Acta Cardiologica Sinica最新文献

{"title":"Association between Premorbid Renin-Angiotensin-Aldosterone System Blockade and the Risk of Acute Kidney Injury in Critically Ill Patients.","authors":"Ruey-Hsing Chou,&nbsp;Shang-Feng Yang,&nbsp;Cheng-Hsueh Wu,&nbsp;Yi-Lin Tsai,&nbsp;Ya-Wen Lu,&nbsp;Jiun-Yu Guo,&nbsp;Po-Hsun Huang,&nbsp;Shing-Jong Lin","doi":"10.6515/ACS.202309_39(5).20230301B","DOIUrl":"https://doi.org/10.6515/ACS.202309_39(5).20230301B","url":null,"abstract":"<p><strong>Background: </strong>Angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) are commonly used for hypertension and cardiovascular diseases. However, whether their use increases the risk of acute kidney injury (AKI) and should be discontinued during acute illness remains controversial.</p><p><strong>Methods: </strong>This retrospective study enrolled 952 dialysis-free patients who were admitted to intensive care units (ICUs) between 2015 and 2017, including 476 premorbid long-term (> 1 month) ACEi/ARB users. Propensity score matching was performed to adjust for age, gender, comorbidities, and disease severity. The primary endpoint was the occurrence of AKI during hospitalization, and the secondary endpoint was mortality or dialysis within 1 year.</p><p><strong>Results: </strong>Compared with non-users, the ACEi/ARB users were not associated with an increased AKI risk during hospitalization [66.8% vs. 70.4%; hazard ratio (HR): 1.13, 95% confidence interval (CI): 0.97-1.32, p = 0.126]. However, the ACEi/ARB users with sepsis (HR: 1.29, 95% CI: 1.04-1.60, p = 0.021) or hypotension (HR: 1.21, 95% CI: 1.02-1.14, p = 0.034) were found to have an increased AKI risk in subgroup analysis. Nevertheless, compared with the non-users, the ACEi/ARB users were associated with a lower incidence of mortality or dialysis within 1 year (log-rank p = 0.011).</p><p><strong>Conclusions: </strong>Premorbid ACEi/ARB usage did not increase the incidence of AKI, and was associated with a lower 1-year mortality and dialysis rate in patients admitted to ICUs. Regarding the results of subgroup analysis, renin-angiotensin-aldosterone system blockade may still be safe and beneficial in the absence of sepsis or circulation failure. Further large-scale studies are needed to confirm our findings.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 5","pages":"709-719"},"PeriodicalIF":1.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10499963/pdf/acs-39-709.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10655883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Hidden Heart Disease: Shedding Light on Cardiac Amyloidosis.","authors":"Cheng-Hsuan Tsai, Yen-Hung Lin, Yen-Wen Wu","doi":"10.6515/ACS.202307_39(4).20230526A","DOIUrl":"10.6515/ACS.202307_39(4).20230526A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 4","pages":"544-545"},"PeriodicalIF":1.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346058/pdf/acs-39-544.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Serum Galectin-3 and Growth Differentiation Factor-15 Levels and Coronary Slow Flow Phenomenon.","authors":"Yasin Yuksel,&nbsp;Cennet Yıldız,&nbsp;Huri Bulut","doi":"10.6515/ACS.202307_39(4).20221128A","DOIUrl":"https://doi.org/10.6515/ACS.202307_39(4).20221128A","url":null,"abstract":"<p><strong>Background: </strong>Coronary slow flow phenomenon (CSFP) is characterized by delay in the progression of contrast material in the coronary tree that is not accompanied by significant coronary artery narrowing. Pathophysiologic pathways underpinning CSFP still remain poorly understood.</p><p><strong>Objectives: </strong>To evaluate the relationship between serum galectin-3 (GAL-3) and growth differentiation factor-15 (GDF-15) levels with CSFP.</p><p><strong>Methods: </strong>Fifty CSFP patients and 40 subjects with normal coronary arteries were included in this retrospective study. The patients' serum GDF-15 and GAL-3 concentration levels were measured using relevant kits. Thrombolysis in myocardial infarction frame count (TFC) of each patients was determined.</p><p><strong>Results: </strong>We did not find any differences with respect to clinical and demographic features between the two groups. GDF-15 and GAL-3 concentration levels were significantly higher in the patients with CSFP. Moreover GDF-15 and GAL-3 concentration levels were positively correlated with TFC (GDF-15; r = 0.448, GAL-3; r = 0.642, p < 0.001 for both). Multivariate logistic regression showed that GAL-3 and GDF-15 were predictors of the CSFP. Similarly, GDF-15 and GAL-3 were the only predictors of TFC. More specifically, GDF-15 and GAL-3 concentration levels of 182.18 pg/mL and 8.58 ng/mL predicted CSFP with sensitivities of 76% and 87.5%, respectively, and specificities of 84% and 75%, respectively.</p><p><strong>Conclusions: </strong>GDF-15 and GAL-3 levels were increased in the CSFP patients and predicted the presence and severity of CSFP. Thus, these two biomarkers might prove useful in relation to the diagnosis of CSFP.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 4","pages":"572-579"},"PeriodicalIF":1.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346052/pdf/acs-39-572.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kounis Syndrome after Administration of Iopromide-Based Contrast.","authors":"Shiun Woei Wong,&nbsp;Alimi Ahmad Hatib","doi":"10.6515/ACS.202307_39(4).20230416B","DOIUrl":"https://doi.org/10.6515/ACS.202307_39(4).20230416B","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 4","pages":"667-669"},"PeriodicalIF":1.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346062/pdf/acs-39-667.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2023 Expert Consensus of the Taiwan Society of Cardiology on the Diagnosis and Treatment of Cardiac Amyloidosis.","authors":"Chun-Chieh Wang,&nbsp;Wei-Ting Chang,&nbsp;Yen-Hung Lin,&nbsp;Bing-Hsiean Tzeng,&nbsp;Ting-Hsing Chao,&nbsp;Chung-Lieh Hung,&nbsp;Yen-Wen Wu,&nbsp;Cheng-Hsuan Tsai,&nbsp;Wei-Wen Lin,&nbsp;Kuan-Cheng Chang,&nbsp;Hung-Yu Chang,&nbsp;Wen-Chung Yu,&nbsp;Wen-Hwa Wang,&nbsp;Cheng-I Cheng,&nbsp;Tzung-Dau Wang,&nbsp;Charles Jia-Yin Hou,&nbsp;Wen-Jone Chen","doi":"10.6515/ACS.202307_39(4).20230610A","DOIUrl":"https://doi.org/10.6515/ACS.202307_39(4).20230610A","url":null,"abstract":"<p><p>Cardiac amyloidosis is one form of systemic amyloidosis caused by abnormal amyloid fibrils deposited in the extracellular space of the myocardium causing heart failure because of restrictive cardiomyopathy and conduction disturbances. The incidence and prevalence of cardiac amyloidosis are higher than previously noted, particularly among special populations. The most common forms of cardiac amyloidosis are light chain and transthyretin amyloid cardiomyopathy. Even though more than 70% of patients with systemic amyloidosis have cardiac amyloidosis, the diagnosis is often delayed, suggesting significant gaps in the knowledge of cardiac amyloidosis and a lack of multidisciplinary teamwork in our daily practice. The Taiwan Society of Cardiology Heart Failure Committee organized experts to draft the \"Expert Consensus on the diagnosis and treatment of cardiac amyloidosis.\" This statement aims to help clinicians and healthcare professionals improve early diagnosis and management of cardiac amyloidosis in Taiwan. The expert panel met virtually to review the data and discuss the consensus statements. Our review provided practical information about diagnostic methods and algorithms, clinical clues and red-flag signs, cardiac amyloidosis per se and its comorbidities treatment modalities, and follow-up plans for asymptomatic transthyretin gene carriers. We especially innovate two acronyms, \"HFpEF MUTED CALL\" and \"HFmrEF MUST COUNT\", to help in the early diagnosis and screening of transthyretin amyloid cardiomyopathy as shown in the Central Illustration.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 4","pages":"511-543"},"PeriodicalIF":1.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346051/pdf/acs-39-511.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Tafamidis in Patients with Ala97Ser Hereditary Transthyretin Cardiac Amyloidosis: A Six-Month Follow-Up Study.","authors":"Cheng-Hsuan Tsai,&nbsp;An-Li Yu,&nbsp;Yuan-Kun Aden Wu,&nbsp;Mao-Yuan Su,&nbsp;Mei-Fang Cheng,&nbsp;Chia-Hung Chou,&nbsp;Chia-Tung Shun,&nbsp;Hsueh-Wen Hsueh,&nbsp;Jimmy Jyh-Ming Juang,&nbsp;Ming-Jen Lee,&nbsp;Ping-Huei Tseng,&nbsp;Sung-Tsang Hsieh,&nbsp;Chi-Chao Chao,&nbsp;Yen-Hung Lin","doi":"10.6515/ACS.202307_39(4).20221116A","DOIUrl":"https://doi.org/10.6515/ACS.202307_39(4).20221116A","url":null,"abstract":"<p><strong>Background: </strong>Hereditary transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive and fatal disease. A97S (p.Ala117Ser) is the most common transthyretin genetic mutation in Taiwan. Tafamidis is a transthyretin stabilizer, and it has been shown to improve outcomes. However, its effect on A97S ATTR-CM subtypes remains unknown.</p><p><strong>Objectives: </strong>This study aimed to investigate the efficacy of tafamidis in patients with hereditary A97S ATTR-CM after 6 months of treatment.</p><p><strong>Methods: </strong>We retrospectively analyzed ATTR-CM patients who received tafamidis (61 mg/day) treatment at National Taiwan University Hospital. Functional status, biochemistry and echocardiography were measured at baseline and after 6 months of tafamidis treatment. The outcome measure was to compare the N-terminal pro-brain natriuretic peptide (NT-proBNP) level at baseline and after 6 months of tafamidis treatment.</p><p><strong>Results: </strong>Twenty patients were enrolled in this study. Their mean age was 63.0 ± 5.8 years and 75% were men. The baseline left ventricular (LV) mass index was 200.9 ± 63.9 g/m², and the baseline LV ejection fraction was 58.9 ± 13.5%. After 6 months of treatment, the log NT-proBNP level significantly improved from 2.9 ± 0.6 to 2.7 ± 0.5 (p = 0.036). Subgroup analysis showed that the LV posterior wall thickness and left atrial diameter were significantly higher in the patients with improved NT-proBNP, suggesting the benefits of tafamidis for ATTR-CM patients with severe cardiac involvement.</p><p><strong>Conclusions: </strong>The patients with hereditary A97S ATTR-CM in this study had decreased levels of NT-proBNP after 6 months of tafamidis treatment, and this reduction was especially pronounced in those with more severe cardiac involvement.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 4","pages":"619-627"},"PeriodicalIF":1.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346048/pdf/acs-39-619.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wide QRS Complex Tachycardia after Catheter Ablation of Bundle Branch Reentrant Tachycardia: What is the Mechanism?","authors":"Chi-Jen Weng,&nbsp;Fa-Po Chung","doi":"10.6515/ACS.202307_39(4).20230306B","DOIUrl":"https://doi.org/10.6515/ACS.202307_39(4).20230306B","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 4","pages":"651-653"},"PeriodicalIF":1.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346054/pdf/acs-39-651.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and Study Design of the TSOC-Fully Organized Registry for the Management of Symptomatic ACS Study (T-FORMOSA Study).","authors":"Ting-Hsing Chao,&nbsp;Hung-I Yeh,&nbsp;Kou-Gi Shyu,&nbsp;Chih-Hung Lai,&nbsp;Jen-Kuang Lee,&nbsp;Chin-Chou Huang,&nbsp;Ji-Hung Wang,&nbsp;I-Chang Hsieh,&nbsp;Chia-Ti Tsai,&nbsp;Wen-Lieng Lee,&nbsp;Ping-Yen Liu,&nbsp;Tzung-Dau Wang,&nbsp;Wen-Jone Chen,&nbsp;Charles Jia-Yin Hou","doi":"10.6515/ACS.202307_39(4).20230306D","DOIUrl":"https://doi.org/10.6515/ACS.202307_39(4).20230306D","url":null,"abstract":"<p><strong>Background: </strong>Successful implementation of practice guidelines has been challenging in the treatment of acute coronary syndrome (ACS), leaving room for improvement. A nationwide registry can provide more information than that recorded in the National Health Insurance Research Database (NHIRD).</p><p><strong>Methods: </strong>We conducted a prospective, nationwide, multi-center ACS full spectrum registry involving 3600 patients admitted to hospitals within 24 hours of the onset of myocardial infarction with ST-segment elevation or ACS without ST-segment elevation. In total, 41 sites including medical centers and regional hospitals were selected across Taiwan. The data for each patient are collected at 3 time points for the main study: during hospitalization, 6 months, and 12 months after the discharge. The milestone for first patient in was reached on January 7, 2022, and complete enrollment is expected before October 2023. The primary aims of the main study are to determine the degree of guideline-directed medical therapies and to identify prognostic predictors associated with 1-year composite outcomes, including death, myocardial infarction, stroke, and unplanned coronary revascularization in ACS patients. Thereafter, the patient data will be analyzed every 3 to 5 years for up to 20 years after discharge using the NHIRD in the extended study.</p><p><strong>Conclusions: </strong>We hypothesized that a greater increase in the implementation of guideline-directed medical therapies can be observed. The results of the current study will add new and important information regarding a broad spectrum of ACS to drive further investigations.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 4","pages":"561-571"},"PeriodicalIF":1.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346056/pdf/acs-39-561.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatorenal Syndrome in Fontan Circulation with Atypical Hemodynamic Presentation.","authors":"Yu-Ling Huang,&nbsp;Chun-An Chen,&nbsp;Mei-Hwan Wu,&nbsp;Jou-Kou Wang,&nbsp;Hsi-Chuan Hung,&nbsp;Hīng-Ka Lîm","doi":"10.6515/ACS.202307_39(4).20230307A","DOIUrl":"https://doi.org/10.6515/ACS.202307_39(4).20230307A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 4","pages":"646-650"},"PeriodicalIF":1.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346047/pdf/acs-39-646.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alternative Occlusion Method with Handmade Umbrella in Renal Artery Perforation.","authors":"Akin Torun,&nbsp;Ulas Bildirici","doi":"10.6515/ACS.202307_39(4).20230416A","DOIUrl":"https://doi.org/10.6515/ACS.202307_39(4).20230416A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 4","pages":"654-657"},"PeriodicalIF":1.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346050/pdf/acs-39-654.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}