Kardiol Pol
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Randomized Controlled Trial
Oral versus intravenous hydration and renal function in diabetic patients undergoing percutaneous coronary interventions.
Contrast-induced nephropathy (CIN) is a serious complication of percutenous coronary interventions (PCI). Proper hydration reduces the risk of PCI. Wheter oral hydration is as effective as intravenous one has not been well established. ⋯ Our study demonstrates that the oral hydration with mineral water and intravenous hydration with 0.9% NaCl have similar effects on renal function in diabetic patients undergoing coronary angiography and angioplasty.
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Randomized Controlled Trial
Variability of aortic blood flow predicts fluid responsiveness in spontaneously breathing healthy volunteers.
Assessment of fluid responsiveness is an important topic in acute cardiology. Echocardiographic measurement of respiratory variations of aortic blood velocity in ventilated shock patients can accurately predict the effect of volume expansion. On the other hand, it remains unclear whether this respiratory variability is a common physiological reaction to hypovolaemia and whether its measurement is applicable also in spontaneously breathing patients. ⋯ DVpeakao and DVTIao reflect preload-dependent changes of CI in healthy spontaneously breathing volunteers and predict fluid responsiveness.
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Randomized Controlled Trial
Right ventricular apex versus right ventricular outflow tract pacing: prospective, randomised, long-term clinical and echocardiographic evaluation.
In patients treated with permanent pacing, the electrode is typically placed in the right ventricular apex (RVA). Published data indicate that such electrode placement leads to an unfavourable ventricular depolarization pattern, while right ventricular outflow tract (RVOT) pacing seems to be more physiological. ⋯ In patients with normal LV function permanent RVA pacing leads to LV systolic and diastolic function deterioration. RVOT pacing can reduce the unfavourable effect and can slow down cardiac remodelling caused by permanent RV pacing. Clinical and echocardiographic benefits observed in the RVOT group after 7 years of pacing are reflected by lower NT-proBNP levels in this group of patients.
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Randomized Controlled Trial
Is transport with platelet GP IIb/IIIa inhibition for primary percutaneous coronary intervention more efficient than on-site thrombolysis in patients with STEMI admitted to community hospitals? Randomised study. Early results.
The advantage of primary percutaneous coronary intervention (pPCI) in the management of ST-elevation myocardial infarction (STEMI) over thrombolytic therapy has been demonstrated. However, an optimal medical treatment of STEMI patients admitted to regional hospitals without catheterisation facilities has not yet been established. Delay in initiation of pPCI resulting from transportation to the catheterisation laboratory may diminish the benefits of such therapy in comparison with thrombolysis administered in a regional hospital. Early initiation of therapy with platelet glycoprotein IIb/IIIa receptor inhibitor, which provides protection for the transportation, may be a reasonable solution to maintain the advantage of pPCI over thrombolysis alone in STEMI patients. ⋯ A strategy of invasive therapy involving transport with GP IIb/IIIa receptor inhibitor and pPCI in STEMI patients admitted to hospital without catheterisation facilities was found to be more effective than thrombolytic therapy alone employed in the regional hospitals.
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Randomized Controlled Trial Clinical Trial
Effect of leukocyte-depleted blood cardioplegia on the early outcome in patients with preserved left ventricular function undergoing surgical revascularisation.
It has been shown that leukocytes play one of the key roles in the myocardial reperfusion injury. ⋯ The use of leukocyte-depleted blood cardioplegia during elective CABG did not improve the early outcome.