scholarly journals Markers of myocardial damage after radiofrequency ablation of tachyarrhythmia

2020 ◽  
Vol 24 (1) ◽  
pp. 9
Author(s):  
O. L. Zayfrid ◽  
K. A. Chueva ◽  
E. S. Vasichkina ◽  
A. V. Mikhailov ◽  
D. S. Lebedev ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Conflict Of Interest ◽  
Creatine Phosphokinase ◽  
Troponin I ◽  
Myocardial Damage ◽  
The Past ◽  
Damage Indicator ◽  
Expression Site ◽  
Critical Revision ◽  
Indicator Data

<p>This study presents literature data over the past few years on markers of acute myocardial damage after radiofrequency ablation. Information on markers such as troponin I and T, creatine phosphokinase and its fractions, CRP and interleukins and myoglobin is presented in detail. For each potential myocardial damage indicator, data related to their expression site, chemical basis of each marker and correlation between the degree of damage caused by radiofrequency exposure and the levels of various biomarkers of myocardial damage are provided.</p><p>Received 12 November 2019. Revised 26 February 2020. Accepted 27 February 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest</strong>: Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: O.L. Zajfrid, R.B. Tatarsky, E.S. Vasichkina<br />Drafting the article: O.L. Zajfrid, K.A. Chueva, A.V. Mikhailov <br />Critical revision of the article: O.L. Zajfrid, R.B. Tatarsky, E.S. Vasichkina, I.L. Nikitina, D.S. Lebedev<br />Final approval of the version to be published: O.L. Zajfrid, K.A. Chueva, E.S. Vasichkina, A.V. Mikhailov, D.S. Lebedev, I.L. Nikitina, R.B. Tatarsky</p>

scholarly journals Current algorithms for the treatment of chronic coronary total occlusions

2020 ◽  
Vol 24 (2) ◽  
pp. 9
Author(s):  
O. V. Krestyaninov ◽  
D. A. Khelimskii ◽  
A. G. Badoian ◽  
R. U. Ibragimov ◽  
R. A. Naydenov
Keyword(s):  
Clinical Practice ◽  
Success Rate ◽  
Conflict Of Interest ◽  
Interventional Cardiology ◽  
Final Approval ◽  
Technical Success ◽  
The Past ◽  
Complex Group ◽  
Critical Revision

<p>Chronic coronary total occlusions (CTOs) represent the most complex group of lesions in interventional cardiology, and technical success in their treatment depends on not only the characteristics of the lesions themselves but also the experience of the operator.<br />Over the past few years, many CTO recanalisation techniques have been proposed, leading to the need for standardisation to achieve a higher success rate. As a result, a number of algorithms that allow the surgeon to choose one or another recanalisation technique depending on the angiographic features of the vessel have been proposed.<br />This article provides an overview of the main algorithms for choosing a CTO recanalisation strategy and considers the clinical and angiographic characteristics that form the basis of the algorithms. The possibility of their use in clinical practice has also been evaluated.</p><p>Received 7 April 2020. Revised 27 April 2020. Accepted 27 April 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and design: O.V. Krestyaninov, D.A. Khelimskii<br />Drafting the article: O.V. Krestyaninov, D.A. Khelimskii, A.G. Badoian, R.A. Naydenov, R.U. Ibragimov<br />Critical revision of the article: R.A. Naydenov, R.U. Ibragimov<br />Final approval of the version to be published: O.V. Krestyaninov, D.A. Khelimskii, A.G. Badoian, R.A. Naydenov, R.U. Ibragimov</p>

Estimation of the Safety of Intraoperative Fluid Therapy during Great Abdominal Surgery in Patients with Coronary Heart Disease

2020 ◽  
Vol 5 (5) ◽  
pp. 158-163
Author(s):  
V. I. Lysenko ◽  
◽  
E. A. Karpenko ◽  
Ya. V. Morozova
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Fluid Therapy ◽  
Troponin I ◽  
Significant Proportion ◽  
Myocardial Damage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cardiac Complications ◽  
Fluid Regimen

The study of intraoperative fluid therapy tactics has been of great interest over the past few years, especially in people with concomitant coronary heart disease, as they make up a significant proportion of all surgical patients. The purpose of our study was to assess the risk of intraoperative myocardial damage in patients with concomitant coronary heart disease depending on the fluid regimen used based on monitoring of hemodynamic parameters, electrocardiogram and biomarkers of myocardial damage. Material and methods. The study involved 89 patients, who were divided into two groups depending on the tactics of intraoperative fluid therapy – restrictive and liberal. In order to detect cardiac complications at different stages, we assessed biomarkers of myocardial damage Troponin I, NT-proBNP by solid-phase enzyme-linked immunosorbent assay (ELISA). Results and discussion. Analysis of the obtained data showed that MINS (myocardial injury in noncardiac surgery) incidents were diagnosed in 5 patients (11.1%) in the first group and in 6 patients (13.6%) in the second. In patients of both groups there was an increase in NT-proBNP in the dynamics at all stages, and in the 2nd group, with a liberal regimen of intraoperative fluid therapy, it was more pronounced. It should be noted that the obtained values of NT-proBNP in all patients did not differ significantly from those allowed for this age group; such dynamics of NT-proBNP may indicate a relative risk of complications of liberal fluid therapy in patients with baseline heart failure. One of the important points when choosing the mode of fluid therapy in patients with high cardiac risk is the assessment of the initial volemic status and careful monitoring of water balance in the perioperative period with the desire for "zero" balance. The obtained dynamics of laboratory markers of myocardial damage indicates that in patients with a significant reduction in cardiac reserves compensated for heart failure, a restrictive fluid regimen is preferable, which is also confirmed by slight changes in the concentration of biomarkers. Conclusion. Thus, the study demonstrated the relative safety of selected fluid regimens in patients with concomitant coronary heart disease without signs of congestive heart failure

scholarly journals Can indicators of myocardial damage predict carbon monoxide poisoning outcomes?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hitoshi Koga ◽  
Hideki Tashiro ◽  
Kouta Mukasa ◽  
Tomohiro Inoue ◽  
Aya Okamoto ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Qt Interval ◽  
Troponin I ◽  
Morphological Changes ◽  
Carbon Monoxide Poisoning ◽  
Myocardial Damage ◽  
Qt Dispersion ◽  
Ecg Changes ◽  
Corrected Qt Interval ◽  
Logistic Analysis

Abstract Background Carbon monoxide causes electrical, functional, and morphological changes in the heart. It is unclear, however, whether the indicators of myocardial damage can predict the patient’s prognosis after carbon monoxide poisoning. This retrospective study aimed to investigate the relationship between the carboxyhemoglobin level and electrocardiographic (ECG) changes and whether the ECG changes and troponin I levels are related to the patient’s prognosis after carbon monoxide poisoning. Methods Carboxyhemoglobin, troponin I, and ECG parameters were measured in 70 patients with carbon monoxide poisoning. The QT and RR intervals were measured for each ECG lead in all patients, and the corrected QT interval and corrected QT dispersion were calculated. Results The correlation between the maximum corrected QT interval and the carboxyhemoglobin level was significant (P = 0.0072, R2 = 0.1017), as were the relationships between QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2358) and the corrected QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2613). The multivariate logistic analysis showed that the significant predictors of sequential disability were corrected QT dispersion (P = 0.0042), and troponin I level (P = 0.0021). Conclusions Patients’ prognosis following carbon monoxide poisoning can be predicted based on corrected QT dispersion and the troponin I level. Patients with myocardial damage should be monitored not only for their cardiovascular outcome but also for their neurological outcome and their prognosis.

scholarly journals Peripheral Blood MicroRNAs as Potential Biomarkers of Myocardial Damage in Acute Viral Myocarditis

Genes ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 420
Author(s):  
Maria Marketou ◽  
Joanna Kontaraki ◽  
Alexandros Patrianakos ◽  
George Kochiadakis ◽  
Ioannis Anastasiou ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Troponin I ◽  
Left Ventricular Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Viral Myocarditis ◽  
Myocardial Damage ◽  
Left Ventricular ◽  
Cardiovascular Development ◽  
Acute Viral Myocarditis

Background: microRNAs (miRs) have emerged as important modulators of cardiovascular development and disease. Our aim was to determine whether cardiac-related miRs such as miR-21-5p and miR-1-3p were differentially expressed in acute viral myocarditis and whether any of them was related with the extent of myocardial damage and left ventricular dysfunction. Methods: We enrolled 40 patients with acute viral myocarditis. Blood samples were taken on admission and miRs expression levels in peripheral blood mononuclear cells were quantified by real-time reverse transcription polymerase chain reaction. Results: miR-21-5p, miR-1-3p were significantly elevated in acute myocarditis. miR-21-5p levels showed a strong correlation with global longitudinal strain (r = 0.71, p < 0.01), while miR-1-3p had significant correlations with troponin I (r = 0.79, p < 0.01). Conclusions: The expression of miR-21-5p and miR-1-3p in peripheral blood is increased in acute viral myocarditis, and this increase is correlated with myocardial damage and indicative of left ventricular systolic dysfunction in these patients.

Abstract 229: Determination of Phase-specific Biomarkers of Viral Myocarditis Induced by Theiler’s virus Using Multivariate Analyses of Viral Genome, Troponin, Transcriptome and Echocardiography Data

2013 ◽  
Vol 113 (suppl_1) ◽  
Author(s):  
Eiichiro Kawai ◽  
Seiichi Omura ◽  
Fumitaka Sato ◽  
Nicholas E Martinez ◽  
Viromi Fernando ◽  
...  
Keyword(s):  
Immune Responses ◽  
Viral Replication ◽  
Microarray Data ◽  
Viral Genome ◽  
Troponin I ◽  
Multivariate Analyses ◽  
Viral Myocarditis ◽  
Myocardial Damage ◽  
Heart Tissue ◽  
Viral Rna

Viral myocarditis has been proposed to be initiated by viral replication in the heart (acute phase), followed by immune-mediated damage (subacute phase), where each phase requires anti-viral and immunomodulatory treatments, respectively. There are no specific biomarkers to distinguish acute from subacute phases of myocarditis while serum troponin, echocardiography, and myocardial biopsy data have been used for diagnosis clinically. To determine the phase-specific biomarkers, we used a mouse model for myocarditis induced by Theiler’s murine encephalomyelitis virus (TMEV), which belongs to the genus Cardiovirus, the family Picornaviridae. We conducted multivariate analyses of viral genome, serum cardiac troponin I, echocardiography, histology, and transcriptome using microarray data of the heart tissue harvested on 4 (acute) and 7 (subacute) days post infection (dpi). The level of viral RNA semi-quantified by RT-PCR was 10-fold higher on 4 dpi (ΔCt = 2.5×10-2 ± 4.9×10-3) than 7 dpi (ΔCt = 2.6×10-3 ± 3.0×10-4) (P < 0.05). Serum troponin was undetectable in 4 of 10 mice on 4 dpi and only in 1 of 10 mice on 7 dpi; the serum troponin levels (ng/ml) on 4 dpi (42.9 ± 15.6) were significantly lower than 7 dpi (249.9 ± 62.8) (P < 0.05). The levels of viral RNA and troponin were strongly correlated on 4 dpi (r = 0.79, P < 0.05), but not 7 dpi (P = 0.12), suggesting that viral replication could be a major cause of myocardial damage only on 4 dpi. We found multiple high intensity cardiac lesions using echocardiography with histological myocarditis on 7 dpi, but not 4 dpi. Transcriptome analyses of microarray data showed upregulation of genes associated with innate immune responses in samples from 4 and 7 dpi, compared with controls. Samples from 7 dpi showed upregulation of genes associated with T, B, and antigen presenting cells and downregulation of cardiac myosin-related genes (Myl4, Myl7, and Mybphl), compared with 4 dpi, suggesting that acquired immune responses contribute to cardiomyocyte damage on 7 dpi. In summary, the chronological order of emergence of biomarker candidates was 1) viral genome and innate immunity, 2) troponin, and 3) acquired immunity and echo and histological changes.

scholarly journals Salidroside pretreatment protects against myocardial injury induced by heat stroke in mice

2019 ◽  
Vol 47 (10) ◽  
pp. 5229-5238
Author(s):  
Guo-dong Chen ◽  
Heng Fan ◽  
Jian-Hua Zhu
Keyword(s):  
Oxidative Stress ◽  
Myocardial Injury ◽  
Troponin I ◽  
Heat Stroke ◽  
Cardiac Injury ◽  
Myocardial Damage ◽  
Thiobarbituric Acid ◽  
Protective Effects ◽  
Creatine Kinase Mb ◽  
Factor Α

Objective To explore the protective effects and mechanisms of salidroside on myocardial injury induced by heat stroke (HS) in mice. Methods We pretreated mice with salidroside for 1 week and then established an HS model by exposure to 41.2°C for 1 hour. We then examined the effects of salidroside on survival. We also assessed the severity of cardiac injury by pathology, and analyzed changes in levels of myocardial injury markers, inflammatory cytokines, and oxidative stress. Results Salidroside pretreatment significantly reduced HS-induced mortality and improved thermoregulatory function. Salidroside also provided significant protection against HS-induced myocardial damage, and decreased the expression levels of cardiac troponin I, creatine kinase-MB, and lactate dehydrogenase. Moreover, salidroside attenuated HS-induced changes in the inflammation markers tumor necrosis factor-α, interleukin (IL)-6, and IL-10, and down-regulated the oxidative stress response indicated by thiobarbituric acid reactant substances, malondialdehyde, reduced glutathione, and superoxide dismutase. Conclusions Salidroside pretreatment protected against HS-induced myocardial damage, potentially via a mechanism involving anti-inflammatory and anti-oxidative effects.

scholarly journals Frontal QRS-T angle as a predictive marker for myocardial damage in acute carbon monoxide poisoning

2021 ◽  
pp. 096032712110434
Author(s):  
Yusuf K Tekin ◽  
Gülaçan Tekin ◽  
Naim Nur ◽  
İlhan Korkmaz ◽  
Sefa Yurtbay
Keyword(s):  
Carbon Monoxide ◽  
Creatine Kinase ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Myocardial Damage ◽  
Cardiac Troponin I ◽  
Arterial Oxygen ◽  
Co Poisoning ◽  
Arterial Blood ◽  
Creatine Kinase Mb

Introduction The present study was undertaken to investigate the prognostic value of the frontal QRS-T angle associated with adverse cardiac outcomes in patients with carbon monoxide (CO) poisoning in early stages in the emergency department. Materials and methods The data of 212 patients with CO poisoning who were admitted to the ED between January 2010 and May 2020 were retrospectively analyzed. The frontal QRS-T angle was obtained from the automatic reports of the EKG device. Results Compared to patients without myocardial damage, among patients with myocardial damage, statistically high creatinine, creatine kinase MB, cardiac troponin I, and frontal QRS-T angle values were found ( p < 0.001 for all parameters), while the saturation of arterial blood pH and arterial oxygen values were found to be lower ( p = 0.002 and p < 0.001, respectively). The frontal QRS-T angle values were correlated with creatine kinase, creatine kinase-MB, cardiac troponin I, and oxygen saturation (SpO2) in arterial blood (r = 0. 232, p = 0.001; r = 0. 253, p = < 0.001; r = 0. 389, p = < 0.001; r = −0. 198, p = 0.004, respectively). The optimum cut-off value of the frontal QRS-T angle was found to be 44.5 (area under the curve: 0.901, 95% confidence interval: 0.814–0.988, sensitivity: 87%, specificity: 84%). Conclusions The frontal QRS-T angle, a simple and inexpensive parameter that can be easily obtained from 12-lead surface electrocardiography, can be used as an early indicator in the detection of myocardial damage in patients with CO poisoning.

scholarly journals A clinical case of repeated correction of Ebstein’s anomaly using the ‘cone reconstruction’ method

2020 ◽  
Vol 24 (2) ◽  
pp. 102
Author(s):  
N. M. Troshkinev ◽  
E. A. Svyazov ◽  
O. V. Mochula ◽  
N. A. Shmakova ◽  
I. V. Ivanova ◽  
...  
Keyword(s):  
Informed Consent ◽  
Conflict Of Interest ◽  
Ebstein’S Anomaly ◽  
Reconstruction Method ◽  
Hemodynamic Parameters ◽  
Resonance Imaging ◽  
Ebstein's Anomaly ◽  
Mean Pressure ◽  
Critical Revision ◽  
The Right

<p>We report the case of a 16-year-old child with Ebstein’s anomaly who successfully underwent recorrection via the ‘cone reconstruction’ method using a tricuspid valve-in-ring implant. Because the patient had high-grade atrioventricular block, a pacemaker was implanted. Ultrasound and magnetic resonance imaging were conducted to determine the anatomy of the right ventricle and its hemodynamic parameters. Echocardiography performed at the time of discharge revealed an improvement in the hemodynamic parameters of the patient after the correction: triuspid valve regurgitation is mild and peak/mean pressure gradient 10/5 mmHg.</p><p>Received 9 January 2020. Revised 16 March 2020. Accepted 17 March 2020.</p><p><strong>Informed consent:</strong> The patient’s informed consent to use the records for medical purposes is obtained.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Drafting the article: N.M. Troshkinev, O.V. Mochula, O.A. Egunov<br />Literature review: N.A. Shmakova, I.V. Ivanova<br />Illustrations: N.M. Troshkinev, O.V. Mochula<br />Critical revision of the article: E.V. Krivoshchekov, E.A. Svyazov<br />Surgical treatment: E.V. Krivoshchekov, O.A. Egunov, N.M. Troshkinev<br />Final approval of the version to be published: N.M. Troshkinev, E.A. Svyazov, O.V. Mochula, N.A. Shmakova, I.V. Ivanova, O.A. Egunov, E.V. Krivoshchekov</p>

scholarly journals Role of Radiofrequency Ablation in the Management of Unresectable Pancreatic Cancer

2021 ◽  
Vol 7 ◽  
Author(s):  
Muhammad Nadeem Yousaf ◽  
Hamid Ehsan ◽  
Ahmad Muneeb ◽  
Ahsan Wahab ◽  
Muhammad K. Sana ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiofrequency Ablation ◽  
Surgical Resection ◽  
Retrospective Studies ◽  
Advanced Disease ◽  
Protein Denaturation ◽  
Solid Organ ◽  
Unresectable Pancreatic Cancer ◽  
The Past

Pancreatic cancer is one of the most aggressive malignancies of the digestive tract and carries a poor prognosis. The majority of patients have advanced disease at the time of diagnosis. Surgical resection offers the only curative treatment, but only a small proportion of patients can undergo surgical resection. Radiofrequency ablation (RFA) is a well-known modality in the management of solid organ tumors, however, its utility in the management of pancreatic cancer is under investigation. Since the past decade, there is increasing use of RFA as it provides a feasible palliation treatment in the management of unresectable pancreatic cancer. RFA causes tumor cytoreduction through multiple mechanisms such as coagulative necrosis, protein denaturation, and activation of anticancer immunity. The safety profile of RFA is controversial because of the high risk for complications, however, small prospective and retrospective studies have shown promising results in its applicability for palliative management of unresectable pancreatic malignancies. In this review, we discuss different approaches of RFA, their indications, technical accessibility, safety, and major complications in the management of unresectable pancreatic cancer.

Circulating Erythrocyte Microparticles and the Biochemical Extent of Myocardial Injury in ST Elevation Myocardial Infarction

Cardiology ◽  
2016 ◽  
Vol 136 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Georgios Giannopoulos ◽  
Dimitrios A. Vrachatis ◽  
Georgios Oudatzis ◽  
Georgios Paterakis ◽  
Christos Angelidis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Injury ◽  
Troponin I ◽  
Multivariable Analysis ◽  
Area Under The Curve ◽  
Myocardial Damage ◽  
Primary Angioplasty ◽  
St Elevation Myocardial Infarction ◽  
Vascular Effects ◽  
St Elevation

Objectives: Red blood cell microparticles (RBCm) have potential adverse vascular effects and they have been shown to be elevated in ST elevation myocardial infarction (STEMI). The purpose of this study is to investigate their relationship with biochemical infarct size. Methods: RBCm were quantified with flow cytometry in blood drawn from 60 STEMI patients after a primary angioplasty. The creatine kinase-myocardial brain fraction (CK-MB) was measured at predefined time points and the area under the curve (AUC) was calculated. Results: RBCm count was correlated with CK-MB AUC (Spearman's ρ = 0.83, p < 0.001). The CK-MB AUC values per RBCm quartile (lower to upper) were: 3,351 (2,452-3,608), 5,005 (4,450-5,424), 5,903 (4,862-10,594), and 8,406 (6,848-12,782) ng × h/ml, respectively. From lower to upper quartiles, the maximal troponin I values were: 42.2 (23.3-49.3), 49.6 (28.8-54.1), 59.2 (41.4-77.3), and 69.1 (48.0-77.5) ng/ml (p = 0.005). In multivariable analysis, RBCm remained a significant predictor of CK-MB AUC (standardized β = 0.63, adjusted p = 0.001). Conclusions: Erythrocyte microparticles appear to be related to the total myocardial damage biomarker output. The exact pathophysiologic routes, if any, for this interaction remain to be identified. However, these results suggest that erythrocytes may be a - thus far virtually ignored - player in the pathogenesis of ischemic injury.

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