हृदय रोग एवं निदान

Cardiovascular Diseases (CVDs) are the leading cause of death worldwide. While traditional risk factors like high blood pressure, smoking, and obesity are well-known, there exist hidden risk factors that often go unnoticed. This article delves into the silent threats to cardiovascular health, shedding light on lesser-known factors that contribute to the rising CVD epidemic. Understanding and addressing these hidden risk factors is essential for effective prevention and management. Cardiovascular Diseases (CVDs) have long held the dubious distinction of being the leading global cause of death, claiming an estimated 17.9 million lives each year. While many risk factors for CVD are well-documented, such as smoking, high blood pressure, and obesity, there is a lurking menace in the form of hidden risk factors that often evade our attention. These hidden risk factors quietly contribute to the CVD epidemic, and understanding them is crucial for better prevention and management strategies.

Stress is an unavoidable part of modern life, affecting individuals across the globe in various ways. While it is a natural response to challenging situations, chronic stress can lead to severe health issues, including Cardiovascular Disease (CVD). This article explores the intricate relationship between stress and CVD, highlighting the mechanisms that link them and emphasizing the importance of effective stress management as a preventive and therapeutic measure. It also discusses practical strategies for managing stress and reducing the risk of CVD, emphasizing lifestyle changes, mindfulness techniques, and social support networks. Physical activity is a powerful stress reducer. Exercise releases endorphins, which are natural mood lifters, and it also helps regulate stress hormones. Engaging in regular physical activity can lower blood pressure, improve heart health, and reduce the risk of CVD. A well-balanced diet can have a significant impact on both stress levels and cardiovascular health. Foods rich in antioxidants, such as fruits and vegetables, can help combat the inflammation associated with stress.

Background: Acute Type A Aortic Dissection (TAAD) is a life-threatening disease. Apart from the well- known atherosclerotic risk factor, circadian, seasonal and climate-related patterns are also factors with a significantly higher risk in winter, on the first day of the working week, and in the morning hours (between 6 a.m. and 12 p.m.). Acute TAAD can also be triggered by higher mean arterial blood pressure with corresponding blood pressure peaks, and changes in atmospheric pressure. The aim of this study is to analyze climatic parameters in the catchment area of Kiel in northern Germany which can influence the occurrence of acute TAAD.

Methods: All acute TAAD repairs from January 1^st, 2012 to November 24^th, 2017 in the University of Hospital Schleswig-Holstein Campus (UKSH) were evaluated. Traumatic aortic dissections were excluded. Statistics were performed regarding to R&R commander programs using Wilcoxon rank sum test for data correlation analyzes.

Results: A total of 181 acute TAAD repairs were identified. There were no significant correlation between the mean temperature and the number of acute TAAD incidents, the mean differences between the daily averages of the weather parameters or the mean temperature on the days (0-14) before the onset of acute TAAD. However, precipitation remains constant on the 3^rd and 4^th days before acute dissection and decreases the day before (t=-1). On the day of acute dissection (t=0), it increases significantly.

Conclusion: Relative climatic changes (rather than absolute values) may have a greater effect on the incidence of acute dissection. The effect of climatic variations appear to depend on the local context, such as the initial value at which the variation begins. Lower temperatures (from a higher baseline temperature) have a different effect than lowering it from an already low value. In the Kiel region in northern Europe, the occurrence of acute TAAD is not related to temperature but does increase significantly on days with higher precipitation.

Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians who specialize in this field of medicine are called cardiologists, a specialty of internal medicine. Pediatric cardiologists are pediatricians who specialize in cardiology. Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons, a specialty of general surgery.

Objectives: Our aim was to compare available Transcatheter Aortic Valve Replacement (TAVR) valves using direct and indirect evidence from Randomized Controlled Trials (RCT).

Background: TAVR is now an established treatment for majority of patients with severe aortic stenosis. However, there is limited data comparing various valves.

Methods: We performed a systematic search of electronic databases for RCT comparing a TAVR valve to a valve or surgery. A Bayesian network meta-analysis was performed to compile evidence from both direct and indirect comparisons at 30 days and at one year.

Results: Twelve studies with 10,307 patients eligible for TAVR met the criteria and were included. Self-expanding Valve Core valve type (SEV_C) is associated with higher risk of pacemaker implantation and use of >1 valve, SEV Accurate type (SEV_A) is associated with higher risk of ≥ moderate Aortic Regurgitation (AR) and death, and Mechanically Expandable Valve (MEV) is associated with lower risk of ≥ moderate AR but higher risk of pacemaker at 30 days, SEV_C and MEV were associated with higher pacemaker rates compared balloon expandable valve (BEV) at 1 year. There is no difference among the valves in stroke at 30 days and 1 year.

Conclusions: At 30 days, BEV was superior on one or more outcomes of mortality, pacemaker implantation, >1 valve implantation and ≥ moderate AR compared to other valves except the higher rate ≥ moderate AR compared to MEV. At one year, BEV was associated with lower odds of pacemaker implantation compared to SEV_C and MEV but not different on other end points.

Hereditary, observational and clinical intercession studies demonstrate that coursing levels of Remainder Cholesterol (RC) are related with cardiovascular sicknesses. However, it is still unclear how well RC can predict cardiovascular mortality in the general population. The 19,650 adults in the United States who participated in our study were drawn from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. The Sampson formula was used to divide non-High-Density Lipoprotein Cholesterol (non-HDL-C) by Low-Density Lipoprotein Cholesterol (LDL-C) to arrive at RC. Subgroup analysis, restricted cubic spline analysis and multivariate Cox regression were used to investigate the connection between RC and cardiovascular mortality. Independent of conventional risk factors, elevated RC levels was linked to cardiovascular mortality.

Hereditary, observational and clinical mediation studies demonstrate that coursing levels of fatty oils and cholesterol moved in fatty substance rich lipoproteins (remainder cholesterol) can foresee cardiovascular occasions. This study looked at the relationship between major cardiovascular events and a group of older people with high cardiovascular risk's triglycerides and residual cholesterol (remnant-C). This study searched the high risk primary prevention PREDIMED trial population for Major Adverse Cardiovascular Events (MACEs) and determined the baseline lipid profile. The mean age of the participants was: 67 years; index of mass in kg: 30 kg/m²; 43% men; 48% with diabetes) after a middle development of 4.8 years. The association between incident MACEs and lipid concentrations (either as continuous or categorical variables) was evaluated using both unadjusted and adjusted Cox proportional hazard models (N=6,901; n cases=263). Triglycerides' HR (hazard ratio) in multivariable adjusted analyses was as follows: 1.04; 95 percent confidence interval: 1.02 to 1.06 or 0.11 mmol/l, per 10 mg/dl; HDL-C (HR: p 0.001), non-high density lipoprotein cholesterol 1.05; 95% CI: 1.01 to 1.10 or 0.26 mmol/l, per 10 mg/dl; p=0.026) and remainder C (HR: 1.21; 95% CI: 1.10 to 1.33 or 0.26 mmol/l, per 10 mg/dl; MACEs were not associated with HDL-C or low density lipoprotein cholesterol (p=0.001), however. MACEs were also associated with atherogenic dyslipidemia (triglycerides>150 mg/dl (1.69 mmol/l) and HDL-C 40 mg/dl (1.03 mmol/l) in men or 50 mg/dl (1.29 mmol/l) in women) (HR: 1.44; 95% CI: 1.04 to 2.00; p=0.030). Regardless of whether LDL-C levels were on target at 100 mg/dl (2.59 mmol/l), subjects with residual C concentrations below 30 mg/dl (0.78 mmol/l) were more likely to experience MACEs. Triglyceride and remnant-C levels, but not LDL-C, were associated with cardiovascular outcomes in overweight or obese individuals at high cardiovascular risk, independent of other risk factors.