Enalapril and eplerenone disparately impact on cellular signalling in DIC. Eplerenone, on top of Dox treatment was not protective and associated with increased levels of plasma aldosterone and of cardiac CTGF. In contrast, we show that primary prevention with enalapril preserves LV morphology and function in a clinically relevant model of chronic DIC, with increased stimulation of the PI3K/AKT/mTOR axis and normal CTGF levels suggesting potential therapeutic implications.
An 88-year-old woman with a prior history of aortic stenosis and history of valvuloplasty presented with worsening symptoms of heart failure and dizziness. She underwent successful transcatheter aortic valve replacement (TAVR) without complications. Follow-up echocardiograms revealed a small fistula connecting aorta to the right ventricle. The patient was initially asymptomatic but 3 months later developed overload of the right ventricle and heart failure and chose to continue medical therapy. She died of progressive heart failure at 9 months from onset of fistula. Aorto-right ventricular fistula is a rare complication of TAVR with only four cases reported in literature thus far.
Compared with unmodified ischemia, K(+)-modified ischemia resulted in marked activation delay and a high incidence of ventricular fibrillation. Based on measurements of longitudinal conduction velocity, the inhibitory effect of verapamil, and the results of experiments with high [K+]e plus epinephrine, we conclude that the marked activation delay during K(+)-modified ischemia represents conduction mediated by the slow inward current. Because the conditions produced by K(+)-modified ischemia (high [K+]e with minimal acidosis) are similar to conditions in and near ischemic border regions, we hypothesize that responses mediated by the slow inward current may occur in such regions during unmodified ischemia and may participate in the development of reentrant arrhythmias.
Activation recovery intervals obtained from unipolar electrograms provide an accurate assessment of changes in action potential duration throughout the ischemic zone during acute no-flow ischemia, provided the characteristics of the electrograms meet specific predetermined criteria.
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