Anatolian Journal of Cardiology最新文献

Background: Major cardiovascular events (MACE) are more common in type 2 diabetes mellitus (T2DM) patients, and early diagnosis can prevent significant morbidity and mortality. The aim of this study was to investigate the predictiveness of fragmented QRS (fQRS) showing MACE in T2DM patients.

Methods: A total of 227 T2DM patients (mean age 52, 51% male) without any cardiovascular disease who came to the cardiology outpatient clinic between March 01 and July 31, 2019, were included in the study. The patients were divided into 2 groups according to fQRS on electrocardiography (ECG), and 36 months of follow-up was done. The development of acute coronary syndrome, coronary revascularization, and cerebrovascular accident were accepted as MACE.

Results: More MACE was seen in the group with fQRS on ECG (P =.026). Although there were more fQRS in patients with proteinuria, it was not statistically significant (P =.069). More myocardial infarcts (7.9%) and more cerebrovascular events (6.3%) were seen in the group with fQRS. While revascularization was performed on 3 patients in the fQRS group, revascularization was not performed on the patients in the non-fqrs group. In multiple Cox regression analysis, fQRS showed an independent predictor of MACE [P =.025, hazard ratio = 2.42 (1.117-5.221)], more MACE was seen in the fQRS (+) group in the kaplan-meier analysis (P =.022).

Conclusion: More MACE was seen in the fQRS group in T2DM patients without a previous history of cardiovascular events. Fragmented QRS was found to be an independent predictor in showing MACE. Care should be taken in terms of MACE development in T2DM patients with fQRS.

Background: Supraflex (Sahajanand Medical Technologies Limited, Surat, India) is a new-generation, biodegradable polymer-coated sirolimus-eluting stent (SES) designed on an ultrathin (60 µm) cobalt-chromium platform with a flexible 'S-link.' The S-FLEX Slovakia registry aimed to assess the safety and effectiveness of Supraflex SES in an all-comers population, with a subgroup of diabetic patients.

Methods: This was a prospective, observational, multi-center, post-market registry conducted between February 2018 and May 2019. All consecutive patients with symptomatic coronary artery disease scheduled for percutaneous coronary intervention with Supraflex SES were enrolled. The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, target vessel myocardial infarction (TV-MI), or clinically indicated target lesion revascularization (CI-TLR) by percutaneous or surgical methods at 1-year follow-up. Stent thrombosis was a safety endpoint.

Results: A total of 413 patients was assessed (145 diabetics and 268 nondiabetics). At 1-year follow-up, the primary endpoint of TLF occurred in 5.1% patients, comprised of 3.9% cardiac deaths, 0.5% TV-MI, and 0.7% CI-TLR. Overall stent thrombosis occurred in 0.5% patients at 1-year follow-up. In the subgroup analysis, TLF occurred in 6.2% diabetics and 4.5% nondiabetics (P =.433) and comprised 4.8% and 3.4% cardiac deaths (P =.447), 0.7% and 0.4% TV-MI (P =.653), and 0.7%, and 0.7% CI-TLR (P =.952) in diabetics and non-diabetics, respectively. Overall stent thrombosis occurred in 0.7% diabetic and 0.4% non-diabetic patient (P =.659).

Conclusion: This registry demonstrates favourable clinical outcomes after the implantation of the ultrathin biodegradable polymer coated Supraflex SES in an all-comers population, with event rates that were similar in diabetic and nondiabetic patients.

Myocardial ischemia/reperfusion injury (MIRI) is a pathophysiological process connected to the onset of numerous heart disorders. The pathogenesis of MIRI is complex, and it mainly involves calcium overload, classic oxidative stress, mitochondrial disorder, inflammation, microvascular disorder, and cell death. The clinical treatment options for MIRI are presently constrained, making it imperative to develop new treatment modalities. Recent studies have demonstrated that ferroptosis is the main cause of MIRI. Ferroptosis is a new type of regulated iron-dependent cell death whose mechanism and targeted therapy are anticipated to be novel therapeutic techniques for MIRI. Herein, the primary mechanism underlying ferroptosis (the 3 major metabolic routes involving iron, amino acids, and lipids, and in MIRI, the specific mechanism and therapeutic target of ferroptosis) are discussed to determine the potential therapeutic approach for MIRI.

Background: Computed tomography (CT) image integration is of limited use in left ventricular (LV) ablation due to inadequate accuracy of registration. The current study aimed to investigate the accuracy and feasibility of extra-cavity LV image registration via the coronary cusp.

Methods: Consecutive patients were enrolled as the validation group (n = 41) and feasibility group (n = 48). After extra-cavity registration via the aortic root, the LV anatomy derived from CT image was activated and moved into real space. Accuracy of LV anatomy via this registration method was verified by intracardiac echocardiography reconstruction in the validation group and tested further in the feasibility group via measuring the location differences (<3 mm) and volume difference (<8 mL).

Results: In validation group, the LV volume of CT image and ICE map were comparable (113.6 ± 15.5 mL vs. 109.0 ± 15.3 mL, P =.27), and the location difference was 3.1 ± 1.1 mm at LV summit, 1.8 ± 0.9 mm at the free wall, and 1.8 ± 0.7 mm at the LV apex. There was a mean of 2.9 ± 1.2 mm and 3.0 ± 1.0 mm length difference in anterior PM and posterior PM, the position difference of the PM's base was 2.8 ± 0.9 mm for anterior PM and 2.2 ± 0.9 mm for posterior PM. In feasibility group, the distance differences of LV summit, LV septum, LV apex, and LV free averaged 1.8 ± 0.8 mm, 1.5 ± 0.7 mm, 1.4 ± 0.6 mm, 1.3 ± 0.7 mm, respectively. Compared with validation group, acute success (100% vs. 96.5%, P =.51), complications rate (4.9% vs. 2.0%, P = 0.59) and fluoroscopic time (1.6 ± 1.1 vs. 1.9 ± 1.6 minutes, P =.30) exhibited no significant difference, but was significantly reduced with procedure time (74.5 ± 8.1 vs. 61.2 ± 9.5 minutes, P <.001) with CT image registration only.

Conclusion: LV mapping and ablation could be successfully achieved by extra-cavity registration via coronary cusp without needing positions within LV beforehand.

Background: This study aimed to analyze trends in the burden of myocarditis in the Chinese population during 1990-2019.

Methods: The Global Burden of Disease (GBD) database aims to assess the burden of various diseases and injuries on a global scale, and the contribution of relevant risk factors to the burden of disease was also included. In this study, we collected age-standardized incidence and mortality rates for myocarditis in China from 1990 to 2019 using GBD 2019. The age-period-cohort model was utilized to calculate local drift, longitudinal age patterns, as well as the ratios of period and cohort.

Results: The age-standardized incidence and mortality rates of myocarditis in both men and women presented a decreasing trend during 1990-2019 [average annual percentage change (AAPC) of men = -0.202 (95% CI: -0.213 to -0.191); AAPC of women = -0.263 (95% CI: -0.27 to -0.256) for incidence; AAPC of men = -0.233 (95% CI: -0.371 to -0.094); AAPC of women = -0.872 (95% CI: -1.112 to -0.631) for mortality]. Longitudinal age curves showed that myocarditis incidence and mortality rates elevated with age among individuals aged 15-95+ years, with a higher growth rate in men than in women. The period and cohort ratios for both men and women showed similar decreasing trends. Local drift values for the incidence and mortality rates of myocarditis showed an increasing trend among individuals aged 70-75 years and above.

Conclusion: Although the overall burden of myocarditis in China presented a decreasing trend during 1990-2019, the male and elderly populations still have a higher risk of incidence and mortality. Therefore, it is essential for the health-care system to introduce effective prevention and treatment measures for myocarditis.

Resistance exercise is a form of exercise that increases muscular strength and endurance by exercising a muscle or muscle group against external resistance. Resistance exercises have an important potential in preventing cardiac diseases, increasing treatment efficiency, and improving quality of life. In spite of the fact that the vast majority of cardiology research to date has focused on aerobic exercise, an increasing number of studies on resistance exercise have been published in the past few years. Although resistance exercise was combined with aerobic exercise in most of these studies, its isolated efficacy was also examined. In conditions such as coronary artery disease, peripheral artery disease, heart failure, arrhythmias, and cardiac rehabilitation, resistance exercise (RE) is regarded as a potentially beneficial approach. In addition to interventional and medical treatments, resistance exercise can also be considered as a cost-effective and sustainable method. The effects of resistance exercise on a variety of cardiovascular conditions were investigated in this evaluation of the literature.