简介:Objective:Toassessthecardiovascularabnormalitiesinpatientswithspontaneoussubarachnoidhemorrhage(SAH).Methods:AllpatientsadmittedtoourinstitutionwithaprimarydiagnosisofspontaneousSAHandhadatransthoracicechocardiogram(TTE)performedfrom1stofJuly2011until30thofMay2014wereenrolled.Results:Outof2058patientsadmittedtoourinstitutionwithadiagnosisofSAH,overathreeyearperiod,only244patients(12%)hadTTEperformedduringtheindexhospitalization.Inthisselectedcohort,themeanagewas59yearsand66%ofpatientswerefemale.ElevatedtroponinTwasnoticedin37%ofpatientsandQTcprolongationwasthecommonestECGabnormalityoccurringin49%ofthepatients.Thirtyninepatients(16%)hadarestingsegmentalwallmotionabnormalityontheTTE,includingfivepatientswithapicalballooning.In-hospitalmortalitywas15.6%(38patients).Conclusion:CardiovascularabnormalitiesinselectedpatientswithSAHwhohadcardiacultrasoundarerelativelycommon;howevertheincidenceofventricularballooningislow.InordertoattainthecorrectincidenceofcardiovascularabnormalitiesinSAHpatients,allpatientsadmittedwithSAHshouldundergoTTEandhaveECGandcardiacmarkerscheckedduringtheirhospitalization.
简介:BackgroundTheeffectofselectiveradiofrequencyablationfortreatingparoxysmalsupraventriculartachycardia(PSVT)anditsassociatedparoxysmalatrialfibrillation(PAF)wasassessed.MethodsDatawerecollectedretrospectivelyfrompatientsdiagnosedofPSVTandsubsequentlytreatedwithradiofrequencyablation.Regularmonthlyfollow-upbydynamicelectrocardiography(ECG)wasperformed.Incidentratesofatrialfibrillationbeforeandafterablationwerecompared.Results382PSVTpatientswith58havingatrialfibrillationwereenrolled.TheorderofcomplicatedPAFfromhightolowinthesepatientswasdisplayedas:atrialtachycardia(AT),atrioventricularreentranttachycardia(AVRT)andatrioventricularnodalreentranttachycardia(AVNRT).AmongAVRTpatients,PAFwasmorefrequentinpatientshavingaccessorypathways.AVNRTpatientshadsignificantlylowerPAFratecomparingtootherpatients.PAFincidentratewassignificantlyreducedbyradiofrequencyablationtherapy.ConclusionWeadviseregulardynamicECGforPSVTpatients,especiallythosewithatrialflutter,ATorpre-excitationsyndrome.SelectiveradiofrequencyablationisafeasibleapproachfortreatingAFcomplicatedPSVTpatients.
简介:BackgroundValvularheartdisease(VHD)isdefinedasastructuralorfunctionalabnormalityincardiacvalvewhichencompassesanumberofcommoncardiovascularconditions.ThisstudywasaimedtoanalyzetheepidemiologicalchangesofVHDinasinglecardiovascularcenterofSouthernChina.MethodsAtotalof13,138VHDpatientsofGuangdonggeneralhospitalfromJanuary2011toDecember2013werescreenedbytransthoracicechocardiography(TTE)ortransesophagealechocardiography(TEE)andenrolledforthisstudy.Themorbidity,etiologicalspectrumandmanagementofthesepatientswereanalyzed.Continuousvariableswereexpressedasmean±standarddeviation.Categoricalvariableswereexpressedasratioorpercentage.ResultsPatientsinthisstudyweredividedintodifferentgroupsandwereanalyzedthroughoutchangesinmorbidity,etiologicalspectrumandmanagement.ConclusionsTheprevalenceofVHDremainshighinSouthernChinaandRHDisstilltheleadingetiologyofVHD.Butmorbidityrateisreducedandsurgeryisstillthemaintreatmentoption.
简介:BackgroundLargepercutaneouscoronaryintervention(PCI)centershaveshownstatisticallybetterprognosiswithtransradialapproach(TRA)comparedwithtransfemoralapproach(TFA).SowetriedtocomparetheoutcomesbetweenTRAandTFAinonehighvolumePCIcenterinST-segmentelevationmyocardialinfarction(STEMI)patientsundergoingprimaryPCI.MethodSixhundredandsixtytwoSTEMIpatientswhounderwentprimaryPCIwithstentsimplantationwereretrospectivelyincludedfromJune1,2006toApril30,2011inourhospitalandprospectivelyfollowedforoneyear.Theprimaryendpointwasdefinedasin-hospitalnetadverseclinicalevents(NACE)whichincludeddeath,myocardialinfarction(MI),stroke,targetvesselrevascularization(TVR)andmajorbleeding.Thesecondaryendpointwasdefinedas1yearmajoradversecardiovascularevents(MACE)whichincludeddeath,MIandTVR.ResultsTheoccurrenceratesofNACE(8.0%vs.17.0%,P=0.0018),accesssitecomplications(4.0%vs.10.7%P=0.0027)andaccesssite-relatedmajorbleeding(2.4%vs.6.3%,P=0.0254)wereallhigherintheTFAgroupthanintheTRAgroup.Theincidencerateof1yearMACEwassimilarbetweenTRAandTFA(8.5%vs.13.2%,P=0.0932).TheinverseprobabilitiesweightingmatchedmultivariableCoxregressionanalysisshowedTRAwasanindependentpredictoroflowerratesofin-hospitalNACE(HR:0.58,95%CI:0.34-0.99,P=0.0477),in-hospitaldeath(HR:0.31,95%CI:0.10-0.73,P=0.0499)andaccesssitecomplications(HR:0.37,95%CI:0.19-0.73,P=0.0040).ConclusionsTRAshowedgreatefficacyandsafetyforSTEMIpatientsundergoingprimaryPCIinhighvolumePCIcenters.Itshouldberecommendedasroutinepracticeinfuture,andespeciallyinthosepatientswithhighriskofbleeding.