Background Catecholamine excess arising from pheochromocytomas and paragangliomas (PPGLs) can cause a wide spectrum of cardiac manifestations, including acute cardiac complications (ACCs) and subclinical myocardial injuries (SMIs). In this study, we aimed to conduct a comprehensive analysis of ACCs and SMIs in a large cohort of patients with PPGLs. Methods We retrospectively analyzed the clinical data of consecutive patients with PPGLs admitted between January 2013 and July 2020 (n = 189). The prevalence of ACCs and SMIs and characteristics of patients identified with ACCs and SMIs were investigated. Moreover, comparisons were performed between patients with and without ACCs. Results Fourteen patients (7.4%) fulfilled the criteria for ACCs, including nine (4.8%) who presented with Takotsubo-like cardiomyopathy, four (2.1%) with heart failure with preserved ejection fraction, and finally one (0.5%) with catecholamine-induced cardiomyopathy. Compared to those without ACCs (n = 175), patients with ACCs had a higher prevalence of epinephrine-producing PPGLs (81.8% vs 33.9%, P = 0.006) and were more likely to show invasive behavior (61.5% vs 27.3%, P = 0.022) or hemorrhage/necrosis (53.9% vs 17.4%, P = 0.005) on histology. The apical sparing pattern (5/7, 71.4%) was the dominant impairment pattern of longitudinal strain (LS) for patients displaying Takotsubo-like cardiomyopathy. In patients without cardiac symptoms, a fairly high proportion (21/77, 27.3%) of patients who underwent screening for troponin and/or natriuretic peptide and/or echocardiography had SMIs. Conclusions One in every fourteen PPGL patients presented with ACCs, and in the patients with Takotsubo-like cardiomyopathy, the apical sparing pattern was the primary impairment pattern of LS. Additionally, nearly one-third of patients without symptoms had SMIs. The diagnosis of PPGLs should be considered in patients with acute reversible cardiomyopathy, especially in those exhibiting an apical sparing pattern of LS.

The purpose was to explore the effect of the WeChat platform health management and refined continuous nursing model on life quality of patients with acute myocardial infarction (AMI) after PCI. 100 AMI patients treated in the cardiovascular medicine of the First Affiliated Hospital of Soochow University from June 2018 to June 2019 were selected as the study subjects and randomly divided into research group and reference group, with 50 cases in each group. The reference group received routine nursing after PCI, while the research group received WeChat platform health management and continuous refined nursing. There were no significant differences in sex ratio, age, BMI, complications, education level, and residence between the two groups of patients ( P > 0.05 ). The MPR values of patients in the two groups after intervention were significantly higher than those before intervention ( P < 0.05 ), and the MPR value in the research group after intervention was significantly higher than that in the reference group ( P < 0.05 ). The SF-36 scores of patients in the two groups after intervention were significantly higher than those before intervention ( P < 0.001 ), and the SF-36 score in the research group after intervention was higher than that in the reference group ( P < 0.001 ). The emotional, physical, and economic dimensions of patients in the research group after intervention were significantly lower than those in the reference group ( P < 0.001 ). The HAMA and HAMD scores of patients in the research group after intervention were significantly lower than those in the reference group ( P < 0.001 ). The nursing satisfaction score of patients in the research group was significantly higher than that in the reference group ( P < 0.001 ). The total incidence of complications of patients in the research group after intervention was significantly lower than that in the reference group ( P < 0.05 ). The WeChat platform health management and refined continuous nursing model can effectively improve the medication compliance of patients after PCI, improve the life quality, alleviate depression and anxiety, and reduce postoperative complications, with a definite effect, which is worthy of promotion and application.

Background: Previously, we developed a novel C oronary A rtery T ree description and L esion E valua T ion (CatLet © ) angiographic scoring system, which was capable of accounting for the variability in the coronary anatomy and assisting in the risk-stratification of patients with acute myocardial infarction (AMI). Our preliminary study revealed that the CatLet score better predicted clinical outcomes for AMI patients than the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score. However, the reproducibility of the CatLet score in both inter- and intra-observer remains to be evaluated. Methods: A total of 30 consecutive AMI patients, admitted in September of 2015, were independently assessed by two experienced interventional cardiologists to evaluate the inter-observer reproducibility of the CatLet score. Another set of 49 consecutive AMI patients, admitted between September and October in 2014, were assessed by one of the two interventional cardiologists on two occasions 3 months apart to evaluate the intra-observer reproducibility of the CatLet score. The weighted kappa was used to express the degree of agreement. Results: The weighted kappa values (95% confidence interval) for the intra- and inter-observer reproducibility of the CatLet Score were 0.82 (0.59–1.00, Z = 7.23, P < 0.001) and 0.86 (0.54–1.00, Z = 5.20, P < 0.001), respectively, according to the tertile analysis (≤14, 15–22, >22). Regarding the adverse characteristics pertinent to lesions and dominance parameters, the kappa values for the inter-observer variability were 0.80 (0.56–1.00, Z = 6.47, P < 0.001) for total number of lesions, 0.57 (0.28–0.85, Z = 3.03, P < 0.001) for bifurcation, 0.69 (0.43–0.96, Z = 5.06, P < 0.001) for heavy calcification, 1.00 (0.72–1.00, Z = 6.93, P < 0.001) for tortuosity, 0.54 (0.26–0.82, Z = 3.78, P < 0.001) for thrombus, 0.69 (0.48–0.91, Z = 6.29, P < 0.001) for right coronary artery dominance, 0.69 (0.41–0.96, Z = 4.91, P < 0.001) for left anterior descending artery length, and 0.22 (0.06–0.51, Z = 1.56, P = 0.06) for diagonal size. Equivalent values for the intra-observer variability were moderate to almost perfect (range...

Aims: A meta-analysis was conducted to evaluate the safety and efficacy of novel oral anticoagulants (NOACs) compared with vitamin K antagonists (VKAs) in patients with left ventricular thrombus (LVT).Methods and Results: We searched PubMed, Web of Science, and Cochrane Library for cohort studies comparing the use of VKAs vs. NOACs for the treatment of LVT from the earliest date available to September 30, 2020. The predetermined efficacy and safety outcomes included thromboembolic events, resolution of LVT, clinically significant bleedings, and all-cause death. Fixed-effects model was used to estimate the pooled effects. Publication bias analyses and sensitivity analyses were conducted to check the robustness of results. A total of 6 studies enrolling 837 patients (mean age 60.2 ± 1.6 years; 77.2% were male) were included. We found no significant differences in thromboembolic events [relative risk (RR) 1.69, 95% confidence interval (CI) 0.94–3.06, P 0.08, I2 12.7%], the rate of resolution of thrombus (RR 1.08, 95% CI 0.96–1.21, P 0.21, I2 4.8%), and clinically significant bleedings (RR 0.70, 95% CI 0.37–1.32, P 0.27, I2 0%) between the VKAs and NOACs group. Additionally, no significant difference in all-cause mortality was found between the two groups (RR 1.24, 95% CI 0.79–1.96, P 0.35, I2 0.0%). Sensitivity analyses, using the “1-study removed” method, detected no significant differences.Conclusion: NOACs and VKAs have similar efficacy and safety in treating LVT, prompting the inference that NOACs are the possible alternatives of VKAs in LVT therapy.

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