Pub Date : 2023-04-01Epub Date: 2023-06-02DOI: 10.1097/CP9.0000000000000050
Kun Miao, Jinsheng Lai, Feng Wang, Luyun Wang, Chunxia Zhao, Dao Wen Wang
Herein, we report the case of a young female patient who suffered from myositis and heart failure due to fulminant myocarditis induced by the 2019 coronavirus disease (COVID-19). After receiving intra-aortic balloon pump (IABP) and immunomodulatory treatment, her vital signs gradually stabilized and the IABP was removed. Cardiac and muscle magnetic resonance imaging confirmed extensive myocardial and skeletal muscle edema. Though it is not uncommon for COVID-19 infection to be complicated by myocarditis and myositis, such serious muscle injury warrants clinical vigilance.
{"title":"COVID-19 infection with complicated fulminant myocarditis: a case report.","authors":"Kun Miao, Jinsheng Lai, Feng Wang, Luyun Wang, Chunxia Zhao, Dao Wen Wang","doi":"10.1097/CP9.0000000000000050","DOIUrl":"10.1097/CP9.0000000000000050","url":null,"abstract":"<p><p>Herein, we report the case of a young female patient who suffered from myositis and heart failure due to fulminant myocarditis induced by the 2019 coronavirus disease (COVID-19). After receiving intra-aortic balloon pump (IABP) and immunomodulatory treatment, her vital signs gradually stabilized and the IABP was removed. Cardiac and muscle magnetic resonance imaging confirmed extensive myocardial and skeletal muscle edema. Though it is not uncommon for COVID-19 infection to be complicated by myocarditis and myositis, such serious muscle injury warrants clinical vigilance.</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 2","pages":"144-148"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/fa/cp9-8-144.PMC10364644.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and purpose: Cardiovascular disease is the leading cause of disease burden globally. Previous studies have suggested that air pollution is a risk factor for cardiovascular symptoms, however, the results are controversial. Thus, we conducted this study to systematically review available evidence quantifying the relationship between exposure to ambient gaseous and particulate air pollutants and cardiovascular symptoms. Methods: Three databases were searched up to September 10, 2022, for articles investigating the association of air pollutants including sulfur dioxide, nitrogen dioxide, ozone, carbon monoxide, and particulate matter with aerodynamic diameters of ≤10 μm and ≤2.5 μm (PM10 and PM2.5) with cardiovascular symptoms of chest pain, shortness of breath, respiratory distress, and palpitation. Random-effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (95% CI) for chest pain in association with PM2.5. Egger test was used to assess publication bias in the included studies. Results: Of the 16 studies that were included in the systematic review, 10 were used to calculate the pooled OR for chest pain. Most of them were from developed countries, where air pollution levels were relatively low. Short-term exposure to air pollutants may increase the risk of chest pain, with the pooled OR 1.016 (95% CI 1.003–1.030) per 10 μg/m³ increment of PM2.5. Conclusions: Air pollution is a potential risk factor for cardiovascular symptoms, especially chest pain. However, most current studies are conducted in low-pollution regions. More studies from high-pollution regions are needed to confirm the role of ambient air pollution in cardiovascular symptoms and reveal the underlying health effects.
{"title":"Association of ambient air pollution and cardiovascular symptoms: a systematic review and meta-analysis","authors":"Shiyu Zhou, Fangchao Liu, Hanrui Liu, Sihan Huang, Xiangfeng Lu, Jianfeng Huang","doi":"10.1097/CP9.0000000000000054","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000054","url":null,"abstract":"Background and purpose: Cardiovascular disease is the leading cause of disease burden globally. Previous studies have suggested that air pollution is a risk factor for cardiovascular symptoms, however, the results are controversial. Thus, we conducted this study to systematically review available evidence quantifying the relationship between exposure to ambient gaseous and particulate air pollutants and cardiovascular symptoms. Methods: Three databases were searched up to September 10, 2022, for articles investigating the association of air pollutants including sulfur dioxide, nitrogen dioxide, ozone, carbon monoxide, and particulate matter with aerodynamic diameters of ≤10 μm and ≤2.5 μm (PM10 and PM2.5) with cardiovascular symptoms of chest pain, shortness of breath, respiratory distress, and palpitation. Random-effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (95% CI) for chest pain in association with PM2.5. Egger test was used to assess publication bias in the included studies. Results: Of the 16 studies that were included in the systematic review, 10 were used to calculate the pooled OR for chest pain. Most of them were from developed countries, where air pollution levels were relatively low. Short-term exposure to air pollutants may increase the risk of chest pain, with the pooled OR 1.016 (95% CI 1.003–1.030) per 10 μg/m³ increment of PM2.5. Conclusions: Air pollution is a potential risk factor for cardiovascular symptoms, especially chest pain. However, most current studies are conducted in low-pollution regions. More studies from high-pollution regions are needed to confirm the role of ambient air pollution in cardiovascular symptoms and reveal the underlying health effects.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 1","pages":"134 - 143"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47847294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01Epub Date: 2023-04-14DOI: 10.1097/CP9.0000000000000046
Hongyang Shu, Chunxia Zhao, Dao Wen Wang
Coronavirus disease 2019 (COVID-19) disease has infected nearly 600 million people, resulting in > 6 million deaths, with many of them dying from cardiovascular diseases. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is caused by a combination of the virus surface spike protein and the human angiotensin-converting enzyme 2 (ACE2) receptor. In addition to being highly expressed in the lungs, ACE2 is widely distributed in the heart, mainly in myocardial cells and pericytes. Like other types of viruses, SARS-CoV-2 can cause myocarditis after infecting the myocardial tissue, which is attributed to the direct damage of the virus and uncontrolled inflammatory reactions. Patients with chest tightness, palpitation, abnormal electrocardiogram, and cardiac troponin elevation, should be suspected of myocarditis within 1-3 weeks of COVID-19 infection. When the hemodynamics change rapidly, fulminant myocarditis should be suspected. Cardiac ultrasound, myocardial biopsy, cytokine detection, cardiac magnetic resonance imaging, 18F-fluorodeoxyglucose positron emission tomography, and other examination methods can assist in the diagnosis. Although scientists and clinicians have made concerted efforts to seek treatment and prevention measures, there are no clear recommendations for the treatment of COVID-19-related myocarditis. For most cases of common myocarditis, general symptomatic and supportive treatments are used. For COVID-19-related fulminant myocarditis, it is emphasized to achieve "early identification, early diagnosis, early prediction, and early treatment" based on the "life support-based comprehensive treatment regimen." Mechanical circulatory support therapy can rest the heart, which is a cure for symptoms, and immune regulation therapy can control the inflammatory storms which is a cure for the disease. Furthermore, complications of COVID-19-related myocarditis, such as arrhythmia, thrombosis, and infection, should be actively treated. Herein, we summarized the incidence rate, manifestations, and diagnosis of COVID-19-related myocarditis and discussed in detail the treatment of COVID-19-related myocarditis, especially the treatment strategy of fulminant myocarditis.
{"title":"Understanding COVID-19-related myocarditis: pathophysiology, diagnosis, and treatment strategies.","authors":"Hongyang Shu, Chunxia Zhao, Dao Wen Wang","doi":"10.1097/CP9.0000000000000046","DOIUrl":"10.1097/CP9.0000000000000046","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19) disease has infected nearly 600 million people, resulting in > 6 million deaths, with many of them dying from cardiovascular diseases. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is caused by a combination of the virus surface spike protein and the human angiotensin-converting enzyme 2 (ACE2) receptor. In addition to being highly expressed in the lungs, ACE2 is widely distributed in the heart, mainly in myocardial cells and pericytes. Like other types of viruses, SARS-CoV-2 can cause myocarditis after infecting the myocardial tissue, which is attributed to the direct damage of the virus and uncontrolled inflammatory reactions. Patients with chest tightness, palpitation, abnormal electrocardiogram, and cardiac troponin elevation, should be suspected of myocarditis within 1-3 weeks of COVID-19 infection. When the hemodynamics change rapidly, fulminant myocarditis should be suspected. Cardiac ultrasound, myocardial biopsy, cytokine detection, cardiac magnetic resonance imaging, 18F-fluorodeoxyglucose positron emission tomography, and other examination methods can assist in the diagnosis. Although scientists and clinicians have made concerted efforts to seek treatment and prevention measures, there are no clear recommendations for the treatment of COVID-19-related myocarditis. For most cases of common myocarditis, general symptomatic and supportive treatments are used. For COVID-19-related fulminant myocarditis, it is emphasized to achieve \"early identification, early diagnosis, early prediction, and early treatment\" based on the \"life support-based comprehensive treatment regimen.\" Mechanical circulatory support therapy can rest the heart, which is a cure for symptoms, and immune regulation therapy can control the inflammatory storms which is a cure for the disease. Furthermore, complications of COVID-19-related myocarditis, such as arrhythmia, thrombosis, and infection, should be actively treated. Herein, we summarized the incidence rate, manifestations, and diagnosis of COVID-19-related myocarditis and discussed in detail the treatment of COVID-19-related myocarditis, especially the treatment strategy of fulminant myocarditis.</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 2","pages":"72-81"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/89/cp9-8-072.PMC10364646.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1097/CP9.0000000000000047
J. Ban, Runmei Ma, An Liu, Qing Wang, Chen Chen, Qinghua Sun, Yanwen Wang, Jianlin Hu, Tiantian Li
Background and purpose: Evidence investigating the association between ambient fine particulate matter (PM2.5) and acute incidence of myocardial infarction in developing countries is limited. This study aims to investigate linear and nonlinear patterns for the association between PM2.5 and acute incidence of myocardial infarction based on multicounty registry dataset and evaluate the reduction of premature myocardial infarction incidence under different pollution control objectives in China. Methods: Thirty-six thousand six hundred and seventy-nine registered myocardial infarction incidence cases from 15 Chinese counties from January 1, 2013, to December 31, 2017, were obtained. We adopted a time-stratified case-crossover design with conditional logistic regression models. Results: With a 10 μg/m3 increase in PM2.5 exposure, there was an increase of 0.98% (95% CI: 0.40%–1.57%) in acute incidence risk of myocardial infarction. The corresponding values for males and individuals aged over 74 years were 1.58% (95% CI: 0.82%–2.35%) and 1.19% (95% CI: 0.35%–2.05%) respectively, indicating higher risks than other groups. The nonlinear concentration–response curve indicated a steeper slope under daily exposure below 50 μg/m3 and the marginal avoided premature morbidity became larger under the current air quality standard. Conclusions: The robust findings from this study may suggest the necessity for a continuous reduction of PM2.5 exposure concentration from the perspectives of public health.
{"title":"Ambient PM2.5 and acute incidence of myocardial infarction in China: a case-crossover study and health impact assessment","authors":"J. Ban, Runmei Ma, An Liu, Qing Wang, Chen Chen, Qinghua Sun, Yanwen Wang, Jianlin Hu, Tiantian Li","doi":"10.1097/CP9.0000000000000047","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000047","url":null,"abstract":"Background and purpose: Evidence investigating the association between ambient fine particulate matter (PM2.5) and acute incidence of myocardial infarction in developing countries is limited. This study aims to investigate linear and nonlinear patterns for the association between PM2.5 and acute incidence of myocardial infarction based on multicounty registry dataset and evaluate the reduction of premature myocardial infarction incidence under different pollution control objectives in China. Methods: Thirty-six thousand six hundred and seventy-nine registered myocardial infarction incidence cases from 15 Chinese counties from January 1, 2013, to December 31, 2017, were obtained. We adopted a time-stratified case-crossover design with conditional logistic regression models. Results: With a 10 μg/m3 increase in PM2.5 exposure, there was an increase of 0.98% (95% CI: 0.40%–1.57%) in acute incidence risk of myocardial infarction. The corresponding values for males and individuals aged over 74 years were 1.58% (95% CI: 0.82%–2.35%) and 1.19% (95% CI: 0.35%–2.05%) respectively, indicating higher risks than other groups. The nonlinear concentration–response curve indicated a steeper slope under daily exposure below 50 μg/m3 and the marginal avoided premature morbidity became larger under the current air quality standard. Conclusions: The robust findings from this study may suggest the necessity for a continuous reduction of PM2.5 exposure concentration from the perspectives of public health.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 1","pages":"111 - 117"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41613821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1097/CP9.0000000000000048
P. Du, Kailai Lu, Can-Jing Zhang, Ting Liu, Jianlin Hu, Tiantian Li
Background and purpose: Acute myocardial infarction (AMI) is a manifestation of coronary artery disease. Fine particulate matter (PM2.5) has been regarded as a risk factor for AMI-related mortality and hospitalizations. Agricultural activities contribute greatly to PM2.5 formation, indicating potential health risks of PM2.5 in agricultural areas. Health effect studies on agricultural source remain scarce, and currently available evidence is controversial. This study investigated the health effects of short-term exposure to PM2.5 from agricultural sources on AMI onset using a nationwide analysis in China. Methods: We reviewed case records from the China Cardiovascular Association Database and extracted the data of 355,815 patients with AMI onset from 1,653 hospitals for the period 2015 to 2018. We obtained daily concentrations of PM2.5 from agricultural sources using the source-oriented Community Multiscale Air Quality model. Moreover, we proposed a time-stratified case-crossover study to examine associations between exposure to PM2.5 from agricultural sources and AMI onset and determined lag effects with a maximum of 3 days. Additionally, we conducted multiple subgroup and sensitivity analyses. Results: Exposure to PM2.5 from agricultural sources caused a significantly increased risk of the onset of AMI and its subtypes. Short-term exposure to PM2.5 from agricultural sources on the current day (lag 0) was positively associated with a 4.4% (95% confidence interval [95% CI]: 3.3%–5.5%), 4.9% (95% CI: 3.5%–6.3%), and 3.4% (95% CI: 1.5%–5.4%) increase in the odds of AMI, ST-elevation myocardial infarction (STEMI), and non-STEMI (NSTEMI), for each 10 μg/m3 increase. Meanwhile, higher risk estimations were pronounced in individuals who were aged above 65 years, who lived in southern China, and who resided in the rural area setting, and significant differences were mostly found in NSTEMI onsets. Conclusions: Short-term exposure to PM2.5 from agricultural sources may trigger the onset of AMI and its two subtypes. Improving agriculture management through ammonia emission abatement can help in achieving PM2.5 reduction and protecting public health.
{"title":"Association of PM2.5 from agriculture sources and acute myocardial infarction onset: results from 2015 to 2018 in China","authors":"P. Du, Kailai Lu, Can-Jing Zhang, Ting Liu, Jianlin Hu, Tiantian Li","doi":"10.1097/CP9.0000000000000048","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000048","url":null,"abstract":"Background and purpose: Acute myocardial infarction (AMI) is a manifestation of coronary artery disease. Fine particulate matter (PM2.5) has been regarded as a risk factor for AMI-related mortality and hospitalizations. Agricultural activities contribute greatly to PM2.5 formation, indicating potential health risks of PM2.5 in agricultural areas. Health effect studies on agricultural source remain scarce, and currently available evidence is controversial. This study investigated the health effects of short-term exposure to PM2.5 from agricultural sources on AMI onset using a nationwide analysis in China. Methods: We reviewed case records from the China Cardiovascular Association Database and extracted the data of 355,815 patients with AMI onset from 1,653 hospitals for the period 2015 to 2018. We obtained daily concentrations of PM2.5 from agricultural sources using the source-oriented Community Multiscale Air Quality model. Moreover, we proposed a time-stratified case-crossover study to examine associations between exposure to PM2.5 from agricultural sources and AMI onset and determined lag effects with a maximum of 3 days. Additionally, we conducted multiple subgroup and sensitivity analyses. Results: Exposure to PM2.5 from agricultural sources caused a significantly increased risk of the onset of AMI and its subtypes. Short-term exposure to PM2.5 from agricultural sources on the current day (lag 0) was positively associated with a 4.4% (95% confidence interval [95% CI]: 3.3%–5.5%), 4.9% (95% CI: 3.5%–6.3%), and 3.4% (95% CI: 1.5%–5.4%) increase in the odds of AMI, ST-elevation myocardial infarction (STEMI), and non-STEMI (NSTEMI), for each 10 μg/m3 increase. Meanwhile, higher risk estimations were pronounced in individuals who were aged above 65 years, who lived in southern China, and who resided in the rural area setting, and significant differences were mostly found in NSTEMI onsets. Conclusions: Short-term exposure to PM2.5 from agricultural sources may trigger the onset of AMI and its two subtypes. Improving agriculture management through ammonia emission abatement can help in achieving PM2.5 reduction and protecting public health.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 1","pages":"118 - 125"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49574316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01Epub Date: 2023-07-20DOI: 10.1097/CP9.0000000000000043
Feng Bai, Jun Pu, Wenliang Che, Jiyan Chen, Mao Chen, Wei Chen, Xiaoping Chen, Yundai Chen, Xianwu Cheng, Xiang Cheng, Hongliang Cong, Cuilian Dai, Dali Fan, Guosheng Fu, Lei Gao, Chuanyu Gao, Wei Gao, Junbo Ge, Ben He, Tao Hu, Congxin Huang, Jing Huang, Yong Huo, Shaobin Jia, Jun Jiang, Zhicheng Jing, Xiangqing Kong, Lang Li, Yan Li, Yigang Li, Zhijuan Li, Chun Liang, Xianhe Lin, Xianxia Liu, Xuebo Liu, Chengzhi Lu, Genshan Ma, Yitong Ma, Wei Mao, Xia Mei, Zhongping Ning, Jiafu Ou, Shaderdin Slaj, Chengxing Shen, Haiming Shi, Hong Shi, Bei Shi, Xi Su, Ningling Sun, Qizhu Tang, Fang Wang, Changqian Wang, Jin Wang, Yanqing Wu, Yongjian Wu, Yunlong Xia, Dingcheng Xiang, Pingxi Xiao, Ping Xie, Dingding Xiong, Yawei Xu, Jiefu Yang, Lixia Yang, Zaixin Yu, Zuyi Yuan, Haitao Yuan, Guogang Zhang, Heng Zhang, Jian Zhang, Li Zhang, Ruiyan Zhang, Shuning Zhang, Shuyang Zhang, Zheng Zhang, Guoan Zhao, Xianxian Zhao, Jingang Zheng, Haoyi Zheng, Daxin Zhou, Shenghua Zhou, Yujie Zhou
The primary site of infection in COVID-19 exhibit is the respiratory system, but multiple organ systems could be affected. The virus could directly invade cardiomyocytes. Alternatively, cytokine storm could lead to myocardial injury. More importantly, the management of existing cardiovascular diseases must be re-examined in COVID-19 due to, for example, interaction between antiviral agents and with a wide variety of pharmacological agents. The Branch of Cardiovascular Physicians of Chinese Medical Doctor Association organized a panel of experts in cardiovascular and related fields to discuss this important issue, and formulated the "2023 Chinese Expert Consensus on the Impact of COVID-19 on the Management of Cardiovascular Diseases." The Consensus was drafted on the basis of systematic review of existing evidence and diagnosis and treatment experience, and covers three major aspects: myocardial injury caused by COVID-10 and COVID-19 vaccine, the impact of COVID-19 on patients with cardiovascular disease, and the impact of COVID-19 on the cardiovascular system of healthy people, and rehabilitation guidance recommendations. The Consensus involves 11 core clinical issues, including incidence, pathogenesis, clinical manifestations, treatment strategies, prognosis, and rehabilitation. It is our hope that this Consensus will provide a practical guidance to cardiologists in the management of cardiovascular diseases in the new era of COVID-19 pandemic.
{"title":"2023 Chinese expert consensus on the impact of COVID-19 on the management of cardiovascular diseases.","authors":"Feng Bai, Jun Pu, Wenliang Che, Jiyan Chen, Mao Chen, Wei Chen, Xiaoping Chen, Yundai Chen, Xianwu Cheng, Xiang Cheng, Hongliang Cong, Cuilian Dai, Dali Fan, Guosheng Fu, Lei Gao, Chuanyu Gao, Wei Gao, Junbo Ge, Ben He, Tao Hu, Congxin Huang, Jing Huang, Yong Huo, Shaobin Jia, Jun Jiang, Zhicheng Jing, Xiangqing Kong, Lang Li, Yan Li, Yigang Li, Zhijuan Li, Chun Liang, Xianhe Lin, Xianxia Liu, Xuebo Liu, Chengzhi Lu, Genshan Ma, Yitong Ma, Wei Mao, Xia Mei, Zhongping Ning, Jiafu Ou, Shaderdin Slaj, Chengxing Shen, Haiming Shi, Hong Shi, Bei Shi, Xi Su, Ningling Sun, Qizhu Tang, Fang Wang, Changqian Wang, Jin Wang, Yanqing Wu, Yongjian Wu, Yunlong Xia, Dingcheng Xiang, Pingxi Xiao, Ping Xie, Dingding Xiong, Yawei Xu, Jiefu Yang, Lixia Yang, Zaixin Yu, Zuyi Yuan, Haitao Yuan, Guogang Zhang, Heng Zhang, Jian Zhang, Li Zhang, Ruiyan Zhang, Shuning Zhang, Shuyang Zhang, Zheng Zhang, Guoan Zhao, Xianxian Zhao, Jingang Zheng, Haoyi Zheng, Daxin Zhou, Shenghua Zhou, Yujie Zhou","doi":"10.1097/CP9.0000000000000043","DOIUrl":"10.1097/CP9.0000000000000043","url":null,"abstract":"<p><p>The primary site of infection in COVID-19 exhibit is the respiratory system, but multiple organ systems could be affected. The virus could directly invade cardiomyocytes. Alternatively, cytokine storm could lead to myocardial injury. More importantly, the management of existing cardiovascular diseases must be re-examined in COVID-19 due to, for example, interaction between antiviral agents and with a wide variety of pharmacological agents. The Branch of Cardiovascular Physicians of Chinese Medical Doctor Association organized a panel of experts in cardiovascular and related fields to discuss this important issue, and formulated the \"2023 Chinese Expert Consensus on the Impact of COVID-19 on the Management of Cardiovascular Diseases.\" The Consensus was drafted on the basis of systematic review of existing evidence and diagnosis and treatment experience, and covers three major aspects: myocardial injury caused by COVID-10 and COVID-19 vaccine, the impact of COVID-19 on patients with cardiovascular disease, and the impact of COVID-19 on the cardiovascular system of healthy people, and rehabilitation guidance recommendations. The Consensus involves 11 core clinical issues, including incidence, pathogenesis, clinical manifestations, treatment strategies, prognosis, and rehabilitation. It is our hope that this Consensus will provide a practical guidance to cardiologists in the management of cardiovascular diseases in the new era of COVID-19 pandemic.</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 2","pages":"82-102"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0b/59/cp9-8-082.PMC10358441.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9856057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-03-27DOI: 10.1097/CP9.0000000000000037
Zihang Huang, Aijun Sun
{"title":"Metabolism, inflammation, and cardiovascular diseases from basic research to clinical practice.","authors":"Zihang Huang, Aijun Sun","doi":"10.1097/CP9.0000000000000037","DOIUrl":"10.1097/CP9.0000000000000037","url":null,"abstract":"","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 1","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/52/b4/cp9-8-4.PMC10178914.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9492946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-04-27DOI: 10.1097/CP9.0000000000000036
Ge Gao, Tao Zheng, Beidi Lan, Weiying Hui, Shi Chen, Zuyi Yuan, Yue Wu, John Y L Chiang, Tao Chen
Elevated lipoprotein(a) is associated with an increased risk of atherosclerotic cardiovascular disease. Evolocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, has been shown to reduce lipoprotein(a). However, the effect of evolocumab on lipoprotein(a) in patients with acute myocardial infarction (AMI) is poorly studied. This study aims to investigate the change in lipoprotein(a) under evolocumab therapy in patients with AMI.
Methods: This retrospective cohort analysis included a total of 467 AMI patients with LDL-C level >2.6 mmol/L upon admission, among whom 132 received in-hospital evolocumab (140 mg every 2 weeks) plus statin (20 mg atorvastatin or 10 mg rosuvastatin per day) and the remaining 335 received statin only. Lipid profiles at 1-month follow-up were compared between the two groups. A propensity score matching analysis was also conducted based on age, sex, and baseline lipoprotein(a) at a 1:1 ratio using a 0.02 caliper.
Results: At the 1-month follow-up, the lipoprotein(a) level decreased from 27.0 (17.5, 50.6) mg/dL to 20.9 (9.4, 52.5) mg/dL in evolocumab plus statin group, but increased from 24.5 (13.2, 41.1) mg/dL to 27.9 (14.8, 58.6) mg/dL in statin only group. The propensity score matching analysis included 262 patients (131 in each group). In subgroup analysis of the propensity score matching cohort stratified by the baseline lipoprotein(a) at cutoff values of 20 and 50 mg/dL, the absolute change in lipoprotein(a) was -4.9 (-8.5, -1.3), -5.0 (-13.9, 1.9), -0.2 (-9.9, 16.9) mg/dL in three subgroups in evolocumab plus statin group, and 0.9 (-1.7, 5.5), 10.7 (4.6, 21.9), 12.2 (2.9, 35.6) mg/dL in three subgroups in statin only group. In comparison to statin only group, evolocumab plus statin group had lower lipoprotein(a) level at 1 month in all subgroups (P < 0.05).
Conclusions: In-hospital initiation of evolocumab on a background statin therapy reduced lipoprotein(a) level at 1-month follow-up in patients with AMI. Evolocumab plus statin therapy inhibited the increase in lipoprotein(a) in statin only therapy, regardless of the baseline lipoprotein(a) level.
{"title":"Effect of in-hospital evolocumab therapy on lipoprotein(a) in patients with acute myocardial infarction: a retrospective cohort study and a propensity score matching analysis.","authors":"Ge Gao, Tao Zheng, Beidi Lan, Weiying Hui, Shi Chen, Zuyi Yuan, Yue Wu, John Y L Chiang, Tao Chen","doi":"10.1097/CP9.0000000000000036","DOIUrl":"10.1097/CP9.0000000000000036","url":null,"abstract":"<p><p>Elevated lipoprotein(a) is associated with an increased risk of atherosclerotic cardiovascular disease. Evolocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, has been shown to reduce lipoprotein(a). However, the effect of evolocumab on lipoprotein(a) in patients with acute myocardial infarction (AMI) is poorly studied. This study aims to investigate the change in lipoprotein(a) under evolocumab therapy in patients with AMI.</p><p><strong>Methods: </strong>This retrospective cohort analysis included a total of 467 AMI patients with LDL-C level >2.6 mmol/L upon admission, among whom 132 received in-hospital evolocumab (140 mg every 2 weeks) plus statin (20 mg atorvastatin or 10 mg rosuvastatin per day) and the remaining 335 received statin only. Lipid profiles at 1-month follow-up were compared between the two groups. A propensity score matching analysis was also conducted based on age, sex, and baseline lipoprotein(a) at a 1:1 ratio using a 0.02 caliper.</p><p><strong>Results: </strong>At the 1-month follow-up, the lipoprotein(a) level decreased from 27.0 (17.5, 50.6) mg/dL to 20.9 (9.4, 52.5) mg/dL in evolocumab plus statin group, but increased from 24.5 (13.2, 41.1) mg/dL to 27.9 (14.8, 58.6) mg/dL in statin only group. The propensity score matching analysis included 262 patients (131 in each group). In subgroup analysis of the propensity score matching cohort stratified by the baseline lipoprotein(a) at cutoff values of 20 and 50 mg/dL, the absolute change in lipoprotein(a) was -4.9 (-8.5, -1.3), -5.0 (-13.9, 1.9), -0.2 (-9.9, 16.9) mg/dL in three subgroups in evolocumab plus statin group, and 0.9 (-1.7, 5.5), 10.7 (4.6, 21.9), 12.2 (2.9, 35.6) mg/dL in three subgroups in statin only group. In comparison to statin only group, evolocumab plus statin group had lower lipoprotein(a) level at 1 month in all subgroups (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>In-hospital initiation of evolocumab on a background statin therapy reduced lipoprotein(a) level at 1-month follow-up in patients with AMI. Evolocumab plus statin therapy inhibited the increase in lipoprotein(a) in statin only therapy, regardless of the baseline lipoprotein(a) level.</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 1","pages":"46-52"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/d2/cp9-8-46.PMC10179980.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9869960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1097/CP9.0000000000000041
Chung-Te Liu, Jiun-Yu Guo, R. Chou, Ya-Wen Lu, Y. Tsai, C. Kuo, Chun-Chin Chang, Po‐Hsun Huang, Jaw-wen Chen, Shing-Jong Lin
Background and purpose: The association of circulating endothelial progenitor cells (EPCs) with different cardiovascular diseases and their related major adverse cardiovascular events (MACE) remained inconclusive. We aimed to clarify associations between the circulating EPC levels and the risk of MACE concerning different atherosclerosis-related diseases. Methods: This prospective cohort study was conducted from December 2009 to March 2015. Patients who underwent non-emergent coronary angiography (CAG) were included. The circulating EPC levels were measured using flow cytometry prior to the CAG procedure. The study evaluation of circulating EPC levels among patients with obstructive coronary artery disease (CAD) and other comorbidities. Patients were then assigned to tertiles by circulating EPC levels to evaluate the predictive values of the development of MACEs. Results: The study enrolled 1099 patients, of whom, 736 (67%) were men, with a mean age of 66.7 ± 12.5 years old. Overall, 637 (58%) patients were diagnosed with obstructive CAD according to CAG. MACE occurred in 268 (24.4%) patients. Circulating EPC levels were lower in patients with peripheral artery disease (PAD) but not associated with the presence of obstructive CAD, atrial fibrillation, chronic kidney disease (CKD), heart failure, and diabetes mellitus. Higher circulating EPC levels are linked with higher MACE among patients with suspected CAD, regardless of the presence or absence of obstructive CAD or CKD. The association did not present in patients with PAD. Conclusions: Higher circulating EPC levels are associated with a greater risk of MACE, regardless of the presence of obstructive CAD or CKD. This association was not apparent in the patients with PAD, suggesting impaired endothelial repair in these patients.
{"title":"Endothelial progenitor cells and major adverse cardiovascular events in patients receiving elective coronary angiography","authors":"Chung-Te Liu, Jiun-Yu Guo, R. Chou, Ya-Wen Lu, Y. Tsai, C. Kuo, Chun-Chin Chang, Po‐Hsun Huang, Jaw-wen Chen, Shing-Jong Lin","doi":"10.1097/CP9.0000000000000041","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000041","url":null,"abstract":"Background and purpose: The association of circulating endothelial progenitor cells (EPCs) with different cardiovascular diseases and their related major adverse cardiovascular events (MACE) remained inconclusive. We aimed to clarify associations between the circulating EPC levels and the risk of MACE concerning different atherosclerosis-related diseases. Methods: This prospective cohort study was conducted from December 2009 to March 2015. Patients who underwent non-emergent coronary angiography (CAG) were included. The circulating EPC levels were measured using flow cytometry prior to the CAG procedure. The study evaluation of circulating EPC levels among patients with obstructive coronary artery disease (CAD) and other comorbidities. Patients were then assigned to tertiles by circulating EPC levels to evaluate the predictive values of the development of MACEs. Results: The study enrolled 1099 patients, of whom, 736 (67%) were men, with a mean age of 66.7 ± 12.5 years old. Overall, 637 (58%) patients were diagnosed with obstructive CAD according to CAG. MACE occurred in 268 (24.4%) patients. Circulating EPC levels were lower in patients with peripheral artery disease (PAD) but not associated with the presence of obstructive CAD, atrial fibrillation, chronic kidney disease (CKD), heart failure, and diabetes mellitus. Higher circulating EPC levels are linked with higher MACE among patients with suspected CAD, regardless of the presence or absence of obstructive CAD or CKD. The association did not present in patients with PAD. Conclusions: Higher circulating EPC levels are associated with a greater risk of MACE, regardless of the presence of obstructive CAD or CKD. This association was not apparent in the patients with PAD, suggesting impaired endothelial repair in these patients.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 1","pages":"37 - 45"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48457163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-04-04DOI: 10.1097/CP9.0000000000000045
[This corrects the article DOI: 10.1097/CP9.0000000000000020.].
[这更正了文章DOI:10.1097/CP90000000000000020.]。
{"title":"Erratum to Stretococcus <i>gallolyticus</i> infective endocarditis, a different presentation-a case report.","authors":"","doi":"10.1097/CP9.0000000000000045","DOIUrl":"10.1097/CP9.0000000000000045","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1097/CP9.0000000000000020.].</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 1","pages":"67"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/1e/cp9-8-67.PMC10180010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9471441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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