Journal articles on the topic 'Early ischaemic heart disease'
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Penna, Claudia, Saveria Femminò, Giuseppe Alloatti, Maria F. Brizzi, Tommaso Angelone, and Pasquale Pagliaro. "Extracellular Vesicles in Comorbidities Associated with Ischaemic Heart Disease: Focus on Sex, an Overlooked Factor." Journal of Clinical Medicine 10, no. 2 (January 17, 2021): 327. http://dx.doi.org/10.3390/jcm10020327.
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Extracellular vesicles (EV) are emerging early markers of myocardial damage and key mediators of cardioprotection. Therefore, EV are becoming fascinating tools to prevent cardiovascular disease and feasible weapons to limit ischaemia/reperfusion injury. It is well known that metabolic syndrome negatively affects vascular and endothelial function, thus creating predisposition to ischemic diseases. Additionally, sex is known to significantly impact myocardial injury and cardioprotection. Therefore, actions able to reduce risk factors related to comorbidities in ischaemic diseases are required to prevent maladaptive ventricular remodelling, preserve cardiac function, and prevent the onset of heart failure. This implies that early diagnosis and personalised medicine, also related to sex differences, are mandatory for primary or secondary prevention. Here, we report the contribution of EV as biomarkers and/or therapeutic tools in comorbidities predisposing to cardiac ischaemic disease. Whenever possible, attention is dedicated to data linking EV to sex differences.
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Rasmiena, Aliki A., Theodore W. Ng, and Peter J. Meikle. "Metabolomics and ischaemic heart disease." Clinical Science 124, no. 5 (November 12, 2012): 289–306. http://dx.doi.org/10.1042/cs20120268.
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Ischaemic heart disease accounts for nearly half of the global cardiovascular disease burden. Aetiologies relating to heart disease are complex, but dyslipidaemia, oxidative stress and inflammation are cardinal features. Despite preventative measures and advancements in treatment regimens with lipid-lowering agents, the high prevalence of heart disease and the residual risk of recurrent events continue to be a significant burden to the health sector and to the affected individuals and their families. The development of improved risk models for the early detection and prevention of cardiovascular events in addition to new therapeutic strategies to address this residual risk are required if we are to continue to make inroads into this most prevalent of diseases. Metabolomics and lipidomics are modern disciplines that characterize the metabolite and lipid complement respectively, of a given system. Their application to ischaemic heart disease has demonstrated utilities in population profiling, identification of multivariate biomarkers and in monitoring of therapeutic response, as well as in basic mechanistic studies. Although advances in magnetic resonance and mass spectrometry technologies have given rise to the fields of metabolomics and lipidomics, the plethora of data generated presents challenges requiring specific statistical and bioinformatics applications, together with appropriate study designs. Nonetheless, the predictive and re-classification capacity of individuals with various degrees of risk by the plasma lipidome has recently been demonstrated. In the present review, we summarize evidence derived exclusively by metabolomic and lipidomic studies in the context of ischaemic heart disease. We consider the potential role of plasma lipid profiling in assessing heart disease risk and therapeutic responses, and explore the potential mechanisms. Finally, we highlight where metabolomic studies together with complementary -omic disciplines may make further inroads into the understanding, detection and treatment of ischaemic heart disease.
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MORALIDIS, E. "betaBlockers enhance early diastolic filling in ischaemic heart disease: a radionuclide assessment." Heart 86, no. 4 (October 1, 2001): 457. http://dx.doi.org/10.1136/heart.86.4.457.
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Ryan, Matthew, Holly Morgan, Mark C. Petrie, and Divaka Perera. "Coronary revascularisation in patients with ischaemic cardiomyopathy." Heart 107, no. 8 (January 12, 2021): 612–18. http://dx.doi.org/10.1136/heartjnl-2020-316856.
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Heart failure resulting from ischaemic heart disease is associated with a poor prognosis despite optimal medical treatment. Despite this, patients with ischaemic cardiomyopathy have been largely excluded from randomised trials of revascularisation in stable coronary artery disease. Revascularisation has multiple potential mechanisms of benefit, including the reversal of myocardial hibernation, suppression of ventricular arrhythmias and prevention of spontaneous myocardial infarction. Coronary artery bypass grafting is considered the first-line mode of revascularisation in these patients; however, evidence from the Surgical Treatment of Ischaemic Heart Failure (STICH) trial showed a reduction in mortality, though this only became apparent with extended follow-up due to an excess of early adverse events in the surgical arm. There is currently no randomised controlled trial evidence for percutaneous coronary intervention in patients with ischaemic cardiomyopathy; however, the REVIVED-BCIS2 trial has recently completed recruitment and will address this gap in the evidence. Future directions include (1) clinical trials of revascularisation in patients hospitalised with heart failure, (2) defining the role of viability and ischaemia testing in heart failure, (3) studies to enhance the understanding of the mechanistic effects of revascularisation and (4) generating models to refine pre- and post-revascularisation risk prediction.
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SECKL, J. "Early life events and later development of Ischaemic heart disease." Lancet 342, no. 8881 (November 1993): 1236. http://dx.doi.org/10.1016/0140-6736(93)92215-f.
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Rahman, Md Mahbubu, Md Aminur Razzaque, Iftikher Alam, Asif Iqbal, Golam Rahman Mallick, Swati Munshi, Md Wareshuzzaman, and AK Mohammad Qudrath E. Hasan. "Cardiac Cephalgia: Angina in the Head." Bangladesh Medical Journal 48, no. 3 (February 2, 2021): 46–49. http://dx.doi.org/10.3329/bmj.v48i3.51798.
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Cardiac cephalgia is a migraine like headache that occurs during episodes of myocardial ischaemia. Although most of the patients presenting with ischaemic heart disease have chest pain, there are other rare presenting symptoms like cardiac cephalgia. Headache can be the only presentation of coronary artery disease. We report a case of a 57 years-old man, Presenting with only headache during brisk walking, Exercise Tolerance Test (ETT) was positive for Electrocardiograph (ECG) evidence of provocable myocardial ischemia, who latter was diagnosed as double vessel coronary artery diseaseon Coronary Angiogram (CAG). As the patient preferred remaining without revascularization, he was put onto optimum medical management for ischaemic heart disease. A follow up visit after one month revealed, marked improvement of the headache with anti anginal medications. Early evaluation and diagnosis of the headache symptom should be done because treatment with anti-migraine drugs may deteriorate headache and undermine the diagnosis of coronary artery disease.
Bangladesh Med J. 2019 Sep; 48 (3): 46-49
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Søndergaard, Grethe, Susanne Oksbjerg Dalton, Laust Hvas Mortensen, and Merete Osler. "Educational inequality in cardiovascular diseases: a sibling approach." Scandinavian Journal of Public Health 46, no. 1 (October 9, 2017): 83–91. http://dx.doi.org/10.1177/1403494817734775.
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Aims: Educational inequality in diseases in the circulatory system (here termed cardiovascular disease) is well documented but may be confounded by early life factors. The aim of this observational study was to examine whether the associations between education and all cardiovascular diseases, ischaemic heart disease and stroke, respectively, were explained by family factors shared by siblings. Methods: The study population included all individuals born in Denmark between 1950 and 1979 who had at least one full sibling born in the same period. Using Cox regression, data were analysed in conventional cohort and within-sibship analyses in which the association was examined within siblings discordant on education. Assuming that attenuation of associations in the within-sibship as compared with the cohort analyses would indicate confounding from factors shared within families. Results: A lower educational status was associated with a higher risk of cardiovascular disease, ischaemic heart disease and stroke. All associations attenuated in the within-sibship analyses, in particular in the analyses on ischaemic heart disease before age 45 years. For instance, in the cohort analyses, the hazard rate of ischaemic heart disease among women less than 45 years who had a primary school education was 94% (hazard ratio 1.94 (1.78–2.12) higher than among those with a vocational education, while it attenuated to 51% (hazard ratio 1.51 (1.34–1.71)) in the within-sibship analysis. Conclusions: Confounding from factors shared by siblings explained the associations between education and the cardiovascular disease outcomes but to varying degrees. This should be taken into account when planning interventions aimed at reducing educational inequalities in the development of cardiovascular disease, ischaemic heart disease and stroke.
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Muradov, A. G., V. U. Efendiev, A. V. Andin, D. B. Drobot, D. P. Demidov, and V. A. Sakovich. "The history of coronary surgery development." Siberian Medical Review, no. 3 (2021): 15–25. http://dx.doi.org/10.20333/25000136-2021-3-15-25.
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The leading place among cardiovascular diseases in the world – 50% – belongs to the ischaemic heart disease. Coronary bypass grafting is the golden standard for treatment of patients with multivessel ischaemic heart disease. The modern level of coronary surgery makes it possible to perform safe and efficacious direct revascularisation with hospital lethality not exceeding 1-3%. This article presents a review of literature devoted to the history of coronary surgery development including analysis of relevant sources dated 2010-2020 published in PubMed and Google Scholar databases: from first experimental procedures in the beginning of the 20th century and indirect myocardial revascularisation methods to direct bypass grafting of the impaired heart vessels actively developed since early 1960s. The article describes types of grafts applied with description of advantages and disadvantages of each one as well as contemporary methods and conditions for coronary bypass grafting and further prospects in development of ischaemic heart disease surgery.
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Dorofeeva, N. P., S. A. Pleskachev, S. V. Shlyk, E. V. Tchigaeva, E. A. TherAnanyanz, O. G. Mashtalova, I. E. Koulikova, A. S. Pleskachev, and S. S. Todorov. "CLINICAL AND PATHOGENETIC ASPECTS OF ISCHAEMIC HEART DISEASE COMPLICATED BY CHTONIC HEART FAILURE." Journal of Clinical Practice 2, no. 1 (March 15, 2011): 67–73. http://dx.doi.org/10.17816/clinpract2167-73.
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Objectives: To investigate genetic and neurohumoral determinants of chronic heart failure (CHF) development and progression in ischaemic heart disease (IHD) patients. Methods: Serum neurohormone level analysis (angiotensin II, aldosterone, endotheline1, NTproBNP, TNFα) and genotyping (genes encoding ACE, angiotensinogen, and type1 angiotensin II receptors ) were implemented in 100 patients Results: Activation of endotheline and NTproBNP is characteristic of early CHF stages while decompensation of chronic heart failure shows elevation in aldosterone and TNFα . Structural polymorphism of renineangiotensine system genes is not significant in CHF development and progression in IHD patients.
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Evans-Cheung, Trina C., H. Jonathan Bodansky, Roger C. Parslow, and Richard G. Feltbower. "Early deaths from ischaemic heart disease in childhood-onset type 1 diabetes." Archives of Disease in Childhood 103, no. 10 (January 24, 2018): 981–83. http://dx.doi.org/10.1136/archdischild-2017-314265.
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AimsThe risk of ischaemic heart disease (IHD) death in early type 1 diabetes onset was assessed using death certification data.MethodsThe Yorkshire Register of type 1 Diabetes in Children and Young People was linked to clinically validated death certification data for those diagnosed under 15 years. Standardised mortality ratios (SMRs) were calculated using the England and Wales population and IHD death rates between 1978 and 2014 by 5-year age group and sex.ResultsThe cohort included 4382 individuals (83 097 person years). Of 156 deaths, nine were classed as IHD deaths before clinical validation. After clinical validation, 14 IHD deaths were classified, with an SMR of 13.8 (95% CI 8.2 to 23.3) and median age at death of 35.1 years (range 21.9–47.9 years).ConclusionsThere is an early emergence of death from IHD in early onset type 1 diabetes. Underascertainment of IHD deaths was present without clinical validation of death certification.
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Martins-Marques, Tania, Steve Catarino, Monica Zuzarte, Carla Marques, Paulo Matafome, Paulo Pereira, and Henrique Girão. "Ischaemia-induced autophagy leads to degradation of gap junction protein connexin43 in cardiomyocytes." Biochemical Journal 467, no. 2 (April 2, 2015): 231–45. http://dx.doi.org/10.1042/bj20141370.
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GJIC (gap junction intercellular communication) between cardiomyocytes is essential for synchronous heart contraction and relies on Cx (connexin)-containing channels. Increased breakdown of Cx43 has been often associated with various cardiac diseases. However, the mechanisms whereby Cx43 is degraded in ischaemic heart remain unknown. The results obtained in the present study, using both HL-1 cells and organotypic heart cultures, show that simulated ischaemia induces degradation of Cx43 that can be prevented by chemical or genetic inhibitors of autophagy. Additionally, ischaemia-induced degradation of Cx43 results in GJIC impairment in HL-1 cells, which can be restored by autophagy inhibition. In cardiomyocytes, ubiquitin signals Cx43 for autophagic degradation, through the recruitment of the ubiquitin-binding proteins Eps15 (epidermal growth factor receptor substrate 15) and p62, that assist in Cx43 internalization and targeting to autophagic vesicles, via LC3 (light chain 3). Moreover, we establish that degradation of Cx43 in ischaemia or I/R (ischaemia/reperfusion) relies upon different molecular players. Indeed, degradation of Cx43 during early periods of ischaemia depends on AMPK (AMP-activated protein kinase), whereas in late periods of ischaemia and I/R Beclin 1 is required. In the Langendorff-perfused heart, Cx43 is dephosphorylated in ischaemia and degraded during I/R, where Cx43 degradation correlates with autophagy activation. In summary, the results of the present study provide new evidence regarding the molecular mechanisms whereby Cx43 is degraded in ischaemia, which may contribute to the development of new strategies that aim to preserve GJIC and cardiac function in ischaemic heart.
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Ketterer, Mark W., Faye Fitzgerald, Beth Thayer, Richard Moraga, Greg Mahr, Steven J. Keteyian, Cathy McGowan, Paul Stein, and A. David Goldberg. "Psychosocial and Traditional Risk Factors in Early Ischaemic Heart Disease: Cross-Sectional Correlates." European Journal of Cardiovascular Risk 7, no. 6 (December 2000): 409–13. http://dx.doi.org/10.1177/204748730000700603.
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Padro, Teresa, Olivia Manfrini, Raffaele Bugiardini, John Canty, Edina Cenko, Giuseppe De Luca, Dirk J. Duncker, et al. "ESC Working Group on Coronary Pathophysiology and Microcirculation position paper on ‘coronary microvascular dysfunction in cardiovascular disease’." Cardiovascular Research 116, no. 4 (February 8, 2020): 741–55. http://dx.doi.org/10.1093/cvr/cvaa003.
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Although myocardial ischaemia usually manifests as a consequence of atherosclerosis-dependent obstructive epicardial coronary artery disease, a significant percentage of patients suffer ischaemic events in the absence of epicardial coronary artery obstruction. Experimental and clinical evidence highlight the abnormalities of the coronary microcirculation as a main cause of myocardial ischaemia in patients with ‘normal or near normal’ coronary arteries on angiography. Coronary microvascular disturbances have been associated with early stages of atherosclerosis even prior to any angiographic evidence of epicardial coronary stenosis, as well as to other cardiac pathologies such as myocardial hypertrophy and heart failure. The main objectives of the manuscript are (i) to provide updated evidence in our current understanding of the pathophysiological consequences of microvascular dysfunction in the heart; (ii) to report on the current knowledge on the relevance of cardiovascular risk factors and comorbid conditions for microcirculatory dysfunction; and (iii) to evidence the relevance of the clinical consequences of microvascular dysfunction. Highlighting the clinical importance of coronary microvascular dysfunction will open the field for research and the development of novel strategies for intervention will encourage early detection of subclinical disease and will help in the stratification of cardiovascular risk in agreement with the new concept of precision medicine.
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Davydova, E. V. "Dysregulation of cardiac sinus pace-making activity in cardiopathy with underlying pneumoconiosis." PULMONOLOGIYA, no. 5 (October 28, 2008): 51–55. http://dx.doi.org/10.18093/0869-0189-2008-0-5-51-55.
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Pneumoconiosis has one of the leading positions in occupational pathology at most industrial regions of Russia. This disease is characterized by torpid, slowly progressive course. The most frequent cause of death of working-aged patients with pneumoconiosis is the heart involvement. Using rhythmocardiography, the present authors have detected autonomic cardioneuropathy which is a pathogenic basis for early clinical manifestations of ischaemic heart disease in patients with pneumoconiosis.
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Chatterjee, T., A. S. Macdonald, and H. R. Waters. "A Model for Ischaemic Heart Disease and Stroke I: The Model." Annals of Actuarial Science 3, no. 1-2 (September 2008): 45–81. http://dx.doi.org/10.1017/s1748499500000452.
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ABSTRACTWe construct a stochastic model of an individual's lifetime that includes diagnosis with ischaemic heart disease and stroke and also the development of the major risk factors for these conditions: hypercholesterolaemia, hypertension, diabetes and obesity. Smoking, another major risk factor, is treated deterministically. Mathematically, the model is a continuous time, finite state space Markov process, with the individual's age playing the rôle of time. The model is parameterised using data from the Framingham Heart Study, with parameter values adjusted so that the model is appropriate for UK conditions in the early 21st century. The model has been designed so that it can be used to quantify the effects of:(i) trends, in particular increasing prevalence of obesity.(ii) changes in behaviour, in particular smoking patterns, and(iii) treatments, in particular statins for hypercholesterolaemia.These applications are covered in two accompanying papers.
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Seferović, Petar M., Marija M. Polovina, and Andrew J. S. Coats. "Heart failure in dilated non-ischaemic cardiomyopathy." European Heart Journal Supplements 21, Supplement_M (December 1, 2019): M40—M43. http://dx.doi.org/10.1093/eurheartj/suz212.
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Abstract Heart failure (HF) is the prevailing cause of morbidity and mortality in patients with dilated non-ischaemic cardiomyopathy (DCM) and DCM is one of several causes of HF, with several distinct epidemiological and clinical features which may have important implications for its management and prognosis. This article reviews cardiovascular monitoring of specific characteristics of HF in DCM. DCM is defined as ventricular dilatation and systolic dysfunction in the absence of abnormal loading conditions or significant coronary artery disease, the predominant phenotypes of being HFmrEF or HFrEF. DCM accounts for ∼40% of all cardiomyopathies but its true prevalence among patients with HFrEF is difficult to ascertain with certainty. Compared with patients with other HF aetiologies, individuals with DCM tend to be younger, more likely male and less likely to have associated comorbidities. A genetic aetiology of DCM is deemed responsible for ∼40% of cases. Confirmation of a specific genetic background is clinically relevant (e.g. Duchene or Backer muscular dystrophies, lamin A/C mutation), because those patients may be at a high risk of progressive left ventricular dysfunction or conduction system disease and sudden death, prompting early prophylaxis with an implantable cardioverter defibrillator. However, in most instances, HF in DCM has a multifactorial aetiology, with multiple factors needing to be systematically evaluated and/or monitored, since correction of reversible causes or (e.g. tachycardia-induced cardiomyopathy, alcohol intoxication, iron-overload, cancer therapies etc.) or targeting specific pathophysiological causes could lead to an improvement in clinical status. The treatment of DCM encompasses HF-related pharmacological and device therapies, and aetiology-specific treatments. At present, options for aetiology-related therapies are limited, and their effectiveness mostly requires confirmation from larger scale randomized trials. Whether outcomes of patients with HF in DCM differ from those with other HF aetiologies is unresolved. DCM is attributable for >40% of patients receiving mechanical circulatory support for advanced HF and it is the leading indication for heart transplantation. More aetiology-specific information is needed both in the evaluation and treatment of dilated cardiomyopathy.
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BARAUSKIENE, V. "P2111 Prediction of early recurrence of atrial fibrillation in patients with ischaemic heart disease." European Heart Journal 24, no. 5 (March 2003): 393. http://dx.doi.org/10.1016/s0195-668x(03)95105-0.
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Kral, B. G., L. C. Becker, D. Vaidya, L. R. Yanek, and D. M. Becker. "Silent myocardial ischaemia and long-term coronary artery disease outcomes in apparently healthy people from families with early-onset ischaemic heart disease." European Heart Journal 32, no. 22 (July 23, 2011): 2766–72. http://dx.doi.org/10.1093/eurheartj/ehr261.
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Løkkegaard, E., Z. Jovanovic, B. L. Heitmann, N. Keiding, B. Ottesen, and A. T. Pedersen. "The association between early menopause and risk of ischaemic heart disease: Influence of Hormone Therapy." Maturitas 53, no. 2 (January 2006): 226–33. http://dx.doi.org/10.1016/j.maturitas.2005.04.009.
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Jones, Julia L., Natalie G. Lumsden, Koen Simons, Anis Ta'eed, Maximilian P. de Courten, Tissa Wijeratne, Nicholas Cox, et al. "Using electronic medical record data to assess chronic kidney disease, type 2 diabetes and cardiovascular disease testing, recognition and management as documented in Australian general practice: a cross-sectional analysis." Family Medicine and Community Health 10, no. 1 (February 2022): e001006. http://dx.doi.org/10.1136/fmch-2021-001006.
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ObjectivesTo evaluate the capacity of general practice (GP) electronic medical record (EMR) data to assess risk factor detection, disease diagnostic testing, diagnosis, monitoring and pharmacotherapy for the interrelated chronic vascular diseases—chronic kidney disease (CKD), type 2 diabetes (T2D) and cardiovascular disease.DesignCross-sectional analysis of data extracted on a single date for each practice between 12 April 2017 and 18 April 2017 incorporating data from any time on or before data extraction, using baseline data from the Chronic Disease early detection and Improved Management in PrimAry Care ProjecT. Deidentified data were extracted from GP EMRs using the Pen Computer Systems Clinical Audit Tool and descriptive statistics used to describe the study population.SettingEight GPs in Victoria, Australia.ParticipantsPatients were ≥18 years and attended GP ≥3 times within 24 months. 37 946 patients were included.ResultsRisk factor and disease testing/monitoring/treatment were assessed as per Australian guidelines (or US guidelines if none available), with guidelines simplified due to limitations in data availability where required. Risk factor assessment in those requiring it: 30% of patients had body mass index and 46% blood pressure within guideline recommended timeframes. Diagnostic testing in at-risk population: 17% had diagnostic testing as per recommendations for CKD and 37% for T2D. Possible undiagnosed disease: Pathology tests indicating possible disease with no diagnosis already coded were present in 6.7% for CKD, 1.6% for T2D and 0.33% familial hypercholesterolaemia. Overall prevalence: Coded diagnoses were recorded in 3.8% for CKD, 6.6% for T2D, 4.2% for ischaemic heart disease, 1% for heart failure, 1.7% for ischaemic stroke, 0.46% for peripheral vascular disease, 0.06% for familial hypercholesterolaemia and 2% for atrial fibrillation. Pharmaceutical prescriptions: the proportion of patients prescribed guideline-recommended medications ranged from 44% (beta blockers for patients with ischaemic heart disease) to 78% (antiplatelets or anticoagulants for patients with ischaemic stroke).ConclusionsUsing GP EMR data, this study identified recorded diagnoses of chronic vascular diseases generally similar to, or higher than, reported national prevalence. It suggested low levels of extractable documented risk factor assessments, diagnostic testing in those at risk and prescription of guideline-recommended pharmacotherapy for some conditions. These baseline data highlight the utility of GP EMR data for potential use in epidemiological studies and by individual practices to guide targeted quality improvement. It also highlighted some of the challenges of using GP EMR data.
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Polonara, G., J. Bove, L. Regnicolo, N. Herber, E. Cesaroni, and N. Zamponi. "Paediatric Cerebrovascular Disease: Neuroradiological Diagnosis." Rivista di Neuroradiologia 18, no. 3 (June 2005): 304–14. http://dx.doi.org/10.1177/197140090501800306.
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The low incidence (2.6 cases in 100,000) of cerebrovascular disease in paediatric patients compared with the adult population makes it a diagnostic challenge. Etiological factors have changed over time: whereas in the past bacterial meningitis was the most frequent cause, heart disease, haematological disorders, vasculopathy and viral infections have now become the most common. Haemorrhagic stroke is most frequently due to arteriovenous malformations (AVMs), cavernous angioma, haematological disorders and intracranial aneurysms. Traumatic or fibrodyplastic arterial thrombosis is extremely rare. Venous thrombosis most commonly affects the upper sagittal sinus. In two thirds of cases the cause of stroke remains unknown. For years, symptoms of acute CNS deficits have been studied with computed tomography (CT), especially to rule out haemorrhage. To avoid exposing paediatric patients to ionizing radiation, magnetic resonance imaging (MRI), more sensitive and specific for the identification of acute ischaemic stroke, is currently the first-line diagnostic technique. In particular, diffusion-weighted sequences are capable of early identification of ischaemic areas. Association with perfusion techniques will define the areas at high risk of further damage and to attempt to estimate the final volume of the lesion. MR spectroscopy contributes to the characterization of ischaemic lesions. MR angiography (MRA) has proved to be a noninvasive technique with the same diagnostic effectiveness as conventional angiography for dissections, transient cerebral arteriopathy and moyamoya. The cervical arteries are studied using contrast-enhanced sequences. Conventional angiography remains the technique of choice for the study of small vessels disease and AVMs.
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Liu, Yan, Bo Yin, and Yanping Cong. "The Probability of Ischaemic Stroke Prediction with a Multi-Neural-Network Model." Sensors 20, no. 17 (September 3, 2020): 4995. http://dx.doi.org/10.3390/s20174995.
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As is known, cerebral stroke has become one of the main diseases endangering people’s health; ischaemic strokes accounts for approximately 85% of cerebral strokes. According to research, early prediction and prevention can effectively reduce the incidence rate of the disease. However, it is difficult to predict the ischaemic stroke because the data related to the disease are multi-modal. To achieve high accuracy of prediction and combine the stroke risk predictors obtained by previous researchers, a method for predicting the probability of stroke occurrence based on a multi-model fusion convolutional neural network structure is proposed. In such a way, the accuracy of ischaemic stroke prediction is improved by processing multi-modal data through multiple end-to-end neural networks. In this method, the feature extraction of structured data (age, gender, history of hypertension, etc.) and streaming data (heart rate, blood pressure, etc.) based on a convolutional neural network is first realized. A neural network model for feature fusion is then constructed to realize the feature fusion of structured data and streaming data. Finally, a predictive model for predicting the probability of stroke is obtained by training. As shown in the experimental results, the accuracy of ischaemic stroke prediction reached 98.53%. Such a high prediction accuracy will be helpful for preventing the occurrence of stroke.
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Imazio, Massimo, and Mark Nidorf. "Colchicine and the heart." European Heart Journal 42, no. 28 (May 7, 2021): 2745–60. http://dx.doi.org/10.1093/eurheartj/ehab221.
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Abstract Colchicine is a unique, sophisticated anti-inflammatory agent that has been used for decades for the prevention of acute inflammatory flares in gout and familial Mediterranean fever. In recent years, clinical trials have demonstrated its potential in a range of cardiovascular (CV) conditions. Colchicine is avidly taken up by leucocytes, and its ability to bind to tubulin and interfere with microtubular function affects the expression of cytokines and interleukins, and the ability of neutrophils to marginate, ingress, aggregate, express superoxide, release neutrophil extracellular traps, and interact with platelets. In patients with acute and recurrent pericarditis, clinical trials in >1600 patients have consistently shown that colchicine halves the risk of recurrence [relative risk (RR) 0.50, 95% confidence interval (CI) 0.42–0.60]. In patients with acute and chronic coronary syndromes, multicentre randomized controlled trials in >11 000 patients followed for up to 5 years demonstrated that colchicine may reduce the risk of CV death, myocardial infarction, ischaemic stroke and ischaemia-driven revascularization by >30% (RR 0.63, 95% CI 0.49–0.81). The use of colchicine at doses of 0.5–1.0 mg daily in CV trials has proved safe. Early gastrointestinal intolerance limits its use in ∼10% of patients; however, ∼90% of patients tolerate it well over the long term. Despite isolated case reports, clinically relevant drug interactions with moderate to strong CYP3A4 inhibitors/competitors or P-glycoprotein inhibitors/competitors are rare if this dosage of colchicine is used in the absence of advanced renal or liver disease. The aim of this review is to summarize the contemporary data supporting the efficacy and safety of colchicine in patients with CV disease.
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Rafique, Rafia, and Naumana Amjad. "Dietary predictors of early-onset ischaemic heart disease in a sample drawn from a Pakistani population." Heart Asia 4, no. 1 (2012): 129–34. http://dx.doi.org/10.1136/heartasia-2011-010090.
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Durrington, P. N., L. Hunt, M. Ishola, S. Arrol, and D. Bhatnagar. "APOLIPOPROTEINS (a), AI, AND B AND PARENTAL HISTORY IN MEN WITH EARLY ONSET ISCHAEMIC HEART DISEASE." Lancet 331, no. 8594 (May 1988): 1070–73. http://dx.doi.org/10.1016/s0140-6736(88)91895-8.
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Young, A., G. Koduri, M. Batley, E. Kulinskaya, A. Gough, S. Norton, and J. Dixey. "Mortality in rheumatoid arthritis. Increased in the early course of disease, in ischaemic heart disease and in pulmonary fibrosis." Rheumatology 46, no. 2 (July 28, 2006): 350–57. http://dx.doi.org/10.1093/rheumatology/kel253.
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James Barron, Anthony, Turgunbai Aijigitov, and Aigul Baltabaeva. "Is it time to change? Portable echocardiography demonstrates high prevalence of abnormalities in self-presenting members of a rural community in Kyrgyzstan." JRSM Cardiovascular Disease 7 (January 2018): 204800401877973. http://dx.doi.org/10.1177/2048004018779736.
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Objectives Cardiovascular disease accounts for 42% of male and 51% of female mortality within Europe. Kyrgyzstan, population of almost 6 million, has amongst the highest rates within Europe, second only to Uzbekistan for female cardiovascular disease mortality (588 per 100,000). We attempted to identify established cardiovascular disease prevalence within a rural community in Kyrgyzstan using portable echocardiography. Design Free open access echocardiography (VIVID-I, GE, USA) was offered to all adults in Batken district. Routine echocardiographic views were obtained and analysis performed using EchoPac Clinical Workstation (GE, USA). Mild valvular regurgitation, mild LV hypertrophy, patent foramen ovales and mild atrial enlargement were considered mild abnormalities; compensated ischaemic or valvular heart disease – moderate abnormalities, and decompensated congenital, ischaemic or valvular disease – severe abnormalities. Results One hundred and twenty five adults (48 male, 77 female), mean age 53 ± 16 years, underwent echocardiography. Only 16% of participants had no significant abnormality, 46% had mild disease, 25% moderate, compensated disease and 13% had severe disease. Nine percent had congenital heart disease including one tetralogy of Fallot and one Ebstein’s anomaly. Average LV function was normal, however, 19 participants had EF < 50%. Forty percent of participants had a new diagnosis warranting formal follow-up, 12% a new diagnosis of heart failure. Conclusion Using portable echocardiography, we identify a higher than reported prevalence of cardiovascular disease in rural Kyrgyzstan. Absence of portable tools and specialists for early diagnosis might lead to presentation in an advanced stage of disease when little can be done to improve mortality. Embracing remote access diagnostics is essential for disease identification within rural communities.
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Kisely, Stephen R. "The Relationship between Admission to Hospital with Chest Pain and Psychiatric Disorder." Australian & New Zealand Journal of Psychiatry 32, no. 2 (April 1998): 172–79. http://dx.doi.org/10.3109/00048679809062726.
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Objective: Psychosocial variables have been identified as important predictors of outcome in patients with chest pain. Most attention has focused on patients with ischaemic heart diseases or those in outpatient settings. This paper compares focuses on inpatients, and compares patients with ischaemic heart disease to those with non-specific chest pain. Method: A search of the literature on chest pain and psychiatric disorder from 1972 onwards using Medline, Index Medicus and the bibliographies of retrieved articles. Results: One-third of patients admitted with acute chest pain have psychiatric disorder as measured by standardised interviews. Patients who have had psychiatric symptoms prior to admission and those with non-specific pain appear to be most at risk of continuing psychiatric morbidity. In patients with ischaemic heart disease, psychiatric symptoms on admission are more strongly related to subsequent social outcome than variables such as severity of infarct or the presence of angina. Psychiatric symptoms may also effect physical morbidity and possibly mortality, although further research is required to clarify the latter finding. In patients with nonspecific pain, further research is indicated to identify aetiological and maintaining factors for continued non-specific pain. There is, however, a strong association with alcohol and cigarette use. Conclusions: The prediction of outcome requires careful assessment of previous or current psychiatric symptoms in patients admitted with chest pain, irrespective of underlying diagnosis. Early intervention with psychological treatment for patients with non-specific chest pain is indicated; this may also involve help to reduce smoking. There is also further evidence that mortality following myocardial infarction is closely linked to psychiatric disorder, although prior psychiatric disorder may be more important than “post-infarction” depression. Larger and more methodologically rigorous studies are required to further clarify these findings.
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Kochergina, A., V. Leonova, N. Kochergin, and O. Barbarash. "Preparation of Patients for Elective Percutaneous Coronary Intervention: Management of Risk Factors as an Approach to Increase in Intervention Efficacy." Medical University 2, no. 3 (September 1, 2019): 100–109. http://dx.doi.org/10.2478/medu-2019-0014.
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Abstract The article is a topical literature review of the place of percutaneous coronary interventions in the structure of elective revascularisation procedures, preoperative preparation of patients with stable ischaemic heart disease before percutaneous coronary intervention, the prospects of the technique, taking into account the latest advances in intervention cardiology (intravascular methods for assessing the hemodynamic significance of stenosis, drug eluting stents). Modern data of the early and long-term results of percutaneous coronary intervention are presented, the predictable potentially modifiable risks of adverse events are described, and ways to correct them are discussed. The results of randomised studies comparing the effectiveness of different approaches for managing patients with stable coronary heart disease (medical therapy, percutaneous coronary intervention) are presented, and prospects for using new drugs to improve the early and late outcomes of endovascular revascularisation are discussed.
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Smith, G. C. S. "Spontaneous loss of early pregnancy and risk of ischaemic heart disease in later life: retrospective cohort study." BMJ 326, no. 7386 (February 22, 2003): 423–24. http://dx.doi.org/10.1136/bmj.326.7386.423.
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Pantos, Constantinos, Iordanis Mourouzis, and Dennis V. Cokkinos. "Thyroid hormone as a therapeutic option for treating ischaemic heart disease: From early reperfusion to late remodelling." Vascular Pharmacology 52, no. 3-4 (March 2010): 157–65. http://dx.doi.org/10.1016/j.vph.2009.11.006.
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Kostrzewska, Paulina, Aleksander Całkosiński, Maciej Majewski, and Klara Malinowski. "Holiday heart syndrome: influence of alcohol on heart rhythm." Pediatria i Medycyna Rodzinna 17, no. 4 (December 31, 2021): 299–302. http://dx.doi.org/10.15557/pimr.2021.0047.
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The impact of alcohol on human health is widely known. There is a large body of research about positive (the “French paradox”) and negative effects of alcohol consumption. The relationship between excessive alcohol consumption and cardiac arrhythmias was first described in the 1970s in people who consumed alcohol heavily, mainly on weekends or holidays, but also in those who drank little or did not consume any alcohol. The term “holiday heart syndrome” was used for the first time by Philip Ettinger with reference to healthy people without cardiovascular disease. Excessive alcohol consumption can cause arrhythmias, most often in the form of atrial fibrillation. Ethanol and its metabolites have a toxic impact on cardiac myocytes; moreover, alcoholic cardiomyopathy accounts for one-third of all cases of non‐ischaemic dilated cardiomyopathy. It is possible to restore normal heart function through early diagnosis and cessation of alcohol consumption. The prevalence of holiday heart syndrome depends on the drinking habits of the study population. Holiday heart syndrome should be considered especially in patients without overt heart disease with a new onset of atrial fibrillation. Although relapses do occur, the clinical course is mild and specific antiarrhythmic therapy is usually not warranted. People diagnosed with cardiovascular disease benefit from minimising the amount of alcohol consumption. There is no safe amount of alcohol to drink and especially those with alcoholic cardiomyopathy should strive for abstinence in order to optimise treatment.
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Tuter, Denis S., Philippe Y. Kopylov, Abram L. Syrkin, Oleg S. Glazachev, Roman N. Komarov, Andrei I. Katkov, Ljudmila P. Severova, Ekaterina V. Ivanova, Young Zhang, and Hugo Saner. "Intermittent systemic hypoxic–hyperoxic training for myocardial protection in patients undergoing coronary artery bypass surgery: first results from a single-centre, randomised controlled trial." Open Heart 5, no. 2 (November 2018): e000891. http://dx.doi.org/10.1136/openhrt-2018-000891.
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BackgroundAlthough remote ischaemic preconditioning (RIP) provides protection against myocardial ischaemia and reperfusion injury during cardiac surgery, it is not widely used. Systemic intermittent hypoxic–hyperoxic training (IHHT) may be a suitable alternative.MethodsThis is a prospective, single-centre, randomised controlled trial. 127 patients with ischaemic heart disease and indication for coronary artery bypass graft (CABG) surgery from the Cardiology Clinic IM Sechenov First Moscow State Medical University were randomly assigned to IHHT, IHHT-control or RIP. Primary endpoint was serum concentration of troponin I and lactate 2 and 24 hours after surgery.ResultsMedian value for troponin I 24 hours after surgery was 1.068 (0.388–1.397) ng/mL in the IHHT group and was significantly lower compared with IHHT-controls with 1.980 (1.068–3.239) ng/mL (p=0.012) and to the RIP group with 1.762 (1.288–2.186) ng/mL (p=0.029), while there was no significant difference between RIP and the IHHT-control. Serum lactate after surgery was 1.74 (1.23–2.04) mmol/L in the IHHT group and was also significantly lower compared with IHHT-controls with 2.10 (1.80–2.29) mmol/L (p=0.045) and RIP with 2.12 (1.91–2.33) mmol/L (p=0.032). No significant complications or serious adverse events were observed during IHHT. Intraoperative and early postoperative complications did not differ significantly between groups.ConclusionsThe results of this first trial using IHHT for myocardial protection against perioperative ischaemic myocardial injury in patients undergoing CABG surgery are promising and further larger trials should be done with adequate power to detect clinical rather than surrogate marker benefits.
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Bellomo, Francesca, Mariapaola Campisi, Giuseppe Lantone, Paolo Mazzone, Giorgio Firetto, Iacopo Ciccarelli, Matteo Casale, et al. "248 Association between abnormal blood pressure response to exercise and incident cardiovascular events." European Heart Journal Supplements 22, Supplement_N (December 1, 2020): N16. http://dx.doi.org/10.1093/eurheartj/suaa191.
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Abstract Aims The aim of this multicentre registry was to verify the association between an exaggerated blood pressure response (EBPR) to exercise stress test (EST) and evidence of previous myocardial and/or brain ischaemic events in the general population. Methods and results All subjects who underwent EST for screening of ischaemic heart disease and/or follow-up and re-evaluation of heart disease were included in the registry. Patients who discontinued EST due to early muscle exhaustion, younger individuals (<18 years), patients with potentially dangerous channelopathies or ventricular arrhythmias, as well as those with disabling chronic diseases or experiencing cardiovascular events in the 3 months prior to TE. Everyone performed EST on a treadmill or cycle ergometer using similar protocols in the various centres. Based on some study in the literature, we identified the EBPR to exercise for a systolic BP rise >60 mmHg (men) or > 50 mmHg (women) compared to pre-exercise baseline measurement, but also an absolute value >210 or > 190 mmHg, respectively. Retrospectively, we verified the presence of non-disabling ischaemic cardiac and cerebrovascular events over the past 10 years. Five hundred and three subjects of mean age 61 ± 11 years were included in the registry. EST was performed on a treadmill in 65% of subjects and maximal workload was achieved by 75% of them. Subjects with EBPR were 170 (34%) vs. 333 (66%) who had normal response (controls). EBPR group included most male subjects, often overweight and with a higher prevalence of diabetes (31% vs. 20% in the control group, P < 0.01), and with already diagnosed arterial hypertension in a half of cases. Previous ischaemic myocardial events were found in 35% of EBPR subjects vs. 36% of controls (P = NS), while cerebrovascular disease in 20% vs. 10%, respectively (P < 0.005). Conclusion Albeit retrospectively performed, this multicentre registry highlighted an association between EBPR to exercise (present in more than one-third of the subjects examined, especially males) and history of cerebrovascular ischaemic events within 10 years prior to enrolment. In line with previous studies, present data confirmed a clinical impact of EBPR on exercise. However, the precise pathophysiological mechanism(s) need to be clarified yet, also in terms of therapies against such exaggerated functional response and its possible prognostic impact over time.
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Sridhar, P., M. Hedrick, T. Baker, J. Perin, and B. Conlan. "Adipose-Derived Regenerative Cells for the Treatment of Patients with Non-revascularisable Ischaemic Cardiomyopathy – The PRECISE Trial." Interventional Cardiology Review 7, no. 2 (2012): 77. http://dx.doi.org/10.15420/icr.2012.7.2.77.
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Adipose-derived regenerative cells (ADRCs) continue to be evaluated for use in the treatment of patients with chronic heart failure, particularly in those refractory to, or not suitable for, currently available options. This population of cells has demonstrated the ability to facilitate wound repair through the restoration of blood flow in ischaemic conditions, reduction in inflammation and apoptosis, and regeneration of damaged tissue through stem cell differentiation into multiple cell lineages, including cardiac muscle. This approach is particularly useful in the repair or restoration of function to ischaemic tissues in patients where the body’s natural repair mechanisms have failed or been exhausted, such as patients with non-revascularisable, refractory heart failure. The use of ADRCs for these patients has numerous advantages. Primarily, the cells are accessed from a patient’s own tissue, minimising the risk of disease transmission or rejection. Further, the heterogeneity of the cells generates an orchestrated response that targets all phases of the wound healing process. Finally, the cells are readily accessible in real-time without the need for cell expansion, making it a virtually off-the-shelf therapy option. The Celution® System is a safe, GMP-compliant technology designed to automate the preparation of ADRCs at the patient’s bedside. It has been clinically validated for safety and feasibility in two completed cardiac trials; one for acute myocardial infarction and the other for chronic myocardial ischaemia. It is being further evaluated in two ongoing clinical trials for the same indications. In this article, a summary of 18-month follow-up data using the Celution technology for the treatment of patients with non-revascularisable, symptomatic, ischaemic cardiomyopathy will be presented. While additional studies are planned to confirm the efficacy of these cells in the cardiac setting, early clinical data shows promising trends towards the improvement of cardiac function and mortality rate using a technology that can potentially significantly reduce treatment costs compared to the current standard-of-care.
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Sobchenko, I. Y., P. N. Kovalchuk, and A. S. Barbarovich. "INFLUENCE OF MAGNETIC-LASER THERAPY ON THE EFFECTIVENESS OF THE REHABILITATION OF PATIENTS WITH MYOCARDIAL INFARCTION IN EARLY RESTORATIVE PERIOD." Health and Ecology Issues, no. 2 (June 28, 2010): 77–82. http://dx.doi.org/10.51523/2708-6011.2010-7-2-16.
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The results of experimental and clinical investigations are evidence of the positive influence of magnetic-laser therapy on the restorative treatment of patients with ischaemic heart disease. The combination of the impact of laser therapy and magnetic field affords a possibility to increase the treatment effect. The effectiveness of medical rehabilitation of postinfarctic patients in early restorative period by the supravenous magnetic-laser illumination of blood has been shown. It has been ascertained, that the method of magnetic-laser therapy is economically profitable and perspective, conducive to the decline of atherosclerosis progression and decrease of the dosage of antianginal preparations.
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Peters, Nicholas S. "New Insights into Myocardial Arrhythmogenesis: Distribution of Gap-Junctional Coupling in Normal, Ischaemic and Hypertrophied Human Hearts." Clinical Science 90, no. 6 (June 1, 1996): 447–52. http://dx.doi.org/10.1042/cs0900447.
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1. Ischaemic and hypertrophic heart diseases are associated with ventricular arrhythmias, in which abnormal cellular coupling is implicated as having a causative role. The aim of this series of studies was to characterize gap-junctional organization in normal human ventricular myocardium, and to investigate the hypothesis that alterations in the quantity and patterns of expression of myocardial gap junctions occur in ischaemic and hypertrophic myocardial disease. 2. An antibody raised against connexin43 was used for immunohistochemical labelling of myocardium examined by confocal laser scanning microscopy, permitting highly sensitive and quantifiable immunofluorescent imaging of gap junctions through volumes of intact cardiac tissue. 3. Connexin43 gap junctions in normal adult human ventricular myocardium are highly organized into clusters of fluorescent label confined to the intercalated disks as a peripheral ring of larger junctions, with smaller junctions centrally, and occupy a surface area of 0.005 μm2/μm3 myocyte volume. 4. Neonatal human myocardium has a punctate distribution of connexin43 over the entire surface of the ventricular myocytes, with a progressive polarization of the gap junctions towards the positions of the mature intercalated disks, reaching the adult pattern at about 6 years. 5. At the myocardial interface with the scar of a healed infarct, connexin43 gap junction distribution is grossly disturbed, being strewn in longitudinally orientated arrays along the lateral interfaces between degenerated but viable myocytes, which may be due to a redistribution of the pre-existing population of junctions. This altered distribution is present as early as 4 days after coronary occlusion in a canine model, in which it defines the location of circuits causing ventricular tachycardia. 6. Myocardium distant from infarction in patients with ischaemic heart disease has a normal pattern of connexin43 gap junction distribution, but has a 47% reduction in gap junction surface area per unit cell volume, and a 30% reduction per cell. 7. In hypertrophied myocardium from chronically pressure-loaded human left ventricles, connexin43 gap junction expression per myocyte is not significantly different from normal, but is reduced by 40% per unit volume of myocyte. 8. The early phases of the hypertrophic response of myocardium to renovascular hypertension in guinea pigs revealed a substantially increased connexin43 gap junction expression compared with controls, both when measured per cell (increased by 45%) and per unit volume of myocyte (increased by 30%), and therefore showed an alteration apparently contrary to that observed in chronically hypertrophied human ventricular myocardium. 9. In this series of studies, normal adult human ventricular myocardium and the post-natal developmental changes have been characterized with respect to connexin43 gap junction content, and the observed alterations of both distribution and quantity in ischaemic and hypertrophied hearts would be expected to influence myocardial conduction and the arrhythmogenic substrate.
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Németh, N., D. Elmer, L. Horváth, T. Csákvári, R. Pónusz, I. Boncz, and D. Endrei. "PCV51 CHANGES IN THE EARLY MORTALITY RELATED TO ISCHAEMIC HEART DISEASE AMONG PEOPLE AGED 45-59 BETWEEN 1990-2014." Value in Health 23 (May 2020): S99—S100. http://dx.doi.org/10.1016/j.jval.2020.04.155.
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Zeman, Michal, and Monika Okuliarova. "Sex-specific cardiovascular susceptibility to ischaemic myocardial injury following exposure to prenatal hypoxia." Clinical Science 131, no. 23 (November 23, 2017): 2791–94. http://dx.doi.org/10.1042/cs20171255.
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Cardiovascular diseases (CVDs) are the leading cause of mortality and hypertension contributes substantially to the incidence of stroke, coronary artery disease, heart failure, atrial fibrillation and peripheral vascular disease. The origin of hypertension is clearly multifactorial, and a complex and multifaceted approach is necessary to decrease its incidence. The most recognizable factors involved in reducing the incidence of hypertension are prevention, early diagnosis and treatment; however, the importance of the foetal environment and early postnatal development has recently been considered. In clinical practice, these factors are still frequently overlooked, probably because of a lack of knowledge about the underlying mechanisms and effective treatment or prevention. Pathophysiological mechanisms underlying the prenatal programming of CVDs were investigated in the study by Shah et al. published recently in Clinical Science (2017) 131(17), 2303–2317. The study explored cardiac susceptibility of adult male and female rat offspring to ischaemic myocardial injury due to prenatal exposure to hypoxia. The results demonstrated significant changes in global cardiac function and left ventricular dilatation following myocardial infarction in rat offspring prenatally exposed to hypoxia. The effects were gender specific and occurred only in males, whereas females were protected. These findings are important from several perspectives. First, they point to the fact that an inadequate foetal environment can increase susceptibility to death from myocardial infarction. Second, during their reproductive life, females are better protected from cardiovascular insult than males, but it is not known if they lose this advantage after menopause, and can be equally at risk as males.
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El Zein, Ahmed M., Elfateh A. Bukhari, Susan Homeida, and Ishag Adam. "Stroke in CT-scan Department of Khartoum Hospital, Sudan." Tropical Doctor 37, no. 4 (October 1, 2007): 244–45. http://dx.doi.org/10.1258/004947507782332829.
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Prospective data were collected on consecutive patients admitted to Khartoum Teaching Hospital with a diagnosis of stroke. Risk factors and clinical characteristics were assessed by neurological examination and computed tomography scan. A total of 128 patients were enrolled in the study, of whom 74 (57.8%) were men. The age (mean±standard deviation) of the patients was 53±18.5 years. Eighty-five (66.4%) and 43 (33.6%) patients had ischaemic and haemorrhagic stroke, respectively. Hypertension, diabetes mellitus, smoking, heart disease and hypercholesterolaemia were the risk factors for stroke. Thus, further studies are needed on stroke. Hypertension should be discovered early and treated effectively.
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Kautzner, Josef, and Petr Peichl. "Catheter Ablation of Polymorphic Ventricular Tachycardia and Ventricular Fibrillation." Arrhythmia & Electrophysiology Review 2, no. 2 (2013): 135. http://dx.doi.org/10.15420/aer.2013.2.2.135.
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Recently, catheter ablation (CA) has become a therapeutic option to target focal triggers of polymorphic ventricular tachycardia and ventricular fibrillation (VF) in the setting of electrical storm (ES). This strategy was first described in subjects without organic heart disease (i.e. idiopathic VF) and subsequently in other conditions, especially in patients with ischaemic heart disease. In the majority of cases, the triggering focus originates in the ventricular Purkinje system. In patients with Brugada syndrome, besides ablation of focal trigger in the right ventricular outflow tract, modification of a substrate in this region has been described to prevent recurrences of VF. In conclusion, CA appears to be a reasonable strategy for intractable cases of ES due to focally triggered polymorphic ventricular tachycardia and VF. Therefore, early transport of the patient into the experience centre for CA should be considered since the procedure could be in some cases life-saving. Therefore, the awareness of this entity and link to the nearest expert centre are important.
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Mamun, Mohammad Abdullah Al, and Manzoor Hussain. "Neonatal Myocarditis: A Review." Dhaka Shishu (Children) Hospital Journal 35, no. 1 (January 28, 2021): 70–73. http://dx.doi.org/10.3329/dshj.v35i1.51718.
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Neonatal myocarditis is a rare and life-threatening disease with clinical symptoms suggesting bacterial sepsis, accompanied by congestive heart failure, cardiogenic shock and arrhythmias. Enteroviruses and adenoviruses are the most frequent pathogens isolated in myocarditis in neonate. Due to extensive myocyte necrosis in the left ventricle, symptoms may mimic myocardial infarction and circulatory collapse. The diagnosis is suggested by an ischaemic electrocardiogram, raised cardiac enzymes and left ventricular dysfunction. These infants are best managed by early recognition of heart failure, avoidance of hypotension and transfer to an ECMO center. No specific antiviral treatment exists for neonatal myocarditis. Even in the presence of sufficient respiratory and circulatory support, the mortality among neonates with viral myocarditis is high. Majority of survivors develop serious cardiac sequelae. Since neonatal myocarditis is a devastating disease and is not often in the differential diagnosis of neonatal collapse, clinicians should keep a high index of suspicion.
DS (Child) H J 2019; 35(1) : 70-73
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Holmström, Lauri, Anette Haukilahti, Juha Vähätalo, Tuomas Kenttä, Henrik Appel, Antti Kiviniemi, Lasse Pakanen, Heikki V. Huikuri, Robert J. Myerburg, and Juhani Junttila. "Electrocardiographic associations with myocardial fibrosis among sudden cardiac death victims." Heart 106, no. 13 (March 22, 2020): 1001–6. http://dx.doi.org/10.1136/heartjnl-2019-316105.
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ObjectiveA major challenge in reducing the incidence of sudden cardiac death (SCD) is the identification of patients at risk. Myocardial fibrosis has a substantial association with SCD risk but is difficult to identify among general populations. Our aim was to find electrocardiographic (ECG) markers of myocardial fibrosis among SCD victims.MethodsStudy population was acquired from the Fingesture study, which has gathered data from 5869 consecutive autopsied SCD victims in Northern Finland between 1998 and 2017. The degree of fibrosis was determined in histological samples taken from the heart during autopsy and was categorised into four groups: (1) no fibrosis, (2) scattered mild fibrosis, (3) moderate patchy fibrosis and (4) substantial fibrosis. We were able to collect ECGs from 1100 SCD victims.ResultsThe mean age of the study subjects was 66±13 years and 75% were male. QRS duration in ECG correlated with the degree of fibrosis (p<0.001, β=0.153). Prevalence of fragmented QRS complex, pathological Q waves and T wave inversions correlated with increased degree of fibrosis (p<0.001 in each). Depolarisation abnormalities were observed both in ischaemic and non-ischaemic heart disease. Repolarisation abnormalities reached statistical significance only among ischaemic SCD victims. An abnormal ECG was observed in 75.3% of the subjects in group 1, 73.7% in group 2, 88.5% in group 3 and 91.7% in group 4 patients (p<0.001).ConclusionsMyocardial fibrosis was associated with QRS prolongation, deep Q waves, T wave inversions and QRS fragmentation. The results provide potentially useful non-invasive early recognition of patients with fibrotic cardiomyopathy and risk of SCD.
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Laskawski, Grzegorz, Abdelrahman Abdelbar, and Joseph Zacharias. "An endoscopic repair of residual post-myocardial infarction ventricular septal defect." Interactive CardioVascular and Thoracic Surgery 31, no. 4 (October 1, 2020): 580–82. http://dx.doi.org/10.1093/icvts/ivaa127.
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Abstract Post-myocardial infarction (MI) ventricular septal defect (VSD) is a serious condition that is, fortunately, less diagnosed nowadays due to the advances in early diagnosis and treatment of ischaemic heart disease (incidence 1–2%). Despite the lower mortality of both surgical and interventional closure of the defect (25%) as compared to medical therapy (40–50%), there are still risks of residual leak in both approaches. Herein, we describe a case of a successful endoscopic-assisted repair of a delayed residual leak post-MI VSD after surgical repair. An attempt for interventional closure of the leaking point had failed; an endoscopic-assisted minimal access closure was successfully performed.
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Uddin, Mohammad Najim, MA Hannan, Kanuj Kumar Barman, and Mohammad Mashudur Rahman. "D-Dimer in Ischaemic Stroke Subtypes." Bangladesh Journal of Neuroscience 34, no. 1 (January 31, 2018): 25–31. http://dx.doi.org/10.3329/bjn.v34i2.57532.
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Background: Stroke is the third most common cause of death in the developed world after cancer and ischaemic heart disease, and is the most common cause of severe physical disability. Although, there are many patients in Bangladesh suffering from these disorders, systematic research on them, especially serum biological markers of ischaemic stroke are yet to be evaluated. So the objectives of the present study are to see the serum d-dimer among acute ischaemic stroke patient. Methods: This is a hospital based cross sectional study conducted in neurology department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Total 162 cases of acute ischaemic stroke irrespective of their gender were included who were admitted in BSMMU during the period from October, 2012 to October, 2013. Blood sample was taken for d-dimer measurement from each patient and d-dimer was estimated in department of haematology, BSMMU. Results: Among 162 patients with acute ischaemic stroke, it showed that d-dimer level mean was 1.0862 mg/L ± SD 0.9844 with maximum 4.4 and minimum 0.01. D-dimer was highly raised (n=75, 46%; mean 1.6519 ± SD 1.1396; min 0.11 and max 4.4) in early days of 1st week with a descending manner and almost reached normal level (n=87, 54%; mean 0.5986 ± SD 0.4210; min 0.01 and max 2.25) in later half of 2nd week. Conclusion: The study showed that raised d-dimer (DD) was significantly associated total anterior circulation infarction (TACI) & partial anterior circulation infarction PACI and raised DD was significant differentiating point TACI or PACI from lacunar infarction (LACI) & posterior circulation infarction (POCI) and raised D-Dimer might not differentiate between TACI & PACI. Bangladesh Journal of Neuroscience 2018; Vol. 34 (1): 25-31
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Szyguła, Renata, Monika Wierzbicka, and Grażyna Sondel. "Influence of 8-Week Aerobic Training on the Skin Microcirculation in Patients with Ischaemic Heart Disease." Journal of Aging Research 2020 (January 7, 2020): 1–8. http://dx.doi.org/10.1155/2020/4602067.
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Aim of the paper. Microvascular functional impairment in the skin is considered an early predictor of developing cardiovascular diseases and a recognised risk factor of IHD. This is why the aim of the study is investigating if 8-week aerobic training will improve reactivity of skin microcirculation and the function of endothelium in patients with IHD and if the potential improvement will last with lack of physical activity. Materials and Methods. In the study, 48 men took part with a stabilized and pharmacologically controlled ischaemic disease. The participants were randomly divided into two groups with 24 people in each of them. The research group participated in an aerobic march training. The march was taking place 3 times a week for 30–40 minutes over a period of 8 weeks. In the time of training, the subjects did not practise any other physical activity for 8 weeks. The measurement of skin microcirculation was done by using the laser Doppler flowmeter estimating the values of regular flow and the reactions provoked in response to occlusion and temperature. Signal frequency was also analysed which was received by means of laser Doppler flowmetry in the range from 0.01 to 2 Hz during the regular flow. Results. During the first measurement in relation to the initial values, a decrease in body mass was noted by 2.21 kg on average as well as reduction of systolic and diastolic pressure by 10.4 mmHg and 3.68 mmHg, respectively. The regular flow (RF) increased after the training by 2.21%. The provoked reactions were as follows: hyperemic (PRHmax): an increase occurred by 8.76% and hyperthermic (THmax): an increase occurred by 5.38%. The time needed to achieve PRHmax was reduced by 42% and to achieve THmax, by 22%. The heart rhythm and the signal strength of neurogenic rhythm decreased by approximately 8% and 24%, respectively. The signal strength of endothelial rhythm increased by 19%. In the second measurement, a recourse was noted in the values of indicators under investigation, which were assuming values close to the initial ones. In the control group, the measurement values did not change significantly. Conclusions. 8 weeks of systematic aerobic training provides a significant improvement of endothelium functioning, expressed by reactivity improvement in skin microcirculation in patients suffering from ischaemic heart disease. It points to aerobic training as a nonpharmacological effective cardioprotective factor. The improvement effects of skin vascular bed functioning in the group of patients with IHD are impermanent, and they disappear after the period in which patients did not exercise physical activity.
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Velinovic, Milos, Mladen Kocica, Mile Vranes, Petar Djukic, Aleksandar Mikic, Vlada Vukomanovic, Lazar Davidovic, et al. "Surgical revascularisation of the heart in patients with chronic ischaemic cardiomyopathy and left ventricular ejection fraction of less than 30%." Srpski arhiv za celokupno lekarstvo 133, no. 9-10 (2005): 406–11. http://dx.doi.org/10.2298/sarh0510406v.
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INTRODUCTION Patients suffering from chronic ischaemic cardiomyopathy and left ventricular ejection fraction (LVEF) lower than 30% represent a difficult and controversial population for surgical treatment. OBJECTIVE The aim of this study was to evaluate the effects of surgical treatment on the early and long-term outcome of these patients. METHOD The patient population comprised SO patients with LVEF< 30% (78% male, mean age: 583 years, range; 42-75 years) who underwent surgical myocardial revascuiarisation during the period 1995-2000. Patients with left ventricular aneurysms or mitral valve insufficiency were excluded from the study. The following echocardiography parameters were evaluated as possible prognostic indicators; LVEF, fraction of shortening (FS), left ventricular systolic and diastolic diameters (LVEDD, LVESD) and volumes (LVEDV, LVESV), as well as their indexed values (LVESVI). RESULTS Fifteen patients (30%) died during the follow-up, 2/50 intraoperatively (4%). The presence of diabetes mellitus, previous myocardial infarction, main left coronary artery disease, and three-vessel disease, correlated significantly with the surgical outcomes. The patient's age, family history, smoking habits, hypertension, hyperlipidaemia, history of stroke, peripheral vascular disease, and renal failure, did not correlate with the mortality rate. A comparison of preoperative echocardiography parameters between survivors and non-survivors revealed significantly divergent LVEF, LVEDD, LVESD, LVEDV, LVESV, and LVESVI values. Preoperative LVESVi offered the highest predictive value (R=0.595). CONCLUSION Diabetes mellitus, history of myocardial infarction, stenosis of the main branch, and three-vessel disease, significantly affected the peci opera five and long-term outcome of surgical revascuiarisation in patients with ischaemic cardiomyopathy and LVEF<30%. in survivors, LVEF, FS, and systolic and diastolic echocardiography parameters, as well as their indexed values, significantly improved after surgical revascuiarisation. LVESVI provided the highest predictive value for mortality.
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Delgado, Bruno Miguel, Ivo Lopes, Bárbara Gomes, and André Novo. "Early rehabilitation in cardiology – heart failure: The ERIC-HF protocol, a novel intervention to decompensated heart failure patients rehabilitation." European Journal of Cardiovascular Nursing 19, no. 7 (April 22, 2020): 592–99. http://dx.doi.org/10.1177/1474515120913806.
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Background: Decompensated heart failure patients are characterised by functional dependence and low exercise tolerance. Aerobic exercise can improve symptoms, functional capacity and an increase in exercise tolerance. However, the benefits of early rehabilitation have not yet been validated. Objective: To evaluate the safety and feasibility of an aerobic exercise training programme in functional capacity of decompensated heart failure patients. Methodology: A single centre, parallel, randomised controlled, open label trial, with 100 patients. The training group (TG, n=50) performed the training protocol and the control group (CG, n=50) performed the usual rehabilitation procedures. The London chest activity of daily living (LCADL) scale, the Barthel index (BI) and the 6 minute walking test (6MWT) at discharge were used to evaluate the efficacy of the protocol. Safety was measured by the existence of adverse events. Results: The mean age of the patients was 70 years, 20% were New York Heart Association (NYHA) class IV and 80% NYHA class III at admission. The major heart failure aetiology was ischaemic (35 patients) and valvular disease (25 patients). There were no significant differences between groups at baseline in terms of sociodemographic or pathophysiological characteristics. There was a statistically significant difference of 54.2 meters for the training group ( P=0.026) in the 6MWT and at LCADL 12 versus 16 ( P=0.003), but the BI did not: 96 versus 92 ( P=0.072). No major adverse events occurred. Conclusions: The training protocol demonstrated safety and efficacy, promoting functional capacity. This study elucidated about the benefits of a systematised implementation of physical exercise during the patient’s clinical stabilisation phase, which had not yet been demonstrated. Trial registration: Clinicaltrials.gov NCT03838003, URL: https://clinicaltrials.gov/ct2/show/NCT03838003 .
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Cupples, H. E. V., and D. T. McGahey. "Dual pathology: cervicofacial actinomycosis and nicorandil-induced oral ulceration." Journal of Laryngology & Otology 122, no. 4 (May 14, 2007): 422–24. http://dx.doi.org/10.1017/s002221510700816x.
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AbstractIntroduction:Oral ulceration has many causes and is a common presenting symptom in otolaryngology.Case report:This article presents an unusual case of dual pathology oral ulceration in an elderly patient. Oral malignancy was initially suspected, but the history, examination and investigation showed that the oral ulceration was caused by actinomycosis infection and by nicorandil use.Discussion:Cervicofacial acinomycosis is a rare, suppurative bacterial disease in which abscesses can form in the tissues and break through the skin, creating pus-discharging lesions. Nicorandil is a potassium channel blocker used in the treatment of ischaemic heart disease. It has been recently recognised as a cause of persistent ulcerative stomatitis.Conclusion:This case highlights the importance of a high index of suspicion for unusual and reversible causes of oral ulceration, and of dual pathology as a cause. Such vigilance enables early recognition and treatment of potentially reversible conditions.
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Kulhánová, Ivana, Gwenn Menvielle, Rasmus Hoffmann, Terje A. Eikemo, Margarete C. Kulik, Marlen Toch-Marquardt, Patrick Deboosere, et al. "The role of three lifestyle risk factors in reducing educational differences in ischaemic heart disease mortality in Europe." European Journal of Public Health 27, no. 2 (August 12, 2016): 203–10. http://dx.doi.org/10.1093/eurpub/ckw104.
Full textAbstract:
Abstract Background: Ischaemic heart disease (IHD) is one of the leading causes of death worldwide with a higher risk of dying among people with a lower socioeconomic status. We investigated the potential for reducing educational differences in IHD mortality in 21 European populations based on two counterfactual scenarios—the upward levelling scenario and the more realistic best practice country scenario. Methods: We used a method based on the population attributable fraction to estimate the impact of a modified educational distribution of smoking, overweight/obesity, and physical inactivity on educational inequalities in IHD mortality among people aged 30–79. Risk factor prevalence was collected around the year 2000 and mortality data covered the early 2000s. Results: The potential reduction of educational inequalities in IHD mortality differed by country, sex, risk factor and scenario. Smoking was the most important risk factor among men in Nordic and eastern European populations, whereas overweight and obesity was the most important risk factor among women in the South of Europe. The effect of physical inactivity on the reduction of inequalities in IHD mortality was smaller compared with smoking and overweight/obesity. Although the reduction in inequalities in IHD mortality may seem modest, substantial reduction in IHD mortality among the least educated can be achieved under the scenarios investigated. Conclusion: Population wide strategies to reduce the prevalence of risk factors such as smoking, and overweight/obesity targeted at the lower socioeconomic groups are likely to substantially contribute to the reduction of IHD mortality and inequalities in IHD mortality in Europe.