Field Of Heart Research Articles

Early tirofiban versus heparin for bridging dual antiplatelet therapy in patients undergoing coronary endarterectomy combined with coronary artery bypass grafting: a multicenter randomized controlled trial protocol (the THACE-CABG trial)

BackgroundFor complete revascularization, patients with diffuse coronary artery disease should have a coronary endarterectomy and a coronary artery bypass graft (CE-CABG). Sadly, CE can lead to a lack of endothelium, which raises the risk of thrombotic events. Even though daily dual antiplatelet therapies (DAPT) have been shown to reduce thrombotic events, the risk of perioperative thrombotic events is high during the high-risk period after CE-CABG, and there is no consistent protocol to bridge DAPT. This trial aims to compare safety and efficacy between tirofiban and heparin as DAPT bridging strategies after CE-CABG.MethodsIn phase I, 266 patients undergoing CE-CABG will be randomly assigned to tirofiban and heparin treatment groups to compare the two treatments in terms of the primary safety endpoint, chest tube drainage in the first 24 h. If the phase I trial shows tirofiban non-inferiority, phase II will commence, in which an additional 464 patients will be randomly assigned. All 730 patients will be studied to compare major cardiovascular and cerebrovascular events (MACCEs) between the groups in the first 30 days after surgery.DiscussionGiven the possible benefits of tirofiban administration after CE-CABG, this trial has the potential to advance the field of adult coronary heart surgery.Trial registrationchictr.org.cn, ChiCTR2200055697. Registered 6 January 2022. https://www.chictr.org.cn/com/25/showproj.aspx?proj=149451. Current version: 20,220,620.

The retirement years of Doctor Helen B. Taussig: an intersection of art and medicine.

Dr Helen B. Taussig (1898-1986) worked a paediatric cardiologist at the Johns Hopkins University in Baltimore, Maryland from 1930 to 1963. Dr Taussig would become world-renowned for her contributions to the systemic-to-pulmonary artery shunt to treat congenital heart patients with cyanosis. This shunt would eventually be named after the surgeon/cardiologist as the Blalock-Taussig shunt. Dr Taussig's name was also attached to the description of one form of double outlet right ventricle called the Taussig-Bing malformation. Dr Taussig ultimately received the Presidential Medal of Freedom in 1964 as a testimony to her life-long contributions to the field of congenital heart surgery.In 1963, Dr Taussig retired from clinical practice but continued her teaching and academic pursuits at Johns Hopkins for another 14 years. Upon her "second retirement" in 1977, she moved to Kennett Square, PA. This paper will review the retirement years of Dr Helen Taussig and the curious intersection between art and medicine.

Current status of transplantation medicine in the field of heart and lung transplantation : Legal regulations and clinical implementation

Die Transplantationsmedizin in Deutschland ist klar strukturiert und verbindlich geregelt. Zur Stärkung der Organspende wurden die rechtlichen Rahmenbedingungen in den letzten Jahren mehrfach angepasst. Dennoch bleibt die eingeschränkte Organverfügbarkeit die Hauptlimitation dieser Therapie, auch im Bereich der Herz- und Lungentransplantation. Beide Verfahren sind mittlerweile etablierte Therapieoptionen für selektierte Patienten mit terminalem Organversagen. Ziel ist die Verbesserung der Lebensqualität und des Überlebens. Der Erfolg der Therapie hängt maßgeblich von der Selektion geeigneter Empfänger sowie dem optimalen peri- und postoperativen Management ab, einschließlich einer lebenslangen spezialisierten Nachsorge. Die Komplexität der Therapie erfordert ein hohes Maß an speziellen Kenntnissen und Fertigkeiten. Der vorliegende Beitrag fasst den aktuellen Stand der Transplantationsmedizin thorakaler Organe mit dem Fokus auf den Inhalt der neuen Zusatzweiterbildung Transplantationsmedizin zusammen.

Machine learning and artificial intelligence in cardiac transplantation: A systematic review.

BackgroundThis review aims to systematically evaluate the currently available evidence investigating the use of artificial intelligence (AI) and machine learning (ML) in the field of cardiac transplantation. Furthermore, based on the challenges identified we aim to provide a series of recommendations and a knowledge base for future research in the field of ML and heart transplantation.MethodsA systematic database search was conducted of original articles that explored the use of ML and/or AI in heart transplantation in EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to November 2021.ResultsOur search yielded 237 articles, of which 13 studies were included in this review, featuring 463 850 patients. Three main areas of application were identified: (1) ML for predictive modeling of heart transplantation mortality outcomes; (2) ML in graft failure outcomes; (3) ML to aid imaging in heart transplantation. The results of the included studies suggest that AI and ML are more accurate in predicting graft failure and mortality than traditional scoring systems and conventional regression analysis. Major predictors of graft failure and mortality identified in ML models were: length of hospital stay, immunosuppressive regimen, recipient's age, congenital heart disease, and organ ischemia time. Other potential benefits include analyzing initial lab investigations and imaging, assisting a patient with medication adherence, and creating positive behavioral changes to minimize further cardiovascular risk.ConclusionML demonstrated promising applications for improving heart transplantation outcomes and patient‐centered care, nevertheless, there remain important limitations relating to implementing AI into everyday surgical practices.

Current status of transplantation medicine in the field of heart and lung transplantation

Die Transplantationsmedizin in Deutschland ist klar strukturiert und verbindlich geregelt. Zur Stärkung der Organspende wurden die rechtlichen Rahmenbedingungen in den letzten Jahren mehrfach angepasst. Dennoch bleibt die eingeschränkte Organverfügbarkeit die Hauptlimitation dieser Therapie, auch im Bereich der Herz- und Lungentransplantation. Beide Verfahren sind mittlerweile etablierte Therapieoptionen für selektierte Patienten mit terminalem Organversagen. Ziel ist die Verbesserung der Lebensqualität und des Überlebens. Der Erfolg der Therapie hängt maßgeblich von der Selektion geeigneter Empfänger sowie dem optimalen peri- und postoperativen Management ab, einschließlich einer lebenslangen spezialisierten Nachsorge. Die Komplexität der Therapie erfordert ein hohes Maß an speziellen Kenntnissen und Fertigkeiten. Der vorliegende Beitrag fasst den aktuellen Stand der Transplantationsmedizin thorakaler Organe mit dem Fokus auf den Inhalt der neuen Zusatzweiterbildung Transplantationsmedizin zusammen.

Dynamics of the cardioelectric field of rats under chronic exposure to doxorubicin during atrial depolarization

The aim of the work is non-invasive identification of the features of the initial atrial activity by the dynamics of the cardioelectric field on the surface of the chest of experimental animals under chronic exposure to doxorubicin. Materials and methods . The distribution and dynamics of changes in cardioelectric potentials on the surface of the chest of rats under chronic exposure to doxorubicin during the period of initial atrial activity were investigated. Doxorubicin was administered intraperitoneally 1.5 mg/kg once a week for a month. The cumulative dose was 6 mg/kg animal weight. Results . It has been shown that chronic exposure to doxysubicin leads to changes in the positional dynamics of positive and negative cardiopotentials cardioelectric field of heart on the chest surface during the ascending and descending P-wave on the ECG in the II limb leads. It is observed significantly earlier the beginning of cardioelectric field formation, characteristic of atrial depolarization, on the body surface, the beginning, the peak and the end of the P-wave on the ECG in the II limb leads compared to the initial state. Conclusion . Chronic exposure to doxorubicin causes significant changes in the initial atrial activity, which leads to a significant change in the corresponding period of atrial depolarization in the dynamics of the cardioelectric field on the surface of the thorax of animals.

Phenomenon of Demikhov. At N.V. Sklifosovsky Institute (1960–1986). V.P. Demikhov and world transplantology in 1968-1969

The article has reviewed the advances of Soviet and world Transplantology in the field of heart and other organ transplantation achieved by the end of the 1960s. It is shown that there were several groups of doctors and scientists who worked in the USSR dealing with the problem of experimental organ transplantation and trying to bring this experience into clinic. The group of surgeons and urologists (B.V. Petrovsky, Y.M. Lopukhin, etc.) from the Research Institute of Clinical and Experimental Surgery and the 2nd MOLGMI named after N.I. Pirogov, which had the greatest administrative resources and technical capabilities, was successfully implementing kidney transplantation into clinic. The staff of the Faculty Surgery Department (V.S. Savelyev and others) of the 2nd MOLGMI named after N.I. Pirogov developed experimental approaches to heart and liver transplantation. Surgeons from the Tuberculosis Research Institute (N.I. Gerasimenko and others) were dealing with in lung auto- and homotransplats in experiment. All those studies were conducted in close contact with the Department of Operative Surgery and Topographic Anatomy of the 2nd MOLGMI named after N.I. Pirogov (G.E. Ostroverkhov) and the Research Laboratory for Organ Transplantation established at that Department (Y.M. Lopukhin). The leading position in heart transplantation in the country belonged to the Vishnevsky Institute of Surgery (A.A. Vishnevsky, etc.). Surgeons of the MMA named after S.M. Kirov (I.S. Kolesnikov, etc.) rendered a great assistance to the Institute. Apart from these institutions, the Organ Transplantation Laboratory (headed by V.P. Demikhov) worked at N.V. Sklifosovsky Research Institute for Emergency Medicine; it had gained a huge experimental experience, but had very modest opportunities to purchase equipment and pharmaceuticals, to conduct laboratory and morphological studies, having practically no prospects for introducing the results of its research into clinic. Meanwhile, the world clinical Transplantation continued to develop successfully, which was reflected in the materials of the 2nd International Symposium on Heart Transplantation held in 1969 in Montreal (Canada).

Self-regulation, co-regulation and cardio-ception: Parasympathetic ease-and-release in Somatic Movement Dance Therapy

This is a five-part article that shares the compassionate artistry and science behind self-regulation and co-regulation. Each section explores the concept of self-regulation and how Somatic Movement Dance Therapy supports health through self-regulatory and co-regulatory processes. Part 1 offers general reflections on self-regulation and how the field differs from bodywork modalities and mechanistic health regimes. Part 2 shares polyvagal theory and how practice supports a deep parasympathetic state (immobilization without fear). Part 3 enacts a research process where polyvagal theory is evident and applied in practice. Part 4 shares processes of co-regulation and the transpersonal heart-field. Part 5 details somatic touch combined with sense perception of the heart-field. I share photographic images of my students throughout where they are applying theory to practice and, additionally, empirically investigating how theory might support or illuminate their practice. The article shares how parasympathetic ease-and-release is an essential physiological state that underlies self-regulatory health. I also apply research by Doc Childre and Stephen Porges, attending to polyvagal theory and HeartMath; I share how this science shapes my practice and my training course in Somatic Movement Dance Therapy. The article is redacted from my new book, Somatic Movement Dance Therapy: The Healing Art of Self-Regulation and Co-Regulation. Across the pages I share sensory-perceptual pathways into a physiological state of consciousness (a transpersonal field of breath and heart) that supports ease and healing.

Lifetime management of aortic valve disease: Aligning surgical and transcatheter armamentarium to set the tone for the present and the future.

Transcatheter aortic valve replacement (TAVR) has already received the green light for high-, intermediate- and low-risk profiles and is an alternative for all patients regardless of age. It is clear that there has been a push towards the use of TAVR in younger and younger patients (<65 years), which has never been formally tested in randomized controlled trials but seems inevitable as TAVR technology makes steady progress. Lifetime management as a concept will set the tone in the field of the structural heart. Some subjects in this scenario arise, including the importance of optimized prosthetic hemodynamics for lifetime care; surgical procedures in the aortic root; management of structural valve degeneration with valve-in-valve procedures (TAVR-in-surgical aortic valve replacement [SAVR] and TAVR-in-TAVR) and redo SAVR; commissural alignment and cusp overlap for TAVR; the rise in the number of surgical procedures for TAVR explantation; and the renewed interest in the Ross procedure. This article reviews all these issues which will become commonplace during heart team meetings and preoperative conversations with patients in the coming years.

Year in Review 2020: Noteworthy Literature in Cardiothoracic Critical Care.

This year will be forever marked by the drastic changes COVID-19 wrought on our personal and professional lives. New roles and challenges in critical care have forced us to be constantly nimble and flexible in how we approach medicine. The strain of these challenges is apparent throughout the health care community and our society as a whole. Despite this adversity, 2020 will also be remembered for fantastic advances in research. This article is a collection of influential and exciting studies published in 2020 encompassing a broad swath of critical care with a focus on cardiothoracic critical care. Themes include examinations of early extracorporeal membrane oxygenation support for out-of-hospital cardiac arrest patients, the impact of sedation and other risk factors on perioperative mortality, a novel fluid resuscitation strategy following cardiac surgery, and advances in the fields of heart and lung transplantation as well as how they were affected by COVID-19. Given that many cardiothoracic intensivists were redeployed to the care of SARS-CoV-2 patients, we also discuss important advances in therapeutics for the virus.

COVID-19, myocarditis, and the other side of the bed.

COVID-19, myocarditis, and the other side of the bed.

Peculiarities of the Perception of the Lexemes of the Semantic Group «Internal human organs» by Ordinary and Professional Linguistic Consciousness (based on the material of the lexeme heart)

There is psycholinguistic description of the lexeme heart as a component of the semantic group «Internal human organs» is providing in this article. The associative fields of the lexeme heart were formed on the basis of a free associative experiment. This associative experiment was conducted in two groups of respondents: the doctors, the group of students of a medical university, and students of the humanitarian faculties, who doesn’t have medical education. The specificities of the psycholinguistic significance were detected this lexeme in ordinary and professional language consciousness when associative fields, their core and periphery were comparing. The psycholinguistic significance of this lexeme in the two groups is different. The basic meanings, peripheral fields do not match. People who work in medical sphere gave the larger terminological medical vocabulary. It shows the professional awareness of this lexeme by specialists. Psycholinguistic meanings are compared with a generalized lexicographic description. The lexicographic meaning of the lexeme of the heart is wider than the psycholinguistic meaning during the approaches of convergence of the core of the semanthem in the vocabulary descriptions and the results of the experiment. The conclusion was made on the data about the features of the awareness of the lexeme of heart by ordinary and professional language consciousness.

Versatility of fuzzy logic in chronic diseases: A review

The review aims at providing current state of evidence in the field of medicine with fuzzy logic for diagnosing diseases. Literature reveals that fuzzy logic has been used effectively in medicine. Different types of methodologies have been applied to diagnose the diseases based on symptoms, historical and clinical data of an individual. Increase in the number of recent applications of medicine with fuzzy-logic is an indication of growing popularity of fuzzy systems. Fuzzy intelligent systems developed during 2007–2018 have been studied to explore various techniques applied for disease prediction. In the traditional approach, a physician is required to diagnose disease based on historical and clinical data but the intelligent system will help physicians as well as individuals to detect disease at any location of the world. The studies of various fuzzy logic systems and classified fuzzy logic applications in the field of diabetes, iris, heart, breast cancer, dental, cholera, brain tumor, liver, asthma, viral, parkinson, lung, kidney, huntington and chest diseases have been included in the review. This study indicates all the benefits of the fuzzy logic to the society and direction to tackle the diseases that still need software for their accurate detection. Further, different case studies for celiac disease have been reported earlier. The current review aims at exploring the future direction for fuzzy methodologies and domain on celiac disease.

Machine perfusion of thoracic organs.

This article summarizes recent knowledge and clinical advances in machine perfusion (MP) of thoracic organs. MP of thoracic organs has gained much attention during the last decade. Clinical studies are investigating the role of MP to preserve, resuscitate, and assess heart and lungs prior to transplantation. Currently, MP of the cardiac allograft is essential in all type DCD heart transplantation while MP of the pulmonary allograft is mandatory in uncontrolled DCD lung transplantation. MP of thoracic organs also offers an exciting platform to further investigate downregulation of the innate and adaptive immunity prior to reperfusion of the allograft in recipients. MP provides a promising technology that allows pre-transplant preservation, resuscitation, assessment, repair, and conditioning of cardiac and pulmonary allografts outside the body in a near physiologic state prior to planned transplantation. Results of ongoing clinical trials are awaited to estimate the true clinical value of this new technology in advancing the field of heart and lung transplantation by increasing the total number and the quality of available organs and by further improving recipient early and long-term outcome.

Ultra-Sensitive Vector Magnetometer for Magnetocardiographic Mapping

In this paper, the use of a magnetometer based on iron garnet films for magnetocardiographic measurements is described. All measurements were performed at room temperature, without sensor cooling. A map of the three orthogonal vector components of the magnetic field of the human heart was obtained.

O214 Interdependence of heart and brain bioelectrical activity

Objectives To study relationship between bioelectrical activity of brain and heart. The aim was to extract components related to heart activity in multichannel EEG recordings of healthy subjects. Methods The studied group consisted of 20 healthy subjects in age 20–32 yrs. Bioelectrical activity of the brain, electrooculography (HEOG and VEOG), respiratory signal and ECG from V5 derivation were recorded. In EEG signal an ECGEEG component related to the action of heart and one related to the interactions between the electric fields of heart and brain were extracted. The variations of the ECGEEG potential during the heart beat cycle were mapped. Results In the study group the topographic distribution of the ECGEEG potential had a cyclic change during the heart beat cycle. ECGEEG component revealed differences in polarity and amplitude as well as asymmetrical topographic distribution. The series of consecutive maps indicate asymmetry with anti-clockwise rotation. Conclusions The results indicate the significant, simultaneous changes of the analysed parameters of the EEG and ECG signals which suggests that they can be considered as indicators of the interaction between the autonomic and the central nervous systems. Significance Investigations of the relationship between the bioelectrical activities of heart and brain allow to expand the diagnostic capabilities of EEG and ECG, especially in the differential diagnosis of the neurologic and cardiologic diseases.

A Method and an Algorithm to Reconstruct the Spatial Structure of Current Density Vectors in Magnetocardiography

The spatial distribution of parameter values (measured at points of the plane of observation) of the magnetic field of the human heart is associated with the distribution of current density vectors in the plane parallel to the plane of measurements and secant relative to the heart. The inverse problem is solved with the help of the Fourier integral transform. The algorithm is modeled based on real data of magnetometric investigations of the human heart.

(879) - The Effect of Inflow Cannula Length on the Intraventricular Flow Field of the EvaHeart LVAD-Assisted Heart

(879) - The Effect of Inflow Cannula Length on the Intraventricular Flow Field of the EvaHeart LVAD-Assisted Heart

Визуализация процесса возбуждения в синоатриальной области сердца кошки при раздражении блуждающего нерва

Визуализация процесса возбуждения в синоатриальной области сердца кошки при раздражении блуждающего нерва

Optical multichannel room temperature magnetic field imaging system for clinical application

Optically pumped magnetometers (OPM) are a very promising alternative to the superconducting quantum interference devices (SQUIDs) used nowadays for Magnetic Field Imaging (MFI), a new method of diagnosis based on the measurement of the magnetic field of the human heart. We present a first measurement combining a multichannel OPM-sensor with an existing MFI-system resulting in a fully functional room temperature MFI-system.