Progress in cardiovascular diseases最新文献

{"title":"Role of multimodality imaging in infective endocarditis: Contemporary diagnostic and prognostic considerations","authors":"Bo Xu ,&nbsp;Krishna O. Sanaka ,&nbsp;Ikram-Ul Haq ,&nbsp;Reza M. Reyaldeen ,&nbsp;Duygu Kocyigit ,&nbsp;Gösta B. Pettersson ,&nbsp;Shinya Unai ,&nbsp;Paul Cremer ,&nbsp;Richard A. Grimm ,&nbsp;Brian P. Griffin","doi":"10.1016/j.pcad.2023.10.007","DOIUrl":"10.1016/j.pcad.2023.10.007","url":null,"abstract":"<div><p><span><span>Infective endocarditis (IE) describes the infection of native and prosthetic cardiac valves as well as cardiac implantable electronic devices. </span>Echocardiography<span> is the most widely used imaging technique<span> for evaluation of IE. Due to its reduced sensitivity in detection of prosthetic valve IE and cardiac implantable electronic device related IE and related complications, complementary techniques such as cardiac computed tomography (CT) and 18-flurodeoxyglucose positron emission tomography/CT play an emerging role. Therefore, multiple guidelines recommend the use of </span></span></span>multimodality imaging in the diagnosis and management of IE. In this review, we aim to compare the various guidelines and to discuss the role of imaging in the diagnosis, detection of complications, monitoring of treatment response, and prognostication of IE.</p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136153882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient reported outcomes in obstructive hypertrophic cardiomyopathy undergoing myectomy: Results from SPIRIT-HCM study","authors":"Albree Tower-Rader ,&nbsp;Natalie Szpakowski ,&nbsp;Zoran B. Popovic ,&nbsp;Barabara Bittel ,&nbsp;Agostina Fava ,&nbsp;Susan Ospina ,&nbsp;Bo Xu ,&nbsp;Maran Thamilarasan ,&nbsp;Amgad Mentias ,&nbsp;Nicholas G. Smedira ,&nbsp;Milind Y. Desai","doi":"10.1016/j.pcad.2023.06.001","DOIUrl":"10.1016/j.pcad.2023.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Patient reported outcomes (PRO) can assess quality of life<span> (QOL) in obstructive hypertrophic cardiomyopathy<span> (oHCM). In symptomatic oHCM patients, we sought to study the correlation between various PROs, their association with physician reported New York Heart Association (NYHA) class and changes after surgical myectomy.</span></span></p></div><div><h3>Methods</h3><p>We prospectively studied 173 symptomatic oHCM patients undergoing myectomy (age 51 years, 62% men) between 3/17–6/20. PROs, including a) Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score b) Patient-Reported Outcomes Measurement Information System [PROMIS] c) Duke Activity Status Index [DASI] &amp; d) European QOL score [EQ-5D], along with NYHA class, 6-min walk test (6MWT) distance and peak left ventricular outflow tract gradient (PLVOTG) were recorded at baseline and 12 month follow-up.</p></div><div><h3>Results</h3><p>The median baseline PRO scores (KCCQ summary, PROMIS physical, PROMIS mental, DASI, EQ-5D) were 50, 67, 63, 25, 50, 37, 44, 25 and 0.61, respectively; 6MWT distance was 366 m. There were significant correlations between various PROs (r-values between 0.66 and 0.92, <em>p</em> &lt; 0.001), but only modest correlations with 6MWT and provokable LVOTG (r-values between 0.2 and 0.5, <em>p</em><span> &lt; 0.01). At baseline, 35–49% patients in NYHA class II had PROs worse than median, while 30–39% patients in NYHA Class III/IV had PROs better than median. At follow-up, a 20 point improvement in KCCQ summary score was observed in 80%, 4 point improvement in DASI score in 83%, 4 point improvement in PROMIS physical score 86% and a 0.04 point improvement in EQ-5D in 85%); along with improvements in NYHA class (67% in Class I) and peak LVOTG (median 13 mmHg) and 6MWT (median distance 438 m).</span></p></div><div><h3>Conclusions</h3><p>In a prospective study of symptomatic oHCM patients, surgical myectomy significantly improved PROs, LVOT obstruction, and functional capacity, with a high correlation between various PROs. However, there was high rate of discordance between PROs and NYHA class.</p></div><div><h3>Study registration</h3><p><span>ClinicalTrials.gov</span><svg><path></path></svg>: <span>NCT03092843</span><svg><path></path></svg>.</p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9642214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodality imaging of hypertrophic cardiomyopathy","authors":"Tiffany Dong ,&nbsp;Yvonne Gilliland ,&nbsp;Christopher M. Kramer ,&nbsp;Abraham Theodore ,&nbsp;Milind Desai","doi":"10.1016/j.pcad.2023.08.004","DOIUrl":"10.1016/j.pcad.2023.08.004","url":null,"abstract":"<div><p><span>The diagnosis and management of hypertrophic cardiomyopathy (HCM) requires </span>multimodality imaging<span>. Transthoracic echocardiogram<span><span><span> (TTE) remains the first-line imaging modality to diagnose HCM identifying morphology and obstruction, which includes left ventricular outflow obstruction<span>, midcavitary obstruction and systolic anterior motion. Cardiac magnetic resonance imaging (CMR) can adjudicate equivocal cases, rule out alternative diagnoses and evaluate for risk factors of </span></span>sudden cardiac death<span>. Imaging with TTE or transesophageal echocardiogram<span> can also guide alcohol septal ablation or surgical </span></span></span>myectomy respectively. Furthermore, TTE can guide medical management of these patients by following peak gradients. Thus, multimodality imaging in HCM is crucial throughout the course of these patients' care.</span></span></p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10164879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"List of recent issues","authors":"","doi":"10.1016/S0033-0620(23)00097-X","DOIUrl":"https://doi.org/10.1016/S0033-0620(23)00097-X","url":null,"abstract":"","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49699198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise recommendations for patients with hypertrophic cardiomyopathy","authors":"Robyn Bryde ,&nbsp;Matthew W. Martinez ,&nbsp;Michael S. Emery","doi":"10.1016/j.pcad.2023.05.004","DOIUrl":"10.1016/j.pcad.2023.05.004","url":null,"abstract":"<div><p><span>Individuals with hypertrophic cardiomyopathy (HCM) have historically been advised to limit exercise and sports participation to mild-intensity activities due to concerns for </span>sudden cardiac arrest<span> (SCA). However, more contemporary data have shown SCA is rare in patients with HCM and emerging data is shifting towards support for the safety of exercise in this patient population. Recent guidelines endorse exercise in patients with HCM after a comprehensive evaluation and shared-decision making with an expert provider.</span></p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9962368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes in clinical studies of patients with hypertrophic cardiomyopathy","authors":"Nosheen Reza,&nbsp;Sharlene M. Day,&nbsp;Anjali Tiku Owens","doi":"10.1016/j.pcad.2023.08.007","DOIUrl":"10.1016/j.pcad.2023.08.007","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to characterize patient-reported outcomes (PROs) in registered clinical studies of participants with hypertrophic cardiomyopathy (HCM).</p></div><div><h3>Background</h3><p>Therapy for HCM is primarily targeted toward alleviation of symptoms and improvement in function and quality of life<span>. Yet, the contemporary landscape of PROs in HCM clinical research has not been investigated.</span></p></div><div><h3>Methods</h3><p><span>ClinicalTrials.gov</span><svg><path></path></svg> was queried to identify clinical studies of HCM that reported PROs as outcome measures. All studies of HCM as the disease condition were included, and PROs were identified using specific search terms in the Outcome Measures field. Study characteristics were collected and compared between those that did versus did not report PROs.</p></div><div><h3>Results</h3><p>From November 1987 to February 2022, 181 studies including participants with HCM were registered on <span>ClinicalTrials.gov</span><svg><path></path></svg>. Of these, 35 (19%) included PROs as outcome measures. Studies reporting PROs were more likely to be designated as interventional (85.7% vs. 46.6%; <em>p</em> &lt; 0.001) and to involve randomization (65.7% vs. 24.7%; <em>p</em> = 0.003) compared with those that did not report PROs. Prior to 2007, no clinical studies that reported PROs were registered in <span>ClinicalTrials.gov</span><svg><path></path></svg>; however, PRO reporting has increased over the last 15 years. Of the 66 PRO tools or domains included as outcome measures, the Kansas City Cardiomyopathy Questionnaire was the most often used.</p></div><div><h3>Conclusions</h3><p>Only approximately one in five registered clinical studies of participants with HCM report PROs. As medical, percutaneous, and surgical therapies for HCM continue to advance, HCM-specific PRO tools that assess the impacts of these new treatments on meaningful patient-related endpoints are urgently needed.</p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10102340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical therapies for hypertrophic cardiomyopathy: Current state of the art","authors":"Milind Y. Desai ,&nbsp;Anjali Owens ,&nbsp;Andrew Wang","doi":"10.1016/j.pcad.2023.08.006","DOIUrl":"10.1016/j.pcad.2023.08.006","url":null,"abstract":"<div><p><span><span><span><span><span>Hypertrophic cardiomyopathy (HCM) is predominantly an </span>autosomal dominant genetic heart disease with an estimated prevalence of 1 in 200 to 1 in 500 in the general population. Clinical manifestations of HCM vary from asymptomatic state to mild functional intolerance to advanced heart failure, angina, and </span>sudden cardiac death (SCD). Current management options for symptomatic HCM include lifestyle modifications, pharmacotherapy for symptom control and arrhythmia management, SCD </span>risk stratification with or without </span>defibrillator implantation, septal reduction therapy and, in some cases, </span>heart transplantation<span><span>. Until recently, none of the pharmacotherapies for management of HCM had been studied in multicenter randomized controlled trials<span><span>. Mavacamten, a </span>cardiac myosin inhibitor, is the first </span></span>drug<span> studied in this fashion and the first-in-class Food and Drug Administration approved medication that specifically targets the pathophysiology of HCM. We will review the currently available medical treatments for HCM and assess future directions.</span></span></p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10228750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Art and science of risk stratification of sudden cardiac death in hypertrophic cardiomyopathy: Current state, unknowns, and future directions","authors":"Konstantinos C. Siontis,&nbsp;Steve R. Ommen,&nbsp;Jeffrey B. Geske","doi":"10.1016/j.pcad.2023.08.005","DOIUrl":"10.1016/j.pcad.2023.08.005","url":null,"abstract":"<div><p><span><span>The progress in the management of hypertrophic cardiomyopathy (HCM) over the last several decades has resulted in great improvements in </span>quality of life<span> and overall survival for HCM patients. Yet, sudden cardiac death<span> (SCD) due to ventricular tachyarrhythmias is among the common causes of HCM-related mortality. SCD </span></span></span>risk stratification is a central and often challenging domain in the care of the HCM patient. Distinguishing the individuals most likely to benefit from a primary prevention implantable-cardioverter defibrillator (ICD) from those truly at a low risk of SCD in whom an ICD is not necessary is a nuanced process. Clinicians need to carefully balance the potential benefit and risks of ICDs, particularly in young patients. Because of intense investigations in diverse HCM cohorts globally, two main approaches to SCD risk stratification in HCM have emerged, one based on major SCD risk factors and one based on a mathematically derived risk score. In this overview, we discuss the current state, latest advances and remaining unknowns about established and novel markers of risk of SCD in HCM. We also review how the risk factor- and risk score-based assessments can and should be used in conjunction to enhance rather than contradict each other in facilitating informed ICD decision-making in contemporary clinical practice.</p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10491466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolving paradigm and current perception of hypertrophic cardiomyopathy: Implications for management","authors":"Annamaria Del Franco ,&nbsp;Silvia Menale ,&nbsp;Chiara Chiti ,&nbsp;Giulia Biagioni ,&nbsp;Alessia Tomberli ,&nbsp;Mattia Zampieri ,&nbsp;Iacopo Olivotto","doi":"10.1016/j.pcad.2023.08.002","DOIUrl":"10.1016/j.pcad.2023.08.002","url":null,"abstract":"<div><p><span>Recent evidence from imaging and genetic screening studies has clearly shown that hypertrophic cardiomyopathy (HCM) is more common than initially perceived, emphasizing the need to reassess its associated clinical and social burden. While clinical and academic efforts have long been focused on stratification of arrhythmic risk and management of intraventricular obstruction, progression of cardiac dysfunction and heart failure-related complications have emerged as most relevant from the epidemiological standpoint, delineating a major unmet need. Furthermore, a broader perspective of our patients' needs has become central in the care of individuals with HCM, addressing issues that are not strictly clinical but equally important to their wellbeing, such as </span>quality of life<span>, athletic participation, lifestyle and reproductive choices and psychological adaptation to a chronic condition often detected at a young age. The appropriate evaluation and objective assessment of disease burden<span> associated with HCM are increasingly relevant not only to management but also to trial design and evaluation of the efficacy of emerging, targeted treatments. In this review, we discuss the evolving perception of HCM prevalence and natural history, as well as recent acquisitions regarding its true, often under-appreciated socio-economic and clinical burden.</span></span></p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10365965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmet needs and future directions in hypertrophic cardiomyopathy","authors":"Simrat Kaur,&nbsp;Milind Desai","doi":"10.1016/j.pcad.2023.08.001","DOIUrl":"10.1016/j.pcad.2023.08.001","url":null,"abstract":"<div><p><span><span>Hypertrophic cardiomyopathy (HCM) is a highly treatable monogenetic disorder affecting nearly 0.2% of the population. The high burden of this disease demands suitable measures for early diagnosis and preventing as well as tackling misdiagnosis. While conventionally available </span>therapies have been efficacious in reducing symptoms, they have not been able to change the natural history of the disease. The landscape of medical treatment is rapidly changing with advent of novel pharmacotherapies such as </span>cardiac myosin<span> inhibitors. Ongoing investigations in gene editing have demonstrated benefits in correcting underlying genetic mutations and this is where the future of treatment lies. Contemporary procedural techniques as alternatives to available septal reduction therapies independent of coronary vascular anatomy are also emerging. This review details the recent developments, unmet needs and future directions in diagnosis, medical and invasive treatment of HCM.</span></p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":9.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10130038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}