{"title":"Gastropleural Fistula: A Rare But Formidable Complication of Type B Aortic Dissection.","authors":"Po-Ju Chen, Juey-Ming Shih","doi":"10.6515/ACS.202411_40(6).20240930A","DOIUrl":"10.6515/ACS.202411_40(6).20240930A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"814-817"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708996","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}
Metin Coksevim, Mustafa Yenerçağ, Ahmet Onur Kocasarı, Abdülkadir Kara, Ömer Kertmen, Korhan Soylu
{"title":"Predictors of Length of Stay after Transcatheter Aortic Valve Implantation: Impact of Prognostic Nutritional Index.","authors":"Metin Coksevim, Mustafa Yenerçağ, Ahmet Onur Kocasarı, Abdülkadir Kara, Ömer Kertmen, Korhan Soylu","doi":"10.6515/ACS.202409_40(5).20240713A","DOIUrl":"10.6515/ACS.202409_40(5).20240713A","url":null,"abstract":"<p><strong>Background: </strong>Pre-transcatheter aortic valve replacement (TAVR) nutritional status can potentially affect the length of hospital stay (LoS) after TAVR. The Prognostic Nutritional Index (PNI) is a widely recognised nutritional index. We aimed to determine the effect of PNI on LoS in patients undergoing TAVR.</p><p><strong>Methods: </strong>The study population (158 patients) was divided into two groups: early discharge (LoS ≤ 3 days) and late discharge (LoS > 3 days). PNI was calculated before TAVR.</p><p><strong>Results: </strong>In the LoS > 3 days group, the median age, creatinine level, rate of surgical access site closure and rate of major complications were higher, whereas estimated glomerular filtration rate, albumin, haemoglobin, lymphocyte count and PNI were significantly lower. Receiver operating characteristic curve analysis revealed a PNI cutoff of 39 (area under the curve = 0.778, p < 0.001) with 86.8% sensitivity and 55.2% specificity for predicting extended LoS. The 30-day endpoint analysis revealed significantly higher rates of death and hospitalisation with LoS > 3 days and PNI ≤ 39. Multivariate binary logistic regression analysis identified several independent predictors of extended LoS: severe renal insufficiency [odds ratio: 3.951 (95% confidence interval: 1.281-12.191); p = 0.017], surgical access site closure [4.353 (1.701-11.141); p = 0.002), complications [7.448 (1.305-42.518); p = 0.024] and PNI < 39 [5.906 (2.375-14.684); p < 0.005].</p><p><strong>Conclusions: </strong>Decreased PNI may be associated with LoS > 3 days after TAVR. Nutritional status assessed using PNI may be a useful independent predictor of LoS after TAVR.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 5","pages":"608-617"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278630","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":"<sup>18</sup>F-Florbetaben PET/CT for the Diagnosis and Subtyping of Cardiac Amyloidosis: A Case Series and Review of the Literature.","authors":"Yu-Cheng Shih, Bing-Hsiean Tzeng, Meng-Chieh Tsai, Yuan-Bin Yu, Yu-Chien Shiau, Shan-Ying Wang, Yen-Wen Wu","doi":"10.6515/ACS.202409_40(5).20240617D","DOIUrl":"10.6515/ACS.202409_40(5).20240617D","url":null,"abstract":"<p><strong>Objectives: </strong>Cardiac amyloidosis (CA) is a type of systemic amyloidosis. Amyloid-targeting positron emission tomography (PET) has shown potential as an imaging method for CA. However, the optimal imaging protocol and role of <sup>18</sup>F-florbetaben (FBB) PET in the diagnosis and subtyping of CA have yet to be determined.</p><p><strong>Methods: </strong>Patients with suspected CA who had positive or equivocal results of technetium-99m pyrophosphate (PYP) scintigraphy were enrolled for dynamic and late FBB PET imaging. In addition to visual assessment, a kinetic modeling-based approach including target-to-background ratio (TBR) and myocardial retention fraction (RF) of serial images reconstructed from a 20-min dynamic acquisition, and a late image at 110 min post-injection were performed. We compared FBB PET measures of four typical patients with light chain amyloidosis (AL), wild-type transthyretin amyloidosis (ATTRwt), variant transthyretin amyloidosis (ATTRv), and heart failure, respectively. We also reviewed the literature on the clinical use of amyloid PET in CA.</p><p><strong>Results: </strong>Myocardial tracer retention was only found in the AL patient on the late images. TBR and RF were highest in the AL patient followed by the ATTRwt patient, and lowest in the ATTRv and non-CA patients.</p><p><strong>Conclusions: </strong>FBB PET has potential in the detection and non-invasive subtyping of CA, especially in subjects with equivocal PYP findings or monoclonal gammopathy.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 5","pages":"635-643"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278617","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":"2024 Guidelines of the Taiwan Society of Cardiology on the Primary Prevention of Atherosclerotic Cardiovascular Disease --- Part I.","authors":"Ting-Hsing Chao, Tsung-Hsien Lin, Cheng-I Cheng, Yen-Wen Wu, Kwo-Chang Ueng, Yih-Jer Wu, Wei-Wen Lin, Hsing-Ban Leu, Hao-Min Cheng, Chin-Chou Huang, Chih-Cheng Wu, Chao-Feng Lin, Wei-Ting Chang, Wen-Han Pan, Pey-Rong Chen, Ke-Hsin Ting, Chun-Hung Su, Chih-Sheng Chu, Kuo-Liong Chien, Hsueh-Wei Yen, Yu-Chen Wang, Ta-Chen Su, Pang-Yen Liu, Hsien-Yuan Chang, Po-Wei Chen, Jyh-Ming Jimmy Juang, Ya-Wen Lu, Po-Lin Lin, Chao-Ping Wang, Yu-Shien Ko, Chern-En Chiang, Charles Jia-Yin Hou, Tzung-Dau Wang, Yen-Hung Lin, Po-Hsun Huang, Wen-Jone Chen","doi":"10.6515/ACS.202409_40(5).20240724A","DOIUrl":"10.6515/ACS.202409_40(5).20240724A","url":null,"abstract":"<p><p>Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of death worldwide and in Taiwan. It is highly prevalent and has a tremendous impact on global health. Therefore, the Taiwan Society of Cardiology developed these best-evidence preventive guidelines for decision-making in clinical practice involving aspects of primordial prevention including national policies, promotion of health education, primary prevention of clinical risk factors, and management and control of clinical risk factors. These guidelines cover the full spectrum of ASCVD, including chronic coronary syndrome, acute coronary syndrome, cerebrovascular disease, peripheral artery disease, and aortic aneurysm. In order to enhance medical education and health promotion not only for physicians but also for the general public, we propose a slogan <b>(2H2L)</b> for the primary prevention of ASCVD on the basis of the essential role of healthy dietary pattern and lifestyles: \"<b>Healthy Diet and Healthy Lifestyles to Help Your Life and Save Your Lives</b>\". We also propose an acronym of the modifiable risk factors/enhancers and relevant strategies to facilitate memory: \" <b>ABC<sub>2</sub>D<sub>2</sub>EFG-I'M<sub>2</sub> ACE\"</b>: Adiposity, Blood pressure, Cholesterol and Cigarette smoking, Diabetes mellitus and Dietary pattern, Exercise, Frailty, Gout/hyperuricemia, Inflammation/infection, Metabolic syndrome and Metabolic dysfunction-associated fatty liver disease, Atmosphere (environment), Chronic kidney disease, and Easy life (sleep well and no stress). Some imaging studies can be risk enhancers. Some risk factors/clinical conditions are deemed to be preventable, and healthy dietary pattern, physical activity, and body weight control remain the cornerstone of the preventive strategy.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 5","pages":"479-543"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278618","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":"Atlas Drug-Eluting Coronary Stents Inhibit Neointimal Hyperplasia in Sheep Modeling.","authors":"Rasit Dinc, Halit Yerebakan","doi":"10.6515/ACS.202409_40(5).20240618A","DOIUrl":"10.6515/ACS.202409_40(5).20240618A","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity worldwide. Many patients with CAD require mechanical revascularization. However, restenosis after minimally invasive interventions is a major problem for these patients. Fortunately, the controlled drug delivery properties of drug-eluting stents seem to be able to overcome this problem. In this study, the pharmacodynamic and pharmacokinetic properties of Atlas Drug-eluting Coronary Stents coated with poly (lactic acid-coglycolic acid) (PLGA) were evaluated.</p><p><strong>Materials and methods: </strong>This study included 20 non-atherosclerotic female sheep divided into 4 groups that included 4 study and 1 control animal randomly assigned to each group. Animals in the study groups were stented with Atlas Drug-eluting Coronary Stents, and the pharmacodynamic and pharmacokinetic properties were evaluated.</p><p><strong>Results: </strong>Sirolimus was shown to have a statistically important effect on the vascular endothelium. With time, the decrease in sirolimus in blood samples was statistically significant. Two animals died after implantation; however no clinically significant side effects were observed in the others.</p><p><strong>Conclusions: </strong>The results in this study showed a significant reduction in neointimal hyperplasia after experimental implantation of Atlas Drug-eluting Coronary Stents coated with PLGA polymer. Pharmacokinetic studies also showed that the stent did not release a significant amount of sirolimus after 28 days.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 5","pages":"585-594"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278622","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}
Po-Hsueh Su, Ting-Hsing Chao, Mu-Shiang Huang, Wei-Chuan Tsai
{"title":"Determinants of Prosthesis-Patient Mismatch after Aortic Valve Replacement-Ten-Year Cohort Data in Single Center of Taiwan.","authors":"Po-Hsueh Su, Ting-Hsing Chao, Mu-Shiang Huang, Wei-Chuan Tsai","doi":"10.6515/ACS.202409_40(5).20240207B","DOIUrl":"10.6515/ACS.202409_40(5).20240207B","url":null,"abstract":"<p><strong>Background: </strong>Patient-prosthesis mismatch (PPM) after surgical aortic valve replacement for severe aortic stenosis has a significant effect on survival. Few studies have identified the risk factors for PPM and related outcomes. This study investigated these risk factors and clarified the outcomes.</p><p><strong>Methods: </strong>This study enrolled consecutive patients who underwent aortic valve replacement surgery between January 2010 and June 2020 in our hospital. Data on clinical profiles, prosthesis types, echocardiographic parameters before and after surgery, and clinical outcomes including the composite of all-cause mortality and redo valve replacement were collected. We defined moderate and severe PPM as an effective orifice area index value of ≤ 0.85 and ≤ 0.65 cm<sup>2</sup>/m<sup>2</sup>, respectively, measured postoperatively through echocardiography. Potential risk factors for PPM and clinical outcomes were evaluated.</p><p><strong>Results: </strong>A total of 185 patients were enrolled. Body surface area (BSA; 1.68 ± 0.02 vs. 1.62 ± 0.01 m<sup>2</sup>, p = 0.036), renal insufficiency (32.50% vs. 11.70%, p = 0.026), and aortic annulus diameter (1.99 ± 0.05 vs. 2.17 ± 0.03 cm, p = 0.013) were statistically significant risk factors for severe PPM. The primary outcome was observed in 30.00% and 15.86% of the patients with and without severe PPM, respectively (log-rank p = 0.023). Multivariate Cox proportional hazards analysis indicated that severe PPM was a risk factor for the primary outcome (hazard ratio: 2.688, 95% confidence interval: 1.094-6.622, p = 0.031).</p><p><strong>Conclusions: </strong>Our study demonstrated that large BSA, renal insufficiency, and small annulus diameter were risk factors for severe PPM after aortic valve replacement surgery. Severe PPM was associated with worse clinical outcomes.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 5","pages":"595-607"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278625","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}
Dong-Tao Li, Yi Cao, Yi-Gang Qiu, Yu Chen, Jian-Yong Zheng
{"title":"Feasibility and Effectiveness of Venoarterial Extracorporeal Membrane Oxygenation Plus Intra-Aortic Balloon Pump Assisted High-Risk Percutaneous Coronary Intervention in Complex Coronary Disease.","authors":"Dong-Tao Li, Yi Cao, Yi-Gang Qiu, Yu Chen, Jian-Yong Zheng","doi":"10.6515/ACS.202409_40(5).20240617F","DOIUrl":"10.6515/ACS.202409_40(5).20240617F","url":null,"abstract":"<p><strong>Background: </strong>Mechanical circulatory support may facilitate high-risk percutaneous coronary intervention (PCI). This study aimed to assess the feasibility, safety and effectiveness of high-risk PCI under the support of venoarterial extracorporeal membrane oxygenation (VA-ECMO) combined with intra-aortic balloon pump (IABP).</p><p><strong>Methods: </strong>We enrolled patients who received VA-ECMO plus IABP-assisted PCI procedures at our center from April 2012 to June 2018. Major adverse cardiac events (MACEs) included all-cause death, myocardial infarction, and target vessel revascularization.</p><p><strong>Results: </strong>A total of 10 patients were included, with a mean age of 71 years, EuroSCORE II of 19.9%, and SYNTAX score of 39.8. Procedural success was achieved in nine (90%) patients. The mean duration of ECMO support was 1.5 hours, and 2.6 stents were implanted per patient. Major complications included contrast-induced nephropathy needing hemodialysis in one (10%) patient, significant hemoglobin drop requiring blood transfusion in two (20%) patients, pulmonary infection in one (10%) patient, and local surgical incision infection in one (10%) patient. The accumulative mortality rates for the nine patients with procedural success were 0, 22.2%, and 44.4% at 1, 3, and 5 years follow-up, respectively. However, cardiac death occurred in only one (11.1%) patient. In addition, two patients received repeat PCI or coronary artery bypass grafting within two years following the index procedure. The overall incidence rates of MACEs were 11.1%, 44.4%, and 66.7% at 1, 3, and 5 years follow-up, respectively.</p><p><strong>Conclusions: </strong>VA-ECMO plus IABP-assisted high-risk PCI was feasible in patients with complex coronary disease, with a high procedural success rate and acceptable mid-term clinical outcomes.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 5","pages":"577-584"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278626","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":"Catheter-Directed Thrombolysis for Superficial Femoral Artery Thrombosis via the Ipsilateral Dorsalis Pedis Artery.","authors":"Hsin-Fu Lee, Hung-Chi Su, Chi Chuang","doi":"10.6515/ACS.202409_40(5).20240617B","DOIUrl":"10.6515/ACS.202409_40(5).20240617B","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 5","pages":"656-658"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278623","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":"Late Cardiac Involvement of the Glycogen Storage Disease Type IIIa with Massive Left Ventricular Hypertrophy and Late Gadolinium Enhancement.","authors":"Bedirhan Bozkurt Çimen, Samet Yilmaz","doi":"10.6515/ACS.202409_40(5).20240528B","DOIUrl":"10.6515/ACS.202409_40(5).20240528B","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 5","pages":"648-650"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278629","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 Significant Role of Post-Acute Care Programs in Individuals with Heart Failure.","authors":"Ercan Akşit, Hakkı Kaya, Emine Gazi","doi":"10.6515/ACS.202409_40(5).20240531A","DOIUrl":"10.6515/ACS.202409_40(5).20240531A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 5","pages":"663-664"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278633","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}