US Cardiology Review最新文献_第2页

Management of Calcified Coronary Lesions 钙化冠状动脉病变的处理

US Cardiology Review Pub Date : 2024-01-24 DOI: 10.15420/usc.2022.29

Khaled F. Al-Shaibi, Aditya Bharadwaj, Atul Mathur, Ashish Jaikishen, Robert Riley

引用次数: 0

Chest Pain in Women: Gender- and Sex-based Differences in the Presentation and Diagnosis of Heart Disease 女性胸痛：心脏病的表现和诊断中的性别差异

US Cardiology Review Pub Date : 2023-11-28 DOI: 10.15420/usc.2022.30

Mariem A Sawan, Rebecca S Steinberg, Michael N. Sayegh, Christian Devlin, Omid Behbahani-Nejad, Nanette K Wenger

引用次数: 0

Outcomes of Complex Percutaneous Cardiac Interventions in Women 女性复杂经皮心脏介入治疗的结果

US Cardiology Review Pub Date : 2023-11-23 DOI: 10.15420/usc.2022.21

M. Alasnag, V. Paradies, Nicola Ryan, Sara C Martinez

{"title":"Outcomes of Complex Percutaneous Cardiac Interventions in Women","authors":"M. Alasnag, V. Paradies, Nicola Ryan, Sara C Martinez","doi":"10.15420/usc.2022.21","DOIUrl":"https://doi.org/10.15420/usc.2022.21","url":null,"abstract":"Complex percutaneous cardiac intervention (PCI) is a growing procedure in modern day cath labs. The treated population is often older, with multiple comorbidities, complex coronary anatomy, left ventricular dysfunction, and possibly concomitant valvular heart disease and/or cardiogenic shock. As such, PCI of bifurcations, chronic total occlusions, and atherectomy coronary interventions are becoming more common. The outcomes in terms of acute procedural success, procedure-related complications, and long-term mortality or heart failure hospitalizations are important to consider. Unfortunately, to date there is a paucity of data identifying sex and gender disparities following such interventions. With respect to bifurcation lesions, women usually have more comorbidities with less complex coronary anatomy. However, despite less complex anatomy, women have a significantly increased risk of MI. These differences are also noted with left main stem and multivessel disease, during which women appear to have a trend towards worse outcomes following PCI compared with coronary artery bypass grafting. Randomized trials have revealed that women present with increased cardiovascular risk factors, which may contribute to adverse longer-term outcomes. Revascularization of women with concomitant valvular heart disease is particularly challenging because the existing data are conflicted on not only the indication, but also the timing of revascularization. Similarly, women undergoing PCI of calcified lesions with drug-eluting stents have a worse clinical profile and remain at increased ischemic risk. The lower incidence of coronary calcification in women, combined with the under-representation of women in randomized trials, poses a real challenge when attempting to address safety and survival benefit in women undergoing complex interventions. This warrants dedicated trials exploring the safety and efficacy of complex interventions in women.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139244845","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

Transcatheter Tricuspid Valve Replacement: Case Selection, Technical Considerations, and Procedural Planning 经导管三尖瓣置换术：病例选择、技术考虑和手术计划

US Cardiology Review Pub Date : 2023-08-17 DOI: 10.15420/usc.2023.07

M. Shabbir, Pradeep K Yadav, N. Tiwari, P. Velagapudi

{"title":"Transcatheter Tricuspid Valve Replacement: Case Selection, Technical Considerations, and Procedural Planning","authors":"M. Shabbir, Pradeep K Yadav, N. Tiwari, P. Velagapudi","doi":"10.15420/usc.2023.07","DOIUrl":"https://doi.org/10.15420/usc.2023.07","url":null,"abstract":"Tricuspid regurgitation (TR) is a highly prevalent valve disorder in the US, with prevalence increasing with age. Without treatment, severe TR carries a poor prognosis. Tricuspid valve (TV) surgery is recommended for patients with severe TR undergoing left-sided valve surgery. Transcatheter TV repair or transcatheter TV replacement are potential options for patients who are not surgical candidates. A few small studies have demonstrated the feasibility and efficacy of transcatheter TV repair in patients with severe symptomatic TR. Careful patient selection by assessing tricuspid valve anatomy, right ventricular and pulmonary hemodynamics, candidacy for anticoagulation, comorbid conditions, and frailty is key to procedural success. Transcatheter TV repair can be performed via the transjugular or transfemoral access, and requires a large-caliber sheath (up to 45 Fr) and delivery system, particularly with dilated tricuspid annulus due to right ventricular enlargement. Multimodality imaging is essential for diagnosing TR severity, defining valve anatomy, and comprehensive functional assessment of the tricuspid valve, right atrium, and right ventricle. Several prosthetic valves, including the EVOQUE system, NaviGate system, Intrepid valve, and Cardiovalve, are currently being investigated in clinical trials.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45544421","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

An Approach to Non-left Main Bifurcation Lesions: A Contemporary Review 非左主分叉病变的一种方法:当代回顾

US Cardiology Review Pub Date : 2023-08-04 DOI: 10.15420/usc.2022.25

A. Çalık, F. Cader, E. Rafflenbeul, S. Okutucu, S. Khan, I. P. Canbolat, U. Sinan, M. Alasnag

{"title":"An Approach to Non-left Main Bifurcation Lesions: A Contemporary Review","authors":"A. Çalık, F. Cader, E. Rafflenbeul, S. Okutucu, S. Khan, I. P. Canbolat, U. Sinan, M. Alasnag","doi":"10.15420/usc.2022.25","DOIUrl":"https://doi.org/10.15420/usc.2022.25","url":null,"abstract":"Bifurcated anatomical locations in the arterial tree, such as coronary artery bifurcations, are prone to develop obstructive atherosclerotic lesions due to the pro-atherogenic low wall shear stress. The percutaneous treatment of bifurcation lesions is among the most challenging complex coronary interventions, including different multistep stenting strategies. Even though provisional side branch (SB) stenting is recommended as the primary approach in most cases, the debate continues between provisional SB and upfront two-stent strategies, particularly in complex bifurcations consisting of a significantly diseased SB that supplies a crucial myocardial territory. This review will highlight the importance of understanding the bifurcation philosophy and provide an individual algorithmic approach to find the optimal treatment strategy for each patient with a non-left main coronary bifurcation lesion. Considering the most recent scientific evidence, the advantages and disadvantages of each stenting technique and the role of intracoronary imaging to optimize bifurcation percutaneous coronary intervention outcomes will be discussed.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46676021","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 Main Percutaneous Coronary Revascularization 左主干经皮冠状动脉血管重建术

US Cardiology Review Pub Date : 2023-07-20 DOI: 10.15420/usc.2022.24

A. Almoghairi, Nayef Al-Asiri, K. Aljohani, Ayman Alsaleh, Nasser G Alqahtani, M. Alasmary, Rudaynah A Alali, Khaled Tamam, M. Alasnag

{"title":"Left Main Percutaneous Coronary Revascularization","authors":"A. Almoghairi, Nayef Al-Asiri, K. Aljohani, Ayman Alsaleh, Nasser G Alqahtani, M. Alasmary, Rudaynah A Alali, Khaled Tamam, M. Alasnag","doi":"10.15420/usc.2022.24","DOIUrl":"https://doi.org/10.15420/usc.2022.24","url":null,"abstract":"Left main (LM) coronary artery disease accounts for approximately 4–6% of all percutaneous coronary interventions (PCIs). There has been mounting evidence indicating the non-inferiority of LM PCI as a revascularization option, particularly for those with a low SYNTAX score. The EXCEL and NOBEL trials have shaped current guidelines. The European Society of Cardiology assigned a class 2a level of evidence B for isolated LM disease involving the shaft and ostium and a class IIb level of evidence B for isolated LM disease involving the bifurcation or additional two- or three-vessel disease and a SYNTAX score <32. However, data on the use of a single stent or an upfront two-stent strategy for distal LM disease are conflicting, wherein the EBC Main trial reported similar outcomes with a stepwise provisional approach and the DKCRUSH-V trial reported better outcomes with an upfront two-stent strategy using the ‘double-kissing’ crush technique. Although several studies have noted better immediate results with image-guided PCI, there are few data on outcomes in LM disease specifically. In fact, the uptake of imaging in the aforementioned landmark trials was only 40%. More importantly, the role of mechanical circulatory support (MCS) has been less well studied in LM PCI. Indiscriminate use of MCS for LM PCI has been noted in clinical practice. Trials evaluating the benefit of MCS in high-risk PCI demonstrated no benefit. This review highlights contemporary trials as they apply to current practice in LM PCI.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45816328","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

A Case of Primary Cardiac B-cell Lymphoma Diagnosed with Cardiac MRI 心脏MRI诊断原发性心脏b细胞淋巴瘤1例

US Cardiology Review Pub Date : 2023-06-26 DOI: 10.15420/usc.2022.31

Kevin Lee, I. Minga, E. Cameron, J. P. S. Adum, A. Pursnani

引用次数: 0

Invasive Evaluation for Coronary Vasospasm 冠状动脉血管痉挛的侵袭性评价

US Cardiology Review Pub Date : 2023-06-09 DOI: 10.15420/usc.2022.33

Jing Huang, R. Steinberg, Matthew J Brown, S. Rinfret, O. Toleva

{"title":"Invasive Evaluation for Coronary Vasospasm","authors":"Jing Huang, R. Steinberg, Matthew J Brown, S. Rinfret, O. Toleva","doi":"10.15420/usc.2022.33","DOIUrl":"https://doi.org/10.15420/usc.2022.33","url":null,"abstract":"Vasospastic angina (VSA) occurs at rest and on exertion, with transient electrocardiographic ischemic changes. VSA presents with spontaneous coronary artery spasm (CAS); it has been associated with stable angina, acute coronary syndromes, and sudden cardiac death. CAS can be identified in normal arteries or non-obstructive coronary atherosclerosis, but is also prevalent in patients with coronary artery disease. The diagnosis is made with invasive coronary reactivity testing with provocation using acetylcholine (Ach). Epicardial spasms can be visualized through coronary angiography as a reversible epicardial vessel narrowing, while the diagnosis of microvascular spasm can be made when angina symptoms and ECG changes happen following intracoronary Ach without epicardial spasm. Identification of CAS allows for risk stratification and specific therapies targeting endothelial dysfunction and paradoxical vascular smooth muscle cell constriction. Therapies include calcium channel blockers as monotherapy or in a combination of a dihydropyridine and non-dihydropyridine. Short-acting nitrates offer acute symptomatic relief but long-acting nitrates should be used sparingly. This current update on invasive evaluation of VSA discusses unified Ach protocols.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42919751","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

Transcatheter Left Atrial Appendage Closure: Devices Available, Pitfalls, Advantages, and Future Directions 经导管左心房附件闭合术：可用设备、缺点、优势和未来方向

US Cardiology Review Pub Date : 2023-05-25 DOI: 10.15420/usc.2022.37

Chirag P Bavishi

引用次数: 0

Pregnancy and Congenital Heart Disease: Moving Beyond the Current Risk Stratification Tools 妊娠和先天性心脏病：超越当前风险分层工具

US Cardiology Review Pub Date : 2023-05-25 DOI: 10.15420/usc.2022.16

Ajitha Kulasekaran, L. Swan

引用次数: 0