In the newborn several situations of hyperinsulinism can be associated with myocardial hypertrophy and increased contractility. Insulin and the insulin-like growth factors (IGF) are derived from a common ancestral molecule. Insulin exerts mainly metabolic action, whereas the IGFs promote cell multiplication and differentiation. Using an assay system of cultured neonatal myocardial cells the stimulatory action of insulin and the insulin-like growth factors I and II on myocardial cell contractility was investigated. Spontaneously beating aggregates of myocardial cells were synchronized by an electric impulse generator. Contractility was measured via the amplitude of contraction by an optoelectronic system. Insulin at a concentration of 6,250 and 12,500 microU/ml increased the contractility by 11 and 18%; IGF-I at a concentration of 12 and 25 ng/ml, and IGF-II at a concentration of 25 and 50 ng/ml increased the contractility by 16 and 22%, and 13 and 18%, respectively. Lower concentrations did not provoke a significant increase in contractility. Insulin only in supraphysiological doses increases the contractility of neonatal myocardial rat cells, whereas both insulin-like growth factors act in physiological concentrations. Therefore, during hyperinsulinism insulin may increase myocardial contractility via the IGF receptor and not via the insulin receptor.

Animals↗

PubMedDate not supplied

Left ventricular thrombi in three children with dilated cardiomyopathy: diagnostic procedure and clinical course.

In three of nine children with dilated cardiomyopathy (aged 1-9 years), left ventricular thrombi were diagnosed and followed by echocardiography. Thrombi recurred in two patients, in one of them, embolized to the cerebral arteries. Resolution of the thrombi was observed under therapy directed against platelet aggregation. However, this did not prevent thrombus formation.

Cardiomyopathy, Dilated↗

PubMedDate not supplied

Unusual electrocardiogram findings in a preterm infant after fetal tachycardia with hydrops fetalis treated with flecainide.

Fetal tachycardia and signs of hydrops fetalis were diagnosed at 29 weeks of gestation. The heart rate normalized by combined treatment with digoxin and flecainide and was followed by improvement of the hydrops. Premature labor led to delivery at 33 weeks of gestation. The newborn infant showed mild respiratory distress and was in a hemodynamically stable condition. Marked QT segment anomalies on the electrocardiogram during the first postnatal days resolved completely within 3 weeks. They were unlikely to be attributable to myocarditis or myocardial infarction. We speculate that these anomalies were caused by the maternal flecainide therapy.

Adult↗

PubMedDate not supplied

Published pharmacoeconomic analyses: science or marketing?

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Angiotensin-Converting Enzyme Inhibitors↗

PubMedDate not supplied

[Percutaneous removal of embolized catheters from pulmonary arteries or the right heart in children].

We report on our experience in four children with disconnected and embolized venous catheter segments in the pulmonary arteries or the right heart. In three of these, a percutaneous retrieval of the detached catheter via the femoral vene was successful. In one girl, all trials to grasp the catheter segment within the upper pulmonary lobe artery failed. For retrieval, either a snare wire or a Dotter-basket-catheter was used. Additionally, in two cases a tip deflecting guide wire system was proved as helpful for mobilisation of the catheter to better attainable sites of the heart. We conclude that pervenous retrieval of embolized catheter segments in children is possible and should be tried.

Adolescent↗

PubMedDate not supplied

[Myocarditis in acquired toxoplasmosis in childhood].

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Adolescent↗

PubMedDate not supplied

Pericardial teratoma: prenatal diagnosis and course.

We report on a case of primary pericardial teratoma detected in a 29-week-old fetus. Due to cardiac decompensation, pericardiocentesis was performed at 33 weeks of gestation, and surgical excision of the tumor was indicated shortly after birth. The present report draws attention to the impact of fetal echocardiography on perinatal management.

Adult↗