Pub Date : 2023-06-15DOI: 10.61148/2836-2837/ijccci/010
Bjarne Madsen Härdig
Aim of the review: To provide an overview of studies that have published data regarding region and population size, procedure location, team composition, inclusion and exclusion criteria, outcome parameters, and cost–benefit analyses on extracorporeal membrane oxygenation use for refractory out-of-hospital cardiac arrest. Data sources: A structured systematic literature search of articles published prior to April 27, 2021, was performed in online databases (PubMed, EMBASE, ClinicalTrials.gov, the EU Clinical Trials Register, and Cochrane Library). Results: Sixty-three articles were included based on predefined eligibility criteria. The included articles were published between 2011 and 2021, with the highest number of articles in 2020 and 2021 (50%). Of the 58 articles that reported data on organisational topics, 47 reported transporting the patients to the hospital for cannulation, 10 reported initiating extracorporeal cardiopulmonary resuscitation (ECPR) on-scene, and one reported doing both. The most common inclusion criterion was a lower age limit of 18 years (in 86% of the articles). Other inclusion criteria were witnessed collapse (67%) and initial ventricular fibrillation/tachycardia (43%), asystole (3%), pulseless electrical activity (5%), pulmonary embolism (2%), and signs of life during CPR (5%). The most common exclusion criterion was a do-not-resuscitate order (38%). Of the 44 studies reporting outcomes, 77% reported survival to hospital discharge and 50%, a cerebral performance category score of 1-2. Other outcome parameters were sparsely reported. Conclusion: There is a variation in regional size, team composition, inclusion and exclusion criteria and reported outcomes. These discrepancies make it challenging to determine how to effectively use ECPR.
{"title":"A Scoping Review on The Use of Extracorporeal Cardiopulmonary Resuscitation for Refractory Out-Of-Hospital Cardiac Arrest","authors":"Bjarne Madsen Härdig","doi":"10.61148/2836-2837/ijccci/010","DOIUrl":"https://doi.org/10.61148/2836-2837/ijccci/010","url":null,"abstract":"Aim of the review: To provide an overview of studies that have published data regarding region and population size, procedure location, team composition, inclusion and exclusion criteria, outcome parameters, and cost–benefit analyses on extracorporeal membrane oxygenation use for refractory out-of-hospital cardiac arrest. Data sources: A structured systematic literature search of articles published prior to April 27, 2021, was performed in online databases (PubMed, EMBASE, ClinicalTrials.gov, the EU Clinical Trials Register, and Cochrane Library). Results: Sixty-three articles were included based on predefined eligibility criteria. The included articles were published between 2011 and 2021, with the highest number of articles in 2020 and 2021 (50%). Of the 58 articles that reported data on organisational topics, 47 reported transporting the patients to the hospital for cannulation, 10 reported initiating extracorporeal cardiopulmonary resuscitation (ECPR) on-scene, and one reported doing both. The most common inclusion criterion was a lower age limit of 18 years (in 86% of the articles). Other inclusion criteria were witnessed collapse (67%) and initial ventricular fibrillation/tachycardia (43%), asystole (3%), pulseless electrical activity (5%), pulmonary embolism (2%), and signs of life during CPR (5%). The most common exclusion criterion was a do-not-resuscitate order (38%). Of the 44 studies reporting outcomes, 77% reported survival to hospital discharge and 50%, a cerebral performance category score of 1-2. Other outcome parameters were sparsely reported. Conclusion: There is a variation in regional size, team composition, inclusion and exclusion criteria and reported outcomes. These discrepancies make it challenging to determine how to effectively use ECPR.","PeriodicalId":153375,"journal":{"name":"International Journal of Clinical Cardiology and Cardiovascular Interventions","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115271282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-22DOI: 10.61148/2836-2837/ijccci/009
T. Ibrahim
Background: A transient ischaemic attack (TIA) or acute ischaemic stroke (AIS) with transient symptoms can presage a debilitating acute ischaemic stroke and some stroke mimics can have undesired consequences if not diagnosed and treated promptly. The use of computerized tomography (CT), perfusion computerised tomography (P-CT) and diffusion weighted magnetic resonance imaging (DW-MRI) is critical in facilitating early diagnosis and subsequent management of patients with acute focal neurological dysfunctions. Aim: This study investigated the yield of computerised tomography (CT), Perfusion-CT(P-CT), and Diffusion weighted-MRI(DW-MRI) scans in patients Diagnosed with TIA and AIS. Methodology: This is a retrospective cohort study of 162 cases of TIA (55%) and acute ischaemic stroke (AIS), who presented to Goulburn Valley Hospital in Shepparton from January to December 2021. Microsoft EXCEL software was used for statistical analysis. The chi-square test with Yates' correction was used to compare propositions, and a p-value of < 0.05 is considered statistically significant. Results: The male to female ratio was 1.5 to 1, with a mean age of 74 years. The initial CT brain was normal in all 89 TIA patients, while 69.8% of the 63 AIS patients had infarct. 95% of AIS (n=41) patients had perfusion abnormalities on P-CT compared to only 17% of TIA patients (n=71) (P<0.00001). Similarly, 94% of AIS (n=35) compared to 18% of TIA (n=55) patients had diffusion weighted abnormality on DW-MRI (p<0.00001).13.5% of the TIA case(n=5) and 100% of the AIS(n=5) with normal CT and P-CT had diffusion abnormality on DW-MRI. Among the 4 TIA cases that had DW-MRI after normal CT and positive P-CT only 20% (n=1) showed diffusion abnormality. On CT carotid and cerebral angiograms, 49% of TIA (n=37) compared to 76% of AIS (n=55) patients had significant stenosis of over 50% (p<0.01). Conclusion: Normal initial CT brain is a valuable initial test for differentiating TIA from AIS in patients with acute focal neurologic dysfunctions. The addition of P-CT and DW-MRI imaging demonstrated abnormalities in most of those with AIS when compared with those with TIA. Although a small percentage of those with TIA had abnormalities on P-CT and DW-MRI these two modalities add value to investigation of TIA. Therefore, the use of P-CT and DW-MRI are pertinent when the initial CT brain is normal as they are more sensitive in demonstrating abnormalities than plain CT.
{"title":"The Yield of Computerized Tomography, Perfusion Computerized Tomography and Diffusion-Weighted Magnetic Resonance Image in Patients Presenting with Transient Ischemic Attack and Acute Ischaemic Stroke","authors":"T. Ibrahim","doi":"10.61148/2836-2837/ijccci/009","DOIUrl":"https://doi.org/10.61148/2836-2837/ijccci/009","url":null,"abstract":"Background: A transient ischaemic attack (TIA) or acute ischaemic stroke (AIS) with transient symptoms can presage a debilitating acute ischaemic stroke and some stroke mimics can have undesired consequences if not diagnosed and treated promptly. The use of computerized tomography (CT), perfusion computerised tomography (P-CT) and diffusion weighted magnetic resonance imaging (DW-MRI) is critical in facilitating early diagnosis and subsequent management of patients with acute focal neurological dysfunctions. Aim: This study investigated the yield of computerised tomography (CT), Perfusion-CT(P-CT), and Diffusion weighted-MRI(DW-MRI) scans in patients Diagnosed with TIA and AIS. Methodology: This is a retrospective cohort study of 162 cases of TIA (55%) and acute ischaemic stroke (AIS), who presented to Goulburn Valley Hospital in Shepparton from January to December 2021. Microsoft EXCEL software was used for statistical analysis. The chi-square test with Yates' correction was used to compare propositions, and a p-value of < 0.05 is considered statistically significant. Results: The male to female ratio was 1.5 to 1, with a mean age of 74 years. The initial CT brain was normal in all 89 TIA patients, while 69.8% of the 63 AIS patients had infarct. 95% of AIS (n=41) patients had perfusion abnormalities on P-CT compared to only 17% of TIA patients (n=71) (P<0.00001). Similarly, 94% of AIS (n=35) compared to 18% of TIA (n=55) patients had diffusion weighted abnormality on DW-MRI (p<0.00001).13.5% of the TIA case(n=5) and 100% of the AIS(n=5) with normal CT and P-CT had diffusion abnormality on DW-MRI. Among the 4 TIA cases that had DW-MRI after normal CT and positive P-CT only 20% (n=1) showed diffusion abnormality. On CT carotid and cerebral angiograms, 49% of TIA (n=37) compared to 76% of AIS (n=55) patients had significant stenosis of over 50% (p<0.01). Conclusion: Normal initial CT brain is a valuable initial test for differentiating TIA from AIS in patients with acute focal neurologic dysfunctions. The addition of P-CT and DW-MRI imaging demonstrated abnormalities in most of those with AIS when compared with those with TIA. Although a small percentage of those with TIA had abnormalities on P-CT and DW-MRI these two modalities add value to investigation of TIA. Therefore, the use of P-CT and DW-MRI are pertinent when the initial CT brain is normal as they are more sensitive in demonstrating abnormalities than plain CT.","PeriodicalId":153375,"journal":{"name":"International Journal of Clinical Cardiology and Cardiovascular Interventions","volume":"315 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124256283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-22DOI: 10.61148/2836-2837/ijccci/008
E. R. Rios Dueñas
Introduction. Interruption of the aortic arch due to absence of tissue between the ascending and descending portions of the aorta is a pathology of low incidence, yet it has a mortality rate of nearly 90% within the first year of life. Surgical intervention is aimed at re-establishing continuity of the vessel, as well as correcting associated lesions through closure of IVC or performing a pulmonary artery cerclage correction. The mortality is 18% to 42%. The survival rate is close to 73% at one month, 65% at one year and 63% at 3 years after surgery. Materials and Methods. Review of Cardiovascular Surgery database between 2006 and 2019, identifying patients who underwent surgery due to aortic arch interruption. Results. In the last 4 years, an institutional technique was introduced, using pericardium tissue for reconstruction and partial junction of the descending aorta with the arch through advancement of the arterial cannulae towards the brachiocephalic trunk and has been positively associated to brain protection. Since, results have improved: lower tissue traction, greater amplitude of the neoarch and better neurological outcomes have been achieved. The objective of this paper is to identify the most important factors that ultimately determine prognosis and survival of patients with these pathologies, as well as to describe results of the implemented technique. Discussion. Aortic arch surgery is considered to be highly complex. Results yielded in this research showed a high mortality within the first years, which decreased into a similar rate to that of medical literature. The main factors associated with complications identified were a late diagnosis and malnutrition. In addition, morbidity and mortality rates were similar to those reported worldwide.
{"title":"Clinical and Post-Surgical Features and Outcomes in Post-Surgical Patients with Aortic arch Interruption at a Specialty Hospital in Bogotá Between 2006 and 2019. Retrospective Multivariable Analysis","authors":"E. R. Rios Dueñas","doi":"10.61148/2836-2837/ijccci/008","DOIUrl":"https://doi.org/10.61148/2836-2837/ijccci/008","url":null,"abstract":"Introduction. Interruption of the aortic arch due to absence of tissue between the ascending and descending portions of the aorta is a pathology of low incidence, yet it has a mortality rate of nearly 90% within the first year of life. Surgical intervention is aimed at re-establishing continuity of the vessel, as well as correcting associated lesions through closure of IVC or performing a pulmonary artery cerclage correction. The mortality is 18% to 42%. The survival rate is close to 73% at one month, 65% at one year and 63% at 3 years after surgery. Materials and Methods. Review of Cardiovascular Surgery database between 2006 and 2019, identifying patients who underwent surgery due to aortic arch interruption. Results. In the last 4 years, an institutional technique was introduced, using pericardium tissue for reconstruction and partial junction of the descending aorta with the arch through advancement of the arterial cannulae towards the brachiocephalic trunk and has been positively associated to brain protection. Since, results have improved: lower tissue traction, greater amplitude of the neoarch and better neurological outcomes have been achieved. The objective of this paper is to identify the most important factors that ultimately determine prognosis and survival of patients with these pathologies, as well as to describe results of the implemented technique. Discussion. Aortic arch surgery is considered to be highly complex. Results yielded in this research showed a high mortality within the first years, which decreased into a similar rate to that of medical literature. The main factors associated with complications identified were a late diagnosis and malnutrition. In addition, morbidity and mortality rates were similar to those reported worldwide.","PeriodicalId":153375,"journal":{"name":"International Journal of Clinical Cardiology and Cardiovascular Interventions","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115813686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-22DOI: 10.61148/2836-2837/ijccci/007
T. Ibrahim
{"title":"The Pattern of Intracranial Bleed, A Real-World Experience of The Impact of Falls and Use of Antiplatelets and Anticoagulants on The Outcome.","authors":"T. Ibrahim","doi":"10.61148/2836-2837/ijccci/007","DOIUrl":"https://doi.org/10.61148/2836-2837/ijccci/007","url":null,"abstract":"","PeriodicalId":153375,"journal":{"name":"International Journal of Clinical Cardiology and Cardiovascular Interventions","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122029419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-15DOI: 10.61148/2836-2837/ijccci/006
Tania Leme da Rocha Martinez
Taking into consideration that frequently cardiovascular patients do not present major risk factors, there remains a residual risk that can be, at least in part, measured by biomarkers of thrombosis and inflammation, based on clinical trials and clinical observations. This paper presents the role of three biomarkers - Homocysteyne, ultra sensitive C-Reactive Protein and Lipoprotein(a). The official Cardiac and Atherosclerosis Medical Societies conducts expert meetings that publish Recommendations for each of them. These Recommendations may help and guide clinicians as to their decision making regarding prevention of atherosclerotic cardiovascular diseases. Regarding hyperhomocysteinemia a healthy diet is the first choice, before prescribing folic acid and B vitamins supplements. A physician taking any type of nutritional approach to reducing risk should consider a person's overall risk factor profile and personalized diet. As for the inflammatory marker ultra sensitive C-Reactive Protein there is a strong association with risk of fatal vascular events than non fatal vascular events.
{"title":"Expanding The Spectrum Of Biomarkers For Heart Disease: Homocysteine, Us Crp And Lipoprotein(A)","authors":"Tania Leme da Rocha Martinez","doi":"10.61148/2836-2837/ijccci/006","DOIUrl":"https://doi.org/10.61148/2836-2837/ijccci/006","url":null,"abstract":"Taking into consideration that frequently cardiovascular patients do not present major risk factors, there remains a residual risk that can be, at least in part, measured by biomarkers of thrombosis and inflammation, based on clinical trials and clinical observations. This paper presents the role of three biomarkers - Homocysteyne, ultra sensitive C-Reactive Protein and Lipoprotein(a). The official Cardiac and Atherosclerosis Medical Societies conducts expert meetings that publish Recommendations for each of them. These Recommendations may help and guide clinicians as to their decision making regarding prevention of atherosclerotic cardiovascular diseases. Regarding hyperhomocysteinemia a healthy diet is the first choice, before prescribing folic acid and B vitamins supplements. A physician taking any type of nutritional approach to reducing risk should consider a person's overall risk factor profile and personalized diet. As for the inflammatory marker ultra sensitive C-Reactive Protein there is a strong association with risk of fatal vascular events than non fatal vascular events.","PeriodicalId":153375,"journal":{"name":"International Journal of Clinical Cardiology and Cardiovascular Interventions","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124543760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-10DOI: 10.61148/2836-2837/ijccci/005
P. Lo sapio
Aims:Using a retrospective study, we evaluated: the risk of thromboembolism and bleeding following the perioperative management of oral anticoagulants (OACs) and the adherence to the guidelines by the clinicians involved. Methods:Six hundred procedures, 120 for each OAC were collected from a Central Tuscany Surgery Department database. The endpoints were:the 30-days rate of arterial, venous thrombotic events and bleedings, classified by ISTH, and their association with adherence to EHRA guidelines. Results: Three hundreds and seventy one procedures(61%) were at high risk of bleeding. Until 30 days of follow-up, thrombotic events occurred in 4 patients, 7% total bleedings;12.8% of bleedings occurred in inappropriate heparin bridging and 5.7% in patients without bridging (p <.016). Four hundred and forty two (73.7%) procedures were performed in complete adherence to guidelines. At the multivariate analysis inappropriate bridging (HR=2.3;95% CI 1.1-4.7; p=.021) and urologic interventions (HR=2.3;95% CI 1.2-4.4;p=.01) were independent risk factors for bleeding events. Conclusions: Bleedings were significantly correlated with inappropriate heparin bridging even if occurred also in correct management of OACs, being related to the major surgery itself.
目的:通过一项回顾性研究，我们评估了围手术期口服抗凝剂(OACs)治疗后血栓栓塞和出血的风险，以及临床医生对指南的遵守情况。方法:从中央托斯卡纳外科数据库中收集600例手术，每种OAC 120例。终点是:30天内动脉、静脉血栓形成事件和出血发生率，按ISTH分类，以及它们与遵守EHRA指南的关系。结果:371例手术存在高危出血，占61%。截至随访30天，4例患者发生血栓形成事件，总出血7%;12.8%的出血发生在肝素桥接不当的患者中，5.7%发生在未桥接的患者中(p < 0.016)。442例(73.7%)手术完全按照指南进行。在多变量分析中，不适当的桥接(HR=2.3;95% CI 1.1-4.7;p= 0.021)和泌尿系统干预(HR=2.3;95% CI 1.2-4.4;p= 0.01)是出血事件的独立危险因素。结论:出血与肝素桥接不当相关，即使在正确处理OACs时也会发生，与大手术本身有关。
{"title":"Perioperative Management of Oral Anticoagulation: A Real-World Observational Study","authors":"P. Lo sapio","doi":"10.61148/2836-2837/ijccci/005","DOIUrl":"https://doi.org/10.61148/2836-2837/ijccci/005","url":null,"abstract":"Aims:Using a retrospective study, we evaluated: the risk of thromboembolism and bleeding following the perioperative management of oral anticoagulants (OACs) and the adherence to the guidelines by the clinicians involved. Methods:Six hundred procedures, 120 for each OAC were collected from a Central Tuscany Surgery Department database. The endpoints were:the 30-days rate of arterial, venous thrombotic events and bleedings, classified by ISTH, and their association with adherence to EHRA guidelines. Results: Three hundreds and seventy one procedures(61%) were at high risk of bleeding. Until 30 days of follow-up, thrombotic events occurred in 4 patients, 7% total bleedings;12.8% of bleedings occurred in inappropriate heparin bridging and 5.7% in patients without bridging (p <.016). Four hundred and forty two (73.7%) procedures were performed in complete adherence to guidelines. At the multivariate analysis inappropriate bridging (HR=2.3;95% CI 1.1-4.7; p=.021) and urologic interventions (HR=2.3;95% CI 1.2-4.4;p=.01) were independent risk factors for bleeding events. Conclusions: Bleedings were significantly correlated with inappropriate heparin bridging even if occurred also in correct management of OACs, being related to the major surgery itself.","PeriodicalId":153375,"journal":{"name":"International Journal of Clinical Cardiology and Cardiovascular Interventions","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133644724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-10DOI: 10.21203/rs.3.rs-901933/v1
A. Carlessi, L. Perello, C. Pantaley, A. Borsini, L. Rossi, F. Giménez, Julián Leonardi, Ariel Ballina, M. Maillo, P. Rienzo, P. Gonzalo, Martin Gonzalez Vara, Luciana Vegetti, Sebastián Wustten, Lucas Costa, D. Vergara, Cristian Froullet
Background The disease caused by coronavirus (COVID-19) affects the cardiovascular system, whether by direct viral aggression or indirectly through systemic inflammation and multiple organ compromise. A widely used method to determine cardiac injury is troponin measurement. The aim of this study is to evaluate the prevalence of cardiac involvement (CINV) in a population recovered from COVID-19, referred to cardiac MRI (CMR), who did not present troponin elevation. Methods There were 156 patients that recovered from COVID-19 and who did not present troponin elevation referred to CMR. CINV was considered to be the presence of: late gadolinium enhancement (LGE), edema, myocarditis, pericarditis, left ventricular systolic dysfunction (LVSD) and/or depressed right ventricular systolic dysfunction (RVSD). Results Prevalence of CINV was 28.8%, being more frequent in men (p = 0.002), in patients who required hospitalization (p = 0.04) and in those who experienced non-mild cases of infection (p = 0.007). RVSD (17.9%) and LVSD (13.4%) were the most frequent findings. The rate of myocarditis was 0.6%. LGE manifested in 7.1% of patients and its presence was related to less left ventricular ejection fraction (LVEF) (p = 0.0001) and right ventricular ejection fraction (RVEF) (p = 0.04). Conclusion In patients who recovered from COVID-19, 28.8% of CINV was found. It was more frequent in men, in patients who required admission and in patients with cases of non-mild infection. The patients that presented LGE had less LVEF and RVSF.
{"title":"Analysis of cardiac involvement in patients recovered from Covid-19 without troponin elevation, evaluated by cardiovascular magnetic resonance.","authors":"A. Carlessi, L. Perello, C. Pantaley, A. Borsini, L. Rossi, F. Giménez, Julián Leonardi, Ariel Ballina, M. Maillo, P. Rienzo, P. Gonzalo, Martin Gonzalez Vara, Luciana Vegetti, Sebastián Wustten, Lucas Costa, D. Vergara, Cristian Froullet","doi":"10.21203/rs.3.rs-901933/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-901933/v1","url":null,"abstract":"\u0000 Background\u0000\u0000The disease caused by coronavirus (COVID-19) affects the cardiovascular system, whether by direct viral aggression or indirectly through systemic inflammation and multiple organ compromise. A widely used method to determine cardiac injury is troponin measurement. The aim of this study is to evaluate the prevalence of cardiac involvement (CINV) in a population recovered from COVID-19, referred to cardiac MRI (CMR), who did not present troponin elevation.\u0000Methods\u0000\u0000There were 156 patients that recovered from COVID-19 and who did not present troponin elevation referred to CMR. CINV was considered to be the presence of: late gadolinium enhancement (LGE), edema, myocarditis, pericarditis, left ventricular systolic dysfunction (LVSD) and/or depressed right ventricular systolic dysfunction (RVSD).\u0000Results\u0000\u0000Prevalence of CINV was 28.8%, being more frequent in men (p = 0.002), in patients who required hospitalization (p = 0.04) and in those who experienced non-mild cases of infection (p = 0.007). RVSD (17.9%) and LVSD (13.4%) were the most frequent findings. The rate of myocarditis was 0.6%. LGE manifested in 7.1% of patients and its presence was related to less left ventricular ejection fraction (LVEF) (p = 0.0001) and right ventricular ejection fraction (RVEF) (p = 0.04).\u0000Conclusion\u0000\u0000In patients who recovered from COVID-19, 28.8% of CINV was found. It was more frequent in men, in patients who required admission and in patients with cases of non-mild infection. The patients that presented LGE had less LVEF and RVSF.","PeriodicalId":153375,"journal":{"name":"International Journal of Clinical Cardiology and Cardiovascular Interventions","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131054644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-10DOI: 10.61148/2836-2837/ijccci/002
Sibomana Thierry
Background: Venous thromboembolic disease is a real public health problem worldwide because of its high incidence and frequent fatal complications. In a country with limited resources, there is a lack of technical and material resources with low purchasing power. Aim: To determine the epidemiological and clinical aspects of venous thromboembolic disease in Burundian hospitals among patients undergoing prophylaxis. Patients and Methods: This was a prospective descriptive study conducted at kamenge university hospital from September 2019 to December 2019. Was included any patient hospitalized in the internal medicine, surgery and gyneco-obstetrics departments. Results: A total of 352 patients had been hospitalized in the three departments and 66 of them had benefited from thromboprophylaxis, i.e. 18.7% of cases. Among the factors of thrombosis, bed rest for more than 3 days predominated with 96% of cases. Enoxaparin topped the list of low molecular weight heparins prescribed. No physical means were used as thromboprophylaxis. Conclusion: Thromboprophylaxis is underused in our hospitals. In order to reduce the negative impact of thromboembolic disease, health personnel must be trained in its management and the population must be made aware of it.
{"title":"Hospital thromboprophylaxy in country with low income: Case of the university hospital center of Kamenge, Bujumbura, Burundi","authors":"Sibomana Thierry","doi":"10.61148/2836-2837/ijccci/002","DOIUrl":"https://doi.org/10.61148/2836-2837/ijccci/002","url":null,"abstract":"Background: Venous thromboembolic disease is a real public health problem worldwide because of its high incidence and frequent fatal complications. In a country with limited resources, there is a lack of technical and material resources with low purchasing power. Aim: To determine the epidemiological and clinical aspects of venous thromboembolic disease in Burundian hospitals among patients undergoing prophylaxis. Patients and Methods: This was a prospective descriptive study conducted at kamenge university hospital from September 2019 to December 2019. Was included any patient hospitalized in the internal medicine, surgery and gyneco-obstetrics departments. Results: A total of 352 patients had been hospitalized in the three departments and 66 of them had benefited from thromboprophylaxis, i.e. 18.7% of cases. Among the factors of thrombosis, bed rest for more than 3 days predominated with 96% of cases. Enoxaparin topped the list of low molecular weight heparins prescribed. No physical means were used as thromboprophylaxis. Conclusion: Thromboprophylaxis is underused in our hospitals. In order to reduce the negative impact of thromboembolic disease, health personnel must be trained in its management and the population must be made aware of it.","PeriodicalId":153375,"journal":{"name":"International Journal of Clinical Cardiology and Cardiovascular Interventions","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128680250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-10DOI: 10.61148/2836-2837/ijccci/004
A. Soares
This is an article aimed at showing the mentoring role in a fast-changing society, particularly during and after the pandemic by COVID-19. The intense flow of information, feelings and new knowledge changes every day, making it necessary for medical education to be updated to keep up with social and professional dynamics, according to health requirements and new demands on subjects still not widely known. The mentoring program is a development process in which the mentor promotes the professional and personal evolution of mentoring, from the exchange of visions and experiences that allow to expand the repertoire of solutions, especially in the instability that a pandemic imposes. The mentor and mentee are challenged to exchange the traditional environment for the virtual, in order to respect the distance required and the development on digital medicine and distance learning.
{"title":"Mentoring In Cardiology: A Pedagogical Tool In A Rapidly Changing World","authors":"A. Soares","doi":"10.61148/2836-2837/ijccci/004","DOIUrl":"https://doi.org/10.61148/2836-2837/ijccci/004","url":null,"abstract":"This is an article aimed at showing the mentoring role in a fast-changing society, particularly during and after the pandemic by COVID-19. The intense flow of information, feelings and new knowledge changes every day, making it necessary for medical education to be updated to keep up with social and professional dynamics, according to health requirements and new demands on subjects still not widely known. The mentoring program is a development process in which the mentor promotes the professional and personal evolution of mentoring, from the exchange of visions and experiences that allow to expand the repertoire of solutions, especially in the instability that a pandemic imposes. The mentor and mentee are challenged to exchange the traditional environment for the virtual, in order to respect the distance required and the development on digital medicine and distance learning.","PeriodicalId":153375,"journal":{"name":"International Journal of Clinical Cardiology and Cardiovascular Interventions","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124317557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-10DOI: 10.61148/2836-2837/ijccci/001
Julio Echarte Morales
Background and objective: A decrease in the number of admissions due to acute coronary syndrome (ACS) was observed during the COVID-19 pandemic. A study is made of the impact of the pandemic upon the incidence, morbidity-mortality and management of ACS. Materials and methods: A retrospective multicenter study was carried out with data from patients admitted due to ACS between 14 February and 24 June 2020. The following groups were established according to the period of admission: A) one month before strict lockdown; B) during lockdown; and C) one month after lockdown. The primary objective of the study was to assess differences in mortality among the three periods. Differences in the time from symptoms onset to the first medical contact (FMC) were also evaluated. Results: A total of 634 patients were included in the study (group A: 205, group B: 303, group C: 126). A 41% decrease in the number of admissions due to ACS was recorded in the first month of lockdown. A diagnostic delay was observed during lockdown (A: 65 minutes (range 38-112) vs B: 120 minutes (60-300) vs C: 120 minutes (60-360), p < 0.001); this period was not associated to increased mortality, however (HR 1.26; 95%CI 0.53-2.97; p = 0.60). Conclusions: A decrease in the number of admissions due to ACS was recorded during lockdown, with an increase in the time from symptoms onset to FMC in patients with STEACS. This was not associated to an increase in mortality during this period, however.
{"title":"Incidence, Morbidity-Mortality and Management of Acute Coronary Syndrome During the Covid-19 Pandemic","authors":"Julio Echarte Morales","doi":"10.61148/2836-2837/ijccci/001","DOIUrl":"https://doi.org/10.61148/2836-2837/ijccci/001","url":null,"abstract":"Background and objective: A decrease in the number of admissions due to acute coronary syndrome (ACS) was observed during the COVID-19 pandemic. A study is made of the impact of the pandemic upon the incidence, morbidity-mortality and management of ACS. Materials and methods: A retrospective multicenter study was carried out with data from patients admitted due to ACS between 14 February and 24 June 2020. The following groups were established according to the period of admission: A) one month before strict lockdown; B) during lockdown; and C) one month after lockdown. The primary objective of the study was to assess differences in mortality among the three periods. Differences in the time from symptoms onset to the first medical contact (FMC) were also evaluated. Results: A total of 634 patients were included in the study (group A: 205, group B: 303, group C: 126). A 41% decrease in the number of admissions due to ACS was recorded in the first month of lockdown. A diagnostic delay was observed during lockdown (A: 65 minutes (range 38-112) vs B: 120 minutes (60-300) vs C: 120 minutes (60-360), p < 0.001); this period was not associated to increased mortality, however (HR 1.26; 95%CI 0.53-2.97; p = 0.60). Conclusions: A decrease in the number of admissions due to ACS was recorded during lockdown, with an increase in the time from symptoms onset to FMC in patients with STEACS. This was not associated to an increase in mortality during this period, however.","PeriodicalId":153375,"journal":{"name":"International Journal of Clinical Cardiology and Cardiovascular Interventions","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130815614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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