European Journal of Cardiovascular Medicine

Background: Infective endocarditis is a microbial infection of endocardial surface of the heart and vegetation is the characteristic lesion of the disease. Mural endocarditis is a condition of rare diagnosis and may be difficult to find vegetation by standard views in transthoracic echocardiography (TTE). Identifying the mural vegetation not only helps to diagnose Infective endocarditis, but also predicts the risk for developing embolism. Aim of this study is to find the occurrence of embolism in patients with mural endocarditis.Method: A Retrospective, observational study was done for IE patients admitted from the year 2012 to 2018, in which total of 58 patients with definite diagnosis of infective endocarditis were identified. Among which 8 patients were excluded based on the exclusion criteria. Results: Total 50 patients were identifi d with IE, which includes 7 with mural vegetation and 43 without mural vegetation. Cultures were positive in 71.4% and 88.3% IE patients with and without mural vegetation respec- tively. One patient was found to have corynebacterium species with mural vegetation and embolic stroke, which is a rare occurrence. Among 43 IE patients without mural vegetation, 88.3% patients showed presence of veg- etation in echocardiogram. Size of vegetation were 13 ± 6 and 14.6 ± 2.9 mm, respectively (p>0.005). All the patients with mural vegetation and 9.3% from without mural vegetation had cerebral embolic events (p < 0.005).Conclusion: ough mural vegetation is not common, but if present, it helps in diagnosis and also it may predict a propensity for embolism. Our results indicate that in patients with mural endocarditis, the propensity of embo- lism is more.

Congenital heart defects (CHDs) children are malnourished and also had increased morbidity and mortality due to persistent impairment of somatic growth, frequent hospitalisation and increased death rate. All major congenital anomalies comprise of heart defects is Twenty- eight percent Methods– 52 children are taken who are having CHD; detailed clinical examination and Nutritional status examination for Weight for Age, Weight for Height, Body Mass Index, MUAC were taken. Results - In this study on 52 children, 67.3% were in the age group 5-12 years whereas 32.7% belonged to age group 12mon-59mon.The male to female ratio were 1:0.9. 80.8% had ACHD; out of which VSD was the most common (36,5%).19.2% had CCHD, out of which TOF was the most common (13.5%) of ACHD. In children with ACHD, 76.5% had mild, 57.1% had moderate,50% had severe stunting according to height for age whereas in children with CCHD ,23.5% hadmild,42.9% had moderate,50% had severe stunting, statistically significant with p-value - 0.0464

We herein describe an inquisitive electrocardiographic finding encountered during treadmill testing which could have led to disastrous erroneous actions had it not been recognized timely in an ingenious manner. e need to promptly identify such veiled observations is of utmost importance as it can affect the outcomes in an undesirable way. Careful scrutiny of such information should always be matched with accompanying clinical scenario for opti- mal results.

The safety and efficacy of coronary stents utilised for treatment of ischaemic heart disease have been extensively evaluated. In comparison with bare metal stents, first-generation drug-eluting stents more than halved the need for target lesion revascularisation (TLR). However, the long-term safety has been questioned as the first-generation drug-eluting stents seemed to be associated with a small, but increased, risk of (very) late stent thrombosis. The latter may be related to an inflammatory reaction caused by the polymer used for drug release control. The second-generation zotarolimus- eluting Endeavor® stent was believed to represent a safer alternative. We present an overview of our results from a large randomised trial and a large registry, both of which compared clinical outcomes with the Endeavor® and the first-generation sirolimus-eluting Cypher® stent. Both studies indicated that the Endeavor® stent had higher risks of adverse outcomes. We discuss these data in the light of the current available data from other randomised comparisons of these two drug-eluting stents.

Almost any definition of biological life includes the term “movement”, which is inherently linked to the sensation of mechanically induced deformation. As such, mechanosensation (a cell’s perception of mechanical stimuli) as well as mechanotransduction (transmission of mechanically induced signals) belong to the most fundamental processes in biology. These processes are particularly important in cardiovascular physiology, as each cycle of contraction and relaxation causes dynamic deformations of the heart and the large blood vessels. Cardiomyocytes are equipped with different mechanisms aimed to sense any form of mechanical deviation. For example, the titin springs extend and unfold elastic domains during diastolic distension and may serve as a length sensor, in contrast to the Z-discs, which experience particularly high forces during systole and may serve as a tension sensor. Activation of different sensors at the cellular level affects the composition of signalosomes attached to these structures, and these signalling complexes eventually translate the mechanical information into functional alterations via short term (i.e., activation of kinases) or long term (i.e., altered gene expression) effects. At the organ level, mechanosensation is involved in diverse feedback mechanisms such as the Bainbridge reflex, the Frank-Starling mechanism, and ischemic preconditioning. Therefore, it is not surprising that mutations in components of the cardiomyocyte stretch sensory apparatus cause cardiomyopathy and heart failure. Although significant progress has been made in this field during the last decade, the molecular mechanisms underlying mechanosensation still remain poorly understood. The article offers an overview on the fundamental processes involved in cardiomyocyte stretch sensing and provides important links to clinical cardiology.