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Reply to Letter to the Editor: 'More Accurate Impact of as an Independent Predictor of Fragmented QRS on Cardiovascular Events'. 回复致编辑的信:"作为心血管事件独立预测因子的 QRS 波形片段的更准确影响"。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4579
Şükrü Çetin
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引用次数: 0
Equation with Many Unknowns in a Young Patient with Massive Coronary Thrombus. 年轻冠状动脉血栓患者的未知方程式
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4017
Mert Doğan, Berkay Ceyhun Dinçer, Süleyman Cihan Kara, Ahmet Hakan Ateş, Uğur Canpolat
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引用次数: 0
More Accurate Impact of as an Independent Predictor of Fragmented QRS on Cardiovascular Events. 更准确地预测 QRS 波形片段对心血管事件的影响。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4577
Mehmet Erdoğan
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引用次数: 0
Causal Effect of Atrial Fibrillation on Heart Failure Risk in East Asian Ancestry: A Bidirectional Mendelian Randomization Study Using Genome-wide Association Data. 心房颤动对东亚血统心力衰竭风险的因果效应:利用全基因组关联数据的双向孟德尔随机化研究
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4369
Yibin Mei, Fang Ye, Xiaofen Yin, Xianjun Wu

Background: Atrial fibrillation (AF) and heart failure (HF) are prevalent cardiovascular conditions in East Asia, with a complex interrelationship. The directionality of the causal impact of AF on HF risk remains uncertain. This study employs Mendelian randomization (MR) to investigate the potential causal effect of AF on HF.

Methods: Utilizing summary data from genome-wide association studies (GWAS) within the Medical Research Council Integrative Epidemiology Unit open GWAS database, we analyzed 8180 AF cases and 28 612 controls, alongside 9413 HF cases and 203 040 controls, all of East Asian descent. We conducted MR analysis using the inverse variance weighted (IVW) method, complemented by various sensitivity analyses, including bidirectional MR to assess causality in the reverse direction.

Results: Genetically predicted AF was found to be causally associated with an increased risk of HF in East Asian populations (odds ratio = 1.14, 95% CI: 1.10-1.19, P <.001) as per the IVW method. These findings were consistent across multiple MR methods. Sensitivity analyses revealed no significant heterogeneity or pleiotropy. Notably, bidirectional MR analysis showed no causal effect of HF on the risk of developing AF.

Conclusions: The MR analysis supports a unidirectional causal relationship between AF and increased HF risk in East Asian individuals. The absence of a reverse causal effect reinforces the importance of maintaining sinus rhythm to mitigate HF risk. Further research is warranted to corroborate these findings and to explore their clinical implications in depth.

背景:心房颤动(AF)和心力衰竭(HF)是东亚地区普遍存在的心血管疾病,两者之间存在复杂的相互关系。心房颤动对心力衰竭风险的因果影响的方向性仍不确定。本研究采用孟德尔随机法(MR)研究心房颤动对高血压的潜在因果效应:利用医学研究委员会综合流行病学组开放式 GWAS 数据库中全基因组关联研究 (GWAS) 的汇总数据,我们分析了 8180 例心房颤动病例和 28 612 例对照,以及 9413 例心房颤动病例和 203 040 例对照(均为东亚后裔)。我们使用逆方差加权(IVW)方法进行了MR分析,并辅以各种敏感性分析,包括双向MR分析,以评估反向因果关系:结果:研究发现,遗传预测的房颤与东亚人群罹患心房颤动的风险增加存在因果关系(几率比=1.14,95% CI:1.10-1.19,P 结论:MR 分析支持单向的房颤与心房颤动之间的因果关系:磁共振分析支持东亚人心房颤动与心房颤动风险增加之间的单向因果关系。缺乏反向因果效应加强了保持窦性心律对降低高频风险的重要性。为证实这些发现并深入探讨其临床意义,还需要进一步的研究。
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引用次数: 0
Coronary Sinus Ostial Atresia with Coronary Sinus Thrombosis. 冠状动脉窦闭锁伴冠状动脉窦血栓形成
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-14 DOI: 10.14744/AnatolJCardiol.2024.4602
Furkan Ufuk
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引用次数: 0
Role of Cardiac Magnetic Resonance in the Assessment of Patients with Premature Ventricular Contractions: A Narrative Review. 心脏磁共振在评估室性早搏患者中的作用:叙述性综述。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-04 DOI: 10.14744/AnatolJCardiol.2024.4314
Stefan Ailoaei, Laurentiu Sorodoc, Carina Ureche, Gabriel Sandu, Nicolae Sitari, Alexandr Ceasovschih, Mihaela Grecu, Radu Andy Sascau, Cristian Statescu

Premature ventricular contractions (PVCs) are a common finding in clinical practice, requiring a full diagnostic work-up in order to exclude an underlying cardiomyopathy. Still, in a substantial proportion of patients, these investigations do not identify any substrate, and the PVCs are labelled as idiopathic. Cardiac magnetic resonance (CMR) has proven in the last decades as the method of choice for the exploration of patients with cardiomyopathies, since it can identify subtle changes in the myocardial tissue and help with risk stratification. In patients with idiopathic PVCs and a high PVC burden, several studies report the presence of late gadolinium enhancement (LGE) at CMR, which can offer additional diagnostic and prognostic benefits, as well as assistance in catheter ablation procedures, as the risk for adverse cardiac and risk for arrhythmic events events is higher compared to patients without scar. This paper focuses on the impact of the presence of LGE in patients with idiopathic PVCs, reviewing all the relevant studies published so far, including randomized controlled clinical trials, prospective or retrospective cohort studies, case series and case reports as well as systematic reviews.

室性早搏(PVC)是临床实践中的常见病,需要进行全面的诊断检查,以排除潜在的心肌病。然而,在相当一部分患者中,这些检查并不能确定任何基质,PVC 也就被贴上了特发性的标签。过去几十年来,心脏磁共振(CMR)已被证明是检查心肌病患者的首选方法,因为它能发现心肌组织的细微变化,有助于进行风险分层。在特发性 PVC 和 PVC 负荷较高的患者中,有几项研究报告称 CMR 存在晚期钆增强(LGE),这可以提供额外的诊断和预后益处,并有助于导管消融手术,因为与无瘢痕患者相比,患者发生不良心脏事件和心律失常事件的风险更高。本文重点讨论了特发性 PVC 患者出现 LGE 的影响,回顾了迄今为止发表的所有相关研究,包括随机对照临床试验、前瞻性或回顾性队列研究、病例系列和病例报告以及系统综述。
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引用次数: 0
Electrophysiological Assessment of Paresthesia in Patients Following Radial Angiography: A Prospective Study. 桡动脉血管造影术后患者痹痛的电生理评估:前瞻性研究
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-04 DOI: 10.14744/AnatolJCardiol.2024.4173
Cansu Eğilmez Sarıkaya, Fatma Özge Salkın, Caner Sarıkaya

Background: Radial angiography, preferred for its safety and comfort in percutaneous coronary interventions, occasionally leads to paresthesia-a tingling or numbing sensation in the hand. This study aimed to investigate the presence of nerve damage in patients experiencing paresthesia post-radial angiography through electrophysiological examination.

Methods: This prospective study involved 77 patients who developed hand paresthesia following radial angiography. Excluded were those with malignancy, pregnancy, pace-makers, or recent angiography. Nerve conduction studies were performed using the Neuropack MEB 9102K EMG device, assessing sensory and motor amplitudes, latencies, and velocities of median, ulnar, and radial nerves.

Results: The study included 77 patients (23 females, 54 males; average age 58.39 ± 10.44 years). In 11 diabetic patients, polyneuropathy was detected. For the remaining 66 patients, electrophysiological evaluations showed no significant pathological findings. Comparative analysis of both upper extremities revealed no significant differences in nerve conduction parameters between the side where angiography was performed and the other side. Despite paresthesia complaints, no electrophysiological evidence of nerve damage was found, suggesting that symptoms might be due to local irritation rather than direct nerve injury. This aligns with the safety profile of radial angiography and underscores the importance of distinguishing between transient paresthesia and serious nerve complications.

Conclusion: Paresthesia post-radial angiography, while clinically notable, is not typically associated with nerve damage. This study is significant as it is the first in the literature to demonstrate that radial angiography does not cause nerve damage.

背景:桡动脉血管造影术因其在经皮冠状动脉介入治疗中的安全性和舒适性而备受青睐,但偶尔也会导致麻痹--手部刺痛或麻木的感觉。本研究旨在通过电生理学检查,研究放射血管造影术后出现麻痹的患者是否存在神经损伤:这项前瞻性研究涉及 77 名在桡动脉血管造影术后出现手部麻痹的患者。排除了恶性肿瘤、妊娠、心脏起搏器或近期接受过血管造影术的患者。使用 Neuropack MEB 9102K EMG 设备进行神经传导研究,评估正中神经、尺神经和桡神经的感觉和运动幅度、潜伏期和速度:研究包括 77 名患者(23 名女性,54 名男性;平均年龄 58.39 ± 10.44 岁)。在 11 名糖尿病患者中发现了多发性神经病变。其余 66 名患者的电生理评估未发现明显病变。对双上肢进行比较分析后发现,进行血管造影的一侧与另一侧的神经传导参数无明显差异。尽管有麻痹的主诉,但没有发现神经损伤的电生理学证据,这表明症状可能是由于局部刺激而非直接神经损伤引起的。这与桡动脉血管造影术的安全性相符,并强调了区分一过性麻痹和严重神经并发症的重要性:结论:桡动脉血管造影术后的麻痹虽然在临床上值得注意,但通常与神经损伤无关。这项研究意义重大,因为它是文献中首个证明桡动脉血管造影不会导致神经损伤的研究。
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引用次数: 0
Changes in Acute Coronary Syndrome Clinic after the Devastating Earthquake in Türkiye. 土耳其大地震后急性冠状动脉综合征门诊的变化。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-04 DOI: 10.14744/AnatolJCardiol.2024.4207
Oğuz Akkuş, Ramazan Yadsıbaş, Ramazan Furkan Demirkıran, Veysel Elitaş, Özkan Bekler, Fatih Şen, Hülya Binokay, Gamze Akkuş, Ertuğrul Okuyan

Background: We aimed to investigate the clinical and angiographic characteristics of patients with acute coronary syndrome (ACS) who survived this devastating earthquake and were admitted to our hospital in Antakya/Türkiye.

Methods: We retrospectively examined the impact of the earthquake on the occurrences of acute coronary syndromes in Antakya/Türkiye. All 248 consecutive patients with ACS, also survivors of the earthquake in Antakya, were enrolled as the earthquake group. The earthquake group was created from patients hospitalized between February and June in 2023 after the earthquake. In total, 209 consecutive ACS patients who were hospitalized in our cardiology clinic in similar months of 2022 named as the control group.

Results: Patients admitted before the earthquake were more hospitalized with multivessel disease compared to after the earthquake group (P <.001). Myocardial infarction with non-obstructive coronary artery disease (MINOCA) was the main reason for the significant increase rate of ACS after the earthquake. The earthquake patient group had lesser diabetes mellitus than the control group (P <.001). The risk of men suffering from ACS after an earthquake is approximately 2.1 times higher than women (P =.023). Those with a history of revascularization are approximately 1.8 times more likely to have ACS after an earthquake (P =.05). The risk of experiencing ACS after an earthquake is approximately 3.5 times higher for those with a family history than for those without (P <.001).

Conclusion: Effects of the devastating earthquake on the heart are the increase in MINOCA patients triggered by great sudden environmental stress and the decrease in diabetes due to worsening nutritional conditions, respectively.

背景:我们的目的是调查安塔基亚/土耳其医院收治的在大地震中幸存的急性冠状动脉综合征(ACS)患者的临床和血管造影特征:我们回顾性研究了地震对安塔基亚/土耳其急性冠状动脉综合征发生率的影响。所有 248 名连续的急性冠状动脉综合征患者均被纳入地震组,他们也是安塔基亚地震的幸存者。地震组患者来自地震后 2023 年 2 月至 6 月期间住院的患者。在 2022 年类似月份在我院心脏病诊所住院的 209 名连续性 ACS 患者被列为对照组:结果:地震前住院的多支血管疾病患者多于地震后住院的多支血管疾病患者:大地震对心脏的影响分别是:由于环境突变引发的MINOCA患者增加,以及由于营养状况恶化导致的糖尿病患者减少。
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引用次数: 0
Long-term Outcomes of Cryoballoon-based Empirical Superior Vena Cava Isolation in Addition to Pulmonary Vein Isolation in Persistent Atrial Fibrillation. 基于冷冻球囊的经验性上腔静脉隔离术与肺静脉隔离术并用治疗顽固性心房颤动的长期效果。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-04 DOI: 10.14744/AnatolJCardiol.2024.4092
Uğur Canpolat, Hikmet Yorgun, Kudret Aytemir

Background: Superior vena cava (SVC) is atrial fibrillation (AF)'s most common non-pulmonary vein (PV) foci. Studies reported conflictory results when SVC isolation (SVCi) was combined with PVi and long-term outcomes were lacking. Therefore, we aimed to evaluate the long-term efficacy and safety of empirical SVCi as an adjunct to cryoballoon-based PV isolation (PVi) in persistent AF ablation.

Methods: A total of 40 consecutive persistent AF patients (60.6 ± 8.2 years, 52.5% females) who underwent SVCi in addition to PVi compared with a propensity score matched cohort of 40 persistent AF patients (58.6 ± 8.7 years, 50% female) in whom PVi-only was performed. Second-generation cryoballoon (CB2) was used in all procedures. Atrial tachyarrhythmia (ATa) recurrence was defined as the detection of AF, atrial flutter, or atrial tachycardia (≥30 s) after a 3-month blanking period.

Results: Pulmonary veins and SVC were successfully isolated in all patients. At a mean of 46.7 ± 7.8 months follow-up, 22 (55%) patients in the PVi-only group, and 27 (67.5%) patients in the PVi + SVCi group were free of ATa after the index procedure (P =.359). Phrenic nerve injury (PNI) was detected in 2 (5%) patients in the PVi-only group (during right PVi) and 2 (5%) patients in the PVi + SVCi group (during SVCi) (P = 1.00). Cox regression analysis revealed that early recurrence was the only predictor of recurrence (hazard ratio 4.88, 95% confidence interval 1.59-14.96; P =.005).

Conclusion: Long-term results of our small sample-sized study revealed that CB-based PVi + SVCi was associated with outcomes similar to the PVi-only strategy in patients with persistent AF. Although complication rates were similar between the groups, close follow-up of diaphragmatic movement is crucial to prevent PNI during SVCi.

背景:上腔静脉(SVC)是心房颤动(AF)最常见的非肺静脉(PV)病灶。有研究报告称,SVC 分离术(SVCi)与 PVi 联合治疗的结果相互矛盾,且缺乏长期疗效。因此,我们旨在评估经验性 SVCi 作为基于冷冻球囊的 PV 隔离术(PVi)在持续性房颤消融中的辅助治疗的长期疗效和安全性:共有 40 名连续的持续性房颤患者(60.6 ± 8.2 岁,52.5% 为女性)在接受 PVi 的同时接受了 SVCi,与倾向得分匹配的 40 名持续性房颤患者(58.6 ± 8.7 岁,50% 为女性)进行了比较,后者仅接受了 PVi。所有手术均使用第二代冷冻球囊(CB2)。房性心动过速(ATa)复发的定义是在 3 个月空白期后检测到房颤、心房扑动或房性心动过速(≥30 秒):结果:所有患者均成功分离了肺静脉和SVC。在平均 46.7 ± 7.8 个月的随访中,22 名(55%)仅有肺静脉的患者和 27 名(67.5%)肺静脉 + SVCi 组患者在指数手术后没有出现 ATa(P =.359)。仅行腹腔穿刺术组中有 2 例(5%)患者(在右侧腹腔穿刺术期间)和腹腔穿刺术 + SVCi 组中有 2 例(5%)患者(在 SVCi 期间)发现膈神经损伤 (PNI)(P = 1.00)。Cox回归分析显示,早期复发是复发的唯一预测因素(危险比为4.88,95%置信区间为1.59-14.96;P =.005):我们的小样本量研究的长期结果显示,在持续性房颤患者中,基于 CB 的 PVi + SVCi 与单纯 PVi 策略的疗效相似。虽然两组患者的并发症发生率相似,但密切随访膈肌运动对于预防 SVCi 期间的 PNI 至关重要。
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引用次数: 0
Angiojet Rheolytic Thrombectomy, AIZANOI study and COVID-19. 血管喷射溶栓术、AIZANOI 研究和 COVID-19。
IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-06-01 DOI: 10.14744/AnatolJCardiol.2024.6
Çetin Erol
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引用次数: 0
期刊
Anatolian Journal of Cardiology
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