The APEX trial: Effects of allopurinol on exercise capacity, coronary and peripheral endothelial function, and natriuretic peptides in patients with cardiac syndrome X.

Unlabelled: The role of endothelial dysfunction and oxidative stress in the pathogenesis of cardiac syndrome X has recently been recognized. Allopurinol has previously been shown to improve endothelial dysfunction, reduce oxidative stress burden, and improve myocardial efficiency. In this "proof of concept" study, we investigated the effect of allopurinol on exercise capacity, coronary and peripheral endothelial function, and serum B-type natriuretic peptide (BNP: a marker of cardiac function and myocardial ischemia) in patients with cardiac syndrome X.

Impact of paravalvular leakage on outcome in patients after transcatheter aortic valve implantation.

Objectives: The aim of this study was to evaluate the performance of the aortic regurgitation (AR) index as a new hemodynamic parameter in an independent transcatheter aortic valve implantation (TAVI) cohort and validate its application.

Background: Increasing evidence associates more-than-mild periprosthetic aortic regurgitation (periAR) with increased mortality and morbidity; therefore precise evaluation of periAR after TAVI is essential. The AR index has been proposed recently as a simple and reproducible indicator for the severity of periAR and predictor of associated mortality.

Compliance to recommended liver function monitoring in patients on statin therapy.

Product information and national guidelines consistently recommend the estimation of serum alanine aminotranferase (ALT) before and after approximately 3 months as part of risk management following initiation of statin therapy. The aim of this study was to determine compliance to the recommendations for monitoring ALT in patients initiated on statin therapy. The prevalence of abnormal serum ALT levels was also evaluated and compared with current data.

Independent value of echocardiography and N-terminal pro-natriuretic Peptide for the prediction of major outcomes in patients with suspected heart failure.

N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and echocardiography have been shown to have diagnostic and prognostic value for the assessment of heart failure (HF) in the community. This study evaluated whether echocardiography and serum NT-pro-BNP estimation have independent value for the prediction of major outcome in patients with suspected HF from the community. Accordingly, 137 patients with suspected HF referred from the community were followed up after undergoing clinical assessment, electrocardiography, NT-pro-BNP estimation, and echocardiography.

Cost effectiveness of the B type natriuretic peptide, electrocardiography, and portable echocardiography for the assessment of patients from the community with suspected heart failure.

To analyze the cost efficiency of guidelines proposed by the European Society of Cardiology for investigation of patients in the community with suspected heart failure (HF). The guidelines recommend electrocardiography (ECG) and/or measurement of N-terminal pro B type natriuretic peptide (NTproBNP) prior to referral for echocardiography. Portable echocardiography is a new but validated technique for the evaluation of HF.

Value of primary care electrocardiography for the prediction of left ventricular systolic dysfunction in patients with suspected heart failure.

To compare electrocardiogram (ECG) with measurement of N-terminal pro-B-type natriuretic peptides (NTproBNP) as the General Practitioner's (GP) initial test for suspected heart failure patients from the community. We prospectively studied 137 suspected heart failure patients who underwent ECG and NTproBNP estimation; were referred from primary care to a specialist unit for echocardiography. We demonstrated that sensitivity of ECG interpreted by GP was significantly lower than both by ECG interpreted by Hospital Physician (HP) and NTproBNP estimation for the detection of left ventricular systolic dysfunction (LVSD).

Contrast echocardiography versus gated single photon emission computed tomography for the assessment of parameters of left ventricular remodeling after acute myocardial infarction.

Background: Assessment of parameters of left ventricular (LV) remodeling after acute myocardial infarction (AMI) has both therapeutic and prognostic implication. Contrast echocardiography (CE) has the advantage of simultaneously assessing myocardial perfusion and LV remodeling. We aimed to evaluate the accuracy of CE to assess LV remodeling after AMI compared with technetium-99m sestamibi gated single photon emission computed tomography (SPECT).

Clinical benefits of contrast-enhanced echocardiography during rest and stress examinations.

Despite the recent introduction of tissue harmonic imaging in echocardiography, 10-15% of patients have poor endocardial border definition. This may lead to erroneous assessment of regional and global left ventricular (LV) function or to further diagnostic imaging with another modality thus increasing the costs for the healthcare system. The recent development of second generation contrast echocardiography agents such as SonoVue has resulted in several studies showing the value of these agents to outline endocardium clearly, thereby improving assessment of LV function.

Improved accuracy of low-power contrast echocardiography for the assessment of left ventricular remodeling compared with unenhanced harmonic echocardiography after acute myocardial infarction: comparison with cardiovascular magnetic resonance imaging.

Background: Assessment of left ventricular (LV) remodeling after acute myocardial infarction (AMI) has both therapeutic and prognostic implications. Low-power contrast echocardiography (CE) has the advantage of simultaneously assessing myocardial perfusion and LV remodeling.

Objective: This study aimed to evaluate the accuracy of low-power CE to assess LV remodeling after AMI compared with unenhanced harmonic echocardiography (HE).