Cardiology ResearchPub Date : 2024-02-01Epub Date: 2024-02-28DOI: 10.14740/cr1595
Holly Gillis, Christopher McKee, Kristin Chenault, Marco Corridore, Joseph D Tobias
{"title":"Preliminary Experience With Remimazolam for Procedural Sedation and as an Adjunct to General Anesthesia During Diagnostic and Interventional Cardiac Procedures.","authors":"Holly Gillis, Christopher McKee, Kristin Chenault, Marco Corridore, Joseph D Tobias","doi":"10.14740/cr1595","DOIUrl":"10.14740/cr1595","url":null,"abstract":"<p><strong>Background: </strong>Remimazolam is a benzodiazepine which, like midazolam, has sedative, anxiolytic, and amnestic properties. Ester metabolism results in a half-life of 5 - 10 min, a limited context sensitive half-life, and rapid recovery when the infusion is discontinued.</p><p><strong>Methods: </strong>Following the Institutional Review Board (IRB) approval, we performed a retrospective chart review of patients who received remimazolam in the cardiac catheterization, cardiac magnetic resonance imaging (MRI), and electrophysiology suites. The primary objective was to assess efficacy and safety. The secondary objective was to describe bolus and infusion dosing of remimazolam and the need for adjunctive agents to optimize procedural sedation conditions.</p><p><strong>Results: </strong>The study cohort included 26 patients with a median age of 18 years and a total of 33 anesthetic encounters. The most common procedures were endomyocardial biopsy or isolated hemodynamic assessment (right or left heart catheterization). Remimazolam was the primary agent for sedation in 82% of the procedures. The majority of cases (25 encounters, 76%) included a bolus dose of remimazolam prior to the start of an infusion. For those patients who received a starting bolus dose, dosing typically ranged between 30 and 110 µg/kg. Continuous infusion rates of remimazolam varied from 5 to 20 µg/kg/min. No adverse hemodynamic or respiratory effects were noted. Midazolam, fentanyl, and dexmedetomidine were the most frequently used adjunctive agents. One patient required transition to general anesthesia due to the need for a surgical intervention based on the findings of the cardiac catheterization. All other patients were effectively sedated.</p><p><strong>Conclusions: </strong>Our preliminary experience demonstrates that remimazolam effectively provided sedation for diagnostic and therapeutic cardiovascular procedures. Future studies are needed to further define dosing parameters for both bolus dosing and continuous infusion as well as to compare remimazolam to other commonly used for procedural sedation in patients with congenital and acquired heart disease.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 1","pages":"12-17"},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10923259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140093388","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}
Cardiology ResearchPub Date : 2024-02-01Epub Date: 2024-02-28DOI: 10.14740/cr1597
Kazuyuki Kominami, Masatoshi Akino
{"title":"Partial Pressure of End-Tidal Oxygen and Blood Lactate During Cardiopulmonary Exercise Testing in Healthy Older Participants and Patients at Risk of Cardiac Disease.","authors":"Kazuyuki Kominami, Masatoshi Akino","doi":"10.14740/cr1597","DOIUrl":"10.14740/cr1597","url":null,"abstract":"<p><strong>Background: </strong>The partial pressure of end-tidal oxygen (PETO<sub>2</sub>) and end-tidal oxygen concentration (ETO<sub>2</sub>) are among the indices that can be measured by exhaled gas analysis. Several observational studies have shown that skeletal muscle function is impaired in patients with cardiac disease; thus, the assessment of skeletal muscle function is important. Additionally, although it has recently been suggested that the difference in PETO<sub>2</sub> from rest to the ventilatory anaerobic threshold (VAT) reflects oxygen availability in peripheral factors, primarily skeletal muscle, the evidence for this is not well established. Therefore, we hypothesized and investigated whether increased blood lactate (BLa) levels, resulting from decreased skeletal muscle and mitochondrial oxygen availability, and PETO<sub>2</sub> dynamics during cardiopulmonary exercise testing (CPET) would be related.</p><p><strong>Methods: </strong>All participants performed the symptomatic limited CPET, and their BLa levels were measured. The difference in PETO<sub>2</sub> and ETO<sub>2</sub> from rest to VAT determined by the V-slope method (ΔPETO<sub>2</sub> and ΔETO<sub>2</sub>) was calculated and compared with the increase in BLa due to exercise testing.</p><p><strong>Results: </strong>We recruited 22 healthy older participants (nine males; 69.4 ± 6.8 years) and 11 patients with cardiovascular risk (eight males; 73.0 ± 8.8 years). ΔPETO<sub>2</sub> and ΔETO<sub>2</sub> did not differ between the two groups (P = 0.355 and P = 0.369, respectively), showing no correlation between increase in BLa from rest to VAT, but were significantly correlated with an increase in BLa from rest to the end of exercise (ΔPETO<sub>2</sub>, P = 0.030; ΔETO<sub>2</sub>, P = 0.029). The correlation was particularly pronounced among those at cardiovascular risk (ΔPETO<sub>2</sub>, P = 0.012; ΔETO<sub>2</sub>, P = 0.011).</p><p><strong>Conclusions: </strong>ΔPETO<sub>2</sub> and ΔETO<sub>2</sub> from rest to VAT during CPET may be useful as indices reflecting skeletal muscle oxygen utilization capacity.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 1","pages":"29-36"},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10923256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140093387","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}
Michael P. Collins, Mark C. Johnson, Robin C. Ryther, Judith L. Weisenberg, Peter T. Heydemann, Colleen M. Buhrfiend, William A. Scott, Dallas Armstrong, Haley M. Kern, Hoang H. Nguyen
{"title":"The Heart of Rett Syndrome: A Quantitative Analysis of Cardiac Repolarization","authors":"Michael P. Collins, Mark C. Johnson, Robin C. Ryther, Judith L. Weisenberg, Peter T. Heydemann, Colleen M. Buhrfiend, William A. Scott, Dallas Armstrong, Haley M. Kern, Hoang H. Nguyen","doi":"10.14740/cr1580","DOIUrl":"https://doi.org/10.14740/cr1580","url":null,"abstract":"","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"40 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139189799","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":"Left Anterior Descending Artery Dissection in a Female Patient With History of Chest Radiation Treatment and Separate Ostia of the Left Coronary Arteries","authors":"Christos Papageorgiou, Vaios Tzifos","doi":"10.14740/cr1603","DOIUrl":"https://doi.org/10.14740/cr1603","url":null,"abstract":"","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"10 3-5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194818","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}
M. Kalas, Yacoub Khatab, G. Galura, Haider M Alkhateeb, Debabrata Mukherjee, Hernando García, Marc Zuckerman, N. Nickel
{"title":"The Association Between Non-Clinically Apparent Liver Fibrosis and Pulmonary Arterial Hypertension in Hispanic Patients","authors":"M. Kalas, Yacoub Khatab, G. Galura, Haider M Alkhateeb, Debabrata Mukherjee, Hernando García, Marc Zuckerman, N. Nickel","doi":"10.14740/cr1565","DOIUrl":"https://doi.org/10.14740/cr1565","url":null,"abstract":"","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"4 2-3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194931","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}
Bing Xiao, Yan Zhao, Ke Ke Wang, Xiu Chun Yang, Hai Juan Hu, Yue Li, Yun Fei Xu, Zhen Tian Zhang, Shuai Wang, Jing Chao Lu
{"title":"Inhibition of the STIM1/Orai1 Signaling Pathway by Glycine Betaine Mitigates Myocardial Hypertrophy in Spontaneous Hypertension Rats","authors":"Bing Xiao, Yan Zhao, Ke Ke Wang, Xiu Chun Yang, Hai Juan Hu, Yue Li, Yun Fei Xu, Zhen Tian Zhang, Shuai Wang, Jing Chao Lu","doi":"10.14740/cr1583","DOIUrl":"https://doi.org/10.14740/cr1583","url":null,"abstract":"","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"4 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139195864","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":"Mitral Annular Disjunction: Clinical Implications and Surgical Considerations","authors":"Ling Zhu, Y. L. Chua","doi":"10.14740/cr1584","DOIUrl":"https://doi.org/10.14740/cr1584","url":null,"abstract":"","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"89 5-6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139189768","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}
Josiane Kerbage, Olamide O. Dairo, Lauren Ketchum, Craig Smith, Joseph D. Tobias
{"title":"Pulseless Electrical Activity and Perioperative Cardiac Arrest Due to Undiagnosed and Asymptomatic Hypothyroidism During Outpatient Surgery in an Adolescent","authors":"Josiane Kerbage, Olamide O. Dairo, Lauren Ketchum, Craig Smith, Joseph D. Tobias","doi":"10.14740/cr1605","DOIUrl":"https://doi.org/10.14740/cr1605","url":null,"abstract":"","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"62 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139195869","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}
Cardiology ResearchPub Date : 2023-10-01Epub Date: 2023-10-21DOI: 10.14740/cr1417
Raoul R Wadhwa, Brenna M McElderry, James Yu, Samir R Kapadia, A Marc Gillinov, Lars G Svensson, Milind Y Desai
{"title":"Temporal Trends in the United States Patent Landscape: Innovation in Cardiology Across Industry and Academia.","authors":"Raoul R Wadhwa, Brenna M McElderry, James Yu, Samir R Kapadia, A Marc Gillinov, Lars G Svensson, Milind Y Desai","doi":"10.14740/cr1417","DOIUrl":"10.14740/cr1417","url":null,"abstract":"<p><strong>Background: </strong>Novel approaches to diagnostics and therapeutics in medical care reflect the scientific community's evolving understanding of disease states and their clinical implications. Marketable and valuable innovations are generally patented for protection of intellectual property. Here, we explore the landscape of cardiology-related patents in the United States.</p><p><strong>Methods: </strong>All United States patents granted between 2005 and 2020 were included in this study. Keywords filtering was used to identify patents related to cardiovascular medicine. Statistical inference was conducted with the Mann-Kendall trend and analysis of variance tests. The results in this report are entirely reproducible with Python and R scripts available in a publicly accessible repository.</p><p><strong>Results: </strong>Of the 4,453,733 patents issued by the USPTO between 2005 and 2020, 31,048 (0.7%) were identified as cardiology-related patents. We identified the top 10 institutions within the for-profit and not-for-profit categories that were assigned the most cardiology-related patents in this time period. Distributions of number of patents per inventor were heavily right-skewed, with a small number of inventors responsible for a large number of patents each. Patents in the cardiac imaging subgroup took the longest to gain approval after submission (median delay: 3.6 years).</p><p><strong>Conclusions: </strong>By studying the patent universe, we are able to identify underexplored areas within cardiovascular medicine. Obstacles such as long delays between patent application and approval can hamper innovation within a field. As a next step, we aim to use these results to predict the next area within cardiovascular medicine to undergo explosive research and innovation.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"334-341"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71491093","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}