Rafail Koros, Eleni M Domouzoglou, Michail I Papafaklis
{"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 × m<sup>2</sup> <i>vs</i> 9251.7 ± 9555.3 µGy × m<sup>2</sup>, <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}
Lan-Lan Zhang, Bo Wang, Jing Wang, Jia Zhao, Li-Wen Liu
{"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}
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
{"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":"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}
{"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":"Pheochromocytoma presenting with vomiting and heart failure: A case report.","authors":"Han Cheng, Ling-Tong Gu, Jing Yang","doi":"10.4330/wjc.v17.i8.110366","DOIUrl":"10.4330/wjc.v17.i8.110366","url":null,"abstract":"<p><strong>Background: </strong>Pheochromocytoma, a rare catecholamine-secreting tumor, typically presents with the classic triad of headache, palpitations, and diaphoresis, often accompanied by cardiovascular manifestations. While vomiting occurs in approximately 34.5% of cases, it is rarely the predominant and persistent presenting symptom. Pheochromocytoma-induced cardiomyopathy leading to heart failure is a recognized but uncommon complication. Due to its heterogeneous presentations, misdiagnosis and diagnostic delay are frequent.</p><p><strong>Case summary: </strong>A 53-year-old female presented predominantly with persistent and refractory vomiting as her chief complaint, accompanied by signs of acute heart failure [left ventricular ejection fraction (LVEF) 30%]. Initial evaluation at a primary hospital, including coronary angiography (revealing only mild stenosis), led to a misdiagnosis of coronary artery disease. Despite standard anti-thrombotic, anti-heart failure, and anti-emetic therapy, her vomiting persisted and heart failure did not resolve. Subsequent hospitalization revealed dramatic paroxysmal hypertension (202/129 mmHg to 97/51 mmHg) and fever. Significantly elevated plasma metanephrines and normetanephrine, combined with abdominal computed tomography and magnetic resonance imaging, confirmed a right adrenal pheochromocytoma. This diagnosis was significantly delayed due to the atypical prominence of gastrointestinal symptoms masking the underlying endocrine crisis.</p><p><strong>Conclusion: </strong>This case highlights a highly atypical presentation of pheochromocytoma dominated by refractory vomiting and complicated by acute catecholamine-induced cardiomyopathy. It emphatically underscores that pheochromocytoma must be considered in the differential diagnosis for patients presenting with unexplained, treatment-resistant vomiting, particularly when co-existing with acute heart failure. The presence of labile hypertension, even if not initially evident, provides a crucial diagnostic clue. Prompt biochemical screening (catecholamine metabolites) and adrenal imaging are essential to prevent diagnostic delay and enable timely, life-saving surgical intervention.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 8","pages":"110366"},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065520","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}
Muneeb Khawar, Syed Abdullah Shah, Aqsa Komel, Zainab Anfaal, Umad Ali, Moosa Mubarik, Muhammad Khan Buhadur Ali, Awon Muhammad, Muneeb Saifullah, Mirza Muhammad Hadeed Khawar, Abdul Qadeer, Saad Ur Rahman, Mobeen Haider, Abbas Muhammad Mehdi
{"title":"Sex-based outcomes following thoracic endovascular aortic repair for acute complicated type B aortic dissection: A meta-analysis.","authors":"Muneeb Khawar, Syed Abdullah Shah, Aqsa Komel, Zainab Anfaal, Umad Ali, Moosa Mubarik, Muhammad Khan Buhadur Ali, Awon Muhammad, Muneeb Saifullah, Mirza Muhammad Hadeed Khawar, Abdul Qadeer, Saad Ur Rahman, Mobeen Haider, Abbas Muhammad Mehdi","doi":"10.4330/wjc.v17.i8.109738","DOIUrl":"10.4330/wjc.v17.i8.109738","url":null,"abstract":"<p><strong>Background: </strong>Sex disparities in clinical outcomes following thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection (TBAD) are not well understood.</p><p><strong>Aim: </strong>To evaluates the impact of sex on primary and secondary outcomes by comparing male and female cohorts undergoing TEVAR.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE, Cochrane Library, and ScienceDirect identified five studies involving 2572 patients (1153 males and 1419 females). The primary outcome was hospital mortality. Secondary outcomes included reintervention rates, acute kidney injury (AKI), ischemic stroke, limb ischemia, and spinal cord ischemia. Odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>The primary outcome showed no significant difference between males and females for hospital mortality (OR: 1.13, 95%CI: 0.81-1.59, <i>P</i> = 0.47, <i>I</i> <sup>2</sup> = 0). Among secondary outcomes, males had a significantly higher risk of AKI (OR: 1.55, 95%CI: 1.21-2.00, <i>P</i> = 0.0006, <i>I</i>² = 0). No differences were observed for reintervention rates, ischemic stroke, limb ischemia, or spinal cord ischemia.</p><p><strong>Conclusion: </strong>Male patients undergoing TEVAR for complicated TBAD are at increased risk of AKI but show comparable outcomes to females for mortality, ischemic events, reintervention, and other complications. Future research should explore mechanisms and strategies to optimize outcomes.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 8","pages":"109738"},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065674","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":"Role of hydrogen peroxide preconditioning in mesenchymal stem cell-mediated heart regeneration: Molecular insights.","authors":"Anum Siraj, Kanwal Haneef","doi":"10.4330/wjc.v17.i8.107437","DOIUrl":"10.4330/wjc.v17.i8.107437","url":null,"abstract":"<p><p>Mesenchymal stem cells (MSCs) possess unique properties such as immunomodulation, paracrine actions, multilineage differentiation, and self-renewal. Therefore, MSC-based cell therapy is an innovative approach to treating various degenerative illnesses, including cardiovascular diseases. However, several challenges, including low transplant survival rates, low migration to the ischemic myocardium, and poor tissue retention, restrict the application of MSCs in clinical settings. These undesirable cell therapy outcomes mainly originated due to the overproduction of reactive oxygen species (ROS) in the injured heart. MSCs' stress-coping capacity can be enhanced by preconditioning them under conditions similar to the microenvironment of wounded tissues. Hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) is a ROS that has been shown to activate protective cellular mechanisms such as survival, proliferation, migration, paracrine effects, and differentiation at sublethal doses. These processes are induced <i>via</i> phosphatidylinositol 3-kinase/protein kinase B, p38 mitogen-activated protein kinases, c-Jun N-terminal kinase, Janus kinase/signal transducer and activator of the transcription, Notch1, and Wnt signaling pathways. H<sub>2</sub>O<sub>2</sub> preconditioning could lead to many clinical benefits, including ischemic injury reduction, enhanced survival of cellular transplants, and tissue regeneration. In this review, we present an overview of stem cell preconditioning methods and the biological functions activated by H<sub>2</sub>O<sub>2</sub> preconditioning. Furthermore, this review explores the molecular mechanisms underlying the protective cellular functions stimulated under H<sub>2</sub>O<sub>2</sub> preconditioning.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 8","pages":"107437"},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065719","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}