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Ultrasound screening of multifocal atherosclerosis: markers for coronary heart disease

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Journal of Geriatric cardiology 2009年第1期6卷 31-37页

作者： Lachezar Grozdinski Mario Stankev Alexander Doganov Clinic of Vascular Surgery and angiology Clinic of Cardiology National Hospital of Cardiology Sofia Bulgaria Clinic of Vascular Surgery and Angiology Clinic of Cardiology National Hospital of Cardiology Sofia Bulgaria Clinic of Vascular Surgery and Angiology Clinic of Cardiology National Hospital of Cardiology Sofia Bulgaria

Background and Objective The frequency of multifocal atherosclerosis (MFA) in patients with coronary heart disease (CHD) has not been thoroughly studied. The purpose of our study was to perform ultrasound screening for MFA in patients with coronary atherosclerosis and make evaluation of the sensitivity and significance of different atherosclerosis markers. Methods Using Color Dupplex Ultrasound (CDU), we studied 32 clinically healthy persons and 87 patients of the city of B with clinical data for CHD where we also performed coronarography. Results In patients with coronary atherosclerosis we found high frequency of carotid atherosclerosis (93%) and peripheral artery disease (PAD) (81%). We established verifiable thickening of the intima-media (IMT) of the common carotid artery (CCA) and common femoral artery (CFA) in patients with CHD. There is a correlation between the frequency of carotid and femoral stenoses and CHD proven by coronarography. Patients with CHD had a high relative risk to develop carotid (RR = 5) and peripheral atherosclerosis (RR=3.5) and high frequency of asymptomatic stenoses and thromboses of the internal carotid artery (86.9%) and femoral artery (78.3%), as well as aneurisms of the abdominal aorta (8.1%). Markers for CAD with high sensitivity were the atherosclerotic plaques of ICA (0.93) and CFA (0.81) as well as IMT of the CFA (0.84). Conclusions MFA are common among patients with CHD. Ultrasound diagnosis is the method of choice for simultaneous non-invasive screening of carotid, peripheral and MFA and provides sensitive markers for coronary atherosclerosis. The most sensitive and specific markers for CHD are the combination of the IMT and atherosclerotic plaques of CCA, ICA and CFA (100% sensitivity and 0.92 specificity).

关键词： Color Duplex coronary heart disease peripheral artery disease carotid femoral artery atherosclerosis

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Journal of Geriatric cardiology 2023年第8期20卷 555-566页

作者： Alexander Schmitt Kathrin Weidner Jonas Rusnak Marinela Ruka Sascha Egner-Walter Kambis Mashayekhi Péter Tajti Mohamed Ayoub Ibrahim Akin Michael Behnes Tobias Schupp Department of cardiology AngiologyHaemostaseology and Medical Intensive CareUniversity Medical Centre Mannh-eimMedical Faculty MannheimHeidelberg UniversityMannheimGermany European center for AngioScience(ECAS) German Center for Cardiovascular Research(DZHK)partner site Heidelberg/MannheimMannheimGermany Depar-tment of Internal Medicine and cardiology Mediclin Heart Centre LahrLahrGermany Gottsegen György National Ca-rdiovascular center BudapestHungary Division of cardiology and angiology Heart Center University of Bochum-Bad OeynhausenBad OeynhausenGermany

BACKGROUND As a result of improved and novel treatment strategies,the spectrum of patients with cardiovascular disease is consistently ***,those patients are typically older and characterized by increased burden with *** data on the prognostic impact of age in cardiogenic shock(CS)is ***,this study investigates the prognostic impact of age in patients with *** From 2019 to 2021,consecutive patients with CS of any cause were *** prognostic value of age(i.e.,60-80 years and>80 years)was investigated for 30-day all-cause ***’s correlations,Kaplan-Meier analyses,as well as multivariable Cox proportional regression analyses were performed for *** risk assessment was performed based on the presence or absence of CS related to acute myocardial infarction(AMI).RESULTS 223 CS patients were included with a median age of 77 years(interquartile range:69-82 years).No significant difference in 30-day all-cause mortality was observed for both age-groups(54.6%vs.63.4%,log-rank P=0.169;HR=1.273,95%CI:0.886-1.831,P=0.192).In contrast,when analyzing subgroups stratified by CS-etiology,AMI-related CS patients of the group>80 years showed an increased risk of 30-day all-cause mortality(78.1%vs.60.0%,log-rank P=0.032;HR=1.635,95%CI:1.000-2.673,P=0.050),which was still evident after multivariable adjustment(HR=2.072,95%CI:1.174-3.656,P=0.012).CONCLUSIONS Age was not associated with 30-day all-cause mortality in patients with CS of mixed ***,increasing age was shown to be a significant predictor of increased mortality-risk in the subgroup of patients presenting with AMI-CS.

关键词： patients etiology mortality

High Fe‑Loading Single‑Atom Catalyst Boosts ROS Production by Density Effect for Efficient Antibacterial Therapy

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Nano-Micro Letters 2025年第2期17卷 187-203页

作者： Si Chen Fang Huang Lijie Mao Zhimin Zhang Han Lin Qixin Yan Xiangyu Lu Jianlin Shi Department of cardiology Shanghai Tenth People’s HospitalSchool of MedicineTongji UniversityShanghai 200092People’s Republic of China Shanghai Institute of Ceramics Chinese Academy of SciencesShanghai 200050People’s Republic of China Shanghai Frontiers Science center of Nanocatalytic Medicine School of MedicineTongji UniversityShanghai 200092People’s Republic of China

The current single-atom catalysts(SACs)for medicine still suffer from the limited active site ***,we develop a synthetic method capable of increasing both the metal loading and mass-specific activity of SACs by exchanging zinc with *** constructed iron SACs(h^(3)-FNC)with a high metal loading of 6.27 wt%and an optimized adjacent Fe distance of~4 A exhibit excellent oxidase-like catalytic performance without significant activity decay after being stored for six months and promising antibacterial ***,a“density effect”has been found at a high-enough metal doping amount,at which individual active sites become close enough to interact with each other and alter the electronic structure,resulting in significantly boosted intrinsic activity of single-atomic iron sites in h^(3)-FNCs by 2.3 times compared to low-and medium-loading ***,the overall catalytic activity of h^(3)-FNC is highly improved,with mass activity and metal mass-specific activity that are,respectively,66 and 315 times higher than those of commercial Pt/*** addition,h^(3)-FNCs demonstrate efficiently enhanced capability in catalyzing oxygen reduction into superoxide anion(O_(2)·^(−))and glutathione(GSH)*** in vitro and in vivo assays demonstrate the superior antibacterial efficacy of h^(3)-FNCs in promoting wound *** work presents an intriguing activity-enhancement effect in catalysts and exhibits impressive therapeutic efficacy in combating bacterial infections.

关键词： Nanocatalytic medicine Single-atom catalysts Reactive oxygen species(ROS) High metal loading Oxidase catalysis

Paclitaxel-eluting balloon dilation of biliary anastomotic stricture after liver transplantation

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World Journal of Gastroenterology 2015年第3期21卷 977-981页

作者： Anna Hüsing Holger Reinecke Vito R Cicinnati Susanne Beckebaum Christian Wilms Hartmut H Schmidt Iyad Kabar Department of Transplant Medicine University Hospital Münster48149 MünsterGermany Division of angiology Department of Cardiology and AngiologyUniversity Hospital Münster48149 MünsterGermany

AIM:To investigate the safety and effectiveness of endoscopic therapy with a paclitaxel-eluting balloon(PEB) for biliary anastomotic stricture(AS) after liver transplantation(LT).METHODS:This prospective pilot study enrolled 13 consecutive eligible patients treated for symptomatic AS after LT at the University Hospital of Münster between January 2011 and March *** patients were treated by endoscopic therapy with a PEB and followed up every 8 wk by endoscopic retrograde cholangiopancreatography(ERCP).In cases of re-stenosis,further balloon dilation with a PEB was ***-up was continued until 24 mo after the last ***:Initial technical feasibility,defined as successful balloon dilation with a PEB during the initial ERCP procedure,was achieved in 100% of ***-term clinical success(LTCS),defined as no need for further endoscopic intervention for at least 24 mo,was achieved in 12 of the 13 patients(92.3%).The mean number of endoscopic interventions required to achieve LTCS was only 1.7 ± *** failure,defined as the need for definitive alternative treatment,occurred in only one patient,who developed recurrent stenosis with increasing bile duct dilatation that required stent ***:Endoscopic therapy with a PEB is very effective for the treatment of AS after LT,and seems to significantly shorten the overall duration of endoscopic treatment by reducing the number of interventions needed to achieve LTCS.

关键词： Liver transplantation Anastomotic stricture Endosc

Combination of OCT and Raman spectroscopy for improved characterization of atherosclerotic plaque depositions

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Chinese Optics Letters 2017年第9期15卷 31-35页

作者： Kokila Egodage Christian Matthaus Sebastian Dochow Iwan W.Schie Carmen Hardtner Ingo Hilgendorf Jürgen Popp Leibniz Institute of Photonic Technology Albert Einstein Straβe 9Jena 07745Germany Institute of Physical Chemistry and Abbe center of Photonics Friedrich-Schiller-UniversityJena 07743Germany University Heart center Freiburg Department of Cardiology and Angiology IFaculty of MedicineUniversity of FreiburgGermany

The biochemical composition of atherosclerotic plaques is closely related to plaque stability and, therefore, to the associated risk of plaque evolution and rupture. Combinations of current imaging modalities, such as optical coherence tomography（OCT） with spectroscopic methods, therefore offer the possibility of concurrently obtaining morphological as well as chemical information. Raman spectroscopy is one of the most promising techniques that can be combined with intravascular imaging modalities. A microscopy setup merging both techniques has been applied to characterize plaque depositions of a human aorta affected by the disease. Calcified depositions were clearly identified and subsequently confirmed by histopathology.

关键词： Combination of OCT and Raman spectroscopy for improved characterization of atherosclerotic plaque depositions

Influence of cognitive impairment on cardiac mortality after percutaneous coronary intervention in very elderly patients: a retrospective observational study

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Journal of Geriatric cardiology 2019年第10期16卷 733-740页

作者： Tomoko Tomioka Ryokichi Takahashi Yosuke Ikumi Shuhei Tanaka Yoshitaka Ito Hiroki Shioiri Jiro Koyama Kanichi Inoue Department of cardiology South-Miyagi Medical Center

Background Cognitive impairment (CI) increases cardiac mortality among very elderly patients. Percutaneous coronary intervention (PCI) for ischemic heart disease (IHD) patients is considered a favorable strategy for decreasing cardiac mortality. Here, we investigated the influence of CI on cardiac mortality after PCI in very elderly patients. Methods We performed a retrospective observational analysis of patients who received PCI between 2012 and 2014 at the South Miyagi Medical center, Japan. IHD patients over 80 years old who underwent the Mini-Mental State Examination for CI screening during hospitalization and/or who had been diagnosed with CI were included. Participants were divided into CI and non-CI groups, and cardiac mortality and incidence of adverse cardiac events in a 3-year follow-up period were compared between groups. Statistical analyses were performed using the t-test,χ^2 test, and multivariable Cox regression analysis, with major comorbid illness and conventional cardiac risk factors as confounders. Results Of 565 patients, 95 were included (41 CI, 54 non-CI). Cardiac mortality during the follow-up period was significantly higher in the CI group (36%) compared with the non-CI group (13%)(OR = 4.3, 95% CI: 1.56–11.82, P < 0.05). CI was an independent cardiac prognostic factor after PCI and, for CI patients, living only with a CI partner was an independent predictor of cardiac death within three years. Conclusions CI significantly affected cardiac prognosis after PCI in very elderly patients, particularly those living with a CI partner. To improve patients’ prognoses, social background should be considered alongside conventional medical measures.

关键词： Cognitive impairments Family background Mortality Octogenarians Percutaneous coronary intervention

The coronavirus disease-19 pandemic and acute coronary syndrome:a specific impact in the elderly

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Journal of Geriatric cardiology 2022年第5期19卷 325-334页

作者： ViktorČulić Ahmed AlTurki Riccardo Proietti Department of cardiology and angiology University Hospital Centre SplitSplitCroatia University of Split School of Medicine SplitCroatia Division of cardiology McGill University Health CentreMontrealQuebecCanada Liverpool Centre for Cardiovascular Science University of LiverpoolLiverpoolUnited Kingdom

The coronavirus disease-19(COVID-19)pandemic has dramatically burdened healthcare systems worldwide by creating new public health *** addition to the most prevalent presentation of COVID-19 with mild to moderate respiratory symptoms,which occasionally progresses to acute respiratory distress syndrome,cardiovascular complications of COVID-19 include arterial and venous thromboembolic events(pulmonary embolism,acute myocardial infarction(MI)and ischemic stroke),myocarditis/myocardial injury.

关键词： acute respiratory distress

Cardiovascular mechanisms of thyroid hormones and heart failure:Current knowledge and perspectives

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World Journal of cardiology 2024年第5期16卷 226-230页

作者： Viktor Culic Department of cardiology and angiology University Hospital Centre SplitUniversity of Split School of MedicineSplit 21000Croatia

A multiple hormonal imbalance that accompanies heart failure(HF)may have a significant impact on the clinical course in such *** non-thyroidal illness syndrome(NTIS),also referred to as euthyroid sick syndrome or low triiodothyronine syndrome,can be found in about 30%of patients with *** represents a systemic adaptation to chronic illness that is associated with increased cardiac and overall mortality in patients with *** conclusions on thyroid-stimulating hormone,free triiodothyronine,total and free thyroxine are currently unresolved,serum total triiodothyronine levels and the ratio of free triiodothyronine to free thyroxine seem to provide the best correlates to the echocardiographic,laboratory and clinical parameters of disease *** patients with either hyper-or hypothyroidism should be treated according to the appropriate guidelines,but the therapeutic approach to NTIS,with or without HF,is still a matter of *** treatment options include better individual titration of levothyroxine therapy,combined triiodothyronine plus thyroxine therapy and natural measures to increase *** research should further examine the cellular and tissue mechanisms of NTIS as well as new therapeutic avenues in patients with HF.

关键词： Heart failure Non-thyroidal illness syndrome Low triiodothyronine syndrome Therapy Thyroxine Triiodothyronine

Congenital left ventricular aneurysms and diverticula： an entity in search of an identity

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Journal of Geriatric cardiology 2017年第12期14卷 750-762页

作者： Marc-Alexander Ohlow Heart center Department of Cardiology Zentralklinik Bad Berka Germany

Congenital left ventricular aneurysm or diverticulum are rare cardiac malformations described in 809 cases since the first description in 1816, being associated with other cardiac, vascular or thoraco-abdominal abnormalities in about 70%. It appears to be a developmental anomaly, starting in the 4th embryonic week. In an experimental study, targeted knockdown of cardiac troponin T in the chick was performed at day 3, after the heart tube has formed. Morpholino treatment of gene TNNT2 at this stage led to the development of left ventricular diver- ticula （LVD） in the primitive left ventricular wall. Diagnosis of left ventricular aneurysms （LVA）/LVD can be made after exclusion of coro- nary artery disease, local or systemic inflammation or traumatic causes as well as cardiomyopathies. Clinically, most of LVA and LVD are asymptomatic or may cause systemic embolization, congestive heart failure, valvular regurgitation, ventricular wall rupture, ventricular tachycardia or sudden cardiac death. Diagnosis is established by imaging studies （echocardiography, magnetic resonance imaging or left ventricular angiography） visualizing the structural changes and accompanying abnormalities. Mode of treatment has to be individually tai- lored and depends on clinical presentation, accompanying abnormalities and possible complications, options include surgical resection （espe- cially in symptomatic patients）, anticoagulation after systemic embolization, radiofrequency ablation or implantation of an implantable car- dioverter defibrillator （ICD） in case of symptomatic ventricular tachycardias, and occasionally combined with class I- or III-antiarrhythmic drugs. Cardiac death occurs usually in childhood, is significantly more frequent in LVA patients and caused by congestive heart failure in most of the cases, whereas patients diagnosed with LVD died more frequently from rupture of the LVD.

关键词： Aneurysm Congenital Diverticulum Left ventricular Prognosis Therapy