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International Journal of Molecular... Sep 2020Left heart disease is the main cause of clinical pulmonary arterial hypertension (PAH). Common types of left heart disease that result in PAH include heart failure, left... (Review)
Review
Left heart disease is the main cause of clinical pulmonary arterial hypertension (PAH). Common types of left heart disease that result in PAH include heart failure, left ventricular systolic dysfunction, left ventricular diastolic dysfunction and valvular disease. It is currently believed that mechanical pressure caused by high pulmonary venous pressure is the main cause of myocardial infarction (MI) in individuals with ischemic cardiomyopathy and left ventricular systolic dysfunction. In the presence of decreased cardiac function, vascular remodeling of pulmonary vessels in response to long‑term stimulation by high pressure in turn leads to exacerbation of PAH. However, the underlying pathological mechanisms remain unclear. Elucidating the association between the development of MI and PAH may lead to a better understanding of potential risk factors and better disease treatment. In this article, the pathophysiological effects of multiple systems in individuals with MI and PAH were reviewed in order to provide a general perspective on various potential interactions between cardiomyocytes and pulmonary vascular cells.
Topics: Animals; Humans; Lung; Myocardial Infarction; Myocytes, Cardiac; Pulmonary Arterial Hypertension
PubMed: 32582962
DOI: 10.3892/ijmm.2020.4650 -
The Journal of International Medical... Jan 2022Pulmonary embolism and splenic infarction are rare in patients with polycythemia vera. We herein describe a man in his early 60s whose main symptoms were chest...
Pulmonary embolism and splenic infarction are rare in patients with polycythemia vera. We herein describe a man in his early 60s whose main symptoms were chest tightness, cough, and sputum expectoration. Antibiotics, bronchodilators, and mucoactive agents did not improve his symptoms. Pulmonary artery computed tomography angiography showed pulmonary embolism, and abdominal computed tomography showed multiple hypodense foci in the spleen. Bone marrow aspiration cytology, biopsy, and genetic testing confirmed polycythemia vera. The patient's symptoms were relieved after treatment with hydroxyurea and rivaroxaban. This case emphasizes that although pulmonary embolism and splenic infarction are relatively rare in patients with polycythemia vera, the possibility of polycythemia vera should be considered in clinical practice.
Topics: Angiography; Humans; Male; Polycythemia Vera; Pulmonary Embolism; Splenic Infarction; Tomography, X-Ray Computed
PubMed: 35023386
DOI: 10.1177/03000605211072801 -
British Journal of Nursing (Mark Allen... Sep 2022The cardiovascular system, consisting of the heart as the 'pump' and the vascular network of blood vessels, is responsible for the distribution of blood around the body....
The cardiovascular system, consisting of the heart as the 'pump' and the vascular network of blood vessels, is responsible for the distribution of blood around the body. Oxygen molecules attach to haemoglobin in red blood cells and are transported around the body where the oxygen aids cellular metabolism. Any blockage in the blood vessels as a result of build-up of plaques in the endothelium layer would result in an interruption in blood supply and therefore oxygen deprivation (ischaemia). This would lead to necrosis of the distal area of the affected vessel and is known as an infarct. This article aims to describe the normal anatomy and physiology of the cardiovascular system and to explain some of the common associated disorders, with a brief guide to the management of a common heart disorder, myocardial infarction. A case study is included to enhance the knowledge of management of myocardial infarction. An in-depth knowledge and understanding of the cardiovascular system and its associated disorders will enable the nurse to safely assess a patient, recognise a deteriorating patient and seek early intervention.
Topics: Cardiovascular System; Humans; Myocardial Infarction; Oxygen
PubMed: 36149425
DOI: 10.12968/bjon.2022.31.17.886 -
Archives of Pathology & Laboratory... Sep 2020Since making its debut on the global stage in December 2019, coronavirus disease 2019 (COVID-19) has afflicted nearly 4 million people and caused hundreds of thousands...
Since making its debut on the global stage in December 2019, coronavirus disease 2019 (COVID-19) has afflicted nearly 4 million people and caused hundreds of thousands of deaths. Case reports and case series depicting the clinical effects of the causative virus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-have been published, yet few demonstrate the cytopathologic alterations of this disease. We present a clinical-pathologic correlation report of a previously healthy Hispanic woman with laboratory-confirmed COVID-19 who had typical features of acute respiratory distress syndrome (ARDS) and also showed cardiac abnormalities thought to represent fulminant viral myocarditis. Congruent with the ARDS clinical impression, autopsy findings were remarkable for extensive and markedly severe acute lung injury consistent with viral pneumonia, characterized by diffuse alveolar damage, pulmonary infarction, severe pulmonary edema, desquamation of pneumocytes with intra-alveolar aggregation, and pneumocyte morphologic alterations suggestive of viral cytopathic effect. However, there was incongruence between the clinical impression and the cardiovascular pathology findings in that viral myocarditis was not detected on histopathologic evaluation. This case highlights the importance of pathologic corroboration of the clinical impression and, in addition, illuminates the key role autopsy plays during a pandemic by providing valuable insight into viral pathology in tissues.
Topics: Adult; Betacoronavirus; COVID-19; Coronavirus Infections; Fatal Outcome; Female; Heart; Humans; Lung; Mexican Americans; Myocardium; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32422081
DOI: 10.5858/arpa.2020-0217-SA -
Postepy Dermatologii I Alergologii Oct 2022Pulmonary fibrosis (PF) is a chronic progressive interstitial lung disease caused by a variety of factors. (Review)
Review
INTRODUCTION
Pulmonary fibrosis (PF) is a chronic progressive interstitial lung disease caused by a variety of factors.
AIM
To systematically evaluate the therapeutic effect of pterostilbene (PTE) on experimental PF in asthma and other oxidative damage pathway-related diseases, and to provide evidence for clinical treatment.
MATERIAL AND METHODS
Chinese and English databases such as CNKI, Wanfang, VIP, PubMed, Embase, Cochrane Library, and CBM were searched by computer. The Chinese literature on pterostilbene for the treatment of asthma by evaluating experimental pulmonary fibrosis, diabetes, and myocardial infarction was collected from the establishment of a randomized controlled trial until May 2021.Outcome indicators include related physical and chemical indicators such as MDA and SOD. Data were analysed using Review Manager 5.4 software after screening by 2 researchers.
RESULTS
Seven randomized controlled animal experiments were included, with a total sample size of 62 cases. Meta-analysis results showed the following: 1) compared with pulmonary fibrosis, diabetes and other model groups, the pterostilbene intervention group were able to up-regulate SOD, and the effect was better than that of the model group (MD = 20.87, 95% CI: 19.41-22.33; = 7, = 96%); the pterostilbene intervention group could also up-regulate the expression of GSH, and its effect was better than that of the model group (MD = 9.37, 95% CI: 8.67-10.07; = 2, = 98%). The MDA level of the intervention group was significantly down regulated, and the intervention group was also better than the model group. Pterostilbene can prevent experimental PF by lowering the level of MDA.
CONCLUSIONS
Pterostilbene can effectively improve experimental pulmonary fibrosis, diabetes, myocardial infarction, and other oxidative damage pathway-related diseases have certain guiding significance for clinical trials on asthma.
PubMed: 36457679
DOI: 10.5114/ada.2021.108452 -
The Clinical Respiratory Journal Jun 2021Pulmonary infarction (PI) shares similar symptoms and imaging presentations with community-acquired pneumonia (CAP), which might delay diagnosis and lead to devastating...
INTRODUCTION AND OBJECTIVES
Pulmonary infarction (PI) shares similar symptoms and imaging presentations with community-acquired pneumonia (CAP), which might delay diagnosis and lead to devastating consequences. Noncontrast computed tomography (CT) is the first-line examination for the patients with the respiratory symptoms. This study aimed to investigate a radiomics method to differentiate PI from CAP using noncontrast-enhanced CT.
METHODS
Noncontrast-enhanced CT images of 54 patients with PI and 64 patients with CAP were retrospectively selected. All patients were confirmed using computed tomography pulmonary angiography (CTPA). A radiomics model was built with 18 texture features that showed significant differences between PI and CAP patients. For comparison, a clinical model using clinical biomarkers and an integrated model combining the radiomics and clinical biomarkers were also generated. An experienced radiologist performed diagnoses using the noncontrast-enhanced CT images. The parameters of the models were generated using a training dataset of 61 patients, whereas the performance of the models was evaluated using receiver operating characteristic (ROC) analysis and Harrell's concordance index (C-index) applied to a separate validation dataset of 57 patients.
RESULTS
The integrated model achieved the best performance (C-index 0.760, sensitivity 0.703, specificity 0.867, positive predictive value [PPV] 0.826, and negative predictive value [NPV] 0.765). The radiomics model was better than both the clinical model and the radiologist's interpretations (C-index 0.721, 0.707, 0.665, respectively; sensitivity 0.667, 0.630, 0.593; specificity 0.800, 0.785, 0.733; PPV 0.750, 0.739, 0.667; and NPV 0.727, 0.706, 0.667).
CONCLUSIONS
Radiomics features generated from noncontrast-enhanced CT images allow PI to be differentiated from CAP with considerable accuracy. The radiomics-based method could provide useful information in clinical practice.
Topics: Humans; Pneumonia; Pulmonary Infarction; ROC Curve; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 33686798
DOI: 10.1111/crj.13341 -
The Lancet. Respiratory Medicine May 2024
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Myocardial Infarction; Risk Factors
PubMed: 38437859
DOI: 10.1016/S2213-2600(24)00038-9 -
ESC Heart Failure Apr 2023The aim was to describe the prevalence, characteristics, and outcome of patients with acute myocardial infarction (MI) developing left ventricular (LV) systolic...
AIMS
The aim was to describe the prevalence, characteristics, and outcome of patients with acute myocardial infarction (MI) developing left ventricular (LV) systolic dysfunction or pulmonary congestion by applying different criteria to define the population.
METHODS AND RESULTS
In patients with MI included in the Swedish web-system for enhancement and development of evidence-based care in heart disease (SWEDEHEART) registry, four different sets of criteria were applied, creating four not mutually exclusive subsets of patients: patients with MI and ejection fraction (EF) < 50% and/or pulmonary congestion (subset 1); EF < 40% and/or pulmonary congestion (subset 2); EF < 40% and/or pulmonary congestion and at least one high-risk feature (subset 3, PARADISE-MI like); and EF < 50% and no diabetes mellitus (subset 4, DAPA-MI like). Subsets 1, 2, 3, and 4 constituted 31.6%, 15.0%, 12.8%, and 22.8% of all patients with MI (n = 87 177), respectively. The age and prevalence of different co-morbidities varied between subsets. For median age, 70 to 77, for diabetes mellitus, 22 to 33%; for chronic kidney disease, 22 to 38%, for prior MI, 17 to 21%, for atrial fibrillation, 7 to 14%, and for ST-elevations, 38 to 50%. The cumulative incidence of death or heart failure hospitalization at 3 years was 17.4% (95% CI: 17.1-17.7%) in all MIs; 26.9% (26.3-27.4%) in subset 1; 37.6% (36.7-38.5%) in subset 2; 41.8% (40.7-42.8%) in subset 3; and 22.6% (22.0-23.2%) in subset 4.
CONCLUSIONS
Depending on the definition, LV systolic dysfunction or pulmonary congestion is present in 13-32% of all patients with MI and is associated with a two to three times higher risk of subsequent death or HF admission. There is a need to optimize management and improve outcomes for this high-risk population.
Topics: Humans; Aged; Prognosis; Prevalence; Myocardial Infarction; Ventricular Dysfunction, Left; Risk Factors; Pulmonary Edema
PubMed: 36732932
DOI: 10.1002/ehf2.14301 -
Diagnostics (Basel, Switzerland) Nov 2022Behcet's disease (BD) is a chronic systemic inflammatory disorder characterized by underlying chronic vasculitis of both large- and small-caliber vessels. Thoracic... (Review)
Review
Behcet's disease (BD) is a chronic systemic inflammatory disorder characterized by underlying chronic vasculitis of both large- and small-caliber vessels. Thoracic involvement in BD can occur with various types of manifestations, which can be detected with contrast-enhanced MSCT scanning. In addition, MR can be useful in diagnosis. Characteristic features are aneurysms of the pulmonary arteries that can cause severe hemoptysis and SVC thrombosis that manifests as SVC syndrome. Other manifestations are aortic and bronchial artery aneurysms, alveolar hemorrhage, pulmonary infarction, and rarely pleural effusion. Achieving the right diagnosis of these manifestations is important for setting the correct therapy and improving the patient's outcome.
PubMed: 36428928
DOI: 10.3390/diagnostics12112868 -
BMC Health Services Research Jun 2023Diagnosis-Related-Group (DRG) payment is considered a crucial means of addressing the rapid increases of medical cost and variation in cost. This paper analyzes the...
BACKGROUND
Diagnosis-Related-Group (DRG) payment is considered a crucial means of addressing the rapid increases of medical cost and variation in cost. This paper analyzes the impact of DRG payment on variation in hospitalization expenditure in China.
METHOD
Patients with chronic obstructive pulmonary disease (COPD), acute myocardial infarction (AMI) and cerebral infarction (CI) in a Chinese City Z were selected. Patients in the fee-for-service (FFS) payment group and the DRG payment group were used as the control group and intervention group, respectively, and propensity-score-matching (PSM) was conducted. Interquartile distance (IQR), standard deviation (SD) and concentration index were used to analyze variation and trends in terms of hospitalization expenditure across the different groups.
RESULTS
After DRG payment reform, the SD of hospitalization expenditure in respect of the COPD, AMI and CI patients in City Z decreased by 11,094, 4,833 and 4,987 CNY, respectively. The concentration indices of hospitalization expenditures for three diseases are all below 0 (statistically significant), with the absolute value tending to increase year by year.
CONCLUSION
DRG payment can be seen to guide medical service providers to provide effective treatment that can improve the consistency of medical care services, bringing the cost of medical care closer to its true clinical value.
Topics: Humans; Health Expenditures; Hospitalization; Diagnosis-Related Groups; China; Pulmonary Disease, Chronic Obstructive
PubMed: 37355657
DOI: 10.1186/s12913-023-09686-z