The British journal of cardiology最新文献_第5页

CMR is vital in the management of cardiology inpatients: a tertiary centre experience. CMR 对心脏病住院患者的管理至关重要：一家三级中心的经验。

The British journal of cardiology Pub Date : 2023-11-29 eCollection Date: 2023-01-01 DOI: 10.5837/bjc.2023.041

Rumneek Hampal, Kristopher D Knott, Aristides Plastiras, Nicholas H Bunce

{"title":"CMR is vital in the management of cardiology inpatients: a tertiary centre experience.","authors":"Rumneek Hampal, Kristopher D Knott, Aristides Plastiras, Nicholas H Bunce","doi":"10.5837/bjc.2023.041","DOIUrl":"10.5837/bjc.2023.041","url":null,"abstract":"To review the utility of cardiovascular magnetic resonance (CMR) in the management of hospital inpatients, we performed a retrospective review of all inpatient CMR scans performed over a six-month period at a tertiary referral cardiology centre. Patient demographics, indication for CMR imaging, results of the CMR scans and whether the results changed patient management were recorded. Change in management included medication changes, subsequent invasive procedures, or avoidance of such, and hospital discharge. Overall, 169 patients were included in the study cohort, 66% were male, mean age was 57.1 years. The most common indication for inpatient CMR was to investigate for cardiomyopathy (53% of patients). The most prevalent diagnosis post- CMR in our cohort was ischaemic heart disease, including ischaemic cardiomyopathy and coronary artery disease. There was a complete change in diagnosis or additional diagnosis found in 29% of patients following CMR. Overall, inpatient CMR led to a change in management in 77% of patients; the most common being changes to medication regimen. CMR was well tolerated in 99% of patients and image quality was diagnostic in 93% of cine scans performed. In conclusion, CMR is vital for the management of cardiology inpatients, having an impact that is at least as significant as in the management of outpatients.","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":"30 4","pages":"41"},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156870","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}

引用次数: 0

Brachial artery approach for managing retroperitoneal bleed following coronary intervention for STEMI. 采用肱动脉方法处理 STEMI 冠状动脉介入治疗后的腹膜后出血。

The British journal of cardiology Pub Date : 2023-11-29 eCollection Date: 2023-01-01 DOI: 10.5837/bjc.2023.045

Muhammad Usman Shah, Krishna Poudyal, Ramy Goubran, Adnan Ahmed, Yaseen Syed Naqvi

{"title":"Brachial artery approach for managing retroperitoneal bleed following coronary intervention for STEMI.","authors":"Muhammad Usman Shah, Krishna Poudyal, Ramy Goubran, Adnan Ahmed, Yaseen Syed Naqvi","doi":"10.5837/bjc.2023.045","DOIUrl":"10.5837/bjc.2023.045","url":null,"abstract":"Primary percutaneous coronary intervention (PPCI) remains the gold-standard treatment for ST- elevation myocardial infarction (STEMI). Femoral arterial access for the procedure may be an ideal option in patients who are haemodynamically unwell. However, it is associated with rare, but life- threatening, complications such as perforation, leading to retroperitoneal haemorrhage. We present the case of a man in his 50s, admitted with cardiac arrest secondary to inferolateral STEMI. Successful PPCI was performed via right femoral artery, with access gained under ultrasound guidance. However, the patient deteriorated and was diagnosed to have a retroperitoneal haematoma secondary to femoral artery perforation. Additional arterial access via left brachial artery was obtained, and a covered stent was deployed successfully in the right femoral artery with satisfactory haemostasis. The patient recovered successfully and was discharged two weeks later. Early recognition of such complications is imperative to adequate management and percutaneous treatment is a viable option for such situations, in comparison with open surgical repair.","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":"30 4","pages":"45"},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156869","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}

引用次数: 0

Drug therapies for stroke prevention. 预防中风的药物疗法。

The British journal of cardiology Pub Date : 2023-11-29 eCollection Date: 2023-01-01 DOI: 10.5837/bjc.2023.040

Nimisha Shaji, Robert F Storey, William A E Parker

引用次数: 0

Efficacy and tolerability of PCSK9 inhibitors in real-world clinical practice. PCSK9 抑制剂在实际临床实践中的疗效和耐受性。

The British journal of cardiology Pub Date : 2023-11-29 eCollection Date: 2023-01-01 DOI: 10.5837/bjc.2023.044

Prashasthi Devaiah, Sava Handjiev, Jacob George

引用次数: 0

Myocardial revascularisation in complex patients: does it happen as prescribed by the heart team? 复杂患者的心肌血管重建：是否按照心脏团队的规定进行？

The British journal of cardiology Pub Date : 2023-11-29 eCollection Date: 2023-01-01 DOI: 10.5837/bjc.2023.042

Montasir Ali, Adrian Ionescu, Abdul R A Bakhsh, Omer Elsayegh, Hussain Al-Sadi

{"title":"Myocardial revascularisation in complex patients: does it happen as prescribed by the heart team?","authors":"Montasir Ali, Adrian Ionescu, Abdul R A Bakhsh, Omer Elsayegh, Hussain Al-Sadi","doi":"10.5837/bjc.2023.042","DOIUrl":"10.5837/bjc.2023.042","url":null,"abstract":"Guidelines recommend decision- making using the heart team (HT) in complex patients considered for myocardial revascularisation, but there are little data on how this approach works in practice. We data-mined our electronic HT database and selected patients in whom the clinical question referred to revascularisation, and documented HT recommendations and their implementation. We identified 154 patients (117 male), mean age 68.9 ± 11.4 years, discussed between February 2019 and December 2020. The clinical questions were coronary artery bypass graft (CABG) versus percutaneous coronary intervention (PCI) (141 cases, 91%), and medical treatment versus revascularisation by PCI (eight cases, 6%) or by CABG (five cases, 3%). HT recommended CABG in 55 cases (35%), PCI in 43 (28%), medical treatment in 15 (10%), and equipoise in seven (5%) and further investigations in 34 (22%): non-invasive imaging for ischaemia in 11 (32%), invasive coronary physiology studies in eight (24%), further clinical assessment in seven (20%), structural imaging for five (15%), invasive coronary angiography in two (6%), and an electrophysiology opinion in one case (3%). Decisions were implemented in 135 cases (89%). The average time between the HT and the implementation of its decision was 80.5 ± 129.3 days. There were 17 deaths: 10 cardiac, six non- cardiac and one of unknown cause. Patients who survived were younger (68.6 ± 11.3 years) than those who died (73.8 ± 10.0 years, p = 0.03). In conclusion, almost 90% of the decisions of the HT on myocardial revascularisation are implemented, while ischaemia testing is the main investigation required for decision- making. Recent data on the futility of such an approach have not yet permeated clinical practice.","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":"30 4","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156874","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}

引用次数: 0

Improvement in LV end-diastolic pressure after primary PCI and its impact on patients' recovery. 初级 PCI 后左心室舒张末压的改善及其对患者康复的影响。

The British journal of cardiology Pub Date : 2023-11-29 eCollection Date: 2023-01-01 DOI: 10.5837/bjc.2023.043

Usman Hanif Bhatti, Khalid Naseeb, Muhammad Nauman Khan, Vashu Mal, Muhammad Asad Baqai, Musa Karim, Muhammad Asher Khan, Tahir Saghir

{"title":"Improvement in LV end-diastolic pressure after primary PCI and its impact on patients' recovery.","authors":"Usman Hanif Bhatti, Khalid Naseeb, Muhammad Nauman Khan, Vashu Mal, Muhammad Asad Baqai, Musa Karim, Muhammad Asher Khan, Tahir Saghir","doi":"10.5837/bjc.2023.043","DOIUrl":"10.5837/bjc.2023.043","url":null,"abstract":"In this study, we evaluated the change in left ventricular end-diastolic pressure (LVEDP) after primary percutaneous coronary intervention (PCI) and its impact on in-hospital outcomes and 30-day and three-month quality of life (SAQ-7), ejection fraction (EF), and major adverse cardiovascular events (MACE). LVEDP ≥19 mmHg was taken as elevated LVEDP. In a sample of 318 patients, 18.9% (n=60) were females and mean age was 55.7 ± 10.52 years. Post-procedure elevated LVEDP was observed in 20.8% (n=66) with a mean reduction of 1.65 ± 4.35 mmHg. LVEDP declined in 39% (n=124) and increased in 10.7% (n=34). In-hospital mortality rate (9.1% vs. 2.4%, p=0.011), 30-day MACE (9.1% vs. 4.0%), and three-month MACE (21.2% vs. 5.6%) were found to be significantly higher among patients with elevated LVEDP, respectively. Elevated LVEDP was found to be associated with a reduced SAQ-7 score (89.84 ± 8.09 vs. 92.29 ± 3.03, p<0.001) and reduced (25-40%) EF (55.6% vs. 22.6%) at three-month follow-up. LVEDP declined acutely in a significant number of patients after primary PCI. Post- procedure elevated LVEDP was found to be associated with poor quality of life and an increased risk of immediate and short-term MACE.","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":"30 4","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156873","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}

引用次数: 0

The effect of icosapent ethyl on left atrial and left ventricular morphology. icosapent ethyl 对左心房和左心室形态的影响。

The British journal of cardiology Pub Date : 2023-07-11 eCollection Date: 2023-01-01 DOI: 10.5837/bjc.2023.022

Spencer S Kitchin, Suvasini Lakshmanan, April Kinninger, Song S Mao, Mark G Rabbat, Deepak L Bhatt, Matthew J Budoff

{"title":"The effect of icosapent ethyl on left atrial and left ventricular morphology.","authors":"Spencer S Kitchin, Suvasini Lakshmanan, April Kinninger, Song S Mao, Mark G Rabbat, Deepak L Bhatt, Matthew J Budoff","doi":"10.5837/bjc.2023.022","DOIUrl":"10.5837/bjc.2023.022","url":null,"abstract":"Atrial fibrillation (AF) is a common arrhythmia associated with poor outcomes. N-3 fatty acids have been shown to provide significant cardiovascular risk reduction, but they may exacerbate the risk of AF. The pathway by which N-3 fatty acids may be arrhythmogenic is unknown. One possible mechanism involves cardiac chamber morphology alteration. The purpose of this study was to investigate the effect of icosapent ethyl (IPE) on left atrial (LA) size and left ventricular (LV) mass. This study used coronary computed tomographic angiography images gathered from the Effect of Icosapent Ethyl on Progression of Coronary Atherosclerosis (EVAPORATE) trial. EVAPORATE was a randomised, double-blind, placebo-controlled study finding a significant reduction in coronary atherosclerosis progression in patients with residually elevated triglycerides despite statin therapy on 4 g IPE daily versus 4 g placebo daily. Computed tomography images were used to measure LA size and LV mass at 0 and 18 months. Of 80 enrolled patients, 68 were included in the final analysis. Baseline demographics and risk factors were similar between IPE and placebo cohorts. LA anterior- posterior diameter measured on axial (p=0.51) and sagittal (p=0.52) orientations were not different over time. Also, there was no difference between groups in the change in LA volume (p=0.84). Change in LV mass was similar between groups (p=0.13). In conclusion, this study did not detect differences in LA size or LV mass over 18 months between patients on 4 g daily IPE versus placebo.","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":"30 3","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984152","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}

引用次数: 0

SGLT2 inhibitors in CKD and HFpEF: two new large trials and two new meta-analyses. SGLT2抑制剂在慢性肾功能衰竭和高房颤患者中的应用：两项新的大型试验和两项新的荟萃分析。

The British journal of cardiology Pub Date : 2023-02-21 eCollection Date: 2023-01-01 DOI: 10.5837/bjc.2023.003

Kaitlin J Mayne, David Preiss, William G Herrington

引用次数: 0

The prognostic impact of HDL-C level in patients presenting with ST-elevation myocardial infarction. HDL-C水平对ST段抬高型心肌梗死患者预后的影响。

The British journal of cardiology Pub Date : 2023-01-18 eCollection Date: 2023-01-01 DOI: 10.5837/bjc.2023.005

Ahmed Mahmoud El Amrawy, Abdallah Almaghraby, Mahmoud Hassan Abdelnabi

{"title":"The prognostic impact of HDL-C level in patients presenting with ST-elevation myocardial infarction.","authors":"Ahmed Mahmoud El Amrawy, Abdallah Almaghraby, Mahmoud Hassan Abdelnabi","doi":"10.5837/bjc.2023.005","DOIUrl":"10.5837/bjc.2023.005","url":null,"abstract":"Low high-density lipoprotein-cholesterol (HDL-C) concentration is among the strongest independent risk factors for cardiovascular disease, however, studies to assess the cardioprotective effect of normal or high HDL-C level are lacking. To determine the prognostic impact of initial serum HDL-C level on in-hospital major adverse cardiovascular and cerebrovascular events (MACCE) and the one-year all-cause mortality in patients presenting with ST-elevation myocardial infarction (STEMI) we performed a retrospective analysis of the data from 1,415 patients presenting with STEMI in a tertiary-care centre equipped with a 24-hour-ready catheterisation laboratory. The period from June 2014 to June 2017 was reviewed with a follow-up as regards one-year all-cause mortality. Patients were divided into two groups according to HDL-C level. HDL-C <40 mg/dL (2.22 mmol/L) was considered low, while HDL-C ≥40 mg/dL was considered normal. There were 1,109 patients with low HDL-C, while 306 had normal HDL-C levels, which was statistically significant (p<0.001). Total MACCE and all-cause mortality were significantly lower in patients with normal HDL-C (p=0.03 and p=0.01, respectively). In conclusion, this retrospective study to assess the prognostic effect of HDL-C in patients presenting with STEMI, found normal HDL-C level was associated with lower in-hospital MACCE and all-cause mortality at one-year follow-up.","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":"30 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10495758/pdf/BJC-30-01-bjc.2023.005.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10259581","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}

引用次数: 0

Evaluating initiation and real-world tolerability of dapagliflozin for the management of HFrEF. 评估达格列嗪治疗HFrEF的起始和现实耐受性。

The British journal of cardiology Pub Date : 2023-01-18 eCollection Date: 2023-01-01 DOI: 10.5837/bjc.2023.002

Alyson Hui Ling Tee, Gayle Campbell, Andrew D'Silva

{"title":"Evaluating initiation and real-world tolerability of dapagliflozin for the management of HFrEF.","authors":"Alyson Hui Ling Tee, Gayle Campbell, Andrew D'Silva","doi":"10.5837/bjc.2023.002","DOIUrl":"10.5837/bjc.2023.002","url":null,"abstract":"Untreated heart failure with reduced ejection fraction (HFrEF) has a one-year mortality rate of 40%. The DAPA-HF trial found that dapagliflozin reduces mortality and heart failure (HF) hospitalisation by 17% and 30%, respectively. We describe the initiation and real-world tolerability of dapagliflozin for the management of HFrEF at a large university teaching hospital in central London. We reviewed 118 HFrEF patients initiated on dapagliflozin from January to August 2021 in both inpatient and outpatient settings using the Trust's electronic records. A total of 69 (58.4%) patients were on optimised HF pharmacological therapy upon initiation of dapagliflozin. Dapagliflozin was discontinued in 12 (13.0%) patients. Twenty-three (42.6%) patients either discontinued or had a dose reduction in loop diuretics post-initiation of dapagliflozin. In clinical practice, early initiation of dapagliflozin is safe, well-tolerated and resulted in earlier discontinuation or dose reduction in loop diuretics, providing opportunities to further optimise other HF medicines. This retrospective observational study supports the safety of the updated European Society of Cardiology (ESC) guidelines to initiate all four key HF medicines to minimise delays in HF treatment optimisation, which could translate to reduced National Health Service healthcare costs through fewer HF hospitalisations.","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":"30 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10495759/pdf/BJC-30-01-bjc.2023.002.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10264550","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}

引用次数: 0