Global Cardiology Science & Practice最新文献

{"title":"Characterization of morphology and function of the 'neo-atria' after a modified Mustard operation.","authors":"Mohamed Nagy,&nbsp;Hatem Hosny,&nbsp;Amr El Sawy,&nbsp;Ahmed Mahgoub,&nbsp;Magdi H Yacoub","doi":"10.21542/gcsp.2021.21","DOIUrl":"https://doi.org/10.21542/gcsp.2021.21","url":null,"abstract":"<p><p><b>Background:</b> There is a pressing need to improve early and long-term results of the Mustard operation. A modification of the operation was introduced at the Aswan Heart Centre for this purpose which relies on creating new functional atria rather than the two rigid channels in the classical Mustard operation. <b>Objectives:</b> To evaluate the morphology and function of the neo-atria, shortly after modified mustard operation for a 'neglected' patient with TGA, VSD and severe pulmonary hypertension. <b>Methods:</b> A 6-year-old with neglected TGA, VSD and pulmonary hypertension presented with severe cyanosis, clubbing and haemoconcentration (Hb 22 g/dL), underwent the modified Aswan-Mustard operation (MAM) with rapid smooth postoperative recovery. Repeated 2D echograms and multi-slice CT scans, followed by 3D segmentation, were performed after the operation. The size, shape, and morphology of the neo-atria were measured and measurements of the patterns of instantaneous filling and emptying of the right and left ventricles were quantified. <b>Results:</b> The neo-systemic venous atrium consisted of three components with a combined volume of 78 mL/m², all of which contributed to the reservoir, conduit, and importantly contractile function of the neo-atrium. The pulmonary venous atrium consisted of two components with a combined volume of 66 mL/m². These measurements were made at atrial end diastole. The volumes of the systemic venous and the pulmonary venous diminished to 51 and 54 mL/m², respectively, at the end atrial systole - indicating relatively preserved contractile functions. <b>Conclusion:</b> Following the modified Aswan-Mustard operation, neo-atrial function was relatively well preserved compared to the classical operation. The long-term results of these findings and their effects on quality of life need to be studied further.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":" ","pages":"e202121"},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8587206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39644640","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}

{"title":"A case of coronary artery air embolism in a transplanted heart during cardiac allograft vasculopathy surveillance angiography.","authors":"Jeffrey F Spindel,&nbsp;Vikas Singh,&nbsp;Mohammad Mathbout","doi":"10.21542/gcsp.2021.23","DOIUrl":"https://doi.org/10.21542/gcsp.2021.23","url":null,"abstract":"<p><p>Coronary air embolism is a rare iatrogenic complication during invasive coronary angiography or angioplasty that can cause acute chest pain, hypotension, ST-segment elevation myocardial infarction, and even death. We present a case of left anterior descending coronary artery air embolization in a 58-year-old heart transplant patient that occurred during cardiac allograft vasculopathy surveillance angiography. The patient was managed successfully with rapid coronary injections of heparinized saline, catheter disengagement to increase coronary blood flow, and supplementation of 100% oxygen to dissolve the coronary air embolus. This case highlights this rare complication of coronary angiography, importance of prompt recognition of the pathology and subsequent management.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2021 3","pages":"e202123"},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8587195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9278311","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}

{"title":"Anomalous origin of the left main from the right coronary sinus presenting with sudden cardiac death: utility of mechanical circulatory support.","authors":"Hussam Eddin T Al Hennawi,&nbsp;Ibrahim Fahsah,&nbsp;Mohammad F Mathbout","doi":"10.21542/gcsp.2021.24","DOIUrl":"https://doi.org/10.21542/gcsp.2021.24","url":null,"abstract":"<p><p>Anomalies involving the origin of the coronary arteries are extremely rare, with the left main artery coronary artery (LMCA) originating from the right coronary sinus (RCS) one of its rarest forms. Anomalous origin of left main from right coronary sinus poses a high risk of sudden cardiac arrest. In our report, we shed light on the case of a 43-year-old female who suffered a witnessed cardiac arrest due to underlying anomalous origin of the left main artery from right coronary sinus. The patient was initially pronounced dead until return of spontaneous rhythm with concomitant myocardial infarction led to the diagnosis of anomalous coronary artery. This case stresses important points to consider when dealing with the acute management and chronic treatment plan for this subset of high-risk patients. We also consider the utility of mechanical circulatory support in the management of this condition.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":" ","pages":"e202124"},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8587346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39644642","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}

{"title":"EMPEROR-Preserved: SGLT2 inhibitors breakthrough in the management of heart failure with preserved ejection fraction.","authors":"Kerolos Wagdy, Sherif Nagy","doi":"10.21542/gcsp.2021.17","DOIUrl":"10.21542/gcsp.2021.17","url":null,"abstract":"<p><p><b>Background:</b> Heart failure with preserved ejection fraction (HFpEF) is a complex disease which accounts for more than half of all HF hospital admissions with high prevalence and lack of effective evidence-based management. Sodium-glucose cotransporter 2 (SGLT2) inhibitor is a new antidiabetic drug that recently gained a new role in the management of heart failure with reduced ejection fraction but its role in HFpEF had yet to be studied. <b>Study and results:</b> EMPEROR-Preserved trial set out to evaluate the effects of SGLT2 inhibition with empagliflozin on major heart failure outcomes in patients with HFpEF. The patients were randomized in a 1:1 fashion into two groups; to receive either empagliflozin 10 mg per day (<i>n</i> = 2, 997) or placebo (<i>n</i> = 2, 991) in addition to usual therapy. Empagliflozin led to a 21% risk reduction of the composite of cardiovascular death or hospitalization for heart failure, which was mainly related to a 29% lower risk of hospitalization for heart failure rather than effect on cardiovascular death empagliflozin. The effects SGLT2 inhibitors were consistent in all patients. <b>What we have learnt:</b> The EMPEROR-Preserved trial is the first randomized controlled trial testing the efficacy and safety of SGLT2 inhibitor (empagliflozin) in patients with HFpEF. The trial proves that SGLT2 inhibitors (empagliflozin) can significantly reduce HF hospitalization with neutral effect on cardiovascular (CV) death.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":" ","pages":"e202117"},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8587377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39755841","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}

{"title":"Cardiovascular adverse effects of lopinavir/ritonavir and hydroxychloroquine in COVID-19 patients: Cases from a single pharmacovigilance centre.","authors":"Ioanna Istampoulouoglou,&nbsp;Barbara Zimmermanns,&nbsp;Tanja Grandinetti,&nbsp;Catia Marzolini,&nbsp;Annette Harings-Kaim,&nbsp;Sarah Koechlin-Lemke,&nbsp;Irene Scholz,&nbsp;Stefano Bassetti,&nbsp;Anne B Leuppi-Taegtmeyer","doi":"10.21542/gcsp.2021.11","DOIUrl":"https://doi.org/10.21542/gcsp.2021.11","url":null,"abstract":"<p><p>In this article we summarize the cardiovascular adverse events that were observed in three patients during their treatment for COVID-19 and discuss their association with lopinavir/ ritonavir (LPV/r) and hydroxychloroquine (HCQ). The cases were reported to our regional pharmacovigilance centre in April 2020. All three patients were above 75 years in age, male and multimorbid, and had been hospitalized for treatment of COVID-19. As part of their treatment, all of them received a very strictly monitored off-label therapy with LPV/r and HCQ, for which they had given their prior, written, informed consent. In one patient, erythromycin was also administered. All three patients developed a significant QTc time prolongation during or shortly after therapy with the above drugs. On account of this, the treatment had to be discontinued early in each case and QTc time recovered in all three patients.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2021 2","pages":"e202111"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39206751","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}

{"title":"Clinical characteristic, red blood cell indices, iron profile and prognosis of heart failure in females.","authors":"Surender Deora,&nbsp;Jai Bharat Sharma,&nbsp;Shubham Kumar Sharma,&nbsp;Nikhil Chaudhary,&nbsp;Atul Kaushik,&nbsp;Rahul Choudhary,&nbsp;Jaykaran Charan,&nbsp;Deepak Kumar,&nbsp;Gopal Krishna Bohra,&nbsp;Kuldeep Singh","doi":"10.21542/gcsp.2021.13","DOIUrl":"https://doi.org/10.21542/gcsp.2021.13","url":null,"abstract":"<p><p><b>Background:</b> Heart failure is a leading killer worldwide, with concurrent anaemia and iron deficiency portending sepulchral prognosis. Anaemia is rampant, with 53% prevalence in Indian females, but iron deficiency can be present even without anaemia. Therefore, this study was planned to determine the clinical profile, red blood cell indices, and effects of iron deficiency, on the course and prognosis of heart failure in Indian females. <b>Materials and methods:</b> This was a hospital-based observational study, conducted at a tertiary care teaching institute in India. Data from 147 females enrolled in the study between September 2017 to March 2020 was collected out of all patients enrolled in ongoing heart failure registry at the institute. Clinical characteristics at presentation, iron profile, red blood cell indices, treatment and mortality data was collected. <b>Results:</b> Mean age of the subjects (<i>n</i> = 147) was 53.31 ± 17.1 years with 55% non-rheumatic and 45% with rheumatic heart disease. The patients with rheumatic heart disease were younger, with a higher prevalence of atrial fibrillation. Non-rheumatic patients had a higher prevalence of CV risk factors like diabetes, hypertension, renal failure, more patients in NYHA IV, and 83% patients had LVEF ≤40%. Anaemia was present in 49%, however iron deficiency was present in 89% (absolute iron deficiency in 80% and functional iron deficiency in 9%) with no significant difference between rheumatic and non-rheumatic group. Red blood cell indices showed no significant difference across the spectrum of iron deficiency and anaemia, except lower mean corpuscular volume in patients with both iron deficiency and anaemia. The mean survival time was 840 days, with no significant difference between groups. There was significantly higher mortality in patients with iron deficiency (log rank 0.045). <b>Conclusion:</b> Iron deficiency-with or without anaemia-is very high in Indian females, worsening survival in heart failure. Proper diagnosis with iron supplementation will improve the prognosis.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2021 2","pages":"e202113"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39206752","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}

{"title":"Severe degeneration of a sub-coronary pulmonary autograft in a young adult.","authors":"Najma Latif, Ahmed Mahgoub, Mohamed Nagy, Padmini Sarathchandra, Magdi H Yacoub","doi":"10.21542/gcsp.2021.14","DOIUrl":"10.21542/gcsp.2021.14","url":null,"abstract":"<p><p><b>Background.</b> The pulmonary autograft is currently the best valve substitute in terms of longevity and performance. However, there is no agreement about the optimal method of insertion (sub-coronary position or freestanding root). <b>Objectives.</b> We sought to examine the clinical status, detailed imaging and morphometric changes in an explanted pulmonary autograft 22 years after sub-coronary implantation. <b>Methods.</b> A 30-year-old female underwent pulmonary autograft replacement of a severely stenotic valve at the age of 7 years, after presenting to us with signs of moderate to severe heart failure. She underwent clinical examination, detailed imaging including echocardiographic and CT examination with computerised image analysis. The explanted valve was examined by morphometry. <b>Results.</b> Clinical examination showed signs of heart failure (NYHA III). Trans-thoracic and trans-oesophageal 2D echo showed severe malfunction of both the aortic and pulmonary valves associated with dilatation and hypertrophy of both the right and left ventricles. Surgical correction was performed by replacing both the pulmonary and aortic valves with Medtronic 27mm Freestyle valves. The pulmonary autograft showed degeneration of the trilamellar layering of the leaflets, loss and disorganisation of GAGs, increased collagen with fibrotic overgrowth, and markers of fibrosis, inflammation, and calcification. Post-operative imaging showed good correction of the haemodynamic lesions. <b>Conclusion.</b> The pulmonary autograft implanted into the sub-coronary position presented with adverse remodelling, which was detrimental to the functionality and longevity of the valve. <b>Authorship.</b> NL, AM, MN all contributed equally to this paper.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2021 2","pages":"e202114"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39202828","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}

{"title":"Rapidly expanding aortic root mycotic pseudoaneurysm with outflow tract fistula.","authors":"Ishan Parikh,&nbsp;Jeffrey Spindel,&nbsp;Mohammad Mathbout,&nbsp;Shahab Ghafghazi","doi":"10.21542/gcsp.2021.15","DOIUrl":"https://doi.org/10.21542/gcsp.2021.15","url":null,"abstract":"<p><p>We present a 50-year-old patient with chronic Stanford type-A aortic dissection, infective endocarditis, and rapidly expanding peri-aortic myocytic pseudoaneurysm with LVOT fistula. This case highlights the role of multimodality imaging in pathoanatomically complex-case evaluation.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2021 2","pages":"e202115"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39202829","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}

{"title":"High output heart failure as a result of an ilio-caval fistula with a negative shunt series.","authors":"Travis R Huffman,&nbsp;Nadine Sbaih,&nbsp;Mohammad Mathbout,&nbsp;Shahab Ghafghazi","doi":"10.21542/gcsp.2021.16","DOIUrl":"https://doi.org/10.21542/gcsp.2021.16","url":null,"abstract":"<p><p>Congestive heart failure (CHF) with high cardiac output is an uncommon, yet attributable result of non-hemodialysis arteriovenous malformations. While the prevalence of high output heart failure has yet to be determined, it is observably low - specifically when looking at cases of high output heart failure as a result of ruptured abdominal aortic aneurysms (AAA) with fistula formation, an entity that carries a reported incidence of <1% of all complications of AAA. In this report, we present a 64-year-old male with high output heart failure secondary to a ruptured right common iliac aneurysm causing right ilio-iliac and ilio-caval fistulas.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2021 2","pages":"e202116"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39202830","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}

{"title":"Radial artery as a second conduit gains momentum: The RAPCO trial.","authors":"Walid Simry, Ahmed Afifi","doi":"10.21542/gcsp.2021.10","DOIUrl":"10.21542/gcsp.2021.10","url":null,"abstract":"<p><p>In coronary artery bypass grafting (CABG), the use of an internal mammary artery (IMA) to graft the left anterior descending coronary artery (LAD) improves survival and reduces the need for repeat revascularization. The other IMA, radial artery (RA), and saphenous vein (SV) have contested to complete the surgical revascularization. For that purpose, SV remains the most commonly used conduit despite current evidence in favor of arterial grafts. To determine which conduit is best for grafting the second most important coronary artery, Buxton and colleagues have recently published the long term results of their \"Radial Artery Patency and Clinical Outcomes (RAPCO)\" trial.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2021 2","pages":"e202110"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39206750","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}