Reviews in cardiovascular medicine最新文献

{"title":"Control of Pulse Pressure and Factors Affecting it among the Geriatric Population Suffering from Hypertension within the Community.","authors":"Qianfeng Yang, Lishuang Xu, Qingxia Gao, Zhiguang Gao","doi":"10.31083/RCM26156","DOIUrl":"https://doi.org/10.31083/RCM26156","url":null,"abstract":"<p><strong>Background: </strong>To explore the impact of employing the Knowledge, Attitude, and Practice (KAP) model within a unified community physician intervention aimed at managing pulse pressure among elderly individuals with hypertension in Shenyang, along with its associated influencing variables.</p><p><strong>Methods: </strong>2660 hypertensive patients were recruited in the community of Shenyang City in January 2020. After a 1-year KAP intervention by a unified community physician, KAP changes and pulse pressure levels were compared before and after the intervention. Meanwhile, the relevant influences affecting pulse pressure control were explored. Descriptive analysis and multifactorial logistic regression were used.</p><p><strong>Results: </strong>A significant decrease in pulse pressure by 10.71 mmHg (95% CI: 10.09, 11.33 mmHg) was noted among elderly individuals with hypertension in the community after undergoing a rigorous one-year intervention program (t = 33.79, <i>p</i> < 0.05). Pulse pressure control increased from 32.59% at baseline to 64.92% (χ² = 556.43, <i>p</i> < 0.01). Compared to pre-intervention, knowledge about hypertension, awareness of prevention, medication and behavioural adherence improved significantly. A multifactorial logistic regression analysis revealed that the risk factors for pulse pressure control were female sex, a history of comorbid diabetes mellitus and poor adherence to medication due to forgetfulness.</p><p><strong>Conclusions: </strong>Unified community physician interventions can change the perceptions of elderly hypertensive patients, improve medication adherence, and improve poor lifestyle habits, thereby improving pulse pressure control in the geriatric population with hypertension residing in local communities.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"26156"},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543159","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 of the Platelets to High Density Lipoprotein Cholesterol Ratio and Risk of Heart Disease Events in Middle-Aged and Elderly Chinese Population: A Retrospective Cohort Study Utilizing the CHARLS Database.","authors":"Yating Huang, Xin Hou, Fang Lv, Zheng Gong","doi":"10.31083/RCM26403","DOIUrl":"https://doi.org/10.31083/RCM26403","url":null,"abstract":"<p><strong>Background: </strong>The association between the platelet to high-density lipoprotein cholesterol ratio (PHR) and the risk of a heart disease event remains unclear. This study aims to determine whether the PHR can identify individuals at high risk for heart disease events, with a particular focus on middle-aged and elderly Chinese individuals.</p><p><strong>Methods: </strong>The retrospective cohort study encompassed 7188 middle-aged and elderly participants (>45 years) sourced from the China Health and Retirement Longitudinal Study (CHARLS) database. This research utilized longitudinal data from 5 follow-up visits spanning 2011 to 2020, which encompassed the collection of demographic profiles and pertinent blood biomarkers. Kaplan-Meier survival analysis was conducted based on PHR quartiles, with differences assessed using the log-rank test. The Cox proportional hazards model evaluated PHR's hazard ratio (HR) as a predictor of outcome events, with trend tests applied. Restrictive cubic splines (RCS) were employed to explore associations. Subgroup analyses were performed to validate the robustness of the findings.</p><p><strong>Results: </strong>Baseline comparisons across quartiles of the PHR revealed a progressive increase in PHR values (133.16 vs 202.09 vs 267.04 vs 388.24), which corresponded to ascending incidence rates of heart disease (18.20% vs 18.64% vs 18.86% vs 21.59%) (<i>p <</i> 0.05). The Kaplan-Meier survival analysis of PHR quartile groups revealed a notable elevation in the incidence of cardiovascular events in Q4 compared to Q1, Q2, and Q3 throughout the follow-up period (log-rank <i>p <</i> 0.05). Upon adjustment for age, gender, stroke history, drinking, smoking, body mass index (BMI), white blood cell (WBC) count, fasting plasma glucose (FPG), creatinine (Cr), and triglyceride (TG), the Q4 group continued to exhibit a significantly elevated HR relative to Q1 (HR = 1.203, <i>p</i> = 0.023). Furthermore, RCS affirmed a linear association between PHR and heart disease events (Adjusted: Overall <i>p</i> = 0.014, Nonlinear <i>p</i> = 0.588). When analyzing by gender, high PHR was a risk factor for males (Q4: HR = 1.352, <i>p</i> = 0.019), but not for females (Q4: HR = 1.158, <i>p</i> = 0.166). Subgroup analysis indicates a significant association between higher PHR levels and increased risk of cardiac events compared to lower levels.</p><p><strong>Conclusions: </strong>Our study reveals a positive correlation between PHR levels and the incidence of heart disease events in middle-aged and elderly men in China. However, no such correlation was observed in female patients.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"26403"},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543222","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":"Early Predictive Value of Infectious Markers for Ventilator-associated Pneumonia after Stanford Type A Aortic Dissection Surgery.","authors":"Huibiao Deng, Xiaohong Wu, Bo Peng","doi":"10.31083/RCM26002","DOIUrl":"https://doi.org/10.31083/RCM26002","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the early predictive value of infectious markers for ventilator-associated pneumonia (VAP) after Stanford type A aortic dissection surgery.</p><p><strong>Methods: </strong>A retrospective review of the medical records of all patients with Stanford type A aortic dissection admitted to Shanghai General Hospital from July 2020 to July 2023 who received mechanical ventilation after surgery was performed. Patients were divided into infection and non-infection groups according to the presence of VAP. The clinical data of the two groups were compared. The early predictive values of procalcitonin (PCT), C-reactive protein (CRP), the neutrophil/lymphocyte ratio (NLR) and sputum smears for VAP were evaluated by receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>A total of 139 patients with Stanford type A aortic dissection were included in this study. There were 35 cases of VAP infection, and the VAP incidence rate was 25.18%. The CRP, PCT, and NLR levels in the infection group were more significant than those in the non-infection group (<i>p</i> < 0.05). The percentage of positive sputum smears was 80.00% in the infected group and 77.88% in the non-infected group. The ROC curve analysis revealed that the areas under the curve (AUCs) of PCT, the NLR, CRP and sputum smear were 0.835, 0.763, 0.820 and 0.745, respectively, and the AUC for the combined diagnosis was 0.923. The pathogenic bacteria associated with VAP, after Stanford type A aortic dissection, was mainly <i>gram-negative bacteria</i>.</p><p><strong>Conclusions: </strong>The combined application of the NLR, CRP, PCT and sputum smear is helpful for the early diagnosis of VAP after Stanford type A aortic dissection surgery to help clinicians make decisions about treating VAP quickly.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"26002"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543230","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 the Presence of the Ramus Intermedius on Atherosclerosis Plaque Deposition in the Left Bifurcation Region in Low-Risk Individuals.","authors":"Nurul Sazmi Rosani, Rasheeda Mohd Zamin, Raja Rizal Azman Raja Aman, Ahmad Syadi Mahmood Zuhdi, Mahmoud Danaee, Intan Suhana Zulkafli","doi":"10.31083/RCM25252","DOIUrl":"https://doi.org/10.31083/RCM25252","url":null,"abstract":"<p><strong>Background: </strong>Additional bifurcations at the left main coronary artery (LMCA) could modify the geometry of the left coronary system, disturbing haemodynamic flow patterns and potentially altering endothelial shear stress (ESS). A low ESS has been implicated in atherogenesis. The emergence of the ramus intermedius (RI) from the LMCA creates additional branching, but the specific role of the RI in plaque deposition at the left coronary system remains unclear. This study sought to elucidate the potential effects of the RI on plaque formation at the LMCA and its bifurcation.</p><p><strong>Methods: </strong>A retrospective cross-sectional single-centre study was conducted using data from 139 female patients who were identified to have low risk of cardiovascular disease. These patients underwent cardiac computed tomography angiography between January 2017 and December 2018. Contrasted multiplanar coronary images taken during the best diastolic phase were analysed for the presence (experimental group) or absence (control group) of the RI. Measurements of plaques were done at the LMCA and at a 10 mm distance from the ostia of daughter arteries. Plaque data at the left bifurcation region were analysed using descriptive statistics, chi-square, and binary logistic regression tests. A <i>p</i>-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Amongst these low-risk patients, 33.8% (n = 47) had an RI. In the presence of RI, there was an eight-fold increased risk of plaque deposition at the LMCA (adjusted odds ratio, aOR = 8.5) and a three-fold increased risk of plaque deposition at the proximal left anterior descending (pLAD), especially on its lateral wall (aOR = 3.5). However, the RI did not influence plaque deposition at the distance of 10 mm from the ostium of the proximal left circumflex artery.</p><p><strong>Conclusions: </strong>These findings suggest that the RI increases the risk for atherosclerosis plaque deposition by three to eight-fold at the pLAD artery and the LMCA.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"25252"},"PeriodicalIF":1.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543212","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":"CCL11 (Eotaxin) Promotes the Advancement of Aging-Related Cardiovascular Diseases.","authors":"Tanwei Zhang, Yanhong Huang, Xinmeng Ji, Teng Wu, Pingxi Xiao","doi":"10.31083/RCM26020","DOIUrl":"https://doi.org/10.31083/RCM26020","url":null,"abstract":"<p><p>Aging-related diseases, such as cardiovascular diseases (CVDs), neurodegeneration, cancer, etc., have become important factors that threaten the lifespans of older individuals. A chronic inflammatory response is closely related to aging-related diseases. Establishing inflammatory aging clock (iAGE, deep-learning methods on blood immune biomarkers to construct a metric for age-related chronic inflammation) successfully predicted the positive correlation between several factors, including serum C-C-motif chemokine ligand 11 (CCL11) and aging-related diseases. Recently, the role and mechanism of CCL11, an eosinophilic chemokine, in neurodegenerative diseases have been widely reported. Additionally, many research studies have shown a positive correlation with CVDs, but the underlying mechanism remains unknown. This review focuses on the relationship between chronic inflammation and aging. The role of CCL11 will be discussed and summarized in relation to aging-related diseases, especially CVDs.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"26020"},"PeriodicalIF":1.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543227","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":"Could the Hemodynamic Progression of Aortic Valve Stenosis be Slowed Pharmacologically? The Unsolved Dilemma.","authors":"Gloria Santangelo, Francesco Antonini-Canterin, Pompilio Faggiano","doi":"10.31083/RCM26537","DOIUrl":"https://doi.org/10.31083/RCM26537","url":null,"abstract":"","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"26537"},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543161","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 Interatrial Conduction Disorders on Atrial Mechanical Function - Atrial Strain and Pulmonary Veins Reversal Flow in Patients with COVID-19.","authors":"Jacek Zawadzki, Jacek Gajek, Grzegorz Zawadzki, Agnieszka Sławuta, Bartosz Kudliński","doi":"10.31083/RCM25273","DOIUrl":"https://doi.org/10.31083/RCM25273","url":null,"abstract":"<p><strong>Background: </strong>The physiological activation of the left atrium (LA) happens through the Bachmann bundle, which is crucial for the heart's proper functioning. Bayes de Luna first described interatrial blocks (IABs) in 1979, noting their disruption of atrioventricular (AV) synchrony. This study aims to evaluate LA mechanics by analyzing LA strain in cases of normal and impaired interatrial conduction, focusing on retrograde flow in the pulmonary veins (PV).</p><p><strong>Methods: </strong>The study included 51 patients who tested positive for SARS-CoV-2 and exhibited related symptoms. Six patients with persistent atrial fibrillation (AF) were excluded from the study (45 patients qualified in total: 23 males, 22 females; mean age 69.0 ± 12.9 years).</p><p><strong>Results: </strong>IABs were more frequently observed in COVID-19 patients. Thus, they were included despite SARS-CoV-2 being a potential limitation of the study. All participants underwent clinical evaluation, electrocardiography (ECG) (200 mm/s ×256), and echocardiography to assess left ventricular ejection fraction (LVEF), mitral regurgitation (MR), LA volume, global and regional strain, and retrograde flow in the PV. A statistical dependency was found between LA global strain and P-wave morphology, MR, heart failure (HF), and paroxysmal atrial fibrillation (PAF). However, no clear correlation was found between retrograde flow in the PV and LA strain. The mean P-wave duration correlated with its morphology. Additionally, correlations were observed between P-wave morphology and hypertension, being overweight, and PAF.</p><p><strong>Conclusions: </strong>LA mechanics are negatively influenced by IABs. LA global strain correlates with P-wave duration, ejection fraction (EF), and MR independently. Regional LA strain examination is potentially effective for assessing LA mechanics and complements precise ECG.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"25273"},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543211","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":"Adenosine as an Adjunctive Therapy for Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Xue-Mei Feng, Wen-Hui Zhang, Jia Liu","doi":"10.31083/RCM24065","DOIUrl":"https://doi.org/10.31083/RCM24065","url":null,"abstract":"<p><strong>Background: </strong>Adenosine administration can improve coronary blood flow in patients undergoing primary percutaneous coronary intervention (PCI); however, the therapeutic effects of adenosine on ST resolution and major adverse cardiovascular events (MACEs) after PCI remain unclear. This study aimed to assess the therapeutic effects of adjunctive adenosine administration on patients with acute myocardial infarction (AMI) undergoing PCI using a meta-analytic approach.</p><p><strong>Methods: </strong>We conducted a systematic search across PubMed, Embase, and the Cochrane Library to identify eligible randomized controlled trials (RCTs) published from inception through to March 2024. Primary outcomes included ST resolution and MACEs. The pooled analyses were all conducted using the random-effects model. Additionally, exploratory analyses were carried out through the application of sensitivity and subgroup analyses.</p><p><strong>Results: </strong>Twenty-one RCTs involving 2467 patients with AMI were selected for the meta-analysis. Adenosine significantly increased the incidence of ST resolution (relative risk [RR]: 1.30; 95% confidence interval [CI]: 1.15-1.46; <i>p</i> < 0.001), while it significantly reduced the risk of MACEs (RR: 0.67; 95% CI: 0.51-0.87; <i>p</i> = 0.003). Moreover, the use of adenosine was associated with reduced incidences of no reflow (RR: 0.35; 95% CI: 0.24-0.52; <i>p</i> < 0.001) and myocardial blush grade (MBG) 0 to 1 (RR: 0.75; 95% CI: 0.58-0.99; <i>p</i> = 0.041). Furthermore, adenosine significantly reduced the risk of heart failure (RR: 0.66; 95% CI: 0.44-0.99; <i>p</i> = 0.044). Finally, adenosine use was associated with a lower creatine kinase-MB (CK-MB) peak value (weighted mean difference: -36.94; 95% CI: -73.76- -0.11; <i>p</i> = 0.049).</p><p><strong>Conclusions: </strong>This study revealed that adenosine use was associated with an increased incidence of ST resolution, and reduced risk of MACEs.</p><p><strong>The inplasy registration: </strong>INPLASY202510051, https://inplasy.com/inplasy-2025-1-0051/.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"24065"},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543204","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":"Paroxysmal Atrial Fibrillation during Spasm Provocation Test with Acetylcholine: Clinical Characteristics of Patients and Effect on Coronary Microvascular Function Measurements.","authors":"Hiroki Teragawa, Chikage Oshita, Yu Hashimoto, Shuichi Nomura","doi":"10.31083/RCM26456","DOIUrl":"https://doi.org/10.31083/RCM26456","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a complication that occurs following a spasm provocation test (SPT) with acetylcholine (ACh). However, the characteristics of patients with AF remain unclear. Furthermore, the association of AF with the outcome of the coronary microvascular function test (CMFT) is unknown. This study aimed to evaluate whether patients with angina with non-obstructive coronary artery disease (ANOCA) who developed AF during SPT with ACh had any clinical characteristics. Additionally, we assessed the association of AF with the CMFT results.</p><p><strong>Methods: </strong>We included 123 patients with ANOCA who underwent SPT and CMFT. We defined AF as AF during ACh provocation. The coronary arteries that demonstrated AF before CMFT were defined as AF vessels (n = 21) and those in sinus rhythm (SR) were defined as SR-1 vessels (n = 165). Vessels that were restored to sinus rhythm immediately following AF were defined as AF-SR vessels (n = 29) and those that remained in sinus rhythm for some time were defined as SR-2 vessels (n = 136). Coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were obtained, and CFR of <2.0 and/or IMR of ≥25 were diagnosed as coronary microvascular dysfunction (CMD).</p><p><strong>Results: </strong>Of the 123 patients, 31 (25%) had AF but with no characteristic patient background. CFR was significantly lower in AF vessels than in SR-1 vessels (<i>p</i> = 0.035) and IMR did not differ between the two groups (<i>p</i> = 0.918). A study of the three groups that included AF-SR vessels revealed that IMR tended to be lower in AF-SR vessels than in the SR-2 and AF vessels (<i>p</i> = 0.089), and that the frequency of IMR of ≥25 was significantly lower than in the other two groups (<i>p</i> = 0.016).</p><p><strong>Conclusions: </strong>AF occurred in 25% of SPTs with ACh, but the predictive clinical context remains unclear. Our results indicated that AF may affect the outcome of the CMFT. Thus, decisions for CMD management should be made with caution in the presence of AF.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"26456"},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542862","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":"Right Ventricular Dysfunction in Cardiac Anesthesia: Perioperative Assessment and Underlying Mechanisms.","authors":"Kotaro Hori, Ryota Watanabe, Shogo Tsujikawa, Hideki Hino, Tadashi Matsuura, Takashi Mori","doi":"10.31083/RCM26286","DOIUrl":"https://doi.org/10.31083/RCM26286","url":null,"abstract":"<p><p>The importance of right ventricular (RV) function has often been overlooked until recently; however, RV function is now recognized as a significant prognostic predictor in medically managing cardiovascular diseases and cardiac anesthesia. During cardiac surgery, the RV is often exposed to stressful conditions that could promote perioperative RV dysfunction, such as insufficient cardioplegia, volume overload, pressure overload, or pericardiotomy. Recent studies have shown that RV dysfunction during cardiac anesthesia could cause difficulty in weaning from cardiopulmonary bypass or even poor postoperative outcomes. Severe perioperative RV failure may be rare, with an incidence rate ranging from 0.1% to 3% in the surgical population; however, in patients who are hemodynamically unstable after cardiac surgery, almost half reportedly present with RV dysfunction. Notably, details of RV function, particularly during cardiac anesthesia, remain largely unclear since long-standing research has focused predominantly on the left ventricle (LV). Thus, this review aims to provide an overview of the current perspective on the perioperative assessment of RV dysfunction and its underlying mechanisms in adult cardiac surgery. This review provides an overview of the basic RV anatomy, physiology, and pathophysiology, facilitating an understanding of perioperative RV dysfunction; the most challenging aspect of studying perioperative RV is assessing its function accurately using the limited modalities available in cardiac surgery. We then summarize the currently available methods for evaluating perioperative RV function, focusing on echocardiography, which presently represents the most practical tool in perioperative management. Finally, we explain several perioperative factors affecting RV function and discuss the possible mechanisms underlying RV failure in cardiac surgery.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"26286"},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543065","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}