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Patterns of Mortality Occurrence in a cardiology unit of a Low-Income Country: A Critical Analysis at the YaoundéCentral Hospital

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World Journal of Cardiovascular Diseases 2021年第2期11卷 126-134页

作者： Liliane Mfeukeu Kuaté Mazou Ngou Temgoua Hamadou Ba Chris Nadège Nganou Doriane Mbono Bidias Ndongo Joel Nouktadie Tochie Eugene Sobngwi Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon cardiology unit Central Hospital of Yaoundé Yaoundé Cameroon

Background: In-hospital mortality is high in low-income countries. Currently, little is known in Cameroon concerning the characteristics of patients who die in cardiology units. Our objectives were to determine the in-hospital mortality rate;describe the general characteristics of death patients, and factors associated with mortality. Material and Methods: We conducted a retrospective cross-sectional study by reviewing the medical records of all patients admitted to the cardiology unit of the Yaoundé Central Hospital (CHY) between January 2018 andJanuary 2019. The files of all death patients were studied for socio-demographical, clinical and therapeutical variables. Bivariate analysis was conducted to order to check the association between independents variables and time of death. A p-value 0.05 was considered statistically significant. Results: A total number of 860 patients were admitted in the cardiology unit of CHY during the study period. Amongst the 860 patients admitted 78 had a fatal outcome, hence, an in-hospital mortality rate of 9.06%. The male gender was predominant amongst the deceased patients (n = 45). The mean age at death was 69 ± 15.19 years. The median time before death was 6 days and they ranged between 1 to 25 days. Hypertension was the most frequent comorbidity (65.4%). Stroke was the principal cause of admission (40.3%), whereas the main presenting complaint was dyspnea (26.9%). Before being a

关键词： Mortality Occurrence Low Income Country Yaoundé Central Hospital Criti-cal Analysis

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Relationship between longitudinal changes in lipid composition and ischemic stroke among hypertensive patients

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World Journal of Clinical Cases 2025年第4期13卷 18-27页

作者： Cheng-Cheng Wei Yu-Qing Huang Cheng-Hong Yu Department of cardiology Tongxiang First People's HospitalTongxiang 314500Zhejiang ProvinceChina Department of cardiology Guangdong Cardiovascular InstituteGuangzhou 510080Guangdong ProvinceChina

BACKGROUND Dyslipidemia was strongly linked to stroke,however the relationship between dyslipidemia and its components and ischemic stroke remained *** To investigate the link between longitudinal changes in lipid profiles and dyslipidemia and ischemic stroke in a hypertensive *** Between 2013 and 2014,6094 hypertension individuals were included in this,and ischemic stroke cases were documented to the end of *** changes of lipid were stratified into four groups:(1)Normal was transformed into normal group;(2)Abnormal was transformed into normal group;(3)Normal was transformed into abnormal group;and(4)Abnormal was transformed into abnormal *** examine the link between longitudinal changes in dyslipidemia along with its components and the risk of ischemic stroke,we utilized multivariate Cox proportional hazards models with hazard ratio(HR)and 95%*** The average age of the participants was 62.32 years±13.00 years,with 329 women making up 54.0%of the *** the course of a mean follow-up of 4.8 years,143 ischemic strokes *** normal was transformed into normal group was used as a reference,after full adjustments,the HR for dyslipidemia and ischemic stroke among abnormal was transformed into normal group,normal was transformed into abnormal group and abnormal was transformed into abnormal Wei CC et *** changed and ischemic stroke WJCC https://*** 2 February 6,2025 Volume 13 Issue 4 group were 1.089(95%CI:0.598-1.982;P=0.779),2.369(95%CI:1.424-3.941;P<0.001)and 1.448(95%CI:1.002-2.298;P=0.047)(P for trend was 0.233),*** In individuals with hypertension,longitudinal shifts from normal to abnormal in dyslipidemia-particularly in total and low-density lipoprotein cholesterol-were significantly associated with the risk of ischemic stroke.

关键词： Longitudinal change Hypertension Dyslipidemia Lipid profile Ischemic stroke

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Epidemioclinics, Etiologies and Prognosis of Cardiogene Shock State in the Intensive Care unit of the cardiology Department of the G-Spot Hospital

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World Journal of Cardiovascular Diseases 2021年第1期11卷 20-24页

作者： Mariam Sako Massama Konaté Boubacar Sonfo Samba Sidibé Nouhoum Diallo Fatoumata Diarra Mamadou Diakité Coumba Adiaratou Thiam Asmao Keita Ibrahima Sangaré Hamidou Omar Bâ Youssouf Camara Yves Roland Koumaré Alou Sangaré Boureïma Dembélé Ami Diarra Souleymane Coulibaly Ichacka Minta cardiology Department Point “G” Hospital University Center Bamako Mali cardiology Department Hospital MALI Bamako Mali cardiology Department Hospital KATI Bamako Mali cardiology Department Hospital LUXEMBOURG Bamako Mali cardiology Department Gabriel Touré Hospital University Center Bamako Mali

Objective: The work aimed to describe the etiological and evolutionary aspects of cardiogenic shock in the intensive care unit of the cardiology department (USIC) of the G-spot hospital in Bamako, Mali. Materials and Methods: This was a descriptive cross-sectional study from January 1, 2018 to April 30, 2019 that included all patients admitted to the USIC during this period. Each patient benefited from individual data support with systematic recording of socio-demographic, clinical, complementary and therapeutic data and analyzed with the SOFTWARE SPSS 20.0 French version. Results: The study involved 40 patients out of 311 patients hospitalized in USIC, representing a hospital frequency of 12.86%. Males were the most affected (60%) with a sex ratio of 1.50. The modal class was 41 - 60 years with extremes at 18 years and 89 years. Cardiovascular risk factors were dominated by HTA (27.50%), diabetes and tobacco, each with 22.50%. The general signs were tachycardia (90%), oxygen desaturation (77.50%), impregnable blood pressure (62.50%), agitation (52.50%) and an oliguria (70%). At the electrocardiogram the rhythm was sinus (80%), it was an atrial fibrillation (15%), a ventricular tachycardia (10%) and signs of coronary ischemia (necrosis in 35% and ST over shifted in 20% of cases). At cardiac doppler ultrasound,the left ventricle was dilated (50%), the right cavities dilated (30%), segmental kinetic disorder (40%), the left ventricular systolic function (FEVG) impaired (75%) and valve disease (10%). Biology noted hyper-creatinemia (65%), hyper-glycemia (12.50%), anemia and hyponatremia with 20% frequency each. Among etiology, ischemic heart disease accounted for 57.50% followed by pulmonary embolism 20%, dilated valve cardiomyopathy 7.50% and chronic pulmonary heart 2.50%. The trend in the majority of cases was unfavorable with 60% of deaths. Chronic pulmona

关键词： Cardiogenic Shock Etiology Prognostic USIC Hospital Point G

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Fanlian Huazhuo formula:A promising therapeutic approach for metabolic associated steatotic liver disease

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World Journal of Gastroenterology 2025年第1期31卷 167-171页

作者： Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng Department of Medical Education Linkou Chang Gung Memorial HospitalTaoyuan 33305Taiwan Division of cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei 23561Taiwan Division of cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002Taiwan Department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404328Taiwan

This article reviews the study,“Fanlian huazhuo formula alleviates high-fat-dietinduced nonalcoholic fatty liver disease by modulating autophagy and lipid synthesis signaling pathway”published in the World Journal of *** study explores the therapeutic potential of Fanlian Huazhuo formula(FLHZF)in treating metabolic-associated steatotic liver disease(MASLD),demonstrating that FLHZF reduces lipid accumulation,oxidative stress,and liver injury in MASLD models by modulating key signaling pathways involved in lipid metabolism and *** editorial emphasizes the potential of FLHZF as a treatment for MASLD and calls for further research to verify its clinical efficacy.

关键词： Fanlian Huazhuo formula Metabolic associated steatotic liver disease Autophagy Lipid metabolism Oxidative stress

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Transcatheter aortic valve implantation： a revolution in the therapy of elderly and high-risk patients with severe aortic stenosis

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Journal of Geriatric cardiology 2017年第3期14卷 204-217页

作者： Teoman Kilic Irem Yilmaz Invasive cardiology Research and Application unit Department of Cardiology Kocaeli University Kocaeli Turkey Department of cardiology Kocaeli University Kocaeli Turkey

Transcatheter aortic valve implantation （TAV1） represents a real revolution in the field of interventional cardiology for the treatment of elderly or high-risk surgical patients with severe symptomatic aortic valve stenosis. Today, TAVI seems to play a key and a reliable role in the treatment of intermediate and maybe low-risk patients with severe aortic stenosis. TAVI has also evolved from a complex and hazardous procedure into an effective and safe therapy by the development of new generation devices. This article aims to review the background and future of TAVI, elinieal trials and registries with old and new generation TAVI devices and to focus on some open issues related to post-procedural outcomes.

关键词： High risk patients The elderly Transcatheter aortic valve implantation

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Is dual therapy the correct strategy in frail elderly patients with atrial fibrillation and acute coronary syndrome?

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Journal of Geriatric cardiology 2020年第1期17卷 51-57页

作者： Alessio Menditto Roberto Antonicelli cardiology unit Italian National Research Centre on Aging

Atrial fibrillation(AF)is a very common arrhythmia in clinical *** incidence and prevalence are age-related and are growing in the last *** is a risk factor also for coronary artery disease(CAD),and with the evolution of preventive care,the first event(acute coronary syndrome(ACS)or percutaneous coronary intervention(PCI))takes place at a later *** elderly patients with AF and CAD undergo ACS or PCI,they have indication to assume triple *** therapy(oral anticoagulation(OAC)plus dual antiplatelet therapy(DAPT))exposes patients to high bleeding *** the last 10 years,several clinical trials have tested dual therapy(OAC plus single antiplatelet therapy)in AF patients who undergo ACS or elective *** trial has tested warfarin+clopidogrel against triple *** AF-PCI trial has tested low-dose rivaroxaban+P2Y12 inhibitor or very low-dose rivaroxaban+DAPT against standard triple therapy with ***-DUAL PCI trial has tested two doses of dabigatran+P2Y12 inhibitor against standard triple therapy with *** trial has tested apixaban against warfarin both in dual therapy with P2Y12 inhibitor and in triple therapy with a P2Y12 inhibitor and ***-AF PCI,last published study,has tested edoxaban+P2Y12 inhibitor against triple *** these trials show dual therapy reduces significantly bleeding risk than triple *** this paper,we analyze these clinical trials to understand if dual therapy results can be applied to elderly patients and what is probably the better approach in elderly AF patients undergo to ACS or PCI.

关键词： Acute coronary syndrome Atrial fibrillation Dual therapy Oral anticoagulation The elderly

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Externalized conductors and insulation failure in Biotronik defibrillator leads: History repeating or a false alarm?

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World Journal of Clinical Cases 2017年第2期5卷 27-34页

作者： Elia De Maria Ambra Borghi Lorenzo Bonetti Pier Luigi Fontana Stefano Cappelli cardiology unit Ramazzini Hospital

Conductor externalization and insulation failure are frequent complications with the recalled St. Jude Medical Riata implantable cardioverter-defibrillator(ICD) leads. Conductor externalization is a "unique" failure mechanism: Cables externalize through the insulation("inside-out" abrasion) and appear outside the lead body. Recently, single reports described a similar failure also for Biotronik leads. Moreover, some studies reported a high rate of electrical dysfunction(not only insulation failure) with Biotronik Linox leads and a reduced survival rate in comparison with the competitors. In this paper we describe the case of a patient with a Biotronik Kentrox ICD lead presenting with signs of insulation failure and conductor externalization at fluoroscopy. Due to the high risk of extraction we decided to implant a new lead, abandoning the damaged one; lead reimplant was uneventful. Subsequently, we review currently available literature about Biotronik Kentrox and Linox ICD lead failure and in particular externalized conductors. Some single-center studies and a nonprospective registry reported a survival rate between 88% and 91% at 5 years for Linox leads, significantly worse than that of other manufacturers. However, the preliminary results of two ongoing multicenter, prospective registries(GALAXY and CELESTIAL) showed 96% survival rate at 5 years after implant, well within industry standards. Ongoing data collection is needed to confirm longer-term performance of this family of ICD leads.

关键词： Implantable cardioverter defibrillator Biotronik implantable cardioverter defibrillator lead Externalized conductors Insulation failure

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Ventricular Septal Crypts:Remnants of Spontaneous Interventricular Defect Closure?

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Congenital Heart Disease 2023年第1期18卷 1-6页

作者： Alberto Cresti Stefania Sparla Stefania Stefanelli Andrea Picchi Ugo Limbruno cardiology unit Misericordia HospitalGrossetoItaly

Background:Ventricular crypts are quite a common finding during cardiac imaging,but their etiology is unclear.A possible final result of a spontaneous ventricular septal defect closure has been supposed but never investigated in earlier ***:From January 1997 to December 2020,all newborns diagnosed to have a ventricular septal defect were prospectively entered in our database and those with an isolated defect were included in the *** septal defects were classified into four types:perimembranous,trabecular muscular,inlet and outlet.A long-term follow up was performed in order to visualize the possible residual formation of a septal myocardial ***:A total of 376 isolated ventricular septal defects(314 muscular and 54 perimembranous,4 inlet,4 outlet)were *** up ranged from 1 to 23 years and showed that,among muscular type,a spontaneous closure occurred in 284(91%),26 did not close(8,28%),2 required surgical intervention(0,63%),3 were lost at follow up(0,95%).During this period,after spontaneous defect closure closure,20 crypts were found(6,4%).Conclusion:This study shows that a muscular ventricular septal defect may evolve in the 6.4%of cases in a residual septal *** septal crypts occur more frequently in patients affected by hypertrophic and hypertensive cardiomyopathy,they may also represent the evolution of a spontaneous closure of a muscular interventricular defect.

关键词： Ventricular crypts ventricular septal defect cardiac imaging

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New skin closure system facilitates wound healing after cardiovascular implantable electronic device surgery

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World Journal of Clinical Cases 2015年第8期3卷 675-677页

作者： Elia De Maria cardiology unit Ramazzini Hospital

The manuscript describes the efficacy of a new skin closure system(Zip Line?) for wound closure after pacemaker/implantable cardioverter defibrillator surgery. The system is particularly useful when wound healingis difficult with traditional methods and in patients at high risk for surgical site infections(SSIs). This skin closure option is easy and quick to apply and remove, and produces excellent cosmetic results. Although it is associated with a minimal expense upcharge, the benefits, including the potential for decrease in SSI, make it attractive and worth considering for skin closure in device patients, particularly those at increased risk of complications.

关键词： Cardiovascular implantable electronic device infection Surgical wound Skin closure system

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Ticagrelor therapy and atrioventricular block:Do we need to worry?

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World Journal of Clinical Cases 2017年第5期5卷 178-182页

作者： Elia De Maria Ambra Borghi Letizia Modonesi Stefano Cappelli cardiology unit Ramazzini Hospital

Ticagrelor is a potent,direct P2Y12 antagonist with rapid onset of action and intense platelet inhibition,indicated in patients with acute coronary syndromes(ACS).This drug is usually well tolerated,but some patients experience serious adverse effects:Major bleeding;gastrointestinal disturbances;dyspnoea;ventricular pauses > 3 *** the unexpected high incidence of bradyarrhythmias,a PLATO substudy monitored this side effect,showing that ticagrelor was associated with an increase in the rate of sinus bradycardia and sinus arrest compared to *** side effect was usually transient,asymptomatic and not associated with higher incidence of severe atrioventricular(AV) block or pacemaker needs.A panel of experts from Food and Drug Administration did not consider bradyarrhythmias a serious problem in clinical practice and,accordingly,current labeling of the drug does not give any precaution or contraindication regarding this ***,recently some articles have described ACS patients with high-degree,life-threatening,AV block requiring drug discontinuation and,in some cases,pacemaker *** this paper,we describe and discuss five published case reports of severe AV block following ticagrelor therapy and two other cases managed in our *** analysis of literature suggests that,although rarely,ticagrelor can be associated with lifethreatening AV *** and careful monitoring are required especially in patients with already compromised conduction system and/or treated with AV blocking *** studies,with long-term rhythm monitoring,would help to define the outcome of patients at higher risk of developing this complication.

关键词： Ticagrelor Atrioventricular block

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