Archive

Evaluation of the Systolic Pulmonary Pressure during stress Doppler Echocardiography in Mitral Stenosis

Saléha Lehachi*; Fadila Daimellah; Djohar Hannoun; Youcef Laid; Rachid Mechmeche; Mohand Said Issad

    In Mitral Stenosis (MS), the international recommendations favor the indication of Percutaneous Mitral Commissurotomy (PMC) if Systolic Pulmonary Artery Pressure (SPAP) reaches or exceeded 60 mmHg in Doppler echocardiography stress (Grade C).


Treatment of Patients with Asymptomatic Ventricular Pre-Excitation Results of a Tiered Non-Invasive Electrocardiographic and Invasive Electrophysiological Risk Stratification Approach

Konstantinos A Gatzoulis*; Ageliki Laina; Petros Arsenos; Polychronis Dilaveris; Dimitris Tsiachris; Ioannis Skiadas; Christos-Konstantinos Antoniou; Athanasios Kordalis; Stefanos Archontakis; Helias Sotiropoulos; Skevos Sideris; Dimitris Patsourakos; Ioannis Doundoulakis; Stergios Soulaidopoulos; PanagiotisXydis; Anastasia Xintarakou; Konstantinos Tsioufis

    Treatment of asymptomatic Wolff-Parkinson-White (aWPW) patients has been a controversial issue, with approaches ranging from only follow up to ablation of all Accessory Pathways (APs). We aimed to assess the ability of a stepwise, non-invasive and invasive risk stratification approach to detect and manage high risk aWPW patients.


Growth Differentiation Factor 15 in Heart Failure with Preserved Ejection Fraction

Assia Haddad*; Nadia Ould Bessi; Mohamed Karim Guerchani; Ammar Chikouche; Salim Benkhedda

    Heart failure with preserved ejection fraction (HFpEF) is a growing burden in the world, and its pathophysiology is complex and its understanding remains insufficient. Following the comorbidity-inflammation paradigm, biomarkers are a promising screening tool.


Evaluation of the Systolic Pulmonary Pressure during stress Doppler Echocardiography in Mitral Stenosis

Saléha Lehachi*; Fadila Daimellah; Djohar Hannoun; Youcef Laid; Rachid Mechmeche; Mohand Said Issad

    In Mitral Stenosis (MS), the international recommendations favor the indication of Percutaneous Mitral Commissurotomy (PMC) if Systolic Pulmonary Artery Pressure (SPAP) reaches or exceeded 60 mmHg in Doppler echocardiography stress (Grade C).


Study of the Effect of Oleuropein on the Heart Tissue in D-Galactose-Induced Aging in Rat Model

Ghorban Mohammadzadeh; Elham Ranjbar*; Laya Sadat Khorsandi; Mehdi Goudarzi; Hossein Foruozandeh

    Many researchers have indicated that Oleuropein (OLE) has potential ability to decrease oxidative stress and inflammation. As a result, our current study aimed to examine the protective impact of Oleuropein (OLE) against D-Galactose (D-Gal)-induced heart aging in rats model.


Atrial Fibrillation in Heart Failure with Preserved Ejection Fraction

Assia Haddad; Mohamed Karim Guerchani; Nadia Ould Bessi; Salim Benkhedda

    Heart Failure with Preserved Ejection Fraction (HFPEF) accounts for more than half of the cases of heart failure with similar prognsis that HF with Reduced Ejection Fraction (HfrEF). Because Atrial Fibrillation (AF) and HFpEF share common risk factors, they frequently coexist, suggesting a worse prognosis than either of these conditions alone.


Right Atrial Mass in a Patient with Polycystic Kidney Disease: An Uncommon Association

Deepanjan Bhattacharya*; Basudeb Bhattacharjee; Ajay Gautam; Koyel Chakraborty

    Right atrial masses are often quite baffling in asymptomatic patients, and require extensive evaluation. We report the case of a man with polycystic kidney disease with incidentally detected right atrial mass with turned out to be Chiari network.


Electroanatomic Scar and Myocardial Atrophy in Arrhythmogenic Cardiomyopathy - Review of ECG Criteria

Stefan Peters

    Introduction: Electroanatomic scar and myocardial atrophy is the predominant finding of arrhythmogenic cardiomyopathy in either dominant right ventricular, biventricular of dominant left ventricular abnormalities. Lead aVR can describe electroanatomic scar by large Q waves and myocardial atrophy by small R waves. With these two conditions T wave is predominantly negative </= 2mm or in few cases biphasic.


Electrocardiographic Signs of Necrosis and Calcification in Arrhythmogenic Cardiomyopathy

Stefan Peters

    Introduction: Necrosis and massive calcification has been described in arrhythmogenic cardiomyopathy mainly in desmoglein-2 mutations according to mouse models and single human case reports. The overall expected rate of des- moglein-2 mutations is about 5-10 %. In transplanted hearts due to desmoglein-2 mutations signs of right ventricular hypertrophy and other typical findings like right precordial T-wave inversions and epsilon waves were found in about 50% of cases, making right ventricular hypertrophy a unique, typical sign of desmoglein-2 mutations and to a lesser extent Desmocollin-2 and plakoglobin mutations.


Importance of Angiotensinogen as an Upstream Factor of the Intrarenal Renin - Angiotensin System in Patients with Diabetic Nephropathy

Masumi Kamiyama

    The renin-angiotensin system has been found to be a critical regulator of blood volume and systemic vascular resistance. Additionally, the intrarenal renin-angiotensin system is important in the development and progression of diabetic nephropathy. Research on angiotensinogen as a precursor of angiotensin and an upstream factor of the renin–angiotensin system has shown that urinary angiotensinogen is useful as an early biomarker of diabetic nephropathy.


Central Venous Line With Peripheral Access and Long Duration in the Great Saphenous Vein

Francisco J Romero-Bermejo*; Inmaculada Palacio-Valverde

    Introduction: On occasions, vascular access can be a real care challenge and is subject to iatrogenic and patient safety incidents. In the case of bilateral axillary thrombosis, the options for central venoclysis are very limited. We present the first case in adults of central venoclysis in the proximal greater saphenous vein.


Prosthetic Valve Thrmbosis: Literature Review

Khaldi Mohamed

    Valvular heart disease represents a high cardiovascular burden with more than 100 million persons worldwide affected, and related morbidity and mortality are still significant [1]. Surgical valve replacement still is a corner stone for severe valvular disease in patients at low and intermediate risk for surgery [2]. Meanwhile, the last decade witnessed the emergence of transcatheter alternatives meanly for high surgical risk patients with aortic stenosis [2].


Intravascular Lithotripsy Success and Complications, A Real World Comparison Between Tertiary and General Hospital Setting

Nancy Wassef*; David Sarkar; Girish Viswanathan; Prashanth Raju; Ian Cox; Venkatesan Suresh; Mohsin Farooq;Kai Hogrefe; Sivasankar Sangaraju; Salahaddin Ubaid; Sandeep Basavarajaiah

    The use of Intravascular Lithotripsy (IVL) has expanded rapidly in heavily calcified coronary lesions. This is due to a modest learning curve and wide availability in Europe and United Kingdom. In this study, we report real-world IVL experience in high-volume centres with comparison between a tertiary centre and a general hospital in United Kingdom, in terms of safety, efficacy and complications.


Prescription of Guideline-Indicated Antibiotic Prophylaxis for Infective Endocarditis among Patients at High Risk

Anna Parbøl Engelund; Eva Havers-Borgersen; Lauge Østergaard; Lars Køber; Emil L Fosbøl

    Clinical treatment guidelines recommend Antibiotic Prophylaxis (AP) in order to prevent Infective Endocarditis (IE) before invasive dental procedures to high-risk patients including those with prior infective endocarditis or a prosthetic heart valve. We assessed adherence to these recommendations.


Acute and Chronic Right Heart Failure: A Narrative Review of Mechanical Circulatory Support

Jerry Cuenca; Giacomo Scorsese; Deborah Li; Jeremy Poppers; Adrian Fischl

    Historically, the Right Ventricle (RV) has been an underrepresented component of the growing body of literature regarding the circulatory system. Unfortunately, evidence has shown RV failure is closely associated with hospital admissions and increased short- and long-term mortality. RV failure can be categorized as acute or chronic, but the primary mechanisms underlying the development of its decompensation are diminished contractility, circulatory overload, and pressure overload.


Acute Myocarditis Complicated by a Huge Intra-VG Thrombus Responding well to Corticosteroid Therapy: Report of a Case

Brahim Nassour Aware*; Asma Zouad; Imane Tlohi; Salim Arouss; Ghali Bennouna; Leila Azzouzi; Abdel Nasser Drighil; Rachida Habbal

    Myocarditis is a disease defined by the presence of myocardial inflammatory infiltrates associated with myocyte necrosis of non-ischaemic origin. Diagnosis is based on clinical presentation, cardiac MRI and myocardial biopsy. Acute myocarditis may be secondary to infectious, toxic or allergic cardiac disease or may be associated with a systemic disease.


Echocardiographic Findings, Correlation with Cardiac Biomarkers along with their Prognostic significance in Patients with COVID-19 Infection- An Experience from Pakistan

Sheema Saadia; Aiysha Nasir; Taymmia Ejaz; Sameen Iqbal; Hasan Fareed; Fateh Ali Tipoo Sultan*

    Trans-thoracic Echocardiography (TTE) in COVID-19 patients can result in significant healthcare personnel’s exposure and requires personal protective equipment (PPE) in a resource-limited and lower middle-income countries. There is scarce data on echocardiographic findings in COVID-19 patients from countries like Pakistan. This study was done to evaluate the spectrum of echocardiographic findings with indications in COVID-19 patients and their correlation with cardiac and infective biomarkers.


Pulmonary Arteriovenous Malformations - A Rare Cause of Cyanosis in the Pediatric Population

Aziz Farhat*; Khalil Bassam; Mariam Arabi*; Fadi Bitar; Salman Mroueh

    Pulmonary Arteriovenous Malformations (PAVMs) are rare aberrant connections between the lung’s arterial and venous vascular systems. Although uncommon, PAVMs are associated with significant disease burden attributed to their high mortality and difficult management. PAVMs present with non-specific pulmonary and cardiac symptoms with radiographic findings similar to other common pulmonary diseases such as pneumonia and tumors.


Bupivacaine Induced Cardiac Toxicity Mimicking An Acute Non-ST Segment Elevation Myocardial

Fatima Qadri*; Kent Stephenson; Ravi S Akula

    Bupivacaine is widely used as a local anesthetic. Central Nervous System (CNS) and cardiovascular toxicity were reported. There have been very few case reports in the past showing association of bupivacaine induced cardiac toxicity, mostly in young healthy patients. We present a unique case of bupivacaine induced cardiac toxicity in a 69-year-old male with multiple comorbidities mimicking an acute non-ST segment elevation myocardial infarction without CNS toxicity.


Closure of RV Perforation during Pericardiocentesis with PDA Device Closure

Saadia Ilyas; Muhammad Aqdam Aneeq*; Asadullah Khan; Sibtain Nisar; Amir Nawaz

    Iatrogenic perforation of right ventricle is one of major and life threatening complication of Pericardiocentesis. Treatment modalities include either surgical repair or percutaneous device closure of perforation site. In this case we use amplatzer duct occluder device to seal off the RV perforation secondary to incorrect placement of pericardial drain...


Longitudinal Evaluation of Aortic Haemodynamics in Patients after Repair of Aortic Coarctation: A 4D Flow MRI Follow-Up Study

Daniel Hirtler; Julia Romberg; Brigitte Stiller; Julia Geiger

    Background: Patients after repair of Aortic Coarctation (CoA) have high risk of secondary vessel pathologies, regular monitoring is absolutely essential.
Objective: To investigate aortic hemodynamics and wall parameters in adolescent patients and young adults after repair of CoA by 4D flow MRI in a longitudinal study...


Every Syncope is not Benign

Meera R; Bency Baby*

    Introduction: Syncope is a diagnostic challenge to treating physician. Most of the cases have a benign course. But cardiogenic syncope has a worse outcome unless managed. Here we present a case of a 38-year-old presents with recurrent history of syncope since 2 years. Her vitals were normal. ECG and echocardiogram were normal. 24-hour Holter done 2 years back did not show any arrythmia...


Baseline CRP and Cardiac Troponin I Predict Outcomes of Intravenous Thrombolysis and Primary PCI in Patients with St-Segment Elevation Myocardial Infarction

Michelle Viegas*; Varghese Kiron; Srilakshmi MA; Patil CB

    Introduction: To study the effects of baseline cardiac troponin I and C - reactive protein levels in patients admitted with STEMI on outcomes of intravenous thrombolysis and primary PCI
Methods: Prospective observational study with 102 consecutive patients admitted with ST segment elevation myocardial infarction who received either intravenous thrombolysis or who underwent primary PCI.


Ectopic Kidney: A Case Report on Sonographic Finding

Solomon Demissie*; Mulatie Atalay

    An ectopic kidney is the rare condition that occurs when the kidney fails to ascend from its embryologic position in the fetal pelvis to its final position in the renal fossa. This abnormal location leads to various disease conditions.
Case: A 13-year’s old male child came to clinics with a complaining of mass like distention around umbilical region and flank pain.


Measuring the Left Ventricular End - Diastolic Pressure: Out of Fashion But Still of Real Value

Shailesh Dalvi*; Kaneez Makhdoom; Rod Stables; Victoria Pettemerides

    A 69-year-old man with previous coronary artery bypass grafting and recent native vessel percutaneous coronary intervention presented with progressive breathlessness. Left Heart Catheterization (LHC) showed no flow-limiting coronary disease but an elevated end-diastolic pressure with a pattern suggestive of restrictive cardiomyopathy. He was subsequently diagnosed with AL Amyloid with cardiac involvement...


Helping to Control Pulmonary Hypertension in a Trisomy 21 Infant with a Fenestrated Atrial Septal Defect Device

Stephanie Saey; Kurt Bjorkman; Jennifer R Maldonado; Daniel McLennan*

    As an alternative to surgical intervention, transcatheter closure of an atrial septal defect has become the standard treatment for patients with such defects. These procedures typically result in full closure of the defect with limited risks. However, in patients with ASD and coexisting pulmonary hypertension, it is necessary to keep a residual shunt as a decompression mechanism to maintain cardiac output in the setting of acute increases in pulmonary vascular resistance...


Diffuse Alveolar Hemorrhage as an Initial Presentation of Vasculitis: COVID-19 Induced

Badawaki H; Tekriti Z; Najem R; Chaddad R*

    COVID-19 is a disease caused by SARS-CoV-2 that can trigger severe respiratory tract infection. Among COVID-19 symptoms; fever, cough and fatigue are the most commonly reported. Hemoptysis is a reported symptom that could reflect diffuse alveolar hemorrhage. The main reason for hospitalization in COVID-19 infection is the onset of acute hypoxemic respiratory failure due to viral pneumonia, pulmonary embolism or other complications...


Thrombosed Left Circumflex Artery Aneurysm Presenting with Syncope

Sofia Lakhdar*; Chandan Buttar; Akwe Nyabera; Most Sirajum Munira

    A 79-year-old man with history of Coronary Artery Bypass Graft (CABG), atrial fibrillation and recent abdominal aortic aneurysm repair presented after a sudden loss of consciousness. Examination revealed a blood pressure of 130/95 mm Hg, heart rate 84 beats per minute and respiratory rate 18 per minute without any distress...


Delayed Stenting Compared with Immediate Stenting in Patients with ST-Segment Elevation Myocardial Infarction

Mohamed Abed Bouraghda*; Amine Bouzid; Said Benghezal; Sabra Bertal; Mohamed Tahar BOUAFIA; Mohamed Chettibi

    Aims: To compare Delayed Intentional Stent Implantation (DSI) with Immediate Stent Implantation (ISI) in patients with ST-Segment Elevation Myocardial Infarction (STEMI) undergoing Primary Percutaneous Coronary Intervention (PPCI).
Background: Stenting in thrombus-laden arteries can lead to distal embolisations and microvascular obstruction, which have been associated with worse prognosis.


Progressive Unmasking of the ARVC Phenotype Triggered by a Pulmonary Embolism

Anura Malaweera*; Daniel Sado; Rachel Bastiaenen; Paul Scott

    Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is characterised by Right Ventricular (RV) dysfunction, ventricular arrhythmias, and usually presents before the age of 40. We report a case of the ARVC phenotype being unmasked by Pulmonary Emboli (PE) in late adulthood, manifesting as recurrent Ventricular Tachycardia (VT), which was successfully treated with catheter ablation.


The Assessment of Cardiovascular Risk in Patients with Acute Decompensated Heart Failure Accompanied by Chronic Kidney Disease

Joanna Berner; Anna Gluba-Brzózka*; Jacek Rysz

    Heart Failure (HF) with its high prevalence and high death rates, is a complex chronic condition. It has distinct phenotypes classified depending on the ejection fraction. Comorbidities play a crucial role in HF. Kidney disease, which frequently accompanies HF worsens its prognosis. Heart failure and chronic kidney disease aggravates their courses in a complicated network of mutual relationships known as Cardio-Renal Syndrome (CRS)...


Analysis of Excess Consumption in College Students During the COVID-19 Pandemic

Bin Zhao*, Zitan Shi

    With the arrival of COVID-19, some areas are under closed management, bringing about changes in the way people consume. It also leads to the excessive consumption of some people, especially college students. In order to give early warning to unreasonable consumption behavior, this study designed KPAG algorithm to give early warning to consumption risk...


An Unusual Cause of Concordance in the Setting of Left Bundle Branch Block

Omar Alqaisi; Jacob Carter*; Jack Xu; Hakan Paydak

    A 73-year-old female with a past medical history of atrial fibrillation, mechanical mitral valve replacement on warfarin, hypertension and hypothyroidism presented to the emergency department with a fall. She fell and hit her head upon standing up from a seated position. She reported a constant posteriorly located headache along with episodes of nausea and vomiting. She denied chest pain, shortness of breath, syncope and fever.


Impact of Premature Ventricular Complexes on the QT Interval in Patients with Mitral Regurgitation

Simon W Rabkin*; Eric Wong; Matthew T Bennett

    Objective: To Determine the Influence on Cardiac Repolarization, Assessed By QT Interval, Of Premature Ventricular Ectopics (PVC), which frequently occur in mitral regurgitation and can lead to fatal arrhythmias.
Method: Patients (N=20) with PVCs in the setting of mitral regurgitation with sinus rhythm had a detailed analysis of QT interval and PVC wave form. The QRS complex, on a 12 lead ECG, immediately before the PVC (-1) was compared to the first (+1) and second (+2) complex after the PVC.


The Evaluation of the Impact of Nursing Counselling Intervention on the Quality of Life of Patients with Heart Failure, Systematic Review

Stergiani Petaloti*; Anestis Kiosses

    Introduction: Heart Failure (HF) is a chronic debilitating syndrome, which is associated with negative effects on both the physical/physical, mental, and socioeconomic dimension of patients suffering from it. This syndrome is associated with high morbidity and mortality and despite the introduction of new treatment protocols the prognosis continues and remains poor.


Severe Pulmonary Artery Hypertension after Displacement of Endovascular Stent because of Budd-Chiari Syndrome

Xuefeng Lin; Peng Zhu; Shaoyi Zheng*

    We reported a case of a patient who has repeated exercise dyspnea for 1 year and deteriorated for 4 mouths after successful percutaneous angioplasty and the implantation of a stent in the Inferior Vena Cava (IVC) because of Budd-Chiari Syndrome (BCS). Stent displacement which resulted in Pulmonary Artery Hypertension (PAH) was observed...


The Influence of Cancer Therapy on Cardiovascular Events

Humma H Khan; Shazma I Khan*; Zainab S Dar; Hemlata Limbu; Ralitsa Pancheva; Blagovest Stoimenov

    Introduction: Heart disease following cancer treatment may be directly linked to cardiovascular damage which may have been induced by chemotherapy treatment or accelerate the disease process ofatherosclerosis itself, including cancer treatment-related cardiovascular risk factors such as hypertension, diabetes mellitus, and dyslipidemia compared with age-matched counterparts with no cancer history [4]...


Effects of Obesity on Mortality and Morbidity in High-Risk Open Heart Surgery Patients

Hulya Yilmaz Ak; Yasemin Ozsahin; Mehmet Ali Yesiltas*; Ismail Haberal; Baris Sandal; Mustafa Yildiz; Kerem Erkalp; Ziya Salihoglu

    Background: The results of studies on the effect of obesity on mortality and morbidity in cardiac surgery are limited and contradictory. Today, the population of patients referred for open heart surgery is changing, and high-risk patients now represent a significant proportion of surgical candidates. In this study, the effect of obesity on mortality and morbidity in high risk patients in cardiac surgery was investigated retrospectively.


Availability of Protocols, Equipment and Medicines for Cardiovascular Disease Risk Management in Primary Care Health Facilities in Nine African Countries

Pascal Bovet; Dismand Houinato; Charles Mondo; Vash Mungal-Singh; Elizabeth Gatumia; Francois Ndikumwenayo; Awad Mohamed; Touré Ali Ibrahim; Habib Gamra

    Background: Cardiovascular disease, including hypertension and diabetes, is a leading cause of the disease burden in African countries. The World Health Organization has targeted that basic technologies and essential medicines should be available in >80% of health facilities. We examined the availability of protocols, equipment and medicines for the management of CVD risk in primary care health facilities in the public sector in 9 countries in the African region.


Potentiating of Aging-Related Left Ventricular Hypertrophy to Secondhand Smoke Exposure Animal Model

Jia-Ping Wu

    Secondhand smoke (SHS) exposure is associated with an increased risk of coronary artery disease. The aim was to investigate the relationship of SHS exposure in aged mice left ventricle impaired. To explore cardiac remodeling of SHS exposure whether was exacerbated cardiac impaired, especially in the aged mice. The C57BL/6J mice were placed in a transparent exposure chamber, connected to the smoking device, and exposed to 15 cigarettes for 30 min/twice a day/week, for 1 month...


Myocardial Injury, Inflammation and Prothrombotic Response Are Associated with Outcomes of COVID-19 Patients

Rachel T Scarl; Joan-Miquel Balada-LIasat; Nicholas Nowacki; R John Solaro; JoAnna Williams*; Jieli Li*

    Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which causes Coronavirus Disease 2019 (COVID-19) has rapidly grown into a pandemic. SARS-CoV-2 is known to affect the multi-organ systems including myocardial injury. Acute cardiac injury determined by elevated serum troponin levels has been observed in severe cases and is strongly associated with mortality...


Could Sulodexide be Helpful in COVID-19?

Alberto C Frati Munari*; Sergio O Flores Cantu; Nora E Lecuona Huet; Miguel A Bautista Alfaro

    Vascular disorder is prominent in COVID-19, mainly characterized by endothelial damage, severe inflammation and thrombotic trend. We reviewed the data suggesting that sulodexide, a glycosaminoglycan with endothelial protective, vascular anti-inflammatory, and antithromotic activities, could be helpful in this disease.


Evaluating the Role of Deferred Stenting in ST-Segment Elevation Myocardial Infarction Patients Presented with High Thrombus Burden: A Systematic Review and Meta-Analysis

Xiangming Hu; Xing Yang; Xida Li; Haojian Dong*; Yingling Zhou*

    Purpose: This meta-analysis was performed to assess the benefits of deferred stenting (DS) vs. Immediate Stenting (IS) in the ST-Segment Elevation Myocardial Infarction (STEMI) patients presented with high thrombus burden.
Methods: Cochrane Library, Embase, Pubmed, Web of Science and China National Knowledge Internet (CNKI) were searched for eligible literature.


Effects of SGLT2 Inhibitor on Neurohormonal Activity and Electrolyte Management in an Elderly Patient with Type 2 Diabetes Mellitus and Acute Heart Failure: A Case Report

Hajime Kataoka

    Introduction: Effects of a sodium-glucose cotransporter-2 inhibitor (SGLT2i) on changes in the neurohormonal activity were investigated in an 85-year-old patient with Type 2 Diabetes Mellitus (T2DM) and acute Heart Failure (HF). Case presentation: While maintaining the background medications constant, we started her on the SGLT2i empagliflozin 10 mg/d to treat the worsening HF and diabetic derangement. One week later, her body weight was markedly reduced by 3.6 kg, and HF-related physical signs were ameliorated, but serum b-type natriuretic peptide concentration was only slightly reduced.


Evaluation of Valvular Hemodynamics After Surgical Aortic Valve Replacement and Their Impact on the Postprocedural Result After Transcatheter Valve in Valve Implantation

Philipp Kiefer*; Alexandro Hoyer; Thilo Noack; Jörg Seeburger; Norman Mangner; Axel Linke; Felix Woitek; Michael Borger; David Holzhey

    Background: The aim of this study was to determine the influence of the initial hemodynamics after Surgical Aortic Valve Replacement (SAVR) on the postprocedural outcome after transcatheter Valve-in-Valve implantation (ViV). Methods: 147 patients received ViV due to failed surgical aortic valve bioprosthesis between 01/2008 and 5/2019. Aortic valve gradients after SAVR and after transcatheter ViV implantation were available in 62 patients (42.2%).


Protease-Activated Receptor-1 Inhibition by FR171113 Attenuates Cardiac Remodeling Due to Intermittent Hypoxia

Hideki Imano; Ryuji Kato; Yoshio Ijiri; Takehiro Yamaguchi; Yasukatsu Izumi; Atsuo Nomura; Minoru Yoshiyama; Tetsuya Hayashi*

    Objectives: Protease-Activated Receptor (PAR)-1 is a member of a family of G-protein and is activated by a tethered ligand. FR171113, the first non-peptide antagonist of the PAR-1, is effective in preventing occlusive arterial thrombosis without prolonging bleeding time or affecting coagulation time. Obstructive Sleep Apnea (OSA) is a serious sleep disorder that causes cardiovascular disease. Patients with OSA have a high prevalence of atrial fibrillation (AF).


Evaluation of Serum Osteopontin Levels as Biomarkers for Children with Kawasaki Disease

Andre Jakob*; Eva Schachinger; Simon Klau; Markus Hufnagel; Natascha van der Werf Grohmann; Brigitte Stiller; Anja Tengler; Sarah Ulrich

    Objectives: A reliable laboratory test for verifying diagnosis of Kawasaki Disease (KD) has yet to be developed. Given recent increases in KD-like disease among pediatric COVID-19 patients, such a test is of particular interest. Here, we investigate the bone-associated protein osteopontin (OPN)-a protein involved in vascular injury and remodeling-as a potential biomarker for KD, a vascular inflammatory disease.


Unusual “Bail-Out” Method for Management of Distal Coronary Perforation

Plamen Krasimirov Krastev; Stefan Naydenov Naydenov*; Nikolay Margaritov Runev; Emil Ivanov Manov

    Coronary artery perforations occur in 0.2-0.5% of all percutaneous coronary interventions (PCI): up to 60% of these patients need surgical treatment. We present an unusual “bail-out” method for non-surgical management of acute distal coronary perforation. It was applied first in a 73-old patient, underwent an elective coronary intervention for high-grade stenosis in a tertiary hospital.


Ebstein Anomaly without Fetal Hydrops but with Placentomegaly

Aki Mabuchi*; Yukiko Tanaka; Miyoko Waratani; Jo Kitawaki

    This report describes a case of Ebstein anomaly with severe tricuspid regurgitation, severe pulmonary regurgitation, and reversal of flow in the ductus arteriosus. The case was diagnosed as an Ebstein anomaly with circular shunt. Although fetal cardiomegaly had progressed and various indicators of severity of Ebstein anomaly were worsening with advancing gestational age, fetal hydrops was not detected.


Treatment of Hyponatremia with Acetazolamide in Cardiovascular patients: Possible Alternative Diuretic to Vasopressin Antagonists

Hajime Kataoka*

   This study examined the effects of chloride-regaining diuretic acetazolamide (Diamox) on the serum sodium (Na) concentration in cardiovascular patients. Forty-three patients for whom Diamox was added as de-novo/add-on decongestion therapy for worsening heart failure (N= 21) or as modification therapy for hypochloremia (<100 mEq/L) in stable cardiovascular patients (N= 22) were retrospectively examined.


Use of Pulmonary Vasodilator Therapy to Manage Pulmonary Arterial Hypertension with Associated Large Pulmonary Artery Aneurysms and Pulmonary-Systemic Artery Collaterals in the setting of Gerbode Defect

Humna Abid Memon; Derek Gibbs; Jean M Elwing*

   Gerbode defect, described as an abnormal connection between the left ventricle and right atrium, is an extremely rare form of intra-cardiac shunt. Diagnosis of Gerbode is difficult as the shunt is often misdiagnosed initially as Pulmonary Arterial Hypertension (PAH) or tricuspid regurgitation. While diagnosis of Gerbode can be onerous, management of these patients is even more challenging, as their case can be complicated by the development of PAH.


Plaque Modification: Need of the Hour in complex Interventional Procedures – Optical Coherence Tomography Imaging Insights

Rama Kumari N*; Jeetender kumar Jain kala; Shabbir Ali sheik; Ravi Kumar reddy matli

   Stent under expansion is a predictor of in-stent-restenosis and stent thrombosis. Semi-Compliant Balloons (SCBs) are generally used for lesion preparation. It remains unknown whether routine pre dilatation using Non-Compliant Balloons (NCBs) improves stent expansion in calcified coronary lesions, In-stent restenosis coronary lesions.


Impact of CVD on Mortality in Patients Hospitalized with COVID-19 Infection is Varied among Race

Yuan Qin; Anqi Li; Guohua Gong*

   We read the recent paper in the journal by Lala et al. Investigated the impact of myocardial injury in patients hospitalized infected by COVID-19. A similar investigation, including fewer patients hospitalized, was also published recently. We completely agree that troponin elevation among patients hospitalized with COVID-19 is associated with a higher risk of mortality.


Protective Effect of Propolis on Doxorubicin Induced Cardio- and Nephrotoxicity

Samaa Yassin Ali; Adel Abdel-moneim; Eman Salah Abdel-Reheim*

   Doxorubicin, is an antineoplastic drug, induces objective tumor responses in solid tumors as well as in hematologic malignancies. Its major adverse effect are cardiotoxicity and nephrotoxicity. Bee products, such as honey, royal jelly, pollen, and propolis have great attention in recent years. Propolis contains a broad spectrum of compounds that have many biological activities.


Melatonin as a Novel Candidate for Gene Therapy of Atherosclerosis

Amirhosein Moradi; Abdolreza Esmaeilzadeh; Reza Elahi*

   Cardiovascular diseases remain the main cause of death worldwide. Atherosclerosis, the chronic inflammation of large and medium vessels, is the main cause of cardiovascular diseases and their complications. Inflammation has proved to be involved as the main promoter of the atherosclerotic plaque progression. Also, oxidative stress is another factor that has a key role in the pathogenesis of atherosclerosis.


Which is the Best Risk Stratification Approach for Patients with Ventricular Arrhythmias in the Absence of Apparent Structural Heart Disease?

Konstantinos A Gatzoulis; Constantina Aggeli*; Yannis Dimitroglou; Stefanos Archontakis; Petros Arsenos; Ioannis Vlaseros; Polichronis Dilaveris; Christos-Konstantinos Antoniou; Dimitris Patsourakos; Skevos Sideris; Konstantinos Tsioufis; Dimitris Tousoulis

   There is tremendous interest in identifying those at risk among patients presenting with premature ventricular complexes in the absence of apparent Structural Heart Disease (SHD), a frequently met and highly debatable group of individuals. Long-term prognosis of patients presenting with significant burden of isolated and/or complex Ventricular Arrhythmias.


Hot Tub Syncope: Uncommon, but not always Harmless

Nicholas Zingas; James Tollefson; Basanti Mukerji; Vaskar Mukerji*

   Hot tub syncope can result in drowning. With immersion in a hot tub, the high external water temperature, as compared to the body, causes an initial rise in heart rate and blood pressure. However, after the first several minutes of autonomic regulation, the body acclimates to these higher temperatures through peripheral vasodilation to decrease the heat burden.


Cardiac Magnetic Resonance Imaging of Massive Left Ventricular Pseudoaneurysm

Nijat Aliyev*; Majd Ibrahim

    A 64-year-old man with history of coronary artery disease, end-stage renal disease presented with progressive abdominal pain. Abdominal computed tomography revealed nephrolithiasis and hemopericardium. Notably, three years prior to this presentation he had inferior ST-elevation myocardial infarction with Percutaneous Coronary Intervention (PCI) to the right coronary artery.


Spectro-Temporal Characteristics of the Internal Components Mitral (M1) and Tricuspid (T1) of the First Heart Sound (S1) Pulmonary (P2) and Aortic (A2) of the Second Cardiac Sound (S2) Using the Continuous Wavelet Transform (CWT)

L Hamza Cherif; SM Debbal*

    The analysis of phonocardiogram signals by using the wavelet transform is a very important analysis concerning our study and it helps us to better locate the frequency ranges of heart sounds S1 and S2 as well as their internal components (mitral M1, Tricuspid T1, Aortic A2 and Pulmonary P2 respectively) and to have an overview of the spectro-temporal response.


The Excel Controversy, Lesson of the Year: Science, Data and Media

Adam El Gamel

    Traditionally, Coronary Artery Bypass Grafting (CABG) has been considered the primary therapy for isolated or multivessel coronary artery disease with left main stenosis (LMCAD). However, when the three-year outcomes of the Excel trial were published and more recently followed by the five years, the 3 years results changed the European guidelines.


Characterization of Waves in an Electrocardiographic Signal Using Various High-Energy Rays from its Spectral Content

Rerbal S; Debbal SM*; Meziani F

    The electrocardiogram is considered to be one of the most powerful diagnosis tools in medicine; it is routinely used in the assessment of the heart function. In this work, an application was developed and implemented in the Visual Basic (VB) Environment, in order to study the processing time through the detection of the R peak and the selection of different waves (P wave, T wave and QRS complex) present in an ECG.


One Case of Patient Took Warfarin for 10 Years after Biological Mitral Valve Biopsy

Bailang Chen; Xianmian Zhuang; Minxin Wei*

    65-year-old female patient was admitted to the hospital due to chest tightness and shortness of breath. Patients underwent mitral valve replacement in 2010 due to “mitral valve disease”. The patient received the doctor’s advice for long-term, uninterrupted use of warfarin and went to the hospital regularly to review the echocardiogram and the valve was not abnormal.


Internuclear Ophthalmoplegia Following Cardiac Catheterization

Patrick M Barney; Ryan D Gabbard; Komal Joshi; Analkumar Parikh; Vaskar Mukerji*

    A 70-year-old man developed horizontal diplopia following cardiac catheterization for chest pain. His symptoms started immediately after the procedure. He was evaluated by a neuro-ophthalmologist who confirmed the diagnosis as Internuclear Ophthalmoplegia (INO). His vision gradually returned over a 6-month period. INO is a rare occurrence after cardiac catheterization. It is important for physicians to be aware of this condition and its clinical course, which is usually benign.


Delayed Management of a Myocardial Infarction Due to the Outbreak Coronavirus COVID-19

Hery Andrianjafy*; Trung Hung Ta; Giam Tran-Minh

    We report a case of a patient suffering chest pain with finally myocardial infarction diagnosis. His medical care was delayed because of the COVD-19 outbreak that disrupted health care systems. We discuss the importance to maintain access to quality emergency care for patients.


The Most Cited Articles, Authors, Journals, and the Affiliated Countries on the Topic of Cardiology from 2016 to 2018 in Pubmed Central

Shu-Chen Hsing; Tsair-Wei Chien; Willy Chou*; Hsiu-Yu Lai

    To apply the citation analysis to the pattern of international author collaborations on the topic of cardiology from PubMed Central (PMC) and to visualize the results using Google Maps and the Kano model. We obtained 1396 abstracts on September 27, 2019, from PMC based on the keywords of cardiology in title from 2016 to 2019.


Eye diseases associated with systemic hypertension: What a non-ophthalmologist should know?

Rafael Cicconi Arantes*; Juliana Abreu Rio; Lana Martins Menezes; Ricardo Luz Leitao Guerra

    Systemic Hypertension (SH) or elevated blood pressure is a very common medical condition and it’s complications have intimal relation with cardiovascular diseases, being one of the major causes of premature death worldwide. An estimated 1.13 billion people worldwide have SH and fewer than 1 in 5 people with SH have it under control.


Rupture of dissected ascending aorta in redo patients also happens and has manifestations like pulmonary embolism

Hadi abdulsalam Abo Aljadayel*; Alireza Yaghoubi; Sadegh Zargar Nataj; Kourosh Trigarfakheri

    Most physicians believe that ascending aortic dissection in Redo cases never rupture because of adhesion and its relatively not emergent case but it seems not so. We report a case of 65-year-old woman who underwent CABG 5 years ago and came to emergency room with signs of dyspnea, tachypnea, tachycardia, chest pain.


Prevalence of left superior vena cava in patients with congenital heart disease

Abdenasser Drighil; Cody Dinganga; Bah Ali Rida*

    Background: Persistent Left Superior Vena Cava (PLSVC) is an anomaly of systemic venous return with a prevalence of 0.1% to 0.3% in general population and about 3 to 10% in case of Congenital Heart Disease (CHD). This congenital anomaly is without hemodynamic consequence if it’s isolated...


Comparative efficacy and safety associated with apixaban and rivaroxaban treatment in morbidly obese versus non-obese patients

Megan F Duperreault; Gretchen Stern*; Jessica Rimsans; Jean M Connors

    Background: Due to limited enrollment of patients with a BMI > 30 or weight > 100 kg in landmark trials for apixaban and rivaroxaban, the International Society of Thrombosis and Hemostasis (ISTH) recommends against the use of direct oral anticoagulants (DOACs) in those with a BMI > 40 or weight > 120 kg. The purpose of this study was to investigate the efficacy and safety of apixaban and rivaroxaban, prescribed in morbidly obese patients compared to non-obese patients.


Does fast-track recovery improve outcomes in adult cardiac surgery?

Katharina Schulte; Athanasios Antoniou; Rizwan Attia*

    Complications following cardiac surgery can be associated with severe morbidity and mortality. The interdisciplinary approach according to a structured protocol aims to optimise outcomes post cardiac surgery. We aimed to evaluate the evidence of fast track recovery programmes in adult cardiac surgery.


A novel use of extracorporeal membrane oxygenation in the management of prosthetic valve thrombosis during pregnancy

Rizwan Attia; Xun Luo; Victoria Asfour; Vinayak Bapat

    Switching from Coumadin-based to heparin-based anticoagulant for management of mechanical heart valves during pregnancy carries risks. Extracorporeal Membrane Oxygenation (ECMO) may play a role in urgent or life-threatening clinical conditions for resuscitation prior to surgery. A 27-year-old 28-weeks gestation primigravida presented with dyspnoea.


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