Radiation-induced cardiovascular disease(RICVD) is the most common nonmalignant cause of morbidity and mortality among cancer survivors who have undergone mediastinal radiation therapy(RT).Cardiovascular complications...Radiation-induced cardiovascular disease(RICVD) is the most common nonmalignant cause of morbidity and mortality among cancer survivors who have undergone mediastinal radiation therapy(RT).Cardiovascular complications include effusive or constrictive pericarditis,cardiomyopathy,valvular heart disease,and coronary/vascular disease.These are pathophysiologically distinct disease entities whose prevalence varies depending on the timing and extent of radiation exposure to the heart and great vessels.Although refinements in RT dosimetry and shielding will inevitably limit future cases of RICVD,the increasing number of long-term cancer survivors,including those treated with older higher-dose RT regimens,will ensure a steady flow of afflicted patients for the foreseeable future.Thus,there is a pressing need for enhanced understanding of the disease mechanisms,and improved detection methods and treatment strategies.Newly characterized mechanisms responsible for the establishment of chronic fibrosis,such as oxidative stress,inflammation and epigenetic modifications,are discussed and linked to potential treatments currently under study.Novel imaging modalities may serve as powerful screening tools in RICVD,and recent research and expert opinion advocating their use is introduced.Data arguing for the aggressive use of percutaneous interventions,such as transcutaneous valve replacement and drug-eluting stents,are examined and considered in the context of prior therapeutic approaches.RICVD and its treatment options are the subject of a rich and dynamic body of research,and patients who are at risk or suffering from this disease will benefit from the care of physicians with specialty expertise in the emerging field of cardiooncology.展开更多
Introduction: Pericarditis is an inflammation of the pericardium with or without pericardial fluid effusion. Its prevalence is difficult to determine given the many forms that are not symptomatic. In Africa, its preva...Introduction: Pericarditis is an inflammation of the pericardium with or without pericardial fluid effusion. Its prevalence is difficult to determine given the many forms that are not symptomatic. In Africa, its prevalence was 6.3% in Gabon in 2020 and 7.2% in Mali in 2022. In Europe, an Italian study estimates the incidence of acute pericarditis at 27.7 cases per 100,000 people per year. In another study conducted in Finland over a period of 9 years, the incidence of pericarditis requiring hospitalisation was 3.32 cases per 100,000 people per year. The aim of our study was to describe the clinical and paraclinical characteristics of pericarditis observed in the cardiology department of the regional hospital in Mali. Methodology: This was a single centre cross-sectional study from 30 January 2018 to 30 June 2020 in the cardiology department of the Ségou regional hospital. All consenting patients, regardless of age or sex hospitalised in the department for pericarditis confirmed on cardiac ultrasound were included. Data were collected using an individual patient follow-up form recording sociodemographic, clinical, biological, electrocardiographic and echocardiographic data, as well as the course of the disease. Results: Out of 879 patients hospitalized, the hospital frequency was 7.28%. Females predominated, with a sex ratio of 0.42. More than half the patients were aged 45 or younger (59.4%). The mean age of patients was 41.8 ± 18.1 years. Cardiovascular risk factors were dominated by hypertension and smoking (46.9% and 12.5% respectively). The reasons for consultation were dyspnoea (84.3%), chest pain (54.7%), cough (71.9%) and fever (34.4%). Physical signs included muffled heart sounds (76.6%), tachycardia (70.3%), pericardial friction (17.2%) and signs of peripheral stasis in 53.1% of cases. We observed elevated C-reactive protein (CRP) in 57.8% of cases, hypercreatininaemia in 37.5% and positive HIV serology in 3.1%. The major radiographic signs were cardiomegaly in 82.8% and pleural effusion in 37.5%. On e展开更多
Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hy...Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hyperthyroidism. We report the case of a 45-year-old woman admitted for management of pleuro-pericarditis associated with atrial fibrillation in the context of cardiothyreosis. The treatment consisted of a pericardial puncture associated with synthetic anti-thyroid drugs and anti-tuberculosis drugs with positive clinical and echocardiographic outcomes.展开更多
Juvenile systemic lupus erythematosus is a rare entity, affecting children under 16 years of age. Girls are more often affected than boys and the female predominance increases significantly with age. The initial manif...Juvenile systemic lupus erythematosus is a rare entity, affecting children under 16 years of age. Girls are more often affected than boys and the female predominance increases significantly with age. The initial manifestations are highly variable with an insidious and progressive onset. Non-specific symptoms include fever, anorexia, weight loss and asthenia. Pericarditis is the most common cardiac manifestation in systemic lupus erythematosus (SLE), occurring in 10% to 40% of cases. The biological elements of the diagnosis and follow-up of pediatric SLE are identical to those of adults and are based on regular measurement of complement, native anti-DNA antibodies, and inflammatory findings. Treatment is essentially based on corticosteroid therapy.展开更多
基金Supported by The National Institutes of Health to Neal L Weintraub,Nos.HL11264,HL126949,and AR070029
文摘Radiation-induced cardiovascular disease(RICVD) is the most common nonmalignant cause of morbidity and mortality among cancer survivors who have undergone mediastinal radiation therapy(RT).Cardiovascular complications include effusive or constrictive pericarditis,cardiomyopathy,valvular heart disease,and coronary/vascular disease.These are pathophysiologically distinct disease entities whose prevalence varies depending on the timing and extent of radiation exposure to the heart and great vessels.Although refinements in RT dosimetry and shielding will inevitably limit future cases of RICVD,the increasing number of long-term cancer survivors,including those treated with older higher-dose RT regimens,will ensure a steady flow of afflicted patients for the foreseeable future.Thus,there is a pressing need for enhanced understanding of the disease mechanisms,and improved detection methods and treatment strategies.Newly characterized mechanisms responsible for the establishment of chronic fibrosis,such as oxidative stress,inflammation and epigenetic modifications,are discussed and linked to potential treatments currently under study.Novel imaging modalities may serve as powerful screening tools in RICVD,and recent research and expert opinion advocating their use is introduced.Data arguing for the aggressive use of percutaneous interventions,such as transcutaneous valve replacement and drug-eluting stents,are examined and considered in the context of prior therapeutic approaches.RICVD and its treatment options are the subject of a rich and dynamic body of research,and patients who are at risk or suffering from this disease will benefit from the care of physicians with specialty expertise in the emerging field of cardiooncology.
文摘Introduction: Pericarditis is an inflammation of the pericardium with or without pericardial fluid effusion. Its prevalence is difficult to determine given the many forms that are not symptomatic. In Africa, its prevalence was 6.3% in Gabon in 2020 and 7.2% in Mali in 2022. In Europe, an Italian study estimates the incidence of acute pericarditis at 27.7 cases per 100,000 people per year. In another study conducted in Finland over a period of 9 years, the incidence of pericarditis requiring hospitalisation was 3.32 cases per 100,000 people per year. The aim of our study was to describe the clinical and paraclinical characteristics of pericarditis observed in the cardiology department of the regional hospital in Mali. Methodology: This was a single centre cross-sectional study from 30 January 2018 to 30 June 2020 in the cardiology department of the Ségou regional hospital. All consenting patients, regardless of age or sex hospitalised in the department for pericarditis confirmed on cardiac ultrasound were included. Data were collected using an individual patient follow-up form recording sociodemographic, clinical, biological, electrocardiographic and echocardiographic data, as well as the course of the disease. Results: Out of 879 patients hospitalized, the hospital frequency was 7.28%. Females predominated, with a sex ratio of 0.42. More than half the patients were aged 45 or younger (59.4%). The mean age of patients was 41.8 ± 18.1 years. Cardiovascular risk factors were dominated by hypertension and smoking (46.9% and 12.5% respectively). The reasons for consultation were dyspnoea (84.3%), chest pain (54.7%), cough (71.9%) and fever (34.4%). Physical signs included muffled heart sounds (76.6%), tachycardia (70.3%), pericardial friction (17.2%) and signs of peripheral stasis in 53.1% of cases. We observed elevated C-reactive protein (CRP) in 57.8% of cases, hypercreatininaemia in 37.5% and positive HIV serology in 3.1%. The major radiographic signs were cardiomegaly in 82.8% and pleural effusion in 37.5%. On e
文摘Cardiovascular complications during hyperthyroidism are dominated by arrhythmias, heart failure and coronary heart disease. Pericardial effusion which is a common complication of hypothyroidism is extremely rare in hyperthyroidism. We report the case of a 45-year-old woman admitted for management of pleuro-pericarditis associated with atrial fibrillation in the context of cardiothyreosis. The treatment consisted of a pericardial puncture associated with synthetic anti-thyroid drugs and anti-tuberculosis drugs with positive clinical and echocardiographic outcomes.
文摘Juvenile systemic lupus erythematosus is a rare entity, affecting children under 16 years of age. Girls are more often affected than boys and the female predominance increases significantly with age. The initial manifestations are highly variable with an insidious and progressive onset. Non-specific symptoms include fever, anorexia, weight loss and asthenia. Pericarditis is the most common cardiac manifestation in systemic lupus erythematosus (SLE), occurring in 10% to 40% of cases. The biological elements of the diagnosis and follow-up of pediatric SLE are identical to those of adults and are based on regular measurement of complement, native anti-DNA antibodies, and inflammatory findings. Treatment is essentially based on corticosteroid therapy.
