EMJ Cardiology最新文献_第7页

Reversal of Apixaban and Rivaroxaban Anticoagulation by Andexanet Alfa in ANNEXA-A and ANNEXA-R as Assessed by Non-Tissue Factor-Initiated Thrombin Generation Independent of Tissue Factor Pathway Inhibitor 独立于组织因子途径抑制剂的非组织因子启动凝血酶生成评估Andexanet Alfa对阿哌沙班和利伐沙班抗凝逆转ANNEXA-A和ANNEXA-R

EMJ Cardiology Pub Date : 2018-10-11 DOI: 10.33590/emjcardiol/10312045

Genmin Lu, Joyce Lin, M. Bronson, M. Crowther, P. Conley, J. Curnutte

引用次数: 0

The Cardiomyopathy of Iron Deficiency Anaemia 缺铁性贫血的心肌病

EMJ Cardiology Pub Date : 2018-10-11 DOI: 10.33590/emjcardiol/10313387

Shengda Song, Guangsen Li

{"title":"The Cardiomyopathy of Iron Deficiency Anaemia","authors":"Shengda Song, Guangsen Li","doi":"10.33590/emjcardiol/10313387","DOIUrl":"https://doi.org/10.33590/emjcardiol/10313387","url":null,"abstract":"Anaemia is a huge global health challenge. Iron deficiency (ID) is the most prevalent, preventable, and treatable cause of anaemia worldwide. ID anaemia (IDA) is frequent in patients with heart failure. ID is an important factor in the development of heart failure but is also considered a separate condition with unfavourable clinical and prognostic consequences. In this review, the authors narrate how IDA affects the myocardium, and the possible mechanisms surrounding this impact are described. The review summarises the pathological changes seen in ID cardiomyopathy via ECG, videography, and laboratory tests. Using these tests, the early changes in the myocardium of patients with IDA have been recognised, resulting in the identification of pivotal and developmental targets for improving the morbidity and mortality of patients with IDA. Some of the progress in treatment of IDA patients has also been described. Although IDA patients experience myocardium remodelling, patients can recover heart function through iron supplementation, such as using ferric carboxymaltose. In addition, this paper includes a discussion surrounding the sex differences of the disease; however, research on this aspect is limited and should form the focus of future investigations. The authors focus on myocardial changes in adults with acute or chronic IDA.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128243524","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: 3

A Comparison of Different Doses of Dexmedetomidine for Myocardial Protection in Percutaneous Coronary Interventional Patients 不同剂量右美托咪定对经皮冠状动脉介入患者心肌保护作用的比较

EMJ Cardiology Pub Date : 2018-10-11 DOI: 10.33590/emjcardiol/10311345

Tanveer Singh Kundra, P. S. Nagaraja, Parminder Kaur

{"title":"A Comparison of Different Doses of Dexmedetomidine for Myocardial Protection in Percutaneous Coronary Interventional Patients","authors":"Tanveer Singh Kundra, P. S. Nagaraja, Parminder Kaur","doi":"10.33590/emjcardiol/10311345","DOIUrl":"https://doi.org/10.33590/emjcardiol/10311345","url":null,"abstract":"Introduction: Dexmedetomidine has been shown to have a myocardial protective effect in off-pump coronary artery bypass patients. However, the same dosage of dexmedetomidine could not elicit a myocardial protective effect in percutaneous coronary intervention patients. The aim of this study was to assess the effect of different doses of dexmedetomidine when used for myocardial protection in percutaneous coronary interventional patients.\u0000\u0000Methodology: 240 patients (Group D1, treated with dexmedetomidine [n=80]; Group D2, treated with dexmedetomidine [n=80]; and the control group [C; n=80]) were enrolled in the study. Dexmedetomidine was administered over 15 minutes in the respective doses in Groups D1 and D2 at the start of the procedure, while normal saline was given to patients in Group C. Maintenance of dexmedetomidine/NS was started at 0.5 µg/kg/hour in the groups until 30 minutes post-procedure. Creatine phosphokinase (CPK) and CPK-MB, heart rate (HR), mean blood pressure (MAP), and sedation score were noted at baseline (T0), 6 hours (T1), 12 hours (T2), and 24 hours (T3) after the loading dose.\u0000\u0000Results: MAP and HR significantly decreased in D1 and D2 compared to C (p<0.05). None of the patients in D1 had a reduction in MAP <20% and HR <50 bpm; however, 3 patients in D2 had a clinically significant reduction in MAP, and 5 patients had HR <50 bpm. The patients in D2 were more sedated compared to patients in D1 and C. The difference in CPK and CPK-MB was significant at 6 hours, 12 hours, and 24 hours in D2.\u0000\u0000Conclusion: Dexmedetomidine 2 µg/kg provides myocardial protection compared to 1 µg/kg, but at the cost of a clinically significant decrease in MAP and HR. Patients who received dexmedetomidine 2 µg/kg were more sedated compared to patients receiving 1 µg/kg, warranting greater care during and post-procedure.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"29 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114129722","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

Treatment of Chronic Chagasic Patients: Is Killing the Parasite the Only Option? 慢性血吸虫病患者的治疗:杀死寄生虫是唯一的选择吗?

EMJ Cardiology Pub Date : 2018-10-11 DOI: 10.33590/emjcardiol/10313852

H. Rodríguez-Angulo

引用次数: 0

Cardioprotective Approaches to the Management of Patients with Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: Do We Need Increased Surveillance in Elderly Women on Trastuzumab? 人类表皮生长因子受体2阳性乳腺癌患者的心脏保护方法:我们是否需要增加老年妇女曲妥珠单抗的监测?

EMJ Cardiology Pub Date : 2018-10-11 DOI: 10.33590/emjcardiol/10313330

K. Rygiel, Lech Wędrychowicz, M. Lewicki

{"title":"Cardioprotective Approaches to the Management of Patients with Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: Do We Need Increased Surveillance in Elderly Women on Trastuzumab?","authors":"K. Rygiel, Lech Wędrychowicz, M. Lewicki","doi":"10.33590/emjcardiol/10313330","DOIUrl":"https://doi.org/10.33590/emjcardiol/10313330","url":null,"abstract":"Cardiotoxic effects in patients with breast cancer may present as asymptomatic left ventricular (LV) dysfunction or symptomatic LV decline, which can progress to overt heart failure (HF). Trastuzumab is a monoclonal antibody against human epidermal growth factor receptor (HER)2 and is a recommended targeted treatment for patients with overexpression of this receptor. However, the use of trastuzumab is associated with cardiotoxicity, manifested as LV dysfunction or HF. This review addresses the key issues related to individualised cardioprotection and surveillance, especially in elderly patients with HER2-positive breast cancer, based on the current cardio-oncology literature. Cardiac imaging techniques (e.g., echocardiography or multiple-gated acquisition scan) and biomarkers (e.g., cardiac troponins) that play a crucial role in the detection and monitoring of cardiotoxicity related to systemic therapies for breast cancer are briefly described. This review presents cardioprotective approaches, including interruption or termination of trastuzumab therapy, and treatment with an angiotensin-converting enzyme inhibitor, angiotensin-receptor blocker, or beta-blocker, which have been recommended for the reduction of cardiac adverse effects. Since the data relevant to cardiotoxicity of trastuzumab among real-world older women with breast cancer and cardiovascular diseases are still limited, this article focusses on improvements to the cardiac safety of trastuzumab-based regimens. In particular, this review emphasises the importance of intense surveillance in the elderly female population.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"217 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116232548","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

Protecting the Heart in Cancer Patients: The Role of Cardio-Oncology 保护癌症患者的心脏:心脏肿瘤学的作用

EMJ Cardiology Pub Date : 2017-10-12 DOI: 10.33590/emjcardiol/10313142

R. Krone

{"title":"Protecting the Heart in Cancer Patients: The Role of Cardio-Oncology","authors":"R. Krone","doi":"10.33590/emjcardiol/10313142","DOIUrl":"https://doi.org/10.33590/emjcardiol/10313142","url":null,"abstract":"Cardiac disease often impacts cancer therapy, from direct toxicity of cancer therapeutic agents to the coronary endothelium, the myocardium, heart valves, and other structures. This has spawned the development of cardio-oncology programmes, emphasising collaboration between oncologists and cardio-oncologists in order to develop cardiologists with expertise in understanding the impact of various cancer regimens on the heart and developing programmes to manage or prevent heart damage. Cardiac disease and cancer both become more common as people age, as such cardiac disease, including coronary disease, should be screened for and risk factors treated when possible. Cancer-caused cardiac damage is much more responsive to therapy if treated early, so protocols for monitoring heart function to identify early injury need to be established and followed. Newer measures of ventricular function can identify heart injury before a reduction in ejection fraction to permit early initiation of therapy, and protocols to utilise these measures need to be incorporated into routine surveillance. Research is underway to evaluate regimens for cardiac protection prior to the cancer therapy, but at present, the data do not permit broad recommendations.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123471204","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

Neutrophils in Acute Coronary Syndrome 急性冠脉综合征中的中性粒细胞

EMJ Cardiology Pub Date : 2017-10-12 DOI: 10.33590/emjcardiol/10314937

R. Kurup, S. Patel

{"title":"Neutrophils in Acute Coronary Syndrome","authors":"R. Kurup, S. Patel","doi":"10.33590/emjcardiol/10314937","DOIUrl":"https://doi.org/10.33590/emjcardiol/10314937","url":null,"abstract":"Acute coronary syndrome (ACS) encompasses a spectrum of clinical disorders of myocardial ischaemia or infarction, with atherosclerosis leading to coronary plaque formation the predominant disease process. Alterations of endothelial cell integrity involving atherosclerotic plaque surfaces, such as plaque rupture or erosion, can lead to atherothrombosis with subsequent interruption to myocardial blood supply. Over the past two decades, it has become increasingly apparent that inflammation plays a pivotal role in the initiation and progression of atherosclerosis. Inflammatory cytokines have been shown to correlate with the risk and burden of coronary artery disease and there is a growing body of evidence demonstrating the presence of various immune cells in atherosclerotic plaques and coronary thrombus specimens. Due to improved cellular detection methods compared to earlier studies, neutrophils are being increasingly recognised as a key player in the process of athero-inflammation. The aim of this review is to: i) outline the role of neutrophils in ACS and atherothrombosis, ii) describe the process of inflammasome-mediated release of inflammatory cytokines from neutrophils, and iii) discuss multiple parameters of neutrophil activity in ACS, including peripheral neutrophil/lymphocyte ratio; neutrophil microparticle release; expression of neutrophilic granular proteins, including myeloperoxidase, neutrophil elastase, and metalloproteinases; neutrophil extracellular traps release; tissue factor; and neutrophil-macrophage interactions.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126856180","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: 9

Cardiac Cachexia Syndrome 心脏恶病质综合征

EMJ Cardiology Pub Date : 2017-10-12 DOI: 10.33590/emjcardiol/10311709

Teresa Raposo André, A. Lopes Santos, Isabel Maria Mousinho de Almeida Galriça Neto

{"title":"Cardiac Cachexia Syndrome","authors":"Teresa Raposo André, A. Lopes Santos, Isabel Maria Mousinho de Almeida Galriça Neto","doi":"10.33590/emjcardiol/10311709","DOIUrl":"https://doi.org/10.33590/emjcardiol/10311709","url":null,"abstract":"Heart failure is a chronic, progressive, and incurable disease. Cardiac cachexia is a strong predictor of poor prognosis, regardless of other important variables. This review intends to gather evidence to enable recognition of cardiac cachexia, identification of early stages of muscle waste and sarcopenia, and improve identification of patients with terminal heart failure in need of palliative care, whose symptoms are no longer controlled by usual medical measures. The pathophysiology is complex and multifactorial. There are many treatment options to prevent or revert muscle waste and sarcopenia; although, these strategies are less effective in advanced stages of cardiac cachexia. In these final stages, symptomatic palliation plays an important role, focussing on the patient’s comfort and avoiding the ‘acute model’ treatment of aggressive, disproportionate, and inefficient care. In order to provide adequate care and attempt to prevent this syndrome, thus reducing its impact on healthcare, there should be improved communication between general practitioners, internal medicine physicians, cardiologists, and palliative care specialists since heart failure has an unforeseeable course and is associated with an increasing number of deaths and different levels of suffering.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121017952","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: 4

Ectopic Beats: How Many Count? 异位心跳:有多少次算?

EMJ Cardiology Pub Date : 2017-10-12 DOI: 10.33590/emjcardiol/20175188-92

Rupert Simpson, Jessica Langtree, Andrew R J Mitchell

引用次数: 6

Pathophysiology of Ischaemic Mitral Valve Prolapse: A Review of the Evidence and Implications for Surgical Treatment 缺血性二尖瓣脱垂的病理生理学:手术治疗的证据和意义的回顾

EMJ Cardiology Pub Date : 2017-10-12 DOI: 10.33590/emjcardiol/10314035

F. Nappi, C. Spadaccio, M. Chello

{"title":"Pathophysiology of Ischaemic Mitral Valve Prolapse: A Review of the Evidence and Implications for Surgical Treatment","authors":"F. Nappi, C. Spadaccio, M. Chello","doi":"10.33590/emjcardiol/10314035","DOIUrl":"https://doi.org/10.33590/emjcardiol/10314035","url":null,"abstract":"Ischaemic mitral prolapse (IMP) is a pathologic entity encountered in about one-third of patients undergoing surgery for ischaemic mitral regurgitation. IMP is generally the result of a papillary muscle injury consequent to myocardial infarction, but the recent literature is progressively unveiling a more complex pathogenesis. The mechanisms underlying its development are the impairment of one or more components of the mitral apparatus, which comprises the annulus, chordae tendineae, papillary muscle, and left ventricular wall. IMP is not only a disorder of valvular function but also entails coexistent aspects of a geometric disturbance of the mitral valve configuration and of the left ventricular function and dimension. A correct understanding of all these aspects is crucial to guide and tailor the correct therapeutic strategy to be adopted. Localisation of prolapse and anatomic features of the prolapsed leaflets and the subvalvular apparatus should be carefully evaluated as also constituting the major determinants defining patient outcomes. This review will summarise our current understanding of the pathophysiology of and clinical evidence on IMP, with a particular focus on surgical treatment.","PeriodicalId":284912,"journal":{"name":"EMJ Cardiology","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131298689","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