Clinical Cardiology最新文献

{"title":"Melatonin as a Novel Drug to Improve Cardiac Function and Quality of Life in Heart Failure Patients: A Systematic Review and Meta-Analysis","authors":"Abolfazl Sam Daliri,&nbsp;Nima Goudarzi,&nbsp;Arshia Harati,&nbsp;Kourosh Kabir","doi":"10.1002/clc.70107","DOIUrl":"https://doi.org/10.1002/clc.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Heart failure as an advanced cardiac disease has a high incidence and prevalence in all societies nowadays. Many drugs and treatment methods have been discovered for improving heart failure patients' conditions till now in this way melatonin therapy is one of the less-known methods rarely used by clinicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To investigate the positive effect of melatonin on heart failure development, we conducted a systematic review and meta-analysis by searching valid databases with keywords based on the protocol. Based on the eligible criteria, four articles were selected for data synthesis and analysis after scanning the title and/or abstract and reading full-text.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>As a result of analysis, increasing ejection fraction (Mean difference: 2.39 [−1.82, 6.59] <i>p</i> = 0.27), <i>NYHA</i> (New York Heart Association Functional Class) (Odds ratio: 4.84 [1.00, 23.44] <i>p</i> = 0.05), and significant elevation of quality of life (Mean difference: −5.95 [−9.54, −2.35] <i>p</i> = 0.001) were observed. As the effect of melatonin, fatigue, and <i>NT-Pro BNP</i> were reduced but on the contrary sleep quality, appetite, and <i>FMD</i> (Flow-Mediated Dilation) significantly increased.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Thus, melatonin, by increasing psychologic parameters and cardiac potency, could be advised as a novel drug for treatment and palliating heart failure patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Potential Relationship Between HALP Score and In-Hospital Mortality in Acute Heart Failure","authors":"Akbulut Muge,&nbsp;Izci Cenan,&nbsp;Ozyuncu Nil,&nbsp;K. Esenboga","doi":"10.1002/clc.70108","DOIUrl":"https://doi.org/10.1002/clc.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Acute heart failure (AHF) is associated with a dismal prognosis that is even poorer than the majority of cancer types. Therefore, clinical indicators that can aid in determining the prognosis of heart failure are of interest. Multiple risk prediction tools with varying sensitivity and specificities have been introduced before. In the current study, we aimed to evaluate whether the HALP score could accurately predict in-hospital mortality in patients with AHF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated the medical records of a total of 153 patients admitted to our institution between August 2016–May 2018 for acute heart failure. The patients were divided into two groups: Group 1 (patients who died during hospital admission) and Group 2 (patients who were discharged from the hospital). The HALP score was calculated as: hemoglobin (g/L) x albumin (g/L) x lymphocytes (/L)/platelets (/L) for each patient. The two groups were compared in terms of HALP scores. The receiver operator characteristic (ROC) curve was utilized to assess the predictive performance of HALP on in-hospital mortality in AHF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients who died during admission had lower HALP scores compared with the patients who were discharged uneventfully. A ROC curve analysis was performed to predict the optimal cut-off value of the HALP score. The area under the curve (AUC), sensitivity, specificity, and the cut-off value were 0.650, 43%, 57%, 21,5 respectively (<i>p</i> = 0.014).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite all evolving treatment modalities, heart failure-related mortality rates remain high. Prompt recognition of patients with an unfavorable prognosis is vital for the timely implementation of disease-modifying therapeutic interventions. The HALP score, being a readily calculable tool, serves as an effective means to pinpoint individuals at a heightened risk of in-hospital mortality. We believe that the HALP score holds promise as a practical tool for predicting in-mortality among patients admitted for AHF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Denervation Effects on Blood Pressure in Resistant and Uncontrolled Hypertension: A Meta-Analysis of Sham-Controlled Randomized Clinical Trials","authors":"Hamidreza Soleimani,&nbsp;Babak Sattartabar,&nbsp;Bahar Parastooei,&nbsp;Reza Eshraghi,&nbsp;Roozbeh Nazari,&nbsp;Soroush Najdaghi,&nbsp;Sara Hobaby,&nbsp;Ali Etemadi,&nbsp;Mehrdad Mahalleh,&nbsp;Maryam Taheri,&nbsp;Adrian V. Hernandez,&nbsp;Toshiki Kuno,&nbsp;Homa Taheri,&nbsp;Robert J. Siegel,&nbsp;Florian Rader,&nbsp;Behnam N. Tehrani,&nbsp;Mohammad Hossein Mandegar,&nbsp;Ehsan Safaee,&nbsp;Pouya Ebrahimi,&nbsp;Kaveh Hosseini","doi":"10.1002/clc.70104","DOIUrl":"https://doi.org/10.1002/clc.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although some guidelines recommend Renal denervation (RDN) as an alternative to anti-HTN medications, there are concerns about its efficacy and safety. We aimed to evaluate the benefits and harms of RDN in a systematic review and meta-analysis of sham-controlled randomized clinical trials (RCT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Databases were searched until September 10th, 2024, to identify RCTs evaluating RDN for treating URH versus sham control. The primary outcomes were the change in office and ambulatory 24-h systolic (SBP) and diastolic blood pressure (DBP). Secondary outcomes were changes in daytime and nighttime SBP and DBP, home BP, number of anti-HTN drugs, and related complications. Mean differences (MD) and relative risks (RR) described the effects of RDN on BP and complications, respectively, using random effects meta-analyses. GRADE methodology was used to assess the certainty of evidence (COE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found 16 included sham-controlled RCTs [RDN (<i>n</i> = 1594) vs. sham (<i>n</i> = 1225)]. RDN significantly reduced office SBP (MD −4.26 mmHg, 95% CI: −5.68 to −2.84), 24 h ambulatory SBP (MD −2.63 mmHg), office DBP (MD −2.15 mmHg), 24-h ambulatory DBP (MD −1.27 mmHg), and daytime SBP and DBP (MD −3.29 and 2.97 mmHg), compared to the sham. The rate of severe complications was low in both groups (0%–2%). The heterogeneity was high among most indices, and CoE was very low for most outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RDN significantly reduced several SBP and DBP outcomes versus sham without significantly increasing complications. This makes RDN a potentially effective alternative to medications in URH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Year Follow-Up of Patients With Atrial Fibrillation Receiving Edoxaban in Routine Clinical Practice: Results From the Global ETNA-AF Program","authors":"Raffaele De Caterina,&nbsp;Martin Unverdorben,&nbsp;Cathy Chen,&nbsp;Eue-Keun Choi,&nbsp;Yukihiro Koretsune,&nbsp;Doralisa Morrone,&nbsp;Ladislav Pecen,&nbsp;Peter Bramlage,&nbsp;Chun-Chieh Wang,&nbsp;Takeshi Yamashita,&nbsp;Paulus Kirchhof","doi":"10.1002/clc.70091","DOIUrl":"https://doi.org/10.1002/clc.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Randomized clinical trials demonstrated similar efficacy and improved safety of direct oral anticoagulants versus warfarin in patients with atrial fibrillation (AF). Long-term data in routine clinical practice are needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis</h3>\u0000 \u0000 <p>Patients with AF receiving edoxaban at baseline continue to have low annualized effectiveness and safety event rates in the second year of follow-up, with regional variations observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Global ETNA-AF program is a prospective, noninterventional study of patients with AF receiving edoxaban. Patient characteristics and annualized clinical event rates were assessed overall and by region across the 2-year follow-up. Annualized event rates of bleeding and thromboembolic events were assessed within the first year and conditionally in patients who were event-free up to 12 months in the second year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This analysis comprised 26 805 patients from Europe (<i>n</i> = 13 164), Japan (<i>n</i> = 10 342), and non-Japanese Asian regions (<i>n</i> = 3299). Patients from Europe had the highest burden of comorbidities. The annualized event rates for major bleeding, any stroke, all-cause death, and cardiovascular death varied by region. The global annualized event rates in the first and second year were 1.31%/year and 0.86%/year for major bleeding, 1.06%/year and 0.65%/year for any stroke, 0.84%/year and 0.73%/year for cardiovascular death, and 3.05%/year and 3.18%/year for all-cause death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Annualized event rates for any stroke and major bleeding remained low through 2-year follow-up for patients with AF receiving edoxaban at baseline. Differences in annualized event rates for all-cause and cardiovascular mortality between Europe, Japan, and non-Japanese Asian regions may reflect variations in baseline characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Europe, NCT02944019; Japan, UMIN000017011; Korea/Taiwan, NCT02951039; Hong Kong, NCT03247582; and Thailand, NCT03247569.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tragus Nerve Stimulation Attenuates Postural Orthostatic Tachycardia Syndrome in Post COVID-19 Infection","authors":"Zhuo Wang,&nbsp;Tongjian Zhu,&nbsp;Xuping Li,&nbsp;Xin Lai,&nbsp;Mingxian Chen","doi":"10.1002/clc.70110","DOIUrl":"https://doi.org/10.1002/clc.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postural orthostatic tachycardia syndrome (POTS) is characterized by symptoms of orthostatic intolerance and is frequently observed in post-COVID conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We conducted controlled, prospective, and randomized clinical trials to explore the potential therapeutic benefits of low-level tragus stimulation (LL-TS) in patients with POTS following COVID-19 infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study enrolled 57 participants with confirmed post-acute COVID-19 who had been diagnosed with POTS. The ear clip was attached to the right tragus of the patients for stimulation (20 Hz with a 1-ms duration) or sham stimulation. They were divided into two groups: the sham LL-TS group (sham stimulation, <i>n</i> = 26) and the LL-TS group (stimulation for 1 month, <i>n</i> = 31). LL-TS was performed 1 h twice daily for 1 month. Postural tachycardia was evaluated at baseline, 1-month visit, and 1-year visit. Heart rate variability (HRV) and plasma neuropeptide Y (NPY) were evaluated at respective time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of participants was 31.9 ± 7.2 years (61.4% female). LL-TS significantly attenuated the increase in heart rate from supine to a 10-min stand, as well as the average and maximum heart rates after 1 month of treatment. LL-TS also significantly reduced NPY levels. In addition, LL-TS significantly increased the high frequency (HF), but decreased the low frequency (LF) and LF/HF ratio during the postural test (all <i>p</i> &lt; 0.01). These effects persisted during the 1-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LL-TS may be a promising therapeutic approach for attenuating autonomic imbalance in patients with POTS following COVID-19 infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedural Complications and Inpatient Outcomes of Leadless Pacemaker Implantations in Rural Versus Urban Hospitals in the United States","authors":"Amanda Nguyen,&nbsp;Muhammad Zia Khan,&nbsp;Yasar Sattar,&nbsp;Waleed Alruwaili,&nbsp;Sameh Nassar,&nbsp;Mohamed Alhajji,&nbsp;Bandar Alyami,&nbsp;Joseph Neely,&nbsp;Zain Ul Abideen Asad,&nbsp;Siddharth Agarwal,&nbsp;Sameer Raina,&nbsp;Sudarshan Balla,&nbsp;Bao Nguyen,&nbsp;Dali Fan,&nbsp;Douglas Darden,&nbsp;Muhammad Bilal Munir","doi":"10.1002/clc.70081","DOIUrl":"https://doi.org/10.1002/clc.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Disparities in invasive cardiovascular care and outcomes in rural and urban hospitals across the United States have been reported. However, studies investigating disparities regarding leadless pacemaker outcomes and complications based on hospital location are lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate differences in outcomes and complications related to leadless pacemaker implantations among rural and urban hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The National Inpatient Sample was used to identify patients who underwent leadless pacemaker implantations in the United States from 2016 to 2020. Study endpoints assessed included procedural complications and inpatient outcomes of leadless pacemaker implantations among rural and urban hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 2016 to 2020, there were a total of 28 340 and 665 leadless pacemaker implantations in urban and rural hospitals, respectively. Baseline characteristics were similar among both groups, with notable exceptions of higher rates of coagulopathies (13.2% vs. 6.8%, <i>p</i> &lt; 0.001) and peripheral vascular disorders (10.4% vs. 4.5%, <i>p</i> &lt; 0.001) among urban patients. After multivariable adjustment for confounding variables, leadless pacemaker placements occurring in rural hospitals had lower odds of major complications (aOR 0.59, 95% CI 0.41–0.86), but increased odds of inpatient mortality (aOR 1.70, 95% CI 1.21–2.40). Overall, rural leadless pacemaker recipients experienced lower rates of discharge to home, as well as lower costs and length of stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A majority of leadless pacemaker implantations occurred in urban hospitals in the United States. Important differences in outcomes were described based on urban and rural hospital location. Further investigation and policy changes are encouraged to promote improved cardiovascular care and outcomes in rural residents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prognostic Value of Platelet-Albumin-Bilirubin Score in Patients Undergoing Transcatheter Aortic Valve Replacement","authors":"Xueting Duan,&nbsp;Liangzhen Qu,&nbsp;Han Chen","doi":"10.1002/clc.70100","DOIUrl":"https://doi.org/10.1002/clc.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcatheter aortic valve replacement (TAVR) has emerged as a well-established treatment option for patients with aortic valve stenosis and/or regurgitation. However, risk stratification in patients indicated for TAVR remains challenging. This study aimed to evaluate the predictive value of the platelet-albumin-bilirubin (PALBI) score on post-TAVR mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total number of 812 patients with aortic stenosis and/or aortic regurgitation who underwent TAVR were consecutively enrolled in this study. PALBI score was calculated based on preoperative baseline bilirubin levels, albumin levels, and platelet counts. Patients were categorized into two groups according to the median PALBI score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age of the study population at baseline was 74 (IQR: 69.00–80.00) years, and 58.6% were male. During the whole follow-up period, all-cause death was observed in 60 (7.4%) patients and 30 (3.7%) patients died due to cardiovascular events. According to multivariate analysis, a high PALBI score was independently associated with all-cause mortality (HR = 2.679, 95% CI: 1.456–4.930, <i>p</i> = 0.002) and cardiovascular mortality (HR = 2.785, 95% CI: 1.133–6.849, <i>p</i> = 0.026). ROC curve analysis showed a significant predictive value of the PALBI score for all-cause mortality (AUC = 0.633, 95% CI: 0.563–0.704, <i>p</i> = 0.001). Furthermore, the PALBI score strengthens the predictive value of the Society of Thoracic Surgeons (STS) score for all-cause death after TAVR (STS score vs. PALBI score + STS score: AUC: 0.742 vs. 0.768).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A high PALBI score was associated with increased all-cause and cardiovascular mortality in patients after TAVR. PALBI score can further enhance the predictive potential of STS score for all-cause mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Clinical Study of Precision Chemoablation for Hypertrophic Obstructive Cardiomyopathy Without Large Interventricular Septal Branches","authors":"Xinnan Cao,&nbsp;Rong Huang,&nbsp;Haihua Geng,&nbsp;Hu Liu,&nbsp;Yi Gu,&nbsp;Peishu Xu,&nbsp;Yufeng Chen,&nbsp;Jian Yao,&nbsp;Hongzhuan Sheng","doi":"10.1002/clc.70095","DOIUrl":"https://doi.org/10.1002/clc.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to evaluate the clinical efficacy and safety of ultrasound-guided percutaneous septal precision chemical ablation in the treatment of hypertrophic obstructive cardiomyopathy (HOCM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From December 2020 to July 2024, 27 patients with HOCM without large target septal branches (diffuse multiple branches, all less than 1 mm in diameter) were enrolled and underwent ultrasound-guided percutaneous septal chemical ablation. Intraoperative left ventricular outflow tract gradient (LVOTG), postoperative cardiac troponin I (cTnI), complications, and changes in the 36-Item Short Form Survey (SF-36) score, New York Heart Association (NYHA) functional classification and echocardiography parameters in 1 year post-PTSMA were monitored and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Immediate postoperative LVOTG values monitored by catheter and echocardiography were both significantly decreased (both <i>p</i> &lt; 0.05) in the 27 patients, whereas the cTnI level was increased after PTSMA treatment (<i>p</i> &lt; 0.05). One patient developed transient complete right bundle branch block during the procedure. At the 1-year follow-up, these patients showed significantly increased scores in all the eight domains of the SF-36 scale, and markedly improvement in echocardiography-based LVOTG value (<i>p</i> &lt; 0.05) and NYHA functional classification (<i>p</i> &lt; 0.05). However, no significant change were observed in the mean interventricular septal thickness (IVSTh) and left ventricular ejection fraction (LVEF) before and after operation (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ultrasound-guided precision PTSMA with gelatin sponge is a safe and effective treatment approach for HOCM patients, which can reduce the left ventricular outflow tract obstruction and greatly improve the life quality of the patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right Ventricular Systolic Dysfunction Predicts Recovery of Left Ventricular Systolic Function and Reduced Quality of Life in Patients With Arrhythmia-Induced Cardiomyopathy","authors":"Thomas Körtl,&nbsp;Franziska Mühleck,&nbsp;Paul Baum,&nbsp;Markus Resch,&nbsp;Christine Meindl,&nbsp;Ekrem Üçer,&nbsp;Lars S. Maier,&nbsp;Rolf Wachter,&nbsp;Samuel Sossalla,&nbsp;Christian Schach","doi":"10.1002/clc.70070","DOIUrl":"https://doi.org/10.1002/clc.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Arrhythmia-induced cardiomyopathy (AIC) is an underrecognized condition resulting in left ventricular systolic dysfunction (LVSD) that is primarily caused by atrial fibrillation (AFib). The relationship between AIC, right ventricular (RV) function, and quality of life (QoL) has not been well studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a post-hoc analysis of our AIC trial in which we prospectively screened for patients with tachyarrhythmia and newly diagnosed, otherwise unexplained LVSD. Following rhythm restoration, patients were followed up at 2, 4, and 6 months. Only patients with persistent sinus rhythm were analyzed. RV function was assessed via echocardiography (tricuspid annular plane systolic excursion [TASPE] and fractional area change [FAC]) and QoL by the Minnesota Living with Heart Failure Questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of a total of 50 patients recovering from LVSD, 41 were diagnosed with AIC and 9 with non-AIC. Initially, RV function was reduced in the AIC group and recovered after rhythm restoration, whereas no relevant changes were noted in the non-AIC group. QoL was reduced in both groups and also improved after rhythm restoration. Regression analysis identified low TAPSE as a predictive parameter for AIC diagnosis and worse QoL in AIC patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We demonstrated that RV function and QoL are impaired in patients with AIC. Six months after rhythm restoration, TAPSE may serve as an early indicator of AIC while also correlating with QoL. This underscores the importance of detailed echocardiographic evaluation with a focus on RV function in patients with concomitant tachyarrhythmia and LVSD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Neutrophil-to-Lymphocyte Ratio Is an Independent Inflammatory Biomarker for Adverse Events in Patients With Atrial Fibrillation: Insights From the Murcia AF Project II (MAFP-II) Cohort Study","authors":"Eva Soler-Espejo,&nbsp;Francisco Marín,&nbsp;Raquel López-Gálvez,&nbsp;María Pilar Ramos-Bratos,&nbsp;María Sánchez-Villalobos,&nbsp;María Asunción Esteve-Pastor,&nbsp;Gregory Y. H. Lip,&nbsp;José Miguel Rivera-Caravaca,&nbsp;Vanessa Roldán","doi":"10.1002/clc.70102","DOIUrl":"https://doi.org/10.1002/clc.70102","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Systemic inflammation plays a central role in atrial fibrillation (AF). The neutrophil-to-lymphocyte ratio (NLR) is a simple hematological index that has been shown to be associated with prognosis in different pathologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis</h3>\u0000 \u0000 <p>The NLR is associated with an increased risk of adverse events in patients with AF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included a prospective cohort of AF patients who started vitamin K antagonists (VKAs) therapy between July 2016 and June 2018. NLR was assessed at baseline and classified into three categories: low (&lt; 3), moderate (3–5), and high (&gt; 5). During a 2-year follow-up period, all cardiovascular deaths, all-cause deaths, and net clinical outcomes (NCO; either ischemic stroke/transient ischemic attack, major bleeding or all-cause death), were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1050 patients were included (51.4% women; median age 77 years). NLR was available in 936 patients: 507 (54.2%) had low NLR (&lt; 3), 239 (25.5%) had moderate NLR (3–5), and 190 (20.3%) had high NLR (&gt; 5). The primary endpoint was significantly increased in the high NLR category (<i>p</i> = 0.002 for cardiovascular death; <i>p</i> &lt; 0.001 for all-cause mortality, and <i>p</i> &lt; 0.001 for NCO), with higher IRRs (all <i>p</i> &lt; 0.001). Multivariate Cox regression analyses showed that high NLR was independently associated with an increased risk of cardiovascular death (aHR: 2.02; 95% CI: 1.04–3.92), all-cause mortality (aHR: 2.51; 95% CI: 1.58–3.97), and NCO (aHR: 1.99; 95% CI: 1.37–2.87), compared to low NLR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this prospective AF cohort receiving VKAs, elevated NLR was significantly associated with an increased risk of adverse clinical outcomes. NLR has independent prognostic value beyond other classical risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}