1,721,057 research outputs found
Overexpression of phosphodiesterase-2 in mice reduces CaMKII-dependent enhancement of late sodium current through impared beta-adrenergic response
No full textRole of ranolazine in angina, heart failure, arrhythmias, and diabetes
No full textRanolazine which is currently approved as an antianginal agent reduces the Na-dependent Ca overload via inhibition of the late sodium current (late I-Na) and thus improves diastolic tone and oxygen handling during myocardial ischemia. According to accumulating evidence ranolazine also exerts beneficial effects on diastolic and systolic heart failure where late I-Na was also found to be elevated. Moreover, late I-Na Plays a crucial role as an arrhythmic substrate. Ranolazine has been described to have antiarrhythmic effects on ventricular as well as atrial arrhythmias without any proarrythmia or severe organ toxicity as it is common for several antiarrhythmic drugs. In patients with diabetes, treatment with ranolazine led to a significant improvement of glycemic control. In this article possible new clinical indications of the late I-Na-inhibitor ranolazine are reviewed. We summarize novel experimental and clinical studies and discuss the significance of the available data. (C) 2011 Elsevier Inc. All rights reserved
Renal artery ablation instead of pulmonary vein ablation in a hypertensive patient with symptomatic, drug-resistant, persistent atrial fibrillation
No full textMeasurement of response of pulmonal tumors in 64-slice MDCT
No full textBackground: Advances in CT technology from single to multi-detector row CT (MDCT) permit a high resolution and volumetric presentation of pulmonary lesions. This implicates emerging measurement techniques that need to be contrasted with established methods. Purpose: To compare bidimensional, unidimensional, and volumetric methods for evaluation of treatment response in patients with lung lesions. Material and Methods: This study comprised 68 patients with pulmonary lesions who underwent a total of 276 64-MDCTs of chest at baseline and follow-up. RECIST and WHO criteria were used for unidimensional and bidimensional methods and region growing (RG) for volumetry. Patients were classified into four response categories. Respectively, two measurement techniques were contrasted and the. index was calculated. For intra-observer reproducibility the relative measurement error (RME) and. index with regard to agreement of response categories were evaluated. Results: Comparison of WHO und RECIST criteria achieves high correlation with. indices of 0.76 and 0.82. In particular, lesions with moderate increase of size in the range of 25-44% for bidimensional and 12-29% for unidimensional measurement result in different response categories when applying WHO and RECIST criteria. WHO criteria delivered PD more often than RECIST. kappa indices of 0.79 and 0.87 were attained in comparison of RECIST and RG, and 0.83 and 0.84 for WHO and RG. RME was 2.82% for RECIST, 7.53% for WHO, and 8.97% for RG. Intra-observer reproducibility was 95% for RECIST, 95% for WHO, and 96% for RG. Conclusion: The comparison of all methods resulted in no statistically significant differences. WHO criteria seemed to diverge the most, they declared several lesions prematurely as progression, and showed no benefit in comparison to RECIST. RG showed the best reproducibility, considered irregular lesions, was slightly superior to RECIST, and could be applied uniformly. Unidimensional measurement represents an adequate alternative with the advantage of better clinical work flow
Atrial fibrillation leads to electrical remodelling of Na currents. Role of INa inhibition by ranolazine on arrhythmias and contractility
No full textAtrial fibrillation leads to electrical remodelling of Na currents. Role of INa inhibition by ranolazine on arrhythmias and contractility
No full textSubmuscular implantation of insertable cardiac monitors improves the reliability of detection of atrial fibrillation
No full textDiagnosing atrial fibrillation (AF) is highly relevant, as specific secondary prevention is of high importance. Recently, insertable cardiac monitors (ICMs) have been introduced for continuous monitoring to detect asymptomatic episodes of AF. The detection of AF remains challenging due to a relevant incidence of artifacts. This study aimed to compare the effectivity of ICM when placed in a subcutaneous or in a submuscular localization, respectively. We retrospectively analyzed data from 30 patients undergoing pulmonary vein isolation (PVI) for AF and consecutive ICM implantation. ICMs were implanted in two locations: either subcutaneously and parasternally (SC) or under the left major pectoral muscle (SP). Interrogations were continuously retrieved using remote monitoring and during repeated visits in our outpatient clinic. The transmission protocols were scanned for detected AF, and it was ruled by two blinded investigators, if detection was correct or incorrect. Mean age was 67 +/- 10 years, 56 % men, 50 % paroxysmal AF. In 14 of the patients, the ICM was implanted at a SC localization and in 16 patients subpectorally. R-wave amplitude was significantly higher in patents with SP implantation. There were 670 transmitted protocols including 1024 episodes detected as AF. Of these, 54 % were correctly recognized as AF in the SC group. In the SP group, 85 % of the recorded episodes were correctly recognized as AF (p = 0.03). The remaining episodes in both groups showed sinus rhythm with misinterpreted artifacts. To improve effectiveness of detecting AF episodes, it is useful to implant subpectorally
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