Academic literature on the topic 'Cardiovascular system Surgery Risk factors Japan'
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Journal articles on the topic "Cardiovascular system Surgery Risk factors Japan"
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Morikane, K. "Epidemiology and risk factors associated with surgical site infection following surgery on thoracic aorta." Epidemiology and Infection 146, no. 14 (July 11, 2018): 1841–44. http://dx.doi.org/10.1017/s0950268818001930.
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AbstractSurgical site infection (SSI) following cardiovascular surgery has been well documented, possibly owing to its highly invasive nature, but SSI following surgery on the thoracic aorta has not. This study aimed to describe the epidemiology and assess risk factors associated with the latter in Japan using a national database for SSI. Data on surgery on thoracic aorta performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance (JANIS) database. Risk factors were assessed initially by univariate analysis, and then entered into a logistic regression model for final evaluation. The cumulative incidence of SSI was 4.1% (146/3538) and staphylococci were the most frequent pathogens isolated. Factors such as the duration of operation, emergency surgery and male gender were significantly associated with SSI. These findings differ from previous studies on open heart and coronary artery bypass surgery, in which the American Society of Anesthesiologists (ASA) score was significantly associated with SSI, but gender was not. This study suggests that risk stratification in the JANIS system might be improved by incorporating additionally identified factors for risk adjustment, when comparing the incidence of SSI between hospitals.
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Ohtsu, Hiroshi, Akihiko Shimomura, Sakiko Miyazaki, Naohiro Yonemoto, Shinichiro Ueda, Chikako Shimizu, and Kazuhiro Sase. "Cardiotoxicity of adjuvant chemotherapy with trastuzumab: a Japanese claim-based data analysis." Open Heart 9, no. 2 (August 2022): e002053. http://dx.doi.org/10.1136/openhrt-2022-002053.
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ObjectiveAdjuvant chemotherapy with trastuzumab improves the postoperative life expectancy of women with early-stage breast cancer. Although trastuzumab is reportedly cardiotoxic, quantification based on real-world evidence is lacking. Therefore, in this study, we aimed to analyse trastuzumab cardiotoxicity using a nationwide claim-based database.MethodsIn this retrospective study, we used data from a nationwide claims database (Japan Medical Data Center, Tokyo, Japan) under the universal healthcare system. Women with breast cancer who underwent initial surgery were included. Patients with recurrent or advanced-stage breast cancer, with a history of heart failure, receiving neoadjuvant chemotherapy or a preoperative history of less than 6 months were excluded. Propensity score (PS) was calculated using logistic regression based on age, cardiovascular risk factors, radiotherapy and concomitant anthracyclines (AC).ResultsWe identified 12 060 eligible patients (mean age 50.8±8.56 years) between January 2010 and December 2019. After 1:2 PS matching (trastuzumab users, TZ, n=1005; non-users, NT, n=2010), Cox proportional hazards model analysis showed that the rate of heart failure development within 18 months postoperative was significantly higher in the TZ group than in the NT group (adjusted HR 2.28, 95% CI 1.38 to 3.77). Baseline cardiac evaluation in the combined AC/TZ cases was 27.2% preoperative, 66.0% pre-AC and 86.6% pre-TZ, respectively.ConclusionTrastuzumab cardiotoxicity remained relevant in the claim-based analysis adjusted for AC effects. Further collaborative studies in cardio-oncology with real-world data are warranted to improve the rate of baseline cardiovascular risk assessment in patients with cancer scheduled for cardiotoxic cancer treatment.
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Kurazumi, Hiroshi, Masaya Takahashi, and Shigeru Ikenaga. "Outcomes of cardiovascular surgery for chronic dialysis patients in current Japan." Asian Cardiovascular and Thoracic Annals 27, no. 6 (June 19, 2019): 464–70. http://dx.doi.org/10.1177/0218492319859147.
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Background The number of dialysis patients in Japan is rising, with an increasing number requiring cardiovascular surgery. Methods We investigated the short- and long-term outcomes in 70 dialysis patients among a total of 1124 who underwent cardiovascular surgery in our hospital between 2004 and 2016. We investigated outcomes following open surgery and identified factors that affected the prognosis. We also compared the long-term survival rate with the survival rate of the Japanese dialysis population. Results The long-term survival rate was 70.6%, 51.1%, and 19.2% after 3, 5, and 10 years, respectively. The causes of long-term death were heart disease in 8 patients, cerebrovascular disease in 7, cachexia in 3, infection in 2, and other causes in 3. The freedom from cardiac death was 88.7%, 77.9%, and 54.9% after 3, 5, and 10 years, respectively. Multivariate analysis using Cox’s proportional hazard model showed that a history of atherosclerosis obliterans (hazard ratio 5.4, p = 0.05) and mediastinitis (hazard ratio 10.2, p = 0.03) were risk factors for death in long-term follow-up, and a history of atherosclerosis obliterans was an independent risk factor for cardiac death in long-term follow-up (hazard ratio 5.3, p = 0.01). Five-year survival of the study subjects was comparable to that of the Japanese dialysis population. Conclusions The prognosis for dialysis patients after open surgery was equivalent to that of Japanese dialysis patients in general. A high proportion of late postoperative deaths were due to heart disease. Patients with atherosclerosis obliterans had a poor prognosis.
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Morikane, Keita, Hitoshi Honda, and Satowa Suzuki. "Factors Associated With Surgical Site Infection Following Gastric Surgery in Japan." Infection Control & Hospital Epidemiology 37, no. 10 (July 19, 2016): 1167–72. http://dx.doi.org/10.1017/ice.2016.155.
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BACKGROUNDSurgical site infection (SSI) following gastric surgery has not been well documented.OBJECTIVETo describe and assess factors associated with SSI following gastric surgery in Japan using a Japanese national database for healthcare-associated infections.DESIGNA retrospective nationwide surveillance-based study.SETTINGJapanese healthcare facilities.METHODSData on gastric surgeries performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance. Gastric surgery was divided into 3 types of procedures: total gastrectomy (GAST-T), distal gastrectomy (GAST-D), and other types of gastric surgery (GAST-O). The incidence of and factors associated with SSI following gastric surgery were assessed by the 3 types of procedures.RESULTSThe cumulative incidence of SSI following gastric surgery was 8.8% (3,156/36,052). The incidence of SSI following GAST-T (12.4%) was significantly higher than that following GAST-D (7.01%) or GAST-O (7.84%). Besides the 4 conventional risk factors for predicting SSI, additional risk factors were identified. Male sex was significantly associated with SSI following all types of gastric surgery, but the effect of the association was substantially different (adjusted odds ratio, 1.52, 1.47, and 1.28 for GAST-T, GAST-D, and GAST-O, respectively). The effect of an emergency operation was similar. Age was also identified as a risk factor, but the most suitable modification of age as a variable differed.CONCLUSIONSThe incidence and factors associated with SSI following 3 types of gastric surgery differed. To accurately compare hospital performance in SSI prevention following gastric surgery, dividing surgical procedures in the surveillance system into 3 types should be considered.Infect Control Hosp Epidemiol 2016;1–6
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Fujita, Tomoyuki, Hiroyuki Yamamoto, Junjiro Kobayashi, Satsuki Fukushima, Hiroaki Miyata, Kizuku Yamashita, and Noboru Motomura. "Mitral valve surgery for ischemic papillary muscle rupture: outcomes from the Japan cardiovascular surgery database." General Thoracic and Cardiovascular Surgery 68, no. 12 (June 25, 2020): 1439–46. http://dx.doi.org/10.1007/s11748-020-01418-y.
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Abstract Background Ischemic papillary muscle rupture (PMR) is a catastrophic complication following acute myocardial infarction (AMI). We evaluated early outcomes of PMR by using data from the Japan Cardiovascular Surgery Database, a nationwide Japanese registry. Methods We retrospectively analyzed data from 196 patients diagnosed with PMR following AMI in Japan between January 2014 and December 2017. Risk factors for operative mortality and severe complications following mitral valve surgery were analyzed. Results The 30-day and hospital mortality rates were 20% and 26%, respectively. Chronic hemodialysis, abrupt rupture after AMI, resuscitation before surgery, and preoperative venoarterial extracorporeal membrane oxygenation were associated with mortality. Mitral valve replacement was chosen mainly (90%) for surgical correction of mitral regurgitation in these patients. There was no significant difference in short-term outcomes between mitral valve replacement versus mitral valve repair, despite non-matched characteristics in background between the treatment groups. Concomitant coronary artery bypass grafting had no impact on short-term outcomes. Conclusions Information derived from the nationwide database of patients with AMI-associated PMR show that PMR is a rare condition in the modern era. However, PMR is a severe disease with a mortality rate as high as 26%. The severity of the condition is associated with the risk for poor outcomes.
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Abe, Tomonobu, Hiroyuki Yamamoto, Hiroaki Miyata, Noboru Motomura, Yoshiyuki Tokuda, Kazuo Tanemoto, Akihiro Usui, and Shinichi Takamoto. "Patient trends and outcomes of surgery for type A acute aortic dissection in Japan: an analysis of more than 10 000 patients from the Japan Cardiovascular Surgery Database." European Journal of Cardio-Thoracic Surgery 57, no. 4 (December 3, 2019): 660–67. http://dx.doi.org/10.1093/ejcts/ezz323.
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Abstract OBJECTIVES To evaluate the background trends and surgical outcomes for more than 10 000 patients with acute type A dissection in Japan in a recent 8-year period. METHODS Data on replacement of the ascending aorta and/or aortic arch for acute type A dissection were collected from the Japan Cardiovascular Surgery Database from 2008 to 2015. Linear-by-linear association tests or Cuzick’s test for trend was used to evaluate group trends over time. The results were calculated for ascending or hemiarch replacement and arch replacement. A multivariable logistic regression model was used to calculate the risk-adjusted operative mortality rate. RESULTS A total of 11 843 patients were included. The overall 30-day mortality and operative mortality rates were 7.6% and 9.5%, respectively. The number of surgically treated cases increased from 2436 patients in 2008–2009 to 3533 in 2014–2015, a 45.0% increase. A trend analysis revealed significant changes in patient characteristics with time, including increasing age and rate of preoperative renal failure. Despite worsening risk factors, the unadjusted operative mortality rate with arch replacement showed a significant downward trend (P = 0.01; test of trend). The risk-adjusted mortality rate showed a downward trend both in ascending aorta or hemiarch replacement and arch replacement, although the trend was not statistically significant (P > 0.05). CONCLUSIONS Unadjusted and adjusted operative deaths have shown a decreasing trend, although patients undergoing surgery for acute type A dissection have demonstrated worsening of risk factors, such as age and renal failure. The number of surgeries performed for acute type A dissection significantly increased throughout the study period in Japan.
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Morikane, Keita, Hitoshi Honda, Takuya Yamagishi, Satowa Suzuki, and Mayumi Aminaka. "Factors Associated with Surgical Site Infection in Colorectal Surgery: The Japan Nosocomial Infections Surveillance." Infection Control & Hospital Epidemiology 35, no. 6 (June 1, 2014): 660–66. http://dx.doi.org/10.1086/676438.
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Objective.Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). This study aims to assess factors associated with SSI after colorectal surgery in Japan, using a Japanese national database for HAIs.Design.A retrospective nationwide surveillance-based study.Setting.Japanese healthcare facilities.Methods.Data on colon and rectal surgeries performed from 2008 through 2010 were extracted from a national monitoring system for healthcare-associated infections, the Japan Nosocomial Infections Surveillance (JANIS). Factors associated with SSI after colon and rectal surgery were assessed using multivariate logistic regression.Results.The cumulative incidence of SSI for colon and rectal surgery was 15.0% (6,691 of 44,751) and 17.8% (3,230 of 18,187), respectively. Traditional risk factors included in the National Nosocomial Infections Surveillance (NNIS) modified risk index were significant in predicting SSI in the final model for both colon and rectal surgery. Among the additional variables routinely collected in JANIS were factors independently associated with the development of SSI, such as male sex (adjusted odds ratio [aOR], 1.20 [95% confidence interval (CI), 1.14–1.27]), ileostomy or colostomy placement (aOR, 1.13 [95% CI, 1.04–1.21]), emergency operation (aOR, 1.40 [95% CI, 1.29–1.52]), and multiple procedures (aOR, 1.22 [95% CI, 1.13–1.33]) for colon surgery as well as male sex (aOR, 1.43 [95% CI, 1.31–1.55]), ileostomy or colostomy placement (aOR, 1,63 [95% CI, 1.51–1.79]), and emergency operation (aOR, 1.43 [95% CI, 1.20–1.72]) for rectal surgery.Conclusions.For colorectal operations, inclusion of additional variables routinely collected in JANIS can more accurately predict SSI risk than can the NNIS risk index alone.Infect Control Hosp Epidemiol 2014;35(6):660–666
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Yamauchi, Takashi, Hiroshi Takano, Hiroaki Miyata, Noboru Motomura, and Shinichi Takamoto. "Risk Factors for Mortality and Morbidity of Surgical Aortic Valve Replacement for Aortic Stenosis ― Risk Model From a Japan Cardiovascular Surgery Database ―." Circulation Reports 1, no. 3 (March 8, 2019): 131–36. http://dx.doi.org/10.1253/circrep.cr-19-0010.
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Leca, Bianca Maria, Ionuț Stanca, Suzana Florea, Simona Fica, and Anca Elena Sîrbu. "Impact of weight loss on the cardiovascular system after bariatric surgery." Problems of Endocrinology 62, no. 5 (September 22, 2016): 43. http://dx.doi.org/10.14341/probl201662543.
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Introduction. Obesity is a chronic disease with a great impact on the cardiovascular system through its association with type II diabetes, hypertension, dyslipidemia, metabolic syndrome (MetS) and also through direct alterations in cardiac performance and morphology. Recent long term studies prove that substantial weight loss obtained via bariatric surgery is capable of improving cardiac risk factors associated with severe obesity, decreasing the mortality rates.Aim: to assess the long-term changes in cardiovascular risk and cardiac structure in obese patients who had lost weight after laparoscopic sleeve gastrectomy (LSG).Methods. Fifty-two severe obese patients (44±9 years, 57.7% women, BMI=45±8 kg/m2) underwent clinical and biochemical examination and Doppler echocardiograms before and 5 years after LSG.Results. Pre-operatively, 78.4% of patients were hypertensive, 46.2% had diabetes, 73.1% MetS and 44.2% presented left ventricle hypertrophy (LVH), reflecting high cardio-metabolic risk. The patients reassessment was made 61.7±10.5 months after LSG, when a decrease in BMI of 21.9±10% was achieved (p<0.001). The prevalence of hypertension (64.7%), diabetes (32.7%) and MetS (28.8%) decreased compared to the pre-operative examination (p=0.019, p<0.001, p=0.036). An increase in left ventricle mass and left ventricle mass index (LVMI) (p<0.001) and in the prevalence of LVH (57.7%-p=0.001) was recorded. Patients were divided into two groups based on the decrease in LVMI (positive response-38.5%) or increase in LVMI post-surgery (negative response-61.5%), compared with pre-operative values. The group of patients with negative response had lost less weight (p=0.006), had a poor glycemic control (p=0.022), and higher systolic (p=0.004) and diastolic (p=0.030) pressure values compared to the first evaluation.Conclusion. The increase of LVMI after LSG indicates that this study should continue, including a larger number of patients. It is important to identify the factors that can predict an inappropriate response to surgery, in order to prevent and treat them.
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Koga, Masatoshi, Toshiyuki Uehara, Nobuyuki Yasui, Yasuhiro Hasegawa, Kazuyuki Nagatsuka, Yasushi Okada, and Kazuo Minematsu. "Factors Influencing Cooperation Among Healthcare Providers in a Community-Based Stroke Care System in Japan." Journal of Stroke and Cerebrovascular Diseases 20, no. 5 (September 2011): 413–23. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2010.02.012.
Full textBooks on the topic "Cardiovascular system Surgery Risk factors Japan"
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Prout, Jeremy, Tanya Jones, and Daniel Martin. Cardiovascular system. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199609956.003.0001.
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This chapter covers the assessment and investigation of perioperative cardiac risk, the principles of perioperative haemodynamic monitoring and physiological changes in cardiac comorbidity with their relevance to anaesthetic management. Perioperative cardiovascular risk includes assessment of cardiac risk factors, functional capacity and evidence-based guidelines for preassessment. Cardiovascular investigations such as cardiopulmonary exercise testing and scoring systems for cardiac risk are included. Management of the cardiac patient for non-cardiac surgery is detailed. Invasive monitoring with arterial, central venous and pulmonary artery catheters is described. Cardiac output measurement systems including dilution techniques, pulse contour analysis and Doppler are compared. The physiological changes, management and implications for anaesthesia of common cardiac comorbidity including ischaemic heart disease, heart failure, valvular heart disease, pacemakers and pulmonary hypertension are described.
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Balik, Martin. Perioperative cardiac care of the high-risk non-cardiac patient. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0076.
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Non-cardiac surgery conveys a cardiac risk related to the status of the patient’s cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additional tests. The indications for further cardiac testing and treatments are the same as in the non-operative setting, but their timing is dependent on the urgency of surgery, and patient-specific and surgical risk factors. A delay in surgery, due to the use of both non-invasive and invasive preoperative testing, should be limited to those circumstances in which the results of such tests will clearly affect patient management. In high-risk patients, the result of the cardiac assessment helps to choose adequate perioperative monitoring and to indicate for an intensive care unit stay perioperatively. Chronic medications can be adjusted, according to the current knowledge on perioperative management. Drugs with the potential to reduce the incidence of post-operative cardiac events and mortality include beta-blockers, statins, and aspirin. Chronic platelet anti-aggregation and anticoagulation therapies have to be adapted by weighing the risk of bleeding against the risk of thrombotic complications.
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Balik, Martin. Perioperative cardiac care of the high-risk non-cardiac patient. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0076_update_001.
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Non-cardiac surgery conveys a cardiac risk related to the status of the patient’s cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additional tests. The indications for further cardiac testing and treatments are the same as in the non-operative setting, but their timing is dependent on the urgency of surgery, and patient-specific and surgical risk factors. A delay in surgery, due to the use of both non-invasive and invasive preoperative testing, should be limited to those circumstances in which the results of such tests will clearly affect patient management. In high-risk patients, the result of the cardiac assessment helps to choose adequate perioperative monitoring and to indicate for an intensive care unit stay perioperatively. Chronic medications can be adjusted, according to the current knowledge on perioperative management. Drugs with the potential to reduce the incidence of post-operative cardiac events and mortality include beta-blockers, statins, and aspirin. Chronic platelet anti-aggregation and anticoagulation therapies have to be adapted by weighing the risk of bleeding against the risk of thrombotic complications.
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Balik, Martin. Perioperative cardiac care of the high-risk non-cardiac patient. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0076_update_002.
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Non-cardiac surgery conveys a cardiac risk related to the status of the patient’s cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additional tests. The indications for further cardiac testing and treatments are the same as in the non-operative setting, but their timing is dependent on the urgency of surgery, and patient-specific and surgical risk factors. A delay in surgery, due to the use of both non-invasive and invasive preoperative testing, should be limited to those circumstances in which the results of such tests will clearly affect patient management. In high-risk patients, the result of the cardiac assessment helps to choose adequate perioperative monitoring and to indicate for an intensive care unit stay perioperatively. Chronic medications can be adjusted, according to the current knowledge on perioperative management. Drugs with the potential to reduce the incidence of post-operative cardiac events and mortality include beta-blockers, statins, and aspirin. Chronic platelet anti-aggregation and anticoagulation therapies have to be adapted by weighing the risk of bleeding against the risk of thrombotic complications.
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Metzner, Julia I., and Deepak Sharma. Venous Air Embolism. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0025.
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Venous air embolism (VAE) is typically the entrainment of air from the surgical field into the vascular system producing adverse systemic effects based on the severity of embolism. Historically, VAE has most often been associated with sitting position craniotomies. However, there is now a clear recognition of the potential risk of this complication during craniotomy in any position, albeit with lesser incidence and severity. VAE can also occur during cervical spine surgery in the sitting position, although less often. While in many circumstances VAE may be subclinical and even undetected, it has the potential to lead to significant cardiovascular compromise during surgery, with the risk of adverse outcomes. Hence, it is imperative for anesthesiologists to be aware of the causes of and risk factors for VAE, its clinical presentation, diagnostic options, and treatment strategies to effectively prevent and intervene early in this potentially fatal condition.
Book chapters on the topic "Cardiovascular system Surgery Risk factors Japan"
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Balik, Martin. "Perioperative cardiac care of the high-risk non-cardiac patient." In The ESC Textbook of Intensive and Acute Cardiovascular Care, edited by Marco Tubaro, Pascal Vranckx, Eric Bonnefoy-Cudraz, Susanna Price, and Christiaan Vrints, 990–1008. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198849346.003.0075.
Full textAbstract:
Non-cardiac surgery conveys a cardiac risk related to the status of the patient's cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additional tests. The indications for further cardiac testing and treatments are the same as in the non-operative setting, but their timing is dependent on the urgency of surgery, and patient-specific and surgical risk factors. A delay in surgery, due to the use of both non-invasive and invasive preoperative testing, should be limited to those circumstances in which the results of such tests will clearly affect patient management. In high-risk patients, the result of the cardiac assessment helps to choose adequate perioperative monitoring and to indicate for an intensive care unit stay perioperatively. Chronic medications can be adjusted, according to the current knowledge on perioperative management. Drugs with the potential to reduce the incidence of post-operative cardiac events and mortality include beta-blockers, statins, and aspirin. Chronic platelet anti-aggregation and anticoagulation therapies have to be adapted by weighing the risk of bleeding against the risk of thrombotic complications.
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Banerjee, Amitava. "Global perspectives of hypertension and cardiovascular disease." In ESC CardioMed, edited by Gregory Lip, 2883–87. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0697.
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This chapter considers the overall global burden of cardiovascular disease (CVD) and its far-reaching implications. The Global Burden of Disease study has highlighted the mortality and morbidity from CVD in total, as well as individual diseases, allowing cross-country comparisons. In Europe, the European Observational Registry Programme has enabled surveillance of CVD and its management across Europe. Better data have enabled global inequalities in CVD to be uncovered, whether in terms of incidence and prevalence of risk factors or diseases, access to treatments, or long-term outcomes. Particular diseases and risk factors are highlighted from a global perspective. Variation in access to drugs, access to intervention/surgery, and health system barriers are discussed in more detail. Better data has also fuelled better advocacy and awareness for CVD, as well as galvanizing international efforts, whether in the form of the United Nations 2011 High-Level Meeting for Non-Communicable Diseases or specific roadmaps, guidelines, and action plans. In cardiovascular medicine, the evidence base, both in trials and observational studies, has been an exemplar to other areas of medicine, but the evidence base for CVD and its management in low- and middle-income countries still lags, and there is a great need for capacity-building, both in terms of training cardiologists and task-shifting to other non-physician health workers. As well as local capacity, global health can and should be part of the training curricula for cardiologists in Europe and other high-income settings in order to further develop clinical and academic resources. Finally, global disease targets for CVD are now embedded and prioritized in international health policy, which must now be operationalized.
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Chaikovsky, Illya, and Maksym Boreiko. "ELECTROCARDIOGRAPHY AS A PART OF HEART DISEASES SCREENING DURING EPIDEMIOLOGICAL RESEARCH: CURRENT STATE, TECHNOLOGICAL TRENDS, UNRESOLVED ISSUES." In Priority areas for development of scientific research: domestic and foreign experience. Publishing House “Baltija Publishing”, 2021. http://dx.doi.org/10.30525/978-9934-26-049-0-38.
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The goal of this paper is to analyze modern views on the electrocardiography (ECG) for heart disease screening, to review the experience of using portable ECG devices, the amount and nature of information that can be obtained using ECG devices with different numbers of leads, their regulatory base, especially in the context of cardiovascular diseases (CVD) screening. The characteristics of various scales for determining serious cardiovascular events are given. It is concluded that there is a need to personalize the scale risk assessment, i.e. to supplement the traditional risk factors with individual physiologically important parameters recorded using instrumental methods. The most important of these instrumental methods is ECG. A detailed description of numerous studies using ECG predictors of cardiovascular events, both in the general population and in various cohorts, is given, with an indication of their evidentiary power. The evolution of views on the indications for ECG examination of clinically healthy individuals in the course of epidemiological studies is described. Miniature portable electrocardiographic devices that are used by the patient outside the doctor's office as part of a broader trend, point-of-care testing (POCT), i.e. a medical test performed directly at the patient's location, outside the doctor's office, are considered. These are mainly single-channel electrocardiographs with finger electrodes: AfibAlert (USA), AliveCor / Kardia (USA), DiCare (China), ECG Check (USA), HeartCheck Pen (Canada), InstantCheck (Taiwan), MD100E (China), PC -80 (China). REKA E 100 (Singapore), Zenicor (Sweden), Omron Heart Scan (Japan), MDK (Holland). The experience of AliveCor / Kardia in the context of successive obtaining of several FDA approvals is especially considered. The features of screening for cardiovascular diseases using ECG devices with a limited number of leads are analyzed. The original electrocardiographic hardware and software complexes created at the Glushkov Institute of Cybernetics of National Academy of Science of Ukraine are described. The uniqueness of the software of these complexes is based on the analysis of subtle ECG changes that are invisible during the usual visual and/or automatic interpretation of the ECG signal. The idea of the analysis method consists, firstly, in measuring the maximum number of ECG parameters and heart rate variability, and secondly, in positioning each parameter on a scale between the absolute norm and extreme pathology. The software for these devices is structured according to a hierarchical principle. It consists of four levels – from individual particular indicators to the general integral indicator of the functional state of the cardiovascular system. When moving to higher levels of analysis, the information obtained at the previous level is generalized and aggregated. This is expressed in the averaging of all point values of all parameters of indicators of the previous level. indicators of the first level are averaged at the second level, the second – at the third, the third – at the fourth. The complex index, available in the software, is formed on the basis of assessments of generally accepted and original indicators of heart rate variability, characteristics of QRS complexes.
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Al-Suhaymi, Zainab. "Congenital Heart Disease and Surgical Outcome in Down Syndrome." In Genetics and Etiology of Down Syndrome [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.97134.
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The prevalence of congenital heart disease has accounted for nearly one-third of all significant congenital anomalies worldwide. The first report about an association between cardiac anomalies and Down Syndrome was in (1876). Ten years after discovering of Down Syndrome and the credit of association between congenital cardiac anomalies and mongolism was suggested in (1894) by Garrod. There many studies performed to identify a correlation between genotype and phenotype in Down Syndrome, little is known about cardiovascular phenotype in Down Syndrome. Congenital heart disease is considered one of the highest causes of mortality and morbidity in Down Syndrome compared to patients with the same lesion of non-down. There is a big debate about surgical management and considered them as risk factors of surgery with precaution and recent technology, Down Syndrome considered as a normal patient in prognosis. This chapter aimed to shed the light on congenital heart disease in Down Syndrome and current knowledge in specific mutations associated with them and how the effect of innovative technology and management to treat them end at the same outcome and sometimes better based on recent research and Scoring System.