Cardiac Biomarker Levels After a Football Match in Professional Versus Amateur Lithuanian Football Players

Background: There are very limited scientific data available on cardiac troponin I release after intermittentexercise. To know the different factors that mediate cTnI release after exercise is of concern for scientists.In this regard, our study is based on two major goals: 1) to evaluate the cTnI release in individuals duringa sports match; and 2) to understand the impact of the status of the athlete (biological) on the releaseof individual cTnI.Methods: A total of 44 players, including “22 adult professional [PFP]: 24.2±4.5 years, 22 adult amateur[AFP]: 26.5±3.6 years” were involved in a match simulated as real. Successive observations of cTnI releasewere obtained at different settings such as at rest, pre-exercise, and instant-post-exercise at regularintervals of 3, 6, and then 24 h post-exercise.Results: From the obtained results it was observed that the individual highest values were vastly varied,with higher levels of cTnI release baseline and post-exercise for PFP players as compared to those ofAFP (all p < 0.05). Moreover, the cTnI levels were increased (peak post: 0.024 [0.004-0.244] μg/L; p < 0.05). Additionally, the cTnI peak values surpassed the upper limit of reference in 77.3% of PFP (17 PFP).Conclusions: Our study data results affirm that the cTnI release is highly affected by the status of athletes. The cTnI release is enhanced by intermittent exercise

The influence of obesity on in-hospital clinical outcomes after recanalisation of chronic total occlusions

Objectives: Recanalisation of chronic total occlusions (CTOs) in interventional cardiology is one of the most challenging and complex procedures. Currently, no data are available about the impact of BMI on success rates among CTO patients undergoing percutaneous coronary intervention. The aim of this study was to investigate the impact that BMI has on success rates, complications, and procedure characteristics among a large group of CTO patients who underwent percutaneous coronary intervention. Methods: The present study retrospectively included 420 patients who underwent percutaneous coronary intervention for at least one chronic total occlusion in the Hospital of the Lithuanian University of Health Sciences of Kaunas. All patients were grouped by their BMI level based on the World Health Organisation classification. Statistical analyses were performed using SPSS 20.0 software. The value of p < 0.05 was considered as statistically significant. Results: Positive correlations were detected between body mass index and cardiovascular risk factors, as well as the duration of the procedure and fluoroscopy time; likewise, the amount of used contrast increased with the increase of BMI (p < 0.05). Nevertheless, there was no statistically significant difference across all body mass index categories in terms of procedure success, complication rates, and outcomes (p > 0.05). Conclusion: This retrospective study indicates that BMI has no impact on in-hospital outcomes in patients with chronic total occlusion after percutaneous coronary intervention

Cardiac Biomarker Levels After a Football Match in Professional Versus Amateur Lithuanian Football Players

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IVUS-VH relation to the extent and composition of atherosclerotic plaque and clinical outcome prognosis

Background and aim: Most frequent and generally unpredictable coronary plaque rupture impacts the burden of coronary artery disease but features or signs related to plaque remodeling into the high risk structure are not clearly detectable by using ordinary visualization methods. Till yet there are no evident criteria for additional using IVUS. The aim of the study was to determinate intravascular ultrasound virtual histology (IVUS-VH) importance in identifying high risk plaques, which can contribute to increased rupture hazard. Methods: We selected 30 patients with stabile angina pectoris. 50 plaques were analyzed with coronary angiography digital assessment tool and IVUS similarly. Differences of stenoses measured by both methods, then were calculated and compared to composition of plaques evaluated by IVUS-VH. Results: Plaques were mostly formed of fibrous tissue (FI) (2.6 mm2; 57.89 %). Necrosis was found to make in average one-fifth of analyzed plaques (0.75 mm2, 19.60 %). Calcification made up the smallest part of plaques (0.3 mm2, 8.58 %). Plaques with higher necrosis component appeared to be significantly greater in IVUS compared to coronary angiography. In group A necrosis made up 1.40±1.05 mm2; group B – 0.87±0.52 mm2, and group C – 0.62 ±0.45 mm2 (p= 0.020). The same tendency was observed with FI: group A – 3.38±3.20 mm2; group B – 2.90±2.6 mm2 and group C – 2.04±165 mm2 (p= 0.082). Correlation analysis revealed negative moderate relationship between groups and necrosis percentage (r= –0.40, p= 0.004), and FI (r= –0.29, p= 0.039) components of the plaques. Conclusion: IVUS-VH provides new insight into the evaluation of different composition of plaques. However, despite the advantages, IVUS-VH remains costly and not always technically adaptive procedure, so it is necessary to pursue for new methods or technologies to identify atherosclerotic plaques at risk

Artifacts in computer tomography imaging: how it can really affect diagnostic image quality and confuse clinical diagnosis?

Different kinds of artifacts can occur during a computer tomography (CT) scans due to hardware or software related problems, human physiologic phenomenon or physical restrictions. Some of them can seriously affecting diagnostic image quality, while others may simulate or be confused with different pathology. On another words artifact is an artificial feature appearing in an image that is not present in the original investigative object. It is important to recognize these artifacts according to a basic understanding of their origin, especially those mimicking pathology, as they can lead to incorrect diagnosis and cause serious after-effects on patient’s health. We presented an overview of the most common CT artifacts and methods to fix or rectify them. We also provide the original artifacts images and statistics from the Lithuanian University of Health Sciences Kaunas Clinical Hospital obtained from image databases

Artifacts in computer tomography imaging: how it can really affect diagnostic image quality and confuse clinical diagnosis?

Different kinds of artifacts can occur during a computer tomography (CT) scans due to hardware or software related problems, human physiologic phenomenon or physical restrictions. Some of them can seriously affecting diagnostic image quality, while others may simulate or be confused with different pathology. On another words artifact is an artificial feature appearing in an image that is not present in the original investigative object. It is important to recognize these artifacts according to a basic understanding of their origin, especially those mimicking pathology, as they can lead to incorrect diagnosis and cause serious after-effects on patient’s health. We presented an overview of the most common CT artifacts and methods to fix or rectify them. We also provide the original artifacts images and statistics from the Lithuanian University of Health Sciences Kaunas Clinical Hospital obtained from image databases

Correlation between Preoperative Coronary Artery Stenosis Severity Measured by Instantaneous Wave-Free Ratio and Intraoperative Transit Time Flow Measurement of Attached Grafts

Background and Objectives: To assess the correlation between the degree of target coronary artery stenosis measured by instantaneous wave-free ratio (iFR) and the intraoperative transit time flow measurement (TTFM) of attached grafts as well as evaluate flow competition between the native coronary artery and the attached graft according to the severity of stenosis. Materials and Methods: In total, 89 grafts were subjected to intraoperative transit time flow measurement after coronary artery bypass grafting (CABG) in 25 patients with multivessel coronary artery disease (CAD). The iFR was evaluated for all coronary arteries with grafts. The coronary artery stenoses were divided into three groups based on the iFR value: iFR < 0.86 (group 1); iFR 0.86–0.90 (group 2); and iFR > 0.90 (group 3). Results: The mean graft flow (MGF) was 46.9 ± 18.4 mL/min for group 1, 45.3 ± 20.9 mL/min for group 2, and 31.3 ± 18.5 mL/min for group 3. A statistically significant difference was confirmed between groups 1 and 3 (p = 0.002) and between groups 2 and 3 (p = 0.025). The pulsatility index (PI) was 2.49 ± 1.20 for group 1, 2.66 ± 2.13 for group 2, and 4.70 ± 3.66 for group 3. A statistically significant difference was found between groups 1 and 3 (p = 0.006) and between groups 2 and 3 (p = 0.032). Backward flow was detected in 7.5% of grafts for group 1, in 16.6% of grafts for group 2, and in 16% of grafts for group 3. A statistically significant difference was found between groups 1 and 2 (p = 0.025) and between groups 1 and 3 (p = 0.029). Conclusions: The iFR is a useful tool for predicting the impact of competitive flow observed between a native artery and an attached graft. The effect of competitive flow significantly increases when the graft is attached to a vessel with mild coronary stenosis. In a coronary artery where the iFR was not hemodynamically significant, the MGF was lower, the PI was higher, and a larger proportion of grafts with backward flow (BF) was detected compared to when there was significant stenosis (iFR < 0.86)

A Simple Strategy to Reduce Contrast Media Use and Risk of Contrast-Induced Renal Injury during PCI: Introduction of an “Optimal Contrast Volume Protocol” to Daily Clinical Practice

Contrast-induced acute kidney injury is the leading cause of iatrogenic acute nephropathy. Development of contrast-induced nephropathy (CIN) increases the risk of adverse long- and short-term patients outcomes, the hospital costs, and length of hospitalization. There are a couple of methods described for CIN prevention (statin prescription, prehydration, contrast media (CM) clearance from the blood system, and decrease amounts of contrast volume). The CM volume to patient’s creatinine clearance ratio is the main factor to predict the risk of CIN development. The safe CM to creatinine clearance ratio limits have been established. The usage of CM amount depends on personal operators habits and inside center regulations. There is no standardized contrast usage protocol worldwide. The aim of this study was to establish an easy to use, cheap, and efficient protocol to estimate a personalized safe CM dose limit for every patient based on their kidney function. These limits are announced during the “Time Out” before the procedure. Our study included 519 patients undergoing interventional coronary procedures: 207 patients into the “Optimal Contrast Volume” arm and 312 into the control group. Applying the protocol into a daily clinical practice leads to a significant reduction in CM volume used for all type of procedures and the development of CIN in comparison with a control group

Impact of Mineralocorticoid Receptor Gene NR3C2 on the Prediction of Functional Classification of Left Ventricular Remodeling and Arrhythmia after Acute Myocardial Infarction

Background: The NR3C2 gene encodes the mineralocorticoid receptor, which is present on cardiomyocytes. Prior studies reported an association between the presence of NR3C2 single-nucleotide polymorphisms (SNPs) and an increased cortisol production during a stress response such as acute myocardial infarction (AMI), which may lead to adverse cardiac remodeling. Objective: To study the impact of the NR3C2 rs2070950, rs4635799 and rs5522 gene polymorphisms on left ventricular (LV) remodeling, rhythm and conduction disorders in AMI patients. Methods: A cohort of 301 AMI patients who underwent revascularization was included. SNPs of the NR3C2 gene (rs2070950, rs4635799 and rs5522) were evaluated. A total of 127 AMI patients underwent transthoracic echocardiography follow-up after 72 h and 6 months. Results: The rs2070950 GG genotype and rs4635799 TT genotype were most common in patients who had LV end-diastolic volume increase < 20% and the same or increased LV ejection fraction, indicating a possible protective effect of these SNPs. The rs5522 TT genotype was associated with a higher frequency of arrhythmias, while the presence of at least one rs5522 C allele was associated with a lower risk of arrhythmias. Conclusion: SNPs of the NR3C2 gene appear to correlate with better ventricular remodeling and a reduced rate of arrhythmias post-AMI, possibly by limiting the deleterious effects of cortisol on cardiomyocytes