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Approach to a patient with pulmonary hypertension

Journal of Geriatric Cardiology 2019年第6期16卷 478-481页

作者： chakradhari inampudi Anna R Hemnes Alexandros Briasoulis Division of Cardiovascular Diseases University of Iowa Hospitals and Clinics Iowa City Iowa USA Division of Allergy Pulmonary and Critical Care Medicine Vanderbilt University Medical Center Nashville Tennessee USA

Pulmonary hypertension is a common clinical condition that can complicate various cardiac and respiratory abnormalities. Interest in pulmonary hypertension has grown remarkably among the scientific community in the last decade. It is now clear based on the scientific advances have paved the way in understanding the effects of abnormal pulmonary hemodynamics development and its antecedent consequences on the right heart in reducing the quality of life and survival of the patient.

关键词： Pulmonary arterial hypertension

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Trends in the rates of hospitalizations for acute stroke among patients over 90 years of age with atrial fibrillation in the United States： from 2005 to 2014

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Journal of Geriatric Cardiology 2017年第9期14卷 547-552页

作者： Ghanshyam PS Shantha Amgad Mentias Musab Alqasrawi Abdul Qazi chakradhari inampudi Kongkiat Chaikriangkrai Abhishek Deshmuk Steven Bailin Michael Giudici Alexander Mazur Division of Cardiovascular Medicine University of Iowa Hospitals and Clinics lowa City lowa USA Mayo Clinic Rochester MN USA

Background Acute stroke （AS） rates in patients over 90 years of age （very elderly） with atrial fibrillation （AF） in the United States（US） are not known. We assessed trends in hospitalizations for AS among very elderly with AF in the US from 2005 to 2014. Methods Weused the nationwide inpatient sample （NIS） from the USA; 2005-2014. AF and AS diagnoses were abstracted using international classifica-tion of diseases, 9th Revision, clinical modification （ICD-9-CM） codes. Results From 2005 to 2014, 3,606,073 hospitalizations of veryelderly with AF were reported. Of these, 188,948 hospitalizations （141,822 hospitalizations in women and 47,126 hospitalizations in men）had AS as the primary diagnosis. Age adjusted AS hospitalizations increased in the total cohort （3217/million in 2005 to 3871/million in2014）, in women （3540/million in 2005 to 4487/million in 2014） and in men （2490/million in 2005 to 3173/million in 2014）（P 〈 0.001）.Anticoagnlation rates increased in women （8% in 2005 to 19.9% in 2014） and in men （8.9% in 2005 to 21.6% in 2014）. AS rates, thoughnumerically lower than the total cohort, showed an increasing trend in anticoagnlated patients as well （all anticoagulated patients： 212/millionin 2005 to 513/million in 2014; anticoagulated women： 224/million in 2005 to 529/million in 2014, anticoagnlated men： 184/million in 2005to 518/million in 2014）. Conclusions There is an increasing trend in AS hospitalizations among nonagenarians with AF in the US despiteimproving utilization of anticoagulants in this patient population. The etiologies driving this alarming trend are unclear and require fur-ther study.

关键词： Anticoagulation Atrial fibrillation Nonagenarian Stroke

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