Journal of Asian Pacific Society of Cardiology最新文献

{"title":"Multisystem Inflammatory Syndrome in an Adult: A Rare Cause of ST-Segment Elevation MI","authors":"Billy Joseph David, R. Tugade, Ferdinand R Gerodias","doi":"10.15420/japsc.2023.23","DOIUrl":"https://doi.org/10.15420/japsc.2023.23","url":null,"abstract":"The COVID-19 pandemic is a significant worldwide health emergency. Due to the high incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are increasingly recognisable early and long-term outcomes of the disease. One of the uncommon complications of SARS-CoV-2 infection is multisystem inflammatory syndrome in adults (MIS-A). This is a post-sequela of SARS-CoV-2 infection associated with hyperinflammatory syndrome accompanied by extrapulmonary organ dysfunction. The prevalence of MIS-A ranges from 0.2% to 11.7% of the studied SARS-CoV-2 infection cases. The lack of awareness of this condition and unusual constellation of symptoms makes its management challenging. A 36-year-old woman who had a recent SARS-CoV-2 infection presented with chest pain and hypotension. An ECG showed ST-segment elevation in the anteroseptal wall, elevated cardiac enzymes and inflammatory markers. Transthoracic echocardiogram revealed segmental hypokinesia with a mildly reduced ejection fraction of 41%. Coronary angiogram showed normal arteries. A diagnosis of MIS-A was considered and the patient was started on steroids and IV immunoglobulin.","PeriodicalId":321604,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"175 11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139221435","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":"Fat Embolisation in Managing an Iatrogenic Expanding Femoral Artery Pseudoaneurysm","authors":"R. Shariff, R. Khir, S. Kasim","doi":"10.15420/japsc.2022.20","DOIUrl":"https://doi.org/10.15420/japsc.2022.20","url":null,"abstract":"Femoral artery pseudoaneurysm (FAP) is a known complication of femoral artery access. We report a novel case of rapid FAP expansion treated using subcutaneous fat embolisation. A 61-year-old woman became unwell following removal of her right femoral sheath used for a percutaneous coronary intervention. Examination revealed a large femoral haematoma. Bedside ultrasound confirmed a FAP with active expansion. A decision was made to perform a peripheral intervention to manage the pseudoaneurysm. As initial attempts at prolonged balloon inflation failed, subcutaneous fat embolisation was performed as a last attempt in sealing the pseudoaneurysm neck, which was successful. Common risk factors for femoral artery pseudoaneurysm include increasing age, obesity, being a woman, hypertension and a low femoral puncture site and these were all present in this patient. Haemodynamically unstable patients warrant surgical intervention although endovascular interventions have also been successfully reported in the literature. Our case report highlights how subcutaneous fat remains a viable option if embolisation is attempted in a resource-limited setting.","PeriodicalId":321604,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139222909","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":"Mid-term Follow-up of Arch Vessel Angioplasty in Patients with Takayasu Arteritis","authors":"A. Bagchi, S. Tyagi, A. Bansal, M. Gupta, G. Mp","doi":"10.15420/japsc.2023.08","DOIUrl":"https://doi.org/10.15420/japsc.2023.08","url":null,"abstract":"Background: We performed a prospective longitudinal study to report the mid-term follow-up of arch vessel angioplasty in patients with Takayasu’s arteritis following the use of self-expanding stents (SES) or balloon-expandable stents (coronary drug-eluting stents [DES] or peripheral bare metal stents). Methods: Eighteen consecutive Takayasu’s arteritis patients with arch vessel involvement undergoing angioplasty were included in the study. Ostial lesions were treated with DES; other lesions were treated with SES. Twelve patients were treated with 15 SES and eight patients were treated with 14 DES. Lesions were quantified by quantitative angiography before and after the procedure and during check-up angiography at 6 months to compare lumen dimensions with the immediate post-procedural results. Check-up angiography was performed in 10 patients with 13 SES and in six patients with DES. Results: SES had an immediate mean (±SD) lumen gain of 2.95 ± 1.1 mm. At 6 months, although there was a lumen loss of 2.01 ± 1.13 mm, there was a persistent mean lumen gain of 0.94 ± 1.16 mm. Similarly, DES resulted in an immediate mean lumen gain of 2.01 ± 1.13 mm, with a lumen loss of 1.6 ± 0.8 mm, but a persistent mean lumen gain of 0.40 ± 1.26 mm, at 6 months. Conclusion: We showed that both SES and DES may be used to treat patients with arch vessel involvement, with comparable results at the 6-month follow-up, and could provide these patients with significant and persistent symptom relief.","PeriodicalId":321604,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"166 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139225198","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":"Left Main Rotablation: Case Series From a Tertiary Care Centre in North India","authors":"Himanshu Gupta, S. Verma, Y. Sharma, Navjyot Kaur, K. A. Ary","doi":"10.15420/japsc.2023.30","DOIUrl":"https://doi.org/10.15420/japsc.2023.30","url":null,"abstract":"Background: Calcified left main (LM) disease is an important subset of coronary artery disease, associated with a high risk and procedural complexity. Advances in percutaneous coronary intervention (PCI) are making it a viable alternative to coronary artery bypass grafting. Methods: This was a retrospective study of patients aged ≥18 years who underwent rotational atherectomy (RA)-assisted PCI of LM disease at a tertiary-care centre in North India from August 2018 to May 2023. PCIs also involved use of intravascular ultrasound and adjuvant plaque-modifying therapies, such as cutting balloons, and intravascular lithotripsy, as indicated. Procedural details and clinical outcomes were analysed. Results: The study included 55 consecutive patients. A total of 52 patients (94.5%) were men, and the mean age was 64.7 ± 9.0 years. The mean follow-up was 16.3 ± 11.2 months. The mean ejection fraction was 52.7 ± 8.2%. On angiography, the mean SYNTAX score was 34.9 ± 7.7, and true bifurcation lesions (Medina class 1,1,1 or 1,1,0) were present in 22 patients (40%). Adjuvant plaque modification therapy included a cutting balloon in 25 patients (45.5%), and intravascular lithotripsy in nine (16.4%). Intravascular ultrasound guidance was used in 46 patients (83.6%). Supported PCI was performed in six cases (10.9%). Angiographic success was achieved in 100% of the patients. One patient (1.8%) died in hospital due to an upper gastrointestinal bleed. On follow-up, one patient died (1.8%), and target vessel revascularisation was needed for three patients (5.5%). Conclusion: Rotational atherectomy-assisted PCI for calcific LM disease can be performed safely, with judicious use of intravascular ultrasound and adjunct plaque modification therapies, providing satisfying short- to medium-term outcomes.","PeriodicalId":321604,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139225879","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":"Asian Pacific Society of Cardiology Consensus Statement on Management of Coronary Artery Disease in Adults with Late Complications of Kawasaki Disease","authors":"K. Yeo, R. Fukazawa, Mamoru Ayusawa, Ming-Tai Lin, Koji Maemura, Paul Tern, Sofian Johar, Oktavia Lilyasari, Aurelia Leus, S. Lo, Hiroyoshi Yokoi, Y. Mitani","doi":"10.15420/japsc.2022.30","DOIUrl":"https://doi.org/10.15420/japsc.2022.30","url":null,"abstract":"Despite reductions in the mortality of Kawasaki disease with advances in its treatment, a proportion of patients still develop coronary artery dilatation that may persist even into adulthood. These lesions carry an increased risk of myocardial ischaemia and infarction. However, published clinical guidelines on the management and long-term follow up of patients with these late complications of Kawasaki disease are limited. The Asian Pacific Society of Cardiology convened an expert panel to review the available literature and develop consensus recommendations to guide clinicians in this area. The panel developed statements on the assessment and risk stratification of coronary artery disease, investigations for follow up, as well as considerations around treatment of stenotic lesions with medical therapy, percutaneous coronary intervention and coronary artery bypass grafting. Each statement was voted on by each panel member and consensus was reached when 80% of experts voted ‘agree’ or ‘neutral’. This process resulted in the development of consensus recommendations to guide cardiologists and internists in the follow up and management of patients with coronary artery lesions as a late complication of Kawasaki disease.","PeriodicalId":321604,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130766653","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":"Very High Risk of Recurrent Cardiovascular Events in Indonesian Patients with Established Coronary Heart Disease","authors":"D. S. Arsyad, Steven H J Hageman, N. Qalby, Ansariadi, Wahiduddin, A. Qanitha, Idar Mappangara, P. Doevendans, F. Visseren, M. Cramer","doi":"10.15420/japsc.2023.04","DOIUrl":"https://doi.org/10.15420/japsc.2023.04","url":null,"abstract":"Background: Risk prediction for recurrent cardiovascular events and death is advocated by prevention guidelines. Using the recently updated Secondary Manifestations of ARTerial disease (SMART)2 risk score algorithm – recalibrated and validated for the Asian population – we aim to describe the 10-year risk of recurrent events among coronary heart disease (CHD) patients, and to estimate the achievable residual risk after modifying the risk factors according to national guidelines. Methods: Patients at Makassar Cardiac Center Hospital, Indonesia, with established CHD were included. The 10-year recurrent event risk, residual risk and potential absolute risk reduction obtained with risk-factor reduction (systolic blood pressure <140 mmHg, LDL cholesterol <1.8 mmol/l, smoking cessation and use of antithrombotics) was estimated using the SMART2 risk score. Results: In total, 395 CHD patients were enrolled (mean age 57 ± 12 years; 64% men). The 10-year risk of recurrent events in the baseline was 36% (interquartile range 27–51); 65% of participants were considered as very high risk (risk ≥30%). If the risk factors were modified to the optimal targets, the residual risk would decrease to 23% (interquartile range 17–34). Nevertheless, one-third of patients remain in the very high risk category. Conclusion: The risk of recurrent events is extremely high in Indonesian CHD patients. Intensive preventive actions are required to reduce these extremely high risks, but a single, one-size approach is inappropriate due to the large variation in residual risks. Identifying patients that may benefit the most from intensified treatment is crucial, especially in regions where secondary prevention agents are often limited.","PeriodicalId":321604,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131089565","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":"Tricuspid Transcatheter Edge-to-edge Repair","authors":"Chak-yu So, Yiting Fan, Maolong Su, Yan Wang, B. He, Alex Pui-Wai Lee","doi":"10.15420/japsc.2022.41","DOIUrl":"https://doi.org/10.15420/japsc.2022.41","url":null,"abstract":"Tricuspid regurgitation (TR) is a common disease associated with significant morbidities and mortality. In this review, the new grading scheme of TR, the tricuspid valve anatomy and also the different TR mechanisms are summarised. Recently, there have been many evolving technologies to treat TR, and transcatheter edge-to-edge repair is one of the most well-established techniques. Transcatheter edge-to-edge repair is shown to be effective in TR reduction. With increasing clinical experience, a number of echocardiographic predictors of optimal TR reduction have been identified, and a standardised transoesophageal echocardiogram protocol and also different techniques to improve the procedural success are presented. Finally, the uncertainties on the optimal timing of TR intervention and on the clinical benefit of transcatheter edge-to-edge repair are also addressed.","PeriodicalId":321604,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130239747","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":"Influence of Salt Intake on Segmental Lesions of Patients with Ischaemic Heart Disease in Sri Lanka: A Cross-sectional Study","authors":"Harishchandra Amadoru, Rajitha Yasela De Silva, K.G.N.H. Weerasinghe, Maddage Damitha Nandana Gunaratne, P. Mahesh, Sumudu Prasangi Rupasinghe Siriwardena, P. Gamage, Kaluwelle Mudalige Vishva Randhara Alles, Uduwarage Thilini Randima Perera, Ravikaran Anthonypillai, Vasana Suriyaraachchi, Kankanamge Rasika Nuwan Wijesiri, Sajeewanie Nisansala Liyanage, A. Malwatta, Jayasekara Liyanaarachchige Prasanna Jayasekara, R. Jayatissa, A. Kapuruge","doi":"10.15420/japsc.2022.13","DOIUrl":"https://doi.org/10.15420/japsc.2022.13","url":null,"abstract":"Background: Sodium assists in maintaining body fluid balance. Excess sodium intake increases the risk of ischaemic heart disease (IHD) adding to global and local mortality due to non-communicable diseases. Aim: To determine the salt intake levels of patients having coronary artery bypass grafting (CABG) and to explain the relationship between salt consumption and atheroma development. This study used an adapted cross-sectional design with 233 patients admitted to Sri Jayewardenepura General Hospital with acute heart diseases. Method: Demographic and lifestyle-related data, medical history and food intake data were collected. Salt intake was calculated based on the consumption of salt used per month at household level, salt added to food – including in restaurants. Salt content was determined using web-based applications and food tables. Multivariate logistic regression was used to identify variables significantly associated with IHD. Results: In this study, the daily intake of sodium per person was 6,176 mg. This was much higher than WHO’s recommended level of 2,000 mg/day, demonstrating a significant relationship between segmental lesions and sodium intake (p<0.01). The multivariate binary logistic model demonstrated that high salt intake (OR 8.54; 95% CI [4.545–16.734]) and the presence of diabetes (OR 2.23; 95% CI [1.206–4.238]), contributed to the high number of segmental lesions (p<0.01). Conclusion: A high daily intake of sodium increases the risk of atheroma formation in more coronary segments, regardless of age, sex, several known disease conditions and risk factors.","PeriodicalId":321604,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126885845","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":"Evaluation of Subclinical Left Ventricular Systolic Dysfunction By Global Longitudinal Strain Using 2D Speckle Tracking Echocardiography in Angina With Normal Epicardial Coronary Arteries","authors":"C. M. Ahmed, D. M. F. Osmany, Mohammad Nizamul Hossain Sowdagar, S. Banerjee, M. Hoque","doi":"10.15420/japsc.2022.43","DOIUrl":"https://doi.org/10.15420/japsc.2022.43","url":null,"abstract":"Background: Global longitudinal strain (GLS), assessed by 2D speckle tracking echocardiography (2D-STE), may offer a valuable non-invasive method to assess subclinical left ventricular (LV) systolic dysfunction in patients with chest pain but normal epicardial coronary arteries. The primary objective of the study was to detect subclinical LV systolic dysfunction by GLS using 2D-STE in patients with angina with normal coronary arteries and conventional echocardiograms at baseline. Methods: This was a comparative case–control study that included patients with complaints of an ischaemic pattern of chest pain despite normal coronary arteries (cases) and healthy individuals (controls). Resting LV systolic function was assessed by transthoracic echocardiography and GLS using 2D-STE analysis. The results of all three planes in GLS (the apical four-chamber, two-chamber, and three-chamber views) were combined in a single ‘bull’s eye’ summary (agreeing with the standard 17-segment model), which presented the analysis of each segment along with a global peak systolic strain value for the LV. Results: The study included 120 participants (60 cases and 60 controls). The normal reference value of the mean GLS in the control group was −19.7 ± 1.84%. GLS assessed by 2D-STE was significantly impaired in patients with angina-like syndrome with normal epicardial coronary arteries (−18.78 ± 1.87 versus −19.7 ± 1.84%; p<0.007) compared with the control group despite preserved LV ejection fraction. In the case group, GLS reduced significantly in eight patients (13.3%) than control group. Conclusion: Patients with angina with normal epicardial coronary arteries are likely to have microvascular disease. GLS assessed by 2D-STE has the potential to improve the value of echocardiography in coronary microvascular disease detection. Despite normal LV ejection fraction, significant impairment of LV global longitudinal systolic function can differentiate a microvascular group of patients from others who have angina with normal coronaries.","PeriodicalId":321604,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"215 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132888041","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":"System Delays and Target Points: An Analysis of the ST-elevation MI Response Programme in a Single Centre","authors":"B. Toledano, K. B. Garganera, Jose Paolo A Prado, M. Sabas, Gregorio S Martinez","doi":"10.15420/japsc.2022.51","DOIUrl":"https://doi.org/10.15420/japsc.2022.51","url":null,"abstract":"Background: The goal in the treatment of ST-elevation MI (STEMI) is prompt revascularisation. This study aims to assess system delays and identify optimal target points within each step of the response program. Methods: This study included adults aged >19 years enrolled in the acute MI (AMI) registry due to STEMI and treated with emergency percutaneous coronary intervention (PCI) between January 2019 and June 2021. Door-to-balloon times and STEMI diagnosis-to-wire cross times were divided into Met and Unmet groups, and time frames were compared using the Mann–Whitney U-test. For time frames with no significant difference, the median of the Met group was adopted, whereas, for significantly different time frames, the optimal target points were chosen from the highest percentages of Met if the value was less than or equal to the target point and Unmet if the value was greater than the target point. ORs with 95% CIs from binary logistic regression were calculated to predict the Met status. Results: In all, 113 participants were analysed. Significant delays were observed in ECG to paging (p≤0.034), cardiology fellow on duty (CFOD) arrival to STEMI diagnosis (p=0.008), STEMI diagnosis to consent (p≤0.001), consent to cath lab (p≤0.001) and cath lab to puncture (p=0.003). The optimal targets in minutes were as follows: door to ECG (≤9 median), ECG to paging (≤1, OR 2.19, p=0.069), paging to CFOD arrival (≤2 median), CFOD arrival to STEMI diagnosis (≤3, OR 2.15, p=0.086), STEMI diagnosis to consent (≤10, OR 7.57, p≤0.001), consent to cath lab (≤24, OR 15.38, p≤0.001), cath lab to puncture (≤12, OR 2.68, p≤0.043). Conclusion: In a developing country and during the COVID-19 pandemic, the most significant delays in our STEMI programme occurred in obtaining consent for emergency PCI and transferring patients to the cath lab. Optimal target points for each time frame can provide concrete objectives that may increase the likelihood of achieving door-to-balloon time and STEMI diagnosis to wire cross goals.","PeriodicalId":321604,"journal":{"name":"Journal of Asian Pacific Society of Cardiology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131996082","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}