American journal of cardiovascular disease最新文献

{"title":"Multimodality imaging in diagnosis and management of patent ductus arteriosus in an adult: a case report.","authors":"Leila Najmafshar,&nbsp;Mansoreh Abdolhosseini,&nbsp;Asadolah Tanasan,&nbsp;Masoumeh Abdolhosseini,&nbsp;Seyed Kianoosh Hosseini","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patent ductus arteriosus (PDA) is a congenital heart disorder in which a vascular structure between the pulmonary artery and the aorta remains open. PDA normally closes shortly after birth. The treatment in adults is surgical or transcatheter closure. A 47-year-old woman presented to our hospital with a diagnosis of PDA and was treated with transcatheter closure. Although the recovery period of adult patients is long, this patient recovered completely after one day.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"13 4","pages":"272-277"},"PeriodicalIF":1.3,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509450/pdf/ajcd0013-0272.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41099682","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":"<i>CYP2D6</i> and <i>ADRB1</i> genetic polymorphisms and the selection of antihypertensive beta-receptor blockers for hypertensive patients.","authors":"Keping Chen,&nbsp;Ying Li,&nbsp;Chuankun Yang,&nbsp;Peng Xiao,&nbsp;Guochun Li,&nbsp;Yurong Xu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Genetic factors contribute to the variability in individual response to antihypertensive medications. We sought to investigate the frequencies of allele and genotype for <i>CYP2D6</i> and <i>ADRB1</i> genetic polymorphisms and explore their potential impact in influencing the selection of antihypertensive beta-receptor blockers.</p><p><strong>Methods: </strong>The study population was selected from the Han Chinese patients in Zhongda Hospital, which contained 2419 Han Chinese hypertensive individuals and 151 normotensive controls. Each of the above participants underwent venous blood sampling. Then, the gene chip platform was adopted to evaluate the <i>CYP2D6</i> and <i>ADRB1</i> genetic polymorphisms. The allele as well as genotype frequencies for each gene, along with the combined genotypes, were subjected to analysis.</p><p><strong>Results: </strong>The frequency of *1/*1 wild-type homozygous for <i>CYP2D6</i> was 9.71%, while the frequency of *1/*10 heterozygous or *10/*10 mutant homozygous was 59.16% or 31.13%, respectively, as established by gene chip analysis. Similarly, we observed that the genotype frequencies of GG wild-type homozygous for <i>ADRB1</i> was 10.29%, while that of GC heterozygous, or CC mutant homozygous was 44.98%, or 44.73%, respectively. Notably, combined genotypes *1/*10 + CC (25.88%) and *1/*10 + CG (27.78%) had the highest frequencies. Importantly, no substantial differences in the distributions of <i>CYP2D6</i> and <i>ADRB1</i> polymorphism were noted between hypertensive patients and normotensive controls, or among all different grades of hypertension.</p><p><strong>Conclusion: </strong>These findings provide insights into the <i>CYP2D6</i> and <i>ADRB1</i> polymorphisms in hypertensive patients from Han Chinese, which show significant differences compared to other geographic groups of Han Chinese hypertensive patients. These results offer valuable information for future prospective clinical studies on the antihypertensive effects of beta-receptor blockers in Han Chinese hypertensive patients.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"13 4","pages":"264-271"},"PeriodicalIF":1.3,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509456/pdf/ajcd0013-0264.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41102631","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":"Contemporary management of ventricular arrhythmias in heart failure.","authors":"Ourania Kariki, Maximos Georgopoulos, Nikitas Katsillis, Anastasios Chatziantoniou, Stavroula Koskina, Andromahi Zygouri, Athanasios Saplaouras, George Bazoukis, Aggeliki Gkouziouta, Konstantinos Vlachos, Stylianos Dragasis, Panagiotis Mililis, Stamatis Adamopoulos, Michael Efremidis, Konstantinos P Letsas","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Enhanced ventricular arrhythmogenesis is commonly experienced by patients in the end-stage of heart failure spectrum. A high burden of ventricular arrhythmias can affect the ventricular systolic function, lead to unexpected hospitalizations and further deteriorate the prognosis. Management of ventricular arrhythmias in this population is challenging. Implantable cardioverter-defibrillators are protective for the immediate termination of life-threatening arrhythmias but they have no impact in reducing the arrhythmic burden. Combination treatment with invasive (catheter ablation, mechanical hemodynamic support, sympathetic denervation) and noninvasive (antiarrhythmic drugs, medical therapy for heart failure, programming of implantable devices) therapies is commonly required. The aim of this review is to present the available therapeutic options, with main focus on recently published data for catheter ablation and provide a stepwise treatment approach.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"13 4","pages":"207-221"},"PeriodicalIF":1.3,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509449/pdf/ajcd0013-0207.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41128375","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":"First reported case of COVID-19 induced permanent third-degree atrioventricular (AV) block in a young patient.","authors":"Lucy Hickcox,&nbsp;Matthew Rw Smolin,&nbsp;Mohammad Reza Movahed","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>SARS-CoV2 virus, COVID-19, was first reported in Wuhan, China in 2019. The most common symptoms of COVID-19 are dry cough, fever, and diarrhea that occur within 2-14 days of exposure. Primary infection from COVID-19 develops in the respiratory tract. Cardiovascular disease has become a more prominent manifestation of COVID-19 infection, however very little is known regarding the impact of COVID-19 on the cardiac conduction system. We present a young patient with COVID-19 who developed a permanent third-degree Atrioventricular (AV) heart block. This report is the first documentation of COVID-19 induced permanent third-degree heart block in a young male.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"13 4","pages":"278-282"},"PeriodicalIF":1.3,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509457/pdf/ajcd0013-0278.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41100352","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":"A clinician's guide to addressing cardiovascular health based on a revised AHA framework.","authors":"Neel Koyawala, Lena M Mathews, Francoise A Marvel, Seth S Martin, Roger S Blumenthal, Garima Sharma","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The American Heart Association recently published updates to its definition of cardiovascular health (CVH) in its Presidential Advisory called Life's Essential 8. In particular, the update from Life's Simple 7 added a new component of sleep duration and refined definitions of prior components, including measurement of diet, nicotine exposure, blood lipids, and blood glucose. Physical activity, BMI, and blood pressure were unchanged. Together, these eight components create a composite CVH score that clinicians, policy-makers, patients, communities, and businesses can utilize to communicate in a consistent way. Life's Essential 8 also emphasizes the critical role of addressing social determinants of health to improve these individual CVH components, which strongly correlate with future cardiovascular outcomes. This framework should be used across the life spectrum including during pregnancy and childhood to allow improvements in and prevention of CVH at critical time-points. Clinicians can use this framework to advocate for digital health technologies and societal policies that help address and more seamlessly measure the 8 components of CVH with the goal of increasing quality and quantity of life.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"13 2","pages":"52-58"},"PeriodicalIF":1.3,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193249/pdf/ajcd0013-0052.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9507546","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":"Prognostic value of fragmented QRS in acute pulmonary embolism: a cross-sectional-analytic study of the Iranian population.","authors":"Mahsa Asadi Anar,&nbsp;Akram Ansari,&nbsp;Gisou Erabi,&nbsp;Mohammad Rahmanian,&nbsp;Mahdiyeh Movahedi,&nbsp;Fatemeh Chichagi,&nbsp;Niloofar Deravi,&nbsp;Farid Taghavi,&nbsp;Babak Kazemi,&nbsp;Elnaz Javanshir,&nbsp;Erfan Amouei,&nbsp;Samad Ghaffari","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Acute Pulmonary embolism (APE) is considered one of the deadliest cardiovascular diseases. Electrocardiographic (ECG) abnormalities in pulmonary embolism (PE) are increasingly reported. A growing number of studies have recommended that ECG plays a crucial role in the prognostic assessment of PE patients. However, there is scarce data on the prognostic importance of fragmented QRS (fQRS) on outcomes in patients with APE. This study aims to investigate the prognostic value of fQRS in APE patients.</p><p><strong>Materials and methods: </strong>This is a cross-sectional-analytic study. This study included 280 patients diagnosed with APE admitted to Shahid Madani hospital, Tabriz, Iran. Computed tomography pulmonary angiography (CTPA) was used to diagnose APE. A checklist was prepared for all patients, demographic, clinical characteristics, and Major Adverse Cardiopulmonary events (MACPE), including in-hospital mortality, need for thrombolysis, mechanical ventilation, and surgical embolectomy, were recorded. Patients were divided into two groups: patients who manifested fQRS on their ECG and patients who did not; Then, demographic, clinical characteristics, and MACPE were compared in the two groups, as mentioned earlier. Furthermore, all statistical analyses were carried out using SPSS software.</p><p><strong>Results: </strong>48 patients (17.14%) had fQRS(+) on their ECG, and 232 patients (82.86%) did not have it on their ECG. In data analysis, 22 patients (8.7%) had in-hospital mortality, 35 patients (13.9%) needed thrombolysis, nine patients (3.9%) required mechanical ventilation, and 13 patients (5.1%) needed surgical embolectomy. fQRS was not significantly associated with in-hospital mortality (P = 0.225), need for thrombolysis (P = 0.684), mechanical ventilation (P = 1.000), and surgical embolectomy (P = 1.000). Demographic and clinical characteristics were also similar in both groups.</p><p><strong>Conclusions: </strong>This study does not support the idea that fQRS on ECG is a valuable predictor of in-hospital mortality, the need for thrombolysis, mechanical ventilation, and surgical embolectomy.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"13 1","pages":"21-28"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10017924/pdf/ajcd0013-0021.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9145052","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":"The implementation of a value-based learning health system for preventative care in Ontario, Canada.","authors":"Aaron Rosenfeld,&nbsp;Jillian Ball,&nbsp;Sara Rattanasithy,&nbsp;Christine Tsilas,&nbsp;Rachel Miller,&nbsp;Joanne Berardi,&nbsp;Alaina Pupulin,&nbsp;Carolina Carvalho,&nbsp;Samantha Segal,&nbsp;Shaul Kruger,&nbsp;Ravi Bajaj,&nbsp;David Alter","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>While value-based learning health systems may address challenges associated with the integrative delivery of therapeutic lifestyle management in usual care, the extent to which they have been evaluated in real-world settings have remained limited.</p><p><strong>Methods: </strong>To explore the feasibility and user-experiences, associated with the first-year implementation of a preventative Learning Health System (LHS), consecutive patients were evaluated following referral from primary and/or specialty care providers from the Halton and Greater Toronto Area in Ontario, Canada, between December 2020 and December 2021. The integration of a LHS into medical care was facilitated using a digital e-learning platform, and consisted of exercise, lifestyle, and disease-management counselling. The dynamic monitoring of user-data allowed patients and providers to modify goals, treatment plans, and care-delivery in real-time in accordance with patient engagement, weekly exercise, and risk-factor targets. All program costs were covered by the public-payer health care system using a physician fee-for-service payment model. Descriptive statistics evaluated attendance to prescheduled visits, drop-out rates, changes in self-reported weekly Metabolic Expenditure Task-Minutes (MET-MINUTES), perceived changes in health knowledge, lifestyle behaviours, health status, satisfaction with care, and programmatic costs.</p><p><strong>Results: </strong>378 of 437 patients (86.5%) enrolled in the 6-month program; The average age of patients was 61.2 ± 12.2, 156 (41.3%) of which were female and 140 (37.0%) with established coronary disease. After 1 year, 15.6% dropped out of the program. On average, weekly MET-MINUTES rose by 191.1 throughout the program (95% CI [331.82, 57.96], P=0.007), with increases most prominent among sedentary populations. Participants reported significant improvements in perceived health status and health knowledge, at a total health-care delivery cost of $517.70 per patient for a completed program.</p><p><strong>Conclusion: </strong>The implementation of an integrative preventative learning health system was feasible, with high patient engagement and favourable user-experiences. Further research is required to compare health outcomes against usual care.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"13 2","pages":"87-100"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193245/pdf/ajcd0013-0087.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9507548","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":"In-hospital outcomes of acute ischaemic stroke patients with atrial septal defect. A national inpatient sample study.","authors":"Tiberiu Alexandru Pana,&nbsp;Fiona Craigen,&nbsp;Mohamed O Mohamed,&nbsp;Mamas A Mamas,&nbsp;Phyo Kyaw Myint","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and aims: </strong>Atrial septal defects (ASD) are a well-recognised risk factor for acute ischaemic stroke (AIS). We aimed to delineate the relationship between ASD and in-hospital AIS outcomes (mortality, severe stroke (National Institutes of Health Stroke Scale (NIHSS) > 15), prolonged hospitalisation > 4 days and routine home discharge) in contemporary practice using data from the United States National Inpatient Sample.</p><p><strong>Methods: </strong>NIS admissions with a primary diagnosis of AIS between 2016-2018 were extracted. The NIHSS variable had 75% missing data, which were imputed using multiple imputations by chained equations. The relationship between ASD and the main outcomes was modelled using multivariable logistic regressions, adjusting for age, sex, comorbidities, stroke severity and revascularisation therapies.</p><p><strong>Results: </strong>245,859 records representative of 1,229,295 AIS admissions were included, 35,840 (2.91%) of whom had ASD. ASD patients were younger (median age 63 years versus 72 years) and less likely to have traditional cardiovascular risk factors than their counterparts without ASD. ASD was independently associated with 58% lower odds of in-hospital mortality (hazard ratio (95% confidence interval) = 0.42 (0.33-0.54)), 18% lower odds of severe stroke (0.82 (0.71-0.94)), 20% higher odds of routine home discharge (1.20 (1.14-1.28)) and 28% higher odds of prolonged hospitalisation (1.28 (1.21-1.35)).</p><p><strong>Conclusions: </strong>ASD was associated with better in-hospital outcomes, which were likely driven by younger age, lower prevalence of traditional cardiovascular risk factors, and lower stroke severity. Further research is warranted to clarify the ASD anatomical characteristics which are most strongly associated with these associations.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"13 3","pages":"183-191"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10352813/pdf/ajcd0013-0183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202727","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":"Right heart catheterization in clinical practice: a review of basic physiology and important issues relevant to interpretation.","authors":"Gaspar Del Rio-Pertuz,&nbsp;Kenneth Nugent,&nbsp;Erwin Argueta-Sosa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pulmonary artery catheterization is a diagnostic procedure in which a catheter is inserted through a central vein and advanced toward the pulmonary artery to measure right atrial, right ventricular, and pulmonary artery pressures, estimate cardiac output, identify intracardiac shunts, and measure pulmonary vascular resistance. Hemodynamic measurements can provide a better understanding of the pathophysiology of heart failure and pulmonary hypertension, but their proper assessment and optimal use can be challenging due to differences in techniques that can lead to differences in conclusions and therapeutic management strategies. In this review, we will discuss right heart catheterization and its role in clinical practice (e.g., shunt evaluation, management of cardiogenic shock) and summarize important concerns related to measurement and interpretation.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"13 3","pages":"122-137"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10352814/pdf/ajcd0013-0122.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202731","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":"In vitro modeling of crimped Dacron vascular grafts for aortic root replacement.","authors":"Rakan I Nazer,&nbsp;Abdulaziz Alhothali,&nbsp;Ali Albarrati","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To objectively quantify the effect of flattening the crimps in Dacron tube grafts on the radial compliance under pulsatile pressure. We aimed to minimize the dimensional changes in woven Dacron graft tubes by applying axial stretch to the graft. We hypothesize this might reduce the risk of coronary button misalignment in aortic root replacement.</p><p><strong>Methods: </strong>In an in vitro pulsatile model that delivered systemic circulatory pressures to Dacron tube grafts, we measured oscillatory movements in 26-30 mm Dacron vascular tube grafts before and after flattening the graft crimps. We also describe our surgical methods and clinical experiences in replacing the aortic root.</p><p><strong>Results: </strong>Flattening the crimps in Dacron tubes with axial stretching significantly reduced the mean maximal oscillation distance measured radially during each balloon pulse (3.2 ± 0.8 mm, 95% CI: 2.6, 3.7 mm vs. 1.5 ± 0.5 mm, 95% CI: 1.2, 1.7 mm; P < 0.001).</p><p><strong>Conclusion: </strong>The radial compliance of woven Dacron tubes was significantly reduced after flattening the crimps. Applying axial stretch to the Dacron grafts prior to determining the coronary button attachment site can help maintain dimensional stability in the graft, which may reduce the risk of coronary malperfusion in aortic root replacment.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"13 2","pages":"59-67"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193250/pdf/ajcd0013-0059.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9502283","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}