The giant left atrium (GLA) is a rare condition, commonly associated with rheumatic mitral valve disease, and very rarely with non rheumatic heart disease (nRHD). The triple valvular heart disease with involved mitral, aortic and tricuspid valves is quite uncommon. A 47 year female patient with a past medical history of rheumatic heart disease (RHD) and known severe mitral stenosis was with severe breathlessness (NYHA class IV). She had undergone mitral valve commissurotomy and tricuspid valve annuloplasty 12 years previously. Transthoracic echocardiography revealed a giant left atrium, moderate to severe mitral valve restenosis, severe mitral regurgitation, moderate aortic regurgitation and severe tricuspid regurgitation, associated with severe secondary pulmonary hypertension and a markedly dilated right heart chambers. The patient was considered inoperable by the heart team, because of advanced pulmonary hypertension predicting a very high risk for open heart surgery. The final treatment decision was a difficult and complex issue.
{"title":"Giant Left Atrium in Triple Rheumatic Heart Disease","authors":"G. Berisha, E. Haliti, Gani Bajraktari","doi":"10.17987/icfj.v13i0.498","DOIUrl":"https://doi.org/10.17987/icfj.v13i0.498","url":null,"abstract":"The giant left atrium (GLA) is a rare condition, commonly associated with rheumatic mitral valve disease, and very rarely with non rheumatic heart disease (nRHD). The triple valvular heart disease with involved mitral, aortic and tricuspid valves is quite uncommon. A 47 year female patient with a past medical history of rheumatic heart disease (RHD) and known severe mitral stenosis was with severe breathlessness (NYHA class IV). She had undergone mitral valve commissurotomy and tricuspid valve annuloplasty 12 years previously. Transthoracic echocardiography revealed a giant left atrium, moderate to severe mitral valve restenosis, severe mitral regurgitation, moderate aortic regurgitation and severe tricuspid regurgitation, associated with severe secondary pulmonary hypertension and a markedly dilated right heart chambers. The patient was considered inoperable by the heart team, because of advanced pulmonary hypertension predicting a very high risk for open heart surgery. The final treatment decision was a difficult and complex issue.","PeriodicalId":32119,"journal":{"name":"International Cardiovascular Forum Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84293699","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}
Yuhui Zhao, R. Nicoll, A. Diederichsen, H. Mickley, Kristian A. Øvrehus, P. Zamorano, P. Guéret, A. Schmermund, E. Maffei, Filippo Cademartiri, M. Budoff, M. Henein
Background and Aims: Significant stenosis is the principal cause of stable angina but its predictors and their variation by geographical region are unclear.Methods and Results: From the European Calcific Coronary Artery Disease (Euro-CCAD) cohort, we retrospectively investigated 5515 symptomatic patients from northern Europe (Denmark, France, Germany), southern Europe (Italy, Spain) and USA. All had conventional cardiovascular risk factor assessment, angiography and CT scanning for coronary artery calcium (CAC) scoring. There were differences in the patient characteristics between the groups, with the USA patients being younger and having more diet and lifestyle-related risk factors, although hypertension may have been better controlled than in Europe. USA patients had a two-fold increase in prevalence of significant stenosis and a three-fold increase in median CAC score. In all three groups, the log CAC score proved to be the strongest predictor of >50% stenosis followed by male gender. In the USA group, there were no additional independently predictive risk factors, although in northern Europe obesity, hypertension, smoking and hypercholesterolaemia remained predictive, with all risk factors other than hypertension proving to be predictive in the southern Europe group. Without the CAC score as a variable, male gender followed by diabetes were the most important predictors in all three regions, with hypertension also proving predictive in northern Europe.Conclusion: In symptomatic patients, the CAC score and male gender were the two most important predictors of significant stenosis in symptomatic patients in northern and southern Europe and the USA.
{"title":"Coronary Calcification and Male Gender Predict Significant Stenosis in Symptomatic Patients in Northern and Southern Europe and the USA: A Euro-CCAD Study","authors":"Yuhui Zhao, R. Nicoll, A. Diederichsen, H. Mickley, Kristian A. Øvrehus, P. Zamorano, P. Guéret, A. Schmermund, E. Maffei, Filippo Cademartiri, M. Budoff, M. Henein","doi":"10.17987/ICFJ.V13I0.487","DOIUrl":"https://doi.org/10.17987/ICFJ.V13I0.487","url":null,"abstract":"Background and Aims: Significant stenosis is the principal cause of stable angina but its predictors and their variation by geographical region are unclear.Methods and Results: From the European Calcific Coronary Artery Disease (Euro-CCAD) cohort, we retrospectively investigated 5515 symptomatic patients from northern Europe (Denmark, France, Germany), southern Europe (Italy, Spain) and USA. All had conventional cardiovascular risk factor assessment, angiography and CT scanning for coronary artery calcium (CAC) scoring. There were differences in the patient characteristics between the groups, with the USA patients being younger and having more diet and lifestyle-related risk factors, although hypertension may have been better controlled than in Europe. USA patients had a two-fold increase in prevalence of significant stenosis and a three-fold increase in median CAC score. In all three groups, the log CAC score proved to be the strongest predictor of >50% stenosis followed by male gender. In the USA group, there were no additional independently predictive risk factors, although in northern Europe obesity, hypertension, smoking and hypercholesterolaemia remained predictive, with all risk factors other than hypertension proving to be predictive in the southern Europe group. Without the CAC score as a variable, male gender followed by diabetes were the most important predictors in all three regions, with hypertension also proving predictive in northern Europe.Conclusion: In symptomatic patients, the CAC score and male gender were the two most important predictors of significant stenosis in symptomatic patients in northern and southern Europe and the USA.","PeriodicalId":32119,"journal":{"name":"International Cardiovascular Forum Journal","volume":"os-9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87186907","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}
Atriogenic Lt-Rt shunt across a ventricular septal defect is an uncommon finding, but reflects a stiff left ventricular cavity with raised end-diastolic pressure. These findings explain the left atrial enlargement and supraventricular arrhythmia. Thus, those shunts should be considered as safety valves to release the raised left sided pressure into the low pressure right ventricle.
{"title":"Atriogenic Flow Across a Restrictive Subaortic VSD: a Sign of Stiff Left ventricle","authors":"M. Islam, G. Fernandes, Wei Li, M. Henein","doi":"10.17987/ICFJ.V13I0.482","DOIUrl":"https://doi.org/10.17987/ICFJ.V13I0.482","url":null,"abstract":"Atriogenic Lt-Rt shunt across a ventricular septal defect is an uncommon finding, but reflects a stiff left ventricular cavity with raised end-diastolic pressure. These findings explain the left atrial enlargement and supraventricular arrhythmia. Thus, those shunts should be considered as safety valves to release the raised left sided pressure into the low pressure right ventricle. ","PeriodicalId":32119,"journal":{"name":"International Cardiovascular Forum Journal","volume":"25 9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82695855","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}
The International Cardiovascular Forum Journal requires authors to abide by the following guidelines:Manuscript: The corresponding author declares that the manuscript has not been published and is not under consideration elsewhere.Authorship: The corresponding author takes full responsibility for the list of authors. Any modification to the author list including order and composition can only be approved by the Editor-in-Chief following signed agreement from all the authors listed on the original submission.Ethics: The corresponding author states that the material presented has been obtained with the approval of all appropriate animal and/or human ethics committee(s).Permissions: The corresponding author on behalf of all authors confirms whether explicit written consent to publish has been received from any people described, pictured, or recorded and that formal copyright clearance is obtained to publish any video or audio recordings.Registration of Clinical Trials: Prospective registration of any clinical trial in a publically accessible database is a requirement for later publication of such trials in ICFJ. In exceptional circumstance if the trial is not registered, or is registered retrospectively, the reasons for this must be given.Competing Interests: All authors must declare all relevant competing interests (financial, or non-financial, professional, or personal) and state all funding sources.Attribution: The corresponding author accepts full responsibility for the accurate citation and acknowledgement of any material reproduced from other publications including the author’s own prior work.It is incumbent upon the corresponding author to consult the Editor-in-Chief should there be any variance of the above. The Editor-in-Chief retains the right to retract any submission found to be in breach of the above guidelines.
{"title":"Authors’ Responsibilities and Ethical Publishing","authors":"L. Shewan, A. Coats, M. Henein","doi":"10.17987/ICFJ.V13I0.525","DOIUrl":"https://doi.org/10.17987/ICFJ.V13I0.525","url":null,"abstract":"The International Cardiovascular Forum Journal requires authors to abide by the following guidelines:Manuscript: The corresponding author declares that the manuscript has not been published and is not under consideration elsewhere.Authorship: The corresponding author takes full responsibility for the list of authors. Any modification to the author list including order and composition can only be approved by the Editor-in-Chief following signed agreement from all the authors listed on the original submission.Ethics: The corresponding author states that the material presented has been obtained with the approval of all appropriate animal and/or human ethics committee(s).Permissions: The corresponding author on behalf of all authors confirms whether explicit written consent to publish has been received from any people described, pictured, or recorded and that formal copyright clearance is obtained to publish any video or audio recordings.Registration of Clinical Trials: Prospective registration of any clinical trial in a publically accessible database is a requirement for later publication of such trials in ICFJ. In exceptional circumstance if the trial is not registered, or is registered retrospectively, the reasons for this must be given.Competing Interests: All authors must declare all relevant competing interests (financial, or non-financial, professional, or personal) and state all funding sources.Attribution: The corresponding author accepts full responsibility for the accurate citation and acknowledgement of any material reproduced from other publications including the author’s own prior work.It is incumbent upon the corresponding author to consult the Editor-in-Chief should there be any variance of the above. The Editor-in-Chief retains the right to retract any submission found to be in breach of the above guidelines. ","PeriodicalId":32119,"journal":{"name":"International Cardiovascular Forum Journal","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89135171","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}
Two cases of suggested takotsubo syndrome and severe complications have been described. It has been discussed whether these two cases are complications of acute myocardial infarction or suggested takotsubo syndrome.
{"title":"Complications of Acute Myocardial Infarction or Takotsubo Cardiomyopathy: from Intravascular Thrombus Formation to Disseminated Intravascular Coagulation","authors":"S. Peters, B. Götting","doi":"10.17987/icfj.v13i0.535","DOIUrl":"https://doi.org/10.17987/icfj.v13i0.535","url":null,"abstract":"Two cases of suggested takotsubo syndrome and severe complications have been described. It has been discussed whether these two cases are complications of acute myocardial infarction or suggested takotsubo syndrome.","PeriodicalId":32119,"journal":{"name":"International Cardiovascular Forum Journal","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75893615","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}
M. T. Wang, Matthew D. Haydock, J. Pemberton, T. Wang
Background: Mitral valve repair has superior results to replacement for severe degenerative mitral valve disease, however in the infective endocarditis setting, mixed results have been reported. We compared the outcomes of mitral valve repair and replacement for infective endocarditis in this meta-analysis.Methods: MEDLINE, Embase and Cochrane databases from 1 January 1980 to 31 December 2015 were searched for original studies. Two authors evaluated these studies for inclusion independently, then data were extracted and pooled.Results: A total of 3,976 papers was obtained from the search, 99 full-texts were reviewed, and 13 studies which included both mitral valve repair and replacement patients involving 8,130 patients were included for analyses. Pooled rates and odds ratio (95% confidence interval) for operative mortality of repair versus replacement were 3.7% vs 10.9%, 0.33 (0.26-0.41). Odds ratio for long term mortality at 1-year (n=4) was 0.31 (0.14-0.72), and at 5 years (n=8) was 0.42 (0.25-0.69). Peri-operative stroke rates and odds ratio (n=4) were 2.8% vs 3.8%, 0.75 (0.55-1.00). Five year recurrent endocarditis and redo-operations (n=6 for both) odds ratios were 0.39 (0.10-1.58) and 0.49 (0.12-2.02) respectively. Similar results were observed when one large study making up 85% of the meta-analysis cohort population was removed.Conclusion: Mitral valve repair is associated with reduction in mortality and stroke, and similar recurrent endocarditis and redo-operation rates compared to mitral valve replacement in mitral valve endocarditis. It is therefore preferred when feasible, similar to surgery for degenerative mitral valve disease.
背景:对于严重退行性二尖瓣疾病，二尖瓣修复的效果优于置换，然而在感染性心内膜炎的情况下，报道的结果好坏参半。在这项荟萃分析中，我们比较了二尖瓣修复和置换术治疗感染性心内膜炎的结果。方法:检索MEDLINE、Embase和Cochrane数据库1980年1月1日至2015年12月31日的原始研究。两位作者独立评估这些研究纳入，然后提取数据并汇总。结果:检索共获得3976篇论文，检索99篇全文，纳入13项研究，包括二尖瓣修复和二尖瓣置换术患者，涉及8130例患者。修复术与置换术的合并死亡率和优势比(95%可信区间)分别为3.7% vs 10.9%， 0.33(0.26-0.41)。1年(n=4)长期死亡率的优势比为0.31(0.14-0.72)，5年(n=8)长期死亡率的优势比为0.42(0.25-0.69)。围手术期卒中发生率和优势比(n=4)分别为2.8% vs 3.8%， 0.75(0.55-1.00)。5年复发心内膜炎和再手术(n=6)的比值比分别为0.39(0.10-1.58)和0.49(0.12-2.02)。当一项占荟萃分析队列人群85%的大型研究被删除时，也观察到类似的结果。结论:与二尖瓣置换术相比，二尖瓣修复与死亡率和卒中发生率降低有关，并且与二尖瓣心内膜炎复发率和再手术率相似。因此，在可行的情况下，首选手术，类似于退行性二尖瓣疾病的手术。
{"title":"Meta-analysis of Mitral Valve Repair Versus Replacement for Mitral Valve Infective Endocarditis","authors":"M. T. Wang, Matthew D. Haydock, J. Pemberton, T. Wang","doi":"10.17987/icfj.v13i0.504","DOIUrl":"https://doi.org/10.17987/icfj.v13i0.504","url":null,"abstract":"Background: Mitral valve repair has superior results to replacement for severe degenerative mitral valve disease, however in the infective endocarditis setting, mixed results have been reported. We compared the outcomes of mitral valve repair and replacement for infective endocarditis in this meta-analysis.Methods: MEDLINE, Embase and Cochrane databases from 1 January 1980 to 31 December 2015 were searched for original studies. Two authors evaluated these studies for inclusion independently, then data were extracted and pooled.Results: A total of 3,976 papers was obtained from the search, 99 full-texts were reviewed, and 13 studies which included both mitral valve repair and replacement patients involving 8,130 patients were included for analyses. Pooled rates and odds ratio (95% confidence interval) for operative mortality of repair versus replacement were 3.7% vs 10.9%, 0.33 (0.26-0.41). Odds ratio for long term mortality at 1-year (n=4) was 0.31 (0.14-0.72), and at 5 years (n=8) was 0.42 (0.25-0.69). Peri-operative stroke rates and odds ratio (n=4) were 2.8% vs 3.8%, 0.75 (0.55-1.00). Five year recurrent endocarditis and redo-operations (n=6 for both) odds ratios were 0.39 (0.10-1.58) and 0.49 (0.12-2.02) respectively. Similar results were observed when one large study making up 85% of the meta-analysis cohort population was removed.Conclusion: Mitral valve repair is associated with reduction in mortality and stroke, and similar recurrent endocarditis and redo-operation rates compared to mitral valve replacement in mitral valve endocarditis. It is therefore preferred when feasible, similar to surgery for degenerative mitral valve disease.","PeriodicalId":32119,"journal":{"name":"International Cardiovascular Forum Journal","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88362514","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}
HighlightsNausea has been defined as an “unpleasant painless subjective feeling that one will imminently vomit”. While nausea and vomiting are often thought to exist on a temporal continuum, this is not always the case. There are situations when severe nausea may be present without emesis and less frequently, when emesis may be present without preceding nausea. The underlying mechanisms involved in nausea are complex and encompass psychological states, the central nervous system, autonomic nervous system, gastric dysrhythmias, and the endocrine system. We report a 92-year-old male patient with depression, hypothyroidism, and intermittent severe sinus dysfunction, causing nausea, vomiting, and fatigue, pre-syncope and low cerebral output. Dual chamber implantation was performed and 24 hours after the implantation of the device all the symptoms disappeared, the parameters of the pacemaker were stable, and the patient was discharged. At the 1st and the 3rd month after implantation the patient remained asymptomatic. Over-activity of autonomic outflow may be a determinant for overall nausea intensity, probably, may be a potential therapeutic target to be corrected, at least in part, by a dual chamber pacemaker implantation.
{"title":"Gastric Dysrhythmia Corrected by Dual Chamber Pacemaker Implantation","authors":"M. G. Kiuchi","doi":"10.17987/ICFJ.V13I0.492","DOIUrl":"https://doi.org/10.17987/ICFJ.V13I0.492","url":null,"abstract":"HighlightsNausea has been defined as an “unpleasant painless subjective feeling that one will imminently vomit”. While nausea and vomiting are often thought to exist on a temporal continuum, this is not always the case. There are situations when severe nausea may be present without emesis and less frequently, when emesis may be present without preceding nausea. The underlying mechanisms involved in nausea are complex and encompass psychological states, the central nervous system, autonomic nervous system, gastric dysrhythmias, and the endocrine system. We report a 92-year-old male patient with depression, hypothyroidism, and intermittent severe sinus dysfunction, causing nausea, vomiting, and fatigue, pre-syncope and low cerebral output. Dual chamber implantation was performed and 24 hours after the implantation of the device all the symptoms disappeared, the parameters of the pacemaker were stable, and the patient was discharged. At the 1st and the 3rd month after implantation the patient remained asymptomatic. Over-activity of autonomic outflow may be a determinant for overall nausea intensity, probably, may be a potential therapeutic target to be corrected, at least in part, by a dual chamber pacemaker implantation.","PeriodicalId":32119,"journal":{"name":"International Cardiovascular Forum Journal","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79234911","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}
J. Čelutkienė, A. Jakstaite, J. Badarienė, S. Solovjova, Ieva Slivovskaja, R. Navickas, Edita Kazėnaitė, E. Rinkūnienė, A. Čypienė, J. Misiūra, L. Ryliškytė, A. Laucevičius, A. Coats
Aims: To investigate if community detected Metabolic Syndrome (MetS) is associated with the burden of incipient HFpEF in the community. Methods and Results: We prospectively studied 148 consecutive MetS patients identified from the Lithuanian High Cardiovascular Risk primary prevention programme and investigated them further for unknown HFpEF through cardiopulmonary stress testing as well as assessment of BNP levels and of arterial stiffness. Subjects with a peak VO2 value lower than 90% of predicted and/or BNP≥35 ng/l were categorized as having early phase HFpEF. For comparison of this early phase HFpEF with others already clinically diagnosed with HFpEF, patients with both established HFpEF and MetS were selected retrospectively from patients attending our cardiopulmonary stress testing laboratory (n=38). Two thirds of the screening programme-derived MetS population (n=96) demonstrated a reduced exercise capacity and/or an elevated BNP, indicating signs of early HFpEF. Both the clinically diagnosed HFpEF and the screening programme detected MetS group with early HFpEF demonstrated similarly decreased exercise tolerance evaluated by peak oxygen uptake (79.8 ± 22.1% vs 82.7 ± 14.0%, p>0.05). Analysis of arterial markers in the screening programme group revealed statistically significant differences of augmentation index values between groups with and without signs of early HFpEF (p=0.016).Conclusion: A considerable proportion of patients having MetS may be diagnosed with previously undetected early stage HFpEF. The use of objective parameters of exercise capacity and neurohormonal activation might be effectively used for the early detection of HFpEF. Also early HFpEF in this setting is found to be associated with increased arterial stiffness.
目的:探讨社区检测代谢综合征(MetS)是否与社区早期HFpEF负担相关。方法和结果:我们前瞻性研究了来自立陶宛高心血管风险一级预防计划的148例连续MetS患者，并通过心肺压力测试以及BNP水平和动脉僵硬度评估进一步调查了未知的HFpEF。峰值VO2值低于预测值90%和/或BNP≥35 ng/l的受试者被归类为早期HFpEF。为了将这种早期HFpEF与其他临床诊断为HFpEF的患者进行比较，回顾性地从我们心肺压力测试实验室的患者中选择了既有HFpEF又有MetS的患者(n=38)。三分之二的筛查方案衍生的MetS人群(n=96)表现出运动能力下降和/或BNP升高，表明早期HFpEF的迹象。临床诊断的HFpEF和筛查程序检测到的早期HFpEF的MetS组均表现出相似的运动耐量下降，通过峰值摄氧量评估(79.8±22.1% vs 82.7±14.0%，p>0.05)。对筛查方案组动脉标志物的分析显示，有和无早期HFpEF体征组的增强指数值差异有统计学意义(p=0.016)。结论:相当比例的met患者可能被诊断为先前未被发现的早期HFpEF。使用运动能力和神经激素激活等客观参数可有效地用于HFpEF的早期检测。此外，在这种情况下，发现早期HFpEF与动脉僵硬增加有关。
{"title":"Detection of Early Heart Failure with Preserved Ejection Fraction (HFpEF) in Metabolic Syndrome Patients Detected as Part of a National Screening Programme in Middle Aged Subjects","authors":"J. Čelutkienė, A. Jakstaite, J. Badarienė, S. Solovjova, Ieva Slivovskaja, R. Navickas, Edita Kazėnaitė, E. Rinkūnienė, A. Čypienė, J. Misiūra, L. Ryliškytė, A. Laucevičius, A. Coats","doi":"10.17987/ICFJ.V13I0.550","DOIUrl":"https://doi.org/10.17987/ICFJ.V13I0.550","url":null,"abstract":"Aims: To investigate if community detected Metabolic Syndrome (MetS) is associated with the burden of incipient HFpEF in the community. Methods and Results: We prospectively studied 148 consecutive MetS patients identified from the Lithuanian High Cardiovascular Risk primary prevention programme and investigated them further for unknown HFpEF through cardiopulmonary stress testing as well as assessment of BNP levels and of arterial stiffness. Subjects with a peak VO2 value lower than 90% of predicted and/or BNP≥35 ng/l were categorized as having early phase HFpEF. For comparison of this early phase HFpEF with others already clinically diagnosed with HFpEF, patients with both established HFpEF and MetS were selected retrospectively from patients attending our cardiopulmonary stress testing laboratory (n=38). Two thirds of the screening programme-derived MetS population (n=96) demonstrated a reduced exercise capacity and/or an elevated BNP, indicating signs of early HFpEF. Both the clinically diagnosed HFpEF and the screening programme detected MetS group with early HFpEF demonstrated similarly decreased exercise tolerance evaluated by peak oxygen uptake (79.8 ± 22.1% vs 82.7 ± 14.0%, p>0.05). Analysis of arterial markers in the screening programme group revealed statistically significant differences of augmentation index values between groups with and without signs of early HFpEF (p=0.016).Conclusion: A considerable proportion of patients having MetS may be diagnosed with previously undetected early stage HFpEF. The use of objective parameters of exercise capacity and neurohormonal activation might be effectively used for the early detection of HFpEF. Also early HFpEF in this setting is found to be associated with increased arterial stiffness. ","PeriodicalId":32119,"journal":{"name":"International Cardiovascular Forum Journal","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85534677","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}
Abstract:In their introduction to the issue, Priya Chhaya and Reina Murray outline two distinct roles that technology plays in historic preservation: (1) documenting historic places and managing the resulting data and (2) telling the stories of old and historic places. Reflecting on a year of exploring tech in preservation, they also contemplate fundamental questions about its impact—most essentially, how can technology best help us do our work?
{"title":"Preservation Technology: Opening the Field to New Possibilities","authors":"P. Chhaya, R. Murray","doi":"10.1353/fmj.2018.0000","DOIUrl":"https://doi.org/10.1353/fmj.2018.0000","url":null,"abstract":"Abstract:In their introduction to the issue, Priya Chhaya and Reina Murray outline two distinct roles that technology plays in historic preservation: (1) documenting historic places and managing the resulting data and (2) telling the stories of old and historic places. Reflecting on a year of exploring tech in preservation, they also contemplate fundamental questions about its impact—most essentially, how can technology best help us do our work?","PeriodicalId":32119,"journal":{"name":"International Cardiovascular Forum Journal","volume":"34 1","pages":"3 - 4"},"PeriodicalIF":0.0,"publicationDate":"2018-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86894311","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}
R. Tredinnick, E. Gill, Destinee Udelhoven, K. Ponto
Abstract:Staff from the Wisconsin Institute for Discovery's Living Environments Laboratory and the Mount Horeb Area Historical Society describe their use of light detection and ranging (LiDAR) scanning and virtual reality (VR) technologies in preservation. After explaining the mechanisms behind LiDAR and VR and giving a brief history of both, the authors describe their own projects, which include 3-D models of Taliesin East and Wisconsin's Norway Building. Finally, they discuss the future of VR in preservation—its potential and its limitations.
{"title":"Virtual Reality as an Agent of Preservation","authors":"R. Tredinnick, E. Gill, Destinee Udelhoven, K. Ponto","doi":"10.1353/FMJ.2018.0003","DOIUrl":"https://doi.org/10.1353/FMJ.2018.0003","url":null,"abstract":"Abstract:Staff from the Wisconsin Institute for Discovery's Living Environments Laboratory and the Mount Horeb Area Historical Society describe their use of light detection and ranging (LiDAR) scanning and virtual reality (VR) technologies in preservation. After explaining the mechanisms behind LiDAR and VR and giving a brief history of both, the authors describe their own projects, which include 3-D models of Taliesin East and Wisconsin's Norway Building. Finally, they discuss the future of VR in preservation—its potential and its limitations.","PeriodicalId":32119,"journal":{"name":"International Cardiovascular Forum Journal","volume":"50 1","pages":"22 - 29"},"PeriodicalIF":0.0,"publicationDate":"2018-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73362743","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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