EMJ Cardiology最新文献

{"title":"Effect of Age on the Abdominal Aortic Aneurysm: Fuzzy Logic Analysis","authors":"I. Bouharati, K. Bouharati, Nasserdine Boubendir, Slimane Laouamri","doi":"10.33590/emjcardiol/21-00277r1","DOIUrl":"https://doi.org/10.33590/emjcardiol/21-00277r1","url":null,"abstract":"Background: The aneurysm refers to the increase in arterial diameter in a localised position and this is characterised by the non-parallelism of the arterial wall. Despite prediction models trying to anticipate the onset of an aneurysm, the limits of their accuracy are often reached. This is due to the poor definition of the factors favouring the development of the aneurysm. In order to take into account this complex process, this study proposes a fuzzy system in the analysis of the effect of each factor. Methods: As the variability of the diameter of the aorta is a function of several uncertain and imprecise factors, this study deals with data relating to a population of 100 patients diagnosed at the level of the service of the UFAS Setif Hospital in Algeria. This study is limited to the effect of age, which is related to the diameter of the abdominal aorta diagnosed. A fuzzy inference analysis system is proposed. As the system is very complex and in an uncertain environment, its fuzzy logic analysis compensates this uncertainty. Results: Once the system is established from the actual values recorded, it becomes possible to introduce the input variables randomly to automatically read the result at the output with maximum precision. Conclusions: In order to avoid the risk of rupture, it is necessary to diagnose the aneurysm according to the patient's age. The introduction of the variables relating to the patient at the entry of the system allows clinicians to have a precise idea about the aneurysm. Note that the majority of cases are diagnosed accidentally in the absence of a screening program.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128208210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESC Interview: Nico Bruining","authors":"","doi":"10.33590/emjcardiol/10121122","DOIUrl":"https://doi.org/10.33590/emjcardiol/10121122","url":null,"abstract":"","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131877737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Cardiovascular Medicine: From 2022 to 2033","authors":"Janet Nzisa","doi":"10.33590/emjcardiol/10110961","DOIUrl":"https://doi.org/10.33590/emjcardiol/10110961","url":null,"abstract":"","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132635004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of the European Society of Cardiology (ESC) Congress 2022","authors":"","doi":"10.33590/emjcardiol/10001921","DOIUrl":"https://doi.org/10.33590/emjcardiol/10001921","url":null,"abstract":"AFTER 2 years of virtual meetings, the European Society of Cardiology (ESC) adopted a pioneering hybrid format for its 2022 congress, allowing delegates from across the globe to meet onsite in Barcelona, Spain, and also online. Clinicians and academics came together with one common goal: to advance cardiovascular care and improve patient outcomes. This was emphasised by Stephan Achenbach, ESC President, who commented: “At ESC Congress in Barcelona, we discussed the newest science in the light of our collective clinical experience. This is how true progress in cardiovascular medicine is made.” Achenbach spoke about the rapid pace of innovation and advancement since the first doubleblind randomised trial in cardiovascular medicine was completed in 1971. “Numerous large trials are published every year, often practice-changing, and many are first presented at ESC Congress,” he emphasised.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130437987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESC Interview: Allan Böhm","authors":"","doi":"10.33590/emjcardiol/10004094","DOIUrl":"https://doi.org/10.33590/emjcardiol/10004094","url":null,"abstract":"","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123080531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Association of Takotsubo Cardiomyopathy with Acquired Bartter-Like Phenotype and Colonic Stricture","authors":"Ramesh Patel, Rajan Chaudhari, S. Aggarwal","doi":"10.33590/emjcardiol/22-00047","DOIUrl":"https://doi.org/10.33590/emjcardiol/22-00047","url":null,"abstract":"Takotsubo syndrome is a rare entity, and the occurrence of Bartter syndrome\u0000along with Takotsubo syndrome makes it a bizarre incidence. Diagnosis of both\u0000is very crucial and important, as the signs and symptoms tend to be different for\u0000each patient. Here, the authors present a case of Takotsubo cardiomyopathy with\u0000acquired Bartter-like phenotype and colonic stricture. It was promptly diagnosed\u0000and well managed at first incidence, but failing a timely follow-up led to mortality of\u0000patient, which highlights the importance of follow-up.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123548956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Guided Single-Lead ECG May Be a Game-Changer for Symptom-to-Balloon Time Reduction in ST-Elevated Myocardial Infarction","authors":"S. Mehta, D. Vieira, D. Zerpa, Aline Quintana, Madyan Al Troudy, L. Brena-Pastor, C. Whuking, F. Martinez, Jacques Calixte, Devarsh Desai, Surik Sedrakyan, Nataly Rendón, Gabriel Peña","doi":"10.33590/emjcardiol/10098409","DOIUrl":"https://doi.org/10.33590/emjcardiol/10098409","url":null,"abstract":"\u0000 \u0000 \u0000 Over decades, efforts to shave off life-saving minutes from ST-Elevated Myocardial Infarction (STEMI) care centred on reducing door-to-needle and door-to-balloon times. We firmly believe that symptom-to-balloon time should prove a better focus to this end. Challenges come with this goal as it heavily relies on a patient's perception and initiative to seek care, which we deem intelligent and wearable Artificial Intelligence (AI)-driven Single Lead EKG technologies as an attractive solution in modern-day cardiology.\u0000 \u0000 \u0000 \u0000 To provide an accurate, accessible, and cost-effective AI-driven Single Lead STEMI detection algorithm that can be embedded into wearable devices and employed in a self-administered fashion.\u0000 \u0000 \u0000 \u0000 Database: EKG records from Mexico, Colombia, Argentina, and Brazil from April 2014 to December 2019. Dataset: A total of 11,567 12-lead EKG records of 10[s] length with a sampling frequency of 500 Hz, including the following balanced classes: angiographically confirmed and unconfirmed STEMI, branch blocks, non-specific ST-T abnormalities, normal and abnormal (200+ CPT codes, excluding those mentioned above). Cardiologists manually checked the label of each record to ensure precision. Pre-processing: We discard the first and last 250 samples as they may contain a standardisation pulse. The study applied a digital low pass filter of order 5 with a frequency cut-off of 35 Hz. The mean was subtracted from each Lead. Classification: The determined classes were “STEMI” (Including STEMI in different locations of the myocardium – anterior, inferior, and lateral); and “Not-STEMI” (Combination of randomly sample, branch blocks, non-specific ST-T changes, and abnormal records – 25% of each). Training and Testing: A 1-D Convolutional Neural Network was trained and tested with a dataset proportion of 90/10, respectively. A different model was trained and tested for each Lead, using the central 4,500 samples of the records. The last dense layer outputs a probability for each report of being STEMI or Not-STEMI. Lead V2 showed the best overall results. The model was further tested through the same methodology using the best Lead with a subset of the previous data, excluding the unconfirmed STEMI EKG records (Total 7,230 12-lead EKG records for Confirmed Only STEMI dataset). Performance metrics were reported for each experiment and compared.\u0000 \u0000 \u0000 \u0000 Combined STEMI data: Accuracy: 91.2%; Sensitivity: 89.6%; Specificity: 92.9%. Confirmed STEMI Only dataset: Accuracy: 92.4%; Sensitivity: 93.4%; Specificity: 91.4% (Figure 1).\u0000 \u0000 \u0000 \u0000 By assiduously improving the quality of the model's input, we continue to assess our algorithm's performance and reliability for future clinical validation as a potential remote monitoring and early STEMI detection device.\u0000 \u0000 \u0000 \u0000 Type of funding sources: None.\u0000","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134416803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Referrals to Palliative Care for Cardiovascular Patients: A 10-Year Longitudinal Retrospective Study","authors":"L. Van Bulck, Mathilde Giffard, Fatimata Seydou Sall, N. Becoulet, M. Séronde, F. Ecarnot","doi":"10.33590/emjcardiol/10004878","DOIUrl":"https://doi.org/10.33590/emjcardiol/10004878","url":null,"abstract":"\u0000 \u0000 \u0000 Patients with cardiovascular diseases have a significant symptom burden and often have a progressive course towards end-stage disease and ultimately, death. For this reason, consensus guidelines advocate early integration of palliative care into the care for cardiovascular patients, especially those with heart failure. However, palliative care involvement in the care of cardiovascular patients remains suboptimal, whereby only a small proportion of patients are referred to palliative care specialists, and often too late in the disease course. We aimed to examine the current situation and describe the profile, circumstances of death, and time of referral to palliative care of cardiovascular patients over a 10 year period in our unit.\u0000 \u0000 \u0000 \u0000 This retrospective study included all patients with cardiovascular disease who were referred to the mobile palliative care team by the cardiology unit, in a single, large University Hospital in France between 2010 and 2020. All data were extracted from the medical hospital files. We recorded vital status, day of birth, time of referral to palliative care, day of death, and medical diagnoses. We noted whether patients had advance directives (AD).\u0000 \u0000 \u0000 \u0000 A total of 148 patients were identified; full data were available for 144 (97.3%). Of these, 136 (94.4%) died, while 8 (5.6%) were still alive in March 2022. The mean age at the time of death was 75±14 years. The median time between referral to palliative care and death was 9 days (interquartiles, 2, 41.5). We noted the following underlying diseases (patients could have more than one diagnosis): 111 (77%) had heart failure, 58 (40.2%) had ischemic heart disease, 55 (38.2%) had valvular heart disease, 39 (27%) had diabetes, 37 (25.7%) had chronic kidney disease, 30 (20.8%) had pulmonary hypertension, 17 (11.8%) had chronic obstructive pulmonary disease. In addition, 78 (54%) had at least one documented episode of atrial fibrillation, 27 (18.7%) had had a stroke. Place of death was available for 119 patients (82.6%) (Figure): The majority (73, 61.4%) died in the Cardiology department of our hospital; only 17 (14.3%) died at home (see Figure 1). Only 4 patients (2.7%) had documented AD.\u0000 \u0000 \u0000 \u0000 This study suggests that palliative care is still widely under-used in cardiology patients, and is often initiated very close to the time of death, and mainly for heart failure patients. A large proportion of patients still die in the hospital setting. Further, prospective studies are warranted to investigate whether these dispositions corresponds to patients' wishes, and whether earlier initiation of palliative care could improve quality of life for cardiology patients with end-stage disease.\u0000 \u0000 \u0000 \u0000 Type of funding sources: None.\u0000","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124984248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heated Tobacco Products and Cardiovascular Disease: A Narrative Review of Peer-Reviewed Publications","authors":"R. Zimlichman,, E. Scotti, G. Plebani, Amanda Barrell","doi":"10.33590/emjcardiol/10124537","DOIUrl":"https://doi.org/10.33590/emjcardiol/10124537","url":null,"abstract":"Cigarette smoking is a major risk factor for the development of cardiovascular disease (CVD). Cigarette smoke contains toxicants that cross the alveolar barrier into the blood stream and elicit systemic oxidative stress and inflammatory responses, which can lead to an abnormal lipid profile and affect normal vascular functions. These changes predispose smokers to the development and progression of atherosclerosis, leading to various types of CVDs, such as ischaemic heart disease, cerebrovascular disease, peripheral artery disease, and aortic aneurysm. While the best choice a smoker can make is to stop smoking altogether, unfortunately not all smokers make that choice. In recent years, alternative products to cigarettes have been developed to offer a better alternative to continuing to smoke. However, new products representing a better alternative must be scientifically substantiated to understand how they present less risk to users compared with cigarettes. This literature review summarises the results of in vitro, in vivo, and clinical studies that, taken together, show the CVD risk reduction potential of switching from cigarette smoking to these smoke-free products.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115010813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene Therapy in Haemophilia: Updates from Clinical Trials and Insights to Future Technologies","authors":"S. Carter","doi":"10.33590/emjcardiol/10136425","DOIUrl":"https://doi.org/10.33590/emjcardiol/10136425","url":null,"abstract":"At the International Society on Thrombosis and Haemostasis (ISTH) 2022 Congress, held 9th–13th July, multiple oral and poster presentations were dedicated to gene therapy as a treatment for haemophilia A or B. These included updates from clinical trials of adeno-associated virus (AAV)-based gene therapy products and guidance on the real-world monitoring of patients with haemophilia who have received gene therapy, both in the short- and long-term. The unmet needs and challenges associated with gene therapy were also discussed, and several preclinical studies that aimed to refine AAV-based strategies were presented. Finally, there were a number of presentations providing an insight into the ongoing research into alternative gene therapy strategies, including the use of non-viral gene transfer, gene editing strategies, and nanobodies.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"131 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123435663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}