Saturday, September 10, 2011

EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 20

Results Generated From:
Embase <1980 to 2011 Week 36>
Embase (updates since 2011-09-01)


<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
SpO<sub>2</sub> 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.

No comments:

Post a Comment