Ivabradine for Uncontrolled Sinus Tachycardia in Thyrotoxic Cardiomyopathy – Case Report

Background: Beta blockers, mainly propranalol, are usually administered to control heart rate in patients with thyrotoxicosis, especially when congestive heart failure presents. However, when thyrotoxicosis is not controlled, heart rate may be difficult to control even with maximal doses of propranolol. This presentation alerts physicians to the possibility of using ivabradine, a selective inhibitor of the sinoatrial pacemaker, for the control of heart rate. Case presentation: We present a 37-year-old woman with thyrotoxicosis and congestive heart failure whose heart rate was not controlled with a maximal dose of beta blockers during a thyroid storm. The addition of ivabradine, a selective inhibitor of the sinoatrial pacemaker, controlled her heart rate within 48 hours. Conclusion: Ivabradine should be considered in patients with thyrotoxicosis, including those with heart failure, in whom beta blockers are insufficient to control heart rate

Implementasi Metode Penalaran CBR dalam Mengidentifikasi Gejala Awal Penyakit Jantung menggunakan Algoritma Sorensen Coeffient

Heart disease is a condition when the heart is experiencing a disorder. The forms of disturbance that are experienced are usually various. Usually there is a disturbance in the blood vessels of the heart, heart rate, heart cover, or congenital problems. The heart itself is a muscle consisting of four chambers. That is, the first two rooms are located at the top, the atrium (foyer) to the left and right. Then the other two rooms are at the bottom, namely the right and left ventricles. To provide information on how to diagnose the type of disease and how to control heart disease, an application of an expert system that can represent someone who is an expert in their field is needed to provide solutions to this disease problem using the Case-Based Reasoning method with the Sorensen Coeffient approach. The result of this research is the creation of an expert system for diagnosing heart disease using the Case-Based Reasoning method with the Sorensen Coeffient approach which is able to provide solutions to heart disease.Keywords:CBR, Expert system, Heart Disease, Method Sorensen Coeffient.

Assessing Doxorubicin-Induced Cardiomyopathy by 99mTc-3PRGD2 Scintigraphy Targeting Integrin αvβ3 in a Rat Model

The present study evaluated interstitial alterations in doxorubicin-induced cardiomyopathy using a radiolabeled RGD peptide 99mTc-3PRGD2 specific for integrin αvβ3 that targets myofibroblasts.Cardiomyopathy was induced in 20 Sprague-Dawley rats by intraperitoneal doxorubicin injections (2.5 mg/kg/week) for up to six weeks. 99mTc-3PRGD2 scintigraphy was performed in control rats (n = 6) at baseline and three, six, and nine weeks after first doxorubicin administration (n = 6, 6, and 5 for each time point). For another three rats of 6-week modeling, cold c(RGDyK) was co-injected with 99mTc-3PRGD2 to evaluate specific radiotracer binding. Semi-quantitative parameters were acquired to compare radiotracer uptake among all groups. The biodistribution of 99mTc-3PRGD2 was evaluated by a γ-counter after scintigraphy. Haematoxylin and eosin, and Masson’s staining were used to evaluate myocardial injury and fibrosis, while western blotting and immunofluorescence co-localization were used to analyze integrin αvβ3 expression in the myocardium.The 99mTc-3PRGD2 half-life in the cardiac region (Heartt 1/2) of the 9-week model and heart radioactivity percentage (%Heart20 min, %Heart40 min and %Heart60 min) of the 6 and 9-week models were significantly increased compared to the control. Heart-to-background ratio (HBR20 min, HBR40 min and HBR60 min) increase began in the third week, continued until the sixth week, and was reversed in the ninth week, which paralleled the changing trend of cardiac integrin αvβ3 expression. The myocardial biodistribution of 99mTc-3PRGD2 was significantly correlated with integrin β3 expression.The 99mTc-3PRGD2 scintigraphy allows for non-invasive visualization of interstitial alterations during doxorubicin-induced cardiomyopathy.

Acknowledging Sex Differences in In vivo Experiments: Dilemma

The role of the Autonomic Nervous System (ANS) and its organ-specific functions are largely elucidated. Heart Rate Variability (HRV) analysis is a popular tool for the assessment of autonomic cardiac control. Heart rate and its changes are a sensitive indicator of ANS function, therefore cardiovascular autonomic regulation is considered to be the most reliable indicator of ANS activity and status. HRV refers to beat to beat variation in the heart rate that quantifies the interplay between sympathetic and parasympathetic activity of the ANS. Although patterns of HRV hold considerable promise for clarifying issues in clinical applications,

Future Leaders to Watch – Christopher Toepfer and Manuel Schmid

ABSTRACT Future Leaders to Watch is a series of interviews with the first authors of a selection of papers published in Biology Open, helping early-career researchers promote themselves alongside their papers. Christopher Toepfer and Manuel Schmid are co-first authors on ‘Myosin super relaxation (SRX) a perspective on fundamental biology, human disease, and cardiac therapeutics’, published in BiO. Christopher is a Sir Henry Wellcome Postdoctoral Fellow and British Heart Foundation Centre of Research Excellence (CRE) Intermediate Transition Fellow in the department of Cardiovascular Medicine at the Radcliffe Department of Medicine, University of Oxford, UK. Manuel is a Research Assistant in the department of Cardiovascular Medicine at the Radcliffe Department of Medicine, University of Oxford, UK. They are investigating the mechanisms that control heart function and impact acquired and inherited cardiovascular conditions.

Rate control with intravenous diltiazem, verapamil, and metoprolol in acute atrial fibrillation with rapid ventricular rate

Introduction: Diltiazem is a preferred agent for rate control in atrial fibrillation due to its quick onset, minimal side effects, and low cost. Due to its intermittent national shortage since February 2018, the utilization of intravenous metoprolol and verapamil has increased. This study investigated the effect of intravenous diltiazem, metoprolol, and verapamil on rate control in patients with atrial fibrillation with rapid ventricular rate. Methods: This study was a retrospective, single-center, cohort study conducted in patients with acute atrial fibrillation receiving intravenous diltiazem, metoprolol, or verapamil for rapid ventricular rate between 1 January 2012 and 31 August 2018. The primary outcome was the incidence of patients who achieved a rate less than 100 bpm within 1 h of treatment. Secondary outcomes included time to achieve rate control, heart rate at 30 min and 1 h after administration, bradycardia and hypotension incidence, the requirement of other rate control agent(s), inpatient admission, length of stay, and mortality. Results: A total of 73 patients were included in the study. At 1 h after receiving the initial rate control drug, there was no statistically significant difference between diltiazem, metoprolol, and verapamil in achieving rate control. Median time to ventricular rate control was 166 min in the diltiazem group, 297 min in the metoprolol group, and 100.5 min in the verapamil group. Conclusion: There was no difference in achieving rate control when using intravenous diltiazem, metoprolol, or verapamil. Any of the three rate control agents may be used for rate control. However, further studies are needed to determine which agent is superior for rate control.

Strategies to Improve the Outcome of Cryoballoon Ablation in the Treatment of Atrial Fibrillation

Atrial fibrillation (AF) is a common arrhythmia contributing to severe outcomes, including cardiac dysfunction and stroke, and it has drawn great attention around the world. Drug therapies have been available for many years to terminate AF and control heart rate. However, the results from clinical studies on drug therapies have been discouraging. Mounting evidence indicates that radiofrequency catheter ablation (RFCA) is a safe and effective method to maintain sinus rhythm, especially in patients who are drug intolerant or for whom the drugs are ineffective, although it is a technically demanding and complex procedure. Fortunately, a novel application, cryoballoon ablation (CBA), with outstanding characteristics has been widely used. Great outcomes based on CBA have manifested its significant role in the treatment of AF. However, how to improve the safety and efficacy of CBA is a question that has not been well-answered. Would it be helpful to develop a different generation of cryoballoon? Is bonus freezing beneficial, or not? Is it better to prolong freezing time? Dose CBA combined with RFCA bring higher success rates? In this review, we comprehensively summarized useful applications for improving outcomes of CBA in AF patients.