Pub Date : 2021-01-08DOI: 10.31487/J.JICOA.2021.01.04
Laura Anoro Abenoza, Buisán Esporrín Cristina
Non-invasive mechanical ventilation (NIMV) is a therapeutic procedure that aims to supplement or improve ventilatory function. In recent decades, its benefit and multiple indications, have been demonstrated in the treatment of patients with chronic heart failure (CHF) and its acute complications [1]. However, the use of this therapy, in patients with chronic heart failure is not exempt from risks and complications, so it must be carefully individualized and requires close monitoring when ischaemic heart disease and/or arterial hypotension also coexist. Special mention requires the revision of the indication of servo ventilation in patients with severe chronic heart failure, due to its possible adverse effects.
{"title":"Adverse Effects of Non-Invasive Ventilation in Chronic Heart Failure: Keys to Avoid Complications","authors":"Laura Anoro Abenoza, Buisán Esporrín Cristina","doi":"10.31487/J.JICOA.2021.01.04","DOIUrl":"https://doi.org/10.31487/J.JICOA.2021.01.04","url":null,"abstract":"Non-invasive mechanical ventilation (NIMV) is a therapeutic procedure that aims to supplement or improve\u0000ventilatory function. In recent decades, its benefit and multiple indications, have been demonstrated in the\u0000treatment of patients with chronic heart failure (CHF) and its acute complications [1]. However, the use of\u0000this therapy, in patients with chronic heart failure is not exempt from risks and complications, so it must be\u0000carefully individualized and requires close monitoring when ischaemic heart disease and/or arterial\u0000hypotension also coexist. Special mention requires the revision of the indication of servo ventilation in\u0000patients with severe chronic heart failure, due to its possible adverse effects.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43035798","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 : 2021-01-01DOI: 10.31487/j.jicoa.2021.01.02
Y. Korystov, A. Korystova, L. Kublik, M. Levitman, T. Samochvalova, V. Shaposhnikova
The consumption of green tea reduces the risk of cardiovascular diseases and suppresses the development of atherosclerosis. The main factor for the initiation and progression of atherosclerosis is an increase in the production of reactive oxygen species (ROS) in vessels. A significant contribution to the increase in ROS production is made by increased concentration of angiotensin II, a product of the angiotensin-converting enzyme (ACE). The effect of green tea on the level of ROS and ACE activity in blood vessels in vivo has not yet been studied. The activity of ACE in aorta sections of rat was determined by measuring the hydrolysis of hippuryl-L-histidyl-L-leucine, and the production of ROS was estimated from the oxidation of dichlorodihydrofluorescein. Green tea inhibited the radiation-induced activation of the ACE in the aorta of rats on intraperitoneal (i.p.) and peroral administration. Six hours after the administration of tea, the activity of ACE in irradiated rats decreased to the control level, and by 24 h after administration, the tea did not almost affect the ACE activity. On i.p. administration, effective doses were lower than on peroral administration. The concentration of orally administered tea that inhibited the ACE activation in irradiated rats by 50% (IC50) was 1 ml of an extract of 2.1 g of tea brewed per 100 ml of water. One milliliter of i.p. administered green tea (1 g per 100 ml of water) completely suppressed the increased ROS production in the aorta of irradiated rats.
{"title":"Green Tea Suppresses the Radiation-Induced Increase of the AngiotensinConverting Enzyme & Reactive Oxygen Species in the Aorta of Rats","authors":"Y. Korystov, A. Korystova, L. Kublik, M. Levitman, T. Samochvalova, V. Shaposhnikova","doi":"10.31487/j.jicoa.2021.01.02","DOIUrl":"https://doi.org/10.31487/j.jicoa.2021.01.02","url":null,"abstract":"The consumption of green tea reduces the risk of cardiovascular diseases and suppresses the development\u0000of atherosclerosis. The main factor for the initiation and progression of atherosclerosis is an increase in the\u0000production of reactive oxygen species (ROS) in vessels. A significant contribution to the increase in ROS\u0000production is made by increased concentration of angiotensin II, a product of the angiotensin-converting\u0000enzyme (ACE). The effect of green tea on the level of ROS and ACE activity in blood vessels in vivo has\u0000not yet been studied. The activity of ACE in aorta sections of rat was determined by measuring the\u0000hydrolysis of hippuryl-L-histidyl-L-leucine, and the production of ROS was estimated from the oxidation\u0000of dichlorodihydrofluorescein. Green tea inhibited the radiation-induced activation of the ACE in the aorta\u0000of rats on intraperitoneal (i.p.) and peroral administration. Six hours after the administration of tea, the\u0000activity of ACE in irradiated rats decreased to the control level, and by 24 h after administration, the tea did\u0000not almost affect the ACE activity. On i.p. administration, effective doses were lower than on peroral\u0000administration. The concentration of orally administered tea that inhibited the ACE activation in irradiated\u0000rats by 50% (IC50) was 1 ml of an extract of 2.1 g of tea brewed per 100 ml of water. One milliliter of i.p.\u0000administered green tea (1 g per 100 ml of water) completely suppressed the increased ROS production in\u0000the aorta of irradiated rats.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48983621","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 : 2020-12-31DOI: 10.31487/j.jicoa.2020.06.10
R. Vargas
The heart of zebrafish has been used as a simple, low-cost model to study development, structure and function of the heart from early to late stages of life. Also, it has been established as a model to study different cardiac pathologies generated through different methods. Cardiac pathologies include from functional disorders such as arrhythmia, to structural disorders such as hypertrophic heart disease; in many of them, genetic and molecular aspects have been associated. Noteworthy, some of these genetic and molecular factors have been invoked as causes of sudden cardiac death in humans. This adverse outcome is common in many cardiovascular pathologies and can occur at any age. Unfortunately, etiology and physiopathology of sudden cardiac death are unclear, so extensive research in this area is required. This mini-review highlight three related points: First, the relevance of sudden cardiac death in humans. Second, advances in knowledge of the development, function and pathologies in the zebrafish heart model. Finally, the possibility of using the zebrafish model for the study of sudden cardiac. For this review, a literature search was performed using the PubMed database and the search engine Google Scholar: the words sudden cardiac death, zebrafish, arrhythmias, cardiomyopathies were combined for this search.
{"title":"Zebrafish Heart as a Model to Elucidate the Mechanisms of Sudden Cardiac Death","authors":"R. Vargas","doi":"10.31487/j.jicoa.2020.06.10","DOIUrl":"https://doi.org/10.31487/j.jicoa.2020.06.10","url":null,"abstract":"The heart of zebrafish has been used as a simple, low-cost model to study development, structure and\u0000function of the heart from early to late stages of life. Also, it has been established as a model to study\u0000different cardiac pathologies generated through different methods. Cardiac pathologies include from\u0000functional disorders such as arrhythmia, to structural disorders such as hypertrophic heart disease; in many\u0000of them, genetic and molecular aspects have been associated. Noteworthy, some of these genetic and\u0000molecular factors have been invoked as causes of sudden cardiac death in humans. This adverse outcome is\u0000common in many cardiovascular pathologies and can occur at any age. Unfortunately, etiology and\u0000physiopathology of sudden cardiac death are unclear, so extensive research in this area is required. This\u0000mini-review highlight three related points: First, the relevance of sudden cardiac death in humans. Second,\u0000advances in knowledge of the development, function and pathologies in the zebrafish heart model. Finally,\u0000the possibility of using the zebrafish model for the study of sudden cardiac. For this review, a literature\u0000search was performed using the PubMed database and the search engine Google Scholar: the words sudden\u0000cardiac death, zebrafish, arrhythmias, cardiomyopathies were combined for this search.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48538803","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 : 2020-12-31DOI: 10.31487/J.JICOA.2020.06.05
P. Chrbolka, Z. Paluch, G. Pallag
Introduction: Globally, peripheral arterial disease affects almost 200 million individuals at high risk of developing another type of cardiovascular disease with an annual incidence of cardiovascular events and cardiovascular mortality of 4-5% and a risk of acute limb ischaemia and amputation of 5%. All patients with clinical symptomatology of peripheral arterial disease should be treated with statins and antiplatelet drugs. Evidence Acquisition: The authors provide an overview, from the perspective of a clinical pharmacologist, of the pharmacokinetic properties of the antiplatelet agents available, mechanisms of their action, and differences among individual agents in side effects, efficacy and safety as well as a comparison of clinical trials. Evidence Synthesis: In a significant proportion of patients, therapy with clopidogrel is modified, with genetic polymorphism demonstrably preventing effective therapy in a proportion of patients. In cases where an antiplatelet agent other than aspirin is chosen, clopidogrel therapy is rational only if a genetic mutation resulting in ineffective therapy has been ruled out. Effective therapy can be accomplished using the more modern antiplatelet agents with balanced pharmacokinetic and pharmacodynamic properties. Conclusions: Several questions related to treatment of patients with peripheral arterial disease remain to be answered. Expert views on recommended antiplatelet therapy diverge. It would be unethical to ignore the fact that therapy may be ineffective in a proportion of clopidogrel-treated patients. Guidelines for the treatment and prevention of peripheral arterial disease should offer alternative antiplatelet drugs or recommendations to verify a patient´s genetic predisposition. Further clinical trials are warranted to assess the efficacy of individual antiplatelet agents and doses thereof in patients with peripheral arterial disease.
{"title":"Antiplatelet Therapy in Secondary Prevention in Patients with Ischaemic Peripheral Arterial Disease","authors":"P. Chrbolka, Z. Paluch, G. Pallag","doi":"10.31487/J.JICOA.2020.06.05","DOIUrl":"https://doi.org/10.31487/J.JICOA.2020.06.05","url":null,"abstract":"Introduction: Globally, peripheral arterial disease affects almost 200 million individuals at high risk of\u0000developing another type of cardiovascular disease with an annual incidence of cardiovascular events and\u0000cardiovascular mortality of 4-5% and a risk of acute limb ischaemia and amputation of 5%. All patients with\u0000clinical symptomatology of peripheral arterial disease should be treated with statins and antiplatelet drugs.\u0000Evidence Acquisition: The authors provide an overview, from the perspective of a clinical pharmacologist,\u0000of the pharmacokinetic properties of the antiplatelet agents available, mechanisms of their action, and\u0000differences among individual agents in side effects, efficacy and safety as well as a comparison of clinical\u0000trials.\u0000Evidence Synthesis: In a significant proportion of patients, therapy with clopidogrel is modified, with\u0000genetic polymorphism demonstrably preventing effective therapy in a proportion of patients. In cases where\u0000an antiplatelet agent other than aspirin is chosen, clopidogrel therapy is rational only if a genetic mutation\u0000resulting in ineffective therapy has been ruled out. Effective therapy can be accomplished using the more\u0000modern antiplatelet agents with balanced pharmacokinetic and pharmacodynamic properties.\u0000Conclusions: Several questions related to treatment of patients with peripheral arterial disease remain to be\u0000answered. Expert views on recommended antiplatelet therapy diverge. It would be unethical to ignore the\u0000fact that therapy may be ineffective in a proportion of clopidogrel-treated patients. Guidelines for the\u0000treatment and prevention of peripheral arterial disease should offer alternative antiplatelet drugs or\u0000recommendations to verify a patient´s genetic predisposition. Further clinical trials are warranted to assess\u0000the efficacy of individual antiplatelet agents and doses thereof in patients with peripheral arterial disease.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49433073","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 : 2020-12-24DOI: 10.31487/j.jicoa.2020.06.09
C. Ayabakan, K. Tokel, Özlem Sarısoy
Aim: Although limited in assessing right ventricular (RV) function, echocardiography is widely used after correction for tetralogy of Fallot (TOF). The change in echocardiographic measurements of RV in asymptomatic patients after TOF repair over a long follow-up time is not explored yet. The variation in simple echocardiographic measurements during follow-up of our TOF patients are presented. The predictive value of those parameters in determining a future pulmonary valve replacement is sought. Method: Asymptomatic patients surviving the first year after correction for simple TOF from February 2007 to December 2019 at Başkent University, Istanbul Hospital are enrolled. Patients are followed annually with echocardiography including: RV area, volume, length, RV outflow tract (RVOT) diameter and gradient, tricuspid annulus diameter, tricuspid lateral annular tissue velocities, tricuspid annular plane systolic excursion, TEI index RV ejection fraction (EF) measurements. The change in the consecutive echocardiographic measurements during follow-up is analysed. Patients are evaluated with a cardiac magnetic resonance (CMR) imaging when deemed necessary and compared with echocardiographic measurements. Results: A total of 66 patients (54.5% males) are operated at age 14.4±9.3 months (78.8% with transannular patch). Twelve patients had pulmonary valve replacement (PVR) operation at an age 10.1±3.1 years. During follow-up of 7.2±4.3 years, tricuspid annulus diameter, RV area, RV inlet length, RV volume, RV volume index significantly increased (p=0.001 for all), whereas RV inlet length index, TEI and TEI z score decreased (p<0.0001 for all). When means are compared, tricuspid annulus (28.8mm vs 25.0mm; p=0.013), RV volume (72.2ml vs 52.2ml; p=0.042), RV inlet length index (77.9mm/m2 vs 60.2mm/m2 ; p=0.013), RVOT diameter (28.7 vs 23.0; p=0.007) are increased. RV EF is decreased (51.3% vs 60.5%; p=0.011) in those requiring PVR. Those with higher RV area index, RV volume index, tricuspid annulus diameter and tricuspid annular z score in their first echocardiography after the TOF repair, are more likely to have a PVR operation later on (p<0.05 for all). RV volume index ≥39ml/m2 predicts a PVR within 7 years with 100% sensitivity and 74% specificity. Tricuspid annular z score less than -0.43 seems to eliminate the possibility of having a PVR within 7 years with a sensitivity of 44% and specificity of 100%. Conclusion: Observing the sequential change in echocardiographic parameters like RV volume index, RV area index, tricuspid annulus z score is reliable in determining right ventricular function and can limit the costly CMR applications. Cut off values of RV volume index >39ml/m2 and tricuspid annulus z score ≥ - 0.43 after the initial TOF repair may determine patients with higher possibility of having early PVR and indicate a closer follow-up.
{"title":"Echocardiographic Follow-Up of Right Ventricular Function After Tetralogy of Fallot Operation","authors":"C. Ayabakan, K. Tokel, Özlem Sarısoy","doi":"10.31487/j.jicoa.2020.06.09","DOIUrl":"https://doi.org/10.31487/j.jicoa.2020.06.09","url":null,"abstract":"Aim: Although limited in assessing right ventricular (RV) function, echocardiography is widely used after\u0000correction for tetralogy of Fallot (TOF). The change in echocardiographic measurements of RV in\u0000asymptomatic patients after TOF repair over a long follow-up time is not explored yet. The variation in\u0000simple echocardiographic measurements during follow-up of our TOF patients are presented. The predictive\u0000value of those parameters in determining a future pulmonary valve replacement is sought.\u0000Method: Asymptomatic patients surviving the first year after correction for simple TOF from February\u00002007 to December 2019 at Başkent University, Istanbul Hospital are enrolled. Patients are followed annually\u0000with echocardiography including: RV area, volume, length, RV outflow tract (RVOT) diameter and\u0000gradient, tricuspid annulus diameter, tricuspid lateral annular tissue velocities, tricuspid annular plane\u0000systolic excursion, TEI index RV ejection fraction (EF) measurements. The change in the consecutive\u0000echocardiographic measurements during follow-up is analysed. Patients are evaluated with a cardiac\u0000magnetic resonance (CMR) imaging when deemed necessary and compared with echocardiographic\u0000measurements.\u0000Results: A total of 66 patients (54.5% males) are operated at age 14.4±9.3 months (78.8% with transannular\u0000patch). Twelve patients had pulmonary valve replacement (PVR) operation at an age 10.1±3.1 years. During\u0000follow-up of 7.2±4.3 years, tricuspid annulus diameter, RV area, RV inlet length, RV volume, RV volume\u0000index significantly increased (p=0.001 for all), whereas RV inlet length index, TEI and TEI z score\u0000decreased (p<0.0001 for all). When means are compared, tricuspid annulus (28.8mm vs 25.0mm; p=0.013),\u0000RV volume (72.2ml vs 52.2ml; p=0.042), RV inlet length index (77.9mm/m2 vs 60.2mm/m2\u0000; p=0.013),\u0000RVOT diameter (28.7 vs 23.0; p=0.007) are increased. RV EF is decreased (51.3% vs 60.5%; p=0.011) in\u0000those requiring PVR. Those with higher RV area index, RV volume index, tricuspid annulus diameter and\u0000tricuspid annular z score in their first echocardiography after the TOF repair, are more likely to have a PVR\u0000operation later on (p<0.05 for all). RV volume index ≥39ml/m2 predicts a PVR within 7 years with 100%\u0000sensitivity and 74% specificity. Tricuspid annular z score less than -0.43 seems to eliminate the possibility\u0000of having a PVR within 7 years with a sensitivity of 44% and specificity of 100%.\u0000Conclusion: Observing the sequential change in echocardiographic parameters like RV volume index, RV\u0000area index, tricuspid annulus z score is reliable in determining right ventricular function and can limit the\u0000costly CMR applications. Cut off values of RV volume index >39ml/m2\u0000and tricuspid annulus z score ≥ -\u00000.43 after the initial TOF repair may determine patients with higher possibility of having early PVR and\u0000indicate a closer follow-up.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46874964","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 : 2020-12-24DOI: 10.31487/j.jicoa.2020.06.06
Yutang Wang, Dinh Tam Nguyen, Jack Anesi, Michelle Steicke
Periodontal disease is an inflammatory condition around the teeth which affects 20-50% of the worldwide population. In periodontal disease, the bacterial plaque destroys the epithelium of the periodontal pocket and breaks the barrier that separates the tissue and the circulation, allowing oral bacteria and their endotoxins and exotoxins to enter the bloodstream. This can cause health problems, such as atherosclerosis. Aggregatibacter actinomycetemcomitans (Aa) is commonly found in patients with periodontitis and the number of Aa is associated with atherosclerotic lesion size in humans. This review focuses on Aa and atherosclerosis with an emphasis on the interaction of Aa with cell types involved in atherosclerosis formation.
{"title":"Aggregatibacter actinomycetemcomitans and Atherosclerosis","authors":"Yutang Wang, Dinh Tam Nguyen, Jack Anesi, Michelle Steicke","doi":"10.31487/j.jicoa.2020.06.06","DOIUrl":"https://doi.org/10.31487/j.jicoa.2020.06.06","url":null,"abstract":"Periodontal disease is an inflammatory condition around the teeth which affects 20-50% of the worldwide\u0000population. In periodontal disease, the bacterial plaque destroys the epithelium of the periodontal pocket\u0000and breaks the barrier that separates the tissue and the circulation, allowing oral bacteria and their endotoxins\u0000and exotoxins to enter the bloodstream. This can cause health problems, such as atherosclerosis.\u0000Aggregatibacter actinomycetemcomitans (Aa) is commonly found in patients with periodontitis and the\u0000number of Aa is associated with atherosclerotic lesion size in humans. This review focuses on Aa and\u0000atherosclerosis with an emphasis on the interaction of Aa with cell types involved in atherosclerosis\u0000formation.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42537362","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 : 2020-12-18DOI: 10.31487/j.jicoa.2020.06.04
Q. Shen, J. Hiebert, J. Pierce
In the U.S., each year, there are more than 500,000 new cases of all types of heart failure. With high output cardiac failure, there is an elevated cardiac output associated with several conditions and diseases, including obesity, chronic anemia, systemic arterio-venous fistula, hypercapnia, mitochondrial dysfunction, and hyperthyroidism. The underlying pathophysiologic mechanisms relate to a reduction in systemic vascular resistance from arterio-venous shunting or peripheral vasodilation. Often there is a decrease in systemic arterial blood pressure and neurohormonal activation leading to heart failure symptoms of dyspnea and fatigue. In a persistent high output state, patients may experience tachycardia, valvular abnormalities, and ventricular dilatation and/or hypertrophy. In this article, there is a review of high output heart failure, including the prevalence, pathophysiology, and common clinical causes of this disease.
{"title":"Underlying Causes of High Output Heart Failure","authors":"Q. Shen, J. Hiebert, J. Pierce","doi":"10.31487/j.jicoa.2020.06.04","DOIUrl":"https://doi.org/10.31487/j.jicoa.2020.06.04","url":null,"abstract":"In the U.S., each year, there are more than 500,000 new cases of all types of heart failure. With high output\u0000cardiac failure, there is an elevated cardiac output associated with several conditions and diseases, including\u0000obesity, chronic anemia, systemic arterio-venous fistula, hypercapnia, mitochondrial dysfunction, and\u0000hyperthyroidism. The underlying pathophysiologic mechanisms relate to a reduction in systemic vascular\u0000resistance from arterio-venous shunting or peripheral vasodilation. Often there is a decrease in systemic\u0000arterial blood pressure and neurohormonal activation leading to heart failure symptoms of dyspnea and\u0000fatigue. In a persistent high output state, patients may experience tachycardia, valvular abnormalities, and\u0000ventricular dilatation and/or hypertrophy. In this article, there is a review of high output heart failure,\u0000including the prevalence, pathophysiology, and common clinical causes of this disease.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43083527","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 : 2020-12-17DOI: 10.31487/j.jicoa.2020.06.07
J. Boombhi, Antoin Bele, M. Temgoua, B. Hamadou, J. Tochie, D. Tchapmi, C. Nganou, L. Mfeukeu-Kuaté, A. Ménanga, S. Kingue
Background: Contrarily to past concepts, heart failure with preserved ejection fraction (HFpEF) has become more prevalent than heart failure with reduced ejection fraction (HFrEF). Our objective was to study the clinical, cardiovascular and laboratory findings and therapeutic aspects of HFpEF, compared with those of HFrEF in Yaounde, Cameroon. Method: This was an analytical cross-sectional study carried-out at the Central Hospital, General Hospital and Military Hospital of Yaounde, from January to April 2018 (4 months). 201 patients aged at least 18 years old with an echocardiography confirmed diagnosis of heart failure had been enrolled. We excluded 12 patients because they had a congenital ventricular septal defect (2), chronic cor pulmonale (4), mitral stenosis (5), and pericarditis (1). Results: We found that 45.5% of our patients had HFpEF whereas 37.5% had HFrEF. Patients with HFpEF were older and had a significantly higher incidence of hypertension and obesity. HFrEF was significantly more associated with congestive symptoms than HFpEF. The S3 gallop was significantly more present in patients with HFrEF. Patients with HFpEF had significantly higher rate of atrial fibrillation. Furosemide, spironolactone and digoxin were significantly used more frequently in patients with HFrEF. Conclusion: HFpEF is the most frequent form of heart failure in the hospital setting in Yaoundé, Cameroon. Patients with HFpEF were significantly older and more affected by hypertension and obesity than those with HFrEF. Cardiac ultrasound is indispensable to differentiate between the two entities for better management.
{"title":"Comparative Analysis of the Clinical Presentations, Cardiovascular & Laboratory Findings & Treatment of Heart Failure with Preserved & Reduced Ejection Fractions in Cameroon: A Multicenter Cross-Sectional Study","authors":"J. Boombhi, Antoin Bele, M. Temgoua, B. Hamadou, J. Tochie, D. Tchapmi, C. Nganou, L. Mfeukeu-Kuaté, A. Ménanga, S. Kingue","doi":"10.31487/j.jicoa.2020.06.07","DOIUrl":"https://doi.org/10.31487/j.jicoa.2020.06.07","url":null,"abstract":"Background: Contrarily to past concepts, heart failure with preserved ejection fraction (HFpEF) has\u0000become more prevalent than heart failure with reduced ejection fraction (HFrEF). Our objective was to\u0000study the clinical, cardiovascular and laboratory findings and therapeutic aspects of HFpEF, compared with\u0000those of HFrEF in Yaounde, Cameroon.\u0000Method: This was an analytical cross-sectional study carried-out at the Central Hospital, General Hospital\u0000and Military Hospital of Yaounde, from January to April 2018 (4 months). 201 patients aged at least 18\u0000years old with an echocardiography confirmed diagnosis of heart failure had been enrolled. We excluded\u000012 patients because they had a congenital ventricular septal defect (2), chronic cor pulmonale (4), mitral\u0000stenosis (5), and pericarditis (1).\u0000Results: We found that 45.5% of our patients had HFpEF whereas 37.5% had HFrEF. Patients with HFpEF\u0000were older and had a significantly higher incidence of hypertension and obesity. HFrEF was significantly\u0000more associated with congestive symptoms than HFpEF. The S3 gallop was significantly more present in\u0000patients with HFrEF. Patients with HFpEF had significantly higher rate of atrial fibrillation. Furosemide,\u0000spironolactone and digoxin were significantly used more frequently in patients with HFrEF.\u0000Conclusion: HFpEF is the most frequent form of heart failure in the hospital setting in Yaoundé, Cameroon.\u0000Patients with HFpEF were significantly older and more affected by hypertension and obesity than those\u0000with HFrEF. Cardiac ultrasound is indispensable to differentiate between the two entities for better\u0000management.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46159484","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}
Ablation of Atrial Fibrillation (AF) has quickly become an alternative strategy to impact the adverse symptoms and outcomes associated with or caused by AF. Early reports in 1998 demonstrated spontaneous initiation of AF by ectopic beats originating in the Pulmonary Veins (PVs) followed rapidly by showing that Radio Frequency (RF) circumferential ablation around the orifices of the PVs could “electrically disconnect” the PVs from the Left Atria (LA). This resulted in the explosive growth utilizing this procedure for AF Ablation (AFA) across a wide demographic spectrum of recipients. Foreseeable healthy debates have surfaced as to who best benefits and who may actually suffer complications or harm from AFA utilizing present techniques. Disagreement also persists as to whether AFA fundamentally and universally reduces stroke, death, hospitalization or does it initiate a more nuanced set of outcomes. The present effort asks the simple question: Has AFA matured to the point of requisite explicative review? Is it time now to peel back the layers and identify which cohort will be optimally served by AFA and perhaps which ones need demonstration of benefit? The present brief review suggests that prudent employment of AFA must now identify disparities in the variables reflected in these cohort outcomes. This will enable judgment in the use of AFA and the achievement of optimal outcomes.
{"title":"Atrial Fibrillation Ablation: When and Why?","authors":"","doi":"10.33140/coa.05.03.03","DOIUrl":"https://doi.org/10.33140/coa.05.03.03","url":null,"abstract":"Ablation of Atrial Fibrillation (AF) has quickly become an alternative strategy to impact the adverse symptoms and outcomes associated with or caused by AF. Early reports in 1998 demonstrated spontaneous initiation of AF by ectopic beats originating in the Pulmonary Veins (PVs) followed rapidly by showing that Radio Frequency (RF) circumferential ablation around the orifices of the PVs could “electrically disconnect” the PVs from the Left Atria (LA). This resulted in the explosive growth utilizing this procedure for AF Ablation (AFA) across a wide demographic spectrum of recipients. Foreseeable healthy debates have surfaced as to who best benefits and who may actually suffer complications or harm from AFA utilizing present techniques. Disagreement also persists as to whether AFA fundamentally and universally reduces stroke, death, hospitalization or does it initiate a more nuanced set of outcomes. The present effort asks the simple question: Has AFA matured to the point of requisite explicative review? Is it time now to peel back the layers and identify which cohort will be optimally served by AFA and perhaps which ones need demonstration of benefit? The present brief review suggests that prudent employment of AFA must now identify disparities in the variables reflected in these cohort outcomes. This will enable judgment in the use of AFA and the achievement of optimal outcomes.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82055598","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 : 2020-10-16DOI: 10.21203/rs.3.rs-92126/v1
Heya Na, Xianen Fa, Yuyang Zhou, Xiangyang Li, Rui Zhu, Lei Liu, Bing Liu
Objective: To retrospectively analyze the effect of levosimendan on the survival and prognosis of cardiac surgery patients with LVEF < 40%. Methods: the clinical data of 224 patients with preoperative LVEF < 40% were retrospectively analyzed. According to different treatment schemes, the patients were divided into levosimendan group (n = 60) and no-levosimendan group (n = 164,). The control group was treated with routine treatment, and the observation group was treated with levosimendan on the basis of routine treatment. Then a multivariate logistic regression model with a propensity score analysis was used to limit biases and finally the data of 40 patients in each group were selected for analysis. Results: Hemodynamic data showed that the cardiac index, LVEF and PAOP of patients in levosimendan group were significantly improved. The concentration of serum lactic acid in the levosimendan group was lower than that in the control group (P < 0.05). At the same time, postoperative ICU and hospital stay were significantly reduced in levosimendan group (P < 0.05.), Logistics regression analysis showed that levosimendan was the only protective factor for Low cardiac output syndrome (LCOS) (HR=4.33; 95% confidence interval: 1.27- 14.78; P = 0.019). Conclusion: levosimendan can better improve hemodynamics and reduce postoperative ICU time and hospital stay. The use of it tended to decrease the incidence of LCOS significantly.
{"title":"Effect of Levosimendan on the Prognosis of Cardiac Surgery in Patients with Cardiac Insufficiency","authors":"Heya Na, Xianen Fa, Yuyang Zhou, Xiangyang Li, Rui Zhu, Lei Liu, Bing Liu","doi":"10.21203/rs.3.rs-92126/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-92126/v1","url":null,"abstract":"\u0000 Objective: To retrospectively analyze the effect of levosimendan on the survival and prognosis of cardiac surgery patients with LVEF < 40%. Methods: the clinical data of 224 patients with preoperative LVEF < 40% were retrospectively analyzed. According to different treatment schemes, the patients were divided into levosimendan group (n = 60) and no-levosimendan group (n = 164,). The control group was treated with routine treatment, and the observation group was treated with levosimendan on the basis of routine treatment. Then a multivariate logistic regression model with a propensity score analysis was used to limit biases and finally the data of 40 patients in each group were selected for analysis. Results: Hemodynamic data showed that the cardiac index, LVEF and PAOP of patients in levosimendan group were significantly improved. The concentration of serum lactic acid in the levosimendan group was lower than that in the control group (P < 0.05). At the same time, postoperative ICU and hospital stay were significantly reduced in levosimendan group (P < 0.05.), Logistics regression analysis showed that levosimendan was the only protective factor for Low cardiac output syndrome (LCOS) (HR=4.33; 95% confidence interval: 1.27- 14.78; P = 0.019). Conclusion: levosimendan can better improve hemodynamics and reduce postoperative ICU time and hospital stay. The use of it tended to decrease the incidence of LCOS significantly.","PeriodicalId":93027,"journal":{"name":"Journal of integrative cardiology open access","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76543424","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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