Symptoms Of Heart Disease Research Articles

Health-Related Quality of Life After Neonatal Treatment of Symptomatic Tetralogy of Fallot: Insights from the Congenital Cardiac Research Collaborative.

To evaluate the association between initial management strategy of neonatal symptomatic Tetralogy of Fallot (sTOF) and later health-related quality of life (HRQOL) outcomes. We performed a multicenter, cross-sectional evaluation of a previously assembled cohort of infants with sTOF who underwent initial intervention at ≤ 30days of age, between 2005 and 2017. Eligible patients' parents/guardians completed an age-appropriate Pediatric Quality of Life Inventory, a Pediatric Quality of Life Inventory Cardiac Module Heart Disease Symptoms Scale, and a parental survey. The association between treatment strategy and HRQOL was evaluated, and the entire sTOF cohort was compared to published values for the healthy pediatric population and to children with complex congenital heart disease and other chronic illness. The study cohort included 143 sTOF subjects, of which 59 underwent a primary repair, and 84 had a staged repair approach. There was no association between initial management strategy and lower HRQOL. For the entire cohort, in general, individual domain scores decreased as age sequentially increased. Across domain measurements, mean scores for the sTOF cohort were significantly lower than the healthy pediatric population and comparable to those with other forms of complex CHD and other chronic health conditions. The presence of a genetic syndrome was significantly associated with a poor HRQOL (p = 0.003). Initial treatment strategy for sTOF was not associated with differences in late HRQOL outcomes, though the overall HRQOL in this sTOF cohort was significantly lower than the general population, and comparable to others with chronic illness.

Eight-year total, cognitive-affective, and somatic depressive symptoms trajectories and risks of cardiac events

In this study, we analyzed pooled data from two prospective population-based cohorts—the Health Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA)—to explore the association between trajectories of depressive symptoms and the risk of cardiac events. Depressive symptoms were assessed using the 8-item CES-D scale and categorized into somatic and cognitive-affective subtypes. Trajectories were tracked for four surveys from baseline. Heart disease was identified based on self-reported physician-diagnosed conditions. Hazard ratios and 95% confidence intervals were calculated with Cox proportional risk models that adjusted for potential confounders. In total, 17,787 subjects (59.7% female, median age 63 years) were enrolled at baseline. During a 10-year follow-up, 2409 cases of heart disease were identified. Participants with fluctuating (HR = 1.13, 95% CI: 1.06–1.20), increasing (HR = 1.43, 95% CI: 1.25–1.64), and consistently high (HR = 1.64, 95% CI: 1.45–1.84) depressive symptom trajectories exhibited an increased risk of heart disease compared to those with consistently low depressive symptoms, while a decreasing (HR = 1.07, 95% CI: 0.96–1.19) depressive symptom trajectory did not significantly affect the risk of heart disease. Moreover, the association between heart disease and somatic depressive symptoms was found to be stronger than with cognitive-affective symptoms. These findings suggest a significant link between depressive symptom trajectories and heart disease, with particular emphasis on stronger associations with somatic symptoms. It is recommended that the identification and management of depressive symptoms be incorporated into heart disease prevention strategies.

A clinical Study of heart disease among asymptomatic antenatal women detected using Echocardiographic screening

Background: Pregnancy causes reversible changes in the maternal cardiovascular system. Adverse cardiac events during and after pregnancy continue to be the important causes of maternal mortality and morbidity. The signs and symptoms of pregnancy may confuse with signs and symptoms of heart disease. Echocardiography is safe, effective, noninvasive and does not expose the pregnant women to radiation hazards , so it plays a vital role in identifying the hemodynamic and structural changes in cardiovascular disease in asymptomatic antenatal women. Aim & objective: This study aims to screen asymptomatic pregnant women using transthoracic echocardiography. Material & Methods: Purposive sampling was done. The study was conducted at Apollo hospital Bilaspur from January 2024 to April 2024 enrolling 50 pregnant women from all trimester. Those with previous history of heart disease were excluded. Data was analysed for descriptive statistics using Microsoft excel and SPSS V 22 and was summarised using proportions, percentages, and contingency tables. Results: Out of 50 enrolled study participants ,60%(n-30), 28 %(n-14),12%(n-6) were in third, second , first trimester respectively . we found that 6%(n-3) of the patient have either congenital heart disease or acquired heart disease. Out of 3 study participants, 1 had congenital heart disease and 2 had acquired heart disease. Conclusion: Our study shows screening echocardiography will helpful in identifying the heart disesase and reducing maternal mortality and morbidity related to heart disease & this will justify the routine cardiac assessment in each and every pregnant women even in absence of cardiopulmonary symptoms.

Impact of Patient Age on Management of Hypothyroidism: A Survey of Physicians from Three Developing Regions

Abstract Background The thyroid-stimulating hormone (TSH) levels increase with age, and aiming for the same TSH target applicable in a younger population in older patients who are on replacement with thyroid hormones. Methods We assessed practice patterns regarding TSH goals and explored factors influencing physicians' decision-making when managing hypothyroidism. Multiple-choice questions in a case-based survey of a convenience sample of physicians practicing in relevant disciplines in three developing regions. Results Of the total 286, senior physicians represented 63% and mid-grades represented 27% of the respondents. Forty-one percent were endocrinologists, 19% were internists with endocrine interests, and 16% were family physicians. Over half (52%) practiced at a tertiary level and 42% had been in practice for over 20 years. Fifty percent of respondents had more than 20% of their patients over 65 years.Several attributes were factored into decision-making when managing hypothyroidism. Respondents took into account age (75%), preceded by the presence of cardiac arrhythmias (80%), pregnancy (79%), heart disease (78%), and patient symptoms (77%) when determining the treatment strategy. When presented with scenarios differing in patients' age, around 90% of physicians targeted a TSH ≤ 3.0 mIU/L in 30-year-old patients. Fifteen percent of respondents targeted a TSH of 1.6 to 3.0 mIU/L in octogenarians, but 78% targeted a TSH > 3.1 to 5.0 mIU/L in this group. Regardless of sex, physician-reported TSH goal ranges (0.1–0.5, 0.6–1.5, 1.6–3.0, and 3.1–5.0 mIU/L) increased directly to patient age. Overall, respondents were less inclined to start treatment in 85-year-olds than in 70-year-old females with TSH of 6 mU/L (20% vs. 11%). Females with a TSH of 15 mU/L were more likely to get treated than those with a 6 mU/L TSH. Vital persons are more likely to be treated with thyroxine than vulnerable persons for the same TSH levels. Multivariate analysis showed that compared with endocrinologists, family physicians and other specialties were less likely to consider age in their clinical decisions, odds ratio (OR) 0.2 (95% confidence interval [CI] 0.1–0.7), p = 0.018, and OR 0.3 (95% CI 0.1–0.8), p = 0.013, respectively. Conclusion A consensus is needed on the role of patients' age in hypothyroidism management, the complexity of managing hypothyroidism in an older adult patient, and the variability in practice patterns among physicians. Addressing these challenges demands ongoing dialogue and collaboration among health care providers to improve patient care and outcomes in hypothyroidism management across different age groups.

Analysis of the Necessity of Stellate Ganglion Block after Anesthesia to Reduce the Risk of Cardiovascular Accidents in Coronary Heart Disease

Objective: To adjust the sympathetic nervous system through preoperative ultrasound-guided stellate ganglion block and to explore and analyze the situation and necessity of postanesthesia stellate ganglion block to reduce the risk of cardiovascular accidents in coronary heart disease. Methods: 80 patients with cardiovascular risk factors in Songshan Hospital of Chifeng were selected, and the time span would cover from October 2022 to June 2024, with 80 cases of elective surgery and combined coronary heart disease. They will be randomly divided into blocked groups and conventional groups, 40 cases each. Conventional block was performed after anesthesia in patients in the conventional group, and planetary ganglion block was performed after anesthesia in patients in the blocked group. The cardiovascular responses of patients in the two groups were observed, and the number of intraoperative cardiovascular active drugs and the occurrence of cardiovascular adverse events were recorded in patients in the two groups. Results: Analysis of the mean arterial pressure (MAP) and heart rate (HR) values of the two groups of patients at the time points before anesthesia (T0), the moment of tracheal intubation (T1), the moment of surgical skin cutting (T2), the end of the operation (T3), and the 6h postoperative period (T4) showed that the MAP and HR of the blocked group were lower than those of the conventional group at the time points of T1 to T4, and the differences in MAP and HR values of the two groups in different time points compared with the T0 time point were statistically significant (P < 0.05) and the differences in cardiovascular response (P < 0.05) were statistically significant (P < 0.05). significance (P < 0.05). The number of intraoperative cardiovascular active drugs used in the blocked group was shorter than that in the conventional group, and the incidence of cardiovascular adverse events was lower than that in the conventional group, with a statistically significant difference (P < 0.05). Conclusion: By implementing preoperative ultrasound-guided stellate ganglion block in patients with cardiovascular risk factors, the frequency and degree of coronary heart disease symptoms will be reduced, thus reducing the risk of patients, which is worth promoting.

Sex differences in delay times in ST-segment elevation myocardial infarction: A cohort study

BackgroundThe present study analyzes a cohort of consecutive patients with ST-segment elevation acute myocardial infarction (STEMI), evaluating the ischemia–reperfusion times from the perspective of gender differences (females versus males), with a long-term follow-up. MethodsSingle-center analytical cohort study of patients with STEMI in a tertiary hospital, between January 2015 and December 2020. ResultsA total of 2668 patients were included, 2002 (75%) men and 666 (25%) women. The time elapsed from the onset of symptoms to the opening of the artery was 197min (IQR 140–300) vs 220min (IQR 152–340), p=0.004 in men and women respectively. A delay in health care significantly impacts the occurrence of cardiovascular adverse events at follow-up, HR 1.34 [95%CI 1.06–1.70]; p=0.015. ConclusionsWomen took longer to go to health care services and had a longer delay both in the diagnosis of STEMI and in coronary reperfusion. It is imperative to emphasize the necessity of educating women about the recognition of ischemic heart disease symptoms, empowering them to raise early alarms and seek timely medical attention.

Women Acute Myocardial Infarction-Identifying and Understanding the Gender Gap (WAMy-GAP): A Study Protocol.

Barriers to accessing care and misinterpretations of ischemic heart disease symptoms due to lack of awareness contribute to women's delay in seeking care. Women may delay seeking treatment for up to 3 h or even up to 5 days. They often perceive themselves to be at low risk of cardiovascular disease (CVD) and prioritize family responsibilities or household chores. The causes of this delay are multifactorial and influence the decision-making process, particularly in the pre-hospital phase. The objective of this study protocol is to evaluate prodromal symptoms and identify risk behaviors in women with acute myocardial infarction (AMI). This is a protocol for a multicenter study that will be conducted using the mixed-method methodology using the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS) to evaluate symptoms and semi-structured interviews to investigate behaviors. This study protocol is intended to fill an important knowledge gap on premonitory and acute symptoms of AMI in women in Italy, as well as to understand the causes and mechanisms underlying delays in accessing healthcare services during an acute event such as AMI. The investigation of this issue will facilitate the removal of gender-related inequalities in the diagnosis and treatment of acute myocardial infarction while also fostering dialogue on the barriers to behavior change.

Transthoracic ultrasound localization microscopy of myocardial vasculature in patients

Myocardial microvasculature and haemodynamics are indicative of potential microvascular diseases for patients with symptoms of coronary heart disease in the absence of obstructive coronary arteries. However, imaging microvascular structure and flow within the myocardium is challenging owing to the small size of the vessels and the constant movement of the patient’s heart. Here we show the feasibility of transthoracic ultrasound localization microscopy for imaging myocardial microvasculature and haemodynamics in explanted pig hearts and in patients in vivo. Through a customized data-acquisition and processing pipeline with a cardiac phased-array probe, we leveraged motion correction and tracking to reconstruct the dynamics of microcirculation. For four patients, two of whom had impaired myocardial function, we obtained super-resolution images of myocardial vascular structure and flow using data acquired within a breath hold. Myocardial ultrasound localization microscopy may facilitate the understanding of myocardial microcirculation and the management of patients with cardiac microvascular diseases.

ROLE OF CARDIOVASCULAR IMAGING IN CARDIO-ONCOLOGY: A LITERATURE REVIEW

Antitumor drugs are toxic to the cardiovascular system and directly affect cardiac function and anatomy. During the treatment of oncology, patients may experience complications in the form of asymptomatic myocardial dysfunction, severe heart failure, exacerbation of symptoms of coronary heart disease, thromboembolic complications, arterial and pulmonary hypertension, pericardial complications, valve defects and arrhythmias. A number of diagnostic tools are currently available to cardio-oncologists to detect cardiotoxicity, and the choice of imaging method depends on the availability of the specific diagnostic modality and its resolution. The main method for assessing the condition of the heart in cancer patients is echocardiography - a widely available method that enables to assess the structure of the heart and hemodynamics without exposing the patient to an additional dose of ionizing radiation. If imaging is insufficient, the recommended method for assessing cardiac structure and function is magnetic resonance imaging. Computed tomography of the chest, heart and coronary arteries is also used to diagnose complications of cancer treatment. In addition, nuclear medicine techniques, including gated radionuclide ventriculography, are also used to diagnose cardiotoxicity. Electroanatomical mapping systems combined with remote navigation are promising. Early detection of subclinical left ventricular myocardial dysfunction in cancer patients receiving potentially cardiotoxic drugs is advisable and aimed at secondary prophylaxis and prevention of mortality from cardiovascular diseases.

Sex differences in delay times in ST-segment elevation myocardial infarction: A cohort study

BackgroundThe present study analyzes a cohort of consecutive patients with ST-segment elevation acute myocardial infarction (STEMI), evaluating the ischemia–reperfusion times from the perspective of gender differences (females versus males), with a long-term follow-up. MethodsSingle-center analytical cohort study of patients with STEMI in a tertiary hospital, between January 2015 and December 2020. ResultsA total of 2668 patients were included, 2002 (75%) men and 666 (25%) women. The time elapsed from the onset of symptoms to the opening of the artery was 197min (IQR 140–300) vs 220min (IQR 152–340), p=0.004 in men and women respectively. A delay in health care significantly impacts the occurrence of cardiovascular adverse events at follow-up, HR 1.34 [95%CI 1.06–1.70]; p=0.015. ConclusionsWomen took longer to go to health care services and had a longer delay both in the diagnosis of STEMI and in coronary reperfusion. It is imperative to emphasize the necessity of educating women about the recognition of ischemic heart disease symptoms, empowering them to raise early alarms and seek timely medical attention.

Chest Radiography Pearls in Select Adult Congenital Heart Disease.

Congenital heart disease in adult patients (ACHD) includes individuals with native anatomic deformities and those who have benefited from corrective, ameliorative, or interventional heart and vascular interventions. Congenital heart disease is the most common birth defect, although with interventions most survive into adulthood. Newborns and children with complex congenital heart diseases that feature cyanosis fail to thrive, and once this is identified, heart failure can promptly undergo diagnostic evaluations and treatment. However, patients with simple congenital heart disease and subtle clinical signs and symptoms may escape diagnosis until adulthood or experience changes in their cardiac hemodynamics and physiology in settings such as pregnancy or newly diagnosed arrhythmias. The chest X-ray (CXR) is the most common X-ray among all radiological procedures. Individual features or a constellation of features on a CXR are often present in patients who have congenital heart disease. The ability to recognize these CXR features is a valuable skill for making the diagnosis of ACHD and for following these patients as they age, and can complement echocardiographic findings. When used well to diagnose ACHD, the CXR will be the sharpest arrow in the quiver.

Deep learning in the classification and recognition of cardiac activity patterns

Electrocardiography is an examination performed frequently in patients experiencing symptoms of heart disease. Upon a detailed analysis, it has shown potential to detect and identify various activities. In this article, we present a deep learning approach that can be used to analyze ECG signals. Our research shows promising results in recognizing activity and disease patterns with nearly 90% accuracy. In this paper, we present the early results of our analysis, indicating the potential of using deep learning algorithms in the analysis of both onedimensional and two–dimensional data. The methodology we present can be utilized for ECG data classification and can be extended to wearable devices. Conclusions of our study pave the way for exploring live data analysis through wearable devices in order to not only predict specific cardiac conditions, but also a possibility of using them in alternative and augmented communication frameworks.

Health-seeking behavior in Indonesia especially in outer Baduy ethnic with heart disease

Background: Unlike the community in general, the Baduy community in Kanekes Village has a unique way of looking at the modern world, including their sight of modern medicine. Even though they know traditional medicine, in the current context, their traditional medicine efforts have not been able to fully answer the health problems they face today, one of which is cardiac events. 
 Purpose: This study aims to analyze the factors that influence the pattern of health-seeking behavior of the Outer Baduy community against heart disease
 Method: This study is an analytical observational study with a cross-sectional approach to the Outer Baduy community that was diagnosed or suspected of having cardiac problems in 2023. Data was taken using the questionnaire sheets containing data on respondents' characteristics, and their first experience of having heart attack symptoms. The outcome was their health-seeking behavior when facing the circumstances categorized into traditional and modern behavior. The data was analyzed using the Fisher Exact Test to find out the relationship between variables
 Results: Thirty-six respondents are involved in this study. Most respondents were male (25/69.4%) and were in the age range from 48 to 76 years old, had an educational background graduated from elementary school (16/44.4%), worked as traders (18/50.0%), had insurance (26/72.2%) and experiencing symptoms of typical heart disease (30/83.3). Most of the respondents seek modern medicine when experiencing a typical heart attack. There is a p-value of more than 0.05 between age, sex, education level, and occupation with health-seeking behavior. Insurance ownership and respondents' experience of feeling heart attack symptoms to health-seeking behavior p values of 0.000 and 0.002 (< α 0.05) respectively.
 Conclusion: Most respondents seek modern medical help when experiencing typical heart disease. There is no significant relationship between age, sex, education level, and occupation with health-seeking behavior in heart disease. Insurance ownership and experiencing typical symptoms of heart disease significantly affect the health-seeking behavior of the Outer Baduy community. The results of this study can be a consideration for local health policyholders in creating cardiovascular emergency health education programs for the community. The combination of modern curative medicine and traditional preventive medicine can be one approach in the health sector that can be done by the government to reduce morbidity and mortality due to cardiovascular events in the Baduy community. Further studies are needed to explore the Outer Baduy community's knowledge and perception of cardiovascular events and the barriers they face to getting the necessary medication.

Metastatic liver mass with heart failure presentation: A case report

Objective: Dyspnea is a common symptom of heart disease that can also be related to other disorders, such as liver disease. In this case report, we aim to describe a rare case of metastatic liver mass that presented with heart failure. Case Presentation: A 50-year-old woman without a past medical history arrived at our hospital with a history of dyspnea and swelling in the lower extremities. She did not complain of pain, arthralgia, trauma, or chest pain but complained of exertional dyspnea and fatigue that had started one month before and had aggravated two days before. Her laboratory test indicated anemia. In echocardiography, we saw mild right ventricle enlargement and dysfunction, but the left heart was normal with acceptable systolic and diastolic function. In the subcostal view, the inferior vena cava (IVC) was dilated but under compression of a large liver mass. According to our literature review, this is the first case in which a metastatic liver mass had presented with heart failure. Conclusion: In patients presenting with dyspnea, despite normal echocardiographic findings, the exact evaluation of the IVC should be considered.

UNSTABLE ANGINA, LITERATURE REVIEW

Introduction: Angina, or chest pain, is the most frequent symptom of ischemic heart disease, one of the primary origins of morbidity and mortality worldwide. Unstable angina falls within a spectrum under the general term acute coronary syndrome, being the leading cause of death worldwide. Objective: to detail current information related to unstable angina, definition, etiology, epidemiology, anamnesis, physical examination, evaluation, treatment and prevention. Methodology: a total of 28 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 16 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: angina, precordial pain, cardiac management, unstable angina, cardiac emergencies, treatment. Results: Coronary artery disease is estimated to cause more than one third of deaths in individuals over 35 years of age. It is the leading cause of death in this age group. The incidence is more frequent in men; however, as individuals exceed 75 years of age, the incidence between men and women becomes more balanced. The average age of presentation is 62 years. The basis of treatment focuses on improving coronary artery perfusion. Conclusions: Unstable angina is characterized by an onset during rest, its diagnosis is clinical so it is of vital importance to know its clinical, epidemiological manifestations and its evaluation to reach a correct diagnosis, in order to guarantee a timely and adequate treatment. Since this condition continues to be a public health problem that affects a high percentage of the population on a daily basis, it is important to raise awareness of the problem and to try to prevent it by modifying lifestyle. KEY WORDS: angina, precordial pain, cardiology.

CORRELATION OF EPICARDIAL FAT THICKNESS AND SEVERITY OF CORONARY ARTERY DISEASE AS ASSESSED BY SYNTAX SCORE ON CORONARY ANGIOGRAPHY

This study aimed to investigate the correlation between epicardial fat thickness and the severity of coronary artery disease (CAD) as assessed by the Syntax score on coronary angiography. A total of 50 patients with stable ischemic heart disease and uncontrolled anginal symptoms, presenting at the Cardiac Centre, Bahawal Victoria Hospital, Bahawalpur, were included in this study. These patients underwent coronary angiography, and those diagnosed with CAD were enrolled. Trans-thoracic echocardiography was performed to measure epicardial fat thickness. CAD severity was quantified using the Syntax score. Demographic data and other relevant variables were recorded in a pre-designed proforma, and data analysis was carried out using SPSS. The mean age of the study population was 51.2±9.05 years, with 54% of the participants being female. The study revealed a positive correlation between epicardial adipose tissue and the severity of CAD as assessed by the Syntax score (r = 0.426, p-value 0.002). In conclusion, this study found a positive albeit weak correlation between epicardial fat thickness and the severity of CAD as determined by the Syntax score on coronary angiography. These findings provide valuable insights into the potential role of epicardial fat as a marker for CAD severity. Further research is warranted to explore this relationship in larger and more diverse patient populations and to establish its clinical implications.

Optimizing Heart Attack Prediction Through OHE2LM: A Hybrid Modelling Strategy

Predicting heart attacks stands as a significant concern contributing to global morbidity. Within clinical data analysis, cardiovascular disease emerges as a pivotal focus for forecasting, wherein Data Science and machine learning (ML) offer invaluable tools. These methodologies aid in predicting heart attacks by considering various risk factors Just like high blood pressure, increased cholesterol levels, irregular pulse rates, and diabetes, this research aims to enhance the accuracy of predicting heart disease through machine learning techniques.This study introduces a MLdriven approach, termed ML-ELM, dedicated to forecasting heart attacks by analysing diverse risk factors. The proposed ML-ELM model is compared with alternative Utilizing machine learning techniques like Support Vector Machines, Logistic Regression, Naïve Bayes, and XGBoost is a key aspect of this exploration into different approaches for predictive modeling., is part of the research strategy. The dataset utilized for heart disease symptoms is sourced from the UCI ML Repository. The outcomes reveal that our proposed ML-ELM model has demonstrated superior predictive performance among the ML techniques tested. ML models show notable efficiency in identifying heart attack symptoms, particularly with boosting algorithms. Accuracy assessments were employed to gauge the predictive ability, Our suggested model demonstrated an outstanding accuracy rate of 96.77%.

Associations between post-acute sequelae of SARS-CoV-2, COVID-19 vaccination and HIV infection: a United States cohort study.

People with HIV (PWH) are at higher risk of complications from acute COVID-19, but their risk of subsequent post-acute sequelae of SARS-CoV2 (PASC) remains unclear. Although vaccination is protective of PASC among survivors in the general population, its effectiveness in PWH has not been explored. We used the TriNetX health research database to identify patients with and without HIV aged ≥18 years with confirmed SARS-CoV-2 between January 1, 2020 and July 20, 2023. We employed 1:1 propensity score matching to balance HIV and non-HIV cohorts based on demographics and key comorbidities. The primary outcomes accessed odds of PASC and mortality and secondary outcomes assessed odds of PASC and mortality by vaccination status. PASC was defined as new-onset conditions ≥ 28 days after COVID-19 diagnosis. We reported odd ratios (OR) of outcomes with 95% confidence intervals (CI), with statistical significance set at p < 0.05. Of 3,029,340 people with confirmed SARS-CoV-2 infection, 0.5% (n=13,214) were PWH, with 7.5% of PWH (n=989) vaccinated. After 28 days post-COVID-19, PWH had higher odds of mortality compared with their non-HIV counterparts (OR 1.22, 95% CI 1.06-1.40) and developing new-onset HTN (OR 1.18, 95% CI 1.03-1.36), heart disease (OR 1.35 95% CI 1.18-1.54), malignancy (OR 1.49, 95% CI 1.22-1.81), and mental disorders (OR 1.62, 95% CI 1.42-1.85). Furthermore, vaccinated PWH had significantly lower odds of death (OR 0.63, 95% CI 0.42-0.93) and new-onset PASC outcomes: DM (OR 0.65, 95% CI 0.43-0.99), heart disease (OR 0.58, 95% CI 0.4-0.85), mental disorders (OR 0.66, 95% CI 0.43-1.00), fatigue (OR 0.82, 95% CI 0.67-0.98), respiratory (OR 0.82, 95% CI 0.70-0.95) and gastrointestinal symptoms (OR 0.78, 95% CI 0.67-0.90). HIV-positive status increased PASC odds, while COVID-19 vaccination reduced PASC and all-cause mortality risks in PWH.

Improved subcutaneous edema segmentation on abdominal CT using a generated adipose tissue density prior

PurposeEdema, or swelling, is a common symptom of kidney, heart, and liver disease. Volumetric edema measurement is potentially clinically useful. Edema can occur in various tissues. This work focuses on segmentation and volume measurement of one common site, subcutaneous adipose tissue.MethodsThe density distributions of edema and subcutaneous adipose tissue are represented as a two-class Gaussian mixture model (GMM). In previous work, edema regions were segmented by selecting voxels with density values within the edema density distribution. This work improves upon the prior work by generating an adipose tissue mask without edema through a conditional generative adversarial network. The density distribution of the generated mask was imported into a Chan-Vese level set framework. Edema and subcutaneous adipose tissue are separated by iteratively updating their respective density distributions.ResultsValidation results on 25 patients with edema showed that the segmentation accuracy significantly improved. Compared to GMM, the average Dice Similarity Coefficient increased from 56.0 to 61.7% (p<0.05\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$p<0.05$$\\end{document}) and the relative volume difference decreased from 36.5 to 30.2% (p<0.05\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$p<0.05$$\\end{document}).ConclusionThe generated adipose tissue density prior improved edema segmentation accuracy. Accurate edema volume measurement may prove clinically useful.

Symptoms during pregnancy in primiparous women with congenital heart disease

Background: As more women with congenital heart disease (CHD) are reaching childbearing age, it becomes more common for their symptoms to be evaluated during pregnancy. However, pregnancy-related symptoms are similar to those caused by heart disease. This study investigated the prevalence of factors associated with symptoms during pregnancy in women with CHD. Methods: The national birth register was searched for primiparous women with CHD who were registered in the national quality register for patients with CHD. Results: Symptoms during the third trimester were reported in 104 of 465 evaluated women. The most common symptom was palpitations followed by dyspnea. Factors associated with symptoms were tested in a univariable model; higher NYHA classification (>1) (OR 11.3, 95%CI 5.5–23.2), low physical activity (≤3 h/week) (OR 2.1 95%CI 1.3–3.6) and educational level ≤ 12 years (OR 1.9 95%CI 1.2–3.0) were associated with having symptoms. In multivariable analysis, low physical activity level (OR 2.4 95%CI 1.2–5.0) and higher NYHA class (OR 11.3 95%CI 5.0–25.6) remained associated with symptoms during pregnancy. There were no cases with new onset of impaired systemic ventricular function during pregnancy. Conclusion: Symptoms during pregnancy are common in women with CHD but are often already present before pregnancy. Because ordinary symptoms during pregnancy often overlap with symptoms of heart disease, it is important to know if symptoms were present before pregnancy and if they became worse during pregnancy. These results should be included in pre-pregnancy counselling and considered in the monitoring during pregnancy.