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1.
Heart Fail Clin ; 18(1): 115-123, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34776073

RESUMO

"Sudden unexplained death (SUD) is a tragic event for both the family and community, particularly when it occurs in young individuals. Sudden cardiac death (SCD) represents the leading form of SUD and is defined as an unexpected event without an obvious extracardiac cause, occurring within 1 hour after the onset of symptoms. In children, the main causes of SCD are inherited cardiac disorders, whereas coronary artery diseases (congenital or acquired), congenital heart diseases, and myocarditis are rare. The present review examines the current state of knowledge regarding SCD in children, discussing the epidemiology, clinical causes, and prevention strategies."


Assuntos
Morte Súbita Cardíaca , Cardiopatias , Criança , Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/etiologia , Morte Súbita Cardíaca/prevenção & controle , Humanos
2.
Cardiol Clin ; 40(1): 69-76, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34809918

RESUMO

Pulmonary hypertension (PH) due to left heart disease (LHD; group 2 PH) is a common complication of heart failure with reduced ejection fraction and heart failure with preserved ejection fraction and is often related to disease severity and duration of these diseases. PH due to LHD is associated with negative impact on outcomes in addition to worse symptoms and exercise capacity. Risk factors for group 2 PH are older age, hypertension, atrial fibrillation, and features of metabolic syndrome. The main mechanisms for group 2 PH are believed to be vascular remodeling secondary to sustained elevated intravascular pressure.


Assuntos
Cardiopatias , Insuficiência Cardíaca , Hipertensão Pulmonar , Disfunção Ventricular Esquerda , Idoso , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/etiologia , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/epidemiologia , Hipertensão Pulmonar/etiologia , Fatores de Risco , Volume Sistólico
3.
BMC Bioinformatics ; 22(Suppl 5): 92, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34749632

RESUMO

BACKGROUND: Heart sound measurement is crucial for analyzing and diagnosing patients with heart diseases. This study employed phonocardiogram signals as the input signal for heart disease analysis due to the accessibility of the respective method. This study referenced preprocessing techniques proposed by other researchers for the conversion of phonocardiogram signals into characteristic images composed using frequency subband. Image recognition was then conducted through the use of convolutional neural networks (CNNs), in order to classify the predicted of phonocardiogram signals as normal or abnormal. However, CNN requires the tuning of multiple hyperparameters, which entails an optimization problem for the hyperparameters in the model. To maximize CNN robustness, the uniform experiment design method and a science-based methodical experiment design were used to optimize CNN hyperparameters in this study. RESULTS: An artificial intelligence prediction model was constructed using CNN, and the uniform experiment design method was proposed to acquire hyperparameters for optimal CNN robustness. The results indicate Filters ([Formula: see text]), Stride ([Formula: see text]), Activation functions ([Formula: see text]), and Dropout ([Formula: see text]) to be significant factors considerably influencing the ability of CNN to distinguish among heart sound states. Finally, the confirmation experiment was conducted, and the hyperparameter combination for optimal model robustness was Filters ([Formula: see text]) = 32, Kernel Size ([Formula: see text] = 3 × 3, Stride ([Formula: see text]) = (1,1), Padding ([Formula: see text] as same, Optimizer ([Formula: see text] as the stochastic gradient descent, Activation functions ([Formula: see text]) as relu, and Dropout ([Formula: see text]) = 0.544. With this combination of parameters, the model had an average prediction accuracy rate of 0.787 and standard deviation of 0. CONCLUSION: In this study, phonocardiogram signals were used for the early prediction of heart diseases. The science-based and methodical uniform experiment design was used for the optimization of CNN hyperparameters to construct a CNN with optimal robustness. The results revealed that the constructed model exhibited robustness and an acceptable accuracy rate. Other literature has failed to address hyperparameter optimization problems in CNN; a method is subsequently proposed for robust CNN optimization, thereby solving this problem.


Assuntos
Inteligência Artificial , Cardiopatias , Cardiopatias/diagnóstico por imagem , Humanos , Redes Neurais de Computação
5.
Am J Case Rep ; 22: e933427, 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34793412

RESUMO

BACKGROUND There are no guidelines providing an algorithmic approach for the management of right atrial thrombi, to date, owing to a lack of strong supporting studies. In this case series, we describe 2 cases of high-risk patients with massive right atrial thrombi who had different outcomes. CASE REPORT Case 1: A 62-year-old man with ischemic cardiomyopathy and atrial fibrillation, who was on a permanent pacemaker for sick sinus syndrome and was noncompliant with medication for 2 years, presented to the Emergency Department for evaluation of a 2-month history of progressive shortness of breath and swollen neck veins. A cardiac ultrasound confirmed a large right atrial thrombus, and a computed tomography (CT) pulmonary angiogram was negative for pulmonary emboli. He was managed with a heparin infusion and thrombolytic therapy with favorable evolution. Case 2: A 66-year-old man, with a past medical history of nonischemic cardiomyopathy, atrial fibrillation, deep venous thrombosis, and pulmonary emboli a year earlier, presented to an urgent care unit with sudden onset of shortness of breath. A cardiac ultrasound confirmed a large right atrial thrombus, and a CT pulmonary angiogram confirmed bilateral pulmonary emboli. He was managed with a heparin infusion and EkoSonic endovascular system therapy. He subsequently needed venoarterial extracorporeal membrane oxygenation for cardiopulmonary resuscitation and underwent mechanical aspiration thrombectomy. The patient's evolution was unfavorable. CONCLUSIONS In the absence of an evidence-based guideline to approach right atrial thrombi, management should be individualized for each patient, based on the type of thrombi, hemodynamic status, and presence or absence of associated pulmonary emboli.


Assuntos
Cardiopatias , Embolia Pulmonar , Tromboembolia , Trombose , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/terapia , Terapia Trombolítica , Trombose/tratamento farmacológico
6.
Kyobu Geka ; 74(12): 1051-1054, 2021 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-34795153

RESUMO

We report a rare case of a congenital pericardial defect that was incidentally found at thoracoscopic left upper lobe resection in a patient with lung cancer. A 75-year-old man with a left upper lobe lung cancer was referred to our hospital. We performed thoracoscopic left upper lobectomy and incidentally found a pericardial defect intraoperatively. Careful lymph node dissection was necessary to avoid injury of phrenic nerve and pulmonary artery. Surgery for lung cancer was completed without pericardial repair. After surgery, no complications associated with the pericardial defect has not been encountered.


Assuntos
Anormalidades Cardiovasculares , Cardiopatias , Neoplasias Pulmonares , Idoso , Anormalidades Cardiovasculares/diagnóstico por imagem , Anormalidades Cardiovasculares/cirurgia , Humanos , Pulmão , Masculino , Pericárdio
7.
Ann Card Anaesth ; 24(4): 470-472, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34747756

RESUMO

Hydatid infection of the heart is rare and there is always the lethal hazard of cyst perforation. We present an 18-year-old male from Kashmir valley who was admitted to the emergency department of our hospital with fever and chest pain for the last 4 days. Using echocardiography and cardiac tomography (CT), cardiac Echinococcosis was diagnosed. The results of surgical treatment of cardiac Echinococcosis were better than the conservative strategy. Surgical excision was performed. The patient had an uneventful recovery.


Assuntos
Equinococose , Cardiopatias , Adolescente , Dor no Peito , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Ecocardiografia , Coração , Cardiopatias/diagnóstico por imagem , Cardiopatias/cirurgia , Humanos , Masculino
8.
Ann Palliat Med ; 10(10): 11035-11052, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34763466

RESUMO

BACKGROUND: Fundamental transformations in overall population health have occurred in the past five decades and are continuing. Our aim in this study was to characterize the trends in population mortality rates in the United States (U.S.) from 1969 to 2017. METHODS: Data on the 109,836,044 deaths registered in the Surveillance, Epidemiology, and End Results (SEER) database were analyzed by sex, race and ethnicity, and age. Temporal trends in population mortality rates were examined from 1969 to 2017. All data analyses were performed using the SEER*Stat software. RESULTS: The overall mortality rate for males and females in the U.S. per 100,000 population fell by 46.1% and 39.3%, from 1,610.0 and 1,019.3 in 1969 to 867.2 and 619.2 in 2017, respectively. This decline in overall mortality was mainly attributable to a decrease in mortality caused by heart and cerebrovascular diseases. From 1969 to 2017, the overall mortality rate was higher in males than females, and in blacks than whites for both sexes. From 1979 to 2017, the mortality rates of heart diseases, cerebrovascular diseases, and diabetes were all higher in blacks than in whites for both sexes. CONCLUSIONS: The results indicate that the U.S. has dramatically reduced its overall annual mortality rate between 1969 and 2017; however, the disparities among different races are still apparent.


Assuntos
Grupo com Ancestrais do Continente Europeu , Cardiopatias , Bases de Dados Factuais , Grupos Étnicos , Feminino , Humanos , Masculino , Mortalidade , Estados Unidos/epidemiologia
9.
Open Heart ; 8(2)2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34782369

RESUMO

OBJECTIVE: To determine the prevalence of cardiac abnormalities and their relationship to markers of myocardial injury and mortality in patients admitted to hospital with COVID-19. METHODS: A retrospective and prospective observational study of inpatients referred for transthoracic echocardiography for suspected cardiac pathology due to COVID-19 within a London NHS Trust. Echocardiograms were performed to assess left ventricular (LV), right ventricular (RV) and pulmonary variables along with collection of patient demographics, comorbid conditions, blood biomarkers and outcomes. RESULT: In the predominant non-white (72%) population, RV dysfunction was the primary cardiac abnormality noted in 50% of patients, with RV fractional area change <35% being the most common marker of this RV dysfunction. By comparison, LV systolic dysfunction occurred in 18% of patients. RV dysfunction was associated with LV systolic dysfunction and the presence of a D-shaped LV throughout the cardiac cycle (marker of significant pulmonary artery hypertension). LV systolic dysfunction (p=0.002, HR 3.82, 95% CI 1.624 to 8.982), pulmonary valve acceleration time (p=0.024, HR 0.98, 95% CI 0.964 to 0.997)-marker of increased pulmonary vascular resistance, age (p=0.047, HR 1.027, 95% CI 1.000 to 1.055) and an episode of tachycardia measured from admission to time of echo (p=0.004, HR 6.183, 95% CI 1.772 to 21.575) were independently associated with mortality. CONCLUSIONS: In this predominantly non-white population hospitalised with COVID-19, the most common cardiac pathology was RV dysfunction which is associated with both LV systolic dysfunction and elevated pulmonary artery pressure. The latter two, not RV dysfunction, were associated with mortality.


Assuntos
COVID-19/etnologia , Grupos Étnicos , Cardiopatias/etnologia , Ventrículos do Coração/diagnóstico por imagem , Vigilância da População , Comorbidade , Estudos Transversais , Ecocardiografia Doppler , Cardiopatias/diagnóstico , Hospitalização/tendências , Humanos , Pandemias , Prevalência , Quebeque/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida/tendências
11.
Comput Intell Neurosci ; 2021: 8628335, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34804150

RESUMO

Heart diseases are characterized as heterogeneous diseases comprising multiple subtypes. Early diagnosis and prognosis of heart disease are essential to facilitate the clinical management of patients. In this research, a new computational model for predicting early heart disease is proposed. The predictive model is embedded in a new regularization based on decaying the weights according to the weight matrices' standard deviation and comparing the results against its parents (RSD-ANN). The performance of RSD-ANN is far better than that of the existing methods. Based on our experiments, the average validation accuracy computed was 96.30% using either the tenfold cross-validation or holdout method.


Assuntos
Cardiopatias , Aprendizado de Máquina , Cardiopatias/diagnóstico , Humanos
13.
Anticancer Res ; 41(11): 5355-5364, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732405

RESUMO

Cardiotoxicity is a common side effect induced by cancer therapies, which increases the risk of long-term morbidity and mortality in cancer survivors. To date, the mechanism leading to this toxicity is still unclear, thus complicating cardiac safety assessment and predictive factor identification. The advances in technology, particularly regarding radiation therapy and constant development of novel antineoplastic agents, require urgent development of efficient preclinical models to detect drug cardiotoxicity. A myriad of empirical preclinical models have been used to investigate cardiotoxicity, though with limited success. Recently, multicellular spheroid models have gained attention by mimicking the in vivo microenvironment. The aim of this review is to focus on the most relevant preclinical models used to assess antineoplastic drug- and radiotherapy-related cardiotoxicities, with an overview on their current use. It also aims to discuss the possible directions of translational research in the cardio-oncology field.


Assuntos
Antineoplásicos , Cardiopatias/induzido quimicamente , Lesões por Radiação/etiologia , Pesquisa Médica Translacional , Animais , Técnicas Biossensoriais , Cardiotoxicidade , Linhagem Celular , Técnicas de Cocultura , Modelos Animais de Doenças , Cardiopatias/metabolismo , Cardiopatias/patologia , Cardiopatias/fisiopatologia , Humanos , Miócitos Cardíacos/metabolismo , Miócitos Cardíacos/patologia , Lesões por Radiação/metabolismo , Lesões por Radiação/patologia , Lesões por Radiação/fisiopatologia , Radioterapia , Fatores de Risco , Especificidade da Espécie , Microambiente Tumoral
14.
Br J Nurs ; 30(20): 1172-1176, 2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34761982

RESUMO

This is the second of two articles exploring assessment and clinical reasoning of conditions relating to the heart and cardiovascular system in the context of emergency care. In the last article, the structure and function of the heart was reviewed, and reference made to many of the conditions that may affect the heart. In addition, the common presenting complaints of cardiac conditions were highlighted, together with important aspects of the history for each symptom. The full cardiac examination was outlined. In this article, some of the common cardiac conditions will be discussed. These will be linked to common findings in the history, examination, and investigations.


Assuntos
Sistema Cardiovascular , Serviços Médicos de Emergência , Cardiopatias , Cardiopatias/diagnóstico , Humanos , Síncope , Pensamento
15.
Arch Cardiovasc Dis ; 114(10): 634-646, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34742672

RESUMO

BACKGROUND: Despite guidelines describing the optimal diagnostic and therapeutic procedures for patients with suspected cardiac implantable electronic device (CIED) infections, their management is often challenging. AIMS: To describe our diagnostic and therapeutic practices for suspected CIED infection, and to compare them with European Heart Rhythm Association (EHRA) guidelines. METHODS: Patients hospitalized in the tertiary care Nancy University Hospital for suspected CIED infection from 2014 to 2019 were included retrospectively. We applied the EHRA classification of CIED infection, and compared diagnostic and therapeutic management with the EHRA guidelines. RESULTS: Among 184 patients (mean age 72.3±12.4 years), 137 had a proven infection of the lead (by transthoracic echocardiography/transoesophageal echocardiography, 18F-fluorodesoxyglucose positron emission tomography/computed tomography or positive culture of the lead) or an isolated pocket infection without proof of lead infection, and 47 had no proof of CIED infection. According to the EHRA classification, CIED infection was considered as definite in 145 patients and possible in 31 and was excluded in eight patients. Regarding recommended diagnostic procedures, blood cultures were performed in 90.8%, transthoracic echocardiography in 97.8%, transoesophageal echocardiography in 85.9%, 18F-fluorodesoxyglucose positron emission tomography/computed tomography in 50.5% and imaging for embolisms in 78.3% of the patients. Compared with therapeutic recommendations for the 145 cases of definite CIED infection, device removal was performed in 96 patients (66.2%) and antibiotic therapy was prescribed in 130 (89.7%), with a duration equal to or longer than that recommended in 105 (72.4%) of the patients. CONCLUSION: This study underlines the difficulties in following theoretical guidelines in daily practice, where both technical and human considerations interfere with their strict appliance.


Assuntos
Desfibriladores Implantáveis , Cardiopatias , Marca-Passo Artificial , Infecções Relacionadas à Prótese , Idoso , Idoso de 80 Anos ou mais , Desfibriladores Implantáveis/efeitos adversos , Eletrônica , Humanos , Pessoa de Meia-Idade , Marca-Passo Artificial/efeitos adversos , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/terapia , Estudos Retrospectivos
16.
Recurso na Internet em Inglês, Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-48460

RESUMO

No Dia Mundial do Coração, a Organização Pan-Americana da Saúde (OPAS) destaca a importância da prevenção e do tratamento das doenças cardiovasculares – a principal causa de morte nas Américas, que tira dois milhões de vidas cada ano.


Assuntos
América , Doenças Cardiovasculares , Cardiopatias , Acidente Vascular Cerebral
17.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48462

RESUMO

No Brasil, uma em cada quatro pessoas adultas tem obesidade, de acordo com a Pesquisa Nacional de Saúde 2020 e, dentre as pessoas com hipertensão, 70,3% apresentam excesso de peso e 33,2% obesidade (Vigitel 2019), que são fatores de risco para doenças do coração.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Hipertensão/prevenção & controle , Cardiopatias/prevenção & controle
18.
Anticancer Res ; 41(10): 5241-5247, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34593477

RESUMO

AIM: To clarify the clinical and radiological features of isolated tumor thrombi in the inferior vena cava (IVC)/right atrium in patients with hepatocellular carcinoma (HCC) without hepatic vein invasion. PATIENTS AND METHODS: In this retrospective study, from January 2007 to December 2019, a total of 35,163 chemoembolization sessions were performed in 7,704 patients with HCC. Among them, 10 (0.13%) patients had tumor thrombi in the IVC/right atrium without definitive hepatic vein invasion. Computed tomographic (CT) scans, digital subtraction angiograms, and cone-beam CT images were retrospectively reviewed and interpreted. RESULTS: The tumor thrombi were supplied by the right inferior phrenic artery (n=8) or the right internal mammary artery (n=2). Follow-up CT scans in eight patients showed linear accumulation of iodized oil along the diaphragm, which was presumed to be a thrombosis of the phrenic vein. Retrospective review of formal radiological reports of pre-procedural CT scans revealed that a correct diagnosis of tumor thrombi of the IVC/right atrium was made in only three cases. CONCLUSION: HCC invading the phrenic vein may have tumor thrombi in the IVC/right atrium without hepatic vein invasion.


Assuntos
Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/mortalidade , Átrios do Coração/patologia , Cardiopatias/terapia , Veias Hepáticas/patologia , Trombose/terapia , Veia Cava Inferior/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/métodos , Feminino , Seguimentos , Cardiopatias/etiologia , Cardiopatias/patologia , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Trombose/etiologia , Trombose/patologia
19.
Spine (Phila Pa 1976) ; 46(21): E1161-E1167, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34618708

RESUMO

STUDY DESIGN: Single-center retrospective chart review with minimum 2-year follow up. OBJECTIVE: To determine incidence of pulmonary hypertension in adolescent idiopathic scoliosis patients and to determine the effect of scoliosis surgery on pulmonary hypertension. SUMMARY OF BACKGROUND DATA: Spinal deformity in adolescent idiopathic scoliosis can increase right atrial and ventricular pressures secondary to restrictive lung disease. Pulmonary hypertension leading to cor pulmonale is the most feared outcome, however mild pulmonary hypertension in adolescent idiopathic scoliosis (AIS) patients has been reported. No study has previously examined changes in the improvement of right heart function following scoliosis surgery. METHODS: Cobb angle, 2D-echo signs of structural heart disease, aortic root dimensions, tricuspid regurgitant jet velocity (TRV), pulmonary function tests (PFTs), arterial blood gas (ABG), and patient demographics reviewed. Right ventricular systolic pressure (RVSP) estimated using Bernoulli equation (4[TRV]2) and right atrial pressure. RVSP ≥36 mmHg is a surrogate marker for pulmonary hypertension. All echocardiograms were read by board certified Pediatric Cardiologists. Logistic regression used to assess for differences in TRV between groups. RESULTS: Mean preoperative RVSP was significantly elevated in AIS patients (26.9 ±â€Š0.49; P < 0.001) compared with controls (17.25 + 0.88). Only 47 (21%) Group 1 patients had elevated preoperative TRV (≥2.8 m/s) versus none in Group 2 (P < 0.001). Additionally, logistic regression showed AIS patients have odds ratio of 3.29 for elevated TRV (P = 0.007)-an indirect measure of pulmonary hypertension. In all Group 3 patients, the cardiac function normalized postoperatively (mean TRV = 2.09 + 0.23; P < 0.001). No association found between Cobb angle, aortic root parameters, or pulmonary function tests. CONCLUSION: This study found 13.9% of patients with adolescent idiopathic scoliosis had elevated TRV while controls had no TRV abnormalities. Additionally, RVSP measurements demonstrated mild pulmonary hypertension in AIS patients. These abnormal values normalized postoperatively, indicating the benefits of scoliosis surgery on cardiac function in adolescent idiopathic scoliosis.Level of Evidence: 3.


Assuntos
Cardiopatias , Hipertensão Pulmonar , Cifose , Escoliose , Adolescente , Criança , Humanos , Estudos Retrospectivos , Escoliose/diagnóstico por imagem , Escoliose/cirurgia
20.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(5): 1680-1684, 2021 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-34627462

RESUMO

Some non-coding RNAs (ncRNA), as functional RNA molecules, lack potential to encode proteins, but can affect gene expression and disease progression through a variety of mechanisms. In multiple myeloma (MM), cardiovascular disease is one of the most common complications, which may be related to a variety of factors, including patient's own factors, disease-related factors, drug factors, etc. Non-coding RNA is considered to be an important regulator of cardiovascular event risk factors and cell function, and an important candidate target for improving the condition and prognostic assessment. This article briefly summarized the role of non-coding RNA in cardiac amyloidosis caused by MM, damage to the heart by inflammatory factors, and heart disease caused by chemotherapy drugs in recent years.


Assuntos
Doenças Cardiovasculares , Cardiopatias , Mieloma Múltiplo , Humanos , Mieloma Múltiplo/genética , Prognóstico , RNA não Traduzido/genética
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