Global Cardiology Science & Practice最新文献

{"title":"Coronary artery calcium is not universal: Population differences limit the global applicability.","authors":"Humberto Morais, Fidel Manuel Caceres-Loriga","doi":"10.21542/gcsp.2026.16","DOIUrl":"10.21542/gcsp.2026.16","url":null,"abstract":"","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2026 2","pages":"e202616"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015073","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":"Rare case of fulminant myocarditis in a patient with rickettsia infection.","authors":"Nikolaos Tsiamis, Dimitrios Afendoulis, Christos Tountas, Fotis Toulgaridis, Flora Tsakirian, Eleftherios Vidalakis, Georgios Totikidis, Konstantinos Toutouzas, Anastasia Kitsiou","doi":"10.21542/gcsp.2026.15","DOIUrl":"10.21542/gcsp.2026.15","url":null,"abstract":"<p><p>We report a rare case of fulminant myocarditis caused by <i>Rickettsia conorii</i> infection in a 31-year-old previously healthy male from rural Greece. The patient presented with acute chest pain, fever, and an insect bite eschar. Initial electrocardiography (ECG) demonstrated inferior ST-segment elevation, and coronary angiography excluded obstructive coronary artery disease. Within 24 h, the patient deteriorated to hemodynamic collapse, with left ventricular ejection fraction (LVEF) declining to 20-25%. Management included doxycycline, empirical broad-spectrum antibiotics, intravenous corticosteroids, and aggressive diuresis. Serological confirmation of <i>R. conorii</i> infection (IgM titer 1:64) directed targeted antibiotic monotherapy. Cardiac magnetic resonance (CMR) imaging performed two days post-discharge confirmed acute myocarditis per the 2018 Updated Lake Louise Criteria, with extensive late gadolinium enhancement (LGE) involving 28% of LV mass. LVEF recovered to 56% within weeks. This case highlights the potential for <i>R. conorii</i> to precipitate fulminant myocarditis even in immunocompetent young patients, underscoring the importance of clinical suspicion in endemic regions.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2026 2","pages":"e202615"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015167","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":"Temporal trends in mortality related to infective endocarditis and stroke in the United States.","authors":"Sindhu P Srinivasalu, Rekha Rao, Pranav Premkumar, Subhankar Panigrahi, Vaishnavi S Joshi, Elizabeth S R Makka","doi":"10.21542/gcsp.2026.10","DOIUrl":"10.21542/gcsp.2026.10","url":null,"abstract":"<p><p><b>Introduction</b>: Infective endocarditis (IE) remains a significant cause of mortality, and neurological complications-particularly stroke-are associated with worsened outcomes. However, temporal trends in mortality when both conditions co-occur remain underexplored. <b>Aims:</b> To analyze mortality trends in infective endocarditis with stroke as a contributing cause of death using the CDC Multiple Cause of Death (MCD) database from 1999 to 2020. <b>Methods</b>: A retrospective observational study was conducted using the CDC MCD database to assess mortality trends among individuals aged ≥25 years in the United States from 1999 to 2020. Deaths in which infective endocarditis (ICD-10: I33.0) was listed as the underlying cause and cerebral infarction (ICD-10: I63) as a contributing cause were analyzed. Data were stratified by age, sex, race, geographic region, and place of death. Age-adjusted mortality rates (AAMR) and annual percentage change (APC) were calculated. <b>Results</b>: Between 1999 and 2020, 1,761 deaths met the inclusion criteria. The AAMR for IE with stroke demonstrated an initial decline followed by a subsequent increase (APC: 8.30%; 95% CI: 0.74-16.42). Mortality was highest among males, White adults, and those dying in metropolitan areas and medical facilities. Disparities were observed across demographic and geographic subgroups. <b>Conclusions</b>:IE-associated stroke mortality shows a concerning upward trend, with significant disparities by sex, race, and location. These findings underscore the need for targeted prevention strategies and equitable healthcare access for high-risk populations.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2026 2","pages":"e202610"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015173","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":"Mitral leaflet aneurysm and perforation in fulminant infective endocarditis: Insights from real-time three-dimensional echocardiography.","authors":"Miguel Vicente, Catarina David, Fidel Manuel Caceres-Loriga, Humberto Morais","doi":"10.21542/gcsp.2026.18","DOIUrl":"10.21542/gcsp.2026.18","url":null,"abstract":"<p><p>Infective endocarditis is a life-threatening condition with high morbidity and mortality, particularly in low- and middle-income countries. Amongst causes, enterococcal IE accounts for a substantial proportion of cases, with <i>E. faecalis</i> as the predominant species (90%). We report a 59-year-old man with arterial hypertension and type 2 diabetes mellitus who presented with asthenia, low-grade fever, and osteoarticular pain. Laboratory evaluation revealed severe anemia, leukocytosis, and thrombocytopenia. A new holosystolic mitral murmur prompted echocardiography, which identified vegetation, aneurysm, and perforation of the anterior mitral leaflet with severe regurgitation. Blood cultures confirmed <i>E. faecalis</i>, and appropriate antibiotic therapy was initiated. Despite rapid intervention and intensive care, the patient developed acute heart failure and died within 23 days of admission. This case illustrates the fulminant potential of <i>E. faecalis</i> IE complicated by complex mitral valve destruction, and underscores the importance of early recognition, real-time 3D echocardiography, and prompt multidisciplinary intervention in high-risk presentations.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2026 2","pages":"e202618"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015110","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":"Mean platelet volume as a translational biomarker for cardiovascular risk stratification with perspectives for medical education: a systematic review.","authors":"Diego Fernando López-Muñoz, Cristhian Camilo Velandia-Mosquera, Oscar Eduardo Cruz-Becerra, Daniela Andrea Agudelo, Esteban Pineda-Arias, Martha Liliana Girón-Girón","doi":"10.21542/gcsp.2026.12","DOIUrl":"10.21542/gcsp.2026.12","url":null,"abstract":"<p><p><b>Objective</b>:To evaluate the prognostic value of mean platelet volume (MPV) for cardiovascular risk stratification in settings with limited resources. <b>Methods</b>: We conducted a comprehensive systematic review in accordance with the PRISMA 2020 guidelines (PROSPERO registration number: CRD420251156089). From January 2019 to December 2024, we searched five databases (PubMed, Scopus, Web of Science, SciELO and LILACS) for observational studies linking MPV to cardiovascular outcomes. The methodological quality of the studies was assessed using the STROBE criteria, and the certainty of the evidence was assessed using the GRADE approach. <b>Results</b>: Thirteen studies involving 3,085 participants were included. Of these, 12 (92.3%) reported statistically significant associations between elevated mean platelet volume (MPV) and an increased risk of acute myocardial infarction, stroke, and thromboembolism. MPV values in patients experiencing acute events (8.4-10.7 fL) were consistently higher than in the control group. Derived indices, particularly the MPV-to-lymphocyte ratio, demonstrated superior predictive utility compared to MPV alone. However, critical limitations included substantial heterogeneity in the cut-off point (7.45-12 fL), pre-analytical variability and the complete absence of Latin American populations. The overall certainty of the evidence was classified as VERY LOW. <b>Conclusions</b>: Although there is a consistent predictive signal across worldwide cohorts, its current application in clinical practice is prohibited by the VERY LOW certainty of evidence, which is caused by high pre-analytical heterogeneity and a total lack of Latin American data. These results show that MPV should be prioritized for standardized validation studies rather than being used right away in clinical settings.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2026 2","pages":"e202612"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015172","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":"Correction to \"Neurocognitive outcomes and memory transfer in heart transplantation\".","authors":"","doi":"10.21542/gcsp.2026.19","DOIUrl":"10.21542/gcsp.2026.19","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.21542/gcsp.2025.43.].</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2026 2","pages":"e202619"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015067","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":"Cardiopulmonary bypass complications and their predictors in open-heart surgery at a tertiary cardiac care facility in Tanzania.","authors":"Alfred D Luvakule, Silas F Gamba, Edwin R Lugazia, Alex Loth","doi":"10.21542/gcsp.2026.11","DOIUrl":"10.21542/gcsp.2026.11","url":null,"abstract":"<p><p><b>Background</b>: Cardiopulmonary bypass (CPB) is integral to open-heart surgery but carries significant risks of systemic inflammatory response and organ-specific complications. In low-resource settings, limited local data can impede targeted prevention. This study assessed the frequency and predictors of CPB-related complications at the Jakaya Kikwete Cardiac Institute, Tanzania. <b>Methods</b>: A retrospective review examined 195 pediatric and adult patients who underwent open-heart surgery in 2020. Data from perfusion records and ICU charts were analyzed using descriptive statistics and univariate logistic regression. <b>Results</b>: Of the cohort, 55.4% were male and 52.3% were under 16 years. Valvular heart disease was the most common diagnosis (42.1%). At least one major complication occurred in 31.3% of patients, with cardiovascular (10.8%) and bleeding (9.2%) events predominating. Prolonged ICU stay affected 52.8% of cases and in-hospital mortality was 4.1%. Key predictors of complications included younger age, diagnosis type, procedure type, CPB duration, and cross-clamp time. CPB time exceeding 120 min significantly increased the likelihood of prolonged ICU stay. <b>Conclusions</b>: CPB-related complications represent a substantial burden in this setting. Minimising CPB and cross-clamp durations may improve outcomes. Prospective locally driven research is needed to refine management strategies.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2026 2","pages":"e202611"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148014909","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":"Late saphenous vein graft rupture presenting as a compressive mediastinal pseudoaneurysm.","authors":"Dimitrios Afendoulis, Sotirios Tsalamandris, Flora Tsakirian, Nikolaos Tsiamis, Georgios Benetos, Kostas Tsioufis, Konstantinos Toutouzas","doi":"10.21542/gcsp.2026.17","DOIUrl":"10.21542/gcsp.2026.17","url":null,"abstract":"<p><p>Late saphenous vein graft (SVG) pseudoaneurysm is a rare but life-threatening complication of coronary artery bypass graft surgery. An 80-year-old man presented with dyspnea and chest pain two decades after CABG (LIMA-LAD, SVG-RCA). Coronary angiography revealed SVG occlusion with contrast extravasation and mass formation adjacent to the right heart chambers. CT angiography confirmed a 39 mm mediastinal pseudoaneurysm from proximal SVG rupture, compressing the right heart chambers and lung, with consequent left ventricular dysfunction (EF 45%), elevated pulmonary pressures, and orthostatic hypotension. Following Heart Team discussion, the patient underwent successful pseudoaneurysm resection with right coronary artery revascularization using a left radial artery graft. Symptoms and cardiac function improved at one-month follow-up. This case highlights the importance of clinical suspicion for SVG pseudoaneurysm in patients with prior CABG, and the central role of CT angiography and multidisciplinary decision-making in management.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2026 2","pages":"e202617"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015150","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":"Sex disparities in STEMI pathophysiology: Presentation, treatments, and outcomes.","authors":"Akash Gopal, Swetha Reddy, George G Kidess, Mohammad Akkawi, Timir K Paul, Jawad Basit, M Chadi Alraies","doi":"10.21542/gcsp.2026.1","DOIUrl":"10.21542/gcsp.2026.1","url":null,"abstract":"<p><p>Despite the declining rates of ST-segment elevation myocardial infarction (STEMI) and improvements in care standards, significant disparities between sexes persist among patients diagnosed with STEMI. This review summarizes recent and relevant literature that highlights the differences between men and women concerning STEMI pathophysiology, risk factors, clinical presentation, treatment protocols, diagnostic challenges, and outcomes. Many of these disparities interact, resulting in poorer outcomes for female patients with STEMI. However, there is hope through the adoption of evidence-based treatment plans.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2026 1","pages":"e202601"},"PeriodicalIF":0.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672519","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 long-term effectiveness and tolerability of PCSK9 inhibitors in a large cardiovascular tertiary centre: A retrospective cohort analysis.","authors":"Mahmud Tawil, Fatima Omar, Solith Senanayake, Michelle Cowdry, Winston Banya, Emma Neves, Charis Browne, Wala Mattar, Richard Grocott-Mason, Mahmoud Barbir","doi":"10.21542/gcsp.2026.8","DOIUrl":"10.21542/gcsp.2026.8","url":null,"abstract":"<p><p><b>Background:</b> Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) are effective LDL-cholesterol-lowering agents used in patients with familial hypercholesterolaemia (FH) and/or very high cardiovascular risk on maximal lipid-lowering therapy. Real-world long-term outcome data from routine clinical practice is of great value but to date there has been scarce data published from within the United Kingdom. <b>Methods:</b> We performed a retrospective analysis of 364 patients treated with PCSK9 inhibitors in a single tertiary centre lipid clinic. Demographic, clinical, lipid and outcome data were extracted from a prospectively maintained database. Baseline was defined as the value immediately prior to PCSK9i initiation; \"current\" values represent the most recent measurement on therapy. Descriptive statistics are reported; no formal hypothesis testing was performed. <b>Results:</b> Mean age at initiation was 62.2 ± 14.8 years; 57% were male. FH was common: 43.6% had primary heterozygous FH and 3.2% had primary homozygous FH. A further 39.7% had non-FH high or very-high cardiovascular risk despite maximal lipid-lowering therapy. Hypertension was present in ∼38%, diabetes in ∼18%, and ∼22% were current or ex-smokers. At least 42% of patients had documented cardiovascular disease events. Baseline mean LDL-cholesterol was 5.61 ± 1.81 mmol/L (<i>n</i> ≈ 360). On treatment, mean LDL-cholesterol fell to 2.37 ± 1.55 mmol/L, corresponding to a mean absolute reduction of 3.26 mmol/L and a mean percentage reduction of 58.7 ± 20.5% (<i>n</i> = 352 with paired values). Total cholesterol decreased from 7.86 to 4.56 mmol/L on average. Median follow-up on PCSK9i was approximately 5 years (mean 5.0 ± 1.9 years). At latest follow-up, 304/364 patients (83.5%) remained on PCSK9i. Documented side-effects potentially attributable to PCSK9i occurred in 57 patients (15.7%), most commonly non-specific musculoskeletal symptoms or back pain; discontinuation for adverse events appeared infrequently in the dataset. Major adverse cardiovascular events (MACE) or cardiovascular procedures after PCSK9i initiation were not reliably recorded in in the dataset and therefore the only conclusions that can be made are with regards to lipid lowering effectiveness and tolerability. <b>Conclusions:</b> In this real-world tertiary lipid clinic cohort, PCSK9 inhibitors produced large, durable reductions in LDL-cholesterol of around 60% over a median of ∼5 years, with high treatment persistence and a minimal rate of largely non-serious reported side-effects. The observational design, incomplete event coding and lack of a control group limit inference regarding cardiovascular outcomes, but the lipid-lowering effectiveness is consistent with clinical trial data.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2026 1","pages":"e202608"},"PeriodicalIF":0.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672584","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}