Glutathione infusion before primary percutaneous coronary intervention: A randomised controlled pilot study

Objective: In the setting of reperfused ST-elevation myocardial infarction (STEMI), increased production of reactive oxygen species (ROS) contributes to reperfusion injury. Among ROS, hydrogen peroxide (H2O2) showed toxic effects on human cardiomyocytes and may induce microcirculatory impairment. Glutathione (GSH) is a water-soluble tripeptide with a potent oxidant scavenging activity. We hypothesised that the infusion of GSH before acute reoxygenation might counteract the deleterious effects of increased H2O2 generation on myocardium. Methods: Fifty consecutive patients with STEMI, scheduled to undergo primary angioplasty, were randomly assigned, before intervention, to receive an infusion of GSH (2500 mg/25 mL over 10 min), followed by drug administration at the same doses at 24, 48 and 72 hours elapsing time or placebo. Peripheral blood samples were obtained before and at the end of the procedure, as well as after 5 days. H2O2 production, 8-iso-prostaglandin F2α (PGF2α) formation, H2O2 breakdown activity (HBA) and nitric oxide (NO) bioavailability were determined. Serum cardiactroponin T (cTpT) was measured at admission and up to 5 days. Results: Following acute reperfusion, a significant reduction of H2O2 production (p=0.0015) and 8-iso-PGF2α levels (p=0.0003), as well as a significant increase in HBA (p<0.0001)and NO bioavailability (p=0.035), was found in the GSH group as compared with placebo. In treated patients, attenuated production of H2O2 persisted up to 5 days from the index procedure (p=0.009) and these changes was linked to those of the cTpT levels (r=0.41, p=0.023). Conclusion: The prophylactic and prolonged infusion of GSH seems to determine a rapid onset and persistent blunting of H2O2 generation improving myocardial cell survival. Nevertheless, a larger trial, adequately powered for evaluation of clinical endpoints, is ongoing to confirm the current finding

Distal left circumflex coronary artery flow reserve recorded by transthoracic Doppler echocardiography: a comparison with Doppler-wire

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How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study

Background: Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis: We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods: We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results: Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions: Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI

EMG amplitude of the biceps femoris during jumping compared to landing movements

Hamstrings injury is a common occurrence in athletic performance. These injuries tend to occur during a deceleration or landing task suggesting the negative work may be a key component in hamstrings injury. The purpose of this study was to investigate the muscular activity (EMG) of the biceps femoris (BF) in different phases (concentric vs. eccentric) of a Counter Movement Jump (CMJ), Squat Jump (SJ) and the Braking Phase (BP) of a landing task. Twelve female volleyball players performed 5 CMJs, SJs and BPs while surface EMG was recorded using a MuscleLab (BoscoSystem(TM), Norway). EMG values were normalized to an maximal voluntary contraction. A repeated measures analysis of variance (ANOVA) was used to compare mean normalized EMG values of the concentric and eccentric portions of the CMJ with the BP and SJ. The ANOVA revealed significantly lower BF activation in the concentric and eccentric portions of the CMJ compared to the BP (64%, p < 0.001) and SJ (7%, p = 0.02), respectively. These findings suggest that the CMJ relies on a greater contribution of elastic tissues during the concentric and eccentric portions of the movement and thus requires less muscle activation of the BF

Complicanze cardiovascolari nella chirurgia oftalmica

Cardiovascular complications in eye surgery are similar to the complications seen in general surgery. However, particular problems are due to some distinctive features of ophthalmic operations. Moreover interactions are frequent between cardiovascular drugs and eye drops in ophthalmic patients with heart disease. All these concepts are reviewed by the authors in this report.Cardiovascular complications in eye surgery are similar to the complications seen in general surgery. However, particular problems are due to some distinctive features of ophthalmic operations. Moreover interactions are frequent between cardiovascular drugs and eye drops in ophthalmic patients with heart disease. All these concepts are reviewed by the authors in this report