Pub Date : 2022-04-01DOI: 10.1097/CP9.0000000000000016
Bei Liu, Shujuan Yang, Lixia Yang, Bin Zhang, R. Guo
Abstract Background and purpose: Poor ST-segment resolution (STR) is strongly associated with poor prognosis in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). previous studies suggested higher HCY level in the people who live in high altitudes, so a retrospective analysis is conducted to examine the potential relationship between elevated serum HCY and poor STR after PPCI at high altitudes. Methods: This retrospective analysis included 308 high-altitude dwelling patients (1800-2200 meters elevation from the sea level) undergoing PPCI for STEMI during a period from September 2021 to March 2022. Clinical data were collected and statistically analyzed. Results: In comparison to the patients with normal plasma homocysteine (≤15 mmol/L; n = 155), patients with elevated homocysteine (>15 mmol/L) had higher percentage of men (92.81% vs. 80.00%; p = 0.001) and smoker (79.08% vs. 63.87%; p = 0.003), but no difference in other key baseline characteristics. The rate of complete ST-segment resolution after PPCI (≥ 70%) was 83.23% in the control group and 49.67% in the elevated HCY group (p ≤ 0.001). In multivariable regression analysis, poor ST-segment resolution (<70%) was independently associated with longer pain-to-balloon time (OR 0.832; 95%CI: 0.775–0.894), lower uric acid (OR 1.003; 95%CI: 1.000-1.005), and elevated HCY (OR 0.957 vs. normal HCY; 95%CI: 0.937–0.977). Conclusion: Elevated plasma HCY level was associated with poor ST segment resolution in patients undergoing PPCI STEMI at high altitude.
{"title":"Elevated plasma homocysteine level is associated with poor ST-segment resolution in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention at high altitude","authors":"Bei Liu, Shujuan Yang, Lixia Yang, Bin Zhang, R. Guo","doi":"10.1097/CP9.0000000000000016","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000016","url":null,"abstract":"Abstract Background and purpose: Poor ST-segment resolution (STR) is strongly associated with poor prognosis in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). previous studies suggested higher HCY level in the people who live in high altitudes, so a retrospective analysis is conducted to examine the potential relationship between elevated serum HCY and poor STR after PPCI at high altitudes. Methods: This retrospective analysis included 308 high-altitude dwelling patients (1800-2200 meters elevation from the sea level) undergoing PPCI for STEMI during a period from September 2021 to March 2022. Clinical data were collected and statistically analyzed. Results: In comparison to the patients with normal plasma homocysteine (≤15 mmol/L; n = 155), patients with elevated homocysteine (>15 mmol/L) had higher percentage of men (92.81% vs. 80.00%; p = 0.001) and smoker (79.08% vs. 63.87%; p = 0.003), but no difference in other key baseline characteristics. The rate of complete ST-segment resolution after PPCI (≥ 70%) was 83.23% in the control group and 49.67% in the elevated HCY group (p ≤ 0.001). In multivariable regression analysis, poor ST-segment resolution (<70%) was independently associated with longer pain-to-balloon time (OR 0.832; 95%CI: 0.775–0.894), lower uric acid (OR 1.003; 95%CI: 1.000-1.005), and elevated HCY (OR 0.957 vs. normal HCY; 95%CI: 0.937–0.977). Conclusion: Elevated plasma HCY level was associated with poor ST segment resolution in patients undergoing PPCI STEMI at high altitude.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"92 - 96"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48473235","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 : 2022-03-01DOI: 10.1097/CP9.0000000000000007
E. Ruffino, M. Gori, E. D’Elia, E. Sciatti, V. Shi, M. Senni
Abstract Heart failure with reduced ejection fraction (HFrEF) is a common disease requiring multi-drug therapy. Moreover, it is associated with a poor prognosis, with increasing prevalence in the community. In the last decade, two major drug classes were introduced to the heart failure (HF) specialist's arsenal: angiotensin receptor neprilysin inhibitors (ARNIs) and sodium-glucose-cotransporter 2 inhibitors (SGLT2is). The current paradigm of sequential drug therapy is changing, favoring a multi-drug combination therapy upfront, including four “pillar” classes: beta-blockers, mineralcorticoid receptor antagonists (MRAs), ARNIs, and SGLT-2is. Recent putative placebo analyses of large-scale randomized clinical trials compared a combination of all four drug classes with a standard of care and was in favor of the multi-drug combination revealing a hazard ratio for cardiovascular (CV) death and HF hospitalization of 0.5 and 0.32, respectively. We reviewed the approval landmark trials for the four drug classes and have subincluded a short comment about the implications and impact of each study in clinical practice. Moreover, we present more detailed trials concerning the use of these drugs in different settings (eg, acute phase, in-hospital, and outpatient) and more data about the clinical, biochemical, functional, and echographic remodeling effects of the molecules. The results of the meta-analyses and putative placebo analyses in the literature we reviewed suggest the benefit of offering all the best therapy available upfront. This approach ensures maximal life expectancy gain, especially in younger patients, and cuts the costs of rehospitalizations. Thus, this review underlines the importance of the four-drug approach to HFrEF therapy, as recently stated in the ESC guidelines.
{"title":"Four aces of heart failure therapy: systematic review of established and emerging therapies for heart failure with reduced ejection fraction","authors":"E. Ruffino, M. Gori, E. D’Elia, E. Sciatti, V. Shi, M. Senni","doi":"10.1097/CP9.0000000000000007","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000007","url":null,"abstract":"Abstract Heart failure with reduced ejection fraction (HFrEF) is a common disease requiring multi-drug therapy. Moreover, it is associated with a poor prognosis, with increasing prevalence in the community. In the last decade, two major drug classes were introduced to the heart failure (HF) specialist's arsenal: angiotensin receptor neprilysin inhibitors (ARNIs) and sodium-glucose-cotransporter 2 inhibitors (SGLT2is). The current paradigm of sequential drug therapy is changing, favoring a multi-drug combination therapy upfront, including four “pillar” classes: beta-blockers, mineralcorticoid receptor antagonists (MRAs), ARNIs, and SGLT-2is. Recent putative placebo analyses of large-scale randomized clinical trials compared a combination of all four drug classes with a standard of care and was in favor of the multi-drug combination revealing a hazard ratio for cardiovascular (CV) death and HF hospitalization of 0.5 and 0.32, respectively. We reviewed the approval landmark trials for the four drug classes and have subincluded a short comment about the implications and impact of each study in clinical practice. Moreover, we present more detailed trials concerning the use of these drugs in different settings (eg, acute phase, in-hospital, and outpatient) and more data about the clinical, biochemical, functional, and echographic remodeling effects of the molecules. The results of the meta-analyses and putative placebo analyses in the literature we reviewed suggest the benefit of offering all the best therapy available upfront. This approach ensures maximal life expectancy gain, especially in younger patients, and cuts the costs of rehospitalizations. Thus, this review underlines the importance of the four-drug approach to HFrEF therapy, as recently stated in the ESC guidelines.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"20 - 28"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48294937","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 : 2022-03-01DOI: 10.1097/CP9.0000000000000003
Yawei Yang, Jun Yuan, Jing-Fen Xing, M. Fan
Abstract Background: Left ventricular noncompaction (LVNC) is a rare type of cardiomyopathy. The core clinical feature is heart failure that responds poorly to treatments. Case presentation: A 58-year-old woman received various treatments (including metoprolol, benazepril, torasemide, spirolactone, and digoxin) for 4 years for LVNC, but responded poorly. Upon presentation, transthoracic echocardiogram (ECHO) showed 26% left ventricular ejection fraction (LVEF) and class IV diastolic dysfunction. Upon cardiac magnetic resonance imaging (CMRI), the ratio of noncompacted versus compacted myocardium was 3.9. She received guideline-recommended treatments that included sacubitril-valsartan (100 mg/day) in addition to β-blocker, torasemide, spirolactone, digoxin, and isosorbide. Symptoms and signs improved rapidly, and she was discharged 1 week later. Sacubitril-valsartan dosage was adjusted to 200 mg/day 4 weeks later. She remained in relatively good health thereafter. At the last follow-up 16 months later, LVEF was 51% on ECHO. CMRI showed the significantly reduced ratio of 2.8 in noncompacted versus compacted myocardium. Conclusions: Sacubitril-valsartan therapy may result in reverse remodeling and improve long-term outcomes in LVNC patients.
{"title":"Sacubitril-valsartan therapy in a patient with heart failure due to isolated left ventricular noncompaction: a case report and literature review","authors":"Yawei Yang, Jun Yuan, Jing-Fen Xing, M. Fan","doi":"10.1097/CP9.0000000000000003","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000003","url":null,"abstract":"Abstract Background: Left ventricular noncompaction (LVNC) is a rare type of cardiomyopathy. The core clinical feature is heart failure that responds poorly to treatments. Case presentation: A 58-year-old woman received various treatments (including metoprolol, benazepril, torasemide, spirolactone, and digoxin) for 4 years for LVNC, but responded poorly. Upon presentation, transthoracic echocardiogram (ECHO) showed 26% left ventricular ejection fraction (LVEF) and class IV diastolic dysfunction. Upon cardiac magnetic resonance imaging (CMRI), the ratio of noncompacted versus compacted myocardium was 3.9. She received guideline-recommended treatments that included sacubitril-valsartan (100 mg/day) in addition to β-blocker, torasemide, spirolactone, digoxin, and isosorbide. Symptoms and signs improved rapidly, and she was discharged 1 week later. Sacubitril-valsartan dosage was adjusted to 200 mg/day 4 weeks later. She remained in relatively good health thereafter. At the last follow-up 16 months later, LVEF was 51% on ECHO. CMRI showed the significantly reduced ratio of 2.8 in noncompacted versus compacted myocardium. Conclusions: Sacubitril-valsartan therapy may result in reverse remodeling and improve long-term outcomes in LVNC patients.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"56 - 59"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41676095","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 : 2022-03-01DOI: 10.1097/cp9.0000000000000005
Y. Dai, J. Ge
{"title":"Managing residual inflammatory risk in atherosclerotic cardiovascular disease: another piece of the puzzle?","authors":"Y. Dai, J. Ge","doi":"10.1097/cp9.0000000000000005","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000005","url":null,"abstract":"","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43142371","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 : 2022-03-01DOI: 10.1097/CP9.0000000000000009
Yu-Juan Yu, Y. Tse, Siyun Yu, L. Lam, K. Li, Yan Chen, Mei-Zhen Wu, Q. Ren, S. Yu, P. Wong, H. Tse, K. Yiu
Abstract Background: Patients who undergo concomitant aortic and mitral double valve replacement (DVR) have poor postoperative clinical outcomes. The modified Model for End-Stage Liver Disease excluding international normalized ratio (MELD-XI) score and the modified Model for End-Stage Liver Disease score with albumin replacing international normalized ratio (MELD-albumin) score have been reported as predictors of adverse events in hepato-cardiac diseases. The objective of this study was to assess the clinical prognostic value of the two modified Model for End-Stage Liver Disease (MELD) scores in patients undergoing DVR. Methods: A total of 210 patients undergoing DVR were evaluated. Baseline clinical and laboratory parameters were recorded, and EuroSCORE II was calculated for each patient. The outcome of interest was the composite of heart failure hospitalization and cardiovascular mortality. Results: Patients undergoing DVR had a high prevalence of hepato-renal dysfunction. During a median follow-up of 71 months, the MELD-XI and MELD-Albumin scores independently predicted adverse outcomes (hazard ratio [95% confidence interval] = 1.09 [1.03–1.16] and 1.11 [1.06–1.16], P < 0.01, respectively). Kaplan–Meier analysis demonstrated that high MELD-XI and MELD-Albumin scores were associated with an increased risk of adverse events. MELD-Albumin provided incremental prognostic value to clinical parameters and EuroSCORE II (net reclassification index [NRI] = 0.34; P < 0.01). Conclusions: Both the MELD-XI score and MELD-Albumin score can provide useful information to predict adverse outcomes in patients undergoing DVR. The present study supports the monitoring of modified MELD scores to improve preoperative risk stratification for these patients.
{"title":"Prognostic value of MELD-XI and MELD-Albumin scores in double valve replacement","authors":"Yu-Juan Yu, Y. Tse, Siyun Yu, L. Lam, K. Li, Yan Chen, Mei-Zhen Wu, Q. Ren, S. Yu, P. Wong, H. Tse, K. Yiu","doi":"10.1097/CP9.0000000000000009","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000009","url":null,"abstract":"Abstract Background: Patients who undergo concomitant aortic and mitral double valve replacement (DVR) have poor postoperative clinical outcomes. The modified Model for End-Stage Liver Disease excluding international normalized ratio (MELD-XI) score and the modified Model for End-Stage Liver Disease score with albumin replacing international normalized ratio (MELD-albumin) score have been reported as predictors of adverse events in hepato-cardiac diseases. The objective of this study was to assess the clinical prognostic value of the two modified Model for End-Stage Liver Disease (MELD) scores in patients undergoing DVR. Methods: A total of 210 patients undergoing DVR were evaluated. Baseline clinical and laboratory parameters were recorded, and EuroSCORE II was calculated for each patient. The outcome of interest was the composite of heart failure hospitalization and cardiovascular mortality. Results: Patients undergoing DVR had a high prevalence of hepato-renal dysfunction. During a median follow-up of 71 months, the MELD-XI and MELD-Albumin scores independently predicted adverse outcomes (hazard ratio [95% confidence interval] = 1.09 [1.03–1.16] and 1.11 [1.06–1.16], P < 0.01, respectively). Kaplan–Meier analysis demonstrated that high MELD-XI and MELD-Albumin scores were associated with an increased risk of adverse events. MELD-Albumin provided incremental prognostic value to clinical parameters and EuroSCORE II (net reclassification index [NRI] = 0.34; P < 0.01). Conclusions: Both the MELD-XI score and MELD-Albumin score can provide useful information to predict adverse outcomes in patients undergoing DVR. The present study supports the monitoring of modified MELD scores to improve preoperative risk stratification for these patients.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"39 - 47"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43026756","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 : 2022-03-01DOI: 10.1097/CP9.0000000000000004
B. He, Panyang Xu, Qi Zhou, J. Xu, Lu Cai
Abstract Background: Previous studies suggested higher serum N-terminal-pro-B-type natriuretic peptide (NT-proBNP) level with older age and in women, but the reference intervals (RIs) recommended by assay manufacturers do not fully recognize such pattern. Aims: In this study, we aimed to establish a set of age- and sex-specific RIs for serum NT-proBNP in healthy adults from Northeast China. Methods: Healthy adult subjects (20 to ≤95 years old) were recruited from the physical examination center at a teaching hospital during a period from March 2020 to July 2020. Serum NT-proBNP concentration was measured using the VITROS 5600 Integrated System with a chemiluminescence method. RIs were calculated based on the EP28-A3c guidelines by the Clinical and Laboratory Standards Institute. A generalized linear model was performed to factors that were associated with NT-proBNP level. Results: The final analysis included 2,183 subjects (1,074 men and 1,109 women, mean age 54.2 ± 19.5 years). Serum NT-proBNP level increased with advancing age (20 to <50, 50 to <60, 60 to <75 and ≥75 years), and was significantly higher in women than in men with the exception of the ≥75 age group. Higher NT-proBNP level was associated with the female sex, older age, lower body mass index, higher urea nitrogen, higher creatinine, lower uric acid, and lower triglyceride (P < 0.05 for all). The strongest association was with the female sex, followed by age. Conclusions: Serum NT-proBNP level must be interpreted with consideration of sex and age. Higher NT-proBNP is associated with the female sex and older age.
{"title":"Serum N-terminal-pro-B-type natriuretic peptide is dependent on age and sex: a cross-sectional analysis in healthy adults from Northeast China","authors":"B. He, Panyang Xu, Qi Zhou, J. Xu, Lu Cai","doi":"10.1097/CP9.0000000000000004","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000004","url":null,"abstract":"Abstract Background: Previous studies suggested higher serum N-terminal-pro-B-type natriuretic peptide (NT-proBNP) level with older age and in women, but the reference intervals (RIs) recommended by assay manufacturers do not fully recognize such pattern. Aims: In this study, we aimed to establish a set of age- and sex-specific RIs for serum NT-proBNP in healthy adults from Northeast China. Methods: Healthy adult subjects (20 to ≤95 years old) were recruited from the physical examination center at a teaching hospital during a period from March 2020 to July 2020. Serum NT-proBNP concentration was measured using the VITROS 5600 Integrated System with a chemiluminescence method. RIs were calculated based on the EP28-A3c guidelines by the Clinical and Laboratory Standards Institute. A generalized linear model was performed to factors that were associated with NT-proBNP level. Results: The final analysis included 2,183 subjects (1,074 men and 1,109 women, mean age 54.2 ± 19.5 years). Serum NT-proBNP level increased with advancing age (20 to <50, 50 to <60, 60 to <75 and ≥75 years), and was significantly higher in women than in men with the exception of the ≥75 age group. Higher NT-proBNP level was associated with the female sex, older age, lower body mass index, higher urea nitrogen, higher creatinine, lower uric acid, and lower triglyceride (P < 0.05 for all). The strongest association was with the female sex, followed by age. Conclusions: Serum NT-proBNP level must be interpreted with consideration of sex and age. Higher NT-proBNP is associated with the female sex and older age.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"48 - 55"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47379031","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 : 2022-03-01DOI: 10.1097/cp9.0000000000000001
Magnus Bäck, M. Hashem, A. Giani, S. Pawelzik, A. Franco-Cereceda
{"title":"Calcific aortic valve stenosis and COVID-19: clinical management, valvular damage, and pathophysiological mechanisms","authors":"Magnus Bäck, M. Hashem, A. Giani, S. Pawelzik, A. Franco-Cereceda","doi":"10.1097/cp9.0000000000000001","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000001","url":null,"abstract":"","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45433050","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 : 2022-03-01DOI: 10.1097/CP9.0000000000000008
Shidi Hu, Ji'e Yang, Feng Zhang
Abstract Primary percutaneous coronary intervention is the current standard treatment for myocardial infarction, but is associated with ischemia/reperfusion injury for which inflammation is an important part. This review summaries the recent findings in the study of pro- and anti-inflammatory signaling pathways (eg, TLR4/Myd88/NF-κB, MAPKs/NF-κB, NLRP3 inflammasome, JAK2/STAT3, and Nrf2/HO-1) in myocardial ischemia/reperfusion injury, as well as relevant drug development efforts. Despite of the vast body of literature, no concrete advances have been made in translating the new knowledge into clinical practice, but we do anticipate major breakthroughs in the foreseeable future.
{"title":"Signaling pathways of inflammation in myocardial ischemia/reperfusion injury","authors":"Shidi Hu, Ji'e Yang, Feng Zhang","doi":"10.1097/CP9.0000000000000008","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000008","url":null,"abstract":"Abstract Primary percutaneous coronary intervention is the current standard treatment for myocardial infarction, but is associated with ischemia/reperfusion injury for which inflammation is an important part. This review summaries the recent findings in the study of pro- and anti-inflammatory signaling pathways (eg, TLR4/Myd88/NF-κB, MAPKs/NF-κB, NLRP3 inflammasome, JAK2/STAT3, and Nrf2/HO-1) in myocardial ischemia/reperfusion injury, as well as relevant drug development efforts. Despite of the vast body of literature, no concrete advances have been made in translating the new knowledge into clinical practice, but we do anticipate major breakthroughs in the foreseeable future.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"29 - 38"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44708546","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 : 2021-10-01DOI: 10.4103/2470-7511.334396
W. Pan, Nan-Chao Hong, J. Ge, Da-Xin Zhou
Prognosis in subjects with coronary artery fistula (CAF) is highly variable. CAF may remain asymptomatic throughout the entire lifetime in some; however, in others, CAF may become hemodynamically significant and complications ensue. CAF closure, either surgically or via a transcatheter approach, eliminates the underlying anatomical anomaly but is associated with a variety of complications, including but not limited to coronary thrombosis and even full-blown myocardial infarction. In this review, we summarize the evidence that argued for versus against CAF closure and attempt to provide a balanced view of the benefits versus harm of CAF closure in patients with different types of CAF.
{"title":"Coronary artery fistula: To close or not close, that is the question","authors":"W. Pan, Nan-Chao Hong, J. Ge, Da-Xin Zhou","doi":"10.4103/2470-7511.334396","DOIUrl":"https://doi.org/10.4103/2470-7511.334396","url":null,"abstract":"Prognosis in subjects with coronary artery fistula (CAF) is highly variable. CAF may remain asymptomatic throughout the entire lifetime in some; however, in others, CAF may become hemodynamically significant and complications ensue. CAF closure, either surgically or via a transcatheter approach, eliminates the underlying anatomical anomaly but is associated with a variety of complications, including but not limited to coronary thrombosis and even full-blown myocardial infarction. In this review, we summarize the evidence that argued for versus against CAF closure and attempt to provide a balanced view of the benefits versus harm of CAF closure in patients with different types of CAF.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"6 1","pages":"256 - 263"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45288638","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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