bluuebunny/crossref_metadata_2025 huggingface dataset:
Masas musculares supernumerarias de la pared torácica anterior. Reporte de caso y revisión
Authors: Mier-García Juan Felipe , Peña Tobar Carmen Elizabeth , Baena-Caldas Gloria Patricia
Published: September 2024

Introducción: En la pared torácica anterior pueden presentarse masas musculares supernumerarias, estas suelen ubicarse profundas a la piel, por delante del músculo pectoral mayor y de su fascia. Sus fibras pueden cursar paralelas u oblicuas al esternón, presentarse uni o bilateralmente a un lado de éste y con morfología muy variada que se presta a múltiples clasificaciones. Adquieren importancia clínica, especialmente en radiología, porque pueden prestarse a errores en el diagnóstico de algunos tipos de patología mamaria. Material y métodos: Revisión bibliográfica de los variados tipos de masas musculares que pueden presentarse en la pared torácica anterior y reporte de un caso en cadáver masculino de nacionalidad colombiana, de etnia mestiza, disecado por estudiantes de medicina en la sala de disección del Departamento de Morfología de la Universidad del Valle, en Cali, Colombia. Resultados: En el lado derecho de la pared torácica anterior del cadáver se encontró una masa muscular que describía un trayecto vertical, paralelo al borde derecho del esternón, la cual medía, considerando en conjunto todos los fascículos musculares, aproximadamente 7 cm de largo y 2,9 cm de ancho. Conclusion: Dada la ubicación del músculo en la parte anterior de la pared torácica, en relación con el músculo pectoral mayor y la mama, puede tratarse de una variación del llamado “músculo esternal”, del cual pueden derivarse algunas implicaciones radiológicas, quirúrgicas y clínicas, por lo que se considera importante que el personal de la salud conozca la anatomía y la epidemiología de esta variación anatómica para evitar diagnósticos errados.
Infecciones del tracto urinario de la comunidad en el paciente adulto mayor
Authors: Leoni Alberto Francisco , Monterisi Aida , Acuña Paula G
Published: September 2024

Introducción La infección del tracto urinario de la comunidad (ITUco) es frecuente. Los ancianos poseen mayor susceptibilidad, presentando dificultades diagnósticas. La etiología y sensibilidad antimicrobiana es poco conocida en nuestro medio.Objetivos Evaluar en ancianos la incidencia según sexo, signosintomatología, microorganismo recuperado, patrón de resistencia.Material y Métodos Estudio retrospectivo, descriptivo y comparativo. Se analizaron registros de urocultivos del año 2013 del Hospital Nacional de Clínicas (Córdoba- Argentina). Se incluyeron pacientes mayores de 65 años, internados con diagnóstico de ITUco, excluyéndose cateterizados.Variables analizadas: Sexo, sígnosintomatología, etiología y sensibilidad a antimicrobianos. Estudio comparativo mediante test de Chi Cuadrado para variable signosintomatología. Se determinó frecuencias en demás variables categóricas.Resultados Se analizaron 349 pacientes: 1) Urocultivo positivo 191 (caso), negativo 158 (control), 2) Edad promedio 77 años (mujeres 76%, varones 24%), 3) Signosintomatología: Fiebre (45%), sepsis (17%), depresión del sensorio (14%), descompensación cardíaca (11%), 4) Cultivo: Monomicrobiano 95.29%, 5) Identificación y porcentajes de resistencia a antimicrobianos: Escherichia coli (67,7%): ampicilina/sulbactam 52.7%, ciprofloxacina 51.9%, trimetoprima/sulfametoxazol 45.7%, cefotaxima: 12,9 %, amicacina: 3,9 %, Klebsiella pneumoniae (11,97%): ciprofloxacina 60.8%, trimetoprima/sulfametoxazol 50%, cefotaxima 47.8%, amicacina 4.7%. Enterococcus spp. (9,89%): ampicilina 0%, vancomicina 0%. Otros: Cándidas spp. (3.66%), Proteus mirabilis (2,6%), Staphylococcus aureus (2,6%), Enterobacter cloacae (1,56%), Pseudomonas aeruginosa (1,56%). Los  bacilos gramnegativos no presentaron resistencia a imipenem.Conclusiones Los aislamientos fueron mayormente monomicrobianos en mujeres. E. coli fue la bacteria predominante. Destacamos la elevada resistencia a ciprofloxacina, ampicilina/sulbactam y TMS. Se propone evitar su uso empírico, en esta población.
Proteinosis alveolar pulmonarn rol de los anticuerpos ANTI-GM-CSF
Authors: Ernst Glenda , Salvado Alejandro , Grynblat Pedro , Tabaj Gabriela , Garcia Oscar , Cambursano Victor Hugo , Young Pablo
Published: September 2024

La proteinosis alveolar pulmonar (PAP) es una enfermedad infrecuente caracterizada por una alteración en la depuración del surfactante pulmonar. Este proceso es dependiente del factor estimulante de colonias granulocito-monocito (GM-CSF). Aproximadamente un 90 % de los pacientes con PAP presentan anticuerpos que neutralizan este factor, impidiendo la normal homeostasis del surfactante. El tratamiento incluye la realización de lavados pulmonares totales y la administración de GM-CSF cuando los lavados fracasan. A pesar de que el dosaje de los anticuerpos séricos anti-GM-CSF podría contribuir a comprender el origen auto-inmune de la enfermedad, no es una práctica de rutina en ningún centro de salud. Presentamos una revisión sistemática de esta desafiante enfermedad.
Potential Mechanisms of Epicardial Adipose Tissue Influencing Heart Failure with Preserved Ejection Fraction
Authors: Li Qiuxuan , Muhib Ur Rehman , Ma Xiaoteng , Liu Zaiqiang , Gao Fei , Wang Zhijian
Published: September 2024

Heart failure (HF) is the predominant terminal stage and the leading cause of mortality in cardiac disease. Heart failure with preserved ejection fraction (HFpEF) affects roughly 50% of HF patients globally. Due to the global aging population, the prevalence, morbidity, and mortality of HFpEF have gradually increased. Epicardial adipose tissue (EAT), as a key visceral adipose tissue around the heart, affects cardiac diastolic function and exercise reserve capacity. EAT closely adheres to the myocardium and can produce inflammatory factors, neurotransmitters, and other factors through autocrine or paracrine mechanisms, affecting the heart function by inflammatory response, cardiac metabolism and energy supply, cardiomyocyte structure and electrical activity, and pericardial vascular function. Currently, research on the mechanism and treatment methods of HFpEF is constantly improving. EAT may play a multi-level impact on the occurrence and development of HFpEF. This review also summarizes the potential impact of EAT on the heart in HFpEF combined with other metabolism-related diseases such as obesity or diabetes over other obesity-related measures, such as body mass index (BMI) or other adipose tissue. Above all, this review comprehensively summarizes the potential mechanisms by which EAT may affect HFpEF. The objective is to enhance our comprehension and management of HFpEF. Future research should delve into the mechanistic relationship between EAT and HFpEF, and investigate interventions aimed at EAT to improve the prognosis of patients with HFpEF.
Review of Atrioventricular Node Ablation Combined with Permanent His-Purkinje Conduction System Pacing in Patients with Atrial Fibrillation with Heart Failure
Authors: Wang Lina , Tan Chen , Lei Jingshu , LEE CHONGYOU
Published: September 2024

With the advancement of pacing technologies, His-Purkinje conduction system pacing (HPCSP) has been increasingly recognized as superior to conventional right ventricular pacing (RVP) and biventricular pacing (BVP). This method is characterized by a series of strategies that either strengthen the native cardiac conduction system or fully preserve physical atrioventricular activation, ensuring optimal clinical outcomes. Treatment with HPCSP is divided into two pacing categories, His bundle pacing (HBP) and left bundle branch pacing (LBBP), and when combined with atrioventricular node ablation (AVNA), can significantly improve left ventricular (LV) function. It effectively prevents tachycardia and regulates ventricular rates, demonstrating its efficacy and safety across different QRS wave complex durations. Therefore, HPCSP combined with AVNA can alleviate symptoms and improve the quality of life in patients with persistent atrial fibrillation (AF) who are unresponsive to multiple radiofrequency ablation, particularly those with concomitant heart failure (HF) who are at risk of further deterioration. As a result, this “pace and ablate” strategy could become a first-line treatment for refractory AF. As a pacing modality, HBP faces challenges in achieving precise localization and tends to increase the pacing threshold. Thus, LBBP has emerged as a novel approach within HPCSP, offering lower thresholds, higher sensing amplitudes, and improved success rates, potentially making it a preferable alternative to HBP. Future large-scale, prospective, and randomized controlled studies are needed to evaluate patient selection and implantation technology, aiming to clarify the differential clinical outcomes between pacing modalities.
Characteristics of Patients with Spontaneous Coronary Artery Dissection Presenting with Sudden Cardiac Arrest in the United States and the Potential Role of Implantable Cardioverter Defibrillator Therapy
Authors: Krittanawong Chayakrit , Qadeer Yusuf Kamran , Ang Song Peng , Wang Zhen , Alam Mahboob , Sharma Samin , Jneid Hani
Published: September 2024

Background: Spontaneous coronary artery dissection (SCAD) is a disease entity that often occurs in young, healthy women and can cause life-threatening ventricular arrhythmias and sudden cardiac arrest. However, the characteristics and outcomes of SCAD with cardiac arrest are not well characterized. Methods: This study investigated the baseline characteristics of SCAD patients with cardiac arrest using the National Inpatient Sample (NIS) database between 2016 and 2020. In addition, we also sought to determine the potential impact that implantable cardioverter defibrillator (ICD) therapy had on morbidity and mortality in SCAD patients presenting with cardiac arrest. Results: Our findings showed that the SCAD with cardiac arrest population had significantly higher comorbidities, including cardiac arrhythmias, congestive heart failure, pulmonary circulation disorders, liver diseases, solid tumors, coagulopathy, fluid disorders, chronic kidney disease (CKD), anemia secondary to deficiency, psychosis, neurological disorders, carotid artery disease, atrial fibrillation, ventricular arrhythmias (ventricular tachycardia (VT), ventricular fibrillation (VF)), and acute myocardial infarction (AMI), compared to the SCAD without cardiac arrest population. Likewise, for SCAD patients who did not have an ICD in place, we found increasing age, fluid and electrolyte disorders, uncomplicated diabetes, neurological disorders, peripheral vascular disease, pulmonary circulatory disorders, cardiac arrhythmias, and congestive heart failure to be associated with greater mortality. Conclusions: SCAD patients with certain comorbidities (e.g., pulmonary diseases, liver diseases, cancers, coagulopathy, and CKD) who presented with AMI or congestive heart failure should be monitored closely for ventricular arrhythmias as they have a higher chance of progressing to cardiac arrest. ICD therapy can be considered for these patients, but data on the success of this treatment option are limited, and more research needs to be performed to determine whether the benefits of this outweigh the risks.
Transapical Transcatheter Aortic Valve Replacement Under 3-Dimensional Guidance to Treat Pure Aortic Regurgitation in Patients with a Large Aortic Annulus
Authors: Mao Yu , Liu Yang , Zhai Mengen , Jin Ping , Wei Lai , Zhang Haibo , Liu Jian , Pan Xiangbin , Guo Yingqiang , Yang Jian
Published: September 2024

Background: Transcatheter aortic valve replacement (TAVR) is a challenge for patients with aortic regurgitation (AR) and a large annulus. Our goal was to evaluate the clinical outcomes and predictors of transapical TAVR in AR patients with a large annulus and noncalcification and the feasibility and safety of 3-dimensional printing (3DP) in the preprocedural simulation. Methods: Patients with a large annulus (diameter >29 mm) were enrolled and divided into the simulation (n = 43) and the nonsimulation group (n = 82). Surgeons used the specific 3DP model of the simulation group to simulate the main steps before the procedure and to refit the transcatheter heart valve (THV) according to the simulated results. Results: The average annular diameter of the overall cohort was 29.8 ± 0.7 mm. Compared with the nonsimulation group, the simulation group used a higher proportion of extra oversizing for THVs (97.6% vs. 85.4%, p = 0.013), and the coaxiality performance was better (9.7 ± 3.9° vs. 12.7 ± 3.8°, p < 0.001). Both THV displacement and ≥ mild paravalvular leakage (PVL) occurred only in the nonsimulation group (9.8% vs. 0, p < 0.001; 9.8% vs. 0, p < 0.001). Multivariate regression analysis showed that extra oversizing, coaxial angle and annulus diameter were independent predictors of THV displacement and ≥ mild PVL, respectively. Conclusions: Based on 3DP guidance, transapical TAVR using extra oversizing was safe and feasible for patients with noncalcified AR with a large annulus. Extra oversizing and coaxial angle were predictors of postprocedural THV displacement and ≥ mild PVL in such patients.
Feasibility and Exploration of a Standardized Protocol for Cardiac CT Assessment of Rheumatic Mitral Disease
Authors: Liu Zhou , Ren Yue , Liang Jiajun , Zhang Yazhe , Zhang Hongkai , Wang Maozhou , Xu Lei , Liu Yuyong , Jiang Wenjian , Zhang Hongjia
Published: September 2024

Rheumatic mitral valve disease often requires surgical interventions, such as percutaneous mitral commissurotomy, surgical mitral valve repair, or replacement, especially in severe cases. This necessitates a precise preoperative assessment of the extent of mitral valve disease. Currently, transthoracic echocardiography, the gold standard for preoperative assessment, has limitations, such as restricted acoustic windows and dependence on the operator, which can affect the evaluation of subvalvular structures and calcification of the mitral valve. Previous studies have shown that cardiac computed tomography (CT), with its high resolution, strong multiplanar reconstruction capabilities, and sensitivity to calcifications, can effectively overcome these limitations. Therefore, this study aims to summarize and evaluate the effectiveness of cardiac CT in examining mitral valve leaflets, annulus, and subvalvular structures. It also reviews the feasibility and guiding significance of using cardiac CT to assess characteristic rheumatic mitral valve lesions.
A Three-Day Prehabilitation Program is Cost-Effective for Preventing Pulmonary Complications after Heart Valve Surgery: A Health Economic Analysis of a Randomized Trial
Authors: Huang Wei , Wang Yuqiang , Luo Zeruxin , Zhang Xiu , Yang Mengxuan , Su Jianhua , Guo Yingqiang , Yu Pengming
Published: September 2024

Background: While prehabilitation (pre surgical exercise) effectively prevents postoperative pulmonary complications (PPCs), its cost-effectiveness in valve heart disease (VHD) remains unexplored. This study aims to evaluate the cost-effectiveness of a three-day prehabilitation program for reducing PPCs and improving quality adjusted life years (QALYs) in Chinese VHD patients. Methods: A cost-effectiveness analysis was conducted alongside a randomized controlled trial featuring concealed allocation, blinded evaluators, and an intention-to-treat analysis. In total, 165 patients scheduled for elective heart valve surgery at West China Hospital were randomized into intervention and control groups. The intervention group participated in a three-day prehabilitation exercise program supervised by a physiotherapist while the control group received only standard preoperative education. Postoperative hospital costs were audited through the Hospital Information System, and the EuroQol five-dimensional questionnaire was used to provide a 12-month estimation of QALY. Cost and effect differences were calculated through the bootstrapping method, with results presented in cost-effectiveness planes, alongside the associated cost-effectiveness acceptability curve (CEAC). All costs were denominated in Chinese Yuan (CNY) at an average exchange rate of 6.73 CNY per US dollar in 2022. Results: There were no statistically significant differences in postoperative hospital costs (8484 versus 9615 CNY, 95% CI –2403 to 140) or in the estimated QALYs (0.909 versus 0.898, 95% CI –0.013 to 0.034) between the intervention and control groups. However, costs for antibiotics (339 versus 667 CNY, 95% CI –605 to –51), nursing (1021 versus 1200 CNY, 95% CI –330 to –28), and electrocardiograph monitoring (685 versus 929 CNY, 95% CI –421 to –67) were significantly lower in the intervention group than in the control group. The CEAC indicated that the prehabilitation program has a 92.6% and 93% probability of being cost-effective in preventing PPCs and improving QALYs without incurring additional costs. Conclusions: While the three-day prehabilitation program did not significantly improve health-related quality of life, it led to a reduction in postoperative hospital resource utilization. Furthermore, it showed a high probability of being cost-effective in both preventing PPCs and improving QALYs in Chinese patients undergoing valve surgery. Clinical Registration Number: This trial is registered in the Chinese Clinical Trial Registry (URL: https://www.chictr.org.cn/) with the registration identifier ChiCTR2000039671.
Long-Term Prognostic Significance of Three-Dimensional Speckle-Tracking Echocardiography-Derived Left Ventricular Twist in Healthy Adults—Results from the MAGYAR-Healthy Study
Authors: Nemes Attila , Kormányos Árpád , Olajos Dorottya Lilla , Achim Alexandru , Ruzsa Zoltán , Ambrus Nóra , Lengyel Csaba
Published: September 2024

Background: The left ventricular (LV) rotational mechanics are of particular importance in the function of the LV. The rotational movement is the consequence of the arrangement of the subepicardial and subendocardial muscle fibers. These muscle fibers are perpendicular to each other, their contraction creates a characteristic motion. The aim of the present study was to examine the prognostic impact of LV twist assessed by three-dimensional speckle-tracking echocardiography (3D-STE) in healthy circumstances. Methods: 302 healthy adults participated in the study, 181 subjects were excluded due to certain reasons (LV could not be analysed during 3D-STE, subjects were unidentifiable, or lost to follow-up). 121 subjects were involved in the final analysis (mean age of 33.1 ± 12.3 years, 75 males), who were willing to be examined on a voluntary basis. Results: During a mean follow-up of 7.93 ± 4.21 years, 11 healthy adults suffered a cardiovascular event including 2 cardiac deaths. Using receiver operating characteristic analysis, LV twist ≥14.65 degrees as assessed by 3D-STE proved to be significantly predictive regarding the cardiovascular event-free survival (area under the curve 0.70, specificity 70%, sensitivity 65%, p = 0.028). Subjects with LV twist ≥14.65 degrees had higher basal and apical rotations and a significantly higher ratio of these individuals developed cardiovascular events compared to cases with LV twist <14.65 degrees. Subjects with cardiovascular events had lower LV global longitudinal strain, higher basal LV rotation and twist and the ratio of subjects with LV twist ≥14.65 degrees was elevated as compared to cases without events. Conclusions: 3D-STE-derived LV twist independently predicts future cardiovascular events in healthy adults.
Left Atrial Hemodynamics and Clinical Utility in Heart Failure
Authors: Lin Chang- Yi , Lin Shu- I , Lee Ying- Hsiang , Chen Chun- Yen
Published: September 2024

Comprehensive knowledge of the left atrium (LA) and its pathophysiology has emerged as an important clinical and research focus in the heart failure (HF) arena. Although studies on HF focusing on investigating left ventricular remodeling are numerous, those on atrial structural and functional changes have received comparatively less attention. Studies on LA remodeling have recently received increasing attention, and LA pressure (LAP) has become a novel target for advanced monitoring and is a potential therapeutic approach for treating HF. Various devices specifically designed for the direct measurement of LAP have been developed to optimize HF treatment by reducing LAP. This review focuses on LA hemodynamic monitoring and effective LAP decompression.
Causal Relationships between Lymphocyte Subsets and Risk of Coronary Artery Disease: A Two-Sample Mendelian Randomization Study
Authors: Ma Zhao , Liu Libo , Tian Jinfan , Tu Chenchen , Zhang Dongfeng , Zhang Mingduo , Zhang Huan , An Ziyu , Sun Meichen , Zhang Hongjia , Song Xiantao
Published: September 2024

Background: Currently, the causal relationship between lymphocyte subsets and coronary artery disease (CAD) remains unclear. Therefore, we utilized Mendelian randomization (MR) to assess the association between lymphocyte subsets and CAD. Methods: We performed a two-sample MR analysis using publicly available genome-wide association studies (GWAS) datasets. The primary method of analysis to comprehensively evaluate causal effects was the inverse variance-weighted (IVW) method. The four additional MR approaches were MR–Egger, weighted median, simple mode, and weighted mode. Sensitivity analysis incorporated Cochran's Q and MR–Egger intercept tests to identify residual heterogeneity and potential horizontal pleiotropy, respectively. The MR–PRESSO distortion test was applied to identify potential pleiotropic outliers. Leave-one-out analysis confirmed that no single single-nucleotide polymorphism (SNP) significantly affected the MR estimate. We conducted reverse MR analysis to investigate the impact of variables correlated with outcomes in forward MR analysis. Results: The IVW method revealed a significant positive association between B cell count and CAD (odds ratio (OR) = 1.08 (95% CI: 1.04, 1.11), p = 2.67 × 10-5). A similar association was observed between B cell count and myocardial infarction (MI) (OR = 1.07 (95% CI: 1.03, 1.11), p = 5.69 × 10-4). Sensitivity analyses detected no outliers, heterogeneity, or pleiotropy. The reverse MR analysis was conducted to investigate the impact of CAD and MI on B cell count, and the IVW results showed no statistical significance. Conclusions: Our study suggests that a higher absolute B cell count is linked to an increased risk of CAD and MI.
Heart Failure Knowledge Assessment and Perceived Patient Satisfaction in Heart Failure Units: A Multicenter Observational Survey
Authors: Goirigolzarri-Artaza Josebe , Cobo-Marcos Marta , Peña-Conde Laura , Villa Adolfo , Iglesias Diego , Esteban-Férnandez Alberto , Torre Fátima de la , Álvarez-García Jesús , Hérnandez-Hernández Aitor , Górriz-Magaña Juan , Ayala Rocío , Taibo-Urquía Mikel , Beltrán Cristina , Díez-Villanueva Pablo , Restrepo-Córdoba María Alejandra , González Julia González , Iniesta Manjavacas Ángel Manuel , Corredera-García Sara , García-Gómez Sergio , González-Piña María , Gamarra Álvaro , Martínez-Sellés Manuel
Published: September 2024

Background: Self-care and empowerment promotion in patients with heart failure (HF) is essential for improving their prognosis, but there is limited information concerning the patients' depth of knowledge about this pathology as well as patient satisfaction within heart failure units (HFUs). Our objective was to assess both aspects in a cohort of patients regularly followed-up HFUs. Methods: A multicenter, observational study was conducted with consecutive patients followed in 14 HFUs between June and November 2023. It was based on a cross-sectional survey comprising 23 questions related to demographics, knowledge/self-care, and the subjective assessment of perceived quality and satisfaction in HFUs. Results: 281 patients were included (36.7% women, 74.7% aged over 65 years). 48% had hospitalizations for HF or sought emergency department services within the preceding year. The mean correct responses related to knowledge were 9.7 ± 2.3 (80.7% of the total), and 53 patients (18.9%) answered all knowledge questions correctly. 211 (79.6%) could identify potential HF decompensation with abrupt weight gain, and 196 (74.2%) recognized at least three additional signs of worsening HF. 266 patients (98.2%) were likely or very likely to recommend HFUs, and 194 (89.8%) positively appreciated the experience at the day hospital. Conclusions: Patients followed up in HFUs showed adequate but improvable knowledge and capacity for self-care, with a high level of satisfaction.
The Usefulness of Cardiopulmonary Exercise Testing to Detect Functional Improvement after Transcatheter Valve Procedures: What Do We Know So Far?
Authors: Cumitini Luca , Giubertoni Ailia , Patti Giuseppe
Published: September 2024

Transcatheter valve procedures have become a cornerstone in the management of patients with valvular heart disease and high surgical risk, especially for aortic stenosis and mitral and tricuspid regurgitation. Cardiopulmonary exercise testing (CPET) is generally considered the gold standard for objectively quantifying functional capacity, providing a comprehensive evaluation of the human body's performance, particularly in patients with heart failure (HF). Its accurate assessment is valuable for exploring the pathogenetic mechanisms implicated in HF-related functional impairment. It is also useful for objectively staging the clinical severity and the prognosis of the disease. The improvement in functional capacity after transcatheter valve procedures may be clinically relevant and may provide prognostic information, even in this setting. However, it remains to be fully determined as data on the topic are limited. This review aims to summarize the available evidence on the usefulness of CPET to assess functional improvement in patients undergoing transcatheter valve procedures.
The High-Sensitivity C-Reactive Protein to High-Density Lipoprotein Cholesterol Ratio and the Risk of Contrast-Induced Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention
Authors: Deng Linxiao , Chen Hua , Xu Qingbo , Han Kedong , Liu Jin , Chen Shiqun , Deng Jingru , Tian Leigang , Li Zeliang , Lu Xiaozhao , Liu Yong , Liang Yan
Published: September 2024

Background: The high-sensitivity C-reactive protein to high-density lipoprotein cholesterol ratio (CHR) is a novel biomarker associated with coronary artery disease (CAD) risk. This study aimed to analyze the relationship between CHR and contrast-induced acute kidney injury (CI-AKI). Methods: This retrospective cross-sectional research included 10,917 individuals who underwent PCI. CI-AKI was diagnosed using the Kidney Disease: Improving Global Outcomes (KIDIGO) standard. Univariate and multivariable logistic regression analyses were conducted to examine the association between CHR and CI-AKI, followed by a receiver operating characteristic (ROC) curve of participants to assess the clinical diagnostic performance of CHR on CI-AKI. Results: A total of 1037 patients (9.50%) developed CI-AKI after PCI. The age of individuals averaged 64.1 ± 11.1 years old, with 2511 females (23.0%). A multivariate logistic regression study revealed that higher CHR levels were linked to higher CI-AKI incidence rates ([Q4 vs. Q1]: odds ratio (OR) = 1.89, 95% confidence interval (CI) [1.42 to 2.54], p < 0.001). A restricted cubic spline analysis revealed a linear association between CHR and CI-AKI. ROC analysis indicated that CHR was an excellent predictor of CI-AKI (area under ROC curve = 0.606, 95% CI [0.588 to 0.624]). Conclusions: A high CHR level is strongly associated with increased CI-AKI incidence, suggesting that CHR may be an independent risk factor for CI-AKI. Clinical Trial registration: NCT05050877. https://clinicaltrials.gov/study/NCT05050877?tab=results.
The Association between Disseminated Intravascular Coagulation Profiles and Neurologic Outcome in Patients with In-Hospital Cardiac Arrest
Authors: Lee Dong Hun , Lee Byung Kook , Ryu Seok Jin , Lee Ji Ho , Bae Sung Jin , Choi Yun Hyung
Published: September 2024

Background: The relationship between disseminated intravascular coagulation (DIC) profiles and survival or neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients is well known. In contrast, the relationship between DIC profiles and neurological outcomes in patients with in-hospital cardiac arrest (IHCA) remains unclear. This study sought to examine the correlation between DIC profiles and neurological outcomes in IHCA patients. Methods: A retrospective observational study was conducted on comatose adult IHCA patients treated with targeted temperature management between January 2017 and December 2022. DIC profiles were used to calculate the DIC score, and were measured immediately after the return of spontaneous circulation (ROSC). The primary endpoint was a poor neurological outcome at six months, defined by cerebral performance in categories 3, 4, or 5. Multivariate analysis was used to evaluate the association between DIC profiles and poor neurological outcomes. Results: The study included 136 patients, of which 107 (78.7%) patients demonstrated poor neurological outcomes. These patients had higher fibrinogen (3.2 g/L vs. 2.3 g/L) and fibrin degradation product levels (50.7 mg/L vs. 30.1 mg/L) and lower anti-thrombin III (ATIII) levels (65.7% vs. 82.3%). The DIC score did not differ between the good and poor outcome groups. In multivariable analysis, fibrinogen (odds ratio [OR], 1.009; 95% confidence intervals [CI], 1.003–1.016) and ATIII levels (OR, 0.965; 95% CI, 0.942–0.989) were independently associated with poor neurological outcomes. Conclusions: Decreased fibrinogen and ATIII levels after ROSC were an independent risk factor for unfavorable neurological outcomes in IHCA. The DIC score is unlikely to play a significant role in IHCA prognosis in contrast to OHCA.
Three-Tesla Magnetic Resonance Imaging Characteristics of Hypertrophic Cardiomyopathy: A Comparison with Several Echocardiography Parameters
Authors: Ngoc Phung Bao , Thoa Vu Thi Kim , Luu Vu Dang , Hung Pham Manh , Viet Nguyen Khoi , Trang Nguyen Ngoc , Hoa Hoang Thi Van , Lien Le Thi Thuy , Huyen Nguyen Thi , Wan Yung Liang
Published: September 2024

Background: Hypertrophic cardiomyopathy (HCM) is a primary cardiac disorder characterized by myocardial hypertrophy without increased afterload. This study set out to describe the cardiac magnetic resonance (CMR) imaging characteristics of HCM and to evaluate correlations of selected CMR parameters with echocardiography. Methods: This cross-sectional study enrolled 46 patients diagnosed at the Vietnam Heart Institute with HCM and underwent CMR at the Radiology Center, Bach Mai Hospital, from July 2021 to September 2022. Results: A left ventricular outflow tract (LVOT)/aortic valve (AO) diameter ratio of ≥0.38 on CMR was consistent with an LVOT pressure gradient (PG) of <30 mmHg on echocardiography. The LVOT diameter and the LVOT/AO diameter ratio differed significantly between obstructive and non-obstructive HCM. The predominant phenotypes were diffuse asymmetric HCM (32.6%) and septal HCM (37%), followed by apical HCM (6.5%). Most late gadolinium enhancement (LGE) lesions were observed in the mid-wall of the hypertrophic segments. The mean LGE mass was significantly higher in the obstructive group than in the non-obstructive HCM group (p < 0.05). A strong negative correlation (r = –0.66) was found between the LVOT/AO diameter ratio on the CMR and the LVOT PG via echocardiography. Moreover, echocardiography detected morphologic risk factors for sudden cardiac death (SCD) in 80.4% of patients, whereas the corresponding proportion detected by CMR was 91.3%. Patients with systolic anterior motion (SAM) had a risk for a LVOT/AO diameter ratio <0.38, which was 5.7 times the risk observed in their counterparts without SAM. Conclusions: The LVOT/AO diameter ratio detected by CMR is a precise index for classifying hemodynamic HCM groups. CMR was better than echocardiography for SCD risk stratification.
Quality of Life of Patients with Heart Failure Due to Myocardial Ischemia
Authors: Bonek-Wytrych Grażyna , Sierka Oskar , Szynal Magdalena , Dąbek Józefa
Published: September 2024

Background: Heart failure caused by myocardial ischemia is a common cause encountered in clinical practice. A significant problem in heart failure is its progressive, unfavorable course and the associated increased frequency of repeated hospitalizations, as well as a significant deterioration in the functioning of patients, leading to their inability to function independently and a significant decline in the quality of life. This study aimed to assess the quality of life of patients with heart failure due to myocardial ischemia, considering the left ventricular ejection fraction, the number of “diseased” coronary arteries, co-occurring diseases, and cardiovascular risk factors. Methods: A total of 204 patients with decompensated heart failure due to chronic myocardial ischemia were included in this study and examined twice: A: on the first day of hospitalization; A′: from 4 to 8 weeks. For the individual assessment of the quality of life, the WHOQOL-BREF (The World Health Organization Quality of Life - BREF) questionnaire was used. Results: In the group of patients with heart failure in the decompensation stage a statistically significant positive relationship was observed between the number of comorbidities and the social domain (R(A) = 0.197; p(A) = 0.005), the number of diseased coronary arteries and the mental (R(A) = 0.184; p(A) = 0.184) and environmental (R(A) = 0.149; p(A) = 0.034) domains, left ventricular ejection fraction (LVEF%) and quality of life (R(A) = 0.235; p = 0.001) and satisfaction with health (R(A) = 0.235; p = 0.001) and somatic domain (R(A) = 0.194; p = 0.005). A similar result was observed among patients in the long-term follow-up. A statistically significant negative correlation was demonstrated in the mentioned group between the LVEF% value and the social domain (R(A) = –0.235; p = 0.001), as well as in the long-term follow-up (R(A′) = –0.191, p = 0.026). The level of self-assessment of quality of life and satisfaction with health was statistically significantly higher among patients with heart failure in the long-term follow-up (3.20 ± 0.62) than in patients in the decompensation stage (1.98 ± 0.69). Conclusions: The quality of life of the examined patients with heart failure caused by chronic myocardial ischemia was poor, although it improved to average in the long-term follow-up. It was determined by left ventricular ejection fraction, the number of “diseased” coronary arteries, comorbidities, and risk factors.
Pathophysiological Mechanisms of Psychosis-Induced Atrial Fibrillation: The Links between Mental Disorder and Arrhythmia
Authors: Chen Pao-Huan , Kao Yu-Hsun , Chen Yi-Jen
Published: September 2024

Atrial fibrillation (AF) is a common phenomenon of sustained arrhythmia leading to heart failure or stroke. Patients with mental disorders (MD), particularly schizophrenia and bipolar disorder, are at a high risk of AF triggered by the dysregulation of the autonomic nervous system, atrial stretch, oxidative stress, inflammation, and electrical or structural remodeling. Moreover, pathophysiological mechanisms underlying MD may also contribute to the genesis of AF. An overactivated hypothalamic–pituitary–adrenal axis, aberrant renin–angiotensin–aldosterone system, abnormal serotonin signaling, disturbed sleep, and genetic/epigenetic factors can adversely alter atrial electrophysiology and structural substrates, leading to the development of AF. In this review, we provide an update of our collective knowledge of the pathophysiological and molecular mechanisms that link MD and AF. Targeting the pathogenic mechanisms of MD-specific AF may facilitate the development of therapeutics that mitigate AF and cardiovascular mortality in this patient population.
Non-Invasive Serum Markers of Non-Alcoholic Fatty Liver Disease Fibrosis: Potential Tools for Detecting Patients with Cardiovascular Disease
Authors: Chen Ling-Zi , Jing Xu-Bin , Chen Xiang , Xie Yan-Chun , Chen Yun , Cai Xian-Bin
Published: September 2024

Non-alcoholic fatty liver disease (NAFLD), one of the most common chronic liver diseases with a prevalence of 23%–25% globally, is an independent risk factor for cardiovascular diseases (CVDs). Growing evidence indicates that the development of NAFLD, ranging from non-alcoholic fatty liver (NAFL), non-alcoholic steatohepatitis (NASH), advanced fibrosis to cirrhosis, and even hepatocellular carcinoma, is at substantial risk for CVDs, which clinically contribute to increased cardiovascular morbidity and mortality. Non-invasive serum markers assessing liver fibrosis, such as fibrosis-4 (FIB-4) score, aspartate transaminase-to-platelet ratio index (APRI), and NAFLD fibrosis score (NFS), are expected to be useful tools for clinical management of patients with CVDs. This review aims to provide an overview of the evidence for the relationship between the progression of NAFLD and CVDs and the clinical application of non-invasive markers of liver fibrosis in managing patients with CVDs.
Advances in the Management of Spontaneous Coronary Artery Dissection (SCAD): A Comprehensive Review
Authors: Morena Arianna , Giacobbe Federico , De Filippo Ovidio , Angelini Filippo , Bruno Francesco , Siliano Stefano , Giannino Giuseppe , Dusi Veronica , Bianco Matteo , Biolé Carloalberto , Varbella Ferdinando , Cerrato Enrico , D’Ascenzo Fabrizio , De Ferrari Gaetano Maria
Published: September 2024

Spontaneous coronary artery dissection (SCAD) is a rare but significant cause of acute coronary syndrome (ACS), primarily affecting young women, often during pregnancy. Despite its rarity, SCAD poses challenges due to limited evidence on management strategies. This review examines the current state of art of SCAD management, integrating interventional and clinical insights from recent studies. The epidemiology of SCAD is related to its elusive nature, representing only a small fraction of ACS cases, while certainly underestimated. Proposed risk factors include genetic, hormonal, and environmental influences. Angiographic classification may help in SCAD diagnosis, but confirmation often relies on intracoronary imaging. Conservative management constitutes the primary approach, showing efficacy in most cases, although optimal antiplatelet therapy (APT) remains debated due to bleeding risks associated with intramural hematoma. Revascularization is reserved for high-risk cases, guided by angiographic and clinical criteria, with a focus on restoring flow rather than resolving dissection. Interventional strategies emphasize a minimalist approach to reduce complications, utilizing techniques such as balloon dilation and stent placement tailored to individual cases. Long-term outcomes highlight the risk of recurrence, necessitating vigilant follow-up and arrhythmic risk assessment, particularly in patients presenting with ventricular arrhythmias. In conclusion, SCAD management always represents a challenge for the physician, both from a clinical and interventional point of view. Recent clinical evidence and a multidisciplinary approach are vital for optimizing patient outcomes and preventing recurrence. This review offers a concise framework for navigating the complexities of SCAD management in clinical practice and proposes an algorithm for its management.
Methods for Establishing a Rat Model of Rheumatic Heart Disease
Authors: Xian Shenglin , Zeng Zhiyu
Published: September 2024

Rheumatic heart disease (RHD) is responsible for nearly 250,000 deaths annually and poses a significant health threat in developing areas. The unclear pathogenesis of RHD makes the development of cost-effective treatments challenging, particularly as current surgical options are expensive and technologically demanding, exacerbating the economic and quality-of-life burdens for patients. Given the risks associated with direct human experimentation due to the uncertain pathogenesis, using a rat model infected with Group A Streptococcus (GAS) has become a crucial experimental strategy for RHD research. The development of an RHD rat model, refined over 23 years, now stands as a pivotal approach in studies aiming to understand the disease’s pathogenesis. This review summarizes the evolution, characteristics, advantages, and limitations of the RHD rat model, offering insights into potential areas for improvement. It aims to provide researchers with a comprehensive understanding of the model, supporting the advancement of research methodologies and the discovery of innovative treatments for RHD.
The 2023 European Task Force Criteria for Diagnosis of Arrhythmogenic Cardiomyopathy: Historical Background and Review of Main Changes
Authors: Graziano Francesca , Zorzi Alessandro , Ungaro Simone , Bauce Barbara , Rigato Ilaria , Cipriani Alberto , Perazzolo Marra Martina , Pilichou Kalliopi , Basso Cristina , Corrado Domenico
Published: September 2024

Arrhythmogenic cardiomyopathy (ACM) is a cardiac disease featured by non-ischemic myocardial scarring linked to ventricular electrical instability. As there is no single gold-standard test, diagnosing ACM remains challenging and a combination of specific criteria is needed. The diagnostic criteria were first defined and widespread in 1994 and then revised in 2010, approaching and focusing primarily on right ventricular involvement without considering any kind of left ventricular variant or phenotype. Years later, in 2020, with the purpose of overcoming previous limitations, the Padua Criteria were introduced by an international expert report. The main novel elements were the introduction of specific criteria for left ventricular variants as well as the use of cardiac magnetic resonance for tissue characterization and scar detection. The last modifications and refinement of these criteria were published at the end of 2023 as the European Task Force criteria, by a “head-quarter” of ACM international experts, proving the emerging relevance of this condition besides its difficult diagnosis. In this review, emphasizing the progress in understanding the aetiology of the cardiomyopathy, an analysis of the new criteria is presented. The introduction of the term “scarring/arrhythmogenic cardiomyopathy” sets an important milestone in this field, underlying how non-ischemic myocardial scarring—typical of ACM—and arrhythmic susceptibility could be the main pillars of numerous different phenotypic variants regardless of etiology.
Endoscopic diagnosis of larynx pathology
Authors: Vakurova E. S. , Setdikova G. R. , Vasilev V. N.
Published: September 2024

Despite the large number of publications devoted to the diagnosis of laryngeal pathology, the issues of timely and early diagnosis of malignant neoplasms of this localization still remain very relevant. In 2022, the proportion of patients with laryngeal cancer in stages I-II was 40.3%, stage III - 30.3%, stage IV - 28.4%, while 13.1% were actively detected. Accordingly, stage III-IV cancer of the larynx accounts for 58.7%.
The QHL Project
Authors: Jones Robert William
Published: September 2024

The Quantum Holographic Lens (QHL) Project is a groundbreaking initiative that merges the principles of quantum mechanics with the transformative power of holography. By conceptualizing quantum states as holographic projections, the QHL framework provides a novel approach to visualizing and manipulating quantum information. This whitepaper outlines the key theoretical underpinnings of the QHL framework and introduces essential equations, including the Quantum Holographic Master Equation, the Quantum Matrix Equation, and the FidelityWave Equation.The practical applications of the QHL framework extend beyond quantum computing and quantum gravity into revolutionary communication technologies such as NexusLink and HoloData, which enable faster-than-light data transmission and interplanetary communication without the need for matter. Furthermore, the potential of the QHL framework is explored in fields like entertainment, virtual reality, and education, showcasing its ability to reshape the future of digital technology and quantum information systems. The paper also discusses opportunities for collaboration through an open innovation model, inviting researchers and industry leaders to contribute to the advancement of this transformative technology.
Re-evaluating Fictional Narratives: Cognitive and (Cultural) Evolutionary Perspectives on the Absence of Fictionality in Human Societies
Authors: Hong Ze
Published: September 2024

In this article, I argue that fictionality—understood as a form of "make-believe" that requires the audience to suspend disbelief—has been largely absent throughout most of human history. This is due to two key factors: 1) humans are not psychologically predisposed to recognize fictionality, as it is cognitively demanding, and 2) traditional societies often have worldviews that allow for promiscuous causal possibilities, preventing narratives from being marked as fictional by their implausibility. I review extensive ethnographic and historical evidence suggesting that stories we now consider fictional were largely regarded as factual accounts of the past or attempts at such accounts. Additionally, I offer a critical discussion of how the absence of fictionality in diverse human societies impacts evolutionary theorizing about fictionality, as well as the broader cognitive and social consequences of (the lack of) fictional narratives.
Sequential Analyses using Effect Size Confidence Intervals: A Simulation-Based Approach
Authors: Blackwell Simon Edward
Published: September 2024

Sequential Bayesian analyses have been suggested as a means for efficient hypothesis-testing within psychology, often substantially reducing the sample sizes required. In the context of clinical psychology, trial designs using sequential Bayesian analyses have been proposed as a way to accelerate psychological treatment development. However, a focus on Bayesian analyses as a means to conduct sequential testing may hinder uptake of such methods due to a lack of familiarity amongst many researchers. Demonstrating how equivalent sequential analyses are possible using non-Bayesian (e.g., frequentist) analyses could increase the accessibility of these methods and thus the extent to which psychological treatment development research can benefit from more time and resource-efficient trial designs. This paper demonstrates a simple method for sequential testing based on confidence intervals around effect size estimates, and illustrates comparative efficiency to an approach based on Bayes factors.
Interplay of cognition and affect in fourth graders’ mathematics performance: Role of working memory in mediating the effects of math anxiety and interest on arithmetic fluency
Authors: Tapola Anna , Rawlings Anna Maria , Mononen Riikka , Tähti Pinja , Korhonen Johan
Published: September 2024

Working memory (WM) capacity influences students’ mathematics performance together with their emotional and motivational tendencies. The negative relationship between math anxiety and both WM and performance is well-established, and some studies have also found WM to mediate the effect of math anxiety on mathematics performance. However, much less is known, first, about the interplay of WM and positive motivational factors, such as interest in mathematics, and second, about the dynamics of these cognitive and affective processes, particularly among elementary school students. Consequently, in this study, we examined both the direct and mediated effects of math anxiety and interest through WM on fourth grade students’ (N = 332) performance in arithmetic fluency, while acknowledging their generalized anxiety. Findings from a model applying structural equation modeling showed math anxiety to predict performance negatively, while the effects of WM and interest were positive. There was also a negative indirect effect from math anxiety through WM to mathematics performance indicating partial mediation while a corresponding, but positive, effect was not found in terms of interest. Generalized anxiety also played a role in students’ domain-specific tendencies. The results emphasize the importance of acknowledging the interplay of cognition and affect in students’ academic pursuits.