Frontiers in Cardiovascular Medicine最新文献

{"title":"Prognostic value of right ventricular dysfunction in aortic regurgitation after transcatheter aortic valve replacement","authors":"Yu Mao, Yang Liu, Mengen Zhai, Ping Jin, Haibo Zhang, Lai Wei, Xiaoke Shang, Yingqiang Guo, Xiangbin Pan, Jian Yang","doi":"10.3389/fcvm.2024.1424116","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1424116","url":null,"abstract":"BackgroundAortic regurgitation (AR) may lead to right ventricular dysfunction (RVD), but the prognostic value of RVD in patients undergoing transcatheter aortic valve replacement (TAVR) remains unclear. Our goal was to evaluate the clinical implications, predictors and prognostic significance of RVD in patients with pure AR after TAVR.MethodsIn this multicentre prospective study, patients undergoing TAVR were included between January 2019 and April 2021. The patients were divided into four groups according to the results of transthoracic echocardiography pre- and post-TAVR. The primary end point was 2-year all-cause mortality.ResultsA total of 648 patients were divided into four groups: 325 patients (54.3%) in the no RVD group; 106 patients (17.7%) in the new-onset RVD group; 73 patients (12.2%) in the normalized RVD group; and 94 patients (15.7%) in the residual RVD group. At the 2-year follow-up, there were significant differences in all-cause mortality among the four groups (5.2%, 12.3%, 11.0% and 17.0%, respectively; <jats:italic>p</jats:italic> &amp;lt; 0.05). New-onset RVD was correlated with an increased risk of all-cause death and a composite end point and normalized RVD improved clinical outcomes of baseline RVD. Predictors of new-onset RVD included a higher Society of Thoracic Surgeons score, larger left ventricular end-diastolic volume, lower left ventricular ejection fraction, higher systolic pulmonary artery pressure and smaller RV base diameter.ConclusionsChanges in periprocedural RVD status significantly affect the risk stratification outcomes after TAVR. Therefore, they may be used as part of decision-making and risk assessment strategies.Clinical Trial Registration<jats:uri>ClinicalTrials.gov</jats:uri> Protocol Registration System (NCT02917980).","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221643","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":"Long-term outcomes of transcatheter atrial septal defect closure: a single-center retrospective study","authors":"Lalita Honghiranrueng, Supaporn Roymanee, Kanjarut Wongwaitaweewong, Jirayut Jarutach, Rujira Buntharikpornpun","doi":"10.3389/fcvm.2024.1448967","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1448967","url":null,"abstract":"BackgroundTranscatheter atrial septal defect (ASD) closure is the primary approach for treating ASD secundum; however, data on long-term outcomes remain limited. This study aimed to elucidate the prevalence of adverse outcomes following transcatheter ASD closure in a diverse population.MethodsThis retrospective cohort study was conducted at the Songklanagarind Hospital and included patients who underwent transcatheter ASD closure between January 2010 and August 2021.ResultsThe study included 277 patients who completed follow-up for at least 1 year, with varying ages: &amp;lt;25 years (31%), 25–40 years (19%), 40–60 years (34%), and &amp;gt;60 years (16%). The median follow-up duration was 37 months (interquartile range: 20, 61). The overall mortality rate was 1.8%, and no deaths were attributed to device-related complications. Hospitalization due to heart failure occurred in 0.7% of the cases. Most patients improved or stabilized based on the New York Heart Association functional class. Adverse outcomes included new-onset atrial fibrillation (prevalence: 2.7%) and pulmonary hypertension (prevalence: 0.6%). The resolution of pulmonary hypertension varied among age groups, with 100% resolution in patients &amp;lt;25 years. Multivariate analysis identified male sex, overweight, and history of stroke to be significantly associated with adverse outcomes after transcatheter ASD closure.ConclusionTranscatheter ASD closure was safe and effective, with age not being a limiting factor for success. Male sex, being overweight, and a history of stroke were associated with adverse outcomes. These findings contribute to our understanding of the long-term outcomes following ASD closure.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221644","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 essential role of dual-energy x-ray absorptiometry in the prediction of subclinical cardiovascular disease","authors":"Sisi Yang, Qin Chen, Yang Fan, Cuntai Zhang, Ming Cao","doi":"10.3389/fcvm.2024.1377299","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1377299","url":null,"abstract":"Subclinical cardiovascular disease (Sub-CVD) is an early stage of cardiovascular disease and is often asymptomatic. Risk factors, including hypertension, diabetes, obesity, and lifestyle, significantly affect Sub-CVD. Progress in imaging technology has facilitated the timely identification of disease phenotypes and risk categorization. The critical function of dual-energy x-ray absorptiometry (DXA) in predicting Sub-CVD was the subject of this research. Initially used to evaluate bone mineral density, DXA has now evolved into an indispensable tool for assessing body composition, which is a pivotal determinant in estimating cardiovascular risk. DXA offers precise measurements of body fat, lean muscle mass, bone density, and abdominal aortic calcification, rendering it an essential tool for Sub-CVD evaluation. This study examined the efficacy of DXA in integrating various risk factors into a comprehensive assessment and how the application of machine learning could enhance the early discovery and control of cardiovascular risks. DXA exhibits distinct advantages and constraints compared to alternative imaging modalities such as ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography. This review advocates DXA incorporation into cardiovascular health assessments, emphasizing its crucial role in the early identification and management of Sub-CVD.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221645","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":"Tongue color parameters in predicting the degree of coronary stenosis: a retrospective cohort study of 282 patients with coronary angiography","authors":"Jieyun Li, Danqun Xiong, Leixin Hong, Jiekee Lim, Xiangdong Xu, Xinang Xiao, Rui Guo, Zhaoxia Xu","doi":"10.3389/fcvm.2024.1436278","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1436278","url":null,"abstract":"PurposeThis retrospective cohort study aimed to analyze the relationship between tongue color and coronary artery stenosis severity in 282 patients after underwent coronary angiography.MethodsA retrospective cohort study was conducted to collect data from patients who underwent coronary angiography in the Department of Cardiology, Shanghai Jiading District Central Hospital from October 1, 2023 to January 15, 2024. All patients were divided into four various stenosis groups. The tongue images of each patient was normalized captured, tongue body (TC_) and tongue coating (CC_) data were converted into RGB and HSV model parameters using SMX System 2.0. Four supervised machine learning classifiers were used to establish a coronary artery stenosis grading prediction model, including random forest (RF), logistic regression, and support vector machine (SVM). Accuracy, precision, recall, and F1 score were used as classification indicators to evaluate the training and validation performance of the model. SHAP values were furthermore used to explore the impacts of features.ResultsThis study finally included 282 patients, including 164 males (58.16%) and 118 females (41.84%). 69 patients without stenosis, 70 patients with mild stenosis, 65 patients with moderate stenosis, and 78 patients with severe stenosis. Significant differences of tongue parameters were observed in the four groups [TC_R (<jats:italic>P </jats:italic>= 0.000), TC_G (<jats:italic>P </jats:italic>= 0.003), TC_H (<jats:italic>P </jats:italic>= 0.001) and TC_S (<jats:italic>P </jats:italic>= 0.024),CC_R (<jats:italic>P </jats:italic>= 0.006), CC_B (<jats:italic>P </jats:italic>= 0.023) and CC_S (<jats:italic>P </jats:italic>= 0.001)]. The SVM model had the highest predictive ability, with AUC values above 0.9 in different stenosis groups, and was particularly good at identifying mild and severe stenosis (AUC = 0.98). SHAP value showed that high values of TC_RIGHT_R, low values of CC_LEFT_R were the most impact factors to predict no coronary stenosis; high CC_LEFT_R and low TC_ROOT_H for mild coronary stenosis; low TC_ROOT_R and CC_ROOT_B for moderate coronary stenosis; high CC_RIGHT_G and low TC_ROOT_H for severe coronary stenosis.ConclusionTongue color parameters can provide a reference for predicting the degree of coronary artery stenosis. The study provides insights into the potential application of tongue color parameters in predicting coronary artery stenosis severity. Future research can expand on tongue features, optimize prediction models, and explore applications in other cardiovascular diseases.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227299","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":"Comparison of angiography-guided vs. intra-vascular imaging-guiding percutaneous coronary intervention of acute myocardial infarction: a real world clinical practice","authors":"Ting-Yu Lin, Ying-Ying Chen, Shao-Sung Huang, Cheng-Hsueh Wu, Li-Wei Chen, Yu-Lun Cheng, William K. Hau, Chien-Hung Hsueh, Ming-Ju Chuang, Wei-Chieh Huang, Tse-Min Lu","doi":"10.3389/fcvm.2024.1421025","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1421025","url":null,"abstract":"BackgroundThe role of routine intravascular imaging in percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) remains unclear. This study evaluated the clinical outcomes of PCI guided by different imaging modalities in AMI patients.Materials and methodsData from AMI patients who had undergone PCI between 2012 and 2022 were analyzed. The mean follow-up was 12.9 ± 1.73 months. The imaging modality-either intravascular ultrasound (IVUS), optical coherence tomography (OCT), or angiography alone-was selected at the operator's discretion. The primary endpoint was major adverse cardiac events (MACEs), including cardiovascular (CV) death, myocardial infarction (MI), target vessel revascularization.ResultsOf the 1,304 PCIs performed, 47.5% (<jats:italic>n</jats:italic> = 620) were guided by angiography alone, 37.0% (<jats:italic>n</jats:italic> = 483) by IVUS, and 15.4% (<jats:italic>n</jats:italic> = 201) by OCT. PCI guided by intravascular imaging modalities was associated with lower 1-year rates of MI (1.3%, <jats:italic>P</jats:italic> = 0.001) and MACE (5.2%, <jats:italic>P</jats:italic> = 0.036). OCT-guided PCI was linked to lower rates of 1-year CV death (IVUS vs. OCT: 6.2% vs. 1.5%, <jats:italic>P</jats:italic> = 0.016) and MACE (IVUS vs. OCT: 6.4% vs. 2.5%, <jats:italic>P</jats:italic> = 0.032). Intravascular imaging modalities and diabetes were identified as predictors of better and worse 1-year MACE outcomes, respectively.ConclusionPCI guided by intravascular imaging modalities resulted in improved 1-year clinical outcomes compared to angiography-guided PCI alone in AMI patients. OCT-guided PCI was associated with lower 1-year MACE rates compared to IVUS-guided PCI. Therefore, intravascular imaging should be recommended for PCI in AMI, with OCT being particularly considered when appropriate.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221648","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":"Recurrent ventricular arrhythmias and heart failure induced by osimertinib- a case report","authors":"Jiangying Luo, Boda Zhou, Jing Yang, Hao Qian, Yutong Zhao, Fei She, Fang Liu, Ping Zhang","doi":"10.3389/fcvm.2024.1423647","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1423647","url":null,"abstract":"BackgroundOsimertinib is a third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor that has become the first-line treatment for non-small cell lung cancer harboring EGFR mutations, with the potential risk of QT prolongation and heart failure. However, few cases have reported malignant ventricular arrhythmias. Here, we report a case of recurrent ventricular fibrillation (VF) and Torsade de Pointes (TdP) secondary to QT prolongation and heart failure induced by osimertinib.Case summaryA 70-year-old woman presented with chest tightness and dyspnea for 1 week and ventricular fibrillation upon admission, with a medical history of lung adenocarcinoma harboring an EGFR exon 21 p.L858R mutation. She was under osimertinib for 3 months. Electrocardiography after defibrillation suggested QTc prolongation (655 ms) and T wave alternans. Ultrasound cardiography displayed left ventricular ejection fraction (LVEF) of 29% and severe mitral regurgitation. Laboratory tests indicated elevated N-terminal pro-B-type natriuretic peptide and hypokalemia. Genetic testing suggested no pathogenic mutations. We considered acquired long QT syndrome and heart failure with reduced ejection fraction induced by osimertinib as the chief causes of ventricular arrhythmia and hypokalemia as an important trigger. Despite intubation, sedation, and the administration intravenous magnesium and potassium and lidocaine, the patient presented with recurrent TdP, which was managed by a low dose of isoproterenol (ISO, 0.17 ug/min). An implantable cardioverter defibrillator was declined. The patient is surviving without any relapse, with QTc of 490 ms and LVEF of 42% after a 6-month follow up.ConclusionRegular monitoring is required during osimertinib administration, considering the risk of life-threatening cardiac events, such as malignant arrhythmias and heart failure. ISO, with an individual dose and target heart rate, may be beneficial for terminating TdP during poor response to other therapies.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221646","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":"Assessment of aortic stiffness during atrial fibrillation: solutions and considerations","authors":"Kristina Lundwall, Maria Al Nouh, Thomas Kahan, Jonas Spaak","doi":"10.3389/fcvm.2024.1449168","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1449168","url":null,"abstract":"BackgroundMethods to assess aortic stiffness are not validated during ongoing atrial fibrillation (AF) We aimed to determine whether aortic stiffness can be assessed reliably in patients during AF.Methods and resultsCarotid-to-femoral and aortic pulse wave velocity (cf/aoPWV), central blood pressure (BP), and augmentation index (AIx) were assessed by a two-site applanation method and a one-site cuff-based oscillometric method in 40 patients with persistent AF and repeated after cardioversion to SR. Mean age was 63 ± 8 years, 73% male, 50% hypertensive. For the two-site method, cfPWV values were slightly higher in AF than in SR (9.3 ± 1.8 vs. 8.5 ± 1.6 m/s, <jats:italic>p</jats:italic> &amp;lt; 0.001), whereas the one-site method provided similar values in AF and SR (10.1 ± 1.5 vs. 10.0 ± 1.8 m/s).The variability indices from the device was higher in AF for the two-site method (SD 2.5 ± 1.7 vs. 1.0 ± 0.5 m/s, <jats:italic>p</jats:italic> &amp;lt; 0.001) but similar in AF and SR with the one-site method (SD 0.7 ± 0.2 vs. 0.6 ± 0.2 m/s). Both methods yielded higher central BP (+4.8/+6.6 and +4.1/+5.7 mm Hg) and lower Aix (−6.8 and −9.1 mm Hg) in AF.ConclusionsAortic stiffness can be assessed during AF. Both methods yielded higher central BP and lower AIx in AF, but similar results for PWV in AF and SR, also when adjusted for BP changes. The two-site method showed high variability necessitating repeated measurements. The one-site method showed lower device-calculated variability and needed fewer repeated measurements.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221647","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":"Clinical characteristics and long-term prognosis of female patients with acute coronary syndrome.","authors":"Mar Rocamora-Horrach, Óscar M Peiró, Alfredo Bardají, Javier Flores-Benítez, Miguel Ivorra-Cámara, Anna Carrasquer, José Luis Ferreiro","doi":"10.3389/fcvm.2024.1447533","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1447533","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease has traditionally been studied predominantly in men, but understanding its manifestations in women is crucial for effective management. This study aims to evaluate the long-term prognosis of female patients with acute coronary syndrome (ACS) within a tertiary hospital setting in Spain.</p><p><strong>Methods: </strong>Retrospective observational study based on a cohort of consecutive hospitalized patients with ACS from January 2009 to December 2014. Data on demographics, risk factors, treatment, and outcomes were collected, with a median follow-up of 9.2 years.</p><p><strong>Results: </strong>Women with ACS, constituting 27.3% of 2,330 patients, were older and had a higher prevalence of cardiovascular risk factors such as obesity, hypertension, and diabetes mellitus compared to men. They presented with more non-ST-segment elevation myocardial infarction and underwent less coronary angiography. Female patients were also less likely to be treated with acetylsalicylic acid, a second antiplatelet drug, or statins. Despite initial higher mortality rates [hazard ratio (HR) 1.30; 95% confidence interval (CI) 1.13-1.49; <i>p</i> < 0.001], female patients exhibited a more favorable long-term prognosis after adjustments (adjusted HR 0.82; 95% CI 0.71-0.96; <i>p</i> = 0.014), even in the subgroup analysis excluding patients with unstable angina.</p><p><strong>Conclusions: </strong>Women with ACS are more comorbid, but after adjustments, female sex appears to be a protective factor that confers a better long-term prognosis.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153529","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":"Feasibility of tongue image detection for coronary artery disease: based on deep learning.","authors":"Mengyao Duan, Boyan Mao, Zijian Li, Chuhao Wang, Zhixi Hu, Jing Guan, Feng Li","doi":"10.3389/fcvm.2024.1384977","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1384977","url":null,"abstract":"<p><strong>Aim: </strong>Clarify the potential diagnostic value of tongue images for coronary artery disease (CAD), develop a CAD diagnostic model that enhances performance by incorporating tongue image inputs, and provide more reliable evidence for the clinical diagnosis of CAD, offering new biological characterization evidence.</p><p><strong>Methods: </strong>We recruited 684 patients from four hospitals in China for a cross-sectional study, collecting their baseline information and standardized tongue images to train and validate our CAD diagnostic algorithm. We used DeepLabV3 + for segmentation of the tongue body and employed Resnet-18, pretrained on ImageNet, to extract features from the tongue images. We applied DT (Decision Trees), RF (Random Forest), LR (Logistic Regression), SVM (Support Vector Machine), and XGBoost models, developing CAD diagnostic models with inputs of risk factors alone and then with the additional inclusion of tongue image features. We compared the diagnostic performance of different algorithms using accuracy, precision, recall, F1-score, AUPR, and AUC.</p><p><strong>Results: </strong>We classified patients with CAD using tongue images and found that this classification criterion was effective (ACC = 0.670, AUC = 0.690, Recall = 0.666). After comparing algorithms such as Decision Tree (DT), Random Forest (RF), Logistic Regression (LR), Support Vector Machine (SVM), and XGBoost, we ultimately chose XGBoost to develop the CAD diagnosis algorithm. The performance of the CAD diagnosis algorithm developed solely based on risk factors was ACC = 0.730, Precision = 0.811, AUC = 0.763. When tongue features were integrated, the performance of the CAD diagnosis algorithm improved to ACC = 0.760, Precision = 0.773, AUC = 0.786, Recall = 0.850, indicating an enhancement in performance.</p><p><strong>Conclusion: </strong>The use of tongue images in the diagnosis of CAD is feasible, and the inclusion of these features can enhance the performance of existing CAD diagnosis algorithms. We have customized this novel CAD diagnosis algorithm, which offers the advantages of being noninvasive, simple, and cost-effective. It is suitable for large-scale screening of CAD among hypertensive populations. Tongue image features may emerge as potential biomarkers and new risk indicators for CAD.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153530","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":"Autonomic dysfunction as a possible cause of sudden cardiac death in swimming sports.","authors":"Jiri Dostal, Tereza Hybska, Khatuna Saganelidze, Radek Pudil, Josef Stasek","doi":"10.3389/fcvm.2024.1443214","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1443214","url":null,"abstract":"<p><strong>Introduction: </strong>Human diving reflex is a well-studied phenomenon. However, very little is known about the possible relationship between augmented diving reflex and autonomic dysfunction.</p><p><strong>Methods: </strong>We retrospectively studied a group of four swimmers who underwent a diving reflex test as part of the examination due to symptoms related to autonomic dysfunction during swimming. The control group comprised 11 healthy swimmers with no history of these symptoms. A standardized diving reflex test was performed for each athlete in both groups. Hemodynamic profiles, including heart rate, stroke volume, and cardiac output, were recorded.</p><p><strong>Results: </strong>There were no statistically significant differences between the groups in any of the three parameters measured before the test. However, at the end of the test, each parameter (heart rate, stroke volume, and cardiac output) was significantly lower in the swimmers who presented with clinical symptoms related to autonomic dysfunction than in the control group.</p><p><strong>Conclusion: </strong>This observation could shed light on autonomic dysfunction as a possible cause of sudden cardiac death in swimming athletes. It also demonstrated that autonomic dysfunction is presented not only by decreased heart rate but also by stroke volume, causing a drop in cardiac output to the level of hemodynamic collapse.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139725","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}