scholarly journals Biomarkers in Community-Acquired Pneumonia (Cardiac and Non-Cardiac)

2020 ◽  
Vol 9 (2) ◽  
pp. 549 ◽  
Author(s):  
Raúl Méndez ◽  
Irene Aldás ◽  
Rosario Menéndez
Keyword(s):  
Cardiovascular Risk ◽  
Clinical Application ◽  
Host Response ◽  
Clinical Course ◽  
Cardiovascular Complications ◽  
Community Acquired Pneumonia ◽  
Negative Consequences ◽  
Novel Biomarkers ◽  
Complications And Mortality

Community-acquired pneumonia (CAP) remains the first cause of morbidity and mortality worldwide due to infection. Several aspects such as severity and host response are related to its clinical course and outcome. Beyond the acute implications that the infection provokes in the host, pneumonia also has long-term negative consequences. Among them, cardiovascular complications and mortality are the most outstanding. Therefore, an adequate recognition and stratification of the risk of complications and mortality is crucial. Many biomarkers have been studied for these reasons, considering that each biomarker mirrors a different aspect. Moreover, the clinical application of many of them is still being deliberated because of their limitations and the heterogeneity of the disease. In this review, we examine some of the most relevant biomarkers that we have classified as cardiac and non-cardiac. We discuss some classic biomarkers and others that are considered novel biomarkers, which are mainly involved in cardiovascular risk.

scholarly journals UP-TO-DATE STRATEGY FOR SURGICAL TREATMENT OF CANCER PATIENTS WITH SEVERE CONCOMITANT CARDIOVASCULAR DISEASES

2018 ◽  
Vol 23 (3-6) ◽  
pp. 120-128
Author(s):  
Sergei S. Gerasimov ◽  
M. I Davydov ◽  
M. M Davydov
Keyword(s):  
Surgical Treatment ◽  
Cardiovascular Diseases ◽  
Cancer Patients ◽  
Myocardial Revascularization ◽  
Coronary Bypass ◽  
Cardiovascular Complications ◽  
Minimal Risk ◽  
Simultaneous Operations ◽  
Complications And Mortality

Introduction. Surgical treatment of cancer patients with severe concomitant cardiovascular diseases (CVD) is still a debatable issue. Materials and methods. The study involved 170 cancer patients who had surgical operations. Most patients had coronary heart disease (CHD) as severe concomitant cardiovascular disease -133 cases (78.2%). Simultaneous surgeries were performed in 32 (18.8%) patients; step-by-step tactics was achieved in 138 (81.2%) patients. The study evaluated frequency of complications and mortality. Prophylactic efficiency of surgery for severe concomitant CVDs was determined, as well. The causes of deaths within long-term periods were analyzed, and 3- and 5-year survival was calculated by Kaplan-Meier method. Results. Frequency of complications and mortality in radically operated cancer patients accounted for 55.3% and 4.1%, respectively. A higher rate of complications was registered after simultaneous operations as compared with that after step-by-step tactics - 60% and 52.6% , respectively (р>0.05). Prophylactic efficiency of surgery for severe concomitant CVDs in total accounted for 92.4%. The most effective method for prophylactic myocardial revascularization was coronary bypass (CB) performed at the first step. The main cause of death of radically operated patients in the long-term period was tumor process progression - 31.7%, while CVDs caused much less deaths - 9.8% (р =0,001). 3 and 5-year survival accounted for 59% and 46%, respectively. Conclusions: Surgical treatment of severe concomitant CVDs of cancer patients is a highly effective method for prevention of severe cardiovascular complications. Step-by-step tactics is associated with less frequency of complications. Simultaneous surgery with minimal risk may be performed in a selected group of patient. In the long-term follow up period the main factors, which affected 3- and 5-year survival were the radical type of surgery and the advanced cancer process.

scholarly journals Long-term cardiovascular complications following sepsis: is senescence the missing link?

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hamid Merdji ◽  
Valérie Schini-Kerth ◽  
Ferhat Meziani ◽  
Florence Toti
Keyword(s):  
Cardiovascular Risk ◽  
Cardiovascular Events ◽  
Cardiovascular Complications ◽  
Sepsis Syndrome ◽  
Major Adverse Cardiovascular Events ◽  
Accelerated Ageing ◽  
Premature Senescence ◽  
Increased Risk ◽  
Vascular Senescence

AbstractAmong the long-term consequences of sepsis (also termed “post-sepsis syndrome”) the increased risk of unexplained cardiovascular complications, such as myocardial infarction, acute heart failure or stroke, is one of the emerging specific health concerns. The vascular accelerated ageing also named premature senescence is a potential mechanism contributing to atherothrombosis, consequently leading to cardiovascular events. Indeed, vascular senescence-associated major adverse cardiovascular events (MACE) are a potential feature in sepsis survivors and of the elderly at cardiovascular risk. In these patients, accelerated vascular senescence could be one of the potential facilitating mechanisms. This review will focus on premature senescence in sepsis regardless of age. It will highlight and refine the potential relationships between sepsis and accelerated vascular senescence. In particular, key cellular mechanisms contributing to cardiovascular events in post-sepsis syndrome will be highlighted, and potential therapeutic strategies to reduce the cardiovascular risk will be further discussed.

scholarly journals Impact of reducing the duration of antibiotic treatment on the long-term prognosis of community acquired pneumonia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ane Uranga MD ◽  
Amaia Artaraz MD ◽  
Amaia Bilbao MD ◽  
Jose María Quintana MD ◽  
Ignacio Arriaga MD ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Intervention Group ◽  
Cardiovascular Complications ◽  
Community Acquired Pneumonia ◽  
Control Group ◽  
Reactive Protein ◽  
Long Term Prognosis ◽  
The Impact ◽  
Clinical Stability

Abstract Background The optimal duration of antibiotic treatment for community-acquired pneumonia (CAP) is not well established. The aim of this study was to assess the impact of reducing the duration of antibiotic treatment on long-term prognosis in patients hospitalized with CAP. Methods This was a multicenter study assessing complications developed during 1 year of patients previously hospitalized with CAP who had been included in a randomized clinical trial concerning the duration of antibiotic treatment. Mortality at 90 days, at 180 days and at 1 year was analyzed, as well as new admissions and cardiovascular complications. A subanalysis was carried out in one of the hospitals by measuring C-reactive protein (CRP), procalcitonin (PCT) and proadrenomedullin (proADM) at admission, at day 5 and at day 30. Results A total of 312 patients were included, 150 in the control group and 162 in the intervention group. Ninety day, 180 day and 1-year mortality in the per-protocol analysis were 8 (2.57%), 10 (3.22%) and 14 (4.50%), respectively. There were no significant differences between both groups in terms of 1-year mortality (p = 0.94), new admissions (p = 0.84) or cardiovascular events (p = 0.33). No differences were observed between biomarker level differences from day 5 to day 30 (CRP p = 0.29; PCT p = 0.44; proADM p = 0.52). Conclusions Reducing antibiotic treatment in hospitalized patients with CAP based on clinical stability criteria is safe, without leading to a greater number of long-term complications.

Long Term Cardiovascular Risk in Women

2005 ◽  
Vol 2 (4) ◽  
pp. 261-265
Author(s):  
Muna Noori ◽  
Nick Anim-Nyame
Keyword(s):  
Cardiovascular Risk

scholarly journals Severe tricuspid regurgitation 14 years after diagnosis of “transient neonatal tricuspid regurgitation”

Heart ◽  
2001 ◽  
Vol 86 (1) ◽  
pp. 88-90
Author(s):  
D Boshoff ◽  
L Mertens ◽  
M Gewillig
Keyword(s):  
Tricuspid Regurgitation ◽  
Neonatal Period ◽  
Clinical Course ◽  
Subsequent Evolution ◽  
Severe Tricuspid Regurgitation ◽  
Echocardiographic Examination ◽  
Long Term Follow Up ◽  
Transient Tricuspid Regurgitation

A 14 year old girl presented with severe tricuspid regurgitation after she was diagnosed with “transient tricuspid regurgitation of the newborn”. In the neonatal period she had presented with severe tricuspid regurgitation without an obvious underlying anatomical cause. This spontaneously regressed during the first months of life. She was dismissed from follow up at the age of 5 years after complete normalisation of the clinical and echocardiographic examination. The subsequent evolution and management of the patient, as well as the possible pathogenesis responsible for the unusual clinical course, is discussed. This case stresses the importance of long term follow up of patients with transient tricuspid regurgitation.

scholarly journals Assessment of Exercise Intolerance in Patients with Pre-Dialysis CKD with Cardiopulmonary Function Testing: Translation to Everyday Practice

2021 ◽  
pp. 1-15
Author(s):  
Eva Pella ◽  
Afroditi Boutou ◽  
Marieta P. Theodorakopoulou ◽  
Pantelis Sarafidis
Keyword(s):  
Cardiovascular Risk ◽  
Risk Stratification ◽  
Cardiopulmonary Exercise Testing ◽  
Adverse Outcomes ◽  
Exercise Intolerance ◽  
Exercise Limitation ◽  
Integrative Evaluation ◽  
Prognostic Utility ◽  
Risk Potential

<b><i>Background:</i></b> Chronic kidney disease (CKD) is often characterized by increased prevalence of cardiovascular risk factors and increased incidence of cardiovascular events and death. Reduced cardiovascular reserve and exercise intolerance are common in patients with CKD and are associated with adverse outcomes. <b><i>Summary:</i></b> The gold standard for identifying exercise limitation is cardiopulmonary exercise testing (CPET). CPET provides an integrative evaluation of cardiovascular, pulmonary, hematopoietic, neuropsychological, and metabolic function during maximal or submaximal exercise. It is useful in clinical setting for differentiation of the causes of exercise intolerance, risk stratification, and assessment of response to relevant treatments. A number of recent studies have used CPET in patients with pre-dialysis CKD, aiming to assess the cardiovascular reserve of these individuals, as well as the effect of interventions such as exercise training programs on their functional capacity. This review provides an in-depth description of CPET methodology and an overview of studies that utilized CPET technology to assess cardiovascular reserve in patients with pre-dialysis CKD. <b><i>Key Messages:</i></b> CPET can delineate multisystem changes and offer comprehensive phenotyping of factors determining overall cardiovascular risk. Potential clinical applications of CPET in CKD patients range from objective diagnosis of exercise intolerance to preoperative and long-term risk stratification and providing intermediate endpoints for clinical trials. Future studies should delineate the association of CPET indexes, with cardiovascular and respiratory alterations and hard outcomes in CKD patients, to enhance its diagnostic and prognostic utility in this population.

scholarly journals A Similar Lifetime CV Risk and a Similar Cardiometabolic Profile in the Moderate and High Cardiovascular Risk Populations: A Population-Based Study

2021 ◽  
Vol 10 (8) ◽  
pp. 1584
Author(s):  
Małgorzata Chlabicz ◽  
Jacek Jamiołkowski ◽  
Wojciech Łaguna ◽  
Paweł Sowa ◽  
Marlena Paniczko ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Premature Mortality ◽  
Population Based ◽  
Pharmacological Management ◽  
Study Population ◽  
Perspective Model ◽  
European Society Of Cardiology ◽  
Cardiometabolic Profile

Background: Cardiovascular disease (CVD) is a major, worldwide problem that remains the dominant cause of premature mortality in the world, and increasing rates of dysglycaemia are a major contributor to its development. The aim of this study was to investigate the cardiometabolic profile among patients in particular cardiovascular risk classes, and to estimate their long term CV risk. Methods: A total of 931 individuals aged 20–79 were included. The study population was divided into CV risk classes according to the latest European Society of Cardiology recommendations. Results: Most of the analyzed anthropometric, body composition and laboratory parameters did not differ between the moderate and high CV risk participants. Interestingly, estimating the lifetime risk of myocardial infarction, stroke or CV death, using the LIFEtime-perspective model for individualizing CardioVascular Disease prevention strategies in apparently healthy people, yielded similar results in moderate and high CV risk classes. Conclusion: The participants who belonged to moderate and high CV risk classes had very similar unfavorable cardiometabolic profiles, which may result in similar lifetime CV risk. This may imply the need for more aggressive pharmacological and non-pharmacological management of CV risk factors in the moderate CV risk population, who are often unaware of their situation. New prospective population studies are necessary to establish the true cardiovascular risk profiles in a changing society.

Long-term effects (>24 months) of multiple lifestyle intervention on major cardiovascular risk factors among high risk subjects: a meta-analysis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
H Bergum ◽  
I Sandven ◽  
TO Klemsdal
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Total Cholesterol ◽  
Cardiovascular Risk Factors ◽  
Lifestyle Intervention ◽  
Small Study ◽  
Long Term Effects

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Norwegian health department Background The evidence of the long-term effects of multiple lifestyle intervention on cardiovascular risk is uncertain. We aimed to summarize the evidence from randomized clinical trials examining the efficacy of lifestyle intervention on major cardiovascular risk factors in subjects at high cardiovascular risk. Methods  Eligible trials investigated the impact of lifestyle intervention versus usual care with minimum 24 months follow-up, reporting more than one major cardiovascular risk factor. A literature search updated April 15, 2020 identified 12 eligible studies. The results from individual trials were combined using fixed and random effect models, using the standardized mean difference (SMD) to estimate effect sizes. Small-study effect was evaluated, and heterogeneity between studies examined by subgroup and meta-regression analyses considering patient- and study-level variables. Results  Small-study effect was not identified. Lifestyle intervention reduced systolic blood pressure modestly with an estimated SMD of -0.13, 95% confidence interval (CI): -0.21 to -0.04, with moderate heterogeneity (I² = 59%), corresponding to a mean difference of approximately 2 mmHg (MD = -1.86, 95% CI: -3.14 to -0.57, p = 0.0046). This effect disappeared in the subgroup of trials judged at low risk of bias (SMD = 0.02, 95% CI: -0.08 to 0.11). For the outcome total cholesterol SMD was -0.06, 95% CI: -0.13 to 0.00, with no heterogeneity (I² = 0%), indicating no effect of the intervention. Conclusion  Lifestyle intervention resulted in only a modest effect on systolic blood pressure and no effect on total cholesterol after 24 months. Further lifestyle trials should consider the challenge of maintaining larger long-term benefits to ensure impact on cardiovascular outcomes.

Mild gray matter atrophy in patients with long-standing multiple sclerosis and favorable clinical course

2021 ◽  
pp. 135245852110196
Author(s):  
Rosa Cortese ◽  
Marco Battaglini ◽  
Francesca Parodi ◽  
Maria Laura Stromillo ◽  
Emilio Portaccio ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Gray Matter ◽  
Clinical Course ◽  
Resonance Imaging ◽  
Volume Changes ◽  
Magnetic Resonance Imaging Mri ◽  
Global Brain ◽  
Diffuse Brain

The mechanisms responsible for the favorable clinical course in multiple sclerosis (MS) remain unclear. In this longitudinal study, we assessed whether magnetic resonance imaging (MRI)-based changes in focal and diffuse brain damage are associated with a long-term favorable MS diseases course. We found that global brain and gray matter (GM) atrophy changes were milder in MS patients with long-standing disease (⩾30 years from onset) and favorable (no/minimal disability) clinical course than in sex-age-matched disable MS patients, independently of lesions accumulation. Data showed that different trajectories of volume changes, as reflected by mild GM atrophy, may characterize patients with long-term favorable evolution.

Sign in / Sign up

Export Citation Format

Share Document