Volume 2 Issue 1
Research Article: The Clinical Short-Term Outcome of Intravenous Levosimendan In Patients With Acute ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Jiang Y. Wang*, Xi Su, Xiang-ming Wu, Chen W. Liu, Chen YiXu, Zhi P. Zhang, Dan Song, Jian Peng, Hua Yan
Background and Objectives: The goal of this study was to evaluate the effects of intravenous levosimendan (Levo) in patients with acute ST Segment Elevation Myocardial Infarction (STEMI) undergoing Primary Percutaneous Coronary Intervention (PPCI).
Subjects and Methods: This was a randomized, single-center, single-blind study that included 92 patients. Patients were randomly divided into 2groups: 1 received levosimend an (n =48) and the other received placebo (n = 44). Echocardiography was executed and plasma N-terminal pro brain natriuretic peptide (NT-pro-BNP) levels were measured just prior to intravenous levosimendan treatment and 30th days after intravenous levosimendan treatment. The main end point was a 30-day incidence of major adverse cardiac events (MACE; death, myocardial infarction, or target vessel revascularization).
Result: Major adverse cardiac events occurred in 12.8% of patients in the Levo group and 20.62% of those in the control group. NT-pro-BNP of the two groups were decreased 30th days after intravenous levosimendan treatment, however, NT-pro-BNP in the Levo group were significantly lower than those in the control group (P<0.05).Cardiac function in STEMI patients, as reflected by the increased LVEF, FS as well as decreased LVEDd (P<0.05) in all groups at 30 days after intravenous levosimendan treatment, but cardiac function parameters were more obviously improved in the group administered with levosimendan(p<0.05).
Conclusion: Levosimendan can significantly improve the myocardium function of patients with STEMI undergoing PPCI.
Keywords: Levosimendan; Percutaneous Coronary Intervention; NT-pro-BNP; Cardiac Function.
Cite this Article: Wang JY, Su X, Xiang-ming Wu, Liu CW, YiXu C, et al. The Clinical Short-Term Outcome of Intravenous Levosimendan In Patients With Acute ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Int J Cardiovasc Dis Diagn. 2017;2(1): 015-019.
Published: 09 June 2017
Case Report: Intracoronary Imaging Isolates Type 3 Spontaneous Coronary Artery Dissection of the Left Main
Naddi Marah*, Muhammad Khan and Kumudha Ramasubbu
Spontaneous Coronary Artery Dissection (SCAD) is an often under diagnosed condition given its spectrum of clinical presentation, thus posing a significant diagnostic dilemma for clinicians. Pathologically, it occurs as a consequence of non-traumatic, non-iatrogenic separation of arterial walls, creating a false lumen with intramural hematoma (IMH) formation, which may compromise anterograde blood flow and cause ischemia . First defined in 1931 via a post-mortem study, and arbitrarily labeled as a predominantly idiopathic condition, the recent advent and utilization of intracoronary imaging has increased the diagnostic yield of SCAD, highlighted multiple associated predisposing risk factors, and defined the disease subtypes.
Cite this Article: Marah N, Khan M, Ramasubbu K. Intracoronary Imaging Isolates Type 3 Spontaneous Coronary Artery Dissection of the Left Main. Int J Cardiovasc Dis Diagn. 2017;2(1): 011-014.
Published: 02 June 2017
Case Report: A Novel Treatment Strategy in the Setting of Heart Block or Cardiac Arrest Secondly to Coronary Artery Spasm
Jiang Y. Wang*, Xi Su, Chen W. Liu, Chen YiXu, Zhi P. Zhang, Dan Song, Jian Peng, Hua Yan
Coronary artery vasospasm is not yet completely clarified. CAS can lead to sudden cardiac death due to ventricular Coronary Artery Spasm (CAS) is not an uncommon event, but its pathophysiologic mechanisms followed by arrhythmias or heart block. Diltiazem is a core of drugs for the treatment of CAS, but in the setting of heart block or cardiac arrest, administration of the diltiazem may be associated with aggravated heart block or cardiogenic shock. We report a 78-year-oldman who had a complete atrioventricular block with ST-segment elevation and a witnessed cardiac arrest with ventricular tachycardia / ventricular fibrillation, which could not be controlled effectively by defibrillations and positive inotropic action drugs. Emergency coronary angiography revealed that the right coronary artery systems diffuse spasm. We timely adjusted the treatment strategy, and the ventricular tachycardia was successfully terminated by administration of intravenous diltiazem.
Cite this Article: Su X, Wang JY, Liu CW, YiXu C, Zhang ZP, et al. A Novel Treatment Strategy in the Setting of Heart Block or Cardiac Arrest Secondly to Coronary Artery Spasm. Int J Cardiovasc Dis Diagn. 2017;2(1): 008-010.
Published: 16 May 2017
Case Report: Multiple Organ Embolism Secondary to Heparin-Induced Thrombocytopenia after Intra-Aortic Balloon Pump Insertion
Jiang Y. Wang, Xi Su*, Chen W. Liu, Chen YiXu, Zhi P. Zhang Dan Song, JianPeng and Hua Yan
Heparin-Induced Thrombocytopenia (HIT) is a highly prothrombotic disorder mediated by strong platelet-activating antibodies against multi molecular complexes of platelet factor4 and heparin, leading to consumptive thrombocytopenia and potentially devastating thromboembolic complications. Three alternative anticoagulants have been approved for the treatment of HIT: lepirudin, argatroban, and danaparoidsodium. We present a case of multiple organ embolism secondary to heparin-induced thrombocytopenia after IABP insertion in a cardiac shock secondary to acute myocardial infarction and our first experience with the use of a novel oral anticoagulant, rivaroxaban, to treat a case of HIT-associated thrombosis after IABP insertion.
Cite this Article: Su X, Wang JY, Liu CW, YiXu C, Zhang ZP, et al. Acute Myocardial Infarction could Induce Aortic Dissection. Int J Cardiovasc Dis Diagn. 2017;2(1): 004-007.
Published: 02 May 2017
Jiang Y. Wang, Xi Su*, Chen W. Liu, Chen YiXu, Zhi P. Zhang, Dan Song, Jian Peng and Hua Yan
A 52-year-old man with a medical history of hypertension presented to the emergency department with persistent chest pain of 6hours' duration. Electrocardiography performed on arrival revealed anterior ST elevation. He was referred to the cardiac catheterization laboratory for Primary Percutaneous Coronary Intervention (PPCI). The coronary angiogram revealed total proximal Left Anterior Descending Artery (LAD) occlusion. The LAD stenosis was successfully treated with a drug-eluting stent. He experienced extreme thoraco abdominal pain within six hours after PPCI. Thoracoabdominalaortic Computed Tomography Angiography (CTA) was performed to rule out an aortic dissection. Eventually, the patient was successfully treated with endovascular graft exclusion.
Cite this Article: Su X, Wang JY, Liu CW, YiXu C, Zhang ZP, et al. Acute Myocardial Infarction could Induce Aortic Dissection. Int J Cardiovasc Dis Diagn. 2017;2(1): 001-003.
Published: 29 April 2017
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