World Journal of Cardiology最新文献

{"title":"Partial upper sternotomy <i>vs</i> full median sternotomy in obese patients undergoing aortic valve replacement: A meta-analysis.","authors":"Aarushi Gupta, Tinatin Chikhradze, Afrah Arshad, Rahmah Ashar Sakrani, Zainab Khan, Melake Getahun, Samreen Rizwan Ahmed Shaikh, Wajiha Syed, Tanish Baweja, Abhijith Remesan, Cheryl Lewis, Joy Doshi, Muneeb Khawar, Asraf Hussain, Muhammad Muneeb Khawar","doi":"10.4330/wjc.v17.i9.110838","DOIUrl":"10.4330/wjc.v17.i9.110838","url":null,"abstract":"<p><strong>Background: </strong>Obese patients (body mass index ≥ 30 kg/m²) undergoing isolated aortic valve replacement (AVR) face increased surgical risks due to comorbidities. Partial upper sternotomy (PUS), a minimally invasive approach, may reduce complications compared to full median sternotomy (FMS). We hypothesize that PUS improves outcomes over FMS in obese patients undergoing AVR.</p><p><strong>Aim: </strong>To compare the efficacy and safety of PUS <i>vs</i> FMS in obese patients undergoing isolated AVR.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA guidelines, searching PubMed, EMBASE, and Cochrane databases for observational studies comparing PUS <i>vs</i> FMS in obese patients undergoing AVR. Outcomes were analyzed using odds ratios (OR), mean differences (MD), 95% confidence intervals (CI), <i>I</i>² statistic, and Newcastle-Ottawa Scale was used for quality assessment.</p><p><strong>Results: </strong>Four observational studies involving 677 patients were analyzed. PUS reduced intensive care unit stay (MD -2.67 days, 95%CI: -4.43 to -0.90, <i>P</i> = 0.003, <i>I</i>² = 78%) but increased cardiopulmonary bypass time (MD 5.62 minutes, 95%CI: -0.36 to 11.59, <i>I</i>² = 55%). No differences were observed in renal failure (OR 1.13, 95%CI: 0.63-2.94, <i>I</i>² = 0%), atrial fibrillation (OR 0.81, 95%CI: 0.43-1.54, <i>I</i>² = 30%), reexploration (OR 1.09, 95%CI: 0.48-2.47, <i>I</i>² = 0%), postoperative bleeding (OR 1.48, 95%CI: 0.53-4.15, <i>I</i>² = 60%), wound infection (OR 1.23, 95%CI: 0.70-2.14, <i>I</i>² = 0%), hospital stay (MD 0.51 days, 95%CI: -4.13 to 5.15, <i>I</i>² = 90%), or cross-clamp time (MD 4.03 minutes, 95%CI: -0.75 to 8.80, <i>I</i>² = 50%).</p><p><strong>Conclusion: </strong>PUS is safe and effective for obese patients undergoing AVR, reducing intensive care unit stay and enhancing recovery, provided surgical expertise is available.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 9","pages":"110838"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193356","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":"Retraction note to: Medical appraisal of Chinese military aircrew with abnormal results of coronary computed tomographic angiography.","authors":"Jia Zeng, Yao Zhao, Di Gao, Xiang Lu, Jing-Jing Dong, Yan-Bing Liu, Bin Shen","doi":"10.4330/wjc.v17.i9.113720","DOIUrl":"10.4330/wjc.v17.i9.113720","url":null,"abstract":"<p><p>[This retracts the article on p. 522 in vol. 16, PMID: 39351334.].</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 9","pages":"113720"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193369","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":"Association of chronic periodontitis in a broad spectrum of cardiometabolic syndrome: A minireview.","authors":"Shilpi Gupta, Nand Lal, Akshyaya Pradhan, Ajay Kumar Verma","doi":"10.4330/wjc.v17.i9.109126","DOIUrl":"10.4330/wjc.v17.i9.109126","url":null,"abstract":"<p><p>The prevalence of cardiometabolic syndrome (CMS) and increasing mortality rate play a significant role in the global increase of cardiovascular disease (CVD) in developing countries. A group of metabolic syndromes that are risk factors for CVDs are referred to as the CMS. Although the exact mechanism(s) behind the development of the CMS are not known, but multi-organ insulin resistance, a prevalent characteristic of the syndrome, is probably one of them. The two most prevalent dental diseases <i>i.e.</i> periodontitis (PD) and dental caries have been related to several systemic diseases and disorders, such as CMS. Age, alcohol consumption, being obese, possessing diabetes, as well as smoking are risk factors for periodontal diseases, while both CVD and periodontal diseases are linked to systemic inflammation. It has a multifactorial aetiology and is associated with many systemic diseases. When bacteria and their products attack the periodontal tissues, the tissue raises an immune-inflammatory response against the pathogens. This acute phase response is a result of the pathogen's systemic attack and contributes to the overall inflammatory burden of the system. CVD and PD are both diseases associated with systemic inflammation and may be related as they share many common risk factors. Hence, the correlation between these conditions might also have an impact on how dentistry and medicine are practised, thus helping to build a working relationship between the dentist and the physician.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 9","pages":"109126"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193246","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":"Metabolically \"healthy\" obesity in postmenopausal women: Unmasking the cardiovascular risk.","authors":"Rafail Koros, Eleni M Domouzoglou, Michail I Papafaklis","doi":"10.4330/wjc.v17.i9.110228","DOIUrl":"10.4330/wjc.v17.i9.110228","url":null,"abstract":"<p><p>The concept of metabolically healthy obesity (MHO) has attracted growing attention, but its clinical relevance and association with future cardiovascular risk remain unclear. Estrogen deficiency, which signifies the menopause phase, contributes to altered body composition and unfavorable metabolic processes. In this Editorial, we comment on the recent retrospective study by Pingili <i>et al</i>, which used a United States national in-patient population and observed significantly elevated odds of major adverse cardiac and cerebrovascular events in postmenopausal women with MHO compared with their age-matched non-obese counterparts. Of note, disproportionately greater risks were particularly observed among Black patients. These findings along with previous literature data call into question the seemingly benign profile of the MHO state. Obese individuals who appear metabolically healthy present an elevated cardiovascular risk which may be exacerbated in older female populations. These findings emphasize the need for vigilance and improved approaches of risk stratification which would translate into the early application of preventive measures.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 9","pages":"110228"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193299","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":"Gender-based radiation exposure and clinical outcomes in peripheral endovascular intervention for limb ischemia: A prospective study.","authors":"Subrata Kar, Clifton Espinoza","doi":"10.4330/wjc.v17.i9.110220","DOIUrl":"10.4330/wjc.v17.i9.110220","url":null,"abstract":"<p><strong>Background: </strong>Peripheral endovascular intervention (PEVI) is performed using radiation. Radiation has deleterious health consequences for patients and operators.</p><p><strong>Aim: </strong>To investigate the gender radiation disparities and procedural outcomes in PEVI.</p><p><strong>Methods: </strong>A prospective observational study was performed in 186 consecutive patients (65 ± 12 years) at an academic medical center from January 2019 to April 2020 (mean follow-up of 3.9 ± 3.6 months) comparing the gender radiation disparity and outcomes of PEVI (<i>n</i> = 147 underwent intervention, 79.0%). Groups were divided into women (<i>n</i> = 99, 53.2%) and men (<i>n</i> = 87, 48.4%). Primary endpoints included air kerma, dose area product (DAP), fluoroscopy time, and contrast use. Secondary endpoints included all-cause mortality, acute myocardial infarction, acute kidney injury, stroke, repeat revascularization, major adverse limb event, and the composite of complications.</p><p><strong>Results: </strong>Men showed increased DAP compared with women (15221.2 ± 25858.5 µGy × m² <i>vs</i> 9251.7 ± 9555.3 µGy × m², <i>P</i> = 0.047), but no significant difference in air kerma or any other primary endpoints. In the secondary endpoints, no significant difference was found between gender.</p><p><strong>Conclusion: </strong>Men had increased DAP indicating more radiation absorption in the exposed area. Gender outcomes showed no difference in complications. Thus, PEVI can be safely performed in men or women.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 9","pages":"110220"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193346","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":"Early mobilization in patients on venoarterial extracorporeal membrane oxygenation: A scoping review.","authors":"Vasiliki Kanellou, Konstantinos Kaliarntas, Despoina Myrto Dounavi, Irini Patsaki, Dimitrios Kalpaxis, Christos Kourek, Stavros Dimopoulos","doi":"10.4330/wjc.v17.i8.107811","DOIUrl":"10.4330/wjc.v17.i8.107811","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal membrane oxygenation (ECMO) is mainly applied to patients with significant cardiorespiratory failure who do not respond to existing conventional treatments. Patients that are supported with veno-arterial ECMO (VA-ECMO) are considered very-high risk patients to participate in any type of physical therapy (PT) or mobilization. However, cumulative evidence suggests that early mobilization of critically ill patients is feasible, safe, and efficient under certain circumstances.</p><p><strong>Aim: </strong>To summarize the existing evidence on the impact of early mobilization and physiotherapy on VA-ECMO patients.</p><p><strong>Methods: </strong>This is a scoping review that used systematic electronic literature searches (from inception until January 2025) on MEDLINE (PubMed), PEDro, DynaMed, CINAHL, Scopus, Science direct and Hellenic Academic Libraries. Snowball searching method was also applied. Eligible studies included those reporting patients on VA-ECMO who participated in early mobilization or PT, published in English and utilized any primary evidence study design. Studies on children, animals and patients placed on any other ECMO, secondary evidence, and 'grey' literature were excluded.</p><p><strong>Results: </strong>A total of 316 articles were retrieved and 13 were included in the study. Of those, 1 study was a randomized control trial, 4 retrospective studies, 4 retrospective cohort studies, 1 case series and 3 case reports. The sample size of the included studies ranged from 1 to 104 VA-ECMO patients, who were ambulated or received PT interventions, and mobilization frequency ranged from 2 per day to 4 per week. Mobilization of VA-ECMO patients seems to be safe regardless the cannula's position. PT and early mobilization were associated with better weaning from mechanical ventilation, gradual reduction of inotropes and functional capacity improvement after ECMO discharge.</p><p><strong>Conclusion: </strong>Early mobilization in VA-ECMO seems to be safe and can potentially help reduce vasoconstrictors and speed up rehabilitation times. High quality research on early mobilization in VA-ECMO patients is warranted.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 8","pages":"107811"},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065781","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":"Relationship between genotype and clinical phenotype of hypertrophic cardiomyopathy.","authors":"Lan-Lan Zhang, Bo Wang, Jing Wang, Jia Zhao, Li-Wen Liu","doi":"10.4330/wjc.v17.i8.107847","DOIUrl":"10.4330/wjc.v17.i8.107847","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease, mostly inherited in an autosomal dominant manner. It is a global heart disease with complex clinical phenotypes and gene expression. The prevalence rate in the population is 1:500-1:200. This article mainly introduces the diagnostic criteria, pathological manifestations, and genetic basis of HCM, which is the leading cause of sudden death in adolescents and athletes due to exercise, with 60%-70% showing familial clustering. It also discusses the latest progress in the relationship between different genotypes and clinical phenotypes of HCM patients.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 8","pages":"107847"},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065649","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":"Comparative outcomes of robotic surgery <i>vs</i> conventional sternotomy for cardiac myxoma excision: A meta-analysis.","authors":"Mirza Muhammad Hadeed Khawar, Hooria Ejaz, Muhammad Soban Jaffar, Muhammad Kashif, Mavia Habib, Absar Mukhtar, Hafsa Riaz, Syed Abdullah Shah, Awon Muhammad, Umad Ali, Hannan Saeed, Muhammad Khan Buhadur Ali, Rejina Chhetri","doi":"10.4330/wjc.v17.i8.111159","DOIUrl":"10.4330/wjc.v17.i8.111159","url":null,"abstract":"<p><strong>Background: </strong>Cardiac myxoma, a benign intracardiac tumor, is traditionally excised via conventional sternotomy, which is invasive and associated with longer recovery times. Minimally invasive robotic surgery has emerged as a potential alternative, offering reduced trauma and faster recovery. This meta-analysis compares the efficacy and safety of robotic surgery <i>vs</i> conventional sternotomy for cardiac myxoma excision. We hypothesized that robotic surgery would provide comparable safety outcomes with improved postoperative recovery, such as shorter hospital stays and reduced transfusion rates, despite potentially longer operative times.</p><p><strong>Aim: </strong>To assess robotic surgery <i>vs</i> sternotomy for cardiac myxoma regarding operative times, hospital stay, transfusions, and complications.</p><p><strong>Methods: </strong>A systematic review was performed using EMBASE, OVID, Scopus, PubMed, Cochrane, and ScienceDirect databases to identify studies comparing robotic surgery and sternotomy for cardiac myxoma excision. Continuous outcomes were analyzed using mean differences (MDs), and categorical outcomes with odds ratios (ORs) and 95% confidence intervals (95%CIs). A random-effects model was used to pool data, accounting for study heterogeneity.</p><p><strong>Results: </strong>Six studies involving 425 patients (180 robotic, 245 conventional) were included. Robotic surgery significantly increased cross-clamp time (MD = 12.03 minutes, 95%CI: 2.14-21.92, <i>P</i> = 0.02) and cardiopulmonary bypass time (MD = 28.37 minutes, 95%CI: 11.85-44.89, <i>P</i> = 0.001). It reduced hospital stay (MD = -1.86 days, 95%CI: -2.45 to -1.27, <i>P</i> < 0.00001) and blood transfusion requirements (OR = 0.30, 95%CI: 0.13-0.69, <i>P</i> = 0.007). No significant differences were observed in atrial arrhythmia (OR = 0.55, 95%CI: 0.27-1.12) or ventilation time (MD = -1.72 hours, 95%CI: -5.27 to 1.83, <i>P</i> = 0.34).</p><p><strong>Conclusion: </strong>Robotic surgery for cardiac myxoma excision prolongs operative times but shortens hospital stays and reduces transfusion needs, suggesting enhanced recovery without compromising safety.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 8","pages":"111159"},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065689","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":"Effect of extracorporeal membrane oxygenation combined with hemoperfusion on inflammatory factors in patients with cardiogenic shock.","authors":"Jing-Yan Hao, Shi-Fu Wang, Qin Yang, Wei Wang, Zhuo-Xian Zhao, Shan Guo, Ying Zhou, Fei Dong, Wen-Hua Lin","doi":"10.4330/wjc.v17.i8.109903","DOIUrl":"10.4330/wjc.v17.i8.109903","url":null,"abstract":"<p><strong>Background: </strong>Data on adsorptive extracorporeal membrane oxygenation (ECMO) (combined with HA380 hemoperfusion column) on the inflammatory factors in patients with cardiogenic shock (CS) remains limited.</p><p><strong>Aim: </strong>To investigate the effects of adsorptive ECMO on the inflammatory factors in patients with CS.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 81 patients with CS caused by acute myocardial infarction, fulminant myocarditis, or cardiac surgery who required venoarterial ECMO support at TEDA International Cardiovascular Hospital from December 2020 to December 2024. Patients were divided into the conventional ECMO group (42 cases) and the adsorptive ECMO group (ECMO combined with hemoperfusion, 39 cases). The adsorptive ECMO group received 2 columns of HA380 initiation on the first day (the first column connected within 2 hours of ECMO and the second after 12 hours of ECMO), followed by 1 column each day, with each column used for 4-6 hours, totaling 24-30 hours of treatment. Baseline data were compared between the two groups: Inflammatory factor levels (at 0, 6, 12, 24, 48, and 72 hours after ECMO or hemoperfusion initiation); ECMO support duration; successful weaning rate; continuous renal replacement therapy (CRRT) utilization; Sequential Organ Failure Assessment (SOFA) score; Vasoactive-Inotropic Score (VIS); systemic inflammatory response syndrome (SIRS) incidence; and in-hospital survival and 30-/90-day survival after discharge.</p><p><strong>Results: </strong>The adsorptive ECMO group showed significantly lower levels of C-reactive protein, interleukin (IL)-6, tumor necrosis factor (TNF)-α, and lactate from 6 to 72 hours compared with the conventional ECMO group (all <i>P</i> < 0.05), with IL-6 decreasing by 94.4% and tumour necrosis factor alpha by 70.1% from baseline at 72 hours. The adsorptive ECMO group had a significantly shorter ECMO duration [114.0 (75.0-139.0) hours <i>vs</i> 135.0 (73.0-199.3) hours, <i>P</i> = 0.032]; higher successful weaning rate (66.7% <i>vs</i> 42.9%, <i>P</i> = 0.032); a trend toward lower CRRT utilization (54.8% <i>vs</i> 38.5%, <i>P</i> = 0.070); lower post-weaning SOFA score [7 (6-8) <i>vs</i> 9 (8-10), <i>P</i> < 0.001]; significantly reduced VIS (8.4 ± 1.3 <i>vs</i> 9.8 ± 1.6, <i>P</i> < 0.001); and a trend toward lower SIRS incidence (10.3% <i>vs</i> 26.2%, <i>P</i> = 0.065). There were no significant differences in complications, in-hospital survival (64.1% <i>vs</i> 52.4%, <i>P</i> = 0.285); or 30-/90-day survival between the two groups (all <i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Adsorptive ECMO efficiently clears IL-6 and TNF-α, significantly improving ECMO weaning success rate and hemodynamics. However, it has no significant impact on survival, and its efficacy requires validation through prospective studies.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 8","pages":"109903"},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065778","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":"Integrative cardiovascular disease therapy: Linoleic acid restriction, enhanced external counterpulsation, and emerging nanotherapies.","authors":"Joseph Mercola","doi":"10.4330/wjc.v17.i8.110163","DOIUrl":"10.4330/wjc.v17.i8.110163","url":null,"abstract":"<p><p>Cardiovascular disease remains the leading global cause of mortality, projected to increase by 73.4% from 2025 to 2050 despite declining age-standardized rates. Contemporary interventions, such as percutaneous coronary intervention and statins, reduce major adverse cardiovascular events (MACE) by 25%-30%, yet a 20% five-year MACE risk persists in high-risk cohorts. These approaches, historically focused on luminal stenosis, fail to address systemic atherogenesis drivers like endothelial dysfunction and inflammation. Specifically, dietary linoleic acid restriction (< 5 g/day) reduces oxidized low-density lipoprotein by approximately 15% by limiting peroxidation-prone bisallylic bonds, mitigating arterial inflammation, a key atherogenic trigger. Enhanced external counterpulsation, through pulsatile shear stress, enhances nitric oxide-mediated coronary perfusion, alleviating angina in approximately 70% of refractory cases unresponsive to revascularization. Nanoparticle-facilitated chelation targets atherosclerotic plaques with precision, reducing calcium content by up to 30% in preclinical models, offering a novel avenue for lesion reversal. These innovations collectively address residual risk by tackling root causes, oxidative stress, endothelial dysfunction, and plaque instability, potentially halving MACE rates with widespread adoption. Despite promising preliminary data, gaps remain in long-term safety and scalability. Robust clinical trials are needed to validate these approaches, which collectively aim to transform cardiovascular disease management by prioritizing prevention and vascular restoration, potentially reducing coronary events to a public health rarity.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 8","pages":"110163"},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064865","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}