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Effects of Mindfulness Meditation on Anxiety, Self-Efficacy, and Quality of Life in Patients after Coronary Artery Bypass Transplantation 正念冥想对冠状动脉旁路移植术后患者焦虑、自我效能感和生活质量的影响
Pub Date : 2024-06-13 DOI: 10.59958/hsf.7389
Shuyuan Wei, Ji Wang, Hua Xie, Yanshuang Cheng
Objective: This study aimed to determine the effects of mindfulness meditation on the anxiety, self-efficacy, and quality of life of patients after coronary artery bypass grafting (CABG). Methods: Data of 124 patients who underwent CABG in our hospital from May 2020, to May 2022, were collected. In accordance with the presence or absence of mindfulness meditation, the patients were divided into control group (n = 64, conventional cardiac rehabilitation) and observation group (n = 60, conventional cardiac rehabilitation + mindfulness meditation). The Hamilton Anxiety Scale (HAMA), General Self-Efficacy Scale (GSES), quality of life, and postoperative complications were compared between the two groups. Results: No significant difference was observed in the HAMA, GSES, and quality-of-life scores between the two groups after operation (p > 0.05). After the intervention, the HAMA score of the observation group was lower than that of the control group (p < 0.05), and the GSES and quality of life scores of the observation group were higher than those of the control group (p < 0.05). The total incidence of postoperative complications in the observation group (5.00%) was lower than that in the control group (7.81%), without significant difference (p > 0.05). Conclusions: The use of mindfulness meditation for patients undergoing CABG is beneficial to relieve anxiety and improve their self-efficacy and quality of life, hence worthy of adoption.
研究目的本研究旨在确定正念冥想对冠状动脉旁路移植术(CABG)术后患者的焦虑、自我效能感和生活质量的影响。研究方法收集2020年5月至2022年5月在我院接受冠状动脉旁路移植术的124名患者的数据。根据是否进行正念冥想,将患者分为对照组(n=64,常规心脏康复治疗)和观察组(n=60,常规心脏康复治疗+正念冥想)。比较两组患者的汉密尔顿焦虑量表(HAMA)、一般自我效能量表(GSES)、生活质量和术后并发症。结果显示两组患者术后的 HAMA、GSES 和生活质量评分无明显差异(P > 0.05)。干预后,观察组的 HAMA 评分低于对照组(P < 0.05),观察组的 GSES 和生活质量评分高于对照组(P < 0.05)。观察组术后并发症总发生率(5.00%)低于对照组(7.81%),差异无显著性(P > 0.05)。结论对接受心血管造影术的患者使用正念冥想有益于缓解焦虑,提高他们的自我效能和生活质量,因此值得采用。
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引用次数: 0
Influence of Serum Apelin and CD40L Expression Levels on Adverse Cardiovascular Events after PCI 血清凋亡素和 CD40L 表达水平对 PCI 后不良心血管事件的影响
Pub Date : 2024-06-13 DOI: 10.59958/hsf.7385
Jie Zhang, Yanjun Liu, Ning Liu
Objective: This study aimed to investigate the effects of serum levels of apelin and CD40L on major adverse cardiovascular events (MACEs) after percutaneous coronary intervention (PCI). Methods: A case–control study was conducted to select patients undergoing PCI in our hospital from June 2020 to June 2022. Patients were divided into the occurrence group and the non-occurrence group according to whether MACEs occurred during the 12-month follow-up after surgery. Enzyme-linked immunosorbent assay was used to detect the expression levels of serum apelin and CD40L in the two groups, and the correlation between the expression of apelin and CD40L and prognosis was analyzed. Logistic regression analysis was performed on the indicators with differences to analyze the influencing factors of the prognosis of PCI. Results: Compared with the non-occurrence group, the occurrence group had a significantly lower level of apelin and a significantly higher level of CD40L (p < 0.001). Apelin was negatively correlated with the occurrence of MACEs after PCI (r = –0.583, p < 0.001), and CD40L was positively correlated with the occurrence of MACEs after PCI (r = 0.569, p < 0.001). Logistic regression analysis showed that apelin was a protective factor for MACEs after PCI (odds ratio (OR) = 0.248, p < 0.001); CD40L, age, hypertension, and the number of diseased vessels were risk factors for MACEs after PCI (OR = 8.684, 0.018, 0.003, 0.020, p < 0.05). The area under curve (AUC) of apelin combined with CD40L was large, and the predictive value was higher than that of apelin and CD40L alone (AUC values were 0.956, 0.857, 0.905, p < 0.001; p < 0.001; p < 0.001). Conclusions: This study showed that the levels of apelin and CD40L were correlated with MACEs after PCI. Clinicians should pay close attention to the levels of apelin and CD40L in patients after PCI and be alert to the occurrence of MACEs.
研究目的本研究旨在探讨血清凋亡素和 CD40L 水平对经皮冠状动脉介入治疗(PCI)后主要不良心血管事件(MACE)的影响。研究方法选取2020年6月至2022年6月在我院接受PCI手术的患者进行病例对照研究。根据术后 12 个月随访期间是否发生 MACE,将患者分为发生组和未发生组。采用酶联免疫吸附试验检测两组患者血清凋亡素和CD40L的表达水平,并分析凋亡素和CD40L的表达与预后的相关性。对有差异的指标进行逻辑回归分析,分析PCI预后的影响因素。结果与非发生组相比,发生组的凋亡素水平明显降低,CD40L水平明显升高(P<0.001)。凋亡素与PCI后MACE的发生呈负相关(r = -0.583,p < 0.001),CD40L与PCI后MACE的发生呈正相关(r = 0.569,p < 0.001)。逻辑回归分析显示,凋亡素是PCI术后MACE的保护因素(几率比(OR)= 0.248,P<0.001);CD40L、年龄、高血压和病变血管数量是PCI术后MACE的危险因素(OR = 8.684、0.018、0.003、0.020,P<0.05)。凋亡素联合CD40L的曲线下面积(AUC)较大,其预测价值高于单独使用凋亡素和CD40L的预测价值(AUC值分别为0.956、0.857、0.905,P<0.001;P<0.001;P<0.001)。结论该研究表明,凋亡素和CD40L的水平与PCI后的MACEs相关。临床医生应密切关注PCI术后患者的凋亡素和CD40L水平,警惕MACE的发生。
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引用次数: 0
Anomalous Origin of the Right Pulmonary Artery from the Ascending Aorta in a 10-Day-Old Boy: A Case Report 一名出生仅 10 天的男孩右肺动脉从升主动脉异常起源:病例报告
Pub Date : 2024-06-06 DOI: 10.59958/hsf.7017
Lin Luo, Yulan Luo, Qi An, Mei Feng
Anomalous origin of the right pulmonary artery from the ascending aorta is a rare anomaly, comprising approximately 0.1% of all congenital heart diseases. Patients suffered congestive heart failure in infancy, and some patients will experience progressive pulmonary vascular disease without surgical repair. In patients of this disease, early surgical intervention is generally advised and has demonstrated a high level of safety and efficacy, yielding excellent outcomes. We report a unique case involving a 10-day-old boy, characterized by the rare anomalous origination of the right pulmonary artery from the ascending aorta. This case is further complicated by the presence of a patent ductus arteriosus (PDA) and a right descending aorta. The ligation of the PDA and reimplantation of the right pulmonary artery (RPA) were successfully performed. The patient exhibited a favorable recovery trajectory postoperatively.
升主动脉右肺动脉起源异常是一种罕见的异常,约占所有先天性心脏病的 0.1%。患者在婴儿期就会出现充血性心力衰竭,有些患者在没有手术修复的情况下会出现进行性肺血管疾病。对于这种疾病的患者,一般建议尽早进行手术治疗,手术的安全性和有效性都很高,治疗效果也很好。我们报告了一例独特的病例,涉及一名出生仅 10 天的男孩,其特点是右肺动脉罕见地从升主动脉异常起源。该病例因存在动脉导管未闭(PDA)和右降主动脉而变得更加复杂。成功结扎了 PDA 并重新植入了右肺动脉(RPA)。患者术后恢复良好。
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引用次数: 0
Surgical Repair of Giant Dissecting Pulmonary Artery Aneurysm Associated with Atrial Septal Defect and Pulmonary Arterial Hypertension: A Case Report 手术修复伴有房间隔缺损和肺动脉高压的巨大剥离性肺动脉瘤:病例报告
Pub Date : 2024-06-06 DOI: 10.59958/hsf.6835
Wen Xie, Jianrui Ma, Haiyun Yuan, Yong Zhang, Zhuang Jian, Shusheng Wen
Pulmonary artery aneurysm (PAA) and pulmonary artery dissection (PAD) are rare and potentially fatal conditions that may lead to pulmonary artery (PA) rupture and cardiac tamponade. PAA is often associated with other cardiac and congenital heart diseases, such as atrial septal defect (ASD). We report a case of a patient with ASD and a giant dissecting PAA who underwent surgical repair to prevent potentially fatal outcome and discuss the probable etiologies of this case. We present a rare case of a 50-year-old woman with a secundum ASD and severe pulmonary arterial hypertension (PAH) who developed a giant PAA of 114 mm with dissection. The PAA caused extrinsic compression of the left main coronary artery (LMCA), which was misdiagnosed as coronary artery disease (CAD) at local hospital. Right heart catheterization revealed PAH of 73 mmHg and she was referred to our center for further treatment. After 4 months of lowering PAH treatment, she underwent successful surgical repair of the PAA to release the compression of LMCA, as well as mechanical valve replacement, fenestrated ASD closure and tricuspid valvuloplasty. She had an uneventful recovery and showed significant improvement in pulmonary hemodynamics and clinical symptoms at one-year follow-up. PAA with dissection is a rare complication of ASD and PAH that can potentially be fatal. Patients with large or symptomatic PAA and PAD may require early surgical intervention, particularly if they experience compression of nearby structures or are at risk of rupture. It is crucial to promptly refer and consult with specialists and ensure optimal preoperative hemodynamic management to enhance patient outcomes.
肺动脉瘤(PAA)和肺动脉夹层(PAD)是一种罕见且可能致命的疾病,可导致肺动脉(PA)破裂和心脏填塞。PAA 通常伴有其他心脏疾病和先天性心脏病,如房间隔缺损(ASD)。我们报告了一例患有 ASD 和巨大解剖性 PAA 的患者,该患者接受了手术修复,避免了潜在的致命后果,我们还讨论了该病例的可能病因。我们报告了一例罕见病例,患者是一名 50 岁女性,患有继发性 ASD 和严重肺动脉高压(PAH),并伴有 114 毫米的巨大 PAA 和夹层。PAA 对左冠状动脉主干(LMCA)造成外源性压迫,在当地医院被误诊为冠状动脉疾病(CAD)。右心导管检查显示 PAH 为 73 mmHg,她被转到本中心接受进一步治疗。经过 4 个月的 PAH 降压治疗后,她成功地接受了 PAA 手术修复,解除了对 LMCA 的压迫,同时还进行了机械瓣膜置换、ASD 裂隙关闭术和三尖瓣成形术。患者恢复顺利,随访一年后肺血流动力学和临床症状均有明显改善。伴有夹层的 PAA 是 ASD 和 PAH 的罕见并发症,有可能致命。大面积或有症状的 PAA 和 PAD 患者可能需要早期手术干预,尤其是当患者附近结构受到压迫或有破裂风险时。及时转诊和咨询专科医生并确保最佳术前血流动力学管理以提高患者预后至关重要。
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引用次数: 0
Rhythm or Blues: Managing the Electrical State of the Heart with Temporary Pacing Wires 节奏或蓝调:用临时起搏导线管理心脏电状态
Pub Date : 2024-05-22 DOI: 10.59958/hsf.7347
Curt Tribble, Nicholas Teman
Temporary pacing wires are commonly used in cardiac surgical operations. We will review the basic principles of the use of these temporary pacing wires that we teach our residents, with the goal of providing cardiac surgical trainees guidance in the placement and use of these wires.
临时起搏导线常用于心脏外科手术。我们将回顾我们向住院医师传授的使用这些临时起搏导线的基本原则,目的是为心脏外科受训者提供放置和使用这些导线的指导。
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引用次数: 0
Evaluation of the Efficacy of Transcatheter Intervention, Surgery, and Pharmacological Treatment of Functional Mitral Regurgitation — A Bayesian Network Meta-Analysis with ≥12-Month Follow-up 经导管介入治疗、手术和药物治疗功能性二尖瓣反流的疗效评估--≥12 个月随访的贝叶斯网络 Meta 分析
Pub Date : 2024-05-21 DOI: 10.59958/hsf.7387
Qi Cheng, Shu-Ying Ding, Ren-Hui Wang, Jin-Shan Han, Yuan-Zheng Ye, Xiao-Mei Li, Yi-Tong Ma, Zi-Xiang Yu
Aim: Evaluate, using a Bayesian network meta-analysis system, the long-term prognosis of patients with functional mitral regurgitation (FMR) undergoing individual or combined treatment with percutaneous intervention, surgical intervention, or optimal medical therapy. Compare the prognostic outcomes of the different treatment modalities. Methods: Computerized searches of Embase, PubMed, and the Cochrane Library databases were performed. Randomized controlled trials (RCTs) and observational studies were searched to compare prognoses following transcatheter interventions, surgery, and optimal pharmacological treatment for FMR, all with a construction timeframe of 21 October 2023. The primary endpoint event was all-cause mortality. The secondary endpoint events were heart failure readmission rate, mitral regurgitation (MR) ≤2+ improvement rate, New York Heart Association (NYHA) improvement rate (improvement to I–II), and degree of left ventricular ejection fraction (LVEF) improvement. Results: Twenty-six (26) papers were included, comprising 10 RCTs and 16 observational studies involving 5443 patients. A network meta-analysis showed no significant difference in prognosis for all-cause mortality among transcatheter interventions, surgical procedures, and optimal pharmacological treatments. For heart failure readmission rates, mitral valve surgery was superior to MitraClip (odds ratio (OR) = 11.82; 95% confidence interval (CI): 1.67, 90.13). For NYHA (improvement to I–II) improvement rates, the results showed no significant differences for the various mitral interventions. For MR ≤2+ improvement rates, the MitraClip (OR = 3.07; 95% CI: 2.42, 3.76), MitraClip+Guideline-directed medical therapy (GDMT) (OR = 2.93; 95% CI: 2.38, 3.52), mitral valve surgery (OR = 3.01; 95% CI: 2.24, 3.8), and annuloplasty (OR = 4.31; 95% CI: 3.12, 5.58) were superior to GDMT, and mitral valve surgery (OR = 0.07; 95% CI: –0.45, 0.62) was superior to MitraClip+GDMT. For the degree of improvement in LVEF, Carillon+GDMT (mean difference (MD) = –0.97; 95% CI: –1.72, –0.22) was superior to GDMT, mitral valve surgery was superior to Carillon+GDMT (MD = 4.67; 95% CI: 0.92, 8.39); MitraClip+GDMT (MD = 4.01; 95% CI: 1.28, 6.66), GDMT (MD = 3.71; 95% CI: 0.04, 7.35), and annuloplasty were superior to mitral valve surgery (MD = –6.42; 95% CI: –11.96, –0.78). Conclusion: There were no significant differences among the three treatment modalities of transcatheter intervention, surgery, and optimal drug therapy in improving all-cause mortality hard endpoint events, and no significant differences were seen in the rates of heart failure readmission and NYHA improvement (improvement to I–II). However, surgery was superior to transcatheter intervention and optimal drug therapy in terms of improvement in the degree of regurgitation and LVEF.
目的:使用贝叶斯网络荟萃分析系统,评估功能性二尖瓣反流(FMR)患者接受经皮介入、外科介入或最佳药物疗法单独或联合治疗的长期预后。比较不同治疗方式的预后结果。方法:对 Embase、PubMed 和 Cochrane Library 数据库进行计算机检索。搜索了随机对照试验(RCT)和观察性研究,以比较经导管介入治疗、手术和最佳药物治疗 FMR 后的预后,所有研究的构建时限均为 2023 年 10 月 21 日。主要终点事件是全因死亡率。次要终点事件为心衰再入院率、二尖瓣反流(MR)≤2+改善率、纽约心脏协会(NYHA)改善率(改善至I-II)和左室射血分数(LVEF)改善程度。结果:共纳入 26 篇论文,包括 10 项研究性临床试验和 16 项观察性研究,涉及 5443 名患者。一项网络荟萃分析显示,经导管介入治疗、外科手术和最佳药物治疗在全因死亡率方面的预后无明显差异。就心衰再入院率而言,二尖瓣手术优于 MitraClip(几率比 (OR) = 11.82;95% 置信区间 (CI):1.67, 90.13)。在 NYHA(改善至 I-II)改善率方面,结果显示各种二尖瓣介入治疗没有显著差异。对于 MR ≤2+的改善率,MitraClip(OR = 3.07;95% CI:2.42,3.76)、MitraClip+指导性药物治疗(GDMT)(OR = 2.93;95% CI:2.38,3.52)、二尖瓣手术(OR = 3.01;95% CI:2.24,3.8)和瓣环成形术(OR = 4.31;95% CI:3.12,5.58)优于 GDMT,二尖瓣手术(OR = 0.07;95% CI:-0.45,0.62)优于 MitraClip+GDMT。在 LVEF 改善程度方面,Carillon+GDMT(平均差(MD)=-0.97;95% CI:-1.72,-0.22)优于 GDMT,二尖瓣手术优于 Carillon+GDMT(MD = 4.67;95% CI:0.92,8.39);MitraClip+GDMT(MD = 4.01;95% CI:1.28,6.66)、GDMT(MD = 3.71;95% CI:0.04,7.35)和瓣环成形术优于二尖瓣手术(MD = -6.42;95% CI:-11.96,-0.78)。结论经导管介入、手术和最佳药物治疗这三种治疗方式在改善全因死亡率硬终点事件方面没有明显差异,在心衰再入院率和 NYHA 改善率(改善至 I-II)方面也没有明显差异。不过,在改善反流程度和 LVEF 方面,手术治疗优于经导管介入治疗和最佳药物治疗。
{"title":"Evaluation of the Efficacy of Transcatheter Intervention, Surgery, and Pharmacological Treatment of Functional Mitral Regurgitation — A Bayesian Network Meta-Analysis with ≥12-Month Follow-up","authors":"Qi Cheng, Shu-Ying Ding, Ren-Hui Wang, Jin-Shan Han, Yuan-Zheng Ye, Xiao-Mei Li, Yi-Tong Ma, Zi-Xiang Yu","doi":"10.59958/hsf.7387","DOIUrl":"https://doi.org/10.59958/hsf.7387","url":null,"abstract":"Aim: Evaluate, using a Bayesian network meta-analysis system, the long-term prognosis of patients with functional mitral regurgitation (FMR) undergoing individual or combined treatment with percutaneous intervention, surgical intervention, or optimal medical therapy. Compare the prognostic outcomes of the different treatment modalities. Methods: Computerized searches of Embase, PubMed, and the Cochrane Library databases were performed. Randomized controlled trials (RCTs) and observational studies were searched to compare prognoses following transcatheter interventions, surgery, and optimal pharmacological treatment for FMR, all with a construction timeframe of 21 October 2023. The primary endpoint event was all-cause mortality. The secondary endpoint events were heart failure readmission rate, mitral regurgitation (MR) ≤2+ improvement rate, New York Heart Association (NYHA) improvement rate (improvement to I–II), and degree of left ventricular ejection fraction (LVEF) improvement. Results: Twenty-six (26) papers were included, comprising 10 RCTs and 16 observational studies involving 5443 patients. A network meta-analysis showed no significant difference in prognosis for all-cause mortality among transcatheter interventions, surgical procedures, and optimal pharmacological treatments. For heart failure readmission rates, mitral valve surgery was superior to MitraClip (odds ratio (OR) = 11.82; 95% confidence interval (CI): 1.67, 90.13). For NYHA (improvement to I–II) improvement rates, the results showed no significant differences for the various mitral interventions. For MR ≤2+ improvement rates, the MitraClip (OR = 3.07; 95% CI: 2.42, 3.76), MitraClip+Guideline-directed medical therapy (GDMT) (OR = 2.93; 95% CI: 2.38, 3.52), mitral valve surgery (OR = 3.01; 95% CI: 2.24, 3.8), and annuloplasty (OR = 4.31; 95% CI: 3.12, 5.58) were superior to GDMT, and mitral valve surgery (OR = 0.07; 95% CI: –0.45, 0.62) was superior to MitraClip+GDMT. For the degree of improvement in LVEF, Carillon+GDMT (mean difference (MD) = –0.97; 95% CI: –1.72, –0.22) was superior to GDMT, mitral valve surgery was superior to Carillon+GDMT (MD = 4.67; 95% CI: 0.92, 8.39); MitraClip+GDMT (MD = 4.01; 95% CI: 1.28, 6.66), GDMT (MD = 3.71; 95% CI: 0.04, 7.35), and annuloplasty were superior to mitral valve surgery (MD = –6.42; 95% CI: –11.96, –0.78). Conclusion: There were no significant differences among the three treatment modalities of transcatheter intervention, surgery, and optimal drug therapy in improving all-cause mortality hard endpoint events, and no significant differences were seen in the rates of heart failure readmission and NYHA improvement (improvement to I–II). However, surgery was superior to transcatheter intervention and optimal drug therapy in terms of improvement in the degree of regurgitation and LVEF.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"58 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141116986","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: 0
Effect of Extracorporeal Membrane Oxygenation Support on Complex High-Risk Elective Percutaneous Coronary Intervention: A Clinical Research Review of Progress and Outcomes 体外膜氧合支持对复杂高风险择期经皮冠状动脉介入治疗的影响:进展与结果的临床研究回顾
Pub Date : 2024-05-21 DOI: 10.59958/hsf.7319
Yi Teng, Aobo Li, Yali Sheng, Ling Jin, Yang Tao, Xiaojun Kang
Background: The landscape of percutaneous coronary intervention (PCI) has expanded to encompass complex high-risk elective cases, necessitating advanced support strategies to mitigate procedural challenges and ensure patient safety. In this review manuscript, the effect of extracorporeal membrane oxygenation (ECMO) support on complex high-risk elective PCI was critically evaluated through an analysis of relevant clinical studies. The objective is to elucidate the role of ECMO in optimizing procedural success, mitigating complications, and improving long-term patient outcomes in this high-stake domain of interventional cardiology. Methods: A comprehensive search strategy identified seven publications encompassing single-center prospective, retrospective, and case report designs, collectively involving 91 patients undergoing high-risk elective PCI with ECMO support. Results: The results from these studies demonstrated the potential of ECMO support to facilitate successful high-risk elective PCI with favorable procedural outcomes, highlighting the importance of careful patient selection and proactive management of potential complications to further optimize the use of ECMO in this clinical setting. The refinement of patient selection criteria, optimization of procedural techniques, and assessment of long-term clinical outcomes following ECMO-assisted high-risk PCI procedures represent crucial avenues for future research. Conclusions: Overall, the reviewed evidence supports the notion that ECMO represents a valuable tool for providing hemodynamic support during high-risk PCI procedures, particularly in patients deemed at very high risk for surgical revascularization.
背景:经皮冠状动脉介入治疗(PCI)的范围已扩大到包括复杂的高风险择期病例,因此需要先进的支持策略来减轻手术挑战并确保患者安全。在这篇综述手稿中,通过对相关临床研究的分析,严格评估了体外膜肺氧合(ECMO)支持对复杂高风险择期 PCI 的影响。目的是阐明 ECMO 在优化手术成功率、减少并发症和改善介入心脏病学这一高风险领域患者长期预后方面的作用。方法:综合搜索策略确定了七篇出版物,包括单中心前瞻性、回顾性和病例报告设计,共涉及 91 名接受 ECMO 支持的高风险择期 PCI 患者。结果:这些研究结果表明,ECMO 支持具有促进高风险择期 PCI 成功并获得良好手术效果的潜力,同时强调了谨慎选择患者和积极处理潜在并发症的重要性,以进一步优化 ECMO 在这种临床环境中的应用。完善患者选择标准、优化手术技术以及评估 ECMO 辅助高风险 PCI 手术后的长期临床效果是未来研究的重要途径。结论:总体而言,所审查的证据支持这样一种观点,即 ECMO 是在高风险 PCI 手术中提供血流动力学支持的重要工具,尤其是在被视为手术血运重建风险极高的患者中。
{"title":"Effect of Extracorporeal Membrane Oxygenation Support on Complex High-Risk Elective Percutaneous Coronary Intervention: A Clinical Research Review of Progress and Outcomes","authors":"Yi Teng, Aobo Li, Yali Sheng, Ling Jin, Yang Tao, Xiaojun Kang","doi":"10.59958/hsf.7319","DOIUrl":"https://doi.org/10.59958/hsf.7319","url":null,"abstract":"Background: The landscape of percutaneous coronary intervention (PCI) has expanded to encompass complex high-risk elective cases, necessitating advanced support strategies to mitigate procedural challenges and ensure patient safety. In this review manuscript, the effect of extracorporeal membrane oxygenation (ECMO) support on complex high-risk elective PCI was critically evaluated through an analysis of relevant clinical studies. The objective is to elucidate the role of ECMO in optimizing procedural success, mitigating complications, and improving long-term patient outcomes in this high-stake domain of interventional cardiology. Methods: A comprehensive search strategy identified seven publications encompassing single-center prospective, retrospective, and case report designs, collectively involving 91 patients undergoing high-risk elective PCI with ECMO support. Results: The results from these studies demonstrated the potential of ECMO support to facilitate successful high-risk elective PCI with favorable procedural outcomes, highlighting the importance of careful patient selection and proactive management of potential complications to further optimize the use of ECMO in this clinical setting. The refinement of patient selection criteria, optimization of procedural techniques, and assessment of long-term clinical outcomes following ECMO-assisted high-risk PCI procedures represent crucial avenues for future research. Conclusions: Overall, the reviewed evidence supports the notion that ECMO represents a valuable tool for providing hemodynamic support during high-risk PCI procedures, particularly in patients deemed at very high risk for surgical revascularization.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"109 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141115991","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: 0
Correlation between Electrocardiogram Changes and Right Ventricular Systolic Function in Patients with Chronic Atrial Fibrillation 慢性心房颤动患者心电图变化与右心室收缩功能之间的相关性
Pub Date : 2024-05-19 DOI: 10.59958/hsf.7355
Ling Yang, Rong Yan
Background: Chronic atrial fibrillation (CAF) induces various electric disturbances, and a single mutation can cause multifarious phenotypes or combinations. Identifying the correlation of electrocardiogram changes corresponding to the disorders of electrical activity with right ventricular systolic function (RVSF) is important for the treatment and prognosis of CAF. Therefore, this study explored the correlation of electrocardiogram changes and RVSF in patients with CAF. Methods: From March 2022, to March 2023, 97 patients with CAF admitted to the Department of Cardiology of our hospital (study group) and 100 normal people who received health examination (control group) were subjected to echocardiogram and electrocardiogram to record relevant parameters for correlation analysis. Results: Significant differences were found in the electrocardiogram indices and right heart function parameters between the two groups. The study group had significantly higher heart rate, QTc interval, QT interval and T wave time than the control group (p < 0.05). The study group showed significantly higher right ventricular end-diastolic volume (RVEDV) and right ventricular end-systolic volume (RVESV), and lower right ventricular stroke volume (RVSV) and right ventricular ejection fraction (RVEF) than the control group (p < 0.05). Pearson correlation analysis showed that QTc interval, QT interval, and T wave time were positively correlated with RVESV (p < 0.05); QTc interval, QT interval, and T wave time were negatively correlated with RVSV (p < 0.05); and QTc interval was negatively correlated with RVEF (p < 0.05). Conclusion: A correlation exists between electrocardiogram changes and RVSF in patients with CAF.
背景:慢性心房颤动(CAF)会诱发各种电活动紊乱,单个突变可导致多种表型或组合。确定与电活动紊乱相对应的心电图变化与右心室收缩功能(RVSF)的相关性,对 CAF 的治疗和预后非常重要。因此,本研究探讨了 CAF 患者心电图变化与 RVSF 的相关性。研究方法2022年3月至2023年3月,对我院心内科收治的97例CAF患者(研究组)和100例接受健康检查的正常人(对照组)进行超声心动图和心电图检查,记录相关参数,进行相关性分析。结果:两组的心电图指标和右心功能参数存在显著差异。研究组的心率、QTc间期、QT间期和T波时间明显高于对照组(P<0.05)。研究组的右心室舒张末期容积(RVEDV)和右心室收缩末期容积(RVESV)明显高于对照组,而右心室搏出量(RVSV)和右心室射血分数(RVEF)则低于对照组(P<0.05)。皮尔逊相关分析显示,QTc间期、QT间期和T波时间与RVESV呈正相关(P<0.05);QTc间期、QT间期和T波时间与RVSV呈负相关(P<0.05);QTc间期与RVEF呈负相关(P<0.05)。结论CAF 患者的心电图变化与 RVSF 之间存在相关性。
{"title":"Correlation between Electrocardiogram Changes and Right Ventricular Systolic Function in Patients with Chronic Atrial Fibrillation","authors":"Ling Yang, Rong Yan","doi":"10.59958/hsf.7355","DOIUrl":"https://doi.org/10.59958/hsf.7355","url":null,"abstract":"Background: Chronic atrial fibrillation (CAF) induces various electric disturbances, and a single mutation can cause multifarious phenotypes or combinations. Identifying the correlation of electrocardiogram changes corresponding to the disorders of electrical activity with right ventricular systolic function (RVSF) is important for the treatment and prognosis of CAF. Therefore, this study explored the correlation of electrocardiogram changes and RVSF in patients with CAF. Methods: From March 2022, to March 2023, 97 patients with CAF admitted to the Department of Cardiology of our hospital (study group) and 100 normal people who received health examination (control group) were subjected to echocardiogram and electrocardiogram to record relevant parameters for correlation analysis. Results: Significant differences were found in the electrocardiogram indices and right heart function parameters between the two groups. The study group had significantly higher heart rate, QTc interval, QT interval and T wave time than the control group (p < 0.05). The study group showed significantly higher right ventricular end-diastolic volume (RVEDV) and right ventricular end-systolic volume (RVESV), and lower right ventricular stroke volume (RVSV) and right ventricular ejection fraction (RVEF) than the control group (p < 0.05). Pearson correlation analysis showed that QTc interval, QT interval, and T wave time were positively correlated with RVESV (p < 0.05); QTc interval, QT interval, and T wave time were negatively correlated with RVSV (p < 0.05); and QTc interval was negatively correlated with RVEF (p < 0.05). Conclusion: A correlation exists between electrocardiogram changes and RVSF in patients with CAF.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"112 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124473","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: 0
"Brain-First" Total Body Retrograde Perfusion and Retrograde Cerebral Perfusion in Hemi-Arch Replacement 半弓置换术中的 "脑优先 "全身逆行灌注和逆行脑灌注
Pub Date : 2024-05-16 DOI: 10.59958/hsf.7447
Zhen Qin, Yannan Zhou, Bo Wang, Haohan Chen, Jiyue Xiong, Jun Gu
Objective: The purpose of this study is to compare the early outcomes of brain-first total body retrograde perfusion (Bf-TBRP) in comparison with reverse cerebral perfusion (RCP) under moderate hypothermia circulatory arrest (MHCA) for hemi-arch replacement surgery. Methods: We analyzed the data of 88 patients who underwent hemi-arch replacement with Bf-TBRP (n = 18) or RCP (n = 70) under MHCA at West China Hospital of Sichuan University between 1 January 2020, and 31 July 2022. In-hospital mortality, neurological deficits, and other adverse events were recorded, which were evaluated with logistic regression to determine risk factors. Results: There was no significant difference between the Bf-TBRP and RCP groups in in-hospital mortality, cardiac events, neurological deficits, dialysis, gastrointestinal complications, and paralysis (p > 0.05). The Bf-TBRP group was associated with significantly shorter hospital stay [Bf-TBRP: 8 d (interquartile range (IQR), 7–10) vs. RCP: 10 d (IQR, 8–13), p = 0.03] and fewer platelet transfusions [Bf-TBRP: 1.0 (IQR, 0–1.0) vs. RCP: 1.0 (IQR, 1.0–2.0), p = 0.05] than the RCP group. On multivariable logistic regression analysis, emergency surgery (p = 0.05) and surgery duration (p = 0.03) were determined to be risk factors. Conclusions: The study showed that Bf-TBRP is a safe technique for patients undergoing hemi-arch replacement with MHCA.
研究目的本研究的目的是比较在中度低体温循环停滞(MHCA)条件下进行半弓置换手术时,脑先导全身逆行灌注(Bf-TBRP)与反向脑灌注(RCP)的早期疗效。方法我们分析了2020年1月1日至2022年7月31日期间在四川大学华西医院接受MHCA下Bf-TBRP(18例)或RCP(70例)半弓置换术的88例患者的数据。记录了院内死亡率、神经功能缺损和其他不良事件,并通过逻辑回归进行评估,以确定风险因素。结果Bf-TBRP组和RCP组在院内死亡率、心脏事件、神经功能缺损、透析、胃肠道并发症和瘫痪方面无明显差异(P > 0.05)。与 RCP 组相比,Bf-TBRP 组的住院时间明显缩短[Bf-TBRP:8 天(四分位数间距(IQR),7-10)vs RCP:10 天(IQR,8-13),p = 0.03],血小板输注次数明显减少[Bf-TBRP:1.0(IQR,0-1.0)vs RCP:1.0(IQR,1.0-2.0),p = 0.05]。在多变量逻辑回归分析中,急诊手术(p = 0.05)和手术持续时间(p = 0.03)被确定为风险因素。结论该研究表明,Bf-TBRP 是一种安全的技术,适用于接受 MHCA 半弓置换术的患者。
{"title":"\"Brain-First\" Total Body Retrograde Perfusion and Retrograde Cerebral Perfusion in Hemi-Arch Replacement","authors":"Zhen Qin, Yannan Zhou, Bo Wang, Haohan Chen, Jiyue Xiong, Jun Gu","doi":"10.59958/hsf.7447","DOIUrl":"https://doi.org/10.59958/hsf.7447","url":null,"abstract":"Objective: The purpose of this study is to compare the early outcomes of brain-first total body retrograde perfusion (Bf-TBRP) in comparison with reverse cerebral perfusion (RCP) under moderate hypothermia circulatory arrest (MHCA) for hemi-arch replacement surgery. Methods: We analyzed the data of 88 patients who underwent hemi-arch replacement with Bf-TBRP (n = 18) or RCP (n = 70) under MHCA at West China Hospital of Sichuan University between 1 January 2020, and 31 July 2022. In-hospital mortality, neurological deficits, and other adverse events were recorded, which were evaluated with logistic regression to determine risk factors. Results: There was no significant difference between the Bf-TBRP and RCP groups in in-hospital mortality, cardiac events, neurological deficits, dialysis, gastrointestinal complications, and paralysis (p > 0.05). The Bf-TBRP group was associated with significantly shorter hospital stay [Bf-TBRP: 8 d (interquartile range (IQR), 7–10) vs. RCP: 10 d (IQR, 8–13), p = 0.03] and fewer platelet transfusions [Bf-TBRP: 1.0 (IQR, 0–1.0) vs. RCP: 1.0 (IQR, 1.0–2.0), p = 0.05] than the RCP group. On multivariable logistic regression analysis, emergency surgery (p = 0.05) and surgery duration (p = 0.03) were determined to be risk factors. Conclusions: The study showed that Bf-TBRP is a safe technique for patients undergoing hemi-arch replacement with MHCA.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":" 957","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141127462","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: 0
Effect of Early Rehabilitation Exercise on Lower Limb Function and Psychological State After Coronary Artery Bypass Grafting: A Randomized Controlled Trial 早期康复锻炼对冠状动脉旁路移植术后下肢功能和心理状态的影响:随机对照试验
Pub Date : 2024-05-16 DOI: 10.59958/hsf.7477
Hanxiang Ma, Shaojun Huang, Mei You, Jie Yang, Ruijie Zong, Chengxin Zhang
Background: While early rehabilitation exercise has been shown to improve cardiopulmonary function and functional outcomes after revascularization in individuals who have undergone coronary artery bypass grafting (CABG), further research is still needed to fully understand the importance of psychological status and limb functional rehabilitation following CABG. Therefore, the purpose of this study was to investigate the effects of early rehabilitation exercise on lower limb function and mental health after coronary artery bypass grafting. Methods: Eighty patients who underwent CABG were randomly divided into a routine exercise group and an early rehabilitation exercise group. The degree of lower limb swelling, the amount of incision complications, the first time the patient got out of bed after the operation, the length of postoperative hospital stay, activity tolerance and postoperative psychological state were compared between the two groups. Results: The incidence of postoperative lower extremity oedema was 30% in the early rehabilitative exercise group as compared to 52.5% in the routine exercise group. Between the two groups, there was a statistically significant difference (p < 0.05) in the incidence of postoperative lower limb edema as well as the amount of swelling in the thighs and ankles on postoperative days 1, 3, and 5. In the routine exercise group, the first time the patients got out of bed was 3.45 ± 1.09 days, and the length of postoperative hospitalization was 12.75 ± 5.06 days. In the early rehabilitation exercise group, the first time the patients got out of bed was 1.93 ± 0.57 days, and the length of postoperative hospitalization was 9.50 ± 2.92 days. There were statistically significant differences in these two indices between the two groups (p < 0.05). The activity tolerance of patients in the routine exercise group was 46.10 ± 19.09 min at 2 months after surgery and 69.88 ± 19.05 min at 3 months after surgery. The activity tolerance of patients in the early rehabilitation exercise group was 56.40 ± 17.42 min at 2 months after surgery and 105 ± 23.04 min at 3 months after surgery, and there was a significant difference in activity tolerance between the two groups at these time points following surgery (p < 0.05). In addition, there were statistically significant differences in the Patient Health Questionnaire-9, Generalized Anxiety Self-Assessment Scale-7 and Pittsburgh Sleep Quality Index scores between the two groups (p > 0.05). Conclusions: Early rehabilitation exercises can promote the recovery of lower limb function after CABG to a certain extent, shorten the postoperative bed rest time and hospital stay, and effectively improve postoperative psychological well-being and sleep quality.
背景:已有研究表明,早期康复锻炼可改善接受冠状动脉旁路移植术(CABG)的患者血管再通后的心肺功能和功能预后,但要充分了解冠状动脉旁路移植术后心理状态和肢体功能康复的重要性,仍需进一步研究。因此,本研究旨在探讨冠状动脉旁路移植术后早期康复锻炼对下肢功能和心理健康的影响。研究方法将 80 名接受冠状动脉旁路移植术的患者随机分为常规锻炼组和早期康复锻炼组。比较两组患者的下肢肿胀程度、切口并发症数量、术后首次下床活动时间、术后住院时间、活动耐受力和术后心理状态。结果早期康复锻炼组术后下肢水肿发生率为 30%,而常规锻炼组为 52.5%。两组患者术后下肢水肿的发生率以及术后第 1、3 和 5 天大腿和脚踝的肿胀程度差异有统计学意义(P < 0.05)。常规锻炼组患者首次下床活动时间为(3.45±1.09)天,术后住院时间为(12.75±5.06)天。早期康复锻炼组患者首次下床活动时间为(1.93±0.57)天,术后住院时间为(9.50±2.92)天。两组患者的这两项指标差异有统计学意义(P < 0.05)。常规运动组患者术后 2 个月的活动耐量为(46.10 ± 19.09)分钟,术后 3 个月的活动耐量为(69.88 ± 19.05)分钟。早期康复锻炼组患者术后 2 个月时的活动耐量为(56.40 ± 17.42)分钟,术后 3 个月时的活动耐量为(105 ± 23.04)分钟,两组患者在术后上述时间点的活动耐量存在显著差异(P < 0.05)。此外,两组患者在患者健康问卷-9、广泛焦虑自评量表-7 和匹兹堡睡眠质量指数评分方面的差异也有统计学意义(P > 0.05)。结论早期康复锻炼能在一定程度上促进 CABG 术后下肢功能的恢复,缩短术后卧床时间和住院时间,有效改善术后心理状态和睡眠质量。
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The Heart Surgery Forum
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