Effect of Pravastatin as an Adjunctive Therapeutic for Mitral Insufficiency with Hyperlipidemia in a Dog

Pravastatin (PS) has been found to increase left ventricle (LV) expansion capacity and decrease LV constriction and left atrial pressure in healthy dogs. To date, there are no available reports on the effects of PS in dogs with hypercholesterolemia with chronic heart failure (CHF). This case report demonstrates a successful long-term treatment plan using PS in a dog suffering from mitral insufficiency with hyperlipidemia. A 12-year-old, castrated male Chihuahua dog had mitral insufficiency with hyperlipidemia. The dog presented with symptoms of chronic coughing. PS was orally administered (1 mg/kg, SID) in addition to general treatment for mitral insufficiency. The follow-up period was 375 days. PS administration decreased the heart rate (HR), vertebral heart size (VHS), and N-terminal probrain natriuretic peptide (NT-proBNP) concentration of the dog. In addition, PS administration also improved chronic cardiac failure induced by mitral insufficiency and hyperlipidemia. This report suggests that PS can be useful as an adjunctive therapeutic for dogs with hypercholesterolemia with mitral insufficiency.

Efficiency criteria of laboratory support for clinical diagnosis in evaluation of individual life quality and public health elements

The analysis of the informativeness of traditional laboratory markers was performed by verification of individuals with the laboratory features of chronic kidney disease (blood creatinine level exceeding the reference range upper limit) among 142,494 people, who underwent laboratory tests during dispenserization and medical examination during 2015–2019. A stable growth of population groups characterized by preclinical hypercreatininaemia was observed, suggesting the increase of chronic kidney disease rate. Meanwhile the frequency of this population group, corresponding to the obtained values, is considered to be a cardiovascular cohort (primarily affected by chronic cardiac failure) in ‘Chronic kidney disease’ clinical recommendation (2019). Our results clearly demonstrate the cardiorenal continuum. Obtained data can be used in the resource support of the health care system calculation.

Total Artificial Heart Update

The SynCardia Total Artificial Heart (TAH, SynCardia Systems, Tucson, AZ) is the only biventricular cardiac replacement approved for bridge to transplantation by the U.S. Food and Drug Administration (FDA) and which carries the European Union CE mark. It has been implanted in about 2000 patients. In experienced centers, 60 to 80 % of implanted patients have been transplanted and over 80 % of those transplanted have lived for over 1 year. The SynCardia TAH has supported potential cardiac recipients with irreversible biventricular failure for up to 6 years, providing physiologic pulsatile flows of 6 to 8 L/min at filling pressures of less than 10 mmHg allowing for optimal perfusion and recovery of organs such as the kidneys and liver. It is a tested device that provides a method for recovering potential transplant candidates who rapidly decompensate from biventricular failure or who have chronic cardiac failure from a variety of etiologies. This article covers the history, mechanical function and monitoring, implantation, patient selection and management, and outpatient use. It also reviews outcome data from the original FDA study as well as contemporary data from experienced centers.

Endogenous Cardiotonics: Search And Problems

: Medicinal preparations currently used for the treatment of patients with chronic cardiac failure involve those that reduce the heart load (vasodilators, diuretics, beta-blockers, and angiotensin-converting enzyme (ACE) inhibitors). Cardiotonic drugs with the cAMP-dependent mechanism are unsuitable for long-term administration due to the intensification of metabolic processes and an increase in the oxygen demand of the myocardium and all tissues of the body. For many years, digoxin has remained the only preparation enhancing the efficiency of myocardial performance. The detection of digoxin and ouabain in intact animals has initiated a search for other compounds with cardiotonic activity. The review summarizes current data on the effect exerted on the heart performance by endogenous compounds, from simple, such as NO and CO, to steroids, fatty acids, polypeptides, and proteins. Controversial questions and problems with the introduction of scientific achievements into clinical practice are discussed. The results obtained by the authors and their colleagues after many years of studies on the cardiotropic properties of serum lipoproteins are also reported. The experimentally established cardiotonic activity of apoprotein A-1, which is accompanied by a decrease in the relative consumption of oxygen, maybe of great interest.

Heart Transplantation as a Treatment Method for Refractory Heart Failure due to Post-myocarditis Dilated Cardiomyopathy: a Clinical Case

Background. Implementation of mechanical circulatory support and heart transplantation technologies in paediatric clinical practice is changing approaches of diagnostics and treatment of heart failure (HF) in children. The experience of carrying out such operations in Russian Federation is extremely limited until recently due to absence of legal mechanisms of people declaration of intention recording about postmortal use of organs for transplantation.Clinical Case Description. The rare clinical case of drug-refractory (cardiotonic agents and cardioverter defibrillator implantation) chronic cardiac failure caused by post-myocarditis dilated cardiomyopathy (DCM) which demanded heart transplantation. Postoperative course, specific and non-specific complications, diagnostics and correction approaches are described.Conclusion. In the absence of proper analysis of non-specific slight symptoms myocarditis can progress to DCM and be complicated by development of refractory HF. The only method of sustaining child’s life in such case is heart transplantation which is connected with high risk of numerous and life-threatening complications.

A CASE OF BOCHDALECK’S HERNIA AND A GIANT OVARIAN CYST IN A GERIATRIC PATIENT

Some authors define a giant ovarian cyst as having more than a 10 cm diameter . Huge cysts are usually benign or have a low-degree of malignancy . Laparoscopy is considered the gold standard approach to manage benign ovarian cysts but a major factor that will make the surgeon decide to perform or not perform a laparotomy is the size of the ovarian mass. We describe the case of an 86-year-old female patient diagnosed and treated for a giant ovarian cyst. The patient presented with complaints of recently aggravated pain in the left hypochondrium. The main symptom was a giant pelvic and abdominal mass that occupied all the quadrants. The CT scan identified the giant tumor as an ovarian cyst and also revealed a Bochdaleck hernia. Other investigations revealed: arterial hypertension, right bundle branch block, and chronic cardiac failure. The surgical treatment of choice was minimal laparotomy followed by suction of the content of the cyst, excision of the cyst’s wall and left adnexectomy. Despite the advanced anesthesiological risks, the patient developed no postoperative complications. Patients can be operated on successfully even in old age and in complicated cases with good perioperative anaesthetic evaluation and careful election of the surgical technique.