Echocardiographic evaluation of the effects of a single bolus of erythropoietin on reducing ischemia-reperfusion injuries during coronary artery bypass graft surgery; a randomized, double-blind, placebo-control study

Background: Erythropoietin [EPO] is known as a regulating hormone for the production of red blood cells, called erythropoiesis. Some studies have shown that EPO exerts some non-hematopoietic protective effects on ischemia-reperfusion injuries in myocytes. Using echocardiography, we evaluated the effect of EPO infusion on reducing ischemia-reperfusion injuries and improvement of the cardiac function shortly after coronary artery bypass graft surgery [CABG]

Methods: Forty-three patients were recruited in this study and randomly divided into two groups: the EPO group, receiving standard medication and CABG surgery plus EPO [700 IU/ kg], and the control group, receiving standard medication and CABG surgery plus normal saline [10 cc] as placebo. The cardiac function was assessed through echocardiography before as well as at 4 and 30 days after CABG

Results: Echocardiography indicated that the ejection fraction had no differences between the EPO and control groups at 4 days [47.05 +/- 6.29 vs. 45.90 +/- 4.97; P=0.334] and 30 days after surgery [47.27 +/- 28 vs. 46.62 +/- 5.7; P=0.69]. There were no differences between the EPO and control groups in the wall motion score index at 4 [P=0.83] and 30 days after surgery [P=0.902]. In the EPO group, there was a reduction in left ventricular end-systolic and end-diastolic diameters [LVESD and LVEDD, respectively], as compared to the control group

Conclusion: Our results indicated that perioperative exogenous EPO infusion could not improve the ventricular function and wall motion index in the immediate post-CABG weeks. Nevertheless, a reduction in LVEDD and LVESD at 4 days and 30 days after CABG in the EPO group, by comparison with the control group, suggested that EPO correlated with a reduction in the remodeling of myocytes and reperfusion injuries early after CABG

[Recurrent myocardial infarction after very late stent thrombosis, report of one case]

Stent thrombosis as a complication of percutaneous coronary intervention frequently is associated with deadly events such as myocardial infarction and sudden death. Definitions of stent thrombosis have hot been in a uniform manner in different clinical studies. Two episodes of acute ST elevation myocardial infarction nearly two years after implanting a drug -eluting stent in a 58-year-old male patient is reported here. The presence of stent thrombosis was confirmed by coronary angiography

Left Ventricular Non-Compaction Associated with WPW Syndrome

Noncompaction of the ventricular myocardium is an embryonic cardiomyopathy that is increasingly being recognized. Noncompaction of LV myocardium, right ventricular myocardium, or both can occur in isolation, in congenital heart diseases, in valvular heart diseases, in neuromuscular disorders, skeletal abnormalities and in endocrinologic abnormalities. Clinical manifestations of ventricular non-compaction include congestive heart failure, arrhythmia, sudden cardiac death and embolic events. This report is illustrative of non-compaction left ventricle associated with WPW syndrome in a 12-year-old girl presented with aborted sudden cardiac death and heart failure