Extracorporeal circulation (ECC) is an essential tool for the execution of cardiac operations. However, ECC is also associated with undesirable side effects. These include the induction of a systemic inflammatory response associated with leukocyte activation and cytokine release as well as potentially life-threatening complications. The volatile anesthetic sevoflurane has been reported to exert...

INTRODUCTION: The aim of this study was to evaluate the incidence and severity of blunt cardiac injury (BCI) as determined by cardiac magnetic resonance imaging (CMR), and to compare this to currently used diagnostic methods in severely injured patients. MATERIALS AND METHODS: We conducted a prospective, pilot cohort study of 42 major trauma patients from July 2013 to Jan 2015. The cohor...

During chronic stimulation, CD8+ T cells acquire an exhausted phenotype characterized by expression of inhibitory receptors, down-modulation of effector function, and metabolic impairments. T cell exhaustion protects from excessive immunopathology but limits clearance of virus-infected or tumor cells. We transcriptionally profiled antigen-specific T cells from mice infected with lymphocytic cho...

OBJECTIVES: We compared the longer-term impact of the two most commonly applied forms of post-discharge management designed to minimize recurrent hospitalization and prolong survival in typically older patients with chronic heart failure (CHF). METHODS: We followed a multi-center randomized controlled trial cohort of Australian patients hospitalized with CHF and initially allocated to home-b...

OBJECTIVES: This study assessed the burden and determinants of cardiovascular and metabolic risk in a community sample of high risk Indigenous Australians. BACKGROUND: Indigenous Australians are over-represented in the most disadvantaged strata of Australian society. The role of psychosocial and socioeconomic factors in patterning cardiometabolic disease in this population is unclear. METHO...

BACKGROUND: To examine trends in 3-year mortality after a first hospitalization with diagnosed atrial fibrillation in a large cohort with and without important comorbidities. METHODS: The Swedish Hospital Discharge and Cause of Death Registries were linked to investigate trends in mortality for all patients 35 to 84 years hospitalized for the first time with a discharge diagnosis (principal ...

BACKGROUND: We assessed left ventricular dysfunction in a population at high risk for heart failure (HF), and explored associations between ventricular function, HF risk factors and NT-proB natriuretic peptide (NT-proBNP). METHODS AND RESULTS: 3550 subjects at high risk for incident HF (≥60 years plus ≥1 HF risk factor), but without pre-existing HF or left ventricular dysfunction, were recru...

BACKGROUND AND OBJECTIVES: Sympathetic activation is a hallmark of ESRD and adversely affects cardiovascular prognosis. Efferent sympathetic outflow and afferent neural signalling from the failing native kidneys are key mediators and can be targeted by renal denervation (RDN). Whether this is feasible and effective in ESRD is not known. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: In an ini...

BACKGROUND: We sought to assess whether cardiorenal anemia syndrome (CRAS) in chronic heart failure (CHF) patients contributes to sympathetic overactivity through modulation of sympathetic reflexes. METHODS AND RESULTS: We prospectively studied 15 patients with CRAS and CHF and 15 control CHF patients, matched for age, gender distribution, type of cardiomyopathy, left ventricular ejection frac...

BACKGROUND: Atrial fibrillation (AF) represents an increasing public health challenge with profound social and economic implications. METHODS: A comprehensive synthesis and review of the AF literature was performed. Overall, key findings from 182 studies were used to describe the indicative scope and impact of AF from an individual to population perspective. RESULTS: There are many pathway...

BACKGROUND: Children with transposition of the great arteries, in whom an arterial switch operation (ASO) is performed, have been shown to have an increased incidence of sudden death, which may be due to cardiac autonomic imbalance and repolarisation instability. We hypothesised that i) cardiac norepinephrine (NE) kinetics and ii) arterial baroreflex sensitivity (BRS), reflecting sympathetic a...

BACKGROUND: Dissociation between behavioural defensive active coping (AC) control albeit physiological "loss of control" responses was associated with silent ischaemia and structural wall abnormalities in African men. Whether it applies to structural alterations and endothelial dysfunction is uncertain. We therefore aimed to determine AC ethnic-gender specific receiver operating characteristic ...

BACKGROUND: The 12-lead electrocardiogram (ECG) represents an important diagnostic tool for detecting heart disease, but the "normal" ECG in those of African descent has yet to be definitively described. METHODS: We systematically analysed 12-lead ECGs from 387 urban South Africans determined to be heart disease free (using the Minnesota code) following advanced cardiologic assessment, inclu...

BACKGROUND: Angina and intermittent claudication impair function and mobility and reduce health-related quality of life. Both symptoms have similar etiology, yet the physical and psychological impacts of these symptoms are rarely studied in community-based cohorts or in individuals with isolated symptoms. METHODS: The 2003 Scottish Health Survey was a cross-sectional survey which enrolled a ...

BACKGROUND: Patients with Fontan circulation are known to have increased systemic vascular resistance (SVR) however the underlying mechanisms are uncertain. We therefore further investigated the haemodynamic and vascular profile of Fontan patients. METHODS: Eighteen adult subjects aged 25 ± 1 years who had undergone the Fontan procedure in their childhood (at age 6 ± 1 years) and not in clin...

BACKGROUND: The molecular mechanisms of exercise-induced cardioprotection are poorly understood. We recently reported that exercise training down-regulated gene expression of the Ras homolog gene family member A (RhoA). RhoA and its first effectors, the Rho-kinases (ROCK), have already been implicated in the pathogenesis of cardiovascular disease. The aim of this study was to compare the effec...

BACKGROUND: To investigate recent trends in incidence of hemorrhagic and non-hemorrhagic strokes in patients with atrial fibrillation (AF). METHODS: The Swedish Hospital Discharge and Cause of Death Registries were linked to provide outcome data. RESULTS: 321,276 patients 35 to 84years (56.5% male, mean age 71.5years) free of prior stroke with a first AF diagnosis during 1987-2006 were includ...

BACKGROUND: Health outcomes associated with atrial fibrillation (AF) continue to be poor and standard management often does not provide clinical stability. The Standard versus Atrial Fibrillation spEcific managemenT studY (SAFETY) compares the efficacy of a post-discharge, nurse-led, multi-disciplinary programme to optimise AF management with usual care. METHODS: SAFETY is a prospective, mul...

BACKGROUND: It is uncertain if improvements in long-term cardiovascular (CV) mortality have occurred in both men and women with ischemic and non-ischemic forms of heart failure (HF). METHODS: The Western Australia Hospital Morbidity Database was used to identify all index (first-ever) hospitalizations for HF between 1990 and 2005. Patients were followed until death attributed to cardiovascul...

BACKGROUND: Few data describe the case burden of heart disease and cardiovascular risk factors relative to other conditions in urban Africans seeking primary health care. METHODS: A clinical registry captured data on 1311 consecutive primary care patients (99% African) from two primary care clinics in Soweto, South Africa. Those with suspected sub-clinical heart disease had more advanced car...