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	<title>volume-9-issue-4-december-2023 &#8211; JCE &#8211; Journal of Cardiovascular Emergencies</title>
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	<link>https://www.jce.ro</link>
	<description>Cardiology,  Emergency Medicine and Intensive-Care Medicine, Radiology</description>
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		<title>Applications of Artificial Intelligence in Cardiovascular Emergencies – Status Quo and Outlook</title>
		<link>https://www.jce.ro/article/applications-of-artificial-intelligence-in-cardiovascular-emergencies-status-quo-and-outlook/</link>
		
		<dc:creator><![CDATA[Cosmin-Andrei Hatfaludi, Manuela-Daniela Danu, Horia-Andrei Leonte, Andreea- Bianca Popescu, Florin Condrea, Gabriela-Dorina Aldea, Andreea-Elena Sandu, Marius Leordeanu, Constantin Suciu, Ioana-Patricia Rodean, Lucian-Mihai Itu]]></dc:creator>
		<pubDate>Tue, 05 Dec 2023 10:38:25 +0000</pubDate>
				<guid isPermaLink="false">https://www.jce.ro/?post_type=article&#038;p=2449</guid>

					<description><![CDATA[ABSTRACT Cardiovascular diseases are the leading cause of death, with many lives <a class="more-link" href="https://www.jce.ro/article/applications-of-artificial-intelligence-in-cardiovascular-emergencies-status-quo-and-outlook/">Read More ...</a>]]></description>
										<content:encoded><![CDATA[<p style="text-align: justify;"><strong>ABSTRACT</strong></p>
<p style="text-align: justify;">Cardiovascular diseases are the leading cause of death, with many lives being affected by critical emergencies like heart attacks, strokes, and other acute conditions. Recognizing the early warning signs is crucial for highlighting the need for immediate medical attention, especially since a quick intervention may significantly improve short and long-term patient outcome. Artificial intelligence (AI) has become a key technology in healthcare, and especially in the cardiovascular field. AI, and in particular deep learning is well suited for automatically analyzing medical images, signals, and data. Its success rests on the availability of large amounts of curated data, and the access to high performance computing infrastructures for training the deep-learning algorithms. Thus, in cardiovascular care, AI plays a dynamic role in disease detection, predicting disease outcome, and guiding treatment decisions. This review paper details and discusses the current role of AI for the most common cardiovascular emergencies. It provides insight into the specific issues, risk factors, different subtypes of the diseases, and algorithms developed to date, followed by an outlook.</p>
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		<title>Bioengineered Small-Diameter Vascular Xenografts as an Alternative to Autologous Vascular Grafting for Emergency Revascularization – a Preliminary Study</title>
		<link>https://www.jce.ro/article/bioengineered-small-diameter-vascular-xenografts-as-an-alternative-to-autologous-vascular-grafting-for-emergency-revascularization-a-preliminary-study/</link>
		
		<dc:creator><![CDATA[Marius Mihai Harpa, Sânziana Flămând Oltean, Alexandra Iulia Puscas, Raluca Truta, David Emanuel Anitei, Claudiu Ghiragosian, Cosmin Banceu, Ionela Movileanu, Ovidiu Simion Cotoi, Raluca Niculescu, Horatiu Suciu, Dan Simionescu, Hussam Al Hussein]]></dc:creator>
		<pubDate>Mon, 04 Dec 2023 13:57:18 +0000</pubDate>
				<guid isPermaLink="false">https://www.jce.ro/?post_type=article&#038;p=2471</guid>

					<description><![CDATA[ABSTRACT Background: Autologous vascular arterial or venous graft are not available in <a class="more-link" href="https://www.jce.ro/article/bioengineered-small-diameter-vascular-xenografts-as-an-alternative-to-autologous-vascular-grafting-for-emergency-revascularization-a-preliminary-study/">Read More ...</a>]]></description>
										<content:encoded><![CDATA[<p><strong>ABSTRACT</strong></p>
<p style="text-align: justify;"><strong>Background:</strong> Autologous vascular arterial or venous graft are not available in 10-40% of patients, due to vascular pathologies, and the utility of decellularized biological scaffolds would be a solution for those cases. The purpose of this research was to obtain a functional acellular xenograft, prior to in-vivo testing as a vascular graft in an experimental animal. <strong>Materials and method:</strong> Two batches of carotid vasculo-nervous bundles were collected from porcine models from a local slaughterhouse. The arterial grafts were dissected and isolated, obtaining carotid arteries with a caliber of 5–6 mm and a length of approximately 10–12 cm. Two decellularization protocols were used, immersion (n = 10) and perfusion (n = 9). The resulting grafts underwent histological examination, DNA analysis, electrophoresis and spectrophotometry. <strong>Results:</strong> Due to severe tissue damage and friability, the batch that was decellularized using perfusion was not examined. The histological examination of grafts stained with hematoxylin- eosin and DAPI highlighted the absence of nuclei. Spectrophotometry revealed a 90% decellularization, and electrophoresis of revealed the migration band of the material extracted from the fresh tissue, as well as the absence of migration bands in the case of the material extracted from decellularized tissues. <strong>Conclusion:</strong> We successfully used the immersion protocol to obtain a functional acellular vascular graft, in contrast to perfusion decellularization, where intraluminal high pressures damage the extracellular matrix.</p>
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		<title>Regional Differences in the Level of Inflammation Between the Right and Left Coronary Arteries – a Coronary Computed Tomography Angiography Study of Epicardial Fat Attenuation Index in Four Scenarios of Cardiovascular Emergencies</title>
		<link>https://www.jce.ro/article/regional-differences-in-the-level-of-inflammation-between-the-right-and-left-coronary-arteries-a-coronary-computed-tomography-angiography-study-of-epicardial-fat-attenuation-index-in-four-sc-2/</link>
		
		<dc:creator><![CDATA[Emanuel Blîndu, Imre Benedek, Ioana-Patricia Rodean, Vasile-Bogdan Halațiu, Nora Raț, Constantin Țolescu, Theofana Mihăilă, Aurelian Roșca, Botond-Barna Mátyás, Evelin Szabó, Renáta Gerculy, Dan Păsăroiu, Florin Buicu, Theodora Benedek]]></dc:creator>
		<pubDate>Sun, 03 Dec 2023 15:46:17 +0000</pubDate>
				<guid isPermaLink="false">https://www.jce.ro/?post_type=article&#038;p=2453</guid>

					<description><![CDATA[ABSTRACT Introduction: The pericoronary fat attenuation index (FAI) is an emerging computed <a class="more-link" href="https://www.jce.ro/article/regional-differences-in-the-level-of-inflammation-between-the-right-and-left-coronary-arteries-a-coronary-computed-tomography-angiography-study-of-epicardial-fat-attenuation-index-in-four-sc-2/">Read More ...</a>]]></description>
										<content:encoded><![CDATA[<p style="text-align: justify;"><strong>ABSTRACT</strong><br />
<strong>Introduction:</strong> The pericoronary fat attenuation index (FAI) is an emerging computed tomography- derived marker for measuring vascular inflammation at coronary vessels. It holds prognostic significance for major cardiovascular events and enhances cardiac risk assessment, complementing traditional risk factors and coronary artery calcium scores. However, the impact of local coronary circulation factors on pericoronary inflammation development in right versus left coronary arteries has not been clearly understood. <strong>Objective:</strong> This study aimed to investigate the regional differences in inflammation levels between the right and left coronary arteries in four clinical scenarios: acute coronary event in the follow-up period, post-COVID patients, recent percutaneous intervention, and unstable angina with significant lesions on native coronary arteries. <strong>Methods:</strong> The study included 153 patients (mean age 62 years, 70.5% male) who underwent clinically indicated coronary computed tomography angiography (CCTA). Vulnerable plaque features were analyzed to identify high-risk plaques. FAI and the FAI score, a score integrating risk factors and age, were calculated for each case at the left anterior descending artery (LAD), circumflex artery (LCX), and right coronary artery (RCA).<strong> Results:</strong> A total of 459 coronary arteries were analyzed. Both FAI and FAI scores were higher in the RCA (15.23 ± 11.97) compared to the LAD (10.55 ± 6.78) and (11.48 ± 6.5) LCX (p = 0.02). FAI values showed a significantly higher level at the RCA (−71.25 ± 7.47 HU) compared to the LCX (−76 ± 7.68 HU) and the LAD (−73.04 ± 8.9 HU, p &lt;0.0001). This trend persisted across all subgroups, including post-COVID CT scans (−75.49 ± 7.62 HU for RCA vs. −72.89 ± 9.40 HU for the LCX vs. −71.28 ± 7.82 HU for the LAD, p = 0.01) and patients with high-risk plaques (20.98 ± 16.29 for the RCA vs. 11.77 ± 7.68 for the LCX vs. 12.83 ± 6.47 for the LAD, p = 0.03). <strong>Conclusion:</strong> Plaques in different coronary areas show varied vulnerability and inflammation levels. The RCA, in particular, demonstrates greater inflammation susceptibility, with higher inflammation scores in areas surrounding the coronary plaques.</p>
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		<title>Multiple Implantable Cardioverter-Defibrillator Shocks in Ischemic Cardiomyopathy Compels Coronary Vascularization Reassessment</title>
		<link>https://www.jce.ro/article/multiple-implantable-cardioverter-defibrillator-shocks-in-ischemic-cardiomyopathy-compels-coronary-vascularization-reassessment/</link>
		
		<dc:creator><![CDATA[Gabriel Guşetu, Horațiu Comşa, Lorena Mocanu, Dana Pop]]></dc:creator>
		<pubDate>Sat, 02 Dec 2023 15:50:37 +0000</pubDate>
				<guid isPermaLink="false">https://www.jce.ro/?post_type=article&#038;p=2456</guid>

					<description><![CDATA[ABSTRACT The increasing number of patients with heart failure and implantable cardioverter-defibrillators <a class="more-link" href="https://www.jce.ro/article/multiple-implantable-cardioverter-defibrillator-shocks-in-ischemic-cardiomyopathy-compels-coronary-vascularization-reassessment/">Read More ...</a>]]></description>
										<content:encoded><![CDATA[<p style="text-align: justify;"><strong>ABSTRACT</strong><br />
The increasing number of patients with heart failure and implantable cardioverter-defibrillators (ICD) has led to a growing of the emergency presentations for ICD internal shocks. Appropriate shocks are sometimes caused by acute events in the course of disease and could be one of the earliest symptoms contributing to the diagnosis and timely treatment of these acute conditions. We present the case of a 64-year-old male patient with ischemic cardiomyopathy, ICD carrier, who presented to the emergency department for recurrent appropriate ICD shocks caused by episodes of polymorphic ventricular tachycardia and ventricular fibrillation. Even if he did not have chest pain, he was referred to cath lab, where the coronary angiography has shown a severe stenosis at the origin of the left anterior descending artery and a moderate stenosis at the proximal left circumflex artery. The percutaneous revascularization of both lesions resulted in the eradication of the sustained ventricular arrhythmias and the improvement of the clinical status. The case argues for the need for coronary vascularization assessment in ICD carrier patients with ischemic heart failure and adequate recurrent shocks, also emphasizing the importance of remote monitoring in early diagnosis of acute conditions in these patients.</p>
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		<title>A Severe Case of Hantavirus Cardiopulmonary Syndrome in a Patient Presenting as STEMI</title>
		<link>https://www.jce.ro/article/a-severe-case-of-hantavirus-cardiopulmonary-syndrome-in-a-patient-presenting-as-stemi/</link>
		
		<dc:creator><![CDATA[Diana Dobrica, Cristian Alexandru Udroiu, Ruxandra Drăgoi Galrinho, Tudor Borjog, Dragos Vinereanu]]></dc:creator>
		<pubDate>Fri, 01 Dec 2023 15:54:08 +0000</pubDate>
				<guid isPermaLink="false">https://www.jce.ro/?post_type=article&#038;p=2458</guid>

					<description><![CDATA[ABSTRACT Hantavirus cardiopulmonary syndrome (HCPS) is a rare disease caused by Hantaviruses, <a class="more-link" href="https://www.jce.ro/article/a-severe-case-of-hantavirus-cardiopulmonary-syndrome-in-a-patient-presenting-as-stemi/">Read More ...</a>]]></description>
										<content:encoded><![CDATA[<p style="text-align: justify;"><strong>ABSTRACT</strong><br />
Hantavirus cardiopulmonary syndrome (HCPS) is a rare disease caused by Hantaviruses, that are transmitted from rodents to humans through aerosols. In some patients, HCPS can have a severe evolution, with rapid progression to respiratory distress and cardiogenic shock. We present the case of a 56-year-old female patient who was transferred to our hospital with ST-segment elevation myocardial infarction (STEMI) and acute respiratory distress syndrome (ARDS). The coronary angiography showed normal epicardial coronary arteries and the lung computed tomography (CT) raised the suspicion of tracheoesophageal fistula, which was soon refuted by an upper digestive endoscopy. Initially, the evolution was very severe, requiring mechanical ventilation, hemodynamic support, and broad-spectrum antibiotics. Later, serological testing revealed an acute infection with Hantavirus Dobrava type. The patient lives in a rural environment, working in a wheat mill. Despite the severe presentation, the evolution was favorable, with complete remission of the pulmonary and myocardial damage after 2 weeks. We emphasize the importance of HCPS suspicion and specific testing in the early phase of the disease, as well as early admission to an intensive care unit, which is crucial in severe cases and can improve survival in a patient without any specific symptoms or a clear diagnosis.</p>
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