obesity.

Background: Obesity is frequently accompanied by systemic hypertension complicated by left ventricular hypertrophy (LVH). Standard electrocardiography (ECG) is generally accepted screening tool for LVH in systemic hypertension. The aim was to assess currently used ECG criteria in the diagnosis of LVH in morbidly obese patients.

Use of fondaparinux in a pregnant woman with pulmonary embolism and heparin-induced thrombocytopenia.

Background: A serious complication of heparin treatment, heparin-induced thrombocytopenia (HIT) is rarely observed in pregnant women. Drug therapy during pregnancy should always be chosen to minimize fetal risk. The management of HIT in pregnancy represents a medical challenge.

Multidetector computed tomography for acute pulmonary embolism: diagnosis and risk stratification in a single test.

Aims: In patients with acute pulmonary embolism (PE), right ventricular dysfunction at echocardiography is associated with increased in-hospital mortality. The aims of this study in patients with acute PE were to identify a sensitive and simple criterion for right ventricular dysfunction at multidetector computed tomography (MDCT) using echocardiography as the reference standard and to evaluate the predictive value of the identified MDCT criterion for in-hospital death or clinical deterioration.

Methods And Results: Right ventricular dysfunction at MDCT was defined as the right-to-left ventricular dimensional ratio and was centrally assessed by a panel unaware of clinical and echocardiographic data.

Usefulness of echocardiography in the identification of an excessive increase in pulmonary arterial pressure in patients with systemic sclerosis.

Background: In systemic sclerosis (SSc), changes in the lungs and pulmonary hypertension (PH) are complications most adversely affecting the prognosis. Given the availability of specific treatment, early diagnosis of PH is very important. Exercise echocardiography, by increasing the patient's cardiac output, makes it possible to identify patients with elevated pulmonary artery pressure (PAP) during exercise.

Signs of myocardial ischemia on electrocardiogram correlate with elevated plasma cardiac troponin and right ventricular systolic dysfunction in acute pulmonary embolism.

Background: Plasma cardiac troponins (cTn) are frequently elevated in acute pulmonary embolism (APE). ST-segment abnormalities on electrocardiography are also commonly observed in APE patients. However, it has not been defined which ventricle is a potential source of cTn release.

Electrocardiographic differentiation between acute pulmonary embolism and non-ST elevation acute coronary syndromes at the bedside.

Background: Clinical picture of acute pulmonary embolism (APE), with wide range of electrocardiographic (ECG) abnormalities can mimic acute coronary syndromes.

Objectives: Assessment of standard 12-lead ECG usefulness in differentiation at the bedside between APE and non-ST elevation acute coronary syndrome (NSTE-ACS).

Methods: Retrospective analysis of 143 patients: 98 consecutive patients (mean age 63.

The recurrence after ten years - "mother in-law variant" of tako-tsubo syndrome.

The recurrence of left ventricular apical ballooning (LVAB) or tako-tsubo syndrome seems to be rare. Little data exists regarding the recurrence of the disease, especially over the long-term follow-up. We present a case of relapse of LVAB after ten years.

[Diagnosis and treatment of pulmonary embolism in pregnancy].

Pregnancy and puerperium increase the risk of venous thromboembolic disease. As it is potentially life-threatening, all patients with the suspicion of pulmonary embolism require proper diagnosis and, possibly treatment. Venous ultrasonography is usually applied.

Heart rate turbulence impairment and ventricular arrhythmias in patients with systemic sclerosis.

Background: Arrhythmias, conduction disturbances, and cardiac autonomic nervous system dysfunction are the most frequent cardiovascular complications in systemic sclerosis (scleroderma). The aim of the study was to assess heart rate turbulence (HRT) in systemic sclerosis patients and to identify the relationship between HRT and occurrence of arrhythmias.

Methods: Forty-five patients with scleroderma (aged 54.

[QTU pattern in a patient with the Anderson-Tawil syndrome].

The Andersen-Tawil syndrome (ATS) is an autosomal dominant or sporadic disorder characterised by periodic paralysis, cardiac arrhythmias and dysmorphic features. Mutations in KCNJ2, which encodes the inward rectifier K+ channel Kir2.1 can be found in approximately 70% of ATS cases.

[Prophylaxis of pulmonary embolism in pregnancy and puerperium].

Pulmonary embolism is the main cause of death of pregnant women in developed countries. An increased prothrombotic activity is observed during pregnancy. Moreover, the risk of venous thromboembolic disease can be elevated in cases of inherited thrombophilia, antiphospholipid syndrome or previous venous thromboembolic events.

Assessment of renal dysfunction improves troponin-based short-term prognosis in patients with acute symptomatic pulmonary embolism.

Objective: Current risk stratification in acute pulmonary embolism (APE) includes assessment of clinical status, right ventricular overload and plasma troponin concentrations. As impaired renal function is one of the important predictors of mortality in cardiovascular diseases, we hypothesized that it is an independent early mortality marker in APE.

Material And Methods: In prospective cohort study, we observed 220 consecutive patients (86M/134F, 64 +/- 18 years) with APE proven by spiral computed tomography (CT).

[The role of tissue Doppler imaging in diagnosis of pulmonary embolism].

Pulmonary embolism (PE), despite improvement of diagnostic methods often remains undiagnosed. Importantly, the lack of correct diagnosis is one of major factors negatively influencing the prognosis of PE for patients. Echocardiography is frequently performed on patients suspected of PE.

Heart rate turbulence assessment in systemic sclerosis: the role for the detection of cardiac autonomic nervous system dysfunction.

Objective: To assess the heart rate turbulence (HRT) in patients with SSc as a method of assessment for cardiac autonomic nervous function.

Methods: We prospectively studied 68 consecutive patients with SSc before inclusion in the study. After a detailed clinical evaluation, including echocardiography, 45 subjects [aged 54.

Mean platelet volume predicts early death in acute pulmonary embolism.

Background: Recently, mean platelet volume (MPV) was reported to predict venous thromboembolism. Moreover, MPV correlates with platelet reactivity and indicates poor outcome in acute coronary syndromes.

Objective: To examine the hypothesis that in acute pulmonary embolism (APE) MPV is elevated and may predict mortality.

Henoch-Schönlein purpura: an atypical cause of abdominal pain in a 70-year-old man: case report.

Henoch-Schönlein purpura (HSP) is a leukocytoclastic small-vessel vasculitis involving small vessels with the deposition of immune complexes containing immunoglobulin A and neutrophil and eosinophilic infiltration. Clinical manifestations include 4 classic signs and symptoms: skin lesions, arthralgias, abdominal pain, and renal disease. HSP primarily affects children and is uncommon in adults.

Is it possible to use standard electrocardiography for risk assessment of patients with pulmonary embolism?

Background: Risk stratification of patients with acute pulmonary embolism (APE) is crucial for appropriate treatment selection. Shock and hypotonia are known indications for aggressive management. However, in the haemodynamically stable group the best prognosis strategy is still being sought.

[Potential role of endothelin in patients with acute pulmonary embolism and chronic thromboembolic pulmonary hypertension].

Endothelins (ET), a family of three peptides of strong vasoconstrictive properties, participate in the regulation of vascular tone and blood flow. The synthesis and degradation of the ET predominantly take place in the pulmonary vasculature. Elevated plasma ET levels were reported in various forms of arterial pulmonary hypertension including chronic thromboembolic pulmonary hypertension (CTEPH).

Biventricular noncompaction associated with left ventricular systolic and diastolic dysfunction and severe pulmonary hypertension in a young man.

Noncompaction of the ventricular myocardium is a recently recognized genetic cardiomyopathy. The left ventricle is the most affected site, but right ventricular involvement has been reported in some cases. Diagnosis is made with 2-dimensional echocardiography or cardiac magnetic resonance imaging.

Endothelin is not elevated in acute pulmonary embolism.

Introduction: In acute pulmonary embolism (APE) the increase of pulmonary vascular resistance depends on the thromboli load and potentially on the pulmonary bed contraction caused by neurohormonal reaction. Plasma levels of endothelin were reported to be elevated in pulmonary arterial hypertension. However, there are only a few studies assessing endothelin in patients with APE.