CJC Open最新文献

英文中文

“Swinging Movement” of the Helix Fixation Leadless Pacemaker: Benign Phenomenon or Malignant Sign? 螺旋固定无引线起搏器的 "摆动运动"--良性现象还是恶性征兆？

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open

Pub Date : 2024-08-01 DOI: 10.1016/j.cjco.2024.05.001

引用次数: 0

Aspiration Thrombectomy for Intermediate-Risk Pulmonary Embolism 中危肺栓塞吸栓术

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open

Pub Date : 2024-08-01 DOI: 10.1016/j.cjco.2024.04.011

引用次数: 0

Association of Frailty With In-hospital and Long-term Outcomes Among STEMI Patients Receiving Primary Percutaneous Coronary Intervention 接受初级经皮冠状动脉介入治疗的 STEMI 患者的虚弱程度与住院及长期预后的关系

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open

Pub Date : 2024-08-01 DOI: 10.1016/j.cjco.2024.04.005

Background

Frailty is generally a marker of worse prognosis. The impact of frailty on both in-hospital and long-term outcomes in ST-segment-elevation myocardial infarction (STEMI) patients has not been well described. Given this context, we aimed to determine the prevalence and impact of frailty on in-hospital and 1-year outcomes in STEMI patients undergoing primary percutaneous coronary intervention (pPCI).

Methods

This retrospective study reviewed STEMI patients aged ≥ 65 years who underwent pPCI at 1 of the 2 pPCI-capable hospitals at Vancouver Coastal Health. A frailty index (FI) was determined using a deficit-accumulation model, with those with an FI > 0.25 being defined as frail. The primary outcome was 1-year all-cause mortality. The secondary outcomes included in-hospital all-cause mortality, a composite of adverse in-hospital outcomes (all-cause mortality, cardiogenic shock, heart failure, reinfarction, major bleeding, or stroke), and the individual components of the composite.

Results

A total of 1579 patients were reviewed, of which 228 (14.4%) were determined to be frail. After multivariable adjustment, greater frailty (ie, increasing FI) was associated with increased in-hospital all-cause mortality (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.50-2.35, P < 0.001), the composite adverse in-hospital outcome (OR, 1.46; 95% CI, 1.27-1.68, P < 0.001), and 1-year all-cause mortality (OR, 1.48; 95% CI, 1.10-2.00, P = 0.011).

Conclusions

In a contemporary STEMI cohort of older patients receiving pPCI, 1 in 7 patients were frail, with greater frailty being independently associated with increased in-hospital and long-term adverse outcomes. These findings highlight the need for the early recognition of frailty and implementation of an interdisciplinary approach toward the management of frail STEMI patients.

背景虚弱通常是预后较差的标志。关于虚弱对 ST 段抬高型心肌梗死（STEMI）患者院内和长期预后的影响，还没有很好的描述。有鉴于此，我们旨在确定接受一级经皮冠状动脉介入治疗（pPCI）的 STEMI 患者中虚弱的发生率及其对住院和 1 年预后的影响。这项回顾性研究回顾了年龄≥ 65 岁、在温哥华海岸医疗中心两家具备 pPCI 能力的医院中的一家接受 pPCI 治疗的 STEMI 患者。采用赤字累积模型确定虚弱指数 (FI)，将 FI 为 0.25 的患者定义为虚弱患者。主要结果是1年全因死亡率。次要结局包括院内全因死亡率、院内不良结局综合（全因死亡率、心源性休克、心力衰竭、再梗死、大出血或中风）以及综合结果的各个组成部分。结果共对 1579 名患者进行了复查，其中 228 人（14.4%）被确定为体弱者。经多变量调整后，体弱程度越高（即 FI 越高），院内全因死亡率（几率比 [OR]，1.88；95% 置信区间 [CI]，1.50-2.35，P < 0.001）、院内综合不良结局（OR，1.46；95% CI，1.27-1.68，P < 0.结论在接受 pPCI 的当代 STEMI 老年患者队列中，每 7 名患者中就有 1 名体弱者，体弱程度越高，院内和长期不良预后越严重。这些发现凸显了早期识别体弱的必要性，以及采用跨学科方法管理体弱 STEMI 患者的必要性。

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引用次数: 0

Queries on Rilonacept in COVID-19 and Vaccine-Linked Pericarditis: Addressing Study Outcomes 有关 COVID-19 和疫苗相关心包炎中利龙赛普的询问：解决研究结果问题

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open

Pub Date : 2024-08-01 DOI: 10.1016/j.cjco.2024.04.009

引用次数: 0

Trends in Cardiovascular Risk Factors in Canada: Variation by Migration and Temporal Factors, 2001-2018 加拿大心血管风险因素的趋势：2001-2018 年移民和时间因素的变化

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open

Pub Date : 2024-08-01 DOI: 10.1016/j.cjco.2024.04.006

Background

Cardiovascular disease is a leading cause of death in Canada, but how the major cardiovascular risk factors vary across ethnicity and immigration status has yet to be examined.

Methods

Using data from the Canadian Community Health Surveys, national trends in health conditions (hypertension, diabetes, high blood cholesterol level, and obesity) and health behaviours (smoking, activity levels, and alcohol consumption) were estimated for the period 2001-2018. In this cross-sectional study, the trends were then compared across sex, age, ethnicity, and immigration status.

Results

A total of 1,065,391 respondents were examined, for the period 2001-2018. During the study period, the prevalence of the following risk factors increased in Canada over time, as follows: diabetes by 54.5%; hypertension by 23.4%; and obesity by 32.3%. For health behaviours, smoking prevalence decreased overall, especially in racialized populations. Heavy drinking was most prevalent for nonracialized and non-Indigenous Canadian-born populations, and was of lowest prevalence among racialized immigrants. Physical inactivity was most prevalent for racialized immigrant populations. The prevalence of self-reported heart disease decreased by 21.0%, except for racialized established immigrants (≥ 10 years since immigration to Canada), who had a 4.2% increase.

Conclusions

During this study period, decreases occurred in the prevalences of smoking and physical inactivity, along with increases in obesity, diabetes, and hypertension prevalences. By migration-group status, established immigrants in Canada had a higher prevalence of cardiovascular disease risk factors compared to that among their Canadian-born counterparts. Migration gaps should be considered in future interventions targeted at reducing these cardiovascular risk factors in Canada.

背景心血管疾病是加拿大人的主要死因，但不同种族和移民身份的主要心血管风险因素有何差异尚待研究。方法利用加拿大社区健康调查（Canadian Community Health Surveysys）的数据，估算了 2001-2018 年期间全国健康状况（高血压、糖尿病、高血脂和肥胖）和健康行为（吸烟、活动量和饮酒）的趋势。在这项横断面研究中，我们对不同性别、年龄、种族和移民身份的趋势进行了比较。结果 2001-2018年期间，共有1,065,391名受访者接受了调查。在研究期间，加拿大下列风险因素的流行率随时间推移而增加：糖尿病增加了 54.5%；高血压增加了 23.4%；肥胖增加了 32.3%。在健康行为方面，吸烟率总体下降，尤其是在种族人口中。酗酒在非种族和非土著加拿大出生人口中最为普遍，而在种族移民中则最低。缺乏运动在种族化移民中最为普遍。自我报告的心脏病患病率下降了 21.0%，但已定居加拿大的种族移民（移民加拿大≥10 年）除外，他们的患病率上升了 4.2%。结论在本研究期间，吸烟和缺乏运动的患病率有所下降，而肥胖、糖尿病和高血压的患病率有所上升。按移民群体身份划分，在加拿大定居的移民与在加拿大出生的移民相比，心血管疾病风险因素的患病率更高。今后在加拿大采取旨在减少这些心血管风险因素的干预措施时，应考虑移民差距。

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引用次数: 0

Malignant Pericardial Effusion: A Systematic Review 恶性心包积液：恶性心包积液：系统性综述 "恶性心包积液：综述综述"

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open

Pub Date : 2024-08-01 DOI: 10.1016/j.cjco.2024.05.003

Background

Malignant pericardial effusion (Eff) is often asymptomatic and has an unknown prevalence, due to its occult presentation. The condition often is identified postmortem on autopsy, and it is associated with a poor prognosis. Given the late presentation of malignant pericardial Effs, a minimal volume of literature has examined the epidemiology, clinical characteristics, and outcomes of these complex patients. We conducted a systematic review to advance present understanding of this condition.

Methods

A search of 4 databases resulted in 41 case reports meeting criteria. Inclusion criteria were being a patient aged > 18 years who presented with pericardial Eff in the setting of malignancy. Intervention was medical and/or surgical therapy, and the outcome was mortality.

Results

For the 41 patients included, the median age was 54 years, and the majority were male patients (58%). Dyspnea was the leading symptom (90%), and cardiac tamponade was present in 78% of cases. Common cancers included lung, gastrointestinal, and renal neoplasms (59%). Pericardiocentesis occurred in 98% of cases, with a median fluid extraction volume of 1000 mL. Death occurred in 44%, primarily due to disease progression and/or metastasis.

Conclusions

This study presents the largest systematic review on malignancy-induced pericardial Effs to date. Notably, solid tumours, and specifically lung adenocarcinomas, are common culprits. Malignant pericardial Effs are often severe, with a majority of patients presenting with cardiac tamponade. Overall, treatment options are limited, and the associated mortality rate is high.

背景恶性心包积液（Eff）通常无症状，由于表现隐匿，发病率不详。恶性心包积液通常在死后尸检时才被发现，而且预后较差。由于恶性心包炎的发病时间较晚，研究这些复杂患者的流行病学、临床特征和预后的文献极少。我们进行了一项系统性综述，以加深目前对这一病症的了解。方法通过对 4 个数据库的检索，共有 41 篇病例报告符合标准。纳入标准为年龄在 18 岁以下、因恶性肿瘤而出现心包积液的患者。干预措施为药物和/或手术治疗，结果为死亡率。结果在纳入的 41 例患者中，中位年龄为 54 岁，大多数为男性患者（58%）。呼吸困难是主要症状（90%），78%的病例存在心脏填塞。常见的癌症包括肺癌、胃肠道肿瘤和肾脏肿瘤（59%）。98%的病例进行了心包穿刺，抽液量中位数为1000毫升。44%的病例死亡，主要是由于疾病进展和/或转移。值得注意的是，实体瘤，尤其是肺腺癌是常见的罪魁祸首。恶性心包炎通常病情严重，大多数患者会出现心脏填塞。总体而言，治疗方案有限，相关死亡率较高。

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引用次数: 0

Impact of Long COVID-19 on Health Outcomes Among Adults With Preexisting Cardiovascular Disease and Hypertension: A Systematic Review 长COVID-19对已有心血管疾病和高血压的成年人健康状况的影响：系统综述

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open

Pub Date : 2024-08-01 DOI: 10.1016/j.cjco.2024.03.003

Background

This review summarizes the impact of long COVID (LC) on the health of adults with preexisting cardiovascular disease (CVD) and hypertension.

Methods

We searched Medline, Web of Science (Core Collection), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), without language restrictions, for articles published from December 1, 2019 through October 10, 2023, to ensure all relevant studies were captured. We included studies that enrolled adults (aged ≥18 years) diagnosed with CVD prior to COVID-19 infection whose infection was subsequently determined to be LC per the World Health Organization definition. We excluded studies with adults diagnosed with CVD concurrent with or subsequent to COVID-19 or with those who solely self-reported LC. We used a custom-built data extraction form to collect a range of study characteristics. Study quality was assessed using modified versions of the National Heart, Lung, and Blood Institute quality-assessment tools.

Results

A total of 13,779 studies were identified; 53 were included in the final analysis. Of these, 27 were of good quality and 26 were of fair quality. Health outcomes consisted of the presence of prolonged symptoms of LC (n = 29), physiological health outcomes (n = 20), lifestyle behaviours (n = 19), psycho-social outcomes (n = 13), CVD complications (n = 5), and death and hospital readmission (n = 5). Thirty-four studies incorporated 2 or more outcomes, and 19 integrated only 1.

Conclusions

Given the significant impact of LC among individuals with preexisting CVD, specially tailored clinical management is needed for members of this population. Additional studies on the impact of LC among those with CVD and other underlying conditions also would be beneficial.

背景本综述总结了长COVID（LC）对已有心血管疾病（CVD）和高血压的成人健康的影响。方法我们检索了Medline、Web of Science（核心收录）和《护理与专职医疗文献累积索引》（CINAHL）中从2019年12月1日到2023年10月10日发表的文章，没有语言限制，以确保所有相关研究都被收录。我们纳入了纳入在感染 COVID-19 之前已确诊患有心血管疾病的成人（年龄≥18 岁）的研究，根据世界卫生组织的定义，这些成人的感染随后被确定为 LC。我们排除了与 COVID-19 同时或随后诊断出患有心血管疾病的成人或仅自我报告为 LC 的成人的研究。我们使用定制的数据提取表来收集一系列研究特征。研究质量采用美国国家心肺血液研究所质量评估工具的修订版进行评估。结果共鉴定出 13779 项研究；53 项纳入最终分析。其中，27 项研究质量良好，26 项研究质量一般。健康结果包括出现长期低血糖症状（29 例）、生理健康结果（20 例）、生活方式行为（19 例）、社会心理结果（13 例）、心血管疾病并发症（5 例）以及死亡和再次入院（5 例）。有 34 项研究纳入了 2 项或 2 项以上的结果，19 项研究仅纳入了 1 项结果。结论鉴于低血糖对原有心血管疾病患者的重大影响，需要对这一人群进行特别定制的临床管理。对患有心血管疾病和其他潜在疾病的人群进行更多有关低血糖影响的研究也是有益的。

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引用次数: 0

Cardiac Magnetic Resonance Imaging for the Diagnosis of Simultaneous Spontaneous Coronary Artery Dissection and Takotsubo Syndrome 心脏磁共振成像用于诊断自发性冠状动脉夹层和塔克次博综合征

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open

Pub Date : 2024-08-01 DOI: 10.1016/j.cjco.2024.06.003

引用次数: 0

Preliminary Study of a Degenerated Tricuspid Bioprosthetic Valve Implanted via Transcatheter Valve-in-Valve Implantation Guided by 3-Dimensional Printing 通过三维打印引导下的经导管瓣中瓣植入术初步研究退化的三尖瓣生物人工瓣膜

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open

Pub Date : 2024-08-01 DOI: 10.1016/j.cjco.2023.11.023

Background

The procedures of transcatheter tricuspid valve-in-valve (TTViV) replacement are challenging, and the clinical outcomes are still unclear. Our goal was to report the short- and mid-term clinical outcomes of patients who underwent a TTViV implantation guided by 3-dimensional (3D) printing.

Methods

A retrospective analysis was performed on 6 patients who had TTViV implantation from May 2021 to March 2022. The median age was 51 years (range: 18-71 years), and 50.0% of the patients were male. Imaging assessments and 3D printing were performed on all 6 patients before the procedures. The perioperative data were evaluated, and the patients were followed up.

Results

Among the 6 patients, the etiologies of conditions affecting the tricuspid valves at baseline varied widely, including 1 case of Ebstein anomaly, 2 cases of infective endocarditis, 1 case of ventricular septal defect, and 2 cases of rheumatic heart disease. TTViV implantation was successfully performed in all 6 patients via the femoral vein approach; postoperative tricuspid regurgitation disappeared immediately, and the hemodynamic results were satisfactory. During the follow-up, all patients had significant improvement in symptoms and functional status.

Conclusions

TTViV implantation for the treatment of degenerated tricuspid bioprostheses should be considered safe and effective. Multimodal imaging and 3D printing may provide effective guidance for conducting the procedure.

Clinical Trial Registration

ClinicalTrials.gov Protocol Registration System (NCT02917980).

背景经导管三尖瓣瓣中瓣（TTViV）置换术具有挑战性，其临床结果尚不明确。我们的目标是报告在三维（3D）打印引导下接受 TTViV 植入术的患者的短期和中期临床结果。方法对 2021 年 5 月至 2022 年 3 月期间接受 TTViV 植入术的 6 名患者进行了回顾性分析。中位年龄为 51 岁（18-71 岁），50.0% 的患者为男性。手术前对所有 6 名患者进行了成像评估和 3D 打印。结果 6名患者的三尖瓣基线病因差异很大，其中1例为埃布斯坦畸形，2例为感染性心内膜炎，1例为室间隔缺损，2例为风湿性心脏病。所有 6 名患者均通过股静脉途径成功实施了 TTViV 植入术；术后三尖瓣反流立即消失，血液动力学结果令人满意。结论TTViV植入术治疗退变的三尖瓣生物前列腺假体是安全有效的。临床试验注册ClinicalTrials.gov协议注册系统（NCT02917980）。

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引用次数: 0

Reply to Albulushi et al.—Absence of Pericarditis Recurrence in Rilonacept-Treated Patients With COVID-19 and SARS-CoV-2 Vaccination: Results From RHAPSODY Long-term Extension 对 Albulushi 等人的回复--接种 COVID-19 和 SARS-CoV-2 疫苗的里隆赛普治疗患者的心包炎复发率：RHAPSODY长期推广的结果

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open

Pub Date : 2024-08-01 DOI: 10.1016/j.cjco.2024.05.014

引用次数: 0

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