Acta Cardiologica Sinica最新文献

{"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}

{"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}

{"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}