Cardiovascular Reviews

Research Progress on Coronary Microvascular Diseases

Jieying Zhu — 2024-03-29

Coronary microvascular disease (CMVD) is a multifactorial myocardial ischemia-angina condition mainly stemming from abnormalities in the structure and function of coronary microvessels. Currently, there is no specialized treatment for CMVD. Therefore, enhancing research on CMVD can generate insights for subsequent clinical development of personalized treatments. This article delves into the research progress of CMVD and comprehensively reviews its definition, classification, epidemiology, pathological mechanisms, non-drug treatments, and advancements in Western medicine and traditional Chinese medicine approaches.

The Effect of Percutaneous Coronary Intervention in Elderly Patients with Coronary Heart Disease and Its Impact on Cardiac Function Indicators

Wenlin Lu — 2024-03-29

Objective: To analyze the role of percutaneous coronary intervention and its value in elderly patients with coronary heart disease. Methods: A total of 88 elderly patients diagnosed with coronary heart disease between June 2022 and June 2023 were recruited and divided into two groups using the random number table method, with 44 cases in each group. The control group received conventional drug therapy, while the observation group received percutaneous arterial interventional treatment in addition to conventional drug therapy. Clinical efficacy, adverse cardiovascular events, cardiac function indicators, and quality of life were observed in both groups. Results: The observation group demonstrated a significantly higher total effective rate and significantly lower adverse cardiovascular events (P < 0.05). Furthermore, after treatment, the observation group showed a higher left ventricular ejection fraction, as well as lower left ventricular end-systolic diameter, left ventricular end-systolic volume, left ventricular end-diastolic diameter, and left ventricular end-diastolic volume (P < 0.05). Additionally, the observation group had higher scores in all eight dimensions of the SF-36 scale (P < 0.05). Conclusion: For elderly patients diagnosed with coronary heart disease, percutaneous coronary intervention can achieve superior clinical efficacy and high safety and can help improve cardiac function indicators and quality of life.

Sequential Treatment of Acute Heart Failure in the Elderly: Efficacy of Recombinant Human Brain Natriuretic Peptide and Sacubitril-Valsartan

Zhen Huang — 2024-03-29

Objective: To explore the clinical efficacy of recombinant human brain natriuretic peptide (rhBNP) and sacubitril-valsartan in the sequential treatment of acute heart failure (AHF) in older individuals. Methods: Clinical data from 64 older patients with AHF were collected for this study. The patients were divided into two groups: a control group (Group A, n = 34) and an observation group (Group B, n = 30) based on different treatment regimens. Group A received rhBNP treatment, while Group B received sequential treatment with rhBNP and Sacubitril-Valsartan. The evaluation of the sequential treatment’s effect on older patients with AHF was conducted using various indicators. Results: The clinical efficacy rate in Group A (93.33%) was significantly higher than that in Group A (73.53%), with a significant difference observed (P < 0.05). Furthermore, after treatment, the clinical efficacy remained significantly higher in Group B than in Group A. Group B exhibited a significantly higher left ventricular ejection fraction (LVEF) and significantly lower systolic blood pressure, diastolic blood pressure, and heart rate compared to Group A (P < 0.05). Although the left ventricular end-diastolic diameter (LVEDD) was lower in Group B after treatment, the difference was not statistically significant (P = 0.127). Moreover, post-treatment levels of NT-proBNP were significantly lower in Group B compared to Group A (P = 0.01). Additionally, Group B had shorter hospitalization times, faster improvement in clinical symptoms, and further 6-minute walking distances after the treatment compared to Group A (P < 0.01). Conclusion: Sequential treatment with rhBNP and Sacubitril-Valsartan demonstrates promising therapeutic effects in older patients with AHF, suggesting its potential for broader adoption and promotion in clinical practice.

A Case in Which Identification of Cardiac Scar Tissue by MDCT Was Effective in Ablation for Ventricular Tachycardia – A Secondary Publication

Takahiro Iseda — 2024-03-29

During catheterization of ventricular tachycardia, it is often found difficult to identify the origin of ventricular tachycardia when tachycardia is not induced during the procedure or hemodynamics are disrupted. Late gadolinium enhancement (LGE) in cardiac MRI and late Iodine enhancement (LIE) in cardiac CT are reportedly performed to identify myocardial scar tissue and estimate the origin of ventricular tachycardia preoperatively. However, although LGE is useful for identifying the origin of tachycardia, the slice thickness is large and imaging takes a long time, and if a premature beat occurs or the device is inserted during imaging, a good image cannot be obtained. On the other hand, LIE also has poor resolution, making it difficult to take clear images. In this case report, the origin of ventricular tachycardia was presumed preoperatively using a new image processing method called Subtraction Myocardial Image for Late Iodine Enhancement (SMILIE) using a 320-row Area Detector CT, which was useful during catheter ablation.

Progress in the Study of Drugs for Thrombolytic Therapy of Acute Myocardial Infarction

Yayun Ling — 2024-03-29

Acute myocardial infarction has become a serious disease that affects the quality of contemporary human survival, and improved efficacy and risk avoidance can be achieved through the upgrading of thrombolytic drugs and precise intervention. This article takes the development of three generations of thrombolytic drugs as the main line, and combs through the development of thrombolytic drugs from the era of urokinase and streptokinase to Alteplase and single-chain urokinase-type fibrinogen activator and their respective advantages and disadvantages. The advantages of three generations of tissue-type fibrinogen kinase derivatives, Reteplase, and tenecteplase, are compared and described in this article.

Prognostic Value of Cardiac Color Doppler Ultrasound in Patients with Chronic Heart Failure

Meidi Zhu — 2024-03-29

Objective: To investigate the value of cardiac color Doppler ultrasound (CDUS) in determining the clinical characteristics and assessing the prognosis of patients with chronic heart failure (CHF). Methods: 200 patients with CHF admitted to our hospital from January 2021 to June 2023 were selected as the study subjects, and these 200 patients were followed up for 6 months, with 159 cases in the surviving group and 41 cases in the deceased group, and examined with a diagnostic CDUS instrument (model GEVividE95ACUSONSC2000). The detection rate of chronic heart failure and cardiac function indexes of the two groups were observed. Results: The deceased group showed a chronic heart failure detection rate of 92.68%, which was significantly higher than the surviving group (76.73%; P < 0.05). Moreover, the cardiac function indexes of both groups were significantly different (P < 0.05). Conclusion: By performing cardiac ultrasonography on patients with CHF, their cardiac function can be clearly understood and the changes can be timely detected during treatment, hence physicians can formulate a more reasonable treatment plan for patients and improve their quality of life.

A Case of Cone Reconstruction and Aortic Valve Replacement for an Adult Patient Diagnosed with Ebstein’s Anomaly Incidentally during Preoperative Examination of Severe Aortic Regurgitation – A Secondary Publication

Hiroki Sunadoi — 2024-03-29

Recently, there have been some reports that cone reconstruction can be performed in the repair of Ebstein’s anomaly with acceptable results on a child. On an adult with Ebstein’s anomaly, optimal surgical indication and choice of the operative procedure are controversial. A man in his seventies was diagnosed with Ebstein’s anomaly incidentally during the preoperative examination of severe aortic regurgitation. We performed aortic valve replacement and cone reconstruction because his tricuspid regurgitation was moderate. There was no severe complication and he was discharged. No sign of recurrence has been observed after 4 months of follow-up. We present a case in which cone reconstruction and aortic valve replacement were successfully performed on an adult patient diagnosed with Ebstein’s anomaly and severe aortic regurgitation.

Effectiveness of Sodium Creatine Phosphate Combined with Immunoglobulin in the Treatment of Patients with Viral Myocarditis

Fen Yang — 2024-05-07

Objective: To study the effect of using sodium creatine phosphate combined with immunoglobulin therapy in the treatment of patients with viral myocarditis. Methods: Fifty-six cases of viral myocarditis patients were selected and randomly grouped, with 28 cases in each group. The study group underwent treatment using sodium creatine phosphate combined with immunoglobulin, while the control group underwent treatment using immunoglobulin. The outcome differences were compared. Results: After treatment, the study group showed significantly better cardiac function indexes, significantly lower myocardial enzyme spectrum indexes, significantly lower inflammatory mediator levels, and significantly shorter clinical symptom disappearance time as well as recovery time of myocardial enzyme spectrum as compared to the control group (P < 0.05). Conclusion: The effect of using sodium creatine phosphate combined with immunoglobulin in the process of treating patients with viral myocarditis is ideal.

Clinical Effects of Sildenafil in the Treatment of Congenital Heart Disease with Pulmonary Hypertension

Meijuan Ma — 2024-05-08

Objective: To analyze the improvement of mean pulmonary arterial pressure and oxygenation index as well as the therapeutic effect of sildenafil treatment in patients with congenital heart disease and pulmonary arterial hypertension. Methods: A total of 104 patients with congenital heart disease and pulmonary arterial hypertension were recruited from February 2023 to January 2024 and grouped into study and control groups using a randomized numerical table, with 52 patients in each group. The study group received sildenafil treatment, while the control group received conventional treatment. The therapeutic effects of both groups were analyzed and compared. Results: The study group had an average pulmonary arterial pressure of 26.23 ± 2.16 mmHg, an oxygenation index of 241.63 ± 4.86, and a total effective treatment rate of 98.08%, which was significantly better than the control group (P < 0.05). Conclusion: By implementing sildenafil treatment for patients with congenital heart disease and pulmonary hypertension, the mean pulmonary artery pressure and oxygenation index of the patients improved significantly, and the effective rate of treatment increased significantly.