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<1>
Accession Number
2015740729
Authors
Ruiz Ortiz M. Pena M.L. Mesa D. Delgado M. Romo E. Santisteban M. Puentes
M. Lopez Granados A. Castillo J.C. Arizon J.M. De Lezo J.S.
Institution
(Ruiz Ortiz, Pena, Mesa, Delgado, Romo, Santisteban, Puentes, Lopez
Granados, Castillo, Arizon, De Lezo) Cardiology Department, Reina Sofia
University Hospital, Cordoba, Spain
Title
Impact of asymptomatic acute cellular rejection on left ventricle
myocardial function evaluated by means of two-dimensional speckle tracking
echocardiography in heart transplant recipients.
Source
Echocardiography. 32 (2) (pp 229-237), 2015. Date of Publication: 01 Feb
2015.
Publisher
Blackwell Publishing Inc.
Abstract
Background Our objective was to evaluate the impact of asymptomatic acute
cellular rejection (ACR) in left ventricular myocardial strain in heart
transplant (HT) recipients by means of two-dimensional speckle tracking
echocardiography (2DSTE). Methods From September 1, 2009 to December 15,
2010 a conventional echocardiography and 2DSTE exam was performed on all
consecutive HT recipients in their first year posttransplantation within 3
hours of the surveillance endomyocardial biopsies, as well as on 14
healthy controls. The association of strain echocardiographic variables
with different grades of ACR was investigated. Results Of the 78 studies
performed 4 +/- 3 months after HT in 20 patients, 32 studies were
coincident with grade 0R rejection, 41 with grade 1R, and 5 with grade 2R.
Significantly lower values of average radial strain were found with higher
grades of ACR (29.1 +/- 7.7%, 23.2 +/- 8.5%, and 14.3 +/- 8.8% for grades
0R, 1R, and 2R of ACR, P = 0.001). Average deformation was similar for
controls versus transplanted patients, in the absence of acute rejection:
radial 29.1 +/- 10.0% versus 29.1 +/- 7.7%, P = 0.98; circumferential
-19.3 +/- 3.2% versus -20.2 +/- 5.9%, P = 0.62; and longitudinal -20.7 +/-
4.1% versus -18.5 +/- 5.4%, P = 0.19. An average radial strain <25%
presented 100% sensitivity, 48% specificity, 6% positive predictive value,
and 100% negative predictive value for the presence of 2R rejection (area
under the curve 0.80, IC 95% 0.60-0.99, P = 0.048). Conclusion In this
study, HT recipients showed significantly lower values of average radial
left ventricle strain, evaluated by means of 2DSTE, with the presence of
ACR.

<2>
Accession Number
2014962397
Authors
Jashari H. Rydberg A. Ibrahimi P. Bajraktari G. Henein M.Y.
Institution
(Jashari, Ibrahimi, Bajraktari, Henein) Department of Public Health and
Clinical Medicine, Umea University, Sweden
(Rydberg) Department of Clinical Sciences, Umea University, Sweden
Title
Left ventricular response to pressure afterload in children: Aortic
stenosis and coarctation: A systematic review of the current evidence.
Source
International Journal of Cardiology. 178 (pp 203-209), 2015. Date of
Publication: 15 Jan 2015.
Publisher
Elsevier Ireland Ltd
Abstract
Congenital aortic stenosis (CAS) and Coarctation of Aorta (CoA) represent
two forms of pressure afterload that affect the left ventricle (LV), hence
require regular echocardiographic monitoring. Subclinical dysfunction of
the LV exists even in asymptomatic patients with preserved left
ventricular ejection fraction (EF), implying low sensitivity of EF in
predicting optimum time for intervention. In this article we review
patterns of LV myocardial deformation before and after correction of CAS
and CoA in infants, children and adolescents, showing their important role
in monitoring the course of LV dysfunction. A systematic search using
PubMed was performed and suitable studies are presented on a narrative
form. Normal EF and/or fractional shortening (FS), with subclinical
myocardial dysfunction are reported in all studies before intervention.
The short-term results, after intervention, were related to the type of
procedure, with no improvement or further deterioration related to surgery
but immediate improvement after balloon intervention. Long term follow-up
showed further improvement but still subnormal function. Thus correction
of CAS and CoA before irreversible LV dysfunction is vital, and requires
longitudinal studies in order to identify the most accurate parameter for
function prognostication. Until then, conventional echocardiographic
parameters together with myocardial velocities and deformation parameters
should continue to provide follow-up reproducible measures of ventricular
function.

<3>
Accession Number
2014962375
Authors
Briasoulis A. Afonso L. Palla M. Sharma S. Panaich S. Papageorgiou N.
Tousoulis D.
Institution
(Briasoulis, Afonso, Palla, Sharma, Panaich) Wayne State
University/DetroitMedical Center, Department of Cardiology, Detroit, IL
48226, United States
(Papageorgiou, Tousoulis) University of Athens Medical School, 1st
Department of Cardiology, Greece
Title
Culprit-vessel versus complete revascularization during primary
angioplasty in ST-elevation myocardial infarction: An updated
meta-analysis.
Source
International Journal of Cardiology. 178 (pp 171-174), 2015. Date of
Publication: 15 Jan 2015.
Publisher
Elsevier Ireland Ltd

<4>
Accession Number
2014962079
Authors
Shao Y. Fan Y. Li J. Cao H. Liu B. Wang J. Yang J. Zhang Q. Hu X.
Institution
(Shao, Fan, Li, Cao, Liu, Wang, Yang, Zhang, Hu) Department of Surgery,
First Affiliated Hospital of China Medical University, Shenyang 110001,
China
Title
Does elevated asymmetrical dimethylarginine predict major adverse cardiac
events and mortality in patients after percutaneous coronary
intervention?.
Source
International Journal of Cardiology. 178 (pp 188-190), 2015. Date of
Publication: 15 Jan 2015.
Publisher
Elsevier Ireland Ltd

<5>
Accession Number
2014960958
Authors
Pezawas T. Grimm M. Ristl R. Kivaranovic D. Moser F.T. Laufer G.
Schmidinger H.
Institution
(Pezawas, Moser, Schmidinger) Department of Internal Medicine II, Devision
of Cardiology, Medical University of Vienna, Wahringer Gurtel 18-20,
Vienna 1090, Austria
(Grimm, Laufer) Department of Cardiothoracic Surgery, Medical University
of Vienna, Vienna, Austria
(Ristl, Kivaranovic) Center for Medical Statistics Informatics and
Intelligent Systems, Medical University of Vienna, Vienna, Austria
Title
Primary preventive cardioverter-defibrillator implantation (Pro-ICD) in
patients awaiting heart transplantation. A prospective, randomized,
controlled 12-year follow-up study.
Source
Transplant International. 28 (1) (pp 34-41), 2015. Date of Publication: 01
Jan 2015.
Publisher
Blackwell Publishing Ltd
Abstract
Summary The aim of this study was to evaluate whether short-term primary
preventive cardioverter-defibrillator (ICD) implantation as bridge to
heart transplantation (HTX) provides any survival benefit. Thirty-three
patients awaiting HTX were randomized to either conventional therapy
(control group) or primary preventive ICD implantation (ICD group).
Fourteen patients had ischemic cardiomyopathy (ICM) and 19 patients had
dilated cardiomyopathy (DCM). Sixteen patients were randomized to the ICD
group and 17 patients were randomized to the control group. Twenty
patients (61%) were transplanted after a waiting time of 10 +/- 9 months.
The remaining 13 patients (39%) were not transplanted because of clinical
improvement (n = 5), cerebral hemorrhage (n = 3), or death (n = 5). On the
waiting list, 3 ICD patients with DCM developed slow VTs without ICD
intervention, two patients with ICM (6%) had fast VT terminated by the
ICD, and no arrhythmic death was observed. After 11.9 years (median), 13
of 20 HTX patients (65%) and 5 of 13 non-HTX patients (38%) were alive.
Survivors had a higher LVEF (22 +/- 6 vs. 17 +/- 4%, P = 0.0092) and a
better exercise capacity (75 +/- 29 vs. 57 +/- 24 Watt, P = 0.0566) at
baseline as compared to nonsurvivors. This study may not support the
general use of primary preventive ICDs as a short-term bridge to heart
transplantation.

<6>
Accession Number
2015691805
Authors
Sondergaard E.S. Fonnes S. Gogenur I.
Institution
(Sondergaard) Department of Anesthesiology, Roskilde Hospital, Kogevej
7-13, Roskilde 4000, Denmark
(Fonnes) Department of Gastroenterology, Herlev Hospital, University of
Copenhagen, Herlev, Denmark
(Gogenur) Department of Surgery, Koge Hospital, University of Copenhagen,
Koge, Denmark
Title
Endothelial dysfunction after non-cardiac surgery: A systematic review.
Source
Acta Anaesthesiologica Scandinavica. 59 (2) (pp 140-146), 2015. Date of
Publication: 01 Feb 2015.
Publisher
Blackwell Munksgaard
Abstract
Background More than 50% of patients with increased troponin levels after
non-cardiac surgery have an impaired endothelial function pre-operatively.
Non-invasive markers of endothelial function have been developed for the
assessment of endothelial dysfunction. The aim of this paper was to
systematically review the literature to evaluate the association between
non-cardiac surgery and non-invasive markers of endothelial function.
Methods A systematic search was conducted in MEDLINE, EMBASE and Cochrane
Library Database according to the PRISMA guidelines. Endothelial
dysfunction was described only with non-invasive measurements done both
pre- and post-operatively and published in English. All types of
non-cardiac surgery and both men and women of all ages were included.
Results We found 1722 eligible studies in our search, and of these, five
studies fulfilled our inclusion and exclusion criteria. Endothelial
function was disturbed in patients after non-cardiac surgery. Three
studies found a significant decrease in the endothelial function
immediately after surgery (2 and 24 h post-operatively). Two studies found
that patients with previous endothelial dysfunction and scheduled for
surgery (renal transplantation and vascular surgery respectively) had an
improvement in endothelial dysfunction 1 month after surgery. Conclusion
Endothelial function changes in relation to surgery. Assessment of
endothelial function by non-invasive measures has the potential to guide
clinicians in the prevention or treatment of post-operative myocardial
damage.

<7>
Accession Number
2015687728
Authors
Panthee N. Ono M.
Institution
(Panthee, Ono) Department of Cardiac Surgery, University of Tokyo, 7-3-1
Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
Title
Spinal cord injury following thoracic and thoracoabdominal aortic repairs.
Source
Asian Cardiovascular and Thoracic Annals. 23 (2) (pp 235-246), 2015. Date
of Publication: 23 Feb 2015.
Publisher
SAGE Publications Inc.
Abstract
Objective: To discuss the currently available approaches to prevent spinal
cord injury during thoracic and thoracoabdominal aortic repairs. Methods:
We carried out a PubMed search up to 2013 using the Medical Subject
Headings: "aortic aneurysm/surgery" and "spinal cord ischemia"; "aortic
aneurysm, thoracic/surgery" and "spinal cord ischemia"; "aneurysm/surgery"
and "spinal cord ischemia/cerebrospinal fluid"; "aortic aneurysm/surgery"
and "paraplegia". All 190 original articles satisfying our inclusion
criteria were analyzed for incidence, predictors, and other pertinent
variables related to spinal cord injury, and we compared the results in
recent publications with those in earlier reports. Results: The mean age
of the 38,491 patients was 65.3 +/- 4.9 years. The overall incidence of
paraplegia and/or paraparesis was 7.1% +/- 6.1% (range 0%-32%). The
incidence of spinal cord injury before 2000, from 2001 to 2007, and
2008-2013 was 9.0% +/- 6.7%, 7.0% +/- 6.1%, and 5.9% +/- 5.2%,
respectively (p = 0.019). Various predictors of spinal cord injury were
identified, extent of disease being the most common. Modification of
surgical techniques, use of adjuncts, and better understanding of spinal
cord perfusion physiology were attributed to the decrease in postoperative
spinal cord injury in recent years. Conclusions: Spinal cord injury after
thoracic and thoracoabdominal aortic repair poses a real challenge to
cardiovascular surgeons. However, with evolving surgical strategies,
identification of predictors, and use of various adjuncts over the years,
the incidence of spinal cord injury after thoracic/thoracoabdominal aortic
repair has declined. Embracing a multimodality approach offers a good
insight into combating this grave complication.

<8>
Accession Number
2015636070
Authors
Giaquinta S. Michaels M.G. McCullers J.A. Wang L. Fonnesbeck C. O'Shea A.
Green M. Halasa N.B.
Institution
(Giaquinta, O'Shea, Halasa) Pediatrics, Vanderbilt University Medical
Center, Nashville, TN, United States
(Michaels, Green) Pediatrics, Children's Hospital of Pittsburgh,
Pittsburgh, PA, United States
(McCullers) Pediatrics, St. Jude Children's Research Hospital, Memphis,
TN, United States
(McCullers) Pediatrics, University of Tennessee, Health Sciences Center,
Memphis, TN, United States
(Wang, Fonnesbeck) Biostatistics, Vanderbilt University Medical Center,
Nashville, TN, United States
Title
Randomized, double-blind comparison of standard-dose vs. high-dose
trivalent inactivated influenza vaccine in pediatric solid organ
transplant patients.
Source
Pediatric Transplantation. 19 (2) (pp 219-228), 2015. Date of Publication:
01 Mar 2015.
Publisher
Blackwell Publishing Inc.
Abstract
Children who have undergone SOT mount a lower immune response after
vaccination with TIV compared to healthy controls. HD or SD TIV in
pediatric SOT was given to subjects 3-17 yr and at least six months
post-transplant. Subjects were randomized 2:1 to receive either the HD (60
mug) or the SD (15 mug) TIV. Local and systemic reactions were solicited
after each vaccination, and immune responses were measured before and
after each vaccination. Thirty-eight subjects were enrolled. Mean age was
11.25 yr; 68% male, 45% renal, 26% heart, 21% liver, 5% lung, and 5%
intestinal. Twenty-three subjects were given HD and 15 SD TIV. The median
time since transplant receipt was 2.2 yr. No severe AEs or rejection was
attributed to vaccination. The HD group reported more tenderness and local
reactions, fatigue, and body ache when compared to the SD cohort, but
these were considered mild and resolved within three days. Subjects in the
HD group demonstrated a higher percentage of four-fold titer rise to H3N2
compared to the SD group. HD influenza vaccine was well tolerated and may
have increased immunogenicity. A phase 2 trial is needed to confirm.

<9>
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Accession Number
2014771741
Authors
Veerasamy M. Edwards R. Ford G. Kirkwood T. Newton J. Jones D. Kunadian V.
Institution
(Veerasamy, Ford, Newton, Jones, Kunadian) Institute of Cellular Medicine,
Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne NE2
4HH, United Kingdom
(Veerasamy, Edwards, Kunadian) Cardiothoracic Centre, Freeman Hospital,
Newcastle upon Tyne, United Kingdom
(Kirkwood, Newton) Institute for Ageing and Health, Newcastle University,
Newcastle upon Tyne, United Kingdom
Title
Acute coronary syndrome among older patients: A review.
Source
Cardiology in Review. 23 (1) (pp 26-32), 2015. Date of Publication: 14 Dec
2015.
Publisher
Lippincott Williams and Wilkins
Abstract
Ischemic heart disease is the leading cause of mortality worldwide. Due to
advances in medicine in the past few decades, life expectancy has
increased resulting in an aging population in developed and developing
countries. Acute coronary syndrome causes greater morbidity and mortality
in this group of older patients, which appears to be due to age-related
comorbidities. This review examines the incidence and prevalence of acute
coronary syndrome among older patients, examines current treatment
strategies, and evaluates the predictors of adverse outcomes. In
particular, the impact of frailty on outcomes and the need for frailty
assessment in developing future research and management strategies among
older patients are discussed.

<10>
Accession Number
2014740136
Authors
Afshani N. Schulein S. Biccard B.M. Thomas J.M.
Institution
(Afshani) Department of Anaesthetics, University of Cape Town, Groote
Schuur Hospital, Anzio Road, Observatory, Cape Town 7925, South Africa
(Schulein) Department of Anesthetics, Toronto General Hospital, University
of Toronto, Toronto, Canada
(Schulein) McMaster University, ON, Canada
(Biccard) Perioperative Research Group, Department of Anaesthetics,
University of Kwazulu-Natal, Durban, South Africa
(Thomas) Department of Anaesthetics, Red Cross War Memorial Children's
Hospital, Cape Town, South Africa
Title
Clinical utility of B-type natriuretic peptide (NP) in pediatric cardiac
surgery - A systematic review.
Source
Paediatric Anaesthesia. 25 (2) (pp 115-126), 2015. Date of Publication: 01
Feb 2015.
Publisher
Blackwell Publishing Ltd
Abstract
Background NP is a biomarker that has been used in the diagnosis,
management, and prognostication of a number of cardiovascular disorders in
the pediatric population. The physiological role of this hormone is to
allow the myocardium to adapt to stress or strain imposed by a volume
and/or pressure load. Objective The aim of this study was to determine the
utility of preoperative and postoperative NP to predict outcome in
pediatric patients undergoing cardiac surgery for structural congenital
heart disease. Method We conducted a systematic review by searching three
electronic databases using the search terms 'paediatric' or 'pediatric'
and 'B-type natriuretic peptide'. Twenty peer-reviewed papers were
included in the study. Results Preoperative NP levels were associated with
the severity of cardiac failure in several studies. Preoperative NPs also
correlated with early postoperative outcome measures such as duration of
cardiopulmonary bypass, duration of mechanical ventilation, presence of
low cardiac output syndrome, length of stay in the intensive care unit and
in one study, death. Early (within 24 h) postoperative NPs showed a
stronger correlation than preoperative NPs to early postoperative adverse
events. Conclusion NPs provide a simple, noninvasive and complementary
tool to echocardiography that can be used to assist clinicians in the
assessment and management of pediatric patients with congenital heart
disease in the perioperative period.

<11>
Accession Number
2015718648
Authors
Bhargava S. Tamaskar A. Chakravarty N. Shende S. Shidhaye R.V.
Institution
(Bhargava, Tamaskar, Chakravarty, Shende, Shidhaye) Department of
Anesthesiology and Critical Care, L.N. Medical College, J.K. Hospital,
Kolar Road, Bhopal 462042, India
Title
Comparative study of thoracic epidural fentanyl with sufentanil for
postoperative pain relief in thoracic surgery.
Source
Anaesthesia, Pain and Intensive Care. 18 (3) (pp 260-264), 2014. Date of
Publication: 01 Jul 2014.
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Objectives: Both fentanyl and sufentanil have been used, either alone or
with local anesthetics, for thoracic epidural analgesia. This study was
undertaken to compare quality and safety of thoracic epidural fentanyl and
thoracic epidural sufentanil for providing postoperative analgesia for 48
hours after thoracic surgery. Methodology: In a prospective randomized,
controlled study, 70 patients age group between 20-60 years, of either
gender, scheduled for routine thoracic surgery were randomly distributed
into two groups of 35 patients each. Postoperatively, fentanyl 50 mug in
Group-F and sufentanil 20 mug in Group-S, diluted in 10 ml of normal
saline was injected in the thoracic epidural space (between T6 - T8)
through the catheter and then repeated 6 hourly. Pain intensity score,
onset of analgesia, number of top-ups required and overall patient
satisfaction score were recorded. Results: Mean onset of analgesia was
10.31 +/- 1.5 min with sufentanil group as against 14.23 +/- 1.2 min with
fentanyl group. Pain Intensity (PPI) score < 1 was observed in 78.21%
observations belonging to sufentanil group and in 50 % observations
belonging to fentanyl group. Twenty five patients (71.4%) from sufentanil
group and 30 patients (85.7%) from fentanyl group required rescue
analgesia. The patient's feedback on pain relief was graded as very good
or good by 78.5% of the patients in Group-S and 69% patients in Group-F.
Conclusion: Though both drugs are equally safe, sufentanil is faster
acting, more potent and efficient analgesic than fentanyl when used for
postoperative pain relief in thoracic surgeries via thoracic epidural
approach.

<12>
Accession Number
2015730454
Authors
Phan K. Xie A. Tsai Y.-C. Kumar N. La Meir M. Yan T.D.
Institution
(Phan, Xie, Yan) Collaborative Research (CORE) Group, Macquarie University
Hospital, Macquarie University, 2 Technology Place, Sydney, Australia
(Phan) Sydney Medical School, University of Sydney, Sydney, Australia
(Tsai) Prince Charles Hospital, Chermside, Australia
(Kumar, La Meir) Department of Cardiothoracic Surgery and Cardiology,
Academic Hospital Maastricht, Cardiovascular Research Institute
Maastricht, Maastricht, Netherlands
(La Meir) University Hospital Brussels, Brussels, Belgium
(Yan) Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital,
University of Sydney, Sydney, Australia
Title
Biatrial ablation vs. left atrial concomitant surgical ablation for
treatment of atrial fibrillation: A meta-analysis.
Source
Europace. 17 (1) (pp 38-47), 2014. Date of Publication: 25 Nov 2014.
Publisher
Oxford University Press
Abstract
Aims Surgical ablation performed concomitantly with cardiac surgery has
emerged as an effective curative strategy for atrial fibrillation (AF).
Left atrial (LA) lesion sets for ablation have been suggested to reduce
procedural times and post-surgical bradycardia compared with biatrial (BA)
lesions. Given the inconclusive literature regarding BA vs. LA ablation,
the present meta-analysis sought to assess the current evidence. Methods
and results Electronic searches were performed using six databases from
their inception to December 2013, identifying all relevant randomized
trials and observational studies comparing BA vs. LA surgical ablation AF
patients undertaking cardiac surgery. In 10 included studies, 2225 patient
results were available for analysis to compare BA (n = 888) vs. LA (n =
1337) ablation. Sinus rhythm prevalence was higher in the BA cohort
compared with the LA cohort at 6-month and 12-month follow-up, but similar
beyond 1 year. Permanent pacemaker implantations were higher in the BA
cohort, but 30-day and late mortality, neurological events, and
reoperation for bleeding were similar between BA and LA groups.
Conclusions Biatrial and LA ablations produced comparable 30-day and late
mortality but LA was associated with significantly reduced permanent
pacemaker implantation rates. Biatrial ablation appeared to be more
efficacious than LA ablation in achieving SR at 1 year, but this
difference was not maintained beyond 1 year. Trends appear to be driven by
the preferential selection of long-standing and persistent AF patients for
the BA approach. Future randomized studies of adequate follow-up are
required to validate risks and benefits of BA vs. LA surgical ablation.

<13>
Accession Number
2015789289
Authors
Paikin J.S. Hirsh J. Ginsberg J.S. Weitz J.I. Chan N.C. Whitlock R.P. Pare
G. Johnston M. Eikelboom J.W.
Institution
(Paikin, Whitlock, Eikelboom) Hamilton General Hospital, McMaster
University, Hamilton, ON, Canada
(Paikin, Hirsh, Ginsberg, Weitz, Pare, Eikelboom) Department of Medicine,
McMaster University, Hamilton, ON, Canada
(Hirsh, Chan, Whitlock, Pare, Johnston, Eikelboom) Population Health
Research Institute, McMaster University, Hamilton, ON, Canada
(Ginsberg, Weitz, Eikelboom) Thrombosis and Atherosclerosis Research
Institute, McMaster University, Hamilton, ON, Canada
Title
Multiple daily doses of acetyl-salicylic acid (ASA) overcome reduced
platelet response to once-daily ASA after coronary artery bypass graft
surgery: A pilot randomized controlled trial.
Source
Journal of Thrombosis and Haemostasis. 13 (3) (pp 448-456), 2015. Date of
Publication: 01 Mar 2015.
Publisher
Blackwell Publishing Ltd
Abstract
Summary: Background: The efficacy of ASA for prevention of graft failure
following CABG surgery may be limited by incomplete platelet inhibition
due to increased post-operative platelet turnover. Objectives: To
determine whether acetyl-salicylic acid (ASA) 325 mg once-daily or 81 mg
four-times daily overcomes the impaired response to ASA 81 mg once-daily
in post-operative coronary artery bypass graft (CABG) patients. Methods:
We randomized 110 patients undergoing CABG surgery to either ASA 81 mg
once-daily, 81 mg four times daily or 325 mg once-daily and compared their
effects on serum thromboxane B₂ (TXB₂) suppression
and arachidonate-induced platelet aggregation. Results: One hundred
patients were included in the final analysis. Platelet counts fell after
surgery, reached a nadir on day 2, and then gradually increased. Although
there was near complete suppression of TXB₂ on the second or
third post-operative day, TXB₂ levels increased in parallel
with the rise in platelet count on subsequent days. This increase was most
marked in patients receiving ASA 81 mg once-daily and less evident in
those receiving ASA four times daily. On post-operative day 4, (i) median
TXB₂ levels were lower with four times daily ASA than with
either ASA 81 mg once-daily (1.1 ng/mL; Quartile(Q) Q1,Q3: 0.5, 2.4 and
13.3 ng/mL; Q1,Q3: 7.8, 30.8 ng/mL, respectively; P < 0.0001) or ASA 325
mg once-daily (3.4 ng/mL; Q1,Q3: 2.0, 8.2 ng/mL; P = 0.002), and (ii) ASA
given four times daily was more effective than ASA 81 mg once-daily and
325 mg once-daily at suppressing platelet aggregation. Conclusions: Four
times daily ASA is more effective than ASA 81 and 325 mg once-daily at
suppressing serum TXB₂ formation and platelet aggregation
immediately following CABG surgery.

<14>
Accession Number
2015684592
Authors
Feldman A.M. She L. McNamara D.M. Mann D.L. Bristow M.R. Maisel A.S.
Wagner D.R. Andersson B. Chiariello L. Hayward C.S. Hendry P. Parker J.D.
Racine N. Selzman C.H. Senni M. Stepinska J. Zembala M. Rouleau J.
Velazquez E.J. Lee K.L.
Institution
(Feldman) Department of Medicine, Temple University School of Medicine,
3500 N. Broad Street, Philadelphia, PA 19140, United States
(Velazquez) Department of Medicine, Duke University School of Medicine,
Durham, NC, United States
(She, Lee) Duke Clinical Research Institute, Durham, NC, United States
(McNamara) Department of Medicine, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
(Mann) Department of Medicine, Washington University in St. Louis School
of Medicine, St. Louis, MO, United States
(Bristow) Department of Medicine, University of Colorado at Denver,
Denver, CO, United States
(Maisel) Department of Medicine, University of California, San Diego, CA,
United States
(Selzman) Department of Surgery, University of Utah Hospital, Salt Lake
City, UT, United States
(Wagner) Laboratory of Cardiovascular Research, Luxembourg Heart
Institute, Luxembourg, Luxembourg
(Andersson) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Chiariello) Department of Cardiac Surgery, Policlinico Tor Vergata of
Rome, Rome, Italy
(Senni) Department of Medicine, Ospedali Riuniti, Bergamo, Italy
(Hayward) Department of Cardiology, St. Vincent's Hospital, Sydney, NSW,
Australia
(Hendry) Department of Cardiac Surgery, Ottawa Heart Institute, Ottawa,
ON, Canada
(Parker) Department of Medicine, Toronto General Hospital, Toronto, ON,
Canada
(Racine, Rouleau) Department of Medicine, Montreal Heart Institute,
Montreal, QC, Canada
(Stepinska) Valvular Heart Department, National Institute of Cardiology,
Warsaw, Poland
(Zembala) Department of Cardiac Surgery, Silesian Center for Heart
Diseases, Zabrze, Poland
Title
Genetic variants are not associated with outcome in patients with coronary
artery disease and left ventricular dysfunction: Results of the genetic
substudy of the Surgical Treatment for Ischemic Heart Failure (STICH)
trials.
Source
Cardiology (Switzerland). 130 (2) (pp 69-81), 2015. Date of Publication:
24 Feb 2015.
Publisher
S. Karger AG
Abstract
Objectives and Background: We evaluated the ability of 23 genetic variants
to provide prognostic information in patients enrolled in the Genetic
Substudy of the Surgical Treatment for Ischemic Heart Failure (STICH)
trials. Methods: Patients assigned to STICH Hypothesis 1 were randomized
to medical therapy with or without coronary artery bypass grafting (CABG).
Those assigned to STICH Hypothesis 2 were randomized to CABG or CABG with
left ventricular reconstruction. Results: In patients assigned to STICH
Hypothesis 2 (n = 714), no genetic variant met the prespecified
Bonferroni-adjusted threshold for statistical significance (p < 0.002);
however, several variants met nominal prognostic significance: variants in
the beta₂-adrenergic receptor gene (beta₂-AR
Gln27Glu) and in the A₁-adenosine receptor gene
(A₁-717 T/G) were associated with an increased risk of a
subject dying or being hospitalized for a cardiac problem (p = 0.027 and
0.031, respectively). These relationships remained nominally significant
even after multivariable adjustment for prognostic clinical variables.
However, none of the 23 genetic variants influenced all-cause mortality or
the combination of death or cardiovascular hospitalization in the STICH
Hypothesis 1 population (n = 532) by either univariate or multivariable
analysis. Conclusion: We were unable to identify the predictive genotypes
in optimally treated patients in these two ischemic heart failure
populations.

<15>
Accession Number
2015791353
Authors
Gu W.-J. Wang F. Liu J.-C.
Institution
(Gu, Liu) Department of Anesthesiology, Hospital of Guangxi Medical
University, Nanning, China
(Wang) Department of Anesthesiology, General Hospital of Jinan Military
Command, Jinan, China
Title
Effect of lung-protective ventilation with lower tidal volumes on clinical
outcomes among patients undergoing surgery: A meta-analysis of randomized
controlled trials.
Source
CMAJ. 187 (3) (pp E101-E109), 2015. Date of Publication: 17 Feb 2015.
Publisher
Canadian Medical Association (1867 Alta Vista Drive, Ottawa KIG5W8,
Canada. E-mail: dahlia@car.ca)
Abstract
Background: In anesthetized patients undergoing surgery, the role of
lung-protective ventilation with lower tidal volumes is unclear. We
performed a meta-analysis of randomized controlled trials (RCTs) to
evaluate the effect of this ventilation strategy on postoperative
outcomes. Methods: We searched electronic databases from inception through
September 2014. We included RCTs that compared protective ventilation with
lower tidal volumes and conventional ventilation with higher tidal volumes
in anesthetized adults undergoing surgery. We pooled outcomes using a
random-effects model. The primary outcome measures were lung injury and
pulmonary infection. Results: We included 19 trials (n = 1348). Compared
with patients in the control group, those who received lung-protective
ventilation had a decreased risk of lung injury (risk ratio [RR] 0.36, 95%
confidence interval [CI] 0.17 to 0.78; I² = 0%) and pulmonary
infection (RR 0.46, 95% CI 0.26 to 0.83; I² = 8%), and higher
levels of arterial partial pressure of carbon dioxide (standardized mean
difference 0.47, 95% CI 0.18 to 0.75; I² = 65%). No significant
differences were observed between the patient groups in atelectasis,
mortality, length of hospital stay, length of stay in the intensive care
unit or the ratio of arterial partial pressure of oxygen to fraction of
inspired oxygen. Interpretation: Anesthetized patients who received
ventilation with lower tidal volumes during surgery had a lower risk of
lung injury and pulmonary infection than those given conventional
ventilation with higher tidal volumes. Implementation of a lung-protective
ventilation strategy with lower tidal volumes may lower the incidence of
these outcomes.

<16>
Accession Number
2014721843
Authors
McMaster K. Sanchez-Ramos L. Kaunitz A.M.
Institution
(McMaster, Sanchez-Ramos, Kaunitz) Department of Obstetrics and
Gynecology, University of Florida, College of Medicine - Jacksonville,
Jacksonville, FL, United States
Title
Balancing the efficacy and safety of misoprostol: A meta-analysis
comparing 25 versus 50 micrograms of intravaginal misoprostol for the
induction of labour.
Source
BJOG: An International Journal of Obstetrics and Gynaecology. 122 (4) (pp
468-476), 2014. Date of Publication: 01 Mar 2015.
Publisher
Blackwell Publishing Ltd
Abstract
Background The optimal dose of misoprostol for the induction of labour
remains uncertain. Objectives To compare the efficacy and safety of 25
versus 50 micrograms of intravaginal misoprostol tablets for the induction
of labour and cervical ripening. Search strategy We performed electronic
and manual searches to identify relevant randomised trials. Selection
criteria The efficacy outcomes assessed were rates of vaginal delivery
within 24 hours, delivery within one dose, and oxytocin augmentation, and
interval to delivery. The safety outcomes assessed were incidences of
tachysystole, hyperstimulation, caesarean delivery, cesarean delivery for
non-reassuring fetal heart rate (FHR), operative vaginal delivery,
abnormal 5-minute Apgar score, abnormal cord gas values, admission to a
neonatal intensive care unit (NICU), and meconium passage. Data collection
and analysis Thirteen studies (1945 women) were included. Relative risk
(RR) and 95% confidence intervals (CI) were calculated using fixed-effects
and random-effects models. Main results We found that 25 micrograms was
less efficacious, with lower rates of delivery after one dose (RR 0.59;
95% CI 0.39-0.88) and vaginal delivery within 24 hours (RR 0.88; 95% CI
0.79-0.96), and with increased rates of oxytocin augmentation (RR 1.54,
95% CI 1.36-1.75). We noted an improved safety profile with 25 micrograms,
however, with decreased rates of tachysystole (RR 0.46; 95% CI 0.35-0.61),
hyperstimulation (RR 0.5; 95% CI 0.31-0.78), caesarean deliveries for
non-reassuring FHR (RR 0.67; 95% CI 0.52-0.87), NICU admissions (RR 0.63;
95% CI 0.4-0.98), and meconium passage (RR 0.65; 95% CI 0.45-0.96).
Conclusions Although 50 micrograms of intravaginal misoprostol may be more
efficacious, safety concerns make the 25-microgram dose preferable.

<17>
Accession Number
2015694930
Authors
Siegmund-Schultze N.
Title
Preconditioning for bypass surgery: Heart-distant, short ischemic phases
are cardioproctive.
Source
Deutsches Arzteblatt International. 110 (40) (pp A1860), 2013. Date of
Publication: 04 Oct 2013.
Publisher
Deutscher Arzte-Verlag GmbH (Dieselstrasse 2 (Postfach 0254), Cologne
50859, Germany. E-mail: verlag@aerzteblatt.de)

<18>
Accession Number
2015791165
Authors
Billings F.T. Petracek M.R. Roberts L.J. Pretorius M.
Institution
(Roberts, Pretorius) Division of Clinical Pharmacology, Department of
Medicine, Vanderbilt University Medical School, Nashville, TN, United
States
(Petracek) Department of Cardiac Surgery, Vanderbilt University Medical
School, Nashville, TN, United States
(Roberts) Department of Pharmacology, Vanderbilt University Medical
School, Nashville, TN, United States
(Billings, Pretorius) Department of Anesthesiology, Vanderbilt University
Medical School, Nashville, TN, United States
Title
Perioperative intravenous acetaminophen attenuates lipid peroxidation in
adults undergoing cardiopulmonary bypass: A randomized clinical trial.
Source
PLoS ONE. 10 (2) , 2015. Article Number: e0117625. Date of Publication: 23
Feb 2015.
Publisher
Public Library of Science
Abstract
Background: Cardiopulmonary bypass (CPB) lyses erythrocytes and induces
lipid peroxidation, indicated by increasing plasma concentrations of free
hemoglobin, F₂-isoprostanes, and isofurans. Acetaminophen
attenuates hemeprotein-mediated lipid peroxidation, reduces plasma and
urine concentrations of F₂-isoprostanes, and preserves kidney
function in an animal model of rhabdomyolysis. Acetaminophen also
attenuates plasma concentrations of isofurans in children undergoing CPB.
The effect of acetaminophen on lipid peroxidation in adults has not been
studied. This was a pilot study designed to test the hypothesis that
acetaminophen attenuates lipid peroxidation in adults undergoing CPB and
to generate data for a clinical trial aimed to reduce acute kidney injury
following cardiac surgery. Methods and Results: In a prospective
double-blind placebo-controlled clinical trial, sixty adult patients were
randomized to receive intravenous acetaminophen or placebo starting prior
to initiation of CPB and for every 6 hours for 4 doses. Acetaminophen
concentrations measured 30 min into CPB and post-CPB were 11.9+/- 0.6
mug/mL (78.9+/-3.9 muM) and 8.7+/- 0.3 mug/mL (57.6+/-2.0 muM),
respectively. Plasma free hemoglobin increased more than 15-fold during
CPB, and haptoglobin decreased 73%, indicating hemolysis. Plasma and
urinary markers of lipid peroxidation also increased during CPB but
returned to baseline by the first postoperative day. Acetaminophen reduced
plasma isofuran concentrations over the duration of the study (P = 0.05),
and the intraoperative plasma isofuran concentrations that corresponded to
peak hemolysis were attenuated in those subjects randomized to
acetaminophen (P = 0.03). Perioperative acetaminophen did not affect
plasma concentrations of F₂-isoprostanes or urinary markers of
lipid peroxidation. Conclusions: Intravenous acetaminophen attenuates the
increase in intraoperative plasma isofuran concentrations that occurs
during CPB, while urinary markers were unaffected. Trial Registration:
ClinicalTrials.gov NCT01366976.

<19>
Accession Number
2014722173
Authors
Matzelle S.J. Murphy M.J. Weightman W.M. Gibbs N.M. Edelman J.J.B. Passage
J.
Institution
(Matzelle, Murphy, Weightman, Gibbs) Department of Anaesthesia, Sir
Charles Gairdner Hospital, Nedlands, WA, Australia
(Edelman, Passage) Department of Cardiothoracic Surgery, Sir Charles
Gairdner Hospital, Nedlands, WA, Australia
(Passage) School of Medicine, Fremantle, University of Notre Dame, WA,
Australia
Title
Minimally invasive mitral valve surgery using single dose antegrade
custodiol cardioplegia.
Source
Heart Lung and Circulation. 23 (9) (pp 863-868), 2014. Date of
Publication: 01 Sep 2014.
Publisher
Elsevier Ltd
Abstract
Objective: Our unit began a minimally invasive mitral surgery (MIMS)
program utilising antegrade Custodiol solution as the sole cardioplegia.
The aim of this paper is to report our results of this program.
Patients/Methods: Early clinical outcomes were identified and assessed for
the first consecutive 100 MIMS patients with comparisons made to a
historical group operated via a sternotomy (n. =. 113). The efficacy of
myocardial protection was assessed using surrogate outcomes of myocardial
protection with serial sodium concentrations also analysed. Results: Six
hours postoperatively 12 patients required inotropic support. Peak
troponin-I in the first 24. hours was 5.1 (0.8-40. mug/L [median(range)].
Sodium levels decreased following administration of Custodiol but by six
hours postoperatively the sodium had returned to greater than 130mmol/L in
all but five patients. Blood transfusion was smaller in the MIMS versus
historical group (RBC 17% vs. 65%). MIMS patients had a shorter duration
of ventilation, hospital stay and one-year mortality rate (0%).
Conclusions: In this series of patients undergoing MIMS, single dose
antegrade Custodiol offers satisfactory and safe myocardial protection.
Early clinical outcomes were also satisfactory. Whilst our findings are
observational, they nevertheless support the use of this less invasive
approach to mitral surgery using single dose Custodiol for myocardial
protection.

<20>
Accession Number
2014740233
Authors
Jarral O.A. Saso S. Harling L. Ashrafian H. Naase H. Casula R. Athanasiou
T.
Institution
(Jarral, Saso, Harling, Ashrafian, Naase, Casula, Athanasiou) Department
of Surgery and Cancer, Imperial College, London, United Kingdom
Title
Organ dysfunction in patients with left ventricular impairment: What is
the effect of cardiopulmonary bypass?.
Source
Heart Lung and Circulation. 23 (9) (pp 852-862), 2014. Date of
Publication: 01 Sep 2014.
Publisher
Elsevier Ltd
Abstract
Objective: We have previously demonstrated that avoidance of
cardiopulmonary bypass may reduce early mortality and cardiac related
complications in patients with left ventricular dysfunction. This study
examines the impact of cardiopulmonary bypass in the same subgroup in
terms of organ dysfunction and non-cardiac related complications. Methods:
A systematic literature review identified 24 studies including 7,976
patients. Data was extracted for the following outcomes of interest:
stroke, renal failure, ventilation time, pulmonary complications and
sternal wound infection. Random effects meta-analysis was used to
aggregate the data. Sensitivity and heterogeneity were assessed. Results:
Meta-analysis through subgroup analysis of the highest quality studies
revealed that the off-pump technique is associated with significantly
lower incidence of stroke, renal failure, ventilation time and sternal
wound infection. Conclusion: These results highlight an important link
between cardiopulmonary bypass and the incidence of multi-organ
dysfunction in patients with left ventricular dysfunction. The results add
to the growing body of evidence that off-pump surgery is more beneficial
in high-risk patients. Even in the light of mixed reports on graft patency
and completeness of revascularisation, the technique may be justified in
selected patients in attempt to reduce organ dysfunction.

<21>
Accession Number
2015785990
Authors
Ghiasi A. Shafiee A. Omran A.S. Ghaffari-Marandi N. Shirzad M. Barkhordari
K.
Institution
(Ghiasi) Department of Anesthaesiology and Critical Care, Tehran Heart
Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Shafiee, Ghaffari-Marandi, Barkhordari) Department of Cardiovascular
Research, Tehran Heart Center, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Omran, Shirzad) Department of Cardiac Surgery, Tehran Heart Center,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
Title
The effect of continuous low dose methylprednisolone infusion on
inflammatory parameters in patients undergoing coronary artery bypass
graft surgery: A randomized-controlled clinical trial.
Source
Acta Medica Iranica. 53 (2) (pp 104-111), 2015. Date of Publication: 2015.
Publisher
Medical Sciences University of Teheran
Abstract
This trial was performed to determine if a continuous low-dose infusion of
methylprednisolone is as effective as its bolus of high-dose in reducing
inflammatory response. The study was single-center, doubleblinded
randomized clinical trial and performed in a surgical intensive care unit
of an academic hospital. In this study, 72 consecutive patients undergoing
elective coronary artery bypass grafting (CABG) were assigned to receive
either a methylprednisolone loading dose (1mg/kg) followed by continuous
infusion (2mg/Kg/24 hours for 1 day) (low-dose regime) or a single dose of
methylprednisolone (15 mg/kg) before cardiopulmonary bypass (high dose
regime). Serum concentrations of IL-6 and C-reactive protein (CRP) were
measured preoperatively and 6, 24 and 48 hours after surgery, and serum
creatinine was measured before the operation and 24, 48 and 72 hours
postoperatively. The measurements were then compared between the groups to
evaluate the efficacy of each regimen. The basic characteristics and
measurements were not different between the study groups. There was no
significant difference in IL-6 and CRP elevation (P=0.52 and P=0.46,
respectively). Early outcomes such as the length of stay in the intensive
care unit, intubation time, changes in serum creatinine and blood glucose
levels, inotropic support, insulin requirements, and rate of infection
were also similar in both groups. A continuous low dose infusion of
methylprednisolone was as effective as a single high dose
methylprednisolone in reducing the inflammatory response after CABG with
extracorporeal circulation with no significant difference in the
postoperative measurements and outcomes.

<22>
Accession Number
71797486
Authors
Visser M. De Mol B.A. Van Leeuwen P.A.
Institution
(Visser, Van Leeuwen) Surgery, VU University, Medical Center, Amsterdam,
Netherlands
(Visser, De Mol) Cardiothoracic Surgery, Academic Medical Center,
University of Amsterdam, Amsterdam, Netherlands
Title
Nutrition during surgery increases myocardial arginine/adma ratio and
essential amino acids in patients undergoing off-pump coronary artery
bypass grafting: A randomized controlled trial.
Source
Clinical Nutrition. Conference: 35th European Society for Clinical
Nutrition and Metabolism, ESPEN Congress Leipzig Germany. Conference
Start: 20130831 Conference End: 20130903. Conference Publication:
(var.pagings). 32 (pp S27), 2013. Date of Publication: September 2013.
Publisher
Churchill Livingstone
Abstract
Rationale: Nitric oxide (NO) is essential for proper cardiovascular
functioning but might be low in the surgical patient as its precursor
arginine decreases and the NO synthase inhibitor asymmetric
dimethylarginine (ADMA) increases in these patients resulting in a low
arginine/ADMA ratio. Besides arginine, several amino acids are essential
for proper cardiovascular metabolism. We investigated whether
supplementation of (par) enteral nutrition during surgery can increase
myocardial arginine/ADMA ratio and amino acids. Methods: In 33 patients
undergoing off-pump coronary artery bypass grafting, enteral, parenteral
or no nutrition (control) was supplemented from two days before, during,
until two days after surgery. A myocardial tissue sample was taken before
and after revascularization, and analysed for arginine/ADMA ratio, and
amino acids concentrations. Results: During surgery the increases in
myocardial arginine/ ADMA ratio, branched chain amino acids (BCAA) and
essential amino acids (EAA) concentrations were significantly higher in
the enteral and parenteral group compared to the control group
(arginine/ADMA ratio: 47.7 (30.7-74.9), 49.6 (33.0-68.0), and 26.0
(15.4-32.5), p = 0.012; BCAA (nmol/g tissue): 12.6 (7.1-27.1), 14.9
(6.6-23.6), and 1.0 (-1.8-9.2), p = 0.029; EAA (nmol/g tissue): 15.2
(7.4-39.2), 26.8 (3.4-48.2), and 4.1 (-11.9-11.7) p = 0.040). Conclusion:
Enteral or parenteral nutrition during surgery can increase the
arginine/ADMA ratio, and BCAA and EAA concentrations in the human heart.