Scandinavian Cardiovascular Journal最新文献_第9页

Association between inflammatory markers and survival in comatose, resuscitated out-of-hospital cardiac arrest patients 院外心脏骤停昏迷复苏患者的炎症标志物与生存之间的关系

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Scandinavian Cardiovascular Journal

Pub Date : 2022-05-12 DOI: 10.1080/14017431.2022.2074093

Anne Toftgaard Pedersen, J. Kjaergaard, C. Hassager, M. Frydland, J. Hartvig Thomsen, Anika Klein, H. Schmidt, J. Møller, S. Wiberg

Abstract Objectives Prognostication after out-of-hospital cardiac arrest (OHCA) remains challenging. The inflammatory response after OHCA has been associated with increased mortality. This study investigates the associations and predictive value between inflammatory markers and outcome in resuscitated OHCA patients. Design The study is based on post hoc analyses of a double-blind controlled trial, where resuscitated OHCA patients were randomized to receive either exenatide or placebo. Blood was analyzed for levels of inflammatory markers the day following admission. Primary endpoint was time to death for up to 180 days. Secondary endpoints included 180-day mortality and poor neurological outcome after 180 days, defined as a cerebral performance category (CPC) of 3 to 5. Results Among 110 included patients we found significant associations between higher leucocyte quartile and increasing mortality in univariable analysis (OR 2.6 (95%CI 1.6–4.2), p < .001), as well as in multivariable analysis (OR 2.1 (95%CI 1.1–4.0), p = .02). A significant association was found between higher neutrophil quartile and increasing mortality in univariable analysis (OR 3.0 (95%CI 1.8–5.0), p < .001) as well as multivariable analysis (OR 2.4 (95%CI 1.2–4.6), p = .01). Leucocyte and neutrophil levels were predictive of poor outcome after 180 days with area under the receiver operating characteristics curves of 0.79 and 0.81, respectively. We found no associations between CRP and lymphocyte levels versus outcome. Conclusions Total leucocyte count and neutrophil levels measured the first day following OHCA were significantly associated with 180-day all-cause mortality and may potentially act as early predictors of outcome. Clinical trial registration www.clinicaltrials.gov, unique identifier: NCT02442791

摘要目的院外心脏骤停（OHCA）后的预后仍然具有挑战性。OHCA后的炎症反应与死亡率增加有关。本研究调查了炎症标志物与OHCA复苏患者预后之间的相关性和预测价值。设计该研究基于一项双盲对照试验的事后分析，其中复苏的OHCA患者被随机分配接受艾塞那肽或安慰剂。入院后第二天分析血液中炎症标志物的水平。主要终点是死亡时间长达180 天。次要终点包括180天死亡率和180天后的不良神经系统结果天，定义为3至5的大脑表现类别（CPC）。结果在110例纳入的患者中，我们在单变量分析中发现，较高的白细胞四分位数与死亡率增加之间存在显著相关性（OR 2.6（95%CI 1.6–4.2），p < .001），以及多变量分析（OR 2.1（95%CI 1.1–4.0），p = .02）。在单变量分析中，中性粒细胞四分位数较高与死亡率增加之间存在显著相关性（OR 3.0（95%CI 1.8-5.0），p < .001）以及多变量分析（OR 2.4（95%CI 1.2–4.6），p = .01）。白细胞和中性粒细胞水平可预测180 受试者工作特性曲线下面积分别为0.79和0.81。我们发现CRP和淋巴细胞水平与结果之间没有关联。结论OHCA后第一天测量的总白细胞计数和中性粒细胞水平与180天全因死亡率显著相关，可能是预后的早期预测因素。临床试验注册www.clinicaltrials.gov，唯一标识符：NCT02442791

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引用次数: 5

Less invasive aortic valve replacement using the trifecta bioprosthesis 使用三瓣生物假体的微创主动脉瓣置换术

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Scandinavian Cardiovascular Journal

Pub Date : 2022-05-10 DOI: 10.1080/14017431.2022.2071460

A. Agnino, Ascanio Graniero, P. Gerometta, L. Giroletti, G. Albano, C. Roscitano, A. Anselmi

Abstract Objectives. The safety and effectiveness of the Trifecta GT bioprosthesis (introduced in 2016) in less invasive aortic valve replacement are scarcely investigated. Our aim was to evaluate the immediate and initial follow-up results of this device in the context of less invasive surgery. We discuss patient-specific strategies for the selection of the surgical approach. Methods. A retrospective review of 133 patients undergoing AVR with the Trifecta GT through three less invasive accesses (UMS, Upper ministernotomy; RMS, Reversed ministernotomy; RAMT, Right anterior minithoracotomy) was performed. In-hospital, follow-up and hemodynamic performance (PPM, Patient-prosthesis mismatch) data were collected. Results. Among patients, 79% received UMS, 11% RMS and 10% RAMT. Selection of approach was based on preoperative anatomical analysis (CT-scan) and planned concomitant procedures. There was no operative mortality, no valve-related adverse events. There were 36 concomitant procedures. No significant intergroup differences occurred in cardiopulmonary bypass, aortic clamp, mechanical ventilation time, ICU stay and average bleeding. There were two cases of moderate PPM (1.5%) and no instances of severe PPM; there were no significant (≥2/4) perivalvular leaks. Average mean gradient at discharge was 8 ± 3 mmHg. At follow-up (average: 2.5 ± 0.9 years, 100% complete, 315 patient years) there was no mortality and no valve-related adverse event. Hemodynamic performance was maintained at follow-up. Conclusions. The optimal device for less invasive AVR needs to be individualized, as well as the selection of the surgical approach. The use of the Trifecta GT bioprosthesis appears to be reproductible whatever less invasive approach is employed, with confirmed excellent hemodynamic performance.

抽象目标。Trifecta GT生物瓣膜（2016年推出）在微创主动脉瓣置换术中的安全性和有效性几乎没有研究。我们的目的是在微创手术的背景下评估该设备的即时和初步随访结果。我们讨论了选择手术入路的针对患者的策略。方法。对133名使用Trifecta GT通过三种微创途径（UMS，上小切口；RMS，反向小切口；RAMT，右前小切口）接受AVR的患者进行了回顾性审查。在医院，收集随访和血液动力学表现（PPM，患者假体不匹配）数据。后果在患者中，79%接受UMS，11%接受RMS，10%接受RAMT。入路的选择基于术前解剖分析（CT扫描）和计划的伴随手术。无手术死亡，无瓣膜相关不良事件。共有36例伴随手术。体外循环、主动脉夹、机械通气时间、ICU住院时间和平均出血量在组间无显著差异。有两例中度PPM（1.5%），没有严重PPM；无明显（≥2/4）瓣周渗漏。出院时的平均梯度为8 ± 3. mmHg。随访时（平均：2.5 ± 0.9 年，100%完成，315患者年），没有死亡，也没有瓣膜相关的不良事件。随访时维持血液动力学表现。结论。微创AVR的最佳装置需要个性化，以及手术方法的选择。Trifecta GT生物瓣膜的使用似乎是可复制的，无论采用何种微创方法，都具有良好的血液动力学性能。

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引用次数: 1

Validation of an automated measurement method for determination of the ankle-brachial index 踝臂指数自动测量方法的验证

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Scandinavian Cardiovascular Journal

Pub Date : 2022-05-02 DOI: 10.1080/14017431.2022.2069855

Fatima Zebari, Vishal Amlani, M. Langenskiöld, J. Nordanstig

Abstract Objective. Lower extremity atherosclerotic disease (LEAD) diagnosis is largely based on ankle-brachial index (ABI) recordings. Equipment that could automatically determine ABI may facilitate LEAD identification within a broad range of health services. We aimed to test the measurement properties of an automated oscillometric ABI measurement device (MESI ABPI MD®) as compared to manual reference ABI measurements in patients with and without LEAD. Design. A total of 153 patients with and without LEAD visiting a vascular surgery clinic underwent manual and automated ABI measurements. In total, 306 limbs were investigated. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the automated ABI device overall validity, with the manual method as reference. Correlation analysis (Spearman) was used to assess patterns of correlation between measurement methods while Bland–Altman plots were used to quantify measurement agreement. Results. Sensitivity and specificity for the automated ABI device were 75 and 67% whereas PPV and NPV were 72 and 71%, respectively. The correlation coefficient (automated versus manual measurements) was r = 0.552, p < .01. Bland-Altman plots revealed proportional bias and a tendency by the automated device to overestimate lower ABI values and underestimate higher ABI values. The best agreement between automated and manual ABI recordings was observed within the normal ABI range. Conclusions. The ABPI MD® device performance was unfavorable. The automated device tended to overestimate lower ABI values while underestimating higher values, which may lead to underdiagnosis of LEAD. Our data do not support the use of this automated ABI measurement device in clinical practice.

摘要目标。下肢动脉粥样硬化性疾病（LEAD）的诊断主要基于踝臂指数（ABI）记录。可以自动确定ABI的设备可以在广泛的医疗服务中促进LEAD识别。我们的目的是测试自动示波ABI测量设备（MESI ABPI MD®）与手动参考ABI测量相比，在患有和不患有LEAD的患者中的测量特性。设计共有153名患有和不患有LEAD的患者在血管外科诊所接受了手动和自动ABI测量。总共调查了306条肢体。以手动方法为参考，计算灵敏度、特异性、阳性预测值（PPV）和阴性预测值（NPV），以评估自动ABI装置的总体有效性。相关性分析（Spearman）用于评估测量方法之间的相关性模式，而Bland–Altman图用于量化测量一致性。后果自动ABI装置的灵敏度和特异性分别为75%和67%，而PPV和NPV分别为72%和71%。相关系数（自动测量与手动测量）为r = 0.552，p < .01.Bland-Altman图揭示了比例偏差和自动化设备高估较低ABI值和低估较高ABI值的趋势。在正常ABI范围内观察到自动和手动ABI记录之间的最佳一致性。结论。ABPI MD®装置性能不佳。自动化设备往往高估了较低的ABI值，而低估了较高的值，这可能导致lead的诊断不足。我们的数据不支持在临床实践中使用这种自动ABI测量设备。

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引用次数: 1

Comparison of free arterial and saphenous vein grafting in outcomes after coronary bypass surgery 游离动脉和隐静脉移植在冠状动脉搭桥术后疗效的比较

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Scandinavian Cardiovascular Journal

Pub Date : 2022-04-08 DOI: 10.1080/14017431.2022.2060525

V. Abromaitiene, J. Greisen, H. Kimose, Zidryne Karaliunaite, C. Jakobsen

Abstract Objectives. The goal of this study was to examine whether the use of free arterial grafts could reduce the need for repeated revascularization and all-cause mortality in patients undergoing coronary artery grafting. Design. The cohort study included 17,354 consecutive adults with isolated coronary artery grafting from 2000 to 2016 in three cardiac surgery centers. Data were obtained from the Western Denmark Heart Registry. Propensity matching with 24 factors was used to establish comparable groups of patients receiving either vein grafts (n = 1019) or free arterial grafts (n = 1019) for outcome analysis. Results. The need for repeated revascularization and all-cause mortality was similar in both graft groups at 10 years of follow-up. Creatine-Kinase MB Isoenzyme >100 μg/L increased the risk of repeated revascularization rate after 1, 5 and 10 years. Conclusions. Long-term outcomes in revascularization and survival are comparable after free arterial or saphenous vein grafting.

抽象的目标。本研究的目的是研究游离动脉移植是否可以减少冠状动脉移植患者的反复血运重建需求和全因死亡率。设计。该队列研究纳入了2000年至2016年在三个心脏外科中心连续进行孤立冠状动脉移植的17,354名成年人。数据来自西丹麦心脏登记处。采用24个因素的倾向匹配，建立接受静脉移植(n = 1019)或游离动脉移植(n = 1019)患者的可比较组，进行结果分析。结果。在10年的随访中，两个移植组的重复血运重建需求和全因死亡率相似。肌酸激酶MB同工酶>100 μg/L增加了1、5和10年后重复血运重建率的风险。结论。游离动脉或隐静脉移植在血运重建和生存方面的长期结果是相当的。

引用次数: 1

Respiratory failure and bioelectrical phase angle are independent predictors for long-term survival in acute heart failure 呼吸衰竭和生物电相角是急性心力衰竭患者长期生存的独立预测因子

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Scandinavian Cardiovascular Journal

Pub Date : 2022-04-07 DOI: 10.1080/14017431.2022.2060527

P. Scicchitano, M. Ciccone, M. Iacoviello, P. Guida, M. De Palo, A. Potenza, M. Basile, P. Sasanelli, Francesco Trotta, M. Sanasi, P. Caldarola, F. Massari

Abstract Background. The assessment of long-term mortality in acute decompensated heart failure (ADHF) is challenging. Respiratory failure and congestion play a fundamental role in risk stratification of ADHF patients. The aim of this study was to investigate the impact of arterial blood gases (ABG) and congestion on long-term mortality in patients with ADHF. Methods and results. We enrolled 252 patients with ADHF. Brain natriuretic peptide (BNP), blood urea nitrogen (BUN), phase angle as assessed by means of bioimpedance vector analysis, and ABG analysis were collected at admission. The endpoint was all-cause mortality. At a median follow-up of 447 d (interquartile range [IQR]: 248–667), 72 patients died 1–840 d (median 106, IQR: 29–233) after discharge. Respiratory failure types I and II were observed in 78 (19%) and 53 (20%) patients, respectively. The ROC analyses revealed that the cut-off points for predicting death were: BNP > 441 pg/mL, BUN > 1.67 mmol/L, partial pressure in oxygen (PaO2) ≤69.7 mmHg, and phase angle ≤4.9°. Taken together, these four variables proved to be good predictors for long-term mortality in ADHF (area under the curve [AUC] 0.78, 95% CI 0.72–0.78), thus explaining 60% of all deaths. A multiparametric score based on these variables was determined: each single-unit increase promoted a 2.2-fold augmentation of the risk for death (hazard ratio [HR] 2.2, 95% CI 1.8–2.8, p< .0001). Conclusions. A multiparametric approach based on measurements of BNP, BUN, PaO2, and phase angle is a reliable approach for long-term prediction of mortality risk in patients with ADHF.

抽象的背景。急性失代偿性心力衰竭(ADHF)的长期死亡率评估具有挑战性。呼吸衰竭和充血是ADHF患者风险分层的基础。本研究的目的是探讨动脉血气(ABG)和充血对ADHF患者长期死亡率的影响。方法与结果。我们招募了252例ADHF患者。入院时采集脑钠肽(BNP)、血尿素氮(BUN)、生物阻抗矢量分析测定的相位角、ABG分析。终点是全因死亡率。中位随访447 d(四分位数间距[IQR]: 248-667)， 72例患者出院后1-840 d死亡(中位106例，IQR: 29-233)。I型和II型呼吸衰竭分别为78例(19%)和53例(20%)。ROC分析显示，预测死亡的截止点为:BNP > 441 pg/mL, BUN > 1.67 mmol/L, PaO2≤69.7 mmHg，相位角≤4.9°。总之，这四个变量被证明是ADHF长期死亡率的良好预测因子(曲线下面积[AUC] 0.78, 95% CI 0.72-0.78)，因此可以解释60%的死亡。基于这些变量确定了多参数评分:每增加一个单位，死亡风险增加2.2倍(风险比[HR] 2.2, 95% CI 1.8-2.8, p< 0.0001)。结论。基于BNP、BUN、PaO2和相位角测量的多参数方法是预测ADHF患者死亡风险的可靠方法。

{"title":"Respiratory failure and bioelectrical phase angle are independent predictors for long-term survival in acute heart failure","authors":"P. Scicchitano, M. Ciccone, M. Iacoviello, P. Guida, M. De Palo, A. Potenza, M. Basile, P. Sasanelli, Francesco Trotta, M. Sanasi, P. Caldarola, F. Massari","doi":"10.1080/14017431.2022.2060527","DOIUrl":"https://doi.org/10.1080/14017431.2022.2060527","url":null,"abstract":"Abstract Background. The assessment of long-term mortality in acute decompensated heart failure (ADHF) is challenging. Respiratory failure and congestion play a fundamental role in risk stratification of ADHF patients. The aim of this study was to investigate the impact of arterial blood gases (ABG) and congestion on long-term mortality in patients with ADHF. Methods and results. We enrolled 252 patients with ADHF. Brain natriuretic peptide (BNP), blood urea nitrogen (BUN), phase angle as assessed by means of bioimpedance vector analysis, and ABG analysis were collected at admission. The endpoint was all-cause mortality. At a median follow-up of 447 d (interquartile range [IQR]: 248–667), 72 patients died 1–840 d (median 106, IQR: 29–233) after discharge. Respiratory failure types I and II were observed in 78 (19%) and 53 (20%) patients, respectively. The ROC analyses revealed that the cut-off points for predicting death were: BNP > 441 pg/mL, BUN > 1.67 mmol/L, partial pressure in oxygen (PaO2) ≤69.7 mmHg, and phase angle ≤4.9°. Taken together, these four variables proved to be good predictors for long-term mortality in ADHF (area under the curve [AUC] 0.78, 95% CI 0.72–0.78), thus explaining 60% of all deaths. A multiparametric score based on these variables was determined: each single-unit increase promoted a 2.2-fold augmentation of the risk for death (hazard ratio [HR] 2.2, 95% CI 1.8–2.8, p< .0001). Conclusions. A multiparametric approach based on measurements of BNP, BUN, PaO2, and phase angle is a reliable approach for long-term prediction of mortality risk in patients with ADHF.","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"56 1","pages":"28 - 34"},"PeriodicalIF":2.2,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48962719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Cost-effectiveness of screening for atrial fibrillation in a single primary care center at a 3-year follow-up 在单一初级保健中心进行3年随访的心房颤动筛查的成本效益

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Scandinavian Cardiovascular Journal

Pub Date : 2022-04-07 DOI: 10.1080/14017431.2022.2060523

F. Ghazal, M. Aronsson, F. Al-Khalili, M. Rosenqvist, L. Levin

Abstract Objectives The aim of this study was to estimate the cost-effectiveness of intermittent electrocardiogram (ECG) screening for atrial fibrillation (AF) among 70–74-year old individuals in primary care. We also aimed to assess adherence to anticoagulants, severe bleeding, stroke and mortality among screening-detected AF cases at three-year follow-up. Methods A post hoc analysis based on a cross-sectional screening study for AF among 70–74-year old patients, who were registered at a single primary care center, was followed for three years for mortality. Data about adherence to anticoagulants, incidence of stroke and severe bleeding among screening-detected AF cases, were collected from patient’s records. Markov model and Monte Carlo simulation were used to assess the cost-effectiveness of the screening program. Results The mortality rate among screening-detected AF cases (n = 16) did not differ compared to the 274 individuals with no AF (hazard ratio 0.86, CI 0.12–6.44). Adherence to anticoagulants was 92%. There was no stroke or severe bleeding. The incremental cost-effectiveness ratio of screening versus no screening was EUR 2389/quality-adjusted life year (QALY) gained. The screening showed a 99% probability of being cost-effective compared to no screening at a willingness-to-pay threshold of EUR 20,000 per QALY. Conclusion Screening for AF among 70–74-year olds in primary care using intermittent ECG appears to be cost-effective at 3-year follow-up with high anticoagulants adherence and no increased mortality.

摘要目的本研究的目的是评估在70–74岁的初级保健人群中进行间歇性心电图（ECG）筛查以治疗心房颤动（AF）的成本效益。我们还旨在评估三年随访中筛查出的房颤病例对抗凝血剂的依从性、严重出血、中风和死亡率。方法对在单一初级保健中心登记的70–74岁患者进行了一项基于房颤横断面筛查研究的事后分析，并对其死亡率进行了三年的随访。从患者记录中收集筛查出的房颤病例中抗凝药物的依从性、中风发生率和严重出血的数据。Markov模型和蒙特卡罗模拟用于评估筛查计划的成本效益。结果筛查发现的房颤患者死亡率（n = 16）与274名无房颤患者相比没有差异（危险比0.86，CI 0.12–6.44）。抗凝药物的依从性为92%。没有中风或严重出血。筛查与不筛查的成本效益增量比为2389/质量调整生命年（QALY）。在每个QALY支付20000欧元的意愿阈值下，与没有筛查相比，筛查显示出99%的成本效益。结论在初级保健的70–74岁人群中，使用间歇心电图筛查房颤，在3年的随访中似乎具有成本效益，抗凝剂依从性高，死亡率不增加。

{"title":"Cost-effectiveness of screening for atrial fibrillation in a single primary care center at a 3-year follow-up","authors":"F. Ghazal, M. Aronsson, F. Al-Khalili, M. Rosenqvist, L. Levin","doi":"10.1080/14017431.2022.2060523","DOIUrl":"https://doi.org/10.1080/14017431.2022.2060523","url":null,"abstract":"Abstract Objectives The aim of this study was to estimate the cost-effectiveness of intermittent electrocardiogram (ECG) screening for atrial fibrillation (AF) among 70–74-year old individuals in primary care. We also aimed to assess adherence to anticoagulants, severe bleeding, stroke and mortality among screening-detected AF cases at three-year follow-up. Methods A post hoc analysis based on a cross-sectional screening study for AF among 70–74-year old patients, who were registered at a single primary care center, was followed for three years for mortality. Data about adherence to anticoagulants, incidence of stroke and severe bleeding among screening-detected AF cases, were collected from patient’s records. Markov model and Monte Carlo simulation were used to assess the cost-effectiveness of the screening program. Results The mortality rate among screening-detected AF cases (n = 16) did not differ compared to the 274 individuals with no AF (hazard ratio 0.86, CI 0.12–6.44). Adherence to anticoagulants was 92%. There was no stroke or severe bleeding. The incremental cost-effectiveness ratio of screening versus no screening was EUR 2389/quality-adjusted life year (QALY) gained. The screening showed a 99% probability of being cost-effective compared to no screening at a willingness-to-pay threshold of EUR 20,000 per QALY. Conclusion Screening for AF among 70–74-year olds in primary care using intermittent ECG appears to be cost-effective at 3-year follow-up with high anticoagulants adherence and no increased mortality.","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":"56 1","pages":"35 - 41"},"PeriodicalIF":2.2,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47659302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Administration of intracoronary adenosine before stenting for the prevention of no-reflow in patients with ST-elevation myocardial infarction st段抬高型心肌梗死患者支架置入术前冠状动脉内腺苷的应用

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Scandinavian Cardiovascular Journal

Pub Date : 2022-03-07 DOI: 10.1080/14017431.2022.2035807

M. Sadeghian, Seyyed Hossein Mousavi, Zahra Aamaraee, A. Shafiee

Abstract Objectives: No-reflow phenomenon during the primary percutaneous intervention (PCI) for ST-elevation myocardial infarction (STEMI) is accompanied by a poor clinical outcome and mortality. We aimed to determine the effect of intracoronary adenosine in preventing the no-reflow phenomenon, as detected by three different methods, in patients who underwent primary (PCI). Design. In this single-blinded randomized controlled trial, patients with acute STEMI who presented to our center and underwent primary PCI were randomized to the intervention group who received intracoronary adenosine before stenting or the control group who received the standard treatment. No-reflow phenomenon was detected using thrombolysis in myocardial infarction (TIMI) flow grade, TIMI frame count, and myocardial blush grade (MBG). The incidence of the no-reflow phenomenon was then compared between the intervention and control groups. Results. The adenosine group consisted of 110 patients (age = 57 ± 11 years; 92 (84%) male) while 118 patients were in the control group (age = 59 ± 12 years; 89 (75%) male). There was no difference between the study groups in baseline characteristics. The frequency of no-reflow phenomenon was lower in the adenosine group as assessed by TIMI flow grade (15 [14%] vs. 41 [35%]), MBG (23 [21%] vs. 63 [53%]) and TIMI frame count (16 [14%] vs. 50 [42%]) (p < .001 for all). This effect remained significant after adjustment for confounding variables. Conclusion. Intracoronary adenosine could effectively prevent the no-reflow phenomenon in STEMI patients who underwent primary PCI.

【摘要】目的:st段抬高型心肌梗死(STEMI)经皮介入治疗(PCI)时无血流再流现象伴随较差的临床结局和死亡率。我们的目的是确定冠状动脉内腺苷在预防非血流现象中的作用，通过三种不同的方法检测，在接受原发性PCI的患者中。设计。在这项单盲随机对照试验中，到我们中心就诊并接受首次PCI治疗的急性STEMI患者被随机分为支架植入前接受冠状动脉内腺苷治疗的干预组和接受标准治疗的对照组。采用溶栓法检测心肌梗死(TIMI)血流等级、TIMI帧数和心肌红晕等级(MBG)有无再流现象。然后比较干预组和对照组之间无血流现象的发生率。结果。腺苷组110例患者(年龄= 57±11岁;其中男性92例(84%)，对照组118例(年龄59±12岁;89例(75%)男性)。两组在基线特征上没有差异。通过TIMI血流等级(15[14%]比41[35%])、MBG(23[21%]比63[53%])和TIMI帧数(16[14%]比50[42%])评估，腺苷组无血流现象的频率较低(p < 0.05)。对所有人来说都是001)。在调整混杂变量后，这种效果仍然显著。结论。冠状动脉内腺苷可有效预防STEMI患者行首次PCI的无血流现象。

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引用次数: 1

Effect of maturation on parasympathetic modulation during exercise and recovery. 运动和恢复过程中成熟对副交感神经调节的影响。

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Scandinavian Cardiovascular Journal

Pub Date : 2022-02-01 DOI: 10.1080/14017431.2022.2035809

Justin P Guilkey, Brandon Dykstra, Jennifer Erichsen, C Eric Heidorn, Anthony D Mahon

Objectives: This study examined the effect of maturation on parasympathetic nervous system (PNS) response from rest to light- to moderate-intensity exercise and recovery from maximal exercise in pre- (n = 10; maturity offset = -3.0 ± 1.2 years; age = 10.1 ± 1.9 years), mid- (n = 9; maturity offset = -0.1 ± 0.6 years; age = 13.7 ± 1.0 years), and postpubertal (n = 10; maturity offset = 1.9 ± 0.6 years; age = 15.6 ± 1.2 years) boys and men (n = 10; age = 24.1 ± 2.0 years).

Design: Participants completed seated rest, light-intensity exercise (50% HR_max), and moderate-intensity exercise (65% HR_max). Following moderate-intensity exercise, intensity was ramped to elicit maximal HR and followed by 25 min of seated recovery. Log transformed values for root mean square of successive differences (lnRMSSD), high-frequency power (lnHF) and normalized HF power (lnHFnu) assessed PNS modulation during 3 min of rest, light-intensity exercise, moderate-intensity exercise, and 3-min epochs throughout recovery.

Results: During light-intensity exercise, lnRMSSD and lnHF were greater in prepubertal (lnRMSSD = 3.4 ± 0.3 ms; lnHF = 5.4 ± 0.7 ms²) compared to men (lnRMSSD = 2.8 ± 0.5 ms; lnHF = 4.0 ± 0.9 ms²). During moderate-intensity exercise, lnHF differed between prepubertal and men (2.8 ± 1.0 vs. 1.4 ± 1.0 ms²). During recovery, HRV variables were greater in prepubertal compared to postpubertal and men.

Conclusions: Prepubertal boys have reduced PNS withdrawal during light-intensity exercise and greater PNS reactivation following exercise.

目的:本研究考察了成熟对副交感神经系统(PNS)从休息到轻到中等强度运动的反应和从最大运动中恢复的影响。成熟期偏移= -3.0±1.2年;年龄= 10.1±1.9岁)，中年(n = 9;成熟期偏移= -0.1±0.6年;年龄= 13.7±1.0岁)，青春期后(n = 10;期限偏移= 1.9±0.6年;年龄= 15.6±1.2岁)，男、男各10例;年龄= 24.1±2.0岁)。设计:参与者完成坐式休息、低强度运动(50% HRmax)和中等强度运动(65% HRmax)。在中等强度的运动后，强度增加到最大心率，然后进行25分钟的静坐恢复。连续差均方根(lnRMSSD)、高频功率(lnHF)和归一化高频功率(lnHFnu)的对数变换值评估了休息3分钟、低强度运动、中等强度运动和整个恢复过程中3分钟时期的PNS调制。结果:低强度运动时，青春期前lnRMSSD、lnHF显著增高(lnRMSSD = 3.4±0.3 ms;lnRMSSD = 5.4±0.7 ms2)与男性(lnRMSSD = 2.8±0.5 ms;lnHF = 4.0±0.9 ms2)。在中等强度运动中，lnHF在青春期前和男性之间存在差异(2.8±1.0 vs1.4±1.0 ms2)。在恢复期间，与青春期后和男性相比，青春期前的HRV变量更高。结论:青春期前男孩在低强度运动中PNS戒断减少，运动后PNS重新激活增加。

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引用次数: 0

Christmas holiday triggers of myocardial infarction. 圣诞节诱发心肌梗塞。

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Scandinavian Cardiovascular Journal

Pub Date : 2021-12-01 Epub Date: 2021-09-29 DOI: 10.1080/14017431.2021.1983638

Anneli Olsson, Ida Thorén, Moman A Mohammad, Rebecca Rylance, Pyotr G Platonov, David Sparv, David Erlinge

Objectives: Christmas holidays have been associated with the highest incidence of myocardial infarction (MI). We wanted to assess possible triggers of MI during Christmas. Design: A nationwide, retrospective postal survey with case-control design. All individuals suffering an MI during the Christmas holidays 2018 and 2019 in Sweden were identified through the SWEDEHEART registry and a control group matched in age and gender with chronic coronary syndrome who did not seek medical attention during Christmas were asked for participation. Subjects completed a questionnaire asking them to rate 27 potential MI-triggers as having occurred more or less than usual. Results: A total of 189 patients suffering an MI on Christmas Eve, Christmas Day, or Boxing Day, and 157 patients in the control group responded to the questionnaire, representing response rates of 66% and 62%, respectively. Patients with MI on Christmas experienced more stress (37% vs. 21%, p = .002), depression (21% vs. 11%, p = .024), and worry (26% vs. 10%, p < .001) compared to the control group. The food and sweets consumption was increased in both groups, but to a greater extent in the control group (33% vs. 50%, p = .002 and 32% vs. 43%, p = .031). There were no increases in quarrels, anger, economic worries, or reduced compliance with medication. Conclusions: Patients suffering MI on Christmas holiday experienced higher levels of stress and emotional distress compared to patients with chronic coronary syndrome, possibly contributing to the phenomenon of holiday heart attack. Understanding what factors increase the number of MI on Christmas may help reduce the excess number of MIs and cardiovascular burden.

目的:圣诞节假期与心肌梗死(MI)的最高发生率有关。我们想评估圣诞节期间心肌梗死的可能诱因。设计:采用病例对照设计的全国性回顾性邮政调查。通过SWEDEHEART登记处确定了2018年和2019年瑞典圣诞节假期期间患有心肌梗死的所有个体，并要求年龄和性别与圣诞节期间未就医的慢性冠状动脉综合征相匹配的对照组参与研究。受试者完成了一份调查问卷，要求他们对27个潜在的mi触发因素进行评级，这些触发因素比平时发生的更多或更少。结果:共有189例在平安夜、圣诞节、节礼日发生心肌梗死的患者和157例对照组患者参与了问卷调查，反应率分别为66%和62%。圣诞节发生心肌梗死的患者有更多的压力(37%对21%，p = 0.002)、抑郁(21%对11%，p = 0.024)和担忧(26%对10%，p = 0.024)。002和32%对43%，p = 0.031)。争吵、愤怒、经济担忧或药物依从性降低都没有增加。结论:与慢性冠状动脉综合征患者相比，圣诞节假期心肌梗死患者的压力和情绪困扰水平更高，这可能是节日心脏病发作的原因。了解是什么因素增加了圣诞节期间心肌梗死的数量，可能有助于减少心肌梗死的过量数量和心血管负担。

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引用次数: 4

Normalized handgrip strength and future risk of hypertension: findings from a prospective cohort study. 标准化握力与未来高血压风险:一项前瞻性队列研究的结果。

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Scandinavian Cardiovascular Journal

Pub Date : 2021-12-01 Epub Date: 2021-10-11 DOI: 10.1080/14017431.2021.1983206

Setor K Kunutsor, Timo H Mäkikallio, Ari Voutilainen, David Hupin, Jari A Laukkanen

Previous reports of an association between handgrip strength (HGS) and the risk of hypertension have utilized cross-sectional designs. We aimed to assess the prospective association between HGS and hypertension risk in a general population. Handgrip strength was assessed at baseline in 463 Finnish men and women aged 61-73 years. Handgrip strength was normalized (HGS/body weight^2/3). After 16 years median follow-up, 110 hypertension cases occurred. Comparing the extreme tertiles of normalized HGS, the multivariable adjusted hazard ratio (95% CI) for hypertension was 0.63 (0.38-1.04). Previous evidence of associations may have been driven by study design limitations such as lack of temporality.

先前关于握力(HGS)与高血压风险之间关系的报道采用了横断面设计。我们的目的是评估一般人群中HGS和高血压风险之间的前瞻性关联。对463名年龄在61-73岁之间的芬兰男性和女性的握力进行了基线评估。握力归一化(HGS/体重2/3)。中位随访16年后，发生高血压110例。比较归一化HGS的极端位数，高血压的多变量校正危险比(95% CI)为0.63(0.38-1.04)。先前的关联证据可能是由于研究设计的限制，如缺乏时间性。

引用次数: 6