Cardiology and cardiovascular medicine最新文献

{"title":"Development of In-Hospital Outcomes in Patients undergoing Transcatheter Aortic Valve Implantation (TAVI) at an Interdisciplinary Heart Center: A Single-Center Experience of 489 Consecutive Cases.","authors":"Mukaram Rana,&nbsp;Margit Niethammer,&nbsp;Christian Sellin,&nbsp;Hilmar Dörge,&nbsp;Holger Eggebrecht,&nbsp;Volker Schächinger","doi":"10.26502/fccm.92920309","DOIUrl":"https://doi.org/10.26502/fccm.92920309","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter Aortic Valve Implantation (TAVI) has emerged over time, reflected in appropriate adjustments in the European Society of Cardiology (ESC) guidelines in 2007, 2012 and 2017.</p><p><strong>Objective: </strong>The aim of this study was to analyze in-hospital outcomes after TAVI in the development within a single heart center over a period of 10 years depending on adjustments in the guidelines, infrastructural and procedural determinants.</p><p><strong>Methods: </strong>489 consecutive patients who underwent TAVI from 2010 and 2019 at our center were analyzed retrospectively. Patients were divided into 3 groups of different treatment circumstances depending on guidelines adjustments and local infrastructural progress (group 1: 2010-2015 (n = 132), group 2: 2016-2017 (n = 155), group 3: 2018-2019 (n = 202). The primary endpoint was defined as all-cause in-hospital mortality. Secondary endpoints were selected according to the Valve Academic Research Consortium (VARC)-2 definitions. Multivariate logistic regression analysis was performed to determine predictors of in-hospital mortality. Statistical significance was assumed for p < 0.05.</p><p><strong>Results: </strong>489 patients (346 (70.8 %) transfemoral and 143 (29.2 %) transapical) underwent TAVI. Comparing periods (group 1 vs. 2 vs. 3) age (82.1 ± 6.2 vs. 82.5 ± 4.8 vs. 81.1 ± 5.1 years, p = 0.012) and EuroSCORE II (8.4 ± 6.0 vs. 5.8 ± 4.9 vs. 5.5 ± 5.0 %, p < 0.001) declined over time. Rates of in-hospital mortality decreased significantly (9.1 % vs. 5.8 % vs. 2.5 %, p = 0.029), especially with observed-to-expected mortality ratios indicating a disproportionate decline of in-hospital mortality (1.08 vs. 1.00 vs. 0.45). Furthermore, post-procedural complications, such as acute kidney injury stage 3 (10.6 % vs. 3.2 % vs. 4.5 %, p = 0.016) and bleeding complications (14.4 % vs. 11.6 % vs 7.9 %, p = 0.165) decreased from group 1 to 3. However, rates of permanent pacemaker implantations (7.6 % vs. 11.0 % vs. 22.8 %, p < 0.001) increased, associated with a switch towards self-expanding valves (0.0 % vs. 61.3 % vs. 76.7 %, p < 0.001). Length of hospitalization as well as stay at intensive care and intermediate care unit could be reduced significantly during the observation period. In multivariate analysis age (OR: 1.103; 95 % CI: 1.013 - 1.202; p = 0.025), creatinine level before TAVI (OR: 1.497; 95 % CI: 1.013 - 2.212; p = 0.043), atrial fibrillation (OR: 2.956; 95 % CI: 1.127 - 7.749; p = 0.028) and procedure duration (OR: 1.017; 95 % CI: 1.009 - 1.025; p < 0.001) could be identified as independent predictors of in-hospital mortality.</p><p><strong>Conclusion: </strong>This study identified age, creatinine level before TAVI, the presence of atrial fibrillation and procedure duration as independent predictors for in-hospital mortality. Although these predictors decreased during the observation period, the decline in hospital-mortality was disproportionate, w","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"7 2","pages":"52-68"},"PeriodicalIF":0.0,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9522117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective Effect of Pituitary Adenylate Cyclase-Activating Polypeptide-38 Against Radiation-Induced Myocardial Injury in Mice","authors":"Huan Li, P. Yi, Qian Zhu, Lu Cao, Cheng Xu, Min Li, Jia-yi Chen","doi":"10.26502/fccm.92920325","DOIUrl":"https://doi.org/10.26502/fccm.92920325","url":null,"abstract":"","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and Becoming of Chest Pain of Undetermined Origin After Leaving the Emergency Department","authors":"F. Bouriche, Aurélia Ruf, S. Yvorra, P. Michelet","doi":"10.26502/fccm.92920331","DOIUrl":"https://doi.org/10.26502/fccm.92920331","url":null,"abstract":"","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Dysfunction Predicts Major Adverse Cardiovascular Events in Black and Latino Patients Who have Atrial Fibrillation","authors":"Muhammad Zeeshan, Erik B. Lehman, Gerald V. Naccarelli, Tariq Ali Ahmad, Raji Ayinla, Sudhanshu Bhatnagar","doi":"10.26502/fccm.92920343","DOIUrl":"https://doi.org/10.26502/fccm.92920343","url":null,"abstract":"Background: Atrial Fibrillation (AF) is present in over 6 million Americans. However, AF occurs less commonly in African Americans and Latinos compared to Caucasians. Major adverse cardiovascular events (MACE) is the leading cause of death in these populations. Hypothesis: We theorize that glomerular filtration rates (GFR) is an independent risk factor for MACE in African Americans and Latinos with non-valvular AF (NVAF).","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136003073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical Left Ventricular Disfunction in Obese Children: Are we Late?","authors":"B Riaño-Mendez, M Ruiz-del Campo, P Garcia-Navas, A Ibiricu-Lecumberri, MY Ruiz-del Prado","doi":"10.26502/fccm.92920345","DOIUrl":"https://doi.org/10.26502/fccm.92920345","url":null,"abstract":"Aim: Longitudinal global strain (LGS) is reduced in obese patients with preserved ejection fraction of the left ventricle (LV). TAPSE/PAPS ratio, recently described, may be a step forward a more efficient RV function evaluation. The aim of the present study was to screen left and right subclinical dysfunction in obese pediatric patients without comorbidities.","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136003954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical Carditis in Acute Rheumatic Fever: A Single Center Experience","authors":"Md. Saidul Alam, Mohammad Abdul Hye, Shuperna Ahmed, Md. Aminul Islam, Mustanshirah Lubna, B. Bhattacharjee, Md Arifur Rahman, M. Jobayer","doi":"10.26502/fccm.92920341","DOIUrl":"https://doi.org/10.26502/fccm.92920341","url":null,"abstract":"Background: Acute rheumatic fever (ARF) is an important public health problem in developing countries. Subclinical carditis (SCC) that is detected only by echocardiogram without audible heart murmurs is relatively common in ARF. The aim of this study was to determine the pattern of SCC in patients of ARF in a specialized center in Bangladesh. Methods : This cross-sectional study was conducted from April 2019 to May 2021 at the National Center for Control of Rheumatic Fever and Heart Diseases. Hundred consecutive diagnosed patients of acute rheumatic fever with SCC were included in the study. Diagnosis of ARF was done according to the revised Jones criteria in 2015. A total of 362 clinically suspected patients of ARF were screened and among them, 100 patients were detected of having SCC by Doppler echocardiography. Results: Mean age of patients with ARF and SCC was 11.8 ±3.6 years and 10.8 ±3.3 years respectively and female was predominant (52.6% in ARF and 57.7% in SCC). Majority of patients (94%) with SCC had a mitral valve involvement and isolated mitral regurgitation was the most common (84%) valvular lesion. Detected valvular lesions mostly were not severe; all the aortic regurgitation and almost all mitral regurgitation (98.8%) were mild and trivial in nature of severity. Conclusion: Common presence of SCC among ARF patients in our study agreed with the recommendations of revised Jones Criteria. Therefore, it is suggested that echocardiography should be done in every suspected patient with ARF for early detection of subclinical carditis and to reduce","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidized Low-density Lipoproteins and Lipopolysaccharides Augment Carotid Artery Plaque Vulnerability in Hypercholesterolemic Microswine.","authors":"S Nooti,&nbsp;V Rai,&nbsp;M M Radwan,&nbsp;F G Thankam,&nbsp;H Singh,&nbsp;Y S Chatzizisis,&nbsp;D K Agrawal","doi":"10.26502/fccm.92920338","DOIUrl":"https://doi.org/10.26502/fccm.92920338","url":null,"abstract":"<p><p>Atherosclerosis is a chronic inflammatory disease and hypercholesterolemia is a risk factor. This study aims to compare the potency of lipopolysaccharide (LPS) and oxidized low-density lipoproteins (oxLDL) to induce plaque formation and increase plaque vulnerability in the carotid artery of hypercholesterolemic Yucatan microswine. Atherosclerotic lesions at the common carotid artery junction and ascending pharyngeal artery were induced in hypercholesterolemic Yucatan microswine at 5-6 months of age with balloon angioplasty. LPS or oxLDL were administered intraluminally at the site of injury after occluding the arterial flow temporarily. Pre-intervention ultrasound (US), angiography, and optical coherence tomography (OCT) were done at baseline and just before euthanasia to assess post-op parameters. The images from the US, OCT, and angiography in the LPS and the oxLDL-treated group showed increased plaque formation with features suggestive of unstable plaque, including necrotic core, thin fibrous caps, and a signal poor region more with oxLDL compared to LPS. Histomorphology of the carotid artery tissue near the injury corroborated the presence of severe lesions in both LPS and oxLDL-treated pigs but more in the oxLDL group. Vascular smooth muscle and endothelial cells treated with LPS and oxLDL showed increased folds changes in mRNA transcripts of the biomarkers of inflammation and plaque vulnerability compared to untreated cells. Collectively, the results suggest that angioplasty-mediated intimal injury of the carotid arteries in atherosclerotic swine with local administration of LPS or ox-LDL induces vulnerable plaques compared to angioplasty alone and oxLDL is relatively more potent than LPS in inducing vulnerable plaque.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"7 4","pages":"273-294"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421630/pdf/nihms-1920665.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9996740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thromboembolism in the Complications of Long COVID-19.","authors":"Leilani A Lopes,&nbsp;Devendra K Agrawal","doi":"10.26502/fccm.92920317","DOIUrl":"https://doi.org/10.26502/fccm.92920317","url":null,"abstract":"<p><p>SARS-CoV-2 is a +ssRNA helical coronavirus responsible for the global pandemic caused by coronavirus disease 19 (COVID-19). Classical clinical symptoms from primary COVID-19 when symptomatic include cough, fever, pneumonia or even ARDS; however, they are limited primarily to the respiratory system. Long-COVID-19 sequalae is responsible for many pathologies in almost every organ system and may be present in up to 30% of patients who have developed COVID-19. Our review focuses on how long-COVID-19 (3 -24 weeks after primary symptoms) may lead to an increased risk for stroke and thromboembolism. Patients who were found to be primarily at risk for thrombotic events included critically ill and immunocompromised patients. Additional risk factors for thromboembolism and stroke included diabetes, hypertension, respiratory and cardiovascular disease, and obesity. The etiology of how long-COVID-19 leads to a hypercoagulable state are yet to be definitively elucidated. However, anti-phospholipid antibodies and elevated D-dimer are present in many patients who develop thromboembolism. In addition, chronic upregulation and exhaustion of the immune system may lead to a pro-inflammatory and hypercoagulable state, increasing the likelihood for induction of thromboembolism or stroke. This article provides an up-to-date review on the proposed etiologies for thromboembolism and stroke in patients with long-COVID-19 and to assist health care providers in examining patients who may be at a higher risk for developing these pathologies.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"7 2","pages":"123-128"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"False Atrial Fibrillation Alerts from Smartwatches are Associated with Decreased Perceived Physical Well-being and Confidence in Chronic Symptoms Management.","authors":"Khanh-Van Tran, Andreas Filippaios, Kamran Noorishirazi, Eric Ding, Dong Han, Fahimeh Mohagheghian, Qiying Dai, Jordy Mehawej, Ziyue Wang, Darleen Lessard, Edith Mensah Otabil, Alex Hamel, Tenes Paul, Matthew F Gottbrecht, Timothy P Fitzgibbons, Jane Saczynski, Ki H Chon, David D McManus","doi":"10.26502/fccm.92920314","DOIUrl":"10.26502/fccm.92920314","url":null,"abstract":"<p><p>Wrist-based wearables have been FDA approved for AF detection. However, the health behavior impact of false AF alerts from wearables on older patients at high risk for AF are not known. In this work, we analyzed data from the Pulsewatch (NCT03761394) study, which randomized patients (≥50 years) with history of stroke or transient ischemic attack to wear a patch monitor and a smartwatch linked to a smartphone running the Pulsewatch application vs to only the cardiac patch monitor over 14 days. At baseline and 14 days, participants completed validated instruments to assess for anxiety, patient activation, perceived mental and physical health, chronic symptom management self-efficacy, and medicine adherence. We employed linear regression to examine associations between false AF alerts with change in patient-reported outcomes. Receipt of false AF alerts was related to a dose-dependent decline in self-perceived physical health and levels of disease self-management. We developed a novel convolutional denoising autoencoder (CDA) to remove motion and noise artifacts in photoplethysmography (PPG) segments to optimize AF detection, which substantially reduced the number of false alerts. A promising approach to avoid negative impact of false alerts is to employ artificial intelligence driven algorithms to improve accuracy.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"7 2","pages":"97-107"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10358285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9862434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Analysis of CYP2C19 Alleles and Clopidogrel Resistance Among Bangladeshi Patients with Acute Coronary Syndrome","authors":"Mohsin Ahmed, Sayeedur Rahman Khan, Aminur Razzaque, M. Arifur Rahman, S. Islam, Mainul Islam, Monwarul Islam AKM, Mohammad Ullah Firoze, Md. Matiur Rahman, T. Ahmad, Kudrat-E-Khuda Cm, Shiblee Sa","doi":"10.26502/fccm.92920321","DOIUrl":"https://doi.org/10.26502/fccm.92920321","url":null,"abstract":"","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}