The British journal of cardiology最新文献

{"title":"Total ischaemic time in STEMI: factors influencing systemic delay.","authors":"Cormac T O'Connor, Abdallah Ibrahim, Anthony Buckley, Caoimhe Maguire, Rajesh Kumar, Jatinder Kumar, Samer Arnous, Thomas J Kiernan","doi":"10.5837/bjc.2022.017","DOIUrl":"10.5837/bjc.2022.017","url":null,"abstract":"<p><p>Total ischaemic time in ST-elevation myocardial infarction (STEMI) has been shown to be a predictor of mortality. The aim of this study was to assess the total ischaemic time of STEMIs in an Irish primary percutaneous coronary intervention (pPCI) centre. A single-centre prospective observational study was conducted of all STEMIs referred for pPCI from October 2017 until January 2019. There were 213 patients with a mean age 63.9 years (range 29-96 years). The mean ischaemic time was 387 ± 451.7 mins. The mean time before call for help (patient delay) was 207.02 ± 396.8 mins, comprising the majority of total ischaemic time. Following diagnostic electrocardiogram (ECG), 46.5% of patients had ECG-to-wire cross under 90 mins as per guidelines; 73.9% were within 120 mins and 93.4% were within 180 mins. Increasing age correlated with longer patient delay (Pearson's r=0.2181, p=0.0066). Women exhibited longer ischaemic time compared with men (508.96 <i>vs.</i> 363.33 mins, respectively, p=0.03515), driven by a longer time from first medical contact (FMC) to ECG (104 <i>vs.</i> 34 mins, p=0.0021). The majority of total ischaemic time is due to patient delay, and this increases as age increases. Women had longer ischaemic time compared with men and longer wait from FMC until diagnostic ECG. This study suggests that improved awareness for patients and healthcare staff will be paramount in reducing ischaemic time.</p>","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":" ","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534116/pdf/BJC-29-02-bjc.2022.017.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33496845","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":"Evaluation of the prognostic value of the admission ECG in COVID-19 patients: a meta-analysis.","authors":"Mateusz Wawrzeńczyk,&nbsp;Marcin D Grabowski","doi":"10.5837/bjc.2022.018","DOIUrl":"https://doi.org/10.5837/bjc.2022.018","url":null,"abstract":"<p><p>The assessment of the prognostic value of the admission electrocardiography (ECG) (specifically of the duration of the PR and QTc intervals, the QRS complex and the heart rate [HR]) in COVID-19 patients on the basis of nine observational studies (n=1,424) indicates that relatively long duration of the QTc interval and QRS complex, as well as higher HR, are linked to a severe course of COVID-19, which may be of use in risk stratification. Since there are important differences in suggested indicators of adverse prognosis between observational studies, further research is necessary to clarify high-risk criteria.</p>","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":" ","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534115/pdf/BJC-29-02-bjc.2022.018.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33496846","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 use of PYP scan for evaluation of ATTR cardiac amyloidosis at a tertiary medical centre.","authors":"Joshua Dower,&nbsp;Danai Dima,&nbsp;Mumtu Lalla,&nbsp;Ayan R Patel,&nbsp;Raymond L Comenzo,&nbsp;Cindy Varga","doi":"10.5837/bjc.2022.019","DOIUrl":"https://doi.org/10.5837/bjc.2022.019","url":null,"abstract":"<p><p>Cardiac transthyretin amyloidosis (ATTR) is an often underdiagnosed disease that can lead to significant morbidity and mortality for patients. In recent years, technetium-99m pyrophosphate scintigraphy (PYP) imaging has become a standard of care diagnostic tool to help clinicians identify this disease. With newly emerging therapies for ATTR cardiomyopathy, it is critical to identify patients who are eligible for therapy as early as possible. At our institution, we sought to describe the frequency of PYP scanning and how it has impacted the management of a patient suspected to have amyloid cardiomyopathy. Between 1 January 2017 and 31 December 2020, we identified 273 patients who completed PYP scanning for evaluation of cardiac amyloidosis at Tufts Medical Center, a tertiary care centre. We reviewed pertinent clinical data for all study subjects. A PYP scan was considered positive when the heart to contralateral lung ratio was greater than or equal to 1.5, with a visual grade of 2 or 3, and confirmation with single-photon emission computerised tomography (SPECT) imaging. In total there were 55 positive, 202 negative, and 16 equivocal PYP scans. Endomyocardial biopsies were rarely performed following PYP results. Of the seven patients with a positive PYP scan who underwent biopsy, five were positive for ATTR amyloid; of the patients with a negative scan who were biopsied, none were positive for ATTR amyloidosis and two were positive for amyloid light-chain (AL) amyloidosis. The biomarkers troponin I, B-type naturietic peptide (BNP), and N-terminal pro-BNP (NT-proBNP), as well as the interventricular septal end-diastolic thickness (IVSd) seen on echocardiogram, were all found to be statistically higher in the PYP positive cohort than in the PYP negative cohort using Mann-Whitney U statistical analysis. In total, 27 out of the 55 patients with a positive PYP scan underwent therapy specific for cardiac amyloid. In conclusion, this study reinforces the clinical significance of the PYP scan in the diagnosis and management of cardiac amyloidosis. A positive scan allowed physicians to implement early amyloid-directed treatment while a negative scan encouraged physicians to pursue an alternative diagnosis.</p>","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":" ","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534106/pdf/BJC-29-02-bjc.2022.019.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33496847","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":"Viruses, vaccines and cardiovascular effects.","authors":"Anthony R Rees","doi":"10.5837/bjc.2022.016","DOIUrl":"10.5837/bjc.2022.016","url":null,"abstract":"","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":" ","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534113/pdf/BJC-29-02-bjc.2022.016.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33497311","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":"Drive-by collection and self-fitting of ambulatory electrocardiogram monitoring.","authors":"Mark T Mills,&nbsp;Sarah Ritzmann,&nbsp;Maisie Danson,&nbsp;Gillian E Payne,&nbsp;David R Warriner","doi":"10.5837/bjc.2022.012","DOIUrl":"https://doi.org/10.5837/bjc.2022.012","url":null,"abstract":"<p><p>Ambulatory electrocardiogram (AECG) monitoring is a common cardiovascular investigation. Traditionally, this requires a face-to-face appointment. In order to reduce contact during the COVID-19 pandemic, we investigated whether drive-by collection and self-fitting of the device by the patient represents an acceptable alternative. A prospective, observational study of consecutive patients requiring AECG monitoring over a period of one month at three hospitals was performed. Half underwent standard (face-to-face) fitting, and half attended a drive-by service to collect their monitor, fitting their device at home. Outcome measures were quality of the recordings (determined as good, acceptable or poor), and patient satisfaction. A total of 375 patients were included (192 face-to-face, 183 drive-by). Mean patient age was similar between the two groups. The quality of the AECG recordings was similar in both groups (52.6% good in face-to-face <i>vs.</i> 53.0% in drive-by; 34.9% acceptable in face-to-face <i>vs.</i> 32.2% in drive-by; 12.5% poor in face-to-face <i>vs.</i> 14.8% in drive-by; Chi-square statistic 0.55, p=0.76). Patient satisfaction rates were high, with all patients in both groups satisfied with the care they received. In conclusion, drive-by collection and self-fitting of AECG monitoring yields similar AECG quality to conventional face-to-face fitting, with high levels of patient satisfaction.</p>","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":" ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534118/pdf/BJC-29-02-bjc.2022.012.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33496844","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":"Angina with coronary microvascular dysfunction and its physiological assessment: a review with cases.","authors":"Pitt O Lim","doi":"10.5837/bjc.2022.013","DOIUrl":"https://doi.org/10.5837/bjc.2022.013","url":null,"abstract":"<p><p>Imagine that it is possible to know, the actual coronary blood flow. Would this not remove any doubt, if a chest pain is the heart's fault?</p>","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":" ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534121/pdf/BJC-29-02-bjc.2022.013.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33496848","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":"Iatrogenic aortic dissection of the descending aorta after percutaneous coronary intervention.","authors":"Kristen Westenfield,&nbsp;Shannon Mackey-Bojack,&nbsp;Yale L Wang,&nbsp;Kevin M Harris","doi":"10.5837/bjc.2022.014","DOIUrl":"https://doi.org/10.5837/bjc.2022.014","url":null,"abstract":"<p><p>Aortic dissection is a rare and potentially fatal complication of coronary angiography. We report a case of a woman in her late 80s who underwent a left femoral approach coronary angiogram for evaluation of a transcatheter aortic valve replacement (TAVR). Following the procedure, she had a cardiac arrest and was found to have a descending aortic dissection on transoesophageal echocardiogram. Autopsy showed an acute intimal tear of the descending aorta, most likely related to catheter manipulation. Patients undergoing evaluation for TAVR, who tend to be elderly with concomitant atherosclerosis, are at risk for complications following cardiac catheterisation including aortic dissection.</p>","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":" ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534119/pdf/BJC-29-02-bjc.2022.014.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33496849","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":"Dermatological manifestations of cardiac conditions.","authors":"Arnav Katira,&nbsp;Ravish Katira","doi":"10.5837/bjc.2022.009","DOIUrl":"https://doi.org/10.5837/bjc.2022.009","url":null,"abstract":"<p><p>Various cardiac disorders seen in general and acute medicine have dermatological manifestations that may provide critical clues to the underlying disease. This review will discuss the important dermatological signs seen in cardiac conditions. We believe greater interdisciplinary liaison will improve our understanding of the link between the dermatological and cardiovascular systems and the underlying disease processes.</p>","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":"29 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196073/pdf/BJC-29-01-bjc.2022.009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40392259","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":"Pipedreams, the pandemic and PoTS: is the post-COVID-19 era a turning point for PoTS services?","authors":"Morwenna Opie,&nbsp;Michaela Nuttall","doi":"10.5837/bjc.2022.007","DOIUrl":"https://doi.org/10.5837/bjc.2022.007","url":null,"abstract":"","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":"29 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196074/pdf/BJC-29-01-bjc.2022.007.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40392264","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":"Obstructive sleep apnoea and atrial fibrillation: a key omission in guidelines.","authors":"Natalia Shafiqa,&nbsp;Ari Manuel,&nbsp;Gregory Y H Lip,&nbsp;Sriram Iyer","doi":"10.5837/bjc.2022.010","DOIUrl":"https://doi.org/10.5837/bjc.2022.010","url":null,"abstract":"","PeriodicalId":74959,"journal":{"name":"The British journal of cardiology","volume":"29 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196072/pdf/BJC-29-01-bjc.2022.010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40392267","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}