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Fulminant Myocarditis: Brief Review 暴发性心肌炎:综述
Pub Date : 2021-08-17 DOI: 10.31579/2692-9759/022
E. Amsterdam, Muhammad Majid
Fulminant myocarditis (FM) is a rare disease characterized by acute hemodynamic impairment and ventricular arrhythmias due to severe myocardial inflammation. It is typically preceded by a viral infection but any of multiple other toxic and infective agents may also be the inciting agent. Diagnosis is based on biomarkers and/or cardiac imaging, but endomyocardial biopsy is the standard test for confirming the diagnosis. FM usually requires therapeutic support of cardiac function and treatment of malignant arrhythmias. Contrary to prior concepts, recent evidence has revealed that patients with FM are more likely to die or need heart transplantation than those with the nonfulminant form of the disease. Early recognition and aggressive management are essential for favorable outcomes.
暴发性心肌炎(FM)是一种罕见的疾病,其特征是严重的心肌炎症引起急性血流动力学损害和室性心律失常。它通常在病毒感染之前发生,但多种其他毒性和感染性因子中的任何一种也可能是诱发因子。诊断是基于生物标志物和/或心脏成像,但心内膜心肌活检是确认诊断的标准测试。FM通常需要治疗性的心功能支持和恶性心律失常的治疗。与先前的概念相反,最近的证据表明,FM患者比非暴发性形式的患者更容易死亡或需要心脏移植。早期识别和积极的管理对于取得良好的结果至关重要。
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引用次数: 0
IVIG: The Heart Savior in Covid 19 era IVIG:新冠时代的心脏救世主
Pub Date : 2021-08-17 DOI: 10.31579/2692-9759/026
R. Chaddad, Matina Hamadeh, Amena Khatoun, Zouheir Kreidly, C. Najjar, Pierre Nassar, Malek Moussa
Coronavirus disease 2019 (COVID-19) is defined as illness caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV), which was first identified as an outbreak in Wuhan City, Hubei Province, China [1]. Cases of multisystem inflammatory syndrome after Covid – 19 infection have been extensively documented in children. CDC reported 27 cases of multisystem inflammatory syndrome in adults (MIS-A) in direct reports through October 2020, as well as various case series and published case reports [2]. Cytokine storm, as a trigger of the progression of HF in patients with COVID-19, has become a novel focus to explore therapies for target populations [3]. In this article, we briefly present a case of a Covid-19 infection associated myocarditis complicated by acute heart failure successfully treated with IVIG.
2019冠状病毒病(COVID-19)被定义为由一种新型冠状病毒引起的疾病,现在称为严重急性呼吸综合征冠状病毒2 (SARS-CoV-2;以前称为2019-nCoV),该病毒最初在中国湖北省武汉市被确定为疫情[1]。Covid - 19感染后的多系统炎症综合征病例在儿童中有广泛的记录。截至2020年10月,CDC报告了27例成人多系统炎症综合征(MIS-A)的直接报告,以及各种病例系列和发表的病例报告[2]。细胞因子风暴作为COVID-19患者HF进展的触发因素,已成为探索靶向人群治疗方法的新焦点[3]。在这篇文章中,我们简要地介绍了一例Covid-19感染相关心肌炎合并急性心力衰竭的病例,并成功地用IVIG治疗。
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引用次数: 0
Description of the Mechanism of Positive Inotropic Action of the Isoquinoline Alkaloid F-18 异喹啉生物碱F-18正性肌力作用机理的描述
Pub Date : 2021-06-10 DOI: 10.31579/2692-9759/023
S. Rustamov, I. Jumayev, Sadriddin N. Boboev, Eldor B. Ibragimov, Pulat B. Usmanov, Sherzod N. Zhurakulov
This study evaluated the mechanism of inotropic effect of an isoquinoline alkaloid derivative, 1-(2´-bromine-4´,5´-dimethoxyphenyl)-6,7-dimethoxy-1,2,3,4- tetrahydroisoquinoline (F-18) using electrically stimulated rat left ventricular papillary muscle of rat. The F-18 alkaloid have been shown to have positive inotropic effect on papillary muscle contraction activity, IC50 value -14,6 µM. Са2+L-channel blocker - nifedipine was used in experiments. Inotropic effects of F-18 isoquinoline alkaloid on cardiomyocytes were suggested, based on results obtained in experiments carried in cardiomyocytes SR Ca2+- transport systems modulation.
本研究利用电刺激大鼠左心室乳头肌,评价异喹啉生物碱衍生物1-(2′-溴-4′,5′-二甲氧基苯基)-6,7-二甲氧基-1,2,3,4-四氢异喹啉(F-18)的肌力作用机制。F-18生物碱对乳头肌收缩活性有正性肌力作用,IC50值为- 14.6µM。Са2+ l通道阻滞剂硝苯地平。基于对心肌细胞SR Ca2+转运系统调节的实验结果,提出了F-18异喹啉生物碱对心肌细胞的肌力作用。
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引用次数: 1
Energy/information dissipation and blood flow in human body 人体的能量/信息耗散和血液流动
Pub Date : 2021-05-10 DOI: 10.31579/2692-9759/017
M. Beraia, G. Beraia
The amount of work done to displace blood in systemic arteries and capillaries exceeds the work done by the left ventricle. Besides, at the heartbeat, electromagnetic energy dissipates from the heart to the whole human body. For the problem study, the dielectric spectroscopy method was used. Ringer’s, amino acid solution, and heparinized venous blood were affected by the external electromagnetic oscillations (100-65000Hz, 1-8MHz.) in 17 healthy individuals. Correlations were noted between the initial and induced signal forms/frequencies according to the impedance of the system. The electric impulse from the heart initiates an oscillating electric field around the charged cells/particles and an emerging repulsing electromagnetic force, based on the electroacoustic phenomena, promotes the blood flow, in addition to the pulse pressure from the myocardial contraction. Blood conduces mechanical, electromagnetic waves of different frequencies and transmits energy/information to implement the spontaneous chemical processes in the human body.
在全身动脉和毛细血管中置换血液所做的功超过左心室所做的功。此外,在心跳时,电磁能量从心脏散发到整个人体。对于问题的研究,采用了介电光谱方法。研究了17例健康人体外电磁振荡(100-65000Hz, 1-8MHz)对林格氏血、氨基酸溶液和肝素化静脉血的影响。根据系统的阻抗,注意到初始和感应信号形式/频率之间的相关性。来自心脏的电脉冲在带电细胞/粒子周围引发振荡电场,并基于电声现象产生排斥电磁力,除了来自心肌收缩的脉冲压力外,还促进了血液流动。血液传导不同频率的机械波、电磁波,传递能量/信息,实现人体内自发的化学过程。
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引用次数: 0
Coronary Artery Vasospasm: A Unique Cause of ST-Elevation Myocardial Infarction in COVID19 冠状动脉血管痉挛:冠状动脉st段抬高心肌梗死的一个独特原因
Pub Date : 2021-05-10 DOI: 10.31579/2692-9759/021
Julia Peterson, Shahad Al Chalaby, Oluwayemisi L. Adejumo, Xin Yang
Coronary artery vasospasm (CAV) is an under-recognized cause of ACS in patients with COVID-19. Difference in pathophysiology and management increases the importance of the identification of these patients. We describe the first case of CAV in a patient with COVID-19 in the absence of signs of severe systemic inflammation.
冠状动脉血管痉挛(CAV)是COVID-19患者ACS的一个未被充分认识的原因。病理生理和治疗的差异增加了识别这些患者的重要性。我们描述了在没有严重全身性炎症迹象的COVID-19患者中出现的第一例CAV。
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引用次数: 0
Algorithm for diagnosis and typing of ALCAPA syndrome ALCAPA综合征的诊断与分型算法
Pub Date : 2021-05-10 DOI: 10.31579/2692-9759/020
Mariela Céspedes Almira, Adel Eladio González Morejón, Giselle Serrano Ricardo, Tania Rosa González Rodríguez, Judith Escobar Bermúdez
ALCAPA syndrome was characterized by anomalous origin of left coronary artery from pulmonary artery. Its clinical presentation is varied and although it is an anomaly of congenital origin, it is not exclusive to pediatric ages. Its epidemiological documentation is difficult. We aimed to make the non-invasive diagnosis of the ALCAPA syndrome and its variants. An observational, prospective and cross-sectional study was conducted with 31 patients with a positive echocardiographic diagnosis of ALCAPA syndrome at Pediatric Cardio Center “William Soler” from 2005 to 2018. The variables with significance for diagnosis were the echocardiographic visualization of the anomalous connection and the reversed flow in the left coronary artery. The variables with significance for typing were age at diagnosis, ischemia in the electrocardiogram, echocardiographic visualization of left ventricle papillary muscles fibrosis, presence of severe mitral regurgitation, left ventricle spheroidal remodeling, left ventricle ejection fraction, left ventricular end-diastolic volume index, and left ventricular end-diastolic diameter index. An algorithm integrated by various diagnostic modalities associated with echocardiography as a tool for the detection of ALCAPA was developed. The documentation of the diagnostic and classificatory aspects of the syndrome is possible by detecting echocardiographic elements in conjunction with electrocardiographic and radiological aspects.
ALCAPA综合征以左冠状动脉起源于肺动脉异常为特征。它的临床表现是多种多样的,虽然它是先天性起源的异常,但它并不专属于儿科年龄。它的流行病学文献是困难的。我们的目的是对ALCAPA综合征及其变异进行无创诊断。本研究对2005年至2018年William Soler儿科心脏中心超声心动图诊断为ALCAPA综合征阳性的31例患者进行了一项观察性、前瞻性和横断面研究。超声心动图显示异常连接和左冠状动脉血流逆转对诊断有重要意义。诊断年龄、心电图缺血、超声心动图显示左心室乳头状肌纤维化、严重二尖瓣返流、左心室球体重构、左心室射血分数、左室舒张末期容积指数、左室舒张末期内径指数对分型有重要意义。结合超声心动图作为ALCAPA检测工具的各种诊断模式,开发了一种算法。该综合征的诊断和分类方面的文件是可能的,通过检测超声心动图元素结合心电图和放射学方面。
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引用次数: 0
COVID-19 pneumonitis induced myocardial infarction and multi-organ failure: an ethical and clinical challenge COVID-19肺炎致心肌梗死和多器官衰竭:伦理和临床挑战
Pub Date : 2021-05-10 DOI: 10.31579/2692-9759/018
S. Pallikadavath, Zakariyya Vali, Sanjay S Bhandari, Gerry P McCann
A 62-year-old man presented at the height of the first wave of the coronavirus disease 2019 (COVID-19) pandemic with hypoxia, multi-organ failure and haemodynamic instability. The electrocardiogram and echocardiogram were indicative of inferolateral ST segment elevation myocardial infarction. His hypoxia was initially thought to be driven by acute pulmonary oedema due to cardiac failure, but this was out-of-proportion to his left-ventricular function. This aroused suspicion of COVID-19 which he subsequently tested positive for. He was not deemed to be candidate for primary percutaneous intervention, intubation or mechanical ventilation; a difficult decision to make in a previously healthy, young patient. Clinical decisions were complicated by late presentation and hospital pressures related to the pandemic. Similar clinical scenarios are likely as we move into the next stages of the pandemic. Establishing clinical frameworks to help clinicians make these decisions, and identifying barriers to healthcare attendance, may be priorities for policy-makers.
一名62岁男性在2019冠状病毒病(COVID-19)第一波大流行高峰期出现缺氧、多器官衰竭和血流动力学不稳定。心电图和超声心动图提示ST段内抬高型心肌梗死。他的缺氧最初被认为是由心力衰竭引起的急性肺水肿引起的,但这与他的左心室功能不成比例。这引起了对COVID-19的怀疑,随后他的检测结果呈阳性。他不被认为是初级经皮介入治疗、插管或机械通气的候选人;对一个健康的年轻病人来说,这是一个艰难的决定。由于就诊时间较晚以及与大流行有关的医院压力,临床决定变得复杂。随着我们进入大流行的下一个阶段,类似的临床情况很可能出现。建立临床框架来帮助临床医生做出这些决定,并确定医疗服务的障碍,可能是政策制定者的优先事项。
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引用次数: 0
Tips and Tricks in Below-Knee Peripheral Artery Disease Interventions 膝关节以下外周动脉疾病干预的提示和技巧
Pub Date : 2021-05-10 DOI: 10.31579/2692-9759/019
H. Degirmenci, Eftal Murat Bakırcı, Ş. Yurt
Critical leg ischemia, which threatens lower extremity and life, is an important form of lower extremity peripheral artery disease. Below-knee peripheral artery disease is an important part of critical leg ischemia. The most important treatment of below-knee peripheral artery disease is endovascular treatment. Knowing the endovascular treatment techniques is very important in increasing the success of the procedure. For this reason, we have presented this mini review called tips and tricks in below-knee peripheral artery disease interventios.
下肢严重缺血是下肢外周动脉疾病的一种重要形式,严重威胁着下肢的生命安全。膝下外周动脉病变是严重下肢缺血的重要组成部分。膝关节以下外周动脉疾病最重要的治疗方法是血管内治疗。了解血管内治疗技术对提高手术成功率非常重要。出于这个原因,我们提出了这个小综述,称为膝以下外周动脉疾病干预的提示和技巧。
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引用次数: 0
Scintigraphy after Various Methods of Myocardial Revascularization 各种心肌血运重建术后的显像
Pub Date : 2020-10-13 DOI: 10.31579/2692-9759/007
Y. Shevchenko, G. Borshev, D. Ulbashev, M. Vahromeeva, A. Vahrameeva
Abstract. This article presents a comprehensive assessment of the perfusion-functional state of the LV myocardium after direct and indirect revascularization methods at various times after surgery to evaluate the complex relationship between myocardial viability and the method of revascularization. The research shows a significant advantage to using the YurLeon method of inducing extracardial revascularization of the myocardium in patients with diffuse coronary lesions. Aim. Comparative dynamic of scintigraphic indicators with various methods of revascularization. Materials and Methods.The study included 214 patients who underwent myocardial revascularization in various ways. Gated-SPECT was performed before the operation, as well as 1 month, 6 months, 1 year, and 2 or more years after the operation. Results.The groups of patients after CABG and CABG+YurLeon had differences in SRS indicators one year after surgery: 6.58±7.37 (after CABG) and 1.01±1.49 (CABG+YurLeon)(p<0.05).The most significant changes in systolic thickening (WT) occurred in segments with an accumulation of 26-40%: 1.78±1.84 (CABG), 0.51±0.85 (CABG+YurLeon), 2.6±1.19(PCI); and in segments 41-50%: 1.23±1.10 (CABG), 0.14±0.39 (CABG+YurLeon), 2.1±0.8 (PCI) (p<0.05).In the long-term period after revascularization, the total percentage of LV myocardial segments with "functional-perfusion mismatch" stood at: 11.08±11.69% of segments (CABG), 1.26±2.7% (CABG+YurLeon), 18.44±8.70% (PCI) (p<0.05). Conclusion. Comprehensive diagnostics of patients before surgery, including gated-SPECT, allow medical professionals to more effectively choose the method of revascularization and predict the nearest and separated results. Coronary bypass surgery together with the YurLeon technique of indirect myocardial revascularization in patients with severe diffuse lesions of the coronary artery shows more effective results than other methods of surgically treating IHD.
摘要本文通过对术后不同时间直接和间接血运重建术后左室心肌灌注功能状态的综合评价,来评价心肌活力与血运重建术方法之间的复杂关系。本研究显示,在弥漫性冠状动脉病变患者中,使用YurLeon法诱导心外心肌血运重建具有显著优势。的目标。不同血运重建方法的星形指标的动态比较。材料与方法。该研究包括214例以不同方式接受心肌血运重建术的患者。术前、术后1个月、6个月、1年、2年及以上分别行gate - spect检查。结果。CABG组与CABG+YurLeon组术后1年SRS指标差异:CABG组(6.58±7.37)、CABG+YurLeon组(1.01±1.49)(p<0.05)。收缩增厚(WT)最显著的变化发生在积累26-40%的节段:1.78±1.84 (CABG), 0.51±0.85 (CABG+YurLeon), 2.6±1.19(PCI);41 ~ 50%节段:CABG组为1.23±1.10,CABG+YurLeon组为0.14±0.39,PCI组为2.1±0.8 (p<0.05)。在血运重建后的长期内,左室心肌段“功能-灌注失配”的总比例分别为:CABG(11.08±11.69%)、CABG+YurLeon(1.26±2.7%)、PCI(18.44±8.70%)(p<0.05)。结论。术前对患者的全面诊断,包括门控spect,使医疗专业人员能够更有效地选择血运重建方法,并预测最近和分离的结果。冠状动脉绕道手术联合YurLeon间接心肌血运重建术治疗冠状动脉严重弥漫性病变的效果优于其他手术治疗方法。
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引用次数: 2
Report of Rare Cases of Heart Complications in Covid-19 Patients 新型冠状病毒肺炎患者罕见心脏并发症报告
Pub Date : 2020-10-13 DOI: 10.31579/2692-9759/011
T. L. Martinez, A. Gasparoto, Thomaz Braga Ceglias, A. Saldanha, A. Margeotto, Rafaela Cristina Goebel Winter Gasparoto
It is known that the new Coronavirus has tropism by the heart cells, especially in the most severe presentations of the disease. Several cardiac complications, directly and indirectly, related to infection have been described.
众所周知,新型冠状病毒具有心脏细胞的趋向性,特别是在疾病最严重的时候。一些心脏并发症,直接或间接地与感染有关的已被描述。
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引用次数: 0
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Cardiology Research and Reports
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