Continuing Cardiology Education最新文献

Abdominal aortic aneurysm: screening and management 腹主动脉瘤:筛查和处理

Continuing Cardiology Education Pub Date : 2018-07-27 DOI: 10.1002/cce2.73

G. Giugliano, D. Gerardi, M. Annunziata, B. Trimarco, G. Esposito, E. Stabile

引用次数: 2

Classification and pathophysiology of pulmonary hypertension 肺动脉高压的分型及病理生理

Continuing Cardiology Education Pub Date : 2018-07-27 DOI: 10.1002/cce2.71

J. R. Sysol, R. F. Machado

{"title":"Classification and pathophysiology of pulmonary hypertension","authors":"J. R. Sysol, R. F. Machado","doi":"10.1002/cce2.71","DOIUrl":"10.1002/cce2.71","url":null,"abstract":"<div>\u0000 \u0000 <p>Pulmonary hypertension is a fatal disease of multiple etiologies that is estimated to affect over 100 million people worldwide. The disease is defined hemodynamically as a mean pulmonary artery pressure ≥ 25 mmHg at rest. Despite important advances in our understanding of the pathobiology of this disease and improvements in patient management, outcomes are still poor and no curative treatments are currently available. The complex nature of this disease requires detailed clinical evaluation for accurate diagnosis and treatment. Recent advances in clinical recognition, classification, and understanding of the underlying pathological processes in pulmonary hypertension have led to improved diagnostic testing and therapeutic options for patients. A hallmark of pulmonary hypertension is an increased pulmonary vascular resistance which leads to progressive elevations in pulmonary artery pressure, resulting in compensatory right ventricular hypertrophy and, ultimately, heart failure. Clinically, these pulmonary vascular changes initially present as nonspecific symptoms, including unexplained dyspnea on exertion, fatigue, chest pain, and syncope. Signs of right ventricular dysfunction are also frequently present. Common pathogenic features of pulmonary hypertension include sustained pulmonary vasoconstriction, vascular remodeling of the small pulmonary arteries, in situ thrombosis, and increased vascular wall stiffness, resulting in increased pulmonary arterial pressure due to increased pulmonary vascular resistance. Despite improvements in clinical classification and understanding of the underlying pathogenic mechanisms of pulmonary hypertension, current therapies are limited to supportive care and targeting pulmonary vasoconstriction. There remains a need to identify novel therapeutic targets in this disease. This review provides a succinct overview of the clinical classification and pathophysiology of PH that can be used as a reference by physicians and physician-scientists.</p>\u0000 </div>","PeriodicalId":100331,"journal":{"name":"Continuing Cardiology Education","volume":"4 1","pages":"2-12"},"PeriodicalIF":0.0,"publicationDate":"2018-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/cce2.71","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86910987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 32

Myocardial perfusion SPECT and SPECT/CT in interventional cardiology 心肌灌注SPECT和SPECT/CT在介入性心脏病学中的应用

Continuing Cardiology Education Pub Date : 2018-07-27 DOI: 10.1002/cce2.76

E. Trägårdh, P. Hasbak, B. Hesse

{"title":"Myocardial perfusion SPECT and SPECT/CT in interventional cardiology","authors":"E. Trägårdh, P. Hasbak, B. Hesse","doi":"10.1002/cce2.76","DOIUrl":"10.1002/cce2.76","url":null,"abstract":"<div>\u0000 \u0000 <p>Myocardial perfusion imaging with single-photon emission computed tomography (SPECT) is an important and widely used non-invasive imaging test for the diagnosis and semiquantification of myocardial ischemia. SPECT data, acquired after a stress test and at rest on a gamma camera, shows left ventricular tracer uptake during stress and at rest. The tracer distributions are proportionate to the relative, regional coronary-flow distributions, respectively. A stress-induced perfusion defect reflects myocardial ischemia, while a permanent defect, unchanged from stress to rest, indicates myocardial infarction. By ECG-gating global and regional left ventricular function can also be assessed. The three most important indications for SPECT in the setting of interventional cardiology include (1) the diagnosis of coronary artery disease in intermediate-risk patients, (2) the assessment of ischemia in patients with prior successful revascularization and recurrence of symptoms, and (3) the diagnosis of acute coronary syndrome in the emergency department. The amount of ischemia is related to the outcome of patients undergoing revascularization. It was observed that patients with an ischemic area of <10% of the left ventricle demonstrated by SPECT benefit from staying on optimal medical therapy, whereas patients with more ischemia on SPECT benefit from revascularization. Guidelines and appropriate use criteria for the indications of SPECT in relation to interventional cardiology have been published by the European Society and American College of Cardiology.</p>\u0000 </div>","PeriodicalId":100331,"journal":{"name":"Continuing Cardiology Education","volume":"4 1","pages":"45-50"},"PeriodicalIF":0.0,"publicationDate":"2018-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/cce2.76","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74026726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Pulmonary arterial hypertension in congenital heart disease 先天性心脏病肺动脉高压

Continuing Cardiology Education Pub Date : 2018-07-27 DOI: 10.1002/cce2.74

A. A. Frogoudaki, M. A. Gatzoulis

引用次数: 1

The role of echocardiography in the diagnostic work-up of pulmonary hypertension 超声心动图在肺动脉高压诊断中的作用

Continuing Cardiology Education Pub Date : 2018-07-27 DOI: 10.1002/cce2.72

V. Sachpekidis, H. Karvounis, G. Giannakoulas

{"title":"The role of echocardiography in the diagnostic work-up of pulmonary hypertension","authors":"V. Sachpekidis, H. Karvounis, G. Giannakoulas","doi":"10.1002/cce2.72","DOIUrl":"10.1002/cce2.72","url":null,"abstract":"<div>\u0000 \u0000 <p>Pulmonary hypertension (PH) is a disorder with sometimes a challenging diagnosis, which can be made only by right heart catheterization. The role of echocardiography in the work-up of these patients is manifold. Its main contribution is in the assessment of the presence of PH in the setting of a clinical suspicion and thus it serves as a gatekeeper to avoid unnecessary invasive catheterizations. In this regard, estimation of pulmonary artery pressure is a central but not the only component that should be pursued, since there are many other additional echocardiographic features that can help the clinician to estimate the probability of the presence of PH more accurately and to fully assess its pathophysiological consequences. In addition, echocardiography can offer invaluable insight into right ventricular size and function, which is the cardiac chamber that is mainly affected by the disease and finally, it can provide important clues about the cause of PH and mainly help identify patients with pulmonary venous hypertension, in which treatment is entirely different from patients with precapillary hypertension. This review summarizes the echocardiographic findings commonly observed in patients with PH and focuses on important features that allow the clinician to exploit the full potential of this modality when assessing these patients.</p>\u0000 </div>","PeriodicalId":100331,"journal":{"name":"Continuing Cardiology Education","volume":"4 1","pages":"13-22"},"PeriodicalIF":0.0,"publicationDate":"2018-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/cce2.72","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89951918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Current knowledge on very late stent thrombosis 目前对晚期支架血栓形成的认识

Continuing Cardiology Education Pub Date : 2018-07-27 DOI: 10.1002/cce2.75

N. Kafkas, S. Dragasis

{"title":"Current knowledge on very late stent thrombosis","authors":"N. Kafkas, S. Dragasis","doi":"10.1002/cce2.75","DOIUrl":"10.1002/cce2.75","url":null,"abstract":"<div>\u0000 \u0000 <p>Very late stent thrombosis (VLST) represents a rare, but potentially lethal complication, in the era of percutaneous coronary intervention. Its etiology, pathogenesis, and predictive factors have not yet been established due to its relatively low prevalence and multifactorial nature. In this review article, after presenting the current definitions on stent thrombosis, we focus on the contemporary data on VLST, for both bare-metal stents and drug-eluting stents. Possible pathophysiological mechanisms and predictive factors are also illustrated, with data drawn from several multicenter studies. Factors such as younger patients, smokers at the time of initial DES implantation, STEMI or the presence of thrombus at the time of initial DES implantation, overlapping stents, seem to represent independent predictors of VLST. Finally, there is a special reference on cases of VLST, studied with optical coherence tomography (OCT). OCT managed to identify the cause of VLST in over 97% of the cases in these studies, whereas some of the most common mechanisms of VLST in these patients were stent malapposition, neoatherosclerosis rupture, uncovered struts, and stent underexpansion.</p>\u0000 </div>","PeriodicalId":100331,"journal":{"name":"Continuing Cardiology Education","volume":"4 1","pages":"40-44"},"PeriodicalIF":0.0,"publicationDate":"2018-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/cce2.75","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82721428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Cell therapy for cardiac diseases 心脏疾病的细胞疗法

Continuing Cardiology Education Pub Date : 2018-04-16 DOI: 10.1002/cce2.69

E. Tseliou

引用次数: 0

Recent advances in cardiac gene therapy strategies targeting advanced heart failure 针对晚期心力衰竭的心脏基因治疗策略研究进展

Continuing Cardiology Education Pub Date : 2018-04-16 DOI: 10.1002/cce2.68

C. Chen, T. Seeger, V. Termglinchan, I. Karakikes

引用次数: 1

Echocardiography in non‐ischemic cardiomyopathies: differential diagnosis from athlete's heart 非缺血性心肌病的超声心动图诊断:与运动员心脏的鉴别诊断

Continuing Cardiology Education Pub Date : 2017-12-01 DOI: 10.1002/cce2.65

H. Dores, N. Cardim