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Acute exacerbation of COPD is associated with fourfold elevation of cardiac troponin T.

https://arctichealth.org/en/permalink/ahliterature120267
Source
Heart. 2013 Jan;99(2):122-6
Publication Type
Article
Date
Jan-2013
Author
Vidar Søyseth
Rahul Bhatnagar
Nils Henrik Holmedahl
Anke Neukamm
Arne Didrik Høiseth
Tor-Arne Hagve
Gunnar Einvik
Torbjørn Omland
Author Affiliation
Department of Medicine, Akershus University Hospital, University of Oslo, Sykehusvn 25, Lørenskog 1478, Norway. vidar.soyseth@medisin.uio.no
Source
Heart. 2013 Jan;99(2):122-6
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Biological Markers - blood
Cross-Sectional Studies
Disease Progression
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Myocardial Ischemia - blood - epidemiology - etiology
Norway - epidemiology
Prognosis
Pulmonary Disease, Chronic Obstructive - blood - complications - physiopathology
Retrospective Studies
Risk Assessment - methods
Risk factors
Troponin T - blood
Abstract
To investigate if acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with myocardial injury, expressed as elevated high sensitive cardiac troponin T (hs-cTnT), and to identify determinants of hs-cTnT in chronic obstructive pulmonary disease (COPD) patients.
In a cross-sectional study, hs-cTnT in patients hospitalised for AECOPD was compared with hs-cTnT in COPD patients in their stable state.
The study was conducted at a teaching and a pulmonary rehabilitation clinic.
Consecutive admissions to participating units for the years 2010-2011 meeting objective, standardised criteria for AECOPD and stable COPD.
Ratio of hs-cTnT in hospitalised AECOPD patients compared with stable COPD patients. Change in the ratio of hs-cTnT per unit increase of relevant covariables.
The geometric mean of hs-cTnT in the index group was 25.8 ng/l (95% CI 21.1 to 31.7) compared with 4.55 ng/l (95% CI 3.72 to 5.67) in the reference group. After inclusion of relevant covariables, multiple linear regression analyses showed that the ratio between hs-cTnT in AECOPD patients and the references was 4.26 (95% CI 3.02 to 6.00) and that hs-cTnT increased 1.41-fold (95% CI 1.20 to 1.68), for each quartile increase in leucocyte count in stable COPD but not in AECOPD. Higher hs-cTnT levels were also associated with the presence of pathological q-waves (p=0.012) and electrocardiographic left ventricular hypertrophy (p=0.039), long-term oxygen treatment (p=0.002) and decreasing forced expiratory volume in 1 s (p=0.014). A significant univariable association between cTnT and arterial hypoxaemia was also found but this association was attenuated almost to a zero effect after inclusion of relevant covariates.
AECOPD is associated with higher hs-cTnT as compared with stable COPD. In stable COPD, hs-cTnT appears to be positively associated with indices of COPD severity, whereas we were unable to identify significant determinants of hs-cTnT in AECOPD.
Notes
Comment In: Heart. 2013 Jun;99(12):89423674512
Comment In: Heart. 2013 Jun;99(12):89423514977
PubMed ID
23024006 View in PubMed
Less detail

Acute versus chronic myocardial injury and long-term outcomes.

https://arctichealth.org/en/permalink/ahliterature309340
Source
Heart. 2019 12; 105(24):1905-1912
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Date
12-2019
Author
Erik Kadesjö
Andreas Roos
Anwar Siddiqui
Liyew Desta
Magnus Lundbäck
Martin J Holzmann
Author Affiliation
Functional Area of Emergency Medicine, Karolinska University Hospital, 14184, Stockholm.
Source
Heart. 2019 12; 105(24):1905-1912
Date
12-2019
Language
English
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Acute Disease
Adult
Aged
Aged, 80 and over
Biomarkers - blood
Chronic Disease
Female
Follow-Up Studies
Heart Failure - etiology - mortality
Humans
Male
Middle Aged
Myocardial Infarction - complications - diagnosis - mortality - therapy
Myocardial Revascularization - methods
Prognosis
Sweden - epidemiology
Troponin T - blood
Abstract
There is a paucity of data regarding prognosis in patients with acute versus chronic myocardial injury for long-term outcomes. We hypothesised that patients with chronic myocardial injury have a similar long-term prognosis as patients with acute myocardial injury.
In an observational cohort study of 22?589 patients who had high-sensitivity cardiac troponin T (hs-cTnT) measured in the emergency department during 2011-2014, we identified all patients with level >14?ng/L and categorised them as acute myocardial injury, type 1 myocardial infarction (T1MI), type 2 myocardial infarction (T2MI) or chronic myocardial injury through adjudication. We estimated adjusted HRs with 95% CIs for the primary outcome all-cause mortality and secondary outcomes MI, and heart failure in patients with acute myocardial injury, T1MI and T2MI compared with chronic myocardial injury.
In total, 3853 patients were included. During 3.9 (±2) years of follow-up, 48%, 24%, 44% and 49% of patients with acute myocardial injury, T1MI, T2MI and chronic myocardial injury died, respectively. Patients with acute myocardial injury had higher adjusted risks of death (1.21, 95% CI 1.08 to 1.36) and heart failure (1.24, 95% CI 1.07 to 1.43), but a similar risk for myocardial infarction (MI) compared with the reference group. Patients with T1MI had a lower adjusted risk of death (0.86, 95% CI 0.74 to 1.00) and higher risk of MI (2.09, 95% CI 1.62 to 2.68), but a similar risk of heart failure. Patients with T2MI had a higher adjusted risk of death (1.46, 95% CI 1.18 to 1.80) and heart failure (1.30, 95% CI 1.00 to 1.69) compared with patients with chronic myocardial injury.
Absolute long-term risks for death are similar, and adjusted risks are slightly higher, among patients with acute myocardial injury and T2MI, respectively, compared with chronic myocardial injury. The lowest risk of long-term mortality was found in patients with T1MI. Both acute and chronic myocardial injury are associated with very high risks of adverse outcomes.
PubMed ID
31337668 View in PubMed
Less detail

The anesthesia in abdominal aortic surgery (ABSENT) study: a prospective, randomized, controlled trial comparing troponin T release with fentanyl-sevoflurane and propofol-remifentanil anesthesia in major vascular surgery.

https://arctichealth.org/en/permalink/ahliterature108812
Source
Anesthesiology. 2013 Oct;119(4):802-12
Publication Type
Article
Date
Oct-2013
Author
Espen E Lindholm
Erlend Aune
Camilla B Norén
Ingebjørg Seljeflot
Thomas Hayes
Jan E Otterstad
Knut A Kirkeboen
Author Affiliation
* Senior Consultant Anesthetist, ‡ Clinical Nurse Specialist and Research Assistant, Department of Anesthesiology, # Senior Consultant Cardiologist, Department of Cardiology, Vestfold Hospital Trust, Tønsberg, Norway. † Consultant Cardiologist, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway. § Professor, Clinical Cardiovascular Translational Research, Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevål, Norway; and Faculty of Medicine, University of Oslo, Oslo, Norway. ? Senior Consultant Vascular Surgeon, Scandinavian Venous Centre, Oslo, Norway. ** Faculty of Medicine, University of Oslo; and Clinical Professor in Anesthesiology, Department of Anesthesiology, Oslo University Hospital, Ullevål, Norway.
Source
Anesthesiology. 2013 Oct;119(4):802-12
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anesthesia, General - methods
Anesthetics, Combined - blood
Anesthetics, Inhalation - blood
Anesthetics, Intravenous - blood
Aorta, Abdominal - surgery
Cardiotonic Agents - blood
Female
Fentanyl - blood
Humans
Male
Methyl Ethers - blood
Middle Aged
Norway
Piperidines - blood
Postoperative Complications - blood
Propofol - blood
Prospective Studies
Surgical Procedures, Elective - methods
Troponin T - blood - drug effects
Abstract
On the basis of data indicating that volatile anesthetics induce cardioprotection in cardiac surgery, current guidelines recommend volatile anesthetics for maintenance of general anesthesia during noncardiac surgery in hemodynamic stable patients at risk for perioperative myocardial ischemia. The aim of the current study was to compare increased troponin T (TnT) values in patients receiving sevoflurane-based anesthesia or total intravenous anesthesia in elective abdominal aortic surgery.
A prospective, randomized, open, parallel-group trial comparing sevoflurane-based anesthesia (group S) and total intravenous anesthesia (group T) with regard to cardioprotection in 193 patients scheduled for elective abdominal aortic surgery. Increased TnT level on the first postoperative day was the primary endpoint. Secondary endpoints were postoperative complications, nonfatal coronary events and mortality.
On the first postoperative day increased TnT values (>13 ng/l) were found in 43 (44%) patients in group S versus 41 (43%) in group T (P = 0.999), with no significant differences in TnT levels between the groups at any time point. Although underpowered, the authors found no differences in postoperative complications, nonfatal coronary events or mortality between the groups.
In elective abdominal aortic surgery sevoflurane-based anesthesia did not reduce myocardial injury, evaluated by TnT release, compared with total intravenous anesthesia. These data indicate that potential cardioprotective effects of volatile anesthetics found in cardiac surgery are less obvious in major vascular surgery.
Notes
Comment In: Anesthesiology. 2014 May;120(5):1289-9024755800
Comment In: Anesthesiology. 2014 May;120(5):1291-224755801
Comment In: Anesthesiology. 2014 May;120(5):1292-724755802
Comment In: Anesthesiology. 2014 May;120(5):1288-924755799
PubMed ID
23838709 View in PubMed
Less detail

Assessment of dexrazoxane as a cardioprotectant in doxorubicin-treated children with high-risk acute lymphoblastic leukaemia: long-term follow-up of a prospective, randomised, multicentre trial.

https://arctichealth.org/en/permalink/ahliterature140706
Source
Lancet Oncol. 2010 Oct;11(10):950-61
Publication Type
Article
Date
Oct-2010
Author
Steven E Lipshultz
Rebecca E Scully
Stuart R Lipsitz
Stephen E Sallan
Lewis B Silverman
Tracie L Miller
Elly V Barry
Barbara L Asselin
Uma Athale
Luis A Clavell
Eric Larsen
Albert Moghrabi
Yvan Samson
Bruno Michon
Marshall A Schorin
Harvey J Cohen
Donna S Neuberg
E John Orav
Steven D Colan
Author Affiliation
University of Miami, Leonard M Miller School of Medicine, Miami, FL, USA. slipshultz@med.miami.edu
Source
Lancet Oncol. 2010 Oct;11(10):950-61
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Antibiotics, Antineoplastic - adverse effects
Biological Markers - blood
Canada
Cardiomyopathies - blood - chemically induced - physiopathology - prevention & control - ultrasonography
Cardiovascular Agents - therapeutic use
Child
Child, Preschool
Disease-Free Survival
Doxorubicin - adverse effects
Female
Humans
Kaplan-Meier Estimate
Male
Myocardial Contraction - drug effects
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy - mortality
Prospective Studies
Puerto Rico
Razoxane - therapeutic use
Risk assessment
Risk factors
Survivors
Time Factors
Treatment Outcome
Troponin T - blood
United States
Ventricular Function, Left - drug effects
Young Adult
Abstract
Doxorubicin chemotherapy is associated with cardiomyopathy. Dexrazoxane reduces cardiac damage during treatment with doxorubicin in children with acute lymphoblastic leukaemia (ALL). We aimed to establish the long-term effect of dexrazoxane on the subclinical state of cardiac health in survivors of childhood high-risk ALL 5 years after completion of doxorubicin treatment.
Between January, 1996, and September, 2000, children with high-risk ALL were enrolled from nine centres in the USA, Canada, and Puerto Rico. Patients were assigned by block randomisation to receive ten doses of 30 mg/m² doxorubicin alone or the same dose of doxorubicin preceded by 300 mg/m² dexrazoxane. Treatment assignment was obtained through a telephone call to a centralised registrar to conceal allocation. Investigators were masked to treatment assignment but treating physicians and patients were not; however, investigators, physicians, and patients were masked to study serum cardiac troponin-T concentrations and echocardiographic measurements. The primary endpoints were late left ventricular structure and function abnormalities as assessed by echocardiography; analyses were done including all patients with data available after treatment completion. This trial has been completed and is registered with ClinicalTrials.gov, number NCT00165087.
100 children were assigned to doxorubicin (66 analysed) and 105 to doxorubicin plus dexrazoxane (68 analysed). 5 years after the completion of doxorubicin chemotherapy, mean left ventricular fractional shortening and end-systolic dimension Z scores were significantly worse than normal for children who received doxorubicin alone (left ventricular fractional shortening: -0·82, 95% CI -1·31 to -0·33; end-systolic dimension: 0·57, 0·21-0·93) but not for those who also received dexrazoxane (-0·41, -0·88 to 0·06; 0·15, -0·20 to 0·51). The protective effect of dexrazoxane, relative to doxorubicin alone, on left ventricular wall thickness (difference between groups: 0·47, 0·46-0·48) and thickness-to-dimension ratio (0·66, 0·64-0·68) were the only statistically significant characteristics at 5 years. Subgroup analysis showed dexrazoxane protection (p=0·04) for left ventricular fractional shortening at 5 years in girls (1·17, 0·24-2·11), but not in boys (-0·10, -0·87 to 0·68). Similarly, subgroup analysis showed dexrazoxane protection (p=0·046) for the left ventricular thickness-to-dimension ratio at 5 years in girls (1·15, 0·44-1·85), but not in boys (0·19, -0·42 to 0·81). With a median follow-up for recurrence and death of 8·7 years (range 1·3-12·1), event-free survival was 77% (95% CI 67-84) for children in the doxorubicin-alone group, and 76% (67-84) for children in the doxorubicin plus dexrazoxane group (p=0·99).
Dexrazoxane provides long-term cardioprotection without compromising oncological efficacy in doxorubicin-treated children with high-risk ALL. Dexrazoxane exerts greater long-term cardioprotective effects in girls than in boys.
US National Institutes of Health, Children's Cardiomyopathy Foundation, University of Miami Women's Cancer Association, Lance Armstrong Foundation, Roche Diagnostics, Pfizer, and Novartis.
Notes
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PubMed ID
20850381 View in PubMed
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Association of Heart Rate With Troponin Levels Among Patients With Symptomatic Atrial Fibrillation.

https://arctichealth.org/en/permalink/ahliterature304687
Source
JAMA Netw Open. 2020 09 01; 3(9):e2016880
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-01-2020

Association of severe placental insufficiency and systemic venous pressure rise in the fetus with increased neonatal cardiac troponin T levels.

https://arctichealth.org/en/permalink/ahliterature54039
Source
Am J Obstet Gynecol. 2000 Sep;183(3):726-31
Publication Type
Article
Date
Sep-2000
Author
K. Mäkikallio
O. Vuolteenaho
P. Jouppila
J. Räsänen
Author Affiliation
Departments of Obstetrics and Gynecology and Physiology, University of Oulu, Oulu, Finland.
Source
Am J Obstet Gynecol. 2000 Sep;183(3):726-31
Date
Sep-2000
Language
English
Publication Type
Article
Keywords
Adult
Birth weight
Blood Flow Velocity
Cardiomyopathies - blood - etiology
Female
Fetus - physiology
Gestational Age
Humans
Hydrogen-Ion Concentration
Hypertension - blood - complications
Infant, Newborn
Placental Insufficiency - complications - physiopathology
Pre-Eclampsia - blood - complications
Pregnancy
Pregnancy Complications
Pulsatile Flow
Research Support, Non-U.S. Gov't
Troponin T - blood
Umbilical Arteries
Uterus - blood supply
Venous Pressure
Abstract
OBJECTIVE: The aim of this study was to test the hypothesis that severe placental insufficiency and a rise in fetal systemic venous pressure are associated with fetal myocardial cell damage, which in turn leads to increased neonatal troponin T levels. STUDY DESIGN: Sixty-six neonates born after uncomplicated pregnancy and delivery were included in the control group. Study groups 1 and 2 consisted of 32 and 5 neonates, respectively, born to women with hypertensive disorder. In study group 1 the fetal intra-abdominal portion of the umbilical vein showed normal nonpulsatile blood flow pattern in every case. In study group 2 all the fetuses had atrial pulsations in the intraabdominal umbilical vein. After delivery blood samples were collected from the umbilical arteries, and cardiac troponin T concentrations were measured with commercially available enzyme-linked immunosorbent assay kits. A clinically significant troponin T level was set at >/=0.10 ng/mL. RESULTS: In study group 1 the maternal main uterine arterial blood flow pattern was normal in 30 cases and abnormal in 2 cases. Umbilical artery blood velocity waveforms were normal in 26 fetuses, 4 fetuses had a decreased diastolic blood flow, 1 fetus had an absent diastolic blood flow pattern, and 1 fetus had a retrograde diastolic blood flow pattern. In study group 2 maternal uterine arterial Doppler findings were abnormal in every case, and all the fetuses had retrograde diastolic blood flow pattern in the umbilical artery. Neonatal troponin T levels were 0.10 ng/mL, with the range from 0.11 to 0.35 ng/mL. In study group 2 troponin T concentrations were significantly higher (P
PubMed ID
10992200 View in PubMed
Less detail

Balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension.

https://arctichealth.org/en/permalink/ahliterature108764
Source
Heart. 2013 Oct;99(19):1415-20
Publication Type
Article
Date
Oct-2013
Author
Arne K Andreassen
Asgrimur Ragnarsson
Einar Gude
Odd Geiran
Rune Andersen
Author Affiliation
Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway. aandreas@ous-hf.no
Source
Heart. 2013 Oct;99(19):1415-20
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Balloon - adverse effects - mortality
Arterial Pressure
Biological Markers - blood
Cardiac Catheterization
Cardiac output
Chronic Disease
Endarterectomy
Exercise Test
Exercise Tolerance
Female
Humans
Hypertension, Pulmonary - blood - diagnosis - mortality - physiopathology - surgery - therapy
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Norway
Peptide Fragments - blood
Predictive value of tests
Prospective Studies
Pulmonary Embolism - blood - diagnosis - mortality - physiopathology - surgery - therapy
Recovery of Function
Time Factors
Treatment Outcome
Troponin T - blood
Ventricular Function, Right
Abstract
To examine the effect of balloon pulmonary angioplasty (BPA) on chronic thromboembolic pulmonary hypertension (CTEPH) in patients with inoperable disease or persistent pulmonary hypertension after pulmonary endarterectomy.
Observational cohort study.
Referred patients with inoperable or persistent CTEPH.
Twenty consecutive CTEPH patients (10 females), aged 60±10 years.
Right heart catheterisation, functional capacity (cardiopulmonary exercise testing (CPET) and NYHA class) and blood sampled biomarkers N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T examined at the time of diagnosis and repeated in all patients 3 months after the last BPA.
Seventy-three catheterisations were performed with 18.6±6.1 BPAs per patient on segmental and subsegmental arteries. Two deaths occurred following the first BPA, with an overall 10% periprocedural death rate. Reperfusion oedema complicated seven procedures. Comparisons before and after BPA showed significant haemodynamic improvements, including decreased mean pulmonary artery pressure (mPAP) (45±11 mm Hg vs 33±10 mm Hg; p
PubMed ID
23846611 View in PubMed
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Campylobacter jejuni-associated perimyocarditis: two case reports and review of the literature.

https://arctichealth.org/en/permalink/ahliterature284008
Source
BMC Infect Dis. 2016 Jun 14;16:289
Publication Type
Article
Date
Jun-14-2016
Author
Fredrik Hessulf
Johan Ljungberg
Per-Anders Johansson
Mats Lindgren
Johan Engdahl
Source
BMC Infect Dis. 2016 Jun 14;16:289
Date
Jun-14-2016
Language
English
Publication Type
Article
Keywords
Abdominal Pain - physiopathology
Animals
Anti-Bacterial Agents - therapeutic use
C-Reactive Protein - metabolism
Campylobacter Infections - blood - diagnosis - drug therapy - physiopathology
Campylobacter jejuni
Chickens
Diarrhea - physiopathology
Echocardiography
Electrocardiography
Emergency Service, Hospital
Fever - physiopathology
Hospitalization
Humans
Male
Myocarditis - blood - diagnosis - drug therapy - physiopathology
Pericarditis - blood - diagnosis - drug therapy - physiopathology
Sweden
Travel
Troponin T - blood
Young Adult
Abstract
Campylobacter spp. are among the most common bacterial causes of gastroenteritis world-wide and mostly follow a benign course. We report two cases of Campylobacter jejuni-associated perimyocarditis, the first two simultaneous cases published to date and the third and fourth cases over all in Sweden, and a review of the literature.
A previously healthy 24-yo male (A) presented at the Emergency Department(ED) with recent onset of chest pain and a 3-day history of abdominal pain, fever and diarrhoea. The symptoms began within a few hours of returning from a tourist visit to a central European capital. Vital signs were stable, the Electrocardiogram(ECG) showed generalized ST-elevation, laboratory testing showed increased levels of C-reactive protein(CRP) and high-sensitive Troponin T(hsTnT). Transthoracic echocardiogram (TTE) was normal, stool cultures were positive for C Jejuni and blood cultures were negative. Two days after patient A was admitted to the ED his travel companion (B), also a previously healthy male (23-yo), presented at the same ED with almost identical symptoms: chest pain precipitated by a few days of abdominal pain, fever and diarrhoea. Patient B declared that he and patient A had ingested chicken prior to returning from their tourist trip. Laboratory tests showed elevated CRP and hsTnT but the ECG and TTE were normal. In both cases, the diagnosis of C jejuni-associated perimyocarditis was set based on the typical presentation and positive stool cultures with identical strains. Both patients were given antibiotics, rapidly improved and were fully recovered at 6-week follow up.
Perimyocarditis is a rare complication of C jejuni infections but should not be overlooked considering the risk of heart failure. With treatment, the prognosis of full recovery is good but several questions remain to be answered regarding the pathophysiology and the male preponderance of the condition.
Notes
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PubMed ID
27297408 View in PubMed
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Can prolonged QTc and cTNT level predict the acute and long-term prognosis of stroke?

https://arctichealth.org/en/permalink/ahliterature139146
Source
Int J Cardiol. 2012 Mar 22;155(3):414-7
Publication Type
Article
Date
Mar-22-2012
Author
Clara Hjalmarsson
Lena Bokemark
Sara Fredriksson
Jessica Antonsson
Alieh Shadman
Björn Andersson
Author Affiliation
The Stroke Unit, Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden. clara.hjalmarsson@vgregion.se
Source
Int J Cardiol. 2012 Mar 22;155(3):414-7
Date
Mar-22-2012
Language
English
Publication Type
Article
Keywords
Acute Disease
Aged
Biological Markers - blood
Chronic Disease
Electrocardiography
Female
Follow-Up Studies
Humans
Male
Predictive value of tests
Prognosis
Retrospective Studies
Severity of Illness Index
Stroke - blood - diagnosis - mortality
Survival Rate - trends
Sweden - epidemiology
Time Factors
Troponin T - blood
Abstract
Previous studies in patients with stroke indicate that QTc prolongation and elevated cTNT are related to increased risk of all-cause and cardiovascular mortality.
We analysed the importance of electrocardiographic (ECG) abnormalities and elevated serum cardiac troponin (cTNT)--at baseline examination--as potential predictors for acute and long-term mortalities after stroke in a follow-up of 478 patients with a mean age of 78 years.
In a multivariate analysis, strong predictors for poor prognosis during the acute phase were: elevated cTNT (p=0.001); stroke severity (p=0.004); ischemia on ECG (p=0.044); and age (p=0.050). Prolonged QTc interval was on the limit to statistical significance (p=0.050) when using multivariate analysis, while clearly significant in a Cox-regression (when corrected for missing cTNT values). One year after stroke, when adjusted for covariates (gender, diabetes mellitus, hypertension, and ischemic heart disease), elevated cTNT (p=0.001), stroke severity (p=0.014), and age (p=0.031) retained a significant relation with mortality. Moreover, atrial fibrillation was strongly correlated with poor survival (p=0.009). Cox regression confirmed the predictive value of QTc, cTNT, age, and stroke severity, as markers of acute mortality in relation to stroke.
Prolonged repolarization time independently predicts poor prognosis during the acute phase, but not one year after stroke. In the absence of acute myocardial infarction, elevated initial cTNT is strongly related to poor outcome, both during the acute phase and one year after stroke.
PubMed ID
21093074 View in PubMed
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Cardiac arrhythmias in poorly performing Standardbred and Norwegian-Swedish Coldblooded trotters undergoing high-speed treadmill testing.

https://arctichealth.org/en/permalink/ahliterature311741
Source
Vet J. 2021 Jan; 267:105574
Publication Type
Journal Article
Date
Jan-2021
Author
J Slack
D Stefanovski
T F Madsen
C T Fjordbakk
E Strand
C Fintl
Author Affiliation
University of Pennsylvania, New Bolton Center, Department of Clinical Studies, 382 West Street Rd Kennett Square, PA 19348, USA. Electronic address: slackj@vet.upenn.edu.
Source
Vet J. 2021 Jan; 267:105574
Date
Jan-2021
Language
English
Publication Type
Journal Article
Keywords
Animals
Arrhythmias, Cardiac - epidemiology - physiopathology - veterinary
Electrocardiography - methods - veterinary
Exercise Test - veterinary
Heart rate
Horse Diseases - epidemiology - physiopathology
Horses
Lactic Acid - blood
Male
Norway
Physical Conditioning, Animal - physiology
Running - physiology
Sweden
Troponin T - blood
Abstract
The significance of cardiac arrhythmias and their possible association with upper airway obstruction are frequently considered in the clinical investigation of poor performance. The specific aims of this retrospective study of a group of poorly performing Standardbred and Norwegian-Swedish Coldblooded trotters were to: (1) describe the overall frequency and frequency distributions of arrhythmias; (2) describe arrhythmia characteristics including percent prematurity, relative recovery cycle lengths and QRS morphology; (3) describe variability of normal RR intervals; and (4) explore possible associations between upper airway abnormalities and arrhythmia categories during peak exercise and recovery. The records of 103 trotters presented to the Norwegian University of Life Sciences for high-speed treadmill testing were reviewed. The occurrence of at least one arrhythmic event was high (77-78%) when considering all exercise periods and 6-10% prematurity criteria. Triplets, salvos, and/or paroxysmal tachyarrhythmias occurred in 8% of horses during peak exercise. Complex ventricular arrhythmias occurred in 15% of horses in the first 2 min of recovery. Evaluation of QRS morphology and return cycle lengths demonstrated areas of overlap in characteristics typically attributed to either supraventricular or ventricular arrhythmias. There was no association between airway diagnosis and arrhythmias during any exercise period. The maximum average HR during peak exercise was an excellent predicter for complex ventricular arrhythmias during recovery. Because perfect categorization of arrhythmias is not possible, future studies should report descriptive arrhythmia information. Prospective studies that evaluate various degrees of upper airway obstruction and the effect on known initiators of arrhythmogenesis are needed.
PubMed ID
33375960 View in PubMed
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