Publications by authors named "Shih-Hsien Sung"

In the past, patients with pulmonary hypertension (PH) were advised to avoid exercise due to concerns that it might strain cardiac function and exacerbate symptoms. However, recent evidence indicates that structured exercise programs can enhance outcomes and improve health-related quality of life for these patients. Consequently, exercise rehabilitation is now recommended in international guidelines as a key component of PH management.

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  • Transcatheter valve-in-valve (VIV) and valve-in-ring (VIR) therapies for failing mitral bioprosthetic valves are being researched to understand their effectiveness and safety over time.
  • A meta-analysis reviewed 34 studies involving 7,047 patients to assess short and long-term outcomes, focusing on complications like mortality, stroke, and procedural success rates.
  • Findings indicated high success rates of 94.8% for VIV and 80.5% for VIR, with varying short-term mortality and stroke risks across VIV, VIR, and traditional redo surgical mitral valve replacements (SMVR).
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We investigated the potential of the transmission line model as a digital twin of aneurysmal aorta by comparatively analyzing how a uniform lossless tube-load model were fitted to the carotid and femoral artery tonometry waveforms pertaining to (i) 79 abdominal aortic aneurysm (AAA) patients vs their matched controls (CON) and (ii) 35 AAA patients before vs after endovascular aneurysm repair (EVAR). The uniform lossless tube-load model fitted the tonometry waveforms pertaining to AAA as well as CON and EVAR. In addition, the parameters in the tube-load model exhibited physiologically explainable changes: when normalized, both pulse transit time and reflection coefficient increased with AAA and decreased after EVAR, which can be explained by the increase in arterial compliance and the decrease in arterial inertance due to the aortic expansion associated with AAA.

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Background: Heart failure (HF) with improved ejection fraction (HFimpEF) is a recently identified phenotype of HF, which had better cardiovascular outcomes compared with persistent HF with reduced ejection fraction (HFrEF). The present study aimed to investigate the predictive value of tissue inhibitor of metalloproteinase (TIMP)-1 and matrix metalloproteinases-9 (MMP-9) in the recovery of left ventricular ejection fraction (LVEF).

Methods: Subjects who presented with acute decompensated HF and reduced LVEF of ≤40% were eligible for this study.

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  • * It categorizes LVH severity based on left ventricular mass index (LVMI) and assesses left ventricular function using global longitudinal strain (GLS).
  • * Findings show that the severity of LVH and impaired GLS are associated with higher rates of major adverse cardiovascular events (MACE) over five years, suggesting that these factors can serve as important risk indicators for patients with Fabry disease.
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  • Heart failure (HF) is a major global health issue, with similar death and rehospitalization rates across different types, but previous Taiwanese registries largely focused on hospitalized patients with HF reduced ejection fraction (HFrEF) before 2019, limiting their applicability to other types.
  • The Taiwan Society of Cardiology Heart Failure Registry 2020 aims to enroll 3,370 patients from 27 hospitals, including both inpatients with acute decompensated HF and outpatients who were hospitalized within the last six months, and will collect detailed health data over a two-year follow-up.
  • This registry is designed to provide insights into the epidemiology, guideline adherence, clinical outcomes, and disease progression for patients with all HF
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  • Heart failure with preserved ejection fraction (HFpEF) is a complex condition affecting the heart and other organs, leading to significant health issues, especially in younger patients in Asia with high rates of diabetes and kidney disease.
  • The diagnosis involves a 2-step algorithm focusing on symptoms, ejection fraction, natriuretic peptide levels, and tests for heart abnormalities; if uncertain, additional stress testing may be required.
  • Management includes controlling comorbidities, lifestyle changes like weight loss and exercise, and pharmacological treatments such as diuretics and SGLT2 inhibitors to improve patient outcomes.
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Background: Demographics of pulmonary hypertension (PH) has changed a lot over the past forty years. Several recent registries noted an increase in mean age of PH but only a few of them investigated the characteristics of elderly patients. Thus, we aimed to analyze the characteristics of PH in such a population in this study.

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Hemodynamic parameters derived from pulse wave analysis have been shown to predict long-term outcomes in patients with heart failure (HF). Here we aimed to develop a deep-learning based algorithm that incorporates pressure waveforms for the identification and risk stratification of patients with HF. The first study, with a case-control study design to address data imbalance issue, included 431 subjects with HF exhibiting typical symptoms and 1545 control participants with no history of HF (non-HF).

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Background: While cardiovascular complications are the most common cause of mortality in Fabry disease, the relationship between globotriaosylceramide (GL-3) accumulation, the hallmark of Fabry cardiomyopathy, and cardiac hypertrophy has not been fully elucidated.

Methods: We developed unbiased stereology protocols to quantify the ultrastrcture of Fabry cardiomyopathy. Endomyocardial biopsies from 10 adult male enzyme replacement therapy naïve Fabry patients with IVS4 + 919G>A GLA mutation were studied.

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Introduction: Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) have been linked to clinical outcomes in patients with coronary artery disease (CAD). However, the prognostic value of TIMP-1 in patients with CAD who underwent coronary artery bypass grafting (CABG) has not been elucidated. We aimed to investigate the correlations of TIMP-1 with high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in the long-term prognosis of consecutive patients who underwent CABG.

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  • Women are at a higher risk for negative cardiovascular outcomes after percutaneous coronary interventions (PCIs) compared to men with coronary artery disease (CAD).
  • A study followed 6,647 CAD patients receiving PCI over about 52.7 months, analyzing outcomes like cardiac death and heart failure.
  • Results indicated that women had significantly increased risks for major cardiovascular events, particularly younger women under 60, who faced even worse outcomes than their male counterparts.
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This study explored the effects of advance care planning interventions on end-of-life treatment decisions among patients with heart failure. The study design was a randomized controlled trial. An intervention involving a motivational video, a cartoon version educational brochure, and a guided discussion was implemented.

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The prognostic value of exercise capacity has been demonstrated in subjects with established cardiovascular diseases. We aim to evaluate the independence of exercise capacity measured by treadmill exercise test (TET) in predicting long-term outcomes among various comorbidities. This study was conducted from January 2003 to December 2012 in a tertiary medical center in Taiwan.

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  • Surgery helps patients with severe primary mitral regurgitation (PMR) live longer, but it doesn't seem to help those with severe secondary mitral regurgitation (SMR) as much.
  • The study looked at over 1,100 heart failure patients from 2002 to 2012, comparing those with PMR and SMR.
  • Results showed more PMR patients had surgery and benefited from it, while SMR patients often had other health issues that affected their survival.
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The prevalence of heart failure is increasing, causing a tremendous burden on health care systems around the world. Although mortality rate of heart failure has been significantly reduced by several effective agents in the past 3 decades, yet it remains high in observational studies. More recently, several new classes of drugs emerged with significant efficacy in reducing mortality and hospitalization in chronic heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF).

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Background: Pulmonary arterial hypertension (PAH), defined as the presence of a mean pulmonary artery pressure > 20 mmHg, pulmonary artery wedge pressure ≤ 15 mmHg, and pulmonary vascular resistance (PVR) > 2 Wood units based on expert consensus, is characterized by a progressive and sustained increase in PVR, which may lead to right heart failure and death. PAH is a well-known complication of connective tissue diseases (CTDs), such as systemic sclerosis, systemic lupus erythematosus, Sjogren's syndrome, and other autoimmune conditions. In the past few years, tremendous progress in the understanding of PAH pathogenesis has been made, with various novel diagnostic and screening methods for the early detection of PAH proposed worldwide.

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Background: It is unclear whether hydroxymethylglutaryl-CoA reductase inhibitor (statin) therapy decreases the risk of mortality and cardiovascular disease (CVD) in patients undergoing peritoneal dialysis (PD).

Methods: We performed a literature search of PubMed, Cochrane Library, Embase, and other databases for research publications up to June 2022. The outcomes of interest were fatal and nonfatal CVDs, all-cause mortality, and changes in the biochemical profiles.

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Background A previously underrecognized phenotype of left ventricular apical aneurysm (LVAA) has been increasingly identified in Fabry disease. This study explored LVAA's clinical prevalence and its prognostic implications over a long-term follow-up. Methods and Results We retrospectively analyzed 268 consecutive patients with Fabry disease at a tertiary medical center.

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Abdominal aortic aneurysms (AAAs) are lethal but treatable yet substantially under-diagnosed and under-monitored. Hence, new AAA monitoring devices that are convenient in use and cost are needed. Our hypothesis is that analysis of arterial waveforms, which could be obtained with such a device, can provide information about AAA size.

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Background: Patients with hypertrophic cardiomyopathy (HCM) have heterogeneous outcomes. As risk stratification mostly focuses on left-side myocardial function, we sought to investigate the prognostic value of right ventricular (RV) function in patients with HCM.

Methods: This retrospective cohort study included patients with HCM.

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Hypertension-related death is the leading cause of mortality worldwide, making blood pressure (BP) control an important issue. Salt substitute is a non-pharmaceutical strategy to improve hypertension control. The goal of this study was to evaluate the effect of salt substitute on BP and cardiovascular disease.

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Blood pressure variability (BPV) is independently associated with higher cardiovascular risks. However, whether BPV is associated with poor outcomes for coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) remained undetermined. We aimed to investigate the relationship between BPV and the outcomes of CAD patients undergoing PCI.

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