Hellenic Journal of Cardiology最新文献

{"title":"ECMO versus IABP for patients with STEMI complicated by cardiogenic shock undergoing primary PCI: a Chinese National Study and propensity-matched analysis.","authors":"Hongbo Yang, Lingfeng Luo, Yanan Song, Jiatian Cao, Jing Chen, Feng Zhang, Yiwen Tan, Yan Zheng, Zhonghan Sun, Juying Qian, Zheyong Huang, Junbo Ge","doi":"10.1016/j.hjc.2024.09.008","DOIUrl":"10.1016/j.hjc.2024.09.008","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the association between the utilization of extracorporeal membrane oxygenation (ECMO) or intra-aortic balloon pump (IABP) and in-hospital mortality among patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock undergoing primary percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>Data encompassing 9635 cases of STEMI complicated by cardiogenic shock and treated with primary PCI using ECMO/IABP support were retrieved from the Chinese Cardiovascular Association database (2019-2021). We conducted an analysis to assess the in-hospital survival disparities among percutaneous mechanical circulatory device recipients and explore the potential advantages of ECMO through multivariable logistic regression analysis within a propensity score-matched (1:2) cohort population.</p><p><strong>Results: </strong>ECMO was administered to 2028 patients, whereas IABP was used in 7607 patients. Patients supported by ECMO showed a lower in-hospital mortality than those supported by IABP (7.2% versus 15.1%, p < 0.001). Within the propensity-matched (case: control = 1:2) cohort, we noted a 34% reduced risk of in-hospital mortality among patients supported by ECMO compared with those supported by IABP (7.7% versus 11.7%; odds ratio = 0.66; 95% CI, 0.53-0.80; p < 0.001) independent of age, sex, systolic blood pressure, obesity, smoke, hypertension, diabetes, dyslipidemia, family history of coronary artery disease, coronary artery disease, stroke, atrial filiation, peripheral artery disease, chronic kidney disease, vascular lesion sites, 3A-grade hospital, and regional distributions in China.</p><p><strong>Conclusion: </strong>Among patients undergoing primary PCI for STEMI complicated by cardiogenic shock, ECMO was associated with better in-hospital survival than IABP.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of cardiovascular drugs on hyperglycemia and diabetes: a review of 'unspoken' side effects.","authors":"Wynne Widiarti, Pandit Bagus Tri Saputra, Cornelia Ghea Savitri, Johanes Nugroho Eko Putranto, Firas Farisi Alkaff","doi":"10.1016/j.hjc.2024.09.007","DOIUrl":"10.1016/j.hjc.2024.09.007","url":null,"abstract":"<p><strong>Aims: </strong>The increasing prevalence of cardiovascular diseases has led to the widespread use of cardiovascular drugs that can adversely impact glucose metabolism. This review focuses on the latest evidence on the potential of cardiovascular drugs to induce adverse glycemic effects but also the underlying mechanisms, prevention, and management strategies.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was conducted across scientific databases until May 25th, 2024.</p><p><strong>Results: </strong>Certain cardiovascular drugs can induce hyperglycemia through multiple mechanisms, including altered the secretion and sensitivity of insulin through direct cytotoxic effects toward pancreatic beta cells and increased glucose secretion. Notably, diuretics, beta-blockers, calcium channel blockers, and statins have been associated with significant glycemic disturbances. The risk of hyperglycemia varies based on individual factors, drug dosages, and concurrent medications. These drug-induced hyperglycemic effects may sometimes reverse upon discontinuation of related medication. Effective management should include lifestyle modifications, the use of glucose-lowering medications, and opting for lower-risk cardiovascular drugs. Monitoring for hyperglycemia involves educating affected individuals and conducting regular blood glucose tests. Identifying at-risk individuals and implementing preventive measures are crucial for improving both cardiovascular and metabolic outcomes.</p><p><strong>Conclusions: </strong>Certain cardiovascular drugs significantly contribute to hyperglycemia and diabetes mellitus through various mechanisms. Effective management includes identifying at-risk individuals, choosing lower-risk medications, and implementing monitoring and preventive strategies. Further research is needed to fully understand these mechanisms and develop targeted interventions to prevent and manage cardiovascular drug-induced hyperglycemia, thereby improving clinical outcomes.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central versus peripheral VA ECMO for cardiogenic shock: an 8-year experience of a tertiary cardiac surgery center in Greece.","authors":"Michael Antonopoulos, Antigone Koliopoulou, Dimitrios Elaiopoulos, Kyriaki Kolovou, Dimitra Doubou, Anna Smyrli, Prodromos Zavaropoulos, Nektarios Kogerakis, Sokratis Fragoulis, Konstantinos Perreas, Georgios Stavridis, Stamatis Adamopoulos, Themistocles Chamogeorgakis, Stavros Dimopoulos","doi":"10.1016/j.hjc.2024.09.006","DOIUrl":"10.1016/j.hjc.2024.09.006","url":null,"abstract":"<p><strong>Background: </strong>Venoarterial extracorporeal membrane oxygenation (VA ECMO) has emerged as an effective rescue therapy in patients with cardiogenic shock refractory to standard treatment protocols, and its use has been rising worldwide in the last decade. Although experience and availability are growing, outcomes remain poor. There is need for evidence to improve clinical practice and outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of all patients who were supported with VA ECMO for cardiogenic shock at our institution between January 2015 and January 2023. The study purpose was to compare outcomes between patients who were supported with central versus peripheral configuration.</p><p><strong>Results: </strong>ECMO was applied in 108 patients, 48 (44%) of whom received central configuration and 60 (56%) peripheral. Patients supported with central VA ECMO were more likely to be supported for post-cardiotomy shock (odds ratio [OR] 4.6 [95% confidence interval (CI) 2.03-10.41]), while patients in the peripheral group were predominantly treated for chronic heart failure decompensation (OR 9.4 [95% CI 1.16-76.3]). Central VA ECMO had lower survival rates during ECMO support (29.2% versus 51.7%, p = 0.018) and at discharge (8% versus 37%, p = 0.001). These patients were at high risk of complications, such as acute kidney injury (AKI) (OR 2.37 [95% CI 1.06-5.3], p = 0.034) and major bleeding (OR 3.08 [95% CI 1.36-6.94], p < 0.001).</p><p><strong>Conclusions: </strong>Patients on central VA ECMO were supported mainly for post-cardiotomy shock, presented with more complications such as major bleeding and AKI, and had worse survival to hospital discharge compared with patients on peripheral VA ECMO. Patient selection, timing of implementation, cannulation strategy, and configuration remain the main determinants of clinical outcome.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of polymer-free biolimus-eluting stents versus durable polymer novolimus-eluting stents in a real-world clinical practice (FREEDOM-DES trial).","authors":"Soohyung Park, Seung-Woon Rha, Byoung Geol Choi, Sang Ho Park, Jae-Bin Seo, Ju Yeol Baek, Jae Woong Choi, Yong Hoon Kim, Ji-Hun Ahn, Gi Chang Kim, Weon Kim, Soo-Han Kim, Markz Rmp Sinurat, Se Yeon Choi, Jin Ah Cha, Su Jin Hyun, Cheol Ung Choi, Chang Gyu Park","doi":"10.1016/j.hjc.2024.09.005","DOIUrl":"10.1016/j.hjc.2024.09.005","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is endocarditis always the answer?","authors":"Dimitrios Oikonomidis, Alexandros Pappas, Evangelos Tatsis, Athanasios Tasoulis, Constantinos Papadopoulos","doi":"10.1016/j.hjc.2024.09.004","DOIUrl":"10.1016/j.hjc.2024.09.004","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of neutrophil extracellular traps burden with clinical and angiographic characteristics in patients with ST-elevation myocardial infarction.","authors":"Nikolaos Stalikas, Sofia-Eleni Tzorakoleftheraki, Efstratios Karagiannidis, Matthaios Didagelos, Antonios Ziakas, Vasileios Kamperidis, George Giannakoulas, Vasileios Vassilikos, Triantafyllia Koletsa, George Giannopoulos","doi":"10.1016/j.hjc.2024.09.001","DOIUrl":"10.1016/j.hjc.2024.09.001","url":null,"abstract":"<p><strong>Background: </strong>The precise triggers for atherosclerotic plaque rupture and the underlying pathophysiology of coronary thrombogenesis remain elusive. Polymorphonuclear neutrophils, particularly their formation of neutrophil extracellular traps (NETs), have garnered attention in the context of coronary atherothrombosis. This study sought to explore the association of NETs burden with clinical and angiographic characteristics in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI) and thrombus aspiration (TA).</p><p><strong>Methods: </strong>For this study, 336 consecutive STEMI patients undergoing pPCI were considered for TA. Aspirated thrombi underwent histological analysis and NETs quantification via immunohistochemistry. Potential associations of clinical variables and angiographic outcomes with NETs burden were assessed.</p><p><strong>Results: </strong>Manual TA was selectively performed in 72 cases with increased thrombotic burden, and 60 thrombi were suitable for analysis and included in the current study. Most thrombi specimens displayed lytic features (63%), and almost three out of four were identified as white thrombi. Increased NETs burden was significantly associated with prolonged pain-to-balloon time (>300 min), OR = 10.29 (95% CI 2.11-42.22, p = 0.001), and stress-induced hyperglycemia OR = 6.58 (95% CI 1.23-52.63, p < 0.01) after multivariate regression analysis. Additionally, distal embolization, and left ventricular ejection fraction ≤40% were more frequent among patients with an elevated NETs burden OR = 16.9 (95% CI 4.23-44.52, p < 0.01) and OR = 3.2 (95% CI 1.05-12.1, p = 0.05), respectively.</p><p><strong>Conclusion: </strong>Elevated NETs burden in STEMI thrombi may be due to delayed reperfusion and stress-induced hyperglycemia, and it is associated with an increased risk of distal embolization and lower left ventricular ejection fraction. Further research is needed to elucidate the role of NETs as a potential therapeutic target in acute atherothrombosis.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary artery thromboembolism as a cause of myocardial infarction with non-obstructive coronary arteries (MINOCA)","authors":"","doi":"10.1016/j.hjc.2024.05.001","DOIUrl":"10.1016/j.hjc.2024.05.001","url":null,"abstract":"<div><p>Acute myocardial infarction (AMI) usually represents the clinical manifestation of atherothrombotic coronary artery disease (CAD) resulting from atherosclerotic plaque rupture. However, there are cases in which coronary angiography or coronary computed tomography angiography reveals patients with acute coronary syndrome with non-obstructive CAD. This clinical entity is defined as myocardial infarction with non-obstructive coronary arteries (MINOCA) and often considered as a clinical dynamic working diagnosis that needs further investigations for the establishment of a final etiologic diagnosis. The main causes of a MINOCA working diagnosis include atherosclerotic, non-atherosclerotic (vessel-related and non–vessel-related), and thromboembolic causes This literature review aimed to investigate the major thromboembolic causes in patients presenting with MINOCA regarding their etiology and pathophysiologic mechanisms, as well as diagnostic and treatment methods.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"79 ","pages":"Pages 70-83"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966624001052/pdfft?md5=c3dfca621877bbdb369e93d24ecb20cb&pid=1-s2.0-S1109966624001052-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiogenetics: que será, será. Ou non?","authors":"Charalambos Vlachopoulos,&nbsp;George Lazaros","doi":"10.1016/j.hjc.2024.09.003","DOIUrl":"10.1016/j.hjc.2024.09.003","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"79 ","pages":"Pages 1-2"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966624002021/pdfft?md5=142af1e8337503305ac179da08972198&pid=1-s2.0-S1109966624002021-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular global longitudinal strain and cardiorespiratory fitness in patients with heart failure: Systematic review and meta-analysis","authors":"","doi":"10.1016/j.hjc.2023.09.010","DOIUrl":"10.1016/j.hjc.2023.09.010","url":null,"abstract":"<div><h3>Background</h3><p>There is no definition for strain deformation values in relation to cardiorespiratory fitness (CRF) in different heart failure (HF) phenotypes.</p></div><div><h3>Aim</h3><p>To identify the relationship between echocardiographic systolic function measurements and CRF in HF patients.</p></div><div><h3>Methods</h3><p>Systematic review and meta-analysis following the PRISMA recommendations. Studies reporting echocardiographic assessments of left ventricular global longitudinal strain (LVGLS), left ventricular ejection fraction (LVEF), and direct measurement of peak oxygen uptake (VO_2peak) in HF patients with reduced or preserved LVEF (HFrEF, HFpEF) were included. The patients were divided into Weber classes according to VO_2peak.</p></div><div><h3>Results</h3><p>A total of 25 studies involving of 2,136 patients (70.5% with HFpEF) were included. Mean LVEF and LVGLS were similar in HFpEF patients in Weber Class A/B and Class C/D. In HFrEF patients, a non-significant difference was found in LVEF between Weber Class A/B (30.2% [95%CI: 29.6 to 30.9%]) and Class C/D (25.2% [95%CI: 20.5 to 29.9%]). In HFrEF patients, mean LVGLS was significantly lower in Class C/D compared to Class A/B (6.5% [95%CI: 6.0 to 7.1%] and 10.3% [95%CI: 9.0 to 11.5%], respectively). The correlation between VO_2peak and LVGLS (r² = 0.245) was nearly twofold stronger than that between VO_2peak and LVEF (r² = 0.137).</p></div><div><h3>Conclusions</h3><p>Low LVGLS values were associated with low CRF in HFrEF patients. Although a weak correlation was found between systolic function at rest and CRF, the correlation between VO_2peak and LVGLS was nearly twofold stronger than that with LVEF, indicating that LVGLS may be a better predictor of CRF in patients with HFrEF.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"79 ","pages":"Pages 58-69"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623001811/pdfft?md5=7c16bf98d34d1821f21d8bc122c5d4c3&pid=1-s2.0-S1109966623001811-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41140287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple systemic arterial aneurysms in large-vessel vasculitis","authors":"","doi":"10.1016/j.hjc.2023.12.005","DOIUrl":"10.1016/j.hjc.2023.12.005","url":null,"abstract":"<div><p>Large-vessel vasculitis (LVVs) is a rare inflammatory disease that predominantly affects young females' aorta and its main branches, coronary arteries, and pulmonary arteries. Clinical manifestations result from vascular stenosis, occlusion, and dilation, sometimes complicated by aneurysm rupture or dissection. Early diagnosis and treatment of LVVs are paramount to reducing the risk of ischemic complications such as visual loss and strokes, vascular stenosis and occlusion, and aortic aneurysm formation. The diagnosis of LVVs is often challenging because the presenting clinical features are nonspecific in many cases and are often shared by different types of autoimmune and inflammatory diseases including other systemic vasculitides. Prompt identification of vasculitides is important because they are associated with an increased risk of mortality. Left undiagnosed or mismanaged, these conditions may result in serious adverse outcomes that might otherwise have been avoided or minimized. We report a rare case of the LVVs with multisystemic vascular aneurysms and catastrophic complications of ruptured abdominal aortic aneurysm. Our case highlights that an early diagnosis of the diverse manifestations of vasculitis and a high index of clinical suspicion is essential to avoid delays in disease recognition that may result in permanent or life-threatening morbidity.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"79 ","pages":"Pages 92-94"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623002312/pdfft?md5=a4928904dc53104dbca49e7542ce0445&pid=1-s2.0-S1109966623002312-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139066013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}