Search Our Scientific Publications & Authors

J Cardiopulm Rehabil Prev 2019 May;39(3):138-145

Department of Physical Therapy, College of Applied Health Sciences, The University of Illinois at Chicago (Drs Ozemek and Arena); and Department of Health and Exercise Science Wake Forest University, Winston-Salem, North Carolina (Dr Berry).

Pulmonary arterial hypertension (PAH) is characterized by impaired pulmonary vascular structure and function and is commonly associated with symptoms of dyspnea, fatigue, and potentially syncope. With chronic exposure to elevated pulmonary pressures, dramatic right ventricular dysfunction is common, thereby compromising cardiorespiratory fitness and increasing the risk of mortality. Collective investigative efforts, both at the preclinical and clinical levels, have established the safety and efficacy of regular exercise training in improving quality of life, cardiorespiratory fitness, and the physiologic profile of patients with PAH. Read More

Eur Heart J Case Rep 2018 Jun 11;2(2):yty048. Epub 2018 Apr 11.

[This corrects the article DOI: 10.1093/ehjcr/yty020.][This corrects the article DOI: 10. Read More

Indian J Pediatr 2019 Apr 24. Epub 2019 Apr 24.

Department of Pediatric Cardiology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain.

Eur Heart J Case Rep 2018 Dec 29;2(4):yty131. Epub 2018 Nov 29.

Department of Cardiology, Seth GS Medical College, KEM Hospital, Achary Dhonde MargParel, Mumbai, Maharashtra, India.

Background: Though primary malignant tumours of the heart are rare, secondary metastatic affection of the heart is quite common. Common presentations include pericardial effusion, obstruction of inflow and outflow tracts and arrhythmias, most notably tachyarrhythmias, and very rarely complete heart blocks (CHBs).

Case Summary: A 28-year-old man suffering from carcinoma of the tongue underwent a surgery in the form of radical hemimandibulectomy. Read More

Eur Heart J Case Rep 2018 Dec 26;2(4):yty128. Epub 2018 Nov 26.

Department of Internal Medicine, University Hospital Innsbruck, Anichstr. 35, Innsbruck, Austria.

Background: Carotid sinus syndrome (CSS) is an exaggerated response to carotid sinus baroreceptor stimulation, which may result in hypotension, prolonged asystole, and subsequently transient loss of consciousness due to cerebral hypoperfusion. However, this commonly benign syndrome may have lethal consequences under certain circumstances such as scuba diving.

Case Summary: We report the case of a trained 73-year-old male diver, who survived an almost fatal diving accident without any neurological deficits due to cardiac arrest under water. Read More

Eur Heart J Case Rep 2018 Dec 26;2(4):yty106. Epub 2018 Sep 26.

Department of Cardiology, Herlev-Gentofte Hospital, University Hospital Copenhagen, Herlev Ringvej 75, Copenhagen, Denmark.

Background: Prolongation of the QT interval on the electrocardiogram is clinically important due to the association with an increased risk of sudden cardiac death. A long QT interval may be genetically determined (congenital long QT syndrome) or be drug-induced long QT syndrome e.g. Read More

Eur Heart J Case Rep 2018 Dec 11;2(4):yty103. Epub 2018 Oct 11.

Department of Cardiology, Crozer-Chester Medical Center, Upland, PA, USA.

Background: Cardiac sarcoidosis (CS) accounts for a substantial morbidity and mortality. Early recognition of CS is important to prevent such detrimental consequences. A definite diagnosis of cardiac sarcoidosis remains challenging. Read More

Eur Heart J Case Rep 2018 Mar 5;2(1):yty020. Epub 2018 Mar 5.

Department of Cardiology and Angiology I, Heart Center Freiburg University, Hugstetter Str. 55, 79106 Freiburg, Germany.

Introduction: Parasystole refers to an ectopic pacemaker that discharges with a constant rate competing with the primary pacemaker of the heart the sinus node. Parasystolic pacemakers have been described in the atrium, atrioventricular node, His bundle, and in the ventricle. Ventricular parasystole usually carries a benign prognosis, but there are a few reports of ventricular tachyarrhythmia initiated by parasystolic beats. Read More

Int Heart J 2019 Apr 25. Epub 2019 Apr 25.

Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine.

Severe aortic atherosclerosis is a risk factor for stroke during coronary artery bypass grafting (CABG). The purpose of this study was to evaluate the incidence of postoperative neurologic complications after off-pump CABG (OPCAB) with a proximal seal system (Heartstring).From January 2011 to December 2014, 729 patients underwent isolated OPCAB. Read More

J R Soc Med 2019 Apr 24:141076819843656. Epub 2019 Apr 24.

2 City Hospital, Birmingham B18 7QH, UK.

Heart Surg Forum 2019 Mar 11;22(2):E131-E133. Epub 2019 Mar 11.

Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

Background: Pacemaker lead-related thrombosis is a rare but severe complication in patients with pacing lead implantation in the right ventricle. We present a case with recurrent syncope after single-chamber implantable cardioverter defibrillator (ICD) implantation. Pacing lead-related thrombosis was observed during open-heart surgery. Read More

Eur Stroke J 2016 Sep 4;1(3):222-230. Epub 2016 Aug 4.

Department of Medical Gerontology, Trinity College, Dublin, Ireland.

Introduction: Hypertension is a recognised risk factor for lacunar stroke. However, their association has been evaluated using static blood pressure (BP) assessment in supine or sitting position alone. We hypothesised that impaired dynamic (orthostatic) BP control may associate with lacunar strokes. Read More

High Alt Med Biol 2019 Apr 19. Epub 2019 Apr 19.

1 School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.

Lanfranconi, Francesca, Alessandra Ferri, Luca Pollastri, Manuela Bartesaghi, Massimiliano Novarina, Giovanni De Vito, Egidio Beretta, and Lucio Tremolizzo. Impact of hanging motionless in harness on respiratory and blood pressure reflex modulation in mountain climbers. 16:000-000, 2019. Read More

Cardiol Rev 2019 Apr 12. Epub 2019 Apr 12.

From the Cardiology Division, Department of Medicine, Westchester Medical Center/ New York Medical College, Valhalla, NY 10595.

The Brugada syndrome is an inherited channelopathy that alters the main transmembrane ion currents that constitute the cardiac action potential. These changes not only modify the resting electrocardiogram, but also predispose patients to develop malignant ventricular tachyarrhythmias that can lead to syncope, cardiac arrest, and sudden cardiac death. This syndrome is responsible for nearly 20% of all sudden cardiac deaths in patients with structurally normal hearts and up to 12% of all sudden cardiac deaths. Read More

J Cardiovasc Echogr 2019 Jan-Mar;29(1):1-6

Cardiomyopathies and Heart Failure Department, Monaldi Hospital, Università della Campania "Luigi Vanvitelli," Nocera Inferiore, Italy.

Introduction: In patients affected by hypertrophic cardiomyopathy (HCM), left atrial volume index (LAVi) is associated with an increased risk of tachyarrhythmias and major clinical events. To date, the clinical meaning of LAVi measured during exercise (stress LAVi [sLAVi]) has not yet been investigated in HCM. This study sought to evaluate the correlation between LAVi/sLAVi and clinical outcome (risk of arrhythmias and heart failure [HF]) in patients with HCM. Read More

J Saudi Heart Assoc 2019 Jul 8;31(3):111-113. Epub 2019 Mar 8.

Department of Internal Medicine, Thumbay Hospital Day Care Rolla, Sharjah, United Arab EmiratesUnited Arab Emirates.

We report regarding a young lady who presented with recurrent syncopal episodes associated with palpitations, documented to be due to rapid wide QRS tachycardia, subsequently detected to have thyrotoxicosis and who responded promptly to appropriate medication to become free from arrhythmia. Read More

Ann Indian Acad Neurol 2019 Apr-Jun;22(2):210-212

Department of Neurology, Bombay Hospital and Institute of Medical Sciences, Mumbai, Maharashtra, India.

Introduction: New-onset refractory status epilepticus (NORSE) is uncommon and almost 50% of cases are cryptogenic. We report the rare development of NORSE following carotid artery stenting (CAS), a procedure which is increasingly being used to treat the carotid stenosis.

Materials And Methods: Patients who developed NORSE following CAS for the prevention of stroke over a period of 5 years were analyzed retrospectively. Read More

Acad Emerg Med 2019 Apr 22. Epub 2019 Apr 22.

Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Background: Overuse of head computed tomography (CT) for syncope has been reported. However, there is no literature synthesis on this overuse. We undertook a systematic review to determine the use and yield of head CT and risk factors for serious intracranial conditions among syncope patients. Read More

Am J Emerg Med 2019 Apr 12. Epub 2019 Apr 12.

Department of Emergency Medicine, Baylor Scott and White Health, 2401 S 31(st) Street, Temple, TX 76508, United States of America.

Typically, the left anterior descending artery (LAD) and left circumflex artery (LCX) arise from the left main coronary artery. However, uncommon coronary anomalies may be found in clinical practice. This case presents with a rare finding where the LAD originates from the right coronary artery (RCA) separately from the LCX and takes an interarterial pathway to reach its perfusion territory. Read More

BMJ Case Rep 2019 Apr 20;12(4). Epub 2019 Apr 20.

Internal Medicine, Abington Hospital - Jefferson Health, Abington, PA, USA.

Syncope is a sudden loss and gain of consciousness. Traditionally, it is caused by the abnormalities of neurological, cardiac or vasovagal systems. We present a case of a 19-year-old woman presenting with recurrent syncopal episodes with no apparent cause. Read More

Diabetes Res Clin Pract 2019 Apr 17. Epub 2019 Apr 17.

Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy. Electronic address:

Study hypothesis cardiac autonomic dysfunction might lead to higher vaso vagal syncope (VVS) recurrence rate in type 2 diabetes mellitus (T2DM) patients vs. non diabetics patients.

Background: VVS recurrence might be due to alterations of autonomic system function, as assessed by heart rate variability (HRV). Read More

Pacing Clin Electrophysiol 2019 Apr 20. Epub 2019 Apr 20.

Heart Center, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, P. R.

Background: Syncope is a perplexing challenge that often receives thorough evaluation, yet the diagnosis remains unclear. Usually, the emergency department is the first point at which patients present with syncope. However, diverse medical factors, including low diagnostic rates and inconsistent management by doctors, add to healthcare costs and delay diagnosis for syncope patients. Read More

Pacing Clin Electrophysiol 2019 Apr 20. Epub 2019 Apr 20.

University of Wisconsin School of Medicine and Public Health, Department of Medicine.

Front Neurosci 2019 29;13:301. Epub 2019 Mar 29.

Department of Clinical Sciences, Faculty of Medicine, Clinical Research Center, Lund University, Malmö, Sweden.

Postural Orthostatic Tachycardia Syndrome (POTS) is a cardiovascular autonomic disorder characterized by orthostatic intolerance and high prevalence among young women. The etiology of POTS is uncertain, though autoimmunity and inflammation may play an important role. We aimed to identify novel inflammatory biomarkers associated with POTS. Read More

J Neurosci Rural Pract 2019 Apr-Jun;10(2):207-211

Department of Radiodiagnosis, Indian Naval Hospital Ship Asvini, Mumbai, Maharashtra, India.

Introduction: Emergency head computed tomography (CT) is rising exponentially during off working hours due to evidence-based medicine, patient's expectation and desires, easy availability and apprehension of medico-legal cases, thereby raising health-care cost. There is huge gap in demand and supply of radiologist, especially during off working hours. There is need to know the pattern of emergency head findings. Read More

Indian Heart J 2019 Jan - Feb;71(1):1-6. Epub 2019 Jan 30.

Department of Cardiology, Government Medical College, Kozhikode, India.

Background: Carotid sinus syndrome accounts for one third of patients who presents with unexplained syncope. Prevalence of carotid sinus hypersensitivity (CSH) in Indians has not been studied till now.

Objectives: To assess the prevalence and associations of CSH in symptomatic patients above 50 years and to study its prognostic significance pertaining to sudden cardiac death, syncope, recurrent pre syncope and falls on 1 year follow up. Read More

JACC Clin Electrophysiol 2019 Apr 30;5(4):516-522. Epub 2019 Jan 30.

Cardiovascular Pathology Department, St. George's, University of London, London, United Kingdom. Electronic address:

Objectives: This study sought to describe the clinical and pathological features of anomalous origin of a coronary artery (AOCA) in sudden cardiac death (SCD) victims.

Background: AOCA from the inappropriate sinus of Valsalva or from the pulmonary artery is increasingly diagnosed with current imaging techniques. AOCA is a possible cause of SCD. Read More

PLoS One 2019 18;14(4):e0214733. Epub 2019 Apr 18.

Department of Clinical Pharmacology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan.

The study aims to clarify the mechanism in patients with neurally mediated syncope (NMS), focusing on the adenylate cyclase (AC) activity level in lymphocytes. This study included 40 subjects: 22 healthy volunteers and 18 NMS patients. We investigated the changes in AC activity that occur during of syncope at rest and during the head-up tilt (HUT) test. Read More

Open Heart 2019 25;6(1):e001015. Epub 2019 Mar 25.

Department of Clinical Sciences, Lund University, Malmö, Sweden.

Objective: Pacemaker (PM) therapy is effective when syncope is associated with bradycardia, but syncope recurrences and fall injuries after PM implantation may occur. We aimed to survey indications and outcomes of PM implantation, following evaluation of unexplained syncope.

Methods: Among 1666 consecutive unpaced patients investigated in a tertiary syncope unit by carotid-sinus massage (CSM), head-up tilt test (HUT) and ECG monitoring, 106 (6. Read More

Clin Case Rep 2019 Apr 14;7(4):816-820. Epub 2019 Mar 14.

Centre for Research and Development Uppsala University/Region Gävleborg Gävle Sweden.

Contrast-enhanced echocardiography or cardiac magnetic resonance imaging is of value in the diagnosis of apical hypertrophic cardiomyopathy. Apical hypertrophic cardiomyopathy is rare in Caucasians, and gene negativity does not rule out the diagnosis. Risk stratification for sudden cardiac death and decisions about anticoagulation in cases with atrial fibrillation should be based on guidelines. Read More

Clin Case Rep 2019 Apr 6;7(4):758-761. Epub 2019 Mar 6.

Division of Cardiology, Department of Internal Medicine Iwate Medical University Morioka Japan.

An 18-year-old young female with a convulsive syncope during apheresis donation demonstrated a prolonged sudden sinus arrest continued for approximately 30-second on monitor ECG. This prolonged sinus arrest may relate accidental serious complications in ordinal apheresis donation. Continuous electrocardiogram monitor and correspondence are indispensable. Read More

Clin Case Rep 2019 Apr 19;7(4):686-688. Epub 2019 Feb 19.

Department of Electrophysiology, Heart Center University of Leipzig Leipzig Germany.

This case emphasizes the value of cardiac MRI and genetic testing in the early phase of ARVD/C. It also emphasizes the increased risk of SCD for patients with ARVD/C participating in competitive sports, even with immediate cardiopulmonary resuscitation. Read More

J Cardiol Cases 2019 Apr 21;19(4):115-116. Epub 2018 Dec 21.

Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.

A 67-year-old man without symptoms presented with significant negative T wave on electrocardiography. No significant abnormality was detected by echocardiography. Cardiac magnetic resonance imaging (CMR) showed trivial hypertrophied myocardium in apex. Read More

J Cardiol Cases 2019 Apr 6;19(4):111-114. Epub 2019 Feb 6.

Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a slow-developing cardiomyopathy characterized by ventricular arrhythmias and fibrofatty replacement of the right ventricular (RV) myocardium. Its clinical diagnosis is challenging because of its variable clinical presentation and low genetic penetrance. We describe the case of a 67-year-old man who was diagnosed as having ARVC/D with a desmoplakin mutation that appeared after occlusion of an atrial septal defect (ASD). Read More

Med Princ Pract 2019 Apr 16. Epub 2019 Apr 16.

Objectives: Coronary artery fistulas connecting coronary arteries to cardiac cavities are rare but clinically significant anomalies.

Clinical Presentation And Intervention: A 47-year-old male patient presented with syncope. Left ventricular dysfunction was detected on echocardiography. Read More

J Hosp Med 2019 Apr 8;14:E1-E5. Epub 2019 Apr 8.

Icahn School of Medicine at Mount Sinai, New York, New York.

Background: Hospital medicine continues to grow in workforce, clinical scope, and academic inquiry. This article provides a summary of recent high-impact publications for busy clinicians who provide care to hospitalized adults.

Methods: Authors reviewed articles that were published between March 2017 and March 2018 for the Update in Hospital Medicine presentations at the 2018 Society of Hospital Medicine and Society of General Internal Medicine annual meetings. Read More

Am J Cardiol 2019 Mar 19. Epub 2019 Mar 19.

Division of Cardiology, Massachusetts General Hospital, Cardiovascular Performance Program, Boston, Massachusetts. Electronic address:

Clinical guidelines advocate for customization of exercise testing to address patient-specific diagnostic goals, including reproduction of presenting exertional symptoms. However, the diagnostic yield of adding customized exercise testing to graded exercise in patients presenting with exertional complaints has not been rigorously examined and is the focus of this study. Using prospectively collected data, we analyzed the diagnostic yield of customized additional exercise provocation following inconclusive graded exercise test with measurement of gas exchange. Read More

Transplant Proc 2019 Apr 8;51(3):875-879. Epub 2019 Jan 8.

Department of Lung Transplantation, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China. Electronic address:

Objective: To investigate the risk factors for perioperative mortality in patients with severe idiopathic pulmonary hypertension (IPAH) undergoing lung transplantation (LTx).

Methods: Twenty-two IPAH patients were included in the study and were divided 2 groups: a case group with early death post LTx (n = 5, 22.7%) and the remaining 17 recipients (87. Read More

Int J Cardiol Heart Vasc 2019 Jun 28;23:100349. Epub 2019 Mar 28.

Manchester University NHS Foundation Trust, United Kingdom.

Background: The use of pacemakers in the treatment of cardioinhibitory vasovagal syncope is controversial with a mixed message from the limited evidence base. Single chamber leadless pacemakers have been shown to be an effective alternative option to conventional pacemakers.

Objective: This study examines the use of leadless pacemakers in a cardioinhibitory vasovagal population in the United Kingdom. Read More

J Am Coll Cardiol 2019 Apr;73(14):1756-1765

Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address:

Background: Information on young patients with Brugada syndrome (BrS) and arrhythmic events (AEs) is limited.

Objectives: The purpose of this study was to describe their characteristics and management as well as risk factors for AE recurrence.

Methods: A total of 57 patients (age ≤20 years), all with BrS and AEs, were divided into pediatric (age ≤12 years; n = 26) and adolescents (age 13 to 20 years; n = 31). Read More

Physiol Meas 2019 Apr 10. Epub 2019 Apr 10.

Internal Medicine and Syncope Unit, Humanitas Clinical and Research Center, Rozzano, ITALY.

Background: Indoor microclimate may affect students' wellbeing, cardiac autonomic control and cognitive performance with potential impact on learning capabilities. Aim. To assess the effects of classroom temperature variations on the autonomic profile and student's cognitive capabilities. Read More

Anaesthesist 2019 Apr 10. Epub 2019 Apr 10.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland.

Background: Recent studies demonstrated that in-hospital emergencies are linked to a higher patient mortality. In approximately 10% of patients an unexpected incident occurs during the hospital stay. Therefore, the establishment of in-hospital medical emergency teams (MET) is becoming more important in the interdisciplinary emergency treatment. Read More

Monaldi Arch Chest Dis 2019 Mar 27;89(1). Epub 2019 Mar 27.

San Giovanni Addolorata Community Hospital, Cardiology and Rehabilitation Unit, Department of Medicine, Rome.

We reported a case of a young adult male aged 18 years admitted in our institution for syncope during a basketball match. No previous symptoms were reported. Electrocardiogram (ECG) showed T-wave inversion in the anterior leads and an incomplete right bundle branch block. Read More

Neuropsychopharmacol Rep 2019 Apr 9. Epub 2019 Apr 9.

Mie Prefectural Mental Medical Center, Tsu, Japan.

Aims: The use of new psychoactive substances (NPS) has become increasingly widespread over the last decade, in Japan and internationally. NPS are associated with a range of increasingly serious clinical, public, and social issues. Political measures to ameliorate the effects of NPS in Japan have focused on tightening regulation rather than establishing treatment methods. Read More

Cureus 2019 Jan 29;11(1):e3983. Epub 2019 Jan 29.

Cardiology, Cleveland Clinic - Fairview Hospital, Cleveland, USA.

Complete heart block (CHB) is an unfortunate complication of an anterior and inferior myocardial infarction (MI). We present a case of an atherosclerotic occlusion of the first septal perforator leading to CHB requiring permanent pacemaker placement in a young patient. A 33-year-old healthy white male presented to the emergency department with an episode of syncope. Read More

BMJ Case Rep 2019 Apr 8;12(4). Epub 2019 Apr 8.

Radiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK.

A 29-year-old female patient presented with chest pain, breathlessness and syncope on the background of constitutional symptoms, oral ulceration and a rash. Multiple investigations were performed, including a CT pulmonary angiogram (CTPA) that was initially felt to show imaging features consistent with a diagnosis of chronic thromboembolic disease (CTED). The patient was referred to a tertiary pulmonary hypertension centre and the possibility of pulmonary vasculitis was raised. Read More

J Electrocardiol 2019 Apr 4;54:90-92. Epub 2019 Apr 4.

Cardiology Department, ASST Nord Milano, Ospedale E. Bassini, Cinisello Balsamo, Milan, Italy.

Brugada phenocopies are clinical entities characterized by electrocardiographic patterns that are identical to true Brugada syndrome, but are elicited by a number of clinical circumstances. ECG normalizes upon resolution of underlying condition, family history of arrhythmic syncope or ventricular arrhythmias is strictly absent and provocative tests with sodium channel blockers have to be negative. We describe herein the case of type-2 ECG Brugada pattern in a patient with acute pulmonary embolism presenting with recurrent syncope but negative provocative test with sodium channel blockers. Read More

Heart Vessels 2019 Apr 8. Epub 2019 Apr 8.

Department of Cardiology, IPGME&R and SSKM Hospital, Flat-B1, GB-43, Narayantala (west), DB Nagar, Kolkata, West Bengal, 700059, India.

Several studies have reported the adverse effects of right ventricular apical pacing. Permanent His bundle pacing is proved to be the most physiological. But it can be technically difficult sometimes. Read More