Journal of Cardiovascular Pharmacology and Therapeutics最新文献

{"title":"Factors Associated With the Recovery of Left Ventricular Ejection Fraction in Patients With Anthracycline-Induced Left Ventricular Dysfunction.","authors":"Tyler Shugg, Tk Nguyen, Xuesi Hua, Blair Richards, James Rae, Robert Dess, Daniel Perry, Bradley Kay, Salim S Hayek, Monika Leja, Jasmine A Luzum","doi":"10.1177/10742484241304304","DOIUrl":"10.1177/10742484241304304","url":null,"abstract":"<p><strong>Background: </strong>Neurohormonal blocking drugs, like beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs), are recommended for treating anthracycline-induced left ventricular dysfunction (AILVD). However, there is limited evidence supporting their benefit. Therefore, this study evaluated associations of neurohormonal blockers and other clinical factors with recovery of left ventricular ejection fraction (LVEF) in patients with AILVD.</p><p><strong>Methods: </strong>This retrospective chart review assessed patients treated with at least one dose of anthracycline, then had ≥10% LVEF reduction or post-anthracycline LVEF value <50%, and then had a follow-up LVEF measurement ≥90 days later. The primary endpoint was LVEF recovery (highest follow-up LVEF-lowest LVEF post-anthracycline). Variables from univariable tests with <i>P</i> < .1 were incorporated in a multiple linear regression model for independent factors significantly associated with LVEF recovery (<i>P</i> < .05).</p><p><strong>Results: </strong>Out of 104 patients, 83% were female, 86% self-reported white race, 53% had breast cancer, median (IQR) age was 52 (22) years, and LVEF recovery was 14% (16%). The final multivariable model included 2 significant variables: beta-blocker dose after anthracycline exposure (every 25 mg increase in beta-blocker dose was associated with 5.0% increase in LVEF recovery; <i>P</i> = .0005) and the time between the start of the anthracycline and the lowest LVEF post-anthracycline (every 5-year increase in time was associated with 1.8% decrease in LVEF recovery; <i>P</i> = .0379).</p><p><strong>Conclusions: </strong>In patients with AILVD, a higher beta-blocker dose and earlier detection of LVEF reduction post-anthracycline were significantly and independently associated with improved LVEF recovery. These findings need to be validated in a larger, independent cohort.</p>","PeriodicalId":15281,"journal":{"name":"Journal of Cardiovascular Pharmacology and Therapeutics","volume":"30 ","pages":"10742484241304304"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971029","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":"Thanks to Reviewers.","authors":"","doi":"10.1177/10742484251315246","DOIUrl":"https://doi.org/10.1177/10742484251315246","url":null,"abstract":"","PeriodicalId":15281,"journal":{"name":"Journal of Cardiovascular Pharmacology and Therapeutics","volume":"30 ","pages":"10742484251315246"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin K Antagonist Use and Level of Anticoagulation Control Among Patients at a Tertiary Hospital in Northern Tanzania.","authors":"Sarah K Gharib, Abid M Sadiq, Faryal M Raza, Sophia S Muhali, Annette A Marandu, Norman J Kyala, Eliasa K Ndale, Venance P Maro, William P Howlett, Elifuraha W Mkwizu, Nyasatu G Chamba, Furaha S Lyamuya, Elichilia R Shao, Kajiru G Kilonzo","doi":"10.1177/10742484251315104","DOIUrl":"10.1177/10742484251315104","url":null,"abstract":"<p><strong>Background: </strong>Vitamin K antagonists (VKA) continue to be the principal anticoagulants for both the treatment and prevention of venous thromboembolism. The use of VKA often requires regular monitoring to avoid over-anticoagulation and prevent thromboembolic complications. The aim was to determine the indication for VKA use and factors associated with suboptimal anticoagulation control among patients in northern Tanzania.</p><p><strong>Methods: </strong>This was a retrospective cohort study that examined the anticoagulation data of patients on long-term VKA from 1^st January 2020 to 31^st December 2022. Eligible participants were those on VKAs for at least 7 days and with at least 3 international normalized ratio (INR) results. The level of anticoagulation control was determined through the calculation of the time-in-therapeutic range (TiTR) using the Rosendaal and the percent of INR in therapeutic range methods.</p><p><strong>Results: </strong>TiTR was found to be 17% using the direct method and 16% using the Rosendaal formula. 102 tests out of 365 were within the target range (28%). Absence of health insurance (aRR: 1.24, 95% CI: 1.06-1.44, <i>P</i> = .007), alcohol consumption (aRR: 1.37, 95% CI: 1.15-1.62, <i>P</i> < .001), and prolonged intervals between tests of 14 to 28 days (aRR: 1.34, 95% CI: 1.05-1.74, <i>P</i> = .018) showed association with INR being out of range.</p><p><strong>Conclusion: </strong>Patients who achieved target therapeutic anticoagulation control were less than the acceptable 65%. Anticoagulation outcomes were better in patients with frequent INR monitoring and those with health insurance. Alcohol consumption carries a high risk of poor anticoagulation control. Further studies are needed to enforce better INR control.</p>","PeriodicalId":15281,"journal":{"name":"Journal of Cardiovascular Pharmacology and Therapeutics","volume":"30 ","pages":"10742484251315104"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Cardiac Mechanisms of the Sodium Glucose Co-Transporter 2 Inhibitor Class.","authors":"Steven Hopkins, Faiz Baqai, Saivaroon Gajagowni, Gavin Hickey","doi":"10.1177/10742484251323428","DOIUrl":"https://doi.org/10.1177/10742484251323428","url":null,"abstract":"<p><p>BackgroundSodium-glucose co-transporter 2 (SGLT2) inhibitors have demonstrated significant cardiovascular benefits in clinical trial. While their role in reducing heart failure hospitalizations and cardiovascular mortality is well established, the precise mechanisms underlying their direct cardiac effects remain unclear. This literature review aims to synthesize current knowledge on the molecular and physiological pathways by which SGLT2 inhibitors may exert effects on cardiac tissue, independent of glycemic control.MethodsA comprehensive review of peer-reviewed articles, randomized controlled trials, meta-analyses, and mechanistic studies published in PubMed and related databases was conducted. The search focused on studies examining the direct impact of SGLT2 inhibitors on cardiac function, remodeling, metabolism, and intracellular signaling pathways. Only studies evaluating the cardiac effects separate from their glucose-lowering action were included in the analysis.ResultsThis review identified several key mechanisms by which SGLT2 inhibitors may benefit the heart directly, including reductions in oxidative stress, inflammation, and myocardial fibrosis. Emerging evidence suggests that these drugs modulate key pathways such as sodium-hydrogen exchange (NHE) inhibition, improvement of mitochondrial function, and promotion of ketone body utilization in cardiomyocytes.ConclusionsSGLT2 inhibitors appear to confer direct cardioprotective effects. These include anti-inflammatory, anti-fibrotic, and energy efficiency improvements in the myocardium. The findings highlight new potential therapeutic mechanisms and provide a foundation for further research into the non-diabetic use of SGLT2 inhibitors in heart failure and other cardiac conditions. Understanding these direct effects could lead to optimized treatment strategies for patients with and without diabetes.</p>","PeriodicalId":15281,"journal":{"name":"Journal of Cardiovascular Pharmacology and Therapeutics","volume":"30 ","pages":"10742484251323428"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypopituitarism and Cardiovascular Risk.","authors":"Ivana Kraljević, Mirsala Solak, Ante Mandić, Katarina Mlekuš Kozamernik, Maja Raičević, Anida Divanović Slato, Zlata Kovačević, Emir Muzurović","doi":"10.1177/10742484251332398","DOIUrl":"https://doi.org/10.1177/10742484251332398","url":null,"abstract":"<p><p>Hypopituitarism, resulting from a partial or complete deficiency of anterior or posterior pituitary hormones, is associated with increased cardiovascular (CV) morbidity and mortality. This heterogeneous endocrinological disorder may arise from various etiologies, including genetic mutations, pituitary tumors, traumatic brain injury, and autoimmune diseases. Hypopituitarism often results in multiple endocrine deficits that contribute to metabolic dysregulation characterized by insulin resistance, dyslipidemia, and increased visceral adiposity, all known risk factors for CV disease (CVD). Additionally, the presence of chronic inflammation and endothelial dysfunction further increases the risk of CVD in these patients. While standard hormone replacement therapy (HRT) is crucial for restoring hormonal balance, it can sometimes have adverse metabolic effects that can exacerbate atherosclerosis and CVD. Emerging evidence suggests that optimizing HRT regimens and addressing specific hormone deficiencies, such as growth hormone and cortisol, may reduce these risks and improve CV outcomes. This review comprehensively analyzes the etiology, pathophysiological mechanisms underlying CV risk in anterior pituitary dysfunction, and treatment strategies to mitigate CV morbidity and mortality in patients with hypopituitarism.</p>","PeriodicalId":15281,"journal":{"name":"Journal of Cardiovascular Pharmacology and Therapeutics","volume":"30 ","pages":"10742484251332398"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pathophysiology of Vasovagal Syncope and New Approaches to its Pharmacological Treatment.","authors":"Dalyia Abu-Ghazaleh, David A Taylor, Louise Roberts, Indu Singh, Vinicius Cruzat, Roselyn B Rose'Meyer","doi":"10.1177/10742484251351140","DOIUrl":"10.1177/10742484251351140","url":null,"abstract":"<p><p>Syncope refers to the transient loss of consciousness and the most common type of syncope is vasovagal syncope (VVS), usually occurring when a person is in an upright position, and/or after exposure to intense stress. The sequelae of VVS is caused by an increase in sympathetic tone and heart rate combined with an underfilled left ventricular chamber that leads to stimulation of cardiac afferent C fibers ultimately leading to bradycardia and vasodilation causing a reduction in venous return, cerebral hypoperfusion and VVS. Several treatment options have been tested including physical counter-pressure measures, electrical pacing, cardioneuroblation. Pharmacological interventions and clinical trials for VVS are summarized in this review; however, there is still limited evidence of their efficacy for reducing episodes of VVS. This review will examine studies using animal models of the vasovagal reflex arc to investigate the physiological mechanisms and neurotransmitters associated with VVS, the tilt-table test that induces VVS in patients and the potential sources of cardiac and platelet mediators that can activate cardiac afferent C fibers. This study will also consider how the previously investigated pharmacotherapies provide insight into the multiple mechanisms involved in VVS and propose new targets for the pharmacological treatment of VVS.</p>","PeriodicalId":15281,"journal":{"name":"Journal of Cardiovascular Pharmacology and Therapeutics","volume":"30 ","pages":"10742484251351140"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Concomitant Therapy of Direct Oral Anticoagulants with Amiodarone in Atrial Fibrillation: A Meta-analysis.","authors":"Kazuhiko Kido, Mikiko Shimizu, Tsuyoshi Shiga, Masayuki Hashiguchi","doi":"10.1177/10742484251351148","DOIUrl":"10.1177/10742484251351148","url":null,"abstract":"<p><p>BackgroundThe concomitant therapy of amiodarone with direct oral anticoagulants (DOACs) significantly increases the concentrations of DOACs and may increase the bleeding risks. Multiple real-world studies compared the concomitant therapy of amiodarone and DOACs versus the DOAC alone, but their main findings were contradictory.MethodsA meta-analysis compared the concomitant therapy of amiodarone and DOACs versus DOACs monotherapy. Database searches through May 1, 2025, were performed. The primary outcome was major bleeding. The secondary outcomes included stroke or systemic embolism, any bleeding, all-cause mortality, gastrointestinal bleeding, and intracranial bleeding.ResultsThis meta-analysis included a total of nine studies. There were no significant differences in major bleeding between the concomitant therapy of amiodarone and DOAC and DOAC monotherapy groups (OR 1.12; 95% CI 0.98, 1.27; <i>P</i> = .09; <i>I</i>² = 64%). No significant differences in any bleeding (OR 1.18; 95% CI 0.88, 1.57; <i>P</i> = .27; <i>I</i>² = 77%), gastrointestinal bleeding (OR 0.97; 95% CI 0.84, 1.11; <i>P</i> = .65; <i>I</i>² = 56%), and intracranial bleeding (OR 1.14; 95% CI 1.00, 1.30; <i>P</i> = .05; <i>I</i>² = 32%) were also found between the two groups. No significant differences in stroke or systemic embolism were found between the two groups (OR 0.86; 95% CI 0.74, 1.00; <i>P</i> = .05; <i>I</i>² = 34%).Conclusion and RelevanceThe concomitant therapy of amiodarone and DOACs did not significantly increase the bleeding risks or decrease the risk of stroke or systemic embolism compared to the DOAC monotherapy. The drug-drug interactions between amiodarone and DOACs may not be clinically significant.</p>","PeriodicalId":15281,"journal":{"name":"Journal of Cardiovascular Pharmacology and Therapeutics","volume":"30 ","pages":"10742484251351148"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of JAK/STAT Signaling Pathway and Its Downstream Influencing Factors in the Treatment of Atherosclerosis","authors":"Xin Zhang, Suwen Chen, Guoliang Yin, Pengpeng Liang, Yanan Feng, Wenfei Yu, Decheng Meng, Hongshuai Liu, Fengxia Zhang","doi":"10.1177/10742484241248046","DOIUrl":"https://doi.org/10.1177/10742484241248046","url":null,"abstract":"Atherosclerosis is now widely considered to be a chronic inflammatory disease, with increasing evidence suggesting that lipid alone is not the main factor contributing to its development. Rather, atherosclerotic plaques contain a significant amount of inflammatory cells, characterized by the accumulation of monocytes and lymphocytes on the vessel wall. This suggests that inflammation may play a crucial role in the occurrence and progression of atherosclerosis. As research deepens, other pathological factors have also been found to influence the development of the disease. The Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway is a recently discovered target of inflammation that has gained attention in recent years. Numerous studies have provided evidence for the causal role of this pathway in atherosclerosis, and its downstream signaling factors play a significant role in this process. This brief review aims to explore the crucial role of the JAK/STAT pathway and its representative downstream signaling factors in the development of atherosclerosis. It provides a new theoretical basis for clinically affecting the development of atherosclerosis by interfering with the JAK/STAT signaling pathway.","PeriodicalId":15281,"journal":{"name":"Journal of Cardiovascular Pharmacology and Therapeutics","volume":"14 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140798518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to Electronic Waterpipes Increases the Risk of Occlusive Cardiovascular Disease in C57BL/6J Mice","authors":"Precious O. Badejo, Shelby S. Umphres, Hamdy E.A. Ali, Ahmed B. Alarabi, Shahnaz Qadri, Fatima Z. Alshbool, Fadi T. Khasawneh","doi":"10.1177/10742484241242702","DOIUrl":"https://doi.org/10.1177/10742484241242702","url":null,"abstract":"IntroductionIt is well documented that cardiovascular disease (CVD) is the leading cause of death in the US and worldwide, with smoking being the most preventable cause. Additionally, most smokers die from thrombotic-based diseases, in which platelets play a major role. To this end, because of the proven harm of smoking, several novel tobacco products such as electronic(e)-waterpipe have been gaining popularity among different sectors of the population, partly due to their “false” safety claims. While many investigators have focused on the negative health effects of traditional cigarettes and e-cigarettes on the cardiovascular system, virtually little or nothing is known about e-waterpipes, which we investigated herein.Methods and MaterialsTo investigate their occlusive CVD effects, we employed a whole-body mouse exposure model of e-waterpipe vape/smoke and exposed C57BL/6J male mice (starting at 7 weeks of age) for 1 month, with the controls exposed to clean air. Exposures took place seven times a week, according to the well-known Beirut protocol, which has been employed in many studies, as it mimics real-life waterpipe exposure scenarios; specifically, 171 puffs of 530 ml volume of the e-liquid at 2.6 s puff duration and 17 s puff interval.ResultsThe e-waterpipe exposed mice had shortened bleeding and occlusion times, when compared to the clean air controls, indicating a prothrombotic phenotype. As for the mechanism underlying this phenotype, we found that e-waterpipe exposed platelets exhibited enhanced agonist-triggered aggregation and dense granule secretion. Also, flow cytometry analysis of surface markers of platelet activation showed that both P-selectin and integrin GPIIb-IIIa activation were enhanced in the e-waterpipe exposed platelets, relative to the controls. Finally, platelet spreading and Akt phosphorylation were also more pronounced in the exposed mice.ConclusionWe document that e-waterpipe exposure does exert untoward effects in the context of thrombosis-based CVD, in part, via promoting platelet hyperreactivity.","PeriodicalId":15281,"journal":{"name":"Journal of Cardiovascular Pharmacology and Therapeutics","volume":"39 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thanks to Reviewers","authors":"","doi":"10.1177/10742484241229293","DOIUrl":"https://doi.org/10.1177/10742484241229293","url":null,"abstract":"","PeriodicalId":15281,"journal":{"name":"Journal of Cardiovascular Pharmacology and Therapeutics","volume":"170 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139954497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}