Justyna Jankowska-Sanetra, Krzysztof Sanetra, Marta Konopko, Monika Kutowicz, Magdalena Synak, Krzysztof Milewski, Paweł Kaźmierczak, Łukasz Kołtowski, Piotr P Buszman
Background: An investigation of baseline characteristics, treatment, and outcomes in patients with stable coronary disease after the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS- -CoV-2) pandemic may provide valuable data and is beneficial for public health strategy in upcoming years.
Methods: A multi-institutional registry, including 10 cardiology departments, was searched for patients admitted from June 2020 to October 2020. The baseline characteristics (age, gender, symptoms, comorbidities), treatment (non-invasive, invasive, surgical), and hospitalization outcome (mortality, myocardial infarction, stroke, composite endpoint - major adverse cardiac and cerebrovascular events [MACCE]) were evaluated. The comparison was made to parameters presented by patients from the same timeframe in 2019 (June-October). Multivariable analysis was performed.
Results: Number of hospitalized stable patients following lockdown was lower (2498 vs. 1903; p < 0.0001). They were younger (68.0 vs. 69.0; p < 0.019), more likely to present with hypertension (88.5% vs. 77.5%; p < 0.0001), diabetes (35.7% vs. 31.5%; p = 0.003), hyperlipidemia (67.9% vs. 55.4%; p < 0.0001), obesity (35.8% vs. 31.3%; p = 0.002), and more pronounced symptoms (Canadian Cardiovascular Society [CCS] III and CCS class IV angina: 30.4% vs. 26.5%; p = 0.005). They underwent percutaneous treatment more often (35.0% vs. 25.9%; p < 0.0001) and were less likely to be referred for surgery (3.7% vs. 4.9%; p = 0.0001). There were no significant differences in hospitalization outcome. New York Heart Association (NYHA) class IV for heart failure was a risk factor for both mortality and MACCE in multivariate analysis.
Conclusions: The SARS-CoV-2 2019 pandemic affected the characteristics and hospitalization course of stable angina patients hospitalized following the first wave. The hospitalization outcome was similar in the analyzed time intervals. The higher prevalence of comorbidities raises concern regarding upcoming years.
背景:对第一波严重急性呼吸综合征冠状病毒2 (SARS- cov -2)大流行后稳定冠状动脉疾病患者的基线特征、治疗和结局的调查可能提供有价值的数据,并有利于未来几年的公共卫生策略。方法:检索2020年6月至2020年10月住院的多机构注册中心,包括10个心脏科。评估基线特征(年龄、性别、症状、合并症)、治疗(无创、有创、手术)和住院结果(死亡率、心肌梗死、卒中、复合终点-主要心脑血管不良事件[MACCE])。与2019年同一时间段(6月至10月)患者提供的参数进行比较。进行多变量分析。结果:封锁后住院的稳定患者人数较低(2498人对1903人;P < 0.0001)。他们更年轻(68.0 vs 69.0;P < 0.019),更有可能出现高血压(88.5%比77.5%;P < 0.0001),糖尿病(35.7% vs. 31.5%;P = 0.003)、高脂血症(67.9% vs. 55.4%;P < 0.0001),肥胖(35.8% vs. 31.3%;p = 0.002),以及更明显的症状(加拿大心血管学会[CCS] III级和CCS IV级心绞痛:30.4% vs. 26.5%;P = 0.005)。他们接受经皮治疗的频率更高(35.0% vs. 25.9%;P < 0.0001),且转诊手术的可能性较低(3.7% vs. 4.9%;P = 0.0001)。两组住院转归无显著差异。在多变量分析中,纽约心脏协会(NYHA)心衰IV级是死亡率和MACCE的危险因素。结论:2019年SARS-CoV-2大流行影响了第一波后住院的稳定期心绞痛患者的特征和住院时间。住院治疗结果在分析的时间间隔内相似。合并症的高患病率引起了对未来几年的关注。
{"title":"The impact of first wave of the SARS-CoV-2 2019 pandemic in Poland on characteristics and outcomes of patients hospitalized due to stable coronary artery disease.","authors":"Justyna Jankowska-Sanetra, Krzysztof Sanetra, Marta Konopko, Monika Kutowicz, Magdalena Synak, Krzysztof Milewski, Paweł Kaźmierczak, Łukasz Kołtowski, Piotr P Buszman","doi":"10.5603/CJ.a2022.0094","DOIUrl":"https://doi.org/10.5603/CJ.a2022.0094","url":null,"abstract":"<p><strong>Background: </strong>An investigation of baseline characteristics, treatment, and outcomes in patients with stable coronary disease after the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS- -CoV-2) pandemic may provide valuable data and is beneficial for public health strategy in upcoming years.</p><p><strong>Methods: </strong>A multi-institutional registry, including 10 cardiology departments, was searched for patients admitted from June 2020 to October 2020. The baseline characteristics (age, gender, symptoms, comorbidities), treatment (non-invasive, invasive, surgical), and hospitalization outcome (mortality, myocardial infarction, stroke, composite endpoint - major adverse cardiac and cerebrovascular events [MACCE]) were evaluated. The comparison was made to parameters presented by patients from the same timeframe in 2019 (June-October). Multivariable analysis was performed.</p><p><strong>Results: </strong>Number of hospitalized stable patients following lockdown was lower (2498 vs. 1903; p < 0.0001). They were younger (68.0 vs. 69.0; p < 0.019), more likely to present with hypertension (88.5% vs. 77.5%; p < 0.0001), diabetes (35.7% vs. 31.5%; p = 0.003), hyperlipidemia (67.9% vs. 55.4%; p < 0.0001), obesity (35.8% vs. 31.3%; p = 0.002), and more pronounced symptoms (Canadian Cardiovascular Society [CCS] III and CCS class IV angina: 30.4% vs. 26.5%; p = 0.005). They underwent percutaneous treatment more often (35.0% vs. 25.9%; p < 0.0001) and were less likely to be referred for surgery (3.7% vs. 4.9%; p = 0.0001). There were no significant differences in hospitalization outcome. New York Heart Association (NYHA) class IV for heart failure was a risk factor for both mortality and MACCE in multivariate analysis.</p><p><strong>Conclusions: </strong>The SARS-CoV-2 2019 pandemic affected the characteristics and hospitalization course of stable angina patients hospitalized following the first wave. The hospitalization outcome was similar in the analyzed time intervals. The higher prevalence of comorbidities raises concern regarding upcoming years.</p>","PeriodicalId":9492,"journal":{"name":"Cardiology journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/ed/cardj-30-3-337.PMC10287081.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10079432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angela Di Giorgio, Claudia Carnuccio, Antonio Nesci, Alessia D'Alessandro, Angelo Santoliquido
A 78-year-old woman was admitted to our hospital for ongoing chest pain. Electrocardiogram showed ST-segment elevation in inferior leads and primary percutaneous coronary intervention (PCI) was successfully performed from the right ulnar artery, as a result of cannulation failure of the ipsilateral radial artery. The patient reported a right transradial PCI some years earlier. After removal of the hemostatic device, a painful pulsatile mass was revealed in the distal forearm. Color Doppler ultrasonography (CDUS) showed complete occlusion of the right radial artery and iatrogenic ulnar artery pseudoaneurysm (Fig. 1)
{"title":"Ulnar artery thrombosis after percutaneous thrombin injection of a pseudoaneurysm with a concomitant radial artery occlusion: Three complications after percutaneous coronary intervention.","authors":"Angela Di Giorgio, Claudia Carnuccio, Antonio Nesci, Alessia D'Alessandro, Angelo Santoliquido","doi":"10.5603/cj.94372","DOIUrl":"10.5603/cj.94372","url":null,"abstract":"A 78-year-old woman was admitted to our hospital for ongoing chest pain. Electrocardiogram showed ST-segment elevation in inferior leads and primary percutaneous coronary intervention (PCI) was successfully performed from the right ulnar artery, as a result of cannulation failure of the ipsilateral radial artery. The patient reported a right transradial PCI some years earlier. After removal of the hemostatic device, a painful pulsatile mass was revealed in the distal forearm. Color Doppler ultrasonography (CDUS) showed complete occlusion of the right radial artery and iatrogenic ulnar artery pseudoaneurysm (Fig. 1)","PeriodicalId":9492,"journal":{"name":"Cardiology journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d9/57/cardj-30-4-675.PMC10508067.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2022-10-06DOI: 10.5603/CJ.a2022.0092
Michal Canetti, Rafael Kuperstein, Ido Cohen, Shir Raibman-Spector, Elad Maor, Ilan Hai, Israel M Barbash, Ehud Regev, Adi Butnaru, Amit Segev, Victor Guetta, Paul Fefer
Background: The treatment of choice for severe rheumatic mitral stenosis is balloon mitral valvuloplasty (BMV). Numerous predictors of immediate and long-term procedural success have been described. The aims of this study were to describe our experience with BMV over the last decade and to evaluate predictors of long-term event-free survival.
Methods: Medical records were retrospectively analyzed of patients who underwent BMV between 2009 and 2021. The primary outcome was a composite endpoint of all-cause mortality, mitral valve replacement (MVR), and repeat BMV. Long-term event-free survival was estimated using Kaplan-Meier curves. Logistic regression was used to create a multivariate model to assess pre-procedural predictors of the primary outcome.
Results: A total of 96 patients underwent BMV during the study period. The primary outcome occurred in 36 patients during 12-year follow-up: one (1%) patient underwent re-BMV, 28 (29%) underwent MVR, and eight (8%) died. Overall, event-free survival was 62% at 12 years. On multivariate analysis, pre-procedural left atrial volume index (LAVI) > 80 mL/m2 had a significant independent influence on event-free survival, as did previous mitral valve procedure and systolic pulmonary arterial pressure above 50 mmHg.
Conclusions: Despite being a relatively low-volume center, excellent short and long-term results were demonstrated, with event-free survival rates consistent with previous studies from high-volume centers. LAVI independently predicted long-term event-free survival.
{"title":"Left atrial size predicts long-term outcome after balloon mitral valvuloplasty.","authors":"Michal Canetti, Rafael Kuperstein, Ido Cohen, Shir Raibman-Spector, Elad Maor, Ilan Hai, Israel M Barbash, Ehud Regev, Adi Butnaru, Amit Segev, Victor Guetta, Paul Fefer","doi":"10.5603/CJ.a2022.0092","DOIUrl":"10.5603/CJ.a2022.0092","url":null,"abstract":"<p><strong>Background: </strong>The treatment of choice for severe rheumatic mitral stenosis is balloon mitral valvuloplasty (BMV). Numerous predictors of immediate and long-term procedural success have been described. The aims of this study were to describe our experience with BMV over the last decade and to evaluate predictors of long-term event-free survival.</p><p><strong>Methods: </strong>Medical records were retrospectively analyzed of patients who underwent BMV between 2009 and 2021. The primary outcome was a composite endpoint of all-cause mortality, mitral valve replacement (MVR), and repeat BMV. Long-term event-free survival was estimated using Kaplan-Meier curves. Logistic regression was used to create a multivariate model to assess pre-procedural predictors of the primary outcome.</p><p><strong>Results: </strong>A total of 96 patients underwent BMV during the study period. The primary outcome occurred in 36 patients during 12-year follow-up: one (1%) patient underwent re-BMV, 28 (29%) underwent MVR, and eight (8%) died. Overall, event-free survival was 62% at 12 years. On multivariate analysis, pre-procedural left atrial volume index (LAVI) > 80 mL/m2 had a significant independent influence on event-free survival, as did previous mitral valve procedure and systolic pulmonary arterial pressure above 50 mmHg.</p><p><strong>Conclusions: </strong>Despite being a relatively low-volume center, excellent short and long-term results were demonstrated, with event-free survival rates consistent with previous studies from high-volume centers. LAVI independently predicted long-term event-free survival.</p>","PeriodicalId":9492,"journal":{"name":"Cardiology journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33490348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Heart failure (HF) is nowadays classified as HF with reduced ejection fraction (HFrEF), HF with mildly reduced EF (HFmrEF), and HF with preserved EF (HFpEF). Endothelial dysfunction (assessed by flow-mediated dilatation [FMD]), increased arterial stiffness (assessed by carotid-femoral pulse-wave velocity [PWV]), and galectin-3, a biomarker of myocardial fibrosis, have been linked to major adverse cardiovascular events (MACE) in patients with ischemic HF.
Methods: In this study we prospectively enrolled 340 patients with stable ischemic HF. We assessed the brachial artery FMD, carotid-femoral PWV, and galectin-3 levels, and patients were followed up for MACE according to HF group.
Results: Interestingly, the FMD values exhibited a stepwise improvement according to left ventricular ejection fraction (LVEF) (HFrEF: 4.74 ± 2.35% vs. HFmrEF: 4.97 ± 2.81% vs. HFpEF: 5.94 ± ± 3.46%, p = 0.01), which remained significant after the evaluation of possible confounders including age, sex, cardiovascular risk factors, and number of significantly stenosed epicardial coronary arteries (b coefficient: 0.990, 95% confidence interval: 0.166-1.814, p = 0.019). Single-vessel coronary artery disease was more frequent in the group of HFpEF (HFrEF: 56% vs. HFmrEF: 64% vs. HFpEF: 73%, p = 0.049). PWV did not display any association with LVEF. Patients who presented MACE exhibited worse FMD values (4.51 ± 2.35% vs. 5.32 ± 2.67%, p = 0.02), and the highest tertile of galectin-3 was linked to more MACEs (36% vs. 5.9%, p = 0.01).
Conclusions: Flow-mediated dilatation displayed a linear improvement with LVEF in patients with ischemic HF. Deteriorated values are associated with MACE. Higher levels of galectin-3 might be used for risk stratification of patients with ischemic HF.
{"title":"The prognostic role of galectin-3 and endothelial function in patients with heart failure.","authors":"Vasiliki Tsigkou, Gerasimos Siasos, Evangelos Oikonomou, Marina Zaromitidou, Konstantinos Mourouzis, Stathis Dimitropoulos, Evanthia Bletsa, Nikolaos Gouliopoulos, Panagiota K Stampouloglou, Maria-Evi Panoilia, Georgios Marinos, Konstantinos Tsioufis, Manolis Vavuranakis, Dimitris Tousoulis","doi":"10.5603/CJ.a2022.0074","DOIUrl":"10.5603/CJ.a2022.0074","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is nowadays classified as HF with reduced ejection fraction (HFrEF), HF with mildly reduced EF (HFmrEF), and HF with preserved EF (HFpEF). Endothelial dysfunction (assessed by flow-mediated dilatation [FMD]), increased arterial stiffness (assessed by carotid-femoral pulse-wave velocity [PWV]), and galectin-3, a biomarker of myocardial fibrosis, have been linked to major adverse cardiovascular events (MACE) in patients with ischemic HF.</p><p><strong>Methods: </strong>In this study we prospectively enrolled 340 patients with stable ischemic HF. We assessed the brachial artery FMD, carotid-femoral PWV, and galectin-3 levels, and patients were followed up for MACE according to HF group.</p><p><strong>Results: </strong>Interestingly, the FMD values exhibited a stepwise improvement according to left ventricular ejection fraction (LVEF) (HFrEF: 4.74 ± 2.35% vs. HFmrEF: 4.97 ± 2.81% vs. HFpEF: 5.94 ± ± 3.46%, p = 0.01), which remained significant after the evaluation of possible confounders including age, sex, cardiovascular risk factors, and number of significantly stenosed epicardial coronary arteries (b coefficient: 0.990, 95% confidence interval: 0.166-1.814, p = 0.019). Single-vessel coronary artery disease was more frequent in the group of HFpEF (HFrEF: 56% vs. HFmrEF: 64% vs. HFpEF: 73%, p = 0.049). PWV did not display any association with LVEF. Patients who presented MACE exhibited worse FMD values (4.51 ± 2.35% vs. 5.32 ± 2.67%, p = 0.02), and the highest tertile of galectin-3 was linked to more MACEs (36% vs. 5.9%, p = 0.01).</p><p><strong>Conclusions: </strong>Flow-mediated dilatation displayed a linear improvement with LVEF in patients with ischemic HF. Deteriorated values are associated with MACE. Higher levels of galectin-3 might be used for risk stratification of patients with ischemic HF.</p>","PeriodicalId":9492,"journal":{"name":"Cardiology journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40633587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2021-10-13DOI: 10.5603/CJ.a2021.0123
Stanisław Surma, Marcin Basiak, Monika Romańczyk, Krzysztof J Filipiak, Bogusław Okopień
Colchicine is an effective anti-inflammatory agent used to treat gout, coronary artery disease, viral pericarditis, and familial Mediterranean fever. It has been found to act by preventing the polymerization of the protein called tubulin, thus inhibiting inflammasome activation, proinflammatory chemokines, and cellular adhesion molecules. Accumulating evidence suggests that some patients with coronavirus disease 2019 (COVID-19) suffer from "cytokine storm" syndrome. The ideal anti-inflammatory in this setting would be one that is readily available, cheap, orally administered, with a good safety profile, well- tolerated, and that prevents or modulates inflammasome activation. The researchers selected colchicine for their study. This paper is a review of the literature describing the effects of colchicine, which is a drug that is being increasingly used, especially when standard therapy fails. Colchicine was shown to reduce inflammatory lung injury and respiratory failure by interfering with leukocyte activation and recruitment. In this publication, we try to systematically review the current data on new therapeutic options for colchicine. The article focuses on new data from clinical trials in COVID-19, rheumatic, cardiovascular, and other treatment such as familial Mediterranean fever, chronic urticaria, and PFAPA syndrome (periodic fever, aphthous, stomatitis, pharyngitis, and cervical adenitis). We also summarize new reports on the side effects, drug interactions, and safety of colchicine.
{"title":"Colchicine - From rheumatology to the new kid on the block: Coronary syndromes and COVID-19.","authors":"Stanisław Surma, Marcin Basiak, Monika Romańczyk, Krzysztof J Filipiak, Bogusław Okopień","doi":"10.5603/CJ.a2021.0123","DOIUrl":"10.5603/CJ.a2021.0123","url":null,"abstract":"<p><p>Colchicine is an effective anti-inflammatory agent used to treat gout, coronary artery disease, viral pericarditis, and familial Mediterranean fever. It has been found to act by preventing the polymerization of the protein called tubulin, thus inhibiting inflammasome activation, proinflammatory chemokines, and cellular adhesion molecules. Accumulating evidence suggests that some patients with coronavirus disease 2019 (COVID-19) suffer from \"cytokine storm\" syndrome. The ideal anti-inflammatory in this setting would be one that is readily available, cheap, orally administered, with a good safety profile, well- tolerated, and that prevents or modulates inflammasome activation. The researchers selected colchicine for their study. This paper is a review of the literature describing the effects of colchicine, which is a drug that is being increasingly used, especially when standard therapy fails. Colchicine was shown to reduce inflammatory lung injury and respiratory failure by interfering with leukocyte activation and recruitment. In this publication, we try to systematically review the current data on new therapeutic options for colchicine. The article focuses on new data from clinical trials in COVID-19, rheumatic, cardiovascular, and other treatment such as familial Mediterranean fever, chronic urticaria, and PFAPA syndrome (periodic fever, aphthous, stomatitis, pharyngitis, and cervical adenitis). We also summarize new reports on the side effects, drug interactions, and safety of colchicine.</p>","PeriodicalId":9492,"journal":{"name":"Cardiology journal","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/5d/cardj-30-2-297.PMC10129269.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9770047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Aortic stiffness is a well-known cardio-vascular risk factor. For years, different methods have been studied in the assessment of aortic elastic properties and large arterial stiffness for risk stratification. Herein is an assessment of the role of intravascular ultrasound (IVUS) imaging for the evaluation of aortic elastic properties.
Methods: Intravascular ultrasound imaging of the aorta was performed in 12 patients with transthoracic echocardiography (TTE) and computed tomography (CT) evidence for enlargement of the ascending aorta - diameter ≥ 40.0 mm. Mechanical properties of the aorta were derived from the measured diameters and intra-aortic pressure. Paired samples T-test analyses were performed to determine differences between measurements derived by TTE, CT and IVUS.
Results: Mean values of the calculated elastic properties via IVUS of the ascending aorta were as follows: compliance 0.021 ± 0.02; strain 205 ± 4.3; aortic stiffness index 4.3 ± 0.75; elastic modulus 0.31 ± 0.05. On paired T-test analysis maximum ascending aortic diameter measured by CT aortography and IVUS did not differ significantly (t = -0.19, p = 0.985), but a significant difference between IVUS measurements and TTE derived diameters was found (t = 13.118, p = 0.034). On average, IVUS diameters were 2.3 mm larger than the results acquired by TTE (95% confidence interval: 14.21-17.13).
Conclusions: Intravascular ultrasound examination of the ascending aorta provided larger diameters than the ones collected by means of TTE. However, IVUS measurements did not differ significantly from diameters derived by CT aortography.
背景:主动脉僵硬是众所周知的心血管危险因素。多年来,人们研究了不同的方法来评估主动脉弹性特性和大动脉硬度的风险分层。本文评估了血管内超声(IVUS)成像在主动脉弹性特性评估中的作用。方法:对12例经胸超声心动图(TTE)和计算机断层扫描(CT)证实升主动脉扩大(直径≥40.0 mm)的患者行主动脉血管内超声显像。主动脉的力学性能由测量的直径和主动脉内压得出。进行配对样本t检验分析,以确定TTE、CT和IVUS测量结果之间的差异。结果:经IVUS计算的升主动脉弹性特性平均值为:顺应性0.021±0.02;菌株205±4.3;主动脉硬度指数4.3±0.75;弹性模量0.31±0.05。配对t检验分析显示,CT主动脉造影与IVUS测量的最大升主动脉内径无显著差异(t = -0.19, p = 0.985),但IVUS测量的最大升主动脉内径与TTE测量的最大升主动脉内径有显著差异(t = 13.118, p = 0.034)。IVUS直径比TTE测量结果平均大2.3 mm(95%可信区间:14.21-17.13)。结论:血管内超声检查所获得的升主动脉直径大于TTE检查所得的升主动脉直径。然而,IVUS测量值与CT主动脉造影术测量值没有明显差异。
{"title":"Intravascular ultrasound imaging in evaluation of aortic stiffness: A proof-of-concept study.","authors":"Niya Boykova Mileva, Dobrin Iotkov Vassilev","doi":"10.5603/CJ.a2021.0003","DOIUrl":"https://doi.org/10.5603/CJ.a2021.0003","url":null,"abstract":"<p><strong>Background: </strong>Aortic stiffness is a well-known cardio-vascular risk factor. For years, different methods have been studied in the assessment of aortic elastic properties and large arterial stiffness for risk stratification. Herein is an assessment of the role of intravascular ultrasound (IVUS) imaging for the evaluation of aortic elastic properties.</p><p><strong>Methods: </strong>Intravascular ultrasound imaging of the aorta was performed in 12 patients with transthoracic echocardiography (TTE) and computed tomography (CT) evidence for enlargement of the ascending aorta - diameter ≥ 40.0 mm. Mechanical properties of the aorta were derived from the measured diameters and intra-aortic pressure. Paired samples T-test analyses were performed to determine differences between measurements derived by TTE, CT and IVUS.</p><p><strong>Results: </strong>Mean values of the calculated elastic properties via IVUS of the ascending aorta were as follows: compliance 0.021 ± 0.02; strain 205 ± 4.3; aortic stiffness index 4.3 ± 0.75; elastic modulus 0.31 ± 0.05. On paired T-test analysis maximum ascending aortic diameter measured by CT aortography and IVUS did not differ significantly (t = -0.19, p = 0.985), but a significant difference between IVUS measurements and TTE derived diameters was found (t = 13.118, p = 0.034). On average, IVUS diameters were 2.3 mm larger than the results acquired by TTE (95% confidence interval: 14.21-17.13).</p><p><strong>Conclusions: </strong>Intravascular ultrasound examination of the ascending aorta provided larger diameters than the ones collected by means of TTE. However, IVUS measurements did not differ significantly from diameters derived by CT aortography.</p>","PeriodicalId":9492,"journal":{"name":"Cardiology journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/da/cardj-30-2-221.PMC10129260.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9400946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maciej Dudek, Lukasz Szarpak, Frank W Peacock, Aleksandra Gasecka, Tomasz Michalski, Pawel Wroblewski, Halla Kaminska, Gabriela Borkowska, Ewa Skrzypek, Adam Smereka, Jaroslaw Meyer-Szary, Sylwia Marciniak, Mariola Malecka
Background: Echocardiography in the setting of resuscitation can provide information as to the cause of the cardiac arrest, as well as indicators of futility. This systematic review and meta-analysis were performed to determine the value of point-of-care ultrasonography (PoCUS) in the assessment of survival for adult patients with cardiac arrest.
Methods: This meta-analysis was performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, Web of Science, Cochrane have been searched from databases inception until March 2nd 2021. The search was limited to adult patients with cardiac arrest and without publication dates or country restrictions. Papers were chosen if they met the required criteria relating to the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this diagnostic technique concerning resuscitation outcomes.
Results: This systematic review identified 20 studies. Overall, for survival to hospital discharge, PoCUS was 6.2% sensitivity (95% confidence interval [CI] 4.7-8.0%) and 2.1% specific (95% CI 0.8-4.2%). PoCUS sensitivity and specificity for return of spontaneous circulation were 23.8% (95% CI 21.4-26.4%) and 50.7% (95% CI 45.8-55.7%) respectively, and for survival to admission 13.8% (95% CI 12.2-15.5%) and 20.1% (95% CI 16.2-24.3%), respectively.
Conclusions: The results do not allow unambiguous recommendation of PoCUS as a predictor of resuscitation outcomes and further studies based on a large number of patients with full standardization of operators, their training and procedures performed were necessary.
背景:超声心动图在复苏的设置可以提供信息的心脏骤停的原因,以及徒劳的指标。本系统综述和荟萃分析旨在确定即时超声检查(PoCUS)在评估心脏骤停成年患者生存中的价值。方法:本荟萃分析遵循系统评价和荟萃分析首选报告项目(PRISMA)指南进行。PubMed, EMBASE, Web of Science, Cochrane从数据库建立到2021年3月2日已被检索。该研究仅限于心脏骤停的成年患者,没有发表日期或国家限制。如果论文符合与复苏结果相关的诊断技术的敏感性、特异性、准确性、阳性预测值和阴性预测值相关的要求标准,则选择论文。结果:本系统综述确定了20项研究。总体而言,对于存活至出院,PoCUS敏感性为6.2%(95%可信区间[CI] 4.7-8.0%),特异性为2.1% (95% CI 0.8-4.2%)。PoCUS对自发循环恢复的敏感性和特异性分别为23.8% (95% CI 21.4-26.4%)和50.7% (95% CI 45.8-55.7%),对存活至入院的敏感性和特异性分别为13.8% (95% CI 12.2-15.5%)和20.1% (95% CI 16.2-24.3%)。结论:该结果不允许明确推荐PoCUS作为复苏结果的预测指标,并且基于大量患者的进一步研究,操作员的完全标准化,他们的培训和操作程序是必要的。
{"title":"Diagnostic performance of point-of-use ultrasound of resuscitation outcomes: A systematic review and meta-analysis of 3265 patients.","authors":"Maciej Dudek, Lukasz Szarpak, Frank W Peacock, Aleksandra Gasecka, Tomasz Michalski, Pawel Wroblewski, Halla Kaminska, Gabriela Borkowska, Ewa Skrzypek, Adam Smereka, Jaroslaw Meyer-Szary, Sylwia Marciniak, Mariola Malecka","doi":"10.5603/CJ.a2021.0044","DOIUrl":"https://doi.org/10.5603/CJ.a2021.0044","url":null,"abstract":"<p><strong>Background: </strong>Echocardiography in the setting of resuscitation can provide information as to the cause of the cardiac arrest, as well as indicators of futility. This systematic review and meta-analysis were performed to determine the value of point-of-care ultrasonography (PoCUS) in the assessment of survival for adult patients with cardiac arrest.</p><p><strong>Methods: </strong>This meta-analysis was performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, Web of Science, Cochrane have been searched from databases inception until March 2nd 2021. The search was limited to adult patients with cardiac arrest and without publication dates or country restrictions. Papers were chosen if they met the required criteria relating to the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this diagnostic technique concerning resuscitation outcomes.</p><p><strong>Results: </strong>This systematic review identified 20 studies. Overall, for survival to hospital discharge, PoCUS was 6.2% sensitivity (95% confidence interval [CI] 4.7-8.0%) and 2.1% specific (95% CI 0.8-4.2%). PoCUS sensitivity and specificity for return of spontaneous circulation were 23.8% (95% CI 21.4-26.4%) and 50.7% (95% CI 45.8-55.7%) respectively, and for survival to admission 13.8% (95% CI 12.2-15.5%) and 20.1% (95% CI 16.2-24.3%), respectively.</p><p><strong>Conclusions: </strong>The results do not allow unambiguous recommendation of PoCUS as a predictor of resuscitation outcomes and further studies based on a large number of patients with full standardization of operators, their training and procedures performed were necessary.</p>","PeriodicalId":9492,"journal":{"name":"Cardiology journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/20/cardj-30-2-237.PMC10129265.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9406806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kounis syndrome (KS), an allergen-induced coronary artery disorder, is classified as type I, causing vasospastic allergic angina; type II, causing allergic acute coronary syndrome (ACS) contrib-uted to vulnerable plaque; and type III, causing coronary artery stent thrombosis. Herein, we report the first documented type II KS case diag - nosed using optical coherence tomography (OCT) and coronary angioscopy (CAS). An 80-year-old man underwent resection for bladder cancer. One gram of cefazolin was administered at the beginning of surgery, and rocuronium and propofol were administered before intubation. A few minutes later, the patient’s blood pressure dropped suddenly from 120/80 mmHg to 70/40 mmHg, and
{"title":"Type II Kounis syndrome diagnosed by optical coherence tomography and coronary angioscopy.","authors":"Yuhei Nojima, Hidenori Adachi, Madoka Ihara, Shinsuke Nanto","doi":"10.5603/CJ.2023.0010","DOIUrl":"https://doi.org/10.5603/CJ.2023.0010","url":null,"abstract":"Kounis syndrome (KS), an allergen-induced coronary artery disorder, is classified as type I, causing vasospastic allergic angina; type II, causing allergic acute coronary syndrome (ACS) contrib-uted to vulnerable plaque; and type III, causing coronary artery stent thrombosis. Herein, we report the first documented type II KS case diag - nosed using optical coherence tomography (OCT) and coronary angioscopy (CAS). An 80-year-old man underwent resection for bladder cancer. One gram of cefazolin was administered at the beginning of surgery, and rocuronium and propofol were administered before intubation. A few minutes later, the patient’s blood pressure dropped suddenly from 120/80 mmHg to 70/40 mmHg, and","PeriodicalId":9492,"journal":{"name":"Cardiology journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/96/cardj-30-1-157.PMC9987555.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9407500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Acute myocardial infarction (AMI) is the leading cause of death for patients with cardiovascular disease (CVD). Although researchers have made substantial efforts to elucidate its pathogenesis, the molecular mechanisms underlying AMI remain unknown. The aim of this study was to use proteomics to identify differentially expressed proteins (DEPs) and the possible biological functions and metabolic pathways related to coronary blood microparticles (MPs) in patients with AMI and stable coronary artery disease (SCAD); this study will allow for the identification of individuals at risk of acute thrombosis.
Methods: The study was performed on 5 AMI patients and 5 SCAD patients. DEPs were identified, and Gene Ontology (GO) enrichment and KEGG pathway enrichment analyzes were performed to determine the relative abundance and biological function of the significant DEPs that were identified in the present study.
Results: The current analysis identified 198 DEPs in the coronary blood of AMI patients and SCAD patients, including 85 proteins that were significantly upregulated and 113 proteins that were significantly downregulated. GO enrichment analysis demonstrated that GDP binding and GTP binding were enriched in molecular function. Similarly, KEGG pathway enrichment analysis revealed that the identified proteins were involved in pantothenate and coenzyme A biosynthesis, starch and sucrose metabolism, and the AMPK signalling pathway.
Conclusions: The proteome of coronary MPs differs between patients with AMI and patients with SCAD. In summary, the GO terms and KEGG pathways enriched by the DEPs may reflect the possible molecular mechanisms underlying the pathogenesis of acute thrombosis in patients with AMI.
{"title":"Proteomics analysis of coronary blood microparticles in patients with acute myocardial infarction.","authors":"Yiping Ma, Yujuan Yuan, Zulipiya Aili, Miribani Maitusong, Hao Li, Muyesai Nijiati","doi":"10.5603/CJ.a2022.0081","DOIUrl":"https://doi.org/10.5603/CJ.a2022.0081","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial infarction (AMI) is the leading cause of death for patients with cardiovascular disease (CVD). Although researchers have made substantial efforts to elucidate its pathogenesis, the molecular mechanisms underlying AMI remain unknown. The aim of this study was to use proteomics to identify differentially expressed proteins (DEPs) and the possible biological functions and metabolic pathways related to coronary blood microparticles (MPs) in patients with AMI and stable coronary artery disease (SCAD); this study will allow for the identification of individuals at risk of acute thrombosis.</p><p><strong>Methods: </strong>The study was performed on 5 AMI patients and 5 SCAD patients. DEPs were identified, and Gene Ontology (GO) enrichment and KEGG pathway enrichment analyzes were performed to determine the relative abundance and biological function of the significant DEPs that were identified in the present study.</p><p><strong>Results: </strong>The current analysis identified 198 DEPs in the coronary blood of AMI patients and SCAD patients, including 85 proteins that were significantly upregulated and 113 proteins that were significantly downregulated. GO enrichment analysis demonstrated that GDP binding and GTP binding were enriched in molecular function. Similarly, KEGG pathway enrichment analysis revealed that the identified proteins were involved in pantothenate and coenzyme A biosynthesis, starch and sucrose metabolism, and the AMPK signalling pathway.</p><p><strong>Conclusions: </strong>The proteome of coronary MPs differs between patients with AMI and patients with SCAD. In summary, the GO terms and KEGG pathways enriched by the DEPs may reflect the possible molecular mechanisms underlying the pathogenesis of acute thrombosis in patients with AMI.</p>","PeriodicalId":9492,"journal":{"name":"Cardiology journal","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/20/cardj-30-2-286.PMC10129261.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9407800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}