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BackgroundBody weight loss is an important feature of heart failure (HF) and tumors. It is related to both reduced survival and adverse reactions to therapy in both of these conditions. The mechanisms of body weight loss in patients with HF and tumors are considered to be similar. Yet, studies comparing those two populations are generally lacking. The aim of this study was to compare anthropometric and laboratory data, related to weight loss, between patients with chronic HF and patients with different tumors as well as control population.MethodsLaboratory and anthropometric data on 143 consecutive patients with chronic HF and malignant diseases as well as data for 20 controls were collected.ResultsPatients with HF had lower levels of C-reactive protein (CRP) and albumin compared to controls. Anthropometric measurements revealed lower body mass index (BMI), muscle strength, mid-arm circumference, and waist circumference in patients with HF compared to controls. Measurements of biceps, triceps, subscapular, and suprailiac skinfolds were also lower in HF group. Compared to solid tumor group, HF patients had lower levels of CRP and higher levels of hemoglobin. Solid tumor patients had lower values of BMI and subscapular skinfold thickness, as well as higher muscle strength compared to HF group. Finally, compared to patients with solid hematological tumors, HF group had lower levels of albumin, lower muscle strength, as well as lower mid-arm circumference.ConclusionWe found differences in anthropometric and laboratory features, related to weight loss, in patients with HF compared to control population that were expected. On the other hand, observed differences in HF group compared to patients with various tumors could imply different pathophysiological mechanisms of weight loss between those groups. Such data could serve as a cornerstone for studies with larger numbers of patients and deeper pathophysiological insight.

Distal embolization during coronary intervention of thrombotic material resulting in compromised coronary flow is a common complication usually described in the context of invasive treatment of the acute ST-segment elevation myocardial infarction (STEMI). In our case we report distal embolization, presumably with calcified atherosclerotic plaque fragment. It occurred during elective percutaneous coronary intervention on subostial part of right coronary artery. Fortunately, this embolization did not compromise distal flow but it resulted in a significant de novo lesion of the right coronary artery crux. This lesion was uncrossable for dilatation balloons using a variety of different basic and advanced tools and techniques. Therefore, we decided to perform rotational atherectomy that enabled a successful percutaneous coronary intervention with stent implantation.

The loss of a stent during percutaneous coronary intervention (PCI) is a rare complication of the procedure. Multiple manoeuvres for the stent extraction exist, using a small balloon being a common one (2). This case report demonstrates the loss of stent in the proximal segment of the RCA whose extraction attempt with a small size SCB failed. The SCB was unable to cross through the stent and kept pushing the stent distally up until the target location where it successfully crossed through the stent. Subsequent dilatation with larger size balloons achieved full stent expansion at the target location.

Heart failure (HF) with mid-range or mildly reduced ejection fraction (HFmrEF) is a separate clinical entity in the HF spectrum, with a left ventricular ejection fraction ranging from 40 to 49%. While sodium glucose co-transporter 2 inhibitors have become the cornerstone therapy for the entire HF spectrum, there are a few clinical trials of HFmrEF. This prospective observational study was conducted at Dubrava University Hospital, Zagreb, Croatia, from May 2021 to October 2023. We recruited 137 participants diagnosed with HFmrEF at admission. The majority were male, with a median age of 72 and overweight. A total of 110 participants were followed for 6 months and LVEF remained the same in the majority of patients (n = 62, 56.4%), improved in 32 patients (29.1%), and decreased in 3 patients (2.73%). A total of 64 participants were followed for 12 months: 39 remained the same (60.94%) and 25 improved. There were 13 deaths in (9.5%). While the empagliflozin group had a lower BMI at 6-month- and lower HbA1c at 12-month follow-up, there were no differences in death, HF hospitalizations, ER visits, or urinary tract infections in between groups. Despite recent and daily advances in the treatment of all HF phenotypes, HFmrEF still represents a challenge in everyday clinical practice.

Destructive thyroiditis is a self-limited disease characterized by acute release of preformed thyroid hormones. We present a patient with extremely rare acute painful thyroiditis after percutaneous coronary intervention (PCI) in acute myocardial infarction without ST-elevation. The acute onset of thyroid pain and increase of fT3, fT4 and parameters of inflammation were compatible with acute destructive thyroiditis. Such acute thyroiditis probably resulted from local inflammation induced by a large amount of iodine given to the patient via iodinated contrast media used during PCI. Because of the increasing number of patients referred to cardiac catheterization, invasive cardiologists should be aware of the potentially serious thyroid dysfunction that can result from iodinated contrast use. The aim of our paper is, in the light of the patient presented, to discuss the pathophysiology, clinical presentations, therapy and potential preventive measures in patients that develop thyroid dysfunction after PCI.

Ventricular fibrillation (VF) is a life-threatening arrhythmia that can lead to sudden cardiac death by compromising cardiac output. It is a common complication of acute myocardial infarction (MI) due to the electrical instability of the myocardium. Refractory VF is defined as sustained VF that persists despite appropriate interventions.