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Minerva cardioangiologica最新文献

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Circulating VEGF and atherosclerosis risk: is it perhaps the case to reevaluate association with the inflammatory state? 循环血管内皮生长因子与动脉粥样硬化风险:是否需要重新评估与炎症状态的关系?
Q3 Medicine Pub Date : 2020-09-30 DOI: 10.23736/S0026-4725.20.05338-4
A. Carrizzo, Francesca Pagano
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引用次数: 0
Excess all-cause mortality during COVID-19 outbreak: potential role of untreated cardiovascular disease. COVID-19暴发期间的高全因死亡率:未经治疗的心血管疾病的潜在作用
Q3 Medicine Pub Date : 2020-09-30 DOI: 10.23736/S0026-4725.20.05349-9
A. Saglietto, F. D’Ascenzo, E. Cavarretta, G. Frati, M. Anselmino, F. Versaci, G. Biondi‐Zoccai, G. D. de Ferrari
BACKGROUNDSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has rapidly spread globally. Due to different testing strategies, under-detection of positive subjects and COVID-19-related-deaths remains common. Aim of this analysis was to assess the real impact of COVID-19 through the analysis of 2020 Italian all-cause mortality data compared to historical series.METHODSWe performed a retrospective analysis of 2020 and 2015-2019 all-cause mortality data released by the Italian National Institute for Statistics (ISTAT) for the time period 'January 1 - March 21'. This preliminary sample included 1,084 Italian municipalities showing at least 10 deaths during the above-mentioned timeframe and an increase in mortality of more than 20% as compared to the previous five years (2015-2019), with a resulting coverage of 21% of Italian population. The difference between 2020 observed and expected deaths (mean of weekly deaths in 2015-2019) was computed, together with mortality rate ratio (MRR) for each of the four weeks following detection of the first autochthonous COVID-19 case in Italy (23 February, 2020 - 21 March, 2020), as well as for this entire timeframe. Subgroup analysis by age groups was also performed.RESULTSOverall MRR was 1.79 [1.75-1.84], with an observed excess mortality of 8,750 individuals in the investigated sample, which in itself outweighs Italian Civil Protection report of only 4,825 COVID-19-related deaths across Italy, as of March 21. Subgroup analysis did not show any difference in mortality rate in '0-14 years' age group, while MRRs were significantly increased in older age groups, in particular in patients >75 years (MRR 1.84 [1.79-1.89]). In addition, week-by-week analysis showed a progressive increase in MRR during this period, peaking in the last week (15 March, 2020 - 21 March, 2020) with an estimated value of 2.65 [2.53-2.78].CONCLUSIONSThe analysis of all-cause mortality data in Italy indicates that reported COVID-19-related deaths are an underestimate of the actual death toll. All-cause death should be seen as the epidemiological indicator of choice to assess the real mortality impact exerted by SARS-CoV-2, given that it also best reflects the toll on frail patient subsets (eg the elderly or those with cardiovascular disease).
背景:严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)大流行已在全球迅速蔓延。由于检测策略不同,未检测到阳性受试者和与covid -19相关的死亡仍然很常见。本分析的目的是通过分析2020年意大利全因死亡率数据与历史序列的比较,评估COVID-19的实际影响。方法我们对意大利国家统计局(ISTAT)发布的2020年和2015-2019年“1月1日至3月21日”期间的全因死亡率数据进行了回顾性分析。这一初步样本包括1,084个意大利城市,显示在上述时间框架内至少有10人死亡,与前五年(2015-2019年)相比,死亡率增加了20%以上,覆盖了21%的意大利人口。计算了2020年观察到的死亡人数与预期死亡人数(2015-2019年每周死亡人数的平均值)之间的差异,以及在意大利发现第一例本土COVID-19病例(2020年2月23日至2020年3月21日)后的四周以及整个时间框架内的死亡率比率(MRR)。按年龄组进行亚组分析。结果总体MRR为1.79[1.75-1.84],调查样本中观察到的超额死亡率为8750人,这本身就超过了意大利民防部门报告的截至3月21日意大利全国仅4825例与covid -19相关的死亡。亚组分析显示0-14岁年龄组的死亡率无差异,而老年组的MRR显著升高,特别是>75岁的患者(MRR为1.84[1.79-1.89])。此外,逐周分析显示,MRR在此期间逐渐增加,在最后一周(2020年3月15日- 2020年3月21日)达到峰值,估计值为2.65[2.53-2.78]。结论对意大利全因死亡率数据的分析表明,报告的covid -19相关死亡人数低于实际死亡人数。全因死亡应被视为评估SARS-CoV-2对实际死亡率影响的首选流行病学指标,因为它也最能反映体弱患者亚群(如老年人或心血管疾病患者)的死亡人数。
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引用次数: 9
Should different ECG-QRSd criteria be used for men and women with heart failure for cardiac resynchronization therapy? 在心脏再同步化治疗中,男性和女性心衰患者是否应该使用不同的ECG-QRSd标准?
Q3 Medicine Pub Date : 2020-09-30 DOI: 10.23736/S0026-4725.20.05329-3
Haim Moti
In the present paper we review data of the efficacy of CRT based on baseline QRS duration and morphology in patients with heart failure due to left ventricle systolic dysfunction. We specifically review data that analyzed men and women separately. The main findings suggest benefit of CRT in patients with baseline LBBB, but not in patients without LBBB. Benefit is directly related to QRS duration at baseline with increasing rates and magnitude of echocardiographic response ( in terms of improvement in ejection fraction and decrease un LV size) and clinical response with increasing baseline QRS. The effect was most pronounced when QRSd was above 150 ms. Among women treated with CRT, similar to men, the benefit is also confined mainly to patients with baseline LBBB. In contrast to men benefit is evident starting with QRSd >130 ms. These findings may suggest that different QRS duration criteria should be used for men and women considered for CRT.
在本文中,我们回顾了基于基线QRS持续时间和形态学的CRT在左心室收缩功能障碍引起的心力衰竭患者中的疗效。我们特别回顾了分别分析男性和女性的数据。主要研究结果表明,CRT对基线LBBB患者有益,但对无LBBB患者无效。益处与基线QRS持续时间直接相关,超声心动图反应率和幅度增加(射血分数改善和左室大小减少),临床反应与基线QRS增加有关。当QRSd大于150ms时,效果最为明显。在接受CRT治疗的女性中,与男性相似,获益也主要局限于基线LBBB患者。与男性相比,QRSd >130 ms时获益明显。这些发现可能表明,对于考虑接受CRT的男性和女性,应该使用不同的QRS持续时间标准。
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引用次数: 0
Hydrochlorothiazide therapy: impact on early recurrence of atrial fibrillation after catheter ablation? 氢氯噻嗪治疗对导管消融后房颤早期复发的影响?
Q3 Medicine Pub Date : 2020-09-29 DOI: 10.23736/S0026-4725.20.05170-1
K. Filipovic, B. Bellmann, A. Sultan, J. Lüker, T. Plenge, D. Steven
BACKGROUNDHypokalemia has been linked to electrocardiogram changes and afterdepolarization-mediated arrhythmias. However, the association betweeen hypokalemia and atrial fibrillation (AF) has not been well studied. Hydrochlorothiazide (HCT) diuretic therapy was shown to be associated with hypokalemia in multiple studies. We aimed to determine whether HCT therapy is associated with early recurrence of AF after radiofrequency (RF) catheter ablation during a 3 month follow-up.METHODSWe performed a retrospective registry analysis of our internal AF ablation registry, containing 807 consecutive patients that underwent RF ablation for symptomatic AF. Propensity score matching was used to match 156 patients on HCT therapy with 156 controls. Furthermore, we performed propensity score matching between the first and the fourth quartile of baseline serum potassium (K) concentrations in the initial population (n=807).RESULTSWe observed a small but statistically significant difference in baseline mean potassium levels between the HCT group and the control group (4.03 mmol/l vs. 4.19 mmol/l respectively, p= 0.001). There was no difference in short term recurrence of atrial fibrillation in the HCT group compared to the propensity score matched control group (41.0% (n=64) vs. 45.5% (n=71), p=0.424). In the comparison between the first and the fourth quartile of baseline serum potassium values, no difference in AF recurrence (38.2% (n=63) vs. 37.0% (n=61), p=0.820) during a 3 month follow up after ablation was observed between both groups.CONCLUSIONSPatients on HCT therapy showed no difference in short term recurrence of AF after ablation compared to propensity matched controls.
背景:低钾血症与心电图改变和去极化后介导的心律失常有关。然而,低钾血症与心房颤动(AF)之间的关系尚未得到很好的研究。多项研究表明,氢氯噻嗪(HCT)利尿剂治疗与低钾血症有关。我们的目的是在3个月的随访中确定HCT治疗是否与射频(RF)导管消融后AF的早期复发有关。方法:我们对内部房颤消融登记进行了回顾性登记分析,包括807例连续接受射频消融治疗症状性房颤的患者。倾向评分匹配用于156例HCT治疗患者和156例对照。此外,我们在初始人群(n=807)的基线血清钾(K)浓度的第一个和第四个四分位数之间进行了倾向评分匹配。结果HCT组和对照组的基线平均钾水平差异虽小,但有统计学意义(分别为4.03 mmol/l和4.19 mmol/l, p= 0.001)。与倾向评分匹配的对照组相比,HCT组房颤短期复发率无差异(41.0% (n=64) vs 45.5% (n=71), p=0.424)。在基线血钾值的第一和第四个四分位数的比较中,两组在消融后3个月的随访中房颤复发率无差异(38.2% (n=63) vs 37.0% (n=61), p=0.820)。结论:与倾向匹配的对照组相比,HCT治疗的患者消融后房颤短期复发无差异。
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引用次数: 0
Procedural sedation and analgesia for percutaneous high tech cardiac procedures. 经皮高科技心脏手术的镇静和镇痛。
Q3 Medicine Pub Date : 2020-09-29 DOI: 10.23736/S0026-4725.20.05211-1
A. Zangrillo, Federica Morselli, Gaetano Lombardi, A. Yavorovskiy, V. Likhvantsev, L. Beretta, F. Monaco, G. Landoni
The interest in percutaneous high tech cardiac procedures has increased in recent years together with its safety and efficacy. In fragile patients, procedural sedation and analgesia are used to perform most of the procedures. General anesthesia remains the technique of choice during the team learning curve and might be required in selected patients or in emergent situations. Despite the high costs of percutaneous high tech cardiac procedures, the decrease in length of hospital stay, rate of intensive care admission and complications, balance the increase in devices costs. In fragile patients who undergo percutaneous high tech cardiac procedures, the primary role of the anesthesiologist is to prevent the need forpostprocedural intensive care unit and complications rate. Starting from the experience of a large university third level hospital we identified the eight most commonly performed contemporary percutaneous high tech cardiac procedures (ventricular tachycardia and atrial fibrillation ablation, protected percutaneous coronary intervention, transcatheter aortic valve implantation, MitraClip®, percutaneous patent foramen ovale closure, left atrial appendage closure, and dysfunctional lead extraction), discuss the role of procedural sedation and analgesia in this setting, and explore future perspectives.
近年来,对经皮高科技心脏手术的兴趣随着其安全性和有效性而增加。在身体脆弱的病人中,大多数手术都使用程序性镇静和镇痛。在团队学习过程中,全麻仍然是首选技术,在特定的患者或紧急情况下可能需要全麻。尽管经皮高科技心脏手术的费用很高,但住院时间、重症监护住院率和并发症的减少抵消了设备成本的增加。在接受经皮高科技心脏手术的虚弱患者中,麻醉师的主要作用是防止术后重症监护病房的需要和并发症的发生率。从一家大型大学三级医院的经验出发,我们确定了八种最常用的当代经皮高科技心脏手术(室性心动过速和房颤消融、经皮保护性冠状动脉介入治疗、经导管主动脉瓣植入、MitraClip®、经皮卵圆孔未闭闭合、左心房附件闭合和功能障碍铅提取)。讨论程序性镇静和镇痛在这种情况下的作用,并探讨未来的前景。
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引用次数: 2
Factors associated with recurrent postinfarction ventricular tachycardia following ablation: a meta-analysis. 消融后复发性室性心动过速相关因素:荟萃分析。
Q3 Medicine Pub Date : 2020-09-29 DOI: 10.23736/S0026-4725.20.05128-2
J. Kewcharoen, N. Prasitlumkum, S. Titichoatrattana, Chutikarn Wittayalikit, A. Trongtorsak, C. Kanitsoraphan, P. Putthapiban, K. Poonsombudlert, P. Rattanawong, Eugene H. Chung
BACKGROUNDAblation of ventricular tachycardia is the main therapy for patients with drug-refractory VT. Although evidence suggests that VT ablation could lower the incidence of recurrent VT, many cases still develop VT in follow-up. In this study, we performed a systematic review and meta-analysis to examine risk factors for recurrent VT in patients with postinfarction VT who underwent VT ablation.METHODSWe comprehensively searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were cohort studies, experimental trials, or randomized controlled trials that evaluate the risk of recurrent VT in postinfarction VT patients who underwent VT ablation. Data from each study were combined using random-effects.RESULTSThirteen studies involving 1,803 postinfarction patients who underwent VT ablation were included. Inducibility after the procedure (pooled HR=1.71, p<0.001), lower baseline left ventricular ejection fraction (LVEF) (pooled HR=0.98, p<0.001) and higher baseline New York Heart Association (NYHA) classification (pooled HR=1.34, p=0.003) were significantly associated with VT recurrence during the follow-up. There was no significant association between age, gender or diabetes mellitus and VT recurrence.CONCLUSIONSOur meta-analysis demonstrated that inducibility after the procedure, lower baseline LVEF and higher baseline NYHA classification were associated with an increased risk of VT recurrence in postinfarction VT patients who underwent VT ablation.
背景:室性心动过速消融是药物难治性室性心动过速患者的主要治疗方法。尽管有证据表明室性心动过速消融可以降低室性心动过速复发的发生率,但许多患者在随访中仍发生室性心动过速。在这项研究中,我们进行了系统回顾和荟萃分析,以检查梗死后室速消融患者复发性室速的危险因素。方法综合检索MEDLINE和EMBASE自成立至2020年3月的数据库。纳入的研究包括队列研究、实验试验或随机对照试验,这些研究评估了接受房室消融术的梗死后房室患者再次发生房室的风险。每个研究的数据使用随机效应进行组合。结果纳入13项研究,涉及1803例接受VT消融的梗死后患者。术后诱导(合并HR=1.71, p<0.001)、较低基线左室射血分数(合并HR=0.98, p<0.001)和较高基线纽约心脏协会(NYHA)分级(合并HR=1.34, p=0.003)与随访期间VT复发显著相关。年龄、性别、糖尿病与室速复发无显著相关性。结论:我们的荟萃分析表明,手术后的诱导性、较低的基线LVEF和较高的基线NYHA分级与梗死后接受房室消融的房室复发风险增加有关。
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引用次数: 0
Stentys coronary system: current status and future direction. Stentys冠状动脉系统:现状及未来发展方向。
Q3 Medicine Pub Date : 2020-09-29 DOI: 10.23736/S0026-4725.20.05167-1
M. Golino, Silvia Nuzzo, C. Briguori
Stentys self-apposing stent was designed to face complex lesions in the precincts of percutaneous coronary interventions. Nitinol platform and disconnectable struts were designed to provide a complete apposition on the vessel wall in challenging lesions such as significant tapering, primary angioplasty in ST segment elevation myocardial infarction and bifurcation. Stentys X-Position S is a sirolimus eluting stent with a novel delivery system aiming to improve positioning. Clinical trials showed good results in terms of procedural success rate, clinical outcome and short term strut apposition. Nevertheless, Stentys stent did not show superiority over the conventional balloon-expandable stents in the clinical outcomes. Authors underlined the importance of a learning curve and an adequate training period to get familiar with the device's features. Future trials in an all-comer population using the novel X-Position S stent will confirm the preliminary findings and strengthen evidence in clinical practice.
Stentys的自体支架设计用于处理经皮冠状动脉介入治疗领域的复杂病变。镍钛诺平台和可分离支撑物被设计用于在具有挑战性的病变(如明显变细、ST段抬高心肌梗死和分叉的初级血管成形术)中提供血管壁上的完整贴合。Stentys X-Position S是一种西罗莫司洗脱支架,具有新颖的输送系统,旨在改善定位。临床试验在手术成功率、临床预后和近期支架放置方面均取得了良好的效果。然而,Stentys支架在临床结果上并没有表现出优于传统球囊扩张支架的优势。作者强调了学习曲线的重要性和足够的训练期,以熟悉设备的功能。未来在所有患者中使用新型X-Position S支架的试验将证实初步发现,并在临床实践中加强证据。
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引用次数: 0
Differences in heart rate among recent marijuana use groups. 近期吸食大麻人群的心率差异。
Q3 Medicine Pub Date : 2020-09-29 DOI: 10.23736/S0026-4725.20.05239-1
L. Keen, A. Abbate, V. Clark, F. Moeller, Alex Y. Tan
BACKGROUNDMarijuana use increases cardiac sympathetic activity within minutes of its use and this effect may begin to decrease as soon as one hour after marijuana use. However, the cardiovascular effects of marijuana use more than an hour after use is poorly characterized. The purpose of the current study is to compare heart rate, a marker of cardiac sympathetic activity, across recent marijuana use groups (never used=63; recent use [in the past 24 hours; subacute] = 13; in the past 7 days, but not in the past 24 hours = 17). Overall, the current sample included 93 African American/Black college students, with a mean age of 20.03 (SD = 2.21).METHODSParticipants completed a demographic form, a brief battery of psychological questionnaires, and had their heart rate assessed at baseline.RESULTSAnalysis of covariance showed that heart rate was statistically significantly lower in the recent use group (M = 62.38) compared with the non-users group (M = 73.92). This difference persisted before and after statistically adjusting for demographic covariates.CONCLUSIONSThese results suggest that there may be a cardiovascular process that occurs when using marijuana that results in a compensatory, reduced heart rate.
背景:吸食大麻会在几分钟内增加心脏交感神经活动,而这种影响可能在吸食大麻一小时后开始减弱。然而,使用大麻超过一小时后对心血管的影响尚不清楚。当前研究的目的是比较心率,心脏交感神经活动的标志,在最近的大麻使用组(从未使用=63;最近使用[过去24小时内;亚急性]= 13;在过去7天内,但不在过去24小时内= 17)。总体而言,目前的样本包括93名非裔美国人/黑人大学生,平均年龄为20.03岁(SD = 2.21)。方法参与者完成了一份人口统计表格,一系列简短的心理问卷,并在基线时评估了他们的心率。结果协方差分析显示,近期服药组心率(M = 62.38)明显低于未服药组(M = 73.92)。这种差异在人口统计协变量调整前后仍然存在。结论:这些结果表明,使用大麻时可能发生心血管过程,导致代偿性心率降低。
{"title":"Differences in heart rate among recent marijuana use groups.","authors":"L. Keen, A. Abbate, V. Clark, F. Moeller, Alex Y. Tan","doi":"10.23736/S0026-4725.20.05239-1","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05239-1","url":null,"abstract":"BACKGROUND\u0000Marijuana use increases cardiac sympathetic activity within minutes of its use and this effect may begin to decrease as soon as one hour after marijuana use. However, the cardiovascular effects of marijuana use more than an hour after use is poorly characterized. The purpose of the current study is to compare heart rate, a marker of cardiac sympathetic activity, across recent marijuana use groups (never used=63; recent use [in the past 24 hours; subacute] = 13; in the past 7 days, but not in the past 24 hours = 17). Overall, the current sample included 93 African American/Black college students, with a mean age of 20.03 (SD = 2.21).\u0000\u0000\u0000METHODS\u0000Participants completed a demographic form, a brief battery of psychological questionnaires, and had their heart rate assessed at baseline.\u0000\u0000\u0000RESULTS\u0000Analysis of covariance showed that heart rate was statistically significantly lower in the recent use group (M = 62.38) compared with the non-users group (M = 73.92). This difference persisted before and after statistically adjusting for demographic covariates.\u0000\u0000\u0000CONCLUSIONS\u0000These results suggest that there may be a cardiovascular process that occurs when using marijuana that results in a compensatory, reduced heart rate.","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76775516","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}
引用次数: 0
DES: new presumed effects over in-stent restenosis prevention. DES:预防支架内再狭窄的新推测效应。
Q3 Medicine Pub Date : 2020-09-25 DOI: 10.23736/S0026-4725.20.05372-4
L. Macovei, R. Magopet, G. Campo
{"title":"DES: new presumed effects over in-stent restenosis prevention.","authors":"L. Macovei, R. Magopet, G. Campo","doi":"10.23736/S0026-4725.20.05372-4","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05372-4","url":null,"abstract":"","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89699365","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}
引用次数: 0
Lower extremities arterial disease (LEAD): not a peripheral issue. 下肢动脉疾病(LEAD):不是外周问题。
Q3 Medicine Pub Date : 2020-09-25 DOI: 10.23736/S0026-4725.20.05404-3
G. Gasparini, G. Andò, F. Imperadore, L. Santoro, D. Regazzoli
{"title":"Lower extremities arterial disease (LEAD): not a peripheral issue.","authors":"G. Gasparini, G. Andò, F. Imperadore, L. Santoro, D. Regazzoli","doi":"10.23736/S0026-4725.20.05404-3","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05404-3","url":null,"abstract":"","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86705155","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}
引用次数: 0
期刊
Minerva cardioangiologica
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