{"title":"Maturity-onset diabetes of the young (MODY) - in search of ideal diagnostic criteria and precise treatment","authors":"","doi":"10.1016/j.pcad.2024.03.004","DOIUrl":"10.1016/j.pcad.2024.03.004","url":null,"abstract":"<div><p><span><span>Maturity-onset diabetes of the young (MODY) is a spectrum of clinically heterogenous forms of monogenic diabetes mellitus characterized by autosomal dominant inheritance, onset at a young age, and </span>absence<span><span> of pancreatic islets<span> autoimmunity. This rare form of hyperglycemia<span>, with clinical features<span> overlapping with type 1 and type 2 diabetes mellitus, has 14 subtypes with differences in prevalence and complications occurrence which tailor therapeutic approach. MODY phenotypes differ based on the gene involved, gene penetrance and expressivity. While MODY 2 rarely leads to </span></span></span></span>diabetic complications<span> and is easily managed with lifestyle interventions alone, more severe subtypes, such as MODY 1, 3, and 6, require an individualized treatment approach to maintain a patient's quality of life and prevention of complications. This review summarizes current evidence on the presentation, diagnosis, and management of MODY, an example of a </span></span></span>genetic<span> cause of hyperglycemia that calls for a precision medicine approach.</span></p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"85 ","pages":"Pages 14-25"},"PeriodicalIF":5.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186765","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":"Association between testosterone replacement therapy and cardiovascular outcomes: A meta-analysis of 30 randomized controlled trials","authors":"","doi":"10.1016/j.pcad.2024.04.001","DOIUrl":"10.1016/j.pcad.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><p><span>The Cardiovascular safety of testosterone replacement therapy (TRT) among men with </span>hypogonadism<span> is not well established to date. Hence, we sought to evaluate the cardiovascular disease (CVD) outcomes among patients receiving testosterone therapy by using all recently published randomized controlled trials.</span></p></div><div><h3>Methods</h3><p>We performed a systematic literature search on PubMed, EMBASE, and <span><span>Clinicaltrial.gov</span><svg><path></path></svg></span><span> for relevant randomized controlled trials (RCTs) from inception until September 30th, 2023.</span></p></div><div><h3>Results</h3><p>A total of 30 randomized trials with 11,502 patients were included in the final analysis. The mean age was ranging from 61.61 to 61.82 years. Pooled analysis of primary and secondary outcomes showed that the incidence of any CVD events (OR, 1.12 (95%CI: 0.77–1.62), <em>P</em> = 0.55), stroke (OR, 1.01 (95%CI: 0.68–1.51), <em>P</em> = 0.94), myocardial infarction (OR, 1.05 (95%CI: 0.76–1.45), <em>P</em> = 0.77), all-cause mortality (OR, 0.94 (95%CI: 0.76–1.17), <em>P</em> = 0.57), and CVD mortality (OR, 0.87 (95%CI: 0.65–1.15), <em>P</em> = 0.31) was comparable between TRT and placebo groups.</p></div><div><h3>Conclusion</h3><p>Our analysis indicates that for patients with hypogonadism, testosterone replacement therapy does not increase the CVD risk and all-cause mortality.</p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"85 ","pages":"Pages 45-53"},"PeriodicalIF":5.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782341","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":"Stratified medicine for acute and chronic coronary syndromes: A patient-tailored approach","authors":"","doi":"10.1016/j.pcad.2024.06.003","DOIUrl":"10.1016/j.pcad.2024.06.003","url":null,"abstract":"<div><p>The traditional approach to management of cardiovascular disease relies on grouping clinical presentations with common signs and symptoms into pre-specified disease pathways, all uniformly treated according to evidence-based guidelines (“one-size-fits-all”). The goal of precision medicine is to provide the right treatment to the right patients at the right time, combining data from time honoured sources (e.g., history, physical examination, imaging, laboratory) and those provided by multi-omics technologies. In patients with ischemic heart disease, biomarkers and intravascular assessment can be used to identify endotypes with different pathophysiology who may benefit from distinct treatments. This review discusses strategies for the application of stratified management to patients with acute and chronic coronary syndromes.</p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"85 ","pages":"Pages 2-13"},"PeriodicalIF":5.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033062024000914/pdfft?md5=45089945244c502b4c1bed7ce3f27bc5&pid=1-s2.0-S0033062024000914-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474121","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":"List of recent issues","authors":"","doi":"10.1016/S0033-0620(24)00107-5","DOIUrl":"10.1016/S0033-0620(24)00107-5","url":null,"abstract":"","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"85 ","pages":"Page A3"},"PeriodicalIF":5.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011521","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":"RNA in cardiovascular disease: A new frontier of personalized medicine","authors":"","doi":"10.1016/j.pcad.2024.01.016","DOIUrl":"10.1016/j.pcad.2024.01.016","url":null,"abstract":"<div><p><span><span>Personalized medicine has witnessed remarkable progress with the emergence of RNA therapy, offering new possibilities for the treatment of various diseases, and in particular in the context of cardiovascular disease (CVD). The ability to target the </span>human genome through RNA manipulation offers great potential not only in the treatment of cardiac pathologies but also in their diagnosis and prevention, notably in cases of </span>hyperlipidemia<span><span> and myocardial infarctions. While only a few RNA-based treatments have entered clinical trials or obtained approval from the US Food and Drug Administration, the growing body of research on this subject is promising. However, the development of RNA therapies faces several challenges that must be overcome. These include the efficient delivery of drugs into cells, the potential for immunogenic responses, and safety. Resolving these obstacles is crucial to advance the development of RNA therapies. This review explores the newest developments in medical studies, treatment plans, and results related to RNA therapies for </span>heart disease. Furthermore, it discusses the exciting possibilities and difficulties in this innovative area of research.</span></p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"85 ","pages":"Pages 93-102"},"PeriodicalIF":5.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139508330","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-based cardio-oncology rehabilitation for cardiotoxicity prevention during breast cancer chemotherapy: The ONCORE randomized controlled trial","authors":"","doi":"10.1016/j.pcad.2024.02.002","DOIUrl":"10.1016/j.pcad.2024.02.002","url":null,"abstract":"<div><h3>Background</h3><p>Breast cancer (BC) treatment with anthracyclines and/or anti-human epidermal growth factor receptor-2 (HER2) antibodies is associated with an increased risk of cardiovascular disease complications, including cancer therapy-related cardiac dysfunction (CTRCD). While Cardio-Oncology Rehabilitation (CORe) programs including exercise have emerged to minimize these risks, its role in preventing CTRCD is unclear.</p></div><div><h3>Objectives</h3><p>We investigated the effectiveness of an exercise-based CORe program in preventing CTRCD [left ventricular ejection fraction (LVEF) drop ≥10% to a value <53% or a decrease >15% in global longitudinal strain (GLS)]. Secondary outcomes examined changes in cardiac biomarkers, physical performance including peak oxygen consumption, psychometric and lifestyle outcomes. Safety, adherence, and patient satisfaction were also assessed.</p></div><div><h3>Methods</h3><p>This is a randomized controlled trial including 122 early-stage BC women receiving anthracyclines and/or anti-HER2 antibodies, randomized to CORe (<em>n</em> = 60) or usual care with exercise recommendation (<em>n</em> = 62). Comprehensive assessments were performed at baseline and after cardiotoxic treatment completion. The average duration of the intervention was 5.8 months.</p></div><div><h3>Results</h3><p>No cases of CTRCD were identified during the study. LVEF decreased in both groups, but was significantly attenuated in the CORe group [−1.5% (−2.9, −0.1); <em>p</em> = 0.006], with no changes detected in GLS or cardiac biomarkers<em>.</em> The CORe intervention led to significant body mass index (BMI) reduction (<em>p</em> = 0.037), especially in obese patients [3.1 kg/m<sup>2</sup> (1.3, 4.8)]. Physical performance and quality-of-life remained stable, while physical activity level increased in both groups. No adverse events were detected.</p></div><div><h3>Conclusions</h3><p>This study suggests that CORe programs are safe and may help attenuate LVEF decline in BC women receiving cardiotoxic therapy and reduce BMI in obese patients.</p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"85 ","pages":"Pages 74-81"},"PeriodicalIF":5.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033062024000239/pdfft?md5=19240ce5cbd8090655038918b2907d54&pid=1-s2.0-S0033062024000239-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139922083","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":"Dose-response associations of the American Heart Association's new “Life's essential 8” metrics with all-cause and cardiovascular mortality in a nationally representative sample from the United States","authors":"","doi":"10.1016/j.pcad.2024.06.001","DOIUrl":"10.1016/j.pcad.2024.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Our aim was to examine the prospective dose-response associations of American Heart Association's (AHA) LIFE's Essential 8 (LE8) score and number of cardiovascular health (CVH) factors with high score with all-cause and cardiovascular disease (CVD) related mortality.</p></div><div><h3>Methods</h3><p>We pooled 6 consecutive waves of the National Health and Nutrition Examination Survey (NHANES) comprising rounds between 2007 and 2008 and 2017–2018. We calculated hazard ratios (HRs) and conducted restricted cubic splines models to assess the dose-response association of LE8 score and CVH factors with all-cause and CVD mortality.</p></div><div><h3>Results</h3><p>Analyses included 23,531 adults aged 18 years and over (mean [SD] age, 43.6 [16.7] years; 11,979 [51%] female; 8960 [38.1%] non-Hispanic white individuals) with a median follow-up of 7.3 years (IQR 4.3–10.1), corresponding to 168,033 person-years.</p><p>The dose-response analyses showed a significant inverse curvilinear trend for the association between LE8 score with all-cause and CVD mortality. The optimal risk reduction for all-cause mortality was found at 100 points of the LE8 Score (HR, 0.50; 95% CI, 0.27–0.93) compared to the reference (median LE8 score [62.5 points]). Moreover, the dose-response association between LE8 and CVD mortality also exhibited a significant inverse curvilinear association up to 90 points (HR, 0.41; 95% CI, 0.17–0.99). Optimal levels of LE8 score may be able to avert around 40% of the annual all-cause and CVD deaths among the US adult population.</p></div><div><h3>Conclusions</h3><p>Best-case scenario of CVH may reduce around 40% of the all-cause and CVD annual mortality among adults in the United States.</p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"85 ","pages":"Pages 31-37"},"PeriodicalIF":5.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461491","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":"Pathophysiology, diagnosis and management of right ventricular failure: A state of the art review of mechanical support devices","authors":"","doi":"10.1016/j.pcad.2024.06.009","DOIUrl":"10.1016/j.pcad.2024.06.009","url":null,"abstract":"<div><p><span><span>The function of the right ventricle (RV) is to drive the forward flow of blood to the pulmonary system for oxygenation before returning to the </span>left ventricle<span>. Due to the thin myocardium of the RV, its function is easily affected by decreased </span></span>preload<span><span>, contractile motion abnormalities, or increased afterload. While various etiologies can lead to changes in RV structure and function, sudden changes in RV afterload can cause acute RV failure<span><span><span> which is associated with high mortality. Early detection and diagnosis of RV failure is imperative for guiding initial medical management. Echocardiographic findings of reduced tricuspid annular plane systolic excursion (<1.7) and RV wall motion (RV S′ <10 cm/s) are quantitatively supportive of RV systolic dysfunction. Medical management commonly involves utilizing </span>diuretics or fluids to optimize RV preload, while correcting the underlying insult to </span>RV function<span>. When medical management alone is insufficient, mechanical circulatory support (MCS) may be necessary. However, the utility of MCS for isolated RV failure remains poorly understood. This review outlines the differences in flow rates, effects on </span></span></span>hemodynamics<span><span>, and advantages/disadvantages of MCS devices such as intra-aortic balloon pump, Impella, centrifugal-flow right ventricular assist devices, </span>extracorporeal membrane oxygenation<span>, and includes a detailed review of the latest clinical trials and studies analyzing the effects of MCS devices in acute RV failure.</span></span></span></p></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"85 ","pages":"Pages 103-113"},"PeriodicalIF":5.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474120","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}