Therapeutic Advances in Cardiovascular Disease最新文献

{"title":"Percutaneous image-guided management of a misplaced pericardiocentesis catheter into the inferior vena cava.","authors":"Haytham Derbel, Mahdi Krichen, Youssef Zaarour, Salim Jazzar, Mario Ghosn, Vania Tacher, Hicham Kobeiter","doi":"10.1177/17539447241234655","DOIUrl":"10.1177/17539447241234655","url":null,"abstract":"<p><p>Misplacement of pericardiocentesis catheter in central veins is a rare complication that can be managed with several methods. In this case, we report a percutaneous image-guided plug-assisted management of a misplaced pericardiocentesis catheter into the inferior vena cava through a transhepatic tract successfully occluded. This minimally invasive technique was not previously described in this setting and had a favorable long-term outcome.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241234655"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139940846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary intravascular lithotripsy in contemporary practice: challenges and opportunities in coronary intervention.","authors":"Ankush Gupta, Abhinav Shrivastava, Jaskaran Singh Dugal, Sanya Chhikara, Rajesh Vijayvergiya, Navreet Singh, Ajit Chandrakant Mehta, Nalin Kumar Mahesh, Ajay Swamy","doi":"10.1177/17539447241263444","DOIUrl":"10.1177/17539447241263444","url":null,"abstract":"<p><p>Percutaneous coronary intervention (PCI) of calcified coronary arteries is associated with poor outcomes. Poorly modified calcified lesion hinders the stent delivery, disrupts drug-carrying polymer, impairs drug elution kinetics and results in under-expanded stent (UES). UES is the most common cause of acute stent thrombosis and in-stent restenosis after PCI of calcified lesions. Angiography has poor sensitivity for recognition and quantification of coronary calcium, thereby mandating the use of intravascular imaging. Intravascular imaging, like intravascular ultrasound and optical coherence tomography, has the potential to accurately identify and quantify the coronary calcium and to guide appropriate modification device before stent placement. Available options for the modification of calcified plaque include modified balloons (cutting balloon, scoring balloon and high-pressure balloon), atherectomy devices (rotational atherectomy and orbital atherectomy) and laser atherectomy. Coronary intravascular lithotripsy (IVL) is the newest addition to the tool box for calcified plaque modification. It produces the acoustic shockwaves, which interact with the coronary calcium to cause multiplanar fractures. These calcium fractures increase the vessel compliance and result in desirable minimum stent areas. Coronary IVL has established its safety and efficacy for calcified lesion in series of Disrupt CAD trials. Its advantages over atherectomy devices include ease of use on workhorse wire, ability to modify deep calcium, no debris embolization causing slow flow or no-flow and minimal thermal injury. It is showing promising results in modification of difficult calcified lesion subsets such as calcified nodule, calcified left main bifurcation lesions and chronic total occlusion. In this review, authors will summarize the mechanism of action for IVL, its role in contemporary practice, evidence available for its use, its advantages over atherectomy devices and its imaging insight in different calcified lesion scenarios.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241263444"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing coronary artery plaque analysis via artificial intelligence-driven cardiovascular computed tomography.","authors":"Jeffrey Xia, Kinan Bachour, Abdul-Rahman M Suleiman, Jacob S Roberts, Sammy Sayed, Geoffrey W Cho","doi":"10.1177/17539447241303399","DOIUrl":"10.1177/17539447241303399","url":null,"abstract":"<p><p>Coronary computed tomography angiography (CCTA) is a noninvasive imaging modality of cardiac structures and vasculature considered comparable to invasive coronary angiography for the evaluation of coronary artery disease (CAD) in several major cardiovascular guidelines. Conventional image acquisition, processing, and analysis of CCTA imaging have progressed significantly in the past decade through advances in technology, computation, and engineering. However, the advent of artificial intelligence (AI)-driven analysis of CCTA further drives past the limitations of conventional CCTA, allowing for greater achievements in speed, consistency, accuracy, and safety. AI-driven CCTA (AI-CCTA) has achieved a significant reduction in radiation exposure for patients, allowing for high-quality scans with sub-millisievert radiation doses. AI-CCTA has demonstrated comparable accuracy and consistency in manual coronary artery calcium scoring against expert human readers. An advantage over invasive coronary angiography, which provides luminal information only, CCTA allows for plaque characterization, providing detailed information on the quality of plaque and offering further prognosticative value for the management of CAD. Combined with AI, many recent studies demonstrate the efficacy, accuracy, efficiency, and precision of AI-driven analysis of CCTA imaging for the evaluation of CAD, including assessing degree stenosis, adverse plaque characteristics, and CT fractional flow reserve. The limitations of AI-CCTA include its early phase in investigation, the need for further improvements in AI modeling, possible medicolegal implications, and the need for further large-scale validation studies. Despite these limitations, AI-CCTA represents an important opportunity for improving cardiovascular care in an increasingly advanced and data-driven world of modern medicine.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241303399"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity in the editorial boards of medical journals: a perspective from the Middle East.","authors":"Zainab Atiyah Dakhil, Mohammed Dheyaa Marsool Marsool, Mohammed Saad Qasim, May Saad Al-Jorani","doi":"10.1177/17539447241300022","DOIUrl":"10.1177/17539447241300022","url":null,"abstract":"<p><p>Despite the significant increase in women in academic medicine over the last 50 years, women are still under-represented in leadership positions in academia. However, there is a lack of data on the diversity of editorial boards in Middle Eastern medical journals. So, we aim to portray the diversity of editorial boards of Iraqi medical journals by conducting a cross-sectional analysis of the editorial boards' members of all Iraqi medical journals. Gender, affiliation and specialty were extracted from the journals' websites and/or from the professional profiles of the editorial board members. Twenty-five journals and 446 editorial board members were analysed. More than half of editorial board members specialized in basic science, while 39.76% specialized in clinical specialties. Approximately, 20.18% of editorial board members (regardless their role) were women. Four percent of editor-in-chief were women. There were significant differences in editorial role according to gender (<i>p</i> < 0.0001), yet residency (<i>p</i> = 0.688) and specialty (<i>p</i> = 0.190) did not differ according to their gender. Most editorial board members were affiliated with Baghdad. So, we can conclude that there is a significant under-representation of women across all roles on the editorial board of medical journals especially in the leading positions. All stakeholders, publishers, authors and academics should commit to ensure the diversity of editorial boards.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241300022"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the no-reflow phenomenon in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: a systematic review of clinical prediction models.","authors":"Reza Ebrahimi, Mahdi Rahmani, Parisa Fallahtafti, Amirhossein Ghaseminejad-Raeini, Alireza Azarboo, Arash Jalali, Mehdi Mehrani","doi":"10.1177/17539447241290438","DOIUrl":"10.1177/17539447241290438","url":null,"abstract":"<p><strong>Background: </strong>The no-reflow (NRF) phenomenon is the \"Achilles heel\" of interventionists after performing percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). No definitive treatment has been proposed for NRF, and preventive strategies are central to improving care for patients who develop NRF.</p><p><strong>Objectives: </strong>In this study, we aim to investigate the clinical prediction models developed to predict NRF in STEMI patients undergoing primary PCI.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Data sources and methods: </strong>Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were observed. Studies that developed clinical prediction modeling for NRF after primary PCI in STEMI patients were included. Data extraction was performed using the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies (CHARMS) checklist. The Prediction Model Risk of Bias Assessment Tool (PROBAST) tool was used for critical appraisal of the included studies.</p><p><strong>Results: </strong>The three most common predictors were age, total ischemic time, and preoperative thrombolysis in myocardial infarction flow grade. Most of the included studies internally validated their developed model via various methods: random split, bootstrapping, and cross-validation. Only three studies (18%) externally validated their model. Six studies (37%) reported a calibration plot with or without the Hosmer-Lemeshow test. The reported area under the curve ranged from 0.648 to 0.925. The most common biases were in the statistical domain.</p><p><strong>Conclusion: </strong>Clinical prediction models aid in individualizing care for STEMI patients with NRF after primary PCI. Of the 16 included studies, we report four to have a low risk of bias and low concern with regard to our research question, which should undergo external validation with or without updating in future studies.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241290438"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a) distribution in hospitalised Asian patients with ischaemic heart disease.","authors":"Wann Jia Loh, Chong Boon Teo, Oliver Simon, Colin Yeo","doi":"10.1177/17539447241306936","DOIUrl":"10.1177/17539447241306936","url":null,"abstract":"<p><strong>Background: </strong>Elevated lipoprotein(a) [Lp(a)] is a common hyperlipidaemic condition with strong genetic predisposition and is independently associated with ischaemic heart disease (IHD). A Mendelian randomisation study has suggested that elevated Lp(a) is likely to confer similar causal risks as heterozygous familial hypercholesterolemia for premature IHD. We aimed to characterise the clinical profiles of admitted patients with IHD with at least one Lp(a) measurement. We also investigated whether elevated Lp(a) concentration was associated with premature onset of IHD.</p><p><strong>Methods: </strong>This is a descriptive, non-interventional, retrospective study with data from a single tertiary hospital IHD Lp(a) cohort in Singapore, which consecutively recruited 521 patients with IHD admitted to the hospital.</p><p><strong>Results: </strong>A total of 82.2% were men, 46.6% had newly diagnosed IHD and 10% had premature IHD. The median Lp(a) levels was 35.2 nmol/L. 70.8% of patients had normal Lp(a) concentrations (<70 nmol/L), 13.4% of people with Lp(a) ⩾ 70 to <120 nmol/L and 15.7% of patients with Lp(a) ⩾ 120 nmol/L. Lp(a) distribution was positively skewed to the right for all ethnicities. Patients of Indian ethnicity and of female gender had higher levels of Lp(a) compared with other ethnicities and gender, respectively. Multivariable regression analysis identified Lp(a) ⩾ 155 mmol/L to be associated with development of premature IHD (OR = 2.90, 95% CI: 1.26-6.67, <i>p</i> = 0.012).</p><p><strong>Conclusion: </strong>There exist differences in Lp(a) distribution across ethnicities and gender. The subgroup analysis suggests that Lp(a) ⩾ 155 mmol/L was associated with premature onset of IHD.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241306936"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's new in cardiac amyloidosis? Pharmacological treatment, physical activity, and care of patients with transthyretin cardiac amyloidosis.","authors":"Ezequiel J Zaidel, Sol C Song, Juan J Sterba, Agustina Piccinato, María Candelaria Ramos, Silvina L Cacia","doi":"10.1177/17539447241295957","DOIUrl":"10.1177/17539447241295957","url":null,"abstract":"<p><p>Awareness, proper diagnosis and treatment of cardiac amyloidosis have increased, but there are still several unmet needs that have to be addressed for the optimal care of the disease. In this comprehensive review, we describe current and future treatments for both hereditary and wild-type TTR cardiac amyloidosis and also review lifestyle, including current challenges and opportunities for specific dietary concerns and exercise sports for these patients.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241295957"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142636067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasospastic angina: a review on diagnostic approach and management.","authors":"Kenny Jenkins, Graziella Pompei, Nandine Ganzorig, Sarah Brown, John Beltrame, Vijay Kunadian","doi":"10.1177/17539447241230400","DOIUrl":"10.1177/17539447241230400","url":null,"abstract":"<p><p>Vasospastic angina (VSA) refers to chest pain experienced as a consequence of myocardial ischaemia caused by epicardial coronary spasm, a sudden narrowing of the vessels responsible for an inadequate supply of blood and oxygen. Coronary artery spasm is a heterogeneous phenomenon that can occur in patients with non-obstructive coronary arteries and obstructive coronary artery disease, with transient spasm causing chest pain and persistent spasm potentially leading to acute myocardial infarction (MI). VSA was originally described as Prinzmetal angina or variant angina, classically presenting at rest, unlike most cases of angina (though in some patients, vasospasm may be triggered by exertion, emotional, mental or physical stress), and associated with transient electrocardiographic changes (transient ST-segment elevation, depression and/or T-wave changes). Ischaemia with non-obstructive coronary arteries (INOCA) is not a benign condition, as patients are at elevated risk of cardiovascular events including acute coronary syndrome, hospitalization due to heart failure, stroke and repeat cardiovascular procedures. INOCA patients also experience impaired quality of life and associated increased healthcare costs. VSA, an endotype of INOCA, is associated with major adverse events, including sudden cardiac death, acute MI and syncope, necessitating the study of the most effective treatment options currently available. The present literature review aims to summarize current data relating to the diagnosis and management of VSA and provide details on the sequence that treatment should follow.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241230400"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10860484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of coronary artery calcium score and coronary CT angiography to guide cardiovascular prevention and treatment.","authors":"Maria Rita Lima, Pedro M Lopes, António M Ferreira","doi":"10.1177/17539447241249650","DOIUrl":"10.1177/17539447241249650","url":null,"abstract":"<p><p>Currently, cardiovascular risk stratification to guide preventive therapy relies on clinical scores based on cardiovascular risk factors. However, the discriminative power of these scores is relatively modest. The use of coronary artery calcium score (CACS) and coronary CT angiography (CCTA) has surfaced as methods for enhancing the estimation of risk and potentially providing insights for personalized treatment in individual patients. CACS improves overall cardiovascular risk prediction and may be used to improve the yield of statin therapy in primary prevention, and possibly identify patients with a favorable risk/benefit relationship for antiplatelet therapies. CCTA holds promise to guide anti-atherosclerotic therapies and to monitor individual response to these treatments by assessing individual plaque features, quantifying total plaque volume and composition, and assessing peri-coronary adipose tissue. In this review, we aim to summarize current evidence regarding the use of CACS and CCTA for guiding lipid-lowering and antiplatelet therapy and discuss the possibility of using plaque burden and plaque phenotyping to monitor response to anti-atherosclerotic therapies.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241249650"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular clot removal in small and tortuous arteries: a case series.","authors":"Gowri Kiran Puvvala, Anastasios Psyllas, Jürgen Hinkelmann, Daniel Herzenstiel, Grigorios Korosoglou","doi":"10.1177/17539447241271989","DOIUrl":"10.1177/17539447241271989","url":null,"abstract":"<p><p>Acute limb ischemia (ALI) due to arterial thromboembolic occlusion is a critical emergency in vascular medicine, requiring attention for rapid diagnosis and intervention, to prevent limb loss and major amputation, which is associated with patient disability in the long term. Traditionally, surgical embolectomy has been used for the treatment of ALI. Endovascular treatment of ALI traditionally involved catheter-directed thrombolysis. This option, however, poses some limitations, including an increased risk for access site and systemic bleeding complications, especially in patients with high bleeding risk. Therefore, in the last decades, several devices have been developed and tested for the mechanical endovascular treatment of ALI. Such devices involve either rotational thrombectomy or continuous thrombus aspiration. While rotational thrombectomy is limited in rather large arteries due to the risk of dissection and perforation in arteries <3 mm, continuous thrombus aspiration can be applied in smaller vessels and tortuous anatomies. In our case series we present a minimal-invasive endovascular approach for the treatment of two patients with ALI due to thrombotic occlusion of tortious and small diameter arteries. Minimal-invasive mechanical thrombectomy using the Penumbra Aspiration System emerged as a successful alternative to surgical embolectomy, enabling prompt treatment and with a short hospital stay for both patients. Our article therefore highlights the use of continuous thrombus aspiration in small diameter vessels and tortuous anatomies, which may represent a contraindication for the use of rotational thrombectomy. In addition, this technique may be applied even in patients with higher bleeding risk since additional lysis is not necessary in patients, where complete thrombus removal can be achieved by this device.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"18 ","pages":"17539447241271989"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}