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Microvasc Res 2021 Jun 8:104195. Epub 2021 Jun 8.

Department of Neonatology, Kaifeng Maternity and Children Health Hospital, Kaifeng City, Henan Province 475002, PR China.

Background: This study was carried out to investigate the effect of microRNA miR-532-5p on the proliferation of hypertension endothelial cells.

Methods: Angiotensin II (Ang II)-treated human umbilical vein endothelial cells (HUVECs) and primary human aortic endothelial cells (HAECs) were used as cell models to imitate the pathological changes in endothelial cells under hypertensive conditions. The expression levels of miR-532-5p and programmed cell death protein 4 (PDCD4) were detected by Quantitative Real-time PCR (qRT-PCR). Read More

Crit Care Med 2021 Jun 9. Epub 2021 Jun 9.

Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA. Center for the Study of Healthcare Innovation, Implementation, and Policy, Health Services Research and Development, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA. Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Division of Hospital Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA. Division of Pulmonary, Critical Care Medicine, and Sleep Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Objectives: Airway management during in-hospital cardiac arrest represents a fundamental component of resuscitative efforts, yet little is known about temporal trends in intubation during in-hospital cardiac arrest. Our objective was to investigate changes in in-hospital cardiac arrest airway management over time and in response to national guideline updates.

Design: Observational cohort study of a prospectively collected database. Read More

Neurol Neurochir Pol 2021 Jun 11. Epub 2021 Jun 11.

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing, 100053 Beijing, China.

Heart Rhythm O2 2020 Oct 27;1(4):297-310. Epub 2020 Aug 27.

Division of General Internal Medicine, University of Washington, Seattle, Washington.

The prevention and treatment of sudden cardiac death (SCD) remains a significant public health challenge. For patients with a history of sudden death attributable to ventricular arrhythmia, implantable cardioverter-defibrillator (ICD) therapy is a mainstay of treatment, although these patients remain at high risk for recurrent ventricular arrhythmia and defibrillator therapies. In this review, we summarize landmark clinical trials evaluating the efficacy of ICD therapy in secondary prevention patients, review clinical outcomes including mode of death in survivors of SCD, and highlight the role for systematic diagnostic evaluation. Read More

Heart Rhythm O2 2020 Oct 25;1(4):283-287. Epub 2020 Jun 25.

Department of Medicine, Cooper Medical School of Rowan University, Camden, New Jersey.

Background: Heightened risk of cardiac arrest following physical exertion has been reported. Among patients with an implantable defibrillator, an appropriate shock for sustained ventricular arrhythmia was preceded by a retrospective self-report of engaging in mild-to-moderate physical activity. Previous studies evaluating the relationship between activity and sudden cardiac arrest lacked an objective measure of physical activity and women were often underrepresented. Read More

Eur Heart J Case Rep 2021 Mar 24;5(3):ytab103. Epub 2021 Mar 24.

Department of Cardiology, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153, USA.

Background: Coronavirus disease 19 (COVID-19) reinfection has been a topic of discussion with data still emerging. Viral antibodies are known to develop upon initial infection; however, it is unclear the amount of protection this confers against reinfection. Additionally, COVID-19-associated coagulopathy (CAC) is a well-documented phenomenon; however, there are no high-quality studies to support the treatment of outpatients beyond standard indications of venous thromboembolism (VTE) prophylaxis. Read More

Eur Heart J Case Rep 2021 Mar 22;5(3):ytab092. Epub 2021 Mar 22.

Department of Cardiology, Santa Chiara Hospital, 2, Largo Medaglie d'Oro, 38122 Trento, Italy.

Background: A 'catecholamine storm' in a case of pheochromocytoma can lead to a transient left ventricular dysfunction similar to Takotsubo cardiomyopathy. A cardiogenic shock can thus develop, with high left ventricular end-diastolic pressure and a reduction in coronary perfusion pressure. This scenario can ultimately lead to a cardiac arrest, in which unloading the left ventricle with a peripheral left ventricular assist device (Impella) could help in achieving the return of spontaneous circulation (ROSC). Read More

Eur Heart J Case Rep 2021 Mar 13;5(3):ytab072. Epub 2021 Mar 13.

Department of Advanced Heart Failure, Sands-Constellation Heart Institute, Rochester Regional Health, 1425 Portland Avenue, Rochester, NY 14621, USA.

Background: Cardiac sarcoidosis (CS) and arrhythmogenic right ventricular cardiomyopathy (ARVC) are rare causes of ventricular arrhythmias and are associated with sudden cardiac death. Differentiation between both is important for proper management.

Case Summary: We present a 56-year-old man with sudden cardiac arrest and was diagnosed to have ARVC based on cardiac magnetic resonance imaging (MRI). Read More

Eur Heart J Case Rep 2021 Mar 1;5(3):ytab054. Epub 2021 Mar 1.

Cardiology Department, CHU Clermont-Ferrand, Rue Montalembert, 63000 Clermont-Ferrand, France.

Background: Myocarditis is a known cause of sudden cardiac death of the athlete. The impact of direct chest trauma in at-risk sports or activities in patients with a history of myocarditis has never been demonstrated or studied. We report herein two cases of life-threatening ventricular arrhythmia secondary to non-penetrating blunt chest trauma while playing contact sports. Read More

J Am Coll Cardiol 2021 Jun;77(23):2890-2905

Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; Department of Cardiology, North West Heart Centre, Manchester University NHS Foundation Trust, Wythenshawe Campus, Manchester, United Kingdom.

Background: Risk stratification for ventricular arrhythmias (VA) and sudden death in nonischemic dilated cardiomyopathy (DCM) remains suboptimal.

Objectives: The goal of this study was to provide an improved risk stratification algorithm for VA and sudden death in DCM.

Methods: This was a retrospective cohort study of consecutive patients with DCM who underwent cardiac magnetic resonance with late gadolinium enhancement (LGE) at 2 tertiary referral centers. Read More

J Am Heart Assoc 2021 Jun 11:e020216. Epub 2021 Jun 11.

Department of Anesthesiology Center for Perioperative Organ Protection Duke University Medical Center Durham NC.

Background Ischemia/reperfusion injury impairs proteostasis, and triggers adaptive cellular responses, such as the unfolded protein response (UPR), which functions to restore endoplasmic reticulum homeostasis. After cardiac arrest (CA) and resuscitation, the UPR is activated in various organs including the brain. However, the role of the UPR in CA has remained largely unknown. Read More

Eur Heart J Case Rep 2021 May 24;5(5):ytab142. Epub 2021 May 24.

Department of Cardiovascular Medicine, McLaren Macomb Regional Medical Center, 1000 Harrington Street, Mount Clemens, MI 48043, USA.

Background: Takotsubo cardiomyopathy (TCM) can clinically present as an acute coronary syndrome; however, the former has regional wall motion abnormalities that extend beyond a single coronary vascular territory without any plaque rupture. Takotsubo cardiomyopathy classically involves apical ballooning of left ventricle (LV). It is uncommon for TCM to present as cardiopulmonary arrest (CPA) along with third-degree atrioventricular (AV) block. Read More

Front Cell Dev Biol 2021 24;9:677867. Epub 2021 May 24.

Department of Microbiology and Immunology, Institute of Molecular Virology and Immunology, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China.

Despite prophylactic vaccination campaigns, high-risk human papillomavirus (HPV)-induced cervical cancer remains a significant health threat among women, especially in developing countries. The initial occurrence and consequent progression of this cancer type primarily rely on, E6 and E7, two key viral oncogenes expressed constitutively, inducing carcinogenesis. Thus, E6/E7 have been proposed as ideal targets for HPV-related cancer diagnosis and treatment. Read More

J Cardiovasc Surg (Torino) 2021 Jun 9. Epub 2021 Jun 9.

Department of Cardiac Surgery, American Heart of Poland, Bielsko-Biała, Poland.

Background: The evidence regarding the impact of patient's age and gender on del Nido cardioplegia cadioprotection capability in adults is strongly limited.

Methods: A group of 75 patients undergoing aortic valve replacement (AVR) with del Nido cardioplegia was divided into Group 1 (male) and Group 2 (female). Creatine kinase (CK-MB isoenzyme) and high sensitivity troponin T (hs-TnT) values at 24 hours and 48 hours, occurrence of cardiac activity during crossclamp and ventricular fibrillation (VF) during reperfusion were compared. Read More

Pulm Circ 2021 Apr-Jun;11(2):20458940211013671. Epub 2021 May 14.

Division of Cardiology, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.

Pregnancy is hazardous with pulmonary arterial hypertension, but maternal mortality may have fallen in recent years. We sought to systematically evaluate pulmonary arterial hypertension and pregnancy-related outcomes in the last decade. We searched for articles describing outcomes in pregnancy cohorts published between 2008 and 2018. Read More

Methodist Debakey Cardiovasc J 2021 Apr 25;17(1):65-67. Epub 2021 Mar 25.

Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas.

Loperamide, a μ-opioid receptor agonist, can cause cardiotoxicity by inhibiting the potassium ion channel and slowing cardiomyocyte repolarization. This, in turn, can lead to frequent early afterdepolarizations, the most common mechanism of drug-induced long QT syndrome and torsades de pointes. Apical hypertrophic cardiomyopathy (AHCM) is a nonobstructive hypertrophic cardiomyopathy rarely associated with malignant arrhythmias. Read More

Circ Cardiovasc Imaging 2021 Jun 9:CIRCIMAGING121012549. Epub 2021 Jun 9.

Department of Medicine (Cardiology), University of Ottawa Heart Institute, Canada (J.G.E.Z., J.Z.W., L.M.M., R.S.B.B., R.A.dk.).

Background: Current risk assessment approaches fail to identify the majority of patients at risk of sudden cardiac arrest (SCA). Noninvasive imaging of the cardiac sympathetic nervous system using single-photon emission computed tomography and positron emission tomography offers the potential for refining SCA risk assessment. While various [C]meta-hydroxyephedrine quantification parameters have been proposed, it is currently unknown whether regional denervation or global innervation yields greater SCA risk discrimination. Read More

Resuscitation 2021 Jun 4. Epub 2021 Jun 4.

National Advisory Unit for Prehospital Emergency Medicine (NAKOS) and Department of Anaesthesiology. Oslo University Hospital and University of Oslo. Po Box 4956 Nydalen, N-0424 Oslo, Norway.

Aim: Chest compressions delivered by a load distributing band (LDB) induce artefacts in the electrocardiogram. These artefacts alter shock decisions in defibrillators. The aim of this study was to demonstrate the first reliable shock decision algorithm during LDB compressions. Read More

Ann Thorac Surg 2021 Jun 4. Epub 2021 Jun 4.

Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.

Background: Mortality for infants on the heart transplant wait list remains unacceptably high, and available mechanical circulatory support is suboptimal. Our goal is to demonstrate the feasibility of utilizing genetically engineered pig (GEP) heart as a bridge to allotransplantation by transplantation of a GEP heart in a baboon.

Methods: Four baboons underwent orthotopic cardiac transplantation from GEP donors. Read More

J Am Heart Assoc 2021 Jun 5:e020353. Epub 2021 Jun 5.

Department of Anesthesiology and Critical Care, and The Center for Simulation, Advanced Education, and Innovation The Children's Hospital of Philadelphia Philadelphia PA.

Background Amplitude spectral area (AMSA) predicts termination of fibrillation (TOF) with return of spontaneous circulation (ROSC) and survival in adults but has not been studied in pediatric cardiac arrest. We characterized AMSA during pediatric cardiac arrest from a Pediatric Resuscitation Quality Collaborative and hypothesized that AMSA would be associated with TOF and ROSC. Methods and Results Children aged <18 years with cardiac arrest and ventricular fibrillation were studied. Read More

Respirol Case Rep 2021 Jul 26;9(7):e00791. Epub 2021 May 26.

Division of Thoracic Surgery, Department of Surgery National Taiwan University Hospital Yun-Lin Branch Douliu Taiwan.

The diagnosis of pneumopericardium can be challenging, as the symptoms are sometimes non-specific and can mimic those of other diseases. Especially, focal pneumopericardium presenting with regional ST-segment elevation on the electrocardiogram can be difficult to diagnose. Here, we present the case of a patient with pneumopericardium secondary to oesophageal cancer that was first diagnosed with community-acquired pneumonia and subsequently classified with acute coronary syndrome after an episode of cardiac arrest. Read More

Notf Rett Med 2021 Jun 2:1-20. Epub 2021 Jun 2.

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, CV4 7AL Coventry, Großbritannien.

The European Resuscitation Council has produced these basic life support guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include cardiac arrest recognition, alerting emergency services, chest compressions, rescue breaths, automated external defibrillation (AED), cardiopulmonary resuscitation (CPR) quality measurement, new technologies, safety, and foreign body airway obstruction. Read More

Notf Rett Med 2021 Jun 2:1-72. Epub 2021 Jun 2.

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, CV4 7AL Coventry, Großbritannien.

Informed by a series of systematic reviews, scoping reviews and evidence updates from the International Liaison Committee on Resuscitation, the 2021 European Resuscitation Council Guidelines present the most up to date evidence-based guidelines for the practice of resuscitation across Europe. The guidelines cover the epidemiology of cardiac arrest; the role that systems play in saving lives, adult basic life support, adult advanced life support, resuscitation in special circumstances, post resuscitation care, first aid, neonatal life support, paediatric life support, ethics and education. Read More

Notf Rett Med 2021 Jun 2:1-23. Epub 2021 Jun 2.

Emergency Department, Antwerp University Hospital and University of Antwerp, Edegem, Belgien.

These European Resuscitation Council education guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidance to citizens and healthcare professionals with regard to teaching and learning the knowledge, skills and attitudes of resuscitation with the ultimate aim of improving patient survival after cardiac arrest. Read More

Clin Res Cardiol 2021 Jun 5. Epub 2021 Jun 5.

Department of Cardiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk, Belgium.

Background: Contemporary data on left ventricular function (LVF) recovery in patients with left ventricular dysfunction after ST-elevation myocardial infarction (STEMI) are scarce and to date, no comparison has been made with patients with a baseline normal LVF. This study examined predictors of LVF recovery and its relation to outcomes in STEMI.

Methods: Patients presenting with STEMI between January 2010 and December 2016 were categorized in three groups after 3 months according to left ventricular ejection fraction (EF): (i) baseline normal LVF (EF ≥ 50% at baseline); (ii) recovered LVF (EF < 50% at baseline and ≥ 50% after 3 months); and (iii) reduced LVF (EF < 50% at baseline and after 3 months). Read More

Can J Cardiol 2021 Jun 3. Epub 2021 Jun 3.

Division of Cardiac Surgery, Department of Surgery, Western University, London, ON.

In an effort to further improve surgical outcomes in patients with acute type A aortic dissection (ATAD), the Canadian Thoracic Aortic Collaborative (CTAC), with the support of the Canadian Society of Cardiac Surgeons (CSCS), endeavored to develop quality indicators (QIs) for the management of patients with ATAD. After two successive consultations with the CTAC membership, 11 QIs were selected and separated into 5 broad categories: pre-operative (time from presentation to diagnosis, time from presentation to the operating room), intra-operative (use of hypothermic circulatory arrest and antegrade cerebral perfusion), 30-day outcomes (30-day rates of all-cause mortality, 30-day rates of new post-operative stroke), 1-year outcomes (1-year rates of follow-up imaging, 1-year rates of all-cause mortality, and 1-year rates of surgical re-intervention), and institutional (institutional surgical volumes, individual surgical volumes and presence of institutional aortic disease teams). The purpose of this manuscript was to describe the process by which QIs for the management of ATAD were developed and the feasibility by which they may be collected using existing clinical and administrative data sources. Read More

Thromb Res 2021 May 29;204:1-8. Epub 2021 May 29.

Stavanger University Hospital, Department of Cardiology, Stavanger, Norway; University of Bergen, Department of Clinical Science, Bergen, Norway.

Background: Cardiac arrest and cardiopulmonary resuscitation (CPR) are associated with activated coagulation and microvascular fibrin deposition with subsequent multiorgan failure and adverse outcome.

Objectives: Activated Factor XI-antithrombin (FXIa-AT) complex, activated Factor IX-antithrombin (FIXa-AT) complex and thrombin-antithrombin (TAT) complex were measured as markers of coagulation activation, and evaluated as independent prognostic indicators in out-of-hospital cardiac arrest (OHCA) patients.

Methods: From February 2007 until December 2010 blood samples were collected in close approximation to CPR from patients with OHCA of assumed cardiac origin. Read More

Intensive Care Med 2021 Jun 5. Epub 2021 Jun 5.

Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.

Purpose: This study aimed to determine the prevalence and predictors of death or new disability following critical illness.

Methods: Prospective, multicentre cohort study conducted in six metropolitan intensive care units (ICU). Participants were adults admitted to the ICU who received more than 24 h of mechanical ventilation. Read More

J Clin Anesth 2021 Jun 1;73:110366. Epub 2021 Jun 1.

Department of Anesthesiology, Intensive Care, Emergency Medicine, Transfusion Medicine, and Pain Therapy, Protestant Hospital of the Bethel Foundation, Bielefeld University Hospital, Campus Bielefeld-Bethel, University of Bielefeld, Burgsteig 13, 33617 Bielefeld, Germany. Electronic address:

Study Objective: To determine 30-day-mortality, incidence and characteristics of perioperative cardiac arrest as well as the respective independent risk factors in preterm infants undergoing non-cardiac surgery.

Design: Retrospective observational Follow-up-study.

Setting: Bielefeld University Hospital, a German tertiary care hospital. Read More

Surg Neurol Int 2021 26;12:183. Epub 2021 Apr 26.

Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio, United States.

Background: Although a well-recognized phenomenon of the tentorium and posterior fossa, the trigeminocardiac reflex (TCR) has been rarely reported during surgery involving the posterior falx cerebri.

Case Description: We present the case of a 63-year-old woman who underwent repeat resection of an atypical parasagittal meningioma involving the posterior falx. During resection, TCR was repeatedly elicited during manipulation and coagulation of the falx. Read More