{"title":"Do Patients With Arterial Occlusive Disease of Different Etiologies Benefit Equally From Cilostazol?","authors":"Burak Can Depboylu, Serkan Yazman, Bugra Harmandar, Muruvvet Funda Tetik, Hande Istar, Kadir Arslan, Gokhan Ilhan","doi":"10.14503/THIJ-21-7747","DOIUrl":"https://doi.org/10.14503/THIJ-21-7747","url":null,"abstract":"<p><strong>Background: </strong>Cilostazol is a guideline-recommended drug that improves intermittent claudication and quality of life in patients with chronic atherosclerotic peripheral arterial disease. The drug is used for most etiologies of arterial occlusive diseases in clinical practice. This study aimed to evaluate whether patients benefit equally from cilostazol regardless of etiology.</p><p><strong>Methods: </strong>Patients on cilostazol were divided into 4 groups according to arterial occlusive disease etiology: (1) atherosclerosis, (2) diabetic angiopathy, (3) embolism/thrombosis, and (4) Buerger disease. Patients' maximum walking distance, ankle-brachial index score and distal tissue oxygen saturation (Sto2), clinical improvement onset time, ability to reach maximum benefit time, vascular surgeries, and wounds were compared before they started cilostazol and after 12 months. Results were evaluated at a statistical significance of P < .05.</p><p><strong>Results: </strong>In 194 patients, 307 target extremities were evaluated in the 4 disease groups. After cilostazol use, maximum walking distance, ankle-brachial index score, and distal Sto2 increased significantly in all groups (P < .001), but distal Sto2 in the diabetic angiopathy and Buerger disease groups was significantly lower than in the atherosclerosis group (P < .001). Ankle-brachial index and distal Sto2 differences in the Buerger disease group were significantly lower (both P < .001). The vascular surgery counts decreased significantly in the atherosclerosis and embolism/thrombosis groups (P = .019 and P = .004, respectively).</p><p><strong>Conclusion: </strong>Patients with nonatherosclerotic arterial occlusive disease also benefit from cilostazol, but patients with Buerger disease or diabetic angiopathy seem to benefit less. Combining cilostazol with anticoagulant or antiaggregant agents and closer monitoring of these patients may produce better results.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":"50 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969766/pdf/i1526-6702-50-1-e217747.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10799498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Islam Abudayyeh, Hambik Tankazyan, Jessica Heimes, David G Rabkin, Anees J Razzouk
{"title":"Giant Aneurysm of Left Main Coronary Artery in a Patient With Prior Operation for 4-Valve Endocarditis.","authors":"Islam Abudayyeh, Hambik Tankazyan, Jessica Heimes, David G Rabkin, Anees J Razzouk","doi":"10.14503/THIJ-21-7676","DOIUrl":"https://doi.org/10.14503/THIJ-21-7676","url":null,"abstract":"<p><p>Left main coronary artery aneurysm is an unusual complication of infective endocarditis. Although this type of aneurysm is often asymptomatic, rupture and thrombus formation that result in myocardial infarction are known complications; therefore, prompt recognition and surgical intervention are warranted. This report describes a patient who presented with a giant left main coronary artery aneurysm 3.5 years after being treated for 4-valve endocarditis. The management and technical aspects of this challenging case are discussed here.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":"50 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969769/pdf/i1526-6702-50-1-e217676.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10795685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anthony Simone, Juka S Kim, Jeanne Huchting, Asim Rafique, Ruhsen Ozcaglayan, Richard J Shemin, Olcay Aksoy, Murray H Kwon
{"title":"Transcatheter Aortic Valve Replacement for Severe Aortic Valve Stenosis: Do Patients Experience Better Quality of Life Regardless of Gradient?","authors":"Anthony Simone, Juka S Kim, Jeanne Huchting, Asim Rafique, Ruhsen Ozcaglayan, Richard J Shemin, Olcay Aksoy, Murray H Kwon","doi":"10.14503/THIJ-21-7659","DOIUrl":"https://doi.org/10.14503/THIJ-21-7659","url":null,"abstract":"<p><strong>Background: </strong>Aortic valve replacement improves survival for patients with low-gradient aortic valve stenosis, but there is a paucity of data on postoperative quality of life for this population.</p><p><strong>Methods: </strong>In a single-center retrospective analysis of 304 patients with severe aortic valve stenosis who underwent transcatheter aortic valve replacement, patients were divided into 4 groups based on mean pressure gradient, left ventricular ejection fraction, and stroke volume index. Using the Kansas City Cardiomyopathy Questionnaire-12, quality of life was assessed immediately before and 1 month after transcatheter aortic valve replacement.</p><p><strong>Results: </strong>Most patients in the low-flow, low-gradient group were men; this group had higher relative rates of cardiovascular disease and type 2 diabetes than the paradoxical low-flow, low-gradient group; the normal-flow, low-gradient group; and the high-gradient group. All-cause mortality did not differ significantly among the groups at 1 month after surgery, and all groups experienced a significant improvement in quality-of-life scores after surgery. The mean improvement was 27 points in the low-flow, low-gradient group, 25 points in the paradoxical low-flow, low-gradient group, 30 points in the normal-flow, low-gradient group, and 30 points in the high-gradient group (all P < .001).</p><p><strong>Conclusion: </strong>Quality of life improves significantly across all subgroups of aortic valve stenosis after trans-catheter aortic valve replacement, regardless of flow characteristics or aortic valve gradients.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":"50 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969767/pdf/i1526-6702-50-1-e217659.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10805881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Texas Heart Institute Medal and Ray C. Fish Award for Scientific Achievement in Cardiovascular Diseases.","authors":"","doi":"10.14503/THIJ-23-8096","DOIUrl":"https://doi.org/10.14503/THIJ-23-8096","url":null,"abstract":"","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":"50 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10806417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relationship Between Obstructive Sleep Apnea Severity and Serum Endocan Levels in Patients With Hypertension.","authors":"Serkan Yazan, Hüseyin Karakurt, Hamdi Püşüroğlu","doi":"10.14503/THIJ-21-7664","DOIUrl":"https://doi.org/10.14503/THIJ-21-7664","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is common in middle-aged adults and has been associated with various cardiovascular disorders; endothelial dysfunction may play a role in the pathogenesis of these disorders in patients with OSA. Endothelial cell specific molecule-1 (endocan) is a marker of vascular pathology, which is correlated with endothelial dysfunction. This study investigates the relationship between serum endocan levels and OSA severity in patients with hypertension.</p><p><strong>Methods: </strong>A retrospective review included 48 patients with OSA and hypertension but without conventional cardiovascular risk factors, and 67 patients with OSA who did not have hypertension. The correlation between serum endocan levels and the apnea-hypopnea index (AHI) was investigated in both groups.</p><p><strong>Results: </strong>There was a significant correlation between the serum endocan level and the AHI in patients with OSA and hypertension (r = 0.308; P = .033), but there was no such correlation in patients without hypertension (r = 0.193; P = .118). However, when both groups were combined (ie, all patients with OSA), there was a significant correlation between serum endocan levels and the AHI (r = 0.228; P = .014). On multiple logistic regression analysis, endocan levels were independent predictors of OSA severity in patients with OSA and hypertension (P = .029).</p><p><strong>Conclusion: </strong>In patients with OSA and hypertension, serum endocan levels are significantly correlated with the AHI. Measurement of endocan may have a place in evaluating patients with OSA and hypertension for adverse cardiovascular events, and they may even help to guide OSA therapy for these patients.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":"50 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969776/pdf/i1526-6702-50-1-e217664.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9362659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiac Fibroma Presenting With Left Bundle Branch Block in an Adult With Gorlin Syndrome.","authors":"Kumar Jatti, Ramya Dhandapani, Vishal Sharma, Balazs Ruzsics","doi":"10.14503/THIJ-20-7247","DOIUrl":"https://doi.org/10.14503/THIJ-20-7247","url":null,"abstract":"","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":"50 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969773/pdf/i1526-6702-50-1-e207247.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10806418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana V Pejcic, Milos N Milosavljevic, Slobodan Jankovic, Goran Davidovic, Marko M Folic, Nevena D Folic
{"title":"Kounis Syndrome Associated With the Use of Diclofenac.","authors":"Ana V Pejcic, Milos N Milosavljevic, Slobodan Jankovic, Goran Davidovic, Marko M Folic, Nevena D Folic","doi":"10.14503/THIJ-21-7802","DOIUrl":"https://doi.org/10.14503/THIJ-21-7802","url":null,"abstract":"<p><strong>Background: </strong>Diclofenac is a widely used analgesic, anti-inflammatory, antipyretic drug. In several case reports, its use was associated with the occurrence of Kounis syndrome. The aim of this review was to investigate and summarize published cases of Kounis syndrome suspected to be associated with the use of diclofenac.</p><p><strong>Methods: </strong>Electronic searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and the Serbian Citation Index.</p><p><strong>Results: </strong>Twenty publications describing the 20 patients who met inclusion criteria were included in the systematic review. Specified patient ages ranged from 34 to 81 years. Eighteen (90.0%) patients were male. Five patients (25.0%) reported a previous reaction to diclofenac. Reported time from the used dose of diclofenac to onset of the first reaction symptoms ranged from immediately to 5 hours. Diclofenac caused both type I and type II Kounis syndrome, with the presence of various cardiovascular, gastrointestinal, dermatologic, and respiratory signs and symptoms. Most patients experienced hypotension (n = 15 [75.0%]) and chest pain (n = 12 [60.0%]). The most frequently reported finding on electrocardiogram was ST-segment elevations (n = 17 [85.0%]). Coronary angiogram showed normal coronary vessels in 9 patients (45.0%), with some pathologic findings in 8 patients (40.0%).</p><p><strong>Conclusion: </strong>Clinicians should be aware that Kounis syndrome may be an adverse effect of diclofenac. Prompt recognition and withdrawal of the drug, with treatment of both allergic and cardiac symptoms simultaneously, is important.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":"50 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969777/pdf/i1526-6702-50-1-e217802.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10788072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Freedom From Stent Fracture-Related Complications of Vascular Longitudinal Remodeling in a Patient With Heart Failure and a Degraded Bioresorbable Vascular Scaffold.","authors":"Chi-Jen Chang, Chien-Lin Lee, Jen-Fang Cheng, Yi-Chih Wang, Juey-Jen Hwang","doi":"10.14503/THIJ-21-7732","DOIUrl":"https://doi.org/10.14503/THIJ-21-7732","url":null,"abstract":"<p><p>Because vascular geometric change during the long-term process of cardiac chamber remodeling in heart failure is usually unpredictable after coronary stenting, the risk of acquired metallic stent fracture can persist. This rare but possible complication could be minimized with the implantation of bioresorbable vascular scaffold because of its unique properties. Here, the authors report on 1 patient with heart failure who received optical coherence tomography evaluation between 3 and 3.5 years after bioresorbable vascular scaffold implantation. Measurement of the discernible struts of bioresorbable vascular scaffold provided evidence of coronary longitudinal remodeling without serious risk of complications related to metallic stent fracture resulting from cardiac remodeling.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":"50 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969783/pdf/i1526-6702-50-1-e217732.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10796475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mostafa Abohelwa, Mohamed Elmassry, Gaspar Del-Rio-Pertuz, Jason Wischmeyer
{"title":"Atrial Flutter Leads to Diagnosis of Metastatic Melanoma Involving the Heart.","authors":"Mostafa Abohelwa, Mohamed Elmassry, Gaspar Del-Rio-Pertuz, Jason Wischmeyer","doi":"10.14503/THIJ-21-7709","DOIUrl":"https://doi.org/10.14503/THIJ-21-7709","url":null,"abstract":"","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":"50 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969791/pdf/i1526-6702-50-1-e217709.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10796476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}