Scandinavian Cardiovascular Journal最新文献

{"title":"Exercise-induced change in circulating NT-proBNP could not distinguish between patients with and without coronary artery disease: the CADENCE study","authors":"J. Cwikiel, MortenW. Fagerland, K. Wachtell, H. Arnesen, I. Seljeflot, A. Flaa","doi":"10.1080/14017431.2022.2075562","DOIUrl":"https://doi.org/10.1080/14017431.2022.2075562","url":null,"abstract":"Abstract Objective. In patients with chest pain, exercise stress test has a moderate accuracy for coronary artery disease (CAD). Adding a reliable cardiac biomarker to the exercise test could potentially improve the precision of the test. We investigated circulating NT-proBNP levels before and during exercise stress test in patients with and without angiographically verified CAD. We hypothesized that NT-proBNP would give an additive diagnostic value to the exercise stress test. Methods. In patients presenting with symptoms of stable CAD, venous blood samples were taken at rest and within 5 min of termination of a maximal stress test on a bicycle ergometer. All study participants underwent coronary angiography. Significant CAD was defined as ≥75% stenosis in one or more segments of the coronary arteries. Results. Of the 297 participants, significant CAD was found in 111 (37%) patients. Resting levels of NT-proBNP were significantly higher in patients with CAD compared with patients without CAD (74.18 vs. 56.03 ng/L), p = .005. During exercise, NT-proBNP levels increased in the total population (p < .001). The rise was, however, not significantly different between the two groups (8.24 vs. 8.51 ng/L), p = .700. Combining resting NT-proBNP with positive exercise stress test was superior to exercise test alone in predicting CAD, AUC = 0.68 vs. 0.64. Conclusion. Exercise-induced change in circulating NT-proBNP could not distinguish between patients with or without CAD. However, resting levels of NT-proBNP were significantly higher in patients with CAD than those without CAD.","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42977644","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":"Digitalis therapy in patients with ventricular tachyarrhythmias.","authors":"Tobias Schupp,&nbsp;Julian Müller,&nbsp;Max von Zworowsky,&nbsp;Mohammad Abumayyaleh,&nbsp;Kathrin Weidner,&nbsp;Jonas Rusnak,&nbsp;Kambis Mashayekhi,&nbsp;Thomas Bertsch,&nbsp;Ibrahim Akin,&nbsp;Michael Behnes","doi":"10.1080/14017431.2022.2091793","DOIUrl":"https://doi.org/10.1080/14017431.2022.2091793","url":null,"abstract":"<p><p><i>Objective</i>. The study sought to assess the prognostic value of treatment with digitalis on long-term prognosis in patients with ventricular tachyarrhythmias and atrial fibrillation (AF) and/or heart failure (HF). <i>Background</i>. Data regarding the outcome of digitalis therapy following ventricular tachyarrhythmias is limited. <i>Methods.</i> A large retrospective registry was used including consecutive patients with episodes of ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2015. Patients treated with digitalis were compared to patients without. The primary prognostic endpoint was all-cause mortality at 3 years, secondary endpoints comprised a composite arrhythmic endpoint (i.e. recurrences of ventricular tachyarrhythmias, appropriate implantable cardioverter defibrillator (ICD) therapies, sudden cardiac death) and cardiac rehospitalization. Kaplan Mayer survival curves, multivariable cox regression, and time trend analyses were applied for statistics. <i>Results.</i> Eight hundred and thirty-one patients were included (20% treated with digitalis and 80% without). At 3 years, digitalis treatment was not associated with all-cause mortality following ventricular tachyarrhythmias (24 <i>vs.</i> 21%, log-rank <i>p</i> = .736; HR = 1.063; 95% CI 0.746-1.515; <i>p</i> = .736). However, digitalis therapy was associated with an increased risk of the composite arrhythmic endpoint (38 <i>vs.</i> 23%; log-rank <i>p</i> = .001; HR = 1.719; 95% CI 1.279-2.311; <i>p</i> = .001) and cardiac rehospitalization (31 <i>vs.</i> 18%; log-rank <i>p</i> = .001; HR = 1.829; 95% CI 1.318-2.538; <i>p</i> = .001), which was still evident within multivariable Cox regression analyses. Finally, digitoxin may be associated with a worse prognosis than digoxin. <i>Conclusion.</i> Digitalis therapy was not associated with mortality in patients with ventricular tachyarrhythmias, but with increased risk of the composite arrhythmic endpoint and cardiac rehospitalization at 3 years.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40566058","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":"Holistic review and meta-analysis of independent impact of the residual SYNTAX score on prognosis in patients with acute coronary syndrome.","authors":"Chuang Li,&nbsp;Jiang-Yuan Li,&nbsp;De-Jing Feng,&nbsp;Xin-Chun Yang,&nbsp;Le-Feng Wang,&nbsp;Kun Xia","doi":"10.1080/14017431.2022.2095434","DOIUrl":"https://doi.org/10.1080/14017431.2022.2095434","url":null,"abstract":"<p><p><i>Objectives</i>. The appropriate extent of revascularization following primary intervention is unknown. We conducted a systematic review and meta-analysis of residual Syntax score (rSS) to predict the outcomes and provide guide to optimal management of revascularization following primary intervention. <i>Designs</i>. Previously published studies from 2007 to 2020 assessing the prognostic impact of rSS after ACS were included for this meta-analysis. The primary endpoint was defined as the major adverse clinical events (MACE) in multivariable analysis. The risk ratios (RRs) with 95% confidence intervals (CI) were calculated using the RevMan 5.4 software. <i>Results</i>. A total of 8,157 participants complicated with ACS from 12 clinical studies were included in this analysis. Based on the wide range of rSS studies available, we classified it into two major groups: rSS < 8 and rSS ≥ 8. In multivariate analysis, the rSS was an independent risk marker for MACE [RR = 1.04 (95%CI; 1.00-1.08)], all-cause mortality [RR = 1.05 (1.03-1.07)] and cardiovascular death [RR = 1.05 (1.03-1.07)]. Patients with incomplete revascularization (ICR) showed higher prevalence of MACE along with all-cause mortality, cardiovascular morality, and recurrent myocardial infarction without significant heterogeneity [RR = 1.60 (1.03-1.07), 2.30 (1.57-3.38), 3.57 (2.09-6.10) and 1.70 (1.38-2.09), respectively]. The patients with rSS ≥ 8 presented higher frequency of all-cause mortality [RR = 2.99 (2.18-4.09)], cardiovascular death [RR = 3.32 (2.22-4.95)], and recurrent myocardial infarction [RR = 1.64 (1.34-2.02)]. <i>Conclusion</i>. The meta-analysis indicated that an rSS value of 8 could be a reasonable cut-off for incomplete revascularization after ACS and is an efficient tool to guide revascularization. In future, detailed research should focus on investigation of the optimal value of the rSS score.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40571715","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 Tp-e/QT ratio with SYNTAX score II in patients with coronary artery disease.","authors":"Faysal Şaylık,&nbsp;Tufan Çınar,&nbsp;Murat Selçuk,&nbsp;Tayyar Akbulut","doi":"10.1080/14017431.2022.2107236","DOIUrl":"https://doi.org/10.1080/14017431.2022.2107236","url":null,"abstract":"Abstract Background. The SYNTAX score II (SS) is an angiographic tool, which grades the complexity of coronary artery lesions and predicts short- and long-term events. Tp-e/QT ratio is a novel electrocardiographic marker for the risk of ventricular arrhythmias. We aimed to investigate whether there was a correlation between SS and Tp-e/QT ratio.Methods. A total of 227 consecutive patients who underwent elective coronary angiography were enrolled in this study. Patients who had a lumen diameter >1.5 mm and at least % 50 diameter stenosis on coronary angiogram were determined as coronary artery disease (CAD) group, and others were identified as a control group. The SS was calculated for the CAD group, and SS ≥23 was defined as a high SS group, and SS < 23 was identified as a low SS group. Electrocardiographic indices, such as Tp-e and Tp-e/QT, were measured for all patients. A multivariable logistic regression analysis was performed with variables age, interventricular septum thickness (IVS), hypertension, and Tp-e/QT. Results. Tp-e interval and Tp-e/QT ratio were higher in the CAD group compared with the control group. Tp-e, corrected Tp-e (cTP-e) and Tp-e/QT were higher in the high SS group than in the low SS group. The cTp-e and Tp-e/QT were correlated with SS score. Age, IVS and Tp-e/QT ratio were independent predictors of high SS in the logistic regression analysis. Conclusions. Tp-e/QT ratio was an independent predictor of high SS and might be used for risk stratification in CAD patients.","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10447221","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":"Glyceraldehyde-derived advanced glycation end-products are associated with left ventricular ejection fraction and brain natriuretic peptide in patients with diabetic adverse cardiac remodeling.","authors":"Yuushi Yasuda,&nbsp;Hirofumi Aoki,&nbsp;Wataru Fujita,&nbsp;Kousuke Fujibayashi,&nbsp;Minoru Wakasa,&nbsp;Yasuyuki Kawai,&nbsp;Hiroaki Nakanishi,&nbsp;Kazuyuki Saito,&nbsp;Masayoshi Takeuchi,&nbsp;Kouji Kajinami","doi":"10.1080/14017431.2022.2095013","DOIUrl":"https://doi.org/10.1080/14017431.2022.2095013","url":null,"abstract":"<p><p><i>Objectives</i>: Glyceraldehyde-derived advanced glycation end-products (Glycer-AGEs) have a strong binding affinity for their cognate receptor and elicit oxidative stress and inflammation. However, it remains unknown whether the levels of Glycer-AGEs correlate with the severity of cardiac function and heart failure in patients with diabetic adverse cardiac remodeling (DbCR). Fourteen heart failure patients with type 2 diabetes mellitus (DM) without other cardiac disorders (DbCR group) were enrolled. Another 14 patients with idiopathic dilated cardiomyopathy (DCM) without DM were served as a control (DCM group). All patients were assessed for serum Glycer-AGEs, nitrotyrosine (NT), and tumor necrosis factor alpha (TNFα) and for plasma brain natriuretic peptide (BNP). The left ventricular ejection fraction (LVEF) was evaluated by echocardiography. <i>Results</i>: The mean serum levels of Glycer-AGEs, NT, and TNFα in the DbCR group were significantly higher than those in the DCM group (for Glycer-AGEs, <i>p</i> = .0073; for NT, <i>p</i> = .005; for TNFα, <i>p</i> < .0001, respectively). In the patients with DbCR, the levels of serum Glycer-AGEs and TNFα were closely associated with LVEF and BNP values. <i>Conclusions</i>: Both Glycer-AGEs and TNFα showed close associations with LVEF and the levels of BNP in patients with DbCR. Glycer-AGEs and TNFα may play a pathological role in the development of DbCR.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40474706","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":"A comparison of risk scores’ long-term predictive abilities for patients diagnosed with ST elevation myocardial infarction who underwent early percutaneous coronary intervention","authors":"A. Aldujeli, A. Haq, A. Hamadeh, Auguste Stalmokaite, Laurynas Maciulevicius, Egle Labanauskaite, I. Navickaitė, Z. Kurnickaite, G. Jaruševičius, R. Unikas, D. Zaliaduonytė, K. Tecson","doi":"10.1080/14017431.2022.2066718","DOIUrl":"https://doi.org/10.1080/14017431.2022.2066718","url":null,"abstract":"Abstract Objective. To compare the long-term (5 year) prognostic values of commonly used risk scores on major adverse cardiovascular events (MACE) in a cohort of patients who underwent primary PCI for STEMI. Design. We created a composite endpoint of MACE, defined as the occurrence of any of the following events within 5 years: ischemic or hemorrhagic stroke, target vessel revascularization, nonfatal myocardial infarction, cardiovascular death. We dichotomized risk scores into high risk and not high risk according to the literature’s pre-existing cutoffs as follows: GRACE score >127 = high risk, SYNTAX I score ≥33 = high risk, SYNTAX II ≥32 high risk, TIMI >8 = high risk. We utilized the area under the receiver operating characteristic curve (AUC) as the metric for predictive ability. Results. There were 768 patients in this study and 416 (54.2%), 209 (27.2%), 511 (66.5%), and 74 (9.6%) were at high risk according to the GRACE, SYNTAX I, SYNTAX II, and TIMI scores, respectively. The AUCs for 5-year MACE were 0.54 (95% confidence interval (CI): 0.49–0.59, p = .0947), 0.79 (95% CI: 0.75–0.83, p < .0001), 0.58 (95% CI: 0.54–0.62, p = .0004), and 0.5 (95% CI: 0.48–0.53, p = .7259), respectively. Conclusion. SYNTAX I score was superior in predicting MACE in patients with STEMI and a high burden of CAD. Utilizing the basal SYNTAX I score in STEMI patients with significant non-culprit CAD may improve risk stratification, decision-making, and outcomes.","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44095993","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":"Prediction of postoperative atrial fibrillation with postoperative epicardial electrograms.","authors":"Louise Feilberg Rasmussen,&nbsp;Jan Jesper Andreasen,&nbsp;Sam Riahi,&nbsp;Gregory Y H Lip,&nbsp;Søren Lundbye-Christensen,&nbsp;Jacob Melgaard,&nbsp;Claus Graff","doi":"10.1080/14017431.2022.2130421","DOIUrl":"https://doi.org/10.1080/14017431.2022.2130421","url":null,"abstract":"<p><p><i>Objectives.</i> New-onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. The arrhythmia often entails a longer hospital stay, greater risk of other complications, and higher mortality both short- and long-term. An investigation of the use of early atrial electrograms in predicting POAF in cardiac surgery was performed. <i>Design.</i> In this prospective observational study, a total of 99 consecutive adult patients undergoing coronary artery bypass grafting, valve surgery or both were included. On the first postoperative morning, standard 12-lead electrograms (ECG), unipolar atrial electrograms (aEG), and vital values were recorded. The outcome was new-onset POAF within one month postoperatively. <i>Results.</i> Three multivariable prediction models for POAF were formed using measurements derived from the ECG, aEG, and patient characteristics. Age, body mass index, and two unipolar electrogram measurements quantifying local activation time and fractionation were strongly associated with the outcome POAF. The performance of the POAF prediction models was assessed through receiver operating curve characteristics with cross-validation, and discrimination using the leave-one-out-method to internally validate the models. The cross-validated area under the receiver operating characteristic curve (AUC) was improved in a prediction model using atrial-derived electrogram variables (AUC 0.796, 95% CI 0.698-0.894), compared with previous ECG and clinical models (AUC 0.716, 95% CI 0.606-0.826 and AUC 0.718, 95% CI 0.613-0.822, respectively). <i>Conclusions.</i> This study found that easily obtainable measurements from atrial electrograms may be helpful in identifying patients at risk of POAF in cardiac surgery.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10412104","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":"Echocardiographic diagnosis of heart failure with preserved ejection fraction in elderly patients with hypertension.","authors":"Magnus C Johansson,&nbsp;Annika Rosengren,&nbsp;Michael Fu","doi":"10.1080/14017431.2022.2129777","DOIUrl":"https://doi.org/10.1080/14017431.2022.2129777","url":null,"abstract":"<p><p><i>Objectives</i>. The aim of this study is to evaluate the diagnostic performance of echocardiography for the diagnosis of heart failure with preserved ejection fraction (HFpEF) in the elderly and to validate the Heart Failure Association diagnostic algorithm (HFA-PEFF). <i>Design.</i> A case-control study was conducted in patients with hypertension with or without HFpEF who were matched for age (<i>n</i> = 33; 78.4 ± 5.3 years) and sex. Participants underwent echocardiography including assessment of left atrial (LA) volume index (LAVI), early mitral filling to early diastolic mitral annulus velocity ratio (<i>E</i>/<i>e</i>'), LA reservoir strain (LASr), tissue Doppler LA contraction (<i>a</i>'), right ventricular isovolumic relaxation time (RVIVRT), and a 6-minute walk test (6-MWT). The filling pressure algorithm from the European association of cardiovascular imaging (EACVI) 2021 was applied. The HFA-PEFF score was also applied, using echocardiography parameters and the value of NT pro-BNP, without considering symptomatic status. <i>Results.</i> Echocardiographic parameters identified patients with HFpEF with an area under the curve (AUC) >0.9 for <i>E</i>/<i>e</i>', RVIVRT, LASr, <i>a</i>', and the ratio of LAVI/<i>a</i>'. LASr correlated with 6-MWT (<i>r</i> = 0.59, <i>p</i> = .0003). The EACVI algorithm classified all controls with normal filling pressure and 94% of patients with HFpEF with increased filling pressure. When the HFA-PEFF diagnostic algorithm was validated, a high score (≥5 points) had 100% sensitivity for HFpEF, while 88% of controls had intermediate scores (2-4 points). <i>Conclusion</i>. The EACVI filling pressure algorithm, RVIVRT, LASr, and the ratio LAVI/<i>a</i>' were accurate for diagnosing HFpEF in elderly patients with hypertension. The HFA-PEFF score had high sensitivity but limited ability to exclude HFpEF.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10760646","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":"Hemodynamic changes during aortic valve surgery among patients with aortic stenosis.","authors":"Rasmus Carter-Storch,&nbsp;Søren Mose Hansen,&nbsp;Jordi S Dahl,&nbsp;Kasper Enevold,&nbsp;Nils Sofus Borg Mogensen,&nbsp;Henrik Berg,&nbsp;Marie-Annick Clavel,&nbsp;Jacob E Møller","doi":"10.1080/14017431.2022.2099008","DOIUrl":"https://doi.org/10.1080/14017431.2022.2099008","url":null,"abstract":"<p><p><i>Introduction.</i> Patients with severe aortic stenosis (AS) undergoing surgery are at increased risk of hypotension and hypoperfusion. Although treatable with inotropic agents or fluid, little is known about how these therapies affect central hemodynamics in AS patients under general anesthesia. We measured changes in central hemodynamics after dobutamine infusion and fluid bolus among patients with severe AS and associated these changes with preoperative echocardiography. <i>Methods.</i> We included 33 patients with severe AS undergoing surgical AVR. After induction of general anesthesia, hemodynamic measurements were obtained with a pulmonary artery catheter, including Cardiac index (CI), stroke volume index (SVi) and pulmonary capillary wedge pressure (PCWP). Measurements were repeated during dobutamine infusion, after fluid bolus and lastly after sternotomy. <i>Results.</i> General anesthesia resulted in a decrease in CI and SVi compared to preoperative values. During dobutamine infusion CI increased but mean SVi did not (38 ± 12 vs 37 ± 13 ml/m², <i>p</i> = .90). Higher EF and SVi before surgery and a larger decrease in SVi after induction of general anesthesia were associated with an increase in SVi during dobutamine infusion. After fluid bolus both CI, SVi (48 ± 12 vs 37 ± 13 ml/min/m², <i>p</i> < .0001) and PCWP increased. PCWP increased mostly among patients with a larger LA volume index. <i>Conclusion.</i> In patients with AS, CI can be increased with both dobutamine and fluid during surgery. Dobutamine's effect on SVI was highly variable and associated with baseline LVEF, and an increase in CI was mostly driven by an increase in heart rate. Fluid increased SVi at the cost of an increase in PCWP.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40601832","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":"Diagnosis and treatment of the rare procedural complication of malpositioned pacing leads in the left heart: a single center experience.","authors":"Rasmus Borgquist,&nbsp;Maiwand Farouq,&nbsp;Hanna Markstad,&nbsp;Johan Brandt,&nbsp;David Mörtsell,&nbsp;Steen Jensen,&nbsp;Uzma Chaudhry,&nbsp;Lingwei Wang","doi":"10.1080/14017431.2022.2099013","DOIUrl":"https://doi.org/10.1080/14017431.2022.2099013","url":null,"abstract":"<p><p><i>Objectives</i>. This study assessed the management approach and outcome of the pacemaker or implantable cardioverter-defibrillator (ICD) leads malpositioned in the left heart. Malpositioned leads (MPLs) may have deleterious consequences, and appropriate management remains uncertain. <i>Methods</i>. The study population included all patients referred to a single institution for MPL in the left side of the heart after pacemaker or ICD implantation during the period from 2015 to 2021. The approach and outcome of lead management were retrospectively assessed. <i>Results</i>. During the study period, 6887 patients underwent device implantation. MPL was diagnosed in five patients (0.07%). In four cases, the pacing lead was placed in a coronary sinus (CS) branch, while the pacing lead was inside the left ventricle (LV) in one case. Symptoms suggestive of lead malposition were reported by 2 patients (40%). One of the patients presented with recurrent TIAs. Another presented with inappropriate ICD shocks. In one asymptomatic case, an ICD lead changed position from the right ventricle to the CS, suggesting idiopathic lead migration. In 4/5 patients, the leads were removed or repositioned by percutaneous approach, with no major periprocedural complications. <i>Conclusions</i>. In this series of MPL in the left heart, two patients presented with thromboembolic events or inappropriate ICD shocks. These serious complications highlight the critical need for early correct diagnosis and proper management of MPL.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40635502","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}