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Late recognition of cardiac implantable electronic device misplacement in left ventricle: a case report. 心脏植入式电子设备误置左心室的后期识别:病例报告。
IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-25 Epub Date: 2024-06-20 DOI: 10.1080/14796678.2024.2363627
Fatemeh Bahrami, Babak Sattartabar, Farnoosh Larti, Mehrzad Rahmanian, Reza Mollazadeh

Background: Cardiac electronic device implantation may be associated with complications. Case Summary: This is a report of inadvertent implantation of implantable cardioverter-defibrillator lead through an unrecognized sinus venosus atrial septal defect into the left ventricle that was not diagnosed early after implantation. Six months later chest x-ray showed an abnormal lead course that was confirmed with echocardiography as to be in the left ventricle. Surgical removal of the implantable cardioverter-defibrillator lead, repair of atrial septal defect, and correction of abnormal pulmonary venous connections were performed. Meanwhile, follow-up of the patient receiving a new dual chamber permanent pacemaker from the contralateral side and discussion of the aforementioned complication are addressed. Conclusion: Early diagnosis of device implantation complication is of paramount importance and prevents potential catastrophic complications.

背景:心脏电子装置植入可能与并发症有关。病例摘要:这是一份关于植入式心律转复除颤器导联通过未被发现的窦静脉房室间隔缺损意外植入左心室的报告,植入后未及早诊断。6 个月后,胸部 X 光片显示导联走向异常,超声心动图证实导联位于左心室。手术切除了植入式心律转复除颤器导联,修复了房间隔缺损,并纠正了异常的肺静脉连接。同时,对接受对侧新的双腔永久起搏器的患者进行了随访,并讨论了上述并发症。结论设备植入并发症的早期诊断至关重要,可预防潜在的灾难性并发症。
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引用次数: 0
Emerging therapies for refractory hypercholesterolemia: a narrative review. 治疗难治性高胆固醇血症的新疗法:综述。
IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-25 Epub Date: 2024-07-10 DOI: 10.1080/14796678.2024.2367860
Agnieszka Pawlos, Etienne Khoury, Daniel Gaudet

Refractory hypercholesterolemia (RH) is characterized by the failure of patients to achieve therapeutic targets for low-density lipoprotein-cholesterol (LDL-C) despite receiving maximal tolerable doses of standard lipid-lowering treatments. It predominantly impacts individuals with familial hypercholesterolemia (FH), thereby elevating the risk of cardiovascular complications. The prevalence of RH is now recognized to be substantially greater than previously thought. This review provides a comprehensive insight into current and emerging therapies for RH patients, including groundbreaking genetic-based therapeutic approaches. The review places emphasis on the dependency of therapies on low-density lipoprotein receptors (LDLRs) and highlights the critical role of considering LDLR activity in RH patients for individualization of the treatment.

难治性高胆固醇血症(RH)的特点是患者在接受最大可耐受剂量的标准降脂治疗后,低密度脂蛋白胆固醇(LDL-C)仍无法达到治疗目标。它主要影响家族性高胆固醇血症(FH)患者,从而增加了心血管并发症的风险。现在人们认识到,RH 的发病率远高于之前的想象。本综述全面介绍了针对 RH 患者的现有疗法和新兴疗法,包括基于基因的突破性治疗方法。该综述强调了疗法对低密度脂蛋白受体(LDLR)的依赖性,并强调了考虑 RH 患者 LDLR 活性对个体化治疗的关键作用。
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引用次数: 0
Double arterial vs. single axillary cannulation in acute type A aortic dissections: a meta-analysis. 急性 A 型主动脉夹层中的双动脉插管与单腋窝插管:一项荟萃分析。
IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-25 Epub Date: 2024-07-04 DOI: 10.1080/14796678.2024.2367875
Yoshiyuki Yamashita, Serge Sicouri, Aleksander Dokollari, Khalid Ridwan, Nicholas Clarke, Roberto Rodriguez, Scott Goldman, Basel Ramlawi

Aim: To evaluate the effects of double (axillary and femoral) vs. single (axillary) cannulation on early outcomes of acute type A aortic dissection (ATAAD). Materials & methods: Meta-analysis using PubMed/MEDLINE, Scopus, and Cochrane databases through August 23, 2023. Focused on operative mortality, postoperative stroke, re-exploration for bleeding, spinal cord injury, and renal replacement therapy. Results: Among 5 propensity score-matched studies with 2127 patients, double cannulation showed comparable mortality and higher rates of postoperative stroke (pooled odds ratio: 1.69, 95% confidence interval: 1.19-2.39) and need for renal replacement therapy (pooled odds ratio: 1.35, 95% confidence interval: 1.13-1.60) compared with single cannulation. Conclusion: Double arterial cannulation in ATAAD surgery is associated with increased postoperative stroke and renal replacement therapy than single cannulation.

目的:评估双(腋窝和股骨)插管与单(腋窝)插管对急性 A 型主动脉夹层(ATAAD)早期预后的影响。材料与方法:使用 PubMed/MEDLINE、Scopus 和 Cochrane 数据库(截至 2023 年 8 月 23 日)进行 Meta 分析。重点关注手术死亡率、术后中风、因出血再次手术、脊髓损伤和肾脏替代治疗。结果:在 5 项有 2127 名患者的倾向评分匹配研究中,双插管与单插管相比,死亡率相当,但术后中风率(汇总几率比:1.69,95% 置信区间:1.19-2.39)和肾脏替代治疗需求率(汇总几率比:1.35,95% 置信区间:1.13-1.60)较高。结论与单动脉插管相比,ATAAD 手术中的双动脉插管与术后中风和肾脏替代治疗的增加有关。
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引用次数: 0
Bifocal coronary sinus pacing and transcatheter tricuspid valve-in-valve implantation: an innovative combined approach. 双焦点冠状窦起搏和经导管三尖瓣瓣中瓣植入术:一种创新的联合方法。
IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-25 Epub Date: 2024-07-08 DOI: 10.1080/14796678.2024.2366095
Vincenzo Ezio Santobuono, Paolo Basile, Marco Gentile, Annalisa Logiacco, Francesca Amati, Maria Cristina Carella, Riccardo Memeo, Emanuela De Cillis, Alessandro Santo Bortone, Cinzia Forleo, Marco Matteo Ciccone, Andrea Igoren Guaricci

One of the most common complications of tricuspid valve replacement is atrioventricular block (AVB), often requiring permanent pacing. The endocardial pacemaker lead, placed in the right ventricle, may sometimes interfere with the implanted prosthesis, causing its early dysfunction and the need for alternative sites of pacing. To the best of our knowledge, we present the first case of a successful combined percutaneous procedure consisting of the implantation of two leads in the coronary sinus for univentricular bifocal pacing and a transcatheter tricuspid valve-in-valve implantation in a young patient with severe dysfunction of the tricuspid bioprosthesis, requiring permanent pacing for a postsurgical complete atrioventricular block.

三尖瓣置换术最常见的并发症之一是房室传导阻滞(AVB),通常需要永久起搏。放置在右心室的心内膜起搏导联有时可能会干扰植入的人工瓣膜,导致其早期功能障碍,需要更换起搏部位。据我们所知,我们介绍了第一例成功的经皮联合手术,包括在冠状窦植入两个导联用于单心室双焦点起搏,以及经导管三尖瓣瓣中瓣植入术,该患者年轻,三尖瓣生物假体功能严重失调,术后完全性房室传导阻滞需要永久性起搏。
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引用次数: 0
Empagliflozin in the treatment of heart failure. Empagliflozin 用于治疗心力衰竭。
IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-25 Epub Date: 2024-06-12 DOI: 10.1080/14796678.2024.2360818
Aimen Shafiq, Ishaque Hameed, Jan Biegus, Marat Fudim, Muhammad Shahzeb Khan

Heart failure (HF) affects more than 60 million individuals globally. Empagliflozin is currently approved for type 2 diabetes and chronic HF. Clinical trials have demonstrated that empagliflozin reduces the composite end point of hospitalizations for HF and mortality and improves the quality of life irrespective of left ventricular ejection fraction. Empagliflozin is a once-daily medication with minimal drug-drug interactions and does not require titration. Empagliflozin causes mild weight loss and does not significantly reduce blood pressure. Empagliflozin acts as an enabler for other HF drugs by reducing the risk of hyperkalemia. Empagliflozin is also beneficial for chronic kidney disease which exists commonly with HF. This review outlines the pharmacokinetics, pharmacodynamics, safety, and efficacy of empagliflozin in HF across various sub-groups and settings.

心力衰竭(HF)影响着全球 6000 多万人。目前,恩格列净已获准用于治疗 2 型糖尿病和慢性心力衰竭。临床试验表明,无论左心室射血分数如何,Empagliflozin 都能降低心力衰竭住院率和死亡率的综合终点,并改善生活质量。Empagliflozin 每日用药一次,药物间相互作用极小,无需滴定。Empagliflozin 会导致轻度体重减轻,并且不会明显降低血压。Empagliflozin 可降低高钾血症的风险,从而成为其他高血压药物的辅助药物。Empagliflozin 还有益于慢性肾病,而慢性肾病通常与高血压同时存在。本综述概述了 Empagliflozin 在不同亚组和不同情况下治疗高血压的药代动力学、药效学、安全性和有效性。
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引用次数: 0
Pre-hospital evaluation of chest pain patients using the modified HEART-score: rationale and design. 使用改良 HEART 评分对胸痛患者进行院前评估:原理与设计。
IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-25 Epub Date: 2024-06-28 DOI: 10.1080/14796678.2024.2356995
Jaouad Azzahhafi, Dean Rpp Chan Pin Yin, Mirjam Epping, Hajar Bofarid, Sem Aof Rikken, Thijs Verhagen, Rene Boomars, Anja Radstok, Jaco Houtgraaf, Angela Bikker, Jurriën M Ten Berg

Background: This study assesses how ambulance paramedics using the modified HEART-score with a point-of-care cardiac troponin (cTn) compare to the emergency physicians using the modified HEART-score with a high-sensitive cTn (hs-cTn) in patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS), focusing on interobserver agreement and diagnostic performance. Methods: In this prospective multicenter cohort, we compare four cTn testing strategies (serial point of care and hs-cTn cTn measurement) with and without the HEART-score. Outcomes include the HEART-score's interobserver agreement, NSTE-ACS at discharge, major adverse cardiovascular events (MACE) after 30 days, and diagnostic accuracy of the different strategies. Conclusion: The POPular HEART study aims to improve NSTE-ACS diagnostic pathways, promoting pre-hospital detection and ruling out of NSTE-ACS to minimize unnecessary hospitalizations and associated costs.Clinical Trial Registration: NCT04851418 (ClinicalTrials.gov).

背景:本研究评估了救护车护理人员与急诊科医生在疑似非 STE-ACS 患者中使用改良 HEART 评分和床旁心肌肌钙蛋白(cTn)的情况,重点是观察者之间的一致性和诊断效果。方法:在这一前瞻性多中心队列中,我们比较了使用和不使用 HEART-score 的四种 cTn 检测策略(序列护理点和 hs-cTn cTn 测量)。结果包括 HEART 评分的观察者间一致性、出院时的 NSTE-ACS、30 天后的主要不良心血管事件 (MACE) 以及不同策略的诊断准确性。结论POPular HEART 研究旨在改善 NSTE-ACS 诊断路径,促进院前检测和排除 NSTE-ACS 以减少不必要的住院治疗和相关费用:临床试验注册:NCT04851418(ClinicalTrials.gov)。
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引用次数: 0
Assessment of short-term results of thrombosuction during primary percutaneous coronary intervention in patients with acute myocardial infarction. 评估急性心肌梗死患者经皮冠状动脉介入治疗期间血栓抽吸术的短期效果。
IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-25 Epub Date: 2024-07-09 DOI: 10.1080/14796678.2024.2365080
Mahdi Zahedi, Amir Hosein Mollazadeh Moghddam

Aim: The study investigated the short-term outcomes of thrombosuction during primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction. Materials & methods: The study consisted of 57 patients who underwent primary or rescue PCI. The effect of thrombosuction on thrombolysis in myocardial infarction (TIMI) flow, failure to restore blood flow in the target vessel, and occurrence of mortality were reviewed in patients. Results: Thrombosis was performed in 45.61% of patients. Thrombosuction during PCI resulted in significant incremental TIMI-flow changes in this group of patients compared with patients who did just PCI. In 86.6%, these changes were three-degree and the initial TIMI-flow has changed from 0 to 3. Conclusion: The number of patients who underwent rescue PCI was higher than the smaller number of individuals who underwent thrombosuction.

目的:本研究探讨了在急性心肌梗死患者进行初级经皮冠状动脉介入治疗(PCI)期间进行血栓抽吸术的短期效果。材料与方法:研究对象包括 57 名接受初级或抢救性 PCI 的患者。研究回顾了血栓抽吸术对心肌梗死溶栓(TIMI)流量的影响、靶血管血流恢复失败以及死亡率的发生情况。结果显示45.61%的患者发生了血栓形成。与只进行 PCI 的患者相比,PCI 期间的血栓抽吸术使这组患者的 TIMI 血流发生了显著的增量变化。在 86.6% 的患者中,这些变化为三度,初始 TIMI 流量从 0 变为 3:接受抢救性 PCI 的患者人数多于接受血栓抽吸术的人数。
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引用次数: 0
STEMI or not STEMI? A multimodality imaging approach to a challenging intracardiac mass with a tricky presentation. STEMI 或非 STEMI?以多模态成像方法处理表现棘手的心内肿块。
IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-25 Epub Date: 2024-06-20 DOI: 10.1080/14796678.2024.2360845
Laura Piscitelli, Antonio Gianluca Robles, Roberto Costantino, Valentina Forte, Silvio Romano, Luigi Sciarra, Francesco Bartolomucci, Domenico Riccardo Rosario Chieppa

Cardiac tumors, due to the various clinical scenarios and their histological subtypes, are still challenging for clinicians. They are differentiated into primary and secondary. The latest are more common and are usually lung and breast cancers, melanomas, and lymphoma metastasis. We present a case of a 73-year-old woman, with a history of breast cancer 10 years earlier, admitted to Cath lab for an elevation of the ST-segment of the electrocardiogram, myocardial infarction. Echocardiogram showed a curious abnormality in the myocardial wall. Thanks to a multimodality imaging strategy, including contrast-enhanced echocardiography and cardiac magnetic resonance, characterization of the underlying pathology was clear and, thus, the appropriate management and therapy.

心脏肿瘤的临床表现和组织学亚型多种多样,对临床医生来说仍是一项挑战。它们可分为原发性和继发性。原发性肿瘤更常见,通常是肺癌、乳腺癌、黑色素瘤和淋巴瘤转移瘤。我们介绍了一例 73 岁的女性病例,她 10 年前曾患乳腺癌,因心电图 ST 段升高和心肌梗死被送入心电图室。超声心动图显示心肌壁出现异常。由于采用了多模态成像策略,包括对比增强超声心动图和心脏磁共振,明确了潜在的病理特征,从而进行了适当的处理和治疗。
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引用次数: 0
Anomalous coronary artery masquerading as a root abscess: a case report. 伪装成根部脓肿的异常冠状动脉:病例报告。
IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-04-25 Epub Date: 2024-05-28 DOI: 10.1080/14796678.2024.2354623
Abeline R Watkins, Ryaan El-Andari, Andy Liu, Blaine Achen, Jayan Nagendran

Congenital coronary artery anomalies are rare and most often clinically benign. We present a case of a 67-year-old male with osteomyelitis and persistent bacteremia with an anomalous left coronary artery mimicking an aortic root abscess. A transesophageal echocardiogram revealed a hypoechoic potential space around the aortic root, highly suspicious for a root abscess. Urgent cardiac surgery was performed, revealing no infection but an anomalous coronary artery arising from the right coronary sinus. This case highlights the importance of considering atypical anatomy in the diagnosis of infectious cardiac processes. While this resemblance should not delay intervention for suspected abscesses, it emphasizes the need to be aware of congenital differences in imaging for patients with known anomalies or asymptomatic patients with unknown anatomy.

先天性冠状动脉异常非常罕见,临床上多为良性。我们报告了一例 67 岁男性患者的病例,他患有骨髓炎和持续菌血症,左冠状动脉异常模仿主动脉根部脓肿。经食道超声心动图显示主动脉根部周围存在低回声潜在空间,高度怀疑为根部脓肿。患者接受了紧急心脏手术,结果显示没有感染,但右侧冠状窦出现异常冠状动脉。该病例强调了在诊断心脏感染过程中考虑非典型解剖的重要性。虽然这种相似性不应该延误对疑似脓肿的干预,但它强调了在对已知异常的患者或解剖结构不明的无症状患者进行影像学检查时需要注意先天性差异。
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引用次数: 0
Long-term clinical outcomes of intravascular imaging-guided percutaneous coronary intervention versus angiography-guided percutaneous coronary intervention in complex coronary lesions: a systematic review and meta-analysis. 血管内成像引导的经皮冠状动脉介入治疗与血管造影引导的经皮冠状动脉介入治疗在复杂冠状动脉病变中的长期临床疗效对比:系统回顾和荟萃分析。
IF 1.7 Q3 Medicine Pub Date : 2024-04-16 DOI: 10.2217/fca-2023-0124
Danish Ali Ashraf, Usman Ahmed, Z. Z. Khan, Fiza Mushtaq, Shehar Bano, Ali Raza Khan, Saad Azam, Abdullah Haroon, Salman Ahmed Malik, Raza Aslam, Jai Kumar, Farva Zaib Khan, Amna Faheem, Sarwan Kumar, Saad Hassan
Background: In this study, we aim to discuss the long-term clinical outcomes of intravascular ultrasound imaging-guided percutaneous intervention (IVUS-PCI) versus angiography-guided percutaneous coronary intervention (PCI) in complex coronary lesions over a mean period of 2 years. Methods: A systematic search and meta-analysis were conducted to assess the efficacy of using intravascular ultrasound or optical coherence tomography guidance in coronary artery stenting compared to angiography. Results: A total of 11 randomized controlled trials with 6740 patients were included. For the primary outcome, a pooled analysis (3.2 vs 5.6%). For secondary outcomes, the risk was significantly low in image-guided percutaneous intervention compared with angiography. Conclusion: Intravascular imaging-guided PCI is significantly more effective than angiography-guided PCI in reducing the risk of target lesion revascularization, target vessel revascularization, cardiac death, major adverse cardiovascular events and stent thrombosis.
研究背景本研究旨在探讨血管内超声成像引导下经皮介入治疗(IVUS-PCI)与血管造影引导下经皮冠状动脉介入治疗(PCI)在复杂冠状动脉病变中平均 2 年的长期临床疗效。方法:进行系统检索和荟萃分析,评估在冠状动脉支架植入术中使用血管内超声或光学相干断层扫描引导与血管造影术引导的疗效比较。结果:共纳入了 11 项随机对照试验,共 6740 名患者。对主要结果进行了汇总分析(3.2% 对 5.6%)。在次要结果方面,图像引导经皮介入治疗的风险明显低于血管造影。结论:在降低靶病变血运重建、靶血管血运重建、心源性死亡、主要不良心血管事件和支架血栓形成的风险方面,血管内成像引导的PCI明显比血管造影引导的PCI更有效。
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引用次数: 0
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Future cardiology
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