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PLoS One 2021 3;16(5):e0251124. Epub 2021 May 3.

Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan.

Background: High-degree atrioventricular block (HAVB) is a prognostic factor for survival in patients with inferior ST-segment elevation myocardial infarction (STEMI). However, there is little information about factors associated with temporary pacing (TP). The aim of this study was to find factors associated with TP in patients with inferior STEMI. Read More

J Vis Exp 2021 Apr 17(170). Epub 2021 Apr 17.

Department of Pharmacology and Pharmacotherapy, Semmelweis University; Pharmahungary Group;

The development of heart failure is the most powerful predictor of long-term mortality in patients surviving acute myocardial infarction (MI). There is an unmet clinical need for prevention and therapy of post-myocardial infarction heart failure (post-MI HF). Clinically relevant pig models of post-MI HF are prerequisites for final proof-of-concept studies before entering into clinical trials in drug and medical device development. Read More

J Interv Cardiol 2021 20;2021:8835104. Epub 2021 Apr 20.

Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.

Objective: The initial recanalization rate of coronary chronic total occlusions (CTOs) is >85% when performed by experienced operators, but only 10% of prior failed CTO patients receive reattempted recanalization. This retrospective study analyzed the success rate and strategies used in reattempt percutaneous coronary intervention (PCI) of CTOs after prior failures.

Methods: Overall, 206 patients with 212 CTOs were enrolled. Read More

Eur Rev Med Pharmacol Sci 2021 Apr;25(8):3296-3299

Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Objective: Ventricular septal defect (VSD) is an uncommon but frequently fatal complication following acute myocardial infarction. In medically treated patients, mortality rates exceed 90%, while the surgical repair is associated with better outcomes, even though optimal surgical timing is still under debate.

Case Report: We present the case of a 78-years-old man with no previous remarkable cardiological history admitted to our Emergency Department with the diagnosis of anterior ST-elevation myocardial infarction and significant reduction of left ventricular ejection fraction. Read More

Circ Heart Fail 2021 Apr 27. Epub 2021 Apr 27.

The Cardiovascular Center, Tufts Medical Center, Boston, MA.

: Cardiogenic shock occurring in the setting of advanced heart failure (HF-CS) is increasingly common. However, recent studies have focused almost exclusively on acute myocardial infarction related cardiogenic shock. We sought to define clinical, hemodynamic, metabolic, and treatment parameters associated with clinical outcomes among HF-CS patients, using data from the Cardiogenic Shock Working Group (CSWG) Registry. Read More

Catheter Cardiovasc Interv 2021 Apr 19. Epub 2021 Apr 19.

The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio, USA.

Background: Among acute myocardial infarction patients with cardiogenic shock (AMICS), a number of key variables predict mortality, including cardiac arrest (CA) and shock classification as proposed by Society for Cardiovascular Angiography and Intervention (SCAI). Given this prognostic importance, we examined the frequency of reporting of high risk variables in published randomized controlled trials (RCTs) of AMICS patients.

Methods: We identified 15 RCTs enrolling 2,500 AMICS patients and then reviewed rates of CA, baseline neurologic status, right heart catheterization data, lactate levels, inotrope and vasopressor requirement, hypothermia, mechanical ventilation, left ventricular ejection fraction (LVEF), mechanical circulatory support, and specific cause of death based on the primary manuscript and Data in S1. Read More

Gen Thorac Cardiovasc Surg 2021 Apr 18. Epub 2021 Apr 18.

Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Right ventricular (RV) pseudoaneurysm is very rare and is seen after penetrating chest trauma, cardiac surgery, infective endocarditis, myocardial infarction, syphilis, endomyocardial biopsy, lead extraction. Idiopathic right ventricular pseudoaneurysm is even rarer. They have varied presentations depending on the etiology. Read More

J Gen Physiol 2021 Jul;153(7)

Department of Physiology and Cell Biology, College of Medicine, Ohio State University, Columbus, OH.

The two main phases of the mammalian cardiac cycle are contraction and relaxation; however, whether there is a connection between them in humans is not well understood. Routine exercise has been shown to improve cardiac function, morphology, and molecular signatures. Likewise, the acute and chronic changes that occur in the heart in response to injury, disease, and stress are well characterized, albeit not fully understood. Read More

F1000Res 2021 11;10:13. Epub 2021 Jan 11.

Department of Physiology and Medical Biochemistry, Airlangga University, Surabaya, Indonesia.

Pulmonary embolism is a potentially life-threatening condition. Despite advances in diagnostics, lack of consensus and delays in determining the diagnosis of pulmonary embolism are still important problems. We report the diagnosis and management of a 37-year-old man suffering from massive pulmonary embolism, a large protruding thrombus, and dilated cardiomyopathy. Read More

Case Rep Cardiol 2021 19;2021:6686227. Epub 2021 Mar 19.

Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.

A 46-year-old man was admitted with non-ST elevation myocardial infarction and newly diagnosed acutely decompensated heart failure. Echocardiogram demonstrated left ventricular ejection fraction of 30% with basal inferior and inferolateral akinesis. Coronary angiography showed mild diffuse coronary artery disease and an anomalous right coronary artery arising from the left coronary cusp. Read More

Circ J 2021 Apr 7. Epub 2021 Apr 7.

Division of Cardiology, Department of Medicine, Nihon University School of Medicine.

J Res Med Sci 2020 26;25:107. Epub 2020 Nov 26.

Department of Cardiovascular Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Percutaneous coronary intervention (PCI) is the treatment of choice for patients with ST-segment elevation myocardial infarction (STEMI). Effect of coronary artery dominance on the patients' outcome following primary PCI (PPCI) is not fully investigated. We investigated the association of coronary artery dominance with complications and 1-year mortality rate of PPCI. Read More

Front Cardiovasc Med 2021 19;8:647812. Epub 2021 Mar 19.

Institute of Molecular Biology and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russia.

Pericardial fluid is enriched with biologically active molecules of cardiovascular origin including microRNAs. Investigation of the disease-specific extracellular microRNAs could shed light on the molecular processes underlying disease development. Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart disease characterized by life-threatening arrhythmias and progressive heart failure development. Read More

Case Rep Cardiol 2021 15;2021:6626330. Epub 2021 Mar 15.

Department of Anaesthesia, Orchid Medical Centre, Ranchi, India.

We report a rare case of a 39-year-old male who presented with acute inferior wall myocardial infarction (IWMI). Coronary angiography revealed an anomalous single coronary artery arising from the right coronary cusp. Premature atherosclerotic coronary artery disease (CAD) with critical stenosis in the mid right coronary artery (RCA), proximal posterior left ventricular (PLV) artery, and distal left circumflex (LCX) artery was detected during angiography. Read More

Eur Heart J Suppl 2021 Mar 27;23(Suppl A):A15-A22. Epub 2021 Mar 27.

Department of Anesthesia and Intensive Care, IRCCS ISMETT, UPMC Italy, Via Ernesto Tricomi 5, 90127 Palermo, Italy.

The clinical management of patients on Impella support requires multimodality monitoring and imaging. Upon intensive care unit admission, echocardiography is essential to ensure correct pump positioning/guide repositioning, to monitor acute myocardial infarction/device-related cardiac complications and to evaluate baseline left and right ventricular function. Over time, the echocardiographic assessment of myocardial viability has become an essential target for guiding mechanical circulatory support escalation and long-term strategies. Read More

Heart 2021 Apr 2. Epub 2021 Apr 2.

Cardiology, Saint James's Hospital, Dublin, Ireland.

Cardiogenic shock (CS) remains the leading cause of death in patients hospitalised with acute myocardial infarction with mortality as high as 40%-50% prior to hospital discharge. The failure of inotropic therapy to maintain adequate perfusion and to prevent irreversible end-organ failure has led to attempts to improve outcomes by mechanical circulatory support (MCS) devices. Axial flow ventricular assist devices, namely Impella, are an attractive therapeutic option due to their positive haemodynamic benefits and ease of use. Read More

Indian J Crit Care Med 2021 Mar;25(3):340-342

Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States and Outcomes Research Consortium, Cleveland, OH, United States.

It is extremely rare for a cardiac tumor to present with coronary-cameral fistulas. A 66-year-old Caucasian male presented with worsening dyspnea and subsequently had a cardiac catheterization for an ST-elevation myocardial infarction, revealing no evidence of coronary artery disease but multiple coronary-cameral fistulas. Venoarterial (VA) extracorporeal membrane oxygenation was initiated for a severe cardiogenic shock. Read More

ESC Heart Fail 2021 Mar 24. Epub 2021 Mar 24.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Pharmaceutical Sciences Medicine, Dentistry, Okayama, Japan.

Aims: Fibrosis-4 index (FIB-4 index), calculated by age, aspartate aminotransferase, alanine aminotransferase, and platelet count, is a simple marker to evaluate liver fibrosis and is associated with right-sided heart failure. However, the clinical relevance of FIB-4 in patients with heart failure with preserved ejection fraction (HFpEF) remains unclear. We investigated the prognostic implication of the FIB-4 index regarding right ventricular dysfunction in patients with HFpEF. Read More

World J Clin Cases 2021 Mar;9(8):1877-1884

Department of Electrocardiology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi Province, China.

Background: Typically, right coronary artery (RCA) occlusion causes ST-segment elevation in inferior leads. However, it is rarely observed that RCA occlusion causes ST-segment elevation only in precordial leads. In general, an electrocardiogram is considered to be the most important method for determining the infarct-related artery, and recognizing this is helpful for timely discrimination of the culprit artery for reperfusion therapy. Read More

JBI Evid Synth 2021 Mar 17. Epub 2021 Mar 17.

School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Banyo, QLD, Australia.

Objective: This systematic review will aim to summarize and evaluate the literature describing the evidence regarding adverse events from the administration of nitrates during right ventricular myocardial infarction.

Introduction: Withholding nitrates in the setting of right ventricular myocardial infarction (RVMI) is currently recommended by the American Heart Association, European Society of Cardiology, and in the Australian Journal of General Practice, due to the risk that decreased preload in the setting of already compromised right ventricular ejection fraction may reduce cardiac output and precipitate hypotension or exacerbate cardiogenic shock. The original evidence from 1989 underpinning these recommendations displays methodological weaknesses including low sample size and confounding interventions. Read More

Eur Heart J Case Rep 2021 Feb 18;5(2):ytaa579. Epub 2021 Feb 18.

Department of Cardiothoracic Surgery, University Medical Center Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.

Background: Intramyocardial dissecting haematoma is a rare and potentially life-threatening complication of myocardial infarction (MI). Only a few isolated cases have been reported so far.

Case Summary: We report the case of a patient with a large, obstructing intramyocardial haematoma of the ventricular septum following MI due to plaque rupture of the right coronary artery (RCA) and following successful coronary intervention. Read More

Eur Heart J Case Rep 2021 Feb 5;5(2):ytaa546. Epub 2021 Jan 5.

Department of Pathology, Nash General Hospital of University of North Carolina Health Care.

Background : ST-elevation myocardial infarction (STEMI) requires timely coronary reperfusion but localizing ST-segment elevation (STE) can develop in clinical settings other than STEMI.

Case Summary : We report a case of a 66-year-old man, with a history of diabetes mellitus and arthritis presenting with haemoptysis and chest pain. The electrocardiogram (ECG) at presentation showed marked localizing STE but emergent cardiac catheterization showed no significant coronary artery obstruction and the serial serum cardiac troponin levels were within normal limits. Read More

Cureus 2021 Feb 12;13(2):e13316. Epub 2021 Feb 12.

Internal Medicine Department, Northside Hospital Gwinnett, Lawrenceville, USA.

Coronary-cameral fistulae (CCF) are rare, frequently incidental findings uncommonly noted during routine coronary angiography. They are nearly always congenital and are sometimes associated with other cardiac malformations. They can also be acquired due to trauma or chronic inflammation. Read More

Ter Arkh 2020 Dec 15;92(12):67-74. Epub 2020 Dec 15.

Sechenov First Moscow State Medical University (Sechenov University).

Aim: Study of the remodeling of the carotid arteries with violation of intracardiac hemodynamics in patients with MFA, and the estimation of the main parameters of dyslipidemia, apoptosis, and oxidative stress in patients with high vascular risk older age group (6175 years) in a Regional vascular center of Ufa.

Materials And Methods: Depending on the predominant lesion of the vascular pool, patients were divided into 3 clusters by the method of hierarchical analysis of categorical variables according to the clinical manifestation of atherosclerotic lesions of the heart, brain and lower limb arteries confirmed by coronary angiography, ultrasound Doppler of the main arteries of the head and lower extremities. 96 of them were IPA with a primary lesion of the heart (1st cluster), the 96 IPA with a predominance of lesions of the carotid arteries (2nd cluster), 96 patients with ischemia of lower extremities (3rd cluster). Read More

Acta Biomater 2021 May 11;126:394-407. Epub 2021 Mar 11.

Department of Pharmaceutical Technology and Chemistry, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain. Electronic address:

Despite tremendous progress in cell-based therapies for heart repair, many challenges still exist. To enhance the therapeutic potential of cell therapy one approach is the combination of cells with biomaterial delivery vehicles. Here, we developed a biomimetic and biodegradable micro-platform based on polymeric microparticles (MPs) capable of maximizing the therapeutic potential of cardiac progenitor cells (CPCs) and explored its efficacy in a rat model of chronic myocardial infarction. Read More

Turk Kardiyol Dern Ars 2021 Mar;49(2):151-155

Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Summary- Ventricular septal rupture (VSR) is an ominous mechanical complication of acute myocardial infarction (MI) accompanied with a poor prognosis. Transcatheter closure (TCC) of VSR has been proposed as an alternative approach for surgery. This study presents a 79-year-old man with diabetes mellitus, hypertension, dyslipidemia, and chronic stable angina with 3-vessel coronary artery disease, who had refused a coronary artery bypass graft. Read More

CJEM 2021 Mar 4;23(2):185-194. Epub 2021 Jan 4.

Northern Ontario School of Medicine, 935 Ramsey Lake Road, Sudbury, ON, P3E2C6, Canada.

Introduction: Kussmaul's sign, the absence of a drop in jugular venous pressure or a paradoxical increase in jugular venous pressure on inspiration, can be evaluated as an indicator of right ventricular myocardial infarction. Right ventricular myocardial infarction complicates 30-50% of inferior myocardial infarctions and is associated with increased mortality when compared to inferior myocardial infarction without right ventricular involvement. Early recognition allows maintenance of preload. Read More

ESC Heart Fail 2021 Mar 10. Epub 2021 Mar 10.

Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.

Aims: The aim of the study was to assess the association of P-selectin with outcomes in heart failure with preserved ejection fraction (HFpEF).

Methods And Results: This is a prospective, observational study of 130 HFpEF patients who underwent clinical profiling, blood sampling, 6 min walk testing, Minnesota Living with Heart Failure Questionnaire evaluation, echocardiography, cardiovascular magnetic resonance imaging, calculation of the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk scores, and blinded plasma P-selectin measurement. Patients were followed up for the endpoint of all-cause mortality. Read More

J Nippon Med Sch 2021 Mar 9. Epub 2021 Mar 9.

Department of General Medicine and Health Science, Nippon Medical School.

Amyloid light-chain (AL) cardiac amyloidosis is known to result in restrictive cardiomyopathy, which has a poor prognosis. Although electrocardiography (ECG) is useful for its diagnosis and management, there are few reports on the long-term follow-up of electrocardiographic changes. The patient in the present case was a 62-year-old woman who visited our hospital due to palpitation and lower leg edema. Read More

Multimed Man Cardiothorac Surg 2021 03 2;2021. Epub 2021 Mar 2.

Division of Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy

We present the case of a 65-year-old patient who developed a large posterobasal ventricular septal defect resulting from an extensive acute myocardial infarction involving the inferior and basal septum and wall. We repaired the interventricular lesion by verticalizing the cardiac apex to perform a left posterobasal ventriculotomy. We removed a great part of the residual infarcted tissue, leaving the residual scar in place. Read More