CVIA Journal

Announcing a new article publication for Cardiovascular Innovations and Applications journal.   Spontaneous heparin-induced thrombocytopenia is a pro-thrombotic syndrome in which anti-heparin antibodies develop without heparin exposure.

A 78-year-old man who underwent a successful lumbar laminectomy presented to the hospital 5 days after discharge for stroke-like symptoms and was found to have acute infarcts of the bilateral frontal lobes. The patient was found to be severely thrombocytopenic and was incidentally found to have an inferior wall myocardial infarction. Further investigation led to the diagnosis of bilateral lower extremity deep vein thromboses. His overall clinical presentation prompted a detailed hematologic workup that indicated positivity for heparin-induced thrombocytopenia despite no previous exposure to heparin products.

This case study illustrates a patient with no prior lifetime heparin exposure who underwent laminectomy with subsequent development of acute infarcts of the bilateral frontal lobes, an inferior wall myocardial infarction, and bilateral lower extremity deep vein thromboses, with concern for sequelae of spontaneous heparin-induced thrombocytopenia.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0007

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Jong Kun Park, Ilan Vavilin and Jacob Zaemes et al. Spontaneous Heparin-Induced Thrombocytopenia Presenting as Concomitant Bilateral Cerebrovascular Infarction and Acute Coronary Syndrome. CVIA. Vol. 7(1). DOI: 10.15212/CVIA.2023.0007

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  This study was aimed at investigating the effects of preoperative treatment with a loading dose of statins combined with a PCSK9 inhibitor on coronary blood perfusion and short-term cardiovascular adverse events in patients with ST-segment elevation myocardial infarction (STEMI).   Sixty-five patients with STEMI who had visited the Shanxi Cardiovascular Disease Hospital between May 2018 and May 2021 were enrolled in the study. The enrolled patients had no history of oral statins or antiplatelet therapy. The patients were divided into a combined treatment group (loading dose of statins combined with PCSK9 inhibitors, 35 patients) and a routine treatment group (loading dose of statins only, 30 patients). The primary endpoints were thrombolysis in myocardial infarction (TIMI) blood flow grading, corrected TIMI frame count (CTFC), and TIMI myocardial perfusion grading (TMPG), immediately after and 30 days after the operation. The secondary endpoint was a composite endpoint of cardiovascular death, nonfatal myocardial infarction, and target vessel revascularization 30 days after the operation.   The combined treatment group had significantly lower CTFC (14.09 ± 8.42 vs 26 ± 12.42, P = 0.04) and better TMPG (2.74 ± 0.61 vs 2.5 ± 0.73, P = 0.04) than the routine treatment group immediately after the operation. Similarly, the combined treatment group had a significantly lower CTFC (16.29 ± 7.39 vs 26.23 ± 11.53, P = 0.04) and significantly better TMPG (2.94 ± 0.24 vs 2.76 ± 0.43, P = 0.01) than the routine treatment group 1 month after the operation.   Preoperative treatment with a loading dose of high-intensity statins combined with PCSK9 inhibitors increased coronary blood flow and myocardial perfusion after emergency thrombus aspiration in patients with STEMI. However, the treatment did not significantly decrease the incidence of cardiovascular death, nonfatal myocardial infarction, or target vessel revascularization.

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Effects of Loading-Dose Statins Combined with PCSK9 Inhibitor Pre-Treatment before Primary Percutaneous Coronary Intervention on the Short-Term Prognosis in Patients with ST-Segment Elevation Myocardial Infarction, An, Jian, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0011

Announcing a new article publication for Cardiovascular Innovations and Applications journal.   Atrial fibrillation is the most common arrhythmia leading to cardiogenic stroke. Without membranous sructure between epicardial adipose tissue and atrial myocardium, epicardial adipose tissue directly covers the surface of the atrial myocardium. The formation of an epicardial adipose tissue inflammatory microenvironment, fibrosis, infiltration by epicardial adipose tissue, autonomic dysfunction and oxidative stress are important mechanisms that trigger and maintain atrial fibrillation. 

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Role of Epicardial Adipose Tissue in Triggering and Maintaining Atrial Fibrillation, Tian, Ye, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0012

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  Primary cardiac tumors are extremely uncommon. Here, the author of this article reports the case of a patient with a primary left ventricular interstitial tumor presenting with hemodynamically unstable ventricular tachycardia. In response to hemodynamically unstable ventricular tachycardia, an implantable cardioverter-defibrillator was inserted. One month after defibrillator implantation, the patient developed episodes of high ventricular tachycardia that could not be effectively terminated by catheter radiofrequency ablation, thus further confirming that the ventricular tachycardia was induced by the left ventricular interstitial tumor. 

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: A Rare Case of a Primary Cardiac Tumor Presenting as Fatal Ventricular Tachycardia, Guo, Xueya, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0014 

Announcing a new article publication for Cardiovascular Innovations and Applications journal.   Sleep is essential to the normal psychological and physiological activities of the human body. Increasing evidence indicates that sleep deprivation is associated with the occurrence, development, and poor treatment effects of various arrhythmias. Sleep deprivation affects not only the peripheral nervous system but also the central nervous system, which regulates the occurrence of arrhythmias. In addition, sleep deprivation is associated with apoptotic pathways, mitochondrial energy metabolism disorders, and immune system dysfunction. Although studies increasingly suggest that pathological sleep patterns are associated with various atrial and ventricular arrhythmias, further research is needed to identify specific mechanisms and recommend therapeutic interventions. This article summarizes the findings of sleep deprivation in animal experiments and clinical studies, current challenges, and future research directions in the field of arrhythmias.

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: The Role of Sleep Deprivation in Arrhythmias, Yin, Dechun, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0013  

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  A non-invasive predictive model has not been established to identify the severity of coronary lesions in young adults with acute coronary syndrome (ACS). In this retrospective study, 1088 young adults (≤45 years of age) first diagnosed with ACS who underwent coronary angiography were enrolled and randomized 7:3 into training or testing datasets. To build the nomogram, the authors determined optimal predictors of coronary lesion severity with the Least Absolute Shrinkage and Selection Operator and Random Forest algorithm. The predictive accuracy of the nomogram was assessed with calibration plots, and performance was assessed with the receiver operating characteristic curve, decision curve analysis and the clinical impact curve. Seven predictors were identified and integrated into the nomogram: age, hypertension, diabetes, body mass index, low-density lipoprotein cholesterol, mean platelet volume and C-reactive protein. Receiver operating characteristic analyses demonstrated the nomogram’s good discriminatory performance in predicting severe coronary artery disease in young patients with ACS in the training (area under the curve 0.683, 95% confidence interval [0.645–0.721]) and testing (area under the curve 0.670, 95% confidence interval [0.611–0.729]) datasets. The nomogram was also well-calibrated in both the training (P = 0.961) and testing (P = 0.302) datasets. Decision curve analysis and the clinical impact curve indicated the model’s good clinical utility. A simple and practical nomogram for predicting coronary artery disease severity in young adults ≤45 years of age with ACS was established and validated.

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Nomogram for Predicting the Severity of Coronary Artery Disease in Young Adults ≤45 Years of Age with Acute Coronary Syndrome, Zhang, Wenbin, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0016

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Paroxysmal atrial fibrillation can be triggered by non-pulmonary vein foci, such as the superior vena cava. The authors of this article report the case of a patient with a 6-year history of paroxysmal atrial fibrillation who received cryoballoon ablation in 2012 but relapsed. The patient then received cardiac radiofrequency ablation, which successfully isolated the left pulmonary vein and superior vena cava, but the arrhythmia relapsed again. The tachycardia was finally successfully terminated by ablation on the free wall without recurrence during a 2-year following up. Superior vena cava isolation may not require ablation isolation with a full circle way and can be accomplished by ablating several connection points between the superior vena cava and the right atrium.

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Termination of Recurrent Atrial Fibrillation by Superior Vena Cava Isolation: A Case Report, Yin, Dechun, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0017

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  Inflammation plays a role in coronary artery disease (CAD). The neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR) and platelet/lymphocyte ratio (PLR) are blood parameters associated with inflammation. The authors of this article aimed to perform a systematic comparison and study the predictive values of these inflammatory parameters with respect to CAD stage.   A total of 513 patients who had undergone coronary angiography (CAG) were retrospectively analyzed. Clinical status, lipid profiles, CAG scans and hematological parameters were collected. NLR, MLR and PLR were calculated. All patients were classified into a normal coronary group (n = 133), coronary atherosclerosis (CA) group (n = 149), chronic coronary syndrome (CCS) group (n = 175) or acute myocardial infarction (AMI) group (n = 56). NLR, MLR and PLR were compared among groups. NLR and MLR were higher in the CCS and AMI groups. PLR was higher in the AMI group. The AMI group had higher NLR, PLR and MLR than the CCS group. Logistic regression analysis revealed that NLR (OR:1.227, 95% CI: 1.016–1.482. P < 0.05) had a strong significant correlation with CAD. Area under the ROC curve of NLR was 0.580 (95% CI = 0.516–0.644) in predicting CCS and 0.727 (95% CI = 0.642–0.811) in predicting AMI.   NLR may be associated with the occurrence and progression of CAD, and may serve as a marker of inflammation.

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: The Neutrophil/Lymphocyte Ratio is Associated with Different Stages of Development of Coronary Artery Disease, Du, Jianlin, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0018

Announcing a new article publication for Cardiovascular Innovations and Applications journal. According to the findings of randomized controlled trials, blood lipid levels in patients with coronary heart disease (CHD) can be significantly decreased through a combination of pitavastatin and ezetimibe; however, the effects and clinical applications of this treatment remain controversial. This article objectively assesses the efficacy and safety of pitavastatin and ezetimibe in lowering blood lipid levels.

Relevant studies were retrieved from electronic databases, including PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP, and WanFang Data, from database inception to June 8, 2022. The levels of low-density lipoprotein cholesterol, total cholesterol, triglycerides, and high-density lipoprotein cholesterol in patients’ serum after treatment were the primary endpoint.

Nine randomized controlled trials (2586 patients) met the inclusion criteria. The meta-analysis indicated that pitavastatin plus ezetimibe resulted in significantly lower levels of LDL-C [standardized mean difference (SMD)=−0.86, 95% confidence interval (CI) (−1.15 to −0.58), P<0.01], TC [SMD=−0.84, 95% CI (−1.10 to −0.59), P<0.01], and TG [SMD=−0.59, 95% CI (−0.89 to −0.28), P<0.01] than pitavastatin alone.

Pitavastatin plus ezetimibe significantly decreased serum LDL-C, TC, and TG levels in patients with CHD.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0004

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Ruping Cai, Chen Chang and Xingjie Zhong et al. Lowering of Blood Lipid Levels with a Combination of Pitavastatin and Ezetimibe in Patients with Coronary Heart Disease: A Meta-Analysis. CVIA. Vol. 7(1). DOI: 10.15212/CVIA.2023.0004

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Intracoronary murmur results from turbulent flow due to coronary artery narrowing. This study evaluated the diagnostic performance of a method for acoustic analysis of turbulent murmur caused by coronary artery stenosis in coronary artery disease (CAD) in Chinese populations.

Patients admitted to the cardiovascular department of the Sixth Medical Center of the Chinese People’s Liberation Army General Hospital between September 2021 and June 2022 for elective coronary angiography were prospectively enrolled. A digital electronic stethoscope was used to record heart sounds before angiography. Quantitative coronary angiography (QCA) served as the “gold standard” for CAD diagnosis to evaluate the diagnostic performance of the acoustic analysis method for CAD.

A total of 452 patients had complete QCA and heart sound data. The final interpretation results of the acoustic analysis method indicated 310 disease cases and 142 normal results. Increasing the cut-off values of coronary artery diameter stenosis from 30% to 50%, 70%, and 90% increased the sensitivity and NPV of the acoustic analysis method; the sensitivity was 75.6%, 81.9%, 83.3%, and 85.7%, respectively; the NPV was 33.1%, 57.0%, 69.7%, and 88.0%, respectively; the specificity and PPV decreased (specificity of 75.8%, 70.4%, 51.0%, and 37.5%, respectively; PPV of 95.2%, 89.0%, 69.4%, and 32.9%, respectively); and the AUC values were 0.757, 0.762, 0.672, and 0.616, respectively. The sensitivity of the acoustic analysis method for one-vessel disease was 86.6% when the cut-off value was 50%. The sensitivity for identifying left anterior descending coronary artery lesions was best, at 90.7%. The sensitivity for identifying isolated coronary artery branch lesions was 66.7%, whereas the sensitivity for identifying three-vessel disease in multi-vessel coronary artery lesions was better, at 82.9%.

Acoustic analysis of turbulent murmur caused by coronary artery stenosis for diagnosis of CAD may have favorable performance in the Chinese population. This method has good performance in CAD diagnosis with a cut-off coronary artery diameter for stenosis of 50%.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2022.0023

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Pan-Guo Zhao, Yi-Xiong Huang and Li-Ping Xiao et al. Diagnosis of Coronary Artery Disease by Acoustic Analysis of Turbulent Murmur Caused by Coronary Artery Stenosis: A Single Center Study from China. CVIA. Vol. 7(1). DOI: 10.15212/CVIA.2022.0023