Introduction: The functional anatomy of the myocardium allows envisioning that it initiates and ends at the origin of the great vessels. In our research, we have always considered that it should have a point of attachment to allow its helical rotation to fulfill the fundamental movements of shortening-torsion (systole) and lengthening-detorsion (suction), which once found, was called the cardiac fulcrum. Materials and methods: A total of 31 hearts, arising from the morgue and slaughterhouse were used: 17 corresponded to bovids and 14 were human. Anatomical and histological studies were performed. The heart was fixed in 10% buffered formalin. Hematoxylin-eosin, Masson’s trichrome staining technique, and 4-micron sections were used for the histological study, and 10 % formalin was used as a buffer. Results: The anatomical investigations have revealed that all the hearts (bovids and humans) have myocardial support whose histological structure in the analyzed specimens presents with an osseous or chondroid-tendinous character. In this structure, which we have called the cardiac fulcrum, are inserted the myocardial fibers at the origin and end of the band, which correspond to the continuous myocardium coiled as a helix. Conclusion: This description of the fulcrum would end the problem of lack of support of the myocardium to fulfill its function of suction/ejection.
{"title":"The Fulcrum of the Human Heart (Cardiac fulcrum)","authors":"Trainini Jorge Carlos, Wernicke Mario, Beraudo Mario, Trainini Alejandro","doi":"10.29328/journal.jccm.1001171","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001171","url":null,"abstract":"Introduction: The functional anatomy of the myocardium allows envisioning that it initiates and ends at the origin of the great vessels. In our research, we have always considered that it should have a point of attachment to allow its helical rotation to fulfill the fundamental movements of shortening-torsion (systole) and lengthening-detorsion (suction), which once found, was called the cardiac fulcrum. Materials and methods: A total of 31 hearts, arising from the morgue and slaughterhouse were used: 17 corresponded to bovids and 14 were human. Anatomical and histological studies were performed. The heart was fixed in 10% buffered formalin. Hematoxylin-eosin, Masson’s trichrome staining technique, and 4-micron sections were used for the histological study, and 10 % formalin was used as a buffer. Results: The anatomical investigations have revealed that all the hearts (bovids and humans) have myocardial support whose histological structure in the analyzed specimens presents with an osseous or chondroid-tendinous character. In this structure, which we have called the cardiac fulcrum, are inserted the myocardial fibers at the origin and end of the band, which correspond to the continuous myocardium coiled as a helix. Conclusion: This description of the fulcrum would end the problem of lack of support of the myocardium to fulfill its function of suction/ejection.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"9 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139451292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Revascularization procedures for chronic complete occlusion (CTO) are technically challenging but aim to improve left ventricular (LV) function. The aim of this study is to evaluate the value of global longitudinal strain (GLS) measured by 2D-speckle tracking echocardiography( 2D-STE) in the assessment of LV reverse remodeling in patients with CTO undergoing revascularization by percutaneous coronary intervention (PCI). Methods: Our study included 54 patients with CTO treated by PCI. We evaluate LV systolic function by measurement of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and the GLS within 24 hours before the PCI and after 3 months post-procedure. Results: The mean age of the patients was 56.65 ± 7.65 years; 74.1% were males. There was a significant improvement in the LVESV (p < 0.001), LVEF (p < 0.001), and GLS (p < 0.001) at 3 months post-PCI, and by multivariate regression analysis, the GLS was the single most significant predictor of LV reverse remodeling post revascularization (p < 0.001). Conclusion: Revascularization of coronary CTO lesions by PCI is associated with a significant improvement in regional and global LV function. The GLS measured by 2D-STE is a strong predictor of LV reverse remodeling post-CTO interventions.
{"title":"Value of Speckle Tracking Echocardiography in Prediction of Left Ventricular Reverse Remodeling in Patients with Chronic total Occlusion Undergoing Percutaneous Coronary Interventions","authors":"Magdy Gehan, Azab Sahar Hamdy, Esmail Yasmin Ali, Elfaky Mohamed Khalid","doi":"10.29328/journal.jccm.1001170","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001170","url":null,"abstract":"Background: Revascularization procedures for chronic complete occlusion (CTO) are technically challenging but aim to improve left ventricular (LV) function. The aim of this study is to evaluate the value of global longitudinal strain (GLS) measured by 2D-speckle tracking echocardiography( 2D-STE) in the assessment of LV reverse remodeling in patients with CTO undergoing revascularization by percutaneous coronary intervention (PCI). Methods: Our study included 54 patients with CTO treated by PCI. We evaluate LV systolic function by measurement of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and the GLS within 24 hours before the PCI and after 3 months post-procedure. Results: The mean age of the patients was 56.65 ± 7.65 years; 74.1% were males. There was a significant improvement in the LVESV (p < 0.001), LVEF (p < 0.001), and GLS (p < 0.001) at 3 months post-PCI, and by multivariate regression analysis, the GLS was the single most significant predictor of LV reverse remodeling post revascularization (p < 0.001). Conclusion: Revascularization of coronary CTO lesions by PCI is associated with a significant improvement in regional and global LV function. The GLS measured by 2D-STE is a strong predictor of LV reverse remodeling post-CTO interventions.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"46 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139151404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-28DOI: 10.29328/journal.jccm.1001169
Sonwani Hari Prasad
Patients with heart failure may live longer if they receive chronic treatment with beta-adrenergic blocking medications. Unresolved are the mechanisms underlying the beneficial effects and if they may be applied to ischemic heart failure. Rats (n = 28) underwent echocardiographic-Doppler exams one and six weeks following a simulated operation or myocardial infarction (MI). After the first echocardiography, rats were randomized to either no therapy or 500 mg/l of propranolol in their drinking water. The noninfected left ventricular (LV) papillary muscles were used to record isometric contractions and intracellular Ca transients simultaneously. Untreated MI rats had a restrictive LV diastolic filling pattern, decreased systolic function (13% ± 2%), and significant LV dilatation (10.6 ± 0.4 mm vs. 8.9 ± 0.3 mm, MI vs. control). The LV chamber diameters of the propranolol-treated MI rats were 10.6 ± 0.5 mm, and systolic performance (13% ± 2%). Higher LV end-diastolic pressures (27 ± 2 mmHg vs. 20 ± 3 mmHg) and a more constrained LV diastolic filling pattern (increased ratio of early to late filling velocities and faster E wave deceleration rate) were seen in the propranolol-treated animals. Papillary muscle contractility in untreated MI rats was lower (1.6 ± 0.3 g mm²). Furthermore, the inotropic response to isoproterenol was attenuated, and Ca transients were extended. During isoproterenol stimulation, beta-adrenergic blocking administration had no effect on force development (1.6 ± 0.3 g mm²) or the length of Ca transients. Rats with postinfarction heart failure receiving chronic propranolol treatment did not have improvements in systolic function or LV remodeling. Propranolol exacerbated LV diastolic pressures and filling patterns. Additionally, there was no discernible improvement in intracellular contractility following treatment, Calcium control, or beta-adrenergic sensitivity in the myocardium that is not infarcted).
心力衰竭患者如果长期接受β-肾上腺素能阻断药物治疗，寿命可能会更长。这种有益作用的机制以及是否可应用于缺血性心力衰竭尚无定论。大鼠（n = 28）在模拟手术或心肌梗塞（MI）后一周和六周接受了超声心动图-多普勒检查。第一次超声心动图检查后，大鼠被随机分配接受不治疗或在饮用水中添加 500 毫克/升普萘洛尔的治疗。用未感染的左心室乳头肌同时记录等长收缩和细胞内钙离子瞬态。未经治疗的 MI 大鼠左心室舒张期充盈模式受限，收缩功能下降（13% ± 2%），左心室显著扩张（10.6 ± 0.4 mm vs. 8.9 ± 0.3 mm，MI vs. 对照组）。普萘洛尔治疗的 MI 大鼠的左心室腔直径为 10.6 ± 0.5 毫米，收缩功能为（13% ± 2%）。经普萘洛尔治疗的动物左心室舒张末期压力更高（27 ± 2 mmHg vs. 20 ± 3 mmHg），左心室舒张期充盈模式更受限制（早期充盈速度与晚期充盈速度之比增加，E波减速速度加快）。未经治疗的心肌梗死大鼠的乳头肌收缩力较低（1.6 ± 0.3 g mm²）。此外，对异丙肾上腺素的肌力反应减弱，钙离子瞬态延长。在异丙肾上腺素刺激期间，β-肾上腺素能阻断剂对肌力发展（1.6 ± 0.3 g mm²）或钙离子瞬时的长度没有影响。梗死后心力衰竭的大鼠接受长期普萘洛尔治疗后，收缩功能或左心室重塑没有改善。普萘洛尔加剧了左心室舒张压和充盈模式。此外，治疗后细胞内收缩力、钙控制或未梗死心肌的β肾上腺素能敏感性均无明显改善。）
{"title":"Rats with Postinfarction Heart Failure: Effects of Propranolol Therapy on Intracellular Calcium Regulation and Left Ventricular Function","authors":"Sonwani Hari Prasad","doi":"10.29328/journal.jccm.1001169","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001169","url":null,"abstract":"Patients with heart failure may live longer if they receive chronic treatment with beta-adrenergic blocking medications. Unresolved are the mechanisms underlying the beneficial effects and if they may be applied to ischemic heart failure. Rats (n = 28) underwent echocardiographic-Doppler exams one and six weeks following a simulated operation or myocardial infarction (MI). After the first echocardiography, rats were randomized to either no therapy or 500 mg/l of propranolol in their drinking water. The noninfected left ventricular (LV) papillary muscles were used to record isometric contractions and intracellular Ca transients simultaneously. Untreated MI rats had a restrictive LV diastolic filling pattern, decreased systolic function (13% ± 2%), and significant LV dilatation (10.6 ± 0.4 mm vs. 8.9 ± 0.3 mm, MI vs. control). The LV chamber diameters of the propranolol-treated MI rats were 10.6 ± 0.5 mm, and systolic performance (13% ± 2%). Higher LV end-diastolic pressures (27 ± 2 mmHg vs. 20 ± 3 mmHg) and a more constrained LV diastolic filling pattern (increased ratio of early to late filling velocities and faster E wave deceleration rate) were seen in the propranolol-treated animals. Papillary muscle contractility in untreated MI rats was lower (1.6 ± 0.3 g mm²). Furthermore, the inotropic response to isoproterenol was attenuated, and Ca transients were extended. During isoproterenol stimulation, beta-adrenergic blocking administration had no effect on force development (1.6 ± 0.3 g mm²) or the length of Ca transients. Rats with postinfarction heart failure receiving chronic propranolol treatment did not have improvements in systolic function or LV remodeling. Propranolol exacerbated LV diastolic pressures and filling patterns. Additionally, there was no discernible improvement in intracellular contractility following treatment, Calcium control, or beta-adrenergic sensitivity in the myocardium that is not infarcted).","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"175 11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139222615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.29328/journal.jccm.1001168
Piracha Zahra Zahid, Gilani Syed Shayan, Tariq Muhammad Nouman, Saeed Umar, Rana Muhammad Shahmeer Fida, Fatima Muqaddas, Sohail Azka, Abbasi Umer Ali, Faisal Faizan, Ur Rehman Mubeen, Maheen Maliha, Rasool Madeeha, Ghazal Misbah, Noor Seneen, Noor Elyeen
The intricate interplay between viral infections and cardiovascular complications has garnered significant attention from 2018 to 2023. Extensive research during this period has unveiled substantial connections between various viruses and cardiovascular diseases. Notable examples include Cytomegalovirus (CMV), coxsackievirus, influenza, Human Immunodeficiency Virus (HIV), Epstein-Barr Virus (EBV), Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), as well as coxsackievirus A and B, enteroviruses, adenovirus, and parvovirus B19. These viruses exert diverse influences on cardiovascular health through various pathways, contributing to endothelial dysfunction, inflicting direct damage on cardiac tissue, and triggering inflammatory responses. The intricate interplay between viral infections and cardiovascular health underscores the importance of considering viral pathogens within the framework of cardiovascular disease development, clinical management practices, and future research initiatives. This systematic review comprehensively scrutinizes the cardiovascular impacts stemming from various viral infections, casting a revealing light on their underlying mechanisms and associated clinical implications. These valuable insights can guide clinical management strategies, preventive measures and further investigations into the complex connection between viral infections and cardiovascular diseases, emphasizing the necessity for ongoing research and vigilance in comprehending and managing these pathogen-induced cardiac manifestations.
从 2018 年到 2023 年，病毒感染与心血管并发症之间错综复杂的相互作用引起了人们的极大关注。在此期间进行的广泛研究揭示了各种病毒与心血管疾病之间的实质性联系。显著的例子包括巨细胞病毒（CMV）、柯萨奇病毒、流感、人类免疫缺陷病毒（HIV）、爱泼斯坦-巴氏病毒（EBV）、严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2），以及柯萨奇病毒 A 和 B、肠道病毒、腺病毒和副病毒 B19。这些病毒通过各种途径对心血管健康产生不同的影响，导致内皮功能障碍，对心脏组织造成直接损伤，并引发炎症反应。病毒感染与心血管健康之间错综复杂的相互作用凸显了在心血管疾病发展、临床管理实践和未来研究计划框架内考虑病毒病原体的重要性。这篇系统性综述全面审视了各种病毒感染对心血管的影响，揭示了病毒感染的内在机制和相关临床意义。这些有价值的见解可以指导临床管理策略、预防措施和对病毒感染与心血管疾病之间复杂联系的进一步研究，强调了在理解和管理这些病原体诱发的心脏表现方面进行持续研究和保持警惕的必要性。
{"title":"Unmasking the Viral Veil: Exploring the Cardiovascular Intrigue of Pathogenic Infections","authors":"Piracha Zahra Zahid, Gilani Syed Shayan, Tariq Muhammad Nouman, Saeed Umar, Rana Muhammad Shahmeer Fida, Fatima Muqaddas, Sohail Azka, Abbasi Umer Ali, Faisal Faizan, Ur Rehman Mubeen, Maheen Maliha, Rasool Madeeha, Ghazal Misbah, Noor Seneen, Noor Elyeen","doi":"10.29328/journal.jccm.1001168","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001168","url":null,"abstract":"The intricate interplay between viral infections and cardiovascular complications has garnered significant attention from 2018 to 2023. Extensive research during this period has unveiled substantial connections between various viruses and cardiovascular diseases. Notable examples include Cytomegalovirus (CMV), coxsackievirus, influenza, Human Immunodeficiency Virus (HIV), Epstein-Barr Virus (EBV), Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), as well as coxsackievirus A and B, enteroviruses, adenovirus, and parvovirus B19. These viruses exert diverse influences on cardiovascular health through various pathways, contributing to endothelial dysfunction, inflicting direct damage on cardiac tissue, and triggering inflammatory responses. The intricate interplay between viral infections and cardiovascular health underscores the importance of considering viral pathogens within the framework of cardiovascular disease development, clinical management practices, and future research initiatives. This systematic review comprehensively scrutinizes the cardiovascular impacts stemming from various viral infections, casting a revealing light on their underlying mechanisms and associated clinical implications. These valuable insights can guide clinical management strategies, preventive measures and further investigations into the complex connection between viral infections and cardiovascular diseases, emphasizing the necessity for ongoing research and vigilance in comprehending and managing these pathogen-induced cardiac manifestations.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"19 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139244484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-24DOI: 10.29328/journal.jccm.1001167
Bah Karamo, Jallow Amadou Wurry, Ns Bah Adama, Touray Musa
Background and aim: Congestive heart failure is a prevalent and serious condition that poses significant challenges in the emergency department setting. Prompt and accurate management of congestive heart failure patients is crucial for improving outcomes and optimizing resource utilization. This study aims to address these challenges by developing a machine learning algorithm and comparing it to a traditional logistic regression model that can assist in the triage, resource allocation, and long-term prognostication of congestive heart failure patients. Methods: In this investigation, we used the MIMIC-III database, a publicly accessible resource containing patient data from ICU settings. Traditional logistic regression, along with the robust XGBoost and random forest algorithms, was harnessed to construct predictive models. These models were built using a range of pretreatment clinical variables. To pinpoint the most pertinent features, we carried out a univariate analysis. Ensuring robust performance and broad applicability, we adopted a nested cross-validation approach. This method enhances the precision and validation of our models by implementing multiple cross-validation iterations. Results: The performance of machine learning algorithms was assessed using the area under the receiver operating characteristic curve (AUC). Notably, the random forest algorithm, despite having lower performance among the machine learning models still demonstrated significantly higher AUC than traditional logistic regression. The AUC for the XGBoost was 0.99, random forest 0.98, while traditional logistic regression was 0.57. The most important pretreatment variables associated with congestive heart failure include total bilirubin, creatine kinase, international normalized ratio (INR), sodium, age, creatinine, potassium, gender, alkaline phosphatase, and platelets. Conclusion: Machine learning techniques utilizing multiple pretreatment clinical variables outperform traditional logistic regression in aiding the triage, resource allocation, and long-term prognostication of congestive heart failure patients in the intensive care unit setting using MIMIC III data.
{"title":"Developing a Machine Learning Algorithm for Improved Management of Congestive Heart Failure Patients in the Emergency Department","authors":"Bah Karamo, Jallow Amadou Wurry, Ns Bah Adama, Touray Musa","doi":"10.29328/journal.jccm.1001167","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001167","url":null,"abstract":"Background and aim: Congestive heart failure is a prevalent and serious condition that poses significant challenges in the emergency department setting. Prompt and accurate management of congestive heart failure patients is crucial for improving outcomes and optimizing resource utilization. This study aims to address these challenges by developing a machine learning algorithm and comparing it to a traditional logistic regression model that can assist in the triage, resource allocation, and long-term prognostication of congestive heart failure patients. Methods: In this investigation, we used the MIMIC-III database, a publicly accessible resource containing patient data from ICU settings. Traditional logistic regression, along with the robust XGBoost and random forest algorithms, was harnessed to construct predictive models. These models were built using a range of pretreatment clinical variables. To pinpoint the most pertinent features, we carried out a univariate analysis. Ensuring robust performance and broad applicability, we adopted a nested cross-validation approach. This method enhances the precision and validation of our models by implementing multiple cross-validation iterations. Results: The performance of machine learning algorithms was assessed using the area under the receiver operating characteristic curve (AUC). Notably, the random forest algorithm, despite having lower performance among the machine learning models still demonstrated significantly higher AUC than traditional logistic regression. The AUC for the XGBoost was 0.99, random forest 0.98, while traditional logistic regression was 0.57. The most important pretreatment variables associated with congestive heart failure include total bilirubin, creatine kinase, international normalized ratio (INR), sodium, age, creatinine, potassium, gender, alkaline phosphatase, and platelets. Conclusion: Machine learning techniques utilizing multiple pretreatment clinical variables outperform traditional logistic regression in aiding the triage, resource allocation, and long-term prognostication of congestive heart failure patients in the intensive care unit setting using MIMIC III data.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"63 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135317212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-23DOI: 10.29328/journal.jccm.1001166
Bagchi Sushil Kumar, Moniruzzaman Md, Nahar Sharifun, Khalequzzaman Md, Chowdhury Sanjib, Choudhury Amal Kumar
Background: Patients undergoing percutaneous coronary intervention are at risk of different complications such as periprocedural bleeding and acute hemoglobin reduction that can lead to myocardial injury. Blood loss through the catheter during the procedure and through puncture site haematoma causes periprocedural acute haemoglobin drop. Objectives: To find out the association between acute haemoglobin reduction and myocardial injury after PCI in patients with unstable angina. Methods: This prospective observational study was conducted at the National Institute of Cardiovascular Diseases (NICVD) for one year of time. A total of 130 patients were enrolled based on inclusion and exclusion criteria during the study period. Haemoglobin and troponin-I were measured before and after PCI within 24 to 48 hours of the procedure. On the basis of post-procedural acute haemoglobin level, the study population was categorized into two groups: Group I patients with normal haemoglobin levels and Group II patients with significant acute haemoglobin reduction (≥ 1 gm/dl). Results: A total of 24 patients developed a periprocedural myocardial injury, among them 17 (70.8%) were in the reduced haemoglobin group and 7 (29.2%) in the normal haemoglobin group. Elevation of troponin I after PCI was higher in group II than in group I patients with a statistically significant difference. Multivariate logistic regression analysis showed that haemoglobin reduction was an independent predictor of PMI (OR 1.94; 95% CI, 1.241-8.684; p = 0.01). Conclusion: Periprocedural haemoglobin reduction in patients with unstable angina was associated with myocardial injury after percutaneous coronary intervention (PCI).
{"title":"Association of Periprocedural Haemoglobin Reduction and Myocardial Injury in Patients with Unstable Angina Undergoing Percutaneous Coronary Intervention","authors":"Bagchi Sushil Kumar, Moniruzzaman Md, Nahar Sharifun, Khalequzzaman Md, Chowdhury Sanjib, Choudhury Amal Kumar","doi":"10.29328/journal.jccm.1001166","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001166","url":null,"abstract":"Background: Patients undergoing percutaneous coronary intervention are at risk of different complications such as periprocedural bleeding and acute hemoglobin reduction that can lead to myocardial injury. Blood loss through the catheter during the procedure and through puncture site haematoma causes periprocedural acute haemoglobin drop. Objectives: To find out the association between acute haemoglobin reduction and myocardial injury after PCI in patients with unstable angina. Methods: This prospective observational study was conducted at the National Institute of Cardiovascular Diseases (NICVD) for one year of time. A total of 130 patients were enrolled based on inclusion and exclusion criteria during the study period. Haemoglobin and troponin-I were measured before and after PCI within 24 to 48 hours of the procedure. On the basis of post-procedural acute haemoglobin level, the study population was categorized into two groups: Group I patients with normal haemoglobin levels and Group II patients with significant acute haemoglobin reduction (≥ 1 gm/dl). Results: A total of 24 patients developed a periprocedural myocardial injury, among them 17 (70.8%) were in the reduced haemoglobin group and 7 (29.2%) in the normal haemoglobin group. Elevation of troponin I after PCI was higher in group II than in group I patients with a statistically significant difference. Multivariate logistic regression analysis showed that haemoglobin reduction was an independent predictor of PMI (OR 1.94; 95% CI, 1.241-8.684; p = 0.01). Conclusion: Periprocedural haemoglobin reduction in patients with unstable angina was associated with myocardial injury after percutaneous coronary intervention (PCI).","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"3 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135460556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19DOI: 10.29328/journal.jccm.1001165
Kumar Viveka
Background: Transcatheter Aortic Valve Replacement (TAVR) is an established treatment for severe, symptomatic Aortic Stenosis (AS). However, the presence of low coronary heights confers a high risk for coronary obstruction during or after TAVR. Case: In this case report, we present our experience with transfemoral-TAVR in an elderly, high-risk (STS score – 12.08%) female severe AS patient with low coronary heights (right: 7.4 mm, left: 8.7 mm). She had lower annulus area (287 mm2) and moderately low valve area (0.7 cm2) as well. Her mean and peak pressure gradients (PGs) were 38 mmHg and 61 mmHg, respectively. Upon the Heart Team’s evaluation, TAVR was recommended and a 20 mm Balloon Expandable (BE) Myval Transcatheter Heart Valve (THV) was selected. No peri-procedural or post-procedural complications were reported and the post-procedural hemodynamics, namely the mean and peak PGs improved to 16 mmHg and 30 mmHg after TAVR, respectively. The patient was discharged in a stable condition after four days of hospital stay. Conclusion: We report the successful implantation of a small-sized BE Myval THV (20 mm) in a patient with low coronary heights. Life-threatening complications including paravalvular leak, coronary obstruction, or annular rupture were well averted; hence, we ascertain that the Myval THV is a suitable device for treating severe AS in difficult anatomies. However, the viability of the novel valve needs to be reaffirmed in larger studies.
{"title":"Preventing Coronary Occlusion in an Elderly Severe Aortic Stenosis Patient with Critically Low Coronary Heights – A Case Report","authors":"Kumar Viveka","doi":"10.29328/journal.jccm.1001165","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001165","url":null,"abstract":"Background: Transcatheter Aortic Valve Replacement (TAVR) is an established treatment for severe, symptomatic Aortic Stenosis (AS). However, the presence of low coronary heights confers a high risk for coronary obstruction during or after TAVR. Case: In this case report, we present our experience with transfemoral-TAVR in an elderly, high-risk (STS score – 12.08%) female severe AS patient with low coronary heights (right: 7.4 mm, left: 8.7 mm). She had lower annulus area (287 mm2) and moderately low valve area (0.7 cm2) as well. Her mean and peak pressure gradients (PGs) were 38 mmHg and 61 mmHg, respectively. Upon the Heart Team’s evaluation, TAVR was recommended and a 20 mm Balloon Expandable (BE) Myval Transcatheter Heart Valve (THV) was selected. No peri-procedural or post-procedural complications were reported and the post-procedural hemodynamics, namely the mean and peak PGs improved to 16 mmHg and 30 mmHg after TAVR, respectively. The patient was discharged in a stable condition after four days of hospital stay. Conclusion: We report the successful implantation of a small-sized BE Myval THV (20 mm) in a patient with low coronary heights. Life-threatening complications including paravalvular leak, coronary obstruction, or annular rupture were well averted; hence, we ascertain that the Myval THV is a suitable device for treating severe AS in difficult anatomies. However, the viability of the novel valve needs to be reaffirmed in larger studies.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"208 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30DOI: 10.17352/2455-2976.000199
D’Angelo Alisia, Berardino Martina Di, Matarazzo Alessio, Forte Oriana, Fondi Antonella, Di Giacinto Gabriella, Ripari Patrizio
Eating Disorders represent one of the fastest-growing mental health problems in the world. While a diagnosis of an eating disorder can only be made after careful psychiatric evaluation, the detection of “at-risk” individuals can be conducted through screening programs that use tools such as the Eating Attitude Test (EAT-26), a test used to measure the symptoms and concerns characteristic of eating disorders. This observational study was designed to evaluate the presence of at-risk individuals, using the EAT-26, among young athletes in “lean sports”, young athletes in non-”lean sports”, young non-athlete sportspeople, and young people who did not practice any sports. In addition, the presence of a correlation between the risk of developing eating disorders, gender, and age was also investigated. The results identified a prevalence of risk of 13% among study participants. None of the subjects who did not engage in any physical activity obtained a test score that could be considered at risk. Furthermore, no correlation was found between gender and the scores obtained. These results should be taken into consideration to emphasize the importance of nutritional intervention by expert and qualified personnel within various sports societies, in order to prevent the development of these pathologies and at the same time increase and improve performance.
{"title":"Observational study on the eating behavior of a heterogeneous group of young athletes","authors":"D’Angelo Alisia, Berardino Martina Di, Matarazzo Alessio, Forte Oriana, Fondi Antonella, Di Giacinto Gabriella, Ripari Patrizio","doi":"10.17352/2455-2976.000199","DOIUrl":"https://doi.org/10.17352/2455-2976.000199","url":null,"abstract":"Eating Disorders represent one of the fastest-growing mental health problems in the world. While a diagnosis of an eating disorder can only be made after careful psychiatric evaluation, the detection of “at-risk” individuals can be conducted through screening programs that use tools such as the Eating Attitude Test (EAT-26), a test used to measure the symptoms and concerns characteristic of eating disorders. This observational study was designed to evaluate the presence of at-risk individuals, using the EAT-26, among young athletes in “lean sports”, young athletes in non-”lean sports”, young non-athlete sportspeople, and young people who did not practice any sports. In addition, the presence of a correlation between the risk of developing eating disorders, gender, and age was also investigated. The results identified a prevalence of risk of 13% among study participants. None of the subjects who did not engage in any physical activity obtained a test score that could be considered at risk. Furthermore, no correlation was found between gender and the scores obtained. These results should be taken into consideration to emphasize the importance of nutritional intervention by expert and qualified personnel within various sports societies, in order to prevent the development of these pathologies and at the same time increase and improve performance.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135082997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-27DOI: 10.29328/journal.jccm.1001164
Del Río Ignacio Juárez, Medinilla Enrique Villagrán, Albarrán Ali Ayaon, Alonso Miguel Angel Rubio, Peinado Angel Aroca
Cardiac revascularization surgery has a long history. Its results and safety are well known. Nonetheless, the long-term patency rate of certain grafts used in cardiac revascularization is non-optimal, and CABG is associated with a risk of cerebrovascular stroke due to aortic manipulation. We have developed a simple control quality protocol of the anastomosis performed in CABG, aiming to improve the long-term patency of certain grafts used in cardiac revascularization surgery and reduce the risk of cerebrovascular stroke in those patients.
{"title":"Conduit quality control protocol in CABG","authors":"Del Río Ignacio Juárez, Medinilla Enrique Villagrán, Albarrán Ali Ayaon, Alonso Miguel Angel Rubio, Peinado Angel Aroca","doi":"10.29328/journal.jccm.1001164","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001164","url":null,"abstract":"Cardiac revascularization surgery has a long history. Its results and safety are well known. Nonetheless, the long-term patency rate of certain grafts used in cardiac revascularization is non-optimal, and CABG is associated with a risk of cerebrovascular stroke due to aortic manipulation. We have developed a simple control quality protocol of the anastomosis performed in CABG, aiming to improve the long-term patency of certain grafts used in cardiac revascularization surgery and reduce the risk of cerebrovascular stroke in those patients.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135587514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The identification of new markers of thrombotic risk and early diagnosis of Non-ST-segment Elevation Myocardial Infarction (NSTEMI) could allow the optimization of the therapy and predict short and long-term prognosis. Aims and objective: We aimed to assess the impact of Immature Platelet Fraction (IPF) and Mean Platelet Volume (MPV) levels on the extent of Coronary Artery Disease (CAD) in patients with NSTEMI undergoing coronary angiography. Methods: This is a prospective observational study in which 100 subjects of Non-ST Elevation Myocardial Infarction were recruited. For the measurement of platelet count, IPF and MPV samples were analyzed by an automated hematology analyzer (Sysmex XN 1000). Patients were subjected to coronary angiography as per institutional protocol and the extent of coronary artery lesion was noted. Result: A cutoff of MPV (fL) ≥ 10.6 can predict the involvement of the left anterior descending artery (LAD) with a sensitivity of 84%, and a specificity of 50%. With the cutoff of IPF (%) ≥ 2.4, it can even predict the type of disease i.e., Double Vessel Disease (DVD), or Triple Vessel Disease (TVD) with a sensitivity of 97%, and a specificity of 19%. Mean IPF values and MPV levels were significantly higher in patients with LAD involvement i.e., 4.40 ± 1.72% (p = 0.003) and 12.45 ± 1.88 (p = 0.030) respectively than in patients without involvement of LAD i.e., 2.78 ± 1.50% and 11.08 ± 2.19 respectively. Conclusion: Immature platelet fraction and mean platelet volume were significantly associated with the involvement of the left anterior descending artery which was the most commonly involved vessel in patients with NSTEMI. Mean platelet volume was also associated with TVD which was statistically significant. MPV and IPF can be useful early independent hematologic markers to identify patients with a higher risk for significant CAD as they are readily available and inexpensive.
{"title":"Correlation between the Values of Immature Platelet Fraction and Mean Platelet Volume with the Extent of Coronary Artery Disease in Patients with Non-ST-Segment Elevation Myocardial Infarction","authors":"Rauf Shadab, Kumar Tarun, Kumar Vijay, Nath Ranjit Kumar","doi":"10.29328/journal.jccm.1001163","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001163","url":null,"abstract":"Introduction: The identification of new markers of thrombotic risk and early diagnosis of Non-ST-segment Elevation Myocardial Infarction (NSTEMI) could allow the optimization of the therapy and predict short and long-term prognosis. Aims and objective: We aimed to assess the impact of Immature Platelet Fraction (IPF) and Mean Platelet Volume (MPV) levels on the extent of Coronary Artery Disease (CAD) in patients with NSTEMI undergoing coronary angiography. Methods: This is a prospective observational study in which 100 subjects of Non-ST Elevation Myocardial Infarction were recruited. For the measurement of platelet count, IPF and MPV samples were analyzed by an automated hematology analyzer (Sysmex XN 1000). Patients were subjected to coronary angiography as per institutional protocol and the extent of coronary artery lesion was noted. Result: A cutoff of MPV (fL) ≥ 10.6 can predict the involvement of the left anterior descending artery (LAD) with a sensitivity of 84%, and a specificity of 50%. With the cutoff of IPF (%) ≥ 2.4, it can even predict the type of disease i.e., Double Vessel Disease (DVD), or Triple Vessel Disease (TVD) with a sensitivity of 97%, and a specificity of 19%. Mean IPF values and MPV levels were significantly higher in patients with LAD involvement i.e., 4.40 ± 1.72% (p = 0.003) and 12.45 ± 1.88 (p = 0.030) respectively than in patients without involvement of LAD i.e., 2.78 ± 1.50% and 11.08 ± 2.19 respectively. Conclusion: Immature platelet fraction and mean platelet volume were significantly associated with the involvement of the left anterior descending artery which was the most commonly involved vessel in patients with NSTEMI. Mean platelet volume was also associated with TVD which was statistically significant. MPV and IPF can be useful early independent hematologic markers to identify patients with a higher risk for significant CAD as they are readily available and inexpensive.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135721038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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