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    Risk stratification in Takotsubo Syndrome: a role of mitral annular plane systolic excursion.
    QJM 2018 Jan 15. Epub 2018 Jan 15.
    First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
    Aims: Takotsubo syndrome (TTS) patients have a higher mortality rate than the general population. Our study was conducted to determine the short- and long-term outcome of TTS patients associated with a significantly compromised mitral annular plane systolic excursion (MAPSE) on hospital admission.

    Methods And Results: Our institutional database constituted a collective of 53 patients diagnosed with TTS between 2003 and 2016. Read More

    Mechanical support in cardiogenic shock complicating acute coronary syndrome: ready for prime time?
    Curr Vasc Pharmacol 2018 Jan 16. Epub 2018 Jan 16.
    Department of Cardiology, Hopital Nord, Marseille. France.
    Cardiogenic shock (CS) is a major challenge in current cardiology. Over the last decade, cardiogenic shock mortality has decreased somewhat, but it still remains high, particularly when associated with ischaemic heart disease. The challenges are numerous and include prevention, accurate diagnosis, prompt management and effective therapies to support a failing heart and prevent multi-organ failure. Read More

    Refractory Pulmonary Edema and Upper Body Hypoxemia During Veno-Arterial Extracorporeal Membrane Oxygenation-A Case for Atrial Septostomy.
    Artif Organs 2018 Jan 18. Epub 2018 Jan 18.
    Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ, USA.
    Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides mechanical circulatory support for patients with advanced cardiogenic shock, facilitating myocardial recovery and limiting multi-organ failure. In patients with severely limited left ventricular ejection, peripheral VA-ECMO can further increase left ventricular and left atrial pressures (LAP). Failure to decompress the left heart under these circumstances can result in pulmonary edema and upper body hypoxemia, that is, myocardial and cerebral ischemia. Read More

    Simultaneous total occlusion of two coronary arteries associated with use of drospirenone-ethinyl estradiol (oral contraceptive).
    Turk Kardiyol Dern Ars 2018 Jan;46(1):69-72
    Department of Cardiology, Bağcılar Training and Research Hospital, İstanbul, Turkey.
    Although the use of oral contraceptives is associated with an increased risk of venous thromboembolic disease, the risk of myocardial infarction (MI) is unclear. A new, third-generation contraceptive agent, drospirenone-ethinyl estradiol, which contains less estrogen and a new progestogen, drospirenone, in a different combination, has been considered more reliable in terms of risk of MI. However, there have been some cases of MI associated with the use of drospirenone-ethinyl estradiol, despite the protective effects of this oral contraceptive. Read More

    Clinical characteristics and outcomes of acute coronary syndrome patients with intra-aortic balloon pump inserted in intensive cardiac care unit of a tertiary clinic.
    Turk Kardiyol Dern Ars 2018 Jan;46(1):10-17
    Department of Cardiology, Haydapaşa Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey.
    Objective: An intra-aortic balloon pump (IABP) is a mechanical support device that is used in addition to pharmacological treatment of the failing heart in intensive cardiac care unit (ICCU) patients. In the literature, there are limited data regarding the clinical characteristics and in-hospital outcomes of acute coronary syndrome patients in Turkey who had an IABP inserted during their ICCU stay. This study is an analysis of the clinical characteristics and outcomes of these acute coronary syndrome patients. Read More

    [Value of arterial blood lactic acid in the evaluation of disease severity and prognosis in neonatal shock].
    Zhongguo Dang Dai Er Ke Za Zhi 2018 Jan;20(1):17-20
    Department of Neonatology, Wuhan Children's Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China.
    Objective: To evaluate the value of blood lactic acid (BLA) as a predictor for the severity and prognosis of neonatal shock.

    Methods: A total of 326 neonates with shock were enrolled and divided into three groups based on the severity, namely mild group (n=147), moderate group (n=105), and severe group (n=74). BLA level was measured during and early after (about 6 hours later) fluid resuscitation, and lactate clearance rate (LCR) was calculated. Read More

    Influence of operator experience and PCI volume on transfemoral access techniques: A collaboration of international cardiovascular societies.
    Cardiovasc Revasc Med 2017 Dec 27. Epub 2017 Dec 27.
    Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, United States.
    Introduction: Transfemoral access (TFA) is widely used for coronary angiography and percutaneous coronary intervention (PCI). The influence of operator age, gender, experience, and procedural volume on performance of femoral arterial access has not been studied.

    Methods: A survey instrument was developed and distributed via e-mail from professional societies to interventional cardiologists worldwide from March to December 2016. Read More

    Effectiveness and Safety of Transcatheter Aortic Valve Implantation in Patients With Pure Aortic Regurgitation and Advanced Heart Failure.
    Am J Cardiol 2017 Dec 11. Epub 2017 Dec 11.
    Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy. Electronic address:
    Results of transcatheter aortic valve implantation (TAVI) for treatment of severe noncalcific isolated aortic regurgitation (AR) complicated by advanced heart failure or cardiogenic shock has been previously reported only in isolated case reports. Current self-expanding transcatheter aortic valves are designed to treat aortic valve stenosis, and have also been implanted in cases of severe AR due to degenerated bioprosthesis and in very few cases of native aortic valves. We report 13 consecutive inoperable patients with noncalcific, pure AR, and advanced heart failure treated with emergency percutaneous transfemoral implantation with self-expandable CoreValves at our institution between July 2012 and September 2017. Read More

    [Analysis of mortality and hospital stay in cardiac surgery in Mexico 2015: Data from the National Cardiology Institute].
    Arch Cardiol Mex 2018 Jan 9. Epub 2018 Jan 9.
    Terapia Intensiva Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.
    Objective: To analyse hospital mortality in patients subjected to cardiac surgery in Mexico during the year 2015, and identify the mortality risks factors, and its correlation with days of hospital stay in the cardiovascular intensive care unit.

    Method: The database of Cardiovascular Intensive Care of the National Institute of Cardiology was examined for this cases and controls study that included only adult patients subjected to cardiac surgery during the year 2015.

    Results: A total of 571 patients were subjected to a surgical procedure. Read More

    Soluble ST2 in end-stage heart failure, before and after support with a left ventricular assist device.
    Eur J Clin Invest 2018 Jan 11. Epub 2018 Jan 11.
    Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
    Background: The interleukin-33 (IL-33)/supressor of tumorigenicity 2 (ST2) pathway is suggested to play an important role in fibrosis, remodeling and the progression of heart failure (HF). Increased soluble (sST2) levels are associated with adverse outcome in the average HF population. Less is known about sST2 levels in end-stage HF. Read More

    New-onset Takayasu's Arteritis as Acute Myocardial Infarction.
    Intern Med 2018 Jan 11. Epub 2018 Jan 11.
    Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Japan.
    We herein report the case of a 25-year-old Japanese woman with left-main-trunk acute myocardial infarction (LMT-AMI). She had cardiogenic shock, so emergency percutaneous intervention was performed. Intravascular ultrasound of LMT-AMI showed that the three-layered structure of the intima, tunica media, and adventitia was not clearly visible, and the vessel was concentrically thickened; unstable plaque and calcification were not seen. Read More

    Propranolol-Induced Circulatory Collapse in a Patient With Thyroid Crisis and Underlying Thyrocardiac Disease: A Word of Caution.
    J Investig Med High Impact Case Rep 2017 Oct-Dec;5(4):2324709617747903. Epub 2017 Dec 20.
    Detroit Medical Center, Wayne State University, Detroit, MI, USA.
    Thyrotoxic crisis or thyroid storm is a severe form of hyperthyroidism and a rare endocrinological emergency. The cornerstones of medical therapy in thyroid storm include decreasing the levels of circulating T3 in the blood as well as inhibiting the hormone's peripheral effects through β-adrenergic blockade. Propranolol is the preferred agent for β-blockade in hyperthyroidism and thyroid storm due to its additional effect of blocking the peripheral conversion of inactive T4 to active form T3. Read More

    Successful use of extracorporeal membrane oxygenation support in severe septic shock with associated acute cardiomyopathy.
    J Card Surg 2018 Jan 4. Epub 2018 Jan 4.
    Department of Cardiology, Saint Thomas West Hospital, Nashville, Tennessee.
    A 24-year-old female presented with sepsis and cardiogenic shock 4 days after vaginal delivery. Veno-arterial extracorporeal membrane oxygenation (VA ECMO) therapy was used for cardiovascular support as a bridge for recovery. The use of VA ECMO in patients with cardiogenic shock secondary to sepsis is reviewed. Read More

    Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database.
    J Card Surg 2018 Jan 4. Epub 2018 Jan 4.
    Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
    Purpose: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD.

    Methods: Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. Read More

    Recreational Marijuana Use and Acute Myocardial Infarction: Insights from Nationwide Inpatient Sample in the United States.
    Cureus 2017 Nov 3;9(11):e1816. Epub 2017 Nov 3.
    Department of Medicine, Division of Cardiology, Atlanta Veterans Affairs Medical Center and Emory University School of Medicine.
    Background Marijuana is a widely used recreational substance. Few cases have been reported of acute myocardial infarction following marijuana use. To our knowledge, this is the first ever study analyzing the lifetime odds of acute myocardial infarction (AMI) with marijuana use and the outcomes in AMI patients with versus without marijuana use. Read More

    Optimal course of treatment in acute cardiogenic shock complicating myocardial infarction.
    Expert Rev Cardiovasc Ther 2018 Jan 9. Epub 2018 Jan 9.
    b Department of Medicine I , Carl-von-Basedow Hospital Merseburg , Germany.
    Introduction: About 5% of patients with myocardial infarction suffer from cardiogenic shock as a complication, with a mortality of ≥30%. Primary percutaneous coronary intervention as soon as possible is the most successful therapeutic approach. Prognosis depends not only on the extent of infarction, but also - and even more - on organ hypoperfusion with consequent development of multiple organ dysfunction syndrome. Read More

    Safety and effectiveness of selective carotid angioplasty prior to cardiac surgery: a single-centre matched case-control study.
    Interact Cardiovasc Thorac Surg 2018 Jan 3. Epub 2018 Jan 3.
    Department of Biostatistics, Haga Teaching Hospitals, Netherlands.
    Objectives: Reducing the rate of postoperative stroke after cardiac surgery remains challenging, especially in patients with occlusive cerebrovascular disease. Angioplasty in all patients with high-grade carotid artery stenosis has not been shown to be effective in reducing the post-surgical stroke rate. In this study, we present the initial results of a different approach using selective carotid angioplasty only in patients with poor intracranial collaterals. Read More

    Gender difference with the use of percutaneous left ventricular assist device in patients undergoing complex high-risk percutaneous coronary intervention: From pVAD Working Group.
    Eur Heart J Acute Cardiovasc Care 2018 Jan 1:2048872617745790. Epub 2018 Jan 1.
    Department of Cardiology, North Shore University Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA.
    Background: The interventional treatment of complex high-risk indicated patients is technically difficult and can result in poor outcomes. Thus, percutaneous left ventricular assist devices are being increasingly used to provide hemodynamic support. No data is available comparing male and female for Complex High-risk Indicated Patients treated with percutaneous left ventricular assist devices. Read More

    Fulminant giant-cell myocarditis on mechanical circulatory support: Management and outcomes of a French multicentre cohort.
    Int J Cardiol 2018 Feb;253:105-112
    Medical Intensive Care Unit, iCAN, Institute of Cardiometabolism and Nutrition, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address:
    Aims: Giant-cell myocarditis (GCM) is a rare and often fatal form of myocarditis. Only a few reports have focused on fulminant forms. We describe the clinical characteristics, management and outcomes of GCM patients rescued by mechanical circulatory support (MCS). Read More

    "Around the World" - How to Reach Native Coronary Artery Lesions through Long and Tortuous Aortocoronary Bypass Grafts.
    Hellenic J Cardiol 2018 Jan 3. Epub 2018 Jan 3.
    Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA. Electronic address:
    For patients with prior coronary artery bypass graft surgery, reaching lesions in native coronary arteries distal to the anastomosis of bypass grafts can be challenging due to long distance between the graft ostium and the lesion and significant tortuosity that needs to be traversed. We describe one such lesion in a patient presenting with non-ST segment elevation myocardial infarction and cardiogenic shock. The lesion was successfully treated using a variety of strategies, including use of a short guide catheter, long guidewire, a guide catheter extension, long shaft balloons and stents, and short length stents. Read More

    [Epidemiological characteristics of ST-segment elevation myocardial infarction in Peru: Results of the PEruvian Registry of ST-segment Elevation Myocardial Infarction (PERSTEMI)].
    Arch Cardiol Mex 2018 Jan 2. Epub 2018 Jan 2.
    Departamento de Enfermería, Instituto Nacional Cardiovascular (INCOR), Lima, Perú.
    Objective: To determine the epidemiological characteristics, treatment, reperfusion strategies and in-hospital adverse events of patients with ST elevation myocardial infarction in Peru.

    Methods: Observational, prospective multicentre study in patients over 18 years admitted to hospital with a diagnosis of ST elevation myocardial infarction.

    Results: A total of 396 patients were enrolled in the registry during February 2016 to February 2017. Read More

    Nonejecting Hearts on Femoral Veno-Arterial Extracorporeal Membrane Oxygenation: Aortic Root Blood Stasis and Thrombus Formation-A Case Series and Review of the Literature.
    Crit Care Med 2018 Jan 4. Epub 2018 Jan 4.
    Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
    Objectives: Cardiogenic shock constitutes the final common pathway of cardiac dysfunction associated with tissue hypoperfusion and organ failure. Besides treatment of the underlying cause, temporary mechanical circulatory support serves as a supportive measure. Extracorporeal membrane oxygenation can effectively prevent hypoxemia and end-organ dysfunction, but knowledge about patient selection, risks, and complications remains sparse. Read More

    The Use of ECMO for the Treatment of Refractory Cardiac Arrest or Postarrest Cardiogenic Shock Following In-Hospital Cardiac Arrest: A 10-Year Experience.
    J Intensive Care Med 2018 Jan 1:885066617751398. Epub 2018 Jan 1.
    2 Department of Critical Care Medicine, UPMC, Pittsburgh, PA, USA.
    Objectives: Extracorporeal membrane oxygenation (ECMO) has been increasingly used in the treatment of refractory cardiac arrest (extracorporeal cardiopulmonary resuscitation [ECPR]) and postarrest cardiogenic shock (PACS). Our primary objective was to determine the 1-year survival of patients who were treated with ECMO for PACS or in ECPR.

    Methods: We conducted a retrospective analysis of hospitalized patients in a tertiary care facility who underwent treatment with ECMO for ECPR or PACS. Read More

    Use of Impella 5.0 Prior to Transcatheter Aortic Valve Replacement in a Patient with Severe Aortic Stenosis and Cardiogenic Shock.
    J Heart Valve Dis 2017 Jul;26(4):485-487
    Texas A&M Health Science Center College of Medicine/Scott and White Medical Center, Temple, TX, USA.
    The use of transcatheter aortic valve replacement (TAVR) has risen dramatically during the past decade. Notably, the procedure can reduce symptoms and improve prognosis in patients who would otherwise be excluded from intervention due to prohibitive surgical risk. During the same time period, the use of percutaneous mechanical circulatory support devices for patients with severe left ventricular dysfunction, including the Impella System (Abiomed, Inc. Read More

    Predictors of Outcomes in Myocardial Infarction and Cardiogenic Shock.
    Cardiol Rev 2018 Jan 3. Epub 2018 Jan 3.
    Section of Advanced Heart Failure, Mechanical Circulatory Support, and Pulmonary Vascular disease, University of Alabama at Birmingham, Birmingham, AL.
    Myocardial infarction (MI) complicated by cardiogenic shock (CS) is a major cause of cardiovascular morbidity and mortality. Predictors of outcomes in AMI-CS include clinical, laboratory, radiologic variables, as well as management strategies. This article reviews the existing literature on short- and long-term predictors and risk stratification in MI complicated by CS. Read More

    Evolved role of the cardiovascular intensive care unit (CICU).
    J Intensive Care 2017 22;5:72. Epub 2017 Dec 22.
    Department of Emergency and General Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556 Japan.
    Cardiovascular intensive care refers to special systemic management for the patients with severe cardiovascular disease (CVD), which consists of heart disease and vascular disease. CVD is one of the leading causes of death in the world. In order to prevent death due to CVDs, an intensive care unit for severe CVD patients, so-called cardiovascular intensive care unit (CICU), has been developed in many general hospitals. Read More

    A single-center experience with 12 consecutive cases of pregnancy among patients with membranous ventricular septal aneurysm.
    BMC Pregnancy Childbirth 2018 Jan 3;18(1). Epub 2018 Jan 3.
    Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
    Background: Membranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy and delivery in patients with MVSA has not been reported in the literature. Read More

    Elevation of Serum APE1/Ref-1 in Experimental Murine Myocarditis.
    Int J Mol Sci 2017 Dec 8;18(12). Epub 2017 Dec 8.
    Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea.
    Myocarditis is an inflammatory disease of the myocardium that causes cardiogenic shock and death. However, endomyocardial biopsy that is, the gold standard for a diagnosis is limited. Apurinic/apyrimidinic endonuclease 1/redox effector factor-1 (APE1/Ref-1) is a multifunctional protein, which is involved in DNA-based excision repair pathway, and in redox signaling, its changes are observed in various cardiovascular diseases including hypertension and coronary artery disease. Read More

    Long-term clinical outcomes in patients with cardiogenic shock according to left ventricular function: The French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) programme.
    Arch Cardiovasc Dis 2017 Dec 28. Epub 2017 Dec 28.
    Department of Cardiology, HEGP, AP-HP, 75015 Paris, France; Université Paris-Descartes, 75006 Paris, France.
    Background: Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) remains a major concern. Failure of the left ventricular (LV) pump is the primary insult in most forms of CS, but other parts of the circulatory system and diastolic function contribute to shock. However, little is known of the clinical presentation, management and outcomes according to LV function in these patients. Read More

    Outcomes and Predictors of Mortality After Mitral Valve Surgery in High-Risk Elderly Patients: The Heidelberg Experience.
    Med Sci Monit 2017 Dec 31;23:6193-6200. Epub 2017 Dec 31.
    Department of Cardiac Surgery, Heart and Marfan Center, University of Heidelberg, Heidelberg, Germany.
    BACKGROUND Overall, life expectancy at the age of 80 has significantly increased in the industrialized world and the proportion of this age class undergoing cardiac surgery has also grown. In this context, we have analyzed a contemporary series of octogenarians undergoing mitral valve surgery at our institution. MATERIAL AND METHODS We performed a retrospective analysis of 138 consecutive octogenarians receiving mitral valve surgery between January 2006 and April 2017. Read More

    Gender Impact on 30-Day Readmissions After Hospitalization With Acute Myocardial Infarction Complicated by Cardiogenic Shock (from the 2013 to 2014 National Readmissions Database).
    Am J Cardiol 2017 Dec 11. Epub 2017 Dec 11.
    Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, Florida. Electronic address:
    Previous studies have suggested that women are more likely to have increased risk of readmissions after acute myocardial infarction (AMI); however, this difference has not been examined in the setting of AMI complicated by cardiogenic shock. Thus, we aimed to compare 30-day readmissions in women versus men initially admitted with AMI complicated with cardiogenic shock. In this observational study, we used the Nationwide Readmissions Databases years 2013 and 2014 to identify subjects who were initially hospitalized with a primary diagnosis of AMI complicated by cardiogenic shock, and discharged alive. Read More

    The effect of angiotensin II on blood pressure in patients with circulatory shock: a structured review of the literature.
    Crit Care 2017 Dec 28;21(1):324. Epub 2017 Dec 28.
    Department of Critical Care, King's College London, Guy's & St Thomas' NHS Foundation Hospital, London, SE1 7EH, UK.
    Background: Circulatory shock is a common syndrome with a high mortality and limited therapeutic options. Despite its discovery and use in clinical and experimental settings more than a half-century ago, angiotensin II (Ang II) has only been recently evaluated as a vasopressor in distributive shock. We examined existing literature for associations between Ang II and the resolution of circulatory shock. Read More

    Extracorporeal membrane oxygenation for cardiogenic shock due to alcoholic cardiomyopathy: a long-term follow-up of 4 cases.
    Interact Cardiovasc Thorac Surg 2017 Dec 20. Epub 2017 Dec 20.
    Intensive Care Unit, Centre Hospitalier Universitaire La Réunion, Site Félix Guyon, Saint-Denis, France.
    Even though alcoholism is a major health concern, alcoholic cardiomyopathy is a little-known pathology. The exact prevalence remains elusive (20-40% of dilated cardiomyopathy). However, it can lead to dilated cardiomyopathy, heart failure and refractory cardiogenic shock. Read More

    Critical Illness-Related Corticosteroid Insufficiency in Cardiogenic Shock Patients: Prevalence and Prognostic Role.
    Shock 2017 Dec 26. Epub 2017 Dec 26.
    Service de Réanimation Médicale Brabois, CHRU Nancy, Pôle Cardio-Médico-Chirurgical, 54511 Vandoeuvre-les-Nancy, France.
    Background: Cardiogenic shock shares with septic shock common hemodynamic features, inflammatory patterns and most likely similar complications such as critical illness-related corticosteroid insufficiency. The aim of this study was to evaluate the prevalence of critical illness-related corticosteroid insufficiency in cardiogenic shock patients and to secondarily assess its prognostic value on 90-day mortality.

    Methods: A single-centre prospective observational study conducted over a three-year period and including all patients with cardiogenic shock. Read More

    Upfront triple combination therapy-induced pulmonary edema in a case of pulmonary arterial hypertension associated with Sjogren's syndrome.
    Respir Med Case Rep 2018 7;23:55-59. Epub 2017 Dec 7.
    Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
    Clinical efficacy of combination therapy using vasodilators for pulmonary arterial hypertension (PAH) is well established. However, information on its safety are limited. We experienced a case of primary Sjogren's syndrome associated with PAH where the patient developed pulmonary edema immediately after the introduction of upfront triple combination therapy. Read More

    Prolonged circulatory support with an Impella assist device in the management of cardiogenic shock associated with takotsubo syndrome, severe sepsis and acute respiratory distress syndrome.
    SAGE Open Med Case Rep 2017 14;5:2050313X17741013. Epub 2017 Dec 14.
    Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA.
    Severe sepsis has been known to trigger for takotsubo syndrome which is associated with profound physical or emotional stress. Severe sepsis is also associated with sepsis-induced cardiomyopathy, a reversible myocardial depression. We report a case in which a patient with takotsubo syndrome, cardiogenic shock, severe sepsis, and adult respiratory distress syndrome was managed with an Impella Cardiac Power circulatory support device for 108 h (4. Read More

    Selective implantation of durable left ventricular assist devices as primary therapy for refractory cardiogenic shock.
    J Thorac Cardiovasc Surg 2017 Nov 21. Epub 2017 Nov 21.
    Cardiovascular Surgery, Mount Sinai Hospital, New York, NY. Electronic address:
    Objective: Surgical therapy for refractory primary cardiogenic shock is largely based on emergent placement of extracorporeal membrane oxygenation or short-term ventricular assist devices. We have adopted a strategy of routine implantation of durable left ventricular assist devices (LVAD) as initial therapy for refractory cardiogenic shock, in patients who are potential candidates for heart transplantation, and report our experience.

    Methods: Retrospective review of 43 consecutive patients with refractory shock caused by acute myocardial infarction (n = 21) or acute decompensated heart failure (n = 22) who were treated with primary implantation of a durable LVAD in a single institution. Read More

    Extracorporeal Membrane Oxygenation (ECMO): An Option for Cardiac Reccovery from Advanced Cardiogenic Shock.
    Heart Surg Forum 2017 12 22;20(6):E274-E277. Epub 2017 Dec 22.
    Heart and Vascular Institute, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania, USA.
    Mechanical circulatory support can prevent multi-organ failure and death in patients with advanced cardiogenic shock. Here we describe our experience using extracorporeal membrane oxygenation (ECMO) for treatment of advanced cardiogenic shock which has been used by our team for daily routine care in more than 200 patients during the last five years at the Penn State Medical Center. Venoarterial (VA) ECMO has been used as a viable therapeutic option for advanced cardiogenic shock as a bridge to recovery (BTR) or bridge to next decision (BTD). Read More

    A Case of Anterolateral Papillary Muscle Rupture Caused by Isolated First Diagonal Branch Occlusion.
    Heart Surg Forum 2017 12 21;20(6):E263-E265. Epub 2017 Dec 21.
    Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, Japan.
    A 74-year-old man hospitalized due to acute myocardial infarction (AMI) of the first diagonal branch developed cardiogenic shock. Ultrasonography showed anterolateral papillary muscle rupture (PMR) which caused anterior mitral leaflet prolapse and severe mitral valve regurgitation, and he successfully underwent mitral valve replacement. Anterolateral PMR causing anterior mitral leaflet prolapse due to obstruction of the first diagonal branch is rare and should be considered in such an AMI case. Read More

    Advancements in mechanical circulatory support for patients in acute and chronic heart failure.
    J Thorac Dis 2017 Oct;9(10):4070-4083
    Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
    Cardiogenic shock (CS) continues to have high mortality and morbidity despite advances in pharmacological, mechanical, and reperfusion approaches to treatment. When CS is refractory to medical therapy, percutaneous mechanical circulatory support (MCS) should be considered. Acute MCS devices, ranging from intra-aortic balloon pumps (IABPs) to percutaneous temporary ventricular assist devices (VAD) to extracorporeal membrane oxygenation (ECMO), can aid, restore, or maintain appropriate tissue perfusion before the development of irreversible end-organ damage. Read More

    Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: The Detroit cardiogenic shock initiative.
    Catheter Cardiovasc Interv 2017 Dec 20. Epub 2017 Dec 20.
    Department of Cardiology, Henry Ford Hospital, Detroit, Michigan.
    Objective: The 'Detroit Cardiogenic Shock Initiative' is a single-arm, multicenter study to assess the feasibility of early mechanical circulatory support (MCS) in patients who present with acute myocardial infarction complicated by cardiogenic shock (AMICS) who undergo percutaneous coronary intervention.

    Methods: Between July 2016 and February 2017, 4 metro Detroit sites participated in the study. The centers agreed to treat patients with AMICS using a mutually agreed-upon protocol emphasizing invasive hemodynamic monitoring and rapid initiation of MCS. Read More

    β-Blocker Therapy Prior to Admission for Acute Coronary Syndrome in Patients Without Heart Failure or Left Ventricular Dysfunction Improves In-Hospital and 12-Month Outcome: Results From the GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2).
    J Am Heart Assoc 2017 Dec 20;6(12). Epub 2017 Dec 20.
    Adult Cardiology, Heart Hospital - Hamad Medical Corporation, Doha, Qatar
    Background: The prognostic impact of β-blockers (BB) in acute coronary syndrome (ACS) patients without heart failure (HF) or left ventricular dysfunction is controversial, especially in the postreperfusion era. We sought to determine whether a BB therapy before admission for ACS has a favorable in-hospital outcome in patients without HF, and whether they also reduce 12-month mortality if still prescribed on discharge.

    Methods And Results: The GULF-RACE 2 (Gulf Registry of Acute Coronary Events-2) is a prospective multicenter study of ACS in 6 Middle Eastern countries. Read More

    Newborn in cardiogenic shock.
    Heart 2017 Dec 20. Epub 2017 Dec 20.
    Department of Pediatric Cardiology, University of Leipzig, Heart Center, Leipzig, Germany.
    Clinical Introduction: A 2-month-old baby boy was referred to our centre due to tachycardia and acute heart failure. The ECG showed a narrow complex tachycardia with a heart rate of 300 beats per minute (Figure 1). Echocardiographically, a patent foramen ovale and a parachute mitral valve with mild regurgitation were diagnosed; cardiac function was highly impaired. Read More

    Veno-arterial extracorporeal membrane oxygenation in addition to primary PCI in patients presenting with ST-elevation myocardial infarction.
    Neth Heart J 2017 Dec 19. Epub 2017 Dec 19.
    Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.
    Introduction: Primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI) can cause great haemodynamic instability. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can provide haemodynamic support in patients with STEMI but data on outcome and complications are scarce.

    Methods: An in-hospital registry was conducted enrolling all patients receiving VA-ECMO. Read More

    Medulla Oblongata Hemorrhage and Reverse Takotsubo Cardiomyopathy.
    Neurocrit Care 2017 Dec 19. Epub 2017 Dec 19.
    Division of Critical Care Neurology, Division of Neurocritical Care, Department of Neurology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA.
    Background: Acute brain injury with strong surges of adrenergic outflow has resulted in takotsubo cardiomyopathy, but there are surprisingly few reports of takotsubo cardiomyopathy after intracranial hemorrhage, and none have been described from hemorrhage within the brainstem.

    Results: We describe a patient with reverse and reversible cardiomyopathy following a hemorrhage in the lateral medulla oblongata. While it is limited in size, the location of the hemorrhage caused acute systolic failure with left ventricular ejection fraction of 27% and vasopressor requirement for cardiogenic shock and pulmonary edema. Read More

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