Reviews in cardiovascular medicine最新文献

{"title":"Thromboembolism in Patients with Cancer: A Practical Guide to Recurrent Events.","authors":"Sergey Kozhukhov, Nataliia Dovganych","doi":"10.31083/j.rcm2511406","DOIUrl":"https://doi.org/10.31083/j.rcm2511406","url":null,"abstract":"<p><p>Cancer patients have an increased risk of venous thromboembolism (VTE), and VTE is the second most common cause of death among them. Anticoagulation plays a key role in the treatment of cancer-associated thrombosis (CAT). Low-molecular-weight heparin (LMWH) or direct oral anticoagulants (DOACs) are effective and generally safe options for cancer-associated VTE. However, those patients have a 10-20% risk of VTE recurrence in spite of using anticoagulants. The main reasons for recurrent VTE (rVTE) can be non-compliance, inadequate dosing of anticoagulants, thrombocytopenia and malignancy progression. Despite the publication of major guidelines regarding the management of CAT, the treatment of patients with rVTE is undefined. Treatment options for rVTE include bridging to LMWH in cases of oral anticoagulants use, LMWH dose escalation, and sometimes considering inserting a vena cava filter. This review paper summarizes the management of cancer-associated VTE, risk factors for rVTE and the treatment algorithm of rVTE.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"25 11","pages":"406"},"PeriodicalIF":1.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771879","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":"Conservative Approach versus Percutaneous Coronary Intervention in Patients with Spontaneous Coronary Artery Dissection from a National Population-Based Cohort Study.","authors":"Chayakrit Krittanawong, Beatriz Castillo Rodriguez, Song Peng Ang, Yusuf Kamran Qadeer, Zhen Wang, Mahboob Alam, Samin Sharma, Hani Jneid","doi":"10.31083/j.rcm2511404","DOIUrl":"https://doi.org/10.31083/j.rcm2511404","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Spontaneous coronary artery dissection (SCAD) is a rare and often underdiagnosed cause of acute coronary syndrome (ACS), predominantly affecting younger women without traditional cardiovascular risk factors. The management of SCAD remains a subject of debate, likely secondary to inconclusive evidence. This study aims to compare the clinical outcomes of SCAD patients treated with optimal medical therapy (OMT) versus those who underwent percutaneous coronary intervention (PCI) using a national population-based cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective analysis using the National Inpatient Sample (NIS) database from 2016 to 2020. The study included patients identified with SCAD using the ICD-10-CM (the International Classification of Diseases, Tenth Revision, Clinical Modification) code I25.42. We excluded individuals who did not receive PCI or coronary angiography, those who underwent coronary artery bypass grafting, and patients with incomplete records. The primary outcome was in-hospital mortality, while secondary outcomes included acute kidney injury, cardiac arrest, cardiogenic shock, use of temporary mechanical circulatory support, cost of hospitalization, and length of stay. National estimates were obtained using discharge weights, and statistical comparisons were performed using chi-square tests and linear regression. Multivariate logistic regression was employed to identify predictors of mortality and other outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 31,105 SCAD patients were included in the study, with 10,480 receiving OMT and 20,625 undergoing PCI. Patients in the PCI group were older (mean age 64 vs. 54 years) and had higher comorbidities compared to those in the OMT group. The proportion of SCAD patients receiving PCI declined from 72% in 2016 to 60% in 2020. In multivariable analysis, PCI was associated with increased in-hospital mortality (odds ratio (OR) 1.89, 95% confidence interval (CI) 1.24-2.90, &lt;i&gt;p&lt;/i&gt; = 0.0003), cardiogenic shock (OR 2.29, 95% CI 1.71-3.07, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), use of a left ventricular assist device (LVAD) (OR 3.97, 95% CI 2.42-6.53, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), and an intra-aortic balloon pump (IABP) (OR 2.24, 95% CI 1.63-3.09, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Trends also suggested an association between PCI and cardiac arrest, extracorporeal membrane oxygenation (ECMO), and acute kidney injury (AKI). The PCI group had significantly higher hospitalization costs and longer lengths of stay compared to the OMT group (both &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this large, national cohort study, SCAD patients who underwent PCI had significantly higher risks of adverse in-hospital outcomes, including mortality, compared to those treated with OMT. These findings underscore the importance of careful patient selection and the potential advantages of conservative management in SCAD, particularly in patients without severe or unstable presentations. Furth","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"25 11","pages":"404"},"PeriodicalIF":1.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771923","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":"From Pulmonary Embolism to Chronic Thromboembolic Pulmonary Hypertension: A Pathophysiological Approach.","authors":"Parham Shahidi, Luise Mentzel, Stephan Blazek, Dmitry Sulimov, Holger Thiele, Karl Fengler","doi":"10.31083/j.rcm2511402","DOIUrl":"https://doi.org/10.31083/j.rcm2511402","url":null,"abstract":"<p><p>Venous thromboembolism presenting as deep vein thrombosis or pulmonary embolism (PE) remains to be an important cause of mortality and morbidity worldwide. Despite its significance and incidence, compared to many other cardiovascular conditions there are significant gaps in knowledge in many aspects of it, including its pathophysiology. A rare sequela of PE is chronic thromboembolic pulmonary hypertension (CTEPH). This complication has a poor outcome and data is scarce in this field. Many therapeutic approaches are based solely on clinical expertise, which can be explained by the complex and not fully understood pathobiology of this disease. Over the years, many theories have been proposed regarding its genesis. Although generally acute PE is accepted as a trigger for CTEPH, this condition is multifactorial and cannot be explained by recurring PEs only. By reviewing the current evidence, we have demonstrated that thrombus non-resolution in CTEPH is due to multiple mechanisms and predisposing factors including: inflammation, small-vessel disease, impaired angiogenesis, platelet dysfunction, coagulopathies, malignancy, impaired fibrinolysis, genetics and many other components. Based on the current evidence, we aimed to explain the pathophysiology CTEPH, PE and the connection between these two important diseases. Furthermore, we highlight the negative hemodynamic effects of CTEPH and PE on the right ventricle and its role in further exacerbation of these patients.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"25 11","pages":"402"},"PeriodicalIF":1.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771770","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":"Comparison of the Effects of Long-term Hemodialysis and Peritoneal Dialysis Modalities on Left Ventricular Functions.","authors":"Mehmet Usta, Selma Kenar Tiryakioğlu, Alparslan Ersoy, Nur Özer Şensoy, Ömer Furkan Demir, Mustafa Cagatay Buyukuysal","doi":"10.31083/j.rcm2511401","DOIUrl":"https://doi.org/10.31083/j.rcm2511401","url":null,"abstract":"<p><strong>Background: </strong>Hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) affect left ventricular hemodynamics. This study compared the effect of two treatment modalities, CAPD and HD, on left ventricular systolic and diastolic functions in maintenance dialysis patients.</p><p><strong>Methods: </strong>A total of 47 patients (24 CAPD and 23 HD) undergoing long-term dialysis were included in the study. Left ventricular functions, left ventricular hypertrophy, and left ventricular geometry were evaluated using echocardiography.</p><p><strong>Results: </strong>The mean age of the patients was 58.6 ± 11.2 years. The mean dialysis time was 125.1 ± 35.2 months. When echocardiographic parameters were examined, left ventricular muscle mass, mass index, E/e' ratios, and global longitudinal strain were significantly higher in the CAPD group. The rates of diastolic dysfunction (66.7% <i>vs</i>. 26.1%) and left ventricular hypertrophy (91.7% <i>vs</i>. 60.9%) were higher in the CAPD group than in the HD group. Dialysis modality CAPD, abnormal global longitudinal strain (GLS), and increased serum calcium were associated with an increased risk of diastolic dysfunction.</p><p><strong>Conclusions: </strong>The study results demonstrated that left ventricle (LV) diastolic dysfunction and deterioration in left ventricular geometry were significantly higher in patients receiving long-term CAPD treatment than for long-term HD treatment.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"25 11","pages":"401"},"PeriodicalIF":1.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771921","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":"Clinical Decision Making and Technical Approaches in Implantable Cardioverter-Defibrillator Procedures: A Step by Step Critical Appraisal of Literature.","authors":"Eva Roseboom, Marcelle D Smit, Hessel F Groenveld, Michiel Rienstra, Alexander H Maass","doi":"10.31083/j.rcm2511403","DOIUrl":"https://doi.org/10.31083/j.rcm2511403","url":null,"abstract":"<p><p>The selection of an appropriate implantable cardioverter-defibrillator (ICD) type and implantation strategy involves a myriad of considerations. While transvenous ICDs are standard, the rise of non-transvenous options like subcutaneous ICDs and extravascular ICDs is notable for their lower complication rates. Historical preferences for dual chamber ICDs have shifted to single-chamber ICDs. Single-coil ICDs are preferred for easier extraction, and the use of the DF-4 connector is generally recommended. Cephalic cutdown is the preferred venous access technique, while axillary vein puncture is a viable alternative. The right ventricular apex remains the preferred lead position until further evidence on conduction system pacing emerges. Left-sided, subcutaneous ICD implantation is considered reliable, contingent on specific cases. A meticulous perioperative plan, including antibiotic prophylaxis and an antithrombotic regimen, is crucial for successful implantation.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"25 11","pages":"403"},"PeriodicalIF":1.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771919","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":"Gene Analysis of Four Families with Severe Peripartum Cardiomyopathy Reveals Known Gene Mutations and Supports the Recent Call for Screening.","authors":"Mengmeng Li, Kaili Yin, Liang Chen, Jiazhen Chang, Na Hao","doi":"10.31083/j.rcm2511399","DOIUrl":"https://doi.org/10.31083/j.rcm2511399","url":null,"abstract":"<p><strong>Background: </strong>Peripartum cardiomyopathy (PPCM) is a rare disease that causes maternal morbidity and mortality worldwide. However, the etiology of PPCM is still unclear, and the rate of recovery varies between patients. Understanding the genetic factors underpinning PPCM may provide new insights into its pathogenesis.</p><p><strong>Methods: </strong>This genetic study screened six patients with severe PPCM and their family members using a panel of 204 genes associated with inherited cardiomyopathy.</p><p><strong>Results: </strong>The six probands progressed to severe cardiac dysfunction during follow-up, with a low left ventricular ejection fraction of <30% and a significant increase in left ventricular end-diastolic diameter. Genetic analysis showed that four of the six probands had pathogenic mutations. No specific mutation was identified in the other two probands. Further screening of the probands' families identified that eight family members shared the same mutation with their probands. The total positive genetic mutation rate was 46% (12/26). Among those with genetic mutations, women who had pregnancies showed symptoms of heart disease.</p><p><strong>Conclusions: </strong>For PPCM patients with a genetic predisposition, pregnancy may exert pathogenic effects in terms of disease initiation and progression. Patients with PPCM with a first-degree relative diagnosed with inherited cardiomyopathy may benefit from genetic counselling.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"25 11","pages":"399"},"PeriodicalIF":1.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771779","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":"Prognostic Value of Left Ventricular Myocardial Strain Parameters Derived from Cardiac Magnetic Resonance Feature Tracking Technique in Light-Chain Cardiac Amyloidosis Patients: A Pilot Study.","authors":"Rile Nai, Jia Liu, Kai Zhao, Shuai Ma, Wei Ma, Jiangkai He, Shasha Xu, Jianxiu Lian, Wei Li, Jianxing Qiu","doi":"10.31083/j.rcm2511400","DOIUrl":"https://doi.org/10.31083/j.rcm2511400","url":null,"abstract":"<p><strong>Background: </strong>Previous research on the prognostic implications of left ventricular myocardial strain using cardiac magnetic resonance feature tracking (CMR-FT) in light-chain cardiac amyloidosis (AL-CA) has shown promising potential. This study aimed to evaluate the prognostic significance of global and segmental left ventricular myocardial strain in AL-CA patients, specifically analyzing the American Heart Association's 16 segments.</p><p><strong>Methods: </strong>A total of 75 consecutive patients (50 men, mean age: 55.6 ± 10.0 years) who underwent CMR examination with histologically confirmed systemic AL-CA were retrospectively enrolled between January 2014 and November 2022. Both global and segmental myocardial strain and the American Heart Association's 16 segments were quantified using CMR-FT on the steady-state free precession (SSFP) cine sequence. A comparative analysis was conducted between survivors and non-survivors based on the defined endpoint. Student <i>t</i>-test or Mann-Whitney U, receiver operating characteristic curve, Kaplan-Meier event-free survival curve, and Cox proportional hazards regression were used. Significance was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>Following a median follow-up of 34 months, 16 out of 75 patients experienced mortality events. B-type natriuretic peptides (BNP) (<i>p</i> < 0.001), global radial strain (RS_global) (<i>p</i> = 0.033), and RS in the basal inferior segment (RS_bas-inferior) (<i>p</i> = 0.025) remained significant as independent predictors of all-cause mortality. The cut-off values were identified as 24.97% for RS_global, and 20.97% for RS_bas-inferior. Kaplan-Meier survival curves revealed significantly reduced event-free survival for individuals in the lower cut-off groups for RS_global and RS_bas-inferior (<i>p</i> = 0.013, <i>p</i> < 0.001, respectively).</p><p><strong>Conclusions: </strong>Radial strain for the global and the basal inferior segment may prove valuable for risk stratification in patients with AL-CA.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"25 11","pages":"400"},"PeriodicalIF":1.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771808","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":"Predictive Value of Coronary Calcifications for Future Cardiac Events in Asymptomatic Patients with Severe Chronic Kidney Disease.","authors":"Martin Greif, Korbinian Lackermair, Matthias Wessely, Franz von Ziegler, Alexander Becker","doi":"10.31083/j.rcm2511398","DOIUrl":"https://doi.org/10.31083/j.rcm2511398","url":null,"abstract":"<p><strong>Background: </strong>Coronary calcification is a well-established risk factor for cardiovascular events. This retrospective study sought to determine the predictive value of coronary calcification in a specific group of patients with chronic kidney disease.</p><p><strong>Methods: </strong>We included 1094 asymptomatic patients (724 males, 370 females, age 62 ± 9.3 years) referred for cardiological examination. Patents were divided into two groups depending on their renal function. Coronary calcification was determined with a multi-slice computer tomography (CT) scanner. For quantification of coronary calcification the Agatston score was calculated. Over a mean follow up period of 6.2 ± 1.3 years we observed the rate of cardiovascular events (185 events, 61 myocardial infarctions, 103 revascularizations, 21 cardiac deaths).</p><p><strong>Results: </strong>The calcium score was significantly higher in patients with severe kidney disease (glomerular filtration rate (GFR) ≤30 mL/min/1.72 m²) compared with those with normal to moderate reduced renal function (GFR ≥30 mL/min/1.72 m²) (207 ± 190 <i>vs</i>.121 ± 169, <i>p</i> ≤ 0.001). The event rate in patients with severe impaired renal function was significantly higher compared to patients with normal to moderate reduced renal function (20.6% <i>vs</i>. 14.8%, <i>p</i> = 0.0001). The hazard ratio for cardiovascular events increased constantly with the calcium score in both groups. The hazard ratio in patients with severe kidney disease was significantly lower compared to patients in corresponding groups with regular to moderate reduced renal function (7.3 <i>vs</i>. 9.3, <i>p</i> = 0.01). No cardiac events were observed in patients with a calcium score of 0.</p><p><strong>Conclusions: </strong>We could demonstrate that risk prediction with the calcium score is possible in patients with severe chronic kidney disease even if the calcium score overestimates the risk for future cardiovascular events compared to patients with normal to moderate reduced renal function.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"25 11","pages":"398"},"PeriodicalIF":1.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771696","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":"Relationship between 24-h Ambulatory Blood Pressure Variability and Degree of Renal Artery Stenosis in Hospitalized Patients with Hypertension.","authors":"Xiaoyang Luo, Wei Liu, Xi Peng, Pengqiang Li","doi":"10.31083/j.rcm2511397","DOIUrl":"https://doi.org/10.31083/j.rcm2511397","url":null,"abstract":"<p><strong>Background: </strong>Blood pressure variability (BPV) is a critical risk factor for cardiovascular outcomes and is associated with atherosclerotic renal artery stenosis (ARAS), which is diagnosed using digital subtraction angiography (DSA). However, the relationship between the degree of renal artery stenosis (d-RAS), diagnosed using renal artery contrast-enhanced ultrasound (CEUS), and 24-hour ambulatory BPV in hospitalized patients with ARAS remains unclear.</p><p><strong>Methods: </strong>Hospitalized hypertensive patients were divided into ARAS and non-ARAS groups based RAS diagnoses using CEUS. The ARAS patients were further classified into unilateral and bilateral categories. Quantification of BPV over 24 hours, daytime, and nighttime utilized standard deviation (SD), coefficient of variation (CV), and average real variability (ARV). Percentage stenosis was used to evaluate d-RAS. Pearson's and multivariate beta regression analyses were used to assess correlations between BPV and d-RAS.</p><p><strong>Results: </strong>We found that 24-hour systolic BPV (SBPV), presented as SD, CV, and ARV indices, was positively correlated with unilateral d-RAS (R¹ = 0.460, <i>p</i> = 0.001; R¹ = 0.509, <i>p</i> < 0.001; R¹ = 0.677, <i>p</i> < 0.001, respectively). This correlation was consistent with the daytime SBPV (R¹ = 0.512, <i>p</i> < 0.001; R¹ = 0.539, <i>p</i> < 0.001; R¹ = 0.678, <i>p</i> < 0.001, respectively) and daytime diastolic BPV (DBPV) (R¹ = 0.379, <i>p</i> = 0.010; R¹ = 0.397, <i>p</i> = 0.007; R¹ = 0.319, <i>p</i> = 0.033, respectively). Similarly, 24-hour DBPV assessed by SD and CV also correlated positively with unilateral d-RAS (R¹ = 0.347, <i>p</i> = 0.019; R¹ = 0.340, <i>p</i> = 0.022, respectively), as did nighttime SBPV assessed by ARV indices (R¹ = 0.415, <i>p</i> = 0.005). No significant correlations were found between BPV and bilateral d-RAS (<i>p</i> > 0.05). Multivariate beta regression analysis indicated that 24-hour SBPV (odds ratio [OR] = 1.035, 95% confidence interval [CI]: 1.054-1.607, <i>p</i> = 0.035) and daytime SBPV (OR = 1.033, 95% CI: 1.004-1.061, <i>p</i> = 0.023; both evaluated via AVR) were independent risk factors for d-RAS.</p><p><strong>Conclusions: </strong>SBPV is positively correlated with unilateral d-RAS at all time points. Both 24-hour and daytime SBPV (evaluated using ARV indices) were identified as independent d-RAS risk factors.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"25 11","pages":"397"},"PeriodicalIF":1.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771794","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":"Successful Percutaneous Coronary Intervention for Chronic Total Occlusion in Left Ventricular Systolic Dysfunction Patients with and without Diabetes Mellitus.","authors":"Xi Wu, Qin Li, Mingxing Wu, Haobo Huang, Zhe Liu, He Huang, Lei Wang","doi":"10.31083/j.rcm2511396","DOIUrl":"https://doi.org/10.31083/j.rcm2511396","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) and left ventricular (LV) systolic dysfunction are common in patients who receive percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). This study aimed to investigate the clinical outcomes of LV systolic dysfunction patients who had successful PCI for CTO over two years, with or without DM.</p><p><strong>Methods: </strong>This cohort included 185 patients with LV systolic dysfunction undergoing successful PCI for CTO. A comparative analysis was performed on individual data and clinical outcomes among patients with and without DM after a two-year follow-up.</p><p><strong>Results: </strong>DM was identified in 99 (53.5%) patients who exhibited a higher incidence of chronic kidney disease (CKD), elevated serum creatinine levels, increased hemoglobin A1c, and reduced estimated glomerular filtration rates (<i>p</i> < 0.05). Patients with diabetes also experienced increased multi-vessel disease, a higher number of lesions per patient, as well as elevated multicenter chronic total occlusion registry in Japan (J-CTO) and Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) scores (<i>p</i> < 0.05). During the two-year follow-up, the DM group showed a greater occurrence of major adverse cardiovascular events (MACEs) compared with the non-DM group (24.2% versus 12.8%, <i>p</i> < 0.001). The DM group also had higher rates of all-cause mortality (9.1% versus 3.5%, <i>p</i> < 0.002), cardiac death (8.1% versus 1.2%, <i>p</i> < 0.001), and target vessel revascularization (18.2% versus 7.1%, <i>p</i> < 0.001). Multivariable logistic regression analysis demonstrated that the presence of DM is not an independent predictor of MACEs (hazard ratio (HR): 0.58; 95% confidence interval (CI): 0.32 to 1.03; <i>p</i> = 0.260). Moreover, the multi-vessel disease (HR: 1.69; 95% CI: 1.21 to 2.36; <i>p</i> = 0.002), CKD (HR: 1.38; 95% CI: 1.08 to 1.78; <i>p</i> = 0.011) and complete revascularization (HR: 0.36; 95% CI: 0.14 to 0.88; <i>p</i> = 0.026) had a significant association with MACEs.</p><p><strong>Conclusions: </strong>In patients with LV systolic dysfunction who underwent successful CTO-PCI, those with diabetes exhibited a higher trend toward the incidence of MACEs over two years.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"25 11","pages":"396"},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771804","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}