Minerva cardiology and angiology最新文献

{"title":"Clinical implications of coronary microvascular dysfunction in patients with non-obstructive coronary artery disease and role of the thermodilution method.","authors":"Alice Benedetti, Gianluca Castaldi, Paul Vermeersch, Adriaan Wilgenhof, Carl Convens, Benjamin Scott, Stefan Verheye, Pierfrancesco Agostoni, Carlo Zivelonghi","doi":"10.23736/S2724-5683.23.06289-0","DOIUrl":"10.23736/S2724-5683.23.06289-0","url":null,"abstract":"<p><p>More than 60% of patients undergoing coronary angiography present no coronary artery disease (CAD). Angina and myocardial ischemia are classically determined by epicardial vascular obstruction, but coronary microvascular dysfunction (CMD) may also represent a possible cause for these phenomena. Two endotypes of CMD have been recognized, with two different pathophysiological mechanisms: structural CMD, characterized by low coronary flow reserve (CFR) and high microvascular resistance (MVR) values; and functional CMD, characterized by low CFR and normal MVR values. According to the present data, almost half of patients with non-obstructive CAD have shown signs of CMD. For this reason, further investigations for microvascular function assessment should be considered when evaluating no-CAD patients complaining of angina or presenting signs of myocardial ischemia. The thermodilution method is currently becoming a widespread invasive technique due to its feasibility and high reproducibility for coronary physiology evaluation. Furthermore, a recently introduced technique - called continuous thermodilution - allows for direct measurement of absolute coronary flow and resistances. The role of this brand-new technique in the clinical scenario is however still to be fully investigated and its use is at present limited to research purposes only. Among no-CAD patients, both structural and functional CMD are related to a worse prognosis in term of mortality and major adverse cardiovascular events (MACE). In this review, we will discuss the present evidence supporting the definition, prevalence and clinical implication of the different forms of CMD and the technical aspects of its invasive assessment.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"23-37"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9140296","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":"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}

{"title":"Clinical utility of myocardial work assessment in arterial hypertension and cardiovascular diseases.","authors":"Andrea Vitali, Fouad A Zouein, George W Booz, Raffaele Altara","doi":"10.23736/S2724-5683.24.06654-7","DOIUrl":"10.23736/S2724-5683.24.06654-7","url":null,"abstract":"<p><p>In clinical practice, ventricular ejection fraction (EF) and global longitudinal strain (GLS) are the most often used parameters for evaluating left ventricular systolic function, despite the impact that variable loading conditions have. Alternatively, the myocardial efficiency (ME) of the heart, encompassing cardiac energy formation and dissipation, along with myocardial oxygen consumption (MVO<inf>2</inf>), is a useful surrogate for assessing myocardial work (MW), a parameter correlated with the pressure-strain loop (PSL), arterial pressure, and cardiac output (CO). This refinement proves especially practical in defining cardiac work across various clinical contexts, including arterial hypertension and heart failure (HF), the primary conditions associated with cardiovascular mortality. In this review, we explore how many invasive and non-invasive studies have shown that MW and consequently ME are correlated with the state of cardiovascular wellbeing and myocardial performance, allowing it to be integrated with other parameters present in clinical practice.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066623","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":"Prognostic utility of assessing ventricular-arterial coupling in arterial hypertension and cardiovascular diseases.","authors":"Andrea Vitali, Fouad A Zouein, George W Booz, Raffaele Altara","doi":"10.23736/S2724-5683.24.06655-9","DOIUrl":"10.23736/S2724-5683.24.06655-9","url":null,"abstract":"<p><p>The assessment of myocardial function and its coupling with the arterial system, called ventricular-arterial coupling (VAC), is of paramount importance in many clinical fields, from arterial hypertension, which is the main cause of cardiovascular diseases and death, to heart failure. VAC has been the subject of studies for several decades both from an energetic cost and the impact it can exert on cardiovascular performance. Although more attention has been paid to the relationship between the left ventricle and the left arterial circuit in compromised hemodynamic stages, VAC has aroused interest in many other aspects of study, from its application in pathologies of the right sections of the heart to its clinical impact in prevention and cardiovascular risk factors. In this review we will focus on the importance of the hemodynamic data of the VAC in various clinical contexts and its possible applications in the future as a diagnostic and prognostic parameter in the cardiac clinic.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024101","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 effect of propolis supplementation on blood pressure: a systematic review and meta-analysis of controlled trials.","authors":"Hongyan Qu, Li Cao, Ziye Wen, Chao Li, Meihong Xiao","doi":"10.23736/S2724-5683.24.06656-0","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06656-0","url":null,"abstract":"<p><strong>Introduction: </strong>The current meta-analysis aimed to determine the efficacy of propolis supplementation on hypertension.</p><p><strong>Evidence acquisition: </strong>The systematic review and meta-analysis. were undertaken on five online databases to find clinical trials assessing the effects of propolis on systolic blood pressure (SBP) and diastolic blood pressure (DBP) markers up to October 2023. The pooled estimation of the weighted mean difference (WMD) and the corresponding 95% confidence intervals (CI) were calculated using a fixed-effect model. Egger's regression test was used to assess publication bias.</p><p><strong>Evidence synthesis: </strong>A significant decrease was observed in SBP levels following propolis supplementation (WMD=-5.58 mmHg, 95% CI: -7.74, -3.42; I²=42.99%, P=0.08). However, no significant change was found in the levels of DBP (WMD=-1.34 mmHg, 95% CI: -6.10, 3.41; I²=75.94%, P<0.01). Moreover, studies with an experimental design (-5.53, 95% CI: -13.24, 2.18) and trials with <30 individuals (-3.96, 95% CI: -7.98, 0.06) did not demonstrate a significant impact of propolis on SBP levels. In trials with an experimental design, a substantial decrease in DBP levels was seen in subgroup analyses after propolis supplementation (-9.29, 95% CI: -12.50, -6.08).</p><p><strong>Conclusions: </strong>The results of the study revealed the positive effects of propolis supplementation in the context of hypertension, as evidenced by a reduction in SBP levels.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024102","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":"A study protocol for evaluating aortic stiffness modifications in patients treated with endovascular aortic repair.","authors":"Daniele Bissacco, Chiara Grignaffini, Silvia Romagnoli, Elisa Gherbesi, Maurizio Domanin, Renato Casana, Paolo Salvi, Gianfranco Parati, Diego Gallo, Stefano Carugo, Umberto Morbiducci, Santi Trimarchi","doi":"10.23736/S2724-5683.23.06502-X","DOIUrl":"10.23736/S2724-5683.23.06502-X","url":null,"abstract":"<p><strong>Background: </strong>Arterial stiffness, particularly aortic stiffness (AoS), is associated with an increased risk of cardiovascular disease. Endovascular repair for abdominal (EVAR) and thoracic (TEVAR) aortic disease may increase AoS. This study protocol aims to assess changes in AoS before and after interventions for aortic disease.</p><p><strong>Methods: </strong>Patients scheduled for EVAR or TEVAR during a three-year period will be enrolled. An indirect AoS indicator, carotid-to-femoral pulse wave velocity (cf-PWV) will be measured non-invasively using applanation tonometry and reported with others perioperative data before and after the endovascular treatment. Moreover, cardiological data will be collected through echocardiography.</p><p><strong>Results: </strong>Fifty EVAR and 50 TEVAR will be enrolled. We will primarily analyze changes in cf-PWV. To ensure the reliability of our findings, we will also include supplementary data such as clinical information, morphological data, and functional echocardiographic data.</p><p><strong>Conclusions: </strong>By examining AoS modifications before and after endovascular aortic repair, this study aims to enhance our understanding of how arterial stiffness changes following endoprosthesis deployment. The findings from the applied protocol are expected to be informative for innovative graft designs with minimized mechanical mismatch with the aortic wall and with improved vascular hemodynamic, aligning with the current trend in improving patient outcomes. Moreover, understanding these modifications is important for predicting and improving long-term cardiovascular outcomes in patients undergoing such interventions.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"649-655"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318709","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":"Association of neighborhood socioeconomic status with echocardiographic parameters and re-admission following transcatheter aortic valve replacement.","authors":"Irbaz Hameed, Melissa Todice, Adham Ahmed, Adrian A Higaki, Ayesha Mubasher, Ritu Agarwal, Matthew L Williams","doi":"10.23736/S2724-5683.24.06541-4","DOIUrl":"10.23736/S2724-5683.24.06541-4","url":null,"abstract":"<p><strong>Background: </strong>Data on predictors of poor hemodynamic presentation and rehospitalizations following transcatheter aortic valve replacement (TAVR) are limited. We evaluate the association between neighborhood socioeconomic status (NSES) on echocardiographic presentation and post-TAVR readmission at a high-volume institution.</p><p><strong>Methods: </strong>All patients undergoing TAVR at a single institution between 2012 and 2022 were included. Patient addresses, baseline variables including Society of Thoracic Surgeons (STS) preoperative risk of mortality and frailty, and post-procedural outcomes were extracted from electronic health records. Using a validated US Census Bureau Index, the NSES of each patient (1-100) was tabulated, with lower values correlating to increased social deprivation. Patients were separated into four ranked groups based on NSES (rank 1: 1-25, rank 4: 76-100). Multivariable regression was performed to determine variables associated with number of days hospitalized in one-year following index TAVR procedure.</p><p><strong>Results: </strong>A total of 2031 patients were included. The median NSES was 68 (IQR: 53-80). There was a total of 232 (11.4%) readmissions. The median number of days hospitalized in one year following TAVR was 4 (interquartile range [IQR]: 2-7) After adjusting for baseline variables including STS risk score and patient frailty, compared to patients in the lowest ranked socioeconomic group, patients of higher NSES were associated with lower aortic valve gradients at baselines (Exp[β]=0.997, 95% CI: 0.993-0.999, P=0.049). Additionally, compared to patients in the lowest ranked socioeconomic group, patients of NSES were associated with shorter duration of readmission after risk-factor adjustments (Exp[β]=0.996, 95% CI: 0.992-0.999, P=0.032).</p><p><strong>Conclusions: </strong>Patients of lower socioeconomic status are associated with higher aortic valve gradient at baseline and more days hospitalized in the first year after their index TAVR procedure after adjusting for other risk factors. As TAVR volume continues to expand, physicians and health systems must consider this independent factor when determining patient prognosis and readmission policies.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"640-648"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260377","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":"Using ChatGPT to perform a systematic review: a tutorial.","authors":"Lefteris Teperikidis, Aristi Boulmpou, Christodoulos Papadopoulos, Giuseppe Biondi-Zoccai","doi":"10.23736/S2724-5683.24.06568-2","DOIUrl":"10.23736/S2724-5683.24.06568-2","url":null,"abstract":"<p><p>This tutorial provides a comprehensive guide on leveraging ChatGPT for systematic literature reviews, leveraging actual applications in cardiovascular research. Systematic reviews, while essential, are resource-intensive, and ChatGPT offers a potential solution to streamline the process. The tutorial covers the entire review process, from preparation to finalization. In the preparation phase, ChatGPT assists in defining research questions and generating search strings. During the screening phase, ChatGPT can efficiently screen titles and abstracts, processing multiple abstracts simultaneously. The tutorial also introduces an intermediate step of generating study summaries that leads to the generation of reliable data extraction tables. For assessing the risk of bias, ChatGPT can be prompted to perform these tasks. Using each tool's explanation document to generate an appropriate prompt is an efficient method of reliable risk of bias assessments using ChatGPT. However, users are cautioned about potential hallucinations in ChatGPT's outputs and the importance of manual validation. The tutorial emphasizes the need for vigilance, continuous refinement, and gaining experience with ChatGPT to ensure accurate and reliable results. The methods presented have been successfully tried in several projects, but they remain in nascent stages, with ample room for improvement and refinement.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"547-567"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759781","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":"Sophocarpine attenuates doxorubicin-induced heart injury through inhibition of fibrosis.","authors":"Yang Fu, Meng Li, Huang Zhang, Yi-Fei Dong","doi":"10.23736/S2724-5683.24.06507-4","DOIUrl":"10.23736/S2724-5683.24.06507-4","url":null,"abstract":"<p><strong>Background: </strong>Doxorubicin (DOX) is a potent anti-cancer medication that is associated with numerous adverse effects, particularly concerning damage to the heart.</p><p><strong>Methods: </strong>This study aimed to investigate the impact of sophocarpine (SOP) on DOX-induced heart injury through both in vivo and in vitro experiments. The experimental techniques employed encompassed echocardiography, hematoxylin/eosin (H&E) staining, Masson staining, immunohistochemical staining, western blotting, and so on.</p><p><strong>Results: </strong>Echocardiography showed that SOP alleviated DOX-induced cardiac dysfunction, as evidenced by the improvements in both left ventricle ejection fraction and left ventricle fractional shortening. DOX caused upregulations of creatine kinase-MB and lactate dehydrogenase, while SOP decreased these indices. Staining methods such as H&E and Masson showed that SOP reversed the pathological changes induced by DOX. DOX elevated the expression levels of fibrosis-associated proteins such as Collagen I, Collagen III, α-SMA, Fibronectin, MMP-2, and MMP-9. However, SOP reversed these changes. Moreover, the study further revealed that SOP inhibited the TGF-β1/Smad3 signaling pathway.</p><p><strong>Conclusions: </strong>These findings imply that SOP has the potential to mitigate DOX-induced heart injury by suppressing fibrosis. The underlying molecular mechanism may involve the inhibition of the TGF-β1/Smad3 signaling pathway.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"568-576"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088107","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":"Eosinophilic myocarditis: from etiology to diagnostics and therapy.","authors":"Marco Russo, Zumrud Ismibayli, Serena Antonaci, Giovanni C Piccinni","doi":"10.23736/S2724-5683.23.06297-X","DOIUrl":"10.23736/S2724-5683.23.06297-X","url":null,"abstract":"<p><p>Eosinophilic myocarditis (EM) is a rare, potentially life-threatening, form of inflammatory heart disease characterized by eosinophilic infiltration of the myocardium. Different diseases are involved in its etiopathogeneses, such as eosinophilic granulomatosis with polyangiitis (or Churg-Strauss Syndrome), hypereosinophilic syndromes, parasitic infections, drug reactions, paraneoplastic syndromes and primary immunodeficiencies (e.g. Omenn Syndrome). There is a wide spectrum of clinical pictures at presentation ranging from chronic restrictive cardiomyopathy (Loeffler cardiomyopathy) to acute necrotizing myocarditis with cardiogenic shock. The genetic contribution and the environmental interplay, such as SARS-CoV-2 infection and related vaccines, are fields not well studied yet. Many non-invasive tools, mainly echocardiography and cardiac magnetic resonance imaging, along with invasive procedures, such as endomyocardial biopsy, are the crucial steps in the diagnostic workup. The correct diagnosis is a challenge but mandatory for timely and appropriate immunosuppressive therapy.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"656-673"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10319304","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}