RESUMEN
OBJECTIVE: Peripheral artery disease (PAD) is a highly prevalent disease that places major lifestyle limitations and mortality risk on affected individuals. As the understanding of the disease has grown in the medical community, it is unknown which literature has made the greatest impact on the knowledge of PAD. We performed a bibliometric analysis using the number of citations as an indication of impact to analyze the top 100 most influential articles on PAD management. METHODS: A retrospective search of the Web of Science (Thomson Reuters, New York, NY) database for English-only publications was conducted in November 2020. We identified initial references from the database using the search terms "Peripheral Arterial Disease," "Peripheral Vascular Disease," "Claudication," "Critical Limb Ischemia," "Chronic Limb Threatening Ischemia," "Rest Pain," "Ischemic Ulcer," "Toe Gangrene," "Ankle Brachial Index," and "Leg Ischemia" in Web of Science Core Collections. Articles were ranked based on the number of citations and then analyzed based on citation count and average number of citations per year. Additional metrics included the overall average number of publications per year, the journals, journal discipline, author (including degree and gender), institution, country, topic area, and the level of evidence. RESULTS: The most popular articles were published between 1959 and 2017, with 46,716 citations in total (average 27.26 citations/y). The most popular article had 2225 citations in total and was Rutherford's "Recommended standards for reports dealing with lower extremity ischemia: Revised version." Peak years of citations were 2016, 2014, and 2018 (2753, 2674, and 2639 citations, respectively). Top journals for the most cited publications were Circulation, Journal of Vascular Surgery, and the Lancet with 21, 13, and 7 articles, respectively. A majority of articles originated from the United States (58 articles), followed by the United Kingdom (15 articles) and Germany (13 articles). Major topic areas of interest and trends in the progressive understanding of PAD were noted. Top areas of focus included surgical interventions (29%), therapeutic angiogenesis (15%), epidemiological studies in PAD (14%), and diagnosis and evaluation (13%). In the top cited literature, 48% (14/29) of surgical articles investigated endovascular interventions for PAD. CONCLUSIONS: Overall, PAD research has evolved from basic epidemiological studies to advanced management with continued investigation toward future, improved treatments for PAD.
Asunto(s)
Investigación Biomédica/tendencias , Técnicas de Diagnóstico Cardiovascular/tendencias , Publicaciones Periódicas como Asunto/tendencias , Enfermedad Arterial Periférica/diagnóstico , Enfermedad Arterial Periférica/terapia , Procedimientos Quirúrgicos Vasculares/tendencias , Bibliometría , Procedimientos Endovasculares/tendencias , Humanos , Enfermedad Arterial Periférica/epidemiología , Estudios Retrospectivos , Factores de TiempoRESUMEN
Malignant hypertension has not disappeared, it has been forgotten. Its incidence is increasing again. It considerably worsens the prognosis of young patients (35 to 55 years old on average). There might be susceptibility factors, several hypotheses are under study. New diagnostic criteria and therapeutic options have been proposed and will have to be validated. Faced with these important challenges for patients, the first prospective multicentric register on this pathology will be set up in France in September 2019.
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Hipertensión Maligna , Técnicas de Diagnóstico Cardiovascular/tendencias , Susceptibilidad a Enfermedades/epidemiología , Francia/epidemiología , Humanos , Hipertensión Maligna/diagnóstico , Hipertensión Maligna/epidemiología , Hipertensión Maligna/terapia , Incidencia , Pronóstico , Sistema de RegistrosRESUMEN
Although echocardiography remains the mainstay imaging technique for the evaluation of patients with valvular heart disease (VHD), innovations in noninvasive imaging in the past few years have provided new insights into the pathophysiology and quantification of VHD, early detection of left ventricular (LV) dysfunction, and advanced prognostic assessment. The severity grading of valve dysfunction has been refined with the use of Doppler echocardiography, cardiac magnetic resonance (CMR), and CT imaging. LV ejection fraction remains an important criterion when deciding whether patients should be referred for surgery. However, echocardiographic strain imaging can now detect impaired LV systolic function before LV ejection fraction reduces, thus provoking the debate on whether patients with severe VHD should be referred for surgery at an earlier stage (before symptom onset). Impaired LV strain correlates with the amount of myocardial fibrosis detected with CMR techniques. Furthermore, accumulating data show that the extent of fibrosis associated with severe VHD has important prognostic implications. The present Review focuses on using these novel imaging modalities to assess pathophysiology, early LV dysfunction, and prognosis of major VHDs, including aortic stenosis, mitral regurgitation, and aortic regurgitation.
Asunto(s)
Técnicas de Diagnóstico Cardiovascular , Enfermedades de las Válvulas Cardíacas , Válvulas Cardíacas/diagnóstico por imagen , Técnicas de Diagnóstico Cardiovascular/clasificación , Técnicas de Diagnóstico Cardiovascular/tendencias , Enfermedades de las Válvulas Cardíacas/diagnóstico , Enfermedades de las Válvulas Cardíacas/fisiopatología , Humanos , Invenciones , Pronóstico , Índice de Severidad de la EnfermedadAsunto(s)
Investigación Biomédica/tendencias , Cardiología/tendencias , Enfermedades Cardiovasculares/diagnóstico por imagen , Técnicas de Diagnóstico Cardiovascular/tendencias , Animales , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/terapia , Diagnóstico por Imagen/tendencias , Difusión de Innovaciones , Predicción , Humanos , Imagen Multimodal/tendencias , Selección de Paciente , Valor Predictivo de las Pruebas , Pronóstico , Medición de Riesgo , Factores de RiesgoRESUMEN
Eleven years after the publication of the first guidelines worldwide on pericardial diseases by the European Society of Cardiology (ESC), the international expert group of the ESC has updated the original document of 28 pages with 275 references. The final version of the new guidelines is more voluminous with 44 pages of recommendations but only 233 references. A continuing medical education (CME) certified update of the 2004 guidelines was published in the journal Herz volume 7/2014. In comparison to 2004 the 2015 guidelines have remained virtually unchanged in the sections detailing diagnostics, differential diagnosis, pathology and pathophysiology. Substantial progress has been made in magnetic resonance imaging (MRI) of pericarditis and epicarditis and in the practically universal recommendation of colchicine for all forms of pericarditis and pericardial effusion, whether acute, chronic or recurrent. This can truly be called progress; however, little has changed since 2004 even in tertiary referral centers or universities with respect to the etiological classification of acute or recurrent forms of pericarditis or pericardial effusion. By classifying pericardial syndromes much too often as idiopathic when a malignant or bacterial cause has been excluded, the underlying cause is often overlooked. Standstill in diagnosis is in the end regress because we too often lag behind our actual diagnostic and interventional possibilities.
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Infecciones Bacterianas/diagnóstico , Infecciones Bacterianas/terapia , Cardiología/normas , Técnicas de Diagnóstico Cardiovascular/normas , Pericarditis/diagnóstico , Pericarditis/terapia , Cardiología/tendencias , Diagnóstico Diferencial , Técnicas de Diagnóstico Cardiovascular/tendencias , Europa (Continente) , Medicina Basada en la Evidencia , Humanos , Guías de Práctica Clínica como AsuntoRESUMEN
The works deals with a retrospective analysis of the medical records of the Clinic of General Surgery of the North-West State Medical University named after I.I. Mechnikov on treatment of patients presenting with embolism of the aorta and major arteries over 40 years. All in all, over the period from 1971 to 2010 a total of 3,110 patients with embolism of the aorta and major arteries underwent consultations and were operated on. To the present-day trends in surgery of embologenic arterial obstruction one should first of all refer a decrease in the number of patients with embolism of the aorta and major arteries of the limbs, which may be related to achievement in modern cardiology and cardiosurgery in treatment of patients with cardiovascular diseases - potential sources of arterial embolism. Besides, there occurred considerable changes in the structure of embologenic diseases, in favour of an increased number of people suffering from CAD, which to e certain degree modified the incidence of lesions of various vascular basins. Thus, the number of embolisms of proximal portions of the vascular bed decreased considerably. This is largely related to a decrease in the number of patients presenting with decompensated ischaemia of extremities. 86.9% of patients were subjected to emergency operations. An increased number of people with atherosclerosis of peripheral arteries required widening of indications for performing reconstructive-and-plastic operative interventions. Experience of the Clinic shows that a timely performed revascularizing operation, including a reconstructive on, application of modern methods of prevention of ischaemic syndrome, carrying out comprehensive rehabilitation measures in the postoperative period made it possible to considerably improve the immediate results of treatment. While during the first 20 years a total lethality rate amounted to 18.8% with the postoperative one equalling 17.1%, these parameters over the past 10 years were 8.8% and 6.9%, respectively.
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Aorta Abdominal , Arterias , Embolectomía , Embolia , Extremidades , Isquemia/cirugía , Complicaciones Posoperatorias/epidemiología , Aorta Abdominal/patología , Aorta Abdominal/fisiopatología , Aorta Abdominal/cirugía , Arterias/diagnóstico por imagen , Arterias/fisiopatología , Arterias/cirugía , Interpretación Estadística de Datos , Técnicas de Diagnóstico Cardiovascular/tendencias , Embolectomía/efectos adversos , Embolectomía/métodos , Embolectomía/tendencias , Embolia/complicaciones , Embolia/diagnóstico , Embolia/etiología , Embolia/cirugía , Extremidades/irrigación sanguínea , Extremidades/fisiopatología , Humanos , Isquemia/etiología , Isquemia/fisiopatología , Evaluación de Procesos y Resultados en Atención de Salud/estadística & datos numéricos , Evaluación de Procesos y Resultados en Atención de Salud/tendencias , Flujo Sanguíneo Regional , Estudios Retrospectivos , UltrasonografíaRESUMEN
Amyloidosis is a rare disease in which insoluble extracellular protein fibrils in ß-pleated sheets infiltrate multiple organs, causing organ dysfunction and failure. Amyloidoses are generally classified into light chain or primary systemic amyloidosis, hereditary amyloidosis (most commonly, transthyretin amyloidosis), senile systemic amyloidosis, secondary amyloidosis, and isolated atrial amyloidosis. At least 100 different amyloidogenic proteins have been identified in humans and can be differentiated by mass spectroscopy after laser capture microdissection and genetic testing. Organ involvement can include kidneys, skin, blood vessels, central and peripheral nervous systems, lungs, liver, intestines, and heart. Developments in noninvasive techniques are facilitating earlier and more accurate diagnosis. Management depends on the specific disease type, thus early and accurate diagnosis is imperative. Prognosis generally correlates with degree of cardiac involvement but varies widely with specific amyloid protein type. New treatment strategies involving chemotherapy and organ transplantation are improving survival, but prognosis is guarded.
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Amiloidosis/diagnóstico , Cardiomiopatías/diagnóstico , Amiloidosis/terapia , Amiloidosis Familiar/diagnóstico , Amiloidosis Familiar/terapia , Cardiomiopatías/terapia , Técnicas de Diagnóstico Cardiovascular/tendencias , Diagnóstico Precoz , Humanos , PronósticoRESUMEN
From June 10th -14th, 2011, Yaroslavl played host to the traditional VIII International Conference
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Circulación Sanguínea , Sistema Cardiovascular , Hemorreología , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/tratamiento farmacológico , Enfermedades Cardiovasculares/metabolismo , Enfermedades Cardiovasculares/fisiopatología , Sistema Cardiovascular/metabolismo , Sistema Cardiovascular/fisiopatología , Congresos como Asunto , Técnicas de Diagnóstico Cardiovascular/tendencias , Quimioterapia/métodos , Enfermedades Hematológicas/sangre , Enfermedades Hematológicas/diagnóstico , Enfermedades Hematológicas/tratamiento farmacológico , Enfermedades Hematológicas/fisiopatología , Hemostasis , Humanos , Neovascularización FisiológicaRESUMEN
BACKGROUND: Although variation in use of invasive coronary procedures has been shown, the relationship between invasive diagnostic cardiac catheterization (Cath) and subsequent revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) is not known. We evaluated the temporal trends and variation in invasive Cath, PCI, and CABG across hospital systems in North Carolina. METHODS: All Cath, PCI, and CABG procedures performed in North Carolina from 2003 to 2009 were identified using data reported in the annual North Carolina State Medical Facilities Plan. Rates and variation in procedure use, relative rates of PCI to Cath, CABG to Cath, and CABG to PCI were compared over the study period between hospitals that performed at least 25 Cath, 25 PCI, and 25 CABG procedures. RESULTS: The rates of all invasive procedures per 100,000 population declined: 24% for Cath, 16% for PCI, and 35% for CABG. However, the relative rate of PCI to Cath over the study period increased by 11%, whereas the relative rate of CABG to Cath decreased by 13%. Hospital level analysis showed significant variation in the relative rate of both PCI to Cath (10%-90%, P < .05) and CABG to Cath (5%-35%, P < .05). CONCLUSIONS: Although the use of all invasive cardiac procedures declined, the relative rate of PCI to Cath increased over the study period. There was also significant variation in the mode of revascularization (CABG and PCI) across hospital systems in North Carolina. Further research is needed to understand drivers of coronary revascularization.
Asunto(s)
Angioplastia Coronaria con Balón/estadística & datos numéricos , Angiografía Coronaria/estadística & datos numéricos , Puente de Arteria Coronaria/estadística & datos numéricos , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/terapia , Evaluación de Resultado en la Atención de Salud , Procedimientos Quirúrgicos Cardiovasculares/tendencias , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Técnicas de Diagnóstico Cardiovascular/tendencias , Hospitales/estadística & datos numéricos , Humanos , North CarolinaRESUMEN
Complex aortic disease continues to have a high mortality and morbidity despite advances in medical and surgical treatment. Repair of thoracoabdominal aneurysms, treatment of patients with connective tissue disorders, and the approach to dissections of the ascending and descending aorta have evolved over time; however, the results of intervention in all but highly specialized centers remain poor. As vascular surgeons, our role must extend beyond that of the pure technician; we have been vested with the life-long care of these patients and, therefore, have a responsibility to the patient in addition the scientific community and society at large to create a strategy for management that serves all three interests justly. We will outline some of the changes in the conceptual approach that we consider important to the treatment of complex aortic disease.
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Enfermedades de la Aorta/diagnóstico , Enfermedades de la Aorta/cirugía , Diagnóstico por Imagen/tendencias , Técnicas de Diagnóstico Cardiovascular/tendencias , Procedimientos Quirúrgicos Vasculares/tendencias , HumanosRESUMEN
Atherosclerosis affects all vascular beds, including the coronary, carotid, intracerebral, peripheral and aortic vascular beds, and is responsible for tremendous morbidity and mortality, with the most serious outcomes being myocardial infarction, stroke and death. Historically the effects of vascular narrowing and associated thrombosis have been key indicators of disease in the coronary and carotid territories, with degrees of vascular stenosis being of profound importance in carotid surgery trials. Our improving understanding of the biology of atheromatous lesions and the development of alternative therapeutic agents which can initiate actual plaque regression have created a need to attempt to image plaque itself, with the carotid artery being an achievable target. This article reviews current strategies for assessing carotid atherosclerotic disease, particularly with reference to identifying plaque components and risk of rupture, the so-called vulnerable plaque.
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Aterosclerosis/diagnóstico , Enfermedades de las Arterias Carótidas/diagnóstico , Técnicas de Diagnóstico Cardiovascular/tendencias , Angiografía de Substracción Digital , Humanos , Angiografía por Resonancia Magnética , Tomografía de Emisión de Positrones , UltrasonografíaAsunto(s)
Cardiología , Cardiopatías/epidemiología , Adolescente , Adulto , Anciano , Cardiología/educación , Cardiología/organización & administración , Cardiología/tendencias , Causas de Muerte , Niño , Enfermedad Coronaria/epidemiología , Atención a la Salud , Técnicas de Diagnóstico Cardiovascular/estadística & datos numéricos , Técnicas de Diagnóstico Cardiovascular/tendencias , Femenino , Servicios de Salud/provisión & distribución , Humanos , Masculino , Persona de Mediana Edad , Administración en Salud Pública , Cardiopatía Reumática/epidemiología , Fumar/epidemiología , Siria/epidemiologíaRESUMEN
The atherothromboses is the principal cause of death in the western World, the rupture of the vulnerable plaque is the trigger of the acute coronary syndromes. The importance of identifying the vulnerable plaque before its rupture continues being a challenge. At the moment the diagnosis can be made by noninvasive methods, like the presence of risk factors and blood markers of vulnerability and invasive methods like angiocospic. Although several methods exist, there is no one that gives all morphologic and inflammatory activity; it seems that the thermography is going to be the most helpful. The future will be not just the diagnosis of vulnerable plaque but the vulnerable patient.
Asunto(s)
Humanos , Enfermedad de la Arteria Coronaria , Técnicas de Diagnóstico Cardiovascular/tendencias , PredicciónAsunto(s)
Evaluación de la Tecnología Biomédica/tendencias , Evaluación de la Tecnología Biomédica , Ecocardiografía/instrumentación , Ecocardiografía/métodos , Ecocardiografía/normas , Servicio de Cardiología en Hospital/historia , Servicio de Cardiología en Hospital/tendencias , Técnicas de Diagnóstico Cardiovascular/tendencias , Técnicas de Diagnóstico CardiovascularRESUMEN
A dilatação fluxo-mediada endotélio-dependente da artéria branquial (DILA) ou simplesmente reatividade da artéria branquial é hoje o melhor procedimento para avaliar a função endotelial. A técnica é ultrasonográfica, não invasiva, simples e de fácil aprendizado, muito embora exija certo cuidado por parte do examinador. O aumento do fluxo do sangue resultante da hiperemia isquemia-induzida estimula a liberação de óxido nítrico(NO) pelo endotélio, resposta que está comprometida em pacientes de risco para doença coronariana, vale dizer, diabéticos, hipertensos, tabagistas e hiperlipidêmicos. Além disso a DILA vem também sendo utilizada na toxemia gravídica, doença que tem na sua fisiopatologia a pontificar a disfunção endotelial...