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“Background: We studied the relation between liver function abnormalities and hemodynamic profile in patients with heart failure (HF).
Methods and Results: in 323 HF patients, liver function was determined by aspartate and alanine aminotransferase (AST, ALT), alkaline phosphatase, gamma-glutamyl transpeptidase (GGT), lactate dehydrogenase, and direct and total bilirubin (Bili
dir, Bili tot). Central venous pressure (CVP) and cardiac index (CI) were determined invasively. Follow-up consisted of time to all-cause mortality. Mean age was 53 +/- 15 Years, and 60% were male. In multivariable analysis, all liver function tests related to CVP, but higher CVP was predominantly related to GGT (r = 0.336, P < .001) and Bili dir (r Selleck Natural Product Library = 0.370, P < .001). Only elevated AST (r = -0.177, P
< .01), ALT (r = -0.130, P < .05), and Bill tot (r = -0.158, P < .01) were associated with both low CI and elevated CVP. The prognostic value of abnormal liver function tests was related to their interaction with CI and FDA approved Drug Library screening CVP.
Conclusions: Elevated liver function tests mainly indicate higher CVP, whereas only the presence of elevated AST. ALT, or Bili dir may indicate a low Cl. The absence of prognostic information in the presence of invasive hemodynamic measurements suggests that abnormal liver function tests in HF reflect
a poor hemodynamic status. (J Cardiac Fail 2010:16:84-90)”
“Objective: To evaluate our early experience with endovascular revascularization in patients with acute thromboembolic occlusion of the superior mesenteric artery (SMA).
Methods: A retrospective review was conducted of all patients who underwent endovascular revascularization for acute thromboennbolic SMA occlusion www.selleckchem.com/products/VX-765.html from May 2005 to May 2012. Endovascular revascularization was performed using aspiration, intra-arterial thrombolysis, and adjunctive stent-placement techniques. Laparotomy was performed if the patient developed clinical signs of advanced bowel ischemia after endovascular procedure.
Results: Twenty-one patients underwent endovascular revascularization for acute thromboembolic SMA occlusion. All presented with acute-onset abdominal pain. Three patients had rebound tenderness before the procedure. Computed tomography angiography revealed complete occlusion in seven cases and incomplete occlusion in 14 cases, with no evidence of free gas or bowel necrosis. The median duration from onset of symptoms to revascularization was 8.7 +/- 4.1 hours (range, 2-18 hours).