{"title":"Accuracy of subtraction fractional flow reserve with computed tomography in identifying early revascularization in patients with coronary artery disease.","authors":"Tingting Zhu, Defu Li, Jinhan Qiao, Qian Li, Yinghao Xu, Bing Ge, Liming Xia","doi":"10.1080/14017431.2024.2373082","DOIUrl":"10.1080/14017431.2024.2373082","url":null,"abstract":"<p><strong>Objectives: </strong>The diagnostic performance of fractional flow reserve with computed tomography (FFR-CT) is affected by the presence of calcified plaque. Subtraction can remove the influence of calcification in coronary computed tomography angiography (CCTA) to increase confidence in the diagnosis of coronary artery stenosis. Our purpose is to investigate the accuracy of post-subtraction FFR-CT in predicting early revascularization.</p><p><strong>Design: </strong>Based on CCTA data of 237 vessels from 79 patients with coronary artery disease, subtraction CCTA images were obtained at a local post-processing workstation, and the conventional and post-subtraction FFR-CT measurements and the difference in proximal and distal FFR-CT values of the narrowest segment of the vessel (ΔFFR-CT) were analyzed for their accuracy in predicting early coronary artery hemodynamic reconstruction.</p><p><strong>Results: </strong>With FFR-CT ≤ 0.8 as the criterion, the accuracy of conventional and post-subtraction FFR-CT measurements in predicting early revascularization was 73.4% and 77.2% at the patient level, and 64.6% and 72.2% at the vessel level, respectively. The specificity of post-subtraction FFR-CT measurements was significantly higher than that of conventional FFR-CT at both the patient and vessel levels (P of 0.013 and 0.015, respectively). At the vessel level, the area under the curve of receiver operating characteristic was 0.712 and 0.797 for conventional and post-subtraction ΔFFR-CT, respectively, showing a difference (P = 0.047), with optimal cutoff values of 0.07 and 0.11, respectively.</p><p><strong>Conclusion: </strong>The post-subtraction FFR-CT measurements enhance the specificity in predicting early revascularization. The post-subtraction ΔFFR-CT value of the stenosis segment > 0.11 may be an important indicator for early revascularization.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"58 1","pages":"2373082"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498878","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}
Trym Løvseth Kavlie, Henrik Agerup Kildahl, Håvard Dalen, Dag Ole Nordhaug, Katrine Hordnes Slagsvold, Bjørnar Leangen Grenne, Espen Holte
{"title":"Five-year outcomes of mitral valve repair for leaflet prolapse at a medium-sized Norwegian university hospital.","authors":"Trym Løvseth Kavlie, Henrik Agerup Kildahl, Håvard Dalen, Dag Ole Nordhaug, Katrine Hordnes Slagsvold, Bjørnar Leangen Grenne, Espen Holte","doi":"10.1080/14017431.2024.2379336","DOIUrl":"10.1080/14017431.2024.2379336","url":null,"abstract":"<p><p><i>Objective</i>. To evaluate patient characteristics and 5-year outcomes after surgical mitral valve (MV) repair for leaflet prolapse at a medium-sized cardiothoracic center. <i>Background</i>. Contemporary reports on the outcome of MV repair at medium-sized cardiothoracic centers are sparse. <i>Methods</i>. Patients receiving open-heart surgery with MV repair due to primary mitral regurgitation caused by leaflet prolapse between 2015 and 2021, without active endocarditis, were included. Clinical data, complications, re-interventions, mortality, and echocardiographic data were retrospectively registered from electronical patient charts, both pre-operatively and from post-operative follow-ups. <i>Results</i>. One hundred and three patients were included, 83% male, with a mean age of 62 years. All-cause mortality was 9% during a median follow-up time of 4.9 years. Re-intervention rate on the MV was 4%. Post-operative complications before last available follow-up visit at median 3.0 years were infrequent, with new-onset atrial fibrillation/flutter in 16%, post-operative MV regurgitation grade II or above in 17% and post-operative tricuspid regurgitation grade II or above in 14%. <i>Conclusions</i>. These data demonstrate that surgical MV repair for leaflet prolapse at a medium-sized cardiothoracic center was associated with low re-intervention rate and few severe complications. The presented results are comparable to data from surgical high-volume centers, indicating that surgical MV repair can be safely performed at selected medium-sized cardiothoracic centers.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"58 1","pages":"2379336"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760723","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}
Lars T Nilsson, Therese Andersson, Bo Carlberg, Lars Å Johansson, Stefan Söderberg
{"title":"Electrocardiographic abnormalities and NT-proBNP levels at long-term follow-up of patients with dyspnea after pulmonary embolism.","authors":"Lars T Nilsson, Therese Andersson, Bo Carlberg, Lars Å Johansson, Stefan Söderberg","doi":"10.1080/14017431.2024.2373090","DOIUrl":"10.1080/14017431.2024.2373090","url":null,"abstract":"<p><strong>Objectives: </strong>Electrocardiogram (ECG) and measurement of plasma brain natriuretic peptides (BNP) are established markers of right ventricular dysfunction (RVD) in the setting of acute pulmonary embolism (PE) but their value at long-term follow-up is largely unknown. The purpose of this prospective study was to determine the prevalence of ECG abnormalities, describe levels of N-terminal proBNP (NT-proBNP), and establish their association with dyspnea at long-term follow-up after PE.</p><p><strong>Design: </strong>All Swedish patients diagnosed with acute PE in 2005 (<i>n</i> = 5793) were identified through the Swedish National Patient Registry. Surviving patients in 2007 (<i>n</i> = 3510) were invited to participate. Of these, 2105 subjects responded to a questionnaire about dyspnea and comorbidities. Subjects with dyspnea or risk factors for development of chronic thromboembolic pulmonary hypertension were included in the study in a secondary step, which involved collection of blood samples and ECG registration.</p><p><strong>Results: </strong>Altogether 49.3% had a completely normal ECG. The remaining participants had a variety of abnormalities, 7.2% had atrial fibrillation/flutter (AF). ECG with any sign of RVD was found in 7.2% of subjects. Right bundle branch block was the most common RVD sign with a prevalence of 6.4%. An abnormal ECG was associated with dyspnea. AF was associated with dyspnea, whereas ECG signs of RVD were not. 61.2% of subjects had NT-proBNP levels above clinical cut-off (>125 ng/L). The degree of dyspnea did not associate independently with NT-proBNP levels.</p><p><strong>Conclusions: </strong>We conclude that the value of ECG and NT-proBNP in long term follow-up after PE lies mostly in differential diagnostics.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"58 1","pages":"2373090"},"PeriodicalIF":1.2,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493164","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}
Lauri Mansikkaniemi, Hirokazu Miyashita, Juha Sinisalo, Juhani Stewart, Petri Laine
{"title":"A reply to the letter to the editor \"Common practice of underreporting and downplaying adverse events and exaggerating benefits in patients undergoing percutaneous coronary intervention of chronic total occlusions\".","authors":"Lauri Mansikkaniemi, Hirokazu Miyashita, Juha Sinisalo, Juhani Stewart, Petri Laine","doi":"10.1080/14017431.2024.2373102","DOIUrl":"10.1080/14017431.2024.2373102","url":null,"abstract":"","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"58 1","pages":"2373102"},"PeriodicalIF":1.2,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477353","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":"Common practice of underreporting and downplaying adverse events and exaggerating benefits in patients undergoing percutaneous coronary intervention of chronic total occlusions.","authors":"Mohammad Reza Movahed","doi":"10.1080/14017431.2024.2373070","DOIUrl":"10.1080/14017431.2024.2373070","url":null,"abstract":"","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"58 1","pages":"2373070"},"PeriodicalIF":1.2,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493163","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":"Hyperglycemia-simulating environment attenuated experimentally induced calcification in cultured human aortic valve interstitial cells.","authors":"Arsenii Zabirnyk, Daria Evensen, John-Peder Escobar Kvitting, Mari-Liis Kaljusto, Kåre-Olav Stensløkken, Jarle Vaage","doi":"10.1080/14017431.2024.2353070","DOIUrl":"https://doi.org/10.1080/14017431.2024.2353070","url":null,"abstract":"<p><p><i>Objectives:</i> The role of diabetes mellitus as a risk factor for the development of calcific aortic valve disease has not been fully clarified. Aortic valve interstitial cells (VICs) have been suggested to be crucial for calcification of the valve. Induced calcification in cultured VICs is a good <i>in vitro</i> model for aortic valve calcification. The purpose of this study was to investigate whether increased glucose levels increase experimentally induced calcification in cultured human VICs. <i>Design:</i> VICs were isolated from explanted calcified aortic valves after valve replacement. Osteogenic medium induced calcification of cultured VICs at different glucose levels (5, 15, and 25 mM). Calcium deposits were visualized using Alizarin Red staining and measured spectrophotometrically. <i>Results:</i> The higher the glucose concentration, the lower the level of calcification. High glucose (25 mM) reduced calcification by 52% compared with calcification at a physiological (5 mM) glucose concentration (correlation and regression analysis: <i>r</i> = -0.55, <i>p</i> = .025 with increased concentration of glucose). <i>Conclusions: In vitro</i> hyperglycemia-like conditions attenuated calcification in VICs. High glucose levels may trigger a series of events that secondarily stimulate calcification of VICs <i>in vivo</i>.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"58 1","pages":"2353070"},"PeriodicalIF":2.2,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958960","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}
Tim Somers, Hedwig M. J. M. Nies, Ilse J. E. Kouijzer, Pui Yuen Lee, Wim J. Morshuis, Guillaume S. C. Geuzebroek
{"title":"Mycotic aortic aneurysms: characteristic macroscopic findings in a case series","authors":"Tim Somers, Hedwig M. J. M. Nies, Ilse J. E. Kouijzer, Pui Yuen Lee, Wim J. Morshuis, Guillaume S. C. Geuzebroek","doi":"10.1080/14017431.2024.2341696","DOIUrl":"https://doi.org/10.1080/14017431.2024.2341696","url":null,"abstract":"Infected or mycotic aortic aneurysms (MAAs) are a rare type of aneurysms. Due to the high risk of rupture, MAAs are life-threatening conditions. Early diagnosis and treatment are necessary, yet MAA...","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"29 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580209","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}
Håvard Ulsaker, Henrik Halvorsen, Audun Ole Braaten, Eric Dorenberg, Beate Rikken Lindberg, Kåre Christian Nordhus, Øyvind Jakobsen, Reidar Brekken, Arne Seternes, Frode Manstad-Hulaas
{"title":"Early and mid-term results after endovascular repair of thoracoabdominal aortic aneurysms using the off-the-shelf multibranched t-Branch device: a national multi-center study","authors":"Håvard Ulsaker, Henrik Halvorsen, Audun Ole Braaten, Eric Dorenberg, Beate Rikken Lindberg, Kåre Christian Nordhus, Øyvind Jakobsen, Reidar Brekken, Arne Seternes, Frode Manstad-Hulaas","doi":"10.1080/14017431.2024.2335906","DOIUrl":"https://doi.org/10.1080/14017431.2024.2335906","url":null,"abstract":"Objective: The multibranched off-the-shelf Zenith® t-Branch (Cook Medical, Bloomington, IN) device is commonly chosen for endovascular repair of thoracoabdominal aortic aneurysms. The aim of this s...","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"23 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580033","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}
William Herrik Nielsen, Finn Gustafsson, Peter Skov Olsen, Peter Bo Hansen, Kasper Rossing, Nikolaj Bang Lilleør, Peter Hasse Møller-Sørensen, Christian Holdflod Møller
{"title":"Short-term outcomes after heart transplantation using donor hearts preserved with ex vivo perfusion.","authors":"William Herrik Nielsen, Finn Gustafsson, Peter Skov Olsen, Peter Bo Hansen, Kasper Rossing, Nikolaj Bang Lilleør, Peter Hasse Møller-Sørensen, Christian Holdflod Møller","doi":"10.1080/14017431.2023.2267804","DOIUrl":"10.1080/14017431.2023.2267804","url":null,"abstract":"<p><p>The standard Conventional Cold Storage (CCS) during heart transplantation procurement is associated with time-dependent ischemic injury to the graft, which is a significant independent risk factor for post-transplant early morbidity and mortality - especially when cold ischemic time exceeds four hours. Since 2018, Rigshospitalet (Copenhagen, Denmark) has been utilising <i>ex vivo</i> perfusion (Organ Care System, OCS) in selected cases. The objective of this study was to compare the short-term clinical outcomes of patients transplanted with OCS compared to CCS. <i>Methods</i>: This retrospective single-centre study was based on consecutive patients undergoing a heart transplant between January 2018 and April 2021. Patients were selected for the OCS group when the cold ischemic time was expected to exceed four hours. The primary outcome measure was six-month event-free survival. <i>Results</i>: In total, 48 patients were included in the study; nine were transplanted with an OCS heart. The two groups had no significant differences in baseline characteristics. Six-month event-free survival was 77.8% [95% CI: 54.9-100%] in the OCS group and 79.5% [95% CI: 67.8-93.2%] in the CCS group (<i>p</i> = 0.91). While the OCS group had a median out-of-body time that was 183 min longer (<i>p</i> < 0.0001), the cold ischemic time was reduced by 51 min (<i>p</i> = 0.007). <i>Conclusion:</i> In a Scandinavian setting, our data confirms that utilising OCS in heart procurement allows for a longer out-of-body time and a reduced cold ischemic time without negatively affecting safety or early post-transplant outcomes.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"57 1","pages":"2267804"},"PeriodicalIF":2.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41211189","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":"Preparing the spinal cord - priming or preconditioning? A systematic review of experimental studies.","authors":"Johanna Herajärvi, Tatu Juvonen","doi":"10.1080/14017431.2023.2166100","DOIUrl":"10.1080/14017431.2023.2166100","url":null,"abstract":"<p><p><i>Objectives.</i> Paraplegia is devastating complication associated with thoracic and thoracoabdominal aortic aneurysm repair. Vast evidence has been gathered on pre-, peri- and postoperative protective adjuncts aiming to minimize spinal cord ischemia. This review focuses on the pretreatment phase of open surgical or endovascular aortic procedures and gathers the experimental data on the interventional preconditioning and priming methods that increase the spinal cord ischemic tolerance. <i>Design.</i> By the start of March 2021, a systematic review was performed in PubMed, Scopus and Web of Science core collection to identify the articles that reported (i) either an ischemic preconditioning, remote ischemic preconditioning or priming method prior to (ii) experimental spinal cord ischemia performed in endovascular or open surgical fashion mimicking either thoracic, abdominal or thoracoabdominal aortic aneurysm procedures. (iii) The outcomes were reported <i>via</i> neurological, motor-evoked potential, somatosensory-evoked potential, histopathological, immunohistochemical, physiological analysis, or in different combinations of these measurements. <i>Results.</i> The search yielded 7802 articles, and 57 articles were included in the systematic review. The articles were assessed by the evaluated species, the utilized pretreatment, the measured protective effects, and the suggested underlying mechanisms. <i>Conclusions.</i> The reviewed articles showed several possible mechanisms in ischemic and remote ischemic preconditioning for prevention of spinal cord ischemia. The main suggested method for priming was arteriogenetic stimulus. Future studies should confirm these hints of arteriogenetic stimulus with more precise quantification of the protective recruitment process.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"57 1","pages":"2166100"},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10592364","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}