Objectives The goal of this study was to compare transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) for the diagnosis of cardiac device–related endocarditis (CDI). ...Background The diagnosis of infective endocarditis (IE) was established by using the modified Duke criteria based mainly on echocardiography and blood culture results. No previous studies have compared ICE with TEE for the diagnosis of IE. Methods We prospectively enrolled 162 patients (age 72 ± 11 years; 125 male) who underwent transvenous lead extraction: 152 with CDI and 10 with lead malfunction (control group). Using the modified Duke criteria, we divided the patients with infection into 3 groups: 44 with a “definite” diagnosis of IE (group 1), 52 with a “possible” diagnosis of IE (group 2), and 56 with a “rejected” diagnosis of IE (group 3). TEE and ICE were performed before the procedure. Results In group 1, ICE identified intracardiac masses (ICM) in all 44 patients; TEE identified ICM in 32 patients (73%). In group 2, 6 patients (11%) had ICE and TEE both positive for ICM, 8 patients (15%) had a negative TEE but a positive ICE, and 38 patients (73%) had ICE and TEE both negative. In group 3, 2 patients (3%) had ICM both at ICE and TEE, 1 patient (2%) had an ICM at ICE and a negative TEE, and 53 patients (95%) had no ICM at ICE and TEE. ICE and TEE were both negative in the control group. Conclusions ICE represents a useful technique for the diagnosis of ICM, thus providing improved imaging of right-sided leads and increasing the diagnostic yield compared with TEE.
Objective To evaluate the preoperative presence of C-reactive protein (CRP) and troponin T(hs-TnT) in patients with coronary artery disease (CAD) undergoing cardiopulmonary bypass (CPB) in order to ...better clarify the role of atrial inflammation and/or myocardial ischemia in the development of postoperative atrial fibrillation (POAF). Design Prospective, nonrandomized study. Setting University hospital. Participants Thirty-eight consecutive ischemic patients admitted to the authors’ hospital for CAD undergoing elective on-pump coronary artery bypass grafting (CABG). Intervention Elective on-pump CABG. Measurements and Main Results Peripheral blood samples were collected from all patients before and 24 hours after CABG to assess high sensitive (hs)-CRP and troponin T (hs-TnT) levels. The patients’ heart rhythm was monitored by continuous ECG telemetry. Biopsies from the right atrial appendage were obtained at the beginning of the CABG procedure in order to perform immunohistochemistry for CRP and reverse transcription polymerase chain reaction for CRP mRNA expression. Fourteen patients out of 38 (36%) developed POAF. Atrial CRP was found in 31 patients (82%), 10 with POAF and 21 with sinus rhythm (71% v 87% respectively, p = ns). None of the atrial samples was positive for CRP mRNA. Atrial CRP did not correlate with serum hs-CRP levels and with occurrence of POAF, but with the incidence of diabetes (p = 0.010). Postoperative hs-TnT levels, but not hs-CRP levels, were identified as the only predictor of POAF occurrence (p = 0.016). Conclusions In patients undergoing CABG, neither peripheral nor tissue preoperative CRP levels, but only postoperative hs-TnT levels, correlated with POAF, suggesting the primary role of an ischemic trigger of atrial fibrillation.
Intracoronary injection of bone marrow stem cells seems to improve left ventricular (LV) function after acute myocardial infarction (AMI). Granulocyte colony-stimulating factor (G-CSF) could improve ...myocardial function and perfusion noninvasively through mobilization of stem cells into peripheral blood, although previous clinical trials have produced controversial results. Forty-one patients with large anterior wall AMI at high risk of unfavorable remodeling were randomized 1:2 to G-CSF (10 μg/kg/day for 5 days) or to conventional therapy. All patients underwent successful primary or rescue percutaneous coronary intervention. LV function was assessed by echocardiography before G-CSF administration, ≥5 days after AMI, and at follow-up. Only patients with a LV ejection fraction <50% at baseline were enrolled in the study. After a median follow-up of 5 months (range 4 to 6) patients treated with G-CSF exhibited improvement in LV ejection fraction, from 40 ± 6% to 45 ± 6% (p = 0.068) in the absence of LV dilation (LV end-diastolic volume from 147 ± 33 to 144 ± 46 ml at follow-up, p = 0.77). In contrast, patients treated conventionally exhibited significant LV dilation (LV end-diastolic volume from 141 ± 35 to 168 ± 41 ml, p = 0.002) in the absence of change in LV ejection fraction (from 38 ± 6% to 38 ± 8%, p = 0.95). However, when comparing patients treated with G-CSF with controls, variations in these parameters were significantly different at 2-way analysis of variance (p = 0.04 for LV end-diastolic volume, p = 0.02 for LV ejection fraction). In conclusion, G-CSF prevents unfavorable LV remodeling and improves LV function in patients with large anterior wall AMI and decreased LV ejection fraction after successful percutaneous coronary intervention.
Ethanol Abolishes Ischemic Preconditioning in Humans Niccoli, Giampaolo, MD, PhD; Altamura, Luca, MD; Fabretti, Alessandro, MD ...
Journal of the American College of Cardiology,
01/2008, Letnik:
51, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Ethanol Abolishes Ischemic Preconditioning in Humans Giampaolo Niccoli, Luca Altamura, Alessandro Fabretti, Gaetano A. Lanza, Luigi M. Biasucci, Antonio G. Rebuzzi, Antonio Maria Leone, Italo Porto, ...Francesco Burzotta, Carlo Trani, Filippo Crea Ischemic preconditioning (IPC) is the most potent form of endogenous myocardial protection from irreversible ischemic injury. Experimental observations suggest that acute ethanol administration might abolish IPC. We randomized 30 patients to oral gin or water before angioplasty to assess the effect of alcohol intake on IPC in humans. We evaluated ST-segment shift by intracoronary electrocardiogram during 2 sequential balloon inflations. We show that administration of a moderate dose of ethanol abolishes IPC occurring during sequential episodes of myocardial ischemia and is associated with worsening ischemia.
Background Postmortem and clinical studies have shown an early and prevalent involvement of the radiohumeral joint in primary and secondary arthritis of the elbow. The lateral resurfacing elbow (LRE) ...prosthesis has recently been developed for the treatment of lateral elbow arthritis. However, few data have been published on LRE results. Materials and methods A prospective multicenter study was designed to assess LRE preliminary results. There were 20 patients (average age, 55 years). Preoperative diagnosis were primary osteoarthritis in 11 and post-traumatic osteoarthritis in 9. All patients underwent open debridement and LRE prosthesis. Patients were evaluated preoperatively and postoperatively with the Mayo Elbow Performance Score (MEPS), modified American Shoulder Elbow Surgeons (m-ASES) elbow assessment, and the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH). Mean follow-up was 22.6 months. Results At the last follow-up, the mean improvement of MEPS and m-ASES was 35 ( P = .001) and 34 ( P = .001) respectively; the average Quick DASH decreased by 29 ( P = .001). Average range of motion was improved by 35° ( P = .001). MEPI results were excellent in 12 patients, good in 2, and fair and poor in 3 each. Mild overstuffing was observed in 5 patients, and an implant malpositioning in 3. The implant survival rate was 100%. Conclusion LRE showed promising results in this prospective investigation. Most patients had an uneventful postoperative course and have shown a painless elbow joint, with satisfactory functional recovery at short-term follow-up. Further studies with longer follow-up are warranted.
Measurements of inclusive jet production are performed in pp and Pb+Pb collisions at sNN=2.76 TeV with the ATLAS detector at the LHC, corresponding to integrated luminosities of 4.0 and 0.14 nb-1, ...respectively. The jets are identified with the anti-kt algorithm with R=0.4, and the spectra are measured over the kinematic range of jet transverse momentum 32<pT<500 GeV and absolute rapidity y<2.1 and as a function of collision centrality. The nuclear modification factor RAA is evaluated, and jets are found to be suppressed by approximately a factor of 2 in central collisions compared to pp collisions. The RAA shows a slight increase with pT and no significant variation with rapidity.
Dijet events produced in LHC proton-proton collisions at a center-of-mass energy radicals = 8 TeV are studied with the ATLAS detector using the full 2012 data set, with an integrated luminosity of ...20.3 fb super(-1). Dijet masses up to about 4.5 TeV are probed. No resonancelike features are observed in the dijet mass spectrum. Limits on the cross section times acceptance are set at the 95% credibility level for various hypotheses of new phenomena in terms of mass or energy scale, as appropriate. This analysis excludes excited quarks with a mass below 4.06 TeV, color-octet scalars with a mass below 2.70 TeV, heavy W' bosons with a mass below 2.45 TeV, chiral W* bosons with a mass below 1.75 TeV, and quantum black holes with six extra space-time dimensions with threshold mass below 5.66 TeV.
A search for the decay of neutral, weakly interacting, long-lived particles using data collected by the ATLAS detector at the LHC is presented. This analysis uses the full data set recorded in 2012: ...20.3 fb-1 of proton-proton collision data at s=8 TeV. The search employs techniques for reconstructing decay vertices of long-lived particles decaying to jets in the inner tracking detector and muon spectrometer. Signal events require at least two reconstructed vertices. No significant excess of events over the expected background is found, and limits as a function of proper lifetime are reported for the decay of the Higgs boson and other scalar bosons to long-lived particles and for Hidden Valley Z' and Stealth SUSY benchmark models. The first search results for displaced decays in Z' and Stealth SUSY models are presented. The upper bounds of the excluded proper lifetimes are the most stringent to date.
A
bstract
The factor of four increase in the LHC luminosity, from 0
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5
×
10
34
cm
−
2
s
−
1
to 2
.
0
×
10
34
cm
−
2
s
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, and the corresponding increase in pile-up collisions during the 2015–2018 ...data-taking period, presented a challenge for the ATLAS trigger, particularly for those algorithms that select events with missing transverse momentum. The output data rate at fixed threshold typically increases exponentially with the number of pile-up collisions, so the legacy algorithms from previous LHC data-taking periods had to be tuned and new approaches developed to maintain the high trigger efficiency achieved in earlier operations. A study of the trigger performance and comparisons with simulations show that these changes resulted in event selection efficiencies of
>
98% for this period, meeting and in some cases exceeding the performance of similar triggers in earlier run periods, while at the same time keeping the necessary bandwidth within acceptable limits.
Measuring longitudinally polarized vector boson scattering in
WW
channel is a promising way to investigate unitarity restoration with the Higgs mechanism and to search for possible physics beyond the ...Standard Model. In order to perform such a measurement, it is crucial to develop an efficient reconstruction of the full
W
boson kinematics in leptonic decays with the focus on polarization measurements. We investigated several approaches, from traditional ones up to advanced deep neural network structures, and we compared their abilities in reconstructing the
W
boson reference frame and in consequently measuring the longitudinal fraction
W
L
in both semi-leptonic and fully-leptonic
WW
decay channels.
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