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April-June 2020
Volume 5 | Issue 2
Page 55-100
Online since Tuesday, June 30, 2020
Accessed 1,008 times.

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P. 55
Yu-Xin He, Hasan Jilaihawi
Transcatheter aortic valve replacement (TAVR) has developed rapidly in recent years as an alternative to surgical aortic valve replacement for patients with aortic valve diseases. As a minimally invasive approach, procedure success and good outcomes for patients largely depend on the procedure planning before TAVR. Moreover, imaging plays a vital role in contemporary TAVR planning. Among different types of imaging modalities, computed tomography (CT) is central. This article provides a systematic review of the role of CT in TAVR planning, including anatomic measurement and TAVR risk evaluation.
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P. 62
Yu-Liang Long, Wen-Zhi Pan, Da-Xin Zhou, Jun-Bo Ge
In recent years, transcatheter treatment of mitral regurgitation (MR) has been extensively explored and has shown promising results. After transcatheter mitral valve repair (TMVr) with MitraClip has become a routine strategy in patients with symptomatic degenerate MR at prohibitive surgical risk, the benefits of TMVr are now being examined in patients with functional MR (FMR). However, the contradictory observations in COAPT and MITRA-FR clinical trials so far have suggested that only patients with severe FMR disproportionate to left ventricular disorder may benefit from this interventional therapy. Nevertheless, more evidence is required to support this hypothesis. In addition, various new devices have been developed, including two original designs from China Mainland, which have displayed excellent performance. Several percutaneous (femoral vein.transseptal) valves used in transcatheter mitral valve replacement have been developed and have also shown good feasibility. Furthermore, hybrid techniques in MR therapies have been emerging, which may reduce residual MR and improve the treatment effects.
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P. 71

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P. 81
Yun-Lan Lu, Li Zhu, Gui-Hua Hou, Xiao-Dong Gao, Wu-Xian Chen, Hua-Fen Liu, Xiao-Fang Gu, Zhen-Tao Shi, Ying Wang, Hong-Mei Wen, Juan Xiao, Su-Yu Yao, Wen-Li Zhao, Ming-Xia Zheng, Consensus for Nursing Management of Patients with Suspected COVID.19 Undergoing Primary PCI Expert Group
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P. 89
Li-Wen Bao, Kun Xie, Li-Lian Bao, Ying Shan, Xin-Yu Zhuang, Hai-Ming Shi, Yong Li, Xiu-Fang Gao, for the UPPDATE collaboration
Objectives: This study aimed to investigate the association between the metabolic syndrome (MetS) components and chronic kidney disease (CKD) in hypertension of different low-density lipoprotein cholesterol (LDL-C) levels. Methods: This national cross-sectional study was conducted in hospitals in 24 cities of China and comprised of 4792 eligible hypertensive participants with a recorded creatinine level between 2017 and 2018. All participants underwent a clinical survey and clinical assessment and were required to provide biomedical reports within 1 year from their outpatient visit. Student's t-test, log-rank, and Chi-square tests and receiver operating characteristic curve (ROC) analysis were used in data analysis. Results: Participants' average age was 65.82 ± 12.74 years; 54.65% were male. Overall, 52.73%, 63.29%, 26.84%, and 77.27% of participants had a high waist circumference, elevated triglyceride (TG) level, low high-density lipoprotein cholesterol level, and impaired fasting glucose/diabetes, respectively. The adjusted odds ratio (OR) for CKD with MetS was 1.67 (95% confidence interval [CI] 1.32–2.10, P < 0.001). The risk of CKD was associated with older age (OR: 1.05, 95% CI: 1.04–1.06, P < 0.001), female (OR: 1.25, 95% CI: 1.01–1.55, P < 0.001), higher LDL-C level (OR: 1.17, 95% CI: 1.08–1.27, P = 0.03), higher TG level (OR: 1.38, 95% CI: 1.13–1.68, P = 0.001), impaired fasting glucose/diabetes (OR 1.48, 95% CI: 1.2–1.85, P < 0.001), and a combination of two or more than three MetS components (OR: 1.7, 95% CI: 1.07–2.71, P = 0.025; OR: 2.03, 95% CI: 1.08–3.13, P = 0.008, respectively) (ROC curve: 0.7). MetS remained significantly associated with CKD in both LDL-C subgroups, but different associations between the MetS components and CKD were found. Conclusions: MetS and its components are less associated with CKD of LDL-C <2.6 mmol/L than LDL-C ≥2.6 mmol/L in hypertension. LDL-C is significantly associated with CKD in hypertension of LDL-C level ≥2.6 mmol/L subgroup.
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P. 97
Jian-An Wang, Xin-Ping Lin, Ju-Bo Jiang, Xian-Bao Liu, Jun Jiang, Zhao-Xia Pu, Li-Han Wang, Hua-Jun Li, Fei Lv
A 68-year-old man presented with chest distress recurring for the past 10 years. An echocardiogram demonstrated bicuspid aortic valve malformation with severe aortic stenosis and ventricular septal thickness of 22 mm. The patient underwent successful transcatheter aortic valve replacement (TAVR). Six months later, he complained of worsening dyspnea and chest distress (New York Heart Association Class III) on exertion. Besides a functional normal AV prosthesis, the echocardiography indicated the left ventricular outflow tract obstruction peak gradient of 122 mmHg at rest. Alcohol septal ablation was performed as the patient was unable to tolerate morrow procedure. His symptoms were relieved immediately after ablation, and no major cardiovascular events were observed during the 20-month follow-up. In conclusion, among patients with concomitant hypertrophic obstructive cardiomyopathy and severe aortic valvular stenosis, consideration for TAVR and alcohol septal ablation should only be made for patients who are at high surgical risk or cannot tolerate thoracotomy.
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