Minerva cardiology and angiology最新文献

{"title":"Diagnostic performance of RAC2 combined with CT-FFR parameters in coronary heart disease.","authors":"Zhanying Zhu, Jiani Xu, Haitao Wang, Wei Jin, Miao Liu","doi":"10.23736/S2724-5683.24.06618-3","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06618-3","url":null,"abstract":"<p><strong>Background: </strong>The incidence and mortality of coronary heart disease (CHD) are high in the elderly population. CT fractional flow reserve (CT-FFR) is a potential diagnostic technique for cardiovascular diseases. In order to mine valuable biomarkers to combine CT-FFR parameters to improve the diagnostic accuracy of CHD.</p><p><strong>Methods: </strong>In this study, GEO database was used to screen the key genes of CHD. GraphPad software was used to construct receiver operating characteristic (ROC) curve, and SPSS software was used for logistic regression analysis. Inflammatory cell model was constructed by treating human cardiac microvascular endothelial cells (HMVEC-Cs) with TNF-α to explore the role of RAC2 in this process.</p><p><strong>Results: </strong>Real time quantitative PCR (RT-qPCR) results showed high-expression of RAC2 in CHD patients, which were reversed after nitric ester drug therapy. The analysis of ROC curves displayed that RAC2 combined with CT-FFR had a higher diagnostic value for CHD (AUC=0.971, 95% CI 0.950-0.992) compared to the single factor, and RAC2 was an independent risk factor for poor prognosis in CHD patients treated with nitric ester drugs (AUC=0.888, 95% CI 0.814-0.961, P<0.001). Overexpression of RAC2 further enhanced the elevated expression levels of NF-κB, NLRP3, IL-1β, and IL-6, induced by TNF-α, and its silence had the opposite effect.</p><p><strong>Conclusions: </strong>RAC2 promoted the inflammatory response of HMVEC-Cs and predicted a poor prognosis in CHD patients. The combination of RAC2 and CT-FFR parameters was a good classifier for diagnosing CHD.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular mechanics assessment in amyloidosis patients: a systematic review and meta-analysis.","authors":"Andrea Sonaglioni, Priscilla Torretta, Gian L Nicolosi, Michele Lombardo","doi":"10.23736/S2724-5683.24.06683-3","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06683-3","url":null,"abstract":"<p><strong>Background: </strong>Over the last decade, a small number of studies have used speckle tracking echocardiography (STE) or cardiac magnetic resonance (CMR) for measuring left ventricular (LV) mechanics in patients with amyloidosis. This systematic review and meta-analysis aimed at assessing the overall influence of amyloidosis on LV global longitudinal strain (GLS) and regional longitudinal strain at basal (BLS), mid (MLS) and apical (ALS) level, respectively.</p><p><strong>Methods: </strong>All imaging studies assessing LV-GLS, LV-BLS, LV-MLS and LV-ALS in amyloidosis patients versus healthy controls, selected from PubMed and EMBASE databases, were included. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment of Case-Control Studies. Continuous data (LV-GLS, LV-BLS, LV-MLS and LV-ALS) were pooled as a standardized mean differences (SMDs) comparing amyloidosis group with healthy controls. The overall SMDs of LV-GLS, LV-BLS, LV-MLS and LV-ALS were calculated using the random-effect model.</p><p><strong>Results: </strong>The full-texts of 13 studies with 553 amyloidosis patients and 575 healthy controls were analyzed. STE (53.8%) and CMR (46.2%) studies were separately analyzed. Average LV-GLS magnitude was significantly impaired in amyloidosis patients vs. controls in both STE (13.8±3.9 vs. 19.8±2.7%) and CMR (12.3±4 vs. 17.9±3.5%) studies. The impairment of segmental strain detected in amyloidosis patients was prevalent at basal and mid level, with relative \"apical sparing.\" SMDs obtained for LV-GLS (SMD -1.80, 95% CI: -2.35, -1.24, P <0.001), LV-BLS (-1.98; 95% CI: -2.51, -1.45, P <0.001) and LV-MLS (-1.84; 95% CI: -2.46, -1.23, P <0.001) assessment were significantly larger than that obtained for LV-ALS (-0.72; 95% CI: -1.31, -0.13, P=0.02) measurement. Substantial heterogeneity was found among the studies assessing LV-GLS (I²=92.5%), LV-BLS (I²=91.4%), LV-MLS (I²=94.3%) and LV-ALS (I²=94.6%). Egger's test yielded a P value of 0.10, 0.20, 0.09 and 0.55 for LV-GLS, LV-BLS, LV-MLS and LV-ALS assessment respectively, indicating no publication bias. On meta-regression analysis, none of the moderators was significantly associated with effect modification for LV-GLS, LV-BLS, LV-MLS and LV-ALS (all P<0.05).</p><p><strong>Conclusions: </strong>Amyloidosis has a large negative effect on LV-GLS, primarily related to the deterioration of segmental longitudinal strain at the basal and mid level, with relative apical sparing.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Mass Index and outcomes following transcatheter aortic valve replacement: going beyond customs.","authors":"Andrea Marrone, Alfonso Ielasi","doi":"10.23736/S2724-5683.25.06844-9","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06844-9","url":null,"abstract":"","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the intriguing relationship: epicardial adipose tissue correlation with left atrial and left ventricular function across different heart failure types.","authors":"Zhen Wang, Kun D Chen, Chen Y Jin, Fang Nie","doi":"10.23736/S2724-5683.24.06601-8","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06601-8","url":null,"abstract":"<p><strong>Background: </strong>The association between epicardial adipose tissue (EAT) and heart failure has garnered significant attention. The objective of this study is to investigate the relationship between EAT and cardiac function across various heart failure phenotypes.</p><p><strong>Methods: </strong>The study cohort included 33 cases in the control group and 121 cases in the heart failure group, stratified into subgroups: 40 with heart failure with reduced ejection fraction (HFrEF), 38 with heart failure with mid-range ejection fraction (HFmrEF), and 43 with heart failure with preserved ejection fraction (HFpEF). Researchers collected epicardial adipose tissue thickness, clinical data, and echocardiographic parameters from all participants. Left ventricular (LV) systolic function was assessed using global longitudinal strain (GLS), and left atrial (LA) function was evaluated using LA strain during reservoir, conduit, and contraction phases. Fitted curves illustrating the relationship between EAT and LV ejection fraction (LVEF), as well as GLS and LA strain, were constructed. Multivariable linear regression was employed to analyze the correlation between EAT and GLS, LASr, LAScd, and LASct after adjusting for confounding factors.</p><p><strong>Results: </strong>A nonlinear relationship was observed between EAT and LVEF, GLS, LASr, LAScd, and LASct. EAT thickness varied across groups: HFpEF (7.9±0.8 mm)>Control (5.1±0.6 mm)>HFmrEF (4.6±0.9 mm)>HFrEF (4.0±0.7 mm). After adjusting for age, gender, BMI, and relevant medical history, the correlation coefficients between EAT and GLS were 0.21, 0.17, and -0.12 in HFrEF, HFmrEF, and HFpEF groups, respectively. In the HFrEF group, EAT showed positive correlations with LASr and LAScd (0.1 and 0.1), and negative correlations with LASr, LAScd, and LASct in the HFpEF group (-0.03, -0.06, and -0.07).</p><p><strong>Conclusions: </strong>EAT thickness follows the order: HFpEF>Control>HFmrEF>HFrEF. Thicker EAT in HFpEF is associated with poorer LV and LA function, while the opposite trend is observed in HFrEF and HFmrEF. LA function is more compromised in HFmrEF and HFrEF compared to HFpEF.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-related efficacy and safety of sodium tanshinone II A sulfonate for the treatment of unstable angina pectoris: a meta-analysis.","authors":"Na Wang, Zeyuan Fan","doi":"10.23736/S2724-5683.24.06631-6","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06631-6","url":null,"abstract":"<p><strong>Introduction: </strong>Unstable angina pectoris (UAP), a prevalent form of angina pectoris, is caused by coronary artery stenosis, elevated blood viscosity, and atheromatous plaque that blocks blood vessels. A meta-analysis was conducted to evaluate the efficacy and safety of various injectable doses of sodium tanshinone II A sulfonate (STS) for UAP treatment.</p><p><strong>Evidence acquisition: </strong>The Web of Science, CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, and Embase databases were used to search for randomized controlled trials (RCTs) using STS until December 29^th, 2023. The selection of studies solely focused on conventional Western medicine (WM) and different STS dosages (40, 50, 60, or 80 mg/day) combined with WM. The risk of bias was evaluated using the Quality in Prognostic Studies (QUIPS) tool. The standardized mean difference (SMD) or risk ratio (RR) was used to develop the random-effects or fixed-effects model.</p><p><strong>Evidence synthesis: </strong>The study included 31 RCTs. The results of the meta-analysis showed that compared with WM alone, combination of WM and STS at 40 mg/day (RR: 1.15 [95% CI: 1.03, 1.29]; P=0.027) or 60 mg/day (RR: 1.20 [95% CI: 1.11, 1.30]; P=0.0005) increased electrocardiographic efficacy. Compared with WM alone, 40 mg/day of STS plus WM reduced plasma viscosity (SMD: -0.78 [95% CI: -1.60, 0.04]; P=0.056); whole blood low viscosity (SMD: -0.58 [95% CI: -0.95, -0.21]; P=0.015); CRP (SMD: -1.07 [95% CI: -2.10, -0.03]; P=0.047); and adverse events (SMD: -1.62 [95% CI: -3.55, 0.31]; P=0.069). In addition to 40 mg of STS, we found that 60 mg of STS plus WM reduced the incidence of adverse events (SMD: -1.01 [95% CI: -2.07, 0.04]; P=0.055).</p><p><strong>Conclusions: </strong>This meta-analysis indicated that the combination of STS on 40 mg/day with WM enhanced the safety and clinical efficacy of UAP therapy.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging ChatGPT in cardiogeriatrics.","authors":"Barbara Antonazzo, Vassilios S Vassiliou, Attilio Lauretti, Giuseppe Biondi-Zoccai","doi":"10.23736/S2724-5683.24.06808-X","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06808-X","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) into healthcare is transforming medical practice, and this holds true also for the prevention, diagnosis and treatment of cardiovascular disease in older patients. Large language models (LLMs) like ChatGPT (OpenAI, San Francisco, CA, USA) represent cutting edge AI tools which may offer significant potential to enhance patient care by improving communication, aiding in diagnosis, and assisting in treatment planning. In elderly patients, who often present with complex health profiles and multiple comorbidities, AI can prove particularly beneficial, and it can analyze extensive data to provide personalized, evidence-based recommendations. For instance, ChatGPT can support clinicians in managing polypharmacy by identifying potential drug interactions and suggesting optimal medication regimens, thereby reducing adverse effects. Additionally, AI tools can help overcome therapeutic inertia by prompting timely treatment adjustments, ensuring that elderly patients receive appropriate interventions. However, the successful implementation of AI in cardiogeriatrics requires robust technological infrastructures, a synergistic integration with electronic health records, and careful consideration of ethical and privacy concerns. Ongoing collaboration between technologists and healthcare professionals is essential to address these challenges and fully realize the benefits of AI in enhancing cardiovascular care for the elderly.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specific phenotypes of heart failure with preserved/reduced ejection fraction according to Body Mass Index.","authors":"Kenichi Matsushita, Kazumasa Harada, Takahiro Jimba, Takashi Kohno, Hiroki Nakano, Daisuke Kitano, Makoto Takei, Shun Kohsaka, Hideaki Yoshino, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama","doi":"10.23736/S2724-5683.24.06633-X","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06633-X","url":null,"abstract":"<p><strong>Background: </strong>The relationship between Body Mass Index (BMI) and acute heart failure (HF) remains ill-defined. This study aimed to compare the influence of BMI on in-hospital mortality between patients with acute HF with preserved ejection fraction (HFpEF) and those with acute HF with reduced ejection fraction (HFrEF) and to examine the specific phenotypes of HFpEF/HFrEF according to BMI.</p><p><strong>Methods: </strong>This multicenter retrospective study included 5313 and 6332 consecutive patients with acute HFpEF and HFrEF, respectively. Low, normal, and high BMIs were defined as BMI <18.5, 18.5 ≤BMI <25.0, and BMI ≥25.0, respectively. Overweight/obesity was defined as BMI ≥25.0. Kaplan-Meier survival curves and log-rank tests were used for between-group comparisons of in-hospital mortality. Univariable and multivariable Cox regression analyses were performed to identify significant prognostic factors.</p><p><strong>Results: </strong>A paradoxical association between overweight/obesity and survival benefits, the so-called obesity paradox exists in HFpEF (log-rank P<0.05 in low BMI vs. normal BMI, low BMI vs. high BMI, and normal BMI vs. high BMI). In HFrEF, a trend towards lower in-hospital mortality was observed in patients with higher BMI. However, the obesity paradox in patients with HFrEF was not as evident as that in patients with HFpEF. Significant differences in the clinical characteristics and prognostic factors for in-hospital mortality were observed among the groups according to BMI.</p><p><strong>Conclusions: </strong>The obesity paradox was more evident in patients with HFpEF than in those with HFrEF. Specific phenotypes of HFpEF and HFrEF according to BMI were revealed.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of epicardial adipose tissue with coronary calcium score and coronary artery stenosis severity in patients suspected of coronary artery disease.","authors":"Şenol Coşkun, Sercan Sinir, Akın Torun","doi":"10.23736/S2724-5683.24.06645-6","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06645-6","url":null,"abstract":"<p><strong>Background: </strong>The primary aim of the study was to assess the relationship between epicardial adipose tissue (EAT) volume and Coronary Calcium Score (CCS), in addition to coronary artery stenosis severity and carotid intima-media thickness (CIMT).</p><p><strong>Methods: </strong>This single-center retrospective study included patients suspected of ischemic heart disease. All patients underwent computerized tomography coronary angiogram by which their EAT volume, CCS, and coronary stenosis degree were measured. Carotid Doppler ultrasound was used to determine CIMT. Most recent laboratory values, including inflammation markers and lipid profiles, were collected from the hospital database. CCS was calculated by using the Agatston method.</p><p><strong>Results: </strong>A total of 109 patients were included in the study. The mean age was 51.7±9.7 years, and 38.5% were female. EAT volume, but not CCS, was significantly greater in patients with diabetes mellitus than patients without. CCS was significantly higher in the high EAT volume tertile than in low and moderate EAT volume tertiles. The number of patients with CCS>100 and >400 were significantly more common in high EAT volume tertile compared to other tertiles. EAT volume was significantly increased as the severity of the coronary stenosis increased. EAT volume emerged as an independent associate of CCS in addition to age and sex. CIMT was significantly correlated both with EAT volume and CCS.</p><p><strong>Conclusions: </strong>EAT volume appeared as a significant and independent associate of CCS. Moreover, both EAT volume and CCS increased as the severity of the atherosclerosis increased.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive role of intracoronary electrocardiography for procedural success in coronary no-reflow.","authors":"Ayşe N Özkaya Ibiş, Hamza Sunman, Kamuran Kalkan, Çağatay Tunca, Alperen Taş, Mehmet T Özkan, Nadire I Erol, Murat Tulmaç","doi":"10.23736/S2724-5683.24.06667-5","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06667-5","url":null,"abstract":"<p><strong>Background: </strong>The no-reflow phenomenon (NRP) is associated with increased mortality and morbidity in patients with ST-segment elevation myocardial infarction (STEMI). Despite the lack of a definitive treatment for NRP, predicting procedural success remains a challenge. This study aims to evaluate the potential of intracoronary electrocardiography (ic-ECG) in predicting the success of the primary percutaneous coronary intervention (pPCI) in STEMI patients who develop NRP.</p><p><strong>Methods: </strong>Patients with acute anterior STEMI who underwent pPCI between November 2021 and May 2022 were included in this prospective study. Patients were categorized into two groups based on the thrombolysis in myocardial infarction (TIMI) flow grade, with those having a grade less than 3 defined as NRP. The NRP group was further analyzed to explore the relationship between the percentage of ST-segment resolution (STR) in ic-ECG records taken during pPCI and the recovery of left ventricular ejection fraction (LVEF).</p><p><strong>Results: </strong>Seventy-one patients with acute anterior STEMI were included in the study, 26 of whom (36.6%) developed the NRP. Baseline characteristics such as peak troponin levels (6267.8±2488.4 vs. 3244.6±3183 ng/mL, P=0.013), low-density lipoprotein cholesterol (LDL-C) levels (104.5±40 vs. 138.8±29.9 mg/dL, P=0.021), and total cholesterol levels (167.5±44.5 vs. 222.7±69.2 mg/dL, P=0.024) were significantly different between patients with and without LVEF recovery in the NRP group. Importantly, the change in ic-ECG STR was significantly higher in the recovery group (65.5±17% vs. 21±22.3%, P<0.001). Multivariate regression analysis confirmed that the percentage change in ic-ECG STR was an independent predictor of LVEF recovery (P=0.035). A cut-off ic-ECG STR change greater than 42% was identified through ROC analysis as a predictor of LVEF recovery with a sensitivity of 100% and specificity of 84.6% (AUC=0.938, P<0.001).</p><p><strong>Conclusions: </strong>The percentage change in ST-segment resolution measured by ic-ECG is an independent predictor of LVEF recovery in STEMI patients who develop NRP. A greater than 42% change in ic-ECG STR during the procedure is independently associated with improved LVEF, highlighting its value in guiding clinical decision-making and improving patient outcomes.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of sudden cardiac arrest.","authors":"Marinos Kosmopoulos, David G Benditt","doi":"10.23736/S2724-5683.24.06607-9","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06607-9","url":null,"abstract":"<p><p>Sudden cardiac arrest, and in particular sudden out-of-hospital cardiac arrest (OHCA) remains a major public health concern in which survival statistics, and in particular neurologically intact survival statistics, have remained largely unimproved over many decades. Overall survival remains approximately 10%, being somewhat better in victims receiving bystander cardiopulmonary resuscitation (CPR), and those who are found to have a shockable rhythm (i.e., VT or VF). CPR and defibrillation (especially public-access defibrillation) remain the essential immediate management tools. However, recent research has introduced several novel adjunctive interventions (e.g., mechanical compression-decompression devices, 'head-up' CPR methodology, portable extra-corporeal circulatory assistance [ECPR]) that will hopefully impact survival positively. In any case, it is apparent that no single resuscitative tool will be sufficient to markedly improve OHCA survival; the combined application of a multi-faceted strategy is needed. This might comprise bystander CPR, combined use of 'head-up' CPR along with impedance threshold valve [ITD] and active compression-decompression mechanical chest compression devices. Application of mobile ECPR devices as early as possible during resuscitation appears to improve outcomes albeit expensive and complex to deploy broadly. Employed together, these novel steps, offer the possibility of moving the survival needle in a positive direction.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}