Initial balloon versus surgical valvuloplasty in children with isolated congenital aortic stenosis: Influence on timing of aortic valve replacement.

Objective: To evaluate the influence of initial intervention on the long-term outcomes in congenital aortic stenosis.

Methods: Two hundred forty-three children underwent initial intervention between 1997 and 2022, by surgical valvuloplasty in 92 (32% neonates, 36% infants) and balloon valvuloplasty in 151 (27% neonates, 30% infants). Twenty-eight patients (11.

Remote monitoring of cardiac implanted electronic devices: legal requirements and ethical principles - ESC Regulatory Affairs Committee/EHRA joint task force report.

The European Union (EU) General Data Protection Regulation (GDPR) imposes legal responsibilities concerning the collection and processing of personal information from individuals who live in the EU. It has particular implications for the remote monitoring of cardiac implantable electronic devices (CIEDs). This report from a joint Task Force of the European Heart Rhythm Association and the Regulatory Affairs Committee of the European Society of Cardiology (ESC) recommends a common legal interpretation of the GDPR.

Genetic Influences of OPRM1, OPRD1 and COMT on Morphine Analgesia in a Multi-Modal, Multi-Tissue Human Experimental Pain Model.

Human studies on experimentally induced pain are of value to elucidate the genetic influence on morphine analgesia under controlled conditions. The aim of this study was to investigate whether genetic variants of mu-, kappa- and delta-opioid receptor genes (OPRM1, OPRK1 and OPRD1) and catechol-O-methyltransferase gene (COMT) are associated with the morphine analgesia. The study was a randomized, double-blind, two-way, crossover, single-dose study conducted in 40 healthy participants, where morphine was compared with placebo.

Utility of Intravascular Ultrasound in Percutaneous Revascularization of Chronic Total Occlusions: An Overview.

Intravascular ultrasound has been used for >20 years to guide percutaneous coronary intervention in different subsets of coronary lesions. During the last decade, the interest in percutaneous coronary intervention for chronic total occlusion (CTO) has increased dramatically, leading to high success rates. Failure of guidewire crossing is the most common reason for failed CTO attempts.

Appropriateness of percutaneous revascularization of coronary chronic total occlusions: an overview.

Coronary chronic total occlusions (CTOs) are commonly encountered in patients undergoing coronary angiography. Several observational studies have demonstrated that successful CTO revascularization is associated with better cardiovascular outcomes and enhanced quality of life (QOL). However, in the absence of randomized trials, its prognostic benefit for patients remains debated.

Retrograde Recanalization of Chronic Total Occlusions in Europe: Procedural, In-Hospital, and Long-Term Outcomes From the Multicenter ERCTO Registry.

Background: A retrograde approach improves the success rate of percutaneous coronary interventions (PCIs) for chronic total occlusions (CTOs).

Objectives: The authors describe the European experience with and outcomes of retrograde PCI revascularization for coronary CTOs.

Methods: Follow-up data were collected from 1,395 patients with 1,582 CTO lesions enrolled between January 2008 and December 2012 for retrograde CTO PCI at 44 European centers.

The genetic influences on oxycodone response characteristics in human experimental pain.

Human experimental pain studies are of value to study basic pain mechanisms under controlled conditions. The aim of this study was to investigate whether genetic variation across selected mu-, kappa- and delta-opioid receptor genes (OPRM1, OPRK1and OPRD1, respectively) influenced analgesic response to oxycodone in healthy volunteers. Experimental multimodal, multitissue pain data from previously published studies carried out in Caucasian volunteers were used.

Association Between Human Pain-Related Genotypes and Variability in Opioid Analgesia: An Updated Review.

On an individual level, there is a difference in the analgesic response to a given opioid. Various factors such as gender, age, and genetic variation can affect the analgesic response. The genetic variation can influence pharmacokinetics (eg drug transporters and drug-metabolizing enzymes) and/or pharmacodynamics (eg opioid receptor and catechol-O-methyltransferase enzymes).

Total anomalous pulmonary venous connection: outcome of postoperative pulmonary venous obstruction.

Objective: Pulmonary venous obstruction (PVO) is an important cause of late mortality in total anomalous pulmonary venous connection (TAPVC). We aimed to describe current practices for the management of postoperative PVO and the efficacy of the different interventional procedures.

Methods: We conducted a retrospective international collaborative population-based study involving 19 pediatric cardiac centers in the United Kingdom, Ireland, and Sweden.

Erythropoietin as a treatment of anemia in heart failure: systematic review of randomized trials.

Background: Anemia in heart failure is both common and associated with worse symptoms and increased mortality. Several small randomized controlled trials (RCTs) have assessed erythropoiesis-stimulating agents (ESAs), but definitive evaluation and clinical guidance are required. We sought to systematically review the effects of ESAs in chronic heart failure.

Yin Yang 1 expression and localisation in quadriceps muscle in COPD.

Introduction: Yin Yang 1 (YY1) is a transcriptional repressor that inhibits muscle gene expression and myogenesis. YY1 has not previously been investigated in the skeletal muscle of patients with COPD. The aims of this study were to investigate YY1 expression and localisation in the quadriceps muscle of COPD patients compared to healthy age-matched controls, and examine the relationship between YY1 expression and localisation and quadriceps muscle fibre cross-sectional area (CSA) in COPD patients.

Contemporary predictors of coronary artery disease in patients referred for angiography.

Aims: Risk stratification is often used to determine the need and priority for coronary angiography. We investigated the contemporary value of Framingham and SCORE risk models, individual risk factors, B-type natriuretic peptide and high-sensitivity C-reactive protein (hs-CRP) in the current era of intensive risk management.

Methods And Results: Coronary artery disease (CAD) was obstructive (>or=50% stenosis) in 328 of 539 patients referred for elective diagnostic coronary angiography (61%).

Prevalence, predictors, and prognostic value of renal dysfunction in adults with congenital heart disease.

Background: Renal insufficiency in patients with ischemic heart disease and acquired heart failure is associated with higher mortality and morbidity. We studied the prevalence of renal dysfunction in adult patients with congenital heart disease (ACHD) and its relation to outcome.

Methods And Results: A total of 1102 adult patients with congenital heart disease (age 36.

Tumour necrosis factor-alpha production in fibrosing alveolitis is macrophage subset specific.

Background: Previous studies have revealed that tumour necrosis factor (TNF)-alpha is upregulated in fibrosing alveolitis (FA) in humans. The aim of this study was to compare the TNF-alpha secretory profile of alveolar macrophages (AMs) and peripheral blood monocytes (Mos) of patients with cryptogenic FA and systemic sclerosis (SSc), a rheumatological disorder in which lung fibrosis can occur. In particular, we wished to assess whether TNF-alpha levels differ between SSc patients with FA (FASSc) and a nonfibrotic group.

Cutting balloon angioplasty and stenting for aorto-ostial lesions.

Objective: To investigate the use of a cutting balloon to overcome aorto-ostial lesions before stent implantation and thereby reduce the restenosis rate.

Design: Observational follow up study.

Setting: Tertiary referral centre.

Cardiovascular effects of intravenous midazolam after open heart surgery.

Midazolam is the sedating agent of choice in many paediatric intensive care units, and is usually administered as a continuous intravenous infusion with or without a preceding bolus dose. Ten haemodynamically stable children, ventilated in the early postoperative period after cardiac surgery and receiving intravenous morphine infusions, were given an intravenous bolus followed by a continuous infusion of midazolam. Haemodynamic data were recorded before the bolus, and 15 minutes and one hour later.

Interventional catheterization in paediatric cardiology.

The primary role of interventional procedures in the management of some congenital heart diseases is established and their clinical utility broadens every day. Yesterday's relatively crude procedures have been replaced by safe and more effective techniques. Improvements and new developments in specifically designed paediatric equipment have played a significant role.

Flow patterns in the dilated ischemic left ventricle studied by MR imaging with velocity vector mapping.

Magnetic resonance velocity vector mapping was used to study flow patterns in dilated and healthy left ventricles. Eleven patients (age mean +/- SD, 57 +/- 12 years) with dilated left ventricle resulting from coronary artery disease and 10 healthy volunteers (age 50 +/- 9) were studied. Cine gradient echo images were acquired in the left ventricle vertical and horizontal long axes.

Cardiac involvement in mucopolysaccharidoses: effects of allogeneic bone marrow transplantation.

Echocardiography was performed in 16 children undergoing bone marrow transplantation (BMT) for mucopolysaccharidoses. Cardiac involvement before BMT was detected in seven (44%). One year after BMT (11 patients/five with cardiac involvement), left ventricular restriction resolved in 2/3 patients and hypertrophy in one.

Contemporary results of balloon valvuloplasty and surgical valvotomy for congenital aortic stenosis.

The purpose of this study was to compare contemporary results of balloon dilatation and surgery for valvar aortic stenosis in infants and children in the five years between August 1988 and October 1993. Thirty four children underwent attempted balloon valvuloplasty (age 1 day-16 years, weight 1720 g-68 kg) (group 1), eight of whom were neonates with critical aortic stenosis. During the same period, 17 children underwent direct surgical valvotomy (group 2) (seven neonates).

Sequential oxidative damage, and changes in iron-binding and iron-oxidising plasma antioxidants during cardiopulmonary bypass surgery.

Cardiopulmonary bypass patients undergoing heart valve replacement surgery appear to be under oxidative stress, when compared with normal healthy controls, by showing increased levels of protein and lipid damage. During bypass surgery two further episodes of oxidative stress occur. The first is seen when patients are placed on extracorporeal blood circulation and oxygenation which results in a rise in lipid peroxides and thiobarbituric acid-reactive substances.