Zinc (Zn) supplementation in acute myocardial ischaemia and reperfusion (I/R) is cardioprotective, however the effect of dietary Zn deficiency on I/R outcomes is unknown. Furthermore, Zn deficiency leads to VSMC apoptosis, but its effect on vascular function has not been determined. The aims of this study were therefore to determine the effect of a Zn deficient diet in rats on the outcome of I/R and ex vivo vascular function. Male rats were allocated to one of three groups: 1) Zn adequate (ZA) diet (35mg Zn/kg) fed ad libitum; 2) Zn deficient (ZD) diet (

Declining trends in the incidence of hip fractures in people aged 65 years or over in years 2000–2011 S. Giannini, S. Sella, M. Rossini, D. Braghin, D. Gatti, MT Vilei, A. Amabile, M. Fusaro, AC Frigo, G. Sergi, R. Lovato, M. Nobile, F. Fabris and S. Adami 60

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice. One of its most devastating complications is the development of thromboembolism leading to fatal or disabling stroke. Oral anticoagulation (OAC, warfarin) is the standard treatment for stroke prevention in patients with AF with an increased stroke risk. However, there are several obstacles to long-term OAC therapy, including the risk of serious bleeding, several drug–drug interactions and the need for frequent blood testing. Although newer oral anticoagulants have been developed, these drugs also face issues of major bleeding and non-compliance. Therefore, alternative treatment options for stroke prevention in patients with AF with a high stroke risk are needed. Percutaneous left atrial appendage (LAA) occlusion is an evolving therapy, which should be taken into consideration in those patients with non-valvular AF with a high stroke risk and contraindications for OAC. This article aims to discuss the rationale for LAA closure, the available LAA occlusion devices and their clinical evidence until now. Moreover, we discuss the importance of proper patient selection, the role of various imaging techniques and the need for a more tailored postprocedural antithrombotic therapy.

Background: Temporary percutaneous left ventricular assist devices (TPLVAD) can be inserted and removed in awake patients. They substitute left ventricular function for a period of up to a few weeks and provide an excellent backup and bridge to recovery or decision. Methods: Retrospective analysis of 75 patients who received TPLVAD to treat cardiogenic shock (n 5 49) or to facilitate high-risk percutaneous coronary intervention (PCI) (n 5 26). Forty-two patients with cardiogenic shock and 16 patients with high-risk PCI received a TandemHeart and 7 patients and 10 patients, respectively, received an Impella Recover LP 2.5. Outcome and related complications up to 1 month are reported with reference to device depending function. Results: One-month survival was 53% in patients with shock and 96% in patients with PCI. Conclusion: TPLVADs can support the failing heart with acceptable risk. Outcome is better in prophylactic use than in patients with cardiogenic shock. VC 2011 Wiley-Liss, Inc.

Animal experiments have shown that the coronary circulation is pressure distensible, i.e., myocardial blood volume (MBV) increases with perfusion pressure. In humans, however, corresponding measurements are lacking so far. We sought to quantify parameters reflecting coronary distensibility such as MBV and coronary resistance (CR) during and after coronary angioplasty. Thirty patients with stable coronary artery disease underwent simultaneous coronary perfusion pressure assessment and myocardial contrast echocardiography (MCE) of 37 coronary arteries and their territories during and after angioplasty. MCE yielded MBV and myocardial blood flow (MBF; in ml · min(-1) · g(-1)). Complete data sets were obtained in 32 coronary arteries and their territories from 26 patients. During angioplasty, perfusion pressure, i.e., coronary occlusive pressure, and MBV varied between 9 and 57 mmHg (26.9 ± 11.9 mmHg) and between 1.2 and 14.5 ml/100 g (6.7 ± 3.7 ml/100 g), respectively. After successful angioplasty, perfusion pressure and MBV increased significantly (P < 0.001 for both) and varied between 64 and 118 mmHg (93.5 ± 12.8 mmHg) and between 3.7 and 17.3 ml/100 g (9.8 ± 3.4 ml/100 g), respectively. Mean MBF increased from 31 ± 20 ml · min(-1) · g(-1) during coronary occlusion, reflecting collateral flow, to 121 ± 33 ml · min(-1) · g(-1) (P < 0.01), whereas mean CR, i.e., the ratio of perfusion pressure and MBF, decreased by 20% (P < 0.001). In conclusion, the human coronary circulation is pressure distensible. MCE allows for the quantification of CR and MBV in humans.

In presence of immunosuppression Cytomegalovirus (CMV) infection can cause severe and potentially fatal infection involving multiple organs. In healthy immunocompetent individuals CMV usually causes an asymptomatic or mild infection with spontaneous cure. No specific therapy is needed. Rarely, however, the primary infection can be severe with multiple organs injuries and fatal cases are described. In these situations antiviral therapy is indicated and the clinical and biological response is very rapidly good. We describe a clinical case and present a review of the literature.