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Ventricular Arrhythmia in the Fontan Circulation:Prevalence,Risk Factors and Clinical Implications

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Congenital Heart Disease 2023年第5期18卷 507-523页

作者： Charis Tan Diana Zannino Carley Clendenning Sophie Offen Thomas LGentles Julian Ayer David Tanous Vishva Wijesekera Leeanne Grigg David Celermajer Mark McGuire Yves d’Udekem Rachael Cordina Department of Cardiothoracic Surgery Royal Prince Alfred HospitalCamperdownAustralia Sydney Medical School University of SydneyCamperdownAustralia Clinical Epidemiology and Biostatistics Unit Murdoch Children’s Research InstituteParkvilleAustralia Department of Cardiology Royal Prince Alfred HospitalCamperdownAustralia Department of Paediatric Cardiology Starship HospitalAucklandNew Zealand Department of Paediatric Cardiology The Children’s Hospital at WestmeadWestmeadAustralia Department of Cardiology Westmead HospitalWestmeadAustralia Adult Congenital Heart Disease Unit The Prince Charles HospitalBrisbaneAustralia Department of Cardiology The Royal Melbourne HospitalMelbourneAustralia Heart Research Institute CamperdownAustralia Department of cardiac Surgery The Royal Children’s Hospital MelbourneParkvilleAustralia Department of Paediatrics The University of MelbourneParkvilleAustralia

Objective:sudden cardiac death(SCD)and malignant ventricular arrhythmia(VA)are increasingly recognized as important issues for people living with a Fontan circulation,but data are *** sought to characterize the cohort who had sudden cardiac death,most likely related to VA and/or documented VA in the Australia and New Zealand Fontan Registry including risk factors and clinical ***:A retrospective cohort study was *** criteria were documented non-sustained ventricular tachycardia,sustained ventricular tachycardia,ventricular fibrillation,resuscitated cardiac arrest or SCD>30 days post-Fontan ***:Of 1611 patients,20(1.2%)had VA;14(1.0%)had VA without SCD and 6(deaths recorded in Registry;5 of those had documented VA at the time of arrest and 1 was presumed to be VA-associated).The median age at first VA was 20.5(14–32)years,10(50%)were females,and the median age at Fontan operation was 8(4–17)*** univariable analysis,hypoplastic left heart syndrome(p=0.03)and older age Fontan operation(pdeath or heart transplant(HR 3.27(1.19,8.98),p=0.02).Conclusions:A proportion of people living with a Fontan circulation have malignant *** VA screening in this cohort is *** data are needed to aid risk stratification.

关键词： Fontan congenital cardiac arrhythmia sudden cardiac death ventricular tachyarrhythmia

Acute lymphocytic myocarditis

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Journal of Geriatric Cardiology 2018年第7期15卷 527-528页

作者： Maedeh Ganji Jose Ruiz-Morales Saif Ibrahim Cardiology Department University of Florida Jacksonville FL USA Internal Medicine Department University of Florida Jacksonville FL USA Interventional Cardiology Department University of Alabama-Birmingham Birmingham AL USA

Myocarditis is an inflammatory disease of the myocardium. The clinical presentation of myocarditis may range from subclinical to sudden death. The incidence of fatal myocarditis, which often presents with sudden or rapid death, has been estimated at 0.15/100.000 in the general population and is highest in infants and young adults （but may affect any age group）. However, diffuse myocarditis in autopsies of sudden death is 〈 2% in adult.

关键词： Cardiomyopathy Myoearditis Heart attack STEMI sudden cardiac death

Postmortem imaging as a complementary tool for the investigation of cardiac death

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Forensic Sciences Research 2019年第3期4卷 211-222页

作者： Katarzyna Michaud Pia Genet Sara Sabatasso Silke Grabherr Lausanne University Hospital and University of Lausanne University Center of Legal Medicine Lausanne-GenevaLausanneSwitzerland Geneva University Hospital University Center of Legal Medicine Lausanne-GenevaGenevaSwitzerland

In the past 2 decades,modern radiological methods,such as multiple detector computed tomography (MDCT),MDCT-angiography,and cardiac magnetic resonance imaging (MRI)were introduced into postmortem practice for investigation of sudden death (SD),including cases of sudden cardiac death (SCD).In forensic cases,the underlying cause of SD is most frequently cardiovascular with coronary atherosclerotic disease as the leading *** are many controversies about the role of postmortem imaging in establishing the cause of death and especially the value of minimally invasive autopsy *** paper discusses the state of the art for postmortem radiological evaluation of the heart compared to classical postmortem examination,especially in cases of *** SCD cases,postmortem CT is helpful to estimate the heart size and to visualize haemopericardium and calcified plaques and valves,as well as to identify and locate cardiovascular *** methods are useful to provide a detailed view of the coronary arteries and to analyse them,especially regarding the extent and location of stenosis and *** postsurgical cases,it allows verification and documentation of the patency of stents and bypass grafts before opening the *** MRI is used to investigate soft tissues such as the myocardium,but images are susceptible to postmortem changes and further work is necessary to increase the understanding of these radiological aspects,especially of the ischemic *** postsurgery cases,the value of postmortem imaging of the heart is reportedly for the diagnostic and documentation *** implementation of new imaging methods into routine postmortem practice is challenging,as it requires not only an investment in equipment but,more importantly,investment in the expertise of interpreting the *** those requirements are implemented,however,they bring great advantages in investigating cases of SCD,as they allow documentation of the body,ori

关键词： Forensic sciences forensic pathology sudden cardiac death postmortem imaging postmortem CT-angiography minimally invasive autopsy autopsy

Comparison of the‘Seattle’and‘International’Criteria Electrocardiogram Interpretation in Division II Female Collegiate Athletes:A Preliminary Study

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Journal of Science in Sport and Exercise 2023年第3期5卷 274-279页

作者： Ludmila Cosio-Lima N.Kumar Brooke L.Adlof J.Simpson A.Crawley Y.Lee University of West Florida 11000 University Parkway#72/220PensacolaFL 32514USA

Purpose A 12-lead electrocardiogram(ECG)is a screening tool to detect abnormalities that may predispose athletes to sud-den cardiac *** standardized criteria have been introduced to better interpret ECG data,however this research has predominantly focused on male *** is important to include female athletes in research to better define ECG character-istics in this *** purpose of this study was to compare the Seattle and International Criteria ECG abnormalities in Division II female collegiate athletes of various *** Fifty-six females(age 20.2±1.4 years;height 1.70±0.7 m;weight 69.5±8.9 kg)completed a resting 12-lead ECG *** data was classified as‘normal’and‘abnormal’according to the parameters of each criterion and abnormal conditions were ***-square analysis was used to assess statistical comparisons between *** There was a significant difference in abnormal classifications as the total number of ECGs identified as abnormal using the Seattle Criteria decreased from 12(21.4%)to 2(3.6%)when using the International Criteria(P<0.05).African American athletes had a higher number of abnormal ECG’s compared to White and Latina athletes using the Seattle Criteria(P=0.03).Conclusions The International Criteria significantly reduces the total number of abnormal ECG readings in female collegiate athletes compared to the Seattle Criteria and did not overly identify African American athletes with *** research is necessary to expand on this study and clearly define criteria for female athletes of various ethnicities.

关键词： 12-lead ECG Female athletes sudden cardiac death ECG abnormalities

Pathology of atherosclerotic coronary artery disease in the young Indian population

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Forensic Sciences Research 2019年第3期4卷 241-246页

作者： Pradeep Vaideeswar Shashank Tyagi Saranya Singaravel Department of Pathology(Cardiovascular&Thoracic Division) Seth GS Medical College&KEM HospitalMumbaiIndia Department of Forensic Medicine&Toxicology Seth GS Medical College&KEM HospitalMumbaiIndia

Atherosclerotic coronary artery disease (CAD) is of great concern in young adults because of its potential to cause great *** arena of cardiology has gained importance in South Asian countries,particularly India due to increased prevalence that is related to traditional risk factors,altered life styles and inherent risk *** this study,we sought to evaluate,at autopsy,the pathology of atherosclerotic CAD in young patients with ischemic heart disease (IHD).A 10-year retrospective autopsy-based study was carried out in a large tertiary-care centre and patients aged ≤45 years with IHD were *** of 545 autopsied cases of IHD,95 patients (17.4%) were *** these 95 patients,84 (88.4%) had IHD related to atherosclerotic CAD;the youngest patient was 18years *** there was sole involvement of left anterior descending artery and the presence of fibrous *** of the plaque morphology,the commonest complication was thrombosis produced by plaque erosion seen in 36.9% of *** coronary insufficiency was noted in 52 patients (61.9%),while healed infarctions were surprisingly noted in 28 patients (33.3%).Screening for IHD in the young population may help to improve prognosis by detecting subclinical disease,although more studies are necessary to establish reference limits for this young *** research must also focus on treatment concerns that are specific to young patients.

关键词： Forensic sciences forensic pathology ischemic heart disease coronary atherosclerosis young adults sudden cardiac death

Myocarditis–A silent killer in athletes:Comparative analysis on the evidence before and after COVID-19 pandemic

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Sports Medicine and Health Science 2024年第3期6卷 232-239页

作者： Jonathan Van Name Kainuo Wu Lei Xi Virginia Commonwealth University School of Medicine(M.D.Class 2024) RichmondVA23298USA Pauley Heart Center Division of CardiologyDepartment of Internal MedicineVirginia Commonwealth UniversityRichmondVA23298-0204USA

Myocarditis is a rare cardiomyocyte inﬂammatory process,typically caused by viruses,with potentially devastating cardiac sequalae in both competitive athletes and in the general *** into myocarditis prevalence in the Coronavirus disease 2019(COVID-19)era suggests that infection with Severe acute respiratory syndrome coronavirus(SARS-CoV-2)is an independent risk factor for myocarditis,which is conﬁrmed mainly through cardiovascular magnetic resonance *** studies indicated that athletes have a decreased risk of myocarditis after recent COVID-19 infection compared to the general ***,given the unique nature of competitive athletics with their frequent participation in high-intensity exercise,athletes possess distinct factors of susceptibility for the development of myocarditis and its subsequent severe cardiac complications(e.g.,sudden cardiac death,fulminant heart failure,etc.).Under this context,this review focuses on comparing myocarditis in athletes versus non-athletes,owing special attention to the distinct clinical presentations and outcomes of myocarditis caused by different viral pathogens such as cytomegalovirus,Epstein-Barr virus,human herpesvirus-6,human immunodeﬁciency virus,and Parvovirus B19,both before and after the COVID-19 pandemic,as compared with *** illustrating distinct clinical presentations and outcomes of myocarditis in athletes versus non-athletes,we also highlight the critical importance of early detection,vigilant monitoring,and effective management of viral and non-viral myocarditis in athletes and the necessity for further optimization of the return-to-play guidelines for athletes in the COVID-19 era,in order to minimize the risks for the rare but devastating cardiac fatality.

关键词： COVID-19 Myocarditis Cardiovascular symptomatology Athlete susceptibility Return-to-play sudden cardiac death Viral pathogens High-intensity exercise

Cystic tumour of the atrioventricular node: case report and literature review

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Forensic Sciences Research 2019年第3期4卷 287-289页

作者： Stephen D.Cohle Spectrum Health Grand RapidsMIUSA

Cystic tumour of the atrioventricular node is the smallest tumour that can cause sudden cardiac *** lesion arises from foregut endodermal rests which become enfolded into the heart during *** causing heart block,the tumour can cause sudden death despite pacemaker *** death in such cases can be caused by arrhythmogenic ectopic foci arising from impaired electrical impulse propagation through the abnormal atrioventricular junction conducting tissue.

关键词： Forensic sciences forensic pathology cystic tumour of the AV node AV node tumour sudden cardiac death cardiac arrhythmias

Genetic basis of atrial fibrillation

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Genes & Diseases 2016年第4期3卷 257-262页

作者： Oscar Campuzano Alexandra Perez-Serra Anna Iglesias Ramon Brugada Cardiovascular Genetics Center University of GironaIDIBGISpain Department of Medical Sciences School of MedicineUniversity of GironaSpain Cardiomyopathies Unit Hospital Josep TruetaGironaSpain

Atrial fibrillation is the most common sustained arrhythmia and remains as one of main challenges in current clinical *** disease may be induced secondary to other diseases such as hypertension,valvular heart disease,and heart failure,conferring an increased risk of stroke and sudden *** studies have provided evidence that genetic factors play an important role and up to 30%of clinically diagnosed patients may have a family history of atrial *** date,several rare variants have been identified in a wide range of genes associated with ionic channels,calcium handling protein,fibrosis,conduction and *** advances in clinical,genetic and molecular basis have been performed over the last decade,improving diagnosis and ***,the genetics of atrial fibrillation is complex and pathophysiological data remains still unraveling.A better understanding of the genetic basis will induce accurate risk stratification and personalized clinical *** this review,we have focused on current genetics basis of atrial fibrillation.

关键词： Arrhythmia Atrial fibrillation Genetics Heart failure sudden cardiac death

Potential role of an athlete-focused echocardiogram in sports eligibility

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World Journal of Cardiology 2021年第8期13卷 271-297页

作者： Stefano Palermi Alessandro Serio Marco Vecchiato Felice Sirico Francesco Gambardella Fabrizio Ricci Franco Iodice Juri Radmilovic Vincenzo Russo Antonello D'Andrea Department University of Naples Federico IINaples 80131Italy Sport and Exercise Medicine Division Department of MedicineUniversity Hospital of PadovaPadova 35128Italy Department of Neuroscience Imaging and Clinical Sciences“G.d’Annunzio”University of Chieti-PescaraChieti 66100Italy Department of Clinical Sciences Faculty of MedicineLund UniversityClinical Research CenterMalmö21428Sweden Casa di Cura Villa Serena Pescara 65013Italy Unit of Cardiology Department of Translational Medical SciencesUniversity of Campania“Luigi Vanvitelli”Monaldi HospitalNaples 80131Italy Unit of Cardiology and Intensive Coronary Care “Umberto I”HospitalNocera Inferiore 84014Italy

sudden cardiac death(SCD)of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart *** screenings(PPs)have been conceived for the potential to prevent SCD in young athletes by early identification of cardiac *** European Society of Cardiology protocol for PPs includes history collection,physical examination and baseline electrocardiogram,while further examinations are reserved to individuals with abnormalities at first-line ***,transthoracic echocardiography has been hypothesized to have a primary role in the *** review aims to describe how to approach an athlete-focused echocardiogram,highlighting what is crucial to focus on for the different diseases(cardiomyopathies,valvulopathies,congenital heart disease,myocarditis and pericarditis)and when is needed to pay attention to overlap diagnostic zone(“grey zone”)with the athlete's *** properly tested,focused echocardiography by sports medicine physicians may become standard practice in larger screening practices,potentially available during first-line evaluation.

关键词： Echocardiogram Athletes Sport eligibility Pre-participation screening sudden cardiac death Sport cardiology