Journal of Clinical Cardiology最新文献

{"title":"Shaping the Future of Cardiac Wellness: Exploring Revolutionary Approaches in Disease Management and Prevention","authors":"T. Addissouky, Ibrahim El Tantawy El Sayed, Majeed M. A. Ali, Yuliang Wang, Ayman El Baz, N. Elarabany, Ahmed A. Khalil","doi":"10.33696/cardiology.5.048","DOIUrl":"https://doi.org/10.33696/cardiology.5.048","url":null,"abstract":"Cardiovascular diseases (CVDs) remain a leading cause of morbidity and mortality worldwide. Effective prevention and management strategies are essential to reduce the burden of CVDs. This review summarizes recent advances in the prevention and management of CVDs. In terms of prevention, lifestyle modifications, such as diet, exercise, and smoking cessation, remain important strategies. Pharmacological interventions, including statins, antiplatelet agents, and antihypertensive medications, have also shown benefits. Innovative approaches, such as genetic testing and risk stratification, targeted prevention strategies, and the use of mobile health technology, are being explored. In terms of management, acute management strategies, such as reperfusion therapy for myocardial infarction, acute heart failure management, and stroke management, have improved outcomes. Chronic management strategies, including medical therapy for heart failure, arrhythmia management, and device therapy for heart failure, have also shown benefits. Innovative approaches, such as precision medicine and personalized treatment, the use of artificial intelligence in diagnosis and treatment, and advances in traditional Chinese and regenerative medicine, are being investigated. While recent advances in the prevention and management of CVDs are promising, challenges remain in implementing these strategies, including cost-effectiveness, access to care, and resistance to change in clinical practice. Continued research and innovation are essential to reduce the burden of CVDs and improve patient outcomes.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"14 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139536173","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":"In-Stent Restenosis: Achilles’ Heel of Post-PCI Era","authors":"Sheng Zhou, Le Yang, Biyang Feng, Lei Liu, Li-Ming Chen","doi":"10.33696/cardiology.5.047","DOIUrl":"https://doi.org/10.33696/cardiology.5.047","url":null,"abstract":"Despite advancements in stent design and polymer coatings over the past two decades, 1% to 2% of patients annually still experience instent restenosis (ISR). ISR reduces myocardial perfusion, may develop symptoms of myocardial ischemia, and thus leads to a high risk of myocardial infarction and cardiac death. Given that millions of drug-eluting stents (DES) are implanted globally every year, ISR remains a prevalent clinical issue with significant public health implications. Coronary intravascular imaging, includes intravascular ultrasound (IVUS) and optical coherence tomography (OCT), can help physicians gain deeper insights into the potential mechanisms of ISR. The preferred treatment strategy hinges on an accurate diagnosis and better understanding of etiology. The mechanism of ISR is multifaceted, and its treatment is challenging. Although the risk of ISR continues to decrease with advancements in DES application, further research is still needed to enrich the treatment options for ISR.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"56 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139536086","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":"COVID Pneumonia, Non-ST Elevation Myocardial Infarction, QRS Fragmentation, and Electrocardiographic Wavy Triple or Yasser's Sign in Hodgkin Lymphoma-Prognostic Influence and Serious Outcome","authors":"Yasser Mohammed Hassanain Elsayed","doi":"10.33696/cardiology.4.046","DOIUrl":"https://doi.org/10.33696/cardiology.4.046","url":null,"abstract":"Rationale: The COVID-19 virus with severe acute respiratory syndrome (SARS) has a remarkable effect on morbidity and mortality. Non-ST elevation myocardial infarction (NSTEMI) is a category of acute coronary syndrome (ACS) that may represent a primary cardiac manifestation of COVID-19 disease. The QRS-complex fragmentation had been considered a hallmark of structural heart disease. Wavy triple, an electrocardiographic sign (Yasser’s sign) is a new specific diagnostic sign and therapeutic guide for hypocalcemia. Immunosuppression is a shared criterion for both cancers such as lymphomas and COVID-19 virus infection. Objectives: This case study aimed to clarify the role of COVID-19 viral pneumonia, chemotherapy, and Hodgkin lymphoma in the probability of the current case deterioration. Patient concerns: A 70-year-old, housewife, widow female, Egyptian patient was presented to the emergency department with COVID-19 pneumonia with Non-ST elevation myocardial infarction recently diagnosed as Hodgkin lymphoma. Methods: This is a retrospective-observational case study. Diagnosis: COVID pneumonia with Non-ST elevation myocardial infarction, QRS-complex fragmentation, and Wavy triple electrocardiographic sign (Yasser’s sign) in Hodgkin lymphoma disease. Interventions: CT pulmonary angiography, electrocardiography, and oxygenation. Outcomes: Bad response and poor outcomes in the presence of numerous remarkable serious risk factors were the results. Lessons: Hypocalcemia with Wavy triple electrocardiographic sign (Yasser’s sign) and not hypercalcemia is a new description association that may be present in a malignancy. The association of COVID pneumonia with the recent use of chemotherapy in Hodgkin lymphoma is highly interesting in case of deterioration and away to death. An elderly age, female sex, COVID-19 pneumonia, Non-ST elevation myocardial infarction, sinus tachycardia, QRS-complex fragmentation, Wavy triple electrocardiographic signs (Yasser’s sign), and Hodgkin lymphoma disease are constellation serious risk factors.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"109 38","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135136230","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":"EASI Monitoring: An Alternative to Conventional Electrocardiography in the Recording of Ventricular Tachycardia","authors":"Mauro Buelga Suárez, Lorena Piña Astete, Miguel Cayetano Amores Luque, Jesús García Montalvo, Ana Tur Sainz, Nerea Peñaranda Romero, Patricia Rodríguez Sánchez, María Irene Muñoz Gómez, Gonzalo Luis Alonso Salinas","doi":"10.33696/cardiology.4.045","DOIUrl":"https://doi.org/10.33696/cardiology.4.045","url":null,"abstract":"This study compares the EASI monitoring setting with the conventional 12-lead electrocardiogram (ECG) in patients experiencing ventricular tachycardia (VT) episodes. The results revealed that the EASI monitoring setting demonstrated a VT morphology that closely resembled that of the conventional ECG in the majority of cases. This finding suggests that EASI monitoring could serve as a valuable alternative in situations where obtaining a conventional ECG is either risky or not feasible.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"39 19","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135873407","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":"Short-Term Outcomes Following Transcatheter Aortic Valve Implantation: Classical Low-Flow Low-Gradient Versus Normal-Flow Low-Gradient Severe Aortic Stenosis","authors":"Benjamin Fogelson, Raj Baljepally, Hassan Tahir, James Livesay, Tyler Coombes, Chirag Patel, Ghassan Wadi, Raymond Dieter III","doi":"10.33696/cardiology.4.044","DOIUrl":"https://doi.org/10.33696/cardiology.4.044","url":null,"abstract":"Background: Both classical severe low-flow low-gradient aortic stenosis (LFLG-AS) and severe normal-flow low-gradient aortic stenosis (NFLG-AS) patients undergo transcatheter aortic valve implantation (TAVI). However, few studies have compared outcomes between the two groups. Our study aimed to assess short term post-TAVI outcomes between classical LFLG-AS and NFLG-AS. Methods: We conducted a retrospective, single-center, analysis of 206 patients who underwent TAVI between January 2011 to September 2020. Of these, 44 (males: 33) had classical LFLG-AS and 162 (males: 89) had NFLG-AS. Six-month primary outcomes included all-cause and cardiovascular mortality. Multiple secondary outcomes were assessed including stroke, myocardial infarction (MI), new-onset atrial fibrillation, acute kidney injury (AKI), major bleeding, vascular complications, and repeat hospitalizations from cardiac causes. Results: The cumulative six-month all-cause and cardiovascular mortality were similar between classical severe LFLG-AS and NFLG-AS patients (6.81 % vs. 4.32 %, P = 0.49 and 2.27 % vs. 2.47 %, P = 0.93 respectively). All secondary outcomes were also similar, except for a statistically significant higher rate of AKI in patients with classical LFLG-AS (P = < 0.0001). Conclusion: Except for a higher incidence of AKI in patients with severe classical LFLG-AS, six-month post-TAVI outcomes did not differ between classical LFLG-AS and NFLG-AS.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135511453","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":"The Use of CHA2DS2-VASc Score to Predict Functional Outcomes of Mechanical Thrombectomy","authors":"James Livesay, Benjamin Fogelson, Shawna Stephens, Chirag Patel, William Dieter, Hassan Tahir, Brian Wiseman, Raj Baljepally","doi":"10.33696/cardiology.4.043","DOIUrl":"https://doi.org/10.33696/cardiology.4.043","url":null,"abstract":"Background: Mechanical thrombectomy is widely used for revascularization of acute ischemic strokes from large vessel occlusions. Functional outcomes following mechanical thrombectomy are typically assessed using the modified Rankin scale. CHA2DS2-VASc score is commonly used to estimate the stroke risk of patients with atrial fibrillation, but studies have verified its use in other various situations. Our study aimed to assess the utility of CHA2DS2-VASc score in predicting outcomes of patients undergoing mechanical thrombectomy. Methods: We performed a single center retrospective study. Of patients with acute ischemic stroke who underwent mechanical thrombectomy for large vessel occlusion (n = 448). CHA2DS2-VASc score was calculated on each patient and the study population was grouped based on low-risk ≤ 2, intermediate risk 3-4 and high-risk ≥ 5. Association between CHA2DS2-VASc score and 90-day modified Rankin score as well as in-hospital, 30-day, and 1-year mortality was evaluated and compared between the three groups. Results: A total of 312 patients met criteria for the study. Patients in the high-risk CHA2DS2-VASc score had a significantly higher modified Rankin score (4.48) when compared to low (2.57) and intermediate (3.82) risk groups. Higher CHA2DS2-VASc scores were also associated with a significantly higher in-hospital, 30-day, and one year mortality. Conclusion: CHA2DS2-VASc score, a simple bed-side tool, can predict higher mortality and worse functional outcomes in acute ischemic stroke patients undergoing mechanical thrombectomy for large vessel occlusions.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"48 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135511135","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":"Improve Survival of Out of Hospital Cardiac Arrest with Video-directed Chest Compressions","authors":"Annabelle Shen, Alexander Shen","doi":"10.33696/cardiology.4.042","DOIUrl":"https://doi.org/10.33696/cardiology.4.042","url":null,"abstract":"Background: Cardiovascular disease has been the leading cause of mortality worldwide for the past century, but advancements in health intervention have led to a decline of over 20%. However, the Out of Hospital Cardiac Arrest (OHCA) mortality rate remains unacceptably high, exceeding 90% over the past few decades. The primary reasons are the lack of cardiopulmonary resuscitation (CPR) knowledge and delayed medical response [1]. In 2018, the American Heart Association (AHA) introduced audio-directed CPR by 911 operators. However, the effectiveness of this approach in guiding laypeople to perform CPR is far from optimal [2]. Methods: Laypeople were randomly divided into audio and video groups, with each group receiving instructions through their respective medium on how to perform CPR on manikins. Simulated OHCA scenarios were created, involving on-site testing with subjects having no prior CPR experience, and a remote call site providing CPR instructions either through audio or video. Both on-site and online activities were recorded and analyzed. The accuracy of hand positions, the time of CPR initiation, the speed and effectiveness (depth) of chest compressions were tracked and compared between the audio and video guided groups based on AHA requirements. Results: Across 61 trials, CPR initiation occurred in 22 ± 11 seconds in the audio group and 22 ± 6 seconds in the video group. Hand location accuracy was 77% in audio participants and 97% in video participants (p<0.05). The average speed of CPR was 0.55 ± 0.23 seconds with audio guidance and 0.45 ± 0.27 seconds with video guidance. The effectiveness of compressions was 33% ± 39% in the audio group and significantly improved to 79% ± 26% in the video group (p<0.0001). Conclusion: The implementation of a new video-guided CPR system can significantly enhance CPR effectiveness when compared to the audio-assisted approach.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135923352","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":"Guidelines Oriented Approach to Lipid (GOAL) Lowering Quality Improvement International Program","authors":"A. Langer, M. Tan, C. Spindler, O. Berwanger, Diane Camara, Khalid Al Faraidy, M. Akbar, W. Almahmeed, M. Alcocer-Gamba","doi":"10.33696/cardiology.4.041","DOIUrl":"https://doi.org/10.33696/cardiology.4.041","url":null,"abstract":"Background: Despite practice guidelines, strategies for lowering LDL-C are often poorly adopted in clinical practice. \u0000Materials and Methods: Five countries (Brazil, Kuwait, Mexico, Saudi Arabia, and UAE) enrolled 2,422 patients with atherosclerotic cardiovascular disease (ASCVD) or familial hypercholesterolemia (FH) with low density lipoprotein cholesterol level (LDL-C) above 1.4 mmol/L. Patients were followed at 6 ± 2 months intervals to assess LDL-C level and treatment with ezetimibe and/or proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i).\u0000Results: 2422 patients 60.4 ± 11.7 years old and 29% women were enrolled from 87 participating cardiology sites. Overall, 91.1% of patients had coronary artery disease and FH in 12.3%. At baseline LDL-C was 2.96 ± 1.36 mmol/L and 1.87 ± 1.28 mmol/L (p<0.0001) at last available observation (n=2014). Proportion of patients achieving LDL<1.4 mmol/L (primary endpoint) increased from zero to 41.4% (p<0.0001). \u0000At baseline, 99.2% of patients were on statin (81.3% high intensity statin), 34.4% on ezetimibe and its use increased significantly (62.9%, p<0.0001). PCSK9i use increased to 35.0% from baseline to last follow up (p<0.0001). Clinical outcomes such as ACS, CVA/TIA, PCI, CABG, or hospitalization for ASCVD reasons were recorded in 10.7% of patients during the follow up. Patients with no event had an overall LDL-C of 1.90 ± 1.3 mmol/L while those with an event had LDL-C significantly higher at the visit immediately prior to event (2.70 ± 1.35, p=0.0001).\u0000Conclusion: The results indicate the feasibility of overcoming treatment inertia and improving LDL-C control which should help to achieve reduction in cardiovascular morbidity and mortality in ASCVD patients.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90670513","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":"When the Right Coronary Artery is Tortuous and Too Big for Standard Coronary Stents: “The Child-in Mother Carotid Stent Technique”","authors":"G. Piedimonte, E. Cerrato, G. Zanda, C. Rolfo, F. Tomassini, A. Franzé, M. Pavani, Rosario Tripodi, F. Varbella","doi":"10.33696/cardiology.4.040","DOIUrl":"https://doi.org/10.33696/cardiology.4.040","url":null,"abstract":"Routine implementation of guide extension catheters in percutaneous coronary intervention (PCI) has significantly increased success rates in challenging anatomies, such as in tortuous and severe calcified vessels. Recently, the “Child-In-Mother technique” has been tested successfully in carotid artery stenting (CAS) in patients with severe tortuosity of the common or internal carotid artery (ICA).\u0000\u0000In the present report, we propose to use the “Child-in-Mother technique” to facilitate the delivery of a carotid stent in an ectatic, thrombotic and tortuous right coronary artery (RCA) in a patient presenting with acute coronary syndrome (ACS).","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"179 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74721314","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":"Ischemic Cardiomyopathy Evaluation with Coronary Calcium Score and CT Angiogram","authors":"Agara Kumar, Nebat Hussen, Suvasini Lakshmanan, Venkat Manubolu, April Kinninger, Matthew Budoff, Sion K. Roy","doi":"10.33696/cardiology.4.038","DOIUrl":"https://doi.org/10.33696/cardiology.4.038","url":null,"abstract":"Our study aimed to examine the prevalence of atherosclerotic burden in a predominantly non-white cohort of patients from LA County who underwent coronary artery calcium scoring (CACS) and coronary CT angiogram (CCTA) for the evaluation of cardiomyopathy of ischemic origin. Ischemic cardiomyopathy, primarily caused by reduced blood supply to the heart, is the most common type of cardiomyopathy. CCTA is a well-established and non-invasive imaging test used to assess the extent of coronary artery disease (CAD) in individuals suspected of having it. We analyzed data from 131 patients with cardiomyopathy who were referred to Harbor-UCLA Medical Center between August 2016 and September 2020. These patients had no chest pain, no q waves on electrocardiogram (ECG), and exhibited cardiomyopathy with reduced ejection fraction (EF) without wall motion abnormalities on transthoracic echocardiogram. Among the 131 patients included in our study, the average age was 54.6 years, with 93 (71%) being male. The racial distribution was as follows: 71 (54%) Hispanic, 17 (13%) White, 24 (18%) African American, and 10 (8%) Asian. Various risk factors for coronary artery disease were present, including diabetes mellitus (30%), hypertension (75%), hyperlipidemia (45%), and smoking (46%). We assessed CACS using the Agatston score, while atherosclerotic disease burden was evaluated using total plaque score (TPS), total segment stenosis score (TSSS), and segment involvement score (SIS). Of the patients, 55 (42%) had a CACS of zero, 28 (21%) had a CACS below 10, and the median (interquartile range) of TPS was 1 (1, 5). The median TSSS and SIS were both 1 (1, 5) and 0 (1, 4), respectively. A total of 23 patients (18%) exhibited 50% stenosis indicative of obstructive CAD, while 13 patients (10%) had even more severe stenosis of 75% or greater. Our findings revealed that the majority of patients in our cohort had non-obstructive CAD, suggesting that non-ischemic factors were the primary cause of their cardiomyopathy. Additionally, our study demonstrated that CCTA is an effective non-invasive diagnostic tool for cardiomyopathy, allowing for the avoidance of more invasive procedures in a predominantly non-white population receiving care at a public hospital in LA County.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135309894","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}