Journal Of Cardiovascular Emergencies最新文献

{"title":"Efficacy of Tolvaptan in Elderly Patients with Heart Failure and Preserved Ejection Fraction","authors":"Yoriyasu Suzuki, A. Murata, S. Tsujimoto, Y. Ochiumi, Tatsuya Ito","doi":"10.2478/jce-2019-0007","DOIUrl":"https://doi.org/10.2478/jce-2019-0007","url":null,"abstract":"Abstract Background: There is no known therapy with proven efficacy for improving clinical outcomes in elderly patients with heart failure (HF) and preserved ejection fraction (HFpEF). In this study, we aimed to evaluate the efficacy of tolvaptan (TLV) in elderly HFpEF patients. Methods: This retrospective observational study involved 100 consecutive elderly HFpEF patients hospitalized at the Nagoya Heart Center, Japan. Inclusion criteria were: (1) patients aged ≥75 years; (2) first hospitalization secondary to HF; (3) received medical therapy for HF, without invasive treatment; and (4) clinical follow-up for >6 months after discharge. The primary endpoint was rehospitalization due to worsening HF, and the secondary endpoint was worsening renal function (WRF) during hospitalization and at 6 months after discharge. Sixty background-matched HFpEF patients were divided into 2 groups: with TLV therapy (TLV (+), n = 29) and without TLV therapy (TLV (–), n = 31). In the TLV (+) group, TLV therapy was continued after discharge. Clinical outcomes of these patients were evaluated. Results: Bed rest period and length of hospital stay were significantly shorter in the TLV (+) group than in the TLV (−) group. The dose of loop diuretics, mean serum creatinine levels, and incidence of WRF development were significantly lower in the TLV (+) group. Incidence of rehospitalization was also significantly lower in the TLV (+) group (log-rank test; p = 0.018). The multivariate logistic regression analysis demonstrated that TLV therapy reduces the incidence of rehospitalization in elderly patients with HFpEF. Conclusions: TLV therapy reduced the bed rest period, length of hospital stay, and rate of rehospitalization without WRF in elderly HFpEF patients, suggesting that TLV could represent an effective therapy for this group of patients.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"151 1","pages":"59 - 65"},"PeriodicalIF":0.4,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77489677","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":"Mean Platelet Volume Predicts Short-term Prognosis in Young Patients with St-segment Elevation Myocardial Infarction","authors":"Y. Çanga, A. Emre, M. Karataş, A. Çalık, N. S. Yelgeç, U. Yıldız, S. Terzi","doi":"10.2478/jce-2019-0008","DOIUrl":"https://doi.org/10.2478/jce-2019-0008","url":null,"abstract":"Abstract Background: Acute ST-elevation myocardial infarction (STEMI) is an uncommon diagnosis in patients less than 40 years of age. Over the last two decades, there is an increase in the frequency of cardiovascular events among young adults. However, at present there is only limited clinical data on the clinical characteristics and outcomes of STEMI in young patients who were treated with primary percutaneous coronary intervention (pPCI). Plaque erosion is the underlying pathological mechanism leading to STEMI in the vast majority of young adults. Thrombi that complicate superficial erosion seem more platelet-rich than the fibrinous clots precipitated by plaque rupture. Mean platelet volume (MPV) is recognized as a marker of the platelet activation process and may be a better indicator of short-term prognosis than the inflammatory markers in young patients with STEMI. Therefore, we aimed to investigate clinical and angiographic characteristics, risk factors and the independent value of MPV on predicting short-term major adverse cardiovascular events (MACEs) in young adults with STEMI. Methods: A total of 349 patients aged 40 years or younger who underwent pPCI at our center between 2010–2015 with the diagnosis of STEMI were retrospectively analyzed. Results: The mean age of the patients was 36.4 ± 3.6 years and 90% of them were men. Smoking was by far the most frequent cardiovascular risk factor. MACEs were observed in 23 patients (6.6%), and according to the multivariate regression analysis, Killip IIIIV (OR 7.52, 95% CI 1.25–45.24, p = 0.03), lower admission SBP (OR 0.94, 95% CI 0.90–0.98, p <0.01) and increased MPV (OR 1.67, 95% CI 1.05–2.67, p = 0.03) were found to be independently correlated with MACE in the study population. Conclusion: Our results indicate that MPV is an independent predictor of MACEs at the short-term follow-up in young patients with STEMI undergoing pPCI. Accordingly, we suggested that MPV, a marker of platelet activation, could play a significant role in predicting clinical evolution in young patients with STEMI.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"56 1","pages":"50 - 58"},"PeriodicalIF":0.4,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81554648","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":"New ICCUs – a Modern Perspective on Acute Cardiac Care","authors":"T. Benedek, R. Hodaș","doi":"10.2478/jce-2019-0010","DOIUrl":"https://doi.org/10.2478/jce-2019-0010","url":null,"abstract":"","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"20 1","pages":"47 - 49"},"PeriodicalIF":0.4,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89606358","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":"Coronary Plaque Geometry and Thoracic Fat Distribution in Patients with Acute Chest Pain – a CT Angiography Study","authors":"M. Rațiu, N. Raț, Tiberiu Nyulas, Geanina Moldovan, V. Rus, T. Benedek, I. Benedek","doi":"10.2478/jce-2019-0001","DOIUrl":"https://doi.org/10.2478/jce-2019-0001","url":null,"abstract":"Abstract The aim of our study was to investigate the correlation between volumes of thoracic fat distributed in different compartments and the geometry of vulnerable coronary plaques assessed by coronary computed tomography angiography (CCTA), in patients with acute chest pain. Methods: This was a non-randomized, observational, single-center study, including 50 patients who presented in the emergency department with acute chest pain who underwent 128-slice single-source CCTA. Plaque geometry was evaluated in transversal and longitudinal planes, and the assessment of adipose tissue was performed using the Syngo.via Frontier (Siemens AG, Healthcare Sector, Forchheim, Germany) research platform. Results: Eccentric plaques presented a significantly higher incidence of spotty calcification (40% vs. 22%, p = 0.018), whereas positive remodeling, volume of low attenuation plaque, and incidence of napkin-ring sign were not significantly different between the study groups or in ascending versus descending plaques. The volume of pericoronary fat around the plaque was significantly larger near eccentric lesions (707.68 ± 454.08 mm3 vs. 483.25 ± 306.98 mm3, p = 0.046) and descendent plaques (778.26 ± 479.37 mm3 vs. 473.60 ± 285.27 mm3, p = 0.016). Compared to ascending lesions, descendent ones presented a significantly larger volume of thoracic fat (1,599.25 ± 589.12 mL vs. 1,240.71 ± 291.50 mL), while there was no significant correlation between thoracic fat and cross-sectional eccentricity. Conclusions: The phenotype of plaque distribution and geometry seems to be associated with a higher vulnerability of coronary lesions and may be influenced by the local accumulation of inflammatory mediators released by the pericoronary epicardial adipose tissue.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"36 1","pages":"18 - 24"},"PeriodicalIF":0.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75456802","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":"Smart Technology – a Future Field in Acute Cardiac Care","authors":"Monica Marton-Popovici, Aura-Gabriela Casu","doi":"10.2478/jce-2019-0003","DOIUrl":"https://doi.org/10.2478/jce-2019-0003","url":null,"abstract":"","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"60 1","pages":"32 - 34"},"PeriodicalIF":0.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74482296","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":"Particularities of Acute Myocardial Infarction in Young Adults","authors":"L. Anghel, C. Prisăcariu, R. Sascău, L. Macovei, E. Cristea, Georgiana Prisacariu, C. Stătescu","doi":"10.2478/jce-2019-0005","DOIUrl":"https://doi.org/10.2478/jce-2019-0005","url":null,"abstract":"Abstract Coronary heart disease occurs more often in patients over the age of 45. However, recent data shows a growing incidence of coronary events in younger patients also. Young patients with acute myocardial infarction (AMI) represent a relatively small proportion of subjects suffering from an acute ischemic event. However, they represent a subset that is distinguished from elderly patients by a different profile of risk factors, often atypical clinical presentation, and different prognosis. The prevalence of risk factors such as smoking, dyslipidemia, and a family history of coronary events is higher in this group of patients compared to the general population with AMI. Because of an important negative impact on the patients’ psychology, impaired working abilities, and a high socioeconomical burden, myocardial infarction in young patients represents an important cardiovascular pathology. This manuscript aims to present the particularities of AMI occuring at a young age, in comparison with the rest of the population with AMI.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"21 1","pages":"25 - 31"},"PeriodicalIF":0.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90437128","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":"Myocardial Revascularization in Critical Patients with Acute Myocardial Infarction and Cardiogenic Shock – a Perspective on New European Recommendations","authors":"T. Benedek","doi":"10.2478/jce-2019-0004","DOIUrl":"https://doi.org/10.2478/jce-2019-0004","url":null,"abstract":"Patients with multivessel disease and acute myocardial infarction (AMI) complicated with cardiogenic shock (CS) present one of the worst outcomes in the field of cardiac critical care, with mortality rates reported as high as 45– 50% even in the presence of the most modern facilities for advanced cardiac support.1 The main recent directions of development in the field of emergency care for critical patients with CS and AMI are represented by: the change introduced by the new European recommendations regarding the revascularization of culprit lesions only in patients with AMI and CS, the implementation of regional networks for reducing time delays from symptom onset to revascularization, and the use of modern equipment for advanced cardiac support.1–3 The first major change in the therapeutic strategy for CS-AMI patients is related to the recent change in the European recommendation for primary revascularization in patients with multivessel disease and CS complicating AMI. Several years ago, the SHOCK (Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock) trial demonstrated that emergency revascularization can significantly improve survival in patients with CS complicating AMI.2 However, in the presence of multivessel disease, there were inconclusive data to support the need for complete revascularization of all lesions in emergency conditions.3 Until recently, while major international guidelines recommended against urgent revascularization of non-culprit lesions in hemodynamically stable patients with STEMI, European guidelines recommended that revascularization of non-culprit arteries should be considered in patients with CS (indication class IIa).4 The recent guidelines on myocardial revascularization published by the European Society of Cardiology clearly advise against complete revascularization in patients with CS, recommending revascularization of the culprit lesion only (the lesion that caused infarction) and staged procedures for the non-culprit lesions.5 This change in recommendations is mainly caused by the recently published results of the CULPRIT-SHOCK trial, which demonstrated that in patients with multivessel disease, AMI, and CS, a strategy consisting in primary percutaneous coronary intervention (PCI) of the culprit lesion only is associated with a significant risk reduction in 30-day all-cause mortality (43.3% vs. 51.6%, HR = 0.84, p = 0.03) and with a significantly lower incidence of the composite endpoint consisting in all-cause mortality or severe renal failure, compared to a strategy consisting in complete revascularization of all coronary lesions in emergency.6 Therefore, the current guidelines published this year strongly recommend culprit lesion-only primary PCI in patients with CS complicating AMI. The second major direction for development in cardiac critical care for CS patients is represented by the efforts to implement appropriate logistics for reducing time deMyocardial Revascularization in C","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"14 1","pages":"5 - 6"},"PeriodicalIF":0.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77318217","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":"Interventional Treatment of Cardiac Emergencies in Children with Congenital Heart Diseases","authors":"E. Cinteză, A. Nicolescu, C. Filip, Georgiana Nicolae, Gabriela Duică, C. Grigore, Hyam Mahmoud","doi":"10.2478/jce-2019-0002","DOIUrl":"https://doi.org/10.2478/jce-2019-0002","url":null,"abstract":"Abstract Cardiac emergencies in children represent an extremely important issue in medical practice. In general, interventional treatment could be optional in many situations, however it can be indicated in emergency conditions. There are many diseases at pediatric age that can benefit from interventional treatment, thus reducing the surgical risks and subsequent complications. Balloon atrioseptostomy, patent ductus arteriosus (PDA) closure, percutaneous or hybrid closure of a ventricular septal defect, pulmonary or aortic valvuloplasty, balloon angioplasty for aortic coarctation, implantation of a stent for coarctation of the aorta, for severe stenosis of the infundibulum of the right ventricle, or for PDA correction are among the procedures that can be performed in emergency situations. This review aims to present the current state of the art in the field of pediatric interventional cardiology.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"188 1","pages":"17 - 7"},"PeriodicalIF":0.4,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77690606","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":"A New Definition of Acute Myocardial Infarction – Changing Perspectives in Acute Cardiac Care","authors":"I. Benedek","doi":"10.2478/jce-2018-0024","DOIUrl":"https://doi.org/10.2478/jce-2018-0024","url":null,"abstract":"","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"37 1","pages":"167 - 169"},"PeriodicalIF":0.4,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78722261","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":"Can We Reduce the Socioeconomic Burden of Acute Myocardial Infarction Already in the Acute Phase?","authors":"Iosif-Alexandru Samu","doi":"10.2478/jce-2018-0025","DOIUrl":"https://doi.org/10.2478/jce-2018-0025","url":null,"abstract":"","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"115 1","pages":"201 - 202"},"PeriodicalIF":0.4,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86793712","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}