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Effect of negative remodeling of the side branch ostium on the efficacy of a two-stent strategy for distal left main bifurcation lesions:an intravascular ultrasound study

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Journal of Geriatric cardiology 2024年第5期21卷 506-522页

作者： Yi XU Tian XU Jia-Cong NONG Xiao-Han KONG Meng-Yao ZHAO Zhi-Jing GAO Yi-Fei WANG Wei YOU Pei-Na MENG Yu-He ZHOU Xiang-Qi WU Zhi-Ming WU Mei-En ZHAN Yan-Qing WANG De-Feng PAN Fei YE Department of cardiology Nanjing First HospitalNanjing Hospital Affiliated to Nanjing Medical UniversityNanjing Medical UniversityNanjingChina Department of cardiology Clinical Medicine School of Nanjing UniversityNanjingChina Department of cardiology Tianchang People’s HospitalTianchangChina Department of cardiology the Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina

OBJECTIVES To investigate whether negative remodeling(NR) detected by intravascular ultrasound(IVUS) of the side branch ostium(SBO) would affect in-stent neointimal hyperplasia(NIH) at the one-year follow-up and the clinical outcome of target lesion failure(TLF) at the long-term follow-up for patients with left main bifurcation(LMb) lesions treated with a two-stent *** A total of 328 patients with de novo true complex LMb lesions who underwent a 2-stent strategy of percutaneous coronary intervention(PCI) treatment guided by IVUS were enrolled in this study. We divided the study into two phases. Of all the patients, 48 patients who had complete IVUS detection pre-and post-PCI and at the 1-year follow-up were enrolled in phase Ⅰ analysis, which aimed to analyze the correlation between NR and in-stent NIH at SBO at the 1-year follow-up. If the correlation was confirmed, the cutoff value of the remodeling index(RI) for predicting NIH ≥ 50% was analyzed next. The phase Ⅱ analysis focused on the incidence of TLF as the primary endpoint at the 1-to 5-year follow-up for all 328 patients by grouping based on the cutoff value of *** In phase I: according to the results of a binary logistic regression analysis and receiver operating characteristic(ROC) analysis, the RI cutoff value predicting percent NIH ≥ 50% was 0.85 based on the ROC curve analysis, with a sensitivity of 85.7%, a specificity of 88.3%, and an AUC of 0.893(0.778, 1.000), P = 0.002. In phase Ⅱ: the TLR rate(35.8% vs. 5.3%, P < 0.0001)was significantly higher in the several NR(s NR, defined as RI ≤ 0.85) group than in the non-s NR *** The NR of LCx O is associated with more in-stent NIH post-PCI for distal LMb lesions with a 2-stent strategy,and NR with RI ≤ 0.85 is linked to percent NIH area ≥ 50% at the 1-year follow-up and more TLF at the 5-year follow-up.

关键词： lesions remodeling intravascular

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Atorvastatin, etanercept and the nephrogenic cardiac sympathetic remodeling in chronic renal failure rats

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Journal of Geriatric cardiology 2024年第4期21卷 443-457页

作者： Jing-Yue XU Zheng-Kai XUE Ya-Ru ZHANG Xing LIU Xue ZHANG Xi YANG Tong LIU Kang-Yin CHEN Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of CardiologyTianjin Institute of Cardiologythe Second Hospital of Tianjin Medical UniversityTianjinChina

BACKGROUND Chronic renal failure(CRF) patients are predisposed to arrhythmias, while the detailed mechanisms are unclear. We hypothesized the chronic inflammatory state of CRF patients may lead to cardiac sympathetic remodeling, increasing the incidence of ventricular arrhythmia(VA) and sudden cardiac death. And explored the role of atorvastatin and etanercept in this *** A total of 48 rats were randomly divided into sham operation group(Sham group), CRF group, CRF + atorvastatin group(CRF + statin group), and CRF + etanercept group(CRF + rhTNFR-Fcgroup). Sympathetic nerve remodeling was assessed by immunofluorescence of growth-associated protein 43(GAP-43) and tyrosine hydroxylase positive area fraction. Electrophysiological testing was performed to assess the incidence of VA by assessing the ventricular effective refractory period and ventricular fibrillation threshold. The levels of tumor necrosis factor-alpha(TNF-α) and interleukin-1beta were determined by Western blotting and enzyme-linked immunosorbent *** Echocardiogram showed that compared with the Sham group, left ventricular end-systolic diameter and ventricular weight/body weight ratio were significantly higher in the CRF group. Hematoxylin-eosin and Masson staining indicated that myocardial fibers were broken, disordered, and fibrotic in the CRF group. Western blotting, enzyme-linked immunosorbent assay,immunofluorescence and electrophysiological examination suggested that compared with the Sham group, GAP-43 and TNF-α proteins were significantly upregulated, GAP-43 and tyrosine hydroxylase positive nerve fiber area was increased, and ventricular fibrillation threshold was significantly decreased in the CRF group. The above effects were inhibited in the CRF + statin group and the CRF + *** In CRF rats, TNF-α was upregulated, cardiac sympathetic remodeling was more severe, and the nephrogenic cardiac sympathetic remodeling existed. Atorvastatin and etanercept c

关键词： remodeling cardiac inhibited

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The impact of being in the COVID-19 pandemic on in-hospital mortality of non-infected patients aged 80 years and older with ST-elevation myocardial ınfarction

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Journal of Geriatric cardiology 2024年第7期21卷 768-774页

作者： Mustafa Ebik Muhammet Gürdoğan UğurÖzkan Department of cardiology Edirne SultanMurat State HospitalEdirneTurkey Department of cardiology School of MedicineTrakya UniversityEdirneTurkey

The COVID-19 outbreak in late 2019 was declared a pandemic by the World Health Organization(WHO)on March 12,2020.[1]As of the latest WHO data,COVID-19 has caused over 770 million cases and nearly 7 million deaths worldwide.[2]Hospitalizations due to COVID-19 are correlated with advanced age.[3,4]According to re-ports,individuals over the age of 65 account for 80%of COVID-19-related deaths.[3,4]This is primar-ily due to the increased burden of comorbidity with age.

关键词： infected patients mortality

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Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the cardiology Department of Kati University Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 333-342页

作者： Boubacar Sonfo Coumba Thiam Mariam Sako Massama Konaté Youssouf Camara Mamadou Touré Boubacar Diarra Diakaridja Sacko Samba Sidibé Bassan Diarra Hamidou Camara Asmaou Keita Konimba Diarra Hamidou Oumar Bâ Ibrahima Sangaré Youssouf Guindo Sanoussi Daffe Daouda Fofana Souleymane Coulibaly Ichaka Menta Department of cardiology University Hospital Bocar Sidy Sall Kati Mali Department of cardiology University Hospital of Point G Bamako Mali Department of cardiology Mali Hospital Bamako Mali Department of cardiology University Hospital Mother-Child Luxembourg Bamako Mali Department of cardiology University Hospital Gabriel Tour&#233 Bamako Mali Department of cardiology Kayes Hospital Kayes Mali

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

关键词： Hypertensive Therapeutic Adherence University Hospital of Kati

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Isolated Ventricular Septal Defect: Ultrasound, Therapeutic and Evolutionary Aspects of 85 Cases in the cardiology Department of the Ignace Deen National Hospital in Conakry

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World Journal of Cardiovascular Diseases 2024年第8期14卷 465-479页

作者： Mamadou Bassirou Bah Amadou Diouldé Doumbouya Elhdj Yaya Balde Mamadou Aliou Balde Alpha Kone Ibrahima Sory Sylla Mamadou Dian Bah Aboulaye Bah Mamadou Diallo Thierno Siradjo Balde Abdoulaye Camara Morlaye Soumaoro Ibrahima Sory Barry Souleymane Diakité Mamadou Dadhi Balde cardiology Department of the Ignace Deen Hospital Conakry Guinea cardiology Department Donka Hospital Conakry Guinea

Introduction: Ventricular septal defect (VSD) is the most common congenital heart disease of all congenital heart defects. The aim of this study was to investigate the echographic, therapeutic and evolutionary aspects of ventricular septal defects (VSD) in the general cardiology department of the Hôpital National Ignace Deen. Methods: A retrospective data collection was carried out from January 2018 to December 2023 including 85 cases of isolated IVC was performed. The variables studied were epidemiological, clinical, paraclinical, therapeutic and evolutionary. Results: Of the 320 patients seen during the study period for congenital heart disease, 85 (26.556%) were isolated IVCs. Age at diagnosis ranged from 3 months to 16 years, with an average age of 3.59 years. The most represented ethnic group was the Fulani (50.58%). The 8.24% came from consanguineous marriage versus 22.35%. 91.76% of children had a history of bronchitis. The most common clinical signs found were systolic murmur (90.58%), growth retardation (51.76%). Only 4 cases (4.70%) had a malformation associated with IVC represented by DiGeorges disease (2.35%) and trisomy 21 (2.35%). Nearly half the patients had type IIb VIC (44.71%). The other half were represented by type 1 (18.82%), type IIa (20%), type III (10.59%) and type IV (5.88%). According to site more than two-thirds of VICs (71.64%) were perimembranous in location, followed by infundibular (16.47%) and muscular (11.76%) VICs. In our study 55.29% presented an indication for both surgical intervention and medical treatment, while 16.47% required only medical treatment. In contrast, 28.23% were placed under exclusive surveillance. Of the 47 patients for whom surgery was indicated, 29 (61.17%) underwent surgical repair, while 18 (38.83%) were awaiting confirmation for surgery. Conclusion: VIC is the most common congenital heart disease. An early detection strategy and the establishment of specialized centers could improve the outcome of these chil

关键词： Ventricular Septal Defect Congenital Heart Disease Ignace Deen

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Is primary transcatheter aortic valve implantation the new normal?

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Journal of Geriatric cardiology 2024年第4期21卷 458-461页

作者： R.Anantharaman C.Sundar Kamal Kant Jena K.Arun Department of cardiology Kauvery HospitalChennaiIndia

Degenerative calcific aortic valve stenosis(AS)is the most common valvular heart disease in elderly.^[1] It is well documented that symptomatic severe AS follows a malignant course leading to cardiogenic shock(CS).

关键词： aortic stenosis implantation

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Gut microbiome regulates inflammation and insulin resistance:a novel therapeutic target to improve insulin sensitivity

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Signal Transduction and Targeted Therapy 2024年第3期9卷 825-827页

作者： Dilvin Semo Holger Reinecke Rinesh Godfrey Vascular Signalling Molecular CardiologyDepartment of Cardiology I-Coronary and Peripheral Vascular DiseaseHeart FailureUniversity Hospital Münster48149 MünsterGermany

In a recent study published in Nature,Takeuchi et *** a multiomics strategy in humans to provide compelling evidence that increased carbohydrate metabolism by the gut microbiota contributes to insulin resistance(IR).The authors uncovered a previously unknown link between elevated gut monosaccharides and host inflammatory cytokines and suggest potential intervention opportunities to combat IR by targeting specific gut microbial species.

关键词： metabolism inflammation al.

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Thrombolysis in Pulmonary Embolia at the cardiology Department of Aristide le Dantec cardiology Department

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World Journal of Cardiovascular Diseases 2024年第9期14卷 521-538页

作者： Joseph Salvador Mingou Marguerite Téning Diouf Fatou Aw Simon Antoine Sarr Khadim Rassoul Diop Malick Bodian Mouhamadou Bamba Ndiaye Maboury Diao Abdoul Kane cardiology Department Aristide le Dantec Hospital Dakar Senegal cardiology Department Dalal Jam Hospital Dakar Senegal

Introduction: Venous thromboembolic disease is the 3rd most common cardiovascular pathology. Acute pulmonary embolism constitutes its most serious presentation and a major cause of mortality, morbidity and hospitalization in Africa and Senegal. The objectives of this work were to study the epidemiological profile of pulmonary embolisms and to evaluate the practice of thrombolysis in patients in a cardiological setting. Methodology: A retrospective, descriptive study was carried out in the cardiology department of the Aristide le Dantec Hospital (HALD) over the period from August 2011 to December 2019 in patients hospitalized in the cardiology department for pulmonary embolism confirmed by CT angiography and/or with thrombi on cardiac ultrasound and who had also benefited from thrombolysis. Results: Thirty-one patients with pulmonary embolism were thrombolyzed. There was a predominance of the female gender with an average age of 45.97 years. Risk factors were dominated by age (61.29%) followed by obesity (32.26%) and prolonged immobilization (22.5%). The functional signs were dominated by dyspnea (77.42%) followed by chest pain (51.62%) and cough (35.48%). The physical signs were dominated by right heart failure in 22.5% of cases, pulmonary condensation syndrome in 19.35%, and inflammatory large leg in 12.9% of cases. Echocardiography and chest CT angiography were the means of diagnosis. Nine of our patients presented with an intracardiac mass. Thrombotic treatment was administered in all patients. The average length of hospitalization was 12.32 days and in-hospital mortality was 32.26%. Conclusion: Pulmonary embolism does exist in our regions and is responsible for heavy mortality. Rapid and efficient support is essential. Prevention remains the corner-stone in the fight against this pathology.

关键词： Pulmonary Embolism Thrombolysis Senegal

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Clinical Value of the Quantitative Flow Ratio to Predict Long-term Target Vessel Failure in Patients with In-stent Restenosis after Drug-coated Balloon Angioplasty

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Current Medical Science 2024年第3期44卷 561-567页

作者： Xiang-qi WU Long-bo LI Wei YOU Zhi-ming WU Lei ZHAO Zhi-hui WANG Pei-na MENG Bin LIU Fei YE Department of cardiology Nanjing First HospitalNanjing Medical UniversityNanjing210006China Department of cardiology The Second Hospital of Jilin UniversityJilin130000China

Objective The study sought to investigate the clinical predictive value of quantitative flow ratio(QFR)for the long-term target vessel failure(TVF)outcome in patients with in-stent restenosis(ISR)by using drug-coated balloon(DCB)treatment after a long-term *** This was a retrospective study.A total of 186 patients who underwent DCB angioplasty for ISR in two hospitals from March 2014 to September 2019 were *** QFR of the entire target vessel was measured *** primary endpoint was TVF,including target vessel-cardiac death(TV-CD),target vessel-myocardial infarction(TV-MI),and clinically driven-target vessel revascularization(CD-TVR).Results The follow-up time was 3.09±1.53 years,and 50 patients had *** QFR immediately after percutaneous coronary intervention(PCI)was significantly lower in the TVF group than in the no-TVF *** Cox regression analysis indicated that the QFR immediately after PCI was an excellent predictor for TVF after the long-term follow-up[hazard ratio(HR):5.15×10−5(6.13×10−8−0.043);P<0.01].Receiver-operating characteristic(ROC)curve analysis demonstrated that the optimal cut-off value of the QFR immediately after PCI for predicting the long-term TVF was 0.925(area under the curve:0.886,95%confidence interval:0.834–0.938;sensitivity:83.40%,specificity:88.00;P<0.01).In addition,QFR≤0.925 post-PCI was strongly correlated with the TVF,including TV-MI and CD-TVR(P<0.01).Conclusion The QFR immediately after PCI showed a high predictive value of TVF after a long-term follow-up in ISR patients who underwent DCB angioplasty.A lower QFR immediately after PCI was associated with a worse TVF outcome.

关键词： percutaneous coronary intervention in-stent restenosis target vessel failure quantitative flow ratio

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Conquer coronary artery perforation with magic hands

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Journal of Geriatric cardiology 2024年第4期21卷 379-386页

作者： Yi-Lun ZOU Jian-Qiang LI Ding-Yu WANG Yong-Tai GONG Li SHENG Yue LI Department of cardiology the First Affiliated Hospital of Harbin Medical UniversityHarbinChina

Coronary artery perforation(CAP) poses a significant challenge for interventional cardiologists. Management of CAP depends on the location and severity of the perforation. The conventional method for addressing the perforation of large vessels involves the placement of a covered stent, while the perforation of distal and collateral vessels is typically managed using coils, autologous skin, subcutaneous fat, microspheres, gelatin sponge, thrombin or other substances. However, the above techniques have certain limitations and are not applicable in all scenarios. Our team has developed a range of innovative strategies for effectively managing CAP. This article provides an insightful review of the various tips and tricks for the treatment of CAP.

关键词： coronary sponge perforation

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