Cardiology RSS : Gourt

Permanent Cardiology Job in Great Location Oklahoma with 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.

Permanent Cardiology Job in Not Disclosed West Virginia with Locum Medical Group

An Interventional or Invasive Cardiologist needed for a busy private practice in Glen Dale, West Virginia due to growth. Compensation is a competitive base salary plus full benefits, including malpractice,

Permanent Cardiology Job in EASTERN New York with 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

Permanent Cardiology Job in Central Connecticut with 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

Permanent Cardiology Job in Central Maine Maine with 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

Permanent Cardiology Job in SE Connecticut Connecticut with 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

Permanent Cardiology Job in boston Massachusetts with 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

Permanent Cardiology Job in Great Family Environment Maine with 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

Permanent Cardiology Job in Boston Massachusetts with 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.

Locum to Permanent Cardiology Job in Columbia South Carolina with Medical Search International

BE/ BC Non Invasive or Diagnostic Cardiology-Locums or Locums to Perm-Columbia, SC Area A busy office based practice in the greater Columbia, SC is seeking a BC/BE Non Invasive or Diagnostic Cardiologist

Permanent Cardiology Job in Metro SC South Carolina with Medical Search International

CARDIOLOGIST / NON-INVASIVE / NON-INTERVENTIONAL Opportunity to join a multispecialty group consisting of 3 cardiologists, 2 pulmonologists and 1 neurologist this group practice out of 2 hospitals and

Locum Tenens Cardiology Job in Eastern North Carolina with Medical Search International

Coverage needed 6/15-6/30. Responsibilities: See patients in office, read echoes, ECGs and nuclear studies, do hospital consults and be on call some evenings for ED and hospitalists. Call or email

Permanent Cardiology Job in Greater Huntsville Alabama with 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

Permanent Cardiology Job in Greater Memphis, Nashville, Knoxville & Chattanooga Tennessee with Medical Search International

Metro area hospitals in greater Memphis, Nashville, Knoxville & Chattanooga are seeking BC/BE Cardiologist to joint their specialty groups Options for Interventional, Invasive and general). State license

Permanent Cardiology Job in Greater State College Area Pennsylvania with Medical Search International

A prestigious Medical Center located in the greater State College area of Pennsylvania is seeking a BC/BE Cardiologist to join their specialty group. State license is preferred but eligibility is acceptable.

Permanent Cardiology Job in Greater OKC Oklahoma with Medical Search International

A prestigious Medical Center located in greater OKC is seeking a Cardiologist. The ideal candidate will be BC/BE with emphasis on Electrophysiology. State license is preferred but eligibility is acceptable.

Permanent Cardiology Job in Northwest Mississippi Mississippi with Medical Search International

A large Medical Center located in Northwest Mississippi is seeking a BC/BE Cardiologist to join their multidisciplinary group. State license is preferred but eligibility is acceptable. Residents and fellows

Permanent Cardiology Job in NATIONWIDE Texas with Physician Referral Network

Physician Referral Network is your best source to learn about the latest practice opportunities. We are not a recruiting firm, so we promise you'll never be pressured to look at or take a position that

Locum Tenens Cardiology Job in SW Miami close to South Beach and the art Deco District. Florida with Candidate Direct Physician Staffing

Cardiology Jobs - Florida Physician Job Type: Locum Tenens Start: August 1 through August 7 Shift: M-F 8-5 Office Based Setting only Salary: Negotiable Job Requirements: Bilingual in Spanish,

Permanent Cardiology Job in Located in the heart of Florida's Nature Coast, this City was selected Florida's outstanding rural community for the Year 2000. Florida with Candidate Direct Physician Staffing

Cardiology Jobs - Florida Physician Job Type: Permanent in FL Start: Immediate Opening Shift: To be discussed at interview Salary: This Interventional Cardiologist job offers income guarantee

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

Bare metal or drug-eluting stent implantation in last remaining vessel PCI? A serious dilemma.

Related Articles Bare metal or drug-eluting stent implantation in last remaining vessel PCI? A serious dilemma. Acta Cardiol. 2009 Apr;64(2):281-5 Authors: Zhang L, Zhu J, Kiemeneij F This case report describes the treatment of an old male diabetic patient with last remaining vessel coronary artery disease and poor left ventricular function. In presence of an old occlusion of the left main coronary artery, a subtotal stenosis of a dominant right coronary artery required angioplasty. After ample consideration it was decided to implant a bare metal stent (BMS) instead of a drug-eluting stent (DES). The major reason was the fear for early discontinuation of clopidogrel in case a drug-eluting stent was placed. The procedure and follow-up are described followed by an overview of current literature concerning similar pathology. PMID: 19476127 [PubMed - indexed for MEDLINE]

Vertebral artery stenting by using coronary intervention techniques and devices.

Related Articles Vertebral artery stenting by using coronary intervention techniques and devices. Acta Cardiol. 2009 Apr;64(2):279-80 Authors: Kilic H, Balci M, Akdemir R Atherosclerotic disease of the vertebro/basilar vessels is an important cause of posterior circulation infarction. Commonly, the primary atheroma forms at the origin of the vertebral arteries. Although initial treatment is medical, arch and four-vessel studies (CTA, MRA, or DSA) are warranted if symptoms continue. Endovascular management of vertebral artery stenosis might be highlighted as a good option in selected patients. This is a case of endoluminal stenting of vertebral artery with a durable result. PMID: 19476126 [PubMed - indexed for MEDLINE]

Successful resection of a giant subpericardial lipoma with recurrent ventricular arrhythmias.

Related Articles Successful resection of a giant subpericardial lipoma with recurrent ventricular arrhythmias. Acta Cardiol. 2009 Apr;64(2):275-7 Authors: Zhao BQ, Dong AQ, Cai SY We report a case of a giant subpericardial lipoma with ventricular arrhythmias. It was resected through a median sternotomy without cardiopulmonary bypass. The tumour was about 21x23x5 cm and weighed 2100 g. After resection the heart rhythm returned to sinus rhythm. PMID: 19476125 [PubMed - indexed for MEDLINE]

Contralateral pneumothorax after endocardial dual-chamber pacemaker implantation resulting from atrial lead perforation.

Related Articles Contralateral pneumothorax after endocardial dual-chamber pacemaker implantation resulting from atrial lead perforation. Acta Cardiol. 2009 Apr;64(2):271-3 Authors: Van Herendael H, Willems R We describe the occurrence of a right-sided pneumothorax following a left-sided dual chamber pacemaker implantation, due to a perforation of the screw of the J-shaped active-fixation lead through the right atrial wall. A review of the literature regarding complications of different atrial lead types (passive vs. active and J-shape vs. straight) is provided. Current data suggest that passive-fixation leads could have an advantage, provided they can be positioned satisfactorily because of the lower risk of pericardial complications. If active-fixation leads are used, straight leads might be preferable above J-shaped leads because of the lower rate of perforation. PMID: 19476124 [PubMed - indexed for MEDLINE]

Pulmonary infundibular stenosis and ventricular septum defect: usefulness of cardiac CT.

Related Articles Pulmonary infundibular stenosis and ventricular septum defect: usefulness of cardiac CT. Acta Cardiol. 2009 Apr;64(2):269-70 Authors: Martín M, Luyando LH, Morís C A 35-year-old man with a history of syncope and echocardiographic diagnosis of right ventricular outflow tract obstruction and ventricular septum defect was submitted to complete evaluation with an Aquilion Toshiba 64-multislice CT in order to confirm diagnosis and to complete information prior to surgery. PMID: 19476123 [PubMed - indexed for MEDLINE]

The absence of pathological myofibre disarray in the diabetic heart: is it a paradox?

Related Articles The absence of pathological myofibre disarray in the diabetic heart: is it a paradox? Acta Cardiol. 2009 Apr;64(2):267-8 Authors: McLachlan CS, Lasker S, Keramat Ali SM, Wang L, Jelinek H Myofibre disarray in progressive hypertrophic cardiomyopathy (HCM) is a well established pathological cardiac tissue change and thereby represents a biomarker for that condition. On the other hand, in diabetic cardiomyopathy, myofibre disarray historically has been reported not to occur. This is surprising given that many of the pathological, remodelling and mechanical changes that present in the diabetic ventricle are also present in HCM, for example, myocardial stiffness, myocardial hypertrophy, apoptosis, cell slippage, extensive collagen expression and fibrosis. The question therefore begs is the absence of myocyte disarray in the diabetic heart a paradox or simply an oversight? PMID: 19476122 [PubMed - indexed for MEDLINE]

Why does the general practitioner refer patients with chest pain not-urgently to the specialist or urgently to the emergency department? Influence of the certainty of the initial diagnosis.

Related Articles Why does the general practitioner refer patients with chest pain not-urgently to the specialist or urgently to the emergency department? Influence of the certainty of the initial diagnosis. Acta Cardiol. 2009 Apr;64(2):259-65 Authors: Bruyninckx R, Van den Bruel A, Aertgeerts B, Van Casteren V, Buntinx F BACKGROUND: Chest pain is an initial symptom for several minor diseases but acute myocardial infarction (AMI) should not be missed. AIM: To assess the influence of initial diagnosis and degree of certainty of this initial diagnosis on the referral decision and the referral method (urgent-non-urgent) in patients contacting their GP with chest pain. STUDY DESIGN: Observational study. SETTING: The study was performed in a sentinel network of general practices in Belgium, covering almost 1.6% of the population. SUBJECTS: All patients attending their GP and complaining of chest pain during 2003. METHOD: The relationships were reported as proportions and in odds ratios (OR) with their 95% confidence intervals. RESULTS: 1996 patients were included (men 52%). Men were referred more often (OR = 1.44; 95% CI: 1.13-1.82). Age shows no relation to referral (OR = 1.06; 95% CI: 0.83-1.35) but predicts urgent referral (OR = 1.46; 95% CI: 1.02-2.08). Odds ratios in case of serious heart disease were high with 11.58 (95% CI: 5.72-23.44) when the GP was certain of his diagnosis and 2.96 (95% CI: 1.59-5.51) if not. If the GP was uncertain, in all disease categories 54% (95% CI: 48-59) of the patients were referred non-urgently. CONCLUSION: Referral rates for patients with chest pain were influenced by the initial diagnosis and the degree of certainty of this initial diagnosis. PMID: 19476121 [PubMed - indexed for MEDLINE]

Pre-hospital statin therapy may not reduce incidence of all-cause mortality and overall MACCE during hospital stay after coronary artery bypass graft surgery.

Related Articles Pre-hospital statin therapy may not reduce incidence of all-cause mortality and overall MACCE during hospital stay after coronary artery bypass graft surgery. Acta Cardiol. 2009 Apr;64(2):253-7 Authors: Zhang M, Kang JP, Nie SP, Lv Q, Liu XH, Ma CS BACKGROUND: The available literature has not been able to demonstrate the exact association between preoperative statin therapy and the reduction in the rates of major adverse cardiac and cerebrovascular events (MACCE). The aim of this study is to explore these unanswered questions. METHODS: A review of patients having CABG surgery between June 2003 and September 2005 (n=2013) was performed at Beijing Anzhen Hospital of the Capital University of Medical Science The preoperative demographic, morbidity and co-morbidity variability and the preoperative medications were compared between two groups: group I, on statins, n=904; group II, not on statins, n=1109. A Cox proportional hazard analysis was performed to determine the independent risk-reducing association with outcome variability after CABG surgery. RESULTS: Our study demonstrated that pre-hospital statins therapy did not reduce the risk of all-cause mortality or overall MACCE during hospital stay (1.7% versus 2.4%, respectively, P > 0.05; 4.4% versus 4.5%; P > 0.05, respectively). Compared with patients not receiving statin therapy, the hazard ratio for all-cause mortality during hospital stay was 0.696 (95% CI, 0.394-1.231, P = 0.213). The significant predictors of mortality during follow-up are age, triple-vessel CAD and blood creatinine (Cr) level. CONCLUSIONS: Pre-hospital statin therapy did not reduce the risk of mortality or the rates of MACCE during in hospital stay after CABG surgery. PMID: 19476120 [PubMed - indexed for MEDLINE]

Plasma total homocysteine concentrations in a Turkish population sample.

Related Articles Plasma total homocysteine concentrations in a Turkish population sample. Acta Cardiol. 2009 Apr;64(2):247-51 Authors: Yaman H, Akgul EO, Kurt YG, Cakir E, Gocgeldi E, Kunak ZI, Macit E, Cayci T, Erbil MK OBJECTIVES: The purpose of this study is to determine the reference of plasma total homocysteine levels from a Turkish population and to investigate the relationship of plasma total homocysteine levels with sex and age groups. DESIGN AND METHODS: Plasma total homocysteine levels were measured in 2257 Turkish individuals (1381 men and 876 women) aged 1-90 years. Plasma total homocysteine concentrations were determined using high performance liquid chromatography with fluorescence detector. RESULTS: The mean plasma total homocysteine level was significantly higher in men (mean, 10.6 micromol/L) than in women (mean, 8.7 micromol/L), P < 0.001. The mean plasma total homocysteine levels for the 1-10, 11-20, 21-30, and 31-40, 41-50, 51-60, and 61-70, 71-80, 81-90 age groups, were 6.5, 9.6, 10.1, and 10.4, 10.5, 10.9, and 11.3, 12.7, 14.6 miromol/L in men and 7.1, 7.6, 7.5, and 7.8, 8.7, 9.4, and 10.3, 11.2, 13.3 micromol/L in women, respectively. CONCLUSIONS: These data indicate the significance of sex- and age-associated differences of plasma total homocysteine levels in Turkish subjects. Plasma total homocysteine levels were increasing with age and men were found to have higher levels than women, as is found in other populations. PMID: 19476119 [PubMed - indexed for MEDLINE]

Ethnic differences in overweight and obesity between Han and Mongolian rural Chinese.

Related Articles Ethnic differences in overweight and obesity between Han and Mongolian rural Chinese. Acta Cardiol. 2009 Apr;64(2):239-45 Authors: Zhang X, Sun Z, Zheng L, Liu S, Xu C, Li J, Li J, Hu D, Sun Y BACKGROUND: Ethnic differences in the prevalence of obesity are known to exist. However, little is known about obesity in different ethnic rural Chinese. This study was designed to investigate the epidemiologic features of overweight and obesity in Han and Mongolian rural Chinese. METHODS: A cross-sectional survey was conducted during 2004-2006, which made use of a multistage cluster sampling method to select a representative sample in Fuxin county, Liaoning province, China. 36,154 Han people and 9236 Mongolian people aged > or =35 years were examined. At baseline, lifestyle and other factors were obtained. Overweight and obesity were defined according to the World Health Organization classification and Chinese criteria, respectively. RESULTS: Using WHO criteria, 21.3% of the Han people and 26.1% of the Mongolians had overweight or obesity (P < 0.001). The corresponding figure was 33.4% of the Han people and 40.3% of the Mongolians by Chinese criteria (P < 0.001). The prevalence of overweight was significantly higher in Mongolian people than Han people (P < 0.001). Multivariate logistic regression revealed that female gender, high levels of education and current drinking status were the common risk factors for Han and Mongolian overweight or obese participants, while age > or =65 years and current smoking status were the common protective factors. Below the age of 65 years, a positive association was observed between age and overweight or obesity in Han people, but not in the Mongolian people. High levels of physical activity as a protective factor and diabetes as a risk factor were shown in Han but not in Mongolian people. CONCLUSIONS: There were ethnic differences in overweight and obesity between Han and Mongolian rural Chinese. These differences might be due to different factors between these two ethnicities such as age, physical activity and diabetes. PMID: 19476118 [PubMed - indexed for MEDLINE]

Relationships between paced QRS duration and left cardiac structures and function.

Related Articles Relationships between paced QRS duration and left cardiac structures and function. Acta Cardiol. 2009 Apr;64(2):231-8 Authors: Su Y, Pan W, Gong X, Cui J, Shu X, Ge J BACKGROUND: In patients with congestive heart failure, QRS duration (QRSd) is correlated with left ventricular (LV) ejection fraction (LVEF), ventricular dyssynchrony and patients' prognosis. However, little is known about the relationships between paced QRS duration (pQRSd) to cardiac structures and function and ventricular dyssynchrony in patients with chronic right ventricular apical (RVA) pacing, which were investigated in this study. METHODS: Seventy patients implanted with DDD(R) pacemaker for high- or third-degree atrioventricular block were enrolled to study pQRSd and echocardiographic variables, including aortic root dimension (AO), left atrial dimension (LAD), LV end-systolic dimension (LVDs), LV end-diastolic dimension (LVDd), interventricular septum thickness (IVST), LV posterior wall thickness (LVPWT), LVEF, interventricular mechanical delay (IVMD), systolic asynchrony index (Ts-SD) and septal-to-lateral delay.The relationships between pQRSd and such variables were examined. RESULTS: The pQRSd correlated positively with LVDd (r = 0.3166, P < 0.05), LVDs (r = 0.3741, P < 0.05), LAD (r = 0.5848, P < 0.01), IVST (r = 0.2925, P < 0.05), and negatively with LVEF (r = -0.3037, P < 0.05). No significant correlations were found between pQRSd and AO, LVPWT, IVMD, Ts-SD and septal-to-lateral delay (all P > 0.05). There was no significant correlation between LVEF and IVMD, Ts-SD, septal-to-lateral delay (P > 0.05). However, IVMD, Ts-SD and septal-to-lateral delay were greater in patients with low LVEF than in patients with normal LVEF (P < 0.05). A cut-off value for pQRSd of 180 ms had a sensitivity of 85.71% and a specificity of 66.67% to detect left atrial dilation. CONCLUSION: pQRSd is correlated with left cardiac structures and LV systolic function. pQRSd > or =180 ms indicates left atrial dilation. There is no correlation between pQRSd and ventricular dyssynchrony. PMID: 19476117 [PubMed - indexed for MEDLINE]

Comparison of intracoronary adenosine and isosorbide dinitrate on no-reflow/slow flow during rotational atherectomy.

Related Articles Comparison of intracoronary adenosine and isosorbide dinitrate on no-reflow/slow flow during rotational atherectomy. Acta Cardiol. 2009 Apr;64(2):225-30 Authors: Tsao TP, Cheng SM, Cheng CC, Yang SP OBJECTIVE: To compare the effect of intracoronary adenosine and isosorbide dinitrate (ISDN) on no-reflow/slow flow during high-speed rotational atherectomy (HSRA) in patients with complex coronary artery disease (CAD). METHODS AND RESULTS: Medical records from consecutive patients diagnosed with complex CAD between November 2002 and March 2006 who underwent HSRA at the Tri-Service General Hospital, National Defence Medical Centre in Taipei, Taiwan, were included in this study. Patients in the adenosine group (n=32) received a 50 microg intracoronary adenosine bolus prior to the initiation of burr rotation and during each ablation. Patients in the ISDN group (n=58) received a 0.5 mg intracoronary ISDN bolus at comparable time points. Angiographic success was achieved in 100% of patients in the adenosine group and 98.3% (57/58) in the ISDN group.The procedural success rates were 96.9% (31/32) in the adenosine group and 89.7% (52/58) in the ISDN group. One patient (3.1%) from the adenosine group and six patients (10.3%) from the ISDN group experienced no-reflow/slow flow (P = 0.414). No in-hospital mortality occurred and target vessel revascularization was unnecessary. CONCLUSIONS: Intracoronary administration of either adenosine or ISDN during HSRA appears safe and administration of either agent may be effective in decreasing the incidence of no-reflow/slow flow during HSRA. Further large, prospective, randomized, placebo-controlled trials are required. PMID: 19476116 [PubMed - indexed for MEDLINE]

Impact of interval versus steady state exercise on nitric oxide production in patients with left ventricular dysfunction.

Related Articles Impact of interval versus steady state exercise on nitric oxide production in patients with left ventricular dysfunction. Acta Cardiol. 2009 Apr;64(2):219-24 Authors: Deljanin Ilic M, Ilic S, Lazarevic G, Kocic G, Pavlovic R, Stefanovic V AIM: The aim of the present study was to assess the impact of the interval exercise training (IET) vs. steady state exercise training (SSET) on nitric oxide production, through changes of circulating blood markers of endothelial function, including stable end-products of nitric oxide (NOx) and S-nitrosothiols (RSNOs) in patients with left ventricular dysfunction (LVD). PATIENTS AND METHODS: The impact of the IET vs. SSET on NOx and RSNOs production was assessed in a total of 31 (25 male, 6 female) patients with LVD (ejection fraction <40%), who were admitted to our residential rehabilitation centre. Patients were randomised into an IET group (n=18; 15 min interval exercise sessions, 2 times daily) and an SSET group (n=13; 5-10 min steady state exercise sessions, 2 times daily), and exercised every day over a period of 3 weeks. The modified Saville-Griess method was used to determine NOx and RSNOs concentrations. RESULTS: A significant increase was observed both for NOx (P < 0.05) and RSNOs (P < 0.001) in the IET group, as well as for RSNOs in the SSET group (P < 0.001). Both training methods were observed to significantly improve exercise capacity, as demonstrated for increased workload (P < 0.001 and P < 0.05 for the IET and SSET groups, respectively) and duration (P < 0.001 and P < 0.01 for the IET and SSET groups, respectively) of the exercise stress test at the end of the study. CONCLUSION: The results of the present study have demonstrated an increased nitric oxide production and improved exercise capacity in patients with left ventricular dysfunction, who were engaged in an interval exercise programme for three weeks, and clearly indicated an advantage of interval compared to steady state training method for cardiovascular rehabilitation. PMID: 19476115 [PubMed - indexed for MEDLINE]

Non-invasive tissue Doppler imaging pulmonary capillary wedge pressure measurement improves NT-proBNP prognostic value in heart failure.

Related Articles Non-invasive tissue Doppler imaging pulmonary capillary wedge pressure measurement improves NT-proBNP prognostic value in heart failure. Acta Cardiol. 2009 Apr;64(2):213-8 Authors: Berni A, Cappelli F, Bitossi L, Cecioni I, Cappelli B, Toncelli L, Galanti G, Poggesi L OBJECTIVE: The aim of the present study was to investigate whether the improvement of pulmonary capillary wedge pressure (PCWP) non-invasively assessed with tissue Doppler imaging is able to predict prognosis and cardiac-related mortality in patients with heart failure (HF), as previously demonstrated for NT-proBNP. METHODS: We prospectively studied 23 patients (74 +/- 10 y; 17 M, 6 F) with acute HF. NT-proBNP and PCWP were measured at admission and discharge. NT-proBNP concentrations were determined by a chemiluminescent immunoassay kit. PCWP was assessed using the ratio of transmitral E velocity to the early diastolic mitral annulus velocity (E'), with the formula PCWP = 1.9 + 1.24 (E/E'). Patients were divided in two groups according to the clinical end-point based on cardiac death and hospital readmission for HF. RESULTS: After a mean follow-up of 230 days, 10 patients reached the end-point (group A), while 13 patients resulted event-free (group B). In group B, NT-proBNP values significantly decreased (3816 +/- 7424 vs. 6799 +/- 10537 pg/mL, P < 0.01) and PCWP improved (17 +/- 7 vs. 23 +/- 12 mmHg, P < 0.01). The decrease in both NT-proBNP and PCWP values was able to identify the majority of patients (77%) with an event-free survival at follow-up, whereas 70% of patients who reached the end-point had discordant changes in NT-proBNP and PCWP (chi2 = 5.06, P < 0.05). CONCLUSIONS: The combination of a biochemical marker such as NT-proBNP and a new indicator of LV filling pressure (E/E') allows to estimate the prognostic impact of standard medical therapy even in a small group of HF patients. PMID: 19476114 [PubMed - indexed for MEDLINE]

Serum levels of C-reactive protein and uric acid in patients with cardiac syndrome X.

Related Articles Serum levels of C-reactive protein and uric acid in patients with cardiac syndrome X. Acta Cardiol. 2009 Apr;64(2):207-11 Authors: Eroglu S, Elif Sade L, Yildirir A, Demir O, Bozbas H, Muderrisoglu H OBJECTIVES: Angina-like chest pain, a positive result from a stress test, and normal coronary arteries are characteristics of patients with cardiac syndrome X (CSX). Serum levels of C-reactive protein (CRP), which is a marker of a systemic inflammatory state, are associated with coronary atherosclerosis and endothelial dysfunction. Serum uric acid (UA) levels have also been implicated in the development of atherosclerotic cardiovascular disease. However, little is known about the association of serum UA and CRP levels with CSX. METHODS: In all, 250 subjects (100 patients with CSX, 100 with coronary artery disease (CAD), and 50 control subjects) were enrolled in the study. Coronary arteries were evaluated by conventional coronary angiography in the CSX and CAD groups. All patients underwent a noninvasive stress test. To determine whether they are potential risk factors for CSX, serum CRP and UA levels were compared among the 3 groups. RESULTS: Serum levels of CRP were higher in patients with CSX or CAD than in the control subjects (4.4 +/- 3.1 and 4.5 +/- 2.9 mg/L, respectively, vs. 1.9 +/- 1.6 mg/L; P < 0.001), but those levels were similar in patients with CSX or CAD. Uric acid levels were higher in patients with CSX or CAD than in the control subjects (5.5 +/- 1.1 mg/dl and 5.9 +/- 1.4 mg/dl, respectively, vs. 4.4 +/- 1.2 mg/dl; P < 0.00 1), but those levels were also similar in patients with CSX or CAD. CONCLUSIONS: In patients with CSX, serum CRP and UA levels were as high as those in patients with CAD. Elevated serum CRP and UA levels may contribute to the development of CSX. PMID: 19476113 [PubMed - indexed for MEDLINE]

Expression or secretion of IL-17 in the peripheral blood mononuclear cells from patients with dilated cardiomyopathy.

Related Articles Expression or secretion of IL-17 in the peripheral blood mononuclear cells from patients with dilated cardiomyopathy. Acta Cardiol. 2009 Apr;64(2):201-5 Authors: Huang Y, Wu W, Wang Y OBJECTIVE: The objective of the study was to investigate the relation between interleukin-17 (IL-17) level in the plasma and in peripheral blood mononuclear cells (PBMCs), and dilated cardiomyopathy (DCM) disease severity. METHODS AND RESULTS: 30 patients with DCM and 20 normal adults as control were studied. IL-17 protein level in plasma, PBMC culture supernatants, and phytohaemagglutinin-stimulated PBMC culture supernatants were measured with ELISA. IL-17 mRNA expression in PBMCs was detected by reverse transcription-polymerase chain reaction. Results showed that the IL-17 protein level in PHA-stimulated PBMC culture supernatants or its mRNA level in the PHA-stimulated PBMC, but not in plasma or in PBMC culture supernatants, was significantly elevated in DCM patients compared with normal control subjects.The IL-17 protein level in cultured supernatants and the IL-17 mRNA level in the PBMCs were strongly correlated with the heart function of DCM patients. CONCLUSIONS: The ability to express IL-17 protein or mRNA in PBMC is abnormal and the change strongly correlates with the heart function of DCM patients. PMID: 19476112 [PubMed - indexed for MEDLINE]

Retrospective analysis of risk factors in young patients with coronary artery disease in Guangdong and Zhejiang, China.

Related Articles Retrospective analysis of risk factors in young patients with coronary artery disease in Guangdong and Zhejiang, China. Acta Cardiol. 2009 Apr;64(2):195-9 Authors: Fang C, Chen Y, Nie R, Li G, Xu G, Zhou S, Wang J OBJECTIVES: The objective of this study is to investigate the clustering status of risk factors for young patients with coronary artery disease (CAD) and analyse the relationship between risk factors and CAD. METHODS: 168 patients with CAD aged under 45 years, 170 age-matched non-CAD individuals (angiographically normal) and 170 patients with CAD aged over 45 years were set as CAD group, control group and reference group, respectively. Plasma levels of lipids, C-reactive protein (CRP), traditional risk factors (hypertension, hyperlipidaemia, diabetes, obesity, smoking) were evaluated. RESULTS: The following results were obtainted: (I) there was a significant difference in gender, proportion of smoking, TC and TG between the CAD group and the control group, and also in gender, smoking, hypertension, diabetes, BMI and blood lipids between the CAD group and the reference group (P < 0.05); (2) there was a significant difference in levels ofTG,TC, HDL-C, LDL-C and BMI (P < 0.05), but no remarkable difference in ApoB/ApoA1 and CRP between the CAD group and the reference group (P > 0.05).There were significant differences in TG, ApoB/ApoA1 and CRP (P < 0.05), but no remarkable difference in other factors between the CAD group and the control group (P > 0.05); (3) logistic regression showed a close relationship between CAD and smoking (OR = 2.5, 95% CI: 1.43-3.98), CRP (OR = 2.71,95% CI: 1.46-5.88),TG (OR = 1.58, 95% CI: 1.25-2.75) and ApoB/ApoA1 (OR = 1.93, 95% CI: 1.14-3.13). CONCLUSIONS: Smoking, CRP, ApoB/ApoA1 ratio and TG are independent risk factors for young patients with CAD. PMID: 19476111 [PubMed - indexed for MEDLINE]

Chronic mitral regurgitation--significance of the echocardiographic determinants in predicting severity.

Related Articles Chronic mitral regurgitation--significance of the echocardiographic determinants in predicting severity. Acta Cardiol. 2009 Apr;64(2):187-93 Authors: Leśniak-Sobelga A, Kostkiewicz M, Olszowska M, Pieniazek P, Tracz W The aim of study was to determine the significance of the best echocardiographic parameters for assessing the severity of mitral regurgitation (MR). METHODS: The study population consisted of 107 patients, mean age 52 +/- 7 y with chronic isolated non-ischaemic MR. Quantification of the MR was performed using echocardiography through the proximal isovelocity surface area method (regurgitant volume (RV) and the effective regurgitant orifice (ERO) were calculated) and the assessment of vena contracta width (VCW). RESULTS: The ROC curve analysis and Peto odds used to differentiate between the significant (III-IV grade) and non-significant (I-II grade) MR groups of patients indicated thatVCW, RV and ERO were the most powerful predictors of MR.The area under the ROC curve was 0.931, 0.944, 0.927, respectively.The cut-off values defining significant MR were: VCW > or =7 mm, RV > or =45 ml, ERO > or = 0.33 cm2. CONCLUSIONS: The most powerful predictors of severe MR are VCW, ERO and RV. PMID: 19476110 [PubMed - indexed for MEDLINE]

Centralized Pan-European survey on the undertreatment of hypercholesterolaemia (CEPHEUS).

Related Articles Centralized Pan-European survey on the undertreatment of hypercholesterolaemia (CEPHEUS). Acta Cardiol. 2009 Apr;64(2):177-85 Authors: Hermans MP, Van Mieghem W, Vandenhoven G, Vissers E The CEntralized Pan-European survey on tHE Under-treatment of hypercholeSterolaemia (CEPHEUS) was initiated to quantify the degree of under-treatment of hypercholesterolaemia in Europe. Its primary objective was to establish the proportion of treated patients reaching the LDL-C goals according to the Third Joint European Task Force guidelines. Secondary objectives targeted subgroups of primary or secondary prevention patients and those with a metabolic syndrome. Further-more, CEPHEUS also aimed at the identification of determinants for under-treatment. Among the patients available for evaluation in Belgium (n=6276), 58.5% reached LDL-C goals as recommended by the 2003 European guidelines, 59.8% in primary prevention, 55.8% in secondary prevention, and 55.8% of those with a metabolic syndrome. The majority of patients (82.5%) was treated with statins. The univariate significant (P < 0.10) predictors of attaining LDL-C goal were the following: (a) nonsmoker, (b) no history of PAD or CAD, (c) absence of metabolic syndrome, (d) lower CV risk category, (e) absence of patient's concerns about treatment changes, (f) no withdrawal of lipid-lowering therapy when on target, (g) optimal. treatment adherence, (h) no patient's frustrations, (i) lipid-monitoring frequency, (j) physician being a specialist and (k) physicians finding it stressful to get patients on target. In an adjusted multi-level model, achievement of the LDL-C goals was significantly associated with: (a) type of lipid-lowering therapy, (b) risk category the patient fell into, (c) LDL-C level before initiating treatment, (d) patient's feelings about the treatment, (e) patient's acknowledgement about current cholesterol level and (f) self-reported drug compliance. PMID: 19476109 [PubMed - indexed for MEDLINE]

Does preoperative degree of aortic insufficiency influence early and midterm results of sparing surgery?

Related Articles Does preoperative degree of aortic insufficiency influence early and midterm results of sparing surgery? Acta Cardiol. 2009 Apr;64(2):171-6 Authors: Pacini D, Botta L, Bracchetti G, Massi F, Di Marco L, Cattabriga I, Di Bartolomeo R OBJECTIVE: Aortic valve-sparing operations have shown excellent results in patients with aortic root and or ascending aorta aneurysm. Aortic valve regurgitation is frequently detected in these patients as a result of significant dilation of the aortic root.The aim of this study was to assess the impact of preoperative aortic incompetence degree on the early and midterm outcomes of sparing surgery. METHODS: From September 2001 to July 2006, 84 patients with aortic root aneurysm underwent aortic valve-sparing surgery according to the reimplantation technique. Depending on preoperative grade of aortic insufficiency (AI), two groups were identified: 31 patients (study group, SG) with AI grade III-IV and 53 (control group, CG) with AI grade II or less. The Gelweave Valsalva prosthesis was used in 76 patients (90.5%). Intraoperative, perioperative variables and outcomes at follow-up were retrospectively compared between the groups. RESULTS: Patient demographics and types of operations were comparable between groups. Early mortality rates were almost identical in both groups (3.2% SG vs. 5.7% CG; P = 0.961); at follow-up (FU), no patient died in both groups. Grade III-IV AI was similar in both groups early postoperatively (6.4% SG vs. 3.8% CG; P = 0.981) and during follow-up (13.3% vs. 8%; P = 0.755). Reoperaton rate for AI was 3.3% in SG vs. 6% in CG (P = 0.980). CONCLUSIONS: Preoperative degree of aortic regurgitation does not impair the outcomes of the valve-sparing operation which seem to depend on more factors. Early results were affected by the learning curve but midterm outcomes showed a progressive improvement. Patients with satisfactory reconstruction show stable results over time. PMID: 19476108 [PubMed - indexed for MEDLINE]

Effect of atrial fibrillation ablation on left atrial contractile function in patients with paroxysmal atrial fibrillation and a relatively well preserved atrial function.

Related Articles Effect of atrial fibrillation ablation on left atrial contractile function in patients with paroxysmal atrial fibrillation and a relatively well preserved atrial function. Acta Cardiol. 2009 Apr;64(2):167-9 Authors: Dagres N, Hindricks G, Kottkamp H, Varounis C, Bode K, Arya A, Sommer P, Kremastinos DT, Piorkowski C OBJECTIVES: There are inconsistent findings regarding the impact of ablation for atrial fibrillation (AF) on left atrial (LA) contractile function. We investigated the ablation effect on LA function in patients with paroxysmal AF. METHODS: Two hundred eighty-nine patients (mean age 56 +/- 9 years) underwent catheter ablation for paroxysmal AF. Transthoracic (TTE) and transoesophageal echocardiography (TEE) were performed at baseline and at 6 and 12 months after ablation for assessment of LA diameter, left atrial appendage emptying velocity (LAAEV), and A-wave peak velocity. RESULTS: LA function before ablation was relatively well preserved (LAAEV 54 +/- 19 cm/s, A-wave 59 +/- 23 cm/s). During follow-up, there was no significant change of LAAEV: from 54 +/- 19 cm/s at baseline to 54 +/- 18 at 6 months and 52 +/- 20 cm/s at 12 months (P = ns).The LA diameter at baseline was 4.2 +/- 0.6 cm and showed no significant change at 6 and 12 months (4.1 +/- 0.6 and 4.1 +/- 0.5 cm, P = ns). There was also no change of the A-wave (59 +/- 23 cm/s before ablation, 59 +/- 27 cm/s at 6 months and 53 +/- 12 cm/s at 12 months, P = ns). CONCLUSIONS: In patients with paroxysmal AF and relatively well preserved LA function, AF ablation leads to no significant deterioration of atrial function. PMID: 19476107 [PubMed - indexed for MEDLINE]

The complexity of platelet metabolism and its contribution to atherothrombosis.

Related Articles The complexity of platelet metabolism and its contribution to atherothrombosis. Acta Cardiol. 2009 Apr;64(2):157-65 Authors: Puddu P, Muscari A, Puddu GM, Cravero E, Giannoni C, Zoli M Platelet functions are multiple, complex and not limited to haemostasis. In fact, platelets play a relevant role in vascular inflammation and atherosclerosis (ATS). In the presence of vascular lesions or inflammation, endothelial denudation or activation triggers mechanisms that render the circulating platelets adhesive for the vascular wall. Endothelial lesions expose subendothelial matrix components, such as collagen, von Willebrand factor, fibronectin and other adhesive proteins. Platelet adhesion depends on the interaction between these components and platelet receptors (mainly glycoprotein (GP) VI and GPlb-IX-V). Adhesion triggers the platelet release of inflammatory and mitogenic substances that alter the thromboresistant endothelial surface, enhance the chemoattraction of leukocytes, stimulate smooth muscle cell proliferation and contribute to matrix degradation. Finally, GPIIb-IIIa receptors are activated, leading to firm platelet aggregation and thrombus formation. Platelets participate in the formation of mural thrombi in the late stages of atherosclerotic disease, but also adhere to endothelial cells during the earlier stages of atherosclerotic plaque development. Moreover, platelets exert important functions in modulating inflammatory and immune processes. An improved comprehension of the complex platelet pathophysiology could suggest new therapeutic strategies to reduce the impact of atherosclerotic disease. PMID: 19476106 [PubMed - indexed for MEDLINE]

Risk assessment in patients with heart valve disease facing non-cardiac surgery.

Related Articles Risk assessment in patients with heart valve disease facing non-cardiac surgery. Acta Cardiol. 2009 Apr;64(2):151-5 Authors: Hulselmans M, Vandermeulen E, Herregods MC Cardiac-related perioperative complications are well-known in general practice. The role of echocardiography in preoperative risk assessment before non-cardiac surgery remains unclear though. In this article we discuss recently published guidelines, articles and opinions in the domain of preoperative risk assessment of patients with valvular heart disease undergoing non-cardiac surgery. We created a risk stratification model that can be used in daily practice. This model may increase our awareness of the risks associated with heart valve disease in the perioperative period. PMID: 19476105 [PubMed - indexed for MEDLINE]