Vessel plus最新文献_第7页

Malperfusion syndromes in acute type A aortic dissection 急性A型主动脉夹层的灌注不良综合征

Vessel plus Pub Date : 2022-01-01 DOI: 10.20517/2574-1209.2021.108

X. Lou, E. Chen

引用次数: 1

Department of veterans affairs post-coronary artery bypass graft patients’ atrial fibrillation: 10-year outcomes 退伍军人事务部冠状动脉搭桥术后患者房颤:10年结局

Vessel plus Pub Date : 2022-01-01 DOI: 10.20517/2574-1209.2021.119

J. Quin, G. Almassi, J. Collins, B. Carr, F. Grover, A. L. Shroyer

{"title":"Department of veterans affairs post-coronary artery bypass graft patients’ atrial fibrillation: 10-year outcomes","authors":"J. Quin, G. Almassi, J. Collins, B. Carr, F. Grover, A. L. Shroyer","doi":"10.20517/2574-1209.2021.119","DOIUrl":"https://doi.org/10.20517/2574-1209.2021.119","url":null,"abstract":"Aim: This Department of Veterans Affairs’ (VA) research project evaluated the impact of postoperative atrial fibrillation (POAF) upon 10-year outcomes for coronary artery bypass grafting (CABG) patients. Methods: Veterans enrolled in the “Randomized On-/Off-pump Bypass” (ROOBY) trial with new-onset POAF post-CABG were compared to those without POAF with respect to 10-year atrial fibrillation (AF) and mortality rates. Multivariable logistic regression examined whether AF was independently associated with 10-year survival after holding other preoperative risk factors constant. Results: Of the 2203 ROOBY veterans enrolled at 18 VA medical centers from 2002 to 2008, 100 patients with preoperative AF (n = 93) or unknown post-CABG POAF status (n = 7) were excluded. The POAF rate was 26.2% (n = 551/2103). The POAF patients were older and had more co-morbidities than the non-POAF patients (n = 1552). The AF rate among 10-year ROOBY POAF survivors was 18.9% (n = 64/338) compared to 5.8% (n = 61/1048) for non-POAF patients; P < 0.001. Compared to non-POAF patients’ 10-year survival of 70%, the ROOBY POAF veterans’ 10-year survival rate was 63%. Baseline risks inversely associated with 10-year survival included age, chronic obstructive pulmonary disease, serum creatinine > 1.5, peripheral vascular disease, and smoking. Holding these factors constant, POAF was not independently associated with 10-year survival. Conclusion: Post-CABG, ROOBY POAF veterans had higher rates of 10-year AF, which was negatively associated with 10-year survival; however, this association was not significant. Given that POAF may adversely impact 10-year AF rates, additional investigation appears warranted to improve future POAF patients’ care.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67654829","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}

引用次数: 0

Current status and future prospects of percutaneous treatment of mitral valve disease: repair vs. replacement 经皮治疗二尖瓣疾病的现状及未来展望:修复与置换

Vessel plus Pub Date : 2022-01-01 DOI: 10.20517/2574-1209.2021.135

M. Sabaté

引用次数: 0

Mid-basal left ventricular longitudinal dysfunction as a prognostic marker in mutated transthyretin-related cardiac amyloidosis 中基性左心室纵向功能障碍作为突变的甲状腺素相关的心脏淀粉样变性的预后标志

Vessel plus Pub Date : 2022-01-01 DOI: 10.20517/2574-1209.2021.86

R. Licordari, F. Minutoli, F. Cappelli, A. Micari, L. Colarusso, Federico Antonio Francesco Di Paola, M. Campisi, A. Recupero, A. Mazzeo, G. Di Bella

{"title":"Mid-basal left ventricular longitudinal dysfunction as a prognostic marker in mutated transthyretin-related cardiac amyloidosis","authors":"R. Licordari, F. Minutoli, F. Cappelli, A. Micari, L. Colarusso, Federico Antonio Francesco Di Paola, M. Campisi, A. Recupero, A. Mazzeo, G. Di Bella","doi":"10.20517/2574-1209.2021.86","DOIUrl":"https://doi.org/10.20517/2574-1209.2021.86","url":null,"abstract":"Aim: Mutated transthyretin (TTRv) cardiac amyloidosis (CA) represents an uncommon form of CA. Our study aimed to assess the best echocardiographic prognostic parameter in the early stage of TTRv amyloidosis with cardiomyopathy. Methods: In total, 99 patients with TTRv in New York Heart Association class I or II and with no clinical history of previous cardiac disease were studied. Assessment with 99mTc-DPD whole-body scan showed CA in 46 patients. At the first medical contact, an echocardiographic examination was performed. In addition to conventional left ventricular (LV), echocardiographic measurements [ejection fraction (EF), dimensions and diastolic function, global longitudinal strain (GLS), longitudinal strain of the 4 apical segments, longitudinal strain of the 12 mid-basal segments (MBLS)] and their ratio [relative regional strain ratio (RRSR)] were obtained. Patient outcome was evaluated during a follow-up with an average duration of six years. Cardiac death and appropriate implantable cardiac defibrillator (ICD) shock were considered major events. Results: A higher value of LV thickness, E/E’, and RRSR and lower LV volumes, EF, GLS, MBLS were observed in patients with CA than the ones with only TTRv. During follow-up (median of 7.7 years), 25 major events (23 cardiac death and 2 appropriate ICD shocks) occurred. The logistic univariate analyses showed that LV EF, LV septal thickness, E/E’, GLS, and MBLS were all predictors of cardiovascular death. In multivariate analysis, MBLS was the only independent predictor of major events. A cut off of -14 of MBLS was selected as the best value to discriminate a worse prognosis on Kaplan-Meyer analysis. Conclusion: Longitudinal dysfunction is observed in the early stages of ATTRv amyloidosis with cardiomyopathy. Medio-basal LV longitudinal dysfunction is a strong independent echocardiographic predictor of cardiac death.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67655566","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}

引用次数: 1

Complex role of RhoA in regulating vascular smooth muscle cell phenotypes in type 2 diabetes RhoA在调节2型糖尿病血管平滑肌细胞表型中的复杂作用

Vessel plus Pub Date : 2022-01-01 DOI: 10.20517/2574-1209.2022.26

Yaw Asare-Amankwah, K. Riches-Suman, Yajing Wang, Alexander D. Verin

{"title":"Complex role of RhoA in regulating vascular smooth muscle cell phenotypes in type 2 diabetes","authors":"Yaw Asare-Amankwah, K. Riches-Suman, Yajing Wang, Alexander D. Verin","doi":"10.20517/2574-1209.2022.26","DOIUrl":"https://doi.org/10.20517/2574-1209.2022.26","url":null,"abstract":"The incidence of type 2 diabetes mellitus (T2DM) is growing globally, and the major cause of morbidity and mortality in these patients is the premature development of cardiovascular disease. Consequently, medical interventions, such as coronary artery bypass graft surgery and widespread statin prescriptions, are common in this patient group. Smooth muscle cells are the major structural component of the vascular wall. They play a crucial role in post-bypass recovery to successfully revascularize the heart by switching between differentiated (contractile) and dedifferentiated (synthetic) phenotypes. However, in patients with T2DM, these cells have functional defects that may affect bypass integration. RhoA is a small GTPase that regulates many functions, such as motility and phenotypic regulation of smooth muscle cells. RhoA is dependent upon a stimulus, and it can drive the contractile smooth muscle cell phenotype present in the healthy condition or the (mal)adaptive phenotypes prevalent in disease or in response to injury. We hypothesize that RhoA deregulation plays a major role in vascular complications of T2DM. This protein is deregulated in T2DM smooth muscle cells, which may in part explain the functional defects of smooth muscle tissue and the subsequent failure rate of bypass in these patients. An important consideration in this circumstance is the use of statin therapies because these further inhibit RhoA activity. The effect of inhibition of RhoA activity in patients with T2DM who have a bypass is currently unknown.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67655988","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}

引用次数: 0

Postoperative atrial fibrillation is associated with increased resource utilization after cardiac surgery: a regional analysis of the Southeastern United States 术后心房颤动与心脏手术后资源利用率增加有关:美国东南部地区分析

Vessel plus Pub Date : 2022-01-01 DOI: 10.20517/2574-1209.2021.116

R. Hawkins, Raymond J. Strobel, M. Joseph, M. Quader, N. Teman, G. Almassi, J. Mehaffey

{"title":"Postoperative atrial fibrillation is associated with increased resource utilization after cardiac surgery: a regional analysis of the Southeastern United States","authors":"R. Hawkins, Raymond J. Strobel, M. Joseph, M. Quader, N. Teman, G. Almassi, J. Mehaffey","doi":"10.20517/2574-1209.2021.116","DOIUrl":"https://doi.org/10.20517/2574-1209.2021.116","url":null,"abstract":"Aim: Postoperative atrial fibrillation (POAF) is a known risk factor for morbidity and mortality following cardiac surgery though contemporary resource utilization data is limited. We hypothesize that POAF increases the length of stay, hospital cost, and discharges to facilities, though this trend may be tempering over time. Methods: Records were extracted for all patients in a regional database who underwent coronary artery bypass grafting, aortic valve replacement, or both (2012-2020). Patients without a history of atrial fibrillation were stratified by POAF for univariate analysis. Patients were propensity-score matched to account for baseline, operative, and postoperative differences. Results: Of the 27,307 cardiac surgery patients, 23% developed POAF. Matching resulted in 5926 well-balanced pairs of patients with and without POAF. Every metric of resource utilization was higher for patients with POAF, including ICU length of stay (58 h vs. 49 h, P < 0.0001), postoperative length of stay (7 days vs. 5 days, P < 0.0001), discharge to a facility (27% vs. 23%, P < 0.0001), and readmission (11% vs. 8%). The mean additional total hospital cost attributable to POAF was $6705 by paired analysis. A sensitivity analysis of only patients without major complications demonstrated similarly increased resource utilization for patients with POAF. Conclusions: POAF was associated with an increased 9 additional ICU hours, 2 postoperative days, 18% more discharges to a facility, and 33% greater readmissions. An additional $6705 is associated with POAF. These conservative estimates demonstrate the broad impact of POAF on in and out of hospital resource utilization that warrants future efforts at containment and quality improvement.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67654370","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}

引用次数: 1

Cytosorb® haemoadsorption: a potential game changer for patients needing myocardial surgical revascularisation Cytosorb®血液吸附:一个潜在的游戏规则改变患者需要心肌手术血运重建

Vessel plus Pub Date : 2022-01-01 DOI: 10.20517/2574-1209.2021.61

Clarissa Ng Yin Ling, K. Umakumar, L. Moss, U. Stock, S. Raja, E. D. de Waal, N. Marczin

{"title":"Cytosorb® haemoadsorption: a potential game changer for patients needing myocardial surgical revascularisation","authors":"Clarissa Ng Yin Ling, K. Umakumar, L. Moss, U. Stock, S. Raja, E. D. de Waal, N. Marczin","doi":"10.20517/2574-1209.2021.61","DOIUrl":"https://doi.org/10.20517/2574-1209.2021.61","url":null,"abstract":"Cytosorb, an extracorporeal blood purification system, utilises the principles of haemoadsorption to remove low molecular weight substances from the blood, including multiple cytokines such as interleukin (IL)-1b, IL-6, IL-8, and tumour necrosis factor-α, and anti-platelet drugs aiming to improve clinical outcomes. Given the prominent role of pro-inflammatory cytokines in various inflammatory states, Cytosorb has seen growing application as a therapeutic immunomodulator including surgery. This review focuses on the effects of the use of Cytosorb in patients undergoing coronary artery bypass grafting (CABG) and the indications of removal of cytokines and anti-platelet agents such as ticagrelor. The evidence supports the feasibility and safety profile of Cytosorb, with no device-related adverse events reported in all studies. Initial studies suggest significant potential for Cytosorb in urgent or emergency CABG surgery to remove anti-platelet medication with promising benefits on clinical outcomes including fewer blood product transfusions, decreased length of intensive care unit stay, and lower re-sternotomy rates. Furthermore, a cost saving analysis indicated that intraoperative removal of ticagrelor with Cytosorb would be cost effective in the setting of emergency cardiac surgery. However, the evidence remains inconclusive when Cytosorb is used in elective CABG surgery for cytokine removal. Definite high quality clinical trials for both indications for Cytosorb in CABG surgery are needed to clarify if there is a clinically significant benefit in clinical outcomes. There is substantial trial activity for the application of Cytosorb in higher risk cardiac surgery to establish the place of Cytosorb in future treatment pathways in cardiac surgery.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67655282","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}

引用次数: 1

Atrial fibrillation in mechanical circulatory support patients 机械循环支持患者心房颤动

Vessel plus Pub Date : 2022-01-01 DOI: 10.20517/2574-1209.2021.136

J. Obeid, Ashutosh Yaligar, A. Mclarty, H. Tannous, T. Bilfinger, A. L. Shroyer

{"title":"Atrial fibrillation in mechanical circulatory support patients","authors":"J. Obeid, Ashutosh Yaligar, A. Mclarty, H. Tannous, T. Bilfinger, A. L. Shroyer","doi":"10.20517/2574-1209.2021.136","DOIUrl":"https://doi.org/10.20517/2574-1209.2021.136","url":null,"abstract":"Atrial fibrillation (AF) is known to be one of the most common arrhythmias noted in cardiac procedures and is frequently associated with heart failure. As frequent interventions for patients with heart failure involve implantation of mechanical circulatory assist devices (e.g., left ventricular assist devices), it is timely to review the role this arrhythmia has on adverse clinical outcomes. A comprehensive literature search was conducted for PubMed. Relevant medical subject heading (MeSH) terms used in the initial literature search include “Heart-Assist Devices”, “Extracorporeal Membrane Oxygenation”, “Atrial Fibrillation”, “Heart Failure”, “Mortality”, “Hospital Readmission”, “stroke”, “Postoperative Complications”. In this review, the relevant literature was highlighted to identify the incidence, clinical impacts, and management of AF surrounding mechanical circulatory support implantation. The incidence of AF in this mechanical circulatory support device population was similar to that of patients with other cardiac procedures (10%-40%). Moreover, in most studies, preoperative AF was not significantly associated with adverse outcomes. In contrast, however, it appears that postoperative atrial fibrillation may predispose patients to increased risk for thromboembolic events and adverse long-term outcomes.","PeriodicalId":75299,"journal":{"name":"Vessel plus","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67655495","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}

引用次数: 0

New endovascular techniques for false lumen thrombosis in aortic dissection after thoracic endovascular aortic repair 胸主动脉腔内修复术后主动脉夹层假腔血栓的血管内新技术

Vessel plus Pub Date : 2022-01-01 DOI: 10.20517/2574-1209.2022.04

F. Buia, V. Russo, D. Attinà, F. Niro, L. Lovato

引用次数: 0

Cardiac amyloidosis: the pathologist’s point of view 心脏淀粉样变:病理学家的观点

Vessel plus Pub Date : 2022-01-01 DOI: 10.20517/2574-1209.2022.05

M. De Gaspari, N. Finato, C. Basso

引用次数: 0