Cardiology最新文献

{"title":"Deep Learning-Based Method for Rapid 3D Whole-Heart Modeling in Congenital Heart Disease: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1159/000542318","DOIUrl":"10.1159/000542318","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Chest Pain, Diagnosis, and Clinical Outcome in Patients Hospitalized with Acute Dyspnea: Data from the ACE 2 Study.","authors":"Rahul Bhatnagar, Kristian Berge, Arne Didrik Høiseth, Torbjørn Omland, Magnus Nakrem Lyngbakken, Helge Røsjø","doi":"10.1159/000541897","DOIUrl":"10.1159/000541897","url":null,"abstract":"<p><strong>Introduction: </strong>Patients hospitalized due to dyspnea sometimes also report concomitant chest pain. Whether co-existing chest pain in patients with acute dyspnea associates with specific diagnosis and clinical outcome is not known.</p><p><strong>Method: </strong>We included 313 patients admitted to Akershus University Hospital with acute dyspnea and asked the patients directly on hospital admission whether they had experienced chest pain during the last 24 h. We examined the associations between chest pain and (1) diagnosis of the index hospitalization and (2) clinical outcome during follow-up. The diagnosis for the index hospitalization was adjudicated as acute heart failure (HF) or non-HF etiology of acute dyspnea by two experts working independently. Non-HF patients were further sub-grouped into chronic obstructive pulmonary disease (COPD) or non-COPD etiology.</p><p><strong>Results: </strong>In total, 143 patients were admitted with acute HF (46% of the population), 83 patients with COPD (26% of the population), and 87 patients with non-HF, non-COPD-related dyspnea (28% of the population). Ninety-six patients (31%) with acute dyspnea reported chest pain during the last 24 h prior to hospital admission. The prevalence of chest pain was not statistically different for patients who were hospitalized with acute HF (n = 42, 44%), acute exacerbation of COPD (n = 22, 23%), or non-HF, non-COPD-related dyspnea (n = 32, 33%), p > 0.05 for all comparisons between groups. During median of 823 days follow-up, 114 patients died (36%). Patients with dyspnea and concomitant chest pain did not have different outcome compared to patients with dyspnea and no chest pain (log-rank test: p = 0.09). Chest pain prior to admission was neither associated with all-cause mortality in any of the adjudicated diagnosis groups.</p><p><strong>Conclusions: </strong>Chest pain was reported in 31% of patients hospitalized with acute dyspnea but the prevalence did not differ according to adjudicated diagnosis. Patients with dyspnea and chest pain did not have worse outcome compared to patients with dyspnea and no chest pain.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcome of Patients with Atrial Fibrillation and High Risk of Stroke Treated with Oral Anticoagulation or Left Atrial Appendage Occlusion: A Cardinality Matched Analysis.","authors":"Thomas Gilhofer, Victoria Bokemeyer, Victor Schweiger, Mario Gehler, Jonathan Michel, Mi Chen, Alessandro Candreva, Linn Ryberg, Christian Templin, Barbara Stähli, Julia Stehli, Alexander Gotschy, Philipp Jakob, Frank Ruschitzka, Stefanie Aeschbacher, Philipp Krisai, Leo H Bonati, Moa Lina Haller, Nicolas Rodondi, Juerg Beer, Peter Ammann, Giorgio Moschovitis, Elia Rigamonti, Stefan Osswald, David Conen, Fabian Nietlispach, Ronald Karl Binder, Tobias Reichlin, Michael Kühne, Albert Markus Kasel","doi":"10.1159/000541907","DOIUrl":"10.1159/000541907","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial fibrillation (AF) poses a significant risk of stroke. Left atrial appendage occlusion (LAAO) is an alternative for patients with contraindications to oral anticoagulation (OAC) or with high risk of bleeding. This study aims to compare the outcomes of LAAO versus conventional stroke prevention in high-risk AF-patients.</p><p><strong>Methods: </strong>This secondary analysis incorporates data from the prospective Swiss-AF and Beat-AF cohorts, and the Zurich LAAO Registry. Cardinality matching was performed to create two comparable cohorts: conventional treatment (92% OAC) and LAAO. The primary endpoint was a composite of stroke, cardiovascular (CV) death, and clinically relevant bleeding. Kaplan-Meier method with competing risk analysis was used.</p><p><strong>Results: </strong>Each group included 468 patients (age 76.4 [70.5, 82.0] years, 33% female). The LAAO group exhibited higher baseline bleeding risk (HAS BLED 2.0 [1.0-3.0] versus 3.0 [3.0-4.0]; p < 0.001). Median follow-up time: 6.0 (4.7-7.0) years in conventional treatment group and 4.0 (1.5-6.1) in LAAO group. No significant difference in the primary composite endpoint (HR 0.87, 95% CI: 0.72-1.06, p = 0.18), stroke risk (HR 1.14, 95% CI: 0.66-1.97, p = 0.64), or CV mortality (HR 1.08, 95% CI: 0.82-1.42, p = 0.60) was observed between groups. LAAO correlated with a significantly lower risk of clinically relevant bleeding (HR 0.61, 95% CI: 0.47-0.80, p < 0.001).</p><p><strong>Conclusion: </strong>In this cardinality matched analysis with long-term follow-up, LAAO showed similar stroke and CV death rates but lower clinically relevant bleeding risk compared to conventional therapy in high-risk AF-patients.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-15"},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Deep Learning-Based Method for Rapid 3D Whole-Heart Modeling in Congenital Heart Disease.","authors":"Haiping Huang, Yisheng Wu","doi":"10.1159/000541980","DOIUrl":"10.1159/000541980","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to develop a deep learning-based method for generating three-dimensional heart mesh models for patients with congenital heart disease by integrating medical imaging and clinical diagnostic information.</p><p><strong>Methods: </strong>A deep learning model was trained using CT and cardiac MRI, along with clinical data from 110 patients. The Web-based platform automatically outputs STL files for 3D printing and Unity 3D OBJ files for virtual reality (VR) applications upon uploading the medical images and diagnostic information. The models were tested on three congenital heart disease cases, with corresponding 3D-printed and VR heart models generated.</p><p><strong>Results: </strong>The 3D-printed and VR heart models received high praise from professional doctors for their anatomical accuracy and clarity. Evaluations indicated that the proposed method effectively and rapidly reconstructs complex congenital heart disease structures, proving useful for preoperative planning and diagnostic support.</p><p><strong>Conclusion: </strong>The 3D modeling approach has the potential to enhance the precision of surgical planning and diagnosis for congenital heart disease. Future studies should explore larger datasets and training models for different types of congenital heart disease to validate the model's broad applicability.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-16"},"PeriodicalIF":1.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Predictive Value of T-Lymphocyte Subset Distribution for the Occurrence and Prognosis of Atrial Fibrillation.","authors":"Xinpeng You, Wenxing Guo, Yang He, Qing Li, Ren Qian, Wenyou Tu, Ling Yang, Qi Jiang","doi":"10.1159/000541870","DOIUrl":"10.1159/000541870","url":null,"abstract":"<p><strong>Introduction: </strong>The effect of T lymphocytes on atrial fibrillation (AF) is still unclear. We aimed to assess the associations between the T-lymphocyte subgroup distribution and incident AF and AF prognosis.</p><p><strong>Methods: </strong>Consecutive patients were enrolled from June 2020 to October 2021. Their T-cell subgroups, including CD3, CD4, and CD8 T cells, and the CD4/CD8 ratio (CDR) were measured. We assessed the relationships between the CDR and composite endpoints, including hospitalization due to heart failure, stroke or systemic embolism, and cardiovascular mortality rates.</p><p><strong>Results: </strong>A total of 45,905 patients, among whom 818 had AF, were enrolled. The proportions of the T-lymphocyte subgroups CD3 (OR: 0.9995; 95% CI: 0.9993-0.9997, p < 0.001), CD4 (OR: 0.9995; 95% CI: 0.9991-0.9998, p = 0.004), and CD8 (OR: 0.9988; 95% CI: 0.9984-0.9992, p < 0.001) and the CDR (OR: 1.2714; 95% CI: 1.1355-1.4165, p < 0.001) were correlated with AF incidence. The CDR was associated with AF incidence (OR: 1.1998; 95% CI: 1.0746-1.3336, p < 0.001) after adjustment. High CDR was associated with a higher rate of hospitalization due to heart failure (HR: 3.45; 95% CI: 1.71-6.96, p < 0.001), stroke, or systemic embolism (HR: 2.54; 95% CI: 1.32-4.91, p = 0.005), and cardiovascular mortality (HR: 2.25; 95% CI: 1.05-4.84, p = 0.038). There was no significant difference in all-cause mortality between CDR strata (HR: 1.61; 95% CI: 0.90-2.87, p = 0.111).</p><p><strong>Conclusion: </strong>Elevated CDR was positively associated with the incidence and prognosis of AF. This finding may help improve the prevention and treatment of AF.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Atrial Volumes and Strain: Integrating Approach in Predicting Atrial Fibrillation and Recurrence after Ablation.","authors":"Antonio Vitarelli","doi":"10.1159/000541847","DOIUrl":"10.1159/000541847","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Left Ventricular Geometry, Systolic Ejection Time, and Estimated Glomerular Filtration Rate in Ambulatory Patients with Preserved Left Ventricular Ejection Fraction.","authors":"Lee A Goeddel, Sergio Navarrete, Natalie Waldron, Anjali D'Amiano, Nauder Faraday, Joao A C Lima, Chirag R Parikh, Karen Bandeen-Roche, Allison G Hays, Charles Brown Iv","doi":"10.1159/000541725","DOIUrl":"10.1159/000541725","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Cardiac function is important to quantify for risk stratification. Although left ventricular ejection fraction (LVEF) is commonly used, and identifies patients with poor systolic function, other easily acquired measures of cardiac function are needed, particularly to stratify patients with relatively preserved LVEF. LV relative wall thickness (RWT) has been associated with adverse clinical outcomes in patients with preserved LVEF, but the clinical relevance of this observation is not known. The purpose of this study was to assess whether increased RWT is a marker of subclinical cardiac dysfunction as measured by a surrogate of LV dysfunction and left ventricular ejection time (LVET) and if increased RWT is independently associated with chronic kidney disease (CKD), an important clinical outcome and cardiovascular disease risk equivalent.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study enrolled ambulatory patients 18 years and older undergoing routine transthoracic echocardiography (TTE) at Johns Hopkins Hospital from January 2017 to January 2018. Patients with LVEF &lt;50%, severe valvular disease, or liver failure were excluded. Multivariable regression evaluated the relationship between RWT, LVET, and CKD adjusted for demographics, comorbidities, and vital signs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We analyzed data from 375 patients with mean age (±SD) 52.2 ± 15.3 years of whom 58% were female. Mean ± SD of RWT was 0.45 ± 0.10, while mean ± SD of LVET was 270 ms ± 33. In multivariable linear regression adjusted for demographics, comorbidities, vital signs, and left ventricular mass, each 0.1 increase in RWT was associated with a decrease of 4.6 ms in LVET, indicating worse cardiac function (β, ± 95% CI) (-4.60, -7.37 to -1.48, p = 0.004). Of those with serum creatinine available 1 month before or after TTE, 20% (50/247) had stage 3 or greater CKD. In logistic regression (adjusted for sex, comorbidities, and medications), each 0.1 unit increase in RWT was associated with an 61% increased odds of CKD (aOR = 1.61, 1.03-2.53, p = 0.037). In multivariable ordinal regression adjusted for the same covariates, each 0.1 unit increase in RWT was associated with a 44% increased odds of higher CKD stage (aOR = 1.44, 1.03-2.02, p = 0.035). There was a trend but no statistically significant relationship between RWT and change in estimated glomerular filtration rate at 1 year.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In an outpatient cohort undergoing TTE, increased RWT was independently associated with a surrogate of subclinical systolic dysfunction (LVET) and CKD. This suggests that RWT, an easily derived measure of LV geometry on TTE, may identify clinically relevant subclinical systolic dysfunction and patients with worse kidney function. Additional investigation to further clarify the relationships between RWT, systolic function, and kidney dysfunction over time and how this information may guide clinical intervent","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Use of Systolic Pulmonary Artery Pressure/Pulmonary Artery Acceleration Time Ratio in Severe Functional Tricuspid Regurgitation with Pulmonary Hypertension.","authors":"Walter Serra, Andrea Botti, Luigi Vignali, Alfredo Chetta","doi":"10.1159/000541529","DOIUrl":"10.1159/000541529","url":null,"abstract":"<p><strong>Introduction: </strong>To date, there is no specific evidence or criteria for the selection of patients with PH and severe tricuspid insufficiency that can be initiated into correction of tricuspid valvulopathy. Tricuspid regurgitation is a risk marker independent of mortality in patients with pulmonary hypertension. The critical factor for the procedure's success is to find the parameters to select patients so that they do not become just a futile act.</p><p><strong>Method: </strong>From the initial group of 271 patients, a final group of 123 patients were selected, all diagnosed with precapillary PH confirmed by catheterization and with tricuspid regurgitation by echocardiography. Patients were in groups 1 and 2 according to the 2022 Pulmonary Hypertension Guidelines. Patients with right to left shunt were not excluded.</p><p><strong>Results: </strong>In patients with severe precapillary PH, the sPAP/PAAT ratio was close to 1 (0.89 ± 0.43), while in patients with mild precapillary PH or in the postcapillary group, the sPAP/PAAT ratio was considerably lower (0.47 ± 0.20, p &lt; 0.001). The average sPAP/PAAT of deceased patients was 0.76. Among the 68 deceased patients, 42 (61.70%) had severe tricuspid regurgitation.</p><p><strong>Conclusion: </strong>In our study, the average sPAP/PAAT ratio of the deceased patients with severe FTR was 0.76 mm Hg/ms; nevertheless, this knowledge could have a potential use but is not sufficient for full-informed qualification or disqualification for valve intervention, which requires specific TTVR-related data.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Cardiac Function Recovery in Patients with Paroxysmal Atrial Fibrillation after Catheter Radiofrequency Ablation Using Two-Dimensional Speckle Tracking Imaging and Real-Time Three-Dimensional Echocardiography.","authors":"Rui Han, Ying-Chen Mei, Hai-Wei Li, Rong-Juan Li, Yi-Hua He, Ze-Feng Wang, Yong-Quan Wu","doi":"10.1159/000541247","DOIUrl":"https://doi.org/10.1159/000541247","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the utility of 2D-STI and real-time three-dimensional echocardiography (RT-3DE) in assessing changes in left atrial (LA) structure and function in patients with paroxysmal atrial fibrillation (PAF) post-radiofrequency catheter ablation (RFCA).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 44 PAF patients who underwent RFCA at BA Hospital from March 2022 to March 2023. An age- and gender-matched control group of 32 healthy individuals was also included. Comprehensive echocardiographic parameters including LA dimensions (LAAPD, LALRD), volumes (LAVmin, LAVmax), ejection fraction (LAEF), and tissue velocities (a', Ar) were compared between groups. Post-RFCA changes in these parameters were also assessed at 1, 3, and 6 months.</p><p><strong>Results: </strong>Pre-RFCA, PAF patients demonstrated larger LA dimensions and volumes with reduced LAEF and tissue velocities compared to controls. Post-RFCA, there was a significant improvement in LAEF and left ventricular ejection fraction at 1, 3, and 6 months, with the most pronounced changes observed at 6 months. LA dimensions increased initially but then decreased from 1 to 6 months post-RFCA. Notably, strain rate (SRS, SRE, SRA) measurements in various LA segments improved progressively, with the most significant enhancements at 6 months, suggesting improved atrial mechanics.</p><p><strong>Conclusion: </strong>The application of 2D-STI and RT-3DE provides a quantitative means to evaluate the structural and functional changes in the LA of PAF patients following RFCA. The progressive improvements in LA dimensions, volumes, and strain measurements up to 6-month post-RFCA indicate the potential of these techniques in monitoring treatment efficacy and patient recovery.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Outcomes following a Conservative Approach to Hemodynamically Significant Patent Ductus Arteriosus: A Comparison across Two Periods.","authors":"Yu-Mi Seo, Sae Yun Kim, Young-Ah Youn","doi":"10.1159/000541477","DOIUrl":"10.1159/000541477","url":null,"abstract":"<p><strong>Introduction: </strong>Patent ductus arteriosus (PDA) is a commonly encountered morbidity that occurs inversely with gestational age. In response to the growing trend of avoiding PDA ligation and prophylactic interventions, our center adopted a conservative approach starting in September 2020. This approach involves more precise fluid restriction for hemodynamically significant (hs) PDA. This study aimed to evaluate whether a conservative approach to hsPDA has led to a reduction in adverse clinical outcomes for very low birth weight infants (VLBWIs) during the period of conservative treatment.</p><p><strong>Methods: </strong>Since more conservative approach to hsPDA was adopted since September 2020, the two periods were divided into period 1 (January 2015 to August 2020) and period 2 (September 2020 to June 2023). Fluid therapy was carefully monitored and advanced from day 1 in all VLBWI, and a more conservative approach as fluid restriction was attempted in hsPDA during period 2.</p><p><strong>Results: </strong>Of the 540 VLBWI with hsPDA, 348 infants were born and diagnosed with hsPDA. Period 2 demonstrated a significantly higher rate of medical treatment (79.17% vs. 19.51%) and lower PDA ligation (54.17% vs. 78.05%). Period 2 showed a greater adherence to conservative fluid restriction compared to period 1. Bronchopulmonary dysplasia (BPD) and BPD ≥ moderate, sepsis, necrotizing enterocolitis (≥ grade 2), IVH (grade ≥3) were notably lower in period 2 with lower mortality. In regard to PDA-related treatment, primary PDA ligation was significantly higher in period 1. The secondary PDA ligation after medical failure and more conservative fluid restriction were significantly higher in period 2. At corrected age of 18-24 months, cognitive score was significantly lower in VLBWI born in period 1 compared to those born in period 2.</p><p><strong>Conclusion: </strong>Our study demonstrated that a conservative approach to hsPDA led to better clinical outcomes and improved cognitive scores at a corrected age of 18-24 months compared to the period of active PDA ligation. This conservative strategy, involving more precise fluid restriction and the judicious use of appropriate diuretics, has shown to improve clinical outcomes with minimal intervention.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}