首页 > 最新文献

Cardiology Research最新文献

英文 中文
Yield of Tilt Table Test in Diagnosing Syncope in Patients With Suspected Neurally Mediated Syncope. 倾斜试验对疑似神经介导性晕厥的诊断价值。
IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-11-18 DOI: 10.14740/cr1701
Bandar Saeed Al-Ghamdi, Nagy Fagir, Fahmi Alnahdi, Ahmad Alhamami, Mawadah Baali, Sara Alghamdi, Nadiah Alruwaili, Edward De Vol

Background: Syncope is a common medical condition. The reflex or neurally mediated syncope (NMS) is the most frequent type. The tilt table test (TTT) helps distinguish syncope from other common causes of complete loss of consciousness, such as epilepsy, define syncope subtypes and guide management. This study aimed to assess the TTT yield in patients with suspected NMS and to compare the nitroglycerin (NTG) and isoproterenol (Isuprel) provocative protocols.

Methods: This study was a retrospective analysis of the data of 426 consecutive patients who underwent TTT at the Heart Center at King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia, between January 1, 2006, and March 31, 2017.

Results: The age at referral for TTT ranged from 7 to 84 years (mean 38.4 ± 15.75 years), and 212 (49.8%) were males. The main clinical manifestations were recurrent syncope in 259 patients (60.8%), a single syncopal episode in 60 (14.1%), and pre-syncope or dizzy spells without loss of consciousness in 171(25.1%). The test was positive in 295 patients (69.2%), with type 1 (mixed response) seen in 151 patients (51.19%), type 2a (cardioinhibitory without pause) in 16 (5.4%), type 2b (cardioinhibitory with pause) in 10 patients (3.39%), and type 3 (vasodepressor) in 118 patients (40%). A false positive test was seen in 11 patients (2.6%) and a false negative in 27 patients (6.3%). The overall test sensitivity was 91%, specificity was 89%, positive predictive value (PPV) was 96%, and negative predictive value (NPV) was 79%.

Conclusions: The TTT is beneficial in diagnosing syncope in males and females and patients of young and old ages. A provocative test utilizing NTG provides a shorter, more straightforward test with the same diagnostic accuracy as the isoproterenol test. Lifestyle modification is effective and remains the primary intervention in managing patients with NMS.

背景:晕厥是一种常见的医学疾病。反射性或神经介导性晕厥(NMS)是最常见的类型。倾斜试验(TTT)有助于区分晕厥与其他常见的完全失去意识的原因,如癫痫,确定晕厥亚型和指导管理。本研究旨在评估疑似NMS患者的TTT产率,并比较硝酸甘油(NTG)和异丙肾上腺素(Isuprel)刺激方案。方法:本研究回顾性分析了2006年1月1日至2017年3月31日期间在沙特阿拉伯利雅得费萨尔国王专科医院和研究中心(KFSH&RC)心脏中心连续接受TTT治疗的426例患者的数据。结果:转介TTT年龄7 ~ 84岁(平均38.4±15.75岁),男性212例(49.8%)。主要临床表现为复发性晕厥259例(60.8%),单次晕厥发作60例(14.1%),晕厥前或不伴有意识丧失的眩晕发作171例(25.1%)。295例(69.2%)患者检测阳性,其中1型(混合反应)患者151例(51.19%),2a型(无暂停心抑制)患者16例(5.4%),2b型(无暂停心抑制)患者10例(3.39%),3型(血管降压药)患者118例(40%)。11例患者(2.6%)出现假阳性,27例患者(6.3%)出现假阴性。总灵敏度为91%,特异性为89%,阳性预测值(PPV) 96%,阴性预测值(NPV) 79%。结论:TTT对男性和女性、青年和老年患者的晕厥诊断均有一定的价值。使用NTG的挑衅测试提供了一个更短,更直接的测试,与异丙肾上腺素测试相同的诊断准确性。生活方式改变是有效的,并且仍然是管理NMS患者的主要干预措施。
{"title":"Yield of Tilt Table Test in Diagnosing Syncope in Patients With Suspected Neurally Mediated Syncope.","authors":"Bandar Saeed Al-Ghamdi, Nagy Fagir, Fahmi Alnahdi, Ahmad Alhamami, Mawadah Baali, Sara Alghamdi, Nadiah Alruwaili, Edward De Vol","doi":"10.14740/cr1701","DOIUrl":"10.14740/cr1701","url":null,"abstract":"<p><strong>Background: </strong>Syncope is a common medical condition. The reflex or neurally mediated syncope (NMS) is the most frequent type. The tilt table test (TTT) helps distinguish syncope from other common causes of complete loss of consciousness, such as epilepsy, define syncope subtypes and guide management. This study aimed to assess the TTT yield in patients with suspected NMS and to compare the nitroglycerin (NTG) and isoproterenol (Isuprel) provocative protocols.</p><p><strong>Methods: </strong>This study was a retrospective analysis of the data of 426 consecutive patients who underwent TTT at the Heart Center at King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia, between January 1, 2006, and March 31, 2017.</p><p><strong>Results: </strong>The age at referral for TTT ranged from 7 to 84 years (mean 38.4 ± 15.75 years), and 212 (49.8%) were males. The main clinical manifestations were recurrent syncope in 259 patients (60.8%), a single syncopal episode in 60 (14.1%), and pre-syncope or dizzy spells without loss of consciousness in 171(25.1%). The test was positive in 295 patients (69.2%), with type 1 (mixed response) seen in 151 patients (51.19%), type 2a (cardioinhibitory without pause) in 16 (5.4%), type 2b (cardioinhibitory with pause) in 10 patients (3.39%), and type 3 (vasodepressor) in 118 patients (40%). A false positive test was seen in 11 patients (2.6%) and a false negative in 27 patients (6.3%). The overall test sensitivity was 91%, specificity was 89%, positive predictive value (PPV) was 96%, and negative predictive value (NPV) was 79%.</p><p><strong>Conclusions: </strong>The TTT is beneficial in diagnosing syncope in males and females and patients of young and old ages. A provocative test utilizing NTG provides a shorter, more straightforward test with the same diagnostic accuracy as the isoproterenol test. Lifestyle modification is effective and remains the primary intervention in managing patients with NMS.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 6","pages":"453-459"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Mechanism and Management of Pneumopericardium Caused by Right Ventricular Lead Perforation. 右心室导联穿孔致心包气肿的发生机制及治疗。
IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-12-03 DOI: 10.14740/cr1738
Tomo Komaki, Yuuki Ueno, Noriyuki Mohri, Akihito Ideishi, Kohei Tashiro, Shin-Ichiro Miura, Masahiro Ogawa

An 83-year-old man underwent dual-chamber pacemaker placement for complete atrioventricular block at another hospital. The active-fixation ventricular lead was positioned on the free wall of the anterior right ventricle. Ventricular pacing failure occurred on the day after pacemaker implantation, and fluoroscopy revealed right ventricular (RV) lead perforation. The patient was transferred to our hospital, and chest computed tomography revealed a severe pneumothorax and moderate pneumopericardium. These symptoms were relieved after chest tube drainage, and the patient's hemodynamics stabilized. The RV lead was percutaneously removed using simple traction under fluoroscopic guidance with cardiac surgical backup and was uneventfully refixed to the RV septum. Although there have been several reports of pneumopericardium caused by atrial lead perforation, there are very few cases related to RV lead. Pneumopericardium complicated by pneumothorax due to RV lead perforation can be relieved using chest tube drainage without the need for pericardiocentesis.

一位83岁的男性在另一家医院接受了双室起搏器放置的完全性房室传导阻滞。主动固定心室导联被放置在右前心室的游离壁上。心脏起搏器植入次日发生心室起搏衰竭,透视显示右心室导联穿孔。患者被转至我院,胸部计算机断层扫描显示严重气胸和中度气包心包。胸管引流后症状缓解,血流动力学稳定。右心室导联在透视引导下经皮取下,在心脏手术辅助下进行简单牵引,并顺利地重新固定在右心室隔上。虽然有几例心房导联穿孔引起心包气肿的报道,但很少有与右心室导联有关的病例。由于右心室导联穿孔导致的心包并发气胸可以通过胸管引流而不需要心包穿刺来缓解。
{"title":"The Mechanism and Management of Pneumopericardium Caused by Right Ventricular Lead Perforation.","authors":"Tomo Komaki, Yuuki Ueno, Noriyuki Mohri, Akihito Ideishi, Kohei Tashiro, Shin-Ichiro Miura, Masahiro Ogawa","doi":"10.14740/cr1738","DOIUrl":"10.14740/cr1738","url":null,"abstract":"<p><p>An 83-year-old man underwent dual-chamber pacemaker placement for complete atrioventricular block at another hospital. The active-fixation ventricular lead was positioned on the free wall of the anterior right ventricle. Ventricular pacing failure occurred on the day after pacemaker implantation, and fluoroscopy revealed right ventricular (RV) lead perforation. The patient was transferred to our hospital, and chest computed tomography revealed a severe pneumothorax and moderate pneumopericardium. These symptoms were relieved after chest tube drainage, and the patient's hemodynamics stabilized. The RV lead was percutaneously removed using simple traction under fluoroscopic guidance with cardiac surgical backup and was uneventfully refixed to the RV septum. Although there have been several reports of pneumopericardium caused by atrial lead perforation, there are very few cases related to RV lead. Pneumopericardium complicated by pneumothorax due to RV lead perforation can be relieved using chest tube drainage without the need for pericardiocentesis.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 6","pages":"472-476"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Promising Pathway Toward Mitigation and Eradication of Coronary Artery Disease. 缓解和根除冠状动脉疾病的一条有希望的途径。
IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-12-03 DOI: 10.14740/cr1721
Ronald P Karlsberg, Geoffrey W Cho, Jairo Aldana-Bitar

Cardiovascular disease remains the leading cause of death in the United States and globally. Significant advances have been made throughout the history of cardiology and the treatment of this disease; however, these efforts have not halted the alarming statistics. Emerging approaches, such as artificial intelligence applied to cardiac imaging, genetic testing, and genetic silencing, may offer essential additional steps in treating the disease. Moreover, new pathways of the disease are being identified, which differ from traditional risk factors and offer a fresh, innovative approach. This paper focuses on a novel strategy that includes identifying and treating multiple pathways of the disease using both new and traditional interventions. These interventions include plaque-directed therapy rather than surrogate therapy, with the potential to mitigate consequences and possibly eradicate the disease through personalized, multi-approach treatments similar to those used in cancer treatment.

心血管疾病仍然是美国和全球的主要死亡原因。心脏病学和该病的治疗在历史上取得了重大进展;然而,这些努力并没有阻止令人震惊的统计数字。新兴的方法,如将人工智能应用于心脏成像、基因检测和基因沉默,可能会为治疗这种疾病提供必要的额外步骤。此外,正在确定疾病的新途径,这些途径不同于传统的风险因素,并提供了一种新的、创新的方法。本文的重点是一种新的策略,包括识别和治疗多种途径的疾病使用新的和传统的干预措施。这些干预措施包括斑块定向治疗,而不是替代治疗,有可能减轻后果,并可能通过类似于癌症治疗中使用的个性化、多方法治疗来根除疾病。
{"title":"A Promising Pathway Toward Mitigation and Eradication of Coronary Artery Disease.","authors":"Ronald P Karlsberg, Geoffrey W Cho, Jairo Aldana-Bitar","doi":"10.14740/cr1721","DOIUrl":"10.14740/cr1721","url":null,"abstract":"<p><p>Cardiovascular disease remains the leading cause of death in the United States and globally. Significant advances have been made throughout the history of cardiology and the treatment of this disease; however, these efforts have not halted the alarming statistics. Emerging approaches, such as artificial intelligence applied to cardiac imaging, genetic testing, and genetic silencing, may offer essential additional steps in treating the disease. Moreover, new pathways of the disease are being identified, which differ from traditional risk factors and offer a fresh, innovative approach. This paper focuses on a novel strategy that includes identifying and treating multiple pathways of the disease using both new and traditional interventions. These interventions include plaque-directed therapy rather than surrogate therapy, with the potential to mitigate consequences and possibly eradicate the disease through personalized, multi-approach treatments similar to those used in cancer treatment.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 6","pages":"415-424"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of Heart Rate Fluctuation on Aerobic Training Outcomes in Patients With Stable Coronary Artery Disease: A Prospective Study. 心率波动对稳定期冠心病患者有氧训练结果的影响:一项前瞻性研究
IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-11-08 DOI: 10.14740/cr1710
Jun Hong Liu, Hui Hui Song, Hua Fang Zhang, Jia Lin Ji, Xue Jiao Zhou, Xi Cai Sun

Background: This study aimed to evaluate the effects of different heart rate fluctuation ranges during aerobic training on outcomes in patients with stable coronary artery disease (CAD).

Methods: Ninety-seven patients diagnosed with stable CAD were enrolled between March 2017 and December 2019. Participants were randomly assigned to three groups: the control (CON) group, the medium-intensity heart rate small range (MIS) group, and the medium-intensity heart rate large range (MIL) group. The CON group received standard care and patient education, while the MIS and MIL groups underwent personalized rehabilitation training with specific heart rate fluctuation targeted ranges, in addition to standard care. Cardiopulmonary function and exercise performances were assessed using resting heart rate (RHR), maximum heart rate (HRmax), heart rate recovery (HRR), and a 6-min walk test (6MWT) at the baseline and after 16 weeks of training.

Results: The MIS group demonstrated a significant reduction in RHR compared to the CON and MIL groups. While both exercise rehabilitation groups exhibited improvement in HRR, only the MIS group achieved a statistically significant improvement compared to the CON group. Post-training HRmax and 6MWT performance increased in both MIS and MIL groups, with only the MIL group presenting statistical significance compared to the CON group.

Conclusion: Exercise rehabilitation with different training regimens can enhance cardiac function in patients with CAD. Different heart rate modulation strategies yielded distinct effects on cardiopulmonary function. Maintenance of a narrower heart rate fluctuation during exercise was observed to significantly enhance the effectiveness of rehabilitation, which could lead to new treatment protocols or optimization of existing strategies for patients with cardiovascular conditions. The combination of 6MWT and power bicycle training may offer an effective method for improving cardiac function in community-based rehabilitation settings.

背景:本研究旨在评估有氧训练中不同心率波动范围对稳定型冠心病(CAD)患者预后的影响。方法:2017年3月至2019年12月,入选97例诊断为稳定型CAD的患者。参与者被随机分为三组:对照组(CON)、中等强度心率小范围组(MIS)和中等强度心率大范围组(MIL)。CON组接受标准护理和患者教育,而MIS组和MIL组除了接受标准护理外,还接受了具有特定心率波动目标范围的个性化康复训练。在基线和训练16周后,使用静息心率(RHR)、最大心率(HRmax)、心率恢复(HRR)和6分钟步行测试(6MWT)来评估心肺功能和运动表现。结果:与CON和MIL组相比,MIS组的RHR显著降低。虽然两个运动康复组的HRR都有改善,但只有MIS组与CON组相比有统计学上的显著改善。训练后HRmax和6MWT表现在MIS组和MIL组均有提高,只有MIL组与CON组相比有统计学意义。结论:不同训练方案的运动康复可改善冠心病患者的心功能。不同的心率调节策略对心肺功能有不同的影响。观察到在运动期间保持较窄的心率波动可显着提高康复的有效性,这可能导致新的治疗方案或优化心血管疾病患者的现有策略。6MWT与动力自行车训练相结合可能是改善社区康复环境中心功能的有效方法。
{"title":"Effects of Heart Rate Fluctuation on Aerobic Training Outcomes in Patients With Stable Coronary Artery Disease: A Prospective Study.","authors":"Jun Hong Liu, Hui Hui Song, Hua Fang Zhang, Jia Lin Ji, Xue Jiao Zhou, Xi Cai Sun","doi":"10.14740/cr1710","DOIUrl":"10.14740/cr1710","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the effects of different heart rate fluctuation ranges during aerobic training on outcomes in patients with stable coronary artery disease (CAD).</p><p><strong>Methods: </strong>Ninety-seven patients diagnosed with stable CAD were enrolled between March 2017 and December 2019. Participants were randomly assigned to three groups: the control (CON) group, the medium-intensity heart rate small range (MIS) group, and the medium-intensity heart rate large range (MIL) group. The CON group received standard care and patient education, while the MIS and MIL groups underwent personalized rehabilitation training with specific heart rate fluctuation targeted ranges, in addition to standard care. Cardiopulmonary function and exercise performances were assessed using resting heart rate (RHR), maximum heart rate (HRmax), heart rate recovery (HRR), and a 6-min walk test (6MWT) at the baseline and after 16 weeks of training.</p><p><strong>Results: </strong>The MIS group demonstrated a significant reduction in RHR compared to the CON and MIL groups. While both exercise rehabilitation groups exhibited improvement in HRR, only the MIS group achieved a statistically significant improvement compared to the CON group. Post-training HRmax and 6MWT performance increased in both MIS and MIL groups, with only the MIL group presenting statistical significance compared to the CON group.</p><p><strong>Conclusion: </strong>Exercise rehabilitation with different training regimens can enhance cardiac function in patients with CAD. Different heart rate modulation strategies yielded distinct effects on cardiopulmonary function. Maintenance of a narrower heart rate fluctuation during exercise was observed to significantly enhance the effectiveness of rehabilitation, which could lead to new treatment protocols or optimization of existing strategies for patients with cardiovascular conditions. The combination of 6MWT and power bicycle training may offer an effective method for improving cardiac function in community-based rehabilitation settings.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 6","pages":"460-466"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does Chronic Kidney Disease Influence Revascularization Strategy After Acute Coronary Syndrome? A Systematic Review and Meta-Analysis. 慢性肾病是否影响急性冠脉综合征后的血运重建策略?系统回顾和荟萃分析。
IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-01 Epub Date: 2024-12-03 DOI: 10.14740/cr1731
Jemima K Scott, Matthew Letts, Wafaa Hajee-Adam, Hoi Man Chau, Lucy E Selman, Fergus J Caskey, Pippa K Bailey, Raimondo Ascione, Tom Johnson, Yoav Ben-Shlomo

Background: Coronary artery bypass grafting (CABG) provides superior long-term outcomes to percutaneous coronary intervention (PCI) for complex multivessel coronary artery disease (CAD). People with chronic kidney disease (CKD) have increased prevalence of multivessel CAD, but also increased surgical risk. We investigated whether CKD predicted real-world use of CABG, versus PCI, in patients revascularized for acute coronary syndrome (ACS).

Methods: Embase, MEDLINE, Scopus and CENTRAL were searched to identify articles referring to ACS and invasive coronary intervention in high-income countries (2012 - 2023). Articles were included if CABG rates were reported in ACS patients with and without CKD receiving revascularization. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2; proxy definitions were accepted. Random effect meta-analyses were used to determine the average effect of CKD on odds of CABG, stratified by ACS type and dialysis use.

Results: Searches generated 15,138 articles, of which 13 observational studies were included (n = 1,682,207). Amongst revascularized ACS patients, those with CKD were more likely to receive CABG than those without (pooled odds ratio (OR) = 1.50 (95% confidence interval (CI) = 1.30 - 1.72). This association was stronger following ST-elevation myocardial infarction (STEMI) than non-ST-elevation ACS (NSTE-ACS) (OR: 1.54 (95% CI: 1.23 - 1.93)) versus 1.16 (1.10 - 1.23), respectively).

Conclusions: In high-income countries, revascularized ACS patients with CKD receive CABG (versus PCI) more frequently than those without kidney disease. However, accounting for lower use of coronary angiography in the CKD population removed this association following NSTE-ACS. Greater use of invasive angiography in those with NSTE-ACS and CKD might therefore increase access to revascularization, and thereby improve outcomes.

背景:对于复杂的多支冠状动脉疾病(CAD),冠状动脉旁路移植术(CABG)比经皮冠状动脉介入治疗(PCI)具有更好的长期疗效。慢性肾脏疾病(CKD)患者多血管CAD患病率增加,但手术风险也增加。我们研究了CKD是否能预测急性冠脉综合征(ACS)患者在现实生活中使用CABG,而不是PCI。方法:检索Embase、MEDLINE、Scopus和CENTRAL,以确定高收入国家(2012 - 2023年)有关ACS和冠脉介入治疗的文章。如果有或没有CKD的ACS患者接受血运重建术的冠脉搭桥率被纳入文献。CKD定义为肾小球滤过率< 60 mL/min/1.73 m2;代理定义被接受。随机效应荟萃分析用于确定CKD对冠脉搭桥几率的平均影响,并按ACS类型和透析使用分层。结果:检索产生15,138篇文章,其中包括13项观察性研究(n = 1,682,207)。在血管重建化的ACS患者中,CKD患者比无CKD患者更容易接受冠脉搭桥(合并优势比(OR) = 1.50(95%可信区间(CI) = 1.30 - 1.72)。st段抬高型心肌梗死(STEMI)与非st段抬高型ACS (NSTE-ACS)的相关性更强(OR分别为1.54 (95% CI: 1.23 - 1.93)和1.16(1.10 - 1.23))。结论:在高收入国家,血管重建的ACS合并CKD患者接受CABG(与PCI相比)的频率高于无肾脏疾病的患者。然而,考虑到CKD人群冠状动脉造影使用率较低,在NSTE-ACS后消除了这种关联。因此,在NSTE-ACS和CKD患者中更多地使用侵入性血管造影术可能会增加血运重建的机会,从而改善预后。
{"title":"Does Chronic Kidney Disease Influence Revascularization Strategy After Acute Coronary Syndrome? A Systematic Review and Meta-Analysis.","authors":"Jemima K Scott, Matthew Letts, Wafaa Hajee-Adam, Hoi Man Chau, Lucy E Selman, Fergus J Caskey, Pippa K Bailey, Raimondo Ascione, Tom Johnson, Yoav Ben-Shlomo","doi":"10.14740/cr1731","DOIUrl":"10.14740/cr1731","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery bypass grafting (CABG) provides superior long-term outcomes to percutaneous coronary intervention (PCI) for complex multivessel coronary artery disease (CAD). People with chronic kidney disease (CKD) have increased prevalence of multivessel CAD, but also increased surgical risk. We investigated whether CKD predicted real-world use of CABG, versus PCI, in patients revascularized for acute coronary syndrome (ACS).</p><p><strong>Methods: </strong>Embase, MEDLINE, Scopus and CENTRAL were searched to identify articles referring to ACS and invasive coronary intervention in high-income countries (2012 - 2023). Articles were included if CABG rates were reported in ACS patients with and without CKD receiving revascularization. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m<sup>2</sup>; proxy definitions were accepted. Random effect meta-analyses were used to determine the average effect of CKD on odds of CABG, stratified by ACS type and dialysis use.</p><p><strong>Results: </strong>Searches generated 15,138 articles, of which 13 observational studies were included (n = 1,682,207). Amongst revascularized ACS patients, those with CKD were more likely to receive CABG than those without (pooled odds ratio (OR) = 1.50 (95% confidence interval (CI) = 1.30 - 1.72). This association was stronger following ST-elevation myocardial infarction (STEMI) than non-ST-elevation ACS (NSTE-ACS) (OR: 1.54 (95% CI: 1.23 - 1.93)) versus 1.16 (1.10 - 1.23), respectively).</p><p><strong>Conclusions: </strong>In high-income countries, revascularized ACS patients with CKD receive CABG (versus PCI) more frequently than those without kidney disease. However, accounting for lower use of coronary angiography in the CKD population removed this association following NSTE-ACS. Greater use of invasive angiography in those with NSTE-ACS and CKD might therefore increase access to revascularization, and thereby improve outcomes.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 6","pages":"425-438"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diverse Concepts in Definitions of Dilated Cardiomyopathy: Theory and Practice. 扩张型心肌病定义中的不同概念:理论与实践》。
IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-09-16 DOI: 10.14740/cr1679
Michael C Myers, Boris Breznen, Yue Zhong, Sonomi Maruyama, Cindy Bueno, Arnaud Bastien, Mir Sohail Fazeli, Negar Golchin

Our understanding of dilated cardiomyopathy (DCM) is evolving as new insights into the underlying pathophysiology become available. Professional organizations and clinical experts are improving definitions of DCM, allowing for more accurate treatment recommendations. This review summarized key published literature describing definitions and/or diagnostic criteria for DCM. Embase was searched from database inception to September 19, 2022 for 1) publications reporting definitions of DCM by major professional organizations and related opinion papers, and 2) clinical studies in DCM and heart failure with reduced ejection fraction. Sixty-eight records were included in this review. Definitions of DCM provided by two major professional organizations (American Heart Association (AHA) and European Society of Cardiology (ESC)) agreed on the clinical presentation of DCM; however, they differed in the classification of DCM within the larger context of cardiomyopathy taxonomies. Both organizations agreed that DCM could be clinically defined by the presence of left ventricular dilation and contractile dysfunction in the absence of abnormal loading conditions and severe coronary artery disease. AHA guidelines divided cardiomyopathies into two major groups (primary and secondary) based on predominant organ involvement. DCM was classified as primary cardiomyopathy with mixed (genetic and/or acquired) etiology. Conversely, ESC published a clinically oriented taxonomy in which cardiomyopathies were grouped into specific morphological and functional phenotypes; each was subclassified into familial or non-familial forms. Opinion papers further elaborated on the complex interplay between genetics and environment in the etiology of DCM. Several articles summarized the importance of the new and updated diagnostic tools, such as cardiac magnetic resonance imaging, electrocardiogram, and other biomarkers, in correctly identifying the etiology of DCM. Within clinical studies, most inclusion criteria used standard definitions proposed by leading professional associations (AHA and ESC). Clinical study investigators sometimes used a narrower definition of DCM using additional criteria for the left ventricular ejection fraction threshold value and left ventricular dilatation. Current efforts in cardiology research are focused on a more granular understanding of DCM etiology and the natural history of the disease. Definitions of DCM found in clinical studies mainly rely on published guidelines, with some studies adding idiosyncratic inclusion criteria refining the broad definitions of DCM.

随着人们对扩张型心肌病(DCM)的病理生理学有了新的认识,我们对它的理解也在不断发展。专业组织和临床专家正在改进 DCM 的定义,以便提出更准确的治疗建议。本综述总结了已发表的描述 DCM 定义和/或诊断标准的主要文献。从数据库建立之初到 2022 年 9 月 19 日,对 Embase 进行了检索,检索内容包括:1)主要专业组织报告 DCM 定义的出版物和相关意见书;2)DCM 和射血分数降低型心力衰竭的临床研究。本次研究共纳入 68 条记录。两大专业组织(美国心脏协会 (AHA) 和欧洲心脏病学会 (ESC))对 DCM 的定义就 DCM 的临床表现达成了一致;但是,它们在心肌病分类标准的大背景下对 DCM 的分类存在分歧。两个组织都认为,DCM 的临床定义是:在没有异常负荷条件和严重冠状动脉疾病的情况下,左心室扩张和收缩功能障碍。AHA 指南根据主要受累器官将心肌病分为两大类(原发性和继发性)。DCM 被归类为混合(遗传和/或获得性)病因的原发性心肌病。与此相反,ESC 出版了以临床为导向的分类法,将心肌病分为特定的形态和功能表型;每种表型又分为家族性和非家族性两种。评论文章进一步阐述了遗传与环境在 DCM 病因学中的复杂相互作用。多篇文章总结了新的和更新的诊断工具(如心脏磁共振成像、心电图和其他生物标记物)在正确确定 DCM 病因方面的重要性。在临床研究中,大多数纳入标准都采用了主要专业协会(AHA 和 ESC)提出的标准定义。临床研究人员有时会使用左心室射血分数阈值和左心室扩张的附加标准来缩小 DCM 的定义范围。目前心脏病学研究的重点是对 DCM 的病因和自然病史有更深入的了解。临床研究中发现的 DCM 定义主要依赖于已发布的指南,一些研究增加了特异性纳入标准,对 DCM 的广泛定义进行了细化。
{"title":"Diverse Concepts in Definitions of Dilated Cardiomyopathy: Theory and Practice.","authors":"Michael C Myers, Boris Breznen, Yue Zhong, Sonomi Maruyama, Cindy Bueno, Arnaud Bastien, Mir Sohail Fazeli, Negar Golchin","doi":"10.14740/cr1679","DOIUrl":"https://doi.org/10.14740/cr1679","url":null,"abstract":"<p><p>Our understanding of dilated cardiomyopathy (DCM) is evolving as new insights into the underlying pathophysiology become available. Professional organizations and clinical experts are improving definitions of DCM, allowing for more accurate treatment recommendations. This review summarized key published literature describing definitions and/or diagnostic criteria for DCM. Embase was searched from database inception to September 19, 2022 for 1) publications reporting definitions of DCM by major professional organizations and related opinion papers, and 2) clinical studies in DCM and heart failure with reduced ejection fraction. Sixty-eight records were included in this review. Definitions of DCM provided by two major professional organizations (American Heart Association (AHA) and European Society of Cardiology (ESC)) agreed on the clinical presentation of DCM; however, they differed in the classification of DCM within the larger context of cardiomyopathy taxonomies. Both organizations agreed that DCM could be clinically defined by the presence of left ventricular dilation and contractile dysfunction in the absence of abnormal loading conditions and severe coronary artery disease. AHA guidelines divided cardiomyopathies into two major groups (primary and secondary) based on predominant organ involvement. DCM was classified as primary cardiomyopathy with mixed (genetic and/or acquired) etiology. Conversely, ESC published a clinically oriented taxonomy in which cardiomyopathies were grouped into specific morphological and functional phenotypes; each was subclassified into familial or non-familial forms. Opinion papers further elaborated on the complex interplay between genetics and environment in the etiology of DCM. Several articles summarized the importance of the new and updated diagnostic tools, such as cardiac magnetic resonance imaging, electrocardiogram, and other biomarkers, in correctly identifying the etiology of DCM. Within clinical studies, most inclusion criteria used standard definitions proposed by leading professional associations (AHA and ESC). Clinical study investigators sometimes used a narrower definition of DCM using additional criteria for the left ventricular ejection fraction threshold value and left ventricular dilatation. Current efforts in cardiology research are focused on a more granular understanding of DCM etiology and the natural history of the disease. Definitions of DCM found in clinical studies mainly rely on published guidelines, with some studies adding idiosyncratic inclusion criteria refining the broad definitions of DCM.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 5","pages":"319-329"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Role of Inducible Nitric Oxide Synthase in Assessing the Functional Level of Coronary Artery Lesions in Chronic Coronary Syndrome. 诱导型一氧化氮合成酶在评估慢性冠状动脉综合征冠状动脉病变功能水平中的作用
IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-10-11 DOI: 10.14740/cr1700
Admina Senderovic, Semira Galijasevic

Chronic coronary syndrome (CCS) is a long-term manifestation of coronary artery disease, marked by stable but recurring chest pain and myocardial ischemia due to the gradual buildup of atherosclerotic plaques in the coronary arteries. It is a metabolic disorder of coronary arteries characterized by oxidative stress, endothelial dysfunction, inflammation, and hyperlipidemia. The imbalance in oxidative-antioxidative status contributes to stable ischemic heart disease. Oxidative stress involves reactive oxygen and nitrogen species, leading to low-density lipoprotein (LDL) oxidation. Endothelial dysfunction, marked by reduced nitric oxide (NO) bioavailability, is an early onset of CCS, affecting vasodilation, cell proliferation, and inflammatory responses. Enzyme myeloperoxidase (MPO), traditionally considered protective, plays a dual role in initiating and progressing inflammatory diseases. MPO interacts with NO, modulating its catalytic activity. Elevated NO levels inhibit MPO through a reversible complex formation, preventing NO-induced inhibition by inducible nitric oxide synthase (iNOS). MPO also inactivates endothelial nitric oxide synthase (eNOS) and reacts with L-arginine, hindering NO synthesis. The interplay between MPO and NO significantly influences inflammation sites, impacting peroxidation rates and oxidation reactions. Peroxynitrite, a reactive species, contributes to nitration of tyrosine residues and lipid peroxidation. Mechanistic pathways suggest MPO enhances iNOS catalytic activity, influencing CCS development. iNOS, implicated in inflammation and atherosclerosis, is connected to NO regulation. This review analyzes the complex interplay of MPO, iNOS, and NO that affects plaque morphology, oxidative stress, and inflammation, contributing to atherosclerosis progression. Therefore, it is possible that the phenotypes of atherosclerotic plaques, focal and diffuse coronary artery disease, could be defined by the relationship between MPO and iNOS.

慢性冠状动脉综合征(CCS)是冠状动脉疾病的一种长期表现,其特征是由于冠状动脉中的动脉粥样硬化斑块逐渐堆积而导致的稳定但反复发作的胸痛和心肌缺血。它是冠状动脉的一种代谢紊乱,以氧化应激、内皮功能障碍、炎症和高脂血症为特征。氧化-抗氧化状态的失衡导致缺血性心脏病的稳定。氧化应激涉及活性氧和氮物种,导致低密度脂蛋白(LDL)氧化。以一氧化氮(NO)生物利用率降低为特征的内皮功能障碍是慢性缺血性心脏病的早期症状,会影响血管扩张、细胞增殖和炎症反应。传统上被认为具有保护作用的髓过氧化物酶(MPO)在炎症性疾病的发生和发展中扮演着双重角色。MPO 与 NO 相互作用,调节其催化活性。NO 水平升高会通过可逆复合物的形成抑制 MPO,阻止 NO 诱导的诱导型一氧化氮合酶(iNOS)的抑制作用。MPO 还会使内皮一氧化氮合酶(eNOS)失活,并与 L-精氨酸发生反应,阻碍一氧化氮的合成。MPO 和 NO 之间的相互作用会对炎症部位产生重大影响,影响过氧化率和氧化反应。过氧化亚硝酸盐是一种活性物质,有助于酪氨酸残基的硝化和脂质过氧化。机理途径表明,MPO 可增强 iNOS 的催化活性,影响 CCS 的发展。iNOS 与炎症和动脉粥样硬化有关,与 NO 的调节有关。本综述分析了 MPO、iNOS 和 NO 的复杂相互作用,它们影响斑块形态、氧化应激和炎症,从而导致动脉粥样硬化的发展。因此,动脉粥样硬化斑块、局灶性和弥漫性冠状动脉疾病的表型有可能由 MPO 和 iNOS 之间的关系来定义。
{"title":"The Role of Inducible Nitric Oxide Synthase in Assessing the Functional Level of Coronary Artery Lesions in Chronic Coronary Syndrome.","authors":"Admina Senderovic, Semira Galijasevic","doi":"10.14740/cr1700","DOIUrl":"https://doi.org/10.14740/cr1700","url":null,"abstract":"<p><p>Chronic coronary syndrome (CCS) is a long-term manifestation of coronary artery disease, marked by stable but recurring chest pain and myocardial ischemia due to the gradual buildup of atherosclerotic plaques in the coronary arteries. It is a metabolic disorder of coronary arteries characterized by oxidative stress, endothelial dysfunction, inflammation, and hyperlipidemia. The imbalance in oxidative-antioxidative status contributes to stable ischemic heart disease. Oxidative stress involves reactive oxygen and nitrogen species, leading to low-density lipoprotein (LDL) oxidation. Endothelial dysfunction, marked by reduced nitric oxide (NO) bioavailability, is an early onset of CCS, affecting vasodilation, cell proliferation, and inflammatory responses. Enzyme myeloperoxidase (MPO), traditionally considered protective, plays a dual role in initiating and progressing inflammatory diseases. MPO interacts with NO, modulating its catalytic activity. Elevated NO levels inhibit MPO through a reversible complex formation, preventing NO-induced inhibition by inducible nitric oxide synthase (iNOS). MPO also inactivates endothelial nitric oxide synthase (eNOS) and reacts with L-arginine, hindering NO synthesis. The interplay between MPO and NO significantly influences inflammation sites, impacting peroxidation rates and oxidation reactions. Peroxynitrite, a reactive species, contributes to nitration of tyrosine residues and lipid peroxidation. Mechanistic pathways suggest MPO enhances iNOS catalytic activity, influencing CCS development. iNOS, implicated in inflammation and atherosclerosis, is connected to NO regulation. This review analyzes the complex interplay of MPO, iNOS, and NO that affects plaque morphology, oxidative stress, and inflammation, contributing to atherosclerosis progression. Therefore, it is possible that the phenotypes of atherosclerotic plaques, focal and diffuse coronary artery disease, could be defined by the relationship between MPO and iNOS.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 5","pages":"330-339"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of Post-Loop Diuretic Urinary Sodium Level on Length of Stay and Rehospitalization in Acutely Decompensated Heart Failure Patients. 循环利尿后尿钠水平对急性失代偿期心力衰竭患者住院时间和再住院率的影响
IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-09-16 DOI: 10.14740/cr1696
Rarsari Soerarso, Dian Yaniarti Hasanah, Emir Yonas, Fikri Muhamad Yamin Tawari, Sunu Budhi Raharjo, Bambang Budi Siswanto, Maarten J Cramer, Pim van der Harst, Marish I F J Oerlemans

Background: In Indonesia, heart failure has become a major community problem because of the high cost of care, low quality of life, and premature death. Until now, loop diuretics are still the main therapy in patients with acute decompensated heart failure with clinical congestion. Diuretic responsiveness can be assessed objectively by measuring sodium urine. This study aimed to determine the response of natriuresis 2 h after loop diuretic administration and its relationship to length of stay and readmission within 30 days in daily clinical practice.

Methods: This is a prospective cohort study conducted at the National Cardiovascular Center Harapan Kita Hospital in acute decompensated heart failure patients. Patient characteristics were collected from medical records. Response to intravenous (IV) loop diuretics was assessed using urinary sodium laboratory panels. The primary outcomes of interest in this study were length of stay and rehospitalization. Analyses were conducted between the outcome of interests and patient characteristics.

Results: There were 51 acute decompensated heart failure patients in this study with 78.4% males. The mean age was 52.47 ± 13.62. The mean ejection fraction was 37.53±17.95%, with the majority of patients having a left ventricular ejection fraction less than 40% (62.7% of study subjects). The average glomerular filtration rate of subjects in this study was 57.29 ± 27.25 mL/min. Pearson correlation test between pre- and post-loop diuretic urinary sodium showed trends of significant correlation (r = -0.238, P = 0.093) and (r = -0.308, P = 0.028), respectively. Patients with lower pre-loop diuretic urinary sodium were shown to have a shorter length of stay (8.57 ± 6.161 vs. 5.30 ± 4.01, P = 0.04), while patients with lower post-loop diuretic urinary sodium showed trends of longer length of stay (8.67 ± 4.14 vs. 6.03 ± 5.39, P = 0.126).

Conclusions: In this study, we observe lower rehospitalization in patients with higher pre-loop diuretic urinary sodium levels. Post-loop diuretic urinary sodium level was shown to be inversely related to length of stay in acute decompensated heart failure patients.

背景:在印度尼西亚,心力衰竭已成为一个主要的社区问题,因为其治疗成本高、生活质量低、过早死亡。迄今为止,襻利尿剂仍是临床充血的急性失代偿性心力衰竭患者的主要治疗方法。通过测量尿钠可客观评估利尿剂的反应性。本研究旨在确定襻利尿剂用药 2 小时后的尿钠反应及其与日常临床实践中住院时间和 30 天内再入院的关系:这是一项前瞻性队列研究,在国家心血管中心北原医院进行,对象是急性失代偿性心力衰竭患者。从病历中收集患者特征。通过尿钠化验单评估患者对静脉注射环利尿剂的反应。本研究的主要结果是住院时间和再次住院时间。对相关结果和患者特征进行了分析:本研究共有 51 名急性失代偿性心力衰竭患者,其中 78.4% 为男性。平均年龄为(52.47±13.62)岁。平均射血分数为(37.53±17.95)%,大多数患者的左心室射血分数低于 40%(占研究对象的 62.7%)。研究对象的平均肾小球滤过率为(57.29±27.25)毫升/分钟。循环前和循环后利尿剂尿钠之间的皮尔逊相关性检验分别显示出显著的相关趋势(r = -0.238,P = 0.093)和(r = -0.308,P = 0.028)。循环前利尿剂尿钠较低的患者住院时间较短(8.57 ± 6.161 vs. 5.30 ± 4.01,P = 0.04),而循环后利尿剂尿钠较低的患者住院时间呈延长趋势(8.67 ± 4.14 vs. 6.03 ± 5.39,P = 0.126):在本研究中,我们观察到循环利尿前尿钠水平较高的患者再住院率较低。循环利尿后的尿钠水平与急性失代偿性心力衰竭患者的住院时间成反比。
{"title":"Effect of Post-Loop Diuretic Urinary Sodium Level on Length of Stay and Rehospitalization in Acutely Decompensated Heart Failure Patients.","authors":"Rarsari Soerarso, Dian Yaniarti Hasanah, Emir Yonas, Fikri Muhamad Yamin Tawari, Sunu Budhi Raharjo, Bambang Budi Siswanto, Maarten J Cramer, Pim van der Harst, Marish I F J Oerlemans","doi":"10.14740/cr1696","DOIUrl":"https://doi.org/10.14740/cr1696","url":null,"abstract":"<p><strong>Background: </strong>In Indonesia, heart failure has become a major community problem because of the high cost of care, low quality of life, and premature death. Until now, loop diuretics are still the main therapy in patients with acute decompensated heart failure with clinical congestion. Diuretic responsiveness can be assessed objectively by measuring sodium urine. This study aimed to determine the response of natriuresis 2 h after loop diuretic administration and its relationship to length of stay and readmission within 30 days in daily clinical practice.</p><p><strong>Methods: </strong>This is a prospective cohort study conducted at the National Cardiovascular Center Harapan Kita Hospital in acute decompensated heart failure patients. Patient characteristics were collected from medical records. Response to intravenous (IV) loop diuretics was assessed using urinary sodium laboratory panels. The primary outcomes of interest in this study were length of stay and rehospitalization. Analyses were conducted between the outcome of interests and patient characteristics.</p><p><strong>Results: </strong>There were 51 acute decompensated heart failure patients in this study with 78.4% males. The mean age was 52.47 ± 13.62. The mean ejection fraction was 37.53±17.95%, with the majority of patients having a left ventricular ejection fraction less than 40% (62.7% of study subjects). The average glomerular filtration rate of subjects in this study was 57.29 ± 27.25 mL/min. Pearson correlation test between pre- and post-loop diuretic urinary sodium showed trends of significant correlation (r = -0.238, P = 0.093) and (r = -0.308, P = 0.028), respectively. Patients with lower pre-loop diuretic urinary sodium were shown to have a shorter length of stay (8.57 ± 6.161 vs. 5.30 ± 4.01, P = 0.04), while patients with lower post-loop diuretic urinary sodium showed trends of longer length of stay (8.67 ± 4.14 vs. 6.03 ± 5.39, P = 0.126).</p><p><strong>Conclusions: </strong>In this study, we observe lower rehospitalization in patients with higher pre-loop diuretic urinary sodium levels. Post-loop diuretic urinary sodium level was shown to be inversely related to length of stay in acute decompensated heart failure patients.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 5","pages":"350-357"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impact of Remote Ischemic Preconditioning on Inflammation Markers in Patients Undergoing Coronary Artery Bypass Grafting. 远程缺血预处理对冠状动脉旁路移植术患者炎症标志物的影响
IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-10-11 DOI: 10.14740/cr1702
Cezar Luca, Alexandra Boieriu, Daniela Neculoiu, Diana Tint

Background: This study aimed to investigate if remote ischemic preconditioning reduces the inflammatory process on patients undergoing coronary artery bypass grafting (CABG).

Methods: We conducted a case-control study involving 80 patients, half of whom underwent ischemic preconditioning for severe coronary artery disease (CAD) and subsequently underwent CABG. We assessed interleukin (IL)-1 and IL-6 levels using the enzyme-linked immunosorbent assay (ELISA) method, high-sensitivity troponin I (hsTnI) using chemiluminescent immunoassay (CLIA), and C-reactive protein (CRP) using the turbidimetric method at three key time points: before surgery (visit 1 or V1), immediately postoperatively (visit 2 or V2), and 1 week postoperatively (visit 3 or V3) in all subjects.

Results: Ischemic preconditioned patients showed a significant decrease in proinflammatory markers (IL-1, IL-6) but not in CRP or hsTnI.

Conclusions: This study demonstrated that remote ischemic preconditioning significantly reduced the levels of specific proinflammatory markers (IL-1 and IL-6), which may suggest general systemic protection. However, it did not demonstrate cardioprotection per se, as evidenced by the absence of a statistically significant decrease in hsTnI level.

背景:本研究旨在探讨远程缺血预处理能否减轻冠状动脉旁路移植术(CABG)患者的炎症过程:本研究旨在探讨远程缺血预处理是否能减少冠状动脉旁路移植术(CABG)患者的炎症过程:我们对 80 名患者进行了病例对照研究,其中一半患者因严重冠状动脉疾病(CAD)接受了缺血预处理,随后接受了 CABG。我们使用酶联免疫吸附测定法(ELISA)评估了所有受试者的白细胞介素(IL)-1 和 IL-6 水平,使用化学发光免疫测定法(CLIA)评估了高敏肌钙蛋白 I(hsTnI)水平,使用比浊法评估了所有受试者的 C 反应蛋白(CRP)水平:结果:缺血预处理患者的促炎症标志物(IL-1、IL-6)显著下降,但CRP或hsTnI没有下降:本研究表明,远端缺血预处理可显著降低特定促炎症标志物(IL-1 和 IL-6)的水平,这可能暗示了全身性保护。结论:该研究表明,远程缺血预处理能明显降低特定促炎症标志物(IL-1 和 IL-6)的水平,这可能提示了全身保护作用,但它本身并没有显示出心脏保护作用,这一点从 hsTnI 水平没有出现统计学意义上的显著下降可以看出。
{"title":"The Impact of Remote Ischemic Preconditioning on Inflammation Markers in Patients Undergoing Coronary Artery Bypass Grafting.","authors":"Cezar Luca, Alexandra Boieriu, Daniela Neculoiu, Diana Tint","doi":"10.14740/cr1702","DOIUrl":"https://doi.org/10.14740/cr1702","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate if remote ischemic preconditioning reduces the inflammatory process on patients undergoing coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>We conducted a case-control study involving 80 patients, half of whom underwent ischemic preconditioning for severe coronary artery disease (CAD) and subsequently underwent CABG. We assessed interleukin (IL)-1 and IL-6 levels using the enzyme-linked immunosorbent assay (ELISA) method, high-sensitivity troponin I (hsTnI) using chemiluminescent immunoassay (CLIA), and C-reactive protein (CRP) using the turbidimetric method at three key time points: before surgery (visit 1 or V1), immediately postoperatively (visit 2 or V2), and 1 week postoperatively (visit 3 or V3) in all subjects.</p><p><strong>Results: </strong>Ischemic preconditioned patients showed a significant decrease in proinflammatory markers (IL-1, IL-6) but not in CRP or hsTnI.</p><p><strong>Conclusions: </strong>This study demonstrated that remote ischemic preconditioning significantly reduced the levels of specific proinflammatory markers (IL-1 and IL-6), which may suggest general systemic protection. However, it did not demonstrate cardioprotection <i>per se</i>, as evidenced by the absence of a statistically significant decrease in hsTnI level.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 5","pages":"369-376"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advances in the Understanding and Treatment of Chronic Chagas Cardiomyopathy. 慢性恰加斯病心肌病的认识和治疗进展。
IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-09-16 DOI: 10.14740/cr1665
Jordan Llerena-Velastegui, Almendra Lopez-Usina, Camila Mantilla-Cisneros

Chronic Chagas cardiomyopathy (CCC) poses significant health challenges not only in Latin America but also in non-endemic regions due to global migration. The complexity and severity of CCC call for an updated and thorough review to inform clinical practices and direct future research efforts. This review seeks to consolidate current knowledge on CCC, emphasizing diagnostic, therapeutic, and prognostic facets to facilitate better management and understanding of the disease. An exhaustive examination was conducted, analyzing peer-reviewed articles published between January 2020 and April 2024, sourced from prominent medical databases such as PubMed and Scopus. The review delineates crucial aspects of CCC pathophysiology, evaluates patient outcomes, identifies diagnostic challenges, and assesses treatment efficacy. Our findings prompt the need for revised clinical guidelines and stress the importance of continued research to enhance therapeutic strategies and disease comprehension. It is imperative that future studies address these identified gaps to advance patient care and treatment options for CCC.

慢性恰加斯病心肌病(CCC)不仅在拉丁美洲,而且还因全球移民而在非流行地区构成了重大的健康挑战。由于 CCC 的复杂性和严重性,需要对其进行全面的最新综述,以指导临床实践和未来的研究工作。本综述旨在整合当前有关 CCC 的知识,强调诊断、治疗和预后方面,以促进更好地管理和了解该疾病。本综述对 2020 年 1 月至 2024 年 4 月间发表的同行评审文章进行了详尽的分析,这些文章来自 PubMed 和 Scopus 等著名医学数据库。综述描述了 CCC 病理生理学的关键方面,评估了患者的预后,确定了诊断难题,并评估了治疗效果。我们的研究结果提示了修订临床指南的必要性,并强调了继续研究以提高治疗策略和疾病理解能力的重要性。当务之急是在未来的研究中解决这些已发现的不足,以推进对患者的护理和 CCC 的治疗方案。
{"title":"Advances in the Understanding and Treatment of Chronic Chagas Cardiomyopathy.","authors":"Jordan Llerena-Velastegui, Almendra Lopez-Usina, Camila Mantilla-Cisneros","doi":"10.14740/cr1665","DOIUrl":"https://doi.org/10.14740/cr1665","url":null,"abstract":"<p><p>Chronic Chagas cardiomyopathy (CCC) poses significant health challenges not only in Latin America but also in non-endemic regions due to global migration. The complexity and severity of CCC call for an updated and thorough review to inform clinical practices and direct future research efforts. This review seeks to consolidate current knowledge on CCC, emphasizing diagnostic, therapeutic, and prognostic facets to facilitate better management and understanding of the disease. An exhaustive examination was conducted, analyzing peer-reviewed articles published between January 2020 and April 2024, sourced from prominent medical databases such as PubMed and Scopus. The review delineates crucial aspects of CCC pathophysiology, evaluates patient outcomes, identifies diagnostic challenges, and assesses treatment efficacy. Our findings prompt the need for revised clinical guidelines and stress the importance of continued research to enhance therapeutic strategies and disease comprehension. It is imperative that future studies address these identified gaps to advance patient care and treatment options for CCC.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"15 5","pages":"340-349"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Cardiology Research
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1