169 results on '"Hsien-Li Kao"'
Search Results
2. TCTAP C-027 When Do We Do PCI to CTO Instead of Culprit Lesion in Patients With ACS?
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Sheng-Fu Liu, Mu-Yang Hsieh, and Hsien-Li Kao
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Cardiology and Cardiovascular Medicine - Published
- 2023
3. Agreement regarding overcoming hypertension in the Asian Hypertension Society Network 2022
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Satoshi Hoshide, Koichi Yamamoto, Kenichi Katsurada, Yuichiro Yano, Akira Nishiyama, Ji-Guang Wang, S. N. Narasingan, Narsingh Verma, Erwinanto Erwinanto, Yuda Turana, Sang Hyun Ihm, Sungha Park, Nik Sherina Hanafi, Yook-Chin Chia, Tsolmon Unurjargal, Saulat Siddique, Deborah Ignacia D. Ona, Narayanaswamy Venketasubramanian, Boon Wee Teo, Godwin Constantine, Hsien-Li Kao, Chi-Sheng Hung, Apichard Sukonthasarn, Sirisawat Kunanon, Huynh Van Minh, Kazuomi Kario, Koichi Node, Hiroshi Itoh, and Hiromi Rakugi
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Physiology ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2022
4. Edoxaban Versus Dual Antiplatelet Therapy for Leaflet Thrombosis and Cerebral Thromboembolism After TAVR: The ADAPT-TAVR Randomized Clinical Trial
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Duk-Woo, Park, Jung-Min, Ahn, Do-Yoon, Kang, Kyung Won, Kim, Hyun Jung, Koo, Dong Hyun, Yang, Seung Chai, Jung, Byungjun, Kim, Yiu Tung Anthony, Wong, Cheung Chi Simon, Lam, Wei-Hsian, Yin, Jeng, Wei, Yung-Tsai, Lee, Hsien-Li, Kao, Mao-Shin, Lin, Tsung-Yu, Ko, Won-Jang, Kim, Se Hun, Kang, Sung-Cheol, Yun, Seung-Ah, Lee, Euihong, Ko, Hanbit, Park, Dae-Hee, Kim, Joon-Won, Kang, Jae-Hong, Lee, and Seung-Jung, Park
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Pyridines ,Anticoagulants ,Thrombosis ,Aortic Valve Stenosis ,Transcatheter Aortic Valve Replacement ,Thiazoles ,Treatment Outcome ,Risk Factors ,Aortic Valve ,Thromboembolism ,Physiology (medical) ,Humans ,Cardiology and Cardiovascular Medicine ,Platelet Aggregation Inhibitors - Abstract
Background: It is unknown whether the direct oral anticoagulant edoxaban can reduce leaflet thrombosis and the accompanying cerebral thromboembolic risk after transcatheter aortic valve replacement. In addition, the causal relationship of subclinical leaflet thrombosis with cerebral thromboembolism and neurological or neurocognitive dysfunction remains unclear. Methods: We conducted a multicenter, open-label randomized trial comparing edoxaban with dual antiplatelet therapy (aspirin plus clopidogrel) in patients who had undergone successful transcatheter aortic valve replacement and did not have an indication for anticoagulation. The primary end point was an incidence of leaflet thrombosis on 4-dimensional computed tomography at 6 months. Key secondary end points were the number and volume of new cerebral lesions on brain magnetic resonance imaging and the serial changes of neurological and neurocognitive function between 6 months and immediately after transcatheter aortic valve replacement. Results: A total of 229 patients were included in the final intention-to-treat population. There was a trend toward a lower incidence of leaflet thrombosis in the edoxaban group compared with the dual antiplatelet therapy group (9.8% versus 18.4%; absolute difference, −8.5% [95% CI, −17.8% to 0.8%]; P =0.076). The percentage of patients with new cerebral lesions on brain magnetic resonance imaging (edoxaban versus dual antiplatelet therapy, 25.0% versus 20.2%; difference, 4.8%; 95% CI, −6.4% to 16.0%) and median total new lesion number and volume were not different between the 2 groups. In addition, the percentages of patients with worsening of neurological and neurocognitive function were not different between the groups. The incidence of any or major bleeding events was not different between the 2 groups. We found no significant association between the presence or extent of leaflet thrombosis with new cerebral lesions and a change of neurological or neurocognitive function. Conclusions: In patients without an indication for long-term anticoagulation after successful transcatheter aortic valve replacement, the incidence of leaflet thrombosis was numerically lower with edoxaban than with dual antiplatelet therapy, but this was not statistically significant. The effects on new cerebral thromboembolism and neurological or neurocognitive function were also not different between the 2 groups. Because the study was underpowered, the results should be considered hypothesis generating, highlighting the need for further research. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03284827.
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- 2022
5. Serial neurocognitive changes following transcatheter aortic valve replacement: comparison between low and intermediate-high risk groups
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Tsung-Yu Ko, Hsien-Li Kao, Chih-Fan Yeh, Jiu-Hsiang Lin, Ching-Chang Huang, Ying-Hsien Chen, Chi-Chao Chao, Hung-Yuan Li, Chih-Yang Chan, Lung-Chun Lin, Yih-Sharng Chen, Ming-Jiuh Wang, and Mao-Shin Lin
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Transcatheter Aortic Valve Replacement ,Aging ,Cognition ,Treatment Outcome ,Risk Factors ,Humans ,Aortic Valve Stenosis ,Prospective Studies ,Cell Biology ,Neuropsychological Tests - Abstract
Data comparing the neurocognitive trajectory between low and intermediate-high risk patients following transcatheter aortic valve replacement (TAVR) is never reported.To report serial neurocognitive changes up to 1 year post-TAVR in low and intermediate-high risk groups as well as overall cohort.Prospective neurological assessments (NIHSS and Barthel Index), global cognitive tests (MMSE and Alzheimer Disease Assessment Scale-Cognitive Subtest, ADAS-cog) and executive performances (Color Trail Test A and B and verbal fluency), were applied at baseline, 3 months and 1 year post-TAVR.In overall cohort, persistent improvement to 1 year in MMSE, ADAS-cog, Color Trail Test A and B was found. According to the STS score, the study cohort was divided into low (4%,TAVR was associated with persistent improvement in global cognitive function, as well as in attention and psychomotor processing speed, up to 1 year in overall cohort. However, improvement in tests for executive functions can only be seen in low risk group.
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- 2022
6. Aldosterone-to-renin ratio (ARR) as a screening tool for primary aldosteronism (PA)
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Chia-Hung Lin, Ching-Han Lin, Mu-Chi Chung, Chi-Sheng Hung, Fen-Yu Tseng, Leay Kiaw Er, Charles Jia-Yin Hou, Yen-Hung Lin, Vin-Cent Wu, Hao-Min Cheng, Hsien-Li Kao, Kwan-Dun Wu, and Tai-Shuan Lai
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General Medicine - Published
- 2023
7. TCTAP C-087 Revascularization in Patient With Left Main Coronary Artery Chronic Total Occlusion and Left Ventricular Dysfunction
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Cheng-Wei Lien, Paul Hsien-Li Kao, and Jiun-Yang Chiang
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Cardiology and Cardiovascular Medicine - Published
- 2022
8. List of contributors
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Nidal Abi Rafeh, Pierfrancesco Agostoni, Sukru Akyuz, Khaldoon Alaswad, Ziad A. Ali, Salman S. Allana, Chadi Alraies, Mario Araya, Alexandre Avran, Lorenzo Azzalini, Avtandil Babunashvili, Subhash Banerjee, Sripal Bangalore, Baktash Bayani, Michael Behnes, Ravinay Bhindi, Nicolas Boudou, Nenad Ž. Božinović, Leszek Bryniarski, Alexander Bufe, Christopher E. Buller, M. Nicholas Burke, Pedro Pinto Cardoso, Mauro Carlino, Joao L. Cavalcante, Tarek Chami, Raj H. Chandwaney, Konstantinos Charitakis, Victor Y. Cheng, James W. Choi, Evald Høj Christiansen, Yashasvi Chugh, Antonio Colombo, Claudia Cosgrove, Kevin Croce, Ramesh Daggubati, Félix Damas de los Santos, Rustem Dautov, Rhian E. Davies, Tony de Martini, Ali E. Denktas, Joseph Dens, Carlo di Mario, Roberto Diletti, Zisis Dimitriadis, Darshan Doshi, Parag Doshi, Kefei Dou, Mohaned Egred, Basem Elbarouni, Ahmed M. ElGuindy, Amr Elhadidy, Stephen Ellis, Javier Escaned, Panayotis Fasseas, Farshad Forouzandeh, Sergey Furkalo, Andrea Gagnor, Alfredo R. Galassi, Robert Gallino, Roberto Garbo, Santiago Garcia, Gabriele Gasparini, Junbo Ge, Lei Ge, Pravin Kumar Goel, Omer Goktekin, Nieves Gonzalo, Sevket Gorgulu, Luca Grancini, J. Aaron Grantham, Raviteja Guddeti, Elias V. Haddad, Allison B. Hall, Jack J. Hall, Sean Halligan, Franklin Leonardo Hanna Quesada, Colm Hanratty, Stefan Harb, Scott A. Harding, Raja Hatem, David Hildick-Smith, Jonathan M. Hill, Taishi Hirai, Mario Iannaccone, Wissam Jaber, Farouc A. Jaffer, Yangsoo Jang, Brian K. Jefferson, Allen Jeremias, Risto Jussila, Nikolaos Kakouros, Artis Kalnins, Sanjog Kalra, Arun Kalyanasundaram, David E. Kandzari, Hsien-Li Kao, Judit Karacsonyi, Dimitri Karmpaliotis, Hussien Heshmat Kassem, Kathleen Kearney, Jimmy Kerrigan, Jaikirshan Khatri, Dmitrii Khelimskii, Ajay J. Kirtane, Paul Knaapen, Spyridon Kostantinis, Michalis Koutouzis, Mihajlo Kovacic, Oleg Krestyaninov, A.V. Ganesh Kumar, Prathap Kumar N., Katherine J. Kunkel, Pablo Manuel Lamelas, Seung-Whan Lee, Thierry Lefevre, Gregor Leibundgut, Nicholas J. Lembo, Martin Leon, John R. Lesser, Raymond Leung, Soo-Teik Lim, Sidney Tsz Ho Lo, William Lombardi, Michael Luna, Ehtisham Mahmud, Madeline K. Mahowald, Anbukarasi Maran, Konstantinos Marmagkiolis, Evandro Martins Filho, Kambis Mashayekhi, Margaret B. McEntegart, Michael Megaly, Perwaiz Meraj, Lampros Michalis, Anastasios N. Milkas, Owen Mogabgab, Jeffrey Moses, Muhammad Munawar, Bilal Murad, Alexander Nap, Andres Navarro, William J. Nicholson, Anja Øksnes, Göran Olivecrona, Mohamed A. Omer, Jacopo Andrea Oreglia, Lucio Padilla, Mitul P. Patel, Rajan A.G. Patel, Taral Patel, Ashish Pershad, Duane Pinto, Paul Poommipanit, Marin Postu, Srini Potluri, Stylianos Pyxaras, Alexandre Schaan de Quadros, Michael Ragosta, Sunil V. Rao, Vithala Surya Prakasa Rao, Sudhir Rathore, Joerg Reifart, Athanasios Rempakos, Jeremy Rier, Robert Riley, Stéphane Rinfret, Juan J. Russo, Meruzhan Saghatelyan, Gurpreet S. Sandhu, Yader Sandoval, Ricardo Santiago, James Sapontis, Alpesh Shah, Evan Shlofmitz, Kendrick A. Shunk, George Sianos, Bahadir Simsek, Elliot J. Smith, Anthony Spaedy, James Spratt, Julian W. Strange, Bradley Strauss, Péter Tajti, Hector Tamez, Khalid O. Tammam, Craig A. Thompson, Aurel Toma, Catalin Toma, Ioannis Tsiafoutis, Etsuo Tsuchikane, Imre Ungi, Barry F. Uretsky, Georgios J. Vlachojannis, Minh Nhat Vo, Hoang Vu Vu, Simon Walsh, Daniel Weilenmann, Gerald Werner, Jarosław Wójcik, Jason Wollmuth, Eugene B. Wu, R. Michael Wyman, Iosif Xenogiannis, Bo Xu, Masahisa Yamane, Luiz F. Ybarra, and Robert W. Yeh
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- 2023
9. Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry
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Giuseppe De Luca, Magdy Algowhary, Berat Uguz, Dinaldo C. Oliveira, Vladimir Ganyukov, Oliver Busljetik, Miha Cercek, Lisette Okkels Jensen, Poay Huan Loh, Lucian Calmac, Gerard Roura i Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto D’Uccio, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor Becerra Munoz, Michael Kang-yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Lux Arpad, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Vincent Flavien, Enrico Fabris, Iñigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Helder Pereira, Stephane Manzo-Silberman, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehitola, Rui Teles, Christos Mantis, Ylitalo Antti, João António Brum Silveira, Cesar Rodrigo Zoni, Ivan Bessonov, Giuseppe Uccello, George Kochiadakis, Dimitrios Alexopulos, Carlos E. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie C. C. Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Alfonso Ielasi, Giuliana Cortese, Guido Parodi, Mohammed Abed Burgadha, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, and Monica Verdoia
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ACUTE MYOCARDIAL-INFARCTION ,IMPACT ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Age factors in disease ,PRIMARY ANGIOPLASTY ,COVID-19 ,ageing ,ST-segment elevation myocardial infarction ,General Medicine ,COVID-19 Pandemic, 2020 ,Factors d'edat en les malalties ,Infart de miocardi ,Myocardial infarction ,All institutes and research themes of the Radboud University Medical Center ,PERFUSION ,Mortalitat ,MANAGEMENT ,Pandèmia de COVID-19, 2020 ,ST-SEGMENT ELEVATION ,Mortality - Abstract
Contains fulltext : 291566.pdf (Publisher’s version ) (Open Access) BACKGROUND: The constraints in the management of patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic have been suggested to have severely impacted mortality levels. The aim of the current analysis is to evaluate the age-related effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI within the registry ISACS-STEMI COVID-19. METHODS: This retrospective multicenter registry was performed in high-volume PPCI centers on four continents and included STEMI patients undergoing PPCI in March-June 2019 and 2020. Patients were divided according to age (< or ≥75 years). The main outcomes were the incidence and timing of PPCI, (ischemia time longer than 12 h and door-to-balloon longer than 30 min), and in-hospital or 30-day mortality. RESULTS: We included 16,683 patients undergoing PPCI in 109 centers. In 2020, during the pandemic, there was a significant reduction in PPCI as compared to 2019 (IRR 0.843 (95%-CI: 0.825-0.861, p < 0.0001). We found a significant age-related reduction (7%, p = 0.015), with a larger effect on elderly than on younger patients. Furthermore, we observed significantly higher 30-day mortality during the pandemic period, especially among the elderly (13.6% vs. 17.9%, adjusted HR (95% CI) = 1.55 [1.24-1.93], p < 0.001) as compared to younger patients (4.8% vs. 5.7%; adjusted HR (95% CI) = 1.25 [1.05-1.49], p = 0.013), as a potential consequence of the significantly longer ischemia time observed during the pandemic. CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures, with a larger reduction and a longer delay to treatment among elderly patients, which may have contributed to increase in-hospital and 30-day mortality during the pandemic.
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- 2023
10. Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry
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Giuseppe De Luca, Stephane Manzo-Silberman, Magdy Algowhary, Berat Uguz, Dinaldo C. Oliveira, Vladimir Ganyukov, Oliver Busljetik, Miha Cercek, Lisette Okkels, Poay Huan Loh, Lucian Calmac, Gerard Roura i Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto di Uccio, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor Becerra, Michael Kang-yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Lux Arpad, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Vincent Flavien, Enrico Fabris, Iñigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Helder Pereira, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, João António Brum Silveira, Cesar Rodrigo Zoni, Ivan Bessonov, Giuseppe Uccello, George Kochiadakis, Dimitrios Alexopulos, Carlos E. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie C. C. Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Alfonso Ielasi, Giuliana Cortese, Guido Parodi, Mohamed Abed Bouraghda, Marcia Moura, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, De Luca, G., Manzo-Silberman, S., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Busljetik, O., Cercek, M., Okkels, L., Loh, P. H., Calmac, L., Ferrer, G. R. I., Quadros, A., Milewski, M., Scotto di Uccio, F., von Birgelen, C., Versaci, F., Ten Berg, J., Casella, G., Wong Sung Lung, A., Kala, P., Diez Gil, J. L., Carrillo, X., Dirksen, M., Becerra, V., Lee, M. K. -Y., Juzar, D. A., de Moura Joaquim, R., Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A., Galasso, G., Arpad, L., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A. H., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martinez-Luengas, I. L., Boccalatte, M., Ojeda, F. B., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H. -L., Fores, J. S., Vignali, L., Pereira, H., Ordonez, S., Arat Ozkan, A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Antti, Y., Brum Silveira, J. A., Zoni, C. R., Bessonov, I., Uccello, G., Kochiadakis, G., Alexopulos, D., Uribe, C. E., Kanakakis, J., Faurie, B., Gabrielli, G., Barrios, A. G., Bachini, J. P., Rocha, A., Tam, F. C. C., Rodriguez, A., Lukito, A. A., Saint-Joy, V., Pessah, G., Tuccillo, A., Ielasi, A., Cortese, G., Parodi, G., Bouraghda, M. A., Moura, M., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.
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IMPACT ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,percutaneous coronary intervention ,PRIMARY ANGIOPLASTY ,COVID-19 ,General Medicine ,ADMISSION ,ST-segment elevation myocardial infarction ,INSIGHTS ,WUHAN ,All institutes and research themes of the Radboud University Medical Center ,CLINICAL CHARACTERISTICS ,ELEVATION-MYOCARDIAL-INFARCTION ,gender ,MANAGEMENT ,Factors sexuals en les malalties ,Sex factors in disease - Abstract
Contains fulltext : 290798.pdf (Publisher’s version ) (Open Access) BACKGROUND: Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. METHODS: This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. RESULTS: We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12). CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.
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- 2023
11. Assessing the Impact of Transcatheter Aortic Valve Implantation on Cardiac Catheterisation: A Multicentric Study
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Hsien-Li Kao, Maurizio Tespili, Iván J. Núñez Gil, Edgar Tay, Carlo Francisco Santos Gochuico, Yinghao Lim, Jonathan Yap, Fabrizio D'Ascenzo, Mao-Shin Lin, Alfonso Ielasi, Kay Woon Ho, Alessandro Depaoli, Alex Fernando Castro Mejía, and Michael Kang-Yin Lee
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Male ,Pulmonary and Respiratory Medicine ,Coronary angiography ,Cardiac Catheterization ,medicine.medical_specialty ,Transcatheter aortic ,Cardiac catheterisation ,030204 cardiovascular system & hematology ,Prosthesis Design ,Logistic regression ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,030212 general & internal medicine ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Mean age ,Retrospective cohort study ,Aortic Valve Stenosis ,Treatment Outcome ,Aortic Valve ,Heart Valve Prosthesis ,Baseline characteristics ,Angiography ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
The success rate of coronary angiography (CA) after transcatheter aortic valve implantation (TAVI) is variable. Our aim was to investigate CA difficulty, outcomes, and predictors of difficult CA after TAVI.This was an international multicentric retrospective cohort study that included patients with TAVI and subsequent CA between January 2010 and December 2019. Difficulty with CA was graded as 1 (normal), 2 (partial engagement, complete vessel opacification), 3 (partial engagement, incomplete vessel opacification), and 4 (unsuccessful angiography). Patients were grouped as (a) "easy" (grade 1 for left and right) or (b) "difficult" (grade1 for either). We compared baseline characteristics and outcomes, and performed multivariate logistic regression for predictors of difficult CA.Of 96 patients included (mean age 77.4±8.7 years, 48 [50%] male), 88 (92%) had successful CA. Right CA was successful in 80 (83%) patients and left CA in 91 (95%) (p0.0001). The "difficult" group (n=41 [43%]) had higher Society of Thoracic Surgery (STS) scores (7.6±4.9 vs 5.4±4.0; p=0.022), smaller annulus perimeters (72.4±5.4 mm vs 76.2±9.4 mm; p=0.049), greater use of self-expanding valves (83% vs 18%; p0.0001), increased valve size (26.8±2.1 mm vs 25.6±3.0 mm; p=0.032), and increased oversizing for area (44.3%±17.4% vs 23.6%±22.0%; p=0.0002) and perimeter (17.5%±8.2% vs 7.1%±10.8%; p0.0001). There was no difference in outcomes except for increased major bleeding (7.3% vs 0.0%; p=0.042). The strongest predictor for "difficult" CA was self-expanding valves when compared to balloon-expandable valves (adjusted odds ratio [aOR], 15.23; 95% confidence interval [CI], 2.27-102.40). Society of Thoracic Surgery score was borderline predictive (aOR, 1.26; 95% CI, 1.04-1.52).Our results show that after TAVI, CA success rate is high, right CA is more difficult than left, self-expanding valves predispose to difficult CA, and STS score weakly predicts difficult CA. This study is hypothesis-generating and more research is required to confirm these findings.
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- 2021
12. A Systematic Review and Meta-Analysis of Clinical Outcomes of Patients Undergoing Chronic Total Occlusion Percutaneous Coronary Intervention
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Bahadir, Simsek, Spyridon, Kostantinis, Judit, Karacsonyi, Khaldoon, Alaswad, Michael, Megaly, Dimitrios, Karmpaliotis, Amirali, Masoumi, Wissam A, Jaber, William, Nicholson, Stephane, Rinfret, Kambis, Mashayekhi, Gerald S, Werner, Margaret, McEntegart, Seung-Whan, Lee, Jaikirshan J, Khatri, Scott A, Harding, Alexandre, Avran, Farouc A, Jaffer, Darshan, Doshi, Hsien-Li, Kao, Georgios, Sianos, Masahisa, Yamane, Anastasios, Milkas, Lorenzo, Azzalini, Roberto, Garbo, Khalid, Tammam, Nidal, Abi Rafeh, Ilias, Nikolakopoulos, Evangelia, Vemmou, Bavana V, Rangan, M Nicholas, Burke, Santiago, Garcia, Kevin J, Croce, Eugene B, Wu, Etsuo, Tsuchikane, Carlo, Di Mario, Alfredo R, Galassi, Andrea, Gagnor, Paul, Knaapen, Yangsoo, Jang, Byeong-Keuk, Kim, Paul B, Poommipanit, and Emmanouil S, Brilakis
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Observational Studies as Topic ,Treatment Outcome ,Percutaneous Coronary Intervention ,Coronary Occlusion ,Myocardial Infarction ,Odds Ratio ,Humans ,Randomized Controlled Trials as Topic - Abstract
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) can improve patient symptoms, but it remains controversial whether it impacts subsequent clinical outcomes.In this systematic review and meta-analysis, we queried PubMed, ScienceDirect, Cochrane Library, Web of Science, and Embase databases (last search: September 15, 2021). We investigated the impact of CTO-PCI on clinical events including all-cause mortality, cardiovascular death, myocardial infarction (MI), major adverse cardiovascular event (MACE), stroke, subsequent coronary artery bypass surgery, target-vessel revascularization, and heart failure hospitalizations. Pooled analysis was performed using a random-effects model.A total of 58 publications with 54,540 patients were included in this analysis, of which 33 were observational studies of successful vs failed CTO-PCI, 19 were observational studies of CTO-PCI vs no CTO-PCI, and 6 were randomized controlled trials (RCTs). In observational studies, but not RCTs, CTO-PCI was associated with better clinical outcomes. Odds ratios (ORs) and 95% confidence intervals (CIs) for all-cause mortality, MACE, and MI were 0.52 (95% CI, 0.42-0.64), 0.46 (95% CI, 0.37-0.58), 0.66 (95% CI, 0.50-0.86), respectively for successful vs failed CTO-PCI studies; 0.38 (95% CI, 0.31-0.45), 0.57 (95% CI, 0.42-0.78), 0.65 (95% CI, 0.42-0.99), respectively, for observational studies of CTO-PCI vs no CTO-PCI; 0.72 (95% CI, 0.39-1.32), 0.69 (95% CI, 0.38-1.25), and 1.04 (95% CI, 0.46-2.37), respectively for RCTs.CTO-PCI is associated with better subsequent clinical outcomes in observational studies but not in RCTs. Appropriately powered RCTs are needed to conclusively determine the impact of CTO-PCI on clinical outcomes.
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- 2022
13. Detection of Carotid Artery Stenosis Based on Video Motion Analysis for Fast Screening
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Cheng‐Hsuan Tsai, Ching‐Chang Huang, Hao‐Ming Hsiao, Ming‐Ya Hung, Guan‐Jie Su, Li‐Han Lin, Ying‐Hsien Chen, Mao‐Shin Lin, Chih‐Fan Yeh, Chi‐Sheng Hung, and Hsien‐Li Kao
- Subjects
Ultrasonography, Doppler, Duplex ,ROC Curve ,Predictive Value of Tests ,Humans ,Carotid Stenosis ,Stents ,Cardiology and Cardiovascular Medicine ,Sensitivity and Specificity - Abstract
Background Carotid artery stenosis (CAS) is a common cause of ischemic stroke, and the early detection of CAS may improve patient outcomes. Carotid Doppler ultrasound is commonly used to diagnose CAS. However, it is costly and may not be practical for regular screening practice. This article presents a novel noninvasive and noncontact detection technique using video‐based motion analysis (VMA) to extract useful information from subtle pulses on the skin surface to screen for CAS. Methods and Results We prospectively enrolled 202 patients with prior carotid Doppler ultrasound data. A short 30‐second video clip of the neck was taken using a commercial mobile device and analyzed by VMA with mathematical quantification of the amplitude of skin motion changes in a blinded manner. The first 40 subjects were used to set up the VMA protocol and define cutoff values, and the following 162 subjects were used for validation. Overall, 54% of the 202 subjects had ultrasound‐confirmed CAS. Using receiver operating characteristic curve analysis, the area under the curve of VMA‐derived discrepancy values to differentiate patients with and without CAS was excellent (area under the curve, 0.914 [95% CI, 0.874–0.954]; P Conclusions A simple and accurate screening technique to quickly screen for CAS using a VMA system is feasible, with acceptable sensitivity and specificity.
- Published
- 2022
14. TCTAP C-057 How to Overcome Acute Bend in Antegrade Proximal Circumflex In-Stent Chronic Total Occlusion
- Author
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Entzu Liu and Paul Hsien-Li Kao
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
15. Asia Pacific TAVI registry (an APSIC initiative): initial report of early outcomes
- Author
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Wei Hsian Yin, Paul Hsien-Li Kao, Seung-Jung Park, Mohd Ali Rosli, Jonathan Yap, Kay Woon Ho, Wasan Udayacherm, Wacin Buddhari, Thet Khaing, Huay Cheem Tan, Michael K.Y. Lee, Mao-Shin Lin, Kentaro Hayashida, Paul Toon Lim Chiam, Edgar Tay, Ryo Yanagisawa, Jun Jie Zhang, and Enrique Fabio Posas
- Subjects
Geography ,Asia pacific ,Socioeconomics - Published
- 2021
16. Development of an Efficient and Sensitive Chemical Derivatization-Based LC–MS/MS Method for Quantifying Gut Microbiota-Derived Metabolites in Human Plasma and Its Application in Studying Cardiovascular Disease
- Author
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Hsien-Li Kao, Hsin-Yu Liao, Wei-Kai Wu, Ching-Hua Lee, Ching-Hua Kuo, and Chin-Yi Wang
- Subjects
0301 basic medicine ,Butyrate ,Disease ,Gut flora ,Biochemistry ,03 medical and health sciences ,chemistry.chemical_compound ,Tandem Mass Spectrometry ,Liquid chromatography–mass spectrometry ,medicine ,Humans ,Derivatization ,Chromatography ,030102 biochemistry & molecular biology ,biology ,Tryptophan ,General Chemistry ,Fatty Acids, Volatile ,biology.organism_classification ,medicine.disease ,Gastrointestinal Microbiome ,030104 developmental biology ,chemistry ,Cardiovascular Diseases ,Human plasma ,Metabolic syndrome ,Chromatography, Liquid - Abstract
Recently, the gut microbiota has been found to be associated with many diseases, such as inflammatory bowel disease, depression, Parkinson's disease, cancer, metabolic syndrome, and cardiovascular disease (CVD). Among various gut microbiota-derived metabolites (GMs), short-chain fatty acids (SCFAs), bile acids (BAs), and tryptophan (TRP) metabolites are the most frequently discussed metabolites. LC-MS/MS shows advantages in quantifying the levels of metabolites with good sensitivity and selectivity; however, the poor ionization efficiency and polar characteristics of SCFAs make their analysis challenging, especially when analyzing plasma samples with low SCFA concentrations. Moreover, without characteristic fragment ions for unconjugated BAs and different detection ion modes for TRP metabolites and BAs, GM analysis is complex and time-consuming. To overcome these problems, we developed a derivatization method combined with LC-MS/MS to enhance the sensitivity and LC retention of GMs. Through derivatization with 3-nitrophenylhydrazine (3-NPH), 7 SCFAs, 9 bile acids, and 6 tryptophan metabolites can be simultaneously analyzed via separation within 14 min on a reversed-phase C18 column. For accurate quantification, 13C6-3NPH-labeled standards were used as one-to-one internal standards. This derivatization approach was optimized and then validated. We further applied this method to investigate the targeted GM profile in patients with CVD. The results showed a significant reduction in plasma butyrate levels in CVD patients compared with healthy controls, suggesting its potentially protective role in CVD. In summary, this work provides a sensitive and effective LC-MS/MS method for simultaneously quantifying gut microbiota-related metabolites in human plasma, which could benefit various future gut microbiota-related studies.
- Published
- 2021
17. Agreement regarding overcoming hypertension in the Asian Hypertension Society Network 2022
- Author
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Satoshi, Hoshide, Koichi, Yamamoto, Kenichi, Katsurada, Yuichiro, Yano, Akira, Nishiyama, Ji-Guang, Wang, S N, Narasingan, Narsingh, Verma, Erwinanto, Erwinanto, Yuda, Turana, Sang Hyun, Ihm, Sungha, Park, Nik Sherina, Hanafi, Yook-Chin, Chia, Tsolmon, Unurjargal, Saulat, Siddique, Deborah Ignacia D, Ona, Narayanaswamy, Venketasubramanian, Boon Wee, Teo, Godwin, Constantine, Hsien-Li, Kao, Chi-Sheng, Hung, Apichard, Sukonthasarn, Sirisawat, Kunanon, Huynh Van, Minh, Kazuomi, Kario, Koichi, Node, Hiroshi, Itoh, and Hiromi, Rakugi
- Published
- 2022
18. Comparison between drug-coated balloons and drug-eluting stents in very small coronary artery interventions
- Author
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Cheng-Hsuan, Tsai, Chih-Fan, Yeh, Shih-Wei, Meng, Chi-Sheng, Hung, Mao-Shin, Lin, Ching-Chang, Huang, Chun-Kai, Chen, Kuo-Ping, Huang, Ying-Hsien, Chen, and Hsien-Li, Kao
- Subjects
Percutaneous Coronary Intervention ,Treatment Outcome ,Multidisciplinary ,Humans ,Drug-Eluting Stents ,Female ,Coronary Artery Disease ,Acute Coronary Syndrome ,Retrospective Studies - Abstract
The optimal management of very small vessel (reference diameter from 2.0 to 2.25 mm) in percutaneous coronary interventions (PCIs) is controversial. We aimed to compare the efficacy and safety of drug-coated balloons (DCBs) and drug-eluting stents (DESs) for de-novo very small vessel interventions. We conducted a retrospective analysis of consecutive patients who received very small vessel PCI with a DCB or DES between January 2018 and March 2021. The outcome measures were the incidence of ischemia-driven target lesion revascularization (TLR) and major adverse cardiac and cerebrovascular events (MACCEs) within 1 year after PCI. MACCEs were defined as the composite of ischemia-driven TLR, all-cause death, non-fatal acute coronary syndrome, stroke, or heart failure requiring hospitalization. A total of 205 patients undergoing PCI with a DCB or DES were enrolled in this study. The procedural complication rate was 2.5% in the DES group and 1.7% in the DCB group (P = 1.000). After 1-year of follow-up, the cumulative incidence of TLR was 7.2% in the DCB group and 4.9% in the DES group (P = 0.530). The cumulative incidence of MACCEs was 10.6% in the DCB group and 12.7% in the DES group (P = 0.769). Only female gender, acute coronary syndrome on presentation, and dual antiplatelet therapy duration
- Published
- 2022
19. Cardiovascular Risk Reduction After Renal Denervation According to Time in Therapeutic Systolic Blood Pressure Range
- Author
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Felix Mahfoud, Giuseppe Mancia, Roland E. Schmieder, Luis Ruilope, Krzysztof Narkiewicz, Markus Schlaich, Bryan Williams, Flavio Ribichini, Joachim Weil, Hsien-Li Kao, Oriol Rodriguez-Leor, Elias Noory, Tiong Kiam Ong, Thierry Unterseeh, Pedro de Araújo Gonçalves, Andreas Zirlik, Khaled Almerri, Faisal Sharif, Lucas Lauder, Marianne Wanten, Martin Fahy, and Michael Böhm
- Subjects
Male ,Blood Pressure ,Middle Aged ,Blood Pressure Monitoring, Ambulatory ,Kidney ,Denervation ,Treatment Outcome ,Cardiovascular Diseases ,Risk Factors ,Heart Disease Risk Factors ,Hypertension ,Humans ,Female ,Prospective Studies ,Sympathectomy ,Cardiology and Cardiovascular Medicine ,Antihypertensive Agents ,Aged - Abstract
Renal denervation (RDN) has been shown to lower blood pressure (BP), but its effects on cardiovascular events have only been preliminarily evaluated. Time in therapeutic range (TTR) of BP is associated with cardiovascular events.This study sought to assess the impact of catheter-based RDN on TTR and its association with cardiovascular outcomes in the GSR (Global SYMPLICITY Registry).Patients with uncontrolled hypertension were enrolled and treated with radiofrequency RDN. Office and ambulatory systolic blood pressure (OSBP and ASBP) were measured at 3, 6, 12, 24, and 36 months postprocedure and used to derive TTR. TTR through 6 months was assessed as a predictor of cardiovascular events from 6 to 36 months using a Cox proportional hazard regression model.As of March 1, 2022, 3,077 patients were enrolled: 42.2% were female; mean age was 60.5 ± 12.2 years; baseline OSBP was 165.6 ± 24.8 mm Hg; and baseline ASBP was 154.3 ± 18.7 mm Hg. Patients were prescribed 4.9 ± 1.7 antihypertensive medications at baseline and 4.8 ± 1.9 at 36 months. At 36 months, mean changes were -16.7 ± 28.4 and -9.0 ± 20.2 mm Hg for OSBP and ASBP, respectively. TTR through 6 months was 30.6%. A 10% increase in TTR after RDN through 6 months was associated with significant risk reductions from 6 to 36 months of 15% for major adverse cardiovascular events (P 0.001), 11% cardiovascular death (P = 0.010), 15% myocardial infarction (P = 0.023), and 23% stroke (P 0.001).There were sustained BP reductions and higher TTR through 36 months after RDN. A 10% increase in TTR through 6 months was associated with significant risk reductions in major cardiovascular events from 6 to 36 months. (Global SYMPLICITY Registry [GSR] DEFINE; NCT01534299).
- Published
- 2022
20. TCTAP A-001 Prediction Model for In-Stent Restenosis After Carotid Artery Angioplasty and Stenting
- Author
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Sheng-Fu Liu, Ying-Hsien Chen, Mao-Shin Lin, Ching-Chang Huang, Chih-Fan Yeh, Cheng-Hsuan Tsai, and Hsien-Li Kao
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
21. Association of Major Adverse Cardiac Events and Beta-Blockers in Patients with and without Atherosclerotic Cardiovascular Disease: Long-Term Follow-Up Results of the T-SPARCLE and T-PPARCLE Registry in Taiwan
- Author
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Patrick Yan-Tyng Liu, Fang-Ju Lin, Chih-Fan Yeh, Yu-Chung Hsiao, Chin-Feng Hsuan, Wei-Tien Chang, Hsien-Li Kao, Jiann-Shing Jeng, Yen-Wen Wu, I-Chang Hsieh, Ching-Chang Fang, Kuo-Yang Wang, Kuan-Cheng Chang, Tsung-Hsien Lin, Wayne Huey-Herng Sheu, Yi-Heng Li, Wei-Hsian Yin, Hung-I Yeh, Jaw-Wen Chen, and Chau-Chung Wu
- Subjects
beta-blocker ,major adverse cardiac events ,event-free survival ,Taiwan cohort ,atherosclerotic cardiovascular disease ,General Medicine - Abstract
Beta-blockers are widely used, but the benefit is now challenged in patients at risk of atherosclerotic cardiovascular disease (ASCVD) in the present coronary reperfusion era. We aimed to identify the risk factors of a major adverse cardiac event (MACE) and the long-term effect of beta-blockers in two large cohorts in Taiwan. Two prospective observational cohorts, including patients with known atherosclerosis cardiovascular disease (T-SPARCLE) and patients with at least one risk factor of ASCVD but without clinically evident ASCVD (T-PPARCLE), were conducted in Taiwan. The primary endpoint is the time of first occurrence of a MACE (cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, and cardiac arrest with resuscitation). Between December 2009 and November 2014, with a median 2.4 years follow-up, 11,747 eligible patients (6921 and 4826 in T-SPARCLE and T-PPARCLE, respectively) were enrolled. Among them, 273 patients (2.3%) met the primary endpoint. With multivariate Cox PH model analysis, usage of beta-blocker was lower in patients with MACE (42.9% vs. 52.4%, p < 0.01). In patients with ASCVD, beta-blocker usage was associated with lower MACEs (hazard ratio 0.72; p < 0.001), but not in patients without ASCVD. The event-free survival of beta-blocker users remained higher during the follow-up period (p < 0.005) of ASCVD patients. In conclusion, in ASCVD patients, reduced MACE was associated with beta-blocker usage, and the effect was maintained during a six-year follow-up. Prescribing beta-blockers as secondary prevention is reasonable in the Taiwanese population.
- Published
- 2023
22. TCT-549 Impact of COVID-19 Pandemic on TAVR Activity: A Worldwide Registry
- Author
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Xavier Armario, Jennifer Carron, Mohamed Abdel-Wahab, Didier Tchetche, Sabine Bleiziffer, Thierry Lefevre, Thomas Modine, Alexander Wolf, Thomas Pilgrim, Pedro Villablanca, Michael Cunnington, Nicolas Van Mieghem, Christian Hengstenberg, Lars Sondergaard, Martin Swaans, Bernard Prendergast, Marco Barbanti, John Webb, Neal Uren, Jon Resar, Mao Chen, David Hildick-Smith, Mark Spence, David Zweiker, Rodrigo Bagur, Hospital de Cruz, Flavio Ribichini, Duk-Woo Park, Pablo Codner, Joanna Wykrzykowska, Matjaz Bunc, Rodrigo Estevez-Loureiro, Karl Poon, Matthias Götberg, Hüseyin Ince, Azeem Latib, Erik Packer, Marco Angelillis, Yusuke Kobari, Luis Nombela-Franco, Yingqiang Guo, Mikko Savontaus, Amr A. Arafat, Chad Kliger, David Roy, Béla Merkely, Mariana Silva, Jonathon White, Masanori Yamamoto, Pedro Carrilho Ferreira, Stefan Toggweiler, Yohei Ohno, Ines Rodrigues, Soledad Ojeda, Vasileios Voudris, Marek Grygier, Khaled Almerri, Ignacio Cruz-Gonzalez, Viliam Fridrich, Jose De la Torre Hernandez, Nicolo Piazza, Stephane Noble, Dabit Arzamendi, null İbrahim halil Kurt, Johan Bosmans, Martins Erglis, Ivan Casserly, Fadi Sawaya, Ravinay Bhindi, Joelle Kefer, Wei-Hsian Yin, Liesbeth Rosseel, Hyo-Soo Kim, Stephen O'Connor, Farrel Hellig, Matias Sztejfman, Oscar Mendiz, Robert Xuereb, Fabio Brito Jr, Vilhelmas Bajoras, Mohammed Balghith, Michael Kang-Yin Lee, Guering Eid-Lidt, Bert Vandeloo, Vinicius Vaz, Mirvat Alasnag, Gian Paolo Ussia, Jorge Mayol, Gennaro Sardella, Wacin Buddhari, Hsien-Li Kao, Antonio Dager, Apostolos Tzikas, Ahmad Edris, Luis Gutierrez, Eduardo Arias, Mehmet Erturk, César Nicolás Conde Vela, Darko Boljevic, Adolfo Ferrero Guadagnoli, Ahmed ElGuindy, Luciano Santos, Luis Perez, Gabriel Maluenda, Ali Rıza Akyüz, Imad Alhaddad, Haitham Amin, So Chak Yu, Arif Alnooryani, Juan Albistur, Quang Nguyen, and Darren Mylotte
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
23. Sex differences following percutaneous coronary intervention or coronary artery bypass surgery for acute myocardial infarction
- Author
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Donna Shu-Han Lin, Yu-Sheng Lin, Jen-Kuang Lee, and Hsien-Li Kao
- Subjects
Heart Failure ,Male ,Gender Studies ,Sex Characteristics ,Percutaneous Coronary Intervention ,Treatment Outcome ,Endocrinology ,Myocardial Infarction ,Humans ,Female ,Coronary Artery Bypass ,Retrospective Studies - Abstract
Background Women have been underrepresented in the literature; the effects of female sex on outcomes in patients with acute myocardial infarction (AMI) remain unclear. Objectives This study compares the real-world outcomes of women and men with AMI who have undergone revascularization via percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). Methods This is a retrospective cohort study utilizing data from the Taiwan National Health Insurance database. We identified patients who were admitted for AMI and who underwent coronary revascularization during the index admission period between January 1, 2001, and December 31, 2013. Patients were then categorized based on the treatment received into PCI and CABG groups. In-hospital and long-term outcomes were compared between women and men in each group. Interaction tests were then performed to determine whether the differences between sexes were modified by the mode of revascularization. Analyses were repeated after propensity score matching between women and men in each group to minimize possible confounders. We also conducted subgroup analyses, stratifying by the presence of diabetes mellitus, congestive heart failure, and chronic kidney disease. Results We enrolled 67,534 patients who met the inclusion criteria in the analysis; 60,207 patients had undergone PCI (13,514 female and 46,693 male), while 7327 patients had received CABG (1762 female and 5565 male). Prior to matching, enrolled female patients were older on average, with more comorbidities. In-hospital and long-term outcomes were worse in women, particularly in the PCI group. After matching, the incidence of hospitalization for heart failure (HHF) was higher in women (10.4% vs 8.0%, OR 1.32, 95% CI 1.22–1.43), with fewer repeat revascularizations (28.1% vs 32.4%, OR 0.84, 95% CI 0.81–0.88). Both observations were more pronounced in the PCI group (HHF: P for interaction = 0.0496; repeat revascularization: P for interaction = 0.021). Conclusions Women presenting with AMI exhibited worse in-hospital and long-term outcomes than men, especially among women who received PCI as the initial mode of revascularization. Women who underwent PCI were more likely to be admitted for heart failure during follow-up. Possible socioeconomic inequalities or a distinct pathobiology of cardiac ischemia between sexes may underlie these results; thus, further investigation is needed.
- Published
- 2022
24. Incidence, risk factors and predictors of cardiovascular mortality for aortic stenosis among patients with diabetes mellitus
- Author
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Tsung-Yu Ko, Ting-Tse Lin, Jung Chi Hsu, Yen-Yun Yang, Shu-Lin Chuang, Lian-Yu Lin, Hsien-Li Kao, and Yi-Lwun Ho
- Subjects
Heart Failure ,Endocrinology ,Diabetes Mellitus, Type 2 ,Risk Factors ,Endocrinology, Diabetes and Metabolism ,Incidence ,Internal Medicine ,Humans ,Female ,General Medicine ,Aortic Valve Stenosis - Abstract
To find the incidence, risk factors and predictors of cardiovascular (CV) mortality for aortic stenosis (AS) in patients with type 2 diabetes mellitus (T2DM).Between 2014 and 2019, 20,979 patients with T2DM who underwent echocardiography were enrolled for analysis. The mean follow-up period was 34 months. Multiple risk factors and outcomes for patients with and without AS were presented.AS was present in 776 (3.70%) patients. Age, female, chronic kidney disease, hyperlipidemia, and peripheral arterial disease statistically increased risk of AS. The CV mortality (adjusted hazard ratio [aHR] = 1.97; 95% confidence interval [CI] 1.336 - 2.906, p 0.001) and risk of hospitalization for heart failure (HHF) (aHR = 1.73, 95% CI 1.442-2.082, p 0.001) were significantly increased in patients with AS, without significant differences in acute myocardial infarction and stroke. Severity of AS, body mass index (27 kg/mAS was associated with an increased risk of CV mortality and HHF in patients with T2DM.
- Published
- 2022
25. 2022 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension
- Author
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Tzung-Dau, Wang, Chern-En, Chiang, Ting-Hsing, Chao, Hao-Min, Cheng, Yen-Wen, Wu, Yih-Jer, Wu, Yen-Hung, Lin, Michael Yu-Chih, Chen, Kwo-Chang, Ueng, Wei-Ting, Chang, Ying-Hsiang, Lee, Yu-Chen, Wang, Pao-Hsien, Chu, Tzu-Fan, Chao, Hsien-Li, Kao, Charles Jia-Yin, Hou, and Tsung-Hsien, Lin
- Subjects
Original Article - Abstract
Hypertension is the most important modifiable cause of cardiovascular (CV) disease and all-cause mortality worldwide. Despite the positive correlations between blood pressure (BP) levels and later CV events since BP levels as low as 100/60 mmHg have been reported in numerous epidemiological studies, the diagnostic criteria of hypertension and BP thresholds and targets of antihypertensive therapy have largely remained at the level of 140/90 mmHg in the past 30 years. The publication of both the SPRINT and STEP trials (comprising > 8,500 Caucasian/African and Chinese participants, respectively) provided evidence to shake this 140/90 mmHg dogma. Another dogma regarding hypertension management is the dependence on office (or clinic) BP measurements. Although standardized office BP measurements have been widely recommended and adopted in large-scale CV outcome trials, the practice of office BP measurements has never been ideal in real-world practice. Home BP monitoring (HBPM) is easy to perform, more likely to be free of environmental and/or emotional stress, feasible to document long-term BP variations, of good reproducibility and reliability, and more correlated with hypertension-mediated organ damage (HMOD) and CV events, compared to routine office BP measurements. In the 2022 Taiwan Hypertension Guidelines of the Taiwan Society of Cardiology (TSOC) and the Taiwan Hypertension Society (THS), we break these two dogmas by recommending the definition of hypertension as ≥ 130/80 mmHg and a universal BP target of < 130/80 mmHg, based on standardized HBPM obtained according to the 722 protocol. The 722 protocol refers to duplicate BP readings taken per occasion ("2"), twice daily ("2"), over seven consecutive days ("7"). To facilitate implementation of the guidelines, a series of flowcharts encompassing assessment, adjustment, and HBPM-guided hypertension management are provided. Other key messages include that: 1) lifestyle modification, summarized as the mnemonic S-ABCDE, should be applied to people with elevated BP and hypertensive patients to reduce life-time BP burden; 2) all 5 major antihypertensive drugs (angiotensin-converting enzyme inhibitors [A], angiotensin receptor blockers [A], β-blockers [B], calcium-channel blockers [C], and thiazide diuretics [D]) are recommended as first-line antihypertensive drugs; 3) initial combination therapy, preferably in a single-pill combination, is recommended for patients with BP ≥ 20/10 mmHg above targets; 4) a target hierarchy (HBPM-HMOD- ambulatory BP monitoring [ABPM]) should be considered to optimize hypertension management, which indicates reaching the HBPM target first and then keeping HMOD stable or regressed, otherwise ABPM can be arranged to guide treatment adjustment; and 5) renal denervation can be considered as an alternative BP-lowering strategy after careful clinical and imaging evaluation.
- Published
- 2022
26. From reverse CART to antegrade wire access: a guide to externalisation, tip-in, rendezvous, and snaring from the APCTO club
- Author
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Sidney Lo, Jie Qian, Jiyan Chen, Eugene B. Wu, Lei Ge, Scott A. Harding, Soo Teik Lim, Etsuo Tsuchikane, Seung-Whan Lee, and Paul Hsien-Li Kao
- Subjects
Cart ,business.industry ,Computer science ,Rendezvous ,Club ,business ,Computer network - Published
- 2020
27. Targeting mechanosensitive endothelial TXNDC5 to stabilize eNOS and reduce atherosclerosis in vivo
- Author
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Chih-Fan Yeh, Shih-Hsin Cheng, Yu-Shan Lin, Tzu-Pin Shentu, Ru-Ting Huang, Jiayu Zhu, Yen-Ting Chen, Sandeep Kumar, Mao-Shin Lin, Hsien-Li Kao, Po-Hsun Huang, Esther Roselló-Sastre, Francisca Garcia, Hanjoong Jo, Yun Fang, Kai-Chien Yang, UCH. Departamento de Medicina y Cirugía, and Producción Científica UCH 2022
- Subjects
Proteínas ,Atherosclerosis ,Multidisciplinary ,Proteins ,SciAdv r-articles ,Biomedicine and Life Sciences ,Health and Medicine ,Molecular biology ,Biología molecular ,Molecular Biology ,Research Article ,Ateroesclerosis - Abstract
Although atherosclerosis preferentially develops at arterial curvatures and bifurcations where disturbed flow (DF) activates endothelium, therapies targeting flow-dependent mechanosensing pathways in the vasculature are unavailable. Here, we provided experimental evidence demonstrating a previously unidentified causal role of DF-induced endothelial TXNDC5 (thioredoxin domain containing 5) in atherosclerosis. TXNDC5 was increased in human and mouse atherosclerotic lesions and induced in endothelium subjected to DF. Endothelium-specific Txndc5 deletion markedly reduced atherosclerosis in ApoE−/− mice. Mechanistically, DF-induced TXNDC5 increases proteasome-mediated degradation of heat shock factor 1, leading to reduced heat shock protein 90 and accelerated eNOS (endothelial nitric oxide synthase) protein degradation. Moreover, nanoparticles formulated to deliver Txndc5-targeting CRISPR-Cas9 plasmids driven by an endothelium-specific promoter (CDH5) significantly increase eNOS protein and reduce atherosclerosis in ApoE−/− mice. These results delineate a new molecular paradigm that DF-induced endothelial TXNDC5 promotes atherosclerosis and establish a proof of concept of targeting endothelial mechanosensitive pathways in vivo against atherosclerosis., Description, Targeting flow-sensitive TXNDC5, an ER protein driving endothelial dysfunction by destabilizing eNOS, lessens atherosclerosis.
- Published
- 2022
28. Effects of short-term oral anticoagulation following surgical bioprosthetic aortic valve replacement
- Author
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Tsung-Yu Ko, Jui-Hsiang Lin, Kuan-Chih Huang, Ling-Yi Wei, Yi-Lwun Ho, Hsien-Li Kao, and Hsi-Yu Yu
- Subjects
General Medicine - Abstract
Short-term oral anticoagulation (OAC) is recommended for patients after surgical bioprosthetic aortic valve replacement (bAVR); however, the potential benefits remain controversial. This study evaluated the effects of short-term OAC following bAVR.From 2010 to 2017, total 450 patients who underwent bAVR were enrolled. The outcomes of patients who did (OAC group) and who did not receive OAC (without-OAC group) after bAVR were compared. Propensity-score matching (PSM) was used to adjust for potential confounders, and a 1:1 matched cohort was formed. The main outcomes were all-cause mortality and bioprosthetic valve dysfunction (BVD).A total of 175 (39%) patients received OAC after bAVR. The median follow-up period was 2.9 years, the median duration of OAC use was 4 months; 162 pairs of patients were identified after the PSM. There was no significant difference in the prevalence of 1-year embolism/ischemic stroke between the OAC and without-OAC group in PSM cohort (0.62% vs. 1.89% for embolism, p = 0.623; 0 vs. 1.23% for ischemic stroke, p = 0.499). The prevalence of 1-year intracranial hemorrhage (ICH) between OAC and without-OAC group was also comparable (0.62% vs. 0.62%, p = 1). The OAC group had a lower all-cause mortality (adjusted hazard ratio (aHR):0.488, 95% confidence interval (CI): 0.259-0.919). There was also a trend for reduced BVD in the OAC group (aHR: 0.661, 95% CI: 0.339-1.290).Our study demonstrated that short-term OAC use after bAVR was associated with lower all-cause mortality. The prevalence of 1-year embolism/ischemic stroke/ICH were comparable despite of OAC use.
- Published
- 2022
29. Advances in CrossBoss/Stingray use in antegrade dissection reentry from the Asia Pacific Chronic Total Occlusion Club
- Author
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Sidney Lo, Ji Yan Chen, Jie Qian, Eugene B. Wu, Scott A. Harding, Lei Ge, Arun Kalyanasundaram, Emmanouil S. Brilakis, Seung-Whan Lee, Kambis Mashayekhi, Soo Teik Lim, Hsien-Li Kao, and Etsuo Tsuchikane
- Subjects
Cardiac Catheterization ,Asia ,Time Factors ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Balloon ,Total occlusion ,Cardiac Catheters ,Decision Support Techniques ,Coronary Restenosis ,03 medical and health sciences ,0302 clinical medicine ,Asia pacific ,Stingray ,HRC—hybrid revascularization coronary ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Operations management ,030212 general & internal medicine ,Angioplasty, Balloon, Coronary ,Core Curriculum ,Vascular Patency ,business.industry ,Australia ,Equipment Design ,General Medicine ,Reentry ,CTO—Chronic Total occlusion ,Treatment Outcome ,Coronary Occlusion ,PCI—percutaneous coronary intervention ,Chronic Disease ,CAD—coronary artery disease ,Cardiology and Cardiovascular Medicine ,business ,Swap (computer programming) ,Algorithms ,New Zealand - Abstract
Antegrade dissection reentry with Stingray device (Boston Scientific, Marlborough, MA) accounts for 20–34% of the chronic total occlusion (CTO) cases in the various hybrid operators' CTO registries and is an important component of CTO crossing algorithms. The Stingray device can facilitate antegrade dissection and reentry, however its use is low outside North America and Europe. The Asia Pacific CTO Club along with three experience Stingray operators from the US, Europe and India, created an algorithm guiding use of the CrossBoss and Stingray catheter. This APCTO Stingray algorithm defines when to use the CrossBoss and Stingray device recommending a reduction in CrossBoss use except for in‐stent restenosis lesions and immediate transition from knuckle wiring to the Stingray device. When antegrade wiring fails, choice of Stingray‐facilitated reentry versus parallel wiring depends on operator experience, device availability, cost concerns, and anatomical factors. When the antegrade wire enters the subintimal space, we recommend using a rotational microcatheter to produce a channel and deliver the Stingray balloon—so called the “bougie technique.” We recommend early switch to Stingray rather than persisting with single wire redirection or parallel wire. We recommend choosing a suitable reentry zone based on preprocedural computer tomography or angiogram, routine use of stick and swap, routine use of Subintimal TRAnscatheter Withdrawal (STRAW) through the Stingray balloon, and the multi stick and swap technique. We believe these techniques and algorithm can facilitate incorporation of the Stingray balloon into the practice of CTO interventionists globally.
- Published
- 2019
30. Conus branch artery utilization in percutaneous coronary intervention for chronic total occlusion
- Author
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Shih-Wei Meng, Ching-Chang Huang, Chih-Kuo Lee, Chun-Kai Chen, Chih-Fan Yeh, Ying-Hsien Chen, Mao-Shin Lin, and Hsien-Li Kao
- Subjects
Multidisciplinary ,Percutaneous Coronary Intervention ,Treatment Outcome ,Coronary Occlusion ,Risk Factors ,Chronic Disease ,Humans ,Registries ,Coronary Angiography ,Coronary Vessels ,Retrospective Studies - Abstract
Data on the prevalence of conus branch artery (CBA) is scarce, and its utilization in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is non-existing. The present study examined carefully in a large cohort the angiographic prevalence of CBA, its role as a collateral channel for the occlusion, and the potential usage of CBA in contemporary CTO PCI. We retrospectively examined consecutive CTO PCIs from our database between 2016 and 2019. All CTO PCIs were evaluated and the results with complications were recorded to determine the prevalence and utilization of CBA. From January 2016 to December 2019, a total of 556 CTO PCI attempts in 546 patients by high-volume operators were enrolled. The clinical, angiographic, and procedural details were collected. CBA was identifiable in 85.3% of these patients, and CBA providing visible collaterals connected to CTO distal lumen was found in 27.8% of patients. 84 CBA were used for balloon anchoring, 17 for selective distal true lumen visualization, and 9 as actual retrograde interventional collateral channel during CTO PCI. Only 1 patient suffered from chest pain during CBA balloon anchoring, and no other procedural complication such as arrhythmia or perforation occurred.CBA is frequently seen in coronary CTO. Its existence provided potential for various CTO PCI technique applications, without increase in risk.
- Published
- 2021
31. Results of Streamlining TAVR Procedure Towards a Minimalist Approach: A Single Center Experience in Taiwan
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Hsien-Li Kao, Lung-Chun Lin, Chih-Fan Yeh, Tsung-Yu Ko, Yih-Sharng Chen, Ying-Hsien Chen, Yi-Chang Chen, Mao-Shin Lin, Chih-Yang Chan, Ching-Chang Huang, and Ming-Jiuh Wang
- Subjects
Computer science ,Operations management ,Single Center - Abstract
Background Trans-femoral transcatheter aortic valve replacement (TF-TAVR) performed under conscious sedation (LACS) is not yet become routine practice in Taiwan. We aimed to compared the results between patients received general anesthesia (GA) versus LACS. Methods Our cohort was divided into 3 groups: initial 48 patients received TF-TAVR under routine GA (GA group), subsequent 50 patients under routine LACS (LACS group 1), and recent 125 patients under LACS (LACS group 2). The baseline, procedural characteristics and all outcomes were prospectively collected and retrospectively compared. Results From Sep 2010 to July 2019, a total of 223 patients were included for The procedure time (157.6 ± 39.4 mins vs 131.6 ± 30.3 vs 95.2 ± 40.0
- Published
- 2021
32. TCTAP A-045 Clinical Predictors of Successful Weaning VA-ECMO
- Author
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Sheng-Fu Liu, Chih Yu Hsu, Chih-Kuo Lee, and Paul Hsien-Li Kao
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
33. TCTAP C-138 Shaking Aortic Plaque
- Author
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Sheng-Fu Liu, Ying-Hsien Chen, Po-Chih Lin, and Paul Hsien-Li Kao
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
34. TCTAP C-110 Stuck Rotational Atherectomy Burr During Percutaneous Coronary Intervention of Left Main Plus Proximal Left Circumflex Artery Total Occlusion
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Hao-Yun Chang and Paul Hsien-Li Kao
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
35. Atherosclerosis Amelioration by Allicin in Raw Garlic through Gut Microbiota and Trimethylamine-N-Oxide Modulation
- Author
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Wei-Kai Wu, Ming-Shiang Wu, Hsien-Li Kao, Lee-Yan Sheen, Chieh-Chang Chen, Huai-Syuan Huang, Kent-Vui Chong, Ting-Chin David Shen, Alexander N. Orekhov, Cheng-Chih Hsu, Chi-Tang Ho, Po-Yu Liu, Suraphan Panyod, Hsiao-Li Chuang, Yu-Tang Yang, Rou-An Chen, Pei-Chen Chen, Ching-Hu Chung, Tur-Fu Huang, Kai-Chien Yang, and Angela Yu-Chen Lin
- Subjects
Trimethylamine N-oxide ,Gut flora ,Applied Microbiology and Biotechnology ,Microbiology ,digestive system ,Article ,Microbial ecology ,Methylamines ,Mice ,chemistry.chemical_compound ,Animals ,Humans ,Disulfides ,Food science ,Garlic ,Allicin ,biology ,QR100-130 ,Health care ,food and beverages ,Oxides ,Atherosclerosis ,Sulfinic Acids ,biology.organism_classification ,Gastrointestinal Microbiome ,Mice, Inbred C57BL ,chemistry ,Microbiome ,Biotechnology - Abstract
Cardiovascular disease (CVD) is strongly associated with the gut microbiota and its metabolites, including trimethylamine-N-oxide (TMAO), formed from metaorganismal metabolism of ʟ-carnitine. Raw garlic juice, with allicin as its primary compound, exhibits considerable effects on the gut microbiota. This study validated the benefits of raw garlic juice against CVD risk via modulation of the gut microbiota and its metabolites. Allicin supplementation significantly decreased serum TMAO in ʟ-carnitine-fed C57BL/6 J mice, reduced aortic lesions, and altered the fecal microbiota in carnitine-induced, atherosclerosis-prone, apolipoprotein E-deficient (ApoE−/−) mice. In human subjects exhibiting high-TMAO production, raw garlic juice intake for a week reduced TMAO formation, improved gut microbial diversity, and increased the relative abundances of beneficial bacteria. In in vitro and ex vivo studies, raw garlic juice and allicin inhibited γ-butyrobetaine (γBB) and trimethylamine production by the gut microbiota. Thus, raw garlic juice and allicin can potentially prevent cardiovascular disease by decreasing TMAO production via gut microbiota modulation.
- Published
- 2021
36. Intentional combination of ProGlide and Angio-Seal for femoral access haemostasis in transcatheter aortic valve replacement
- Author
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Yih-Sharng Chen, Chih-Fan Yeh, Tsung-Yu Ko, Hsien-Li Kao, Ying-Ju Liu, Ying-Hsien Chen, Ching-Chang Huang, Chih-Yang Chan, Mao-Shin Lin, Lung-Chun Lin, and Chi-Sheng Hung
- Subjects
Male ,Cardiac Catheterization ,medicine.medical_specialty ,Transcatheter aortic ,medicine.medical_treatment ,Femoral artery ,030204 cardiovascular system & hematology ,Cohort Studies ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,Valve replacement ,Femoral access ,medicine.artery ,medicine ,Humans ,Angio seal ,Prospective Studies ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Aged, 80 and over ,Hemostasis ,Arterial dissection ,Hemostatic Techniques ,business.industry ,Incidence (epidemiology) ,Combined Modality Therapy ,Surgery ,Femoral Artery ,Treatment Outcome ,Cohort ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
To describe and evaluate the intentional combination of Angio-Seal (AS) and Perclose ProGlide (PP) in achieving haemostasis in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR).This study cohort was divided into two groups: dual PP versus one AS with one PP (AS + PP) used for common femoral artery haemostasis. The baseline, procedural characteristics and all outcomes (defined according toVARC-2 criteria) were prospectively collected and retrospectively compared.Overall, a total of 151 consecutive patients (68 men; 80.9 ± 7.3 years old) were evaluated. Of these, 51 patients (33.8%) underwent TAVR using the dual PP, and 100 (66.2%) using one AS with one PP. There were no significant differences in the baseline characteristics of both patient groups, except higher incidence of chronic pulmonary disease in dual PP group (21.6% vs 7%, P = 0.009). Patients in AS + PP group had lower rate of arterial stricture (21.6% vs 8%, P = 0.017), arterial dissection (13.7% vs 4.0%), requiring endovascular intervention for puncture site issues (21.6% vs 9.0%, P = 0.031). Less procedural time (139.8 ± 36.9vs97.9 ± 31.4 min, P 0.001)contrast medium consumption (223.9 ± 88.3vs174.1 ± 49.7 ml, P 0.001) were also observed in AS+PP group. There were no statistically significant differences between 2 groups in regards of closure device failure, major and minor vascular complications, nor major and minor bleeding.Intentional combination of one PP and one AS for femoral access haemostasis in patients undergoing TAVR is feasible and safe, with low risk of vascular and bleeding complications.
- Published
- 2019
37. Quantification of cardiac pumping mechanics in rats by using the elastance–resistance model based solely on the measured left ventricular pressure and cardiac output
- Author
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Ming-Shiou Wu, Kuo-Chu Chang, Hsien-Li Kao, Yih-Sharng Chen, Ru-Wen Chang, Chun-Yi Chang, Chih-Hsien Wang, Ya-Jung Cheng, and En-Ting Wu
- Subjects
Male ,0301 basic medicine ,Cardiac output ,Systole ,Physiology ,Clinical Biochemistry ,Cardiac performance ,Derivative ,Elastance ,Ventricular resistance ,03 medical and health sciences ,0302 clinical medicine ,Heart Rate ,Triangular aortic flow ,Integrative Physiology ,Physiology (medical) ,Ventricular Pressure ,Animals ,Ventricular Function ,Cardiac Output ,Rats, Wistar ,Isovolumetric contraction ,Aorta ,Physics ,Maximum flow problem ,Ventricular elastance ,Heart ,Mechanics ,Aortic flow ,Rats ,Pulse pressure ,030104 developmental biology ,Isovolumic contraction ,Ventricular pressure ,030217 neurology & neurosurgery - Abstract
The cardiac pumping mechanics can be characterized by both the maximal systolic elastance (Emax) and theoretical maximum flow (Qmax), which are generated using an elastance–resistance model. The signals required to fit the elastance–resistance model are the simultaneously recorded left ventricular (LV) pressure and aortic flow (Qm), followed by the isovolumic LV pressure. In this study, we evaluated a single-beat estimation technique for determining the Emax and Qmax by using the elastance–resistance model based solely on the measured LV pressure and cardiac output. The isovolumic LV pressure was estimated from the measured LV pressure by using a non-linear least-squares approximation technique. The measured Qm was approximated by an unknown triangular flow (Qtri), which was generated by using a fourth-order derivative of the LV pressure. The Qtri scale was calibrated using the cardiac output. Values of EmaxtriQ and QmaxtriQ obtained using Qtri were compared with those of EmaxmQ and QmaxmQ obtained from the measured Qm. Healthy rats and rats with chronic kidney disease or diabetes mellitus were examined. We found that the LV Emax and Qmax can be approximately calculated using the assumed Qtri, and they strongly correlated with the corresponding values derived from Qm (P
- Published
- 2019
38. Statement of the Asian Hypertension Society Network: the Okinawa Declaration on the unity of hypertension societies in Asian countries and regions to overcome hypertension and hypertension-related diseases
- Author
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Tzung-Dau Wang, Ji-Guang Wang, Hsien-Li Kao, Koichi Node, Hirotaka Shibata, Yook Chin Chia, Naoki Kashihara, Deborah Ignacia D. Ona, Satoko Nakamura, Boon Wee Teo, Toshihiko Ishimitsu, S. N. Narasingan, Kouichi Tamura, Hiroshi Itoh, Apichard Sukonthasarn, Atsuhiro Ichihara, Mohd Arifin Mohd Ali, Tomohiro Katsuya, Erwinanto Erwinanto, Akira Nishiyama, Katsuyuki Miura, Godwin Constantine, Saulat Siddique, Sang-Hyun Ihm, Huynh Van Minh, Tatsuo Shimosawa, Masashi Mukoyama, Tsolmon Unurjargal, Kazuomi Kario, Kazunori Toyoda, Hisashi Kai, Mitsuru Ohishi, Yusuke Ohya, Hiromi Raukgi, and Shigeyuki Saito
- Subjects
Economic growth ,Asia ,Physiology ,Statement (logic) ,Declaration ,Asian People ,Political science ,Hypertension ,Internal Medicine ,Asian country ,Humans ,Societies ,Cardiology and Cardiovascular Medicine ,Societies, Medical - Published
- 2021
39. E-30 | Meta-Analysis of Successful vs. Failed Chronic Total Occlusion Percutaneous Coronary Intervention
- Author
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Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Dimitrios Karmpaliotis, Wissam A. Jaber, William J. Nicholson, Stéphane Rinfret, Kambis Mashayekhi, Gerald S. Werner, Margaret McEntegart, Seung W. Lee, Bo Xu, Jaikirshan Khatri, Scott A. Harding, Alexandre Avran, Farouc A. Jaffer, Darshan Doshi, Hsien-Li Kao, George Sianos, Masahisa Yamane, Anastasios Milkas, Lorenzo Azzalini, Roberto Garbo, Khalid Omar Tammam, Nidal Abi Rafeh, Ilias Nikolakopoulos, Evangelia Vemmou, Olga C. Mastrodemos, Bavana V. Rangan, M. Nicholas Burke, Santiago Garcia, Kevin J. Croce, Eugene B. Wu, Etsuo Tsuchikane, Carlo Di Mario, Alfredo R. Galassi Prof, Andrea Gagnor, Paul Knaapen, Yangsoo Jang, Byeong-Keuk Kim, Paul Poommipanit, and Emmanouil S. Brilakis
- Published
- 2022
40. E-31 | Meta-analysis of Chronic Total Occlusion Percutaneous Coronary Intervention vs. Medical Management Only in Observational Studies and Randomized Controlled Trials
- Author
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Bahadir Simsek, Spyridon Kostantinis, Judit Karacsonyi, Khaldoon Alaswad, Michael S. Megaly, Dimitrios Karmpaliotis, Wissam A. Jaber, William J. Nicholson, Kambis Mashayekhi, Gerald S. Werner, Margaret McEntegart, Seung W. Lee, Bo Xu, Scott A. Harding, Alexandre Avran, Ilias Nikolakopoulos, Evangelia Vemmou, Olga C. Mastrodemos, Bavana V. Rangan, Lorenzo Azzalini, Farouc A. Jaffer, Kevin J. Croce, Hsien-Li Kao, George Sianos, Masahisa Yamane, Eugene B. Wu, Etsuo Tsuchikane, Anastasios Milkas, Carlo Di Mario, Alfredo R. Galassi Prof, Roberto Garbo, Andrea Gagnor, Paul Knaapen, Khalid Omar Tammam, Yangsoo Jang, Byeong-Keuk Kim, Nidal Abi Rafeh, and Emmanouil S. Brilakis
- Published
- 2022
41. Overexpansion of the SAPIEN 3 Transcatheter Heart Valve in a Tricuspid Aortic Valve with Huge Annulus
- Author
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Wen-Pin Hsiao, Mao Shin Lin, Hsien Li Kao, Ying-Hsien Chen, and Yih-Sharng Chen
- Subjects
Annulus (mycology) ,Aortic valve ,medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Internal medicine ,cardiovascular system ,medicine ,Cardiology ,Heart valve ,business - Abstract
Transcatheter aortic valve replacement (TAVR) has become a treatment alternative for patients with severe aortic stenosis. As broadened indications and increasing clinical demand, the population referred for TAVR will become much more heterogeneous and anatomically challenging. Herein, we report an 88-year-old man with severe aortic stenosis and huge aortic annulus (annular area 831.8 mm2) successfully treated with overexpansion of a 29 mm Edwards SAPIEN 3 transcatheter heart valve.
- Published
- 2021
42. Lesion impacts on long-term outcomes in patients implanted with bioresorbable vascular scaffold
- Author
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Mao-Shin Lin, Fu-Tien Chiang, Juey-Jen Hwang, Hsien-Li Kao, Yi-Chih Wang, and Cho-Kai Wu
- Subjects
Adult ,Male ,Acute coronary syndrome ,medicine.medical_specialty ,Coronary Artery Disease ,Coronary Angiography ,Prosthesis Design ,Lesion ,Percutaneous Coronary Intervention ,Absorbable Implants ,medicine ,Humans ,In patient ,Bioresorbable vascular scaffold ,Aged ,Proportional hazards model ,business.industry ,Hazard ratio ,Lesion Complexity ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,medicine.disease ,Treatment Outcome ,Female ,Radiology ,medicine.symptom ,business ,Kidney disease - Abstract
Bioresorbable vascular scaffold (BVS) had been implanted to several kinds of complex coronary lesions in real-world practice. We tested if long-term outcomes of BVS for complex lesions would be worse than that for relatively simple lesions.We analyzed 457 patients (59 ± 12 years, 87% male) with 714 BVS implanted for their 529 lesions and median follow-up of 32.7 (26.8-39.3) months. Complex group (N = 284) was defined as those with BVS for acute coronary syndrome, chronic total occlusion, bifurcation/ostial lesions, instent restenosis/hybrid with metallic stents, diffuse lesions (overlapped by 2 BVS with each ≧ 18 mm), venous graft/left main lesions, or lesions after rotablation. We compared their outcomes with the remaining 173 patients as non-complex group.The complex group had more chronic kidney disease (7% vs. 2%), multivessel disease (78% vs. 65%), use of intravascular imaging (40% vs. 23%), and more BVS (1.8 ± 0.9 vs. 1.1 ± 0.3) with longer total lengths (47 ± 22 vs. 29 ± 8 mm) implanted than non-complex group (all p 0.05). However, the long-term target lesion revascularization (TLR) or target lesion failure (TLF) was similar (log rank p 0.05) between the two groups. Multivariate Cox regression analyses showed BVS for ACC/AHA type C lesions was independently associated with higher risks of TLR (hazard ratio: 2.7, 95% CI = 1.1-6.6) and TLF (hazard ratio: 2.6, 95% CI = 1.1-6.3).Comparable outcomes were found between BVS for complex and non-complex lesion category. However, higher risks of TLR and TLF for type C lesions still suggested the prognostic impact of lesion complexity on long-term outcomes of BVS.
- Published
- 2021
43. Impact of Conduction Disturbances on Left Ventricular Mass Regression and Remodeling Following Transcatheter Aortic Valve Replacement
- Author
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Tsung-Yu Ko, Hsien-Li Kao, Ying-Ju Liu, Chih-Fan Yeh, Ching-Chang Huang, Ying-Hsien Chen, Chi-Sheng Hung, Chih-Yang Chan, Lung-Chun Lin, Yih-Sharng Chen, and Mao-Shin Lin
- Abstract
Our study aimed to compare the difference of LV mass regression and remodeling in regard of conduction disturbances (CD) following transcatheter aortic valve replacement (TAVR). A prospective analysis of 152 consecutive TAVR patients was performed. 53 patients (34.9%) had CD following TAVR, including 30 (19.7%) permanent pacemaker implantation and 23 (15.2%) new left bundle branch block. In 123 patients with 1-year follow-up, significant improvement of LV ejection fraction (LVEF) (baseline vs 12-month: 65.1±13.2 vs 68.7±9.1, P=0.017) and reduced LV end-systolic volume (LVESV) (39.8±25.8 vs 34.3±17.1, P=0.011) was found in non-CD group (N=85), but not in CD group (N=38). Both groups had significant decrease in LV mass index (baseline vs 12-month: 148.6±36.9 vs. 136.4±34.7 in CD group, p=0.023; 153.0±50.5 vs. 125.6±35.1 in non-CD group, p
- Published
- 2021
44. List of contributors
- Author
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J. Dawn Abbott, Nidal Abi Rafeh, Mazen Abu Fadel, Pierfrancesco Agostoni, Sukru Akyuz, Khaldoon Alaswad, Dimitrios Alexopoulos, Dominick J. Angiolillo, Herbert D. Aronow, Alexandre Avran, Lorenzo Azzalini, Avtandil M. Babunashvili, Jayant Bagai, Subhash Banerjee, Kenneth Baran, Mir Babar Basir, Nicolas Boudou, Konstantinos Dean Boudoulas, Christos V. Bourantas, Nenad Ž. Božinović, Leszek Bryniarski, Alexander Bufe, M. Nicholas Burke, Heinz Joachim Büttner, Pedro Pinto Cardoso, Mauro Carlino, Jeff Chambers, Konstantinos Charitakis, Yiannis S. Chatzizisis, Ivan J. Chavez, James W. Choi, Evald Høj Christiansen, Mauricio G. Cohen, Francesco Costa, Felix Damas de los Santos, Rustem Dautov, Tony De Martini, Ali E. Denktas, Joseph Dens, Zisis Dimitriadis, Anthony Doing, Mohaned Egred, Basem Elbarouni, Ahmed M. El Guindy, Abdallah El Sabbagh, Panayotis Fasseas, Dmitriy N. Feldman, Sergey Furkalo, Andrea Gagnor, Alfredo R. Galassi, Roberto Garbo, Santiago Garcia, Gabriele L. Gasparini, Anthony H. Gershlick, Mario Goessl, Luca Grancini, Abdul Hakeem, Allison B. Hall, Stefan Harb, Raja Hatem, Jose P.S. Henriques, Yangsoo Jang, Risto Jussila, Artis Kalnins, Arun Kalyanasundaram, Paul Hsien-Li Kao, Judit Karacsonyi, Lampros Karagounis, Antonios Karanasos, Dimitri Karmpaliotis, Houman Khalili, Jaikirshan J. Khatri, Dmitrii Khelimskii, Byeong-Keuk Kim, Louis P. Kohl, Daniel M. Kolansky, Michalis Koutouzis, Oleg Krestyaninov, Faisal Latif, Seung-Whan Lee, Thierry Lefevre, Nicholas J. Lembo, Ehtisham Mahmud, Konstantinos Marmagkiolis, Kambis Mashayekhi, Kreton Mavromatis, Michael Megaly, Owen Mogabgab, Michael R. Mooney, Jeffrey W. Moses, Bilal Murad, Alexander Nap, William Nicholson, Dimitrios N. Nikas, Ilias Nikolakopoulos, Goran Olivecrona, Mohamed A. Omer, Jacopo Andrea Oreglia, Lucio Padilla, Ioannis Paizis, Carmelo Panetta, Mitul Patel, Ashish Pershad, Marin Postu, Srini Potluri, Anil Poulose, Stylianos Pyxaras, Sunil V. Rao, Sudhir Rathore, Amir Ravandi, Nicolaus Reifart, Robert F. Riley, Stephane Rinfret, Gurpreet S. Sandhu, Yader Sandoval, Elias Sanidas, Ricardo Santiago Trinidad, Jeffrey M. Schussler, Arnold Seto, Alok Sharma, Arslan Shaukat, Mehdi H. Shishehbor, Evan Shlofmitz, Richard Shlofmitz, Paul Sorajja, Anthony Spaedy, Peter Tajti, Jacqueline E. Tamis-Holland, Aurel Toma, Konstantinos Toutouzas, Jay H. Traverse, Huu Tam Truong, Sotiris Tsalamandris, Ioannis Tsiafoutis, Imre Ungi, Emmanouil Vavouranakis, Evangelia Vemmou, Minh N. Vo, Vassilis Voudris, Yale Wang, Jarosław Wójcik, Jason Wollmuth, Eugene B. Wu, Iosif Xenogiannis, Masahisa Yamane, and Luiz Fernando Ybarra
- Published
- 2021
45. TCTAP A-042 Comparison Between Drug-Coated Balloon and Drug-Eluting Stent in Very Small Coronary Artery Intervention
- Author
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Cheng-Hsuan Tsai, Mao-Shin Lin, Ching-Chang Huang, Chih-Fan Yeh, Ying-Hsien Chen, and Paul Hsien-Li Kao
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
46. Long-term outcomes and left ventricular diastolic function of sarcomere mutation-positive and mutation-negative patients with hypertrophic cardiomyopathy: a prospective cohort study
- Author
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Yih-Shurng Chen, Tzu-Pin Lu, Wen-Jone Chen, Fu-Lan Chang, Ching-Yu Shih, Yen-Hung Lin, Dun-Hui Yang, Juey-Jen Hwang, Jyh-Ming Jimmy Juang, Mao-Yuan M. Su, Shih-Fan Sherri Yeh, Cho-Kai Wu, Sung-Liang Yu, Ching-Yu Julius Chen, Lian-Yu Lin, Ling Ping Lai, Hsien-Li Kao, and Ying-Chieh Liao
- Subjects
0303 health sciences ,medicine.medical_specialty ,Ejection fraction ,business.industry ,medicine.drug_class ,Hazard ratio ,Diastole ,Hypertrophic cardiomyopathy ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,Sudden cardiac death ,03 medical and health sciences ,0302 clinical medicine ,Heart failure ,Internal medicine ,Natriuretic peptide ,Cardiology ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Prospective cohort study ,030304 developmental biology - Abstract
Aims Hypertrophic cardiomyopathy (HCM) is an inheritable disease that leads to sudden cardiac death and heart failure (HF). Sarcomere mutations (SMs) have been associated with HF. However, the differences in ventricular function between SM-positive and SM-negative HCM patients are poorly characterized. Methods and results Of the prospectively enrolled 374 unrelated HCM patients in Taiwan, 115 patients underwent both 91 cardiomyopathy-related gene screening and cardiovascular magnetic resonance (45.6 ± 10.6 years old, 76.5% were male). Forty pathogenic/likely pathogenic mutations were identified in 52 patients by next-generation sequencing. The SM-positive group were younger at first cardiovascular event (P = 0.04) and progression to diastolic HF (P = 0.02) with higher N-terminal pro-brain natriuretic peptide (NT-proBNP) [New York Heart Association (NYHA) Class III/IV symptoms with left ventricular ejection fraction > 55%] than the SM-negative group (P Conclusion SM-positive HCM patients had a higher extent of myocardial fibrosis and more severe ventricular diastolic dysfunction than those without, which may contribute to earlier onset of advanced HF, suggesting the importance of close surveillance and early treatment throughout life.
- Published
- 2020
47. Transcatheter aortic valve implantation during the COVID-19 pandemic: Clinical expert opinion and consensus statement for Asia
- Author
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Mann Chandavimol, Fabio Enriques Posas, Jimmy Kim Fatt Hon, Kentaro Hayashid, Ashok Seth, Hsien-Li Kao, Nguyen Ngoc Quang, Duk-Woo Park, Edgar Tay, Michael K. Lee, William Kok-Fai Kong, Mao-Shin Lin, Kay Woon Ho, Doni Firman, Mao Chen, Wacin Buddhari, Rosli Mohd Ali, and Wei Hsien Yin
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Asia ,Infectious Disease Transmission, Patient-to-Professional ,Transcatheter aortic ,Best practice ,030204 cardiovascular system & hematology ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,COVID-19 Testing ,Surveys and Questionnaires ,Pandemic ,Preoperative Care ,medicine ,Infection control ,Humans ,Pandemics ,Infection Control ,Interventional cardiology ,business.industry ,Remote Consultation ,COVID-19 ,Aortic Valve Stenosis ,Length of Stay ,medicine.disease ,Triage ,Stenosis ,030228 respiratory system ,Cardiothoracic surgery ,Aortic valve stenosis ,Surgery ,Medical emergency ,business ,Cardiology and Cardiovascular Medicine - Abstract
Objectives The impact of the COVID-19 pandemic on the treatment of patient with aortic valve stenosis is unknown and there is uncertainty on the optimal strategies in managing these patients. Methods This study is supported and endorsed by the Asia Pacific Society of Interventional Cardiology. Due to the inability to have face to face discussions during the pandemic, an online survey was performed by inviting key opinion leaders (cardiac surgeon/interventional cardiologist/echocardiologist) in the field of transcatheter aortic valve implantation (TAVI) in Asia to participate. The answers to a series of questions pertaining to the impact of COVID-19 on TAVI were collected and analyzed. These led subsequently to an expert consensus recommendation on the conduct of TAVI during the pandemic. Results The COVID-19 pandemic had resulted in a 25% (10-80) reduction of case volume and 53% of operators required triaging to manage their patients with severe aortic stenosis. The two most important parameters used to triage were symptoms and valve area. Periprocedural changes included the introduction of teleconsultation, preprocedure COVID-19 testing, optimization of protests, and catheterization laboratory set up. In addition, length of stay was reduced from a mean of 4.4 to 4 days. Conclusion The COVID-19 pandemic has impacted on the delivery of TAVI services to patients in Asia. This expert recommendation on best practices may be a useful guide to help TAVI teams during this period until a COVID-19 vaccine becomes widely available.
- Published
- 2020
48. Characterization of TMAO productivity from carnitine challenge facilitates personalized nutrition and microbiome signatures discovery
- Author
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Yi-Chia Lee, Angela Yu-Chen Lin, Hsiao Li Chuang, Ching-Hu Chung, Yu Wei Wu, Han Chun Kuo, Suraphan Panyod, Hsien-Li Kao, Po-Yu Liu, Tina H.T. Chiu, Hsin Bai Zou, Ben-Yang Liao, Ming-Shiang Wu, Ching-Hua Kuo, Ying Hsien Chen, Sen-Lin Tang, Chieh Chang Chen, Alexander N. Orekhov, Jin Town Wang, Wei-Kai Wu, Lee-Yan Sheen, and Cheng-Chih Hsu
- Subjects
Adult ,Male ,Microbiology (medical) ,Emergencia timonensis ,Administration, Oral ,Trimethylamine N-oxide ,Computational biology ,030204 cardiovascular system & hematology ,Biology ,Gut flora ,Microbiology ,lcsh:Microbial ecology ,Methylamines ,Mice ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Carnitine ,Machine learning ,medicine ,Animals ,Humans ,Microbiome ,030304 developmental biology ,Clostridiales ,0303 health sciences ,Gut microbiome ,Research ,Microbiota ,Oral carnitine challenge test ,Personalized nutrition ,biology.organism_classification ,Cardiovascular disease ,chemistry ,lcsh:QR100-130 ,Female ,Ihubacter massiliensis ,medicine.drug - Abstract
The capability of gut microbiota in degrading foods and drugs administered orally can result in diversified efficacies and toxicity interpersonally and cause significant impact on human health. Production of atherogenic trimethylamine N-oxide (TMAO) from carnitine is a gut microbiota-directed pathway and varies widely among individuals. Here, we demonstrated a personalized TMAO formation and carnitine bioavailability from carnitine supplements by differentiating individual TMAO productivities with a recently developed oral carnitine challenge test (OCCT). By exploring gut microbiome in subjects characterized by TMAO producer phenotypes, we identified 39 operational taxonomy units that were highly correlated to TMAO productivity, including Emergencia timonensis, which has been recently discovered to convert γ-butyrobetaine to TMA in vitro. A microbiome-based random forest classifier was therefore constructed to predict the TMAO producer phenotype (AUROC = 0.81) which was then validated with an external cohort (AUROC = 0.80). A novel bacterium called Ihubacter massiliensis was also discovered to be a key microbe for TMA/TMAO production by using an OCCT-based humanized gnotobiotic mice model. Simply combining the presence of E. timonensis and I. massiliensis could account for 43% of high TMAO producers with 97% specificity. Collectively, this human gut microbiota phenotype-directed approach offers potential for developing precision medicine and provides insights into translational research.
- Published
- 2020
49. Additional file 1 of Characterization of TMAO productivity from carnitine challenge facilitates personalized nutrition and microbiome signatures discovery
- Author
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Wu, Wei-Kai, Suraphan Panyod, Po-Yu Liu, Chieh-Chang Chen, Hsien-Li Kao, Hsiao-Li Chuang, Ying-Hsien Chen, Hsin-Bai Zou, Kuo, Han-Chun, Ching-Hua Kuo, Ben-Yang Liao, Chiu, Tina H. T., Ching-Hu Chung, Lin, Angela Yu-Chen, Yi-Chia Lee, Tang, Sen-Lin, Jin-Town Wang, Wu, Yu-Wei, Cheng-Chih Hsu, Lee-Yan Sheen, Orekhov, Alexander N., and Wu, Ming-Shiang
- Abstract
Additional file 1:. Tables S1-S2 and Figures S1-S12
- Published
- 2020
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50. How to Cross CTO Lesion from Retrograde Approach
- Author
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Hsien-Li Kao
- Subjects
Computer science ,business.industry ,Retrograde approach ,Computer vision ,Artificial intelligence ,business - Abstract
Retrograde approach is essential to achieve high overall success in the intervention for chronic total occlusions. Once the operator delivers the retrograde wire through collateral channels into the distal true lumen, he/she has to decide how to proceed crossing the actual occluded coronary segment. In addition to know how to apply a variety of techniques correctly, one must also know how to choose these techniques in a structured fashion. Instead of futile persistence, the efficient operator will and should switch to the next reasonable step following a logical algorithm.
- Published
- 2020
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