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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

Predictive factors of short term outcome after liver transplantation: A review

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World Journal of Gastroenterology 2016年第26期22卷 5936-5949页

作者： Giuliano Bolondi Federico Mocchegiani Roberto Montalti Daniele Nicolini Marco Vivarelli Lesley De Pietri Anaesthesiology Intensive Care and Pain Therapy Medical Residency University of Modena and Reggio Emilia division of Hepatobiliary and Transplant Surgery Department of Experimental Medicine Polytechnic University of Marche division of Anaesthesiology and intensive care Unit Department of Cardiology Thoracic and Vascular Surgery Critical Care Medicine Arcispedale Santa Maria Nuova-IRCCS

Liver transplantation represents a fundamental therapeutic solution to end-stage liver disease. The need for liver allografts has extended the set of criteria for organ acceptability, increasing the risk of adverse outcomes. Little is known about the early postoperative parameters that can be used as valid predictive indices for early graft function, retransplantation or surgical reintervention, secondary complications, long intensive care unit stay or death. In this review, we present state-of-the-art knowledge regarding the early post-transplantation tests and scores that can be applied during the first postoperative week to predict liver allograft function and patient outcome, thereby guiding the therapeutic and surgical decisions of the medical staff. Post-transplant clinical and biochemical assessment of patients through laboratory tests (platelet count, transaminase and bilirubin levels, INR, factor V, lactates, and Insulin Growth Factor 1) and scores (model for end-stage liver disease, acute physiology and chronic health evaluation, sequential organ failure assessment and model of early allograft function) have been reported to have good performance, but they only allow late evaluation of patient status and graft function, requiring days to be quantified. The indocyanine green plasma disappearance rate has long been used as a liver function assessment technique and has produced interesting, although not univocal, results when performed between the 1th and the 5th day after transplantation. The liver maximal function capacity test is a promising method of metabolic liver activity assessment, but its use is limited by economic cost and extrahepatic factors. To date, a consensual definition of early allograft dysfunction and the integration and validation of the above-mentioned techniques, through the development of numerically consistent multicentric prospective randomised trials, are necessary. The medical and surgical management of trans

关键词： Liver transplant Liver failure Early allograft dysfunction Primary non-function Initial poor function Outcome predictors Post operative Scoring system Indocyanine green Liver maximal functional capacity

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

Transoesophageal echocardiography during liver transplantation

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World Journal of Hepatology 2015年第23期7卷 2432-2448页

作者： Lesley De Pietri Federico Mocchegiani Chiara Leuzzi Roberto Montalti Marco Vivarelli Vanni Agnoletti division of Anaesthesiology and intensive care Unit Azienda Ospedaliero-Universitaria di Modena-Policlinico Transplantation Unit Polytechnic University of Marche Unit of Interventional cardiology Arcispedale Santa Maria Nuova IRCCS division of Anaesthesiology and intensive care Unit Arcispedale Santa Maria Nuova IRCCS

Liver transplantation(LT) has become the standard of care for patients with end stage liver disease. The allocation of organs, which prioritizes the sickest patients, has made the management of liver trans-plant candidates more complex both as regards their comorbidities and their higher risk of perioperative complications. Patients undergoing LT frequently display considerable physiological changes during the pro-cedures as a result of both the disease process and the surgery. Transoesophageal echocardiography(TEE), which visualizes dynamic cardiac function and overall contractility, has become essential for perioperative LT management and can optimize the anaesthetic management of these highly complex patients. More-over, TEE can provide useful information on volume status and the adequacy of therapeutic interventions and can diagnose early intraoperative complications, such as the embolization of large vessels or development of pulmonary hypertension. In this review, directed at clinicians who manage TEE during LT, we show why the procedure merits a place in challenging anaesthetic environment and how it can provide essential information in the perioperative management of compromised patients undergoing this very complex surgical procedure.

关键词： Liver transplantation Transoesophageal echocardiog

Predicting cardiovascular events in out-of-hospital patients presenting with atypical chest pain and complete left bundle branch block: role of CTA and echocardiographic Global Longitudinal Strain

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Journal of Geriatric cardiology 2024年第7期21卷 760-767页

作者： Guido Pastorini Fabio Anastasio Anna Botto Valentina Tardivo Mauro Feola cardiology division Regina Montis Regalis HospitalASLCN1Mondovi’Italy intensive care Regina Montis Re-galis HospitalASLCN1 Mondovi’Italy School of Geriatry University of MedicineTurinItaly

Background Out-of-hospital patients presenting with atypical chest pain and complete left bundle branch block(LBBB)have to be stratified for the presence of coronary artery disease and the risk of developing heart failure(HF).We investigated the pro-gnostic role of coronary CT-angiography(CTA)and echocardiographic global longitudinal strain(GLS)in those patients in a mid-term *** Out-of-hospital patients with LBBB underwent echocardiography and a 64-slice CT angiography were evaluated *** of HF or a cardiovascular death were the events *** Seventy-eight patients(32 female;mean age:66.0±10.4 years were *** a follow-up of 33 months(IQR:17-77),one patient(1.5%)experienced a cardiovascular death,14 patients(17.9%)required urgent outpatient visits due to acute de-compensated HF(12 hospitalizations).Echocardiography showed a slightly reduced left ventricular ejection fraction(LVEF)(50.0%±9.8%)and GLS within the normal range(-16.2%±4.1%).CTA analysis showed coronary stenosis>50%in 28 patients(35.9%).A high Agatston score(>100)was observed in 29.5%.Notably,25 patients(32.1%)were diagnosed with left main coron-ary artery disease and 15 patients(16.7%)underwent revascularization during the follow *** associations were ob-served between events and LVEF(P=0.001),diastolic dysfunction grade≥2(P=0.02),GLS(P<0.001),multiple coronary stenos-is(P=0.04)and Agatston score(P=0.05).Multivariate analysis confirmed the relationships with LVEF(R^(2)=0.89,P<0.001),dia-stolic dysfunction(R^(2)=3.30,P=0.04),GLS(R^(2)=1.43,P<0.001),and Agatston score(R^(2)=1.01,P=0.05).Conclusions In patients with complete LBBB,CTA and GLS identified those at a high risk of development HF.

关键词： patients echocardiographic branch

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

Iatrogenic atrial septal defects after transseptal puncture for percutaneous left atrial appendage occlusion and their hemodynamic effects

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Journal of Geriatric cardiology 2022年第9期19卷 675-684页

作者： Ioannis Drosos Roberta De Rosa Philipp C.Seppelt Sebastian Cremer Silvia Mas-Peiro Katrin Hemmann Jana Oppermann Recha Blessing Mariuca Vasa-Nicotera Andreas M.Zeiher Zisis Dimitriadis division of cardiology Department of Medicine IIIUniversity Hospital FrankfurtGoethe University Frankfurt am MainFrankfurtGermany German Center for Cardiovascular Research(DZHK) BerlinGermany Cardiopulmonary Institute(CPI) FrankfurtGermany Center of cardiology University Medical Center MainzMainzGermany Di-vision of cardiology and intensive care Department of Internal MedicineSt.Ansgar HospitalHöxterGermany

Background Percutaneous left atrial appendage occlusion(LAAO)requires puncture of the interatrial *** immediate hemodynamic effects of iatrogenic atrial septal defects(iASD)after LAAO have not been examined so *** aimed at evaluat-ing these effects through invasive measurements of pressure and oxygen ***,we assessed the incidence of per-sistent iASD at three *** Forty-eight patients scheduled for percutaneous LAAO were prospectively included in the *** and oxygen saturation were measured(1)in the right atrium(RA)before transseptal puncture,(2)in the left atrium(LA)through the transseptal sheath after transseptal puncture,(3)in the LA after removal of introducer sheath,and(4)in the RA after removal of introducer *** echocardiography was performed at three months to detect *** Pressure in the RA increased significantly after removing the introducer sheath(P=0.034),whereas no difference was found in oxygen saturation in the RA(P=0.623).Pressure measurement in the LA showed no significant difference after re-moving the introducer sheath(P=0.718).Oxygen saturation in the LA also showed no significant difference(P=0.129).Follow-up transesophageal echocardiogram at 3 months revealed a persistent iASD in 4 patients(8.5%).CONCLUSIONS Our study suggests that iASD after percutaneous LAAO does not result in significant shunts directly after the procedure,although a significant increase of mean right atrial pressure can be *** iASDs after percutaneous LAAO seem to be relatively rare at three months.

关键词： atrial septal puncture

Tissue with high intelligence quotient Adipose-derived stem cells in neural regeneration

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Neural Regeneration Research 2009年第12期4卷 1116-1120页

作者： George N.Chaldakov Marco Fiore Anton B.Tonchev Mariyana G.Hristova Vesselka Nikolova Luigi Aloe division of Cell Biology Medical University Institute of Neurobiology and Molecular Medicine National Research Council and Rita Levi-Montalcini European Brain Research Institute Department of Endocrinology Medical Center Third Clinic of cardiology Intensive Cardiac Care UnitUniversity St Marina Hospital

The aim of the present review is to highlight the possible neuroregenerative potential ol adipose-derived stem cells. The key property of stem cells is plasticity including self-renewal, multilineage differentiation, and migration, whereas the required property is transplantability. For a long time, embryonic stem cells were thought to be the only source of pluripotency, a dogma that has been challenged during the last decade. Today, an alternative option might be adipose-derived stem cells, as easily accessible, ethical and autologous cellular source. Recent knowledge of adipobiology increasingly recognizes that adipose tissue is the major endo- and paracrine organ of the human body. Likewise, numerous neuropetides, neurotrophic factors, neurotransmitters, hypothalamic and steroid hormones and their receptors are shared by adipose tissue and brain. Accordingly, the regenerative potential of neuroprotective factor-secreting adipose-derived stem cells is outlined. Whether the possible benefits of adipose stem cell-based therapy may be mediated via cell transdifferentiation and/or paracrine mechanisms remains to further be evaluated.

关键词： adipose tissue neurodegeneration neurotrophic factors regeneration stem cells

Initial clinical experience using the Echo Navigator~-system during structural heart disease interventions

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World Journal of cardiology 2015年第9期7卷 562-570页

作者： Jan Balzer Tobias Zeus Katharina Hellhammer Verena Veulemans Silke Eschenhagen Eva Kehmeier Christian Meyer Tienush Rassaf Malte Kelm division of cardiology Pneumology and Angiology Department of Medicine University Hospital Duesseldorf

AIM: To present our initial clinical experience using this innovative software solution for guidance of percutaneous structural heart disease ***: Left atrial appendage, atrial septal defect and paravalvular leak closure, transaortic valve repair and Mitra Clip procedures were performed in the catheter laboratory under fluoroscopic and echocardiographic guidance. The two-dimensional and three-dimensional images generated by the transesophageal echocardiography probe were interfaced with the fluoroscopic images in real-time using the Echo Navigator-***:The application of the novel image fusion technology was safe and led to a better appreciation of multimodality imaging guidance due to improved visualization of the complex relationship between catheter devices and anatomical ***:The Echo Navigator-system is a feasible and safe tool for guidance of interventional procedures in structural heart *** innovative technology may improve confidence of interventional cardiologists in targeting and positioning interventional devices in order to increase safety,accuracy,and efficacy of percutaneous interventions in the catheter laboratory.

关键词： Fusion imaging Interventional guidance Percutaneou