597 research outputs found
Barriers to implementation of evidence-based electrical therapies and the need for outcome research: role of European registries
No full textAlthough clinical trial results and the implementation of current guidelines appear to have encouraged progress in the treatment of arrhythmias, great discrepancies still exist between European Society of Cardiology (ESC) member countries. Guidelines are not adhered to for a variety of reasons. This cannot be explained only by economic factors, although these obviously play a substantial role. Other factors responsible for adequate guideline implementation appear to be the lack of trained personnel, the lack of infrastructure, or different health insurance systems. In this complex scenario, the data based on European registries are useful for creating standards and harmonizing the treatment of arrhythmias. Moreover, a summary of registry data, such as presented in the European Heart Rhythm Association (EHRA) White Book, can provide the opportunity to share and exchange information among ESC member countries on specific needs for improvements, reimbursement policy, and training issues
A minimally invasive approach for open surgical thoracoabdominal aortic replacement: experimental concept for a novel surgical procedure
No full textOBJECTIVES: We aimed to develop a simple, reliable, and timesaving technique for the therapy of thoracoabdominal aortic (TAA) aneurysms that are not suitable for endovascular repair. METHODS: In this pilot study, we sought to combine the advantages of classic open vascular procedure with the use of endoscopic surgical tools and small skin incisions to develop a minimally invasive approach for TAA replacement. The following procedures were used: endoscopic exposure and closure of the lower intercostal arteries; small posterolateral thoracotomy and left retroperitoneal incisions to expose the anastomotic regions of the aorta; partial anticoagulation; passive bypass and sequential aortic clamping; tunnelling of the graft through the native aortic lumen (endoaneurysmorrhaphy) and open performance of vascular anastomosis. RESULTS: Five mixed-breed dogs (25-35 kg) underwent minimally invasive TAA replacement. All animals survived the operation without blood transfusion (lowest Hb = 5.5 mg/dl). Total operation time was 364 +/- 46.3 min. Clamping times were 17.6 +/- 3.2 min for proximal anastomosis, 33.2 +/- 2.48 min for visceral patch and 11 +/- 2.3 min for distal anastomosis. The pull-through procedure of graft through the native aorta was performed during the visceral clamp time. CONCLUSIONS: Surgical replacement of the TAA through small transverse incisions of the thoracic and abdominal wall is feasible and allows open performance of all vascular anastomosis with no leakage at any anastomotic site. Further experimental studies and clinical implementation are needed to establish the safety and long-term outcome of minimally invasive TAA replacement as a possible primary therapeutic tool for complex aneurysms that are not suitable for endovascular treatment and require open surgical repair.European Society of Vascular Surger
Sex-specific associations between alcohol consumption, cardiac morphology, and function as assessed by magnetic resonance imaging: insights form the UK Biobank Population Study
No full textThis is a pre-copyedited, author-produced version of an article accepted for publication in
European Heart Journal - Cardiovascular Imaging following peer review. The version of record: Judit Simon, Kenneth Fung, Márton Kolossváry, Mihir M Sanghvi, Nay Aung, Jose Miguel Paiva, Elena Lukaschuk, Valentina Carapella, Béla Merkely, Marcio S Bittencourt, Júlia Karády, Aaron M Lee, Stefan K Piechnik, Stefan Neubauer, Pál Maurovich-Horvat, Steffen E Petersen, Sex-specific associations between alcohol consumption, cardiac morphology, and function as assessed by magnetic resonance imaging: insights form the UK Biobank Population Study, European Heart Journal - Cardiovascular Imaging, jeaa242, https://doi.org/10.1093/ehjci/jeaa242
is available online at: https://doi.org/10.1093/ehjci/jeaa24
May Strenuous Endurance Sports Activity Damage the Cardiovascular System of Healthy Athletes? A Narrative Review
No full textThe positive effects of physical activity are countless, not only on the cardiovascular system but on health in general. However, some studies suggest a U-shape relationship between exercise volume and effects on the cardiovascular system. On the basis of this perspective, moderate-dose exercise would be beneficial compared to a sedentary lifestyle, while very high-dose physical activity would paradoxically be detrimental. We reviewed the available evidence on the potential adverse effects of very intense, prolonged exercise on the cardiovascular system, both acute and chronic, in healthy athletes without pre-existing cardiovascular conditions. We found that endurance sports activities may cause reversible electrocardiographic changes, ventricular dysfunction, and troponin elevation with complete recovery within a few days. The theory that repeated bouts of acute stress on the heart may lead to chronic myocardial damage remains to be demonstrated. However, male veteran athletes with a long sports career show an increased prevalence of cardiovascular abnormalities such as electrical conduction delay, atrial fibrillation, myocardial fibrosis, and coronary calcifications compared to non-athletes. It must be underlined that the cause–effect relationship between such abnormalities and the exercise and, most importantly, the prognostic relevance of such findings remains to be established
Relative contribution of right ventricular longitudinal shortening and radial displacement to global pump function in healthy volunteers
No full textContemporary diagnostic approach to arrhythmogenic cardiomyopathy: The three-step work-up
No full textArrhythmogenic Cardiomyopathy (ACM) is a cardiac disorder characterized by non-ischemic myocardial scarring, which may lead to ventricular electrical instability and systolic dysfunction. Diagnosing ACM is challenging as there is no single gold-standard test and a combination of criteria is required. The first diagnostic criteria were established in 1994 and revised in 2010, focusing primarily on right ventricular involvement. However, in 2019, an international expert report identified limitations of previous diagnostic scoring and developed the 2020 Padua criteria with also included criteria for diagnosis of left ventricular variants and introduced cardiac magnetic resonance tissue characterization findings for detection of left ventricular myocardial scar. These criteria were further refined and published in 2023 as the European Task Force criteria, gaining international recognition. This review provides an overview of the 20 years of progresses on the disease diagnostic from the ori..
Cardiac magnetic resonance imaging in children with chronic kidney disease and renal transplantation.
No full textSchaefer B, Rusai K, Toth A, Pasti K, Ujszaszi A, Kreko M, Horvath E, Sallay P, Reusz GS, Merkely B, Tulassay T, Szabo AJ. Cardiac magnetic resonance imaging in children with chronic kidney disease and renal transplantation. Pediatr Transplantation 2012. (c) 2012 John Wiley & Sons A/S. Abstract: CV disease is the major cause of death in patients with CKD. Recently, CMR imaging emerges as a complementary method providing advantages in cardiac assessment; however, data on CMR in pediatric CKD are scarce. We performed CMR in 15 children: two with CKD, six on peritoneal dialysis, seven on hemodialysis, and in 18 children 5.1 (0.4-15.4) yr after kidney Tx. Eight children underwent CMR six months before and after Tx. Results are presented as mean z score +/- SD. LV EF was higher and in the normal range in Tx patients compared with CKD (-0.3 +/- 1 vs. -2.1 +/- 1.6, respectively, p < 0.05), whereas RV EF was similar (-0.9 +/- 1.4 vs. -0.9 +/- 1.8, p = n.s.). End-diastolic and end-systolic LV volume index (0 +/- 1.7 vs. 2.1 +/- 3.1; 0.2 +/- 1.2 vs. 3.1 +/- 3.7, both p < 0.05) and LV mass index (1.4 +/- 1.5 vs. 3.4 +/- 2.9, p < 0.05) were lower in Tx children. All parameters improved in the eight children after Tx. In conclusion, our CMR analysis suggests marked improvement of cardiac function and morphology in children after kidney Tx. CMR might be an appropriate complementary method for measuring detailed cardiac status in children with CKD
Upcycling Centre Zuidoost: From waste to resource
No full textThe Zuidoost district is divided in mono-functional zones, such as housing in the Bijlmer and Holendrecht area and working in the Amstel III area. The Upcycling Centre Zuidoost will connect both sides in the future of 2050 in a physical, social and economic way. This is done by creating a building that becomes the driver of the circular economy. It is a place where waste is transported to and sorted, whereafter start-ups will upcycle the waste into new products. The start-ups will create new sustainable jobs to fight the high unemployment rate in Zuidoost and generate new local economic value. Program such as a market, shops and a restaurant will form an attractive and easily approachable building and creates social inclusion and interaction between all the different users.Architecture, Urbanism and Building Science
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