Reviews in cardiovascular medicine最新文献

{"title":"Key Mechanisms of Oxidative Stress-Induced Ferroptosis in Heart Failure with Preserved Ejection Fraction and Potential Therapeutic Approaches.","authors":"Junling Lin, Bingtao Li, Xueqi Guo, Guodong Li, Qi Zhang, Wenjuan Wang","doi":"10.31083/RCM26613","DOIUrl":"10.31083/RCM26613","url":null,"abstract":"<p><p>The prevalence of heart failure with preserved ejection fraction (HFpEF) is increasing annually, particularly among patients with metabolic disorders such as hypertension and diabetes. However, there is currently no treatment capable of altering the natural course of HFpEF. Recently, the interplay between oxidative stress and ferroptosis in cardiovascular diseases has drawn extensive attention; however, minimal research has been published on the mechanisms of oxidative stress and ferroptosis in HFpEF. This paper reviews the relevant mechanisms through which oxidative stress is induced and promotes ferroptosis during the development of HFpEF. The review also explores more efficacious treatment approaches for HFpEF by inhibiting oxidative stress and ferroptosis, thereby offering a theoretical foundation for verifying the feasibility of these methods for further research. As tumor-targeted therapy progresses, the survival period of tumor patients is prolonged, and cardiovascular events have gradually emerged as one of the most crucial causes of death among tumor patients. Hence, inhibiting the vascular endothelial growth factor (VEGF) pathway has become a major target in tumor treatment, significantly enhancing patient survival. Nevertheless, secondary cardiovascular complications and events, such as myocardial injury and subsequent heart failure, have severely impacted patient survival and quality of life. Therefore we have also explored the potential mechanism through which novel targeted anti-cancer drugs induce HFpEF via ferroptosis. Additionally, we reviewed the specific modes of action for preventing and treating HFpEF without influencing their anti-cancer therapeutic effect.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"26613"},"PeriodicalIF":1.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754412","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 and Associated Factors of Frailty in Patients with Chronic Heart Failure: A Systematic Review and Meta-Analysis.","authors":"Longren Wu, Si Liu, Meijun Zhang, Xiaoyun Xiong","doi":"10.31083/RCM26854","DOIUrl":"10.31083/RCM26854","url":null,"abstract":"<p><strong>Background: </strong>Although numerous studies have investigated the prevalence of chronic heart failure (CHF) and the factors influencing frailty in patients with CHF, the findings remain inconsistent. Therefore, this review aimed to systematically evaluate the prevalence and associated frailty factors in patients with CHF to establish an evidence-based foundation for risk assessment and treatment strategies.</p><p><strong>Methods: </strong>A comprehensive search was conducted across multiple databases, including EMBASE, the Cochrane Library, PubMed, Web of Science, CINAHL, Chinese Biological Medicine (CBM), CNKI, and Wan Fang up to August 25, 2024. The objective was to identify observational studies that examined factors influencing frailty in CHF patients. The quality of the selected studies was evaluated using appropriate assessment tools, and a meta-analysis was performed to determine the relevant factors associated with frailty in this population.</p><p><strong>Results: </strong>A total of 23 articles containing 6287 patients were included. The prevalence of frailty in patients with CHF was 39% (95% confidence interval (CI): 0.33-0.45). Factors shown to be positively associated with frailty in CHF patients were older age, cerebrovascular accidents, longer hospital stay, larger left atrial diameter, higher number of comorbidities, poor New York Heart Association (NYHA) functional class, and poor sleep quality. Conversely, higher albumin, hemoglobin, and left ventricular ejection fraction (LVEF) levels were negatively associated with frailty.</p><p><strong>Conclusions: </strong>The prevalence of frailty in patients with CHF is relatively high and varies according to different assessment tools applied. Thus, establishing specific frailty assessment tools for CHF patients and providing targeted interventions based on important factors are essential for reducing the burden of frailty and improving outcomes.</p><p><strong>The prospero registration: </strong>CRD42023448771, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023448771.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"26854"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754170","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":"Roles of Autophagy, Mitophagy, and Mitochondria in Left Ventricular Remodeling after Myocardial Infarction.","authors":"Xin Zhang, Shuai Shao, Qiuting Li, Yi Wang, Mowei Kong, Chunxiang Zhang","doi":"10.31083/RCM28195","DOIUrl":"10.31083/RCM28195","url":null,"abstract":"<p><p>This review examines the mechanisms of left ventricular dysfunction, focusing on the interplay between ventricular remodeling, autophagy, and mitochondrial dysfunction following myocardial infarction. Left ventricular dysfunction directly affects the heart's pumping efficiency and can lead to severe clinical outcomes, including heart failure. After myocardial infarction, the left ventricle may suffer from weakened contractility, diastolic dysfunction, and cardiac remodeling, progressing to heart failure. Thus, this article discusses the pathophysiological processes involved in ventricular remodeling, including the injury and repair of infarcted and non-infarcted myocardia, adaptive changes, and specific changes in left ventricular systolic and diastolic functions. Furthermore, the role of autophagy in maintaining cellular energy homeostasis, clearing dysfunctional mitochondria, and the key role of mitochondrial dysfunction in heart failure is addressed. Finally, this article discusses therapeutic strategies targeting mitochondrial dysfunction and enhancing mitophagy, providing clinicians and researchers with the latest insights and future research directions.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"28195"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754181","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":"Aortic Valve Intervention in Patients with Aortic Stenosis and Small Annulus.","authors":"Ahmed Abdalwahab, Muntaser Omari, Mohammad Alkhalil","doi":"10.31083/RCM26738","DOIUrl":"10.31083/RCM26738","url":null,"abstract":"<p><p>Over the last two decades, the management of aortic stenosis has undergone significant transformation due to developments in surgical techniques and the introduction of transcatheter aortic valve implantation (TAVI). These transformations have enabled improved patient selection and treatments to be tailored based on individual clinical and anatomical characteristics. Both surgical and transcatheter options have resulted in reduced mortality and enhanced quality of life for patients with aortic stenosis. Nonetheless, treating patients with small aortic annulus remains challenging despite advances in current technology. The insertion of a small prosthetic valve, leading to patient prosthetic mismatch, has been associated with heart failure hospitalization, early structural valve degeneration, and long-term mortality. Although aortic root enlargement was historically employed to address this issue, stentless and sutureless valves in the supra-annular position and, more recently, TAVI have emerged as alternative treatments for patients with small annulus and severe aortic stenosis. This review will provide an overview of the prevalence and anatomical characteristics of patients with aortic stenosis and small annulus. Additionally, we will discuss current treatment options, including surgery and TAVI, used to mitigate procedural and long-term adverse outcomes in this group.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"26738"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754221","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":"A Case-Control Study on Risk Factors and Outcomes in Congestive Heart Failure.","authors":"Mohammad Shakil Ahmad, Abdulrahman Obaid Matar Alharbi, Abdullah Tawakul, Abdulrahman Mohammed Alturiqy, Mansour Alzahrani, Riyaz Ahamed Shaik","doi":"10.31083/RCM26601","DOIUrl":"10.31083/RCM26601","url":null,"abstract":"<p><strong>Background: </strong>Congestive heart failure (CHF) represents an important health issue characterised by considerable morbidity and mortality. This study sought to identify risk factors for CHF and to evaluate clinical outcomes between CHF patients and control subjects.</p><p><strong>Methods: </strong>Data were obtained through interviews, physical examinations, and medical records. Risk variables encompassed hypertension, diabetes, dyslipidaemia, tobacco use, alcohol use, sedentary lifestyle, dietary practices, age, gender, and familial history of cardiovascular disease. The outcomes were all-cause mortality, cardiovascular mortality, hospitalisation, major adverse cardiovascular events (MACE), quality of life as measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and functional level according to the New York Heart Association (NYHA) classification. Statistical analyses including <i>t</i>-tests, Chi-square tests, logistic regression and Cox regression.</p><p><strong>Results: </strong>The findings indicated that hypertension (71.8% vs. 38.5%, <i>p</i> < 0.001), diabetes (47.9% vs. 28.2%, <i>p</i> = 0.002), dyslipidaemia (54.7% vs. 41.0%, <i>p</i> = 0.04), smoking (42.7% vs. 29.1%, <i>p</i> = 0.03), and physical inactivity (65.8% vs. 41.9%, <i>p</i> < 0.001) were more prevalent in cases. Cases exhibited increased hospitalisations (1.8 ± 1.2 vs. 0.7 ± 0.9, <i>p</i> < 0.001), prolonged stays (10.5 ± 5.4 vs. 6.2 ± 3.8 days, <i>p</i> < 0.001), elevated 30-day rehospitalisation rates (21.4% vs. 8.5%, <i>p</i> = 0.007), and a greater incidence of intensive care units (ICU) admissions (17.1% vs. 6.0%, <i>p</i> = 0.01). All-cause mortality (35.9% vs. 17.1%, <i>p</i> = 0.001), cardiovascular mortality (25.6% vs. 10.3%, <i>p</i> = 0.003), and MACE (51.3% vs. 25.6%, <i>p</i> < 0.001) were greater in cases. Quality of life (45.8 ± 12.4 vs. 25.6 ± 10.3, <i>p</i> < 0.001) and functional status (55.6% vs. 23.9%, <i>p</i> < 0.001) were inferior in cases.</p><p><strong>Conclusion: </strong>CHF patients had greater rates of modifiable risk variables and worse clinical outcomes than controls, underscoring the necessity for comprehensive risk management.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"26601"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753872","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":"Network Meta-Analysis on the Effects of Traditional Chinese Exercise on Stroke Patients.","authors":"Fengwei Gao, Panpan Yan, Fengjie Qiao, Chunshun Wang, Guochun Liu, Ningning Liu, Jidong Zhang, Yongzhi Ma","doi":"10.31083/RCM27104","DOIUrl":"10.31083/RCM27104","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a common cerebrovascular disease characterized by a high incidence rate, significant disability, frequent recurrence, and elevated mortality. Exercise plays a crucial role in stroke rehabilitation, yet the relationship between traditional Chinese exercise and stroke recovery remains unclear. This study aims to evaluate the effectiveness of various conventional Chinese exercises through a systematic network meta-analysis and identify the most effective interventions for improving the rehabilitation outcomes of stroke patients.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and the China Science and Technology Journal Database (up to July 2024) to identify randomized controlled trials (RCTs) evaluating traditional Chinese exercises for stroke patients. Trials were included if they utilized at least one form of traditional Chinese exercise. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool (ROB 2.0). Data analysis was performed using Stata 17.0 and the Mvmeta package, employing a random-effects model.</p><p><strong>Results: </strong>A total of 43 studies involving 2083 stroke patients were included. These studies assessed outcomes including upper limb motor function, lower limb motor function, overall motor ability, walking ability, balance ability, self-care ability, cognitive function, depression, quality of life, and sleep quality. Baduanjin, originating in the Song Dynasty and consisting of eight movements based on traditional Chinese medicine theories,was the most effective in improving upper limb motor function, overall motor ability, walking ability, self-care ability, cognitive function, quality of life, and sleep quality. Taiji, a practice integrating Chinese philosophy, martial arts, and wellness concepts, was the most effective in enhancing lower limb motor function. Wuqinxi, inspired by the dynamic movements of animals such as the tiger, deer, bear, apes, and birds, showed the best results for balance improvement. Liuzijue, a traditional exercise combining specific sound production, breathing, and movement, was most effective in alleviating depressive symptoms.</p><p><strong>Conclusions: </strong>These findings suggest that Baduanjin may be the most effective intervention for stroke rehabilitation. However, further high-quality RCTs are required to confirm these results.</p><p><strong>The prospero registration: </strong>CRD42024566780, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024566780.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"27104"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753823","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":"Effect of Hypoglycemic Drugs on Patients with Heart Failure with or without T2DM: A Bayesian Network Meta-analysis.","authors":"Zhaolun Zhang, Siqi Liu, Jiawen Xian, Yali Zhang, Chunyu Zhang, Zhiyuan Wang, Hongmei Deng, Jian Feng, Lei Yao","doi":"10.31083/RCM26154","DOIUrl":"10.31083/RCM26154","url":null,"abstract":"<p><strong>Background: </strong>Anti-diabetic drugs have been noted to have a cardioprotective effect in patients with diabetes and heart failure (HF). The purpose of this study was to perform a Bayesian network meta-analysis to evaluate the impact of various anti-diabetic drugs on the prognosis of HF patients with and without diabetes.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane, and Web of Science for randomized controlled trials (RCTs) published before November 2024 that investigated the use of anti-diabetic medications in patients with HF. Primary outcomes included re-admission due to HF, all-cause death, cardiovascular death, serum N-terminal pro-brain natriuretic peptide (NTpro-BNP) levels, and left ventricular ejection fraction (LVEF). A Bayesian network meta-analysis was used to compare the effectiveness of different anti-diabetic drugs.</p><p><strong>Results: </strong>A total of 33 RCTs involving 29,888 patients were included. Sotagliflozin was the most effective in reducing the risk of re-admission due to HF and all-cause death, with a cumulative probability of 0.84 and 0.83, respectively. Liraglutide reduced the risk of cardiovascular death in HF patients with a cumulative probability of 0.97 and had the best efficacy in reducing NTpro-BNP levels with a cumulative probability of 0.69. Empagliflozin was best in improving LVEF in HF patients, with a cumulative probability of 0.69.</p><p><strong>Conclusions: </strong>This Bayesian network meta-analysis demonstrates that sotagliflozin may be the best option for HF patients with and without diabetes. However, due to the small number of articles in this study, our results must be treated cautiously. Subsequently, there is an urgent need for more high-quality studies to validate our findings.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"26154"},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754392","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 Influence of Risk Factor Modification on Atrial Fibrillation Outcomes and Their Impact on the Success of Catheter Ablation.","authors":"Nakul Chandan, Vishnu Ashok, Taesoon Hwang, Ven Gee Lim, Thomas Lachlan, Helen Eftekhari, Gordon McGregor, Faizel Osman","doi":"10.31083/RCM27175","DOIUrl":"10.31083/RCM27175","url":null,"abstract":"<p><p>The global prevalence of atrial fibrillation (AF) is growing with a significant increase in AF burden. The pathophysiology of AF is complex and exhibits a strong relationship with modifiable lifestyle AF risk factors, such as physical inactivity, smoking, obesity, and alcohol consumption, as well as co-morbidities, such as hypertension, diabetes mellitus, and cardiovascular disease. Current evidence suggests that cardiac rehabilitation and lifestyle risk factor modification can potentially lower the overall AF burden. Additionally, AF ablation can be an effective treatment for a rhythm control strategy, but reducing AF recurrences post-catheter ablation is paramount. Thus, addressing these modifiable lifestyle risk factors and co-morbidities is critical, as the recent 2024 European Society of Cardiology AF guidance update highlights. A comprehensive approach to treating these risk factors is essential, especially given the rising prevalence of AF. This article provides a state-of-the-art update on the evidence of addressing AF-related risk factors and co-morbidities, particularly in patients undergoing AF ablation.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"27175"},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754244","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":"Association between the Clinical Frailty Scale and Neurological Outcomes in Out-of-Hospital Cardiac Arrest: A Retrospective Study.","authors":"Haw Hwai, Chien-Kai Wu, Chien-Yu Chi, Min-Shan Tsai, Chien-Hua Huang","doi":"10.31083/RCM26333","DOIUrl":"10.31083/RCM26333","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a physical condition characterized by increased vulnerability to external stressors. This study investigated the impact of premorbid frailty, as measured by the Clinical Frailty Scale (CFS), on neurological prognosis in patients with out-of-hospital cardiac arrest (OHCA).</p><p><strong>Methods: </strong>This is a single-center retrospective study. Data from 2006 to 2020 were analyzed for 595 adult OHCA patients admitted to the intensive care unit of National Taiwan University Hospital following resuscitation. Variables included demographics, medical history, resuscitation details, post-resuscitation data, and frailty assessments based on CFS. The primary outcome was favorable neurological performance, defined as a cerebral performance category (CPC) score of 2 or less at discharge.</p><p><strong>Results: </strong>In total, 523 of the 595 patients were included in the analysis. Among these, 224 survived, and 173 exhibited favorable neurological outcomes. Patients with favorable outcomes had significantly lower CFS scores than those with poor outcomes (3.2 ± 1.5 vs. 4.5 ± 1.8, <i>p</i> < 0.0001). The proportion of favorable neurological outcomes declined as CFS scores increased. Multivariate logistic regression analysis identified several factors independently associated with worse neurological outcomes: CFS >4 (odds ratio (OR): 0.301, 95% confidence interval (CI): 0.163-0.540), age >70 years (OR: 0.969, 95% CI: 0.953-0.986), history of malignancy (OR: 0.421, 95% CI: 0.209-0.813), epinephrine >2 mg during resuscitation (OR: 0.776, 95% CI: 0.712-0.840), and arterial blood gas pH <7.1 (OR: 28.396, 95% CI: 6.487-129.350). The model demonstrated good performance, with an area under the curve (AUC) value of 0.853. No significant relationships were observed between CFS and other variables.</p><p><strong>Conclusions: </strong>CFS values ≤4 were independently associated with favorable neurological outcomes following OHCA.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"26333"},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754339","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":"Application and Research of Left Bundle Branch-Optimized Cardiac Resynchronization Therapy in Ischemic Cardiomyopathy.","authors":"Denghong Zhang, Mingjian Lang, Benjamin Samraj Prakash Earnest, Ihab Elsayed Mohamed Ali Abdou","doi":"10.31083/RCM26240","DOIUrl":"10.31083/RCM26240","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the effectiveness of left bundle branch-optimized cardiac resynchronization therapy (LOT-CRT) in patients diagnosed with heart failure and reduced ejection fraction due to ischemic cardiomyopathy.</p><p><strong>Methods: </strong>A total of 78 patients with ischemic cardiomyopathy who underwent pacemaker implantation at a single center between March 2020 and March 2022 were randomly assigned to two groups based on different pacing methods: LOT-CRT group (n = 39) and biventricular pacing (BVP) group (n = 35). Pacing threshold, impedance, electrocardiogram QRS wave duration during pacing, ventricular pacing ratio during follow-up, and cardiac ultrasound-related indicators were compared immediately after surgery and at the six-month follow-up.</p><p><strong>Results: </strong>The two groups were similar regarding baseline characteristics, cardiac ultrasound and magnetic resonance imaging (MRI) parameters, and overall cardiac function. However, the BVP group demonstrated higher pacing thresholds and impedance levels immediately after surgery and at the six-month follow-up (<i>p</i> < 0.001). Moreover, the X-ray exposure time was significantly longer in the BVP group compared to the LOT-CRT group. While no significant differences in QRS duration were observed between the groups preoperatively, the QRS duration in the LOT-CRT group was significantly shorter both immediately after surgery and during follow-up (<i>p</i> < 0.001). No significant differences were found between the groups in terms of the New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF), or left ventricular end-diastolic diameter (LVEDD). Six months post-surgery, both groups showed modest improvements in NYHA class, LVEF, and LVEDD, with the LOT-CRT group demonstrating significant improvements (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>LOT-CRT may be an alternative treatment for patients with heart failure complicated by left bundle branch block due to ischemic cardiomyopathy in whom BVP is ineffective.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 3","pages":"26240"},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754257","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}