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Association of Dietary Inflammatory Potential in Metabolically Healthy and Metabolically Unhealthy Obese Individuals 代谢健康和代谢不健康肥胖个体饮食炎症潜能的关联
Q4 Medicine Pub Date : 2023-09-15 DOI: 10.36660/ijcs.20230102
Lara Ribeiro Pinto, L. N. Aranha, R. Luiz, Gláucia Maria Moraes de Oliveira, G. Rosa
,
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引用次数: 0
Performance Measures in STEMI after COVID-19 Pandemic: Results from the RECUIMA Registry COVID-19大流行后STEMI的绩效衡量:来自RECUIMA注册表的结果
Q4 Medicine Pub Date : 2023-09-15 DOI: 10.36660/ijcs.20220118
N. Espinola-Zavaleta, A. Michel-Vasquez, M. Santos-Medina, Geovedy Martínez-García, Maidelis Prieto-Guerra, Lázaro Mata Cuevas, M. Rodríguez-Ramos
Abstract Background To offer proper medical care to patients with ST-segment Elevation Acute Myocardial Infarction (STEMI) in low- and middle-income settings (LMIS) is challenging. However, it is not known if performance indicators have changed back after the epidemiological recovery. Objective to describe performance measures (PM) in patients with STEMI during and after the COVID-19 pandemic. Methods Observational study of patients with STEMI, from an LMIS, with analysis of PM suggested in the 2017 AHA-ACC Performance Measures for Adults with STEMI. COVID-19 period was determined from January 2020 to October 2021, and from November 2021 to February 2022 as the post-COVID-19 period. Baseline characteristics, treatments and selected PM were compared using the χ2 test or Mann-Whitney U test. All tests were two-sided, and statistical significance was considered as p-value <0.05. Coronary interventionism-related PM were not reported. Results Administration of thrombolysis decreased (71.2% vs 51.6% (p: 0.001)), while the delay time for its administration (Median (Interquartile Range)) increased considerably (30 min (16-60) to 45 min (35- 60) (p: 0.003)). Aspirin at admission was administered in each period at 92.9% vs 94.2% (p: 0.62); and at discharge to 97.8% vs 98.9% (p: 0.48). Beta-blockers, P2Y12 inhibitors, statins, and angiotensin-converting enzyme inhibitors in patients with heart failure were administered to 67.1% vs 85.1% (p: 0.01), 96.4% vs 84% (p: 0.001), 96.2 % vs 95.7% (p: 1), and 81.2% vs 94.3% (p: 0.14), respectively. Conclusion Despite this being a current period of epidemiological recovery, the COVID-19 pandemic continues to negatively impact the care of patients with STEMI.
{"title":"Performance Measures in STEMI after COVID-19 Pandemic: Results from the RECUIMA Registry","authors":"N. Espinola-Zavaleta, A. Michel-Vasquez, M. Santos-Medina, Geovedy Martínez-García, Maidelis Prieto-Guerra, Lázaro Mata Cuevas, M. Rodríguez-Ramos","doi":"10.36660/ijcs.20220118","DOIUrl":"https://doi.org/10.36660/ijcs.20220118","url":null,"abstract":"Abstract Background To offer proper medical care to patients with ST-segment Elevation Acute Myocardial Infarction (STEMI) in low- and middle-income settings (LMIS) is challenging. However, it is not known if performance indicators have changed back after the epidemiological recovery. Objective to describe performance measures (PM) in patients with STEMI during and after the COVID-19 pandemic. Methods Observational study of patients with STEMI, from an LMIS, with analysis of PM suggested in the 2017 AHA-ACC Performance Measures for Adults with STEMI. COVID-19 period was determined from January 2020 to October 2021, and from November 2021 to February 2022 as the post-COVID-19 period. Baseline characteristics, treatments and selected PM were compared using the χ2 test or Mann-Whitney U test. All tests were two-sided, and statistical significance was considered as p-value <0.05. Coronary interventionism-related PM were not reported. Results Administration of thrombolysis decreased (71.2% vs 51.6% (p: 0.001)), while the delay time for its administration (Median (Interquartile Range)) increased considerably (30 min (16-60) to 45 min (35- 60) (p: 0.003)). Aspirin at admission was administered in each period at 92.9% vs 94.2% (p: 0.62); and at discharge to 97.8% vs 98.9% (p: 0.48). Beta-blockers, P2Y12 inhibitors, statins, and angiotensin-converting enzyme inhibitors in patients with heart failure were administered to 67.1% vs 85.1% (p: 0.01), 96.4% vs 84% (p: 0.001), 96.2 % vs 95.7% (p: 1), and 81.2% vs 94.3% (p: 0.14), respectively. Conclusion Despite this being a current period of epidemiological recovery, the COVID-19 pandemic continues to negatively impact the care of patients with STEMI.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89954071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Quality of Life in Patients After Acute ST-Segment Elevation Myocardial Infarction 急性st段抬高型心肌梗死患者的生活质量
Q4 Medicine Pub Date : 2023-09-15 DOI: 10.36660/ijcs.20230041
Bárbara de Matos Santos, Itana Samara Santana Guimarães, K. Avena, Ivan de Mattos Paiva, Pollianna de Souza Roriz
Background: ST-segment elevation myocardial infarction (STEMI) is the acute coronary syndrome with the highest severity and mortality. It can affect physical health and well-being of patients, and consequently their quality of life (QoL). Objective: To describe the QoL of patients at 30 days and 180 days after STEMI, focusing on sex differences and repercussions on physical and mental dimensions. Methods: Observational study with 174 STEMI patients included in the study on STEMI conducted in the city of Salvador, Brazil (PERSISST). The QoL of patients at 30 days (D30) and 180 days (D180) after the coronary event was assessed using the 12-item short form health survey (SF-12). Physical and mental components of QoL were calculated using the SF-12 OrthoToolKit. Descriptive analysis of data was made using the IBM SPSS software, version 25.0. Results: Mean age of participants at D30 and D180 was 57.1±11.4 years and 60.5±10.9 years, respectively, with a higher prevalence of men (55.8% and 56.8%). In general, patients had a poor QoL at both time points (scores 49.1±8.9 and 49.9±8.4, respectively). Analysis by sex, however, showed that men had a good QoL at both 30D (score 51.8±7.4) and 180 D (score 51.3±7.7), whereas a poor QoL was found among women at these time points (45.7±9.6 and 48.1±9.0, respectively). Men showed higher physical and mental health scale scores than women at both D30 and D180, and there was a greater impairment of the physical component in both sexes. Conclusion: Patients had poor QoL at 30 days and 180 days after STEMI, with a greater impairment of the physical component and a worse QoL perception among women than men at both time points.
背景:st段抬高型心肌梗死(STEMI)是严重程度和死亡率最高的急性冠状动脉综合征。它可以影响患者的身体健康和福祉,从而影响他们的生活质量(QoL)。目的:描述STEMI后30天和180天患者的生活质量,重点分析性别差异及其对身心维度的影响。方法:在巴西萨尔瓦多市(PERSISST)进行的STEMI研究中纳入174例STEMI患者的观察性研究。采用12项健康问卷(SF-12)评估冠状动脉事件后30天(D30)和180天(D180)患者的生活质量。使用SF-12 OrthoToolKit计算生活质量的生理和心理成分。采用IBM SPSS 25.0版本对数据进行描述性分析。结果:参与者在D30和D180时的平均年龄分别为57.1±11.4岁和60.5±10.9岁,男性患病率较高(55.8%和56.8%)。总体而言,患者在两个时间点的生活质量较差(分别为49.1±8.9分和49.9±8.4分)。然而,性别分析显示,男性在30D(51.8±7.4分)和180 D(51.3±7.7分)的生活质量较好,而女性在这些时间点的生活质量较差(分别为45.7±9.6分和48.1±9.0分)。在D30和D180上,男性的身体和心理健康得分都高于女性,而且男女在身体方面的损害都更大。结论:STEMI后30天和180天患者的生活质量较差,在这两个时间点,女性患者的身体成分受损更大,生活质量感知也比男性差。
{"title":"Quality of Life in Patients After Acute ST-Segment Elevation Myocardial Infarction","authors":"Bárbara de Matos Santos, Itana Samara Santana Guimarães, K. Avena, Ivan de Mattos Paiva, Pollianna de Souza Roriz","doi":"10.36660/ijcs.20230041","DOIUrl":"https://doi.org/10.36660/ijcs.20230041","url":null,"abstract":"Background: ST-segment elevation myocardial infarction (STEMI) is the acute coronary syndrome with the highest severity and mortality. It can affect physical health and well-being of patients, and consequently their quality of life (QoL). Objective: To describe the QoL of patients at 30 days and 180 days after STEMI, focusing on sex differences and repercussions on physical and mental dimensions. Methods: Observational study with 174 STEMI patients included in the study on STEMI conducted in the city of Salvador, Brazil (PERSISST). The QoL of patients at 30 days (D30) and 180 days (D180) after the coronary event was assessed using the 12-item short form health survey (SF-12). Physical and mental components of QoL were calculated using the SF-12 OrthoToolKit. Descriptive analysis of data was made using the IBM SPSS software, version 25.0. Results: Mean age of participants at D30 and D180 was 57.1±11.4 years and 60.5±10.9 years, respectively, with a higher prevalence of men (55.8% and 56.8%). In general, patients had a poor QoL at both time points (scores 49.1±8.9 and 49.9±8.4, respectively). Analysis by sex, however, showed that men had a good QoL at both 30D (score 51.8±7.4) and 180 D (score 51.3±7.7), whereas a poor QoL was found among women at these time points (45.7±9.6 and 48.1±9.0, respectively). Men showed higher physical and mental health scale scores than women at both D30 and D180, and there was a greater impairment of the physical component in both sexes. Conclusion: Patients had poor QoL at 30 days and 180 days after STEMI, with a greater impairment of the physical component and a worse QoL perception among women than men at both time points.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"41 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72479148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Religiosity and Spirituality: The Relationship Between Psychosocial Factors and Cardiovascular Health 宗教信仰与灵性:心理社会因素与心血管健康的关系
Q4 Medicine Pub Date : 2023-09-15 DOI: 10.36660/ijcs.20220176
José Ícaro Nunes Cruz, Adelle Cristine Lima Cardozo, E. Melo, Juliana Maria Chianca Lira, Giulia Vieira Santos, G. Salazar, Bruna Oliveira, Mariano César de Souza Reis, Diego Maldini Borba de Lima, Philipi Santos Soares, Antônio Carlos Sobral Sousa, J. Oliveira
,
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引用次数: 1
High Cardiorespiratory Optimal Point Values Are Related to Cardiovascular Mortality in Men Aged 46 to 70 Years: a Prospective Cohort Study 46 - 70岁男性心血管疾病死亡率与高心肺最佳点值相关:一项前瞻性队列研究
Q4 Medicine Pub Date : 2023-09-15 DOI: 10.36660/ijcs.20230090
CLAUDIO GIL ARAUJO, P. Ramos, J. Laukkanen, J. Myers, S. Kunutsor, M. Harber, T. Eijsvogels, B. Marinho, C. G. S. E. Silva
Background: Several hemodynamic and respiratory variables measured during cardiopulmonary exercise testing (CPX) have been shown to predict survival. One such measure is the cardiorespiratory optimal point (COP) that reflects the best possible circulation-respiration interaction, but there are still limited data on its relationship with adverse outcomes. Objective : To assess the association between COP and cardiovascular mortality in men aged 46 to 70 years. Methods : A sample of 2201 men who had anthropometric, clinical, and COP data obtained during cycling CPX between 1995 and 2022 was extracted from the CLINIMEX Exercise cohort. COP was identified as the minimal minute-to-minute VE/VO 2 during CPX. Vital data were censored on October 31, 2022 for ICD-10-identified cardiovascular deaths. Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (95% CIs). Results : The mean ± standard deviation age was 57 ± 6 years and the median COP value was 24 (interquartile range = 21.2 to 27.4). During a mean follow-up of 4688 ± 2416 days, 129 (5.6%) patients died from cardiovascular causes. The death rates for low (< 28), high (28 to 30), and very high (> 30) categories of COP were 3.2%, 9.6%, and 18.7%, respectively. Following adjustment for age, history of myocardial infarction, diagnosis of coronary artery disease, and diabetes mellitus, the HR (95% CI) for cardiovascular mortality comparing very high versus low COP was 2.76 (1.87 to 4.07; p < 0.001). Conclusions : Our data indicate that, for a general population-based sample of men, COP > 30 represents a considerably higher risk for cardiovascular death. Information on COP could assist cardiovascular risk assessment in men.
背景:在心肺运动试验(CPX)中测量的几个血液动力学和呼吸变量已被证明可以预测生存。其中一种测量方法是心肺最佳点(COP),它反映了最佳的循环-呼吸相互作用,但关于其与不良后果的关系的数据仍然有限。目的:探讨46 ~ 70岁男性COP与心血管疾病死亡率的关系。方法:从cliinimex运动队列中提取1995年至2022年期间骑行CPX期间获得人体测量学、临床和COP数据的2201名男性样本。COP被确定为CPX期间最小的每分钟VE/VO 2。2022年10月31日,icd -10确定的心血管死亡的重要数据被审查。采用Cox比例风险模型估计95%置信区间(95% ci)的风险比(hr)。结果:平均±标准差年龄为57±6岁,COP值中位数为24(四分位数间距为21.2 ~ 27.4)。在平均随访4688±2416天期间,129例(5.6%)患者死于心血管疾病。低(< 28)级、高(28 ~ 30)级和极高(> 30)级的死亡率分别为3.2%、9.6%和18.7%。在调整了年龄、心肌梗死史、冠状动脉疾病诊断和糖尿病等因素后,比较非常高和低COP的心血管死亡率的HR (95% CI)为2.76(1.87至4.07;P < 0.001)。结论:我们的数据表明,对于一般人群为基础的男性样本,COP > 30代表心血管死亡的风险相当高。COP信息有助于男性心血管风险评估。
{"title":"High Cardiorespiratory Optimal Point Values Are Related to Cardiovascular Mortality in Men Aged 46 to 70 Years: a Prospective Cohort Study","authors":"CLAUDIO GIL ARAUJO, P. Ramos, J. Laukkanen, J. Myers, S. Kunutsor, M. Harber, T. Eijsvogels, B. Marinho, C. G. S. E. Silva","doi":"10.36660/ijcs.20230090","DOIUrl":"https://doi.org/10.36660/ijcs.20230090","url":null,"abstract":"Background: Several hemodynamic and respiratory variables measured during cardiopulmonary exercise testing (CPX) have been shown to predict survival. One such measure is the cardiorespiratory optimal point (COP) that reflects the best possible circulation-respiration interaction, but there are still limited data on its relationship with adverse outcomes. Objective : To assess the association between COP and cardiovascular mortality in men aged 46 to 70 years. Methods : A sample of 2201 men who had anthropometric, clinical, and COP data obtained during cycling CPX between 1995 and 2022 was extracted from the CLINIMEX Exercise cohort. COP was identified as the minimal minute-to-minute VE/VO 2 during CPX. Vital data were censored on October 31, 2022 for ICD-10-identified cardiovascular deaths. Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (95% CIs). Results : The mean ± standard deviation age was 57 ± 6 years and the median COP value was 24 (interquartile range = 21.2 to 27.4). During a mean follow-up of 4688 ± 2416 days, 129 (5.6%) patients died from cardiovascular causes. The death rates for low (< 28), high (28 to 30), and very high (> 30) categories of COP were 3.2%, 9.6%, and 18.7%, respectively. Following adjustment for age, history of myocardial infarction, diagnosis of coronary artery disease, and diabetes mellitus, the HR (95% CI) for cardiovascular mortality comparing very high versus low COP was 2.76 (1.87 to 4.07; p < 0.001). Conclusions : Our data indicate that, for a general population-based sample of men, COP > 30 represents a considerably higher risk for cardiovascular death. Information on COP could assist cardiovascular risk assessment in men.","PeriodicalId":32690,"journal":{"name":"International Journal of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81179774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The Relationship between Basal Serum Lipoprotein(a) Levels and the Pulmonary Artery to Ascending Aorta Ratio in COVID-19 Survivors COVID-19幸存者基础血清脂蛋白(a)水平与肺动脉/升主动脉比值的关系
Q4 Medicine Pub Date : 2023-09-15 DOI: 10.36660/ijcs.20220208
U. Küçük, B. Kırılmaz
Background: Coronavirus disease (COVID-19) can cause permanent damage to vascular structures by directly or indirectly affecting the cardiopulmonary system. Lipoprotein(a) [Lp(a)] is an important identified risk factor for vascular endothelial cell dysfunction. Objective: The aim of this study was to reveal the relationship between Lp(a) levels measured at the time of COVID-19 diagnosis and the pulmonary artery (PA) to the ascending aorta (Ao) ratio (PA:Ao ratio) in survivors evaluated by transthoracic echocardiography (TTE). Methods: The study sample consisted of 100 patients who recovered from COVID-19 in the past 3 to 6 months. The relationship between the change in the PA:Ao ratio (ΔPA:Ao) and the Lp(a) levels measured at the time of diagnosis was evaluated. Diameter measurements at baseline and follow-up were evaluated with TTE. Results: A significant increase was found in PA, Ao, and epicardial adipose tissue (EAT) thickness in TTE (p< 0.001 for all). There was a weak correlation between D-dimer and high-sensitivity cardiac troponin measured at the time of diagnosis and ΔPA:Ao and ΔEAT in survivors. However, a positive and strong correlation was observed between Lp(a) levels and ΔPa:Ao (r = 0.628, p< 0.001) and ΔEAT (r = 0.633, p< 0.001). Conclusion: There may be dysfunction in vascular structures due to COVID-19. For the first time in the literature, a strong correlation was shown between the Lp(a) levels measured at the time of diagnosis and ΔPA:Ao and ΔEAT values in patients with COVID-19.
背景:冠状病毒病(COVID-19)可通过直接或间接影响心肺系统,对血管结构造成永久性损伤。脂蛋白(a) [Lp(a)]是血管内皮细胞功能障碍的重要危险因素。目的:本研究旨在揭示经胸超声心动图(TTE)评估的幸存者在COVID-19诊断时测量的Lp(a)水平与肺动脉(PA)与升主动脉(Ao)比值(PA:Ao比值)之间的关系。方法:研究样本为近3 ~ 6个月内康复的100例新冠肺炎患者。评估PA:Ao比值(ΔPA:Ao)变化与诊断时测定的Lp(a)水平之间的关系。基线和随访时的直径测量用TTE进行评估。结果:TTE组PA、Ao和心外膜脂肪组织(EAT)厚度显著增加(p< 0.001)。在诊断时测量的d -二聚体和高敏感性心肌肌钙蛋白与幸存者的ΔPA:Ao和ΔEAT之间存在弱相关性。然而,Lp(a)水平与ΔPa:Ao (r = 0.628, p< 0.001)和ΔEAT (r = 0.633, p< 0.001)呈正相关。结论:新冠肺炎可能导致血管结构功能障碍。在文献中首次发现诊断时测量的Lp(a)水平与COVID-19患者的ΔPA:Ao和ΔEAT值之间存在强相关性。
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引用次数: 0
Non-Targeted Self-Measured Blood Pressure and Hypertension Control in Public and Private Health Systems in Brazil 巴西公共和私人卫生系统的非目标自我测量血压和高血压控制
Q4 Medicine Pub Date : 2023-08-28 DOI: 10.36660/ijcs.202220144
Gabriela de Oliveira Salazar, G. D. O. Almeida, J. A. Barreto-Filho, M. Almeida-Santos, E. Melo, F. Aidar, José Ícaro Nunes Cruz, J. Oliveira, L. Baumworcel, A. Sousa
Background: It is estimated that more than 30% of the Brazilian population has systemic arterial hypertension (SAH), and mostly as an uncontrolled disease. The most recent Brazilian Guideline of Hypertension recommends the practice of self-measurement of blood pressure (BP) as one of the strategies for a better control of SAH, but there is no consensus about the efficiency of this tool. Objective: To assess the control of SAH and the practice of non-targeted self-measured BP (SMBP) among hypertensive users of the Unified Health System (SUS) and the Supplementary Network (SN). Methods: This is a cross-sectional, observational, analytical study, with a stratified probability sample. One thousand volunteers were investigated, being 500 from SUS and 500 from the SN. Uni and multivariate analyses were performed considering a 5% significance level. Results: Patients from SUS presented inferior sociodemographic data (schooling, social status) in relation to those of the SN (p < 0.001), and showed lower control of SAH (p = 0.014), as well as more visits to the emergency room in the past year due to hypertension (p = 0.002), and fewer regular appointments with the cardiologist (p = 0.004). SMBP was equally present in both assessed groups (p = 0.567), even though users of the SN have been more advised to not conduct such a practice (p = 0.002). SMBP (p < 0.001) was an independent factor for uncontrolled SAH both in SUS (OR = 3.424) and in the SN (OR = 3.474). Conclusion: Patients in SUS presented lower SAH control. The practice of SMBP, mostly practiced with an uncalibrated digital device, was equally present in both groups and became an independent factor of uncontrolled SAH.
背景:据估计,超过30%的巴西人患有全身性动脉高血压(SAH),并且大多数是一种无法控制的疾病。最新的巴西高血压指南建议将自我测量血压(BP)作为更好地控制SAH的策略之一,但对于该工具的效率尚无共识。目的:评价统一卫生系统(SUS)和补充网络(SN)高血压用户的SAH控制情况和非目标自测血压(SMBP)的使用情况。方法:这是一项横断面、观察性、分析性研究,采用分层概率样本。1000名志愿者接受了调查,其中500人来自SUS, 500人来自SN。考虑5%的显著性水平进行单因素和多因素分析。结果:SUS患者的社会人口学资料(学校教育、社会地位)低于SN患者(p < 0.001), SAH控制率较低(p = 0.014),过去一年因高血压就诊急诊室的次数较多(p = 0.002),与心脏病专家的定期就诊次数较少(p = 0.004)。SMBP在两个评估组中同样存在(p = 0.567),即使SN的用户被更多地建议不要进行这种做法(p = 0.002)。SMBP (p < 0.001)是SUS (OR = 3.424)和SN (OR = 3.474)未控制的SAH的独立因素。结论:SUS患者SAH控制率较低。SMBP的实践,大多是用未校准的数字设备进行的,在两组中都同样存在,并成为不受控制的SAH的独立因素。
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引用次数: 0
Inflammation in Cardiovascular Disease: Current Status and Future Perspectives 心血管疾病中的炎症:现状和未来展望
Q4 Medicine Pub Date : 2023-08-28 DOI: 10.36660/ijcs.20230072
F. Fonseca, M. C. Izar
Atherosclerosis has been defined as an inflammatory disease. Three decades of research have pointed to a pivotal role of interleukin 6 for many aspects of cardiovascular disease, not the least of which is atherosclerosis. In this review, experimental and clinical studies are reported on a timeline, exploring mechanisms and possible explanations that form the basis of current knowledge. Some successful clinical trials were proof of concept studies, showing that not only inflammatory biomarkers are related to cardiovascular outcomes, but also that decreasing inflammation can reduce cardiovascular events. Great advances have been made in the management of residual cardiovascular risk due to cholesterol, thrombosis, and metabolic diseases, but the next frontier now seems to be targeting inflammation. In the upcoming years, the importance of inflammation will be evaluated in high-risk patients with chronic kidney disease, after acute coronary heart disease or heart failure with preserved ejection fraction. Inflammation seems to precede the development of cardiovascular risk factors. Moreover, counseling for a heathy lifestyle and, when necessary, the use of cardiometabolic therapies capable of decreasing inflammation, might be important.
动脉粥样硬化被定义为一种炎症性疾病。三十年的研究表明,白细胞介素6在心血管疾病的许多方面都起着关键作用,其中最重要的是动脉粥样硬化。在这篇综述中,实验和临床研究报告了一个时间表,探索机制和可能的解释,形成当前知识的基础。一些成功的临床试验是概念研究的证明,表明炎症生物标志物不仅与心血管结局有关,而且减少炎症可以减少心血管事件。在胆固醇、血栓和代谢性疾病引起的剩余心血管风险的管理方面已经取得了很大的进展,但下一个前沿领域现在似乎是针对炎症。在未来的几年里,炎症的重要性将被评估在高风险的慢性肾脏疾病患者,急性冠心病或心力衰竭后保留射血分数。炎症似乎先于心血管危险因素的发展。此外,健康生活方式的咨询,必要时使用能够减少炎症的心脏代谢疗法,可能很重要。
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引用次数: 0
Home-based Virtual Reality Exercise Program During the Maintenance Stage of Cardiac Rehabilitation: A Randomized Controlled Trial 基于家庭的虚拟现实运动计划在心脏康复维持阶段:一项随机对照试验
Q4 Medicine Pub Date : 2023-08-28 DOI: 10.36660/ijcs.20190177
Ágata Vieira, C. Melo, Andreia Noites, J. Machado, Joaquim Mendes
Background: Home-based virtual reality technology may become an alternative to cardiac rehabilitation. Objectives: To evaluate the effects of a specific, home-based exercise program, performed either through a virtual reality ( Kinect ) or a conventional format (booklet) in the maintenance stage of cardiac rehabilitation for six months on functional muscle strength of the lower limbs, physical activity and exercise tolerance. Methodology: This is a randomized clinical trial ( ClinicalTrials.gov — NCT02753829) with individuals with coronary artery disease from a hospital in Porto, Portugal, randomly allocated to an experimental group “1” (EG1; n = 11), submitted to a virtual reality exercise program (Kinect); an experimental group “2” (EG2; n = 11), submitted to an exercise program described in a booklet (conventional format); or a control group (CG) (n=11), submitted to routine care. Parameters of functional muscle strength of the lower limbs (sit-to-stand test ), physical activity (accelerometer) and exercise tolerance (stress test) were assessed and compared between the groups. Descriptive and inferential statistics were applied, with 95% with a significance level of 0.05. Results: Significant improvements in functional muscle strength of the lower limbs were observed in EG1 compared to EG2, at three months (19.5 ± 7.7 versus 11.9 ± 4.7, p = 0.042), and at six months (23.0 ± 7.7 versus 14.6 ± 4.6, p = 0.027) of intervention. Conclusions: The program did not demonstrate superior results, in relation to the control group and among the different formats, in physical activity and effort tolerance. In relation to the functional muscle strength of the lower limbs, the virtual reality format showed significantly better results when compared to the conventional format only.
背景:基于家庭的虚拟现实技术可能成为心脏康复的替代方案。目的:评估特定的、基于家庭的锻炼计划的效果,通过虚拟现实(Kinect)或传统形式(小册子)在心脏康复的维持阶段进行六个月,对下肢功能性肌肉力量、身体活动和运动耐受性的影响。方法:这是一项随机临床试验(ClinicalTrials.gov - NCT02753829),来自葡萄牙波尔图一家医院的冠状动脉疾病患者被随机分配到实验组“1”(EG1;n = 11),提交虚拟现实练习程序(Kinect);实验组“2”(EG2);N = 11),提交到一本小册子(传统格式)中描述的锻炼计划;对照组(CG) (n=11)接受常规护理。评估并比较两组患者下肢功能性肌力(坐立测试)、体力活动(加速度计)和运动耐量(压力测试)参数。采用描述统计和推理统计,95%,显著性水平为0.05。结果:EG1组与EG2组相比,在干预3个月时(19.5±7.7比11.9±4.7,p = 0.042)和干预6个月时(23.0±7.7比14.6±4.6,p = 0.027),下肢功能性肌力均有显著改善。结论:该方案在体力活动和努力耐受性方面,与对照组和不同形式的方案相比,没有表现出优越的结果。在下肢的功能性肌肉力量方面,虚拟现实格式与传统格式相比,显示出明显更好的结果。
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引用次数: 0
Value-based Health Care Impact on Cardiovascular and Metabolic Diseases 基于价值的医疗保健对心血管和代谢疾病的影响
Q4 Medicine Pub Date : 2023-08-28 DOI: 10.36660/ijcs.20230083
A. Etges, Gabriela Boff Comiran, Anna Luiza Reinehr Ferreira, C. Polanczyk
metabolic changes starting with insulin resistance, dyslipidemia, hypertension, and obesity that affect the cardiovascular system. In Brazil, cardiovascular diseases were the leading cause of death in 2019, with coronary disease and stroke being on top, with a population prevalence of 6.1%.1 It is estimated that more than 17 million Brazilians have diabetes, 46% of whom are unaware of the disease. Associated illnesses such as ischemic disease, stroke, and diabetes represent a high economic burden on health systems, justified by their high incidence, population aging, and increasing incorporation of more expensive technologies. Central Illustration: Value-based Health Care Impact on Cardiovascular and Metabolic Diseases
从胰岛素抵抗、血脂异常、高血压和肥胖开始的代谢变化,影响心血管系统。在巴西,心血管疾病是2019年的主要死亡原因,冠状动脉疾病和中风位居榜首,人口患病率为6.1% 1据估计,超过1700万巴西人患有糖尿病,其中46%的人没有意识到这种疾病。缺血性疾病、中风和糖尿病等相关疾病是卫生系统的沉重经济负担,其发病率高、人口老龄化以及越来越多地采用更昂贵的技术是合理的。中心插图:基于价值的医疗保健对心血管和代谢疾病的影响
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引用次数: 0
期刊
International Journal of Cardiovascular Sciences
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