Levosimendan Reduces Mortality and Low Cardiac Output Syndrome in Cardiac Surgery

Thorac cardiovasc Surg DOI: 10.1055/s-0039-3400496 Background There has been conflicting evidence concerning the effect of levosimendan on clinical outcomes in patients undergoing cardiac surgery. Therefore, we performed a systematic review and conducted this meta-analysis to provide evidence for/against the administration of levosimendan in cardiac surgery patients. Methods We performed a meta-analysis from literature search in PubMed, EMBASE, and Cochrane Library. Only randomized controlled trials comparing the administration of levosimendan in cardiac surgery patients with a control group (other inotrope, standard therapy/placebo, or an intra-aortic balloon pump) were included. In addition, at least one clinical outcome had to be mentioned: mortality, myocardial infarction, low cardiac output syndrome (LCOS), acute kidney injury, renal replacement therapy, atrial fibrillation, prolonged inotropic support, length of intensive care unit, and hospital stay. The pooled treatment effects (odds ratio [OR], 95% confidence intervals [CI]) were assessed using a fixed or random effects model. Results The literature search retrieved 27 randomized, controlled trials involving a total of 3,198 patients. Levosimendan led to a significant reduction in mortality (OR: 0.67; 95% CI: 0.49–0.91; p = 0.0087). Furthermore, the incidence of LCOS (OR: 0.56, 95% CI: 0.42–0.75; p 
Source: The Thoracic and Cardiovascular Surgeon - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Original Cardiovascular Source Type: research

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AbstractBackgroundPatients with atrial fibrillation (AF) and dementia experience reduced quality of life and increased mortality. Technetium 99m ECD brain perfusion single-photon emission computed tomography (99mTc-ECD brain perfusion SPECT) is a beneficial modality for diagnosing dementia and identifying high-risk patients with mild cognitive impairment. The aim of this study was to evaluate the prognostic value of brain perfusion using99mTc-ECD SPECT in patients with AF and dementia.MethodsOf a total of 405 consecutive patients diagnosed with AF as cardiac outpatients with dementia using the Mini-Mental State Examination...
Source: EJNMMI Research - Category: Radiology Source Type: research
ConclusionsIn a limited population of AF patients with preserved LV function and PET CFC indicating occult CAD, treatment with 1C AADs appears not to increase mortality. A larger study would be required to confidently assess safety of these drugs in this context.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Low-dose aspirin reduces the frequency of adverse vascular events in those at increased risk of occlusive cardiovascular disease (CVD). People who benefit include those: with a history of myocardial infarction, ischaemic stroke, unstable or stable angina, peripheral arterial disease, or atrial fibrillation (1). The pathophysiology of CVD risk contributes to cognitive decline through multiple pathways that include cerebral hypo-perfusion, hypoxia, hippocampal atrophy, emboli, or infarcts (2,3). However, the value of aspirin use in prevention of cognitive impairment remains uncertain since results relating to the influence o...
Source: Maturitas - Category: Primary Care Authors: Source Type: research
Conclusion: Some cases with CCI treated with IV-tPA and endovascular intervention were reported, but the treatment strategy should be still discussed multidisciplinary. Especially, the administration of antithrombotic drugs for CCI should be carefully performed because fatal hemorrhage such as cardiac tamponade can occur. PMID: 31893142 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
Authors: Mineki T, Yoda S, Hatta T, Hayase M, Monno K, Hori Y, Suzuki Y, Matsumoto N, Okumura Y Abstract Objective We aimed to stratify the risk of major cardiovascular (MCV) events in Japanese patients with known or suspected coronary artery disease (CAD) who had normal single-photon emission computed tomographic myocardial perfusion imaging (SPECT MPI) findings and to compare the risk by generation. Methods This was a retrospective study. The composite endpoint was the occurrence of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke. Patients The study subjects were 2,035 patients with nor...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
ConclusionIn patients with suspected AMI timely applying of MDCT, angiography, endovascular revascularization and ICG quality control of perfusion after revascularization are expedient to improve the results of treatment. These patients should be treated by a multidisciplinary team consisting of a cardiologist, a cardiovascular and endovascular surgeon, a general surgeon with experience in working with such patients.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Publication date: Available online 13 May 2019Source: Physiology &BehaviorAuthor(s): Catharina Elizabeth Myburgh, Leoné Malan, Marisa Möller, Martin Magnusson, Olle Melander, Henri Guise Laurie Rauch, Faans Steyn, Nicolaas Theodor MalanAbstractBackgroundDefensive coping (DefS) was associated with a vulnerable cardiovascular profile in Blacks. The copeptin/vasopressin system is a manifestation of hypothalamic-pituitary-adrenal-axis activity and may act as an acute compensatory mechanism when there is a disruption in volume-loading homeostasis, i.e. when cardiac stress is evident. Whether DefS will influence ...
Source: Physiology and Behavior - Category: Physiology Source Type: research
Yolanda Benito1, Pablo Martinez-Legazpi1*, Lorenzo Rossini2, Candelas Pérez del Villar1, Raquel Yotti1, Yolanda Martín Peinador3, Daniel Rodríguez-Pérez4, M. Mar Desco4, Constancio Medrano1, Jose Carlos Antoranz4, Francisco Fernández-Avilés1, Juan C. del Álamo2,5 and Javier Bermejo1 1Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón and CIBERCV, Madrid, Spain 2Department of Mechanical and Aerospace ...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Publication date: Available online 6 January 2019Source: Molecular and Cellular EndocrinologyAuthor(s): Brian Martin, Guillermo Romero, Guy SalamaAbstractRelaxin is a hormone of pregnancy first discovered for its ability to induce ligament relaxation in nonpregnant guinea pig and is important for softening of the birth canal during parturition, decidualization, implantation, nipple development and increased maternal renal perfusion, glomerular filtration, and cardiac output. Subsequently, relaxin has been shown to exert multiple beneficial cardiovascular effects during pathological events such as hypertension, atrial fibri...
Source: Molecular and Cellular Endocrinology - Category: Endocrinology Source Type: research
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