Effect of metabolic syndrome on mean pulmonary arterial pressures in patients with acute pulmonary embolism treated with catheter-directed thrombolysis

Stewart, Lauren K.; Beam, Daren M.; Casciani, Thomas; Cameron, Scott J.; Kline, Jeffrey A.

doi:10.1016/j.ijcard.2019.12.043

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…Relevant research reports show that in recent years, global chronic diseases, especially cardiovascular and cerebrovascular diseases, are on the rise, and pulmonary embolism, as a common cardiovascular chronic disease, is also on the rise and is second only to hypertension and heart disease. 11 Clinical practice shows that early detection, diagnosis, and treatment can effectively improve the efficiency of clinical treatment and improve the quality of life of patients, so an efficient early diagnosis method is particularly important in the diagnosis and treatment of APE. APE patients are often accompanied by left ventricular diastolic dysfunction, which can lead to poor prognosis, 12 so early diagnosis of left ventricular diastolic function is of great significance to clinical diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinical application value of echocardiography in evaluating left ventricular diastolic function in patients with acute pulmonary embolism

et al. 2022

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Objective To explore the clinical value of echocardiography in the assessment of left ventricular diastolic function in patients with acute pulmonary embolism (APE). Methods APE patients in our hospital from June 2019 to June 2021 were selected as the observation group. They were divided into low-risk group (19 cases), medium-risk group (16 cases) and high-risk group (15 cases). The non-APE people in our hospital during the same period were selected as the control group. All subjects underwent echocardiography to observe the performance of APE patients under echocardiography. The peak velocity ratio S-wave/D-wave (S/D), early diastolic annular velocity/advanced diastolic annular velocity (Ea/Aa), early filling/early diastolic annular velocity (E/Ea), and early filling/early diastolic annular velocity (E/Ea) were compared with Ar and Vp, respectively; receiver operator characteristic (ROC) curve was used to evaluate the value of echocardiography in evaluating left ventricular diastolic function in patients with APE. Results Echocardiography show different manifestations of APE patients. Compared with the control group, S/D, Ea/Aa, and Vp in the observation group were significantly decreased and E/Ea and Ar in the observation group were significantly increased ( p < 0.05). With the increase of risk stratification, S/D, Ea/Aa, and Vp gradually decreased, E/Ea and Ar gradually increased, and the difference was statistically significant ( p < 0.05). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, area under curve (AUC), and 95% CI were 89.52%, 65.57%, 72.86%, 80.82%, 75.38%, 0.730, and 0.629–0.831, respectively. Conclusion Echocardiography can effectively evaluate left ventricular diastolic function in patients with APE, and there are significant differences in left ventricular diastolic function in different risk stratification, which has important reference value for clinical diagnosis and treatment of APE.

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Section: Discussionmentioning

confidence: 99%

Clinical application value of echocardiography in evaluating left ventricular diastolic function in patients with acute pulmonary embolism

et al. 2022

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“…[97] A separate study examining the effect of MetS on patients with acute PE receiving treatment with CDT reported an association between MetS and higher remaining mean pulmonary arterial pressures post-lysis, suggesting a potential underlying resistance to this therapy (Figure 1). [98] Further, a large retrospective analysis of patients with VTE found the components of MetS to be the most significant predictors of VTE recurrence, with recurrence risk increasing stepwise with the presence of each additional MetS criterion (Figure 2). [99] Conditions associated with a hyperfibrinolytic state In addition to iatrogenic hyperfibrinolysis occurring after the administration of thrombolytic therapy, several congenital and acquired conditions may result in chronic activation of the endogenous fibrinolytic system, leading to a hyperfibrinolytic state.…”

Section: Disorders Of Fibrinolysismentioning

confidence: 97%

Fibrinolytics for the treatment of pulmonary embolism

Stewart

Kline

2020

Translational Research

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“…11 The MetS is a common risk factor for the morbidity and mortality of cardiovascular events such as myocardial infarction, stroke, sudden cardiac death, and thrombosis. [13][14][15][16][17][18] Furthermore different studies showed that the presence of MetS leads to a 1.4-to 2.5-fold higher risk (in men even a 4.4-fold higher risk) of developing chronic renal disease. [19][20][21][22][23] The purpose of this review is to highlight the associations between the MetS as a whole and of its individual components with chronic kidney disease.…”

Section: Introductionmentioning

confidence: 99%

“…The MetS is a common risk factor for the morbidity and mortality of cardiovascular events such as myocardial infarction, stroke, sudden cardiac death, and thrombosis 13–18 . Furthermore different studies showed that the presence of MetS leads to a 1.4‐ to 2.5‐fold higher risk (in men even a 4.4‐fold higher risk) of developing chronic renal disease 19–23 …”

Section: Introductionmentioning

confidence: 99%

Association of metabolic syndrome and chronic kidney disease

Scurt,

Ganz,

Herzog

et al. 2023

Obesity Reviews

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SummaryThe prevalence of kidney disease is increasing rapidly worldwide, reflecting rising rates of obesity, diabetes, and associated metabolic syndrome (MetS). Chronic kidney disease and related comorbidities such as obesity, diabetes, and hypertension place a significant financial burden on healthcare systems. Despite the widespread use of RAAS inhibitors, intensive blood pressure and glycemic control, and newer therapeutic options consisting of sodium/glucose cotransporter‐2 (SGLT‐2) inhibitors or glucagon‐like peptide‐1 (GLP‐1) receptor agonists, a significant risk of progression to end‐stage renal disease remains in the high‐risk obese and diabetic population. The MetS is a cluster of cardiovascular risk factors that adversely affect the development and progression of chronic kidney failure. According to the criteria of the World Health Organization, it is defined by visceral adiposity, impaired glucose tolerance or insulin resistance, atherogenic dyslipidemia, raised blood pressure, and microalbuminuria with a albumin‐to‐creatinine ratio ≥30 mg/g. At molecular level MetS is marked by a proinflammatory state and increased oxidative stress leading to various pathophysiological changes causing endothelial dysfunction and a hypercoagulable state. Because the kidney is a highly vascularized organ, it is especially susceptible for those microvascular changes. Therefore, the MetS and its individual components are associated with the premature development, acceleration, and progression of chronic kidney disease. Therefore, it is becoming increasingly important to elucidate the underlying mechanisms of MetS‐associated chronic kidney disease in order to develop new strategies for preventing and slowing the progression of renal disease. In this review, we will elucidate (i) the renal structural, hemodynamic, and metabolic changes that occur in obesity and obesity‐related kidney injury; (ii) the clinicopathological characteristics of obesity‐related kidney injury, primarily focusing on obesity‐associated glomerulopathy; (iii) the potential additional factors or predisposing factors that may turn patients more susceptible to renal structural or functional compensatory failure and subsequent injury.

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Effect of metabolic syndrome on mean pulmonary arterial pressures in patients with acute pulmonary embolism treated with catheter-directed thrombolysis

Cited by 6 publications

References 27 publications

Clinical application value of echocardiography in evaluating left ventricular diastolic function in patients with acute pulmonary embolism

Clinical application value of echocardiography in evaluating left ventricular diastolic function in patients with acute pulmonary embolism

Fibrinolytics for the treatment of pulmonary embolism

Association of metabolic syndrome and chronic kidney disease

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