International journal of cardiology
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The small peptide urocortin (Ucn) has the ability to protect the heart by reducing cardiac cell loss during myocardial ischemia/reperfusion, and improving post-ischemic cardiac performance. Although its mechanism of action is not clearly defined, investigations have revealed that Ucn acts through several kinase pathways, and modulates a group of genes which synergistically minimize mitochondrial damage. ⋯ Serum Ucn levels may be clinically useful to diagnose cases of mild sub-lethal ischemia, lacking elevation of cardiac enzymes and electrocardiogram changes. Infusion of Ucn may also help reduce the extent of the iatrogenic ischemic/reperfusion injury, associated with cardioplegic arrest.
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Left ventricular hypertrabeculation/noncompaction is mainly detected by echocardiography. Left ventricular hypertrabeculation/noncompaction is commonly associated with cardiac and extra-cardiac disorders, preferentially neuromuscular disorders. Left ventricular hypertrabeculation/noncompaction is mainly located within the left ventricular apex, lateral, posterior and anterior wall but only rarely in the medial and basal portions of the interventricular septum. Aim of the present review is to summarize the knowledge about septal affection in left ventricular hypertrabeculation/noncompaction. ⋯ Septal affection in left ventricular hypertrabeculation/noncompaction is a finding in predominantly children and adolescents. Septal left ventricular hypertrabeculation/noncompaction occurs more in females than in males. Patients with septal left ventricular hypertrabeculation/noncompaction have a poor prognosis. Septal left ventricular hypertrabeculation/noncompaction is most likely congenital. The association of septal left ventricular hypertrabeculation/noncompaction with extracardiac abnormalities and neuromuscular disorders remains unclear. Presumably left ventricular hypertrabeculation/noncompaction affecting the septum does not represent a cardiac manifestation of a neuromuscular disorder.
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Medical practice is moving fast towards non-invasive and non-surgical disease management. While significant progress has been made with coronary artery disease prevention, MDCT stands as an ideal non-invasive tool for its progression. ⋯ Although the main concern of current cardiology practice is the coronary stenotic disease, arterial wall calcification itself may significantly contribute to patients' symptoms. Thus, in addition to the beneficial use of MDCT in patients with mild to moderate risk for coronary disease, the unique information it provides on wall disease may assist the management of symptomatic patients with no flow-limiting lesions.
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The purpose of our study was to evaluate the results of endovascular treatment of symptomatic vertebro-basilar insufficiency (VBI) unresponsive to medical therapy. ⋯ Posterior fossa ischemia is an under-diagnosed condition that occurs with relative frequency in cardiac patients. Awareness of this condition and adequate non-invasive testing permits identification of these patients. Endovascular treatment using coronary wires and stents including drug eluting stents, seems to be the treatment of choice for vertebral artery revascularization due to the high technical success rate, low complication rate, and long-term durability.
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Acute pericarditis is often accompanied by some degree of myocarditis. In clinical practice both pericarditis and myocarditis coexist because they share common etiologic agents, mainly cardiotropic viruses. The term "myopericarditis" indicates a primarily "pericarditic syndrome" and it is responsible for the majority of cases. ⋯ The natural history of myopericarditis in large populations is not known with accuracy. On follow-up, the majority of these cases had objective normalization of echocardiography, electrocardiography, laboratory testing, and functional status, although up to 14% may report atypical, non-limiting chest discomfort. Unfortunately, few data have been published on myopericarditis, the paper reviews current available evidence on the presentation, management, and prognosis of myopericarditis.