Prevalence and Clinical Correlates of Spontaneous Echo Contrast in Patients on Oral Anticoagulation Undergoing Catheter Ablation for Atrial Fibrillation
Christian Grebmer, Carsten Lennerz, Amir Brkic, Patrick Blazek, Severin Weigand, Verena Semmler, Marc Kottmaier, Felix Bourier, Lena Friedrich, Elena Risse, Stephanie Brooks, Marie Kornmayer, Marta Telishevska, Tilko Reents, Christof Kolb, Gabriele Hessling and Isabel Deisenhofer
Article Type: Research Article | First Published: June 19, 2019
Spontaneous echo contrast (SEC) in the left atrial appendage (LAA) is associated with an increased risk of cerebral embolism in patients with atrial fibrillation (AF). Novel oral anticoagulants (NOACs) are increasingly prescribed as first-line therapy and have shown a comparable benefit-risk ratio compared to vitamin K antagonists (VKAs). The aim of this study was to investigate whether NOACs decrease the incidence of SEC compared to VKA. ...
Unroofed Coronary Sinus Syndrome Presenting with Early Pulmonary Hypertension
Maria E Franco-Fuenmayor, MD, Numra A Aleem, MD, Jorge D Salazar, MD, and Ashraf M Aly, MD
Article Type: Case Report | First Published: June 13, 2019
Isolated partial or complete absence of the coronary sinus roof hemodynamically behaves like an atrial septal defect and rarely causes pulmonary hypertension. We report a case of unroofed coronary sinus (URCS) presenting with post-operative cyanosis due to pulmonary hypertensive crisis following surgical repair of a ventricular septal defect at 6 months of age. He had progressively decreased stamina with gradual increase in pulmonary pressure requiring surgical closure of the URCS by 6 years of ...
Impact of Low-Dose Intracoronary Alteplase Infusion after Successful Primary Percutaneous Coronary Intervention
Ismail Mohamed Ibrahim, Ahmed S Eldamanhory, Mahmoud Abdelaziz and Abdelrashid Abdelaziz
Article Type: Research Article | First Published: June 05, 2019
In ST elevation myocardial infarction (STEMI), intracoronary thrombolysis after primary percutaneous coronary intervention (PPCI) was found to improve microvascular perfusion, yet without improvement in left ventricular (LV) remodeling. Our study aimed to find out possible effect on LV longitudinal function. 102 anterior STEMI patients eligible for PPCI were divided into: Alteplase group (53 patients; received intracoronary 0.3 mg/kg alteplase after PPCI) and control group (49 patients; treated ...
Left Ventricular Pacing in Patients with Mechanical Tricuspid Valve Replacement
Sara Khodor, Shreya Mishra, Dany Sayad and Anant Kharod
Article Type: Case Report | First Published: June 01, 2019
In patients with mechanical tricuspid valve replacement (TVR), management of atrioventricular conduction abnormalities can be challenging given inaccessibility of the right ventricle (RV) with an endocardial pacing lead. While implantation of an epicardial lead may serve as an alternative; it requires invasive surgical placement and is not an ideal option in patients with prior thoracotomy. The development of specialized leads have made lead implantation via coronary sinus (CS) an attractive alt...
Relationship between Hypovitaminosis D and Cardiac Abnormalities in Pre Dialysis Chronic Kidney Disease
Maria Carolina Neves, Luis Sette, Monica Becker, Lucila Valente and Brivaldo Markman Filho
Article Type: Research Article | First Published: June 01, 2019
The presence of structural and functional changes in the left ventricle (LV) are good predictors of cardiovascular events in patients with chronic kidney disease (CKD) and are associated with decreasing renal function. Studies in CKD patients on hemodialysis evidenced associations of serum 25-OH vitamin D (vit D) with myocardial function and structural changes. However, it is not known whether serum vit D is associated with Doppler echocardiogram (ECHO)-based cardiac changes in patients with CKD...
Hyperlipidemia Management in Proprotein Convertase Subtilisin- Kexin Type 9 (PCSK 9) Inhibitors Era
Abdulhalim Jamal Kinsara
Article Type: Original Article | First Published: June 01, 2019
Significant improvement in control of cardiovascular risk factors has been driven by performance measurement that focused on attainment of specific risk factor thresholds for blood glucose, lipids and blood pressure. Diet, statin and ezetimibe have reasonably controlled hyperlipidemia. However the discovery of proprotein convertase subtilisin-kexin type 9 inhibitors has given new hope of reaching the target lipid profile especially in the high-risk group and familial hypercholesterolemia. Here w...
Molecular Basis of Pulmonary Hypertension
Ambrin Farizah Babu
Article Type: Review Article | First Published: May 31, 2019
Pulmonary hypertension is a life threatening incurable disorder. The advances in physiology, genetics, and molecular biology have greatly improved our understanding of the cellular and molecular mechanisms underlying the disorder. In this review, the recent progresses in the understanding of molecular mechanism are presented. Many studies show that pulmonary hypertension is caused due to mitochondrial dysfunction, endothelin-1, prostacyclin and serotonin. These findings and their exploitation wi...
Current Endocarditis Prophylaxis Guidelines and Incidence of Infection
Article Type: Review Article | First Published: May 30, 2019
Infective endocarditis (IE) defined as an infection caused by bacteria that enter the bloodstream and settle in the endocardium, a heart valve or a blood vessel, has maintained a high prevalence, morbidity and mortality over the past few decades. The most obvious changes over time have been in terms of factors that lead to IE. For e.g. A larger elderly population, decrease in Rheumatic heart disease (RHD) cases, Increased use of prosthetic heart valves, increased intravenous drug abuse, and incr...