The European journal of cardiovascular medicine最新文献

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Effects of Aerobic Fitness and Adiposity on Coagulation Biomarkers in Men vs. Women with Elevated Blood Pressure. 有氧健身和肥胖对血压升高男性与女性凝血生物标志物的影响

The European journal of cardiovascular medicine

Pub Date : 2012-09-01 Epub Date: 2012-09-24

Kathleen L Wilson, Lianne Tomfohr, Kate Edwards, Cindy Knott, Suzi Hong, Laura Redwine, Karen Calfas, Cheryl L Rock, Roland von Känel, Paul J Mills

A hypercoagulable state is a potential mechanism linking elevated blood pressure (BP), adiposity and a sedentary lifestyle to development of coronary heart disease (CHD). We examined relationships among aerobic fitness and adiposity in 76 sedentary subjects with elevated BP. Blood levels of plasminogen activator inhibitor-1 (PAI-1), D-dimer, von Willebrand factor (vWF) and thrombomodulin were assessed as biomarkers of coagulation. In individuals with elevated BP, percent body fat and fitness were associated with biomarkers indicative of a hypercoagulable state, even after demographic and metabolic factors were considered. D-dimer was positively associated with percent body fat (beta=0.37, p=0.003). PAI-1 was higher in men than in women (beta=-0.31, p=0.015) and associated with lower VO2peak (beta=-0.35, p=0.024). Thrombomodulin was positively associated with VO2peak (beta=0.56, p< 0.01). vWF was not significantly associated with fitness or adiposity. Our results emphasise that both percent body fat and physical fitness are important in the maintenance of haemostatic balance.

高凝状态是将血压（BP）升高、肥胖和久坐不动的生活方式与冠心病（CHD）发展联系起来的潜在机制。我们研究了 76 名血压升高的久坐受试者的有氧健身和脂肪之间的关系。血液中的纤溶酶原激活物抑制剂-1（PAI-1）、D-二聚体、von Willebrand因子（vWF）和血栓调节蛋白水平作为凝血的生物标志物进行了评估。在血压升高的人群中，即使考虑了人口和代谢因素，体脂百分比和体能也与指示高凝状态的生物标志物相关。D 二聚体与体脂百分比呈正相关（β=0.37，P=0.003）。男性的 PAI-1 高于女性（β=-0.31，p=0.015），并与较低的 VO2 峰值相关（β=-0.35，p=0.024）。血栓调节蛋白与 VO2peak 呈正相关（β=0.56，p< 0.01）。我们的研究结果强调，体脂率和体能对维持止血平衡都很重要。

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引用次数: 0

Optimal Antihypertensive Combination Treatments 最佳抗高血压联合治疗

The European journal of cardiovascular medicine

Pub Date : 2012-03-01 DOI: 10.5083/EJCM.20424884.76

M. Volpe, G. Tocci, S. A. Omar

引用次数: 0

Comparison of Hybrid and Norwood Strategies in Hypoplastic Left Heart Syndrome 混合策略与诺伍德策略治疗左心发育不全综合征的比较

The European journal of cardiovascular medicine

Pub Date : 2012-03-01 DOI: 10.5083/EJCM.20424884.70

H. Kato, O. Honjo, C. Caldarone, G. Arsdell

The Norwood-based strategy for single ventricle palliation has improved with technical innovations and refinements over the last decades; such as regional cerebral perfusion during aortic arch reconstruction [1], placement of a right ventricle-to-pulmonary artery (RV-PA) shunt rather than a systemic-to-pulmonary shunt [2, 3], and the concept of aggressive afterload reduction to maximise oxygen delivery following Norwood procedure [4, 5].

在过去的几十年里，随着技术的创新和改进，基于诺伍德的单心室姑息策略得到了改进;例如主动脉弓重建[1]期间的局部脑灌注，放置右心室-肺动脉(RV-PA)分流而不是全身-肺分流[2,3]，以及在Norwood手术后积极减少后负荷以最大限度地输送氧气的概念[4,5]。

引用次数: 3

Drug-eluting Balloons in Coronary Artery Disease: Past, Present and Future 药物洗脱气球在冠状动脉疾病中的应用:过去、现在和未来

The European journal of cardiovascular medicine

Pub Date : 2012-03-01 DOI: 10.5083/EJCM.20424884.69

A. Belkacemi, P. Stella, M. Voskuil, K. Onsea, Chunlai Shao, P. Doevendans, Pierfrancesco Agoston

The use of drug eluting stents (DES) majorly reduced in-stent restenosis though preventing not only recoil of the vessel wall and late negative remodelling, but also significantly inhibiting neo-intimal hyperplasia formation. However, concerns about in-stent thrombosis, and the dependency on prolonged dual antiplatelet therapy, and continued restenosis in complex lesion subsets, led to a search for alternative treatment devices that will tackle restenosis rates without the drawbacks associated with DES.2-5 1. University Medical Center Utrecht, department of Interventional Cardiology

药物洗脱支架(DES)的使用不仅可以防止血管壁反冲和晚期负性重构，还可以显著抑制新内膜增生的形成，从而减少支架内再狭窄。然而，对支架内血栓形成的担忧，对长期双重抗血小板治疗的依赖，以及复杂病变亚群中持续的再狭窄，导致寻找替代治疗设备，以解决再狭窄率，而没有des相关的缺点。乌得勒支大学医学中心介入心脏病学系

引用次数: 0

How To Prevent Foot Ulcers In Diabetic Patients 如何预防糖尿病患者足部溃疡

The European journal of cardiovascular medicine

Pub Date : 2012-03-01 DOI: 10.5083/EJCM.20424884.75

G. Morshed

Among diabetics, 15% are at risk of developing foot ulcers(1). Annual incidence ranges between 1% to 4.1%(2) and prevalence is between 4% to 10%(3-4). Diabetic foot problems are one of the commonest causes of admission to hospital for diabetic sufferers, and diabetics are affected more than non diabetics(5). Foot ulcers affect the physical and emotional state of diabetic persons and can lead to financial losses(6-9).

在糖尿病患者中，15%有患足部溃疡的风险(1)。年发病率在1%至4.1%之间(2)，患病率在4%至10%之间(3-4)。糖尿病足问题是糖尿病患者入院的最常见原因之一，糖尿病患者比非糖尿病患者受影响更大(5)。足部溃疡会影响糖尿病患者的身体和情绪状态，并可能导致经济损失(6-9)。

引用次数: 1

Echocardiographic Partition Values and Prevalence of Left Ventricular Hypertrophy in Hypertensive Jamaicans 超声心动图分割值和流行的左心室肥厚高血压牙买加人

The European journal of cardiovascular medicine

Pub Date : 2012-02-01 DOI: 10.5083/EJCM.20424884.73

Chiranjivi Potu, Edwin Tulloch-Reid, Dainia S. Baugh, Olusegun. A Ismail, E. Madu

Background: Left ventricular hypertrophy (LVH) detected by either electrocardiography or echocardiography has been shown to be an extremely strong predictor of morbidity and mortality in patients with essential hypertension and in members of the general population. Alternative to LVH, left ventricular geometrical patterns offer incremental prognostic value beyond that provided by the other cardiovascular risk factors including left ventricular mass (LVM). Combination of LVM and relative wall thickness (RWT) can be used to identify different left ventricular geometrical patterns. Various indexation methods normalised for LVM have been shown to offer prognostic significance. There was no prior study on the prevalence of LVH and geometric patterns in hypertensive patients in Jamaica using multiple partition values. Our study was designed to estimate the prevalence of LVH and geometrical patterns in a hypertensive Caribbean population in Jamaica using 10 different published cut-off values. Methods: Clinical and echocardiographic data were collected from 525 consecutive hypertensive patients attending the cardiology clinic of the Heart Institute of the Caribbean over a period of 24 months who met the inclusion criteria for the study. LVM was calculated using different methods of indexation for body size and different partition values (PV) to identify LVH as described below: LVM/ BSA (g/m 2 ) PVs for men/women 116/104, 125/110, 125/125, 131/100; LVM/height (g/m) PVs 143/102, 126/105; LVM/height 2.0 PV 77.5/58.0; LVM/height 2.13 PV 68/61 and LVM/height 2.7 (g/m 2.7 ) PVs 51/51 and 49.2/46.7. RWT was calculated using the formula 2 X Posterior Wall Thickness (PWT)/ Left Ventricular Internal Diameter in diastole (LVIDd). Left ventricular geometrical patterns were categorised utilising the RWT and LVM. The impact of selected indexation methods and PVs on the prevalence of LVH and geometrical patterns were analysed. Results: Complete data was obtained in 501(95.5%) of the 525 subjects (40.5% men & 59.5% women). The prevalence of LVH ranged between 19.3–38.5%. The highest prevalence of LVH was found when the LVM was indexed to the height with a partition value of 126 g/ht in men and 105 g/ht in women and height raised to the power of 2.7 with a partition value of 49.2 g/ht 2.7 in men and 46.7 g/ht 2.7 in women. Abnormal LV geometry ranged between 71.4-77.8%. Concentric remodelling was the most common type of abnormal geometry (38.5-52.1%) while the eccentric hypertrophy was the least common type (3.99-10.3%) found for all indexation methods and partition values. Concentric hypertrophy (15.3-28.9%) was the second most common type of abnormal geometry found in our patients.

背景:通过心电图或超声心动图检测到的左心室肥厚(LVH)已被证明是原发性高血压患者和普通人群中发病率和死亡率的一个极其强大的预测指标。作为LVH的替代方案，左心室几何形态提供了比其他心血管危险因素(包括左心室质量(LVM))更大的预后价值。结合LVM和相对壁厚(RWT)可以识别不同的左心室几何模式。为LVM标准化的各种指数化方法已被证明具有预后意义。在牙买加，尚无使用多分区值对高血压患者LVH患病率和几何模式的研究。我们的研究旨在使用10个不同的已公布的临界值来估计牙买加加勒比地区高血压人群中LVH的患病率和几何模式。方法:临床和超声心动图数据收集525名连续24个月在加勒比海心脏研究所心脏病学诊所就诊的符合研究纳入标准的高血压患者。LVM采用不同的身体大小指标法和不同的分区值(PV)计算，确定LVH如下:LVM/ BSA (g/ m2)男性/女性的PV为116/104、125/110、125/125、131/100;LVM/高度(g/m) pv: 143/102、126/105;LVM/高度2.0 PV 77.5/58.0;LVM/高度2.13 PV 68/61和LVM/高度2.7 (g/m 2.7) PV 51/51和49.2/46.7。RWT采用公式2 ×后壁厚度(PWT)/左心室舒张内径(LVIDd)计算。利用RWT和LVM对左心室几何模式进行分类。分析了所选择的指数方法和pv对LVH患病率和几何模式的影响。结果:525例受试者中有501例(95.5%)获得完整资料，其中男性40.5%，女性59.5%。LVH患病率在19.3 ~ 38.5%之间。当LVM以身高为指标时，LVH的患病率最高，男性为126 g/ht，女性为105 g/ht，身高增加到2.7次，男性为49.2 g/ht 2.7，女性为46.7 g/ht 2.7。左室几何形态异常在71.4 ~ 77.8%之间。同心重构是最常见的几何异常类型(38.5-52.1%)，而偏心肥大是最不常见的类型(3.99-10.3%)。同心肥大(15.3-28.9%)是我们患者中第二常见的几何形状异常类型。

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引用次数: 3

Management Options in Atrial Fibrillation – The Role of Vernakalant 房颤的治疗选择-维那卡兰特的作用

The European journal of cardiovascular medicine

Pub Date : 2012-01-01 DOI: 10.5083/EJCM.20424884.61

S. Hohnloser, S. A. Omar

AF is characterised by uncoordinated electrical activation of the atria, apparent as the absence of coordinated P waves on the ECG. This rapid supraventricular activity then leads to an irregularly irregular and usually rapid ventricular response rate.[1] The pathophysiology of AF is complex and likely to be multifactorial. Its existence is reliant on the structural and electrical remodelling of the left atrium, which provides the substrate that sustains the arrhythmia. Often, AF is initiated by a trigger originating from the root of the pulmonary veins. [2, 3]

房颤的特征是心房不协调的电激活，明显表现为心电图上没有协调的P波。这种快速的室上活动随后导致不规则且通常快速的心室反应率房颤的病理生理是复杂的，可能是多因素的。它的存在依赖于左心房的结构和电重构，它提供了维持心律失常的基质。房颤通常是由肺静脉根部的触发引起的。(2、3)

引用次数: 0

A review of risk factors and cardiovascular disease in diabetes care - 2011 糖尿病护理中的危险因素和心血管疾病综述- 2011

The European journal of cardiovascular medicine

Pub Date : 2011-08-01 DOI: 10.5083/EJCM.20424884.43

J. Cederholm, P. Nilsson

Evidence exists today from observational studies that hyperglycemia is an important risk factor for cardiovascular diseases, with a risk increase per 1 %-unit increase in HbA1c of 27% in type 1 diabetes (1) and 11-16% in type 2 diabetes (2, 3), independently of clinical characteristics and other traditional risk factors. A risk reduction by glucose-lowering has most obviously been demonstrated in patients with type 1 diabetes, often younger or middle-aged with less traditional risk factors than patients with type 2 diabetes.

目前有观察性研究证据表明，高血糖是心血管疾病的重要危险因素，1型糖尿病患者HbA1c每增加1%，其风险增加27%(1)，2型糖尿病患者每增加1%，其风险增加11% -16%(2,3)，独立于临床特征和其他传统危险因素。在1型糖尿病患者中，通过降低血糖来降低风险的效果最为明显，1型糖尿病患者通常是年轻人或中年人，与2型糖尿病患者相比，他们的传统风险因素较少。

引用次数: 9

Epicardial Ventricular Tachycardia Ablation: Clinical Practice and Recent Developments 心外膜室性心动过速消融:临床实践和最新进展

The European journal of cardiovascular medicine

Pub Date : 2011-08-01 DOI: 10.5083/EJCM.20424884.48

M. Efremidis, G. Kollias, Athens Greece

It is ambiguous whether one should use this approach only after an endocardial VT ablation failure or when the ECG of clinical VT suggests an epicardial origin. Consequently, multiple published ECG criteria may be used to predict epicardial VT origin. A maximal deflection index (MDI, the longest precordial lead onset-peak time divided by total QRS duration) of 0.55 or more is reported to identify idiopathic epicardial VT with high sensitivity and specificity (4).

引用次数: 0

Gastrointestinal Complications Following Heart Surgery: An Updated Review 心脏手术后的胃肠道并发症:最新综述

The European journal of cardiovascular medicine

Pub Date : 2011-08-01 DOI: 10.5083/EJCM.20424884.32

D. Karangelis, K. Oikonomou, T. Koufakis, G. Tagarakis

Gastrointestinal (GI) complications occurring after cardiac surgery are considered as “second line” complications due to their scarcity. Cardiac surgeons, ICU staff and nursing personnel are usually aware and suspicious of cardiac-related mishappenings after heart surgery; however they often tend to underestimate potentially lethal manifestations involving the gastrointestinal track, or organs of the abdomen and subsequent complications because of their relative infrequency and the fact that they lack a “visible connection” to the primary target organ of the operation.

心脏手术后发生的胃肠道(GI)并发症由于其稀缺性被认为是“二线”并发症。心脏外科医生、ICU工作人员和护理人员通常对心脏手术后发生的与心脏相关的意外事件有所了解和怀疑;然而，他们往往倾向于低估潜在的致命表现，包括胃肠道或腹部器官以及随后的并发症，因为它们相对较少，而且它们与手术的主要目标器官缺乏“可见联系”。

引用次数: 10

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