Objective: This study aimed to compare the value of thoracic paravertebral block and ultrasound-guided erector spinal muscle plane block in video-assisted analgesia after thoracic surgery. Methods: Patients undergoing video-assisted thoracic surgery at our hospital from March 2022 to May 2023 were included as the subjects of this retrospective study. According to different analgesia methods, they were divided into an ultrasound group (acoustic-guided erector spinae plane block) and a conventional group (thoracic paravertebral block). General demographic data, sufentanil dose, propofol dose, blood loss and fluid replacement volume, puncture depth and time, length of stay, complications, number of analgesic pump compression, forced vital capacity (FVC), 1 s forced expiratory volume (FEV1), peak expiratory flow rate (PEFR), visual simulation (VAS) score, and 15 recovery quality evaluation components were collected Table (QoR-15). Propensity score matching (PSM) was used to balance the baseline data of the two groups. Data were analyzed by t test, chi-square test, and analysis of variance. Results: A total of 116 patients were included in this study, including 52 in the ultrasound group and 64 in the conventional group. Before PSM, statistically significant differences in age, weight, lesion location, and surgical methodmethod existed among the groups (p < 0.05). PSM matching was performed in a 1:1 ratio, and a total of 82 patients were enrolled in the ultrasound and conventional groups. The baseline data of the two groups were not statistically significant. The complications, hospital stay, pressing times of analgesic pump, and puncture depth and time in the ultrasound group were lower than those in the conventional group (p < 0.05). Two groups of tube drawing when resting and cough VAS difference (p > 0.05), but after 12, 24, and 48 h, ultrasonic VAS scores were lower than those of the normal group (p < 0.05). When two groups of T1 lung function difference (p > 0.05), but the T2, T3 FVC, FEV1, and PEFR ultrasound group were higher than those of the conventional group (p < 0.05). No significant difference in preoperative QoR-15 score existed between the two groups (p > 0.05), but the postoperative QoR-15 score in the ultrasound group was higher than that in the conventional group (p < 0.05). Conclusions: Ultrasound-guided erector spinae plane block had stronger analgesic effect, which can reduce the pressing times of analgesic pump, quickly reduce pain, and improve lung function with fewer complications. Thus, it can significantly improve the quality of postoperative recovery and reduce the length of hospital stay, rendering its application worthy of promotion.
{"title":"Comparison of Thoracic Paravertebral Block and Ultrasound-guided Erector Spinae Plane Block for Postoperative Analgesia after Video-Assisted Thoracic Surgery: A Retrospective Study","authors":"Huizhen He, Siqi Zhang, Zhihui Wei","doi":"10.59958/hsf.7087","DOIUrl":"https://doi.org/10.59958/hsf.7087","url":null,"abstract":"Objective: This study aimed to compare the value of thoracic paravertebral block and ultrasound-guided erector spinal muscle plane block in video-assisted analgesia after thoracic surgery. Methods: Patients undergoing video-assisted thoracic surgery at our hospital from March 2022 to May 2023 were included as the subjects of this retrospective study. According to different analgesia methods, they were divided into an ultrasound group (acoustic-guided erector spinae plane block) and a conventional group (thoracic paravertebral block). General demographic data, sufentanil dose, propofol dose, blood loss and fluid replacement volume, puncture depth and time, length of stay, complications, number of analgesic pump compression, forced vital capacity (FVC), 1 s forced expiratory volume (FEV1), peak expiratory flow rate (PEFR), visual simulation (VAS) score, and 15 recovery quality evaluation components were collected Table (QoR-15). Propensity score matching (PSM) was used to balance the baseline data of the two groups. Data were analyzed by t test, chi-square test, and analysis of variance. Results: A total of 116 patients were included in this study, including 52 in the ultrasound group and 64 in the conventional group. Before PSM, statistically significant differences in age, weight, lesion location, and surgical methodmethod existed among the groups (p < 0.05). PSM matching was performed in a 1:1 ratio, and a total of 82 patients were enrolled in the ultrasound and conventional groups. The baseline data of the two groups were not statistically significant. The complications, hospital stay, pressing times of analgesic pump, and puncture depth and time in the ultrasound group were lower than those in the conventional group (p < 0.05). Two groups of tube drawing when resting and cough VAS difference (p > 0.05), but after 12, 24, and 48 h, ultrasonic VAS scores were lower than those of the normal group (p < 0.05). When two groups of T1 lung function difference (p > 0.05), but the T2, T3 FVC, FEV1, and PEFR ultrasound group were higher than those of the conventional group (p < 0.05). No significant difference in preoperative QoR-15 score existed between the two groups (p > 0.05), but the postoperative QoR-15 score in the ultrasound group was higher than that in the conventional group (p < 0.05). Conclusions: Ultrasound-guided erector spinae plane block had stronger analgesic effect, which can reduce the pressing times of analgesic pump, quickly reduce pain, and improve lung function with fewer complications. Thus, it can significantly improve the quality of postoperative recovery and reduce the length of hospital stay, rendering its application worthy of promotion.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"35 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140735202","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}
Pasquale Totaro, Cristian Monterosso, Martina Musto, Giulia Magrini, Stefano Pelenghi
Left ventricle free wall rupture (LVFWR) is a potentially catastrophic complication of acute myocardial infarction (AMI). Despite its incidence has been significantly reduced in the recent era, it still carries a high mortality as it is the cause of up to 15% of all death following AMI. Prompt surgical treatment of subacute (oozing type) LVFWR can prevent a more devastating rupture (blow-out type), thus improving patients survival. Here we report our original hybrid “double patch” technique which combined sutureless and stitched repair to treat complex cases of LVFWR.
{"title":"Double Patch Hybrid Technique for Treatment of Complex Left Ventricle Acute Free Wall Rupture","authors":"Pasquale Totaro, Cristian Monterosso, Martina Musto, Giulia Magrini, Stefano Pelenghi","doi":"10.59958/hsf.7171","DOIUrl":"https://doi.org/10.59958/hsf.7171","url":null,"abstract":"Left ventricle free wall rupture (LVFWR) is a potentially catastrophic complication of acute myocardial infarction (AMI). Despite its incidence has been significantly reduced in the recent era, it still carries a high mortality as it is the cause of up to 15% of all death following AMI. Prompt surgical treatment of subacute (oozing type) LVFWR can prevent a more devastating rupture (blow-out type), thus improving patients survival. Here we report our original hybrid “double patch” technique which combined sutureless and stitched repair to treat complex cases of LVFWR.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"254 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The infected aneurysm is a rare disease; antibiotic therapy combined with surgical treatment is the most common treatment currently available after computed tomography (CT) imaging and blood culture confirmation. We herein report a case of a 25-year-old male with infective endocarditis that caused an infective aneurysm of the mesenteric artery. We hope to help with the diagnosis and treatment of similar patients.
{"title":"A Rare Case of Infective Aneurysm of Mesenteric Artery Due to Infective Endocarditis: Diagnosis and Treatment","authors":"Shengjun Wu, Sihan Miao, Lin Li","doi":"10.59958/hsf.6927","DOIUrl":"https://doi.org/10.59958/hsf.6927","url":null,"abstract":"The infected aneurysm is a rare disease; antibiotic therapy combined with surgical treatment is the most common treatment currently available after computed tomography (CT) imaging and blood culture confirmation. We herein report a case of a 25-year-old male with infective endocarditis that caused an infective aneurysm of the mesenteric artery. We hope to help with the diagnosis and treatment of similar patients.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"486 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140750756","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}
Atrial septal defect (ASD) is a common congenital heart disease, and can be treated with occluders. However, occluder detachment remains one of the most urgent complications to be resolved. This paper reported a case of ASD occluder detachment, which was successfully resolved with gastroscopic biopsy forceps. A 57-year-old woman complained chest distress for over one week, and was admitted to cardiovascular department of Sir Run Run Shaw Hospital. Based on echocardiography, the patient was diagnosed as ASD, mitral and tricuspid valve regurgitation. On the second day after percutaneous closure of residual ASD, routine chest radiographs showed the occluder detached into the abdominal aorta. After a thorough evaluation and examination, we decided to use gastric biopsy forceps to remove occluder. As a result, the patient recovered well and discharged from the hospital. For postoperative patients with ASD, when occlusion devices detached and conventional strategies could not extract the occluders, gastric biopsy forceps would be appliable. Compared to conventional strategies, gastric biopsy forceps have better grasping force, and provide secure fixing for disconnected or detached occlusion devices in cardiac interventional surgeries.
{"title":"Shed Atrial Septal Occluder Removed by Gastric Biopsy Forceps: A Case Report","authors":"Kai-Li Wang, Yan Ma, Wu-Hua Zhang, Yang-Yun Lou","doi":"10.59958/hsf.6909","DOIUrl":"https://doi.org/10.59958/hsf.6909","url":null,"abstract":"Atrial septal defect (ASD) is a common congenital heart disease, and can be treated with occluders. However, occluder detachment remains one of the most urgent complications to be resolved. This paper reported a case of ASD occluder detachment, which was successfully resolved with gastroscopic biopsy forceps. A 57-year-old woman complained chest distress for over one week, and was admitted to cardiovascular department of Sir Run Run Shaw Hospital. Based on echocardiography, the patient was diagnosed as ASD, mitral and tricuspid valve regurgitation. On the second day after percutaneous closure of residual ASD, routine chest radiographs showed the occluder detached into the abdominal aorta. After a thorough evaluation and examination, we decided to use gastric biopsy forceps to remove occluder. As a result, the patient recovered well and discharged from the hospital. For postoperative patients with ASD, when occlusion devices detached and conventional strategies could not extract the occluders, gastric biopsy forceps would be appliable. Compared to conventional strategies, gastric biopsy forceps have better grasping force, and provide secure fixing for disconnected or detached occlusion devices in cardiac interventional surgeries.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"178 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751611","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}
Objective: To investigate the risk factors of hypoattenuated leaflet thickening (HALT) in the early stage after transfemoral transcatheter aortic valve implantation (TAVI). Methods: Patients who underwent transfemoral TAVI in the Affiliated Hospital of Qingdao University from January 2021 to June 2023 were selected. According to the results of four-dimensional computed tomography (4DCT), patients were divided into HALT group and non-HALT group. The perioperative data of the two groups were collected to find the risk factors of HALT in the early postoperative period. Results: A total of 100 patients underwent TAVI operation via femoral artery, 2 died after operation, 1 discharged due to cerebral complication, and 2 patients had incomplete 4DCT data. The data of 95 patients were completely collected, including 56 males and 39 females, with an average age of (72.0 ± 6.7) years and a body mass index of (24.0 ± 3.7) kg/m2. 10 patients had HALT, the incidence was 10.5%. 85 patients were in the non-HALT group, including 52 males (61.2%). 10 patients were in the HALT group, 4 cases were male (40%). There were no significant differences in age, sex, body mass index (BMI), hypertension, diabetes, chronic obstructive pulmonary disease (COPD), brain complications, coronary heart disease, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and operation time between the two groups. And the differences between the two groups in perioperative white blood cell, neutrophil, lymphocyte and platelet counts, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and creatinine were not significant. Compared with the non-HALT group, patients in the HALT group had a higher proportion of isolated aortic insufficiency, a lower proportion of post dilatation after valve release, and a higher proportion of valves with skirts. Conclusion: Isolated aortic insufficiency, without post dilatation after valve release, and use of valves with skirt are associated with early HALT after transfemoral TAVI.
目的研究经胸主动脉瓣植入术（TAVI）术后早期主动脉瓣叶增厚（HALT）的风险因素。研究方法选取2021年1月至2023年6月在青岛大学附属医院接受经胸主动脉瓣置换术（TAVI）的患者。根据四维计算机断层扫描（4DCT）结果，将患者分为 HALT 组和非 HALT 组。收集两组患者的围手术期数据，以发现术后早期 HALT 的风险因素。结果共有 100 名患者接受了经股动脉的 TAVI 手术，其中 2 人术后死亡，1 人因脑部并发症出院，2 人的 4DCT 数据不完整。完整收集了95例患者的数据，其中男性56例，女性39例，平均年龄（72.0±6.7）岁，体重指数（24.0±3.7）kg/m2。10 名患者患有 HALT，发病率为 10.5%。85 名患者属于非 HALT 组，包括 52 名男性（61.2%）。HALT 组有 10 例患者，其中 4 例为男性（40%）。两组患者在年龄、性别、体重指数（BMI）、高血压、糖尿病、慢性阻塞性肺疾病（COPD）、脑部并发症、冠心病、左室舒张末期直径（LVEDD）、左室收缩末期直径（LVESD）、左室射血分数（LVEF）和手术时间等方面无明显差异。两组围手术期白细胞、中性粒细胞、淋巴细胞和血小板计数、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）和肌酐差异无显著性。与非 HALT 组相比，HALT 组患者孤立性主动脉瓣关闭不全的比例较高，瓣膜松解后扩张的比例较低，瓣膜带裙的比例较高。结论孤立性主动脉瓣关闭不全、瓣膜释放后无扩张后遗症、使用带裙边的瓣膜与经股动脉 TAVI 术后早期 HALT 有关。
{"title":"Risk Factors for Early HALT after Transfemoral TAVI","authors":"YuHui Wu, Rui Jiang, Weili Liu, Zhanjun Qu, Qingjiang Wang, Qingzhe Zhao, Guozhang Tang, Lipeng Zhao, Zhitao Yang, Yanchao Li, Lei Jiang","doi":"10.59958/hsf.7175","DOIUrl":"https://doi.org/10.59958/hsf.7175","url":null,"abstract":"Objective: To investigate the risk factors of hypoattenuated leaflet thickening (HALT) in the early stage after transfemoral transcatheter aortic valve implantation (TAVI). Methods: Patients who underwent transfemoral TAVI in the Affiliated Hospital of Qingdao University from January 2021 to June 2023 were selected. According to the results of four-dimensional computed tomography (4DCT), patients were divided into HALT group and non-HALT group. The perioperative data of the two groups were collected to find the risk factors of HALT in the early postoperative period. Results: A total of 100 patients underwent TAVI operation via femoral artery, 2 died after operation, 1 discharged due to cerebral complication, and 2 patients had incomplete 4DCT data. The data of 95 patients were completely collected, including 56 males and 39 females, with an average age of (72.0 ± 6.7) years and a body mass index of (24.0 ± 3.7) kg/m2. 10 patients had HALT, the incidence was 10.5%. 85 patients were in the non-HALT group, including 52 males (61.2%). 10 patients were in the HALT group, 4 cases were male (40%). There were no significant differences in age, sex, body mass index (BMI), hypertension, diabetes, chronic obstructive pulmonary disease (COPD), brain complications, coronary heart disease, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and operation time between the two groups. And the differences between the two groups in perioperative white blood cell, neutrophil, lymphocyte and platelet counts, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and creatinine were not significant. Compared with the non-HALT group, patients in the HALT group had a higher proportion of isolated aortic insufficiency, a lower proportion of post dilatation after valve release, and a higher proportion of valves with skirts. Conclusion: Isolated aortic insufficiency, without post dilatation after valve release, and use of valves with skirt are associated with early HALT after transfemoral TAVI.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"89 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140234112","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}
Yasin Kılıç, Izatullah Jalalzai, Ebubekir Sonmez, B. Erkut
Background: The objective of our study was to provide the initial outcomes of the traditional coronary artery surgery approach and the on-pump beating heart surgery in terms of survival and morbidity in patients who needed emergency surgery for acute myocardial infarction. Methods: A single-center retrospective study was performed from November 2013 to September 2023 on a total of 212 patients requiring emergency coronary artery surgery. Group I patients (n = 108) received traditional coronary artery bypass grafting with cross-clamping, while Group II patients (n = 104) underwent on-pump coronary surgery on the beating heart. Results: There were no disparities observed in the preoperative left ventricular function, percutaneous coronary intervention, intra-aortic balloon usage, or clinical-hemodynamic characteristics. Group I patients had significantly higher rates of postoperative mortality and low cardiac output syndrome, as well as a greater utilization of intra-aortic balloons and a higher requirement for extracorporeal membrane oxygenation (p < 0.001). Conclusions: Ultimately, the on-pump beating heart approach could serve as a viable alternative to enhance the preservation of cardiac function and decrease postoperative complications and mortality rates in patients with acute myocardial infarction who require emergency surgery.
{"title":"Comparison of On-Pump Beating Heart Surgery Versus Conventional Bypass Surgery in Patients with Acute Myocardial Infarction Requiring Urgent Revascularization","authors":"Yasin Kılıç, Izatullah Jalalzai, Ebubekir Sonmez, B. Erkut","doi":"10.59958/hsf.7203","DOIUrl":"https://doi.org/10.59958/hsf.7203","url":null,"abstract":"Background: The objective of our study was to provide the initial outcomes of the traditional coronary artery surgery approach and the on-pump beating heart surgery in terms of survival and morbidity in patients who needed emergency surgery for acute myocardial infarction. Methods: A single-center retrospective study was performed from November 2013 to September 2023 on a total of 212 patients requiring emergency coronary artery surgery. Group I patients (n = 108) received traditional coronary artery bypass grafting with cross-clamping, while Group II patients (n = 104) underwent on-pump coronary surgery on the beating heart. Results: There were no disparities observed in the preoperative left ventricular function, percutaneous coronary intervention, intra-aortic balloon usage, or clinical-hemodynamic characteristics. Group I patients had significantly higher rates of postoperative mortality and low cardiac output syndrome, as well as a greater utilization of intra-aortic balloons and a higher requirement for extracorporeal membrane oxygenation (p < 0.001). Conclusions: Ultimately, the on-pump beating heart approach could serve as a viable alternative to enhance the preservation of cardiac function and decrease postoperative complications and mortality rates in patients with acute myocardial infarction who require emergency surgery.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"49 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140231162","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}
Objective: This study aims to explore the application effect of adjuvant therapy with esmolol hydrochloride on new-onset atrial fibrillation (NOAF) in patients with severe sepsis. Methods: Retrospective analysis was conducted on 170 patients with NOAF and severe sepsis admitted to our hospital from January 2022 to January 2023. After excluding eight patients who did not meet the inclusion criteria, the remaining 162 patients were included in the study. Based on different treatment methods, the patients were divided into the control group (n = 83, routine treatment) and the observation group (n = 79, esmolol hydrochloride in combination with routine treatment). The cardiac function indexes such as left atrial diameter, left ventricular end-diastolic dimension, left ventricular end-systolic dimension and left ventricular ejection fraction; left atrial wall tension-related indexes, including atrial natriuretic peptide, B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide; inflammatory factors, including a C-reactive protein, high-sensitivity C-reactive protein, interleukin-6 and procalcitonin and the incidence of adverse reactions were compared between the two groups. Statistical methods were used to process and compare the above-mentioned data and index results. Results: No significant difference was observed in cardiac function indexes, left atrial wall tension-related indexes and inflammatory factors in both groups before treatment (p > 0.05). After treatment, the observation group had lower cardiac function indexes, left atrial wall tension-related indexes and inflammatory factors than the control group (p < 0.05), and the incidence of adverse reactions in the two groups was similar (p < 0.05). Conclusion: The adjuvant therapy with esmolol hydrochloride has a certain clinical effect on patients with severe sepsis and NOAF, which improves the cardiac function of such patients and reduces their inflammation levels up to a point, showing a clinical application value.
研究目的本研究旨在探讨盐酸艾司洛尔辅助治疗对重症脓毒症患者新发心房颤动（NOAF）的应用效果。研究方法对我院2022年1月至2023年1月收治的170例NOAF合并重症脓毒症患者进行回顾性分析。在排除 8 名不符合纳入标准的患者后，将其余 162 名患者纳入研究。根据不同的治疗方法，将患者分为对照组（n = 83，常规治疗）和观察组（n = 79，盐酸艾司洛尔联合常规治疗）。心功能指标，如左心房直径、左心室舒张末期容积、左心室收缩末期容积和左心室射血分数；左心房壁张力相关指标，包括心房钠尿肽、B 型钠尿肽和 N 端前 B 型钠尿肽；比较两组患者的炎症因子，包括 C 反应蛋白、高敏 C 反应蛋白、白细胞介素-6 和降钙素原，以及不良反应的发生率。采用统计学方法对上述数据和指标结果进行处理和比较。结果治疗前，两组患者的心功能指标、左心房壁张力相关指标及炎症因子无明显差异（P>0.05）。治疗后，观察组心功能指标、左心房壁张力相关指标和炎症因子均低于对照组（P＜0.05），两组不良反应发生率相似（P＜0.05）。结论盐酸艾司洛尔对重症脓毒症合并NOAF患者进行辅助治疗具有一定的临床效果，可改善此类患者的心功能，并在一定程度上降低其炎症水平，显示出临床应用价值。
{"title":"Application Evaluation of Esmolol Hydrochloride-Assisted Interventional Therapy on New-Onset Atrial Fibrillation in Patients with Severe Sepsis: A Retrospective Study","authors":"Lixiao Sun, Jie Su","doi":"10.59958/hsf.7273","DOIUrl":"https://doi.org/10.59958/hsf.7273","url":null,"abstract":"Objective: This study aims to explore the application effect of adjuvant therapy with esmolol hydrochloride on new-onset atrial fibrillation (NOAF) in patients with severe sepsis. Methods: Retrospective analysis was conducted on 170 patients with NOAF and severe sepsis admitted to our hospital from January 2022 to January 2023. After excluding eight patients who did not meet the inclusion criteria, the remaining 162 patients were included in the study. Based on different treatment methods, the patients were divided into the control group (n = 83, routine treatment) and the observation group (n = 79, esmolol hydrochloride in combination with routine treatment). The cardiac function indexes such as left atrial diameter, left ventricular end-diastolic dimension, left ventricular end-systolic dimension and left ventricular ejection fraction; left atrial wall tension-related indexes, including atrial natriuretic peptide, B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide; inflammatory factors, including a C-reactive protein, high-sensitivity C-reactive protein, interleukin-6 and procalcitonin and the incidence of adverse reactions were compared between the two groups. Statistical methods were used to process and compare the above-mentioned data and index results. Results: No significant difference was observed in cardiac function indexes, left atrial wall tension-related indexes and inflammatory factors in both groups before treatment (p > 0.05). After treatment, the observation group had lower cardiac function indexes, left atrial wall tension-related indexes and inflammatory factors than the control group (p < 0.05), and the incidence of adverse reactions in the two groups was similar (p < 0.05). Conclusion: The adjuvant therapy with esmolol hydrochloride has a certain clinical effect on patients with severe sepsis and NOAF, which improves the cardiac function of such patients and reduces their inflammation levels up to a point, showing a clinical application value.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"13 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140232105","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}
Objective: To investigate the effect and mechanism of the Danshen and Zhizi Compatibility (DZ) on alleviating heart injury and cardiac ferroptosis in rats with myocardial infarction. Methods: A rat model of myocardial infarction was established by ligation of the left anterior descending artery. The rats were equally and randomly divided into 5 groups. The sham group underwent open-chest surgery without arterial ligation, while the other 4 groups underwent surgery, including 3 groups treated with low dose (4 g/kg/d), high dose (8 g/kg/d) DZ and high dose (8 g/kg/d) DZ supplemented with H-89 (0.5 mg/kg/d) respectively. The sham and myocardial infarction group received the same volume of saline. 14 days after surgery, the serum and heart tissues were harvested to detect cyclic adenosine monophosphate (cAMP) and protein kinase A (PKA) activity, heart injury and the level of ferroptosis. Results: G-protein coupled receptors (GPCRs) have a high binding affinity with the main components of DZ, which indicated that DZ probably contributed to ameliorating cardiac injury by activating downstream cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) signaling. Treatment with the high dose of DZ significantly increased cAMP concentration in the serum, PKA activity in the heart tissue and upregulated perilipin (PLIN)5 expression. DZ significantly attenuated heart injury, whereas H-89 reversed the protective effects of DZ. In addition, DZ administration inhibited ferroptosis as evidenced by reduced malondialdehyde (MDA), and 4-hydroxynonenal (4-HNE) levels. In addition, DZ increased glutathione (GSH) levels and Glutathione peroxidase (GPX)4 protein expression in heart tissue, whereas H-89 abrogated the regulatory effect of DZ. Conclusion: Our results demonstrated that DZ alleviated heart injury and cardiac ferroptosis in myocardial infarction through the cAMP-PKA signalling pathway.
{"title":"Danshen and Zhizi Compatibility Alleviates Heart Injury and Cardiac Ferroptosis in Myocardial Infarction in Rats by Cyclic Adenosine Monophosphate/Protein Kinase A Signaling","authors":"Jianqiao Zhao, Yifan Li, Hao Zhi, Wanying Hong, Jianping Shen","doi":"10.59958/hsf.7149","DOIUrl":"https://doi.org/10.59958/hsf.7149","url":null,"abstract":"Objective: To investigate the effect and mechanism of the Danshen and Zhizi Compatibility (DZ) on alleviating heart injury and cardiac ferroptosis in rats with myocardial infarction. Methods: A rat model of myocardial infarction was established by ligation of the left anterior descending artery. The rats were equally and randomly divided into 5 groups. The sham group underwent open-chest surgery without arterial ligation, while the other 4 groups underwent surgery, including 3 groups treated with low dose (4 g/kg/d), high dose (8 g/kg/d) DZ and high dose (8 g/kg/d) DZ supplemented with H-89 (0.5 mg/kg/d) respectively. The sham and myocardial infarction group received the same volume of saline. 14 days after surgery, the serum and heart tissues were harvested to detect cyclic adenosine monophosphate (cAMP) and protein kinase A (PKA) activity, heart injury and the level of ferroptosis. Results: G-protein coupled receptors (GPCRs) have a high binding affinity with the main components of DZ, which indicated that DZ probably contributed to ameliorating cardiac injury by activating downstream cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) signaling. Treatment with the high dose of DZ significantly increased cAMP concentration in the serum, PKA activity in the heart tissue and upregulated perilipin (PLIN)5 expression. DZ significantly attenuated heart injury, whereas H-89 reversed the protective effects of DZ. In addition, DZ administration inhibited ferroptosis as evidenced by reduced malondialdehyde (MDA), and 4-hydroxynonenal (4-HNE) levels. In addition, DZ increased glutathione (GSH) levels and Glutathione peroxidase (GPX)4 protein expression in heart tissue, whereas H-89 abrogated the regulatory effect of DZ. Conclusion: Our results demonstrated that DZ alleviated heart injury and cardiac ferroptosis in myocardial infarction through the cAMP-PKA signalling pathway.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"178 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140235814","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}
Jia Hu, Hongling Ran, Xi Zeng, Zhe-Yuan Zhang, Xinchun Yuan
Purpose To investigate the diagnostic value of nonintrusive left ventricular pressure–strain loop (LV-PSL) for assessing overall myocardial function in sufferers with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) with or without coronary stenosis. The results of this research might provide insights into the diagnosis and management of NSTE-ACS. Methods All 268 sufferers with NSTE-ACS who were received by the First Affiliated Hospital of Nanchang University between June 2019 and June 2021 were enrolled. Sufferers with single or multiple extramural coronary diameter stenosis ≥70% on coronary angiography were defined as the stenosis group. All sufferers underwent noninvasive LV-PSL construction by using cuff blood pressure as the left ventricular pressure before coronary angiography, and the resulting images were imported and analysed with offline analysis software to obtain global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE). The correlation between severity Gensini score and myocardial work (MW) parameters was identified through Spearman analysis. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off values for predicting coronary stenosis, and logistic regression analysis was used to identify independent factors affecting left ventricular myocardial function in sufferers of NSTE-ACS. The occurrence of adverse cardiac events during the follow-up period was recorded. Results Through the comparative analysis of general clinical data, significant differences were found between the stenosis and nonstenosis groups in terms of gender, hyperlipidaemia, hypertension and smoking. However, statistical difference was observed only for hypertension (stenosis group 54.2%; p < 0.05) and hypercholesterolaemia (stenosis group 53.5%; p < 0.05). GLS (tz value 3.063), GCW (tz value 11.494), GWI (tz value 9.627) and GWE (tz value 12.780) reduced and GWW (tz value 11.504) increased in the stenosis group compared with those in the nonstenosis group. All differences were statistically significant (all p < 0.05). Severity Gensini scores were negatively correlated with GLS, GCW, GWI and GWE but positively correlated with GWW (p < 0.001). The ROC curve and univariate and multivariate logistic regression analyses revealed that GWE (odds ratio (OR) 2.881; 95% confidence internal (95% CI) 2.176–3.816; p < 0.001) had the largest area under the curve and greatest sensitivity for coronary stenosis diagnosis. GWE was (OR 2.875; 95% CI 2.217–3.727; p < 0.001) and (OR 2.881; 95% CI 2.176–3.816; p < 0.001). During an average follow-up period of 26.7 months, 19 sufferers experienced adverse cardiac events. GWE exhibited high predictive ability for identifying such events. Conclusions Noninvasive LV-PSL can identify whether sufferers of NSTE-ACS have acute coronary stenosis regardless of the location or size of the stenosis and
{"title":"Correlation between Left Ventricular Pressure–Strain Loop and Severity in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome and Its Application Value in Short-Term Prognosis Evaluation","authors":"Jia Hu, Hongling Ran, Xi Zeng, Zhe-Yuan Zhang, Xinchun Yuan","doi":"10.59958/hsf.7283","DOIUrl":"https://doi.org/10.59958/hsf.7283","url":null,"abstract":"Purpose To investigate the diagnostic value of nonintrusive left ventricular pressure–strain loop (LV-PSL) for assessing overall myocardial function in sufferers with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) with or without coronary stenosis. The results of this research might provide insights into the diagnosis and management of NSTE-ACS. Methods All 268 sufferers with NSTE-ACS who were received by the First Affiliated Hospital of Nanchang University between June 2019 and June 2021 were enrolled. Sufferers with single or multiple extramural coronary diameter stenosis ≥70% on coronary angiography were defined as the stenosis group. All sufferers underwent noninvasive LV-PSL construction by using cuff blood pressure as the left ventricular pressure before coronary angiography, and the resulting images were imported and analysed with offline analysis software to obtain global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE). The correlation between severity Gensini score and myocardial work (MW) parameters was identified through Spearman analysis. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off values for predicting coronary stenosis, and logistic regression analysis was used to identify independent factors affecting left ventricular myocardial function in sufferers of NSTE-ACS. The occurrence of adverse cardiac events during the follow-up period was recorded. Results Through the comparative analysis of general clinical data, significant differences were found between the stenosis and nonstenosis groups in terms of gender, hyperlipidaemia, hypertension and smoking. However, statistical difference was observed only for hypertension (stenosis group 54.2%; p < 0.05) and hypercholesterolaemia (stenosis group 53.5%; p < 0.05). GLS (tz value 3.063), GCW (tz value 11.494), GWI (tz value 9.627) and GWE (tz value 12.780) reduced and GWW (tz value 11.504) increased in the stenosis group compared with those in the nonstenosis group. All differences were statistically significant (all p < 0.05). Severity Gensini scores were negatively correlated with GLS, GCW, GWI and GWE but positively correlated with GWW (p < 0.001). The ROC curve and univariate and multivariate logistic regression analyses revealed that GWE (odds ratio (OR) 2.881; 95% confidence internal (95% CI) 2.176–3.816; p < 0.001) had the largest area under the curve and greatest sensitivity for coronary stenosis diagnosis. GWE was (OR 2.875; 95% CI 2.217–3.727; p < 0.001) and (OR 2.881; 95% CI 2.176–3.816; p < 0.001). During an average follow-up period of 26.7 months, 19 sufferers experienced adverse cardiac events. GWE exhibited high predictive ability for identifying such events. Conclusions Noninvasive LV-PSL can identify whether sufferers of NSTE-ACS have acute coronary stenosis regardless of the location or size of the stenosis and ","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"172 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140247149","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}
Background: Improving patients' outcomes using enhanced recovery after surgery (ERAS) during the surgical period has significant economic savings and increases organizational productivity. We evaluated the effects of ERAS protocol on outcomes including high sensitive-C-reactive protein (hs-CRP), hospitalization, intensive care unit (ICU) stay, feeding tolerance and pain score of cardiac surgical patients. Methods: A total of 260 patients were randomly assigned to the ERAS and control groups according to stratified block randomization. Fasting time in the ERAS group reduced from the conventional 12 h to 6 h with light meals. Also, on the day of the operation, 2 hours before the surgery, they received 250 mL of oral carbohydrate solution containing 25 g glucose. The control group received conventional standard care. Serum hs-CRP was measured before and after the operation. Results: Out of 260 participants, 107 patients received protocolized care (ERAS group), and 103 patients received conventional standard care. Recommendations to follow the ERAS resulted in a significant reduction in hs-CRP relative to the control group (p = 0.001). Complaints about thirst, hunger, anxiety, and pain were significantly less in the intervention group than the control group (All p-values = 0.001). In addition, the length of hospitalization, ICU stay, ventilation time, and first mobility were significantly shorter in the ERAS group (All p-values = 0.001). Besides, the first postoperative meal started earlier in the intervention group than the control group (p = 0.001). Conclusion: ERAS approach can lead to improvement in postoperative inflammation, thirst, hunger, anxiety, pain, duration of hospitalization, duration of ICU stay, first mobility, and ventilation time.
{"title":"Adherence to the Enhanced Recovery After Surgery in Cardiac Surgery Patients: A Randomized Clinical Trial","authors":"Shirin Hosseini, Saeid Hosseini, Zahra Vahdat Shariatpanahi, Majid Maleki, Fereydoon Noohi, Ziya Totonchi","doi":"10.59958/hsf.6885","DOIUrl":"https://doi.org/10.59958/hsf.6885","url":null,"abstract":"Background: Improving patients' outcomes using enhanced recovery after surgery (ERAS) during the surgical period has significant economic savings and increases organizational productivity. We evaluated the effects of ERAS protocol on outcomes including high sensitive-C-reactive protein (hs-CRP), hospitalization, intensive care unit (ICU) stay, feeding tolerance and pain score of cardiac surgical patients. Methods: A total of 260 patients were randomly assigned to the ERAS and control groups according to stratified block randomization. Fasting time in the ERAS group reduced from the conventional 12 h to 6 h with light meals. Also, on the day of the operation, 2 hours before the surgery, they received 250 mL of oral carbohydrate solution containing 25 g glucose. The control group received conventional standard care. Serum hs-CRP was measured before and after the operation. Results: Out of 260 participants, 107 patients received protocolized care (ERAS group), and 103 patients received conventional standard care. Recommendations to follow the ERAS resulted in a significant reduction in hs-CRP relative to the control group (p = 0.001). Complaints about thirst, hunger, anxiety, and pain were significantly less in the intervention group than the control group (All p-values = 0.001). In addition, the length of hospitalization, ICU stay, ventilation time, and first mobility were significantly shorter in the ERAS group (All p-values = 0.001). Besides, the first postoperative meal started earlier in the intervention group than the control group (p = 0.001). Conclusion: ERAS approach can lead to improvement in postoperative inflammation, thirst, hunger, anxiety, pain, duration of hospitalization, duration of ICU stay, first mobility, and ventilation time.","PeriodicalId":503802,"journal":{"name":"The Heart Surgery Forum","volume":"83 9‐10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140267134","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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