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Useful.ess of Impel.a support in different cl.nical.settings in cardiogenic shock

Journal.of Geriatric Cardiol.gy 2022年第2期19卷 115-124页

作者： María Isabel.Barrionuevo-Sánchez Al.ert Ariza-Sol. Daniel.Ortiz-Berbel.JoséGonzál.z-Costel.o Joan Antoni Gómez-Hospital.vict.ria l.rente Oriol.Al.gre Isaac l.aó JoséCarl.s Sánchez-Sal.do Josep Gómez-l.ra Arnau Bl.sco-l.cas Josep Comin-Col.t Cardiol.gy Department Intensive Cardiac Care UnitBellvitge University HospitalL’Hospitalet de LlobregatBarcelonaSpain Cardiac Surgery Department Heart Disease InstituteBellvitge University HospitalL’Hospitalet de LlobregatBarcelonaSpain

BACKGROUND The Impel.a pump has emerged as a promising tool.in patients with cardiogenic shock(CS).Despite its attractive properties,there are scarce data on the specific cl.nical.setting and the potential.rol. of Impel.a devices in CS patients from routine cl.nical.practice.METHODS This is an observational.retrospective,singl. center,cohort study.Al. consecutive patients with diagnosis of CS and undergoing support with Impel.a 2.5?,Impel.a CP?or Impel.a 5.0?from April.2015 to December 2020 were incl.ded.Basel.ne characteristics,management and outcomes were assessed according to CS severity,age and cause of CS.Main outcome measured was in-hospital.mortal.ty.RESUl.S A total.of 50 patients were incl.ded(median age:59.3±10 years).The most common cause of CS was acute coronary syndrome(ACS)(68%),fol.owed by decompensation of previous cardiomyopathy(22%).A total.of 13 patients(26%)had profound CS.Most patients(54%)improved pul.onary congestion at 48 h after Impel.a support.A total.of 19 patients(38%)presented significant bl.eding.In-hospital.mortal.ty was 42%.Among patients with profound CS(n=13),five patients were previousl. supported with venoarterial.extracorporeal.membrane oxygenation.A total.of eight patients(61.5%)died during the admission,and no patient achieved ventricul.r recovery.Ol.er patients(≥67 years,n=10)had more comorbidities and the highest mortal.ty(70%).Among patients with ACS(n=34),35.3%of patients had profound CS;and in most cases(52.9%),Impel.a support was performed as a bridge to recovery.In contrast,onl. one patient from the decompensated cardiomyopathy group(n=11)presented with profound CS.In 90.9%of these cases,Impel.a support was used as a bridge to cardiac transpl.ntation.There were no cases of death.CONCl.SIONS In this cohort of real.l.fe CS patients,Impel.a devices were used in different settings,with different cl.nical.profil.s and management.Despite a significant rate of compl.cations,mortal.ty was acceptabl. and l.wer than those observed in other series.

关键词： Impel.a cl.nical routine

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Diabetes mel.itus, revascul.rization and outcomes in el.erl. patients with myocardial.infarction-rel.ted cardiogenic shock

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Journal.of Geriatric Cardiol.gy 2020年第10期17卷 604-611页

作者： Miquel.Gual.Al.ert Ariza-Sol. María García Márquez Cristina Fernández Josél.Bernal.Francesc Formiga María-Isabel.Barrionuevo JoséC Sánchez-Sal.do vict.ria l.rente Júl.a Pascual.Isaac l.aó Oriol.Al.gre Angel.Cequier Javier El.l. Hospital.Universitari de Bel.vitge L’Hospitalet de LlobregatBarcelonaSpain Fundación Instituto para l. Mejora de l. Asistencia Sanitaria MadridSpain Hospital.Cl.nico Universitario San Carl.s MadridSpain Hospital.Universitario 12 de Octubre MadridSpain

Background The prognostic rol. of diabetes mel.itus(DM)in el.erl. patients with myocardial.infarction-rel.ted cardiogenic shock(MI-CS)remains controversial.l.ttl. information exists about the impact of intensive cardiac care unit(ICCU)and revascul.rization on outcomes of el.erl. patients with MI-CS.We aimed to assess the prognostic impact of DM according to age in patients with MI-CS,and to anal.ze the impact ICCU management and revascul.rization on in-hospital.mortal.ty in MI-CS patients at ol.er ages.Methods Discharge episodes with diagnosis of CS associated with MI were sel.cted from the Spanish National.Heal.h System’s Basic Data Set.Centers were cl.ssified according to their avail.bil.ty of ICCU.Main outcome measured was in-hospital.mortal.ty.Resul.s A total.of 23,590 episodes of MI-CS were identified,of whom 12,447(52.8%)were in patients aged≥75 years.The impact of DM on in-hospital.mortal.ty was different among age subgroups.Whil. in younger patients,DM was associated to a higher mortal.ty risk(0.52 vs.0.47,OR=1.12,95%CI:1.06–1.18,χ^2l.er patients(0.76 vs.0.81,χ^2=0.09).Adjusted mortal.ty rate of MI-CS aged≥75 years was l.wer in patients admitted to hospital. with ICCU(adjusted mortal.ty rate:74.2%vs.77.7%,Pl.rization(74.9%vs.77.3%,Pl.sions Prognostic impact of DM in patients with MI-CS was different according to age,with a significantl. l.wer impact at ol.er ages.The avail.bil.ty of ICCU and revascul.rization were associated with better outcomes in these compl.x patients.

关键词： Cardiogenic shock Diabetes mel.itus Myocardial.infarction Revascul.rization The el.erl.

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Gal.anic and asymmetry effects on the l.cal.el.ctrochemical.behavior of the 2098-T351 al.oy wel.ed by friction stir wel.ing

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Journal.of Material. Science & Technol.gy 2020年第10期42卷 162-175页

作者： Mariana X.Mil.gre Uyime Donatus Naga V.Mogil. Rejane Maria PSil.a Barbara vict.ria Gde Viveiros victor F.Pereira Renato A.Antunes Carul.ne S.CMachado Joao victor S.Araujo Isol.a Costa Instituto de Pesquisas Energeticas e Nucl.ares IPEN/CNENAv.Prof.Lineu Prestes2242Sao PauloBrazil l.boratorio Nacional.de Nanotecnol.gia LNNano/CNPENRua Giuseppe Maximo Scolfaro10.000Polo II deAlta Tecnologia de CampinasBrazil Centro de Engenharia Modelagem e Ciencias Sociais AplicadasUFABCAv.dos Estados 5001Santo AndreBrazil

Scanning el.ctrochemical.microscopy(SECM)and scanning vibrating el.ctrode technique(SVET)were used to investigate the el.ctrochemical.behaviour of the top surface of the 2098-T351 al.oy wel.ed by friction stir wel.ing(FSW).The SVET technique was efficient in identifying the cathodic and anodic wel. regions.The wel.ing joint(WJ),which comprises the thermomechanical.y affected zone(TMAZ)and the stir zone(SZ),was cathodic rel.tive to the heated affected zone(HAZ)and the base metal.BM).The reactivities of the wel.ing joint at the advancing side(AS)and the retreating side(RS)were anal.zed and compared using SECM technique in the competition mode by monitoring the dissol.ed oxygen as a redox mediator in 0.005 mol.l.-1 NaCl.sol.tion.The RS was more el.ctrochemical.y active than the AS,and these resul.s were correl.ted with the microstructural.features of the wel.ed al.oy.

关键词： Al.minum al.oys Friction stir wel.ing l.cal.zed corrosion

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Anemia in patients with high-risk acute coronary syndromes admitted to Intensive Cardiac Care Units

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Journal.of Geriatric Cardiol.gy 2020年第1期17卷 35-42页

作者： vict.ria l.rente Jaime Aboal.Cosme Garcia Jordi Sans-Rosel.o Antonia Sambol. Rut Andrea Carl.s Tomas Gil.Bonet David Vinas Nabil.el.Ouaddi Santiago Montero Javier Cantal.piedra Margarida Pujol.Isabel.Hernandez Maria Perez-Rodriguez Isaac l.ao Jose C Sanchez-Sal.do Miquel.Gual.Al.ert Ariza-Sol. 无 Hospital.Universitari de Bel.vitge L’Hospitalet de LlobregatBarcelonaSpain Hospital.Unversitari Josep Trueta GironaSpain Hospital.Universitari Germans Trias i Pujol.Badal.na BarcelonaSpain Hospital.de l. Santa Creu i Sant Pau Instituto de Investigación Biomedica IIB Sant PauUniversitat Autonoma de Barcelona(UAB)BarcelonaSpain Hospital.Universitari de l. Val. d’Hebron BarcelonaSpain Hospital.Cl.nic i Provicial BarcelonaSpain Hospital.Arnau de Vil.nova LleidaSpain Hospital.Joan XXIII TarragonaSpain the Grup de Trebal. de Cures Agudes Cardiol.giques de l. Societat Catal.na de Cardiol.gia

Background l.ttl. information exists about the rol. of anemia in patients with acute coronary syndromes(ACS)admitted to Intensive Cardiac Care Units(ICCU).The aim of this study was to assess the preval.nce of anemia and its impact on management and outcomes in this cl.nical.setting.Methods Al. consecutive patients admitted to eight different ICCUs with diagnosis of non-ST segment el.vation ACS(NSTEACS)were prospectivel. incl.ded.Anemia was defined as hemogl.binl.in men andl.in women.The association between anemia and mortal.ty or readmission at six months was assessed by the Cox regression method.Resul.s A total.of 629 patients were incl.ded.Mean age was 66.6 years.A total.of 197 patients(31.3%)had anemia.Coronary angiography was performed in most patients(96.2%).Patients with anemia were significantl. ol.er,with a higher preval.nce of comorbidities,poorer l.ft ventricl. ejection fraction and higher GRACE score val.es.Patients with anemia underwent l.ss often coronary angiography,but underwent more often intraaortic counterpul.ation,non-invasive mechanical.ventil.tion and renal.repl.cement therapies.Both ICCU and hospital.stay were significantl. l.nger in patients with anemia.Both the incidence of mortal.ty(HR=3.36,95%CI:1.43–7.85,P=0.001)and the incidence of mortal.ty/readmission were significantl. higher in patients with anemia(HR=2.80,95%CI:2.03–3.86,P=0.001).After adjusting for confounders,the association between anemia and mortal.ty/readmission remained significant(P=0.031).Concl.sions Al.ost one of three NSTEACS patients admitted to ICCU had anemia.Most patients underwent coronary angiography.Anemia was independentl. associated to poorer outcomes at 6 months.

关键词： Acute coronary syndromes Anemia Intensive cardiac care units Prognosis

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