Journal of Cardiovascular Development and Disease最新文献

{"title":"Spinal Cord Stimulation for Refractory Angina Pectoris: Current Status and Future Perspectives, a Narrative Review.","authors":"Roberto Gazzeri, Jacopo Mosca, Felice Occhigrossi, Marco Mercieri, Marcelo Galarza, Matteo Luigi Giuseppe Leoni","doi":"10.3390/jcdd12010033","DOIUrl":"10.3390/jcdd12010033","url":null,"abstract":"<p><p>Refractory angina pectoris (RAP) is a clinical syndrome characterized by persistent chest pain caused by myocardial ischemia that is unresponsive to optimal pharmacological therapy and revascularization procedures. Spinal cord stimulation (SCS) has emerged as a promising therapeutic option for managing RAP, offering significant symptom relief and improved quality of life. A systematic literature review was conducted to evaluate the clinical effectiveness, mechanisms of action, and safety profile of SCS in treating RAP. Comprehensive searches were performed in PubMed, Scopus, and Web of Science for studies published between 1990 and 2023. Of 328 articles identified, 6 met the inclusion and exclusion criteria for final analysis. The included studies consistently demonstrated that SCS significantly reduces the frequency of anginal episodes and nitroglycerin use while improving exercise capacity and quality of life. Proposed mechanisms include modulation of pain signals via the gate control theory, enhancement of autonomic balance, and redistribution of myocardial perfusion. Novel stimulation modalities, including high-frequency, Burst, and Differential Target Multiplexed (DTM), show potential advantages in enhancing patient comfort and clinical outcomes. Nevertheless, long-term studies are necessary to validate these findings and establish the comparative efficacy of these advanced technologies. SCS is a safe and effective therapy for patients with RAP who are unsuitable for surgical interventions. Innovations in neurostimulation, including closed-loop systems and personalized treatment strategies have the potential to further optimize outcomes. Rigorous clinical trials are needed to consolidate the role of SCS as a cornerstone therapy for the management of RAP.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Outcomes of Patients with Aortic Stenosis Stratified by Sex: An Asian Perspective.","authors":"Joy Y S Ong, Aloysius S T Leow, Chun Yi Ng, Poay Huan Loh, Swee Chye Quek, William K F Kong, Tiong Cheng Yeo, Ching Hui Sia, Kian Keong Poh","doi":"10.3390/jcdd12010032","DOIUrl":"10.3390/jcdd12010032","url":null,"abstract":"<p><strong>Background: </strong>Severe aortic stenosis (AS) stratified by sex has been increasingly studied in the European population. Sex-specific outcomes in Asian patients with AS remain poorly defined. Hence, we aimed to study the clinical characteristics and impact of sex in moderate-to-severe AS, undergoing both invasive and conservative interventions in an Asian cohort over 10 years.</p><p><strong>Methods: </strong>Consecutive data with echocardiographic diagnoses of AS were stratified according to gender in a tertiary academic center between 2011 and 2021. Demographics, comorbidities, and clinical outcomes were compared.</p><p><strong>Results: </strong>Seven hundred and three (703) patients were included (56%, <i>n</i> = 397 were female). Calcific AS was the dominant etiology in both genders. Females had higher incidences of anemia (<i>p</i> < 0.001) and chronic kidney disease (<i>p</i> = 0.026); although, females had lower incidences of cardiovascular complications of coronary artery disease (CAD) (<i>p</i> = 0.002) and prior acute myocardial infarction (AMI) (<i>p</i> = 0.015). Echocardiographically, females had a smaller left ventricular outflow tract diameter (LVOTd) (<i>p</i> < 0.001), LV mass (<i>p</i> < 0.001), and left ventricle end diastolic volume (LVEDV) (<i>p</i> < 0.001). Conversely, the left atrial (LA) area (<i>p</i> < 0.001) and volume index (LAVI) (<i>p</i> < 0.001) were larger in females. Females had higher average E/e' (<i>p</i> = 0.010) ratios compared to males. The mean follow-up duration between genders was 4.1 ± 3.3 years. Upon univariate analysis, a greater proportion of female AS patients encountered cardiovascular (CV) hospitalization during follow-up (female: 27.5%, <i>n</i> = 109 vs. male: 18.3%, <i>n</i> = 56; <i>p</i> = 0.005) compared to male patients, but there were no significant differences for the outcomes of heart failure (<i>p</i> = 0.612), stroke (<i>p</i> = 0.664), and all-cause mortality (<i>p</i> = 0.827). Fewer females underwent aortic valve (AV) intervention compared to males (21.2% vs. 27.8%, <i>p</i> = 0.042), albeit with a longer duration to AV intervention (3.6 years ± 2.4 vs. 2.6 years ± 2.3, <i>p</i> = 0.016). In the severe AS cohort, female sex remained an independent predictor for subsequent heart failure (aHR 2.89, 95% CI 1.01-8.29, <i>p</i> = 0.048) and CV hospitalization (aHR 20.0, 95% CI 1.19-335, <i>p</i> = 0.037) after adjustments for age, ethnicity, body mass index (BMI), comorbidities, left ventricular ejection fraction (LVEF), and AV intervention.</p><p><strong>Conclusions: </strong>There was no difference in heart failure, stroke, and all-cause mortality outcomes between male and female Asian patients with moderate-to-severe AS. However, there were more cardiovascular hospitalizations, with fewer and longer duration to AV intervention in females compared to males in our cohort.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Axillary Artery Cannulation as Standard Perfusion Strategy in Minimally Invasive Coronary Artery Bypass Grafting.","authors":"Christian Sellin, Ahmed Belmenai, Volodymyr Demianenko, Marius Grossmann, Hilmar Dörge","doi":"10.3390/jcdd12010031","DOIUrl":"10.3390/jcdd12010031","url":null,"abstract":"<p><strong>Objective: </strong>Cardiopulmonary bypass (CPB) via the right axillary artery (RAA) has become an alternative perfusion strategy, especially in complex aortic procedures. This study delineates our technique and outcome with direct axillary cannulation utilizing the Seldinger technique, which we adopted as the standard perfusion strategy in the sternum-sparing minimally invasive total coronary revascularization via left anterior thoracotomy (TCRAT) using CPB.</p><p><strong>Methods: </strong>From November 2019 to December 2023, a total of 413 consecutive patients underwent nonemergent isolated coronary artery bypass grafting (CABG) via left anterior minithoracotomy on CPB with peripheral cannulation via the RAA and cardioplegic cardiac arrest, using this technique as a default strategy in the daily routine. All patients had multivessel coronary artery disease. The primary outcome was intraoperative cannulation-related complications (bleeding, revision, ischemia, wound healing complications). The secondary outcome was cannulation-related events during follow-up (blood pressure differences, incidence of brachial plexus injury, clinical signs of circulatory problems of arm and hand, re-interventions). Mean midterm follow-up was 18.7 ± 12.3 [1.1-51.2] months. During follow-up, 16 patients died. Overall, a total of 397 patients (344 male; 67.6 ± 9.7 [32-88]) were included for follow-up (100%).</p><p><strong>Results: </strong>The RAA was successfully cannulated in 100% of patients. A cannula size of 16 Fr was used in 34.6%, 18 Fr in 63.9% and 20 Fr in 1.5% of all patients. There was no intraoperative bleeding complication. In two patients, intraoperative revision of the RAA was required, necessitating a venous patch repair. At follow-up, there were no differences between the systolic and diastolic blood pressure or the pressure gradients between the right and left arm. Transient numbness of the right hand was observed in two patients. Permanent numbness was not observed. No patient needed further intervention or surgical revision of the RAA.</p><p><strong>Conclusions: </strong>The right axillary cannulation is feasible and safe in terms of vascular injury and brachial plexus injury with excellent in-hospital and follow-up outcome.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed Tomography Angiography in the Catheterization Laboratory: A Guide Towards Optimizing Coronary Interventions.","authors":"Eirini Beneki, Kyriakos Dimitriadis, Nikolaos Pyrpyris, Alexios Antonopoulos, Konstantinos Aznaouridis, Panagiotis Antiochos, Christos Fragoulis, Henri Lu, David Meier, Konstantinos Tsioufis, Stephane Fournier, Constantina Aggeli, Georgios Tzimas","doi":"10.3390/jcdd12010028","DOIUrl":"10.3390/jcdd12010028","url":null,"abstract":"<p><p>Cardiac computed tomography (CT) has become an essential tool in the pre-procedural planning and optimization of coronary interventions. Its non-invasive nature allows for the detailed visualization of coronary anatomy, including plaque burden, vessel morphology, and the presence of stenosis, aiding in precise decision making for revascularization strategies. Clinicians can assess not only the extent of coronary artery disease but also the functional significance of lesions using techniques like fractional flow reserve (FFR-CT). By providing comprehensive insights into coronary structure and hemodynamics, cardiac CT helps guide personalized treatment plans, ensuring the more accurate selection of patients for percutaneous coronary interventions or coronary artery bypass grafting and potentially improving patient outcomes.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interindividual Variability Response to Resistance and High-Intensity Interval Training on Blood Pressure Reduction in Hypertensive Older Adults.","authors":"Johnattan Cano-Montoya, Nicolas Hurtado, Carolina Núñez Vergara, Sebastián Báez Vargas, Marcela Rojas-Vargas, Sergio Martínez-Huenchullán, Cristian Alvarez, Mikel Izquierdo","doi":"10.3390/jcdd12010030","DOIUrl":"10.3390/jcdd12010030","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the effects of resistance training (RT) and high-intensity interval training (HIIT) on systolic (SBP) and diastolic blood pressure (DBP) in hypertensive older adults undergoing pharmacological therapy over four and eight weeks. We compared the efficacy of RT and HIIT in reducing non-responders (NRs) between weeks 4 and 8 and analyzed time-course adaptations in NRs and responders (Rs).</p><p><strong>Methods: </strong>Thirty-nine participants were randomized into RT-G (<i>n</i> = 13), HIIT-G (<i>n</i> = 13), or control (CG, <i>n</i> = 13) groups. RT utilized elastic bands, and HIIT involved cycle ergometers, with three weekly 30 min sessions for 8 weeks. SBP and DBP were measured before intervention and at weeks 4 and 8, respectively. Individual responses were classified as NRs or Rs using the Hopkins method (SDIR = √[SDExp2-SDCon2]). Time-course adaptations were evaluated.</p><p><strong>Results: </strong>Both the RT-G and HIIT-G reduced SBP at 8 weeks (RT-G: -13 mmHg; [ES: 1.12]; HIIT-G: -12 mmHg [ES: 0.8]; both <i>p</i> < 0.05). The proportion of NRs for SBP decreased from 46% to 38% in RT-G and 69% to 46% in HIIT-G. Rs showed a peak SBP reduction at 4 weeks (-14.7 and -25.5 mmHg), stabilizing by week 8 (-22.8 and -19.6 mmHg) in RT-G and HIIT-G, respectively.</p><p><strong>Conclusion: </strong>Eight weeks of RT and HIIT effectively reduced SBP and NR prevalence, with time-course adaptations favoring Rs.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Disease Risk Factors in the Native American Population.","authors":"Krista Goerger, Karla Abbott, Mark K Larson, Michael Holinstat","doi":"10.3390/jcdd12010027","DOIUrl":"10.3390/jcdd12010027","url":null,"abstract":"<p><p>Native Americans are disproportionately affected by cardiovascular disease in comparison with other racial and ethnic groups in the United States. Previous research has analyzed risk factors, quantified prevalence rates, and examined outcomes of cardiovascular disease in Native Americans, yet few studies have considered the role of societal and psychological factors on the increased burden of cardiovascular disease in Native Americans. Modifiable risk factors for cardiovascular disease, including poor nutrition, reduced physical activity, obesity, and increased substance use, are exacerbated in Native American communities due to cultural and historical factors. Further, Native Americans have endured historical trauma and continue to experience additional financial and healthcare stressors, resulting in increased levels of chronic stress. Chronic activation of stress responses through the hypothalamic-pituitary-adrenal and autonomic nervous system increases inflammation and cardiovascular dysfunction resulting in an increased risk for cardiovascular disease. Therefore, it is critical to examine the connection between these stressors and the cardiovascular health disparities in Native American communities to create effective strategies to improve health outcomes.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement.","authors":"Hao-Wei Lee, Chih-Hui Chin, Po-Chin Chou, Chia-Hsiu Chang, Chiu-Ling Tsai, Chi-Hung Huang","doi":"10.3390/jcdd12010029","DOIUrl":"10.3390/jcdd12010029","url":null,"abstract":"<p><strong>Background: </strong>A staging system based on cardiac damage for severe aortic stenosis (AS) has been validated for prognosis prediction following transcatheter aortic valve replacement (TAVR). Our study aims to investigate whether TAVR can lead to changes in cardiac damage shortly after the procedure and how these changes impact prognosis.</p><p><strong>Method: </strong>Patients in this retrospective cohort study were classified into five stages (0-4) before TAVR based on the echocardiographic findings of cardiac damage. The closest echocardiogram after TAVR was used for restaging cardiac damage. The primary composite outcome was all-cause mortality or hospitalization due to heart failure (HF).</p><p><strong>Results: </strong>A total of 64 patients were enrolled (53.1% male, mean age 81.7 ± 7.7 years). Within a mean interval of 4 days (interquartile range = 3 to 7 days) after TAVR, cardiac damage improved in 25.0% of patients, while it worsened in 20.3%. During a median follow-up of 2.5 ± 1.9 years, 34.4% of patients met the primary endpoint, which included 16 deaths and 6 HF hospitalizations. Cox regression analysis revealed that improvement in cardiac damage correlated with a lower risk of composite death or HF hospitalization (HR: 0.095; 95% CI: 0.014-0.627; <i>p</i> = 0.015).</p><p><strong>Conclusions: </strong>TAVR can lead to changes in cardiac damage over a short period in patients with severe AS, and rapid improvement in cardiac damage after TAVR is associated with a better prognosis.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Outcomes in Heart Failure Patients with Implantable Pulmonary Artery Pressure Monitors: A Single Centre Irish Experience.","authors":"Niall Leahy, Cillian O'Brien, Sara Essa Alsubai, Eileen Coen, Darragh Murphy, Faisal Sharif","doi":"10.3390/jcdd12010025","DOIUrl":"10.3390/jcdd12010025","url":null,"abstract":"<p><p><b>Background:</b> Hospitalisation for acute decompensated heart failure (HF) portends a poor prognosis. Fluid retention manifesting in dyspnoea and oedema are important clinical features of decompensated heart failure and drive hospital admissions. Intracardiac and pulmonary artery pressure (PAP) monitoring can help predict heart failure decompensation, as changes in these haemodynamics occur before clinical congestion manifests. <b>Methods:</b> A retrospective single centre analysis of patients who underwent insertion of the Cordella™ PA Sensor System (Endotronix, Inc., Chicago, IL, USA) in University Hospital Galway, Ireland, as part of three separate clinical trials-SIRONA 1, SIRONA 2, PROACTIVE HF, was performed. The primary clinical outcome assessed was the difference between HF hospitalisation pre- and post-sensor implantation. <b>Results:</b> In total, there were 33 patients with symptomatic HF who underwent device insertion between 2018 and 2023. All patients had NYHA class 3 heart failure, and 48.5% (<i>n</i> = 16) of patients had HF with reduced ejection fraction. Only one device-related complication was noted, and no pressure sensor failures occurred. In total, there were 26 admissions for HF decompensation 1-year pre-device insertion and only three admissions post-insertion. The difference in the mean number of HF hospitalisations per patient pre- and post-device insertion was 0.70 (<i>p</i> < 0.0001). The difference in mean NYHA class score pre- and post-insertion was 1.0 (<i>p</i> < 0.001). <b>Conclusions:</b> Data from this single-centre cohort study have shown that the insertion of the Cordella™ PA Sensor System in symptomatic HF patients was safe and resulted in statistically significant improvements in HF hospitalisations and NYHA class.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive Central Pulmonary Embolism with Riding Embolus and Concomitant Aortic Arch Embolism-Should We Diagnose Patients Earlier for Blood Clotting Disorders? Case Report.","authors":"Anna Lis, Paweł Kowalski, Marcin Wita, Tomasz Zawadzki, Tomasz Ilczak, Wojciech Żurawiński, Mateusz Majewski","doi":"10.3390/jcdd12010026","DOIUrl":"10.3390/jcdd12010026","url":null,"abstract":"<p><p>Paradoxical embolism occurs when a clot originates in the venous system and traverses through a pulmonary or intracardiac shunt into the systemic circulation, with a mortality rate of around 18%. The risk factors for arterial embolism and venous thrombosis are similar, but different disease entities can lead to a hypercoagulable state of the blood, including antithrombin III (AT III) deficiency. We report the case of a 43-year-old man with a massive central pulmonary embolism with a rider embolus and concomitant aortic arch embolism with involvement of the brachiocephalic trunk, bilateral subclavian and axillary arteries, and the right vertebral artery, followed by a secondary ischaemic stroke. The Pulmonary Embolism Response Team (PERT) consulted the patient on several occasions; he was treated initially with an intravenous infusion of unfractionated heparin under activation partial thromboplastin time (APTT) and AT III substitution. After several days of hospitalisation and the conversion of pharmacotherapy to oral anticoagulants, the patient was discharged home in a stable condition with recommendations for further follow-up in appropriate clinics. This case highlights the role of in-depth diagnostics for coagulation disorders in patients after pulmonary embolism, especially without known risk factors.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Risk: Short Review of Current Approach in Non Cardiac Surgery.","authors":"Andreea Boghean, Cristian Guțu, Dorel Firescu","doi":"10.3390/jcdd12010024","DOIUrl":"10.3390/jcdd12010024","url":null,"abstract":"<p><p>The rate of major surgery is constantly increasing worldwide, and approximately 85% are non-cardiac surgery. More than half of patients over 45 years presenting for non-cardiac surgical interventions have cardiovascular risk factors, and the most common: chronic coronary syndrome and history of stroke. The preoperative cardiovascular risk is determined by the comorbidities, the clinical condition before the intervention, the urgency, duration or type. Cardiovascular risk scores are necessary tools to prevent perioperative cardiovascular morbidity and mortality and the most frequently used are Lee/RCRI (Revised Cardiac Risk Index), APACHE II (Acute Physiology and Chronic Health Evaluation), POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity), The American University of Beirut (AUB)-HAS2. To reduce the perioperative risk, there is a need for an appropriate preoperative risk assessment, as well as the choice of the type and timing of surgical intervention. Quantification of surgical risk as low, intermediate, and high is useful in identifying the group of patients who are at risk of complications such as myocardial infarction, thrombosis, arrhythmias, heart failure, stroke or even death. Currently there are not enough studies that can differentiate the risk according to gender, race, elective versus emergency procedure, the value of cardiac biomarkers.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}