Journal of Cardiovascular Development and Disease最新文献

{"title":"Exploring the Current Status of Risk Stratification in Hypertrophic Cardiomyopathy: From Risk Models to Promising Techniques.","authors":"Alexandros Kasiakogias, Christos Kaskoutis, Christos-Konstantinos Antoniou, Stavros Georgopoulos, Dimitrios Tsiachris, Petros Arsenos, Alexandrina Kouroutzoglou, Dimitrios Klettas, Charalambos Vlachopoulos, Konstantinos Tsioufis, Konstantinos Gatzoulis","doi":"10.3390/jcdd12030101","DOIUrl":"10.3390/jcdd12030101","url":null,"abstract":"<p><p>Improving clinical prediction of sudden cardiac death is a crucial step in the management of patients with hypertrophic cardiomyopathy. However, finding the optimal method for risk evaluation has been challenging, given the complexity and the wide variation in clinical phenotypes. This is particularly important, as these patients are often of younger age and defibrillator implantation is associated with a low but tangible long-term risk of adverse events. A number of risk factors, including degree of hypertrophy, presence of syncope and family history of sudden cardiac death, have typically been considered to indicate a higher risk. The European risk score for prediction of sudden cardiac death is widely used; however, it may not apply well in patients with specific forms of the condition, such as those with extreme hypertrophy. Increasing evidence suggests that the presence and extent of myocardial fibrosis assessed with cardiac magnetic resonance imaging should be considered in clinical decision-making. Some research suggests that integrating electrophysiological studies into traditional risk assessment models may further optimize risk prediction and significantly improve accuracy in detecting high risk patients. Novel cardiac imaging techniques, better understanding of the genetic substrate and artificial intelligence-based algorithms may prove promising for risk refinement. The present review article provides an updated and in-depth viewpoint.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence and Impact of Atrial Fibrillation on Patients with Chronic Total Occlusions: Insights from the National Inpatient Sample.","authors":"Maximilian Will, Konstantin Schwarz, Eric Holroyd, Josip A Borovac, Adnan I Qureshi, Gregory Y H Lip, Julia Mascherbauer, Gregor Leibundgut, Thomas W Weiss, Chun Shing Kwok","doi":"10.3390/jcdd12030100","DOIUrl":"10.3390/jcdd12030100","url":null,"abstract":"<p><p>The impact of atrial fibrillation (AF) on patients with chronic total occlusions (CTOs) at the national level remains unclear. In this study, we conducted a retrospective analysis of data from the National Inpatient Sample to assess the characteristics and in-hospital outcomes of patients with CTO based on the presence or absence of AF. Multiple logistic and linear regressions examined factors associated with AF and evaluated its impact on length of stay (LoS), cost, and mortality. The analysis included 480,180 patients diagnosed with CTO, with AF present in 28.0% of cases. Patients with CTOs and AF were older (median age 73 vs. 66 years, <i>p</i> < 0.001) and exhibited lower female representation (25.0% vs. 27.9%, <i>p</i> < 0.001). Factors most strongly associated with AF included previous heart failure (OR 1.98, 95% CI 1.92-2.05, <i>p</i> < 0.001), liver disease (OR 1.37, 95% CI 1.27-1.48, <i>p</i> < 0.001), and obesity (OR 1.25, 95% CI 1.20-1.30, <i>p</i> < 0.001). AF correlated with increased in-hospital mortality (OR 1.29, 95% CI 1.18-1.40, <i>p</i> < 0.001), ischemic stroke (OR 1.27, 95% CI 1.13-1.42, <i>p</i> < 0.001), and major bleeding (OR 1.38, 95% CI 1.30-1.46). Moreover, AF was associated with a longer LoS (coef 1.58, 95% CI 1.50 to 1.67, <i>p</i> < 0.001) and higher in-hospital costs (coef 6.22, 95% CI 5.81 to 6.63, <i>p</i> < 0.001). Patients with CTOs and AF were older and had more underlying health problems compared to patients without AF. The patients with AF have worse outcomes in terms of mortality, ischemic stroke, major bleeding, length of stay, and costs.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early vs. Late Endovascular Extension Following Frozen Elephant Trunk Procedure: Effects on Clinical Outcomes and Aortic Remodeling.","authors":"Martin Wenkel, Nancy Halloum, Achim Neufang, Marco Doemland, Philipp Pfeiffer, Ahmad Ghazy, Chris Probst, Daniel-Sebastian Dohle, Hendrik Treede, Hazem El Beyrouti","doi":"10.3390/jcdd12030099","DOIUrl":"10.3390/jcdd12030099","url":null,"abstract":"<p><strong>Background/objectives: </strong>The frozen elephant trunk (FET) technique was introduced as a possible single-stage procedure for treating aortic arch pathologies. However, up to a third of patients are reported to need subsequent completion (extension). This retrospective analysis aimed to evaluate the impact of early (within 30 days; EC group) versus late (>30 days; LC group) endovascular completion with thoracic endovascular aortic repair (TEVAR) in patients treated with FET.</p><p><strong>Methods: </strong>A single-center, retrospective analysis of all consecutive patients for the period between June 2017 and December 2023 who underwent FET and received endovascular extension was conducted. Indications for endovascular extension were aneurysms of the descending aorta, aneurysmal progress, endoleak, malperfusion, distal stent-induced new entry (dSINE), and aortic rupture.</p><p><strong>Results: </strong>A total of 37 of 232 FET patients received endovascular extension (15.9%). Average age at the time of TEVAR was 63.3 ± 10.3 years. There was an increase in the maximum total aortic diameter post-FET from 40.8 ± 9 mm to 45.1 ± 14 mm prior to TEVAR. Only 14 patients (37.8%) had the desired complete occlusion of the false lumen or aneurysm prior to extension; 23 (62.2%) still had relevant perfusion of the false lumen or aneurysm. The EC and LC groups were defined by time between FET and TEVAR: a mean of 4.8 ± 5.2 days in the EC group and 18.4 ± 18 months in the LC group. The EC group had markedly more complex procedures, reflected in intensive care (10.7 ± 6.9 vs. 0.1 ± 0.3 days, <i>p</i> < 0.001) and hospitalization (22.4 ± 14.0 vs. 8.1 ± 5.6 days, <i>p</i> = 0.003) durations. There was one early death due to multiorgan failure in the EC group and there were none in the LC group. There were no major cardiac events in either group. In the EC group, seven patients (50%) suffered from postoperative respiratory failure and four (28.6%) developed acute kidney failure requiring dialysis. Only one patient in the LC group (4.3%) experienced complications. During follow-up, another three patients (21.4%) of the EC group died, but none of the LC group did. Post-extension aortic remodeling was similar in both groups, with complete occlusion achieved in 27 cases (72%) during early follow-up and increased to 90.6% after a mean of 22.0 ± 23.4 months.</p><p><strong>Conclusions: </strong>Following aortic arch repair using FET, there is still a need for second-stage repair in 16% of patients. Endovascular completion post-FET is safe and feasible with a technical success rate of 100%, but early completion is associated with greater morbidity and mortality. TEVAR extension surgery may be better delayed, if possible, until after recovery from the hybrid arch repair.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Series of Completely Thrombosed Abdominal Aortic Aneurysms.","authors":"Raffaello Bellosta, Giulia Anna Sala, Marco Franchin, Luca Luzzani, Alessandro Pucci, Gabriele Piffaretti, Maria Cristina Cervarolo","doi":"10.3390/jcdd12030098","DOIUrl":"10.3390/jcdd12030098","url":null,"abstract":"<p><strong>Background: </strong>Completely thrombosed AAA (th-AAA) has been infrequently described in the literature. The present study evaluated the incidence and report the outcomes of open surgical repair (OSR) of a clinical series of th-AAAs.</p><p><strong>Methods: </strong>This is a single-center, observational cohort study of consecutive th-AAAs identified between 10 October 1998, and 31 January 2024. Open repair was carried out through a transperitoneal route, and Dacron knitted graft replacement. Follow-up included the clinical visit and duplex ultrasound at 30 days, and annually thereafter. The primary outcome was overall survival. The secondary outcome was the freedom from aorta-related reintervention.</p><p><strong>Results: </strong>Out of 2237 AAA repairs, we identified 16 (0.7%) th-AAAs. They were all men with a mean age of 74 years ± 8 (range, 54-89). The median of aneurysm diameter was 49 mm (IQR, 46-52). Rupture was the presenting scenario in four (25%) patients. Early mortality and major amputation did not occur. At a mean follow-up of 70 months ± 48 (range, 11-192), the freedom from aorta-related mortality was 100%, and graft-related complications were not observed.</p><p><strong>Conclusions: </strong>The incidence of th-AAA was <1%. Although rupture was the presenting scenario in nearly 25% of the cases, OSR was safe and effective due to the absence of aorta-related mortality and the long-term durability of the repair.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic Effects of Positive Airway Pressure: A Cardiologist's Overview.","authors":"Anna Di Cristo, Andrea Segreti, Nardi Tetaj, Simone Pasquale Crispino, Emiliano Guerra, Emanuele Stirpe, Gian Paolo Ussia, Francesco Grigioni","doi":"10.3390/jcdd12030097","DOIUrl":"10.3390/jcdd12030097","url":null,"abstract":"<p><p>Positive airway pressure (PAP) therapy is widely used to manage both acute and chronic respiratory failure and plays an increasingly important role in cardiology, particularly in treating patients with respiratory comorbidities. PAP, including continuous positive airway pressure and noninvasive ventilation, significantly impacts hemodynamics by altering intrathoracic pressure, affecting preload, afterload, and stroke volume. These changes are crucial in conditions such as acute cardiogenic pulmonary edema, where PAP can enhance gas exchange, reduce the work of breathing, and improve cardiac output. PAP reduces the left ventricular afterload, which in turn increases stroke volume and myocardial contractility in patients with left-sided heart failure. However, the role of PAP in right ventricular function and its effects on venous return and cardiac output are critical in the cardiac intensive care setting. While PAP provides respiratory benefits, it must be used cautiously in patients with right heart failure or preload-dependent conditions to avoid adverse outcomes. Additionally, in recent years, the use of PAP has expanded in the treatment of severe obstructive sleep apnea and obesity hypoventilation syndrome, both of which significantly influence cardiovascular events and heart failure. This review provides an in-depth analysis of the hemodynamic effects of PAP in cardiovascular disease, focusing on its impact on ventricular function in both acute and chronic conditions. Evaluating clinical studies, guidelines, and recent advancements offers practical insights into the physiological mechanisms and key clinical considerations. Furthermore, this review aims to serve as a helpful guide for clinicians, assisting in decision-making processes where PAP therapy is applied.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Socioeconomic Status (SES) with Procedural Management and Mortality After Percutaneous Coronary Intervention (PCI): An Observational Study from the Pan-London PCI (BCIS) Registry.","authors":"Krishnaraj S Rathod, Pitt Lim, Sam Firoozi, Richard Bogle, Ajay K Jain, Philip A MacCarthy, Miles C Dalby, Iqbal S Malik, Anthony Mathur, James Spratt, Ranil De Silva, Roby Rakhit, Jonathan Hill, Sundeep Singh Kalra, Simon Redwood, Richard Andrew Archbold, Andrew Wragg, Daniel A Jones","doi":"10.3390/jcdd12030096","DOIUrl":"10.3390/jcdd12030096","url":null,"abstract":"<p><strong>Background: </strong>Lower socioeconomic status (SES) has been associated with increased mortality from coronary heart disease. This excess risk, relative to affluent patients, may be due to a combination of more adverse cardiovascular-risk factors, inequalities in access to cardiac investigations, longer waiting times for cardiac revascularisation and lower use of secondary prevention drugs. We sought to investigate whether socio-economic status influenced long-term all-cause mortality after PCI in a large metropolitan city (London), which serves a population of 11 million people with a mixed social background over a 10-year period.</p><p><strong>Methods: </strong>We conducted an observational cohort study of 123,780 consecutive PCI procedures from the Pan-London (United Kingdom) PCI registry. This data set is collected prospectively and includes all patients treated between January 2005 and December 2015. The database includes PCI performed for stable angina and ACS (ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina). Patient socio-economic status was defined by the English Index of Multiple Deprivation (IMD) score, according to residential postcode. Patients were analysed by quintile of IMD score (Q1, least deprived; Q5, most deprived). Median follow-up was 3.7 (IQR: 2.0-5.1) years and the primary outcome was all-cause mortality.</p><p><strong>Results: </strong>The mean age of the patients was 64.3 ± 12.1 years and 25.2% were female. A total of 22.4% of patients were diabetic and 27.3% had a history of previous myocardial infarction. The rates of long-term all-cause mortality increased progressively across quintiles of IMD score, with patients in Q5 showing significantly higher long-term mortality rates compared with patients in Q1 (<i>p</i> = 0.0044). This persisted following the inclusion of a propensity score in the proportional hazard model as a covariate (HR for Q5 compared to Q1: 1.15 [95% CI: 1.10-1.42]).</p><p><strong>Conclusions: </strong>This study has demonstrated that low SES is an independent predictor of adverse clinical outcomes following PCI in the large, diverse metropolitan city of London. There clearly are inequalities in cardio-vascular risk factors, time to access to medical treatment/PCI, access to complex imaging and devices during PCI, access to secondary prevention after PCI, and even race differences. Hence, attention to reducing the burden of cardiovascular risk factors and improving primary prevention, particularly in patients with lower SES, is required.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Findings and Methodological Shortcomings of Investigations Concerning the Relationship Between Sleep Duration and Blood Pressure: A Comprehensive Narrative Review.","authors":"Michael H Smolensky, Ramón C Hermida, Richard J Castriotta, Yong-Jian Geng","doi":"10.3390/jcdd12030095","DOIUrl":"10.3390/jcdd12030095","url":null,"abstract":"<p><p>Cardiology and sleep societies recommend 7-9 h sleep/night for adults (7-8 h for seniors) and more for youngsters; nonetheless, short sleep duration (SSD) of <7 h/night is epidemic. We searched PubMed for representative investigations, including those cited by meta-analyses, that reported association between SSD and long sleep duration (LSD) of >9 h/night and blood pressure (BP) levels to assess shortcomings of their methods. Studies indicate both SSD and LSD negatively impact BP despite major deficiencies, such as (i) reliance mainly on cross-sectional rather than longitudinal protocols, (ii) inclusion of participants diagnosed with hypertension (HTN) and/or taking antihypertension medications, (iii) assessment of BP and diagnosis of HTN performed by single wake-time office measurement rather than multiple measurements performed by 24 h ambulatory BP monitoring (ABPM), and (iv) determination of SD by subjective recall, single-night polysomnography, or diary recordings rather than objective wrist actigraphy of sufficient duration. The limited number of ABPM-based studies, despite evidencing major shortcomings, particularly (i) assessment for 24 h rather than preferred ≥48 h and (ii) inclusion of subjects diagnosed with HTN and/or taking antihypertension medications, also report association between abnormal SD and elevated 24 h 'daytime'/wake-time diastolic and systolic (SBP) means plus 'nighttime'/sleep-time SBP mean and dipping-the latter two indices, in combination, the strongest predictors of major adverse cardiovascular events.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brugada Syndrome and Exercise: Is It Time for a Paradigm Change?","authors":"Carolina Miguel Gonçalves, Adriana Vazão, Mariana Carvalho, Margarida Cabral, André Martins, Mónica Amado, Joana Pereira, Fátima Saraiva, Hélia Martins, Hélder Dores","doi":"10.3390/jcdd12030094","DOIUrl":"10.3390/jcdd12030094","url":null,"abstract":"<p><strong>Background: </strong>Despite the multiple benefits of exercise for health, exercise in the presence of arrhythmic disorders can trigger adverse clinical events, including sudden cardiac death (SCD). The aim of this narrative review is to summarize the most recent recommendations regarding physical activity and exercise in individuals with Brugada Syndrome (BrS).</p><p><strong>Methods: </strong>An advanced literature search was performed on the Pubmed and clinicaltrials.gov databases and published articles/clinical trials registered until September 2024 were analyzed. The final analysis included 33 articles.</p><p><strong>Results: </strong>Despite initial reports suggesting a higher risk of SCD in BrS, the risk is not as high as expected, and there is no evidence that exercise is an independent predictor. Therefore, scientific recommendations have become less restrictive. However, consensus on risk scores is lacking, making the evaluation of BrS a real challenge. The most recent recommendations emphasize individual evaluation, risk stratification, shared decision-making, and general preventive measures, allowing asymptomatic BrS patients as well as genotype positive/phenotype negative patients to participate in competitive sports, excluding sports under extreme conditions. Regarding patients with an implantable cardioverter defibrillator, both leisure and competitive sports may be considered in asymptomatic patients, avoiding contact sports.</p><p><strong>Conclusions: </strong>Research on the relationship between exercise and cardiovascular disease is evolving, but evidence-based recommendations for sports in BrS patients are scarce and further studies are needed.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression, Anxiety, and Quality of Life in a Cardiac Rehabilitation Program Without Dedicated Mental Health Resources Post-Myocardial Infarction.","authors":"Carlos Bertolín-Boronat, Víctor Marcos-Garcés, Héctor Merenciano-González, María Luz Martínez Mas, Josefa Inés Climent Alberola, Nerea Perez, Laura López-Bueno, María Concepción Esteban Argente, María Valls Reig, Ana Arizón Benito, Alfonso Payá Rubio, César Ríos-Navarro, Elena de Dios, Jose Gavara, Manuel F Jiménez-Navarro, Francisco Javier Chorro, Juan Sanchis, Vicente Bodi","doi":"10.3390/jcdd12030092","DOIUrl":"10.3390/jcdd12030092","url":null,"abstract":"<p><p>Anxiety and depression are common after a myocardial infarction (MI), so psychological and psychiatric mental health (MH) interventions are recommended during Cardiac Rehabilitation Programs (CRP). We aim to evaluate anxiety and depression symptoms and quality of life in MI sufferers followed in a CRP without dedicated MH resources. We prospectively included 164 MI patients in our CRP without dedicated MH resources. Patient Health Questionnaire 2-item (PHQ-2) and Generalized Anxiety Disorder 2-item (GAD-2) questionnaires for depression and anxiety screening (altered if ≥3 points) and the 36-Item Short Form Survey Instrument (SF-36) to analyze four MH components and Mental Component Summary (MCS) were assessed at the beginning and after CRP. The mean age was 61.35 ± 10.76 years, and most patients were male (86.6%). A significant improvement in SF-36 mental components (from +5.94 ± 27.98 to +8.31 ± 25 points, <i>p</i> < 0.001) and SF-36-MCS (+1.85 ± 10.23 points, <i>p</i> = 0.02) was noted, as well as a reduction in depression and anxiety symptoms in PHQ-2 and GAD-2 (<i>p</i> < 0.001). However, 33 (20.1%) patients showed a positive screening for depression and/or anxiety at the end of the program. These patients were younger (56.6 ± 8.05 vs. 62.55 ± 11.05 years, <i>p</i> = 0.004) and showed significantly worse initial scores of SF-36 mental components, PHQ-2, and GAD-2 (<i>p</i> < 0.001). We conclude that a Phase 2 CRP without dedicated MH resources can achieve significant improvements in MH well-being after MI. However, one-fifth of the population had substantial depression and/or anxiety symptoms at the end of the program. This subset, characterized by worse initial MH scores, may benefit from specific MH interventions during CRP.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Transesophageal Echocardiographic Guidance in Cardiac Surgery.","authors":"Yannis Dimitroglou, Antonios Karanasos, Andreas Katsaros, Argyro Kalompatsou, Grigorios Tsigkas, Konstantinos Toutouzas, Costantinos Tsioufis, Constantina Aggeli, Periklis Davlouros","doi":"10.3390/jcdd12030093","DOIUrl":"10.3390/jcdd12030093","url":null,"abstract":"<p><p>Transesophageal echocardiography (TEE) is a valuable tool for diagnosing structural heart diseases, offering superior resolution compared to transthoracic echocardiography. It allows for real-time evaluation of cardiac valves and both systolic and diastolic heart function. Additionally, TEE facilitates the prompt detection of potential complications during cardiac surgeries, such as paravalvular leaks, iatrogenic aortic dissections, and pericardial effusions. Advances in imaging, including 3D echocardiography, have further enhanced the visualization of complex structures like cardiac valves, providing \"surgical views\" that improve preoperative planning. These features have also made TEE indispensable for postoperative evaluation of cardiac valve repairs and for intraoperative guidance during minimally invasive procedures. This review article aims to summarize the indications for using TEE as an intraoperative tool in cardiac surgery.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}