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Research Progress on the Pathogenesis and Treatment of Neoatherosclerosis

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Current Medical Science 2024年第4期44卷 680-685页

作者： Yi-shan GUO Ning YANG Zhen WANG Yu-miao WEI Department of cardiology Hubei Key Laboratory of Biological Targeted TherapyHubei Engineering Research Center for Immunological Diagnosis and Therapy of Cardiovascular DiseasesUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China Department of cardiology Binzhou Medical University HospitalBinzhou256600China Department of Gynecology Binzhou Medical University HospitalBinzhou256600China

Neoatherosclerosis(NA)within stents has become an important clinical problem after coronary artery stent ***-stent restenosis and in-stent thrombosis are the two major complications following coronary stent placement and seriously affect patient *** the common pathological basis of these two complications,NA plaques,unlike native atherosclerotic plaques,often grow around residual oxidized lipids and stent *** main components are foam cells formed by vascular smooth muscle cells(VSMCs)engulfing oxidized lipids at lipid residue *** research mainly focuses on optical coherence tomography(OCT)and intravascular ultrasound(IVUS),but the specific pathogenesis of NA is still unclear.A thorough understanding of the pathogenesis and pathological features of NA provides a theoretical basis for clinical *** article reviews the previous research of our research group and the current situation of domestic and foreign research.

关键词： neoatherosclerosis vascular smooth muscle cells

Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali

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World Journal of Cardiovascular Diseases 2024年第2期14卷 77-87页

作者： Youssouf Camara Hamidou Oumar Ba Ibrahima Sangaré Boubacar Sonfo Coumba Adiaratou Thiam Mahamadou Sékou Diakité Koniba Diarra Karamba Touré Massama Konaté Ichaka Menta cardiology Department University Hospital Professeur Bocar Sidi Sall Kati Kati Mali cardiology Department University Hospital Gabriel Touré Bamako Mali cardiology Department Mali Hospital Bamako Mali

Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

关键词： Stress Test Ischemic Heart Disease Mali

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

Role of intravascular ultrasound and optical coherence tomography in intracoronary imaging for coronary artery disease:a systematic review

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Journal of Geriatric cardiology 2024年第1期21卷 104-129页

作者： Maruf Sarwar Stephen Adedokun Mahesh Anantha Narayanan Department of Cardiovascular Sciences White River HealthBatesvilleARUSA Division of cardiology University of Tennessee at MemphisTNUSA University of Arkansas Medical Sciences Little RockARUSA

Coronary angiography has long been the standard for coronary imaging,but it has limitations in assessing vessel wall anatomy and guiding percutaneous coronary intervention(PCI).Intracoronary imaging techniques like intravascular ultrasound(IVUS)and optical coherence tomography(OCT)can overcome these *** uses ultrasound and OCT uses near-infrared light to visualize coronary pathology in unique ways due to differences in temporal and spatial *** techniques have evolved to offer clinical utility in plaque characterization and vessel assessment during ***-analyses and adjusted observational studies suggest that both IVUS and OCT-guided PCI correlate with reduced cardiovascular risks compared to angiographic guidance *** IVUS demonstrates consistent clinical outcome benefits,OCT evidence is less *** has progressed from early motion detection to high-resolution systems,with smaller compatible *** utilizes near infrared light to achieve unparalleled resolutions,but requires temporary blood clearance for optimal *** visualization and guidance make IVUS and OCT well-suited for higher risk PCI in patients with diabetes and chronic kidney disease by allowing detailed visualization of complex lesions and ensuring optimal stent deployment and positioning in PCI for patients with type 2 diabetes and chronic kidney disease,improving *** and recent advancements in zero-and low-contrast OCT techniques can reduce nephrotoxic contrast exposure,thus helping to minimize PCI complications in these high-risk patient *** and OCT provide valuable insights into coronary pathophysiology and guide interventions precisely compared to angiography *** have comparable clinical outcomes,emphasizing the need for tailored imaging choices based on clinical *** refinement and integration of intravascular imaging will likely play a pivotal role in optimizing coronary interventions and outcomes.

关键词： coronary anatomy limitations

Treatment and Clinical Management of Chronic Thromboembolic Pulmonary Hypertension:An Update of Literature Review

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Congenital Heart Disease 2024年第2期19卷 157-176页

作者： Yuan Ren Yingxian Sun Zhiguang Yang Yanli Chen The Department of cardiology The First Affiliated Hospital of China Medical UniversityShenyang110000China The Radiology Department Shengjing Hospital of China Medical UniversityShenyang110020China

Chronic thromboembolic pulmonary hypertension(CTEPH)is a chronic,progressive,debilitating,and life-threa-tening complication of pulmonary embolism(PE).Recent technological advances have permitted various treat-ment options for the treatment of CTEPH,including surgery,angioplasty,and medical treatment,depending on the location and characteristics of *** endarterectomy(PEA)is the treatment of choice for CTEPH,as it offers excellent long-term outcomes and a high probability of ***,various medical and interventional therapies are currently being developed for patients with inoperable *** review mainly summarizes the current treatment approaches of CTEPH,offering more options for specialist physicians to,thus,better manage chronic thromboembolic syndromes.

关键词： Chronic thromboembolic pulmonary hypertension(CTEPH) chronic thromboembolic pulmonary disease(CTEPD) pulmonary endarterectomy(PEA) balloon pulmonary angioplasty(BPA) COVID-19

Incidence, Clinical Presentation and Angiographic Findings among Patients with Coronary Artery Ectasia in Gaza

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Health 2024年第3期16卷 234-241页

作者： Mohammed Habib cardiology Department Alshifa Hospital Gaza Palestine

Background: Coronary artery ectasia (CAE) is a rare form of aneurysmal coronary heart disease. This condition increases risk of ischemia that leaded to stable angina pectoris and also acute coronary syndrome. Objective: To evaluate the incidence of CAE and to analyze clinical and angiographic characteristics among patients with symptomatic coronary artery disease. Methods: Retrospective trial of diagnostic coronary angiography which was performed at Alshifa hospital in Gaza, included all patients with coronary heart disease and underwent diagnostic coronary angiography from March 2014 to March 2023. We evaluate the incidence, clinical presentation and angiographic findings of patients with symptomatic coronary ectasia. Results: Of the 12,534 angiograms analyzed, CAE was found in 539 patients, an incidence of 4.3%. The mean age was 59.2 ± 11.7 years, and male gender predominate 81.8%. A 285 (52.9%) of patients found to have single ectatic vessel at their angiographic results. In two vessels 120 patients (22.3%), in three vessels 95 patients (17.6%) and in three vessel plus left main in 39 patients (7.2%). 70.9% angiograms showed pure ectasia without associated significant stenotic lesions in the same vessel. The right coronary artery (RCA) was the commonest affected vessel by ectasia. The most common presentation of patients is non ST segment elevation acute coronary syndrome. Conclusion: The incidence of coronary ectasia was 4.3%. Non ST segment elevation acute coronary syndrome was the most common clinical presenting. Only 30% of patients have additionally significant coronary artery stenosis. The majority of patients had single vessel involvement and right coronary artery was the most common involved vessel. Despite a dapper understanding of CAE in last years, there are still come critical issues about optimal treatment. Large multicenter randomized control trials are recommended to guide the clinician in the management of this complex sitting of patients.

关键词： CAE STEMI Non-STE-ACS Stable Angina Pectoris

Deferred revascularization in diabetic patient according to combined invasive functional and intravascular imaging data:A case report

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World Journal of Clinical Cases 2024年第13期12卷 2269-2274页

作者： Arif Al Nooryani Wael Aboushokka Branko Beleslin Biljana Nedeljkovic-Beleslin Department of cardiology Al Qassimi HospitalSharjah 1234United Arab Emirates Department of cardiology Medical FacultyUniversity of BelgradeBelgrade 11000Serbia Institute of Endocrinology Diabetes and Metabolic DisordersUniveristy Clinical Center of SerbiaBelgrade 11000Serbia Department of Internal Medicine/Endocrinology Medical facultyUniversity of BelgradeBelgrade 11000Serbia

BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary ***,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional *** SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest *** coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted *** undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup *** of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal *** Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.

关键词： Fractional flow reserve Coronary flow reserve Index of microvascular resistance Optical coherence tomography Intermediate coronary stenosis Case report

Evaluation of AVNRT & AVRT by Different Criteria: Old & New

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World Journal of Cardiovascular Surgery 2024年第7期14卷 95-106页

作者： Abdul Hamid Tahmina Alam Sonali Rizwan Rehan Pijous Biswas Subas Caandro Datta Asif Zaman Department of cardiology Chattagram Medical College Hospital Chattagram Bangladesh Chattagram Medical College Hospital Chattagram Bangladesh Department of cardiology National Institute of Cardiovascular Disease Dhaka Bangladesh Department of cardiology Bangamata Sheikh Fozilatunnesa Mujib General Hospital Sirajganj Bangladesh Department of cardiology Evercare Hospital Dhaka Bangladesh

The two most frequent causes of paroxysmal SVT are atrioventricular tachycardia (AVRT) and atrioventricular nodal re-entrant tachycardia (AVNRT). The purpose of this study was to assess the diagnostic efficacy of traditional and newly proposed ECG criteria in the identification of Avnrt and Avrt. Aim of the Study: The aim of this study was to evaluate Atrioventricular Nodal Reentrant Tachycardia (AVNRT) and Atrioventricular Re-entrant Tachycardia (AVRT) using both traditional and novel criteria. Methods: This prospective observational study was conducted at the Electrophysiology Unit, Department of cardiology, National Institute of Cardiovascular Diseases (NICVD) in Dhaka, from February 2019 to January 2020. A total of 62 patients with Supraventricular Tachycardia (SVT) undergoing electrophysiology study (EPS) were included. Standard ECG criteria were applied for the differential diagnosis, and electrophysiological diagnoses were made using established criteria. Statistical analysis, including descriptive statistics and appropriate tests, was performed using SPSS 23.0. Result: In our study of 62 patients with Supraventricular Tachycardia (SVT), we found that 66.1% had AVNRT and 33.9% had AVRT. The mean age in AVNRT was higher than AVRT (41.3 ± 9.7 vs. 38.5 ± 14.3, p = 0.36) with statistically no significant difference, with similar gender distribution between AVNRT and AVRT groups. Classical AVNRT criteria were present in 30.6% of patients, and 45.2% showed a Pseudo R' wave in aVR. Additionally, 30.6% had an RP interval ≥100ms, more prevalent in AVRT patients (66.7%). Conclusion: Integrating traditional and novel criteria, including lead aVR analysis, enhances the electrocardiographic diagnosis of AVNRT and AVRT, offering a pathway to refined patient care.

关键词： SVT (Supraventricular Tachycardia) AVNRT (Atrioventricular Nodal Re-Entrant Tachycardia) AVRT (Atrioventricular Re-Entrant Tachycardia) ECG Criteria Electrophysiology

Efficacy of Huoxue Qianyang Qutan Recipe on essential hypertension:A randomized,double-blind,placebo-controlled trial

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Journal of Integrative Medicine 2024年第4期22卷 484-492页

作者： Jun Xie Yu-long Ma Ming-tai Gui Lei Yao Jian-hua Li Ming-zhu Wang Xun-jie Zhou Yi-fan Wang Ming-yi Zhao Hui Cao Bo Lu De-yu Fu Department of cardiology Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 200437China Shanghai University of Traditional Chinese Medicine Shanghai 200120China

Background:Hypertension,a prevalent disease,is a significant risk factor for coronary heart *** Qianyang Qutan Recipe (HQQR),a traditional Chinese herbal remedy,has been used for treating hypertension over several ***:This study assesses HQQR’s efficacy for controlling blood pressure among patients with hypertension related to blood stasis,yang hyperactivity and ***,setting,participants and interventions:A randomized controlled trial was conducted at the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,China,from July 2020 to June *** components of HQQR were identified using thin-layer chromatography and high-performance liquid *** aged18–80 years,exhibiting traditional Chinese medicine syndromes of blood stasis,yang hyperactivity or phlegm,along with grades 1 or 2 hypertension,were randomly categorized into two *** intervention group was given HQQR granules alongside conventional hypertension treatment,while the control group was given placebo granules in addition to conventional treatment for 12 *** outcome measures:The primary outcome was clinic blood pressure,whereas secondary outcomes included metabolic indices (e.g.,homeostasis model assessment of insulin resistance[HOMA-IR],total cholesterol[TC],low-density lipoprotein cholesterol and triglyceride),target organ damage indices (left ventricular mass index and urinary albumin creatinine ratio[UACR]) and inflammation indices(interleukin-6[IL-6]and high-sensitivity C-reactive protein[hs-CRP]).Results:HQQR’s primary components were identified as salvianolic acid B,emodin and ferulic *** the 216 participants (108 in each group),compared to the control,the intervention group exhibited significant improvements (P<0.001) in clinic systolic blood pressure ([136.24±7.63]vs[130.06±8.50]mmHg),clinic diastolic blood pressure ([84.34±8.72]vs[80.46±6.05]mmHg),home systol

关键词： Huoxue Qianyang Qutan Recipe Hypertension Target organ damage Glycolipid metabolism Inflammatory Chinese herbal compound