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Temporary Mechanical Circulatory Support: Left, Right, and Biventricular Devices. 临时机械循环支持:左心室、右心室和双心室装置。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.2174/1573403X19666230314115853
Michael Dangl, Michael Albosta, Hoda Butros, Matthias Loebe

Temporary mechanical circulatory support (MCS) encompasses a wide array of invasive devices, which provide short-term hemodynamic support for multiple clinical indications. Although initially developed for the management of cardiogenic shock, indications for MCS have expanded to include prophylactic insertion prior to high-risk percutaneous coronary intervention, treatment of acute circulatory failure following cardiac surgery, and bridging of end-stage heart failure patients to more definitive therapies, such as left ventricular assist devices and cardiac transplantation. A wide variety of devices are available to provide left ventricular, right ventricular, or biventricular support. The choice of a temporary MCS device requires consideration of the clinical scenario, patient characteristics, institution protocols, and provider familiarity and training. In this review, the most common forms of left, right, and biventricular temporary MCS are discussed, along with their indications, contraindications, complications, cannulations, hemodynamic effects, and available clinical data.

临时机械循环支持(MCS)包括一系列侵入性设备,为多种临床适应症提供短期血液动力学支持。尽管最初是为治疗心源性休克而开发的,但MCS的适应症已经扩展到包括在高风险经皮冠状动脉介入治疗前预防性插入、心脏手术后急性循环衰竭的治疗,以及将终末期心力衰竭患者桥接到更明确的治疗方法,例如左心室辅助装置和心脏移植。多种装置可用于提供左心室、右心室或双心室支持。选择临时MCS设备需要考虑临床情况、患者特征、机构协议以及提供者的熟悉程度和培训。在这篇综述中,讨论了最常见的左心室、右心室和双心室临时MCS形式,以及它们的适应症、禁忌症、并发症、插管、血液动力学影响和可用的临床数据。
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引用次数: 0
Appraisal of Cardiovascular Risk Factors, Biomarkers, and Ocular Imaging in Cardiovascular Risk Prediction. 心血管风险因素、生物标志物和眼部成像在心血管风险预测中的评估。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.2174/1573403X19666230727101926
Julie S Moore, M Andrew Nesbit, Tara Moore

Cardiovascular disease remains a leading cause of death worldwide despite the use of available cardiovascular disease risk prediction tools. Identification of high-risk individuals via risk stratification and screening at sub-clinical stages, which may be offered by ocular screening, is important to prevent major adverse cardiac events. Retinal microvasculature has been widely researched for potential application in both diabetes and cardiovascular disease risk prediction. However, the conjunctival microvasculature as a tool for cardiovascular disease risk prediction remains largely unexplored. The purpose of this review is to evaluate the current cardiovascular risk assessment methods, identifying gaps in the literature that imaging of the ocular microcirculation may have the potential to fill. This review also explores the themes of machine learning, risk scores, biomarkers, medical imaging, and clinical risk factors. Cardiovascular risk classification varies based on the population assessed, the risk factors included, and the assessment methods. A more tailored, standardised and feasible approach to cardiovascular risk prediction that utilises technological and medical imaging advances, which may be offered by ocular imaging, is required to support cardiovascular disease prevention strategies and clinical guidelines.

尽管使用了可用的心血管疾病风险预测工具,但心血管疾病仍然是全球死亡的主要原因。通过眼部筛查提供的亚临床阶段的风险分层和筛查来识别高危个体,对于预防重大心脏不良事件很重要。视网膜微血管在糖尿病和心血管疾病风险预测中的潜在应用已得到广泛研究。然而,结膜微血管作为心血管疾病风险预测的工具在很大程度上尚未被探索。这篇综述的目的是评估当前的心血管风险评估方法,确定眼部微循环成像可能填补的文献空白。这篇综述还探讨了机器学习、风险评分、生物标志物、医学成像和临床风险因素的主题。心血管风险分类因评估人群、包括的风险因素和评估方法而异。需要一种更具针对性、标准化和可行的心血管风险预测方法,利用眼部成像可能提供的技术和医学成像进步,来支持心血管疾病预防策略和临床指南。
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引用次数: 0
Myocardial Infarction as a Consequence of Mitochondrial Dysfunction. 线粒体功能障碍引起的心肌梗死。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.2174/1573403X19666230508114311
Pranay Wal, Namra Aziz, Yash Kumar Singh, Ankita Wal, Sourabh Kosey, Awani Kumar Rai

Acute myocardial infarction is an event of myocardial necrosis caused by unstable ischemic syndrome. Myocardial infarction (MI) occurs when blood stops flowing to the cardiac tissue or myocardium and the heart muscle gets damaged due to poor perfusion and reduced oxygen supply. Mitochondria can serve as the arbiter of cell fate in response to stress. Oxidative metabolism is the function of mitochondria within the cell. Cardiac cells being highly oxidative tissue generates about 90% of their energy through oxidative metabolism. In this review, we focused on the role of mitochondria in energy generation in myocytes as well as its consequences on heart cells causing cell damage. The role of mitochondrial dysfunction due to oxidative stress, production of reactive oxygen species, and anaerobic production of lactate as a failure of oxidative metabolism are also discussed.

急性心肌梗死是由不稳定缺血性综合征引起的心肌坏死事件。当血液停止流向心脏组织或心肌,心肌因灌注不良和氧气供应减少而受损时,就会发生心肌梗死(MI)。线粒体可以作为细胞对压力反应命运的仲裁者。氧化代谢是细胞内线粒体的功能。作为高度氧化组织的心脏细胞通过氧化代谢产生约90%的能量。在这篇综述中,我们重点讨论了线粒体在肌细胞能量产生中的作用,以及它对心脏细胞造成细胞损伤的影响。还讨论了氧化应激引起的线粒体功能障碍、活性氧的产生和乳酸的厌氧产生作为氧化代谢失败的作用。
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引用次数: 0
Incidence, Current Guidelines and Management of Gastrointestinal Bleeding after Transcatheter Aortic Valve Replacement: A Systematic Review. 经导管主动脉瓣置换术后胃肠道出血的发生率、当前指南和管理:一项系统综述。
IF 1.9 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2174/1573403X18666220623150830
Devina Adalja, Harshvardhan Zala, Varun Victor, Aakash Sheth, Charles Willyard, Emi Suzuki, Harsh P Patel, Monil Majmundar, Saraschandra Vallabhajosyula, Rajkumar Doshi

Background: There is a significant increase in morbidity and mortality in patients complicated by major bleeding following transcatheter aortic valve replacement (TAVR). It has become more challenging to manage such complications when the patient needs to be on anticoagulation or antiplatelet agent post-procedure to prevent thrombotic/embolic complications.

Methods: We systematically reviewed all available randomized controlled trials and observational studies to identify incidence rates of gastrointestinal bleeding post-procedure. After performing a systematic search, a total of 8731 patients from 15 studies (5 RCTs and 10 non-RCTs) were included in this review.

Results: The average rate of gastrointestinal bleeding during follow-up was 3.0% in randomized controlled trials and 1.9% among observational studies.

Conclusion: Gastrointestinal bleeding has been noted to be higher in the RCTs as compared to observational studies. This review expands knowledge of current guidelines and possible management of patients undergoing TAVR.

背景:经导管主动脉瓣置换术(TAVR)后并发大出血的患者的发病率和死亡率显著增加。当患者在术后需要服用抗凝剂或抗血小板药物以预防血栓/栓塞并发症时,处理此类并发症变得更具挑战性。方法:我们系统地回顾了所有可用的随机对照试验和观察性研究,以确定术后胃肠道出血的发生率。在进行系统搜索后,来自15项研究(5项随机对照试验和10项非随机对照试验)的8731名患者被纳入本综述。结果:在随机对照试验中,随访期间胃肠道出血的平均发生率为3.0%,在观察性研究中为1.9%。结论:与观察性研究相比,随机对照试验中的胃肠道出血率更高。这篇综述扩展了对接受TAVR的患者的当前指南和可能的管理的了解。
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引用次数: 0
Machine-learning Algorithms for Ischemic Heart Disease Prediction: A Systematic Review. 缺血性心脏病预测的机器学习算法:系统综述。
IF 1.9 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2174/1573403X18666220609123053
Salam H Bani Hani, Muayyad M Ahmad

Purpose: This review aims to summarize and evaluate the most accurate machinelearning algorithm used to predict ischemic heart disease.

Methods: This systematic review was performed following PRISMA guidelines. A comprehensive search was carried out using multiple databases such as Science Direct, PubMed MEDLINE, CINAHL, and IEEE explore.

Results: Thirteen articles published between 2017 to 2021 were eligible for inclusion. Three themes were extracted: the commonly used algorithm to predict ischemic heart disease, the accuracy of algorithms to predict ischemic heart disease, and the clinical outcomes to improve the quality of care. All methods have utilized supervised and unsupervised machine-learning.

Conclusion: Applying machine-learning is expected to assist clinicians in interpreting patients' data and implementing optimal algorithms for their datasets. Furthermore, machine-learning can build evidence-based that supports health care providers to manage individual situations who need invasive procedures such as catheterizations.

目的:本综述旨在总结和评估用于预测缺血性心脏病的最准确的机器学习算法。方法:根据PRISMA指南进行系统回顾。使用Science Direct、PubMedMEDLINE、CINAHL和IEEE explore等多个数据库进行了全面搜索。结果:2017年至2021年间发表的13篇文章符合入选条件。提取了三个主题:预测缺血性心脏病的常用算法,预测缺血性心脏疾病的算法的准确性,以及提高护理质量的临床结果。所有方法都使用了有监督和无监督的机器学习。结论:应用机器学习有望帮助临床医生解释患者的数据并为其数据集实现最佳算法。此外,机器学习可以建立基于证据的基础,支持医疗保健提供者管理需要导管等侵入性程序的个人情况。
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引用次数: 5
Acute Right Ventricular Failure: Pathophysiology, Diagnostic Approach with Emphasis on the Role of Echocardiography. 急性右心室衰竭:病理生理学,超声心动图作用的诊断方法。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.2174/1573403X19666230206115611
Han Naung Tun, Abdallah Almaghraby, Vladyslav Kavalerchyk, Denisa Muraru, Hatem Soliman-Aboumarie, Mahmoud Abdelnabi

Right ventricular function is one of the important predictors of survival in heart failure patients. In the past, there has been only limited knowledge regarding right-sided heart failure when compared to left-sided failure. However, there are more emerging data in recent years, and several studies have emphasized the unique features of the right ventricle regarding its anatomy, pathophysiology, clinical consequences, diagnostic modalities, and treatment options. Despite that, management of acute right ventricular failure is still challenging. This article summarizes an overview of acute right heart failure including pathophysiology, causes, clinical features, and diagnostic work-up with emphasis on the role of echocardiography.

右心室功能是心力衰竭患者生存的重要预测因素之一。在过去,与左侧心力衰竭相比,关于右侧心力衰竭的知识有限。然而,近年来有更多的新数据,一些研究强调了右心室在解剖学、病理生理学、临床后果、诊断模式和治疗选择方面的独特特征。尽管如此,急性右心室衰竭的治疗仍然具有挑战性。本文综述了急性右心衰竭的病理生理学、病因、临床特征和诊断检查,并强调了超声心动图的作用。
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引用次数: 0
Coronary Artery Aneurysms as a Cause of Acute Coronary Syndrome Presentation - A Focused Review. 冠状动脉瘤作为急性冠状动脉综合征的病因——一篇重点综述。
IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 DOI: 10.2174/1573403X19666230331103508
Azka Latif, Amy Tran, Junaid Ahsan, Noman Lateef, Waiel Abusina, Vikas Kapoor, Zoraiz Ahsan, Soban Ahmad, Mohsin Mirza

Coronary artery aneurysms (CAA) are defined as a dilation of a coronary vessel greater than 1.5 times the diameter of a local reference vessel. While CAAs tend to be incidental findings on imaging, they result in complications, such as thrombosis, embolization, ischemia, arrhythmias, and heart failure. Among symptomatic cases, chest pain has been the most common manifestation of CAAs. This necessitates an understanding of CAAs as a cause of acute coronary syndrome (ACS) presentation. However, due to the unclear pathophysiology of CAAs and their variable presentation complicated by similar ACS conditions, there is no clear strategy for CAA management. In this article, we will discuss the contribution of CAAs to ACS presentations and review the current management options for CAAs.

冠状动脉瘤(CAA)是指冠状血管的扩张大于局部参考血管直径的1.5倍。虽然CAA往往是影像学上的偶然发现,但它们会导致并发症,如血栓形成、栓塞、缺血、心律失常和心力衰竭。在有症状的病例中,胸痛是CAA最常见的表现。这就需要了解CAA作为急性冠状动脉综合征(ACS)表现的原因。然而,由于CAA的病理生理学尚不清楚,其可变表现因类似的ACS条件而复杂,因此没有明确的CAA管理策略。在本文中,我们将讨论CAA对ACS演示的贡献,并回顾CAA的当前管理选项。
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引用次数: 0
Vertebral Artery Interventions: A Comprehensive Updated Review. 椎动脉介入治疗:一篇全面更新的综述。
IF 1.9 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2174/1573403X18666220317093131
Oscar Maitas, Tamunoinemi Bob-Manuel, Justin Price, Abdullah Noor, Koyenum Obi, Nelson Okoh, Kiran Garikapati, Jeong Kim, Sanjida Jahan, James S Jenkins

Patients with posterior circulation ischemia due to vertebral artery stenosis account for 20 to 25% of ischemic strokes and have an increased risk of recurrent stroke. In patients treated with medical therapy alone, the risk of recurrence is particularly increased in the first few weeks after symptoms occur, with an annual stroke rate of 10 to 15%. Additionally, obstructive disease of the vertebrobasilar system carries a worse prognosis, with a 30% mortality at 2-years if managed medically without additional surgical or endovascular intervention. Percutaneous transluminal angioplasty and stenting of symptomatic vertebral artery stenosis are promising options widely used in clinical practice with good technical results; however, the improved clinical outcome has been examined in various clinical trials without a sufficient sample size to conclusively determine whether stenting is better than medical therapy. Surgical revascularization is an alternative approach for the treatment of symptomatic vertebral artery stenosis that carries a 10-20% mortality rate. Despite the advances in medical therapy and endovascular and surgical options, symptomatic vertebral artery stenosis continues to impose a high risk of stroke recurrence with associated high morbidity and mortality. This review aims to provide a focused update on the percutaneous treatment of vertebral artery stenosis, its appropriate diagnostic approach, and advances in medical therapies.

由于椎动脉狭窄导致后循环缺血的患者占缺血性中风的20%至25%,并且复发性中风的风险增加。在单独接受药物治疗的患者中,在症状出现后的最初几周,复发的风险尤其增加,每年的中风率为10%至15%。此外,椎基底动脉系统阻塞性疾病的预后更差,如果在没有额外手术或血管内干预的情况下进行医学治疗,2年时死亡率为30%。症状性椎动脉狭窄的经皮腔内血管成形术和支架置入术是临床上广泛应用的有前景的选择,具有良好的技术效果;然而,在没有足够的样本量来最终确定支架置入术是否优于药物治疗的情况下,各种临床试验都对改善的临床结果进行了检查。手术血运重建是治疗症状性椎动脉狭窄的一种替代方法,死亡率为10-20%。尽管在药物治疗、血管内和手术选择方面取得了进展,但有症状的椎动脉狭窄仍然会带来中风复发的高风险,并伴有高发病率和高死亡率。这篇综述旨在对经皮治疗椎动脉狭窄、其适当的诊断方法和医学治疗进展进行重点更新。
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引用次数: 0
Takotsubo Cardiomyopathy and COVID-19: A Case Report and Literature Review. Takotsubo型心肌病与新冠肺炎:病例报告和文献回顾。
IF 1.9 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2174/1573403X18666220818155039
Solís Gabriel José, Edgar Francisco Carrizales-Sepúlveda, Raymundo Vera-Pineda, Eliu Jefte Morales-Rendón, José de Jesús Ortiz-Corona, Ramiro Flores-Ramírez

Background: Takotsubo cardiomyopathy is characterized by transient regional ventricular abnormalities in the absence of coronary artery disease and is reported as a complication of COVID-19.

Case presentation: It can have a diverse clinical presentation, occasionally resembling an acute coronary syndrome, and progress to acute heart failure and cardiogenic shock, adversely affecting patients' prognosis. A high index of suspicion and a thorough diagnostic approach supported by ancillary studies like echocardiography and coronary angiography is key for an accurate diagnosis and correct medical treatment. Herein, we report a patient with severe COVID-19 who developed Takotsubo cardiomyopathy.

Conclusion: We also present a detailed literature review regarding the relationship between COVID-19 and Takotsubo cardiomyopathy.

背景:Takotsubo心肌病的特征是在没有冠状动脉疾病的情况下出现短暂的区域性心室异常,并被报道为COVID-19的并发症。病例表现:它可以有不同的临床表现,偶尔类似于急性冠状动脉综合征,并发展为急性心力衰竭和心源性休克,对患者的预后产生不利影响。高怀疑指数和由超声心动图和冠状动脉造影等辅助研究支持的彻底诊断方法是准确诊断和正确治疗的关键。在此,我们报告了一名患有严重新冠肺炎并发展为Takotsubo心肌病的患者。结论:我们还对新冠肺炎与Takotsubo心肌病之间的关系进行了详细的文献综述。
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引用次数: 0
CHARGE-AF: A Useful Score For Atrial Fibrillation Prediction? CHARGE-AF:预测心房颤动的有用分数?
IF 1.9 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2174/1573403X18666220901102557
Christos Goudis, Stylianos Daios, Fotios Dimitriadis, Tong Liu

Atrial fibrillation (AF) is the commonest arrhythmia in clinical practice and is associated with increased morbidity and mortality. Various predictive scores for new-onset AF have been proposed, but so far, none have been widely used in clinical practice. CHARGE-AF score was developed from a pooled diverse population from three large cohorts (Atherosclerosis Risk in Communities study, Cardiovascular Health Study and Framingham Heart Study). A simple 5-year predictive model includes the variables of age, race, height, weight, systolic and diastolic blood pressure, current smoking, use of antihypertensive medication, diabetes mellitus, history of myocardial infarction and heart failure. Recent studies report that the CHARGE-AF score has good discrimination for incident AF and seems to be a promising prediction model for this arrhythmia. New screening tools (smartphone apps, smartwatches) are rapidly developing for AF detection. Therefore, the wide application of the CHARGE-AF score in clinical practice and the upcoming usage of mobile health technologies and smartwatches may result in better AF prediction and adequate stroke prevention, especially in high-risk patients.

心房颤动(AF)是临床上最常见的心律失常,与发病率和死亡率的增加有关。新发性房颤的各种预测评分已经被提出,但到目前为止,还没有一种在临床实践中得到广泛应用。CHARGE-AF评分是从三个大队列(社区动脉粥样硬化风险研究、心血管健康研究和弗雷明汉心脏研究)的不同人群中得出的。一个简单的5年预测模型包括年龄、种族、身高、体重、收缩压和舒张压、当前吸烟、抗高血压药物的使用、糖尿病、心肌梗死和心力衰竭史等变量。最近的研究报告称,CHARGE-AF评分对发生的房颤有很好的辨别力,似乎是这种心律失常的一个很有前途的预测模型。新的AF检测筛查工具(智能手机应用程序、智能手表)正在迅速发展。因此,CHARGE-AF评分在临床实践中的广泛应用,以及移动健康技术和智能手表的即将使用,可能会带来更好的AF预测和充分的中风预防,尤其是在高危患者中。
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引用次数: 0
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Current Cardiology Reviews
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