Pub Date : 2024-10-17eCollection Date: 2024-01-01DOI: 10.3389/fcvm.2024.1449058
Cheng-Yang Jing, Le Zhang, Lin Feng, Jia-Chen Li, Li-Rong Liang, Jing Hu, Xing Liao
Background: This study aimed to synthesize the recommendations for prediction models in cardiovascular clinical practice guidelines (CPGs) and assess the methodological quality of the relevant primary modeling studies.
Methods: We performed a systematic literature search of all available cardiovascular CPGs published between 2018 and 2023 that presented specific recommendations (whether in support or non-support) for at least one multivariable clinical prediction model. For the guideline-recommended models, the assessment of the methodological quality of their primary modeling studies was conducted using the Prediction model Risk Of Bias ASsessment Tool (PROBAST).
Results: In total, 46 qualified cardiovascular CPGs were included, with 69 prediction models and 80 specific recommendations. Of the 80 specific recommendations, 74 supported 57 models (53 were fully recommended and 4 were conditionally recommended) in cardiovascular practice with moderate to strong strength. Most of the guideline-recommended models were focused on predicting prognosis outcomes (53/57, 93%) in primary and tertiary prevention, focusing primarily on long-term risk stratification and prognosis management. A total of 10 conditions and 7 types of target population were involved in the 57 models, while heart failure (14/57, 25%) and a general population with or without cardiovascular risk factor(s) (12/57, 21%) received the most attention from the guidelines. The assessment of the methodological quality of 57 primary studies on the development of the guideline-recommended models revealed that only 40% of the modeling studies had a low risk of bias (ROB). The causes of high ROB were mainly in the analysis and participant domains.
Conclusions: Global cardiovascular CPGs presented an unduly positive appraisal of the existing prediction models in terms of ROB, leading to stronger recommendations than were warranted. Future cardiovascular practice may benefit from well-established clinical prediction models with better methodological quality and extensive external validation.
{"title":"Recommendations for prediction models in clinical practice guidelines for cardiovascular diseases are over-optimistic: a global survey utilizing a systematic literature search.","authors":"Cheng-Yang Jing, Le Zhang, Lin Feng, Jia-Chen Li, Li-Rong Liang, Jing Hu, Xing Liao","doi":"10.3389/fcvm.2024.1449058","DOIUrl":"10.3389/fcvm.2024.1449058","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to synthesize the recommendations for prediction models in cardiovascular clinical practice guidelines (CPGs) and assess the methodological quality of the relevant primary modeling studies.</p><p><strong>Methods: </strong>We performed a systematic literature search of all available cardiovascular CPGs published between 2018 and 2023 that presented specific recommendations (whether in support or non-support) for at least one multivariable clinical prediction model. For the guideline-recommended models, the assessment of the methodological quality of their primary modeling studies was conducted using the Prediction model Risk Of Bias ASsessment Tool (PROBAST).</p><p><strong>Results: </strong>In total, 46 qualified cardiovascular CPGs were included, with 69 prediction models and 80 specific recommendations. Of the 80 specific recommendations, 74 supported 57 models (53 were fully recommended and 4 were conditionally recommended) in cardiovascular practice with moderate to strong strength. Most of the guideline-recommended models were focused on predicting prognosis outcomes (53/57, 93%) in primary and tertiary prevention, focusing primarily on long-term risk stratification and prognosis management. A total of 10 conditions and 7 types of target population were involved in the 57 models, while heart failure (14/57, 25%) and a general population with or without cardiovascular risk factor(s) (12/57, 21%) received the most attention from the guidelines. The assessment of the methodological quality of 57 primary studies on the development of the guideline-recommended models revealed that only 40% of the modeling studies had a low risk of bias (ROB). The causes of high ROB were mainly in the analysis and participant domains.</p><p><strong>Conclusions: </strong>Global cardiovascular CPGs presented an unduly positive appraisal of the existing prediction models in terms of ROB, leading to stronger recommendations than were warranted. Future cardiovascular practice may benefit from well-established clinical prediction models with better methodological quality and extensive external validation.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1449058"},"PeriodicalIF":2.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557528","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}
Pub Date : 2024-10-17eCollection Date: 2024-01-01DOI: 10.3389/fcvm.2024.1432235
Jiaqi Fan, Jun Chen, Lihan Wang, Po Hu, Jubo Jiang, Xinping Lin, Giorgia Rocatello, Matthieu De Beule, Yi Tie, Yifei Wang, Sihang Cheng, Xianbao Liu, Jian'an Wang
Background: Coronary obstruction (CO) is a rare but devasting complication during transcatheter aortic valve replacement (TAVR).
Objectives: We aim to demonstrate that the predicted distance between the coronary ostia and the closest structure derived with patient-specific computer simulation is associated with CO risk during TAVR.
Methods: We retrospectively analysed 14 aortic stenosis patients who underwent TAVR through finite element simulation. The frame deformation predicted with patient-specific computer simulation was qualitatively and quantitatively compared to the post-operative device deformation. The minimum distance between each coronary ostium and the closest structure was calculated and compared in patients who developed CO, at high risk of CO, and at no risk of CO.
Results: Four patients experienced CO during TAVR, 5 patients were at high risk of CO, and the remaining 5 patients had no risk of CO. A high coefficient of determination was obtained for all measurements extracted from the simulated device and the post-operative device (≥0.95). Simulations predicted shorter distance between the coronary ostium and the closest structure in patients who experienced CO, compared to patients at high risk of CO or who did not experience this complication (right coronary: 5.9 vs. 6.8 vs. 8.8 mm, left coronary: 3.0 vs. 3.3 vs. 6.5 mm respectively).
Conclusions: The distance between the coronary ostium and the closest structure was lower in patients who experienced CO during TAVR through patient-specific computational simulation. This technology enables coronary obstruction analysis before TAVR in the future.
背景:冠状动脉阻塞(CO)是经导管主动脉瓣置换术(TAVR)中一种罕见但严重的并发症:我们的目的是证明,通过患者特异性计算机模拟得出的冠状动脉口与最近结构之间的预测距离与TAVR期间的冠状动脉阻塞风险有关:方法:我们通过有限元模拟对 14 名接受 TAVR 的主动脉瓣狭窄患者进行了回顾性分析。我们将患者特定计算机模拟预测的支架变形与术后设备变形进行了定性和定量比较。计算了每个冠状动脉骨膜与最近结构之间的最小距离,并对出现 CO、CO 高风险和无 CO 风险的患者进行了比较:结果:4 名患者在 TAVR 期间发生了 CO,5 名患者有 CO 的高风险,其余 5 名患者没有 CO 的风险。从模拟设备和术后设备中提取的所有测量值的决定系数都很高(≥0.95)。与 CO 高风险患者或未发生 CO 并发症的患者相比,模拟预测发生 CO 的患者冠状动脉骨膜与最近结构之间的距离较短(右冠状动脉:5.9 mm vs. 6.8 mm vs. 8.8 mm,左冠状动脉:3.0 mm vs. 3.3 mm vs. 6.5 mm):结论:通过患者特异性计算模拟,在TAVR过程中出现CO的患者冠状动脉骨膜与最近结构之间的距离较小。该技术可在未来的 TAVR 术前进行冠状动脉阻塞分析。
{"title":"Coronary obstruction analysis in transcatheter aortic valve implantation through patient-specific computational modelling.","authors":"Jiaqi Fan, Jun Chen, Lihan Wang, Po Hu, Jubo Jiang, Xinping Lin, Giorgia Rocatello, Matthieu De Beule, Yi Tie, Yifei Wang, Sihang Cheng, Xianbao Liu, Jian'an Wang","doi":"10.3389/fcvm.2024.1432235","DOIUrl":"10.3389/fcvm.2024.1432235","url":null,"abstract":"<p><strong>Background: </strong>Coronary obstruction (CO) is a rare but devasting complication during transcatheter aortic valve replacement (TAVR).</p><p><strong>Objectives: </strong>We aim to demonstrate that the predicted distance between the coronary ostia and the closest structure derived with patient-specific computer simulation is associated with CO risk during TAVR.</p><p><strong>Methods: </strong>We retrospectively analysed 14 aortic stenosis patients who underwent TAVR through finite element simulation. The frame deformation predicted with patient-specific computer simulation was qualitatively and quantitatively compared to the post-operative device deformation. The minimum distance between each coronary ostium and the closest structure was calculated and compared in patients who developed CO, at high risk of CO, and at no risk of CO.</p><p><strong>Results: </strong>Four patients experienced CO during TAVR, 5 patients were at high risk of CO, and the remaining 5 patients had no risk of CO. A high coefficient of determination was obtained for all measurements extracted from the simulated device and the post-operative device (≥0.95). Simulations predicted shorter distance between the coronary ostium and the closest structure in patients who experienced CO, compared to patients at high risk of CO or who did not experience this complication (right coronary: 5.9 vs. 6.8 vs. 8.8 mm, left coronary: 3.0 vs. 3.3 vs. 6.5 mm respectively).</p><p><strong>Conclusions: </strong>The distance between the coronary ostium and the closest structure was lower in patients who experienced CO during TAVR through patient-specific computational simulation. This technology enables coronary obstruction analysis before TAVR in the future.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1432235"},"PeriodicalIF":2.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557526","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}
Pub Date : 2024-10-17eCollection Date: 2024-01-01DOI: 10.3389/fcvm.2024.1447913
Chenkai Xu, Yongfu Song, Yuejiao Lan, Yongji Wang, Na Wang, Xiaodan Lu
Objectives: There is limited amount of research on the association between fecal incontinence (FI) and cardiovascular disease (CVD). This study aims to evaluate whether there is a relationship between FI and CVD among adults in the United States.
Methods: This study employed a cross-sectional design, encompassing 11,237 adults aged 20 years and older, drawn from the National Health and Nutrition Survey conducted from 2005 to 2010. FI was defined as the involuntary monthly leakage of solid, liquid, or mucus stool. The presence of CVD was evaluated through a questionnaire. Adjusted odds ratios (OR) were computed utilizing a multivariate logistic regression model. Subgroup analyses were conducted to ascertain the stability of the results.
Results: Following adjustments for population characteristics, lifestyle habits, laboratory tests, and comorbidities, a significant association was observed between FI and elevated CVD risk (OR: 1.47, 95% CI: 1.21-1.79, P < 0.001). Subgroup analysis uncovered a strong correlation between FI and CVD among participants aged 45-65 years (OR: 1.78, 95%CI: 1.31-2.43). In the participants to aged 66 and above, this correlation persisted (OR: 1.31, 95% CI: 1.01-1.70).
Conclusions: This study reveals a significant positive correlation between FI and CVD. Middle-aged and older adults are considered high-risk population for developing CVD, thus emphasizing the importance of screening and timely intervention.
研究目的有关大便失禁(FI)与心血管疾病(CVD)之间关系的研究数量有限。本研究旨在评估美国成年人大便失禁与心血管疾病之间是否存在关系:本研究采用横断面设计,从 2005 年至 2010 年进行的全国健康与营养调查中抽取了 11,237 名 20 岁及以上的成年人。FI的定义是每月不自主地排出固体、液体或粘液粪便。是否患有心血管疾病通过问卷进行评估。利用多变量逻辑回归模型计算调整后的几率比(OR)。为确定结果的稳定性,还进行了分组分析:在对人群特征、生活习惯、实验室检查和合并症进行调整后,观察到 FI 与心血管疾病风险升高之间存在显著关联(OR:1.47,95% CI:1.21-1.79,P 结论:该研究揭示了 FI 与心血管疾病风险升高之间的显著正相关:本研究揭示了 FI 与心血管疾病之间的显著正相关性。中老年人被认为是心血管疾病的高危人群,因此强调了筛查和及时干预的重要性。
{"title":"Association between fecal incontinence and cardiovascular disease in adult Americans: evidence from NHANES 2005-2010.","authors":"Chenkai Xu, Yongfu Song, Yuejiao Lan, Yongji Wang, Na Wang, Xiaodan Lu","doi":"10.3389/fcvm.2024.1447913","DOIUrl":"10.3389/fcvm.2024.1447913","url":null,"abstract":"<p><strong>Objectives: </strong>There is limited amount of research on the association between fecal incontinence (FI) and cardiovascular disease (CVD). This study aims to evaluate whether there is a relationship between FI and CVD among adults in the United States.</p><p><strong>Methods: </strong>This study employed a cross-sectional design, encompassing 11,237 adults aged 20 years and older, drawn from the National Health and Nutrition Survey conducted from 2005 to 2010. FI was defined as the involuntary monthly leakage of solid, liquid, or mucus stool. The presence of CVD was evaluated through a questionnaire. Adjusted odds ratios (OR) were computed utilizing a multivariate logistic regression model. Subgroup analyses were conducted to ascertain the stability of the results.</p><p><strong>Results: </strong>Following adjustments for population characteristics, lifestyle habits, laboratory tests, and comorbidities, a significant association was observed between FI and elevated CVD risk (OR: 1.47, 95% CI: 1.21-1.79, <i>P</i> < 0.001). Subgroup analysis uncovered a strong correlation between FI and CVD among participants aged 45-65 years (OR: 1.78, 95%CI: 1.31-2.43). In the participants to aged 66 and above, this correlation persisted (OR: 1.31, 95% CI: 1.01-1.70).</p><p><strong>Conclusions: </strong>This study reveals a significant positive correlation between FI and CVD. Middle-aged and older adults are considered high-risk population for developing CVD, thus emphasizing the importance of screening and timely intervention.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1447913"},"PeriodicalIF":2.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557525","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}
<p><strong>Objective: </strong>Aortic dissection (AD) is a severe aortic disease with high mortality, and its pathogenesis remains elusive. To explore the regulatory mechanisms of AD, we integrated public RNA sequencing (RNA-seq) and single-cell RNA sequencing (scRNA-seq) datasets to screen the hub genes of AD and further analyzed their functions, which may provide references to the diagnosis and treatment of AD.</p><p><strong>Methods: </strong>Four AD-related datasets were obtained from the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis and differential expression analysis were applied to identify overlapping genes in dataset GSE153434. Protein-protein interaction (PPI) network was constructed based on overlapping genes. Five methods (closeness, degree, EPC, MCC, and MNN) were used to pick hub genes. The receiver operating characteristic curve was used to evaluate the diagnostic efficiency of the hub genes in extra datasets GSE98770 and GSE52093. scRNA-seq dataset GSE213740 was used to explore the expression and function of the hub genes at the single-cell level. Quantitative real-time polymerase chain reaction was used to verify the expression of hub genes in beta-aminopropionitrile (BAPN)-induced mouse thoracic aortic aneurysm and dissection (TAAD) model.</p><p><strong>Results: </strong>A total of 71 overlapping genes were screened by intersecting the significant genes in the pink module and the differentially expressed genes. A PPI network with 45 nodes and 74 edges was generated, and five top hub genes (<i>HIF1A</i>, <i>HGF</i>, <i>HMOX1</i>, <i>ITGA5</i>, and <i>ITGB3</i>) were identified. All the hub genes had area under the curve values above 0.55. scRNA-seq data analysis showed that <i>HIF1A</i> was significantly upregulated in macrophages and <i>HGF</i> was significantly upregulated in vascular smooth muscle cells (SMCs) of the ascending aortas in AD patients. HIF1A may transcriptionally regulate multiple downstream target genes involving inflammation (<i>TLR2</i>, <i>ALOX5AP</i>, and <i>MIF</i>), glycolysis (<i>ENO1</i>, <i>LDHA</i>, and <i>GAPDH</i>), tissue remodeling (<i>PLAU</i>), and angiogenesis (<i>SERPIN</i> and <i>VEGFA</i>). HGF may participate in the signaling among SMCs, fibroblasts, and endothelial cells through binding to different receptors (MET, EGFR, IGF1R, and KDR). The mRNA expression of <i>Hif1a</i>, <i>Hgf</i>, and their target genes, including <i>Alox5ap</i>, <i>Serpine1</i>, <i>Tlr2</i>, <i>Plau</i>, <i>Egfr</i>, and <i>Igf1r</i>, was significantly upregulated in aortic tissues of BAPN-treated mice.</p><p><strong>Conclusion: </strong>By integrating RNA-seq and scRNA-seq data, we identified <i>HIF1A</i> and <i>HGF</i> as two hub genes with good diagnostic efficiency for AD. HIF1A in macrophages may promote AD formation by promoting inflammation, glycolysis, tissue remodeling, and angiogenesis, and HGF may mediate signaling among SMCs, fibroblasts, and endothelial cells in the
{"title":"Identifying <i>HIF1A</i> and <i>HGF</i> as two hub genes in aortic dissection and function analysis by integrating RNA sequencing and single-cell RNA sequencing data.","authors":"Hai-Bing Li, Chang Liu, Xiang-Di Mao, Shu-Zheng Yuan, Li Li, Xin Cong","doi":"10.3389/fcvm.2024.1475991","DOIUrl":"10.3389/fcvm.2024.1475991","url":null,"abstract":"<p><strong>Objective: </strong>Aortic dissection (AD) is a severe aortic disease with high mortality, and its pathogenesis remains elusive. To explore the regulatory mechanisms of AD, we integrated public RNA sequencing (RNA-seq) and single-cell RNA sequencing (scRNA-seq) datasets to screen the hub genes of AD and further analyzed their functions, which may provide references to the diagnosis and treatment of AD.</p><p><strong>Methods: </strong>Four AD-related datasets were obtained from the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis and differential expression analysis were applied to identify overlapping genes in dataset GSE153434. Protein-protein interaction (PPI) network was constructed based on overlapping genes. Five methods (closeness, degree, EPC, MCC, and MNN) were used to pick hub genes. The receiver operating characteristic curve was used to evaluate the diagnostic efficiency of the hub genes in extra datasets GSE98770 and GSE52093. scRNA-seq dataset GSE213740 was used to explore the expression and function of the hub genes at the single-cell level. Quantitative real-time polymerase chain reaction was used to verify the expression of hub genes in beta-aminopropionitrile (BAPN)-induced mouse thoracic aortic aneurysm and dissection (TAAD) model.</p><p><strong>Results: </strong>A total of 71 overlapping genes were screened by intersecting the significant genes in the pink module and the differentially expressed genes. A PPI network with 45 nodes and 74 edges was generated, and five top hub genes (<i>HIF1A</i>, <i>HGF</i>, <i>HMOX1</i>, <i>ITGA5</i>, and <i>ITGB3</i>) were identified. All the hub genes had area under the curve values above 0.55. scRNA-seq data analysis showed that <i>HIF1A</i> was significantly upregulated in macrophages and <i>HGF</i> was significantly upregulated in vascular smooth muscle cells (SMCs) of the ascending aortas in AD patients. HIF1A may transcriptionally regulate multiple downstream target genes involving inflammation (<i>TLR2</i>, <i>ALOX5AP</i>, and <i>MIF</i>), glycolysis (<i>ENO1</i>, <i>LDHA</i>, and <i>GAPDH</i>), tissue remodeling (<i>PLAU</i>), and angiogenesis (<i>SERPIN</i> and <i>VEGFA</i>). HGF may participate in the signaling among SMCs, fibroblasts, and endothelial cells through binding to different receptors (MET, EGFR, IGF1R, and KDR). The mRNA expression of <i>Hif1a</i>, <i>Hgf</i>, and their target genes, including <i>Alox5ap</i>, <i>Serpine1</i>, <i>Tlr2</i>, <i>Plau</i>, <i>Egfr</i>, and <i>Igf1r</i>, was significantly upregulated in aortic tissues of BAPN-treated mice.</p><p><strong>Conclusion: </strong>By integrating RNA-seq and scRNA-seq data, we identified <i>HIF1A</i> and <i>HGF</i> as two hub genes with good diagnostic efficiency for AD. HIF1A in macrophages may promote AD formation by promoting inflammation, glycolysis, tissue remodeling, and angiogenesis, and HGF may mediate signaling among SMCs, fibroblasts, and endothelial cells in the ","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1475991"},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544675","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}
Pub Date : 2024-10-16eCollection Date: 2024-01-01DOI: 10.3389/fcvm.2024.1366180
Decai Zeng, Shuai Chang, Xiaofeng Zhang, Yanfeng Zhong, Cai Yongzhi, Tongtong Huang, Ji Wu
Background: The thickness and motion of the Interatrial Septum (IAS) possibly serves as indicators of both structural and functional remodeling of left atrium. This study aims to use transesophageal echocardiography (TEE) to assess IAS motion in non-valvular atrial fibrillation (NVAF) and investigate its correlation with the risk of spontaneous echo contrast (SEC) and thrombus (TH).
Methods: We conducted a cross-sectional study on 318 patients with NVAF who underwent transthoracic echocardiography and TEE. IAS motion was defined as the maximum displacement of IAS observed throughout the cardiac cycles using M-mode TEE.
Results: The prevalence of SEC/TH was 39.9% (127/318) in the overall group. In paroxysmal atrial fibrillation (PAF), the prevalence rate of SEC/TH was 25.3% (47/186), compared to 60.6% (80/132) in persistent atrial fibrillation (PeAF). Multivariable analyses showed that LA volume index (LAVI), mean E/e', S/D ratio, IAS motion and CHA2DS2-VASc scores were significantly associated with SEC/TH. Patients with lower IAS motion showed a higher prevalence of SEC/TH compared to those with higher IAS motion (71.3% vs. 11.6%; P < 0.001). The IAS motion under sinus rhythm could better predict risk of SEC/TH, while the predictive efficacy under AF rhythm was slightly attenuated but still had a high AUC value (0.779). A significant positive correlation was observed between the IAS motion and the LAA filling velocity (PAF r = 0.47; P<0.001 and PeAF r = 0.38; P < 0.001, respectively), LAA emptying velocity (PAF r = 0.55; P < 0.001 and PeAF r = 0.47; P < 0.001, respectively) and LAVI (PAF r = 0.59; P < 0.001 and PeAF r = 0.44; P < 0.001, respectively). The integration of the IAS motion to the CHA2DS2-VASc, LAVI and mean E/e' provided important incremental predictive value of SEC/TH (AUC = 0.859 vs. 0.826, P = 0.02).
Conclusion: IAS motion measured by TEE correlates well with LAA flow velocity and LA size and is independently associated with SEC/TH in NVAF. Additionally, lower IAS motion is associated with a higher prevalence of SEC/TH. Furthermore, the integration of IAS motion to CHA2DS2-VASc, LAVI and mean E/e' can provide additional value for the prediction of SEC/TH.
背景:房间隔(IAS)的厚度和运动可能是左心房结构和功能重塑的指标。本研究旨在使用经食道超声心动图(TEE)评估非瓣膜性心房颤动(NVAF)患者的 IAS 运动,并研究其与自发回声对比(SEC)和血栓(TH)风险的相关性:我们对 318 名接受经胸超声心动图和 TEE 检查的 NVAF 患者进行了横断面研究。IAS运动定义为使用M型TEE观察到的整个心动周期中IAS的最大位移:结果:SEC/TH的发病率为39.9%(127/318)。在阵发性心房颤动(PAF)中,SEC/TH的患病率为25.3%(47/186),而在持续性心房颤动(PeAF)中,SEC/TH的患病率为60.6%(80/132)。多变量分析显示,LA容积指数(LAVI)、平均E/e'、S/D比值、IAS运动和CHA2DS2-VASc评分与SEC/TH显著相关。与 IAS 运动较高的患者相比,IAS 运动较低的患者 SEC/TH 患病率更高(71.3% vs. 11.6%;P r = 0.47;Pr = 0.38;P r = 0.55;P r = 0.47;P r = 0.59;P r = 0.44;P P = 0.02):结论:通过 TEE 测量的 IAS 运动与 LAA 流速和 LA 大小密切相关,并且与 NVAF 的 SEC/TH 独立相关。此外,较低的 IAS 运动与较高的 SEC/TH 发生率相关。此外,将 IAS 运动与 CHA2DS2-VASc、LAVI 和平均 E/e' 整合可为 SEC/TH 的预测提供额外价值。
{"title":"The incremental value of interatrial septum motion in predicting thrombus or spontaneous echo contrast in patients with non-valvular atrial fibrillation: an observational study on transesophageal echocardiography.","authors":"Decai Zeng, Shuai Chang, Xiaofeng Zhang, Yanfeng Zhong, Cai Yongzhi, Tongtong Huang, Ji Wu","doi":"10.3389/fcvm.2024.1366180","DOIUrl":"10.3389/fcvm.2024.1366180","url":null,"abstract":"<p><strong>Background: </strong>The thickness and motion of the Interatrial Septum (IAS) possibly serves as indicators of both structural and functional remodeling of left atrium. This study aims to use transesophageal echocardiography (TEE) to assess IAS motion in non-valvular atrial fibrillation (NVAF) and investigate its correlation with the risk of spontaneous echo contrast (SEC) and thrombus (TH).</p><p><strong>Methods: </strong>We conducted a cross-sectional study on 318 patients with NVAF who underwent transthoracic echocardiography and TEE. IAS motion was defined as the maximum displacement of IAS observed throughout the cardiac cycles using M-mode TEE.</p><p><strong>Results: </strong>The prevalence of SEC/TH was 39.9% (127/318) in the overall group. In paroxysmal atrial fibrillation (PAF), the prevalence rate of SEC/TH was 25.3% (47/186), compared to 60.6% (80/132) in persistent atrial fibrillation (PeAF). Multivariable analyses showed that LA volume index (LAVI), mean E/e', S/D ratio, IAS motion and CHA2DS2-VASc scores were significantly associated with SEC/TH. Patients with lower IAS motion showed a higher prevalence of SEC/TH compared to those with higher IAS motion (71.3% vs. 11.6%; <i>P</i> < 0.001). The IAS motion under sinus rhythm could better predict risk of SEC/TH, while the predictive efficacy under AF rhythm was slightly attenuated but still had a high AUC value (0.779). A significant positive correlation was observed between the IAS motion and the LAA filling velocity (PAF <i>r</i> = 0.47; <i>P</i><0.001 and PeAF <i>r</i> = 0.38; <i>P</i> < 0.001, respectively), LAA emptying velocity (PAF <i>r</i> = 0.55; <i>P</i> < 0.001 and PeAF <i>r</i> = 0.47; <i>P</i> < 0.001, respectively) and LAVI (PAF <i>r</i> = 0.59; <i>P</i> < 0.001 and PeAF <i>r</i> = 0.44; <i>P</i> < 0.001, respectively). The integration of the IAS motion to the CHA2DS2-VASc, LAVI and mean E/e' provided important incremental predictive value of SEC/TH (AUC = 0.859 vs. 0.826, <i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>IAS motion measured by TEE correlates well with LAA flow velocity and LA size and is independently associated with SEC/TH in NVAF. Additionally, lower IAS motion is associated with a higher prevalence of SEC/TH. Furthermore, the integration of IAS motion to CHA2DS2-VASc, LAVI and mean E/e' can provide additional value for the prediction of SEC/TH.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1366180"},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544680","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}
Pub Date : 2024-10-16eCollection Date: 2024-01-01DOI: 10.3389/fcvm.2024.1396973
Wei Bao, Yan Zhang, Xiao-Jia Huang, Ning Gu
Objective: Investigating the causal connection that exists between inflammatory bowel disease (IBD) and hypertension (HT). To gain a deeper insight into the correlation among IBD, gut microbiota, and HT, we conducted a two-step, two-sample Mendelian randomization study.
Methods: An investigation of genome-wide association study (GWAS) summary-level data was utilized to conduct a two-sample Mendelian randomization (MR) analysis of genetically predicted inflammatory bowel disease: (12,882cases, 21,770controls) on Systolic/Diastolic blood pressure (N = 2,564). Subsequently, two-step MR analyses revealed that the relationship between IBD and SBP was partly mediated by Faecalicatena glycyrrhizinilyticum. The robustness of the findings was confirmed through several sensitivity assessments.
Results: This MR study showed that increase in genetically predicted IBD was associated with higher risk of genetically predicted SBP (OR: 1.08, 95% CI: 1.01-1.16, P < 0.05) and DBP (OR: 1.09, 95% CI: 1.02-1.17, P < 0.05), respectively. Inverse variance weighted (IVW) MR analysis also showed that increase in genetically predicted IBD was associated with higher abundance Faecalicatena glycyrrhizinilyticum (OR: 1.03, 95% CI: 1.01-1.04, P < 0.05), which subsequently associated with increased SBP risk (OR: 1.42, 95% CI: 1.06-1.9, P < 0.05). Faecalicatena glycyrrhizinilyticum abundance in stool was responsible for mediating 11% of the genetically predicted IBD on SBP.
Conclusion: The research proposed a causal link between Inflammatory Bowel Disease (IBD) and Hypertension (HT), with a little percentage of the impact being influenced by Faecalicatena glycyrrhizinilyticum in stool. Mitigating gut microbiome may decrease the heightened risk of hypertension in people with inflammatory bowel disease.
{"title":"The role of gut microbiome in mediating the effect of inflammatory bowel disease on hypertension: a two-step, two-sample Mendelian randomization study.","authors":"Wei Bao, Yan Zhang, Xiao-Jia Huang, Ning Gu","doi":"10.3389/fcvm.2024.1396973","DOIUrl":"10.3389/fcvm.2024.1396973","url":null,"abstract":"<p><strong>Objective: </strong>Investigating the causal connection that exists between inflammatory bowel disease (IBD) and hypertension (HT). To gain a deeper insight into the correlation among IBD, gut microbiota, and HT, we conducted a two-step, two-sample Mendelian randomization study.</p><p><strong>Methods: </strong>An investigation of genome-wide association study (GWAS) summary-level data was utilized to conduct a two-sample Mendelian randomization (MR) analysis of genetically predicted inflammatory bowel disease: (12,882cases, 21,770controls) on Systolic/Diastolic blood pressure (<i>N</i> = 2,564). Subsequently, two-step MR analyses revealed that the relationship between IBD and SBP was partly mediated by <i>Faecalicatena glycyrrhizinilyticum</i>. The robustness of the findings was confirmed through several sensitivity assessments.</p><p><strong>Results: </strong>This MR study showed that increase in genetically predicted IBD was associated with higher risk of genetically predicted SBP (OR: 1.08, 95% CI: 1.01-1.16, <i>P</i> < 0.05) and DBP (OR: 1.09, 95% CI: 1.02-1.17, <i>P</i> < 0.05), respectively. Inverse variance weighted (IVW) MR analysis also showed that increase in genetically predicted IBD was associated with higher abundance <i>Faecalicatena glycyrrhizinilyticum</i> (OR: 1.03, 95% CI: 1.01-1.04, <i>P</i> < 0.05), which subsequently associated with increased SBP risk (OR: 1.42, 95% CI: 1.06-1.9, <i>P</i> < 0.05). <i>Faecalicatena glycyrrhizinilyticum</i> abundance in stool was responsible for mediating 11% of the genetically predicted IBD on SBP.</p><p><strong>Conclusion: </strong>The research proposed a causal link between Inflammatory Bowel Disease (IBD) and Hypertension (HT), with a little percentage of the impact being influenced by <i>Faecalicatena glycyrrhizinilyticum</i> in stool. Mitigating gut microbiome may decrease the heightened risk of hypertension in people with inflammatory bowel disease.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1396973"},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544681","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}
Pub Date : 2024-10-16eCollection Date: 2024-01-01DOI: 10.3389/fcvm.2024.1498410
Liane Beretta De Azevedo, Gabriel Grizzo Cucato, Bente Morseth
{"title":"Editorial: Sedentary behaviour and cardiometabolic health.","authors":"Liane Beretta De Azevedo, Gabriel Grizzo Cucato, Bente Morseth","doi":"10.3389/fcvm.2024.1498410","DOIUrl":"10.3389/fcvm.2024.1498410","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1498410"},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142550049","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}
Pub Date : 2024-10-16eCollection Date: 2024-01-01DOI: 10.3389/fcvm.2024.1435738
Maira Rubab, John D Kelleher
Previous research has suggested a potential link between vitamin D (VD) deficiency and adverse cardiovascular health outcomes, although the findings have been inconsistent. This study investigates the association between VD deficiency and cardiovascular disease (CVD) within the context of established CVD risk factors. We utilized a Random Forest model to predict both CVD and VD deficiency risks, using a dataset of 1,078 observations from a rural Chinese population. Feature importance was evaluated using SHapley Additive exPlanations (SHAP) to discern the impact of various risk factors on the model's output. The results showed that the model for CVD prediction achieved a high accuracy of 87%, demonstrating robust performance across precision, recall, and F1 score metrics. Conversely, the VD deficiency prediction model exhibited suboptimal performance, with an accuracy of 52% and lower precision, recall, and F1 scores. Feature importance analysis indicated that traditional risk factors such as systolic blood pressure, diastolic blood pressure, age, body mass index, and waist-to-hip ratio significantly influenced CVD risk, collectively contributing to 70% of the model's predictive power. Although VD deficiency was associated with an increased risk of CVD, its importance in predicting CVD risk was notably low. Similarly, for VD deficiency prediction, CVD risk factors such as systolic blood pressure, glucose levels, diastolic blood pressure, and body mass index emerged as influential features. However, the overall predictive performance of the VD deficiency prediction model was weak (52%), indicating the absence of VD deficiency-related risk factors. Ablation experiments confirmed the relatively lower importance of VD deficiency in predicting CVD risk. Furthermore, the SHAP partial dependence plot revealed a nonlinear relationship between VD levels and CVD risk. In conclusion, while VD deficiency appears directly or indirectly associated with increased CVD risk, its relative importance within predictive models is considerably lower when compared to other risk factors. These findings suggest that VD deficiency may not warrant primary focus in CVD risk assessment and prevention strategies, however, further research is needed to explore the causal relationship between VD deficiency and CVD risk.
以往的研究表明,维生素 D(VD)缺乏与不良心血管健康后果之间存在潜在联系,但研究结果并不一致。本研究结合已确定的心血管疾病(CVD)风险因素,调查了维生素 D 缺乏与心血管疾病(CVD)之间的关联。我们使用随机森林模型预测心血管疾病和 VD 缺乏的风险,数据集包含来自中国农村人口的 1,078 个观测值。使用SHapley Additive exPlanations(SHAP)评估了特征的重要性,以辨别各种风险因素对模型输出结果的影响。结果表明,心血管疾病预测模型的准确率高达 87%,在精确度、召回率和 F1 分数指标上都表现出稳健的性能。相反,VD 缺乏症预测模型表现不佳,准确率为 52%,精确度、召回率和 F1 分数都较低。特征重要性分析表明,收缩压、舒张压、年龄、体重指数和腰臀比等传统风险因素对心血管疾病风险有显著影响,共占模型预测能力的 70%。尽管VD缺乏与心血管疾病风险的增加有关,但其在预测心血管疾病风险方面的重要性明显较低。同样,对于 VD 缺乏症的预测,收缩压、血糖水平、舒张压和体重指数等心血管疾病风险因素也是有影响的特征。然而,VD 缺乏症预测模型的整体预测性能较弱(52%),表明缺乏 VD 缺乏症相关的风险因素。消融实验证实,VD 缺乏在预测心血管疾病风险方面的重要性相对较低。此外,SHAP 部分依存图显示 VD 水平与心血管疾病风险之间存在非线性关系。总之,尽管VD缺乏似乎与心血管疾病风险的增加直接或间接相关,但与其他风险因素相比,其在预测模型中的相对重要性要低得多。这些研究结果表明,在心血管疾病风险评估和预防策略中,VD 缺乏可能不值得重点关注,但是,还需要进一步研究来探讨 VD 缺乏与心血管疾病风险之间的因果关系。
{"title":"Assessing the relative importance of vitamin D deficiency in cardiovascular health.","authors":"Maira Rubab, John D Kelleher","doi":"10.3389/fcvm.2024.1435738","DOIUrl":"10.3389/fcvm.2024.1435738","url":null,"abstract":"<p><p>Previous research has suggested a potential link between vitamin D (VD) deficiency and adverse cardiovascular health outcomes, although the findings have been inconsistent. This study investigates the association between VD deficiency and cardiovascular disease (CVD) within the context of established CVD risk factors. We utilized a Random Forest model to predict both CVD and VD deficiency risks, using a dataset of 1,078 observations from a rural Chinese population. Feature importance was evaluated using SHapley Additive exPlanations (SHAP) to discern the impact of various risk factors on the model's output. The results showed that the model for CVD prediction achieved a high accuracy of 87%, demonstrating robust performance across precision, recall, and F1 score metrics. Conversely, the VD deficiency prediction model exhibited suboptimal performance, with an accuracy of 52% and lower precision, recall, and F1 scores. Feature importance analysis indicated that traditional risk factors such as systolic blood pressure, diastolic blood pressure, age, body mass index, and waist-to-hip ratio significantly influenced CVD risk, collectively contributing to 70% of the model's predictive power. Although VD deficiency was associated with an increased risk of CVD, its importance in predicting CVD risk was notably low. Similarly, for VD deficiency prediction, CVD risk factors such as systolic blood pressure, glucose levels, diastolic blood pressure, and body mass index emerged as influential features. However, the overall predictive performance of the VD deficiency prediction model was weak (52%), indicating the absence of VD deficiency-related risk factors. Ablation experiments confirmed the relatively lower importance of VD deficiency in predicting CVD risk. Furthermore, the SHAP partial dependence plot revealed a nonlinear relationship between VD levels and CVD risk. In conclusion, while VD deficiency appears directly or indirectly associated with increased CVD risk, its relative importance within predictive models is considerably lower when compared to other risk factors. These findings suggest that VD deficiency may not warrant primary focus in CVD risk assessment and prevention strategies, however, further research is needed to explore the causal relationship between VD deficiency and CVD risk.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1435738"},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544672","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}
Introduction: Obesity is associated with impairment of wound healing and tissue regeneration. Angiogenesis, the formation of new blood capillaries, plays a key role in regenerative lung growth after unilateral pneumonectomy (PNX). We have reported that obesity inhibits angiogenesis. The effects of obesity on post-PNX lung vascular and alveolar regeneration remain unclear.
Methods: Unilateral PNX is performed on Lepob/ob obese mice to examine vascular and alveolar regeneration.
Results: Regenerative lung growth and expression of vascular endothelial growth factor (VEGF) and its receptor VEGFR2 induced after PNX are inhibited in Lepob/ob obese mice. The levels of adiponectin that exhibits pro-angiogenic and vascular protective properties increase after unilateral PNX, while the effects are attenuated in Lepob/ob obese mice. Post-PNX regenerative lung growth and increases in the levels of VEGF and VEGFR2 are inhibited in adiponectin knockout mice. Adiponectin stimulates angiogenic activities in human lung endothelial cells (ECs), which is inhibited by decreasing the levels of transcription factor Twist1. Adiponectin agonist, AdipoRon restores post-PNX lung growth and vascular and alveolar regeneration in Lepob/ob obese mice.
Discussion: These findings suggest that obesity impairs lung vascular and alveolar regeneration and adiponectin is one of the key factors to improve lung regeneration in obese people.
简介肥胖与伤口愈合和组织再生障碍有关。血管生成(新毛细血管的形成)在单侧肺切除术(PNX)后的肺再生生长中起着关键作用。我们曾报道过肥胖会抑制血管生成。肥胖对单侧肺切除术后肺血管和肺泡再生的影响仍不清楚:方法:对 Lep o b / o b 肥胖小鼠进行单侧 PNX,以检查血管和肺泡再生情况:结果:Lep o b / o b 肥胖小鼠的肺再生生长和 PNX 后诱导的血管内皮生长因子(VEGF)及其受体 VEGFR2 的表达受到抑制。单侧 PNX 后,具有促血管生成和血管保护特性的脂肪连通素水平升高,而 Lep o b / o b 肥胖小鼠的这种效应减弱。在脂肪连通素基因敲除小鼠中,PNX 后肺再生生长以及血管内皮生长因子和血管内皮生长因子受体 2 水平的增加受到抑制。脂肪连接素能刺激人肺内皮细胞(ECs)的血管生成活性,而转录因子 Twist1 水平的降低能抑制血管生成活性。Adiponectin 激动剂 AdipoRon 可恢复 Lep o b / o b 肥胖小鼠 PNX 后的肺生长以及血管和肺泡再生:这些研究结果表明,肥胖会损害肺血管和肺泡再生,而脂肪连素是改善肥胖者肺再生的关键因素之一。
{"title":"Inhibition of angiogenesis and regenerative lung growth in <i>Lep<sup>ob/ob</sup></i> mice through adiponectin-VEGF/VEGFR2 signaling.","authors":"Tendai Hunyenyiwa, Priscilla Kyi, Mikaela Scheer, Mrudula Joshi, Mario Gasparri, Tadanori Mammoto, Akiko Mammoto","doi":"10.3389/fcvm.2024.1491971","DOIUrl":"10.3389/fcvm.2024.1491971","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is associated with impairment of wound healing and tissue regeneration. Angiogenesis, the formation of new blood capillaries, plays a key role in regenerative lung growth after unilateral pneumonectomy (PNX). We have reported that obesity inhibits angiogenesis. The effects of obesity on post-PNX lung vascular and alveolar regeneration remain unclear.</p><p><strong>Methods: </strong>Unilateral PNX is performed on <i>Lep</i> <sup><i>o</i> <i>b</i> <i>/</i> <i>o</i> <i>b</i></sup> obese mice to examine vascular and alveolar regeneration.</p><p><strong>Results: </strong>Regenerative lung growth and expression of vascular endothelial growth factor (VEGF) and its receptor VEGFR2 induced after PNX are inhibited in <i>Lep</i> <sup><i>o</i> <i>b</i> <i>/</i> <i>o</i> <i>b</i></sup> obese mice. The levels of adiponectin that exhibits pro-angiogenic and vascular protective properties increase after unilateral PNX, while the effects are attenuated in <i>Lep</i> <sup><i>o</i> <i>b</i> <i>/</i> <i>o</i> <i>b</i></sup> obese mice. Post-PNX regenerative lung growth and increases in the levels of VEGF and VEGFR2 are inhibited in adiponectin knockout mice. Adiponectin stimulates angiogenic activities in human lung endothelial cells (ECs), which is inhibited by decreasing the levels of transcription factor Twist1. Adiponectin agonist, AdipoRon restores post-PNX lung growth and vascular and alveolar regeneration in <i>Lep</i> <sup><i>o</i> <i>b</i> <i>/</i> <i>o</i> <i>b</i></sup> obese mice.</p><p><strong>Discussion: </strong>These findings suggest that obesity impairs lung vascular and alveolar regeneration and adiponectin is one of the key factors to improve lung regeneration in obese people.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1491971"},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544676","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}
Pub Date : 2024-10-15eCollection Date: 2024-01-01DOI: 10.3389/fcvm.2024.1433945
Weiguang Chen, Xiaoling Gao, Hong Li
Cardiac tamponade is a critical cardiovascular condition where timely diagnosis and treatment are crucial. The formation of an intrapericardial hematoma following acupuncture therapy is clinically rare. This paper reports a case of an elderly female patient who experienced severe chest pain and syncope during acupuncture therapy, subsequently diagnosed with traumatic hemopericardium and acute cardiac tamponade, complicated by cardiogenic shock. Under ultrasound guidance, pericardial puncture and drainage were successfully performed. The patient's symptoms were alleviated, her vital signs stabilized, and follow-up outcomes were favorable. This case provides valuable reference for understanding the pathogenesis, diagnosis, and treatment of pericardial hemorrhage following acupuncture therapy, integrating both clinical practice and literature review.
{"title":"Case Report: Massive intrapericardial hematoma following acupuncture therapy.","authors":"Weiguang Chen, Xiaoling Gao, Hong Li","doi":"10.3389/fcvm.2024.1433945","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1433945","url":null,"abstract":"<p><p>Cardiac tamponade is a critical cardiovascular condition where timely diagnosis and treatment are crucial. The formation of an intrapericardial hematoma following acupuncture therapy is clinically rare. This paper reports a case of an elderly female patient who experienced severe chest pain and syncope during acupuncture therapy, subsequently diagnosed with traumatic hemopericardium and acute cardiac tamponade, complicated by cardiogenic shock. Under ultrasound guidance, pericardial puncture and drainage were successfully performed. The patient's symptoms were alleviated, her vital signs stabilized, and follow-up outcomes were favorable. This case provides valuable reference for understanding the pathogenesis, diagnosis, and treatment of pericardial hemorrhage following acupuncture therapy, integrating both clinical practice and literature review.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1433945"},"PeriodicalIF":2.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142550048","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}