The impact of personality factors on delay in seeking treatment of acute myocardial infarctionBMC Cardiovascular Disorders - Tập 11 - Trang 1-7 - 2011
Mona Schlyter, Lena André-Petersson, Gunnar Engström, Patrik Tydén, Margareta Östman
Early hospital arrival and rapid intervention for acute myocardial infarction is essential for a successful outcome. Several studies have been unable to identify explanatory factors that slowed decision time. The present study examines whether personality, psychosocial factors, and coping strategies might explain differences in time delay from onset of symptoms of acute myocardial infarction to arrival at a hospital emergency room. Questionnaires on coping strategies, personality dimensions, and depression were completed by 323 patients ages 26 to 70 who had suffered an acute myocardial infarction. Tests measuring stress adaptation were completed by 180 of them. The patients were then categorised into three groups, based on time from onset of symptoms until arrival at hospital, and compared using logistic regression analysis and general linear models. No correlation could be established between personality factors (i.e., extraversion, neuroticism, openness, agreeableness, conscientiousness) or depressive symptoms and time between onset of symptoms and arrival at hospital. Nor was there any significant relationship between self-reported patient coping strategies and time delay. We found no significant relationship between personality factors, coping strategies, or depression and time delays in seeking hospital after an acute myocardial infraction.
Relationship between serum interleukin-6 levels and severity of coronary artery disease undergoing percutaneous coronary interventionBMC Cardiovascular Disorders -
Nouha Bouzidi, Habib Gamra
Abstract
Background
Cytokines play a potential role in atherosclerosis pathogenesis and progression. We investigated the association of interleukin-6 (IL-6) with the angiographic severity of coronary artery disease (CAD).
Methods
Three hundred ten angiografically diagnosed CAD patients and 210 controls were enrolled in this study. CAD patients were stratified according to IL-6 cut-off value into high levels IL-6 group (≥ 9.5 pg/mL) and low levels IL-6 group (< 9.5 pg/mL). The severity of CAD was assessed according to Gensini score (GS), artery stenosis degree and the number of vessels involved. The mean age was 60.3 ± 11.0 years.
Results
The level of IL-6 in patients was increased compared to controls and ranged from 1.5 to 3640.0 pg/mL. High levels of IL-6 were significantly associated with high levels of GS (> 40) but not with stenosis degree and vessel score. GS levels were significantly more elevated in patients with high levels of IL-6 group than in low IL6 levels patients (60.6 ± 39.5 vs 46.7 ± 37.2; p = 0.027). The analysis of the ROC curve performed in myocardial infarction patients showed that IL-6 (AUC: 0.941 (CI 95% 0.886, 0.997; p < 0.001) could be a powerful predictor marker in evaluating the infarct size after myocardial infarction when compared to myonecrosis biomarkers.
Conclusions
IL-6 levels were associated with the severity of CAD assessed by the GS. Based on the highest levels of IL-6 measured in patients with STEMI, our study strongly suggests that IL-6 could be a powerful marker in evaluating the myocardial necrosis.
Trial registration
ClinicalTrials.gov Number: NCT03075566 (09/03/2017).
Staged open surgery for bicuspid aortic valve regurgitation and coarctation of the aorta in a Jehovah’s witnessBMC Cardiovascular Disorders - Tập 20 - Trang 1-3 - 2020
Kohei Sumi, Shigehiko Yoshida, Yoshitaka Okamura, Tomokazu Nakamura
Jehovah’s Witnesses refuse allogeneic blood transfusions, which makes cardiovascular surgery challenging. Surgeons must minimize blood and fluid loss within one procedure. We herein describe a 17-year-old male Jehovah’s Witness with bicuspid aortic valve regurgitation and coarctation of the aorta. The procedures were performed in the following order: aortic valve replacement combined with Nick’s aortic root enlargement, right axillary artery–bilateral external iliac artery bypass, and distal arch–descending aorta bypass. Axillary artery–bilateral external iliac artery bypass maintained distal perfusion and reduced the amount of heparin during distal arch–descending aorta bypass surgery.
Các Angiopoietin-1 và -2 trong máu, thụ thể Angiopoietin Tie-2 và Yếu tố tăng trưởng nội mạch loại A như các dấu ấn sinh học của nhồi máu cơ tim cấp: một nghiên cứu đối chứng nối tiếp có tiềm năng Dịch bởi AI BMC Cardiovascular Disorders - Tập 11 - Trang 1-9 - 2011
Carlos Iribarren, Bruce H Phelps, Jeanne A Darbinian, Edward R McCluskey, Charles P Quesenberry, Evangelos Hytopoulos, Joseph H Vogelman, Norman Orentreich
Angiogenesis được tăng cường trong tình trạng thiếu máu cơ tim. Tuy nhiên, dữ liệu hiện có hạn chế trong việc đánh giá giá trị của các dấu ấn sinh học angiogenic tuần hoàn trong việc dự đoán tỷ lệ mắc nhồi máu cơ tim cấp (AMI) trong tương lai. Mục tiêu của chúng tôi là kiểm tra mối liên hệ giữa nồng độ tuần hoàn của các dấu ấn của angiogenesis với nguy cơ xảy ra nhồi máu cơ tim cấp (AMI) ở nam giới và nữ giới. Chúng tôi đã thực hiện một nghiên cứu trường hợp - đối chứng (trong một nhóm lớn người đang điều trị tại Kaiser Permanente Northern California) bao gồm 695 trường hợp AMI và 690 đối chứng đã được ghép cặp riêng biệt theo độ tuổi, giới tính và chủng tộc/dân tộc. Nồng độ huyết thanh trung vị [khoảng giữa các tứ phân] của yếu tố tăng trưởng nội mạch loại A (VEGF-A; 260 [252] vs. 235 [224] pg/mL; p = 0.01) và angiopoietin-2 (Ang-2; 1.18 [0.66] vs. 1.05 [0.58] ng/mL; p < 0.0001) cao hơn đáng kể ở những trường hợp AMI so với đối chứng. Ngược lại, nồng độ thụ thể tyrosine kinase đặc hiệu nội mô (Tie-2; 14.2 [3.7] vs. 14.0 [3.1] ng/mL; p = 0.07) và nồng độ angiopoietin-1 (Ang-1; 33.1 [13.6] vs. 32.5 [12.7] ng/mL; p = 0.52) không khác biệt đáng kể theo tình trạng trường hợp - đối chứng. Sau khi điều chỉnh cho các yếu tố như trình độ học vấn, huyết áp cao, tiểu đường, hút thuốc, tiêu thụ rượu, chỉ số khối cơ thể, LDL-C, HDL-C, triglycerides và protein phản ứng C, mỗi lần tăng 1 đơn vị của Ang-2 dưới dạng điểm Z được liên kết với khả năng tăng 1.17 lần (khoảng tin cậy 95%, từ 1.02 đến 1.35) nhồi máu cơ tim cấp, và tứ phân trên của Ang-2, so với tứ phân thấp nhất, được liên kết với khả năng tăng 1.63 lần (khoảng tin cậy 95%, từ 1.09 đến 2.45) nhồi máu cơ tim cấp. Dữ liệu của chúng tôi hỗ trợ vai trò của Ang-2 như một dấu ấn sinh học của sự kiện nhồi máu cơ tim cấp độc lập với các yếu tố nguy cơ truyền thống.
#Angiogenesis #nhồi máu cơ tim cấp #dấu ấn sinh học #angiopoietin #yếu tố tăng trưởng nội mạch
A case of primary aldosteronism with a negative aldosterone-to-renin ratioBMC Cardiovascular Disorders - Tập 21 - Trang 1-6 - 2021
Fengyi Liu, Liang Wang, Yanchun Ding
Primary aldosteronism (PA), as a cause of secondary hypertension, can cause more serious cardiovascular damage than essential hypertension. The aldosterone-to-renin ratio (ARR) is recommended as the most reliable screening method for PA, but ARR screening is often influenced by many factors. PA cannot be easily excluded when negative ARR. We report the case of a 45-year-old Chinese man with resistant hypertension. Three years ago, he underwent a comprehensive screening for secondary hypertension, including the ARR, and the result was negative. After that, the patient's blood pressure was still poorly controlled with four kinds of antihypertensive drugs, the target organ damage of hypertension progressed, and hypokalaemia was difficult to correct. When the patient was hospitalized again for comprehensive examination, we found that aldosterone levels had significantly increased, although the ARR was negative. An inhibitory test with saline was further carried out, and the results suggested that aldosterone was not inhibited; therefore, PA was diagnosed. We performed a unilateral adenoma resection for this patient, and spironolactone was continued to control blood pressure. After the operation, blood pressure is well controlled, and hypokalaemia is corrected. When the ARR is negative, PA cannot be easily excluded. Comprehensive analysis and diagnosis should be based on the medication and clinical conditions of patients.
Validation of the VEINES-QOL quality of life instrument in venous leg ulcers: repeatability and validity study embedded in a randomised clinical trialBMC Cardiovascular Disorders - Tập 15 - Trang 1-12 - 2015
J. Martin Bland, Jo C. Dumville, Rebecca L. Ashby, Rhian Gabe, Nikki Stubbs, Una Adderley, Arthur R. Kang’ombe, Nicky A. Cullum
VEINES-QOL/Sym is a disease-specific quality of life instrument for use in venous diseases of the leg. Its relative scoring system precludes comparisons between studies. There were very few venous leg ulcer patients in the validation samples. We report a validation study for venous leg ulcers and develop a scoring system which enables comparison between studies. Four hundred fifty-one participants in the VenUS IV trial of the management of venous leg ulcers were asked to complete a VEINES-QOL questionnaire at recruitment, along with SF-12, pain, and other aspects of quality of life. VEINES-QOL was repeated after two weeks and after 4 months. Healing of ulcers was confirmed by blind assessment of digital photographs. Three scoring systems for VEINES-QOL were compared. No floor or ceiling effects were observed for VEINES-QOL items, item-item correlations were weak to moderate, item-score correlations were moderate. Internal reliability was good. The VEINES-Sym subscale was confirmed by factor analysis. Test-retest reliability was satisfactory for the scale scores; individual items showed moderate to good agreement. Relationships with SF-12, pain, and the quality items confirmed construct validity. Participants whose ulcers had healed showed greater mean increase in scores than did those yet to heal, though they continued to report leg problems. An intrinsic scoring method appeared superior to the original relative method. VEINES-QOL was suitable for use in the study of venous leg ulcers. The intrinsic scoring method should be adopted, to facilitate comparisons between studies. VenUS IV is registered with the ISRCTN register, number
ISRCTN49373072
.
Bipolar radiofrequency catheter ablation for refractory perimitral flutter: a case reportBMC Cardiovascular Disorders - Tập 15 - Trang 1-6 - 2015
Kenichiro Yamagata, Dan Wichterle, Petr Peichl, Bashar Aldhoon, Robert Čihák, Josef Kautzner
Mitral isthmus is often targeted as a part of stepwise approach during radiofrequency ablation for persistent atrial ablation. Acute success rate in achieving the mitral isthmus block is only modest, late reconduction rate is relatively high and, consequently, incomplete lesion may be proarrhythmic. We describe the first-in-man experience with successful MI ablation by bipolar RF energy delivery. A 64-year-old caucasian man after two previous ablation procedures for drug resistant atrial fibrillation in recent four years, which included pulmonary vein isolation and linear left atrial lesions, was referred for the treatment of recurrent perimitral flutter. Despite the third attempt to create bidirectional block at the mitral isthmus region, we were not even able to stop the arrhythmia by aggressive unipolar radiofrequency ablation both from the left atrium and coronary sinus, because of deeply embedded slow conducting channel probably around the vein of Marshall. Arrhythmia was finally terminated and the block was achieved by bipolar radiofrequency ablation between two irrigated-tip catheters positioned at the left atrial endocardium and contralaterally inside the coronary sinus. Bipolar radiofrequency energy delivery can be an option for ablation of perimitral flutter resistant to standard unipolar radiofrequency ablation. This may improve clinical outcome of patients undergoing non-pharmacological treatment for persistent atrial fibrillation. The safety and efficacy of this technique has to be confirmed in future studies.
Relationship of arterial tonometry and exercise in patients with chronic heart failure: a systematic review with meta-analysis and trial sequential analysisBMC Cardiovascular Disorders - Tập 22 Số 1
Xing Gong, Mei‐Chen Hu, Mei Li
Abstract
Background
Arterial stiffness is a common characteristic in patients with chronic heart failure (CHF), and arterial tonometric technologies related to arterial stiffness are novel and effective methods and have an important value in the diagnosis and prognosis of CHF. In terms of ameliorating arterial stiffness in patients with CHF, exercise training is considered an adjuvant treatment and also an effective means in the diagnosis and judgment of prognosis. However, there are huge controversies and inconsistencies in these aspects. The objective of this meta-analysis was to systematically test the connection of arterial tonometry and exercise in patients with CHF.
Methods
Databases, including MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, were accessed from inception to 7 March 2022. The meta-analysis was then conducted, and trial sequential analysis (TSA) was performed jointly to further verify our tests and reach more convincing conclusions by using RevMan version 5.4 software, STATA version 16.0 software, and TSA version 0.9.5.10 Beta software.
Results
Eighteen articles were included, with a total of 876 participants satisfying the inclusion criteria. The pooling revealed that flow-mediated dilation (FMD) was lower in basal condition [standardized mean difference (SMD): − 2.28%, 95% confidence interval (CI) − 3.47 to − 1.08, P < 0.001] and improved significantly after exercise (SMD: 5.96%, 95% CI 2.81 to 9.05, P < 0.001) in patients with heart failure with reduced ejection fraction (HFrEF) compared with healthy participants. The high-intensity training exercise was more beneficial (SMD: 2.88%, 95% CI 1.78 to 3.97, P < 0.001) than the moderate-intensity training exercise to improve FMD in patients with CHF. For augmentation index (AIx), our study indicated no significant differences (SMD: 0.50%, 95% CI − 0.05 to 1.05, P = 0.074) in patients with heart failure with preserved ejection fraction (HFpEF) compared with healthy participants. However, other outcomes of our study were not identified after further verification using TSA, and more high-quality studies are needed to reach definitive conclusions in the future.
Conclusions
This review shows that FMD is lower in basal condition and improves significantly after exercise in patients with HFrEF compared with healthy population; high-intensity training exercise is more beneficial than moderate-intensity training exercise to improve FMD in patients with CHF; besides, there are no significant differences in AIx in patients with HFpEF compared with the healthy population. More high-quality studies on this topic are warranted.
Neutrophilic granulocyte percentage is associated with anxiety in Chinese hospitalized heart failure patientsBMC Cardiovascular Disorders - Tập 22 - Trang 1-8 - 2022
Qian Ma, Feng-bo Zhang, En-sheng Yao, Shuo Pan
In patients with heart failure, anxiety disorder is common and associated with adverse prognosis. This study intended to find more confounding factors of Chinese heart failure patients. We enrolled 284 hospitalized heart failure patients, whose New York Heart Association (NYHA) classed as II-IV and left ventricular ejection fraction (LVEF) ≤ 45%. All the patients were scaled in Hamilton Rating Scale for Anxiety (14-items) (HAM-A14). Ordinal logistic regression analysis was performed to examine the association of correlated factors with anxiety disorder. There were 184 patients had anxiety accounting for 64.8% of all 284 hospitalized heart failure patients. The neutrophilic granulocyte percentage, urea nitrogen, total bilirubin and brain natriuretic peptide were positively associated with HAM-A14 score, meanwhile, the hemoglobin, red blood cells counts, albumin and LVEF were negatively associated with HAM-A14 score (All P < 0.05). After the adjustments of sex, hemoglobin, urea nitrogen, total bilirubin, albumin and brain natriuretic peptide, the neutrophilic granulocyte percentage was significantly associated with anxiety (OR = 43.265, P = 0.012). The neutrophilic granulocyte percentage was 0.616 ± 0.111, 0.640 ± 0.102, 0.681 ± 0.106 and 0.683 ± 0.113 in heart failure patients with no anxiety, possible anxiety, confirmed anxiety and obvious anxiety, respectively. Neutrophilic granulocyte percentage as well as the traditional risk factors such as sex, urea nitrogen and brain natriuretic peptide is associated with anxiety in hospitalized heart failure patients.
