Lupine Publishers Group

Vaishali Verma, Sanjeev Asotra*, Rajesh Sharma, PC Negi, Arvind Kandoria, Neeraj Ganju, Rajeev Marwaha, Shivani Rao, Kunal Mahajan and Ashu Gupta

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Introduction: Prosthetic valve thrombosis (PVT) is a rare but serious complication of valve replacement, most often encountered with mechanical prostheses. The present study aims to evaluate patients with prosthetic valve thrombosis in terms of the clinical characteristics, risk determinants, treatment, and outcomes in the prospective observational study. Material and Methods: The observational study was conducted in a tertiary care center. All patients suspected of having prosthetic valve dysfunction underwent clinical, echocardiography, and fluoroscopic examination. Data regarding risk determinants, clinical characteristics, and response to treatment were categorized under 3 classes, complete response, partial response, and failed treatment (based upon serial echocardiography and fluoroscopy) were recorded. Result: Out of 29 patients 17..... ReadMore

Sanjeev Asotra*, Rahul Nijhawan, Rajesh Sharma, Neeraj Ganju and Shivani Rao

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Ortner’s syndrome or Cardiovocal syndrome is hoarseness due to left recurrent laryngeal nerve palsy caused by mechanical affection of nerve from enlarged cardiovascular structures. A middle-aged female presented to us with a long history of hoarseness of voice and exertional dyspnea. The diagnosis of pulmonary artery aneurysm presenting as Ortner’s syndrome was made..... ReadMore

Mehmet Ali Şahin, Mehmet Yokusoglu, Ertuğrul Özal and Erkan Kuralay*

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Introduction: Risk of conversion to on-pump surgery is one of the concerns about off-pump CABG surgery. Conversion to on-pump surgery carries high morbidity and mortality risk. Our study aimed to investigate the relation between transverse heart and the risk of conversion to on-pump CABG . Materials and Methods: Our study consisted of 3000 patients who underwent isolated off-pump CABG surgery between June 2010 and February 2020. All patients have at least one CABG in the Cx region. We have described vertical and transverse heart according to angle between the left anterior descending artery (LAD) and the left part of the sternal retractor.Results: Our conversion rate was 7.1%. The average intensive care unit (ICU) stay was 1.17±0.10 days in successful off-pump surgery but 3.11±2.11 days in converted surge..... ReadMore

Nabil A. Elshourbagy*, Harold Meyers, Sherin S Abdel-Meguid1, Kavitha Godugu, Taher A Salaheldin, Dhruba J Bharali and Shaker A Mousa

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PCSK9 is a well validated target for the treatment of hypercholesterolemia. Several pharmaceutical companies focused on the development of injectable monoclonal antibodies. Shifa Biomedical has focused on developing orally bioavailable small molecule PCSK9/LDLR antagonists. PCSK9 antagonists were identified through virtual screening at the PCSK9 surface where the LDLR-EGF-A binds. An SAR study of many analogues were done for their ability to antagonize the PCSK9/LDLR interaction in an in vitro ELISA assay, upregulate the LDLR in a cell-based assay, and increase LDL uptake in a fluorescent Dil-LDL assay. The most potent compound meeting these criteria was P-4, formulated by a nanocrystal/targeted delivery approach for the in vivo studies. Nano formulated P-4 was named P-21. P-4 exhibited a concentration-dependent inhibition of the PCSK9/LD..... ReadMore

Sanjeev Asotra*, Kavita Negi, Rajesh Sharma, P.C Negi and K S Sood

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Coronary artery disease is an important global cause of morbidity and mortality and high prevalence is found in the Indian population. Collaterals developed in coronary arteries help in the protection of the myocardium from infarction, preservation of ventricular functions, and thus reducing cardiovascular events. The objective of this study is to assess the prevalence, clinical predictors of coronary collaterals, relationship with severity of coronary artery disease, regional wall motion abnormality, and left ventricular global ejection fraction.Methods: 302 consecutive coronary angiograms of patients of clinical diagnosis of coronary artery disease were analyzed. Focused clinical history, demographic profile, and risk factors were analyzed. Medical history focused on..... ReadMore

Trainini Jorge*, Lowenstein Jorge, Beraudo Mario, Labrada Luis M, Jesus Valle Ingeniero, Trainini Alejandro, Lowenstein-Haber Diego, Bastarrica Maria Elena

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The role of the vortex in cardiac remodeling should be understood as an etiopathogenic factor in the myocardial wall with its consequent dilation and not as a cause of this wall’s alteration. It is not necessary to consider the random molecular behavior in the intraventricular vortex as maximum unpredictability. Randomness becomes uniformity. For example, in a balloon, particles move in all directions but exert the same pressure. This is analogous to the left ventricle: molecules collide against each other as a dense and anarchic crowd. A fluid applies pressure on the surface with which it makes contact, but if the chaotic elements become ordered, we have regularity. A milliliter of blood contains around one hundred trillion particles. It is impossible to combine their equations. Probability in statistics was used to find..... ReadMore

Jean-Baptiste Guichard*, Antoine Da Costa, Nicolas Maillard, Cécile Romeyer, Pierre Croisille and Karl Isaaz

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Background – Catheter ablation of atrial fibrillation (AF) is performed to restore and maintain a sinus rhythm. Remote magnetic navigation system (RMNS) allows an efficient and safe procedure. Left atrial (LA) anatomic barriers of this device are not well known. Aims – This study was aimed to evaluate clinical, echocardiographic and cardiac computed tomography (CCT) anatomic LA characteristics as predictors of stereotaxic AF procedure duration. Methods – From February 2015 to April 2016, 102 symptomatic and drug refractory AF patients were consecutively enrolled in an observational, prospective trial when first AF ablation. AF Radiofrequency (RF) was performed with a RMNS using Niobe ES. Clinical endpoints and LA characteristics were reported, prospectively by a transthoracic and transesophageal echocardiography, and CCT scan. Re..... ReadMore

Nura A Mohamed*, Isra Mareib, Sergio Crovella, and Haissam Abou-Saleh

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For the past few months, the world has been facing another coronavirus disease, COVID-19, caused by the SARS- CoV-2, giving the rise of a pandemic. In the vast majority of infected individuals, SARS-CoV-2 causes a mild ailment, but in some subjects, it progresses to severe disease or even death, with some groups being at high risk. However, SARS-CoV-2 is not the first coronavirus that caused serious, sometimes fatal, disease. Almost 20 years ago, SARS-CoV and later MERS were coronaviruses that led to severe diseases but did not result in pandemics. Some of the therapeutic lessons learned during the SARS-COV and MERS epidemics are being used now to treat COVID-19 patients, such as the still debated use of Chloroquine. However, there were other important preclinical studies performed around the time of SARS-COV and MERS epidemics that may a..... ReadMore

Masoud Mirzaie, Michael Schultz, Peter Schwartz, Zaur Guliyev and Sheila Fatehpur

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Dilated cardiomyopathy (DCM) is a cardiac disease characterized by dilatation and impaired systolic function of the left or both ventricles. The etiology of DCM is multifactorial, and many different clinical conditions can lead to the phenotype of DCM. During recent years, the pathophysiology of DCM has been under intensive investigation, and, thereby, the knowledge of DCM has increased rapidly. However, the pathophysiological mechanisms, by which morphological modifications eventually result in clinical heart failure, are complex and not yet totally resolved. Better knowledge of the morphological background and disease-originating mechanisms would probably help us to focus early treatment on the right subjects and potentially also develop new treatment options in the affected patie..... ReadMore

A Mammeri, Guermaz R, Brouri M and Tebaibia A

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Background: Many studies have documented an increased risk of the development of hypertension (HT) and subsequent cardiovascular diseases (CVD) in persons with prehypertension (PHT). The aim of this study was to assess the prevalence of PHT in Algiers, and to explore the association between PHT and established cardiovascular risk factors (CVRF). To our knowledge, this is the first report on this subject in our country.Method: A cross-sectional study was conducted in primary care consultation on a sample of 1086, 18-79 years old, unknown hypertensive. They benefited from screening for PHT (defined by JNCVII as a systolic pressure between 120-139mmhg and a diastolic pressure between 80-89 mmhg) and HT (a systolic pressure ≥140 mmhg and / or a diastolic ≥90 mmhg). After completion of a detailed demographic and medica..... ReadMore

Mirzaie Masoud*, Michael Schultz, Peter Schwartz, Zaur Guliyev and Sheila Fatehpur

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Objective: Thoracic aneurysms occur most frequently with 60% in ascending aorta and arch, und with 40% the descending aorta, although the etiological factors are different for individual segments. While, depending on localization, factors such as atherosclerosis, bicuspid aortic valve, familial thoracic aortic aneurysm syndrome, Turner syndrome, Marfan syndrome, aortic arteritis in Takayasu’s arteritis, trauma and dissection lead to the formation of thoracic aortic aneurysms, the structural changes of the basement membrane and the exact causes of the mechanism of thoracic aortic aneurysm are not known. The aim of this study was to investigate the pathophysiological origin of thoracic aortic aneurysms from a morphological point of view.Patients and methods: For this study, between 2007 and..... ReadMore

Nicholas J Leeper, Windsor Ting, Akshay Kharat, Brian Murphy, Jeffrey S Berger, Alex Simpson and Ariel Berger*

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Background: Low-dose aspirin (ASA) is often used for secondary prevention of major adverse cardiovascular events (MACE) and/or major adverse limb events (MALE) in chronic coronary artery disease (CAD) or peripheral artery disease (PAD). The COMPASS trial demonstrated adding rivaroxaban to low-dose ASA significantly decreased relative risk of these events. However, its absolute impact depends on real-world effectiveness of ASA monotherapy, as clinical trials differ from clinical practice.Objectives: To examine real-world rates of MACE and MALE among patients receiving ASA as secondary prevention.Methods: We used a large US claims database linked to electronic medical records to identify patients with chronic CAD/PAD who were using ASA for secondary prevention. We then assessed occurrence of MACE and MALE from date chronic..... ReadMore

Pierre A Guertin*

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The benefits of exercising are well-recognized–experts and governmental health agencies agree that regular endurance training generally reduces the risks of metabolic and cardiovascular diseases. In turn, the consequences of a sedentary lifestyle and physical inactivity caused by disease or trauma are also well-documented- e.g., walking or being moderately active physically less than 30 minutes per day generally increases the risks of developing obesity, infections, osteoporosis, metabolic disorders, cardiovascular problems, and dyslipidemia in able-bodied persons. However, the threshold levels of exercising for meaningful health benefits in people suffering from paralysis or the upper limits of endurance training beyond which, injuries, sequelae, and long-term secondary problems that may be induced in able-bodied and people with ..... ReadMore

Lázara Eloisa Rodríguez García* and Juan Guiteras Gene

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Myocardial infarction is the most common presentation of ischemic heart disease. WHO estimated that in 2002 12.6% of deaths worldwide were due to ischemic heart disease, which is the leading cause of death in developed countries and the third leading cause of death in developing countries, post-AIDS and low respiratory infections. In developed countries such as the United States, deaths from heart disease are more numerous than cancer mortality. Coronary pathies cause one in five deaths in the United States and where more than one million people suffer a coronary attack each year, 40% of which will die as a result of a heart attack. So an American will die every minute of a coronary pathological event. They also occur in the patient who does not care for a gastritis tha..... ReadMore

Vivek Kamath*

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Common signs of corona virus infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. People who are suffering from prevailing chronic diseases such as cancer, heart disease, high blood pressure, diabetes, chronic kidney disease, etc. may die due to their weaker immunity system. Most of the people around the world died due to panic attack and due to extreme fear. A fear of not having vaccination for the virus infections has also taken a big death toll. Therefore, it is very important to build a stronger robust immune system and patients need to think positive and follow the positive approach to combat the disease..... ReadMore

Ferrer Marrero Daisy* and Ochoa Montes Luis Alberto

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Frequently there are people who, directly or indirectly, have suffered the loss of a loved one in circumstances that make it more surreal and painful; There are instances of individuals who, being well, on the street, will abruptly fall to the ground and cannot receive medical assistance; or that being young, healthy and strong, like some athletes, die without previous signs, leaving behind an impact of recognized importance on their friends and family. This phenomenon or process, known as sudden death (SD), as it occurs, is characterized by being a natural type of death, as it is..... ReadMore

Vu Tuan Nguyen*

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Pulmonary valvular endocarditis is rare disease, the majority of reported cases previously showed isolated PV endocarditis without clear underlying predisposition factors. We report here a 52 ages female patient with endocarditis of pulmonary valve associated with sub valvular pulmonary aneurism, the underlying pulmonary valvular stenosis and RVOT stenosis were confirmed. The 2DTTE, 3D TEE and MDCT-640 were used to make exactly the diagnosis. Patient was under went an un complicated surgical procedure...... ReadMore

Vu Tuan Nguyen*

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Objectives: Background: Real-time three dimensional transesophageal echocardiography or RT-3DTEE, with advances in image processing and display, has increased the availability and utility of TEE to a variety of clinical settings as diagnosis and catheter intervention.Patients & Methods: We study all Patients with RT-3DTEE, presented in MEDIC HCMC from October 2010 to May 2020.Results: From October 2010 to May 2020, in MEDIC HCM, we have already performed 1276 cases ofReal-time 3DTEE: Mitral Stenosis (31%), Atrial Septal Defects (16%) and other diseases of the heart.The display of three dimensional images of 3DTEE providing important information’s to assess the anatomical structures and the severity of diseases prior to perform interventional procedure.Conclusion: Real-time 3DTEE overcomes the limi..... ReadMore

José Sampayo*

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Objectives: To know the frequency of Metabolic Syndrome in patients with Psoriasis who come to the consultation of the Dermatology Service of the Autonomous University Hospital of the Andes November 2017 to May 2018. Materials and Methods: Observational analytical descriptive study. Patients with Psoriasis diagnoses who attended the dermatology office were selected, PASI, ATP-III, Framingham and GLOBORISK were applied. Results: 55 patients, 55% men and 45% women, there was statistical correlation between older age groups and PASI index (p=0.023). The main modifiable cardiovascular risk factors were smoking, sedentary lifestyle and obesity, statistical correlation was found for sedentary lifestyle (p=0.047). The main non-modifiable cardiovascular risk factors were Hypertension and Diabetes showing both statistical significance (p=0.004),..... ReadMore

Seriki SA*

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Backgrounds: Desmodium adscendens is one of the medicinal herbs used in the management of some medical conditions in recent times. The current study investigates the effects of aqueous leave extract of Desmodium adscendens on the serum levels of Sodium, Chloride, Potassium, and Bicarbonate ions, and by inference on the cardiovascular function in healthy wistar rats. Method: Twenty-four (24) wistar rats grouped into four (n=6) were used for the research. Group 1 served as control, while Groups 2, 3, and 4 were treated orally with low, median and high doses of the extract of D adscendens for four weeks, after which blood was collected separately from each group and the serum level of the electrolyte determined by appropriate methods and comparison made with the control group and among the groups. Results: There was significant decrease (P..... ReadMore

Yasser A El Sayed*

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We report an eight year female patient admitted to the department of pediatrics at Abbasia Pulmonary Hospital at Cairo, Egypt. The child was complaining of pain on the right lower chest and upper abdomen. On evaluation by CT of the chest, there was a huge posterior mediastinal mass occupying more than three quarters of the right hemithorax. Preoperative histopathology using CT guided needle biopsy revealed ganglioneuroma. The tumor was resected completely via right standard postero-lateral thoracotomy without complications. Postoperative histopathology confirmed the diagnosis of ganglioneuroma...... ReadMore

Fatou Aw Leye *, Bodian M, Akanni S, Bathily C Sarr SA, Mingou JS, Affangla A, Diouf MT, Ndiaye M Diop CMBM, Ndiaye PN, Balde DW, Ngaïdé AA, Dioum M, Leye M, Ndiaye MB, Mbaye A, Kane Ad, Kane A, Diao M and Serigne Abdou BA

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Sudeb Mukherjee* and Saumyajit Ghosh

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Summary Peripheral Arterial Disease (PAD) is narrowing of peripheral arteries. It affects a large number of populations worldwide. Narrowing of the peripheral arteries are due to atherosclerosis of these arteries. Underlying reasons includes smoking, hypertension, dyslipidemia and many others. This review discusses all the risk factors for causation of PAD in short with review of relevant literature. Background PAD is a narrowing of the arteries other than those that supply the heart or the brain [1]. When narrowing occurs in the heart it is called coronary artery disease while in the brain it is called cerebrovascular disease. Peripheral artery disease most commonly affects the legs, but other arteries may also be involved [2]. The classic symptom is leg pain when walking which resolves with rest, known as intermittent claudicatio..... ReadMore

Haydar Yasa*

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Background: Despite the association of hyperuricemia with cardiovascular risk factors, it has remained controversial as to whether uric acid is an independent predictor of cardiovascular disease, with many studies in favor and others against. The results of this study are expected to enhance our knowledge regarding the role of uric acid level on outcomes of patients with carotid artery endarterectomy and thus can be used by clinician in determining patient’s prognosis. Methods: Patients evaluation were performed by collecting prospective data on patients undergoing CEA at our hospital from September 2012 to May 2019, primary CEA was performed on 120 consecutive patients in the same surgical groups. From this sample, patients who underwent isolated CEA were selected, and this population was then divided into those with hyperurisemia (..... ReadMore

Vickram Singh* and Dip Mukhopadhyay

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Fast Brain MRI Protocol: Use of limited-sequence Brain MRI to confirm the diagnosis of stroke and identify ‘Stroke Mimics’ after negative initial neuroimaging following stroke thrombolysis..... ReadMore

Massimo Maiani, Sandro Sponga, Anita Brondani, Vincenzo Tursi, Angelo Morelli, Andrea Lechiancole*, Daniela Piani, Mauro Driussi, Helena Ortis and Ugolino Livi

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In the last years, left ventricular assist device (LVAD) indications have significantly broadened including candidates with multiple comorbidities even requiring combined surgical strategy. We present a case of a 56-year old patient affected by postischemic dilated cardiomyopathy in whom a lung nodule diagnosed during preoperative CT-scan could have contraindicated LVAD destination therapy. The patient underwent through a median sternotomy concomitant LVAD implantation on cardiopulmonary bypass followed by an atypical resection of the anterior part of the right lower lobe lung. A multidisciplinary, step-by-step approach to reduce the risk of right ventricular failure, bleeding and infections is presented..... ReadMore

Maryam Panahiazar*, Roohallah Alizadehsani, Andrew M Bishara, Yorick Chern, Dexter Hadley and Ramin E Baygui

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Cardiovascular disease (CVD) encompasses a broad range of conditions. Coronary Artery Disease (CAD), commonly referred to as Ischemic Heart Disease (IHD), is the leading cause of death, morbidity, and mortality in the United State and women continue to have poorer outcomes than men. The causes of these discrepancies have yet to be fully elucidated. In this review, we reported gender-based studies of diagnosis, treatment, and outcome of CVD in the last 20 years...... ReadMore

Seiichiro Takeshita*, Takashi Kanai, Yoichi Kawamura and Shigeaki Nonoyama

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It is important to predict Kawasaki Disease (KD) patients who will be resistant to Intravenous Immunoglobulin (IVIG) before starting the initial treatment, as these patients may have severe inflammation and vasculitis, which will likely lead to the development of Coronary Artery Lesions (CALs). An intensive initial treatment combined with IVIG and additional anti-inflammatory drugs is reported to reduce the occurrence of IVIG resistance and CALs. Although risk scoring systems using usual laboratory data to predict IVIG-resistant patients have mainly been developed in Japan, these systems did not accurately predict non-responders to IVIG among patients in the other countries. In this review, we provide a comprehensive overview of the main risk scoring systems and evaluate the relevant literature..... ReadMore

Awad Magbri*, Mariam El Magbri, Suhail Aftab, Karen Miller, Amanda Sinks, Stephen Ehret, Leisa Niki Canales and Aimee Blankenship RN

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Abstract The authors discuss a case of a rare complications of vascular access creation in a hemodialysis patient “ischemic monomelic neuropathy”. This is an ischemic axonal injury to the nerves supplying the left hand after arterio-venous graft placement for hemodialysis. The authors also discuss the diagnosis, pathophysiology and treatment of this rare vascular access complications that sometimes occurs in hemodialysis patients immediately following arterio-venous fistula or graft (AVF or AVG) placement..... ReadMore

Taha Ahmed, Hafeez ul Hassan Virk and E Dean Nukta*

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EchocardiogramMildly decreased left ventricular systolic function with ejection fraction of 45% with no significant valvular or pericardial abnormalities.Diagnostic Left heart catheterizationa. 90% stenosis of proximal left anterior descending (LAD) arteryb. 80% stenosis of mid left circumflex (LCx) arteryc. chronic total occlusion of right coronary artery (RCA)d. SYNTAX score of 19 (Figure 2)..... ReadMore

Fanyan Luo*, Lizhi Lv, Weijie Ye and Rong Liu

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Background: Accumulated evidence suggests that dysregulated expression of long non-coding RNAs (lnc RNAs) may participate in the development of cardiovascular diseases. In this study, we aim at identifying circulating lnc RNAs associated with acute myocardial infarction (AMI).Materials and methods: By repurposing microarray probes from two public datasets (GSE48080, GSE66360) from gene expression omnibus database, an array-based transcriptional analysis of lnc RNAs in AMI patients and controls were conducted by us. Data analyses with R and Bioconductor.Results: Six lnc RNAs (MIR22HG, RP11-296O14.3, IDI2-AS1, RP11-539L10.2, MIR3945HG, RP11-96D1.11) were identified to be expression differently in AMI (Bonferroni p value <0.01), and a distinguish score was constructed based on the expression data of two lnc ..... ReadMore

Adam Ahamat Ali*, Kevin Kodingar and Lemone Houchine

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Introduction: Cardiac decompensation factors are numerous. Their identification allows better management of patients and limits the rate of rehospitalization. The aim of this work was to identify cardiac decompensation factors and improve their management at the renaissance hospital in N’Djamena, Chad.Patients and Methods: This was a cross-sectional retrospective study conducted in the cardiology department at N’Djamena Renaissance Hospital, over a period of one year, from 01 January 2018 to 01 January 2019. All patients hospitalized for cardiac decompensation during this period and consented, were included.Results: During the period of our study, 52 patients were included. The sex ratio was 1.9. The mean age was 48±9 years old. The predominant cardiovascular risk factors were arterial hyperte..... ReadMore

Ismail Fahmi, Elly Nurachmah*, Sri Yona and Tuti Herawati

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Physical activity is a secondary prevention that can reduce mortality and re-admission in patients with myocardial infarction. The objective of this study was to identify the relationship with physical activity of myocardial infarction patients after treatment. This study used a cross sectional method. A total of 150 myocardial infarction patients were selected using a purposive sampling technique. The results showed that the majority of STEMI post-treatment patients have mild physical activity (82%). There is also a significant relationship between depression and the level of physical activity of myocardial infarction patients after treatment (p = 0.003), OR = 0.144 (95% CI; 0.032-0.635). Depression in myocardial infarction patients at the time of the attack, if not intervened properly, it will persist and affect physical activity..... ReadMore

Vu Tuan Nguyen*

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Background: Coronary anomalies are the causes of sudden cardiac deaths in young peoples, but usually asymptomatic. We perform this retrospective study to determine the types and prevalence of Coronary Anomalies of origin and course.Method: The data of 9572 patients with Coronary CT-angiography by MDCT 640 Aquilion Toshiba machine were analyzed.Results: Anomalous origin and course of coronary artery were detected in 47 (0.49%) of 9572 patients. The anomalous origins of Circumflex Artery from the RCA or the right sinus of Valsalva are most frequently visualized ( 15 pts [31.9%] ). High taking off of RCA observed in 11 pts ( 23.4% ).The RCA rising from the left sinus of Valsalva were seen in 8 pts ( 17% ).The Left Coronary Artery originates from the right sinus of Valsalva in 5 pts ( 10,6% ).The RCA arising from the LAD in ..... ReadMore

Duong Phi Son* and Nguyen Tuan Vu

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Background: Congenital heart diseases associated with more malformations, complex aortopulmonary collaterals and anomalous coronary artery.Echocardiography is the initial diagnostic method but this method can be limited in complex congenital heart diseases.Purpose: To assess the role of MDCT in congenital heart diseases (CHD) diagnosis compare with operative result and interventional angiography.Methods: 910 patients with congenital heart diseases of 31.000 patients underwent cardiac angiography with 64 and 320 section CT at Medic Medical Center since 09/09/2006 to 30/12/2015.Results: There are 658 operated cases, most of operated cases demonstrated the exact diagnosis of MDCT in congenital heart diseases.Conclusions: MDCT is the fast and non-invasive diagnostic method with ..... ReadMore

Vu Tuan Nguyen*

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A young female patient of 15y.o presented at my hospital by dyspnea on effort and palpitation for one year. Mental deficiency was notified. Physical examination detected a 3/6 continuous murmur at the 2ndRICS. In the past history, PDA had been suspected by her physician, associated with recurrent bronchitis. Trans-thoracic Echocardiography showed an enlarged LV of 57mm with normal EF of 69% , LCA=5mm, RCA=3.5mm at origin, no suspected sign of PDA was seen. Only a continuous flow was visualized in the PA. CT-Angiography with IV contrast medium showed the Left Common Carotid Artery rising from the Pulmonary Artery trunk. PDA was not presented. The Left Common Carotid Artery then was re-implanted into the aortic arch normally with a favorable post-operative progress...... ReadMore

Birol Karabulut, Ayse Simsek and Baran Cengiz Arcagok

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Introduction: A great number of the studies have shown that platelets play a role in closure of the PDA. However, studies that reported that platelet parameters were not associated with PDA were also published. We also wanted to contribute to clarify the relationship between PDA and platelet parameters.Materials and Methods: Preterm infants that less than 34 gestational weeks were examined to echocardiography at the time of detected clinical findings or within 24-72 h after admission to our unit, routinely. The patients were divided into two groups according to echocardiography findings randomly; hsPDA require ductal closure treatment and non-hsPDA. The platelet count, MPV, PDW, PCT and Platelet Mass Index values of both groups were compared...... ReadMore

N Craig, S Krishnamoorthy*, M Halim and A Venkataraman

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TakotSubo Cardio Myopathy (TSCM) is a reversible form of cardiomyopathy characterized by transient left ventricular (LV) systolic dysfunction. Clinically often mimics acute myocardial infarction (AMI) with chest pain or breathlessness with electrocardiographic, cardiac marker(s) and LV wall motion abnormalities. In a third of patients, significant emotional or physical stress precedes the presentation. Often, these patients have normal epicardial coronaries or non-flow obstructive coronary disease. In most patients, LV function shows complete recovery within weeks with favorable outcomes. We report a unique case of TSCM following sudden emotional stress with typical transient apical ballooning; nevertheless, with severe co-existent triple vessel coronary artery disease and complete recovery of cardiac function on medical management..... ReadMore

Ahmed N Ghanem*

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rofessor Peter Bacchetti’s excellent article [1], highlighting “the other problem of peer review of finding flaws that are not really there based on unfounded statistical criticism, and its de- moralizing effect on authors”. I wish to add some thoughts to the debated issues. Professor David Horrobin’s original classics on the subject [2,3]. have not yet been surpassed. It was updated recently [4] and prompted some contributory thoughts [5]. Having enough experience as author of reject articles and some as peer reviewer, I find the most devastating effect to author’s morale is making no comment, giving no reason for rejection or not replying all...... ReadMore

Daniela Di Lisi*, Francesca Macaione, Giuseppina Novo and Calogero Comparato

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Hypertrophic cardiomyopathy (HCM) is the most common cardiac disease affecting the cardiac muscle. It can manifest in different forms with or without left ventricular outflow obstruction, with or without right ventricle involvement. Forms with biventricular hypertrophy seem to have poor prognosis. In our case, we describe a young patient with sarcomeric biventricular hypertrophic cardiomyopathy (MYH7 mutation), the poor prognosis of this form and strategies options adopted after failure of medical treatment. It is not always easy the management of hypertrophic cardiomiopathy, after medical treatment failure, especially in children. In some cases, heart transplantation is the only one therapeutic option..... ReadMore

Francesco Bianco*, Piergiusto Vitulli, Valentina Bucciarelli, Alvin Chandra, Masatoshi Minamisawa and Sabina Gallina

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Left ventricular non-compaction (LVNC) is a myocardial disorder, classically defined as a double-layered myocardium, consisting of a thick, spongy/hypertrabeculated, non-compacted endocardial segment and a thin, compacted, epicardial portion. The American Heart Association (AHA) classifies LVNC as a distinct primary genetic cardiomyopathy, while the European Association of Cardiology (ESC) as an unclassified cardiomyopathy. Despite the magnitude of the entire literature yield on this topic, to date the pathogenesis, prognosis, and treatment are still unclear. Prevalence and mortality can range respectively from 0.05% to 0.26% and 5% to 47%, but they are affected by the imaging criteria adopted for the diagnosis. In fact, LVNC has been for years incidentally discovered during autopsy of unexplained sudden cardiac deaths. Conv..... ReadMore

Morani G*, Bolzan B, Zimelli E, Tomasi L and Ribichini FL

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Upgrading procedure is relatively common since indications to cardiac resynchronization therapy (CRT) and implantable defibrillator are increasing. A relatively frequent phenomenon that the operator may encounter is some degree of venous obstruction around the previously implanted leads, which may become completely occlusive. In these situations, upgrading procedure may be challenging and various manoeuvers have been described. We describe a case of intraprocedural percutaneous transluminal angioplasty (PTA) of occlusive stenosis of the innominate vein, performed during an upgrading procedure from bicameral cardiac implantable defibrillator (ICD) to CRT-D...... ReadMore

Trainini Jorge C*, Trainini Alejandro, Valle Cabezas Jesus and Cabo Javier

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ntroduction and Objective: Recent research has determined that the “cardiac suction” phase occurs between systole and diastole. The aim of this work was to analyze the suction capacity of the left ventricle after excluding the right ventricle through an atriopulmonary bridge.Methods: An atriopulmonary bridge was performed on six dogs, followed by right coronary artery occlusion to generate right ventricular dysfunction. Cardiac output (CO), cardiac index (CI), systolic index (SI), left ventricular stroke work index (LVSWI), right ventricular stroke work index (RVSWI), systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR) were evaluated using a Swan Ganz catheter. Recordings were acquired at baseline before any procedure, 60 minutes after right coronary occlusion wit..... ReadMore

Nwafor IA*, Nwafor MN, Gbenimachor MN, Onodugo CI, Anakwe RC and Nwagha TU

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Background: In our center, NCTCE, there are 2 intensive care units (general and cardiac), where critically ill patients are admitted and managed. Anticoagulation is usually indicated in such patients for atrial fibrillation, valve replacement and DVT prophylaxis.Objective: To determine the role of a clinical pharmacist in the therapeutic and clinical appraisal of such patients on anticoagulation.Materials and Method: Over a 2-year period (June 2015 –May 2017), a study design to determine the role of a clinical pharmacist in anticoagulant treatment was made in both ICU. This was a prospective longitudinal study. Here, demography, the anticoagulation on which interventions were made on, duration of admission, areas and determinants of a clinical p..... ReadMore

Babar B Chaudhri*

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In this review, we hope to give a perspective of the new realities of cardiac mechanical circulatory assist devices. New iterations of devices are providing greater durability and freedom of complications. Work is near to provide internal batteries and transcutaneous energy transfer systems for completely implantable systems, avoiding the need for an externalized drive line...... ReadMore

Ranjan Modi*

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Embolization is a known complication of LAA closure. It may be caused by insufficient anchoring of the device to the appendage or to the delivery system. We present a case of embolization of amplatz cardiac plug...... ReadMore

Robert Skopec*

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Psychopathy of the careerist is a developmental disorder marked by emotional deficits and an increased risk for antisocial behavior. It is not equivalent to the diagnosis Antisocial Personality Disorder, which concentrates only on the increased risk for antisocial behavior and not a specific cause-ie, the reduced empathy and guilt that constitutes the emotional deficit. Our review considers data regarding the neurobiology of this disorder. Dysfunction within the amygdala�s role in reinforcement learning and the role of ventromedial frontal cortex in the representation of reinforcement value is stressed. Data is also presented indicating potential difficulties within parts of temporal and posterior cingulate cortex. Suggestions are made with respect to why these deficits lead to the development of the disorder. Knowled..... ReadMore

Ahmed N Ghanem*

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The answer to the heading question is an affirmative yes! Not only persistence to elevate the central venous pressure (CVP) but also pulmonary capillary wedge pressure (PCWP) is among the fundamental commonly practiced but most misleading reasons for overzealous fluid infusion in managing haemodynamic shock of poly-trauma victims and inducing volumetric overload shock (VOS)...... ReadMore

Farsky Stefan* and Sidlo Robert

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The aim of the study was to find out whether early blood pressure (TK) values in patients with fixed and medically treated hypertension correlated with sleep quality during the previous night, and that treatment with rilmenidine affects not only TK but also improves sleep quality by reducing sympathetic activity. In a previous study, 1216 patients with hypertension and metabolic syndrome found that up to 59% of them reported improvement in sleep during treatment with rilmenidine. We investigated 993 patients with essential hypertension who failed to reach TK target values despite 79% and 79% had abdominal obesity. Treatment with rilmenidine was added to the existing treatment. The study lasted for 3 months. At the beginning and end of the study, anthropometric and basic biochemical examinations, repeated heart rate a..... ReadMore

G Morani, E Zimelli*

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Leadless pacemakers: a brand new technology with a low rate of lead and pocket complications compared to traditional transvenous pacing. What it is known until now, current issues and future perspectives...... ReadMore