Journal of Cardiovascular Development and Disease最新文献

筛选
英文 中文
Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement.
IF 2.4 4区 医学
Journal of Cardiovascular Development and Disease Pub Date : 2025-01-16 DOI: 10.3390/jcdd12010029
Hao-Wei Lee, Chih-Hui Chin, Po-Chin Chou, Chia-Hsiu Chang, Chiu-Ling Tsai, Chi-Hung Huang
{"title":"Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement.","authors":"Hao-Wei Lee, Chih-Hui Chin, Po-Chin Chou, Chia-Hsiu Chang, Chiu-Ling Tsai, Chi-Hung Huang","doi":"10.3390/jcdd12010029","DOIUrl":"10.3390/jcdd12010029","url":null,"abstract":"<p><strong>Background: </strong>A staging system based on cardiac damage for severe aortic stenosis (AS) has been validated for prognosis prediction following transcatheter aortic valve replacement (TAVR). Our study aims to investigate whether TAVR can lead to changes in cardiac damage shortly after the procedure and how these changes impact prognosis.</p><p><strong>Method: </strong>Patients in this retrospective cohort study were classified into five stages (0-4) before TAVR based on the echocardiographic findings of cardiac damage. The closest echocardiogram after TAVR was used for restaging cardiac damage. The primary composite outcome was all-cause mortality or hospitalization due to heart failure (HF).</p><p><strong>Results: </strong>A total of 64 patients were enrolled (53.1% male, mean age 81.7 ± 7.7 years). Within a mean interval of 4 days (interquartile range = 3 to 7 days) after TAVR, cardiac damage improved in 25.0% of patients, while it worsened in 20.3%. During a median follow-up of 2.5 ± 1.9 years, 34.4% of patients met the primary endpoint, which included 16 deaths and 6 HF hospitalizations. Cox regression analysis revealed that improvement in cardiac damage correlated with a lower risk of composite death or HF hospitalization (HR: 0.095; 95% CI: 0.014-0.627; <i>p</i> = 0.015).</p><p><strong>Conclusions: </strong>TAVR can lead to changes in cardiac damage over a short period in patients with severe AS, and rapid improvement in cardiac damage after TAVR is associated with a better prognosis.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032869","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}
引用次数: 0
Clinical Characteristics and Outcomes in Heart Failure Patients with Implantable Pulmonary Artery Pressure Monitors: A Single Centre Irish Experience.
IF 2.4 4区 医学
Journal of Cardiovascular Development and Disease Pub Date : 2025-01-14 DOI: 10.3390/jcdd12010025
Niall Leahy, Cillian O'Brien, Sara Essa Alsubai, Eileen Coen, Darragh Murphy, Faisal Sharif
{"title":"Clinical Characteristics and Outcomes in Heart Failure Patients with Implantable Pulmonary Artery Pressure Monitors: A Single Centre Irish Experience.","authors":"Niall Leahy, Cillian O'Brien, Sara Essa Alsubai, Eileen Coen, Darragh Murphy, Faisal Sharif","doi":"10.3390/jcdd12010025","DOIUrl":"10.3390/jcdd12010025","url":null,"abstract":"<p><p><b>Background:</b> Hospitalisation for acute decompensated heart failure (HF) portends a poor prognosis. Fluid retention manifesting in dyspnoea and oedema are important clinical features of decompensated heart failure and drive hospital admissions. Intracardiac and pulmonary artery pressure (PAP) monitoring can help predict heart failure decompensation, as changes in these haemodynamics occur before clinical congestion manifests. <b>Methods:</b> A retrospective single centre analysis of patients who underwent insertion of the Cordella™ PA Sensor System (Endotronix, Inc., Chicago, IL, USA) in University Hospital Galway, Ireland, as part of three separate clinical trials-SIRONA 1, SIRONA 2, PROACTIVE HF, was performed. The primary clinical outcome assessed was the difference between HF hospitalisation pre- and post-sensor implantation. <b>Results:</b> In total, there were 33 patients with symptomatic HF who underwent device insertion between 2018 and 2023. All patients had NYHA class 3 heart failure, and 48.5% (<i>n</i> = 16) of patients had HF with reduced ejection fraction. Only one device-related complication was noted, and no pressure sensor failures occurred. In total, there were 26 admissions for HF decompensation 1-year pre-device insertion and only three admissions post-insertion. The difference in the mean number of HF hospitalisations per patient pre- and post-device insertion was 0.70 (<i>p</i> < 0.0001). The difference in mean NYHA class score pre- and post-insertion was 1.0 (<i>p</i> < 0.001). <b>Conclusions:</b> Data from this single-centre cohort study have shown that the insertion of the Cordella™ PA Sensor System in symptomatic HF patients was safe and resulted in statistically significant improvements in HF hospitalisations and NYHA class.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033115","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}
引用次数: 0
Massive Central Pulmonary Embolism with Riding Embolus and Concomitant Aortic Arch Embolism-Should We Diagnose Patients Earlier for Blood Clotting Disorders? Case Report.
IF 2.4 4区 医学
Journal of Cardiovascular Development and Disease Pub Date : 2025-01-14 DOI: 10.3390/jcdd12010026
Anna Lis, Paweł Kowalski, Marcin Wita, Tomasz Zawadzki, Tomasz Ilczak, Wojciech Żurawiński, Mateusz Majewski
{"title":"Massive Central Pulmonary Embolism with Riding Embolus and Concomitant Aortic Arch Embolism-Should We Diagnose Patients Earlier for Blood Clotting Disorders? Case Report.","authors":"Anna Lis, Paweł Kowalski, Marcin Wita, Tomasz Zawadzki, Tomasz Ilczak, Wojciech Żurawiński, Mateusz Majewski","doi":"10.3390/jcdd12010026","DOIUrl":"10.3390/jcdd12010026","url":null,"abstract":"<p><p>Paradoxical embolism occurs when a clot originates in the venous system and traverses through a pulmonary or intracardiac shunt into the systemic circulation, with a mortality rate of around 18%. The risk factors for arterial embolism and venous thrombosis are similar, but different disease entities can lead to a hypercoagulable state of the blood, including antithrombin III (AT III) deficiency. We report the case of a 43-year-old man with a massive central pulmonary embolism with a rider embolus and concomitant aortic arch embolism with involvement of the brachiocephalic trunk, bilateral subclavian and axillary arteries, and the right vertebral artery, followed by a secondary ischaemic stroke. The Pulmonary Embolism Response Team (PERT) consulted the patient on several occasions; he was treated initially with an intravenous infusion of unfractionated heparin under activation partial thromboplastin time (APTT) and AT III substitution. After several days of hospitalisation and the conversion of pharmacotherapy to oral anticoagulants, the patient was discharged home in a stable condition with recommendations for further follow-up in appropriate clinics. This case highlights the role of in-depth diagnostics for coagulation disorders in patients after pulmonary embolism, especially without known risk factors.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032682","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}
引用次数: 0
Perioperative Risk: Short Review of Current Approach in Non Cardiac Surgery.
IF 2.4 4区 医学
Journal of Cardiovascular Development and Disease Pub Date : 2025-01-13 DOI: 10.3390/jcdd12010024
Andreea Boghean, Cristian Guțu, Dorel Firescu
{"title":"Perioperative Risk: Short Review of Current Approach in Non Cardiac Surgery.","authors":"Andreea Boghean, Cristian Guțu, Dorel Firescu","doi":"10.3390/jcdd12010024","DOIUrl":"10.3390/jcdd12010024","url":null,"abstract":"<p><p>The rate of major surgery is constantly increasing worldwide, and approximately 85% are non-cardiac surgery. More than half of patients over 45 years presenting for non-cardiac surgical interventions have cardiovascular risk factors, and the most common: chronic coronary syndrome and history of stroke. The preoperative cardiovascular risk is determined by the comorbidities, the clinical condition before the intervention, the urgency, duration or type. Cardiovascular risk scores are necessary tools to prevent perioperative cardiovascular morbidity and mortality and the most frequently used are Lee/RCRI (Revised Cardiac Risk Index), APACHE II (Acute Physiology and Chronic Health Evaluation), POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity), The American University of Beirut (AUB)-HAS2. To reduce the perioperative risk, there is a need for an appropriate preoperative risk assessment, as well as the choice of the type and timing of surgical intervention. Quantification of surgical risk as low, intermediate, and high is useful in identifying the group of patients who are at risk of complications such as myocardial infarction, thrombosis, arrhythmias, heart failure, stroke or even death. Currently there are not enough studies that can differentiate the risk according to gender, race, elective versus emergency procedure, the value of cardiac biomarkers.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032838","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}
引用次数: 0
The Management of the Aortic Arch in Type A Aortic Dissection: Replace, Repair with the AMDS, or Leave for Another Day?
IF 2.4 4区 医学
Journal of Cardiovascular Development and Disease Pub Date : 2025-01-12 DOI: 10.3390/jcdd12010023
Ryaan El-Andari, Michael C Moon
{"title":"The Management of the Aortic Arch in Type A Aortic Dissection: Replace, Repair with the AMDS, or Leave for Another Day?","authors":"Ryaan El-Andari, Michael C Moon","doi":"10.3390/jcdd12010023","DOIUrl":"10.3390/jcdd12010023","url":null,"abstract":"<p><strong>Objectives: </strong>Acute type A aortic dissection (ATAAD) is a life-threatening condition that requires emergent surgical intervention. Numerous surgical approaches exist for ATAAD, and controversy remains regarding the optimal arch interventions for ATAAD patients. Aortic Arch Interventions: Approaches to ATAAD repair include hemiarch repair or extended arch repairs, including the hemiarch with a hybrid stent implantation, such as the AMDS hybrid Prosthesis, total arch replacement (TAR), and the use of an elephant trunk and frozen elephant trunk. While indications for each procedure exist, such as entry tears in the arch, arch aneurysms, and head vessel communications for TAR and malperfusion and a reduced risk of distal anastomotic new entry tears in Debakey I aortic dissection for the AMDS and frozen elephant trunks, the optimal intervention depends on numerous factors. Surgeon and center experience, resource availability, patient risk, and anatomy all contribute to the decision-making process. TAR has improved in safety over the years and has been demonstrated to be comparable to the hemiarch repair in terms of safety in many settings. TAR may also prevent adverse remodeling and can effectively treat more distal diseases, the presence of arch tears, arch aneurysms, and branch vessel involvement or malperfusion.</p><p><strong>Conclusions: </strong>Numerous surgical approaches exist to manage ATAAD, allowing for the surgeon to tailor the repair to the individual patient and pathology. TAR allows for single or staged repair of extensive pathologies and can address distal entry tears, the aneurysmal arch, and head vessel pathologies. In cases with malperfusion, an AMDS can be used in many cases. The management strategy for ATAAD should always involve performing the best surgery for the patient, although in cases where a total arch is indicated but cannot be performed safely by a non-aortic surgeon, the safest approach may be to perform a hemiarch initially and to plan for an elective arch reoperation in the case it is required following close surveillance.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032944","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}
引用次数: 0
Differences in Arrhythmia Detection Between Harvard Step Test and Maximal Exercise Testing in a Paediatric Sports Population.
IF 2.4 4区 医学
Journal of Cardiovascular Development and Disease Pub Date : 2025-01-11 DOI: 10.3390/jcdd12010022
Massimiliano Bianco, Fabrizio Sollazzo, Riccardo Pella, Saverio Vicentini, Samuele Ciaffoni, Gloria Modica, Riccardo Monti, Michela Cammarano, Paolo Zeppilli, Vincenzo Palmieri
{"title":"Differences in Arrhythmia Detection Between Harvard Step Test and Maximal Exercise Testing in a Paediatric Sports Population.","authors":"Massimiliano Bianco, Fabrizio Sollazzo, Riccardo Pella, Saverio Vicentini, Samuele Ciaffoni, Gloria Modica, Riccardo Monti, Michela Cammarano, Paolo Zeppilli, Vincenzo Palmieri","doi":"10.3390/jcdd12010022","DOIUrl":"10.3390/jcdd12010022","url":null,"abstract":"<p><strong>Background: </strong>Sport practice may elevate the risk of cardiovascular events, including sudden cardiac death, in athletes with undiagnosed heart conditions. In Italy, pre-participation screening includes a resting ECG and either the Harvard Step Test (HST) or maximal exercise testing (MET), but the relative efficacy of the latter two tests for detecting arrhythmias and heart conditions remains unclear.</p><p><strong>Methods: </strong>This study examined 511 paediatric athletes (8-18 years, 76.3% male) without known cardiovascular, renal, or endocrine diseases. All athletes underwent both HST and MET within 30 days. Absolute data and data relative to theoretical peak heart rates, arrhythmias (supraventricular and ventricular) and cardiovascular diagnoses were collected.</p><p><strong>Results: </strong>HST resulted in a lower peak heart rate than MET (181.1 ± 9.8 vs. 187.5 ± 8.1 bpm, <i>p</i> < 0.001), but led to the detection of more supraventricular (18.6% vs. 13.1%, <i>p</i> < 0.001) and ventricular (30.5% vs. 22.7%, <i>p</i> < 0.001) arrhythmias, clustering during recovery (<i>p</i> = 0.014). This pattern was significant in males but not females. Among athletes diagnosed with cardiovascular diseases (22.3%), HST identified more ventricular arrhythmias (26.3% vs. 18.4%, <i>p</i> = 0.05), recovery-phase arrhythmias (20.2% vs. 14.0%, <i>p</i> = 0.035), and polymorphic arrhythmias (6.1% vs. 1.8%, <i>p</i> = 0.025).</p><p><strong>Conclusions: </strong>HST detects arrhythmias more effectively than MET in young male athletes, especially during recovery. More ventricular arrhythmias were highlighted even in athletes with cardiovascular conditions.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032145","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}
引用次数: 0
Risk Factors for Coronary Events After Robotic Hybrid Off-Pump Coronary Revascularization.
IF 2.4 4区 医学
Journal of Cardiovascular Development and Disease Pub Date : 2025-01-10 DOI: 10.3390/jcdd12010021
Aleksander Dokollari, Beatrice Bacchi, Serge Sicouri, Francesco Cabrucci, Massimo Bonacchi, Danielle Spragan, Mary Ann C Wertan, Nitin Ghorpade, Stephanie Kjelstrom, Georgia Montone, Yoshiyuki Yamashita, Basel Ramlawi, Francis Sutter
{"title":"Risk Factors for Coronary Events After Robotic Hybrid Off-Pump Coronary Revascularization.","authors":"Aleksander Dokollari, Beatrice Bacchi, Serge Sicouri, Francesco Cabrucci, Massimo Bonacchi, Danielle Spragan, Mary Ann C Wertan, Nitin Ghorpade, Stephanie Kjelstrom, Georgia Montone, Yoshiyuki Yamashita, Basel Ramlawi, Francis Sutter","doi":"10.3390/jcdd12010021","DOIUrl":"10.3390/jcdd12010021","url":null,"abstract":"<p><strong>Objectives: </strong>The impact of long-term complications after robotic hybrid coronary revascularization (HCR), including persistent angina, repeat revascularization, and myocardial infarction (MI), remains limited. This study aims to determine the risk factors for coronary events after robotic HCR and their time-varying effects on outcomes.</p><p><strong>Methods: </strong>We identified all consecutive patients who underwent robotic HCR at our institution. Baseline characteristics were explored as possible risk factors for angina, MI, and repeat revascularization with stents at any time during the follow-up.</p><p><strong>Results: </strong>A total of 875 patients (mean age 71.1 ± 11.1 years) were included. After a median follow-up of 3.32 years (IQR 1.18-6.34 years), angina occurred in 134 patients (15.3%), repeat revascularization with stents in 139 patients (15.8%), and MI in 36 patients (4.1%). The hazard rates for all outcomes increased with follow-up time, with a notable early rise around two years of follow-up for angina and, to a lesser extent, repeat revascularization. The risk factors were the lack of radial artery graft use, black race, diabetes, obesity, chronic obstructive pulmonary disease, low ejection fraction <50%, severe left main coronary artery stenosis (>50%), and more than three-vessel disease.</p><p><strong>Conclusions: </strong>Optimization of modifiable periprocedural risk factors may positively impact long-term prognosis in patients undergoing robotic HCR.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032887","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}
引用次数: 0
Bridging the Gaps in Atrial Fibrillation Management in the Emergency Department.
IF 2.4 4区 医学
Journal of Cardiovascular Development and Disease Pub Date : 2025-01-08 DOI: 10.3390/jcdd12010020
Brian Xiangzhi Wang
{"title":"Bridging the Gaps in Atrial Fibrillation Management in the Emergency Department.","authors":"Brian Xiangzhi Wang","doi":"10.3390/jcdd12010020","DOIUrl":"10.3390/jcdd12010020","url":null,"abstract":"<p><p>Atrial fibrillation (AF) frequently presents in emergency departments (EDs), contributing significantly to adverse cardiovascular outcomes. Despite established guidelines, ED management of AF often varies, revealing important gaps in care. This review addresses specific challenges in AF management for patients in the ED, including the nuances of rate versus rhythm control, the timing of anticoagulation initiation, and patient disposition. The updated 2024 European Society of Cardiology (ESC) guidelines advocate early rhythm control for select patients while recommending rate control for others; however, uncertainties persist, particularly regarding these strategies' long-term impact on outcomes. Stroke prevention through timely anticoagulation remains crucial, though the ideal timing, especially for new-onset AF, needs further research. Additionally, ED discharge protocols and follow-up care for AF patients are often inconsistent, leaving many without proper long-term management. Integration of emerging therapies, including direct oral anticoagulants and advanced antiarrhythmic drugs, shows potential but remains uneven across EDs. Innovative multidisciplinary models, such as \"AF Heart Teams\" and observation units, could enhance care but face practical challenges in implementation. This review underscores the need for targeted research to refine AF management, optimize discharge protocols, and incorporate novel therapies effectively. Standardizing ED care for AF could significantly reduce stroke risk, lower readmission rates, and improve overall patient outcomes.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033176","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}
引用次数: 0
Physician Perceptions of the Safety and Efficacy of GLP-1 Receptor Agonists: Underestimation of Cardiovascular Risk Reduction and Discrepancies with Clinical Evidence.
IF 2.4 4区 医学
Journal of Cardiovascular Development and Disease Pub Date : 2025-01-07 DOI: 10.3390/jcdd12010019
Srikanth Krishnan, Pratyaksh K Srivastava, Jayram Attaluri, Rebecca Nayeri, Dhananjay Chatterjee, Jay Patel, Ali Nsair, Matthew Budoff, Arash Nayeri
{"title":"Physician Perceptions of the Safety and Efficacy of GLP-1 Receptor Agonists: Underestimation of Cardiovascular Risk Reduction and Discrepancies with Clinical Evidence.","authors":"Srikanth Krishnan, Pratyaksh K Srivastava, Jayram Attaluri, Rebecca Nayeri, Dhananjay Chatterjee, Jay Patel, Ali Nsair, Matthew Budoff, Arash Nayeri","doi":"10.3390/jcdd12010019","DOIUrl":"10.3390/jcdd12010019","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonists (GIP/GLP-1 RAs) are emerging as effective treatments for obesity and cardiometabolic disease. This study evaluated physician perceptions of the safety and efficacy of semaglutide and tirzepatide through a questionnaire administered to 165 attending physicians specializing in internal or family medicine, with 122 responses received. Physicians reported an average patient weight loss of 9.22%, significantly lower than the 14.9% and 18.5% reported in the STEP and SURMOUNT trials, respectively. Estimated side effect rates (32.62%) were markedly lower than trial-reported rates (89.7% and 80.5%), while estimated discontinuation rates (8.59%) exceeded trial data. Cardiovascular benefits were perceived by 48.4% of physicians in diabetic patients, consistent with random guessing, and by only 39.3% in nondiabetic patients, significantly below random guessing expectations. These results highlight discrepancies between physician perceptions and clinical evidence, suggesting gaps in understanding regarding these agents' efficacy and safety profiles. Addressing these gaps could enhance physician knowledge, patient adherence, and clinical outcomes.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032864","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}
引用次数: 0
Accuracy and Reproducibility of a Modified Echocardiographic Method for Right Ventricular Output Calculation in Neonates.
IF 2.4 4区 医学
Journal of Cardiovascular Development and Disease Pub Date : 2025-01-06 DOI: 10.3390/jcdd12010018
Carlotta Milocchi, Silvia Nogara, Giorgia Mazzuca, Federica Runfola, Martina Ciarcià, Iuri Corsini, Benjamim Ficial
{"title":"Accuracy and Reproducibility of a Modified Echocardiographic Method for Right Ventricular Output Calculation in Neonates.","authors":"Carlotta Milocchi, Silvia Nogara, Giorgia Mazzuca, Federica Runfola, Martina Ciarcià, Iuri Corsini, Benjamim Ficial","doi":"10.3390/jcdd12010018","DOIUrl":"10.3390/jcdd12010018","url":null,"abstract":"<p><p>We aimed to evaluate the accuracy and reproducibility of right ventricular output (RVO) using different anatomical landmarks: the internal pulmonary valve diameter (PVD) between the valve hinge points (hinge-PVD) according to the traditional technique, and PVD between the valve leaflet tips (tip-PVD). This was a retrospective analysis of prospective collected data. All neonates with echocardiographic measurements of RVO and left ventricular output (LVO) without congenital heart disease, including patent ductus arteriosus and patent foramen ovale > 3 mm, were included. Accuracy was assessed by comparison with LVO. Intra- and inter-observer reproducibility of the off-line analysis were assessed. Forty-five neonates were included. RVO calculation with tip-PVD was more accurate than hinge-PVD in comparison with LVO, r<sup>2</sup> 0.712 versus 0.464, bias (95% limits of agreement) 1.4 mL/kg/min (-26-29 mL/kg/min) versus 61 mL/kg/min (-11-132 mL/kg/min), respectively. Both hinge-PVD and tip-PVD presented similar reproducibility, with an intra-observer bias (95% LOA) of 0.3 (-1.0-0.5) and -0.2 (-0.8-0.5) respectively, and an inter-observer bias of 0.1 (-1.3-1.6) and 0.1 (-1.4-1.6). RVO calculation using tip-PVD was more accurate than the conventional technique, with similar reproducibility.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033174","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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信