Takotsubo Cardiomyopathy: A Brief Review.

Takotsubo cardiomyopathy is a reversible cardiomyopathy with a unique morphological feature of the left ventricle characterized by an apical ballooning appearance known for approximately known 25 years. Catecholamine drive plays an essential role in the pathogenesis and pathophysiology of Takotsubo cardiomyopathy; hence, it is also called stress cardiomyopathy. Physical stress could also have an impact and leads to a greater variety of characteristics in Takotsubo cardiomyopathy. Supportive and symptomatic medication remains the mainstay therapy with priority to improving the function of the left ventricle for several days and full recovery in 3-4 weeks. Due to its similarity with myocardial infarction, Takotsubo cardiomyopathy requires careful diagnosis and management for the best possible outcome.

Galectin-3: a novel biomarker for the prognosis of heart failure.

Heart failure (HF) is still a global burden which carries substantial risk of morbidity and mortality. Thus, appropriate approach of diagnosis and layering the prognosis of HF are of great importance. In this paper we discuss and review a novel biomarker, which is called galectin-3 and already approved by Food and Drugs Administration (FDA) as a prediction tool for HF. Galectin-3, which is secreted by macrophages under the influence of mediators like osteopontin, has been known for its significant role in mediating cardiac fibrosis and inflammation. Numerous studies have shown galectin-3 as a novel prognostic biomarker with high predictive value for cardiovascular mortality and re-hospitalization in HF patients. However, there are also other contradictive studies displayed galectin-3 inferiority against other existed HF prognostic biomarkers like NT-proBNP and ST2. Nevertheless, galectin-3 has some advantages such as more stability and resistance against hemodynamic loading and unloading state, and also it could act as an early indicator of cardiac fibrosis, ventricular remodeling, and renal impairment in HF patients.

The New Mayo Clinic Risk Score Characteristics in Acute Coronary Syndrome in Patients Following Percutaneous Coronary Intervention.

Background: Mortality and major adverse cardiac events (MACE) frequently occur after percutaneous coronary intervention (PCI). Therefore, the ability to predict such events through an established risk stratification method is of great importance. The present study was aimed at determining the risk stratification of mortality and MACE in post-PCI patients at the intensive cardiac care unit of Cipto Mangunkusumo Hospital (CMH) using 7 variables of the New Mayo Clinic Risk Score (NMCRS). Method: This cross-sectional study drew upon secondary data gathered from the medical records of 313 patients that underwent PCI at the intensive cardiac care unit (ICCU) of CMH between August 1st, 2013, and August 31st, 2014. The primary end point was all-cause mortality and MACE. Seven variables in the NMCRS, namely age, left ventricular ejection fraction, serum creatinine, preprocedural cardiogenic shock, myocardial infarction, and peripheral arterial disease, were evaluated. Results: The mortality and MACE incidence rates in the post-PCI patients were 3.8% (95%CI: 2.6-5.0) and 8.3% (95% CI: 6.6-10.0), respectively. Regarding the NMCRS stratification, elderly patients with lower left ventricular ejection fraction, increased serum creatinine, preprocedural cardiogenic shock, myocardial infarction, and peripheral arterial disease had higher mortality and MACE incidence rates among the post-PCI patients. The mortality and MACE incidence rates significantly increased in the post-PCI patients with a higher NMCRS. Conclusion: Patients with a higher NMCRS had a tendency toward higher mortality and MACE incidence rates following PCI.