Cardiology and cardiovascular medicine最新文献

{"title":"Left Atrial Mechanics and Functional Capacity in HFpEF pts with Paroxysmal Atrial Fibrillation","authors":"A. Moya, M. Kodeboina, A. Katbeh, M. Penicka, S. Verstreken, M. Vanderheyden","doi":"10.26502/fccm.92920306","DOIUrl":"https://doi.org/10.26502/fccm.92920306","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 \u0000 \u0000 \u0000 Exercise capacity and ventilatory efficiency are often impaired in heart failure patients with preserved ejection fraction (HFpEF). Since left atrial (LA) pressure, particularly during exercise plays a major role in the exercise intolerance observed in these patients, we aimed to characterize the contribution of resting LA mechanical properties, assessed by two-dimensional speckle tracking echocardiography upon exercise capacity.\u0000 \u0000 \u0000 \u0000 To evaluate relationship between LA mechanics, measured by LA strain (LAS) and parameters of exercise capacity, assessed by cardiopulmonary exercise testing (CPET) in HFpEF patients with dyspnea and paroxysmal atrial fibrillation (AF).\u0000 \u0000 \u0000 \u0000 The study included 23 consecutive patients (63 ± 8 years, 83 % males) with dyspnea (NYHA≥II), paroxysmal AF and preserved LV ejection fraction (≥50%), referred for elective pulmonary vein ablation. The probability of HFpEF was estimated using H2FPEF score. During sinus rhythm, all patients underwent speckle tracking echocardiography and cardiopulmonary exercise testing by treadmill. Peak oxygen uptake (VO2max) served as measure of functional capacity and ventilation/carbon dioxide output (VE/VCO2) slope as surrogate of ventilation/perfusion mismatch.\u0000 \u0000 \u0000 \u0000 Out of all the echocardiographic indices, only LA contractile strain and strain rate showed significant correlation with peak VO2 (both p < 0.05). All three strain components of LA phasic function, i.e. reservoir, conduit and contractile LAS, had significant relationship with VE/VCO2 slope (all p<0.050). Patients with LA strain rate above the median had significantly higher VE/VCO2 slope (p=0.025) and lower peak VO2 (p=0.010). In contrast, no correlations were observed between exercise parameters and LA volumes or LA emptying fraction or any other echocardiographic indices.\u0000 \u0000 \u0000 \u0000 In HFpEF patients, VO2 max and VE/VCO2 slope are closely related to LA contractile strain, suggesting that abnormalities in LA mechanics may contribute to the blunted exercise capacity observed. Therefore, these markers can be used as an echocardiographic surrogate of functional capacity in HFpEF patients with paroxysmal AF.\u0000","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41543048","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":"Echocardiographic Evaluation of His Bundle Pacing in Patients with Prolonged PR Intervals.","authors":"Ethan Fry,&nbsp;Karam Ayoub,&nbsp;Vincent L Sorrell,&nbsp;Joseph Souza,&nbsp;Aaron Hesselson,&nbsp;Steve Leung,&nbsp;Kristin Ellison","doi":"10.26502/fccm.92920310","DOIUrl":"https://doi.org/10.26502/fccm.92920310","url":null,"abstract":"<p><strong>Background: </strong>Patients with PR intervals >240ms have atrio-ventricular (AV) dyssynchrony, which can increase risk of atrial fibrillation and all-cause mortality. When requiring pacing, long AV delays (AVDs) have been programmed to avoid ventricular dyssychrony. His bundle pacing (HBP) may provide improved AV synchrony in patients with prolonged PR.</p><p><strong>Methods: </strong>10 patients with sinus node dysfunction and prolonged PR who received HBP were studied. Real-time echocardiographic was performed with 3 pacemaker modes (RV septal, non-selective HBP, and selective HBP) using the following pacemaker settings: control (no ventricular pacing), pacing with AVD of 180ms, 150ms, 120ms, 100ms, and 70ms. Echocardiographic Doppler measurements: EA/RR, >40% = AV synchrony; E/e', <8 = normal left atrial pressure; pulmonic-to-aortic pre-ejection time difference, <40ms = interventricular synchrony; septal-to-lateral wall activation time difference, <56ms = intraventricular synchrony; and LVOT VTI. Unpaired T test was used to evaluate for significance. Exclusion criteria: persistent atrial fibrillation, second-degree AV block.</p><p><strong>Results: </strong>Compared to control programming, HBP showed a 31.5% increase in EA/RR time, a decrease in E/e' of 26.9%, and an increase in the LVOT VTI of 21.3%. Compared to RV septal pacing, there was a similar increase in LVOT VTI. These findings met statistical significance and were considered optimal based on Doppler echocardiography findings primarily at AVDs of 150ms and 120ms. Comparisons between selective and non-selective pacing were not significantly different.</p><p><strong>Conclusion: </strong>Compared to controls and RV septal pacing, physiologic His bundle pacing was shown to increase markers of AV synchrony and LV stroke volume while maintaining ventricular synchrony.</p>","PeriodicalId":72523,"journal":{"name":"Cardiology and cardiovascular medicine","volume":"7 2","pages":"69-78"},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167774/pdf/nihms-1883379.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9452436","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":"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}