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Association of Arterial Carbon Dioxide Tension Following In-Hospital Cardiac Arrest With Survival and Favorable Neurologic Outcome. 院内心脏骤停后动脉二氧化碳张力与存活率和良好神经系统预后的关系
Critical Pathways in Cardiology Pub Date : 2024-06-01 Epub Date: 2024-02-19 DOI: 10.1097/HPC.0000000000000350
Natalie Millet, Sam Parnia, Yevgeniy Genchanok, Puja B Parikh, Wei Hou, Jignesh K Patel
{"title":"Association of Arterial Carbon Dioxide Tension Following In-Hospital Cardiac Arrest With Survival and Favorable Neurologic Outcome.","authors":"Natalie Millet, Sam Parnia, Yevgeniy Genchanok, Puja B Parikh, Wei Hou, Jignesh K Patel","doi":"10.1097/HPC.0000000000000350","DOIUrl":"10.1097/HPC.0000000000000350","url":null,"abstract":"<p><strong>Background: </strong>In-hospital cardiac arrest (IHCA) continues to be associated with high morbidity and mortality. The objective of this study was to study the association of arterial carbon dioxide tension (PaCO2) on survival to discharge and favorable neurologic outcomes in adults with IHCA.</p><p><strong>Methods: </strong>The study population included 353 adults who underwent resuscitation from 2011 to 2019 for IHCA at an academic tertiary care medical center with arterial blood gas testing done within 24 hours of arrest. Outcomes of interest included survival to discharge and favorable neurologic outcome, defined as Glasgow outcome score of 4-5.</p><p><strong>Results: </strong>Of the 353 patients studied, PaCO2 classification included: hypocapnia (PaCO2 <35 mm Hg, n = 89), normocapnia (PaCO2 35-45 mm Hg, n = 151), and hypercapnia (PaCO2 >45 mm Hg, n = 113). Hypercapnic patients were further divided into mild (45 mm Hg < PaCO2 ≤55 mm Hg, n = 62) and moderate/severe hypercapnia (PaCO2 > 55 mm Hg, n = 51). Patients with normocapnia had the highest rates of survival to hospital discharge (52.3% vs. 32.6% vs. 30.1%, P < 0.001) and favorable neurologic outcome (35.8% vs. 25.8% vs. 17.9%, P = 0.005) compared those with hypocapnia and hypercapnia respectively. In multivariable analysis, compared to normocapnia, hypocapnia [odds ratio (OR), 2.06; 95% confidence interval (CI), 1.15-3.70] and hypercapnia (OR, 2.67; 95% CI, 1.53-4.66) were both found to be independently associated with higher rates of in-hospital mortality. Compared to normocapnia, while mild hypercapnia (OR, 2.53; 95% CI, 1.29-4.97) and moderate/severe hypercapnia (OR, 2.86; 95% CI, 1.35-6.06) were both independently associated with higher in-hospital mortality compared to normocapnia, moderate/severe hypercapnia was also independently associated with lower rates of favorable neurologic outcome (OR, 0.28; 95% CI, 0.11-0.73), while mild hypercapnia was not.</p><p><strong>Conclusions: </strong>In this prospective registry of adults with IHCA, hypercapnia noted within 24 hours after arrest was independently associated with lower rates of survival to discharge and favorable neurologic outcome.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933346","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
Sex-Age Interplay Among Young Aged Egyptians With First Acute Myocardial Infarction. 首次发生急性心肌梗死的埃及年轻人中性别与年龄的相互作用
Critical Pathways in Cardiology Pub Date : 2024-06-01 Epub Date: 2023-12-29 DOI: 10.1097/HPC.0000000000000345
Ibtesam I El-Dosouky, Montaser M El Seqelly, Ahmed M Ebrahiem, Mohamed Abdelhady Mohamed
{"title":"Sex-Age Interplay Among Young Aged Egyptians With First Acute Myocardial Infarction.","authors":"Ibtesam I El-Dosouky, Montaser M El Seqelly, Ahmed M Ebrahiem, Mohamed Abdelhady Mohamed","doi":"10.1097/HPC.0000000000000345","DOIUrl":"10.1097/HPC.0000000000000345","url":null,"abstract":"<p><strong>Background: </strong>The burden of modifiable risk factors in young Egyptian adults presenting with first acute myocardial infarction (AMI), sex differences, sex-age interplay, and its relationship with demographic, angiographic characteristics, and type of AMI is a good topic for discussion.</p><p><strong>Methods: </strong>The study enrolled 165 young (≤45 years old) consecutive, eligible patients diagnosed with first AMI (ST-elevation myocardial infarction, non-ST-elevation myocardial infarction), for their demographic, angiographic, echocardiographic, and laboratory investigations and gender differences.</p><p><strong>Results: </strong>Our population were 29-45 years old and 12.1% were females, most of whom had ST-elevation myocardial infarction; obesity in females and smoking in males were the most prevalent; and the younger the age of females presenting with AMI the more aggressive underlying risk factors and the more reduction in left ventricular ejection fraction. Most of the female culprit lesions were thrombotic and the severity of atherosclerotic culprit lesions correlated positively with blood pressure.</p><p><strong>Conclusions: </strong>The age paradox in young females (regarding left ventricular ejection fraction and the traditional risk factors) and the thrombotic nature of the culprit lesion mandate early intensive 1-year and 2-year preventive strategies against coronary heart disease (CHD) with special concern for obesity as the main trigger early in life with proper control of blood pressure. In males, smoking cessation programs are the main target to ameliorate the progress of CHD hand in hand with the other 1-year and 2-year preventive strategies of CHD.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404696","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
Validity of the Triglyceride-Glucose Indices for Predicting the Severity of Coronary Artery Disease in Patients With Nondiabetic Chronic Coronary Syndrome. 甘油三酯-葡萄糖指数预测非糖尿病慢性冠状动脉综合征患者冠状动脉疾病严重程度的有效性。
Critical Pathways in Cardiology Pub Date : 2024-06-01 Epub Date: 2024-02-15 DOI: 10.1097/HPC.0000000000000348
Ibtesam I El-Dosouky, Ahmed S Ammar, Abdelmaaboud Ahmed Abdelmaaboud, Moataz A Elkot
{"title":"Validity of the Triglyceride-Glucose Indices for Predicting the Severity of Coronary Artery Disease in Patients With Nondiabetic Chronic Coronary Syndrome.","authors":"Ibtesam I El-Dosouky, Ahmed S Ammar, Abdelmaaboud Ahmed Abdelmaaboud, Moataz A Elkot","doi":"10.1097/HPC.0000000000000348","DOIUrl":"10.1097/HPC.0000000000000348","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index was shown to be an independent predictor of coronary artery disease (CAD) progression and prognosis. However, whether the TyG index can predict the severity of CAD in nondiabetic patients with chronic coronary syndrome remains unclear.</p><p><strong>Methods: </strong>A total of 118 individuals who underwent elective coronary angiography were classified into group A (59 with coronary lesions) and group B (59 with normal coronary arteries; as a control group) after coronary angiography and laboratory tests for fasting and the postprandial (PP) TyG index. The complexity of CAD was determined by the Synergy Between Percutaneous Coronary Intervention (SYNTAX) score (SYNTAX score >22 indicated moderate-high risk), and patients diagnosed with diabetes or prediabetes were excluded.</p><p><strong>Results: </strong>The TyG index was not related to the SYNTAX score in groups A and B; however, in the CAD group with an low-density lipoprotein (LDL) concentration <70 mg/dL (group A1), a fasting TyG index ≥8.25 and a PP TyG index ≥11 could predict moderate-high SYNTAX risk score; in addition, the odds ratio (OR) was 4.3× higher and the relative risk (RR) was 1.8× greater (OR = 4.3, RR = 1.8, 95% confidence interval = 1.4-13.5, P < 0.05) for individuals with a higher fasting TyG index ≥8.25 to have a moderate-high SYNTAX risk score. Individuals with a higher PP TyG index ≥11 had OR of 2.6× higher and a RR of 1.4× greater to have moderate-high SYNTAX risk score.</p><p><strong>Conclusions: </strong>Both fasting and PP TyG levels were associated with greater coronary anatomical complexity (SYNTAX score >22) in nondiabetic chronic coronary patients with LDL <70 mg/dL. Fasting and the PP TyG indices can serve as noninvasive predictors of CAD complexity in nondiabetic patients with LDL <70 mg/dL and could change the management and therapeutic approaches.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736304","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
Gender-based Disparity in Performing Aortic Valve Surgery in the United State Before Availability of Percutaneous Valve Implantation. 经皮主动脉瓣植入术前美国主动脉瓣手术的性别差异。
Critical Pathways in Cardiology Pub Date : 2024-06-01 Epub Date: 2023-12-04 DOI: 10.1097/HPC.0000000000000344
Mohammad Reza Movahed, Arman Soltani Moghadam, Mehrnoosh Hashemzadeh, Mehrtash Hashemzadeh
{"title":"Gender-based Disparity in Performing Aortic Valve Surgery in the United State Before Availability of Percutaneous Valve Implantation.","authors":"Mohammad Reza Movahed, Arman Soltani Moghadam, Mehrnoosh Hashemzadeh, Mehrtash Hashemzadeh","doi":"10.1097/HPC.0000000000000344","DOIUrl":"10.1097/HPC.0000000000000344","url":null,"abstract":"<p><strong>Background: </strong>Aortic valve surgery has been performed increasingly in high-risk patients. The goal of this study was to evaluate this trend based on gender in the United States before the availability of percutaneous aortic valve replacement.</p><p><strong>Method: </strong>The Nationwide Inpatient Sample database was utilized to calculate the age-adjusted utilization rate for aortic valve surgery from 1988 to 2011 in the United States using International Classification of Diseases, Ninth Revision coding for aortic valve surgery.</p><p><strong>Results: </strong>A total population of 258,506 patients who underwent aortic valve between 1988 and 2011 were available for our study over the age of 20. We found that the age-adjusted rate of aortic valve surgery gradually increased from 1988 until 2009 and stabilized thereafter with a persistently higher rate for men. For men, age-adjusted rate in 1988 was 13.3 per 100,000 versus 27.0 in year in the year 2011 per 100,000. For women, the age-adjusted rate in 1988 was 6.07 per 100,000 versus 11.4 in year 2011 per 100,000.</p><p><strong>Conclusions: </strong>Aortic valve surgery utilization has stabilized in recent years in both genders in the United States. However, this rate has been persistently more than double in men. The cause of this higher utilization in males needs further investigation.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138478771","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
Reversal or Repletion Treatment Strategies and Outcomes of Patients With Major Bleeding Events Managed in the Emergency Department: Large Real-Life Investigation in the Northwestern Healthcare District of Tuscany. 急诊科处理的重大出血事件患者的逆转或补液治疗策略与疗效:托斯卡纳西北医疗保健区的大型实际调查。
Critical Pathways in Cardiology Pub Date : 2024-06-01 Epub Date: 2024-05-22 DOI: 10.1097/HPC.0000000000000360
Alberto Conti, Marco Leorin, Irene Carlotta Bogazzi, Noemi Renzi, Giuseppe Pepe, Fabiana Frosini, Lucilla Furesi, Luca Dalla Tomasina, Paolo Pennati, Lorenzo Ghiadoni
{"title":"Reversal or Repletion Treatment Strategies and Outcomes of Patients With Major Bleeding Events Managed in the Emergency Department: Large Real-Life Investigation in the Northwestern Healthcare District of Tuscany.","authors":"Alberto Conti, Marco Leorin, Irene Carlotta Bogazzi, Noemi Renzi, Giuseppe Pepe, Fabiana Frosini, Lucilla Furesi, Luca Dalla Tomasina, Paolo Pennati, Lorenzo Ghiadoni","doi":"10.1097/HPC.0000000000000360","DOIUrl":"10.1097/HPC.0000000000000360","url":null,"abstract":"<p><strong>Objective: </strong>To verify the incidence of bleeding events in patients on ongoing anticoagulant treatment in the real world and compare the results of different reversal or repletion strategies currently available for pharmacological treatment.</p><p><strong>Methods: </strong>Patients managed in the emergency department (ED) with major bleeding events, on ongoing anticoagulation were stratified according to bleeding site and reversal or repletion therapy with andexanet alfa (ADX), idarucizumab (IDA), prothrombin complex concentrate (PCC), and vitamin K (Vit-K).</p><p><strong>Endpoint: </strong>Death at 30 days was compared in the subgroups with cerebral hemorrhage (CH) and gastrointestinal (GI) bleeding.</p><p><strong>Results: </strong>Of the 809,397 visits in the years 2022-2023 at 6 EDs in the northwestern health district of Tuscany, 5372 patients with bleeding events were considered; 3740 were excluded due to minor bleeding or propensity score matching. Of the remaining 1632 patients with major bleeding, 548 on ongoing anticoagulation were enrolled; 334 received reversal or repletion agents. Patients with CH (n = 176) and GI bleeding (n = 108) represented the primary analysis cohorts in the study's strategic treatment assessment. Overall, 30-day survival of patients on ongoing aFXa treatment receiving on-label ADX versus off-label PCC showed a relative increase of 71%, while 30-day survival of patients on ongoing aFII receiving on-label IDA versus off-label PCC showed a relative increase of 30%; no substantial difference was found when comparing on-label PCC combined with Vit-K versus off-label Vit-K alone. Indeed, patients undergoing on-label ADX or IDA showed a statistically significant difference over off-label PCC (ADX vs. PCC: n = 15, events = 4, mean ± SD 82.50 ± 18.9, vs. 49, 13, 98.82 ± 27, respectively; analysis of variance [ANOVA] variance 8627; P < 0.001; posthoc test diff 32, 95% confidence interval: 28-35; P < 001; IDA vs. PCC: 20, 5, 32.29 ± 15.0 vs. 2, 1, 28.00 ± 0.0, respectively; ANOVA 1484; P < 0.001; posthoc test -29, -29 -29, respectively; P = n.d.). On-label PCC combined with Vit-K showed overall a slight statistically significant difference versus off-label Vit-K alone (52, 16, 100.58 ± 22.6 vs. 53, 11, 154.62 ± 29.8, respectively; ANOVA 310; P < 0.02; posthoc test 4, 0.7-7.2, respectively; P < 0.02). Data were confirmed in the group of patients with CH (ADX vs. PCC: n = 13, events = 3, mean ± SD 91.55 ± 18.6 vs. 78, 21, 108.91 ± 20.9, respectively; ANOVA variance 10,091, F = 261; P < 0.001; posthoc difference test 36, 95% confidence interval: 30-41; P < 0.001; IDA vs. PCC: 10, 2, 4.50 ± 2.5 vs. 78, 21, 108.91 ± 20.9, respectively; ANOVA 16,876,303, respectively; P < 0.001; posthoc test 41, 34-47, respectively; P < 0.001). On-label PCC combined with Vit-K showed an overall slight statistically significant difference compared with off-label Vit-K alone (P < 0.01 and P < 0.001 in the subgroups of CH and GI bl","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089200","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
Characterizing Adaptive Changes and Patient Survival After 2018 Donor Allocation Restructuring: A UNOS Database Analysis. 2018 年捐献者分配结构调整后的适应性变化和患者存活特征:UNOS 数据库分析。
Critical Pathways in Cardiology Pub Date : 2024-06-01 Epub Date: 2024-05-22 DOI: 10.1097/HPC.0000000000000359
Takuma Miyamoto, Christopher David Pritting, Rob Tatum, Danial Ahmad, Yevgeniy Brailovsky, Mahek K Shah, Indranee Rajapreyar, J Eduardo Rame, Rene J Alvarez, John W Entwistle, Howard Todd Massey, Vakhtang Tchantchaleishvili
{"title":"Characterizing Adaptive Changes and Patient Survival After 2018 Donor Allocation Restructuring: A UNOS Database Analysis.","authors":"Takuma Miyamoto, Christopher David Pritting, Rob Tatum, Danial Ahmad, Yevgeniy Brailovsky, Mahek K Shah, Indranee Rajapreyar, J Eduardo Rame, Rene J Alvarez, John W Entwistle, Howard Todd Massey, Vakhtang Tchantchaleishvili","doi":"10.1097/HPC.0000000000000359","DOIUrl":"10.1097/HPC.0000000000000359","url":null,"abstract":"<p><strong>Purpose: </strong>We sought to characterize adaptive changes to the revised United Network for Organ Sharing donor heart allocation policy and estimate long-term survival trends for heart transplant (HTx) recipients.</p><p><strong>Methods: </strong>Patients listed for HTx between October 17, 2013 and September 30, 2021 were identified from the United Network for Organ Sharing database, and stratified into pre- and postpolicy revision groups. Subanalyses were performed to examine trends in device utilization for extracorporeal membranous oxygenation (ECMO), durable left ventricular assist device (LVAD), intra-aortic balloon pump (IABP), microaxial support (Impella), and no mechanical circulatory support (non-MCS). Survival data post-HTx were fitted to parametric distributions and extrapolated to 5 years.</p><p><strong>Results: </strong>We identified 27,523 HTx waitlist candidates during the study period, most of whom (n = 16,376) were waitlisted in the prepolicy change period. Overall, 19,554 patients underwent HTx during the study period (pre: 12,037 and post: 7517). Listings increased after the policy change for ECMO ( P < 0.01), Impella ( P < 0.01), and IABP ( P < 0.01) patients. Listings for LVAD ( P < 0.01) and non-MCS ( P < 0.01) patients decreased. HTx increased for ECMO ( P < 0.01), Impella ( P < 0.01), and IABP ( P < 0.01) patients after the policy change and decreased for LVAD ( P < 0.01) and non-MCS ( P < 0.01) patients. Waitlist survival increased for the overall ( P < 0.01), ECMO ( P < 0.01), IABP ( P < 0.01), and non-MCS ( P < 0.01) groups. Waitlist survival did not differ for the LVAD ( P = 0.8) and Impella ( P = 0.1) groups. Post-transplant survival decreased for the overall ( P < 0.01), LVAD ( P < 0.01), and non-MCS ( P < 0.01) populations.</p><p><strong>Conclusions: </strong>Allocation policy revisions have contributed to greater utilization of ECMO, Impella, and IABP, decreased utilization of LVADs and non-MCS, increased waitlist survival, and decreased post-HTx survival.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071594","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
Left Atrial Peak Systolic Strain as an Indicator Pathway of Diastolic Dysfunction of the Left Ventricle. 作为左心室舒张功能障碍指标途径的左心房收缩应变峰值。
Critical Pathways in Cardiology Pub Date : 2024-06-01 Epub Date: 2024-05-22 DOI: 10.1097/HPC.0000000000000349
Christian Osmar Chávez, Osmar Antonio Centurión, Alfredo Javier Meza, Rocío Del Pilar Falcón, Karina E Scavenius, Laura B García, Orlando R Sequeira, Judith M Torales, Erdulfo J Galeano
{"title":"Left Atrial Peak Systolic Strain as an Indicator Pathway of Diastolic Dysfunction of the Left Ventricle.","authors":"Christian Osmar Chávez, Osmar Antonio Centurión, Alfredo Javier Meza, Rocío Del Pilar Falcón, Karina E Scavenius, Laura B García, Orlando R Sequeira, Judith M Torales, Erdulfo J Galeano","doi":"10.1097/HPC.0000000000000349","DOIUrl":"10.1097/HPC.0000000000000349","url":null,"abstract":"<p><strong>Background: </strong>Left atrial peak systolic strain (LA-PSS) imaging is an emerging index of left atrial function, and it was shown to be decreased in heart failure with preserved ejection fraction (EF). We aimed to determine whether LA-PSS could be used as an additional diagnostic parameter to current existing guidelines for the presence of left ventricle diastolic dysfunction (LVDD).</p><p><strong>Materials and methods: </strong>A total of 190 consecutive adult patients with cardiovascular risk factors and normal left ventricle EF with no prior history of heart failure were included in the study. Speckle tracking software was used to study ventricular parietal deformity, left ventricle global longitudinal systolic strain, and LA-PSS.</p><p><strong>Results: </strong>The median left ventricle global longitudinal systolic strain was -19%, with a significant difference ( P < 0.001) between patients with normal diastolic function versus those with LVDD. The median LA-PSS was 33% (30% to 38%) ( P < 0.001). Most patients (61%) had grade 1 atrial dysfunction based on PSS (range 24%-35%). The analysis of the area under the receiver operating characteristic curve of the LA-PSS as a potential indicator pathway of LVDD was 67% [95% confidence interval (CI), 62-72], and 75% (95% CI, 70-80), when the indeterminate pattern was included. The decreased LA-PSS made it possible to reclassify patients with an indeterminate pattern of diastolic function in 96% of cases.</p><p><strong>Conclusions: </strong>These results support the potential role of LA-PSS as an additional parameter for the diagnosis of LVDD in patients with normal EF, and may be integrated into the guidelines for routine evaluation of patients.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933349","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
EXPLORATORY ANALYSIS OF URINE PO2 PERI-PROCEDURAL KINETICS AND CI-AKI PROGNOSTIC ABILITIES IN PATIENTS UNDERGOING PCI. 对接受心肺复苏术的患者在术前尿 PS2 动力学和 Ci-aki 预后能力的探索性分析。
Critical Pathways in Cardiology Pub Date : 2024-05-23 DOI: 10.1097/HPC.0000000000000367
Georgios Chalikias, Dimitrios Stakos, Theodoros Kostakis, Choulia Nalmbant, Belkis Malkots, Vasilios Koutroulos, Kalliopi Theodoridou, Adina Thomaidis, Dimitrios Tziakas
{"title":"EXPLORATORY ANALYSIS OF URINE PO2 PERI-PROCEDURAL KINETICS AND CI-AKI PROGNOSTIC ABILITIES IN PATIENTS UNDERGOING PCI.","authors":"Georgios Chalikias, Dimitrios Stakos, Theodoros Kostakis, Choulia Nalmbant, Belkis Malkots, Vasilios Koutroulos, Kalliopi Theodoridou, Adina Thomaidis, Dimitrios Tziakas","doi":"10.1097/HPC.0000000000000367","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000367","url":null,"abstract":"<p><p>Novel contrast-induced acute kidney injury (CI-AKI) biomarkers are needed to detect earlier and with greater precision the pathophysiological changes in renal medulla associated with kidney damage. We prospectively assessed the kinetics of urine oxygen tension (PO2) in control healthy individuals, and its prognostic ability for CI-AKI in patients undergoing percutaneous coronary intervention (PCI). We enrolled 202 consecutive patients (78% men, mean age 66±10 years) treated with elective or urgent PCI. PO2 was measured using a point-of-care (POC) standard blood gas analyzer at 3 time points (baseline, post -within 3 hours- PCI and at 24 hours post PCI) in urine samples. CI-AKI was defined as an increase of ≥25% or ≥0.5 mg/dl in pre-PCI serum creatinine at 48 hours post PCI. Between baseline and post-PCI measurements, patients without CI-AKI showed a decrease of -37 (36) mmHg in PO2 urine levels whereas patients with CI-AKI showed a decrease of only -23 (38) mmHg. (P=0.014). Using ROC analysis, percentage change in urine PO2 immediately after PCI relative to baseline levels, significantly predicted CI-AKI (AUC 0.804 95%CI 0.717-0.892). A significant drop in urine oxygen tension appears as a normal response of the kidney medulla to an acute insult (contrast media) immediately post PCI with a recovery to baseline levels 24 hours later. Absence or attenuation of this drop in urine oxygen tension could predict CI-AKI earlier and more precisely.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089137","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
Patient-triggered events poorly predict presence of atrial tachyarrhythmia on ambulatory electrocardiogram monitors in patients with heart failure. 患者触发事件对心力衰竭患者流动心电图监护仪上出现心房快速性心律失常的预测效果不佳。
Critical Pathways in Cardiology Pub Date : 2024-05-22 DOI: 10.1097/HPC.0000000000000366
Maranda Herner, Zameer Abedin, Michael Torre, Yue Zhang, Cody Orton, Ann Lyons, Benjamin A Steinberg
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引用次数: 0
National Trends, Mortality and Outcomes in Intravascular Imaging-Guided Versus Angiography-Guided Percutaneous Coronary Intervention in the United States. 美国血管内成像引导经皮冠状动脉介入治疗与血管造影引导经皮冠状动脉介入治疗的全国趋势、死亡率和疗效。
Critical Pathways in Cardiology Pub Date : 2024-05-13 DOI: 10.1097/HPC.0000000000000363
Chayakrit Krittanawong, Song Peng Ang, Yusuf Kamran Qadeer, Zhen Wang, Mahboob Alam, Hani Jneid, Samin Sharma
{"title":"National Trends, Mortality and Outcomes in Intravascular Imaging-Guided Versus Angiography-Guided Percutaneous Coronary Intervention in the United States.","authors":"Chayakrit Krittanawong, Song Peng Ang, Yusuf Kamran Qadeer, Zhen Wang, Mahboob Alam, Hani Jneid, Samin Sharma","doi":"10.1097/HPC.0000000000000363","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000363","url":null,"abstract":"<p><p>Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have become increasingly utilized in patients undergoing percutaneous coronary intervention (PCI). Despite these purported advantages, prior reports regarding the use of IVUS and OCT have indicated that contemporary use of intravascular imaging remains low with significant regional variation. Here, we present the findings of an updated contemporary analysis regarding the use of IVUS/OCT guided PCI vs. angiography-guided PCI in the United States. We also evaluated in-hospital mortality and clinical outcomes between IVUS/OCT-guided PCI versus angiography-guided PCI-only over million patients in the United States. There has been a significant decrease in the number of PCIs performed, while there has been increasing in trend of IVUS/OCT-guided PCI over this period. Most importantly, we found that IVUS/OCT guided PCI were associated with better clinical outcomes in terms of in-hospital mortality, compare with angiography guided PCI.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071699","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
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