Cardiology Research最新文献

{"title":"Obstructive Sleep Apnea as a Predictor of Inducible Atrial Flutter During Pulmonary Vein Isolation in Patients With Atrial Fibrillation: Clinical Significance and Follow-Up Outcomes.","authors":"John Taylor,&nbsp;Sohiub N Assaf,&nbsp;Abdallah N Assaf,&nbsp;Eric Heidel,&nbsp;William Mahlow,&nbsp;Raj Baljepally","doi":"10.14740/cr1491","DOIUrl":"10.14740/cr1491","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) and atrial flutter (AFL) often coexist in patients and may lead to severe symptoms and complications. Despite their coexistence, prophylactic cavotricuspid isthmus (CTI) ablation has failed to reduce the incidence of recurrent AF or new onset AFL. In contrast, the presence of inducible AFL during pulmonary vein isolation (PVI) has been shown to be predictive of symptomatic AFL during follow-up. However, the potential role of obstructive sleep apnea (OSA) as a predictor of inducible AFL during PVI in patients with AF remains unclear. Therefore, this study aimed to examine the potential role of OSA as a predictor of inducible AFL during PVI in patients with AF and reexamine the clinical significance of inducible AFL during PVI in terms of recurrent AFL or AF during follow-up.</p><p><strong>Methods: </strong>We conducted a single-center, non-randomized retrospective study on patients who underwent PVI between October 2013 and December 2020. A total of 192 patients were included in the study after screening 257 patients for exclusion criteria, which included a previous history of AFL or previous PVI or Maze procedure. All patients underwent a transesophageal echocardiogram (TEE) prior to their ablation to rule out a left atrial appendage thrombus. The PVI was performed using both fluoroscopic and electroanatomic mapping derived from intracardiac echocardiography. After the confirmation of PVI, additional electrophysiology (EP) testing was performed. AFL was classified as typical or atypical based on the origin and activation pattern. Descriptive and frequency statistics were performed to describe the demographic and clinical characteristics of the sample, and Chi-square and Fisher's exact tests were used to compare independent groups on categorical outcomes. Logistic regression analysis was performed to adjust for confounding variables. The study was approved by the Institutional Review Board, and informed consent was waived given the retrospective nature of the study.</p><p><strong>Results: </strong>Of the 192 patients included in the study, 52% (n = 100) had inducible AFL after PVI, with 43% (n = 82) having typical right AFL. Bivariate analysis showed statistically significant differences between the groups for OSA (P = 0.04) and persistent AF (P = 0.047) when examining the outcome of any inducible AFL. Similarly, only OSA (P = 0.04) and persistent AF (P = 0.043) were significant when examining the outcome of typical right AFL. Multivariate analysis showed that only OSA was significantly associated with any inducible AFL after controlling for other variables (adjusted odds ratio (AOR) = 1.92, 95% confidence interval (CI): 1.003 - 3.69, P = 0.049). Of the 100 patients with inducible AFL, 89 underwent additional ablation for AFL prior to completion of their procedure. At 1 year, the rates of recurrence for AF, AFL, and either AF or AFL were 31%, 10%, and 38%, respectively. There was no signific","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/76/cr-14-183.PMC10257505.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bradycardia and Outcomes in COVID-19 Patients on Remdesivir: A Multicenter Retrospective Study.","authors":"Chukwuemeka A Umeh,&nbsp;Stella Maguwudze,&nbsp;Harpreet Kaur,&nbsp;Ozivefueshe Dimowo,&nbsp;Niyousha Naderi,&nbsp;Armin Safdarpour,&nbsp;Tarik Hussein,&nbsp;Rahul Gupta","doi":"10.14740/cr1493","DOIUrl":"https://doi.org/10.14740/cr1493","url":null,"abstract":"<p><strong>Background: </strong>Antiviral agents, such as remdesivir, have shown promising results in helping reduce the morbidity and healthcare burden of coronavirus disease 2019 (COVID-19) in hospitalized patients. However, many studies have reported a relationship between remdesivir and bradycardia. Therefore, this study aimed to analyze the relationship between bradycardia and outcomes in patients on remdesivir.</p><p><strong>Methods: </strong>We conducted a retrospective study of 2,935 consecutive COVID-19 patients admitted to seven hospitals in Southern California in the United States between January 2020 and August 2021. First, we did a backward logistic regression to analyze the relationship between remdesivir use and other independent variables. Finally, we did a backward selection Cox multivariate regression analysis on the sub-group of patients who received remdesivir to evaluate the mortality risk in bradycardic patients on remdesivir.</p><p><strong>Results: </strong>The mean age of the study population was 61.5 years; 56% were males, 44% received remdesivir, and 52% developed bradycardia. Our analysis showed that remdesivir was associated with increased odds of bradycardia (odds ratio (OR): 1.9, P < 0.001). Patients that were on remdesivir in our study were sicker patients with increased odds of having elevated C-reactive protein (CRP) (OR: 1.03, P < 0.001), elevated white blood cell (WBC) on admission (OR: 1.06, P < 0.001), and increased length of hospital stay (OR: 1.02, P = 0.002). However, remdesivir was associated with decreased odds of mechanical ventilation (OR: 0.53, P < 0.001). In the sub-group analysis of patients that received remdesivir, bradycardia was associated with reduced mortality risk (hazard ratio (HR): 0.69, P = 0.002).</p><p><strong>Conclusions: </strong>Our study showed that remdesivir was associated with bradycardia in COVID-19 patients. However, it decreased the odds of being on a ventilator, even in patients with increased inflammatory markers on admission. Furthermore, patients on remdesivir that developed bradycardia had no increased risk of death. Clinicians should not withhold remdesivir from patients at risk of developing bradycardia because bradycardia in such patients was not found to worsen the clinical outcome.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/15/cr-14-192.PMC10257499.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Artery Disease as an Independent Predictor of Cardiovascular Mortality in COVID-19 Patients.","authors":"Hywel Soney,&nbsp;Nathan DeRon,&nbsp;Lucas Wang,&nbsp;Lawrence Hoang,&nbsp;Mujahed Abualfoul,&nbsp;Yi Zhao,&nbsp;Kristopher Aten,&nbsp;Victor Canela,&nbsp;Sri Prathivada,&nbsp;Michael Vu,&nbsp;Manavjot Sidhu","doi":"10.14740/cr1471","DOIUrl":"https://doi.org/10.14740/cr1471","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) is associated with increased risk of cardiovascular mortality. However, little is known about the combined effect of coronary artery disease (CAD) and COVID-19 on mortality. We aimed to investigate the incidence of cardiovascular and all-cause mortality in COVID-19 patients with CAD.</p><p><strong>Methods: </strong>This multicenter retrospective study identified 3,336 COVID-19 patients admitted between March and December 2020. Data points were manually reviewed in the patients' electronic health records. Multivariate logistic regression was used to assess whether CAD and its subtypes were associated with mortality.</p><p><strong>Results: </strong>This study shows that CAD was not an independent predictor of all-cause mortality (odds ratio (OR): 1.512, 95% confidence interval (CI): 0.1529 - 14.95, P = 0.723). However, there was a significant increase in cardiovascular mortality in patients with CAD compared to those without (OR: 6.89, 95% CI: 2.706 - 17.53, P < 0.001). There was no significant difference in all-cause mortality in patients with left main artery and left anterior descending artery disease (OR: 1.29, 95% CI: 0.80 - 2.08, P = 0.29). However, CAD patients with a history of interventions (e.g., coronary stenting or coronary artery bypass graft) showed increased mortality compared to those solely treated by medical management (OR: 1.93, 95% CI: 1.12 - 3.33, P = 0.017).</p><p><strong>Conclusions: </strong>CAD is associated with a higher incidence of cardiovascular mortality but not all-cause mortality in COVID-19 patients. Overall, this study will help clinicians identify characteristics of COVID-19 patients with increased risk of mortality in the setting of CAD.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/79/cr-14-221.PMC10257497.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Study on the Association of Serum Branched-Chain Amino Acids With Lipid and Hepatic Markers.","authors":"Hari Krishnan Krishnamurthy,&nbsp;Swarnkumar Reddy,&nbsp;Vasanth Jayaraman,&nbsp;Karthik Krishna,&nbsp;Qi Song,&nbsp;Tianhao Wang,&nbsp;Kang Bei,&nbsp;John J Rajasekaran","doi":"10.14740/cr1454","DOIUrl":"https://doi.org/10.14740/cr1454","url":null,"abstract":"<p><strong>Background: </strong>Serum levels of branched-chain amino acids (BCAAs) are associated with various vital physiological functions and thus elevation in circulating levels results in several metabolic disturbances. Serum levels of BCAAs are strong predictors of various metabolic disorders. Their association with cardiovascular health is uncertain. The study aimed to investigate the association of BCAAs with circulating levels of vital cardiovascular and hepatic markers.</p><p><strong>Methods: </strong>The study population of 714 individuals was included from the population tested for the vital cardio and hepatic biomarkers at the Vibrant America Clinical Laboratories. The subjects were stratified into four quartiles based on the serum levels of BCAAs, and their association with vital markers was studied using the Kruskal-Wallis test. Pearson's correlation analyzed the univariant relationship of BCAAs with selected cardio and hepatic markers.</p><p><strong>Results: </strong>BCAAs exhibited a strong negative correlation with serum HDL. Serum triglycerides were found to have a positive correlation with serum levels of leucine and valine. Univariant analysis exhibited a strong negative correlation between serum levels of BCAAs and HDL, and a positive correlation was observed between triglycerides and amino acids isoleucine and leucine. Among analyzed hepatic markers, alanine transaminase exhibited a considerable association with BCAAs.</p><p><strong>Conclusions: </strong>The elevated levels of serum BCAAs are strongly associated with serum HDL and triglycerides. Consumption of these supplements must be in coordination with healthcare providers to avoid metabolic and cardiovascular risk.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/b8/cr-14-167.PMC10257501.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Accelerated Catheter-Directed Thrombolysis.","authors":"Mrhaf Alsamman,&nbsp;Ali Mohsin Choudhry,&nbsp;Abdulaziz Mheir AlSaadi,&nbsp;Rakesh Prashad","doi":"10.14740/cr1490","DOIUrl":"https://doi.org/10.14740/cr1490","url":null,"abstract":"<p><p>Venous thromboembolism is a very common presentation in the hospital setting. In patients with high-risk pulmonary embolism (PE) or PE and hemodynamic instability, systemic thrombolytic treatment is generally indicated. In those with contraindications to systemic thrombolysis, catheter-directed local thrombolytic therapy and surgical embolectomy are currently considered. In particular, catheter-directed thrombolysis (CDT) is a drug delivery system coupling the endovascular drug administration nearby in the thrombus and the local facilitating effect of ultrasounds. The applications of CDT are currently debated. Here we provide a systematic review of the clinical utilization of CDT.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/7c/cr-14-161.PMC10257504.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9621243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest Pain in Acute Myocardial Infarction and Its Association With the Culprit Artery and Fibrotic Segment Identified by Cardiac Magnetic Resonance.","authors":"Weverton Ferreira Leite,&nbsp;Rui Manuel Dos Santos Povoa,&nbsp;Adriano Mendes Caixeta,&nbsp;Celso Amodeo,&nbsp;Gilberto Szarf,&nbsp;Maria Teresa Nogueira Bombig,&nbsp;Maria Cristina Oliveira Izar,&nbsp;Luciana Netto Gioia,&nbsp;Wilma Noia Ribeiro,&nbsp;Francisco Antonio Helfenstein Fonseca","doi":"10.14740/cr1468","DOIUrl":"https://doi.org/10.14740/cr1468","url":null,"abstract":"<p><strong>Background: </strong>It is still very controversial whether the characteristics of pain in the acute myocardial infarction could be related to the culprit coronary artery. There are no data about associations of pain with the ST-segment elevation myocardial infarction (STEMI) and left ventricular (LV) fibrotic segments.</p><p><strong>Methods: </strong>Data from 328 participants who had STEMI and were included in the B and T Types of Lymphocytes Evaluation in Acute Myocardial Infarction (BATTLE-AMI) study were analyzed. The culprit artery was identified by coronary angiography and the injured myocardial segments by cardiac magnetic resonance. The statistical significance was established by P value < 0.05.</p><p><strong>Results: </strong>A total of 223 patients (68%) were selected. Association was not observed between chest pain and the culprit artery (P = 0.237), as well as between pain irradiation and the culprit artery (P = 0.473). No significant difference was observed in the pain localization in relation to the segments in the short axis basal, mid, apical, and long axis, except for the mid inferior segment. The data were not considered clinically relevant because this association was observed in only one of 17 segments after multiple comparisons.</p><p><strong>Conclusions: </strong>In patients with STEMI, no associations were observed between the location or irradiation of acute chest pain and/or adjacent areas and the culprit artery, or between pain and segmental myocardial fibrosis in the LV.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/e0/cr-14-097.PMC10116939.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9742655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Possible Exquisite Crosstalk of Urate Transporter 1 With Other Urate Transporters for Chronic Kidney Disease and Cardiovascular Disease Induced by Dotinurad.","authors":"Hidekatsu Yanai,&nbsp;Hiroki Adachi,&nbsp;Mariko Hakoshima,&nbsp;Hisayuki Katsuyama","doi":"10.14740/cr1496","DOIUrl":"https://doi.org/10.14740/cr1496","url":null,"abstract":"We previously reported that the switching from fenofibrate to the selective peroxisome proliferator-activated receptor (PPAR) α modulator, pemafibrate, increased serum uric acid (UA) levels and reduced estimated glomerular filtration rate (eGFR) in patients with dyslipidemia [1]. Fenofibrate has a property to decrease serum UA by inhibition of urate transporter 1 (URAT1) by its major metabolite [2]. Although fenofibrate was reported to decrease the eGFR [3], the mechanism of fenofibrate-induced renal impairment has been remained unclear. Further, our previous discussion on such issue was premature [1]. Recently, the role of UA transporters has been clarified [4] (Fig. 1a). Renal excretion of UA is the major regulator of serum UA, and renal UA reabsorption is mainly mediated by URAT1 and glucose transporter 9 (GLUT9). Organic anion transporters (OATs) 1, 3 transport UA from the renal interstitial into renal proximal tubule epithelial cells. ATP-binding cassette, subfamily G, 2 (ABCG2) has been identified as a high-capacity UA exporter that mediates renal and/or extrarenal UA excretion. Indoxyl sulfate (IS) is a well-known uremic toxin that accumulates under renal impairment and is involved in the progression of chronic kidney disease (CKD) and cardiovascular disease (CVD), by inducing inflammation and free radical production [5, 6]. IS excretion is also mediated by OAT1/3 and ABCG2 as well as UA excretion [4]. ABCG2 inhibitors, such as febuxostat (xanthin oxidase (XO) inhibitor), caused renal IS accumulation by suppressing its excretion via ABCG2 in rats [7]. Fenofibrate completely inhibits ABCG2 which may lead to increase in renal IS [8], resulting in elevation of eGFR. Another XO inhibitor, topiroxostat, also inhibits ABCG2, however, allopurinol does not inhibit ABCG2. OAT inhibitors such as probenecid (uricosuric drug, URAT1, and GLUT9 inhibitor), suppressed IS uptake into the kidney, leading to increased plasma IS [7]. Increased plasma IS may be harmful to cardiovascular system by inducing inflammation and free radical production. Benzbromarone (uricosuric drug) inhibits OAT1 and OAT3, however, its inhibitory potency for OAT1/3 is lower than those of probenecid [9], which may not lead to an increase in plasma IS. Probenecid and benzbromarone inhibit ABCG2, which may be unfavorably associated with renal function. In short, the inhibition of OAT1/3 and ABCG2 increase IS in plasma and kidney, which may be unfavorably associated with the development of CVD and CKD, respectively. Very recently, we reported that the addition of the selective URAT1 inhibitor dotinurad to highly-evidence-proved drugs to improve CKD such as sodium-glucose cotransporter 2 (SGLT2) inhibitor and a glucagon-like peptide 1 (GLP-1) receptor agonist, improved eGFR in a diabetic patient with CKD stage G4 [10]. Dotinurad inhibits URAT1 specifically, however, does not inhibit ABCG2 [9], and reduces renal UA accumulation, which may increase the transport of renal accumulated IS b","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/15/cr-14-158.PMC10116931.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9742656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium Chloride Physiological Saline Solution Versus Water Preparations Injectable in the Use of Shockwave Intravascular Lithotripsy: A Single-Center Experience.","authors":"Quentin Landolff,&nbsp;Matthieu Godin,&nbsp;Alexandre Canville,&nbsp;Benjamin Honton,&nbsp;Jacques Monsegu,&nbsp;Marine Quillot,&nbsp;Jacques Berland,&nbsp;Rene Koning,&nbsp;Nicolas Amabile","doi":"10.14740/cr1489","DOIUrl":"https://doi.org/10.14740/cr1489","url":null,"abstract":"<p><strong>Background: </strong>Shockwave intravascular lithotripsy (IVL) coronary system is a very useful new technology for <i>de novo</i> severely calcified coronary artery plaques before percutaneous coronary intervention (PCI). The device uses a semi-compliant low-pressure balloon, integrated into a sterile catheter, to deliver by vaporizing fluid an expanding bubble that generates high-pressure ultrasonic energy by waves that create multiplane longitudinal micro-macro fractures in calcified plaques, which facilitate optimal stent placement and expansion, and luminal gain.</p><p><strong>Methods: </strong>The use of Shockwave IVL coronary system in our cardiac catheterization laboratory (Cath lab) at the \"Clinique Saint-Hilaire\" in Rouen, France, started in March 2019, with 42 procedures performed since this date: two patients in 2019, two patients in 2020, seven patients in 2021, 23 patients in 2022, and eight patients since the beginning of 2023.</p><p><strong>Results: </strong>We had experienced problems at the beginning of our activity for the first 11 patients (two patients in 2019, two patients in 2020, and seven patients in 2021): after less than five pulses, the shock therapy stopped. We used initially for Shockwave IVL semi-compliant low-pressure integrated balloons a mixture of 50% contrast and 50% water preparations injectable (PPI). After changing water PPI by sodium chloride physiological saline solution, we never encountered this problem again for the following 31 patients (23 patients in 2022, and eight patients since the beginning of 2023). In fact, the proper functioning of Shockwave IVL system requires ions in balloon mixture in addition to the contrast. It is thanks to the ions contained in sodium chloride physiological saline solution that the spark necessary for shocks delivery after balloon inflation is produced.</p><p><strong>Conclusions: </strong>Water PPI or sodium chloride physiological saline solution is used in angioplasty balloons in a lot of Cath labs worldwide. It is therefore essential to disseminate in the worldwide Cath lab the obligation to put in Shockwave IVL semi-compliant low-pressure integrated balloons sodium chloride physiological saline solution, rather than water PPI for optimal performance, and the importance of Shockwave Medical reporting this to interventional cardiologists.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/e3/cr-14-149.PMC10116940.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9445393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Atrial Remodeling in Patients With Severe Rheumatic Mitral Stenosis and Sinus Rhythm Using Two-Dimensional and Three-Dimensional Speckle Tracking Echocardiography.","authors":"Taher Said Abd Elkareem,&nbsp;Taghreed Abdelrahman Ahmed,&nbsp;Layla Ahmed Mohamed","doi":"10.14740/cr1465","DOIUrl":"https://doi.org/10.14740/cr1465","url":null,"abstract":"<p><strong>Background: </strong>In mitral stenosis (MS), the combination of an increase in left atrium (LA) pressure and atrial inflammatory response is accompanied by increase in interstitial fibrosis of the atrial wall with disorganization of atrial muscle bundles, LA dysfunction and subsequently LA dilatation. We aimed to assess the effect of severe rheumatic MS on LA volumes and mechanics.</p><p><strong>Methods: </strong>We enrolled 40 patients with pure severe rheumatic MS and sinus rhythm as a patient group and 30 healthy subjects as a control group. All patient and control groups underwent two-dimensional (2D) transthoracic echo to measure left ventricle (LV) dimensions, function, LA deformations, estimated systolic pulmonary artery pressure (EPAP), and left ventricle global longitudinal strain (LV GLS). Also LA volumes and mechanics (LA strain during LV systole (reservoir function) and LV diastole (early = conduit, and late = booster pump = atrial contraction)) were measured by three-dimensional (3D) transthoracic echo; mitral valve (MV) area was measured by 3D transesophageal echo (as routine pre-percutaneous MV commissurotomy using multiplanar reconstruction in mid-esophageal apical long-axis view from LA prospective).</p><p><strong>Results: </strong>By 2D transthoracic echo, patient group revealed significantly lower all LA function vs. control group including LA strain during reservoir (24 ± 6 vs. 43 ± 3, P < 0.001), LA strain during conduit (-11 ± 3 vs. -25 ± 2, P < 0.001), and during booster pump (-13 ± 4 vs. -18 ± 1, P < 0.001). EPAP was significantly higher in patient group (48 ± 7 vs. 27 ± 4 in control group). LV GLS was significantly lower in patient group (-16±2% vs. -23±2% in control group). All 3D LA volumes were significantly higher in patient group than control group including maximum LA volume (LAVmax) (76 ± 18 vs. 50 ± 5, P < 0.001), indexed LA volume (LAVi) (44.6 ± 10.1 vs. 28.7 ± 3.7, P < 0.001), LV minimum volume (LAVmin) (51 ± 15 vs. 30 ± 4, P < 0.001), and LA volume pre atrial contraction (LAVpre A) (63 ± 15 vs. 41 ± 6, P < 0.001). Also, there was significantly decreased LA strain using 3D speckle tracking echo in patient group including systolic deformation of LA (reservoir function) (23 ± 6 vs. 41 ± 3, P < 0.001) and diastolic deformation, early diastole (conduit function) (-10 ± 2 vs. -24 ± 2, P < 0.001), and late diastole (booster pump function) (-13 ± 4 vs. -18 ± 1, P < 0.001).</p><p><strong>Conclusions: </strong>All LA function markedly reduced in pure severe rheumatic MS. The reduction of LA mechanics is directly related to the degree of reduction of the stenotic MV area. LV GLS significantly reduced in severe MS and its reduction is directly related to the degree of reduction of the stenotic MV area and the LAVi by 3D echo.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/0e/cr-14-142.PMC10116933.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9390008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immobilizing Interstitial Cardiac Fibrosis.","authors":"Yuriy L Shevchenko,&nbsp;Alexey V Plotnitsky,&nbsp;Daniil S Ulbashev","doi":"10.14740/cr1467","DOIUrl":"https://doi.org/10.14740/cr1467","url":null,"abstract":"<p><strong>Background: </strong>The alterations in the endomysium and perimysium might cause compaction and gradual mechanical compression of cardiomyocytes resulting in their immobilization. This process finally leads to severe stiffening, so that the newly formed frame around individual cardiomyocytes and their clusters hinders normal diastole, and later systole. This phenomenon is referred to as immobilizing interstitial cardiac fibrosis (IICF). Deciphering the molecular and structural elements of myocardial changes is the key to understanding the pathogenetic foundations of heart failure development.</p><p><strong>Methods: </strong>The study included 69 patients. Group I (n = 32) included patients with IICF; group II (n = 37) was comparison group. We evaluated the clinical picture, anamnesis of the disease, the results of physical examination, laboratory and instrumental examination of patients and autopsy data.</p><p><strong>Results: </strong>In the anamnesis, patients with IICF were more likely to have diseases than patients in the control group: arrhythmia and impaired conductivity (88% vs. 19%, odds ratio (OR): 30.0; 95% confidence interval (CI): 7.918 - 113.7, P < 0.001), systemic connective tissue diseases (78% vs. 5%, OR: 62.5; 95% CI: 11.9 - 326.5, P < 0.001), viral infections (including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) (53% vs. 19%, OR: 4.86; 95% CI: 1.66 - 14.25, P = 0.003), type 2 diabetes mellitus (47% vs. 8%, OR: 10.0; 95% CI: 2.54 - 39.34, P < 0.001), radiation therapy for mediastinal lymphoma and other oncological diseases (19% vs. 0%, P = 0.008), focal infections (sinusitis, osteomyelitis, periodontitis, nephritis, cystitis, pyelonephritis, pleurisy, etc.) within 12 months (31% vs. 11%, P = 0.069), chronic kidney disease (25% vs. 8%, P = 0.097), and tuberculosis (9% vs. 0%, P = 0.095). We have identified a statistically significant difference between the groups: the volume of the fibrosis zone (17.5±9.2% vs. 4.9±2.3%, P = 0.001), the expression of type I collagen (5,182 ± 1,301 vs. 2,189 ± 754 in 1 mm², P = 0.0001), type III collagen (7,562 ± 1,405 vs. 2,320 ± 541 in 1 mm², P = 0.0001), matrix metalloproteinase (MMP)-2 (12,850 ± 6,200 vs. 9,501 ± 7,145 in 1 mm², P = 0.005), MMP-9 (15,745 ± 5,695 vs. 6,920 ± 3,125 in 1 mm², P = 0.0001), connexin-43 (25,689 ± 14,871 vs. 37,523 ± 12,561 in 1 mm², P = 0.001), fibronectin (3,448 ± 720 vs. 1,544 ± 610 in 1 mm², P = 0.0001), and transforming growth factor β (TGF-β) (5,121 ± 1,243 vs. 2,531 ± 1,489 in 1 mm², P = 0.001).</p><p><strong>Conclusion: </strong>IICF is a separate pathological condition and one of the main causes of chronic heart failure. It is induced by changes in the myocardial connective tissue that prevent normal functioning of the myocardium.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0c/12/cr-14-123.PMC10116936.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9445391","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}