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151.
Rosman J Dhillon S Mayer A Hanon S Paul S 《Indian pacing and electrophysiology journal》2007,7(4):215-217
Background
Cardiac Resynchronization Therapy (CRT) is indicated for the treatment of advanced heart failure with severe systolic dysfunction and intraventricular conduction delay. Patient selection for this technology is vital, though it remains unclear which patients benefit most from CRT. We tested the hypothesis that patients with non-ischemic cardiomyopathy have a superior mortality benefit from CRT than ischemic cardiomyopathy patients.Methods
We evaluated 95 CRT patients to determine which factors predict mortality.Results
Patients with non-ischemic cardiomyopathy had a significantly better prognosis than patients with ischemic cardiomyopathy.Conclusion
Larger prospective studies can substantiate this finding and better delineate which patients benefit most from CRT. 相似文献152.
目的总结和分析同期施行冠状动脉搭桥和心脏瓣膜手术的体外循环方法。方法125例患者分为3组:M组(冠脉病变及二尖瓣病变)75例,A组(冠脉病变及主动脉瓣病变)34例,D组(冠脉病变及二尖瓣和主动脉瓣病变)16例。心肌保护采用4:1冷含血停搏液,应用单纯顺灌、顺灌逆灌结合、顺灌桥灌结合、顺逆灌和桥灌结合技术。结果术中转流平稳,血流动力学稳定,监测指标均在正常范围,无手术死亡。结论同期施行冠状动脉搭桥和心脏瓣膜手术,术中良好的心肌保护方法和合理的体外循环灌注是保证手术顺利成功的重要因素。 相似文献
153.
Beno?te Bourdin Behzad Shakeri Marie-Philippe Tétreault Rémy Sauvé Sylvie Lesage Lucie Parent 《The Journal of biological chemistry》2015,290(5):2854-2869
L-type Ca2+ channels play a critical role in cardiac rhythmicity. These ion channels are oligomeric complexes formed by the pore-forming CaVα1 with the auxiliary CaVβ and CaVα2δ subunits. CaVα2δ increases the peak current density and improves the voltage-dependent activation gating of CaV1.2 channels without increasing the surface expression of the CaVα1 subunit. The functional impact of genetic variants of CACNA2D1 (the gene encoding for CaVα2δ), associated with shorter repolarization QT intervals (the time interval between the Q and the T waves on the cardiac electrocardiogram), was investigated after recombinant expression of the full complement of L-type CaV1.2 subunits in human embryonic kidney 293 cells. By performing side-by-side high resolution flow cytometry assays and whole-cell patch clamp recordings, we revealed that the surface density of the CaVα2δ wild-type protein correlates with the peak current density. Furthermore, the cell surface density of CaVα2δ mutants S755T, Q917H, and S956T was not significantly different from the cell surface density of the CaVα2δ wild-type protein expressed under the same conditions. In contrast, the cell surface expression of CaVα2δ D550Y, CaVα2δ S709N, and the double mutant D550Y/Q917H was reduced, respectively, by ≈30–33% for the single mutants and by 60% for the latter. The cell surface density of D550Y/Q917H was more significantly impaired than protein stability, suggesting that surface trafficking of CaVα2δ was disrupted by the double mutation. Co-expression with D550Y/Q917H significantly decreased CaV1.2 currents as compared with results obtained with CaVα2δ wild type. It is concluded that D550Y/Q917H reduced inward Ca2+ currents through a defect in the cell surface trafficking of CaVα2δ. Altogether, our results provide novel insight in the molecular mechanism underlying the modulation of CaV1.2 currents by CaVα2δ. 相似文献
154.
Ashley Chin Jeffrey S. Healey Carlos S. Ribas Girish M. Nair 《Indian pacing and electrophysiology journal》2015,15(2):121-124
Defibrillation testing is no longer routinely performed after automatic implantable cardioverter-defibrillator (AICD) implantation. However, certain subjects undergoing AICD implantation may be at higher risk of undersensing of ventricular arrhythmias resulting in potentially fatal outcomes. We present the case of a 30-year-old woman with hypertrophic cardiomyopathy (HCM; ‘asymmetric septal hypertophy’ morphologic variant) and prophylactic AICD who experienced an out of hospital cardiac arrest. AICD interrogation revealed undersensing as a result of intermittent high amplitude electrograms during an episode of ventricular fibrillation (VF). The subject underwent replacement and repositioning of the AICD lead along with pulse generator replacement (that utilized a different VF sensing algorithm) with appropriate sensing of VF and successful defibrillation testing. The presence of intermittent high amplitude electrograms during episodes of VF in AICDs using the AGC function should be recognized as a situation that may necessitate interventions to prevent undersensing and consequent delay in therapy. 相似文献
155.
156.
Anna Mara Scandroglio Gabriele Finco Marina Pieri Roberto Ascari Maria Grazia Calabrò Daiana Taddeo Francesca Isella Annalisa Franco Mario Musu Giovanni Landoni Ottavio Alfieri Alberto Zangrillo 《BMC anesthesiology》2015,15(1)
Background
The elderly undergo cardiac surgery more and more frequently, often present multiple comorbidities, assume chronic therapies, and present a unique physiology. Aim of our study was to analyze the experience of a referral cardiac surgery center with all types of cardiac surgery interventions performed in patients ≥80 years old over a six years’ period.Methods
A retrospective observational study performed in a university hospital. 260 patients were included in the study (3.5% of the patients undergoing cardiac surgery in the study period).Results
Mean age was 82 ± 1.8 years. Eighty-five percent of patients underwent elective surgery, 15% unplanned surgery and 4.2% redo surgery. Intervention for aortic valve pathology and coronary artery bypass grafting were performed in 51% and 46% of the patients, respectively. Interventions involving the mitral valve were the 26% of the total, those on the tricuspid valve were 13% and those on the ascending aortic arch the 9.6%. Postoperative low output syndrome was identified in 44 patients (17%). Mortality was 3.9% and most of the patients (91%) were discharged from hospital in good clinical conditions. Hospital mortality was lower in planned vs unplanned surgery: 3.8% vs 14% respectively. Chronic obstructive pulmonary disease (OR 9.106, CI 2.275 – 36.450) was the unique independent predictor of mortality.Conclusions
Clinicians should be aware that cardiac surgery can be safely performed at all ages, that risk stratification is mandatory and that hemodynamic treatment to avoid complications is expected.Electronic supplementary material
The online version of this article (doi:10.1186/1471-2253-15-15) contains supplementary material, which is available to authorized users. 相似文献157.
Wang Y Xu F Chen J Shen X Deng Y Xu L Yin J Chen H Teng F Liu X Wu W Jiang B Guo DA 《Phytomedicine》2011,19(1):13-19
Cardiac fibroblasts play the key role in cardiac function and matrix metalloproteinases-9 (MMP-9) is a well known contributor to the development of myocardial remodeling. However, the direct regulation of MMP-9 on the function of cardiac fibroblasts and the underlying mechanism are far from elucidation. In the present research, recombinant protein encoding catalytic domain of MMP-9 (MMP-9 CD) was constructed and the function of neonatal cardiac fibroblasts was investigated by cell proliferation assay, migration assay, picrosirius red assay, multiplex cytokine assay and fibroblast phenotype detection. 200 nM MMP-9 CD stimulated cardiac fibroblasts migration (169.4±22.5% versus 100±0%, p<0.01), increased collagen synthesis (1.5±0.2 fold, p<0.05), up-regulated the secretion of ICAM (574.0±40.1 versus 268.5±8.6pg/ml, p<0.01), TNF-α (192.6±11.0 versus 14.4±1.8pg/ml, p<0.001), IL-6 (1500.9±70.2 versus 323.4±40.6pg/ml, p<0.001) and sVCAM-1 (30.3±4.3 versus 7.0±0.1 pg/ml, p<0.05) and down-regulated VEGF (436.5±148.9 versus 1034.3±28.1 pg/ml, p<0.05) significantly with modest effects on proliferation. Accompanying with these regulations, transition of fibroblasts to myofibroblast was confirmed by immunofluorescent stain of α-smooth muscle actin (α-SMA) with MMP-9 CD treatment. Furthermore, salvianolic acid B (SalB) inhibited the effects of MMP-9 CD significantly. In conclusion, our results provide evidence for a direct influence of MMP-9 on cardiac fibroblast migration, collagen and cytokine secretion, which can be attenuated by SalB. 相似文献
158.
目的研究医学手术实验用小型猪体外循环下心脏手术的麻醉管理及麻醉效果。方法实验用小型猪34例,分为CPB下停跳组手术组(停跳组,18例)及CPB下并行手术组(并行组,16例),行自体心包片三尖瓣置换术。记录实验中麻醉药物及血管活性药用量,基础麻醉、麻醉维持及麻醉苏醒时间,术后3天、一周存活状况等,并评价基础麻醉及全麻效果。结果 34例均在全麻下顺利完成手术,各期血流动力学平稳,仅停跳组一例术后3天内死亡,存活率97.1%,麻醉效果良好。结论合理的麻醉药物与血管活性药物的联合应用,仔细的临床观察与正确而迅速的处理是小型猪体外循环下心脏手术麻醉的关键。 相似文献
159.
目的探讨多重干预RAAS对大鼠慢性心功能不全心室重构及血钾的影响。方法实验采用缩窄大鼠腹主动脉法建立慢性压力负荷致心功能不全动物模型,选6周龄20只雌性SD大鼠,随机分4组(每组5只),B组(手术模型组)、C组(卡托普利组)、D组(卡托普利+缬沙坦组)、E组(卡托普利+缬沙坦+螺内酯组),另随机抽取5只同龄雌性SD大鼠假手术作为对照(A组)。给药8周后用Doppler超声心动图检测大鼠心脏结构和心功能各项参数的变化,放射免疫法测定血浆AngⅡ,ALDO浓度,并生化检测血钾水平。结果腹主动脉结扎后第9周,与A组比较,B组舒张末期室间隔厚度(IVSTD)、舒张末期左室后壁厚度(LVPWTD)、相对室壁厚度(RWT)、左室重量(LVM)、左室重量与体重比(LVM/BW)均显著提高(P<0.05);C、D、E组与B组相比,LVM,LVM/BW下降显著(P<0.05)。各药物干预组(C、D、E)血浆AngⅡ,ALDO水平明显低于B组(P<0.05),以联合应用螺内酯组明显。各药物干预组与A组和B组相比较,血钾水平差异无显著性(P>0.05)。结论联合应用卡托普利、缬沙坦及螺内酯多重干预RAAS能明显改善大鼠慢性心功能不全心室重构,对血钾无明显影响。 相似文献
160.
R. J. Folkeringa R. G. Tieleman J. G. Maessen M. H. Prins R. Nieuwlaat H. J. G. M. Crijns 《Netherlands heart journal》2011,19(1):17-23