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The influence of pressure injury risk on the association between left ventricular ejection fraction and all-cause mortality in patients with acute myocardial infarction 80 years or older

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World Journal of Emergency Medicine 2023年第2期14卷 112-121页

作者： Bao-tao Huang Yi-heng Cheng Bo-sen Yang Yi-ke Zhang Fang-yang Huang Yong Peng Xiao-bo Pu Mao Chen Department of Cardiology West China HospitalSichuan UniversityChengdu 610041China

BACKGROUND: We aimed to investigate whether the pressure injury risk mediates the association of left ventricular ejection fraction(LVEF) with all-cause death in patients with acute myocardial infarction(AMI) aged 80 years or ***: This retrospective cohort study included 677 patients with AMI aged 80 years or older from a tertiary-level hospital. Pressure injury risk was assessed using the Braden scale at admission, and three risk groups(low/minimal, intermediate, high) were defined according to the overall score of six different variables. LVEF was measured during the index hospitalization for AMI. All-cause death after hospital discharge was the primary ***: Over a median follow-up period of 1,176 d(interquartile range [IQR], 722–1,900 d), 226(33.4%) patients died. Multivariate Cox regression analysis showed that reduced LVEF was associated with an increased risk of all-cause death only in the high-risk group of pressure injury(adjusted hazard ratios [HR]=1.81, 95% confidence interval [CI]: 1.03–3.20;P=0.040), but not in the low/minimal-(adjusted HR=1.29, 95%CI: 0.80–2.11;P=0.299) or intermediate-risk groups(adjusted HR=1.14, 95%CI: 0.65–2.02;P=0.651). Significant interactions were detected between pressure injury risk and LVEF(adjusted P=0.003). The cubic spline with hazard ratio plot revealed a distinct shaped curve relation between LVEF and all-cause death among different pressure injury risk ***: In older patients with AMI, the risk of pressure injury mediated the association between LVEF and all-cause death. The classification of older patients for both therapy and prognosis assessment appears to be improved by the incorporation of pressure injury risk assessment into AMI care management.

关键词： Pressure injuries left ventricular ejection fraction Death Geriatrics Myocardial infarction

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Interaction between the left ventricular ejection fraction and left ventricular strain and its relationship with coronary stenosis

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World Journal of Clinical Cases 2023年第10期11卷 2246-2253页

作者： Hai-Yan Gui Shu-Wen Liu Dong-Fang Zhu MRI Room Harbin No.4 HospitalHarbin 150026Heilongjiang ProvinceChina Department of Cardiology Harbin No.4 HospitalHarbin 150026Heilongjiang ProvinceChina

BACKGROUND Coronary artery stenosis(CAS)is the most common type of heart disease and the leading cause of death in both men and women *** occurs when the arteries that supply blood to the heart muscle harden and become narrower due to plaque buildup-cholesterol and other material-on their inner *** a result,the heart muscle cannot receive the blood or oxygen it *** heart attacks happen when a blood clot suddenly cuts off the hearts'blood supply,causing permanent heart *** To analyze the relationship between the left ventricular ejection fraction(LVEF),left ventricular strain(LVS),and coronary *** A total of 190 participants were enrolled in this *** control group comprised 93 healthy individuals,and observation group comprised 97 patients with coronary heart disease who were hospitalized between July 2020 and September *** lesions were assessed using the Gensini score,and the LVEF and LVS were measured using magnetic resonance imaging(MRI).The interaction between the LVEF and LVS was examined using a linear regression *** relationship between LVEF and coronary stenosis was examined using Spearman’s *** The LVEF of the observation group was lower than that of the control *** left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV)of the observation group were significantly higher than those of the control group(P<0.05).The longitudinal and circumferential strains(LS,CS)of the observation group were significantly higher than those of the control group;however,the radial strain(RS)of the observation group was significantly lower than that of the control group(P<0.05).LVS,LS,and CS were significantly negatively correlated with the LVEF,and RS was positively correlated with the *** were significant differences in the LVEF,LVESV,and LVEDV of patients with different Gensini scores;the LVEF significantly decreased and the LVESV and LVEDV increased w

关键词： Magnetic resonance imaging left ventricular ejection fraction left ventricular strain Coronary stenosis left ventricular end-diastolic volume left ventricular end-systolic volume

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Baseline left ventricular ejection fraction associated with symptom improvements in both children and adolescents with postural tachycardia syndrome under metoprolol therapy

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Chinese Medical Journal 2021年第16期134卷 1977-1982页

作者： Yuan-Yuan Wang Zhen-Hui Han Yu-Li Wang Ying Liao Chun-Yu Zhang Ping Liu Chao-Shu Tang Jun-Bao Du Hong-Fang Jin Ya-Qian Huang Department of Pediatrics Peking University First HospitalBeijing 100034China Department of Pediatrics Children’s Hospital of KaifengHenan 475000China Key Laboratory of Molecular Cardiovascular Sciences Ministry of EducationBeijing 100191China Department of Physiology and Pathophysiology Health Science CentrePeking UniversityBeijing 100191China.

Background:Postural tachycardia syndrome(POTS)is a common childhood disease that seriously affects the patient’s physical and mental *** study aimed to investigate whether pre-treatment baseline left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)values were associated with symptom improvement after metoprolol therapy for children and adolescents with ***:This retrospective study evaluated 51 children and adolescents with POTS who received metoprolol therapy at the Peking University First Hospital between November 2010 and July *** patients had completed a standing test or basic head-up tilt test and cardiac echocardiography before *** response was evaluated 3 months after starting metoprolol *** pre-treatment baseline LVEF and LVFS values were evaluated for correlations with decreases in the symptom score after treatment(DSS).Multivariable analysis was performed using factors with a P value of0.050).However,responders had significantly higher baseline LVEF(71.09%±4.44%vs.67.17%±4.88%,t=2.789,P=0.008)and LVFS values(40.00[38.00,42.00]%vs.36.79%±4.11%,Z=2.542,P=0.010)than the *** baseline LVEF and LVFS were positively correlated with DSS(r=0.378,P=0.006;r=0.363,P=0.009),*** regression analysis revealed that LVEF was independently associated with the response to metoprolol therapy in children and adolescents with POTS(odds ratio:1.201,95%confidence interval:1.039–1.387,P=0.013).Conclusions:Pre-treatment baseline LVEF was associated with symptom improvement after metoprolol treatment for children and adolescents with POTS.

关键词： Children left ventricular ejection fraction left ventricular fractional shortening Metoprolol Postural tachycardia syndrome

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Clinical characteristics and prognosis of heart failure with normal left ventricular ejection fraction in elderly patients

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Chinese Medical Journal 2012年第16期125卷 2853-2857页

作者： LIU De-ping WANG Fan ZENG Xue-zhai ZHANG Xin-chao Department of Cardiology Beijing Hospital theMinistry of Health of China Beijing 100730 China Department ofEmergency Beijing Hospital theMinistry of Health of China Beijing 100730 China

Background The term heart failure with normal ejection fraction （HFNEF） is often used to describe the syndrome of heart failure with normal ejection fraction. Based on the previous studies, HFNEF has a significant morbidity and mortality and is associated with a similar prognosis to heart failure with reduced ejection fraction （HFREF）. The present study aimed to investigate the clinical characteristics and prognosis of HFNEF in elderly patients. Methods Consecutive elderly patients （〉60 years old） hospitalized for the first episode of heart failure （HF） in Beijing Hospital from January 2003 to December 2009 were retrospectively recruited. Three hundred and ten patients with HF were eligible for our study. As recently recommended, a cut-off value of 50% was used to distinguish HFNEF （LVEF〉50%） from HFREF （LVEF〈50%）. Data were retrospectively obtained from hospital records and databases. Follow-up data were obtained by telephone and from hospital records. For every eligible patient, the clinical characteristics and prognosis were collected and compared between the HFNEF and HFREF groups. Results Patients with HFNEF accounted for 54.5% of all cases of elderly patients with HF. Compared with HFREF, the elderly patients with HFNEF had a higher proportion of females （62.1% vs. 32.6%, P 〈0.001）, higher body mass index （BMI）（（24.9±4.7） vs. （23.5±4.0） kg/m2, P=0.011）, higher systolic blood pressure at admission （（141.5±22.6） vs. （134.3±18.6） mmHg, P=0.002）, but lower hemoglobin levels （（118.3±22.7） vs. （125.8±23.8） g/L, P=0.005）. The incidence of coronary heart disease （43.2% vs. 65.2%, P 〈0.001） and myocardial infarction （16.6% vs. 46.1%, P 〈0.001） were significantly lower in elderly patients with HFNEF than in those with HFREF （P 〈0.001）. With a mean follow-up of 33.5 （0.5-93） months, 120 patients （38.7%） died, including 94 （30.3%） cardiac deaths. The HFNEF group had fewer deaths than the HFREF group at the end of the first follow-up （46/169 （27.2%） vs. 58/141 （41.1%）） an

关键词： heart failure left ventricular ejection fraction prognosis

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The Clinical Association of left Atrial Function with left ventricular ejection fraction

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World Journal of Cardiovascular Surgery 2023年第3期13卷 45-54页

作者： Vignendra Ariyarajah Hiten Patel Atif Shaikh Khurram Liaqat Sirin Apiyasawat Department of Medicine Heart Care Consultants New York USA Division of Cardiology The Brooklyn Hospital Center New York USA Southeastern Cardiology and Cardiovascular Clinic Lumberton North Carolina USA Cardiology Consultants of Philadelphia Limerick Pennsylvania USA Comanche County Memorial Hospital Lawton Oklahoma USA Division of Cardiology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand

The left atrium (LA) has been recognized as a morphophysiological barometer of left ventricular (LV) diastolic dysfunction. Because in the myocardial ischemia cascade where LV diastolic dysfunction often precedes LV systolic dysfunction, the LA which fashions as an early marker of diastolic anomaly, could equally reflect a declining LV function and/or be a good predictor of potential sequelae. We assessed this association of LA function with reduced LV systolic function among hospitalized patients. Among patients with reduced LV ejection fraction, LA passive ejection fraction was lower (0.172 ± 0.12 vs. 0.232 ± 0.14, p = 0.013) whereas LA kinetic energy was higher (6.48 ± 6.3 vs. 4.57 ± 3.5, p = 0.005). Echocardiographic assessment of LA function, therefore, appears correlated with LVEF and could be important when risk stratifying hospitalized patients.

关键词： left Atrial Function left Atrial Kinetic Energy left ventricular Function left ventricular ejection fraction Echocardiography

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left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

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World Journal of Cardiology 2024年第1期16卷 40-48页

作者： Farah Yasmin Abdul Moeed Rohan Kumar Ochani Hamna Raheel Malik Ali Ehtsham Awan Ayesha Liaquat Arisha Saleem Muhammad Aamir Nael Hawwa Salim Surani Department of Internal Medicine Yale University School of MedicineNew HavenCT 06511United States Department of Medicine Dow University of Health ScienceKarachi 74200SindhPakistan Department of Medicine SUNNY Upstate Medical UniversitySyracuseNY 13210United States Department of Cardiovascular Medicine Lehigh Valley Heart and Vascular InstituteAllentownPA 18105United States Department of Medicine Cleveland ClinicClevelandOH 44195United States Department of Medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

BACKGROUND left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIM To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of *** Systematic review and Meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology *** In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with *** A significant reduction in New York Heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT ***,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

关键词： left bundle branch pacing Biventricular pacing QRS duration left ventricular ejection fraction Heart failure

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Discharge heart rate and 1-year clinical outcomes in heart failure patients with atrial fibrillation

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Chinese Medical Journal 2022年第1期135卷 52-62页

作者： Fuwei Xing Xin Zheng Lihua Zhang Shuang Hu Xueke Bai Danli Hu Bing Li Jing Li Department of Cardiology The First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouGuangdong 510080China National Clinical Research Center for Cardiovascular Diseases NHC Key Laboratory of Clinical Research for Cardiovascular MedicationsState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeNational Center for Cardiovascular DiseasesBeijing 100037China Department of Cardiology The Third Hospital of Jilin UniversityChangchunJilin 130031China

Background: The association between heart rate and 1-year clinical outcomes in heart failure (HF) patients with atrial fibrillation (AF), and whether this association depends on left ventricular ejection fraction (LVEF), are unclear. We investigated the relationship between discharge heart rate and 1-year clinical outcomes after discharge among hospitalized HF patients with AF, and further explored this association that differ by LVEF ***: In this analysis, we enrolled 1760 hospitalized HF patients with AF from the China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure study from August 2016 to May 2018. Patients were categorized into three groups with low (<65 beats per minute [bpm]), moderate (65-85 bpm), and high (≥86 bpm) heart rate measured at *** proportional hazard models were employed to explore the association between heart rate and 1-year primary outcome, which was defined as a composite outcome of all-cause death and HF ***: Among 1760 patients, 723 (41.1%) were women, the median age was 69 (interquartile range [IQR]: 60-77) years, median discharge heart rate was 75 (IQR: 69-84) bpm, and 934 (53.1%) had an LVEF <50%. During 1-year follow-up, a total of 792 (45.0%) individuals died or had at least one HF hospitalization. After adjusting for demographic characteristics, smoking status, medical history, anthropometric characteristics, and medications used at discharge, the groups with low (hazard ratio [HR]: 1.32, 95% confidence interval [CI]: 1.05-1.68,P = 0.020) and high (HR: 1.34, 95% CI: 1.07-1.67,P = 0.009) heart rate were associated with a higher risk of 1-year primary outcome compared with the moderate group. A significant interaction between discharge heart rate and LVEF for the primary outcome was observed (P for interaction was 0.045). Among the patients with LVEF ≥50%, only those with high heart rate were associated with a higher risk of primary outcome compared with the g

关键词： Atrial fibrillation Heart failure Heart rate left ventricular ejection fraction

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Heart failure with preserved ejection fraction: A distinct heart failure phenotype?

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World Journal of Clinical Cases 2022年第32期10卷 12052-12055页

作者： Filippos Triposkiadis Grigorios Giamouzis John Skoularigis Andrew Xanthopoulos Department of Cardiology University Hospital of LarissaLarissa 41110Greece

The present work discusses the serious confusion resulting from the arbitrary nomenclature of heart failure with preserved ejection fraction(HFpEF),the presumed underlying pathophysiology,and the supposed features.A consequence of this misconception is that HFpEF trials have recruited patients with entirely different characteristics rendering the extrapolation of the results of one study to the other infeasible and dramatically affecting diagnosis and treatment.

关键词： Heart failure Preserved Nomenclature left ventricular ejection fraction Pathophysiology Phenotypic persistence

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Arrhythmia and its risk factors post myocardial infarction:A prospective study

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Journal of Acute Disease 2022年第1期11卷 26-31页

作者： Rajinder Sharma Ishfaq Chowdhary Ankita Sharma Department of Medicine Government Medical CollegeJammuIndia

Objectives:To determine the occurrence of arrhythmia and its associated risk factors in the first week after acute myocardial infarction(MI).Methods:A total of 100 patients with acute MI were recruited,who were followed up for one week to determine the occurrence of arrhythmia and its association with electrolyte disturbances,left ventricular ejection fraction(LVEF),and demographic *** and multivariate logistic regression was used to identify significant risk factors of ***:Among 100 cases,arrhythmia was seen in 27 *** tachycardia was the commonest,followed by ventricular premature beats and sinus *** fraction,serum calcium and magnesium were significantly different between non-arrhythmia and arrhythmia patients(Pejection fraction was an independent significant risk factor of *** with ejection fraction>40%had a significantly lower risk of arrhythmia with an adjusted odds ratio of 0.22(95%CI:0.08 to 0.64).Conclusions:Arrhythmia is common in the first week after myocardial *** type of arrhythmia and the type of block may depend on the heart muscles involved during myocardial *** fraction is a risk factor that may affect the occurrence of arrhythmia.

关键词： Arrhythmia Myocardial infarction left ventricular ejection fraction

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Long Term Follow-Up of Cardiotoxicity in Breast Cancer Treatment: A Case Report

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World Journal of Cardiovascular Diseases 2023年第3期13卷 130-137页

作者： Jose Luis Siller-Nava Adrian Espejel-Guzman Javier Serrano-Roman Aldo Cabello-Ganem Alexis D. Aparicio Ortiz Nilda Espinola-Zavaleta Department of Nuclear Cardiology National Institute of Cardiology Ignacio Chavez Mexico City Mexico Mexican Social Security Institute IMSS Mexico City Mexico Department of Echocardiography ABC Medical Center I.A.P. Mexico City Mexico

Background: Cardiac toxicity is currently defined as a symptomatic decrease in left ventricular ejection fraction (LVEF) of more than 5% or an asymptomatic decrease of at least 10% to a value of under 50% in repeated evaluations on conventional transthoracic echocardiogram (TTE), as well as a Global Longitudinal Strain (GLS) value Aims: To highlight using GLS rather than modified Simpson 2D-LVEF for the evaluation of long-term cardiotoxicity. Case Presentation: The case concerns a 73-year-old female patient with a history of breast cancer chemotherapy and anthracyclines-based therapy who presented symptoms of late cardiac toxicity related to the chemotherapeutic treatment. In the following years, the patient remained asymptomatic with a 2D-LVEF of 48%, dilation of the left atrium was found, and the reservoir phase strain was severely decreased. Conclusion: The preferred method for evaluating cardiovascular complications associated with chemotherapy is the TTE, which is performed prior to the start of treatment, during therapy, and in the follow-up. Myocardial deformation as a predictor of cardiotoxicity allows the identification of subclinical heart failure.

关键词： Cardiotoxicity Breast Cancer Global Longitudinal Strain left ventricular ejection fraction Heart Failure

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