cardiac patients
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2022 ◽  
Vol 8 ◽  
Author(s):  
Ekaterina Kushnareva ◽  
Vladimir Kushnarev ◽  
Anna Artemyeva ◽  
Lubov Mitrofanova ◽  
Olga Moiseeva

Objective: Immune checkpoints inhibitors are promising and wide-spread agents in anti-cancer therapy. However, despite their efficacy, these agents could cause cardiotoxicity, a rare but life-threatening event. In addition, there are still no well-described predictive factors for the development of immune-related adverse events and information on high risk groups. According to known experimental studies we hypothesized that cardiovascular diseases may increase myocardial PD-L1 expression, which could be an extra target for Checkpoint inhibitors and a potential basis for complications development.Methods: We studied patterns of myocardial PD-L1 expression in non-cancer-related cardiovascular diseases, particularly ischemic heart disease (n = 12) and dilated cardiomyopathy (n = 7), compared to patients without known cardiovascular diseases (n = 10) using mouse monoclonal anti-PD-L1 antibody (clone 22C3, 1:50, Dako). Correlation between immunohistochemical data and echocardiographic parameters was assessed. Statistical analyses were performed using R Statistical Software—R studio version 1.3.1093.Results: In the myocardium of cardiac patients, we found membranous, cytoplasmic, and endothelial expression of PD-L1 compared to control group. In samples from patients with a history of myocardial infarction, PD-L1 membrane and endothelial expression was more prominent and frequent, and cytoplasmic and intercalated discs staining was more localized. In contrast, samples from patients with dilated cardiomyopathy displayed very faint endothelial staining, negative membrane staining, and more diffuse PD-L1 expression in the cytoplasm and intercalated discs. In samples from the non-cardiac patients, no convincing PD-L1 expression was observed. Moreover, we discovered a significant negative correlation between PD-L1 expression level and left ventricular ejection fraction and a positive correlation between PD-L1 expression level and left ventricular end-diastolic volume.Conclusions: The present findings lay the groundwork for future experimental and clinical studies of the role of the PD-1/PD-L1 pathway in cardiovascular diseases. Further studies are required to find patients at potentially high risk of cardiovascular adverse events associated with immune checkpoint inhibitors therapy.


2021 ◽  
Vol 16 ◽  
pp. 11
Author(s):  
Ananya Shukla ◽  
Satvik Jain ◽  
Nihal Mohammed ◽  
Tasneem Hussain ◽  
Indrajit Banerjee

Objectives: Coronary artery disease (CAD), also known as ischemic heart disease or atherosclerotic cardiovascular disease (CVD), is one of the major causes of morbidity and mortality globally and has contributed to about 80% of sudden deaths. There have been advancements in the diagnosis and treatment of CAD, some of which are still going on to improve patient care, however, there is a dearth of information regarding the various challenges the patients go through after being diagnosed with CAD and so a qualitative study was conducted on cardiac patients in Mauritius to shine a light on the various aspects of life affected by CAD. This is the first qualitative study conducted on cardiac patients in Mauritius. Material and Methods: A phenomenological qualitative study was performed on 12 patients who were diagnosed with CAD, at the Cardiac Unit of Victoria Hospital, Mauritius. By the use of NVivo 12 (Windows) Plus software, after it was transcribed, codes/nodes and themes were generated. Results: Twenty-five different codes were inferred from the study done and from the respective codes, eight main themes were established. The main themes drawn from the study were as follows: Emotional factors, risk factors, optimistic factors, support, awareness of your health, consequences, lifestyle modifications, and the healthcare system. Conclusion: An event of CAD is an experience with multifaceted influences on innumerable aspects of the patient’s life. The study illuminated the immense sufferings and emotional bearings of those patients who were living with heart disease. They expressed their overbearing, insecurities, and a loss of control over various aspects of their lives. This study provided various thought-provoking themes that emerged after transcribing the qualitative interviews. It also highlighted the various challenges faced by patients and how the beliefs of patients with CAD were vital to sustaining them. Family support is a vital aspect in keeping the patient both motivated to follow their treatment and emotionally grounded.


Author(s):  
Rooholah Askari ◽  
Raziyeh Montazeralfaraj ◽  
Sara Jambarsang ◽  
Reyhaneh Sadat Mirhosini

Background: Health promotion includes the concepts of health education, disease prevention and rehabilitation services. Accordingly, the implementation of standards and indicators of health promotion in hospitals is necessary to ensure the quality of the services provided. Therefore, this study was conducted to investigate the effect of implementing a health promotion hospital plan on the awareness of hospitalized cardiac patients in selected educational hospitals in Yazd. Methods: This was an interventional study, which was performed on 62 cardiac patients referred to 2 selected educational hospitals of Yazd University of Medical Sciences. 31 patients from Afshar Hospital (the case group), and 31 patients from Shahid Sadoughi Hospital (the control group) were selected by purposive sampling method. In the case group, in addition to the routine trainings, the subjects received face to face and group educational interventions based on the Health Belief Model and the Guidelines to the American Cardiovascular and Pulmonary Rehabilitation Association for 3 months, and were finally given an educational package. The samples in the control group also underwent routine training. Data analysis was performed using a questionnaire based on Health Belief Model, before the educational intervention and 3 months after, using SPSS 23 software, Chi-square and independent t-tests. Results: Awareness scores in the case and control groups before the intervention were 7.90 ± 4.01 and 10.67 ± 5.31, and after the intervention were 21 ± 1.61 and 11.54 ± 5.31 respectively, and a significant difference was seen in the scores of the post-intervention group (p < 0.001). Conclusion: The implementation of the health promotion hospital plan can be effective in increasing the awareness and improving the performance of cardiac patients. Therefore, it is recommended for hospitals to move towards health promotion.


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