Pub Date : 2023-03-03DOI: 10.17352/2455-2976.000193
E. Assisi, Libener E, Grossgasteiger S, Marine Ottavio, Resnyak S
The myocardial bridge is an intramural course of a coronary artery in which a more or less long section of a coronary branch, instead of running normally on the epicardial surface of the heart, deepens early in the myocardium, coming to be surrounded by a ring or sleeve of muscle fiber cells that, contracting in systole, can cause an ab-extrinsic “throttling” of the artery. The guidelines for granting eligibility for competitive sports have evolved over time: from 2009, when any case of myocardial bridging indicated exclusion of eligibility, to today, when only significant bridges, i.e. ‘long’ bridges > 1 cm and > 3 mm deep, place a restriction on competitive sports activity.
{"title":"Myocardial bridges and competitive sports fitness between past and future","authors":"E. Assisi, Libener E, Grossgasteiger S, Marine Ottavio, Resnyak S","doi":"10.17352/2455-2976.000193","DOIUrl":"https://doi.org/10.17352/2455-2976.000193","url":null,"abstract":"The myocardial bridge is an intramural course of a coronary artery in which a more or less long section of a coronary branch, instead of running normally on the epicardial surface of the heart, deepens early in the myocardium, coming to be surrounded by a ring or sleeve of muscle fiber cells that, contracting in systole, can cause an ab-extrinsic “throttling” of the artery. The guidelines for granting eligibility for competitive sports have evolved over time: from 2009, when any case of myocardial bridging indicated exclusion of eligibility, to today, when only significant bridges, i.e. ‘long’ bridges > 1 cm and > 3 mm deep, place a restriction on competitive sports activity.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81734677","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 : 2023-02-21DOI: 10.17352/2455-2976.000192
Liao Da-Ming, Chen Chieh
According to the WHO’s report, the number of people with diabetes worldwide is increasing, and the prevalence of type 2 diabetes in adults who is over 18 years old has risen from 4.7% in the 1980s to 8.5% in 2014. Among them, the prevalence of diabetes in low- and middle-income countries has even reached as high as 9.3% over the decades. Metabolic-Associated Fatty Liver Disease (MAFLD) is not only affecting the liver but is also considered a problem for the heart, as there is about 25% of the patients suffer from the cardiovascular syndrome. Around the world, the elderly population is growing rapidly. The elderly population is growing faster than expected, with Taiwan becoming an aged society in 2018. One of the health issues associated with aging is the population with cardiovascular disease increases. Patient care may result in huge expenditures on the national economy, society, family care, medical resources, and drugs. This article adopts perspectives from literature reviews using databases such as Cochrane Library, PubMed (Medline), Up-to-date and Google scholar using three main methods: search for keywords cardiovascular disease, physical fitness, exercise prescription intervention, quality of life, cardio metabolic disease, etc.; search for related articles on physical activity and cardiovascular disease, neuroendocrine, molecular biology, etc.; combined with case-control studies, systematic review and meta-analysis, analytical research, and randomized control studies to explore the effects of physical activity intervention and the fitness level of the elderly on the epidemiology of the cardiovascular disease, prevention of cardio metabolic disease, improvement of quality of life. Understanding which types of exercise intervention help improve the quality of life of patients with cardiovascular disease. This article aims to propose exercise prescriptions for physical fitness to prevent cardiovascular disease; be used as a reference for health promotion in the world, provide guidance on cardiovascular disease prevention and cardiovascular disease care for the elderly, and construct guidelines on physical fitness and exercise prescriptions in Taiwan.
{"title":"A Narrative review of exercise and metabolic disease of the heart","authors":"Liao Da-Ming, Chen Chieh","doi":"10.17352/2455-2976.000192","DOIUrl":"https://doi.org/10.17352/2455-2976.000192","url":null,"abstract":"According to the WHO’s report, the number of people with diabetes worldwide is increasing, and the prevalence of type 2 diabetes in adults who is over 18 years old has risen from 4.7% in the 1980s to 8.5% in 2014. Among them, the prevalence of diabetes in low- and middle-income countries has even reached as high as 9.3% over the decades. Metabolic-Associated Fatty Liver Disease (MAFLD) is not only affecting the liver but is also considered a problem for the heart, as there is about 25% of the patients suffer from the cardiovascular syndrome. Around the world, the elderly population is growing rapidly. The elderly population is growing faster than expected, with Taiwan becoming an aged society in 2018. One of the health issues associated with aging is the population with cardiovascular disease increases. Patient care may result in huge expenditures on the national economy, society, family care, medical resources, and drugs. This article adopts perspectives from literature reviews using databases such as Cochrane Library, PubMed (Medline), Up-to-date and Google scholar using three main methods: search for keywords cardiovascular disease, physical fitness, exercise prescription intervention, quality of life, cardio metabolic disease, etc.; search for related articles on physical activity and cardiovascular disease, neuroendocrine, molecular biology, etc.; combined with case-control studies, systematic review and meta-analysis, analytical research, and randomized control studies to explore the effects of physical activity intervention and the fitness level of the elderly on the epidemiology of the cardiovascular disease, prevention of cardio metabolic disease, improvement of quality of life. Understanding which types of exercise intervention help improve the quality of life of patients with cardiovascular disease. This article aims to propose exercise prescriptions for physical fitness to prevent cardiovascular disease; be used as a reference for health promotion in the world, provide guidance on cardiovascular disease prevention and cardiovascular disease care for the elderly, and construct guidelines on physical fitness and exercise prescriptions in Taiwan.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81242026","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 : 2023-01-18DOI: 10.29328/journal.jccm.1001147
H. Mohammed, E. Somaya
Background: The concurrent occurrence of acute ischemic stroke and acute myocardial infarction is an extremely rare emergency condition that can be lethal. The causes, prognosis and optimal treatment in these cases are still unclear. Methods: We conducted the literature review and 2 additional cases at Al-Shifa Hospital, we analyzed clinical presentations, risk factors, type of myocardial infarction, site of stroke, modified ranking scale and treatment options. We compare the mortality rate among patients with combination intervention treatment (both percutaneous coronary intervention for coronary arteries and mechanical thrombectomy for cerebral vessels) and medical treatment at the hospital and 90 days after stroke. Results: In addition to our cases, we identified 94 cases of concurrent cardio-cerebral infarction from case reports and series with a mean age of 62.5 ± 12.6 years. Female 36 patients (38.3%), male 58 patients (61.7%). Only 21 (22.3%) were treated with combination intervention treatment. The mortality rate at hospital discharge was (33.3%) and the mortality rate at 90 days was (49.2%). In patients with the combination intervention treatment group: the hospital mortality rate was 13.3% and the 90-day mortality rate was: 23.5% compared with the mortality rate in medical treatment (23.5% at the hospital and 59.5% at 90 days (p value 0.038 and 0.012 respectively) Conclusion: Concurrent cardio-cerebral infarction prognosis is very poor, about a third of patients died before discharge and half of the patients died 90 days after stroke. Despite only one-quarter of patients being treated by combination intervention treatment, this treatment modality significantly reduces the mortality rate compared to medical treatment.
{"title":"Outcomes of intervention treatment for concurrent cardio-cerebral infarction: a case series and meta-analysis","authors":"H. Mohammed, E. Somaya","doi":"10.29328/journal.jccm.1001147","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001147","url":null,"abstract":"Background: The concurrent occurrence of acute ischemic stroke and acute myocardial infarction is an extremely rare emergency condition that can be lethal. The causes, prognosis and optimal treatment in these cases are still unclear. Methods: We conducted the literature review and 2 additional cases at Al-Shifa Hospital, we analyzed clinical presentations, risk factors, type of myocardial infarction, site of stroke, modified ranking scale and treatment options. We compare the mortality rate among patients with combination intervention treatment (both percutaneous coronary intervention for coronary arteries and mechanical thrombectomy for cerebral vessels) and medical treatment at the hospital and 90 days after stroke. Results: In addition to our cases, we identified 94 cases of concurrent cardio-cerebral infarction from case reports and series with a mean age of 62.5 ± 12.6 years. Female 36 patients (38.3%), male 58 patients (61.7%). Only 21 (22.3%) were treated with combination intervention treatment. The mortality rate at hospital discharge was (33.3%) and the mortality rate at 90 days was (49.2%). In patients with the combination intervention treatment group: the hospital mortality rate was 13.3% and the 90-day mortality rate was: 23.5% compared with the mortality rate in medical treatment (23.5% at the hospital and 59.5% at 90 days (p value 0.038 and 0.012 respectively) Conclusion: Concurrent cardio-cerebral infarction prognosis is very poor, about a third of patients died before discharge and half of the patients died 90 days after stroke. Despite only one-quarter of patients being treated by combination intervention treatment, this treatment modality significantly reduces the mortality rate compared to medical treatment.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42251637","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: Some studies have evaluated the role of QRS duration (QRSd) as predictor of response to Cardiac Resynchronization Therapy (CRT). However, their results are still not entirely clear. The goal of our study was to determine the correlation between the relative change in QRS narrowing index (QI) compared to clinical outcome and prognosis in patients who underwent CRT implantation. Methods: We collected clinical and echocardiographic data of 115 patients in whome a CRT device was implanted in accordance with current guidelines. QRS duration before and after CRT implantation and QI were measured. Results: After 6 months, a significant improvement in all echocardiographic parameters was detected. QI was correlated to reverse remodelling (r = +0.19; 95% CI: 0.006 to 0.35, p = 0,049). The value of QI that predicted best LV reverse remodelling after 6 months of CRT was 12.25% (sensitivity = 65,5%, specificity = 75%, area under the curve = 0.737, p = 0,001). Independent predictors of QI are sex, serum creatinine and eGFR measured at baseline and LVEF pre-CRT performed by echocardiography. We observed an betterment in their HF clinical composite score and NYHA class at 12 months. We have also investigated the clinical outcomes and the possible sex differences related to QI. Conclusions: Patients with a larger QI after CRT initiation showed greater echocardiographic reverse remodelling and better outcome from death or cardiovascular hospitalization. QI seems to be an easy-to- measure variable that could be used or evaluated to predict CRT response but further studies are needed.
{"title":"A possible easy way to predict response to cardiac resynchronization therapy: The role of QRS Index","authors":"Coppola Giuseppe, Madaudo Cristina, Prezioso Amedeo, Bonnì Enrico, Novo Giuseppina, Sucato Vincenzo, Ciaramitaro Gianfranco, Galassi Alfredo Ruggero, Corrado Egle","doi":"10.17352/2455-2976.000191","DOIUrl":"https://doi.org/10.17352/2455-2976.000191","url":null,"abstract":"Background: Some studies have evaluated the role of QRS duration (QRSd) as predictor of response to Cardiac Resynchronization Therapy (CRT). However, their results are still not entirely clear. The goal of our study was to determine the correlation between the relative change in QRS narrowing index (QI) compared to clinical outcome and prognosis in patients who underwent CRT implantation. Methods: We collected clinical and echocardiographic data of 115 patients in whome a CRT device was implanted in accordance with current guidelines. QRS duration before and after CRT implantation and QI were measured. Results: After 6 months, a significant improvement in all echocardiographic parameters was detected. QI was correlated to reverse remodelling (r = +0.19; 95% CI: 0.006 to 0.35, p = 0,049). The value of QI that predicted best LV reverse remodelling after 6 months of CRT was 12.25% (sensitivity = 65,5%, specificity = 75%, area under the curve = 0.737, p = 0,001). Independent predictors of QI are sex, serum creatinine and eGFR measured at baseline and LVEF pre-CRT performed by echocardiography. We observed an betterment in their HF clinical composite score and NYHA class at 12 months. We have also investigated the clinical outcomes and the possible sex differences related to QI. Conclusions: Patients with a larger QI after CRT initiation showed greater echocardiographic reverse remodelling and better outcome from death or cardiovascular hospitalization. QI seems to be an easy-to- measure variable that could be used or evaluated to predict CRT response but further studies are needed.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"76 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86389561","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 : 2023-01-06DOI: 10.29328/journal.jccm.1001146
Bisignani Antonio, Madeo Andrea, De Bonis Silvana, Vico Riccardo, Bisignani Giovanni
Hydatid cysts primarily affect the liver and secondary involvement may be seen in almost any anatomic location. We describe the unusual pericardial location of the Echinococcus cysts in an asymptomatic patient with suggestive cardiac magnetic resonance imaging.
{"title":"Isolated multiple pericardial hydatid cysts in an asymptomatic patient: Role of the CMR","authors":"Bisignani Antonio, Madeo Andrea, De Bonis Silvana, Vico Riccardo, Bisignani Giovanni","doi":"10.29328/journal.jccm.1001146","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001146","url":null,"abstract":"Hydatid cysts primarily affect the liver and secondary involvement may be seen in almost any anatomic location. We describe the unusual pericardial location of the Echinococcus cysts in an asymptomatic patient with suggestive cardiac magnetic resonance imaging.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49029968","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 : 2022-12-27DOI: 10.29328/journal.jccm.1001145
Christian Millogo Georges Rosa, Koudougou Kologo Jonas, Arthur Seghda Taryètba André, T. Boro, L. Benon, K. Samadoulougou André, P. Zabsonré
Marfan syndrome is a dominant autosomal genetic disease of the connective tissue, leading to various complications. Cardiovascular complications are the main ones, with dilation of the aorta and aortic dissection which is the main cause of death. Double dissection with different sites of departure is scarcely reported by the literature. We reported the case of a 22-year’s-old young patient admitted for acute chest and abdominal pains, and cardiogenic shock. Investigations reported a double dissection of the aorta with a recent one of type A and an old one of type B. Ghent diagnostic criteria were used to allow the diagnosis of Marfan disease. Surgical management corrected successfully the type A dissection. Early diagnostic and adequate management of aortic complications can reduce the high mortality rate of patients with Marfan syndrome.
{"title":"Double aortic dissection in a patient with Marfan disease. A case report","authors":"Christian Millogo Georges Rosa, Koudougou Kologo Jonas, Arthur Seghda Taryètba André, T. Boro, L. Benon, K. Samadoulougou André, P. Zabsonré","doi":"10.29328/journal.jccm.1001145","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001145","url":null,"abstract":"Marfan syndrome is a dominant autosomal genetic disease of the connective tissue, leading to various complications. Cardiovascular complications are the main ones, with dilation of the aorta and aortic dissection which is the main cause of death. Double dissection with different sites of departure is scarcely reported by the literature. We reported the case of a 22-year’s-old young patient admitted for acute chest and abdominal pains, and cardiogenic shock. Investigations reported a double dissection of the aorta with a recent one of type A and an old one of type B. Ghent diagnostic criteria were used to allow the diagnosis of Marfan disease. Surgical management corrected successfully the type A dissection. Early diagnostic and adequate management of aortic complications can reduce the high mortality rate of patients with Marfan syndrome.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42258343","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 : 2022-12-20DOI: 10.17352/2455-2976.000190
Koruga Djuro, Bandić Jadran, Matija Lidija, Mihajlović Spomenko, Koruga Igor, Ilanković Nikola
In literature and clinical reports connections between a heart condition (blood properties) and emotional and mental states are documented [1,2]. It is well known that psychosocial risk factors may lead to the activation of mechanisms responsible for somatic dysfunction of the cardiovascular system.
{"title":"Does “biological quantum entanglement” exists?","authors":"Koruga Djuro, Bandić Jadran, Matija Lidija, Mihajlović Spomenko, Koruga Igor, Ilanković Nikola","doi":"10.17352/2455-2976.000190","DOIUrl":"https://doi.org/10.17352/2455-2976.000190","url":null,"abstract":"In literature and clinical reports connections between a heart condition (blood properties) and emotional and mental states are documented [1,2]. It is well known that psychosocial risk factors may lead to the activation of mechanisms responsible for somatic dysfunction of the cardiovascular system.","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83952159","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 : 2022-12-15DOI: 10.17352/2455-2976.000189
Siegel Arthur J
Male gender and the marathon were shown to be independent and significant risk factors for cardiac arrest in United States road races in a 10-year registry beginning in 2000, during which events increased in frequency during the latter half of the study [1].
{"title":"Aspirin is used to mitigate the increasing frequency of marathon-related cardiac arrests","authors":"Siegel Arthur J","doi":"10.17352/2455-2976.000189","DOIUrl":"https://doi.org/10.17352/2455-2976.000189","url":null,"abstract":"Male gender and the marathon were shown to be independent and significant risk factors for cardiac arrest in United States road races in a 10-year registry beginning in 2000, during which events increased in frequency during the latter half of the study [1].","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78874446","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 : 2022-12-06DOI: 10.17352/2455-2976.000188
Perrotta Giulio
Background and objectives: Heart failure is a pathological condition characterized by the inability of the heart to pump (cardiac output) an adequate amount of blood to meet the metabolic needs of the body or, at any rate, to be able to do so only at the expense of increased filling pressures in one or more cardiac chambers and the upstream venous circulation. The research group states here the primary objective of expanding the indications contained in the ESC 2021 with the results of the last year on the subject of treatment profiles, to facilitate a better understanding of the overall clinical picture and contribute to the next edition of the guidelines. Materials and methods: Systematic literature review in the English language from January 1, 2021, to September 30, 2022, on PubMed/MedLine, Web on Science, and Cochrane archive. Our search strategy retrieved 8,317 articles. We excluded books and papers, meta-analyses, reviews, and systematic reviews and selected only 46 studies most significant about the clinical trial and randomized controlled trial. Results: The recent ESC 2021 guidelines are accurate and timely, and have confirmed their usefulness from a functional perspective, including concerning certain aspects that were represented as a “grey area”. Early risk prediction plays a key role in the subsequent management of patients, and to optimize risk prediction and intensity of management, one should take into account that: a) biomarkers have improved the understanding of the pathophysiology of heart failure and may therefore help to adjust the intensity of management in AHF; b) among the wide variety of biomarkers currently available, NT-proBNP and cTn seem the most promising in this indication; c) among the risk scores described, those combining demographic and clinical parameters with biomarkers in a model with routinely available rapid variables seem the most promising tools; d) in addition to biomarkers, age, systolic blood pressure, respiratory rate, oxygen saturation, creatinine, electrolytes, and blood urea nitrogen are the most commonly used predictor variables in the risk scores described; e) among the models selected, the MEESSI-AHF risk score appears to be currently the most promising tool for predicting the risk of AHF; f) during the management of decompensated patients (and in later stages), the psychological aspect is completely ignored, thus promoting the worsening of psychological symptoms (the need is as evident during the acute episode as it is in the daily management of chronic heart failure). Conclusions: The scientific literature search enriched the structure of ESC 2021, suggesting its implementation, with other findings related to new drug therapies such as Sotagliflozin, Hydrochlorothiazide Apabetalone, Alprostadil, Empagliflozin, Sacubitril/Valsartan, Dapagliflozin, Sodium-glucose co-transporter-2 inhibitors, and biomarkers such as Urinary sodium (UNa+), IL-6 levels and rh-brain natriuretic peptide (rhBNP), as w
背景和目的:心力衰竭是一种病理状态，其特征是心脏不能泵出(心输出量)足够的血液来满足身体的代谢需要，或者，无论如何，只能以增加一个或多个心腔和上游静脉循环的充血压力为代价。研究小组在此指出，主要目标是扩大ESC 2021中包含的适应症，以及去年治疗概况主题的结果，以促进对整体临床情况的更好理解，并为下一版指南做出贡献。材料和方法:从2021年1月1日到2022年9月30日，在PubMed/MedLine、Web on Science和Cochrane archive上进行系统的英文文献综述。我们的搜索策略检索了8317篇文章。我们排除了书籍和论文、荟萃分析、综述和系统综述，只选择了46项关于临床试验和随机对照试验最重要的研究。结果:最近的ESC 2021指南是准确和及时的，并且从功能的角度证实了它们的有用性，包括涉及某些被表示为“灰色地带”的方面。早期风险预测在患者的后续管理中起着关键作用，为了优化风险预测和管理强度，人们应该考虑到:a)生物标志物提高了对心力衰竭病理生理学的理解，因此可能有助于调整AHF的管理强度;b)在目前可用的各种生物标志物中，NT-proBNP和cTn似乎在这一适应症中最有希望;C)在所描述的风险评分中，那些将人口统计学和临床参数与生物标志物结合在一个具有常规快速变量的模型中的方法似乎是最有希望的工具;D)除生物标志物外，年龄、收缩压、呼吸速率、血氧饱和度、肌酐、电解质和血尿素氮是所描述的风险评分中最常用的预测变量;e)在所选择的模型中，meessii -AHF风险评分似乎是目前最有希望预测AHF风险的工具;F)在失代偿患者的管理过程中(以及后期)，完全忽视了心理方面，从而促进了心理症状的恶化(在急性发作期间，这种需求与慢性心力衰竭的日常管理一样明显)。结论:科学文献检索丰富了ESC 2021的结构，提示其实施，其他研究结果与新药物治疗相关，如索他列净、氢氯噻嗪阿帕他龙、前列地尔、恩帕列净、苏比里尔/缬沙坦、达格列净、钠-葡萄糖共转运蛋白-2抑制剂和生物标志物，如尿钠(UNa+)、IL-6水平和rh-脑利钠肽(rhBNP)，以及使用正念呼吸、骨科手法治疗、电肌刺激、低水平耳屏刺激、静脉动脉体外膜氧合、口服营养补充剂，以及心力衰竭与肠道生态失调的相关假说，以及心理特征。然而，这些临床研究存在一些必须考虑到的局限性，例如所选人群样本的规模有限，或者某些研究由生产所用药物的同一家制药公司资助这一事实所决定的利益冲突，这并不一定代表从研究中获得的结果受到负面限制。
{"title":"Heart Failure (HF): Recent innovations in clinical therapy and critical profiles of acute and chronic forms","authors":"Perrotta Giulio","doi":"10.17352/2455-2976.000188","DOIUrl":"https://doi.org/10.17352/2455-2976.000188","url":null,"abstract":"Background and objectives: Heart failure is a pathological condition characterized by the inability of the heart to pump (cardiac output) an adequate amount of blood to meet the metabolic needs of the body or, at any rate, to be able to do so only at the expense of increased filling pressures in one or more cardiac chambers and the upstream venous circulation. The research group states here the primary objective of expanding the indications contained in the ESC 2021 with the results of the last year on the subject of treatment profiles, to facilitate a better understanding of the overall clinical picture and contribute to the next edition of the guidelines. Materials and methods: Systematic literature review in the English language from January 1, 2021, to September 30, 2022, on PubMed/MedLine, Web on Science, and Cochrane archive. Our search strategy retrieved 8,317 articles. We excluded books and papers, meta-analyses, reviews, and systematic reviews and selected only 46 studies most significant about the clinical trial and randomized controlled trial. Results: The recent ESC 2021 guidelines are accurate and timely, and have confirmed their usefulness from a functional perspective, including concerning certain aspects that were represented as a “grey area”. Early risk prediction plays a key role in the subsequent management of patients, and to optimize risk prediction and intensity of management, one should take into account that: a) biomarkers have improved the understanding of the pathophysiology of heart failure and may therefore help to adjust the intensity of management in AHF; b) among the wide variety of biomarkers currently available, NT-proBNP and cTn seem the most promising in this indication; c) among the risk scores described, those combining demographic and clinical parameters with biomarkers in a model with routinely available rapid variables seem the most promising tools; d) in addition to biomarkers, age, systolic blood pressure, respiratory rate, oxygen saturation, creatinine, electrolytes, and blood urea nitrogen are the most commonly used predictor variables in the risk scores described; e) among the models selected, the MEESSI-AHF risk score appears to be currently the most promising tool for predicting the risk of AHF; f) during the management of decompensated patients (and in later stages), the psychological aspect is completely ignored, thus promoting the worsening of psychological symptoms (the need is as evident during the acute episode as it is in the daily management of chronic heart failure). Conclusions: The scientific literature search enriched the structure of ESC 2021, suggesting its implementation, with other findings related to new drug therapies such as Sotagliflozin, Hydrochlorothiazide Apabetalone, Alprostadil, Empagliflozin, Sacubitril/Valsartan, Dapagliflozin, Sodium-glucose co-transporter-2 inhibitors, and biomarkers such as Urinary sodium (UNa+), IL-6 levels and rh-brain natriuretic peptide (rhBNP), as w","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73482851","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 : 2022-12-06DOI: 10.29328/journal.jccm.1001144
Zaoui Nassime, Boukabous Amina, I. Nabil, Bachir Nadhir, T. Ali
Introduction: Cardiovascular diseases are the leading cause of death in the world, headed by coronary artery disease, which is secondary to atherosclerosis. The latter recognizes classic risk factors such as diabetes, high blood pressure, tobacco, and dyslipidemia and other less classic factors such as chronic inflammation of rheumatoid arthritis. Many studies have highlighted the correlation between this chronic inflammation and clinical coronary disease but very few have focused on the anatomical correlation. Objective: To describe the correlation between the chronic biological inflammation of rheumatoid arthritis and anatomical coronary lesions on angiography. Method: This observational, retrospective, single-center study, including over 10 years, of patients with rheumatoid arthritis, confirmed the EULAR 2010 criteria and presented with coronary artery disease requiring coronary angiography. Patients with missing data or in whom coronary angiography was not done were excluded (n = 14). We divided then the patients according to the existence or not of chronic inflammation to study the impact of the latter on the existence (Stenosis < 50% vs. stenosis ≥ 50%), the extent (single vs. multivessel disease), and the severity of the coronary lesions (syntax score < 32 vs. ≥ 32). Results: 202 patients (49♂/153♀) aged between 30-75 years with a history of rheumatoid arthritis have had a coronary event requiring coronary angiography, were included; The mean ejection fraction at baseline was 57.3% +/- 5.8 (37 vs.-65%). 75% of them were ≥ 65 years old. 55% were diabetics, 61% with hypertension, 38% with dyslipidemia, and 19% were smokers. Chronic inflammation was diagnosed in 70% of them on non-specific parameters (ESR, CRP, fibrinogen, anemia, and rheumatoid factor). All patients had coronary angiography, which made it possible to identify the coronary lesions according to their existence (Stenosis < 50%: 51 patients vs. stenosis ≥ 50%: 151 patients), the extent (single: 86 patients vs. multivessel disease: 116 patients) and the severity of the coronary lesions (syntax score < 32: 142 patients vs. ≥ 32: 60 patients). Chronic inflammation of rheumatoid arthritis was correlated in bivariate and multivariate analysis (after excluding the impact of other risk factors) with the existence and extent of coronary lesions (p < 0.05) but not with their severity (p > 0.05). Discussion: The two limitations of this work are the monocentric nature of the study and the absence of specific inflammatory parameters such as anti-CCP antibodies. Strengths are anatomical correlations and multivariate analysis. Chronic inflammation apart from any influence of the various risk factors predisposes to the existence and extent of coronary lesions (p < 0.05). The severity of coronary lesions assessed by Syntax Score was not correlated with chronic inflammation, although other studies suggest that this inflammation is the cause of complex lesions. Interpretation: Rheumatoid arthrit
{"title":"Correlation between chronic inflammation of rheumatoid arthritis and coronary lesions: “About a monocentric series of 202 cases”","authors":"Zaoui Nassime, Boukabous Amina, I. Nabil, Bachir Nadhir, T. Ali","doi":"10.29328/journal.jccm.1001144","DOIUrl":"https://doi.org/10.29328/journal.jccm.1001144","url":null,"abstract":"Introduction: Cardiovascular diseases are the leading cause of death in the world, headed by coronary artery disease, which is secondary to atherosclerosis. The latter recognizes classic risk factors such as diabetes, high blood pressure, tobacco, and dyslipidemia and other less classic factors such as chronic inflammation of rheumatoid arthritis. Many studies have highlighted the correlation between this chronic inflammation and clinical coronary disease but very few have focused on the anatomical correlation. Objective: To describe the correlation between the chronic biological inflammation of rheumatoid arthritis and anatomical coronary lesions on angiography. Method: This observational, retrospective, single-center study, including over 10 years, of patients with rheumatoid arthritis, confirmed the EULAR 2010 criteria and presented with coronary artery disease requiring coronary angiography. Patients with missing data or in whom coronary angiography was not done were excluded (n = 14). We divided then the patients according to the existence or not of chronic inflammation to study the impact of the latter on the existence (Stenosis < 50% vs. stenosis ≥ 50%), the extent (single vs. multivessel disease), and the severity of the coronary lesions (syntax score < 32 vs. ≥ 32). Results: 202 patients (49♂/153♀) aged between 30-75 years with a history of rheumatoid arthritis have had a coronary event requiring coronary angiography, were included; The mean ejection fraction at baseline was 57.3% +/- 5.8 (37 vs.-65%). 75% of them were ≥ 65 years old. 55% were diabetics, 61% with hypertension, 38% with dyslipidemia, and 19% were smokers. Chronic inflammation was diagnosed in 70% of them on non-specific parameters (ESR, CRP, fibrinogen, anemia, and rheumatoid factor). All patients had coronary angiography, which made it possible to identify the coronary lesions according to their existence (Stenosis < 50%: 51 patients vs. stenosis ≥ 50%: 151 patients), the extent (single: 86 patients vs. multivessel disease: 116 patients) and the severity of the coronary lesions (syntax score < 32: 142 patients vs. ≥ 32: 60 patients). Chronic inflammation of rheumatoid arthritis was correlated in bivariate and multivariate analysis (after excluding the impact of other risk factors) with the existence and extent of coronary lesions (p < 0.05) but not with their severity (p > 0.05). Discussion: The two limitations of this work are the monocentric nature of the study and the absence of specific inflammatory parameters such as anti-CCP antibodies. Strengths are anatomical correlations and multivariate analysis. Chronic inflammation apart from any influence of the various risk factors predisposes to the existence and extent of coronary lesions (p < 0.05). The severity of coronary lesions assessed by Syntax Score was not correlated with chronic inflammation, although other studies suggest that this inflammation is the cause of complex lesions. Interpretation: Rheumatoid arthrit","PeriodicalId":92232,"journal":{"name":"Journal of cardiology and cardiovascular medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48720551","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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