scholarly journals A Novel Technique for the Assessment of Preoperative Cardiovascular Risk: Reactive Hyperemic Response to Short-Term Exercise

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Robert Schier ◽  
Jochen Hinkelbein ◽  
Hanke Marcus ◽  
Ashley Smallwood ◽  
Arlene M. Correa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vascular Function ◽  
Reactive Hyperemia ◽  
Surrogate Marker ◽  
Preoperative Assessment ◽  
Cardiac Risk ◽  
Short Term ◽  
Exact Test ◽  
Cardiac Risk Factors ◽  
Hyperemic Response

Background. Perioperative vascular function has been widely studied using noninvasive techniques that measure reactive hyperemia as a surrogate marker of vascular function. However, studies are limited to a static setting with patients tested at rest. We hypothesized that exercise would increase reactive hyperemia as measured by digital thermal monitoring (DTM) in association to patients' cardiometabolic risk.Methods. Thirty patients (58 ± 9 years) scheduled for noncardiac surgery were studied prospectively. Preoperatively, temperature rebound (TR) following upper arm cuff occlusion was measured before and 10 minutes after exercise. Data are presented as means ± SD. Statistical analysis utilized ANOVA and Fisher’s exact test, withPvalues <0.05 regarded as significant.Results. Following exercise, TR-derived parameters increased significantly (absolute: 0.53 ± 0.95 versus 0.04 ± 0.42∘C,P=0.04, and % change: 1.78 ± 3.29 versus 0.14 ± 1.27 %,P=0.03). All patients with preoperative cardiac risk factors had a change in TR (after/before exercise, ΔTR) with values falling in the lower two tertiles of the study population (ΔTR<1.1%).Conclusion. Exercise increased the reactive hyperemic response to ischemia. This dynamic response was blunted in patients with cardiac risk factors. The usability of this short-term effect for the preoperative assessment of endothelial function warrants further study.

Abstract 2733: Association of Psychological Disorders and Structural Coronary Arterial Disease

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Nakash Grant ◽  
David Choe ◽  
Sumit Khandhar ◽  
Naser Ahmadi ◽  
Gary P Foster
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiac Computed Tomography ◽  
Surrogate Marker ◽  
Psychological Disorders ◽  
Cardiac Risk ◽  
Cardiac Risk Factors ◽  
Coronary Arterial Disease

Background : Growing numbers of American Veterans are diagnosed with psychological disorders and myocardial infarctions without known preexisting cardiac risk factors. Confronted with this information, we studied the association between psychological disorders and the presence of coronary artery calcium. High risk coronary calcification [Agatston method coronary artery calcium score (CAC) >100] is associated with a striking increase in cardiovascular events (hazard ratio>10) making it an excellent surrogate marker. Methods : From a database of VA patients who have undergone cardiac computed tomography, 483 were studied (age 59±12 years, 86% male). Regression analysis was utilized for comparison of CAC score for individuals with depression, anxiety, post-traumatic stress disorder (PTSD) and substance abuse.. Results : After adjustment for age, gender and cardiac risk factors, the odds ratio of CAC≥100 vs. CAC=0 was 1.24 (95% CI 1.02–2.08, p=0.044) for depression, 2.04 (95% CI 1.11– 6.17, p=0.027) for anxiety, 2.28 (95% CI 1.15–5.76, p=0.026) for PTSD and 2.61 (95% CI 1.14 – 6.03, p=0.022) for substance abuse as compared to normal cohort. Conclusion : Veterans with psychological disorders were found to have a significantly higher coronary artery calcification score than those without such disorders. These findings are independent of age, gender and other traditional cardiac risk factors.

The impact of cardiac risk factors on short-term outcomes for children undergoing a Ladd procedure

2017 ◽  
Vol 52 (3) ◽  
pp. 390-394 ◽  
Author(s):  
Luke R. Putnam ◽  
Kathryn T. Anderson ◽  
KuoJen Tsao ◽  
Lillian S. Kao ◽  
Jane A. Lugo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Risk ◽  
Short Term ◽  
Cardiac Risk Factors ◽  
Ladd Procedure ◽  
Outcomes For Children ◽  
The Impact

Regional Cervical Plexus Blockage for Carotid Endarterectomy in Patients with Cardiovascular Risk Factors

2015 ◽  
Vol 18 (4) ◽  
pp. 140 ◽  
Author(s):  
Mehmet Taşar ◽  
Mehmet Kalender ◽  
Okay Güven Karaca ◽  
Ata Niyazi Ecevit ◽  
Salih Salihi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Endarterectomy ◽  
Regional Anesthesia ◽  
Carotid Artery Disease ◽  
Risk Groups ◽  
Cardiac Risk ◽  
Cervical Plexus ◽  
Cardiac Risk Factors ◽  
Significant Difference

Background: Carotid artery disease is not rare in cardiac patients. Patients with cardiac risk factors and carotid stenosis are prone to neurological and cardiovascular complications. With cardiac risk factors, carotid endarterectomy operation becomes challenging. Regional anesthesia is an alternative option, so we aimed to investigate the operative results of carotid endarterectomy operations under regional anesthesia in patients with cardiac risk factors. <br />Methods: We aimed to analyze and compare outcomes of carotid endarterectomy under regional anesthesia with cardiovascular risk groups retrospectively. Between 2006 and 2014, we applied 129 carotid endarterectomy ± patch plasty to 126 patients under combined cervical plexus block anesthesia. Patients were divided into three groups (high, moderate, low) according to their cardiovascular risks. Neurological and cardiovascular events after carotid endarterectomy were compared.<br />Results: Cerebrovascular accident was seen in 7 patients (5.55%) but there was no significant difference between groups (P &gt; .05). Mortality rate was 4.76% (n = 6); it was higher in the high risk group and was not statistically significant (P = .180). Four patients required revision for bleeding (3.17%). We did not observe any postoperative surgical infection.<br />Conclusion: Carotid endarterectomy can be safely performed with regional cervical anesthesia in all cardiovascular risk groups. Comprehensive studies comparing general anesthesia and regional anesthesia are needed. <br /><br />

Conventional cardiac risk factors associated with trastuzumab-induced cardiotoxicity in breast cancer: Systematic review and meta-analysis

2021 ◽  
pp. 100723
Author(s):  
George Koulaouzidis ◽  
Amanda E. Yung ◽  
Diana E. Yung ◽  
Karolina Skonieczna-Żydecka ◽  
Wojciech Marlicz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Cardiac Risk ◽  
Factors Associated ◽  
Cardiac Risk Factors

Sexual Assault While in the Military: Violence as a Predictor of Cardiac Risk?

2003 ◽  
Vol 18 (2) ◽  
pp. 219-225 ◽  
Author(s):  
Susan M. Frayne ◽  
Katherine M. Skinner ◽  
Lisa M. Sullivan ◽  
Karen M. Freund
Keyword(s):  
Risk Factors ◽  
Sexual Assault ◽  
Women Veterans ◽  
Cardiac Risk ◽  
Veterans Administration ◽  
Cardiac Risk Factors ◽  
Military Violence ◽  
Problem Alcohol Use ◽  
History Of ◽  
The Military

The purpose of this article is to determine whether known cardiac risk factors are more prevalent among women veterans who report having sustained sexual assault while in the military. We surveyed a random sample of 3,632 women veterans using Veterans Administration (VA) ambulatory care nationally. Obesity, smoking, problem alcohol use, sedentary lifestyle, and hysterectomy before age 40 were found to be more common in women reporting a history of sexual assault while in the military than in women without such history. An association between myocardial infarction and prior sexual assault history may be mediated in part by known cardiac risk factors.

Cardioprotection with ICRF-187 (Cardioxane) in patients with advanced breast cancer having cardiac risk factors for doxorubicin cardiotoxicity, treated with the FDC regimen

1995 ◽  
Vol 3 (3) ◽  
pp. 176-182 ◽  
Author(s):  
Svetislav Jelić ◽  
Siniša Radulović ◽  
Zora Nešković-Konstantinović ◽  
Miroslav Kreačić ◽  
Zorana Ristović ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Advanced Breast Cancer ◽  
Cardiac Risk ◽  
Advanced Breast ◽  
Cardiac Risk Factors ◽  
Doxorubicin Cardiotoxicity

Abstract 3635: Weight Loss Reverses Left Ventricular Structural Changes In Subjects With Severe Uncomplicated Obesity. A One year Follow Up Study.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Oliver J Rider ◽  
Jane M Francis ◽  
Mohammed K Ali ◽  
Monique R Robinson ◽  
Stefan Neubauer
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Structural Changes ◽  
Total Body Weight ◽  
Cardiac Risk ◽  
Left Ventricular ◽  
Cardiac Risk Factors ◽  
Co Morbidity ◽  
Lv Mass ◽  
One Year

Objective Obesity has been linked to a spectrum of cardiovascular abnormalities from subclinical changes in cardiac structure to overt heart failure. Uncomplicated obesity (i.e. obesity without any other co-morbidity or cardiovascular risk factors) has been shown to cause increased LV mass and LV dilatation. Our hypothesis was that these changes are, at least in part, reversible following significant weight loss over one year. Method Forty-one obese (BMI 37.7 ± 7.4 SD) and 12 age, sex matched controls (BMI 21.6 ± 1.8 SD) with no identifiable cardiac risk factors underwent cardiac MR imaging for the assessment of LV Mass (g), LV end-diastolic volume (EDV; ml), stroke volume (SV; ml) and LV EF (%). Fourteen obese subjects underwent repeat imaging after a one year period of weight loss, averaging 14.6 ± 11.5 % total body weight. Results Obesity per se was associated with elevated LV mass (125 ± 27 vs 89 ± 23g; p<0.001), LV mass indexed to height (74.4 ± 14.3 vs 52.3 ± 11.4g/m; p<0.001) and EDV (147 ± 28 vs 119 ± 24 ml; p<0.001). ESV and SV were also elevated in obesity (47 ± 12 vs 39 ± 12ml; p=0.05, and 100 ± 14 vs 80 ± 18 ml; p<0.001, respectively). LV EF was similar between groups (p=0.83). After weight loss, there was a significant reduction in LV mass (by 16 ± 11g; 135 ± 31 vs 119 ± 28g; p<0.001), LV mass indexed to height (76.4 ± 15.7 vs 68.9 ± 12 g/m; p<0.001). EDV and ESV were significantly smaller after weight loss (146 ± 25 vs 133 ± 23 ml; p<0.001, and 43 ± 12 vs 41 ± 10 ml; p<0.001 respectively). LV EF and SV did not change significantly. Conclusion In subjects with obesity in the absence of identifiable cardiac risk factors, LV hypertrophy and LV dilatation were partially reversible after a one year period of weight loss.

Characteristics and outcomes of acute COVID-19 infection in paediatric and young adult patients with underlying cardiac disease

2021 ◽  
pp. 1-7
Author(s):  
Joshua M. Fisher ◽  
Sarah Badran ◽  
John T. Li ◽  
Jodie K. Votava-Smith ◽  
Patrick M. Sullivan
Keyword(s):  
Risk Factors ◽  
Young Adult ◽  
Pulmonary Disease ◽  
Cardiac Disease ◽  
Single Ventricle ◽  
Cardiac Risk ◽  
Adult Patients ◽  
Chronic Pulmonary Disease ◽  
Cardiac Risk Factors ◽  
Increased Risk

Abstract Objective To describe outcomes of acute coronavirus disease 2019 in paediatric and young adult patients with underlying cardiac disease and evaluate the association between cardiac risk factors and hospitalisation. Study design We conducted a retrospective single-institution review of patients with known cardiac disease and positive severe acute respiratory syndrome coronavirus 2 RT-PCR from 1 March, 2020 to 30 November, 2020. Extracardiac comorbidities and cardiac risk factors were compared between those admitted for coronavirus disease 2019 illness and the rest of the cohort using univariate analysis. Results Forty-two patients with a mean age of 7.7 ± 6.7 years were identified. Six were 18 years of age or more with the oldest being 22 years of age. Seventy-six percent were Hispanic. The most common cardiac diagnoses were repaired cyanotic (n = 7, 16.6%) and palliated single ventricle (n = 7, 16.6%) congenital heart disease. Fourteen patients (33.3%) had underlying syndromes or chromosomal anomalies, nine (21%) had chronic pulmonary disease and eight (19%) were immunosuppressed. Nineteen patients (47.6%) reported no symptoms. Sixteen (38.1%) reported only mild symptoms. Six patients (14.3%) were admitted to the hospital for acute coronavirus disease 2019 illness. Noncardiac comorbidities were associated with an increased risk of hospitalisation (p = 0.02), particularly chronic pulmonary disease (p = 0.01) and baseline supplemental oxygen requirement (p = 0.007). None of the single ventricle patients who tested positive required admission. Conclusions Hospitalisations for coronavirus disease 2019 were rare among children and young adults with underlying cardiac disease. Extracardiac comorbidities like pulmonary disease were associated with increased risk of hospitalisation while cardiac risk factors were not.

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