Pub Date : 2023-08-16DOI: 10.31487/j.jicoa.2023.02.01
Nitin Chandola, S. Mahajan, Salil Garg, Yogendra Pratap Singh, Richa Sharma, T. Bhatia, Basundhara Bansal
Since ventricular arrhythmias are frequently transitory, diagnosing them can be difficult. It has been investigated in the past to diagnose atrial fibrillation (AF) using a smartphone-based ECG. Data on the diagnostic efficacy of smartphone-based ECGs for ventricular arrhythmias, however, is insufficient. Objective: Objectives of this study were a) to evaluate the accuracy of the spandan 12 lead ECG device in detection of the ventricular arrhythmias in comparison to the cardiologist, b) to evaluate the arrhythmia detection accuracy of the conventional ECG machine and spandan smartphone ECG machine to cardiologist diagnosis, and c) to detect spontaneous ventricular arrhythmias (VAs), namely ventricular tachycardia (VT) and supraventricular ectopic (SVE), ventricular ectopics (VE), ventricular premature complexes (VPCs), AV-block and ventricular ectopics (VE) can be fatal. Patients who are susceptible to VT/SVTs always have a risk of sudden cardiac death. Methods: This cross-sectional study, single blinded and single-centric study was carried out at Shri Mahant Indresh Hospital (SMIH), Dehradun from 02-Aug-2022 to 29-Dec-2022. Patients with (n=1137) chest pain, syncope, palpitation, shortness of breath were enrolled from ECG department. A final total of 84 participants considered for the accuracy of interpretation of ventricular arrhythmia detected by the gold standard 12 lead ECG and smartphone-based ECG device along with the cardiologist’s diagnosis. Results: Mean age (SD) was 54.42±14.58 years. The male gender (65.89%) shows the maximum frequency than female gender. Confusion matrix was referred to derive true positive cases for 12 lead standard ECG and smartphone ECG along with the cardiologist’s diagnosis was 46 as compared to 30 from 12 lead gold standard. Sensitivity of smartphone spandan ECG (35.38%) was better than gold standard 12 lead ECG (15.625%), and, PPV and NPV of smartphone spandan ECG was recorded to be better than gold standard 12 lead ECG. Ventricular arrhythmia was detected correctly in 46 (54.7%) cases and 30 (36.58%) cases by smartphone ECG and 12 lead gold standard, respectively. Conclusion: Mobile ECG based devices can be used for detecting the arrhythmias as its overall accuracy of smartphone ECG in detecting the arrhythmias increase by 66.8%, i.e. the significance rise in accuracy of computer interpretation when compared to the cardiologist’s diagnosis.
{"title":"Cross-Sectional, Non-Randomized, Single-Blinded, and Single-Center Study for the Accuracy of 12 Lead Smartphone ECG in the Detection of Ventricular Arrhythmias","authors":"Nitin Chandola, S. Mahajan, Salil Garg, Yogendra Pratap Singh, Richa Sharma, T. Bhatia, Basundhara Bansal","doi":"10.31487/j.jicoa.2023.02.01","DOIUrl":"https://doi.org/10.31487/j.jicoa.2023.02.01","url":null,"abstract":"Since ventricular arrhythmias are frequently transitory, diagnosing them can be difficult. It has been investigated in the past to diagnose atrial fibrillation (AF) using a smartphone-based ECG. Data on the diagnostic efficacy of smartphone-based ECGs for ventricular arrhythmias, however, is insufficient. \u0000Objective: Objectives of this study were a) to evaluate the accuracy of the spandan 12 lead ECG device in detection of the ventricular arrhythmias in comparison to the cardiologist, b) to evaluate the arrhythmia detection accuracy of the conventional ECG machine and spandan smartphone ECG machine to cardiologist diagnosis, and c) to detect spontaneous ventricular arrhythmias (VAs), namely ventricular tachycardia (VT) and supraventricular ectopic (SVE), ventricular ectopics (VE), ventricular premature complexes (VPCs), AV-block and ventricular ectopics (VE) can be fatal. Patients who are susceptible to VT/SVTs always have a risk of sudden cardiac death. \u0000Methods: This cross-sectional study, single blinded and single-centric study was carried out at Shri Mahant Indresh Hospital (SMIH), Dehradun from 02-Aug-2022 to 29-Dec-2022. Patients with (n=1137) chest pain, syncope, palpitation, shortness of breath were enrolled from ECG department. A final total of 84 participants considered for the accuracy of interpretation of ventricular arrhythmia detected by the gold standard 12 lead ECG and smartphone-based ECG device along with the cardiologist’s diagnosis. \u0000Results: Mean age (SD) was 54.42±14.58 years. The male gender (65.89%) shows the maximum frequency than female gender. Confusion matrix was referred to derive true positive cases for 12 lead standard ECG and smartphone ECG along with the cardiologist’s diagnosis was 46 as compared to 30 from 12 lead gold standard. Sensitivity of smartphone spandan ECG (35.38%) was better than gold standard 12 lead ECG (15.625%), and, PPV and NPV of smartphone spandan ECG was recorded to be better than gold standard 12 lead ECG. Ventricular arrhythmia was detected correctly in 46 (54.7%) cases and 30 (36.58%) cases by smartphone ECG and 12 lead gold standard, respectively. \u0000Conclusion: Mobile ECG based devices can be used for detecting the arrhythmias as its overall accuracy of smartphone ECG in detecting the arrhythmias increase by 66.8%, i.e. the significance rise in accuracy of computer interpretation when compared to the cardiologist’s diagnosis.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43499502","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 : 2023-08-08DOI: 10.31487/j.jicoa.2023.01.04
Nitin Chandola, S. Mahajan, Salil Garg, Yogendra Pratap Singh, Richa Sharma, T. Bhatia, Basundhara Bansal
The atrial fibrillation prevalence is found between 0.1% and 4% in community-based research and between 2.8% and 14% in studies conducted in hospitals; nevertheless, a large portion of AF is still misdiagnosed. Smartphone applications for diagnosing AF have been proposed given that a big portion of Indians own smartphones, although it is unknown how accurate these programs would be. The study's objectives were as follows: a) To evaluate the diagnostic efficacy of the Spandan ECG in detecting AF in a single center trial that took place in SMIH Dehradun under the supervision of the cardiologist, and b) to investigate arrhythmia detection through a smartphone-based and monitoring. This single-blinded, cross-sectional, single-center study was conducted at Shri Mahant Indresh Hospital (SMIH), Dehradun, Uttarakhand, India from August 2022 to December 2022. Patients (n=32) undergoing the electrocardiogram (ECG) at the Department of Cardiology of the SMIH, Dehradun during the study period and diagnosed with atrial fibrillation. Mean age (SD) was 59.93±13.81 years. Males (n=17/32, 53.1%) show more frequency than females. Most patients had a medical history of coronary artery disease (21.8%). True positive cases derived from confusion matrix of atrial fibrillation detected using smartphone based ECG and 12 lead standard ECG along with the cardiologist’s diagnosis was 29/32 on smartphone-based as compared to 19/32 from 12 lead gold standard. Atrial fibrillation was detected correctly in 29/32 cases and 19/32 cases by smartphone ECG and 12 lead gold standard, respectively. The study hypotheses that Spandan's ability of real-time ECG monitoring will be useful in evaluating whether a patient's discomfort is caused by recurrent arrhythmia.
{"title":"A Single Blinded, Cross-Sectional, Single-Center Study for the Validation of Atrial Fibrillation Detection using Spandan Smartphone ECG","authors":"Nitin Chandola, S. Mahajan, Salil Garg, Yogendra Pratap Singh, Richa Sharma, T. Bhatia, Basundhara Bansal","doi":"10.31487/j.jicoa.2023.01.04","DOIUrl":"https://doi.org/10.31487/j.jicoa.2023.01.04","url":null,"abstract":"The atrial fibrillation prevalence is found between 0.1% and 4% in community-based research and between 2.8% and 14% in studies conducted in hospitals; nevertheless, a large portion of AF is still misdiagnosed. Smartphone applications for diagnosing AF have been proposed given that a big portion of Indians own smartphones, although it is unknown how accurate these programs would be. The study's objectives were as follows: a) To evaluate the diagnostic efficacy of the Spandan ECG in detecting AF in a single center trial that took place in SMIH Dehradun under the supervision of the cardiologist, and b) to investigate arrhythmia detection through a smartphone-based and monitoring. This single-blinded, cross-sectional, single-center study was conducted at Shri Mahant Indresh Hospital (SMIH), Dehradun, Uttarakhand, India from August 2022 to December 2022. Patients (n=32) undergoing the electrocardiogram (ECG) at the Department of Cardiology of the SMIH, Dehradun during the study period and diagnosed with atrial fibrillation. Mean age (SD) was 59.93±13.81 years. Males (n=17/32, 53.1%) show more frequency than females. Most patients had a medical history of coronary artery disease (21.8%). True positive cases derived from confusion matrix of atrial fibrillation detected using smartphone based ECG and 12 lead standard ECG along with the cardiologist’s diagnosis was 29/32 on smartphone-based as compared to 19/32 from 12 lead gold standard. Atrial fibrillation was detected correctly in 29/32 cases and 19/32 cases by smartphone ECG and 12 lead gold standard, respectively. The study hypotheses that Spandan's ability of real-time ECG monitoring will be useful in evaluating whether a patient's discomfort is caused by recurrent arrhythmia.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45566533","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: Chest radiation therapy (RT) in patients with an implantable cardioverter defibrillator (ICD) can be problematic and cause transitory malfunction or permanent damage to the device. If the ICD cannot be properly shielded from the radiation necessary for the treatment, then it may be necessary to turn off certain aspects (i.e. tachy-therapy) of the device or to temporarily remove the device leaving the patient without protection and exposing to high risk of complications. The wearable cardioverter defibrillator (WCD) is guideline recommended as bridging therapy in patients requiring temporary removal or inactivation of an ICD. Objectives: The objective of this analysis was to assess the wearable cardioverter defibrillator as a tool in high-risk implantable cardioverter defibrillator patients with cancer during the weeks to months of radiation therapy. Methods: Two retrospective cohorts were analyzed from the University of Padova (Italy) and from the manufacturer’s US registry. Patients undergoing RT who had their ICD removed or deactivated and were prescribed a WCD were included. Demographic, medical history and device usage data collected. Results: Eighty patients were analyzed (76 US, 4 Padova). The median age was 69 years and 56% were female. The most common cancer types were breast (44%) and lung (33%). Median wear time of the WCD was 22.2 hours/day over 57 days. Strategies to protect ICDs from RT involved either removing the device (82.5%) or turning off therapy in the remaining 14 (17.5%). Ventricular arrhythmias (VA) were recorded by the wearable cardioverter defibrillator in four patients, with two sustained episodes in a patient that were successfully cardioverter by the wearable cardioverter defibrillator, and three patients with non-sustained ventricular arrhythmias that did not receive shocks. Five deaths occurred four with an asystole event and one while not wearing the device. Conclusions: This study supports a role for the wearable cardioverter defibrillator in protecting implantable cardioverter defibrillator patients while undergoing radiation therapy. Back-up pacing considered for patients at risk of Bradyarrhythmias.
{"title":"Bridging Implantable Cardioverter-Defibrillator Patients Undergoing Radiotherapy with a Wearable Cardioverter-Defibrillator","authors":"","doi":"10.33140/coa.08.01.04","DOIUrl":"https://doi.org/10.33140/coa.08.01.04","url":null,"abstract":"Background: Chest radiation therapy (RT) in patients with an implantable cardioverter defibrillator (ICD) can be problematic and cause transitory malfunction or permanent damage to the device. If the ICD cannot be properly shielded from the radiation necessary for the treatment, then it may be necessary to turn off certain aspects (i.e. tachy-therapy) of the device or to temporarily remove the device leaving the patient without protection and exposing to high risk of complications. The wearable cardioverter defibrillator (WCD) is guideline recommended as bridging therapy in patients requiring temporary removal or inactivation of an ICD. Objectives: The objective of this analysis was to assess the wearable cardioverter defibrillator as a tool in high-risk implantable cardioverter defibrillator patients with cancer during the weeks to months of radiation therapy. Methods: Two retrospective cohorts were analyzed from the University of Padova (Italy) and from the manufacturer’s US registry. Patients undergoing RT who had their ICD removed or deactivated and were prescribed a WCD were included. Demographic, medical history and device usage data collected. Results: Eighty patients were analyzed (76 US, 4 Padova). The median age was 69 years and 56% were female. The most common cancer types were breast (44%) and lung (33%). Median wear time of the WCD was 22.2 hours/day over 57 days. Strategies to protect ICDs from RT involved either removing the device (82.5%) or turning off therapy in the remaining 14 (17.5%). Ventricular arrhythmias (VA) were recorded by the wearable cardioverter defibrillator in four patients, with two sustained episodes in a patient that were successfully cardioverter by the wearable cardioverter defibrillator, and three patients with non-sustained ventricular arrhythmias that did not receive shocks. Five deaths occurred four with an asystole event and one while not wearing the device. Conclusions: This study supports a role for the wearable cardioverter defibrillator in protecting implantable cardioverter defibrillator patients while undergoing radiation therapy. Back-up pacing considered for patients at risk of Bradyarrhythmias.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"681 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72423608","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: Implantable cardiac defibrillators use has been increasing for the last two decades and they are prone to infections. ICD device infection risk factors are many, some are host related while the others are procedures related. Staphylococcus aureus and staphylococcus epidermidis are accountable for 65 to 75% of the total cases of Implantable cardiac devices infections. Case Presentation: A 50 years old male presented to our emergency department with ICD pocket migrated through the skin. The symptoms started over 2 weeks, started as gradual feeling of foreign body moving underneath the skin, associated with mild pain and 3 days before presentation, the ICD penetrated the skin. The patient denied any history of fever, bleeding, pus discharge, palpitations, abnormal shocks or syncope. He was admitted to the hospital, treated for a presumed infection and his ICD device was removed. Conclusion: ICD devices complications are many, including infections. But, to have an infected device protruded through the skin is not a common presentation. We outlined the approach that was taken for this patient and his management in order to enhance the literature in terms of the above mentioned rare presentation.
{"title":"Case Report of Protruded Implantable Cardiac Device through Chest in 50 Years Old Male","authors":"A. AlRajhi","doi":"10.33140/coa.08.01.03","DOIUrl":"https://doi.org/10.33140/coa.08.01.03","url":null,"abstract":"Background: Implantable cardiac defibrillators use has been increasing for the last two decades and they are prone to infections. ICD device infection risk factors are many, some are host related while the others are procedures related. Staphylococcus aureus and staphylococcus epidermidis are accountable for 65 to 75% of the total cases of Implantable cardiac devices infections. Case Presentation: A 50 years old male presented to our emergency department with ICD pocket migrated through the skin. The symptoms started over 2 weeks, started as gradual feeling of foreign body moving underneath the skin, associated with mild pain and 3 days before presentation, the ICD penetrated the skin. The patient denied any history of fever, bleeding, pus discharge, palpitations, abnormal shocks or syncope. He was admitted to the hospital, treated for a presumed infection and his ICD device was removed. Conclusion: ICD devices complications are many, including infections. But, to have an infected device protruded through the skin is not a common presentation. We outlined the approach that was taken for this patient and his management in order to enhance the literature in terms of the above mentioned rare presentation.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86636809","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 : 2023-02-06DOI: 10.31487/j.jicoa.2023.01.02
Alexandre Sacchetti Bezerra, Walter Moisés Tobias Braga, Raphael Ferrari, Rafi Felicio Bauab Dauar, Heitor Andrei Miranda de Carvalho, Rodrigo Delfino Nascimento
A 60-year-old patient came to the IIER due to abdominal pain for 2 days, associated with flu with cough. The patient treated schistosomiasis twice without effects. During physical examination and complementary exams, she presented ecchymosis in the midline of the abdomen, normal platelet level, giant hematoma in the rectus abdominais muscle without periportal changes. A careful retrospective analysis shows inconsistency between the initial platelet levels and the severe progression of the clinical. The investigation and confirmation of thrombocytopenia is very important, and some medical center recommend manual counting through blood smears. Prospective studies are needed to know how platelet measurements should be performed in schistosomiasis.
{"title":"Giant Hematoma of Rectus Abdominis Muscle in a Patient with Schistosomiasis without Periportal Abnormalities","authors":"Alexandre Sacchetti Bezerra, Walter Moisés Tobias Braga, Raphael Ferrari, Rafi Felicio Bauab Dauar, Heitor Andrei Miranda de Carvalho, Rodrigo Delfino Nascimento","doi":"10.31487/j.jicoa.2023.01.02","DOIUrl":"https://doi.org/10.31487/j.jicoa.2023.01.02","url":null,"abstract":"A 60-year-old patient came to the IIER due to abdominal pain for 2 days, associated with flu with cough. The patient treated schistosomiasis twice without effects. During physical examination and complementary exams, she presented ecchymosis in the midline of the abdomen, normal platelet level, giant hematoma in the rectus abdominais muscle without periportal changes. A careful retrospective analysis shows inconsistency between the initial platelet levels and the severe progression of the clinical. The investigation and confirmation of thrombocytopenia is very important, and some medical center recommend manual counting through blood smears. Prospective studies are needed to know how platelet measurements should be performed in schistosomiasis.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46828976","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 : 2023-02-03DOI: 10.31487/j.jicoa.2023.01.01
M. Gaşpar, L. Pașcalău, G. Donato
Common iliac artery aneurysm (CIAA) is a very rare entity, but with potentially disastrous evolution, aneurysm rupture or distal embolization. A specific management, surgical or endovascular procedure, is required. We present a case with a huge distal left common iliac artery aneurysm, in which the diagnosis was made incidentally during a weekly ultrasound examination, in spite of impressive dimensions, 9 cm diameter. The patient was then examined by 128- Slices computed tomography and angio-coronarography. Despite the attractive anatomy for direct surgery with resection of the aneurysm and restoration of the iliac tract through the interposition of a tubular prosthesis, due to the previous pathology of the patient with necrotizing fasciitis in the left lower limb and abdominal wall, endovascular intervention was decided. Because, the big size of the left common iliac artery aneurysm, located distally, with tortuosity of the left common iliac artery as well external iliac artery (EIA), permeable left internal iliac artery (IIA), extensive intra-aneurysmal thrombosis, endovascular procedure was complex and particular. The peculiarities of the case and the complex endovascular technique, with the placement of a stent graft on the infrarenal abdominal aorta, extended on both common iliac arteries, embolization of the left internal iliac artery and extension of the left arm on the external iliac artery, are described in this presentation.
{"title":"A Giant Left Common Iliac Artery Aneurysm with Endovascular Repair: A Case Report","authors":"M. Gaşpar, L. Pașcalău, G. Donato","doi":"10.31487/j.jicoa.2023.01.01","DOIUrl":"https://doi.org/10.31487/j.jicoa.2023.01.01","url":null,"abstract":"Common iliac artery aneurysm (CIAA) is a very rare entity, but with potentially disastrous evolution, aneurysm rupture or distal embolization. A specific management, surgical or endovascular procedure, is required. We present a case with a huge distal left common iliac artery aneurysm, in which the diagnosis was made incidentally during a weekly ultrasound examination, in spite of impressive dimensions, 9 cm diameter. The patient was then examined by 128- Slices computed tomography and angio-coronarography. Despite the attractive anatomy for direct surgery with resection of the aneurysm and restoration of the iliac tract through the interposition of a tubular prosthesis, due to the previous pathology of the patient with necrotizing fasciitis in the left lower limb and abdominal wall, endovascular intervention was decided. Because, the big size of the left common iliac artery aneurysm, located distally, with tortuosity of the left common iliac artery as well external iliac artery (EIA), permeable left internal iliac artery (IIA), extensive intra-aneurysmal thrombosis, endovascular procedure was complex and particular. The peculiarities of the case and the complex endovascular technique, with the placement of a stent graft on the infrarenal abdominal aorta, extended on both common iliac arteries, embolization of the left internal iliac artery and extension of the left arm on the external iliac artery, are described in this presentation.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47748965","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}
Objective: The goal of this systematic review is to determine the effectiveness of empagliflozin in managing patients with heart failure with preserved ejection fraction (HFpEF) as compared with a placebo. Methods: Web of Science, Cochrane, PubMed, and Scopus databases were searched for articles from 2000 to November 2022. Reference lists of articles were manually screened. Trials that recruited patients with HFpEF and reported the effects of empagliflozin were included. Endnote X9 software was used for study screening process. Results: 14 papers out of 1235 found were selected for full-text reviews. The systematic review included nine papers that were all randomized controlled trials. According to the findings of individual trials, empagliflozin is more effective and has a statistically insignificant safety advantage over a placebo. Conclusion: Empagliflozin treatment for HFpEF patients appears to be both safe and efficient when compared to a placebo, according to data of moderate quality
目的:本系统评价的目的是确定与安慰剂相比，恩格列净治疗保留射血分数(HFpEF)的心力衰竭患者的有效性。方法:检索Web of Science、Cochrane、PubMed和Scopus数据库2000年至2022年11月的文章。参考文献列表是手工筛选的。纳入了招募HFpEF患者并报告了恩格列净效果的试验。使用Endnote X9软件进行研究筛选过程。结果:1235篇论文中有14篇入选全文综述。系统综述包括9篇论文，均为随机对照试验。根据个别试验的结果，恩格列净比安慰剂更有效，而且在统计学上没有明显的安全性优势。结论:根据中等质量的数据，与安慰剂相比，恩格列净治疗HFpEF患者似乎既安全又有效
{"title":"Empagliflozin Treatment for Patients with Heart Failure with Preserved Ejection Fraction-A Systematic Review","authors":"","doi":"10.33140/coa.08.01.02","DOIUrl":"https://doi.org/10.33140/coa.08.01.02","url":null,"abstract":"Objective: The goal of this systematic review is to determine the effectiveness of empagliflozin in managing patients with heart failure with preserved ejection fraction (HFpEF) as compared with a placebo. Methods: Web of Science, Cochrane, PubMed, and Scopus databases were searched for articles from 2000 to November 2022. Reference lists of articles were manually screened. Trials that recruited patients with HFpEF and reported the effects of empagliflozin were included. Endnote X9 software was used for study screening process. Results: 14 papers out of 1235 found were selected for full-text reviews. The systematic review included nine papers that were all randomized controlled trials. According to the findings of individual trials, empagliflozin is more effective and has a statistically insignificant safety advantage over a placebo. Conclusion: Empagliflozin treatment for HFpEF patients appears to be both safe and efficient when compared to a placebo, according to data of moderate quality","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87117952","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 : 2022-12-29DOI: 10.31487/j.jicoa.2022.04.01
Xing-Chen Guo, Wan-Hao Gao, Zhi-Wen Zhang, Dong-Dong Zhang, Mu-Wei Li
Objective: To evaluate the therapeutic effects of traditional Chinese medicines Radix astragali (Huangqi, HQ), Ginseng (Renshen, RS), Radix puerariae (Gegen, GG), and Mulberry leaf (Sangye, SY) on diabetic cardiomyopathy (DC) based on bioinformatics and network pharmacology, through gene expression analysis of geo clinical samples, molecular docking of compounds and targets, and molecular dynamics simulation, and to discover new targets for prevention or treatment of DC, in order to facilitate and better serve the discovery of new drugs as well as their application in the clinic. Materials and Methods: For the initial selection of ingredients and targets using the TCMSP as a starting point, we performed a primary screening of ingredients and targets of the four herbs using tools including Cytoscape, Tbtools, R 4.0.2, Autodock Vina, PyMOL, and GROMACS. To further screen the effective ingredients and targets, we performed protein interaction network (PPI) analysis (gene = 12), gene expression analysis (n = 24) by clinical samples of DCs from the gse26887 dataset, biological process (BP) analysis (FDR ≤ 0.05, gene = 7), KEGG pathway analysis (FDR ≤ 0.05, gene = 7), and ingredient target pathway network analysis (gene = 7) by applying these targets from the screen, Biological processes, disease pathways regulated by targets and the relationship between each component target and pathway were obtained. We further screened the targets and visualized the docking results by precision molecular docking of ingredients and targets, after which we performed molecular dynamics simulation and consulted a large number of relevant literature for validation of the results. Results: Through screening, analysis and validation of the data, we finally confirmed the presence of 36 active ingredients in HQ, RS, GG, and SY, which mainly act on AKT1, ADRB2, GSK3B, PPARG, and BCL2 targets, and these five targets mainly regulate PI3K-Akt, Adrenergic signaling in cardiomyocytes, AGE-RAGE signaling pathway in diabetic complications, JAK-STAT, cGMP-PKG, AMPK, and mTOR signaling pathway exert preventive or therapeutic effects on DCM. Molecular dynamics (MD) simulations revealed that the complex formed by Calycosin, Frutinone A, Puerarin, Inophyllum E, the four active components of HQ, RS, GG, and SY, and the four target proteins ADRB2, PPARG, AKT1, and GSK3B acting on DCS is able to exist in a very stable tertiary structure under human environment. Conclusion: Our study successfully explains the effective mechanism of HQ, RS, GG, and SY in ameliorating DC, while predicting the potential targets and active components of HQ, RS, GG, and SY in treating DC, which provides a new basis for investigating novel mechanisms of action at the network pharmacology level and a great support for subsequent DC research.
{"title":"Mechanisms Underlying the Therapeutic Effects of Huangqi, Gegen, Renshen and Sangye in Treating Diabetic Cardiomyopathy Based on Data Mining, Network Pharmacology and Molecular Docking","authors":"Xing-Chen Guo, Wan-Hao Gao, Zhi-Wen Zhang, Dong-Dong Zhang, Mu-Wei Li","doi":"10.31487/j.jicoa.2022.04.01","DOIUrl":"https://doi.org/10.31487/j.jicoa.2022.04.01","url":null,"abstract":"Objective: To evaluate the therapeutic effects of traditional Chinese medicines Radix astragali (Huangqi, HQ), Ginseng (Renshen, RS), Radix puerariae (Gegen, GG), and Mulberry leaf (Sangye, SY) on diabetic cardiomyopathy (DC) based on bioinformatics and network pharmacology, through gene expression analysis of geo clinical samples, molecular docking of compounds and targets, and molecular dynamics simulation, and to discover new targets for prevention or treatment of DC, in order to facilitate and better serve the discovery of new drugs as well as their application in the clinic. \u0000Materials and Methods: For the initial selection of ingredients and targets using the TCMSP as a starting point, we performed a primary screening of ingredients and targets of the four herbs using tools including Cytoscape, Tbtools, R 4.0.2, Autodock Vina, PyMOL, and GROMACS. To further screen the effective ingredients and targets, we performed protein interaction network (PPI) analysis (gene = 12), gene expression analysis (n = 24) by clinical samples of DCs from the gse26887 dataset, biological process (BP) analysis (FDR ≤ 0.05, gene = 7), KEGG pathway analysis (FDR ≤ 0.05, gene = 7), and ingredient target pathway network analysis (gene = 7) by applying these targets from the screen, Biological processes, disease pathways regulated by targets and the relationship between each component target and pathway were obtained. We further screened the targets and visualized the docking results by precision molecular docking of ingredients and targets, after which we performed molecular dynamics simulation and consulted a large number of relevant literature for validation of the results. \u0000Results: Through screening, analysis and validation of the data, we finally confirmed the presence of 36 active ingredients in HQ, RS, GG, and SY, which mainly act on AKT1, ADRB2, GSK3B, PPARG, and BCL2 targets, and these five targets mainly regulate PI3K-Akt, Adrenergic signaling in cardiomyocytes, AGE-RAGE signaling pathway in diabetic complications, JAK-STAT, cGMP-PKG, AMPK, and mTOR signaling pathway exert preventive or therapeutic effects on DCM. Molecular dynamics (MD) simulations revealed that the complex formed by Calycosin, Frutinone A, Puerarin, Inophyllum E, the four active components of HQ, RS, GG, and SY, and the four target proteins ADRB2, PPARG, AKT1, and GSK3B acting on DCS is able to exist in a very stable tertiary structure under human environment. \u0000Conclusion: Our study successfully explains the effective mechanism of HQ, RS, GG, and SY in ameliorating DC, while predicting the potential targets and active components of HQ, RS, GG, and SY in treating DC, which provides a new basis for investigating novel mechanisms of action at the network pharmacology level and a great support for subsequent DC research.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45988314","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 : 2022-12-13DOI: 10.31487/j.jicoa.2022.04.02
Zeliha Yıldırım, Erdinc Eroğlu, N. Benlier, H. Cicek
Background: Endocan, also known as specific molecule-1 in endothelial cell, plays an important role in endothelial dysfunction and inflammatory reaction [1, 2]. Serum endocan, a new biochemical marker of endothelial dysfunction, plays a role in the development of cardiovascular disease (CVD). In this study, we investigate there was a difference in serum endocan, CYP2R1, and Haptoglobin protein levels between patients with DM (+) PAH and those with DM (-) PAH. Methods: 55 volunteer patients who were diagnosed with DM (-) PAH and 24 volunteer patients who came to the same polyclinic and were diagnosed with only DM (+) PAH as a result of the examination were included. Endocan, Haptoglobulin and 25-hydroxylase (CYP2R1) measurements were made with the quantitative Enzyme linked immunosorbent analysis kit. Results: Serum haptoglobulin levels were 1877.01±564.67 (g/L) in the group with DM (-) PAH, 1745.94±612.59 (g/L) in the group with DM (+) PAH, 25-hydroxylase (CYP2R1) levels were 51.41 (2.53-2722.18) (ng/ml) in the group with DM (-) PAH and 25.36 (9.43-624.57) (ng) in the group with DM (+) PAH. /ml) was detected. Serum endocan levels are: 157.95 (29.16-7026.64) (pg/ml) in the group with DM (-) PAH, and 586.23 (138.79- 3876.51) (pg/ml) in the group with DM (+) PAH was detected. Conclusion: We compared serum endocan levels in patients with DM(+) PAH and DM(-)PAH, and we found that there was a significant difference (p<0.001 ). We found that serum endocan levels were significantly higher in patients diagnosed with DM(+) PAH compared to the other group.
{"title":"Investigation of Serum Endocan Levels in Diabetic Peripheral Artery Patients","authors":"Zeliha Yıldırım, Erdinc Eroğlu, N. Benlier, H. Cicek","doi":"10.31487/j.jicoa.2022.04.02","DOIUrl":"https://doi.org/10.31487/j.jicoa.2022.04.02","url":null,"abstract":"Background: Endocan, also known as specific molecule-1 in endothelial cell, plays an important role in endothelial dysfunction and inflammatory reaction [1, 2]. Serum endocan, a new biochemical marker of endothelial dysfunction, plays a role in the development of cardiovascular disease (CVD). In this study, we investigate there was a difference in serum endocan, CYP2R1, and Haptoglobin protein levels between patients with DM (+) PAH and those with DM (-) PAH. \u0000Methods: 55 volunteer patients who were diagnosed with DM (-) PAH and 24 volunteer patients who came to the same polyclinic and were diagnosed with only DM (+) PAH as a result of the examination were included. Endocan, Haptoglobulin and 25-hydroxylase (CYP2R1) measurements were made with the quantitative Enzyme linked immunosorbent analysis kit.\u0000Results: Serum haptoglobulin levels were 1877.01±564.67 (g/L) in the group with DM (-) PAH, 1745.94±612.59 (g/L) in the group with DM (+) PAH, 25-hydroxylase (CYP2R1) levels were 51.41 (2.53-2722.18) (ng/ml) in the group with DM (-) PAH and 25.36 (9.43-624.57) (ng) in the group with DM (+) PAH. /ml) was detected. Serum endocan levels are: 157.95 (29.16-7026.64) (pg/ml) in the group with DM (-) PAH, and 586.23 (138.79- 3876.51) (pg/ml) in the group with DM (+) PAH was detected.\u0000Conclusion: We compared serum endocan levels in patients with DM(+) PAH and DM(-)PAH, and we found that there was a significant difference (p<0.001 ). We found that serum endocan levels were significantly higher in patients diagnosed with DM(+) PAH compared to the other group.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45469567","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}
The cardiac cycle can be divided into two main phases: ventricular contraction (systole) and ventricular relaxation (diastole), at both a macroscopic (Atria and Ventricular) and microscopic level (Actin: Myosin myofilament) [1]. A novel model is elucidated in this paper incorporating the principles of biomechanics, physiology, anatomy and electrophysiology to clinically redefine diastology. The ventricular diastolic phase divided into sub phases. During normal electrophysiological and hemodynamic conditions, the ventricular diastolic phase starts with the closure of the ventricular outflow tract valves (aortic and pulmonic) (S2). One of the three possible intraventricular diastolic vacuum phases follows known as the isovolumic relaxation phase (IVRT). Once the atrio-ventricular valves open, blood flows from the atria to the ventricles passively (producing the e wave) with subsequent active filling of the ventricles with atria contraction (producing the a wave).
{"title":"Pharmaceutical Atrial-Ventricular Optimization in Diastolic Dysfunction: A Clinical Concept Application of Materials Engineering To Myocardial Pathophysiology","authors":"","doi":"10.33140/coa.07.04.03","DOIUrl":"https://doi.org/10.33140/coa.07.04.03","url":null,"abstract":"The cardiac cycle can be divided into two main phases: ventricular contraction (systole) and ventricular relaxation (diastole), at both a macroscopic (Atria and Ventricular) and microscopic level (Actin: Myosin myofilament) [1]. A novel model is elucidated in this paper incorporating the principles of biomechanics, physiology, anatomy and electrophysiology to clinically redefine diastology. The ventricular diastolic phase divided into sub phases. During normal electrophysiological and hemodynamic conditions, the ventricular diastolic phase starts with the closure of the ventricular outflow tract valves (aortic and pulmonic) (S2). One of the three possible intraventricular diastolic vacuum phases follows known as the isovolumic relaxation phase (IVRT). Once the atrio-ventricular valves open, blood flows from the atria to the ventricles passively (producing the e wave) with subsequent active filling of the ventricles with atria contraction (producing the a wave).","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72875636","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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