International journal of cardiology. Heart & vessels最新文献

{"title":"Distinct structural and molecular features of the myocardial extracellular matrix remodeling in compensated and decompensated cardiac hypertrophy due to aortic stenosis","authors":"Victoria Polyakova ,&nbsp;Manfred Richter ,&nbsp;Natalia Ganceva ,&nbsp;Hans-Jürgen Lautze ,&nbsp;Sokichi Kamata ,&nbsp;Jochen Pöling ,&nbsp;Andres Beiras-Fernandez ,&nbsp;Stefan Hein ,&nbsp;Zoltan Szalay ,&nbsp;Thomas Braun ,&nbsp;Thomas Walther ,&nbsp;Sawa Kostin","doi":"10.1016/j.ijchv.2014.05.001","DOIUrl":"10.1016/j.ijchv.2014.05.001","url":null,"abstract":"<div><h3>Objectives</h3><p>We used immuhistochemistry and Western blot to study fibrillar and non-fibrillar collagens, collagen metabolism, matricellular proteins and regulatory factors of the ECM remodeling in left ventricular (LV) septum biopsies from 3 groups of patients with aortic valve stenosis (AS): (AS-1,n = 9): ejection fraction (EF) &gt; 50%; AS-2,(n = 12): EF 30%–50%; AS-3,(n = 9): EF &lt; 30%). Samples from 8 hearts with normal LV function served as controls.</p></div><div><h3>Results</h3><p>In comparison with controls, fibrillar collagens I and III were progressively upregulated from compensated (AS-1) toward decompensated hypertrophy (AS-3). The collagenIII/collagen I ratio decreased 2-fold in the AS-2 and AS-3 groups as compared with AS-1 and controls. Non-fibrillar collagen IV was upregulated only in AS-3 patients, whereas collagen VI progressively increased from AS-1 to AS-3 group. Collagen synthesis in AS-3 was shifted to collagen I, while the maturation/degradation level was shifted to collagen III. RECK was downregulated only in AS-3 patients. Matricellular proteins tenascin and osteopontin were increased in all AS patients. However, thrombospondin 1, 4 and CTGF were increased only in AS-3. Only AS-3 patients were characterized by increased levels of TGFβ1 and downregulation of TGFβ3, TGFβ-activated kinase1 and Smad7. In contrast, Smad3 gradually increased from AS-1 toward AS-3. Similar trend of changes was observed for TNFα-R1 and TNFα-R2, whereas TNFα was diminished only in AS-2 and AS-3.</p></div><div><h3>Conclusions</h3><p>Distinct changes in fibrillar collagen turnover, non-fibrillar collagens, matricellular proteins and the key regulatory profibrotic and anti-fibrotic factors of the myocardial ECM remodeling are involved in the transition from compensated to decompensated LV hypertrophy and HF in human patients with AS.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54358035","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":"Impact of blood urea nitrogen for long-term risk stratification in patients with coronary artery disease undergoing percutaneous coronary intervention","authors":"Masayuki Kawabe ,&nbsp;Akira Sato ,&nbsp;Tomoya Hoshi ,&nbsp;Shunsuke Sakai ,&nbsp;Daigo Hiraya ,&nbsp;Hiroaki Watabe ,&nbsp;Yuki Kakefuda ,&nbsp;Mayu Ishibashi ,&nbsp;Daisuke Abe ,&nbsp;Noriyuki Takeyasu ,&nbsp;Kazutaka Aonuma","doi":"10.1016/j.ijchv.2014.06.002","DOIUrl":"10.1016/j.ijchv.2014.06.002","url":null,"abstract":"<div><h3>Background</h3><p>Few studies have examined the association between blood urea nitrogen (BUN) and mortality in patients with coronary artery disease (CAD). We investigated the prognostic value of BUN concentration at hospital admission in patients with CAD.</p></div><div><h3>Methods</h3><p>A total of 3641 patients with CAD who underwent percutaneous coronary intervention (PCI) were included from April 2007 to June 2011. We measured BUN concentration at hospital admission and compared it with long-term clinical outcome. Patients were classified into three groups according to BUN concentration of &lt; 20 mg/dl, 20 to 25 mg/dl, or &gt; 25 mg/dl. Primary endpoint was all-cause death.</p></div><div><h3>Results</h3><p>During the follow-up period (median 15 months), 248 (6.8%) patients died. A higher BUN level was associated with multivessel disease, lower ejection fraction, lower systolic blood pressure, and higher prevalence of comorbidities. Cox regression analysis showed that patients with BUN of &gt; 25 mg/dl had a hazard ratio (HR) for mortality of 2.73 (95% CI, 1.14 to 6.53; p = 0.023) with an estimated glomerular filtration rate (eGFR) of ≥ 45 ml/min/1.73 m² and a HR of 2.90 (95% CI, 1.75 to 4.82; p &lt; 0.001) with an eGFR of &lt; 45 ml/min/1.73 m². Regardless of acute coronary syndrome or stable CAD, BUN of &gt; 25 mg/dl was independently associated with higher mortality (HR, 2.58; 95% CI, 1.43 to 4.64; p = 0.004 and HR, 2.16; 95% CI, 1.01 to 4.59; p = 0.044, respectively).</p></div><div><h3>Conclusions</h3><p>A BUN of &gt; 25 mg/dl was associated with long-term mortality in CAD patients who underwent PCI independent of traditional cardiovascular risk factors and eGFR.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54358118","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 and 3-year clinical outcomes following ad hoc versus staged percutaneous coronary interventions in chronic total occlusion — A real world practice","authors":"Hsiu-Yu Fang ,&nbsp;Wei-Chieh Lee ,&nbsp;Hesham Hussein ,&nbsp;Chih-Yuan Fang ,&nbsp;Cheng-I Cheng ,&nbsp;Cheng-Hsu Yang ,&nbsp;Chien-Jen Chen ,&nbsp;Chi-Ling Hang ,&nbsp;Hon-Kan Yip ,&nbsp;Yu-Sheng Lin ,&nbsp;Chiung-Jen Wu","doi":"10.1016/j.ijchv.2014.06.012","DOIUrl":"10.1016/j.ijchv.2014.06.012","url":null,"abstract":"<div><h3>Background</h3><p>Ad hoc percutaneous coronary intervention (PCI) which was performed immediately after diagnostic catheterization has become the most common way of coronary intervention. However, limited data is available on in-hospital and long-term outcome comparing ad hoc and staged chronic total occlusion (CTO) PCI. The aim of our study was to figure the short-term and long-term outcomes after ad hoc or staged CTO PCI.</p></div><div><h3>Methods</h3><p>This retrospective analysis included 512 consecutive patients that underwent 561 CTO PCI procedures between January 2002 and December 2009. Patient basic demographics, lesion characteristics, interventional procedure, devices used and in-hospital outcomes were compared between ad hoc and staged CTO PCI groups. 3-Year clinical outcomes that included all-cause mortality, cardiac mortality, myocardial infarction (MI), the need for coronary artery bypass graft surgery (CABG), major adverse cardiac events (MACE) and target vessel revascularization (TVR) were compared. Time-to-event analyses were performed using Kaplan–Meier statistics.</p></div><div><h3>Results</h3><p>Four hundred fifty-one patients (80.4%) were enrolled in ad hoc CTO PCI group. Final successful revascularization was higher in ad hoc CTO PCI group compared with staged CTO PCI group (82.9 vs. 77.3%, <em>p</em> = 0.17) without statistical significance. There was no significant difference between ad hoc CTO PCI and staged CTO PCI groups in in-hospital outcomes such as all-cause mortality, cardiac death, myocardial infarction, urgent bypass surgery, urgent PCI or complications. Patients with ad hoc CTO PCI had lower rate of all-cause mortality (6.2% vs. 6.5%, <em>p</em> = 0.89), the need for CABG (1.9% vs. 2.1%, <em>p</em> = 0.89) but higher rate of cardiac mortality (1.7% vs. 0.0%, <em>p</em> = 0.21), MI (1.0% vs. 0.0%, <em>p</em> = 0.34), MACE (24.1% vs. 17.5%, <em>p</em> = 0.19) and TVR (17.8% vs. 10.0%, <em>p</em> = 0.069) without statistical significance in 3-year clinical outcomes.</p></div><div><h3>Conclusion</h3><p>3-Year clinical outcomes compared with ad hoc CTO PCI and staged CTO PCI had insignificant differences between: all-cause mortality, cardiac mortality, MI, the need for CABG, MACE and TVR.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.06.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54358186","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":"Systemic perfusion at peak incremental exercise in left ventricular assist device recipients: Partitioning pump and native left ventricle relative contribution","authors":"Alessandro Mezzani ,&nbsp;Massimo Pistono ,&nbsp;Ugo Corrà ,&nbsp;Andrea Giordano ,&nbsp;Marco Gnemmi ,&nbsp;Alessandro Imparato ,&nbsp;Paolo Centofanti ,&nbsp;Mauro Rinaldi ,&nbsp;Silvia Colombo ,&nbsp;Elena Canal ,&nbsp;Pantaleo Giannuzzi","doi":"10.1016/j.ijchv.2014.07.004","DOIUrl":"10.1016/j.ijchv.2014.07.004","url":null,"abstract":"<div><h3>Background</h3><p>In continuous-flow left ventricular assist device (LVAD) recipients, little is known about the relative pump- and left ventricle-generated blood flow (PBF and LVBF, respectively) contribution to peak systemic perfusion during incremental exercise and about how PBF/LVBF interplay and exercise capacity may be affected by pump speed increase.</p></div><div><h3>Methods</h3><p>Twenty-two LVAD recipients underwent ramp cardiopulmonary exercise tests at fixed and increasing pump speed (+ 1.5% of baseline speed/10 W workload increase), echocardiography and NT-proBNP dosage. Peak systemic perfusion was peak VO₂/estimated peak arterio-venous O₂ difference, and LVBF was systemic perfusion minus PBF provided by LVAD controller. A change of peak percentage of predicted VO_2max (Δpeak%VO₂) ≥ 3 in increasing- vs. fixed-speed test was considered significant.</p></div><div><h3>Results</h3><p>Tricuspid annular plane systolic excursion (TAPSE) and NT-proBNP were significantly lower and higher, respectively, in Δpeak%VO₂ &lt; 3 than ≥ 3. A LVBF contribution to systemic perfusion significantly larger than that of PBF was observed in Δpeak%VO₂ ≥ 3 vs. &lt; 3 in fixed-speed test, which was further amplified in increasing-speed test (2.4 ± 1.7 l/min vs. 2.0 ± 1.5 l/min and 0.8 ± 2.2 l/min vs. 1.3 ± 2.3 l/min, respectively, p for trend &lt; 0.0005). Among several clinical-instrumental parameters, logistic regression selected only TAPSE &gt; 13 mm as a predictor of Δpeak%VO₂ ≥ 3.</p></div><div><h3>Conclusions</h3><p>A significant LVBF contribution to peak systemic perfusion and pump speed increase-induced peak VO₂ improvement was detectable only in patients with a more preserved right ventricular systolic function and stable hemodynamic picture. These findings should be taken into consideration when designing LVAD controllers aiming to increase pump speed according to increasing exercise demands.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54358245","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":"Automated template matching correlates with earliest activation during mapping of idiopathic premature ventricular contractions","authors":"Jakob Lüker ,&nbsp;Arian Sultan ,&nbsp;Helge Servatius ,&nbsp;Imke Berner,&nbsp;Boris Alexander Hoffmann,&nbsp;Stephan Willems,&nbsp;Daniel Steven","doi":"10.1016/j.ijchv.2014.08.006","DOIUrl":"10.1016/j.ijchv.2014.08.006","url":null,"abstract":"<div><h3>Background</h3><p>Ablation of premature ventricular contractions (PVC) can be challenging due to infrequent spontaneous ectopy and the limitations subjective pacemapping (PM). Activation mapping (AM) provides an objective parameter, but relies on spontaneous ectopic activity.</p></div><div><h3>Objectives</h3><p>The objective of the study was to evaluate the correlation of automated template matching (TM) with activation timing and to investigate potential implications towards ablation success.</p></div><div><h3>Methods</h3><p>Forty patients undergoing catheter ablation of idiopathic outflow tract VT or PVC in 47 procedures were included. PVC/VT origin was determined by PM and AM. A percentage value for PM was calculated using TM software and correlated with corresponding activation timing. Overall, 126 TM and corresponding AM values were analyzed. All patients were followed (313 ± 158 days after ablation) including a 24-hour Holter ECG.</p></div><div><h3>Results</h3><p>A correlation between TM and activation timing (r = 0.66, P &lt; 0.0001) could be shown. Success rate at followup was 77%. No statistically significant coherence of TM percentage and relapse was observed.</p></div><div><h3>Conclusions</h3><p>Template matching correlates with activation timing in the process of mapping idiopathic focal PVC/VT. TM helps to objectify the process of PM and may therefore be helpful to guide successful ablation in the absence of spontaneous ectopy.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.08.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54358302","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":"Trends in percutaneous coronary intervention and angiography in Ireland, 2004–2011: Implications for Ireland and Europe","authors":"S. Jennings ,&nbsp;K. Bennett ,&nbsp;E. Shelley ,&nbsp;P. Kearney ,&nbsp;K. Daly ,&nbsp;W. Fennell","doi":"10.1016/j.ijchv.2014.08.001","DOIUrl":"10.1016/j.ijchv.2014.08.001","url":null,"abstract":"<div><h3>Background/objectives</h3><p>To study temporal trends in crude and age standardised rates of cardiac catheterisation and percutaneous coronary intervention (PCI) in Ireland, 2004–2011.</p></div><div><h3>Methods</h3><p>Two data sources were used: a) a survey of publicly and privately funded hospitals with cardiac catheter laboratories to obtain the annual number of procedures performed and b) anonymised data from the Hospital In-Patient Enquiry (HIPE) for angiography and PCI in acute publicly funded hospitals; age standardised rates were calculated to study trends over time.</p></div><div><h3>Results</h3><p>From 2004 to 2011 the crude rate of angiography and PCI increased by 47.8% and 35.9% respectively, with rates of 6689 and 1825 per million population in 2011. Following age standardisation, however, PCI activity showed a non-significant decrease over time. The PCI to angiography ratio decreased from 30% to 27% and PCI was performed predominantly for stable coronary heart disease (54%) in 2011.</p></div><div><h3>Conclusion</h3><p>Angiography and PCI rates have increased in Ireland but PCI crude and age adjusted rates show divergent trends. While Ireland differs from USA and UK, with a higher proportion of PCI being performed for stable CHD in recent years, little systematic surveillance of cardiological interventions within Europe is available to benchmark improvements in Ireland.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35835748","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":"Elevated urinary albumin excretion complements the Framingham Risk Score for the prediction of cardiovascular risk — response to treatment in the PREVEND IT trial","authors":"Frank P. Brouwers ,&nbsp;Folkert W. Asselbergs ,&nbsp;Hans L. Hillege ,&nbsp;Ron T. Gansevoort ,&nbsp;Rudolf A. de Boer ,&nbsp;Wiek H. van Gilst","doi":"10.1016/j.ijchv.2014.04.004","DOIUrl":"10.1016/j.ijchv.2014.04.004","url":null,"abstract":"<div><h3>Background</h3><p>The PREVEND IT trial reported on a high cardiovascular (CV) event rate in subjects with a baseline urinary albumin excretion (UAE) rate of ≥ 50 mg/24 h. Here, we report on the observed 10-year CV outcome of this population and compare this with the predicted Framingham Risk Score (FRS). In addition, we evaluated the effect of four years of fosinopril treatment on this relation.</p></div><div><h3>Methods and results</h3><p>From the PREVEND IT cohort, 833 subjects without history of CV disease, randomized to fosinopril (N = 412) or placebo (N = 421), were studied. The primary endpoint included CV mortality and adjudicated hospitalization for CV disease during a 10-year follow-up period. Mean age was 51 ± 12 years and 65% were males, while prevalence of diabetes (2.6%) and use of CV drugs (3.5%) was low. Subjects were categorized to high UAE (≥ 50 mg/24 h) or low UAE (&lt; 50 mg/24 h). After 10 years of follow-up, the event rate in the high UAE group was almost twice as high as predicted by the FRS (29.5% vs. 17.2%). Treatment for four years with fosinopril reduced the event rate to comparable levels of that predicted by FRS. The addition of UAE ≥ 50 mg/24 h to the FRS improved the Integrated Discrimination Improvement (P = 0.033) and increased the area under the curve by 0.54% (P = 0.024).</p></div><div><h3>Conclusions</h3><p>The 10-year CV risk of subjects with an elevated UAE (≥ 50 mg/24 h) is substantially underestimated by the FRS. Treatment with fosinopril successfully reduced this increased event rate to FRS-predicted CV risk.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54357938","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":"Fractional flow reserve-guided endovascular therapy for common iliac artery stenosis; a comparison with the exercise ankle brachial index: A case report","authors":"Tsuyoshi Ito ,&nbsp;Hiroshi Fujita,&nbsp;Tomomitsu Tani,&nbsp;Nobuyuki Ohte","doi":"10.1016/j.ijchv.2014.05.003","DOIUrl":"10.1016/j.ijchv.2014.05.003","url":null,"abstract":"","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54358054","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":"Clinical outcomes and risk factors of coronary artery aneurysms after successful percutaneous coronary intervention and drug-eluting stent implantation for chronic total occlusions","authors":"Xin Zhong ,&nbsp;Hua Li ,&nbsp;Chenguang Li ,&nbsp;Nobel Zong ,&nbsp;David Liem ,&nbsp;X'avia Chan ,&nbsp;Shuning Zhang ,&nbsp;Youen Zhang ,&nbsp;Xinggang Wang ,&nbsp;Xing Wu ,&nbsp;Wenbin Zhang ,&nbsp;Kang Yao ,&nbsp;Xuebo Liu ,&nbsp;Lei Ge ,&nbsp;Kai Hu ,&nbsp;Juying Qian ,&nbsp;Mario Deng ,&nbsp;Junbo Ge","doi":"10.1016/j.ijchv.2014.06.004","DOIUrl":"10.1016/j.ijchv.2014.06.004","url":null,"abstract":"<div><h3>Objective</h3><p>The study aimed to analyze the risk factors and long-term outcomes associated with coronary artery aneurysms (CAAs) after successful percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation in patients with CTOs.</p></div><div><h3>Background</h3><p>There are sporadic data available on post-procedure CAAs after transcatheter revascularization for CTOs.</p></div><div><h3>Methods and results</h3><p>A total of 141 patients with 149 CTOs who underwent successful CTO-PCI and DES implantation with angiographic follow-up from 2004 to 2010 were included. Patients were divided into CAA group and non-CAA group according to the presence of CAAs in the follow-up angiography. The independent predictors and major adverse cardiac events (MACEs) including cardiac death, myocardial infarction (MI) and target-vessel revascularization (TVR) were compared between two groups. The incidence of CAAs was 11.4% (17/149) after index procedure. Multivariate analysis showed that age (OR: 0.925, CI 0.873–0.980, P = 0.008), ostial occlusion (OR: 6.715, CI 1.473–30.610, P = 0.014), the parallel wire technique (OR: 6.167, CI 1.709–22.259, P = 0.005) and DES length (OR: 1.030, CI 1.002–1.058, P = 0.036) were the independent predictors of CAAs after successful CTO-PCI and DES implantation. MACEs were similar between two groups (adjusted hazard ratio 0.670; 95% CI 0.160–2.808; P = 0.584) during the 5-year follow-up.</p></div><div><h3>Conclusions</h3><p>The independent predictors of CAAs after successful CTO-PCI and DES implantation are age, ostial occlusion, the parallel wire technique and DES length. CAAs after index procedure are not frequently associated with adverse clinical events under dual antiplatelet therapy. Further large clinical studies are warranted to explore the clinical implications of patients with this distinct new entity.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54358144","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":"Sonothrombolysis in acute stroke and myocardial infarction: A systematic review","authors":"Sebastiaan T. Roos ,&nbsp;Lynda J.M. Juffermans ,&nbsp;Jeroen Slikkerveer ,&nbsp;Evan C. Unger ,&nbsp;Thomas R. Porter ,&nbsp;Otto Kamp","doi":"10.1016/j.ijchv.2014.08.003","DOIUrl":"10.1016/j.ijchv.2014.08.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Current treatment of patients with an acute occlusion of a cranial or a coronary artery, in for example ST segment elevation myocardial infarction (STEMI), consists of either thrombolysis or percutaneous intervention. Various thrombolytic agents (tissue plasminogen activators) are used for reperfusion therapy in patients with STEMI. However, their use may be associated with an increased risk of bleeding which is inherent to their action mechanism. Therefore, new methods of coronary clot resolution are being studied in an attempt to potentiate the efficacy and reduce the side effects of thrombolytics. A new method is ultrasound mediated thrombus dissolution, or sonothrombolysis. The current literature exploring sonothrombolysis is diverse in size and quality. In this systematic review of the current literature, we describe cardiovascular applications of sonothrombolysis in patients. A comparison to the neurovascular application in ischemic stroke is made, as more research has been performed on patients suffering from stroke.</p></div><div><h3>Methods</h3><p>A systematic search was performed following the PRISMA guidelines using EMBASE and MEDLINE databases regarding sonothrombolysis in human ischemic stroke and acute myocardial infarction patients.</p></div><div><h3>Results</h3><p>12 original case–control or randomized controlled trials using a combination of ultrasound and microbubbles were found. 6 trials studied ischemic stroke, and 6 trials studied acute myocardial infarction.</p></div><div><h3>Conclusion</h3><p>This systematic review provides up to date information on the subject of sonothrombolysis.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. Heart & vessels","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchv.2014.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54358267","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}