scholarly journals The Defibrillation Conundrum: New Insights into the Mechanisms of Shock-Related Myocardial Injury Sustained from a Life-Saving Therapy

2021 ◽  
Vol 22 (9) ◽  
pp. 5003
Author(s):  
Nicolas Clementy ◽  
Alexandre Bodin ◽  
Arnaud Bisson ◽  
Ana-Paula Teixeira-Gomes ◽  
Sebastien Roger ◽  
...  
Keyword(s):  
Cardiac Death ◽  
Myocardial Stunning ◽  
Myocardial Injury ◽  
Cell Damage ◽  
New Methods ◽  
Electrical Therapy ◽  
Life Saving ◽  
Metabolic Remodeling ◽  
Electrical Shocks ◽  
Dose Response Effect

Implantable cardiac defibrillators (ICDs) are recommended to prevent the risk of sudden cardiac death. However, shocks are associated with an increased mortality with a dose response effect, and a strategy of reducing electrical therapy burden improves the prognosis of implanted patients. We review the mechanisms of defibrillation and its consequences, including cell damage, metabolic remodeling, calcium metabolism anomalies, and inflammatory and pro-fibrotic remodeling. Electrical shocks do save lives, but also promote myocardial stunning, heart failure, and pro-arrhythmic effects as seen in electrical storms. Limiting unnecessary implantations and therapies and proposing new methods of defibrillation in the future are recommended.

Life-saving myocarditis? A case in a young adult leading to discovery of an anomalous origin of the right coronary artery

2020 ◽  
Vol 30 (10) ◽  
pp. 1510-1511
Author(s):  
Rachel Rosenthal ◽  
Hannah Obasi ◽  
Daniel D. Im
Keyword(s):  
Chest Pain ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Cardiac Death ◽  
Anomalous Origin ◽  
Coronary Artery Anomalies ◽  
Life Saving ◽  
Life Threatening ◽  
The Right ◽  
Anomalous Coronary

AbstractMyocarditis and coronary artery anomalies are both potentially life-threatening aetiologies of cardiac chest pain in children. We present a case of a young man presenting with non-exertional chest pain and subsequently found to have an anomalous origin of the right coronary artery from the left coronary sinus with an interarterial course in addition to a diagnosis of myocarditis. The patient subsequently was able to undergo surgical correction of his anomalous coronary to mitigate the risk of sudden cardiac death.

scholarly journals CURRENT RECOMMENDATIONS ON RISK STRATIFICATION AND SUDDEN CARDIAC DEATH PREVENTION IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY (BASED ON THE 2011 RECOMMENDATIONS BY THE AMERICAN COLLEGE OF CARDIOLOGY / AMERICAN HEART ASSOCIATION)

2013 ◽  
Vol 12 (1) ◽  
pp. 73-79
Author(s):  
E. V. Privalova ◽  
V. Yu. Kaplunova ◽  
N. V. Khabarova ◽  
G. A. Shakaryants ◽  
Yu. N. Belenkov
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Sudden Cardiac Death ◽  
Risk Stratification ◽  
Cardiac Death ◽  
Therapeutic Strategy ◽  
Heart Association ◽  
Preventive Treatment ◽  
Risk Levels ◽  
Life Saving ◽  
Clinical Scenarios

One of the clinical scenarios of hypertrophic cardiomyopathy (HCMP) is sudden cardiac death (SCD). The stratification of SCD risk is the key component of defining the therapeutic strategy in HCMP patients. Timely preventive treatment is the only life-saving intervention in patients with high SCD risk. The available clinical evidence suggests that SCD risk stratification is an effective algorithm for determining the need for preventive treatment. The latter should be individualised, based on the risk levels in each patient. 

scholarly journals Cardiovascular Pathology in Patients With COVID-19

Kardiologiia ◽  
2020 ◽  
Vol 60 (8) ◽  
pp. 23-26
Author(s):  
E. K. Serezhina ◽  
A. G. Obrezan
Keyword(s):  
Heart Failure ◽  
Chest Pain ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Myocardial Injury ◽  
Heart Rhythm ◽  
Hospitalized Patients ◽  
Cardiovascular Pathology ◽  
Heart Rhythm Disorders ◽  
Coronavirus Infection

In the recent months of the COVID-19 pandemics, the cardiological society has faced a new challenge, myocardial injury by the coronavirus infection. According to statistics, 20-40% of hospitalized patients have chest pain, heart rhythm disorders, heart failure, and sudden cardiac death syndrome. This review focuses on recent studies and clinical cases related with this issue.

scholarly journals Thymoquinone dose-dependently attenuates myocardial injury induced by isoproterenol in rats via integrated modulation of oxidative stress, inflammation, apoptosis, autophagy and fibrosis

2021 ◽  
Author(s):  
Mahmoud Mohamed Farag ◽  
Asmaa Ahmed Khalifa ◽  
Wessam Fahmy El-Hadidy ◽  
Radwa Mohamed Rashad
Keyword(s):  
Oxidative Stress ◽  
Myocardial Injury ◽  
Cell Damage ◽  
Myocardial Infarct ◽  
Research Work ◽  
Radical Scavenging ◽  
Cardiac Biomarkers ◽  
Male Rats ◽  
Myocardial Infarct Size ◽  
Myocardial Oxidative Stress

Abstract As rats develop myocardial infarction (MI) like lesions when injected with large doses of isoproterenol (ISO), this investigation was designed to evaluate the effects of low and high doses of thymoquinone (TQ) on ISO-induced myocardial injury in rats. Adult male rats were divided into control, TQ20 (20 mg/kg/day), TQ50 (50 mg/kg/day), and ISO, TQ20 + ISO and TQ50 + ISO groups. In these rats, biochemical, immunobiochemical and histopathological studies were carried out to evaluate myocardial oxidative stress, inflammation, apoptosis, fibrosis and autophagy and serum cardiac biomarkers. The results showed that TQ pretreatment in ISO-administered rats produced a dose-dependent significant reduction of the myocardial infarct size, markedly reduced the ISO-induced elevation in serum cardiac markers and demonstrated several other important findings related to the cardioprotective efficacy of TQ. First, this study is the first reported research work showing that TQ treatment could increase the myocardial reduced glutathione baseline level, adding an indirect antioxidant effect to its known direct free radical scavenging effect. Second, pretreatment with TQ significantly reduced the markers of myocardial oxidative stress, inflammation, fibrosis and apoptosis. Third, TQ acted as an autophagy enhancer ameliorating myocardial cell damage and dysfunction. Thus, the changes associated with ISO-induced myocardial injury were ameliorated with TQ pretreatment. Additionally, the extent of observed improvement was significantly greater with the high TQ dose than with the low dose use. These findings raise the possibility that TQ may serve as a promising prophylactic cardioprotective therapy for patients who are at risk of developing myocardial injury as in cases of MI.

Comparison of the Effects of Levosimendan Dobutamine and Vasodilator Therapy on Ongoing Myocardial Injury in Acute Decompensated Heart Failure

2016 ◽  
Vol 22 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Erkan Gencer ◽  
Volkan Doğan ◽  
Müjgan Tek Öztürk ◽  
Aydın Nadir ◽  
Ahmet Musmul ◽  
...  
Keyword(s):  
Heart Failure ◽  
Myocardial Injury ◽  
Cell Damage ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Systolic Pulmonary Artery Pressure ◽  
Short Term ◽  
Ventricular Ejection Fraction

Background: Cardiac troponins (cTn) are reliable and the most sensitive biomarker in the setting of acute decompensated heart failure (ADHF). Acute decompensated heart failure is usually associated with worsening chronic heart failure, and it may be caused by ongoing minor myocardial cell damage that may occur without any reported precipitating factors. Methods: We compared the short-term effect of levosimendan (LEV), dobutamine (DOB), and vasodilator treatment (nitroglycerin [NTG]) on myocardial injury with hemodynamic, neurohumoral, and inflammatory indicators. One hundred twenty-two patients with a mean age of 66 ± 9 years were treated with LEV (n = 40), DOB (n = 42), and NTG (n = 40) and examined retrospectively. Blood samples (cTnI, N-terminal probrain natriuretic peptide [NT-proBNP], highly sensitive C-reactive protein [HsCRP], and others), left ventricular ejection fraction (LVEF), systolic pulmonary artery pressure (sPAP), and 6-minute walk distance (6MWD) were compared before and after treatment. Results: At admission, detectable levels of cTnI were observed in 53% of patients (≥0.05 ng/mL). Serial changes in the mean cTnI levels were not significantly different between the groups (LEV 0.04 ± 0.01 to 0.03 ± 0.01 ng/mL; DOB 0.145 ± 0.08 to 0.08 ± 0.03 ng/mL; NTG 0.1 ± 0.03 to 0.09 ± 0.02 ng/mL; overall P = .859). Favourable effects on the NT-proBNP, sPAP values, LVEF, 6MWD, and HsCRP were observed overall, especially in the LEV groups. Conclusion: Beneficial effects of short-term use of LEV, DOB, and NTG on ongoing myocardial injury were demonstrated. These findings can be attributed to the anti-ischemic properties as well as the hemodynamic, neurohumoral, and functional benefits from the positive inotropes, especially LEV, in patients with ADHF.

scholarly journals Lysine-Specific Demethylase 2 Suppresses Lipid Influx and Metabolism in Hepatic Cells

2015 ◽  
Vol 35 (7) ◽  
pp. 1068-1080 ◽  
Author(s):  
Katsuya Nagaoka ◽  
Shinjiro Hino ◽  
Akihisa Sakamoto ◽  
Kotaro Anan ◽  
Ryuta Takase ◽  
...  
Keyword(s):  
Cell Damage ◽  
Cellular Processes ◽  
Metabolic Plasticity ◽  
Hepatic Cells ◽  
Lysine Specific Demethylase ◽  
Metabolic Remodeling ◽  
Chromatin Immunoprecipitation Sequencing ◽  
Lipid Metabolism Gene ◽  
Histone H3k4 ◽  
Factor C

Cells link environmental fluctuations, such as nutrition, to metabolic remodeling. Epigenetic factors are thought to be involved in such cellular processes, but the molecular basis remains unclear. Here we report that the lysine-specific demethylase 2 (LSD2) suppresses the flux and metabolism of lipids to maintain the energy balance in hepatic cells. Using transcriptome and chromatin immunoprecipitation-sequencing analyses, we revealed that LSD2 represses the genes involved in lipid influx and metabolism through demethylation of histone H3K4. Selective recruitment of LSD2 at lipid metabolism gene loci was mediated in part by a stress-responsive transcription factor, c-Jun. Intriguingly, LSD2 depletion increased the intracellular levels of many lipid metabolites, which was accompanied by an increased susceptibility to toxic cell damage in response to fatty acid exposure. Our data demonstrate that LSD2 maintains metabolic plasticity under fluctuating environment in hepatocytes by mediating the cross talk between the epigenome and metabolism.

scholarly journals Prinzmetal angina. Questions of pathogenesis, clinic, diagnosis and treatment

2019 ◽  
Vol 91 (11) ◽  
pp. 116-123
Author(s):  
B L Shklovskiy ◽  
A A Prokhorchik ◽  
A N Pyr’ev ◽  
V I Baksheev
Keyword(s):  
High Risk ◽  
Sudden Cardiac Death ◽  
Cardiac Arrhythmias ◽  
Cardiac Death ◽  
Variant Angina ◽  
Cardioverter Defibrillator ◽  
New Methods ◽  
Electrocardiographic Monitoring ◽  
Methods Of Treatment

Current problems of Prinzmetal angina (vasospastic angina, variant angina) considers in this review. Attention is drawn to early diagnosis, which should be comprehensive, taking into account possible atypical courses and the development of complications. The important role of electrocardiographic monitoring (including using implantable recorders) is highlighted. It is emphasized that patients with cardiac arrhythmias, syncope are at high risk of developing sudden cardiac death. In this category of patients, it is recommended to timely determine the indications for implantation of a cardioverter - defibrillator. Authors consider the prospects of using new methods of treatment of angina pectoris.

scholarly journals Mark Josephson and the ICD: A Personal Perspective

2017 ◽  
Vol 6 (1) ◽  
pp. 19
Author(s):  
Charles D Swerdlow ◽  
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Personal Perspective ◽  
Early Adopter ◽  
Clinical Tool ◽  
Cardioverter Defibrillator ◽  
Life Saving ◽  
Ambulatory Patients ◽  
Intellectual Integrity ◽  
Unique Therapy

Mark Josephson dedicated his career to the prevention of premature sudden cardiac death (SCD). Toward that goal, he was an early adopter of the implantable cardioverter defibrillator (ICD) and indefatigable advocate for better ICD technology,1 both as a clinical tool and as living laboratory to study SCD in ambulatory patients. With characteristic intellectual integrity and analytical rigour, he sought an honest and balanced appraisal of the life-saving benefits and serious complications of this unique therapy.

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