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The Efficacy and Safety of Cryoballoon Versus Radiofrequency Ablation for the Treatment of Atrial Fibrillation: A Meta-Analysis of 15 International Randomized Trials. 低温球囊与射频消融治疗心房颤动的有效性和安全性:15项国际随机试验的元分析。
IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2024-10-04 DOI: 10.1097/CRD.0000000000000531
Chuan Huang, Jie Wang, Chaojie He, Kun Yang, Hanru Zhao, Jianfei Chen, Li Su

The purpose of this study was to evaluate the efficacy and safety of cryoballoon versus radiofrequency ablation for the treatment of atrial fibrillation (AF) by systematically reviewing randomized controlled trials (RCTs). Databases of Pubmed, Web of science, Embase, and Cochrane Library were searched for published studies up to June 31, 2022. Only RCTs comparing the efficacy and safety of cryoballoon vs radiofrequency ablation for the treatment of AF were enrolled in meta-analysis. Fifteen RCTs characterizing 2709 patients were finally included. Meta-analysis found that cryoballoon ablation was associated with a similar proportion of patients free from AF [risk ratio (RR): 1.02; 95% confidence interval (CI): 0.93 to 1.12, P = 0.65]. Acute pulmonary vein isolation rate [RR: 1.0; 95% CI: 0.98 to 1.01, P = 0.64] and fluoroscopy time (weighted mean difference: -0.03; 95% CI: -4.35 to 4.28; P = 0.99) were not statistically significant difference. The procedure time was shorter in the cryoballoon ablation (CBA) group (weighted mean difference : -18.76; 95% CI: -27.27 to -10.25; P < 0.0001). Transient phrenic nerve palsy was uniquely observed in the CBA group (RR = 6.66; 95% CI: 2.82 to 15.7, P < 0.0001) and resolved in all during the follow-up period, total complication was similar in both groups (RR = 1.24; 95% CI: 0.86 to 1.79, P = 0.24). Although the procedure time was shorter in CBA group, the efficacy and safety were similar in each group. Compared with radiofrequency ablation for the treatment of AF, patients receiving cryoballoon ablation have similar outcomes. CBA is associated with a shorter duration of procedure.

本研究旨在通过系统回顾随机对照试验(RCT),评估冷冻球囊与射频消融术治疗心房颤动(AF)的有效性和安全性。在 Pubmed、Web of science、Embase 和 Cochrane Library 等数据库中检索了截至 2022 年 6 月 31 日已发表的研究。荟萃分析仅纳入了比较冷冻球囊与射频消融治疗房颤的有效性和安全性的 RCT。最终纳入了 15 项研究,涉及 2709 名患者。荟萃分析发现,冷冻球囊消融术与类似比例的房颤患者无相关性[风险比(RR):1.02;95% 置信区间(CI):0.93 至 1.12,P = 0.65]。急性肺静脉隔离率[RR:1.0;95% CI:0.98 至 1.01,P = 0.64]和透视时间(加权平均差:-0.03;95% CI:-4.35 至 4.28;P = 0.99)差异无统计学意义。冷冻球囊消融术(CBA)组的手术时间更短(加权平均差:-18.76;95% CI:-27.27 至 -10.25;P < 0.0001)。一过性膈神经麻痹仅在 CBA 组出现(RR = 6.66;95% CI:2.82 至 15.7,P <0.0001),在随访期间全部缓解,两组的总并发症相似(RR = 1.24;95% CI:0.86 至 1.79,P = 0.24)。虽然 CBA 组的手术时间较短,但两组的疗效和安全性相似。与射频消融治疗房颤相比,接受冷冻球囊消融治疗的患者疗效相似。冷冻球囊消融术的手术时间更短。
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引用次数: 0
Incidental Breast Arterial Calcifications and Assessment of Coronary Artery Disease Risk: A Review and Recommendation. 意外乳腺动脉钙化与冠状动脉疾病风险评估:综述与建议。
IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2023-06-23 DOI: 10.1097/CRD.0000000000000567
Klaudia J Koziol, William H Frishman

Coronary artery disease (CAD) continues to be the leading cause of morbidity and mortality in women, contributing to about 20%, or nearly 400,000, of female deaths annually in the United States. Despite their significant burden from CAD, women have been traditionally underrepresented in trials, and therefore, there is still much to be studied regarding the sex-based variations that have been reported regarding the pathophysiology, clinical presentation, efficacy of diagnostic workup, and response to therapy in CAD. Previous studies have reported that breast arterial calcifications, commonly found incidentally on screening mammography, may be associated with risk of CAD; however, there are currently no specific guidelines concerning reporting and quantification practices, as well as further workup recommendations for patients who are found to have vascular calcifications. Thus, the question remains whether breast arterial calcifications can serve as a sex-specific marker for CAD, and whether there is enough evidence to support the use of mammography as a screening tool for CAD in women. In this review, we will summarize the current understanding of cardiovascular disease in women, the existing literature regarding breast arterial calcifications and current reporting practices, and the association of vascular calcifications with CAD risk; based on the collected evidence, we will make a recommendation whether screening mammography and breast arterial calcifications should be used to assess CAD risk, and if so, what additional workup, if any, we recommend in women found to have breast arterial calcifications on imaging.

冠状动脉疾病(CAD)仍然是女性发病和死亡的主要原因,在美国,每年约有 20% 或近 40 万女性死于该病。尽管 CAD 给女性带来了巨大的负担,但传统上女性在试验中的代表性一直不足,因此,关于 CAD 的病理生理学、临床表现、诊断工作的有效性和对治疗的反应等方面的性别差异,仍有许多问题有待研究。以往的研究报告显示,乳腺动脉钙化通常是在乳腺放射摄影筛查中偶然发现的,可能与罹患 CAD 的风险有关;但是,目前还没有关于报告和量化方法的具体指南,也没有针对发现血管钙化患者的进一步检查建议。因此,乳腺动脉钙化是否可以作为CAD的性别特异性标志物,以及是否有足够的证据支持使用乳腺X光摄影作为女性CAD的筛查工具,这些问题依然存在。在这篇综述中,我们将总结目前对女性心血管疾病的认识、有关乳房动脉钙化的现有文献和目前的报告方法,以及血管钙化与 CAD 风险的关联;根据收集到的证据,我们将提出建议,说明是否应使用乳房 X 线照相术和乳房动脉钙化筛查来评估 CAD 风险,如果是,我们建议对在成像中发现有乳房动脉钙化的女性进行哪些额外检查(如果有)。
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引用次数: 0
Genetic Problems, Diagnosis, and Cardiovascular Manifestations of Loeys-Dietz Syndrome. Loeys-Dietz 综合征的遗传问题、诊断和心血管表现。
IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2023-05-01 DOI: 10.1097/CRD.0000000000000544
Subo Dey, Ryan Cheikhali, William H Frishman, Wilbert S Aronow

Loeys-Dietz Syndrome (LDS) is an autosomal dominant connective tissue disorder with multisystem involvement of wide spectrum, found to be associated with transforming growth factor-β pathway. LDS is characterized by craniofacial, skeletal, cutaneous, vascular abnormalities along with aortic aneurysm and aortic dissection contributing to mortality and morbidity at a young age. Therefore, timely diagnosis and intervention in patients with LDS is vital. Several gene mutations have been described as contributing factors of LDS, causing widespread and aggressive vascular disease. Based on these gene mutations, 5 types of LDS have been described so far. Besides aortic aneurysm and dissection, some of the other cardiac manifestations of LDS involve cardiomyopathy, valvular abnormality, atrial fibrillation, patent ductus arteriosus, atrial septal defects, etc. Routine imaging of patients' vasculatures and aggressive medical and surgical management are key factors in managing patients with LDS.

洛伊-迪茨综合征(Loeys-Dietz Syndrome,LDS)是一种常染色体显性结缔组织疾病,多系统广泛受累,发现与转化生长因子-β通路有关。LDS 的特征是颅面、骨骼、皮肤和血管异常,同时伴有主动脉瘤和主动脉夹层,导致死亡率和发病率较低。因此,及时诊断和干预 LDS 患者至关重要。有几种基因突变已被描述为 LDS 的致病因素,可导致广泛和侵袭性的血管疾病。根据这些基因突变,迄今已描述了 5 种 LDS 类型。除主动脉瘤和夹层外,LDS 的其他心脏表现还包括心肌病、瓣膜异常、心房颤动、动脉导管未闭、房间隔缺损等。对患者的血管进行常规成像以及积极的内外科治疗是治疗 LDS 患者的关键因素。
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引用次数: 0
Prognostic Value of Frailty for Heart Failure Patients Undergoing Left Ventricular Assist Device Implantation: A Systematic Review. 接受左心室辅助装置植入术的心衰患者体弱的预后价值:系统回顾
IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2023-03-07 DOI: 10.1097/CRD.0000000000000541
Lauren E Meece, Julia Yu, David E Winchester, Matthew Petersen, Eric I Jeng, Mohammad A Al-Ani, Alex M Parker, Juan R Vilaro, Juan M Aranda, Mustafa M Ahmed

Frailty is associated with poor clinical outcomes in heart failure patients. The impact of frailty on outcomes following left ventricular assist device (LVAD) implantation, however, is less clearly defined. We therefore sought to conduct a systematic review to evaluate current frailty assessment strategies and their significance for patients undergoing LVAD implantation. We conducted a comprehensive electronic search of PubMed, Embase, and CINAHL databases from inception until April 2021 for studies examining frailty in patients undergoing LVAD implantation. Study characteristics, patient demographics, type of frailty measurement, and outcomes were extracted. Outcomes were organized into 5 basic categories: implant length of stay (iLOS), 1-year mortality, rehospitalization, adverse events, and quality of life (QOL). Of the 260 records retrieved, 23 studies involving 4935 patients satisfied the inclusion criteria. Approaches to measuring frailty varied, with the 2 most common being sarcopenia determined by computed tomography and Fried's frailty phenotype assessment. Outcomes of interest were also widely variable, with iLOS stay and mortality being the most frequently reported, albeit with differing definitions of both between studies. The heterogeneity among included studies precluded quantitative synthesis. Narrative synthesis showed that frailty by any measure is more likely to be associated with higher mortality, longer iLOS, more adverse events and worse QOL post-LVAD implant. Frailty can be a valuable prognostic indicator in patients undergoing LVAD implantation. Further studies are needed to determine the most sensitive frailty assessment, as well as the ways in which frailty may serve as a modifiable target to improve outcomes following LVAD implantation.

虚弱与心衰患者的不良临床预后有关。然而,虚弱对左心室辅助装置(LVAD)植入术后预后的影响还不太明确。因此,我们试图进行一项系统性综述,评估目前的虚弱评估策略及其对接受左心室辅助器植入术患者的意义。我们对 PubMed、Embase 和 CINAHL 数据库进行了全面的电子检索,检索时间从开始到 2021 年 4 月,检索对象为接受 LVAD 植入术的患者。提取了研究特征、患者人口统计学特征、虚弱测量类型和结果。结果分为 5 个基本类别:植入后住院时间 (iLOS)、1 年死亡率、再住院率、不良事件和生活质量 (QOL)。在检索到的 260 份记录中,有 23 项涉及 4935 名患者的研究符合纳入标准。衡量虚弱程度的方法各不相同,最常见的两种方法是通过计算机断层扫描确定肌肉疏松症和弗里德虚弱表型评估。研究结果的差异也很大,最常报道的是 iLOS 停留时间和死亡率,但不同研究对这两项结果的定义也不尽相同。由于纳入研究之间存在异质性,因此无法进行定量综合。叙述性综述显示,无论以何种标准衡量,体弱都更有可能与更高的死亡率、更长的iLOS时间、更多的不良事件以及植入LVAD后更差的QOL有关。对于接受 LVAD 植入术的患者来说,虚弱可能是一个有价值的预后指标。还需要进一步研究来确定最敏感的虚弱程度评估方法,以及如何将虚弱程度作为可调整的目标,以改善 LVAD 植入术后的预后。
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引用次数: 0
A Novel Approach to Calcium Destruction in Coronary and Peripheral Blood Vessels: Intravascular Lithotripsy. 冠状动脉和外周血管中钙质破坏的新方法:血管内碎石术。
IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2023-03-08 DOI: 10.1097/CRD.0000000000000514
Peter D Lenchur, William H Frishman

Lithotripsy has been used for decades in the treatment of kidney stones and gallstones, in which ultrasound shock waves generated outside of the body are used to physically break up hardened masses. In the past decade, intravascular lithotripsy (IVL), a technology developed by Shockwave Medical Inc. (Santa Clara, CA), has emerged as a novel therapy for the treatment of vascular calcification. In the coronary blood vessels, IVL modifies arterial calcium and enables percutaneous coronary interventions to be performed in a safe and consistent manner, and in the peripheral blood vessels, IVL can be used as a standalone therapy in the treatment of calcified plaque in patients with peripheral artery disease (PAD). Due to the success of the Disrupt CAD and Disrupt PAD clinical trials, IVL is now FDA-approved in the United States for use in both patients with coronary artery disease (CAD) and PAD. The widespread adoption of IVL for PAD is likely to mirror the swift uptake seen in CAD. Although questions remain regarding IVL's high cost and performance compared directly to other technologies such as atherectomy, its ease of use, speed, and safety makes its future extremely promising for the treatment of complex, heavily calcified lesions in both peripheral and coronary vessels. Despite this, more studies are certainly needed to determine in what clinical scenarios IVL should be considered as opposed to atherectomy and if there are types of calcified lesions where IVL is best utilized (ie, concentric vs eccentric).

数十年来,碎石术一直被用于治疗肾结石和胆结石,利用在体外产生的超声冲击波物理击碎硬块。在过去十年中,冲击波医疗公司(加利福尼亚州圣克拉拉市)开发的血管内碎石(IVL)技术已成为治疗血管钙化的一种新型疗法。在冠状动脉血管中,IVL 能改变动脉钙化,使经皮冠状动脉介入治疗安全、稳定地进行;在外周血管中,IVL 可作为一种独立疗法用于治疗外周动脉疾病 (PAD) 患者的钙化斑块。由于 Disrupt CAD 和 Disrupt PAD 临床试验的成功,IVL 现已获得美国 FDA 批准,可用于冠状动脉疾病 (CAD) 和 PAD 患者。IVL 在冠状动脉阻塞患者中的广泛应用很可能与在冠状动脉阻塞患者中的迅速普及如出一辙。虽然与其他技术(如动脉粥样硬化切除术)相比,IVL 的高成本和高性能仍存在疑问,但其使用方便、快速和安全的特点使其在治疗外周和冠状动脉复杂、严重钙化病变方面前景广阔。尽管如此,仍需要进行更多的研究,以确定在哪些临床情况下应考虑使用 IVL 而不是动脉粥样硬化切除术,以及是否有哪些类型的钙化病变最适合使用 IVL(即同心型与偏心型)。
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引用次数: 0
Apical or Septal Right Ventricular Location in Patients Receiving Defibrillation Leads: A Systematic Review and Meta-Analysis. 接受除颤导联的患者右心室位于心尖还是心隔?系统回顾与元分析》。
IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2023-03-08 DOI: 10.1097/CRD.0000000000000527
Helder Santos, Margarida Figueiredo, Sofia B Paula, Mariana Santos, Paulo Osório, Guilherme Portugal, Bruno Valente, Ana Lousinha, Pedro Silva Cunha, Mário Oliveira

This study reviews the published data comparing the efficacy and safety of apical and septal right ventricle defibrillator lead positioning at 1-year follow-up. Systemic research on Medline (PubMed), ClinicalTrials.gov , and Embase was performed using the keywords "septal defibrillation," "apical defibrillation," "site defibrillation," and "defibrillation lead placement," including implantable cardioverter-defibrillator and cardiac resynchronization therapy devices. Comparisons between apical and septal position were performed regarding R-wave amplitude, pacing threshold at a pulse width of 0.5 ms, pacing and shock lead impedance, suboptimal lead performance, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter, readmissions due to heart failure and mortality rates. A total of 5 studies comprising 1438 patients were included in the analysis. Mean age was 64.5 years, 76.9% were male, with a median LVEF of 27.8%, ischemic etiology in 51.1%, and a mean follow-up period of 26.5 months. The apical lead placement was performed in 743 patients and septal lead placement in 690 patients. Comparing the 2 placement sites, no significant differences were found regarding R-wave amplitude, lead impedance, suboptimal lead performance, LVEF, left ventricular end-diastolic diameter, and mortality rate at 1-year follow-up. Pacing threshold values favored septal defibrillator lead placement ( P = 0.003), as well as shock impedance ( P = 0.009) and readmissions due to heart failure ( P = 0.02). Among patients receiving a defibrillator lead, only pacing threshold, shock lead impedance, and readmission due to heart failure showed results favoring septal lead placement. Therefore, generally, the right ventricle lead placement does not appear to be of major importance.

本研究回顾了已发表的数据,比较了心尖和室间隔右心室除颤器导联定位在 1 年随访中的有效性和安全性。使用关键词 "室间隔除颤"、"心尖除颤"、"部位除颤 "和 "除颤导联放置"(包括植入式心律转复除颤器和心脏再同步治疗设备),在 Medline (PubMed)、ClinicalTrials.gov 和 Embase 上进行了系统研究。在 R 波振幅、脉宽 0.5 毫秒时的起搏阈值、起搏和冲击导联阻抗、导联性能不达标、左室射血分数 (LVEF)、左室舒张末期直径、心衰再入院率和死亡率方面,对心尖位置和室间隔位置进行了比较。共有 5 项研究、1438 名患者参与了分析。平均年龄为64.5岁,76.9%为男性,LVEF中位数为27.8%,51.1%为缺血性病因,平均随访时间为26.5个月。743名患者进行了心尖导联置入,690名患者进行了室间隔导联置入。比较两个置入部位,发现R波振幅、导联阻抗、导联性能不达标、LVEF、左室舒张末期直径和随访1年的死亡率均无明显差异。起搏阈值有利于室间隔除颤器导联置入(P = 0.003),冲击阻抗(P = 0.009)和心衰再入院(P = 0.02)也有利于室间隔除颤器导联置入。在接受除颤器导联的患者中,只有起搏阈值、电击导联阻抗和心衰再入院显示出有利于室间隔导联置入的结果。因此,一般来说,右心室导联的放置似乎并不重要。
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引用次数: 0
The Critical Role of the Adipocytokine NOV in Obstructive Sleep Apnea Induced Cardiometabolic Dysfunction: A Review. 脂肪细胞因子 NOV 在阻塞性睡眠呼吸暂停诱发的心脏代谢功能障碍中的关键作用:综述。
IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 Epub Date: 2023-04-25 DOI: 10.1097/CRD.0000000000000556
Eddie W Fakhouri, Stephen J Peterson, William Fakhouri, Ruth Minkin, William H Frishman, Jeremy A Weingarten

Obstructive sleep apnea (OSA) is highly prevalent and associated with oxidative stress, chronic inflammation, and adverse cardiovascular consequences. The comorbid condition of obesity remains epidemic. Both obesity and OSA are highly comorbid in patients with cardiovascular disease including atrial fibrillation, resistant hypertension, congestive heart failure, and coronary artery disease. Patients with these preexisting cardiovascular conditions should be screened for OSA with a low threshold to treat, even if OSA severity is mild. Nephroblastoma overexpressed (NOV/CCN3) protein has been identified in multiple chronic inflammatory states, most notably in obesity and more recently in OSA, even in the absence of obesity. As such, NOV may represent an important biomarker for oxidative stress in OSA and may lead to a deeper understanding of the relationship between OSA and its clinical sequelae.

阻塞性睡眠呼吸暂停(OSA)发病率很高,与氧化应激、慢性炎症和不良心血管后果有关。肥胖症仍然是一种流行病。肥胖和 OSA 都是心血管疾病患者的高合并症,包括心房颤动、抵抗性高血压、充血性心力衰竭和冠状动脉疾病。对患有这些原有心血管疾病的患者应进行 OSA 筛查,即使 OSA 的严重程度较轻,也应降低治疗门槛。肾母细胞瘤过表达(NOV/CCN3)蛋白已在多种慢性炎症状态中被发现,最明显的是在肥胖症中,最近又在 OSA 中被发现,即使没有肥胖症。因此,NOV 可能是 OSA 中氧化应激的一个重要生物标志物,可帮助人们更深入地了解 OSA 及其临床后遗症之间的关系。
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引用次数: 0
Dysautonomia and Postural Orthostatic Tachycardia Syndrome: A Critical Analysis of Dysautonomia: How to Diagnose and Treat. 自主神经失调症和体位性正位性心动过速综合征:Dysautonomia: How to Diagnose and Treat》的批判性分析。
IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-25 DOI: 10.1097/CRD.0000000000000798
Michael I Weintraub, Nicholas L DePace, Ramona Munoz, Karolina Kaczmarski, Ron Manno, Joseph Colombo

A significant number of physicians are unclear of the vast clinical manifestations of dysautonomia and imbalance of the autonomic nervous system, specifically the parasympathetic and sympathetic nervous systems. The major obstacle has been an inability to determine the mechanism of action as well as multisystem dysfunction and a lack of clear-cut testing. Dysautonomia, a pathophysiological malfunction of the sympathetic and parasympathetic nerves in our bodies, can present as altered clinical functions of heart rate (tachycardia/bradycardia), altered breathing patterns, blood pressure (hypertension/hypotension), sweating, digestion, syncope, etc. These symptoms have caused specialists to miss this diagnosis because of relative nonspecificity. Our current analysis of patients demonstrates significant delays in diagnosis, misdiagnosis, and the development of chronic syndromes because of the above. We demonstrate that monitoring of heart rate and blood pressure with changes in position and respiration can be easily and quickly performed without orthostatic stress and can demonstrate the entities of sympathetic withdrawal, cholinergic excessive aspects as well as tachycardia, blood pressure dips with posture, etc. This analysis takes less than an hour without the need for injections or medication, thus more quickly informing the cardiologist/neurologist of the correct diagnosis. We will attempt to demystify these issues so that clinicians and the scientific community will have a better understanding of this entity and consider a diagnosis of dysautonomia earlier in the differential diagnostic process and start treatment approaches sooner.

相当多的医生不清楚自律神经失调症和自律神经系统(特别是副交感神经系统和交感神经系统)失衡的大量临床表现。主要障碍是无法确定作用机制以及多系统功能障碍,并且缺乏明确的测试。自主神经失调症是人体交感神经和副交感神经的病理生理功能失调,临床表现为心率(心动过速/心动过缓)、呼吸模式改变、血压(高血压/高血脂)、出汗、消化、晕厥等功能改变。这些症状由于相对缺乏特异性,导致专科医生漏诊。我们目前对患者的分析表明,由于上述原因,诊断延误、误诊和慢性综合征的发展非常严重。我们证明,随着体位和呼吸的变化监测心率和血压可以在没有正立压力的情况下方便快捷地进行,并能显示交感神经衰退、胆碱能过度以及心动过速、血压随体位下降等实体。这种分析只需不到一个小时的时间,无需注射或服药,因此能更快地告知心脏病学家/神经病学家正确的诊断。我们将尝试揭开这些问题的神秘面纱,以便临床医生和科学界更好地了解这种疾病,在鉴别诊断过程中更早地考虑自律神经失调的诊断,更早地开始治疗方法。
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引用次数: 0
Cardiac Manifestations of Lyme Disease. 莱姆病的心脏表现。
IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-24 DOI: 10.1097/CRD.0000000000000807
Maisha Maliha, Nathaniel Abittan, William H Frishman, Wilbert S Aronow, Joseph Harburger

Lyme disease (LD) is an inflammatory disorder caused by an infectious bacterial agent and is the most common tick-borne illness in the United States and Europe. About 1.5-10% of adults infected with LD develop cardiac complications. This review summarizes the current knowledge of the epidemiology, pathophysiology, and diagnosis of Lyme carditis (LC), as well as the different manifestations of LD in the cardiovascular system. This review will primarily highlight the effect of LD on the cardiac conduction system and also discuss its effect on the myocardium, pericardium, valves, and coronary arteries. The management and prognosis of LC will be reviewed here as well. While this is a comprehensive review of the current literature on LC, there remain many questions regarding the complex relationship between LD and the heart.

莱姆病(Lyme disease,LD)是一种由传染性细菌病原体引起的炎症性疾病,是美国和欧洲最常见的蜱媒疾病。感染莱姆病的成年人中约有 1.5-10%会出现心脏并发症。这篇综述总结了目前关于莱姆心肌炎(LC)的流行病学、病理生理学和诊断的知识,以及莱姆心肌炎在心血管系统中的不同表现。本综述将主要强调莱姆病对心脏传导系统的影响,并讨论其对心肌、心包、瓣膜和冠状动脉的影响。这里还将回顾低密度脂蛋白血症的治疗和预后。虽然这是对目前有关低密度脂蛋白血症文献的全面回顾,但对于低密度脂蛋白血症与心脏之间的复杂关系,仍然存在许多疑问。
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引用次数: 0
Frank J. Veith, MD: Vascular Surgeon, Pioneer, Leader. 弗兰克-维斯(Frank J. Veith)医学博士:血管外科医生、先驱、领袖。
IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-24 DOI: 10.1097/CRD.0000000000000809
Samantha Fountain, George Hines, Reese Wain
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引用次数: 0
期刊
Cardiology in Review
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