Davidwilhelmsen1935

Background Chemerin is a newly discovered adipokine, which has been reported to be associated with the presence of dilated cardiomyopathy (DCM). The present study aims to evaluate the prognostic value of serum chemerin in patients with DCM. Methods A total of 214 patients with DCM was recruited and divided into 4 groups, according to quartiles of chemerin levels. Kaplan-Meier analysis was conducted to compare the survival rates among patients with different levels of chemerin, using the log-rank test. Multivariate Cox regression analysis was performed to assess the association of serum chemerin levels and occurrence of major adverse cardiac events (MACEs), including cardiac mortality, stroke and myocardial infarction. Results The Kaplan-Meier survival analysis indicated that patients with higher concentration of chemerin had shorter event-free survivals for MACEs (P less then .01). Cox regression analysis showed that chemerin was a significant predictor of MACEs (Quartile 3 versus Quartile 1 HR=1.79, 95% CI 1.31-2.79; Quartile 4 versus Quartile 1 HR=2.87, 95% CI 1.79-4.25) and all-cause death (Quartile 3 versus Quartile 1 HR=1.56, 95% CI 1.20-2.42; Quartile 4 versus Quartile 1 HR=2.28, 95% CI 1.52-3.96) after adjusting for potential risk factors. Conclusion Serum chemerin should be a potential prognostic indicator in patients with DCM.Background The Surgical Treatment for Ischemic Heart Failure (STICH) trial showed that surgical revascularization in ischemic cardiomyopathy (ICM) patients improves long-term mortality compared with medical treatment alone. This study examines how veterans with ICM undergoing revascularization fare against patients without ICM; it also examines the outcomes in the veteran population. Methods This is a retrospective review of a single-center database. From 2000 to 2018, 1,461 patients underwent isolated coronary artery bypass grafting (CABG). Two-hundred-one patients with an ejection fraction less than 35% were classified as the ICM cohort. The primary outcome was mortality. Secondary outcomes included postoperative complications. Subgroup analysis was performed within the ICM cohort comparing off-pump CABG (OPCAB) versus on-pump CABG (ONCAB). Results ICM patients had a higher incidence of myocardial infarction (MI), diabetes, chronic kidney disease (CKD), and preoperative intra-aortic balloon pump (IABP) use. The non-ICM cohort was more functionally independent. OPCAB was performed in 80.1% of ICM and 66.3% of non-ICM cohorts. click here There was no statistical difference between ICM and non-ICM cohorts in 30-day mortality (OR 1.94[0.79 - 4.75], P = .15). The ICM cohort had an increased 5-year mortality (OR 1.75[1.14 - 2.69], P = .01) and 10-year mortality (OR 1.71[1.09 - 2.67], P = .02). The ICM cohort showed improved, although not statistically significant, short-term mortality with OPCAB compared with ONCAB (3.1% versus 12.5%, OR 0.31[0.05 - 1.82], P = .20). Conclusion Veterans with ICM undergoing CABG demonstrated similar short-term survival compared with non-ICM veterans. The long-term survival in the ICM cohort still is inferior to patients without ICM. There is a trend toward improved short-term survival in patients with ICM undergoing OPCAB.Introduction Delirium after cardiac surgery is a devastating and important complication. Delirium is defined as "disturbance in attention (i.e., reduced ability to direct, focus, sustain, and shift attention) and awareness (reduced orientation to the environment)." In this study, we analyzed the association of preoperative vitamin D levels and postoperative delirium after cardiac surgery in patients over 65 years. Materials and methods We retrospectively reviewed the data of 212 adult patients above 65 years of age who underwent isolated coronary artery bypass graft surgery from January 2016 to January 2018. The mean age for Group I was 69.7 ± 7.4 and Group II was 70.6 ± 4.8 years. There were 112 female patients in Group I and 46 female patients in Group II. The patient population was divided into 2 groups based on preoperative serum vitamin D (25-hydroxyvitamin D [25-OHD]) levels (normal range of 25-75nmol/L). Group I included patients with preoperative serum 25-OHD level less then 25nmol/L. Group II includesary to confirm these results.Background This study compared the perioperative and follow-up period data of patients who underwent redo tricuspid valve replacements performed via thoracoscopic surgery or median sternotomy. The purpose was to evaluate the feasibility, safety, and surgical outcomes of redo tricuspid valve replacement via uni-port thoracoscopic surgery. Methods Forty-nine patients with severe tricuspid valve regurgitation after left-side valve replacement underwent redo tricuspid valve replacements in our hospital from April 2012 to September 2019. Twenty-six patients underwent uni-port total thoracoscopy surgery, whereas 23 patients had the surgery performed via median sternotomy. We collected perioperative and 3- to 36-month postoperative data. Results No deaths occurred in the intraoperative period. Time of cardiopulmonary bypass in the study group significantly was longer than that in the control group (P less then .05), but the operative times in the study and control groups were not significantly different. Thoracic drainage, length of ICU stay, postoperative hospital stay, and complication rates in the study group were significantly different from those in the control group (P less then .05). Throughout the follow-up period, uni-port total thoracoscopic TVR was not inferior to traditional surgery with respect to cardiac function and recurrence of tricuspid valve regurgitation. Conclusions Uni-port total thoracoscopic tricuspid valve replacement is safe, feasible and effective, and that can be considered as a primary treatment strategy for patients with severe TR after previous left-sided valve procedure.Background Lower limb ischemia in patients with extracorporeal membrane oxygenation (ECMO) via femoral artery catheterization negatively affects patient mortality and survivors' quality of life [Gulkarov 2020]. In this study, ECMO was established via femoral artery catheterization. This study aimed to identify the risk factors of lower limb ischemia to provide sufficient evidence for its prevention. Methods All patients with venoarterial (VA) ECMO via femoral artery catheterization in Zhongshan People's Hospital from January 2008 to November 2019 retrospectively were analyzed. Patients' general information and ECMO-related information were obtained, and the main outcome variables were survival and discharge and intubation-related adverse events (limb ischemia and incision bleeding). Logistic regression analysis was used to determine the independent risk factors of limb ischemia in patients with VA ECMO. Results A total of 179 (98 [54.7%] men and 81 [45.3%] women) eligible patients were included in this study.