International Journal on Heart and Vascular system最新文献

{"title":"A Rare Variant of an Anomalous Origin of the Left Coronary Artery, the Great Masquerader of Angina?","authors":"","doi":"10.51626/ijhvs.2022.02.00009","DOIUrl":"https://doi.org/10.51626/ijhvs.2022.02.00009","url":null,"abstract":"Anomalous aortic origin of the coronary arteries (AAOCA) is a rare set of anatomical variants that can present with symptoms such as angina and dyspnea on exertion with complications including acute coronary syndrome and sudden cardiac death. This case demonstrates a patient presenting with classic anginal symptoms with an incidental finding of one of the rarest variants and its complexity in cannulation: a left main\u0000coronary artery arising from the non-coronary cusp. Despite insignificant left coronary disease on coronary angiography, we had a high index of suspicion for underlying coronary vasospasm as a major contributor to her recurrent symptoms. AAOCA is an anatomical finding that warrants clinician awareness and close follow-up with recommendation for surgery if symptomatic.","PeriodicalId":171962,"journal":{"name":"International Journal on Heart and Vascular system","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122248700","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":"Cardiovascular Morbidity and Mortality in COVID-19:\u0000A Multicenter Retrospective Analysis","authors":"","doi":"10.51626/ijhvs.2022.02.00010","DOIUrl":"https://doi.org/10.51626/ijhvs.2022.02.00010","url":null,"abstract":"Background: Single-center data from COVID-19 studies suggest clinical risk factors for cardiovascular and prothrombotic complications. This study aims to identify clinical risk factors that increased the risk of pulmonary embolism (PE), myocardial infarction (MI), cerebrovascular accident (CVA), mortality, and a composite of major adverse cardiovascular events (MACE) in an urban and diverse multicenter setting.\u0000Methods: Between February and June, 2020, 4,547 patients were seen in the ER of 17 northeastern US hospitals and tested positive for COVID-19; of these, 1,171 patients were treated and released. We retrospectively analyzed the data on 3,376 patients who were admitted to these hospitals. A multivariable logistical regression analyzed patient characteristics and comorbidities in relation to said complications.\u0000Results: COVID-19 infected patients with a history of any cancer were at 2.64 times greater risk (1.519, 4.533; p=.0005) of developing PE; however, increasing age decreased the risk for PE. Patients with a history of heart failure with preserved or reduced ejection fraction (HFpEF, HFrEF) (OR=1.918; 95% CI: 1.230, 2.990; p=.0041 and OR=3.205; 95% CI: 2.272, 4.520; p<.0001), ischemic heart disease (IHD) (OR=2.429; 95% CI:\u00001.836, 3.215; p<.0001), end stage renal disease (ESRD) (OR=1.566 95% CI: 1.002, 2.446; p=.0489) were at higher risk for MI. Women had decreased odds of CVA compared to men (OR=0.716; 95% CI: 0.529, 0.970; p=.0308). ESRD had a positive association with CVA (OR=2.465; 95% CI: 1.545, 3.934; p=.0002). HFrEF was highly associated with MACE while women had decreased odds of MACE (OR=2.020; 95% CI: 1.453, 2.810; p<.0001). Patients with HFrEF (OR=1.623; 95% CI: 1.191, 2.211; p=.0021), chronic kidney disease (OR=1.712; 95% CI: 1.227, 2.389; p=0.0016), and diabetes (OR=1.170; 95% CI: 0.973, 1.407; p=0.0960) had an increased risk of mortality from COVID-19.\u0000Conclusion: Our analysis identified comorbidities that were strongly associated with major COVID-19 complications. Utilizing these findings may help guide clinicians with risk stratification and earlier clinical interventions.\u0000Keywords: COVID-19; Mortality; Myocardial infarction; Pulmonary embolism; Cerebrovascular accident","PeriodicalId":171962,"journal":{"name":"International Journal on Heart and Vascular system","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122988202","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":"Updated Meta-Analysis Comparing FFR-Guided and\u0000Angiographic-Guided Intervention in Patients with Multivessel Coronary Artery Disease","authors":"","doi":"10.51626/ijhvs.2022.02.00007","DOIUrl":"https://doi.org/10.51626/ijhvs.2022.02.00007","url":null,"abstract":"A new method to guide Percutaneous Coronary Interventions (PCI) and Coronary Artery Bypass Graft (CABG) interventions are by FFR, which is a measurement of the hemodynamic significance of coronary stenosis. We conducted an updated meta-analysis of all randomized controlled trials from inception to 5 December 2021 to compare studies that included patients who underwent FFR-guided PCI or CABG. The statistical analysis was performed using a random effect model to Calculate Risk Ratios (RR) and Mean Difference (MD) with 95% Confidence Intervals (CI). Five RCTs were included with a total of 2,288 patients and a median weighted follow-up period of 16.6 months. In this meta-analysis with a small sample size, there was no difference between FFR-guided and angiographicguided interventions for the rates of MACE and all-cause mortality. Moreover, the analysis showed that FFR-guided was associated with\u0000insignificantly decreased rates of MI (RR 0.77, 95% CI 0.51-1.16, p=0.21, I2=18%) and the number of revascularizations (RR 0.82, 95% CI 0.64-1.06, p=0.12, I2=0%). Finally, the average number of stents used per patient significantly favored the FFR-guided group (MD -0.16, 95% CI -0.24 to -0.07, p=0.0003, I2=93%). In conclusion, although FFR-guided did not have any benefit in decreasing MACE or allcause mortality, it was associated with improved outcomes of MI, the number of revascularizations, and the average number of stents.","PeriodicalId":171962,"journal":{"name":"International Journal on Heart and Vascular system","volume":"165 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133590663","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 Role of Diastolic Blood Pressure on Myocardial Heart Patients","authors":"","doi":"10.51626/ijhvs.2022.02.00006","DOIUrl":"https://doi.org/10.51626/ijhvs.2022.02.00006","url":null,"abstract":"","PeriodicalId":171962,"journal":{"name":"International Journal on Heart and Vascular system","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125648671","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":"Acute Myocardial Infarction in a Healthy 57-Year-Old Female; A Case Report","authors":"","doi":"10.51626/ijhvs.2021.01.00005","DOIUrl":"https://doi.org/10.51626/ijhvs.2021.01.00005","url":null,"abstract":"Spontaneous coronary artery dissection (SCAD) commonly present as acute coronary syndrome in otherwise healthy population especially in women. SCAD is defined as dissection involving epicardial coronary arteries, not related to any trauma, or atherosclerosis process or any iatrogenic causes, resulting in intimal disruption and/or Intra-mural hematoma (IMH).\u0000SCAD is often misdiagnosed and therefore the treatment is delayed resulting in complications. This review will focus on a case\u0000presentation and the diagnosis and management of SCAD.","PeriodicalId":171962,"journal":{"name":"International Journal on Heart and Vascular system","volume":"335 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124712144","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":"Role of Experience in Developing an Interventional Nephrology Program at an Academic Center in Pakistan","authors":"","doi":"10.51626/ijhvs.2021.01.00004","DOIUrl":"https://doi.org/10.51626/ijhvs.2021.01.00004","url":null,"abstract":"Background: A well-functioning vascular access is the backbone of renal replacement therapy in chronic kidney disease (CKD). Vascular access management is largely done by vascular surgeons and interventional radiologists who are often unaware of its impact and repercussions in the care of dialysis patients. This has led to delayed dialysis, temporary vascular access, hospitalization, and other associated morbidities. Interventional nephrology is a subspecialty of nephrology that increases the involvement of nephrologists in vascular access procedures. The advent of interventional nephrology as a field has not only improved continuity of care but has also led to uninterrupted dialysis treatments and decreased rate of hospitalization.\u0000Methods: We established a new interventional nephrology service at the Aga Khan University Hospital, Karachi, Pakistan with the help of an interventional nephrologist accredited by the American Society of Diagnostic and interventional nephrology (ASDIN). The study aims to an arrangement of equipment, and training of staff to assist in procedures.\u0000Results: To date, we have placed 20 tunneled dialysis catheters (TDCs), performed 8 arteriovenous fistula (AVF) venoplasty procedures, some venous mapping procedures as well as renal biopsies all in an outpatient setting with good outcomes. We further plan on starting a peritoneal dialysis catheter placement program at our center soon.\u0000Conclusion: In a country like Pakistan where resources are limited, interventional nephrology can provide good vascular access care and timely interventions for vascular access dysfunction while allowing the procedures to take place in an outpatient setting, hence minimizing costs. The current study program may be a guide to help establish a similar program by other specialties with the support of the hospital administration.\u0000Keywords: Interventional nephrology; Vascular access; Chronic kidney disease; End-stage renal disease; Dialysis","PeriodicalId":171962,"journal":{"name":"International Journal on Heart and Vascular system","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131785352","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 Glycemic Index, Postprandial Hypotension and Cardiovascular Disease","authors":"","doi":"10.51626/ijhvs.2021.01.00003","DOIUrl":"https://doi.org/10.51626/ijhvs.2021.01.00003","url":null,"abstract":"High glycemic index diets have been associated with an increased risk of cardiovascular disease events and all-cause mortality. We suggest that part of the reason for this association is through the effect of the rapidly digested high glycemic index\u0000carbohydrate diets in promoting the effects of postprandial hypotension in vulnerable individuals.\u0000Postprandial hypotension has been recognized as a problem especially affecting the frail elderly. The phenomenon occurs earlier in the day and includes syncope and falls acutely and more serious cardiovascular events and increased all-cause mortality in the\u0000longer-term. The mechanism appears to relate to the rapid digestion of carbohydrates foods. Strategies that reduce the amount of meal carbohydrates and their rate of absorption by enzyme inhibition or by delaying gastric emptying and have proved helpful as has increased fluid intake, presumably due to dilution of small intestinal contents and a reduction in the tonicity, so reducing the need for intestinal fluid secretion to dilute osmotically active sugars and products of digestion. In this way the need for increased blood flow to the gut can be reduced, that would otherwise steal blood from the systemic circulation resulting in a drop in blood pressure and an\u0000increase in heart rate. Slowly absorbed or low glycemic index carbohydrates would therefore appear potentially useful as part of the dietary strategy for the treatment of postprandial hypotension and conversely postprandial hypotension could be one of the reasons why high glycemic index diets have been associated with increased CVD risk.","PeriodicalId":171962,"journal":{"name":"International Journal on Heart and Vascular system","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123027660","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}