Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Dec 2020
Meta AnalysisImpella in cardiogenic shock following acute myocardial infarction: a systematic review and meta-analysis.
Cardiogenic shock (CS) conveys a high mortality risk. A cardiac assist device may serve as bridge to patient recovery. We aimed to provide a pooled estimate on mortality and complications from studies evaluating the use of the left ventricular assist device Impella in CS following acute myocardial infarction. In addition, we evaluated whether mortality risk differed with device placement before or after percutaneous coronary intervention (PCI). ⋯ Pooled estimates of Impella use in myocardial infarction with CS revealed a high 30-day mortality; however, as compared to post-PCI, Impella initiation prior to PCI was associated with a survival benefit.
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Wien. Klin. Wochenschr. · Dec 2020
Predicting the presence of coronary artery disease by transesophageal echocardiography.
The accuracy of ultrasound signs as predictors for the presence of coronary artery disease (CAD) has been evaluated extensively in the 1990s and 2000s. Imaging quality has improved tremendously over the last decades. ⋯ With an negative predictive value (NPV) of 80%, the absence of MAC, AS, and aortic plaque makes the presence of significant CAD unlikely. If at least mild AS is present, normal coronary arteries are improbable.
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Wien. Klin. Wochenschr. · Dec 2020
ReviewRecommendations for driving after implantable cardioverter defibrillator implantation and the use of a wearable cardioverter defibrillator : Different viewpoints around the world.
The use of implantable cardioverter defibrillators (ICD) has been shown to improve survival in patients at risk of sudden cardiac death; however, due to the continuous risk of sudden loss of consciousness during arrhythmia or ICD intervention, they pose a potential risk to other road users while driving. A large number of opinions and recommendations from authorities and medical societies all over the world exist regarding driving restrictions after ICD implantation. This analysis provides an overview of the recommendations on driving restrictions from several countries. Furthermore, the use of the wearable and the subcutaneous ICD are taken into account.
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Toxoplasma gondii is a widespread protozoan parasite that infects one third of the global human population. Very little information is known about the impact of T. gondii on patients with heart disease. The aim of the present study was to determine the association between T. gondii exposure and patients suffering from myocardial infarction. ⋯ The PCR-RFLP results showed that 2 of the 3 positive sample had 75bp and 623 bp DNA fragments belonging to type II genotype. The sequencing result confirmed the genotype II of T. gondii. Toxoplasma infection should be considered in myocardial infarction cases.
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Wien. Klin. Wochenschr. · Dec 2020
A little is better than none: the biggest gain of physical activity in patients with ischemic heart disease.
There is a relationship between physical activity and health-related quality of life (HRQL) in healthy people and in patients with ischemic heart disease (IHD). The purpose of this study was to determine whether this relationship between sports or recreational physical activity levels and HRQL has a dose-response gradient in patients with IHD. ⋯ Using generic and IHD-specific HRQL questionnaires, there seems to be an overall dose-dependent gradient betweenincreasing levels of sports or recreational physical activity and higher HRQL in patients with angina, myocardial infarction, and ischemic heart failure. The greatest bang for the public health buck still lies on putting all the effort in changing sedentary lifestyle to at least a moderate active one (1-2 times per week), in particular in cardiac rehabilitation settings.