Journal of the Chinese Medical Association : JCMA
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Premature coronary artery disease (CAD) is a special entity with a strong link to familial hypercholesterolemia, family history of premature CAD, or multiple coexistent atherosclerotic risk factors. Drug-eluting stenting (DES), including paclitaxel-eluting stenting (PES) and sirolimus-eluting stenting (SES), has been proven to have a lower restenotic rate. However, to date, few studies have investigated the clinical and angiographic results of DES in premature CAD patients. ⋯ Based on our single-center experience, DES had good short-term follow-up results for a premature CAD group with diverse and multiple atherosclerotic risk factors.
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Most patients with advanced liver disease have a normal or even supernormal ejection fraction judged by echocardiography. Thus, physicians previously assumed that cardiac function was normal in most patients with liver disease. However, further investigation has uncovered multiple problems in cardiac performance that place patients at risk of heart failure. ⋯ In addition there are additional defects in the electromechanical coupling of the heart that can have significant clinical consequences. These collective pathologic changes are termed "cirrhotic cardiomyopathy" and occur to some degree in all patients with liver disease. This review will explore the pathophysiology of cardiovascular changes in patients with end-stage liver disease.