Heart Views最新文献

{"title":"Relationship of Microalbuminuria with Ischemic Heart Disease in Nondiabetic Subjects.","authors":"Ankit Jain, Vikas Kumar, Kunal Shrimal","doi":"10.4103/heartviews.heartviews_114_23","DOIUrl":"10.4103/heartviews.heartviews_114_23","url":null,"abstract":"<p><strong>Background: </strong>Microalbuminuria has been established as a marker for increased cardiovascular risk in diabetic patients. Nonetheless, its correlation with ischemic heart disease (IHD) among individuals without diabetes has received limited attention. The current study was performed to explore the potential link between microalbuminuria and IHD in nondiabetic subjects.</p><p><strong>Methodology: </strong>During 2 years, a case-control study was executed, encompassing 100 individuals without diabetes who had IHD as cases, and an equal number of 100 non-IHD controls. Microalbuminuria levels were evaluated alongside diverse cardiovascular risk factors in both sets. IBM-SPSS version 25.0 was used for statistical analysis.</p><p><strong>Results: </strong>The mean age, gender distribution, and body mass index were similar between the cases and controls. There was a higher prevalence of smokers and alcohol users among the cases compared to controls. In addition, a positive family history of IHD was more prevalent in the case group. In the case group, the mean values of systolic blood pressure, diastolic blood pressure, mean arterial pressure, fasting blood glucose, cholesterol, low-density lipoprotein (LDL), serum creatinine, and urine albumin levels were notably elevated compared to the control group. A significant increase in microalbuminuria levels in the case group was observed.</p><p><strong>Conclusion: </strong>The results reveal a substantial link between microalbuminuria and IHD in individuals without diabetes. Microalbuminuria was independently correlated with major cardiovascular risk factors, including alcohol and cigarette use, and higher levels of cholesterol, LDL, and serum creatinine. These findings suggest that urine albumin measurements could serve as an early marker for identifying cardiovascular disease risk factors and potentially aid in preventive interventions in the general population.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"28-33"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972070","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":"Transcatheter Aortic Valve Implantation for Severe Aortic Insufficiency Due to Infective Endocarditis in a Patient with Cirrhosis and Hepatocellular Cancer: A Novel Indication.","authors":"Salem Abujalala, Huseyin Ede, Waleed Khalid Abdullatef, Mohammed Ahmad Al-Hijji","doi":"10.4103/heartviews.heartviews_139_23","DOIUrl":"10.4103/heartviews.heartviews_139_23","url":null,"abstract":"<p><p>Infective endocarditis (IE) of the native aortic valve (AV) secondary to <i>Streptococcus infantarius</i> is subacute, a highly destructive pathology leading to aortic regurgitation (AR) and severe cardiac complications such as progressively deteriorating heart failure. In these cases, valvular correction with surgery may not be the optimal option because of multiple chronic illnesses and the use of medications. Although transcatheter AV implantation (TAVI) is a well-known, established alternative method to surgical replacement in patients with severe aortic stenosis, it can be a good alternative in patients with severe AR in whom valvular surgery is not an option due to comorbidities. Here, we presented a case of TAVI in a patient with cirrhosis, hepatocellular cancer, and symptomatic severe AR due to <i>S. infantarius</i> IE.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"43-47"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972110","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":"A Retroperitoneal Paraganglioma Presenting as Acute Coronary Syndrome: A Rare Case Report and Literature Review.","authors":"Abhishek Mishra, Shalendra Singh, Ankit Mathur, Anil Kumar Abbot","doi":"10.4103/heartviews.heartviews_117_23","DOIUrl":"10.4103/heartviews.heartviews_117_23","url":null,"abstract":"<p><p>Paragangliomas are catecholamine-secreting tumors arising from the sympathetic and parasympathetic ganglia. Here, we describe a case in which a young man who had visited the emergency room complaining of headache and shortness of breath was later found to have acute coronary syndrome with accompanying cardio-pulmonary complications necessitating immediate cardiac intervention. Later on, during further management, he was diagnosed with a retroperitoneal paraganglioma. Thus, we try to emphasize the need for a high clinical index of suspicion and urgent radio-imaging for diagnosing this relatively rare clinical entity to prevent fatal outcomes or any long-term morbidity.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"62-66"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972109","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":"Pulsed-field Ablation for Paroxysmal and Persistent Atrial Fibrillation: A Single-center Experience.","authors":"Saleh Albasiri, Amr A Arafat, Ahmed Al Fagih, Lamia Alshengeiti, Khalid A Dagriri, Manal N Alkahtani, Hind Alanazi, Yahya Al Hebaishi","doi":"10.4103/heartviews.heartviews_132_23","DOIUrl":"10.4103/heartviews.heartviews_132_23","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) increases morbidity and mortality. Traditional catheter ablation techniques have limitations. Pulsed-field ablation (PFA) is a new nonthermal ablation method aiming to eliminate arrhythmogenic tissue while minimizing collateral damage. The study reported the initial experience of the prince sultan cardiac center with PFA and the learning curve.</p><p><strong>Patients and methods: </strong>This retrospective study included 33 patients with paroxysmal or persistent AF who underwent ablation with the PFA technique from 2022 to 2023. The study outcomes included short-term and follow-up complications and AF recurrence.</p><p><strong>Results: </strong>The mean age was 48.52 ± 13.97 years, and 24 patients were males (72.73%). Hypertension was the most common comorbidity encountered in 11 patients (33.33%). Thirteen patients (39.39%) were on antiarrhythmic medications, and 26 (78.79%) were on nonvitamin K-dependent oral anticoagulation. The most common indication was symptomatic paroxysmal AF (<i>n</i> = 28; 84.85%). The preprocedural left atrial diameter was 41.82 ± 14.78 mm, and the ejection fraction was 51.36% ±8.41%. The left atrial ablation time was 45.38 ± 17.96 min, the fluoroscopy time was 33.45 ± 15.60 min, and the procedure time was 77.55 ± 19.73 min. No complications were reported postprocedurally or at 3 or 6 months. One patient had recurrent AF; one developed atrial flutter after 9 months and underwent ablation.</p><p><strong>Conclusions: </strong>Pulmonary vein isolation using PFA for paroxysmal and persistent AF might be a safe and effective procedure. Future long-term studies comparing PFA with other ablation techniques are recommended.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"1-6"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972080","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":"Impact of Myocardial Fibrosis in Endurance Athletes: A Systematic Review.","authors":"Rasha Kaddoura, Hassan Al-Tamimi","doi":"10.4103/heartviews.heartviews_13_23","DOIUrl":"10.4103/heartviews.heartviews_13_23","url":null,"abstract":"<p><p>Regular physical exercise is undoubtedly associated with cardiovascular health benefit, increased longevity, and improved endurance performance. Competitive endurance athletes exceed the recommended exercise dose, which lead to pathologic cardiac remodeling such as myocardial fibrosis. This review examines the impact of myocardial fibrosis on atrial and ventricular structures and functions in endurance athletes. A systematic literature search identified eight trials that enrolled 470 athletes. The prevalence of myocardial fibrosis ranged from 13% to 48%, which was commonly of a focal nonischemic pattern. The included studies did not find consistent results on the impact of myocardial fibrosis on ventricular function and volume parameters. Moreover, the prognostic implications of myocardial fibrosis on patient clinical outcomes, such as arrhythmias and mortality, were not reported as there was no long-term follow-up. There is a clear unmet need to encourage larger studies on myocardial fibrosis phenotypes to shed more light on the underlying mechanism, clinical consequences, and prognosis.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"34-42"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972085","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":"Lithium-induced Ebstein's Anomaly.","authors":"Vijaykumar Gupta, Priyavardhan Mishra, Priyanka Mirdha, Anant Patil","doi":"10.4103/heartviews.heartviews_72_24","DOIUrl":"10.4103/heartviews.heartviews_72_24","url":null,"abstract":"<p><p>Ebstein's anomaly (EA) is a rare congenital cardiac defect that occurs when the tricuspid valve leaflets fail to delaminate from the ventricular myocardium, they adhere to the underlying myocardium. Multiple etiologies such as genetic mutation in NKX2-5, family history of congenital cardiac anomalies, and exposure to teratogen such as lithium are associated with this rare cardiac anomaly. In our case, we present an undiagnosed adolescent male with EA who was exposed to lithium during organogenesis.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 4","pages":"267-269"},"PeriodicalIF":0.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249964","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":"A Rare Case of Sudden Death due to Rupture of Saccular Descending Thoracic Aortic Aneurysm with Dissection.","authors":"Jayeshkumar Kanani, Kunjan Modi","doi":"10.4103/heartviews.heartviews_100_24","DOIUrl":"10.4103/heartviews.heartviews_100_24","url":null,"abstract":"<p><p>Ruptured descending thoracic aortic aneurysm (DTAA) is a rare event and remains asymptomatic in over 95% of cases, often leading to the under-detection of most thoracic aortic aneurysms (TAAs) unless incidentally discovered during routine imaging, medical examinations, or autopsy following sudden death. This case report presents a 56-year-old male with a history of hypertension and diabetes mellitus who was managed with regular medication, collapsed suddenly, and was found unconscious. Emergency medical services declared him dead on arrival. An autopsy examination disclosed 2750 g of blood in the left pleural cavity and a 2.5 cm transverse tear in a saccular aneurysm on the descending thoracic aorta with aortic dissection (AD). Histopathological analysis confirmed necrosis, fibrosis, and a mixed inflammatory infiltrate at the rupture site, with features consistent with healed myocardial infarction and grade VII atherosclerosis. This case underscores the importance of recognizing the silent yet fatal nature of saccular aneurysms in the descending thoracic aorta.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 4","pages":"270-274"},"PeriodicalIF":0.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249947","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 Electrocardiographic Conundrum in a Patient on Methadone Maintenance Therapy and Cannabis Coingestion: A Case Report of a Heartbreaking Puzzle.","authors":"Muhammad Adnan Zaman, Amna Amir, Lou Mastrine","doi":"10.4103/heartviews.heartviews_124_24","DOIUrl":"10.4103/heartviews.heartviews_124_24","url":null,"abstract":"<p><p>Methadone is considered relatively safe when compared to other opioids. Methadone, however, can cause respiratory depression and QT prolongation. Among patients on methadone maintenance therapy, the rate of cannabis use is high. Multiple hypotheses, including the 'exit hypothesis' or 'the cannabis association with reduced opioid use,' need validation and further research. In this article, we present an interesting case of a 29-year-old female on methadone maintenance therapy for fifteen years who presented with methadone toxicity likely induced by systemic infection and cannabis co-ingestion. The patient had multiple cardiotoxic effects, including prolonged QT interval managed by antiarrhythmic medications, ST-segment elevation, and stress-induced cardiomyopathy managed conservatively. In this case report, the authors want to highlight the possible effects of methadone and cannabis co-injection, methadone toxicity induced by systemic infections, and increased awareness of these potentially catastrophic cardiotoxic effects in patients on high-dose methadone maintenance therapy.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 4","pages":"275-279"},"PeriodicalIF":0.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249971","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":"Outcomes of Fractional Flow Reserve-guided Deferred Coronary Revascularization.","authors":"Mohammad Reza Beyranvand, Mehdi Sheibani, Hana Mirzabeigi, Hootan Manhoobi","doi":"10.4103/heartviews.heartviews_76_24","DOIUrl":"10.4103/heartviews.heartviews_76_24","url":null,"abstract":"<p><strong>Context: </strong>Fractional flow reserve (FFR) is used to assess the functional significance of intermediate coronary stenosis. An FFR value of 0.80 or less identifies significant lesions, whereas higher values do not require revascularization. The rate of deferred lesion revascularization (DLR) differs among studies.</p><p><strong>Aims: </strong>This study aims to evaluate the outcome of deferring revascularization in intermediate coronary stenoses in angiography with nonischemic values in FFR assessment.</p><p><strong>Settings and design: </strong>This study was conducted in a single center from March 2013 to August 2017.</p><p><strong>Subjects and methods: </strong>The study involved patients diagnosed with moderate (50%-69%) coronary stenosis and noninfarcted FFR (>0.8). All patients were followed up, and total mortality and DLR were recorded.</p><p><strong>Statistical analysis used: </strong>Fisher exact statistical test was used to compare descriptive variables, and the Mann-Whitney statistical test was used for quantitative variables.</p><p><strong>Results: </strong>There were 115 patients with a mean age of 58.35 ± 10.07 years; 71 (61.7%) were male. The mean (range) follow-up period was 32 ± 15 (6-60) months. The mortality rate was 0.8%, and 4.8% of patients had revascularization during the follow-up period.</p><p><strong>Conclusions: </strong>Deferring revascularization and medical management for intermediate coronary lesions with nonischemic FFR (>0.8) are a safe strategy.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 4","pages":"223-228"},"PeriodicalIF":0.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249967","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":"Novel Approach in Treatment of Coarctation of the Aorta with Bifurcation Stenosis of the Left Subclavian Artery - The Road Less Traveled.","authors":"Prashant Bharadwaj, Amanpreet Singh Wasir, Hemali Passwala, Vaibhav Patil","doi":"10.4103/heartviews.heartviews_64_24","DOIUrl":"10.4103/heartviews.heartviews_64_24","url":null,"abstract":"<p><p>Endovascular stenting has emerged as the preferred treatment modality for coarctation of the aorta (CoA). However, CoA can sometimes extend beyond the aortic arch, involving adjacent vessels such as the left subclavian artery (LSA), which complicates conventional interventions. We present a case of CoA associated with proximal LSA stenosis which was successfully treated using a double-wire stent technique. The technique does not compromise the LSA flow and offers a promising alternative in complex CoA cases. A 19-year-old female presented with palpitations with dyspnea (New York Heart Association grade III) for 15 days. She also gave a history of intermittent claudication in the left upper limb for 3 years. Clinical examination revealed pallor and weak pulses in the left upper extremity and both lower extremities, with radio-radial and radio-femoral delays. Blood pressure measurements indicated significant gradients between the limbs, with readings of 244/112 mmHg in the right upper limb, 162/104 mmHg in the left upper limb, and 114/74 mmHg and 116/78 mmHg in the right and left lower limbs, respectively. Auscultation revealed normal S1 and S2 and a systolic murmur in the right interscapular area. Electrocardiogram revealed sinus arrhythmia with T-wave inversions in leads II, aVF, and V1-V6. Echocardiogram revealed severe postductal coarctation with a gradient of 84 mmHg. Computed tomography aortography confirmed a severe coarctation-preductal diameter of 12 mm and postductal diameter of 14 mm, with a concomitant LSA stenosis of 7 mm. The critical challenge in this case was stenting the coarctation without compromising the already symptomatic LSA stenosis. A novel endovascular approach was employed, utilizing two preplaced wires in both the aorta and LSA, followed by deployment of an uncovered stent and final kissing balloon angioplasty. This is the first instance in literature of such an approach being taken. Patients with CoA with associated bifurcation stenosis of the LSA are extremely rare and pose significant challenges for endovascular management. This case highlights a novel and effective interventional strategy, offering a tailored approach to preserve LSA patency while addressing the complex CoA anatomy.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 4","pages":"260-263"},"PeriodicalIF":0.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249966","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}