heart failure

摘要： Objective:To investigate the psychometric properties of the self-care behavior scale in heart failure(HF)patients.The development of self-care behaviors is one of the goals of non-pharmacological care management programs.Methods:After translating the European Heart Failure Self-care Behavior scale(EHFScBS),validity was assessed through explanatory factor analysis;additionally,reliability was assessed through Cronbach alpha and test-retest.The samples comprised of 120 HF patients admitted to hospitals in Tehran during 2017-2018.Results:The mean age of the samples was 67.3±14.04 years.Fifty-four patients(45%)were female.All items of the scale had an acceptable factor loading.Cronbach alpha coefficient was 0.72.The intra-cluster correlation coefficient(ICC)was 0.69.Conclusions:Nurses and clinicians could benefit from the Persian version of HF self-care scale since it would enable them to rapidly assess patients’self-care behaviors and to evaluate the effectiveness of the HF management.

摘要： Patients with heart failure(HF)may be at a higher risk of coronavirus disease 2019(COVID-19)infection and may have a worse outcome due to their comorbid conditions and advanced age.In this narrative review,we aim to study the interaction between COVID-19 and HF from a critical care perspective.We performed a systematic search for studies that reported HF and critical carerelated outcomes in COVID-19 patients in the PubMed and Medline databases.From a total of 1050 papers,we identified 26 that satisfied the eligibility criteria for our review.Data such as patient demographics,HF,intensive care unit(ICU)admission,management,and outcome were extracted from these studies and analyzed.We reported outcomes in heart-transplant patients with COVID-19 separately.In hospitalized patients with COVID-19,the prevalence of HF varied between 4%and 21%.The requirement for ICU admission was between 8%and 33%.HF patients with COVID-19 had an overall mortality rate between 20%and 40%.We identified that HF is an independent predictor of mortality in hospitalized COVID-19 patients,and patients with HF were more likely to require ventilation,ICU admission and develop complications.Patients with HF with reduced ejection fraction did worse than those with HF with midrange ejection fraction,and HF with preserved ejection fraction.COVID-19 patients with HF should be identified early and managed aggressively in an attempt to improve outcomes in this cohort of patients.

摘要： This study reports two observations of heart failure diagnosed in the context of SARS-CoV 2 infection in children at the University Hospital Center of Libreville, Gabon. Long considered exempted from serious forms of Covid-19 infection, the fatal evolution of one of the two cases proves that there is an interest for a more rigorous approach in their management in a pandemic context. The multisystem inflammatory syndrome associated with this virus in children can be responsible for cardiac manifestations that can be life-threatening. Early diagnosis and treatment are necessary to reduce mortality. However, this approach is made difficult in our regions by the limited biomedical equipment and the absence of essential therapies as noted in these two observations.

摘要： BACKGROUND Thrombotic pulmonary embolism(TPE)is one of the most critical diseases in obstetrics but is rarely reported in caesarean section(CS)because TPE patients in CS have a high risk of death and are difficult to diagnose.This case report of TPE during CS was recorded by transthoracic echocardiography(TTE)and can provide a reference for the differential diagnosis of critical illnesses in CS.CASE SUMMARY A 37-year-old pregnant woman with rheumatic heart disease(RHD),gravida 5 and para 1(G5P1),presented for emergency CS at 33 wk and 3 d of gestation under general anesthesia because of acute heart failure,pulmonary hypertension and arrhythmia.After placental removal during CS,TTE revealed a nascent thrombus in the inferior vena cava(IVC)that elongated,detached and fragmented leading to acute thromboembolic events and acute TPE.This report presents the whole process and details of TPE during CS and successful rescue without any sequelae in the patient.This case gives us new ideas for the diagnosis of death or cardiovascular accidents during CS in pregnant women with heart disease and the detailed presentation of the rapid development of TPE may also elucidate new ideas for treatment.This case also highlighted the importance of prophylactic anticoagulation in the management of heart disease during pregnancy.CONCLUSION Pregnancy with heart failure could trigger inferior vena cava(IVC)-origin TPE during CS.Detection and timely treatment can avoid serious consequences.

摘要： BACKGROUND We report a rare case of a large congenital hemangioma(CH)in the maxillofacial region in a female neonate that caused thrombocytopenia and heart failure.With close multidisciplinary collaboration,the congenital hemangioma was successfully resected with good results.CASE SUMMARY The patient was delivered at gestational age of 36 wk by cesarean section due to cephalopelvic disproportion and lack of onset of labor(birth weight:2630 g).A right-sided facial tumor was detected in the fetus during routine antenatal ultrasound examination of the mother at 32 wk of gestation.Physical examination revealed a 7 cm×7 cm×3 cm hard,dull purple-colored mass on the right maxillofacial region.The mass was tense and had prominent surface telangiectasias.Laboratory investigations revealed reduced hemoglobin and platelet count,and increased activated partial thromboplastin time,prothrombin time,and thrombin time.International normalized ratio,fibrin degradation products,and D-Dimer levels were significantly increased.Thromboelastography showed increased alpha angle,mean amplitude,and the clot formation speed.Thyroid-stimulating hormone level was significantly elevated.The patient was administered prednisone,propranolol,euthyrox,vitamin K1,milrinone,and digoxin.After operation,cefepime was administered for anti-infection and propranolol was prescribed at discharge.CONCLUSION We report a rare case of CH in the right maxillofacial region causing thrombocytopenia and heart failure.

摘要： BACKGROUND Endothelin(ET)-traps are Fc-fusion proteins with a design based on the physiological receptors of ET-1.Previous work has shown that use of the selected ET-traps potently and significantly reduces different markers of diabetes pathology back to normal,non-disease levels.AIM To demonstrate the selected ET-traps potently and significantly bind to ET-1.METHODS We performed phage display experiments to test different constructs of ET-traps,and conducted bio-layer interferometry binding assays to verify that the selected ET-traps bind specifically to ET-1 and display binding affinity in the double-digit picomolar range(an average of 73.8 rM,n=6).RESULTS These experiments have confirmed our choice of the final ET-traps and provided proof-of-concept for the potential use of constructs as effective biologics for diseases associated with pathologically elevated ET-1.CONCLUSION There is increased need for such therapeutics as they could help save millions of lives around the world.

摘要： Diabetes mellitus(DM)is a health condition characterized by glucose dysregulation and affects millions of people worldwide.The presentation of heart failure in diabetic cardiomyopathy extends over a wide phenotypic spectrum,commencing from asymptomatic,subclinical structural abnormalities to severely symptomatic biventricular dysfunction with increased mortality risk.Similarly,the spectrum of systolic dysfunction in diabetic-induced heart failure is diverse.DM leads also to cardiac electrical remodeling reacting on various targets.Dipeptidyl peptidase-4(DPP-4)inhibitors reduce glucagon and blood glucose levels by raising levels of the endogenous hormones glucagon-like-peptide 1 and glucose-dependent insulinotropic peptide and constitute a safe and effective glucose lowering treatment option in patients with type 2 DM.Despite DPP-4 inhibitors’efficacy regarding glycemic control,their effect on cardiovascular outcomes(myocardial infarction,stroke,hospitalization for heart failure,hospitalization for unstable angina,hospitalization for coronary revascularization,and cardiovascular death)in diabetic patients has been neutral.The potential correlation between atrial flutter and DPP-4 inhibitors administration needs further investigation.

摘要： Introduction: Cardiac amyloidosis is a rare and under-diagnosed disease. The objective of this study was to collect cases of cardiac amyloidosis in patients hospitalized in the cardiology department of the Centre Hospitalier Intercommunal Alençon-Mamers (CHICAM). Patients and Methods: This was a retrospective descriptive study of the records of patients diagnosed with cardiac amyloidosis. The study took place in the cardiology department of the CHICAM over 12 months (from January 1, 2020 to December 31, 2020). We included the files of patients in whom the diagnosis of cardiac amyloidosis was confirmed on the basis of clinical, echocardiographic, biological, scintigraphic and cardiac MRI evidence. Results: Seven patients were included. The mean age was 86.71 years. Six men for one woman. Most of the patients were in heart failure. There was one case of periorbital ecchymosis. Troponinemia was increased in three patients, NTproBNP was always high with a mean of 1000 ng/L. Cardiac echography showed a hyperbright septum in four cases, concentric hypertrophy of the left ventricle with a mean interventricular septum in diastole of 13.85 mm. Six cases were senile transthyretin amyloidosis (TTR), one case was mutated transthyretin amyloidosis (TTRm). Two cases of death were noted. Conclusion: Cardiac amyloidosis has a poor prognosis due to delayed diagnosis.

摘要： Background:Little is known about exercise cardiac power(ECP),defined as the ratio of directly measured maximal oxygen uptake with peak systolic blood pressure during exercise,on heart failure(HF)risk.We examined the association of ECP and the risk of HF.Methods:This was a population-based cohort study of 2351 men from eastern Finland.The average time to follow-up was 25 years.Participants participated at baseline in an exercise stress test.A total of 313 cases of HF occurred.Results:Men with low ECP(13.92 mL/mmHg,the highest quartile),after adjusting for age.Low ECP was associated with a 1.96-fold risk(95%CI:1.38-2.78,p<0.001)of HF after additional adjustment for conventional risk factors.After further adjustment for left ventricular hypertrophy,the results hardly changed(hazards ratio=1.87,95%CI:1.31-2.66,p<0.001).One SD increase in ECP(3.16 mL/mmHg)was associated with a decreased risk of HF by 28%(95%CI:17%-37%).Conclusion:ECP provides a noninvasive and easily available measure from cardiopulmonary exercise tests in predicting HF.However,ECP did not provide additional value over maximal oxygen uptake.

摘要： Marfan’s syndrome (MFS) is an autosomal dominant disorder characterized by aortic root dilation, mitral valve prolapse and aortic regurgitation. The typical aneurysm location involves the thoracic aorta (60%). Thoracoabdominal aortic dissections are quite infrequent (10%). A type A aortic dissection can have fatal complications, such as aortic rupture and cardiac tamponade, and a prompt diagnosis is crucial. The present case involves a 46-year-old patient with Marfan’s syndrome who was admitted to the emergency department for dyspnea. The patient presented congestive signs and manifestations suggesting acute heart failure. An initial transthoracic echocardiogram (TTE) showed ventricular hypertrophy and diastolic dysfunction. Additionally, TTE showed plurivalvular regurgitation, pulmonary hypertension (42 mmHg), aortic dilatation, and a dissection flap. Coronary computed tomography angiography (CCTA) was performed, confirming the suspicion of ascending aortic dissection. The patient underwent a three-stage intervention for the repair of all the defects, with adequate recovery. This was a rare presentation of aortic dissection in MFS, which was a diagnostic challenge for the heart team.