American heart journal plus : cardiology research and practice最新文献_第2页

Implantable loop recorder migration: Case-based review and implications for clinical practice

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-01-30 DOI: 10.1016/j.ahjo.2025.100505

Allam Harfoush

Introduction

Implantable loop recorders (ILRs) are vital for continuous rhythm monitoring; however, post-implantation migration can impair device function. ILR migration may range from minor positional shifts causing discomfort to severe displacement, potentially resulting in device malfunction or requiring surgical intervention. This review examines migration patterns to identify factors associated with ILR migration.

Methods

A systematic literature search was conducted in PubMed, Cochrane Library, CINAHL, and EMBASE for case reports on ILR migration from inception to October 2024. Data on patient demographics, comorbidities, device models, implantation sites, detection times, and interventions were qualitatively synthesised to identify factors linked to migration.

Results

Older age, female gender, and specific comorbidities emerged as migration risk factors. Device implantation angulation and depth were common contributors. Migration typically followed a posterior or inferior direction and was detected within 5–35 days, often presenting as loss of connection or continuous chest pain. Migration was also observed following patient manipulation of the device. Although migration is rare, cases requiring video-assisted thoracoscopic surgery (VATS) highlight the significant morbidity associated with this complication.

Conclusion

Optimising implantation techniques and employing effective follow-up strategies can reduce the risk of migration and improve migration detection. Further studies with standardised reporting are needed to better understand this complication.

{"title":"Implantable loop recorder migration: Case-based review and implications for clinical practice","authors":"Allam Harfoush","doi":"10.1016/j.ahjo.2025.100505","DOIUrl":"10.1016/j.ahjo.2025.100505","url":null,"abstract":"<div><h3>Introduction</h3><div>Implantable loop recorders (ILRs) are vital for continuous rhythm monitoring; however, post-implantation migration can impair device function. ILR migration may range from minor positional shifts causing discomfort to severe displacement, potentially resulting in device malfunction or requiring surgical intervention. This review examines migration patterns to identify factors associated with ILR migration.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in PubMed, Cochrane Library, CINAHL, and EMBASE for case reports on ILR migration from inception to October 2024. Data on patient demographics, comorbidities, device models, implantation sites, detection times, and interventions were qualitatively synthesised to identify factors linked to migration.</div></div><div><h3>Results</h3><div>Older age, female gender, and specific comorbidities emerged as migration risk factors. Device implantation angulation and depth were common contributors. Migration typically followed a posterior or inferior direction and was detected within 5–35 days, often presenting as loss of connection or continuous chest pain. Migration was also observed following patient manipulation of the device. Although migration is rare, cases requiring video-assisted thoracoscopic surgery (VATS) highlight the significant morbidity associated with this complication.</div></div><div><h3>Conclusion</h3><div>Optimising implantation techniques and employing effective follow-up strategies can reduce the risk of migration and improve migration detection. Further studies with standardised reporting are needed to better understand this complication.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"51 ","pages":"Article 100505"},"PeriodicalIF":1.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160061","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}

引用次数: 0

Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot study

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-01-30 DOI: 10.1016/j.ahjo.2025.100502

Sakshi Shiromani , Ahmed AlBadri , Aaron Lindeke-Myers , Arielle Schwartz , Nishant Vatsa , Esha Dave , Fauzia Rashid , Nieraj Jain , Puja K. Mehta

Objective

To compare retinal microvascular density among women with ischemia with no obstructive coronary artery disease (INOCA) with and without coronary microvascular dysfunction (CMD).

Design

Cross-sectional study.

Setting

Patients with myocardial INOCA often have CMD, possibly indicating systemic vascular dysfunction. While retinal microvasculature relates to many cardiovascular risk factors, its link with CMD remains unknown.

Participants

Women with INOCA (N = 18) and coronary function testing were enrolled and classified into CMD and non-CMD groups, with CMD defined as coronary flow reserve (CFR) <2.5 in response to adenosine.

Interventions

Participants underwent retinal optical coherence tomography angiography for noninvasive imaging of the retinal microvasculature.

Main outcome measures

Vessel density, perfusion density, and area, perimeter, and circularity of the foveal avascular zone (FAZ). Non-parametric statistics were used for comparisons.

Results

Mean age was 54.7 (SD 12.5) years. The CMD (N = 11) and non-CMD (N = 7) groups were balanced with respect to age, BMI, systemic diseases including diabetes, hypertension, and hyperlipidemia, and medications. Those with CMD had a lower retinal vessel density [20.9 (0.7) vs 21.6(0.8), p = 0.006] and lower inner perfusion density [38.5 (1.6) vs 41.2 (0.8), p = 0.006] as compared to those without CMD. There were no differences in the FAZ area, perimeter, or circularity.

Conclusions

In this study of women with INOCA, those with CMD showed lower retinal microvascular and perfusion densities than those without CMD. Direct, non-invasive retinal imaging is feasible, affordable, and may reflect coronary microvascular function in INOCA patients. A larger study, including men, is needed to confirm these findings.

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引用次数: 0

Sex and race disparities in emergency department patients with chest pain and a detectable or mildly elevated troponin

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-01-01 DOI: 10.1016/j.ahjo.2024.100495

Lucas M. Boyer , Anna C. Snavely , Jason P. Stopyra , Subha V. Raman , Jeffrey M. Caterino , Carol L. Clark , Alan E. Jones , Michael E. Hall , Carolyn J. Park , Brian C. Hiestand , Sujethra Vasu , Michael A. Kutcher , W. Gregory Hundley , Simon A. Mahler , Chadwick D. Miller

Background

Identifying and eliminating health disparities is a public health priority. The goal of this analysis is to determine whether cardiac testing or outcome disparities exist by race or sex in patients with detectable to mildly elevated serum troponin.

Methods

We conducted a secondary analysis of the CMR-IMPACT trial that randomized patients with symptoms suggestive of acute coronary syndrome and a detectable or mildly elevated troponin measure from 4 US hospitals to an early invasive angiography or cardiac MRI strategy. The primary endpoint was the composite of all-cause mortality, myocardial infarction, cardiac hospital readmission, and repeat cardiac ED. Secondary outcomes were components of the composite and revascularization.

Results

Participants (n = 312, mean age 61 ± 11 years) were 36.2 % non-white and 40.1 % female. The composite outcome occurred in 63.7 % of non-white vs. 49.8 % of white patients (aHR 1.50, 95 % CI 1.08–2.09) and 53.6 % of female vs. 55.6 % of male patients (aHR 0.93, 95 % CI 0.68–1.28). Non-white (aHR 0.57, 95 % CI 0.35–0.92) patients had lower rates of revascularization also less median stenosis (p < 0.001) and stenosis >70 % (p < 0.001) during index cardiac testing. Despite these findings, ACS after discharge was higher among non-white patients (aHR 1.84, 95 % CI 1.11–3.05). Females had lower rates of revascularization (aHR 0.52, 95 % CI 0.33–0.82), but no increase in ACS after discharge (aHR 0.90, 95 % CI 0.55–1.49).

Conclusion

Non-white patients had higher rates of ACS following discharge despite lower rates of obstructive CAD following standardization of index cardiac testing. Future disparity works should explore care following the index encounter.

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引用次数: 0

Accurate diagnosis of ischemic heart disease without exposure to radiation using non-stress unshielded magnetocardiography 无应激无屏蔽心脏磁图在不暴露于辐射的情况下准确诊断缺血性心脏病。

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-01-01 DOI: 10.1016/j.ahjo.2024.100483

Kirsten Tolstrup , Massoud Akhtari , Donatella Brisinda , Anna M. Meloni , Robert J. Siegel , Riccardo Fenici

Study objectives

To evaluate the capability and accuracy of magnetocardiography (MCG) to identify patients with ischemic chest pain from those with non-ischemic pain and to verify normalcy in the MCG in healthy subjects.

Design

We studied 133 patients (mean age 59 ± 14 years, 69 % male) with chronic or acute chest pain syndrome and 63 healthy subjects (mean age 41.7 ± 12.2 years, 51 % male) using unshielded cryogenically cooled MCG systems (Cardiomag Imaging Inc., 9 and 36 channels) in a general clinical setting. Scan time was 90 s to 6 min. Interventions: The MCG data were processed with the same automated analysis software and results were immediately available. All patients were chest pain free at the time of scanning.

Results

A diagnosis of ischemic chest pain was established in 41 % after non-invasive and invasive testing. Rest MCG was normal in all healthy subjects. An abnormal rest MCG was strongly associated with ischemic chest pain, p < 0.0001 (sensitivity of 86 %, specificity of 80 %, positive (PPV) and negative predictive value (NPV) of 75 % and 89 %, respectively). In comparison, the sensitivity, specificity, PPV and NPV of stress SPECT was 93 %, 72 %, 77 % and 91 %, respectively.

Conclusion

Resting MCG is a rapid risk-free method for the detection of ischemic chest pain without the use of radiation or contrast with results comparable with stress SPECT.

研究目的：评价心磁图（MCG）鉴别缺血性胸痛和非缺血性胸痛的能力和准确性，并验证健康人的MCG是否正常。设计：我们研究了133例慢性或急性胸痛综合征患者（平均年龄59±14岁，69%男性）和63名健康受试者（平均年龄41.7±12.2岁，51%男性），在一般临床环境中使用无屏蔽低温冷却MCG系统（Cardiomag Imaging Inc.， 9和36通道）。扫描时间为90秒至6分钟。干预措施：采用相同的自动分析软件处理MCG数据，并立即获得结果。所有患者在扫描时均无胸痛。结果：41%的患者经无创和有创检查诊断为缺血性胸痛。所有健康受试者休息时的MCG均正常。结论：静息MCG是一种快速无风险的检测缺血性胸痛的方法，无需使用辐射或与应激SPECT的结果相比较。

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引用次数: 0

Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER database 美国房颤患者卒中相关死亡率趋势：来自CDC WONDER数据库的见解

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-01-01 DOI: 10.1016/j.ahjo.2024.100491

Muhammad Abdullah Naveed , Sivaram Neppala , Himaja Dutt Chigurupati , Muhammad Omer Rehan , Ahila Ali , Hamza Naveed , Bazil Azeem , Rabia Iqbal , Manahil Mubeen , Mashood Ahmed , Ayman R. Fath , Timir Paul , Muhammad Bilal Munir

Background

Stroke associated with atrial fibrillation (AF) is a significant cause of mortality. This study analyzed demographic trends and disparities in mortality rates due to stroke in AF patients aged ≥25 years.

Methods

A retrospective analysis was conducted to acquire death data using the Centers for Disease Control and Prevention database from 1999 to 2020. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 persons, and trends were assessed using Average Annual Percentage Change (AAPC) and annual percent change (APC). Data were stratified by year, sex, race/ethnicity, and geographical regions.

Results

Between 1999 and 2020, AF-associated stroke contributed to 331,106 deaths among adults in this study population. Deaths occurred predominantly in medical facilities (43.2 %). The overall AAMR for AF-associated stroke decreased from 7.4 in 1999 to 6.4 in 2020, with an APC of −1.02 (p-value = 0.004). Additionally, AAMR showed a significant decline from 2015 to 2018 with an APC of −7.22 (p-value <0.000001), followed by a striking rise from 2018 to 2020 (APC: 4.98) (p-value = 0.0008). Women had slightly higher AAMR than men (men: 6.6; women: 7.1) (p value = 0.02). AAMRs varied among racial/ethnic groups, with Whites having the highest AAMR (7.4), followed by Blacks (5.4), American Indian or Alaska Natives (4.6), Asian or Pacific Islanders (4.5), and Hispanics (4.1). AAMRs decreased for all races except Blacks. Geographically, AAMRs ranged from 4.3 in Nevada to 11.9 in Vermont, with the Western region showing the highest mortality (AAMR: 7.9). Nonmetropolitan areas had slightly higher AAMRs than metropolitan areas, with both experiencing a decrease over the study period.

Conclusion

This analysis depicts significant demographic and geographic disparities in mortality rates attributed to stroke associated with AF. Targeted interventions and equitable healthcare access are crucial to mitigate these disparities and improve outcomes for this population.

背景：卒中合并心房颤动（AF）是导致死亡的重要原因。本研究分析了年龄≥25岁的房颤患者卒中死亡率的人口统计学趋势和差异。方法：回顾性分析1999年至2020年美国疾病预防控制中心数据库的死亡数据。计算每10万人的年龄调整死亡率（AAMRs），并使用平均年百分比变化（AAPC）和年百分比变化（APC）评估趋势。数据按年份、性别、种族/民族和地理区域分层。结果：在1999年至2020年期间，房颤相关中风导致该研究人群中331,106名成年人死亡。死亡主要发生在医疗设施（43.2%）。af相关卒中的总体AAMR从1999年的7.4下降到2020年的6.4，APC为-1.02 （p值= 0.004）。此外，2015 - 2018年AAMR呈显著下降趋势，APC为-7.22 （p值p值= 0.02）。AAMR因种族/民族而异，白人的AAMR最高（7.4），其次是黑人（5.4），美洲印第安人或阿拉斯加原住民（4.6），亚洲或太平洋岛民（4.5）和西班牙裔（4.1）。除黑人外，所有种族的aamr都有所下降。从地理上看，AAMR从内华达州的4.3到佛蒙特州的11.9不等，西部地区的死亡率最高（AAMR: 7.9）。非大都市地区的aamr略高于大都市地区，在研究期间两者都有所下降。结论：该分析描述了房颤相关卒中死亡率的显著人口统计学和地理差异。有针对性的干预措施和公平的医疗服务获取对于缓解这些差异和改善这一人群的预后至关重要。

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引用次数: 0

Establishment of a nomogram that predicts the risk of heart failure in hemodialysis patients 建立预测血液透析患者心力衰竭风险的线图。

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-01-01 DOI: 10.1016/j.ahjo.2024.100487

Jie Luo, Zhangru Rui, Yun He, Hui Li, Yang Yuan, Wenhong Li

Chronic kidney disease (CKD) is expected to become the fifth leading cause of death globally by 2040. Cardiovascular disease (CVD), particularly heart failure (HF), is a severe complication in CKD patients on hemodialysis. This study aimed to develop a nomogram to predict the risk of heart failure hospitalization in hemodialysis patients, providing a valuable tool for clinical decision-making. We retrospectively analyzed data from 196 patients at Kunming Yanan Hospital's hemodialysis center, including demographic, dialysis-related, and laboratory information. Significant HF predictors identified through univariate and multivariate logistic regression were age, diabetes, dialysis duration, left ventricular mass index (LVMI), albumin (ALB), and ejection fraction (EF). These predictors formed the basis of the nomogram, which demonstrated good discrimination (AUC = 0.728) and calibration (Hosmer-Lemeshow test, P = 0.463). Decision curve analysis confirmed the nomogram's clinical utility across various threshold probabilities. This study's findings can help clinicians identify high-risk patients, improving management strategies and potentially reducing HF-related hospitalizations in the hemodialysis population.

预计到2040年，慢性肾脏疾病（CKD）将成为全球第五大死亡原因。心血管疾病（CVD），特别是心力衰竭（HF），是CKD患者血液透析的严重并发症。本研究旨在建立一种预测血液透析患者心力衰竭住院风险的nomogram方法，为临床决策提供有价值的工具。我们回顾性分析了昆明延安医院血液透析中心196例患者的资料，包括人口统计、透析相关和实验室信息。通过单变量和多变量logistic回归确定的显著HF预测因子为年龄、糖尿病、透析持续时间、左心室质量指数（LVMI）、白蛋白（ALB）和射血分数（EF）。这些预测因子构成了模态图的基础，具有良好的判别性（AUC = 0.728）和校准性（Hosmer-Lemeshow检验，P = 0.463）。决策曲线分析证实了nomogram在不同阈值概率下的临床效用。这项研究的发现可以帮助临床医生识别高危患者，改善管理策略，并有可能减少血液透析人群中与hf相关的住院治疗。

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引用次数: 0

Comparing predictive risk to actual presence of coronary atherosclerosis on coronary computed tomography angiography 冠状动脉计算机断层血管造影预测风险与实际存在冠状动脉粥样硬化的比较。

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-01-01 DOI: 10.1016/j.ahjo.2024.100493

Emma Playford , Simon Stewart , Gerard Hoyne , Geoff Strange , Girish Dwivedi , Christian Hamilton-Craig , Gemma Figtree , David Playford

Background

There is limited data showing the predictive accuracy of traditional cardiovascular risk scores (CVRS) to predict asymptomatic coronary artery disease (CAD) determined by coronary computed tomography angiography (CCTA).

Methods

Asymptomatic individuals without known CAD undergoing a screening CCTA and sufficient data to calculate their CVRS, were extracted retrospectively. Atherosclerosis was extracted using natural language processing of the CCTA report, including the coronary artery calcium score (CACS) and the extent and severity of CAD. Absence of atherosclerosis was defined as both zero plaque and zero CACS, and atherosclerosis was defined as low, moderate, or extensive by location and extent of plaque-burden. CVRS was categorized as high (>15 %), moderate (10–15 %), low (1–9 %) and “zero” (<1 %) risk.

Results

828 individuals (median age 58.6, IQR = 52.0, 65.3 years, 57 % male) met inclusion criteria, and a zero, low, moderate, and high CVRS was identified in 13, 483, 113 and 219 individuals (8 %, 49 %, 74 %, 66 % male), respectively. Predominantly low plaque-burden atherosclerosis was detected in 548 scans (67 % male). However, of the 137 males and 68 females with extensive atherosclerosis, 47 (34 %) and 38 (56 %) respectively had low CVRS classification. Overall, 23 % of males and 31 % of females had CAD predicted by CVRS (Monte Carlo: females, p = 0.024; males, p < 0.001), but there was little to no agreement between CVRS and atherosclerosis burden (Cohen's kappa: males, κ = 0.149; females, κ = 0.096).

Conclusions

In asymptomatic individuals without known CAD, a low CVRS does not exclude extensive CAD. Newer tools incorporating additional markers may be helpful in risk prediction in such individuals.

背景：有有限的数据显示，传统心血管风险评分（CVRS）预测无症状冠状动脉疾病（CAD）的准确性是由冠状动脉计算机断层扫描血管造影（CCTA）确定的。方法：回顾性提取没有已知CAD的无症状个体，进行筛查CCTA，并提供足够的数据来计算其CVRS。使用自然语言处理CCTA报告提取动脉粥样硬化，包括冠状动脉钙评分（CACS）和CAD的程度和严重程度。无动脉粥样硬化被定义为零斑块和零CACS，根据斑块负担的位置和程度，动脉粥样硬化被定义为低、中度或广泛。结果：828例（中位年龄58.6岁，IQR = 52.0, 65.3岁，57%男性）符合纳入标准，其中13例、483例、113例和219例（男性分别占8%、49%、74%和66%）CVRS为零、低、中、高。548次扫描中主要检测到低斑块负荷动脉粥样硬化（67%为男性）。然而，在广泛动脉粥样硬化的137名男性和68名女性中，分别有47名（34%）和38名（56%）的CVRS分级较低。总体而言，23%的男性和31%的女性有CVRS预测的CAD (Monte Carlo：女性，p = 0.024；男性，p κ = 0.149；雌性，κ = 0.096)。结论：在没有已知CAD的无症状个体中，低CVRS并不排除广泛的CAD。包含额外标记的新工具可能有助于这些个体的风险预测。

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引用次数: 0

Cathepsin-D and outcomes in peripartum cardiomyopathy: Results from IPAC 围产期心肌病组织蛋白酶- d与预后：来自IPAC的结果。

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-01-01 DOI: 10.1016/j.ahjo.2024.100489

Vincenzo B. Polsinelli , Karen Hanley-Yanez , Charles F. McTiernan , Kalgi Modi , Jennifer Haythe , Hal Skopicki , Uri Elkayam , Leslie T. Cooper Jr , James D. Fett , Dennis M. McNamara , for the IPAC investigators

Objective

Evaluate the relationship of cathepsin-D (CD) on disease severity and clinical outcomes for women with peripartum cardiomyopathy.

Background

Cathepsin-D is a protease released during oxidative stress that cleaves prolactin (PRL) generating a 16 kDa fragment that is pro-apoptotic, anti-angiogenic, and has been implicated in the pathogenesis of peripartum cardiomyopathy (PPCM).

Methods

In 99 women with newly diagnosed PPCM enrolled in the Investigation in Pregnancy Associated Cardiomyopathy (IPAC) study, CD levels were assessed by ELISA from serum obtained at study entry. Left ventricular ejection fraction (LVEF) was assessed by echocardiography at entry, 6, and 12-months. CD levels were compared to healthy PP and non-PP controls. Survival free from major cardiovascular events (death, transplantation, or left ventricular assist device) was determined up to 12 months post-partum (PP).

Results

Mean age was 30 ± 6 years, with a baseline LVEF of 34 % ± 10. Cathepsin-D levels were higher in PPCM women (278 ± 114 ng/ml) than in healthy PP (190 ± 74, p = 0.02) and healthy non-PP controls (136 ± 79, p < 0.001). There was no association of CD with age, breastfeeding status, or time from delivery to the presentation. Cathepsin-D levels were higher in women with higher New York Heart Association (NYHA) functional class (p = 0.001). Higher tertiles of CD levels were associated with lower event-free survival (p = 0.008).

Conclusions

In this prospective cohort of women with PPCM, higher CD levels at the time of diagnosis were associated with worse symptoms, less recovery of LVEF, and worse clinical outcomes. Circulating CD may contribute to the development of PPCM and influence disease severity, myocardial recovery, and clinical outcomes.

目的：探讨组织蛋白酶- d （CD）与围生期心肌病患者病情严重程度及临床预后的关系。背景：Cathepsin-D是一种在氧化应激过程中释放的蛋白酶，可裂解催乳素（PRL），产生一个16kda的促凋亡、抗血管生成片段，并与围产期心肌病（PPCM）的发病机制有关。方法：入选妊娠相关心肌病调查（IPAC）研究的99名新诊断PPCM的妇女，在研究开始时通过ELISA检测血清中的CD水平。左心室射血分数（LVEF）在入院、6个月和12个月时通过超声心动图评估。将健康PP组和非PP组的CD水平进行比较。无主要心血管事件（死亡、移植或左心室辅助装置）的生存期直至产后12个月（PP）。结果：平均年龄30±6岁，基线LVEF为34%±10。PPCM妇女的Cathepsin-D水平（278±114 ng/ml）高于健康PP组（190±74,p = 0.02）和健康非PP组（136±79,p = 0.001）。较高的CD水平与较低的无事件生存率相关（p = 0.008）。结论：在这个PPCM女性的前瞻性队列中，诊断时较高的CD水平与更严重的症状、更少的LVEF恢复和更差的临床结果相关。循环CD可能促进PPCM的发展，影响疾病严重程度、心肌恢复和临床结果。

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引用次数: 0

Clinical recommendations for telehealth and electronic consultations in the veterans health administration referral coordination initiative 退伍军人保健管理局转诊协调倡议中远程保健和电子咨询的临床建议。

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-01-01 DOI: 10.1016/j.ahjo.2024.100492

David E. Winchester , Lisa Arfons

Telemedicine

Veterans health services

Cardiology

Referral

Consultation

远程医疗退伍军人保健服务心脏病转诊咨询。

引用次数: 0

Leveraging the postpartum period to reduce racial disparities in postpartum hypertension care 利用产后期减少产后高血压护理中的种族差异。

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-01-01 DOI: 10.1016/j.ahjo.2024.100490

Malamo E. Countouris , Jared W. Magnani

Pregnancy provides a window of opportunity for management of hypertension care. Particularly in the postpartum period – the so-called “4th trimester” – individuals of Black race are at increased risk for hypertension-related morbidity and mortality. Telehealth interventions, such as remote blood pressure monitoring programs and virtual postpartum visits, can reduce racial disparities in the delivery of recommended care. System and policy changes can address social factors that impact postpartum care as well. Cardiovascular clinicians have a key role to play in managing hypertension and addressing cardiovascular disease prevention strategies during reproductive years.

妊娠期为高血压护理管理提供了机会之窗。特别是在产后阶段，即所谓的“第四孕期”，黑人患高血压相关疾病和死亡的风险更高。远程保健干预措施，如远程血压监测方案和虚拟产后访问，可以减少在提供推荐护理方面的种族差异。制度和政策的变化也可以解决影响产后护理的社会因素。心血管临床医生在管理高血压和解决育龄期心血管疾病预防策略方面发挥着关键作用。

引用次数: 0