Scandinavian cardiovascular journal : SCJ最新文献

{"title":"Hyperglycemia-simulating environment attenuated experimentally induced calcification in cultured human aortic valve interstitial cells.","authors":"A. Zabirnyk, Daria Evensen, J. Kvitting, M. Kaljusto, K. Stensløkken, Jarle Vaage","doi":"10.1080/14017431.2024.2353070","DOIUrl":"https://doi.org/10.1080/14017431.2024.2353070","url":null,"abstract":"Objectives: The role of diabetes mellitus as a risk factor for the development of calcific aortic valve disease has not been fully clarified. Aortic valve interstitial cells (VICs) have been suggested to be crucial for calcification of the valve. Induced calcification in cultured VICs is a good in vitro model for aortic valve calcification. The purpose of this study was to investigate whether increased glucose levels increase experimentally induced calcification in cultured human VICs. Design: VICs were isolated from explanted calcified aortic valves after valve replacement. Osteogenic medium induced calcification of cultured VICs at different glucose levels (5, 15, and 25 mM). Calcium deposits were visualized using Alizarin Red staining and measured spectrophotometrically. Results: The higher the glucose concentration, the lower the level of calcification. High glucose (25 mM) reduced calcification by 52% compared with calcification at a physiological (5 mM) glucose concentration (correlation and regression analysis: r = -0.55, p = .025 with increased concentration of glucose). Conclusions: In vitro hyperglycemia-like conditions attenuated calcification in VICs. High glucose levels may trigger a series of events that secondarily stimulate calcification of VICs in vivo.","PeriodicalId":137876,"journal":{"name":"Scandinavian cardiovascular journal : SCJ","volume":" 6","pages":"2353070"},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomy-based characteristics of far-field SVC electrograms in right superior pulmonary veins after isolation.","authors":"Wentao Gu,&nbsp;Weizhuo Liu,&nbsp;Jian Li,&nbsp;Jun Shen,&nbsp;Jiawei Pan,&nbsp;Bangwei Wu,&nbsp;Haiming Shi,&nbsp;Xinping Luo,&nbsp;Nanqing Xiong","doi":"10.1080/14017431.2022.2095015","DOIUrl":"https://doi.org/10.1080/14017431.2022.2095015","url":null,"abstract":"<p><p><i>Background</i>. Far-field electrograms from superior vena cava (SVC) can be present in right superior pulmonary vein (RSPV) after pulmonary vein (PV) isolation. <i>Objectives</i>. To analyze the characteristics of far-field SVC potentials in RSPV after PV isolation and the local anatomy difference between patients with and without the potentials. <i>Methods</i>. Patients undergoing PV isolation were retrospectively reviewed, contrast-enhanced computed tomography (CT) was performed before procedure for observing the anatomical relationship between RSPV and SVC. The prevalence and characteristics of far-field SVC electrograms were described and compared to far-field left atrial potentials at the nearest point along the linear ablation lesion. The anatomical proximity of RSPV and SVC on a 2-dimensional horizontal CT view was compared between patients with and without far-field SVC potentials. <i>Results</i>. Far-field SVC electrograms were observed in 35/92(38%) patients with an amplitude of 0.24 ± 0.11 mV and a major deflection slope of 0.051 ± 0.036 mV, both significantly higher than far-field left atrial electrograms (<i>p</i> < .001). In patients with far-field SVC electrograms, 83% had connected RSPV-SVC, defined as distance between RSPV and SVC endocardium less than 3 mm at the layer of RSPV ostium roof, while in patients without far-field SVC electrograms, 70% had disconnected RSPV-SVC. <i>Conclusions</i>. Far-field SVC electrograms appeared in RSPV had a prevalence higher than previously reported and a sharper major deflection compared to far-field left atrial electrograms. Connected RSPV-SVC on CT was associated with the presence of far-field SVC electrograms.</p>","PeriodicalId":137876,"journal":{"name":"Scandinavian cardiovascular journal : SCJ","volume":" ","pages":"224-230"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40587882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous balloon pericardiotomy: efficacy in a series of malignant and nonmalignant cases.","authors":"Holger H Sigusch,&nbsp;Wolff Geisler,&nbsp;Ralf Surber,&nbsp;Marc Schönweiß,&nbsp;Jens Gerth","doi":"10.1080/14017431.2022.2111463","DOIUrl":"https://doi.org/10.1080/14017431.2022.2111463","url":null,"abstract":"<p><strong>Objective: </strong>In the case of malignant pericardial effusion and cardiac tamponade, balloon pericardiotomy is an established minimally invasive option to the surgical creation of a subxiphoid pericardial window. Percutaneous balloon pericardiotomy effectively drains recurrent pericardial fluid by creating a pleuro (-abdominal-) pericardial communication. <i>Design.</i> A series of 26 patients with underlying malignant (<i>n</i> = 12) and nonmalignant (<i>n</i> = 14) diseases underwent percutaneous balloon pericardiotomy between 2008 and 2021. All interventions were done through a subxiphoid access under local anesthesia. <i>Results.</i> The mean survival in the malignant and nonmalignant groups was 1.2 versus 48.0 months, respectively (<i>p</i> < .001). There were neither severe periinterventional complications nor in-hospital deaths. In two patients with nonmalignant disease the surgical creation of a pericardial window was necessary during follow-up. The originally described procedure was modified by the removal of all catheters at the end of the intervention. The procedure was safe. It prevented immobility and facilitated an early discharge from the hospital. <i>Conclusion.</i> Our experiences show that percutaneous balloon pericardiotomy is a minimally invasive approach to successfully provide palliation in the group of patients with underlying malignant disease. On the other hand, we have shown that this technique is safe and feasible in the treatment of pericardial effusion based on nonmalignant disease. We think thereby that pericardial balloon pericardiotomy can be considered as a less invasive alternative to surgery in both groups of patients.</p>","PeriodicalId":137876,"journal":{"name":"Scandinavian cardiovascular journal : SCJ","volume":" ","pages":"331-336"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40425896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance and prognostic value of ST segment depression on ECG during exercise treadmill test in asymptomatic patients with moderate or severe aortic stenosis.","authors":"Gard Mikael Saele Myrmel,&nbsp;Daanyaal Wasim,&nbsp;Ronak Rajani,&nbsp;Denise Parkin,&nbsp;John B Chambers,&nbsp;Sahrai Saeed","doi":"10.1080/14017431.2022.2095437","DOIUrl":"https://doi.org/10.1080/14017431.2022.2095437","url":null,"abstract":"<p><p><i>Objectives.</i> In patients with asymptomatic moderate or severe aortic stenosis (AS), exercise testing is used for evaluating the need for aortic valve intervention. Expert opinions about the clinical significance and prognostic value of ST segment depression on electrocardiography (ECG) during exercise testing in AS is conflicting and there are no large studies exploring this issue. We aimed to explore the association of ST segment depression >5 mm during exercise treadmill test (ETT) with all-cause mortality, aortic valve replacement (AVR) or cardiac-related hospitalization. <i>Design.</i> We performed a retrospective analysis of prospectively collected data of a total of 315 patients (mean age 65 ± 12 years, 67% men) with asymptomatic moderate (<i>n</i> = 209; 66%) or severe (<i>n</i> = 106; 34%) AS. All patients underwent clinical evaluation, echocardiography and ETT. <i>Results.</i> During a mean follow-up of 34.9 ± 34.6 months, 29 (9%) patients died and 235 (74%) underwent AVR. The prevalence of ST segment depression (>5 mm) was 13% (<i>n</i> = 41) in the total study population and was comparable in patients with revealed symptoms (17.6%, <i>n</i> = 16) versus without revealed symptoms (11.3%, <i>n</i> = 25; <i>p</i> = .132). ST segment depression on ETT was strongly associated with aortic valve area. In univariate Cox regression analysis, ST segment depression was not associated with cardiac related hospitalizations (HR 1.65; 95% CI 0.89-3.10, <i>p</i> = .113), all-cause mortality (HR 1.37; 95% CI 0.47-3.98, <i>p</i> = .564) or AVR (HR 1.30; 95% CI 0.89-1.91, <i>p</i> = .170). <i>Conclusion.</i> In patients with moderate or severe AS, ST segment depression during ETT is non-specific, carries no prognostic risk and should be used with caution in the clinical interpretation of exercise test.</p>","PeriodicalId":137876,"journal":{"name":"Scandinavian cardiovascular journal : SCJ","volume":" ","pages":"231-235"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40485383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digitalis therapy in patients with ventricular tachyarrhythmias.","authors":"Tobias Schupp,&nbsp;Julian Müller,&nbsp;Max von Zworowsky,&nbsp;Mohammad Abumayyaleh,&nbsp;Kathrin Weidner,&nbsp;Jonas Rusnak,&nbsp;Kambis Mashayekhi,&nbsp;Thomas Bertsch,&nbsp;Ibrahim Akin,&nbsp;Michael Behnes","doi":"10.1080/14017431.2022.2091793","DOIUrl":"https://doi.org/10.1080/14017431.2022.2091793","url":null,"abstract":"<p><p><i>Objective</i>. The study sought to assess the prognostic value of treatment with digitalis on long-term prognosis in patients with ventricular tachyarrhythmias and atrial fibrillation (AF) and/or heart failure (HF). <i>Background</i>. Data regarding the outcome of digitalis therapy following ventricular tachyarrhythmias is limited. <i>Methods.</i> A large retrospective registry was used including consecutive patients with episodes of ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2015. Patients treated with digitalis were compared to patients without. The primary prognostic endpoint was all-cause mortality at 3 years, secondary endpoints comprised a composite arrhythmic endpoint (i.e. recurrences of ventricular tachyarrhythmias, appropriate implantable cardioverter defibrillator (ICD) therapies, sudden cardiac death) and cardiac rehospitalization. Kaplan Mayer survival curves, multivariable cox regression, and time trend analyses were applied for statistics. <i>Results.</i> Eight hundred and thirty-one patients were included (20% treated with digitalis and 80% without). At 3 years, digitalis treatment was not associated with all-cause mortality following ventricular tachyarrhythmias (24 <i>vs.</i> 21%, log-rank <i>p</i> = .736; HR = 1.063; 95% CI 0.746-1.515; <i>p</i> = .736). However, digitalis therapy was associated with an increased risk of the composite arrhythmic endpoint (38 <i>vs.</i> 23%; log-rank <i>p</i> = .001; HR = 1.719; 95% CI 1.279-2.311; <i>p</i> = .001) and cardiac rehospitalization (31 <i>vs.</i> 18%; log-rank <i>p</i> = .001; HR = 1.829; 95% CI 1.318-2.538; <i>p</i> = .001), which was still evident within multivariable Cox regression analyses. Finally, digitoxin may be associated with a worse prognosis than digoxin. <i>Conclusion.</i> Digitalis therapy was not associated with mortality in patients with ventricular tachyarrhythmias, but with increased risk of the composite arrhythmic endpoint and cardiac rehospitalization at 3 years.</p>","PeriodicalId":137876,"journal":{"name":"Scandinavian cardiovascular journal : SCJ","volume":" ","pages":"198-207"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40566058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holistic review and meta-analysis of independent impact of the residual SYNTAX score on prognosis in patients with acute coronary syndrome.","authors":"Chuang Li, Jiang-Yuan Li, De-Jing Feng, Xin-Chun Yang, Le-Feng Wang, Kun Xia","doi":"10.1080/14017431.2022.2095434","DOIUrl":"10.1080/14017431.2022.2095434","url":null,"abstract":"<p><p><i>Objectives</i>. The appropriate extent of revascularization following primary intervention is unknown. We conducted a systematic review and meta-analysis of residual Syntax score (rSS) to predict the outcomes and provide guide to optimal management of revascularization following primary intervention. <i>Designs</i>. Previously published studies from 2007 to 2020 assessing the prognostic impact of rSS after ACS were included for this meta-analysis. The primary endpoint was defined as the major adverse clinical events (MACE) in multivariable analysis. The risk ratios (RRs) with 95% confidence intervals (CI) were calculated using the RevMan 5.4 software. <i>Results</i>. A total of 8,157 participants complicated with ACS from 12 clinical studies were included in this analysis. Based on the wide range of rSS studies available, we classified it into two major groups: rSS < 8 and rSS ≥ 8. In multivariate analysis, the rSS was an independent risk marker for MACE [RR = 1.04 (95%CI; 1.00-1.08)], all-cause mortality [RR = 1.05 (1.03-1.07)] and cardiovascular death [RR = 1.05 (1.03-1.07)]. Patients with incomplete revascularization (ICR) showed higher prevalence of MACE along with all-cause mortality, cardiovascular morality, and recurrent myocardial infarction without significant heterogeneity [RR = 1.60 (1.03-1.07), 2.30 (1.57-3.38), 3.57 (2.09-6.10) and 1.70 (1.38-2.09), respectively]. The patients with rSS ≥ 8 presented higher frequency of all-cause mortality [RR = 2.99 (2.18-4.09)], cardiovascular death [RR = 3.32 (2.22-4.95)], and recurrent myocardial infarction [RR = 1.64 (1.34-2.02)]. <i>Conclusion</i>. The meta-analysis indicated that an rSS value of 8 could be a reasonable cut-off for incomplete revascularization after ACS and is an efficient tool to guide revascularization. In future, detailed research should focus on investigation of the optimal value of the rSS score.</p>","PeriodicalId":137876,"journal":{"name":"Scandinavian cardiovascular journal : SCJ","volume":" ","pages":"187-197"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40571715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glyceraldehyde-derived advanced glycation end-products are associated with left ventricular ejection fraction and brain natriuretic peptide in patients with diabetic adverse cardiac remodeling.","authors":"Yuushi Yasuda,&nbsp;Hirofumi Aoki,&nbsp;Wataru Fujita,&nbsp;Kousuke Fujibayashi,&nbsp;Minoru Wakasa,&nbsp;Yasuyuki Kawai,&nbsp;Hiroaki Nakanishi,&nbsp;Kazuyuki Saito,&nbsp;Masayoshi Takeuchi,&nbsp;Kouji Kajinami","doi":"10.1080/14017431.2022.2095013","DOIUrl":"https://doi.org/10.1080/14017431.2022.2095013","url":null,"abstract":"<p><p><i>Objectives</i>: Glyceraldehyde-derived advanced glycation end-products (Glycer-AGEs) have a strong binding affinity for their cognate receptor and elicit oxidative stress and inflammation. However, it remains unknown whether the levels of Glycer-AGEs correlate with the severity of cardiac function and heart failure in patients with diabetic adverse cardiac remodeling (DbCR). Fourteen heart failure patients with type 2 diabetes mellitus (DM) without other cardiac disorders (DbCR group) were enrolled. Another 14 patients with idiopathic dilated cardiomyopathy (DCM) without DM were served as a control (DCM group). All patients were assessed for serum Glycer-AGEs, nitrotyrosine (NT), and tumor necrosis factor alpha (TNFα) and for plasma brain natriuretic peptide (BNP). The left ventricular ejection fraction (LVEF) was evaluated by echocardiography. <i>Results</i>: The mean serum levels of Glycer-AGEs, NT, and TNFα in the DbCR group were significantly higher than those in the DCM group (for Glycer-AGEs, <i>p</i> = .0073; for NT, <i>p</i> = .005; for TNFα, <i>p</i> < .0001, respectively). In the patients with DbCR, the levels of serum Glycer-AGEs and TNFα were closely associated with LVEF and BNP values. <i>Conclusions</i>: Both Glycer-AGEs and TNFα showed close associations with LVEF and the levels of BNP in patients with DbCR. Glycer-AGEs and TNFα may play a pathological role in the development of DbCR.</p>","PeriodicalId":137876,"journal":{"name":"Scandinavian cardiovascular journal : SCJ","volume":" ","pages":"208-216"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40474706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term effects of cardiac rehabilitation after heart valve surgery - results from the randomised CopenHeart_VR trial.","authors":"Kirstine L Sibilitz,&nbsp;Lars Hermann Tang,&nbsp;Selina Kikkenborg Berg,&nbsp;Lau Caspar Thygesen,&nbsp;Signe Stelling Risom,&nbsp;Trine Bernholdt Rasmussen,&nbsp;Jean-Paul Schmid,&nbsp;Britt Borregaard,&nbsp;Christian Hassager,&nbsp;Lars Køber,&nbsp;Rod S Taylor,&nbsp;Ann-Dorthe Zwisler","doi":"10.1080/14017431.2022.2095432","DOIUrl":"https://doi.org/10.1080/14017431.2022.2095432","url":null,"abstract":"<p><p><b><i>Aims</i></b>. The CopenHeart_VR trial found positive effects of cardiac rehabilitation (CR) on physical capacity at 4 months. The long-term effects of CR following valve surgery remains unclear, especially regarding readmission and mortality. Using data from he CopenHeart_VR Trial we investigated long-term effects on physical capacity, mental and physical health and effect on mortality and readmission rates as prespecified in the original protocol. <b><i>Methods</i>.</b> A total of 147 participants were included after heart valve surgery and randomly allocated 1:1 to 12-weeks exercise-based CR including a psycho-educational programme (intervention group) or control. Physical capacity was assessed as peak oxygen uptake (VO₂ peak) measured by cardiopulmonary exercise testing, mental and physical health by Short Form-36 questionnaire, Hospital Anxiety and Depression Scale, and HeartQol. Mortality and readmission were obtained from hospital records and registers. Groups were compared using mixed regression model analysis and log rank test. <b><i>Results</i>.</b> No differences in VO₂ peak at 12 months or in self-assessed mental and physical health at 24 months (68% vs 75%, <i>p</i> = .120) was found. However, our data demonstrated reduction in readmissions in the intervention group at intermediate time points; after 3, 6 (43% vs 59%, <i>p</i> = .03), and 12 (53% vs 67%, <i>p</i> = .04) months, respectively, but no significant effect at 24 months. <b><i>Conclusions</i></b>. Exercise-based CR after heart valve surgery reduces combined readmissions and mortality up to 12 months despite lack of improvement in exercise capacity, physical and mental health long-term. Exercise-based CR can ensure short-term benefits in terms of physical capacity, and lower readmission within a year, but more research is needed to sustain these effects over a longer time period. These considerations should be included in the management of patients after heart valve surgery.</p>","PeriodicalId":137876,"journal":{"name":"Scandinavian cardiovascular journal : SCJ","volume":" ","pages":"247-255"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40488472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women with atrial fibrillation undergoing pulmonary vein isolation are more symptomatic but improve more in health-related quality of life and symptom burden than men.","authors":"Carina Carnlöf,&nbsp;Marie Iwarzon,&nbsp;Mats Jensen-Urstad,&nbsp;Fredrik Gadler,&nbsp;Per Insulander","doi":"10.1080/14017431.2022.2107235","DOIUrl":"https://doi.org/10.1080/14017431.2022.2107235","url":null,"abstract":"<p><p>Gender differences in symptoms and perceived health-related quality of life (HRQOL) in patients with atrial fibrillation (AF) referred to pulmonary vein isolation (PVI) have been reported previously. Women experience a lower HRQOL, faster heart rate, and more symptoms such as palpitation and dyspnea than men. Furthermore, they experience worse physical functioning independently of other heart diseases or age. This study evaluates referral patterns and symptoms, morbidity, functional impairment, and HRQOL from a gender perspective in patients with AF before and 6 months after PVI. The study includes 242 patients (121 men), mean age 62 ± 9 years, referred for PVI. Symptoms were assessed with the Symptom Checklist: Frequency and Severity (SCL), HRQOL with Short Form 36 (SF-36), and the functional impairment with Sickness Impact Profile (SIP). The patients' own experiences of the referral process and history of their disease were evaluated with a supplementary questionnaire. The results showed that women improved more than men in HRQOL, SIP, and SCL 6 months post PVI. There were no sex differences in proportion of paroxysmal and persistent AF or ablation outcome. At baseline, women scored higher than men in both scales of the SCL (<i>p</i> < 0.001), scored lower in all components in SF-36, and scored higher in five categories of the SIP. Women were not more reluctant to accept referral for ablation when offered. The conclusion is that women with AF undergoing PVI are more symptomatic but also improve more in HRQOL and in symptom burden than men.</p>","PeriodicalId":137876,"journal":{"name":"Scandinavian cardiovascular journal : SCJ","volume":" ","pages":"316-324"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic changes during aortic valve surgery among patients with aortic stenosis.","authors":"Rasmus Carter-Storch,&nbsp;Søren Mose Hansen,&nbsp;Jordi S Dahl,&nbsp;Kasper Enevold,&nbsp;Nils Sofus Borg Mogensen,&nbsp;Henrik Berg,&nbsp;Marie-Annick Clavel,&nbsp;Jacob E Møller","doi":"10.1080/14017431.2022.2099008","DOIUrl":"https://doi.org/10.1080/14017431.2022.2099008","url":null,"abstract":"<p><p><i>Introduction.</i> Patients with severe aortic stenosis (AS) undergoing surgery are at increased risk of hypotension and hypoperfusion. Although treatable with inotropic agents or fluid, little is known about how these therapies affect central hemodynamics in AS patients under general anesthesia. We measured changes in central hemodynamics after dobutamine infusion and fluid bolus among patients with severe AS and associated these changes with preoperative echocardiography. <i>Methods.</i> We included 33 patients with severe AS undergoing surgical AVR. After induction of general anesthesia, hemodynamic measurements were obtained with a pulmonary artery catheter, including Cardiac index (CI), stroke volume index (SVi) and pulmonary capillary wedge pressure (PCWP). Measurements were repeated during dobutamine infusion, after fluid bolus and lastly after sternotomy. <i>Results.</i> General anesthesia resulted in a decrease in CI and SVi compared to preoperative values. During dobutamine infusion CI increased but mean SVi did not (38 ± 12 vs 37 ± 13 ml/m², <i>p</i> = .90). Higher EF and SVi before surgery and a larger decrease in SVi after induction of general anesthesia were associated with an increase in SVi during dobutamine infusion. After fluid bolus both CI, SVi (48 ± 12 vs 37 ± 13 ml/min/m², <i>p</i> < .0001) and PCWP increased. PCWP increased mostly among patients with a larger LA volume index. <i>Conclusion.</i> In patients with AS, CI can be increased with both dobutamine and fluid during surgery. Dobutamine's effect on SVI was highly variable and associated with baseline LVEF, and an increase in CI was mostly driven by an increase in heart rate. Fluid increased SVi at the cost of an increase in PCWP.</p>","PeriodicalId":137876,"journal":{"name":"Scandinavian cardiovascular journal : SCJ","volume":" ","pages":"276-284"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40601832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}