Effective Heparin Administration and Reversal in Cardiac Surgery: A Pilot Study
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Elsayed YMH. High lateral ischemia, passed sildenafil-inducing infarction, atrial fibroflutter block, Brugada syndrome with aberrancy in MVR, hiatus hernia, and COVID pneumonia: a strange constellation. Series Cardiol Res. 2024;6(1):1-7.
Rationale: Drug-inducing adverse effects may be critical and fatal. There is a reported serious cardiovascular (CV) presentation with sildenafil. Mitral stenosis (MS) is the most common cause of valvular atrial fibrillation (AF) and flutter. Brugada syndrome (BrS) is a genetic disorder with abnormal electrical activity within the heart that carries a higher risk for ventricular fibrillation and sudden death. Hiatal hernia is a herniation of intra-abdominal contents into the thorax. There is a durable relationship between COVID-19 infection and ischemic heart disease.
Patient concerns: A 53-year-old, married Egyptian male teacher, mechanically replaced mitral valve (MV) patient was presented to the physician outpatient clinic with intermittent angina within two weeks’ of post-oral sildenafil tablets and COVID-19 pneumonia.
Diagnosis: High lateral ischemia and passed sildenafil-inducing inferior infarction with variable atrial fibro-flutter block, alternative right bundle branch block (RBBB) beat with type II BrS in mechanically replaced MV with recent hiatus hernia and COVID pneumonia.
Interventions: Cardiothoracic surgery, chest X-ray, electrocardiography, echocardiography, and oxygenation.
Outcomes: There is a good outcome despite numerous noteworthy serious risk factors.
Lessons: High lateral ischemia, passed inferior myocardial infarction (MI), variable atrial fibro-flutter block, RBBB beat, BrS, hypocalcemia, recent hiatus hernia, and COVID pneumonia in the mechanically replaced MV are a serious constellation of risk factors. Alternative RBBB beat with type II BrS is newly described. BrS may be transient. Hypocalcemia and Wavy triple ECG sign (Yasser’s sign) are confusing issues for ischemic heart disease.
Kuliev A, Pakhalchuk T, Prokhorovich M, et al. Expanding application of preimplantation genetic testing for cardiac disease. Series Cardiol Res. 2024;6(1):1-6.
Predisposition to cardiac disease (CD) is currently becoming a common indication for preimplantation genetic testing (PGT). It provides an option for the couplers at risk to avoid the birth of an offspring with a predisposition to CD, as there are no appropriate strategies to prevent CD in the carries of gene mutations predisposing to this condition. The present paper describes the progress in the application of PGT for CD, with its extended application also to carriers of predisposing genes detected through expanded carrier screening (ECS). We present here our experience of 147 PGT cycles for CD, resulting in the birth of 73 children free of predisposing genes to CD, which is a part of our overall PGT series of over one thousand PGT for monogenic disorders (PGT-M). The accumulated experience, presented below, demonstrates considerable progress in using PGT to avoid the birth of children with a genetic predisposition to CD.
Continuation of Beta Blockers in Patients on Inotrope Therapy: A Counterintuitive Dilemma
Withers K*, Raby K, Parker W, German C, Eyadiel L, Hilton T, Goslen K, Green S, Banoian D, Bapat S, Thomas A, Seals A4 and Pisani B
Withers K, Raby K, Parker W, et al. Continuation of beta blockers in patients on inotrope therapy: a counterintuitive dilemma. Series Cardiol Res. 2024;6(1):1-9.
Introduction: Cardiogenic shock (CS) and acute decompensated heart failure (ADHF) are states of low cardiac output that manifest as tissue hypoperfusion and end-organ damage. Current guidelines do not provide recommendations regarding beta blocker (BB) use in CS. This study sought to analyze the effects of BB continuation on in-hospital mortality among patients admitted with ADHF necessitating inotropic therapy.
Methods: A single-center, retrospective study was conducted in adult patients hospitalized with ADHF requiring inotropes over a three-year period. Patients with CS were stratified based on the Society for Cardiovascular Angiography and Interventions (SCAI) classification of CS and Get With The Guidelines-Heart Failure (GWTG-HF) risk score. BB continuation was assessed at admission and was defined as administration for at least 50% of the hospital stay. A time-to-event analysis framework was implemented using Cox proportional hazards models to analyze the effect of BB continuation on in-hospital mortality.
Results: A total of 449 patients were included in the study. Twelve patients were excluded, as there was insufficient data to calculate the GWTG-HF risk score. A significant mortality benefit was seen with BB continuation in all statistical models. When adjusted for SCAI and GWTG-HF risk score, BB continuation was associated with a 65% reduction in in-hospital mortality [HR 0.35 95% CI 0.19-0.64, p = 0.0008].
Conclusion: In select patients with ADHF resulting in CS, there appears to be a mortality benefit associated with continuation of BB on admission that remains significant after adjustment for severity of CS.
Rasti T, Zhu Q, Zhou K, et al. ECG-based arrhythmia detection by a shallow CNN model. Series Cardiol Res. 2024;6(1):1-14.
Recent advances in biomedical applications have focused a lot of emphasis on the detection of what could be caused by cardiovascular disease (CVD). The electrocardiogram (ECG), which depicts the electrical activity of the heart, is the foundation for arrhythmia analysis. Different machine learning methods used on ECG datasets have demonstrated excellent performance in detecting arrhythmias. Nevertheless, feature extraction is necessary for machine learning algorithms. Modern deep learning techniques don't require feature extraction because they learn all the parameters simultaneously, in contrast to these techniques. In this study, a 1D convolutional neural network (CNN) approach is presented and tested on the arrhythmia database of the Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH). The proposed model, which only has three layers, attained an accuracy of 97.40%.
EJ, Elison D, Cham MD, et al. Transcatheter aortic valve-in-valve implantation within a radiolucent stentless valve. Series Cardiol Res. 2024;6(1):1-4.
An 84-year-old man with a Shelhigh Super Stentless valve presented for valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR). Given the lack of radiopaque markers and the presence of a non-coronary cusp (NCC) pseudoaneurysm, implant depth was guided by root aortography at the time of balloon aortic valvuloplasty (BAV) using a pigtail in the right coronary cusp (RCC).
Article DOI: 10.54178/2768-5985.2024a1
