Julia Anna Palfy

Parathormone levels are independently associated with the presence of left ventricular hypertrophy in patients with coronary artery disease

BackgroundAbnormalities of mineral metabolism and inflammation may affect the cardiovascular system. We have assessed the relationship of left ventricular hypertrophy (LVH) with inflammation and mineral metabolism.MethodsLVH was measured in 146 outpatients with stable coronary artery disease (SCAD) using echocardiography. Calcidiol (a vitamin D metabolite), parathyroid hormone (PTH), fibroblast growth factor-23, high-sensitivity C-reactive protein, MCP-1 (monocyte chemoattractant protein-1), galectin-3, NGAL (neutrophil gelatinase-associated lipocalin), and sTWEAK (soluble TNF-related weak inducer of apoptosis) plasma levels were studied.ResultsLVH, defined as septal thickness ≥11 mm, was present in 19.9% of cases. These patients were older [75.0 (61.0-81.0) vs 64.0 (51.0-76.0) years; p=0.002], had higher prevalence of left ventricular ejection fraction (LVEF)>40%, and had higher PTH [84.7 (59.6-104.7) vs 63.2 (49.2-85.2) pg/ml; p=0.007], galectin-3 [9.6 (8.0-11.1) vs 8.3 (6.9-9.9) ng/ml; p=0.037], and NGAL (208.5±87.6 vs 173.9±73.4 ng/ml; p=0.031) plasma levels than those without LVH. Glomerular filtration rate was lower in patients with LVH than in those without it (65.1±20.0 vs 74.7±19.9 mL/min/1.73 m2; p=0.021). There were no significant differences in hypertension (79.3 vs 68.4%; p=0.363) or sex between both groups. Variables showing differences based on univariate analysis and hypertension were entered into a logistic regression analysis. Only age [odds ratio (OR) =1.052 (1.011-1.096); p=0.013], PTH plasma levels [OR=1.017 (1.003-1.031); p=0.021], and LVEF>40% [OR=7.595 (1.463-39.429); p=0.016] were independent predictors of LVH.ConclusionsIn patients with SCAD, elevated PTH levels are independently associated with the presence of LVH. Further studies are needed to elucidate the role of PTH in the development of myocardial hypertrophy.

CorVue algorithm efficacy to predict heart failure in real life: Unnecessary and potentially misleading information?

Heart failure (HF) hospitalizations have a negative impact on quality of life and imply important costs. Intrathoracic impedance (ITI) variations detected by cardiac devices have been hypothesized to predict HF hospitalizations. Although Optivol™ algorithm (Medtronic, Minneapolis, MN, USA) has been widely studied, CorVue™ algorithms (St. Jude Medical, St. Paul, MN, USA) long‐term efficacy has not been systematically evaluated in a “real‐life” cohort.

Comparison of pharmacological treatment alone vs. treatment combined with implantable cardioverter defibrillator therapy in patients older than 75 years: Pharmacological treatment alone vs. treatment with ICD therapy

Implantable cardioverter defibrillator (ICD) reduces mortality in selected patients. However, its role in patients older than 75 years is not well established.

Successful Treatment of Compression of an Anomalous Circumflex Artery After Aortic Valve Replacement With Percutaneous Coronary Intervention

A 74-year-old woman was admitted to the intensive care unit with acute pulmonary edema requiring endotracheal intubation. The presence of an unknown critical aortic stenosis was revealed with markedly calcified mitral annulus and preserved left ventricular ejection fraction. Because the patient

COMPARISON OF OPTIMAL PHARMACOLOGICAL TREATMENT ALONE AND COMBINED WITH CARDIAC RESYNCHRONIZATION THERAPY IN PATIENTS OVER 75 YEARS

Cardiac Resynchronization Therapy (CRT) in patients with heart failure (HF) and a widened QRS complex improves clinical outcomes and reduces mortality in selected patients. Its role in patients aged ≥75 years, is not well established. From January 2008 to April 2012 we have recruited

Pure Right Ventricular Infarction Resulting from Coronary Ectasia: Importance of Diagnostic Imaging

Isolated right ventricular (RV) infarction may occur during percutaneous coronary intervention resulting from selective occlusion of a ventricular branch of the right coronary artery (RCA). We present a case of a pure RV infarction without iatrogenic origin that at the initial electrocardiographic analysis was suggestive of a left anterior descending artery-related acute myocardial infarction. Coronary angiography results made us suspect thrombotic occlusion of a small branch of the ectatic RCA resulting from slow flow. Final diagnosis was confirmed by coronary computed tomographic angiography and cardiac magnetic resonance imaging, underlining the essential diagnostic role of these imaging modalities.