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https://read.qxmd.com/read/30784685/leadless-pacemaker-implantation-in-hemodialysis-patients-experience-with-the-micra-transcatheter-pacemaker
#1
Mikhael F El-Chami, Nicolas Clementy, Christophe Garweg, Razali Omar, Gabor Z Duray, Charles C Gornick, Francisco Leyva, Venkata Sagi, Jonathan P Piccini, Kyoko Soejima, Kurt Stromberg, Paul R Roberts
OBJECTIVES: This study sought to report periprocedural outcomes and intermediate-term follow-up of hemodialysis patients undergoing Micra implantation. BACKGROUND: Leadless pacemakers may be preferred in patients with limited vascular access and high-infection risk, such as patients on hemodialysis. METHODS: Patients on hemodialysis at the time of Micra implantation attempt (n = 201 of 2,819; 7%) from the Micra Transcatheter Pacing Study investigational device exemption trial, Micra Transcatheter Pacing System Continued Access Study Protocol, and Micra Transcatheter Pacing System Post-Approval Registry were included in the analysis...
February 2019: JACC. Clinical Electrophysiology
https://read.qxmd.com/read/30702611/fulminant-type-1-diabetes-mellitus-two-case-reports
#2
Wei You, Jianming Yang, Yanqun Liu, Wen Wang, Li Zhu, Wei Wang, Jun Yang, Fangyuan Chen
RATIONALE: Fulminant type 1 diabetes mellitus (FT1DM) is a new subtype of type 1 diabetes mellitus that was first proposed by the Japanese scholar Imagawa in 2000. In the 2 patient cases described in this study, gastrointestinal symptoms were the first symptoms reported, and the initial blood glucose levels were very high. However, the glycosylated hemoglobin (HbA1c) levels were not very high, the islet β-cell function was almost completely lost in a short time, and the metabolic disorder was severe; the patients' islet β cells demonstrated complete and irreversible functional damage, and the prognosis was poor...
February 2019: Medicine (Baltimore)
https://read.qxmd.com/read/30693911/st-segment-elevation-myocardial-infarction-with-non-obstructive-coronary-arteries-in-a-patient-with-severe-diabetic-acidosis
#3
Renata Mazur, Małgorzata Buksińska-Lisik, Artur Mamcarz
Patients with severe diabetic acidosis may present varying electrocardiography (ECG) abnormalities including ST-segment elevation. The authors described a case of 70-year-old type 2 diabetic woman hospitalized due to ST elevation myocardial infarction and serious metabolic disorders. According to the clinical presentation, the ECG abnormalities and the significant rise in myocardial necrosis biomarkers the patient was diagnosed with myocardial infarction and received a typical pharmacological treatment. In the autopsy, no signs of myocardial infarction and no significant stenoses in the coronary arteries were found, while the features of acute upper gastrointestinal bleeding were observed...
December 28, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://read.qxmd.com/read/30343340/cystathionine-%C3%AE-lyase-expression-is-associated-with-mitochondrial-respiration-during-sepsis-induced-acute-kidney-injury-in-swine-with-atherosclerosis
#4
Tamara Merz, Martin Wepler, Benedikt Nußbaum, Josef Vogt, Enrico Calzia, Rui Wang, Csaba Szabo, Peter Radermacher, Oscar McCook
BACKGROUND: Sepsis is associated with disturbed glucose metabolism and reduced mitochondrial activity and biogenesis, ultimately leading to multiple organ dysfunction, e.g., acute kidney injury (AKI). Cystathionine-γ-lyase (CSE), the major cardiovascular source of endogenous H2 S release, is implicated in the regulation of glucose metabolism and mitochondrial activity through a PGC1α-dependent mechanism, and critical for kidney function. Atherosclerosis is associated with mitochondrial dysfunction and reduced CSE expression...
October 20, 2018: Intensive Care Medicine Experimental
https://read.qxmd.com/read/30333337/a-prospective-randomized-comparison-study-on-effect-of-perioperative-use-of-chloride-liberal-intravenous-fluids-versus-chloride-restricted-intravenous-fluids-on-postoperative-acute-kidney-injury-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting
#5
K Bhaskaran, Ganapathy Arumugam, P V Vinay Kumar
Context and Aims: Off-pump coronary artery bypass graft (OPCABG) is a form of CABG surgery. It is performed without the use of cardiopulmonary bypass machine as a surgical treatment for coronary heart disease. Acute kidney injury (AKI) is one of the common postoperative complications of OPCABG. Previous studies suggest important differences related to intravenous fluid (IVF) chloride content and renal function. We hypothesize that perioperative use of chloride restricted IVFs may decrease incidence and severity of postoperative AKI in patients undergoing OPCABG...
October 2018: Annals of Cardiac Anaesthesia
https://read.qxmd.com/read/30014631/-influence-of-acidosis-on-electrophysiological-characteristics-of-cortical-gabaergic-neurons-in-mice
#6
Li Huang, Chun Wang, Yan Li, Shi-Di Zhao
OBJECTIVE: To investigate the influences of extracellular acidosis on spike encoding and synaptic transmission of cortical GABAergic neurons in mice. METHODS: Twenty mice aged 27-30 d mice were selected to prepare coronary cortical slices and then divided into control group and extracellular acidosis group. In control group,the coronal slices were perfused with artificial cerebrospinal fluid at pH7.4,the action potential threshold potential,absolute refractory period and action potential peak spacing were recorded with the patch-clamp all-cell current clamp mode; the spontaneous excitatory postsynaptic current was recorded with the voltage clamp mode extracellular acidosis group,the artificial cerebrospinal fluid was adjusted at pH6...
May 2018: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://read.qxmd.com/read/29957756/is-it-necessary-to-discontinue-metformin-in-diabetic-patients-with-gfr-60-ml-min-per-1-73-m2-undergoing-coronary-angiography-a-controversy-still-exists
#7
Mohammad Hasan Namazi, Saeed AlipourParsa, Kobra Roohigilani, Morteza Safi, Hossein Vakili, Isa Khaheshi, Fatemeh Abdi, Adel Zare, Shooka Esmaeeli
BACKGROUND: Although metformin is not directly nephrotoxic, it has been postulated that it can impair gluconeogenesis from lactate, which may lead lactate to be accumulated under circumstances such as contrast-induced nephropathy. The present study aims to assess the role of metformin in lactate production in a group of diabetic patients with GFR > 60 ml/min per 1.73 m2undergoing coronary angiography. METHODS: In the present randomized clinical trial, 162 metformin-treated diabetic patients were enrolled...
June 7, 2018: Acta Bio-medica: Atenei Parmensis
https://read.qxmd.com/read/29873642/-lung-and-heart-interaction-chronic-obstructive-pulmonary-disease-and-ischemic-heart-disease
#8
REVIEW
Sara Roversi, Leonardo M Fabbri
The interaction between the lung and the heart is a vast, complex, and fascinating topic and, from a clinical point of view, disorders of the one often influence and promote disorders of the other. This is especially true for chronic diseases, with chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD) representing a classic example. Epidemiologic data indicate that cardiovascular diseases are frequent in patients with COPD, and vice versa. Accordingly, rates of IHD in COPD vary from 4% up to 60%, while, on the other hand, COPD has been reported in up to 30% of patients with coronary artery disease...
March 2018: Giornale Italiano di Cardiologia
https://read.qxmd.com/read/29861560/mortality-and-low-serum-bicarbonate-level-in-patients-on-hemodiafiltration-versus-peritoneal-dialysis
#9
V D Raikou, D Kyriaki
Mortality is substantially elevated in patients on chronic kidney disease in comparison to general population. In this study, we observed the mortality rate in relation to risk factors including low serum bicarbonate level, coronary artery disease (CAD), and dialysis modality in patients on dialysis during a median follow-up time of 60 months. We studied 96 dialysis patients, 62 males and 34 females, on mean age 62.1 ± 14.27 years old. The treatment modalities which were applied were predilution hemodiafiltration (HDF, n = 76), and peritoneal dialysis (PD, n = 20)...
March 2018: Indian Journal of Nephrology
https://read.qxmd.com/read/29850272/unique-ecg-findings-in-acute-pulmonary-embolism-ste-with-reciprocal-changes-and-pathologic-q-wave
#10
Amanda Grant-Orser, Brennan Ballantyne, Wael Haddara
A 68-year-old male presented to the emergency department with retrosternal chest pain, presyncope, and then a pulseless electrical activity cardiac arrest. An ECG prior to his arrest revealed ST elevations in leads V1-V3, Q waves in lead V2, and reciprocal ST depressions in the lateral and inferior leads. He received thrombolytic therapy for a presumptive diagnosis of ST elevation myocardial infarction. Return of spontaneous circulation was achieved and he underwent a coronary angiogram. No critical disease was found and his left ventriculogram showed normal contraction...
2018: Case Reports in Critical Care
https://read.qxmd.com/read/29478240/cardioprotection-by-metformin-beneficial-effects-beyond-glucose-reduction
#11
REVIEW
Leon Varjabedian, Mohammad Bourji, Leili Pourafkari, Nader D Nader
Metformin is a biguanide that is widely used as an insulin-sparing agent to treat diabetes. When compared with the general population, diabetics are twice as likely to die from fatal myocardial infarction and congestive heart failure (CHF). There has been a significant concern regarding the use of metformin in patients with CHF because of their higher tendency to develop lactic acidosis. However, large epidemiological trials have reported better cardiovascular prognosis with metformin compared to other glucose-lowering agents among diabetics...
June 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://read.qxmd.com/read/29381986/st-segment-elevation-associated-with-hydrochloric-acid-ingestion-a-case-report
#12
I-Jeng Yeh, Kuan-Ting Liu
RATIONALE: Electrocardiography (ECG) was used to diagnose acute coronary syndrome, but many other diseases may also result in ST segment change. We report one case of ingested hydrochloric acid present with ST segment elevation in the ECG. However, subsequent coronary angiography did not reveal significant coronary occlusion. PATIENT CONCERNS: An 83-year-old female was transferred to our emergency department (ED) from the branch hospital due to ingestion of toilet bowl cleaner containing 9...
November 2017: Medicine (Baltimore)
https://read.qxmd.com/read/29169212/complications-of-co-2-insufflation-during-endoscopic-vein-harvesting
#13
REVIEW
Alejandro Suarez-Pierre, Yusuke Terasaki, J Trent Magruder, Anubhav Kapoor, Michael C Grant, Jennifer S Lawton
Over the past few decades, the use of endoscopic harvest of the saphenous vein has gained popularity due to a significant reduction in rates of wound infection and improved cosmesis. The widespread adoption of this technique has introduced a set of complications associated with the use CO2 insufflation which facilitates exposure during the vein harvest. We describe a case of pneumoperitoneum with systemic acidosis and subcutaneous air following endoscopic vein harvest for coronary artery bypass grafting and review the complications that may arise from CO2 insufflation during endoscopic vein harvesting...
December 2017: Journal of Cardiac Surgery
https://read.qxmd.com/read/29168157/perioperative-implications-of-sodium-glucose-cotransporter-2-inhibitors-a-case-series-of-euglycemic-diabetic-ketoacidosis-in-three-patients-after-cardiac-surgery
#14
Aaron Lau, Simon Bruce, Erica Wang, Ron Ree, Kevin Rondi, Anthony Chau
PURPOSE: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) comprise the newest class of oral hypoglycemic agents approved for treating type II diabetes mellitus (DM-II). Their use, however, has been associated with the rare development of euglycemic diabetic ketoacidosis (euDKA). We present three cases of euDKA that occurred following elective coronary artery bypass grafting surgery. The role of the anesthesiologist in the prevention, diagnosis, and management of this complication is also discussed...
February 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://read.qxmd.com/read/29111980/impact-of-continuation-of-metformin-prior-to-elective-coronary-angiography-on-acute-contrast-nephropathy-in-patients-with-normal-or-mildly-impaired-renal-functions
#15
Veysel Oktay, İlknur Calpar Çıralı, Ümit Yaşar Sinan, Ahmet Yıldız, Murat Kazım Ersanlı
OBJECTIVE: Discontinuation of metformin treatment in patients scheduled for elective coronary angiography (CAG) is controversial because of post-procedural risks including acute contrast-induced nephropathy (CIN) and lactic acidosis (LA). This study aims to discuss the safety of continuing metformin treatment in patients undergoing elective CAG with normal or mildly impaired renal functions. METHODS: Our study was designed as a single-centered, randomized, and observational study including 268 patients undergoing elective CAG with an estimated glomerular filtration rate of >60 mL/min/1...
November 2017: Anatolian Journal of Cardiology
https://read.qxmd.com/read/28933414/association-between-low-serum-bicarbonate-concentrations-and-cardiovascular-disease-in-patients-in-the-end-stage-of-renal-disease
#16
Vaia D Raikou, Despina Kyriaki
BACKGROUND: Metabolic acidosis, a common condition particularly in the end-stage of renal disease patients, results in malnutrition, inflammation and oxidative stress. In this study, we focused on the association between low serum bicarbonate and cardiovascular disease in patients on intermittent dialysis. METHODS: We studied 52 on-line-pre-dilution hemodiafiltration (on-l HDF) patients, 32 males and 20 females, with a mean age of 58.01 ± 15.4 years old. Metabolic acidosis was determined by serum bicarbonate concentrations less than 22 mmol/L...
November 15, 2016: Diseases (Basel)
https://read.qxmd.com/read/28835362/association-between-acidosis-soon-after-reperfusion-and-contrast-induced-nephropathy-in-patients-with-a-first-time-st-segment-elevation-myocardial-infarction
#17
Masaomi Gohbara, Azusa Hayakawa, Yusuke Akazawa, Shuta Furihata, Ai Kondo, Yusuke Fukushima, Sakie Tomari, Tsutomu Endo, Kazuo Kimura, Kouichi Tamura
BACKGROUND: Contrast-induced nephropathy (CIN) is associated with poor outcomes in patients with acute myocardial infarction. However, the predictors of CIN have yet to be fully elucidated. METHODS AND RESULTS: The study included 273 consecutive patients with a first-time ST-segment elevation myocardial infarction who underwent reperfusion within 12 hours of symptom onset. The exclusion criteria were hemodialysis, mechanical ventilation, or previous coronary artery bypass grafting...
August 23, 2017: Journal of the American Heart Association
https://read.qxmd.com/read/28814195/change-of-plasmalogen-content-of-red-blood-cells-in-myocardial-hypoxia-and-acidosis
#18
Alexander Nikolaevich Osipenko
BACKGROUND: The contribution of hypoxic conditions to the chemical composition of membranes is not completely established. Plasmalogens, containing an alkenyl group with aldehydogenic ether linkage, are significant components of membrane lipids and their level can change in oxygen deficiency. METHODS: Analysis of plasmalogens in red blood cells was performed in patients (n = 17) with coronary heart disease, stable angina (functional class II-III) and coronary atherosclerosis...
February 2018: Acta Cardiologica
https://read.qxmd.com/read/28798316/the-proton-sensing-g-protein-coupled-receptor-t-cell-death-associated-gene-8-tdag8-shows-cardioprotective-effects-against-myocardial-infarction
#19
Akiomi Nagasaka, Chihiro Mogi, Hiroki Ono, Toshihide Nishi, Yuma Horii, Yuki Ohba, Koichi Sato, Michio Nakaya, Fumikazu Okajima, Hitoshi Kurose
Myocardial infarction (MI) is an ischaemic heart condition caused by the occlusion of coronary arteries. Following MI, lactic acid from anaerobic glycolysis increases and infiltrating immune cells produce severe inflammation, which leads to acidosis in the ischaemic heart. However, the physiological implication of this pH reduction remains largely unknown. T-cell death-associated gene 8 (TDAG8) is a proton-sensing G protein-coupled receptor found on cardiac macrophages that recognise increases in extracellular protons...
August 10, 2017: Scientific Reports
https://read.qxmd.com/read/28612026/postoperative-compensatory-ammonium-excretion-subsequent-to-systemic-acidosis-in-cardiac-patients
#20
Friederike Roehrborn, Daniel-Sebastian Dohle, Indra N Waack, Konstantinos Tsagakis, Heinz Jakob, Johanna K Teloh
BACKGROUND: Postoperative acid-base imbalances, usually acidosis, frequently occur after cardiac surgery. In most cases, the human body, not suffering from any severe preexisting illnesses regarding lung, liver, and kidney, is capable of transient compensation and final correction. The aim of this study was to correlate the appearance of postoperatively occurring acidosis with renal ammonium excretion. MATERIALS AND METHODS: Between 07/2014 and 10/2014, a total of 25 consecutive patients scheduled for elective isolated coronary artery bypass grafting with cardiopulmonary bypass were enrolled in this prospective observational study...
2017: BioMed Research International
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