Cardiovascular diagnosis and therapy最新文献

{"title":"IgG4-related disease involving coronary and pulmonary arteries: a case report and literature review","authors":"Jin Cao, Zhaowen Yang","doi":"10.21037/cdt-23-215","DOIUrl":"https://doi.org/10.21037/cdt-23-215","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139016499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pacemaker leads as a potential source of problems in patients who might need a central venous access port","authors":"M. Czajkowski, A. Polewczyk, W. Jacheć, D. Nowosielecka, Łukasz Tułecki, P. Stefańczyk, Andrzej Kutarski","doi":"10.21037/cdt-23-104","DOIUrl":"https://doi.org/10.21037/cdt-23-104","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139022038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bypass failure of internal mammary artery caused by subclavian artery stenosis: its clinical characteristics and cardiovascular outcomes in patients receiving coronary artery bypass graft surgery","authors":"Nobunari Tomura, Y. Kataoka, Kensuke Morris, Eri Kiyoshige, Kunihiro Nishimura, N. Yagi, Kota Murai, T. Iwai, K. Sawada, H. Matama, Satoshi Honda, M. Fujino, Kensuke Takagi, S. Yoneda, F. Otsuka, Yoshio Tahara, Y. Asaumi, T. Satow, Hiroharu Kataoka, Satsuki Fukushima, Tomoyuki Fujita, T. Noguchi","doi":"10.21037/cdt-23-211","DOIUrl":"https://doi.org/10.21037/cdt-23-211","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138985961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Very long-term efficacy and safety of paclitaxel-eluting balloon after a bare-metal stent for the treatment of ST-elevation myocardial infarction: 8-year results of a randomized clinical trial (PEBSI study).","authors":"Arturo García-Touchard, Manel Sabaté, Nieves Gonzalo, Vicente Peral, Beatriz Vaquerizo, Rafael Ruiz-Salmerón, Bruno García Del Blanco, Jesús Jiménez-Mazuecos, Eduardo Molina, Pedro Martínez-Romero, José María Hernandez-García, Valeriano Ruiz-Quevedo, Cristóbal Urbano, Javier Fernández-Portales, José Ramón Rumoroso, Juan Casanova-Sandoval, Eduardo Pinar, Javier Lopez-Pais, Juan Francisco Oteo, Fernando Alfonso","doi":"10.21037/cdt-22-623","DOIUrl":"10.21037/cdt-22-623","url":null,"abstract":"<p><strong>Background: </strong>Drug-eluting stents (DES) are considered the therapy of choice in ST-segment elevation myocardial infarction (STEMI); however, a low persistent rate of revascularizations and stent thrombosis exist over the time. We have previously shown that a paclitaxel (PTX)-drug-coated balloon (DCB) after a bare-metal stent (BMS) implantation (DCB-combined strategy) yields superior angiographic and clinical results compared to BMS in the short term. However, the long-term safety and efficacy of this approach remain uncertain.</p><p><strong>Methods: </strong>An 8-year clinical follow-up was conducted on patients enrolled in the randomized PEBSI-1 trial (NCT01839890). The original trial included patients who suffered a STEMI, patients were randomly assigned to receive a DCB-combined strategy or BMS only and the primary endpoint was in-stent late luminal loss (LLL) at 9-month follow-up. After the completion of this study, death, myocardial re-infarction, ischemia-driven repeated revascularizations included target lesion revascularization (TLR) and target vessel revascularization (TVR), and stent thrombosis, were assessed by yearly contact by a clinical visit, telephone or by electronic records. These outcomes were adhered to ARC-2 criteria.</p><p><strong>Results: </strong>The rate of incomplete follow-up was very low, with only 3 out of 111 patients (2.7%) in the DCB-combined strategy group and 1 out of 112 patients (0.9%) in the BMS group. At 8 years there were a lower rate of TVR [3.7% <i>vs.</i> 14.3%; hazard ratio (HR): 0.243; 95% confidence interval (CI): 0.081-0.727; P=0.006], and a trend towards lower TLR (2.8% <i>vs.</i> 8.9%; HR: 0.300; 95% CI: 0.083-1.090; P=0.052) in the DCB-combined strategy group. No statistical difference between the DCB-combined strategy and BMS groups were found for all causes of death, deaths from cardiovascular disease, reinfarctions or stent thrombosis. Notably in the DCB-combined strategy group, no episode of stent thrombosis occurred after the first year. Similarly, there were no cardiovascular deaths, TVR and TLR in the DCB-combined strategy group after 5 years. In contrast, during the period from year 5 to 8, the BMS group experienced an additional cardiovascular death, as well as one case of TVR, one case of TLR, and one case of stent thrombosis.</p><p><strong>Conclusions: </strong>In STEMI patients, the DCB-combined strategy maintains its safety and clinical efficacy over time. Our rates of TVR, TLR, and very late stent thrombosis (VLST) at very long-term are the lowest ever found in a STEMI trial. Further studies are warranted to assess the potential superiority of this novel strategy as compared with new-generation DES to prevent very late events in these patients.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov; identifier: NCT01839890.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visit-to-visit variability of metabolic parameters and progression of atherosclerosis in computed tomography: follow up of an asymptomatic cohort.","authors":"Yun-Jung Lim, Minkyung Oh, Seung Guk Park, Hyoeun Kim, Sunmi Yoo","doi":"10.21037/cdt-23-75","DOIUrl":"10.21037/cdt-23-75","url":null,"abstract":"<p><strong>Background: </strong>We aimed to examine whether intra-individual variability in traditional risk factors affects the progression of atherosclerosis on subsequent coronary computed tomography angiography (CCTA).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using asymptomatic health examination cohort data from Haeundae Paik Hospital in Korea collected between 2010-2020. A total of 387 adults met the inclusion criteria of having at least two CCTAs without specific symptoms with an interval of more than one year and having completed three or more health examinations. Visit-to-visit variability was evaluated using the average real variability (ARV) of body mass index, waist circumference, systolic and diastolic blood pressure, and plasma glucose, total cholesterol, triglyceride, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol. Progression of coronary artery atherosclerosis was defined as worsening of coronary artery stenosis from baseline to final CCTA. ARV values for various metabolic parameters were stratified into quartiles, and hazard ratios (HRs) and 95% confidence intervals (CIs) for coronary atherosclerosis progression were analyzed using multiple Cox proportional hazards models.</p><p><strong>Results: </strong>There were 126 cases of coronary artery stenosis progression (32.56%) assessed using the Coronary Artery Disease Reporting and Data System during a mean follow up of 3.91 (range, 1-9) years. In the multivariate analysis comparing ARV quartiles for LDL-cholesterol after adjusting for covariates, individuals with higher variability showed an increased risk of stenosis progression: HR 2.23 (95% CI: 1.33-3.73) for the third quartile, HR 1.56 (95% CI: 0.91-2.66) for the fourth quartile (P for trend =0.005). Triglycerides also showed a significant linear trend (P for trend =0.04), and Q4 had a greater risk of stenosis progression (HR, 2.09; 95% CI: 1.24-3.52). Meanwhile, the risk of stenosis progression was significantly reduced as the ARV of HDL-cholesterol increased: HR 0.56 (95% CI: 0.35-0.89) for the third quartile, HR 0.47 (95% CI: 0.27-0.81) for the fourth quartile (P for trend =0.01).</p><p><strong>Conclusions: </strong>High variability in LDL-cholesterol and triglyceride was an independent predictor of coronary artery stenosis progression on subsequent CCTA in our cohort. This finding highlights the importance of maintaining stable state to effectively prevent the progression of coronary artery stenosis in clinical settings.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Delphi consensus on the management of anticoagulation in the COVID-19 pandemic: the MONACO study.","authors":"Carlos Escobar, Ramón Bover Freire, Xavier García-Moll Marimón, Carlos González-Juanatey, Miren Morillas, Alfonso Valle Muñoz, Juan José Gómez Doblas","doi":"10.21037/cdt-23-76","DOIUrl":"10.21037/cdt-23-76","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, guideline documents on the management of anticoagulation were rapidly published. However, these documents did not follow a structured methodology, and significant differences existed between the guidelines. The aim of this expert consensus was to provide recommendations on the clinical management of oral anticoagulation in patients in the context of the COVID-19 pandemic.</p><p><strong>Methods: </strong>A two-round Delphi study was conducted using an online survey. In the first round, panellists expressed their level of agreement with the items on a 9-point Likert scale. Items were selected if they received approval from ≥66.6% of panellists and if they were agreed by the scientific committee. In the second round, panellists revaluated those items that did not meet consensus in the first round.</p><p><strong>Results: </strong>A total of 147 panellists completed the first round, and 144 of them completed the second round. Consensus was reached on 161 items included in five dimensions. These dimensions addressed: (I) management of anticoagulation in patients with atrial fibrillation (AF) without mechanical valves or moderate/severe mitral stenosis during COVID-19 infection; (II) thromboprophylaxis in patients hospitalised for COVID-19; (III) management of anticoagulation at hospital discharge/after COVID-19; (IV) anticoagulation monitoring in the COVID-19 pandemic setting; and (V) role of telemedicine in the management and follow-up of patients with AF in the COVID-19 pandemic setting.</p><p><strong>Conclusions: </strong>These areas of collective agreement could specially guide clinicians in making decisions regarding anticoagulation in patients with COVID-19 during hospitalisation and at discharge, where results from clinical trials are still limited and, in some cases, conflicting.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of superb microvascular imaging for detecting intraplaque neovascularization: a systematic review and meta-analysis.","authors":"Lina Zhao, Yubo Han, Yanling Che, Xuesong Zhang, Min Luo, Jinzhu Li","doi":"10.21037/cdt-23-202","DOIUrl":"10.21037/cdt-23-202","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic plaques can cause carotid artery stenosis, and \"vulnerable plaques\" can even lead to ischemic stroke. The objective of this study was to assess the accuracy of superb microvascular imaging (SMI) for the detection of carotid intraplaque neovascularization (IPN) in patients with atherosclerotic plaques.</p><p><strong>Methods: </strong>We searched the Cochrane Library, Embase, Medline, and Wanfang databases until January 17, 2023. We included original studies with information on diagnostic accuracy of SMI for the evaluation of carotid IPN. The primary outcome was the accuracy of SMI for detecting carotid IPN. A meta-analysis was performed to estimate the accuracy of each parameter. We used the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) to assess the risk of bias for each included article. Meta-regression was performed to determine items that may have contributed to heterogeneity in the sensitivity or specificity of the test.</p><p><strong>Results: </strong>This meta-analysis included 20 studies with 1,589 carotid plaques in 1,225 patients. The analysis showed a sensitivity and specificity of SMI for detecting IPN of 93% [95% confidence interval (CI): 87-96%] and 80% (95% CI: 71-87%), respectively. The risk of bias across the QUADAS-2 domains was low. Only the proportion of dyslipidemia influenced the estimates of sensitivity and specificity.</p><p><strong>Conclusions: </strong>This review suggests that SMI has a good diagnostic performance for detecting carotid IPN. The very high sensitivity with excellent post-test probability indicated that SMI can be recommended to screen for carotid IPN among patients with carotid plaques.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-modality imaging of high-intensity plaques on non-contrast T1-weighted magnetic resonance imaging: a case report.","authors":"Hayato Hosoda, Yu Kataoka, Fumiyuki Otsuka, Yasuhide Asaumi, Teruo Noguchi","doi":"10.21037/cdt-23-125","DOIUrl":"10.21037/cdt-23-125","url":null,"abstract":"<p><strong>Background: </strong>Non-contrast T1-weighted imaging (T1WI) with cardiac magnetic resonance enables to evaluate the intensity of coronary plaque. Plaque-to-myocardial signal intensity ratio (PMR) has been shown to associate with an elevated risk of future coronary events. Of note, PMR >1.4 is a best cut-off value to identify high-risk plaque causing future coronary events. One recent study has reported intraluminal thrombus as a contributor to PMR. However, whether plaque material itself is associated with PMR has not been fully characterized yet. We present three cases with coronary artery stenosis evaluated by non-contrast T1WI-magnetic resonance imaging, optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS)-intravascular ultrasound (IVUS) imaging.</p><p><strong>Case description: </strong>Case 1 exhibited one lesion with high PMR (2.79) at the proximal segment of left anterior descending (LAD) artery. OCT imaging did not identify any obvious intra-luminal thrombus but the presence of lipid-rich plaque harboring cholesterol crystal at the corresponding lesion. In addition, an elevated maximum 4-mm lipid-core burden index (maxLCBI_4mm) (=873) was observed at this lesion by NIRS/IVUS imaging. In case 2, PMR of coronary stenosis at the middle segment of LAD artery was 1.88. This lesion harboured lipidic materials without any thrombus on OCT imaging. NIRS-derived maxLCBI_4mm was 725. Case 3 had a severe stenosis at the middle segment of LAD artery. This lesion exhibited a low PMR (0.90). On OCT and NIRS/IVUS imaging, this lesion was characterized as the presence of small lipid arc with a low maxLCBI_4mm (=386).</p><p><strong>Conclusions: </strong>These cases showed the possible relationship of T1WI-derived PMR with the degree of lipidic plaque components.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of emergent reperfusion therapy using paclitaxel-coated balloons for acute coronary syndrome: lessons from the PEBSI Study.","authors":"Yuki Kondo, Tetsuya Ishikawa, Isao Taguchi","doi":"10.21037/cdt-2023-3","DOIUrl":"10.21037/cdt-2023-3","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Door-to-device time and mortality in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention: insight from real world data of Thai PCI Registry.","authors":"Kitcha Champasri, Suphot Srimahachota, Mann Chandavimol, Wasan Udayachalerm, Ammarin Thakkinstian, Bancha Sookananchai, Wannakorn Phatharajaree, Songsak Kiatchoosakun, Nakarin Sansanayudh","doi":"10.21037/cdt-22-611","DOIUrl":"10.21037/cdt-22-611","url":null,"abstract":"<p><strong>Background: </strong>Timely reperfusion therapy is recommended for patients with ST-segment elevation myocardial infarction (STEMI), and system delay <90 minutes and door-to-device (D2D) time <60 minutes are recommended by the 2017 ESC Guidelines for the management of STEMI patients and have been proposed as a performance measure for triaging patients for primary percutaneous coronary intervention (PCI). However, previous research produced contradictory results regarding the association between D2D time and mortality. Therefore, this study aimed to examine the associations between D2D time and mortality in Thailand.</p><p><strong>Methods: </strong>This cohort study included STEMI patients treated with primary PCI in 39 PCI centres in Thailand from February 27, 2018, to August 1, 2019. Patients were eligible if they met the following criteria: primary STEMI diagnosis, symptom onset within 12 hours, and ST-segment elevation of at least 0.1 mV in 2 or more contiguous leads (at least 0.2 mV in V1-V3) or a new left bundle branch block.</p><p><strong>Results: </strong>Within 12 hours of symptom onset, 3,874 patients underwent primary PCI. The median D2D time was 54 minutes [interquartile range (IQR) 29-90], and there was a significant difference between patients transferred from other hospitals (44 minutes, IQR 25-77, n=2,871) and patients presented directly to PCI centres (81 minutes, IQR 56-129, n=1,003) (P<0.001). Overall, in-hospital mortality was 7.8%. In a multivariable analysis, adjusting for other predictors of mortality and stratifying according to intervals of D2D time, cumulative in-hospital mortality was significantly higher in patients with a D2D time greater than 90 minutes [hazard ratio (HR) 1.5, 95% confidence interval (CI): 1.0-2.1, P=0.046] but not associated with D2D time shorter than 60 minutes (HR 1.2, 95% CI: 0.8-1.8, P=0.319).</p><p><strong>Conclusions: </strong>A D2D time greater than 90 minutes was related to in-hospital mortality in patients with STEMI treated with primary PCI, but a D2D time less than 60 minutes was not consistently associated with D2D time-improved survival in real-world, contemporary practice in Thailand.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}