Yassir Balla, Abdullahi Hashi, Ahmed Osman, M. Hassan, E. Mutlu
Abstract Cerebral sinovenous thrombosis (CSVT) encompasses a spectrum of disorders involving thrombosis of the cerebral venous system. As shown by previous epidemiological studies, the prevalence of cerebral sinovenous thrombosis is 4–7 cases per million people. Nephrotic syndrome was very rarely associated with thrombosis cerebral veins or sinuses. Hypercoagulability and thrombotic complications in nephrotic syndrome are most commonly seen in deep veins of the lower extremities and renal veins. Our case highlights a unique scenario in which cerebral sinovenous thrombosis was the initial presentation of nephrotic syndrome in a patient that was not an important past medical or surgical problem. The patient was brought to the emergency department with severe headache, vomiting, altered mental status, and generalized body swelling. Laboratory results showed proteinuria, hypoalbuminemia and hyperlipidemia. Non-contrast brain CT demonstrated hemorrhagic venous infarct associated with vasogenic edema. A subsequent brain MR venogram demonstrated occlusion of superior sagittal and right transverse sinuses. She was managed with low molecular weight heparin and intervenous corticosteroids then shifted to rivaroxaban and oral steroids, respectively, which resulted in massive clinical improvement and resolution of thrombus.
{"title":"Cerebral Venous Sinus Thrombosis as an Initial Presentation of Nephrotic Syndrome: A Case Report","authors":"Yassir Balla, Abdullahi Hashi, Ahmed Osman, M. Hassan, E. Mutlu","doi":"10.2147/VHRM.S458539","DOIUrl":"https://doi.org/10.2147/VHRM.S458539","url":null,"abstract":"Abstract Cerebral sinovenous thrombosis (CSVT) encompasses a spectrum of disorders involving thrombosis of the cerebral venous system. As shown by previous epidemiological studies, the prevalence of cerebral sinovenous thrombosis is 4–7 cases per million people. Nephrotic syndrome was very rarely associated with thrombosis cerebral veins or sinuses. Hypercoagulability and thrombotic complications in nephrotic syndrome are most commonly seen in deep veins of the lower extremities and renal veins. Our case highlights a unique scenario in which cerebral sinovenous thrombosis was the initial presentation of nephrotic syndrome in a patient that was not an important past medical or surgical problem. The patient was brought to the emergency department with severe headache, vomiting, altered mental status, and generalized body swelling. Laboratory results showed proteinuria, hypoalbuminemia and hyperlipidemia. Non-contrast brain CT demonstrated hemorrhagic venous infarct associated with vasogenic edema. A subsequent brain MR venogram demonstrated occlusion of superior sagittal and right transverse sinuses. She was managed with low molecular weight heparin and intervenous corticosteroids then shifted to rivaroxaban and oral steroids, respectively, which resulted in massive clinical improvement and resolution of thrombus.","PeriodicalId":509369,"journal":{"name":"Vascular Health and Risk Management","volume":"45 38","pages":"177 - 181"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140771136","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}
Hiwot Berhanu, Andualem Mossie, S. Morankar, Tadesse Gemechu, E. Tegene
Background Despite the fact that patients with rheumatic heart disease (RHD) need early medical attention and follow-up, most patients in developing countries tend to present with debilitating complications. The objective of this study was to evaluate the echocardiographic features of adult individuals diagnosed with RHD and examine the associated complications among patients who started follow-up at Jimma Medical Center’s (JMC) cardiac follow-up clinic. Methods A prospective cross-sectional study was conducted at JMC between January 5 and April 15, 2023. Echocardiographic patterns were taken by senior cardiologists; socio-demographic variables, anthropometric measurements, and behavioral factors were collected through a structured questioner. Results The study recruited a total of 115 participants, of whom 86 (74.8%) were female and 29 (25.2%) were male. The mean age of the patients was 32.31 (SD± 12.16) years. The mitral valve was affected in 98.26% of cases, while the aortic and tricuspid valve abnormalities were diagnosed in 49.5% and 21.7%, respectively. The most frequent combinations of valve lesions were mitral regurgitation (MR) + mitral stenosis (MS) + aortic regurgitation (AR) (15.7%), followed by MR + AR + TR (8.7%). The occurrence of MR+MS+AR was higher in females (17.4%) compared to males (10.3%), whereas the occurrence of MS+MR was higher in males (24.1%) compared to females (20.9%). Females have a severely reduced ejection fraction compared to males (84.8% vs 15.2%, P = 0.044). Nearly two-thirds (63.5%) of individuals experienced RHD-related complications; the most commonly encountered complications were pulmonary hypertension (26.1%) and atrial fibrillation (19.1%). Conclusion RHD predominantly affects individuals in their active and productive years, particularly females. Most patients have multiple-valve lesions.
{"title":"Echocardiographic Parameters and Complication Profiles Among Adult Patients with Rheumatic Heart Disease at Jimma Medical Center","authors":"Hiwot Berhanu, Andualem Mossie, S. Morankar, Tadesse Gemechu, E. Tegene","doi":"10.2147/VHRM.S451957","DOIUrl":"https://doi.org/10.2147/VHRM.S451957","url":null,"abstract":"Background Despite the fact that patients with rheumatic heart disease (RHD) need early medical attention and follow-up, most patients in developing countries tend to present with debilitating complications. The objective of this study was to evaluate the echocardiographic features of adult individuals diagnosed with RHD and examine the associated complications among patients who started follow-up at Jimma Medical Center’s (JMC) cardiac follow-up clinic. Methods A prospective cross-sectional study was conducted at JMC between January 5 and April 15, 2023. Echocardiographic patterns were taken by senior cardiologists; socio-demographic variables, anthropometric measurements, and behavioral factors were collected through a structured questioner. Results The study recruited a total of 115 participants, of whom 86 (74.8%) were female and 29 (25.2%) were male. The mean age of the patients was 32.31 (SD± 12.16) years. The mitral valve was affected in 98.26% of cases, while the aortic and tricuspid valve abnormalities were diagnosed in 49.5% and 21.7%, respectively. The most frequent combinations of valve lesions were mitral regurgitation (MR) + mitral stenosis (MS) + aortic regurgitation (AR) (15.7%), followed by MR + AR + TR (8.7%). The occurrence of MR+MS+AR was higher in females (17.4%) compared to males (10.3%), whereas the occurrence of MS+MR was higher in males (24.1%) compared to females (20.9%). Females have a severely reduced ejection fraction compared to males (84.8% vs 15.2%, P = 0.044). Nearly two-thirds (63.5%) of individuals experienced RHD-related complications; the most commonly encountered complications were pulmonary hypertension (26.1%) and atrial fibrillation (19.1%). Conclusion RHD predominantly affects individuals in their active and productive years, particularly females. Most patients have multiple-valve lesions.","PeriodicalId":509369,"journal":{"name":"Vascular Health and Risk Management","volume":"168 3","pages":"157 - 166"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140756867","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}
Purpose Handgrip strength is an indicator of overall muscle strength and has been associated with an increased risk of cardiovascular disease. Evidence suggests that menopause is a risk factor for cardiovascular disease in women, and muscle strength decreases progressively after menopause. Despite the prognostic importance of the decline in muscle strength and increased cardiovascular disease risk among postmenopausal women, evidence of their association is limited. This study aimed to investigate the relationship between handgrip strength and cardiovascular disease risk among postmenopausal, middle-aged Korean women. Patients and Methods Using pooled cohort equations, we calculated the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) among postmenopausal women (N = 2019) aged 50–64 years without cardiovascular disease history from the 2014–2019 Korea National Health and Nutrition Examination Survey. Relative grip strength was defined as measured grip strength divided by body mass index. Logistic regression analysis of a complex sampling design was performed to evaluate the association between relative grip strength and a predicted 10-year ASCVD risk ≥7.5%. Results The average handgrip strength was 24.8 kg, and 5.2% of women were considered for sarcopenia (<18 kg). The quartile-stratified relative grip strength was negatively associated with 10-year ASCVD risk (p < 0.001). In the multiple logistic regression analysis, the adjusted odds ratio for the highest relative grip strength quartile was 0.53 (95% confidence interval [CI]: 0.36–0.78), and that of the group who breastfed for more than 12 months was 1.75 (95% CI: 1.36–2.25) for 10-year ASCVD risk. Conclusion Increased handgrip strength may be associated with lower cardiovascular disease risk among middle-aged postmenopausal women in Korea. Our findings provide critical evidence regarding the importance of increasing handgrip strength among postmenopausal, middle-aged women to reduce cardiovascular disease risk. Handgrip strength measurement might be a valuable screening tool for cardiovascular disease prevention.
{"title":"Association of Handgrip Strength and Cardiovascular Disease Risk Among Middle-Aged Postmenopausal Women: An Analysis of the Korea National Health and Nutrition Examination Survey 2014–2019","authors":"Jinkyung Park, Sooyeon Park","doi":"10.2147/VHRM.S442277","DOIUrl":"https://doi.org/10.2147/VHRM.S442277","url":null,"abstract":"Purpose Handgrip strength is an indicator of overall muscle strength and has been associated with an increased risk of cardiovascular disease. Evidence suggests that menopause is a risk factor for cardiovascular disease in women, and muscle strength decreases progressively after menopause. Despite the prognostic importance of the decline in muscle strength and increased cardiovascular disease risk among postmenopausal women, evidence of their association is limited. This study aimed to investigate the relationship between handgrip strength and cardiovascular disease risk among postmenopausal, middle-aged Korean women. Patients and Methods Using pooled cohort equations, we calculated the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) among postmenopausal women (N = 2019) aged 50–64 years without cardiovascular disease history from the 2014–2019 Korea National Health and Nutrition Examination Survey. Relative grip strength was defined as measured grip strength divided by body mass index. Logistic regression analysis of a complex sampling design was performed to evaluate the association between relative grip strength and a predicted 10-year ASCVD risk ≥7.5%. Results The average handgrip strength was 24.8 kg, and 5.2% of women were considered for sarcopenia (<18 kg). The quartile-stratified relative grip strength was negatively associated with 10-year ASCVD risk (p < 0.001). In the multiple logistic regression analysis, the adjusted odds ratio for the highest relative grip strength quartile was 0.53 (95% confidence interval [CI]: 0.36–0.78), and that of the group who breastfed for more than 12 months was 1.75 (95% CI: 1.36–2.25) for 10-year ASCVD risk. Conclusion Increased handgrip strength may be associated with lower cardiovascular disease risk among middle-aged postmenopausal women in Korea. Our findings provide critical evidence regarding the importance of increasing handgrip strength among postmenopausal, middle-aged women to reduce cardiovascular disease risk. Handgrip strength measurement might be a valuable screening tool for cardiovascular disease prevention.","PeriodicalId":509369,"journal":{"name":"Vascular Health and Risk Management","volume":"349 4","pages":"183 - 194"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140781167","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}
Purpose A family history of premature atherosclerotic cardiovascular disease (ASCVD) confers a greater risk of developing ASCVD. However, the prevalence of ASCVD risk factors among asymptomatic Maltese adults with parental or fraternal history of premature ASCVD is unknown. The study aimed to evaluate and compare their risk with the general population. Patients and Methods Posters to market the project were distributed in cardiac rehabilitation areas. Patients with premature cardiovascular disease facilitated recruitment by informing their relatives about the project. Medical doctors and cardiac rehabilitation nurses referred first-degree relatives. Posters were put up in community pharmacies, and an explanatory video clip was shared on social media for interested individuals to contact researchers. Those eligible were enrolled in a preventive cardiology lifestyle intervention. Their data were compared with the risk in the general population. Results Many first-degree relatives had a suboptimal risk profile, with 60% (N = 89) having a total cholesterol level of >5.0 mmol/L; 54% having a low-density lipoprotein-cholesterol level of >3 mmol/L; 70.5% being overweight/obese, with 62% having a waist circumference greater than the recommended values; 34.8% having hypertension; 56.2% being inadequately adherent to the Mediterranean diet; 62% being underactive, with 18% being sedentary; and 25.8% being smokers. First-degree relatives had significantly higher proportions of underactive lifestyle (p = 0.00016), high body mass index (>25kg/m2) (p = 0.006), and systolic blood pressure (p = 0.001) than the general population, with 30% having metabolic syndrome. Conclusion This study determined the prevalence of lifestyle, biochemical, physiological, and anthropometric cardiovascular risk factors among asymptomatic first-degree relatives of Maltese patients with premature ASCVD. First-degree relatives had considerable prevalences of an underactive lifestyle, hypertension, and obesity, suggesting better screening and early risk factor intervention are needed to modify their risk of ASCVD.
{"title":"Cardiovascular Risk Factors Among First-Degree Relatives of Patients with Premature Cardiovascular Disease in Malta. Baseline Findings from the CRISO Project","authors":"J. Mifsud, Joseph Galea","doi":"10.2147/VHRM.S449672","DOIUrl":"https://doi.org/10.2147/VHRM.S449672","url":null,"abstract":"Purpose A family history of premature atherosclerotic cardiovascular disease (ASCVD) confers a greater risk of developing ASCVD. However, the prevalence of ASCVD risk factors among asymptomatic Maltese adults with parental or fraternal history of premature ASCVD is unknown. The study aimed to evaluate and compare their risk with the general population. Patients and Methods Posters to market the project were distributed in cardiac rehabilitation areas. Patients with premature cardiovascular disease facilitated recruitment by informing their relatives about the project. Medical doctors and cardiac rehabilitation nurses referred first-degree relatives. Posters were put up in community pharmacies, and an explanatory video clip was shared on social media for interested individuals to contact researchers. Those eligible were enrolled in a preventive cardiology lifestyle intervention. Their data were compared with the risk in the general population. Results Many first-degree relatives had a suboptimal risk profile, with 60% (N = 89) having a total cholesterol level of >5.0 mmol/L; 54% having a low-density lipoprotein-cholesterol level of >3 mmol/L; 70.5% being overweight/obese, with 62% having a waist circumference greater than the recommended values; 34.8% having hypertension; 56.2% being inadequately adherent to the Mediterranean diet; 62% being underactive, with 18% being sedentary; and 25.8% being smokers. First-degree relatives had significantly higher proportions of underactive lifestyle (p = 0.00016), high body mass index (>25kg/m2) (p = 0.006), and systolic blood pressure (p = 0.001) than the general population, with 30% having metabolic syndrome. Conclusion This study determined the prevalence of lifestyle, biochemical, physiological, and anthropometric cardiovascular risk factors among asymptomatic first-degree relatives of Maltese patients with premature ASCVD. First-degree relatives had considerable prevalences of an underactive lifestyle, hypertension, and obesity, suggesting better screening and early risk factor intervention are needed to modify their risk of ASCVD.","PeriodicalId":509369,"journal":{"name":"Vascular Health and Risk Management","volume":"42 5","pages":"167 - 176"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140767619","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}
Purpose The aim of this study was to identify independent risk factors for carotid atherosclerosis (CAS) in a population with hyperuricemia (HUA) and develop a CAS risk prediction model. Patients and Methods This retrospective study included 3579 HUA individuals who underwent health examinations, including carotid ultrasonography, at the Zhenhai Lianhua Hospital in Ningbo, China, in 2020. All participants were randomly assigned to the training and internal validation sets in a 7:3 ratio. Multivariable logistic regression analysis was used to identify independent risk factors associated with CAS. The characteristic variables were screened using the least absolute shrinkage and selection operator combined with 10-fold cross-validation, and the resulting model was visualized by a nomogram. The discriminative ability, calibration, and clinical utility of the risk model were validated using the receiver operating characteristic curve, calibration curve, and decision curve analysis. Results Sex, age, mean red blood cell volume, and fasting blood glucose were identified as independent risk factors for CAS in the HUA population. Age, gamma-glutamyl transpeptidase, serum creatinine, fasting blood glucose, total triiodothyronine, and direct bilirubin, were screened to construct a CAS risk prediction model. In the training and internal validation sets, the risk prediction model showed an excellent discriminative ability with the area under the curve of 0.891 and 0.901, respectively, and a high level of fit. Decision curve analysis results demonstrated that the risk prediction model could be beneficial when the threshold probabilities were 1–87% and 1–100% in the training and internal validation sets, respectively. Conclusion We developed and internally validated a risk prediction model for CAS in a population with HUA, thereby contributing to the CAS early identification.
目的 本研究旨在确定高尿酸血症（HUA）人群中颈动脉粥样硬化（CAS）的独立危险因素，并建立 CAS 风险预测模型。患者和方法 该回顾性研究纳入了2020年在中国宁波镇海联华医院接受健康检查（包括颈动脉超声检查）的3579名高尿酸血症患者。所有参与者按 7:3 的比例随机分配到训练集和内部验证集。多变量逻辑回归分析用于确定与 CAS 相关的独立风险因素。使用最小绝对缩减和选择算子结合10倍交叉验证筛选特征变量，并用提名图直观显示得到的模型。使用接收者操作特征曲线、校准曲线和决策曲线分析验证了风险模型的判别能力、校准和临床实用性。结果 在 HUA 群体中，性别、年龄、平均红细胞体积和空腹血糖被确定为 CAS 的独立风险因素。通过筛选年龄、γ-谷氨酰转肽酶、血清肌酐、空腹血糖、总三碘甲状腺原氨酸和直接胆红素，构建了 CAS 风险预测模型。在训练集和内部验证集中，风险预测模型显示出很好的判别能力，曲线下面积分别为 0.891 和 0.901，拟合度很高。决策曲线分析结果表明，当训练集和内部验证集中的阈值概率分别为 1%-87%和 1%-100%时，风险预测模型可发挥有益作用。结论 我们开发并在内部验证了一个针对 HUA 群体的 CAS 风险预测模型，从而有助于 CAS 的早期识别。
{"title":"Development and Internal Validation of a Risk Prediction Model for Carotid Atherosclerosis in the Hyperuricemia Population","authors":"Ximisinuer Tusongtuoheti, Guoqing Huang, Y. Mao","doi":"10.2147/VHRM.S445708","DOIUrl":"https://doi.org/10.2147/VHRM.S445708","url":null,"abstract":"Purpose The aim of this study was to identify independent risk factors for carotid atherosclerosis (CAS) in a population with hyperuricemia (HUA) and develop a CAS risk prediction model. Patients and Methods This retrospective study included 3579 HUA individuals who underwent health examinations, including carotid ultrasonography, at the Zhenhai Lianhua Hospital in Ningbo, China, in 2020. All participants were randomly assigned to the training and internal validation sets in a 7:3 ratio. Multivariable logistic regression analysis was used to identify independent risk factors associated with CAS. The characteristic variables were screened using the least absolute shrinkage and selection operator combined with 10-fold cross-validation, and the resulting model was visualized by a nomogram. The discriminative ability, calibration, and clinical utility of the risk model were validated using the receiver operating characteristic curve, calibration curve, and decision curve analysis. Results Sex, age, mean red blood cell volume, and fasting blood glucose were identified as independent risk factors for CAS in the HUA population. Age, gamma-glutamyl transpeptidase, serum creatinine, fasting blood glucose, total triiodothyronine, and direct bilirubin, were screened to construct a CAS risk prediction model. In the training and internal validation sets, the risk prediction model showed an excellent discriminative ability with the area under the curve of 0.891 and 0.901, respectively, and a high level of fit. Decision curve analysis results demonstrated that the risk prediction model could be beneficial when the threshold probabilities were 1–87% and 1–100% in the training and internal validation sets, respectively. Conclusion We developed and internally validated a risk prediction model for CAS in a population with HUA, thereby contributing to the CAS early identification.","PeriodicalId":509369,"journal":{"name":"Vascular Health and Risk Management","volume":"274 ","pages":"195 - 205"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792726","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: Differences in dominance and stenosis in the complex vertebral artery (VA) network pose challenges in diagnosing and treating cerebrovascular diseases crucial for brain nutrition. This research examines these intricacies, highlighting the importance of detailed diagnosis and treatment methods. Objective: To analyze the prevalence of the dominant VA, evaluate the influence of gender and age on steno-occlusion, and explore the correlation between the dominant VA and stenosed VA segments. Methods: A retrospective study of 249 angiograms from patients with VA stenosed at King Abdullah University Hospital between August 2019 and December 2022. The patients presenting symptoms of vertigo, migraines, headaches, or transient ischemic attacks (TIA) were included, 182 cases were classified based on VA dominance and stenosis severity. The data were analyzed using IBM SPSS 27. Results: Out of the 182 participants, 64.8% were male, with an average age of 61.3 years and 35.2% were female. The prevalence of stenosis was distributed as follows: 26.4% mild, 44.0% moderate, and 29.7% severe. Statistically significant correlations were observed between hypertension, smoking, hyperlipidemia, and the degree of stenosis (p < 0.05), but not with diabetes. The prevalence of left vertebral artery (VA) dominance was found to be 41.1%. Additionally, there was no gender connection observed in the distribution of steno-occlusion (p = 0.434). There is no notable correlation between the degree of stenosis and the dominant vertebral artery (p > 0.05). Conclusion: Angiographic findings reveal the complex relationship between the dominance of the VA, patterns of stenosis, and demographic factors. Individuals with a dominant VA had a greater likelihood of developing stenosis on the opposite non-dominant side. The high occurrence of severe stenosis highlights the need for tailored diagnostic and treatment approaches. Understanding vertebral stenosis as a multifaceted interaction of demographic, lifestyle, and anatomical variables is essential for enhancing treatment strategies.
背景：复杂的椎动脉（VA）网络中支配和狭窄程度的差异给诊断和治疗对大脑营养至关重要的脑血管疾病带来了挑战。本研究探讨了这些错综复杂的问题，强调了详细诊断和治疗方法的重要性。研究目的分析优势 VA 的患病率，评估性别和年龄对狭窄闭塞的影响，并探讨优势 VA 与狭窄 VA 节段之间的相关性。方法：回顾性研究对2019年8月至2022年12月期间阿卜杜拉国王大学医院249例VA狭窄患者的血管造影进行回顾性研究。研究纳入了出现眩晕、偏头痛、头痛或短暂性脑缺血发作（TIA）症状的患者，并根据 VA 优势和狭窄严重程度对 182 例患者进行了分类。数据使用 IBM SPSS 27 进行分析。结果在 182 名参与者中，64.8% 为男性，平均年龄为 61.3 岁，35.2% 为女性。血管狭窄的发病率分布如下：26.4%为轻度，44.0%为中度，29.7%为重度。高血压、吸烟、高脂血症与椎动脉狭窄程度之间存在统计学意义上的相关性（P < 0.05），但与糖尿病之间不存在相关性。左侧椎动脉（VA）优势的发病率为 41.1%。此外，在狭窄闭塞的分布上没有观察到性别差异（P = 0.434）。狭窄程度与优势椎动脉之间没有明显的相关性（P > 0.05）。结论血管造影结果揭示了优势椎动脉、狭窄模式和人口学因素之间的复杂关系。有优势椎动脉的人在非优势椎动脉的对侧发生狭窄的可能性更大。严重椎管狭窄的高发生率凸显了采取有针对性的诊断和治疗方法的必要性。了解椎管狭窄是人口、生活方式和解剖学变量的多方面相互作用，对于改进治疗策略至关重要。
{"title":"Retrospective Cohort Angiographic Analysis of Vertebral Artery Dominance, Stenosis Patterns, and Demographic Correlations","authors":"Izzeddin Qtaish, Mohammad Ayasrah, Noat Qtaish","doi":"10.2147/vhrm.s453352","DOIUrl":"https://doi.org/10.2147/vhrm.s453352","url":null,"abstract":"Background: Differences in dominance and stenosis in the complex vertebral artery (VA) network pose challenges in diagnosing and treating cerebrovascular diseases crucial for brain nutrition. This research examines these intricacies, highlighting the importance of detailed diagnosis and treatment methods. Objective: To analyze the prevalence of the dominant VA, evaluate the influence of gender and age on steno-occlusion, and explore the correlation between the dominant VA and stenosed VA segments. Methods: A retrospective study of 249 angiograms from patients with VA stenosed at King Abdullah University Hospital between August 2019 and December 2022. The patients presenting symptoms of vertigo, migraines, headaches, or transient ischemic attacks (TIA) were included, 182 cases were classified based on VA dominance and stenosis severity. The data were analyzed using IBM SPSS 27. Results: Out of the 182 participants, 64.8% were male, with an average age of 61.3 years and 35.2% were female. The prevalence of stenosis was distributed as follows: 26.4% mild, 44.0% moderate, and 29.7% severe. Statistically significant correlations were observed between hypertension, smoking, hyperlipidemia, and the degree of stenosis (p < 0.05), but not with diabetes. The prevalence of left vertebral artery (VA) dominance was found to be 41.1%. Additionally, there was no gender connection observed in the distribution of steno-occlusion (p = 0.434). There is no notable correlation between the degree of stenosis and the dominant vertebral artery (p > 0.05). Conclusion: Angiographic findings reveal the complex relationship between the dominance of the VA, patterns of stenosis, and demographic factors. Individuals with a dominant VA had a greater likelihood of developing stenosis on the opposite non-dominant side. The high occurrence of severe stenosis highlights the need for tailored diagnostic and treatment approaches. Understanding vertebral stenosis as a multifaceted interaction of demographic, lifestyle, and anatomical variables is essential for enhancing treatment strategies.","PeriodicalId":509369,"journal":{"name":"Vascular Health and Risk Management","volume":"55 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786630","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}
Nittaya Sriprachot, Katekaew Seangpraw, P. Ong-Artborirak
Purpose Hypertension (HT) can cause renal complications or deterioration of kidney function. HT management is very important because it reduces the severity of illnesses. This study aimed to investigate the relationship between health literacy (HL), self-care behaviors (SCB), and biochemical parameters in hypertensive patients with renal complications. Methods A cross-sectional study of 405 hypertensive patients with renal complications among Tai Lue people living in Thailand was conducted using simple random sampling. Face-to-face interviews with questionnaires were used to collect information. Blood pressure (BP) and biochemical parameters, such as fasting blood sugar (FBS) and estimated glomerular filtration rate (eGFR), were measured. Results The participants’ mean age was 68.3 years. A significant correlation was found between HL score, SCB score, systolic BP (SBP), diastolic BP (DBP), FBS, and eGFR (p<0.01). Multiple linear regression revealed that eating salty foods was a risk factor for SBP in males and for SBP and DBP in females. Body mass index (BMI) (B = 0.54), sweet food consumption (B = 13.90), and SCB score (B = −0.29) were significantly associated with FBS level (R2 = 17.8%, p<0.05). Employment (B = 2.55), eating bland food (B = 4.07), receiving information from family (B = 3.53), SCB (B= 0.31), and age (B = −0.51) were all significant factors for eGFR (R2 = 35.0%, p<0.05). Conclusion HL and SCB levels were associated with the health of hypertensive patients with renal complications in the Tai Lue ethnic community. The significance of organizing health education programs is to emphasize increasing HL to lead to self-care decisions and reduce complications in patients, resulting in improved SCB and quality of life in the future.
{"title":"Health Literacy, Self-Care Behaviors, and Biochemical Parameters Among Hypertensive Patients with Renal Complications in the Tai Lue Ethnic Community of Thailand","authors":"Nittaya Sriprachot, Katekaew Seangpraw, P. Ong-Artborirak","doi":"10.2147/VHRM.S450775","DOIUrl":"https://doi.org/10.2147/VHRM.S450775","url":null,"abstract":"Purpose Hypertension (HT) can cause renal complications or deterioration of kidney function. HT management is very important because it reduces the severity of illnesses. This study aimed to investigate the relationship between health literacy (HL), self-care behaviors (SCB), and biochemical parameters in hypertensive patients with renal complications. Methods A cross-sectional study of 405 hypertensive patients with renal complications among Tai Lue people living in Thailand was conducted using simple random sampling. Face-to-face interviews with questionnaires were used to collect information. Blood pressure (BP) and biochemical parameters, such as fasting blood sugar (FBS) and estimated glomerular filtration rate (eGFR), were measured. Results The participants’ mean age was 68.3 years. A significant correlation was found between HL score, SCB score, systolic BP (SBP), diastolic BP (DBP), FBS, and eGFR (p<0.01). Multiple linear regression revealed that eating salty foods was a risk factor for SBP in males and for SBP and DBP in females. Body mass index (BMI) (B = 0.54), sweet food consumption (B = 13.90), and SCB score (B = −0.29) were significantly associated with FBS level (R2 = 17.8%, p<0.05). Employment (B = 2.55), eating bland food (B = 4.07), receiving information from family (B = 3.53), SCB (B= 0.31), and age (B = −0.51) were all significant factors for eGFR (R2 = 35.0%, p<0.05). Conclusion HL and SCB levels were associated with the health of hypertensive patients with renal complications in the Tai Lue ethnic community. The significance of organizing health education programs is to emphasize increasing HL to lead to self-care decisions and reduce complications in patients, resulting in improved SCB and quality of life in the future.","PeriodicalId":509369,"journal":{"name":"Vascular Health and Risk Management","volume":"80 1","pages":"97 - 107"},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140080051","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}
Purpose To analyze the relationship among distribution location, characteristics, and vulnerability of carotid plaque using CTA and provide more information on the risk factors of carotid atherosclerotic plaque. Patients and Methods We retrospectively analyzed the CTA images of the head and neck of 93 patients with carotid atherosclerosis. Atherosclerosis was developed in 148 carotid arteries. The plaques were divided into a high-risk plaque group and a low-risk plaque group according to whether the plaques had high-risk characteristics. The maximum cross-sectional area of carotid artery bifurcation plaque on the axial image was selected, and the cross-sectional lumen was equally divided into four 90-degree sectors, ventral side wall, dorsal side wall, inner side wall, and outer side wall. The differences in the characteristics and distribution locations of the plaques in the two groups were analyzed. The characteristic parameters of the cross-sectional plaques at the bifurcation of the carotid artery. The logistic regression analysis was used to further analyze the risk factors associated with plaque vulnerability. Results Among 148 carotid arteries,80 were classified as high-risk and 68 as low-risk groups. There were significant differences between the two groups concerning the thickness, length, maximum cross-sectional area, burden, and cross-sectional distribution of the plaques (P < 0.05). The plaque distribution on the dorsal side wall of the carotid bifurcation was higher in the high-risk group than that in the low-risk group (P < 0.05), dorsal side wall plaque-independent risk factors for the development of vulnerability of plaques in transient ischemic attack (TIA) patients (95% CI:1.522~6.991, P<0.05). Conclusion High-risk plaques tend to occur on the dorsal side wall of the carotid bifurcation, whereas low-risk plaques tend to occur on the outer side wall of the carotid bifurcation.
{"title":"Evaluation of the Correlation Between Distribution Location and Vulnerability of Carotid Plaque in Patients with Transient Ischemic Attack","authors":"Yinan Zhao, Yan Gu, Ying Liu, Zhongping Guo","doi":"10.2147/VHRM.S447418","DOIUrl":"https://doi.org/10.2147/VHRM.S447418","url":null,"abstract":"Purpose To analyze the relationship among distribution location, characteristics, and vulnerability of carotid plaque using CTA and provide more information on the risk factors of carotid atherosclerotic plaque. Patients and Methods We retrospectively analyzed the CTA images of the head and neck of 93 patients with carotid atherosclerosis. Atherosclerosis was developed in 148 carotid arteries. The plaques were divided into a high-risk plaque group and a low-risk plaque group according to whether the plaques had high-risk characteristics. The maximum cross-sectional area of carotid artery bifurcation plaque on the axial image was selected, and the cross-sectional lumen was equally divided into four 90-degree sectors, ventral side wall, dorsal side wall, inner side wall, and outer side wall. The differences in the characteristics and distribution locations of the plaques in the two groups were analyzed. The characteristic parameters of the cross-sectional plaques at the bifurcation of the carotid artery. The logistic regression analysis was used to further analyze the risk factors associated with plaque vulnerability. Results Among 148 carotid arteries,80 were classified as high-risk and 68 as low-risk groups. There were significant differences between the two groups concerning the thickness, length, maximum cross-sectional area, burden, and cross-sectional distribution of the plaques (P < 0.05). The plaque distribution on the dorsal side wall of the carotid bifurcation was higher in the high-risk group than that in the low-risk group (P < 0.05), dorsal side wall plaque-independent risk factors for the development of vulnerability of plaques in transient ischemic attack (TIA) patients (95% CI:1.522~6.991, P<0.05). Conclusion High-risk plaques tend to occur on the dorsal side wall of the carotid bifurcation, whereas low-risk plaques tend to occur on the outer side wall of the carotid bifurcation.","PeriodicalId":509369,"journal":{"name":"Vascular Health and Risk Management","volume":"62 10","pages":"77 - 87"},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140080262","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}
Xiaoxiao Zhao, Hanjun Zhao, Runzhen Chen, Jiannan Li, Jinying Zhou, Nan Li, S. Yan, Chen Liu, P. Zhou, Yi Chen, Li Song, Hongbing Yan
Background and Aim An elevated triglyceride-glucose (TyG) level is associated with increased risk of mortality in patients with CAD. Trimethylamine N-oxide (TMAO) has mechanistic links to atherosclerotic coronary artery disease (CAD) pathogenesis and is correlated with adverse outcomes. However, the incremental prognostic value of TMAO and TyG in the cohort of optical coherence tomography (OCT)-defined high-risk ST-segment elevation myocardial infarction (STEMI) patients is unknown. Methods We studied 274 consecutive aged ≥18 years patients with evidence of STEMI and detected on pre-intervention OCT imaging of culprit lesions between March 2017 and March 2019. Outcomes There were 22 (22.68%), 27 (27.84%), 26 (26.80%), and 22 (22.68%) patients in groups A-D, respectively. The baseline characteristics according to the level of TMAO and TyG showed that patients with higher level in both indicators were more likely to have higher triglycerides (p < 0.001), fasting glucose (p < 0.001) and higher incidence of diabetes (p = 0.008). The group with TMAO > median and TyG ≤ median was associated with higher rates of MACEs significantly (p = 0.009) in fully adjusted analyses. During a median follow-up of 2.027 years, 20 (20.6%) patients experienced MACEs. To evaluate the diagnostic value of the TyG index combined with TMAO, the area under the receiver operating characteristic curve for predicting MACEs after full adjustment was 0.815 (95% confidence interval, 0.723–0.887; sensitivity, 85.00%; specificity, 72.73%; cut-off level, 0.577). Among the group of patients with TMAO > median and TyG ≤ median, there was a significantly higher incidence of MACEs (p=0.033). A similar tendency was found in the cohort with hyperlipidemia (p=0.016) and diabetes mellitus (p=0.036). Conclusion This study demonstrated the usefulness of combined measures of the TyG index and TMAO in enhancing risk stratification in STEMI patients with OCT-defined high-risk plaque characteristics. Trial Registration This study was registered at ClinicalTrials.gov as NCT03593928.
{"title":"A Combined Measure of the Triglyceride Glucose Index and Trimethylamine N-Oxide in Risk Stratification of ST-Segment Elevation Myocardial Infarction Patients with High-Risk Plaque Features Defined by Optical Coherence Tomography: A Substudy of the OCTAMI Registry Study","authors":"Xiaoxiao Zhao, Hanjun Zhao, Runzhen Chen, Jiannan Li, Jinying Zhou, Nan Li, S. Yan, Chen Liu, P. Zhou, Yi Chen, Li Song, Hongbing Yan","doi":"10.2147/VHRM.S443742","DOIUrl":"https://doi.org/10.2147/VHRM.S443742","url":null,"abstract":"Background and Aim An elevated triglyceride-glucose (TyG) level is associated with increased risk of mortality in patients with CAD. Trimethylamine N-oxide (TMAO) has mechanistic links to atherosclerotic coronary artery disease (CAD) pathogenesis and is correlated with adverse outcomes. However, the incremental prognostic value of TMAO and TyG in the cohort of optical coherence tomography (OCT)-defined high-risk ST-segment elevation myocardial infarction (STEMI) patients is unknown. Methods We studied 274 consecutive aged ≥18 years patients with evidence of STEMI and detected on pre-intervention OCT imaging of culprit lesions between March 2017 and March 2019. Outcomes There were 22 (22.68%), 27 (27.84%), 26 (26.80%), and 22 (22.68%) patients in groups A-D, respectively. The baseline characteristics according to the level of TMAO and TyG showed that patients with higher level in both indicators were more likely to have higher triglycerides (p < 0.001), fasting glucose (p < 0.001) and higher incidence of diabetes (p = 0.008). The group with TMAO > median and TyG ≤ median was associated with higher rates of MACEs significantly (p = 0.009) in fully adjusted analyses. During a median follow-up of 2.027 years, 20 (20.6%) patients experienced MACEs. To evaluate the diagnostic value of the TyG index combined with TMAO, the area under the receiver operating characteristic curve for predicting MACEs after full adjustment was 0.815 (95% confidence interval, 0.723–0.887; sensitivity, 85.00%; specificity, 72.73%; cut-off level, 0.577). Among the group of patients with TMAO > median and TyG ≤ median, there was a significantly higher incidence of MACEs (p=0.033). A similar tendency was found in the cohort with hyperlipidemia (p=0.016) and diabetes mellitus (p=0.036). Conclusion This study demonstrated the usefulness of combined measures of the TyG index and TMAO in enhancing risk stratification in STEMI patients with OCT-defined high-risk plaque characteristics. Trial Registration This study was registered at ClinicalTrials.gov as NCT03593928.","PeriodicalId":509369,"journal":{"name":"Vascular Health and Risk Management","volume":"20 79","pages":"141 - 155"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140406040","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}
Mohamed Hassan, Said Ahmed, Mohamed Hassan, M. Mohamud, A. Abdi
Introduction Myocardial infarction and cardiovascular disease are significant global health issues, particularly in Somalia. The Somali population faces challenges due to armed conflict, limited education, and underdeveloped healthcare infrastructure. Cardiovascular risk factors like diabetes, hypertension, and obesity are prevalent, and Somali people face increased susceptibility. Methods This study examined Somalia residents’ perceptions, attitudes, and behaviors towards myocardial infarction using a cross-sectional paper-based questionnaire. The sample consisted of 313 urban residents in Mogadishu, aged 20 and above. The questionnaire was written in Somali and was designed for the demographic. Knowledge, attitude, and practice scores were categorized into two groups, with associations between knowledge, attitude, and practice with sociodemographic and health characteristics assessed using Logistic Regression. Results This study analyzed data from A random sample of participants who arrived at the hospital for various reasons regarding their perceptions, attitudes, and responses towards myocardial infarction. The mean age was 42 ±19 years, with 54% being male and 46% female. Hypertension was the most common comorbidity, followed by dyslipidemia and diabetes. Over half of the respondents had no formal education, and only 3.8% had a smoking history. About 5.7% had a previous history of myocardial infarction. The mean knowledge score was 11.07 ± 0.697, with 53.35% of respondents not knowing enough about myocardial infarction. The majority of the patients showed a favorable attitude, but only a slight majority could recognize symptoms of myocardial infarction. The majority of the patients had inadequate practice and behavior, with 53.6% not practicing regularly or engaging in sports. Conclusion The research highlights gaps in Mogadishu’s Somali community’s knowledge and practices regarding myocardial infarction. It emphasizes the need for health education, primary care, and community involvement to improve cardiovascular health awareness and reduce MI incidence.
{"title":"Exploring Myocardial Infarction Knowledge, Attitudes, and Practice Among Mogadishu’s Somali Residents","authors":"Mohamed Hassan, Said Ahmed, Mohamed Hassan, M. Mohamud, A. Abdi","doi":"10.2147/VHRM.S448220","DOIUrl":"https://doi.org/10.2147/VHRM.S448220","url":null,"abstract":"Introduction Myocardial infarction and cardiovascular disease are significant global health issues, particularly in Somalia. The Somali population faces challenges due to armed conflict, limited education, and underdeveloped healthcare infrastructure. Cardiovascular risk factors like diabetes, hypertension, and obesity are prevalent, and Somali people face increased susceptibility. Methods This study examined Somalia residents’ perceptions, attitudes, and behaviors towards myocardial infarction using a cross-sectional paper-based questionnaire. The sample consisted of 313 urban residents in Mogadishu, aged 20 and above. The questionnaire was written in Somali and was designed for the demographic. Knowledge, attitude, and practice scores were categorized into two groups, with associations between knowledge, attitude, and practice with sociodemographic and health characteristics assessed using Logistic Regression. Results This study analyzed data from A random sample of participants who arrived at the hospital for various reasons regarding their perceptions, attitudes, and responses towards myocardial infarction. The mean age was 42 ±19 years, with 54% being male and 46% female. Hypertension was the most common comorbidity, followed by dyslipidemia and diabetes. Over half of the respondents had no formal education, and only 3.8% had a smoking history. About 5.7% had a previous history of myocardial infarction. The mean knowledge score was 11.07 ± 0.697, with 53.35% of respondents not knowing enough about myocardial infarction. The majority of the patients showed a favorable attitude, but only a slight majority could recognize symptoms of myocardial infarction. The majority of the patients had inadequate practice and behavior, with 53.6% not practicing regularly or engaging in sports. Conclusion The research highlights gaps in Mogadishu’s Somali community’s knowledge and practices regarding myocardial infarction. It emphasizes the need for health education, primary care, and community involvement to improve cardiovascular health awareness and reduce MI incidence.","PeriodicalId":509369,"journal":{"name":"Vascular Health and Risk Management","volume":" 5","pages":"13 - 20"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139393302","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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