Reviews in cardiovascular medicine最新文献

{"title":"The Role of AMPKα in the Mechanism of Development and Treatment of Heart Failure.","authors":"Yue Feng, Zixiong Zhu, Yubin He, Xuewen Li","doi":"10.31083/RCM36391","DOIUrl":"10.31083/RCM36391","url":null,"abstract":"<p><p>The AMP-activated protein kinase (AMPK) alpha (AMPK<i>α</i>) subunit is the catalytic subunit in the AMPK complex and includes both <i>α</i>1 and <i>α</i>2 isoforms. Phosphorylation of upstream kinases at the Thr172 site in the <i>α</i>-subunit is critical for AMPK activation. The kinases upstream of AMPK include liver kinase B1 (LKB1), calcium/calmodulin-dependent protein kinase kinase <i>β</i> (CaMKK<i>β</i>), and transforming growth factor <i>β</i>-activated kinase 1 (TAK1). LKB1 predominantly regulates the AMPK<i>α</i>2 isoforms, whereas the phosphorylating roles of CaMKK and TAK1 in different isoforms of AMPK<i>α</i> have yet to be properly defined. Moreover, the understanding of the roles of AMPK<i>α</i>1 and <i>α</i>2 remains limited. Significant differences exist between the AMPK<i>α</i>1 and AMPK<i>α</i>2 isoforms regarding tissue distribution, cellular localization, and cardiac-unique roles, with AMPK<i>α</i>2 being the predominant catalytic isoform in the heart. During heart failure (HF), activated AMPK<i>α</i> isoforms, particularly AMPK<i>α</i>2, promote the remodeling of energy metabolism, ameliorate mitochondrial dysfunction, activate mitophagy, attenuate oxidative stress, and reduce cardiomyocyte death, thereby protecting cardiac function and delaying HF progression. Thus, drugs that selectively activate AMPK complexes containing specific <i>α</i>2 isoforms may help treat HF. However, AMPK activators are not currently very subtype-selective, direct agonists remain in clinical trials, and indirect agonists, although widely used in the clinic, have some non-AMPK-dependent effects. Therefore, a compelling need exists to develop subtype-selective activator drugs with greater specificity and efficacy and fewer side effects.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"36391"},"PeriodicalIF":1.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030554","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":"Serum Albumin is Linearly and Negatively Associated With the Risk of All-cause and Cardiovascular Death in Coronary Heart Disease Patients.","authors":"Jiayi Tong, Tao Wang, Qin Wei, Qing Hao, Fuchao Yu, Xuan Xu, Penghao Zhen","doi":"10.31083/RCM38034","DOIUrl":"10.31083/RCM38034","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in treatment and the potential role of serum albumin as a prognostic biomarker, the mortality rate of individuals with coronary heart disease (CHD) continues to increase. Thus, this study aimed to assess the relationship between serum albumin levels and the risk of all-cause mortality and cardiovascular death in individuals with CHD.</p><p><strong>Methods: </strong>This large-scale retrospective cohort study included 1556 participants diagnosed with CHD from the National Health and Nutrition Examination Survey spanning 1999 to 2015. We conducted multivariate Cox regression, subgroup and sensitivity analyses, and restricted cubic spline (RCS) plots to examine the link between serum albumin levels and all-cause mortality and cardiovascular death.</p><p><strong>Results: </strong>After gradually adjusting the confounding variables, serum albumin consistently demonstrated a strong link to increased overall and cardiovascular-related mortality risk when employed as a continuous variable (hazard ratio [HR]: 0.938, 95% confidence interval [CI]: 0.912-0.964; <i>p</i> < 0.001; HR: 0.921, 95% CI: 0.884-0.960; <i>p</i> < 0.001; respectively); meanwhile, serum albumin as a three-category variable, with Tertile 1 (T1, ≤40 g/L), Tertile 2 (T2, 40-43 g/L), and Tertile 3 (T3, >43 g/L), was only closely related to the risk of all-cause death (T2 vs. T1, HR: 0.771, 95% CI: 0.633-0.939; <i>p</i> = 0.010; T3 vs. T1, HR: 0.761, 95% CI: 0.612-0.947; <i>p</i> = 0.014; respectively). Subgroup analysis showed that serum albumin was linked to all-cause mortality across most groups (≤60 or >60 years, male or female, and without hypertension, diabetes, or chronic kidney disease); however, its correlation with cardiovascular death was observed only in the subgroup without hypertension (<i>p</i> < 0.05). The sensitivity analysis indicated that excluding participants with an estimated glomerular filtration rate <30 mL/min/1.73 m² did not alter the association between serum albumin and the risk of all-cause and cardiovascular mortality. Moreover, the RCS analysis further supported a consistent negative linear trend between serum albumin levels and mortality risks (<i>p</i> for nonlinearity >0.05).</p><p><strong>Conclusions: </strong>The serum albumin levels in individuals with CHD were inversely and linearly related to all-cause mortality and cardiovascular death risk.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"38034"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030386","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":"Subclinical Brain Lesions in Magnetic Resonance Imaging are a Potential Indicator of Patent Foramen Ovale Related Migraines in Younger Patients.","authors":"Hong Yang, Fei Ma, Rui Li, Qiang Zhou, Fan Lin, Hesong Zeng, Dao Wen Wang, Jiangang Jiang, Xiang Luo, Hong Wang","doi":"10.31083/RCM37480","DOIUrl":"10.31083/RCM37480","url":null,"abstract":"<p><strong>Background: </strong>The causal relationship between migraines and patent foramen ovale (PFO) remains controversial, and a major unresolved question is how to define migraines attributable to PFO. Thus, this study aimed to determine if brain lesions could be a potential indicator of PFO-related migraines.</p><p><strong>Methods: </strong>Consecutive migraine patients from 2017 to 2019 who underwent transthoracic echocardiography or transcranial Doppler examination with an agitated saline contrast injection were assessed for right-to-left shunts. We then presented diffusion-weighted imaging (DWI) in brain magnetic resonance imaging and its association with PFO in the included patients.</p><p><strong>Results: </strong>A total of 424 patients with a mean age of 44.39 ± 12.06 years were included in this retrospective study. Among them, 244 patients (57.5%) had PFO, and 246 patients (58%) had subclinical brain lesions-the brain lesions presented as single or multiple scattered lesions. No association was observed between PFO prevalence and brain lesions in the total cohort (odds ratio (OR) 0.499); however, a significant association was observed in patients aged less than 46 years (OR, 3.614 in the group aged <34 years, 95% confidence interval (CI) 1.128-11.580, and 3.132 in the group of 34 years ≤ age < 46 years, 95% CI 1.334-7.350, respectively). Lesions in patients with PFO observed using DWI came more from the anterior or multiple than the posterior vascular territory (<i>p</i> = 0.033). DWI lesion numbers, location, and right-to-left shunt amounts did not affect the association between DWI-observed lesions and PFO.</p><p><strong>Conclusions: </strong>This study demonstrated that subclinical brain lesions are associated with PFO and may be used as a potential predictor of PFO-related migraines in patients aged less than 46 years. This may help identify candidate patients for PFO closure in future clinical decisions.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"37480"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030400","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":"Prevalence of Sleep-Disordered Breathing and Cheyne-Stokes Respiration in Patients With Atrial Fibrillation.","authors":"Hiroki Matsumoto, Takatoshi Kasai, Akihiro Sato, Nanako Shiroshita, Sayaki Ishiwata, Shoichiro Yatsu, Jun Shitara, Takao Kato, Shoko Suda, Ryo Naito, Hidemori Hayashi, Tohru Minamino, Hiroyuki Daida","doi":"10.31083/RCM46143","DOIUrl":"10.31083/RCM46143","url":null,"abstract":"<p><strong>Background: </strong>Limited data are available regarding the prevalence of sleep-disordered breathing (SDB), particularly Cheyne-Stokes respiration (CSR), in patients with atrial fibrillation (AF) and left ventricular (LV) systolic dysfunction. Thus, this study aimed to investigate the prevalence of SDB and CSR, as well as the factors associated with these conditions, in patients with AF without LV systolic dysfunction.</p><p><strong>Methods: </strong>Patients with paroxysmal and non-paroxysmal AF underwent echocardiography and cardiorespiratory polygraphy. Multiple linear regression analysis was performed using the apnea-hypopnea index (AHI) and %CSR as the dependent variables.</p><p><strong>Results: </strong>A total of 462 patients were enrolled; 335 patients (72.5%) were diagnosed with SDB (AHI ≥5/h), with a median AHI of 10.3 events per hour (interquartile range, 4.7-20.8). CSR was observed in 107 patients (23.2%). Multiple linear regression analysis showed that age, sex, body mass index, and hypertension were independently correlated with AHI (<i>p</i> = 0.0188, 0.0002, <0.0001, and 0.0457, respectively). Conversely, age, diabetes mellitus (DM), and the plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) level were independently correlated with %CSR (<i>p</i> < 0.0001, 0.0047, and 0.0095, respectively).</p><p><strong>Conclusion: </strong>SDB and CSR were common in patients with AF. CSR was observed in older patients with DM and high NT-proBNP levels.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"46143"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rise of Optical Coherent Tomography in Intracoronary Imaging: An Overview of Current Technology, Limitations, and Future Perspectives.","authors":"Gianluca Castaldi, Georgios Zormpas, Pascal Frederiks, Tom Adriaenssens, Johan Bennett","doi":"10.31083/RCM38123","DOIUrl":"10.31083/RCM38123","url":null,"abstract":"<p><p>Intravascular optical coherence tomography (OCT) has represented a revolutionary invasive imaging method, offering <i>in vivo</i> high-resolution cross-sectional views of human coronary arteries, thereby promoting a significant evolution in the understanding of vascular biology in both acute and chronic coronary pathologies. Since the development of OCT in the early 1990s, this technique has provided detailed insights into vascular biology, enabling a more thorough assessment of coronary artery disease (CAD) and the impact of percutaneous coronary intervention (PCI). Moreover, a series of recent clinical trials has consistently demonstrated the clinical benefits of intravascular imaging (IVI) and OCT-guided PCI, showing improved outcomes compared to angiography-guided procedures, particularly in cases of complex coronary pathology. Nonetheless, despite the advantages of OCT, several limitations remain, including limited penetration depth and the necessity for additional contrast agent administration, which may potentially constrain the widespread adoption of OCT. Moreover, economic and logistical challenges remain, including heterogeneous levels of training among interventional cardiologists, which leads to the underutilization of OCT in the Western world. Meanwhile, emerging technologies and the integration of machine learning and artificial intelligence-based algorithms are set to enhance diagnostic accuracy in daily practice. Future research is necessary to address existing limitations and investigate next-generation devices, further advancing the field of interventional cardiology toward optimal imaging-guided PCI and improved outcomes.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"38123"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and Risk of Sudden Cardiac Death and Arrhythmias: A Systematic Review and Meta-Analysis.","authors":"Yao You, Yongmin Shi, Qingwen Yu, Xiyun Rao, Xuhan Tong, Ting Tang, Siqi Hu, Shenghui Zhang, Xingwei Zhang, Hu Wang, Mingwei Wang, Jiake Tang","doi":"10.31083/RCM36520","DOIUrl":"10.31083/RCM36520","url":null,"abstract":"<p><strong>Background: </strong>Depression is a highly prevalent mental disorder worldwide and is often accompanied by various somatic symptoms. Clinical studies have suggested a close association between depression and cardiac electrophysiological instability, particularly sudden cardiac death (SCD) and arrhythmias. Therefore, this review systematically evaluated the association between depression and the risks of SCD, atrial fibrillation (AF), and ventricular arrhythmias.</p><p><strong>Methods: </strong>This analysis was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The PubMed, Embase, Web of Science, China National Knowledge Infrastructure, VIP, and Wanfang databases were comprehensively searched to identify studies that indicated a correlation between depression and the risk of SCD and arrhythmias from database inception until April 10, 2025. Numerous well-qualified cohort studies were incorporated in this analysis. Correlation coefficients were computed using a random effects model. Statistical analyses were performed using Review Manager 5.4 and STATA 16.0.</p><p><strong>Results: </strong>A total of 20 studies were included in this meta-analysis. We explored the relationship between depression and SCD as well as arrhythmias. Of these diseases, SCD exhibited a statistically significant association with depression (hazard ratio (HR), 2.52, 95% confidence interval (CI): 1.82-3.49). Ventricular tachycardia (VT)/ventricular fibrillation (VF) was also significantly correlated with depression (HR): 1.38, 95% CI: 1.03-1.86). Depression was also considerably more likely to develop following AF. The results also indicated that AF recurrence (HR: 1.89, 95% CI: 1.54-2.33) was more significant than new-onset AF (HR: 1.10, 95% CI: 0.98-1.25).</p><p><strong>Conclusions: </strong>This study highlights a significant association between depression and elevated risks of SCD and arrhythmias, including both AF and VT/VF. These findings underscore the importance of incorporating mental health evaluation into comprehensive cardiovascular risk management strategies.</p><p><strong>The prospero registration: </strong>CRD42024498196, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024498196.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"36520"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030479","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":"Left Ventricular Noncompaction Cardiomyopathy in Children: A Focus on Genetic and Molecular Mechanisms.","authors":"Monica B Lehman, Buyan-Ochir Orgil, Karine Guerrier, Keiichi Hirono, Enkhzul Batsaikhan, Kazuyoshi Saito, John W Collyer, Jeffrey A Towbin, Enkhsaikhan Purevjav","doi":"10.31083/RCM39044","DOIUrl":"10.31083/RCM39044","url":null,"abstract":"<p><p>Left ventricular noncompaction (LVNC), also called noncompaction cardiomyopathy (NCM), is a myocardial disease that affects children and adults. Morphological features of LVNC include a noncompacted spongiform myocardium due to the presence of excessive trabeculations and deep recesses between prominent trabeculae. Incidence and prevalence rates of this disease remain contentious due to varying clinical phenotypes, ranging from an asymptomatic phenotype to fulminant heart failure, cardiac dysrhythmias, and sudden death. There is a strong genetic component associated with LVNC, and nearly half of pediatric LVNC patients harbor an identifiable genetic mutation. Recent studies have identified LVNC-associated mutations in genes involved in intercellular trafficking and cytoskeletal integrity, in addition to well-known mutations causing abnormal cardiac embryogenesis. Currently, the diagnosis is based on symptoms, as well as various diagnostic criteria, including echocardiography, electrocardiograms, and cardiac magnetic resonance imaging. Meanwhile, clinical management is primarily focused on the prevention of complications, such as heart failure, thromboembolic events, life-threatening arrhythmias, and stroke. Continued research is focusing on the genetic etiology, the development of gold-standard diagnostic criteria, and evidence-based treatment guidelines across all age groups. This review article will highlight the genotype-phenotype relationship within pediatric LVNC patients and assess the latest discoveries in genetic and molecular research aimed at improving their diagnostic and therapeutic management.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"39044"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030504","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":"Updated Trends in Valvular Heart Disease-Related Heart Failure in G20-the Group of Twenty Countries: Insights From the Global Burden of Disease Study 2021.","authors":"Cheng Liu, Shenghui Zhang","doi":"10.31083/RCM38912","DOIUrl":"10.31083/RCM38912","url":null,"abstract":"<p><strong>Background: </strong>Valvular heart disease (VHD), including both non-rheumatic valvular heart disease (NRVHD) and rheumatic valvular heart disease (RVHD), is a major global health concern. Moreover, the progression of VHD to heart failure (HF) poses substantial clinical and public health challenges. In light of the global population aging, alongside increasing cardiovascular risk factors, and the additional strain imposed by the COVID-19 pandemic, a timely reassessment of the VHD-related HF burden is urgently needed. Using the most recent data from the Global Burden of Disease (GBD) Study 2021, this study aimed to evaluate the distribution of VHD-related HF burden in 2021, examining the long-term trends from 1990 to 2021, and short-term changes between 2019 and 2021, to provide updated insights to inform future prevention and management strategies.</p><p><strong>Methods: </strong>Using GBD 2021 data, we analyzed the distribution of VHD-related HF burden in age-standardized prevalence rates across the Group of Twenty (G20) countries.</p><p><strong>Results: </strong>The highest NRVHD-related HF burden in 2021 was observed in the United States (US), Italy, and Russia, while the highest RVHD-related HF burden was noted in India, France, and China. Over the past 30 years (1990-2021), the NRVHD-related HF burden decreased in developed countries (e.g., the US, Canada, Japan) but increased in emerging economies (e.g., India, Brazil, South Africa), with significant increases also observed in Argentina, Mexico, Brazil, among other countries. Notably, nearly all G20 countries exhibited a downward trend in RVHD-related HF burden, with Germany and Australia being the exceptions. During the COVID-19 pandemic (2019-2021), the NRVHD-related HF burden declined in most G20 nations, except for South Africa, India, and a few others, while the RVHD-related HF burden increased slightly in countries such as Mexico, Russia, and Indonesia.</p><p><strong>Conclusions: </strong>Trends in NRVHD- and RVHD-related HF burden across G20 countries exhibited notable variations, and these became more pronounced under the impact of the COVID-19 pandemic. These findings underscore the importance of developing long-term strategies to enhance the resilience of healthcare systems, improve chronic disease management, and optimize resource allocation to promote cardiovascular health and preparedness for public health challenges.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"38912"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030576","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":"Takotsubo Syndrome in Patients With Acute Coronary Syndrome or Myocarditis.","authors":"Manuel Martínez-Sellés","doi":"10.31083/RCM39562","DOIUrl":"10.31083/RCM39562","url":null,"abstract":"<p><p>Stress cardiomyopathy/Takotsubo syndrome (TTS) is a transient cardiac condition characterized by sudden and reversible left ventricular dysfunction, typically triggered by emotional or physical stress. The international TTS (InterTAK) score predicts the probability of suffering from TTS. However, the diagnostic algorithm includes three mutually exclusive diagnoses: acute coronary syndrome (ACS), TTS, and acute infectious myocarditis. Thus, we propose to include the conditions in which TTS is associated with ACS or myocarditis. While TTS is commonly associated with non-ischemic stressors, recent evidence has indicated that TTS can be found in patients with ACS. Nonetheless, in some cases, ACS may trigger rather than exclude TTS. Additionally, TTS could also prompt plaque ruptures in coronary arteries. Meanwhile, infections and conditions that cause myocarditis can also produce physical stress that may trigger TTS. Furthermore, TTS has been reported after confirmed viral myocarditis. This opinion article explores the intricate relationships between (i) TTS and ACS, and (ii) TTS and myocarditis, delving into the related pathophysiologies and diagnostic challenges. However, further research is required to elucidate the mechanisms that link TTS with these conditions.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"39562"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030377","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":"Preoperative Risk Factors for Acute Postoperative Atrial Fibrillation in Patients Undergoing Mitral Valve Repair for Degenerative Mitral Regurgitation: Insights Into Cardiac Geometry.","authors":"Hang Xu, Xinhe Xu, Jiexu Ma, Shanshan Zheng, Wu Song, Zhaoji Zhong, Sheng Liu","doi":"10.31083/RCM38938","DOIUrl":"10.31083/RCM38938","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) commonly occurs following surgical repair of degenerative mitral regurgitation (DMR) and is associated with unfavorable outcomes. This study aimed to identify preoperative risk factors for acute POAF in patients undergoing mitral valve repair for DMR, with a specific focus on the role of preoperative echocardiography.</p><p><strong>Methods: </strong>A retrospective study was conducted involving 1127 DMR patients who underwent mitral valve repair between 2017 and 2022. The primary endpoint was the occurrence of acute POAF within 30 days after surgery. Univariate and multivariate logistic regression analyses were performed to identify risk factors for POAF. Additionally, subgroup analyses were conducted to evaluate the predictive value of preoperative parameters for the development of acute POAF.</p><p><strong>Results: </strong>Acute POAF was observed in 152 patients (13.5%). After adjusting for covariates, multivariate analysis revealed that age (odds ratio (OR) 1.05; 95% confidence interval (CI) 1.03-1.07, <i>p</i> < 0.001), hypertension (OR 1.50; 95% CI 1.03-2.21, <i>p</i> = 0.037), left ventricular ejection fraction (OR 0.95; 95% CI 0.92-0.98, <i>p</i> = 0.004), and left atrial enlargement (OR 1.03; 95% CI 1.00-1.06, <i>p</i> = 0.019) were independent predictors of acute POAF. The interventricular septum (IVS) thickness demonstrated a strong association with acute POAF (OR 1.21; 95% CI 1.06-1.38, <i>p</i> = 0.005). The optimal cut-off value for the IVS thickness in predicting acute POAF was 11.0 mm. The adjusted OR of association between an IVS thickness >11 mm and acute POAF was 1.73 (95% CI 1.03-2.89, <i>p</i> = 0.037). The IVS thickness was consistently identified as a significant predictor of POAF in the subgroup analyses.</p><p><strong>Conclusions: </strong>Preoperative assessment of clinical morbidity and echocardiographic parameters, particularly IVS thickness, can be valuable in identifying high-risk patients for acute POAF and informing targeted strategies for prevention and management.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"38938"},"PeriodicalIF":1.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030523","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}