The latest medical research on Cardiology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about cardiology gathered by our medical AI research bot.

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Pre- and intra-operative risk factors predict postoperative respiratory failure after minimally invasive esophagectomy.

Cardiothoracic Surgery

Severe pulmonary complications such as postoperative respiratory failure can occur after minimally invasive oesophagectomy. However, the risk factors have not been well identified. This study aimed to develop a predictive model for the occurrence of postoperative respiratory failure with a large sample.

We collected data from patients with oesophageal cancer who received minimally invasive oesophagectomy at Shanghai Chest Hospital from 2019 to 2022. Univariable and backward stepwise logistic regression analysis of 19 pre- and intraoperative factors were used before model fitting, and its performance was evaluated with the receiver operating characteristic curve. Internal validation was assessed with calibration plot, decision curve analysis, and area under curve with its 95% confidence intervals, obtained from 1000 resamples set by Bootstrap method.

This study enrolled 2,386 patients, of which 57 (2.4%) patients developed postoperative respiratory failure. Backward stepwise logistic regression analysis revealed that age, BMI, cardiovascular disease, diabetes, diffusion capacity of the lungs for carbon monoxide, tumour location, and duration of chest surgery ≥101.5mins were predictive factors. A predictive model was constructed and showed acceptable performance (Area Under Curve: 0.755). The internal validation with the Bootstrap method proves the good agreement for prediction and reality.

Obesity, severe diffusion dysfunction and upper segment oesophageal cancer were strong predictive factors. The established predictive model has acceptable predictive validity for postoperative respiratory failure after minimally invasive oesophagectomy, which may improve the identification of high-risk patients and enable healthcare professionals to preform risk assessment for postoperative respiratory failure at the initial consultation.

Sex differences in Long-Term survival after total arterial coronary artery bypass grafting.

Cardiothoracic Surgery

It is uncertain if the evidence on improved long-term survival of total arterial coronary artery bypass grafting applies to in female patients. This study aims to compare the long-term survival outcomes of using total arterial revascularisation versus at least one saphenous vein graft separately for men and women.

This retrospective analysis of the Australian and New Zealand Society of Cardiac-Thoracic Surgical Database had administrative linkage to the National Death Index. We identified all patients undergoing primary isolated coronary bypass from June 2001 to January 2020 inclusive. Following sex stratification, propensity score matching with 36 variables and Cox proportional hazard regression were used to facilitate adjusted comparisons. A Cox interaction-term analysis was performed to investigate the impact of sex on TAR survival benefit. The primary outcome was all-cause mortality.

Of the 69,624 eligible patients receiving at least two grafts, 13,019 (18.7%) were female patients. Matching generated 14,951 male and 3,530 female pairs. Compared to vein-dependent procedures, total arterial revascularization was associated with significantly reduced incidence of long-term all-cause mortality for both male (HR, 0.86; 95% CI, 0.81-0.91; P < 0.001) and female (HR, 0.82; 95% CI, 0.73-0.91; P < 0.001) cohorts. Interaction term analysis indicated no significant subgroup effect from sex (P = 0.573) on the survival advantage of total arterial revascularization. The treatment effect provided by total arterial revascularisation remained significant across most sex-stratified disease subgroups.

Total arterial revascularization, when compared to the use of at least one saphenous vein graft, provides comparable superior long-term survival outcomes in both females and males.

Configuration of the neo-aortic root after chimney reconstruction in the norwood procedure.

Cardiothoracic Surgery

After staged reconstruction for hypoplastic left heart syndrome (HLHS), the neoaortic root tends to dilate, and the incidence of significant neoaortic valve insufficiency increases with time. This study aimed to evaluate the mid-term outcomes of the neoaortic root geometries and valve function after chimney reconstruction in the Norwood procedure.

Between 2013 and 2021, 20 consecutive patients who underwent chimney reconstruction during the Norwood procedure for HLHS and its variants in our institution were enrolled. The actual diameters of the following points were measured, and Z-scores were calculated based on the normal aortic root geometries using the long axis view of echocardiography at the pre-Norwood stage and the lateral view of angiography at pre-Glenn, pre-Fontan, post-Fontan, and follow-up (age 5-6 years) stages: neoaortic valve annulus; sinus of Valsalva; sinotubular junction; and ascending aorta just proximal to the anastomosis to the aortic arch. The degree of neoaortic valve regurgitation was evaluated by echocardiography at each stage.

The median follow-up period was 3.9 years. Neo-aortic roots after chimney reconstruction were spared from progressive dilation over time. With growth, the conical configuration of the neoaortic roots was preserved without geometrical distortion. The Z-scores of the annulus, sinus of Valsalva, sinotubular junction, and ascending aorta ranged roughly from 4 to 6, 4 to 6, 2 to 4, and 0 to 2, respectively. All neoaortic valves at each stage had mild or no regurgitation.

Chimney reconstruction prevented neoaortic root dilation and avoided significant neoaortic valve regurgitation in the mid-term. These neoaortic dimensions with smooth flow profiles in the neo-aorta after chimney reconstruction may have contributed to the current results. Further studies are needed to clarify the long-term outcomes.

Population-based study on surgical care for primary spontaneous pneumothorax.

Cardiothoracic Surgery

The optimal surgical strategy for primary spontaneous pneumothorax remains a matter of debate and variation in surgical practice is expected. This variation may influence clinical outcomes, such as postoperative complications and length of stay. This national population-based registry study provides an overview and extent of variability of current surgical practice and outcomes in the Netherlands.

To identify national patterns of care and between-hospital variability in the treatment of primary spontaneous pneumothorax, patients who underwent surgical pleurodesis and/or bullectomy between 2014- 2021, were identified from the Dutch Lung Cancer Audit-Surgery database. The type of surgical intervention, postoperative complications, length of stay and ipsilateral recurrences were recorded.

Out of 4,338 patients, 1,851 patients were identified to have primary spontaneous pneumothorax. The median age was 25 years (interquartile range 20-31) and 82% was male. The most performed surgical procedure was bullectomy with pleurodesis (83%). The overall complication rate was 12% (Clavien Dindo grade ≥III 6%), with the highest recorded incidence for persistent air leak >5 days (5%). Median postoperative length of stay was 4 days (interquartile range 3-6) and 0.7% underwent a repeat pleurodesis for ipsilateral recurrence. Complication rate and length of stay differed considerably between hospitals. There were no differences between the surgical procedures. In the Netherlands, surgical patients with primary spontaneous pneumothorax are preferably treated with bullectomy plus pleurodesis. Postoperative complications and length of stay vary widely and are considerable in this young patient group. This may be reduced by optimization of surgical care.

Acute cement dust poisoning: Rigid bronchoscopy and mechanical insufflation-exufflation as an effective and novel treatment for its management.

Cardiothoracic Surgery

This clinical case shows the repercussions of acute exposure to cement dust in the respiratory tract and other mucous membranes. Following a cement...

The Rationale for Using Fixed-Dose Combination Therapy in the Management of Hypertension in Colombia: A Narrative Review.

Cardiovascular Drugs

Hypertension is a major risk factor for cardiovascular disease and the leading cause of death in Colombia. While the rate of hypertension awareness...

Stalactites in the Right Ventricle.

Journal of Cardiovascular Magnetic Resonance

Heart metastatic tumors are more frequent than primary heart tumors. Cardiac metastasis is a rare phenomenon, occurring mainly by direct spread, es...

Constrictive Pericarditis: An Update on Noninvasive Multimodal Diagnosis.

Journal of Cardiovascular Magnetic Resonance

Constrictive pericarditis (CP) is a rare condition that can affect the pericardium after every pericardial disease process and has been described e...

Can Global Longitudinal Strain Assess Asymptomatic Subtle Left Ventricular Dysfunction in Recovered COVID-19 Patients?

Journal of Cardiovascular Magnetic Resonance

Coronavirus disease 2019 (COVID-19) might be associated with cardiac injury as a part of multisystem affection in response to cytokine storms. However, left ventricular (LV) function appears preserved in most of the cases, whereas subtle LV dysfunction might happen in others. Hence, we tried to detect subtle LV dysfunction in patients with COVID-19 using global longitudinal strain (GLS).

We performed a single-center observational study on 90 stable patients who were recently recovered from mild to moderate COVID-19 infections. A transthoracic echocardiographic examination was done for all patients, and GLS assessment was used as an indicator of LV function.

The population age ranged from 27 to 66 years, and the majority of patients were males (54, 73.3%). Besides, 46.7% of the included patients were smokers, 33.3% had hypertension, and 23.3% were diabetics. All the patients had normal LV internal dimensions and ejection fractions. However, 33.3% of them had subclinical LV dysfunction as expressed by reduced GLS. There was no statistically significant correlation between GLS and age, gender, or other risk factors, whereas troponin and C-reactive protein significantly correlated with GLS.

Recovered patients from recent mild to moderate COVID-19 infections might show subtle LV dysfunction as manifested by reduced GLS.

Catch the Cath or Not? A Hamletic Dilemma after 10 Years.

Journal of Cardiovascular Magnetic Resonance

In the last few years, a tremendous advancement has been made in the therapeutical management of several diseases with an increasing need for paren...

Echocardiography in Simple Congenital Heart Diseases: Guiding Adult Patient Management.

Journal of Cardiovascular Magnetic Resonance

This article provides comprehensive insights into the evaluation of simple congenital heart diseases (CHDs) in adults, emphasizing the pivotal role...

Replacement of Ascending Aortic Aneurysm with Anomalous Origin of the Right Coronary Artery: Multidisciplinary Imaging for the Diagnosis.

Journal of Cardiovascular Magnetic Resonance

This case report presents a rare scenario involving a congenital anomaly of the right coronary artery's (RCA) origin in association with an ascendi...