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Do Post-Operative Electrocardiographic (ECG) Changes Indicate any Underlying Graft Problem after CABG? Correlation of Early Post-Operative ECG Changes with CT Coronary Angiography (CTCA) 冠状动脉搭桥术后的心电图变化是否表明有潜在的移植物问题?术后早期心电图变化与CT冠状动脉造影(CTCA)的相关性
Pub Date : 2023-01-01 DOI: 10.26502/fccm.92920323
Abhishek Rajendra Potnis, S. Potwar, B. Aironi, Dwarkanath Vivekanand Kulkarni, U. E. Jadhav, Gaurish Omprakash Sawant
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引用次数: 0
Peri-Coronary Sinus Flutter: A Unique Form of an Atypical Atrial Flutter. A Case Report 冠状动脉周围窦性扑动:非典型心房扑动的一种独特形式。病例报告
Pub Date : 2023-01-01 DOI: 10.26502/fccm.92920307
A. Ziakos, H. Greiss, Angelis Sezenias, A. Sause
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引用次数: 0
Myocarditis in COVID-19 Patients: A Cross-Sectional Study COVID-19患者心肌炎:一项横断面研究
Pub Date : 2023-01-01 DOI: 10.26502/fccm.92920316
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引用次数: 0
Dapagliflozin and Sitagliptin Combination Therapy: An Overview of Clinical Utility in Type 2 Diabetes Mellitus with Multiple Cardiovascular Risk Factors 达格列净和西格列汀联合治疗:合并多种心血管危险因素的2型糖尿病的临床应用综述
Pub Date : 2023-01-01 DOI: 10.26502/fccm.92920319
L. Ravikumar, Ravindra S Kiwalkar, R. H. S., Beerakayala Lokesh, Dhammdeep C. Dabhade
Cardiovascular disease remains the leading cause of mortality in patients with diabetes. Control of multiple cardiovascular risk factors in patients with type 2 diabetes mellitus often leads to substantial reduction in adverse cardiovascular events. Newer antihyperglycemic agents at several randomized controlled trials have demonstrated their cardiovascular safety along with reduction in cardiovascular outcomes in type 2 diabetes mellitus with or without heart failure. Sodium-glucose cotransporter 2 inhibitors and dipeptidyl peptidase-4 inhibitors reported to have positive CV outcomes; especially, combination therapy with dapagliflozin and sitagliptin seem to be suitable therapeutic option. However, data upon the fixed-dose combination of these agents is limited. This review discusses the rationale and clinical utility of combination therapy with dapagliflozin and sitagliptin in improving glycemic control and reducing cardiovascular events in patients with type 2 diabetes mellitus with multiple cardiovascular risk factors.
心血管疾病仍然是糖尿病患者死亡的主要原因。控制2型糖尿病患者的多种心血管危险因素通常会导致不良心血管事件的显著减少。在一些随机对照试验中,新的降糖药已经证明了它们的心血管安全性,并能降低伴有或不伴有心力衰竭的2型糖尿病患者的心血管结局。据报道,钠-葡萄糖共转运蛋白2抑制剂和二肽基肽酶-4抑制剂具有阳性的CV结果;特别是,达格列净和西格列汀联合治疗似乎是合适的治疗选择。然而,关于这些药物的固定剂量组合的数据有限。本文综述了达格列净和西格列汀联合治疗具有多种心血管危险因素的2型糖尿病患者血糖控制和减少心血管事件的原理和临床应用。
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引用次数: 0
Angiographic Findings in Unstable Angina and Prediction of 1-Year Risk of Recurrent Acute Coronary Syndrome or Death: A Nationwide Machine Learning Study 不稳定心绞痛的血管造影结果和预测1年复发急性冠脉综合征或死亡的风险:一项全国性的机器学习研究
Pub Date : 2023-01-01 DOI: 10.26502/fccm.92920330
T. Råmunddal, A. Rawshani, B. Redfors, P. Pétursson, O. Angerås, G. Hirlekar, D. Ioanes, J. Odenstedt, C. Dworeck, S. Völz, A. Myredal
Background: We studied whether machine learning could predict survival, risk of future acute coronary syndrome (ACS) and coronary angiographic (CAG) findings in patients with unstable angina (UA). We also studied whether high-sensitivity troponin levels within normal range can predict the presence of obstructive coronary lesions, risk of future ACS and death. Methods: We used the SWEDEHEART registry to include patients admitted to the coronary care unit due to chest pain, with normal high-sensitivity cardiac troponin T or I (hs-cTnI, hs-cTnT), who underwent CAG and did not receive a final diagnosis of acute myocardial infarction (AMI). We studied CAG findings on segmental level, developed machine learning models predicting the risk of ACS or death within 1-year, and angiographic findings. The latter model predicted CAG resulting in interventions (any) or eliciting further assessments after CAG. Models for ACS and death included 130 candidate predictors and models for angiographic findings included 110 predictors. Results: We included 9’314 patients; 1-year rate of death was 0.9% (n=78) and ACS was 2.7% (n=251). A total of 5455 (61.5%) of CAG resulted in no intervention and no further assessment afterwards, with 40% without significant stenosis. There was a strong association between hs-cTnI (within normal range) and severity of coronary atherosclerosis; e.g 32.4% in patients with hs-cTnI 26-35 ng/L had >50% stenosis in segment 6, as compared with 12.6% in those with hs-cTnI 0-5 ng/L. All segments displayed similar associations with troponin levels. Among 17 predictors for atherosclerosis, hs-cTnI was the strongest predictor of having >50% stenosis in the left anterior descending artery (LAD). Mortality increased at hs-cTnI levels above 10 ng/L for men, but not women. Age and sex adjusted hazard ratio for hs-cTnI 25-35 vs hs-TnI 0-5 was 5.73 (2.14-15.35) for 1-year mortality. No association was noted for hs-cTnT. The strongest predictors of 1-year mortality were C-reactive protein, body mass index, estimated glomerular filtration rate.
背景:我们研究了机器学习是否可以预测不稳定心绞痛(UA)患者的生存、未来急性冠脉综合征(ACS)的风险和冠状动脉造影(CAG)结果。我们还研究了正常范围内的高敏感性肌钙蛋白水平是否可以预测阻塞性冠状动脉病变的存在、未来ACS的风险和死亡。方法:我们使用SWEDEHEART登记纳入因胸痛而入住冠状动脉监护室的患者,高敏感性心肌肌钙蛋白T或I (hs-cTnI, hs-cTnT)正常,接受CAG且未接受最终诊断为急性心肌梗死(AMI)。我们研究了节段水平的CAG结果,开发了预测1年内ACS或死亡风险的机器学习模型,以及血管造影结果。后一种模型预测CAG导致干预(任何)或引发CAG后的进一步评估。ACS和死亡模型包括130个候选预测因子,血管造影结果模型包括110个预测因子。结果:我们纳入了9314例患者;1年死亡率为0.9% (n=78), ACS为2.7% (n=251)。5455例(61.5%)CAG患者未进行干预,术后无进一步评估,40%患者无明显狭窄。hs-cTnI(在正常范围内)与冠状动脉粥样硬化的严重程度有很强的相关性;例如,在hs-cTnI 26-35 ng/L的患者中,32.4%的患者6节段狭窄达50%,而hs-cTnI 0-5 ng/L的患者中,这一比例为12.6%。所有节段均与肌钙蛋白水平有相似的关联。在17个动脉粥样硬化的预测因子中,hs-cTnI是左前降支(LAD)狭窄50%的最强预测因子。hs-cTnI水平高于10纳克/升时,男性死亡率增加,但女性没有。年龄和性别调整后的hs-cTnI 25-35与hs-TnI 0-5的1年死亡率风险比为5.73(2.14-15.35)。hs-cTnT未见关联。1年死亡率最强的预测因子是c反应蛋白、体重指数、估计的肾小球滤过率。
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引用次数: 0
Synergy among Genes and Genes-Environment on Coronary Artery Disease Risk and Prognosis 基因和基因-环境对冠状动脉疾病风险和预后的协同作用
Pub Date : 2023-01-01 DOI: 10.26502/fccm.92920332
M. Mendonça, M. Santos, M. Temtem, Débora Sá, F. Sousa, E. Henriques, S. Freitas, S. Borges, M. Rodrigues, G. Guerra, A. Drumond, A. C. Sousa, R. Palma Reis
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引用次数: 0
The Safety of Heparin-Free Strategy in Patients Supported by Venoarterial Extracorporeal Membrane Oxygenation 静脉体外膜氧合支持患者无肝素策略的安全性
Pub Date : 2023-01-01 DOI: 10.26502/fccm.92920339
Dong Jung Kim, J. H. Lee, J. S. Kim, C. Lim, Kay-Hyun Park, H. Chang
Background: The necessity of heparinization during venoarterial extracorporeal membrane oxygenation (VA-ECMO) is well documented. However, heparinization can increase the risk of bleeding in certain situations. The aim of this study was to investigate the safety of a heparin-free strategy in patients on VA-ECMO. Methods: Data for 90 adult patients on VA-ECMO, wherein cannulation and maintenance were performed by cardiothoracic surgeons and support was provided for >24 h (2018–2021), were retrospectively reviewed. Patients were divided into two groups: heparin-free group, without heparinization for ≥ 24 h during VA-ECMO support (n = 66), and control group (n = 24). Clinical outcomes including hemorrhagic and thromboembolic complications were compared between the two groups. Results: The reasons for VA-ECMO support included post-cardiotomy cardiogenic shock in 37 patients (41.1%), and extracorporeal cardiopulmonary resuscitation in 44 patients (48.9%). The total duration of VA-ECMO was not significantly different between the two groups (132.3±106.1 vs. 141.6±117.9 h, P=0.734). In the heparin-free group, the duration of VA-ECMO without heparinization was 79.8±60.7 h, and 26 patients (39.4%) were completely heparin-free during the support period. No significant difference was found in the frequency of oxygenator changes due to thrombosis between the two groups (8.3 vs. 10.6%, P>0.999). Pump malfunction was not observed in any group. The overall incidence of thromboembolic complications was not significantly different between the two groups. Conclusion: No additional risk of thromboembolic complications was observed with the use of a heparin-free strategy during VA-ECMO support. Appropriate discontinuation of heparinization could be a safe strategy for VA-ECMO patients with active bleeding or a high hemorrhagic risk.
背景:静脉动脉体外膜氧合(VA-ECMO)过程中肝素化的必要性已得到充分证明。然而,在某些情况下,肝素化会增加出血的风险。本研究的目的是调查无肝素策略在VA-ECMO患者中的安全性。方法:回顾性分析90例成人VA-ECMO患者的数据,这些患者由心胸外科医生进行插管和维持,并提供bbbb24 h(2018-2021)的支持。将患者分为两组:无肝素组(66例)和对照组(24例)。无肝素组在VA-ECMO支持期间不进行肝素化治疗≥24 h。比较两组的临床结果,包括出血和血栓栓塞并发症。结果:采用VA-ECMO支持的原因包括开心术后心源性休克37例(41.1%),体外心肺复苏44例(48.9%)。VA-ECMO总持续时间两组比较差异无统计学意义(132.3±106.1∶141.6±117.9 h, P=0.734)。无肝素组未肝素化的VA-ECMO持续时间为79.8±60.7 h, 26例(39.4%)患者在支持期内完全无肝素。两组患者因血栓形成而改变氧合器的频率差异无统计学意义(8.3 vs 10.6%, P < 0.05 0.999)。各组均未见泵故障。两组血栓栓塞并发症的总发生率无显著差异。结论:在VA-ECMO支持期间,使用无肝素策略未观察到血栓栓塞并发症的额外风险。对于有活动性出血或高出血风险的VA-ECMO患者,适当停止肝素化可能是一种安全的策略。
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引用次数: 0
Metadichol Treatment of Fibroblasts and Embryonic Stem Cells Regulates Key Cardiac Progenitors 成纤维细胞和胚胎干细胞的二元醇处理调节关键的心脏祖细胞
Pub Date : 2023-01-01 DOI: 10.26502/fccm.92920340
Palayakotai R. Raghavan
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引用次数: 0
Prevalence and Associated Predictors of Hypertension in Adult Patients with Thyroid Nodules at the Royal Commission Hospital, Kingdom of Saudi Arabia. 沙特阿拉伯王国皇家委员会医院成年甲状腺结节患者高血压患病率及相关预测因素
Pub Date : 2023-01-01 DOI: 10.26502/fccm.9220303
Ahmed M Khair, Mona A Sid Ahmed, Faisal H Alharbi, Soha Hassan, Nusaiba M Elbadwi, Sami Naji Almutairi, Imad R Musa

Background: Hypertension and thyroid nodules (TNs) are common medical problems that are increasing in prevalence globally. Hence, we conducted this study to assess the prevalence and associated predictors of hypertension in adult patients with TNs at the Royal Commission Hospital, Kingdom of Saudi Arabia (KSA).

Methods: A retrospective study was conducted between 1 January 2015 and 31 December 2021. Patients with documented TNs based on the Thyroid Imaging Reporting and Data System (TI-RADS) were recruited to assess the prevalence and associated risk factors for hypertension.

Result: Three hundred ninety-one patients with TNs were recruited for this study. The median (interquartile range, IQR) age was 46.00 (20.0) years, and 332 (84.9%) of the patients were females. The median (IQR) body mass index (BMI) was 30.26 (7.71) kg/m2. There was a high prevalence of hypertension (22.5%) in adult patients with TNs. In the univariate analysis, there were significant associations between diagnosed hypertension in patients with TNs and age, sex, diabetes mellitus (DM), bronchial asthma, triiodothyronine (FT3), total cholesterol and high-density lipoprotein (HDL). In the multivariate analysis, age (OR = 1.076 [95% CI 1.048 - 1.105]), sex (OR = 2.28 [95% CI 1.132 - 4.591]), DM (OR = 0.316 [95% CI 0.175 - 0.573]) and total cholesterol levels (OR = 0.820 [95% CI 0.694 - 0.969]) were significantly associated with hypertension.

Conclusion: There is a high prevalence of hypertension in patients with TNs. Age, female sex, DM and elevated total cholesterol are significant predictors of hypertension in adult patients with TNs.

背景:高血压和甲状腺结节(TNs)是常见的医学问题,在全球范围内的患病率正在上升。因此,我们在沙特阿拉伯王国(KSA)皇家委员会医院进行了这项研究,以评估成年TNs患者的高血压患病率和相关预测因素。方法:2015年1月1日至2021年12月31日进行回顾性研究。根据甲状腺影像学报告和数据系统(TI-RADS),研究人员招募了有TNs记录的患者,以评估高血压的患病率和相关危险因素。结果:391例TNs患者被纳入本研究。年龄中位数(四分位间距,IQR)为46.00岁(20.0岁),女性332例(84.9%)。中位(IQR)体重指数(BMI)为30.26 (7.71)kg/m2。成年TNs患者高血压患病率较高(22.5%)。在单因素分析中,TNs患者的高血压诊断与年龄、性别、糖尿病(DM)、支气管哮喘、三碘甲状腺原氨酸(FT3)、总胆固醇和高密度脂蛋白(HDL)有显著相关。在多因素分析中,年龄(OR = 1.076 [95% CI 1.048 - 1.105])、性别(OR = 2.28 [95% CI 1.132 - 4.591])、糖尿病(OR = 0.316 [95% CI 0.175 - 0.573])和总胆固醇水平(OR = 0.820 [95% CI 0.694 - 0.969])与高血压有显著相关性。结论:TNs患者高血压患病率较高。年龄、女性、糖尿病和总胆固醇升高是成年TNs患者高血压的重要预测因素。
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引用次数: 0
Role of Sodium-Glucose Cotransporter Inhibitors in the Management of Heart Failure: A Position Statement 钠-葡萄糖共转运蛋白抑制剂在心力衰竭治疗中的作用:立场声明
Pub Date : 2023-01-01 DOI: 10.26502/fccm.92920326
P. Mohanan, V. Chopra, R. Yadav, J. Dalal, Mrinal Kanti Das, S. Ray, H. P, P. Kerkar
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引用次数: 0
期刊
Cardiology and cardiovascular medicine
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