EMJ Cardiology最新文献_第4页

A Case Report on Ischaemic Cardiomyopathy with Severe Left Ventricular Dysfunction 缺血性心肌病合并严重左心室功能不全1例报告

EMJ Cardiology Pub Date : 2021-10-11 DOI: 10.33590/emjcardiol/20-00264

Mohammed Misbah Ul Haq, Mohammed Munaf Ur Razzak, N. Ahmed

{"title":"A Case Report on Ischaemic Cardiomyopathy with \u0000Severe Left Ventricular Dysfunction","authors":"Mohammed Misbah Ul Haq, Mohammed Munaf Ur Razzak, N. Ahmed","doi":"10.33590/emjcardiol/20-00264","DOIUrl":"https://doi.org/10.33590/emjcardiol/20-00264","url":null,"abstract":"Ischaemic cardiomyopathy is a condition that arises when heart muscle is weakened because of coronary artery disease or a heart attack. Left ventricular (LV) dysfunction occurs when the left ventricle is either defective or damaged, thus disrupting healthy function. Normal LV function can be perturbed because of several causes. Some cardiac defects such as valvular malformations or conditions block the passage of blood into the body. Effective and cost-effective treatment is available for such patients that can reduce both morbidity and mortality. Herein, the authors present the case of a 69-year-old male who was brought to the emergency department with a history of hypertension on medication. Later, the patient was transferred to the cardiology department. The patient was brought to the hospital after midnight and had bleeding gums, and experienced bleeding from the site of needle puncture. Earlier reports showed that the international normalised ratio was >6.0, and the 2D echocardiogram showed large LV blood clots, mild LV dysfunction, mild mitral regurgitation, and aortic valve stenosis. Finally, the patient was diagnosed with ischaemic cardiomyopathy associated with LV dysfunction. During discharge, the patient and patient’s representative were counselled in layman’s language about the conditions and prognosis of the disease, the use and adherence to medications, lifestyle modifications, and were advised to review back to the cardiologist.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122320360","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}

引用次数: 0

Association Between the Hospital Readmissions Reduction Program and Heart Failure Subtype Readmissions and Mortality in the USA 美国医院再入院减少计划与心力衰竭亚型再入院和死亡率之间的关系

EMJ Cardiology Pub Date : 2021-10-11 DOI: 10.33590/emjcardiol/20-00285

Wasiq Sheikh, Malik Bilal Ahmed, A. Parulkar, Tamara Lhungay, Esseim Sharma, Kevin W Kennedy, Zara Ahmed, Fabio V. Lima, H. Aronow, Antony Chu

{"title":"Association Between the Hospital Readmissions \u0000Reduction Program and Heart Failure Subtype \u0000Readmissions and Mortality in the USA","authors":"Wasiq Sheikh, Malik Bilal Ahmed, A. Parulkar, Tamara Lhungay, Esseim Sharma, Kevin W Kennedy, Zara Ahmed, Fabio V. Lima, H. Aronow, Antony Chu","doi":"10.33590/emjcardiol/20-00285","DOIUrl":"https://doi.org/10.33590/emjcardiol/20-00285","url":null,"abstract":"Background: The Hospital Readmission Reduction Program (HRRP) sought to reduce readmissions by penalising centres with readmissions above the national average, and heart failure (HF) is the leading driver of the readmission penalty. Recent Medicare analyses question the effectiveness of this strategy. This study evaluated the efficacy of HRRP by utilising large national datasets and is the first to analyse based on heart failure subtypes.\u0000\u0000Methods: Aggregate data was used from the National Inpatient Sample (NIS) to study mortality and the National Readmissions Database (NRD) to study readmissions. Both included all payer-types and were stratified by heart failure subtype and time (pre- and post-HRRP implementation).\u0000\u0000Results: Patients with HF with preserved ejection fraction (HFpEF) tended to be older females with a higher proportion of comorbidities compared to patients with HF with reduced ejection fraction (HFrEF). In the post-HRRP period, readmission rates decreased for HFrEF (21.4% versus 22.3%, p<0.001) and HFpEF (21.2% versus 22.4%, p<0.001); readmission rates for the two subtypes were not statistically different compared to the other. Post-HRRP, inpatient mortality was consistent for HFrEF (2.8% versus 2.8%, p=0.087), but decreased for HFpEF (2.4% versus 2.5%, p=0.029). There were no significant differences noted in average length of stay. Patients with HFrEF were more frequently discharged to short-term hospitals or home with home healthcare, and patients with HFpEF were discharged to skilled nursing facilities more often. Estimated inpatient costs decreased in both subtypes post-HRRP, but readmission costs were higher for HFrEF.\u0000\u0000Conclusions: This study suggests that HRRP was associated with minimal change in readmission and inpatient mortality.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121541903","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}

引用次数: 0

Biomarker-Based Guideline-Directed Medical Therapy of Heart Failure: The Gap Between Guidelines and Clinical Practice 基于生物标志物的心力衰竭指导医学治疗:指南与临床实践之间的差距

EMJ Cardiology Pub Date : 2021-10-11 DOI: 10.33590/emjcardiol/21-00012

A. Berezin, A. Berezin

{"title":"Biomarker-Based Guideline-Directed Medical Therapy of Heart Failure: The Gap Between Guidelines and Clinical Practice","authors":"A. Berezin, A. Berezin","doi":"10.33590/emjcardiol/21-00012","DOIUrl":"https://doi.org/10.33590/emjcardiol/21-00012","url":null,"abstract":"Current clinical recommendations provided by the 2016 European Society of Cardiology (ESC) and 2017 American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Failure Society of America (HFSA) are substantially distinguished in the use of circulating biomarkers in the management of heart failure (HF). To date, natriuretic peptides continue being the universal biomarkers used in diagnosis, risk stratification, and prediction of cardiovascular death, all-cause mortality, and HF-related outcomes for patients with both phenotypes of HF. However, biomarkers of fibrosis and inflammation, including soluble suppressor of tumourgenicity 2 and galectin-3, were able to increase predictive ability of natriuretic peptides in HF patients regardless of cardiovascular risk-factor presentation and HF phenotypes. Therefore, there are many various biomarkers describing several pathophysiological processes such as fibrosis, inflammation, oxidative stress, neurohumoral activation, extracellular matrix turnover, and vascular reparation, that play a pivotal role in the natural evolution of HF. This review discusses whether multiple biomarker models are more effective than a single biomarker in improving risk stratification strategies in patients with HF. It emphasises how in routine clinical practice, the multiple biomarker approach to elicit response to therapy of HF and predict clinical outcomes is rare, probably because of the relatively high cost, low affordability, lack of clear recommendations for clinical implementation, and significant disagreements in the interpretation of the data obtained.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"283 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132998038","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}

引用次数: 0

COVID-19 Infection and Myocardial Infarction Pathophysiology and Therapy COVID-19感染与心肌梗死病理生理及治疗

EMJ Cardiology Pub Date : 2021-10-10 DOI: 10.33590/emjcardiol/20-00282

Manraj Raja Singh Gill, J. Ambrose

引用次数: 0

Personalised Approach to Atherosclerotic Cardiovascular Disease: The Future is Here 动脉粥样硬化性心血管疾病的个体化治疗:未来就在这里

EMJ Cardiology Pub Date : 2021-07-21 DOI: 10.33590/emjcardiol/22c3203

Nicola Humphry

{"title":"Personalised Approach to Atherosclerotic Cardiovascular Disease: The Future is Here","authors":"Nicola Humphry","doi":"10.33590/emjcardiol/22c3203","DOIUrl":"https://doi.org/10.33590/emjcardiol/22c3203","url":null,"abstract":"This plenary session began with a focus on cutting edge research into the role of the immune system in atherosclerotic cardiovascular disease (ASCVD). Firstly, Chiara Giannerelli, New York University (NYU) Langone Health and NYU Grossman School of Medicine, New York, USA, emphasised the value of deep phenotyping of atherosclerotic disease to understand the immune mechanisms involved in cardiovascular (CV) risk. She presented data demonstrating an enrichment of phenotypically distinct cluster of differentiation (CD) 4+ and CD8+ T cells in advanced atherosclerotic plaque compared with paired blood and explained how this data can be used to identify drugs with the potential to be repurposed to reduce CV risk.\u0000\u0000Secondly, Eicke Latz, Institute of Innate Immunity, University of Bonn, Germany, presented data from his research team that begins to explain how the Western diet might lead to chronic inflammation and atherogenesis, implicating cholesterol crystals and short-chain sphingomyelins in the reprogramming of granulocyte-monocyte precursor cells (GMP) in this process. The arguments for greater use of imaging and molecular biomarkers in clinical practice were presented by Wolfgang Koenig, German Heart Center Munich, Technical University of Munich, Germany, who speculated that the assessment of CV risk in the future is likely to harness big data and machine learning to achieve accurate risk assessment in individual patients.\u0000\u0000Finally, Amit Khera, Massachusetts General Hospital, Boston, USA, covered the role of genetic factors in the prediction of CV disease (CVD), explaining that a combination of traditional risk factors and polygenic scoring techniques provides the most accurate estimation of CVD risk.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115708704","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}

引用次数: 0

Artificial Intelligence in Patients with Congenital Heart Disease: Where Do We Stand? 先天性心脏病患者的人工智能:我们站在哪里?

EMJ Cardiology Pub Date : 2020-10-20 DOI: 10.33590/emjcardiol/20-00063

Marinka D. Oudkerk Poo, D. Kauw, H. Bleijendaal, B. Mulder, Y. Pinto, B. Bouma, M. Winter

{"title":"Artificial Intelligence in Patients with Congenital \u0000Heart Disease: Where Do We Stand?","authors":"Marinka D. Oudkerk Poo, D. Kauw, H. Bleijendaal, B. Mulder, Y. Pinto, B. Bouma, M. Winter","doi":"10.33590/emjcardiol/20-00063","DOIUrl":"https://doi.org/10.33590/emjcardiol/20-00063","url":null,"abstract":"Life expectancy of patients with congenital heart disease (CHD) has increased in recent decades; however, late complications remain frequent and difficult to predict. Progress in data science has spurred the development of decision support systems and could aid physicians in predicting clinical deterioration and in the management of CHD patients. Newly developed artificial intelligence (AI) algorithms have shown performances comparable to humans in clinical diagnostics using statistical and computational algorithms and are expected to partly surpass human intelligence in the near future. Although much research on AI has been performed in patients with acquired heart disease, little data is available with respect to research on AI in patients with CHD. Learning algorithms in patients with CHD have shown to be promising in the interpretation of ECG, cardiac imaging, and the prediction of surgical outcome. However, current learning algorithms are not accurate enough to be implemented into daily clinical practice. Data on AI possibilities remain scarce in patients with CHD, and studies on large data sets are warranted to increase sensitivity, specificity, accuracy, and clinical relevance of these algorithms.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124727761","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}

引用次数: 1

2020 ESC Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease 2020 ESC心血管疾病患者的运动心脏病学和运动指南

EMJ Cardiology Pub Date : 2020-10-20 DOI: 10.33590/emjcardiol/20f1020

Anaya Malik

{"title":"2020 ESC Guidelines on Sports Cardiology and Exercise in Patients \u0000with Cardiovascular Disease","authors":"Anaya Malik","doi":"10.33590/emjcardiol/20f1020","DOIUrl":"https://doi.org/10.33590/emjcardiol/20f1020","url":null,"abstract":"ADVISING individuals with diseases of the heart on what types and intensities of sport to participate in is not a practice cardiologists typically have official guidelines on. A taskforce from ESC has now come together and created guidelines, the first of their kind, on exercise and sports participation in patients with cardiovascular disease. The guidelines were presented at the ESC Congress 2020 in a session chaired by Prof Antonio Pelliccia, Scientific Director of the Institute of Sports Medicine & Science from Rome, Italy.\u0000\u0000Pelliccia was joined by Prof Martin Halle, President of the European Association of Preventive Cardiology (EAPC), Munich, Germany, and Prof Matthias Wilhem, Head of the Centre for Preventive Cardiology, Sports Medicine, Department of Cardiology at the Inselspital, University Hospital of Bern, Switzerland. The guidelines derived from the need to assist patients who had experienced cardiovascular events and were questioning their limits of sports participation. Prof Halle commented on his experience in the taskforce: “The level of evidence is rather low, so it is very much the personal perspective and the experience of the experts which made us come to that one conclusion in the guidelines. It is something that should be developed in years to come.”\u0000\u0000A series of videos were shown, presented by specialists who were invited to discuss some of the most relevant topics of the guidelines.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120989752","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}

引用次数: 0

Acute Severe Mitral Regurgitation Secondary to Haemophilus parainfluenzae Infective Endocarditis 副流感嗜血杆菌感染性心内膜炎继发的急性严重二尖瓣反流

EMJ Cardiology Pub Date : 2020-10-20 DOI: 10.33590/emjcardiol/20-00153

P. Kelley, Nathaniel C. Warner, S. Venkatesh, T. Thelsa, Weickert

引用次数: 0

High-Density Lipoproteins and Cardiovascular Disease 高密度脂蛋白与心血管疾病

EMJ Cardiology Pub Date : 2020-10-12 DOI: 10.33590/emjcardiol/20-00038

S. Nicholls, H. Brown, K. Bubb

引用次数: 4

Performance and Accuracy of Natural Language Processing to Identify Disease Aetiology from Non-Structured Cardiac MRI Electronic Medical Record Reports 从非结构化心脏MRI电子病历报告中识别疾病病因的自然语言处理的性能和准确性

EMJ Cardiology Pub Date : 2020-09-14 DOI: 10.33590/emjcardiol/2009142

D. Kocyigit, A. Milinovich, Chan M. Lee, M. Silverman, Maleeha, Ahmad, M. Hanna, A. Gabrovsek, Jian Jin, W. Tang, R. Grimm, L. Cho, B. Griffin, S. Flamm, Deborah H Kwon

{"title":"Performance and Accuracy of Natural Language Processing to Identify Disease Aetiology from Non-Structured Cardiac MRI Electronic Medical Record Reports","authors":"D. Kocyigit, A. Milinovich, Chan M. Lee, M. Silverman, Maleeha, Ahmad, M. Hanna, A. Gabrovsek, Jian Jin, W. Tang, R. Grimm, L. Cho, B. Griffin, S. Flamm, Deborah H Kwon","doi":"10.33590/emjcardiol/2009142","DOIUrl":"https://doi.org/10.33590/emjcardiol/2009142","url":null,"abstract":"The utility of cardiac MRI (CMR) in patients with heart failure has been well demonstrated and continues to expand as MRI techniques evolve. Its main superiorities in this patient population include: accurate and reproducible quantification of ventricular systolic functions; enhanced discrimination of abnormal myocardial tissue characteristics (i.e., oedema, interstitial fibrosis, and replacement fibrosis); and assessment of valvular function/morphology, endocardium and pericardium in a single scan.1,2\u0000\u0000CMR is now an essential part of the diagnosis of various types of heart failure, including cardiac amyloidosis, cardiac sarcoidosis, myocarditis, arrhythmogenic right ventricular cardiomyopathy, and iron overload cardiomyopathy. CMR findings also have prognostic implications, such as in hypertrophic cardiomyopathy.1,2These have resulted in an increasing demand and utility of CMR in routine clinical practice. However, the synthesis of imaging findings into a final or differential diagnosis is typically written in free-text, resulting in difficulties with accurately categorising cardiomyopathy types by generic query algorithms.\u0000\u0000Natural language processing (NLP) is an analytical method that has been used to develop computer-based algorithms that handle and transform natural linguistics so that the information can be used for computation.3 It enables gathering and combining of information extracted from various online databases, and helps create solid outputs that could serve as research endpoints, including sample identification and variable collection. In the field of imaging, NLP may also have several clinical applications, such as highlighting and classifying imaging findings, generating follow-up recommendations, imaging protocols, and survival prediction models.4","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121900580","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}

引用次数: 0