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2. Treatment and Imaging Modalities of Giant Coronary Aneurysms Resulting from Kawasaki Disease and Presenting as Acute Inferior Wall Myocardial Infarction

Author

Abu Akel, Mahmood, Hellman, Yaron M., Sawaed, Shtiwi, Sharoni, Erez, Eitan, Amnon, and Flugelman, Moshe Y.

Subjects
Article Subject, cardiovascular system, cardiovascular diseases
Abstract

Giant coronary aneurysms are late sequelae of Kawasaki disease (KD). We describe a 53-year-old patient who presented with acute myocardial infarction and proximal aneurysms of all three coronary arteries. Coronary angiography demonstrated the aneurysms, but CT angiography allowed accurate assessment of the real dimensions of the aneurysms and making the decision on the preferred method of revascularization. The patient underwent coronary bypass surgery and is asymptomatic at follow-up.

Published
2021
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5. Levosimendan beyond inotropy and acute heart failure: Evidence of pleiotropic effects on the heart and other organs: An expert panel position paper

Author

Farmakis, Dimitrios, Alvarez, Julian, Ben Gal, Tuvia, Brito, Dulce, Fedele, Francesco, Fonseca, Candida, Gordon, Anthony C., Gotsman, Israel, Grossini, Elena, Guarracino, Fabio, Harjola, Veli-Pekka, Hellman, Yaron, Heunks, Leo, Ivancan, Visnja, Karavidas, Apostolos, Kivikko, Matti, Lomivorotov, Vladimir, Longrois, Dan, Masip, Josep, Metra, Marco, Morelli, Andrea, Nikolaou, Maria, Papp, Zoltan, Parkhomenko, Alexander, Poelzl, Gerhard, Pollesello, Piero, Ravn, Hanne Berg, Rex, Steffen, Riha, Hynek, Ricksten, Sven-Erik, Schwinger, Robert H. G., Vrtovec, Bojan, Yilmaz, M. Birhan, Zielinska, Marzenna, Parissis, John, Clinicum, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, [Farmakis, Dimitrios -- Parissis, John] Univ Athens, Univ Athens, Dept Cardiol, Heart Failure Unit,Univ Attikon, Athens, Greece -- [Alvarez, Julian] Univ Santiago Compostela, Dept Anesthesia, Santiago De Compostela, Spain -- [Alvarez, Julian] Univ Santiago Compostela, Surg ICU, Santiago De Compostela, Spain -- [Ben Gal, Tuvia] Rabin Med Ctr, Cardiol Clin, Petah Tiqwa, Israel -- [Brito, Dulce] Hosp Santa Maria, Dept Cardiol, Ctr Hosp Lisboa Norte, Lisbon, Portugal -- [Fedele, Francesco] Sapienza Univ Rome, Dept Cardiovasc Resp Nephrol Anesthesiol & Geriat, Rome, Italy -- [Fonseca, Candida] Univ Nova Lisboa, Heart Failure Unit, Dept Internal Med,NOVA Med Sch,Fac Ciencias Med, Hosp Sao Francico Xavier,Ctr Hosp Lisbo Ocidental, Lisbon, Portugal -- [Gordon, Anthony C.] Imperial Coll London, Sect Anaesthet Pain Med & Intens Care, London, England -- [Gotsman, Israel] Hadassah Univ Hosp Jerusalem, Inst Heart, Cardiol Clin, Jerusalem, Israel -- [Grossini, Elena] Univ East Piedmont, Physiol Lab, Novara, Italy -- [Guarracino, Fabio] Azienda Osped Univ Pisana, Dept Anaesthesia & Crit Care Med Cardiothorac Ana, Pisa, Italy -- [Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Emergency Med, Helsinki, Finland -- [Hellman, Yaron] Carmel Hosp, Heart Failure Serv, Haifa, Israel -- [Heunks, Leo] Radboud Univ Nijmegen, Med Ctr, Dept Intens Care, Nijmegen, Netherlands -- [Ivancan, Visnja] Univ Hosp Ctr, Emergency Cardiol Dept, Zagreb, Croatia -- [Karavidas, Apostolos] G Gennimatas Gen Hosp, Dept Cardiol, Athens, Greece -- [Kivikko, Matti -- Pollesello, Piero] Orion Pharma, Crit Care Proprietary Prod, Espoo, Finland -- [Lomivorotov, Vladimir] State Res Inst Circulat Pathol, Dept Anesthesiol & Intens Care, Novosibirsk, Russia -- [Longrois, Dan] Univ Paris Diderot, Hop Uiversitaires Paris Nord Val Seine, Hop Bichat Claude Bernard, Dept Anesthesie Reanimat Chirurg, Paris, France -- [Masip, Josep] Hosp St Joan Despi Moises Broggi, Intens Care Unit, Barcelona, Spain -- [Metra, Marco] Univ & Civil Hosp, Cardiol Clin, Brescia, Italy -- [Morelli, Andrea] Univ Roma La Sapienza, Dept Anesthesiol & Intens Care, Policlin Umberto 1, Rome, Italy -- [Nikolaou, Maria] Sismanoglio & Amalia Fleming Gen Hosp, Dept Cardiol, Athens, Greece -- [Papp, Zoltan] Univ Debrecen, Fac Med, Dept Cardiol, Div Clin Physiol, Debrecen, Hungary -- [Parkhomenko, Alexander] Inst Cardiol, Dept Anesthesiol, Kiev, Ukraine -- [Parkhomenko, Alexander] Inst Cardiol, Intens Care Unit Cardiac Surg Patients, Kiev, Ukraine -- [Poelzl, Gerhard] Univ Klin Innsbruck, Innere Med 3, Innsbruck, Austria -- [Ravn, Hanne Berg] Rigshosp, Ctr Heart, Dept Cardiothorac Anaesthesia, Copenhagen, Denmark -- [Rex, Steffen] Univ Leuven, Dept Cardiovasc Sci, Leuven, Belgium -- [Riha, Hynek] Inst Clin & Expt Med, Dept Anaesthesiol & Intens Care Med, Cardiothorac Anaesthesiol & Intens Care, Prague, Czech Republic -- [Ricksten, Sven-Erik] Univ Gothenburg, Sahlgrenska Univ Hosp, Inst Clin Sci, Dept Anesthesiol & Intens Care Med, Gothenburg, Sweden -- [Schwinger, Robert H. G.] Klinikum Weiden, Med Klin 2, Weiden, Germany -- [Vrtovec, Bojan] Univ Clin Ctr Ljubljana, Dept Cardiol, Ljubljana, Slovenia -- [Yilmaz, M. Birhan] Cumhuriyet Univ, Dept Cardiol, Sivas, Turkey -- [Zielinska, Marzenna] Med Univ Lodz, Dept Intens Cardiac Therapy, Lodz, Poland, Brito, Dulce Alves -- 0000-0003-1278-1847, Lomivorotov, Vladimir -- 0000-0001-8591-6461, Pollesello, Piero -- 0000-0001-6994-768X, YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628, Zielinska, Marzenna -- 0000-0002-0118-8610, Gordon, Anthony -- 0000-0002-0419-547X, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, Alvarez, Julian -- 0000-0002-2518-0891, MORELLI, ANDREA -- 0000-0001-6065-1006, Riha, Hynek -- 0000-0002-9861-7361, Gotsman, Israel -- 0000-0001-9608-2298, and Rex, Steffen -- 0000-0002-3536-9321

Subjects
Levosimendan, 3121 General medicine, internal medicine and other clinical medicine, Inotropes, education, Heart failure, Cardioprotection, Cardiogenic shock, Organ protection
Abstract

WOS: 000384698300056, PubMed ID: 27498374, Levosimendan is a positive inotrope with vasodilating properties (inodilator) indicated for decompensated heart failure (HF) patients with low cardiac output. Accumulated evidence supports several pleiotropic effects of levosimendan beyond inotropy, the heart and decompensated HF. Those effects are not readily explained by cardiac function enhancement and seem to be related to additional properties of the drug such as anti-inflammatory, anti-oxidative and anti-apoptotic ones. Mechanistic and proof-of-concept studies are still required to clarify the underlying mechanisms involved, while properly designed clinical trials are warranted to translate preclinical or early-phase clinical data into more robust clinical evidence. The present position paper, derived by a panel of 35 experts in the field of cardiology, cardiac anesthesiology, intensive care medicine, cardiac physiology, and cardiovascular pharmacology from 22 European countries, compiles the existing evidence on the pleiotropic effects of levosimendan, identifies potential novel areas of clinical application and defines the corresponding gaps in evidence and the required research efforts to address those gaps. (C) 2016 The Authors. Published by Elsevier Ireland Ltd., Orion Pharma Oyj/Abp (Finland); Medis d.o.o. (Croatia); Biomed JR Ltd. (Israel); TENAX Therapeutics Ltd. (U.S.A.), This project did not receive any financial support, apart from unrestricted grants by Orion Pharma Oyj/Abp (Finland), Medis d.o.o. (Croatia), Biomed JR Ltd. (Israel), and TENAX Therapeutics Ltd. (U.S.A.) that covered the logistic expenses related to the consensus meeting in Athens on Feb. 26-27, 2016. The attendees did not receive any honoraria. P.P. and M.K. are employees of Orion Pharma.

Published
2016

7. An Intervention to Reduce the Time Interval Between Hospital Entry and Emergency Coronary Angiography in Patients with ST-Elevation Myocardial Infarction.

Author

Karkabi, Basheer, Jaffe, Ronen, Halon, David A., Merdler, Amnon, Khader, Nader, Rubinshtein, Ronen, Goldstein, Jacob, Zafrir, Barak, Zissman, Keren, Ben-Dov, Nissan, Gabrielly, Michael, Fuks, Alex, Shiran, Avinoam, Adawi, Salim, Hellman, Yaron, Shahla, Johny, Halabi, Salim, Cohen, Shai, Bergman, Irina, and Kassem, Sameer

Published
2017

9. B-TYPE NATRIURETIC PEPTIDE LEVELS PREDICT VENTRICULAR ARRHYTHMIA POST LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION

Author

Hellman, Yaron Moshe, primary, Hadi, Azam, additional, Jani, Milena, additional, Lin, Hongbo, additional, Shen, Changyu, additional, Wang, I-Wen, additional, Wozniak, Thomas, additional, Hashmi, Zubair, additional, Pickrell, Jeanette, additional, Caccamo, Marco, additional, Gradus-Pizlo, Irmina, additional, and Malik, dnan, additional

Published
2014
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12. A prescribed walking regimen plus arginine supplementation improves function and quality of life for patients with pulmonary arterial hypertension: a pilot study.

Author

Brown MB, Kempf A, Collins CM, Long GM, Owens M, Gupta S, Hellman Y, Wong V, Farber M, and Lahm T

Abstract

Current evidence suggests that exercise training is beneficial in pulmonary arterial hypertension (PAH). Unfortunately, the standard supervised, hospital-based programs limit patient accessibility to this important intervention. Our proof-of-concept study aimed to provide insight into the usefulness of a prescribed walking regimen along with arginine supplementation to improve outcomes for patients with PAH. Twelve PAH patients (all women) in New York Heart Association (NYHA) functional class (FC) II (n = 7) or III (n = 5) and in stable condition for ≥ 3 months were enrolled. Patients performed home- and fitness-center- based walking at 65-75% heart rate (HR) reserve for 45 min, six sessions/week for 12 weeks. Concomitant L-arginine supplementation (6000 mg/day) was provided to maximize beneficial endothelial training adaptations. Cardiopulmonary exercise testing, 6-min walk testing (6MWT), echocardiography, laboratory studies, and quality of life (QoL) survey (SF-36) were performed at baseline and 12 weeks. Eleven patients completed the study (72 session adherence rate = 96 ± 3%). Objective improvement was demonstrated by the 6MWT distance (increased by 40 ± 13 m, P = 0.01), VO 2 max (increased by 2 ± 0.7 mL/kg/min, P = 0.02), time-to-VO 2 max (increased by 2.5 ± 0.6 min, P = 0.001), VO 2 at anaerobic threshold (increased by 1.3 ± 0.5 mL/kg/min, P = 0.04), HR recovery (reduced by 68 ± 23% in slope, P = 0.01), and SF-36 subscales of Physical Functioning and Energy/Fatigue (increased by 70 ± 34% and 74 ± 34%, respectively, P < 0.05). No adverse events occurred, and right ventricular function and brain natriuretic peptide levels remained stable, suggesting safety of the intervention. This proof-of-concept study indicates that a simple walking regimen with arginine supplementation is a safe and efficacious intervention for clinically stable PAH patients, with gains in objective function and QoL measures. Further investigation in a randomized controlled trial is warranted.

Published
2018
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