scholarly journals Extrasystolic arrhythmia – an unaccounted risk factor of atherosclerosis development in main arteries?

2021 ◽  
Vol 6 (2) ◽  
pp. 48-53
Author(s):  
Olga A. Germanova ◽  
Giuseppe Galati ◽  
Vladimir A. Germanov ◽  
Yurii V. Shchukin ◽  
Andrei V. Germanov
Keyword(s):  
Risk Factor ◽  
Type A ◽  
Left Ventricular ◽  
Tibialis Posterior ◽  
Control Group ◽  
Additional Risk Factor ◽  
Hydraulic Shock ◽  
Additional Risk ◽  
Atherosclerotic Process ◽  
The Impact

Objectives to determine the hemodynamic changes within arterial vessels in different variants of extrasystole, to analyze whether extrasystole is an additional risk factor for the development of atherosclerosis. Material and methods. The study included 286 patients (175 men and 111 women) with extrasystole of more than 3000 per day and 88 patients with extrasystole of less than 3000 per day as a control group. When selecting eligible patients for the study, we tried to minimize the impact of traditional risk factors of atherosclerosis. The presence of cardiocerebral complications in medical history was also considered. The examination methods used in the study are electrocardiography, phonocardiography, 24-hour electrocardiography monitoring, Doppler ultrasound of the brachiocephalic vessels, lower extremities arteries, renal arteries, transthoracic or transesophageal echocardiography. Stress echocardiography was performed if indicated; as well as renal artery angiography, coronary angiography, computed tomography of the brain with angioprogram. When performing a biochemical blood test, the lipid spectrum and hemostasiogram were necessarily determined. All patients underwent left ventricular apexcardiography, as well as sphygmography, recorded on arteries of elastic type (a. Carotis communis) and muscular-elastic type (a. Tibialis posterior). The clinical examinations were confirmed and modeled using the original "Device for modeling of intra-arterial circulation", developed by us (RF patent No. 202780 dated 05.03.2021). Results. We determined an increase in the main parameters of the heart biomechanics and the kinetics of the main arteries in the 1st post-extrasystolic wave in patients with various types of extrasystole with the following pattern: the earlier extrasystole had appeared in the cardiocycle, the greater was the increase in the parameters under observation. A universal concept of hydraulic shock and possible cases of its formation were described. Conclusion. Extrasystole is an additional risk factor for the onset and progression of atherosclerosis. Hydraulic shock during the passage of the 1st post-extrasystolic wave is a powerful traumatic factor for the walls of the arteries, which can lead to the formation of an atherosclerotic process.

Prevalence and prognostic impact of left ventricular systolic dysfunction after acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.J Jernberg ◽  
E.O Omerovic ◽  
E.H Hamilton ◽  
K.L Lindmark ◽  
L.D Desta ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Risk Factor ◽  
Reperfusion Therapy ◽  
Left Ventricular ◽  
Funding Source ◽  
Additional Risk Factor ◽  
Additional Risk

Abstract Background Left ventricular dysfunction after an acute myocardial infarction (MI) is associated with poor outcome. The PARADISE-MI trial is examining whether an angiotensin receptor-neprilysin inhibitor reduces the risk of cardiovascular death or worsening heart failure (HF) in this population. The aim of this study was to examine the prevalence and prognosis of different subsets of post-MI patients in a real-world setting. Additionally, the prognostic importance of some common risk factors used as risk enrichment criteria in the PARADISE-MI trial were specifically examined. Methods In a nationwide myocardial infarction registry (SWEDEHEART), including 87 177 patients with type 1 MI between 2011–2018, 3 subsets of patients were identified in the overall MI cohort (where patients with previous HF were excluded); population 1 (n=27 568 (32%)) with signs of acute HF or an ejection fraction (EF) <50%, population 2 (n=13 038 (15%)) with signs of acute HF or an EF <40%, and population 3 (PARADISE-MI like) (n=11 175 (13%)) with signs of acute HF or an EF <40% and at least one risk factor (Age ≥70, eGFR <60, diabetes mellitus, prior MI, atrial fibrillation, EF <30%, Killip III-IV and STEMI without reperfusion therapy). Results When all MIs, population 1 (HF or EF <50%), 2 (HF or EF <40%) and 3 (HF or EF <40% + additional risk factor (PARADISE-MI like)) were compared, the median (IQR) age increased from 70 (61–79) to 77 (70–84). Also, the proportion of diabetes (22% to 33%), STEMI (38% to 50%), atrial fibrillation (10% to 24%) and Killip-class >2 (1% to 7%) increased. After 3 years of follow-up, the cumulative probability of death or readmission because of heart failure in the overall MI population and in population 1 to 3 was 17.4%, 26.9%, 37.6% and 41.8%, respectively. In population 2, all risk factors were independently associated with death or readmission because of HF (Age ≥70 (HR (95% CI): 1.80 (1.66–1.95)), eGFR <60 (1.62 (1.52–1.74)), diabetes mellitus (1.35 (1.26–1.44)), prior MI (1.16 (1.07–1.25)), atrial fibrillation (1.35 (1.26–1.45)), EF <30% (1.69 (1.58–1.81)), Killip III-IV (1.34 (1.19–1.51)) and STEMI without reperfusion therapy (1.34 (1.21–1.48))) in a multivariable Cox regression analysis. The risk increased with increasing number of risk factors (Figure 1). Conclusion Depending on definition, post MI HF is present in 13–32% of all MI patients and is associated with a high risk of subsequent death or readmission because of HF. The risk increases significantly with every additional risk factor. There is a need to optimize management and improve outcomes for this high risk population. Figure 1 Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novartis

Hematogenous thrombophilia as an additional risk factor for cerebral circulation disorders

2021 ◽  
Author(s):  
И.В. Куртов ◽  
С.П. Кривова ◽  
Р.К. Хайретдинов ◽  
И.Л. Давыдкин
Keyword(s):  
Risk Factor ◽  
Factor Viii ◽  
Blood Coagulation ◽  
Genetic Polymorphisms ◽  
Additional Risk Factor ◽  
Factor Viii Level ◽  
Aged Patients ◽  
Additional Risk ◽  
Viii Level ◽  
The Impact

Введение. Гематогенная тромбофилия служит дополнительным фактором риска нарушений мозгового кровообращения (НМК). Цель исследования: изучить влияние повышенного уровня фактора VIII и нарушений в системе фибринолиза на НМК у пациентов с сочетанной патологией системы свертывания крови. Материалы и методы. Обследовано 20 пациентов с перенесенными ишемическими инсультами в возрасте от 36 до 56 лет. Определяли показатели плазменного, тромбоцитарного звеньев гемостаза, системы фибринолиза, а также генетические полиморфизмы системы гемостаза. Результаты. У всех пациентов выявлены различные сочетания генетических полиморфизмов, связанных с изменениями антикоагулянтного звена гемостаза, а также дефекты системы фибринолиза и коагуляционного звена гемостаза, что является дополнительным фактором риска НМК. Заключение. У пациентов молодого и среднего возраста, перенесших острое НМК по ишемическому типу, необходимо исследование системы свертывания крови, включающее определение содержания фактора VIII в крови, показателей системы фибринолиза и уровня гомоцистеина. Background. Hematogenous thrombophilia is an additional risk factor for cerebral circulatory disorders (ССD). Objectives: to study the impact of increased factor VIII level and disturbances of fibrinolysis system on ССD in patients with combined pathology of blood coagulation. Patients/Methods. We examined 20 patients with ischemic strokes aged from 36 to 56 years. The parameters of plasma hemostasis, platelet function, fibrinolysis system, as well as the genetic polymorphisms of hemostasis system were determined. Results. All patients had different combinations of genetic polymorphisms associated with anticoagulant hemostasis changes, as well as defects in fibrinolysis system and coagulation hemostasis that is an additional risk factor for ischemic stroke. Conclusions. In young and middle-aged patients with history of acute ischemic ССD, it is necessary to study blood coagulation, including the determination of blood factor VIII level, fibrinolysis system parameters and homocysteine content.

Is extended arch replacement for acute type a aortic dissection an additional risk factor for mortality?

2003 ◽  
Vol 76 (4) ◽  
pp. 1209-1214 ◽  
Author(s):  
M.Erwin S.H Tan ◽  
Karl M.E Dossche ◽  
Wim J Morshuis ◽  
Johannes C Kelder ◽  
Frans G.J Waanders ◽  
...  
Keyword(s):  
Risk Factor ◽  
Aortic Dissection ◽  
Type A ◽  
Additional Risk Factor ◽  
Acute Type ◽  
Additional Risk ◽  
Type A Aortic Dissection

The role of the angle of the ascending aortic curvature on the development of type A aortic dissection: ascending aortic angulation and dissection

2019 ◽  
Vol 29 (4) ◽  
pp. 615-620 ◽  
Author(s):  
Safa Gode ◽  
Okan Akinci ◽  
Cigdem Tel Ustunısık ◽  
Onur Sen ◽  
Ersin Kadirogulları ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Type A ◽  
Ascending Aorta ◽  
Additional Risk Factor ◽  
Additional Risk ◽  
Type A Aortic Dissection

Abstract OBJECTIVES Type A aortic dissection (TAD), which consists of an intimal tear in the aorta, necessitates emergency surgery. Various risk factors related to aortic dissection have been defined in the literature. According to our hypothesis, a narrower angle of ascending aortic curvature (AAAC) may be an additional risk factor in relation to aortic dissection due to the increased force applied to the aortic wall. METHODS Patients undergoing ascending aortic surgery due to an ascending aortic aneurysm (AsAA) (n = 105) and patients undergoing such surgery because of the occurrence of TAD (n = 101) were enrolled in this study. The AAAC was measured using Cobb’s method; the measurements were made on all patients by just 1 cardiovascular radiologist using 3-dimensional computerized tomographic imaging. This measurement was made indirectly by using the aortic valve and brachiocephalic artery to avoid obtaining misleading data as a result of distortions due to dissection. A statistical comparison was also performed relating the traditional risk factors for TAD to other clinical and echocardiographic parameters: the diameter of the ascending aorta and the AAAC. RESULTS The AAAC was found to be narrower statistically in the TAD group (α = 76.2° ± 17.5°) than it was in the AsAA group (α = 92.9° ± 13°) (P < 0.001). Furthermore, mean ascending aortic diameter (P = 0.019), the presence of a bicuspid aorta (P = 0.007) and aortic valve stenosis (P = 0.005) were higher in the AsAA group. According to multivariable analyses, a narrower AAAC is a significant predictor for the development of TAD (odds ratio 0.93, 95% confidence interval 0.91–0.95; P < 0.001). Overall hospital mortality from various causes including stroke, myocardial infarction, bleeding or renal failure was 13% in the TAD group and 7% in the AsAA group. CONCLUSIONS According to this study, the AAAC was significantly smaller in aortic dissection patients than in aortic aneurysm patients. This may be related to higher shear stress and elevated pressure on the ascending aorta in patients with a narrower AAAC. Thus, a narrower AAAC may be an additional risk factor in the development of TAD. Therefore, we may need to be more careful in terms of looking for the development of aortic dissection in patients with narrower AAAC.

scholarly journals Early and Late Complications After Abdominal Surgery in Patients With COVID-19 in Armenia

2021 ◽  
Author(s):  
Karine Aloyan ◽  
Hayk Harutyunyan ◽  
Arayik Voskanyan
Keyword(s):  
Risk Factor ◽  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Medical Center ◽  
Late Complications ◽  
Additional Risk Factor ◽  
Surgical Mortality ◽  
Rt Pcr ◽  
Additional Risk ◽  
The Impact

Abstract Background Coronavirus disease 2019 (COVID-19) is one of the challenging topics in surgery nowadays. Available data indicate high surgical mortality and many postoperative complications in surgical patients with various stages of coronavirus infection. But still a little is known on early and late outcomes of abdominal surgery in patients with COVID-19, especially in countries with limited resources. In this article we describe early and late complications after abdominal surgery in patients recovering from COVID-19. We define early and late complications as those developing during 1-30 and 31-60 postoperative days, accordingly. Methods A prospective cohort study is conducted at Astghik Medical Center, Yerevan, Armenia, from February 1 until October 31, 2020. The study population comprised 259 patients with COVID-19 and 245 patients without COVID-19 matched by operation type, age, sex, and comorbidities, underwent abdominal surgery. Differences between early (1-30 postoperative days) and late (31-60 postoperative days) complications in both groups were analyzed. Patients with COVID-19 had been diagnosed based on both clinical and laboratory (RT-PCR, reverse transcriptase-polymerase chain reaction assay in nasopharyngeal swabs) criteria at least 14 days before abdominal surgery. Patients without COVID-19 were not screened at time of surgery, but were free from any respiratory symptoms and had negative RT-PCR results during preoperative 14 days. The primary endpoints were early and late postoperative complications. Secondary endpoints were to determine 60-day surgical mortality and the impact of comorbidities as additional risk factor of postoperative complications in patients with COVID-19. Results A total of 29 patients with COVID-19 developed early or late postoperative complications. Only 4 patients without COVID-19 with early postoperative complications were identified. The median age of patients with COVID-19 who had early and late postoperative complications were 54.5 (range: 45-64) and 69.5 (range: 65-74), correspondingly. At least one comorbidity was present in 25 (86.2%) of 29 patients with COVID-19 who developed early or late postoperative complications. A 60-day surgical mortality was 14.3%. Conclusion COVID-19 is associated with high risk for postoperative complications of abdominal surgery even if surgical procedures are performed after 14 days of COVID-19 onset. Only patients aged 45 to 74 years developed complications in our study. Presence of at least one comorbidity was an additional risk factor of postoperative complications. Larger and better designed studies are needed to find out indicators for early detection of postoperative complications in patients with COVID-19, especially in people older than 45 years and in those with comorbidities.

HLA-DP variation as additional risk factor in IDDM

Diabetes ◽  
1990 ◽  
Vol 39 (7) ◽  
pp. 855-857 ◽  
Author(s):  
S. Easteal ◽  
M. R. Kohonen-Corish ◽  
P. Zimmet ◽  
S. W. Serjeantson
Keyword(s):  
Risk Factor ◽  
Additional Risk Factor ◽  
Additional Risk

scholarly journals Review of Irish patients meeting ST elevation criteria during the COVID-19 pandemic

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001716
Author(s):  
Luke Byrne ◽  
Roisin Gardiner ◽  
Patrick Devitt ◽  
Caleb Powell ◽  
Richard Armstrong ◽  
...  
Keyword(s):  
Public Health ◽  
Public Perception ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
St Elevation ◽  
The Impact ◽  
Transfer Times

IntroductionThe COVID-19 pandemic has seen the introduction of important public health measures to minimise the spread of the virus. We aim to identify the impact government restrictions and hospital-based infection control procedures on ST elevation myocardial infarction (STEMI) care during the COVID-19 pandemic.MethodsPatients meeting ST elevation criteria and undergoing primary percutaneous coronary intervention from 27 March 2020, the day initial national lockdown measures were announced in Ireland, were included in the study. Patients presenting after the lockdown period, from 18 May to 31 June 2020, were also examined. Time from symptom onset to first medical contact (FMC), transfer time and time of wire cross was noted. Additionally, patient characteristics, left ventricular ejection fraction, mortality and biochemical parameters were documented. Outcomes and characteristics were compared against a control group of patients meeting ST elevation criteria during the month of January.ResultsA total of 42 patients presented with STEMI during the lockdown period. A significant increase in total ischaemic time (TIT) was noted versus controls (8.81 hours (±16.4) vs 2.99 hours (±1.39), p=0.03), with increases driven largely by delays in seeking FMC (7.13 hours (±16.4) vs 1.98 hours (±1.46), p=0.049). TIT remained significantly elevated during the postlockdown period (6.1 hours (±5.3), p=0.05), however, an improvement in patient delays was seen versus the control group (3.99 hours (±4.5), p=0.06). There was no difference seen in transfer times and door to wire cross time during lockdown, however, a significant increase in transfer times was seen postlockdown versus controls (1.81 hours (±1.0) vs 1.1 hours (±0.87), p=0.004).ConclusionA significant increase in TIT was seen during the lockdown period driven mainly by patient factors highlighting the significance of public health messages on public perception. Additionally, a significant delay in transfer times to our centre was seen postlockdown.

scholarly journals Association between apolipoprotein gene polymorphisms and hyperlipidemia: a meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xiao-Ning Zhao ◽  
Quan Sun ◽  
You-Qin Cao ◽  
Xiao Ran ◽  
Yu Cao
Keyword(s):  
Risk Factor ◽  
Cerebrovascular Disease ◽  
Gene Polymorphisms ◽  
Meta Analysis ◽  
Control Group ◽  
Case Group ◽  
Healthy Controls ◽  
Ε4 Allele ◽  
Different Populations ◽  
The Impact

Abstract Background Hyperlipidemia plays an important role in the etiology of cardio-cerebrovascular disease. Over recent years, a number of studies have explored the impact of apolipoprotein genetic polymorphisms in hyperlipidemia, but considerable differences and uncertainty have been found in their association with different populations from different regions. Results A total of 59 articles were included, containing in total 13,843 hyperlipidemia patients in the case group and 15,398 healthy controls in the control group. Meta-analysis of the data indicated that APOA5–1131 T > C, APOA1 -75 bp, APOB XbaI, and APOE gene polymorphisms were significantly associated with hyperlipidemia, with OR values of 1.996, 1.228, 1.444, and 1.710, respectively. All P-values were less than 0.05. Conclusions Meta-analysis of the data indicated that the C allele of APOA5 1131 T > C, the A allele at APOA1-75 bp, the APOB XbaI T allele, and the ε2 and ε4 allele of APOE were each a risk factor for susceptibility for hyperlipidemia.

scholarly journals Altered Expression Levels of MMP1, MMP9, MMP12, TIMP1, and IL-1βas a Risk Factor for the Elevated IOP and Optic Nerve Head Damage in the Primary Open-Angle Glaucoma Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Lukasz Markiewicz ◽  
Dariusz Pytel ◽  
Bartosz Mucha ◽  
Katarzyna Szymanek ◽  
Jerzy Szaflik ◽  
...  
Keyword(s):  
Risk Factor ◽  
Aqueous Humor ◽  
Open Angle Glaucoma ◽  
Luciferase Assay ◽  
Control Group ◽  
Promoter Regions ◽  
Altered Expression ◽  
Expression Levels ◽  
The Impact

The aim of presented work was to analyze the impact of particular polymorphic changes in the promoter regions of the -1607 1G/2GMMP1, -1562 C/TMMP9, -82 A/GMMP12, -511 C/TIL-1β, and 372 T/CTIMP1genes on their expression level in POAG patients. Blood and aqueous humor samples acquired from 50 patients with POAG and 50 control subjects were used for QPCR and protein levels analysis by ELISA.In vivopromoter activity assays were carried on HTM cells using dual luciferase assay. All studied subjects underwent ophthalmic examination, including BCVA, intraocular pressure, slit-lamp examination, gonioscopy, HRT, and OCT scans. Patients with POAG are characterized by an increased mRNA expression ofMMP1,MMP9,MMP12, andIL-1βgenes as compared to the control group (P<0.001). Aqueous humor acquired from patients with POAG displayed increased protein expression of MMP1, MMP9, MMP12, and IL-1βcompared to the control group (P<0.001). Allele -1607 1G ofMMP1gene possesses only 42,91% of the -1607 2G allele transcriptional activity and allele -1562 C ofMMP9gene possesses only 21,86% of the -1562 T allele. Increased expression levels of metalloproteinases can be considered as a risk factor for the development of POAG.

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