Minerva cardiology and angiology最新文献

{"title":"Cerebrovascular events after perioperative paroxysmal atrial fibrillation in patients undergoing aortic valve replacement.","authors":"Andrew Cassar, Gabriella Montanaro, Bettina Booker, Mark A Sammut, Alexander Manche, Joseph F Galea","doi":"10.23736/S2724-5683.24.06551-7","DOIUrl":"10.23736/S2724-5683.24.06551-7","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) is common after aortic valve replacement (AVR). However, the long-term risk of cerebrovascular ischemic events (CVA) associated with POAF in this scenario is not known. The study objective was to look at the long-term risk of stroke in patients undergoing AVR with POAF compared to those with no POAF, particularly in patients having a bioprosthetic valve and not discharged on anticoagulation. We also looked at the risk of peri-operative stroke and long-term mortality.</p><p><strong>Methods: </strong>A retrospective study of 831 patients undergoing AVR were followed up for a median of 6.5 years. The primary outcome was the occurrence of CVA after discharge, comparing those with to those without POAF, after excluding patients with a past history of atrial fibrillation (AF). They were divided into two cohorts, those having bioprosthetic valves (without oral anticoagulation), and those with a mechanical valve (with oral anticoagulation). Other outcomes studied were the incidence of early perioperative CVA comparing patients with a history of AF to those with no history, and long-term mortality in the different cohorts.</p><p><strong>Results: </strong>There was no increased risk of long-term stroke in patients with POAF when compared to those without POAF, neither in bioprosthetic valves (adjusted HR 1.14; CI 95% 0.46-2.83, P=0.78)-nor in mechanical valves (adjusted HR 1.41; CI 95% 0.55-3.65, P=0.48). Patients with a history of AF had an increased risk of perioperative stroke (OR 1.5; CI 95% 1.3-13.8, P=0.01).</p><p><strong>Conclusions: </strong>Patients undergoing bioprosthetic AVR who develop POAF are not at an increased risk of stroke despite not being on any oral anticoagulation.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"95-103"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604654","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":"Tribute to Prof. Alessandro Santo Bortone.","authors":"Emanuela De Cillis, Martino Pepe, Antonio Gaglione, Vincenzo Pestrichella, Alfredo Marchese, Filippo Masi, Fortunato Iacovelli, Gaetano Contegiacomo, Elia Iorio, Nicola Signore, Giuseppe Colonna, Arturo Giordano, Giancarlo Piccinni, Andrea I Guaricci, Marco M Ciccone","doi":"10.23736/S2724-5683.24.06749-8","DOIUrl":"10.23736/S2724-5683.24.06749-8","url":null,"abstract":"","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750940","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":"Is vitamin D a new target for patients with acute coronary syndrome and diastolic dysfunction?","authors":"Rita Pavasini, Monica Verdoia","doi":"10.23736/S2724-5683.24.06766-8","DOIUrl":"10.23736/S2724-5683.24.06766-8","url":null,"abstract":"","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"54-56"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750849","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":"Low vitamin D levels are associated with impaired diastolic function in patients with acute coronary syndrome.","authors":"Engin Algül, Nail B Özbeyaz, Haluk F Şahan, Faruk Aydinyilmaz, Aslan Erdoğan, Muhammed Erzurum, Hamza Sunman, Tolga H Efe, Özcan Özdemir","doi":"10.23736/S2724-5683.24.06515-3","DOIUrl":"10.23736/S2724-5683.24.06515-3","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D deficiency is a common clinical picture associated with poor cardiovascular prognosis. It is also associated with impaired diastolic dysfunction in stable coronary artery disease. We investigated the relationship between vitamin D levels and diastolic dysfunction in patients with acute coronary syndrome (ACS).</p><p><strong>Methods: </strong>One hundred seventeen patients with the ACS were enrolled in this cross-sectional study. The diastolic function of the patients was evaluated using echocardiography before discharge. We analyzed the relation between serum levels of 25(OH)D and echocardiographic measures of diastolic dysfunction.</p><p><strong>Results: </strong>IVRT and E/e' were found to be significantly greater in patients with low vitamin D levels (115.48±13.64 vs. 106.88±14.80 ms, P<0.05; 10.19±2.80 vs. 8.1±3.2, P<0.05). When regression tests were performed, it was shown that vitamin D level was a predictor (OR=0.935, 95% CI: 0.886-0.987; P=0.015) and independent risk factor (OR=0.942, 95% CI: 0.888-0.998; P=0.042) for the development of diastolic dysfunction.</p><p><strong>Conclusions: </strong>We found that low vitamin D levels are associated with impaired diastolic function in patients with ACS with preserved left ventricular systolic function.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"57-64"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750936","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":"Atrial fibrillation in transthyretin amyloidotic cardiomyopathy: prevalence and echocardiographic predictors.","authors":"María R Rodríguez, Ana Spaccavento, Mirta Diez, Diego Conde, Lucrecia M Burgos, Ivana M Seia, Alejandro Meretta, Adrian Baranchuk, Shyla Gupta, Juan P Costabel","doi":"10.23736/S2724-5683.24.06566-9","DOIUrl":"10.23736/S2724-5683.24.06566-9","url":null,"abstract":"<p><strong>Background: </strong>Conduction disorders and arrhythmias frequently accompany cardiac amyloidosis (CA), with atrial fibrillation (AF) being the most prevalent manifestation. The prevalence of AF varies across different types of CA, with transthyretin (TTR) type showing the highest prevalence upon diagnosis.</p><p><strong>Methods: </strong>A retrospective, observational analysis was conducted to evaluate the prevalence of AF and to identify echocardiographic predictors related to the development of AF in our population of patients with transthyretin cardiac amyloidosis (TTR-CA).</p><p><strong>Results: </strong>A total of 99 patients with TTR-CA were identified, with a median age of 82 (75-85) years, a median ejection fraction of 50% (43-60) and 97 of them wild type. At the time of cardiomyopathy diagnosis, 55% had AF, and during follow-up, 43% developed new AF. Among the latter group, there was a non-significant tendency to have a smaller diastolic diameter, lower left ventricular ejection fraction, increased septal thickness, higher pulmonary pressure, and lower tissue velocities, with statistical significance only found in the right ventricular S wave velocity: 8.5 cm/s (7.7-9) vs. 9.7 cm/s (8.4-10) (P=0.046).</p><p><strong>Conclusions: </strong>The high prevalence and incidence of AF in TTR-CA is demonstrated in our series. Doppler echocardiography might help to identify patients with signs of more advanced cardiomyopathy, such as lower right ventricle tissue velocity, who might be at higher risk of developing AF and gain the benefit of prompt diagnosis and treatment.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"104-112"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350099","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":"Artificial intelligence tools in medicine: navigating the horizon of promise and caution.","authors":"Francesco A Veneziano, Giuseppe Biondi-Zoccai","doi":"10.23736/S2724-5683.24.06646-8","DOIUrl":"10.23736/S2724-5683.24.06646-8","url":null,"abstract":"","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"4-7"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750179","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":"Isolated tricuspid regurgitation: a new entity to face. Prevalence, prognosis and treatment of isolated tricuspid regurgitation.","authors":"Michele Di Mauro, Giorgia Bonalumi, Ilaria Giambuzzi, Giulia Masiero, Giuseppe Tarantini","doi":"10.23736/S2724-5683.23.06294-4","DOIUrl":"10.23736/S2724-5683.23.06294-4","url":null,"abstract":"&lt;p&gt;&lt;p&gt;In recent years the tricuspid is no longer considered the \"forgotten valve,\" but nowadays, specialists focused the treatment of tricuspid regurgitation (TR) especially at the time of left heart valve (LHV) surgery, overlooking the emerging entity of isolated TR. Its incidence appears to be rising along with the higher prevalence of atrial fibrillation (AF), intracardiac devices and intravenous drug users. Hence, the aim of the present review is to summarize the available evidences in terms of natural history, clinical presentation and treatment of isolated TR. Tricuspid regurgitation is commonly classified into primary and secondary etiology. Primary or organic TR is relatively uncommon (10%) and may be due to either acquired or congenital diseases. Conversely, secondary or functional TR, caused by dilatation and flattening of the tricuspid annulus along with increase of leaflet tethering due to the remodeling of the right ventricle (RV) has become in last decade an emerging entity. Secondary TR may be due grade progression after left heart valve surgery, to previous TV surgery failure, RV remodeling or permanent AF. Primary TR causes pure volume overload on initially normal right-sided cardiac chambers. Conversely, RV enlargement is the major finding of secondary TR; RV systolic area, RV spherical index and right atrial area were identified as independent factors correlated with TV tethering height. The RV has less muscle mass than the left ventricle, and RV systolic function is therefore more load sensitive. Thus, pulmonary hypertension results in an early fall in RV ejection fraction and associated RV enlargement. An interesting entity is isolated TR related to AF, whose prevalence is estimated to be 14% in recent studies. It is known to cause dilation of the mitral and tricuspid annulus, together with changes in the dynamic mechanisms that govern the variation in area size during the cardiac cycle; as a matter of fact the relative change in TA area was significantly lower in AF (13.5%) than in sinus rhythm (SR) (33.1%). In isolated TR, medical therapy (MT) is indicated only in patients with secondary TR having also severe RV/LV dysfunction or severe pulmonary hypertension. Diuretics are the main MT in case of isolated TR in the presence of right HF in carefully selected candidates, surgery can be performed safely with good long-term survival and it should be considered early at first stages. In the treatment of isolated TR we had two diametrically opposed approaches so far, such as medical therapy, based almost exclusively on diuretics, and surgical therapy. In this scenario, trans-catheter approach is gaining momentum, including repair or replacement treatment. The former sees the use of devices for direct or indirect annuloplasty, or leaflet approximation. The second consists of orthotopic or heterotopic replacement devices (transcatheter tricuspid valve replacement devices). Evidences from randomized studies and longer follow-up will ","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"38-53"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9253066","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":"Applications and potential of machine, learning augmented chest X-ray interpretation in cardiology.","authors":"Michael R Milne, Hassan K Ahmad, Quinlan D Buchlak, Nazanin Esmaili, Cyril Tang, Jarrel Seah, Nalan Ektas, Peter Brotchie, Thomas H Marwick, Catherine M Jones","doi":"10.23736/S2724-5683.24.06288-4","DOIUrl":"10.23736/S2724-5683.24.06288-4","url":null,"abstract":"<p><p>The chest X-ray (CXR) has a wide range of clinical indications in the field of cardiology, from the assessment of acute pathology to disease surveillance and screening. Despite many technological advancements, CXR interpretation error rates have remained constant for decades. The application of machine learning has the potential to substantially improve clinical workflow efficiency, pathology detection accuracy, error rates and clinical decision making in cardiology. To date, machine learning has been developed to improve image processing, facilitate pathology detection, optimize the clinical workflow, and facilitate risk stratification. This review explores the current and potential future applications of machine learning for chest radiography to facilitate clinical decision making in cardiology. It maps the current state of the science and considers additional potential use cases from the perspective of clinicians and technologists actively engaged in the development and deployment of deep learning driven clinical decision support systems.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"8-22"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624065","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":"Arterial vascular complications predictive score in extrasystolic arrhythmia \"EX-prognosis\".","authors":"Olga Germanova, Giuseppe Galati, Andrey Germanov, Yurii Shchukin, Timur Syunyakov, Giuseppe Biondi-Zoccai","doi":"10.23736/S2724-5683.24.06549-9","DOIUrl":"10.23736/S2724-5683.24.06549-9","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was the creation of an optimal model for predicting arterial vascular complications in patients with extrasystolic arrhythmia.</p><p><strong>Methods: </strong>A single-center prospective study was performed with involving 634 patients with supraventricular or ventricular extrasystoles (ES) of 700 or more per 24 hours. The control group consisted of 106 people with ES less than 700 per 24 hours. The main and control groups were initially equivalent in anthropometric criteria and concomitant pathology. The list of examinations included laboratory methods (including lipid profile, coagulograms), as well as instrumental studies (transthoracic and/or transesophageal echocardiography (EchoCG), Doppler ultrasound of the brachiocephalic arteries and arteries of the lower extremities, 24-hours ECG monitoring, according to the indications - computed tomography or magnetic resonance imaging of the brain, coronary angiography, stress echocardiography. Prospective observation of patients performed for 1 year after the initial examination. Combined end points: development of arterial vascular complications - stroke, myocardial infarction, distal arterial embolism of other locations. We studied the data on identified complications. Next, we built models for predicting complications in various ways: Decision Tree; Bootstrap Forest; Boosted Tree; Neural Boosted; Support Vector Machines; Fit Stepwise; Nominal Logistic; Generalized Regression Lasso; Generalized Regression Forward Selection; Generalized Regression Pruned Forward Selection; Generalized Regression Elastic Net; Generalized Regression Ridge. To assess the quality of the models and compare them we used cross-validation with 30 replications.</p><p><strong>Results: </strong>The highest profit values with minimal values of false positive results were obtained for the Bootstrap Forest model. Basing on this model, we created arterial vascular complications predictive score in extrasystolic arrhythmia \"EX-prognosis\" that included the following parameters: atheroma type III in carotid arteries - 3 points; age 69+ years old - 2 points; ES appearing before transmitral blood flow peak in cardiac cycle 700 and more per 24 hours - 1 point; carotid arteries stenosis, non-significant - 1 point. If total number is 3 and more points, the risk of arterial vascular complications within 1 year is high.</p><p><strong>Conclusions: </strong>We recommend to use the scale \"EX-prognosis\" in the clinical practice. For a quick assessment of the total risk, it is optimal to implement the risk14.exe program - calculator - developed by us for a personal computer, based on this scale.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"86-94"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391812","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":"Long-term clinical impact of angiographic complexity in left main trifurcation percutaneous coronary interventions.","authors":"Mila Kovacevic, Francesco Burzotta, Goran Stankovic, Alaide Chieffo, Dejan Milasinovic, Milenko Cankovic, Milovan Petrovic, Cristina Aurigemma, Enrico Romagnoli, Francesco Bianchini, Lazzaro Paraggio, Zlatko Mehmedbegovic, Carlo Trani","doi":"10.23736/S2724-5683.24.06531-1","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06531-1","url":null,"abstract":"<p><strong>Background: </strong>Current evidence on the long-term outcome and its determinants in patients with unprotected left main trifurcation (LMT) treated with percutaneous coronary intervention (PCI) is based on small-sized studies. We aimed to assess the clinical, anatomical and procedural factors impacting long-term clinical outcomes of patients with LMT treated by PCI.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective study on consecutive patients with unprotected LMT in stable or acute coronary settings who underwent PCI with drug-eluting-stent implantation. Primary endpoint was major adverse cardiovascular events (MACE), defined as composite of all-cause death, myocardial infarction, and target lesion revascularization. LMT lesions complexity was graded according to a modified Medina LMT score, which, together with standard criteria of >50% stenosis in any of the branches, included the presence of disease extent >5 mm in the two major side-branches.</p><p><strong>Results: </strong>A total of 103 patients were analyzed, mean age 67.5 years, 37.9% with diabetes mellitus, 47.6% presenting with acute coronary syndrome, 8.7% in cardiogenic shock, with a mean SYNTAX Score of 28.1. Procedural success (angiographic success without in-hospital MACE) was achieved in 99 patients (96.1%). During 3-year follow-up, 18 patients (17.9%) experienced MACE, mainly due to target lesion revascularization (TLR), which occurred in 12 patients (11.9%). At multivariable analysis, modified Medina LMT score was the only independent predictor of MACE (HR 1.538 [1.081-2.189], P=0.017).</p><p><strong>Conclusions: </strong>PCI in patients with LMT is associated with a high procedural success rate and acceptable long-term clinical outcomes. Baseline LMT lesion complexity, assessed by an original modified Medina LMT score, is an independent driver of long-term clinical outcomes.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":"73 1","pages":"77-85"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557323","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}