BACKGROUND: The clinical impact of Periprocedural myocardial injury (PMI) in patients undergoing permanent pacemaker implantation with Left Bundle Branch Area Pacing (LBBAP) is unknown. METHODS: 130 patients undergoing LBBAP from January 2020 to June 2021 and completing 12 months follow up were enrolled to assess the impact of PMI on composite clinical outcome (CCO) defined as any of the following: all-cause death, hospitalization for heart failure (HHF), hospitalization for acute coronary syndrome (ACS) and ventricular arrhythmias (VAs). High sensitivity Troponin T (HsTnT) was measured up to 24-h after intervention to identify the peak HsTnT values. PMI was defined as increased peak HsTnT values at least > 99th percentile of the upper reference limit (URL: 15 pg/ml) in patients with normal baseline values. RESULTS: PMI occurred in 72 of 130 patients (55%). ROC analysis yielded a post-procedural peak HsTnT cutoff of fourfold the URL for predicting the CCO (AUC: 0.692; p = 0.023; sensitivity 73% and specificity 71%). Of the enrolled patients, 20% (n = 26) had peak HsTnT > fourfold the URL. Patients with peak HsTnT > fourfold the URL exhibited a higher incidence of the CCO than patients with peak HsTnT ≤ fourfold the URL (31% vs. 10%; p = 0.005), driven by more frequent hospitalizations for ACS (15% vs. 3%; p = 0.010). Multiple (> 2) lead repositions attempts, the use of septography and stylet-driven leads were independent predictors of higher risk of PMI with peak HsTnT > fourfold the URL. CONCLUSIONS: PMI seems common among patients undergoing LBBAP and may be associated with an increased risk of clinical outcomes in case of more pronounced (peak HsTnT > fourfold the URL) myocardial damage occurring during the procedure.

• MeSH
• Bundle-Branch Block MeSH
• Cardiac Pacing, Artificial MeSH
• Middle Aged MeSH
• Humans MeSH
• Heart Injuries etiology   MeSH
• Aged MeSH
• Troponin T * blood   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Power hammers are mechanised forging devices that constitute a pivotal part of steel manufacturing. Power hammer-associated injuries are a rare occurrence. We report a noteworthy case of a 52-year-old man who sustained a high-energy penetrating injury while working with a power (counterblow) hammer. The man used a sizable disc-shaped metallic object to dislodge the forging wedged in the machine by applying the force of the striking ram on it. On impact, the object ejected and struck the man in the right lateral portion of the chest. The autopsy disclosed extensive damage to the thoracic and abdominal organs. The cause of death was opined to be exsanguination due to penetrating trauma of the heart and transection of the descending aorta. The investigation confirmed a breach of safety regulations. To the best of our knowledge, this is the first power (counterblow) hammer-related fatality in medico-legal literature.

• MeSH
• Aorta, Thoracic injuries   pathology   MeSH
• Foreign Bodies pathology   MeSH
• Exsanguination * etiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Wounds, Penetrating * pathology   MeSH
• Heart Injuries pathology   MeSH
• Accidents, Occupational MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

This research aimed to evaluate whether vagus nerve stimulation (VNS) could effectively prevent septic shock-induced cardiac injury in rats and investigate the potential mechanisms. Female Sprague-Dawley rats were divided into the Sham group (sham cecal ligation and puncture [CLP] plus vagal nerve trunk separation), the Vehicle group (CLP plus vagal nerve trunk separation), and the VNS groups (CLP plus vagal nerve trunk separation plus VNS). The left ventricular function was analyzed by echocardiography. Histologic examinations of the cardiac tissues were performed through hematoxylin and eosin staining and TUNEL staining. The Vehicle group had worse cardiac function, higher levels of cardiac injury markers, and enhanced myocardial apoptosis than the Sham group. The rats in the VNS groups had enhanced cardiac function, lower levels of cardiac injury markers, and inhibited myocardial apoptosis than those in the Vehicle group. Elevated interleukin-1beta and tumor necrosis factor-alpha-levels and activated nuclear factor kappa B (NF-kappa-B) signal in septic shock rats were inhibited by the performance of VNS. This study suggests that VNS contributes to the reduction of myocardial apoptosis and improvement of left ventricular function to attenuate septic shock-induced cardiac injury in rats. The performance of VNS inhibits the inflammatory responses in heart tissues via the regulation of NF-kappa-B signal.

• MeSH
• Rats MeSH
• Myocardium pathology   MeSH
• NF-kappa B MeSH
• Heart Injuries * pathology   MeSH
• Rats, Sprague-Dawley MeSH
• Shock, Septic * complications   therapy   pathology   MeSH
• Heart MeSH
• Vagus Nerve Stimulation * MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

To investigate the effect of hydrogen sulfide (H2S) on myocardial injury in sepsis-induced myocardial dysfunction (SIMD), male C57BL/6 mice were intraperitoneally injected with lipopolysaccharide (LPS) (10 mg/kg, i.p.) to induce cardiac dysfunction without or with the H2S donor sodium hydrosulfide (NaHS) (50 μmol/kg, i.p.) administration 3 h after LPS injection. Six hours after the LPS injection, echocardiography, cardiac hematoxylin and eosin (HE) staining, myocardial damage and inflammatory biomarkers and Western blot results were analyzed. In mice, the administration of LPS decreased left ventricular ejection fraction (LVEF) by 30 % along with lowered H2S levels (35 % reduction). It was observed that cardiac troponin I (cTnI), tumor necrosis factor-alpha (TNF-alpha), and interleukin-1beta (IL-1beta) levels were all increased (by 0.22-fold, 2000-fold and 0.66-fold respectively). HE staining revealed structural damage and inflammatory cell infiltration in the myocardial tissue after LPS administration. Moreover, after 6 h of LPS treatment, toll-like receptor 4 (TLR4) and nod-like receptor protein 3 (NLRP3) expressions were up-regulated 2.7-fold and 1.6-fold respectively. When compared to the septic mice, NaHS enhanced ventricular function (by 0.19-fold), decreased cTnI, TNF-alpha, and IL-1beta levels (by 11 %, 33 %, and 16 % respectively) and downregulated TLR4 and NLRP3 expressions (by 64 % and 31 % respectively). Furthermore, NaHS did not further improve cardiac function and inflammation in TLR4-/- mice or mice in which NLRP3 activation was inhibited by MCC950, after LPS injection. In conclusion, these findings imply that decreased endogenous H2S promotes the progression of SIMD, whereas exogenous H2S alleviates SIMD by inhibiting inflammation via the TLR4-NLRP3 pathway suppression.

• MeSH
• Ventricular Function, Left MeSH
• Cardiomyopathies * MeSH
• Lipopolysaccharides toxicity   MeSH
• Mice, Inbred C57BL MeSH
• Mice MeSH
• Heart Injuries * MeSH
• NLR Family, Pyrin Domain-Containing 3 Protein MeSH
• Sepsis * chemically induced   complications   drug therapy   MeSH
• Hydrogen Sulfide * pharmacology   therapeutic use   MeSH
• Stroke Volume MeSH
• Tumor Necrosis Factor-alpha MeSH
• Toll-Like Receptor 4 metabolism   MeSH
• Inflammation pathology   MeSH
• Animals MeSH
• Check Tag
• Male MeSH
• Mice MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

Kontext: Periprocedurální poškození myokardu a jeho význam pro klinickou praxi u stabilizovaných pa- cientů je stále předmětem diskuse. Tímto tématem se za celé roky zabývala řada studií s různými definicemi, prahovými hodnotami a biomarkery. Cílem naší studie bylo popsat výsledný klinický stav pacientů s periprocedurálním poškozením myokardu pomocí definic nejnovějších, 4. doporučených postupů UDMI. Metody: Do monocentrické studie bylo retrospektivně zařazeno 238 pacientů po elektivní perkutánní koronární intervenci. Pacienti s periprocedurálním poškozením myokardu byli po výkonu srovnáni s pacienty s normálními hodnotami troponinu z hlediska výsledného klinického stavu. Mezi primární sledované parametry patřily úmrtí, infarkt myokardu, cévní mozková příhoda, refrakterní angina pectoris, revaskularizace cílové léze a hospitalizace pro akutní koronární syndrom do jednoho roku. Výsledky: Periprocedurální poškození myokardu bylo zjištěno u 67,2 % (n = 160) pacientů. Počty lézí a stentů, celková délka stentů, celkový průměr stentů, stav po dilataci, počty překrývajících se stentů, stenty na bifurkacích a skóre SYNTAX byly statisticky významně vyšší ve skupině s poškozením myokardu. Uvedené sledované parametry se vyskytly u 16 pacientů (11 ve skupině s poškozením myokardu a 5 v kontrolní skupině). Během sledování nedošlo k žádnému úmrtí. Poprocedurální zvýšení hodnot troponinu nebylo nijak spojeno se sledovanými parametry (11 vs. 5; p = 0,56). V Kaplanově-Meierově analýze se křivky sledovaných parametrů v obou skupinách od sebe nevzdalovaly (log rank test; 95% interval spolehlivosti [CI], p = 0,71). Závěry: Velikost a délka stenu, dilatace po výkonu, překrývání stentů a implantace stentů do lézí v bifurkacích zvyšují riziko poškození myokardu. Periprocedurální poškození myokardu u stabilní anginy pectoris nelze použít k predikci výsledného stavu pacienta po jednom roce.

Background: Periprocedural myocardial injury and its clinical significance in stable patients are still under discussion. This subject has been assessed in many studies with different definitions, thresholds, and biomarkers for years. This study aimed to determine the clinical outcomes of periprocedural myocardial injury based on latest 4th UDMI guideline definitions. Methods: 238 patients who underwent elective percutaneous coronary intervention at single center were retrospectively enrolled. Patients who developed periprocedural myocardial injury were compared with patients with normal troponin values after the procedure for clinical outcomes. Primary clinical endpoints were death, MI, stroke, refractory angina, target vessel revascularization and hospitalization due to acute coronary syndrome at one year. Results: Periprocedural myocardial injury was observed in 67.2% (n = 160) of patients. Number of lesions and stents, total stent length, total stent diameter, post-dilatation, overlapping stents, bifurcation stenting and SYNTAX score were significantly higher in myocardial injury group. Clinical outcomes occurred in 16 patients, 11 of 16 had myocardial injury group, 5 of 16 had control group. No mortality was seen during the follow-up. Postprocedural troponin elevation was not associated with clinical outcomes (11 vs. 5, p = 0,56). Kaplan-Meier curve of clinical end points did not show any separation between the curves (Log rank test, 95% CI, p = 0,71). Conclusion: Stent size and length, post-dilatation, overlapping stents and stenting of bifurcation lesions lead to increase in myocardial injury. Periprocedural myocardial injury in stable angina does not predict clinical outcomes at one year.

• MeSH
• Kaplan-Meier Estimate MeSH
• Percutaneous Coronary Intervention MeSH
• Middle Aged MeSH
• Humans MeSH
• Heart Injuries * epidemiology   etiology   complications   MeSH
• Aged MeSH
• Angina, Stable * complications   MeSH
• Statistics as Topic MeSH
• Troponin analysis   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Clinical Study MeSH

• MeSH
• Humans MeSH
• Thoracic Injuries classification   MeSH
• Heart Injuries * classification   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

There is growing evidence that methamphetamine use during pregnancy may produce detrimental cardiovascular effects in the adult offspring. Prior work demonstrated that chronic methamphetamine exposure throughout the gestational period causes adult female offspring to become hypersensitive to myocardial ischemic injury. The goal of the present study was to determine whether this methamphetamine-induced effect occurs early or late in the gestational period. Pregnant female rats were divided into 4 experimental groups. Groups 1 and 2 received subcutaneous injections of saline (group 1) or methamphetamine (5 mg/kg) (group 2) throughout the gestational period. Group 3 received methamphetamine injections on days 1-11 and saline on days 12-22, and group 4 received saline on days 1-11 and methamphetamine on days 12-22. Hearts were isolated from adult (8 weeks) female offspring and subjected to 30 min ischemia and 2 hours reperfusion on a Langendorff isolated heart apparatus. Contractile function was measured via an intraventricular balloon, and infarct size was measured by triphenyltetrazolium chloride staining. Infarcts were significantly larger in methamphetamine exposed offspring regardless of whether they had been exposed to methamphetamine during the first half or the second half of the gestational period. Prenatal exposure to methamphetamine had no effect on preischemic contractile function or postischemic recovery of contractile function. These data indicate that methamphetamine use during either the first half or second half of pregnancy increases susceptibility to myocardial infarction in adult female offspring. These data provide further evidence that prenatal exposure to methamphetamine may increase the risk of developing cardiovascular diseases during adulthood.

• MeSH
• Myocardial Infarction * MeSH
• Rats MeSH
• Humans MeSH
• Methamphetamine * toxicity   MeSH
• Heart Injuries * MeSH
• Rats, Sprague-Dawley MeSH
• Heart MeSH
• Pregnancy MeSH
• Prenatal Exposure Delayed Effects * chemically induced   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Diagnosis, Differential MeSH
• Humans MeSH
• Heart Injuries * diagnosis   classification   pathology   therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Acute respiratory distress syndrome (ARDS) is characterized by diffuse lung damage, inflammation, oedema formation, and surfactant dysfunction leading to hypoxemia. Severe ARDS can accelerate the injury of other organs, worsening the patient ́s status. There is an evidence that the lung tissue injury affects the right heart function causing cor pulmonale. However, heart tissue changes associated with ARDS are still poorly known. Therefore, this study evaluated oxidative and inflammatory modifications of the heart tissue in two experimental models of ARDS induced in New Zealand rabbits by intratracheal instillation of neonatal meconium (100 mg/kg) or by repetitive lung lavages with saline (30 ml/kg). Since induction of the respiratory insufficiency, all animals were oxygen-ventilated for next 5 h. Total and differential counts of leukocytes were measured in the arterial blood, markers of myocardial injury [(troponin, creatine kinase - myocardial band (CK-MB), lactate dehydrogenase (LD)] in the plasma, and markers of inflammation [tumour necrosis factor (TNF)alpha, interleukin (IL)-6], cardiovascular risk [galectin-3 (Gal-3)], oxidative changes [thiobarbituric acid reactive substances (TBARS), 3-nitrotyrosine (3NT)], and vascular damage [receptor for advanced glycation end products (RAGE)] in the heart tissue. Apoptosis of heart cells was investigated immunohistochemically. In both ARDS models, counts of total leukocytes and neutrophils in the blood, markers of myocardial injury, inflammation, oxidative and vascular damage in the plasma and heart tissue, and heart cell apoptosis increased compared to controls. This study indicates that changes associated with ARDS may contribute to early heart damage what can potentially deteriorate the cardiac function and contribute to its failure.

• MeSH
• Apoptosis physiology   MeSH
• Biomarkers metabolism   MeSH
• Rabbits MeSH
• Disease Models, Animal MeSH
• Oxidative Stress physiology   MeSH
• Heart Injuries metabolism   pathology   MeSH
• Lung Injury metabolism   pathology   MeSH
• Meconium Aspiration Syndrome metabolism   pathology   MeSH
• Respiratory Distress Syndrome metabolism   pathology   MeSH
• Inflammation metabolism   pathology   MeSH
• Animals MeSH
• Check Tag
• Rabbits MeSH
• Male MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

This paper deals with a fatal stab wound suffered by a 29-year-old man and nonfatal injuries of 35-year-old and 67-year-old saw operators. Rip saw is a machine that is specially designed for making a rip cut, a cut made parallel to the direction of the wood grain. Rip-saw-related injuries mostly occur when a person is struck by the cutting material, which usually involves splinters of irregular shape and diameter. When the splinter strikes the body diagonally, the injuries may include abrasions, lacerations, and cut wounds; in situations where the victim is struck directly, the most common injuries are oval- or star-shaped stab wounds with a varying width of abrasions around the wounds. Therefore, such injuries may come across as injuries produced by a knife-like instrument, which is an added difficulty in the interpretation of such injuries.

• MeSH
• Wounds, Stab pathology   MeSH
• Adult MeSH
• Fibula diagnostic imaging   injuries   MeSH
• Tibial Fractures diagnostic imaging   etiology   MeSH
• Humans MeSH
• Tomography, X-Ray Computed MeSH
• Thoracic Injuries pathology   MeSH
• Hand Injuries etiology   pathology   MeSH
• Heart Injuries pathology   MeSH
• Accidents, Occupational * MeSH
• Aged MeSH
• Fractures, Comminuted diagnostic imaging   etiology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Case Reports MeSH