Editorial commentary: Interpreting and dealing with myocardial stunning
When first reported, it was not accepted that myocardial function recovered hours later following resumption of normal coronary flow after brief occlusion in dogs [1]. Later, the term myocardial stunning was applied to the phenomenon of delayed recovery of regional myocardial contractile function after myocardial reperfusion, despite the absence of irreversible damage and restoration of normal coronary flow [2]. In fact, when the coronary artery is occluded, myocardial necrosis begins at the center in the sub-endocardial region, and a wave front of necrosis propagates toward the peripheral adjacent area and the subepicardi...
Source: Trends in Cardiovascular Medicine - November 27, 2017 Category: Cardiology Authors: Dawod Sharif Source Type: research
Controversies in brugada syndrome
The Brugada syndrome is an inherited channelopathy associated with increased risk of ventricular arrhythmias and sudden death, often occurring during sleep or resting conditions. Although this entity has been described more than twenty years ago, it remains one of the most debated among channelopathies, with several open questions on its genetic substrate, arrhythmia mechanisms and clinical management. Studies on the genetics and physiopathology bases of the Brugada syndrome have opened novel investigative pathways and concepts that are now entering the field of cardiovascular genetics and are applied to other inherited ar...
Source: Trends in Cardiovascular Medicine - November 27, 2017 Category: Cardiology Authors: Marina Cerrone Source Type: research
Idiopathic Malignant Premature Ventricular Contractions
The presence of premature ventricular contractions (PVCs) in patients with structurally normal hearts was once considered a benign phenomenon. These “benign” or idiopathic PVCs, in susceptible patients, however, may develop malignant potential and trigger ventricular fibrillation and result in sudden cardiac death. Alternatively, idiopathic PVCs can also induce cardiomyopathy. Clinical recognition of these entities can lead to effective targ eted therapy. In the first instance, treatment consists of ablating the PVC source and implanting a defibrillator, whereas in the second scenario, ablating the PVC origin can norma...
Source: Trends in Cardiovascular Medicine - November 27, 2017 Category: Cardiology Authors: James E. Ip, Bruce B. Lerman Source Type: research
Current interpretation of myocardial stunning
Myocardial stunning is a temporary post-ischemic cardiac mechanical dysfunction. As such, it is a heterogeneous entity and different conditions can promote its occurrence. Transient coronary occlusion, increased production of catecholamines and endothelin, and myocardial inflammation are all possible causes of myocardial stunning. Possible underlying mechanisms include an oxyradical hypothesis, calcium overload, decreased responsiveness of myofilaments to calcium, and excitation-contraction uncoupling due to sarcoplasmic reticulum dysfunction. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - November 27, 2017 Category: Cardiology Authors: Andrea Igoren Guaricci, Gabriella Bulzis, Gianluca Pontone, Pietro Scicchitano, Rossella Carbonara, Mark Rabbat, Delia De Santis, Marco Matteo Ciccone Source Type: research
Editorial comment: Interpreting and dealing with myocardial stunning
When first reported, it was not accepted that myocardial function recovered hours later following resumption of normal coronary flow after brief occlusion in dogs [1]. Later, the term myocardial stunning was applied to the phenomenon of delayed recovery of regional myocardial contractile function after myocardial reperfusion, despite the absence of irreversible damage and restoration of normal coronary flow [2]. In fact, when the coronary artery is occluded, myocardial necrosis begins at the center in the sub-endocardial region, and a wave front of necrosis propagates towards the peripheral adjacent area and the subepicard...
Source: Trends in Cardiovascular Medicine - November 27, 2017 Category: Cardiology Authors: Dawod Sharif Source Type: research
Pro-arrhythmic effects of low plasma [K+] in human ventricle: An illustrated review
Potassium levels in the plasma, [K+]o, are regulated precisely under physiological conditions. However, increases (from approx. 4.5 to 8.0mM) can occur as a consequence of, e.g., endurance exercise, ischemic insult or kidney failure. This hyperkalemic modulation of ventricular electrophysiology has been studied extensively. Hypokalemia is also common. It can occur in response to diuretic therapy, following renal dialysis, or during recovery from endurance exercise. In the human ventricle, clinical hypokalemia (e.g., [K+]o levels of approx. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - November 23, 2017 Category: Cardiology Authors: Beatriz Trenor, Karen Cardona, Lucia Romero, Juan F. Gomez, Javier Saiz, Sridharan Rajamani, Luiz Belardinelli, Wayne Giles Source Type: research
Pro-arrhythmic Effects of Low Plasma [K+] in Human Ventricle: An Illustrated Review ☆
Potassium levels in the plasma, [K+]o, are regulated precisely under physiological conditions. However, increases (from approx. 4.5 to 8.0mM) can occur as a consequence of e.g. endurance exercise, ischemic insult or kidney failure. This hyperkalemic modulation of ventricular electrophysiology has been studied extensively. Hypokalemia is also common. It can occur in response to diuretic therapy, following renal dialysis, or during recovery from endurance exercise. In the human ventricle, clinical hypokalemia (e.g. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - November 23, 2017 Category: Cardiology Authors: Beatriz Trenor, Karen Cardona, Lucia Romero, Juan F. Gomez, Javier Saiz, Sridharan Rajamani, Luiz Belardinelli, Wayne Giles Source Type: research
Editorial commentary: Heart failure in systemic lupus erythematosus: A problem to address
Cardiac involvement in systemic inflammatory erythematosus (SLE) is a complex condition that encompasses aspects yet to be elucidated. Besides those well recognized cardiovascular manifestations of SLE including coronary artery disease, pulmonary hypertension and valvular disease, the ultimate clinical consequence of these pathologies will be heart failure [1]. In this issue of the Journal, Dhakal et al. [2] highlighted the evolving problems of heart failure in patients with SLE, which usually first develops at a young age. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - November 8, 2017 Category: Cardiology Authors: Kai-Hang Yiu, Hung-Fat Tse Source Type: research
Editorial commentary for Dhakal: Heart failure in systemic lupus erythematosus: A problem to address
Cardiac involvement in systemic inflammatory erythematosus (SLE) is a complex condition that encompasses aspects yet to be elucidated. Besides those well recognized cardiovascular manifestations of SLE including coronary artery disease, pulmonary hypertension and valvular disease, the ultimate clinical consequence of these pathologies will be heart failure [1]. In this issue of the Journal, Dhakal et al. [2] highlighted the evolving problems of heart failure in patients with SLE, which usually first develops at a young age. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - November 8, 2017 Category: Cardiology Authors: Kai-Hang Yiu, Hung-Fat Tse Source Type: research
Heart failure in systemic lupus erythematosus: A problem to address
Cardiac involvement in systemic inflammatory erythematosus (SLE) is a complex condition that encompasses aspects yet to be elucidated. Besides those well recognized cardiovascular manifestations of SLE including coronary artery disease, pulmonary hypertension and valvular disease, the ultimate clinical consequence of these pathologies will be heart failure [1]. In this issue of the Journal, Dhakal et al. [2] highlighted the evolving problems of heart failure in patients with SLE, which usually first develops at a young age. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - November 8, 2017 Category: Cardiology Authors: Kai-Hang Yiu, Hung-Fat Tse Source Type: research
Fabry disease: Review and experience during newborn screening
Fabry disease (FD) is an X-linked lysosomal storage disease and is the result of mutation in the α-Galactosidase A gene; such mutations cause a deficiency in α-Galactosidase A enzyme and an accumulation of glycosphingolipid in tissue. Affected males with classic FD have little or no enzyme activity and have an early onset of symptoms and signs, including acroparesthesias, hypohidrosis, angiok eratomas, gastrointestinal dysfunction and/or a characteristic corneal dystrophy during childhood/adolescence. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - October 20, 2017 Category: Cardiology Authors: Ting-Rong Hsu, Dau-Ming Niu Source Type: research
Fabry Disease: Review and experience during newborn screening
Fabry disease (FD) is an X-linked lysosomal storage disease and is the result of mutation in the α-Galactosidase A gene; such mutations cause a deficiency in α-Galactosidase A enzyme and an accumulation of glycosphingolipid in tissue. Affected males with classic FD have little or no enzyme activity and have an early onset of symptoms and signs, including acroparesthesias, hypohidrosis, angiok eratomas, gastrointestinal dysfunction and/or a characteristic corneal dystrophy during childhood/adolescence. (Source: Trends in Cardiovascular Medicine)
Source: Trends in Cardiovascular Medicine - October 20, 2017 Category: Cardiology Authors: Ting-Rong Hsu, Dau-Ming Niu Source Type: research
Non-PCI/CABG Therapies for Refractory Angina
Angina persists for many patients despite modern medical therapy and/or revascularization, and this is referred to as refractory angina. All patients with refractory angina must be treated with aggressive risk factor modification plus optimized medical management. β-blockers and nitrates are usually first-line agents; however most patients require multiple medications for refractory symptom control. Novel agents, such as ranolazine and ivabradine, as well as non-pharmacologic therapies, such as enhanced external counterpulsation and cardiac rehabilitation, m ay provide relief or reduction of angina. (Source: Trends in Car...
Source: Trends in Cardiovascular Medicine - October 20, 2017 Category: Cardiology Authors: Ki E. Park, C. Richard Conti Source Type: research
