Current Cardiology Reports最新文献

{"title":"The Rapidly Evolving Landscape of DCD Heart Transplantation.","authors":"Yashutosh Joshi, Katherine Wang, Campbell MacLean, Jeanette Villanueva, Ling Gao, Alasdair Watson, Arjun Iyer, Mark Connellan, Emily Granger, Paul Jansz, Peter Macdonald","doi":"10.1007/s11886-024-02148-w","DOIUrl":"https://doi.org/10.1007/s11886-024-02148-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarise current international clinical outcomes from donation after circulatory death heart transplantation (DCD-HT); discuss procurement strategies, their impact on outcomes and overall organ procurement; and identify novel approaches and future areas for research in DCD-HT.</p><p><strong>Recent findings: </strong>Globally, DCD-HT survival outcomes (regardless of procurement strategy) are comparable to heart transplantation from brain dead donors (BDD). Experience with normothermic machine perfusion sees improvement in rates of primary graft dysfunction. Techniques have evolved to reduce cold ischaemic exposure to directly procured DCD hearts, though controlled periods of cold ischaemia can likely be tolerated. There is interest in hypothermic machine perfusion (HMP) for directly procured DCD hearts, with promising early results. Survival outcomes are firmly established to be equivalent between BDD and DCD-HT. Procurement strategy (direct procurement vs. regional perfusion) remains a source of debate. Methods to improve allograft warm ischaemic tolerance are of interest and will be key to the uptake of HMP for directly procured DCD hearts.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation in Chemotherapy-Induced Cardiotoxicity.","authors":"Elizabeth Hutchins, Eric H Yang, Ashley F Stein-Merlob","doi":"10.1007/s11886-024-02131-5","DOIUrl":"https://doi.org/10.1007/s11886-024-02131-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>In this review we describe the role of inflammation in chemotherapy-induced cardiotoxicity with a particular focus on anthracycline-induced cardiomyopathy (AIC). First, we discuss inflammation associated with anthracyclines at a cellular level. Next, we discuss the clinical implications of these inflammatory mechanisms for early detection and cardioprotective strategies in patients undergoing anthracycline treatment.</p><p><strong>Recent findings: </strong>Key inflammatory pathways identified in AIC include cytokine release, upregulation of the innate immune system via toll-like receptors, and activation of the inflammasome. Emerging evidence suggests a role for inflammatory biomarkers in detecting subclinical AIC. Advanced imaging techniques, such as cardiac PET with novel tracers targeting inflammation, may enhance early detection. Both traditional cardioprotective strategies and novel anti-inflammatory therapies show potential in preventing and treating AIC. Understanding the inflammatory mechanisms involved in AIC provides new opportunities for early detection and targeted cardioprotective strategies in patients undergoing anthracycline treatment and informs our understanding of other forms of chemotherapy-induced cardiotoxicity.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress Echocardiography for Assessment of Diastolic Function.","authors":"J Lukas Laws, Tania Ruiz Maya, Deepak K Gupta","doi":"10.1007/s11886-024-02142-2","DOIUrl":"https://doi.org/10.1007/s11886-024-02142-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Diastolic dysfunction is an important, though often underappreciated, cause for exertional dyspnea. Echocardiography enables noninvasive evaluation of diastolic function and filling pressure, but images acquired at rest may be insensitive for detection of exertional abnormalities. This review focuses on stress echocardiography to assess diastolic function, including traditional and novel techniques, with emphasis on specific patient sub-groups in whom this testing may be valuable.</p><p><strong>Recent findings: </strong>Emerging data informs patient selection for diastolic stress testing. Further, increasing literature provides considerations for performance and interpretation of diastolic metrics relevant to patients with heart failure with preserved ejection fraction, hypertrophic cardiomyopathy, athletes, and those with microvascular coronary dysfunction. Methods, such as speckle-tracking and multi-modality imaging, provide additional and complementary information for non-invasive diastolic assessment. This review serves as a guide to optimally utilize existing and novel techniques of stress echocardiography for diastolic assessment across a broad range of patients.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Embolic Protection: Is There a Benefit for Left Atrial and Mitral Valve Procedures?","authors":"Besir Besir, Samir R Kapadia","doi":"10.1007/s11886-024-02132-4","DOIUrl":"https://doi.org/10.1007/s11886-024-02132-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to highlight the current evidence on the use of cerebral embolic protection devices (CEPD) in left atrial and transcatheter mitral valve procedures. It also aims to summarize the antithrombotic management of patients undergoing such procedures.</p><p><strong>Recent findings: </strong>Ischemic stroke is one of the most devastating complications of structural heart procedures. The manifestation of periprocedural stroke can range from asymptomatic and detectable only through brain imaging to major stroke with neurological deficits. CEP devices were initially developed to mitigate the risk of stroke associated with transcatheter aortic valve replacement (TAVR). However, the efficacy of such devices during different cardiac interventions is yet to be fully demonstrated, especially in left atrial appendage closure (LAAO), and mitral valve interventions. Few studies demonstrated that the risk of periprocedural strokes after LAAO and mitral valve interventions is not negligible and is highest during the periprocedural period and then falls. The majority of patients undergoing those procedures have cerebral ischemic injuries detected on diffusion-weighted magnetic resonance imaging (DW-MRI). Moreover, a reasonable number of those patients had debris embolization on the filters of the CEPD. Pharmacological therapy with antithrombotic agents before, during, or after structural heart interventions is crucial and should be tailored to each patient's risk of bleeding and ischemia. Close monitoring that includes a full neurological assessment and frequent follow-up visits with cardiac echocardiography are important. The risk of periprocedural stroke in left atrial and transcatheter mitral valve procedures is not negligible. Pharmacological therapy with antithrombotic agents before, during, or after structural heart interventions is important to mitigate the risk of stroke, especially the long-term risk. More prospective studies are needed to assess the efficacy of CEPD in such procedures.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Psychosocial Care Needs in Women with Peripheral Artery Disease.","authors":"Eman Mubarak, Jacob Cleman, Gaëlle Romain, Carlos Mena-Hurtado, Kim G Smolderen","doi":"10.1007/s11886-024-02106-6","DOIUrl":"10.1007/s11886-024-02106-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Peripheral artery disease (PAD) is a growing global epidemic. Women with PAD are at elevated risk of experiencing psychosocial stressors that influence the diagnosis, management, and course of their illness due to unique sex- and gender-based factors.</p><p><strong>Recent findings: </strong>We review existing evidence for increased psychosocial risk in women with PAD with a focus on mood disorders, chronic stress, pain experiences, substance use disorders, health behaviors and illness perceptions, and healthcare access. We discuss how these factors exacerbate PAD symptomatology and lead to adverse outcomes. Existing gaps in women's vascular care are reviewed and potential solutions to bridge these gaps through psychosocial care integration are proposed. Current care paradigms for women's vascular care do not adequately screen for and address psychosocial comorbidities. Clinician education, integration of evidence-based psychological care strategies, implementation of workflows for the management of individuals with PAD and mental health comorbidities, reform to reimbursement structures, and further advocacy are needed in this space. This review provides a construct for integrated behavioral health care for women with PAD and advocates for further integration of care.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Outcomes of Uric Acid Lowering Medications: A Meta-Analysis.","authors":"Yasser Jamil, Dana Alameddine, Mahmoud El Iskandarani, Ankit Agrawal, Aro D Arockiam, Elio Haroun, Heba Wassif, Patrick Collier, Tom Kai Ming Wang","doi":"10.1007/s11886-024-02138-y","DOIUrl":"https://doi.org/10.1007/s11886-024-02138-y","url":null,"abstract":"<p><strong>Background: </strong>Although hyperuricemia is a recognized risk factor for cardiovascular diseases, mixed results have been reported regarding the associations between uric acid-lowering medications and cardiovascular events. This meta-analysis compared the cardiovascular outcomes of different uric acid-lowering medications and placebo.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched OVID Medline, Embase, Web of Science, and Cochrane databases to identify potentially relevant articles until December 2023. Studies must be randomized or observational, report cardiovascular and mortality outcomes, and compare uric acid-lowering medications to placebo or each other. Data was analyzed using Revman (version 5.4) software.</p><p><strong>Results: </strong>A total of 3,393 studies were searched, after which 47 studies were included, totaling 3,803,509 patients (28 studies comparing xanthine oxidase inhibitors (XOI) versus placebo, 17 studies comparing allopurinol and febuxostat, and 2 studies comparing XOI and uricosuric agents). Overall mean age was 57.3 years, and females comprised 20.8% of all studies. There were no significant differences between XOI and placebo for cardiovascular outcomes (mortality, myocardial infarction, major adverse cardiovascular events, heart failure, or arrhythmia). There was significant heterogeneity in all these pooled analyses. Comparing Allopurinol to Febuxostat, there was a lower risk of heart failure in febuxostat than allopurinol in 3 RCTs (OR 0.66, 95% CI 0.50-0.89, p = 0.006). Other cardiovascular outcomes were not different. Lastly, when comparing XOI and uricosuric agents, no significant differences in MI rates were evident.</p><p><strong>Conclusion: </strong>XOI was not associated with reduced cardiovascular events compared to placebo. When comparing XOI agents, Febuxostat might reduce the risk of HF, but future studies are required to confirm the findings from the current study.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Ventricular Arrhythmias in Heart Failure: Can Less Be More?","authors":"Eitan Frankel, Reginald Ho","doi":"10.1007/s11886-024-02107-5","DOIUrl":"10.1007/s11886-024-02107-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Ventricular arrhythmias (VAs) affect many patients with heart failure and underlying structural heart disease and are associated with significant morbidity and mortality. Antiarrhythmic drugs are often the initial treatment, but medication alone often fails to sufficiently suppress VAs. While catheter ablation (CA) remains the gold standard for treatment of VAs, CA is an invasive procedure and can be associated with periprocedural complications including acute clinical decompensation. Thus, there is an important need for alternative therapies.</p><p><strong>Recent findings: </strong>Recent advances in risk stratification and the development of new ablation technologies may reduce some of the periprocedural complications and limitations of CA. In addition, less invasive therapies for VAs may provide an alternative treatment strategy for patients in both the acute and chronic setting. For patients acutely admitted with ventricular tachycardia electrical storm (VT-ES) or recurrent VT and cardiogenic shock, risk stratification tools have been developed to identify patients at high risk of acute hemodynamic decompensation during CA. These patients require a multidisciplinary approach and might need mechanical circulatory support (MCS) if CA is selected as the treatment strategy. Alternatively, less invasive therapies targeting the autonomic nervous system may be reasonable. In the chronic setting, developments in medical therapy have reduced the risk of sudden cardiac death in heart failure patients and stereotactic whole-body radiation (SBRT) has evolved as a potential, non-invasive therapy. Further research is needed to personalize VA therapy for individual patients.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Going from Primary to Primordial Prevention: Is the Juice Worth the Squeeze?","authors":"Andrew Chiou, Melody Hermel, Zohar Chai, Ariana Eiseman, Sheila Jeschke, Sandeep Mehta, Unab Khan, Zahra Hoodbhoy, Nilofer Safdar, Adeel Khoja, Vashma Junaid, Elizabeth Vaughan, Anwar T Merchant, Junaid Iqbal, Aysha Almas, Salim S Virani, Sana Sheikh","doi":"10.1007/s11886-024-02109-3","DOIUrl":"10.1007/s11886-024-02109-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>While primary prevention strategies target individuals who are at high risk of cardiovascular disease, there is rising interest towards primordial prevention that focuses on preventing the development of risk factors upstream of disease detection. Therefore, we review the advantages of primordial prevention interventions on minimizing future cardiovascular events.</p><p><strong>Recent findings: </strong>Primordial prevention of atherosclerotic cardiovascular disease involves behavioral, genetic, and environmental strategies, starting from fetal/infant health and continuing throughout childhood and young adulthood. Early interventions focusing on modifiable risk factors such as physical inactivity, non-ideal body weight, smoking, and environmental pollutants are important towards preventing the initial occurrence of risk factors such as hypertension, dyslipidemia, and diabetes to ultimately reduce cardiovascular disease. Implementing primordial prevention strategies early on in life can minimize cardiovascular events and lead to healthy aging in the population. Future studies can further evaluate the effectiveness of various primordial prevention strategies.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Rehabilitation in Saudi Arabia: Current Status and Future Directions.","authors":"Ahmad M Osailan","doi":"10.1007/s11886-024-02105-7","DOIUrl":"10.1007/s11886-024-02105-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cardiovascular diseases (CVDs) are the leading cause of mortality in Saudi Arabia. Cardiac rehabilitation (CR) is one of the well-known interventions to control and minimize the burden of CVDs. Despite recommendations, CR utilization remains suboptimal in Saudi Arabia due to many reasons, including limited awareness, logistical barriers, shortage of specialized facilities and trained professionals, and perceptions about CVDs illness. This review is to evaluate the current status, effectiveness, accessibility, and challenges of CR utilization in Saudi Arabia, and to explore potential future directions for improving these services. The review addresses key questions regarding the incidence of CVDs, the characteristics of existing CR programs, barriers to CR access, and stakeholder perspectives.</p><p><strong>Recent findings: </strong>Recent studies demonstrate that the effectiveness of CR, particularly exercise training, in improving outcomes for post-coronary artery bypass grafting (CABG) patients is well-documented, though data on its impact on other cardiac conditions is limited. There are significant barriers to CR utilization in Saudi Arabia, including limited awareness, logistical challenges, a shortage of specialized facilities and trained professionals, and cultural perceptions about CVD. Stakeholder perspectives highlight the necessity for culturally sensitive and inclusive approaches, particularly in addressing gender-specific needs and enhancing patient-provider communication. The Saudi Vision 2030 presents opportunities to expand and enhance CR services in alignment with international standards. This review found that while CR is a crucial intervention for managing CVDs, its utilization in Saudi Arabia is suboptimal due to various barriers. To improve CR access and effectiveness, future strategies should focus on increasing public and professional awareness, developing infrastructure, training healthcare professionals, and fostering public-private partnerships. These measures are essential to making CR more accessible and tailored to the diverse needs of the Saudi population, ultimately enhancing the quality of cardiovascular care and patient outcomes in the region.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Recurrent Heart Failure Hospitalizations on the Risk of Cardiovascular and all-Cause Mortality: a Systematic Review and Meta-Analysis.","authors":"Marzieh Ketabi, Zahra Mohammadi, Zhila Fereidouni, Omid Keshavarzian, Zeinab Karimimoghadam, Fatemeh Sarvi, Reza Tabrizi, Mahmoud Khodadost","doi":"10.1007/s11886-024-02112-8","DOIUrl":"10.1007/s11886-024-02112-8","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) is a significant worldwide concern due to its substantial impact on mortality rates and recurrent hospitalizations. The relationship between recurrent hospitalizations and mortality in individuals diagnosed with heart failure has been the subject of conflicting findings in previous studies. A meta-analysis was conducted to investigate the association between recurrent heart failure hospitalizations (HFHs) and mortality.</p><p><strong>Methods: </strong>We conducted a systematic search across various online databases, such as PubMed, Embase, Web of Science, ProQuest, Scopus, Science Direct, and Google Scholar, to locate studies that examined the connection between recurrent HFHs and cardiovascular (CV) mortality as well as all-cause mortality until January 2023. To evaluate the heterogeneity among the studies, we employed I2 and Cochran's Q test.</p><p><strong>Results: </strong>In total, 143,867 participants from seven studies were included in the analysis. Recurrent HFHs were found to be strongly associated with elevated risks of both cardiovascular (CV) mortality and all-cause mortality. The pooled hazard ratios (HRs) indicated a non-significant association for CV mortality (HR = 4.28, 95% CI: 0.86-7.71) but a significant association for all-cause mortality (HR = 2.76, 95% CI: 2.05-3.48). Subgroup analyses revealed a reduction in heterogeneity when stratified by factors such as quality score, sample size, hypertension comorbidity, number of recurrent HFHs, and follow-up time. A clear correlation was observed between the frequency of HFH and the mortality risk. Various subgroups, including those with diabetes, atrial fibrillation, and chronic kidney disease, showed significant associations between recurrent HFHs and all-cause mortality. Additionally, recurrent HFHs were significantly associated with CV mortality in subgroups such as heart failure with reduced ejection fraction (HFrEF), atrial fibrillation, and diabetes.</p><p><strong>Conclusion: </strong>This meta-analysis provides evidence of an association between recurrent HFH and elevated risk of both CV mortality and all-cause mortality. The findings consistently indicate that a higher frequency of HFH is strongly associated with an increased likelihood of mortality.</p>","PeriodicalId":10829,"journal":{"name":"Current Cardiology Reports","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}