Results Generated From:
EMBASE <1980 to 2010 Week 08>
EMBASE (updates since 2010-02-18)
<1>
Accession Number
2010095768
Authors
Ten Brinke E.A. Burkhoff D. Klautz R.J. Tschope C. Schalij M.J. Bax J.J.
Van Der Wall E.E. Dion R.A. Steendijk P.
Institution
(Ten Brinke, Schalij, Bax, Van Der Wall, Steendijk) Department of
Cardiology, Leiden University Medical Centre, PO Box 9600, 2300RC, Leiden,
Netherlands.
(Burkhoff) Department of Medicine, Columbia University, New York City, NY,
United States.
(Klautz, Dion) Department of Cardiothoracic Surgery, Leiden University
Medical Centre, Leiden, Netherlands.
(Tschope) Department of Cardiology and Pneumology, Charite-University,
Berlin, Germany.
Title
Single-beat estimation of the left ventricularend-diastolic
pressure-volume relationship in patients with heart failure.
Source
Heart. 96(3)(pp 213-219), 2010. Date of Publication: February 2010.
Publisher
BMJ Publishing Group
Abstract
Aims: To test a method to predict the end-diastolic pressure-volume
relationship (EDPVR) from a single beat in patients with heart failure.
Methods and results: Patients (New York Heart Association class III-IV)
scheduled for mitral annuloplasty (n=9) or ventricular restoration (n=10)
and patients with normal left ventricular function undergoing coronary
artery bypass grafting (n=12) were instrumented with pressure-conductance
catheters to measure pressure-volume loops before and after surgery. Data
obtained during vena cava occlusion provided directly measured EDPVRs.
Baseline end-diastolic pressure (Pm) and volume (Vm) were used for
single-beat prediction of EDPVRs. Root-mean-squared error (RMSE) between
measured and predicted EDPVRs, was 2.79+/-0.21 mm Hg. Measured versus
predicted end-diastolic volumes at pressure levels 5, 10, 15 and 20 mm Hg
showed tight correlations (R 2=0.69e0.97). Bland-Altman analyses indicated
overestimation at 5 mm Hg (bias: pre-surgery 44 ml (95% CI 29 to 58 ml);
post-surgery 35 ml (23 to 47 ml)) and underestimation at 20 mm Hg (bias:
pre-surgery -57 ml (-80 to -34 ml); post-surgery -13 ml (-20 to -7.0 ml)).
End-diastolic volumes were significantly different between groups and
between conditions, but these differences were not dependent on the method
(ie, measured versus predicted). RMSEs were not different between groups
or conditions, nor dependent on Vm or P m, indicating that EDPVR
prediction was equally accurate over a wide volume range. Conclusions:
Single-beat EDPVRs obtained from hearts spanning a wide range of sizes and
conditions accurately predicted directly measured EDPVRs with low RMSE.
Single-beat EDPVR indices correlated well with directly measured values,
but systematic biases were present at low and high pressures. The
single-beat method facilitates less invasive EDPVR estimation,
particularly when coupled with emerging non-invasive techniques to measure
pressures and volumes.
<2>
Accession Number
2010054182
Authors
Bower W.F. Lee P.Y. Kong A.P.S. Jiang J.Y. Underwood M.J. Chan J.C.N. van
Hasselt C.A.
Institution
(Bower, Lee, Underwood) Department of Surgery, The Chinese University of
Hong Kong, Hong Kong, Hong Kong.
(Kong, Chan) Department of Medicine and Therapeutics, The Chinese
University of Hong Kong, Hong Kong, Hong Kong.
(Jiang) Hong Kong Branch, the Chinese Cochrane Centre, School of Public
Health, Hong Kong, Hong Kong.
(van Hasselt) Department of Otorhinolaryngology, Head and Neck Surgery,
The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Title
Peri-operative hyperglycemia: a consideration for general surgery?.
Source
American Journal of Surgery. 199(2)(pp 240-248), 2010. Date of
Publication: February 2010.
Publisher
Elsevier Inc.
Abstract
Background: Intraoperative hyperglycemia in cardiac and neurosurgical
patients is significantly associated with morbidity. Little is known about
the perioperative glycemic profile or its impact in other surgical
populations or in nondiabetic patients. Methods: A systematic review of
blood glucose values during major general surgical procedures reported
since 1980 was conducted. Data extracted included blood glucose measures,
study sample size, gender distribution, age grouping, study purpose,
surgical procedure, anesthetic details, and infusion regime. Excluded
studies were those with subjects with diabetes insipidus, insulin-treated
diabetes, renal or hepatic failure, adrenal gland tumors or dysfunction,
pregnancy, and emergency or trauma surgery. Results: Blood glucose levels
rose significantly with the induction of anesthesia (P < .001) in
nondiabetic patients. At incision, 2 hours, 4 hours, and 6 hours, 30%,
40%, 38%, and 40% of studies, respectively, reported hyperglycemia.
Conclusions: Factors that confound or protect against significant rises in
perioperative glycemic levels in nondiabetic patients were identified. The
findings facilitate investigating the impact of hyperglycemia on general
surgical outcomes. copyright 2010 Elsevier Inc. All rights reserved.
<3>
Accession Number
2009617494
Authors
Biyik I. Gulculer M. Karabiga M. Ergene O. Tayyar N.
Institution
(Biyik) Department of Cardiology, Usak State Hospital, Usak, Turkey.
(Gulculer, Karabiga) Department of Cardiovascular Surgery, Usak State
Hospital, Usak, Turkey.
(Ergene) Department of Cardiology, Ataturk Education and Training
Hospital, Izmir, Turkey.
(Tayyar) Department of Management and Statistics, Usak Universty, Usak,
Turkey.
Title
Efficacy of gabapentin versus diclofenac in the treatment of chest pain
and paresthesia in patients with sternotomy.
Source
Anadolu Kardiyoloji Dergisi. 9(5)(pp 390-396), 2009. Date of Publication:
2009.
Publisher
Aves Yayincilik
Abstract
Objective: Chronic post-sternotomy chest pain and paresthesia (PCPP) are
frequently seen and reduce the quality of life. We aimed to demonstrate
the efficacy and safety of gabapentin compared with diclofenac in the
treatment of PCPP and to elucidate the similarities of PCPP to neuropathic
pain syndromes. Methods: The prospective, randomized, open-label, blinded
end-point design of study was used. One hundred and ten patients having
PCPP lasting three months or more were randomized to receive 800 mg/daily
gabapentin (n=55) and 75 mg/daily diclofenac (n=55) for thirty days. All
patients have undergone cardiac surgery and median sternotomy. The
perception of pain or paresthesia was evaluated as 0-Normal (no pain or
paresthesia), 1-Mild, 2-Moderate, 3-Severe at baseline and after thirty
days of treatment. Recurrences were questioned after three months.
Statistical analyses were performed using independent samples t,
Chi-square, continuity correction, Fisher's exact, Mann Whitney U and
Kruskal Wallis tests. Results: In gabapentin group, mean pain and
paresthesia scores regressed from 2.12+/-0.76 to 0.54+/-0.83 (p<0.001) and
from 1.72+/-0.74 to 0.49+/-0.62 (p<0.001), respectively. Mean pain and
paresthesia scores regressed in diclofenac group from 1.93+/-0.8 to
1.0+/-1.13 (p<0.001) and from 1.76+/-0.74 to 1.24+/-0.96 (p=0.002),
respectively. Although, both gabapentin and diclofenac were found to be
effective without obvious side effects in the treatment of PCPP (p<0.001),
gabapentin was found to be superior to diclofenac (p=0.001 and p<0.001,
respectively). Adverse effects were seen in 7% of patients on gabapentin
and 4% of patients on diclofenac. Results also showed that symptomatic
relief with gabapentin lasts longer than diclofenac (p<0.001). Conclusion:
Both gabapentin and diclofenac are effective in the treatment of chronic
PCPP, without obvious side effects. However, gabapentin is found to be
superior to diclofenac and its effects sustain longer. The results show
that there may be some evidence in PCPP as a kind of neuropathic pain.
copyrightCopyright 2009 by AVES Yayincilik Ltd.
<4>
Accession Number
2010054094
Authors
Singh S.K. Desai N.D. Chikazawa G. Tsuneyoshi H. Vincent J. Zagorski B.M.
Pen V. Moussa F. Cohen G.N. Christakis G.T. Fremes S.E.
Institution
(Singh, Desai, Chikazawa, Tsuneyoshi, Vincent, Moussa, Cohen, Christakis,
Fremes) Division of Cardiac and Vascular Surgery, Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, Ont., Canada.
(Pen) Division of Medical Imaging, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, Ont., Canada.
(Zagorski, Fremes) Institute for Clinical Evaluative Science, Toronto,
Ont., Canada.
Title
The Graft Imaging to Improve Patency (GRIIP) clinical trial results.
Source
Journal of Thoracic and Cardiovascular Surgery. 139(2)(pp 294-301.e1),
2010. Date of Publication: February 2010.
Publisher
Mosby Inc.
Abstract
Objective: This trial aimed to determine whether intraoperative graft
assessment with criteria for graft revision would decrease the proportion
of patients with 1 or more graft occlusions or stenoses or major adverse
cardiac events 1 year after coronary artery bypass grafting. Methods: A
single-center, randomized, single-blinded, controlled clinical trial was
designed. Patients were randomized to either of 2 groups: intraoperative
graft patency assessment using indocyanine-green fluorescent angiography
and transit-time flowmetry, with graft revision according to a priori
criteria (imaging group), or standard intraoperative management (control
group). Patients underwent follow-up angiography at 1 year. Results:
Between September 2005 and August 2008, 156 patients undergoing isolated
coronary bypass grafting were enrolled (imaging, n = 78; control, n = 78).
Demographic and angiographic characteristics were similar between groups.
Operative, crossclamp, and cardiopulmonary bypass times were all
nonsignificantly longer in the imaging arm. The number of grafts per
patients was similar (imaging, 3.0 +/- 0.7; control, 3.0 +/- 0.7). The
frequency of major adverse cardiac events (death, myocardial infarction,
repeat revascularization) was not different between groups at 1 year
postoperatively (imaging, 7.7%; control, 7.7%). One-year angiography was
performed in 107 patients (imaging, 55 patients/160 grafts; control, 52
patients/152 grafts). The proportion of patients with 1 graft occlusion or
more was comparable in the imaging (30.9%) and control (28.9%) groups
(relative risk [95% confidence interval], 1.1 [0.6-1.9]; P = .82), as were
other graft patency end points. The incidence of saphenous vein graft
occlusion was high in both groups. Conclusions: Routine intraoperative
graft assessment is safe but does not lead to a marked reduction in graft
occlusion 1-year after bypass grafting. The incidence of saphenous vein
graft failure remains high despite contemporary practice and routine
intraoperative graft surveillance. copyright 2010 The American Association
for Thoracic Surgery.
<5>
Accession Number
2010054063
Authors
Ponce Gonzalez M.A. Serda G.J. Suarez P.R. Perez-Penate G. Gilart J.F.
Navarro P.C.
Institution
(Ponce Gonzalez, Serda, Perez-Penate, Navarro) Department of Pulmonary
Medicine, Dr Negrin Gran Canaria University Hospital, Las Palmas de Gran
Canaria, Spain.
(Suarez, Gilart) Department of Thoracic Surgery, Dr Negrin Gran Canaria
University Hospital, Las Palmas de Gran Canaria, Spain.
(Ponce Gonzalez) Hospital at Home Unit, Dr Negrin Gran Canaria University
Hospital, Las Palmas de Gran Canaria, Spain.
Title
Long-term cardiopulmonary function after thoracic sympathectomy:
Comparison between the conventional and simplified techniques.
Source
Journal of Thoracic and Cardiovascular Surgery. 139(2)(pp 405-410), 2010.
Date of Publication: February 2010.
Publisher
Mosby Inc.
Abstract
Objective: We sought to compare the long-term effects of conventional and
simplified thoracic sympathectomy on cardiopulmonary function. Methods: We
performed a prospective and randomized study of 32 patients with diagnoses
of primary hyperhidrosis who were candidates for either conventional or
simplified thoracic sympathectomy. Patients were randomized according to
the type of procedure: conventional thoracic sympathectomy (18 patients)
and simplified thoracic sympathectomy (14 patients). Before surgical
intervention, forced spirometry, body plethysmography, measurement of the
diffusing capacity of the lung for carbon monoxide (Dlco), and exercise
tests were carried out in all patients. These evaluations were performed
again 1 year after the procedure to assess the long-term effects of
sympathectomy. Results: Lung function tests revealed a significant
decrease in forced expiratory volume in 1 second (FEV1) and forced
expiratory flow between 25% and 75% of vital capacity (FEF25%-75%) in both
groups (FEV1 of -6.3% and FEF25%-75% of -9.1% in the conventional thoracic
sympathectomy group and FEV1 of -3.5% and FEF25%-75% of -12.3% in the
simplified thoracic sympathectomy group). Dlco and heart rate at rest and
maximal values after exercise were also significantly reduced in both
groups (Dlco of -4.2%, Dlco corrected by alveolar volume of -6.1%, resting
heart rate of -11.8 beats/min, and maximal heart rate of -9.5 beats/min in
the conventional thoracic sympathectomy group and Dlco of -3.9%, Dlco
corrected by alveolar volume of -5.2%, resting heart rate of -10.7
beats/min, and maximal heart rate of -17.6 beats/min in the simplified
thoracic sympathectomy group). Airway resistance increased significantly
in the group of patients undergoing conventional thoracic sympathectomy
(+13%). Despite all these changes, the patients remained asymptomatic. No
significant differences were found between the conventional and simplified
thoracic sympathectomy groups. Conclusions: Simplified and conventional
thoracic sympathectomy resulted in a long-term reduction in FEV1,
FEF25%-75%, Dlco, and resting and maximal heart rate, as well as a mild
but significant increase in airway resistance in the conventional thoracic
sympathectomy group, without any clinical consequence to the patient.
These changes were unrelated to the level of transection of the thoracic
sympathetic chain. copyright 2010 The American Association for Thoracic
Surgery.
<6>
Accession Number
2010100701
Authors
Gerriets T. Schwarz N. Sammer G. Baehr J. Stolz E. Kaps M. Kloevekorn
W.-P. Bachmann G. Schonburg M.
Institution
(Gerriets, Schwarz, Stolz, Kaps) Department of Neurology, Justus-Liebig
University Giessen, Giessen, Germany.
(Gerriets, Schwarz, Baehr, Schonburg) Experimental Neurology Research
Group, Justus-Liebig University Giessen, Giessen, Germany.
(Gerriets, Schwarz, Baehr, Schonburg) Kerckhoff Clinic, Bad Nauheim,
Germany.
(Sammer) Department of Psychiatry, Justus-Liebig University Giessen,
Giessen, Germany.
(Kloevekorn, Schonburg) Department of Cardiac Surgery, Kerckhoff Clinic,
Bad Nauheim, Germany.
(Bachmann) Department of Radiology, Kerckhoff Clinic, Bad Nauheim,
Germany.
Title
Protecting the brain from gaseous and solid micro-emboli during coronary
artery bypass grafting: A randomized controlled trial.
Source
European Heart Journal. 31(3)(pp 360-368), 2010. Date of Publication:
February 2010.
Publisher
Oxford University Press
Abstract
AimsThe purpose of the study was to investigate whether intra-operative
filter devices protect the brain during coronary artery bypass grafting
(CABG) and to determine the impact of solid and gaseous micro-emboli on
neuropsychological functioning.Methods and resultsPatients undergoing CABG
received either an intra-aortic filter (Embol-X) (n = 43), designed to
reduce solid micro-emboli, a dynamic bubble trap (DBT) (n = 50), designed
to reduce gaseous micro-emboli, or no additional device (control group) (n
= 50). Cognitive functioning was assessed before and 3 months after CABG.
Micro-emboli signals (MES) were detected during surgery using transcranial
Doppler (TCD) sonography. Cerebral magnetic resonance imaging (MRI) was
carried out before and after surgery. Primary endpoint was the cognitive
outcome of the filter groups compared with the controls. Analysis of
covariance was performed using the post-operative cognitive test scores as
continuous variables in covariance of the corresponding pre-operative
scores. Secondary endpoints were the MES rates and the number of acute
ischaemic lesions after CABG. Compared with the controls, cognitive
functioning of the DBT group was better in executive functioning (t =
2.525, P = 0.0065) and verbal short-term memory (t = 2.420, P = 0.009).
The Embol-X group did not perform better in any test. The total number of
MES was lower in the DBT group (median 99, P = 0.0019), but not in the
Embol-X group (median 162.5, P > 0.05), both compared with controls
(median 164.5). After surgery, 17 patients displayed small ischaemic brain
lesions on MRI with equal distribution between the
groups.ConclusionGaseous micro-embolization contributes to
neuropsychological decline, which is measurable 3 months post-operatively.
No filter device could protect the brain during CABG completely. However,
the use of the DBT tends to improve the cognitive outcome after CABG. Gas
filters are recommendable for neuroprotection during cardiac surgery.
<7>
Accession Number
2010050882
Authors
Gu S. Su P.-X. Liu Y. Yan J. Zhang X.-T. Wang T.-Y.
Institution
(Gu, Su, Liu, Yan, Zhang) Department of Cardiac Surgery, Beijing Chaoyang
Hospital, Capital Medical University, Beijing 100020, China.
(Wang) Department of Cardiothoracic Surgery, Beijing Friendship Hospital,
Capital Medical University, Beijing 100033, China.
Title
Low-dose amiodarone for the prevention of atrial fibrillation after
coronary artery bypass grafting in patients older than 70 years.
Source
Chinese Medical Journal. 122(24)(pp 2928-2932), 2009. Date of
Publication: 20 Dec 2009.
Publisher
Chinese Medical Association
Abstract
Background: Atrial fibrillation (AF) is one of the most common arrhythmia
after coronary artery bypass grafting (CABG), which not only increases the
suffering of the patients, but also prolongs hospital stay and enhances
cost of care, especially for patients older than 70 years. This study was
designed to evaluate the efficacy and safety of low-dose amiodarone in the
prevention of AF after CABG, especially for the elderly. Methods: Two
hundred and ten senile patients undergoing off-pump CABG were included in
this prospective, randomized, double-blind and placebo controlled study.
Patients were given 10 mg/kg of amiodarone (low-dose amiodarone group,
n=100) or placebo (control group, n=110) daily for 7 days before surgery
and followed by 200 mg of amiodarone or placebo daily for 10 days
postoperatively. Results: Postoperative AF occurred in 16 patients (16%)
receiving amiodarone and in 36 (37.7%) patients receiving placebo
(P=0.006). AF occurred at (58.13+/-16.63) hours after CABG in the low-dose
amiodarone group and at (45.03+/-17.40) hours in the control group
(P=0.018). The maximum ventricular rate during AF was significantly slower
in the low-dose amiodarone group ((121.42+/-28.91) beats/min) than in the
control group ((134.11+/-30.57) beats/min, P=0.036). The duration of AF
was (10.92+/-9.56) hours for the low-dose amiodarone group compared with
(14.81+/-10.37) hours for the control group (P=0.002). The postoperative
left ventricular ejection fraction (LVEF) was significantly improved in
the low-dose amiodarone group (from (59.9 +/-10.3)% to (63.4+/-11.4)%,
P=0.001), and significantly higher compared with the control group
((58.5+/-10.7)%, P=0.002). Both groups had a similar incidence of
complication other than rhythm disturbances (12.0% vs 16.4%, P=0.368). The
low-dose amiodarone group patients had shorter hospital stays
((11.8+/-3.2) days vs (13.8+/-4.7) days, P=0.001) and lower cost of care
(RMB (79 115+/-16 673) Yuan vs RMB (84 997+/-21 587) Yuan, P=0.031) than
that of control group patients. The in-hospital mortality was not
significantly different between the two groups (1.0% vs 0.9%, P=0.946).
Conclusions: Perioperative low-dose oral amiodarone appeared to be
cost-effective in the prevention and delay of new-onset postoperative AF
in aged patients. It significantly reduced ventricular rate and duration
of AF after CABG, decreased hospital cost and stay, as well as promoted
the amelioration of left ventricular systolic function. Furthermore,
low-dose amiodarone was safe to use and well tolerated with low toxic and
side effects, and did not increase the risk of complications and
mortality. It is proved to be a first-line therapy and as routine
prophylaxis for AF after CABG, especially for elderly patients complicated
with left ventricular dysfunction.
<8>
Accession Number
2010071935
Authors
Mkele G.
Title
Selective COX-2 inhibitors - Balancing risks and benefits.
Source
SA Pharmaceutical Journal. 76(10)(pp 30-31), 2009. Date of Publication:
November-December 2009.
Publisher
Medpharm Publications
Abstract
While selective inhibitors of cyclo-oxygenase 2 were developed to exploit
the therapeutic benefits of non-steroidal anti-inflammatory drugs while
avoiding their gastro-intestinal side-effects, they have been reported to
increase the risk of myocardial infarction and atherothrombotic events in
patients taking them on a chronic basis. The withdrawal of the COX-2
inhibitors namely rofecoxib, valdecoxib and lumiracoxib from the world
markets as a result of associated serious adverse effects, cast a shadow
on the safety of the entire class of COX-2 inhibitors and raised questions
on the inherent cardiovascular risk of the entire class in relation to
their potential benefits. Below is a brief review of the atherothrombotic
events associated with this class of drugs, the clinical trials that
brought these events to the fore and the current warnings for those
products still available on our markets.
<9>
Accession Number
2009652679
Authors
Nigwekar S.U. Navaneethan S.D. Parikh C.R. Hix J.K.
Institution
(Nigwekar) Department of Internal Medicine, Rochester General Hospital,
University of Rochester School of Medicine, Rochester, NY, United States.
(Navaneethan) Department of Nephrology and Hypertension, Glickman
Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, United
States.
(Parikh) Section of Nephrology, Yale School of Medicine, New Haven, CT,
United States.
(Hix) Department of Nephrology, Rochester General Hospital, University of
Rochester School of Medicine, Rochester, NY, United States.
Title
Atrial natriuretic peptide for management of acute kidney injury: A
systematic review and meta-analysis.
Source
Clinical Journal of the American Society of Nephrology. 4(2)(pp 261-272),
2009. Date of Publication: 01 Feb 2009.
Publisher
American Society of Nephrology
Abstract
Background and objectives: Randomized controlled trials (RCTs) with atrial
natriuretic peptide (ANP) have shown inconsistent effects for renal
end-points. The authors aimed to systematically review these trials to
ascertain the benefit of ANP in prevention and treatment of acute kidney
injury (AKI). Design, setting, participants, & measurements: The authors
searched MEDLINE, EMBASE, and Cochrane Renal Health Library that
investigated ANP in adult patients considered with or at risk for AKI.
Outcomes were analyzed separately for prevention and treatment of AKI.
Results: Nineteen RCTs (11 prevention, 8 treatment) involving 1861
participants were included. Pooled analysis of prevention trials showed a
trend toward reduction in renal replacement therapy in the ANP group (OR =
0.45, 95% CI, 0.21 to 0.99) and good safety profile, but no improvement in
mortality. For the treatment of established AKI, ANP, particularly in high
doses, was associated with a trend toward increased mortality and more
adverse events. Subgroup analysis of AKI after a major surgery (14 RCTs,
817 participants) showed a significant reduction in renal replacement
therapy requirement in the ANP group (OR = 0.49, 95% CI, 0.27 to 0.88).
Included RCTs were mostly low- or moderate-quality, underpowered studies.
Conclusions: There are an insufficient number of high-quality studies to
make any definite statement about the role of ANP in AKI. Analysis of the
existing literature suggests ANP might be associated with beneficial
clinical effects when administered in patients undergoing major surgery
such as cardiovascular surgery. Its use, in low doses, should be explored
further in this setting. Copyright copyright 2009 by the American Society
of Nephrology.
<10>
Accession Number
2010057539
Authors
Gong X. Su Y. Pan W. Cui J. Liu S. Shu X.
Institution
(Gong, Su, Cui, Liu, Shu) Department of Cardiology, Shanghai Institute of
Cardiovascular Disease, Fudan University, 180 Fenglin Road, Shanghai
200032, China.
(Pan) Department of Cardiology, Zhongshan Hospital, Shanghai, China.
Title
Is right ventricular outflow tract pacing superior to right ventricular
apex pacing in patients with normal cardiac function?.
Source
Clinical Cardiology. 32(12)(pp 695-699), 2009. Date of Publication:
December 2009.
Publisher
John Wiley and Sons Inc.
Abstract
Background: Whether right ventricular outflow tract (RVOT) pacing is
superior to right ventricular apex (RVA) pacing in terms of ventricular
synchrony, cardiac function, and remodeling in patients with normal
cardiac function is still unknown. Hypothesis: Right ventricular outflow
tract pacing is superior to RVA pacing in patients with normal cardiac
function. Methods: A total of 96 consecutive patients with high or
third-degree atrial ventricular block were enrolled and randomized into 2
groups: RVOT pacing group (n = 48) and RVA pacing group (n = 48). Tissue
Doppler imaging (TDI) and 2D echocardiography were performed to study left
ventricular (LV) systolic and diastolic synchrony, LV volumes, and
function. Results: Therewere no significant differencesin baseline
characteristicsbetweenthe 2 groups. Left ventricular systolic asynchrony
is more severe in the RVA pacing group than in the RVOT pacing group (P <
0.05), while diastolic synchrony is not significantly (NS) different
between the 2 groups after pacing. There were no significant differences
with respect to the mean myocardial systolic (Sm) and early diastolic
velocities (Em), LV ejection fraction, LV end-diastolic and systolic
volume in the 2 groups at 12 months of follow-up (all NS). Conclusions:
Although RVOT pacing caused more synchronous LV contraction compared with
RVA pacing, it had no benefit over RVA pacing in aspect of preventing
cardiac remodeling and preserving LV systolic function after 12 months of
pacing in patientswith normal cardiac function. copyright 2009Wiley
Periodicals, Inc.
<11>
Accession Number
2010038727
Authors
Kunt A.T. Akgun S. Atalan N. Bitir N. Arsan S.
Institution
(Kunt, Akgun, Atalan, Bitir) Department of Cardiovascular Surgery,
Bahcelievler Medicana Hospital, Istanbul, Turkey.
(Arsan) Department of Cardiovascular Surgery, Marmara University Medical
School, Istanbul, Turkey.
Title
Furosemide infusion prevents the requirement of renal replacement therapy
after cardiac surgery.
Source
Anadolu Kardiyoloji Dergisi. 9(6)(pp 499-504), 2009. Date of Publication:
2009.
Publisher
Aves Yayincilik
Abstract
Objective: Acute kidney injury (AKI) is a devastating complication
following cardiac surgery and the ideal management is controversial. This
prospective, randomized, open-label and double-blinded study analyzed the
renoprotective effects of furosemide infusion and intermittent bolus
therapy administered with dopamine infusion in cardiac surgical patients.
Methods: Between August 1, 2007 and July 31, 2008, 100 adult patients
undergoing elective coronary artery bypass surgery (CABG) surgery with
normal renal function (creatinine <1.4 mg/dl) were enrolled in the study.
The patients were randomized for the comparison of intermittent (Group 1,
n=50, 1mg-3mg/kg) and continuous infusion of furosemide (Group 2, n=50,
10mg/ml). Continuous variables were expressed as mean +/- SD and compared
by unpaired Student's t test or ANOVA for repeated measures. Statistical
significance was assumed if p value was <0.05. Results: Renal replacement
therapy (RRT) was used in 5% of patients (all in group 1, p=0.028). The
30-day mortality was 5%. Only 2 patients became hemodialysis dependent in
group 1. Group 2 patients showed a continuous and higher urine output
postoperatively than group 1 (p<0.001). Both groups had significant
increase in peak postoperative serum creatinine values (p<0.001), however
peak postoperative creatinine-clearance was significantly lower in group 1
(p<0.001). Conclusion: Acute kidney injury necessitating RRT makes a small
percentage of patients undergoing cardiac surgery and if RRT is not
required the survival is excellent. Continuous infusion of furosemide
seems to be effective in promoting diuresis and decreasing the need for
RRT. However further multicenter studies with different doses of
furosemide are required to confirm these results. copyright Copyright 2009
by AVES Yayincilik Ltd.
<12>
Accession Number
2010036990
Authors
Bonvini R.F. Sztajzel R. Dorsaz P.-A. Righini M. Bonvin C. Alibegovic J.
Sigwart U. Camenzind E. Verin V. Sztajzel J.
Institution
(Bonvini, Dorsaz, Alibegovic, Sigwart, Camenzind, Verin, Sztajzel)
Cardiology Service, University Hospital, Geneva, Switzerland.
(Sztajzel, Bonvin) Neurology Department, University Hospital, Geneva,
Switzerland.
(Righini) Angiology and Hemostasis Division, University Hospital, Geneva,
Switzerland.
Title
Incidence of atrial fibrillation after percutaneous closure of patent
foramen ovale and small atrial septal defects in patients presenting with
cryptogenic stroke.
Source
International Journal of Stroke. 5(1)(pp 4-9), 2010. Date of Publication:
February 2010.
Publisher
Blackwell Publishing Ltd
Abstract
Objective: The occurrence of atrial fibrillation after percutaneous
closure of a patent foramen ovale for cryptogenic stroke has been reported
in a variable percentage of patients. However, its precise incidence and
mechanism are presently unclear and remain to be elucidated. Design:
Prospective follow-up study. Patients: Ninety-two patients undergoing a
percutaneous patent foramen ovale closure procedure (closure group) for
cryptogenic stroke were compared with a similar group of 51 patients, who
were medically treated. Methods: A systematic arrhythmia follow-up
protocol to assess the incidence of AF was performed including a 7-day
event-loop recording at day 1, after 6 and 12 months in patients of the
closure group and compared with those of the medically treated group.
Results: The incidence of AF was similar in both study groups during a
follow-up of 12 months, including 7.6% (95% CI: 3.1-15.0%) in the closure
and 7.8% (95% CI: 2.18-18.9%) in the medically treated group (P=1.0). The
presence of a large patent foramen ovale was the only significant risk
factor for the occurrence of AF as demonstrated by a multivariate Cox
regression analysis (95% CI, 1.275-20.018; P=0.021). Conclusions: Our
findings indicate that patients with cryptogenic stroke and patent foramen
ovale have a rather high incidence of AF during a follow-up of 12 months.
Atrial fibrillation occurred with a similar frequency whether the patent
foramen ovale/atrial septal defect was successfully percutaneously closed
or was medically managed. The presence of a large patent foramen ovale was
the only significant predictor of AF occurrence during follow-up.
copyright 2010 The Authors. Journal compilation copyright 2010 World
Stroke Organization.
<13>
Accession Number
2010071839
Authors
Karahan S.C. Koramaz I. Altun G. Ucar U. Topbas M. Mentese A. Kopuz M.
Institution
(Karahan, Ucar, Mentese, Kopuz) Department of Biochemistry, Karadeniz
Technical University, Faculty of Medicine, TR61080 Trabzon, Turkey.
(Koramaz, Altun) Department of Cardiovascular Surgery, Karadeniz Technical
University, Trabzon, Turkey.
(Topbas) Department of Public Health, Faculty of Medicine, Karadeniz
Technical University, Trabzon, Turkey.
Title
Ischemia-modified albumin reduction after coronary bypass surgery is
associated with the cardioprotective efficacy of cold-blood cardioplegia
enriched with N-acetylcysteine: A preliminary study.
Source
European Surgical Research. 44(1)(pp 30-36), 2010. Date of Publication:
January 2010.
Publisher
S. Karger AG
Abstract
Background: The aims of this preliminary study were to determine the
alteration of serum ischemia-modified albumin (IMA) levels and to
investigate whether IMA may be used as an indicator of the
cardioprotective efficacy of N-acetylcysteine (NAC) in patients undergoing
coronary bypass grafting (CABG). Patients and Methods: Forty-four patients
were randomized into one of two groups on the basis of cardioplegic
strategies, either cold-blood cardioplegia enriched with NAC (50 mg/kg) or
cold-blood cardioplegia alone. Serum IMA, cardiac troponin T (cTnT) and
malondialdehyde (MDA) levels determined in NAC-enriched patients before
and after CABG were compared with those of the NAC-free group. The albumin
cobalt binding assay was used for IMA determination. Results: Serum IMA
levels were significantly elevated after cross-clamping and peaked at 6 h
after reperfusion in the two groups. In NAC-enriched patients, IMA levels
determined 6, 12, 24 and 48 h after reperfusion were significantly lower
than those of the NAC-free group (p [less-than or equal to] 0.001, p <
0.001, p < 0.001 and p < 0.001, respectively). IMA returned to baseline 24
h after reperfusion differently from cTnT and MDA in the NAC-enriched
group. Conclusions: IMA may be used as not only an indicator of myocardial
ischemia-reperfusion injury, but also as a useful indicator of the
cardioprotective effect of NAC in CABG. copyright 2009 S. Karger AG,
Basel.
<14>
Accession Number
2010075882
Authors
Wenwu Z. Debing Z. Renwei C. Jian L. Guangxian Y. Pingbo L. Xinmin Z.
Institution
(Wenwu, Debing, Renwei, Jian, Guangxian, Pingbo) Department of
Cardiothoracic Surgery, Hunan Children's Hospital, Changsha, Hunan, China.
(Xinmin) Department of Cardiothoracic Surgery, 2nd Xiangya Hospital,
Center South University, Changsha, Hunan, China.
Title
Limb ischemic preconditioning reduces heart and lung injury after an open
heart operation in infants.
Source
Pediatric Cardiology. 31(1)(pp 22-29), 2010. Date of Publication: January
2010.
Publisher
Springer New York
Abstract
Open heart surgery supported by cardiopulmonary bypass is associated with
heart and lung ischemia-reperfusion injury (IRI). Limb remote ischemic
preconditioning (RIPC) reduces injury caused by ischemia-reperfusion in
multiple distant organs. We conducted a prospective clinical trial
(randomized and controlled) to test the feasibility and safety of limb
RIPC, as well as its protective effects against myocardial and pulmonary
IRI for infants undergoing repair of simple congenital heart defects.
Infants undergoing repair of ventricular septal defects were enrolled in
our study and randomly assigned to one of two treatment groups: limb RIPC
or control. RIPC was induced twice (24 h and 1 h preoperatively) via three
5-min cycles of ischemia and reperfusion on the left upper arm using a
blood pressure cuff. Lung compliance, respiratory index (RI), and cardiac
inotropic score (IS) were calculated for each patient. Serum
concentrations of the following factors were measured perioperatively:
interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor (TNF)-alpha;
lactate dehydrogenase (LDH), creatine kinase (CK), and its isoenzyme
(CK-MB), and troponin I (TnI); malondialdehyde (MDA) and superoxide
dismutase (SOD). The expression of heat shock protein 70 (HSP 70) in
cardiomyocytes was analyzed by Western blot. Surgical outcomes, including
limb movement and sensory function, were recorded in detail. Sixty infants
weighting less than 7 kg were studied, with 30 patients in the RIPC group
and 30 in the control group. Within 6 months of discharge from the
hospital, no limb disability, sensory disturbance, or other surgical
complications were found in any patient. Compared with the control group,
patients in the RIPC group had higher Cs and Cd, along with lower RI and
IS at various postoperative phases. At the beginning of the operation,
serum concentrations of IL-6, IL-8, IL-10, TNF-alpha, LDH, CK, and TnI
were higher in the RIPC group than the control group. Postoperatively,
release of cytokines and leakage of heart enzymes were attenuated in the
RIPC group; serum concentrations of cytokines and heart enzymes were lower
in the RIPC group at some, but not all, postoperative time points.
Furthermore, the RIPC group had lower coronary sinus venous concentrations
of MDA and higher concentrations of SOD. Similarly, the expression of HSP
70 was upregulated in cardiomyocytes from the RIPC group. Limb RIPC can be
applied safely and easily in infants, can attenuate systemic inflammatory
response syndrome, and can increase systemic tolerance to IRI, imparting a
protective effect against myocardial and pulmonary IRI. The expression of
HSP 70 has an important role in the mechanism of action for RIPC.
copyright 2009 Springer Science+Business Media, LLC.
<15>
Accession Number
2010056670
Authors
Saso S. James D. Vecht J.A. Kidher E. Kokotsakis J. Malinovski V. Rao C.
Darzi A. Anderson J.R. Athanasiou T.
Institution
(Saso, James, Vecht, Kidher, Kokotsakis, Malinovski, Rao, Darzi, Anderson,
Athanasiou) Department of Biosurgery and Surgical Technology, and
Surgical, Epidemiology Unit, Imperial College London, London, United
Kingdom.
Title
Effect of Skeletonization of the Internal Thoracic Artery for Coronary
Revascularization on the Incidence of Sternal Wound Infection.
Source
Annals of Thoracic Surgery. 89(2)(pp 661-670), 2010. Date of Publication:
February 2010.
Publisher
Elsevier USA
Abstract
Use of the internal thoracic artery in coronary revascularization confers
excellent benefit. We assessed the impact of skeletonization on the
incidence of postoperative sternal wound infection in patients undergoing
coronary artery bypass grafting. We also investigated whether there is an
advantage in using this technique when harvesting both internal thoracic
arteries in high-risk groups, such as diabetic patients. Skeletonization
was associated with beneficial reduction in the odds ratio of sternal
wound infection (odds ratio, 0.41; 95% confidence interval, 0.26 to 0.64).
This effect was more evident when analyzing diabetic patients undergoing
bilateral internal thoracic artery grafting (odds ratio, 0.19; 95%
confidence interval, 0.10 to 0.34). copyright 2010 The Society of Thoracic
Surgeons.
<16>
[Use Link to view the full text]
Accession Number
2010048881
Authors
Kowey P.R. Dorian P. Mitchell L.B. Pratt C.M. Roy D. Schwartz P.J.
Sadowski J. Sobczyk D. Bochenek A. Toft E.
Institution
(Kowey) Division of Cardiovascular Disease, Lankenau Hospital, Institute
of Medical Research, Wynnewood PA, United States.
(Dorian) Division of Cardiology, St Michael's Hospital, University of
Toronto, Toronto, ON, Canada.
(Mitchell) Libin Cardiovascular Institute of Alberta, Calgary Health
Region, University of Calgary, Calgary, AB, Canada.
(Pratt) Baylor College of Medicine, Methodist Hospital, Houston, TX,
United States.
(Roy) Department of Medicine, Montreal Heart Institute, Universite de
Montreal, Montreal, QC, Canada.
(Schwartz) Department of Cardiology, University of Pavia, Fondazione IRCCS
Policlinico San Matteo, Pavia, Italy.
(Sadowski, Sobczyk) Cardiovascular Surgery and Transplantology Department,
Jagiellonian University, Krakow, Poland.
(Bochenek) First Department of Cardiac Surgery, Medical University of
Silesia, Katowice, Poland.
(Toft) Department of Health Science and Technology, Aalborg University and
Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Title
Vernakalant hydrochloride for the rapid conversion of atrial fibrillation
after cardiac surgery a randomized, double-blind, placebo-controlled
trial.
Source
Circulation: Arrhythmia and Electrophysiology. 2(6)(pp 652-659), 2009.
Date of Publication: December 2009.
Publisher
Lippincott Williams and Wilkins
Abstract
Background-Postoperative atrial arrhythmias are common and are associated
with considerable morbidity. This study was designed to evaluate the
efficacy and safety of vernakalant for the conversion of atrial
fibrillation (AF) or atrial flutter (AFL) after cardiac surgery. Methods
and Results-This was a prospective, randomized, double-blind,
placebo-controlled trial of vernakalant for the conversion of AF or AFL
after coronary artery bypass graft, valvular surgery, or both. Patients
were randomly assigned 2:1 to receive a 10-minute infusion of 3 mg/kg
vernakalant or placebo. If AF or AFL was present after a 15-minute
observation period, then a second 10-minute infusion of 2 mg/kg
vernakalant or placebo was given. The primary end point was the conversion
of postcardiac surgery AF or AFL to sinus rhythm within 90 minutes of
dosing. In patients with AF, 47 of 100 (47%) who received vernakalant
converted to SR compared with 7 of 50 (14%) patients who received placebo
(P<0.001). The median time to conversion was 12 minutes. Vernakalant was
not effective in converting postoperative AFL to sinus rhythm. Two serious
adverse events occurred within 24 hours of vernakalant administration
(hypotension and complete atrioventricular block). There were no cases of
torsades de pointes, sustained ventricular tachycardia, or ventricular
fibrillation. There were no deaths. Conclusions-Vernakalant was safe and
effective in the rapid conversion of AF to sinus rhythm in patients who
had AF after cardiac surgery. Copyright copyright 2009 American Heart
Association, Inc.
<17>
[Use Link to view the full text]
Accession Number
2010048878
Authors
Piccini J.P. Lopes R.D. Kong M.H. Hasselblad V. Jackson K. Al-Khatib S.M.
Institution
(Piccini, Lopes, Kong, Hasselblad, Jackson, Al-Khatib) Duke Clinical
Research Institute, PO Box 17969, Durham, NC 27715, United States.
Title
Pulmonary vein isolation for the maintenance of sinus rhythm in patients
with atrial fibrillation a meta-analysis of randomized, controlled trials.
Source
Circulation: Arrhythmia and Electrophysiology. 2(6)(pp 626-633), 2009.
Date of Publication: December 2009.
Publisher
Lippincott Williams and Wilkins
Abstract
Background-Catheter ablation is an established yet evolving
nonpharmacologic intervention for the maintenance of sinus rhythm in
patients with atrial fibrillation (AF). The efficacy and safety of
pulmonary vein isolation (PVI) compared with medical therapy remain in
question. Methods and Results-We conducted a meta-analysis of all
randomized, controlled trials comparing PVI and medical therapy for the
maintenance of sinus rhythm. The primary end point in this analysis was
freedom from recurrent AF at 12 months. The relative efficacy of PVI was
estimated using random-effects modeling according to intention to treat.
We identified 6 trials that randomized a total of 693 patients with AF to
PVI or control. PVI was associated with markedly increased odds of freedom
from AF at 12 months of follow-up (n=266/344 [77%] versus n 102/346 [29%];
odds ratio, 9.74; 95% CI, 3.98 to 23.87). When we excluded the trial that
only enrolled patients with persistent AF (Q-statistic, 2.485; P=0.647
after exclusion), PVI was associated with even greater odds of AF-free
survival (15.78; 95% CI, 10.07 to 24.73). PVI was associated with a
decreased hospitalization for cardiovascular causes (14 versus 93 per 100
person-years; rate ratio, 0.15; 95% CI, 0.10 to 0.23). Among those
randomly assigned to PVI, 17% required a repeat PVI ablation before 12
months. The rate of major complications was 2.6% (n=9/344) in the catheter
ablation group. Conclusions-Compared with a nonablation treatment
strategy, PVI results in dramatically increased freedom from AF at 1 year.
Although the procedure can be associated with major complications, the
risk of these complications is comparable to other interventional
procedures. (Circ Arrhythm Electrophysiol. 2009;2:626-633.) Copyright
copyright 2009 American Heart Association, Inc.
