Heart International最新文献

{"title":"Magnesium for Prevention of New-onset Postoperative Atrial Fibrillation Following Cardiac Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Sara Ghazizadeh, Alireza Malektojari, Zahra Javidfar, Shaghayegh Lahuti, Rahele Shokraei, Mohadeseh Zeinaee, Amirhosein Badele, Raziyeh Mirzadeh, Mitra Ashrafi, Fateme Afra, Mohammad Hamed Ersi, Marziyeh Heydari, Ava Ziaei, Zohreh Rezvani, Jasmine Mah, Dena Zeraatkar, Shahin Abbaszadeh, Tyler Pitre","doi":"10.17925/HI.2025.19.1.6","DOIUrl":"10.17925/HI.2025.19.1.6","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis article aimed to investigate the efficacy of magnesium in preventing new-onset postoperative atrial fibrillation (POAF).</p><p><strong>Methods: </strong>We searched Medline, Embase, Web of Science and Cochrane Library without any language or publication date restriction up to August 2023. We included randomized controlled trials (RCTs) that enrolled adults undergoing cardiac surgery without a history of atrial fibrillation, exploring the effect of magnesium supplementation in preventing new-onset POAF. We assessed the risk of bias using the Cochrane Risk of Bias 2.0 (RoB 2.0) tool. We conducted a random-effects meta-analysis using R and assessed the certainty of the evidence.</p><p><strong>Results: </strong>A total of 24 RCTs with 3,373 participants were included. We found that magnesium may reduce the risk of POAF compared to the control group (relative risk [RR]: 0.55; 95% confidence interval [CI]: 0.41, 0.74; low certainty). The subgroup analysis for trials with low/some concerns risk of bias showed that magnesium reduces the risk of new-onset POAF compared to control (RR: 0.70 [95% CI: 0.58, 0.84]; high certainty). Magnesium consumption had no significant effect on all-cause mortality (RR: 1.00 [95% CI: 0.34, 2.90]) or days of hospitalization (mean difference: -0.34 [95% CI: -0.94, 0.26]).</p><p><strong>Conclusion: </strong>The evidence indicates that magnesium administration reduces the incidence of new-onset POAF.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"19 1","pages":"3-11"},"PeriodicalIF":2.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707267","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":"Monitoring Disease Progression in Transthyretin Amyloid Cardiomyopathy.","authors":"Adam Ioannou","doi":"10.17925/HI.2025.19.1.5","DOIUrl":"10.17925/HI.2025.19.1.5","url":null,"abstract":"<p><p>Transthyretin amyloid cardiomyopathy is a progressive and fatal cardiomyopathy caused by the deposition of misfolded transthyretin in the form of amyloid fibrils in the myocardium. The advent of various highly efficacious transthyretin amyloid-specific disease-modifying therapies has sparked a growing interest in identifying the clinical indicators of disease progression that will be crucial in guiding treatment decisions. Markers of disease progression include changes in commonly measured biomarkers such as the N-terminal pro-B-type natriuretic peptide and the estimated glomerular filtration rate, a decline in the 6-m inute walk test distance, outpatient diuretic intensification, changes in heart failure symptom burden and also changes in various cardiac-imaging parameters. Considering the wide array of markers that can detect disease progression, it is likely that a comprehensive clinical assessment will involve monitoring multiple markers simultaneously. Integrating multiple markers of disease progression offers additional insights beyond individual markers, enabling a refined assessment of disease trajectory and mortality risk. Many of these markers are readily available, simple to measure and universally applicable, making them easy to implement in clinical practice for identifying patients with advancing disease and a heightened risk of mortality.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"19 1","pages":"20-25"},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707268","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 Systematic Review of Clinical Trials on Mavacamten in Hypertrophic Cardiomyopathy.","authors":"Pavan Kumar Reddy Kalluru, Sowmya Manjari Siddenthi, Sai Sudha Valisekka, Siva Keerthana Suddapalli, Uday Teja Juturu, Sunanda Chagam Reddy, Anjani Matturi, Sai Goutham Reddy Yartha, Deekshitha Kuchi, Vaishak Ramesh Batchu, Apoorva Cherukuri","doi":"10.17925/HI.2025.19.1.7","DOIUrl":"10.17925/HI.2025.19.1.7","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertrophic cardiomyopathy (HCM) is characterised by unusual thickening of the interventricular septum leading to dynamic left ventricular outflow tract obstruction, mitral valve regurgitation, impaired diastolic function and arrhythmias. Mavacamten (MYK-461) is a first-in-class, selective allosteric modulator of cardiac myosin adenosine triphosphatase and received US Food and Drug Administration (FDA) approval on 28 April 2022 to treat symptomatic obstructive HCM (oHCM).</p><p><strong>Methods: </strong>A systematic search of Medline/PubMed and ClinicalTrials. gov was conducted using advanced search strategies with the terms 'mavacamten/MYK-461' and 'hypertrophic cardiomyopathy/HCM' to identify and include all clinical trials published to date.</p><p><strong>Results: </strong>The clinical efficacy of mavacamten has been consistently demonstrated in the PIONEER-HCM, MAVERICK-HCM, EXPLORER-HCM, VALOR-HCM, EXPLORER-CN-HCM and HORIZON-HCM clinical trials - there was a notable decrease in the left ventricular outflow tract gradient. Apart from the MAVERICK experiment, which revealed no discernible change in functional class or peak volume of oxygen uptake (pVO₂) in non-oHCM patients, improvements were reported in New York Heart Association functional class, pVO₂ and quality-of-l ife metrics. Except for the PIONEER trial, which didn't report biomarker data such as N-terminal pro B-type natriuretic peptide (NT-proBNP) and troponins, mavacamten significantly reduced biomarkers in all investigations. Additionally, the VALOR trial showed that there was a reduced need for septal reduction therapy. Although systolic dysfunction is a major safety risk that requires careful monitoring, mavacamten was generally well tolerated.</p><p><strong>Conclusion: </strong>Mavacamten offered a promising, non-invasive pharmacological therapy for patients with symptomatic oHCM, particularly for those who are not candidates for or who have failed conventional treatments.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"19 1","pages":"31-40"},"PeriodicalIF":2.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707264","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":"Complications with Left Bundle Branch Area Pacing: The Flip Side of the Coin.","authors":"Samuel Stempfel, Heli Tolppanen, Valérian Valiton, Haran Burri","doi":"10.17925/HI.2025.19.1.3","DOIUrl":"10.17925/HI.2025.19.1.3","url":null,"abstract":"<p><p>Left bundle branch area pacing has been a breakthrough in pacing therapy and is being increasingly adopted. It delivers a more physiological form of pacing compared with right ventricular and biventricular pacing and also avoids the risk of perforation of the ventricular free wall. However, the therapy comes at the price of new complications related to the transseptal route for placing the lead. This article provides an update on these complications and discusses how to avoid and manage these adverse events.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"19 1","pages":"26-30"},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707266","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":"Retrospective Comparison of Device Versus Suture for Patent Foramen Ovale Closure.","authors":"Bryan W Kluck, Rahul Gupta, Andrew Orzel","doi":"10.17925/HI.2025.19.1.4","DOIUrl":"10.17925/HI.2025.19.1.4","url":null,"abstract":"<p><strong>Background: </strong>The use of an implantable closure device with medical therapy to prevent recurrent stroke in patent foramen ovale (PFO)-associated stroke has been shown to be superior to medical therapy alone. Recently, an alternative, suture-based method also has shown promise for effective PFO closure. There has been little published data comparing the outcomes of these two technologies.</p><p><strong>Methods: </strong>This retrospective study explores the safety and efficacy outcomes of device-based versus suture-based percutaneous PFO intervention. The occurrence of post-procedural atrial fibrillation was of primary interest. Data from 55 single-institution, single-operator PFO closure cases between 1 January 2021 and 8 April 2022 were analyzed. Closure occurred via one of two Food and Drug Administration (FDA)-approved occluders or the NobleStitch™ EL suture-based approach. Data were transcribed into a registered REDCap database for descriptive analysis. Demographics, medical history, imaging, procedural and post-procedural outcomes were the variables collected for each participant.</p><p><strong>Results: </strong>All patients had successful PFO closure without major adverse outcomes. Overall efficacy was similar between the two groups. No patient had a residual shunt greater than grade 1. Several suture-group patients required multiple sutures for satisfactory closure. Those who had multiple sutures had no anomalous anatomic PFO features. Three patients (5%), all from the device group, developed atrial fibrillation after PFO closure.</p><p><strong>Conclusions: </strong>This study supports the safety and efficacy of device- and suture-based approaches in PFO closure. Suture-based closure would seem a reasonable option where device-based closure raises concerns. Future studies could further explore the observed disparity of atrial fibrillation occurrence between the two PFO closure strategies.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"19 1","pages":"48-56"},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707270","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":"Multidimensional Determinants of Functional Status in Patients with Heart Failure.","authors":"Jia-Rong Wu, Abigail Latimer, Ashmita Thapa, Cynthia Arslanian-Engoren, Jennifer L Smith, Jessica Harman Thompson, Chin-Yen Lin, JungHee Kang, Muna Hammash, Muhammad I Amin, Martha J Biddle, Kyoung Suk Lee, Seongkum Heo, Debra K Moser","doi":"10.17925/HI.2025.19.1.2","DOIUrl":"10.17925/HI.2025.19.1.2","url":null,"abstract":"<p><strong>Introduction: </strong>Functional status is a predictor of rehospitalization and mortality in patients with heart failure (HF). The purpose of this study was to test the variables in the Multidimensional Model of Functional Status (MMFS) as determinants of functional status.</p><p><strong>Methods: </strong>Using structural equation modelling, we analysed data from 520 patients with HF to determine the best multivariate model of functional status. In the MMFS, the potential determinants of functional status include demographic, clinical, psychosocial, behavioural and symptom burden variables. We measured functional status using the Duke Activity Status Index. Other variables were collected by standardized questionnaires and patient interviews.</p><p><strong>Results: </strong>Patients who were older, less educated, or had greater comorbidity burden or greater symptom burden had worse functional status. Sex, body mass index, depression, anxiety and social support were indirectly associated with functional status mediated by symptom burden. Being married was indirectly associated with better functional status via the pathways of more social support and fewer depressive symptoms through lower symptom burden.</p><p><strong>Conclusion: </strong>Multidimensional variables proposed in the MMFS were directly and indirectly associated with functional status. Among these variables, symptom burden is the most important mediator. Targeting these variables, especially symptom burden, may improve patients' functional status.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"19 1","pages":"41-47"},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707269","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":"Community-based Participatory Research in Cardiovascular Disease Prevention for Middle-aged Women: A Systematic Review.","authors":"Rnda I Ashgar","doi":"10.17925/HI.2025.19.1.1","DOIUrl":"10.17925/HI.2025.19.1.1","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality among women, particularly those of childbearing age and middle-aged women, who face heightened risks due to physiological changes, stress and systemic barriers. Women of colour and those from low socioeconomic backgrounds are disproportionately affected.</p><p><strong>Aim: </strong>This article evaluates the effectiveness of community-based participatory research (CBPR) in reducing CVD risk among midlife women, emphasizing the cultural relevance of interventions as a critical factor for success.</p><p><strong>Methodology: </strong>Following the PRISMA guidelines, a systematic search of PubMed, Scopus and Web of Science identified 15 studies, including randomized controlled trials, practice-based participatory research (PBPRs) and mixed-methods research. These studies implemented CBPR interventions focusing on diet, physical activity, stress management and community participation for underserved populations. Outcomes measured included systolic and diastolic blood pressure, serum cholesterol, Body Mass Index (BMI) and fasting blood glucose, as well as participants' knowledge, behaviours and perceived community capacity.</p><p><strong>Results: </strong>The analysis showed reductions in systolic and diastolic blood pressure (7 and 4 mmHg, respectively), low-density lipoprotein cholesterol (10-15 mg/dL) and BMI (0.5-1.2 kg/m²), along with increases in high-density lipoprotein cholesterol (5-8 mg/dL). Culturally tailored interventions, such as dietary adjustments, group exercise and peer support, demonstrated improved compliance and maintenance of behavioural changes. Patterns of cultural relevance, trust and community ownership emerged as key determinants of success. CBPR offers significant potential for addressing health disparities and reducing CVD risk.</p><p><strong>Conclusion: </strong>Expanding CBPR approaches and conducting long-term interventions can enhance health equity and achieve lasting benefits across diverse populations.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"19 1","pages":"12-19"},"PeriodicalIF":2.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707265","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":"Coronary Dissection - Back to the Future - Finding Good in the Bad!","authors":"Rajkumar Natarajan, Natasha Corballis, Ioannis Merinopoulos, Vassilios S Vassiliou, Simon C Eccleshall","doi":"10.17925/HI.2024.18.2.5","DOIUrl":"10.17925/HI.2024.18.2.5","url":null,"abstract":"<p><p>It has been recognized for decades that dissections occur as a mechanism of balloon angioplasty. A successful angioplasty result contains some degree of intimal splitting and disruption, which usually heals well. Nonetheless, some dissections are extensive, leading to serious ischaemic complications. The concept of therapeutic coronary dissection started evolving in the 1970s and seems to be a favourable mechanism for drug delivery in the current era of drug-coated balloons. This article will primarily focus on studies undertaken to understand the mechanism of balloon angioplasty and the morphological changes in the plaque post-balloon angioplasty. In the early days of balloon angioplasty, there was an enormous interest in dissections, mainly to prevent acute vessel closure events and to address the importance of their occurrence in relation to vessel restenosis. We will review the historical background, studies defining the clinical, angiographic and morphological patterns of the dissection spectrum and various currently evolving management strategies.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"18 2","pages":"14-23"},"PeriodicalIF":1.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065142","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":"Transcatheter Management of Tricuspid Regurgitation: A Review of Contemporary Evidence.","authors":"Yasser M Sammour, Muhammad Faraz Anwaar, Francisco Cabral-Amador, Jian Garcia, Joe Aoun, Sana Kazmi, Nadeen Faza, Stephen H Little, Michael J Reardon, Neal S Kleiman, Sachin S Goel","doi":"10.17925/HI.2024.18.2.4","DOIUrl":"10.17925/HI.2024.18.2.4","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) is a common valvular heart disease that is associated with increased morbidity and mortality. Traditional surgical interventions, though definitive, carry considerable complexities and risks, especially for high-risk patients, with in-hospital mortality rates of ˜9%. This resulted in the undertreatment of many patients with TR, creating a substantial unmet need. This has stimulated the development of transcatheter techniques, such as transcatheter tricuspid valve replacement, tricuspid edge-to-edge repair, tricuspid annuloplasty, caval valve implantation and many others, which offer less-i nvasive alternatives with promising early results and sustained benefits. This review provides a contemporary outlook on different transcatheter tricuspid valve interventions in patients with severe TR and assesses the existing clinical data regarding the safety and effectiveness of these devices in a rapidly expanding space.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"18 2","pages":"24-36"},"PeriodicalIF":1.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065150","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":"Understanding Diabetic Cardiomyopathy: Insulin Resistance and Beyond.","authors":"Aditya John Binu, Nitin Kapoor","doi":"10.17925/HI.2024.18.2.2","DOIUrl":"10.17925/HI.2024.18.2.2","url":null,"abstract":"<p><p><b>Background:</b> Diabetic cardiomyopathy (DC) is a syndrome of heart failure occurring in patients with diabetes mellitus (DM), independent of other risk factors. It is a relatively underdiagnosed condition with a prolonged subclinical phase. There is an abundance of studies put forward to explain the underlying pathogenic mechanisms observed in this condition. This review aims to summarize the evidence available in contemporary medical literature with regard to the molecular mechanisms, abnormalities in signalling and metabolism and structural and functional abnormalities manifesting as DC. <b>Methods:</b> We conducted a literature search using the terms 'diabetic cardiomyopathy', 'heart failure AND Diabetes mellitus', 'Cardiomyopathy AND Diabetes mellitus'. We searched the reference lists of included studies and relevant systematic reviews. <b>Results:</b> In this review, we elucidate all the mechanisms that have been postulated to have a role in the pathogenesis of DC, in addition to insulin resistance, such as inflammation, renin-angiotensin-aldosterone system activation and deranged protein homeostasis. <b>Conclusions:</b> DC is an underrecognized cardiac complication of DM. A comprehensive knowledge of all the pathways and mediators will aid in the development of diagnostic and prognostic markers, screening protocols and novel management strategies.</p>","PeriodicalId":12836,"journal":{"name":"Heart International","volume":"18 2","pages":"7-13"},"PeriodicalIF":1.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065163","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}