Canadian Journal of Cardiology最新文献

{"title":"Enhancing Care in Cardiogenic Shock: Role of Palliative Care in Acute Cardiogenic Shock Through Destination Therapy","authors":"Annie Hung MB, BCh, BAO ,&nbsp;Michael Slawnych MD, PhD ,&nbsp;Caroline McGuinty MD","doi":"10.1016/j.cjca.2025.01.032","DOIUrl":"10.1016/j.cjca.2025.01.032","url":null,"abstract":"<div><div>Despite advances in the management of cardiogenic shock (CS), morbidity and mortality in CS remain exceedingly high and one third of patients do not survive their admission. Palliative care (PC) is an interdisciplinary approach focussed on improving the quality of life of patients and families facing life-threatening illness. Rates of PC use in CS remain low, despite evidence suggesting decreased symptom burden and reduced use of health care in patients with heart failure and in critical care settings. PC should occur in tandem with mobilization of aggressive life-sustaining measures such as mechanical circulatory support (MCS) and extracorporeal membrane oxygenation (ECMO) in the care of patients presenting with CS. In this review, we describe the role of PC throughout the care continuum of patients with acute CS through to destination therapy with a left ventricular assist device. We explore the current use of PC in CS and challenges to goals-of-care discussions posed by MCS and ECMO, and highlight strategies on integrating PC in acute and chronic CS. Finally, we demonstrate the importance of incorporating PC early in management and challenge the traditional use of PC primarily as an end-of-life intervention.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 669-681"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate vs Delayed Angiography After Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation","authors":"David Dorian MD, FRCPC,&nbsp;Paul Dorian MD, MSc, FRCPC","doi":"10.1016/j.cjca.2024.05.015","DOIUrl":"10.1016/j.cjca.2024.05.015","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Page 794"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141134885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Personal Perspective on Circulatory Support and Outcomes in Shock: Past, Present, and Future","authors":"David A. Baran MD, FACC, FSCAI, FHFSA","doi":"10.1016/j.cjca.2024.11.012","DOIUrl":"10.1016/j.cjca.2024.11.012","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 568-572"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0828-282X(25)00208-9","DOIUrl":"10.1016/S0828-282X(25)00208-9","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Page A8"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Dorian and Dorian—Risk Assessment in Immediate vs Delayed Angiography After Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation Decisions","authors":"Sean van Diepen MD, MSc,&nbsp;Michel R. Le May MD,&nbsp;Patricia Alfaro RN, MSc,&nbsp;Michael J. Goldfarb MD, MSc,&nbsp;Adriana Luk MD, MSc,&nbsp;Rebecca Mathew MD,&nbsp;Maude Peretz-Larochelle MDCM,&nbsp;Erin Rayner-Hartley MD,&nbsp;Juan J. Russo MD,&nbsp;Janek M. Senaratne MD, MS,&nbsp;Craig Ainsworth MD,&nbsp;Emilie Belley-Côté MD, PhD,&nbsp;Christopher B. Fordyce MD, MHS, MSc,&nbsp;Julie Kromm MD,&nbsp;Christopher B. Overgaard MD,&nbsp;Gregory Schnell MD,&nbsp;Graham C. Wong MD, MPH","doi":"10.1016/j.cjca.2024.06.015","DOIUrl":"10.1016/j.cjca.2024.06.015","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Page 795"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Replacement Therapy in Patients With Cardiogenic Shock: Refining the AEIOUs in Cardiovascular Patients","authors":"Evan J. Wiens MD, MSc ,&nbsp;Jacob C. Jentzer MD ,&nbsp;P. Elliott Miller MD, MHS ,&nbsp;Saraschandra Vallabhajosyula MD, MSc ,&nbsp;David D. Berg MD, MPH ,&nbsp;Sean M. Bagshaw MD, MSc ,&nbsp;Sean van Diepen MD, MSc","doi":"10.1016/j.cjca.2024.11.004","DOIUrl":"10.1016/j.cjca.2024.11.004","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 779-783"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Nitric Oxide in the Sweep Gas for Patients Receiving Extracorporeal Membrane Oxygenation or Cardiopulmonary Bypass","authors":"Roberto Chiletti MD, FCICM, MBA ,&nbsp;Sophie H. Fincher BPhysio, MBBS, FCICM ,&nbsp;Stephen B. Horton PhD, CCP(Aus), CCP(USA), FACBS ,&nbsp;Giles J. Peek MD, FRCS, CTh, FFICM, FELSO ,&nbsp;Paul Checchia MD, FCCM, FACC ,&nbsp;Warwick Butt MBBS, FRACP, FCICM, FELSO","doi":"10.1016/j.cjca.2024.12.027","DOIUrl":"10.1016/j.cjca.2024.12.027","url":null,"abstract":"<div><div>Nitric oxide (NO) was proclaimed the 1992 “molecule of the year” by Culotta in <em>Science</em> magazine because of its importance in neuroscience, physiology, and immunology. Inhaled NO has been in clinical use for over 35 years to decrease pulmonary hypertension and improve oxygenation. Over the past 20 years, there has been much research into understanding the role of NO on cell surface receptors, mitochondria, and intracellular processes that involve calcium and superoxide radicals. This research has shown that, irrespective of the cause, NO has a major role in the systemic inflammatory response syndrome and ischemia-reperfusion injury.<span><span>¹</span></span> More recent clinical research has focussed on NO use in patients undergoing cardiopulmonary bypass and receiving extracorporeal life support, with some centres incorporating NO into sweep gas as part of routine practice. In this article we review NO pathways in humans, the biologic effects of NO, the interplay between NO and red blood cells, and animal and human studies on the effects of exogenously administered NO.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 621-629"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CJCA_ANN_Call for Original Papers_Transplantation_proof","authors":"","doi":"10.1016/S0828-282X(25)00213-2","DOIUrl":"10.1016/S0828-282X(25)00213-2","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages A9-A10"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Higher Temperature During Moderate Hypothermic Circulatory Arrest Increase the Risk of Paraplegia in Acute DeBakey I Aortic Dissection Patients?","authors":"Xiaomeng Wang MD, PhD ,&nbsp;Jiawang Ma MD ,&nbsp;Chenglong Li MD, PhD ,&nbsp;Feng Yang MD ,&nbsp;Liangshan Wang MD, PhD ,&nbsp;Zhongtao Du MD, PhD ,&nbsp;Haiyang Li MD, PhD ,&nbsp;Junming Zhu MD, PhD ,&nbsp;Hongjia Zhang MD, PhD ,&nbsp;Xiaotong Hou MD, PhD","doi":"10.1016/j.cjca.2024.06.027","DOIUrl":"10.1016/j.cjca.2024.06.027","url":null,"abstract":"<div><h3>Background</h3><div>In this study, we sought to assess the safety of high-moderate (24.1-28.0°C) and low-moderate (20.1-24.0°C) systemic hypothermia during circulatory arrest (MHCA) in patients with acute DeBakey I aortic dissection (DeBakey I AAD), particularly concerning spinal cord protection.</div></div><div><h3>Methods</h3><div>From 2009 to 2020, 1759 patients with DeBakey I AAD who underwent frozen elephant trunk and total arch replacement surgery at a tertiary centre were divided into preoperative malperfusion (viscera, spinal cord, or lower extremities) and nonmalperfusion subgroups. The baseline differences were balanced with the use of propensity score matching. Prognoses were compared between those who were subjected to high-MHCA (nasopharyngeal temperature 24.1-28.0°C) and low-MHCA (nasopharyngeal temperature 20.1-24.0°C).</div></div><div><h3>Results</h3><div>In the nonmalperfusion subgroup (n = 1389), 469 pairs of matched patients showed lower in-hospital mortality and incidence of acute kidney injury in the high-MHCA group than in the low-MHCA group: in-hospital mortality 7.0% vs 10.2% (<em>P</em> = 0.01); acute kidney injury, 57.1% vs 64.6% (<em>P</em> &lt; 0.01). The duration of mechanical ventilation was shorter in the high-MHCA group than that in the low-MHCA group (<em>P</em> = 0.03). No significant difference in the incidence of paraplegia was observed between the 2 groups. In the malperfusion subgroup (n = 370), 112 pairs of matched patients showed a higher incidence of paraplegia in the high-MHCA group than in the low-MHCA group (15.9% vs 6.5%; <em>P</em> = 0.04).</div></div><div><h3>Conclusions</h3><div>The safety of high-MHCA, a commonly used temperature management strategy during aortic arch surgery, was recognised in most patients with DeBakey I AAD. However, among patients with preoperative distal organ malperfusion, low-MHCA may be more appropriate owing to an increased risk of postoperative paraplegia associated with high-MHCA.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 749-760"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unresolved Controversies in Revascularization for Cardiogenic Shock with Acute Myocardial Infarction","authors":"Nathaniel R. Smilowitz MD, MS","doi":"10.1016/j.cjca.2024.08.281","DOIUrl":"10.1016/j.cjca.2024.08.281","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 768-770"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}