Pub Date : 2020-12-31DOI: 10.46619/JOH.2020.1-1006
Koshi Rreze, S. Maja, Miličić Davor, Elezi Shpend
INTRODUCTION The aim of our study was to compare clinical characteristics, risk factors, treatment modalities and medium-term outcomes in STEMI patients in two different countries, Croatia and Kosovo. MATERIAL AND METHODS The study included 77 consecutive patients from two regional hospitals, included in the STEMI network of University Clinical Center Zagreb, Croatia (group 1), and 75 STEMI consecutive patients treated in regional Hospital Gjakova, Kosovo (group 2). Standard laboratory tests were performed in both study groups. Patients were treated by the standard protocol of the country and hospital where they were treated. Immediate clinical outcomes and 6 months follow up results regarding MACE were compared. RESULTS There was no significant difference between groups in basic clinical characteristic except for diabetes mellitus, (x2 = 6.96, P = 0.008, P <0.01) and glycaemia control (U’ = 1530, P = 0.013).No significant difference between two groups in laboratory findings. There was a difference in percent of patients treated with primary PCI, 71 in gr 1 and 55 in group 2, reaching statistical significance (x2 test 8,261, p = 0.0045). In patients treated with PCI, there was no difference in “door to balloon time” (DTB) between groups. There was a remarkable difference in proportion of drug eluting stent (DES) implantation (3.5% in group 1, 29.1% in group 2 (x2 test 13.5, P = 0.0002).The difference partly derives from the relatively large number of balloon interventions in group 2. There was 2 deaths in group 1 in early hospital period, both during interventional procedure, one of the patients was in cardiogenic shock. There was no early mortality in group 2. In 6 month clinical follow up there were 3 deaths in group 2, all in patient with no revascularization, and no death in group 1. CONCLUSION We compared the clinical characteristics, treatment strategies and outcomes, in STEMI patients from two countries. After initial mortality, patients from Croatia had a better mid-term survival after recovery from their AMI compared to patients from Kosovo. Use of revascularization procedures was beneficial, but it was less often performed in Kosovo
本研究的目的是比较克罗地亚和科索沃两个不同国家STEMI患者的临床特征、危险因素、治疗方式和中期结局。材料和方法:本研究纳入来自克罗地亚萨格勒布大学临床中心STEMI网络的两家地区医院的77例连续患者(组1)，以及在科索沃Gjakova地区医院治疗的75例连续STEMI患者(组2)。两个研究组均进行了标准实验室检查。病人按照接受治疗的国家和医院的标准方案接受治疗。比较MACE的即时临床结果和6个月随访结果。结果两组间除糖尿病(x2 = 6.96, P = 0.008, P <0.01)和血糖控制(U ' = 1530, P = 0.013)外，其他基本临床特征均无显著差异。两组实验室检查结果无显著差异。首次行PCI治疗的患者百分比，1组71例，2组55例，差异有统计学意义(x2检验8261,p = 0.0045)。在接受PCI治疗的患者中，两组之间的“门到球囊时间”(DTB)没有差异。两组患者药物洗脱支架(DES)植入率差异有统计学意义(1组为3.5%，2组为29.1%)(x2检验13.5,P = 0.0002)。这种差异部分源于第二组中相对较多的球囊干预。1组住院早期死亡2例，均在介入手术中死亡，其中1例为心源性休克。2组无早期死亡。临床随访6个月，2组死亡3例，均为无血运重建患者，1组无死亡病例。结论:我们比较了两个国家STEMI患者的临床特征、治疗策略和结局。与科索沃患者相比，克罗地亚患者在AMI恢复后的中期生存率高于初始死亡率。使用血运重建术是有益的，但在科索沃很少使用
{"title":"Comparison of Clinical Characteristics and Outcomes in Patients with STEMI in Croatia and Kosovo","authors":"Koshi Rreze, S. Maja, Miličić Davor, Elezi Shpend","doi":"10.46619/JOH.2020.1-1006","DOIUrl":"https://doi.org/10.46619/JOH.2020.1-1006","url":null,"abstract":"INTRODUCTION The aim of our study was to compare clinical characteristics, risk factors, treatment modalities and medium-term outcomes in STEMI patients in two different countries, Croatia and Kosovo. MATERIAL AND METHODS The study included 77 consecutive patients from two regional hospitals, included in the STEMI network of University Clinical Center Zagreb, Croatia (group 1), and 75 STEMI consecutive patients treated in regional Hospital Gjakova, Kosovo (group 2). Standard laboratory tests were performed in both study groups. Patients were treated by the standard protocol of the country and hospital where they were treated. Immediate clinical outcomes and 6 months follow up results regarding MACE were compared. RESULTS There was no significant difference between groups in basic clinical characteristic except for diabetes mellitus, (x2 = 6.96, P = 0.008, P <0.01) and glycaemia control (U’ = 1530, P = 0.013).No significant difference between two groups in laboratory findings. There was a difference in percent of patients treated with primary PCI, 71 in gr 1 and 55 in group 2, reaching statistical significance (x2 test 8,261, p = 0.0045). In patients treated with PCI, there was no difference in “door to balloon time” (DTB) between groups. There was a remarkable difference in proportion of drug eluting stent (DES) implantation (3.5% in group 1, 29.1% in group 2 (x2 test 13.5, P = 0.0002).The difference partly derives from the relatively large number of balloon interventions in group 2. There was 2 deaths in group 1 in early hospital period, both during interventional procedure, one of the patients was in cardiogenic shock. There was no early mortality in group 2. In 6 month clinical follow up there were 3 deaths in group 2, all in patient with no revascularization, and no death in group 1. CONCLUSION We compared the clinical characteristics, treatment strategies and outcomes, in STEMI patients from two countries. After initial mortality, patients from Croatia had a better mid-term survival after recovery from their AMI compared to patients from Kosovo. Use of revascularization procedures was beneficial, but it was less often performed in Kosovo","PeriodicalId":50184,"journal":{"name":"Journal of Heart Valve Disease","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81516938","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}
Pub Date : 2020-12-31DOI: 10.46619/JOH.2020.1-1003
S. Jaspal, Wibawanti Retno
INTRODUCTION Heart failure with preserved ejection fraction (HFpEF) is a condition where the left ventricular function is ≥50%. This population has a high morbidity and mortality compared to its counter-part heart failure with reduced ejection fraction (HFrEF). However treatment in this group remain spares. Hypertension medications are widely used in practice for patients with heart failure with reduced ejection fraction, however its efficacy in HFpEF is still an ongoing research. METHOD Evidence based research from various different search engines such as Medline® , Cochrane ® , and Proquest® with inclusion of high quality evidence such as meta-analysis, systematic review, RCT, and cohort studies. The selected papers were screened for validity, importance and applicability to the case in question. RESULT The two different RCTs studies showed that ACE-I had no effects in HFpEF. Research by Kitzman et al. showed that ACE-I did not show any improvement of left ventricular mass, neuro-hormonal profile, and 6 minutes walking test. This was also confirmed by Zi et al., which in addition showed that ACE-I did not increase the quality of life in the geriatric subjects. CONCLUSION All in all, ACE-I as a type of anti-hypertensive medication does not benefit geriatric population of HFpEF
{"title":"Anti-Hypertensive Medication in Geriatric Population with HFpEF","authors":"S. Jaspal, Wibawanti Retno","doi":"10.46619/JOH.2020.1-1003","DOIUrl":"https://doi.org/10.46619/JOH.2020.1-1003","url":null,"abstract":"INTRODUCTION Heart failure with preserved ejection fraction (HFpEF) is a condition where the left ventricular function is ≥50%. This population has a high morbidity and mortality compared to its counter-part heart failure with reduced ejection fraction (HFrEF). However treatment in this group remain spares. Hypertension medications are widely used in practice for patients with heart failure with reduced ejection fraction, however its efficacy in HFpEF is still an ongoing research. METHOD Evidence based research from various different search engines such as Medline® , Cochrane ® , and Proquest® with inclusion of high quality evidence such as meta-analysis, systematic review, RCT, and cohort studies. The selected papers were screened for validity, importance and applicability to the case in question. RESULT The two different RCTs studies showed that ACE-I had no effects in HFpEF. Research by Kitzman et al. showed that ACE-I did not show any improvement of left ventricular mass, neuro-hormonal profile, and 6 minutes walking test. This was also confirmed by Zi et al., which in addition showed that ACE-I did not increase the quality of life in the geriatric subjects. CONCLUSION All in all, ACE-I as a type of anti-hypertensive medication does not benefit geriatric population of HFpEF","PeriodicalId":50184,"journal":{"name":"Journal of Heart Valve Disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80186341","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}
INTRODUCTION Although the catheter ablation of frequent premature ventricular complexes (PVCs) from outflow tracts is reported as a highly successful procedure especially in patients with structurally normal hearts, but some cases create a great challenge. Patients with prosthetic valves often are not considered for radiofrequency ablation (RFA) due to risk of possible fatal and nonfatal complications. CASE SUMMARY We describe a rare experience of performing RFA in this high risk, challenging patient. A 76-years-old man with history of coronary artery bypass graft (CABG) due to previous myocardial infarct (MI) and aortic valve replacement with bioprosthetic valve for his aortic insufficiency was referred to our department due to feeling of suffocation and irregularity of pulse during a flight. RF ablation was scheduled for him due to high PVC burden. PVCs showed LBBB morphology, inferior axis with transition in (V3-V4) leads. After failed attempt of RFA through the right outflow tract (RVOT), PVC was terminated from the left coronary cusp. DISCUSSION This case highlights the fact that efficacy of the radiofrequency ablation in patients with bioprosthetic valves is feasible. It has to be emphasized that in such a challenging case, risk of severe complications should be weighted against its benefit.
{"title":"Radiofrequency Ablation of Ventricular Arrhythmias on Bioprosthetic Valve, a Never Found Case Before","authors":"Taherpour Mehdi, Fazeli Farzad, Nazari Hossein, Emkanjoo Zahra","doi":"10.46619/JOH.2020.1-1007","DOIUrl":"https://doi.org/10.46619/JOH.2020.1-1007","url":null,"abstract":"INTRODUCTION Although the catheter ablation of frequent premature ventricular complexes (PVCs) from outflow tracts is reported as a highly successful procedure especially in patients with structurally normal hearts, but some cases create a great challenge. Patients with prosthetic valves often are not considered for radiofrequency ablation (RFA) due to risk of possible fatal and nonfatal complications. CASE SUMMARY We describe a rare experience of performing RFA in this high risk, challenging patient. A 76-years-old man with history of coronary artery bypass graft (CABG) due to previous myocardial infarct (MI) and aortic valve replacement with bioprosthetic valve for his aortic insufficiency was referred to our department due to feeling of suffocation and irregularity of pulse during a flight. RF ablation was scheduled for him due to high PVC burden. PVCs showed LBBB morphology, inferior axis with transition in (V3-V4) leads. After failed attempt of RFA through the right outflow tract (RVOT), PVC was terminated from the left coronary cusp. DISCUSSION This case highlights the fact that efficacy of the radiofrequency ablation in patients with bioprosthetic valves is feasible. It has to be emphasized that in such a challenging case, risk of severe complications should be weighted against its benefit.","PeriodicalId":50184,"journal":{"name":"Journal of Heart Valve Disease","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85990674","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}
Pub Date : 2020-12-31DOI: 10.46619/JOH.2020.1-1004
S. Saousan, Ad Hind, M. Anass, A. Salim, E. Bennouna, Drighil Abdenasser, Azzouzi Leila, R. Habbal
BACKGROUND The association between antigens A and B and cardiovascular disease is still unclear. Several reports have suggested an important involvement of the ABO blood group system in the susceptibility to thrombosis. Assessing that non-O blood groups in particular A blood group confer a higher risk of venous and arterial thrombosis than group O. Epidemiologic data are typically not available for all racial and ethnics groups. The purpose of this observational study was to identify a probable link between ABO blood group and ischemic and non-ischemic disease in subjects from the province of Casablanca, Morocco and to analyze whether A blood group individuals were at higher risk of ischemic disease or not. METHOD An observational study had been conducted from the beginning of 2017 until the end of 2019 in the Department of Cardiology, University Hospital Centre, Ibn Rochd, Casablanca, Morocco. We recruited consecutive subjects (549 men and 544 woman) at our center between 2017 and 2019. We studied data on age, gender, past history of hypertension, diabetes, smoking, sedentarism, obesity, hyperlipidemia, use of estrogen-progestin contraceptives and blood group distribution. Their ABO blood groups were determined using standard agglutination techniques. In each blood group type, we evaluated the prevalence of ischemic and non-ischemic cardiovascular disease. RESULT Of the 1093 patients whose medical records were reviewed, 482 (44.1%) were carrying blood group A. Of the remaining 611 patients, 353 (32.3%) had blood group O, 212 (19.4%) blood group B, and 46 (4.3%) blood group AB. The diagnosis of ischemic disease (ID) was higher in patients with blood group O (63.3%) than in other blood groups, and the diagnosis of valvular disease was higher in patients with blood group A (48.7%) compared to other groups. In patients with blood group B or AB compared to non-B or non-AB, respectively there was no statistically significant difference in ID incidence. The incidence of ID in men was significantly higher in blood group O (63.2%, p = 0.015) compared with women, while there valvular disease was a statistically higher in women (54.5%, p = 0.035). This difference remains statistically significant after adjustment for common cardiovascular risk factors. CONCLUSION Our study suggests an association between ABO blood group and Ischemic disease and non-ischemic disease in Moroccan population. In African countries, where most of health facilities are understaffed, more rigorous studies with a larger population are needed to give high level of evidence to confirm this association in order to establish the need to be more aggressive in risk factor control in these individuals.
{"title":"ABO Blood Group: A Risk Factor for a Cardiovascular Disease in Adults in Morocco","authors":"S. Saousan, Ad Hind, M. Anass, A. Salim, E. Bennouna, Drighil Abdenasser, Azzouzi Leila, R. Habbal","doi":"10.46619/JOH.2020.1-1004","DOIUrl":"https://doi.org/10.46619/JOH.2020.1-1004","url":null,"abstract":"BACKGROUND The association between antigens A and B and cardiovascular disease is still unclear. Several reports have suggested an important involvement of the ABO blood group system in the susceptibility to thrombosis. Assessing that non-O blood groups in particular A blood group confer a higher risk of venous and arterial thrombosis than group O. Epidemiologic data are typically not available for all racial and ethnics groups. The purpose of this observational study was to identify a probable link between ABO blood group and ischemic and non-ischemic disease in subjects from the province of Casablanca, Morocco and to analyze whether A blood group individuals were at higher risk of ischemic disease or not. METHOD An observational study had been conducted from the beginning of 2017 until the end of 2019 in the Department of Cardiology, University Hospital Centre, Ibn Rochd, Casablanca, Morocco. We recruited consecutive subjects (549 men and 544 woman) at our center between 2017 and 2019. We studied data on age, gender, past history of hypertension, diabetes, smoking, sedentarism, obesity, hyperlipidemia, use of estrogen-progestin contraceptives and blood group distribution. Their ABO blood groups were determined using standard agglutination techniques. In each blood group type, we evaluated the prevalence of ischemic and non-ischemic cardiovascular disease. RESULT Of the 1093 patients whose medical records were reviewed, 482 (44.1%) were carrying blood group A. Of the remaining 611 patients, 353 (32.3%) had blood group O, 212 (19.4%) blood group B, and 46 (4.3%) blood group AB. The diagnosis of ischemic disease (ID) was higher in patients with blood group O (63.3%) than in other blood groups, and the diagnosis of valvular disease was higher in patients with blood group A (48.7%) compared to other groups. In patients with blood group B or AB compared to non-B or non-AB, respectively there was no statistically significant difference in ID incidence. The incidence of ID in men was significantly higher in blood group O (63.2%, p = 0.015) compared with women, while there valvular disease was a statistically higher in women (54.5%, p = 0.035). This difference remains statistically significant after adjustment for common cardiovascular risk factors. CONCLUSION Our study suggests an association between ABO blood group and Ischemic disease and non-ischemic disease in Moroccan population. In African countries, where most of health facilities are understaffed, more rigorous studies with a larger population are needed to give high level of evidence to confirm this association in order to establish the need to be more aggressive in risk factor control in these individuals.","PeriodicalId":50184,"journal":{"name":"Journal of Heart Valve Disease","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79109843","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}
Pub Date : 2020-12-31DOI: 10.46619/JOH.2020.1-1002
N. Praveen, O. Naidu, K. K. Anjani, S. Ravi, Reddy P Kmk
Restrictive cardiomyopathy (RCMP) is infrequent in occurrence compared to the other cardiomyopathies. The stiff ventricular walls impair the diastolic function, increase the filling pressures, and thereby result in heart failure. Amyloidosis, a systemic disorder is the most common cause of RCMP. The amyloid diagnosis is often missed as the features are masqueraded by the presence of other conditions. The Bicuspid aortic valve (BAV) is the most common congenital anomaly of the cardiovascular system occurring in approximately 0.5-2% of the general population. We present a case of bicuspid aortic valvular heart disease masking the amyloidosis with heart failure in a middle-aged male.
{"title":"An Interesting Case of Heart Failure in a Patient with Bicuspid Aortic Valve - Unveiling the Diagnosis of Amyloidosis","authors":"N. Praveen, O. Naidu, K. K. Anjani, S. Ravi, Reddy P Kmk","doi":"10.46619/JOH.2020.1-1002","DOIUrl":"https://doi.org/10.46619/JOH.2020.1-1002","url":null,"abstract":"Restrictive cardiomyopathy (RCMP) is infrequent in occurrence compared to the other cardiomyopathies. The stiff ventricular walls impair the diastolic function, increase the filling pressures, and thereby result in heart failure. Amyloidosis, a systemic disorder is the most common cause of RCMP. The amyloid diagnosis is often missed as the features are masqueraded by the presence of other conditions. The Bicuspid aortic valve (BAV) is the most common congenital anomaly of the cardiovascular system occurring in approximately 0.5-2% of the general population. We present a case of bicuspid aortic valvular heart disease masking the amyloidosis with heart failure in a middle-aged male.","PeriodicalId":50184,"journal":{"name":"Journal of Heart Valve Disease","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86993525","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}
Pub Date : 2019-11-13DOI: 10.1007/978-3-030-23104-0_3
M. Clavel, N. Côté, P. Pibarot
{"title":"Aortic Stenosis","authors":"M. Clavel, N. Côté, P. Pibarot","doi":"10.1007/978-3-030-23104-0_3","DOIUrl":"https://doi.org/10.1007/978-3-030-23104-0_3","url":null,"abstract":"","PeriodicalId":50184,"journal":{"name":"Journal of Heart Valve Disease","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90586205","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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