{"title":"Real-Time Cardiac Abnormality Monitoring and Nursing for Patient Using Electrocardiographic Signals.","authors":"Huamin Ao, Enjian Zhai, Le Jiang, Kailin Yang, Yuxuan Deng, Xiaoyang Guo, Liuting Zeng, Yexing Yan, Moujia Hao, Tian Song, Jinwen Ge, Junpeng Chen","doi":"10.1159/000539767","DOIUrl":"10.1159/000539767","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease nursing is a critical clinical application that necessitates real-time monitoring models. Previous models required the use of multi-lead signals and could not be customized as needed. Traditional methods relied on manually designed supervised algorithms, based on empirical experience, to identify waveform abnormalities and classify diseases, and were incapable of monitoring and alerting abnormalities in individual waveforms.</p><p><strong>Methods: </strong>This research reconstructed the vector model for arbitrary leads using the phase space-time-delay method, enabling the model to arbitrarily combine signals as needed while possessing adaptive denoising capabilities. After employing automatically constructed machine learning algorithms and designing for rapid convergence, the model can identify abnormalities in individual waveforms and classify diseases, as well as detect and alert on abnormal waveforms.</p><p><strong>Result: </strong>Effective noise elimination was achieved, obtaining a higher degree of loss function fitting. After utilizing the algorithm in Section 3.1 to remove noise, the signal-to-noise ratio increased by 8.6%. A clipping algorithm was employed to identify waveforms significantly affected by external factors. Subsequently, a network model established by a generative algorithm was utilized. The accuracy for healthy patients reached 99.2%, while the accuracy for APB was 100%, for LBBB 99.32%, for RBBB 99.1%, and for P-wave peak 98.1%.</p><p><strong>Conclusion: </strong>By utilizing a three-dimensional model, detailed variations in electrocardiogram signals associated with different diseases can be observed. The clipping algorithm is effective in identifying perturbed and damaged waveforms. Automated neural networks can classify diseases and patient identities to facilitate precision nursing.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"25-35"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141417903","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}
CardiologyPub Date : 2025-01-01Epub Date: 2024-08-06DOI: 10.1159/000540526
Shana A B Burrowes, Erin Zisman, Lori E Fantry, Quoc Bui, Angela Wu, John Sorkin, Michael Miller, Shashwatee Bagchi
{"title":"Changes in Atherosclerotic Cardiovascular Disease Risk Scores in a Predominantly Black Cohort with HIV and Associated Comorbidities: A Preliminary Study.","authors":"Shana A B Burrowes, Erin Zisman, Lori E Fantry, Quoc Bui, Angela Wu, John Sorkin, Michael Miller, Shashwatee Bagchi","doi":"10.1159/000540526","DOIUrl":"10.1159/000540526","url":null,"abstract":"<p><strong>Introduction: </strong>People with HIV (PWH) have an increased risk of atherosclerotic cardiovascular disease (ASCVD) compared to non-PWH, but the reasons for this increased risk remain elusive. We investigated the change in ASCVD risk scores over 4 years to identify clinical factors associated with change in risk scores or high-risk scores.</p><p><strong>Methods: </strong>We conducted a preliminary study using retrospective analysis of PWH, between 40 and 75 years old, seen at the Evelyn Jordan Center with at least two routine HIV visits. We collected clinical and demographic data and calculated the ASCVD risk scores using the Pooled Cohort Equation. Exploratory analyses examined change in risk score categories over time. Final adjusted analysis examined factors associated with change in continuous risk scores over time.</p><p><strong>Results: </strong>Our sample included 187 PWH; 166 were black/African American and 79 were female. We found no significant change in ASCVD risk score over time. The risk score was significantly higher in PWH with hepatitis C (7.34%; 95% CI: 2.59, 12.09; p = 0.003) and trended higher in those with dual hepatitis B/C and hepatitis B compared to those without hepatitis (p = 0.07).</p><p><strong>Conclusion: </strong>We found that ASCVD risk did not change over a 4-year period among predominantly black young PWH, but infection with hepatitis C and dual hepatitis B/C were associated with higher ASCVD risk scores. Our findings illustrate the need for further longitudinal studies evaluating change in cardiovascular disease (CVD) risk and investigating viral hepatitis as an added potential contributor to increased CVD risk in high-risk, vulnerable populations.</p><p><strong>Introduction: </strong>People with HIV (PWH) have an increased risk of atherosclerotic cardiovascular disease (ASCVD) compared to non-PWH, but the reasons for this increased risk remain elusive. We investigated the change in ASCVD risk scores over 4 years to identify clinical factors associated with change in risk scores or high-risk scores.</p><p><strong>Methods: </strong>We conducted a preliminary study using retrospective analysis of PWH, between 40 and 75 years old, seen at the Evelyn Jordan Center with at least two routine HIV visits. We collected clinical and demographic data and calculated the ASCVD risk scores using the Pooled Cohort Equation. Exploratory analyses examined change in risk score categories over time. Final adjusted analysis examined factors associated with change in continuous risk scores over time.</p><p><strong>Results: </strong>Our sample included 187 PWH; 166 were black/African American and 79 were female. We found no significant change in ASCVD risk score over time. The risk score was significantly higher in PWH with hepatitis C (7.34%; 95% CI: 2.59, 12.09; p = 0.003) and trended higher in those with dual hepatitis B/C and hepatitis B compared to those without hepatitis (p = 0.07).</p><p><strong>Conclusion: </strong","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"194-202"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2025-01-01Epub Date: 2024-08-10DOI: 10.1159/000540885
Muhammad Shaheer Bin Faheem
{"title":"Zilebesiran: A Potential Life-Altering Remedy for Hypertensive Patients.","authors":"Muhammad Shaheer Bin Faheem","doi":"10.1159/000540885","DOIUrl":"10.1159/000540885","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"210-211"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916162","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":"Dose-Dependent Relationship between Iron Metabolism and Perioperative Myocardial Injury in Cardiac Surgery with Cardiopulmonary Bypass: A Retrospective Analysis.","authors":"Qian Li, Hong Lv, Yuye Chen, Jingjia Shen, Jia Shi, Chenghui Zhou","doi":"10.1159/000541213","DOIUrl":"10.1159/000541213","url":null,"abstract":"<p><strong>Introduction: </strong>We sought to comprehensively explore the potential linear and nonlinear relationship between preoperative iron metabolism and perioperative myocardial injury (PMI) following cardiac surgery with cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>Patients who underwent cardiac surgery with CPB between December 2018 and April 2021 were retrospectively collected. The measurements of iron metabolism included serum iron (SI), serum ferritin (SF), transferrin (TRF), transferrin saturation (TS), and total iron-binding capacity (TIBC). Logistic regression and restricted cubic spline (RCS) models were used for linear and nonlinear analysis. The primary outcome was PMI with a 100× upper reference limit.</p><p><strong>Results: </strong>Of 2,420 patients screened, 744 eligible patients were enrolled for the final analysis. The incidence of PMI was 25.7%. No significant linear relationship was observed. In the RCS models adjusted with age (median: 56), female, and history of diabetes, a statistically significant difference was detected between TRF (p for nonlinear 0.0152) or TIBC (p for nonlinear 0.0477) and PMI. The gentle U-shaped relationship observed between TRF, TIBC, and PMI suggests that when TRF and TIBC increase, the risk decreases, reaching its lowest point when TRF = 2.4 and TIBC = 54. Nevertheless, as TRF and TIBC continue to increase, the risk starts to rise again. Subgroup analyses yielded consistent findings, with a notable emphasis on older patients who were more susceptible to variations in iron metabolism.</p><p><strong>Conclusion: </strong>Iron metabolism, including TRF, and TIBC, exhibited a nonlinear relationship with PMI by the RCS model adjusted by age, gender, and history of diabetes.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"311-319"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2025-01-01Epub Date: 2024-09-06DOI: 10.1159/000541302
Takahiro Okumura, Toyoaki Murohara
{"title":"Gender Differences in Cardiovascular Disease: Perspectives on Disparities in Women's Treatment and Outcomes.","authors":"Takahiro Okumura, Toyoaki Murohara","doi":"10.1159/000541302","DOIUrl":"10.1159/000541302","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"191-193"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153169","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}
CardiologyPub Date : 2025-01-01Epub Date: 2024-07-17DOI: 10.1159/000540204
Shijian Chen, Ziheng Yu, Wen Wen, Jiming Chen, Kongjie Lu
{"title":"NLRP3 Expression and Its Predictive Role in Heart Failure with Preserved Ejection Fraction among Non-Valvular Atrial Fibrillation Patients.","authors":"Shijian Chen, Ziheng Yu, Wen Wen, Jiming Chen, Kongjie Lu","doi":"10.1159/000540204","DOIUrl":"10.1159/000540204","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to investigate the expression and predictive value of NOD-like receptor thermal protein domain-related protein 3 (NLRP3) in patients with non-valvular atrial fibrillation (NVAF) with heart failure with preserved ejection fraction (HFpEF).</p><p><strong>Methods: </strong>This was a retrospective analysis of 121 patients diagnosed with NVAF. According to the occurrence of HFpEF, 81 patients were assigned to the NVAF group and 40 patients to the NVAF/HFpEF group. The levels of NLRP3, B natriuretic peptide (BNP), and interleukin-1β (IL-1β) were determined using ELISA. Independent predictors for HFpEF in NVAF were determined using logistic regression. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of each factor.</p><p><strong>Results: </strong>Expression levels of NLRP3, BNP, and IL-1β in the NVAF/HFpEF group, as well as the H2FPEF score were significantly higher than those in the NVAF group. Pearson analysis showed that NLRP3, BNP, and IL-1β expression levels in NVAF patients and the H2FPEF score was positively correlated (r = 0.409, r = 0.244, r = 0.299, p < 0.001). Multivariate logistic regression analysis showed that the NLRP3, BNP, or H2FPEF score can be used as independent factor for predicting the occurrence of HFpEF in NVAF. ROC curves showed that the areas under the curve of NLRP3, BNP, and H2FPEF scores for predicting the occurrence of HFpEF in NVAF patients were 0.856, 0.831, and 0.811, respectively.</p><p><strong>Conclusion: </strong>The NLRP3 level is elevated in the peripheral blood of NVAF patients with HFpEF and is positively correlated with the H2FPEF score. NLRP3 may serve as a potential predictor of HFpEF in patients with NVAF.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"72-78"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533675","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}
CardiologyPub Date : 2025-01-01Epub Date: 2024-08-02DOI: 10.1159/000540406
Ye Ding, Jingai Zhu, Geng Xu, Qing Cheng, Chun Zhu
{"title":"Single-Cell RNA-Seq Analysis of Hearts in Patients with Fetal Tetralogy of Fallot.","authors":"Ye Ding, Jingai Zhu, Geng Xu, Qing Cheng, Chun Zhu","doi":"10.1159/000540406","DOIUrl":"10.1159/000540406","url":null,"abstract":"<p><strong>Introduction: </strong>To explore the cytological characteristics of tetralogy of Fallot (TOF), we collected samples and investigated the differences in the cytological classification between normal fetal hearts and fetal hearts with congenital defects. We then performed single-cell sequencing analysis to search for possible differential genes of disease markers.</p><p><strong>Methods: </strong>Here, the right ventricles of a heart sample with TOF and a healthy human fetal heart sample were analyzed through single-cell sequencing. Data quality control filtering, comparison, quantification, and identification of recovered cells on the raw data were performed using Cell Ranger, thereby ultimately obtaining gene expression matrices for each cell. Subsequently, Seurat was used for cell filtration, standardization, cell subgroup classification, differential expression gene analysis of each subgroup, and marker gene screening.</p><p><strong>Results: </strong>Bioinformatic analysis identified 9,979 and 15,224 cells from the healthy and diseased samples, respectively, with an average read depth of 25,000/cell. The cardiomyocyte cell populations, derived from the abnormal samples identified through the first-level graph-based analysis, were separated into six distinct cell clusters.</p><p><strong>Conclusion: </strong>Our study provides some information on TOF in a fetus, which can offer a new reference for the early detection and treatment of TOF by comparing defective heart cells with normal heart cells.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"221-232"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888540","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}
CardiologyPub Date : 2025-01-01Epub Date: 2024-09-24DOI: 10.1159/000541477
Yu-Mi Seo, Sae Yun Kim, Young-Ah Youn
{"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":"294-302"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136602/pdf/","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":"OA","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":"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><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 mon","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"166-177"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965856/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2025-01-01Epub Date: 2024-08-01DOI: 10.1159/000540685
Kaijun Zhang, Le Yang, Rensen Zhang, Jingdong Ma, Min Cheng, Penghui Yang, Ping Xiang, Mi Li, Xue Zhou
{"title":"Feasibility and Success of Muscular Ventricular Septal Defect Occluders and Mushroom-Shaped Occluders in Transcatheter Patent Ductus Arteriosus Closure in Low-Weight Children: A Propensity Score-Matched Retrospective Analysis from a Chinese National Regional Health Center.","authors":"Kaijun Zhang, Le Yang, Rensen Zhang, Jingdong Ma, Min Cheng, Penghui Yang, Ping Xiang, Mi Li, Xue Zhou","doi":"10.1159/000540685","DOIUrl":"10.1159/000540685","url":null,"abstract":"<p><strong>Introduction: </strong>Muscular ventricular septal defect occluders (MVSDOs) have been attempted as an option in low-weight patients with patent ductus arteriosus (PDA). However, few studies have assessed the safety of transcatheter patent ductus arteriosus closure (TCPC) using MVSDO. Therefore, we compared the outcomes in low-weight patients who used MVSDO and mushroom-shaped occluder (MSO).</p><p><strong>Methods: </strong>Medical records of children under 10 kg (n = 417) who underwent TCPC from 2015 to 2021 at a Chinese health center were reviewed. They were divided into MSO (n = 372) and MVSDO (n = 45) groups. A 1:1 propensity score matching (PSM) was done considering gender, height, weight, body surface area (BSA), PDA diameter, and BSA-corrected PDA diameter.</p><p><strong>Results: </strong>All 45 children in the MVSDO group (mean weight: 5.92 ± 1.32 kg) achieved successful immediate occlusion. One case in the MVSDO group experienced device migration within 24 h requiring unplanned surgery. MVSDO significantly ameliorated pulmonary artery hypertension. After PSM, each group comprised 41 children. The MVSDO group had a smaller effect on platelet counts (MVSDO vs. MSO = 259.85 ± 114.82 vs. 356.12 ± 134.37, p < 0.001), a reduced incidence of thrombocytopenia (MVSDO vs. MSO = 2/41 vs. 7/41, p = 0.001), and a higher rate of residual shunting (MVSDO vs. MSO = 16/41 vs. 5/41, p = 0.005), compared with the MSO group. Thrombocytopenia resolved during hospitalization and micro-shunts disappeared by 6 months. No pulmonary artery or descending aortic secondary stenosis was observed in 1-year follow-up.</p><p><strong>Conclusions: </strong>MVSDO used in low-weight children is feasible, with high success and satisfactory postoperative and short-term follow-up outcomes, including lower thrombocytopenia incidence, compared to MSO. Further long-term studies with larger samples are recommended.</p><p><strong>Introduction: </strong>Muscular ventricular septal defect occluders (MVSDOs) have been attempted as an option in low-weight patients with patent ductus arteriosus (PDA). However, few studies have assessed the safety of transcatheter patent ductus arteriosus closure (TCPC) using MVSDO. Therefore, we compared the outcomes in low-weight patients who used MVSDO and mushroom-shaped occluder (MSO).</p><p><strong>Methods: </strong>Medical records of children under 10 kg (n = 417) who underwent TCPC from 2015 to 2021 at a Chinese health center were reviewed. They were divided into MSO (n = 372) and MVSDO (n = 45) groups. A 1:1 propensity score matching (PSM) was done considering gender, height, weight, body surface area (BSA), PDA diameter, and BSA-corrected PDA diameter.</p><p><strong>Results: </strong>All 45 children in the MVSDO group (mean weight: 5.92 ± 1.32 kg) achieved successful immediate occlusion. One case in the MVSDO group experienced device migration within 24 h requiring unplanned surgery. MVSDO significantly ameliorated pulmonary artery h","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"212-220"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}