ABSTRACT
BACKGROUND: Intravascular lithotripsy (IVL) is a novel technique increasingly used for plaque modification and endovascular revascularization in patients with severe calcification and peripheral artery disease. However, much of the available literature on IVL is focused on its use in coronary arteries, with relatively limited data on non-coronary artery use. AIM: To analyze the safety and efficacy of current IVL use in non-coronary artery lesions, as reported in case reports and case series. METHODS: We searched EMBASE, PubMed, and Reference Citation Analysis databases for case reports and case series on IVL use in peripheral artery disease. We then extracted variables of interest and calculated the mean and proportions of these variables. RESULTS: We included 60 patients from 33 case reports/case series. Ninety-eight percent of the cases had IVL usage in only one blood vessel, while four had the IVL used in two vessels (2.0%), resulting in 64 Lesions treated with IVL. The mean age of the patients was 73.7 (SD 10.9). IVL was successfully used in severe iliofemoral artery stenosis (51.6%), severe innominate, subclavian, and carotid artery stenosis (26.7% combined), and severe mesenteric vessel stenosis (9.4%). Additionally, IVL was successfully used in severe renal (7.8%) and aortic artery (4.7%) stenosis. There were complications in 12% of the cases, with dissection being the commonest. CONCLUSION: IVL has successfully used in plaque modification and endovascular revascularization in severely calcified and challenging lesions in the iliofemoral, carotid, subclavian, aorta, renal, and mesenteric vessels. The most severe but transient complications were with IVL use in the aortic arch and neck arteries.
ABSTRACT
Coconut oil has been gaining popularity recently, especially with health enthusiasts claiming it to be the best fat for consumption. What is the ideal cooking fat? The answer that we are all looking for is just not solely based on one health consequence but several. Our study focuses on the cardiovascular aspects of using coconut oil by its influence on low-density lipoprotein (LDL). Cardiovascular diseases (CVDs) are the major cause of death and mortality worldwide. Hence, they are the focus of this study. For centuries, coconut oil has been used by several populations worldwide who consume it as part of their staple diets. However, they have also been consuming the flesh/meat of coconuts and decreased processed foods. One such population is the pacific islanders, who had increased LDL and decreased high-density lipoprotein (HDL) when they moved out of their natural habitat and accepted a more westernized diet. Even though coconut oil has a stronghold on the LDL aspect of the lipid parameters, which is our study's focus, it also increases HDL, whose effects on cardiovascular health are still controversial although it is called "good cholesterol." Cardiologists now utilize the ratio of total to HDL cholesterol to assess CVD risk more reliably. There have not been many human studies to support coconut oil's LDL and CVD advantages, considering all these variables. A thorough search of five databases, including PubMed, PubMed Central, Google Scholar, Cochrane Library, and ScienceDirect, was done. The last search was done on October 8th, 2021. Studies were selected based on the following criteria: last five years, English language, human studies, randomized controlled trials (RCTs), systematic reviews and meta-analysis, narrative reviews, and cross-sectional studies were included using medical subject headings (MeSH) search and keyword search. Eight hundred and ninety-nine articles were found, and eight papers were picked after quality appraisal. These included one narrative review, three RCTs, one cross-sectional study, and three systematic reviews and meta-analyses. The results showed that coconut oil did not behave differently than other saturated fats to reduce LDL. One study showed that coconut oil did not increase LDL compared to additional saturated fat like butter or lard. Coconut oil also has antioxidant properties that may prevent oxidative stress that affects cardiovascular health. However, studies in this sector are limited.
ABSTRACT
High-intensity interval training (HIIT), an exercise training modality of cardiac rehabilitation, has shown growing evidence of improving cardiovascular patients' prognosis and health outcomes. This study aimed to identify and summarize the effects of HIIT in heart failure (HF) patients, heart transplantation (HTx) recipients, and HF patients before and after HTx. This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. For the past five years, a systematic search was done using PubMed, PubMed Central, Cochrane, Google Scholar, and ScienceDirect databases on September 15, 2021. Studies were selected based on the following predefined eligibility criteria: English-language randomized controlled trials (RCTs), observational studies, systematic reviews, and meta-analyses, which included HF patients and HTx patients, and assessment of effects HIIT. The relevant data were extracted to a predefined template. Consequently, quality assessment was done using each study's most commonly used assessment tools. The initial search generated 551 studies. Nine studies were included in the final selection - four RCTs, one cohort, one quasi-experimental study, two systematic reviews with meta-analyses, and one narrative review. HIIT was found to be generally superior or similar with other exercise training on VO2 peak, heart rate, LVEF, cardiac biomarkers, vascular function, blood pressure, body composition, and adverse events in HF patients and the aforementioned with QoL among HTx recipients. Data on cardiac remodeling and QoL of HF patients were inconclusive.
