In vivo and in vitro evidence for pleiotropic effects of levosimendan in the intensive care setting

Levosimendan, in addition to its inotropic properties, could have anti-inflammatory and anti-oxidative properties, and can potentially decrease the deleterious effects of reactive oxygen species on the tissues. In their study, Hasslacher and colleagues provided not only in vitro but also in vivo evidence that levosimendan could preserve organ function in acute heart failure and septic-shock-induced myocardial depression via cooling down the oxidative burst of circulating cells

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 an hourly time integral of the 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

Does electrocardiography at admission predict outcome in Crimean-Congo hemorrhagic fever

Background & objectives: Crimean-Congo hemorrhagic fever is an acute viral hemorrhagic fever withconsiderable mortality. Despite increasing knowledge about hemorrhagic fever viruses, the pathogenesis ofCrimean-Congo hemorrhagic fever and causes of death were not well described. We aimed to evaluate whetherthere were electrocardiographic parameters designating mortality among these patients.Study design: This retrospective study was performed among confirmed Crimean-Congo hemorrhagic fevercases in Turkey. Electrocardiography was available in 49 patients within 24 h of hospitalization. Allelectrocardiograms were evaluated by two expert cardiologists according to Minnesota coding system.Results: Among patients with available electrocardiograms, there were 31 patients who survived, and 18patients who died of Crimean-Congo hemorrhagic fever. Both groups were similar in terms of age, sex, bodytemperature, heart rate, and blood parameters. T-wave changes and bundle branch block were more frequentlyencountered among those who died. Presence of T-wave negativity or bundle branch block in this cohort ofpatients with Crimean-Congo hemorrhagic fever predicted death with a sensitivity of 72.7%, specificity of92.6%, positive predictive value of 88.9%, negative predictive value of 80.6%.Conclusions: We think within the light of our findings that simple electrocardiography at admission may helprisk stratification among Crimean-Congo hemorrhagic fever cases

Initial syncope associated with alternating attacks of supraventricular tachycardia and atrioventricular block long after surgical correction of tricuspid atresia

The Fontan procedure has become a generic term to define a surgical procedure that orients the systemic venous return directly to the pulmonary arteries, and has been used as a palliative operation for pulmonary atresia, tricuspid atresia, double inlet ventricle and complex single ventricle. The earliest type of Fontan procedure was a simple atriopulmonary anastomosis between the right atrium and the pulmonary artery. Atrial arrhythmias, particularly atrial flutter and sinus node dysfunction may occur in the early and late postoperative period after simple atriopulmonary anastomosis. The case presented here represents a much delayed occurrence of an initial syncope due to alternating attacks of SVT (supraventricular tachycardia) and second degree heart block on admission 21 years after simple atriopulmonary anastomosis performed for the correction of tricuspid atresia. (Cardiol J 2008; 15: 186-188

The effect of smoking on cardiac diastolic parameters including Vp, a more reliable and newer parameter

Background: Previous studies have focused mainly on the acute effects of smoking on the diastolic function of the heart. The present study was conducted to demonstrate the chronic effects of smoking on the diastolic functional parameters of the heart, including transmitral M- mode coloured flow propagation velocity (Vp), among relatively younger asymptomatic adults. Method: Hundred smokers with histories of incessant smoking for at least one year prior to the time of the investigation were included in the prospectively designed study as group I. Group II consisted of 35 non-smokers, matched for age and gender. Addiction to smoking was graded according to the modified Fagerström test for nicotine dependence (M-FNDT). Each smoker was designated by a nicotine dependence index (NDI) according to the M-FNDT. Groups I and II were compared with respect to major diastolic functional parameters on transthoracic echocardiography (TTE), including the E/A ratio, deceleration time (DT), isovolumic relaxation time (IVRT) and Vp, along with basic clinical and echocardiographic parameters. Results: Thirty one smokers in group 1 and 5 non-smokers in group 2 were excluded from the study according to the pre-defined exclusion criteria. Therefore 69 smokers (mean age: 30 &#177; 4.9 years, M/F: 32/37) in group I were compared with 30 non-smokers (mean age: 31.4 &#177; 4.8 years, M/F: 15/15) in group II. In group I the mean values of E/A and Vp were significantly lower (p < 0.001), whereas the mean values of IVRT and DT were significantly higher (p < 0.001) than in group II. In group I the value of NDI was positively correlated with the values of DT and IVTR (p < 0.001) and negatively correlated with the value of Vp (p < 0.001). Conclusion: Conventional and relatively new parameters of cardiac diastolic function, in particular Vp, were found to be impaired in smokers demonstrating the chronic adverse effects of smoking on the diastolic function of the heart. The severity of this impairment was closely correlated with the degree of addiction to smoking. (Cardiol J 2007; 14: 281-286

Wpływ palenia tytoniu na parametry funkcji rozkurczowej lewej komory, w tym na Vp jako nowszy i bardziej wiarygodny parametr

Wstęp: We wcześniejszych badaniach skupiano się głównie na doraźnym, bezpośrednim wpływie palenia tytoniu na funkcję rozkurczową serca. Celem niniejszej pracy było przedstawienie wpływu długotrwałego palenia tytoniu na parametry funkcji rozkurczowej serca, w tym prędkość propagacji napływu mitralnego (Vp), ocenianą w badaniu doplerowskim znakowanym kolorem w prezentacji jednowymiarowej u stosunkowo młodych dorosłych bez objawów. Metody: Badanie miało charakter prospektywny. Do grupy I zakwalifikowano 100 osób palących tytoń nieprzerwanie przez przynajmniej rok przed rozpoczęciem badania. Grupę II stanowiło 35 niepalących pacjentów, dostosowanych do grupy I pod względem wieku i płci. Za pomocą zmodyfikowanego Kwestionariusza Tolerancji Nikotyny Fagerströma (M-FNDT) oceniono stopień uzależnienia od nikotyny u badanych pacjentów. Następnie na podstawie wskaźnika uzależnienia od nikotyny (NDI) uzyskanego z M-FNDT każdego z palaczy przydzielono do odpowiedniej podgrupy. Obie grupy pacjentów porównano na podstawie głównych parametrów rozkurczowych uzyskanych za pomocą echokardiografii przezklatkowej, takich jak stosunek E/A, czas deceleracji (DT), czas rozkurczu izowolumetrycznego (IVRT) i Vp, a także na podstawie podstawowych parametrów klinicznych i echokardiograficznych. Wyniki: Opierając się na wstępnych kryteriach wyłączenia, z badania wykluczono 31 palaczy z grupy I oraz 5 niepalących z grupy II. W rezultacie porównano 69 palaczy (śr. wiek: 30 &#177; &#177; 4,9 roku, M/K: 32/37) z grupy I oraz 30 niepalących (śr. wiek: 31,4 &#177; 4,8 roku, M/K: 15/15) z grupy II. W grupie I średnie wartości stosunku E/A oraz Vp były wyraźnie niższe (p < 0,001), podczas gdy średnie wartości IVRT oraz DT były znamiennie wyższe (p < 0,001) niż w grupie II. W grupie I wartość NDI była wprost proporcjonalna do DT oraz IVTR (p < 0,001) oraz odwrotnie proporcjonalna do Vp (p < 0,001). Wnioski: Zarówno konwencjonalne, jak i względnie nowe parametry oceny funkcji rozkurczowej lewej komory, zwłaszcza Vp, okazały się znacznie gorsze u osób palących tytoń, co odzwierciedla szkodliwy wpływ palenia na funkcję rozkurczową serca. Wielkość tego pogorszenia ściśle korelowała ze stopniem uzależnienia od palenia. (Folia Cardiologica Excerpta 2007; 2: 485&#8211;491

Efeito do levosimendan em pacientes com insuficiência cardíaca sistólica severa e agravamento da função renal

FUNDAMENTO: O levosimendan, um sensibilizador de cálcio, aumenta a sensibilidade do coração para o cálcio, aumentando assim a contratilidade miocárdica, sem aumento do cálcio intracelular. Recentemente foi demonstrado que o levosimendan era benéfico na melhoria da função renal. No entanto, fica por determinar que o efeito benéfico esteja relacionado em forma diferencial ao status renal durante o evento-índice. OBJETIVO: O objetivo do presente estudo foi determinar se o levosimendan pode melhorar o resultado renal em pacientes com insuficiência cardíaca aguda descompensada com e sem agravamento da função renal. MÉTODOS: Quarenta e cinco pacientes consecutivos que tiveram uma taxa de filtração glomerular reduzida e pelo menos dois dados consecutivos quanto à função renal, antes da administração de levosimendan, foram incluídos no estudo. Os pacientes foram classificados em dois grupos, com e sem agravamento da função renal com base no aumento da creatinina sérica > 0,3 mg/dL. RESULTADOS: Uma melhoria significativa foi observada na função renal em pacientes com agravamento da função renal (creatinina sérica de 1,4 ± 0,16 a 1,21 ± 0,23 mg/dL, p = 0,001 e taxa de filtração glomerular de 48,9 ± 15 a 59,3 ± 21,8 mL/min/m², p = 0,011), apesar de que não houve melhoria significativa em aqueles sem agravamento da função renal (creatinina sérica de 1,29 ± 0,33 a 1,37 ± 0,66 mg/dL, p = 0,240 e taxa de filtração glomerular de 53,7 ± 17,6 a 52,9 ± 21,4 mL/min/m², p = 0,850). CONCLUSÃO: O levosimendan parece proporcionar um efeito de realce renal em pacientes com severa insuficiência cardíaca sistólica descompensada aguda e agravamento da função renal. Considerar esse efeito diferencial poderia contribuir a obter resultados renais benéficos. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0

A Year in the Life of the EU-CardioRNA COST Action: CA17129 Catalysing Transcriptomics Research in Cardiovascular Disease

The EU-CardioRNA Cooperation in Science and Technology (COST) Action is a European-wide consortium established in 2018 with 31 European country members and four associate member countries to build bridges between translational researchers from academia and industry who conduct research on non-coding RNAs, cardiovascular diseases and similar research areas. EU-CardioRNA comprises four core working groups (WG1-4). In the first year since its launch, EU-CardioRNA met biannually to exchange and discuss recent findings in related fields of scientific research, with scientific sessions broadly divided up according to WG. These meetings are also an opportunity to establish interdisciplinary discussion groups, brainstorm ideas and make plans to apply for joint research grants and conduct other scientific activities, including knowledge transfer. Following its launch in Brussels in 2018, three WG meetings have taken place. The first of these in Lisbon, Portugal, the second in Istanbul, Turkey, and the most recent in Maastricht, The Netherlands. Each meeting includes a scientific session from each WG. This meeting report briefly describes the highlights and key take-home messages from each WG session in this first successful year of the EU-CardioRNA COST Action. © 2020 by the authors