51
|
Abdelradi A, Mosleh W, Kattel S, Al-Jebaje Z, Tajlil A, Pokharel S, Sharma UC. Galectin-3 Predicts Long-Term Risk of Cerebral Disability and Mortality in Out-of-Hospital Cardiac Arrest Survivors. J Pers Med 2024; 14:994. [PMID: 39338248 PMCID: PMC11432796 DOI: 10.3390/jpm14090994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/10/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is associated with high mortality and cerebral disability in survivors. Current models of risk prediction and survival are mainly based on resuscitation duration. We examined the prognostic value of circulating biomarkers in predicting mortality and severe cerebral disability for OHCA survivors, alongside traditional clinical risk indicators. METHODS Biomarkers including BNP, troponin I, and galectin-3 were measured at hospital admission in resuscitated OHCA patients. Prognostic significance for mortality and cerebral disability involving circulating biomarkers, resuscitation duration, demographics, and laboratory and clinical characteristics was examined via univariate and multivariate Cox proportional hazards regression models. The incremental prognostic value of the index covariates was examined through model diagnostics, focusing on the Akaike information criterion (AIC) and Harrell's concordance statistic (c-statistic). RESULTS In a combinatorial analysis of 144 OHCA survivors (median follow-up 5.7 years (IQR 2.9-6.6)), BNP, galectin-3, arterial pH, and resuscitation time were significant predictors of all-cause death and severe cerebral disability, whereas troponin I levels were not. Multivariate regression, adjusting for BNP, arterial pH, and resuscitation time, identified galectin-3 as an independent predictor of long-term mortality. Multiple linear regression models also confirmed galectin-3 as the strongest predictor of cerebral disability. The incorporation of galectin-3 into models for predicting mortality and cerebral disability enhanced fit and discrimination, demonstrating the incremental value of galectin-3 beyond traditional risk predictors. CONCLUSIONS Galectin-3 is a significant, independent long-term risk predictor of cerebral disability and mortality in OHCA survivors. Incorporating galectin-3 into current risk stratification models may enhance early prognostication and guide targeted clinical interventions.
Collapse
Affiliation(s)
- Amr Abdelradi
- Division of Cardiology, Department of Medicine, Jacob’s School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14068, USA; (A.A.)
| | - Wasim Mosleh
- Division of Cardiology, Department of Medicine, Jacob’s School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14068, USA; (A.A.)
| | - Sharma Kattel
- Division of Cardiovascular Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA
| | - Zaid Al-Jebaje
- Division of Cardiovascular Medicine, Department of Medicine, Henry Ford Health System, Detroit, MI 48202, USA
| | - Arezou Tajlil
- Division of Cardiology, Department of Medicine, Jacob’s School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14068, USA; (A.A.)
| | - Saraswati Pokharel
- Division of Thoracic Pathology and Oncology, Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
| | - Umesh C. Sharma
- Division of Cardiology, Department of Medicine, Jacob’s School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14068, USA; (A.A.)
| |
Collapse
|
52
|
Bourg C, Istratoaie S, Donal E. The right ventricular marathon: endurance and adaptation in elderly with secondary tricuspid regurgitation. Acta Cardiol 2024:1-3. [PMID: 39295541 DOI: 10.1080/00015385.2024.2396750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Accepted: 08/21/2024] [Indexed: 09/21/2024]
Affiliation(s)
- Corentin Bourg
- Department of Cardiology, University of Rennes, CHU Rennes, INSERM, LTSI - UMR 1099, Rennes, France
| | - Sabina Istratoaie
- Department of Pharmacology, Toxicology, and Clinical Pharmacology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Erwan Donal
- Department of Cardiology, University of Rennes, CHU Rennes, INSERM, LTSI - UMR 1099, Rennes, France
| |
Collapse
|
53
|
Finsterer J. Syncope in Kearns-Sayre syndrome may not only be due to AV-block, but may also have other causes due to the multiorgan nature of the disease. Acta Cardiol 2024:1-2. [PMID: 39295531 DOI: 10.1080/00015385.2024.2404774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Accepted: 09/08/2024] [Indexed: 09/21/2024]
Affiliation(s)
- Josef Finsterer
- Department of Neurology, Neurology & Neurophysiology Center, Vienna, Austria
| |
Collapse
|
54
|
Ramputi L, Mazzaccaro D, Tissir K, Trevisan MB, Conte G, Nano G, Menicanti L, Castelvecchio S. Anatomical variations of origin of the internal carotid artery: Report of two cases and systematic review of the literature. Vascular 2024:17085381241283095. [PMID: 39292968 DOI: 10.1177/17085381241283095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2024]
Abstract
BACKGROUND Anatomical variations of origin of the internal carotid artery (ICA) are very uncommon and may pose a diagnostic and therapeutic challenge. OBJECTIVE We report a case of direct origin of the right ICA from the innominate artery (aplasia of common carotid artery) and a case of duplication of right ICA in healthy patients who performed duplex ultrasound (DUS) for primary cardiovascular prevention screening. METHODS In both cases, the ultrasound scan was performed both in a transverse plane and on the longitudinal axis, and in one of the two cases, a computed tomography angiography was performed to confirm the diagnosis. A review of the current literature about anatomical variations of origin of carotid arteries was also performed. RESULTS The most frequent congenital anomaly is represented by the aplasia of the CCA, followed by the agenesis and by the duplication of the ICA. In most cases, the anomaly is discovered occasionally and symptoms are aspecific. Diagnosis is usually confirmed through a multimodality imaging approach, including DUS of extracranial carotid arteries, magnetic resonance imaging (MRI), and computed tomographic angiography. In most cases, treatment was conservative, with pharmacological therapy aimed at the symptoms. CONCLUSION The recognition of such variations is mandatory, particularly when the patient needs a surgical treatment that may involve the vessel with the anatomical variations.
Collapse
Affiliation(s)
- Lucia Ramputi
- Department of Cardiovascular Prevention and Gender Medicine, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Daniela Mazzaccaro
- Operative Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Karima Tissir
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Manuel Bruno Trevisan
- Endocrinology Unit, Clinical Nutrition and Cardiometabolic Prevention Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Giovanni Nano
- Operative Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Lorenzo Menicanti
- Department of Cardiothoracic Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Serenella Castelvecchio
- Department of Cardiovascular Prevention and Gender Medicine, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| |
Collapse
|
55
|
Dojcinovic B, Banjac N, Vukmirovic S, Dojcinovic T, Vasovic LV, Mihajlovic D, Vasovic V. The LUSBI Protocol (Lung Ultrasound/BREST Score/Inferior Vena Cava)-Its Role in a Differential Diagnostic Approach to Dyspnea of Cardiogenic and Non-Cardiogenic Origin. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1521. [PMID: 39336562 PMCID: PMC11433694 DOI: 10.3390/medicina60091521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 09/04/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: PoCUS ultrasound applications are widely used in everyday work, especially in the field of emergency medicine. The main goal of this research was to create a diagnostic and therapeutic protocol that will integrate ultrasound examination of the lungs, ultrasound measurements of the inferior vena cava (assessment of central venous pressure) and BREST scores (risk stratification for heart failure), with the aim of establishing a more effective differential diagnostic approach for dyspneic patients. Materials and Methods: A cross-sectional study was conducted in the emergency medicine department with the educational center of the community health center of Banja Luka. Eighty patients of both sexes were included and divided into experimental and control groups based on the presence or absence of dyspnea as a dominant subjective complaint. Based on the abovementioned variables, the LUSBI protocol (lung ultrasound/BREST score/inferior vena cava) was created, including profiles to determine the nature of the origin of complaints. The biochemical marker of heart failure NT pro-BNP served as a laboratory confirmation of the cardiac origin of the complaints. Results: The distribution of NT pro BNP values in the experimental group showed statistically significant differences between individual profiles of the LUSBI protocol (p < 0.001). Patients assigned to group B PLAPS 2 had significantly higher average values of NT pro-BNP (20159.00 ± 3114.02 pg/mL) compared to other LUSBI profiles. Patients from the experimental group who had a high risk of heart failure according to their BREST scores also had a significantly higher average maximum expiratory diameter compared to those without heart failure (p = 0.004). A statistically significant difference (p = 0.001) in LUSBI profiles was observed between the groups of patients divided according to CVP categories. Conclusion: The integration of the LUSBI protocol into the differential diagnosis of dyspnea has been shown to be very effective in confirming or excluding a cardiac cause of the disease in patients.
Collapse
Affiliation(s)
- Boris Dojcinovic
- Emergency Medical Service of Primary Health Care Center in Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
- Medical Faculty, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
| | - Nada Banjac
- Emergency Medical Service of Primary Health Care Center in Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
- Medical Faculty, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
| | - Sasa Vukmirovic
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Medical Faculty, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Tamara Dojcinovic
- Medical Faculty, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
- Internal Medicine Clinic, University Clinical Center of the Republic of Srpska, 78000 Banja Luka, Bosnia and Herzegovina
| | - Lucija V Vasovic
- Institute for Pulmonary Diseases of Vojvodina, 21000 Novi Sad, Serbia
- Medical Faculty, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Dalibor Mihajlovic
- Emergency Medical Service of Primary Health Care Center in Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
- Medical Faculty, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina
| | - Velibor Vasovic
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Medical Faculty, University of Novi Sad, 21000 Novi Sad, Serbia
| |
Collapse
|
56
|
Euper M, Schreieck J, Bladt M, Zdanyte M, Goldschmied A, Sigle M, Angiolillo DJ, Gorog DA, Jacobsen MR, Sørensen R, Rath D, Gawaz M, Geisler T. Dynamics of Thrombogenicity and Platelet Function and Correlation with Bleeding Risk in Patients Undergoing M-TEER Using the PASCAL System. Thromb Haemost 2024. [PMID: 39293482 DOI: 10.1055/s-0044-1790604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2024]
Abstract
BACKGROUND Transcatheter mitral valve repair is performed in a patient population at risk for thrombotic and bleeding events. The effects on platelet function and reactivity and their association with bleeding events after mitral transcatheter edge-to-edge therapy (M-TEER) have not been systematically examined. OBJECTIVES We sought to investigate the association of different parameters of platelet function and thrombogenicity with bleeding events post M-TEER. METHODS In this single-center study, 100 consecutive patients with mitral regurgitation receiving TEER were analyzed. Blood was taken directly from the guide-catheter in the left atrium before and after placing the device. Blood samples were analyzed using impedance aggregometry (Multiplate) and TEG6s. The results were compared pre- and postprocedural. The primary outcome was any bleeding complication according to the Bleeding Academic Research Consortium classification within 6 months. RESULTS A total of 41 patients experienced bleeding events. TEG analysis showed a significant decrease in ADP aggregation and increase in ADP inhibition. In ROC-analysis, TEG ADP aggregation and inhibition and Multiplate ADP aggregation showed moderate predictive values for bleeding events. The delta-ADP-Test (Multiplate) showed the strongest prediction of bleeding (area under the curve: 0.69). Adding platelet function and TEG markers to a model of clinical bleeding risk factors improved the prediction for bleeding events. CONCLUSION This study indicates that thrombogenicity might be affected immediately after M-TEER probably due to changes in flow conditions. In particular, platelet aggregation involving the ADP receptor pathway significantly correlated with postprocedural bleeding events. Whether these results could guide peri-interventional antithrombotic therapy and improve peri- and postprocedural outcome requires further investigation.
Collapse
Affiliation(s)
- Miriam Euper
- Department of Cardiology and Angiology, University Hospital Tübingen, Germany
| | - Jürgen Schreieck
- Department of Cardiology and Angiology, University Hospital Tübingen, Germany
| | - Mareike Bladt
- Department of Cardiology and Angiology, University Hospital Tübingen, Germany
| | - Monika Zdanyte
- Department of Cardiology and Angiology, University Hospital Tübingen, Germany
| | - Andreas Goldschmied
- Department of Cardiology and Angiology, University Hospital Tübingen, Germany
| | - Manuel Sigle
- Department of Cardiology and Angiology, University Hospital Tübingen, Germany
| | - Dominick J Angiolillo
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States
| | - Diana A Gorog
- Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Mia Ravn Jacobsen
- Departement of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Rikke Sørensen
- Departement of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Dominik Rath
- Department of Cardiology and Angiology, University Hospital Tübingen, Germany
| | - Meinrad Gawaz
- Department of Cardiology and Angiology, University Hospital Tübingen, Germany
| | - Tobias Geisler
- Department of Cardiology and Angiology, University Hospital Tübingen, Germany
| |
Collapse
|
57
|
Buckley BJR, Long L, Risom SS, Lane DA, Berg SK, Gluud C, Palm P, Sibilitz KL, Svendsen JH, Zwisler AD, Lip GYH, Neubeck L, Taylor RS. Exercise-based cardiac rehabilitation for adults with atrial fibrillation. Cochrane Database Syst Rev 2024; 9:CD011197. [PMID: 39287086 PMCID: PMC11406592 DOI: 10.1002/14651858.cd011197.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
BACKGROUND Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, disrupts the heart's rhythm through numerous small re-entry circuits in the atrial tissue, leading to irregular atrial contractions. The condition poses significant health risks, including increased stroke risk, heart failure, and reduced quality of life. Given the complexity of AF and its growing incidence globally, exercise-based cardiac rehabilitation (ExCR) may provide additional benefits for people with AF or those undergoing routine treatment for the condition. OBJECTIVES To assess the benefits and harms of ExCR compared with non-exercise controls for people who currently have AF or who have been treated for AF. SEARCH METHODS We searched the following electronic databases: CENTRAL in the Cochrane Library, MEDLINE Ovid, Embase Ovid, PsycINFO Ovid, Web of Science Core Collection Thomson Reuters, CINAHL EBSCO, LILACS BIREME, and two clinical trial registers on 24 March 2024. We imposed no language restrictions. SELECTION CRITERIA We included randomised clinical trials (RCTs) that investigated ExCR interventions compared with any type of non-exercise control. We included adults 18 years of age or older with any subtype of AF or those who had received treatment for AF. DATA COLLECTION AND ANALYSIS Five review authors independently screened and extracted data in duplicate. We assessed risk of bias using Cochrane's RoB 1 tool as outlined in the Cochrane Handbook for Systematic Reviews of Interventions. We assessed clinical and statistical heterogeneity by visual inspection of the forest plots and by using standard Chi² and I² statistics. We performed meta-analyses using random-effects models for continuous and dichotomised outcomes. We calculated standardised mean differences where different scales were used for the same outcome. We used the GRADE approach to assess the certainty of the evidence. MAIN RESULTS We included 20 RCTs involving a total of 2039 participants with AF. All trials were conducted between 2006 and 2024, with a follow-up period ranging from eight weeks to five years. We assessed the certainty of evidence as moderate to very low. Five trials assessed comprehensive ExCR programmes, which included educational or psychological interventions, or both; the remaining 15 trials compared exercise-only cardiac rehabilitation with controls. The overall risk of bias in the included studies was mixed. Details on random sequence generation, allocation concealment, and use of intention-to-treat analysis were typically poorly reported. Evidence from nine trials (n = 1173) suggested little to no difference in mortality between ExCR and non-exercise controls (risk ratio (RR) 1.06, 95% confidence interval (CI) 0.76 to 1.49; I² = 0%; 101 deaths; low-certainty evidence). Based on evidence from 10 trials (n = 825), ExCR may have little to no effect on SAEs (RR 1.30, 95% CI 0.63 to 2.67; I² = 0%; 28 events; low-certainty evidence). Evidence from four trials (n = 378) showed that ExCR likely reduced AF recurrence (measured via Holter monitoring) compared to controls (RR 0.70, 95% CI 0.56 to 0.88; I² = 2%; moderate-certainty evidence). ExCR may reduce AF symptom severity (mean difference (MD) -1.59, 95% CI -2.98 to -0.20; I² = 61%; n = 600; low-certainty evidence); likely reduces AF symptom burden (MD -1.61, 95% CI -2.76 to -0.45; I² = 0%; n = 317; moderate-certainty evidence); may reduce AF episode frequency (MD -1.29, 95% CI -2.50 to -0.07; I² = 75%; n = 368; low-certainty evidence); and likely reduces AF episode duration (MD -0.58, 95% CI -1.14 to -0.03; I² = 0%; n = 317; moderate-certainty evidence), measured via the AF Severity Scale (AFSS) questionnaire. Moderate-certainty evidence from six trials (n = 504) showed that ExCR likely improved the mental component summary measure in health-related quality of life (HRQoL) of the 36-item Short Form Health Survey (SF-36) (MD 2.66, 95% CI 1.22 to 4.11; I² = 2%), but the effect of ExCR on the physical component summary measure was very uncertain (MD 1.75, 95% CI -0.31 to 3.81; I² = 52%; very low-certainty evidence). ExCR also may improve individual components of HRQoL (general health, vitality, emotional role functioning, and mental health) and exercise capacity (peak oxygen uptake (VO2peak) and 6-minute walk test) following ExCR. The effects of ExCR on serious adverse events and exercise capacity were consistent across different models of ExCR delivery: centre compared to home-based, exercise dose, exercise only compared to comprehensive programmes, and aerobic training alone compared to aerobic plus resistance programmes. Using univariate meta-regression, there was evidence of significant association between location of trial and length of longest follow-up on exercise capacity. AUTHORS' CONCLUSIONS Due to few randomised participants and typically short-term follow-up, the impact of ExCR on all-cause mortality or serious adverse events for people with AF is uncertain. ExCR likely improves AF-specific measures including reduced AF recurrence, symptom burden, and episode duration, as well as the mental components of HRQoL. ExCR may improve AF symptom severity, episode frequency, and VO2peak. Future high-quality RCTs are needed to assess the benefits of ExCR for people with AF on patient-relevant outcomes including AF symptom severity and burden, AF recurrence, AF-specific quality of life, and clinical events such as mortality, readmissions, and serious adverse events. High-quality trials are needed to investigate how AF subtype and clinical setting (i.e. primary and secondary care) may influence ExCR effectiveness.
Collapse
Affiliation(s)
- Benjamin JR Buckley
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, UK
- Cardiovascular Health Sciences, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpoool, UK
| | - Linda Long
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, , University of Glasgow, Glasgow, UK
| | - Signe S Risom
- Department of Cardiology, Herlev and Gentofte , University Hospital, Copenhagen, Denmark
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, UK
| | - Selina K Berg
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
- University of Southern Denmark, Odense, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Christian Gluud
- Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Pernille Palm
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Kirstine L Sibilitz
- Department of Cardiology and Internal Medicine, Amager and Hvidovre University Hospital, Copenhagen, Denmark
| | - Jesper H Svendsen
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Ann-Dorthe Zwisler
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Gregory YH Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Science, University of Liverpool, Liverpool, UK
| | - Lis Neubeck
- Centre for Cardiovascular Health, Edinburgh Napier University, Edinburgh, UK
| | - Rod S Taylor
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
| |
Collapse
|
58
|
Başyiğit F, Uçar O, Yücel EC, Turan N, Yaman B, Özdemir Ö, Balcı MM, Tolunay H. A new electrocardiographic parameter terminal D1S + D3R predicts right ventricular dilatation in acute pulmonary embolism. Acta Cardiol 2024:1-9. [PMID: 39286922 DOI: 10.1080/00015385.2024.2396760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 08/03/2024] [Accepted: 08/21/2024] [Indexed: 09/19/2024]
Abstract
OBJECTIVE Right ventricular (RV) overload findings affect the risk classification and treatment approach in acute pulmonary embolism (APE). Recently, it was reported that a new electrocardiography (ECG) parameter, terminal D1S + D3R (T-D1S + D3R) pattern, supported the diagnosis of APE. We aim to search the relationship between T-D1S + D3R pattern and right ventricular dilatation (RVD) in APE. METHODS This single-centre, retrospective study was designed with patients aged > 18 years. We screened 267 patients who underwent transthoracic echocardiography (TTE) because of confirmed APE in our emergency department. This study included 72 patients with RVD and 139 patients without RVD [male 41.7%, median age 73,0 (20.8) years; 49.6% male, median age 64,0 (24.0) years]. We compared T-D1S + D3R between RVD (+) and RVD (-) groups. RESULTS We determined that RVD (+) group had more patients with the T-D1S + D3R parameter than RVD (-) group [51 (70.8%) vs. 25 (18.0%), p < 0.001]. In the univariate logistic regression analyses S1Q3T3, (in)complete right bundle branch block (RBBB), T-D1S + D3R, D3-V1 T wave inversion (TWI), V1-3/4 TWI, V1-3/4 ST-segment elevation, and frontal QRS-T [f(QRS-T)] angle predicted RVD, while T-D1S + D3R, V1-3/4 ST-segment elevation, and f(QRS-T) angle remained independent predictors of RVD in patients with APE. CONCLUSIONS T-D1S + D3R, a new ECG parameter, was an independent predictor of RVD in patients with APE.
Collapse
Affiliation(s)
- Funda Başyiğit
- Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Oğuz Uçar
- Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Emine Cansu Yücel
- Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Nazlı Turan
- Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Belma Yaman
- Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Özcan Özdemir
- Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey
| | | | - Hatice Tolunay
- Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey
| |
Collapse
|
59
|
De Greef F, Selvais N, Aminian A. Effects of interatrial septal shunt repair on disabling migraine 'Time passes, the question remains'. Acta Cardiol 2024:1-2. [PMID: 39287011 DOI: 10.1080/00015385.2024.2404769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Accepted: 09/08/2024] [Indexed: 09/19/2024]
Affiliation(s)
- Francois De Greef
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Nicolas Selvais
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Adel Aminian
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| |
Collapse
|
60
|
Simek IM, Sturdza A, Knoth J, Spannbauer A, Bergler-Klein J, Vögele-Kadletz M, Widder J, Schmid MP. Cardiac metastasis in uterine cervical cancer : A systematic review and case study. Strahlenther Onkol 2024:10.1007/s00066-024-02274-y. [PMID: 39287630 DOI: 10.1007/s00066-024-02274-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/16/2024] [Indexed: 09/19/2024]
Abstract
PURPOSE Cardiac metastasis from cervical cancer is rare and only scarcely documented. We aim to present a new case and systematically summarize the available literature. MATERIALS AND METHODS PubMed, Scopus, Web of Science, Central, and ClinicalTrials.gov were systematically searched following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria. Results were screened via title, abstract, and full text. Additionally, the reference lists of all papers chosen for the review were screened. RESULTS Eighty-one papers were identified, describing 86 cases in total. Cardiac metastasis occurred at all stages of cervical cancer and in all age groups. Median time from initial diagnosis to diagnosis of cardiac metastasis was 12 months. Patients mainly complained of dyspnea and chest pain, 60.8% had pathologic ECG (electrocardiographic) findings. The cardiac mass was most frequently detected by transthoracic echography. The most common tumor histology was squamous cell carcinoma. Chemotherapy and surgical interventions were the main treatment modalities. Median survival after diagnosis of cardiac metastasis was 3 months. CONCLUSION This largest review on cardiac metastases from cervical cancer confirmed the heart as a very infrequent site of metastasis. There are < 100 cases described in the literature, with very poor prognosis and undefined clinical management.
Collapse
Affiliation(s)
- I-M Simek
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - A Sturdza
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - J Knoth
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - A Spannbauer
- Department of Cardiology, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria
| | - J Bergler-Klein
- Department of Cardiology, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria
| | - M Vögele-Kadletz
- Department of Cardiac Surgery, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria
| | - J Widder
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - M P Schmid
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| |
Collapse
|
61
|
Wu H, Yin Y, Lei F, Ma X, Lu W, Shen Y, Zhang L, Liu X, Hu W, Ye X, Yang C. Influence of metabolic syndrome on plaque features and clinical outcomes in patients with acute coronary syndrome. Clin Res Cardiol 2024:10.1007/s00392-024-02540-0. [PMID: 39297939 DOI: 10.1007/s00392-024-02540-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 08/30/2024] [Indexed: 09/21/2024]
Abstract
BACKGROUND AND AIMS Currently, the influence of metabolic syndrome (Mets) on the plaque characteristics and prognosis of patients with acute coronary syndrome (ACS) is poorly understood. Thus, the study aimed to characterize the pancoronay plaques of ACS patients with Mets using optical coherence tomography (OCT) and to evaluate the cohort's prognosis. METHODS Between February 2015 and September 2020, 745 ACS patients who underwent OCT imaging of the three coronary arteries were included, divided into Mets (n = 252) and non-Mets (n = 493) groups. The major adverse cardiovascular event (MACE) was a composite of cardiac death, non-fatal myocardial infarction (MI), and revascularization. RESULTS Compared to the non-Mets group, the Mets group exhibited a higher proportion of females and cases of multivessel disease. In the Mets group, culprit lesions were found to have a greater degree of stenosis, thinner fibrous cap thickness and more thin-cap fibroatheroma (TCFA). Additionally, nonculprit lesions were more likely to exhibit plaque rupture, high-risk plaque characteristics, TCFA, macrophage infiltration, cholesterol crystals, and layered plaque. After a median follow-up of 2 years, 8.3% of patients experienced MACE, a rate that was higher in the Mets group, primarily attributed to non-fatal myocardial infarction and cardiac death. Multivariate analysis showed that Mets (aHR 1.73, p = 0.037), high-risk plaque (aHR 2.63, p < 0.001), age (aHR 1.03, p = 0.020), and left ventricular ejection fraction (aHR 0.96, p = 0.002) were independent predictors of MACE. CONCLUSIONS The presence of Mets increased the vulnerability of the entire coronary tree and worsened the prognosis for patients with ACS.
Collapse
Affiliation(s)
- Hanzhi Wu
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
- Department of Cardiology, Changzhou Traditional Chinese Medicine Hospital, 25 Heping North Road, Tianning District, Changzhou, 213000, China
| | - Yanwei Yin
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
- Department of Cardiology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
| | - Fangmeng Lei
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
- Department of Cardiology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
| | - Xiaoxue Ma
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
- Department of Cardiology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
| | - Wenlin Lu
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
- Department of Cardiology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
| | - Yanqing Shen
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
- Department of Cardiology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
| | - Lizhu Zhang
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
- Department of Cardiology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
| | - Xiaoxiao Liu
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
- Department of Cardiology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
| | - Wenjing Hu
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
- Department of Cardiology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China
| | - Xinhe Ye
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China.
- Department of Cardiology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China.
| | - Chengjian Yang
- Department of Cardiology, Wuxi No. 2 People's Hospital, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China.
- Department of Cardiology, Jiangnan University Medical Center, 68 Zhongshan Road, Liangxi District, Wuxi, 214000, China.
| |
Collapse
|
62
|
Xu Z, Tang J, Xin Chen, Jin Y, Zhang H, Liang R. Associations of C-reactive protein-albumin-lymphocyte (CALLY) index with cardiorenal syndrome: Insights from a population-based study. Heliyon 2024; 10:e37197. [PMID: 39296012 PMCID: PMC11408039 DOI: 10.1016/j.heliyon.2024.e37197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/24/2024] [Accepted: 08/29/2024] [Indexed: 09/21/2024] Open
Abstract
Background Cardiorenal syndrome (CRS) is a complex condition characterized by the interplay of immune imbalance and inflammation. The C-reactive protein-Albumin-lymphocyte (CALLY) CALLY index serves as a new immune-nutritional scoring system, but its predictive value for CRS remains to be established. Methods In this study, we analyzed data from 27,978 participants in National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. The CALLY index was calculated as the ratio of albumin to lymphocyte, divided by C-reactive protein (CRP) multiplied by 104. CRS was defined by the coexistence of cardiovascular disease and chronic kidney disease (eGFR <60 mL/min/1.73 m2). Multivariate weighted logistic regression models were employed to determine the odds ratio and 95 % confidence interval for the association between the CALLY index and CRS. Receiver operating characteristic (ROC) curves and restricted cubic spline (RCS) curves were used to assess the predictive efficacy and nonlinear relationship, respectively. Results The prevalence of CRS in the study population was 1.22 %. Our findings revealed a significant inverse relationship between the CALLY index and CRS risk, with lower CALLY index values being associated with a higher likelihood of CRS (OR = 0.95, 95 % CI = 0.94-0.96, P < 0.001). Participants in higher quartiles of the CALLY index showed a progressively reduced risk of CRS (P for trend <0.001). Moreover, the CALLY index demonstrated superior predictive performance compared to other inflammatory indicators, such as systemic immune-inflammation index (SII), neutrophil/high-density lipoprotein ratio (NHR), lymphocyte/high-density lipoprotein ratio (LHR), monocyte/high-density lipoprotein ratio (MHR), and platelet/high-density lipoprotein ratio (PHR) (AUC = 0.672, 95 % CI = 0.643-0.701). Conclusions This study underscores the significant negative correlation between the CALLY index and the risk of cardiorenal syndrome. The CALLY index emerges as a robust and independent predictor of CRS, outperforming traditional inflammatory markers. This finding highlights the potential utility of the CALLY index as a clinical tool for identifying individuals at risk for CRS.
Collapse
Affiliation(s)
- Zhehao Xu
- Department of General Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
| | - Jiao Tang
- Department of Cardiovascular Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, China
| | - Xin Chen
- Department of Cardiovascular Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, China
| | - Yian Jin
- Department of General Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
| | - Huanji Zhang
- Department of Cardiovascular Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, China
| | - Ruiyun Liang
- Department of Respiratory Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China
| |
Collapse
|
63
|
Yang X, He S, Pang Y, Rong K. Clinical value of artificial intelligence 3D echocardiography in evaluating left atrial volume and pulmonary vein structure in patients with atrial fibrillation. Clinics (Sao Paulo) 2024; 79:100487. [PMID: 39284276 PMCID: PMC11419795 DOI: 10.1016/j.clinsp.2024.100487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/30/2024] [Accepted: 08/11/2024] [Indexed: 09/27/2024] Open
Abstract
OBJECTIVE To explore the clinical value of 3D Echocardiography (3DE) in evaluating the changes of left atrial volume and pulmonary vein structure in patients with Atrial Fibrillation (AF). METHODS Clinical data were collected from 54 AF patients. Left Atrial Anteroposterior Diameter (LADap), Left Atrial left and right Diameter (LADml), and Left Atrial upper and lower Diameter (LADsi) were measured; the maximum Left Atrial Volume (LAVmax), minimum Left Atrial Volume (LAVmin), left atrial presystolic volume (LAVpre), and Cross-Sectional Area (CSA) of each pulmonary vein were analyzed. Passive Ejection Fraction (LAPEF) was calculated. The differences in left atrial volume and pulmonary vein structure between patients with AF and healthy people were compared, and the correlation between the indexes was analyzed. The diagnostic value of the above indicators for AF patients was analyzed. RESULTS LADap, LADml, LADsi, LAVmax, LAVmin, LAVpre, LAPEF, LSPV CSA, LIPV CSA, RSPV CSA, and RIPV CSA of AF patients were significantly higher. There was a significant positive correlation between left atrial diameter and pulmonary vein structure. There was a significant positive correlation between left atrial volume and pulmonary vein structure. There was a negative correlation between LAPEF and pulmonary vein structure. LADap, LADml, LADsi, LAVmax, LAVmin, LAVpre, LAPEF, LSPV CSA, LIPV CSA, RSPV CSA, and RIPV CSA had a diagnostic value for AF patients. CONCLUSION 3DE is applicable for evaluating left atrial volume and pulmonary vein structure in patients with AF.
Collapse
Affiliation(s)
- Xiaomin Yang
- Department of Cardiovascular Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai City, China
| | - Shujun He
- Department of Ultrasound, Ezhou Central Hospital, Ezhou City, Hubei Province, China
| | - Yang Pang
- Department of Cardiovascular Medicine, Shanghai Changzheng Hospital (The Second Affiliated Hospital of Naval Medical University), Shanghai City, China
| | - Kun Rong
- Department of Ultrasound Diagnosis, Qingdao Special Servicemen Recuperation Center of PLA Navy, Qingdao City, Shandong Province, China.
| |
Collapse
|
64
|
Reed GW, Harmon EK, Harb S, Yun J, Krishnaswamy A, Abraham WT, Kapadia S. Design and Rationale of the V-Wave Shunt MitraClip Study. Am J Cardiol 2024; 227:29-36. [PMID: 38950689 DOI: 10.1016/j.amjcard.2024.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/03/2024] [Accepted: 06/10/2024] [Indexed: 07/03/2024]
Abstract
Heart failure (HF) and moderate-to-severe mitral regurgitation (MR) with residual elevations in left atrial pressure (LAP) after MitraClip may remain symptomatic and experience subsequent HF readmissions. The V-Wave interatrial shunt system is a permanent interatrial septal implant that shunts blood from the left-to-right atrium and serves to continuously unload the left atrium. Although the V-Wave shunt has previously been studied in patients with HF, the safety and feasibility of its deployment at the time of the MitraClip procedure is unknown. The V-Wave Shunt MitraClip Study (NCT04729933) is an early feasibility study that aims to demonstrate the safety and efficacy of implantation of the V-Wave shunt device at the time of MitraClip procedure. Patients with moderate-to-severe secondary MR with left ventricular ejection fraction 20% to 50% and New York Heart Association functional class III/IV symptoms despite optimal medical therapy, residual mean LAP ≥20 mm Hg after MitraClip, and mean LAP-right atrial pressure difference ≥5 mm Hg are included. The primary safety end point is a composite outcome of all-cause death, stroke, myocardial infarction device embolization, cardiac tamponade, or device-related re-intervention or surgery at 30 days. Patients will be followed up to 5 years. Enrollment is ongoing, with 30-day results expected by the end of 2024. The V-Wave Shunt Mitraclip Study aims to demonstrate the safety and efficacy of the implantation of the V-Wave interatrial shunt device at the time of index MitraClip placement which may serve as an adjunctive method by which continuous left atrial unloading may be achieved.
Collapse
Affiliation(s)
- Grant W Reed
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
| | - Evan K Harmon
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Serge Harb
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - James Yun
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Amar Krishnaswamy
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - William T Abraham
- Division of Cardiovascular Medicine, Ohio State University, Columbus, Ohio
| | - Samir Kapadia
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
65
|
Chen YD, Wen ZG, Long JJ, Wang Y. Association Between Systemic Inflammation Response Index and Slow Coronary Flow Phenomenon in Patients with Ischemia and No Obstructive Coronary Arteries. Int J Gen Med 2024; 17:4045-4053. [PMID: 39290232 PMCID: PMC11407316 DOI: 10.2147/ijgm.s481538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 09/07/2024] [Indexed: 09/19/2024] Open
Abstract
Background Inflammation plays a key role in the pathogenesis of slow coronary flow phenomenon (SCFP). SCFP is a condition that can complicate the management of ischemia and no obstructive coronary arteries (INOCA), making it essential to identify reliable predictors. Although the systemic inflammation response index (SIRI) has been proven to relate to various cardiovascular diseases. However, the predictive value of SIRI for SCFP in patients with INOCA remains unclear. Methods A total of 1422 patients with INOCA were consecutively included in this study. 89 individuals were diagnosed with SCFP (the SCFP group). A 1:2 age- and -sex-matched patients with INOCA and normal blood flow were selected as the control group (n=178). Plasma neutrophil, monocyte, and lymphocyte counts were collected so as to determine the value of SIRI. Results Patients with SCFP had an elevated level of body mass index (BMI) and an increased incidence of smoking and diabetes. The SIRI was significantly higher in the SCFP group than in the controls (2.3±1.3 vs 1.8±1.3, p=0.002). The SIRI increased as the number of coronary arteries involved in the SCFP increased. Univariate analyses showed that BMI, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and SIRI were associated with SCFP. Multivariate logistic regression analysis revealed that BMI and SIRI were independent predictors of SCFP occurrence. The ROC curve showed that when the SIRI was > 1.140, the sensitivity and specificity were 87.6% and 60.1%, respectively, and the area under the ROC curve (AUC) was 0.644 (95% CI: 0.578-0.710, P < 0.001). Conclusion The findings demonstrated that an increased SIRI may have a potential role in distinguishing SCFP in patients with INOCA. SIRI could improve the predictive value of SCFP compared to neutrophils, monocytes, and lymphocytes alone.
Collapse
Affiliation(s)
- Yang-Da Chen
- Department of Emergency Medicine, Shenzhen Luohu Hospital Group Luohu People's Hospital (The Third Affiliated Hospital of Shenzhen University), Shenzhen, People's Republic of China
| | - Zhi-Gao Wen
- Department of Emergency Medicine, Shenzhen Luohu Hospital Group Luohu People's Hospital (The Third Affiliated Hospital of Shenzhen University), Shenzhen, People's Republic of China
| | - Jun-Jie Long
- Department of Emergency Medicine, Shenzhen Luohu Hospital Group Luohu People's Hospital (The Third Affiliated Hospital of Shenzhen University), Shenzhen, People's Republic of China
| | - Yong Wang
- Department of Cardiology, Shenzhen Luohu Hospital Group Luohu People's Hospital (The Third Affiliated Hospital of Shenzhen University), Shenzhen, People's Republic of China
| |
Collapse
|
66
|
Andersen ML, Moyses-Oliveira M, Tufik S. Unlocking the role of Galectin-3: Implications for sleep disorders and health. Sleep Med 2024; 124:110-114. [PMID: 39288581 DOI: 10.1016/j.sleep.2024.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 09/06/2024] [Accepted: 09/12/2024] [Indexed: 09/19/2024]
Abstract
Galectin-3 is a member of the lectin family, and is an intriguing protein that is found in diverse tissues across the body. It is known for its multifaceted involvement in various physiological functions, including tissue repair, immune function and neuroinflammation in the central nervous system. It also serves as a paracrine signal, promoting the growth of certain cells and contributing to fibrosis, while higher levels of Galectin-3 in the bloodstream correlate with an increased risk of mortality and cardiovascular disease-related outcomes in the general population. Recent scientific studies have identified a potential link between Galectin-3 and sleep disorders. However, the precise mechanisms through which galectin-3 influences sleep disorders remain an active area of investigation. Although initial studies suggest a potential association between Galectin-3 and sleep disruptions, including conditions, such as insomnia, insufficient sleep time, and obstructive sleep apnea, further research is required to establish a more definitive relationship. This review explores recent findings regarding the potential connection between Galectin-3 and sleep patterns, and offers insights into the complex interplay between this protein and sleep. These discoveries present promising prospects for the development of innovative therapeutic approaches aimed at sleep disorder management, using Galectin-3 as a potential target for interventions or as a biomarker for sleep health.
Collapse
Affiliation(s)
- Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Instituto do Sono, São Paulo, Brazil.
| | - Mariana Moyses-Oliveira
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Instituto do Sono, São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Instituto do Sono, São Paulo, Brazil
| |
Collapse
|
67
|
Xu L, Que D, Yu W, Yan J, Zhang X, Wang Y, Yang Y, Liang M, Zhang R, Song X, Yang P. His bundle pacing combined with atrioventricular node ablation for atrial fibrillation: a systematic review and meta-analysis. Expert Rev Med Devices 2024:1-9. [PMID: 39268942 DOI: 10.1080/17434440.2024.2402561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 09/01/2024] [Indexed: 09/15/2024]
Abstract
INTRODUCTION AND OBJECTIVE His bundle pacing (HBP) could replace failed biventricular pacing (BVP) in guidelines (IIa Indication), but the high capture thresholds and backup lead pacing requirements limit its development. We assessed the efficacy and safety of HBP combined with atrioventricular node ablation (AVNA) for atrial fibrillation (AF) and compared with BVP and left bundle branch pacing (LBBP). METHODS We reviewed PubMed, Embase, Web of Science, and Cochrane Library databases on left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) score, QRS duration (QRSd), and pacing threshold. RESULTS Thirteen studies included 1115 patients (639 with HBP, 338 with BVP, and 221 with LBBP). Compared with baseline, HBP improved LVEF (mean difference [MD]: 9.24 [6.10, 12.37]; p < 0.01), reduced NYHA score (MD: -1.12 [-1.34, -0.91]; p < 0.01), increased QRSd (MD: 10.08 [4.45, 15.70]; p < 0.01), and rose pacing threshold (MD: 0.16 [0.05, 0.26]; p < 0.01). HBP had comparable efficacy to BVP and LBBP and lower QRSd (p < 0.05). HBP had a lower success rate (85.97%) and more complications (16.1%). CONCLUSION HBP combined with AVNA is effective for AF, despite having a lower success rate and more complications. Further trials are required to determine whether HBP is superior to BVP and LBBP.
Collapse
Affiliation(s)
- Liang Xu
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| | - Dongdong Que
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| | - Wenjie Yu
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| | - Jing Yan
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| | - Xiuli Zhang
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| | - Yuxi Wang
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| | - Yashu Yang
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| | - Miaoyuan Liang
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| | - Ronghua Zhang
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| | - Xudong Song
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| | - Pingzhen Yang
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Guangzhou, Guangdong, China
- Heart Center of Zhujiang Hospital, Sino-Japanese Cooperation Platform for Translation Research in Heart Failure, Guangzhou, Guangdong, China
| |
Collapse
|
68
|
Wang TY, Yang Q, Cheng XY, Ding JC, Hu PF. Beyond weight loss: the potential of glucagon-like peptide-1 receptor agonists for treating heart failure with preserved ejection fraction. Heart Fail Rev 2024:10.1007/s10741-024-10438-2. [PMID: 39269643 DOI: 10.1007/s10741-024-10438-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2024] [Indexed: 09/15/2024]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with various phenotypes, and obesity is one of the most common and clinically relevant phenotypes of HFpEF. Obesity contributes to HFpEF through multiple mechanisms, including sodium retention, neurohormonal dysregulation, altered energy substrate metabolism, expansion of visceral adipose tissue, and low-grade systemic inflammation. Glucagon-like peptide-1 (GLP-1) is a hormone in the incretin family. It is produced by specialized cells called neuroendocrine L cells located in the distal ileum and colon. GLP-1 reduces blood glucose levels by promoting glucose-dependent insulin secretion from pancreatic β cells, suppressing glucagon release from pancreatic α cells, and blocking hepatic gluconeogenesis. Recent evidence suggests that GLP-1 receptor agonists (GLP-1 RAs) can significantly improve physical activity limitations and exercise capacity in obese patients with HFpEF. The possible cardioprotective mechanisms of GLP-1 RAs include reducing epicardial fat tissue thickness, preventing activation of the renin-angiotensin-aldosterone system, improving myocardial energy metabolism, reducing systemic inflammation and cardiac oxidative stress, and delaying the progression of atherosclerosis. This review examines the impact of obesity on the underlying mechanisms of HFpEF, summarizes the trial data on cardiovascular outcomes of GLP-1 RAs in patients with type 2 diabetes mellitus, and highlights the potential cardioprotective mechanisms of GLP-1 RAs to give a pathophysiological and clinical rationale for using GLP-1 RAs in obese HFpEF patients.
Collapse
Affiliation(s)
- Tian-Yu Wang
- Department of The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qiang Yang
- Department of Cardiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xin-Yi Cheng
- Department of The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jun-Can Ding
- Department of The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Peng-Fei Hu
- Department of Cardiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
| |
Collapse
|
69
|
Naziri Z, Rahimlou M, Rezaei M, Tabrizi R, Nasr M, Motazedian M, Kardeh S. High dietary antioxidant intake linked to lower risk of myocardial infarction: a nested case-control study. BMC Cardiovasc Disord 2024; 24:485. [PMID: 39261811 PMCID: PMC11391677 DOI: 10.1186/s12872-024-04158-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 09/02/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND In developing nations, myocardial infarction (MI) remains a significant contributor to deaths from sudden cardiac arrest, with diet playing a key role in its incidence through oxidative stress mechanisms. Although the connection between the Dietary Antioxidant Index (DAI) and cardiovascular diseases has been demonstrated in some studies, the relationship between DAI and MI has not been extensively explored. Therefore, this research aims to investigate this association. METHODS We conducted a nested case-control study involving 156 MI cases and 312 healthy controls, utilizing data from the Fasa Adults Cohort Study (FACS), a population-based study of individuals aged 35-70 residing in Fasa, Iran, with 11,097 participants included at baseline. The DAI was determined by normalizing the intake values of six dietary vitamins and minerals, adjusting by subtracting the global mean, and then dividing by the global standard deviation. MI diagnosis was established by an experienced cardiologist using electronic medical records. Conditional logistic regression was employed to examine the association between DAI and MI. RESULTS There were no significant differences between the case and control groups in terms of age (P = 0.96), gender distribution (P = 0.98), and education level (P = 0.38). In a multiple conditional logistic regression analysis, after adjusting for key variables-including body mass index (BMI), smoking status, education level, and serum levels of triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), fasting blood sugar (FBS), saturated fatty acids (SFA), and polyunsaturated fatty acids (PUFA)-an inverse association was found between DAI and the risk of myocardial infarction (MI) [adjusted Odds Ratio (Adj OR) = 0.88, 95% Confidence Interval (CI): 0.85-0.92; P < 0.001]. CONCLUSIONS This study highlights the crucial role of the DAI in reducing the risk of myocardial infarction. Promoting diets rich in antioxidants presents a straightforward and effective strategy for MI prevention and the promotion of cardiovascular health, underscoring the novelty and significance of this research in dietary approaches to disease prevention.
Collapse
Affiliation(s)
- Zahra Naziri
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
- USERN Office, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mehdi Rezaei
- Department of Cardiology, Fars Society of Internal Medicine, Fars-Iranian Heart Association, Shiraz, Iran
| | - Reza Tabrizi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
| | | | - Mohammadreza Motazedian
- Clinical Research Development Unit, Valiasr Hospital, Fasa University of Medical Sciences, Fasa, Iran
| | - Sina Kardeh
- Department of Medicine, University of British Columbia, Vancouver, BC, V6T1Z3, Canada
| |
Collapse
|
70
|
Naum AG, Jari I, Moisii L, Ursu AM, Moisii P. Imaging and Biomarkers: The Assesment of Pulmonary Embolism Risk and Early Mortality. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1489. [PMID: 39336530 PMCID: PMC11433879 DOI: 10.3390/medicina60091489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 08/13/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: Pulmonary embolism (PE) incidence has been increasing in the last 10 years. Computed thoracic pulmonary angiography (CTPA) had a major role in PE diagnosis and prognosis. The main purpose of this study was as follows: the prognostic value of a CTPA parameter, pulmonary artery obstruction index (PAOI), in PE risk assessment and the predictive accuracy of biomarkers, D-dimer and cardiac Troponin T (c-TnT), in 7-day mortality. A second objective of the research was to investigate the relationship between imaging by PAOI and these biomarkers in different etiologies of PE. Materials and Methods: This study comprised 109 patients with PE, hospitalized and treated between February 2021 and August 2022. They had different etiologies of PE: deep vein thrombosis (DVT); persistent atrial fibrillation (AF); chronic obstructive pulmonary disease (COPD) exacerbation; COVID-19; and cancers. The investigations were as follows: clinical examination; D-dimer testing, as a mandatory method for PE suspicion (values ≥500 µg/L were highly suggestive for PE); c-TnT, as a marker of myocardial injury (values ≥14 ng/L were abnormal); CTPA, with right ventricle dysfunction (RVD) signs and PAOI. Treatments were according to PE risk: systemic thrombolysis in high-risk PE; low weight molecular heparins (LWMH) in high-risk PE, after systemic thrombolysis or from the beginning, when systemic thrombolysis was contraindicated; and direct oral anticoagulants (DOAC) in low- and intermediate-risk PE. Results: PAOI had a high predictive accuracy for high-risk PE (area under curve, AUC = 0.993). D-dimer and cTnT had a statistically significant relationship with 7-day mortality for the entire sample, p < 0.001, and for AF, p = 0.0036; COVID-19, p = 0.003; and cancer patients, p = 0.005. PAOI had statistical significance for 7-day mortality only in COVID-19, p = 0.045, and cancer patients, p = 0.038. The relationship PAOI-D-dimer and PAOI-c-TnT had very strong statistical correlation for the entire sample and for DVT, AF, COPD, and COVID-19 subgroups (Rho = 0.815-0.982). Conclusions: PAOI was an important tool for PE risk assessment. D-dimer and c-TnT were valuable predictors for 7-day mortality in PE. PAOI (imaging parameter for PE extent) and D-dimer (biomarker for PE severity) as well as PAOI and c-TnT (biomarker for myocardial injury) were strongly correlated for the entire PE sample and for DVT, AF, COPD, and COVID-19 patients.
Collapse
Affiliation(s)
- Alexandru Gratian Naum
- 2nd Morphofunctional Sciences Department, Biophysics and Medical Physics, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania;
- “Neolife” Medical Center, 52 Carol I Avenue, 700503 Iasi, Romania
| | - Irina Jari
- 2nd Surgical Department, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania;
- St. Spiridon Emergency Hospital, Radiology and Medical Imaging Clinique, 1st Independentei Avenue, 700111 Iasi, Romania;
| | - Liliana Moisii
- 2nd Surgical Department, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania;
- St. Spiridon Emergency Hospital, Radiology and Medical Imaging Clinique, 1st Independentei Avenue, 700111 Iasi, Romania;
| | - Andra Mara Ursu
- St. Spiridon Emergency Hospital, Radiology and Medical Imaging Clinique, 1st Independentei Avenue, 700111 Iasi, Romania;
| | - Paloma Moisii
- 1st Medical Department “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Promedicanon “Cardiology Office”, 15 Prisacii Valley, 707410 Valea Lupului, Romania
| |
Collapse
|
71
|
Morris SA, Flyer JN, Yetman AT, Quezada E, Cappella ES, Dietz HC, Milewicz DM, Ouzounian M, Rigelsky CM, Tierney S, Lacro RV. Cardiovascular Management of Aortopathy in Children: A Scientific Statement From the American Heart Association. Circulation 2024; 150:e228-e254. [PMID: 39129620 DOI: 10.1161/cir.0000000000001265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Aortopathy encompasses a spectrum of conditions predisposing to dilation, aneurysm, dissection, or rupture of the aorta and other blood vessels. Aortopathy is diagnosed commonly in children, from infancy through adolescence, primarily affecting the thoracic aorta, with variable involvement of the peripheral vasculature. Pathogeneses include connective tissue disorders, smooth muscle contraction disorders, and congenital heart disease, including bicuspid aortic valve, among others. The American Heart Association has published guidelines for diagnosis and management of thoracic aortic disease. However, these guidelines are predominantly focused on adults and cannot be applied adeptly to growing children with emerging features, growth and developmental changes, including puberty, and different risk profiles compared with adults. Management to reduce risk of progressive aortic dilation and dissection or rupture in children is complex and involves genetic testing, cardiovascular imaging, medical therapy, lifestyle modifications, and surgical guidance that differ in many ways from adult management. Pediatric practice varies widely, likely because aortopathy is pathogenically heterogeneous, including genetic and nongenetic conditions, and there is limited published evidence to guide care in children. To optimize care and reduce variation in management, experts in pediatric aortopathy convened to generate this scientific statement regarding the cardiovascular care of children with aortopathy. Available evidence and expert consensus were combined to create this scientific statement. The most common causes of pediatric aortopathy are reviewed. This document provides a general framework for cardiovascular management of aortopathy in children, while allowing for modification based on the personal and familial characteristics of each child and family.
Collapse
|
72
|
Cueto-Robledo G, Roldan-Valadez E, Garcia-Lezama M, Garcia-Cesar M, Navarro-Vergara DI, Torres-Rojas MB. Updated review on pulmonary arterial hypertension: Differences between down syndrome and non-down syndrome populations. Curr Probl Cardiol 2024; 49:102840. [PMID: 39260114 DOI: 10.1016/j.cpcardiol.2024.102840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2024] [Accepted: 09/03/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) is a major concern in patients with Down syndrome (DS) and congenital heart disease (CHD). Understanding the unique characteristics of PAH in these populations is essential for developing tailored management strategies. This review examines differences in PAH between DS and non-DS (nDS) patients with CHD, focusing on pathophysiology, clinical presentation, hemodynamic profiles, and treatment outcomes. METHODS A retrospective analysis of 93 adults with PAH was conducted, including 18 with DS and 75 with CHD but without DS (nDS). Data on demographics, clinical presentations, comorbidities, and hemodynamic parameters were collected using echocardiography and right heart catheterization. Statistical analyses included Mann-Whitney U tests, Student's t-tests, and Kaplan-Meier survival analysis to compare the DS and nDS groups. RESULTS DS patients presented with PAH at a younger age (mean age 25.06 years) compared to nDS patients (mean age 42.4 years; p < 0.001). Hypothyroidism was more prevalent in DS patients (61.1 %) than in nDS patients (29.3 %; p = 0.012). Hemodynamic assessments showed lower mean arterial pressure (MAP) in DS patients (76.24 ± 11.6 mmHg) versus nDS patients (93.95 ± 15 mmHg; p < 0.001), and a higher TAPSE/PASP ratio (0.41 vs. 0.23; p = 0.009), suggesting less severe right ventricular dysfunction. DS patients had a significant survival advantage over nDS patients (p = 0.043). CONCLUSIONS DS patients have distinct clinical and hemodynamic profiles in PAH, requiring personalized management. Early detection and tailored treatment are crucial for improving outcomes. Further research should refine these strategies and explore new therapies.
Collapse
Affiliation(s)
- Guillermo Cueto-Robledo
- Hospital General de México, Cardiorespiratory Emergencies, 06720, Mexico City, Mexico; Hospital General de México, Pulmonary Circulation Clinic, 06720, Mexico City, Mexico; National Autonomous University of Mexico, Faculty of Medicine, 04510, Mexico City, Mexico.
| | - Ernesto Roldan-Valadez
- Instituto Nacional de Rehabilitación, Division of Research, 14389, Mexico City, Mexico; I.M. Sechenov First Moscow State Medical University (Sechenov University), Radiology Department, 119992, Moscow, Russia.
| | - Melissa Garcia-Lezama
- Department of Surgery, Centro Médico Nacional La Raza, P.° de las Jacarandas S/N, La Raza, Azcapotzalco, 02990, Mexico City, Mexico.
| | - Marisol Garcia-Cesar
- Hospital General de México, Cardiorespiratory Emergencies, 06720, Mexico City, Mexico.
| | | | | |
Collapse
|
73
|
Adachi T, Adachi S, Nakano Y, Nishiyama I, Hirose M, Murohara T. Controlling Nutritional Status Score Predicts 1-Year Outcomes in Chronic Thromboembolic Pulmonary Hypertension. Circ Rep 2024; 6:381-388. [PMID: 39262638 PMCID: PMC11383544 DOI: 10.1253/circrep.cr-24-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/27/2024] [Accepted: 07/13/2024] [Indexed: 09/13/2024] Open
Abstract
Background The prognosis for patients with chronic thromboembolic pulmonary hypertension (CTEPH) using their nutritional status has not been established. We investigated the relationship between the prognosis of patients with CTEPH and the Controlling Nutritional Status (CONUT) score, which is a nutritional assessment tool. Methods and Results A total of 157 patients with CTEPH was enrolled in the study. The primary outcome was defined as the composite outcome of all-cause mortality and non-elective hospitalization due to heart failure. Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff CONUT score for predicting the 1-year rate of the primary outcome. Patients were divided into 2 groups according to the significant cutoff value and compared. Undernutrition was observed in 51.6% of patients. ROC analysis revealed a significant cutoff CONUT score of 3.5 (area under the curve=0.789). The incidence rate of the primary composite outcome was higher in the high CONUT group (score ≥4) than in the low CONUT group (score ≤3; 20% vs. 2.2%; P<0.001). Cox analysis revealed the CONUT score per point increase was an independent risk factor for the primary composite outcomes (hazard ratio 2.301; 95% confidence interval 1.081-4.895; P=0.031). Conclusions The CONUT score can predict the 1-year rate of all-cause death and non-elective hospitalization in patients with CTEPH.
Collapse
Affiliation(s)
- Takeshi Adachi
- Department of Cardiology, Nagoya University Hospital Nagoya Japan
| | - Shiro Adachi
- Department of Cardiology, Nagoya University Hospital Nagoya Japan
| | - Yoshihisa Nakano
- Center for Advanced Medicine and Clinical Research, Department of Advanced Medicine, Nagoya University Hospital Nagoya Japan
| | - Itsumure Nishiyama
- Department of Cardiology, Nagoya University Graduate School of Medicine Nagoya Japan
| | - Miku Hirose
- Department of Cardiology, Nagoya University Graduate School of Medicine Nagoya Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Hospital Nagoya Japan
| |
Collapse
|
74
|
Muiño-Mosquera L, Cervi E, De Groote K, Dewals W, Fejzic Z, Kazamia K, Mathur S, Milleron O, Mir TS, Nielsen DG, Odermarsky M, Sabate-Rotes A, van der Hulst A, Valenzuela I, Jondeau G. Management of aortic disease in children with FBN1-related Marfan syndrome. Eur Heart J 2024:ehae526. [PMID: 39250726 DOI: 10.1093/eurheartj/ehae526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/14/2024] [Accepted: 07/31/2024] [Indexed: 09/11/2024] Open
Abstract
Marfan syndrome (MFS) is a hereditary connective tissue disorder with an estimated prevalence of 1:5000-1:10 000 individuals. It is a pleiotropic disease characterized by specific ocular, cardiovascular, and skeletal features. The most common cardiovascular complication is aortic root dilatation which untreated can lead to life-threatening aortic root dissection, mainly occurring in adult patients. Prompt diagnosis, appropriate follow-up, and timely treatment can prevent aortic events. Currently there are no specific recommendations for treatment of children with MFS, and management is greatly based on adult guidelines. Furthermore, due to the scarcity of studies including children, there is a lack of uniform treatment across different centres. This consensus document aims at bridging these gaps of knowledge. This work is a joint collaboration between the paediatric subgroup of the European Network of Vascular Diseases (VASCERN, Heritable Thoracic Aortic Disease Working Group) and the Association for European Paediatric and Congenital Cardiology (AEPC). A group of experts from 12 different centres and 8 different countries participated in this effort. This document reviews four main subjects, namely, (i) imaging of the aorta at diagnosis and follow-up, (ii) recommendations on medical treatment, (iii) recommendations on surgical treatment, and (iv) recommendations on sport participation.
Collapse
Affiliation(s)
- Laura Muiño-Mosquera
- Department of Paediatrics, division of Paediatric Cardiology, Ghent University Hospital, C. Heymanslaan 10, Ghent 9000, Belgium
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Elena Cervi
- Inherited Cardiovascular Diseases Centre, Cardiology, Great Ormond Street Hospital, London, United Kingdom
| | - Katya De Groote
- Department of Paediatrics, division of Paediatric Cardiology, Ghent University Hospital, C. Heymanslaan 10, Ghent 9000, Belgium
| | - Wendy Dewals
- Department of Paediatrics, division of Paediatric Cardiology, Antwerp University Hospital, Antwerp, Belgium
| | - Zina Fejzic
- Department of Paediatrics, division of Paediatric Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Kalliopi Kazamia
- Department of Paediatric Cardiology, Stockholm-Uppsala, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Sujeev Mathur
- Department of Cardiovascular Imaging, Guy's and St Thomas Hospital, London, United Kingdom
| | - Olivier Milleron
- Centre de réference pour le syndrome de Marfan et apparentés, Department of Cardiology, Bichat Claude Bernard Hospital, Université Paris Cité, INSERM U1148, Paris, France
| | - Thomas S Mir
- Childrens Heart Centre, Paediatric Cardiology, University Clinics Hamburg, Hamburg, Germany
| | - Dorte G Nielsen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Anna Sabate-Rotes
- Department of Paediatric Cardiology, Hospital Vall D'Hebron, Barcelona, Spain
| | - Annelies van der Hulst
- Department of Paediatrics, Division of Paediatric Cardiology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Irene Valenzuela
- Department of Clinical and Molecular Genetics, Hospital Vall d'Hebron, Barcelona, Spain
| | - Guillaume Jondeau
- Centre de réference pour le syndrome de Marfan et apparentés, Department of Cardiology, Bichat Claude Bernard Hospital, Université Paris Cité, INSERM U1148, Paris, France
| |
Collapse
|
75
|
Bizzi E, Cavaleri F, Mascolo R, Conte E, Maggiolini S, Decarlini CC, Maestroni S, Collini V, Sicignano LL, Verrecchia E, Manna R, Pancrazi M, Trotta L, Lopalco G, Malandrino D, Pallini G, Catenazzi S, Carrozzo L, Emmi G, Lazaros G, Brucato A, Imazio M. Recurrent pericarditis in older adults: Clinical and laboratory features and outcome. J Am Geriatr Soc 2024. [PMID: 39247990 DOI: 10.1111/jgs.19150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Current guidelines for the diagnosis and treatment of pericarditis refer to the general adult population. Few and fragmentary data regarding recurrent pericarditis in older adults exist. OBJECTIVE OF THE STUDY Given the absence of specific data in scientific literature, we hypothesized that there might be clinical, laboratory and outcome differences between young adults and older adults affected by idiopathic recurrent pericarditis. MATERIALS AND METHODS We performed an international multicentric retrospective cohort study analyzing data from patients affected by recurrent pericarditis (idiopathic or post-cardiac injury) and referring to tertiary referral centers. Clinical, laboratory, and outcome data were compared between patients younger than 65 years (controls) and patients aged 65 or older. RESULTS One hundred and thirty-three older adults and 142 young adult controls were enrolled. Comorbidities, including chronic kidney diseases, atrial fibrillation, and diabetes, were more present in older adults. The presenting symptom was dyspnea in 54.1% of the older adults versus 10.6% in controls (p < 0.001); pain in 32.3% of the older adults versus 80.3% of the controls (p < 0.001). Fever higher than 38°C was present in 33.8% versus 53.5% (p = 0.001). Pleural effusion was more prevalent in the older adults (55.6% vs 34.5%, p < 0.001), as well as severe pericardial effusion (>20 mm) (24.1% vs 12.7%, p = 0.016) and pericardiocentesis (16.5% vs 8.5%, p = 0.042). Blood leukocyte counts were significantly lower in the older adults (mean + SE: 10,227 + 289/mm3 vs 11,208 + 285/mm3, p = 0.016). Concerning therapies, NSAIDS were used in 63.9% of the older adults versus 80.3% in the younger (p = 0.003), colchicine in 76.7% versus 87.3% (p = 0.023), corticosteroids in 49.6% versus 26.8% (p < 0.001), and anakinra in 14.3% versus 23.9% (p = 0.044). CONCLUSIONS Older adults affected by recurrent pericarditis show a different clinical pattern, with more frequent dyspnea, pleural effusion, severe pericardial effusion, and lower fever and lower leukocyte count, making the diagnosis sometimes challenging. They received significantly less NSAIDs and colchicine, likely due to comorbidities; they were also treated less commonly with anti-IL1 agents, and more frequently with corticosteroids.
Collapse
Affiliation(s)
- Emanuele Bizzi
- Internal Medicine Department, Fatebenefratelli and Sacco Hospitals, Milan, Italy
| | - Francesco Cavaleri
- Internal Medicine Department, Fatebenefratelli and Sacco Hospitals, Milan, Italy
| | - Ruggiero Mascolo
- Internal Medicine Department, Fatebenefratelli and Sacco Hospitals, Milan, Italy
| | - Edoardo Conte
- Clinical Cardiology and Cardiovascular Imaging Unit, Galeazzi-Sant'Ambrogio Hospital IRCCS, Milan, Italy
| | - Stefano Maggiolini
- Cardiology Division, Cardiovascular Department, San L. Mandic Hospital, Merate (Lc), Italy
| | | | - Silvia Maestroni
- Internal Medicine Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Valentino Collini
- Department of Medicine (DMED), University of Udine, Udine, Italy
- Cardiothoracic Department, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Ludovico Luca Sicignano
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elena Verrecchia
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Raffaele Manna
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimo Pancrazi
- Internal Medicine Department, Fatebenefratelli and Sacco Hospitals, Milan, Italy
| | - Lucia Trotta
- Internal Medicine Department, Fatebenefratelli and Sacco Hospitals, Milan, Italy
| | - Giuseppe Lopalco
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari, Bari, Italy
| | - Danilo Malandrino
- Department of Medical, Surgery and Health Sciences, University of Trieste, and Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy
| | - Giada Pallini
- Internal Medicine Department, Fatebenefratelli and Sacco Hospitals, Milan, Italy
| | - Sara Catenazzi
- Internal Medicine Department, Fatebenefratelli and Sacco Hospitals, Milan, Italy
| | - Luisa Carrozzo
- Internal Medicine Department, Fatebenefratelli and Sacco Hospitals, Milan, Italy
| | - Giacomo Emmi
- Department of Medical, Surgery and Health Sciences, University of Trieste, and Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy
| | - George Lazaros
- First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonio Brucato
- Internal Medicine Department, Fatebenefratelli and Sacco Hospitals, Milan, Italy
- Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Luigi Sacco Hospital, Milan, Italy
| | - Massimo Imazio
- Department of Medicine (DMED), University of Udine, Udine, Italy
- Cardiothoracic Department, University Hospital Santa Maria della Misericordia, Udine, Italy
| |
Collapse
|
76
|
Stenman C, Wallinder A, Holmberg E, Karason K, Magnusson J, Dellgren G. Malignancies After Heart Transplantation. Transpl Int 2024; 37:12109. [PMID: 39314924 PMCID: PMC11417470 DOI: 10.3389/ti.2024.12109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 08/01/2024] [Indexed: 09/25/2024]
Abstract
Heart transplant patients have an increased risk of developing cancer. Patients who underwent HTx between 1985 and 2017 were included. Detection of cancer was obtained by cross-checking the study population with the Swedish Cancer-Registry and the Cause-of-Death-Registry. A total of 664 patients were followed for a median of 7.7 years. In all, 231 malignancies were diagnosed in 138 patients. Compared to the general population the excess risk of cancer following HTx was 6.2-fold calculated as the standardized incidence ratio (SIR) and 2.9-fold after exclusion of non-melanoma skin cancer (NMSC). The most common malignancies were NMSC, non-Hodgins lymphoma, and lung cancer. There was no significant difference in overall survival between those with and without a history of cancer before HTx (p = 0.53). During a median follow-up of 7.7 years, 19% of HTx recipients developed cancer, 6.2-fold higher relative to the general population, and 2.9-fold higher when excluding NMSC. Risk factors for malignancies (excluding NMSC) included previous smoking, hypertension and prolonged ischemic time; and for NMSC, increasing age, seronegative CMV-donors, and azathioprine. A previous cancer in selected recipients results in similar survival compared to those without cancer prior to HTx.
Collapse
Affiliation(s)
- Caroline Stenman
- Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Andreas Wallinder
- Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Erik Holmberg
- Regional Cancer Center West, Region Västra Götaland, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristjan Karason
- Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jesper Magnusson
- Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Internal Medicine/Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Göran Dellgren
- Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
77
|
Luo Y, Yuan D. Case Report: A giant right atrial appendage aneurysm in a child. Front Cardiovasc Med 2024; 11:1384972. [PMID: 39314762 PMCID: PMC11416930 DOI: 10.3389/fcvm.2024.1384972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 08/21/2024] [Indexed: 09/25/2024] Open
Abstract
Right atrial appendage aneurysm is an extremely rare cardiac anomaly. With unclear etiology, there is still no standard treatment method. Clinical symptoms and complications are important indicators for surgical resection. A 2-year-old boy without obvious cardiac symptoms was diagnosed with a giant right atrial outpouching arising from the right atrial appendage by computed tomography. The right atrial outpouching measured approximately 95 × 43 mm. Due to its large size and potential impact on function of right atrium and ventricle, the aneurysm was resected in surgery. During the surgery a 105 × 55 mm noncontractile cystic structure was found locating on the right anterior side of the right atrium. No other abnormalities like intracavity thrombus were detected. The patient was discharged five days after surgery. Postoperative recovery was uneventful.
Collapse
Affiliation(s)
- Yulan Luo
- Department of Pediatric Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dou Yuan
- Department of Cardiovascular Surgery, Cheng Du Shang Jin Nan Fu Hospital, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
78
|
Quien M, Bae JY, Jang SJ, Davila C. Short term outcomes and resource utilization in de-novo versus acute on chronic heart failure related cardiogenic shock: a nationwide analysis. Front Cardiovasc Med 2024; 11:1454884. [PMID: 39314766 PMCID: PMC11416976 DOI: 10.3389/fcvm.2024.1454884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 08/26/2024] [Indexed: 09/25/2024] Open
Abstract
Background There has been growing recognition of non-ischemic etiologies of cardiogenic shock (CS). To further understand this population, we aimed to investigate differences in clinical course between acute on chronic heart failure related (CHF-CS) and de-novo CS (DN-CS). Methods Using the Nationwide Readmission Database, we examined 92,426 CS cases. Outcomes of interest included in-hospital and 30-day outcomes and use of advanced heart failure therapies. Results Patients with DN-CS had higher in-hospital mortality than the CHF-CS cohort (32.6% vs. 30.4%, p < 0.001). Mechanical circulatory support (11.9% vs. 8.6%, p < 0.001) was more utilized in DN-CS. Renal replacement therapy (13.8% vs. 15.5%, p < 0.001) and right heart catheterization (16.0% vs. 21.0%, p < 0.001) were implemented more in the CHF-CS cohort. The CHF-CS cohort was also more likely to undergo LVAD implantation (0.4% vs. 3.6%, p < 0.001) and heart transplantation (0.5% vs. 2.0%, p < 0.001). Over the study period, advanced heart failure therapy utilization increased, but the proportion of patients receiving these interventions remained unchanged. Thirty days after index hospitalization, the CHF-CS cohort had more readmissions for heart failure (1.1% vs. 2.4%, p < 0.001) and all causes (14.1% vs. 21.1%, p < 0.001) with higher readmission mortality (1.1% vs. 2.3%, p < 0.001). Conclusion Our findings align with existing research, demonstrating higher in-hospital mortality in the DN-CS subgroup. After the index hospitalization, however, the CHF-CS cohort performed worse with higher all-cause readmission rate and readmission mortality. The study also underscores the need for further investigation into the underutilization of certain interventions and the observed trends in the management of these CS subgroups.
Collapse
Affiliation(s)
- Mary Quien
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale New Haven Health Bridgeport Hospital, Bridgeport, CT, United States
| | - Ju Young Bae
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale New Haven Health Bridgeport Hospital, Bridgeport, CT, United States
| | - Sun-Joo Jang
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale New Haven Hospital, New Haven, CT, United States
| | - Carlos Davila
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale New Haven Hospital, New Haven, CT, United States
| |
Collapse
|
79
|
Shi Q, Xu J, Zeng L, Lu Z, Chen Y. A nomogram for predicting short-term mortality in ICU patients with coexisting chronic obstructive pulmonary disease and congestive heart failure. Respir Med 2024; 234:107803. [PMID: 39251097 DOI: 10.1016/j.rmed.2024.107803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 08/29/2024] [Accepted: 09/07/2024] [Indexed: 09/11/2024]
Abstract
OBJECTIVE This study aimed to develop and validate a nomogram for predicting 28-day and 90-day mortality in intensive care unit (ICU) patients who have chronic obstructive pulmonary disease (COPD) coexisting with congestive heart failure (CHF). METHODS An extensive analysis was conducted on clinical data from the Medical Information Mart for Intensive Care IV database, covering patients over 18 years old with both COPD and CHF, who were were first-time ICU admissions between 2008 and 2019. The least absolute shrinkage and selection operator (LASSO) regression method was employed to screen clinical features, with the final model being optimized using backward stepwise regression guided by the Akaike Information Criterion (AIC) to construct the nomogram. The predictive model's discrimination and clinical applicability were evaluated via receiver operating characteristic (ROC) curves, calibration curves, the C-index, and decision curve analysi s (DCA). RESULTS This analysis was comprised of a total of 1948 patients. Patients were separated into developing and validation cohorts in a 7:3 ratio, with similar baseline characteristics between the two groups. The ICU mortality rates for the developing and verification cohorts were 20.8 % and 19.5 % at 28 days, respectively, and 29.4 % and 28.3 % at 90 days, respectively. The clinical characteristics retained by the backward stepwise regression include age, weight, systolic blood pressure (SBP), respiratory rate (RR), oxygen saturation (SpO2), red blood cell distribution width (RDW), lactate, partial thrombosis time (PTT), race, marital status, type 2 diabetes mellitus (T2DM), malignant cancer, acute kidney failure (AKF), pneumonia, immunosuppressive drugs, antiplatelet agents, vasoactive agents, acute physiology score III (APS III), Oxford acute severity of illness score (OASIS), and Charlson comorbidity index (CCI). We developed two separate models by assigning weighted scores to each independent risk factor: nomogram A excludes CCI but includes age, T2DM, and malignant cancer, while nomogram B includes only CCI, without age, T2DM, and malignant cancer. Based on the results of the AUC and C-index, this study selected nomogram A, which demonstrated better predictive performance, for subsequent validation. The calibration curve, C-index, and DCA results indicate that nomogram A has good accuracy in predicting short-term mortality and demonstrates better discriminative ability than commonly used clinical scoring systems, making it more suitable for clinical application. CONCLUSION The nomogram developed in this study offers an effective assessment of short-term mortality risk for ICU patients with COPD and CHF, proving to be a superior tool for predicting their short-term prognosis.
Collapse
Affiliation(s)
- Qiangqiang Shi
- Department of Respiratory Medicine, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, China.
| | - Jiali Xu
- Department of Respiratory Medicine, Changxing People's Hospital, Huzhou, China.
| | - Longhuan Zeng
- Department of High Dependency Unit (Respiratory Support), Hangzhou Geriatric Hospital, Hangzhou, China.
| | - Ziyi Lu
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, China.
| | - Yang Chen
- Department of High Dependency Unit (Respiratory Support), Hangzhou Geriatric Hospital, Hangzhou, China.
| |
Collapse
|
80
|
Ashour AM, Masa'deh R, Hamaideh SH, Elshatarat RA, Yacoub MI, Almagharbeh WT, Alhejaili AA, Alshahrani BD, Sobeh DE, Eltayeb MM. Examining the influence of anxiety and depression on medication adherence among patients diagnosed with acute myocardial infarction. BMC Psychol 2024; 12:473. [PMID: 39243104 PMCID: PMC11378470 DOI: 10.1186/s40359-024-01959-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 08/20/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Effective medication adherence is vital for managing acute myocardial infarction (AMI) and enhancing patient well-being. This study aimed to evaluate medication adherence levels and associated factors among AMI patients using standardized assessment tools. METHODS Employing a cross-sectional descriptive design, the study involved 210 patients diagnosed with acute myocardial infarction. Participants completed the General Medication Adherence Scale (GMAS), Hospital Anxiety and Depression Scale (HADS), and provided socio-demographic details. RESULTS The study revealed partial adherence to medications among AMI patients, with mean scores of 24.89 (± 3.64) out of 33. Notably, good adherence was observed in non-adherence due to patient behavior (mean ± SD = 11.8 ± 2.3 out of 15) and additional disease burden (mean ± SD = 8.65 ± 2.21 out of 12), while partial adherence was noted in non-adherence due to financial constraints (mean ± SD = 4.44 ± 1.34 out of 6). Patients reported mild anxiety (mean ± SD = 8.38 ± 2.81) and no depressive symptoms (mean ± SD = 7.43 ± 2.42). Multiple linear regression analysis indicated that employed status, younger age, shorter duration of MI, lower anxiety, and depression levels were associated with higher medication adherence. However, factors such as monthly income, gender, educational level, and marital status did not predict medication adherence. CONCLUSION The study highlights the significance of addressing anxiety and depression levels and considering socio-demographic factors when designing interventions to enhance medication adherence among AMI patients. Further research is needed to explore additional determinants of medication adherence and develop tailored interventions to improve patient outcomes post-AMI.
Collapse
Affiliation(s)
- Audai M Ashour
- Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | - Rami Masa'deh
- Faculty of Nursing, Applied Science Private University, Amman, Jordan.
| | - Shaher H Hamaideh
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Rami A Elshatarat
- Department of Medical and Surgical Nursing, College of Nursing, Taibah University, Madinah, Saudi Arabia
| | | | - Wesam T Almagharbeh
- Medical Surgical Nursing Department, Faculty of Nursing, University of Tabuk, Tabuk, Saudi Arabia
| | - Asim Abdullah Alhejaili
- Department of Medical and Surgical Nursing, College of Nursing, Taibah University, Madinah, Saudi Arabia
| | - Bassam Dhafer Alshahrani
- Department of Medical and Surgical Nursing, College of Nursing, Taibah University, Madinah, Saudi Arabia
- Honorary Fellow, School of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Dena Eltabey Sobeh
- Department of Medical Surgical Nursing, College of Nursing, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia
| | - Mudathir M Eltayeb
- Department of Medical Surgical Nursing, College of Nursing, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia
| |
Collapse
|
81
|
Conde D, Garcia MA, Gomez M, Gurovich AN. Exercise-Induced Shear Stress Drives mRNA Translation In Vitro. Curr Issues Mol Biol 2024; 46:9895-9905. [PMID: 39329941 PMCID: PMC11430095 DOI: 10.3390/cimb46090589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 09/01/2024] [Accepted: 09/04/2024] [Indexed: 09/28/2024] Open
Abstract
The vascular endothelium is the first line of defense to prevent cardiovascular disease. Its optimal functioning and health are maintained by the interaction of the proteins-endothelial nitric oxide synthase (eNOS), sirtuin 1 (SIRT1), and endothelin 1 (ET1)-and the genes that encode them-NOS3, SIRT1, and EDN1, respectively. Aerobic exercise improves endothelial function by allegedly increasing endothelial shear stress (ESS). However, there are no current data exploring the acute effects of specific exercise-induced ESS intensities on these regulatory proteins and genes that are associated with endothelial function. The purpose of this study was to assess the acute changes in endothelial proteins and gene expression after exposure to low-, moderate-, and high-intensity exercise-induced ESS. Human umbilical vein endothelial cells (HUVECs) were exposed to resting ESS (18 dynes/cm2, 60 pulses per minute (PPM)), low ESS (35 dynes/cm2, 100 PPM), moderate ESS (50 dynes/cm2, 120 PPM), and high ESS (70 dynes/cm2, 150 PPM). Protein and gene expression were quantified by fluorescent Western blot and RTqPCR, respectively. All exercise conditions showed an increase in eNOS and SIRT1 expression and a decrease in NOS3 and SIRT1 gene expression when compared to resting conditions. In addition, there was no expression of ET1 and an increase in EDN1 gene expression when compared to resting conditions. These results show that (1) exercise-induced ESS increases the expressions of vascular protective proteins and (2) there is an inverse relationship between the proteins and their encoding genes immediately after exercise-induced ESS, suggesting that exercise has a previously unexplored translational role catalyzing mRNA to proteins.
Collapse
Affiliation(s)
- Daniel Conde
- Clinical Applied Physiology (CAPh) Lab, The University of Texas at El Paso, El Paso, TX 79968, USA
- Department of Physical Therapy and Movement Sciences, The University of Texas at El Paso, El Paso, TX 79968, USA
| | - Mario A Garcia
- Driskill Graduate Program in Life Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60208, USA
| | - Manuel Gomez
- Clinical Applied Physiology (CAPh) Lab, The University of Texas at El Paso, El Paso, TX 79968, USA
- Interdisciplinary Health Sciences Ph.D. Program, The University of Texas at El Paso, El Paso, TX 79968, USA
| | - Alvaro N Gurovich
- Clinical Applied Physiology (CAPh) Lab, The University of Texas at El Paso, El Paso, TX 79968, USA
- Department of Physical Therapy and Movement Sciences, The University of Texas at El Paso, El Paso, TX 79968, USA
- Interdisciplinary Health Sciences Ph.D. Program, The University of Texas at El Paso, El Paso, TX 79968, USA
| |
Collapse
|
82
|
Magon A, Hendriks JM, Conte G, Caruso R. Description of self-care behaviours in patients with non-valvular atrial fibrillation on oral anticoagulant therapy: a scoping review. Eur J Cardiovasc Nurs 2024; 23:582-591. [PMID: 38267024 DOI: 10.1093/eurjcn/zvae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/26/2024]
Abstract
AIMS The primary aim of this scoping review was to explore and categorize the medication-related self-care behaviours exhibited by patients with non-valvular atrial fibrillation (NVAF) who are on oral anticoagulant (OAC) therapy. METHODS AND RESULTS A scoping review was performed, and the systematic search of the literature yielded an initial 887 records. After deduplication and screening, 61 studies were included in the analysis, ranging from 2003 to 2023. The studies represented a wide geographical distribution and diverse methodologies. The results identified 16 self-care behaviours: a higher focus of the included literature on self-care monitoring (60.65% of studies), followed by self-care management and self-care maintenance (each 16.39%). These behaviours ranged from regular blood testing to consulting healthcare providers and lifestyle changes. The results also highlighted the relationship between treatment satisfaction, self-efficacy, and adherence. Several studies emphasized the critical role of healthcare providers in influencing medication adherence. Furthermore, patient knowledge, quality of life, and psychological factors were identified as key elements affecting self-care behaviours. CONCLUSION The review provides a comprehensive landscape of medication-related self-care behaviours among NVAF patients on OAC therapy. It underscores the predominance of self-care monitoring behaviours and the critical roles of healthcare providers, psychological factors, and patient knowledge in influencing these behaviours. The findings also highlight the necessity for an integrated, patient-centred approach to improving self-care and self-management in OAC treatment. Future research should focus on addressing the identified gaps, including the relative lack of studies on lifestyle modification, emotional well-being, and technology-assisted interventions. REGISTRATION This review is part of a broader project and is documented at ClinicalTrials.gov: NCT05820854.
Collapse
Affiliation(s)
- Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Centre for Heart Rhythm Disorders, The University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy
| |
Collapse
|
83
|
Antoun I, Li X, Kotb AI, Vali Z, Abdelrazik A, Koya A, Mavilakandy A, Koev I, Nizam A, Eldeeb H, Somani R, Ng A. The Role of P Wave Parameters in Predicting Pulmonary Vein Isolation Outcomes for Paroxysmal Atrial Fibrillation: An Observational Cohort Study. J Cardiovasc Dev Dis 2024; 11:277. [PMID: 39330335 PMCID: PMC11431974 DOI: 10.3390/jcdd11090277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 08/28/2024] [Accepted: 09/03/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Pulmonary vein isolation (PVI) is an effective management method for paroxysmal atrial fibrillation (PAF). The P wave in the 12-lead electrocardiogram (ECG) represents atrial depolarisation. This study aims to utilise the P wave to predict PVI outcomes for PAF. METHODS This single-centre retrospective study aimed to predict PVI outcomes using P wave parameters. It included 211 consecutive patients with first PVI for PAF between 2018 and 2019 and targeted the pulmonary veins (PVs). Procedure success was defined by freedom of ECG-documented AF at 12 months. Digital 12-lead ECGs with 1-50 hertz bandpass filters were monitored before the procedure. Corrected P wave duration (PWDc), P wave amplitude (PWV), P wave dispersion (PWDisp), intra-atrial block (IAB), P wave area (PWA), and P wave terminal force in V1 (PTFV1) were measured before ablation and correlated with the outcomes. RESULTS Successful PVI occurred in 154 patients (73%). Demographics were similar between both arms. P wave parameters correlated with PVI failure included increased PWDc in all leads except for lead III, aVR, and V3, decreased PWV in lead I (hazard ratio [HR]: 0.7, 95% confidence interval [CI]: 0.53-0.95), lead II (HR: 0.45, 95% CI: 0.22-0.65), aVL (HR: 0.58, 95% CI: 0.22-0.98), and aVF (HR: 0.67, 95% CI: 0.58-0.87), decreased PWA in lead I (HR: 0.55, 95% CI: 0.21-0.76), lead II (HR: 0.48, 95% CI: 0.34-0.87), aVL (HR: 0.65, 95% CI: 0.45-0.96), and aVF (HR: 0.61, 95% CI: 0.32-0.89), and the presence of IAB (HR: 2, 95% CI: 1.4-4.2, p = 0.02). PWDisp and PTFV1 were not correlated with PVI outcome. CONCLUSIONS PWDc, PWA, PWV, and IAB are valuable predictors for PVI outcome for PAF at 12 months.
Collapse
Affiliation(s)
- Ibrahim Antoun
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Xin Li
- Department of Engineering, University of Leicester, Leicester LE1 7RH, UK
| | - Ahmed I Kotb
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Zakkariya Vali
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
- Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Ahmed Abdelrazik
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Abdulmalik Koya
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Akash Mavilakandy
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Ivelin Koev
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Ali Nizam
- Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Hany Eldeeb
- Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Riyaz Somani
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
- Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
| | - André Ng
- Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
- Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
- National Institute for Health Biomedical Centre, Leicester LE3 9QP, UK
| |
Collapse
|
84
|
Turek Ł, Sadowski M, Kurzawski J, Janion M. Left Atrial Appendage Thrombus as a Marker of Disease Severity in 500 Patients with Atrial Fibrillation on Oral Anticoagulation: A 13-Year Follow-Up Study. J Clin Med 2024; 13:5258. [PMID: 39274471 PMCID: PMC11396769 DOI: 10.3390/jcm13175258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 08/24/2024] [Accepted: 09/02/2024] [Indexed: 09/16/2024] Open
Abstract
Background/Objective: Whether left atrial appendage thrombus (LAAT) in patients with atrial fibrillation (AF) on chronic anticoagulation significantly increases cardiovascular risk is unknown. This study aimed to assess LAAT prevalence and its predictive role in cardiovascular events among consecutive anticoagulated patients with AF admitted for electrical cardioversion. Methods: This prospective study included 500 patients. The primary outcome was LAAT on transesophageal echocardiography. Patients were followed up for a median of 1927.5 (interquartile range 1004-2643) days to assess cardiovascular events. Results: LAAT was detected in 65 (13%) patients. No significant differences in stroke, transient ischemic attack, systemic thromboembolic events, or myocardial infarction prevalence were observed between patients with AF with and without LAAT. Hospitalization for heart failure (HF) was more frequent in patients with LAAT than in those without LAAT; however, the effect of LAAT on HF hospitalization was not statistically significant. Patients with LAAT had a significantly higher risk of cardiovascular death than those without LAAT. LAAT and greater left atrial (LA) diameter were associated with higher rates of cardiovascular death. The independent HF hospitalization predictors were greater LA diameter, lower left ventricular ejection fraction (LVEF), and estimated glomerular filtration rate (eGFR). Conclusions: Patients with AF who received anticoagulation therapy showed a high prevalence of LAAT. LAAT and greater LA diameter were associated with significantly higher rates of cardiovascular death. LAAT, greater LA diameter, lower LVEF, and lower eGFR were associated with poor prognosis in anticoagulated patients with AF and were predictors of disease severity.
Collapse
Affiliation(s)
- Łukasz Turek
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Marcin Sadowski
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Jacek Kurzawski
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Marianna Janion
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| |
Collapse
|
85
|
Bochkarev M, Korostovtseva L, Rotar O, Verbitskaya E, Sviryaev Y, Zhernakova Y, Shalnova S, Konradi A, Chazova I, Boytsov S, Shlyakhto E. Predictors of sleepiness in a large-scale epidemiology study ESSE-RF. Front Neurol 2024; 15:1431821. [PMID: 39296956 PMCID: PMC11408917 DOI: 10.3389/fneur.2024.1431821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 08/19/2024] [Indexed: 09/21/2024] Open
Abstract
Introduction To identify predictors of excessive daytime sleepiness we analyzed data from the 'Epidemiology of cardiovascular diseases in regions of Russia (ESSE-RF)' study. Methods Data from participants of the cohort study ESSE-RF (2012-2013), aged 25-64 years, from 13 regions of Russia were analyzed (2012-2013). The participants were interviewed regarding their sleep complaints, including difficulties with initiating and maintaining sleep, sleepiness, and use of sleeping pills. Sleepiness was considered significant if it occurred at least three times a week. The examination encompassed social, demographic, and anthropometric measures, lifestyle factors, self-reported diseases, and laboratory parameters. The final analysis included 13,255 respondents. Results Frequent (≥3 times/week) sleepiness was reported by 5,8%, and occasional sleepiness (1-2 times/week) by 10.8% of respondents. Multivariate regression analysis identified significant predictors of frequent sleepiness. Sleep complaints (insomnia, sleep apnea, snoring) and frequent use of sleep medication were prominent factors. Additionally, age, female gender, higher education, and retirement status were associated with sleepiness. Beyond demographics and sleep, the analysis revealed predictors: abnormal anxiety levels, low high-density lipoprotein, high salt intake and following medical conditions: arrhythmia, hypertension, myocardial infarction, other heart diseases, and renal disease. Conclusion This study identified a significant prevalence of EDS in Russians, aligning with global trends. However, findings suggest potential regional variations. Analysis revealed a complex interplay of factors contributing to EDS, highlighting the importance of individualized treatment approaches for improved sleep health.
Collapse
Affiliation(s)
| | | | - Oxana Rotar
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Elena Verbitskaya
- Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Yurii Sviryaev
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | | | - Svetlana Shalnova
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia
| | | | - Irina Chazova
- National Medical Research Center for Cardiology, Moscow, Russia
| | - Sergey Boytsov
- National Medical Research Center for Cardiology, Moscow, Russia
| | - Evgeny Shlyakhto
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| |
Collapse
|
86
|
Zhang X, Guo Y, Xu H. Case Report: Acute myocarditis in a patient with Duchenne muscular dystrophy. Front Cardiovasc Med 2024; 11:1419496. [PMID: 39290213 PMCID: PMC11405220 DOI: 10.3389/fcvm.2024.1419496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 08/21/2024] [Indexed: 09/19/2024] Open
Abstract
Background Cardiovascular complications are the leading cause of death among individuals with Duchenne muscular dystrophy (DMD). However, due to the difficulty in evaluating individuals with inactive DMD, acute myocardial injury may be overlooked. Case presentation An 11-year-old boy with DMD presented to the emergency department with a 5-day history of persistent nasal congestion, runny nose, and cough. He was regularly taking prednisolone acetate, angiotensin-converting enzyme (ACE) inhibitors, and β-blockers for suspected DMD-associated cardiomyopathy. Upon presentation, a substantially elevated cardiac troponin I (cTnI) level of 19.8 μg/L and abnormal electrocardiogram (ECG) results were detected. Further cardiac magnetic resonance imaging (CMR) showed myocardial inflammation with localized T2 hyperintensity from the basal to middle lateral and inferior walls, as well as late gadolinium enhancement (LGE) from the basal to apical inferior lateral walls, supporting a diagnosis of acute myocarditis. Subsequently, the patient showed clinical improvement in response to combination treatment with intravenous immunoglobulin, oral prednisolone acetate, potassium chloride sustained-release tablets, anti-heart failure medication, and broad-spectrum antibiotics. Conclusions We report a rare case of acute myocarditis in a patient with DMD, potentially due to upper respiratory tract infection. This case highlights the importance of early myocarditis recognition and treatment in patients with DMD.
Collapse
Affiliation(s)
- Xinyuan Zhang
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yingkun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Huayan Xu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
87
|
Pérez Molina CDJ, Castañeda Orjuela C, Valbuena Hernandez P, Pérez Arias RI, Pérez Arias MA, Arias Copete AM. Therapeutic interventions for heart failure in Colombia: result of a Delphi panel. PLoS One 2024; 19:e0304124. [PMID: 39226250 PMCID: PMC11371197 DOI: 10.1371/journal.pone.0304124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/07/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVE The objective of this study was to validate the main therapies used in the treatment of heart failure through a clinical consensus conducted by cardiology experts in Colombia. METHODS The Delphi technique was employed, which involves a series of consultation rounds with experts to reach a consensus. Cardiologists with experience in HF treatment were selected, and they were sent electronic questionnaires to assess the relevance of various therapeutic interventions. Consensus was defined when at least 70% of the experts agreed on the relevance of an intervention. RESULTS Fourteen cardiology experts participated in the study. In the first round, nine therapeutic interventions were evaluated, but insufficient agreement was reached to form a consensus. A second round was conducted, where feedback was provided to the experts, and they were asked to rate the relevance of the interventions using a Likert scale. Consensus was achieved for eight of the evaluated therapeutic interventions. The focus of the third round was on the interventions that had not reached consensus in the previous rounds. CONCLUSIONS This study provides clinical consensus on therapeutic interventions for HF in Colombia. Nine therapeutic interventions were identified as relevant by the experts. These findings can help improve HF treatment and optimize clinical outcomes in Colombia. It is important to note that this study was conducted with local experts, and the results may not be generalizable to other populations.
Collapse
Affiliation(s)
- Clímaco de Jesús Pérez Molina
- Department of Cardiology, Clinic of The Universidad de la Sabana, Bogotá, Colombia
- Electrophysiology Service, Sanitas Colombia Clinic, Bogotá, Colombia
- AVIDANTI Clinic, Ibagué, Colombia
| | | | | | | | | | | |
Collapse
|
88
|
Fang Y, Fan C, Li Y, Xie H. The influence of Helicobacter pylori infection on acute coronary syndrome and lipid metabolism in the Chinese ethnicity. Front Cell Infect Microbiol 2024; 14:1437425. [PMID: 39290976 PMCID: PMC11405380 DOI: 10.3389/fcimb.2024.1437425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 08/16/2024] [Indexed: 09/19/2024] Open
Abstract
Background Acute coronary syndrome (ACS) patients frequently present a relatively high prevalence of Helicobacter pylori (H. pylori) infection. H. pylori was previously hypothesized to induce ACS through the regulation of lipid levels. However, the risk of H. pylori-induced ACS varies significantly among different ethnic groups, and the associations between H. pylori and lipid parameters remain unclear. This study aimed to systematically assess the risk of ACS in Chinese populations with H. pylori infection while also evaluating the effects of H. pylori on lipid parameters. Materials and methods A hospital-based case-control study involving 280 participants was conducted. Immunoblotting was used for the detection and genotyping of H. pylori. The associations between H. pylori and ACS, as well as lipid parameters, were analyzed via the chi-square test and a multiple logistic regression model. Results H. pylori infection significantly increased the risk of ACS among all participants (adjusted odds ratio (OR) = 4.04, 95% confidence interval (CI): 1.76-9.25, P < 0.05), with no associations with virulence factors (cytotoxin-associated gene A (CagA) or vacuole toxin geneA (VacA)). Subgroup analysis revealed a significant increase in the risk of ACS among the elderly population aged 56-64 years with H. pylori infection. Additionally, a substantial association was observed between H. pylori and acute myocardial infarction (AMI). No significant differences were found in lipid parameters, including low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and the LDL/HDL ratio, between individuals positive and negative for H. pylori infection. Similar results were observed between the ACS group and the control group. Conclusions Our study has demonstrated for the first time that H. pylori does not significantly impact lipid metabolism but increases the risk of ACS fourfold in the Chinese population (OR = 4.04, 95% CI: 1.76-9.25). Furthermore, the virulence factors of H. pylori (CagA and VacA) may not be involved in the mechanisms by which they promote the development of ACS. This finding provides additional evidence for the association between H. pylori and ACS among different ethnic groups and refutes the biological mechanism by which H. pylori affects ACS through lipid metabolism regulation. Regular screening for H. pylori and eradication treatment in elderly individuals and those at high risk for ACS may be effective measures for reducing the incidence of ACS. Future research should include multicenter randomized controlled trials and explore host genetics and the effects of H. pylori on the gut microbiota as potential biological pathways linking H. pylori and ACS.
Collapse
Affiliation(s)
- Yizhen Fang
- Department of Clinical Laboratory, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Department of Clinical Laboratory, Xiamen Key Laboratory of Precision Medicine for Cardiovascular Disease, Xiamen, China
| | - Chunming Fan
- Department of Clinical Laboratory, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Department of Clinical Laboratory, Xiamen Key Laboratory of Precision Medicine for Cardiovascular Disease, Xiamen, China
| | - Yun Li
- Blood Transfusion Department, Affiliated Fuzhou First Hospital of Fujian Medical University, Fuzhou, China
| | - Huabin Xie
- Department of Clinical Laboratory, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Department of Clinical Laboratory, Xiamen Key Laboratory of Precision Medicine for Cardiovascular Disease, Xiamen, China
| |
Collapse
|
89
|
Ko SM. Evaluation of myocardial strain using cardiovascular magnetic resonance imaging in patients with β-thalassemia major. J Cardiovasc Imaging 2024; 32:26. [PMID: 39252137 PMCID: PMC11384706 DOI: 10.1186/s44348-024-00033-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 08/13/2024] [Indexed: 09/11/2024] Open
Affiliation(s)
- Sung Min Ko
- Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
| |
Collapse
|
90
|
Woźniak P, Iwańczyk S, Błaszyk M, Stępień K, Lesiak M, Mularek-Kubzdela T, Araszkiewicz A. Coronary Artery Aneurysm or Ectasia as a Form of Coronary Artery Remodeling: Etiology, Pathogenesis, Diagnostics, Complications, and Treatment. Biomedicines 2024; 12:1984. [PMID: 39335497 PMCID: PMC11428638 DOI: 10.3390/biomedicines12091984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/19/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024] Open
Abstract
Coronary artery aneurysm or ectasia (CAAE) is a term that includes both coronary artery ectasia (CAE) and coronary artery aneurysm (CAA), despite distinct phenotypes and definitions. This anomaly can be found in 0.15-5.3% of coronary angiography. CAE is a diffuse dilatation of the coronary artery at least 1.5 times wider than the diameter of the normal coronary artery in a patient with a length of over 20 mm or greater than one-third of the vessel. CAE can be further subdivided into diffuse and focal dilations by the number and the length of the dilated vessels. Histologically, it presents with extensive destruction of musculoelastic elements, marked degradation of collagen and elastic fibers, and disruption of the elastic lamina. Conversely, CAA is a focal lesion manifesting as focal dilatation, which can be fusiform (if the longitudinal diameter is greater than the transverse) or saccular (if the longitudinal diameter is smaller than the transverse). Giant CAA is defined as a 4-fold enlargement of the vessel diameter and is observed in only 0.02% of patients after coronary. An aneurysmal lesion can be either single or multiple. It can be either a congenital or acquired phenomenon. The pathophysiological mechanisms responsible for the formation of CAAE are not well understood. Atherosclerosis is the most common etiology of CAAE in adults, while Kawasaki disease is the most common in children. Other etiological factors include systemic connective tissue diseases, infectious diseases, vasculitis, congenital anomalies, genetic factors, and idiopathic CAA. Invasive assessment of CAAE is based on coronary angiography. Coronary computed tomography (CT) is a noninvasive method that enables accurate evaluation of aneurysm size and location. The most common complications are coronary spasm, local thrombosis, distal embolization, coronary artery rupture, and compression of adjacent structures by giant coronary aneurysms. The approach to each patient with CAAE should depend on the severity of symptoms, anatomical structure, size, and location of the aneurysm. Treatment methods should be carefully considered to avoid possible complications of CAAE. Simultaneously, we should not unnecessarily expose the patient to the risk of intervention or surgical treatment. Patients can be offered conservative or invasive treatment. However, there are still numerous controversies and ambiguities regarding the etiology, prognosis, and treatment of patients with coronary artery aneurysms. This study summarizes the current knowledge about this disease's etiology, pathogenesis, and management.
Collapse
Affiliation(s)
- Patrycja Woźniak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Sylwia Iwańczyk
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Maciej Błaszyk
- Department of Radiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Konrad Stępień
- Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, Prądnicka 80 Street, 31-202 Kraków, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Tatiana Mularek-Kubzdela
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Aleksander Araszkiewicz
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| |
Collapse
|
91
|
Hajiqasemi M, Ebrahimzade M, Ghelichkhan ZA, Huang X, Morkos D, Jennings D, Talasaz AH. Ivabradine Approved and Other Uses in Clinical Practice: A Systematic Review. J Cardiovasc Pharmacol 2024; 84:276-288. [PMID: 39027978 DOI: 10.1097/fjc.0000000000001609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 06/26/2024] [Indexed: 07/20/2024]
Abstract
ABSTRACT Heart rate (HR) stands as a prognostic indicator of cardiovascular disease and a modifiable risk factor in heart failure (HF). Medication intolerance can curtail the application of conventional HR-lowering β-blockers to the optimum target dose. Ivabradine (IVA), a specific negative-chronotropic agent, selectively inhibits I f current in pacemaker cells of the sinoatrial node without depressing myocardial contractility or comprising hemodynamics. This review summarized ivabradine's clinical labeled and off-label uses and mechanism of action focusing on the clinical outcomes. PubMed was searched up to January 2024 using the main keywords of IVA, coronary artery disease (CAD), HF, postural tachycardia syndrome (POTS), and tachyarrhythmia. To comprehensively review IVA's clinical indications, mechanisms, and therapeutic effects, all studies investigating treatment with IVA in humans were included, comprising different types of studies such as randomized controlled trials and longitudinal prospective observational studies. After screening, 141 studies were included in our review. A large number of reviewed articles were allocated to heart failure with reduced ejection fraction and CAD, suggesting IVA as an alternative to β-blockers in case of contraindications or intolerance. The beneficial effects of IVA as premedication for coronary computed tomography angiography, HR lowering in POTS, and inappropriate sinus tachycardia constituted most studies among off-label uses. The promising results have been reported on the efficacy of IVA in controlling HR, especially in patients with inappropriate sinus tachycardia or POTS. Owing to the unique mechanism of action, IVA has the potential to be used more frequently in future clinical practice.
Collapse
Affiliation(s)
| | | | | | - Xena Huang
- Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Long Island University, New York, NY
- Department of Pharmacy, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY; and
| | - Demyana Morkos
- Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Long Island University, New York, NY
| | - Douglas Jennings
- Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Long Island University, New York, NY
- Department of Pharmacy, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY; and
| | - Azita H Talasaz
- Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Long Island University, New York, NY
- Department of Pharmacy, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY; and
- Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University, Richmond, VA
| |
Collapse
|
92
|
Maury E, Brouyère S, Jansen M. Characteristics of Patients With Atherosclerotic Cardiovascular Disease in Belgium and Current Treatment Patterns for the Management of Elevated LDL-C Levels. Clin Cardiol 2024; 47:e24330. [PMID: 39206747 PMCID: PMC11358763 DOI: 10.1002/clc.24330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 07/18/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Dyslipidemia remains the major cause of atherosclerotic cardiovascular disease (ASCVD). Lipid management in patients with increased cardiovascular (CV) risk needs improvement across Europe, and data gaps are noticeable at the country level. HYPOTHESIS We described the current treatment landscape in Belgium, hypothesizing that lipid management in patients with ASCVD remains inadequate and aiming to understand the reasons. METHODS Using data from an anonymized primary care database in Belgium derived from 494 750 individuals, we identified those with any CV risk factor between November 2019 and October 2022 and described the clinical features of patients with ASCVD. The main outcomes were the proportion of patients (i) receiving lipid-lowering therapies (LLTs), (ii) per low-density lipoprotein cholesterol (LDL-C) threshold, stratified per LLT, (iii) reaching the 2021 ESC recommended LDL-C goals, and (iv) LDL-C reduction per type of LLT was also determined. RESULTS Among 40 888 patients with very high CV risk, 24 859 had established ASCVD. Most patients with ASCVD were either receiving monotherapy (59.6%) or had no documented LLT (25.1%). Further, 64.2% of those with no documented LLT exhibited LDL-C levels ≥ 100 mg/dL. Among common treatment options, one of the greatest improvements in LDL-C levels was achieved with combination therapy of statin and ezetimibe, reducing LDL-C levels by 41.5% (p < 0.0001). Yet, in this group, 24.8% of patients had still LDL-C levels ≥ 100 mg/dL and only 20.7% were at goal. CONCLUSION Our study emphasizes the importance of developing strategies to help patients achieve their LDL-C goals, with a focus on supporting the implementation of combination LLT in routine clinical practice.
Collapse
Affiliation(s)
| | | | - Mieke Jansen
- Medical DepartmentNovartis PharmaVilvoordeBelgium
| |
Collapse
|
93
|
Boriani G, Bonini N, Imberti JF, Vitolo M, Gerra L, Mantovani M, Serafini K, Birtolo C, Tartaglia E, Mei DA. Clinical decisions for appropriate management of patients with atrial fibrillation. Panminerva Med 2024; 66:266-280. [PMID: 38656767 DOI: 10.23736/s0031-0808.24.05114-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
The management of patients with atrial fibrillation (AF) requires intricate clinical decision-making to optimize outcomes. In everyday clinical practice, physicians undergo difficult choices to better manage patients with AF. They need to balance thromboembolic and bleeding risk to focus on patients' symptoms and to manage a variety of multiple comorbidities. In this review, we aimed to explore the multifaceted dimensions of clinical decision-making in AF patients, encompassing the definition and diagnosis of clinical AF, stroke risk stratification, oral anticoagulant therapy selection, consideration of bleeding risk, and the ongoing debate between rhythm and rate control strategies. We will also focus on possible grey zones for the management of AF patients. In navigating this intricate landscape, clinicians must reconcile the dynamic interplay of patient-specific factors, evolving guidelines, and emerging therapies. The review underscores the need for personalized, evidence-based clinical decision-making to tailor interventions for optimal outcomes according to specific AF patient profiles.
Collapse
Affiliation(s)
- Giuseppe Boriani
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Polyclinic of Modena, University of Modena and Reggio Emilia, Modena, Italy -
| | - Niccolò Bonini
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Polyclinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Jacopo F Imberti
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Polyclinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Vitolo
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Polyclinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Gerra
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Polyclinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Marta Mantovani
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Polyclinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Kevin Serafini
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Polyclinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Birtolo
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Polyclinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrico Tartaglia
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Polyclinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Davide A Mei
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Polyclinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
94
|
Sugimoto K, Nishimura M, Ito N, Hosomi R, Fukunaga K, Nishihira J. Effects of Daily Consumption of Scallop Oil Prepared from Internal Organs of Japanese Giant Scallop (Patinopecten yessoensis) on Serum Lipid Composition and Its Safety: A Randomized, Double-blind, Placebo-controlled, Parallel Group Comparison Study. J Oleo Sci 2024; 73:1201-1212. [PMID: 39168625 DOI: 10.5650/jos.ess24105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024] Open
Abstract
Scallop oil (SCO) prepared from the internal organs of the Japanese giant scallop (Patinopecten yessoensis) contains eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and phospholipids (PL). It was previously shown that SCO consumption improves cholesterol and triacylglycerols (TG) contents in mice. The present study demonstrated the effects of daily SCO consumption (1.2 g/day, containing 376 mg of EPA, 63 mg of DHA, and 150 mg of PL) for 12 weeks in human subjects. In this randomized, doubleblind, placebo-controlled, parallel group comparison study, 70 Japanese subjects with serum TG levels ≥120 but < 200 mg/dL were recruited and randomly assigned to the SCO or placebo group. All subjects ingested six capsules per day for 12 weeks. We conducted medical interviews, body composition measurements, vital sign examinations, and blood sampling at weeks 0 (baseline), 4, 8, and 12, and measured peripheral blood flow at weeks 0 and 12. In the case of subjects with higher serum TG levels, SCO consumption decreased the changes in serum TG and malondialdehyde-low density lipoprotein (MDA-LDL) levels compared with the placebo group. Safety assessment revealed no medically significant changes due to continuous SCO consumption. The findings indicate that 1.2 g/day of SCO consumption may be beneficial for reducing serum TG and MDA-LDL levels in persons with higher TG levels.
Collapse
Affiliation(s)
- Koki Sugimoto
- Faculty of Food and Nutritional Sciences, Toyo University
| | - Mie Nishimura
- Department of Medical Management and Informatics, Hokkaido Information University
| | - Naohito Ito
- Department of Medical Management and Informatics, Hokkaido Information University
| | - Ryota Hosomi
- Department of Life Science and Biotechnology, Kansai University
| | - Kenji Fukunaga
- Department of Life Science and Biotechnology, Kansai University
| | - Jun Nishihira
- Department of Medical Management and Informatics, Hokkaido Information University
| |
Collapse
|
95
|
Ramos CDO, Sant'Ana MR, Gonçalves GR, Rios TDS, Nakandakari SCBR, Burger B, Fernandes LGR, Zollner RDL, de Oliveira AN, Ramos RC, da Silva ASR, Pauli JR, de Moura LP, Ropelle ER, Mansour E, Cintra DE. The Effects of High-Fat Diet and Flaxseed Oil-Enriched Diet on the Lung Parenchyma of Obese Mice. Mol Nutr Food Res 2024; 68:e2300050. [PMID: 39205544 DOI: 10.1002/mnfr.202300050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/28/2024] [Indexed: 09/04/2024]
Abstract
Omega-3 (ω3) fatty acids are widely investigated for their anti-inflammatory potential, however, there is little evidence regarding their action in the lung parenchyma in the context of obesity. The objective is to investigate the effects of flaxseed oil (FS), rich in α-linolenic (C18:3 - ω3), on the lungs of obese mice. Mice were fed a high-fat diet (HF) for 8 weeks to induce obesity. Subsequently, a part of these animals received HF containing FS oil for another 8 weeks. The HF consumption induced weight gain and hyperglycemia. The lung parenchyma shows a complete fatty acids profile, compared to the control group (CT). In the lung parenchyma, FS increases the ω3 content and, notwithstanding a reduction in the interleukins (IL) IL1β and IL18 contents compared to HF. However, FS promoted increased alveolar spaces, followed by MCP1 (Monocytes Chemoattractant Protein-1) positive cell infiltration and a dramatic reduction in the anti-inflammatory cytokine, IL10. Despite reducing the pulmonary inflammatory response, the consumption of a food source of ω3 was associated with alterations in the lipid profile and histoarchitecture of the lung parenchyma, which can lead to the development of pulmonary complications. This study brings an alert against the indiscriminate use of ω3 supplements, warranting caution.
Collapse
Affiliation(s)
- Camila de Oliveira Ramos
- Nutritional Genomics Laboratory, LabGeN, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
| | - Marcella Ramos Sant'Ana
- Nutritional Genomics Laboratory, LabGeN, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
| | - Giovana Rios Gonçalves
- Nutritional Genomics Laboratory, LabGeN, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
| | - Thaiane da Silva Rios
- Nutritional Genomics Laboratory, LabGeN, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
| | - Susana Castelo Branco Ramos Nakandakari
- Nutritional Genomics Laboratory, LabGeN, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
- Nutrigenomics and Lipids Research Center, CELN, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
| | - Beatriz Burger
- Laboratory of Nutrients and Tissue Repair, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
| | | | - Ricardo de Lima Zollner
- Laboratory of Translational Immunology, School of Medical Sciences, UNICAMP, São Paulo, 13484-350, Brazil
| | - Arthur Noin de Oliveira
- Innovare Biomarkers Laboratory, School of Pharmaceutical Sciences, UNICAMP, São Paulo, 13484-350, Brazil
| | - Rodrigo Catharino Ramos
- Innovare Biomarkers Laboratory, School of Pharmaceutical Sciences, UNICAMP, São Paulo, 13484-350, Brazil
| | | | - José Rodrigo Pauli
- Laboratory of Molecular Biology of Exercise, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
- OCRC - Obesity and Comorbidities Research Center, UNICAMP, São Paulo, 13484-350, Brazil
| | - Leandro Pereira de Moura
- Laboratory of Molecular Biology of Exercise, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
- OCRC - Obesity and Comorbidities Research Center, UNICAMP, São Paulo, 13484-350, Brazil
| | - Eduardo Rochete Ropelle
- Laboratory of Molecular Biology of Exercise, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
- OCRC - Obesity and Comorbidities Research Center, UNICAMP, São Paulo, 13484-350, Brazil
| | - Eli Mansour
- Department of Clinical Medicine, School of Medical Sciences, UNICAMP, São Paulo, 13484-350, Brazil
| | - Dennys Esper Cintra
- Nutritional Genomics Laboratory, LabGeN, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
- Nutrigenomics and Lipids Research Center, CELN, School of Applied Sciences, UNICAMP, São Paulo, 13484-350, Brazil
- OCRC - Obesity and Comorbidities Research Center, UNICAMP, São Paulo, 13484-350, Brazil
| |
Collapse
|
96
|
Lee KCY, Williams AL, Wang L, Xie G, Jia W, Fujimoto A, Gerschenson M, Shohet RV. PKM2 regulates metabolic flux and oxidative stress in the murine heart. Physiol Rep 2024; 12:e70040. [PMID: 39256891 PMCID: PMC11387154 DOI: 10.14814/phy2.70040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/28/2024] [Accepted: 08/28/2024] [Indexed: 09/12/2024] Open
Abstract
Cardiac metabolism ensures a continuous ATP supply, primarily using fatty acids in a healthy state and favoring glucose in pathological conditions. Pyruvate kinase muscle (PKM) controls the final step of glycolysis, with PKM1 being the main isoform in the heart. PKM2, elevated in various heart diseases, has been suggested to play a protective role in cardiac stress, but its function in basal cardiac metabolism remains unclear. We examined hearts from global PKM2 knockout (PKM2-/-) mice and found reduced intracellular glucose. Isotopic tracing of U-13C glucose revealed a shift to biosynthetic pathways in PKM2-/- cardiomyocytes. Total ATP content was two-thirds lower in PKM2-/- hearts, and functional analysis indicated reduced mitochondrial oxygen consumption. Total reactive oxygen species (ROS) and mitochondrial superoxide were also increased in PKM2-/- cardiomyocytes. Intriguingly, PKM2-/- hearts had preserved ejection fraction compared to controls. Mechanistically, increased calcium/calmodulin-dependent kinase II activity and phospholamban phosphorylation may contribute to higher sarcoendoplasmic reticulum calcium ATPase 2 pump activity in PKM2-/- hearts. Loss of PKM2 led to altered glucose metabolism, diminished mitochondrial function, and increased ROS in cardiomyocytes. These data suggest that cardiac PKM2 acts as an important rheostat to maintain ATP levels while limiting oxidative stress. Although loss of PKM2 did not impair baseline contractility, its absence may make hearts more sensitive to environmental stress or injury.
Collapse
Affiliation(s)
- Katie C. Y. Lee
- Department of Medicine, John A. Burns School of MedicineUniversity of HawaiiHonoluluHawaiiUSA
- Department of Cell and Molecular Biology, John A. Burns School of MedicineUniversity of HawaiiHonoluluHawaiiUSA
| | - Allison L. Williams
- Department of Medicine, John A. Burns School of MedicineUniversity of HawaiiHonoluluHawaiiUSA
| | - Lu Wang
- University of Hawaii Cancer CenterHonoluluHawaiiUSA
| | - Guoxiang Xie
- University of Hawaii Cancer CenterHonoluluHawaiiUSA
| | - Wei Jia
- University of Hawaii Cancer CenterHonoluluHawaiiUSA
| | - Anastasia Fujimoto
- Department of Cell and Molecular Biology, John A. Burns School of MedicineUniversity of HawaiiHonoluluHawaiiUSA
| | - Mariana Gerschenson
- Department of Cell and Molecular Biology, John A. Burns School of MedicineUniversity of HawaiiHonoluluHawaiiUSA
| | - Ralph V. Shohet
- Department of Medicine, John A. Burns School of MedicineUniversity of HawaiiHonoluluHawaiiUSA
| |
Collapse
|
97
|
Doğan MT, Can U, Alp H, Ayguneş U. Serum Endocan Levels in Children with Acute Rheumatic Fever. Niger J Clin Pract 2024; 27:1051-1056. [PMID: 39348324 DOI: 10.4103/njcp.njcp_783_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 08/21/2024] [Indexed: 10/02/2024]
Abstract
BACKGROUND Acute rheumatic fever is an immunologically delayed autoimmune sequel of throat infection caused by group A streptococcus. The aim of this study was to evaluate endocan levels in patients with acute rheumatic fever and compare with the control group. AIM The aim of this study was to evaluate endocan levels in patients with acute rheumatic fever and compare with the control group. METHODS Twenty-three children with acute rheumatic fever (11 men, 12 females; mean age 13 ± 2.7 years; range 5 to 15 years) and a healthy control group of 31 children (16 men, 15 females; mean age 13.8 ± 2.4 years; range 5 to 15 years) were recruited. The sedimentation rate, C-reactive protein, antistreptolysin-O titres, and endocan levels were examined in each group. RESULTS Before anti-inflammatory therapy, endocan levels in the acute rheumatic fever group were not statistically significant to those in the control group, respectively (200.64 ng/L, 120.71 ng/L, P = 0.208). After anti-inflammatory therapy, endocan levels were significantly higher in the acute rheumatic fever group than in the control group, respectively (260.87 ng/L vs. 120.71 ng/L, P < 0.01). A significant difference was found in endocan levels before and after anti-inflammatory therapy in the group of acute rheumatic fever, respectively (200.64 ng/L vs. 260.87 ng/L, P = 0.033). Endocan levels after anti-inflammatory therapy were statistically higher in the severe carditis group compared to those of the mild carditis group, respectively (344.56 ng/L vs. 191.01 ng/L, P < 0.01). CONCLUSION Our study showed that serum endocan levels increased during the subacute phase of acute rheumatic fever. We suggest that serum endocan level can be used as a new biomarker to identify the degree of cardiac involvement in acute rheumatic fever.
Collapse
Affiliation(s)
- M T Doğan
- Department of Pediatric Cardiology, Selcuk University, MD, Konya, Turkey
| | - U Can
- Department of Biochemistry, Konya City Hospital, Konya, Turkey
| | - H Alp
- Department of Pediatric Cardiology, Karamanoğlu Mehmet Bey University, Karaman, Turkey
| | - U Ayguneş
- Department of Pediatric Hematology and Oncology, Konya Training and Research Hospital, MD, Konya, Turkey
| |
Collapse
|
98
|
Banerjee P, Chau K, Kotla S, Davis EL, Turcios EB, Li S, Pengzhi Z, Wang G, Kolluru GK, Jain A, Cooke JP, Abe J, Le NT. A Potential Role for MAGI-1 in the Bi-Directional Relationship Between Major Depressive Disorder and Cardiovascular Disease. Curr Atheroscler Rep 2024; 26:463-483. [PMID: 38958925 DOI: 10.1007/s11883-024-01223-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE OF REVIEW Major Depressive Disorder (MDD) is characterized by persistent symptoms such as fatigue, loss of interest in activities, feelings of sadness and worthlessness. MDD often coexist with cardiovascular disease (CVD), yet the precise link between these conditions remains unclear. This review explores factors underlying the development of MDD and CVD, including genetic, epigenetic, platelet activation, inflammation, hypothalamic-pituitary-adrenal (HPA) axis activation, endothelial cell (EC) dysfunction, and blood-brain barrier (BBB) disruption. RECENT FINDINGS Single nucleotide polymorphisms (SNPs) in the membrane-associated guanylate kinase WW and PDZ domain-containing protein 1 (MAGI-1) are associated with neuroticism and psychiatric disorders including MDD. SNPs in MAGI-1 are also linked to chronic inflammatory disorders such as spontaneous glomerulosclerosis, celiac disease, ulcerative colitis, and Crohn's disease. Increased MAGI-1 expression has been observed in colonic epithelial samples from Crohn's disease and ulcerative colitis patients. MAGI-1 also plays a role in regulating EC activation and atherogenesis in mice and is essential for Influenza A virus (IAV) infection, endoplasmic reticulum stress-induced EC apoptosis, and thrombin-induced EC permeability. Despite being understudied in human disease; evidence suggests that MAGI-1 may play a role in linking CVD and MDD. Therefore, further investigation of MAG-1 could be warranted to elucidate its potential involvement in these conditions.
Collapse
Affiliation(s)
- Priyanka Banerjee
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
- Medical Physiology, College of Medicine, Texas A&M Health Science Center, Bryan, TX, USA
| | - Khanh Chau
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Sivareddy Kotla
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eleanor L Davis
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Estefani Berrios Turcios
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Shengyu Li
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Zhang Pengzhi
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Guangyu Wang
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | | | - Abhishek Jain
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
- Department of Biomedical Engineering, College of Engineering, Texas A&M University, College Station, TX, USA
- Department of Medical Physiology, School of Medicine, Texas A&M Health Science Center, Bryan, USA
| | - John P Cooke
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Junichi Abe
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nhat-Tu Le
- Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA.
| |
Collapse
|
99
|
Aus dem Siepen F, Meissner C, Hofmann E, Hein S, Nagel C, Hegenbart U, Schönland SO, Andre F, Frey N, Kristen AV. Response to therapy with tafamidis 61 mg in patients with cardiac transthyretin amyloidosis: real-world experience since approval. Amyloid 2024; 31:226-231. [PMID: 39018203 DOI: 10.1080/13506129.2024.2376202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 06/16/2024] [Accepted: 07/01/2024] [Indexed: 07/19/2024]
Abstract
AIMS Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive disease that causes heart failure due to amyloid fibril deposition. Tafamidis was approved as the first causal treatment in 2020. We here report on real-world data in patients treated with tafamidis for at least 12 months according to the recently defined European Society for Cardiology (ESC) consensus criteria for disease progression. METHODS AND RESULTS Three hundred and eight wildtype and 31 hereditary ATTR-CM patients were prospectively enrolled after first diagnosis of ATTR-CM and initiation of tafamidis 61 mg once daily treatment. After 12 months, significant deterioration in Karnofsky Index, estimated glomerular filtration rate (eGFR), N-terminal brain natriuretic peptide (NT-proBNP), septum thickness and left ventricular ejection fraction (LVEF) could be observed, significant disease progression was only detected in 25 patients (9%) using ESC consensus criteria. Mean survival time was 37 months with no differences between responders and non-responders. NT-proBNP was the only independent predictor for poor therapy response (p = .008). CONCLUSIONS The majority of patients showed no significant disease progression according to the ESC consensus criteria after 12 months of therapy with tafamidis. However, at 12 months, treatment response based on the ESC consensus criteria was not associated with improved survival. Moreover, higher levels of NT-proBNP at diagnosis of ATTR-CM appears to predict poorer treatment response, confirming that timely initiation of therapy is advantageous.
Collapse
Affiliation(s)
- Fabian Aus dem Siepen
- Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Christopher Meissner
- Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Eva Hofmann
- Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Selina Hein
- Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Nagel
- Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Ute Hegenbart
- Department of Hematology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan O Schönland
- Department of Hematology, University Hospital Heidelberg, Heidelberg, Germany
| | - Florian Andre
- Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Norbert Frey
- Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Arnt V Kristen
- Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
100
|
Vest AR, Schauer PR, Rodgers JE, Sanderson E, LaChute CL, Seltz J, Lavie CJ, Mandras SA, Tang WHW, daSilva-deAbreu A. Obesity and Weight Loss Strategies for Patients With Heart Failure. JACC. HEART FAILURE 2024; 12:1509-1527. [PMID: 39093256 DOI: 10.1016/j.jchf.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 05/29/2024] [Accepted: 06/04/2024] [Indexed: 08/04/2024]
Abstract
Obesity is a common comorbidity among patients with heart failure with reduced ejection fraction (HFrEF) or heart failure with preserved ejection fraction (HFpEF), with the strongest pathophysiologic link of obesity being seen for HFpEF. Lifestyle measures are the cornerstone of weight loss management, but sustainability is a challenge, and there are limited efficacy data in the heart failure (HF) population. Bariatric surgery has moderate efficacy and safety data for patients with preoperative HF or left ventricular dysfunction and has been associated with reductions in HF hospitalizations and medium-term mortality. Antiobesity medications historically carried concerns for cardiovascular adverse effects, but the safety and weight loss efficacy seen in general population trials of glucagon-like peptide 1 (GLP-1) and gastric inhibitory polypeptide/GLP-1 agonists are highly encouraging. Although there are safety concerns regarding GLP-1 agonists in advanced HFrEF, trials of the GLP-1 agonist semaglutide for treatment of obesity have confirmed safety and efficacy in patients with HFpEF.
Collapse
Affiliation(s)
- Amanda R Vest
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Kaufman Center for Heart Failure Treatment and Recovery, Cleveland Clinic, Cleveland, Ohio, USA.
| | - Philip R Schauer
- Metamor Metabolic Institute, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Jo E Rodgers
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Emily Sanderson
- Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, USA
| | - Courtney L LaChute
- Department of Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Jessica Seltz
- Frances Stern Nutrition Center, Tufts Medical Center, Boston, Massachusetts, USA
| | - Carl J Lavie
- Department of Cardiology, Ochsner Medical Center, New Orleans, Louisiana, USA; University of Queensland Ochsner Clinical School, University of Queensland, New Orleans, Louisiana, USA
| | - Stacy A Mandras
- Transplant Institute, AdventHealth Orlando, Orlando, Florida, USA
| | - W H Wilson Tang
- Doctoral School, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Adrian daSilva-deAbreu
- Doctoral School, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|