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  • Ovid Technologies (Wolters Kluwer Health)  (487)
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  • 1
    Online Resource
    Online Resource
    Heart Failure and Patient‐Reported Outcomes in Adults With Congenital Heart Disease from 15 Countries
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of the American Heart Association Vol. 11, No. 9 ( 2022-05-03)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 9 ( 2022-05-03)
    Abstract: Heart failure (HF) is the leading cause of mortality and associated with significant morbidity in adults with congenital heart disease. We sought to assess the association between HF and patient‐report outcomes in adults with congenital heart disease. Methods and Results As part of the APPROACH‐IS (Assessment of Patterns of Patient‐Reported Outcomes in Adults with Congenital Heart disease—International Study), we collected data on HF status and patient‐reported outcomes in 3959 patients from 15 countries across 5 continents. Patient‐report outcomes were: perceived health status (12‐item Short Form Health Survey), quality of life (Linear Analogue Scale and Satisfaction with Life Scale), sense of coherence‐13, psychological distress (Hospital Anxiety and Depression Scale), and illness perception (Brief Illness Perception Questionnaire). In this sample, 137 (3.5%) had HF at the time of investigation, 298 (7.5%) had a history of HF, and 3524 (89.0%) had no current or past episode of HF. Patients with current or past HF were older and had a higher prevalence of complex congenital heart disease, arrhythmias, implantable cardioverter‐defibrillators, other clinical comorbidities, and mood disorders than those who never had HF. Patients with HF had worse physical functioning, mental functioning, quality of life, satisfaction with life, sense of coherence, depressive symptoms, and illness perception scores. Magnitudes of differences were large for physical functioning and illness perception and moderate for mental functioning, quality of life, and depressive symptoms. Conclusions HF in adults with congenital heart disease is associated with poorer patient‐reported outcomes, with large effect sizes for physical functioning and illness perception. Registration URL: https://clinicaltrials.gov ; Unique identifier: NCT02150603.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.121.024993
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2653953-6
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  • 2
    Online Resource
    Online Resource
    Changing Spectrum of Infective Endocarditis in Children : A 30 Years Experiences from a Tertiary Care Center in Taiwan
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Pediatric Infectious Disease Journal Vol. 33, No. 5 ( 2014-05), p. 467-471
    Details
    In: Pediatric Infectious Disease Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 5 ( 2014-05), p. 467-471
    Type of Medium: Online Resource
    ISSN: 0891-3668
    URL: Article
    DOI: 10.1097/INF.0000000000000145
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 2020216-7
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  • 3
    Online Resource
    Online Resource
    Exercise Capacity and Ventricular Remodeling After Transcatheter Ventricular Septal Defect Closure in Asymptomatic or Minimally Symptomatic Adolescents and Adults
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation: Cardiovascular Interventions Vol. 13, No. 6 ( 2020-06)
    Details
    In: Circulation: Cardiovascular Interventions, Ovid Technologies (Wolters Kluwer Health), Vol. 13, No. 6 ( 2020-06)
    Abstract: Transcatheter ventricular septal defect (VSD) closure is a safe and efficacious alternative to surgery. However, its benefits in asymptomatic or minimally symptomatic patients remain unknown. Methods: Sixty patients with VSD aged 12 to 60 years underwent cardiopulmonary exercise test and echocardiography 1 day before transcatheter VSD closure and 6 months after intervention (closure group). Thirty patients who did not receive the intervention underwent the same evaluations over 6 months (observation group). Results: No significant change in exercise function was observed after VSD closure, except for increased peak oxygen (O 2 ) pulse (absolute increase: 0.4±1.4 mL/beat). Left ventricular end-diastolic dimension and mitral peak early filling velocity-to-early diastolic annular velocity ratio decreased (absolute decrease: 0.3±0.6 cm and 0.7±1.9, respectively). Despite unchanged overall peak O 2 consumption, 33% of closure group patients exhibited clinically significant improvements in peak O 2 consumption ( 〉 10% increase relative to baseline). This was not related to the pulmonary flow-to-systemic flow ratio or baseline exercise capacity. By contrast, all exercise function parameters deteriorated significantly in the observation group. Subgroup analysis revealed that patients with a baseline left ventricular end-diastolic dimension Z score of 〉 2 exhibited a significantly greater improvement in peak O 2 consumption, peak O 2 pulse, and oxygen uptake efficiency slope than did the observation group. Conclusions: Compared with conservative management, transcatheter VSD closure prevents deterioration in exercise capacity and promotes left ventricular reverse remodeling in asymptomatic or minimally symptomatic patients. These benefits are most prominent in patients whose left ventricular end-diastolic dimension Z score before intervention is 〉 2, irrespective of baseline peak O 2 consumption and pulmonary flow/systemic flow ratio. Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT03127748.
    Type of Medium: Online Resource
    ISSN: 1941-7640 , 1941-7632
    URL: Article
    DOI: 10.1161/CIRCINTERVENTIONS.119.008813
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2450801-9
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  • 4
    Online Resource
    Online Resource
    Association between modifiable vascular risk factors and rapid progression of postradiation carotid artery stenosis
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Journal of the Chinese Medical Association Vol. 86, No. 7 ( 2023-07), p. 627-632
    Details
    In: Journal of the Chinese Medical Association, Ovid Technologies (Wolters Kluwer Health), Vol. 86, No. 7 ( 2023-07), p. 627-632
    Abstract: Postradiotherapy carotid vasculopathy is a clinically relevant complication in patients with head and neck cancer receiving radiotherapy. In this study, we investigated the factors associated with the development and progression of carotid artery stenosis (CAS) in such patients. Methods: Patients who received radiotherapy for head and neck cancers between October 2011 and May 2019 at a medical center in Taiwan were eligible for inclusion in this study. This study included patients who underwent two consecutive carotid duplex examinations within an interval of 1 to 3 years. The factors associated with ≥50% CAS at baseline and follow-up were analyzed. Results: In total, 694 patients (mean age, 57.8 ± 9.9 years; men, 75.2%; nasopharyngeal cancer, 73.3%) were included. The mean interval between radiotherapy and carotid duplex examination was 9.9 ± 5.9 years. At baseline, 103 patients had ≥50% CAS, which was significantly associated with tobacco smoking, hypercholesterolemia, and a prolonged interval between radiotherapy and carotid duplex examination. A total of 586 patients did not have CAS at baseline; of them, 68 developed ≥50% CAS during follow-up. Hypertension and hypercholesterolemia were identified as independent risk factors for CAS progression. Conclusion: Modifiable vascular risk factors, such as hypertension and hypercholesterolemia, appear to be significantly associated with the rapid progression of postradiotherapy CAS in patients with head and neck cancer.
    Type of Medium: Online Resource
    ISSN: 1726-4901
    URL: Article
    DOI: 10.1097/JCMA.0000000000000936
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2202774-9
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  • 5
    Online Resource
    Online Resource
    Abstract 216: Natural History of Kawasaki Disease with Medium-sized Coronary Aneurysm: Long-term Follow-up in a Tertiary Medical Center
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 131, No. suppl_2 ( 2015-04-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 131, No. suppl_2 ( 2015-04-28)
    Abstract: Objectives: Patients with coronary artery aneurysms are at risk for thrombotic and stenotic complications later in their lives. The longitudinal changes of medium-sized coronary aneurysms caused by Kawasaki disease (KD) and their long-term outcome are still unclear in Taiwan. Methods: We retrospectively reviewed medical records of KD patients with medium-sized coronary aneurysms (4-8mm). The longitudinal change of coronary diameters were re-evaluated by domestic coronary z score calculator. The coronary artery diametes were transformed to standard deviation units from the mean (Z-score) normalized for body surface area. We also look for the potential risk factors for the persistence of coronary lesions. Results: Between 1983 and 2012, 56 KD patients suffered from medium aneurysms. The male to female ratio was 41:15. The mean age of disease onset was 2.13 years old, and 39.3% (22 of 56) was diagnosed at below 1 year old. The mean follow up duration was 8.2 years. No death occurred in this group of patient, and only one patient with persistent coronary aneurysm and stenosis/calcification had clinical evidence of myocardial ischemia. However, coronary aneurysms persisted in 24 (42.8%) patients and were associated with stenosis in 8 patients (14.3%), and calcification in 4 patients (7.1%). The coronary aneurysm persistence-free survival rates at 6 months, and 1, 2, 5 years after KD onset were 81%, 69%, 52%, 43%, respectively. Chi-square analysis revealed KD patients with history of ever deterioration of coronary Z score were significantly associated with the persistence of coronary aneurysms ( P = 0.0125). However, the initial aneurysm Z score (+4.43 vs +4.49), male gender or IVIG use were not risk factors to the persistence of coronary aneurysms. Conclusion: The prognosis of Kawasaki disease patient who developed medium size coronary aneurysm was good. However, those with ever deterioration of coronary Z scores were high risk group to have persistent coronary aneurysms. Specific therapies to promote vascular health in these patients should be advocated.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.131.suppl_2.216
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1466401-X
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  • 6
    Online Resource
    Online Resource
    Abstract O.65: Long-term Outcome of Patients with Giant Coronary Aneurysms caused by Kawasaki Disease: A 30-year Experience in a Single Center in Taiwan
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 131, No. suppl_2 ( 2015-04-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 131, No. suppl_2 ( 2015-04-28)
    Abstract: Background: Patients with coronary artery aneurysms are at risk for thrombotic and stenotic complications later in their lives. The longitudinal changes of giant coronary aneurysms caused by Kawasaki disease (KD) and their long-term outcome are still unclear in Taiwan. Methods: By retrospective chart review of patients diagnosed with Kawasaki disease complicated by giant coronary aneurysms, we analyze incidence of ischemic event, survival rates, and related risk factors. Results: Between 1984 and 2012, 28 patients (24 male and 4 female) developed giant aneurysms. The mean age at onset and observe period was 3.8 years (range from 0.41 - 10.3 years) and 12 years (0 to 36.8 years), respectively. The initial median coronary Z-score was +5.75 (+0.62 to +19.06) in left main coronary artery, +4.49 (-0.18 to +11.19) in left anterior descending artery, +6.71 (+1.79 to +14.46) in right coronary artery. None of the giant aneurysms regressed during follow-up. The 5- and 35-year survival rates were 0.92 and 0.69, respectively. Except the three deaths, four additional male patients were diagnosed with acute myocardial infarction (AMI), and 2 of these diagnoses occurred within 1 year of KD onset. The incidence of AMI or death in patients with giant aneurysms was 26%, and 67% of the AMI occurred within the first year of KD onset. Clinical evidence of ischemia as documented in nuclear medicine studies was also noted in a further 9 patients (33%), and only one was female. AMI/death-free survival rates were 76% and 69% at 10 and 20 years after KD onset, respectively. Ischemia event-free survival rates were 63% and 36% at 10 and 20 years after disease onset. Men tended to have AMI and ischemia, and only one ischemia patient was female. The hazard ratio of gender on the ischemia events was 2.70 (95% CI: 0.33 - 21.73, P = 0.38). Conclusions: The long-term survival of KD patients with giant coronary aneurysms is guarded. Ischemic heart disease is the major cause of morbidity and mortality. Male KD patients, once they had giant aneurysms, tend to have ischemic events. Other risk factors need to be validated in a larger cohort.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.131.suppl_2.o65
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1466401-X
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  • 7
    Online Resource
    Online Resource
    Prognostic Value of Submaximal Exercise Data for Cardiac Morbidity in Fontan Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Medicine & Science in Sports & Exercise Vol. 46, No. 1 ( 2014-01), p. 10-15
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. 1 ( 2014-01), p. 10-15
    Type of Medium: Online Resource
    ISSN: 0195-9131
    URL: Article
    DOI: 10.1249/MSS.0b013e31829f8326
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 8
    Online Resource
    Online Resource
    Pulmonary Hypertension in Adult Congenital Heart Disease in Asia: A Distinctive Feature of Complex Congenital Heart Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of the American Heart Association Vol. 11, No. 7 ( 2022-04-05)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 7 ( 2022-04-05)
    Abstract: The epidemiology of pulmonary hypertension (PH) in patients with adult congenital heart disease in Western countries is already known. We investigate clinical characteristics of PH in adult congenital heart disease with emphasis on complex congenital heart disease (CHD) from an Asian cohort in Taiwan. Methods and Results All adult patients (aged 〉 18 years) diagnosed with CHD between January 2007 and July 2018 qualified for the study. PH was determined by cardiac catheterization data or echocardiography reports. In accord with the World Symposia on Pulmonary Hypertension, CHD was further categorized as simple, severe, or complex CHD (including pulmonary atresia‐ventricular septal defect and single‐ventricle anomalies). There were 4301 patients (55.6% women), 15.7% with severe and 3.9% with complex CHD. The cumulative incidence of PH was 4.4% (95% CI, 3.8–5.0). Our multivariable regression model indicated 4.2‐fold mortality increase (95% CI, 3.0–5.9) in the presence of PH, with age, female sex, and severe or complex CHD linked to higher incidence of PH. Only 49% of patients received PH‐specific therapy. Five‐ and 10‐year survival rates of patients with PH (n=190) were 72.3% (95% CI, 65.1%–78.4%) and 58.8% (95% CI, 50.1%–66.5%), respectively. Survival rates in those with Eisenmenger syndrome, PH after defect correction, and complex CHD were similar. Low oxygen saturation and high uric acid levels were associated with increased mortality. Conclusions In this sizable Asian adult CHD cohort, the cumulative incidence of PH was aligned with that of Western countries. Mortality proved higher in patients with PH versus without PH. Although complex CHD carried greater risk of PH compared with other adult CHD subsets, survival rate was similar.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.121.022596
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2653953-6
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  • 9
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    Online Resource
    Do Different Data Processing Methods Distort Minute Ventilation - Carbon Dioxide Production Relationship (VE/VCO2 slope)? : 2741 Board #40 June 3 2:00 PM - 3:30 PM
    Ovid Technologies (Wolters Kluwer Health) ; 2011
    In:  Medicine & Science in Sports & Exercise Vol. 43, No. 5 ( 2011-05), p. 767-
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. 5 ( 2011-05), p. 767-
    Type of Medium: Online Resource
    ISSN: 0195-9131
    URL: Article
    DOI: 10.1249/01.MSS.0000402133.33810.e7
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2011
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 10
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    Abstract 201: Risk Factors Of Persistent Coronary Artery Dilatation In Taiwanese Children With Kawasaki Disease.
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 131, No. suppl_2 ( 2015-04-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 131, No. suppl_2 ( 2015-04-28)
    Abstract: Background: Kawasaki disease (KD) is an acute, systemic vasculitis disease of childhood, which may lead to cardiovascular complications, particularly coronary artery (CA) dilatation or aneurysm formation, and could result in morbidity and mortality. The Z score of coronary artery decreased from initial value within first few 2-3 months after fever onset. We follow the echocardiographic measurements of KD patients over time, and attempt to find the associated factors of persistent dilated coronary artery. Methods: Initial presentations, clinical laboratory data, echocardiography measurements and treatment were obtained from the patients with acute Kawasaki disease over 4 years period in a single medical center hospital. The patients were divided into 3 groups according to the initial maximum Z score of any coronary artery which were normalized for body surface area. We followed the echocardiography regularly at initial acute phase, 2-4 week, 5-12week, and 〉 3 months after fever onset. The maximal Z score of any coronary artery branches 〉 +2 at any time were defined as having abnormalities. Results: We included total 169 patients with acute KD during 2008-2012. A maximal Z score for any of the coronary artery branches greater than +2 at acute phase was noted in 31.4% (53 of 169) of patients. During the following-up period, all except one patients (1 of 138) of the patients with initial maximal Z score 〈 +2.5, the coronary artery have no abnormality at the end of following up. In contrast, the patients with initial maximal Z score≧+2.5 were more likely to have persistent coronary abnormalities over time (5 of 31, P 〈 0.001). We also found hypoalbuminemia (P=0.006) and unresponsiveness to initial intravenous immunoglobulin treatment (P 〈 0.001) associated with deteriorated or persistent CA abnormality within one month of disease onset. Conclusion: Coronary artery dilatation with Z score≧+2.5 at acute phase of Kawasaki disease, hypoalbuminemia and IVIG unresponsiveness are significantly associated with persistent CA abnormality at one month after KD onset. That indicated how to avoid IVIG unresponsiveness at the initial treatment of KD is a critical issue.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.131.suppl_2.201
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1466401-X
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