Frontiers in Cardiovascular Medicine最新文献

{"title":"Monocyte adhesion to and transmigration through endothelium following cardiopulmonary bypass shearing is mediated by IL-8 signaling.","authors":"Hao Zhou, Marta Scatena, Lan N Tu, Cecilia M Giachelli, Vishal Nigam","doi":"10.3389/fcvm.2024.1454302","DOIUrl":"10.3389/fcvm.2024.1454302","url":null,"abstract":"<p><strong>Introduction: </strong>The use of cardiopulmonary bypass (CPB) can induce sterile systemic inflammation that contributes to morbidity and mortality, especially in children. Patients have been found to have increased expression of cytokines and transmigration of leukocytes during and after CPB. Previous work has demonstrated that the supraphysiologic shear stresses existing during CPB are sufficient to induce proinflammatory behavior in non-adherent monocytes. The interactions between shear stimulated monocytes and vascular endothelial cells have not been well studied and have important translational implications. With these studies, we tested the hypothesis that non-physiological shear stress experienced by monocytes during CPB affects the integrity and function of the endothelial monolayer.</p><p><strong>Methods: </strong>We have used an <i>in vitro</i> CPB model to study the interaction between THP-1 monocyte-like cells and human neonatal dermal microvascular endothelial cells (HNDMVECs). THP-1 cells were sheared in polyvinyl chloride (PVC) tubing at 2.1 Pa, twice of the physiological shear stress, for 2 h. ELISA, adhesion and transmigration assays, qPCR, and RNA silencing were used to assess the interactions between THP-1 cells and HNDMVECs were characterized after co-culture.</p><p><strong>Results: </strong>We found that sheared THP-1 cells adhered to and transmigrated through the HNDMVEC monolayer more readily than static THP-1 controls. Sheared THP-1 cells disrupted the VE-cadherin and led to the reorganization of cytoskeletal F-actin of HNDMVECs. A higher level of IL-8 was detected in the sheared THP-1 and HNDMVEC co-culture medium compared to the static THP-1 and HNDMVEC medium. Further, treating HNDMVECs with IL-8 resulted in increased adherence of non-sheared THP-1 cells, and upregulation in HNDMVECs of vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1). Finally, inhibition of HNDMVECs CXCR2/IL-8 receptor with Reparixin and of IL-8 expression with siRNA blocked sheared THP-1 cell adhesion to the endothelial monolayer.</p><p><strong>Conclusions: </strong>These results suggest that CPB-like sheared monocytes promote IL-8 production followed by increased endothelium permeability, and monocyte adhesion and transmigration. This study revealed a novel mechanism of post-CPB inflammation and will contribute to the development of targeted therapeutics to prevent and repair the damage to neonatal patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1454302"},"PeriodicalIF":2.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term patient-reported outcomes following congenital heart surgery in adults.","authors":"Thibault Schaeffer, Pauline Bossers, Doris Kienmoser, Oktay Tutarel, Paul Philipp Heinisch, Masamichi Ono, Julie Cleuziou, Jelena Pabst von Ohain, Jürgen Hörer","doi":"10.3389/fcvm.2024.1501680","DOIUrl":"10.3389/fcvm.2024.1501680","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the long-term impact of cardiac surgery on the quality of life in adults with congenital heart disease (ACHDs).</p><p><strong>Methods: </strong>Patients who had undergone cardiac surgery for congenital heart disease (CHD) at the age of 18 years or more were recruited in a single-center, cross-sectional study. The enrolled subjects completed online questionnaires to assess patient-reported outcomes: perceived health status and life satisfaction, psychological functioning, health behaviors, and illness perception. Clinical variables were correlated to the score results, and results were compared to representative samples from international and German national surveys of healthy subjects and ACHDs.</p><p><strong>Results: </strong>We enrolled 196 ACHDs (54% women), including 55% with more than one cardiac surgery during their lifetime. The median age at the survey was 43 years, with a median of 13 years since their last cardiac surgery. The majority of patients reported improved subjective wellbeing after cardiac operation and were in functional New York Heart Association class I or II. The severity of underlying CHD, number of previous cardiac operations, and beta-blocker medication had the most substantial negative effects on illness perception. Measured quality of life and health risk behaviors were within the range of values internationally reported for healthy and CHD subjects, respectively.</p><p><strong>Conclusions: </strong>ACHD, several years after cardiac surgery, reported a subjective improvement in their wellbeing, a life satisfaction comparable to that of healthy individuals, and low health risk behaviors. Illness perception is strongly correlated with the severity of the underlying CHD.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1501680"},"PeriodicalIF":2.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic valve replacement in a bicuspid aortic valve patient followed by reoperation for ascending aorta rupture: a case report.","authors":"Yuehang Yang, Xinyi Liu, Junwei Liu, Jiawei Shi, Huadong Li","doi":"10.3389/fcvm.2024.1471686","DOIUrl":"10.3389/fcvm.2024.1471686","url":null,"abstract":"<p><p>Bicuspid aortic valve (BAV), the most common congenital cardiac anomaly, predisposes individuals to aortic stenosis and regurgitation due to valve degeneration. Abnormal hemodynamics, arterial wall characteristics, and genetic factors contribute to ascending aorta dilatation, potentially leading to severe complications like aortic dissection. Presently, the most recent guidelines propose that individuals with BAV requiring valve replacement due to valve dysfunction should undergo simultaneous replacement of the ascending aorta when the diameter of aortic dilatation exceeds 4.5 cm. A 60-year-old female patient previously underwent mechanical aortic valve replacement and ascending aortoplasty at our center due to aortic stenosis and a 4.3 cm diameter ascending aorta. In the sixth postoperative year, she was readmitted due to ascending aorta rupture, resulting in blood entering the right atrium and causing acute right heart failure. We performed repair of the rupture and concomitant ascending aorta replacement to prevent further exacerbation of the patient's condition.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1471686"},"PeriodicalIF":2.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Operative experience on descending aorta with Takayasu arteritis: a review.","authors":"Fu Yining, Yuexin Chen","doi":"10.3389/fcvm.2024.1525748","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1525748","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fcvm.2023.1181285.].</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1525748"},"PeriodicalIF":2.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence-assisted echocardiographic monitoring in pediatric patients on extracorporeal membrane oxygenation.","authors":"Weiling Chen, Jinhui Wu, Zhenxuan Zhang, Zhifan Gao, Xunyi Chen, Yu Zhang, Zhou Lin, Zijian Tang, Wei Yu, Shumin Fan, Heye Zhang, Bei Xia","doi":"10.3389/fcvm.2024.1418741","DOIUrl":"10.3389/fcvm.2024.1418741","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous extracorporeal membrane oxygenation (ECMO) is administered to pediatric patients with cardiogenic shock or cardiac arrest. The traditional method uses focal echocardiography to complete the left ventricular measurement. However, echocardiographic determination of the ejection fraction (EF) by manual tracing of the endocardial borders is time consuming and operator dependent. The standard visual assessment is also an inherently subjective procedure. Artificial intelligence (AI) based machine learning-enabled image analysis might provide rapid, reproducible measurements of left ventricular volumes and EF for ECMO patients.</p><p><strong>Objectives: </strong>This study aims to evaluate the applicability of AI for monitoring cardiac function based on Echocardiography in patients with ECMO.</p><p><strong>Materials and methods: </strong>We conducted a retrospective study involving 29 hospitalized patients who received ECMO support between January 2017 and December 2021. Echocardiogram was performed for patients with ECMO, including at pre-ECMO, during cannulation, during ECMO support, during the ECMO wean, and a follow up within 3 months after weaning. EF assessment of all patients was independently evaluated by junior physicians (junior-EF) and experts (expert-EF) using Simpson's biplane method of manual tracing. Additionally, raw data images of apical 2-chamber and 4-chamber views were utilized for EF assessment via a Pediatric ECMO Quantification machine learning-enabled AI (automated-EF).</p><p><strong>Results: </strong>There was no statistically significant difference between the automated-EF and expert-EF for all groups (<i>P</i> > 0.05). However, the differences between junior-EF and automated-EF and expert-EF were statistically significant (<i>P</i> < 0.05). Inter-group correlation coefficients (ICC) indicated higher agreement between automated-EF and expert manual tracking (ICC: 0.983, 95% CI: 0.977∼0.987) compared to junior assessments (ICC: 0.932, 95% CI: 0.913∼0.946). Bland-Altman analysis showed good agreements among the automated-EF and the expert-EF and junior-EF assessments. There was no significant intra-observer variability for experts' manual tracking or automated measurements.</p><p><strong>Conclusions: </strong>Automated EF measurements are feasible for pediatric ECMO echocardiography. AI-automated analysis of echocardiography for quantifying left ventricular function in critically ill children has good consistency and reproducibility with that of clinical experts. The automated echocardiographic EF method is reliable for the quantitative evaluation of different heart rates. It can fully support the course of ECMO treatment, and it can help improve the accuracy of quantitative evaluation.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1418741"},"PeriodicalIF":2.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis.","authors":"Xiuqing Li, Yubao Wang, Jie Xu, Kaili Luo, Tao Dong","doi":"10.3389/fcvm.2024.1334730","DOIUrl":"10.3389/fcvm.2024.1334730","url":null,"abstract":"<p><strong>Background: </strong>Trimethylamine N-oxide (TMAO) has been widely explored and considered as a biomarker for adverse cardiovascular events. However, the relationships between TMAO adverse cardiovascular events are inconsistent in patients. Therefore, this meta-analysis aimed to estimate association between TMAO levels and the prognosis of patients with myocardial infarction (MI).</p><p><strong>Methods: </strong>We searched PubMed, EMBASE, the Cochrane Library, and Web of Science from inception to July 2, 2023, to retrieve all relevant clinical trials. Associations between TMAO levels, major adverse cardiovascular events (MACE), all-cause mortality, recurrent MI, stroke, etc., were systematically addressed. Outcomes included MACE, all-cause mortality, recurrent MI, rehospitalization caused by heart failure, stroke, revascularization, SYNTAX score, and multivessel disease. A fixed/random-effects model should be adopted to calculate the pooled estimates. Besides, funnel plot, Begg's test and Egger' test were used to test publication bias.</p><p><strong>Results: </strong>A total of nine studies were included in our meta-analysis. Our results indicated that higher TMAO levels were associated with greater risk of MACE (RR = 1.94; 95% CI = 1.39 to 2.73), all-cause mortality (RR = 1.56; 95% CI = 1.00 to 2.44), and MI (RR = 1.21; 95% CI = 1.01 to 1.45). No significant association was found in stroke, SYNTAX, and multivessel disease. Besides, our results reported that the association between TMAO levels and MACE after MI was not affected by the geographic localization.</p><p><strong>Conclusion: </strong>This study was the first meta-analysis that showed a significant positive association of TMAO levels with MACE, all-cause mortality, and recurrent MI in patients with MI.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=460400, PROSPERO (CRD42023460400).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1334730"},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circadian rhythm pattern of symptom onset in patients with ST-segment elevation myocardial infarction in the Chinese population.","authors":"Yibo Guo, Lina Cui, Lulu Li, Zhuozhong Wang, Chao Fang, Bo Yu","doi":"10.3389/fcvm.2024.1393390","DOIUrl":"10.3389/fcvm.2024.1393390","url":null,"abstract":"<p><strong>Background: </strong>The peak incidence of cardiovascular diseases (CVD) usually occurs in the morning. This study aimed to investigate the exact distribution pattern of peak incidence of ST-segment elevation myocardial infarction (STEMI) in the Chinese population, and to explore whether it is associated with the prognosis.</p><p><strong>Methods: </strong>This study included 7,805 patients with STEMI from the multicenter, prospective AMI cohort in China, for whom had a definite time of symptom onset. In the overall population and the predefined subgroup populations, the circadian rhythms of STEMI onset were statistically analyzed. Then patients were divided into four groups based on the time of onset (6 h interval) to assess the association of symptom onset time and major adverse cardiovascular and cerebrovascular events (MACCE) after discharge.</p><p><strong>Results: </strong>The onset of STEMI had a bimodal distribution: a well-defined primary peak at 8:38 AM [95% confidence interval (CI): 7:49 to 9:28 AM], and a less well-defined secondary peak at 12:55 PM (95% CI: 7:39 AM to 18:10 PM) (bimodal: <i>P</i> < 0.001). A similar bimodal circadian rhythm pattern was observed in subgroups of patients with STEMI defined with respect to day of the week, age, sex, and coronary risk factors. Notedly, the two peaks on Sunday were significantly later than other days, and the secondary peaks became clear and concentrated. In addition, no significant difference was found in MACCE among the four groups (<i>P</i> = 0.905).</p><p><strong>Conclusions: </strong>In the Chinese population, the onset of STEMI exhibited a bimodal circadian rhythm pattern, with a clear primary peak and a less clear secondary peak. One-year clinical outcomes were unrelated to the timing of STEMI onset.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1393390"},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A generalized equation for predicting peak oxygen consumption during treadmill exercise testing: mitigating the bias from total body mass scaling.","authors":"Everton J Santana, Nicholas Cauwenberghs, Bettia E Celestin, Tatiana Kuznetsova, Christopher Gardner, Ross Arena, Leonard A Kaminsky, Matthew P Harber, Euan Ashley, Jeffrey W Christle, Jonathan Myers, Francois Haddad","doi":"10.3389/fcvm.2024.1393363","DOIUrl":"10.3389/fcvm.2024.1393363","url":null,"abstract":"<p><strong>Background: </strong>Indexing peak oxygen uptake (VO₂peak) to total body mass can underestimate cardiorespiratory fitness (CRF) in women, older adults, and individuals with obesity. The primary objective of this multicenter study was to derive and validate a body size-independent scaling metric for VO₂peak. This metric was termed exercise body mass (EBM).</p><p><strong>Method: </strong>In a cohort of apparently healthy individuals from the Fitness Registry and the Importance of Exercise National Database, we derived EBM using multivariable log-normal regression analysis. Subsequently, we developed a novel workload (WL) equation based on speed (Sp), fractional grade (fGr), and heart rate reserve (HRR). The generalized equation for VO₂peak can be expressed as VO₂peak = Cst × EBM × WL, where Cst is a constant representing the VO₂peak equivalent of one metabolic equivalent of task. This generalized equation was externally validated using the Stanford exercise testing (SET) dataset.</p><p><strong>Results: </strong>A total of 5,618 apparently healthy individuals with a respiratory exchange ratio >1.0 (57% men, mean age 44 ± 13 years) were included. The EBM was expressed as Mass (kg)^0.63 × Height (m)^0.53 × 1.16 (if a man) × exp (-0.39 × 10^-4 × age²), which was also approximated using simple sex-specific additive equations. Unlike total body mass, EBM provided body size-independent scaling across both sexes and WL categories. The generalized VO₂peak equation was expressed as 11 × EBM × [2 + Sp (in mph) × (1.06 + 5.22 × fGr) + 0.019 × HRR] and had an <i>R</i> ² of 0.83, <i>p</i> < 0.001. This generalized equation mitigated bias in VO₂peak estimations across age, sex, and body mass index subgroups and was validated in the SET registry, achieving an <i>R</i> ² of 0.84 (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>We derived a generalized equation for measuring VO₂peak during treadmill exercise testing using a novel body size-independent scaling metric. This approach significantly reduced biases in CRF estimates across age, sex, and body composition.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1393363"},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of serum iron with all-cause mortality and cardiovascular mortality in the cardiovascular patients: a retrospective cohort study based on the NHANES 1999-2018.","authors":"Jing Lu, Zhen Ma, Xiaoxue Zhang, Wenhao Zhong, Yunzeng Zou, Jie Yuan","doi":"10.3389/fcvm.2024.1414792","DOIUrl":"10.3389/fcvm.2024.1414792","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is one of the leading global causes of death, and serum iron (SI) levels may be associated with the mortality of CVD. However, there is still a knowledge gap regarding the relationship between SI and mortality in the CVD population.</p><p><strong>Methods: </strong>An analysis was conducted utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. In our study, SI was used as the independent variable, and the mortality of the CVD patients was considered as the outcome. Kaplan-Meier curves, multivariable Cox proportional hazards model, and restricted cubic spline were employed to examine the association between SI and all-cause mortality and cardiovascular mortality in CVD patients. Subgroup analysis was also carried out based on age, sex, weight, hypertension, Type 2 diabetes mellitus, and smoking status.</p><p><strong>Results: </strong>A retrospective cohort study design was utilized, incorporating data from 1,903 CVD patients with an average age of 64.29 years. Kaplan-Meier survival analysis demonstrated significant differences in all-cause mortality and cardiovascular mortality among the CVD patients based on quartiles of SI. Following multivariable adjustment, lower SI was associated with an increased risk of all-cause and cardiovascular mortality in CVD patients. The highest quartile of SI exhibited a 43% reduction in all-cause mortality (HR = 0.57, 95% CI: 0.45-0.72) and a 74% reduction in cardiovascular mortality (HR = 0.26, 95% CI: 0.16-0.43) when compared to the lowest quartile. Restricted cubic spline showed a nonlinear relationship between SI and all-cause mortality and a linear relationship between SI and cardiovascular mortality. Additionally, the inverse relationship between SI levels and outcomes in the CVD patients remained consistent in subgroup analysis.</p><p><strong>Conclusion: </strong>Higher SI is associated with a decreased risk of all-cause and cardiovascular mortality in CVD patients. Our results emphasize the importance of iron supplementation for this particular group.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1414792"},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing supraventricular tachyarrhythmia in pregnant patients within the emergency department.","authors":"Di Pan, Zhongqing Chen, Haibo Chen","doi":"10.3389/fcvm.2024.1517990","DOIUrl":"10.3389/fcvm.2024.1517990","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy increases the risk of supraventricular tachycardia (SVT) due to physiological changes. This study reviews the management of SVT in pregnant patients in the emergency department (ED).</p><p><strong>Methods: </strong>We retrospectively analyzed 15 pregnant patients with SVT treated at Shenzhen Second People's Hospital ED from 2015 to 2023. Treatments included vagal nerve stimulation, pharmacotherapy, esophageal pacing, cardioversion, and radiofrequency ablation.</p><p><strong>Results: </strong>The average patient age was 30.3 years. All presented with palpitations, and none had hemodynamic instability. Treatment success varied: 3 patients reverted spontaneously, 5 responded to vagal stimulation, and 4 to esophageal pacing. One required verapamil, and another responded to labetalol after failing vagal and pacing treatments.</p><p><strong>Conclusion: </strong>When managing SVT during pregnancy, it is important to consider the patient's stability, the stage of pregnancy, and the safety of medications. For unstable patients, electrical cardioversion is the preferred option; for stable patients, vagus nerve stimulation (VNS) or other alternative treatments, such as adenosine, should be considered.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1517990"},"PeriodicalIF":2.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}