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Clinical profile and outcomes in very elderly patients with atrial fibrillation anticoagulated with rivaroxaban: data from the EMIR study

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Journal of Geriatric cardiology 2024年第7期21卷 723-732页

作者： Francisco Marín Manuel Anguita Sánchez Iñaki Lekuona Marcelo Sanmartín Fernán-dez Vivencio Barrios carlos Perez Muñoz Juan Cosín-Sales Alejandro IPérez Cabeza Vanesa Roldán Schilling carles Rafols Priu Esteban Orenes-Piñero María Asunción Es-teve-Pastor department of cardiology Hospital Clínico Universitario Virgen de la ArrixacaIMIB-ArrixacaUniversity of MurciaCIBERCVMurciaSpain department of cardiology Hospital Reina Sofía CórdobaIMIBICUniversity of CordobaCIBERCVCórdobaSpain Hospital Galdakao-Usansolo BizkaiaSpain department of cardiology Hospital Uni-versitario Ramony CajalCIBERCVMadridSpain department of cardiology University Hospital Ramóny CajalAl-caláUniversityMadridSpain Medical Center La Capillita Sanlúcar de Barrameda.Private cardiology clinicJerez de la FronteraSpain department of cardiology Hospital Arnau de VilanovaValenciaSpain department of car-diology Virgen de la Victoria University HospitalCIBERCV.MalagaSpain department of Haematology Hospital Clínico Universitario Virgen de la ArrixacaUniversity of MurciaMurciaSpain department of Medical Affairs Bayer HispaniaBarcelonaSpain department of Biochemistry and Molecular Biology-A University of MurciaMurciaSpain

Objectives To analyze the clinical profile,adequacy of treatment with rivaroxaban and outcomes in octogenarians with atrial fibrillation(AF),taking rivaroxaban in clinical *** Observational and non-interventional study that included AF adults recruited from 79 Spanish centers,anticoagulated with rivaroxaban ≥ 6 months before being *** were analyzed according to age(≥ 80 vs.cardiovascular death and major bleeding were 1.03%,1.24%,1.03% and 1.75%,respectively,in octogenarian *** for progressive heart failure death and major bleeding,rates of outcomes in octogenarians were similar compared to younger *** octogenarians,the concomitant use of antiplatelet agents and non-severe dementia were independently associated with the development of ischemic stroke,whereas previous coronary revascularization and heart failure with MACE,and higher HAS-BLED score with major *** In clinical practice,around one third of patients taking rivaroxaban are *** patients have many comorbidities and a high thromboembolic *** that,rates of adverse events remain *** is adequately prescribed in the majority of octogenarians.

关键词： patients atrial bleeding

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cardiac surgery in Octogenarians and Beyond: Single Center Experience

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Open Journal of Thoracic surgery 2013年第2期3卷 51-56页

作者： Reda E. Al-Refaie Hashem Aliter Ricardo Gallo Ali Youssef Mushabab Al-Murayeh Edwin Ravikumar department of cardiac surgery and car- diology Armed Forces Hospitals Southern Region Khamis Mushayt KSA department of cardiothoracic surgery Mansoura University Hospitals Mansoura Egypt

Background: Increasing numbers of octogenarians and improvements in surgical techniques and postoperative care have resulted in increasing cardiac operations in this age. The aim is to analyze our experience of cardiac surgery on octogenarians and beyond concerning postoperative morbidities and mortality. Methods: 67 octogenarians and nonagenarians underwent open heart surgery in our hospital between 2001 to 2009 were retrospectively reviewed. Data included baseline preoperative status, intraoperative and perioperative course, and immediate outcomes. Results: The mean age was 86.22 ± 6.1 years. 86.6% patients were males. Symptoms were dyspnea;Class II in 13.4%, Class III in 55.2%, Class IV in 31.4% patients;angina in 82.1%, and CHF in 25.4% patients. The mean EF was 37.8% ± 10. Risk factors include smoking in 52.2%, DM in 37.3%, hypertension in 28.4%, obesity in 25.4%, previous MI in 22.4%, COPD in 17.9%, renal insufficiency in 11.9%, pulmonary hypertension in 7.5%, PVD in 6%, and cerebrovascular disease in 3% patients. The procedures were isolated CABG in 73%, AVR in 9%, MVR in 6%, CABG/valve in 9%, and MVR and AVR in 3% patients. Complications were 18%. It included renal impairment in 18%, arrhythmias in 14.9%, bleeding in 6%, prolonged ventilation in 13.4%, CHF in 4.5%, gastrointestinal bleeding in 4.5%, wound infection in 7.5%, and cerebrovascular accident in 3%. Hospital mortality was 9% patients. Conclusions: cardiac surgery can be performed safely with acceptable hospital morbidity and mortality in octogenarians and beyond. Early referral and proper selection of patients are mandatory to improve immediate postoperative survival.

关键词： Coronary Artery Bypass Graft Valve Octogenarians Nonagenarian

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Clinical cardiac regenerative studies in children

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World Journal of cardiology 2017年第2期9卷 147-153页

作者： Imre J Pavo Ina Michel-Behnke Division of Pediatric car-diology Department of Pediatrics and Adolescent MedicineMedical University of ViennaA1090 ViennaAustria

Although the incidence of pediatric heart failure is low, the mortality is relatively high, with severe clinical symptoms requiring repeated hospitalization or intensive care treatment in the surviving patients. cardiac biopsy specimens have revealed a higher number of resident human cardiac progenitor cells, with greater proliferation and differentiation capacity, in the neonatal period as compared with adults, demonstrating the regeneration potential of the young heart, with rising interest in cardiac regeneration therapy in critically ill pediatric patients. We review here the available literature data, searching the MEDLINE, Google Scholar and EMBASE database for completed, and *** homepage for ongoing studies involving pediatric cardiac regeneration reports. Because of difficulties conducting randomized blinded clinical trials in pediatric patients, mostly case reports or cohort studies with a limited number of individuals have been published in the field of pediatric regenerative cardiology. The majority of pediatric autologous cell transplantations into the cardiac tissue have been performed in critically ill children with severe or terminal heart failure. Congenital heart disease, myocarditis, and idiopathic hypertrophic or dilated cardiomyopathy leading to congestive heart failure are some possible areas of interest for pediatric cardiac regeneration therapy. Autologous bone marrow mononuclear cells, progenitor cells, or cardiospheres have been applied either intracoronary or percutaneously intramyocardially in severely ill children, leading to a reported clinical benefit of cell-based cardiac therapies. In conclusion, compassionate use of autologous stem cell administration has led to at least short-term improvement in heart function and clinical stability in the majority of the critically ill pediatric patients.

关键词： Congenital heart disease Heart failure cardiac regeneration Cell-based therapy Hospitalization Children

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Essen score in the prediction of cerebrovascular events compared with cardiovascular events after ischaemic stroke or transient ischaemic attack:a nationwide registry analysis

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Journal of Geriatric cardiology 2022年第4期19卷 265-275页

作者： Long LI Ze-Ning JIN Yue-Song PAN Jing JING Xia MENG Yong JIANG Hao LI Cai-Xia GUO Yong-Jun WANG department of cardiology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina department of car-diology and Beijing Key Laboratory of Hypertension Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina department of cardiology Beijing Tongren HospitalCapital Medical UniversityBeijingChina

BACKGROUND The Essen risk score improves stratification of patients with acute ischemic stroke by early stroke *** study showed it could also predict myocardial infarction(MI).This study aimed to compare the Essen score’s ability to predict cerebrovascular events with compared cardiovascular *** We included patients with acute ischaemic stroke or transient ischaemic attack within seven days from the Third China National Stroke ***-year cumulative event rates of combined vascular events(a composite of MI,stroke recurrence or vascular death)and cardiac events(a composite of MI,heart failure or cardiac death)was estimated using the Kaplan-Meier *** predictive value of the Essen score was assessed with *** multivariate Cox regression analyses,we assessed whether Essen score,etiological subtype and imaging parameters were associated with *** Of 13,012 patients were included,the cumulative one-year event rates were 10.03%for combined vascular events and 0.77%for cardiac events,*** with those with an Essen scorecardiac events(HR=2.30,95%CI:1.53−3.44).The score tended to be more predictive of the risk of MI(C-statistic=0.63,95%CI:0.55−0.71)and cardiac events(C-statistic=0.62,95%CI:0.56−0.67)than stroke recurrence(C-statistic=0.55,95%CI:0.54−0.57)and combined vascular events(C-statistic=0.56,95%CI:0.54−0.57).In multivariable analysis after adjusted Essen score,patients with multiple acute in-farctions or single acute infarctions and large artery atherosclerosis subtype were independently associated with an increased risk of combined vascular *** the cardioembolism subtype was associated with an increased risk of cardiac *** The Essen score is potentially more suitable for risk stratification of cardiovascular events than cerebrovasc

关键词： transient score statistic

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Kirschner wire migration from the right second rib to the right ventricle： a case report

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Chinese Journal of Traumatology 2013年第5期16卷 292-294页

作者： WANG Song BAO Zheng LUO Ling-fu department of Thoracic surgery Affiliated NanhuaHospital University of South China Hengyang 421002China department of cardiac surgery Second XiangyaHospital Central South University Changsha 410011China

Migrations of orthopedic wires to car- diovascular system are uncommon and rarely reported. We report a case of right ventricle embolization with the Kirschner wire that was used for right 2nd rib osteosynthesis 2 years and 8 months previously in a 50-year-old man. The patient was asymptomatic and migration of the Kirschner wire was discovered by routine chest X-ray. An 8 cm-long Kirschner wire was successfully retrieved from the right ventricle. The treatment strategy for Kirschner wire removal from right ventricle is discussed.

关键词： Bone wires Heart ventricles Rib fractures

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Predictive value of neutrophil-to-lymphocyte ratio in coronary chronic total occlusion patients

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Journal of Geriatric cardiology 2024年第5期21卷 542-549页

作者： Qian LI Yue YU Ya-Qiong ZHOU Yi ZHAO Jin WU Yuan-Jing WU Bin DU Pei-Jian WANG Tao ZHENG department of cardiovascular Medicine the First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anChina department of cardiology First Affiliated Hospital of Chengdu Medical CollegeChengduChina department of Neurology the First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anChina

BACKGROUND The neutrophil to lymphocyte ratio(NLR)has been reported as a novel predictor for atherosclerosis and car-diovascular *** study aimed to determine the effects of NLR on long-term clinical outcomes of chronic total occlusion(CTO)*** A total of 670 patients with CTO who met the inclusion criteria were included at the end of the follow-up *** were divided into tertiles according to their baseline NLR levels at admission:low(n=223),intermediate(n=223),and high(n=224).The incidence of major adverse cardiac events(MACEs)during the follow-up period,including all-cause death,nonfatal myocardial infarction(MI),or ischemia-driven revascularization,were compared among the three *** Major adverse cardiac events were observed in 27 patients(12.1%)in the low tertile,40(17.9%)in the intermediate tertile,and 61(27.2%)in the high NLR tertile(Pcardiovascular risk in patients with CTO.

关键词： patients coronary occlusion

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Leiomyosarcoma with coronary fistulae and ventricular septal perforation： A case study

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Journal of Geriatric cardiology 2014年第4期11卷 354-356页

作者： Dang-Sheng HUANG Yu-Mei WANG Yu CHEN department of cardiology the First Affiliated Hospital of Chinese PLA General Hospital Beijing100048 China department of cardiac surgery Peking University People's Hospital Beijing 100044 China

Coronary fistulae and ventricular septal perforation are very rare clinically, and even less caused by cardiac leiomyosarcoma. A case is reported that a 67-year-old female had cardiac leiomyosarcoma with progressive heart failure and coronary fistulae and ventricular septal perforation. This case was special since all ante-mortem examinations and cardiac surgery failed to detect the presence of any abnormal car-diac mass. Therefore, the malignant cardiac tumors could appear in an invasive form without mass and be one of the causes of the coronary fistulae and ventricular septal perforation.

关键词： cardiac leiomyosarcoma Coronary fistulae Ventricular septal perforation Heart failure

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pregnane X receptor and constitutive androstane receptor modulate differently CYp3A-mediated metabolism in earlyand late-stage cholestasis

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World Journal of Gastroenterology 2017年第42期23卷 7519-7530页

作者： Daniela Gabbia Arianna Dalla Pozza Laura Albertoni Roberta Lazzari Giorgia Zigiotto Maria carrara Vincenzo Baldo Tatjana Baldovin Annarosa Floreani Sara De Martin department of Pharmaceutical and Pharmacological Sciences University of Padova department of Medicine General Pathology and Cytopathology UnitUniversity of Padova department of cardiac Thoracicand Vascular SciencesHygiene and Public Health UnitUniversity of Padova department of surgery Oncology and GastroenterologyUniversity of Padova

AIM To ascertain whether cholestasis affects the expression of two CYP3 A isoforms(CYP3 A1 and CYP3 A2) and of pregnane X receptor(PXR) and constitutive androstane receptor(car).METHODS Cholestasis was induced by bile duct ligation in 16 male Wistar rats; whereas 8 sham-operated rats were used as controls. Severity of cholestasis was assessed on histological examination of liver sections, and serum concentrations of albumin, AST, ALT, GGT, ALPK and bilirubin. Gene and protein expressions of PXR, car, CYP3 A1 and CYP3 A2 were assessed by means of q RT-PCR and Western blot, respectively. Alterations in CYP3 A activity were measured by calculating the kinetic parameters of 4-OH and 1'-OH-midazolam hydroxylation, marker reactions for CYP3 A *** The m RNA and protein expression of CYP3 A1 increased significantly in mild cholestasis(P car, which was measured because they both translocate into the cell nucleus after their activation, virtually disappeared in the late stage of cholestatic injury, after an initial increase. These results indicate that early-and late-stage cholestasis affects CYP3 Amediated drug metabolism differently, probably as consequence of the different activation of PXR and *** Early-and late-stage cholestasis affects CYP3 Amediated drug metabolism differently. PXR and car might be targeted therapeutically to promote CYP3 Amediated liver detoxification.

关键词： Cholestasis CYP3A Drug metabolism Pregnane X receptor Constitutive androstane receptor

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不同ST段偏移分析方法和正电子发射断层扫描术(PET)评估心肌梗死面积的关系

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 21-22页

作者： Desmet W.J. Mesotten L.V. Maes A.F. 艾文婷 department of car diology UH Gasthuisberg Herestraat 49 3000 Leuven BelgiumDr.

Objective: To study the relation between resolution of ST segment devia tion an d infarct size using positron emission tomography. Methods: 45 patients with ST segment elevation acute myocardial infarction treated with thrombolysis or percu taneous coronary intervention were studied prospectively. An ECG was taken befor e and at (mean (SD)) 100 (45) min after reperfusion therapy. ECGs were analysed by three methods. Residual ST segment deviation, obtained from the ECG immediate ly after completion of reperfusion therapy, was defined by summation for each of the three methods. Relative resolution of ST segment deviation was defined as t he absolute resolution divided by the ST segment deviation score at baseline x 1 00(%). After 29 (14) hours, myocardial blood flow was measured with 13NH3. For each patient, the regions with a myocardial blood flow cardium (=hypoperfusion) and cardial hypope rfusion and ST segment deviation scores at baseline and after reperfusion therap y. After reperfusion therapy, residual ST segment deviation in the single lead w ith maximum ST segment deviation was as good at discriminating between fertiles of myocardial damage as summed ST segment elevation. Relative ST segment resolut ion did not discriminate between different degrees of myocardial damage. Conclus ions: In the individual patient, residual ST segment deviation after reperfusion in the single lead with maximum ST segment deviation is at least as good as sum med ST elevation in predicting final myocardial damage.

关键词：心肌梗死面积 PET ST段偏移再灌注治疗心肌血流正常心肌急性心肌梗死分析方法心电图分析低灌注

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主动脉瓣狭窄程度影响左房室平面位移而不影响左心室射血分数

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世界核心医学期刊文摘（心脏病学分册） 2005年第2期1卷 37-38页

作者： Rydberg E. Gudmundsson P. Kennedy L. 郭宁 department of car diology MalmUniversity Hospital S-205 02 Malm Sweden Dr.

Aims: To examine how left atrioventricular plane displacement(AVPD), a widely used measure of left ventricular(LV) function, is related to presence and degree of aortic stenosis. Methods and results: cardiac dimensions, LV filling, left A VPD, LV ejection fraction (LVEF), and valve function were assessed by echocardio graphy/Doppler in 182 patients with various cardiac diseases (mean (SD) age 69(1 2) years, 36%women), 49 consecutive with and 133 consecutive without aortic ste nosis. In an analysis of covariance, neither left AVPD nor LVEF was independentl y correlated with the presence of aortic stenosis. However, looking separately a t patients with aortic stenosis, left AVPD (p=0.03) but not LVEF correlated inde pendently with degree of aortic stenosis in multiple linear regression analysis. In patients with aortic stenosis, an abnormal left AVPD had 94%sensitivity and 90%negative predictive value with regard to severe aortic stenosis, compared w ith 56%and 62%, respectively, for LVEF. Conclusion: In patients with cardiac d isease, neither left AVPD nor LVEF correlated independently with presence of aor tic stenosis. However, in patients with aortic stenosis, left AVPD but not LVEF correlated with the degree of aortic valve obstruction and left AVPD but not LVE F had high sensitivity and negative predictive value with regard to severe aorti c stenosis. Compared with LVEF, left AVPD is an earlier and more sensitive marke r of LV haemodynamic load in patients with aortic stenosis.

关键词：左心室射血分数主动脉瓣狭窄多普勒检测主动脉狭窄充盈量阴性预测值瓣膜功能超声心动图梗阻程度血流动力学

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