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Amlodipine and Landmark Trials: A Review 氨氯地平和标志性试验综述
Pub Date : 2021-07-30 DOI: 10.29245/2578-3025/2021/3.1215
M. Yunus Khan, Sadanand R Shetty, A. Oomman, P. Jain, K. Gaurav
High blood pressure is considered one of the major risk factors for heart disease. In addition to evidence of low heart disease and death with adequate control of blood pressure, antihypertensive treatment is still less effective in clinical practice. It is well documented that there is a decrease in cardiovascular events, such as stroke and MI, with potent therapies to combat high blood pressure. This, however, is generally believed to be the result of a phase. This review paper includes and focuses on evidence from clinical trials in support of amlodipine as a first-line anti-hypertensive agent, showing how its unique properties can provide better cardiovascular protection compared to other antihypertensive agents to prevent stroke and cardiovascular disease. Evidence from the many randomized controlled trials presented below shows that amlodipine has excellent efficacy and safety, as a first-rate anti-hypertensive agent not only to control BP but also to safely improve patient outcomes. Patients treated with this drug have benefited as they have fewer hospitals and lower rates of recovery. Its unique mechanism of action leads to a reduction in the development of atherosclerosis. In addition, amlodipine with effective BP control for 24 hours may also be helpful as an adjunct to the treatment of patients with renal impairment by reducing the progression of end-stage renal disease.
高血压被认为是心脏病的主要危险因素之一。除了在充分控制血压的情况下出现低心脏病和死亡的证据外,抗高血压治疗在临床实践中的效果仍然较差。有充分的证据表明,通过有效的治疗来对抗高血压,心血管事件(如中风和心肌梗死)会减少。然而,这通常被认为是一个阶段的结果。这篇综述论文包括并重点介绍了支持氨氯地平作为一线抗高血压药物的临床试验证据,表明与其他抗高血压药物相比,氨氯地平的独特特性可以提供更好的心血管保护,以预防中风和心血管疾病。以下许多随机对照试验的证据表明,氨氯地平具有良好的疗效和安全性,是一种一流的降压药,不仅可以控制血压,而且可以安全地改善患者的预后。使用这种药物治疗的患者受益匪浅,因为他们的医院更少,康复率更低。其独特的作用机制可减少动脉粥样硬化的发展。此外,氨氯地平在24小时内有效控制血压,也可能有助于通过减少终末期肾病的进展来辅助治疗肾损伤患者。
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引用次数: 2
Hemodynamics in the Aorta and Pulmonary Arteries of Congenital Heart Disease Patients: A Mini Review 先天性心脏病患者主动脉和肺动脉的血流动力学:一个小综述
Pub Date : 2021-06-30 DOI: 10.29245/2578-3025/2021/2.1213
L. Johnston, M. Boumpouli, A. Kazakidi
Congenital heart disease, which affects more than one million newborns globally each year, contributes to an increased risk of cardiovascular disease and ultimately reduced life expectancy. Computational fluid dynamics (CFD) enables detailed, non-invasive characterization of complex physiological pressure and flow fields, thus improving our understanding of congenital heart disease hemodynamics. In recent years, this has driven clinical decision-making, surgical planning, and the evaluation of innovative surgical techniques. In this mini review, CFD methods applied to the study of congenital abnormalities, with a focus on the aorta and pulmonary bifurcation, are discussed. The clinical relevance and future directions of CFD modelling are also reviewed.
先天性心脏病每年影响全球100多万新生儿,导致心血管疾病风险增加,最终缩短预期寿命。计算流体动力学(CFD)能够对复杂的生理压力和流场进行详细、无创的表征,从而提高我们对先天性心脏病血液动力学的理解。近年来,这推动了临床决策、手术计划和创新手术技术的评估。在这篇小型综述中,讨论了CFD方法在先天性畸形研究中的应用,重点是主动脉和肺分叉。还对CFD建模的临床相关性和未来方向进行了综述。
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引用次数: 5
Commentary: Description of the Position and Performance of an Echocardiogram by Subcostal View During the Prone Position in A Patient with Severe Pneumonia Caused by COVID-19 解说词:一例新冠肺炎引起的重症肺炎患者俯卧位超声心动图的位置和表现描述
Pub Date : 2021-01-19 DOI: 10.29245/2578-3025/2021/1.1210
César Del Castillo Gordillo, Mario Alfaro Diaz
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引用次数: 0
https://www.cardiologyresearchjournal.com/articles/what-are-adults-illness-representations-mood-and-quality-of-life-after-myocardial-infarction.html https://www.cardiologyresearchjournal.com/articles/what-are-adults-illness-representations-mood-and-quality-of-life-after-myocardial-infarction.html
Pub Date : 2020-10-01 DOI: 10.29245/2578-3025/2020/4.1205
Elizabeth P. Tolmie, G. Lindsay, P. Belcher
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引用次数: 0
Shockwave Coronary Lithoplasty for the Treatment of Under-Expanded Stent 冲击波冠状动脉成形术治疗支架扩张不足
Pub Date : 2020-07-01 DOI: 10.29245/2578-3025/2020/3.1202
E. J. Tassone, C. Tripolino, G. Morabito, Placido Grillo, B. Missiroli
The presence of coronary calcification is a hard challenge for the interventional cardiologist, as it is associated with incomplete stent expansion and frequently stent failure. In recent years, innovative techniques has been developed to treat coronary calcific lesions such as rotational atherectomy. However, many of them are burdened with an increased procedural risk. Recently, a new technique called “Shockwave Coronary Lithoplasty System” has been introduced in order to treat calcific coronary lesions with greater safety. Shockwave procedure allows treating the most calcific coronary lesions with simplicity and safety. This system employs the sound waves, similar to that used for treating kidney stone, in order to crush the calcific lesions. In this minireview we explain the characteristics of the method and we provide a description of the technique in detail on the basis of the preliminary experience of the first cases. In particular, we will demonstrate that this technique is more effective and safer than traditional techniques employing atherectomy, also providing for the first time a therapeutic chance for the treatment of under-expanded stents in many clinical contexts. *Correspondence to: Eliezer Joseph Tassone, Department of Cardiac Surgery, Cardiology Unit, Sant ’Anna Hospital, Catanzaro, Italy, E-mail: eliezerjoseph.tassone@gmail.com
冠状动脉钙化的存在对介入心脏病专家来说是一个艰巨的挑战,因为它与支架扩张不完全和支架经常失效有关。近年来,已经开发出治疗冠状动脉钙化病变的创新技术,如旋磨术。然而,他们中的许多人承担着越来越大的程序风险。最近,一种名为“冲击波冠状动脉整形系统”的新技术被引入,以更安全地治疗钙化的冠状动脉病变。冲击波手术可以简单安全地治疗钙化最严重的冠状动脉病变。该系统采用声波,类似于用于治疗肾结石的声波,以粉碎钙化病变。在这篇小型综述中,我们解释了该方法的特点,并在第一个案例的初步经验的基础上详细描述了该技术。特别是,我们将证明这项技术比采用斑块切除术的传统技术更有效、更安全,也首次为在许多临床情况下治疗扩张不足的支架提供了治疗机会*致:Eliezer Joseph Tassone,意大利卡坦扎罗Sant’Anna医院心脏外科,心脏科,电子邮件:eliezerjoseph.tassone@gmail.com
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引用次数: 1
Left Atrial Appendage Occlusion in Patients with Non-Valvular Atrial Fibrillation and History of Intracranial Hemorrhage: A Review 非瓣膜性心房颤动患者左心耳闭塞与颅内出血史的回顾
Pub Date : 2020-05-01 DOI: 10.29245/2578-3025/2020/2.1197
S. Hosseini, Cristina Pecci, M. Ajmal
Atrial Fibrillation (AF) is associated with an increased risk of thromboembolism due to formation of intracardiac thrombus mostly in left atrial appendage. Anticoagulant agents are used to reduce the risk of thromboembolism but have concerning bleeding side effect, making their use very challenging particularly in patients with high HAS-BLED risk score. WATCHMAN device (Boston Scientific, St. Paul, Minnesota) is a Left Atrial Appendage Occlusion (LAAO) device, which was tested in two major randomized trials. PROTECT AF (Percutaneous Left Atrial Appendage Closure for Stroke Prophylaxis in Patients with Atrial Fibrillation) trial, and PREVAIL (Prospective Randomized Evaluation of the WATCHMAN Left Atrial Appendage Closure Device in Patients with Atrial Fibrillation versus Long Term warfarin Therapy) trial, both evaluated WATCHMAN device’s safety and efficacy compared to warfarin. These trials showed WATCHMAN device to be noninferior to warfarin. However, patients with history of intracranial hemorrhage were excluded from these trials due to concern of increased recurrent bleeding in presence of perioperative use of anticoagulation. Purpose of this review is to evaluate existing evidence and share our experience of LAAO in this high-risk population.
心房颤动(AF)与血栓栓塞的风险增加有关,因为心内血栓的形成主要发生在左心房附件。抗凝剂用于降低血栓栓塞的风险,但有出血的副作用,这使得抗凝剂的使用非常具有挑战性,特别是在高ha - bled风险评分的患者中。WATCHMAN装置(Boston Scientific, St. Paul, Minnesota)是一种左心耳闭塞(LAAO)装置,在两个主要的随机试验中进行了测试。PROTECT(经皮左心房附件关闭术预防房颤患者卒中)试验和precprev (WATCHMAN左心房附件关闭装置与长期华法林治疗的前瞻性随机评价)试验,均评价了WATCHMAN装置与华法林相比的安全性和有效性。这些试验表明WATCHMAN装置不逊于华法林。然而,有颅内出血史的患者被排除在这些试验之外,因为担心围手术期使用抗凝剂会增加复发性出血。本综述的目的是评估现有的证据,并分享我们在这一高危人群中LAAO的经验。
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引用次数: 1
Cardiac Sarcoidosis: Role of Multimodality Imaging for Diagnosis and Treatment 心脏结节病:多模态成像在诊断和治疗中的作用
Pub Date : 2020-04-01 DOI: 10.29245/2578-3025/2020/2.1194
D. Bhandare, A. Kottam
The clinical presentation of cardiac sarcoidosis (CS) ranges from an incidentally discovered condition to heart failure and sudden death. The diagnosis of CS is tough, and as a result, CS is often under-recognized in clinical practice. CS is mostly noted in the setting of systemic sarcoidosis, though isolated CS can occur. Frequently clinical criteria require the diagnosis of extracardiac disease in order to establish the diagnosis of CS in the absence of having a positive endomyocardial biopsy. While endomyocardial biopsy provides a high specificity for diagnosing CS, this invasive test has a limited sensitivity. There is incomplete knowledge of disease development and a deficient consensus on the ideal methods for disease recognition. We discuss CS in general, the clinical disease, diagnostic algorithms, latest guidelines and management.
心脏结节病(CS)的临床表现从偶然发现到心力衰竭和猝死不等。CS的诊断是困难的,因此,CS在临床实践中往往被低估。CS主要发生在系统性结节病的背景下,尽管孤立的CS也可能发生。通常,临床标准要求诊断心外疾病,以便在没有心肌内膜活检阳性的情况下确定CS的诊断。虽然心内膜肌活检对诊断CS具有很高的特异性,但这种侵入性检查的敏感性有限。对疾病发展的认识不完全,对疾病识别的理想方法也缺乏共识。我们讨论CS的一般情况,临床疾病,诊断算法,最新指南和管理。
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引用次数: 0
Digital Health: New Approaches in Hypertension Management 数字健康:高血压管理的新方法
Pub Date : 2020-02-01 DOI: 10.29245/2578-3025/2020/1.1186
J. Kitt, R. Fox, K. Tucker
Hypertension is a key risk factor for cardiovascular disease. Globally, approximately a third of people with hypertension remain undiagnosed, and of those diagnosed, about half are not taking antihypertensive medication. The World Health Organization has estimated that globally hypertension directly or indirectly causes the deaths of at least nine million people every year. There is a trend towards self-monitoring of blood pressure (BP), where patients are empowered to be involved in hypertension screening and diagnosis. Novel technology, including smartphones and Blue-tooth® enabled telemonitoring, are new tools that are likely to be increasingly important in hypertension management. Several studies have shown the benefit of self-monitoring of BP coupled with co-interventions (such as telemonitoring) in improving BP management. However, these new technologies must be properly assessed and clinically validated prior to widespread implementation in the general population, or within special groups. In this mini-review, we examine how technology might improve the detection and management of hypertension.
高血压是心血管疾病的主要危险因素。在全球范围内,约有三分之一的高血压患者未得到诊断,而在被诊断出高血压的患者中,约有一半没有服用抗高血压药物。世界卫生组织估计,全球每年至少有900万人直接或间接死于高血压。自我监测血压(BP)是一种趋势,患者被授权参与高血压筛查和诊断。包括智能手机和蓝牙远程监测在内的新技术在高血压管理中可能越来越重要。几项研究表明,自我监测血压与联合干预(如远程监测)相结合,可以改善血压管理。然而,这些新技术必须经过适当的评估和临床验证,才能在普通人群或特殊群体中广泛应用。在这篇简短的综述中,我们探讨了技术如何改善高血压的检测和管理。
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引用次数: 3
Stented Porcine and Pericardial Bioprostheses - A historical review 猪支架和心包生物假体-历史回顾
Pub Date : 2019-10-01 DOI: 10.29245/2578-3025/2019/5.1179
A. Martino, G. Falcetta, A. Milano, U. Bortolotti
Stented bioprostheses have been extensively used clinically to replace diseased cardiac valves with the clear advantage over mechanical prostheses of avoiding the use of chronic anticoagulation in most cases. During the past five decades, however, based on clinical and pathological experience, tissue calcification and cusp tears were identified as the main determinants of failure of porcine and pericardial bioprostheses, respectively. Tissue treatments to mitigate dystrophic calcification together with structural modifications in valve design have produced a current generation of bioprosthetic valves which show excellent overall performance and considerably increased durability when compared with old models. Further ongoing research aims to provide even more durable bioprostheses in order to allow reduction of the age threshold for implantation also in younger subjects, helping to contrast effectively the rapidly expanding role of catheter-based interventions.
支架生物假体在临床上已广泛应用于病变心脏瓣膜的替代,其明显优于机械假体,在大多数情况下避免使用慢性抗凝。然而,在过去的五十年中,根据临床和病理经验,组织钙化和尖端撕裂分别被确定为猪和心包生物假体失败的主要决定因素。减轻营养不良钙化的组织治疗和瓣膜设计的结构修改产生了当前一代的生物假体瓣膜,与旧模型相比,它们表现出出色的整体性能和显著提高的耐用性。进一步正在进行的研究旨在提供更耐用的生物假体,以降低年轻受试者的植入年龄门槛,帮助有效地对比导管干预快速扩大的作用。
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引用次数: 0
Long Non-Coding RNAs: Crucial Players of Cardiomyocyte Apoptosis 长非编码RNA:心肌细胞凋亡的关键因素
Pub Date : 2019-10-01 DOI: 10.29245/2578-3025/2019/5.1178
Xiatian Chen, Ziqian Liu, Zhe Li, Jinning Gao, Zhongjie Yu, Peifeng Li, L. Aung
Long non-coding RNAs (lncRNAs) have gained more attention in recent years as a potential new regulator of nearly all biological regulation. LncRNAs are over 200 nucleotides in length, and it can interact with other non-coding RNAs or specific proteins to influence the gene expression. Cardiomyocyte apoptosis is associated with cardiovascular diseases. Accumulating studies have uncovered novel lncRNAs-mediated regulation of cardiovascular diseases; however, the knowledge of the mechanisms by how to act is still limited. This review highlights the role of lncRNAs involved in cardiomyocyte apoptosis with a focus on the regulatory axis. These examples may provide helpful insights on how lncRNAs interfere with cardiomyocyte apoptosis.
近年来,长非编码RNA(lncRNA)作为几乎所有生物调控的潜在新调控因子,受到了越来越多的关注。lncRNA长度超过200个核苷酸,它可以与其他非编码RNA或特定蛋白质相互作用,影响基因表达。心肌细胞凋亡与心血管疾病有关。越来越多的研究发现了新的lncRNA介导的心血管疾病调控;然而,对如何采取行动的机制的了解仍然有限。这篇综述强调了lncRNA在心肌细胞凋亡中的作用,重点是调节轴。这些例子可能为lncRNA如何干扰心肌细胞凋亡提供有用的见解。
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引用次数: 1
期刊
Journal of cardiology and cardiovascular sciences
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