Journal of integrative cardiology open access最新文献

{"title":"Gender Difference in Lipid Profile in Hypertensive Patients’ Hospital-Based Study","authors":"","doi":"10.33140/coa.07.01.05","DOIUrl":"https://doi.org/10.33140/coa.07.01.05","url":null,"abstract":"Background and objectives: Hypertension and dyslipidemia are the integral components of metabolic syndrome. It has emerged as cause of substantial mortality in both genders. The objective of the study was to find out the prevalence of dyslipidemia in both gender and difference in pattern of lipid profile in hypertensive patients. Methods: This was an observational study conducted in 2018 to 2019 at Sir Syed university Hospital Karachi Pakistan. Sample size of 250 diagnosed cases of hypertension (comprising equal number of males and females) were collected. The lipid values were interpreted in normal or high-risk category by applying NCEP ATPIII criterion. Fasting sample were collected for sugar and lipid profile. Anthropometric, demographic and biochemical data was tabulated. Categorical variables were displayed as mean ± standard deviation and percentage respectively, compared with chi-square test. Student 't' test was use to assess the difference for the lipid profile at 5% significance level. The prevalence of dyslipidemia was estimated for men and women, and pattern in lipid profile were compared. The factors associated with dyslipidemia in both genders were calculated by multiple logistic regression expressed as odd Ratio with 95% confidence interval (C.I). To evaluate the effect of age on dyslipidemia we made four age groups 25-65 years and lipid pattern was compared. Results: Dyslipidemia was found 63% of hypertensive group, 72% women were dyslipidemia than 54% men and pattern of lipid in males showed low LDL and high cholesterol and in females’ high triglycerides and low HDL. The Predictors of dyslipidemia in female were old age, BMI kg/m2 high blood pressure level, depression and lack of physical activity and in men smoking intake of fried, salty food, smoking and obesity with increasing age. Females have more triglycerides total cholesterol and low HDL compared to men. Conclusion: Dyslipidemia was more found in women with hypertension but as the age increasing more women have dyslipidemia. while treating hypertensive patient’s lipid lowering management gender heterogeneity should be considered.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76343764","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}

{"title":"Oral Vasoactive Medications: A Summary of Midodrine and Droxidopa as Applied to Orthostatic Dysfunction","authors":"","doi":"10.33140/coa.07.01.08","DOIUrl":"https://doi.org/10.33140/coa.07.01.08","url":null,"abstract":"This is a summary of the uses and applications of two vasoactive drugs, Midodrine (ProAmatine) and Droxidopa (Northera), in the treatment of Orthostatic Dysfunction (OD) disorders, including Neurogenic Orthostatic Hypotension, Postural Orthostatic Tachycardia Syndrome (POTS). This summary based on 15 years of experience monitoring and serially treating over 4000 patients with OD from all around the world and supportive literature. OD caused by an abnormal (decrease) in α-adrenergic, or α-Sympathetic, activity when assuming a head-up posture (e.g., sitting or standing). OD symptoms typically include lightheadedness, brain-fog, neurocognitive loss, fatigue, sleep difficulties, anxiety, and Syncope. Decreasing α-adrenergic activity upon head-up postural change often underlies OD and may be relieved with vasoactive medications. Midodrine and Droxidopa are the only medications that are FDA approved and approved for NOH. Except for their specific uses with NOH, these medications are used off-label with other forms of OD, including POTS, Orthostatic Hypotension, Orthostatic Intolerance and Vasovagal Syncope when co-morbid with OD. This summary will expand the knowledge of Midodrine and Northera, describe their advantages and disadvantages, and describe their comparative data. Hope this summary will help to make the clinician more comfortable diagnosing these disorders as well as using these treatments for this large population of patients with poor Quality of Life and poor functioning","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81832570","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}

{"title":"Long-Covid Syndrome: A Multi-Organ Disorder","authors":"","doi":"10.33140/coa.07.01.07","DOIUrl":"https://doi.org/10.33140/coa.07.01.07","url":null,"abstract":"Long-COVID Syndrome, a multi-organ disorder, that persists beyond 12 weeks post-acute SARS-CoV-2 Infection COVID-19. Here we provide a definition for this syndrome and discuss the organs that are involved. The involvement of multiple organs is due to that fact that angiotensin converting enzyme-2 receptors (the entry points for the virus), inflammation and oxidative stress (the immediate effects of the virus) effect all systems of the body. We suggest that this is then perpetuated by a resulting autonomic dysfunction. Since the autonomic dysfunction also effects all systems of the body, the initial infection is compounded and perpetuated by the resulting autonomic dysfunction underlying the Long-COVID Syndrome. We discuss the symptoms and suggest therapies that target the underlying autonomic dysfunction to relieve the symptoms, rather than merely treating symptoms. In addition to treating the autonomic dysfunction, the therapy also treats chronic inflammation and oxidative stress. To fully document the autonomic dysfunction, a full assessment of the autonomic nervous system is recommended, including Cardio-Respiratory Monitoring. Specific measurements of Parasympathetic and Sympathetic activity, both at rest and in response to challenges, connects all symptoms of Long-COVID to the documented autonomic dysfunction(s)","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"04 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90365104","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}

{"title":"The Efficacy and Safety of the Off-Label Dose of Direct Oral Anti-Coagulants Treatment in Patients with Atrial Fibrillation in China","authors":"","doi":"10.33140/coa.07.01.09","DOIUrl":"https://doi.org/10.33140/coa.07.01.09","url":null,"abstract":"Background: Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Anti-coagulation therapy, especially direct oral anti-coagulants (DOACs) is an indispensable therapy for AF. Considering the increased risks of bleeding, the off-label dose of DOACs has been applied in East Asia. However, the efficacy and safety of off-label dose of DOACs is controversial. Here, we investigate its efficacy and safety in AF patients in China. Methods: This is a retrospective cohort study. Patients diagnosed with AF between January 2015 and December 2015 were recruited. Participants were divided into three groups according to DOACs dose: standard dose of anti-coagulation (SAG) group, off-label dose of DOACs (OFL) group and non-anti-coagulation (NCG) group. Primary endpoint event was all-cause mortality. Secondary endpoint events included thromboembolic events, acute coronary syndrome, major bleeding and any rehospitalization. All endpoints were collected in 2020. Results: 296 patients were included in this study. All-cause mortality in NCG (52%) group was the highest among these three groups (p<0.001), and there was no significant difference between OFL (14%) and SAG group (19%, p=0.601). Compared to SAG group (1.8%), patients in OFL group (16.2%) had higher risk of stroke and thromboembolic events (p<0.001). The incidence of other events including major bleeding (p=0.597) were similar between SAG group (8.1%) and OFL group (5.4%). Conclusions: Off-label dose of DOACs shows no overall benefits in the occurrence of thromboembolic risk compared to the standard dose of DOACs in AF patients in China. Collectively, standard dose of DOACs should be advocated in China.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79173838","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}

{"title":"24-Hour Electrocardiographic (ECG) Holter Recording during Hypertensive Cardiopathy in Health Facilities in Lome","authors":"Pio Machihude, S. Péssinaba, HD Sama, YM Afassinou, Kyr D Almeida, B. Atta, T. Tcherou, WD Kaziga, AM Bakai","doi":"10.31487/j.jicoa.2022.01.01","DOIUrl":"https://doi.org/10.31487/j.jicoa.2022.01.01","url":null,"abstract":"Objective: To evaluate the 24-hour Holter ECG recording in hypertensive heart disease.\u0000Methods: This was a descriptive and analytical cross-sectional study on files of patients with hypertensive heart disease, carried out from October 2016 to October 2019, in two health facilities in Lome (TOGO). Electrical left ventricular hypertrophy (LVH) was defined by the Sokolow-Lyon and Cornell indices. On echocardiography, the HVG according to the criteria of the American Society of Echocardiography, was the characteristic retained for a CH. Holter-ECG recordings were carried out over 24 hours by two Holter devices.\u0000Results: 107 patients were included, with a sex ratio of 1.89 (M / F). The mean age was 62.2 ± 12 years. The mean duration of the evolution of hypertension was 10.8 ± 9.1 years. On standard ECG, arrhythmias were more frequent (32.6%) with ACFA in 5.6% of cases. The prevalence of echocardiographic HVG was 74.8%, predominantly concentric, and was significantly found in hypertensive patients over 10 years of age. During the 24-hour Holter ECG recording, ACFA was the common arrhythmia (30%), episodic in 90.6% of cases and permanent 9.4% and was statistically associated with OG size, sex and age. The Holter ECG detected sustained ventricular tachycardia in 7 patients (6.5%). The Recording was normal 12.1% of the time.\u0000Conclusion: Hypertensive heart disease is the first of the cardiac complications of hypertension. The Holter ECG is a tool for the detection of fatal severe paroxysmal events that go unnoticed on the surface ECG such as AC/AF, sustained ventricular tachycardias.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42230211","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}

{"title":"Cystic Adventitial Popliteal Disease: Personal Experience and Literature Review","authors":"","doi":"10.33140/coa.07.01.03","DOIUrl":"https://doi.org/10.33140/coa.07.01.03","url":null,"abstract":"Background: Cystic adventitial disease (CAD) primarily affects arteries and is described as a rare vascular disorder characterized by fluid accumulation in the adventitial layer of a vessel which may cause luminal narrowing or even complete occlusion. Nowadays different pathogenetic theories exist as well as different treatment solution. Case Report: We report two cases of cystic adventitial disease of the popliteal artery treated over the last 4 years in healthy men. Both experienced the sudden onset of intermittent calf claudication; one also presented blue toe syndrome. In both cases the diagnose was confirmed after open surgery and histological evaluation. Complete resection and autologous vein bypass were performed in one case; complete resection and direct end to end anastomosis in the others. Discussion: Cystic adventitial disease is a rare vascular disorder with different interesting theories on its aetiology. Treatment options include percutaneous ultrasound-guided aspiration, endovascular approaches and open surgical cyst excision with or without direct reconstruction. In our Institution, we faced two popliteal CAD cases; open surgery represented the treatment strategy for both: in the first case an autologous vein bypass was performed, while in the second case the artery contiguity was restored with an end-to-end anastomosis. Both patients experienced full relief of symptoms without any recurrence of the disease. Conclusion: Even if rare, popliteal artery CAD has to be suspected in young healthy patients who refer the sudden onset of acute or sub-acute symptoms related to peripheral arterial occlusive disease. Differential diagnose between popliteal entrapment syndrome and popliteal aneurysms is not always easy. When CAD is suspected or diagnosed a conventional surgical approach is recommended.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87320101","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}

{"title":"Role of Natriuretic Terminal Pro B-type Natriuretic Peptide (NT-Pro-BNP) in Diagnosis of Heart Failure in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD), Retrospective Cohort Study Conducted in Karachi, Pakistan","authors":"","doi":"10.33140/coa.07.01.01","DOIUrl":"https://doi.org/10.33140/coa.07.01.01","url":null,"abstract":"Introduction: COPD and heart failure effecting millions of people in the world where as combinedly becomes deadlier and affecting the major population of different regions of world, also increasing the rate of morbidity and mortality. Diagnosis of heart failure in COPD patients or COPD in heart failure patient is very difficult for cardiologist and pulmonologist. Objective: Acute exacerbation of COPD concomitant with Heart failure is among the diseases responsible for increasing the Mortality, morbidity, economic burden on patients, health care system and to see the impact on gender-based incidence Early use of NT-Pro-BNP is evaluated in COPD patients for diagnosis of heart failure in Pakistan due to socio-cultural and economical differences this study was conducted. Methods: The study was conducted in 7th Day Karachi Adventist hospital from Nov 2020 to Nov 2021, retrospective cohort study in admitted patients with acute exacerbation of COPD. Qualitative variables including gender, age groups, smoking status, symptoms and clinical finding were recorded. Data was entered and analyzed in statistical package for social sciences (SPSS) version 22. Quantitative variables including age in years, duration of COPD, NT-Pro-BNP level and ejection fraction was presented in mean and standard deviation. For the determination of association between qualitative variables chi-square test was used. Results: In our study heart failure was reported in 89 (85.5%) patients of AECOPD on the basis of Pro -BNP level with Heart Failure & COPD without Heart Failure in 15 (14.4%) patients by using NT-Pro-BNP as a marker of heart Failure. independent sample was used for calculating mean difference (8042.2),95 %CI (1060.7-23.0) and P-value 0.02 *between patients of COPD with heart failure and without HF P-value shows significant difference between Pro BNP level of COPD with heart failure and without Heart failure. Gender of Patients with COPD was male in 61 (58.6%) patients and female in 43 (41.3%). Mean age of the patient with acute exacerbation of COPD was 70.0±11.2 (40-98) years. Age distribution of patients with acute exacerbation of COPD in male vs female was in age group <50 years was 4 (3.8%) vs 1 (0.9%), in age group 50-75 years was 50 (48%) vs 22 (21.1%), and in age group <75 years was 20 (19.2%) vs 7 (6.7%) shows male patients more suffering than women in all age groups. On history and clinical examination Symptoms of shortness of breathing and Coughing were more in male then female. Mean ejection fraction of patients with acute exacerbation of COPD without HF minimum E.F was 40% and maximum was 70% with mean 26%. COPD with HF minimum E.F was 20% and maximum was 70% with mean 52% ±16.6 (20-70%). Mean Pro-BNP level of patients with acute exacerbation of COPD was 7498 ±12221 (17-36000) pg/ml. Chi-square test value was 0.122 and P-value was 0.7. Conclusion: It was concluded from this study that the level of NT-Pro-BNP in patients with acute Exacerbation of COPD. diagn","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77315725","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}

{"title":"Temporal Changes in Key Signal Transduction Pathways Mediating Muscle Protein Synthesis with Adaptive and Maladaptive Right Ventricular Hypertrophy in Pulmonary Arterial Hypertension","authors":"R. Middleton, M. Fournier, R. Rogers, Brandon S. Grimes, Xuan Xu, M. Lewis","doi":"10.21203/rs.3.rs-1047703/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-1047703/v1","url":null,"abstract":"\u0000 BackgroundPulmonary Arterial Hypertension (PAH) is a progressive cardiopulmonary disease and is characterized by occlusive remodeling of pulmonary arterioles and increased pulmonary vascular resistance. With the onset of PAH, the right ventricle (RV) of the heart adapts to the increased afterload pressure by undergoing adaptive hypertrophic remodeling to maintain adequate blood flow. However, for unknown reasons, maladaptive influences ensue, resulting in impaired RV function with progressive decompensation and right heart failure. Using a rodent model of PAH, we evaluated key signaling pathways mediating cardiac muscle protein synthesis in the RV during the adaptive hypertrophy phase, with preserved right heart function, and the decompensated maladaptive phase, in which right heart failure (RHF) was clinically present.MethodsMale Sprague-Dawley rats were injected subcutaneously with 60mg/kg Monocrotaline (MCT) and RV function was assessed by echocardiography during PAH disease progression. RV tissue was collected during the adaptive and maladaptive phases of PAH and cell signaling pathways involved in survival, hypertrophy, and autophagy, as well as fibrosis and vascularization, were probed using qPCR, Western blotting and histology. Statistical analysis was performed using ANOVA to compare differences between the independent groups and Student-Newman-Keuls test was used to compare differences within independent groups.ResultsAnalysis of protein and gene expression changes in PAH animals identified three key signaling pathways involved in the shift toward maladaptive right heart failure: i) PI3K/Akt/mTOR; ii) GSK-3; iii) MAPK/ERK, as well as IGF-1 regulation. During adaptive hypertrophy, significant increments of phosphorylated proteins in the three signaling pathways were observed with increases in RV fibrosis and decreased capillarity found. In the maladaptive phase, mTORC1 and its downstream effector p-70S6K were significantly activated, contributing to the decreased LC3-I/II ratio, a marker of autophagy inhibition. Additionally, p27, a cyclin-dependent kinase (CDK) inhibitor, which has been recently implicated in regulating mTOR activity to inhibit autophagy and promote heart failure was significantly downregulated. ConclusionWe propose that autophagy inhibition in conjunction with other maladaptive processes reported in the decompensated RV muscle contributes to the genesis of overt RHF in PAH and that a continuum of changes characterizes the adaptive and maladaptive phases in the RV muscle.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91203387","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}

{"title":"Poor Trends in Glycemic, Weight and Blood Pressure Control during Screening in Population among Small town of Karachi.","authors":"","doi":"10.33140/coa.06.03.02","DOIUrl":"https://doi.org/10.33140/coa.06.03.02","url":null,"abstract":"Introduction: Diabetes is common cause of mortality in adults globally due to the increase in the risk of vascular complications. Pakistanis are an ethics group having an inherent predilection to develop diabetes. But this rise in incidence and prevalence is associated with demographics a social pattern, life style, unawareness due to low-literacy rate thus leading to obesity in the country. The high number of people in the pre-diabetic state or with undiagnosed diabetes represents large pool of individuals in rural areas than urban areas. Aims and Objective: Knowing the prevalence of these comorbidities like Diabetes, obesity and Hypertension contributing with each other is important for determining the size of the population that may benefit from strategies that reduce blood pressure and weight while controlling blood glucose. Prevention and control need to be structured at all levels of prevention and through the Promotion of early detection of diabetes through screening and diabetes education. Material and Methods: All persons aged 20-70 years attending the medical camps organized in small towns near to Karachi during (2017 June-2021 June) were tested for diabetes for free with help of Sindh Graduate Association and Go Red for Women Program Pakistan Cardiac Society. Data on their age, gender, height, weight, diabetes status and blood pressure were also taken. Basal mass Index was calculated and stratified as per WHO classifications. 2120 persons were screened but complete data for 1289 persons was available for analysis. Result: Out of 1289 screened people who attended the medical camps, 377 were known diabetics with mean age was 47.5 years with 66% being above 40. 60.2% had poor glycemic control using an optimum of <7.8 mmol/L, 54.59% had poor glycemic control with blood sugars exceeding 10 mmol/L. patients with HBA1c<7%, 50% being hypertensive in spite of the treatment. 62% of women were either overweight or obese then 33.3% in men. BMI above 30 kg/m2 as measure of obesity was found in 32%. in all those who were known diabetics. 12% (92) of those not known to have diabetes had either impaired glucose tolerance or were newly diagnosed diabetics. Conclusion: In our Study the Large proportion of diabetics were found with poor glycemic control. The majority of known diabetes patients were also at risk due to owning overweight, obesity and poorly controlled blood pressure, Emphasis should be on the promotion of early detection of diabetes through screening and diabetes education in under develop areas of Pakistan.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81442881","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}

{"title":"Effects on Cerebral Oxygen Balance in Coronary Artery Bypass Grafting: A Comparison of Conventional and Minimal Extracorporeal Circulation","authors":"","doi":"10.33140/coa.06.03.04","DOIUrl":"https://doi.org/10.33140/coa.06.03.04","url":null,"abstract":"Objective: To investigate the cerebral oxygen balance difference between minimal extracorporeal circulation (MECC) and conventional extracorporeal circulation (CECC) during coronary artery bypass grafting. Methods: 20 patients undergoing coronary artery bypass grafting with cardiopulmonary bypass (CPB) were divided into two groups, the CECC group (n=10) and the MECC group (n=10). Blood withdrawn from radial artery and right jugular vein were analyzed at the following timepoints: during the anesthesia induction (T1), before CPB (T2), the initiation of CPB (T3), aorta crossclamped (T4), after temperature decreased (T5), during stable hypothermia (T6), initiation of rewarming (T7), aorta unclamped (T8), after weaning of CPB (T9), end of the operation (T10).The artery oxygen content (CaO2 ) and cerebral oxygen extraction ratio (OER) were calculated. The mean artery pressure (MAP), hemoglobin (Hb), nasopharyngeal temperature (NPT), and pump perfusion flow were recorded during the operation. Results: (1) MAP and Hb of MECC group were significantly higher than those in the CECC group from T3 to T10 (P<0.05); perfusion flow in MECC group during CPB was significantly lower than those in CECC group (P<0.05); NPT in MECC group was significantly higher than those in CECC group (P<0.05). (2) During T3-T4 and T8-T9, jugular venous oxygen saturation in CECC group was significantly lower than those in MECC (P<0.05); OER in CECC group was significantly higher than those in MECC group (P<0.05). (3) The arterial lactic acid and venous lactic acid in these two groups were decreased gradually from T3 to T10. Thearteriovenous difference in lactic acid in CECC group were higher than those in MECC group during T3-T4 and T8-T9 (P<0.05). Conclusion: Patients undergoing coronary artery bypass grafting with MECC enjoy more stable blood pressure, less intense hemodilution and lighter temperature disturbance than those with CECC, which indicating a better cerebral oxygen balance in CABG.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"123 7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79619308","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}