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https://www.readbyqxmd.com/read/28197279/a-sudden-change-of-heart-a-case-of-rapidly-reversed-stress-cardiomyopathy-in-a-critically-ill-patient
#1
Michael I Brener, Ali R Keramati, Marek A Mirski, Oscar H Cingolani
We report the case of a 79-year-old woman who presented to our hospital for elective removal of an infratentorial meningioma and suffered a periprocedural cardiac arrest. Shortly after uncomplicated induction of anesthesia prior to the surgery, the patient became hypotensive and bradycardic, culminating ultimately in a cardiac arrest with pulseless electrical activity. Return of spontaneous circulation occurred within 90 seconds of arrest, but the patient remained dependent on maximal doses of epinephrine and dopamine for hemodynamic support...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28185059/severe-proarrhythmic-potential-of-the-antiemetic-agents-ondansetron-and-domperidone
#2
Gerrit Frommeyer, Christina Fischer, Christian Ellermann, Philipp S Lange, Dirk G Dechering, Simon Kochhäuser, Michael Fehr, Lars Eckardt
The potential of ondansetron and domperidone, both clinically established antiemetic agents, to increase the QT-interval has been described in several case reports. Therefore, the aim of the present study was to investigate whether these drugs may provoke polymorphic ventricular tachycardia in a sensitive experimental model of drug-induced proarrhythmia. In 10 female rabbits, ondansetron (1, 5 and 10 µM, n = 10) or domperidone (0.5, 1 and 2 µM, n = 8) was infused after obtaining baseline data. Eight endo- and epicardial monophasic action potentials and a simultaneously recorded 12-lead ECG reproduced the clinically observed QT-prolongation (ondansetron: 1 µM:+17 ms, 5 µM:+41 ms, 10 µM:+78 ms, p < 0...
February 9, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28122469/dexmedetomidine-for-refractory-intracranial-hypertension
#3
Kendra J Schomer, Christian M Sebat, Jason Y Adams, Jeremiah J Duby, Kiarash Shahlaie, Erin L Louie
Dexmedetomidine (DEX) is a selective α2 adrenergic agonist that is commonly used for sedation in the intensive care unit (ICU). The role of DEX for adjunctive treatment of refractory intracranial hypertension is poorly defined. The primary objective of this study was to determine the effect of DEX on the need for rescue therapy (ie, hyperosmolar boluses, extraventricular drain [EVD] drainages) for refractory intracranial hypertension. Secondary objectives included the number of intracranial pressure (ICP) excursions, bradycardic, hypotensive, and compromised cerebral perfusion pressure episodes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28091703/bolus-application-of-landiolol-and-esmolol-comparison-of-the-pharmacokinetic-and-pharmacodynamic-profiles-in-a-healthy-caucasian-group
#4
Günther Krumpl, Ivan Ulc, Michaela Trebs, Pavla Kadlecová, Juri Hodisch
PURPOSE: The aim of this prospective study was to compare in non-Asian subjects the pharmacokinetics (PK), pharmacodynamics (PD), safety, and tolerability of two short-acting cardioselective β1-adrenergic antagonists, landiolol and esmolol, after administration of three different bolus dosages. MATERIALS AND METHODS: We conducted a single-center, prospective, double-blinded, randomized study in three cross-over periods with 12 healthy subjects (7 women and 5 men, mean age of 24...
January 13, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28089877/permanent-pacemaker-implantation-in-octogenarians-with-unexplained-syncope-and-positive-electrophysiologic-testing
#5
Georgios Giannopoulos, Charalampos Kossyvakis, Vasiliki Panagopoulou, Dimitrios Tsiachris, Konstantinos Doudoumis, Maria Mavri, Dimitrios Vrachatis, Konstantinos Letsas, Michael Efremidis, Apostolos Katsivas, John Lekakis, Spyridon Deftereos
BACKGROUND: Syncope is a common problem in the elderly, and a permanent pacemaker is a therapeutic option when a bradycardic etiology is revealed. However, the benefit of pacing when no association of symptoms to bradycardia has been shown is not clear, especially in the elderly. OBJECTIVE: The aim of this study was to evaluate the effect of pacing on syncope-free mortality in patients aged 80 years or older with unexplained syncope and "positive" invasive electrophysiologic testing (EPT)...
January 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28011835/comparing-maximum-rate-and-sustainability-of-pacing-by-mechanical-vs-electrical-stimulation-in-the-langendorff-perfused-rabbit-heart
#6
T Alexander Quinn, Peter Kohl
AIMS: Mechanical stimulation (MS) represents a readily available, non-invasive means of pacing the asystolic or bradycardic heart in patients, but benefits of MS at higher heart rates are unclear. Our aim was to assess the maximum rate and sustainability of excitation by MS vs. electrical stimulation (ES) in the isolated heart under normal physiological conditions. METHODS AND RESULTS: Trains of local MS or ES at rates exceeding intrinsic sinus rhythm (overdrive pacing; lowest pacing rates 2...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27871603/prophylactic-phenylephrine-infusion-for-the-prevention-of-hypotension-after-spinal-anesthesia-in-the-elderly-a-randomized-controlled-clinical-trial
#7
Fabrice Ferré, Philippe Marty, Laura Bruneteau, Virgine Merlet, Benoît Bataille, Anne Ferrier, Claude Gris, Matt Kurrek, Olivier Fourcade, Vincent Minville, Agnes Sommet
STUDY OBJECTIVE: Hypotension frequently occurs during spinal anesthesia (SA), especially in the elderly. Phenylephrine is effective to prevent SA-induced hypotension during cesarean delivery. The objective of this study was to evaluate the efficacy and safety of prophylactic infusion of phenylephrine after SA for orthopedic surgery in the elderly. DESIGN: This prospective, randomized, double-blind, and placebo-controlled study included 54 patients older than 60 years undergoing elective lower limb surgery under SA (injection of 10 mg of isobaric bupivacaine with 5 μg of sufentanyl)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27844147/acute-ivabradine-treatment-reduces-heart-rate-without-increasing-atrial-fibrillation-inducibility-irrespective-of-underlying-vagal-activity-in-dogs
#8
Kazunori Uemura, Masashi Inagaki, Can Zheng, Toru Kawada, Meihua Li, Masafumi Fukumitsu, Masaru Sugimachi
Ivabradine, a bradycardic agent, has been shown to stably reduce patient's heart rate (HR) in the setting of acute cardiac care. However, an association between atrial fibrillation (AF) risk and acute ivabradine treatment remains a controversial clinical issue, and has not been thoroughly investigated. Bradycardia and abnormal atrial refractoriness induced by ivabradine treatment may enhance vulnerability to AF induction, especially when vagal nerve is concurrently activated. We aimed to experimentally investigate the effects of acute ivabradine treatment with/without concurrent vagal activation on AF inducibility...
November 14, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27816306/intravenous-electrical-vagal-nerve-stimulation-prior-to-coronary-reperfusion-in-a-canine-ischemia-reperfusion-model-markedly-reduces-infarct-size-and-prevents-subsequent-heart-failure
#9
Takahiro Arimura, Keita Saku, Takamori Kakino, Takuya Nishikawa, Takeshi Tohyama, Takafumi Sakamoto, Kazuo Sakamoto, Takuya Kishi, Tomomi Ide, Kenji Sunagawa
BACKGROUND: Reducing myocardial damage is a prerequisite to prevent chronic heart failure after acute myocardial infarction (AMI). Although vagal nerve stimulation (VNS) has been repeatedly demonstrated to have potent anti-infarct effect, technical difficulties have precluded its clinical application. We developed a novel therapeutic strategy of intravenous VNS (iVNS) and examined whether iVNS administered prior to coronary reperfusion in a canine AMI model reduces infarct size and prevents heart failure...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27794538/methyl-cpg-binding-protein-2-function-in-cholinergic-neurons-mediates-cardiac-arrhythmogenesis
#10
José A Herrera, Christopher S Ward, Xander H T Wehrens, Jeffrey L Neul
Sudden unexpected death occurs in one quarter of deaths in Rett Syndrome (RTT), a neurodevelopmental disorder caused by mutations in Methyl-CpG-binding protein 2 (MECP2). People with RTT show a variety of autonomic nervous system (ANS) abnormalities and mouse models show similar problems including QTc interval prolongation and hypothermia. To explore the role of cardiac problems in sudden death in RTT, we characterized cardiac rhythm in mice lacking Mecp2 function. Male and female mutant mice exhibited spontaneous cardiac rhythm abnormalities including bradycardic events, sinus pauses, atrioventricular block, premature ventricular contractions, non-sustained ventricular arrhythmias, and increased heart rate variability...
October 18, 2016: Human Molecular Genetics
https://www.readbyqxmd.com/read/27776979/chronic-kidney-disease-impairs-renal-nerve-and-haemodynamic-reflex-responses-to-vagal-afferent-input-through-a-central-mechanism
#11
REVIEW
Ibrahim M Salman, Cara M Hildreth, Jacqueline K Phillips
We investigated age- and sex-related changes in reflex renal sympathetic nerve activity (RSNA) and haemodynamic responses to vagal afferent stimulation in a rodent model of chronic kidney disease (CKD). Using anaesthetised juvenile (7-8weeks) and adult (12-13weeks) Lewis Polycystic Kidney (LPK) and Lewis control rats of either sex (n=63 total), reflex changes in RSNA, heart rate (HR) and mean arterial pressure (MAP) to vagal afferent stimulation (5-s train, 4.0V, 2.0-ms pulses, 1-16Hz) were measured. In all groups, stimulation of the vagal afferents below 16Hz produced frequency-dependent reductions in RSNA, HR and MAP, while a 16Hz stimulus produced an initial sympathoinhibition followed by sympathoexcitation...
October 11, 2016: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/27763697/changes-in-cardiovascular-responses-to-chemoreflex-activation-of-rats-recovered-from-protein-restriction-are-not-related-to-at1-receptors
#12
Renato Willian Martins Sá, Andrea Siqueira Haibara, Paula Magalhães Gomes, Giovana Lopes Aguiar, Rafael Souza Leopoldino Nascimento, Maria Lucia Pedrosa, Andréia Carvalho Alzamora, Lisandra Brandino de Oliveira, Leonardo Máximo Cardoso
What is the central question of this study? In this study, we sought to investigate whether cardiovascular responses to peripheral chemoreflex activation of rats recovered from protein restriction are related to activation of AT1 receptors. What is the main finding and its importance? This study highlights the fact that angiotensinergic mechanisms activated by AT1 receptors do not support increased responses to peripheral chemoreflex activation by KCN in rats recovered from protein restriction. Also, we found that protein restriction led to increased resting ventilation in adult rats, even after recovery...
January 1, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/27702859/antiarrhythmic-effect-of-vernakalant-in-an-experimental-model-of-long-qt-syndrome
#13
Gerrit Frommeyer, Catharina Clauss, Christian Ellermann, Harilaos Bogossian, Dirk G Dechering, Simon Kochhäuser, Florian Reinke, Christian Pott, Lars Eckardt
AIMS: The antiarrhythmic drug vernakalant exerts antiarrhythmic effects in atrial fibrillation. Recent experimental data suggest interactions with the late sodium current and antiarrhythmic effects in ventricular arrhythmias. We aimed at investigating whether treatment with vernakalant reduces polymorphic ventricular tachycardia (VT) in an experimental model of Long-QT-syndrome (LQTS). METHODS AND RESULTS: Twenty-nine isolated rabbit hearts were assigned to two groups and treated with erythromycin (300 µM, n = 15) or veratridine (0...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27694213/effects-of-various-types-of-anesthesia-on-hemodynamics-cardiac-function-and-glucose-and-lipid-metabolism-in-rats
#14
Yusuke Sano, Shogo Ito, Mamoru Yoneda, Kai Nagasawa, Natsumi Matsuura, Yuichiro Yamada, Ayako Uchinaka, Yasuko K Bando, Toyoaki Murohara, Kohzo Nagata
Anesthesia can affect respiratory, circulatory, and endocrine systems but is necessary for certain experimental procedures such as echocardiography and blood sampling in small animals. We have now investigated the effects of four types of anesthesia [pentobarbital sodium (PENT), ketamine-xylazine (K/X), and low- or high-dose isoflurane (ISO)] on hemodynamics, cardiac function, and glucose and lipid metabolism in Sprague-Dawley rats. Aortic pressure, heart rate, and echocardiographic parameters were measured at various time points up to 45 min after the induction of anesthesia, and blood was then collected for measurement of parameters of glucose and lipid metabolism...
December 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27693394/central-mechanism-of-the-cardiovascular-responses-caused-by-l-proline-microinjected-into-the-paraventricular-nucleus-of-the-hypothalamus-in-unanesthetized-rats
#15
Silvana Lopes-Azevedo, Cristiane Busnardo, Fernando Morgan Aguiar Corrêa
Previously, we reported that microinjection of l-proline (l-Pro) into the paraventricular nucleus of the hypothalamus (PVN) caused vasopressin-mediated pressor responses in unanesthetized rats. In the present study, we report on the central mechanisms involved in the mediation of the cardiovascular effects caused by the microinjection of l-Pro into the PVN. Microinjection of increasing doses of l-Pro (3-100 nmol/100nL) into the PVN caused dose-related pressor and bradycardic responses. No cardiovascular responses were observed after the microinjection of equimolar doses (33nmol/100nL) of its isomer d-Proline (d-Pro) or Mannitol...
September 29, 2016: Brain Research
https://www.readbyqxmd.com/read/27676327/chronic-sarpogrelate-treatment-reveals-5-ht7-receptor-in-the-serotonergic-inhibition-of-the-rat-vagal-bradycardia
#16
José Ángel García-Pedraza, Mónica García, María Luisa Martín, Nélida Eleno, Asunción Morán
5-Hydroxytryptamine (5-HT) modulates the cardiac parasympathetic neurotransmission, inhibiting the bradyarrhythmia by 5-HT2 receptor activation. We aimed to determine whether the chronic selective 5-HT2 blockade (sarpogrelate) could modify the serotonergic modulation on vagal cardiac outflow in pithed rat. Bradycardic responses in rats treated with sarpogrelate (30 mg·kg·d; orally) were obtained by electrical stimulation of the vagal fibers (3, 6, and 9 Hz) or intravenous (IV) injections of acetylcholine (1, 5, and 10 μg/kg)...
January 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/27667485/functional-pharmacological-characterisation-of-ser100-in-cardiovascular-health-and-disease
#17
Inmaculada C Villar, Kristen J Bubb, Amie J Moyes, Eva Steiness, Trygve Gulbrandsen, Finn Olav Levy, Adrian J Hobbs
BACKGROUND AND PURPOSE: SER100 is a selective nociceptin receptor (NOP) agonist with sodium-potassium-sparing aquaretic and anti-natriuretic activity. This study was designed to characterize the functional cardiovascular pharmacology of SER100 in vitro and in vivo, including experimental models of cardiovascular disease. EXPERIMENTAL APPROACH: Haemodynamic, ECG parameters and heart rate variability (HRV) were determined using radiotelemetry in healthy, conscious mice...
September 25, 2016: British Journal of Pharmacology
https://www.readbyqxmd.com/read/27618277/relative-bradycardia-in-patients-with-septic-shock-requiring-vasopressor-therapy
#18
Sarah J Beesley, Emily L Wilson, Michael J Lanspa, Colin K Grissom, Sajid Shahul, Daniel Talmor, Samuel M Brown
OBJECTIVES: Tachycardia is common in septic shock, but many patients with septic shock are relatively bradycardic. The prevalence, determinants, and implications of relative bradycardia (heart rate, < 80 beats/min) in septic shock are unknown. To determine mortality associated with patients who are relatively bradycardic while in septic shock. DESIGN: Retrospective study of patients admitted for septic shock to study ICUs during 2005-2013. SETTING: One large academic referral hospital and two community hospitals...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27607083/adherence-to-the-current-guidelines-for-bradycardic-pacing-in-the-octogenarian-and-nonagenarian-populations
#19
Vivienne Kim, James Pemberton, Fiona Riddell, Khang-Li Looi
AIM: A significant proportion of single-chamber ventricular pacemakers are implanted in octogenarian and nonagenarian patients. We aimed to assess whether the current pacing guideline is adhered for these populations. METHODS: We retrospectively identified patients ≥80 years of age, who received their first pacemaker from July 2010 to June 2013. RESULTS: A total of 356 patients were identified. Mean age was 86.1 years and 82.6 years for single and dual-chamber pacemakers respectively (p<0...
September 9, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27581812/carotid-baroreflex-function-at-the-onset-of-cycling-in-men
#20
Thales C Barbosa, Lauro C Vianna, Takeshi Hashimoto, Lonnie Grove Petersen, Niels D Olesen, Hayato Tsukamoto, Henrik Sørensen, Shigehiko Ogoh, Antonio Claudio L Nóbrega, Niels H Secher
Arterial baroreflex function is important for blood pressure control during exercise, but its contribution to cardiovascular adjustments at the onset of cycling exercise remains unclear. Fifteen healthy male subjects (24 ± 1 years) performed 45-s trials of low- and moderate-intensity cycling, with carotid baroreceptor stimulation by neck suction at -60 Torr applied 0-5, 10-15, and 30-35 s after the onset of exercise. Cardiovascular responses to neck suction during cycling were compared to those obtained at rest...
August 31, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
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