Isolated diastolic dysfunction--diagnostic value of tissue Doppler imaging, colour M-mode and N-terminal pro B-type natriuretic peptide.

Introduction: For diagnosis of diastolic dysfunction of the left ventricle (DDF), measurement of relaxation velocity (V(R)) by tissue Doppler imaging (V(R)), flow propagation velocity of transmitral inflow (v(p)) as well as the measurement of serum levels of N-terminal pro b-type natriuretic peptide (NT-proBNP) compete with the standard echocardiographic DDF-measures because of several disadvantages of the latter.

Methods: We examined the diagnostic value of method 1, 2 and NT-proBNP in 120 patients with echocardiographic-proven DDF and in 20 patients without. Patients were classified according to the DDF-stage by standard echocardiographic parameters (transmitral E/A-ratio, deceleration time, isovolumetric relaxation time) into stage I, II and III and furthermore subdivided by the presence of dyspnoea.

Dilated cardiomyopathy may be an early sign of the C826A Fukutin-related protein mutation.

Limb-girdle muscular dystrophy LGMD2I is caused by mutations in the fukutin-related protein (FKRP) gene. Clinically, LGMD2I exhibits a great phenotypic variability ranging from severe, rapidly progressive weakness and wasting of the limb-girdle muscles to mild disorders. Here, we present three siblings without clinical signs of muscle dystrophy, but with dilated cardiomyopathy.

Surgical trauma affects the proinflammatory status after cardiac surgery to a higher degree than cardiopulmonary bypass.

Objectives: Cytokines contribute to the development of the systemic inflammatory response syndrome or multiple-organ failure frequently observed after cardiopulmonary bypass-supported cardiac surgery. To quantify the contribution of bypass-induced versus trauma-induced inflammatory response after coronary artery bypass grafting, we examined plasma cytokine levels in 120 patients with coronary artery disease who were treated with or without cardiopulmonary bypass-assisted procedures.

Methods: Patients were treated in accordance with one of the following protocols: (1) elective percutaneous coronary intervention without cardiopulmonary bypass (n = 69), (2) cardiopulmonary bypass-supported percutaneous coronary intervention (cardiopulmonary bypass-percutaneous coronary intervention; n = 10), and (3) cardiopulmonary bypass-supported coronary artery bypass grafting (cardiopulmonary bypass-coronary artery bypass grafting; n = 41).

Science review: natriuretic peptides in critical illness.

The present review will cover the mechanisms of release and the potential pathophysiological role of different natriuretic peptides in critically ill patients. By focusing on the cardiovascular system, possible implications of natriuretic peptides for diagnosis and treatment will be presented. In critical illness such as sepsis, trauma or major surgery, systemic hypotension and an intrinsic myocardial dysfunction occur.

Plasma atrial natriuretic peptide and brain natriuretic peptide are increased in septic shock: impact of interleukin-6 and sepsis-associated left ventricular dysfunction.

Objective: Interest has recently focused on the use of neurohormonal markers such as atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) as indices of left ventricular systolic dysfunction and prognosis in heart failure. Also, peptides belonging to the interleukin-6 (IL-6) family have been shown to induce ANP and BNP secretion. We hypothesized that BNP and ANP spillover in the peripheral circulation reflects left ventricular dysfunction and IL-6 production in septic shock.

[Significance of the heart-lung machine for the concept of minimal invasive heart surgery].

Proinflammatory cytokines have been implicated in mediating myocardial dysfunction in a systemic inflammatory reaction following open heart surgery with extracorporeal circulation (ECC). The present study aimed to distinguish the surgical impact on cytokine release from the influence of ECC in a model of supported angioplasty. The extracorporeal circulation and not surgical trauma was found to be the main trigger of the systemic inflammatory response.

[Systemic inflammatory reactions to extracorporeal therapy measures (II): Cardiopulmonary bypass].

About 65,000 cardiac patients undergo surgery annually in Germany with the assistance of cardiopulmonary bypass. The "post pump inflammatory response" (the systemic and myocardial inflammatory response syndrome post cardiac surgery), triggered at least in part by the cardiopulmonary bypass, contributes substantially towards morbidity (e.g.

[The heart in infection and MODS (multiple organ dysfunction syndrome)].

Dysfunctioning of the heart forms part of the multiple organ dysfunction syndrome (MODS) in sepsis and SIRS. This acute septic cardiomyopathy is often underestimated in degree and relevance, although yet in fact 10% of all sepsis fatalities are due to intractable heart failure. This potentially reversible cardiomyopathy is characterized by a considerable pump failure, is not primarily ischemic, coronary blood flow being normal or even enhanced; left and right ventricle are enlarged as a consequence of an increased ventricular compliance.

Complement and tumor necrosis factor-alpha contribute to Mac-1 (CD11b/CD18) up-regulation and systemic neutrophil activation during endotoxemia in vivo.

The increased expression of Mac-1 (CD11b/CD18) adhesion glycoproteins on neutrophils was studied using flow cytometry in male Fischer 344 rats treated with 5 mg/kg Salmonella enteritidis endotoxin. A rapid and sustained threefold increase of Mac-1 expression was observed after endotoxin injection. Inhibition of complement activation with the soluble complement receptor type 1 (sCR1) completely suppressed the initial up-regulation of Mac-1 (< or = 15 min) but did not prevent the activation during the later phase (30-90 min).

Prevention of ischemia/reperfusion injury in the rat liver by atrial natriuretic peptide.

Background/aims: Atrial natriuretic peptide (ANP) protects against hypoxia/reoxygenation-induced damage of cultured hepatocytes, thus suggesting a therapeutic potential in the liver. Therefore, the effects of ANP on hepatic ischemia/reperfusion injury after warm ischemia were studied.

Methods: Livers of male Sprague-Dawley rats subjected to 60 minutes of warm ischemia at 37 degrees C were perfused in the presence or absence of 200 and 20 nmol/L ANP.

Role of the liver in splanchnic extraction of atrial natriuretic factor in the rat.

Mesenteric, hepatic and splanchnic extraction of C-terminal and N-terminal atrial natriuretic factor was investigated in male Sprague-Dawley rats. Plasma concentrations (mean +/- S.E.

A highly sensitive and rapid radioimmunoassay for the determination of arginine8-vasopressin.

A highly sensitive radioimmunossay for arginine8-vasopressin (argipressin; INN) measurement was developed using Amberlite XAD 2 resin columns to extract arginine8-vasopressin from acidified human plasma. Arginine8-vasopressin was determined by a rapid radioimmunoassay method (2 x 20 h) using a specific antibody and 125I-labelled antigen. The bound fraction was separated by adsorption of the free fraction onto bovine serum albumin-coated charcoal; this resulted in low unspecific binding of less than 2%.