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Incidence and trends of cardiovascular mortality after common cancers in young adults:Analysis of surveillance, epidemiology and end-results program

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World Journal of Cardiology 2016年第6期8卷 368-374页

作者： Sadeer G Al-Kindi Guilherme H Oliveira Onco-Cardiology Center University Hospitals Seidman Cancer Center and Harrington Heart and Vascular Institute

AIM: To describe the incidence of cardiovascular mortality(CVM) in survivors of major cancers and identify its trends over the past two decades. METHODS: We used the surveillance, epidemiology and end-results 19 registry to identify young adults(20-49 years), diagnosed with the following major primary cancers: Lung, breast, liver/intrahepatic bile duct, pancreas, prostate, colorectal, and ovarian from 1990 through 2012 and identified the cumulative incidence of CVM after adjusting for confounding factors. RESULTS: We identified a total of 301923 cancers(breast 173748, lung 38938, colorectal 31722, prostate 22848, ovary 16065, liver 9444, pancreas 9158). A total of 2297(0.8%) of patients had incident CVM. Lung(10-year cumulative CVM 2.4%) and liver(1.73%) cancers had the highest incidence of CVM, while breast(0.6%) and prostate(1.2%) had the lowest CVM mortality, even after multiple adjustments(P < 0.001). Overall, there was a significant improvement in CVM since 1990 [2005-2012 vs 1990-1994, adjusted HR 0.63(0.54-0.72), P < 0.001]. This was driven by improvements in CVM in lung cancers(P = 0.02), breast(P < 0.001), and a trend in ovarian cancer(P = 0.097).There was no statistically significant improvement in CVM among survivors of colorectal, pancreatic, liver, or prostate ***: The risk of CVM differs among different cancers, and is highest among survivors of lung and liver cancers. The incidence of CVM has decreased over the past 2 decades mainly among survivors of lung and breast cancers.

关键词： Cardiovascular disease Cancer Trends Cardiovascular mortality Type of Cancer

Ideal Cardiovascular Health Metrics and Coronary Artery Calcification in Northern Chinese Population:A Cross-sectional Study

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Biomedical and Environmental Sciences 2016年第7期29卷 475-483页

作者： LUO Tai Yang LIU Xiao Hui DAI Tian Yi LIU Xin Min ZHANG Qian DONG Jian Zeng Department of Cardiology Beijing An Zhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vascular Diseases

Objective Coronary artery calcification（CAC） is a well-established risk predictor of coronary heart disease events and is recognized as an indicator of subclinical *** A cross-sectional study consisting of 2999 participants aged ≥40 years from the Jidong community of Tangshan City,an industrial and modern city of China,was conducted between 2013 and 2014 to examine the association between the ideal cardiovascular health（CVH） metrics and *** ideal CVH metrics were determined based on the definition of the American heart Association（AHA）.The participants were then grouped into 4 categories according to the quartiles of their CVH metric scores as follows：first quartile（0-2）,second quartile（3）,third quartile（4）,and fourth quartile（5-7）.CAC was assessed by using high-pitch dual-source CT,and patients were identified based on thresholds of 0,10,100,or 400 Agatston units,as per common *** The prevalence of subclinical atherosclerosis was 15.92%,13.85%,6.76%,and 1.93%,determined by using the CAC scores at thresholds of 0,10,100,and 400 Agatston units,*** with the group in the first quartile,the other three CVH groups had a lower odds ratio of CAC 0 after adjusting for age,sex,income level,education level,and alcohol use in the logistic regression *** odds ratios in these groups were 0.86 [95% confidence interval（CI）,0.63-1.17;P0.05],0.75（95% CI,0.55-1.02;P0.05）,and 0.49（95% CI,0.35-0.69;P0.05）,*** associations of CAC with the CVH metrics were consistent when different CAC cutoff scores were used（0,10,100,or 400）.Conclusion The participants with more-ideal cardiovascular metrics had a lower prevalence of subclinical atherosclerosis determined according to CAC *** an ideal cardiovascular health may be valuable in the prevention of atherosclerosis in the general population.

关键词： Ideal cardiovascular health Coronary artery calcification Atherosclerosis

Contemporary characteristics and outcomes of adults with familial dilated cardiomyopathy listed for heart transplantation

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World Journal of Cardiology 2019年第1期11卷 38-46页

作者： Mohamed Khayata Sadeer G Al-Kindi Guilherme H Oliveira Cardiology Section Department of Internal Medicine University Hospitals Cleveland Medical Center Harrington Heart and Vascular Institute

BACKGROUND Familial dilated cardiomyopathy(FDCM) account for 20%-30% of non-ischemic cardiomyopathies(NICM). Previous published data showed that some patients with FDCM tend to have rapidly progressive disease; however, five-year mortality was not significantly different in the familial and non-familial forms of NICM with optimal medical *** To better define the characteristics and clinical outcomes of FDCM patients listed for heart transplantation(HT).METHODS We queried the United Network for Organ Sharing Registry to identify FDCM patients listed for HT between January 2008 and September 2015 and compared them to NICM and ischemic cardiomyopathy(ICM) patients. We included all patients ≥ 18 years old and we separated patients to three groups: FDCM, NICM and ICM. Chi-square test was used to compare between categorical variables, the t-test was used to compare between continues variables, and Cox-proportional hazards model was used to perform time-dependent survival *** Of the 24809 adults listed for HT, we identified 677 patients(2.7%) with the diagnosis of FDCM. Compared to patients with NICM and ICM, FDCM patients were younger(FDCM 43.9 ± 13.5 vs NICM 50.9 ± 12.3, P heart(FDCM 1.3% vs NICM 0.6%, P = 0.039; vs ICM 0.4%, P =0.002). Additionally, patients with FDCM were less frequently delisted for clinical deterioration or death and more likely to be transplanted compared to those with NICM [hazard ratio(HR): 0.617, 95% confidence interval(CI): 0.47-0.81; HR: 1.25,95%CI: 1.14-1.37, respectively], and ICM(HR: 0.5, 95%CI: 0.38-0.66; HR: 1.18,95%CI: 1.08-1.3, respectively). There was more frequent rejection among patients with FDCM(FDCM 11.4% vs NICM 9.8%, P = 0.28; vs I

关键词： Familial dilated cardiomyopathy End-stage heart failure Wait list Transplant Outcomes

The interactions between bloodstream and vascular structure on aortic dissecting aneurysmal model: A numerical study

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Acta Mechanica Sinica 2013年第3期29卷 462-468页

作者： Zeng-Sheng Chen Zhan-Ming Fan Xi-Wen Zhang Department of Engineering Mechanics School of AerospaceTsinghua University institute of heart Pulmonary & Vascular Diseases Capital University of Medical Science Affiliated Beijing Anzhen Hospital

Stent-graft implantation is an important means of clinical treatment for aortic dissecting aneurysm （ADA）. However, researches on fluid dynamics effects of stent were rare. Computer simulation was used to investigate the interactions between bloodstream and vascular structure in a stented ADA, which endures the periodic pulse velocity and pressure. We obtained and analyzed the flow velocity distribution, the wall displacement and wall stress in the ADA. By comparing the different results between a non-stented and a stented ADA, we found that the insertion of a vascular graft can make the location of maximum stress and displacement move from the aneurysm lumen wall to the artery wall, accompanied with a greatly decrease in value. These results imply that the placement of a stent-graft of any kind to oc-clude ADA will result in a decreased chance of rupture.

关键词： Aortic dissecting aneurysm (ADA) · Stent-graft · Fluid-structure interaction (FIS)

Experimental and computational studies on the flow fields in aortic aneurysms associated with deployment of AAA stent-grafts

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Acta Mechanica Sinica 2007年第5期23卷 495-501页

作者： Xiwen Zhang Zhaohui Yao Yan Zhang Shangdong Xu Department of Engineering Mechanics Tsinghua University Beijing 100084 China institute of heart Pulmonary and Vascular Diseases Capital University of Medical Science Affiliated Beijing Anzhen Hospital Beijing 100029 China

Pulsatile flow fields in rigid abdominal aortic aneurysm （AAA） models were investigated numerically, and the simulation results are found in good agreement with particle image velocimetry （PIV） measurements. There are one or more vortexes in the AAA bulge, and a fairly high wall shear stress exists at the distal end, and thus the AAA is in danger of rupture. Medical treatment consists of inserting a vascular stent-graft in the AAA, which would decrease the blood impact to the inner walls and reduce wall shear stress so that the rupture could be prevented. A new computational model, based on porous medium model, was developed and results are documented. Therapeutic effect of the stent-graft was verified numerically with the new model.

关键词： Abdominal aortic aneurysm Numerical simulation Particle image velocimetry Wall shear stress Stent-graft

Role of cardiovascular intervention as a bridge to liver transplantation

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World Journal of Gastroenterology 2014年第31期20卷 10651-10657页

作者： Zankhana Raval Matthew E Harinstein James D Flaherty Bluhm Cardiovascular institute Feinberg School of Medicine of Northwestern UniversityChicago IL 60611 United States University of Pittsburgh Medical Center heart and vascular institute Pittsburgh PA 15219 United States

End stage liver disease(ESLD) is associated with many specific derangements in cardiovascular physiology, which influence perioperative outcomes and may pro-foundly influence diagnostic and management strate-gies in the preoperative period. This review focuses on evidence-based diagnosis and management of coro-nary, hemodynamic and pulmonary vascular disease in this population with an emphasis on specific strategies that may provide a bridge to transplantation. Specifi-cally, we address the underlying prevalence of cardio-vascular disease states in the ESLD population, and relevant diagnostic criteria thereof. We highlight tradi-tional and non-traditional predictors of cardiovascular outcomes following liver transplant, as well as data to guide risk-factor based diagnostic strategies. We go on to discuss the alterations in cardiovascular physiology which influence positive- and negative-predictive values of standard noninvasive testing modalities in the ESLD population, and review the data regarding the safetyand efficacy of invasive testing in the face of ESLD and its co-morbidities. Finally, based upon the totality of available data, we outline an evidence-based ap-proach for the management of ischemia, heart failure and pulmonary vascular disease in this population. It is our hope that such evidence-driven strategies can be employed to more safely bridge appropriate candidates to liver transplant, and to improve their cardiovascular health and outcomes in the peri-operative period.

关键词： Perioperative management Liver transplantation Coronary heart disease Cirrhotic cardiomyopathy heart failure Pulmonary vascular disease

Successful cardiopulmonary resuscitation combined with thrombolysis for massive pulmonary embolism during peri-cardiac arrest

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World Journal of Emergency Medicine 2022年第6期13卷 495-499页

作者： Mei-ning Li Yan-hui Lu Ya-min Li Hai-yun Wang Yu-hong Mi Emergency and Critical Care Center Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vascular DiseaseBeijing 100029China

Dear editor,Pulmonary thromboembolism(PTE)has become the third most lethal type of thrombotic disease in the world.[1]Thrombolysis has been advised for high-risk PTE patients,however due to its unique pathophysiology,which differs from other atherosclerotic diseases,this can still be a challenge for PTE patients.[2]We reported two cases with a high-risk of PTE that had the onset of or progressed to cardiac arrest(CA)during hospitalization and were successfully managed with cardiopulmonary resuscitation(CPR)combined with thrombolytic therapy.

关键词： resuscitation cardiac embolism

Diagnosis and treatment of hypertensive crises in the elderly patients

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Journal of Geriatric Cardiology 2007年第1期4卷 50-55页

作者： Joseph Varon Neil E. Strickman University of Texas Health Science Center at Houston Houston Texas USA Peripheral vascular Lab at HGCA Peripheral Vascular Interventional Cardiology at Texas Heart Institute / St Lukes Episcopal Hospital Houston Texas USA

Hypertension is a common clinical problem in the elderly worldwide and physicians of all types are likely to encounter patients with hypertensive urgencies and emergencies in these patients. Although various terms have been applied to these conditions, they are all characterized by acute elevations in blood pressure and evidence of end-organ injury. Prompt, but carefully considered therapy is necessary to limit morbidity and mortality. A wide range of pharmacologic alternatives are available to the practitioner to control blood pressure and treat complications in these patients. The management of the elderly patient with hypertensive crises needs to include close monitoring and a gentle decline in blood pressure to avoid catastrophic complications, exacerbation of ischemic myopathy, and vascular insufficiency.

关键词： hypertension hypertensive crises hypertensive encephalopathy aortic dissection beta-blocker calcium channel blocker clevidipine fenoldopam nitroprusside labetalol nicardipine elderly

Tricuspid valve endocarditis:Cardiovascular imaging evaluation and management

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World Journal of Clinical Cases 2021年第30期9卷 8974-8984页

作者： Agostina M Fava Bo Xu Section of Cardiovascular Imaging Robert and Suzanne TomsichDepartment of Cardiovascular MedicineSydell and Arnold Miller Family HeartVascular and Thoracic InstituteCleveland ClinicClevelandOH 44195United States

Right-sided infective endocarditis is an increasingly recognized disease entity,with tricuspid valve being most frequently *** factors for tricuspid valve endocarditis(TVIE)include intravenous drug use,cardiac implantable electronic devices and indwelling *** aureus is the predominant causative organism in *** diagnosis of infective endocarditis(IE)is based on clinical manifestations,blood cultures,and the presence of valvular vegetations detected by *** imaging is helpful when there is ongoing clinical suspicion for IE following initially negative *** computed tomography allows for assessment of extra-cardiac complications in TVIE,including pulmonary septic emboli.18F-fluorodeoxyglucose positron emission tomography/computed tomography and radiolabelled white blood cell,single-photon emission computed tomography provide important clinical information concerning the presence of IE in right-sided prosthetic valves or cardiac implantable electronic *** aim of this review is to provide an update on TVIE,discussing the role of multimodality imaging in TVIE and the management of these patients.

关键词： Tricuspid valve endocarditis Multimodality imaging Echocardiography Computed tomography Positron emission tomography/computed tomography