Acta Cardiologica Sinica最新文献

{"title":"Ten-Year Clinical Progression in a Patient with Fabry Disease: A Longitudinal Study.","authors":"Ching-Ping Chao, Yen-Wen Wu, Heng-Hsu Lin, Meng-Chieh Tsai, Wen-Po Chuang","doi":"10.6515/ACS.202411_40(6).20240909A","DOIUrl":"10.6515/ACS.202411_40(6).20240909A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"805-809"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708952","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 of Self-Expanding Valves with Increased Capture of Larger Debris by Cerebral Protection System in Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis.","authors":"Amy Jing Ling, Yung-Tsai Lee, Wei-Hsian Yin, Tien-Ping Tsao, Kuo-Chen Lee, Huan-Chiu Lin, Chun-Ting Liu, Jeng Wei","doi":"10.6515/ACS.202411_40(6).20240730A","DOIUrl":"10.6515/ACS.202411_40(6).20240730A","url":null,"abstract":"<p><strong>Background: </strong>Mixed evidence exists regarding stroke rates when comparing self-expanding valves (SEVs) to balloon-expandable valves (BEVs) in transcatheter aortic valve replacement (TAVR). This study investigates the debris captured by the SENTINEL cerebral protection system (CPS) during TAVR.</p><p><strong>Methods: </strong>Seventy-five consecutive patients who underwent TAVR with CPS from March to December 2023 were recruited. Collected debris underwent histopathologic analysis, categorized by size (< 2 mm, 2-5 mm, > 5 mm) and quantity. Logistic regression analysis was used to identify predictors for the presence of particles > 5 mm in size.</p><p><strong>Results: </strong>Of the 75 patients, 39 received SEVs and 36 received BEVs. Baseline characteristics were similar between the groups. The BEV group had significantly more frequent concomitant percutaneous coronary interventions (p = 0.013), while the SEV group had longer TAVR procedure (p = 0.019) and fluoroscopy times (p = 0.006). All patients had visible debris, predominantly valve tissue (SEV vs. BEV = 79.8% vs. 47.2%; p = 0.308), calcification (SEV vs. BEV = 23.1% vs. 36.1%; p = 0.215), and thrombus (SEV vs. BEV = 15.4% vs. 5.6%; p = 0.855). No significant differences were observed in particle count and particle size < 5 mm between the SEV and BEV groups. However, logistic regression analysis revealed that the patients who received SEVs had a 16.78-fold increased likelihood of having captured debris > 5 mm compared to those who received BEVs.</p><p><strong>Conclusions: </strong>Our study demonstrated that significantly more particles sized > 5 mm were captured by the CPS during TAVR in the SEV group, underscoring the importance of using the CPS during TAVR, especially in younger patients receiving SEVs.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"751-761"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708981","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":"Correlating Electrocardiograms with Echocardiographic Parameters in Hemodynamically-Significant Aortic Regurgitation Using Deep Learning.","authors":"Yi-Ting Li, Kuang-Chien Chiang, Alexander Te-Wei Shieh, Tetsuji Kitano, Yosuke Nabeshima, Chung-Yen Lee, Kang Liu, Kuan-Yu Lai, Meng-Han Tsai, Li-Ting Ho, Wen-Jone Chen, Masaaki Takeuchi, Tzung-Dau Wang, Li-Tan Yang","doi":"10.6515/ACS.202411_40(6).20240918B","DOIUrl":"10.6515/ACS.202411_40(6).20240918B","url":null,"abstract":"<p><strong>Background: </strong>Of all electrocardiogram (ECG) deep-learning (DL) models used to detect left-sided valvular heart diseases, aortic regurgitation (AR) has been the hardest to detect. Moreover, to what extent ECGs could detect AR-related left ventricular (LV) remodeling and dysfunction is unknown.</p><p><strong>Objectives: </strong>We aimed to evaluate the ability of DL-based ECG models to predict LV remodeling parameters associated with hemodynamically significant AR.</p><p><strong>Methods: </strong>From 573 consecutive patients, 1457 12-lead ECGs close to baseline transthoracic echocardiograms confirming ≥ moderate-severe AR and before aortic valve surgery were retrospectively collected. A ResNet-based model was used to predict LV ejection fraction (LVEF), LV end-diastolic dimension (LVEDD), LV end-systolic dimension index (LVESDi), LV mass index (LVMi), LV end-diastolic volume index (LVEDVi), LV end-systolic volume index (LVESVi), and bicuspid aortic valve (BAV) from the ECGs. Five-fold cross-validation was used for model development (80%) with the held-out testing set (20%) to evaluate its performance.</p><p><strong>Results: </strong>Our DL model achieved area under receiver operating characteristic curves (AUROCs) of 0.77, 0.80, and 0.87 for discriminating LVEF < 55%, < 50%, and < 40%. For LVEDD > 65 mm, LVESDi > 30 mm/m², LVESVi > 45 ml/m², LVEDVi > 99 ml/m², LVMi > 158 mm/m², and BAV, our model also achieved significant results, with AUROCs of 0.83, 0.85, 0.84, 0.81, 0.78, and 0.74, respectively. The SHapley Additive exPlanation values showed that our model focused on the QRS complex while making decisions.</p><p><strong>Conclusions: </strong>Our DL model found correlations between ECGs and parameters indicating LV remodeling and dysfunction in patients with significant AR. Analyzing ECGs with DL models may assist in the timely detection of LV dysfunction and screening for the necessity of additional echocardiography exams, especially when echocardiography might not be readily available.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"762-780"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708991","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":"Short-Term Use of Ivabradine in Critical Ill Patients with Atrial Fibrillation and Rapid Ventricular Response.","authors":"Wei-Cheng Lin, Shoa-Lin Lin","doi":"10.6515/ACS.202411_40(6).20240916A","DOIUrl":"10.6515/ACS.202411_40(6).20240916A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"820-821"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709008","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":"A Case with a Short QT Interval and Idiopathic Ventricular Fibrillation Due to Carnitine Transporter Defect.","authors":"Chen-Jung Hsu, Cheng-I Wu, Yenn-Jiang Lin","doi":"10.6515/ACS.202411_40(6).20240721A","DOIUrl":"10.6515/ACS.202411_40(6).20240721A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"801-804"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708978","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":"Biventricular Cardiomyopathy in a Setting of Neutropenic Sepsis, Clenbuterol and 2,4 Dinitrophenol Abuse - A Case Report.","authors":"Fan Yang, Wen Jun Eran Sim, Shiun Woei Wong","doi":"10.6515/ACS.202411_40(6).20240925A","DOIUrl":"10.6515/ACS.202411_40(6).20240925A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"810-813"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708984","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":"Short and Mid-Term Outcomes of Rotarex Mechanical Thrombectomy for Acute Limb Ischemia in Taiwan: A Retrospective Study in a Single Medical Center.","authors":"Shun-Kai Yu, Nai-Yu Chi, Ching-Tang Chang, Tzu-Chieh Lin, Yi-Hsueh Liu, Wei-Chung Tsai, Wen-Hsien Lee, Ho-Ming Su, Tsung-Hsien Lin, Po-Chao Hsu","doi":"10.6515/ACS.202411_40(6).20240812A","DOIUrl":"10.6515/ACS.202411_40(6).20240812A","url":null,"abstract":"<p><strong>Background: </strong>Acute limb ischemia (ALI) is a medical emergency necessitating immediate action to avert irreversible tissue harm and limb loss. Rotarex mechanical thrombectomy (RMT) has become an efficient treatment alternative for ALI. However, there is a lack of data on RMT in Taiwan.</p><p><strong>Methods: </strong>We retrospectively analyzed 61 ALI patients treated with RMT at our hospital between January 2016 and January 2022. We collected baseline characteristics, laboratory and angiographic data. We also examined the outcomes at 30 days, 6 months, and 1 year, including major amputations, minor amputations, all-cause mortality, and major adverse limb events (MALEs).</p><p><strong>Results: </strong>Among the 61 RMT-treated patients, the average age was 70 ± 14 years. ALI affected the upper extremities in 9 cases and lower extremities in 52 cases. One-year outcomes revealed 2 major amputations (3.3%), 2 minor amputations (3.3%), 6 all-cause deaths (9.8%), and 10 MALEs (16.4%). After multiple logistic regression analysis, hemoglobin drop was significantly associated with 1-year all-cause mortality, and a history of peripheral artery disease (PAD) was significantly associated with MALEs.</p><p><strong>Conclusions: </strong>Our research is the first investigation into the application of RMT for ALI in Taiwan. The short- and mid-term outcomes after RMT for ALI revealed reductions in amputation, mortality, and MALE rates. In addition, a decline in hemoglobin level was a significant predictor of increased mortality, and a history of PAD was a significant predictor of increased MALEs following RMT.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"793-800"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709003","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 Distribution of Left Ventricular Ejection Fraction, Characteristics, and Clinical Outcomes of Patients with Newly Diagnosed Heart Failure in Taiwan.","authors":"Cze Ci Chan, Hung-Chi Su, Chi Chuang, Tzyy-Jer Hsu, Fu-Chih Hsiao, Pao-Hsien Chu","doi":"10.6515/ACS.202411_40(6).20240918A","DOIUrl":"10.6515/ACS.202411_40(6).20240918A","url":null,"abstract":"<p><strong>Background: </strong>Data regarding the distribution of left ventricular ejection fraction among patients with newly diagnosed heart failure (HF) and the outcomes of patients with heart failure with preserved ejection fraction (HFpEF) in Taiwan are limited.</p><p><strong>Methods: </strong>Patients with newly diagnosed HF were identified from a multi-institutional database between 2016 and 2020. Outcomes were compared between patients with HFpEF and heart failure with reduced ejection fraction (HFrEF) after propensity score matching (PSM).</p><p><strong>Results: </strong>Of 7,736 newly diagnosed HF patients, 4,393 (56.8%) had HFpEF and 1,977 (25.6%) had HFrEF. The HFpEF group was older (71.5 vs. 64.2 years) and more likely to be female (48.9% vs. 31.1%). Comorbidities were more common in the HFpEF patients. Median follow-up was 2.1 years. Prior to PSM, the HFpEF patients had higher all-cause mortality risk [hazard ratio (HR) 1.21, 95% confidence interval (CI) 1.11-1.33] but lower cardiovascular (CV) death risk (HR 0.84, 95% CI 0.72-0.97) compared to those with HFrEF. The HFpEF group had a trend of higher overall hospitalization risk (HR 1.06, 95% CI 0.99-1.14), but lower HF hospitalization risk (HR 0.61, 95% CI 0.55- 0.67). After PSM, all-cause mortality and overall hospitalization were comparable. The HFpEF group had lower rates of CV death (HR 0.82, 95% CI 0.68-1.0) and HF hospitalization (HR 0.60, 95% CI 0.53-0.69) compared to the HFrEF group.</p><p><strong>Conclusions: </strong>Among patients with newly diagnosed HF, HFpEF is the predominant phenotype, characterized by older age, higher female prevalence, and increased comorbidities. After adjusting for these factors, all-cause death and hospitalization risks became similar between the HFpEF and HFrEF patients. The HFpEF patients had lower risks of CV death and HF hospitalization.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"740-750"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708954","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":"Response to Letter to the Editor: Clinical Implication of Atrial Conductance Impairment on New-Onset Atrial Fibrillation after Transcatheter Aortic Valve Implantation.","authors":"Ugur Nadir Karakulak","doi":"10.6515/ACS.202411_40(6).20240919A","DOIUrl":"10.6515/ACS.202411_40(6).20240919A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"822-823"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709001","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":"Clinical Implication of Atrial Conductance Impairment on New-Onset Atrial Fibrillation after Transcatheter Aortic Valve Implantation.","authors":"Naoya Kataoka, Teruhiko Imamura","doi":"10.6515/ACS.202411_40(6).20240915A","DOIUrl":"10.6515/ACS.202411_40(6).20240915A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"819"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708986","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}