Impella CP in cardiogenic shock due to acute myocardial infarction: From primary angioplasty to LIMA-LAD grafting.
Heart Rate Variability in Children and Adolescents with Cerebral Palsy—A Systematic Literature Review
Cardiac autonomic dysfunction has been reported in patients with cerebral palsy (CP). The aim of this study was to assess the existing literature on heart rate variability (HRV) in pediatric patients with CP and a special attention was paid to the compliance of the studies with the current HRV assessment and interpretation guidelines. A systematic review was performed in PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases searched for English language publications from 1996 to 2019 using Medical Subject Headings (MeSH) terms “heart rate variability” and “cerebral palsy” in conjunction with additional inclusion criteria: studies limited to …
Letter by Sacha and Feusette Regarding Article, “Dynamic Edematous Response of the Human Heart to Myocardial Infarction: Implications for Assessing Myocardial Area at Risk and Salvage”
We have read with a great interest the article by Fernandez-Jimenez et al presenting a bimodal edematous reaction of reperfused myocardium after ST-segment elevation myocardial infarction (STEMI).1 According to the study, the initial edema emerges early and disappears by 24 hours; however, the second edema appears between days 4 and 7 after reperfusion. The authors conclude that the assessment of …
Is It Time to Begin a Public Campaign Concerning Frailty and Pre-frailty? A Review Article
Frailty is a state that encompasses losses in physical, psychological or social domains. Therefore, frail people demonstrate a reduced potential to manage external stressors and to respond to life incidents. Consequently, such persons are prone to various adverse consequences such as falls, cognitive decline, infections, hospitalisation, disability, institutionalisation and death. Pre-frailty is a condition predisposing and usually preceding the frailty state. Early detection of frailty (i.e., pre-frailty) may present an opportunity to introduce effective management to improve outcomes. Exercise training appears to be the basis of such management in addition to periodic monitoring of food i…
Cusp overlap technique for transcatheter self-expanding aortic valve implantation
Transcatheter aortic valve implantation (TAVI) may cause atrioventricular conduction disturbances and, consequently, the necessity for permanent pacemaker implantation (PPI). This is because the His bundle surfaces at the basal part of the membranous septum (in the neighbourhood of the non-coronary cusp) and implant depth greater than the length of the membranous septum may interfere with the conduction system [1]. To mitigate this risk, the valve should be implanted at a high position to minimize the contact of the valve frame with the base of membranous septum. During TAVI, the valve is usually positioned in a coplanar fluoroscopic projection with 3 cusps view, but for a self-expanding va…
Clinical manifestations of cancer in patients with acute pulmonary embolism
Background Neoplasmatic disease increases the risk of acute pulmonary embolism (APE) by different pathophysiological mechanisms that favor thrombosis in patients with cancer. Recently, the role of cancer (active and occult) in the prevalence of venous thromboembolism has been discussed more thoroughly in the subject literature. Material Medical records of 366 consecutive patients with a diagnosis of APE (aged: mean = 65.0 ± 16.6, median = 68, range = 19–94; men = 41%/women = 59%) were collected with a wide range of demographic data, medical history of coexisting diseases, computer examination, and laboratory tests. Methods The APE patients were analyzed in two groups: negative cancer cases …
Heart rate rather than heart rate variability is better associated with cardiorespiratory fitness in adults
This study aimed to examine the association of heart rate (HR) and heart rate variability (HRV) with cardiorespiratory fitness (CRF) in adults. This cross-sectional study included 204 participants: 132 young adults (67% women; 22.3 ± 2.3 years) and 72 middle-aged adults (53% women; 53.2 ± 5 years). HR and HRV were measured using a Polar RS800CX heart rate monitor. CRF was assessed using a metabolic cart during an incremental test. HR was negatively associated with CRF relative to body weight (BW) in young adults adjusting for sex, age, and physical activity (β ranged from -0.200 to -0.195; all
Real-Life Outcomes of Coronary Bifurcation Stenting in Acute Myocardial Infarction (Zabrze–Opole Registry)
Percutaneous coronary intervention (PCI) of bifurcation lesions is a technical challenge associated with high risk of adverse events, especially in primary PCI. The aim of the study is to analyze long-term outcomes after PCI for coronary bifurcation in acute myocardial infarction (AMI). The outcome was defined as the rate of major adverse cardiac event related to target lesion failure (MACE-TLF) (death-TLF, nonfatal myocardial infarction-TLF and target lesion revascularization (TLR)) and the rate of stent thrombosis (ST). From 306 patients enrolled to the registry, 113 were diagnosed with AMI. In the long term, AMI was not a risk factor for MACE-TLF. The risk of MACE-TLF was dependent on th…
Balloon aortic valvuloplasty, Impella insertion and complex coronary intervention: is this all feasible fully percutaneously via upper limb access?
Complex high-risk indicated patients (CHIP) with a limited vascular access constitute a real challenge for percutaneous coronary interventions (PCI), particularly if they require mechanical circulatory support devices. A 73-year-old man with recent non-ST segment elevation myocardial infraction, depressed left ventricular function (ejection fraction, 40%), aortic stenosis (max/mean gradient, 50/32 mm Hg; aortic valve area and its index, 1.0 cm2 and 0.5 cm2/m2) and numerous comorbidities (including recently diagnosed lung cancer in the initial phase) was scheduled by the heart team for balloon aortic valvuloplasty (BAV) and Impella-supported complex PCI of the left main (LM) and the left ant…
Comprehensive coordinated care after myocardial infarction (KOS-Zawał) : a patient's perspective
Fully percutaneous insertion and removal of the Impella CP via a subclavian approach
The Impella (Abiomed) is a mechanical circulatory support device which augments cardiac output, but may also unload a left ventricle during venoarterial extracorporeal membrane oxygenation (ECMO) [1]. However, the Impella requires an access to a large artery and this may be problematic in a severe peripheral arterial disease. The presented case demonstrates how to insert and remove the Impella CP via a subclavian approach without surgical cutting.
MitraClip Implantation in Holography.
Ultra-low contrast coronary angiography and zero-contrast percutaneous coronary intervention for prevention of contrast-induced nephropathy: step-by-step approach and review
Contrast-induced nephropathy is a serious complication after intravascular administration of iodinated contrast media and is associated with numerous adverse outcomes. Its prevalence is particularly high in patients with multiple comorbidities who undergo coronary angiography and percutaneous coronary intervention (PCI). Currently, the only effective method to prevent contrast-induced kidney injury is adequate hydration and a reduction of contrast volume during the intervention. Recently, new approaches aiming to minimize contrast usage have been proposed, i.e., ultra-low contrast angiography and zero-contrast PCI. However, neither tutorials for these techniques nor reviews of their outcome…
Concomitant use of veno-arterial extracorporeal membrane oxygenation and Impella in the intensive care unit: a case report of fulminant myocarditis with multi-organ failure
Angiographic co-registration of instantaneous wave-free ratio and intravascular ultrasound improves functional assessment of borderline lesions in the coronary artery
The Role of Heart Rate on the Associations Between Body Composition and Heart Rate Variability in Children With Overweight/Obesity: The ActiveBrains Project
The authors would like to thank all the participants who volunteered for this investigation. This work is the part of a Ph.D. Thesis conducted in the Biomedicine Doctoral Studies of the University of Granada, Spain.
Heart Rate Variability and Other Autonomic Markers in Children and Adolescents
Impact of using different levels of threshold-based artefact correction on the quantification of heart rate variability in three independent human cohorts
Heart rate variability (HRV) is a non-invasive indicator of autonomic nervous system function. HRV recordings show artefacts due to technical and/or biological issues. The Kubios software is one of the most used software to process HRV recordings, offering different levels of threshold-based artefact correction (i.e., Kubios filters). The aim of the study was to analyze the impact of different Kubios filters on the quantification of HRV derived parameters from short-term recordings in three independent human cohorts. A total of 312 participants were included: 107 children with overweight/obesity (10.0 ±
Zero-contrast percutaneous coronary intervention of saphenous vein graft in a patient with chronic renal failure
Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects
Introduction Zero-contrast percutaneous coronary intervention (zero-PCI) is a new method for prevention of contrast-induced acute kidney injury (AKI) in patients with chronic kidney disease (CKD). However, evidence for its feasibility, safety and clinical utility is limited to reports of single cases or series of patients. Aim To present outcomes of zero-PCI in patients with severe CKD, including hemodialysis subjects, who were treated with this procedure in order to preserve their renal function. Material and methods Twenty-nine zero-PCIs were performed, mostly as a staged procedure, in 20 patients with advanced CKD. In this group, 4 patients were treated with hemodialysis but presented pr…
Heart Rate Is a Better Predictor of Cardiorespiratory Fitness Than Heart Rate Variability in Overweight/Obese Children: The ActiveBrains Project
The authors would like to thank all the participants who volunteered for this investigation. This work is part of a Ph.D. thesis conducted in the Biomedicine Doctoral Studies of the University of Granada, Spain.