Heart Matters

A complex and only partially decrypted code of the heart: Heart Rate Variability

by Stefanos Demertzis on 29 July 2024

An emerging tool allowing for some visual to internal balance, stress resilience and healthy longevity.

The heart rate is defined by the number of heartbeats per minute (bpm). As with any biological measure a range of values is defined as normal taking into consideration the age and biological sex. In the case of heart rate this range (at rest) is for adults between 60 and 100 bpm with significant individual variations depending on fitness level, health conditions and idiosyncrasy. Even at a constant heart rate (bpm), the timely distance between singular heart beats varies despite the same final count per minute. This phenomenon is called Heart Rate Variability (HRV). The fluctuation of heart rate is the result of complex dynamic and non-linear interactions of several physiological systems.
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Re-connect

by Stefanos Demertzis on 6 November 2023

More than 3 years have passed from the last post. Dense and intense years due to a series of issues. Among them the pandemic, major institutional changes, a significant academic and teaching engagement with the new Master of Medicine at the USI, the conclusion of a Master in Diving & Hyperbaric Medicine at the University of Padova and most of all, sadly, a major loss in the family. Now, however, it’s time to re-connect. We will re-connect through a collection of topics, such as prevention of cardiovascular diseases and diseases in general, trends in heart medicine, topics on longevity research and much more.

SARS-CoV-2 pandemic: complex systems wobbling

by Stefanos Demertzis on 30 April 2020

We live in a complex system. Complex systems are those that are intrinsically difficult to model due to interactions between their parts or between a given system and its environment. Their reaction to a given input is unpredictable. The capacity of a complex system to absorb hits and disturbances and still retain basic function and structure is called resilience. Non-resilient systems destabilize and mutate to new, most frequently, less desirable states¹. The coronavirus disease (Covid-19), the pandemic disease caused by the SARS-CoV-2 virus, demonstrates how susceptible our complex systems are, when the disturbance cannot be controlled rapidly and effectively.

Translational research: from bedside to bench and to bedside again!

by Stefanos Demertzis on 9 November 2019

When research is the subject, you have certainly heard the words “translational research” or “from bench to bedside”.
What do these words mean?

Cardiac surgery and sports

by Stefanos Demertzis on 9 December 2018

The topic might seem a contradiction, how can it be possible to engage in intense sport with an operated heart? It is possible, but not for everyone and not in each case. The topic is complex and requires a differentiated approach. The major components of the equation are the following:

Nature of the disease
Functional condition of the heart
Response of the heart and of the whole cardiovascular system to the operation
Presence of any residual or other disease with particular relevance to intense sport
Attitude of the patient and his/her family
Sports history of the patient

Minimally invasive valve surgery: cannulation of the right axillary artery.

by Stefanos Demertzis on 16 October 2018

Our surgical technique for cannulation of the right axillary artery and fully percutaneous TEE-guided cannulation of the right atrium in minimally invasive valve surgery is presented with a video in the CTSNet. Our data point towards a better cerebral protection with this technique.

Taking teaching of (cardiac) surgery to another level

by Stefanos Demertzis on 7 August 2018

I very well remember my first experiences as a medical student in the operating room. I was ordered to stand in a corner with my back to the wall (just as the surgeon ordered), almost motionless because of the staff’s worry that I might touch and contaminate something sterile. I could only listen to the surgeon describing what he was doing. That was a humiliating experience and I was close to abandoning my goal of becoming a surgeon.

States of mind: #2 – Quality of care

by Stefanos Demertzis on 10 March 2018

Quality of medical and surgical care is a profoundly felt need of every patient, of every involved family. Although based on slightly different motivations, the same is requested by those who pay for the care. Therefore, the interest in defining and measuring the quality of provided care is high. This is, however, a highly complex endeavor. It requires in-depth knowledge, differentiation, multiple perspectives and expert judgment.

How can we define “quality of care”?

The Institute of Medicine (IOM) of the US National Academy of Sciences defines it as “the degree to which health services for individuals and population increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”

Time for a new training model in cardiac surgery

by Stefanos Demertzis on 14 January 2018

Traditionally, technical skills in surgery are taught by the “apprentice model”: trainee surgeons learn under supervision in the operating room, by performing portions of or complete real operations on real patients.

A bolt out of the blue: acute aortic dissection

by Stefanos Demertzis on 4 September 2017

This is one of the biggest emergencies in heart surgery, or, dare I say, of medicine in general. From a subjective wellbeing, a sudden sharp and excruciating pain in the chest makes the person reach out for medical help. As soon as the patient arrives to the ER, a diagnostic protocol for acute chest pain is carried out. Once acute myocardial infarction is ruled out, the patient must undergo a CT scan to either exclude or confirm acute aortic dissection.