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Lin C, Ge Q, Wang L, Zeng P, Huang M, Li D. Predictors, prevalence and prognostic role of pulmonary hypertension in patients with chronic kidney disease: a systematic review and meta-analysis. Ren Fail 2024; 46:2368082. [PMID: 38938193 PMCID: PMC11216249 DOI: 10.1080/0886022x.2024.2368082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/08/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND To estimate the predictors, prevalence and prognostic role of pulmonary hypertension (PH) in patients with chronic kidney disease (CKD) using meta-analysis. METHODS The PubMed, EmBase, and the Cochrane library were systematically searched for eligible studies from inception till May 2024. All of pooled analyses were performed using the random-effects model. RESULTS Fifty observational studies involving 17,558 CKD patients were selected. The prevalence of PH in CKD patients was 38% (95% confidence interval [CI]: 33%-43%), and the prevalence according to CKD status were 31% (95% CI: 20%-42%) for CKD (I-V), 39% (95% CI: 25%-54%) for end stage kidney disease (ESKD) (predialysis), 42% (95% CI: 35%-50%) for ESKD (hemodialysis), and 26% (95% CI: 19%-34%) for renal transplant. We noted the risk factors for PH in CKD included Black individuals (relative risk [RR]: 1.39; 95% CI: 1.18-1.63; p < 0.001), chronic obstructive pulmonary disease (RR: 1.48; 95% CI: 1.21-1.82; p < 0.001), cardiovascular disease history (RR: 1.62; 95% CI: 1.05-2.51; p = 0.030), longer dialysis (RR: 1.70; 95% CI: 1.18-2.46; p = 0.005), diastolic dysfunction (RR: 1.88; 95% CI: 1.38-2.55; p < 0.001), systolic dysfunction (RR: 3.75; 95% CI: 2.88-4.87; p < 0.001), and grade 5 CKD (RR: 5.64; 95% CI: 3.18-9.98; p < 0.001). Moreover, PH in CKD patients is also associated with poor prognosis, including all-cause mortality, major cardiovascular events, and cardiac death. CONCLUSION This study systematically identified risk factors for PH in CKD patients, and PH were associated with poor prognosis. Therefore, patients with high prevalence of PH should be identified for treatment.
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Affiliation(s)
- Chunlong Lin
- Department of Respiratory and Critical Care Medicine, Yueyang municipal Hospital of Hunan Normal University, Hunan, China
| | - Qilong Ge
- Department of Respiratory and Critical Care Medicine, Yueyang municipal Hospital of Hunan Normal University, Hunan, China
| | - Lei Wang
- Department of Respiratory and Critical Care Medicine, Yueyang municipal Hospital of Hunan Normal University, Hunan, China
| | - Pan Zeng
- Department of Respiratory and Critical Care Medicine, Yueyang municipal Hospital of Hunan Normal University, Hunan, China
| | - Mingmin Huang
- Department of Respiratory and Critical Care Medicine, Yueyang municipal Hospital of Hunan Normal University, Hunan, China
| | - Dan Li
- Department of Respiratory and Critical Care Medicine, Yueyang municipal Hospital of Hunan Normal University, Hunan, China
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2
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Yuan S, Li S, Ruan J, Liu H, Jiang T, Dai H. Chronic kidney disease and pulmonary hypertension: Progress in diagnosis and treatment. Transl Res 2024; 273:16-22. [PMID: 38960282 DOI: 10.1016/j.trsl.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 06/13/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024]
Abstract
Pulmonary hypertension (PH) is a medical condition characterized by elevated pulmonary vascular resistance and pressure, resulting from different diseases. Due to their high occurrence of PH, intricate hemodynamic classification, and frequently multifactorial cause and mechanism, individuals suffering from chronic kidney disease (CKD) are categorized as the fifth primary group of PH. Based on both domestic and international research, this article provides information on the epidemiology, risk factors, pathogenesis, and targeted drug treatment of PH associated with CKD.
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Affiliation(s)
- Shanshan Yuan
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao 266011, PR China
| | - Shicheng Li
- Department of Cardiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, PR China
| | - Jiangwen Ruan
- Department of Cardiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Institute of Cardiovascular Sciences, Guangxi Academy of Medical Sciences, Nanning 530021, PR China
| | - Hui Liu
- Division of Biology and Chemistry, Paul Scherrer Institut, 5232, Villigen, Switzerland; Department of Health Sciences and Technology, ETH Zurich, 8092, Zurich, Switzerland
| | - Tongmeng Jiang
- Key Laboratory of Emergency and Trauma of Ministry of Education, Key Laboratory of Haikou Trauma, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital, Hainan Medical University, Haikou 571199, PR China; Engineering Research Center for Hainan Bio-Smart Materials and Bio-Medical Devices, Key Laboratory of Hainan Functional Materials and Molecular Imaging, College of Emergency and Trauma, Hainan Academy of Medical Sciences, Hainan Medical University, Haikou 571199, PR China.
| | - Hongyan Dai
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao 266011, PR China.
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3
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Horn D. From prevention to treatment: Prescription medication, information, and health behaviors. HEALTH ECONOMICS 2024; 33:2618-2644. [PMID: 39107842 DOI: 10.1002/hec.4885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 07/15/2024] [Accepted: 07/23/2024] [Indexed: 10/03/2024]
Abstract
Medical innovations may lessen the perceived risk of disease which can decrease the take-up of healthy behaviors, a phenomenon known as risk compensation. In contrast, a diagnosis provides updated information about the state of one's health which may motivate positive behavior change. In this paper, I consider how behavior changes in response to a diagnosis of cardiovascular disease (CVD) before and after the FDA approval of new classes of drugs to treat high blood pressure and high cholesterol in 1973. I find that individuals diagnosed with CVD are more likely to follow a diet and decrease body-mass index in response to the diagnosis, irrespective of medication approvals. Nonsmoking is a notable exception. Prior to medication availability, there is no change in smoking behavior in response to a CVD diagnosis. Conversely, when medication is available, there is a significant decline in smoking. The empirical complementarity of medication and smoking cessation may be driven by increased exposure to medical professionals (who emphasize the harms of smoking) or because medication decreases the risk of CVD death which heightens the importance of investing in future health.
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Affiliation(s)
- Danea Horn
- Department of Clinical Pharmacy, Center for Center for Translational and Policy Research on Precision Medicine, University of California, San Francisco, California, USA
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4
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Pourmand A, Checkeye H, Varghese B, Solomon AJ, Tran QK. The Role of Troponin Testing in Patients with Supraventricular Tachycardia, Systematic Review and Meta-Analysis. J Emerg Med 2024; 67:e402-e413. [PMID: 39242347 DOI: 10.1016/j.jemermed.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Supraventricular tachycardia (SVT) is commonly evaluated in the emergency department (ED). While troponin has been shown to be elevated in SVT, its usefulness for predicting coronary artery disease and future adverse cardiovascular outcomes has not been shown. OBJECTIVES We aimed to evaluate the prognostic utility of troponin measurement as part of SVT management in the ED. METHODS We performed a literature search in the PubMed and Scopus databases from inception to August 30, 2023, including all studies reporting troponin measurements in adult patients (age > 18 years) presenting to the ED with supraventricular tachycardia. The primary outcome of interest for this study was the prevalence of elevated troponin in patients with SVT. Secondary outcomes included the prevalence of major adverse cardiac events (MACE) and additional cardiac testing with significant findings. RESULTS We included 7 studies (500 patients) in our analysis. Six studies reported the number of patients with SVT and elevated troponin, with a pooled prevalence of 46% (95% CI 27-66%, I2 93%). The pooled prevalence of all MACE in our study was 6% (95% CI 1-25%), while the prevalence for MACE among patients with elevated serum troponin levels was 11% (95% CI 4-27%). CONCLUSIONS Troponin levels are frequently ordered for ED patients with SVT and are often elevated. However, this review suggests that they have low prognostic value in predicting MACE.
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Affiliation(s)
- Ali Pourmand
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington DC.
| | - Hannah Checkeye
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington DC
| | - Bennet Varghese
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington DC
| | - Allen J Solomon
- Division of Cardiology, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington DC
| | - Quincy K Tran
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland
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5
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Okda SM, El-Bassiouny NA, El Amrawy AM, Salahuddin A, Elonsy SM, Kassem AB. Impact of CYP2D6*2A, CYP2D6*4 and CYP3A5*3 genetic polymorphisms on Bisoprolol peak concentration and clinical response in acute coronary syndrome patients. Br J Clin Pharmacol 2024; 90:2539-2553. [PMID: 38886107 DOI: 10.1111/bcp.16134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 04/25/2024] [Accepted: 05/21/2024] [Indexed: 06/20/2024] Open
Abstract
AIMS Acute coronary syndrome (ACS) represents a major cause of death. Bisoprolol is commonly used in the management of ACS. This study aims to investigate the impact of CYP2D6*2A, CYP2D6*4 and CYP3A5*3 genetic polymorphisms on pharmacokinetics and clinical response of bisoprolol in ACS patients. METHODS This is an open-label cohort study that included 127 ACS patients and studied the effect of CYP3A5*3, CYP2D6*2A and CYP2D6*4 genotyping using real-time polymerase chain reaction on steady state bisoprolol plasma peak concentration analysed by high performance liquid chromatography-fluorescence detector. RESULTS Regarding CYP3A5*3, the mean peak bisoprolol concentration for CC, CT and TT genotypes were 4.25 ± 1.20, 3.93 ± 1.10 and 1.79 ± 0.69 ng/mL, respectively (P < .001). Higher systolic (126 ± 5.47 mmHg), diastolic blood pressure (82 ± 2.73 mmHg) and heart rate (97.80 ± 3.03 beats/min) were also observed in CYP3A5*3 TT carriers (P < .05). In CYP2D6*2A, the peak concentration of bisoprolol was lower in CC carriers (3.54 ± 1 ng/mL) compared to GG (4.38 ± 1.25 ng/mL) and GC carriers (4.07 ± 1.29 ng/mL, P = .019). In CYP2D6*4, the mean bisoprolol peak concentration in CC carriers was 3.98 ± 1.31 ng/mL, which was lower than T allele carriers (4.5 ± 0.8, P = .02). No differences in heart rate, systolic, diastolic blood pressure or bisoprolol dose were observed among CYP2D6*2A or CYP2D6*4 variants. Smokers exhibited lower bisoprolol peak concentration (3.96 ± 1.2 ng/mL) compared to nonsmokers (4.55 ± 1.34 ng/mL, P = .037). CONCLUSION There is an association between CYP3A5*3, CYP2D6*4, CYP2D6*2A variants and bisoprolol peak concentration, which may serve as a guide in the future in choosing the optimum dose of bisoprolol in ACS patients.
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Affiliation(s)
- Sherouk M Okda
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
| | - Noha A El-Bassiouny
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
| | | | - Ahmad Salahuddin
- Department of Biochemistry, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
- Department of Biochemistry, College of Pharmacy, Al-Ayen Iraqi University, Thi-Qar, Iraq
| | - Sohila M Elonsy
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
| | - Amira B Kassem
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
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6
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Raeburn K, duPlessis M, Loukas M. Muscularization of the chordae tendinea of the mitral anterior papillary muscle. Surg Radiol Anat 2024; 46:1693-1698. [PMID: 39190035 DOI: 10.1007/s00276-024-03465-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 08/11/2024] [Indexed: 08/28/2024]
Abstract
The chordae tendineae, described as fibro-collagenous structures, support the leaflets of the atrioventricular valves of the heart in various ways. The chordae tendineae are composed of collagen and elastic fibers. They connect to the ventricular side of the valve leaflets' free border and hinder the leaflets from swinging back into the atrial cavity during systole. Mitral valve chordae tendineae have been classified using a variety of classification systems. To our knowledge, we report a variant chordae tendinea that has yet to be described in the literature. The variant, present only on the mitral anterior papillary muscle, did not show the characteristic appearance of the chorda tendineae. Muscular fibers were observed extending from a larger than usual mitral anterior papillary muscle, inserting into the rough zone of the anterior leaflet. Several tendinous primary and secondary true leaflet chordae emerge from the apical portion of the anterior papillary muscle, inserting into the anterior leaflet's free edge and rough zone. Contraction of this muscular chorda during systole could disrupt the mechanics of valvular closure and result in possible regurgitation across the mitral valve. Additionally, this structure may be subject to rupture during myocardial infarction, leading to valvular dysfunction. The developmental connection between the chordae and papillary muscles could explain the anomalous muscularization of the chordae tendineae observed in this case.
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Affiliation(s)
- Kazzara Raeburn
- Department of Anatomical Sciences, School of Medicine, St. George's University, West Indies, Grenada.
| | - Maira duPlessis
- Department of Anatomical Sciences, School of Medicine, St. George's University, West Indies, Grenada
| | - Marios Loukas
- Department of Anatomical Sciences, School of Medicine, St. George's University, West Indies, Grenada
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7
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Giorgi F, Fanali A, Tramonti F. A critical evaluation of choice negotiation for patient-centred medicine and psychotherapy. J Eval Clin Pract 2024; 30:1169-1175. [PMID: 38308615 DOI: 10.1111/jep.13968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 01/11/2024] [Indexed: 02/05/2024]
Abstract
STUDY AIMS The present paper aimed at discussing how the process of decision-making should be taken care of in healthcare services. METHODS This is a position paper based on a review of the relevant literature about meaning-making processes in medical encounters and psychotherapy. DISCUSSION Authors argued that choice options could be perceived as meaningful by patients if their uncertainties were taken into account and grounded on mutual understanding and reciprocal trust. To this end, any decision-making process should satisfy the patient's legitimate expectations by making choices and habits compatible. CONCLUSION In depht analysis of meaning-making processes is crucial for better refining good practices of shared decision-making.
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8
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Bond RM, Bello NA, Ansong A, Ferdinand KC. Public health and system approach in eliminating disparities in hypertensive disorders and cardiovascular outcomes in non-Hispanic Black women across the pregnancy life course. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2024; 46:100445. [PMID: 39319102 PMCID: PMC11419889 DOI: 10.1016/j.ahjo.2024.100445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 08/04/2024] [Accepted: 08/11/2024] [Indexed: 09/26/2024]
Abstract
Hypertension is one of the leading risk factors for cardiovascular disease. The ACC/AHA/Multisociety hypertension guideline covered all aspects of the recommendations for optimal blood pressure diagnosis and management to improve cardiovascular outcomes. Despite this, there remains a growing prevalence of hypertension within the United States, largely in non-Hispanic Black women at earlier stages of their life course. This highlights the evident racial disparities, but offers a targeted opportunity for improved outcomes. With hypertension increasingly seen in the antenatal and immediate postpartum period, and obstetrics societies weighing in on the need to alter pharmacotherapy initiation goals, national initiatives have purposefully targeted pregnant and postpartum women in an effort to improve outcomes. This same energy must also re-focus health care efforts across the entire health continuum. Public health and system strategies are in place to do so, with the strongest enforcing initiatives as early as childhood with a greater focus on primordial prevention.
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Affiliation(s)
- Rachel M Bond
- Women's Heart Health, Dignity Health, Arizona, 3240 S Mercy Road Suite 312, Gilbert, AZ 85287, United States of America
| | - Natalie A Bello
- Smidt Heart Institute, Cedars Sinai Medical Center, 127 S San Vincente BLVD Suite A3100, Los Angeles, CA 90048, United States of America
| | - Annette Ansong
- Children's National Hospital, 111 Michigan Avenue, NW, Washington, DC 20010, United States of America
| | - Keith C Ferdinand
- John W. Deming Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, #8548, New Orleans, LA 70112, United States of America
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9
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Mortezaeian H, Taheri M, Ebrahimi P, Esmaeili Z, Anafje M. Successful transcatheter coil embolization of a coronary cameral fistula in a young male with a structurally normal heart: A case report. Int J Surg Case Rep 2024; 124:110397. [PMID: 39357484 DOI: 10.1016/j.ijscr.2024.110397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 09/26/2024] [Accepted: 09/29/2024] [Indexed: 10/04/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Coronary-cameral fistulas (CCFs) are the anomalous connection between a coronary artery (CA) and a great vessel or cardiac chamber. About 90 % of CA fistulas are congenital and are related to persistent sinusoids during the embryonic period. Most fistulas originate from the right and left anterior descending CAs. The circumflex CA is rarely involved. CASE PRESENTATION A 20-year-old male was referred to a tertiary children's heart hospital center due to retrosternal chest pain (CP) and dyspnea on exertion (functional class Ш). The transthoracic echocardiography (TTE) was done, and it demonstrated a dilated left coronary artery (LCA) (size:5 mm) with a large aneurysm (2 cm) and a small orifice to the right ventricle (RV) body. Then, cardiac angiography was done, and dilated LCA and CCF were demonstrated in the RV. Subsequently, the aneurysm was occluded by eight coils. CLINICAL DISCUSSION CCAs can be treated by transcatheter approach or surgical repair. In the presented case, we planned to treat this condition through Cardiac Angiography. Cardiac Angiography was done, and eight coils occluded the aneurysm. The day after the angiography, the symptoms were completely resolved, and the patient didn't complain of CP and dyspnea. CONCLUSION CCFs represent an uncommon cardiac anomaly with diverse anatomical variations and clinical manifestations. Coronary angiography (CAG) is the most accurate diagnostic test to determine fistula anatomy and possible therapeutic options. Small symptomatic and large fistulas, regardless of symptoms, necessitate intervention through either a transcatheter approach or surgical repair.
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Affiliation(s)
- Hojjat Mortezaeian
- Interventional Research Center, Rajaie Cardiovascular, Medical and Research Institute, IUMS, Tehran, Iran
| | - Maryam Taheri
- Tehran HeartCenter, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pouya Ebrahimi
- Tehran HeartCenter, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Esmaeili
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Anafje
- Cardiogenetic Research Center, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
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10
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Messika-Zeitoun D, Mousavi J, Pourmoazen M, Cotte F, Dreyfus J, Nejjari M, Attias D, Kloeckner M, Ghostine S, Pierrard R, Eker A, Levy F, Le Dolley Y, Houel R, Unni RR, Burwash IG, Dryden A, Hynes M, Nicholson D, Labinaz M, Chan V, Albertini JN, Mesana T. Computational simulation model of transcatheter edge-to-edge mitral valve repair: a proof-of-concept study. Eur Heart J Cardiovasc Imaging 2024; 25:1415-1422. [PMID: 38801398 PMCID: PMC11441041 DOI: 10.1093/ehjci/jeae137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/23/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
AIMS As transcatheter mitral valve (MV) interventions are expanding and more device types and sizes become available, a tool supporting operators in pre-procedural planning and the clinical decision-making process is highly desirable. We sought to develop a finite element computational simulation model to predict the results of transcatheter edge-to-edge repair (TEER) interventions. METHODS AND RESULTS We prospectively enrolled patients with secondary mitral regurgitation (MR) referred for a clinically indicated TEER. The 3D trans-oesophageal echocardiograms performed at the beginning of the procedure were used to perform the simulation. On the 3D dynamic model of the MV that was first obtained, we simulated the clip implantation using the same clip type, size, number, and implantation location that was used during the intervention. The 3D model of the MV obtained after the simulation of the clip implantation was compared with the clinical results obtained at the end of the intervention. We analysed the degree and location of residual MR and the shape and area of the diastolic MV area. We performed computational simulation on five patients. Overall, the simulated models predicted well the degree and location of the residual regurgitant orifice(s) but tended to underestimate the diastolic mitral orifice area. CONCLUSION In this proof-of-concept study, we present preliminary results on our algorithm simulating clip implantation in five patients with functional MR. We show promising results regarding the feasibility and accuracy in terms of predicting residual MR and the need to improve the estimation of the diastolic MV area.
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Affiliation(s)
- David Messika-Zeitoun
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada K1Y 4W7
| | | | | | | | - Julien Dreyfus
- Department of Cardiology, Centre Cardiologique du Nord, Saint-Denis, France
| | - Mohammed Nejjari
- Hemodynamic Department, Centre Cardiologique du Nord, Saint-Denis, France
| | - David Attias
- Department of Cardiology, Centre Cardiologique du Nord, Saint-Denis, France
| | - Martin Kloeckner
- Groupe Hospitalier Paris Saint Joseph, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Said Ghostine
- Groupe Hospitalier Paris Saint Joseph, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Romain Pierrard
- Cardiology Department, Saint Etienne University Hospital, Saint-Etienne, France
| | | | | | - Yvan Le Dolley
- Percutaneous Therapy Valve Unit, Hôpital Saint Joseph, Marseille, France
| | - Remi Houel
- Percutaneous Therapy Valve Unit, Hôpital Saint Joseph, Marseille, France
| | - Rudy R Unni
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada K1Y 4W7
| | - Ian G Burwash
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada K1Y 4W7
| | - Adam Dryden
- Division of Anesthesiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Mark Hynes
- Division of Anesthesiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Donna Nicholson
- Division of Anesthesiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Marino Labinaz
- Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada K1Y 4W7
| | - Vincent Chan
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Canada
| | | | - Thierry Mesana
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Canada
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11
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Alexander VS, Vogel AD, Silvano ZT, Javed H, Mitta A, Rajab TK. Organizational challenges for partial heart transplantation. Future Cardiol 2024:1-10. [PMID: 39330872 DOI: 10.1080/14796678.2024.2404775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 09/12/2024] [Indexed: 09/28/2024] Open
Abstract
Partial heart transplantation (PHT) has emerged as a new treatment strategy to correct unrepairable heart valve dysfunction in pediatric patients. PHT selectively replaces the dysfunctional components of the recipient's heart and spares the native ventricles. As a result, the transplant biology of PHTs differs from heart transplants. Notably, donor hearts that are unsuitable for whole heart transplantation can be used, graft preservation can be prolonged and immunosuppression levels can be lowered. These nuances of PHT transplant biology have important implications for organizational aspects of PHT clinical application.
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Affiliation(s)
- Vincent S Alexander
- Department of Cardiovascular Surgery, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR 72202, USA
- Division of Research, Alabama College of Osteopathic Medicine, 445 Health Sciences Blvd, Dothan, AL 36303, USA
| | - Andrew D Vogel
- Department of Cardiovascular Surgery, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR 72202, USA
- Division of Research, Alabama College of Osteopathic Medicine, 445 Health Sciences Blvd, Dothan, AL 36303, USA
| | - Zachary T Silvano
- Department of Cardiovascular Surgery, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR 72202, USA
- Division of Research, Alabama College of Osteopathic Medicine, 445 Health Sciences Blvd, Dothan, AL 36303, USA
| | - Herra Javed
- Department of Cardiovascular Surgery, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR 72202, USA
| | - Alekhya Mitta
- Department of Cardiovascular Surgery, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR 72202, USA
- Division of Research, University of South Carolina, 1705 College St, Close-Hipp Suite 552, Columbia, SC 29208, USA
| | - Taufiek Konrad Rajab
- Department of Cardiovascular Surgery, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR 72202, USA
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12
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Goldman D, Reddi P, Al-Kawaz M, Yaeger KA, Hardigan T, Mehta A, Scaggiante J, Tomalty RD, Gulotta P, Fennell V, Vidal GA, Poongkunran M, Milburn JM, Majidi S. Higher intracranial positioning of an 8 Fr guide catheter improves efficacy of aspiration thrombectomy in large vessel occlusion stroke. J Neurointerv Surg 2024:jnis-2024-022026. [PMID: 39299745 DOI: 10.1136/jnis-2024-022026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/31/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Higher positioning of a large bore guide catheter during endovascular thrombectomy (EVT) is hypothesized to potentially improve thrombectomy success. OBJECTIVE To evaluate the safety and efficacy of intracranial guide catheter placement during EVT using a multicenter database. METHODS We reviewed data on consecutive patients undergoing EVT for anterior circulation large vessel occlusion (LVO) at three comprehensive stroke centers between October 2019 and December 2022. Participants were allocated to one of two cohorts: intracranial (n=141)-guide catheter tip positioned in the petrous carotid or further distal; and control (n=285)-guide catheter tip below the petrous carotid. Primary outcome was excellent reperfusion (Thrombolysis in Cerebral Ischemia (TICI) 2c or better), first pass effect (TICI 2c or better after one pass), and arterial access to final reperfusion time. The unpaired t-test, Mann-Whitney U test, and Fisher's exact test were used to compare themeans, medians and proportions of the two groups, respectively. P values & lt;0.05 were considered statistically significant two cohorts. RESULTS A total of 426 patients were included in the analysis. Patients with guide catheter location in the petrous segment or further distal had a significantly higher first-pass effect (111/284, 39.1% vs 37/141, 26.2%, P=0.009). There was no significant difference in final excellent recanalization rates between groups (202/285, 70.9% vs 92/141, 65.2%, P=0.266). Furthermore, intracranial positioning of the guide catheter was associated with significantly shorter time to final recanalization (median 21.0 (13.0-38.0) min vs 30.0 (17.0-48.0) min, P<0.001). CONCLUSION Positioning a large bore guide catheter in the petrous segment or further distal resulted in a significantly higher rate of first pass effect, faster procedural times, and equivalent final excellent reperfusion rates compared with more proximal guide catheter placement for patients with anterior circulation LVO.
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Affiliation(s)
- Daryl Goldman
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Preethi Reddi
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mais Al-Kawaz
- Department of Neurosurgery, University of Kentucky, Lexington, Kentucky, USA
| | - Kurt A Yaeger
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Trevor Hardigan
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amol Mehta
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jacopo Scaggiante
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Paul Gulotta
- Department of Radiology, Ochsner Medical Center, New Orleans, Louisiana, USA
| | - Vernard Fennell
- Department of Radiology, Ochsner Medical Center, New Orleans, Louisiana, USA
| | - Gabriel A Vidal
- Department of Neurology, Ochsner Health Network LLC, New Orleans, Louisiana, USA
| | - Mugilan Poongkunran
- Department of Radiology, Ochsner Medical Center, New Orleans, Louisiana, USA
| | - James M Milburn
- Department of Radiology, Ochsner Medical Center, New Orleans, Louisiana, USA
| | - Shahram Majidi
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Saravanan S, Palaniappan NA, Palaniyandi T, Rajinikanth S, Shanmugam R, Wahab MRA. Emerging therapeutic and diagnostic strategies for coronary artery disease: Current trends and future perspectives. Curr Probl Cardiol 2024; 49:102863. [PMID: 39317304 DOI: 10.1016/j.cpcardiol.2024.102863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Accepted: 09/21/2024] [Indexed: 09/26/2024]
Abstract
Coronary vascular disease (CVD) is the general term used to cover conditions like narrowed blood vessels that may cause stroke or heart attack. Coronary artery disease (CAD) is one of the CVD and it is the most severe disease worldwide. The traditional treatment for CAD includes Coronary Artery Bypass Graft Surgery (CABG) and Percutaneous Coronary Intervention (PCI). The evolution of science and technology has led to advancement in the treatment of CAD. Nanoparticles are very suitable for the treatment of CAD by using it as a capsule for targeted drug delivery. Non-coding RNAs like si-RNA and mi-RNA are used as therapeutic agents due to their unique characteristics. In recent years, this si-RNA and miRNA usage in treating diseases has significantly increased. These are used as therapeutic agents for CAD treatment due to their properties like unique mode of action and regulation of gene expression. Another treatment for CAD is stem cells. These are used in CAD treatment because they improve blood supply to the areas where the blood vessels are narrowed down due to atherosclerosis and also, they promote cardiac cell regeneration. These RNA and stem cells are usually encapsulated with nanoparticles to avoid degradation. In this article let us discuss in detail about the treatments of CAD.
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Affiliation(s)
- Suresh Saravanan
- Department of Biotechnology, Dr. M.G.R Educational and Research Institute, Chennai, Tamil Nadu, India
| | - Natarajan Alangudi Palaniappan
- Scientist C (MED), Department of Virology and Biotechnology, ICMR-National Institute for Research in Tuberculosis, Chennai-31, Tamil Nadu, India
| | - Thirunavukkarasu Palaniyandi
- Department of Biotechnology, Dr. M.G.R Educational and Research Institute, Chennai, Tamil Nadu, India; ACS-Advanced Medical Research Institute, Dr. M.G.R Educational and Research Institute, Maduravoyal, Chennai 600095, Tamil Nadu, India.
| | - Suba Rajinikanth
- Department of Pediatrics, Sri Lalithambigai Medical College and Hospital, Adayalampattu Service Road, Chennai 600095, Tamil Nadu, India
| | - Rajeshkumar Shanmugam
- Centre for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, Tamil Nadu, India
| | - Mugip Rahaman Abdul Wahab
- Department of Biotechnology, Dr. M.G.R Educational and Research Institute, Chennai, Tamil Nadu, India
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14
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Milani M, Bertaina M, Ardissino M, Iannaccone M, Boccuzzi GG, Tavecchia G, Oliva F, Sacco A. Unveiling an insidious diagnosis and its implications for clinical practice: Individual patient data systematic review of pregnancy-associated spontaneous coronary artery dissection. Int J Cardiol 2024; 418:132582. [PMID: 39313118 DOI: 10.1016/j.ijcard.2024.132582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Revised: 09/10/2024] [Accepted: 09/18/2024] [Indexed: 09/25/2024]
Abstract
BACKGROUND Pregnancy-Associated Spontaneous Coronary Artery Dissection (P-SCAD) is the most common cause of myocardial infarction in pregnancy and postpartum. Aim of this systematic review is to provide a descriptive picture of P-SCAD presentation, clinical course, management and outcomes. METHODS International databases were systematically screened up to November 2023 and all published P-SCAD case reports/series identified; additionally, we gathered four original cases, establishing a new database for the derived cohort. RESULTS 253 studies (215 case reports, 38 case series) were included for the analysis, enrolling 316 patients admitted between 1952 and 2023. Median age was 34 (SD 5) years old, 64 (20.4 %) were prepartum, 249 (79.6 %) postpartum. Most common presentation was ST-elevation myocardial infarction (72.6 %). Cardiac arrest and cardiogenic shock occurred in 18.4 % and 16.1 %, respectively. Multivessel dissection was present in 45.2 % of cases, with left anterior descending artery being most frequently affected (74.4 %). Initial therapeutic strategy was medical therapy in 54.8 % while upfront revascularization was performed in 45.2 % of cases. Excluding autoptic studies, mortality rate was 4.1 %, without significant differences between pre and postpartum SCAD (p-value 0.6) or according to initial therapeutic approach (p-value 0.5). Recurrences after index event were registered in 74 patients (23.4 %), being more common after medical treatment than in case of immediate revascularization (30.8 versus 18.3 %, p-value 0.02). CONCLUSIONS P-SCAD is a complex clinical scenario: timely diagnosis is difficult, therapeutic management not well-defined, rate of recurrences not negligible. Additional observational studies and dedicated registries are necessary to enhance the management of this rare but severe condition.
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Affiliation(s)
- Martina Milani
- Cardiology Department, Alessandro Manzoni Hospital, ASST Lecco, Lecco, Italy
| | - Maurizio Bertaina
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Torino, Italy.
| | - Maddalena Ardissino
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Mario Iannaccone
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Torino, Italy
| | | | - Giovanni Tavecchia
- Cardiac Intensive Care Unit, "De Gasperis Cardio Center", ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Fabrizio Oliva
- Cardiac Intensive Care Unit, "De Gasperis Cardio Center", ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Alice Sacco
- Cardiac Intensive Care Unit, "De Gasperis Cardio Center", ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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15
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Cho H, Lee J, Cao A, Leong GCW, Chenh K, Abushanab D, Marquina C, Ademi Z. Cost-effectiveness of lowering systolic blood pressure in reducing cardiovascular disease burden in Australia. Curr Probl Cardiol 2024; 49:102859. [PMID: 39299366 DOI: 10.1016/j.cpcardiol.2024.102859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Accepted: 09/16/2024] [Indexed: 09/22/2024]
Abstract
AIM Cardiovascular diseases (CVD) remain a leading global cause of death. This research examines the impact of lowering systolic blood pressure (SBP) on reducing CVD prevalence. It also assesses the cost-effectiveness of such interventions from a healthcare perspective. METHODS A synthesis matrix was created to analyse CVD risk factors (SBP, smoking, diabetes, and cholesterol), identifying SBP as the most impactful modifiable risk factor. We utilised validated health economic model which incorporates pooled cohort risk equations to predict the 10-year risk of the first CVD event, factoring in participants' gender, age, SBP, cholesterol levels, diabetes, and smoking status. The primary outcome was the incremental cost-effectiveness ratio (ICER), measured in costs per quality-adjusted life years (QALYs) and years of life lived. In a hypothetical scenario, we reduced SBP by 20 % in participants with levels ≥140 mmHg, based on the 2016 Hypertension Management Guide (National Heart Foundation of Australia). A 5 % discount rate was applied to all costs and outcomes. RESULTS After reducing SBP by 20 % in participants with levels ≥140 mmHg, we observed a decrease in CVD deaths by 4756 cases (1.21 %) and non-fatal CVD events by 7877 cases (0.77 %). Post-intervention, there was an increase in years of life lived and QALYs experienced by 26,252 years (0.03 %) and 23,928 years (0.03 %), respectively. Acute and chronic costs also decreased, with acute event costs reduced by AUD 24,437,625 (0.28 %) and chronic costs by AUD 18,544,776 (0.71 %). Hypothetical scenario was found to be dominant (cost-saving). CONCLUSIONS Our results demonstrate that reducing SBP at the population level is cost-saving and has a significant positive impact on cardiovascular outcomes and related costs for those at risk of CVD.
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Affiliation(s)
- Haeri Cho
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Jinkyeong Lee
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Alison Cao
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Grant Choo Way Leong
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Kathryn Chenh
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Dina Abushanab
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Clara Marquina
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Zanfina Ademi
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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16
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Cavalcante JS, Riciopo PM, Pereira AFM, Jeronimo BC, Angstmam DG, Pôssas FC, de Andrade Filho A, Cerni FA, Pucca MB, Ferreira Junior RS. Clinical complications in envenoming by Apis honeybee stings: insights into mechanisms, diagnosis, and pharmacological interventions. Front Immunol 2024; 15:1437413. [PMID: 39359723 PMCID: PMC11445026 DOI: 10.3389/fimmu.2024.1437413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/20/2024] [Indexed: 10/04/2024] Open
Abstract
Envenoming resulting from Apis honeybee stings pose a neglected public health concern, with clinical complications ranging from mild local reactions to severe systemic manifestations. This review explores the mechanisms underlying envenoming by honeybee sting, discusses diagnostic approaches, and reviews current pharmacological interventions. This section explores the diverse clinical presentations of honeybee envenoming, including allergic and non-allergic reactions, emphasizing the need for accurate diagnosis to guide appropriate medical management. Mechanistic insights into the honeybee venom's impact on physiological systems, including the immune and cardiovascular systems, are provided to enhance understanding of the complexities of honeybee sting envenoming. Additionally, the article evaluates emerging diagnostic technologies and therapeutic strategies, providing a critical analysis of their potential contributions to improved patient outcomes. This article aims to provide current knowledge for healthcare professionals to effectively manage honeybee sting envenoming, thereby improving patient care and treatment outcomes.
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Affiliation(s)
- Joeliton S Cavalcante
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Pedro Marques Riciopo
- Department of Bioprocess and Biotechnology, School of Agriculture, Agronomic Sciences School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Ana Flávia Marques Pereira
- Center for the Study of Venoms and Venomous Animals of UNESP (CEVAP), São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Bruna Cristina Jeronimo
- Center for the Study of Venoms and Venomous Animals of UNESP (CEVAP), São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Davi Gomes Angstmam
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Felipe Carvalhaes Pôssas
- Minas Gerais Toxicological Information and Assistance Center, João XXIII Hospital, Belo Horizonte, Minas Gerais, Brazil
| | - Adebal de Andrade Filho
- Minas Gerais Toxicological Information and Assistance Center, João XXIII Hospital, Belo Horizonte, Minas Gerais, Brazil
| | - Felipe A Cerni
- Graduate Program in Tropical Medicine of the State University of Amazonas, Manaus, Amazonas, Brazil
| | - Manuela B Pucca
- Center for the Study of Venoms and Venomous Animals of UNESP (CEVAP), São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil
| | - Rui Seabra Ferreira Junior
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
- Center for the Study of Venoms and Venomous Animals of UNESP (CEVAP), São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
- Center for Translational Science and Development of Biopharmaceuticals FAPESP/CEVAP-UNESP, Botucatu, São Paulo, Brazil
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17
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Almajed MR, Almajed A, Antishin S, Saleem A, Wexler B, Mohammed M, Keimig T, Lingam N, Abdul-Nour K, Hudson M. Coronary Artery Aneurysm Thrombosis in a Patient With Marfan Syndrome. JACC Case Rep 2024; 29:102538. [PMID: 39359983 PMCID: PMC11442214 DOI: 10.1016/j.jaccas.2024.102538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/21/2024] [Accepted: 07/30/2024] [Indexed: 10/04/2024]
Abstract
Coronary artery aneurysm in adults is associated with connective tissue disorders, including Marfan syndrome. Coronary artery aneurysms are at risk for thrombosis, which obstructs coronary flow and thus results in myocardial infarction. We present a case of coronary artery aneurysm thrombosis in a patient with Marfan syndrome who presented with acute coronary syndrome.
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Affiliation(s)
| | - Abdulla Almajed
- Department of Internal Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Shannon Antishin
- Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA
| | - Abdulmalik Saleem
- Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA
| | - Benjamin Wexler
- Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA
| | - Mustafa Mohammed
- Division of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Thomas Keimig
- Department of Radiology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Natesh Lingam
- Division of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA
| | | | - Michael Hudson
- Division of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA
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18
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Chen C, Lo CYZ, Ho MJC, Ng Y, Chan HCY, Wu WHK, Ong MEH, Siddiqui FJ. Global Sex Disparities in Bystander Cardiopulmonary Resuscitation After Out-of-Hospital Cardiac Arrest: A Scoping Review. J Am Heart Assoc 2024; 13:e035794. [PMID: 39248262 DOI: 10.1161/jaha.124.035794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
This scoping review collates evidence for sex biases in the receipt of bystander cardiopulmonary resuscitation (BCPR) among patients with out-of-hospital cardiac arrest patients globally. The MEDLINE, PsycINFO, CENTRAL, and Embase databases were screened for relevant literature, dated from inception to March 9, 2022. Studies evaluating the association between BCPR and sex/gender in patients with out-of-hospital cardiac arrest, except for pediatric populations and cardiac arrest cases with traumatic cause, were included. The review included 80 articles on BCPR in men and women globally; 58 of these studies evaluated sex differences in BCPR outcomes. Fifty-nine percent of the relevant studies (34/58) indicated that women are less likely recipients of BCPR, 36% (21/58) observed no significant sex differences, and 5% (3/58) reported that women are more likely to receive BCPR. In other studies, women were found to be less likely to receive BCPR in public but equally or more likely to receive BCPR in residential settings. The general reluctance to perform BCPR on women in the Western countries was attributed to perceived frailty of women, chest exposure, pregnancy, gender stereotypes, oversexualization of women's bodies, and belief that women are unlikely to experience a cardiac arrest. Most studies worldwide indicated that women were less likely to receive BCPR than men. Further research from non-Western countries is needed to understand the impact of cultural and socioeconomic settings on such biases and design customized interventions accordingly.
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Affiliation(s)
- Christina Chen
- Prehospital and Emergency Research Centre, Health Services and Systems Research Duke-NUS Medical School Singapore Singapore
| | | | - Maxz J C Ho
- National University Hospital Singapore Singapore
| | - Yaoyi Ng
- Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | | | - Wellington H K Wu
- Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | - Marcus E H Ong
- Department of Emergency Medicine Singapore General Hospital Singapore Singapore
| | - Fahad J Siddiqui
- Prehospital and Emergency Research Centre, Health Services and Systems Research Duke-NUS Medical School Singapore Singapore
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19
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Rafael-Yarihuaman AE, Wang J, Guevara C, Banerjee A, Stoler RC, Peralta JE, Banerjee S. A Giant Left Anterior Descending Artery Aneurysm and an Updated Review on Coronary Aneurysms. Am J Cardiol 2024; 231:S0002-9149(24)00690-8. [PMID: 39284432 DOI: 10.1016/j.amjcard.2024.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 09/04/2024] [Accepted: 09/09/2024] [Indexed: 09/29/2024]
Affiliation(s)
- Aldo E Rafael-Yarihuaman
- Baylor Scott & White Heart and Vascular Hospital, Dallas, Texas; Baylor University Medical Center, Dallas, Texas
| | - Jerry Wang
- University of Texas at Austin, Austin, Texas
| | | | | | - Robert C Stoler
- Baylor Scott & White Heart and Vascular Hospital, Dallas, Texas; Baylor University Medical Center, Dallas, Texas
| | | | - Subhash Banerjee
- Baylor Scott & White Heart and Vascular Hospital, Dallas, Texas; Baylor University Medical Center, Dallas, Texas.
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20
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Sinardja CWD, Jagannatha GNP, de Liyis BG, Kosasih AM. Safety and efficacy of early beta-blocker initiation in acute heart failure and cardiogenic shock: systematic review and meta-analysis. Egypt Heart J 2024; 76:126. [PMID: 39271587 PMCID: PMC11399533 DOI: 10.1186/s43044-024-00558-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND The beta-blocker (BB) initiation in acute heart failure (AHF) patients is still controversial. Some show the benefit of BB employment in decreasing the mortality outcome. This study aims to assess the safety and efficacy of in-hospital and long-term outcomes of BB initiation in AHF hospitalized patients. We searched multiple databases examining the outcome of AHF patients who had administered BB as the therapy initiation. Primary outcomes were all-cause mortality, composite endpoint after BB initiation when hospitalized, and post-discharge all-cause mortality. The secondary outcomes were adverse events after in-hospital BB initiation, including hypotension and symptomatic bradycardia after BB initiation when hospitalization and rehospitalization. RESULTS Eight cohort studies with 16,639 patients suffering from AHF and cardiogenic shock, with 9923 participants allocated to the early BB group and 6,713 patients in the control group. The follow-up durations ranged from 2 to 24 months. Early BB administration significantly reduced in-hospital composite endpoints (RR: 0.42; 95% CI (0.30-0.58); p < 0.001), in-hospital all-cause mortality (RR: 0.43; 95% CI (0.31-0.61); p < 0.001), discharge mortality (RR: 0.51; 95% CI (0.41-0.63); p < 0.001), and rehospitalization (RR: 0.57; 95% CI (0.44-0.74); p < 0.001). There were no discernible differences in in-hospital BB-related adverse events between the two groups (p = 0.13). Subgroup analyses conducted on AHF patients presenting with cardiogenic shock revealed no significant differences in in-hospital composite endpoint and in-hospital mortality, and similar results were shown in the naive BB population. CONCLUSIONS The BB initiation in AHF patients shows advantages in efficacy and safety outcome.
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Affiliation(s)
- Cyndiana Widia Dewi Sinardja
- Department of Cardiology and Vascular Medicine, Udayana University Hospital, Rumah Sakit Unud Street, Jimbaran, Badung, Bali, Indonesia.
| | - Gusti Ngurah Prana Jagannatha
- Department of Cardiology and Vascular Medicine, Udayana University Hospital, Rumah Sakit Unud Street, Jimbaran, Badung, Bali, Indonesia
- Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Bali, Indonesia
| | - Bryan Gervais de Liyis
- Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Bali, Indonesia
| | - Anastasya Maria Kosasih
- Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Bali, Indonesia
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21
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Yang Y, Liu X, Jin Q, Huang F, Lu Z. Unmasking and quantifying racial bias of large language models in medical report generation. COMMUNICATIONS MEDICINE 2024; 4:176. [PMID: 39256622 PMCID: PMC11387737 DOI: 10.1038/s43856-024-00601-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 08/30/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Large language models like GPT-3.5-turbo and GPT-4 hold promise for healthcare professionals, but they may inadvertently inherit biases during their training, potentially affecting their utility in medical applications. Despite few attempts in the past, the precise impact and extent of these biases remain uncertain. METHODS We use LLMs to generate responses that predict hospitalization, cost and mortality based on real patient cases. We manually examine the generated responses to identify biases. RESULTS We find that these models tend to project higher costs and longer hospitalizations for white populations and exhibit optimistic views in challenging medical scenarios with much higher survival rates. These biases, which mirror real-world healthcare disparities, are evident in the generation of patient backgrounds, the association of specific diseases with certain racial and ethnic groups, and disparities in treatment recommendations, etc. CONCLUSIONS: Our findings underscore the critical need for future research to address and mitigate biases in language models, especially in critical healthcare applications, to ensure fair and accurate outcomes for all patients.
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Affiliation(s)
- Yifan Yang
- National Institutes of Health (NIH), National Library of Medicine (NLM), National Center for Biotechnology Information (NCBI), Bethesda, MD, 20894, USA
- University of Maryland at College Park, Department of Computer Science, College Park, MD, 20742, USA
| | - Xiaoyu Liu
- University of Maryland at College Park, Department of Computer Science, College Park, MD, 20742, USA
| | - Qiao Jin
- National Institutes of Health (NIH), National Library of Medicine (NLM), National Center for Biotechnology Information (NCBI), Bethesda, MD, 20894, USA
| | - Furong Huang
- University of Maryland at College Park, Department of Computer Science, College Park, MD, 20742, USA
| | - Zhiyong Lu
- National Institutes of Health (NIH), National Library of Medicine (NLM), National Center for Biotechnology Information (NCBI), Bethesda, MD, 20894, USA.
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22
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Sannino M, Nicolai M, Infusino F, Giulio L, Usai TL, Biscotti G, Azzarri A, De Angelis D’Ossat M, Calcagno S, Calcagno S. Coronary Artery Aneurysms: A Clinical Case Report and Literature Review Supporting Therapeutic Choices. J Clin Med 2024; 13:5348. [PMID: 39336835 PMCID: PMC11432381 DOI: 10.3390/jcm13185348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/31/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024] Open
Abstract
Coronary artery aneurysms (CAAs) are uncommon but significant cardiovascular abnormalities characterized by an abnormal increase in vascular diameter. CAAs are classified based on their shape as either saccular or fusiform, and their causes can range from atherosclerosis, Kawasaki disease, to congenital and iatrogenic factors. CAAs often present asymptomatically, but when symptoms occur, they can include angina, myocardial infarction, or even sudden cardiac death due to intravascular thrombosis involving the CAA. Diagnosis is typically confirmed through coronary angiography, though CT and other imaging techniques can provide additional details. The management of CAAs is variable depending on their size, location, and the presence of symptoms or complications. Treatment options include medical therapy, percutaneous coronary intervention (PCI), or surgical approaches. In this paper, we describe the case report of a 79-year-old male who presented with palpitations and was diagnosed with a right coronary artery aneurysm, and a review of the literature is delineated, underscoring the importance of individualized treatment strategies for CAAs.
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Affiliation(s)
- Michele Sannino
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Matteo Nicolai
- Radiodiagnostic Unit, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.N.); (M.D.A.D.)
| | - Fabio Infusino
- Division of Cardiology, S. Giovanni Evangelista Hospital, 00019 Tivoli, Italy;
| | - Luciani Giulio
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Tommaso Leo Usai
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Giovanni Biscotti
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Alessandro Azzarri
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Marina De Angelis D’Ossat
- Radiodiagnostic Unit, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.N.); (M.D.A.D.)
| | - Sergio Calcagno
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Simone Calcagno
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
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23
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Wong-Siegel JR, Petit CJ, Glatz AC. Pulmonary Atresia and Ventricular Septal Defect Without Major Aortopulmonary Collateral Arteries: Diagnostic Evaluation and the Role of Ductal Stenting. World J Pediatr Congenit Heart Surg 2024:21501351241269953. [PMID: 39234694 DOI: 10.1177/21501351241269953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
Patients with pulmonary atresia (PA) and a ventricular septal defect (VSD), similar to those with tetralogy of Fallot and PA without major aortopulmonary collateral arteries, lack antegrade pulmonary blood flow, and thus require a neonatal intervention for stabilization or augmentation of pulmonary blood flow. The role of ductal stenting in the management of these patients, and the current literature supporting it, will be reviewed.
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Affiliation(s)
- Jeannette R Wong-Siegel
- Division of Pediatric Cardiology, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA
| | - Christopher J Petit
- Division of Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA
| | - Andrew C Glatz
- Division of Pediatric Cardiology, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA
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24
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Wang DD. Key Steps to Writing a Great Case Report: Teach Us. JACC Case Rep 2024; 29:102542. [PMID: 39359515 PMCID: PMC11442339 DOI: 10.1016/j.jaccas.2024.102542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Affiliation(s)
- Dee Dee Wang
- Address for correspondence: Dr Dee Dee Wang, Wayne State University School of Medicine, Detroit, Michigan 48202, USA.
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25
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Braescu L, Sturza A, Sosdean R, Aburel OM, Lazar MA, Muntean D, Luca CT, Brie DM, Feier H, Crisan S, Mornos C. Echocardiographic assessment of epicardial adipose tissue thickness as independent predictor in coronary artery disease. Can J Physiol Pharmacol 2024. [PMID: 39226407 DOI: 10.1139/cjpp-2024-0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
This study aimed to assess the utility of echocardiography-measured epicardial adipose tissue (EAT) thickness (EATT) as an independent predictor for coronary artery disease (CAD), examining its correlation with oxidative stress levels in epicardial tissue and the complexity of the disease in patients undergoing open-heart surgery. This study included a total of 25 patients referred for cardiac surgery with 14 in the CAD group and 11 in the non-CAD group. Epicardial fat was sampled from patients subjected to open-heart surgery. EATT was higher in the CAD group compared to the non-CAD group (8.15 ± 2.09 mm vs. 5.12 ± 1.8 mm, p = 0.001). The epicardial reactive oxygen species level was higher in the CAD group compared to the non-CAD group (21.4 ± 2.47 nmol H2O2/g tisssue/h vs. 15.7 ± 1.55 nmol H2O2/g tisssue/h, p < 0.001). EATT greater than 6.05 mm was associated with CAD, with a sensitivity of 86% and specificity of 73%. Echocardiographically measured EATT is a significant, independent predictor of CAD. Its relationship with increased EAT oxidative stress levels suggests a potential mechanistic link between EATT and CAD pathogenesis. These findings highlight the importance of EATT as a diagnostic tool in assessing the complexity of CAD in patients undergoing cardiac surgery.
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Affiliation(s)
- Laurentiu Braescu
- Department VI Cardiology - Cardiovascular Surgery Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Doctoral School Medicine-Pharmacy, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Adrian Sturza
- Department III Functional Sciences - Pathophysiology, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Center for Translational Research and Systems Medicine, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
| | - Raluca Sosdean
- Department VI Cardiology - Cardiovascular Surgery Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Department VI Cardiology - Cardiology Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
| | - Oana Maria Aburel
- Department III Functional Sciences - Pathophysiology, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Center for Translational Research and Systems Medicine, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
| | - Mihai Andrei Lazar
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Department VI Cardiology - Cardiology Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timișoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Danina Muntean
- Department III Functional Sciences - Pathophysiology, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Center for Translational Research and Systems Medicine, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
| | - Constantin Tudor Luca
- Department VI Cardiology - Cardiovascular Surgery Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Department VI Cardiology - Cardiology Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
| | - Daniel Miron Brie
- Department VI Cardiology - Cardiovascular Surgery Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Department VI Cardiology - Cardiology Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
| | - Horea Feier
- Department VI Cardiology - Cardiovascular Surgery Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Department VI Cardiology - Cardiology Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
| | - Simina Crisan
- Department VI Cardiology - Cardiovascular Surgery Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Department VI Cardiology - Cardiology Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
| | - Cristian Mornos
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Department VI Cardiology - Cardiology Clinic, Institute for Cardiovascular Diseases of Timișoara, "Victor Babeș" University of Medicine and Pharmacy from Timișoara, E. Murgu Sq. No.2, 300041 Timișoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timișoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
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26
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Lam MI, Bai W, Feng Y, Zhang Q, Zhang Y, Jackson T, Rao SY, Ho TI, Su Z, Cheung T, Lopes Lao EP, Sha S, Xiang YT. Comparing network structures of depressive and anxiety symptoms between demographically-matched heart disease and heart disease free samples using propensity score matching: Findings from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). J Psychosom Res 2024; 187:111910. [PMID: 39255588 DOI: 10.1016/j.jpsychores.2024.111910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 07/25/2024] [Accepted: 08/31/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Older adults with heart disease often experience higher rates of comorbid anxiety and depression. This study examined depression and anxiety network structures among older adults with heart disease and their heart disease free peers. METHODS Network analyses of secondary cross-sectional data from the 2017 to 2018 wave of CLHLS were used to construct groups of older adults with and without heart disease using propensity score matching. Depression and anxiety symptoms were assessed using Center for Epidemiological Studies Depression Scale and Generalized Anxiety Disorder Scale, respectively. Central symptoms and bridge symptoms were identified using expected influence. RESULTS 1689 older adults with heart disease and matched control sample of 1689 older adults without heart disease were included. The prevalence and severity of depression and anxiety were significantly higher in older adults with heart disease compared to the control group. There was no significant difference in overall structures of depression and anxiety network models between two the groups. Key central symptoms and bridge symptoms within these groups were highly similar; GAD 2 "Uncontrollable worrying" and GAD 4 "Trouble relaxing" were identified as the most central symptoms, while GAD 1 "Nervousness" and CESD 1 "Feeling bothered" were identified as key bridge symptoms across both network models. CONCLUSION Depression and anxiety are more prevalent in older adults with heart disease than demographically-matched heart disease free controls. However, network structures of these symptoms do not differ between two groups. Accordingly, depression and anxiety psychosocial interventions developed for older adults without heart disease may also benefit older adults with heart disease.
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Affiliation(s)
- Mei Ieng Lam
- Kiang Wu Nursing College of Macau, Macao SAR, China; Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Wei Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin Province 130021, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yanbo Zhang
- Adult Surgical ICU, Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Shu-Ying Rao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Tin-Ian Ho
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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27
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Nabati M, Kavousi S, Yazdani J, Parsaee H. The association between myocardial early systolic lengthening and high risk angiographic territory involvement in patients with non-ST-segment elevation myocardial infarction. J Ultrasound 2024; 27:567-577. [PMID: 38551782 PMCID: PMC11333420 DOI: 10.1007/s40477-024-00885-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/19/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Non-ST-segment elevation myocardial infarction (NSTEMI) is more common than ST-segment elevation myocardial infarction (STEMI), consisting of 60-70% of myocardial infarctions. When left ventricular (LV) pressure increases during early systole, regionally ischaemic myocardium with a reduced active force exhibit stretching. The aim of this study was to evaluate the role of this parameter in determining high risk angiographic territory involvement in NSTEMI patients. RESULTS This study was a descriptive correlational research that was conducted on 96 patients with NSTEMI and a left ventricular ejection fraction ≥ 50% who underwent coronary angiography (CAG). Patients were divided into two groups based on having or not having high risk angiographic territory involvement in CAG. All patients underwent a transthoracic echocardiography during the first day of hospitalization and early systolic lengthening (ESL), duration of ESL (DESL), left ventricular global longitudinal strain (LVGLS), pulsed-wave Doppler-derived transmitral early (E wave) and late (A wave) diastolic velocities, and tissue-Doppler-derived mitral annular early diastolic (e') and peak systolic (s') velocities were determined. The results of this study showed DESL, DESLLAD, and DESLLCX were longer in high risk angiographic territory group than other one (P value 0.016, 0.044, and 0.04, respectively). The logistic regression analysis showed among different variables, only age and ESLLAD had an independent association with high risk angiographic territory involvement (P = 0.01, odds ratio [OR] 1.09, 95% CI 1.021-1.164, and P = 0.024, odds ratio [OR] 1.243, 95% CI 1.029-1.50, respectively). CONCLUSIONS Assessment of myocardial ESLLAD by speckle-tracking echocardiography may be helpful in predicting high risk angiographic territory involvement in patients with NSTEMI. Indeed, a higher value can be considered as a high risk parameter which may show benefit of an early invasive strategy versus a conservative approach.
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Affiliation(s)
- Maryam Nabati
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Saeed Kavousi
- Student Research Committee, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani
- Department of Biostatics, Faculty of Health, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Homa Parsaee
- Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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28
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Lahiri SK, Lu J, Aguilar-Sanchez Y, Li H, Moreira LM, Hulsurkar MM, Mendoza A, Turkieltaub Paredes MR, Navarro-Garcia JA, Munivez E, Horist B, Moore OM, Weninger G, Brandenburg S, Lenz C, Lehnart SE, Sayeed R, Krasopoulos G, Srivastava V, Zhang L, Karch JM, Reilly S, Wehrens XHT. Targeting calpain-2-mediated junctophilin-2 cleavage delays heart failure progression following myocardial infarction. J Mol Cell Cardiol 2024; 194:85-95. [PMID: 38960317 DOI: 10.1016/j.yjmcc.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 06/18/2024] [Accepted: 06/29/2024] [Indexed: 07/05/2024]
Abstract
Coronary heart disease (CHD) is a prevalent cardiac disease that causes over 370,000 deaths annually in the USA. In CHD, occlusion of a coronary artery causes ischemia of the cardiac muscle, which results in myocardial infarction (MI). Junctophilin-2 (JPH2) is a membrane protein that ensures efficient calcium handling and proper excitation-contraction coupling. Studies have identified loss of JPH2 due to calpain-mediated proteolysis as a key pathogenic event in ischemia-induced heart failure (HF). Our findings show that calpain-2-mediated JPH2 cleavage yields increased levels of a C-terminal cleaved peptide (JPH2-CTP) in patients with ischemic cardiomyopathy and mice with experimental MI. We created a novel knock-in mouse model by removing residues 479-SPAGTPPQ-486 to prevent calpain-2-mediated cleavage at this site. Functional and molecular assessment of cardiac function post-MI in cleavage site deletion (CSD) mice showed preserved cardiac contractility and reduced dilation, reduced JPH2-CTP levels, attenuated adverse remodeling, improved T-tubular structure, and normalized SR Ca2+-handling. Adenovirus mediated calpain-2 knockdown in mice exhibited similar findings. Pulldown of CTP followed by proteomic analysis revealed valosin-containing protein (VCP) and BAG family molecular chaperone regulator 3 (BAG3) as novel binding partners of JPH2. Together, our findings suggest that blocking calpain-2-mediated JPH2 cleavage may be a promising new strategy for delaying the development of HF following MI.
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Affiliation(s)
- Satadru K Lahiri
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA
| | - Jiao Lu
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA; Development, Disease Models & Therapeutics Graduate Program, Baylor College of Medicine
| | - Yuriana Aguilar-Sanchez
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA
| | - Hui Li
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Lucia M Moreira
- Cardiovascular Medicine, Radcliffe Dept of Medicine, University of Oxford, UK
| | - Mohit M Hulsurkar
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA
| | - Arielys Mendoza
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA
| | - Mara R Turkieltaub Paredes
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA
| | - Jose Alberto Navarro-Garcia
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA
| | - Elda Munivez
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA
| | - Brooke Horist
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA
| | - Oliver M Moore
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA
| | - Gunnar Weninger
- Department of Physiology and Cellular Biophysics, Center for Molecular Cardiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Sören Brandenburg
- Department of Cardiology & Pneumology, Heart Research Center Göttingen; Cellular Biophysics and Translational Cardiology Section, University Medical Center Göttingen, Göttingen, Germany
| | - Christof Lenz
- Department of Clinical Chemistry, University Medical Center Göttingen, Germany; Bioanalytical Mass Spectrometry, Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany
| | - Stephan E Lehnart
- Department of Cardiology & Pneumology, Heart Research Center Göttingen; Cellular Biophysics and Translational Cardiology Section, University Medical Center Göttingen, Göttingen, Germany
| | - Rana Sayeed
- Cardiothoracic Unit, John Radcliffe Hospital, Oxford, UK
| | | | | | - Lilei Zhang
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Jason M Karch
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA
| | - Svetlana Reilly
- Cardiovascular Medicine, Radcliffe Dept of Medicine, University of Oxford, UK
| | - Xander H T Wehrens
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Integrative Physiology, Baylor College of Medicine, Houston, TX, USA; Department of Medicine/Cardiology, Baylor College of Medicine, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA.
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29
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Qin X, Fan G, Liu Q, Wu M, Bi J, Fang Q, Mei S, Wan Z, Lv Y, Song L, Wang Y. Association between essential metals, adherence to healthy lifestyle behavior, and ankle-brachial index. J Trace Elem Med Biol 2024; 85:127477. [PMID: 38865925 DOI: 10.1016/j.jtemb.2024.127477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Ankle-brachial index (ABI) is a noninvasive diagnostic method for peripheral arterial disease (PAD) and a predictor of cardiovascular events. OBJECTIVE The present study aimed to evaluate the association between individual or combined essential metals and ABI, as well as assess the collective impact of essential metals when coupled with healthy lifestyle on ABI. METHODS A total of 2865 participants were recruited in Wuhan Tongji Hospital between August 2018 and March 2019. Concentrations of essential metals in urine were measured by inductively coupled plasma mass spectrometer. RESULTS The results of general linear regression models demonstrated that after adjusting for confounding factors, there was a positive association between ABI increase and per unit increase of log 10-transformed, creatinine-corrected urinary Cr (β (95 % CI): 0.010 (0.004, 0.016), PFDR = 0.007), Fe (β (95 % CI): 0.010 (0.003, 0.017), PFDR = 0.018), and Co (β (95 % CI): 0.013 (0.005, 0.021), PFDR = 0.007). The WQS regression revealed a positive relationship between the mixture of essential metals and ABI (β (95 % CI): 0.006 (0.003, 0.010), P < 0.001), with Cr and Co contributing most to the relationship (weighted 45.48 % and 40.14 %, respectively). Compared to individuals with unfavorable lifestyle and the lowest quartile of Cr, Fe and Co, those with favorable lifestyle and the highest quartile of Cr, Fe and Co exhibited the most increase in ABI (β (95 % CI): 0.030 (0.017, 0.044) for Cr, β (95 % CI): 0.027 (0.013, 0.040) for Fe, and β (95 % CI): 0.030 (0.016, 0.044) for Co). CONCLUSION In summary, our study indicates that adequate essential metal intake together with healthy lifestyle behaviors perform crucial roles in PAD protection.
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Affiliation(s)
- Xiya Qin
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Gaojie Fan
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qing Liu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mingyang Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianing Bi
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qing Fang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Surong Mei
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhengce Wan
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yongman Lv
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, HangKong Road 13, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Rullo C. Lipomatous hypertrophy of the interatrial septum: A benign cardiac mass. JAAPA 2024; 37:1-3. [PMID: 39190413 DOI: 10.1097/01.jaa.0000000000000037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
ABSTRACT Lipomatous hypertrophy of the interatrial septum (LHIS) is a rare but benign cardiac tumor that can be found on cardiac imaging such as echocardiogram, or during surgery or an autopsy. Cardiac MRI is the best imaging modality to determine the borders of the tumor and its extension into the intraventricular septum and ventricular free wall. Patients require close monitoring because LHIS may cause right or left outflow tract obstruction or superior vena cava obstruction, requiring cardiac surgical intervention. This article describes a patient with LHIS who underwent cardiac surgery because of her increasing symptomatology.
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Affiliation(s)
- Christine Rullo
- Christine Rullo practices at Beacon Medical Group in South Bend, Ind. The author has disclosed no potential conflicts of interest, financial or otherwise
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31
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Rooban S, Arul Senghor K, Vinodhini V, Kumar J. Adropin: A crucial regulator of cardiovascular health and metabolic balance. Metabol Open 2024; 23:100299. [PMID: 39045137 PMCID: PMC11263719 DOI: 10.1016/j.metop.2024.100299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/25/2024] Open
Abstract
Adropin, a peptide discovered in 2008, has gained recognition as a key regulator of cardiovascular health and metabolic balance. Initially identified for its roles in energy balance, lipid metabolism, and glucose regulation, adropin has also been found to improve cardiovascular health by enhancing endothelial function, modulating lipid profiles, and reducing oxidative stress. These protective mechanisms suggest that adropin may be able to help prevent conditions such as atherosclerosis, hypertension, and other cardiovascular diseases. Research has established connections between adropin and cardiovascular risk factors, such as obesity, insulin resistance, and dyslipidemia, positioning it as a valuable biomarker for evaluating cardiovascular disease risk. New studies highlight adropin's diagnostic and prognostic significance, showing that higher levels are linked to better cardiovascular outcomes, while lower levels are associated with a higher risk of cardiovascular diseases. This review aims to summarize current knowledge on adropin, emphasizing its significance as a promising focus in the intersection of cardiovascular health and metabolic health. By summarizing the latest research findings, this review aims to offer insights into the potential applications of adropin in both clinical practice and research, leading to a deeper understanding of its role in maintaining cardiovascular and metabolic health.
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Affiliation(s)
- S. Rooban
- Department of Biochemistry, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, 603203, Kanchipuram, Chennai, Tamil Nadu, India
| | - K.A. Arul Senghor
- Department of Biochemistry, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, 603203, Kanchipuram, Chennai, Tamil Nadu, India
| | - V.M. Vinodhini
- Department of Biochemistry, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, 603203, Kanchipuram, Chennai, Tamil Nadu, India
| | - J.S. Kumar
- Department of General Medicine, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, 603203, Kanchipuram, Chennai, Tamil Nadu, India
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32
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Owais T, Bisht O, El Din Moawad MH, El-Garhy M, Stock S, Girdauskas E, Kuntze T, Amer M, Lauten P. Outcomes of Valve-in-Valve (VIV) Transcatheter Aortic Valve Replacement (TAVR) after Surgical Aortic Valve Replacement with Sutureless Surgical Aortic Valve Prostheses Perceval™: A Systematic Review of Published Cases. J Clin Med 2024; 13:5164. [PMID: 39274377 PMCID: PMC11396541 DOI: 10.3390/jcm13175164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 08/26/2024] [Accepted: 08/27/2024] [Indexed: 09/16/2024] Open
Abstract
Background: Valve-in-Valve (VIV) transcatheter aortic valve replacement (TAVR) is a potential solution for malfunctioning surgical aortic valve prostheses, though limited data exist for its use in Perceval valves. Methods: searches were performed on PubMed and Scopus up to 31 July 2023, focusing on case reports and series addressing VIV replacement for degenerated Perceval bioprostheses. Results: Our analysis included 57 patients from 27 case reports and 6 case series. Most patients (68.4%) were women, with a mean age of 76 ± 4.4 years and a mean STS score of 6.1 ± 4.3%. Follow-up averaged 9.8 ± 8.9 months, the mean gradient reduction was 15 ± 5.9 mmHg at discharge and 13 ± 4.2 mmHg at follow-up. Complications occurred in 15.7% of patients, including atrioventricular block III in four patients (7%), major bleeding or vascular complications in two patients (3.5%), an annular rupture in two patients (3.5%), and mortality in two patients (3.5%). No coronary obstruction was reported. Balloon-expanding valves were used in 61.4% of patients, predominantly the Sapien model. In the self-expanding group (38.6%), no valve migration occurred, with a permanent pacemaker implantation rate of 9%, compared to 5.7% for balloon-expanding valves. Conclusions: VIV-TAVR using both balloon-expanding and self-expanding technologies is feasible after the implantation of Perceval valves; however, it should be performed by experienced operators with experience both in TAVR and VIV procedures.
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Affiliation(s)
- Tamer Owais
- Department of Cardiac Surgery, University Hospital Augsburg, 86156 Augsburg, Germany
- Department of Cardiothoracic Surgery, Cairo University, Giza 12163, Egypt
| | - Osama Bisht
- Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 96450 Coburg, Germany
| | | | - Mohammad El-Garhy
- Department of Cardiology, Heart Vascular Center, 36199 Rotenburg an der Fulda, Germany
| | - Sina Stock
- Department of Cardiac Surgery, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Evaldas Girdauskas
- Department of Cardiac Surgery, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Thomas Kuntze
- Heart Center, Zentralklinik Bad Berka, 99437 Bad Berka, Germany
| | - Mohamed Amer
- Department of Cardiac Surgery, Heart Centre Siegburg-Wuppertal, University Witten-Herdecke, 42103 Wuppertal, Germany
| | - Philipp Lauten
- Heart Center, Zentralklinik Bad Berka, 99437 Bad Berka, Germany
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de Lima JG, de Barros ALBL, Lopes JDL. Factors associated with medication non-adherence among patients with heart failure. Rev Lat Am Enfermagem 2024; 32:e4302. [PMID: 39230133 PMCID: PMC11368070 DOI: 10.1590/1518-8345.6756.4302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/25/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVE to identify the factors contributing to medication non-adherence among patients with heart failure. METHOD cross-sectional and analytical study using the Medida de Adesão ao Tratamento [Treatment Adherence Measure] scale to assess medication non-adherence. Independent variables were collected using the European Heart Failure Self-care Behavior Scale and an instrument developed by the authors based on a previous study. Statistical tests were implemented to analyze data with p≤0.05 statistical significance. RESULTS the sample comprised 340 patients, with 9.4% considered non-adherent. The multiple analysis results showed that one unit increase in an individual's self-care score led to an 8% increase in the prevalence of non-adherence; patients with a family income above three times the minimum wage presented a prevalence of non-adherence equal to 3.5% of the prevalence of those with up to one times the minimum wage; individuals consuming alcohol or with depression presented 3.49 and 3.69 times higher prevalence of non-adherence, respectively, than individuals not presenting such history. CONCLUSION medication non-adherence was associated with self-care, family income, depression, and alcohol consumption.
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Affiliation(s)
| | | | - Juliana de Lima Lopes
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil
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Dinarvand D, Panthakey J, Heidari A, Hassan A, Ahmed MH. The Intersection between Frailty, Diabetes, and Hypertension: The Critical Role of Community Geriatricians and Pharmacists in Deprescribing. J Pers Med 2024; 14:924. [PMID: 39338179 PMCID: PMC11433409 DOI: 10.3390/jpm14090924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/21/2024] [Accepted: 08/27/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Frailty is a clinical syndrome prevalent among the elderly, characterised by a decline in physiological reserves and increased susceptibility to stressors, resulting in higher morbidity and mortality. Diabetes and hypertension are common in frail older individuals, often leading to polypharmacy. In this narrative review, we aimed to evaluate the relationship between frailty, diabetes, and hypertension and to identify effective management strategies and future research directions. Methods: This narrative review was conducted using the Scopus, Medline, PubMed, Cochrane Library, and Google Scholar databases. Results: Frailty significantly impacts the management and prognosis of diabetes and hypertension, which, in turn, affects the progression of frailty. Managing these conditions often involves multiple drugs to achieve strict glycaemic control and blood pressure targets, leading to polypharmacy and associated morbidities, including orthostatic hypotension, falls, fractures, hypoglycaemia, and reduced medication adherence. Identifying frailty and implementing strategies like deprescribing can mitigate the adverse effects of polypharmacy and improve outcomes and quality of life. Despite the availability of effective tools for identifying frailty, many frail individuals continue to be exposed to complex treatment regimens for diabetes and hypertension, leading to increased hospital admissions, morbidity, and mortality. Conclusions: Managing diabetes and hypertension in the frail ageing population requires a multidisciplinary approach involving hospital and community geriatricians and pharmacists. This is important due to the lack of sufficient clinical trials dedicated to diabetes and hypertension in the context of frailty. Future large population studies are needed to assess the best approaches for managing diabetes and hypertension in frail individuals.
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Affiliation(s)
- Daniel Dinarvand
- Department of Medicine, Ashford and St. Peter's Hospital NHS Foundation Trust, Surrey KT16 0PZ, UK
| | - Johann Panthakey
- Department of Medicine, Royal Surrey County Hospital NHS Foundation Trust, Guildford GU2 7XX, UK
| | - Amirmohammad Heidari
- Department of Trauma and Orthopaedics, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8YE, UK
| | - Ahmed Hassan
- Faculty of Medicine, Alexandria University, Alexandria 21321, Egypt
| | - Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK
- Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK
- Honorary Senior Lecturer of the Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham MK18 1EG, UK
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von Zur Mühlen C, Jeuck M, Heidt T, Maulhardt T, Hartikainen T, Supady A, Hilgendorf I, Wolf D, Kaier K, Westermann D, Rilinger J. One-year outcome of robotical vs. manual percutaneous coronary intervention. Clin Res Cardiol 2024:10.1007/s00392-024-02524-0. [PMID: 39167194 DOI: 10.1007/s00392-024-02524-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 08/14/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND Robotic-assisted percutaneous coronary intervention (R-PCI) is a promising technology for optimizing the treatment of patients with coronary heart disease. For a better understanding of the potential of R-PCI in clinical routine compared to conventional manual PCI (M-PCI) both initial treatment success of the index procedure and long-term outcome have to be analysed. METHODS Prospective evaluation from the FRiK (DRKS00023868) registry of all R-PCI cases with the CorPath GRX Cardiology by Siemens Healthineers and Corindus in the Freiburg University Heart Center between 04/2022 and 03/2023. Index procedure success and safety, radiation dose of patients and personnel, and 1-year outcome will be reported. Findings will be compared to a prospective control group of M-PCI patients treated by the same team of interventionalists during the same observation period. RESULTS Seventy patients received R-PCI and were included in the registry. PCI success rate was 100%, with 19% requiring manual assistance. No complications (MACE-major adverse cardiovascular events) occurred. Compared with 70 matched-pair M-PCI patients, there was a higher median procedural time (103 min vs. 67 min, p < 0.001) and fluoroscopy time (18 min vs. 15 min, p = 0.002), and more contrast volume was used (180 ml vs. 160 ml, p = 0.041) in R-PCI vs. M-PCI patients. However, there was no significant difference of the dose-area product (4062 vs. 3242 cGycm2, p = 0.361). One year after the intervention, there was no difference in mortality, rehospitalisation, unscheduled PCI or target vessel failure. Health-related quality of life evaluation 6 and 12 months after the index procedure (NYHA, CCS, SAQ7 and EQ-5D-5L) was similar in both groups. CONCLUSION R-PCI is feasible and safe. Compared to M-PCI, index procedure success rate is high, safety profile is favourable, and manual assistance was required in only few cases. At 1-year follow-up results for R-PCI vs. M-PCI considering mortality, rehospitalisation, morbidity and target vessel failure were equal.
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Affiliation(s)
- Constantin von Zur Mühlen
- Department of Cardiology and Angiology, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Marvin Jeuck
- Department of Cardiology and Angiology, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Timo Heidt
- Department of Cardiology and Angiology, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
- Max Grundig Klinik, Bühl, Germany
| | - Thomas Maulhardt
- Department of Cardiology and Angiology, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Tau Hartikainen
- Department of Cardiology and Angiology, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Alexander Supady
- Interdisciplinary Medical Intensive Care, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Ingo Hilgendorf
- Department of Cardiology and Angiology, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Dennis Wolf
- Department of Cardiology and Angiology, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Klaus Kaier
- Institute of Medical Biometry and Statistics, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Dirk Westermann
- Department of Cardiology and Angiology, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Jonathan Rilinger
- Department of Cardiology and Angiology, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
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Di Muro FM, Bellino M, Esposito L, Attisano T, Meucci F, Mattesini A, Galasso G, Vecchione C, Di Mario C. Role of Mechanical Circulatory Support in Complex High-Risk and Indicated Percutaneous Coronary Intervention: Current Indications, Device Options, and Potential Complications. J Clin Med 2024; 13:4931. [PMID: 39201073 PMCID: PMC11355104 DOI: 10.3390/jcm13164931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024] Open
Abstract
Improved expertise and technological advancements have enabled the safe and effective performance of complex and high-risk-indicated percutaneous coronary intervention (CHIP) in patients previously considered inoperable or high-risk. Mechanical circulatory support (MCS) devices play a crucial role in stabilizing hemodynamics during percutaneous coronary intervention (PCI) -related ischemia, thereby reducing the risk of major adverse events and achieving a more complete revascularization. However, the use of MCS devices in protected PCI is not without risks, including peri-procedural myocardial infarction (MI), bleeding, and access-related complications. Despite numerous observational studies, there is a significant lack of randomized clinical trials comparing different MCS devices in various CHIP scenarios and evaluating their long-term safety and efficacy profiles. This review aims to summarize the current evidence regarding the benefits of MCS devices during CHIPs, offer a practical guide for selecting appropriate devices based on clinical scenarios, and highlight the unanswered questions that future trials need to address.
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Affiliation(s)
- Francesca Maria Di Muro
- Department of Experimental and Clinical Medicine, School of Human Health Sciences, Careggi University Hospital, University of Florence, 50134 Florence, Italy
| | - Michele Bellino
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy; (M.B.); (T.A.); (G.G.); (C.V.)
| | - Luca Esposito
- Department of Advanced Biomedical Sciences, University Federico II, 80138 Naples, Italy;
| | - Tiziana Attisano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy; (M.B.); (T.A.); (G.G.); (C.V.)
| | - Francesco Meucci
- Division of Structural Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy; (F.M.); (A.M.); (C.D.M.)
| | - Alessio Mattesini
- Division of Structural Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy; (F.M.); (A.M.); (C.D.M.)
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy; (M.B.); (T.A.); (G.G.); (C.V.)
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy; (M.B.); (T.A.); (G.G.); (C.V.)
- Vascular Pathophysiology Unit, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Carlo Di Mario
- Division of Structural Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy; (F.M.); (A.M.); (C.D.M.)
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Rezvova MA, Ovcharenko EA, Klyshnikov KY, Glushkova TV, Kostyunin AE, Shishkova DK, Matveeva VG, Velikanova EA, Shabaev AR, Kudryavtseva YA. Electrospun bioresorbable polymer membranes for coronary artery stents. Front Bioeng Biotechnol 2024; 12:1440181. [PMID: 39234270 PMCID: PMC11371781 DOI: 10.3389/fbioe.2024.1440181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 08/09/2024] [Indexed: 09/06/2024] Open
Abstract
Percutaneous coronary intervention, a common treatment for atherosclerotic coronary artery lesions, occasionally results in perforations associated with increased mortality rates. Stents coated with a bioresorbable polymer membrane may offer an effective solution for sealing coronary artery perforations. Additionally, such coatings could be effective in mitigating neointimal hyperplasia within the vascular lumen and correcting symptomatic aneurysms. This study examines polymer membranes fabricated by electrospinning of polycaprolactone, polydioxanone, polylactide-co-caprolactone, and polylactide-co-glycolide. In uniaxial tensile tests, all the materials appear to surpass theoretically derived elongation thresholds necessary for stent deployment, albeit polydioxanone membranes are found to disintegrate during the experimental balloon expansion. As revealed by in vitro hemocompatibility testing, polylactide-co-caprolactone membranes exhibit higher thrombogenicity compared to other evaluated polymers, while polylactide-co-glycolide samples fail within the first day post-implantation into the abdominal aorta in rats. The PCL membrane exhibited significant water leakage in the permeability test. Comprehensive evaluation of mechanical testing, bio- and hemocompatibility, as well as biodegradation dynamics shows the advantage of membranes based on and the mixture of polylactide-co-caprolactone and polydioxanone over other polymer groups. These findings lay a foundational framework for conducting preclinical studies on stent configurations in large laboratory animals, emphasizing that further investigations under conditions closely mimicking clinical use are imperative for making definitive conclusions.
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Affiliation(s)
- Maria A Rezvova
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Evgeny A Ovcharenko
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Kirill Yu Klyshnikov
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Tatiana V Glushkova
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | | | - Daria K Shishkova
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Vera G Matveeva
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Elena A Velikanova
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Amin R Shabaev
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Yulia A Kudryavtseva
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
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Zhai Y, Luo C, Qin N, Cao H, Dong C, Huang Z, Huang D, Wang F, Wei W, Li J, Yang J, Lu X, Huang Z, Wang W. Predictive value of combining urinary N-acetyl-β-D-glucosaminidase and serum homocysteine for contrast-induced nephropathy in patients after percutaneous coronary intervention. Front Cardiovasc Med 2024; 11:1423836. [PMID: 39228665 PMCID: PMC11368722 DOI: 10.3389/fcvm.2024.1423836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 08/01/2024] [Indexed: 09/05/2024] Open
Abstract
Background Contrast-induced nephropathy (CIN) can lead to serious complications following percutaneous coronary intervention (PCI). Urine N-Acetyl-β-D-glucosaminidase (uNAG) and serum homocysteine (sHCY) are both potential predictors for CIN detection, but their combination has not been explored. We aimed to combine uNAG and sHCY as predictors for the early detection of CIN and for prognosis prediction in patients after PCI. Methods A total of 232 consecutive patients who underwent PCI at a university hospital were recruited for this study. According to the European Society of Urology and Reproduction (ESUR) criterion, CIN is defined as an elevation of serum creatinine (sCr) by ≥25% or ≥0.5 mg/dl from baseline within 48 h. We assessed the use of individual biomarkers (uNAG and sHCY) measured around PCI and their combinations for CIN detection and prognosis prediction. Receiver operating characteristic curves (ROC) and area under the curve (AUC) were used to evaluate the predictive efficiency of potential predictors. Results In total, 54 (23.28%) patients developed CIN. Concentrations of uNAG and sHCY increased significantly in CIN subjects (p < 0.05) than non-CIN. CIN could be predicted by uNAG and sHCY but not by creatinine at an early stage. At pre-PCI, 0, 12, 24, and 48 h after PCI, the AUC-ROC value of uNAG in calculating total CIN was 0.594, 0.603, 0.685, 0.657, and 0.648, respectively. The AUC-ROC value of sHCY in calculating total CIN was 0.685, 0.726, 0.771, 0.755, and 0.821, respectively. The panel of uNAG plus sHCY detected CIN with significantly higher accuracy than either individual biomarker alone and earlier than sCr. For detecting total CIN, this panel yielded AUC-ROCs of 0.693, 0.754, 0.826, 0.796, and 0.844 at pre-PCI, 0, 12, 24, and 48 h after PCI, respectively, which were superior to those of the individual biomarkers. For predicting the incidence of major adverse cardiovascular events (MACE) within 30 days to 12 months, the AUC-ROC values for uNAG and sHCY measured before discharge were 0.637 and 0.826, respectively. The combined panel yielded an AUC-ROC of 0.832. The combined detection did not significantly enhance the predictive capability for MACE in patients with CIN. The CIN group and the non-CIN group showed no significant difference in the Coronary Heart Disease Intensive Care Unit (CCU) stay time, hospital stay time, demand for renal replacement therapy, CCU mortality rate, and in-hospital mortality rate. Conclusions The uNAG and sHCY panel demonstrated better sensitivity and specificity for predicting the diagnosis and prognosis of CIN in patients after PCI, earlier than sCr. The combination of these biomarkers revealed a significantly superior discriminative performance for CIN detection and prognosis compared to using uNAG or sHCY alone.
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Affiliation(s)
- Yiling Zhai
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Department of Emergency, Affiliated Liutie Central Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Key Laboratory of Molecular Diagnosis and Application, Affiliated Liutie Central Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Changjun Luo
- Key Laboratory of Molecular Diagnosis and Application, Affiliated Liutie Central Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
- Department of Cardiovascular Medicine, Affiliated Liutie Central Hospital of Guangxi Medical University, Liuzhou, Guangxi, China
| | - Nianying Qin
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hongying Cao
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chunyang Dong
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zhou Huang
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Dongling Huang
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Fan Wang
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Wanxia Wei
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jincheng Li
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jie Yang
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xueling Lu
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zhengzhuang Huang
- Department of Emergency, The First People’s Hospital of Nanning, Nanning, Guangxi, China
| | - Wei Wang
- Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Guangxi University Key Laboratory of Emergency Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Xia P, Zhang Y, Sun Y, Wang J. Transient empty right ventricular ejection phenomenon during percutaneous coronary intervention: A case report. Asian J Surg 2024:S1015-9584(24)01690-7. [PMID: 39152068 DOI: 10.1016/j.asjsur.2024.07.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 07/25/2024] [Indexed: 08/19/2024] Open
Affiliation(s)
- Panpan Xia
- Department of Cardiology, Jing'an District Central Hospital of Shanghai, Fudan University, Shanghai, 200040, China
| | - Yan Zhang
- Department of Cardiology, Jing'an District Central Hospital of Shanghai, Fudan University, Shanghai, 200040, China
| | - Yumin Sun
- Department of Cardiology, Jing'an District Central Hospital of Shanghai, Fudan University, Shanghai, 200040, China.
| | - Jun Wang
- Department of Cardiology, Jing'an District Central Hospital of Shanghai, Fudan University, Shanghai, 200040, China
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Lugo-Gavidia LM, Alcocer-Gamba MA, Martinez-Cervantes A. Challenges and Advances in Interventional Cardiology for Coronary Artery Disease Management. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1323. [PMID: 39202606 PMCID: PMC11356482 DOI: 10.3390/medicina60081323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 07/31/2024] [Accepted: 08/05/2024] [Indexed: 09/03/2024]
Abstract
The development of percutaneous coronary intervention (PCI) has been one of the greatest advances in cardiology and has changed clinical practice for patients with coronary artery disease (CAD). Despite continuous improvements in operators' experience, techniques, and the development of new-generation devices, significant challenges remain in improving the efficacy of PCI, including calcification, bifurcation, multivascular disease, stent restenosis, and stent thrombosis, among others. The present review aims to provide an overview of the current status of knowledge of endovascular revascularization in CAD, including relevant trials, therapeutic strategies, and new technologies addressing particular scenarios that can impact the prognosis of this vulnerable population.
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Affiliation(s)
- Leslie Marisol Lugo-Gavidia
- Mexican Academic Consortium for Clinical Data Acquisition SC, Sinaloa 80230, Mexico
- Dobney Hypertension Centre, Medical School, University of Western Australia, Perth 6000, Australia
| | - Marco Antonio Alcocer-Gamba
- Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Querétaro 76180, Mexico
- Instituto de Corazón de Querétaro, Santiago de Querétaro 76180, Mexico
- Centro de Estudios Clínicos de Querétaro, Santiago de Querétaro 76180, Mexico
| | - Araceli Martinez-Cervantes
- Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Querétaro 76180, Mexico
- Centro de Estudios Clínicos de Querétaro, Santiago de Querétaro 76180, Mexico
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Ali AA, Sakr EE. Left ventricle pedunculated thrombi risks and outcomes: a case report and literature review. J Vasc Bras 2024; 23:e20230124. [PMID: 39286299 PMCID: PMC11404780 DOI: 10.1590/1677-5449.202301242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/21/2024] [Indexed: 09/19/2024] Open
Abstract
A 42-year-old male with ischemic cardiomyopathy presented with acute bilateral femoral artery embolization. After management with embolectomy and fasciotomy in both femoral arteries, transthoracic echocardiography revealed two pedunculated highly mobile left ventricle (LV) thrombi. Given the procedural risk, anticoagulation therapy was recommended over surgery. However, the bleeding risk impeded the continuation of anticoagulation, which increased the thrombus size. Multiorgan failure and disseminated intravascular coagulopathy followed and the patient died. We also systematically reviewed the PubMed and Scopus databases for pedunculated LV thrombi cases and retrieved 74 and 63 reports respectively. Of these, 37 relevant reports (45 cases) plus 11 reports from the manual search were included for data extraction, a total of 56 cases besides our case. Based on the etiologies and risks, LV thrombi are predictable and preventable, especially after ischemic events. A clear diagnostic algorithm and vigilant follow-up are needed as well as multidisciplinary management once a diagnosis is confirmed.
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Affiliation(s)
- Ahmed Ali Ali
- National Heart Institute, Cardiology Department, Giza, Egypt
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42
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Valdes AM, Louca P, Visconti A, Asnicar F, Bermingham K, Nogal A, Wong K, Michelotti GA, Wolf J, Segata N, Spector TD, Berry SE, Falchi M, Menni C. Vitamin A carotenoids, but not retinoids, mediate the impact of a healthy diet on gut microbial diversity. BMC Med 2024; 22:321. [PMID: 39113058 PMCID: PMC11304618 DOI: 10.1186/s12916-024-03543-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/28/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Vitamin A is essential for physiological processes like vision and immunity. Vitamin A's effect on gut microbiome composition, which affects absorption and metabolism of other vitamins, is still unknown. Here we examined the relationship between gut metagenome composition and six vitamin A-related metabolites (two retinoid: -retinol, 4 oxoretinoic acid (oxoRA) and four carotenoid metabolites, including beta-cryptoxanthin and three carotene diols). METHODS We included 1053 individuals from the TwinsUK cohort with vitamin A-related metabolites measured in serum and faeces, diet history, and gut microbiome composition assessed by shotgun metagenome sequencing. Results were replicated in 327 women from the ZOE PREDICT-1 study. RESULTS Five vitamin A-related serum metabolites were positively correlated with microbiome alpha diversity (r = 0.15 to r = 0.20, p < 4 × 10-6). Carotenoid compounds were positively correlated with the short-chain fatty-acid-producing bacteria Faecalibacterium prausnitzii and Coprococcus eutactus. Retinol was not associated with any microbial species. We found that gut microbiome composition could predict circulating levels of carotenoids and oxoretinoic acid with AUCs ranging from 0.66 to 0.74 using random forest models, but not retinol (AUC = 0.52). The healthy eating index (HEI) was strongly associated with gut microbiome diversity and with all carotenoid compounds, but not retinoids. We investigated the mediating role of carotenoid compounds on the effect of a healthy diet (HEI) on gut microbiome diversity, finding that carotenoids significantly mediated between 18 and 25% of the effect of HEI on gut microbiome alpha diversity. CONCLUSIONS Our results show strong links between circulating carotene compounds and gut microbiome composition and potential links to a healthy diet pattern.
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Affiliation(s)
- Ana M Valdes
- Nottingham NIHR Biomedical Research Centre at the School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK.
- Inflammation, Recovery and Injury Sciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
- Department of Twin Research & Genetic Epidemiology, King's College London, London, SE1 7EH, UK.
| | - Panayiotis Louca
- Department of Twin Research & Genetic Epidemiology, King's College London, London, SE1 7EH, UK
- Human Nutrition and Exercise Research Centre, University of Newcastle, Newcastle Upon Tyne, NE2 4HH, UK
| | - Alessia Visconti
- Department of Twin Research & Genetic Epidemiology, King's College London, London, SE1 7EH, UK
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, 10124, Turin, Italy
| | - Francesco Asnicar
- Department CIBIO, University of Trento, Via Sommarive 9, 38123, Povo, Trento, Italy
| | - Kate Bermingham
- Department of Nutritional Sciences, King's College London, 150 Stamford Street, London, SE1 9NH, UK
- Zoe Limited, 164 Westminster Bridge Rd, London, SE1 7RW, UK
| | - Ana Nogal
- Department of Twin Research & Genetic Epidemiology, King's College London, London, SE1 7EH, UK
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Kari Wong
- Metabolon Inc, Research Triangle Park, Morrisville, NC, 27560, USA
| | | | - Jonathan Wolf
- Zoe Limited, 164 Westminster Bridge Rd, London, SE1 7RW, UK
| | - Nicola Segata
- Department CIBIO, University of Trento, Via Sommarive 9, 38123, Povo, Trento, Italy
| | - Tim D Spector
- Department of Twin Research & Genetic Epidemiology, King's College London, London, SE1 7EH, UK
- Zoe Limited, 164 Westminster Bridge Rd, London, SE1 7RW, UK
| | - Sarah E Berry
- Department of Nutritional Sciences, King's College London, 150 Stamford Street, London, SE1 9NH, UK
- Zoe Limited, 164 Westminster Bridge Rd, London, SE1 7RW, UK
| | - Mario Falchi
- Department of Twin Research & Genetic Epidemiology, King's College London, London, SE1 7EH, UK
| | - Cristina Menni
- Department of Twin Research & Genetic Epidemiology, King's College London, London, SE1 7EH, UK.
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Ganni E, Béïque F, Hatzigeorgiou S, Morin JF, Kovacina B, Peretz-Larochelle M. An Unusual Cause of Shock: Bursting a Bubble. JACC Case Rep 2024; 29:102394. [PMID: 39157571 PMCID: PMC11328778 DOI: 10.1016/j.jaccas.2024.102394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 08/20/2024]
Abstract
This study presents the case of a previously healthy 68-year-old woman who presented with shock from tamponade due to hemopericardium. Initial noninvasive imaging did not provide a clear etiology for the hemopericardium. Given the ongoing clinical deterioration and need for diagnosis and treatment, an exploratory sternotomy was performed with successful outcome.
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Affiliation(s)
- Elie Ganni
- Department of Internal Medicine, McGill University, Montreal, Quebec, Canada
| | - François Béïque
- Department of Anesthesiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Sean Hatzigeorgiou
- Division of Cardiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Jean-François Morin
- Division of Cardiac Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Bojan Kovacina
- Department of Radiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Maude Peretz-Larochelle
- Division of Cardiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
- Division of Critical Care Medicine, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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Alharrasi M, Al-Noumani H, Al-Ghassani A, Al-Jadidi S, Al-Maskari M, Al-Zakwani I. Perceived control attitude among heart failure patients in Oman: a multicenter study. Sci Rep 2024; 14:18376. [PMID: 39112654 PMCID: PMC11306552 DOI: 10.1038/s41598-024-67895-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 07/17/2024] [Indexed: 08/10/2024] Open
Abstract
Heart failure (HF) is a global epidemic with a prevalence of over 64.3 million cases worldwide. Several factors account for the increase in the prevalence of HF. The most significant factor is the growing population of older adults. Other factors include improved treatment and survival after myocardial infarction, poorly controlled hypertension (HTN), and diabetes mellitus (DM). As a modifiable construct, perceived control can be improved to promote healthier lifestyle choices, such as self-care, and consequently better health outcomes. A person's perception of control is their conviction that they have the power to deal with adverse circumstances, like receiving an HF diagnosis, and produce favorable results, such as an improvement in symptom status. The objective of this study was to evaluate the factors influencing perceived control attitudes among patients with heart failure in Oman. In this sample of HF patients (N = 180), the mean perceived control attitude was 16.97 ± 2.25. Certain factors had higher effects than others. For example, females (p = 0.006), old age (p < 0.001), those who smoke (p < 0.001), current health compared to one year back (p < 0.001), higher ejection fraction (p = 0.008), and comorbidities (p = 0.026) have significant relationships with perceived control attitude. The perceived control attitude in this sample was found to be adequate. Female gender, old age, smoking, current health, higher EF, and comorbidities were the associated factors of a perceived control attitude. Thus, interventions targeting attitudes, barriers, and social support may improve perceived control. Clinicians should assess and manage perceived control to maintain or improve quality of life.
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Affiliation(s)
- Maryam Alharrasi
- College of Nursing, Sultan Qaboos University, Alkhoud, BO. Box 66, Muscat, Oman.
| | - Huda Al-Noumani
- College of Nursing, Sultan Qaboos University, Alkhoud, BO. Box 66, Muscat, Oman
| | - Amal Al-Ghassani
- Community Health Department, Oman College of Health Sciences, Muscat, Oman
| | | | | | - Ibrahim Al-Zakwani
- Pharmacology & Clinical Pharmacy, Sultan Qaboos University, Muscat, Oman
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Chen J, Lynn EG, Sharma H, Byun JH, Kenyon VA, Sahu KK, Tyrrell DL, Houghton M, Gross PL, Trigatti BL, Shayegan B, Austin RC. Small molecules targeting GRP78 mitigate anti-GRP78 autoantibody-mediated tissue factor procoagulant activity in cultured endothelial cells. J Thromb Haemost 2024:S1538-7836(24)00432-X. [PMID: 39111636 DOI: 10.1016/j.jtha.2024.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 06/21/2024] [Accepted: 07/08/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND The 78-kDa glucose-regulated protein (GRP78) expressed on the cell surface (csGRP78) has been reported to regulate tissue factor (TF) procoagulant activity (PCA) in lesion-resident endothelial cells (ECs), which is further enhanced by circulating anti-GRP78 autoantibodies that bind to the Leu98-Leu115 epitope in GRP78. OBJECTIVES Determine the effects of the engagement of the anti-GRP78 autoantibody to csGRP78 on ECs and the underlying mechanisms that impact TF PCA. METHODS Immunofluorescent staining was used to determine the presence of csGRP78 in tumor necrosis factor α-treated ECs. An established TF PCA assay was used to evaluate human ECs following treatment with anti-GRP78 autoantibodies. The Fura 2-AM assay (Abcam) was used to quantify changes in intracellular Ca2+ levels. Small molecules predicted to bind GRP78 were identified using artificial intelligence. Enzyme-linked immunosorbent assays were used to assess the ability of these GRP78 binders to mitigate TF activity and interfere with the autoantibody/csGRP78 complex. RESULTS In tumor necrosis factor α-treated ECs, anti-GRP78 autoantibodies increased TF PCA. This observation was further enhanced by endoplasmic reticulum stress-induced elevation of csGRP78 levels. Anti-GRP78 autoantibody treatment increased intracellular Ca2+ levels. Sequestering the anti-GRP78 autoantibody with a conformational peptide or blocking with heparin attenuated anti-GRP78 autoantibody-induced TF PCA. We identified B07∗, as a GRP78 binder that diminished anti-GRP78 autoantibody-induced TF PCA on ECs. CONCLUSION These findings show how anti-GRP78 autoantibodies enhance TF PCA that contributes to thrombosis and identify novel GRP78 binders that represent a potential novel therapeutic strategy for treating and managing atherothrombotic disease.
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Affiliation(s)
- Jack Chen
- Department of Medicine, Division of Nephrology, McMaster University, The Research Institute of St. Joe's Hamilton and The Hamilton Center for Kidney Research, Hamilton, Ontario, Canada
| | - Edward G Lynn
- Department of Medicine, Division of Nephrology, McMaster University, The Research Institute of St. Joe's Hamilton and The Hamilton Center for Kidney Research, Hamilton, Ontario, Canada
| | - Hitesh Sharma
- Department of Medicine, Division of Nephrology, McMaster University, The Research Institute of St. Joe's Hamilton and The Hamilton Center for Kidney Research, Hamilton, Ontario, Canada
| | - Jae H Byun
- Department of Medicine, Division of Nephrology, McMaster University, The Research Institute of St. Joe's Hamilton and The Hamilton Center for Kidney Research, Hamilton, Ontario, Canada
| | | | - Kamlesh K Sahu
- Li Ka Shing Applied Virology Institute, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada
| | - D Lorne Tyrrell
- Li Ka Shing Applied Virology Institute, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada
| | - Michael Houghton
- Li Ka Shing Applied Virology Institute, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada
| | - Peter L Gross
- Department of Medicine, Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Science, Hamilton, Ontario, Canada
| | - Bernardo L Trigatti
- Department of Biochemistry and Biomedical Sciences, McMaster University and Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Bobby Shayegan
- Division of Urology, Department of Surgery, McMaster University and The Research Institute of St. Joe's Hamilton, Hamilton, Ontario, Canada
| | - Richard C Austin
- Department of Medicine, Division of Nephrology, McMaster University, The Research Institute of St. Joe's Hamilton and The Hamilton Center for Kidney Research, Hamilton, Ontario, Canada.
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Chen X, Cao H, Li Y, Chen F, Peng Y, Zheng T, Chen M. Hemodynamic influence of mild stenosis morphology in different coronary arteries: a computational fluid dynamic modelling study. Front Bioeng Biotechnol 2024; 12:1439846. [PMID: 39157447 PMCID: PMC11327040 DOI: 10.3389/fbioe.2024.1439846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 07/02/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction: Mild stenosis [degree of stenosis (DS) < 50%] is commonly labeled as nonobstructive lesion. Some lesions remain stable for several years, while others precipitate acute coronary syndromes (ACS) rapidly. The causes of ACS and the factors leading to diverse clinical outcomes remain unclear. Method: This study aimed to investigate the hemodynamic influence of mild stenosis morphologies in different coronary arteries. The stenoses were modeled with different morphologies based on a healthy individual data. Computational fluid dynamics analysis was used to obtain hemodynamic characteristics, including flow waveforms, fractional flow reserve (FFR), flow streamlines, time-average wall shear stress (TAWSS), and oscillatory shear index (OSI). Results: Numerical simulation indicated significant hemodynamic differences among different DS and locations. In the 20%-30% range, significant large, low-velocity vortexes resulted in low TAWSS (<4 dyne/cm2) around stenoses. In the 30%-50% range, high flow velocity due to lumen area reduction resulted in high TAWSS (>40 dyne/cm2), rapidly expanding the high TAWSS area (averagely increased by 0.46 cm2) in left main artery and left anterior descending artery (LAD), where high OSI areas remained extensive (>0.19 cm2). Discussion: While mild stenosis does not pose any immediate ischemic risk due to a FFR > 0.95, 20%-50% stenosis requires attention and further subdivision based on location is essential. Rapid progression is a danger for lesions with 20%-30% DS near the stenoses and in the proximal LAD, while lesions with 30%-50% DS can cause plaque injury and rupture. These findings support clinical practice in early assessment, monitoring, and preventive treatment.
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Affiliation(s)
- Xi Chen
- Department of Mechanics and Engineering, College Architecture and Environment, Sichuan University, Chengdu, China
| | - Haoyao Cao
- Department of Mechanics and Engineering, College Architecture and Environment, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology, Sichuan University, Yibin, China
| | - Yiming Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Peng
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Tinghui Zheng
- Department of Mechanics and Engineering, College Architecture and Environment, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
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47
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Tabi M, Perel N, Taha L, Amsalem I, Hitter R, Maller T, Manassra M, Karmi M, Zacks N, Levy N, Shrem M, Marmor D, Gavriel D, Jarjoui A, Shuvy M, Asher E. Out of hospital cardiac arrest - new insights and a call for a worldwide registry and guidelines. BMC Emerg Med 2024; 24:140. [PMID: 39095722 PMCID: PMC11297571 DOI: 10.1186/s12873-024-01060-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
INTRODUCTION Out of hospital cardiac arrest (OHCA) is a major public health problem with substantial mortality rates worldwide. Genetic diseases and primary electrical disorders are the most common etiologies at younger ages, while ischemic heart disease and cardiomyopathies are common causes at older ages. Despite improvement in prevention and treatment in recent years, OHCA is still a major cause of cardiovascular death. METHOD We report prospective data regarding etiology, characteristics, clinical course, and outcomes of patients with OHCA who were admitted to a tertiary care center intensive cardiac care unit (ICCU) between 2020-2023. RESULTS A total of 92 patients admitted after OHCA were included in the cohort. Mean age was 63.8 ± 13.8 years and 75 (82%) were males. The most common etiology of OHCA was acute coronary syndrome (ACS) in 54 (59%) patients, of whom 46 (85%) patients had ST elevation myocardial infarction and 8 (15%) had non-ST elevation myocardial infarction. During hospitalization, 42 (46%) patients underwent targeted temperature management and 13 (14%) received mechanical circulatory support. Interestingly, 77 (84%) patients underwent coronary angiography, while only 51 (55%) received percutaneous coronary intervention (PCI). Neurologic status was favorable in 49 (53%) patients with Cerebral Performance Category score of 1-2. Overall, mortality rates were relatively low, with 15 (16%) in-hospital deaths and 24 (26%) deaths at 30-day follow-up. CONCLUSION Although ACS was the most common etiology for OHCA, only 55% of patients underwent PCI. Most OHCA patients admitted to the ICCU survived hospitalization and were discharged. Increased awareness, public education, worldwide registries, and specific evidence-based guidelines for the treatment of OHCA patients may lead to improved outcomes for these patients who often carry poor prognoses.
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Affiliation(s)
- Meir Tabi
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Nimrod Perel
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Louay Taha
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Itshak Amsalem
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rafi Hitter
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tomer Maller
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mohamed Manassra
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mohammad Karmi
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Netanel Zacks
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nir Levy
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Maayan Shrem
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Marmor
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - David Gavriel
- Vascular Surgery Department, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Amir Jarjoui
- Department of Medicine, Pulmonary Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mony Shuvy
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Elad Asher
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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48
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Esmailnejad A, Zununi Vahed S, Hejazian SM, Aslanabadi N, Lotfollahhi Gharakhanlu H, Saraei M, Ahmadzadehpournaky A, Ardalan K, Ardalan M, Ghaffari Bavil S. Effectiveness of edaravone in preventing contrast-induced nephropathy in high-risk patients undergoing coronary angiography: A randomized, double-blind trial. Pharmacol Res Perspect 2024; 12:e1228. [PMID: 38956898 PMCID: PMC11219510 DOI: 10.1002/prp2.1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/28/2024] [Accepted: 06/09/2024] [Indexed: 07/04/2024] Open
Abstract
Contrast-induced nephropathy (CIN) is a serious complication that occurs subsequent to the administration of contrast media for therapeutic angiographic interventions. As of present, no effective therapy exists to prevent its occurrence. This single-center double-blind randomized controlled trial aimed to evaluate the effect of edaravone, an antioxidant, in a group of high-risk patients undergoing coronary angiography. Ninety eligible patients with chronic kidney disease Stages 3-4 were randomly assigned to either the control group (n = 45) or the intervention group (n = 45). In the intervention group, one dosage of edaravone (60 mg) in 1 L of normal saline was infused via a peripheral vein 1 h prior to femoral artery-directed coronary angiography. Patients in the control group received an equal amount of infusion in their last hour before angiography. Both groups received intravenous hydration with 0.9% sodium 1 mL/kg/h starting 12 h before and continuing for 24 h after angiography. The primary outcome measure was the onset of CIN, defined as a 25% increase in serum creatinine levels 120 h after administration of contrast media. The occurrence of CIN was observed in 5.5% (n = 5) of the studied population: 2.2% of patients in the intervention group (n = 1) and 8.9% of controls (n = 4). However, this difference was not statistically significant. Administration of a single dosage of edaravone 1 h prior to infusion of contrast media led to a reduction in the incidence of CIN. Further investigations, employing larger sample sizes, are warranted to gain a comprehensive understanding of its efficacy.
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Affiliation(s)
- Azam Esmailnejad
- Cardiovascular Research CenterTabriz University of Medical SciencesTabrizIran
- Kidney Research CenterTabriz University of Medical SciencesTabrizIran
| | | | | | - Naser Aslanabadi
- Cardiovascular Research CenterTabriz University of Medical SciencesTabrizIran
| | | | - Majid Saraei
- Cardiovascular Research CenterTabriz University of Medical SciencesTabrizIran
| | | | - Kasra Ardalan
- School of Pharmacy and Pharmaceutical SciencesIslamic Azad UniversityTeheranIran
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49
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Syed J, Chalasani SH. The 2023 American Geriatrics Society Updated Beers Criteria ® Application in Low- and Middle-Income Countries: A Walk-through. Sr Care Pharm 2024; 39:286-290. [PMID: 39080870 DOI: 10.4140/tcp.n.2024.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
The 2023 update of the American Geriatrics Society Beers Criteria® provides a comprehensive set of guidelines for optimizing medication use in older people. While this update is based on a rigorous review of evidence from clinical trials and research studies published between 2017 and 2022, its application in low- and middle-income countries (LMICs) may present unique challenges and considerations. LMICs often face different health care realities compared with high-income countries, such as limited access to medications, varying prescribing practices, and resource constraints. As a result, the Beers Criteria® 2023 update, which includes the addition, deletion, and revision of medicines based on new evidence, may not be entirely applicable or feasible in these settings. This commentary aims to explore the implications of the 2023 Beers Criteria® update for LMICs, highlighting the need for context-specific adaptations and strategies to optimize medication use and improve health outcomes for older people in resource-limited settings.
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Affiliation(s)
- Jehath Syed
- JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore-15, Karnataka, India
| | - Sri Harsha Chalasani
- JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore-15, Karnataka, India
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50
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Davani DN, Alizadehasl A, Aliabadi AY, Bazrgar A, Pouraliakbar H, Jebelli SFH, Najdaghi S, Zonooz YA. Cardiac papillary fibroelastomas: Unveiling a rare right atrial presentation with surgical insights-A case report and review of the literature. Clin Case Rep 2024; 12:e9207. [PMID: 39114834 PMCID: PMC11303667 DOI: 10.1002/ccr3.9207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/13/2024] [Accepted: 06/20/2024] [Indexed: 08/10/2024] Open
Abstract
Cardiac papillary fibroelastomas (CPF) are rare, benign tumors with thromboembolic potential. We present a 40-year-old male with a right atrial CPF, referred with acute chest pain. Advanced imaging and surgical excision with tricuspid valve repair were crucial, emphasizing the need for early detection and intervention in symptomatic and asymptomatic cases.
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Affiliation(s)
- Delaram Narimani Davani
- Heart Failure Research CenterCardiovascular Research Institute, Isfahan University of Medical ScienceIsfahanIran
| | - Azin Alizadehasl
- Cardio‐Oncology Research Center, Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran
| | - Azam Yalameh Aliabadi
- Cardio‐Oncology Research Center, Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran
| | - Aida Bazrgar
- Student Research Committee, School of MedicineShiraz University of Medical SciencesShirazIran
| | - Hamidreza Pouraliakbar
- Department of Radiology, Rajaie Cardiovascular Medical and Research CentreIran University of Medical SciencesTehranIran
| | | | - Soroush Najdaghi
- Heart Failure Research CenterCardiovascular Research Institute, Isfahan University of Medical ScienceIsfahanIran
| | - Yasamin Afsari Zonooz
- Cardio‐Oncology Research Center, Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran
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