Inherited cardiac arrhythmias (ICA) have become one of the leading causes of sudden cardiac death in people under 40 years old. Variants in the ankyrin-B or ankyrin-2 genes will result in several cardiac arrhythmias ranging from sinus node dysfunction to life-threatening arrhythmias. In this case study, we report a typical ankyrin-2 variant, in which ventricular tachyarrhythmias might be reproduced through exercise or stress tests.
To investigate the clinical value of SDI,EMATc,BNP in the predictive of post-PCI early ventricular remodeling (EVR) in patients with acute myocardial infarction (AMI). 161 patients with asymptomatic acute anterior wall myocardial infarction after PCI were involved; BNP and acoustic cardiography were performed in pre-operation, Color Doppler echocardiography was performed after 72 hours. The patients were divided into two groups, which were the EVRgroup (EF% < 50%, EVR) and the normal left ventricular systolic function group (EF% ≥ 50%, Non- EVR). EMATc、SDI、BNP were independent risk factors for post-PCI EVRin patients with AMI [SDI (OR 15.924, 95% CI 3.649-69.491, p≤0.001) ,EMATc (OR 2.319, 95% CI 1.447-3.719, p<0.001 ) and BNP (OR 1.075, 95% CI 1.018-1.134,p=0.009)]. The area under the ROC curve (AUC) for EMATc was 0.89, with an optimal cutoff point of 12.2, EMATc produced a sensitivity of 80% and a specificity of 83%; whereas, with an optimal cutoff point of 100pg/ml, BNP produced a sensitivity of 46% and a specificity of 83%. EMATc、BNP、SDI have good predictive value for the occurrence of EVR in patients with asymptomatic acute anterior wall myocardial infarction after PCI.
Objective
To compare differences in ST-segment decline between surviving and non-surviving patients with acute fulminant myocarditis (AFM) complicated by ST-segment elevation supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO).
Methods
We retrospectively analyzed the clinical data from patients with AFM complicated by ST elevation receiving VA-ECMO support in our hospital between January 2017 and December 2019. Based on survivorship status at discharge, patients were separated into survivor and non-survivor groups. The degree of decrease in the sum of ST-segment elevation amplitudes (∑STE) at 24 h, 48 h, and 72 h was then compared between these groups to assess the prognostic relevance of these parameters as a noninvasive electrophysiological cardiac biomarker.
Results
In total, 19 AFM patients that underwent VA-ECMO support were included in this study cohort. The mean age of these patients was 35, and 14 survived treatment (73.7%), while 5 did not. Following VA-ECMO support, the 72h∑STE in the survivor group was 0.09 ± 0.093 mm, with this value being significantly lower than that observed in the non-survivor group (0.24 ± 0.270 mm). Significant differences in both 48h∆∑STE (0.73 ± 0.298 vs. 0.65 ± 0.112, P < 0.05) and 72h∆∑STE (0.81 ± 0.353 vs. 0.78 ± 0.045, P < 0.01) were observed when comparing the survivor and non-survivor groups, and the decrease was significantly greater in the survivor group relative to the non-survivor group.
Conclusions
VA-ECMO can effectively treat cardiac arrest or cardiogenic shock resulting from AFM. The magnitude of ST-segment retreat may be associated with patient recovery following myocardial injury, potentially predicting prognostic outcomes together with other indicators in a manner that can guide treatment-related decision-making or inform ECG frequency.
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