Prognostic significance of new onset atrial fibrillation in acute coronary syndrome patients treated conservatively.
CONCLUSIONS: New onset of AF is associated with excessive in-hospital mortality in acute coronary syndrome patients staying on conservative treatment in community hospitals without on-site invasive facilities.
PMID: 20104458 [PubMed - in process] (Source: Cardiology Journal)...
POSTED 01/30/2010 at 12:48 AM --
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Med Sci Monit 2010; 16(2):CR67-74 "Prognosis in diabetic patients with acute myocardial infarction treated invasively is related to renal function"
Conclusions: The prognosis in diabetics with AMI is significantly related to renal function. Diabetics without CKD had similar prognosis to non-diabetics. Multivariate analyses showed that unlike diabetes without renal dysfunction, DM-CKD was an independent risk factor for cardiovascular complications and total mortality. (Source: Medical Science Monitor)...
POSTED 01/29/2010 at 09:18 AM --
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Extracorporeal membrane oxygenation for refractory cardiogenic shock after cardiac surgery: predictors of early mortality and outcome from 51 adult patients [Original articles]
Conclusions: ECMO provides a good temporary cardiopulmonary support in patients with postcardiotomy shock. The preoperative risk factors of failure to withdraw ECMO are poor left-ventricular ejection fraction, systolic blood pressure <90 mmHg and refractory severe metabolic acidosis. The peri-ECMO predictors of mortality include low serum albumin level, low platelet count, low oxygen pressure of the venous tube of the ECMO and poor cardiac systolic function. (Source: European Journal of Cardio-Thoracic Surgery)...
POSTED 01/28/2010 at 01:40 PM --
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Percutaneous Extracorporeal Membrane Oxygenation for Cardiogenic Shock Due to Acute Fulminant Myocarditis [CASE REPORTS]
We report a favorable outcome of an acute fulminant myocarditis in a 25-year-old myasthenia patient with cardiogenic shock supported by percutaneous extracorporeal membrane oxygenation. (Source: The Annals of Thoracic Surgery)...
POSTED 01/27/2010 at 01:27 PM --
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The Glucogram: A New Quantitative Tool for Glycemic Analysis in the Surgical Intensive Care Unit
Conclusions: The glucogram was able to quantify the correlation between AHS and major clinical events with sensitivity of 84% and specificity of 65%. In addition, mean glycemic variability was nearly two times higher for non-survivors. The glucogram may be useful both clinically (i.e., in the electronic ICU) and as a research tool (i.e., in bioinformatic model development). Results of this study provide a foundation for further, larger-scale, multi-parametric, prospective glucogram evaluations. (Source: Journal of Surgical Research)...
POSTED 01/25/2010 at 10:42 AM --
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QTc prolongation during therapeutic hypothermia: are we giving it the attention it deserves?
Conclusion
Our series illustrates QTc prolongation during TH. This carries potential for refibrillation. Guidelines on ECG monitoring during TH are needed, especially since hypothermic myocardium is intrinsically prone to arrhythmias and commonly used antiarrythmic drugs such as amiodarone can prolong the QTc. (Source: Europace)...
POSTED 01/20/2010 at 10:18 AM --
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No Major Differences in 30-Day Outcomes in High-Risk Patients Randomized to Off-Pump Versus On-Pump Coronary Bypass Surgery. The Best Bypass Surgery Trial.
Conclusions-Both off- and on-pump coronary artery bypass grafting can be performed in high-risk patients with low short-term complications. Clinical Trial Registration-clinicaltrials.gov. Identifier: NCT00120991.
PMID: 20083683 [PubMed - as supplied by publisher] (Source: Circulation)...
POSTED 01/17/2010 at 06:00 PM --
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Simultaneous Pulmonary Embolectomy and Aortic Root Replacement
Thorac cardiovasc Surg 2009; 57: 501-503DOI: 10.1055/s-0029-1185392AbstractMassive pulmonary embolism (PE) is characterized by hypotension and cardiogenic shock due to right ventricular failure, and is associated with a high mortality rate. In this case study, we report a simultaneous pulmonary embolectomy and aortic root replacement in a 71-year-old woman with a known ascending aortic aneurysm who sustained a massive PE following a VATS left upper lobectomy for non-small cell lung cancer.[...]© Georg Thieme Verlag KG Stuttgart · New YorkGet connected:Table of contents | Abstract | Full text (Source: The Thoracic and Cardiovascular Surgeon)...
POSTED 01/14/2010 at 10:42 AM --
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Hematocrit Level as a Marker of Outcome in ST-Segment Elevation Myocardial Infarction
In conclusion, although not as strong a predictor of mortality as anemia, erythrocytosis might be associated with increased short-term mortality compared to a normal hematocrit. The measurement of hematocrit can be used as a useful prognostic marker in patients with STEMI. (Source: The American Journal of Cardiology)...
POSTED 01/06/2010 at 06:00 PM --
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A Methodology for Prediction of Acute Hypotensive Episodes in ICU via a Risk Scoring Model including Analysis of ST-Segment Variations
Absract The aim of this study is to detect Acute Hypotensive Episodes (AHE) and Mean Arterial Pressure Dropping Regimes (MAPDRs) using
ECG signal and Arterial Blood Pressure waveforms. To meet this end, the QRS complexes and end-systolic end-diastolic pulses
are first extracted using two innovative Modified Hilbert Transform-Based algorithms namely as ECGMHT and BPMHT. A new smoothing
algorithm is next developed based on piecewise polynomial fitting to smooth the fast fluctuations observed in RR-tachogram,
systolic blood pressure (SBP) and diastolic blood pressure (DBP) trends. Afterwards, in order to consider the mutual influence
of parameters on the evaluation of shock probability, a Sugeno Adaptive Network-based Fuzzy Inference System-ANFIS is trained
using Hasdai et al......
POSTED 01/06/2010 at 12:07 PM --
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Does the Early Administration of Beta-blockers Improve the In-hospital Mortality Rate of Patients Admitted with Acute Coronary Syndrome?
Conclusions: This systematic review failed to demonstrate a convincing in-hospital mortality benefit for using beta-blockers early in the course of patients with an acute or suspected MI. ACADEMIC EMERGENCY MEDICINE 2010; 17:1[ndash]10 © 2010 by the Society for Academic Emergency Medicine (Source: Academic Emergency Medicine)...
POSTED 01/03/2010 at 06:00 PM --
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Case report Aortic thrombosis as a complication of intraaortic balloon
Intra-aortic balloon counterpulsation is often used in critically ill patients with cardiac disease. Commonly accepted indications for its use include cardiogenic shock and mechanical complications of acute myocardial infarction (e.g. ventricular septal defect). The potential benefits of counterpulsation must be weighed against its possible severe thrombotic and hemorrhagic complications. Here we describe a 72-year old female with interventricular septum rupture complicating the course of acute myocardial infarction, in whom the intra-aortic balloon was used to stabilize the circulation prior to the surgery. Despite anticoagulation she developed a thrombus in the abdominal aorta. The risk – benefit ratio and possible ways to predict the complications are discussed. (Source: Articles ......
POSTED 12/30/2009 at 07:57 AM --
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A novel percutaneous mechanical biventricular bridge to recovery in severe cardiac allograft rejection
We describe the case of a 36-year-old man with acute cardiac transplant rejection bridged to recovery using simultaneous Impella 2.5 and TandemHeart percutaneous support devices. The patient underwent orthotopic cardiac transplantation 2 years earlier, and presented to our hospital with allograft failure 7 days after non-compliance with tacrolimus. Because of persistent cardiogenic shock despite intra-aortic balloon and inotropic support, we implanted an Impella 2.5 percutaneous assist device for left ventricular support. Persistent right ventricular dysfunction necessitated insertion of a TandemHeart for right ventricular support. After a course of intravenous solumedrol and anti-thymocyte globulin, both the Impella and TandemHeart devices were successfully weaned and removed. Nine months......
POSTED 12/25/2009 at 09:53 AM --
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Outcomes of elective versus emergent permanent mechanical circulatory support in the elderly: A single-center experience
Conclusions: Our experience indicates that permanent MCS may be successful in highly selected elderly patients with terminal heart failure, especially when elective implantation is performed before development of inotropic dependency or cardiogenic shock. However, outcomes at 12 months in this selective elderly population remain uniformly poor. (Source: The Journal of Heart and Lung Transplantation)...
POSTED 12/25/2009 at 09:53 AM --
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Med Sci Monit 2010; 16(1):CR15-20 "Characteristics and prognosis of coronary revascularization procedure in patients age 80 and older presenting with acute myocardial infarction"
Conclusions: This study demonstrates that the angiographic characteristics of patients ≥80 years are significantly different, associated with an initial increased risk of mortality, and that prognosis of MI is excellent once the acute phase has passed. (Source: Medical Science Monitor)...
POSTED 12/21/2009 at 01:13 PM --
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Septal Ventricular Tachycardia with Alternating LBBB–RBBB Morphology in Isolated Ventricular Noncompaction
We report on a patient with IVNC who presented with cardiogenic shock due to an incessant drug-resistant VT that was cured by radiofrequency ablation. The VT had characteristics of a deep septal focal arrhythmia, which was distinctive by ablation-induced alternation of the rightward and leftward exits, and was difficult to ablate from either side of the ventricular septum. (J Cardiovasc Electrophysiol, Vol. pp. 1-4) (Source: Journal of Cardiovascular Electrophysiology)...
POSTED 12/20/2009 at 06:00 PM --
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Percutaneous coronary intervention or coronary artery bypass surgery for cardiogenic shock and multivessel coronary artery disease?
Conclusions: Limited data from observational studies in patients with CS and multivessel disease suggest that CABG should be considered a complementary reperfusion strategy to PCI and may be preferred, especially when complete revascularization with PCI is not possible. Our data highlight the need for large randomized trials to further evaluate the relative benefit of PCI versus CABG in patients with multivessel coronary disease and CS using contemporary surgical and percutaneous techniques. (Source: American Heart Journal)...
POSTED 12/19/2009 at 07:51 AM --
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Latest Management and Outcomes of Major Pulmonary Embolism in the Cardiovascular Disease Early Transport System:
Conclusions: Early transport and specific reperfusion therapy for major PE were effectively performed by the Tokyo CCU Network, suggesting the efficacy of a specialty management system for major PE.
PMID: 20019409 [PubMed - as supplied by publisher] (Source: Circulation Journal)...
POSTED 12/17/2009 at 06:00 PM --
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Searching for an ideal hemodynamic marker to predict short term outcome in cardiogenic shock
Cardiogenic shock is a lethal condition. Physicians are searching for hemodynamic markers which could help risk stratification of patients in this picture. Torgersen and coworkers present hourly time integral of cardiac power index and cardiac index drops to predict outcomes in the setting of cardiogenic shock. Continuous monitoring of hemodynamic markers may have a role in prediction of outcomes. (Source: Critical Care)...
POSTED 12/09/2009 at 06:00 PM --
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Emergency CABG ‘reasonable approach’ in AMI
Emergency coronary artery bypass graft surgery achieves acceptable results in patients with acute myocardial infarction, especially those without cardiogenic shock, a study suggests. (Source: MedWire News - Cardiology)...
POSTED 12/07/2009 at 06:00 PM --
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