World Journal of Cardiology最新文献

{"title":"Incidence, risk factors and clinical outcomes of pericardial effusion in left ventricular assist device patients.","authors":"Muhammad Zubair Khan, Yevgeniy Brailovsky, Mohammad Alfrad Nobel Bhuiyan, Gregary Marhefka, Abu S M Faisal, Adrija Sircar, Parker O'Neill, J Eduardo Rame, Sona Franklin, Muhammad Waqas, Hadia Shah, Indranee Rajapreyar, Rene J Alvarez","doi":"10.4330/wjc.v17.i6.105330","DOIUrl":"10.4330/wjc.v17.i6.105330","url":null,"abstract":"<p><strong>Background: </strong>Development of pericardial effusion in patients with left ventricular assist devices (LVADs) can be detrimental to health outcomes. This study aims to elucidate the prevalence and risk factors for pericardial effusion in patients with LVADs.</p><p><strong>Aim: </strong>To elucidate risk factors associated with the presence of pericardial effusion in patients with LVADs and compare the clinical outcomes of those with and without pericardial effusion. The secondary goal is to determine the incidence of pericardiocentesis and pericardial window placement in patients with LVADs experiencing pericardial effusion.</p><p><strong>Methods: </strong>Data were obtained from the National Inpatient Sample database between 2016 and 2018. Statistical analysis was performed using Pearson <i>χ</i> ² test and multivariate logistic regression analysis to determine clinical outcomes of pericardial effusion and to identify variables associated with pericardial effusion in LVAD patients, respectively.</p><p><strong>Results: </strong>The prevalence of LVAD was 9850 (0.01%) among total study patients (<i>n</i> = 98112095). The incidence of pericardial effusion among LVAD patients was 640 (6.5%). The prevalence of liver disease (26.6% <i>vs</i> 17.4%), chronic kidney disease (CKD; 54.6% <i>vs</i> 49.4%), hypothyroidism (21.9% <i>vs</i> 18.1%), congestive heart failure (98.4% <i>vs</i> 96.5%), atrial fibrillation (Afib; 58.59% <i>vs</i> 50.5%), coronary artery disease (CAD; 11.7% <i>vs</i> 4.4%), dyslipidemia (31.3% <i>vs</i> 39.3%), and having undergone percutaneous coronary intervention (PCI; 1.6% <i>vs</i> 0.7%) was higher in the pericardial effusion cohort <i>vs</i> the non-pericardial effusion cohort. Multivariate regression analysis demonstrated that CAD (OR = 2.89) and PCI (OR = 2.2) had the greatest association with pericardial effusion in patients with LVADs. These were followed by liver disease (OR = 1.72), hypothyroidism (OR = 1.2), electrolyte derangement (OR = 1.2), Afib (OR = 1.1), and CKD (OR = 1.05). Among patients with LVADs, the median length of stay (33 days <i>vs</i> 27 days) and hospitalization cost (847525 USD <i>vs</i> 792616 USD) were significantly higher in the pericardial effusion cohort compared to the non-pericardial effusion cohort. There was no significant difference in mortality between cohorts. The prevalence of cardiac tamponade was 109 (17.9% of LVAD patients with pericardial effusion). Ten (9.2% of LVAD patients with cardiac tamponade) patients underwent pericardiocentesis and 44 (40.3%) received a pericardial window.</p><p><strong>Conclusion: </strong>This study shows that liver disease, CKD, PCI, hypothyroidism, electrolyte derangement, Afib, and CAD had a significant association with pericardial effusion in LVAD patients. Hospitalization cost and length of stay were higher in the pericardial effusion group, but mortality was the same.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 6","pages":"105330"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508636","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":"Diagnosis and treatment options for sinus of Valsalva aneurysms: A narrative review.","authors":"Kevan English","doi":"10.4330/wjc.v17.i6.102722","DOIUrl":"10.4330/wjc.v17.i6.102722","url":null,"abstract":"<p><p>Sinus of Valsalva aneurysm (SoVA) is a rare cardiac defect that may be congenital or acquired. It is characterized by abnormal dilatation of the aortic root due to a weakened elastic lamina at the junction of the annulus fibrosus and the aortic media. SoVAs are present in approximately 0.09% of the general population and comprise up to 3.5% of all congenital cardiac defects. It is usually found incidentally on cardiac imaging, with a higher incidence observed in the Western populations and a male-to-female ratio of 4:1. A transthoracic two-dimensional echocardiogram is the initial diagnostic test of choice, which may reveal the characteristic \"windsock deformity\" that clinches the diagnosis. Other imaging modalities, such as transesophageal echocardiography and cardiac computed tomography angiography, help provide more extensive details of the aneurysm and its adjacent structures. Management options for ruptured and unruptured SoVA include surgical repair or transcatheter closure, which serves as a game-changing development in treatment. This article aims to provide background information on the epidemiology, pathophysiology, diagnosis, and recent advancements over the past decade in the management of SoVAs.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 6","pages":"102722"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508631","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":"Impact of gut microbiome on atrial fibrillation: Mechanistic insights and future directions in individualized medicine.","authors":"Ajit Singh Brar, Shree Laya Vemula, Vishnu Yanamaladoddi, Sohail Sodhi, Juniali Hatwal, Aalam Sohal, Akash Batta","doi":"10.4330/wjc.v17.i6.107386","DOIUrl":"10.4330/wjc.v17.i6.107386","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is a growing global health burden, with a prevalence of over 52.55 million cases. Rising disability-adjusted life-years, increasing age, and disparities in care have contributed to the worsening severity and mortality of AF. Modifiable risk factors, such as hypertension, obesity, and diabetes mellitus, are associated with alterations in gut microbiota, making the gut-heart axis a potential therapeutic target. Gut dysbiosis influences AF pathogenesis through inflammation, metabolic disruption, and autonomic dysfunction. Key mechanisms include gut barrier dysfunction, short-chain fatty acid (SCFA) depletion, lipopolysaccharides (LPS)-induced inflammation, and ferroptosis-mediated atrial remodeling. Trimethylamine N-oxide, bile acids, and tryptophan metabolites contribute to arrhythmogenic remodeling. Emerging evidence suggests that dietary interventions, including prebiotics and probiotics, as well as gut surveillance, may help mitigate AF progression. Clinical implications of gut modulation in AF include personalized dietary strategies, microbiome assessment through metagenomic sequencing, and targeted interventions such as SCFA-based therapies and ferroptosis inhibition. Metabolite surveillance, including LPS and indoxyl sulfate monitoring, may influence the effectiveness of anticoagulant and antiarrhythmic therapy. Despite growing mechanistic evidence linking gut dysbiosis to AF, clinical applications remain unexplored. This review summarizes the current understanding of the gut microbiome's role in AF.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 6","pages":"107386"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508634","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":"Navigating women with congenital heart disease during pregnancy: Management strategies and future directions.","authors":"Bibhuti B Das, Varun Aggarwal, Shriprasad R Deshpande","doi":"10.4330/wjc.v17.i6.106295","DOIUrl":"10.4330/wjc.v17.i6.106295","url":null,"abstract":"<p><p>Women with adult congenital heart disease (CHD) face unique challenges during pregnancy, as gestational cardiovascular (CV) and hemodynamic changes can exacerbate underlying cardiac conditions. While these adaptations are well tolerated in women with structurally and functionally normal hearts, they pose significant risks for those with adult CHD (ACHD), whether repaired, palliated, or with residual defects. Maternal CHD is associated with an increased risk of adverse CV events, including stroke, heart failure, arrhythmias, and thromboembolic complications during pregnancy and the peripartum period. Effective management requires a multidisciplinary team, including cardiologists, perinatologists, anesthesiologists, and other skilled care providers. Risk stratification tools such as the modified World Health Organization classification, CARPREG II, and ZAHARA scores are useful for predicting maternal and fetal outcomes and guiding clinical decision-making. Preconception counseling plays a critical role in assessing individual risks, optimizing cardiac function, and educating patients about potential complications. Future research should prioritize innovative therapies, including targeted pharmacological agents and minimally invasive interventions, alongside improved screening methods to identify high-risk patients before symptomatic disease manifests. This review synthesizes current literature on managing pregnant women with ACHD, highlights gaps in clinical practice, and explores future directions to enhance care. Addressing these challenges is essential to improving maternal and fetal outcomes and ensuring comprehensive, patient-centered care throughout the reproductive journey.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 6","pages":"106295"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508640","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":"<i>RAF1</i> mutation expands the cardiac phenotypic spectrum of Noonan syndrome: A case report.","authors":"Nan Ma, Zhong-Wei Li, Jia-Jia Liu, Xing-Guang Liu, Xing Zhou, Bo-Wen Wang, Yan-Ling Li, Tian-Cheng Zhang, Ping Xie","doi":"10.4330/wjc.v17.i6.106525","DOIUrl":"10.4330/wjc.v17.i6.106525","url":null,"abstract":"<p><strong>Background: </strong>Noonan syndrome is a relatively common autosomal dominant genetic disorder characterized by cardiovascular defects owing to functional abnormalities in key genes such as <i>RAF1</i>. Mutations in <i>RAF1</i> are typically associated with hypertrophic cardiomyopathy (HCM). However, in this case, the patient exhibited atrial and ventricular septal defects (VSDs).</p><p><strong>Case summary: </strong>This case report describes an 11-year-old boy diagnosed with Noonan syndrome, in whom genetic testing revealed a c.770C>T (p.Ser257 Leu) mutation in <i>RAF1</i>. The patient presented with intermittent chest discomfort and shortness of breath, symptoms that significantly worsened after physical activity. Clinical evaluation revealed marked growth retardation and multiple physical abnormalities. Electrocardiographic and echocardiographic assessments revealed VSDs, atrial septal defects, and left ventricular outflow tract obstruction. Following multidisciplinary consultation, the patient underwent cardiac surgical intervention, which led to clinical improvement; however, they subsequently developed a third-degree atrioventricular block, necessitating the implantation of a permanent pacemaker. During follow-up, echocardiographic findings demonstrated near-complete resolution of the shunt across the atrial and ventricular septa, significant improvement in left ventricular outflow tract obstruction, and notable reduction in ventricular septal thickness. A genetic mutation at the c.770C>T (p.Ser257 Leu) locus of <i>RAF1</i> is typically associated with HCM and pulmonary hypertension. However, this patient's clinical phenotype manifested as HCM, atrial septal defect, and VSD, suggesting that this mutation may involve a different pathophysiological mechanism.</p><p><strong>Conclusion: </strong>This case confirms the genotype-phenotype heterogeneity of Noonan syndrome and highlights the complex management requirements of <i>RAF1</i> mutation-associated cardiac pathologies. Early surgical intervention can ameliorate structural defects, but it must be integrated with genetic counseling and lifelong monitoring to optimize patient outcomes.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 6","pages":"106525"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508628","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":"Mood alteration and heart rate variability in patients with cancer on treatment.","authors":"Yun-Chen Chang, Wei-Nung Liu, Felicia Lin, Gen-Min Lin","doi":"10.4330/wjc.v17.i6.107114","DOIUrl":"10.4330/wjc.v17.i6.107114","url":null,"abstract":"<p><p>In this article, Deng and Song showed compelling evidence on the connection between heart rate variability (HRV) alterations and cancer in 127 cancer patients compared with healthy reference individuals, highlighting autonomic nervous system dysfunction as a significant physiological manifestation in cancer patients. We discussed that the reduced HRV may be associated with cancer treatments, <i>e.g.</i>, operation, chemotherapy and pain control and psychological response such as depression and anxiety related to the affected cancer. A management such as medicine to mood disturbances related to cancer has been shown a benefit to improve HRV in cancer patients.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 6","pages":"107114"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508639","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":"Acute myocardial infarction in the young: A 3-year retrospective study.","authors":"Ahmed Hegazi Abdelsamie, Hani Omar Abdelhadi, Ahmed Taha Abdelwahed","doi":"10.4330/wjc.v17.i6.106445","DOIUrl":"10.4330/wjc.v17.i6.106445","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial infarction (AMI) is rare among patients aged ≤ 40 years but imposes significant morbidity, psychological distress, and economic burden. Approximately 10% of AMI hospitalizations involve patients under 45 years, underscoring the need to study this group. Compared to older patients, young AMI patients exhibit fewer traditional risk factors (<i>e.g.</i>, hypertension, diabetes) but higher rates of smoking, obesity, and non-atherosclerotic causes like spontaneous coronary artery dissection or coronary spasm, often linked to substance use. Global trends show rising obesity and dyslipidemia in young populations, with smoking contributing to 62%-90% of AMI cases in this age group. Family history of coronary artery disease also elevates risk, particularly in acute coronary syndrome. Studies like Bhardwaj <i>et al</i> report that young AMI patients are predominantly male with single-vessel disease, unlike the multi-vessel disease typical in older cohorts. This study characterizes AMI in young adults (≤ 40 years) at a single center, focusing on presentation, risk factors, angiographic findings, and management to guide preventive strategies.</p><p><strong>Aim: </strong>To describe the characteristics of AMI in young patients, including presentation, risk factors, coronary angiography (CAG) findings, and management strategies.</p><p><strong>Methods: </strong>This retrospective cross-sectional study analyzed 91 patients aged 20-40 years diagnosed with AMI at Mouwasat Hospital Dammam, from June 2020 to May 2023. Data on clinical presentation, cardiovascular risk factors, CAG findings, and treatments were collected from medical records. Descriptive statistics were used to summarize findings.</p><p><strong>Results: </strong>Of 91 patients (96.7% male, mean age 35.9 years ± 3.4 years), 43.9% were obese (body mass index > 30 kg/m²). Hyperlipidemia was the most prevalent risk factor (69.2%), followed by smoking (49.5%), diabetes mellitus (33.0%), and hypertension (26.4%). ST-elevation myocardial infarction (STEMI) was the most common presentation (57.1%). The left anterior descending artery was frequently affected (78.0%), with single-vessel disease predominant (72.5%). Most patients underwent percutaneous coronary intervention (PCI) (74.7%), while 8.8% required surgery.</p><p><strong>Conclusion: </strong>Young AMI patients are predominantly obese males with hyperlipidemia and smoking as key risk factors, presenting with STEMI and single-vessel disease amenable to PCI.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 6","pages":"106445"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508629","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":"Eosinophilic myocarditis due to parasitic infection: A case-based minireview.","authors":"Thang Viet Luong, Tien Anh Hoang, Nong Ni Pham, Suong Thi Mai Nguyen, Quoc Bao Tran, Hung Minh Nguyen, Thang Chi Doan, Binh Anh Ho, Hai Nguyen Ngoc Dang","doi":"10.4330/wjc.v17.i6.107729","DOIUrl":"10.4330/wjc.v17.i6.107729","url":null,"abstract":"<p><p>Eosinophilic myocarditis (EM) is a rare inflammatory condition of the heart, often associated with eosinophilic infiltration. While its causes range from allergies to autoimmune and infectious diseases, parasitic infections are an uncommon but critical etiology. This mini-review focuses on a case of EM in a 47-year-old male from Vietnam, linked to <i>Schistosoma spp.</i>, <i>Strongyloides stercoralis</i>, and <i>Toxocara spp.</i> infections. The patient presented with severe chest pain and recovered fully after treatment with corticosteroids and albendazole. Drawing insights from this case and existing literature, we discuss the pathophysiology, diagnostic approaches, and therapeutic strategies for parasite-induced EM. Early diagnosis and tailored treatment are essential to improve clinical outcomes, especially in endemic parasitic areas.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 6","pages":"107729"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508632","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":"Metabolic-dysfunction associated steatotic liver disease and atrial fibrillation: A review of pathogenesis.","authors":"Inderjeet Singh Bharaj, Ajit Singh Brar, Jasraj Kahlon, Anmol Singh, Priya Hotwani, Vikash Kumar, Aalam Sohal, Akash Batta","doi":"10.4330/wjc.v17.i6.106147","DOIUrl":"10.4330/wjc.v17.i6.106147","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) significantly contributes to cardiovascular morbidity, with cardiovascular disease being the leading cause of mortality among affected individuals. Atrial fibrillation (AF), the most common cardiac arrhythmia, is frequently observed in patients with MASLD. While shared metabolic risk factors such as obesity, diabetes, dyslipidemia, and hypertension are implicated, underlying pathophysiological mechanisms that include systemic inflammation, oxidative stress, insulin resistance, endothelial dysfunction, and activation of the renin-angiotensin-aldosterone system (RAAS) are proposed to play significant part in the increased risk of AF in MASLD. The aim is to review the pathogenesis linking MASLD and AF. A comprehensive literature review was conducted, focusing on studies that explore the epidemiology, pathogenesis, and clinical implications of MASLD and AF. Databases searched included PubMed, Scopus, and Web of Science, with keywords such as \"metabolic associated steatotic liver disease\", \"non fibrotic metabolic associated steatohepatitis\", \"Nonalcoholic fatty liver disease\", \"metabolic syndrome\", \"atrial fibrillation\", \"antifibrotic therapies\", \"pathogenesis\", and \"cardiovascular risk\". Chronic low-grade inflammation and oxidative stress in MASLD contribute to atrial structural and electrical remodeling, fostering an arrhythmogenic substrate. Insulin resistance, a hallmark of MASLD, exacerbates metabolic dysfunction and promotes atrial fibrosis. Dysregulated lipid metabolism and gut microbiota alterations further compound cardiovascular risk. Aldosterone dysregulation and systemic inflammation stemming from RAAS activation contributes to the shared pathophysiology. The severity of MASLD does not seem to directly influence the risk of AF, suggesting that even early stages of liver disease can increase susceptibility to this arrhythmia. Effective management of MASLD requires targeted risk-factor modification strategies, including weight management, glycemic control, and pharmacological interventions. A multidisciplinary approach is essential for comprehensive assessment and management of MASLD patients, with a focus on cardiovascular risk assessment and arrhythmia prevention. Future research should explore the impact of emerging MASLD therapeutic agents on the incidence and recurrence of cardiac arrhythmias. Early detection and comprehensive management of MASLD and AF are crucial to mitigate the dual burden of these conditions.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 6","pages":"106147"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508638","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":"Osteosarcopenia in older adults undergoing transcatheter aortic valve replacement: A narrative review of mortality and frailty implications.","authors":"Peng Li, Hui-Ping Zhang","doi":"10.4330/wjc.v17.i5.107320","DOIUrl":"10.4330/wjc.v17.i5.107320","url":null,"abstract":"<p><p>This narrative review examines osteosarcopenia, characterized by the concurrent loss of muscle mass and bone density, as a pivotal marker of frailty in older adults. Its implications for patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis remain underexplored. This review examines the association between osteosarcopenia and adverse clinical outcomes in older adults undergoing TAVR, with an emphasis on mortality. It also evaluates the integration of osteosarcopenia into pre-procedural risk assessments. Contemporary studies were reviewed, focusing on older adults undergoing TAVR. Key parameters included pre-procedural assessments of muscle mass (psoas cross-sectional area) and bone density (lumbar trabecular attenuation) using computed tomography. Clinical correlations with frailty indices, nutritional deficiencies, functional disability and mortality were analyzed. Studies including the FRAILTY-AVR cohort indicate that osteosarcopenia affects 15%-20% of TAVR patients and independently predicts 1-year mortality. Combined deficits in muscle and bone health are associated with elevated risks of post-TAVR complications, prolonged hospitalizations, and worsening disability compared to isolated sarcopenia or osteoporosis (<i>P</i> < 0.05). Incorporating osteosarcopenia into risk stratification models could enhance predictive accuracy for adverse outcomes. Osteosarcopenia serves as a critical biomarker for frailty and should be routinely assessed in pre-TAVR evaluations. Targeted interventions, such as resistance training and nutritional optimization, may mitigate its impact and improve clinical outcomes. Early identification facilitates personalized management strategies, enhancing survival and quality of life in this high-risk cohort.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 5","pages":"107320"},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267384","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}