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Adamu YM, Umar AB, Muhammad AR, Mijinyawa MS, Ismail A. Aberrant right coronary artery in an elderly Nigerian with recent dyspnoea detected on coronary CT angiogram. Radiol Case Rep 2024; 19:2621-2624. [PMID: 38645958 PMCID: PMC11026724 DOI: 10.1016/j.radcr.2024.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/08/2024] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
An anomalous origin of the right coronary artery has been documented in up to 0.92% of the general population, which is more common than an anomalous origin of the left coronary artery. We present a case of an elderly hypertensive man who developed mild dyspnoea on exertion for 3 months with associated retro-sternal pain as well as occasional palpitation which all tend to subside at rest. An electrocardiogram showed evidence of left atrial enlargement. A coronary computed tomographic angiogram was acquired with a 160-slice scanner which revealed the right coronary artery to originate from the left aortic sinus with a retro-aortic pattern of anatomical course. Vascular wall calcifications were noted with multilevel luminal narrowing on the left anterior descending however distal opacification was adequate. Our case further depicts the reason for keeping in mind anatomical variations while evaluating cardiac pathologies even among Black Africans.
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Affiliation(s)
| | | | | | | | - Anas Ismail
- Department of Radiology, Bayero University, Kano, Nigeria
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Pollak KI, Davenport CA, Duck V, Falls A, Pepka S, Parente V, Jackson LR, Johnson KS. Discriminatory and valuing communication behaviors in cardiology encounters. Patient Education and Counseling 2024; 123:108224. [PMID: 38395022 PMCID: PMC10997491 DOI: 10.1016/j.pec.2024.108224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/05/2024] [Accepted: 02/19/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Many have found racial differences in clinician-patient communication using validated codebooks that represent effective communication. No codebooks used for examining racial differences, however, have included patient input. In this paper, we describe creating codebook with Black patient advocates to determine if we could reliably code discriminatory/valuing communication and assess racial differences in these behaviors. METHODS We created a codebook for discriminatory/valuing communication behaviors with the input of Black patient advocates. We used the codebook to analyze data from 101 audio recorded encounters between White cardiologists and Black and White patients. We examined the differences in the prevalence of behaviors in cardiology encounters. RESULTS In comparison to White patients, cardiologists made fewer tailoring statements to their Black patients (68% vs. 49%, p = 0.07). Coders found 4 instances of stereotyping behaviors and only Black patients (p = 0.12). We found no significant associations between any of the other outcomes and patient race. Black patients had a lower incidence of tailoring statements (p = 0.13), lower incidence of interrupting statements (p = 0.16), and higher rushed global score (p = 0.14). CONCLUSION AND PRACTICE IMPLICATIONS We found that coders can reliably identify discriminatory/valuing behaviors in cardiology encounters. Future work should apply these codes to other datasets to assess their validity and generalizability.
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Affiliation(s)
- Kathryn I Pollak
- Cancer Prevention and Control, Duke Cancer Institute, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
| | | | - Veronica Duck
- Cancer Prevention and Control, Duke Cancer Institute, Durham, NC, USA
| | - Allison Falls
- Department of Psychology, Duke University, Durham, NC, USA
| | - Sara Pepka
- Department of Psychology, Duke University, Durham, NC, USA
| | - Victoria Parente
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Larry R Jackson
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Kimberly S Johnson
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Geriatric Research, Education, and Clinical Center (GRECC), Veterans Affairs Medical Center, Durham, NC, USA
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Rosa D, Villa G, Amigoni C, Rossetti AM, Guberti M, Ghirotto L, Manara DF. Role of emotions in the clinical decision-making process of the hospital nurse: A multicentre qualitative study. MethodsX 2024; 12:102590. [PMID: 38322133 PMCID: PMC10844854 DOI: 10.1016/j.mex.2024.102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/26/2024] [Indexed: 02/08/2024] Open
Abstract
While for a long-time emotional reaction and moral distress, have been primarily investigated for the possible outcomes of the nursing decision-making process rather than in terms of their role as antecedents of the final decision taken. The primary study's aim is to explore how inpatient nurses' decision-making takes place in different care settings, with a special focus on the role played by emotions during decision-making. The secondary aim is to explore the subjective experience of hospital nurses in relation to successful and unsuccessful decision-making situations. Multicentre qualitative study, consisting of three phases with different designs: participatory study, grounded theory study, and phenomenological study. Participants will be nurses and may be doctors with various levels of professional experience working in hospital, outpatient, or ward settings. Participants will be recruited through different sampling (purposive and convenience). Data will be collected through focus groups and in-depth interviews with nurses working in different hospital care settings. The researchers expect to find themes that will contribute to a better understanding of the role of emotions in decision-making. The results of this study have the potential of providing important implications to support nurses in the recognition and management of their emotions during the decision-making process.
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Affiliation(s)
- Debora Rosa
- Center for Nursing Research and Innovation, Giulia VILLA, Vita-Salute San Raffaele University, Milan, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Giulia VILLA, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Monica Guberti
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Duilio Fiorenzo Manara
- Center for Nursing Research and Innovation, Giulia VILLA, Vita-Salute San Raffaele University, Milan, Italy
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Maciejewski C, Ozierański K, Barwiołek A, Basza M, Bożym A, Ciurla M, Janusz Krajsman M, Maciejewska M, Lodziński P, Opolski G, Grabowski M, Cacko A, Balsam P. AssistMED project: Transforming cardiology cohort characterisation from electronic health records through natural language processing - Algorithm design, preliminary results, and field prospects. Int J Med Inform 2024; 185:105380. [PMID: 38447318 DOI: 10.1016/j.ijmedinf.2024.105380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Electronic health records (EHR) are of great value for clinical research. However, EHR consists primarily of unstructured text which must be analysed by a human and coded into a database before data analysis- a time-consuming and costly process limiting research efficiency. Natural language processing (NLP) can facilitate data retrieval from unstructured text. During AssistMED project, we developed a practical, NLP tool that automatically provides comprehensive clinical characteristics of patients from EHR, that is tailored to clinical researchers needs. MATERIAL AND METHODS AssistMED retrieves patient characteristics regarding clinical conditions, medications with dosage, and echocardiographic parameters with clinically oriented data structure and provides researcher-friendly database output. We validate the algorithm performance against manual data retrieval and provide critical quantitative and qualitative analysis. RESULTS AssistMED analysed the presence of 56 clinical conditions, medications from 16 drug groups with dosage and 15 numeric echocardiographic parameters in a sample of 400 patients hospitalized in the cardiology unit. No statistically significant differences between algorithm and human retrieval were noted. Qualitative analysis revealed that disagreements with manual annotation were primarily accounted to random algorithm errors, erroneous human annotation and lack of advanced context awareness of our tool. CONCLUSIONS Current NLP approaches are feasible to acquire accurate and detailed patient characteristics tailored to clinical researchers' needs from EHR. We present an in-depth description of an algorithm development and validation process, discuss obstacles and pinpoint potential solutions, including opportunities arising with recent advancements in the field of NLP, such as large language models.
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Affiliation(s)
- Cezary Maciejewski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland; Doctoral School, Medical University of Warsaw, 02-091 Warszawa, Poland; Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 02-091 Warszawa, Poland
| | - Krzysztof Ozierański
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland.
| | - Adam Barwiołek
- Codifive sp. z o.o., Lindleya 16, 02-013 Warszawa, Poland
| | - Mikołaj Basza
- Medical University of Silesia in Katowice, 40-055 Katowice, Poland
| | - Aleksandra Bożym
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland
| | - Michalina Ciurla
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland
| | - Maciej Janusz Krajsman
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 02-091 Warszawa, Poland
| | | | - Piotr Lodziński
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland
| | - Grzegorz Opolski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland
| | - Marcin Grabowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland
| | - Andrzej Cacko
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland; Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 02-091 Warszawa, Poland
| | - Paweł Balsam
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland
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5
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Ediger DS, Brady WJ, Koyfman A, Long B. Further considerations regarding myocarditis. Am J Emerg Med 2024; 79:221-222. [PMID: 38365530 DOI: 10.1016/j.ajem.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/18/2024] Open
Affiliation(s)
- David S Ediger
- Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA
| | - William J Brady
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA.
| | - Alex Koyfman
- Department of Emergency Medicine, UT Southwestern, Dallas, TX, USA
| | - Brit Long
- Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
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Steffens S, Schröder K, Krüger M, Maack C, Streckfuss-Bömeke K, Backs J, Backofen R, Baeßler B, Devaux Y, Gilsbach R, Heijman J, Knaus J, Kramann R, Linz D, Lister AL, Maatz H, Maegdefessel L, Mayr M, Meder B, Nussbeck SY, Rog-Zielinska EA, Schulz MH, Sickmann A, Yigit G, Kohl P. The challenges of research data management in cardiovascular science: a DGK and DZHK position paper-executive summary. Clin Res Cardiol 2024; 113:672-679. [PMID: 37847314 PMCID: PMC11026239 DOI: 10.1007/s00392-023-02303-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 09/01/2023] [Indexed: 10/18/2023]
Abstract
The sharing and documentation of cardiovascular research data are essential for efficient use and reuse of data, thereby aiding scientific transparency, accelerating the progress of cardiovascular research and healthcare, and contributing to the reproducibility of research results. However, challenges remain. This position paper, written on behalf of and approved by the German Cardiac Society and German Centre for Cardiovascular Research, summarizes our current understanding of the challenges in cardiovascular research data management (RDM). These challenges include lack of time, awareness, incentives, and funding for implementing effective RDM; lack of standardization in RDM processes; a need to better identify meaningful and actionable data among the increasing volume and complexity of data being acquired; and a lack of understanding of the legal aspects of data sharing. While several tools exist to increase the degree to which data are findable, accessible, interoperable, and reusable (FAIR), more work is needed to lower the threshold for effective RDM not just in cardiovascular research but in all biomedical research, with data sharing and reuse being factored in at every stage of the scientific process. A culture of open science with FAIR research data should be fostered through education and training of early-career and established research professionals. Ultimately, FAIR RDM requires permanent, long-term effort at all levels. If outcomes can be shown to be superior and to promote better (and better value) science, modern RDM will make a positive difference to cardiovascular science and practice. The full position paper is available in the supplementary materials.
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Affiliation(s)
- Sabine Steffens
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Katrin Schröder
- Institute for Cardiovascular Physiology, Goethe University, Frankfurt Am Main, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site RheinMain, Frankfurt, Germany
| | - Martina Krüger
- Institute of Cardiovascular Physiology, University Hospital Düsseldorf, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany
| | - Christoph Maack
- Comprehensive Heart Failure Center (CHFC), University Clinic Würzburg, Würzburg, Germany
- Medical Clinic 1, University Clinic Würzburg, Würzburg, Germany
| | - Katrin Streckfuss-Bömeke
- Clinic for Cardiology and Pneumology, Georg-August University Göttingen, Göttingen, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Göttingen, Göttingen, Germany
- Institute of Pharmacology and Toxicology, University of Würzburg, Würzburg, Germany
| | - Johannes Backs
- Institute of Experimental Cardiology, University Hospital Heidelberg, Heidelberg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Rolf Backofen
- Faculty of Medicine, Institute for Experimental and Clinical Pharmacology and Toxicology, Albert-Ludwigs-University, Freiburg, Germany
| | - Bettina Baeßler
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Yvan Devaux
- Cardiovascular Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Ralf Gilsbach
- Institute of Experimental Cardiology, University Hospital Heidelberg, Heidelberg, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Jordi Heijman
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Jochen Knaus
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Rafael Kramann
- Institute of Experimental Medicine and Systems Biology, RWTH Aachen Medical Faculty, Aachen, Germany
- Department of Nephrology and Clinical Immunology, RWTH Aachen Medical Faculty, Aachen, Germany
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus MC, Rotterdam, The Netherlands
| | - Dominik Linz
- Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Allyson L Lister
- Oxford E-Research Centre (OeRC), Department of Engineering Science, University of Oxford, Oxford, UK
| | - Henrike Maatz
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Lars Maegdefessel
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
- Department for Vascular and Endovascular Surgery, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Manuel Mayr
- School of Cardiovascular Medicine and Sciences, King's College London British Heart Foundation Centre, London, UK
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Benjamin Meder
- DZHK (German Center for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
- Department of Internal Medicine III (Cardiology, Angiology, and Pneumology), University Hospital Heidelberg, Heidelberg, Germany
| | - Sara Y Nussbeck
- Department of Medical Informatics, University Medical Center Göttingen (UMG), Göttingen, Germany
- Central Biobank UMG, UMG, Göttingen, Germany
| | - Eva A Rog-Zielinska
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg-Bad Krozingen, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marcel H Schulz
- DZHK (German Centre for Cardiovascular Research), Partner Site RheinMain, Frankfurt, Germany
- Institute of Cardiovascular Regeneration, Goethe University, Frankfurt, Germany
| | - Albert Sickmann
- Leibniz-Institut Für Analytische Wissenschaften, ISAS, E.V., Dortmund, Germany
- Department of Chemistry, College of Physical Sciences, University of Aberdeen, Aberdeen, UK
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Gökhan Yigit
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
- German Center of Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Peter Kohl
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg-Bad Krozingen, University of Freiburg, Freiburg, Germany.
- Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- CIBSS Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany.
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Silva-Cardoso J, Santos J, Araújo I, Andrade A, Morais Sarmento P, Santos P, Moura B, Marques I, Peres M, Ferreira JP, Agostinho J, Pimenta J. conTemporary reflectiOns regarding heart failure manaGEmenT - How to ovERcome the PorTuguese barriers (TOGETHER-PT). Rev Port Cardiol 2024; 43:225-235. [PMID: 37689388 DOI: 10.1016/j.repc.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/11/2023] [Accepted: 05/02/2023] [Indexed: 09/11/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Heart failure (HF) is a complex clinical syndrome that is a significant burden in hospitalisations, morbidity, and mortality. Although a significant effort has been made to better understand its consequences and current barriers in its management, there are still several gaps to address. The present work aimed to identify the views of a multidisciplinary group of health care professionals on HF awareness and literacy, diagnosis, treatment and organization of care, identifying current challenges and providing insights into the future. METHODS A steering committee was established, including members of the Heart Failure Study Group of the Portuguese Society of Cardiology (GEIC-SPC), the Heart Failure Study Group of the Portuguese Society of Internal Medicine (NEIC-SPMI) and the Cardiovascular Study Group (GEsDCard) of the Portuguese Association of General and Family Medicine (APMGF). This steering committee produced a 16-statement questionnaire regarding different HF domains that was answered to by a diversified group of 152 cardiologists, internists, general practitioners, and nurses with an interest or dedicated to HF using a five-level Likert scale. Full agreement was defined as ≥80% of level 5 (fully agree) responses. RESULTS Globally, consensus was achieved in all but one of the 16 statements. Full agreement was registered in seven statements, namely 3 of 4 statements for patient education and HF awareness and 2 in 4 statements of both HF diagnosis and healthcare organization, with proportions of fully agree responses ranging from 82.9% to 96.7%. None of the HF treatment statements registered full agreement but 3 of 4 achieved ≥80% of level 4 (agree) responses. CONCLUSION This document aims to be a call-to-action to improve HF patients' quality of life and prognosis, by promoting a change in HF care in Portugal.
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Affiliation(s)
- José Silva-Cardoso
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; RISE - Health Research Network, Portugal.
| | - Jonathan Santos
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; ARS Norte, ACES Vale Sousa Norte, USF Torrão, Portugal
| | - Inês Araújo
- Clínica de Insuficiência Cardíaca, Serviço de Medicina III, Hospital S. Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Aurora Andrade
- Serviço de Cardiologia, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
| | - Pedro Morais Sarmento
- Departamento de Medicina Interna e Hospital de Dia de Insuficiência Cardíaca do Hospital da Luz de Lisboa, Lisboa, Portugal
| | - Paulo Santos
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; RISE - Health Research Network, Portugal; MEDCIDS, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Brenda Moura
- Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Irene Marques
- Serviço de Medicina Interna, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; Unidade Multidisciplinar de Investigação Biomédica - Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Marisa Peres
- Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal
| | - João Pedro Ferreira
- Unic@RISE, Serviço de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Université de Lorraine, Inserm, Centre d'Investigations Cliniques-Plurithématique 14-33, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Joao Agostinho
- Serviço de Cardiologia, Departamento de Coração e Vasos, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal; CCUL, Centro Académico de Medicina de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Joana Pimenta
- Serviço de Medicina Interna, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; UnIC@RISE, Departamento de Medicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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8
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Sano M, Toyota T, Morimoto T, Noguchi Y, Shigeno R, Murai R, Okada T, Sasaki Y, Taniguchi T, Kim K, Kobori A, Ehara N, Kinoshita M, Doi A, Tomii K, Kihara Y, Furukawa Y. Risk stratification and prognosis prediction using cardiac biomarkers in COVID-19: a single-centre retrospective cohort study. BMJ Open 2024; 14:e082220. [PMID: 38658000 DOI: 10.1136/bmjopen-2023-082220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE There is a need for a robust tool to stratify the patient's risk with COVID-19. We assessed the prognostic values of cardiac biomarkers for COVID-19 patients. METHODS This is a single-centre retrospective cohort study. Consecutive laboratory-confirmed COVID-19 patients admitted to the Kobe City Medical Center General Hospital from July 2020 to September 2021 were included. We obtained cardiac biomarker values from electronic health records and institutional blood banks. We stratified patients with cardiac biomarkers as high-sensitive troponin I (hsTnI), N-terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase (CK) and CK myocardial band (CK-MB), using the clinically relevant thresholds. Prespecified primary outcome measure was all-cause death. RESULTS A total of 917 patients were included. hsTnI, NT-proBNP, CK and CK-MB were associated with the significantly higher cumulative 30-day incidence of all-cause death (hsTnI: <5.0 ng/L group; 4.3%, 5.0 ng/L-99%ile upper reference limit (URL) group; 8.8% and ≥99% ile URL group; 25.2%, p<0.001. NT-proBNP: <125 pg/mL group; 5.3%, 125-900 pg/mL group; 10.5% and ≥900 pg/mL group; 31.9%, p<0.001. CK: CONCLUSIONS Elevation of cardiac biomarkers was associated with poor prognosis of COVID-19 patients.
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Affiliation(s)
- Madoka Sano
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Toshiaki Toyota
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takeshi Morimoto
- Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yu Noguchi
- Department of Cardiovascular Medicine, Tenri Hospital, Tenri, Japan
| | - Ryo Shigeno
- Department of Cardiovascular Medicine, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Ryosuke Murai
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Taiji Okada
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yasuhiro Sasaki
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tomohiko Taniguchi
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kitae Kim
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Atsushi Kobori
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Natsuhiko Ehara
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Makoto Kinoshita
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Asako Doi
- Department of Infectious disease, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yasuki Kihara
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Deng H, Liang WY, Chen LQ, Yuen TH, Sahin B, Vasilescu DM, Trinder M, Walley K, Rensen PC, Boyd JH, Brunham LR. CETP inhibition enhances monocyte activation and bacterial clearance and reduces streptococcus pneumonia-associated mortality in mice. JCI Insight 2024; 9:e173205. [PMID: 38646937 DOI: 10.1172/jci.insight.173205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 03/05/2024] [Indexed: 04/25/2024] Open
Abstract
Sepsis is a leading cause of mortality worldwide, and pneumonia is the most common cause of sepsis in humans. Low levels of high-density lipoprotein cholesterol (HDL-C) levels are associated with an increased risk of death from sepsis, and increasing levels of HDL-C by inhibition of cholesteryl ester transfer protein (CETP) decreases mortality from intraabdominal polymicrobial sepsis in APOE*3-Leiden.CETP mice. Here, we show that treatment with the CETP inhibitor (CETPi) anacetrapib reduced mortality from Streptococcus pneumoniae-induced sepsis in APOE*3-Leiden.CETP and APOA1.CETP mice. Mechanistically, CETP inhibition reduced the host proinflammatory response via attenuation of proinflammatory cytokine transcription and release. This effect was dependent on the presence of HDL, leading to attenuation of immune-mediated organ damage. In addition, CETP inhibition promoted monocyte activation in the blood prior to the onset of sepsis, resulting in accelerated macrophage recruitment to the lung and liver. In vitro experiments demonstrated that CETP inhibition significantly promoted the activation of proinflammatory signaling in peripheral blood mononuclear cells and THP1 cells in the absence of HDL; this may represent a mechanism responsible for improved bacterial clearance during sepsis. These findings provide evidence that CETP inhibition represents a potential approach to reduce mortality from pneumosepsis.
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Affiliation(s)
- Haoyu Deng
- Department of Medicine, Faculty of Medicine
- Centre for Heart and Lung Innovation, St. Paul's Hospital
| | - Wan Yi Liang
- Department of Microbiology and Immunology, Faculty of Science, and
| | - Le Qi Chen
- Department of Microbiology and Immunology, Faculty of Science, and
| | - Tin Ho Yuen
- Department of Microbiology and Immunology, Faculty of Science, and
| | - Basak Sahin
- Centre for Heart and Lung Innovation, St. Paul's Hospital
| | | | - Mark Trinder
- Centre for Heart and Lung Innovation, St. Paul's Hospital
- Department of Experimental Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Keith Walley
- Centre for Heart and Lung Innovation, St. Paul's Hospital
| | - Patrick C.N. Rensen
- Department of Medicine, Division of Endocrinology, and
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - John H Boyd
- Department of Medicine, Faculty of Medicine
- Centre for Heart and Lung Innovation, St. Paul's Hospital
| | - Liam R Brunham
- Department of Medicine, Faculty of Medicine
- Centre for Heart and Lung Innovation, St. Paul's Hospital
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10
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Piqueras-Flores J, Villacorta-Argüelles E, Galvin J, Climent-Payá V, Escobar-López LE, Amor-Salamanca A, Garcia-Hernandez S, Esmonde S, Martínez-Del Río J, Soto-Pérez M, Garcia-Pavia P, Ochoa JP. Intermediate-effect size p.Arg637Gln in FHOD3 increases risk of HCM and is associated with an aggressive phenotype in homozygous carriers. J Med Genet 2024; 61:423-427. [PMID: 38160043 DOI: 10.1136/jmg-2023-109413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
Formin homology 2 domain-containing 3 (FHOD3) gene has emerged as one of the main non-sarcomeric genes associated with hypertrophic cardiomyopathy (HCM), but no cases of biallelic variants associated with disease have been described to date. From 2014 until 2021, FHOD3 was evaluated in our center by next-generation sequencing in 22 806 consecutive unrelated probands. The p.Arg637Gln variant in FHOD3 was enriched in our HCM cohort (284 of 9668 probands; 2.94%) compared with internal controls (64 of 11 480; 0.59%) and gnomAD controls (373 of 64 409; 0.58%), with ORs of 5.40 (95% CI: 4.11 to 7.09) and 5.19 (95% CI: 4.44 to 6.07). The variant affects a highly conserved residue localised in a supercoiled alpha helix considered a clustering site for HCM variants, and in heterozygosis can act as a predisposing factor (intermediate-effect variant) for HCM, with an estimated penetrance of around 1%. Additionally, seven homozygous carriers of p.Arg637Gln in FHOD3 were identified. All but one (unaffected) showed an early presentation and a severe HCM phenotype. All this information suggest that p.Arg637Gln variant in FHOD3 is a low-penetrant variant, with an intermediate effect, that contributes to the development of HCM in simple heterozygosis, being associated with a more severe phenotype in homozygous carriers.
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Affiliation(s)
- Jesús Piqueras-Flores
- Inherited Cardiac Diseases Unit, Cardiology Department, Ciudad Real General University Hospital, Ciudad Real, Spain
- Medicine Department, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - Eduardo Villacorta-Argüelles
- Inherited Heart Disease Unit, Cardiology Department, University Hospital of Salamanca, Salamanca, Spain
- Departamento de Medicina, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Joseph Galvin
- Department of Cardiology, The Mater Misericordiae University Hospital, The Dublin Neurological Institute, Dublin, Ireland
| | - Vicente Climent-Payá
- Heart Failure and Inherited Heart Disease Unit, Department of Cardiology, Hospital General Universitario de Alicante, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Luis Enrique Escobar-López
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, IDIPHISA, Madrid, Spain
| | | | | | - Sean Esmonde
- Department of Cardiology, The Mater Misericordiae University Hospital, The Dublin Neurological Institute, Dublin, Ireland
| | - Jorge Martínez-Del Río
- Inherited Cardiac Diseases Unit, Cardiology Department, Ciudad Real General University Hospital, Ciudad Real, Spain
| | - Maeve Soto-Pérez
- Inherited Cardiac Diseases Unit, Cardiology Department, Ciudad Real General University Hospital, Ciudad Real, Spain
| | - Pablo Garcia-Pavia
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, IDIPHISA, Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Juan Pablo Ochoa
- Health in Code, A Coruña, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
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11
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Mat Bah MN, Kasim AS, Sapian MH, Alias EY. Survival outcomes for congenital heart disease from Southern Malaysia: results from a congenital heart disease registry. Arch Dis Child 2024; 109:363-369. [PMID: 38296612 DOI: 10.1136/archdischild-2023-326622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/22/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE Limited population-based studies are available on the survival of congenital heart disease (CHD) from lower- and middle-income countries. Therefore, we evaluated the survival from birth until 15 years and associated factors for mortality. METHODS This population-based cohort study included all children with CHD registered in the Pediatric Cardiology Clinical Information System born between 2006 and 2020 in Johor, Malaysia. The mortality rate was calculated, and Cox proportional hazard regression analysis was used to determine factors associated with mortality. The Kaplan-Meier analysis was used to estimate the survival rates at 1, 5, 10 and 15 years. RESULTS There were 5728 patients with CHD studied, with 1543 (27%) lesions resolved spontaneously, 322 (5.6%) were treated with comfort care, 1189 (21%) required no intervention, and 2674 (47%) needed surgery or intervention. The overall mortality rate was 15%, with a median age of death of 3.7 months (IQR 0.9-9.8 months). Preoperative/intervention death was observed in 300 (11%), and 68 (3.2%) children died within 30 days of surgery or intervention. The overall estimated survival at 1, 5, 10 and 15 years was 88%, 85%, 84% and 83%, respectively. The independent factors associated with mortality were male gender, associated syndrome or extra-cardiac defect, pulmonary hypertension, antenatal diagnosis and severe lesions. CONCLUSIONS Eight out of 10 patients with CHDs survived up to 15 years of age. However, 10% of CHDs who require intervention die before the procedure. Thus, improving congenital cardiac surgery and enhancing the overall healthcare system are crucial to improve survival.
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Affiliation(s)
- Mohd Nizam Mat Bah
- Department of Pediatrics, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - Aina Salwa Kasim
- Department of Pediatrics, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - Mohd Hanafi Sapian
- Department of Pediatrics, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
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12
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Yu W, Kong Q, Jiang S, Li Y, Wang Z, Mao Q, Zhang X, Liu Q, Zhang P, Li Y, Li C, Ding Z, Liu L. HSPA12A maintains aerobic glycolytic homeostasis and Histone3 lactylation in cardiomyocytes to attenuate myocardial ischemia/reperfusion injury. JCI Insight 2024; 9:e169125. [PMID: 38421727 DOI: 10.1172/jci.insight.169125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/21/2024] [Indexed: 03/02/2024] Open
Abstract
Myocardial ischemia/reperfusion (MI/R) injury is a major cause of adverse outcomes of revascularization following myocardial infarction. Anaerobic glycolysis during myocardial ischemia is well studied, but the role of aerobic glycolysis during the early phase of reperfusion is incompletely understood. Lactylation of Histone H3 (H3) is an epigenetic indicator of the glycolytic switch. Heat shock protein A12A (HSPA12A) is an atypic member of the HSP70 family. In the present study, we report that, during reperfusion following myocardial ischemia, HSPA12A was downregulated and aerobic glycolytic flux was decreased in cardiomyocytes. Notably, HSPA12A KO in mice exacerbated MI/R-induced aerobic glycolysis decrease, cardiomyocyte death, and cardiac dysfunction. Gain- and loss-of-function studies demonstrated that HSPA12A was required to support cardiomyocyte survival upon hypoxia/reoxygenation (H/R) challenge and that its protective effects were mediated by maintaining aerobic glycolytic homeostasis for H3 lactylation. Further analyses revealed that HSPA12A increased Smurf1-mediated Hif1α protein stability, thus increasing glycolytic gene expression to maintain appropriate aerobic glycolytic activity to sustain H3 lactylation during reperfusion and, ultimately, improving cardiomyocyte survival to attenuate MI/R injury.
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Affiliation(s)
- Wansu Yu
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, and
| | - Qiuyue Kong
- Department of Anesthesiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Surong Jiang
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, and
| | - Yunfan Li
- Department of Anesthesiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhaohe Wang
- Department of Anesthesiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qian Mao
- Department of Anesthesiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaojin Zhang
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, and
| | - Qianhui Liu
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, and
| | - Pengjun Zhang
- Department of Nuclear Medicine, Nanjing First Hospital of Nanjing Medical University, Nanjing, China
| | - Yuehua Li
- Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, China
| | - Chuanfu Li
- Departments of Surgery, East Tennessee State University, Johnson City, Tennessee, USA
| | - Zhengnian Ding
- Department of Anesthesiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Li Liu
- Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, and
- Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, China
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13
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Zhu P, Li J, Yan F, Islam S, Lin X, Xu X. Allelic heterogeneity of TTNtv dilated cardiomyopathy can be modeled in adult zebrafish. JCI Insight 2024; 9:e175501. [PMID: 38412038 DOI: 10.1172/jci.insight.175501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/21/2024] [Indexed: 02/29/2024] Open
Abstract
Allelic heterogeneity (AH) has been noted in truncational TTN-associated (TTNtv-associated) dilated cardiomyopathy (DCM); i.e., mutations affecting A-band-encoding exons are pathogenic, but those affecting Z-disc-encoding exons are likely benign. The lack of an in vivo animal model that recapitulates AH hinders the deciphering of the underlying mechanism. Here, we explored zebrafish as a candidate vertebrate model by phenotyping a collection of zebrafish ttntv alleles. We noted that cardiac function and sarcomere structure were more severely disrupted in ttntv-A than in ttntv-Z homozygous embryos. Consistently, cardiomyopathy-like phenotypes were present in ttntv-A but not ttntv-Z adult heterozygous mutants. The phenotypes observed in ttntv-A alleles were recapitulated in null mutants with the full titin-encoding sequences removed. Defective autophagic flux, largely due to impaired autophagosome-lysosome fusion, was also noted only in ttntv-A but not in ttntv-Z models. Moreover, we found that genetic manipulation of ulk1a restored autophagy flux and rescued cardiac dysfunction in ttntv-A animals. Together, our findings presented adult zebrafish as an in vivo animal model for studying AH in TTNtv DCM, demonstrated TTN loss of function is sufficient to trigger ttntv DCM in zebrafish, and uncovered ulk1a as a potential therapeutic target gene for TTNtv DCM.
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Affiliation(s)
- Ping Zhu
- Department of Biochemistry and Molecular Biology and
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jiarong Li
- Department of Biochemistry and Molecular Biology and
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Cardiovascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China
| | - Feixiang Yan
- Department of Biochemistry and Molecular Biology and
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Shahidul Islam
- Department of Biochemistry and Molecular Biology and
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Xueying Lin
- Department of Biochemistry and Molecular Biology and
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Xiaolei Xu
- Department of Biochemistry and Molecular Biology and
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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14
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Fröhlich AK, Porthun J, Talha KM, Lena A, Hadzibegovic S, Wilkenshoff U, Sonntag F, Nikolski A, Ramer LV, Zeller T, Keller U, Bullinger L, Anker SD, Haverkamp W, von Haehling S, Doehner W, Rauch U, Skurk C, Cleland JGF, Butler J, Coats AJS, Landmesser U, Karakas M, Anker MS. Association of an impaired GH-IGF-I axis with cardiac wasting in patients with advanced cancer. Clin Res Cardiol 2024:10.1007/s00392-024-02400-x. [PMID: 38587563 DOI: 10.1007/s00392-024-02400-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/07/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Growth hormone (GH) resistance is characterized by high GH levels but low levels of insulin-like growth factor-I (IGF-I) and growth hormone binding protein (GHBP) and, for patients with chronic disease, is associated with the development of cachexia. OBJECTIVES We investigated whether GH resistance is associated with changes in left ventricular (LV) mass (cardiac wasting) in patients with cancer. METHODS We measured plasma IGF-I, GH, and GHBP in 159 women and 148 men with cancer (83% stage III/IV). Patients were grouped by tertile of echocardiographic LVmass/height2 (women, < 50, 50-61, > 61 g/m2; men, < 60, 60-74, > 74 g/m2) and by presence of wasting syndrome with unintentional weight loss (BMI < 24 kg/m2 and weight loss ≥ 5% in the prior 12 months). Repeat echocardiograms were obtained usually within 3-6 months for 85 patients. RESULTS Patients in the lowest LVmass/height2 tertile had higher plasma GH (median (IQR) for 1st, 2nd, and 3rd tertile women, 1.8 (0.9-4.2), 0.8 (0.2-2.2), 0.5 (0.3-1.6) ng/mL, p = 0.029; men, 2.1 (0.8-3.2), 0.6 (0.1-1.7), 0.7 (0.2-1.9) ng/mL, p = 0.003). Among women, lower LVmass was associated with higher plasma IGF-I (68 (48-116), 72 (48-95), 49 (35-76) ng/mL, p = 0.007), whereas such association did not exist for men. Patients with lower LVmass had lower log IGF-I/GH ratio (women, 1.60 ± 0.09, 2.02 ± 0.09, 1.88 ± 0.09, p = 0.004; men, 1.64 ± 0.09, 2.14 ± 0.11, 2.04 ± 0.11, p = 0.002). GHBP was not associated with LVmass. Patients with wasting syndrome with unintentional weight loss had higher plasma GH and GHBP, lower log IGF-I/GH ratio, and similar IGF-I. Overall, GHBP correlated inversely with log IGF-I/GH ratio (women, r = - 0.591, p < 0.001; men, r = - 0.575, p < 0.001). Additionally, higher baseline IGF-I was associated with a decline in LVmass during follow-up (r = - 0.318, p = 0.003). CONCLUSION In advanced cancer, reduced LVmass is associated with increased plasma GH and reduced IGF-I/GH ratio, suggesting increasing GH resistance, especially for patients with wasting syndrome with unintentional weight loss. Higher baseline IGF-I was associated with a decrease in relative LVmass during follow-up.
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Affiliation(s)
- Ann-Kathrin Fröhlich
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Virchow Clinic, German Heart Center Charité, Berlin, Germany
| | - Jan Porthun
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Virchow Clinic, German Heart Center Charité, Berlin, Germany
- Norwegian University of Science and Technology, Campus Gjøvik, Gjøvik, Norway
| | - Khawaja M Talha
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Alessia Lena
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Benjamin Franklin, German Heart Center Charité, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Sara Hadzibegovic
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Benjamin Franklin, German Heart Center Charité, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Ursula Wilkenshoff
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Benjamin Franklin, German Heart Center Charité, Hindenburgdamm 30, 12200, Berlin, Germany
- Berlin Institute of Health, Charité - University Medicine Berlin, Berlin, Germany
| | - Frederike Sonntag
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Virchow Clinic, German Heart Center Charité, Berlin, Germany
| | - Anja Nikolski
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Virchow Clinic, German Heart Center Charité, Berlin, Germany
| | - Luisa Valentina Ramer
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Virchow Clinic, German Heart Center Charité, Berlin, Germany
| | - Tanja Zeller
- University Center of Cardiovascular Science, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Clinic for Cardiology, University Heart and Vascular Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Research, Partner Site HH/Kiel/HL, Hamburg, Germany
| | - Ulrich Keller
- Department of Hematology, Oncology and Cancer Immunology, Charité - University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, a partnership between DKFZ and Charité-Universitätsmedizin Berlin, Berlin, Germany
- Max Delbrück Center, Berlin, Germany
| | - Lars Bullinger
- German Cancer Consortium (DKTK), Partner Site Berlin, a partnership between DKFZ and Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Hematology, Oncology, and Tumor Immunology, Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt University Berlin, Berlin, Germany
| | - Stefan D Anker
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology Campus, Virchow Clinic of German Heart Center Charité, Charité - University Medicine Berlin, Berlin, Germany
| | - Wilhelm Haverkamp
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology Campus, Virchow Clinic of German Heart Center Charité, Charité - University Medicine Berlin, Berlin, Germany
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Wolfram Doehner
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Virchow Clinic, German Heart Center Charité, Berlin, Germany
- Centre for Stroke Research, Berlin, Charité-Universitätsmedizin, Berlin, Germany
| | - Ursula Rauch
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Benjamin Franklin, German Heart Center Charité, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Carsten Skurk
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Benjamin Franklin, German Heart Center Charité, Hindenburgdamm 30, 12200, Berlin, Germany
| | - John G F Cleland
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
| | | | - Ulf Landmesser
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Benjamin Franklin, German Heart Center Charité, Hindenburgdamm 30, 12200, Berlin, Germany
- Berlin Institute of Health, Charité - University Medicine Berlin, Berlin, Germany
| | - Mahir Karakas
- German Centre for Cardiovascular Research, Partner Site HH/Kiel/HL, Hamburg, Germany
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Markus S Anker
- Charité - University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany.
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany.
- Department of Cardiology, Angiology and Intensive Care Medicine Campus Benjamin Franklin, German Heart Center Charité, Hindenburgdamm 30, 12200, Berlin, Germany.
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15
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Biffi A, Palermi S, D'Ascenzi F, Bonifazi M, Zorzi A, Corrado D. Premature ventricular beats in athletes: to detrain or not to detrain? Br J Sports Med 2024; 58:407-408. [PMID: 38471745 DOI: 10.1136/bjsports-2023-107384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Alessandro Biffi
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Stefano Palermi
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
- Public Health Department, University of Naples Federico II, Sulmona, Italy
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Marco Bonifazi
- Department of Medicine, Surgery, and NeuroScience, University of Siena, Siena, Italy
| | - Alessandro Zorzi
- Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Domenico Corrado
- Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
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16
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Chelko SP, Penna VR, Engel M, Shiel EA, Centner AM, Farra W, Cannon EN, Landim-Vieira M, Schaible N, Lavine K, Saffitz JE. NFĸB signaling drives myocardial injury via CCR2+ macrophages in a preclinical model of arrhythmogenic cardiomyopathy. J Clin Invest 2024:e172014. [PMID: 38564300 DOI: 10.1172/jci172014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Nuclear factor kappa-B (NFκB) is activated in arrhythmogenic cardiomyopathy (ACM) patient-derived iPSC-cardiac myocytes under basal conditions and inhibition of NFκB signaling prevents disease in Dsg2mut/mut mice, a robust mouse model of ACM. Here, we used genetic approaches and single cell RNA sequencing to define the contributions of immune signaling in cardiac myocytes and macrophages in the natural progression of ACM using Dsg2mut/mut mice. We found that NFκB signaling in cardiac myocytes drives myocardial injury, contractile dysfunction, and arrhythmias in Dsg2mut/mut mice. NFκB signaling in cardiac myocytes mobilizes macrophages expressing C-C motif chemokine receptor-2 (CCR2+ cells) to affected areas within the heart, where they mediate myocardial injury and arrhythmias. Contractile dysfunction in Dsg2mut/mut mice is caused both by loss of heart muscle and negative inotropic effects of inflammation in viable muscle. Single nucleus RNA sequencing and cellular indexing of transcriptomes and epitomes (CITE-seq) studies revealed marked pro-inflammatory changes in gene expression and the cellular landscape in hearts of Dsg2mut/mut mice involving cardiac myocytes, fibroblasts and CCR2+ macrophages. Changes in gene expression in cardiac myocytes and fibroblasts in Dsg2mut/mut mice were dependent on CCR2+ macrophage recruitment to the heart. These results highlight complex mechanisms of immune injury and regulatory crosstalk between cardiac myocytes, inflammatory cells and fibroblasts in the pathogenesis of ACM.
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Affiliation(s)
- Stephen P Chelko
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, United States of America
| | - Vinay R Penna
- Department of Medicine, Washington University in St. Louis University School of Medicine, St. Louis, United States of America
| | - Morgan Engel
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, United States of America
| | - Emily A Shiel
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, United States of America
| | - Ann M Centner
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, United States of America
| | - Waleed Farra
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, United States of America
| | - Elisa N Cannon
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, United States of America
| | - Maicon Landim-Vieira
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, United States of America
| | - Niccole Schaible
- Departments of Pathology and Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, United States of America
| | - Kory Lavine
- Department of Medicine, Washington University in St. Louis University School of Medicine, St. Louis, United States of America
| | - Jeffrey E Saffitz
- Departments of Pathology and Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, United States of America
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17
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Ediger DS, Brady WJ, Koyfman A, Long B. High risk and low prevalence diseases: Myocarditis. Am J Emerg Med 2024; 78:81-88. [PMID: 38241774 DOI: 10.1016/j.ajem.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/02/2024] [Indexed: 01/21/2024] Open
Abstract
INTRODUCTION Myocarditis is a serious condition that carries with it a high rate of morbidity and mortality. OBJECTIVE This review highlights the pearls and pitfalls of myocarditis, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence. DISCUSSION Myocarditis is an inflammatory syndrome of myocardium, most often resulting from a viral infection, that can cause life-threatening cardiovascular collapse. It has a highly variable presentation and no widely available specific diagnostic test, making it a challenging diagnosis. Emergency clinicians should obtain an electrocardiogram and perform bedside ultrasound to assess cardiac function. Treatment in the ED is largely supportive, focusing on resuscitation, cardiovascular support, cardiology specialist consultation, and appropriate disposition. CONCLUSIONS An understanding of myocarditis can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
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Affiliation(s)
- David S Ediger
- Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA
| | - William J Brady
- Professor, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA.
| | - Alex Koyfman
- Department of Emergency Medicine, UT Southwestern, Dallas, TX, USA
| | - Brit Long
- Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
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18
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Bindi F, Vezzosi T, Sala G, Freccero F, Marmorini P, Bonelli F, Sgorbini M. Evaluation of a smartphone electrocardiograph in healthy foals and comparison to standard base-apex electrocardiography. Vet Res Commun 2024; 48:1227-1232. [PMID: 37947988 PMCID: PMC10998801 DOI: 10.1007/s11259-023-10206-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/22/2023] [Indexed: 11/12/2023]
Abstract
Smartphone-based technology for ECG recording has recently spread as a complementary tool for electrocardiographic screening and monitoring in adult horses and in other animal species. The present study aimed to assess the feasibility and accuracy of a smartphone-based ECG in healthy foals. This was a prospective observational study (authorization n. 45,865/2016) including 22 foals aged less than 21 days. A reference standard base-apex ECG (rECG) was acquired, and a smartphone ECG (sECG) was recorded immediately after by using a smartphone-based single lead electrocardiograph. All ECG tracings were evaluated in a blind fashion by a single board-certified cardiologist, who judged whether the tracings were acceptable for interpretation and performed ECG measurements and diagnosis. The Spearman correlation coefficient, the Cohen's k test and the Bland-Altman test were used to assess the agreement between sECG and rECG. All sECG tracings were acceptable for interpretation. All foals showed sinus rhythm on both rRCG and sECG tracings, with perfect agreement in heart rate classification (κ = 0.87; p < 0.001). No clinically relevant differences were found in the assessment of waves and intervals duration. Concerning P wave and QRS complex polarity, the percentage of agreement between rECG and sECG was 78% and 83%, respectively. About ECG tracing quality, rECG and sECG showed a substantial agreement (κ = 0.624; p < 0.001). In conclusion, the smartphone-based ECG device tested in the present study recorded good quality single-lead ECG tracings in foals, reliable for heart rate and ECG measurements, but different polarity of P waves and QRS complexes was found in some foals in comparison to rECG.
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Affiliation(s)
- Francesca Bindi
- Department of Veterinary Sciences, University of Pisa, via Livornese, San Piero a Grado, 56122, Italy
| | - Tommaso Vezzosi
- Department of Veterinary Sciences, University of Pisa, via Livornese, San Piero a Grado, 56122, Italy.
| | - Giulia Sala
- Department of Veterinary Sciences, University of Pisa, via Livornese, San Piero a Grado, 56122, Italy
| | - Francesca Freccero
- Department of Veterinary Medical Sciences, Università degli Studi di Bologna, Bologna, 40064, Italy
| | | | - Francesca Bonelli
- Department of Veterinary Sciences, University of Pisa, via Livornese, San Piero a Grado, 56122, Italy
| | - Micaela Sgorbini
- Department of Veterinary Sciences, University of Pisa, via Livornese, San Piero a Grado, 56122, Italy
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19
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Spagnolo M, Greco A, Laudani C, Occhipinti G, Rochira C, Imbesi A, Agnello F, Ammirabile N, Faro DC, Finocchiaro S, Mauro MS, Mazzone PM, Landolina D, Capodanno D. Association of trial characteristics with simultaneous publication and its impact on citations and mentions: a cross-sectional study. Rev Esp Cardiol (Engl Ed) 2024; 77:324-331. [PMID: 37848159 DOI: 10.1016/j.rec.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/25/2023] [Indexed: 10/19/2023]
Abstract
INTRODUCTION AND OBJECTIVES Randomized trials are often presented at medical conferences and published simultaneously or later. Predictors of simultaneous publication and its consequences are undetermined. Our aim was to characterize the practice of simultaneous publication, identify its predictors, and evaluate its impact. METHODS In this cross-sectional study, we included randomized trials presented at late-breaking science sessions of major cardiovascular conferences from 2015 to 2021. The association of trial characteristics with the timing of publication was analyzed. The impact of simultaneous vs nonsimultaneous publication was investigated on the number of 1-year citations and 1-month mentions, and the total citations and mentions at the longest observation follow-up. RESULTS Of 478 trials included in the analysis, 48.7% were published simultaneously. Simultaneous publications were more likely to be presented in the main conference room (OR, 6.09; 95%CI, 1.34-36.92; P=.029) and were characterized by a shorter review time (OR, 0.95; 95%CI, 0.91-0.96; P<.001). Simultaneous publications were associated with higher 1-year citations (R2, 43.81; 95%CI, 23.89-63.73; P<.001), 1-month mentions (R2, 132.32; 95%CI, 85.42-179.22; P<.001) and total citations (R2, 222.89; 95%CI, 127.98-317.80; P<.001). CONCLUSIONS Randomized trials presented in the main conference room and with shorter review time were more likely to be published simultaneously. Simultaneous publications were associated with more citations and mentions than nonsimultaneous publications.
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Affiliation(s)
- Marco Spagnolo
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy. https://twitter.com/@marcospagnolo21
| | - Antonio Greco
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy. https://twitter.com/@AGrecoMD
| | - Claudio Laudani
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Giovanni Occhipinti
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Carla Rochira
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Antonino Imbesi
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Federica Agnello
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Nicola Ammirabile
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Denise Cristiana Faro
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Simone Finocchiaro
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Maria Sara Mauro
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Placido Maria Mazzone
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Davide Landolina
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy
| | - Davide Capodanno
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy.
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20
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Okpara S, Lee T, Pathare N, Ghali A, Momtaz D, Ihekweazu U. Cardiovascular Disease in Total Knee Arthroplasty: An Analysis of Hospital Outcomes, Complications, and Mortality. Clin Orthop Surg 2024; 16:265-274. [PMID: 38562631 PMCID: PMC10973625 DOI: 10.4055/cios23224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/16/2023] [Accepted: 09/16/2023] [Indexed: 04/04/2024] Open
Abstract
Background Cardiovascular comorbidities have been identified as a significant risk factor for adverse outcomes following surgery. The purpose of this study was to investigate its prevalence and impact on postoperative outcomes, hospital metrics, and mortality in patients undergoing total knee arthroplasty (TKA). Our hypothesis was that patients with cardiovascular comorbidities would have worse outcomes, greater postoperative complication rates, and increased mortality compared to patients without cardiovascular disease. Methods In this retrospective study, data from the National Inpatient Sample database from 2011 to 2020 were queried for patients who underwent TKA with preexisting cardiac comorbidities, including congestive heart failure (CHF), coronary artery disease (CAD), valvular dysfunction, and arrhythmia. Multivariate logistic regression analyses compared hospital metrics (length of stay, costs, and adverse discharge disposition), postoperative complications, and mortality rates while adjusting for demographic and clinical variables. All statistical analyses were performed using R studio 4.2.2 and Stata MP 17 and 18 with Python package. Results A total of 385,585 patients were identified. Those with preexisting CHF, CAD, valvular dysfunction, or arrhythmias were found to be older and at higher risk of adverse outcomes, including prolonged length of stay, increased hospital charges, and increased mortality (p < 0.001). Additionally, all preexisting cardiac diagnoses led to an increased risk of postoperative myocardial infarction, acute kidney injury (AKI), and need for transfusion (p < 0.001). The presence of valvular dysfunction, arrhythmia, or CHF was associated with an increased risk of thromboembolic events (p < 0.001). The presence of CAD and valvular dysfunction was associated with an increased risk of urologic infection (p < 0.001). Conclusions This study demonstrated that CHF, CAD, valvular dysfunction, and arrhythmia are prevalent among TKA patients and associated with worse hospital metrics, higher risk of perioperative complications, and increased mortality. As our use of TKA rises, a lower threshold for preoperative cardiology referral in older individuals and early preoperative counseling/intervention in those with known cardiac disease may be necessary to reduce adverse outcomes.
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Affiliation(s)
- Shawn Okpara
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Tiffany Lee
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Nihar Pathare
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Abdullah Ghali
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA
| | - David Momtaz
- Department of Orthopedics, UT Health Science Center at San Antonio, San Antonio, TX, USA
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21
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Vrints CJM. Are we ready for prehospital troponin testing by paramedics? Evid Based Nurs 2024; 27:64. [PMID: 37532287 DOI: 10.1136/ebnurs-2023-103753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2023] [Indexed: 08/04/2023]
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22
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López-Bueno R. Better cardiovascular health for a longer life without major diseases. Evid Based Nurs 2024; 27:54. [PMID: 38123955 DOI: 10.1136/ebnurs-2023-103740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Rubén López-Bueno
- Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
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23
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Matoba T, Nakano Y, Katsuki S, Ide T, Matsushima S, Fujino T, Hashimoto T, Shinohara K, Abe K, Hosokawa K, Sakamoto T, Sakamoto I, Kakino T, Ishikita A, Nishizaki A, Sakamoto K, Takase S, Nagayama T, Tohyama T, Nagata T, Kinugawa S, Tsutsui H. Overview of the 87 th Annual Scientific Meeting of the Japanese Circulation Society (JCS2023) - New Challenge With Next Generation. Circ J 2024; 88:615-619. [PMID: 38448007 DOI: 10.1253/circj.cj-24-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
The 87thAnnual Meeting of the Japanese Circulation Society (JCS2023) was held in March 2023 in Fukuoka, Japan, marking the first in-person gathering after the COVID-19 pandemic. With the theme of "New Challenge With Next Generation" the conference emphasized the development of future cardiovascular leaders and technologies such as artificial intelligence (AI). Notable sessions included the Mikamo Lecture on heart failure and the Mashimo Lecture on AI in medicine. Various hands-on sessions and participatory events were well received, promoting learning and networking. Post-event surveys showed high satisfaction among participants, with positive feedback on face-to-face interactions and the overall experience. JCS2023, attended by 17,852 participants, concluded successfully, marking a significant milestone in post-pandemic meetings, and advancing cardiovascular medicine.
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Affiliation(s)
- Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Yasuhiro Nakano
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Shunsuke Katsuki
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takeo Fujino
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Toru Hashimoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Kohtaro Abe
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Kazuya Hosokawa
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takafumi Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Ichiro Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takamori Kakino
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Ayako Ishikita
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Akiko Nishizaki
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Susumu Takase
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Tomomi Nagayama
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takeshi Tohyama
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Takuya Nagata
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
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24
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Brobert G, Ruigomez A, Schink T, Voss A, Herings R, Smits E, Swart KMA, Friberg L, Balabanova Y, Tarenz C, Suzart-Woischnik K, Soriano-Gabarró M, Vora P, Homering M, Dyszynski T, Nagel G, Amaya P, García Rodríguez LA. Challenges and lessons learned from a long-term postauthorisation safety study programme of rivaroxaban in Europe. BMJ Open 2024; 14:e081348. [PMID: 38531587 PMCID: PMC10966716 DOI: 10.1136/bmjopen-2023-081348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/04/2024] [Indexed: 03/28/2024] Open
Abstract
OBJECTIVES To describe opportunities and challenges experienced from the four pharmacoepidemiological database studies included in the rivaroxaban post authorisation safety study (PASS) programme and propose ways to maximise the value of population-based observational research when addressing regulatory requirements. DESIGN PASS programme of rivaroxaban carried out as part of the regulatory postapproval commitment to the European Medicines Agency. SETTING Clinical practice in Germany, the Netherlands, Sweden and the UK (electronic health records)-undertaken by pharmacoepidemiology research teams using country-specific databases with different coding structures. PARTICIPANTS 355 152 patients prescribed rivaroxaban and 338 199 patients prescribed vitamin K antagonists. RESULTS Two major challenges that were encountered throughout the lengthy PASS programme were related to: (1) finalising country-tailored study designs before the extent of rivaroxaban uptake was known, and (2) new research questions that arose during the programme (eg, those relating to an evolving prescribing landscape). RECOMMENDATIONS We advocate the following strategies to help address these major challenges (should they arise in any future PASS): conducting studies based on a common data model that enable the same analytical tools to be applied when using different databases; maintaining early, clear, continuous communication with the regulator (including discussing the potential benefit of studying drug use as a precursor to planning a safety study); consideration of adaptive designs whenever uncertainty exists and following an initial period of data collection; and setting milestones for the review of study objectives.
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Affiliation(s)
| | - Ana Ruigomez
- Spanish Centre for Pharmacoepidemiologic Research, Madrid, Spain
| | - Tania Schink
- Leibniz-Institut für Präventionsforschung und Epidemiologie-BIPS GmbH, Bremen, Germany
| | - Annemarie Voss
- Leibniz-Institut für Präventionsforschung und Epidemiologie-BIPS GmbH, Bremen, Germany
| | - Ron Herings
- PHARMO Institute for Drug Outcomes Research, Utrecht, Netherlands
| | - Elisabeth Smits
- PHARMO Institute for Drug Outcomes Research, Utrecht, Netherlands
| | - Karin M A Swart
- PHARMO Institute for Drug Outcomes Research, Utrecht, Netherlands
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25
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Persad E, Brindefalk B, Rakow A. Blood pressure trends following birth in infants born under 25 weeks' gestational age: a retrospective cohort study. BMJ Paediatr Open 2024; 8:e002438. [PMID: 38531550 DOI: 10.1136/bmjpo-2023-002438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/17/2024] [Indexed: 03/28/2024] Open
Abstract
OBJECTIVE The aim of our study was to describe postnatal blood pressure (BP) trends and evaluate relevant dynamics and outcomes for a subgroup of extremely preterm (EPT) infants. DESIGN Retrospective observational cohort study. SETTING Patients admitted to Karolinska University Hospital Stockholm. PATIENTS EPT infants born between 22+0 and 24+6 weeks' gestational age (GA) undergoing invasive, continuous BP monitoring through an umbilical arterial catheter. MAIN OUTCOME MEASURES Physiological BP trends, the influence of cardiovascular active interventions and fluid boluses on BP, and relevant adverse outcomes, including intraventricular haemorrhage (IVH), necrotising enterocolitis (NEC) and death, were mapped over the first week of life. RESULTS We included 125 infants between January 2009 and November 2021. Mean BP values were 31 mm Hg, 32 mm Hg and 35 mm Hg, at 3 hours, 24 hours and 48 hours, respectively. A pronounced BP dip and nadir were observed around 20 hours, with a mean BP value of 32 mm Hg. 84% received fluid boluses within the first week of life; however, we could not observe any noteworthy change in BP following administration. Only 8% of patients received cardiovascular active drugs, which were too few to infer drug-specific effects. Overall, 48% developed IVH, 15% developed NEC and 25% died. CONCLUSIONS Approximating clinically acceptable mean BP values using GA gives underestimations in these infants. The postnatal BP dip should be regarded as a physiological phenomenon and not automatic grounds for interventions which may momentarily stabilise BP but have no appreciable short-term or long-term effects. Further studies are warranted for improved understanding of clinically relevant trends and outcomes.
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Affiliation(s)
- Emma Persad
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
| | - Björn Brindefalk
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Alexander Rakow
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
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26
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Lu X, Lin X, Cai Y, Zhang X, Meng H, Chen W, Yu P, Chen X. Association of the triglyceride-glucose index with severity of coronary stenosis and in-hospital mortality in patients with acute ST elevation myocardial infarction after percutaneous coronary intervention: a multicentre retrospective analysis cohort study. BMJ Open 2024; 14:e081727. [PMID: 38521531 PMCID: PMC10961576 DOI: 10.1136/bmjopen-2023-081727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/06/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVES To explore the impact of the triglyceride-glucose (TyG) index on the severity of coronary stenosis and the risk of in-hospital mortality in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). DESIGN A multicentre retrospective cohort study. SETTING Patients with STEMI undergoing PCI from three centres in China from 2015 to 2019. PARTICIPANTS A total of 1491 individuals presenting with STEMI were enrolled. PRIMARY OUTCOME MEASURE The degree of coronary stenosis was quantified by the Gensini score (GS). The association between the TyG index and the severity of coronary stenosis was explored by using a logistic regression analysis. Cox proportional hazards regression analyses were used to investigate the associations between the variables and in-hospital mortality. RESULTS We found a significant correlation between the TyG index and the degree of coronary stenosis in the present study. The TyG index was an independent risk factor for the severity of coronary stenosis (OR 2.003, p<0.001). Using the lowest tertile of the TyG (T1) group as a reference, the adjusted ORs for the T2 group and the T3 group and a high GS were 1.732 (p<0.001), 1.968 (p<0.001), respectively, and all p for trend <0.001. For predicting a high GS, the TyG index's area under the curve was 0.668 (95% CI 0.635 to 0.700, p<0.001). Additionally, the TyG index was further demonstrated to be an independent predictor of in-hospital mortality in patients with STEMI (HR 1.525, p<0.001). CONCLUSIONS The TyG index was associated with the severity of coronary stenosis and all-cause in-hospital mortality in patients with STEMI, which may help physicians precisely risk-stratify patients and implement individualised treatment.
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Affiliation(s)
- Xin Lu
- Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xin Lin
- Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yingying Cai
- Department of Cardiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoxiao Zhang
- School of Chinese Medicine, School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Haoyu Meng
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Weiwei Chen
- Department of Vascular Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Peng Yu
- Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiaohu Chen
- Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Oswal A, Bharmappanavara G, Spentzou G. Broad complex rhythm in neonates: is it always a cause for concern? Arch Dis Child Educ Pract Ed 2024; 109:92-94. [PMID: 37833035 DOI: 10.1136/archdischild-2023-326051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/17/2023] [Indexed: 10/15/2023]
Affiliation(s)
- Abhishek Oswal
- Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, UK
| | | | - Georgia Spentzou
- Department of Paediatric Cardiology, Bristol Royal Hospital for Children, Bristol, UK
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Zhang Y, Xie J, Fu E, Cai W, Xu W. Artificial intelligence in cardiology: a bibliometric study. Am J Transl Res 2024; 16:1029-1035. [PMID: 38586089 PMCID: PMC10994793 DOI: 10.62347/hsfe6936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 11/28/2023] [Indexed: 04/09/2024]
Abstract
OBJECTIVES To perform a comprehensive bibliometric analysis of global publications on the applications of artificial intelligence (AI) in cardiology. METHODS Documents related to AI in cardiology published between 2002 and 2022 were retrieved from Web of Science Core Collection. R package "bibliometrix", VOSviewers and Microsoft Excel were applied to perform the bibliometric analysis. RESULTS A total of 4332 articles were included. United States topped the list of countries publishing articles, followed by China and United Kingdom. The Harvard University was the institution that contributed the most to this field, followed by University of California System and University of London. Disease risk prediction, diagnosis, treatment, disease detection, and prognosis assessment were the research hotspots for AI in cardiology. CONCLUSIONS Enhancing cooperation between different countries and institutions is a critical step in leading to breakthroughs in the application of AI in cardiology. It is foreseeable that the application of machine learning and deep learning in various areas of cardiology will be a research priority in the coming years.
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Affiliation(s)
- Yalan Zhang
- Department of Pharmacy, The Second Affiliated Hospital of Fujian Medical UniversityQuanzhou, Fujian, China
| | - Jingwen Xie
- Guangzhou University of Chinese MedicineGuangzhou, Guangdong, China
| | - Enlong Fu
- Guangzhou University of Chinese MedicineGuangzhou, Guangdong, China
| | - Wan Cai
- Shanghai University of Traditional Chinese MedicineShanghai, China
| | - Wentan Xu
- Department of Pharmacy, Jinjiang Municipal HospitalJinjiang, Fujian, China
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Quattrone F, Aimo A, Zuccarino S, Morelli MS, Morfino P, Gioia A, Passino C, Ferrè F, Nuti S, Emdin M. Unmet needs in end-of-life care for heart failure patients. Int J Cardiol 2024; 399:131750. [PMID: 38216064 DOI: 10.1016/j.ijcard.2024.131750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/14/2024]
Abstract
OBJECTIVE To investigate end-of-life (EoL) care for heart failure (HF) in Tuscany (Italy) from healthcare professionals' perspective and identify areas for intervention. METHODS All the directors of Cardiology units (n = 29) and palliative care (PC) units (n = 14) in Tuscany were surveyed on the practices of EoL care. RESULTS Forty-five percent of cardiologists reported that their hospital had some EoL care services for HF patients. However, 75% did not have a multidisciplinary team providing EoL care for HF patients. Sixty-four percent stated that <25% of patients who might benefit from PC did receive it, and 18% stated that no patient received PC. For most of PC specialists, HF patients accounted for <25% of their patients. PC specialists believed that patients with cancer diseases were much more likely to receive PC than HF patients at EoL, and 36% judged that almost no HF patients were timely referred to hospice care. The majority of PC specialists reported that almost no HF patient prepared advance healthcare directives, as opposite to 57% for cancer patients, suggesting poor understanding or acceptance of their terminal condition. CONCLUSIONS The management of HF patients in the EoL stage in Tuscany is often suboptimal. EoL care should be implemented to ensure an adequate quality of life to these patients.
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Affiliation(s)
- Filippo Quattrone
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alberto Aimo
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
| | - Sara Zuccarino
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Maria Sole Morelli
- Bioinformatica Traslazionale e e-Health, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Paolo Morfino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Angela Gioia
- Hospice, UF Cure Palliative, Azienda USL Toscana Nord Ovest, Pisa, Italy
| | - Claudio Passino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Francesca Ferrè
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Sabina Nuti
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Michele Emdin
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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Günay S, Öztürk A, Özerol H, Yiğit Y, Erenler AK. Comparison of emergency medicine specialist, cardiologist, and chat-GPT in electrocardiography assessment. Am J Emerg Med 2024; 80:51-60. [PMID: 38507847 DOI: 10.1016/j.ajem.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/25/2024] [Accepted: 03/12/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION ChatGPT, developed by OpenAI, represents the cutting-edge in its field with its latest model, GPT-4. Extensive research is currently being conducted in various domains, including cardiovascular diseases, using ChatGPT. Nevertheless, there is a lack of studies addressing the proficiency of GPT-4 in diagnosing conditions based on Electrocardiography (ECG) data. The goal of this study is to evaluate the diagnostic accuracy of GPT-4 when provided with ECG data, and to compare its performance with that of emergency medicine specialists and cardiologists. METHODS This study has received approval from the Clinical Research Ethics Committee of Hitit University Medical Faculty on August 21, 2023 (decision no: 2023-91). Drawing on cases from the "150 ECG Cases" book, a total of 40 ECG cases were crafted into multiple-choice questions (comprising 20 everyday and 20 more challenging ECG questions). The participant pool included 12 emergency medicine specialists and 12 cardiology specialists. GPT-4 was administered the questions in a total of 12 separate sessions. The responses from the cardiology physicians, emergency medicine physicians, and GPT-4 were evaluated separately for each of the three groups. RESULTS In the everyday ECG questions, GPT-4 demonstrated superior performance compared to both the emergency medicine specialists and the cardiology specialists (p < 0.001, p = 0.001). In the more challenging ECG questions, while Chat-GPT outperformed the emergency medicine specialists (p < 0.001), no significant statistical difference was found between Chat-GPT and the cardiology specialists (p = 0.190). Upon examining the accuracy of the total ECG questions, Chat-GPT was found to be more successful compared to both the Emergency Medicine Specialists and the cardiologists (p < 0.001, p = 0.001). CONCLUSION Our study has shown that GPT-4 is more successful than emergency medicine specialists in evaluating both everyday and more challenging ECG questions. It performed better compared to cardiologists on everyday questions, but its performance aligned closely with that of the cardiologists as the difficulty of the questions increased.
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Affiliation(s)
- Serkan Günay
- Department of Emergency Medicine, Hitit University Erol Olçok Education and Research Hospital, Çorum, Turkey.
| | - Ahmet Öztürk
- Department of Emergency Medicine, Hitit University Erol Olçok Education and Research Hospital, Çorum, Turkey
| | - Hakan Özerol
- Department of Emergency Medicine, Gaziantep City Hospital, Gaziantep, Turkey
| | - Yavuz Yiğit
- Department of Emergency Medicine, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar.
| | - Ali Kemal Erenler
- Department of Emergency Medicine, Hitit University Erol Olçok Education and Research Hospital, Çorum, Turkey
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31
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Hadad R, Haugaard SB, Christensen PB, Sarac A, Dominguez MH, Sajadieh A. Autonomic Nerve Function Predicts Risk of Early Death after Discharge in Acute Medical Disease. Am J Med 2024:S0002-9343(24)00141-4. [PMID: 38490305 DOI: 10.1016/j.amjmed.2024.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Heart rate variability, a marker of autonomic function, has shown promising prognostic results in specific populations, but has not been tested in a general medical population. We hypothesized that heart rate variability identifies high-risk medical patients early after admission to the hospital. METHODS This was a single-center prospective cohort study of acutely admitted medical patients aged ≥18 years with a life expectancy ≥3 months, included between 2019-2023. Unstable patients needing direct admission to the intensive care unit were excluded. Heart rate variability was recorded within 24 hours of admission for 10 minutes. The standard deviation of normal-normal beats (SDNN) was the primary heart rate variability marker. Low SDNN was defined as the lowest tertile (≤22 ms). The primary outcome was 30-day all-cause mortality. The secondary outcome was 30-day readmission or mortality. RESULTS Among 721 patients included, low SDNN carried an 8-fold greater risk of 30-day mortality in univariate analysis (hazard ratio [HR] 8.3; P = .001); in multivariate analyses a 4-fold greater risk (HR 3.8; P = .037). Low SDNN was associated with the combined outcome of 30-day mortality or readmission (HR 1.5; P = .03) in multivariate analysis. In receiver operating characteristics analyses, low SDNN improved the predictive accuracy of early warning score for 30-day mortality or readmission from 0.63 to 0.71 (P = .008) but did not improve the accuracy for 30-day mortality alone. CONCLUSIONS In patients admitted due to acute medical illness, low heart rate variability predicted 30-day mortality and readmission, suggesting heart rate variability as a tool to identify patients at high and low risk of relevant endpoints.
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Affiliation(s)
- Rakin Hadad
- Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Denmark.
| | - Steen B Haugaard
- Department of Endocrinology, Copenhagen University Hospital of Bispebjerg, Denmark
| | | | - Ayse Sarac
- Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Denmark
| | | | - Ahmad Sajadieh
- Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Denmark
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Kelly CM, Martin JL, Previs MJ. Myosin folding boosts solubility in cardiac muscle sarcomeres. JCI Insight 2024; 9:e178131. [PMID: 38483507 DOI: 10.1172/jci.insight.178131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/05/2024] [Indexed: 04/23/2024] Open
Abstract
The polymerization of myosin molecules into thick filaments in muscle sarcomeres is essential for cardiac contractility, with the attenuation of interactions between the heads of myosin molecules within the filaments being proposed to result in hypercontractility, as observed in hypertrophic cardiomyopathy (HCM). However, experimental evidence demonstrates that the structure of these giant macromolecular complexes is highly dynamic, with molecules exchanging between the filaments and a pool of soluble molecules on the minute timescale. Therefore, we sought to test the hypothesis that the enhancement of interactions between the heads of myosin molecules within thick filaments limits the mobility of myosin by taking advantage of mavacamten, a small molecule approved for the treatment of HCM. Myosin molecules were labeled in vivo with a green fluorescent protein (GFP) and imaged in intact hearts using multiphoton microscopy. Treatment of the intact hearts with mavacamten resulted in an unexpected > 5-fold enhancement in GFP-myosin mobility within the sarcomere. In vitro biochemical assays suggested that mavacamten enhanced the mobility of GFP-myosin by increasing the solubility of myosin molecules, through the stabilization of a compact/folded conformation of the molecules, once disassociated from the thick filaments. These findings provide alternative insight into the mechanisms by which molecules exchange into and out of thick filaments and have implications for how mavacamten may affect cardiac contractility.
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Affiliation(s)
- Colleen M Kelly
- Molecular Physiology and Biophysics Department, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Jody L Martin
- Department of Pharmacology, University of California, Davis, Davis, California, USA
| | - Michael J Previs
- Molecular Physiology and Biophysics Department, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
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Wang X, Du W, Li Y, Yang HH, Zhang Y, Akbar R, Morgan H, Peng T, Chen J, Sadayappan S, Hu YC, Fan Y, Huang W, Fan GC. Macrophage-enriched Sectm1a promotes efficient efferocytosis to attenuate ischemia/reperfusion-induced cardiac injury. JCI Insight 2024; 9:e173832. [PMID: 38456501 DOI: 10.1172/jci.insight.173832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/23/2024] [Indexed: 03/09/2024] Open
Abstract
Efficient clearance and degradation of apoptotic cardiomyocytes by macrophages (collectively termed efferocytosis) is critical for inflammation resolution and restoration of cardiac function after myocardial ischemia/reperfusion (I/R). Here, we define secreted and transmembrane protein 1a (Sectm1a), a cardiac macrophage-enriched gene, as a modulator of macrophage efferocytosis in I/R-injured hearts. Upon myocardial I/R, Sectm1a-KO mice exhibited impaired macrophage efferocytosis, leading to massive accumulation of apoptotic cardiomyocytes, cardiac inflammation, fibrosis, and consequently, exaggerated cardiac dysfunction. By contrast, therapeutic administration of recombinant SECTM1A protein significantly enhanced macrophage efferocytosis and improved cardiac function. Mechanistically, SECTM1A could elicit autocrine effects on the activation of glucocorticoid-induced TNF receptor (GITR) at the surface of macrophages, leading to the upregulation of liver X receptor α (LXRα) and its downstream efferocytosis-related genes and lysosomal enzyme genes. Our study suggests that Sectm1a-mediated activation of the Gitr/LXRα axis could be a promising approach to enhance macrophage efferocytosis for the treatment of myocardial I/R injury.
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Affiliation(s)
| | - Wa Du
- Department of Cancer Biology, and
| | - Yutian Li
- Department of Pharmacology and Systems Physiology
| | - Hui-Hui Yang
- Department of Pharmacology and Systems Physiology
| | - Yu Zhang
- Department of Pharmacology and Systems Physiology
| | - Rubab Akbar
- Department of Pharmacology and Systems Physiology
| | - Hannah Morgan
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Tianqing Peng
- Centre for Critical Illness Research, Lawson Health Research Institute, London, Ontario, Canada
| | - Jing Chen
- Division of Biomedical Informatics and
| | - Sakthivel Sadayappan
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Yueh-Chiang Hu
- Transgenic Animal and Genome Editing Facility, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | - Wei Huang
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Suo E, Driscoll A, Dinh D, Brennan A, Kaye DM, Stub D, Lefkovits J, Reid CM, Hopper I. Comparison of Characteristics and Outcomes in Patients With Acute Decompensated Heart Failure Admitted Under General Medicine and Cardiology Units. Heart Lung Circ 2024:S1443-9506(24)00046-5. [PMID: 38458933 DOI: 10.1016/j.hlc.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/12/2023] [Accepted: 01/11/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Acute decompensated heart failure (ADHF) is a leading cause of cardiovascular disease hospitalisations associated with significant morbidity and mortality. In hospitals, HF patients are typically managed by cardiology or physician teams, with differences in patient demographics and clinical outcomes. This study utilises contemporary HF registry data to compare patient characteristics and outcomes in those with ADHF admitted into General Medicine and Cardiology units. METHODS The Victorian Cardiac Outcomes Registry was utilised to identify patients hospitalised with ADHF 30-day period in each of four consecutive years. We compared patient characteristics, pharmacological management and outpatient follow-up of patients admitted to General Medicine and Cardiology units. Primary outcome measures included in-hospital mortality, 30-day readmission, and 30-day mortality. RESULTS Between 2014 and 2017, a total of 1,253 patients with ADHF admissions were registered, with 53% admitted in General Medicine units and 47% in Cardiology units. General Medicine patients were more likely to be older (82 vs 71 years; p<0.001), female (51% vs 34%; p<0.001), and have higher prevalence of comorbidities and preserved left ventricular function (p<0.001). There were no differences in primary outcome measures between General Medicine and Cardiology in terms of: in-hospital mortality (5.0% vs 3.9%; p=0.35), 30-day readmission (23.4% vs 23.6%; p=0.93), and 30-day mortality (10.0% vs 8.0%; p=0.21). CONCLUSIONS Hospitalised patients with HF continue to have high mortality and rehospitalisation rates. The choice of treatment by General Medicine or Cardiology units, based on the particular medical profile and individual needs of the patients, provides equivalent outcomes.
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Affiliation(s)
| | - Andrea Driscoll
- Deakin University, Melbourne, Vic, Australia; Monash University, Melbourne, Vic, Australia
| | - Diem Dinh
- Monash University, Melbourne, Vic, Australia
| | | | - David M Kaye
- The Alfred Hospital, Melbourne, Vic, Australia; Baker IDI Heart Diabetes Institute, Melbourne, Vic, Australia
| | - Dion Stub
- The Alfred Hospital, Melbourne, Vic, Australia; Monash University, Melbourne, Vic, Australia; Baker IDI Heart Diabetes Institute, Melbourne, Vic, Australia
| | - Jeffrey Lefkovits
- The Alfred Hospital, Melbourne, Vic, Australia; Monash University, Melbourne, Vic, Australia; The Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - Christopher M Reid
- Monash University, Melbourne, Vic, Australia; Curtin University, Perth, WA, Australia
| | - Ingrid Hopper
- The Alfred Hospital, Melbourne, Vic, Australia; Monash University, Melbourne, Vic, Australia.
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Kendall IS, Bates R, Karyiannas S, Sands AJ, Kenny D. Weak femoral pulses post procedure. Arch Dis Child Educ Pract Ed 2024:edpract-2023-326725. [PMID: 38443153 DOI: 10.1136/archdischild-2023-326725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Ian Scott Kendall
- Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Rachel Bates
- Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Steven Karyiannas
- Paediatric Department, Altnagelvin Hospitals Health and Social Services Trust, Londonderry, UK
| | - Andrew J Sands
- Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Damien Kenny
- Paediatric Cardiology Department, Children's Health Ireland, Dublin, Ireland
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Barrington J, Yousef Z, Subbe CP. Wearables in Wales: Entering clinical practice through the backdoor? Future Healthc J 2024; 11:100014. [PMID: 38646060 PMCID: PMC11025048 DOI: 10.1016/j.fhj.2024.100014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
The number of people using wearable technology such as smartwatches and fitness trackers is increasing. Many of these devices can alert the user to a potential arrhythmia such as atrial fibrillation. We aimed to assess potential changes to cardiology practice resulting from their use. An online questionnaire consisting of 12 questions was created and distributed to all consultant cardiologists in Wales. 25 of 102 participants replied, with 92% of these using consumer wearable technology to diagnose atrial fibrillation either 'often' or 'sometimes'. One in four cardiologists received new referrals relating to wearable technology at least weekly. The results demonstrate that cardiologists across Wales are using data from wearable technology in the diagnosis and management of cardiac conditions in the absence of formal guidance. Standardisation of guidelines and pathways is needed to support patients and clinicians and avoid the introduction of wearables through the unregulated backdoor.
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Affiliation(s)
- Jack Barrington
- Betsi Cadwaladr University Health Board, Glan Clwyd Hospital, Bodelwyddan, Rhyl, LL18 5UJ UK
| | - Zaheer Yousef
- Cardiff and Vale University Health Board Cardiff, UK
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37
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Hamza M, Kalsoom S, Riaz A. Comment on "renal denervation for hypertension". Curr Probl Cardiol 2024; 49:102401. [PMID: 38232919 DOI: 10.1016/j.cpcardiol.2024.102401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/19/2024]
Abstract
We have attentively reviewed the article "Renal Denervation for Hypertension" and commend the author's dedication to addressing this intricate subject. However, we wish to highlight a few points that, in our assessment, could enhance the overall quality of the article.
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Affiliation(s)
- Muhammad Hamza
- Department of Medicine, Fazaia Medical College Islamabad, Pakistan.
| | - Sidra Kalsoom
- Department of Medicine, Fazaia Medical College Islamabad, Pakistan
| | - Asma Riaz
- Department of Medicine, Fazaia Medical College Islamabad, Pakistan
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Inam M, Sheikh S, Minhas AMK, Vaughan EM, Krittanawong C, Samad Z, Lavie CJ, Khoja A, D'Cruze M, Slipczuk L, Alarakhiya F, Naseem A, Haider AH, Virani SS. A review of top cardiology and cardiovascular medicine journal guidelines regarding the use of generative artificial intelligence tools in scientific writing. Curr Probl Cardiol 2024; 49:102387. [PMID: 38185435 DOI: 10.1016/j.cpcardiol.2024.102387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/04/2024] [Indexed: 01/09/2024]
Abstract
BACKGROUND Generative Artificial Intelligence (AI) tools have experienced rapid development over the last decade and are gaining increasing popularity as assistive models in academic writing. However, the ability of AI to generate reliable and accurate research articles is a topic of debate. Major scientific journals have issued policies regarding the contribution of AI tools in scientific writing. METHODS We conducted a review of the author and peer reviewer guidelines of the top 25 Cardiology and Cardiovascular Medicine journals as per the 2023 SCImago rankings. Data were obtained though reviewing journal websites and directly emailing the editorial office. Descriptive data regarding journal characteristics were coded on SPSS. Subgroup analyses of the journal guidelines were conducted based on the publishing company policies. RESULTS Our analysis revealed that all scientific journals in our study permitted the documented use of AI in scientific writing with certain limitations as per ICMJE recommendations. We found that AI tools cannot be included in the authorship or be used for image generation, and that all authors are required to assume full responsibility of their submitted and published work. The use of generative AI tools in the peer review process is strictly prohibited. CONCLUSION Guidelines regarding the use of generative AI in scientific writing are standardized, detailed, and unanimously followed by all journals in our study according to the recommendations set forth by international forums. It is imperative to ensure that these policies are carefully followed and updated to maintain scientific integrity.
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Affiliation(s)
- Maha Inam
- Office of the Vice Provost, Research, Aga Khan University, Karachi, Pakistan
| | - Sana Sheikh
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Abdul Mannan Khan Minhas
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Elizabeth M Vaughan
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, United States; Department of Internal Medicine, UTMB, Galveston, TX, United States
| | - Chayakrit Krittanawong
- Leon H. Charney Division of Cardiology, New York University Langone Health, New York, NY, United States
| | - Zainab Samad
- Section of Cardiology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, United States
| | - Adeel Khoja
- Department of Medicine, Aga Khan University, Karachi, Pakistan; Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Melaine D'Cruze
- Institute for Educational Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Leandro Slipczuk
- Cardiology Division, Montefiore Medical Center, Bronx, NY, United States; Albert Einstein College of Medicine, Bronx, NY, United States
| | | | - Azra Naseem
- Institute for Educational Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Adil H Haider
- Dean's Office, Medical College, Aga Khan University Hospital, Karachi, Pakistan
| | - Salim S Virani
- Office of the Vice Provost, Research, Aga Khan University, Karachi, Pakistan; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, United States; Section of Cardiology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan; The Texas Heart Institute, Houston, TX, United States.
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Nakamura Y, Kulkarni NN, Takahashi T, Alimohamadi H, Dokoshi T, Liu E, Shia M, Numata T, Luo EW, Gombart AF, Yang X, Secrest P, Gordts PL, Tsimikas S, Wong GC, Gallo RL. Increased LL37 in psoriasis and other inflammatory disorders promotes LDL uptake and atherosclerosis. J Clin Invest 2024; 134:e172578. [PMID: 38194294 PMCID: PMC10904043 DOI: 10.1172/jci172578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/05/2024] [Indexed: 01/10/2024] Open
Abstract
Patients with chronic inflammatory disorders such as psoriasis have an increased risk of cardiovascular disease and elevated levels of LL37, a cathelicidin host defense peptide that has both antimicrobial and proinflammatory properties. To explore whether LL37 could contribute to the risk of heart disease, we examined its effects on lipoprotein metabolism and show that LL37 enhanced LDL uptake in macrophages through the LDL receptor (LDLR), scavenger receptor class B member 1 (SR-B1), and CD36. This interaction led to increased cytosolic cholesterol in macrophages and changes in expression of lipid metabolism genes consistent with increased cholesterol uptake. Structure-function analysis and synchrotron small-angle x-ray scattering showed structural determinants of the LL37-LDL complex that underlie its ability to bind its receptors and promote uptake. This function of LDL uptake is unique to cathelicidins from humans and some primates and was not observed with cathelicidins from mice or rabbits. Notably, Apoe-/- mice expressing LL37 developed larger atheroma plaques than did control mice, and a positive correlation between plasma LL37 and oxidized phospholipid on apolipoprotein B (OxPL-apoB) levels was observed in individuals with cardiovascular disease. These findings provide evidence that LDL uptake can be increased via interaction with LL37 and may explain the increased risk of cardiovascular disease associated with chronic inflammatory disorders.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Adrian F. Gombart
- Linus Pauling Institute, Department of Biochemistry and Biophysics, Oregon State University, Corvallis, Oregon, USA
| | | | - Patrick Secrest
- Department of Medicine, Division of Endocrinology and Metabolism, and
| | - Philip L.S.M. Gordts
- Department of Medicine, Division of Endocrinology and Metabolism, and
- Glycobiology Research and Training Center, UCSD, La Jolla, California, USA
| | | | - Gerard C.L. Wong
- Department of Bioengineering, UCLA, Los Angeles, California, USA
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Sperotto F, López Guillén JL, Milani GP, Lava SAG. Advances in pediatric cardiology. Eur J Pediatr 2024; 183:983-985. [PMID: 37702768 DOI: 10.1007/s00431-023-05196-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Affiliation(s)
- Francesca Sperotto
- Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - José L López Guillén
- Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada.
- Department of Pediatrics, University of Toronto, Toronto, Canada.
| | - Gregorio P Milani
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Sebastiano A G Lava
- Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
- Heart Failure and Transplantation, Department of Pediatric Cardiology, Great Ormond Street Hospital, London, UK
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Kohs TCL, Weeder BR, Chobrutskiy BI, Kartika T, Moore KK, McCarty OJT, Zonies D, Zakhary B, Shatzel JJ. Predictors of thrombosis during VV ECMO: an analysis of 9809 patients from the ELSO registry. J Thromb Thrombolysis 2024; 57:345-351. [PMID: 38095743 DOI: 10.1007/s11239-023-02909-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 03/26/2024]
Abstract
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a life-saving therapy for critically ill patients, but it carries an increased risk of thrombosis due to blood interacting with non-physiological surfaces. While the relationship between clinical variables and thrombosis remains unclear, our study aimed to identify which factors are most predictive of thrombosis. The Extracorporeal Life Support Organization Registry was queried to obtain a cohort of VV-ECMO patients aged 18 years and older from 2015 to 2019. Patients who were over 80-years-old, at the extremes of weight, who received less than 24 h of ECMO, multiple rounds of ECMO, or had missing data were excluded. Multivariate logistic regression modeling was used to assess predictors of thrombosis and mortality. A total of 9809 patients were included in the analysis, with a mean age of 47.1 ± 15.1 years and an average ECMO run time of 305 ± 353 h. Thrombosis occurred in 19.9% of the cohort, with circuit thrombosis (8.6%) and membrane lung failure (6.1%) being the most common. Multivariate analysis showed that ECMO runs over 14 days (OR: 2.62, P < 0.001) and pregnancy-related complications (OR: 1.79, P = 0.004) were associated with an increased risk of thrombosis. Risk factors for circuit thrombosis included incremental unit increases in the pump flow rate at 24 h (OR: 1.07 [1.00-1.14], P = 0.044) and specific cannulation sites. Increased body weight (OR: 1.02 [1.00-1.04], P = 0.026) and increased duration on ECMO (OR: 3.82 [3.12-4.71], P < 0.001) were predictive of membrane lung failure. Additionally, patients with thrombosis were at increased likelihood of in-hospital mortality (OR: 1.52, P < 0.001). This study identified multiple thrombotic risk factors in VV-ECMO, suggesting that future studies investigating the impact of pregnancy associated complications and ECMO flow rate on hemostasis would be illuminating.
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Affiliation(s)
- Tia C L Kohs
- Department of Biomedical Engineering, Oregon Health & Science University, 3303 S. Bond Avenue, Portland, OR, 97239, USA.
| | - Benjamin R Weeder
- Program in Molecular and Cellular Biology, Oregon Health & Science University, Portland, OR, USA
| | - Boris I Chobrutskiy
- Department of Internal Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Thomas Kartika
- Department of Internal Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Kerry K Moore
- Department of Pharmacy, Oregon Health & Science University, Portland, OR, USA
| | - Owen J T McCarty
- Department of Biomedical Engineering, Oregon Health & Science University, 3303 S. Bond Avenue, Portland, OR, 97239, USA
| | - David Zonies
- Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Bishoy Zakhary
- Department of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Joseph J Shatzel
- Department of Biomedical Engineering, Oregon Health & Science University, 3303 S. Bond Avenue, Portland, OR, 97239, USA
- Division of Hematology and Oncology, Oregon Health & Science University, Portland, OR, USA
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Forzano I, Santulli G. Patent Foramen Ovale: The Unresolved Questions. Top Ital Sci J 2024; 1:10.62684/DMFZ6956. [PMID: 38585657 PMCID: PMC10995646 DOI: 10.62684/dmfz6956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Patent Foramen Ovale (PFO) is a remnant of fetal circulation that could be observed in the 25% of the population worldwide. PFO is associated to numerous clinical conditions as migraines, coronary embolization, transient ischemic attacks, and stroke. The main PFO concerns are related to its correlation to stroke, in particular in young adults. Despite the impact on morbidity that PFO could have, to date there is not clear evidence about its management and treatment. In this narrative review our aim is to summarize the more recent evidence in the literature dealing with PFO, in order to provide an updated overview on this topic.
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Affiliation(s)
- Imma Forzano
- Department of Advanced Biomedical Sciences, Division of Cardiology, "Federico II" University, International Translational Research and Medical Education (ITME) Consortium, Academic Research Unit, 80131, Naples, Italy
| | - Gaetano Santulli
- Department of Advanced Biomedical Sciences, Division of Cardiology, "Federico II" University, International Translational Research and Medical Education (ITME) Consortium, Academic Research Unit, 80131, Naples, Italy
- Department of Medicine (Division of Cardiology), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York City, 10461, NY
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Marchandot B, Faller E, Akladios C, Matsushita K, Bäck M, Jesel L, Schini-Kerth V, Morel O. Fostering Cardio-Endometriosis: A Call to Action for a Comprehensive Understanding of Cardiovascular Disease in Endometriosis. Eur J Prev Cardiol 2024:zwae087. [PMID: 38421615 DOI: 10.1093/eurjpc/zwae087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/06/2024] [Accepted: 02/27/2024] [Indexed: 03/02/2024]
Abstract
Recently, a growing body of evidence has highlighted a concerning link between endometriosis and cardiovascular disease. Endometriosis, a chronic, inflammatory hormone-dependent condition affecting 5 to 10% of reproductive-aged women worldwide, has long been associated with reproductive and gynecological consequences. However, emerging research has suggested that it may also contribute to adverse cardiovascular outcomes. This paper aims to shed light on the importance of recognizing cardio-endometriosis as a new and developing sphere of research in the field of cardiology, thereby urging the medical community to address this pressing issue.
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Affiliation(s)
- Benjamin Marchandot
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Strasbourg, France
- UR 3074 Médecine Cardiovasculaire Translationnelle, Strasbourg, France, CRBS, 67000 Strasbourg, France
| | - Emilie Faller
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg, University Hospital, 1 place de l'Hôpital, 67000 Strasbourg, France
- ENDOALSACE, Strasbourg Expert Center for Endometriosis, Hautepierre Hospital, Strasbourg, University Hospital, 1 place de l'Hôpital, 67000 Strasbourg, France
| | - Cherif Akladios
- Department of Obstetrics and Gynecology, Hautepierre Hospital, Strasbourg, University Hospital, 1 place de l'Hôpital, 67000 Strasbourg, France
- ENDOALSACE, Strasbourg Expert Center for Endometriosis, Hautepierre Hospital, Strasbourg, University Hospital, 1 place de l'Hôpital, 67000 Strasbourg, France
| | - Kensuke Matsushita
- UR 3074 Médecine Cardiovasculaire Translationnelle, Strasbourg, France, CRBS, 67000 Strasbourg, France
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Magnus Bäck
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
- Section of Translational Cardiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Université de Lorraine, Institut National de la Sante et de la Recherche Medicale U1116, Nancy, France
| | - Laurence Jesel
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Strasbourg, France
- UR 3074 Médecine Cardiovasculaire Translationnelle, Strasbourg, France, CRBS, 67000 Strasbourg, France
| | - Valérie Schini-Kerth
- UR 3074 Médecine Cardiovasculaire Translationnelle, Strasbourg, France, CRBS, 67000 Strasbourg, France
| | - Olivier Morel
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Strasbourg, France
- UR 3074 Médecine Cardiovasculaire Translationnelle, Strasbourg, France, CRBS, 67000 Strasbourg, France
- Hanoï Medical University, Vietnam
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44
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Bradford J, Connett GJ. Clubbing and hypoxia in an adolescent male. Arch Dis Child 2024:archdischild-2024-326882. [PMID: 38408859 DOI: 10.1136/archdischild-2024-326882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 02/28/2024]
Affiliation(s)
- Josie Bradford
- University Hospital Southampton NHS Trust, Southampton, UK
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La Vecchia A, Stracquadaino R, Mauri L, Baselli LA, Abdallah R, Cucchetti M, Colli AM, Agostoni C, Dellepiane RM. Risk factors and scores for prediction of coronary artery aneurysms in Kawasaki disease: a European monocentric study. BMC Pediatr 2024; 24:139. [PMID: 38395821 PMCID: PMC10885636 DOI: 10.1186/s12887-024-04623-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Japanese Kawasaki disease (KD) risk scores cannot be adopted in non-Japanese patients. In North American populations a baseline coronary artery Z-score > 2 and the Son score are associated with coronary artery aneurysms (CAAs) at 4 and 8 weeks from disease onset. In European populations, the Kawanet and Kawanet-echo scores are associated with intravenous immunoglobulin resistance. This study aims to evaluate the association between KD risk scores and baseline coronary artery Z-scores with CAAs at one, two, and six months in a European population. METHODS Historical cohort study of all the children diagnosed with KD in a tertiary care hospital in Milan, Italy, between 1st January 2015 and 31st May 2021. Univariate and multivariate (adjusting for age and corticosteroid therapy) logistic regression analyses were used to study the association between the risk scores, a baseline Z-score ≥ 2 and ≥ 2.5 with CAAs. RESULTS Eighty-nine patients were diagnosed with KD at our Centre, and 12 were excluded based on the exclusion criteria. We included 77 patients, 51 (66%) males, and 26 (34%) females, with a median age at presentation of 27 months (IQR 13-46). A baseline Z-score ≥ 2 was correlated with CAAs at one and two-month follow-ups (odds ratio (OR) 10, 95% confidence interval (CI) 2-72, and OR 18, CI 3-357) but not at six-month follow-up. The Son score showed an association with one and two-month follow-up CAAs (OR 3, CI 1.3-7, and OR 3, CI 1.3-8) but not with a six-month follow-up. CONCLUSIONS Patients with a baseline Z-score ≥ 2 are at higher risk for CAAs in the long term. The Son score should be tested in larger European samples. Further studies should keep the observational periods longer than 8 weeks from KD onset.
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Affiliation(s)
- Adriano La Vecchia
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
- Pediatric Area, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via della Commenda 9, Milan, 20122, Italy
| | - Rita Stracquadaino
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Lucia Mauri
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
- Department of Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lucia Augusta Baselli
- Pediatric Area, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via della Commenda 9, Milan, 20122, Italy
| | - Rozan Abdallah
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Martina Cucchetti
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Anna Maria Colli
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
- Department of Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy.
- Pediatric Area, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via della Commenda 9, Milan, 20122, Italy.
| | - Rosa Maria Dellepiane
- Pediatric Area, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via della Commenda 9, Milan, 20122, Italy
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46
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Huang F, Zhang J, Zhou H, Qu T, Wang Y, Jiang K, Liu Y, Xu Y, Chen M, Chen L. B cell subsets contribute to myocardial protection by inducing neutrophil apoptosis after ischemia and reperfusion. JCI Insight 2024; 9:e167201. [PMID: 38290007 DOI: 10.1172/jci.insight.167201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/17/2024] [Indexed: 02/01/2024] Open
Abstract
A robust, sterile inflammation underlies myocardial ischemia and reperfusion injury (MIRI). Several subsets of B cells possess the immunoregulatory capacity that limits tissue damage, yet the role of B cells in MIRI remains elusive. Here, we sought to elucidate the contribution of B cells to MIRI by transient ligation of the left anterior descending coronary artery in B cell-depleted or -deficient mice. Following ischemia and reperfusion (I/R), regulatory B cells are rapidly recruited to the heart. B cell-depleted or -deficient mice exhibited exacerbated tissue damage, adverse cardiac remodeling, and an augmented inflammatory response after I/R. Rescue and chimeric experiments indicated that the cardioprotective effect of B cells was not solely dependent on IL-10. Coculture experiments demonstrated that B cells induced neutrophil apoptosis through contact-dependent interactions, subsequently promoting reparative macrophage polarization by facilitating the phagocytosis of neutrophils by macrophages. The in vivo cardioprotective effect of B cells was undetectable in the absence of neutrophils after I/R. Mechanistically, ligand-receptor imputation identified FCER2A as a potential mediator of interactions between B cells and neutrophils. Blocking FCER2A on B cells resulted in a reduction in the percentage of apoptotic neutrophils, contributing to the deterioration of cardiac remodeling. Our findings unveil a potential cardioprotective role of B cells in MIRI through mechanisms involving FCER2A, neutrophils, and macrophages.
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Affiliation(s)
- Fangyang Huang
- Department of Cardiology
- State Key Laboratory of Biotherapy and Cancer Center
- Laboratory of Heart Valve Disease
| | - Jialiang Zhang
- Department of Cardiology
- Laboratory of Heart Valve Disease
| | - Hao Zhou
- Laboratory of Heart Valve Disease
| | | | - Yan Wang
- Department of Cardiology
- Laboratory of Heart Valve Disease
| | - Kexin Jiang
- Department of Cardiology
- West China School of Medicine, and
| | | | | | - Mao Chen
- Department of Cardiology
- Laboratory of Heart Valve Disease
| | - Li Chen
- Laboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
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Vervoort D, Elfaki LA, Servito M, Herrera-Morales KY, Kanyepi K. Redefining global cardiac surgery through an intersectionality lens. Med Humanit 2024; 50:109-115. [PMID: 38388185 DOI: 10.1136/medhum-2023-012801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 02/24/2024]
Abstract
Although cardiovascular diseases are the leading cause of morbidity and mortality worldwide, six billion people lack access to safe, timely and affordable cardiac surgical care when needed. The burden of cardiovascular disease and disparities in access to care vary widely based on sociodemographic characteristics, including but not limited to geography, sex, gender, race, ethnicity, indigeneity, socioeconomic status and age. To date, the majority of cardiovascular, global health and global surgical research has lacked intersectionality lenses and methodologies to better understand access to care at the intersection of multiple identities and traditions. As such, global (cardiac) surgical definitions and health system interventions have been rooted in reductionism, focusing, at most, on singular sociodemographic characteristics. In this article, we evaluate barriers in global access to cardiac surgery based on existing intersectionality themes and literature. We further examine intersectionality methodologies to study access to cardiovascular care and cardiac surgery and seek to redefine the definition of 'global cardiac surgery' through an intersectionality lens.
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Affiliation(s)
- Dominique Vervoort
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Lina A Elfaki
- University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
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Jiang Z, Guo C, Liu Q, Tian Y, Tian L, Yang Y, Wang J, Chen C, Zheng Y, Li Y, Ou Q, Yang L. Outcomes of single-procedure radiofrequency catheter ablation for idiopathic ventricular arrhythmias: a single-centre retrospective cohort study. BMJ Open 2024; 14:e081815. [PMID: 38382956 PMCID: PMC10882318 DOI: 10.1136/bmjopen-2023-081815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES Radiofrequency catheter ablation is the first-line treatment for idiopathic premature ventricular complexes (PVCs) and ventricular tachycardias (VTs). However, the outcomes were less compared among the categories. The study aims to assess the effectiveness and safety of catheter ablation for idiopathic PVC/VTs in a single high-volume centre, using the right ventricular outflow tract (RVOT) as a reference. DESIGN Retrospective cohort study. SETTING Patient data were collected from a tertiary hospital in Guizhou, China. PARTICIPANTS Between September 2013 and September 2022, 1028 patients (male: 41.3%; age: 46.5±15.6 years) who underwent the first catheter ablation for idiopathic monomorphic PVC/VTs were enrolled. OUTCOME MEASURES Acute success, procedure-related complications, and long-term recurrence were assessed. Antiarrhythmic drugs (AADs) were not administrated after procedures unless recurrence was identified. RESULTS The overall acute success rate was 90.3%, with 368 patients (35.8%) experiencing left ventricular PVC/VTs. No cases of third-degree atrioventricular block or death were reported. Complications were more common in patients with left ventricular PVC/VTs than those with right-sided ones (4.6% vs 0.1%, p<0.001). A total of 926 patients (90.1%) were followed up for an average of 9.7±3.7 months, and only the PVC/VTs category was found to be associated with long-term success rates. The RVOT, endocardial left ventricular outflow tract (endoLVOT), tricuspid annulus (TA) free wall, posterior septum and fascicular VT had long-term success rates exceeding 85%. Other types of PVC/VTs showed significantly higher risks of recurrence. CONCLUSIONS Besides RVOT and fascicular VT, single-procedure catheter ablation without AADs is highly effective for endoLVOT, TA-free wall and posterior septum. Patients with left ventricular PVC/VTs have higher complication risks compared with right ones.
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Affiliation(s)
- Zhi Jiang
- Cardiology Department, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
- Guizhou Provincial Cardiovascular Disease Institute, Guiyang, China
| | - Chuxian Guo
- Guizhou Medical University, Guiyang, Guizhou, China
| | - Qifang Liu
- Cardiology Department, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
- Guizhou Provincial Cardiovascular Disease Institute, Guiyang, China
| | - Ye Tian
- Cardiology Department, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
- Guizhou Provincial Cardiovascular Disease Institute, Guiyang, China
| | - Longhai Tian
- Cardiology Department, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
- Guizhou Provincial Cardiovascular Disease Institute, Guiyang, China
| | - Ying Yang
- Cardiology Department, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
- Guizhou Provincial Cardiovascular Disease Institute, Guiyang, China
| | - Junxian Wang
- Cardiology Department, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
- Guizhou Provincial Cardiovascular Disease Institute, Guiyang, China
| | - Chunyan Chen
- Cardiology Department, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
- Guizhou Provincial Cardiovascular Disease Institute, Guiyang, China
| | - Yaxi Zheng
- Cardiology Department, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
- Guizhou Provincial Cardiovascular Disease Institute, Guiyang, China
| | - Yu Li
- Guizhou Medical University, Guiyang, Guizhou, China
| | - Qiaoqiao Ou
- Guizhou Medical University, Guiyang, Guizhou, China
| | - Long Yang
- Cardiology Department, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
- Guizhou Provincial Cardiovascular Disease Institute, Guiyang, China
- Guizhou Medical University, Guiyang, Guizhou, China
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Jones L, Park J, Dliso S, Hawcutt D, Shantsila A, Lip GYH, Blair JC. Diurnal salivary cortisol and cortisone concentrations in girls with Turner syndrome and healthy controls: a preliminary report. Arch Dis Child 2024; 109:258-259. [PMID: 38071507 DOI: 10.1136/archdischild-2023-326270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 02/21/2024]
Affiliation(s)
- Lily Jones
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Julie Park
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- Department of Endocrinology, Alder Hey Children's Hospital Endocrinology, Liverpool, UK
| | - Silothabo Dliso
- Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK
| | - Daniel Hawcutt
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- National Institute for Health Research, Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK
| | - Alena Shantsila
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool, UK
- Danish Center for Clinical Health Services Research, Aalborg, Denmark
| | - Joanne C Blair
- Endocrinology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
- NIHR Alder Hey Clinical Research Facility, Liverpool, UK
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Hernández-Pinilla A, Clua-Espuny JL, Satué-Gracia EM, Pallejà-Millán M, Martín-Luján FM. Protocol for a multicentre and prospective follow-up cohort study of early detection of atrial fibrillation, silent stroke and cognitive impairment in high-risk primary care patients: the PREFA-TE study. BMJ Open 2024; 14:e080736. [PMID: 38373864 PMCID: PMC10882295 DOI: 10.1136/bmjopen-2023-080736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common type of cardiac arrhythmia. Future estimations suggest an increase in global burden of AF greater than 60% by 2050. Numerous studies provide growing evidence that AF is not only associated with stroke but also with cognitive impairment and dementia. AIM The main goal is to assess the impact of the combined use of cardiac rhythm monitoring devices, echocardiography, biomarkers and neuroimaging on the early diagnosis of AF, silent strokes and cognitive decline, in subjects at high risk of AF. METHODS AND ANALYSIS Two-year follow-up of a cohort of individuals aged 65-85 years at high risk for AF, with no prior diagnosis of either stroke or dementia. The study involves baseline echocardiography, biomarkers, and neuroimaging, yearly cardiac monitoring, and semiannual clinical assessments. Different parameters from these tests will be analysed as independent variables. Throughout the study period, primary outcomes: new diagnoses of AF, stroke and cognitive impairment, along with any clinical and therapeutic changes, will be registered. A first descriptive and bivariate statistical analysis, appropriate to the types of variables, will be done. The information obtained from the data analysis will encompass adjusted risk estimates along with 95% confidence intervals. Event risk predictions will rely on multivariate Cox proportional hazards regression models. The predictive value of the model will be evaluated through the utilisation of receiver operating characteristic curves for area under the curve calculation. Additionally, time-to-event analysis will be performed using Kaplan-Meier curves. ETHICS AND DISSEMINATION This study protocol has been reviewed and approved by the Independent Ethics Committee of the Foundation University Institute for Primary Health Care Research-IDIAP Jordi Gol (expedient file 22/090-P). The authors plan to disseminate the study results to the general public through various scientific events. Publication in open-access journals and presentations at scientific congresses, seminars and meetings is also foreseen. TRIAL REGISTRATION NUMBER NCT05772806.
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Affiliation(s)
- Alba Hernández-Pinilla
- Primary Health Care Centre Reus 2 (CAP Sant Pere), Primary Care Service Camp de Tarragona, Institut Catala de la Salut, Reus, Spain
- Biomedicine Doctoral Programme, Campus Tarragona, Rovira i Virgili University, Reus, Spain
| | - Jose-Luis Clua-Espuny
- Primary Health Care Centre Tortosa 1-Est, Institut Catala de la Salut Gerencia Territorial Terres de l'Ebre, Tortosa, Spain
- Unitat de Suport a la Recerca Terres de l'Ebre, Institut de Recerca en Atenció Primària Jordi Gol, Tortosa, Spain
| | - Eva María Satué-Gracia
- Primary Care Service Camp de Tarragona, Institut Catala De La Salut, Reus, Spain
- Unitat de Suport a la Recerca Camp de Tarragona-Reus, Institut de Recerca en Atenció Primària Jordi Gol, Reus, Spain
| | - Meritxell Pallejà-Millán
- Unitat de Suport a la Recerca Camp de Tarragona-Reus, Institut de Recerca en Atenció Primària Jordi Gol, Reus, Spain
| | - Francisco M Martín-Luján
- Primary Care Service Camp de Tarragona, Institut Catala De La Salut, Reus, Spain
- Unitat de Suport a la Recerca Camp de Tarragona-Reus, Institut de Recerca en Atenció Primària Jordi Gol, Reus, Spain
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