Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute myocardial infarction. We examine 4 atypical presentations of SCAD. These cases highlight treatment course and outcomes for patients with SCAD who do not present with acute coronary syndrome.
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http://dx.doi.org/10.1016/j.jaccas.2024.102539 | DOI Listing |
Biol Pharm Bull
December 2024
Department of Pharmacology, Faculty of Pharmaceutical Sciences, Toho University.
The effect of a citrus-derived flavonoid, hesperetin, on the automaticity and contraction of isolated guinea pig myocardium was examined. Hesperetin inhibited the rate of ectopic action potential firing of the pulmonary vein myocardium; the slope of the diastolic depolarization was decreased with minimum change in the action potential waveform. The effect was dependent on the concentration; the EC value for firing rate was 56.
View Article and Find Full Text PDFResuscitation
December 2024
Cardiovascular Division, University of Minnesota, Minneapolis, MN, U.S.A; Center for Resuscitation Medicine, University of Minnesota, Minneapolis, MN, U.S.A. Electronic address:
Introduction: The haemodynamic effects veno-arterial extracorporeal membrane oxygenation (VA-ECMO) remain inadequately understood. We investigated invasive left ventricular (LV) haemodynamics in patients who underwent treatment with an intensive care strategy involving extracorporeal cardiopulmonary resuscitation (ECPR).
Methods: We conducted invasive haemodynamic assessments on 15 patients who underwent ECPR and achieved return of spontaneous circulation.
JACC Clin Electrophysiol
November 2024
Electrophysiology Section, Division of Cardiology, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA; Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA. Electronic address:
Background: The mechanisms underlying postoperative atrial fibrillation (POAF) remain unclear.
Objectives: The aim of this study was to test the hypothesis that targeted chemical ganglionated plexi (GP) modulation of all major left atrial-pulmonary vein GP using novel nanoformulated calcium chloride (nCaCl) can reverse postoperative neuroelectrical remodeling by suppressing vagosympathetic nerve activity and the localized inflammatory process, both critical substrates of POAF.
Methods: In a novel canine model of POAF with serial thoracopericardiotomies, sympathetic nerve activity (SNA), vagal nerve activity (VNA) and GP nerve activity (GPNA) were recorded; spontaneous and in vivo AF vulnerability were assessed; and atrial and circulating inflammatory markers and norepinephrine (NE) were measured to determine the neuroelectrical remodeling that promotes POAF and its subsequent modulation with nCaCl GP treatment (n = 6) vs saline sham controls (n = 6).
J Extra Corpor Technol
December 2024
College of Medicine and Public Health, Flinders University - Quality and Outcomes Unit, Cardiothoracic Surgical Unit, Division of Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
Background: The utility and uptake of Del Nido cardioplegia in adult cardiac surgery is rapidly increasing. Cases with prolonged aortic cross-clamp times necessitate multi-dosing however an understanding of safe ischaemic times and definitive guidelines in this domain are lacking. Therefore, this study aimed to assess the safety and efficacy of our DNC strategy by comparing post-operative troponin profiles and clinical outcomes between Del Nido and hyperkalaemic cardioplegia for cases with aortic cross-clamp times of greater than 90 min.
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Department of Intensive Care Medicine, Xiangya Hospital, Central South University, Changsha, China.
Rationale: Cardiac arrest (CA) is an acute emergency with high mortality and is closely associated with the risk of brain damage or systemic ischemia-reperfusion injury, post-traumatic stress symptoms.
Patient Concerns: Targeted temperature management in the intensive care unit can improve the neurological outcomes of patients who are comatose after resuscitation from CA. However, there is often a lack of specific evaluation methods for optimal target temperature settings.
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