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Shoureshi P, Tan AY, Koneru J, Ellenbogen KA, Kaszala K, Huizar JF. Arrhythmia-Induced Cardiomyopathy: JACC State-of-the-Art Review. J Am Coll Cardiol 2024; 83:2214-2232. [PMID: 38811098 DOI: 10.1016/j.jacc.2024.03.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 05/31/2024]
Abstract
Arrhythmias frequently accompany heart failure and left ventricular dysfunction. Tachycardias, atrial fibrillation, and premature ventricular contractions can induce a reversible form of dilated cardiomyopathy (CM) known as arrhythmia-induced CM (AiCM). The intriguing question is why certain individuals are more susceptible to AiCM, despite similar arrhythmia burdens. The primary challenge is determining the extent of arrhythmias' contribution to left ventricular systolic dysfunction. AiCM should be considered in patients with a mean heart rate of >100 beats/min, atrial fibrillation, or a PVC burden of >10%. Confirmation of AiCM occurs when CM reverses upon eliminating the responsible arrhythmia. Therapy choice depends on the specific arrhythmia, patient comorbidities, and preferences. After left ventricular function is restored, ongoing follow-up is essential if an abnormal myocardial substrate persists. Accurate diagnosis and treatment of AiCM have the potential to enhance patients' quality of life, improve clinical outcomes, and reduce hospital admissions and overall health care costs.
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Affiliation(s)
- Pouria Shoureshi
- Virginia Commonwealth University/Pauley Heart Center, Richmond, Virginia, USA; Central Virginia Veterans Affair Health Care System, Richmond, Virginia, USA
| | - Alex Y Tan
- Virginia Commonwealth University/Pauley Heart Center, Richmond, Virginia, USA; Central Virginia Veterans Affair Health Care System, Richmond, Virginia, USA
| | - Jayanthi Koneru
- Virginia Commonwealth University/Pauley Heart Center, Richmond, Virginia, USA
| | | | - Karoly Kaszala
- Virginia Commonwealth University/Pauley Heart Center, Richmond, Virginia, USA; Central Virginia Veterans Affair Health Care System, Richmond, Virginia, USA
| | - Jose F Huizar
- Virginia Commonwealth University/Pauley Heart Center, Richmond, Virginia, USA; Central Virginia Veterans Affair Health Care System, Richmond, Virginia, USA.
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2
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Thomas M, Elhindi J, Kamaladasa K, Sirisena T. Antiarrhythmic preferences and outcomes post DC cardioversion for atrial fibrillation, an Australian rural perspective. Aust J Rural Health 2024. [PMID: 38766693 DOI: 10.1111/ajr.13138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Direct current cardioversion (DCCV) remains one of the recommended management strategies for symptomatic atrial fibrillation (AF). Antiarrhythmic drugs (AAD) are prescribed post procedure to maintain sinus rhythm (SR). Limited literature exists on the AAD prescribing practices and their efficacy, post-DCCV in rural Australia. OBJECTIVE The primary aim was to determine the preferred AAD post-DCCV and the factors affecting AAD prescribing practices. The secondary aim was to assess the efficacy of the AAD in maintaining SR. DESIGN A retrospective observational audit of patients with non-valvular AF who underwent successful elective DCCV for symptomatic AF, during 2015-2020 at a regional hospital in New South Wales (NSW) (Dubbo Base Hospital). Patients were followed up for a duration of 12 months post-DCCV. RESULTS 233 patients underwent successful DCCV during the study duration. Amiodarone was the preferred AAD of choice post-DCCV followed by sotalol and flecainide, respectively (36.5% vs. 27.8% vs. 1.3%). 35.2% patients were not prescribed AAD. Amiodarone and sotalol had similar but modest efficacies and neither were superior to no AAD, in maintaining SR 12 months post-DCCV (AF recurrence rate 61.5% vs. 68.2% vs. 71.6% respectively, p = 0.37). Antecedent cerebrovascular accident (CVA), pulmonary disease, smoking, prior treatment with digoxin, diuretics and left ventricular (LV) dysfunction were factors that influenced AAD prescribing practices. CONCLUSION The study demonstrates equal efficacies of amiodarone, sotalol and no AAD in maintaining SR 12 months post-DCCV. Prescribing practices post-DCCV at Dubbo Base Hospital differ from observed national trends and guidelines. AAD prescription requires a multifaceted approach with a key consideration to prioritise safety over efficacy, being mindful of challenges in delivering optimal healthcare in a rural setting.
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Affiliation(s)
- Martin Thomas
- Department of Cardiology, Dubbo Base Hospital, Dubbo, New South Wales, Australia
- Department of Intensive Care Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| | - James Elhindi
- Research and Education Network, Western Sydney Local Health District, Westmead, New South Wales, Australia
| | - Kanishka Kamaladasa
- Department of Cardiology, Dubbo Base Hospital, Dubbo, New South Wales, Australia
| | - Tilak Sirisena
- Department of Cardiology, Dubbo Base Hospital, Dubbo, New South Wales, Australia
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Griffiths JR, Lațcu DG, Ernst S. Catheter ablation of premature ventricular contractions from the anterior papillary muscle of the tricuspid valve: A case report of a combined ECG imaging and remote magnetic navigation approach. HeartRhythm Case Rep 2024; 10:305-309. [PMID: 38799601 PMCID: PMC11116951 DOI: 10.1016/j.hrcr.2023.12.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Affiliation(s)
- Jack R. Griffiths
- Department of Cardiology, Royal Brompton Hospital, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom
| | | | - Sabine Ernst
- Department of Cardiology, Royal Brompton Hospital, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom
- National Heart and Lung Institute, Imperial College, London, United Kingdom
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Attachaipanich T, Thiravetyan B, Tribuddharat N, Jaroonpipatkul S, Navaravong L. Premature Ventricular Contraction-Induced Cardiomyopathy: Contemporary Evidence from Risk Stratification, Pathophysiology, and Management. J Clin Med 2024; 13:2635. [PMID: 38731164 PMCID: PMC11084868 DOI: 10.3390/jcm13092635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/16/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Premature ventricular complexes (PVCs) are commonly encountered problems in clinical settings. The range of symptoms can be from asymptomatic to palpitations, fatigue, or heart failure symptoms. A higher burden of PVCs is a risk factor for development of PVC-induced cardiomyopathy (PIC). Rhythm evaluation by 12-lead ECG and an ambulatory monitoring device are essential. Currently, several imaging modalities, such as echocardiography and cardiac magnetic resonance imaging, are utilized to evaluate the underlying structure that may be related to PIC. Beta blockers and antiarrhythmic drugs are typically part of the initial management strategy. If these fail, catheter ablation of PVCs is typically the next step. The purpose of this article is to summarize the current evidence/knowledge about PIC.
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Affiliation(s)
- Tanawat Attachaipanich
- Cardiac Electrophysiology Research and Training Center, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Ben Thiravetyan
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | | | - Surachat Jaroonpipatkul
- Division of Cardiology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok 10400, Thailand;
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Alqarawi W, Burwash IG, Krahn AD, Healey JS. Arrhythmic Mitral Valve Prolapse: Risk Assessment and Management. Can J Cardiol 2023; 39:1397-1409. [PMID: 37217162 DOI: 10.1016/j.cjca.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/26/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023] Open
Abstract
Arrhythmic mitral valve prolapse (MVP) has gained great interest recently because of the increasing recognition of its potential role in unexplained cardiac arrest. Although evidence has accumulated to show the association of arrhythmic MVP (AMVP) with sudden cardiac death (SCD), risk stratification and management remain unclear. Physicians are faced with the challenges of screening for AMVP among MVP patients and the dilemma of when and how to intervene to prevent SCD in these patients. In addition, there is little guidance to help approach MVP patients who present with an otherwise unexplained cardiac arrest to know whether MVP was the primary cause of cardiac arrest or just an innocent bystander. Herein we review the epidemiology and definition of AMVP, the risk and mechanisms of SCD, and summarize the clinical evidence behind risk markers of SCD and therapeutic interventions that could potentially prevent it. We also propose an algorithm that provides guidance as to how to screen for AMVP and what therapeutic interventions to use. Last, we propose a diagnostic algorithm for approaching patients with otherwise unexplained cardiac arrest who are shown to have MVP.
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Affiliation(s)
- Wael Alqarawi
- Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Division of Cardiology, University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian G Burwash
- Division of Cardiology, University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrew D Krahn
- Center for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey S Healey
- Population Health Research Institute, McMaster University, and Hamilton Health Sciences, Hamilton, Ontario, Canada.
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Tsiachris D, Botis M, Doundoulakis I, Bartsioka LI, Tsioufis P, Kordalis A, Antoniou CK, Tsioufis K, Gatzoulis KA. Electrocardiographic Characteristics, Identification, and Management of Frequent Premature Ventricular Contractions. Diagnostics (Basel) 2023; 13:3094. [PMID: 37835837 PMCID: PMC10572222 DOI: 10.3390/diagnostics13193094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/09/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Premature ventricular complexes (PVCs) are frequently encountered in clinical practice. The association of PVCs with adverse cardiovascular outcomes is well established in the context of structural heart disease, yet not so much in the absence of structural heart disease. However, cardiac magnetic resonance (CMR) seems to contribute prognostically in the latter subgroup. PVC-induced myocardial dysfunction refers to the impairment of ventricular function due to PVCs and is mostly associated with a PVC burden > 10%. Surface 12-lead ECG has long been used to localize the anatomic site of origin and multiple algorithms have been developed to differentiate between right ventricular and left ventricular outflow tract (RVOT and LVOT, respectively) origin. Novel algorithms include alternative ECG lead configurations and, lately, sophisticated artificial intelligence methods have been utilized to determine the origins of outflow tract arrhythmias. The decision to therapeutically address PVCs should be made upon the presence of symptoms or the development of PVC-induced myocardial dysfunction. Therapeutic modalities include pharmacological therapy (I-C antiarrhythmic drugs and beta blockers), as well as catheter ablation, which has demonstrated superior efficacy and safety.
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Affiliation(s)
- Dimitris Tsiachris
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, “Hippokration” Hospital, 11527 Athens, Greece; (M.B.); (I.D.); (L.I.B.); (P.T.); (A.K.); (C.-K.A.); (K.T.); (K.A.G.)
- Athens Heart Center, Athens Medical Center, 15125 Athens, Greece
| | - Michail Botis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, “Hippokration” Hospital, 11527 Athens, Greece; (M.B.); (I.D.); (L.I.B.); (P.T.); (A.K.); (C.-K.A.); (K.T.); (K.A.G.)
| | - Ioannis Doundoulakis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, “Hippokration” Hospital, 11527 Athens, Greece; (M.B.); (I.D.); (L.I.B.); (P.T.); (A.K.); (C.-K.A.); (K.T.); (K.A.G.)
| | - Lamprini Iro Bartsioka
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, “Hippokration” Hospital, 11527 Athens, Greece; (M.B.); (I.D.); (L.I.B.); (P.T.); (A.K.); (C.-K.A.); (K.T.); (K.A.G.)
| | - Panagiotis Tsioufis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, “Hippokration” Hospital, 11527 Athens, Greece; (M.B.); (I.D.); (L.I.B.); (P.T.); (A.K.); (C.-K.A.); (K.T.); (K.A.G.)
| | - Athanasios Kordalis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, “Hippokration” Hospital, 11527 Athens, Greece; (M.B.); (I.D.); (L.I.B.); (P.T.); (A.K.); (C.-K.A.); (K.T.); (K.A.G.)
| | - Christos-Konstantinos Antoniou
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, “Hippokration” Hospital, 11527 Athens, Greece; (M.B.); (I.D.); (L.I.B.); (P.T.); (A.K.); (C.-K.A.); (K.T.); (K.A.G.)
- Athens Heart Center, Athens Medical Center, 15125 Athens, Greece
| | - Konstantinos Tsioufis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, “Hippokration” Hospital, 11527 Athens, Greece; (M.B.); (I.D.); (L.I.B.); (P.T.); (A.K.); (C.-K.A.); (K.T.); (K.A.G.)
| | - Konstantinos A. Gatzoulis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, “Hippokration” Hospital, 11527 Athens, Greece; (M.B.); (I.D.); (L.I.B.); (P.T.); (A.K.); (C.-K.A.); (K.T.); (K.A.G.)
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Essayagh B, Sabbag A, El-Am E, Cavalcante JL, Michelena HI, Enriquez-Sarano M. Arrhythmic mitral valve prolapse and mitral annular disjunction: pathophysiology, risk stratification, and management. Eur Heart J 2023; 44:3121-3135. [PMID: 37561995 DOI: 10.1093/eurheartj/ehad491] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/11/2023] [Accepted: 07/19/2023] [Indexed: 08/12/2023] Open
Abstract
Mitral valve prolapse (MVP) is the most frequent valve condition but remains a conundrum in many aspects, particularly in regard to the existence and frequency of an arrhythmic form (AMVP) and its link to sudden cardiac death. Furthermore, the presence, frequency, and significance of the anatomic functional feature called mitral annular disjunction (MAD) have remained widely disputed. Recent case series and cohorts have shattered the concept that MVP is most generally benign and have emphasized the various phenotypes associated with clinically significant ventricular arrhythmias, including AMVP. The definition, evaluation, follow-up, and management of AMVP represent the focus of the present review, strengthened by recent coherent studies defining an arrhythmic MVP phenotypic that would affect a small subset of patients with MVP at concentrated high risk. The role of MAD in this context is of particular importance, and this review highlights the characteristics of AMVP phenotypes and MAD, their clinical, multimodality imaging, and rhythmic evaluation. These seminal facts lead to proposing a risk stratification clinical pathway with consideration of medical, rhythmologic, and surgical management and have been objects of recent expert consensus statements and of proposals for new research directions.
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Affiliation(s)
- Benjamin Essayagh
- From the Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905, USA
- Department of Echocardiography, Cardio X Clinic, Cannes, France
| | - Avi Sabbag
- The Davidai Center for Rhythm Disturbances and Pacing, Chaim Sheba Medical Center, Tel Hashomer and the Sackler School of Medicine, Tel Aviv University, Ramat-Gan, Israel
| | - Edward El-Am
- From the Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905, USA
| | - João L Cavalcante
- Department of Cardiovascular Medicine, Allina Health Minneapolis Heart Institute - Abbott Northwestern Hospital, 800 E 28th St, Minneapolis, MN 55407, USA
| | - Hector I Michelena
- From the Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905, USA
| | - Maurice Enriquez-Sarano
- Department of Cardiovascular Medicine, Allina Health Minneapolis Heart Institute - Abbott Northwestern Hospital, 800 E 28th St, Minneapolis, MN 55407, USA
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8
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Vázquez-Calvo S, Roca-Luque I, Althoff TF. Management of Ventricular Arrhythmias in Heart Failure. Curr Heart Fail Rep 2023; 20:237-253. [PMID: 37227669 DOI: 10.1007/s11897-023-00608-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE OF REVIEW Despite substantial progress in medical and device-based heart failure (HF) therapy, ventricular arrhythmias (VA) and sudden cardiac death (SCD) remain a major challenge. Here we review contemporary management of VA in the context of HF with one particular focus on recent advances in imaging and catheter ablation. RECENT FINDINGS Besides limited efficacy of antiarrhythmic drugs (AADs), their potentially life-threatening side effects are increasingly acknowledged. On the other hand, with tremendous advances in catheter technology, electroanatomical mapping, imaging, and understanding of arrhythmia mechanisms, catheter ablation has evolved into a safe, efficacious therapy. In fact, recent randomized trials support early catheter ablation, demonstrating superiority over AAD. Importantly, CMR imaging with gadolinium contrast has emerged as a central tool for the management of VA complicating HF: CMR is not only essential for an accurate diagnosis of the underlying entity and subsequent treatment decisions, but also improves risk stratification for SCD prevention and patient selection for ICD therapy. Finally, 3-dimensional characterization of arrhythmogenic substrate by CMR and imaging-guided ablation approaches substantially enhance procedural safety and efficacy. VA management in HF patients is highly complex and should be addressed in a multidisciplinary approach, preferably at specialized centers. While recent evidence supports early catheter ablation of VA, an impact on mortality remains to be demonstrated. Moreover, risk stratification for ICD therapy may have to be reconsidered, taking into account imaging, genetic testing, and other parameters beyond left ventricular function.
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Affiliation(s)
- Sara Vázquez-Calvo
- Arrhythmia Section, Cardiovascular Institute (ICCV), CLÍNIC Barcelona University Hospital, C/Villarroel N° 170, 08036, Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Ivo Roca-Luque
- Arrhythmia Section, Cardiovascular Institute (ICCV), CLÍNIC Barcelona University Hospital, C/Villarroel N° 170, 08036, Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Till F Althoff
- Arrhythmia Section, Cardiovascular Institute (ICCV), CLÍNIC Barcelona University Hospital, C/Villarroel N° 170, 08036, Barcelona, Catalonia, Spain.
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
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Park SM, Lee SY, Jung MH, Youn JC, Kim D, Cho JY, Cho DH, Hyun J, Cho HJ, Park SM, Choi JO, Chung WJ, Kang SM, Yoo BS. Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Management of the Underlying Etiologies and Comorbidities of Heart Failure. INTERNATIONAL JOURNAL OF HEART FAILURE 2023; 5:127-145. [PMID: 37554691 PMCID: PMC10406556 DOI: 10.36628/ijhf.2023.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/01/2023] [Accepted: 07/11/2023] [Indexed: 08/10/2023]
Abstract
Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, long-term anticoagulants are recommended according to the CHA2DS2-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.
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Affiliation(s)
- Sang Min Park
- Division of Cardiology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Soo Youn Lee
- Department of Cardiology, Cardiovascular Center, Incheon Sejong Hospital, Incheon, Korea
| | - Mi-Hyang Jung
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Darae Kim
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University Medicine, Seoul, Korea
| | - Junho Hyun
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun-Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seong-Mi Park
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University Medicine, Seoul, Korea
| | - Jin-Oh Choi
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wook-Jin Chung
- Division of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seok-Min Kang
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Park SM, Lee SY, Jung MH, Youn JC, Kim D, Cho JY, Cho DH, Hyun J, Cho HJ, Park SM, Choi JO, Chung WJ, Kang SM, Yoo BS. Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Management of the Underlying Etiologies and Comorbidities of Heart Failure. Korean Circ J 2023; 53:425-451. [PMID: 37525389 PMCID: PMC10406530 DOI: 10.4070/kcj.2023.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/01/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023] Open
Abstract
Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, long-term anticoagulants are recommended according to the CHA2DS2-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.
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Affiliation(s)
- Sang Min Park
- Division of Cardiology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Soo Youn Lee
- Department of Cardiology, Cardiovascular Center, Incheon Sejong Hospital, Incheon, Korea
| | - Mi-Hyang Jung
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Darae Kim
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University Medicine, Seoul, Korea
| | - Junho Hyun
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyun-Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seong-Mi Park
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University Medicine, Seoul, Korea
| | - Jin-Oh Choi
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wook-Jin Chung
- Division of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seok-Min Kang
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byung-Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
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Marin-Neto JA, Rassi A, Oliveira GMM, Correia LCL, Ramos Júnior AN, Luquetti AO, Hasslocher-Moreno AM, Sousa ASD, Paola AAVD, Sousa ACS, Ribeiro ALP, Correia Filho D, Souza DDSMD, Cunha-Neto E, Ramires FJA, Bacal F, Nunes MDCP, Martinelli Filho M, Scanavacca MI, Saraiva RM, Oliveira Júnior WAD, Lorga-Filho AM, Guimarães ADJBDA, Braga ALL, Oliveira ASD, Sarabanda AVL, Pinto AYDN, Carmo AALD, Schmidt A, Costa ARD, Ianni BM, Markman Filho B, Rochitte CE, Macêdo CT, Mady C, Chevillard C, Virgens CMBD, Castro CND, Britto CFDPDC, Pisani C, Rassi DDC, Sobral Filho DC, Almeida DRD, Bocchi EA, Mesquita ET, Mendes FDSNS, Gondim FTP, Silva GMSD, Peixoto GDL, Lima GGD, Veloso HH, Moreira HT, Lopes HB, Pinto IMF, Ferreira JMBB, Nunes JPS, Barreto-Filho JAS, Saraiva JFK, Lannes-Vieira J, Oliveira JLM, Armaganijan LV, Martins LC, Sangenis LHC, Barbosa MPT, Almeida-Santos MA, Simões MV, Yasuda MAS, Moreira MDCV, Higuchi MDL, Monteiro MRDCC, Mediano MFF, Lima MM, Oliveira MTD, Romano MMD, Araujo NNSLD, Medeiros PDTJ, Alves RV, Teixeira RA, Pedrosa RC, Aras Junior R, Torres RM, Povoa RMDS, Rassi SG, Alves SMM, Tavares SBDN, Palmeira SL, Silva Júnior TLD, Rodrigues TDR, Madrini Junior V, Brant VMDC, Dutra WO, Dias JCP. SBC Guideline on the Diagnosis and Treatment of Patients with Cardiomyopathy of Chagas Disease - 2023. Arq Bras Cardiol 2023; 120:e20230269. [PMID: 37377258 PMCID: PMC10344417 DOI: 10.36660/abc.20230269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Affiliation(s)
- José Antonio Marin-Neto
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | - Anis Rassi
- Hospital do Coração Anis Rassi , Goiânia , GO - Brasil
| | | | | | | | - Alejandro Ostermayer Luquetti
- Centro de Estudos da Doença de Chagas , Hospital das Clínicas da Universidade Federal de Goiás , Goiânia , GO - Brasil
| | | | - Andréa Silvestre de Sousa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Antônio Carlos Sobral Sousa
- Universidade Federal de Sergipe , São Cristóvão , SE - Brasil
- Hospital São Lucas , Rede D`Or São Luiz , Aracaju , SE - Brasil
| | | | | | | | - Edecio Cunha-Neto
- Universidade de São Paulo , Faculdade de Medicina da Universidade, São Paulo , SP - Brasil
| | - Felix Jose Alvarez Ramires
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Fernando Bacal
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Martino Martinelli Filho
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Maurício Ibrahim Scanavacca
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Magalhães Saraiva
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Adalberto Menezes Lorga-Filho
- Instituto de Moléstias Cardiovasculares , São José do Rio Preto , SP - Brasil
- Hospital de Base de Rio Preto , São José do Rio Preto , SP - Brasil
| | | | | | - Adriana Sarmento de Oliveira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Ana Yecê das Neves Pinto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Andre Schmidt
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | - Andréa Rodrigues da Costa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | - Barbara Maria Ianni
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Carlos Eduardo Rochitte
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Hcor , Associação Beneficente Síria , São Paulo , SP - Brasil
| | | | - Charles Mady
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Christophe Chevillard
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Marselha - França
| | | | | | | | - Cristiano Pisani
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | | | - Edimar Alcides Bocchi
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Evandro Tinoco Mesquita
- Hospital Universitário Antônio Pedro da Faculdade Federal Fluminense , Niterói , RJ - Brasil
| | | | | | | | | | | | - Henrique Horta Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | - Henrique Turin Moreira
- Hospital das Clínicas , Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP - Brasil
| | | | | | | | - João Paulo Silva Nunes
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Fundação Zerbini, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | | | | | | | - Luiz Cláudio Martins
- Universidade Estadual de Campinas , Faculdade de Ciências Médicas , Campinas , SP - Brasil
| | | | | | | | - Marcos Vinicius Simões
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | | | | | - Maria de Lourdes Higuchi
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Mauro Felippe Felix Mediano
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
- Instituto Nacional de Cardiologia (INC), Rio de Janeiro, RJ - Brasil
| | - Mayara Maia Lima
- Secretaria de Vigilância em Saúde , Ministério da Saúde , Brasília , DF - Brasil
| | | | | | | | | | - Renato Vieira Alves
- Instituto René Rachou , Fundação Oswaldo Cruz , Belo Horizonte , MG - Brasil
| | - Ricardo Alkmim Teixeira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Coury Pedrosa
- Hospital Universitário Clementino Fraga Filho , Instituto do Coração Edson Saad - Universidade Federal do Rio de Janeiro , RJ - Brasil
| | | | | | | | | | - Silvia Marinho Martins Alves
- Ambulatório de Doença de Chagas e Insuficiência Cardíaca do Pronto Socorro Cardiológico Universitário da Universidade de Pernambuco (PROCAPE/UPE), Recife , PE - Brasil
| | | | - Swamy Lima Palmeira
- Secretaria de Vigilância em Saúde , Ministério da Saúde , Brasília , DF - Brasil
| | | | | | - Vagner Madrini Junior
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | - João Carlos Pinto Dias
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
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12
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Forkmann M, Busch S. [Should we treat asymptomatic premature ventricular contractions?]. Herzschrittmacherther Elektrophysiol 2023; 34:131-135. [PMID: 36941444 DOI: 10.1007/s00399-023-00934-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/24/2023] [Indexed: 03/23/2023]
Abstract
Premature ventricular contractions (PVC) are a common arrhythmia. Therapy is indicated in case of frequent symptomatic PVC or deterioration of left ventricular function. Asymptomatic patients should be evaluated critically for possible PVC-associated symptoms. Catheter ablation of PVCs in patients with normal left ventricular ejection fraction (LVEF) is safe and effective. PVC-induced cardiomyopathy should be considered in unexplained LVEF dysfunction with a PVC burden of at least 10%. If ECG and echocardiography do not clearly rule out structural heart disease (SHD) or the clinical presentation raises suspicion of SHD, cardiac magnetic resonance imaging should be performed. If SHD has been excluded, the guidelines recommend catheter ablation as primary therapy in frequent monomorphic PVC, regardless of symptoms. To prevent PVC-induced cardiomyopathy, ablation can also be considered in asymptomatic patients with a PVC burden > 20%. Also, in patients with known SHD frequent PVC can aggravate LV dysfunction and catheter ablation should be considered.
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Affiliation(s)
- Mathias Forkmann
- II. Med. Klinik für Kardiologie und Angiologie, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Deutschland.
| | - Sonia Busch
- II. Med. Klinik für Kardiologie und Angiologie, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Deutschland
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13
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Hao MY, Zhang Y, Lin N, Fu R, Ji XS, Jiang B, Tu SJ, Hao WJ. Gold self-relay catalysis enabling annulative oxygenation of propargylic alcohols with O-nucleophiles. Chem Commun (Camb) 2023; 59:4032-4035. [PMID: 36924136 DOI: 10.1039/d3cc00089c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
A new gold(I) self-relay catalysis reaction enabling the annulative oxygenation of propargylic alcohols with various O-nucleophiles, such as carboxylic acids, alcohols and TBHP, is reported, producing a series of functionalized benzofurans in moderate to good yields under mild conditions. This protocol benefits from the π- and σ-Lewis acid capability of gold complexes, demonstrating high molecular convergence, broad substrate flexibility, high functional group compatibility and mild conditions.
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Affiliation(s)
- Meng-Ying Hao
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China. .,School of Pharmacy, Zhengzhou Vocational College of Medicine and Health, Zhengzhou 452385, P. R. China
| | - Yin Zhang
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
| | - Na Lin
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
| | - Rong Fu
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
| | - Xiao-Shuang Ji
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
| | - Bo Jiang
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
| | - Shu-Jiang Tu
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
| | - Wen-Juan Hao
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
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14
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Successful radiofrequency catheter ablation of idiopathic premature ventricular complexes originating from the outflow tract improves heart failure-related quality of life. J Interv Card Electrophysiol 2023; 66:363-372. [PMID: 35731329 DOI: 10.1007/s10840-022-01264-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/31/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND To investigate the effect of successful RFCA in patients with idiopathic outflow tract PVCs (OT-PVC) on left heart functions, neurohormonal activation, functional status, and heart failure-related quality of life (HFQoL), with an integrated approach. METHODS Patients with frequent OT-PVCs, determined by 12-lead surface ECG who underwent radiofrequency catheter ablation (RFCA) with an acute success, were prospectivelly enrolled. Left heart functions were evaluated with the use of transthoracic echocardiography, neurohormonal activation with N-terminal Pro-brain natriuretic peptide (BNP), functional class with New York Heart Association (NYHA) and 6-min walking distance (6MWD), and HFQoL with Minnesota Living with Heart Failure Questionnaire (MLHFQ), at baseline and at 6 months. RESULTS A total of 108 patients were included in this study (43 ± 12 years old, 56% male). Majority of the OT-PVCs originated from aortic valve and right ventricle outflow tract (44% and 37%, respectively). Total RF time was 216 ± 87 s. Major complication rate was 0.9%. Left ventricle (LV) ejection fraction increased from 47 ± 8 to 53 ± 6% at 6 months (p < 0.001). Neurohormonal activation was suppressed significantly (104 ± 69 to 83 ± 42, p < 0.001). Functional class improved with %NYHA-I patients increasing from 54 to 89% (p < 0.001) and 6MWD from 293 ± 73 to 335 ± 59 m (p < 0.001). MLHFQ score improved from 32 ± 9 to 23 ± 5 p < 0.001. In multivariable analysis, LV end-systolic diameter (LVESD) and 6MWD were independent predictors of improvement in MLHFQ (for LVESD Uβ: - 0.26, 95%CI [0.44-0.09], p < 0.004 and for 6MWD: 0.04, 95%CI [0.03-0.06], p < 0.001). CONCLUSIONS RFCA of OT-PVCs is associated with improved well-being of patients, determined by left heart functions, neurohormonal activation, functional class, and HFQoL.
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van den Bruck JH, Middeldorp M, Sultan A, Scheurlen C, Seuthe K, Wörmann J, Filipovic K, Kadhim K, Sanders P, Steven D, Lüker J. Impact of ventricular arrhythmia management on suboptimal biventricular pacing in cardiac resynchronization therapy. J Interv Card Electrophysiol 2023; 66:353-361. [PMID: 35697890 PMCID: PMC9977698 DOI: 10.1007/s10840-022-01259-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/24/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reduced biventricular pacing (BiVP) is a common phenomenon in cardiac resynchronization therapy (CRT) with impact on CRT-response and patients' prognosis. Data on treatment strategies for patients with ventricular arrhythmia and BiVP reduction is sparse. We sought to assess the effects of ventricular arrhythmia treatment on BiVP. METHODS In this retrospective analysis, the data of CRT patients with a reduced BiVP ≤ 97% due to ventricular arrhythmia were analyzed. Catheter ablation or intensified medical therapy was performed to optimize BiVP. RESULTS We included 64 consecutive patients (73 ± 10 years, 89% male, LVEF 30 ± 7%). Of those, 22/64 patients (34%) underwent ablation of premature ventricular contractions (PVC) and 15/64 patients (23%) underwent ventricular tachycardia (VT) ablation while 27/64 patients (42%) received intensified medical treatment. Baseline BiVP was 88.1% ± 10.9%. An overall increase in BiVP percentage points of 8.8% (range - 5 to + 47.6%) at 6-month follow-up was achieved. No changes in left ventricular function were observed but improvement in BiVP led to an improvement in NYHA class in 24/64 patients (38%). PVC ablation led to a significantly better improvement in BiVP [9.9% (range 4 to 22%) vs. 3.2% (range - 5 to + 10.7%); p = < 0.001] and NYHA class (12/22 patients vs. 4/27 patients; p = 0.003) than intensified medical therapy. All patients with VT and reduced BiVP underwent VT ablation with an increase of BiVP of 16.3 ± 13.4%. CONCLUSION In this evaluation of ventricular arrhythmia treatment aiming for CRT optimization, both medical therapy and catheter ablation were shown to be effective. Compared to medical therapy, a higher increase in BiVP was observed after PVC ablation, and more patients improved in NYHA class. CLINICAL TRIAL REGISTRATION The study was registered at clinical trials.org in August 2019: NCT04065893.
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Affiliation(s)
- Jan-Hendrik van den Bruck
- Department of Electrophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - Melissa Middeldorp
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Arian Sultan
- Department of Electrophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Cornelia Scheurlen
- Department of Electrophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Katharina Seuthe
- Department of Electrophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Jonas Wörmann
- Department of Electrophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Karlo Filipovic
- Department of Electrophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Kadhim Kadhim
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Daniel Steven
- Department of Electrophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Jakob Lüker
- Department of Electrophysiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
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Wiedmann F, Ince H, Stellbrink C, Kleemann T, Eckardt L, Brachmann J, Gonska BD, Kääb S, Perings CA, Jung W, Lugenbiel P, Hochadel M, Senges J, Frey N, Schmidt C. Single beta-blocker or combined amiodarone therapy in implantable cardioverter-defibrillator and cardiac resynchronization therapy-defibrillator patients: Insights from the German DEVICE registry. Heart Rhythm 2022; 20:501-509. [PMID: 36509321 DOI: 10.1016/j.hrthm.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/23/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Because of its antiarrhythmic potency and due to the lack of alternatives, amiodarone is often used for antiarrhythmic therapy in patients with implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy-defibrillator systems. To date, robust data on the safety and clinical benefit of amiodarone therapy in these patients are missing. OBJECTIVE The purpose of this study was to assess the periprocedural and postprocedural outcomes of combined therapy with beta-blockers plus amiodarone compared to treatment with single beta-blockers in the "real-life" cohort of ICD recipients of the German DEVICE registry. METHODS A total of 4499 patients who underwent ICD implantation, revision, or upgrade in 49 centers participating in the German DEVICE registry were enrolled from March 2007 to February 2014. RESULTS Amiodarone had no significant effect on the success of defibrillation testing. Early implantation-associated complications were similar between the groups. However, 1-year overall mortality was significantly higher in the beta-blocker plus amiodarone cohort (adjusted hazard ratio 2.09; P <.001). Interestingly, among the surviving patients, amiodarone was not associated with a significantly reduced risk of ICD discharges or syncopal events. Furthermore, the occurrence of ventricular tachycardia (VT) storm or incessant VTs and the number of patients scheduled for intracardiac ablation did not differ among both groups, whereas the rate of rehospitalization was lower in the cohort with only beta-blockers. CONCLUSIONS Although amiodarone has no adverse effect on the success of defibrillation testing, our data suggest an increased all-cause mortality under amiodarone therapy, especially in the subgroups of patients with sinus rhythm or severely reduced left ventricular function. In surviving patients, rates of arrhythmic events were comparable.
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Affiliation(s)
- Felix Wiedmann
- Department of Cardiology, UniversityHospital Heidelberg, DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg University, Heidelberg, Germany, HCR, Heidelberg Center for Heart Rhythm Disorders, UniversityHospital Heidelberg, Heidelberg, Germany
| | - Hüseyin Ince
- Department of Cardiology, Vivantes Klinikum Am Urban and Im Friedrichshain, Berlin, Germany, Rostock University, Rostock, Germany
| | | | - Thomas Kleemann
- Department of Cardiology, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany
| | - Lars Eckardt
- Clinic for Cardiology II, University Hospital Münster, AlbertMünster, Germany
| | | | | | - Stefan Kääb
- Department of Medicine I, University Hospital, Ludwig-Maximilians University Munich (LMU), Munich, Germany, DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Christian A Perings
- Katholisches Klinikum Lünen/Werne St.-Marien-Hospital, Medizinische Klinik 1, Lünen, Germany
| | - Werner Jung
- Department of Cardiology, Schwarzwald-Baar Klinikum, Villingen-Schwenningen, Germany
| | - Patrick Lugenbiel
- Department of Cardiology, UniversityHospital Heidelberg, DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg University, Heidelberg, Germany, HCR, Heidelberg Center for Heart Rhythm Disorders, UniversityHospital Heidelberg, Heidelberg, Germany
| | - Matthias Hochadel
- Stiftung Institut für Herzinfarktforschung, Ludwigshafen am Rhein, Germany
| | - Jochen Senges
- Stiftung Institut für Herzinfarktforschung, Ludwigshafen am Rhein, Germany
| | - Norbert Frey
- Department of Cardiology, UniversityHospital Heidelberg, DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg University, Heidelberg, Germany, HCR, Heidelberg Center for Heart Rhythm Disorders, UniversityHospital Heidelberg, Heidelberg, Germany
| | - Constanze Schmidt
- Department of Cardiology, UniversityHospital Heidelberg, DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg University, Heidelberg, Germany, HCR, Heidelberg Center for Heart Rhythm Disorders, UniversityHospital Heidelberg, Heidelberg, Germany.
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17
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Sabbag A, Essayagh B, Barrera JDR, Basso C, Berni A, Cosyns B, Deharo JC, Deneke T, Di Biase L, Enriquez-Sarano M, Donal E, Imai K, Lim HS, Marsan NA, Turagam MK, Peichl P, Po SS, Haugaa KH, Shah D, de Riva Silva M, Bertrand P, Saba M, Dweck M, Townsend SN, Ngarmukos T, Fenelon G, Santangeli P, Sade LE, Corrado D, Lambiase P, Sanders P, Delacrétaz E, Jahangir A, Kaufman ES, Saggu DK, Pierard L, Delgado V, Lancellotti P. EHRA expert consensus statement on arrhythmic mitral valve prolapse and mitral annular disjunction complex in collaboration with the ESC Council on valvular heart disease and the European Association of Cardiovascular Imaging endorsed cby the Heart Rhythm Society, by the Asia Pacific Heart Rhythm Society, and by the Latin American Heart Rhythm Society. Europace 2022; 24:1981-2003. [PMID: 35951656 DOI: 10.1093/europace/euac125] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Avi Sabbag
- The Davidai Center for Rhythm Disturbances and Pacing, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel
| | - Benjamin Essayagh
- Department of Cardiovascular Medicine, Simone Veil Hospital, Cannes 06400, France.,Department of Cardiovascular Medicine, Mayo Clinic, Rochester 55905, Minnesota
| | | | - Cristina Basso
- Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, Università degli Studi di Padova, Padova 35128, Italy
| | - Ana Berni
- Cardiology and Cardiac Electrophysiology, EP Lab. Hospital Angeles Pedregal. Mexico City 10700, Board member, Mexican Society of Cardiology
| | - Bernard Cosyns
- Cardiology Department, Centrum voor hart en vaatziekten, Universitair Ziekenhuis Brussel, Free University of Brussels, Brussels 1090, Belgium
| | - Jean-Claude Deharo
- Department of Cardiology, L'hôpital de la Timone, Marseille, 13005, France
| | - Thomas Deneke
- Clinic for Interventional Electrophysiology, Heart Center RHÖN-KLINIKUM Campus Bad Neustadt, 97616, Germany
| | - Luigi Di Biase
- Albert Einstein College of Medicine at Montefiore Hospital, New York, NY 10467, USA
| | | | - Erwan Donal
- Service de Cardiologie, CCP-CHU Pontchaillou, Rennes 35033, France
| | - Katsuhiko Imai
- Department of Cardiovascular Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima 737-0023, Japan
| | - Han S Lim
- Department of Cardiology, Austin and Northern Health, University of Melbourne, Melbourne 3010, Australia
| | | | - Mohit K Turagam
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Petr Peichl
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague 73117, Czech Republic
| | - Sunny S Po
- Heart Rhythm Institute and Section of Cardiovascular Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, OK 0372, USA
| | - Kristina Hermann Haugaa
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Dipen Shah
- Cantonal Hospital, Cardiology Department, CH-1211 Geneva, Switzerland
| | - Marta de Riva Silva
- Department of Cardiology, Leiden University Medical Center, Leiden 2333, The Netherlands
| | - Philippe Bertrand
- Ziekenhuis Oost-Limburg, Hasselt University, Genk, Hasselt 3600, Belgium
| | - Magdi Saba
- Consultant and Reader in Cardiac Electrophysiology, Director, Advanced Ventricular Arrhythmia Training and Research Program, St. George's Hospital NHS Foundation Trust, St. George's, University of London, SW17 0QT, UK
| | - Marc Dweck
- Centre for cardiovascular science, University of Edinburgh, EH16 4TJ, UK
| | - Santiago Nava Townsend
- Instituto Nacional De Cardiologia Ich, Electrophysiology Department, Mexico Df 14080, Mexico
| | - Tachapong Ngarmukos
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 73170, Thailand
| | - Guilherme Fenelon
- Coordenador - Centro de Arritmia, Hospital Israelita Albert Einstein, São Paulo - SP, 05652-900, Brazil
| | | | - Leyla Elif Sade
- University of Pittsburgh, UPMC, Heart and Vascular Institute, ittsburgh, PA 15219, USA.,C.H.U. du Sart-Tilman, Universite de Liege, Liege 4000, Belgium
| | - Domenico Corrado
- Full Professor of Cardiovascular Medicine, Director, Inherited Arrhythmogenic Cardiomyopathies and Sports Cardiology Unit, Dept. of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padova 35122, Italy
| | - Pier Lambiase
- UCL & Barts Heart Centre, Co-Director of Cardiovascular Research Barts NHS Trust, Inherited Arrhythmia Clinical Lead, UCL MRC DTP Theme Lead, BHRS Committee Research Lead, Institute of Cardiovascular Science, UCL, Department of Cardiology, Barts Heart Centre E1 1BB, UK
| | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders, University of Adelaide, South Australia 5000, Australia
| | - Etienne Delacrétaz
- Clinique Cecil Hirslanden Lausanne & University Hospital Fribourg, Cardiology 1003, Switzerland
| | - Arshad Jahangir
- University of Wisconsin School of Medicine and Public Health, Milwaukee, MI 53705, USA
| | - Elizabeth S Kaufman
- Clinical Electrophysiologist, MetroHealth Medical Center, Professor, Case Western Reserve University 44106, USA
| | - Daljeet Kaur Saggu
- Consultant Cardiologist and Electrophysiologist, AIG HOSPITAL, Hyderabad 500032, India
| | - Luc Pierard
- C.H.U. du Sart-Tilman, Universite de Liege, Liege 4000, Belgium
| | - Victoria Delgado
- Heart Institute, Hospital University Germans Trias i Pujol, Badalona 08916, Spain
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18
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Quality of life and symptoms in patients selected for ablation of ventricular extrasystoles: a prospective study. J Interv Card Electrophysiol 2022; 65:601-607. [PMID: 34855035 DOI: 10.1007/s10840-021-01092-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Evaluation of the impact of catheter ablation for ventricular extrasystoles (VES) in structurally normal hearts on quality of life (QOL) and symptomatology. METHODS Symptom analysis assessed with a disease-specific questionnaire, EHRA score for AF, and QOL analysis at baseline and 1 year after ablation. RESULTS The study enrolled 39 patients between April 2016 and November 2019. Two patients were excluded from further analysis. At baseline, palpitations were reported in 31/37 (84%); syncope in 12/37 (32%); other cardiac symptoms in 33/37 (89%) of patients. The EHRA score was 3 or 4 in 13 patients (35%). With the modified arrhythmia-specific questionnaire (MASQ) psychological and physical scores were 46 and 39%. The overall perception of health in the SF-36 was 56 ± 16%. Ablation was performed in 35/37 (95%). At regular follow-up, symptoms were reported in 14/37 (38%) patients. ECG suggested a good procedural outcome in 65% with VES burden on Holter < 1% in 68%. At follow-up, palpitations were reported in 61% (P < 0.07); syncope in only 1 patient (P < 0.05). The EHRA score was 3 or 4 in only one patient (P < 0.05). MASQ scores improved to 62 and 60% (both p < 0.001). The overall perception of health in the SF-36 became 64 ± 17% (P < 0.02). CONCLUSIONS Patients with VES suffer from a wide variety of symptoms and have a low quality of life, as demonstrated by the EHRA score and conventional questionnaires. After catheter ablation, palpitations are still reported, but become less frequently present. Syncope becomes rare. Quality of life improves significantly from all perspectives.
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Premature Ventricular Contractions (PVCs): A Narrative Review. Am J Med 2022; 135:1300-1305. [PMID: 35907515 DOI: 10.1016/j.amjmed.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/23/2022]
Abstract
Premature ventricular complexes/contractions (PVCs) are relatively common, occurring in 3%-20% of the general population, and are often found during work-up of palpitations or incidentally on routine electrocardiographic testing. They are usually considered benign but can be a sign of underlying cardiac disease and cause significantly impairing symptoms. While often thought of as a problem for the cardiologist, it is not uncommon for PVCs to be identified initially in a primary care or inpatient general medicine setting. This paper will review etiologies, epidemiology, evaluation, and management of PVCs for the internist.
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20
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Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA, Charron P, Corrado D, Dagres N, de Chillou C, Eckardt L, Friede T, Haugaa KH, Hocini M, Lambiase PD, Marijon E, Merino JL, Peichl P, Priori SG, Reichlin T, Schulz-Menger J, Sticherling C, Tzeis S, Verstrael A, Volterrani M. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 2022; 43:3997-4126. [PMID: 36017572 DOI: 10.1093/eurheartj/ehac262] [Citation(s) in RCA: 650] [Impact Index Per Article: 325.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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21
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Zhang Z, Zhou X, Gong C, Chen Y, Fang Y. Effect of perioperative intravenous amiodarone on cardioversion of atrial fibrillation early after video-assisted thoracoscopic surgical ablation: Study protocol for a double-blind randomized controlled trial. Contemp Clin Trials Commun 2022; 30:101010. [PMID: 36246996 PMCID: PMC9562951 DOI: 10.1016/j.conctc.2022.101010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/28/2022] [Accepted: 09/17/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Video-assisted thoracoscopic surgical (VATS) ablation is widely performed in surgical areas to treat atrial fibrillation (AF), which is minimally invasive and highly effective. Amiodarone, known as a class III antiarrhythmic agent, has the greatest potential to maintain sinus rhythm of AF. At present, few studies focused on the efficacy of perioperative intravenous amiodarone in the VATS ablation of AF. Therefore, the trial is designed to investigate the effect of perioperative amiodarone infusion on cardioversion of AF early after VATS ablation. Methods and analysis: This will be a prospective, randomized, double-blind, controlled trial. The trial is to enroll 182 patients aged 18–70 years who will undergo VATS ablation of AF. All eligible participants will be randomly allocated to either the amiodarone or placebo group by using the block randomization in a 1:1 ratio. The primary endpoint will be freedom from atrial arrhythmias 24 h after the VATS procedure and be assessed using the Kaplan-Meier method. All data will be analyzed in accordance with the intention-to-treat principle. Discussion The clinical trial has been designed to investigate the efficacy of perioperative intravenous amiodarone on cardioversion of AF early after VATS ablation. We are hoping to demonstrate that perioperative infusion of amiodarone could improve the maintenance of sinus rhythm 24 h after VATS ablation.
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Key Words
- AF, atrial fibrillation
- Amiodarone
- BIS, bispectral index
- CM, Cox-Maze
- DEA, desethylamiodarone
- ECG, electrocardiograph
- IBP, invasive arterial blood pressure
- ICE, the Institutional Ethics Committee
- ICU, intensive care unit
- LAA, left atrial appendage
- PETCO2, end tidal CO2
- PVI, pulmonary vein isolation
- Persistent atrial fibrillation
- RF, radiofrequency ablation
- Radiofrequency ablation
- SAE, severe adverse events
- TEE, transesophageal echocardiogram
- VATS, video-assisted thoracoscopic surgical
- Video-assisted thoracoscope
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Affiliation(s)
| | | | | | | | - Yin Fang
- Corresponding author. Department of Anesthesia and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing 210029, China.
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22
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Transition Metal Catalyzed Hiyama Cross-Coupling: Recent Methodology Developments and Synthetic Applications. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27175654. [PMID: 36080422 PMCID: PMC9458230 DOI: 10.3390/molecules27175654] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 11/17/2022]
Abstract
Hiyama cross-coupling is a versatile reaction in synthetic organic chemistry for the construction of carbon-carbon bonds. It involves the coupling of organosilicons with organic halides using transition metal catalysts in good yields and high enantioselectivities. In recent years, hectic progress has been made by researchers toward the synthesis of diversified natural products and pharmaceutical drugs using the Hiyama coupling reaction. This review emphasizes the recent synthetic developments and applications of Hiyama cross-coupling.
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23
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Ji XS, Zuo HD, Shen YT, Hao WJ, Tu SJ, Jiang B. Electrochemical selective annulative amino-ketalization and amino-oxygenation of 1,6-enynes. Chem Commun (Camb) 2022; 58:10420-10423. [PMID: 36043317 DOI: 10.1039/d2cc03922b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A new electrochemical selective annulative amino-ketalization and amino-oxygenation of 1,6-enynes with disulfonimides and alcohols is reported, producing a series of functionalized benzofurans under catalyst- and oxidant-free conditions. The annulative aminoketalization proceeds with simple short-chain alcohols such as methanol, ethanol and n-propanol as O-nucleophilic reagents, while the reaction occurs in the annulative aminooxygenation direction in the presence of water and large steric sec-butyl alcohol (SBA).
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Affiliation(s)
- Xiao-Shuang Ji
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
| | - Hang-Dong Zuo
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China. .,School of Environmental and Safety Engineering, Changzhou University, Changzhou, 213164, Jiangsu, P. R. China
| | - Yi-Ting Shen
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
| | - Wen-Juan Hao
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
| | - Shu-Jiang Tu
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
| | - Bo Jiang
- School of Chemistry & Materials Science, Jiangsu Normal University, Xuzhou, 221116, P. R. China.
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Kowlgi GN, Tan AY, Kaszala K, Kontos MC, Lozano P, Ellenbogen KA, Huizar JF. Left ventricular dyssynchrony as marker of early dysfunction in premature ventricular contraction-induced cardiomyopathy. Front Cardiovasc Med 2022; 9:978341. [PMID: 36148047 PMCID: PMC9485544 DOI: 10.3389/fcvm.2022.978341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/03/2022] [Indexed: 01/16/2023] Open
Abstract
Background Strain imaging has been suggested as a tool to detect early left ventricular (LV) dysfunction due to frequent premature ventricular contractions (PVCs) in patients with preserved LV ejection fraction (EF). However, the progression of intraventricular dyssynchrony (IVD), radial, and circumferential strain (RS, CS) in PVC-cardiomyopathy (CM) are unknown. The aim of this study was to elucidate the progression patterns of CS, IVD, and electro-mechanical latency (EML) in PVC-CM. Methods and results Pacemakers were implanted in 20 canines to reproduce ventricular bigeminy at 200ms (PVCs n = 11) for 12 weeks and compared to a sham group (n = 9). We obtained echocardiograms at baseline, 4-, 8- and 12-weeks. RS and CS were obtained at the LV mid-cavitary level. IVD was defined as the time between the earliest and latest peak RS. EML was defined as the time between the onset of QRS and the earliest peak RS. LVEF (62 ± 5 to 42 ± 7%, p < 0.01), CS (-18 ± 3 to -12 ± 3, p < 0.01), and EML (219 ± 37 to 283 ± 46ms, p = 0.02) changed significantly in the PVC group. Peak CS (-18 ± 3 to -14 ± 4, p = 0.02) and IVD (49 ± 31 to 122 ± 103, p = 0.05) had a significant change at 4-weeks despite preserved LVEF (51 ± 5%). IVD normalized while EML increased at weeks 8 and 12. Conclusion Our findings consolidate the existing theory that changes in strain precede changes in LVEF in PVC-CM. While IVD becomes abnormal early in the development of PVC-CM, it pseudo-normalizes at advanced stages due to further increases in EML suggestive of cardiac contractility remodeling. These findings are consistent with recent published data where abnormal LV mechanics could be part of a substrate that can predispose to worse outcome in PVC-Cardiomyopathy.
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Affiliation(s)
- Gurukripa N. Kowlgi
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Alex Y. Tan
- Division of Cardiovascular Diseases, Department of Internal Medicine, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, United States
| | - Karoly Kaszala
- Division of Cardiovascular Diseases, Department of Internal Medicine, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, United States
| | - Michael C. Kontos
- Division of Cardiovascular Diseases, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Pedro Lozano
- Department of Cardiovascular Diseases, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Kenneth A. Ellenbogen
- Division of Cardiovascular Diseases, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Jose F. Huizar
- Division of Cardiovascular Diseases, Department of Internal Medicine, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, United States,Division of Cardiovascular Diseases, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States,*Correspondence: Jose F. Huizar, ; ;
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25
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Gopinathannair R, Pothineni NVK, Trivedi JR, Roukoz H, Cowger J, Ahmed MM, Bhan A, K. Ravichandran A, Bhat G, Al Ahmad A, Natale A, Di Biase L, Slaughter MS, Lakkireddy D. Amiodarone Use and All-Cause Mortality in Patients With a Continuous-Flow Left Ventricular Assist Device. J Am Heart Assoc 2022; 11:e023762. [PMID: 35656998 PMCID: PMC9238747 DOI: 10.1161/jaha.121.023762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Atrial and ventricular arrhythmias are commonly encountered in patients with advanced heart failure, with amiodarone being the most commonly used antiarrhythmic drug in continuous‐flow left ventricular assist device (CF‐LVAD) recipients. The purpose of this study was to assess the impact of amiodarone use on long‐term all‐cause mortality in ptients with a CF‐LVAD. Methods and Results A retrospective multicenter study of CF‐LVAD was conducted at 5 centers including all CF‐LVAD implants from 2007 to 2015. Patients were stratified based on pre–CF‐LVAD implant amiodarone use. Additional use of amiodarone after CF‐LVAD implantation was also evaluated. Primary outcome was all‐cause mortality during long‐term follow‐up. Kaplan‐Meier curves were used to assess survival outcomes. Multivariable Cox regression was used to identify predictors of outcomes. Propensity matching was done to address baseline differences. A total of 480 patients with a CF‐LVAD (aged 58±13 years, 81% men) were included. Of these, 170 (35.4%) were on chronic amiodarone therapy at the time of CF‐LVAD implant, and 310 (64.6%) were not on amiodarone. Rate of all‐cause mortality over the follow‐up period was 32.9% in the amiodarone group compared with 29.6% in those not on amiodarone (P=0.008). Similar results were noted in the propensity‐matched group (log‐rank, P=0.04). On multivariable Cox regression analysis, amiodarone use at baseline was independently associated with all‐cause mortality (hazard ratio, 1.68 [95% CI, 1.1–2.5]; P=0.01). Conclusions Amiodarone use was associated with significantly increased rates of all‐cause mortality in CF‐LVAD recipients. Earlier interventions for arrhythmias to avoid long‐term amiodarone exposure may improve long‐term outcomes in CF‐LVAD recipients and needs further study.
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Affiliation(s)
| | | | - Jaimin R. Trivedi
- Department of Cardiothoracic SurgeryUniversity of LouisvilleLouisvilleKY
| | - Henri Roukoz
- Division of CardiologyUniversity of MinnesotaMinneapolisMN
| | | | | | - Adarsh Bhan
- Division of CardiologyAdvocate Christ Medical CenterOak LawnIL
| | | | - Geetha Bhat
- Division of CardiologyPennsylvania State UniversityHersheyPA
| | | | | | - Luigi Di Biase
- Division of CardiologyMontefiore Medical CenterNew YorkNY
| | - Mark S. Slaughter
- Department of Cardiothoracic SurgeryUniversity of LouisvilleLouisvilleKY
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Pharmacologic Rate versus Rhythm Control for Atrial Fibrillation in Heart Failure Patients. Medicina (B Aires) 2022; 58:medicina58060743. [PMID: 35744006 PMCID: PMC9228123 DOI: 10.3390/medicina58060743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 11/24/2022] Open
Abstract
Atrial fibrillation (AF) and Heart failure (HF) constitute two frequently coexisting cardiovascular diseases, with a great volume of the scientific research referring to strategies and guidelines associated with the best management of patients suffering from either of the two or both of these entities. The common pathophysiological paths, the adverse outcomes, the hospitalization rates, and the mortality rates that occur from various reports and trials indicate that a targeted therapy to the common background of these cardiovascular conditions may reverse the progression of their interrelating development. Among other optimal treatments concerning the prevalence of both AF and HF, the introduction of rhythm and rate control strategies in the guidelines has underlined the importance of sinus rhythm and heart rate control in the prevention of deleterious complications. The use of these strategies in the clinical practice has led to a debate about the superiority of rhythm versus rate control. The current guidelines as well as the published randomized trials and studies have not proved that rhythm control is more beneficial than the rate control treatments in the terms of survival, all-cause mortality, hospitalization rates, and quality of life. Therefore, the current therapeutic strategy is based on the therapy guidelines and the clinical judgment and experience. The aim of this review was to elucidate the endpoints of pharmacologic randomized clinical trials and the clinical data of each antiarrhythmic or rate-limiting medication, so as to promote their effective, individualized, evidence-based clinical use.
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27
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Stereoselective interaction of tolvaptan with amiodarone under racemic metabolic impact by CYP3A5 genotypes in heart failure patients. Eur J Clin Pharmacol 2022; 78:1311-1320. [DOI: 10.1007/s00228-022-03341-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
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Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2022; 145:e895-e1032. [PMID: 35363499 DOI: 10.1161/cir.0000000000001063] [Citation(s) in RCA: 593] [Impact Index Per Article: 296.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AIM The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure" and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure." The 2022 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure. METHODS A comprehensive literature search was conducted from May 2020 to December 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from MEDLINE (PubMed), EMBASE, the Cochrane Collaboration, the Agency for Healthcare Research and Quality, and other relevant databases. Additional relevant clinical trials and research studies, published through September 2021, were also considered. This guideline was harmonized with other American Heart Association/American College of Cardiology guidelines published through December 2021. Structure: Heart failure remains a leading cause of morbidity and mortality globally. The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with heart failure, with the intent to improve quality of care and align with patients' interests. Many recommendations from the earlier heart failure guidelines have been updated with new evidence, and new recommendations have been created when supported by published data. Value statements are provided for certain treatments with high-quality published economic analyses.
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Affiliation(s)
| | | | | | | | | | | | - Anita Deswal
- ACC/AHA Joint Committee on Clinical Practice Guidelines Liaison
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29
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Zhang Q, Nie H, Zhang K, Huang H, Song C. A novel base-promoted intramolecular cyclization approach for the synthesis of benzofurans, benzothiophenes and indoles. Tetrahedron 2022. [DOI: 10.1016/j.tet.2022.132815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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30
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Fischer AJ, Enders D, Eckardt L, Köbe J, Wasmer K, Breithardt G, De Torres Alba F, Kaleschke G, Baumgartner H, Diller GP. Thyroid Dysfunction under Amiodarone in Patients with and without Congenital Heart Disease: Results of a Nationwide Analysis. J Clin Med 2022; 11:jcm11072027. [PMID: 35407633 PMCID: PMC8999848 DOI: 10.3390/jcm11072027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/24/2022] [Accepted: 04/01/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Amiodarone has a profound adverse toxicity profile. Large population-based analyses quantifying the risk of thyroid dysfunction (TD) in adults with and without congenital heart disease (ACHD) are lacking. Methods: All adults registered with a major German health insurer (≈9.2 million members) with amiodarone prescriptions were analyzed. Occurrence of amiodarone-associated TD was assessed. Results: Overall, 48,891 non-ACHD (37% female; median 73 years) and 886 ACHD (34% female; median 66 years) received amiodarone. Over 184,787 patient-years, 10,875 cases of TD occurred. The 10-year risk for TD was 38% in non-ACHD (35% ACHD). Within ACHD, compared to amiodarone-naïve patients, the hazard ratio (HR) for TD was 3.9 at 4 years after any amiodarone exposure. TD was associated with female gender (HR 1.42, p < 0.001) and younger age (HR 0.97 per 10 years, p = 0.009). Patients with congenital heart disease were not at increased risk (HR 0.98, p = 0.80). Diagnosis of complex congenital heart disease, however, was a predictor for TD (HR 1.56, p = 0.02). Amiodarone was continued in 47% of non-ACHD (38% ACHD), and 2.3% of non-ACHD (3.5% ACHD) underwent thyroid surgery/radiotherapy. Conclusions: Amiodarone-associated TD is common and comparable in non-ACHD and ACHD. While female gender and younger age are predictors for TD, congenital heart disease is not necessarily associated with an elevated risk.
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Affiliation(s)
- Alicia Jeanette Fischer
- Department of Cardiology III—Adult Congenital and Valvular Heart Disease, University Hospital Muenster, D-48149 Muenster, Germany; (G.B.); (F.D.T.A.); (G.K.); (H.B.); (G.-P.D.)
- Correspondence:
| | - Dominic Enders
- Institute of Biostatistics and Clinical Research, University Hospital Muenster, D-48149 Muenster, Germany;
| | - Lars Eckardt
- Department of Cardiology II—Electrophysiology, University Hospital Muenster, D-48149 Muenster, Germany; (L.E.); (J.K.); (K.W.)
| | - Julia Köbe
- Department of Cardiology II—Electrophysiology, University Hospital Muenster, D-48149 Muenster, Germany; (L.E.); (J.K.); (K.W.)
| | - Kristina Wasmer
- Department of Cardiology II—Electrophysiology, University Hospital Muenster, D-48149 Muenster, Germany; (L.E.); (J.K.); (K.W.)
| | - Günter Breithardt
- Department of Cardiology III—Adult Congenital and Valvular Heart Disease, University Hospital Muenster, D-48149 Muenster, Germany; (G.B.); (F.D.T.A.); (G.K.); (H.B.); (G.-P.D.)
| | - Fernando De Torres Alba
- Department of Cardiology III—Adult Congenital and Valvular Heart Disease, University Hospital Muenster, D-48149 Muenster, Germany; (G.B.); (F.D.T.A.); (G.K.); (H.B.); (G.-P.D.)
| | - Gerrit Kaleschke
- Department of Cardiology III—Adult Congenital and Valvular Heart Disease, University Hospital Muenster, D-48149 Muenster, Germany; (G.B.); (F.D.T.A.); (G.K.); (H.B.); (G.-P.D.)
| | - Helmut Baumgartner
- Department of Cardiology III—Adult Congenital and Valvular Heart Disease, University Hospital Muenster, D-48149 Muenster, Germany; (G.B.); (F.D.T.A.); (G.K.); (H.B.); (G.-P.D.)
| | - Gerhard-Paul Diller
- Department of Cardiology III—Adult Congenital and Valvular Heart Disease, University Hospital Muenster, D-48149 Muenster, Germany; (G.B.); (F.D.T.A.); (G.K.); (H.B.); (G.-P.D.)
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Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. J Am Coll Cardiol 2022; 79:e263-e421. [PMID: 35379503 DOI: 10.1016/j.jacc.2021.12.012] [Citation(s) in RCA: 674] [Impact Index Per Article: 337.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure" replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure" and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure." The 2022 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure. METHODS A comprehensive literature search was conducted from May 2020 to December 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from MEDLINE (PubMed), EMBASE, the Cochrane Collaboration, the Agency for Healthcare Research and Quality, and other relevant databases. Additional relevant clinical trials and research studies, published through September 2021, were also considered. This guideline was harmonized with other American Heart Association/American College of Cardiology guidelines published through December 2021. STRUCTURE Heart failure remains a leading cause of morbidity and mortality globally. The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with heart failure, with the intent to improve quality of care and align with patients' interests. Many recommendations from the earlier heart failure guidelines have been updated with new evidence, and new recommendations have been created when supported by published data. Value statements are provided for certain treatments with high-quality published economic analyses.
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Ono K, Iwasaki YK, Akao M, Ikeda T, Ishii K, Inden Y, Kusano K, Kobayashi Y, Koretsune Y, Sasano T, Sumitomo N, Takahashi N, Niwano S, Hagiwara N, Hisatome I, Furukawa T, Honjo H, Maruyama T, Murakawa Y, Yasaka M, Watanabe E, Aiba T, Amino M, Itoh H, Ogawa H, Okumura Y, Aoki-Kamiya C, Kishihara J, Kodani E, Komatsu T, Sakamoto Y, Satomi K, Shiga T, Shinohara T, Suzuki A, Suzuki S, Sekiguchi Y, Nagase S, Hayami N, Harada M, Fujino T, Makiyama T, Maruyama M, Miake J, Muraji S, Murata H, Morita N, Yokoshiki H, Yoshioka K, Yodogawa K, Inoue H, Okumura K, Kimura T, Tsutsui H, Shimizu W. JCS/JHRS 2020 Guideline on Pharmacotherapy of Cardiac Arrhythmias. Circ J 2022; 86:1790-1924. [DOI: 10.1253/circj.cj-20-1212] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Yu-ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Masaharu Akao
- Department of Cardiovascular Medicine, National Hospital Organization Kyoto Medical Center
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine
| | - Kuniaki Ishii
- Department of Pharmacology, Yamagata University Faculty of Medicine
| | - Yasuya Inden
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yoshinori Kobayashi
- Division of Cardiology, Department of Medicine, Tokai University Hachioji Hospital
| | | | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Shinichi Niwano
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | | | | | - Tetsushi Furukawa
- Department of Bio-information Pharmacology, Medical Research Institute, Tokyo Medical and Dental University
| | - Haruo Honjo
- Research Institute of Environmental Medicine, Nagoya University
| | - Toru Maruyama
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
| | - Yuji Murakawa
- The 4th Department of Internal Medicine, Teikyo University School of Medicine, Mizonokuchi Hospital
| | - Masahiro Yasaka
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center
| | - Eiichi Watanabe
- Department of Cardiology, Fujita Health University School of Medicine
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Mari Amino
- Department of Cardiovascular Medicine, Tokai University School of Medicine
| | - Hideki Itoh
- Division of Patient Safety, Hiroshima University Hospital
| | - Hisashi Ogawa
- Department of Cardiology, National Hospital Organisation Kyoto Medical Center
| | - Yasuo Okumura
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Chizuko Aoki-Kamiya
- Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular Center
| | - Jun Kishihara
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Eitaro Kodani
- Department of Cardiovascular Medicine, Nippon Medical School Tama Nagayama Hospital
| | - Takashi Komatsu
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
| | | | | | - Tsuyoshi Shiga
- Department of Clinical Pharmacology and Therapeutics, The Jikei University School of Medicine
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Atsushi Suzuki
- Department of Cardiology, Tokyo Women's Medical University
| | - Shinya Suzuki
- Department of Cardiovascular Medicine, The Cardiovascular Institute
| | - Yukio Sekiguchi
- Department of Cardiology, National Hospital Organization Kasumigaura Medical Center
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Noriyuki Hayami
- Department of Fourth Internal Medicine, Teikyo University Mizonokuchi Hospital
| | | | - Tadashi Fujino
- Department of Cardiovascular Medicine, Toho University, Faculty of Medicine
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Mitsunori Maruyama
- Department of Cardiovascular Medicine, Nippon Medical School Musashi Kosugi Hospital
| | - Junichiro Miake
- Department of Pharmacology, Tottori University Faculty of Medicine
| | - Shota Muraji
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center
| | | | - Norishige Morita
- Division of Cardiology, Department of Medicine, Tokai University Hachioji Hospital
| | - Hisashi Yokoshiki
- Department of Cardiovascular Medicine, Sapporo City General Hospital
| | - Koichiro Yoshioka
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine
| | - Kenji Yodogawa
- Department of Cardiovascular Medicine, Nippon Medical School
| | | | - Ken Okumura
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
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An updated systematic review on heart failure treatments for patients with renal impairment: the tide is not turning. Heart Fail Rev 2022; 27:1761-1777. [DOI: 10.1007/s10741-022-10216-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 12/11/2022]
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Kolesnik E, Scherr D, Rohrer U, Benedikt M, Manninger M, Sourij H, von Lewinski D. SGLT2 Inhibitors and Their Antiarrhythmic Properties. Int J Mol Sci 2022; 23:1678. [PMID: 35163599 PMCID: PMC8835896 DOI: 10.3390/ijms23031678] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 12/13/2022] Open
Abstract
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are gaining ground as standard therapy for heart failure with a class-I recommendation in the recently updated heart failure guidelines from the European Society of Cardiology. Different gliflozins have shown impressive beneficial effects in patients with and without diabetes mellitus type 2, especially in reducing the rates for hospitalization for heart failure, yet little is known on their antiarrhythmic properties. Atrial and ventricular arrhythmias were reported by clinical outcome trials with SGLT2 inhibitors as adverse events, and SGLT2 inhibitors seemed to reduce the rate of arrhythmias compared to placebo treatment in those trials. Mechanistical links are mainly unrevealed, since hardly any experiments investigated their impact on arrhythmias. Prospective trials are currently ongoing, but no results have been published so far. Arrhythmias are common in the heart failure population, therefore the understanding of possible interactions with SGLT2 inhibitors is crucial. This review summarizes evidence from clinical data as well as the sparse experimental data of SGLT2 inhibitors and their effects on arrhythmias.
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Affiliation(s)
- Ewald Kolesnik
- Department of Cardiology, University Heart Centre Graz, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Daniel Scherr
- Department of Cardiology, University Heart Centre Graz, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Ursula Rohrer
- Department of Cardiology, University Heart Centre Graz, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Martin Benedikt
- Department of Cardiology, University Heart Centre Graz, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Martin Manninger
- Department of Cardiology, University Heart Centre Graz, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Harald Sourij
- Department of Endocrinology and Diabetology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Dirk von Lewinski
- Department of Cardiology, University Heart Centre Graz, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
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Samuel M, Elsokkari I, Sapp JL. Ventricular tachycardia burden and mortality: association or causality? Can J Cardiol 2022; 38:454-464. [DOI: 10.1016/j.cjca.2022.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 12/24/2022] Open
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Diagnostic and prognostic significance of premature ventricular complexes in community and hospital-based participants: A scoping review. PLoS One 2021; 16:e0261712. [PMID: 34941955 PMCID: PMC8699640 DOI: 10.1371/journal.pone.0261712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/07/2021] [Indexed: 11/21/2022] Open
Abstract
Background While there are published studies that have examined premature ventricular complexes (PVCs) among patients with and without cardiac disease, there has not been a comprehensive review of the literature examining the diagnostic and prognostic significance of PVCs. This could help guide both community and hospital-based research and clinical practice. Methods Scoping review frameworks by Arksey and O’Malley and the Joanna Briggs Institute (JBI) were used. A systematic search of the literature using four databases (CINAHL, Embase, PubMed, and Web of Science) was conducted. The review was prepared adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR). Results A total of 71 relevant articles were identified, 66 (93%) were observational, and five (7%) were secondary analyses from randomized clinical trials. Three studies (4%) examined the diagnostic importance of PVC origin (left/right ventricle) and QRS morphology in the diagnosis of acute myocardial ischemia (MI). The majority of the studies examined prognostic outcomes including left ventricular dysfunction, heart failure, arrhythmias, ischemic heart diseases, and mortality by PVCs frequency, burden, and QRS morphology. Conclusions Very few studies have evaluated the diagnostic significance of PVCs and all are decades old. No hospital setting only studies were identified. Community-based longitudinal studies, which make up most of the literature, show that PVCs are associated with structural and coronary heart disease, lethal arrhythmias, atrial fibrillation, stroke, all-cause and cardiac mortality. However, a causal association between PVCs and these outcomes cannot be established due to the purely observational study designs employed.
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37
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Diagnosis and Treatment of Idiopathic Premature Ventricular Contractions: A Stepwise Approach Based on the Site of Origin. Diagnostics (Basel) 2021; 11:diagnostics11101840. [PMID: 34679539 PMCID: PMC8534438 DOI: 10.3390/diagnostics11101840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/30/2022] Open
Abstract
Premature ventricular contractions in the absence of structural heart disease are among the most common arrhythmias in clinical practice, with well-defined sites of origin in the right and left ventricle. In this review, starting from the electrocardiographic localization of premature ventricular contractions, we investigated the mechanisms, prevalence in the general population, diagnostic work-up, prognosis and treatment of premature ventricular contractions, according to current scientific evidence.
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38
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Antiarrhythmic Agents: a Review and Comment on Relevance in the Current Era—Part 2. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021. [DOI: 10.1007/s11936-021-00944-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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39
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Madhasu M, Doda SR, Begari PK, Dasari KR, Thalari G, Kadari S, Yadav JS. Concise total synthesis of antiarrhythmic drug dronedarone via a conjugate addition followed intramolecular heck cyclization. J Heterocycl Chem 2021. [DOI: 10.1002/jhet.4316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Madhu Madhasu
- Department of Organic Synthesis & Process Chemistry CSIR – Indian Institute of Chemical Technology Hyderabad India
| | - Sai Reddy Doda
- Department of Organic Synthesis & Process Chemistry CSIR – Indian Institute of Chemical Technology Hyderabad India
| | - Prem Kumar Begari
- Department of Organic Synthesis & Process Chemistry CSIR – Indian Institute of Chemical Technology Hyderabad India
| | - Krishna Rao Dasari
- Department of Organic Synthesis & Process Chemistry CSIR – Indian Institute of Chemical Technology Hyderabad India
| | | | - Sudhakar Kadari
- Department of Chemistry Osmania University Hyderabad India
- Department of Synthetic research and development A1 Green Pharma Solutions Miyapur India
| | - Jhillu Singh Yadav
- Department of Organic Synthesis & Process Chemistry CSIR – Indian Institute of Chemical Technology Hyderabad India
- School of Science Indrashil University Kadi India
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40
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Affiliation(s)
- Koji Higuchi
- Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
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41
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Qi H, Han K, Chen S. Palladium-Catalyzed Aryl-Furanylation of Alkenes: Synthesis of Benzofuran-Containing 3,3-Disubstituted Oxindoles. J Org Chem 2021; 86:9384-9395. [PMID: 34210128 DOI: 10.1021/acs.joc.1c00617] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A novel palladium-catalyzed aryl-furanylation of alkenes is described. This protocol provided a straightforward route to the synthesis of various benzofuran-containing 3,3-disubstitutedoxindole derivatives bearing a quarternary carbon center. In the cascade process, one C(sp2)-O bond, two C(sp2)-C(sp3) bonds, an oxindole, and a furan ring are formed in a single chemical operation.
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Affiliation(s)
- Hongbo Qi
- Inner Mongolia Key Laboratory of Fine Organic Synthesis, Department of Chemistry and Chemical Engineering, Inner Mongolia University, Hohhot 010021, China
| | - Kaiming Han
- Inner Mongolia Key Laboratory of Fine Organic Synthesis, Department of Chemistry and Chemical Engineering, Inner Mongolia University, Hohhot 010021, China
| | - Shufeng Chen
- Inner Mongolia Key Laboratory of Fine Organic Synthesis, Department of Chemistry and Chemical Engineering, Inner Mongolia University, Hohhot 010021, China
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Cronin EM, Bogun FM, Maury P, Peichl P, Chen M, Namboodiri N, Aguinaga L, Leite LR, Al-Khatib SM, Anter E, Berruezo A, Callans DJ, Chung MK, Cuculich P, d'Avila A, Deal BJ, Della Bella P, Deneke T, Dickfeld TM, Hadid C, Haqqani HM, Kay GN, Latchamsetty R, Marchlinski F, Miller JM, Nogami A, Patel AR, Pathak RK, Saenz Morales LC, Santangeli P, Sapp JL, Sarkozy A, Soejima K, Stevenson WG, Tedrow UB, Tzou WS, Varma N, Zeppenfeld K. 2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias: executive summary. Europace 2021; 22:450-495. [PMID: 31995197 DOI: 10.1093/europace/euz332] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta-analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow-up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias.
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Affiliation(s)
| | | | | | - Petr Peichl
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Minglong Chen
- Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Narayanan Namboodiri
- Sree Chitra Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | | | | | | | - Elad Anter
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | | | | | | | - Andre d'Avila
- Hospital Cardiologico SOS Cardio, Florianopolis, Brazil
| | - Barbara J Deal
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | | | | | - Claudio Hadid
- Hospital General de Agudos Cosme Argerich, Buenos Aires, Argentina
| | - Haris M Haqqani
- University of Queensland, The Prince Charles Hospital, Chermside, Australia
| | - G Neal Kay
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | | | - John M Miller
- Indiana University School of Medicine, Krannert Institute of Cardiology, Indianapolis, Indiana
| | | | - Akash R Patel
- University of California San Francisco Benioff Children's Hospital, San Francisco, California
| | | | | | | | - John L Sapp
- Queen Elizabeth II Health Sciences Centre, Halifax, Canada
| | - Andrea Sarkozy
- University Hospital Antwerp, University of Antwerp, Antwerp, Belgium
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Han FT. Empiric ablation of asymptomatic PVCs when there is greater than 20% burden but normal left ventricular function-An argument in support of catheter ablation. Heart Rhythm O2 2021; 2:205-209. [PMID: 34113923 PMCID: PMC8183869 DOI: 10.1016/j.hroo.2021.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Frederick T Han
- Section of Cardiac Electrophysiology University of California, San Diego Cardiovascular Institute, La Jolla, California
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44
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Kawada S, Chakraborty P, Roche L, Oechslin EN, Silversides C, Wald RM, Downar E, Harris L, Swan L, Alonso-Gonzalez R, Thorne S, Yamamura K, Nanthakumar K, Mondésert B, Khairy P, Nair K. Role of amiodarone in the management of atrial arrhythmias in adult Fontan patients. Heart 2021; 107:1062-1068. [PMID: 33115764 DOI: 10.1136/heartjnl-2020-317378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Patients with Fontan circulation are known to be at high risk for developing atrial tachyarrhythmias (AAs). Our objective was to examine the efficacy and safety of amiodarone in the management of ATs in adult Fontan patients. METHODS Primary outcomes of this single-centre, retrospective study included freedom from AAs and incidence of adverse effects of amiodarone on Fontan patients. Heart failure (HF) events and composite outcomes of death from any cause, Fontan revision and heart transplantation were evaluated as secondary outcomes. Predictors of HF and discontinuing amiodarone were also evaluated. RESULTS A total of 61 patients (mean age 31.6±11.3 years, 40.9% female), who were treated with amiodarone in between 1995 and 2018, were included. AAs free survival at 1, 3 and 5 years were 76.2%, 56.9% and 30.6%, respectively. During a median follow-up of 50.5 months, 34 (55.7%) patients developed side effects, and 20 (32.8%) patients discontinued amiodarone due to side effects. Thyroid dysfunction was the most common side effect (n=26, 76.5%), amiodarone-induced thyrotoxicosis (AIT) (n=16, 27.1%) being most common thyroid dysfunction. Young age (age <28.5 years) was associated with discontinuing amiodarone (HR 5.50, 95% CI 1.19 to 25.4, p=0.029). AIT significantly increased risk of HF (HR 4.82, 95% CI 1.71 to 13.6, p=0.003). CONCLUSIONS Short-term efficacy of amiodarone in Fontan physiology is acceptable. However, long-term administration is associated with a reduction of efficacy and a significant prevalence of non-cardiac side effects. AIT is associated with exacerbation of HF. The judicious use of amiodarone administration should be considered in this population.
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Affiliation(s)
- Satoshi Kawada
- Electrophysiology department, Division of Cardiology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
| | - Praloy Chakraborty
- Electrophysiology department, Division of Cardiology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
| | - Lucy Roche
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - Erwin N Oechslin
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - Candice Silversides
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - Rachel M Wald
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - Eugene Downar
- Electrophysiology department, Division of Cardiology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
| | - Louise Harris
- Electrophysiology department, Division of Cardiology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
| | - Lorna Swan
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - Rafael Alonso-Gonzalez
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - Sara Thorne
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - Kenichiro Yamamura
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada
| | - Kumaraswamy Nanthakumar
- Electrophysiology department, Division of Cardiology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
| | - Blandine Mondésert
- Electrophysiology Service and Adult Congenital Heart Disease, Department of Medicine, Montreal Heart Instiutue, Montreal, Quebec, Canada
| | - Paul Khairy
- Electrophysiology Service and Adult Congenital Heart Disease, Department of Medicine, Montreal Heart Instiutue, Montreal, Quebec, Canada
| | - Krishnakumar Nair
- Electrophysiology department, Division of Cardiology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
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45
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The Care of Patients With Atrial Fibrillation and Heart Failure. Crit Pathw Cardiol 2021; 20:93-99. [PMID: 32769482 DOI: 10.1097/hpc.0000000000000235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Atrial fibrillation (AF) and heart failure (HF) are the 2 emerging epidemics in global cardiovascular disease. AF remains the most common cardiac arrhythmia, affecting over 33 million adults worldwide, and continues to increase in prevalence as the populations of many nations age. The prevalence of HF also surges, now afflicting 37 million adults globally. Interestingly, these 2 disease processes share many of the same risk factors and stem from many of the same pathophysiologic derangements, with AF occurring in over half of all patients with HF and HF occurring in over one third of all patients with AF. Furthermore, exacerbation of one of these ailments often drives decompensation or compromises therapy of the other, and it has been widely reported that coexistence of AF in patients with HF portends a poorer prognosis. As a result, many clinicians now routinely face the problem of AF in the patient with HF. In this review, we highlight the fundamental pathologic forces embedded in the relationship between AF and HF and then proceed to a discussion on the management of these complex patients with a detailed exploration of the clinical data.
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Prabhu S, Kistler PM. Can the Past Re-Shape the Future?: New Insights Into PVC-Mediated Cardiomyopathy From the CHF-STAT Trial and the Retelling of a Familiar Story. JACC Clin Electrophysiol 2021; 7:391-394. [PMID: 33736757 DOI: 10.1016/j.jacep.2020.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Sandeep Prabhu
- Department of Cardiology, Alfred Hospital, Melbourne, Australia; Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia; Department of Cardiology, University of Melbourne, Melbourne, Australia.
| | - Peter M Kistler
- Department of Cardiology, Alfred Hospital, Melbourne, Australia; Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia; Department of Cardiology, University of Melbourne, Melbourne, Australia; Department of Cardiology, Monash University, Melbourne, Australia
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47
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Begala M, Mancinelli M, Quezada E, Delogu GL. GC/MS n analysis of the crude reaction mixtures from Friedel-Crafts acylation: Unambiguous identification and differentiation of 3-aroylbenzofurans from their 4- and 6-regioisomers. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2021; 35:e9082. [PMID: 33733542 PMCID: PMC8244086 DOI: 10.1002/rcm.9082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
RATIONALE 3-Aroylbenzofurans and their 2-nitrophenyl derivatives constitute fundamental intermediates for the synthesis of target compounds with pharmaceutical properties. However, their preparation via the Friedel-Crafts acylation of 2-phenylbenzofurans, using Lewis acid as catalyst, often leads to mixtures of regioisomeric aroylbenzofurans that can be challenging to distinguish, thus preventing the reaction characterization. METHOD We report a method for the unambiguous identification and differentiation of the desired 3-benzoyl isomers from their 4- and 6-regioisomers in a crude reaction mixture using gas chromatography coupled to multiple-stage mass spectrometric (GC/MSn ) analysis performed in collision-induced dissociation (CID) mode. RESULTS Upon electron ionization, each set of isomers displayed nearly identical mass spectra. MSn revealed fragmentation patterns that varied in the location of the benzoyl group on the benzofuran scaffold: CID experiments performed on the molecular ion allowed the distinction of the 3-acyl isomers from the 4- and 6-regioisomers; CID experiments on the [M - Ar]+ ion allowed the distinction of the 4-benzoyl from the 6-benzoyl regioisomer, when the nitro group is located on the 2-phenyl ring. Moreover, the unusual loss of OH• radical allowed ascertaining the position of the nitro group in 3-acyl regioisomers bearing the NO2 group. The origin of the diagnostic OH• loss was investigated through MSn experiments using 18 O-labelled 3-benzoyl derivatives. CONCLUSIONS The method allows the rapid characterization of crude reaction mixtures of benzoylbenzofurans using solely GC/MSn analysis, simplifying the workflow of extensive isolation and purification for structure elucidation.
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Affiliation(s)
- Michela Begala
- Department of Life and Environmental SciencesUniversity of Cagliari, Cittadella Universitarias.p.8, 09042 MonserratoCagliariItaly
| | - Michele Mancinelli
- Department of Industrial Chemistry “Toso Montanari”University of BolognaViale del Risorgimento 4Bologna40136Italy
| | - Elias Quezada
- Department of Organic ChemistryUniversity of Santiago de CompostelaSantiago de Compostela15782Spain
| | - Giovanna Lucia Delogu
- Department of Life and Environmental SciencesUniversity of Cagliari, Cittadella Universitarias.p.8, 09042 MonserratoCagliariItaly
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48
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Jenghua K, Chinwong S, Chinwong D, Kanjanarat P. Development of a list of potentially inappropriate medications for patients with heart failure (PIMHF). Res Social Adm Pharm 2021; 17:894-903. [DOI: 10.1016/j.sapharm.2020.07.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/10/2020] [Accepted: 07/19/2020] [Indexed: 12/28/2022]
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49
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Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, Boriani G, Castella M, Dan GA, Dilaveris PE, Fauchier L, Filippatos G, Kalman JM, Meir ML, Lane DA, Lebeau JP, Lettino M, Lip GY, Pinto FJ, Neil Thomas G, Valgimigli M, Van Gelder IC, Van Putte BP, Watkins CL. Guía ESC 2020 sobre el diagnóstico y tratamiento de la fibrilación auricular, desarrollada en colaboración de la European Association of Cardio-Thoracic Surgery (EACTS). Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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50
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Yoshie K, Yamasaki M, Yokoyama M, Ueki Y, Tachibana E, Yonemoto N, Nagao K. Prognostic benefits of prior amiodarone or β-blocker use before the onset of ventricular arrhythmia with hemodynamic collapse. Heart Vessels 2021; 36:1430-1437. [PMID: 33721036 DOI: 10.1007/s00380-021-01821-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/26/2021] [Indexed: 11/26/2022]
Abstract
Although antiarrhythmic drugs have long been used for the suppression of various types of arrhythmias, their prior use before the onset of ventricular arrhythmia with hemodynamic collapse and the effect on prognosis is not well known. Data from 1004 consecutive patients with cardiovascular shock in the Japanese Circulation Society's Shock Registry were analyzed. Eighty-four cases of ventricular arrhythmia-induced shock and ROSC (return of spontaneous circulation) were divided into the prior amiodarone or β-blockers use group (Aβ group, n = 27) and the non-amiodarone and non-β-blockers use group (non-Aβ group; n = 57) based on treatment before the onset of those arrhythmias. Clinical outcomes related to hemodynamic collapse such as OHCA (out-of-hospital cardiovascular arrest) was less in the Aβ group [Aβ group, 11/26 (42%) vs. non-Aβ group, 41/56 (73%); p = 0.007]. Similarly, syncope was less common in the Aβ group than in the non-Aβ group [Aβ group 4/27 (15%) vs. non-Aβ group 27/57 (47%); p = 0.004]. Furthermore, prior amiodarone or β-blockers use before the onset of ventricular arrhythmias was strongly associated with both survival at discharge (odds ratio 3.19; 95% confidence interval 1.06-9.67; p = 0.040) and neurological outcomes at discharge (odds ratio 3.96; 95% confidence interval 1.32-11.85; p = 0.014) based on multivariate logistic regression analysis. Prior amiodarone or β-blockers use before the onset of malignant ventricular arrhythmia and maintaining appropriate blood concentrations in advance is associated with a good survival rate and better neurological outcomes after recovery from ventricular arrhythmia with hemodynamic collapse.
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Affiliation(s)
- Koji Yoshie
- JCS Shock Registry Scientific Committee, Tokyo, Japan.
- Department of Emergency and Intensive Care Center, Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan.
| | | | | | - Yasushi Ueki
- JCS Shock Registry Scientific Committee, Tokyo, Japan
| | | | | | - Ken Nagao
- JCS Shock Registry Scientific Committee, Tokyo, Japan
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