Journal of Integrative Cardiology Open Access

Journal Information
ISSN / EISSN : 2674-2489 / 2674-2489
Published by: Science Repository OU (10.31487)
Total articles ≅ 112
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Kassi Anicet Adoubi, Esaie Kossa Soya, Florent Kouakou Diby, Thierry Niamkey, Pinnin Ouattara, Chrisophe Konin
Journal of Integrative Cardiology Open Access, Volume 2022, pp 1-8; https://doi.org/10.31487/j.jicoa.2022.03.01

Abstract:
Background: New classification of heart failure according to ejection fraction calls for exploring in black Africans. Objectives: To determine our patient's characteristics and prognosis of the subtypes of heart failure. Methods: We analysed data from consecutive black African patients hospitalised for heart failure at Heart Institute of Abidjan in 2018 and followed up for one year. Results: Were considered 251 heart failure patients (age: 55.5 ± 16.3 years, 63.7% of males) with preserved (HFpEF) (18.7%), mid-range (HFmrEF) (17.6%), and reduced ejection fraction (HFrEF) (63.7%). HFpEF patients were older (p <0.0001) and had more frequently. acute pulmonary oedema. From an echocardiographic point of view, HFpEF patients had, on average, a smaller left ventricle than the other patients (p <0.001), but a larger left atrium (p <0.05). Clinically, these patients were admitted more often with acute pulmonary oedema (p = 0.01) and had more often comorbidities (p=0.00)4. However, survival was better with HFpEF patients than HFrEF patients (log-rank = 4.61; p = 0.032). HFmrEF patients have an intermediate profile. Conclusion: In our context, although they have the same expression, HFrEF and HFPEF appear very different. We need further studies for a better understanding of HFmrEF.
Vasilopoulou Angeliki, Georgas A, Hristoforou E
Journal of Integrative Cardiology Open Access, Volume 2022, pp 1-7; https://doi.org/10.31487/j.jicoa.2022.02.02

Abstract:
Nowadays, problems in healthcare sector seem to be more crucial than ever. Among these, cardiovascular diseases (CVDs) play an important role, being for years a major threat to human health. In a bid to reduce the number of deaths due to heart diseases by taking precautions, science has turned to the development of devices able to offer early diagnosis of a heart failure. Recently, many biosensors have been developed based on cardiac biomarkers that can be detected in blood and predict the risk of heart failure. Of these, cardiac troponin is the best known, while C-reactive protein and myoglobin have also been used. Troponin is a complex of proteins found in the thin filaments of striated muscles and consists of three protein subunits, I, C and T. In case of myocardial malfunction, troponin is released into the blood. Consequently, the detection of elevated troponin levels at an early stage in human serum, is an indication of high risk of cardiovascular event enabling early medical intervention and treatment. In the present work, after the analysis of heart diseases, medical tests, troponin and its role in controlling myocardial health, there is an overview of the available biosensor platforms for cardiac biomarkers detection.
Cândido Celso Coimbra, Daniel Carvalho de Lima, Helton Oliveira Campos, Lucas Rios Drummond, Simonton Andrade Silveira, Andrea Siqueira Haibara
Journal of Integrative Cardiology Open Access, Volume 2022, pp 1-3; https://doi.org/10.31487/j.jicoa.2022.02.03

Abstract:
The present study shows that hyperglycemic response to hemorrhage is an easy method for evaluating metabolic adjustments in normal rats and in other models that show autonomic and metabolic imbalances. In this regard, the baroreflex control of hyperglycemic response induced by hemorrhage hypotension was evaluated by removing blood through the jugular catheter (1.2 mL/100g b.w./ 2 min). Blood samples (0.2mL) were collected immediately before hemorrhage and at 5, 10, 20 and 30 minutes after hemorrhage [1, 2]. In addition, the baroreflex control of heart rate was assessed by pharmacological test, using intravenous doses of phenylephrine hydrochloride (PE, 10 μg/mL) and sodium nitroprusside (SNP, 10 μg/mL) in random order. Heart rate and blood pressure were measured through the insertion of a polyethylene catheter inserted into the abdominal aorta through the left femoral artery. The derived variables of baroreflex control to heart rate and hemorrhage hyperglycemia response were measured according to the following equation: Y = A1/{1+ exp[A2(X - A3)]} + A4. The evaluation of a new approach for studying the baroreflex effects on metabolic adjustments was done with animals fed with a hypercaloric diet. Hypercaloric diet induced an upward shift in the baroreflex curve to heart rate (p<0.05) and an increased heart rate reflex due to the change in MAP during the operating range (p<0.05). It also shifted the baroreflex curve to a higher level of hyperglycemic response to hemorrhage (p<0.05), as well as, increased maximal gain (p<0.05) and augmented hyperglycemic response to hemorrhage hypotension during the operating range (p<0.05). Therefore, we propose that the baroreflex control of hyperglycemic response should be a useful tool for evaluating metabolic dysfunction related to hemorrhage in models of animals that show autonomic imbalance, such as malnutrition, hypertension, diabetes and obesity.
Feras Chehade, Antoine El Khoury, Samer Nasr
Journal of Integrative Cardiology Open Access, Volume 2022, pp 1-8; https://doi.org/10.31487/j.jicoa.2022.02.01

Abstract:
Objective: Transthyretin cardiac amyloidosis is a rapidly progressive disease, remains underdiagnosed, and has long been considered a rare disease. Diagnosis decision making cannot be based on echography and MRI findings alone because they lack accuracy. However, it requires invasive test of myocardial or fat pad biopsies. Thus, the diagnosis is challenging, and the non-invasive scintigraphic technique using bone-seeking radiopharmaceuticals has become a cornerstone in the workup revealing a myocardial uptake. Our work consists of a single institution retrospective study aiming to estimate the bone scintigraphies, and the prevalence of the transthyretin cardiac amyloidosis in our population. Methods: We have carried out a census of the incidental cardiac uptake on routine bone scintigraphy in 2211 consecutive patients enrolled between 2009 and 2020, mostly performed for oncologic purposes. The visual analysis of the scintigraphic images classifies the cardiac uptake into 3 levels of gradation and evokes the diagnosis of the TTR cardiac amyloidosis in grades 2 and 3. Results: Different grades of myocardial uptake were observed in 1.37 % of all patients. Prevalence of uptake was 0.37% in the 50th, increased dramatically at the 60th (2.49%), and reached 4% above the age of 80. The diagnostic grades 2 and 3 cardiac uptakes were identified in 5 patients (0.23% of overall patients) ranging between 56- and 91-y-old. Our results concord with the trend of disease increases with age. Conclusion: The careful analysis of the bone scintigraphy of all incoming adult patients should allow to make the diagnosis of the TTR cardiac amyloidosis at a preclinical stage and establish new effective treatments. Our results provide an estimate of the number of patients that could be diagnosed and improve the awareness of the corresponding prevalence in our population. In this way, multicentric studies should be implemented by enrolling large cohorts of bone scintigraphy cases.
Pio Machihude, S Pessinaba, Hd Sama, Ym Afassinou, Kyr D Almeida, B Atta, T Tcherou, Wd Kaziga, Am Bakai
Journal of Integrative Cardiology Open Access, Volume 2022, pp 1-5; https://doi.org/10.31487/j.jicoa.2022.01.01

Abstract:
Objective: To evaluate the 24-hour Holter ECG recording in hypertensive heart disease. Methods: This was a descriptive and analytical cross-sectional study on files of patients with hypertensive heart disease, carried out from October 2016 to October 2019, in two health facilities in Lome (TOGO). Electrical left ventricular hypertrophy (LVH) was defined by the Sokolow-Lyon and Cornell indices. On echocardiography, the HVG according to the criteria of the American Society of Echocardiography, was the characteristic retained for a CH. Holter-ECG recordings were carried out over 24 hours by two Holter devices. Results: 107 patients were included, with a sex ratio of 1.89 (M / F). The mean age was 62.2 ± 12 years. The mean duration of the evolution of hypertension was 10.8 ± 9.1 years. On standard ECG, arrhythmias were more frequent (32.6%) with ACFA in 5.6% of cases. The prevalence of echocardiographic HVG was 74.8%, predominantly concentric, and was significantly found in hypertensive patients over 10 years of age. During the 24-hour Holter ECG recording, ACFA was the common arrhythmia (30%), episodic in 90.6% of cases and permanent 9.4% and was statistically associated with OG size, sex and age. The Holter ECG detected sustained ventricular tachycardia in 7 patients (6.5%). The Recording was normal 12.1% of the time. Conclusion: Hypertensive heart disease is the first of the cardiac complications of hypertension. The Holter ECG is a tool for the detection of fatal severe paroxysmal events that go unnoticed on the surface ECG such as AC/AF, sustained ventricular tachycardias.
Mario Bendersky
Journal of Integrative Cardiology Open Access, Volume 2021, pp 1-2; https://doi.org/10.31487/j.jicoa.2021.03.02

Abstract:
In this short communication we report complementary data to previous ones, which confirm the effects of spironolactone in reducing AASI, a marker of arterial stiffness, in essential hypertensive patients after 6 months of treatment.
Lei Xu, Chengfen Yin, Jianguo Li, Zhiyong Wang, Yongle Zhi
Journal of Integrative Cardiology Open Access, Volume 2021, pp 1-6; https://doi.org/10.31487/j.jicoa.2021.04.03

Abstract:
On March 12, 2020, the World Health Organization (WHO) announced that the coronavirus disease 2019 (COVID-19) outbreak had become a pandemic. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which primarily infects the lower airways and binds to Angiotensin-Converting Enzyme 2 (ACE2) on alveolar epithelial cells. ACE2 is widely expressed, not only in the lungs but also in the cardiovascular system. Therefore, SARS-CoV-2 can also damage the myocardium. We analysed three COVID-19 cases that resulted in death and found that either COVID-19 or antiviral drugs could affect the coupling between the autonomic nervous system and the sinus node, thus affecting heart rate variability and preventing the heart rate from rising in response to the increase in body temperature. Early detection of the preclinical phase of cardiac autonomic dysfunction may help determine patients in need of aggressive treatment and control of cardiovascular risk factors. Antiviral drugs should be used with caution in patients with heart injury.
Maj Siercke, Sanne Pagh Moller, Lau Caspar Thygesen, Henrik Sillesen, Dorthe Overgaard
Journal of Integrative Cardiology Open Access, Volume 2021, pp 1-13; https://doi.org/10.31487/j.jicoa.2021.04.01

Abstract:
Aim: This study aimed to explore how qualitative data about rehabilitation for patients with intermittent claudication do provide an enhanced understanding of the quantitative experimental results. Background: The study was a randomized clinical trial comparing a rehabilitation intervention with usual care. A statistically significant difference between rehabilitation and usual care was found in walking distance, physical activity, quality of life and diet. The findings from the quantitative and qualitative analyses were analysed separately on their own tradition. In this study, mixed methods address whether the qualitative results could help explain the quantitative results and bring forward additional information. Design: Complex mixed-method intervention design with a convergent questionnaire variant. Methods: From April 2017- May 2019, patients diagnosed with intermittent claudication were included in a randomized clinical trial (N=118). In addition, qualitative interview informants from the intervention group were sampled from the quantitative study population for a survey (N=43) and focus group interviews (N=10). Interviews were conducted from April 2018-August 2019. Results: Integrated analyses identified how improvement in walking distance, physical activity, diet and quality of life was affected by team spirit, pedometer, education and fun exercise in a local setting. Quantitative and qualitative findings primarily confirmed and expanded each other; however, two discordant results were also evident. Conclusion: Our study adds empirical evidence regarding how a mixed-methods study can be used to obtain a more nuanced understanding of complex healthcare problems. The study provides new knowledge concerning how to set up a rehabilitation programme for patients with intermittent claudication.
Xu Ma, Yulong Li, Qi Sun, Ting Ding, Li Mu, Hui Yuan
Journal of Integrative Cardiology Open Access, Volume 2021, pp 1-7; https://doi.org/10.31487/j.jicoa.2021.03.04

Abstract:
Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a risk predictor for cardiovascular diseases (CVD). Generally, plasma Lp-PLA2 was thought to be secreted by circulatory inflammatory cells. Lp-PLA2 mRNA expression of PBMC may also be a risk predictor. Methods: A total of 104 subjects angiographically verified ACS patients were enrolled, including 73 unstable angina pectoris (UAP) patients and 31 acute myocardial infarction (AMI) patients. Plasma lipids, Lp-PLA2 activity and Lp-PLA2 mass were measured. Lp-PLA2 mRNA expression of PBMC was relatively quantified by real-time fluorescence PCR. Results: Plasma Lp-PLA2 activity was increased in AMI patients compared to UAP patients (395.21±145.91 vs. 328.53±127.03 U/L, p=0.024). Lp-PLA2 mass of AMI patients was also higher than UAP patients (136.43±45.46 vs. 119.16±44.19 ng/mL, p=0.093), while PBMC mRNA expression was not statistically different [1.07 (0.74, 1.57) vs. 0.88(0.49, 1.99), p=0.453]. Comparing Lp-PLA2 mRNA by groups, Lp-PLA2 mRNA level was higher in male ACS patients and smoking ACS patients (p=0.008, p=0.048, respectively). Multivariate logistic regression analysis showed that Lp-PLA2 activity was an AMI risk predictor (OR=5.224, 95% CI 1.687-16.181, p=0.004), after smoking, systolic blood pressure, diabetes and hyperlipidemia were adjusted. Recurrent ACS patients were older (p=0.035), but they showed lower levels of Lp-PLA2 mass and Lp-PLA2 activity (p=0.014, p=0.045, respectively), compared to primary ACS patients. Conclusion: Smoking may be an important regulatory factor for Lp-PLA2 mRNA expression in PBMC. Among three Lp-PLA2 indexes, Lp-PLA2 activity was the best marker indicating AMI risk, while Lp-PLA2 mass maybe play better role as a predictor in avoiding ACS recurrence.
Ruchi Bhandari, R. Constance Wiener, Christopher Waters, Cassandra Bambrick
Journal of Integrative Cardiology Open Access, Volume 2021, pp 1-6; https://doi.org/10.31487/j.jicoa.2021.03.08

Abstract:
Patients with opioid use disorder are more likely to get coronavirus disease 2019 (COVID-19). Cardiovascular diseases frequently present in COVID-19 patients and can increase their susceptibility to invasive infectious diseases, such as infective endocarditis (IE). This study examines the difference in IE incidence following COVID-19 diagnosis between individuals with and without non-medical opioid use. De-identified electronic medical records data were retrieved from TriNetX, a web-based database. Patients in the U.S., aged 18-60 years, with a diagnosis of COVID-19 during January 2020 - January 2021 were included in this study. Development of IE was determined within three months after COVID-19 diagnosis. Logistic regression was conducted to estimate the risk of developing IE between COVID-19 patients with and without opioid use after propensity score matching. COVID-19 patients with non-medical opioid use had 6.8 times the risk of developing IE compared with COVID-19 patients without opioid use (95% CI: 5.44, 8.56; p<0.0001) after propensity score matching. Findings suggest a significant risk of IE among COVID-19 patients with a history of non-medical opioid use. It provides objective evidence to account for baseline opioid use in the risk assessment of IE among COVID-19 patients.
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