Anatolian Journal of Cardiology最新文献

Background: The oscillometrically measured ankle-brachial index (omABI), which is determined by the ratio of ankle to brachial systolic blood pressure measured through oscillography, has been demonstrated as a robust predictor of cardiovascular events. However, the reliability of mean arterial pressure measured by oscillography may be higher than that of systolic blood pressure based on the principle of oscillographic oscillation. We aimed to compare the predictive value of oscillometrically measured ankle-tobrachial mean arterial pressure ratio (omMAPR) and omABI for cardiovascular events and all-cause mortality.

Methods: The observation cohort consisted of a total of 37 803 employees from the Chinese Kailuan Group who underwent limb blood pressure measurements during their participation in physical examination between 2010 and 2017.

Results: After an average follow-up period of 3 years, a total of 589 cardiovascular events and 570 cases of all-cause mortality were observed. The predictive performance of omMAPR was found to be slightly superior to omABI in terms of cardiovascular events (C-statistics: 0.55 vs. 0.51, P < .001) and all-cause mortality (C-statistics: 0.60 vs. 0.55, P <.001). After adjusting for confounders, within a specific range (omMAPR ≤ 1.06 or omABI ≤ 1.12), each 0.1-unit increase in omMAPR was associated with reductions of 14% (HR = 0.86, 95% CI: 0.77-0.96) and 23% (HR = 0.77, 95% CI: 0.70-0.84) in cardiovascular events and all cause mortality, respectively, while each 0.1-unit increase in omABI was associated with reductions of 12% (HR = 0.88, 95% CI: 0.79-0.97) and 22% (HR = 0.78, 95% CI: 0.72-0.85) in cardiovascular events and all-cause mortality, respectively. However, once out of that range (omMAPR > 1.06 or omABI > 1.12), neither omMAPR nor omABI was significantly associated with cardiovascular events or all-cause mortality.

Conclusion: Both omMAPR and omABI within specific ranges (omMAPR ≤ 1.06 or omABI ≤ 1.12) were independent predictors for cardiovascular events and all-cause mortality. Moreover, omMAPR exhibited a slightly superior predictive ability compared to omABI in relation to cardiovascular events and all-cause mortality. The trial registration number is ChiCTR-TNRC-11001489.

Background: Currently available risk stratification models for acute pulmonary embolism (PE) include hemodynamic status, cardiac biomarkers, right ventricle (RV) dysfunction on imaging, and clinical scores. Focusing on the length-tension relationship of the ventricle might have a superior predictive capability over RV dysfunction in terms of mortality and classification of patients with acute PE. In this study, our hypothesis suggests that the tricuspid annular plane systolic excursion (TAPSE)/systolic pulmonary artery pressure (sPAP) ratio has superior predictive capability for in-hospital mortality in patients with acute PE compared to TAPSE or sPAP as distinct measures.

Methods: This single-center study comprised retrospectively evaluated 703 patients referred to our tertiary cardiovascular center with acute PE. We divided patients into quartiles based on the TAPSE/sPAP ratio. Different models were developed to quantify the predictive relationship between in-hospital death and echocardiographic measurements. A base model was created with variables including risk status and RV/LV ratio >1. Then, to evaluate the predictive contribution of each measurement; TAPSE/sPAP, TAPSE, and sPAP were sequentially added to the base model. After that, the performance of each model was evaluated.

Results: Predictive and discriminative power was the highest in model containing TAPSE/sPAP. There was still a significant inverse association between TAPSE/sPAP and the risk of in-hospital death even after adjusting for risk status and RV/LV ratio >1. Receiver operating characteristic curve analysis for TAPSE/sPAP revealed the best cut-off value as 0.34.

Conclusion: The outcomes of our study reveal that the ratio of TAPSE/sPAP serves as a more potent predictor of mortality than either of the 2 measurements taken separately. The interpretation and utilization of the TAPSE/sPAP cut-off value in acute PE can assist in identifying patients at risk of deterioration and guide the consideration of more intensive treatment options across all risk groups.

Background: We aimed to find a gene for coronary artery disease (CAD) early diagnosis by detecting co-pathogenic target gene involved in CAD and pulmonary arterial hypertension (PAH). Methods: Datasets were obtained from the Gene Expression Omnibus (GEO) database, including GSE113079, GSE113439, and GSE12288, to investigate gene expression patterns in cardiovascular diseases. Weighted Gene Co-expression Network Analysis (WGCNA) was performed to identify gene modules associated with clinical traits. Differential gene expression analysis and functional enrichment analysis were carried out. Protein-protein interaction (PPI) networks were constructed. JASPAR database and FIMO tool were utilized to predict transcription factor (TF) binding sites. Results: Fifteen key genes were identified in CAD and PAH, with CNTN1 being prioritized for further investigation due to its high connectivity degree. Upstream regulation analysis identified potential TFs (DRGX, HOXD3, and RAX) and 7 miRNAs targeting CNTN1. The expression profile of CNTN1 was significantly upregulated in CAD samples, and ROC analysis indicated potential diagnostic value for CAD. CMap database analysis predicted potential targeted drugs for CAD. Conclusion: CNTN1 was detected as a co-pathogenetic gene for CAD and PAH. It is highly expressed in CAD patients and has potential value for CAD diagnosis. CNTN1 is potentially regulated by 3 TFs and 7 miRNAs.

Background: To compare distal (dTRA) and classical (cTRA) transradial approaches for coronary catheterization with respect to puncture attempts, puncture time, operator and patient comfort, and safety outcomes.

Methods: In this prospective observational study, patients undergoing coronary catheterization for standard indications via dTRA or cTRA approaches from July 2019 to May 2020 were included. Clinicodemographic and laboratory characteristics were recorded. Puncture time, number of puncture attempts, operator and patient comfort on the visual analogue scale (VAS), and access site complications like hematoma and radial artery occlusion were recorded. Patients were analyzed in the same group as the initial puncture, even if there was a cross-over.

Results: Of the 130 patients (40.8% women), 50.8% and 49.2% belonged to dTRA and cTRA groups, respectively. dTRA group required more than one puncture attempt more frequently than cTRA group (30.3% vs. 15.6%; P =.047); consequently, puncture time was longer (60s vs. 50s; P =.031, respectively). However, puncture time was comparable if the puncture was successful in the first attempt (47.5s vs. 45s; P =.492). Patient comfort was comparable (7.2 ± 0.9 vs. 7.2 ± 1.2; P =.852), but operator comfort was more with cTRA approach (8.3 ± 1.6 vs. 8.8 ± 1.2; P =.048). Post-procedure, cTRA had more minor bleeding than dTRA approach. There was no major bleeding in either group. The occurrence of radial artery occlusion was comparable in both groups.

Conclusion: Although dTRA needed more attempts for successful puncture, puncture time was comparable with cTRA when puncture was successful on the first attempt. Therefore, one attempt at dTRA puncture could be a reasonable approach in patients undergoing coronary catheterization.