Clinical Cardiology最新文献

{"title":"A Meta-Analysis on the Efficacy of Noninvasive Positive Pressure Ventilation Combined With Pressure Support Ventilation in Treating Chronic Heart Failure","authors":"Xiaohong Zhang,&nbsp;Ye Dong,&nbsp;Dongliang Diao,&nbsp;Ming Li","doi":"10.1002/clc.70041","DOIUrl":"10.1002/clc.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the clinical efficacy and safety of noninvasive positive pressure ventilation combined with pressure support ventilation (NPPV-PSV) in the treatment of chronic heart failure (CHF) through a meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted using PubMed, Embase, Web of Science, Cochrane Library, CNKI and Wanfang databases to find randomized controlled trials and cohort studies on NPPV-PSV treatment for CHF. The period of search was set from inception until 2024. Eligible studies were included in a systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 8 studies with 568 patients were included in this meta-analysis. The meta-analysis revealed that compared with conventional treatment, NPPV-PSV treatment had significant advantages in several aspects: clinical efficacy rate (total effect <i>Z</i> = 5.10, OR = 3.12, 95% confidence interval (<i>CI</i>) [2.01, 4.83], <i>p</i> = 0.000), heart rate (HR) (total effect <i>Z</i> = 16.26, MD = −10.50, 95% <i>CI</i> [−11.76, −9.23], <i>p</i> = 0.000), respiratory rate (RR) (total effect <i>Z</i> = 16.50, MD = −6.44, 95% CI [−7.20, −5.67], <i>p</i> = 0.000) and oxygen saturation (total effect <i>Z</i> = 12.40, MD = 0.09, 95% <i>CI</i> [0.08, 0.11], <i>p</i> = 0.000).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Noninvasive positive pressure ventilation combined with PSV treatment significantly improves clinical symptoms, reduces HR and RR and increases oxygen saturation in patients with CHF, showing superior effects compared with conventional treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001228","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":"Health Care Resource Utilization With Dronedarone Versus Sotalol Following Catheter Ablation in Adults With Atrial Fibrillation","authors":"Emily P. Zeitler,&nbsp;Dara Stein,&nbsp;Ron Preblick,&nbsp;Shaum M. Kabadi,&nbsp;David S. McKindley,&nbsp;Jason Rashkin,&nbsp;Samuel Huse,&nbsp;Nicole Stamas,&nbsp;Michael H. Kim","doi":"10.1002/clc.70064","DOIUrl":"10.1002/clc.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinical trials support dronedarone use for atrial fibrillation (AF) following catheter ablation (CA); however, comparative data on health care resource utilization (HCRU) with other antiarrhythmic drugs are lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective analysis of Merative MarketScan databases (January 01, 2012−March 31, 2020) comparatively assessed HCRU in US adults with AF who received dronedarone or sotalol post-CA. Patients with ≥ 12-months' pre-CA data were followed from post-CA index treatment to disenrollment, death, or study end. Sotalol-treated patients were propensity score-matched (1:1) with dronedarone-treated patients. Events/100 patient-years (PY) were analyzed by univariate generalized-linear model with Poisson distribution. Cumulative incidence was analyzed over 12 months by Kaplan–Meier methods. Subgroup analyses were conducted by sex and patients new to dronedarone or sotalol during 12 months pre-CA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Dronedarone and sotalol cohorts were successfully matched (<i>n</i> = 1600 each). Prevalence/100-PY for all-cause, cardiovascular (CV)-related, and atrial tachyarrhythmia (ATA)/AF–related HCRU was lower in dronedarone versus sotalol cohort (all <i>p</i> &lt; 0.05). Cumulative incidence for all-cause, CV-related, ATA/AF-related hospitalizations, and pacemaker implantation was lower in dronedarone versus sotalol cohort (all <i>p</i> &lt; 0.05). Incidence of all-cause and CV-related hospitalizations was lower in dronedarone versus sotalol cohorts in females (<i>n</i> = 460) and males (<i>n</i> = 1115) (all <i>p</i> &lt; 0.05) after rematching. Incidence of ATA/AF-related hospitalization was lower in males versus females receiving dronedarone. For patients new to dronedarone or sotalol (<i>n</i> = 549), HCRU results were generally consistent with primary analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Post-CA dronedarone, versus sotalol, lowered CV-related HCRU in all-comers with AF and in sex subgroups. Findings may contribute to clinical decision making post-CA in patients with AF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982880","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 Applicability of Novel Predictor of Intracranial Hemorrhage in Patients With Atrial Fibrillation in the Contemporary Real-World Clinical Practice","authors":"Naoya Kataoka,&nbsp;Teruhiko Imamura","doi":"10.1002/clc.70078","DOIUrl":"10.1002/clc.70078","url":null,"abstract":"<p>Major bleeding, including intracranial hemorrhage (ICH), is a significant complication in patients with non-valvular atrial fibrillation (NVAF) undergoing treatment with oral anticoagulants (OACs). The authors proposed a novel risk score for predicting ICH in NVAF patients, incorporating variables such as age, sex, nonsmoking status, renal replacement therapy, and OAC use [<span>1</span>]. However, several critical concerns merit discussion.</p><p>The authors compared their proposed risk score with the established HAS-BLED score [<span>1</span>], a widely utilized tool for predicting not only ICH but also other major bleeding events classified as ≥ BARC 3b [<span>2</span>]. Unlike the novel score, the HAS-BLED score includes parameters such as hepatic dysfunction and the use of antiplatelet agents. Consequently, employing the HAS-BLED score as a comparator may not fully capture the nuances of the novel score's predictive capability for ICH specifically.</p><p>Patients with NVAF are susceptible to a range of complications, including thromboembolic events and heart failure. A noteworthy concern is the potential applicability of the novel risk score in predicting these broader complications. Furthermore, in the authors' study, only 6.7% of the cohort were treated with direct oral anticoagulants (DOACs) [<span>1</span>], which currently represent the predominant class of anticoagulants in clinical practice [<span>3</span>]. This limited representation raises questions about the generalizability of the score to patients receiving DOACs, warranting further validation.</p><p>Additionally, prior literature advises against the use of OACs in patients undergoing renal replacement therapy due to heightened bleeding risks [<span>4</span>]. Excluding such patients from the construction of risk scores may be more appropriate to ensure clinical relevance and applicability.</p><p>The authors have nothing to report.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969598","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":"Impact of Standardized Heart Failure Management Center Construction on the Management of Patients With Chronic Heart Failure","authors":"Xiaoxia Guo,&nbsp;Lele Jing,&nbsp;Changlin Zhai,&nbsp;Liang Shen,&nbsp;Huilin Hu","doi":"10.1002/clc.70076","DOIUrl":"10.1002/clc.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Heart failure is extremely harmful to human health and social economics. The purpose of standardized heart failure management center (SHFMC) is to correct the non-standardization of heart failure treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis</h3>\u0000 \u0000 <p>SHFMC has a positive impact on the management and prognosis of patients with chronic heart failure (CHF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The SHFMC database of Jiaxing First Hospital was retrospectively analyzed. Two hundred sixty-three patients with CHF who were hospitalized in the cardiovascular medicine department of Jiaxing First Hospital in Zhejiang Province from January 2020 to December 2020 were identified as study subjects. The SHFMC opening day, July 1, 2020, was used as the dividing line around which the patients were divided into Group A (before the completion of SHFMC, <i>n</i> = 137) and Group B (after, <i>n</i> = 126). The baseline data, treatment standardization, long-term efficacy, 1-year all-cause mortality, and readmission rate of the two groups were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The use of angiotensin receptor enkephalinase inhibitors (ARNIs), β-blockers (β-Bs), and sodium-glucose cotransport protein 2 inhibitors (SGLT2is) increased significantly, and the long-term outcome, readmission rate, and 1-year all-cause mortality of patients improved in group B.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The construction of SHFMC has been associated with consistent improvements in the standardization of CHF treatment, long-term patient outcomes, 1-year cumulative survival rates, and readmission rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945690","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":"Unmasking the Hidden Threat: The Role of Left Ventricular Subendocardial Involvement in Autoimmune Rheumatic Disease","authors":"Danni Wu,&nbsp;Xiao Li,&nbsp;Tianchen Guo,&nbsp;Xiaojin Feng,&nbsp;Xinhao Li,&nbsp;Yining Wang,&nbsp;Wei Chen","doi":"10.1002/clc.70069","DOIUrl":"10.1002/clc.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Late gadolinium enhancement (LGE) has been found in patients with autoimmune rheumatic disease (ARD). However, the prognostic implications of some specific LGE patterns in ARD patients remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the prevalence and prognostic significance of left ventricular (LV) subendocardium-involved LGE (LGEse) in a cohort of ARD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective study evaluated 176 patients diagnosed with ARD with clinically suspected cardiac involvement between 2018 and 2023. LV LGEse was defined as LGE involving the LV subendocardium that did not correspond to a coronary vascular distribution. The endpoints included a composite of cardiac death, heart failure-related admission, cardiogenic shock, and appropriate pacemaker or implantable cardioverter-defibrillator therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 176 consecutive patients, LV LGEse was observed in 22 patients (13%). During a median follow-up of 776 days (interquartile range, 395–1405 days), 20 patients (11%) experienced a composite endpoint. Compared with those without LV LGEse, the LV LGEse group had a greater proportion of men (64% vs. 14%; <i>p</i> &lt; 0.001), lower LV ejection fraction (50% vs. 60%; <i>p</i> = 0.001), greater LV end-diastolic volume index (78 vs. 75; <i>p</i> = 0.043), and more adverse outcomes (32% vs. 8%; <i>p</i> = 0.005). In the univariable and multivariable Cox regression analyses, the LV LGEse showed independent prognostic value. In the sensitivity analyses, the prognostic difference in terms of LV subendocardial involvement remained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In our cohort, LV subendocardial involvement, an underrecognized LGE pattern, was observed in 13% of all patients with autoimmune disease and indicated a worse prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913599","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":"Is There an Association Between Living in a Rural Area and the Incidence of Postoperative Complications or Hospital Readmissions Following Left Ventricular Assist Device (LVAD) Implantation, Compared to Urban Lvad Recipients? A Systematic Review","authors":"Samrat Gollapudi,&nbsp;Abhiram Gollapudi,&nbsp;Sri Banala,&nbsp;Sheraj Singh,&nbsp;Kiran Tadi","doi":"10.1002/clc.70068","DOIUrl":"10.1002/clc.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Left ventricular assist devices (LVADs) are utilized as a therapeutic option for patients with end-stage heart failure. While LVAD implantation can enhance survival rates and quality of life, the procedure has its risks, and postoperative complications are common. This review aims to investigate whether there is an association between living in a rural area and the incidence of postoperative complications or hospital readmissions following LVAD implantation, compared to urban LVAD recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature review examined studies that compared postoperative outcomes between rural and urban LVAD recipients. Data on adverse events, hospitalizations, and mortality rates were extracted, focusing on the impact of geographic location on these outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The review found that rural LVAD recipients may be at a higher risk for certain complications, including gastrointestinal bleeding, ventricular arrhythmias, LVAD complications, and stroke. Rural patients also exhibited higher instances of emergency department visits and hospital readmissions. Despite these challenges, survival rates and heart transplantation outcomes at 1 year were similar between rural and urban recipients. However, rural patients exhibited a higher driveline infection rate at 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this review suggest that rural residency may be associated with an increased risk of certain postoperative complications and hospital readmissions following LVAD implantation. These results highlight the need for healthcare strategies to address the challenges faced by rural LVAD recipients. Further research is necessary to understand the relationship between geographic location and LVAD outcomes and to develop interventions that can improve postoperative care for this vulnerable population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913678","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":"Letter Regarding “Outcomes of Bolus Dose Furosemide Versus Continuous Infusion in Patients With Acute Decompensated Left Ventricular Failure and Atrial Fibrillation”","authors":"Ahmed M. Gazer,&nbsp;Elsayed Hammad","doi":"10.1002/clc.70072","DOIUrl":"10.1002/clc.70072","url":null,"abstract":"<p>We read with interest the recent publication by Khan et al. [<span>1</span>] in <i>Clinical Cardiology</i> titled “<i>Outcomes of Bolus Dose Furosemide Versus Continuous Infusion in Patients With Acute Decompensated Left Ventricular Failure and Atrial Fibrillation</i>”. While the article provides valuable insights into different furosemide strategies in managing patients with acute decompensated heart failure, we noticed an error in Table 1, which presents the baseline patient characteristics. Specifically, the reported patient population underwent a sudden and significant reduction in the arms of the study; for example, an initial cohort of 479 patients reduced or reported to only 14 patients in the T1 arm (intravenous bolus infusion in the table). This error has the potential to misinterpret the results and conclusions of the study.</p><p>We believe these clarifications are essential for readers to fully comprehend the validity and applicability of the study's findings.</p><p>We kindly request the authors and the journal to rectify this error promptly. A corrected version of Table 1 should be published to ensure accurate interpretation of the study findings.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892563","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":"Predictive Value of Machine Learning for the Risk of In-Hospital Death in Patients With Heart Failure: A Systematic Review and Meta-Analysis","authors":"Liyuan Yan,&nbsp;Jinlong Zhang,&nbsp;Le Chen,&nbsp;Zongcheng Zhu,&nbsp;Xiaodong Sheng,&nbsp;Guanqun Zheng,&nbsp;Jiamin Yuan","doi":"10.1002/clc.70071","DOIUrl":"10.1002/clc.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The efficiency of machine learning (ML) based predictive models in predicting in-hospital mortality for heart failure (HF) patients is a topic of debate. In this context, this study's objective is to conduct a meta-analysis to compare and assess existing prognostic models designed for predicting in-hospital mortality in HF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of databases was conducted, including PubMed, Embase, Web of Science, and Cochrane Library up to January 2023. To ensure comprehensiveness, we performed an additional search in June 2023. The Prediction Model Risk of Bias Assessment Tool was employed to assess the validity and reliability of ML models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis incorporated 28 studies involving a total of 106 predictive models based on 14 different ML techniques. In the training data set, these models showed a combined C-index of 0.781, sensitivity of 0.56, and specificity of 0.94. In the validation data set, the models exhibited a combined C-index of 0.758, sensitivity of 0.57, and specificity of 0.84. Logistic regression (LR) was the most frequently used ML algorithm. LR models in the training set had a combined C-index of 0.795, sensitivity of 0.63, and specificity of 0.85, and these measures for LR models in the validation set were 0.751, 0.66, and 0.79, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study indicates that although ML is increasingly being leveraged to predict in-hospital mortality for HF patients, the predictive performance remains suboptimal. Although these models have relatively high C-index and specificity, their ability to predict positive events is limited, as indicated by their low sensitivity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892566","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":"Digital Devices for Arrhythmia Detection: What Is Still Missing?","authors":"Naoya Kataoka,&nbsp;Teruhiko Imamura","doi":"10.1002/clc.70074","DOIUrl":"10.1002/clc.70074","url":null,"abstract":"<p>Various digital devices have been developed to detect atrial fibrillation (AF). Manninger and colleagues demonstrated that intermittent electrocardiogram (ECG)-based digital devices are increasingly being integrated into clinical practice, whereas photoplethysmography (PPG)-based devices are less commonly utilized for the diagnosis and screening of AF [<span>1</span>].</p><p>In the three proposed clinical scenarios—(1) symptomatic low-risk patients, (2) asymptomatic high-risk patients, and (3) symptomatic high-risk patients—many clinicians demonstrated a preference for diagnostic tools other than PPG-based devices [<span>1</span>]. The authors highlighted this trend and emphasized the need for enhanced education regarding novel PPG-based digital technologies. However, ECG-based tools, which provide greater diagnostic accuracy than PPG-based devices, may be more suitable in scenarios (1) and (3), where patients already exhibit clear symptoms of AF.</p><p>The debate over the type of device (PPG-based vs. ECG-based) may not be the most critical issue at present. While PPG-based devices demonstrate high accuracy in AF screening [<span>2</span>], the duration of arrhythmia monitoring is arguably more significant. Devices that impose minimal burden on patients are likely to be preferred for prolonged monitoring.</p><p>The clinical implications of aggressive intervention for AF detected by wearable devices remain uncertain. The prevalence of AF in the general population is quite low (approximately 1%) [<span>2</span>], and among those diagnosed, only 30% experience adverse outcomes such as thromboembolism or heart failure. Consequently, the number needed to treat to achieve a meaningful clinical benefit from wearable devices is exceptionally high [<span>3</span>]. Therefore, optimizing patient selection for the implementation of PPG-based devices warrants greater consideration.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876331","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":"Heart Failure Is Closely Associated With the Expression Characteristics of Type I Interferon-Related Genes","authors":"Jianfeng Zhuo,&nbsp;Yan Zhong,&nbsp;Xiaojuan Luo,&nbsp;Sijie Qiu,&nbsp;Xinmei Li,&nbsp;Yunyu Liang,&nbsp;Yu Wu,&nbsp;Xiyu Zhang","doi":"10.1002/clc.70063","DOIUrl":"10.1002/clc.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between the expression of type I interferon related genes (TIIRGs) and EFrHF is not well understood. This study aimed to investigate the correlation between the expression patterns of TIIRGs and EFrHF using bioinformatics analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An analysis was conducted to examine the expression and distribution of TIIRGs in cardiomyocytes. Afterwards, GSE5406 was utilized as the validation set, including 16 without heart failure, 86 with idiopathic dilated cardiomyopathy (IDCM), and 108 individuals with ischemic cardiomyopathy (ICM). We conducted a comparative analysis of the variations in TIIRGs gene expression across various forms of heart failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were eight genes that showed substantial changes between patients with EFrHF and those without heart failure. A risk model for EFrHF was developed utilizing JAK1 and EIF2AK2, with an area under the curve (AUC) of 0.909. Five genes exhibited notable disparities between IDCM and ICM. Through multivariate analysis, it was shown that JAK1 and IFNA16/IFNA14 were identified as independent risk variables for distinguishing between the two pathogenic categories. The model, utilizing JAK1 and IFNA16/IFNA14, successfully differentiated between IDCM and ICM with an area under the curve (AUC) of 0.722. In the validation set GSE5406, the expression of JAK1 was dramatically downregulated, while EIF2AK2 was significantly upregulated in heart failure (HF) tissues. The model utilizing JAK1 and EIF2AK2 successfully differentiated between those with an illness and those without (AUC = 0.877).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The expression of TIIRGs is strongly associated with the presence and specific subtypes of HF in a pathological context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863523","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}