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Diabetes mellitus, revascularization and outcomes in elderly patients with myocardial infarction-related cardiogenic shock

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Journal of Geriatric Cardiology 2020年第10期17卷 604-611页

作者： Miquel Gual Albert Ariza-Solé María García Márquez Cristina Fernández JoséL Bernal Francesc Formiga María-Isabel Barrionuevo JoséC Sánchez-Salado Victòria Lorente Júlia Pascual Isaac Llaó Oriol Alegre Angel Cequier Javier Elola Hospital Universitari de Bellvitge L’Hospitalet de LlobregatBarcelonaSpain Fundación Instituto para la Mejora de la Asistencia Sanitaria MadridSpain Hospital Clínico Universitario San Carlos MadridSpain Hospital Universitario 12 de Octubre MadridSpain

Background The prognostic role of diabetes mellitus(DM)in elderly patients with myocardial infarction-related cardiogenic shock(MI-CS)remains *** information exists about the impact of intensive cardiac care unit(ICCU)and revascularization on outcomes of elderly patients with *** aimed to assess the prognostic impact of DM according to age in patients with MI-CS,and to analyze the impact ICCU management and revascularization on in-hospital mortality in MI-CS patients at older *** Discharge episodes with diagnosis of CS associated with MI were selected from the Spanish National Health System’s Basic Data *** were classified according to their availability of *** outcome measured was in-hospital *** A total of 23,590 episodes of MI-CS were identified,of whom 12,447(52.8%)were in patients aged≥75 *** impact of DM on in-hospital mortality was different among age *** in younger patients,DM was associated to a higher mortality risk(0.52 vs.0.47,OR=1.12,95%CI:1.06–1.18,χ^2<0.001),this association became non-significant in older patients(0.76 vs.0.81,χ^2=0.09).Adjusted mortality rate of MI-CS aged≥75 years was lower in patients admitted to hospitals with ICCU(adjusted mortality rate:74.2%vs.77.7%,P<0.001)and in patients undergoing revascularization(74.9%vs.77.3%,P<0.001).Conclusions Prognostic impact of DM in patients with MI-CS was different according to age,with a significantly lower impact at older *** availability of ICCU and revascularization were associated with better outcomes in these complex patients.

关键词： cardiogenic shock Diabetes mellitus Myocardial infarction Revascularization The elderly

Management of mantle cell leukemia with cardiac involvement leading to cardiogenic shock

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Frontiers of Medicine 2014年第2期8卷 254-258页

作者： Muhammad Furqan Yamei Chen Akintunde Akinleye Judy Sarungbam Alan Gass Karen Seiter Delong Liu Division of Hematology and Oneology Department of Medicine Westchester Medical Center 100 Woods Rd Valhalla NY 10595 USA Department of Hematology Xiamen Zhongshan Hospital Xiamen University Xiamen 361004 China Department of Pathology Westehester Medical Center 100 Woods Rd Valhalla NY 10595 USA Division of Cardiology Department of Medicine Westchester Medical Center 100 Woods Rd Valhalla NY 10595 USA

Mantle cell lymphoma is an aggressive subtype of B cell non-Hodgkin lymphoma. It can progress to leukemic phase but frank leukemic picture at initial presentation is not common. Leukemic phase indicates advance stage of the disease and generally associated with extensive extra-nodal involvement. Pericardial invasion has been reported, however we could not find a report of myocardial infiltration by this disease since the appraisal of the term ＂mantle cell lymphoma＂ in 1992. Here we report a case of cardiac involvement by mantle cell leukemia leading to cardiogenic shock which complicates the treatment decisions.

关键词： mantle cell lymphoma bendamustine cardiogenic shock

Temporary coronary sinus pacing to improve ventricular dyssynchrony with cardiogenic shock: A case report

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World Journal of Clinical Cases 2021年第20期9卷 5562-5567页

作者： Teressa Reanne Ju Hsin Tseng Hsin-Ti Lin Alexander Lee Wang Chi Chan Lee Yi-Ching Lai Department of Internal Medicine NewYork-Presbyterian Queens HospitalQueensNY 11355United States School of Medicine China Medical UniversityTaichung City 40447Taiwan Department of Critical Care Medicine Guam Regional Medical CityDededo 96929Guam Department of Cardiology Division of Internal MedicineChina Medical University HospitalTaichung City 40447Taiwan

BACKGROUND Temporary transvenous pacing through the coronary sinus is a novel approach rarely used in treating unstable *** modality could provide cardiac pacing while achieving better ventricular *** present a case who received cardiac pacing through the coronary sinus and provide a summary of evidence in the current *** SUMMARY A 55-year-old woman with a history of advanced heart failure was admitted to the rehabilitation ward after a recent *** hospitalization,she had paroxysmal atrial fibrillation with rapid ventricular response resulting from fluid *** atrial fibrillation was spontaneously reversed to sinus rhythm after diuresis,she developed multiple episodes of polymorphic ventricular tachycardia along with sinus bradycardia and prolonged QTc *** became hypotensive despite appropriate medical *** through her implantable cardioverter-defibrillator was attempted but worsened her *** dyssynchrony was *** transvenous atrial pacing through the coronary sinus was performed,which stabilized her blood pressure and improved end-organ perfusion.A permanent biventricular pacemaker was later implanted,and she was safely discharged to a nursing *** Temporary transvenous pacing through the coronary sinus,a novel approach to treat unstable bradycardia,may reduce ventricular dyssynchrony.

关键词： Cardiac resynchronization Artificial pacemaker Coronary sinus Heart failure cardiogenic shock Case report

Thyrotoxicosis induced cardiogenic shock rescued by extracorporeal membrane oxygenation

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Journal of Geriatric Cardiology 2018年第2期15卷 203-204页

作者： Seunghwan Kim Sang-Hoon Seol Yun-Seok Kim Dong-Kie Kim Ki-Hun Kim Doo-Il Kim Department of Internal Medicine INJE University College of Medicine Haeundae Paik hospital Busan South Korea

Cardiomyopahty is one of complications of thyrotoxicosis. About 6% of thyrotoxic patients develop heart failure, but less than 1% of the patients progress dilated cardiomyopathy with systolic left ventricular dysthnct... 详细信息

关键词： cardiogenic shock Extracorporeal membrane oxygenation Thyrotoxic cardiomyopathy

Use of Impella cardiac axial flow pump for cardiogenic shock(A newer alternative)-How good is the evidence?

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BIOCELL 2022年第5期46卷 1139-1150页

作者： RAFIQ AHMED BHAT SYED MANZOOR ALI YOOSUF ALI ASHRAF MUHAMMAD HUSSENBOCUS AKANKSHA RATHI JAVAID AKHTER BHAT ABDUL ALEEM KHAN SYED MAQBOOL RAJA SAQIB IQBAL MD MONOWARUL ISLAM YONGSHENG QU YOU ZHANG YUXIAO SUN WENTAO XIAO ABHISHEK TIBREWAL CHUANYU GAO Zhengzhou University People’s Hospital Department of CardiologyFuwai Central China Cardiovascular HospitalZhengzhouChina Department of Cardiology Super Speciality DivisionGovernment Medical CollegeSrinagarIndia Department of Rheumatology and Immunology Nanjing Drum Tower Hospital Clinical College of Nanjing Medical UniversityNanjingChina Department of Community Medicine Vedanta Institute of Medical SciencesPalgharIndia State Key Laboratory of Crop Genetics and Germplasm Enhancement Nanjing Agricultural UniversityNanjingChina Department of Orthopaedics Nanjing First HospitalNanjing Medical UniversityNanjingChina Department of Paediatrics Batra Hospital and Medical Research CentreNew DelhiIndia Zhengzhou University First Affiliated Hospital ZhengzhouChina Department of Community Medicine Institute of Biostatistics and EpidemiologyGurgaonIndia

The adverse outcomes of a ventricular heart failure(left,right or biventricular)caused by cardiogenic shock are aggravated by lung oedema and organ mal *** advances in medical sciences,revascularisation and mechanical hemodynamic support have proved ineffective in reducing the mortality rate in such patients.A thorough study of the data available about cardio-vascular diseases reveals that the application of conventional methods of treatment are least helpful to practically restore normal functions of heart when it experiences end-stage systolic ventricular ***,to overcome the challenges and find alternatives to address this issue,percutaneous ventricular support devices/machines were designed and successfully *** devices have revolutionized the treatment of ventricular heart failures and are now in use all over the *** this review paper a newer mechanical circulatory support(MCS)device,Impella,has been discussed and compared with a few other devices like Intra-aortic Balloon Pump(IABP),Extracorporeal Circulation(ECLS)and Veno-arterial Extracorporeal Membrane Oxygenation(VA-ECMO).This article studies the challenges being faced during the treatment of cardiogenic shock,and thoroughly discusses the use and effectiveness of Impella Cardiac Axial Pump in each *** can be said that mechanical circulatory support(MCS)device use during percutaneous coronary intervention(PCI)should be individualized based on multiple factors with a recommended use in patients with the greatest potential benefit and a relatively low risk of device-related *** current literature suggests that the outcomes of use of Impella and other mechanical circulatory support devices like IABP and VA-ECMO are *** there seem to be a few advantages of Impella over the others,sufficiently powered,multi-centric,randomised control trials are needed to establish its superiority.

关键词： cardiogenic shock Hemodynamic support Impella Cardiac Axial Pump IABP VA-ECMO

An unusual case of renal calculi leading to myocardial infarction and cardiogenic shock

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World Journal of Emergency Medicine 2017年第2期8卷 148-150页

作者： Vanessa Santos James Espinosa Alan Lucerna Andrew Caravello Department of Emergency Medicine Rowan University SOM Kennedy University Hospital Stratford NJ USA

INTRODUCTION The presentation of cardiogenic shock （CS） is usually straightforward, and includes hypotension, absence of hypovolemia, and clinical signs of poor tissue perfusion such as oliguria, cyanosis, cool extremities and altered mentation. The most common etiology of CS is acute myocardial infarction, Here, we report a case of a 42-year-old male who presented with right flank pain, nausea and vomiting initially thought to be nephrolithiasis, which he had a history of but was ultimately diagnosed with CS due to a type II myocardial infarction. This case illustrates the importance of having a broad differential diagnosis especially when a patient＇s vital signs take a drastic turn since this patient initially resembled someone with nephrolithiasis.

关键词： myocardial infarction cardiogenic shock

Pulmonary artery catheterization in acute myocardial infarction complicated by cardiogenic shock:A review of contemporary literature

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World Journal of Cardiology 2021年第12期13卷 720-732页

作者： Shiva P Ponamgi Muhammad Haisum Maqsood Pranathi R Sundaragiri Michael G DelCore Arun Kanmanthareddy Wissam A Jaber William J Nicholson Saraschandra Vallabhajosyula Division of Cardiovascular Medicine Department of MedicineCreighton University School of MedicineOmahaNE 68154United States Department of Medicine Lincoln Medical Center/Cornell UniversityBronxNY 10451United States Department of Primary Care Internal Medicine Wake Forest Baptist HealthHigh PointNC 30260United States Section of Interventional Cardiology Division of Cardiovascular MedicineDepartment of MedicineEmory University School of MedicineAtlantaGA 30322United States Section of Cardiovascular Medicine Department of MedicineWake Forest University School of MedicineHigh PointNC 27262United States

Acute myocardial infarction(AMI)with left ventricular(LV)dysfunction patients,the most common cause of cardiogenic shock(CS),have acutely deteriorating hemodynamic *** frequent use of vasopressor and inotropic pharmacologic interventions along with mechanical circulatory support(MCS)in these patients necessitates invasive hemodynamic *** the pivotal Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial failed to show a significant improvement in clinical outcomes in shock patients managed with a pulmonary artery catheter(PAC),the use of PAC has become less popular in clinical *** this review,we summarize currently available literature to summarize the indications,clinical relevance,and recommendations for use of PAC in the setting of AMI-CS.

关键词： Pulmonary artery catheter Swan-ganz catheter Acute myocardial infarction cardiogenic shock Hemodynamic monitoring Interventional cardiology Critical care cardiology

Candidates and allocation time for extracorporeal membrane oxygenation in patients with cardiogenic shock

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Emergency and Critical Care Medicine 2021年第2期1卷 75-81页

作者： Baotao Huang Department of Cardiology West China HospitalSichuan UniversityChengduSichuanChina

Extracorporeal membrane oxygenation(ECMO)is a last resort life support in several patients with cardiogenic ***,appropriate candidates and optimal timing of ECMO initiation need to be *** present report reviewed relevant literatures to refine the allocation of ECMO in patients with cardiogenic *** PubMed database was searched from inception to October 5,2020,using the following search terms:"extracorporeal membrane oxygenation"or"mechanical circulatory support"AND"cardiogenic shock"or"cardiac arrest"or"myocardial infarction"or"fulminant myocarditis."The etiology of cardiogenic shock,widened QRS duration,QTc interval prolongation,cardiac arrest,dynamic narrowing of pulse pressure,and speed of lactate accumulation per unit time can be associated with the course of cardiogenic shock,and typically warn that advanced medical circulatory support is *** the critical moment when the circulatory status deteriorates sharply,an immediate physical examination combined with ready-to-use tools such as monitoring data or blood gas analysis results is crucial for assessing the appropriateness and timing of ECMO initiation.

关键词： Candidate cardiogenic shock Cardiovascular Extracorporeal membrane oxygenation Timing

Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock

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World Journal of Cardiology 2023年第9期15卷 439-447页

作者： Bashir Ahmed Solangi Jehangir Ali Shah Rajesh Kumar Mahesh Kumar Batra Gulzar Ali Muhammad Hassan Butt Ambreen Nisar Nadeem Qamar Tahir Saghir Jawaid Akbar Sial Department of Adult Cardiology National Institute of Cardiovascular DiseasesKarachi 75510Pakistan

BACKGROUND cardiogenic shock(CS)is a life-threatening complication of acute myocardial infarction with high morbidity and mortality *** percutaneous coro-nary intervention(PCI)has been shown to improve outcomes in patients with *** To investigate the immediate mortality rates in patients with CS undergoing primary PCI and identify mortality *** We conducted a retrospective analysis of 305 patients with CS who underwent primary PCI at the National Institute of Cardiovascular Diseases,Karachi,Pak-istan,between January 2018 and December *** primary outcome was immediate mortality,defined as mortality within index ***-variate and multivariate logistic regression analyses were performed to identify predictors of immediate *** In a sample of 305 patients with 72.8%male patients and a mean age of 58.1±11.8 years,the immediate mortality rate was found to be 54.8%(167).Multivariable analysis identified Killip class IV at presentation[odds ratio(OR):2.0;95%co-nfidence interval(CI):1.2-3.4;P=0.008],Multivessel disease(OR:3.5;95%CI:1.8-6.9;P<0.001),and high thrombus burden(OR:2.6;95%CI:1.4-4.9;P=0.003)as independent predictors of immediate *** Immediate mortality rate in patients with CS undergoing primary PCI remains high despite advances in treatment *** class IV at presentation,multivessel disease,and high thrombus burden(grade≥4)were identified as independent predictors of immediate *** findings underscore the need for aggressive management and close monitoring of patients with CS undergoing primary PCI,particularly in those with these high-risk characteristics.

关键词： Acute myocardial infarction cardiogenic shock Primary percutaneous coronary intervention Mortality Predictors