Liangrong Wang, Yu Cao, Shuyu Hu, Hongbo Wang, Xiaoyao Li, Jun Ma
Background: This study aimed to establish a clinically relevant animal model for peripheral arterial disease (PAD) that better replicates the complexity observed in human patients. Materials and Methods: Thirty male rats were randomly assigned into the sham (SM), femoral artery resection (FE), constrictor-induced ischemia (CI), two-stage ischemia (TS), or diabetic two-stage ischemia (DT) groups. In the FE group, rats underwent femoral artery resection, whereas the SM group had sham surgery. The CI group received progressive ischemia using two ameroid constrictors, and the TS and DT groups underwent a two-stage ischemia procedure involving initial gradual narrowing with two ameroid constrictors and subsequent femoral artery resection in healthy and diabetic rats, respectively. Perfusion evaluation and functional assessment were conducted at postoperative days 14, 28, and 42. On day 42, hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) protein expression were measured, along with histological examination and immunofluorescence analysis. Results: Motor function deficits and reduced limb reperfusion were most prominent in the TS and DT groups on days 28 and 42 (P < 0.05), exacerbated by type 2 diabetes. Gastrocnemius exhibited upregulated HIF-1α and VEGF protein expression, as well as increased capillary density in response to ischemia. However, the DT group showed significantly lower protein expression and capillary density, along with more severe structural damage compared to other groups (P < 0.05). Conclusion: A clinically relevant rat model of PAD was established by implementing a two-stage ischemia procedure involving initial progressive narrowing and subsequent femoral artery excision in the context of diabetes.
{"title":"Establishment of a two-stage limb ischemia in diabetic rats","authors":"Liangrong Wang, Yu Cao, Shuyu Hu, Hongbo Wang, Xiaoyao Li, Jun Ma","doi":"10.4103/rcm.rcm_43_23","DOIUrl":"https://doi.org/10.4103/rcm.rcm_43_23","url":null,"abstract":"Background: This study aimed to establish a clinically relevant animal model for peripheral arterial disease (PAD) that better replicates the complexity observed in human patients. Materials and Methods: Thirty male rats were randomly assigned into the sham (SM), femoral artery resection (FE), constrictor-induced ischemia (CI), two-stage ischemia (TS), or diabetic two-stage ischemia (DT) groups. In the FE group, rats underwent femoral artery resection, whereas the SM group had sham surgery. The CI group received progressive ischemia using two ameroid constrictors, and the TS and DT groups underwent a two-stage ischemia procedure involving initial gradual narrowing with two ameroid constrictors and subsequent femoral artery resection in healthy and diabetic rats, respectively. Perfusion evaluation and functional assessment were conducted at postoperative days 14, 28, and 42. On day 42, hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) protein expression were measured, along with histological examination and immunofluorescence analysis. Results: Motor function deficits and reduced limb reperfusion were most prominent in the TS and DT groups on days 28 and 42 (P < 0.05), exacerbated by type 2 diabetes. Gastrocnemius exhibited upregulated HIF-1α and VEGF protein expression, as well as increased capillary density in response to ischemia. However, the DT group showed significantly lower protein expression and capillary density, along with more severe structural damage compared to other groups (P < 0.05). Conclusion: A clinically relevant rat model of PAD was established by implementing a two-stage ischemia procedure involving initial progressive narrowing and subsequent femoral artery excision in the context of diabetes.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136208381","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}
Introduction: Although atherosclerotic cardiovascular disease (ASCVD) results have significantly improved in recent years, ASCVD continues to be the world's leading cause of morbidity and mortality. Therefore, in the present study, lifetime risk of ASCVD was calculated in an urban cohort. White-collar employees have higher risk of developing cardiovascular disease events because of their work profile. Aim and Objectives: To calculate lifetime predicted risk of ASCVD among study cohort and to explore factors contributing to the disparities of cardiovascular risks. Materials and Methods: This was community-based cross-sectional study. The baseline data were collected during the period 2016–2019 from Rajkot city, and their lifetime predicted risk of ASCVD was calculated using ASCVD risk calculator. Crude and adjusted prevalence ratio was calculated. Results: The study revealed that 69.25% and 6.37% of participants had low and intermediate lifetime predicted risk of ASCVD, respectively, while the remaining 16.12% and 8.25% had borderline and high risk, respectively. Conclusion: This study indicates that increased lifetime predicted risk of ASCVD was associated with increasing age, male, stress, elevated blood pressure, high level of body mass index, and central obesity among participants.
{"title":"Lifetime predicted risk of atherosclerotic cardiovascular disease among an urban cohort: A cross-sectional study","authors":"Nikita Savani, R. Chauhan, Rajesh Chudasama","doi":"10.4103/rcm.rcm_26_22","DOIUrl":"https://doi.org/10.4103/rcm.rcm_26_22","url":null,"abstract":"Introduction: Although atherosclerotic cardiovascular disease (ASCVD) results have significantly improved in recent years, ASCVD continues to be the world's leading cause of morbidity and mortality. Therefore, in the present study, lifetime risk of ASCVD was calculated in an urban cohort. White-collar employees have higher risk of developing cardiovascular disease events because of their work profile. Aim and Objectives: To calculate lifetime predicted risk of ASCVD among study cohort and to explore factors contributing to the disparities of cardiovascular risks. Materials and Methods: This was community-based cross-sectional study. The baseline data were collected during the period 2016–2019 from Rajkot city, and their lifetime predicted risk of ASCVD was calculated using ASCVD risk calculator. Crude and adjusted prevalence ratio was calculated. Results: The study revealed that 69.25% and 6.37% of participants had low and intermediate lifetime predicted risk of ASCVD, respectively, while the remaining 16.12% and 8.25% had borderline and high risk, respectively. Conclusion: This study indicates that increased lifetime predicted risk of ASCVD was associated with increasing age, male, stress, elevated blood pressure, high level of body mass index, and central obesity among participants.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48665301","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}
Debasish Das, A. Banerjee, Abhinav Kumar, S. Singh, Tutan Das, Manaranjan Dixit
We report an extremely rare case of Williams–Beuren (WB) syndrome in a 10-year-old boy with supravalvular aortic stenosis (SVAS) secondary to a large fibrocalcific eccentric shelf in the ascending aorta with fibrocalcific severe supravalvular pulmonary stenosis, which has not yet been described in the literature. Although the presence of peripheral pulmonary stenosis is well described in Williams syndrome (WS), our case is the unique and first to demonstrate fibrocalcific severe supravalvular pulmonary stenosis in WS without the presence of peripheral pulmonary artery stenosis. Although regarded as a strong genetic insult with 27 gene deletions (almost like biting the gene), it has also bitten the heart in this index child and left a large chunk of supravalvular fibrocalcific mass in the ascending aorta causing SVAS.
{"title":"A rare case of williams–Beuren syndrome with presence of fibrocalcific supravalvular aortic stenosis and supravalvular pulmonary stenosis: Genetic disorder that bites the gene and bites the heart","authors":"Debasish Das, A. Banerjee, Abhinav Kumar, S. Singh, Tutan Das, Manaranjan Dixit","doi":"10.4103/rcm.rcm_9_22","DOIUrl":"https://doi.org/10.4103/rcm.rcm_9_22","url":null,"abstract":"We report an extremely rare case of Williams–Beuren (WB) syndrome in a 10-year-old boy with supravalvular aortic stenosis (SVAS) secondary to a large fibrocalcific eccentric shelf in the ascending aorta with fibrocalcific severe supravalvular pulmonary stenosis, which has not yet been described in the literature. Although the presence of peripheral pulmonary stenosis is well described in Williams syndrome (WS), our case is the unique and first to demonstrate fibrocalcific severe supravalvular pulmonary stenosis in WS without the presence of peripheral pulmonary artery stenosis. Although regarded as a strong genetic insult with 27 gene deletions (almost like biting the gene), it has also bitten the heart in this index child and left a large chunk of supravalvular fibrocalcific mass in the ascending aorta causing SVAS.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45807966","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}
Issei Ota, T. Nomura, K. Ono, Yu Sakaue, Keisuke Shoji, Naotoshi Wada, N. Keira, T. Tatsumi
Dual-lumen catheter (DLC)-facilitated reverse wire technique is considered a method of last resort for inserting a guidewire into a markedly angulated side branch. Moreover, this technique can be practically applied to other types of anatomical variations around the bifurcation. Case 1 was that of a 53-year-old man with a tight stenosis of the proximal left anterior descending artery at the diagonal bifurcation with angiographically apparent coronary dissection. We successfully achieved guidewire insertion into the targeted branch using the DLC-facilitated reverse wire technique. Case 2 involved a 78-year-old man with total occlusion of the mid-portion of the right coronary artery. The guidewire reentry point in the atrioventricular branch was slightly distant from the true distal end of the occlusion. We successfully used the DLC-facilitated reverse wire technique to pass a second guidewire to the posterodescending artery. Case 3 was that of an 80-year-old man whose coronary artery had an aneurysm with severe stenoses at both entry and exit of the aneurysm. We adopted the DLC-facilitated reverse wire technique and easily advanced the guidewire by matching the guidewire advancing path with the direction of the sequential conduit constituted by the coronary aneurysm and stenosis. The timing of decision-making to try the DLC-facilitated reverse wire technique is important. The lesion for which reverse wiring is suitable is usually difficult to be treated with conventional guidewire crossing. We have to promptly judge the validity of applying this technique based on the angiographic findings of targeted lesions and take immediate action to implement this procedure to reduce the procedural time and irradiation dose.
{"title":"Practical use of dual-lumen catheter-facilitated reverse wire technique for nonhighly angulated side branch","authors":"Issei Ota, T. Nomura, K. Ono, Yu Sakaue, Keisuke Shoji, Naotoshi Wada, N. Keira, T. Tatsumi","doi":"10.4103/rcm.rcm_29_22","DOIUrl":"https://doi.org/10.4103/rcm.rcm_29_22","url":null,"abstract":"Dual-lumen catheter (DLC)-facilitated reverse wire technique is considered a method of last resort for inserting a guidewire into a markedly angulated side branch. Moreover, this technique can be practically applied to other types of anatomical variations around the bifurcation. Case 1 was that of a 53-year-old man with a tight stenosis of the proximal left anterior descending artery at the diagonal bifurcation with angiographically apparent coronary dissection. We successfully achieved guidewire insertion into the targeted branch using the DLC-facilitated reverse wire technique. Case 2 involved a 78-year-old man with total occlusion of the mid-portion of the right coronary artery. The guidewire reentry point in the atrioventricular branch was slightly distant from the true distal end of the occlusion. We successfully used the DLC-facilitated reverse wire technique to pass a second guidewire to the posterodescending artery. Case 3 was that of an 80-year-old man whose coronary artery had an aneurysm with severe stenoses at both entry and exit of the aneurysm. We adopted the DLC-facilitated reverse wire technique and easily advanced the guidewire by matching the guidewire advancing path with the direction of the sequential conduit constituted by the coronary aneurysm and stenosis. The timing of decision-making to try the DLC-facilitated reverse wire technique is important. The lesion for which reverse wiring is suitable is usually difficult to be treated with conventional guidewire crossing. We have to promptly judge the validity of applying this technique based on the angiographic findings of targeted lesions and take immediate action to implement this procedure to reduce the procedural time and irradiation dose.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49202343","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}
Seyyed Fakhr-Moosavi, A. Salari, Yasaman‐Sadat Borghei, T. Hasandokht, A. Haghdoost, S. Mousavi, Sajad Ramezani
Introduction: Pulmonary hypertension (PH) is quite common among patients with thalassemia, and it can lead to cardiac failure and even death in those patients. Methods: This current cross-sectional study was conducted with 155 patients with β-thalassemia major and thalassemia intermedia referring to Razi Hospital Rasht, Iran in a recent year. All patients underwent echocardiography and the data (including age, sex, thalassemia type, splenectomy history, deferoxamine usage, hydroxyurea usage, hemoglobin, and ferritin level) were collected by a researcher-made checklist. Data analysis was performed using SPSS software. Results: The prevalence of PH was 13.7% in this study. There was a correlation between sex, thalassemia type, deferoxamine usage, and ferritin level with a prevalence of PH. However, there was not a significant relationship between splenectomy history, hydroxyurea usage, and hemoglobin level with PH prevalence (P = 0.187, P = 0.035, and P = 0.178, respectively). Conclusions: The findings of the study represented that the proposed variables can cause and exacerbate cardiac complications and may have a correlation with the disease's side effects. By conducting more studies and designing a more promising interventional study with a higher sample size, using the results of this study and similar studies, a step could be taken to identify patients susceptible to exacerbation of cardiac complications earlier. By treating them, we may be able to increase their chance of survival in the long run.
{"title":"What is the Prevalence of Pulmonary Hypertension in Thalassemic Patients in Guilan? A Retrospective Analytic Study","authors":"Seyyed Fakhr-Moosavi, A. Salari, Yasaman‐Sadat Borghei, T. Hasandokht, A. Haghdoost, S. Mousavi, Sajad Ramezani","doi":"10.4103/rcm.rcm_18_22","DOIUrl":"https://doi.org/10.4103/rcm.rcm_18_22","url":null,"abstract":"Introduction: Pulmonary hypertension (PH) is quite common among patients with thalassemia, and it can lead to cardiac failure and even death in those patients. Methods: This current cross-sectional study was conducted with 155 patients with β-thalassemia major and thalassemia intermedia referring to Razi Hospital Rasht, Iran in a recent year. All patients underwent echocardiography and the data (including age, sex, thalassemia type, splenectomy history, deferoxamine usage, hydroxyurea usage, hemoglobin, and ferritin level) were collected by a researcher-made checklist. Data analysis was performed using SPSS software. Results: The prevalence of PH was 13.7% in this study. There was a correlation between sex, thalassemia type, deferoxamine usage, and ferritin level with a prevalence of PH. However, there was not a significant relationship between splenectomy history, hydroxyurea usage, and hemoglobin level with PH prevalence (P = 0.187, P = 0.035, and P = 0.178, respectively). Conclusions: The findings of the study represented that the proposed variables can cause and exacerbate cardiac complications and may have a correlation with the disease's side effects. By conducting more studies and designing a more promising interventional study with a higher sample size, using the results of this study and similar studies, a step could be taken to identify patients susceptible to exacerbation of cardiac complications earlier. By treating them, we may be able to increase their chance of survival in the long run.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42185526","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}
Ambukeshwar Singh, V. Narain, Jayesh Sharma, G. Chaudhary, P. Vishwakarma, S. Yadav, S. Dwivedi
Context: Primary percutaneous coronary intervention (PCI) is the most effective reperfusion therapy with low complication rate in comparison to thrombolysis. Aims: We aimed to study the short-term outcomes of primary PCI at a large tertiary care center in India. Settings and Design: A prospective cohort of patients with ST-elevation myocardial infarction (STEMI) who underwent primary PCI was enrolled between December 2015 and November 2016. Subjects and Methods: The demographic profile, risk factors, clinical characteristics, inhospital complications, and outcomes at 30 days were assessed. The primary outcome was a composite of death, reinfarction, and repeat revascularization. Acute left ventricular failure (LVF), complete heart block (CHB) or bradyarrhythmia, ventricular tachycardia (VT) or ventricular fibrillation, stroke, and major thrombolysis in myocardial infarction bleeding were the inhospital complications that were considered the secondary outcomes. Results: A total of 237 STEMI patients with primary PCI were enrolled, accounting for 7.5% of all PCI procedures performed during this period. The mean age was 55.4 ± 11.9 years, and 86.5% were male. The mean window period was 5.1 ± 3.18 h, and the mean door-to-balloon time was 58.4 ± 11.5 min. Prior to PCI, the most often administered antiplatelets were clopidogrel in 54.4% of patients and prasugrel in 55.6%. The aspiration thrombectomy was done in 70.8% of patients. Predilatation with balloon was required in 41.8% of patients. Drug-eluting stents were implanted in 98.3% of patients. The primary outcome was found in 3.3% of patients (deaths – 2.9% and reinfarction – 0.4%) and the secondary outcomes were observed in 13%. The common inhospital complication was CHB or bradyarrhythmia in 5.0% followed by acute LVF in 4.6% and then VT in 2.1%. Conclusions: The primary outcome rate is as good as reported in developed Western countries in contemporary treatment practices of STEMI. CHB and acute LVF were the major inhospital complications among patients of STEMI treated with primary PCI.
{"title":"The short outcomes and in-hospital complications in patients with STEMI revascularized with primary PCI: A prospective registry from India","authors":"Ambukeshwar Singh, V. Narain, Jayesh Sharma, G. Chaudhary, P. Vishwakarma, S. Yadav, S. Dwivedi","doi":"10.4103/rcm.rcm_25_22","DOIUrl":"https://doi.org/10.4103/rcm.rcm_25_22","url":null,"abstract":"Context: Primary percutaneous coronary intervention (PCI) is the most effective reperfusion therapy with low complication rate in comparison to thrombolysis. Aims: We aimed to study the short-term outcomes of primary PCI at a large tertiary care center in India. Settings and Design: A prospective cohort of patients with ST-elevation myocardial infarction (STEMI) who underwent primary PCI was enrolled between December 2015 and November 2016. Subjects and Methods: The demographic profile, risk factors, clinical characteristics, inhospital complications, and outcomes at 30 days were assessed. The primary outcome was a composite of death, reinfarction, and repeat revascularization. Acute left ventricular failure (LVF), complete heart block (CHB) or bradyarrhythmia, ventricular tachycardia (VT) or ventricular fibrillation, stroke, and major thrombolysis in myocardial infarction bleeding were the inhospital complications that were considered the secondary outcomes. Results: A total of 237 STEMI patients with primary PCI were enrolled, accounting for 7.5% of all PCI procedures performed during this period. The mean age was 55.4 ± 11.9 years, and 86.5% were male. The mean window period was 5.1 ± 3.18 h, and the mean door-to-balloon time was 58.4 ± 11.5 min. Prior to PCI, the most often administered antiplatelets were clopidogrel in 54.4% of patients and prasugrel in 55.6%. The aspiration thrombectomy was done in 70.8% of patients. Predilatation with balloon was required in 41.8% of patients. Drug-eluting stents were implanted in 98.3% of patients. The primary outcome was found in 3.3% of patients (deaths – 2.9% and reinfarction – 0.4%) and the secondary outcomes were observed in 13%. The common inhospital complication was CHB or bradyarrhythmia in 5.0% followed by acute LVF in 4.6% and then VT in 2.1%. Conclusions: The primary outcome rate is as good as reported in developed Western countries in contemporary treatment practices of STEMI. CHB and acute LVF were the major inhospital complications among patients of STEMI treated with primary PCI.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46314810","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}
True idiopathic radial artery aneurysm is a rare entity. There are only a few cases reported in the literature. Asymptomatic radial arterial aneurysm in young patients is even rarer. Here, we present a successfully managed case report of a left radial artery aneurysm in a young female who presented to us with a painless, pulsatile swelling at the wrist.
{"title":"Idiopathic radial artery true aneurysm: A rare entity","authors":"Anshuman Darbari, Ruhi Sharma, Rahul Sharma, Ajay Kumar","doi":"10.4103/rcm.rcm_17_22","DOIUrl":"https://doi.org/10.4103/rcm.rcm_17_22","url":null,"abstract":"True idiopathic radial artery aneurysm is a rare entity. There are only a few cases reported in the literature. Asymptomatic radial arterial aneurysm in young patients is even rarer. Here, we present a successfully managed case report of a left radial artery aneurysm in a young female who presented to us with a painless, pulsatile swelling at the wrist.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48659358","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}
Mozhgan Parsaee, A. Rezaeefar, Z. Khajali, Hamideh Khesali, Mohammad Bidkhori, A. Soleimani
Background and Aim: Aortic root dilation is one of the common complications in patients with a history of tetralogy of Fallot total correction (TFTC). We evaluate the frequency of aortic root dilation in adult TFTC patients and analyze probable risk factors related to the dilated aortic root. Materials and Methods and Results: We reviewed echocardiography images of 146 adult TFTC patients who admitted at Rajaie Cardiovascular Medical and Research Center from 1383 to 1399 in an observational retrospective cohort study. Sinus of Valsalva (SOV) was measured in parasternal long-axis view. Aortic root dilation was determined by two definitions. When we adjusted SOV diameter for body surface area and sex, the frequency of aortic root dilation was 68%, with a mean SOV diameter of 3.5 ± 0.7 cm and when we used absolute diameter ≥4 cm for dilated SOV, 22% showed aortic root dilation. By multivariate logistic regression analysis, male sex (odds ratio (OR) = 3.47, P = 0.003), age at the time of TFTC (OR = 1.06, P = 0.009), and aortic regurgitation (OR = 3.97, P = 0.003) were associated with increased adds of dilated aortic root. Three patients underwent aortic surgery, including one case of type A aortic dissection. Conclusion: Although aortic root dilation was common, aneurysmal dilation and adverse events were not so frequent. Serial evaluation of all segments of the ascending aorta, including the aortic root, is important but not more frequent than previously suggested.
背景与目的:主动脉根部扩张是法洛四联症患者的常见并发症之一。我们评估成人TFTC患者主动脉根部扩张的频率，并分析与主动脉根部扩张相关的可能危险因素。材料、方法和结果:我们回顾了1383年至1399年在Rajaie心血管医学和研究中心入院的146例成年TFTC患者的超声心动图。胸骨旁长轴位测量Valsalva窦(SOV)。主动脉根部扩张由两种定义确定。当我们根据体表面积和性别调整SOV直径时，主动脉根部扩张的频率为68%，平均SOV直径为3.5±0.7 cm，当我们使用绝对直径≥4 cm的SOV扩张时，22%的SOV出现主动脉根部扩张。通过多因素logistic回归分析，男性(优势比(OR) = 3.47, P = 0.003)、TFTC时的年龄(OR = 1.06, P = 0.009)、主动脉反流(OR = 3.97, P = 0.003)与主动脉根扩张的增加相关。3例患者接受了主动脉手术，其中1例为A型主动脉夹层。结论:虽然主动脉根部扩张是常见的，但动脉瘤扩张和不良事件并不常见。对升主动脉的所有节段(包括主动脉根)进行连续评估很重要，但并不比以前建议的更频繁。
{"title":"Evaluation of aortic root dilation in adult patients after repair of tetralogy of Fallot","authors":"Mozhgan Parsaee, A. Rezaeefar, Z. Khajali, Hamideh Khesali, Mohammad Bidkhori, A. Soleimani","doi":"10.4103/rcm.rcm_3_22","DOIUrl":"https://doi.org/10.4103/rcm.rcm_3_22","url":null,"abstract":"Background and Aim: Aortic root dilation is one of the common complications in patients with a history of tetralogy of Fallot total correction (TFTC). We evaluate the frequency of aortic root dilation in adult TFTC patients and analyze probable risk factors related to the dilated aortic root. Materials and Methods and Results: We reviewed echocardiography images of 146 adult TFTC patients who admitted at Rajaie Cardiovascular Medical and Research Center from 1383 to 1399 in an observational retrospective cohort study. Sinus of Valsalva (SOV) was measured in parasternal long-axis view. Aortic root dilation was determined by two definitions. When we adjusted SOV diameter for body surface area and sex, the frequency of aortic root dilation was 68%, with a mean SOV diameter of 3.5 ± 0.7 cm and when we used absolute diameter ≥4 cm for dilated SOV, 22% showed aortic root dilation. By multivariate logistic regression analysis, male sex (odds ratio (OR) = 3.47, P = 0.003), age at the time of TFTC (OR = 1.06, P = 0.009), and aortic regurgitation (OR = 3.97, P = 0.003) were associated with increased adds of dilated aortic root. Three patients underwent aortic surgery, including one case of type A aortic dissection. Conclusion: Although aortic root dilation was common, aneurysmal dilation and adverse events were not so frequent. Serial evaluation of all segments of the ascending aorta, including the aortic root, is important but not more frequent than previously suggested.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41505425","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}
Background: Several microorganisms are associated with infective endocarditis (IE), but the most common IE causes are staphylococci and streptococci. Among streptococci, the viridans group streptococci are responsible for a considerable percentage of all IE cases. Methods: Since 2006, the Iranian Registry of Infective Endocarditis has recorded information regarding all adult patients with a definite or possible IE diagnosis according to the modified Duke criteria. Patients with viridans streptococcal endocarditis were detected through three blood culture sets. The patients' demographic characteristics, predisposing factors, clinical presentations, and echocardiographic findings were recorded. Results: Of 731 patients diagnosed with endocarditis, viridans streptococci were found in 46 (6.3%) patients, consisting of 28 (60.9%) men and 18 (39.1%) women at a mean age of 42.56 ± 15.46 years, who were subsequently included in the study. Among the 46 patients with viridans streptococcal endocarditis, 26 had a subacute course, whereas 20 had an acute course. Vegetation was detected in 35 patients. All the patients were treated with the standard antibiotic regimen for viridans streptococcal endocarditis, and cardiac surgery was performed on 16 patients. Conclusions: Clinicians should pay sufficient heed to the following points in all cases of viridans streptococcal endocarditis: firstly, an appropriate antibiotic regimen must be based on a precise minimal inhibitory concentration determination for the usual antibiotics. Secondly, since prolonged antibiotic therapy is crucial to the eradication of microorganisms within vegetation, all patients with viridans streptococcal endocarditis must receive an adequate therapy course.
{"title":"Demographic characteristics, predisposing factors, clinical presentations, echocardiographic findings, complications, and outcomes of patients with viridans streptococcal endocarditis","authors":"P. Moradnejad, S. Boudagh","doi":"10.4103/rcm.rcm_23_22","DOIUrl":"https://doi.org/10.4103/rcm.rcm_23_22","url":null,"abstract":"Background: Several microorganisms are associated with infective endocarditis (IE), but the most common IE causes are staphylococci and streptococci. Among streptococci, the viridans group streptococci are responsible for a considerable percentage of all IE cases. Methods: Since 2006, the Iranian Registry of Infective Endocarditis has recorded information regarding all adult patients with a definite or possible IE diagnosis according to the modified Duke criteria. Patients with viridans streptococcal endocarditis were detected through three blood culture sets. The patients' demographic characteristics, predisposing factors, clinical presentations, and echocardiographic findings were recorded. Results: Of 731 patients diagnosed with endocarditis, viridans streptococci were found in 46 (6.3%) patients, consisting of 28 (60.9%) men and 18 (39.1%) women at a mean age of 42.56 ± 15.46 years, who were subsequently included in the study. Among the 46 patients with viridans streptococcal endocarditis, 26 had a subacute course, whereas 20 had an acute course. Vegetation was detected in 35 patients. All the patients were treated with the standard antibiotic regimen for viridans streptococcal endocarditis, and cardiac surgery was performed on 16 patients. Conclusions: Clinicians should pay sufficient heed to the following points in all cases of viridans streptococcal endocarditis: firstly, an appropriate antibiotic regimen must be based on a precise minimal inhibitory concentration determination for the usual antibiotics. Secondly, since prolonged antibiotic therapy is crucial to the eradication of microorganisms within vegetation, all patients with viridans streptococcal endocarditis must receive an adequate therapy course.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41892384","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 : 2022-07-01DOI: 10.1016/j.atherosclerosis.2022.06.462
E. Begić, Ada Djozic, Emina Karavelic, Nadira Zatric, Adela Sinancevic, A. Džubur, A. Durak-Nalbantić, A. Begić, N. Begić, Amina Šahbaz, Esma Hasanagić, Ena Gogić, N. Naser, F. Zukić, Edin Medjedović, A. Iglica, M. Halilčević, Z. Begić
{"title":"Familial hypercholesterolemia within cardiology practice – single-center experience during 2-year period","authors":"E. Begić, Ada Djozic, Emina Karavelic, Nadira Zatric, Adela Sinancevic, A. Džubur, A. Durak-Nalbantić, A. Begić, N. Begić, Amina Šahbaz, Esma Hasanagić, Ena Gogić, N. Naser, F. Zukić, Edin Medjedović, A. Iglica, M. Halilčević, Z. Begić","doi":"10.1016/j.atherosclerosis.2022.06.462","DOIUrl":"https://doi.org/10.1016/j.atherosclerosis.2022.06.462","url":null,"abstract":"","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48915727","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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