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Epidemiological survey of valvular heart disease for five years in a single cardiovascular center of Southern China: Changes in morbidity, etiological spectrum and management

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South China Journal of Cardiology 2015年第1期16卷 10-15页

作者：梁妍刘方舟吴书林 Department of Cardiology Guangdong Provincial Cardiovascular InstituteGuangdong General HospitalGuangdong Academy of Medical Sciences

Background valvular heart disease （VHD） is defined as a structural or functional abnormality in cardiac valve which encompasses a number of common cardiovascular conditions. This study was aimed to analyze the epidemiological changes of VHD in a single cardiovascular center of Southern China. Methods A total of 13,138 VHD patients of Guangdong general hospital from January 2011 to December 2013 were screened by transthoracic echocardiography （TTE） or transesophageal echocardiography （TEE） and enrolled for this study. The morbidity, etiological spectrum and management of these patients were analyzed. Continuous variables were expressed as mean _＋ standard deviation. Categorical variables were expressed as ratio or percentage. Results Patients in this study were divided into different groups and were analyzed throughout changes in morbidity, etiological spectrum and management. Conclusions The prevalence of VHD remains high in Southern China and RHD is still the leading etiology of VHD. But morbidity rate is reduced and surgery is still the main treatment option.

关键词： epidemiology valvular heart disease etiology cardiac valvular surgery

Mechanical versus biological prosthetic heart valves in pregnant women with valvular heart disease

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South China Journal of Cardiology 2021年第2期22卷 127-134,F0003页

作者： WU Shu-yan HAN Feng-zhen Department of Obstetrics Guangdong Provincial People*s HospitalGuangdong Academy of Medical SciencesGuangzhou 510080China

Background The pregnant women with a prosthetic heart valve(PHV)are considered to have a higher risk of cardiovascular,obstetric and fetal/neonatal complications when they underwent anticoagulation therapy in all 3 *** report evaluated the comparative results of pregnant women wearing mechanical and biological *** The outcomes of different types of PHV were assessed retrospectively in pregnant women in Guangdong Provincial People’s Hospital from January 2008 to May 2021.A total of 243 women(319 pregnancies)were enrolled and divided into mechanical PHV group and biological PHV group according to the types of PHV *** baseline data of all pregnancies were ***,obstetric and fetal/neonatal complications in 201 completed pregnancies of 165 women with different PHV were *** 319 pregnancies occurred,of which 201 pregnancies(165 women)≥20 weeks duration,including 159 pregnancies with mechanical PHV and 42 pregnancies with biological *** were more common in women with mechanical PHV[40 pregnancies(14.65%),≤20 weeks],while only one case was noted in women with biological PHV(P<0.05).The induced abortion rate of women with mechanical PHV(27.11%vs.6.52%,P<0.05)was significantly higher compared with that in women with biological *** incidence of cardiovascular,obstetric and fetal/neonatal complications was equally frequent in both groups after 20 weeks of *** Pregnant women with mechanical PHV were more likely to have a complication of miscarriages than those with biological PHV,mainly due to the anticoagulation *** the other hand,more women with mechanical PHV may choose not to become pregnant than women with biological PHV after counseling the risks of *** was no significant difference in other aspects of maternal and fetal complications after 20 weeks of *** who cannot maintain therapeutic anticoagulation and frequent monitoring of mechanical PHV may

关键词： pregnancy prosthetic heart valves valvular heart disease

The Problem of Rehospitalisation for heart Failure at the Cardiology Department of the Hôpital National Ignace Deen

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World Journal of Cardiovascular diseases 2024年第9期14卷 539-546页

作者： Samoura Sana Bah Mamadou Bassirou Soumaoro Morlaye Samoura Aly Koné Alpha Sylla Ibrahima Sory Samoura Sekouba Barry Ibrahim Sory Balde Elhadj Yaya Balde Mamadou Dadhi Hopital Sino-Guineen Conakry Guinea Hopital National Ignace Deen Conakry Guinea Hopital de Lamiti Sino-Guineenne Conakry Guinea

Introduction: Despite current therapeutic advances, heart failure in sub-Saharan Africa remains a common, serious and costly disease, particularly due to rehospitalizations. The objective of this work was to determine the proportion of rehospitalizations for heart failure and to identify etiological factors. Methodology: This was a retrospective descriptive study with a duration of 8 months from April 1 to November 30, 2021. This study included all patients rehospitalized in the department for heart Failure and who agreed to participate in our study. Results: During the period of our study, 437 patients were hospitalized in the HF department, among which we collected 126 cases of rehospitalization for HF with a frequency of 28.83%. The mean age of our patients was 46.32 ± 18.98 years with the extremes of 15 to 84 years. The most affected age group was between 35 and 44 years old in 24 cases, i.e. a frequency of 19%. We observed a female predominance of 64 cases, i.e. a frequency of 50.8% compared to 62 cases, i.e. a frequency of 49.2% with a sex ratio (M/F) equal to 0.96. 98 cases of our patients, i.e. a frequency of 77.8%, were mutual insurance companies who felt they had the necessary support from those around them. In our sample, the underlying heart disease was mainly represented by valvular heart disease in 59 cases, followed by hypertensive heart disease in 42 cases with the respective frequencies of 46.82% and 33.33%. The majority of our patients were rehospitalized (1 - 3) times after a first episode of HF flare-up in 117 cases or 92.9%. Irregularity at control and therapeutic break were the most common decompensation factors with frequencies of 75.8% and 74.2% respectively. The majority of our patients were rehospitalized (1 - 3) times after a first episode of HF flare-up in 117 cases or 92.9%. Irregularity at control and therapeutic break were the most common decompensation factors with frequencies of 75.8% and 74.2% respectively. Conclusion: It appears in

关键词： heart Failure Rehospitalisation valvular heart disease

Differences in the predictive value of red cell distribution width for the mortality of patients with heart failure due to various heart diseases

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Journal of Geriatric Cardiology 2015年第6期12卷 647-654页

作者： Yang ZHANG Yan WANG Jin-Suo KANG Jin-Xing YU Shi-Jie YIN Xiang-Feng CONG Xi CHEN Department of Clinical Laboratory Center Fuwai Hospital & Cardiovascular Institute Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China Department of heart Failure Center Fuwai Hospital & Cardiovascular Institute Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China

Background Increased red blood cell distribution width （RDW） is associated with adverse outcomes in patients with heart failure （HF）. The objective of this study was to compare the differences in the predictive value of RDW in patients with HF due to different causes. Methods We retrospectively investigated 1,021 HF patients from October 2009 to December 2011 at Fuwai Hospital （Beijing, China）. HF in these patients was caused by three diseases; coronary heart disease （CHD）, dilated cardiomyopathy （DCM） and valvular heart disease （VHD）. Patients were followed-up for 21 ~ 9 months. Results The RDW, mortality and survival duration were significantly different among the three groups. Kaplan-Meier analysis showed that the cumulative survival decreased significantly with increased RDW in patients with HF caused by CHD and DCM, but not in those with HF patients caused by VHD. In a multivariable model, RDW was identified as an independent predictor for the mortality of HF patients with CHD （P 〈 0.001, HR 1.315, 95% CI 1.122-1.543）. The group with higher N-terminal pro-brain natriuretic peptide （NT-proBNP） and higher RDW than median had the lowest cumulative survival in patients with HF due to CHD, but not in patients with HF due to DCM. Conclusions RDW is a prognostic indicator for patients with HF caused by CHD and DCM; thus, RDW adds important information to NT-proBNP in CHD caused HF patients.

关键词： Coronary heart disease Dilated cardiomyopathy heart failure Red blood cell distribution width valvular heart disease

Summary of the 2022 Report on Cardiovascular Health and diseases in China

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Chinese Medical Journal 2023年第24期136卷 2899-2908页

作者： Zengwu Wang Liyuan Ma Mingbo Liu Jing Fan Shengshou Hu on behalf of The Writing Committee of the Report on Cardiovascular Health and diseases in China National Center for Cardiovascular diseases Fuwai HospitalBeijing 100037China 不详

Recent decades have seen the remarkable development of China in medical accessibility and quality index,and the application of a number of new advanced cardiovascular technologies benefits more ***,according to the Annual Report on Cardiovascular Health and diseases in China published in this article,which was organized and summarized by National Center for Cardiovascular diseases,there is still a huge population living with risk factors of cardiovascular diseases(CVD),and the morbidity and mortality of CVD are *** is estimated that there are around 330 million patients suffering from CVD currently,including 245 million of hypertension,13 million of stroke,45.3 million of peripheral artery disease,11.39 million of coronary heart disease(CHD),8.9 million of heart failure,5 million of pulmonary heart disease,4.87 million of atrial fibrillation,2.5 million of rheumatic heart disease,and 2 million of congenital heart *** use,diet and nutrition factors,physical activity,overweight and obesity,and psychological factors are what affect cardiovascular health,while hypertension,dyslipidemia,diabetes,chronic kidney disease,metabolic syndrome,and air pollution are the risk factors for *** this article,in addition to risk factors for CVD,we also report the epidemiological trends of CVD,including CHD,cerebrovascular disease,arrhythmias,valvular heart disease,congenital heart disease,cardiomyopathy,heart failure,pulmonary vascular disease and venous thromboembolism,and aortic and peripheral artery diseases,as well as the basic research and medical device development in *** a word,China has entered a new stage of transforming from high-speed development focusing on scale growth to high-quality development emphasizing on strategic and key technological development to curb the trend of increasing incidence and mortality of CVD.

关键词： Epidemiology Cardiovascular disease Mortality Hypertension valvular heart disease heart failure Cardiomyopathy

heart valve disease in elderly Chinese population： effect of advanced age and comorbidities on treatment decision-making and outcomes

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Journal of Geriatric Cardiology 2016年第7期13卷 593-601页

作者： Kui HU Jun LI Yun WAN Tao HONG Shu-Yang LU Chang-Fa GUO Chun-Sheng WANG Department of Cardiovascular Surgery Zhongshan Hospital Fudan University Shanghai Institute of Cardiovascular Disease Shanghai China Department of Cardiovascular Surgery People's Hospital of Guizhou Province Guiyang Guizhou China Department of Endocrinology & Metabolism Huashan Hospital Fudan University Shanghai China

Background A considerable proportion of elderly patients with symptomatic severe heart valve disease are treated conservatively de- spite clear indications for surgical intervention. However, little is known about how advanced age and comorbidities affect treatment deci-sion-making and therapeutic outcomes. Methods Patients （n = 234, mean age： 78.5 ± 3.7 years） with symptomatic severe heart valve dis- ease hospitalized in our center were included. One hundred and fifty-one patients （65%） were treated surgically （surgical group） and 83 （35%） were treated conservatively （conservative group）. Factors that affected therapeutic decision-making and treatment outcomes were investi- gated and long-term survival was explored. Results Isolated aortic valve disease, female sex, chronic renal insufficiency, aged _〉 80 years, pneumonia, and emergent status were independent factors associated with therapeutic decision-making. In-hospital mortality for the surgical group was 5.3% （8/151）. Three patients （3.6%） in the conservative group died during initial hospitalization. Low cardiac output syndrome and chronic renal insufficiency were identified as predictors of in-hospital mortality in the surgical group. Conservative treatment was identi- fied as the single risk factor for late death in the entire study population. The surgical group had better 5-year （77.2% vs. 45.4%, P 〈 0.0001） and 10-year （34.5% vs. 8.9%, P 〈 0.0001） survival rates than the conservative group, even when adjusted by propensity score-matched analysis. Conclusions Advanced age and geriatric comorbidities profoundly affect treatment decision-making for severe heart valve disease. Valve surgery in the elderly was not only safe but was also associated with good long-term survival while conservative treatment was unfavorable for patients with symptomatic severe valve disease.

关键词： Long-term survival The elderly Treatment outcomes valvular heart disease

Risk of cardiovascular,cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2014年第7期20卷 1724-1745页

作者： Stefano Ballestri Amedeo Lonardo Stefano Bonapace Christopher D Byrne Paola Loria Giovanni Targher Division of Internal Medicine Pavullo Hospital41026 PavulloItaly Department of Biomedical Metabolic and Neural SciencesDivision of Internal Medicine NOCSAEUniversity of Modena and Reggio Emilia and Azienda USLBaggiovara41126 ModenaItaly Division of Cardiology "Sacro Cuore" Hospital37024 NegrarItaly Southampton National Institute for Health Research Biomedical Research Centre University Hospital SouthamptonSouthampton SO16 6YDUnited Kingdom Division of Endocrinology Diabetes and MetabolismDepartment of MedicineUniversity and Azienda Ospedaliera Universitaria Integrata37126 VeronaItaly

Non-alcoholic fatty liver disease(NAFLD)has emerged as a public health problem of epidemic proportions *** clinical and epidemiological evidence indicates that NAFLD is not only associated with liver-related morbidity and mortality but also with an increased risk of coronary heart disease(CHD),abnormalities of cardiac function and structure(e.g.,left ventricular dysfunction and hypertrophy,and heart failure),valvular heart disease(e.g.,aortic valve sclerosis)and arrhythmias(e.g.,atrial fibrillation).Experimental evidence suggests that NAFLD itself,especially in its more severe forms,exacerbates systemic/hepatic insulin resistance,causes atherogenic dyslipidemia,and releases a variety of pro-inflammatory,pro-coagulant and pro-fibrogenic mediators that may play important roles in the pathophysiology of cardiac and arrhythmic ***,these findings suggest that patients with NAFLD may benefit from more intensive surveillance and early treatment interventions to decrease the risk for CHD and other cardiac/arrhythmic *** purpose of this clinical review is to summarize the rapidly expanding body of evidence that supports a strong association between NAFLD and cardiovascular,cardiac and arrhythmic complications,to briefly examine the putative biological mechanisms underlying this association,and to discuss some of the current treatment options that may influence both NAFLD and its related cardiac and arrhythmic complications.

关键词： Non-alcoholic fatty liver disease Cardiovascular disease Cardiac complications Coronary heart disease Myocardial dysfunction valvular heart disease Arrhythmias Arrhythmic complications

Clinical outcomes in patients with native valve infective endocarditis and diabetes mellitus

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World Journal of Cardiology 2021年第1期13卷 11-20页

作者： Temidayo Abe Harry Onoriode Eyituoyo Gabrielle De Allie Titilope Olanipekun Valery Sammah Effoe Kikelomo Olaosebikan Paul Mather Department of Internal Medicine Morehouse School of MedicineAtlantaGA 30310United States Department of Internal Medicine Mercer University School of MedicineMaconGA 31207United States Department of Cardiovascular disease Morehouse School of MedicineAtlantaGA 30310United States Department of Medicine University of Debrecen Medical and Health Science CenterDebrecen 4032Hungary Department of Cardiovascular disease University of PennsylvaniaPennsylvaniaPA 19104United States

BACKGROUND There is a lack of data on the clinical outcomes in patients with native valve infective endocarditis(NVIE)and diabetes mellitus(DM).AIM To investigate(1)trends in the prevalence of DM among patients with NVIE;and(2)the impact of DM on NVIE *** We identified 76385 with NVIE from the 2004 to 2014 National Inpatient Sample,of which 22284(28%)had *** assessed trends in DM from 2004 to 2014 using the Cochrane Armitage *** compared baseline comorbidities,microorganisms,and in-patients procedures between those with vs without *** match analysis and multivariate logistic regression were used to investigate study outcomes in in-hospital mortality,stroke,acute heart failure,cardiogenic shock,septic shock,and atrioventricular *** Crude rates of DM increased from in 22%in 2004 to 30%in *** were significant differences in demographics,comorbidities and NVIE risk factors between the two *** aureus was the most common organism identified with higher rates in patients with DM(33.1%vs 35.6%;Pheart failure(4.6%vs 6.5%;P=0.001),cardiogenic shock(1.5%vs 1.9%;Pheart failure,atrial fibrillation,staphylococcus aureus,and older *** There is an increasing prevalence of DM in NVIE and it is associated with poorer *** studies are crucial to identify the clinical,and sociodemographic contributors to this trend and develop strategies to mitigate its attendant risk.

关键词： Infective endocarditis Native valve infective endocarditis Diabetes mellitus valvular heart disease Cardiovascular disease National Inpatient Sample

TLR2 was overexpressed independent of IL-6 in patients with valvular atrial fibrillation

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The Journal of Biomedical Research 2011年第3期25卷 178-184页

作者： Jian Wang Lei Xue Hailong Cao Fei Cui Ting Dai Yijiang Chen Department of Thoracic and Cardiovascular Surgery the First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu 210029 China Department of Pharmacology Nanjing Medical University Nanjing Jiangsu 210029 China.

Toll-like receptor 2 （TLR2） has recently been shown to be up-regulated in patients with non-valvular atrial fi-brillation （AF）. The present study was aimed to determine whether the pathogenesis and development of AF is associated with the up-regulation of TLR2. Clinical data and right atrial appendage （RAA） specimens were col-lected from 20 patients with persisten AF （PeAF）, 15 patients with paroxysmal AF （PaAF） and 13 patients with no history of AF undergoing valvular replacement. The results showed that gene expression and protein content of TLR2 were increased in both the AF subgroups, compared with the sinus rhythm （SR） group. Between the two AF subgroups, PaAF had a higher TLR2 level than PeAF. However, no difference in interluekin （IL）-6 content was found among the three groups, and no correlation was found between TLR2 and IL-6 in PeAF patients （r = 0.090, P = 0.706）, PaAF patients （r = 0.408, P = 0.131） and AF patients （r = -0.301, P = 0.079）. Immunohistochemical analysis revealed that TLR2 was distributed in RAAs of AF patients and confirmed the immunoblotting results. In conclusion, we demonstrated that TLR2 was elevated in AF （especially PaAF） patients with valvular heart disease, further implicating inflammation involved in the pathogenesis and development of AF.

关键词： Toll-like receptor 2 atrial fibrillation inflammation valvular heart disease