Cardiology RSS : Gourt

Northern California - 1 Hour to the Bay Area :: California :: Noninvasive Cardiology- $500,000+

Non-Invasive Cardiology $500,000+ Earning Potential Northern California One Hour to the Bay area Large Documented Need Be Busy! Financials First-year Income guarantee based on experience. Range $343,000

Various positions all over TX :: Texas :: Executec Recruiters

Cardiology (Invasive/Interventional) - We have one opening for an interventional cardiologist to join a 4-member group. To start an interventional program (the other 3 are non-interventional). Dallas,

Great Family Environment :: Maine :: New England Physician Recruitment Center

ONE OF THE BEST LITTLE CITIES IN THE COUNTRY-BC/BE needed to join busy group of 20 Cardiologists State-of-the-art hospital with full range of diagnostic and therapeutic facilities. Modern, new, and convenient

1 Hour to the Bay Area :: California :: Northern California-Interventional and Non-Intvnl

Cardiology Northern California One Hour to the Bay area Group has needs for Interventional and Non-Interventional Cardiologists Financials One-year Income guarantee based on experience. Range $350,000

Midwest, Siouxland :: Iowa :: Fidelis Partners

INTERVENTIONAL OR NON-INVASIVE CARDIOLOGY $525,000 earnings - 10 weeks Vacation Practice among the best Cardiologists in the nation $525,000 + 10 weeks OFF per year + Being Home for Dinner = Quality

Greater Huntsville :: Alabama :: Medical Search International

A busy medical center located in greater Huntsville is seeking a BC/BE Cardiologist to join a multi-specialty group. Excellent payout mix including 65% private insurance. The hospital provides a broad

Southshore Boston :: Massachusetts :: New England Physician Recruitment Center

Cardiologist - 20 minutes from Boston Multiple locations Hospital affiliated Cardiologist desired to join this 50 Physician Multi-specialty private practice 20 minutes from Boston. With 4 locations

SE Connecticut :: Connecticut :: New England Physician Recruitment Center

Southeastern CT Located 80 minutes from Boston and 90 minutes from NYC, a highly successful and well-established Cardiologist with a large referral base in southeastern CT is seeking a fellowship-trained

Great Location :: Oklahoma :: Onyx M.D.

Hospital-sponsored solo positions for Interventional and Invasive Cardiologists. Solo position or join an established practitioner for Non-Invasive Cardiologists. Competitive income, signing bonus.

Central Maine :: Maine :: New England Physician Recruitment Center

Central ME INVASIVE OR NON INVASIVE 24 doctor, full service regional cardio group seeking BC/BE invasive or non invasive. Prestigious community based private practice. ECHO and Cath a must. Pacemaker

Orange County :: California :: Phyllis Vajda & Associates, LLC

Opportunity Established, reputable solo private practice seeking General Cardiologist with some interventional skills including card cath. Fellowship desirable but not necessary. Partnership track

CARD 166751 :: California :: Carson Kolb Healthcare Group

CALIFORNIA CARDIOLOGY ACADEMIC APPOINTMENT IMMEDIATE NEED FOR A CARDIOLOGIST TRULY MAKE AN IMPACT IN THIS COMMUNITY Unique opportunity to develop and shape a Cardiology program around your areas of

Des Moines :: Iowa :: Horton Smith Associates

One of the largest physician-owned and governed multi-specialty clinics in the Midwest is seeking a Cardiologist to serve as the Program Director for the new Cardiovascular Disease Fellowship program,

Fort Dodge :: Iowa :: Iowa Heart Center

Exciting practice opportunity for BC/BE Non-Interventional Cardiologist Iowa Heart Center, one of the largest cardiovascular practices in the country seeks a non-interventional cardiologist to

CARD67343 :: Iowa :: Carson Kolb Healthcare Group

NATIONALLY RANKED SCHOOLS INTERVENTIONAL CARDIOLOGY OPPORTUNITY TO SUBSPECIALIZE As partner, $525,000 + 10 weeks OFF per year + Only 1 general Cardiology Call per month + Being Home for Dinner = A

Southern :: California :: Southern CA-Established Group-Partnership Track

OPEN TO INTERVENTIONALIST, INVASIVE OR NON-INVASIVE CARDIOLOGIST SOUTHERN CALIFORNIA PARTNERSHIP TRACK SIGNING BONUS PLUS RELOCATION ASSISTANCE BE BUSY DAY ONE! Please contact me if you are interested

EASTERN :: New York :: New England Physician Recruitment Center

Cardiology need 60 minutes from NY City Medical facility 60 minutes from NY City seeks Invasive/Non-Invasive Cardiologist. New facility opened last year, allows them to serve community with more

Central :: Connecticut :: New England Physician Recruitment Center

Non-invasive Cardiology-Central Connecticut's leading Physician group. We would like you to join us. The group employs the latest technology to ensure Physician satsfaction and utilization of time. HER

Boston :: Massachusetts :: New England Physician Recruitment Center

Cardiology--Group practice, Northshore region of Boston, with stellar peers.20 minutes to downtown Boston,227-bed facility that serves the healthcare needs of residents of the North Shore and its surrounding

Boston :: Massachusetts :: New England Physician Recruitment Center

Busy four-person group has opening for noninvasive BC/BE cardiologist who will replace retiring physician. Strong academic affiliation and part-time employment at major Boston teaching hospital.

Study Identifies Key Factor that Links Metabolic Syndrome

A new study led by researchers at Joslin Diabetes Center has identified insulin resistance in the liver as a key factor in the cause of metabolic syndrome and its associated atherosclerosis Additional topics at Heart Disease More research-related news at Consumer Information

CT Scans Effective in Detecting Artery Disease

Additional topics at Heart Disease More research-related news at Consumer Information

Role of the renin-angiotensin system in the promotion of atrial fibrillation.

Related Articles Role of the renin-angiotensin system in the promotion of atrial fibrillation. Acta Cardiol. 2009 Dec;64(6):843; author reply 843-4 Authors: Ramaraj R PMID: 20128169 [PubMed - in process]

Gastroenteritis with severe consequences: a case of sotalol-induced torsades de pointes.

Related Articles Gastroenteritis with severe consequences: a case of sotalol-induced torsades de pointes. Acta Cardiol. 2009 Dec;64(6):839-42 Authors: Michiels V, Miljoen H, Vrints C We present a case of sotalol-induced prolongation of the QT-interval with torsades de pointes in an octogenarian who was hospitalized because of gastroenteritis causing prerenal acute renal failure. Subsequent accumulation of sotalol caused a severe prolongation of the QT-interval on the surface ECG and ultimately torsades de pointes with loss of consciousness. The patient was successfully treated with temporary cardiac pacing, intravenous magnesium sulfate and definitive withdrawal of sotalol. The electrophysiological basis of the pro-arrhythmic properties of sotalol is reviewed in brief, additional risk factors are identified and treatment is outlined. PMID: 20128168 [PubMed - in process]

Sudden cardiac arrest in a patient with an anomalous left main coronary artery originating from the pulmonary artery.

Related Articles Sudden cardiac arrest in a patient with an anomalous left main coronary artery originating from the pulmonary artery. Acta Cardiol. 2009 Dec;64(6):835-7 Authors: Aslanger E, Altun I, Umman B Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an uncommon cardiac abnormality. The clinical picture of ALCAPA may range from asymptomatic course with normal life span to sudden cardiac death. Moreover, from the standpoint of resuscitation science, it constitutes a disadvantageous anatomy for coronary perfusion pressure, generated by chest compressions, which is critical for the return of spontaneous circulation. Here, we report an ALCAPA case diagnosed after out-of-hospital cardiac arrest and successful cardiopulmonary resuscitation. PMID: 20128167 [PubMed - in process]

Very late drug-eluting stent thrombosis in the perioperative period of endoscopic choledocholithotomy.

Related Articles Very late drug-eluting stent thrombosis in the perioperative period of endoscopic choledocholithotomy. Acta Cardiol. 2009 Dec;64(6):831-3 Authors: Nie R, Luo N, Wang J Very late stent thrombosis is an uncommon but life-threatening complication after drug-eluting stent implantation in patients with coronary artery disease. Discontinuation of antiplatelet therapy is reported to be the most powerful predictor of stent thrombosis. This article reports on a case of very late stent thrombosis 54 months after implantation of a drug-eluting stent, in a patient who discontinued dual antiplatelet therapy only 11 days before endoscopic choledocholithotomy, and argues in favour of continuing aspirin therapy perioperatively in surgical patients with low bleeding risk, even if dual antiplatelet therapy has been followed more than 12 months after stent implantation. PMID: 20128166 [PubMed - in process]

Severe ostial stenosis of the left coronary artery in a 12-year-old girl as the first manifestation of Takayasu's arteritis.

Related Articles Severe ostial stenosis of the left coronary artery in a 12-year-old girl as the first manifestation of Takayasu's arteritis. Acta Cardiol. 2009 Dec;64(6):825-9 Authors: Moortgat S, Tuerlinckx D, Bodart E, El Khoury G, Moniotte S We report the case of a 12-year-old girl who presented with isolated chest pain on minimal exertion over the last 2 months. A coronary angiography revealed severe narrowing of the left coronary artery ostium and increased thickness of the ascending aortic wall was demonstrated by transoesophageal echocardiography, suggesting the diagnosis ofTakayasu's arteritis. The patient was successfully treated with corticosteroids and coronary artery bypass graft surgery. PMID: 20128165 [PubMed - in process]

Light chain deposition disease as a rare cause of restrictive cardiomyopathy.

Related Articles Light chain deposition disease as a rare cause of restrictive cardiomyopathy. Acta Cardiol. 2009 Dec;64(6):821-4 Authors: Koopman P, Van Dorpe J, Maes B, Dujardin K We report an unusual case of a 47-year-old Caucasian woman who presented with severe dyspnoea as a manifestation of restrictive cardiomyopathy, found to be due to myocardial deposition of kappa light chains. Non-routine specific immunofluorescence stainings of endomyocardial biopsy specimens were key for the diagnosis of myocardial light chain deposition disease. We discuss non-amyloidotic cardiac immunoglobulin deposition disease in contrast to cardiac amyloidosis. PMID: 20128164 [PubMed - in process]

Changing the guiding catheter over the coronary wire: a simple (and cheap) technique to get out of trouble.

Related Articles Changing the guiding catheter over the coronary wire: a simple (and cheap) technique to get out of trouble. Acta Cardiol. 2009 Dec;64(6):817-9 Authors: Op de Beeck V, Agostoni P During acute myocardial infarction (MI), the culprit lesion is usually composed of thrombus and soft plaque. Sometimes, calcification can be present. A patient with acute MI, due to sub-occlusion of the ostial right coronary artery, underwent primary percutaneous intervention. The procedure was complicated by severe dissection after balloon inflation. The use of standard materials did not allow stent passage, due to an underestimated severe calcification. To provide better support, we changed the guiding catheter for a more supportive one over the coronary guidewire, left in place to avoid rewiring the false lumen.This technique allowed successful stent deployment. PMID: 20128163 [PubMed - in process]

Endocarditis and giant mitral valve aneurysms.

Related Articles Endocarditis and giant mitral valve aneurysms. Acta Cardiol. 2009 Dec;64(6):815-6 Authors: Dote K, Miyasaka Y, Iwasaka T In a 65-year-old man with infective endocarditis, multiple mitral valve aneurysms were detected by echocardiography. Surgical treatment was successful. Aneurysms of the valve are a relatively rare complication of infective endocarditis. Prompt diagnosis and treatment can prevent complications such as embolisation and rupture of the aneurysms. For a patient with a history of unknown fever, this point should be kept in mind. PMID: 20128162 [PubMed - in process]

Recurrent left ventricular myxoma presenting as cerebrovascular accidents in a teenage girl.

Related Articles Recurrent left ventricular myxoma presenting as cerebrovascular accidents in a teenage girl. Acta Cardiol. 2009 Dec;64(6):811-4 Authors: Vermeulen T, Conraads VM, Vrints C, Rodrigus IE Myxoma cordis is the most frequent primary cardiac tumour in adults. Paediatric primary cardiac tumours are rare, the most common type being rhabdomyoma. Atrial and ventricular myxomas occur infrequently in the paediatric age group. Intracardiac myxomas are seen with an estimated incidence of 0.5 per million population per year. Approximately 70% of the affected patients are of female gender. Recurrences are rare (1.3%). Asymptomatic recurrences are observed in young patients who have a familial history of tumour or multifocal myxomas. Although rare, cardiac aetiology (atrial fibrillation, intracardiac thrombi, patent foramen ovale, myxoma, endocarditis) should be considered. In children presenting with central neurological symptoms, a cardiac aetiology has to be considered. We describe a rare case of an 18-year-old girl presenting with a recurrent left ventricular myxoma, accompanied by neurological deficits. PMID: 20128161 [PubMed - in process]

An alien in the heart: giant infective endocarditis.

Related Articles An alien in the heart: giant infective endocarditis. Acta Cardiol. 2009 Dec;64(6):807-9 Authors: Bataille Y, Moonen M, Lancellotti P PMID: 20128160 [PubMed - in process]

"Textbook" myxoma.

Related Articles "Textbook" myxoma. Acta Cardiol. 2009 Dec;64(6):805 Authors: Onsea K, Desmet W PMID: 20128159 [PubMed - in process]

A giant thromboembolus captive in a patent foramen ovale.

Related Articles A giant thromboembolus captive in a patent foramen ovale. Acta Cardiol. 2009 Dec;64(6):803-4 Authors: Holubec T, Vojacek J, Franc P PMID: 20128158 [PubMed - in process]

The Brugada syndrome.

Related Articles The Brugada syndrome. Acta Cardiol. 2009 Dec;64(6):795-801 Authors: Escárcega RO, Jiménez-Hernández M, Garcia-Carrasco M, Perez-Alva JC, Brugada J The Brugada syndrome is an inherited cardiac disorder initially described in 1992 by Pedro and Josep Brugada, with variable electrocardiographic features characteristic of right bundle-branch block, persistent ST-segment elevation in the precordial leads (VI-V3) at rest and sudden cardiac death. The genetic abnormalities that cause Brugada syndrome have been linked to mutations in the ion channel gene SCN5A which encodes for the alpha-subunit of the cardiac sodium channel. A consensus conference report published in 2002 described the diagnostic criteria for the Brugada syndrome and described the three distinct types of Brugada syndrome. In 2005, a second consensus report was published which described the risk stratification and approaches to therapy. Two specific types of ST-segment elevation, coved and saddleback, are observed in the Brugada syndrome, the former of which is reported to relate to a higher incidence of ventricular tachycardial ventricular fibrillation (VTNF) and sudden cardiac death.The objective of this paper is to review the genetics and the molecular biology behind the Brugada syndrome, the diagnostic criteria, including clinical and electrocardiographic characteristics, and current management. PMID: 20128157 [PubMed - in process]

Assessment of left ventricular function in non-dilated and dilated hearts: comparison of contrast-enhanced 2-dimensional echocardiography with multi-detector row CT angiography.

Related Articles Assessment of left ventricular function in non-dilated and dilated hearts: comparison of contrast-enhanced 2-dimensional echocardiography with multi-detector row CT angiography. Acta Cardiol. 2009 Dec;64(6):787-94 Authors: Burianová L, Riedlbauchová L, Lefflerová K, Marek T, Lupínek P, Kautznerova D, Vedlich D, Lánska V, Kautzner J OBJECTIVE: Multidetector-row CT (MDCT) and contrast-enhanced echocardiography (CEE) are being increasingly used for assessment of left ventricular (LV) function. Excellent spatial and contrast resolution of MDCT allows this evaluation along with coronary angiography. CEE improves the accuracy of 2D echocardiography. Data on side-by-side comparison of both techniques for assessment of LV size and function in subjects with a non-dilated or dilated left ventricle are limited. METHODS AND RESULTS: Our study population included 64 patients. Group I included 31 patients with an implanted pacemaker who had a non-dilated left ventricle with preserved systolic function. Group II comprised 33 patients with dilated cardiomyopathy and severe systolic LV dysfunction. LV end-diastolic and end-systolic volumes (LVEDV, LVESV) and ejection fraction (LVEF) were assessed using both CEE and short-axis MDCT. The results obtained by both techniques were compared by linear regression and Bland-Altman analysis. Additionally, intra- and interobserver reproducibility was assessed. Both CEE and MDCT measurements highly correlated (r = 0.61-0.94). However, CEE significantly underestimated LVEDV and LVESV, and this bias was higher with enlarged LV volumes. LVEF was overestimated by CEE in both groups with a higher bias in the group with preserved systolic function. Both intra- and interobserver reproducibility was significantly better for MDCT, the worst reproducibility was observed for CEE in group I. CONCLUSION: Despite a high correlation between MDCT and CEE measurements, CEE provides consistently lower volumes and higher LVEF. This suggests that both methods are not completely interchangeable. Reproducibility of CEE is inferior to reproducibility of MDCT, especially in non-dilated left ventricles with preserved function. PMID: 20128156 [PubMed - in process]

In rats with myocardial infarction, interference by simvastatin with the TLR4 signal pathway attenuates ventricular remodelling.

Related Articles In rats with myocardial infarction, interference by simvastatin with the TLR4 signal pathway attenuates ventricular remodelling. Acta Cardiol. 2009 Dec;64(6):779-85 Authors: Sheng FQ, Xu R, Cheng LX, Zeng QT, Gao W, Wang W, Dang SY, Wang CQ, He CR OBJECTIVE: The objective of this study was to investigate the effect of simvastatin on TLR4,TNF-alpha and IL-6 expression in the myocardium and its relation to left ventricular (LV) remodelling in a rat model of myocardial infarction (MI) and to investigate the mechanism by which simvastatin improves LV remodelling in rats after MI. METHODS AND RESULTS: The rat MI models were established by ligation of the left anterior descending coronary artery and divided into three groups: (I) an untreated MI group; (2) a group treated with simvastatin [40 mg/(kg/d)] for 4 weeks; (3) the sham group. Cardiac geometry and function were determined by echocardiography and infarct size was determined by the histomorphometric analysis; the expression ofTLR4 in the myocardium was measured by RT-PCR and western blotting;TNF-alpha and IL-6 levels in myocardial homogenate and serum were measured by ELISA. LVEDD and LVESD significantly increased and fractional shortening (FS) markedly decreased in the MI group. It was clear that simvastatin inhibited LV dilation and improved LV function after MI without affecting infarct size. The expression of TLR4, TNF-alpha and IL-6 in the myocardium significantly increased in the MI group and simvastatin markedly inhibits the expression of TLR4, TNF-alpha, and IL-6 in the myocardium after MI. Serum TNF-alpha and IL-6 levels between the MI group and the simvastatin group remained unchanged. Both in the MI group and the simvastatin group,TLR4 protein positively related to LVEDD and to the levels of TNF-alpha and IL-6 in the myocardium, respectively. CONCLUSION: Amelioration of LV remodelling in rats after MI by simvastatin might be associated with its effect on the TLR4-mediated signalling pathway in the myocardium. PMID: 20128155 [PubMed - in process]

Prevalence of cardiovascular risk factors in an unselected italian population. Results of the Cardiolab Project 2004-2008.

Related Articles Prevalence of cardiovascular risk factors in an unselected italian population. Results of the Cardiolab Project 2004-2008. Acta Cardiol. 2009 Dec;64(6):771-8 Authors: Grassi G, Arenare F, Dell'oro R, Quarti-Trevano F, Brambilla G, Carugo S, Smith M, Mancia G OBJECTIVE: Screening and educational campaigns on cardiovascular (CV) risk factors are important for primary and secondary prevention of CV disease. The CardioLab project is an observational cross-sectional study aimed at determining the prevalence of CV risk factors in a large unselected sample of the Italian population leaving in northern, central and southern Italy. METHODS AND RESULTS: Data collection included family and clinical history, anthropometric data, blood pressure, blood glucose and total cholesterol values. Individual CV risk profile was assessed throughout by the risk charts of both the Progetto Cuore and the Score Project. In 36,161 participants (56.3% men) with a mean age of 60 years a complete assessment of the above mentioned variables was obtained. 44.4% of the screened subjects was overweight, while approximately 20% of the population displayed an obese state with a body mass index >30 kg/m2. Alterations in blood glucose levels indicating the presence of glucose intolerance were identified in 11.5% of the population while 9.3% displayed overt diabetes. 36.1% and 42.3% had elevated total cholesterol levels (> 200 mg/dl) and blood pressure values (> or = 140/90 mmHg), respectively. New diagnosis of diabetes, hypercholesterolaemia and hypertension was obtained in 5.3%, 23.6% and 19.6%, respectively. Global assessment of the CV risk showed that approximately 12.6% of the population is at a high risk of CV events over a 10-year period. CONCLUSIONS: This large-scale observational study provides important information on the CV risk profile of an unselected Italian population and underlines the need for a more aggressive identification and appropriate correction of CV risk factors. PMID: 20128154 [PubMed - in process]

Results of radiofrequency ablation for permanent atrial fibrillation in patients undergoing mitral valve surgery.

Related Articles Results of radiofrequency ablation for permanent atrial fibrillation in patients undergoing mitral valve surgery. Acta Cardiol. 2009 Dec;64(6):767-70 Authors: Zhou YX, Leobon B, Roux D, Glock Y, Mei YQ, Wang YW, Fournial G OBJECTIVES: The study aim was to evaluate the safety and feasibility of radiofrequency ablation for the surgical treatment of permanent atrial fibrillation in patients with degenerative mitral valve disease. DESIGN: From August 2000 to August 2003, 40 consecutive patients (mean age 69.0 +/- 9.3 years) with permanent atrial fibrillation and degenerative mitral valve disease underwent surgical radiofrequency ablation in conjunction with 22 mitral valve repairs and 18 mitral valve replacements. The mean duration of chronic AF was 5.1 +/- 3.4 years. The completeness of follow-up was 100%. The mean follow-up time was 4.6 +/- 2.0 years (range 0 to 7.8 years). RESULTS: Thirty-day mortality was 2.5% (1 patient), the cause of death was cardiac failure. Cardiac failure and temporary A-V block were the most common postoperative complications. Both occurred in 10% (4 patients). No complication was related to the ablation procedure. At discharge, 65% (26/40) of the patients were in sinus rhythm. Overall incidence of sinus rhythm at the end of the follow-up was 56.4% (22/39).The 1-, 3- and 5-year survival was 97.5%, 91.8% and 85.9%, respectively. CONCLUSION: Mitral valve surgery combined with radiofrequency ablation is a safe and effective procedure in patients with permanent atrial fibrillation and degenerative mitral valve disease. The result is encouraging in restoring sinus rhythm, and an excellent postoperative survival rate can be achieved. PMID: 20128153 [PubMed - in process]

Impact of the lesion location on fractional flow reserve.

Related Articles Impact of the lesion location on fractional flow reserve. Acta Cardiol. 2009 Dec;64(6):761-5 Authors: Sahinarslan A, Kocaman SA, Yazici E, Turfan M, Ozdemir M, Timurkaynak T INTRODUCTION: Fractional flow reserve (FFR) is a method to determine the significance of a lesion. Although an FFR measurement of < 0.75 is accepted to show ischaemia, the effect of the location of the lesion on the coronary artery is not known. This study investigates the effect of lesion location on the FFR measurement. METHOD: Ninety-nine eligible patients who had undergone FFR measurement of an intermediate lesion (40-70% stenosis) at the left anterior descending coronary artery (LAD) were included. The lesions proximal to the origin of the first diagonal branch were accepted as proximal lesions and the remaining lesions were accepted as distal.The patients were categorized according to the degree of the percent diameter stenosis (40-50%, 50-60%, and > 60%) and the reference vessel diameter (RVD) (> or = 2.8 mm and < 2.8 mm). We compared the FFR measurements between proximal and distal lesions among different categories which were set according to anatomical features of the lesions. RESULTS: No significant difference was found between the FFR values of proximal and distal lesions with a similar percent diameter stenosis (0.86 +/- 0.08 vs. 0.83 +/- 0.08; 0.77 +/- 0.11 vs. 0.80 +/- 0.09; 0.75 +/- 0.07 vs. 0.77 +/- 0.08; P = 0.646).We did not find a difference between the FFR values of proximal and distal lesions with a similar RVD either (0.78 +/- 0.03 vs. 0.81 +/- 0.02; 0.84 +/- 0.03 vs. 0.81 +/- 0.01; P = 0.976). Major adverse cardiac event incidence was also similar for proximal and distal lesions (23% vs. 20%; P = 0.793). CONCLUSION: Fractional flow reserve can show the physiological significance of a stenosis independent of the anatomical location of the lesion on the coronary artery. PMID: 20128152 [PubMed - in process]

Predictors of atrial arrhythmias in patients with mitral valve prolapse.

Related Articles Predictors of atrial arrhythmias in patients with mitral valve prolapse. Acta Cardiol. 2009 Dec;64(6):755-60 Authors: Turker Y, Ozaydin M, Acar G, Ozgul M, Hoscan Y, Varol E, Dogan A, Erdogan D OBJECTIVE: Arrhythmias have been reported to occur frequently in symptomatic patients with mitral valve prolapse (MVP). The mechanisms causing atrial arrhythmias in patients with MVP have not been fully investigated. The purpose of this study was to determine the clinical, echocardiographic and heart rate variability parameters, and plasma concentrations of electrolytes and inflammatory markers in predicting atrial arrhythmias in patients with MVP. METHODS: A total of 58 consecutive patients with MVP were included in this study. We performed electrocardiography, echocardiography, Holter analysis, routine biochemical tests including plasma concentrations of electrolytes and inflammatory markers, and evaluated the clinical characteristics. Atrial arrhythmia was defined as occurrence of any of the following: atrial premature contractions, atrial couplets, supraventricular tachycardia, atrial flutter or fibrillation documented by Holter analysis, continuous monitoring or by electrocardiography. RESULTS: Twenty-eight patients (48%) had atrial arrhythmias, and 30 (52%) patients had no atrial arrhythmias. Univariable predictors of atrial arrhythmias included isovolumetric relaxation time, lateral systolic (S'), lateral late diastolic (A'), septal A' Doppler velocities, anterior mitral leaflet thickness, anterior mitral leaflet thickness of > or =5 mm, posterior mitral leaflet thickness and the occurrence of moderate to severe mitral regurgitation. Multivariable logistic regression analysis showed that occurrence of moderate to severe mitral regurgitation was the only independent predictor of atrial arrhythmias (relative risk: 2.4, 95% confidence interval 1.32-4.86, P = 0.005). CONCLUSIONS: The present study showed that the only independent predictor of atrial arrhythmias in patients with MVP is the occurrence of moderate to severe mitral regurgitation. PMID: 20128151 [PubMed - in process]

Blood pressure and anthropometric measurements in Albanian versus Turkish children and adolescents.

Related Articles Blood pressure and anthropometric measurements in Albanian versus Turkish children and adolescents. Acta Cardiol. 2009 Dec;64(6):747-54 Authors: Borici S, Agaoglu NB, Baykan OA, Agirbasli M OBJECTIVE: Understanding intercultural, regional and interracial differences in blood pressure and anthropometric indices may help to determine the contributors of mortality from coronary artery disease in different populations. DESIGN AND SETTING: In this article we used data collected from two different countries: (a) Survey on school children from Istanbul, Turkey, (b) Cross Sectional Study of Albanian school children. RESULTS: We compared age- and gender-matched Albanian and Turkish children and adolescents (age 11-12 y and 15-17 y) living in 2 different countries with regard to blood pressure, weight, height, body mass index (BMI), waist circumference, hip circumference, waist-to-hip (WHpR) and waist-to-height (WHtR) ratio. We observed significant differences in blood pressure, BMI and other anthropometric indices among age- and gender-matched subjects from the two countries. Birthweight was lower among Turkish children and adolescents compared to Albanian subjects (3258 vs. 3510 g, P < 0.01). Turkish children had lower BMI and WHtR compared to Albanian children, while adolescents displayed similar BMI and WHtR. Paradoxically, Turkish children and adolescents displayed higher systolic blood pressures compared to Albanian children and adolescents. Significant differences were observed in the dietary intake and physical activity, which may partially explain the differences in blood pressure and anthropometric indices. CONCLUSIONS: The socio-economic, dietary and physical activity status may account for significant differences in blood pressure and anthropometric indices of children and adolescents living in two different countries. Future studies should focus on the ethnic differences in the definition and prevention of cardiovascular risks among children and adolescents. PMID: 20128150 [PubMed - in process]

Sleep disturbances after cardiac surgery with or without elevated S100B levels.

Related Articles Sleep disturbances after cardiac surgery with or without elevated S100B levels. Acta Cardiol. 2009 Dec;64(6):741-6 Authors: Iskesen I, Kurdal AT, Yilmaz H, Cerrahoglu M, Sirin BH OBJECTIVE: The aim of the study was to investigate sleep disturbances of cardiac surgery patients with or without elevated S100B levels. METHODS AND RESULTS: Twenty-two patients with serum S100B > 0.3 microg/l (study group) 12 hours after cardiac surgery with cardiopulmonary bypass and 23 patients with serum S100B < 0.3 (control group) were investigated in a prospective study. They were evaluated with the use of objective sleep tests. Cardiopulmonary bypass has negatively affected the sleep characteristics in the postoperative period for both groups. Maintenance wakefulness test, total sleep time, total activity score and sleep efficiency scores were significantly shorter in the study group in the postoperative period. Sleep latency, percentage of wakefulness after sleep onset, daytime napping episodes and total nap duration in the same period were significantly higher than in the control group. CONCLUSION: Cardiac surgery affects a patient's sleep characteristics. Patients with elevated S100B values have more sleep disturbances after cardiac surgery than patients with normal S100B values. PMID: 20128149 [PubMed - in process]

Age-related change of serum angiogenic factor levels in patients with coronary artery disease.

Related Articles Age-related change of serum angiogenic factor levels in patients with coronary artery disease. Acta Cardiol. 2009 Dec;64(6):735-40 Authors: Meng R, Pei Z, Chen B, Ma R, Zhang C, Chen B, Zhang A, Wu T, Liu D, Dong Y OBJECTIVE: Vascular endothelial growth factor (VEGF), angiopoietin (Ang)-1 and -2 regulate angiogenesis and might be important in myocardial collateral development. Elevated levels of angiogenic growth factors in patients with coronary artery disease (CAD) have been reported. However, the age-related change of angiogenic growth factors in patients with CAD remains unclear. METHODS AND RESULTS: Serum VEGF, Ang-1 and -2 levels were measured by enzyme-linked immunosorbent assay kits. Serum VEGF, Ang-1 and -2 levels in patients with CAD were significantly higher than those in healthy control subjects. In patients aged <61 years and 61 to 70 years, serum Ang-1 and -2 levels were significantly higher than in patients aged >70 years, serum Ang-2 levels in patients aged <61 years were significantly higher than in patients aged from 61 to 70 years. Serum VEGF levels were not significantly different in the three age groups. Serum VEGF, Ang-1 and -2 levels were not significantly different across the age groups in healthy subjects. Regression analysis showed that there was a negative correlation between age and Ang-1 and -2 in patients with CAD. CONCLUSION: Serum Ang-1 and -2 levels, but notVEGF levels in patients with CAD, are decreased along with advancing age. PMID: 20128148 [PubMed - in process]

Ischaemic stroke complicating primary percutaneous coronary intervention in patients with ST elevation myocardial infarction.

Related Articles Ischaemic stroke complicating primary percutaneous coronary intervention in patients with ST elevation myocardial infarction. Acta Cardiol. 2009 Dec;64(6):729-34 Authors: Ergelen M, Gorgulu S, Uyarel H, Norgaz T, Ayhan E, Akkaya E, Ergelen R, Cicek G, Ugur M, Soylu O, Tezel T, Yekeler I OBJECTIVE: We sought to determine the in-hospital incidence and predictors of ischaemic stroke in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: We reviewed 2638 consecutive patients undergoing 2722 pimary PCI procedures for STEMI during in-hospital stay. Stroke was defined as any new focal neurological deficit lasting > or =24 h, occurring anytime during or after PCI until discharge. Patients with haemorrhagic stroke were excluded. Clinical characteristics and in-hospital outcome were analysed regarding ischaemic stroke in patients undergoing primary PCI. RESULTS: Ischaemic stroke was observed in 20 of the 2722 procedures, an incidence of 0.73%. Patients with ischaemic stroke were older than patients without stroke (mean age 67 +/- 9.6 vs. 56.6 +/- 11.8, P < 0.001). Compared to patients without stroke, female gender, diabetes and hypertension were more prevalent in patients with stroke. Ischaemic stroke was found to be a powerful independent predictor of in-hospital cardiovascular mortality (odds ratio [OR] 6.32, 1.15-34.7; P < 0.001). Left ventricular ejection fraction (LVEF) < 35% (OR 3.13, P = 0.04), contrast-induced nephropathy (OR 2.91, P = 0.04) and tirofiban use (OR 0.23, P = 0.02) were the independent predictors for in-hospital ischaemic stroke. CONCLUSIONS: The present study shows that the incidence of ischaemic stroke in patients undergoing PCI for STEMI is higher and ischaemic stroke increases in-hospital mortality in these patients. Moreover, LVEF < 35% and contrast-induced nephropathy were independent predictors of ischaemic stroke, whereas tirofiban use demonstrated a protective effect to this potentially catastrophic complication. PMID: 20128147 [PubMed - in process]

Impaired chronotropic response to exercise in children with repaired cyanotic congenital heart disease.

Related Articles Impaired chronotropic response to exercise in children with repaired cyanotic congenital heart disease. Acta Cardiol. 2009 Dec;64(6):723-7 Authors: Reybrouck T, Vangesselen S, Gewillig M OBJECTIVE: Conventionally the heart rate response to exercise has been considered as a useful parameter for the assessment of exercise performance. However, in patients with surgical repair of congenital heart defects sino-atrial dysfunction has been observed after cardiac surgery.The purpose of this study was to assess whether the heart rate response to exercise can be used in the assessment of exercise performance. METHODS: Fifty-three patients with surgical repair of congenital heart disease underwent exercise testing.The patients were 19 children with repair of tetralogy of Fallot (TOF), 17 patients with arterial switch operation for transposition of the great arteries and 17 patients with a Fontan circulation for functional univentricular heart. The patients were compared to age-matched control subjects. Exercise capacity was assessed by determination of the maximal oxygen uptake.To account for the effect of age and gender on heart rate response, values in the patients were compared to age-matched control subjects of the same age and gender and were expressed as a Z-score of the normal value. RESULTS: In the 3 groups of patients a lower than normal heart rate response was observed during submaximal and maximal exercise, varying from -1.7 to -4.6 standard deviation scores.This was not associated with normal values for exercise capacity in patients with TOF or Fontan circulation, as should be expected. CONCLUSION: In patients with surgical repair of congenital heart disease, the use of heart rate response in the assessment of cardiovascular exercise performance may be seriously misleading and should be complemented with measurements of gas exchange. PMID: 20128146 [PubMed - in process]

Oxidative stress produced by circulating microparticles in on-pump but not in off-pump coronary surgery.

Related Articles Oxidative stress produced by circulating microparticles in on-pump but not in off-pump coronary surgery. Acta Cardiol. 2009 Dec;64(6):715-22 Authors: Fontaine D, Pradier O, Hacquebard M, Stefanidis C, Carpentier Y, de Canniere D, Fontaine J, Berkenboom G OBJECTIVE: This study was undertaken to assess whether plasmas isolated during off-pump coronary surgery trigger less oxidative stress than those isolated during on-pump surgery. METHODS AND RESULTS: Plasmas were sampled from patients before (TO), just after (TI) and 24 hours after (T2) cardiac surgery (n=24 on-pump and n=10 off-pump). Rings of rat thoracic aortas were incubated for 20 hours with these different plasmas (100 microl + 4 ml medium) or saline (control). Thereafter, superoxide anion production was assessed by chemiluminescence and the mean signal was expressed as percent of that in the control ring. In rat aorta exposed to plasmas from on-pump CABG patients (n=6), the signal was enhanced by 210 +/- 29% at T1 (P < 0.05) and by 174 +/- 29% at T2 (P < 0.05) versus 53 +/- 12% at T0. Moreover, at T1 and T2, there was an upregulation of p22(phox), the key subunit of NADPH oxidase, the main enzyme involved in oxidative stress of the vascular wall. In contrast, off-pump plasmas did not induce this superoxide production. Incubation with microparticles obtained by ultracentrifugation also markedly enhanced the signal at T1 and T2 (vs. T0) in the on-pump group (but not in the off-pump group). Selective removal of CD34, CD105, CD59, CD146, CD42 microparticles using flow cytometry did not abolish the signal. CRP and SAA plasma levels were enhanced only at T2 in both groups. CONCLUSIONS: Plasmas isolated after on-pump but not off-pump coronary bypass surgery can induce superoxide generation by the vascular wall which seems related to circulating microparticles remaining present at least 24 hours after the procedure that might be of endothelial origin. PMID: 20128145 [PubMed - in process]