Global Cardiology Science & Practice最新文献

{"title":"Pulmonary arteriovenous malformations with suspected infiltrative disease: A case report from a peripheral hospital.","authors":"Nabila Azka Namirah, Naufal Fakhri Nugraha, Zahra Nadiah, Zahran Lazuardi Haryawan, Abednego Panggabean","doi":"10.21542/gcsp.2025.1","DOIUrl":"10.21542/gcsp.2025.1","url":null,"abstract":"<p><p>Pulmonary arteriovenous malformations (PAVMs) is a rare condition involving an abnormal connection of the pulmonary vasculature between the artery and vein, bypassing the capillary structure and causing a right-to-left shunt (RLS) of blood flow. This case report describes a 17-year-old female patient presenting with recurrent nose and tongue bleeding. Cyanosis and clubbing of the fingers were observed, along with visible telangiectasis on the skin and mucosal surfaces. Hereditary hemorrhagic telangiectasis (HHT) was diagnosed based on the Curaçao criteria. The RLS manifestations suggested a high probability of PAVM, confirmed by an agitated saline test showing a positive bubble appearance after four beats from the pulmonary vein to the left ventricle. An increased intraventricular wall diameter (19 mm) with a granular sparkling appearance indicated potential cardiac amyloidosis (CA). Speckle tracking echocardiography (STE) revealed a 'cherry-like' appearance in a 'bull's eye' pattern. This case illustrates a diagnostic approach for PAVM in an adolescent HHT patient with suspected CA in a rural setting using limited resources.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 1","pages":"e202501"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Group D of pulmonary arterial hypertension and its relationship to congenital heart disease: Is there a non-invasive way to predict the unpredictable?","authors":"Antoine Fakhry AbdelMassih, Alyaa AlAli, Emad Nasr, Eman Hanafy, Musaab Ramsi","doi":"10.21542/gcsp.2025.5","DOIUrl":"10.21542/gcsp.2025.5","url":null,"abstract":"<p><p>Pulmonary arterial hypertension related to congenital heart disease (PAH-CHD), can pose a few challenging therapeutic challenges. PAH related to CHD can be classified into 4 clinical groups: Group A, which includes patients with Eisenmenger syndrome; Group B, which includes patients with severe PAH due to significant shunt lesions with no reversal of the shunt and no cyanosis; Group C, which includes patients with PAH due to small defects whose clinical picture is comparable to that of IPAH (idiopathic PAH) patients; and Group D, which includes patients with persistent PAH following CHD repair. This review aims to shed light on the possible laboratory markers that can predict whether pulmonary arterial hypertension secondary to a congenital heart defect will improve after repair of the defect or will continue to progress because the patient's PAH is mediated by idiopathic changes and not the shunt lesion itself. This differentiation is crucial for predicting PH prognosis after cardiac repair. See Figure 1 for graphical abstract. 10.7717/gcsp.202505/fig-1Figure 1.Graphical abstract showing laboratory predictors of irreversible pulmonary arterial hypertension.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 1","pages":"e202505"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Vitamin D supplementation in cardiovascular health: A reappraisal.","authors":"Shrishti P Khetan, Shruti Suresh Suvarna","doi":"10.21542/gcsp.2025.10","DOIUrl":"10.21542/gcsp.2025.10","url":null,"abstract":"","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 1","pages":"e202510"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of Monocyte-High Density Lipoprotein ratio to coronary artery diameter in coronary heart disease patients.","authors":"Azhari Gani, Muhammad Diah Yusuf, Siti Adewiyah, Malahayati","doi":"10.21542/gcsp.2025.11","DOIUrl":"10.21542/gcsp.2025.11","url":null,"abstract":"<p><strong>Background: </strong>The Monocyte to High-Density Lipoprotein Ratio (MHR) ratio reflects the proatherogenic and antiatherogenic balance and increased MHR values are related to coronary atherosclerosis obstruction's presence, progressivity, and severity. This study uses medical records and coronary angiography data to assess the correlation between MHR and coronary artery diameter in coronary heart disease patients.</p><p><strong>Methods: </strong>This study involved data from 230 patient medical records. The data collection approach was a cross-section design, and total sampling was performed by citing medical records of patients who underwent coronary angiography at the catheterization installation of Dr. Zainal Abidin Hospital, Banda Aceh, Indonesia.</p><p><strong>Results: </strong>The multivariate test showed that MHR and the coronary slow flow group, MINOCA, and stenosis were significant with a value of <i>p</i> < 0.0001. The results of the bivariate test showed the relationship between MHR and coronary artery diameter in all three groups. Coronary slow flow, MINOCA, and stenosis were insignificant <i>p</i> > 0.05.</p><p><strong>Conclusion: </strong>This study shows that MHR can be a suitable, inexpensive, fast parameter for identifying the severity of coronary atherosclerosis obstruction.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 1","pages":"e202511"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A focus on the assessment of the autonomic function using heart rate variability.","authors":"Youssra Amekran, Narjisse Damoun, Abdelkader Jalil El Hangouche","doi":"10.21542/gcsp.2025.12","DOIUrl":"10.21542/gcsp.2025.12","url":null,"abstract":"<p><p>Heart rate variability (HRV), the variation in the time interval between successive heartbeats, has emerged as a method to evaluate autonomic function and is increasingly accepted as a biomarker reflecting the balance between the sympathetic and parasympathetic nervous system (SNS and PNS, respectively) branches. Since 1996, most HRV measurements have been performed according to the Task Force standards of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. However, despite the established guidelines and growing body of research on HRV, this technique has not been fully incorporated into routine clinical practice. This review provides a comprehensive overview of the different aspects of HRV measurement, highlighting the fundamental principles, available methods, and physiological basis of HRV assessment to elucidate its role in understanding autonomic function in normal and abnormal health conditions.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 1","pages":"e202512"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization and outcomes of single-troponin discharge from the emergency department in a low-risk population.","authors":"Zhengqiu Zhou, Kory Heier, Jeffrey F Spindel, Austin Harris, Emily Slade, Weston McCowan, Dealla Samadi, Joshua Kim, James D Moore, Seth T Stearley, Vedant Gupta","doi":"10.21542/gcsp.2025.8","DOIUrl":"10.21542/gcsp.2025.8","url":null,"abstract":"<p><p><b>Objectives:</b> There is emerging data supporting rapid triage of low-risk chest pain patients to help facilitate Emergency Department (ED) throughput. We assessed an algorithm for accelerated rule-out of acute coronary syndrome in low-risk patients with an undetectable initial high sensitivity cardiac troponin (hs-cTn assays; Roche Diagnostics) in a real-world clinical setting. <b>Methods:</b> All adults presenting with chief complaint of non-traumatic chest pain to our tertiary care ED with HEART score ≤3 with at least one hs-cTn and EKG obtained were included in our study. Data and outcomes were compared three months before and after implementation of our updated Acute Chest Pain Optimal Care Pathway that allowed discharge of patients with an initial troponin below detectable range (<6ng/L). The primary outcome was acute coronary syndrome at presentation or major adverse cardiovascular events within 30 days. Secondary outcomes included ED length of stay, cardiology consultations, and hospital admissions. <b>Results:</b> Of the 229 patients fitting our criteria with a low-risk heart score (≤3) and undetectable initial troponin, zero patients were diagnosed with ACS and one major adverse cardiac event occurred post-implementation (0.8%). There were no significant differences in median ED length of stay pre- (4.5 h, IQR 3.8-6.6) versus post-implementation (4.6 h, IQR 3.5-5.7; <i>p</i> = 0.448), number of cardiology consults (<i>p</i> = 0.305) and hospital admissions (<i>p</i> = 0.261). However, protocol adherence was poor (50%). In a subgroup analysis post-implementation, patients whose care aligned with the algorithm (<i>n</i> = 64, 50.0%) had significantly shorter ED stays (median 4.1 h, IQR 3.3-4.9 vs 5.2 h, IQR 4.4-6.9, <i>p</i>¡0.001), fewer admissions (<i>p</i> = 0.001) but not fewer cardiology consults (<i>p</i> = 0.440). <b>Conclusions:</b> Our study supports current data regarding the safety of accelerated rule out strategy with hs-cTn. However, our conclusions are limited due to its small sample size and retrospective design.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 1","pages":"e202508"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of vitamin D on renin concentration in chronic heart failure patients: a randomized placebo-controlled trial.","authors":"Fathia Mghaieth, Bessem Hammami, Syrine Ben Jeddou, Selim Boudiche, Manel Ben Halima, Jihen Bensassi, Amine Soula, Sameh Hadj Taieb, Moncef Feki, Mohamed S Mourali","doi":"10.21542/gcsp.2025.7","DOIUrl":"10.21542/gcsp.2025.7","url":null,"abstract":"<p><p><b>Background:</b> Hypovitaminosis D and hyperreninemia are associated with poor prognosis in patients with chronic heart failure (CHF). We aimed to evaluate the effect of vitamin D (VitD) supplementation on the renin-angiotensin-aldosterone system (RAAS) in CHF patients with reduced left ventricular ejection fraction (HFrEF). <b>Methods:</b> A double-blind placebo-controlled randomized clinical trial was conducted in HFrEF patients. Patients were randomized to receive two doses of 200,000 IU VitD3 (VitD group) or saline solution (placebo group) at a two-week interval. Plasma 25-hydroxyvitamin D and renin concentrations were assessed at baseline and one month after the first dose. The primary outcome was plasma renin change. The study was registered at the Pan African Clinical Trials Registry as PACTR201908774181973. <b>Results:</b> Forty patients in each group completed the trial. At baseline, hypovitaminosis D and hyperreninemia were found in 85% and 77.5% of patients, respectively, with no differences between VitD and placebo groups. VitD supplementation resulted in an increase in 25-hydroxyvitamin D in the VitD group, only. In parallel, plasma renin decreased in the VitD group [renin change: median (25th percentile; 75th percentile), -34.9 (-110; -7.1)], but did not change in the placebo group [1.35 (-1.2; 8.8)]. No significant changes were found for clinical, echocardiographic, and other biochemical parameters in both groups. <b>Conclusions:</b> A mega-dose of vitamin D resulted in middle-term RAAS suppression but didn't affect cardiac function and clinical features in HFrEF patients. Further research with longer follow-ups is needed to evaluate whether persistent adequate VitD status results in long-term RAAS suppression and cardiac function improvement.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 1","pages":"e202507"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing disparity in mortality rates for ischemic heart disease using CDC-WONDER database: A retrospective analysis.","authors":"Nithin Karnan, Abdirahman Hassan Abdirahman, Gayathri Kilaru, Asis Reet Kaur, Kaustav Majumder, Layla Al Safadi Abou Al Fadel","doi":"10.21542/gcsp.2025.14","DOIUrl":"10.21542/gcsp.2025.14","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic heart disease remains a leading global cause of death, impacting healthcare systems worldwide. In 2019, 32% of global deaths were estimated to be due to cardiovascular events, accounting for approximately 17.9 million people worldwide. Despite technological advances improving diagnosis and treatment, disparities persist, especially between urban and rural areas.</p><p><strong>Methods: </strong>We conducted a retrospective study using the CDC WONDER database extracted on 17th March 2024, ICD-10 code: I20-I25 (Ischemic Heart Disease). We selected the years 1999-2020: Underlying Cause of Death by Bridged-Race Categories divided based on rural and urban deaths, based on 2013 urbanization classification, and grouped by age (10-year age range), gender, and race.</p><p><strong>Results: </strong>Our research indicates a consistent decline in ischemic heart disease mortality across urban and rural regions within all demographic groups from 1999 to 2020. However, a notable exception occurred in 2019 when mortality rates increased in both urban and rural settings. Notably, throughout the entire period under study, rural areas consistently exhibited higher mortality rates compared to their urban counterparts.</p><p><strong>Conclusion: </strong>This study sheds light on the big disparity in mortality rates due to ischemic heart disease in urban versus rural areas in all groups of age, gender, and race. We hope our findings prompt further research to determine the causes of this discrepancy and public health interventions to address it.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 1","pages":"e202514"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the impact of the Index of Multiple Deprivation on percutaneous coronary intervention outcomes: Insights from the British Cardiovascular Intervention Society database.","authors":"Sushant Saluja, Bernard D Keavney, Mohammed Alawami, Magdi El-Omar, Freidoon Keshavarzi, Maaham Saleem, Scott Garg, Simon G Anderson","doi":"10.21542/gcsp.2025.4","DOIUrl":"10.21542/gcsp.2025.4","url":null,"abstract":"<p><p><b>Background:</b> The effect of socioeconomic status on percutaneous coronary intervention (PCI) outcomes in populations with universal healthcare is poorly understood. Previous studies have primarily focused on ST-segment elevation myocardial infarction (STEMI) patients. <b>Methods:</b> We analysed PCI outcomes from the British Cardiovascular Intervention Society database (2007-2014), categorised by deprivation quintiles. The primary endpoint was 30-day all-cause mortality, with hazard ratios calculated using Cox regression, adjusting for hospital clustering. <b>Results:</b> Among 437,024 eligible patients, with 1.78 million person-years of follow-up, 39.9% underwent PCI for stable coronary artery disease (CAD), 38.4% for non-STEMI, and 21.6% for STEMI. During a median follow-up of 3.5 years, 52,258 patients (11.9%) died. Crude mortality rates increased with greater deprivation (from 26.7 per 1,000 person-years in the least deprived to 28.5 per 1,000 in the most deprived; <i>p</i> for trend <0.0001). Increased mortality rates with worsening IMD were observed only in patients treated for non-STEMI. Adjusted for various covariates, including age, sex and PCI indication, 30-day mortality rates were 14% higher (HR: 1.14; 95% CI:1.06 to 1.24; <i>p</i> <0.0001) in the most deprived patients compared to the least deprived. Similar patterns were observed for 1-year (HR:1.09; 95% CI:1.04 to 1.14) and 5-year mortality (HR:1.10; 95% CI:1.06 to 1.16). <b>Conclusion:</b> Socioeconomic deprivation independently increases mortality risk after non-STEMI, but doesn't affect outcomes for stable CAD or STEMI in universal healthcare settings. Targeted strategies are needed to address this disparity.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 1","pages":"e202504"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Puzzling obstructive tumor in the right heart: A large intravascular leiomyomatosis with intracardiac extension.","authors":"Marha M Menaisy, Ahmed Esmail, Ahmed Ramadan, Omar Dawoud, Ahmad Samir","doi":"10.21542/gcsp.2025.9","DOIUrl":"10.21542/gcsp.2025.9","url":null,"abstract":"<p><strong>Objective: </strong>Intravascular leiomyomatosis (IVL) is a rare benign tumor capable of hematogenous spread. Clinical presentation is heterogeneous depending on the destination organ, which often delays identification. Key steps: A 38-year-old female with a recent history of hysterectomy presented with dyspnea and dizziness. Initial workup revealed a huge obstructive growth in the right heart chambers. A thrombus-in-transit was the most likely preliminary diagnosis. Further thorough assessment reduced the likelihood of a thrombus and increased suspicion of a benign tumor. A large IVL with intracardiac extension was then considered. The mass was completely resected through a combined one-stage approach, and IVL was confirmed pathologically. The patient was well-educated about the importance of periodic surveillance for the reported high recurrence rates. What we have learned? IVL is a rare benign tumor that behaves like malignancy and, hence may have nonspecific presentations. Thorough clinical evaluation and collaborated multi-modality imaging are critical keys to the appropriate diagnosis.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 1","pages":"e202509"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}