Vascular Health and Risk Management最新文献

{"title":"Correlation P2Y12 Genetic Polymorphism As Risk Factor of Clopidogrel Resistance in Indonesian Stroke Patients.","authors":"Rakhmad Hidayat,&nbsp;Al Rasyid,&nbsp;Salim Harris,&nbsp;Alida Harahap,&nbsp;Herqutanto,&nbsp;Melva Louisa,&nbsp;Erlin Listiyaningsih,&nbsp;Aldy Safruddin Rambe,&nbsp;Tonny Loho","doi":"10.2147/VHRM.S386107","DOIUrl":"https://doi.org/10.2147/VHRM.S386107","url":null,"abstract":"<p><strong>Background: </strong>Stroke is one of the highest causes of disability and mortality in several countries worldwide. Secondary prevention is important in the management of stroke. Clopidogrel is widely used in Asia as secondary prevention for ischemic stroke, even though several studies in Western show limited data related to clopidogrel resistance in Asia. This study aims to determine the correlation between P2Y12 genetic polymorphism and clopidogrel resistance in Indonesia.</p><p><strong>Methods: </strong>This study was conducted on one-year duration, the subjects were chosen through the consecutive sampling method, all subjects were examined for genetics and resistance to clopidogrel. The data were analyzed through statistical analysis, a bivariate analysis was conducted to determine the correlation between several variables and the resistance variable. This study employed resistance diagnostic methods with VerifyNow. Polymorphism of receptor P2Y12 was tested with the Polymerase Chain Reaction method (PCR) and analysis of restriction fragment length polymorphism (RFLP). The genes tested in this study were G52T and C34T.</p><p><strong>Results: </strong>The number of participants in this study was 112. Examination of gene P2Y12 showed that the majority was homozygote, wild-type C34T allele (67%), and G52T (66.1%). There was no significant correlation between clopidogrel resistance and gene G52T and C34T of P2Y12 (p > 0.05). Hb levels significantly correlated with P2Y12 G52T (p = 0.024). Meanwhile, Fatty Liver significantly correlated with P2Y12 C34T (p = 0.037).</p><p><strong>Conclusion: </strong>Indonesia showed a low clopidogrel resistance rate and a very low C34T and G52T allele P2Y12 gene mutation, meaning that Indonesia had low mutations in the P2Y12. This is the cause of clopidogrel resistance in this study only 15%. Therefore, in a region with less clopidogrel resistance, examination of the P2Y12 gene would not give significant results.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"53-61"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/2f/vhrm-19-53.PMC9893839.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial Hypertrophic Cardiomyopathy: Diagnosis and Management.","authors":"Michael J Litt,&nbsp;Ayan Ali,&nbsp;Nosheen Reza","doi":"10.2147/VHRM.S365001","DOIUrl":"https://doi.org/10.2147/VHRM.S365001","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) is widely recognized as one of the most common inheritable cardiac disorders. Since its initial description over 60 years ago, advances in multimodality imaging and translational genetics have revolutionized our understanding of the disorder. The diagnosis and management of patients with HCM are optimized with a multidisciplinary approach. This, along with increased safety and efficacy of medical, percutaneous, and surgical therapies for HCM, has afforded more personalized care and improved outcomes for this patient population. In this review, we will discuss our modern understanding of the molecular pathophysiology that underlies HCM. We will describe the range of clinical presentations and discuss the role of genetic testing in diagnosis. Finally, we will summarize management strategies for the hemodynamic subtypes of HCM with specific emphasis on the rationale and evidence for the use of implantable cardioverter defibrillators, septal reduction therapy, and cardiac myosin inhibitors.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"211-221"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/6d/vhrm-19-211.PMC10084873.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9358930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Clinical Benefits of Cardio-Ankle Vascular Index Measurement in Urological Diseases.","authors":"Emre Bulbul,&nbsp;Murat Oguz Ozilhan,&nbsp;Ali Sezer,&nbsp;Mustafa Yetisen,&nbsp;Fahri Yavuz Ilki","doi":"10.2147/VHRM.S384937","DOIUrl":"https://doi.org/10.2147/VHRM.S384937","url":null,"abstract":"<p><p>Many factors are considered to affect vascular physiology. It is known that one of the reasons for many diseases is a pathology at the microvascular level. Therefore, the relationship between endothelial dysfunction and many diseases is currently being investigated. The clinical evaluations of arterial stiffness have made it possible to perform necessary risk assessment regarding cardiovascular diseases. In this way, protective measures can be taken against microvascular pathologies in many organs. In this paper, we present a review of studies investigating the relationship between urological conditions and the cardio-ankle vascular index (CAVI), a marker of arterial stiffness. As with erectile dysfunction, some studies have shown that conditions such as lower urinary tract symptoms, overactive bladder, and chronic kidney disease are also associated with an elevated CAVI. The association of erectile dysfunction and chronic kidney disease with vascular pathologies has been clearly demonstrated. In addition, lower urinary tract symptoms may be the first sign of silent vascular dysfunction. Assessing arterial stiffness with CAVI can help prevent future cardiovascular events in these patients.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"127-132"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/ad/vhrm-19-127.PMC10010130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9138578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Diastolic Oscillation Amplitude Used as an Arterial Aging Indicator.","authors":"Fernando M Clara,&nbsp;José Alfie,&nbsp;Adriana Scandurra,&nbsp;Mariana Fita","doi":"10.2147/VHRM.S381452","DOIUrl":"https://doi.org/10.2147/VHRM.S381452","url":null,"abstract":"<p><strong>Introduction: </strong>The compliance of the distal arteries depends on their vasoconstrictor tone and distensibility and is sensitive to endothelial function and aging. C2, a component of the Windkessel model, is a measure of distal arterial compliance, and establishes the magnitude of the pressure rise during early diastole. It is calculated from the diastolic portion of the radial pulse wave using sophisticated analyses. C2 is used as a cardiovascular risk indicator since it decreases with aging, high blood pressure, and diabetes. Here, we propose an alternative method to assess the distal arteries distensibility by measuring the amplitude of the oscillation that occurs at the beginning of diastole.</p><p><strong>Methods: </strong>Peripheral pulse wave was evaluated noninvasively by applanation tonometry in 511 individuals (264 women) aged between 13 and 70 years. Diastolic amplitude (DA) was measured as the peak-to-peak amplitude of the diastolic oscillation. Radial augmentation index (RAIx) and pulse wave velocity (PWV) were also calculated.</p><p><strong>Results: </strong>DA decreased approximately 2% per decade of life between 16 and 70 years from 19% to 7%, and was higher in men than in women (p<0.0001). Linear regression analysis identified RAIx as the strongest predictor of AD (p<0.0001), followed by age and height. Sex modified the age-related decrease in DA (p< 0.001). By applying the method to measure DA from previously published data, we found a strong linear correlation with C2.</p><p><strong>Conclusion: </strong>DA decreased linearly with age in a reciprocal manner to the increase in radial augmentation index, was greater in men than women, and was independent of blood pressure and heart rate, as previously reported for C2. We propose that measuring DA could provide an alternative index to evaluate distal arterial compliance and aging.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"193-200"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/a5/vhrm-19-193.PMC10082575.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9276600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulse Wave Morphology Changes in Aortic Valve Stenosis Detected with Cardio-Ankle Vascular Index.","authors":"Oscar Plunde,&nbsp;Anders Franco-Cereceda,&nbsp;Magnus Bäck","doi":"10.2147/VHRM.S401221","DOIUrl":"https://doi.org/10.2147/VHRM.S401221","url":null,"abstract":"<p><strong>Background: </strong>Cardio-ankle vascular index (CAV) is a measure of systemic arterial stiffness and has been shown to increase after aortic valve surgery. However, change in CAVI-derived pulse wave morphology has not previously been addressed.</p><p><strong>Case study: </strong>A 72-year-old female was transferred to a large center for heart valve interventions for evaluation of her aortic stenosis. Few co-morbidities were detected on medical history, other than previous radiation treatment for breast cancer, and no signs of other concomitant cardiovascular disease. The patient was accepted for surgical aortic valve replacement due to severe aortic valve stenosis and arterial stiffness was assessed with CAVI, as part of an ongoing clinical study. The pre-operative CAVI was 4.7 which after surgery increased almost 100% to 9.35. In tandem, the slope of systolic upstroke pulse morphology captured from brachial cuffs was changed from a prolonged flattened pattern to a steeper.</p><p><strong>Conclusion: </strong>After aortic valve replacement surgery due to aortic valve stenosis, in addition to increased CAVI-derived measures of arterial stiffness, the slope of the CAVI-derived upstroke pulse wave morphology changes to a steeper slope. This finding could have implications in the future of aortic valve stenosis screening and utilization of CAVI.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"325-328"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/ee/vhrm-19-325.PMC10225137.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9605847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Morphological Factors for Ruptured Anterior Communicating Artery Aneurysms.","authors":"Beny Rilianto,&nbsp;Bambang Tri Prasetyo,&nbsp;Ricky Gusanto Kurniawan,&nbsp;Kelvin Theandro Gotama,&nbsp;Pratiwi Raissa Windiani,&nbsp;Abrar Arham,&nbsp;Muhammad Kusdiansah","doi":"10.2147/VHRM.S415213","DOIUrl":"https://doi.org/10.2147/VHRM.S415213","url":null,"abstract":"<p><strong>Introduction: </strong>The anterior communicating artery (ACoA) aneurysm, the most frequent cerebral aneurysm to rupture, carries a significant clinical burden, yet the factors influencing its rupture are limited in Indonesia. This study aims to determine the clinical and morphological features associated with ruptured ACoA compared to non-AcoA aneurysms among Indonesians.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed our center's aneurysm patient registry from January 2019 to December 2022, and compared the clinical and morphological features between ruptured ACoA aneurysms and ruptured aneurysms elsewhere with univariate and multivariate analyses.</p><p><strong>Results: </strong>Of the 292 patients with 325 ruptured aneurysms, 89 were from ACoA. The mean age of patients was 54.99 years, with female preponderance in the non-ACoA group (non-ACoA: 73.31%, ACoA: 46.07%). On univariate analysis, ages ≥60 [ages 60-69: OR = 0.311 (0.111-0.869), <i>p=</i>0.026; ages ≥70: OR = 0.215 (0.056-0.819), <i>p=</i>0.024], female gender [OR = 0.311 (0.182-0.533), <i>p</i><0.001], and smoking [OR=2.069 (1.036-4.057), <i>p=</i>0.022] exhibited significant association with ruptured ACoA aneurysm. On multivariate analysis, only the female gender was independently associated with ruptured ACoA aneurysm (aOR 0.355 [0.436-1.961], <i>p</i>=0.001).</p><p><strong>Conclusion: </strong>In our study, ruptured ACoA aneurysm was inversely associated with advanced age, female gender, presence of daughter aneurysm, and directly associated with smoking. After multivariate adjustment, the female gender showed an independent association with ruptured ACoA aneurysm.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"371-377"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/1f/vhrm-19-371.PMC10319283.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Psychological Stress on Microcirculation Oscillations: Diagnostic Aspects.","authors":"Jerzy Gebicki,&nbsp;Joanna Katarzynska,&nbsp;Andrzej Marcinek","doi":"10.2147/VHRM.S399082","DOIUrl":"https://doi.org/10.2147/VHRM.S399082","url":null,"abstract":"It has long been recognized that psychological stress contributes to heart disease. Prolonged psychological stress is now seen as an important risk factor for the entire vascular system. 1 However, there have been relatively few studies on the effects of psychological stress on the microcirculation. Psychological stress is associated with increased levels of norepinephrine in the circulation, which can cause microvascular vasoconstriction. Using laser Doppler flowmetry, healthy individuals with self-reported high levels of daily psychological stress have been found to show greater norepinephrine-induced vasoconstriction compared with healthy individuals with low stress. 2 Therefore, in this study, we consider microvascular flow perturbation caused by psychological stress as a reliable diagnostic method of stress assessment.","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"79-82"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/04/vhrm-19-79.PMC9926981.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9669426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Immune-Inflammation Index Predicts Prolonged Mechanical Ventilation and Intensive Care Unit Stay After off-Pump Coronary Artery Bypass Graft Surgery: A Single-Center Retrospective Study.","authors":"I Made Adi Parmana,&nbsp;Cindy Elfira Boom,&nbsp;Herdono Poernomo,&nbsp;Chairil Gani,&nbsp;Budi Nugroho,&nbsp;Riza Cintyandy,&nbsp;Lisa Sanjaya,&nbsp;Yudi Hadinata,&nbsp;Dian Raseka Parna,&nbsp;Dudy Arman Hanafy","doi":"10.2147/VHRM.S409678","DOIUrl":"https://doi.org/10.2147/VHRM.S409678","url":null,"abstract":"<p><strong>Purpose: </strong>Coronary artery disease (CAD) is the primary cause of mortality in developing countries. Off-pump coronary artery bypass grafting (OPCAB) offers more upside in revascularization by preventing cardiopulmonary bypass trauma and minimizing aortic manipulation. Even though cardiopulmonary bypass is not involved, OPCAB still causes a significant systemic inflammatory response. This study determines the prognostic values of the systemic immune-inflammation index (SII) towards perioperative outcomes in patients who underwent OPCAB surgery.</p><p><strong>Patients and methods: </strong>This was a single-center retrospective study at the National Cardiovascular Center Harapan Kita, Jakarta, using secondary data from electronic medical records and medical record archives of all patients who underwent OPCAB from January 2019 through December 2021. A total of 418 medical records were obtained, and 47 patients were excluded based on the exclusion criteria. The values of SII were calculated from preoperative laboratory data of segmental neutrophil count, lymphocyte count, and platelet count. Patients were divided into two groups based on the SII cutoff value of 878.056 x 10³/mm³.</p><p><strong>Results: </strong>The baseline SII values of 371 patients were calculated, among which 63 (17%) patients had preoperative SII values of ≥878.057 x 10³/mm³. High SII values were a significant predictor of prolonged ventilation (RR 1.141, 95% CI 1.001-1.301) and prolonged ICU stay (RR 1.218, 95% CI 1.021-1.452) after OPCAB surgery. A positive correlation was observed between SII and hospital length of stay after OPCAB surgery. From the receiver operating characteristic curve analysis, SII predicted prolonged ventilation duration, with an area under the curve of 0.658 (95% CI 0.575-0.741, p = 0.001).</p><p><strong>Conclusion: </strong>High preoperative SII values are capable of predicting prolonged mechanical ventilation and intensive care unit stay after OPCAB surgery.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"353-361"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/f2/vhrm-19-353.PMC10315149.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Palmitic Acid in the Co-Toxicity of Bacterial Metabolites to Endothelial Cells.","authors":"Marcin Choroszy,&nbsp;Kamila Środa-Pomianek,&nbsp;Magdalena Wawrzyńska,&nbsp;Mateusz Chmielarz,&nbsp;Edyta Bożemska,&nbsp;Beata Sobieszczańska","doi":"10.2147/VHRM.S408897","DOIUrl":"https://doi.org/10.2147/VHRM.S408897","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic endotoxemia most often results from obesity and is accompanied by an increase in the permeability of the intestinal epithelial barrier, allowing co-absorption of bacterial metabolites and diet-derived fatty acids into the bloodstream. A high-fat diet (HFD) leading to obesity is a significant extrinsic factor in developing vascular atherosclerosis. In this study, we evaluated the effects of palmitic acid (PA) as a representative of long-chain saturated fatty acids (LCSFA) commonly present in HFDs, along with endotoxin (LPS; lipopolysaccharide) and uremic toxin indoxyl sulfate (IS), on human vascular endothelial cells (HUVECs).</p><p><strong>Methods: </strong>HUVECs viability was measured based on tetrazolium salt metabolism, and cell morphology was assessed with fluorescein-phalloidin staining of cells' actin cytoskeleton. The effects of simultaneous treatment of endothelial cells with PA, LPS, and IS on nitro-oxidative stress in vascular cells were evaluated quantitatively with fluorescent probes. The expression of vascular cell adhesion molecule VCAM-1, E-selectin, and occludin, an essential tight junction protein, in HUVECs treated with these metabolites was evaluated in Western blot.</p><p><strong>Results: </strong>PA, combined with LPS and IS, did not influence HUVECs viability but induced stress on actin fibers and focal adhesion complexes. Moreover, PA combined with LPS significantly enhanced reactive oxygen species (ROS) production in HUVECs but decreased nitric oxide (NO) generation. PA also considerably increased the expression of VCAM-1 and E-selectin in HUVECs treated with LPS or IS but decreased occludin expression.</p><p><strong>Conclusion: </strong>Palmitic acid enhances the toxic effect of metabolic endotoxemia on the vascular endothelium.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"399-409"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/41/vhrm-19-399.PMC10329449.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9800601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Valve Stenosis: From Diagnosis to Current Management Techniques and Future Prospects.","authors":"Federico Marchini,&nbsp;Sofia Meossi,&nbsp;Giulia Passarini,&nbsp;Gianluca Campo,&nbsp;Rita Pavasini","doi":"10.2147/VHRM.S380240","DOIUrl":"https://doi.org/10.2147/VHRM.S380240","url":null,"abstract":"<p><p>Pulmonary stenosis (PS) is mainly a congenital defect that accounts for 7-12% of congenital heart diseases (CHD). It can be isolated or, more frequently, associated with other congenital defects (25-30%) involving anomalies of the pulmonary vascular tree. For the diagnosis of PS an integrated approach with echocardiography, cardiac computed tomography and cardiac magnetic resonance (CMR) is of paramount importance for the planning of the interventional treatment. In recent years, transcatheter approaches for the treatment of PS have increased however, meaning surgery is a possible option for complicated cases with anatomy not suitable for percutaneous treatment. The present review aims to summarize current knowledge regarding diagnosis and treatment of PS.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"379-390"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/8e/vhrm-19-379.PMC10320808.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9809856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}