Hsp60 and heme oxygenase-1 (Hsp32) in acute myocardial infarction
Heat shock proteins (Hsps) are produced in response to various stressors, including ischemia-reperfusion, and they can exit cells and reach the blood. In this pilot study, we determined serum levels of Hsp60 and heme-oxygenase-1 (HO-1; also named Hsp32) in subjects with acute myocardial infarction (AMI) to assess their clinical significance and potential prognostic value. We also performed a bioinformatics analysis of the 2 molecules in search of structural clues on the mechanism of their release from cells. We studied 40 patients consecutively admitted for AMI (male:female patient ratio = 20:20, mean age: 64 ± 13 years) and 40 matched controls. A blood sample was drawn for biochemical anal…
Analysis of N-terminal pro-B-type natriuretic peptide in patients with acute coronary syndromes
Background The N-terminal portion of brain natriuretic peptide (NT-proBNP) has been identified as an indicator of prognosis in different cardiovascular diseases. The objective of this study was to determine the utility of measuring plasma NT-proBNP levels in patients with acute coronary syndromes. Methods and results We studied 66 patients admitted in our division for acute coronary syndromes. Patients underwent a venous blood sample within 24 h from the admission to determine NT-proBNP levels. Increasing plasma levels of NT-proBNP (in tertiles) was associated with a greater history of hypertension and current smoking, whereas biochemical parameters were associated with higher level of crea…
Total occlusion of aortic arch in a 62-year-old man presenting with acute myocardial infarction
Not available
G-protein-coupled receptor kinase 5 polymorphism and Takotsubo cardiomyopathy.
BACKGROUND: Takotsubo cardiomyopathy (TTC) is an increasingly reported clinical syndrome that mimics acute myocardial infarction without obstructive coronary artery disease and is characterized by transient systolic dysfunction of the apical and/or mid-segments of the left ventricle. The syndrome mainly occurs in postmenopausal women with high adrenergic state conditions. Nowadays, the pathophysiology of TTC is not yet known and the possibility of a genetic predisposition is controversial. AIMS: The purpose of this study was to assess the genetic susceptibility to TTC through analysis of the L41Q polymorphism of the G-protein-coupled receptor kinase 5 (GRK5). METHODS AND RESULTS: In a cohor…
Carotid and peripheral atherosclerosis in patients who underwent primary percutaneous coronary intervention and outcome associated with multifocal atherosclerosis.
AIM: The aim of our study was to determine if patients with multifocal atherosclerosis have a worse prognosis than patients with atherosclerosis only in the coronary bed. METHODS: We studied 45 subjects admitted to intensive coronary care unit of the Division of Cardiology with the diagnosis of acute myocardial infarction (AMI). Traditional cardiovascular risk factors were investigated and laboratory analysis included measurement of plasma lipids, glycemia, fibrinogen and high-sensitivity-C-reactive protein (hs-CRP). Each patient underwent coronary-angiography as well as carotid and peripheral arterial ultrasound examination. A follow-up of 13+/-2 months was performed. RESULTS: We found tha…
A strange pneumonia
We report the case of a 62-year-old man with non-ST elevation myocardial infarction complicated by partial rupture of the antero-lateral papillary muscle in which severe mitral regurgitation with lateralized direction towards the right pulmonary veins gave unilateral pulmonary oedema, resembling an acute pneumonia.Unilateral pulmonary oedema is a rare entity, more frequently appearing as opacity of the right lung and always associated with severe mitral regurgitation. It is very important to suspect and promptly recognize unilateral pulmonary oedema because initial misdiagnosis leads to a delay in the initiation of appropriate treatment and to an increased risk of mortality.
Takotsubo cardiomyopathy features at cardiac magnetic resonance
Abstract Diagnosis of Takotsubo cardiomyopathy is based on clinical symptoms, electrocardiographic changes, absence of angiographic significant coronary lesions and presence of suggestive wall motion abnormalities. CardioMRI is an useful complementary tool especially to role out the diagnosis of myocarditis and of myocardial infarction with angiographically normal coronary artery and to document complications of the disease.
Treatment decision making in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy: State of the art
No abstract available
Midventricular dyskinesia during clozapine treatment?
This is the case of a young man suffering from schizophrenia and treated with clozapine. He developed acute heart failure associated with pericardial effusion and midventricular dyskinesia with severe systolic dysfunction and left ventricular dilatation at echocardiogram, readily resolved after the suspension of clozapine therapy. The segmental wall motion abnormalities observed at echocardiogram in this case are peculiar and have never been described before. The possible cardiotoxic effects of clozapine have been reported previously in the literature. Because of its serious potential side effects this drug is not considered the first choice for treatment of schizophrenia. Before beginning …
Assessment of no-reflow phenomenon by myocardial blush grade and pulsed wave tissue doppler imaging in patients with acute coronary syndrome
Background: No-reflow phenomenon is a complication of myocardial revascularization and it is associated with a worse prognosis. Materials and Methods: A prospective study was carried out enrolling patients with acute myocardial infarction (64 patients, 49 male and 15 female, median age 64.9 ± 10.61 years), both STEMI and NSTEMI, who underwent myocardial revascularization with percutaneous coronary intervention (PCI). TIMI flow and Myocardial Blush Grade (MBG) were assessed at baseline (T0), in addition to tissue Doppler imaging (TDI) and electrocardiogram. Cardiological evaluation was also performed at T1 (one month after PCI) and T2 (every year after revascularization for a mean follow-up …
Unusual case of left ventricular pseudoaneurysm.
A 71 year-old man with a history of previous anterior myocardial infarction, triple coronary artery bypass graft and left ventricular (LV) aneurysmectomy was admitted to the cardiology unit for chest pain. Physical examination showed a pulsing mass in the left chest wall. Cardiac multislice computed tomography showed a rare case of LV pseudoaneurysm (6.3 x 6 x 10 cm) communicating by a fistulous trait (1 cm) with the left anterior chest wall (C7-C8), creating a subfascial mass (7.1 x 3.6 cm).
Extracoronary atherosclerosis in patients with chronic ischemic heart disease: Relationship with risk factors and the severity of coronary artery disease
AIM: The aim of the present study was to investigate the prevalence of carotid and/or peripheral atherosclerotic lesions in patients with chronic ischemic heart disease (previous acute myocardial infarction [AMI] or stable angina). METHODS: We studied 248 patients (168 male and 80 female), mean age 63+/-10 years, which were investigated for traditional risk factors. Systolic blood pressure, body mass index, lipid profile, fasting glucose and plasma fibrinogen were also measured. We assessed the prevalence of atherosclerotic lesions in carotid and lower limb arteries, by ultrasound duplex scanning (UDS). RESULTS: Angina was present in 33% of the patients, a previous AMI in 67%, a previous tr…
Decision making and devices approach in a case of left main coronary artery thrombus.
☆ This statement is to certify that all authors have seen being submitted, have contributed significantly to the w legitimacy of the data and its interpretation, and ag International Journal of Cardiology. We attest that the artic has not received prior publication and is not under elsewhere. We adhere to the statement of ethical pub (Shewan LG et al 2013 in press). ☆☆ On behalf of all co-authors, the corresponding author the submission. ⁎ Corresponding author at: Division of Cardiology II, D and Cardiovascular Diseases, University Hospital Paolo Gi 90127 Palermo, Italy. Tel.: +39 1 6554303; fax: +39 1 65 E-mail address: odisseos86@alice.it (V. Sucato).
Takotsubo cardiomyopathy after a positive emotional stress
Takotsubo cardiomyopathy, also known as transient left ventricular apical ballooning syndrome, is a cardiac syndrome mimicking an acute coronary syndrome and characterized by peculiar transient left ventricular wall motion in the absence of significant coronary lesions at coronary angiography. The pathogenic mechanisms linking emotional stress to Takotsubo cardiomyopathy still remain undefined. The onset of Takotsubo cardiomyopathy can be triggered by an acute, intense emotional stress. This is the first report reporting that not only negative stress but also positive stressful event may precede the syndrome.
The role of macrophage colony-stimulating factor in patients with acute myocardial infarction: a pilot study.
We assessed whether macrophage colony-stimulating factor (M-CSF) levels are associated with left ventricular systolic dysfunction (LVSD) in patients with acute myocardial infarction (AMI). We studied 56 patients with AMI (mean age: 67 ± 12 years) and identified those with clinical (Killip class >II) or echocardiographic signs (ejection fraction ≤45%) of LVSD. We evaluated the established cardiovascular risk factors and measured several cardiovascular biomarkers, including M-CSF. Serum M-CSF concentrations (pg/mL) were significantly increased in patients with both clinical and echocardiographic signs of LVSD (460 ± 265 vs 290 ± 210, P = .0103 and 493 ± 299 vs 287 ± 174, P = .0028, respec…
The percutaneous closure of patent foramen ovale (PFO): Impact on the quality of life
takotsubo cardiomiopathy after acute diarrhea
Takotsubo cardiomyopaty is a recently described syndrome characterized by transient left ventricular dysfunction, mimicking an acute coronary syndrome and usually precipitated by a physical or emotional stress. We report the first case of Takotsubo cardiomyopathy after acute diarrhea in a man. It may be argued that severe diarrhea in predisposed individuals may cause an acute stress resulting in increased sympathetic activity leading to this syndrome. Probably the relationship between the adrenergic system and the heart is more complex than general thought and the stimuli which favor an autonomic imbalance and precipitate the syndrome are very disparate in clinical practice.
Thrombotic complications during overt hyperthyroidism
ICD Implantation in Noncompaction of the Left Ventricular Myocardium: A Case Report
Isolated noncompaction of the ventricular myocardium (INVM) is an uncommon cardiomyopathy characterized by the persistence of fetal myocardium with prominent trabecular meshwork and deep intertrabecular recesses, often associated with systolic dysfunction and ventricular dilatation. A 23-year-old man from Burkina Faso was referred to our operative unit with a diagnosis of INVM, made with echocardiogram and magnetic resonance imaging and nonsustained ventricular tachycardia. The literature reports the incidence of malignant ventricular arrhythmias in as many as 47% of the patients and sudden cardiac death in almost 50% of them and this supported our decision to perform implantable cardiovert…
Therapeutic management in Sicilian patients with definite arrhythmogenic right ventricular dysplasia/cardiomyopathy and focus on the role of implantable cardioverter-defibrillator therapy
Arrhythmogenic Right Ventrticular Dysplasia/Cardiomyopathy(ARVD/C) is an inherited cardiomyopathy characterized by right ven-tricularmyocytelosswithfibrofattyreplacement,ahighriskofventric-ular arrhythmias (VA) and sudden cardiac death (SCD) [1]. Preventionof SCD represents the most important management strategy and theachievement of this target can be reached by different therapeuticstrategies including implantable cardioverter-defibrillator (ICD)implantation, pharmacologic therapy, catheter ablation of ventriculartachycardia (VT) and cardiac transplantation [2,3]. The aim of thisstudy is to examine the outcome of the different therapies adopted ina group of affected patients, focusing on th…
Plasma endothelin-1 levels in patients with angina pectoris and normal coronary angiograms.
Some patients with typical angina and electrocardiographic evidence of ischemia have normal coronary angiograms. These patients have a reduced coronary flow reserve and abnormal endothelium-dependent vasodilator responses; this syndrome is known as microvascular angina. Among endothelium-derived peptides, endothelin-1 (ET-1) is a potent vasoconstrictor and an important modulator of microvascular function.Plasma ET-1 was measured in 13 patients with typical angina, instrumental evidence of ischemia, and normal arteriograms and in 20 normal control subjects.Mean concentration of ET-1 was 2.89+/-1.24 pmol/L in patients with angina and normal angiograms and 1.99+/-0.81 pmol/L in normal control …
Prognostic role of aldosterone in patients with acute coronary syndrome: short and medium term follow-up.
AIMS: Different studies have shown a correlation between aldosterone, atherosclerosis and ischemia in the past decade. Evidence exists for the relationship between high levels of aldosterone and augmented risk of cardiovascular diseases, such as hypertension, cardiac failure, coronary artery disease and stroke. The objective of this study was to determine the prognostic role of aldosterone in patients with myocardial infarction. METHODS: The study population included 96 consecutive patients admitted to our department for ST-elevated and non-ST-elevated myocardial infarction from June 2009 to March 2012. Plasma aldosterone levels were measured at admission to hospital in all patients. A 2-ye…
Polycitemia vera and pulmonary embolism: case report
Pulmonary embolism is a rare clinical onset of chronic myeloproliferative diseases. Early diagnosis is very important because medical therapy reduces both mortality and morbility. We describe a case of pulmonary embolism as clinical onset of an unknown myeloproliferative disorder. On the basis of our experience is very important early diagnosis and therapy to reduce incidence of later major thrombotic complications.