EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 11

Results Generated From:
Embase <1980 to 2011 Week 38>
Embase (updates since 2011-09-15)

<1>
Accession Number
2011353422
Authors
Hatemi A.C. Ulusoy R.E. Gursoy M. Tongut A. Canikoglu M. Kaya A. Ay N.P.
Enar R. Sozer F.F. Karaoglu K. Kansiz E.
Institution
(Hatemi, Gursoy, Tongut, Canikoglu, Kansiz) Department of Cardiovascular
Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey
(Ulusoy) Department of Cardiology, Gulhane Military Medical Academy
Haydarpasa Training Hospital, Istanbul, Turkey
(Kaya) Department of Biochemistry Laboratory, Institute of Cardiology,
Istanbul University, Istanbul, Turkey
(Ay) Department of Public Health, Faculty of Medicine, Marmara University,
Istanbul, Turkey
(Enar) Department of Cardiology, Cerrahpasa Faculty of Medicine, Istanbul
University, Istanbul, Turkey
(Sozer, Karaoglu) Department of Anesthesiology and Reanimation, Institute
of Cardiology, Istanbul University, Istanbul, Turkey
Title
Myocardial protection with simultaneous antegrade/vein graft cardioplegia
compared to antegrade cardioplegia alone in elective coronary artery
bypass grafting patients.
Source
Balkan Medical Journal. 28 (1) (pp 75-79), 2011. Date of Publication:
2011.
Publisher
AVES Publishing Co. (Kizilelma CAD. 5/3, Findikzade- Istanbul 34096,
Turkey)
Abstract
Objective: Cardioplegia distribution beyond a stenotic coronary artery may
not be adequate. This problem can be overcome by direct delivery of
cardioplegia via the vein grafts anastomosed during the operation. The aim
of this study is to investigate the results of simultaneous antegrade/vein
graft cardioplegia versus antegrade cardioplegia alone in elective CABG
patients. Material and Methods: Forty consecutive patients were randomized
into the study group to whom antegrade/vein cardioplegia and to the
control group to whom only antegrade cardioplegia was given. Both groups
were similar with respect to demographic characteristics, postoperative
ECG changes and arrhythmia in the ICU, as well as in terms of operative
and postoperative variables (p>0.05). Results: All patients had excellent
operative and postoperative periods without any complications or death.
Release of total CK, CKMB, cTnI and lactate did not differ in the
preoperative and the frst 12^th hour (p>0.05) between the
groups, whereas in the study group a peak for total CK, CKMB, cTnI and
actate, consistent with myocardial injury (p<0.05), was found in the frst
24^th hour, which returned in the 48^th hour (p>0.05).
Conclusion: The primary fnding of this study is the inferiority of
myocardial protection with simultaneous antegrade/vein graft cardioplegia
compared with antegrade cardioplegia alone. Trakya University Faculty of
Medicine.

<2>
Accession Number
2011294372
Authors
Hatemi A.C. Ulusoy R.E. Gursoy M. Tongut A. Canikoglu M. Kaya A. Ay N.P.
Enar R. Sozer F.F. Karaoglu K. Kansiz E.
Institution
(Hatemi, Gursoy, Tongut, Canikoglu, Kansiz) Department of Cardiovascular
Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey
(Ulusoy) Department of Cardiology, Gulhane Military Medical Academy
Haydarpasa Training Hospital, Istanbul, Turkey
(Kaya) Department of Biochemistry Laboratory, Institute of Cardiology,
Istanbul University, Istanbul, Turkey
(Ay) Department of Public Health, Faculty of Medicine, Marmara University,
Istanbul, Turkey
(Enar) Department of Cardiology, Cerrahpasa Faculty of Medicine, Istanbul
University, Istanbul, Turkey
(Sozer, Karaoglu) Department of Anesthesiology and Reanimation, Institute
of Cardiology, Istanbul University, Istanbul, Turkey
Title
Myocardial protection with simultaneous antegrade/vein graft cardioplegia
compared to antegrade cardioplegia alone in elective coronary artery
bypass grafting patients.
Source
Balkan Medical Journal. 28 (1) (pp 75-79), 2011. Date of Publication:
2011.
Publisher
AVES Publishing Co. (Kizilelma CAD. 5/3, Findikzade- Istanbul 34096,
Turkey)
Abstract
Objective: Cardioplegia distribution beyond a stenotic coronary artery may
not be adequate. This problem can be overcome by direct delivery of
cardioplegia via the vein grafts anastomosed during the operation. The aim
of this study is to investigate the results of simultaneous antegrade/vein
graft cardioplegia versus antegrade cardioplegia alone in elective CABG
patients. Material and Methods: Forty consecutive patients were randomized
into the study group to whom antegrade/vein cardioplegia and to the
control group to whom only antegrade cardioplegia was given. Both groups
were similar with respect to demographic characteristics, postoperative
ECG changes and arrhythmia in the ICU, as well as in terms of operative
and postoperative variables (p>0.05). Results: All patients had excellent
operative and postoperative periods without any complications or death.
Release of total CK, CKMB, cTnI and lactate did not differ in the
preoperative and the first 12^th hour (p>0.05) between the
groups, whereas in the study group a peak for total CK, CKMB, cTnI and
lactate, consistent with myocardial injury (p<0.05), was found in the
first 24^th hour, which returned in the 48th hour (p>0.05).
Conclusion: The primary finding of this study is the inferiority of
myocardial protection with simultaneous antegrade/vein graft cardioplegia
compared with antegrade cardioplegia alone. Trakya University Faculty of
Medicine.

<3>
Accession Number
2011499618
Authors
Salgado Filho M.F. Cordeiro V.H. Mota S. Prota M. Lopez M.N. de Lara R.A.
Institution
(Salgado Filho, Cordeiro, Mota, Prota, Lopez, de Lara) Health from
Universidade Federal de Juiz de Fora, Anesthesiologist of INC/MS,
UNIPAC-JF, Brazil
Title
Comparison between the Hemodynamic Parameters of Rigid Laryngoscopy and
Lighted Stylet in Patients with Coronariopathies.
Source
Revista Brasileira de Anestesiologia. 61 (4) (pp 447-455), 2011. Date of
Publication: July-August 2011.
Publisher
Elsevier (P.O. Box 211, Amsterdam 1000 AE, Netherlands)
Abstract
Background and objectives: Anesthesiologists are responsible for airway
management whenever they assume the anesthesia of a patient. In this
study, we compare the hemodynamic parameters of rigid laryngoscopy and
lighted stylet in patients with coronariopathies. Patients and methods:
This randomized clinical trial included 40 patients undergoing myocardial
revascularization assigned into two groups: lighted stylet and rigid
laryngoscope. Besides time of tracheal intubation in each group, heart
rate, mean arterial pressure, changes in ST segment, and central venous
pressure were evaluated during patient preparation, 1 minute and 5 minutes
after anesthetic induction, and 1 minute after tracheal intubation.
Results: Both groups were homogenous regarding demographic data. Time of
tracheal intubation in the rigid laryngoscope group (24 +/- 5 sec) was
lower than that of the lighted stylet group (28 +/- 7 sec), but without
significance. Heart rate showed a reduction in both groups during
anesthetic induction (p < 0.05), but 1 minute after tracheal intubation
the heart rate increased to levels close to baseline levels in both groups
(p > 0.05). In the rigid laryngoscope group mean arterial pressure
increased after tracheal intubation to levels close to those observed
during patient preparation (p > 0.05), while in the lighted stylet group
mean arterial pressure remained below baseline levels (p < 0.05). Central
venous pressure increased on both groups at all times (p < 0.05).
Conclusions: It was possible to observe that both techniques are safe for
tracheal intubation in patients with coronariopathies. However, lighted
stylet has fewer repercussions on mean arterial pressure. 2011 Elsevier
Editora Ltda.

<4>
Accession Number
2011494713
Authors
Anselm D.D. Anselm A.H. Renaud J. Atkins H.L. De Kemp R. Burwash I.G.
Williams K.A. Guo A. Kelly C. Dasilva J. Beanlands R.S.B. Glover C.A.
Institution
(Anselm, Anselm, Renaud, De Kemp, Burwash, Williams, Guo, Kelly, Dasilva,
Beanlands, Glover) Department of Medicine, Division of Cardiology,
University of Ottawa Heart Institute, 40 Ruskin St., Ottawa, ON K1Y 4WY,
Canada
(Anselm) Queen's University, School of Medicine, Kingston, ON, Canada
(Atkins) Division of Haematology, Department of Medicine, Ottawa Hospital,
Ottawa, ON, Canada
Title
Altered myocardial glucose utilization and the reverse mismatch pattern on
rubidium-82 perfusion/F-18-FDG PET during the sub-acute phase following
reperfusion of acute anterior myocardial infarction.
Source
Journal of Nuclear Cardiology. 18 (4) (pp 657-667), 2011. Date of
Publication: August 2011.
Publisher
Springer New York (233 Springer Street, New York NY 10013-1578, United
States)
Abstract
Background: Reperfused myocardium post-acute myocardial infarction (AMI)
may have altered metabolism with implications for therapy response and
function recovery. We explored glucose utilization and the "reverse
mismatch" (RMM) pattern (decreased F-18-fluorodeoxyglucose (FDG) uptake
relative to perfusion) in patients who underwent mechanical reperfusion
with percutaneous coronary intervention (PCI) for AMI. Methods and
Results: Thirty-one patients with anterior wall AMI treated with acute
reperfusion, with left ventricular ejection fraction <=45%, underwent rest
rubidium-82 (Rb-82) and FDG PET 2-10 days post-AMI. Resting
echocardiograms were used to assess wall motion abnormalities. Significant
RMM occurred in 15 (48%) patients and was associated with a shorter time
to PCI of 2.9 hours (2.2, 13.3 hours) compared to patients without
significant RMM: 11.4 hours (3.9, 22.4 hours) (P = .03). Within the
peri-infarct regions, segments with significant RMM were more likely to
have wall motion abnormalities (OR = 2.3 (1.1, 4.7), P = .02) compared to
segments without significant RMM. Conclusions: RMM is a common pattern on
perfusion/FDG PET during the sub-acute phase following reperfusion of AMI
and is associated with shorter times to PCI. Within the peri-infarct
region, RMM occurs frequently and is more often associated with wall
motion abnormalities than segments without RMM. Whether this represents a
myocardial metabolic shift during the sub-acute phase of recovery warrants
further study. 2011 American Society of Nuclear Cardiology.

<5>
Accession Number
2011495790
Authors
Chen Y.-F. Redetzke R.A. Sivertson R.M. Coburn T.S. Cypher L.R. Gerdes
A.M.
Institution
(Chen, Redetzke, Sivertson, Coburn, Cypher, Gerdes) Cardiovascular Health
Research Center, Sanford Research/University of South Dakota, 1100 East
21st Street, Sioux Falls, SD 57105, United States
Title
Post-myocardial infarction left ventricular myocyte remodeling: Are there
gender differences in rats?.
Source
Cardiovascular Pathology. 20 (5) (pp e189-e195), 2011. Date of
Publication: September-October 2011.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
Background: Previous studies have shown gender differences in left
ventricular remodeling after myocardial infarction. Results are varied,
however, and reliable, comprehensive data for changes in cardiac myocyte
shape are not available. Methods: Young adult female and male
Sprague-Dawley rats were used in this study and randomly assigned to the
myocardial infarction and sham myocardial infarction groups. Myocardial
infarction was produced by ligation of the left descending coronary
artery. Four weeks after surgery, left ventricular echocardiography and
hemodynamics were performed before isolating myocytes for size
determination. Results: In general, left ventricular functional changes
after myocardial infarction were comparable. Females developed slightly,
but significantly, more left ventricular hypertrophy than males, and this
was reflected by the relative increases in left ventricular myocyte
volume. In both males and females, however, myocyte hypertrophy was due
exclusively to lengthening of myocytes with no change in myocyte
cross-sectional area. Conclusions: This study demonstrates that
post-myocardial infarction changes in LV function and myocyte remodeling
are remarkably similar in young adult male and female rats. 2011 Elsevier
Inc. All rights reserved.

<6>
Accession Number
2011505643
Authors
Morel J. Salard M. Castelain C. Bayon M.C. Lambert P. Vola M. Auboyer C.
Molliex S.
Institution
(Morel, Salard, Castelain, Bayon, Lambert, Auboyer, Molliex) Departement
d'Anesthesie Reanimation, Centre Hospitalier Universitaire de Saint
Etienne, F-42055 Saint Etienne, France
(Vola) Departement de Chirurgie Cardio-vasculaire, Centre Hospitalier
Universitaire de Saint Etienne, F-42055 Saint Etienne, France
Title
Haemodynamic consequences of etomidate administration in elective cardiac
surgery: A randomized double-blinded study.
Source
British Journal of Anaesthesia. 107 (4) (pp 503-509), 2011. Date of
Publication: October 2011.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Background The consequences of inhibition of cortisol synthesis by a
single dose of etomidate on subsequent vasopressor drug usage and the
duration of relative adrenal insufficiency (RAI) after cardiac surgery are
not known. Methods This was a prospective, randomized, double-blinded
controlled trial of 100 patients undergoing elective cardiac surgery and
receiving either etomidate or propofol at induction of anaesthesia. A
short corticotropin test was performed 12, 24, and 48 h after anaesthesia
induction. RAI was defined as a response <250 nmol litre^-1.
Results The mean (sd) norepinephrine infusion rate during the first 48
postoperative hours was 0.11 (0.01) and 0.11 (0.01) mug kg^-1
min^-1 in the etomidate and propofol groups, respectively
(P=0.89). Time to norepinephrine withdrawal was similar between the
groups. The incidence of RAI was higher in the etomidate group at 12 h
(100 vs 41, P<0.001) and 24 h (85 vs 25, P<0.001). Conclusions A single
bolus of etomidate blunts the hypothalamicpituitaryadrenal axis response
for more than 24 h in patients undergoing elective cardiac surgery, but
this was not associated with an increase in vasopressor requirements.
2011 The Author.

<7>
Accession Number
21597409
Authors
Holinski S. Claus B. Alaaraj N. Dohmen P.M. Neumann K. Uebelhack R.
Konertz W.
Institution
(Holinski, Claus, Alaaraj, Dohmen, Konertz) Department of Cardiovascular
Surgery, Charite Hospital, Medical University, Schumannstr. 20/21, Berlin
10117, Germany
(Neumann) Department of Biometry, Charite Hospital, Medical University,
Berlin, Germany
(Uebelhack) Department of Psychiatry, Charite Hospital, Medical
University, Berlin, Germany
Title
Cerebroprotective effect of piracetam in patients undergoing open heart
surgery.
Source
Annals of Thoracic and Cardiovascular Surgery. 17 (2) (pp 137-142), 2011.
Date of Publication: April 2011.
Publisher
Japanese Association for Coronary Artery Surgery (2-1 Nibancho,
Chiyoda-ku, Tokyo 102-0084, Japan)
Abstract
Objectives: Reduction of cognitive function is a possible side effect
after the use of cardiopulmonary bypass (CPB) during cardiac surgery.
Since it has been proven that piracetam is cerebroprotective in patients
undergoing coronary bypass surgery, we investigated the effects of
piracetam on the cognitive performance of patients undergoing open heart
surgery. Methods: Patients scheduled for elective open heart surgery were
randomized to the piracetam or placebo group in a double-blind study.
Patients received 12 g of piracetam or placebo at the beginning of the
operation. Six neuropsychological subtests from the Syndrom Kurz Test and
the Alzheimer's Disease Assessment Scale were performed preoperatively and
on day 3, post-operatively. To assess the overall cognitive function and
the degree of cognitive decline across all tests after the surgery, we
combined the six test-scores by principal component analysis. Results: A
total of 88 patients with a mean age of 67 years were enrolled into the
study. The mean duration of CPB was 110 minutes. Preoperative clinical
parameters and overall cognitive functions were not significantly
different between the groups. The postoperative combined score of the
neuropsychological tests showed deterioration of cognitive function in
both groups (piracetam: preoperative 0.19 +/- 0.97 vs. postoperative -0.97
+/- 1.38, p <0.0005 and placebo: preoperative -0.14 +/- 0.98 vs.
postoperative -1.35 +/- 1.23, p <0.0005). Patients taking piracetam did
not perform better than those taking placebo, and both groups had the same
decline of overall cognitive function (p = 0.955). Conclusion: Piracetam
had no cerebroprotective effect in patients undergoing open heart surgery.
Unlike the patients who underwent coronary surgery, piracetam did not
reduce the early postoperative decline of neuropsychological abilities in
heart valve patients. 2011 The Editorial Committee of Annals of Thoracic
and Cardiovascular Surgery.

<8>
Accession Number
2011483532
Authors
Song J.E. Kang W.S. Kim D.K. Yoon T.G. Kim T.Y. Bang Y.-S. Kim S.H.
Institution
(Song, Kang, Kim, Yoon, Kim, Kim) Department of Anaesthesiology and Pain
Medicine, Konkuk University School of Medicine, Seoul, South Korea
(Bang) Department of Anaesthesiology and Pain Medicine, CHA Bundang
Medical Centre, CHA University, Seongnam, South Korea
Title
The effect of ulinastatin on postoperative blood loss in patients
undergoing open heart surgery with cardiopulmonary bypass.
Source
Journal of International Medical Research. 39 (4) (pp 1201-1210), 2011.
Date of Publication: 2011.
Publisher
Field House Publishing (6 Sompting Ave, Worthing BN14 8HN, United Kingdom)
Abstract
This prospective, randomized, doubleblind study evaluated the effect of
ulinastatin on postoperative blood loss and transfusion requirements of
patients undergoing open-heart surgery with cardiopulmonary bypass (CPB)
and aortic cross-clamping (ACC). CPB and ACC produce variable systemic
inflammatory reactions that are associated with multiorgan dysfunction via
leucocytes, especially polymorphonuclear neutrophils (PMNs). PMNs increase
blood loss and transfusion requirements. Ulinastatin, a urinary trypsin
inhibitor, inhibits PMN activity and reduces the systemic inflammatory
response. Patients received either 5000 U/kg ulinastatin or the equivalent
volume of normal saline (control group) before ACC. Postoperative blood
loss and transfusion requirements were recorded. Duration of intubation
and length of stay in the intensive care unit (ICU) were also noted. There
were no statistically significant between-group differences in
postoperative blood loss and transfusion requirements. Ulinastatin caused
a non-significant decrease in duration of intubation. Patients who
received ulinastatin had significantly shorter ICU stays than control
patients. 2011 Field House Publishing LLP.

<9>
Accession Number
2011483528
Authors
Shi M. Huang J. Pang L. Wang Y.
Institution
(Shi, Huang, Pang, Wang) Department of Cardiac and Chest Surgery, Huashan
Hospital Affiliated to Fudan University, Shanghai, China
Title
Preoperative insertion of an intra-aortic balloon pump improved the
prognosis of high-risk patients undergoing off-pump coronary artery bypass
grafting.
Source
Journal of International Medical Research. 39 (4) (pp 1163-1168), 2011.
Date of Publication: 2011.
Publisher
Field House Publishing (6 Sompting Ave, Worthing BN14 8HN, United Kingdom)
Abstract
This study investigated the efficacy and safety of preoperative insertion
of an intra-aortic balloon pump (IABP) in highrisk coronary
atherosclerotic disease patients undergoing off-pump coronary artery
bypass grafting (OPCAB). A total of 232 patients were recruited to the
study, of whom 107 underwent percutaneous insertion of an IABP prior to
OPCAB. The remaining 125 patients underwent OPCAB alone. Pre-, peri- and
postoperative parameters were compared between the two groups.
Preoperative insertion of an IABP was associated with a shorter stay in
intensive care, decreased incidence of postoperative dialysis and acute
heart failure, and a reduction in postoperative mortality compared with
OPCAB alone. There were no between-group differences in terms of
haematocrit level, number of distal anastomoses, volume of postoperative
drainage or incidence of reoperation for bleeding and postoperative
stroke/cerebrovascular accident. In conclusion, preoperative insertion of
an IABP improved the prognosis of high-risk CAD patients undergoing OPCAB.
2011 Field House Publishing LLP.

<10>
Accession Number
2011501917
Authors
Ryder R.E.J.
Institution
(Ryder) Diabetes and Endocrine Unit, City Hospital, Dudley Road,
Birmingham B18 7QH, United Kingdom
Title
Pioglitazone: An agent which reduces stroke, myocardial infarction and
death and is also a key component of the modern paradigm for the optimum
management of type 2 diabetes.
Source
British Journal of Diabetes and Vascular Disease. 11 (3) (pp 113-120),
2011. Date of Publication: May-June 2011.
Publisher
SAGE Publications Ltd (55 City Road, London EC1Y 1SP, United Kingdom)
Abstract
A randomised controlled trial (RCT), the PROactive study, was undertaken
to see if pioglitazone improved cardiovascular outcomes in type 2
diabetes. Initially the results were controversial and pioglitazone was
not widely recognised as a beneficial agent for cardiovascular disease. A
meta-analysis of rosiglitazone studies raising the possibility that it was
associated with cardiovascular harm received worldwide media attention and
the negative concern spread to involve pioglitazone through presumed
'class-effect'. A careful re-look at the detail of the PROactive's primary
composite endpoint, which led to the controversy over the outcome,
suggests that medical statistics may have been inadequate to reveal the
real clinical effect. A number of other studies support the interpretation
that pioglitazone significantly improves cardiovascular outcomes. While
the potential risk:benefit of pioglitazone needs to be acknowledged, it
now also needs to be recognised that pioglitazone and metformin are the
only glucose-lowering agents with RCT data demonstrating a reduction in
stroke, myocardial infarction and death in type 2 diabetes. Furthermore
there now exists a strong case that even in type 2 diabetes patients
without known cardiovascular disease, the modern paradigm for management
should involve the combination of metformin, pioglitazone and
glucagon-like peptide 1 agonists used early and aggressively to achieve a
target glycated haemoglobin A_1C <6%. The Author(s), 2011.

<11>
Accession Number
70527117
Authors
Benck U. Schemmer P. Stockle A. Hoeger S. Yard B.A. Kramer B.K. Schnuelle
P.
Institution
(Benck, Stockle, Hoeger, Yard, Kramer, Schnuelle) University Medical
Centre Mannheim, 5th Department of Medicine, Mannheim, Germany
(Schemmer) Liver Transplant Center, Heidelberg University Hospital,
Heidelberg, Germany
Title
Donor dopamine does not affect graft survival after liver transplantation:
Data from a randomized controlled trial.
Source
Transplant International. Conference: 15th Congress of the European
Society for Organ Transplantation, ESOT and 22nd Annual Conference of the
British Society for Histocompatibility and Immunogenetics, BSHI Glasgow
United Kingdom. Conference Start: 20110904 Conference End: 20110907.
Conference Publication: (var.pagings). 24 (pp 11), 2011. Date of
Publication: September 2011.
Publisher
Blackwell Publishing Ltd
Abstract
Background: Treatment of the deceased heart-beating donor with low-dose
dopamine results in less dialysis requirement after kidney transplantation
and appears to improve the outcome after heart transplantation. This study
investigates the clinical course of liver allografts from multi-organ
donors that were enrolled in the randomized dopamine trial
(clinicaltrials.gov Identifier: NCT00115115). Methods: Between March 2004
and August 2007, 264 brain-dead donors were randomly assigned to receive
or to not receive low-dose dopamine. Eligibility criteria included
circulatory stability under low-dose norepinephrine. The present study is
nested in the randomized controlled trial of donor pretreatment with
dopamine. We assessed the outcomes of 197 liver transplants performed at
32 European centers. Results: Dopamine was infused at 4mug/kg/min for a
median duration of 362 minutes (IQR 182 minutes). Donors and recipients
were very similar in baseline characteristics. Thirty-four recipients
(16.8%) were transplanted with high urgency and 23 (11.7%) received a
repeat transplant. Pretransplant MELD score was not different in
recipients of a dopamine treated vs. untreated graft (18+/-8 vs. 19+/-9,
p=0.28). Mean cold ischemic time was 632+/-172 vs. 600+/-170 minutes
(p=0.20). Following transplantation, no differences occurred in
biopsyproven rejection episodes (15.3% vs. 17.2%, p=0.85), requirement of
hemofiltration (27.6% vs. 27.3%, p=0.99), and in-hospital mortality (13.3%
vs. 12.1%, p=0.85). Graft survival was 72.5% vs. 74.8% and 61.2% vs. 63.6%
at one and three years. Conclusion: Contrasting heart and kidney
transplantation, donor pretreatment with dopamine does not improve the
outcome after liver transplantation. Since liver cells specifically
express s-COMT with high activity, dopamine is rapidly degraded in-vivo,
which most likely abrogates its potential to protect the liver graft from
oxidative stress under cold storage conditions.

EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 13

Results Generated From:
Embase <1980 to 2011 Week 37>
Embase (updates since 2011-09-09)

<1>
Accession Number
2011478563
Authors
Sezai A. Wakui S. Akiyama K. Hata M. Yoshitake I. Unosawa S. Shiono M.
Hirayama A.
Institution
(Sezai, Wakui, Akiyama, Hata, Yoshitake, Unosawa, Shiono) Department of
Cardiovascular Surgery, Nihon University School of Medicine, 30-1
Oyaguchikamimachi, Itabashi-ku, Tokyo 173-8610, Japan
(Hirayama) Department of Cardiology, Nihon University School of Medicine,
Tokyo, Japan
Title
Myocardial protective effect of human atrial natriuretic peptide in
cardiac surgery: "hANP shot" in clinical safety trial.
Source
Circulation Journal. 75 (9) (pp 2144-2150), 2011. Date of Publication:
September 2011.
Publisher
Japanese Circulation Society (14 Yoshida Kawaharacho, Sakyo-ku, Kyoto 606,
Japan)
Abstract
Background: We studied low-dose human atrial natriuretic peptide (hANP)
infusion therapy during cardiac surgery and reported the cardiac and renal
protective effects. The efficacy of a bolus injection of hANP (the "hANP
shot") simultaneously with induction of cardioplegia has been proven in
animal experiments. In the present study the clinical effects of this
"hANP shot" were examined. Methods and Results: The subjects were 67
patients undergoing Coronary artery bypass grafting. At the time of
inducing cardioplegia, 1 group received a simultaneous bolus injection of
100 mug of hANP (hANP group) and the other group received an injection of
physiological saline (placebo group). The primary endpoints were (1)
operative mortality and complications, and (2) the creatine kinase
isoenzyme MB (CPK-MB), troponin-I, and human heart fatty acid binding
protein (H-FABP) levels. The secondary endpoints were (1) the incidence of
arrhythmia, and levels of (2) atrial and B-type natriuretic peptides, and
cyclic guanosine monophosphate (cGMP), and (3) renin, angiotensin II, and
aldosterone. Postoperative CPK-MB, troponin-I, and H-FABP levels were
significantly lower in the hANP group than in the placebo group.
Postoperative arrhythmia was significantly less frequent in the hANP group
than in the placebo group. Conclusions: It is possible to achieve
cardioprotective effects based on the safety of the "hANP shot", as well
as from biomarkers of ischemia and results related to arrhythmia. The
"hANP shot" should also be evaluated as a safer and new cardioprotective
method for cardiac surgery.

<2>
Accession Number
2011478553
Authors
Kohro T. Yamazaki T. Izumi T. Daida H. Kurabayashi M. Miyauchi K. Tojo T.
Nagai R.
Institution
(Kohro) Department of Translational Research for Healthcare and Clinical
Science, Graduate School of Medicine, The University of Tokyo, Tokyo,
Japan
(Yamazaki) Department of Clinical Epidemiology and Systems, Graduate
School of Medicine, The University of Tokyo, Tokyo, Japan
(Izumi, Tojo) Department of Cardioangiology, Kitasato University School of
Medicine, Kanagawa, Japan
(Daida, Miyauchi) Department of Cardiology, Juntendo University School of
Medicine, Tokyo, Japan
(Kurabayashi) Department of Medicine and Biological Science, Graduate
School of Medicine, University of Gunma, Gunma, Japan
(Nagai) Department of Cardiovascular Medicine, Graduate School of
Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655,
Japan
Title
Intensively lowering both low-density lipoprotein cholesterol and blood
pressure does not reduce cardiovascular risk in japanese coronary artery
disease patients.
Source
Circulation Journal. 75 (9) (pp 2062-2070), 2011. Date of Publication:
September 2011.
Publisher
Japanese Circulation Society (14 Yoshida Kawaharacho, Sakyo-ku, Kyoto 606,
Japan)
Abstract
Background: Despite mounting evidence of the benefit of intensive lowering
of low-density lipoprotein-cholesterol (LDL-C) in coronary artery disease
(CAD) patients, it has not been shown that intensive lowering of both
LDL-C and blood pressure (BP) reduces cardiovascular events in these
patients. Methods and Results: 498 patients with hypertension and
hypercholesterolemia with >=75% stenosis in at least one major coronary
artery, were recruited from 17 cardiovascular centers in eastern Japan.
Patients were randomly assigned to conventional therapy (CT) or intensive
therapy (IT). CT aimed to reduce BP to <140/90 mmHg and LDL-C to <100
mg/dl, and IT aimed for <120/80 mmHg and <80 mg/dl, respectively. The
primary endpoint was a composite of all deaths, non-fatal myocardial
infarction, unstable angina pectoris, coronary artery bypass graft
surgery, non-fatal stroke, non-fatal major vascular disease, and
peripheral artery disease. The mean follow-up period was 3.2 years. The
achieved systolic BP was 126.8 mmHg for the CT group, and 121.3 mmHg for
the IT group (P<0.001). The achieved LDL-C was 92.1 mg/dl for the CT
group, and 79.6 mg/dl for the IT group (P<0.001). We detected the primary
endpoint in 18 (7.1%) patients in the CT group, and 26 (10.7%) in the IT
group (hazard ratio 1.53, 95% confidence interval 0.84-2.80, P=0.164).
Conclusions: We could not show that intensively lowering both BP and LDL-C
reduced cardiovascular risks in Japanese CAD patients with hypertension
and hypercholesterolemia (UMIN-CTR UMIN000000571).

<3>
Accession Number
2011487948
Authors
Takagi H. Umemoto T.
Institution
(Takagi, Umemoto) Department of Cardiovascular Surgery, Shizuoka Medical
Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan
Title
Intracoronary stem cell injection improves left ventricular remodeling
after acute myocardial infarction: An updated meta-analysis of randomized
trials.
Source
International Journal of Cardiology. 151 (2) (pp 226-228), 2011. Date of
Publication: 01 Sep 2011.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)

<4>
Accession Number
2011483533
Authors
Kim D.H. Park S.Y. Cho H.B. Park S.K. Kang M. Hong Y.S. Hong Y.W.
Institution
(Kim, Park, Cho, Park, Kang, Hong) Department of Anaesthesiology and Pain
Medicine, Ajou University School of Medicine, Suwon, South Korea
(Hong) Department of Thoracic and Cardiovascular Surgery, Ajou University
School of Medicine, Suwon, South Korea
Title
Haemodynamic changes during left anterior descending artery exposure in
off-pump coronary artery bypass: Comparison between use of moist
laparotomy pads and deep pericardial traction sutures for heart
displacement.
Source
Journal of International Medical Research. 39 (4) (pp 1211-1218), 2011.
Date of Publication: 2011.
Publisher
Field House Publishing (6 Sompting Ave, Worthing BN14 8HN, United Kingdom)
Abstract
Haemodynamic changes occurring during heart displacement, using moist
laparotomy pads placed behind the heart (PAD group, n = 26) or deep
pericardial traction sutures (DPS group, n = 25) to facilitate exposure of
the left anterior descending artery during off-pump coronary artery bypass
surgery, were compared. Haemodynamic variables were assessed before and 10
min after displacement of the heart. The central venous pressure, mean
pulmonary artery pressure and pulmonary capillary wedge pressure increased
in both groups. After heart displacement in the PAD group, the cardiac
index, stroke volume index, mixed venous oxygen saturation, right
ventricular ejection fraction and left ventricular stroke work index
decreased significantly, and the systemic vascular resistance and
pulmonary vascular resistance increased significantly; these parameters
remained unchanged in the DPS group. It was concluded that displacement of
the heart using moist laparotomy pads caused significant haemodynamic
derangement compared with that caused by deep pericardial traction
sutures. 2011 Field House Publishing LLP.

<5>
Accession Number
2011482531
Authors
Peiris C.L. Taylor N.F. Shields N.
Institution
(Peiris, Taylor, Shields) Musculoskeletal Research Centre, School of
Physiotherapy, La Trobe University, VIC, Australia
(Peiris, Taylor) Allied Health Clinical Research Office, Eastern Health
Level 2, Box Hill, 5 Arnold St, VIC 3128, Australia
Title
Extra physical therapy reduces patient length of stay and improves
functional outcomes and quality of life in people with acute or subacute
conditions: A systematic review.
Source
Archives of Physical Medicine and Rehabilitation. 92 (9) (pp 1490-1500),
2011. Date of Publication: September 2011.
Publisher
W.B. Saunders (Independence Square West, Philadelphia PA 19106-3399,
United States)
Abstract
Objectives: To investigate whether extra physical therapy intervention
reduces length of stay and improves patient outcomes in people with acute
or subacute conditions. Data Sources: Electronic databases CINAHL,
MEDLINE, AMED, PEDro, PubMed, and EMBASE were searched from the earliest
date possible through May 2010. Additional trials were identified by
scanning reference lists and citation tracking. Study Selection:
Randomized controlled trials evaluating the effect of extra physical
therapy on patient outcomes were included for review. Two reviewers
independently applied the inclusion and exclusion criteria, and any
disagreements were discussed until consensus could be reached. Searching
identified 2826 potentially relevant articles, of which 16 randomized
controlled trials with 1699 participants met inclusion criteria. Data
Extraction: Data were extracted using a predefined data extraction form by
1 reviewer and checked for accuracy by another. Methodological quality of
trials was assessed independently by 2 reviewers using the PEDro scale.
Data Synthesis: Pooled analyses with random effects model to calculate
standardized mean differences (SMDs) and 95% confidence intervals (CIs)
were used in meta-analyses. When compared with standard physical therapy,
extra physical therapy reduced length of stay (SMD=-.22; 95% CI, -.39 to
-.05) (mean difference of 1d [95% CI, 01] in acute settings and mean
difference of 4d [95% CI, 07] in rehabilitation settings) and improved
mobility (SMD=.37; 95% CI,.05.69), activity (SMD=.22; 95% CI,.07.37), and
quality of life (SMD=.48; 95% CI,.29.68). There were no significant
changes in self-care (SMD=.35; 95% CI, -.06.77). Conclusions: Extra
physical therapy decreases length of stay and significantly improves
mobility, activity, and quality of life. Future research could address the
possible benefits of providing extra services from other allied health
disciplines in addition to physical therapy. 2011 American Congress of
Rehabilitation Medicine.

<6>
Accession Number
2011484745
Authors
Zimmerman L. Barnason S. Hertzog M. Young L. Nieveen J. Schulz P. Tu C.
Institution
(Zimmerman, Barnason, Hertzog, Young, Nieveen, Schulz) College of Nursing,
University of Nebraska Medical Center, Lincoln, NE, United States
(Tu) College of Pharmacy, University of New England, Biddeford, ME, United
States
Title
Gender differences in recovery outcomes after an early recovery symptom
management intervention.
Source
Heart and Lung: Journal of Acute and Critical Care. 40 (5) (pp 429-439),
2011. Date of Publication: September-October 2011.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Background: Despite known gender differences in recovery, few studies have
examined symptom management (SM) interventions or responses by gender
after coronary artery bypass surgery (CABS). Objective: The purpose of
this subanalysis was to describe and evaluate differences in response by
gender to an SM intervention on the presence and burden of symptoms,
physical activity, and physical functioning in elderly CABS patients
during the early discharge period (3 and 6 weeks after CABS, and 3 and 6
months after CABS). Methods: The parent study whose data were analyzed to
examine gender differences involved a two-group, randomized clinical trial
design. The 6-week early recovery SM telehealth intervention was delivered
by the Health Buddy. Measures included the Cardiac Symptom Survey, a
Modified 7-Day Activity Interview, an RT3 accelerometer, an Activity
Diary, and the Medical Outcomes Study Short Form 36. This study was not
powered for a gender x group analysis, and we used descriptive statistics,
chi² tests, t tests, and analysis of variance for statistical
analyses. Results: Subjects (n = 232) included 192 men and 40 women, with
a mean age of 71.2 SD, 7 years. The intervention group consisted of 86 men
and 23 women, and the usual care (UC) group consisted of 106 men and 17
women. Data trends suggest that the SM intervention exerted greater impact
on women than on men for symptoms such as fatigue, depression, sleep
problems, and pain. Again, men exhibited higher levels of physical
activity than did women. However, women in the SM group generally had
higher scores than did women in the UC group. Conclusion: Although the
parent study found no effect of an early recovery SM intervention, this
exploratory secondary analysis indicated that women in the intervention
group demonstrated more improvement in measures of physical activity than
did those in the UC group. Further study, using a larger sample, is
necessary to test these preliminary results. 2011 Elsevier Inc.

<7>
[Use Link to view the full text]
Accession Number
2011486009
Authors
Lazar H.L. McDonnell M.M. Chipkin S. Fitzgerald C. Bliss C. Cabral H.
Institution
(Lazar, Fitzgerald) Departments of Cardiothoracic Surgery, Boston Medical
Center, 88 E Newton St, Boston, MA 02118, United States
(McDonnell) Division of Endocrinology, United States
(Bliss, Cabral) Department of Biostatistics, Boston University School of
Medicine, Boston Medical Center, Boston, MA, United States
(Chipkin) Department of Exercise Science, University of Massachusetts
Amherst, Amherst, MA, United States
Title
Effects of aggressive versus moderate glycemic control on clinical
outcomes in diabetic coronary artery bypass graft patients.
Source
Annals of Surgery. 254 (3) (pp 458-464), 2011. Date of Publication:
September 2011.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Objective: This study sought to determine whether aggressive glycemic
control (90-120 mg/dL) would result in more optimal clinical outcomes and
less morbidity than moderate glycemic control (120-180 mg/dL) in diabetic
patients undergoing coronary artery bypass graft (CABG) surgery. Summary
of Background Data: Maintaining serum glucose levels between 120 and 180
mg/dL with continuous insulin infusions decreases morbidity in diabetic
patients undergoing CABG surgery. Studies in surgical patients requiring
prolonged ventilation suggest that aggressive glycemic control (<120
mg/dL) may improve survival; however, its effect in diabetic CABG patients
is unknown. Methods: Eighty-two diabetic patients undergoing CABG were
prospectively randomized to aggressive glycemic control (90-120 mg/dL) or
moderate glycemic control (120-180 mg/dL) using continuous intravenous
insulin solutions (100 units regular insulin in 100 mL: normal saline)
beginning at the induction of anesthesia and continuing for 18 hours after
CABG. Primary end points were the incidence of major adverse events (major
adverse events = 30-day mortality, myocardial infarction, neurologic
events, deep sternal infections, and atrial fibrillation), the level of
serum glucose, and the incidence of hypoglycemic events. Results: There
were no differences in the incidence of major adverse events between the
groups (17 moderate vs 15 aggressive; P = 0.91). Patients with aggressive
control had a lower mean glucose at the end of 18 hours of insulin
infusion (135 +/- 12 mg/dL moderate vs 103 +/- 17 mg/dL aggressive; P <
0.0001). Patients with aggressive control had a higher incidence of
hypoglycemic events (4 vs 30; P < 0.0001). Conclusions: In diabetic
patients undergoing CABG surgery, aggressive glycemic control increases
the incidence of hypoglycemic events and does not result in any
significant improvement in clinical outcomes that can be achieved with
moderate control. Clinical Trials.gov (ID #NCT00460499). 2011 by
Lippincott Williams & Wilkins.

<8>
Accession Number
2011485711
Authors
Imazio M. Brucato A. Rovere M.E. Gandino A. Cemin R. Ferrua S. Maestroni
S. Zingarelli E. Barosi A. Simon C. Sansone F. Patrini D. Vitali E. Belli
R. Ferrazzi P. Trinchero R. Spodick D.H. Adler Y.
Institution
(Imazio, Belli, Trinchero) Cardiology Department, Maria Vittoria Hospital,
Via Cibrario 72, 10141 Torino, Italy
(Brucato, Maestroni, Simon, Ferrazzi) Ospedali Riuniti, Bergamo, Italy
(Rovere, Zingarelli, Sansone) Cardiac Surgery, Ospedale Mauriziano,
Torino, Italy
(Gandino, Barosi) Ospedale Niguarda, Milano, Italy
(Cemin) Department of Cardiology, San Maurizio Regional Hospital, Bolzano,
Italy
(Ferrua) Ospedale Degli Infermi, Rivoli, Italy
(Patrini, Vitali) Humanitas Gavazzeni, Bergamo, Italy
(Spodick) Department of Medicine, St Vincent Hospital, University of
Massachusetts, Worcester, MA, United States
(Adler) Sackler Faculty of Medicine, Tel-Aviv and Misgav Ladach Hospital,
Jerusalem, Kupat Holim Meuhedet, Israel
Title
Colchicine prevents early postoperative pericardial and pleural effusions.
Source
American Heart Journal. 162 (3) (pp 527-532.e1), 2011. Date of
Publication: September 2011.
Publisher
Mosby Inc. (11830 Westline Industrial Drive, St. Louis MO 63146, United
States)
Abstract
Background: No preventive pharmacologic strategies have been proven
efficacious for the prevention of postoperative effusions after cardiac
surgery. Colchicine is safe and efficacious for the prevention of
pericarditis. On this basis, we realized a substudy of the COPPS trial to
assess the efficacy and safety of colchicine for the prevention of
postoperative pericardial and pleural effusions. Methods: The COPPS is a
multicenter, double-blind, randomized trial, where 360 consecutive
patients (mean age 65.7 +/- 12.3 years, 66% men), 180 in each treatment
arm, were randomized on the third postoperative day to receive placebo or
colchicine for 1 month (1.0 mg twice daily for the first day, followed by
a maintenance dose of 0.5 mg twice daily in patients >=70 kg, and halved
doses for patients <70 kg). The incidence of postoperative effusions was
evaluated in each study group. Results: Despite similar baseline features,
colchicine significantly reduced the incidence of postoperative
pericardial (12.8% vs 22.8%, P =.019, relative risk reduction 43.9%, no.
of patients needed to treat 10) and pleural effusions (12.2% vs 25.6%, P
=.002, relative risk reduction 52.3%, no. of patients needed to treat 8).
The rate of side effects (only gastrointestinal intolerance) and drug
withdrawal was similar in the study groups with a trend toward an
increased rate of both events for colchicine. In multivariable analysis,
female gender (hazard ratio 1.76, 95% CI 1.03-3.03, P =.040) and pleura
incision (hazard ratio 2.58, 95% CI 1.53-4.53, P <.001) were risk factors
for postoperative effusions. Conclusions: Colchicine is safe and
efficacious for the primary prevention of postoperative effusions after
cardiac surgery. 2011 Mosby, Inc.

<9>
Accession Number
2011485740
Authors
Farquharson A.L. Metcalf R.G. Sanders P. Stuklis R. Edwards J.R.M. Gibson
R.A. Cleland L.G. Sullivan T.R. James M.J. Young G.D.
Institution
(Farquharson, Cleland, James) Discipline of Medicine, University of
Adelaide, Adelaide, Australia
(Metcalf, Sanders, James, Young) Centre for Heart Rhythm Disorders,
University of Adelaide, Adelaide, Australia
(Gibson, Cleland) FoodPlus Research Centre, University of Adelaide,
Adelaide, Australia
(Sullivan) Data Management and Analysis Centre, Discipline of Public
Health, University of Adelaide, Adelaide, Australia
(Metcalf, James) Rheumatology Unit, Royal Adelaide Hospital, Adelaide,
Australia
(Sanders, Young) Department of Cardiology, Royal Adelaide Hospital,
Adelaide, Australia
(Stuklis, Edwards) Department of Cardiothoracic Surgery, Royal Adelaide
Hospital, Adelaide, Australia
Title
Effect of dietary fish oil on atrial fibrillation after cardiac surgery.
Source
American Journal of Cardiology. 108 (6) (pp 851-856), 2011. Date of
Publication: 15 Sep 2011.
Publisher
Elsevier Inc. (360 Park Avenue South, New York NY 10010, United States)
Abstract
An open-label study reported that ingestion of a fish oil concentrate
decreased the incidence of atrial fibrillation (AF) after coronary artery
bypass grafting (CABG) surgery. However, a general cardiac surgery
population involves valve and CABG surgeries. We undertook a
double-blinded randomized controlled trial to examine the effectiveness of
fish oil supplementation on the incidence of postsurgical AF after CABG
and valve procedures. The primary end point was incidence of AF in the
first 6 days after surgery. Two hundred patients were randomized to
receive fish oil (providing 4.6 g/day of long-chain -3 fatty acids) or a
control oil starting 3 weeks before surgery; 194 subjects completed the
study, with 47 of 97 subjects in the control group and 36 of 97 subjects
in the fish oil group developing AF (odds ratio 0.63, 95% confidence
interval [CI] 0.35 to 1.11). There was a nonstatistically significant
delay in time to onset of AF in the fish oil group (hazard ratio 0.66, 95%
CI 0.43 to 1.01). There was a significant decrease in mean length of stay
in the intensive care unit in the fish oil group (ratio of means 0.71, 95%
CI 0.56 to 0.90). In conclusion, in a mixed cardiac surgery population,
supplementation with dietary fish oil did not result in a significant
decrease in the incidence of postsurgical AF. However, there was a
significant decrease in time spent in the intensive care unit. 2011
Elsevier Inc. All Rights Reserved.

<10>
Accession Number
2011499592
Authors
Kappetein A.P. Feldman T.E. MacK M.J. Morice M.-C. Holmes D.R. Stahle E.
Dawkins K.D. Mohr F.W. Serruys P.W. Colombo A.
Institution
(Kappetein, Serruys) Department of Thoracic Surgery, Erasmus Medical
Centre, PO Box 2040, 3000 CA Rotterdam, Netherlands
(Feldman) NorthShore University Health System, Evanston, IL, United States
(MacK) Baylor Healthcare System, Dallas, TX, United States
(Morice) Institut Cardiovasculaire Paris Sud, Massy, France
(Holmes) Mayo Clinic, Rochester, MN, United States
(Stahle) University Hospital Uppsala, Uppsala, Sweden
(Dawkins) Boston Scientific, Natick, MA, United States
(Mohr) Herzzentrum Universitt Leipzig, Leipzig, Germany
(Colombo) San Raffaele Scientific Institute, Milan, Italy
Title
Comparison of coronary bypass surgery with drug-eluting stenting for the
treatment of left main and/or three-vessel disease: 3-year follow-up of
the SYNTAX trial.
Source
European Heart Journal. 32 (17) (pp 2125-2134), 2011. Date of
Publication: September 2011.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Aims Long-term randomized comparisons of percutaneous coronary
intervention (PCI) to coronary artery bypass grafting (CABG) in left main
coronary (LM) disease and/or three-vessel disease (3VD) patients have been
limited. This analysis compares 3-year outcomes in LM and/or 3VD patients
treated with CABG or PCI with TAXUS Express stents. Methods and
resultsSYNTAX is an 85-centre randomized clinical trial (n 1800).
Prospectively screened, consecutive LM and/or 3VD patients were randomized
if amenable to equivalent revascularization using either technique; if
not, they were entered into a registry. Patients in the randomized cohort
will continue to be followed for 5 years. At 3 years, major adverse
cardiac and cerebrovascular events [MACCE: death, stroke, myocardial
infarction (MI), and repeat revascularization; CABG 20.2 vs. PCI 28.0, P<
0.001], repeat revascularization (10.7 vs. 19.7, P< 0.001), and MI (3.6
vs. 7.1, P 0.002) were elevated in the PCI arm. Rates of the composite
safety endpoint (death/stroke/MI 12.0 vs. 14.1, P 0.21) and stroke alone
(3.4 vs. 2.0, P 0.07) were not significantly different between treatment
groups. Major adverse cardiac and cerebrovascular event rates were not
significantly different between arms in the LM subgroup (22.3 vs. 26.8, P
0.20) but were higher with PCI in the 3VD subgroup (18.8 vs. 28.8, P<
0.001). Conclusion sAt 3 years, MACCE was significantly higher in
PCI-compared with CABG-treated patients. In patients with less complex
disease (low SYNTAX scores for 3VD or low/intermediate terciles for LM
patients), PCI is an acceptable revascularization, although longer
follow-up is needed to evaluate these two revascularization strategies.
2011 The Author.

<11>
Accession Number
2011488484
Authors
Christensen T.D. Larsen T.B. Hjortdal V.E.
Institution
(Christensen, Hjortdal) Department of Cardiothoracic and Vascular Surgery,
Institute of Clinical Medicine, Aarhus University Hospital, Skejby,
DK-8200 Aarhus N, Denmark
(Larsen) Department of Cardiology, Aalborg Hospital and Department of
Health Science and Technology, Aalborg University, Denmark
Title
Self-testing and self-management of oral anticoagulation therapy in
children.
Source
Thrombosis and Haemostasis. 106 (3) (pp 391-397), 2011. Date of
Publication: 2011.
Publisher
Schattauer GmbH (Hoelderlinstr 3 Stuttgart D-70174, Germany)
Abstract
Children and adolescents on oral anticoagulation therapy (OAT) present
special challenges in terms of rapid fluctuations in International
Normalised Ratio (INR) values, interruption in daily life due to frequent
hospital/doctor visits, and difficulties and pain in the performance of
venepuncture. Optimised management of OAT improves the quality of
treatment, potentially accomplished by new methods such as patient
self-testing (PST) and patient self-management (PSM). A review was
performed, identifying 11 trials with children and adolescents. All
studies had different methodological problems, predominantly by being
non-randomised trials. A total of 284 patients were included with a mean
follow-up of 22 months, finding a time within therapeutic INR target range
between 63% and 84%. The coagulometers used for estimating the INR values
were found to have sufficient precision and accuracy for clinical use, but
external quality control is probably advisable. It can be concluded that
PST and PSM are at least as good treatment options as conventional
management in highly selected children. Larger studies, preferably
randomised, controlled trials using clinical endpoints, are obviously
needed in order to elucidate whether these new regimens of treatment are
superior to conventional management of oral anticoagulation therapy.
Schattauer 2011.

<12>
Accession Number
2011481510
Authors
Lyons O. Clough R. Patel A. Saha P. Carrell T. Taylor P.
Institution
(Lyons, Clough, Patel, Saha, Carrell, Taylor) Vascular Surgery Unit,
King's Health Partners, London, United Kingdom
Title
Endovascular management of Stanford type A dissection or intramural
hematoma with a distal primary entry tear.
Source
Journal of Endovascular Therapy. 18 (4) (pp 591-600), 2011. Date of
Publication: August 2011.
Publisher
International Society of Endovascular Specialists (PMB 605, 1928 East
Highland Street, #F104, Phoenix AZ 85016, United States)
Abstract
A systematic review was conducted of all published cases of endovascular
repair of retrograde Stanford type A dissection or intramural hematoma to
determine mortality of this less invasive approach to treatment. Using the
PRISMA guidelines, databases were searched for any of the terms
'dissect$', 'IMH', ('aortic ADJ wall'), 'intramur$', 'intra-mur$' in
combination with any of 'stent$', 'perc$', 'endo$', 'TEVAR' in combination
with any of ('type ADJ A'), 'ascend$' and 'retro$.' The search retrieved
3131 titles, 280 abstracts, and 108 papers. Of 23 relevant papers
selected, mortality data could be extracted from 11 studies, representing
60 patients. Overall in-hospital mortality was 1.8% (95% CI 1.2% to 2.4%).
Additional all-cause mortality during follow-up was 5.4% (95% CI 3.5% to
7.2%). The placement of an endoluminal device in the descending thoracic
aorta to treat a DeBakey IIId/retrograde type A aortic dissection or
intramural hematoma may be a safer procedure in the short to medium term
than open surgical replacement of the ascending aorta (with or without the
arch). Open surgical repair in these patients may therefore be
unjustified. 2011 by the International Society of Endovascular
Specialists.

<13>
Accession Number
70525113
Authors
Boyd S.
Institution
(Boyd) Vanderbilt University, United States
Title
Adverse outcomes after maxillomandibular advancement for treatment of
obstructive sleep apnea.
Source
Journal of Oral and Maxillofacial Surgery. Conference: 93rd Annual
Meeting Scientific Sessions and Exhibition of the American Association of
Oral and Maxillofacial Surgeons, AAOMS 2011 Philadelphia, PA United
States. Conference Start: 20110912 Conference End: 20110917. Conference
Publication: (var.pagings). 69 (9 SUPPL. 1) (pp e25-e26), 2011. Date of
Publication: September 2011.
Publisher
W.B. Saunders
Abstract
Statement of the Problem: Several observational case series studies
indicate that maxillomandibular advancement surgery (MMA) may be a
clinically effective alternative therapy for patients with obstructive
sleep apnea (OSA) who are unable to adhere to CPAP therapy. Surgical
treatment involves inherent risks and it is essential to define the type,
severity and incidence of these potential adverse outcomes to determine
the risk benefit ratio of MMA for the treatment of OSA. To date the
adverse outcomes of MMA have not been systematically analyzed or reported.
The purpose of this study is to determine the type, severity and incidence
of surgical and anesthetic adverse outcomes following MMA for treatment of
OSA. Materials and Methods: This is a retrospective cohort study
consisting of 76 patients who underwent MMA for treatment of OSA at
Vanderbilt Medical Center between 1997 and 2007. A comprehensive
systematic review of the surgical, anesthesia/recovery room and progress
notes were completed for each patient to identify all perioperative
complications, as well as post-operative wound healing problems.
Additionally, polysomnography reports were analyzed to determine the
effectiveness of MMA, as measured by changes in the apnea-hypopnea index
(AHI) and low oxygen saturation after MMA. Methods of Data Analysis:
Descriptive statistical analysis was performed for all continuous
variables and reported as mean +/- SD. The number and proportion of
patients with each observed adverse outcome were tabulated. Two-tailed
paired t tests were used to assess changes in the apnea-hypopnea index
(AHI) and low O2 saturations following MMA. For all analyses, a p-value of
<0.05 was considered statistically significant. Results of Investigation:
The majority of patients were obese (BMI +/- 31.2 +/- 6.9) middle-aged
(45.4 +/- 9.9 years) males (80%) with severe OSA (AHI +/- 54.3 +/- 27.0;
low % SaO2 +/- 77.8 +/- 13.0). Pre-operatively, the group had multiple
co-morbid medical conditions including: hypertension (36%), cardiovascular
disease (14%), history of non-fatal cardiovascular events (9%) and
depression (21%). Standardized osteotomy and stabilization techniques were
used to accomplish MMA. Modified hypotensive anesthetic techniques were
used for the majority of patients (93%). There were no observed deaths or
cardiac events. Intra-operatively the airway was managed by intubation in
the vast majority of patients (96%) with tracheotomy performed in only one
patient. 3% of patients required re-intubation for perioperative control
of the airway. The estimated average blood loss was 390.6 +/- 227.1 ml and
5% of patients received a blood transfusion. No patients experienced
complications requiring return to the operating room. Following surgery,
patients required 2.6 +/- 1.7 days of hospitalization. Wound infections
were uncommon (8%) and were effectively treated by local measures and oral
antibiotics, with no patients requiring intravenous antibiotics or
hospitalization. Surgical treatment by MMA resulted in a significant
reduction in AHI in (54.3 +/- 27.0 to 13.3 +/- 11.6, P <.001) and
improvement in minimum oxygen saturation (77.8% to 83.8%, P <.001).
Conclusion: The results of this study indicate that MMA has a very
favorable risk-benefit ratio, as it may provide safe and effective
treatment for patients with moderate to severe OSA who are unable to
adhere to CPAP therapy.

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Total documents retrieved: 20

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<1>
Accession Number
2011469006
Authors
Montalescot G. Zeymer U. Silvain J. Boulanger B. Cohen M. Goldstein P.
Ecollan P. Combes X. Huber K. Pollack Jr. C. Benezet J.-F. Stibbe O.
Filippi E. Teiger E. Cayla G. Elhadad S. Adnet F. Chouihed T. Gallula S.
Greffet A. Aout M. Collet J.-P. Vicaut E.
Institution
(Montalescot, Silvain, Collet) Institut de Cardiologie, CHU
Pitie-Salpetrire (AP-HP), Universite Paris 6, Paris, France
(Ecollan) SMUR, CHU Pitie-Salpetrire (AP-HP), Universite Paris 6, Paris,
France
(Zeymer) Herzzentrum Klinikum Ludwigshafen, Medizinische Klinik B,
Ludwigshafen, Germany
(Boulanger) SAMU, CH Bretagne Atlantique, Vannes, France
(Filippi) Cardiology Department, CH Bretagne Atlantique, Vannes, France
(Cohen) Division of Cardiology, Newark Beth Israel Medical Center, Newark,
NJ, United States
(Goldstein) SAMU, CHU Lille, France
(Combes) SAMU, Henri Mondor Hospital, Creteil, France
(Teiger) Cardiology Department, Henri Mondor Hospital, Creteil, France
(Huber) Department of Internal Medicine, Cardiology and Emergency
Medicine, Wilhelminenhospital, Vienna, Austria
(Pollack Jr.) Pennsylvania Hospital, University of Pennsylvania,
Philadelphia, PA, United States
(Benezet) SAMU, CH Caremeau, Nimes, France
(Cayla) Cardiology Department, CH Caremeau, Nimes, France
(Stibbe) SAMU, CH de Lagny, Lagny-sur-Marne, France
(Elhadad) Cardiology Department, CH de Lagny, Lagny-sur-Marne, France
(Adnet) SAMU, Hopital Avicenne, Bobigny, France
(Chouihed) SAMU, Hopital Central, Nancy, France
(Gallula) SMUR, Hopital Lariboisire, Paris, France
(Greffet) SAMU, Hopital Necker, Paris, France
(Aout, Vicaut) Unite de Recherche Clinique, Lariboisire Hospital (AP-HP),
Universite Paris 7, Paris, France
Title
Intravenous enoxaparin or unfractionated heparin in primary percutaneous
coronary intervention for ST-elevation myocardial infarction: The
international randomised open-label ATOLL trial.
Source
The Lancet. 378 (9792) (pp 693-703), 2011. Date of Publication: August
20-26, 2011.
Publisher
Elsevier Limited (32 Jamestown Road, London NW1 7BY, United Kingdom)
Abstract
Background Primary percutaneous coronary intervention (PCI) for
ST-elevation myocardial infarction has traditionally been supported by
unfractionated heparin, which has never been directly compared with a new
anticoagulant using consistent anticoagulation and similar antiplatelet
strategies in both groups. We compared traditional heparin treatment with
intravenous enoxaparin in primary PCI. Methods In a randomised open-label
trial, patients presenting with ST-elevation myocardial infarction were
randomly assigned (1:1) to receive an intravenous bolus of 05 mg/kg of
enoxaparin or unfractionated heparin before primary PCI. Wherever
possible, medical teams travelling in mobile intensive care units
(ambulances) selected, randomly assigned (using an interactive voice
response system at the central randomisation centre), and treated
patients. Patients who had received any anticoagulant before randomisation
were excluded. Patients and caregivers were not masked to treatment
allocation. The primary endpoint was 30-day incidence of death,
complication of myocardial infarction, procedure failure, or major
bleeding. The main secondary endpoint was the composite of death,
recurrent acute coronary syndrome, or urgent revascularisation. Analysis
was by intention to treat. This trial is registered at ClinicalTrials.gov,
number NCT00718471. Findings 910 patients were assigned to treatment with
enoxaparin (n=450) or unfractionated heparin (n=460). The primary endpoint
occurred in 126 (28) patients after anticoagulation with enoxaparin versus
155 (34) patients on unfractionated heparin (relative risk [RR] 083, 95 CI
068-101, p=006). The incidence of death (enoxaparin, 17 [4] vs heparin, 29
[6] patients; p=008), complication of myocardial infarction (20 [4] vs 29
[6]; p=021), procedure failure (100 [26] vs 109 [28]; p=061), and major
bleeding (20 [5] vs 22 [5]; p=079) did not differ between groups.
Enoxaparin resulted in a significantly reduced rate of the main secondary
endpoint (30 [7] vs 52 [11] patients; RR 059, 95 CI 038-091, p=0015).
Death, complication of myocardial infarction, or major bleeding (46 [10]
vs 69 [15] patients; p=003), death or complication of myocardial
infarction (35 [8] vs 57 [12]; p=002), and death, recurrent myocardial
infarction, or urgent revascularisation (23 [5] vs 39 [8]; p=004) were all
reduced with enoxaparin. Interpretation Intravenous enoxaparin compared
with unfractionated heparin significantly reduced clinical ischaemic
outcomes without differences in bleeding and procedural success.
Therefore, enoxaparin provided an improvement in net clinical benefit in
patients undergoing primary PCI. Funding Direction de la Recherche
Clinique, Assistance Publique-Hopitaux de Paris; Sanofi-Aventis. 2011
Elsevier Ltd.

<2>
Accession Number
2011462172
Authors
Khedmat H. Taheri S.
Institution
(Khedmat) Internist Center, Baqiyatallah University of Medical Sciences,
Mollasadra st, Vanak sq, Tehran, Iran, Islamic Republic of
(Taheri) Dr Taheri Medical Research Group, Tehran, Iran, Islamic Republic
of
Title
Heart allograft involvement by posttransplant lymphoproliferative
disorders: Report from the PTLD. Int survey.
Source
Experimental and Clinical Transplantation. 9 (4) (pp 258-264), 2011.
Date of Publication: August 2011.
Publisher
Baskent University (26 Austin Avenue,Baglica Kampusu, P.O. Box 337,Ankara
06530, Turkey)
Abstract
Objectives: Owing to the rare incidence of posttransplant
lymphoproliferative disorder of the heart, there is a paucity of data
concerning it. In this study, we pooled data from posttransplant
lymphoproliferative disorder patients from the existing literature. We
sought to analyze and compare characteristics, predictors, and prognoses
of patients with posttransplant lymphoproliferative disorder of the heart.
Materials and Methods: A comprehensive search was made to gather data by
PubMed and Google for reports of lymphoproliferative disorders occurring
in transplant patients occurring within the heart, the heart allograft,
and surrounding tissues. Pooled data were reanalyzed. Results: Overall,
206 patients were entered into the analysis. Transplant recipients with
cardiac posttransplant lymphoproliferative disorders were significantly
more likely to represent multivisceral and disseminated posttransplant
lympho -proliferative disorder (P =.01 and P <.001). Posttransplant
lymphoproliferative disorder in patients with heart involvement were more
likely to involve the genitalia (P=.035), the adrenals (P=.035), the liver
(P=.007), and the kidneys (P <.001). Patients with cardiac posttransplant
lympho proliferative disorder had significantly shorter time from
transplant to development of posttransplant lymphoproliferative disorder
(P=.029). A log-rank test showed a significant inferior patient survival
for transplant recipients with cardiac complications (P=.031). Patients
with a cardiac allograft posttransplant lymphoproliferative disorder were
significantly older at the time of transplant (55.3 +/- 8.4 vs 38.5 +/-
21.8 y; P=.002). Conclusions: Because cardiac posttransplant
lymphoproliferative disorder is associated with multiorgan and
disseminated posttransplant lymphoproliferative disorder, all transplant
recipients who represent posttransplant lympho -proliferative disorder in
the heart should be evaluated for other organs involvement most especially
in the kidneys, liver, and adrenals. Further prospective studies with a
larger patient population are needed to confirm our results. Baskent
University 2011 Printed in Turkey. All Rights Reserved.

<3>
Accession Number
2011460720
Authors
Gertz Z.M. Raina A. Mountantonakis S.E. Zado E.S. Callans D.J. Marchlinski
F.E. Keane M.G. Silvestry F.E.
Institution
(Gertz, Raina, Mountantonakis, Zado, Callans, Marchlinski, Keane,
Silvestry) Division of Cardiovascular Medicine, Hospital of the University
of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States
Title
The impact of mitral regurgitation on patients undergoing catheter
ablation of atrial fibrillation.
Source
Europace. 13 (8) (pp 1127-1132), 2011. Date of Publication: August 2011.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
Aims: Mitral regurgitation (MR) causes left atrium (LA) enlargement and
subsequent atrial fibrillation (AF). The presence of MR may increase
recurrence rates after AF ablation. The purpose of this study was to
determine the impact of MR on recurrence rates after catheter ablation of
AF. Methods and results: We compared 95 patients with moderate or greater
baseline MR (defined by MR jet area to LA area ratio <0.2) and AF
undergoing ablation to 95 randomly selected patients without significant
MR undergoing AF ablation. Electrocardiographic recurrence at 1-year
follow-up was the primary outcome. Patients in the MR cohort had mean
MR/LA ratio 0.37 vs. 0.09 in controls (P< 0.0001). Mitral regurgitation
patients had larger LA dimension (4.5 vs. 4.1 cm, P< 0.0001) and more
persistent AF (71 vs. 28, P< 0.0001). Mitral regurgitation patients had
higher recurrence rates than controls (61 vs. 46, P 0.04). The degree of
MR was higher in patients with recurrence (MR/LA ratio 0.25 vs. 0.20, P
0.03), as was LA dimension (4.5 vs. 4.1 cm, P< 0.0001). In multivariate
analyses, only LA size was an independent predictor of recurrence (odds
ratio 2.9 per centimetre increase in LA dimension, P 0.005). Fifty-five
percent of MR patients had normal leaflet motion, with MR likely due to
atrial remodelling secondary to AF. Conclusions: Mitral regurgitation was
associated with increased AF recurrence after AF ablation, but its impact
was mediated by LA size. Left atrium size was the only independent
predictor of AF recurrence. The high percentage of MR that was likely
secondary to AF may have impacted our findings and deserves further study.
2011 The Author.

<4>
Accession Number
2011460152
Authors
Sundy J.S. Baraf H.S.B. Yood R.A. Edwards N.L. Gutierrez-Urena S.R.
Treadwell E.L. Vazquez-Mellado J. White W.B. Lipsky P.E. Horowitz Z. Huang
W. Maroli A.N. Waltrip II R.W. Hamburger S.A. Becker M.A.
Institution
(Sundy) Duke Clinical Research Unit, Duke University Medical Center,
Durham, NC, United States
(Baraf) Center for Rheumatology and Bone Research, Wheaton, MD, United
States
(Yood) Fallon Clinic, Worcester, MA, United States
(Edwards) Division of Rheumatology, University of Florida, Gainesville,
FL, United States
(Gutierrez-Urena) Medicine/Rheumatology, Hospital Civil de Guadalajara,
Guadalajara, Mexico
(Treadwell) Division of Rheumatology, East Carolina University,
Greenville, NC, United States
(Vazquez-Mellado) Hospital General de Mexico, Mexico City, Mexico
(White) Calhoun Cardiology Center, University of Connecticut School of
Medicine, Farmington, CT, United States
(Horowitz, Huang, Maroli, Waltrip II, Hamburger) Savient Pharmaceuticals,
East Brunswick, NJ, United States
(Becker) Rheumatology Section, University of Chicago, Chicago, IL, United
States
(Horowitz) Celgene Corporation, Warren, NJ, United States
(Waltrip II) Talecris Biotherapeutics, Chapel Hill, NC, United States
Title
Efficacy and tolerability of pegloticase for the treatment of chronic gout
in patients refractory to conventional treatment: Two randomized
controlled trials.
Source
JAMA - Journal of the American Medical Association. 306 (7) (pp 711-720),
2011. Date of Publication: 17 Aug 2011.
Publisher
American Medical Association (515 North State Street, Chicago IL 60654,
United States)
Abstract
Context: Patients with chronic disabling gout refractory to conventional
urate-lowering therapy need timely treatment to control Disease
manifestations related to tissue urate crystal deposition. Pegloticase,
monomethoxypoly(ethylene glycol)-conjugated mammalian recombinant uricase,
was developed to fulfill this need. Objective: To assess the efficacy and
tolerability of pegloticase in managing refractory chronic gout. Design,
Setting, and Patients: Two replicate, randomized, double-blind,
placebo-controlled trials (C0405 and C0406) were conducted between June
2006 and October 2007 at 56 rheumatology practices in the United States,
Canada, and Mexico in patients with severe gout, allopurinol intolerance
or refractoriness, and serum uric acid concentration of 8.0 mg/dL or
greater. A total of 225 patients participated: 109 in trial C0405 and 116
in trial C0406. Intervention: Twelve biweekly intravenous infusions
containing either pegloticase 8 mg at each infusion (biweekly treatment
group), pegloticase alternating with placebo at successive infusions
(monthly treatment group), or placebo (placebo group). Main Outcome
Measure: Primary end point was plasma uric acid levels of less than 6.0
mg/dL in months 3 and 6. Results: In trial C0405 the primary end point was
reached in 20 of 43 patients in the biweekly group (47%; 95% CI, 31%-62%),
8 of 41 patients in the monthly group (20%; 95% CI, 9%-35%), and in 0
patients treated with placebo (0/20; 95% CI, 0%-17%; P < .001 and <.04 for
comparisons between biweekly and monthly groups vs placebo, respectively).
Among patients treated with pegloticase in trial C0406, 16 of 42 in the
biweekly group (38%; 95% CI, 24%-54%) and 21 of 43 in the monthly group
(49%; 95% CI, 33%-65%) achieved the primary end point; no placebotreated
patients reached the primary end point (0/23; 95% CI, 0%-15%; P=.001 and <
.001, respectively). When data in the 2 trials were pooled, the primary
end point was achieved in 36 of 85 patients in the biweekly group (42%;
95% CI, 32%-54%), 29 of 84 patients in the monthly group (35%; 95% CI,
24%-46%), and 0 of 43 patients in the placebo group (0%; 95% CI, 0%-8%; P
< .001 for each comparison). Seven deaths (4 in patients receiving
pegloticase and 3 in the placebo group) occurred between randomization and
closure of the study database (February 15, 2008). Conclusion: Among
patients with chronic gout, elevated serum uric acid level, and
allopurinol intolerance or refractoriness, the use of pegloticase 8 mg
either every 2 weeks or every 4 weeks for 6 months resulted in lower uric
acid levels compared with placebo. Trial Registration clinicaltrials.gov
Identifier: NCT00325195. 2011 American Medical Association. All rights
reserved.

<5>
Accession Number
2011475671
Authors
Mearns B.M.
Title
Gene therapy: Can CUPID rescue the broken hearted?.
Source
Nature Reviews Cardiology. 8 (9) (pp 481), 2011. Date of Publication:
September 2011.
Publisher
Nature Publishing Group (Houndmills, Basingstoke, Hampshire RG21 6XS,
United Kingdom)

<6>
Accession Number
2011429057
Authors
Yeoh T. Hayward C. Benson V. Sheu A. Richmond Z. Feneley M.P. Keogh A.M.
Macdonald P. Fatkin D.
Institution
(Yeoh, Sheu, Richmond, Macdonald, Fatkin) Molecular Cardiology Division,
Victor Chang Cardiac Research Institute, Sydney, Australia
(Hayward, Benson, Feneley, Keogh, Macdonald, Fatkin) Department of
Cardiology, St Vincent's Hospital, Sydney, Australia
(Hayward, Feneley, Keogh, Macdonald, Fatkin) Faculty of Medicine,
University of New South Wales, Sydney, Australia
Title
A Randomised, Placebo-controlled Trial of Carvedilol in Early Familial
Dilated Cardiomyopathy.
Source
Heart Lung and Circulation. 20 (9) (pp 566-573), 2011. Date of
Publication: September 2011.
Publisher
Elsevier Ltd (Langford Lane, Kidlington, Oxford OX5 1GB, United Kingdom)
Abstract
Background: Screening of asymptomatic relatives of patients with dilated
cardiomyopathy (DCM) has identified a population of individuals with left
ventricular dilatation and/or minimally impaired contraction who are
believed to have early disease. A proportion of these individuals with
early disease progress to overt cardiomyopathy, however to our knowledge
there have been no studies that have examined the impact of early
intervention on disease progression. Methods: We evaluated 424
asymptomatic relatives in 110 families of probands with DCM and identified
102 individuals (24%) with suspected "early disease" (EDCM). Thirty-two
EDCM subjects were randomised into a six-month placebo-controlled trial of
the beta-blocker, carvedilol. Transthoracic echocardiography and plasma
nt-proBNP levels were measured at baseline and repeated at six months. The
primary trial endpoint was change in left ventricular end-systolic
diameter after six months. Subjects completing six months of blinded trial
therapy were offered open-label carvedilol and then observed over an
extended period with repeated clinical evaluation and echocardiography.
Results: At baseline, left ventricular dimensions, systolic function and
plasma nt-proBNP levels were similar in carvedilol and placebo groups.
There were no significant changes observed in these parameters in either
treatment group after six months, however reductions in end-diastolic
diameter (% predicted) were observed in carvedilol-treated subjects (P =
0.002) during an open-label median follow-up of 32 months (range: 13-56
months). Conclusions: In an asymptomatic population of individuals with
EDCM, treatment with carvedilol for six months had no effect on
echocardiographic left ventricular dimensions or systolic function,
however longer-term treatment may reverse left ventricular remodelling
(Australian Clinical Trials Registry N012605000204640). 2011.

<7>
Accession Number
2011475679
Authors
Ozkan A. Kapadia S. Tuzcu M. Marwick T.H.
Institution
(Ozkan, Kapadia, Tuzcu, Marwick) Heart and Vascular Institute, Cleveland
Clinic, Mail Code J1-5, 9500 Euclid Avenue, Cleveland, OH 44195, United
States
Title
Assessment of left ventricular function in aortic stenosis.
Source
Nature Reviews Cardiology. 8 (9) (pp 494-501), 2011. Date of
Publication: September 2011.
Publisher
Nature Publishing Group (Houndmills, Basingstoke, Hampshire RG21 6XS,
United Kingdom)
Abstract
Degenerative aortic stenosis (AS) has become the most common valvular
heart disease and the definitive treatment of symptomatic, severe AS is
surgical valve replacement. In the absence of symptoms, the presence of
left ventricular (LV) systolic dysfunction is pivotal in making treatment
decisions for patients with AS. However, the LV ejection fraction is not a
sensitive marker of global LV systolic function in the presence of LV
hypertrophy, implying that asymptomatic patients with AS can have
myocardial dysfunction with preserved LV ejection fraction. Abnormal
myocardial mechanics might explain the pathophysiological processes
underlying chronic pressure overload in AS. In this article, we review how
new echocardiographic deformation parameters-such as myocardial strain,
strain rate, and twist measurements-offer the potential for clinicians to
monitor the course of LV dysfunction in patients with AS. Quantifying
disturbances in LV function might provide insight into the timing of
aortic valve replacement and into the improvement of LV systolic and
diastolic properties through regression of LV hypertrophy and fibrosis
after valve implantation. 2011 Macmillan Publishers Limited. All rights
reserved.

<8>
Accession Number
2011429056
Authors
Rao C. Murphy M.O. Saso S. Pandis D. Grapsa J. Nihoyannopoulos P. Reeves
B.C. Athanasiou T.
Institution
(Rao, Saso, Athanasiou) Department of Biosurgery and Surgical Technology,
Imperial College London, St Mary's Hospital, 10th Floor QEQM Building,
London W2 1NY, United Kingdom
(Murphy, Pandis, Grapsa, Nihoyannopoulos, Reeves, Athanasiou) Department
of Cardiothoracic Surgery, National Heart and Lung Institute, Imperial
College London, London W12 0HS, United Kingdom
(Reeves) Clinical Trials and Evaluation Unit, Bristol Heart Insitute,
Bristol Royal Infirmary, Level 7 Queen's Building, Bristol BS2 8HW, United
Kingdom
Title
Mitral Valve Repair or Replacement for Ischaemic Mitral Regurgitation: A
Systematic Review.
Source
Heart Lung and Circulation. 20 (9) (pp 555-565), 2011. Date of
Publication: September 2011.
Publisher
Elsevier Ltd (Langford Lane, Kidlington, Oxford OX5 1GB, United Kingdom)
Abstract
A literature review was undertaken according to Cochrane guidelines to
identify whether mitral valve repair (MV-Repair) or replacement
(MV-Replacement) is more effective in patients with moderate to severe
ischaemic mitral regurgitation. The literature suggests MV-Repair may have
improved 30-day mortality and long-term survival. All 12 studies
identified, however, were non-randomised, retrospective, and at
significant risk of bias due to heterogeneous surgical techniques and
mismatched patient characteristics. Data describing the need for
reoperation were not sufficiently well reported to analyse. Functional
outcomes and health-related quality of life were not reported. In
conclusion, high-quality randomised comparison of MV-Repair and
MV-Replacement is urgently needed. 2011 Australasian Society of Cardiac
and Thoracic Surgeons and the Cardiac Society of Australia and New
Zealand.

<9>
Accession Number
2011472803
Authors
Naylor A.R. Mehta Z. Rothwell P.M. Bell P.R.F.
Institution
(Naylor, Mehta, Bell) Department of Vascular Surgery, Clinical Sciences
Building, Leicester Royal Infirmary, United Kingdom
(Rothwell) University Department of Clinical Neurology, Radcliffe
Infirmary, Oxford, United Kingdom
Title
Reprinted Article "carotid artery disease and stroke during coronary
artery bypass: A critical review of the literature".
Source
European Journal of Vascular and Endovascular Surgery. 42 (SUPPL.1) (pp
S73-S83), 2011. Date of Publication: September 2011.
Publisher
W.B. Saunders Ltd (32 Jamestown Road, London NW1 7BY, United Kingdom)
Abstract
Objectives: To determine the role of carotid artery disease in the
pathophysiology of stroke after coronary artery bypass (CABG). Design:
Systematic review of the literature. Results: The risk of stroke after
CABG was 2% and remained unchanged between 1970-2000. Two-thirds occurred
after day 1 and 23% died. 91% of screened CABG patients had no significant
carotid disease and had a <2% risk of peri-operative stroke. Stroke risk
increased to 3% in predominantly asymptomatic patients with a unilateral
50-99% stenosis, 5% in those with bilateral 50-99% stenoses and 7-11% in
patients with carotid occlusion. Significant predictive factors for
post-CABG stroke included; (i) carotid bruit (OR 3.6, 95% CI 2.8-4.6),
(ii) prior stroke/TIA (OR 3.6, 95% CI 2.7-4.9) and (iii) severe carotid
stenosis/occlusion (OR 4.3, 95% CI 3.2-5.7). However, the systematic
review indicated that 50% of stroke sufferers did not have significant
carotid disease and 60% of territorial infarctions on CT scan/autopsy
could not be attributed to carotid disease alone. Conclusions: Carotid
disease is an important aetiological factor in the pathophysiology of
post-CABG stroke. However, even assuming that prophylactic carotid
endarterectomy carried no additional risk, it could only ever prevent
about 40-50% of procedural strokes.

<10>
Accession Number
2011461719
Authors
Sezai A. Hata M. Niino T. Yoshitake I. Unosawa S. Wakui S. Kimura H.
Shiono M. Takayama T. Hirayama A.
Institution
(Sezai, Hata, Niino, Yoshitake, Unosawa, Wakui, Kimura, Shiono) Department
of Cardiovascular Surgery, Nihon University School of Medicine, 30-1
Oyaguchi-kamimachi, Itabashi-ku, Tokyo 173-8610, Japan
(Takayama, Hirayama) Department of Cardiology, Nihon University School of
Medicine, Tokyo, Japan
Title
Results of low-dose human atrial natriuretic peptide infusion in
nondialysis patients with chronic kidney disease undergoing coronary
artery bypass grafting: The NU-HIT (Nihon University Working Group Study
of Low-Dose hANP Infusion Therapy during Cardiac Surgery) trial for CKD.
Source
Journal of the American College of Cardiology. 58 (9) (pp 897-903), 2011.
Date of Publication: 23 Aug 2011.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives: The purpose of this comparative study is to prove the efficacy
of the human atrial natriuretic peptide (hANP) in patients with chronic
kidney disease (CKD) undergoing coronary artery bypass graft surgery
(CABG). Background: CKD is an important risk factor for cardiac surgery.
Methods: This was a randomized controlled study of 303 patients with CKD
who underwent CABG, and were divided into a group who received carperitide
infusion and another group without carperitide. The primary endpoints
were: 1) the post-operative dialysis-free rate; and 2) serum creatinine
(sCr) and estimated glomerular filtration rate. The secondary endpoints
were: 1) the early post-operative outcome; 2) outcome at 1 year
post-operatively; 3) the maximum sCr, the rate of increase of sCr, and an
increase of sCr by <0.3 mg/dl compared with the pre-operative value; and
4) ANP and cyclic-guanosine monophosphate levels. Results: The
post-operative sCr was significantly lower in the hANP group not only in
the post-operative acute stage but also in the first year. The maximum Cr
and Cr increase rate were significantly lower in the hANP group (p =
0.00665, p < 0.0001). There was no difference in mortality rate in the
first year post-operatively, and fewer cardiac events and patients going
on dialysis were found in the hANP group (p < 0.0001 and p = 0.0014,
respectively). Conclusions: In the post-operative acute stage, carperitide
showed cardiorenal protective effects that prevented post-operative
cardiac events and initiation of dialysis. Thus, perioperative infusion of
low-dose carperitide may have a significant role in management of patients
with renal dysfunction undergoing on-pump CABG. 2011 American College of
Cardiology Foundation.

<11>
Accession Number
2011461713
Authors
Smit M.D. Crijns H.J.G.M. Tijssen J.G.P. Hillege H.L. Alings M. Tuininga
Y.S. Groenveld H.F. Van Den Berg M.P. Van Veldhuisen D.J. Van Gelder I.C.
Institution
(Smit, Hillege, Groenveld, Van Den Berg, Van Veldhuisen, Van Gelder)
Department of Cardiology, University Medical Center Groningen, University
of Groningen, P.O. Box 30.001, 9700 RB Groningen, Netherlands
(Hillege) Department of Epidemiology, University Medical Center Groningen,
University of Groningen, Groningen, Netherlands
(Crijns) Department of Cardiology, Maastricht University Medical Center,
Maastricht, Netherlands
(Tijssen) Department of Cardiology, Academic Medical Center, Amsterdam,
Netherlands
(Alings) Department of Cardiology, Amphia Hospital, Breda, Netherlands
(Tuininga) Department of Cardiology, Deventer Hospital, Deventer,
Netherlands
(Van Gelder) Interuniversity Cardiology Institute of the Netherlands,
Utrecht, Netherlands
Title
Effect of lenient versus strict rate control on cardiac remodeling in
patients with atrial fibrillation: Data of the RACE II (RAte Control
Efficacy in permanent atrial fibrillation II) study.
Source
Journal of the American College of Cardiology. 58 (9) (pp 942-949), 2011.
Date of Publication: 23 Aug 2011.
Publisher
Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States)
Abstract
Objectives: The aim of this study was to evaluate echocardiographic
remodeling in permanent atrial fibrillation (AF) patients treated with
either lenient or strict rate control. Background: It is unknown whether
in permanent AF, lenient rate control is associated with more adverse
cardiac remodeling than strict rate control. Methods: Echocardiography was
conducted at baseline and at follow-up in 517 patients included in the
RACE II (RAte Control Efficacy in permanent atrial fibrillation II) trial.
Echocardiographic parameters were compared between patients randomized to
lenient rate control (n = 261) or strict rate control (n = 256). Results:
Baseline echocardiographic parameters were comparable between patients
randomized to lenient and strict rate control. Between baseline and
follow-up, significant adverse atrial or ventricular remodeling was not
observed in either group. There were also no significant differences in
atrial and ventricular remodeling between patients who continuously had
heart rates between 80 and 110 beats/min and patients who continuously had
heart rates <80 beats/min during follow-up. Lenient rate control was not
independently associated with changes in echocardiographic parameters:
mean adjusted effect on left atrial size was 1.6 mm (p = 0.09) and 1.1 mm
on left ventricular end-diastolic diameter (p = 0.23). Instead, female sex
was independently associated with adverse remodeling: mean adjusted effect
on left atrial size was 2.4 mm (p = 0.02) and 6.5 mm on left ventricular
end-diastolic diameter (p < 0.0001). Conclusions: Female sex, not lenient
rate control, seemed to be associated with significant adverse cardiac
remodeling in patients with permanent AF such as those enrolled in the
RACE II study. (RAte Control Efficacy in Permanent Atrial Fibrillation
[RACE II]; NCT00392613) 2011 American College of Cardiology Foundation.

<12>
[Use Link to view the full text]
Accession Number
2011477939
Authors
Stone G.W. Kedhi E. Kereiakes D.J. Parise H. Fahy M. Serruys P.W. Smits
P.C.
Institution
(Stone, Parise, Fahy) New York-Presbyterian Hospital, Columbia University
Medical Center, Cardiovascular Research Foundation, New York, NY, United
States
(Kedhi, Smits) Maasstad Ziekenhuis, Rotterdam, Netherlands
(Kereiakes) Christ Hospital Heart and Vascular Center, Lindner Research
Center, Cincinnati, OH, United States
(Serruys) Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands
Title
Differential clinical responses to everolimus-eluting and
paclitaxel-eluting coronary stents in patients with and without diabetes
mellitus.
Source
Circulation. 124 (8) (pp 893-900), 2011. Date of Publication: 23 Aug
2011.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background-: Some (but not all) prior trials have reported differential
outcomes after percutaneous coronary intervention with paclitaxel-eluting
stents versus stents eluting rapamycin analogs according to the presence
of diabetes mellitus. These studies lacked sufficient power to examine
individual safety and efficacy end points. Methods and results-: To
determine whether an interaction exists between the presence of diabetes
mellitus and treatment with everolimus-eluting stents compared with
paclitaxel-eluting stents, we pooled the databases from the Clinical
Evaluation of the Xience V Everolimus Eluting Coronary Stent System in the
Treatment of Patients With De Novo Native Coronary Artery Lesions (SPIRIT)
II, SPIRIT III, SPIRIT IV, and A Trial of Everolimus-Eluting Stents and
Paclitaxel-Eluting Stents for Coronary Revascularization in Daily Practice
(COMPARE) trials in which percutaneous coronary intervention was performed
in 6780 patients, 1869 (27.6%) of whom had diabetes mellitus. Patients
without diabetes mellitus treated with everolimus-eluting stents compared
with paclitaxel-eluting stents had significantly reduced 2-year rates of
mortality (1.9% versus 3.1%; P=0.01), myocardial infarction (2.5% versus
5.8%; P<0.0001), stent thrombosis (0.3% versus 2.4%; P<0.0001), and
ischemia-driven target lesion revascularization (3.6% versus 6.9%;
P<0.0001). In contrast, among patients with diabetes mellitus, there were
no significant differences between the 2 stent types in any measured
safety or efficacy parameter. Significant interactions were present
between diabetic status and stent type for the 2-year end points of
myocardial infarction (P=0.01), stent thrombosis (P=0.0006), and target
lesion revascularization (P=0.02). Conclusions-: We have identified a
substantial interaction between diabetes mellitus and stent type on
clinical outcomes after percutaneous coronary intervention. In patients
without diabetes mellitus, everolimus-eluting stents compared with
paclitaxel-eluting stents resulted in substantial 2-year reductions in
death, myocardial infarction, stent thrombosis, and target lesion
revascularization, whereas no significant differences in safety or
efficacy outcomes were present in diabetic patients. 2011 American Heart
Association, Inc.

<13>
Accession Number
2011481133
Authors
Bhatia N.L. Tajik A.J. Wilansky S. Steidley D.E. Mookadam F.
Institution
(Bhatia, Tajik, Wilansky, Steidley, Mookadam) Cardiovascular Division,
Mayo Clinic Arizona, 13400 E Shea Boulevard, Scottsdale, AZ 85259-5499,
United States
Title
Isolated noncompaction of the left ventricular myocardium in adults: A
systematic overview.
Source
Journal of Cardiac Failure. 17 (9) (pp 771-778), 2011. Date of
Publication: September 2011.
Publisher
Churchill Livingstone Inc. (650 Avenue of the Americas, New York NY 10011,
United States)
Abstract
Background: Owing to inconsistent diagnostic criteria and small
heterogeneous cohorts, little is known about the long-term outcomes of
adult left ventricular noncompaction (LVNC), a rare cardiomyopathy with
potentially serious outcomes. This systematic overview aimed to better
delineate the natural history of adult LVNC. Method and Results: A
comprehensive computerized search using "noncompaction" and its synonyms
initially identified 206 articles, with reference lists subsequently hand
scanned. These searches yielded 5 studies that were eligible for this
systematic overview, identifying adult cohorts with isolated LVNC
diagnosed by similar echocardiographic criteria. This combined cohort (n =
241) was followed for a mean duration of 39 months. The annualized event
rate was 4% for cardiovascular deaths, 6.2% for cardiovascular death and
its surrogates (heart transplantation and appropriate implantable
cardioverter-defibrillator shocks), and 8.6% for all cardiovascular events
(death, stroke, implantable cardioverter-defibrillator shocks, and heart
transplantation.) Familial occurrence of LVNC in first-degree relatives
was identified by echocardiography in 30% of index cases who were
screened. Conclusion: LVNC is an increasingly recognized cardiomyopathy
diagnosed by echocardiography and is associated with familial tendencies,
arrhythmias, thromboembolism, advanced heart failure, and death. 2011
Elsevier Inc. All rights reserved.

<14>
Accession Number
2011474264
Authors
Clark S. Ezra M.
Institution
(Clark) Department of Anaesthetics, Milton Keynes Hospital, United Kingdom
(Ezra) Department of Anaesthetics, Royal Berkshire Hospital, United
Kingdom
Title
Use of dexmedetomidine as a sedative and analgesic agent in critically ill
adult patients.
Source
Journal of the Intensive Care Society. 12 (3) (pp 244-245), 2011. Date
of Publication: July 2011.
Publisher
Stansted News Ltd (134 South Street, Bishop's Stortford, Hertfordshire,
Essex CM23 3BQ, United Kingdom)

<15>
Accession Number
2011472068
Authors
Solheim A. Raeder J.
Institution
(Solheim, Raeder) Department of Anaesthesiology, Oslo University Hospital,
Ullevaal, N-0407 Oslo, Norway
(Raeder) University of Oslo, Medical Faculty, Division of Hospital
Medicine, Norway
Title
Remifentanil versus fentanyl for propofol-based anaesthesia in ambulatory
surgery In Children.
Source
Ambulatory Surgery. 17 (1) (pp 17-20), 2011. Date of Publication: 2011.
Publisher
International Association for Ambulatory Surgery (35-43, Lincoln's Inn
Fields, London WC2A 3PE, United Kingdom)
Abstract
Aim: To test whether remifentanil results in significantly more rapid
emergence in children anaesthesia. Methods: In forty children, age 1-6
yrs, general anaesthesia was induced and maintained with propofol. The
patients were randomized to receive either fentanyl 2 mug/kg at start and
then 1 mug/kg as needed or remifentanil 1 mug/kg bolus followed by
infusion of 0.5 mug/kg/min. Results: The remifentanil patients had
significantly less signs of minor movement at start of surgery, lower
heart rate, lower systolic bloodpressure, less total dose of propofol
during the procedure and higher need of postoperative opioid pain rescue.
Conclusions: Remifentanil, as dosed in this study, did not result in
clinical significant benefits.

<16>
Accession Number
2011465020
Authors
Chodor P. Kurek T. Kowalczuk A. Swierad M. Was T. Honisz G. Swiatkowski A.
Streb W. Kalarus Z.
Institution
(Chodor, Kurek, Swierad, Was, Honisz, Swiatkowski, Streb, Kalarus)
Department of Cardiology, Medical University of Silesia, Silesian Centre
for Heart Diseases, ul. Szpitalna 2, 44-100 Zabrze, Poland
(Kowalczuk) Department and Clinical Ward of Cardiac Surgery and
Transplantology, Medical University of Silesia, Katowice, Silesian Centre
for Heart Diseases, Zabrze, Poland
Title
Radial vs femoral approach with StarClose clip placement for primary
percutaneous coronary intervention in patients with ST-elevation
myocardial infarction. RADIAMI II: A prospective, randomised, single
centre trial.
Source
Kardiologia Polska. 69 (8) (pp 763-771), 2011. Date of Publication:
2011.
Publisher
Klinika Kardiologii CMKP (ul. Grenadierow 51/59, Warsaw 04-073, Poland)
Abstract
Background: Compared to the transfemoral approach (TFA), the transradial
approach (TRA) for primary percutaneous coronary intervention (PCI) is
associated with less risk of access site complications, greater patient
comfort and faster mobilisation. Using vascular closure devices during TFA
can offer similar advantages. Aim: To compare the results of TRA and TFA
using a StarClose device for primary PCI in patients with ST-elevation
myocardial infarction (STEMI). Methods: Patients were randomised to PCI
using TRA (n = 49) or PCI using TFA and StarClose (n = 59). Results:
Door-to-balloon inflation time was 67.4 +/- 17.1 vs 57.5 +/- 17.5 min (p =
0.009) in the TRA and TFA groups respectively. Procedural success rate was
100% and 98.3%, respectively (NS). There were no significant differences
in the incidence of major adverse cardiac events (MACE) or bleeding
complications between the groups: 2.1% and 8.2% in the TRA group vs 1.7%
and 10.2% in the TFA group (NS). Time to resume an upright position and
time to full mobility was comparable in both groups. Conclusions: The TRA
for PCI in patients with STEMI is related to a significantly longer door
to balloon time compared to the TFA. This had no influence on the
incidence of MACE. The duration and efficacy of PCI were comparable in
both groups. Using StarClose after PCI performed via the TFA resulted in
an incidence of access site and bleeding complications comparable to that
found when using TRA. Copyright Polskie Towarzystwo Kardiologiczne.

<17>
Accession Number
2011476479
Authors
Ricci Z. Luciano R. Favia I. Garisto C. Muraca M. Morelli S. Di Chiara L.
Cogo P. Picardo S.
Institution
(Ricci, Favia, Garisto, Morelli, Di Chiara, Cogo) Pediatric Cardiac
Anesthesia/Intensive Care Unit, Department of Pediatric Cardiology and
Cardiac Surgery, Bambino Gesu Children's Hospital, Piazza S. Onofrio 4,
00165, Rome, Italy
(Luciano, Muraca) Clinical Laboratory, Department of Clinical Medicine,
Bambino Gesu Children's Hospital, Piazza S. Onofrio 4, 00165, Rome, Italy
(Picardo) Emergency Department Unit, Bambino Gesu Children's Hospital,
Piazza S. Onofrio 4, 00165, Rome, Italy
Title
High-dose fenoldopam reduces postoperative neutrophil
gelatinase-associated lipocaline and cystatin C levels in pediatric
cardiac surgery.
Source
Critical Care. 15 (3) , 2011. Article Number: R160. Date of
Publication: 29 Jun 2011.
Publisher
BioMed Central Ltd. (Floor 6, 236 Gray's Inn Road, London WC1X 8HB, United
Kingdom)
Abstract
Introduction: The aim of the study was to evaluate the effects of
high-dose fenoldopam, a selective dopamine-1 receptor, on renal function
and organ perfusion during cardiopulmonary bypass (CPB) in infants with
congenital heart disease (CHD).Methods: A prospective single-center
randomized double-blind controlled trial was conducted in a pediatric
cardiac surgery department. We randomized infants younger than 1 year with
CHD and biventricular anatomy (with exclusion of isolated ventricular and
atrial septal defect) to receive blindly a continuous infusion of
fenoldopam at 1 mug/kg/min or placebo during CPB. Perioperative urinary
and plasma levels of neutrophil gelatinase-associated lipocaline (NGAL),
cystatin C (CysC), and creatinine were measured to assess renal injury
after CPB.Results: We enrolled 80 patients: 40 received fenoldopam (group
F) during CPB, and 40 received placebo (group P). A significant increase
of urinary NGAL and CysC levels from baseline to intensive care unit (ICU)
admission followed by restoration of normal values after 12 hours was
observed in both groups. However, urinary NGAL and CysC values were
significantly reduced at the end of surgery and 12 hours after ICU
admission (uNGAL only) in group F compared with group P (P = 0.025 and
0.039, respectively). Plasma NGAL and CysC tended to increase from
baseline to ICU admission in both groups, but they were not significantly
different between the two groups. No differences were observed on urinary
and plasma creatinine levels and on urine output between the two groups.
Acute kidney injury (AKI) incidence in the postoperative period, as
indicated by pRIFLE classification (pediatric score indicating Risk,
Injury, Failure, Loss of function, and End-stage kidney disease level of
renal damage) was 50% in group F and 72% in group P (P = 0.08; odds ratio
(OR), 0.38; 95% confidence interval (CI), 0.14 to 1.02). A significant
reduction in diuretics (furosemide) and vasodilators (phentolamine)
administration was observed in group F (P = 0.0085; OR, 0.22; 95% CI, 0.07
to 0.7).Conclusions: The treatment with high-dose fenoldopam during CPB in
pediatric patients undergoing cardiac surgery for CHD with biventricular
anatomy significantly decreased urinary levels of NGAL and CysC and
reduced the use of diuretics and vasodilators during CPB.Trial
registration: Clinical Trial.Gov NCT00982527. 2011 Ricci et al.; licensee
BioMed Central Ltd.

<18>
Accession Number
2011463165
Authors
Muratore C.A. Baranchuk A.
Institution
(Muratore) Department of Cardiology, Arrhythmia Service, Hospital
Fernandez, Buenos Aires, Argentina
(Baranchuk) Department of Cardiology, Arrhythmia Service, Kingston General
Hospital, Kingston, ON, Canada
Title
Current and emerging therapeutic options for the treatment of chronic
chagasic cardiomyopathy.
Source
Vascular Health and Risk Management. 6 (1) (pp 593-601), 2010. Date of
Publication: 2010.
Publisher
DOVE Medical Press Ltd. (PO Box 300-008, Albany, Auckland, New Zealand)
Abstract
Chagas' disease is an endemic disease in Latin America caused by a
unicellular parasite (Trypanosoma cruzi) that affects almost 18 million
people. This condition involves the heart, causing heart failure,
arrhythmias, heart block, thromboembolism, stroke, and sudden death. In
this article, we review the current and emerging treatment of Chagas'
cardiomyopathy focusing mostly on management of heart failure and
arrhythmias. Heart failure therapeutical options including drugs, stem
cells and heart transplantation are revised. Antiarrhythmic drugs,
catheter ablation, and intracardiac devices are discussed as well.
Finally, the evidence for a potential role of specific antiparasitic
treatment for the prevention of cardiovascular disease is reviewed. 2010
Muratore and Baranchuk, publisher and licensee Dove Medical Press Ltd.

<19>
Accession Number
2011463149
Authors
de Cecco C.N. Buffa V. David V. Fedeli S.
Institution
(de Cecco, Buffa, Fedeli) Department of Cardiovascular Radiology, San
Camillo-Forlanini Hospital, Via Portuense 332, 00149 Rome, Italy
(de Cecco, David) Department of Radiological Sciences, University of Rome,
St Andrea Hospital, Rome, Italy
Title
Novel approaches for the surgical treatment of atrial fibrillation: Time
for a guideline revision?.
Source
Vascular Health and Risk Management. 6 (1) (pp 439-447), 2010. Date of
Publication: 2010.
Publisher
DOVE Medical Press Ltd. (PO Box 300-008, Albany, Auckland, New Zealand)
Abstract
Atrial fibrillation is a major health problem in Western countries, and is
associated with considerable morbidity and resource consumption. Safe and
reliable surgical techniques for the termination of this arrhythmia have
been developed since the time of the original Cox "maze I" procedure.
Novel equipment based on radiofrequency and microwave technologies can be
employed to create transmural atrial lesions, even in the context of
minimally invasive surgery to the atrioventricular valves via right
minithoracotomy. The aim of this paper is to review the recent literature
on this approach, and the clinical results in terms of arrhythmia
termination and postoperative morbidity. With the aim to substantiate the
practice of a simple, yet reliable, surgical ablation during minimally
invasive heart valve surgery, we discuss the results of different patterns
of atrial lesions having different degrees of surgical complexity.
Finally, minimally invasive epicardial ablation for lone atrial
fibrillation represents an emerging surgical indication. The results of
state-of-the-art transcatheter ablation represent now its benchmark of
comparison. 2010 De Cecco et al, publisher and licensee Dove Medical
Press Ltd.

<20>
Accession Number
2011465328
Authors
Amarpal Kinjavdeka P. Aithal H.P. Pawde A.M. Singh J. Udehiya R.
Institution
(Amarpal, Kinjavdeka, Aithal, Pawde, Singh, Udehiya) Division of Surgery,
Indian Veterinary Research Institute, Izatnagar, (Uttar Pradesh), India
Title
Evaluation of xylazine, acepromazine and medetomidine with ketamine for
general anaesthesia in rabbits.
Source
Scandinavian Journal of Laboratory Animal Science. 37 (3) (pp 223-229),
2010. Date of Publication: 2010.
Publisher
Swedish Research Council (StockholmSE-10378Sweden)
Abstract
A randomized, prospective, blinded experimental study was conducted in 32
rabbits of either sex to compare the anaesthetic and physiological effects
of ketamine with different pre-anaesthetics. Rabbits were randomly divided
into 4 equal groups. Xylazine 6 mg/kg in animals of group
xylazine-ketamine (XK), acepromazine 2 mg/kg in animals of group
acepromazine-ketamine (AK), medetomidine 125 mug/kg in group
medetomidine-ketamine 1 (MK1) or medetomidine 250 mug/kg in group
medetomidine-ketamine 2 (MK2) were administered by intramuscular injection
(IM). Five minutes later, ketamine 60 mg/kg was administered
intramuscularly to all the groups. The rabbits were observed for the onset
of weak time, down time, the time to loss of righting reflex, pedal
reflexes and response to surgical stimuli. Heart rate, respiratory rate
and rectal temperature and arterial oxygen saturation of haemoglobin
(SpO2) were recorded up to 60 min. Weak time, down time and time to loss
of righting reflex were the shortest in animals of group MK2 as compared
to the other groups. Pedal reflexes remained intact in all the animals of
XK group, but were abolished in 50% of the AK group, 75% of the MK1 group
and 100% of animals in the MK2 group. Pain was evinced during surgery by
all the animals in group XK, 5 animals in group AK and 4 animals in group
K1. The best analgesia was achieved in the animals of group MK2, where
none of the animals showed pain on surgical stimulation. Heart rate and
SpO₂ decreased significantly (P<0.01) in the animals of groups
XK, MK1 and MK2 but respiratory rate and rectal temperature decreased
significantly (P<0.01) in all the groups. However, all the animals
recovered from anaesthesia without complications. It was concluded that
medetomidine 250 mug/kg and ketamine 60 mg/kg produced excellent
anaesthesia to allow pain free surgery and may be considered suitable for
anaesthesia in New Zealand White rabbits.