Características clínicas de pacientes con falla cardiaca aguda según la función ventricular izquierda / Clinical characteristics of acute heart failure patients according to left ventricular function

Resumen Introducción: la insuficiencia cardiaca aguda es la causa más frecuente de hospitalización en pacientes mayores de 65 años. A la fecha se han publicado pocos estudios descriptivos en la población colombiana, por lo que se realizó un estudio observacional que expone las características clínicas de los pacientes con diagnóstico de falla cardiaca aguda en Colombia. Métodos: se hizo un estudio observacional tipo corte-transversal con información obtenida de historias clínicas de pacientes con diagnóstico de falla cardiaca aguda entre los años 2011 a 2015 en la Fundación Santa Fe de Bogotá. Estos datos se recolectaron a través del Registro Colombiano de Enfermedad Cardiovascular (RECODEC). Resultados: se analizaron los datos de 550 pacientes, con un promedio de edad de 77 años. El análisis univariado evidenció mayor prevalencia de la enfermedad en hombres (55%) y una importante relación con hipertensión arterial (78,2%), enfermedad coronaria (31,8%) y fibrilación auricular (29,6). En cuanto a la estancia hospitalaria, se observó un promedio de 8 días en hospitalización general y de 1 día en la unidad de cuidado intensivo. En el análisis bivariado se dividieron los pacientes en tres grupos según la fracción de eyección del ventrículo izquierdo: disminuida (<40%), limítrofe (41-49%) y preservada (>50). Como desenlaces finales se evaluaron mortalidad (8,4%) y aparición de arritmias (22,5%). Conclusiones: el análisis de la base de datos de RECODEC se ha utilizado para evaluar los aspectos epidemiológicos y clínicos de la enfermedad cardiovascular. Existe la necesidad de crear registros nacionales que en general permitan analizar el comportamiento de la población colombiana.

Abstract Introduction: Acute heart failure is the most frequent cause of hospital admissions in patients over 65 years-old. Only few descriptive studies have been published on the Colombian population. The aim is to carry out an observational study that determines the clinical characteristics of patients with acute heart failure in a hospital in Colombia. Methods: An observational, cross-sectional study was conducted using information from clinical records of patients diagnosed with acute heart failure between 2011 and 2015 in our Foundation. These data were collected using the Colombian Registry of Cardiovascular Disease (RECODEC). Results: The analysis was performed on the data from 550 patients, with a median age of 77 years. The univariate analysis showed a higher prevalence of the disease in men (55%), and a significant association with hypertension (78.2%), coronary disease (31.8%), and atrial fibrillation (29.6%). In the bivariate analysis, the patients were divided into three groups according to their left ventricular ejection fraction: decreased (<40%), restricted (41%-49%), and preserved (> 50%), with the preserved ejection fraction being the most prevalent. The main outcomes were mortality (8.4%) and the occurrence of arrhythmias (22.5%). Conclusions: It is important to take into account that the analysis of the RECODEC database has been used to evaluate the epidemiological and clinical aspects of cardiovascular disease. However, there is a need to create registries at a national level in order to analyse the general characteristics of the Colombian population.

The clinical characteristics and prognosis of patients with peripartum cardiomyopathy / 中华内科杂志

Objective To explore the clinical characteristics and risk factors in patients with peripartum cardiomyopathy (PPCM).Methods A total of 35 patients admitted in Peking Union Medical College Hospital and diagnosed with PPCM between January 1995 and December 2014 was included and analyzed in this study.The subjects were divided into two groups:the early recovery and delayed recovery.Early recovery was defined as normalization of left ventricle ejection fraction (LVEF) ≥ 50％ before 6 months post-diagnosis.Delayed recovery was defined if the length of time required for recovery of LVEF was longer than 6 months or death was reported during follow-up.Risk factors for delayed recovery were assessed.Results The incidence of PPCM was 1 per 1 067 deliveries between the study periods.The age of the 35 patients was (28.9±5.6) years old.Among them,20 (57.1％) patients were not in the first pregnancy,13 (37.1％) had delivered before,and 5 (14.3％) patients had twin pregnancies.The LVEF at diagnosis was (34.1 ±8.0) ％.62.9％ (22 cases) of the subjects were in the early recovery,while 37.1％ (13 cases) of the subjects were in the delayed recovery group,2 of whom suffered death.Multivariate logistic regression indicated that LVEF (OR =1.339,95％ CI 1.063-1.688,P =0.013) and left ventricle end-dilated diameter(OR 0.763,95％CI 0.607-0.960,P =0.021)were independent risk factors for delayed recovery.Conclusions PPCM is a rare but life-threatening complication of pregnancy.LVEF and left ventricle end-dilated diameter at diagnosis were two independent factors associated with the prognosis of PPCM.

Comparison of Cardiac Function Evaluation by 128-Slice Single Source Retrospectively Gated Cardiac CT and 2D/M- mode Echocardiography.

Aims: To study the correlation of Cardiac function/ejection fraction derived from 128 slice MDCT (multi detector computed tomography) results with those of functional data from 2D/M-mode echocardiography. Study Design: Retrospective, comparative study with empirical data. Place and Duration of Study: Department of Radiology at K. Govindaswamy Naidu Medical Trust hospital, Coimbatore, between May 2013 and October 2013. Methodology: For this study, 44 patients (M: F = 35: 9; mean age = 49 years) were randomly chosen who had come between May 2013 and October 2013. All the patients were referred to our department from cardiology as well as non-cardiology OPD’s for coronary CT angiography. Ejection fraction data was obtained using two methods; M-mode echocardiography and 128-slice MDCT using retrospective ECG gated coronary angiographic study. Results: The mean of LVEF (left ventricle ejection fraction) by echo is 64.73 with standard deviation of +/- 5.48 and the mean of LVEF by cardiac CT is 65.18 with standard deviation of +/- 8.70 with P- value of 0.770 (P value ranges from 0-1) which shows good correlation. The evaluation of LVEF by linear regression analysis show good correlation between LVEF by echo and MDCT. (r= 0.486). [r value ranges between -1 and +1]. Conclusion: This study shows the cardiac function evaluation using 128 slice MDCT is as good as the 2D- echocardiography thus the results are interchangeable between the modalities.

Outcome of patients with low ejection fraction undergoing coronary artery bypass grafting / 国际外科学杂志

Objective To evaluate the outcome of patients with low ejection fraction undergoing coronary artery bypass grafting.Methods One hundred and twenty-eight consecutive patients with left ventricular ejection fraction (LVEF) ≤35％,who underwent Off-pump caronary bypass surgery or Cardiopulmonary coronary artery bypass between December 2000 and Novomber 2010 were studied.The outcome of early complication,mortality,LVEF were analyzed.Results LVEF and LVEDD were significantly increased in early postoperation (P ＜ 0.05 ).Use of Intra-aotric balloon counterpulsation(IABP) can decrease early mortality,and postopertive respiratory tract infections,renal insufficiency were found to be the main complications.Conclusions Preoperative low ejection fraction has no relationship with postoperative early mortality.using medicine to adjust heart function,strcity control blood pressure,blood glucose,heart rate preoperation,positive use of IABP postoperativon are key point to decrease early mortality.