Heart Views最新文献

{"title":"Hypertrophic Cardiomyopathy in Iran: General Characteristics, Clinical Presentations, Imaging Features, and Major Adverse Cardiovascular Events of 322 Patients.","authors":"Saman Rostambeigi, Negin Mahmoudi Hamidabad, Sarah Nadri, Azin Alizadehasl, Erfan Hashemi, Hamidreza Pouraliakbar, Anita Sadeghpour","doi":"10.4103/heartviews.heartviews_155_24","DOIUrl":"10.4103/heartviews.heartviews_155_24","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertrophic cardiomyopathy (HCM), the most common inherited cardiomyopathy, has significant clinical presentation and outcome diversity. Early diagnosis and proper management are essential to improve the patient's quality of life and prevent sudden cardiac death. Collecting patient information in each country is the first step in finding the gaps in the proper diagnosis and management of these patients. We aimed to determine the general characteristics of HCM in the largest referral tertiary heart center in Iran.</p><p><strong>Methods: </strong>In this cross-sectional study, between 2016 and 2020, clinical, imaging, and therapeutic data of patients diagnosed with HCM at Rajaie Cardiovascular Medical Research Center were reviewed and followed up to 48 months for Major adverse cardiovascular events (MACE), defined as composite endpoint of death, stroke (nonfatal), hospitalization due to decompensated heart failure (HF) and malignant ventricular arrhythmia defined as sustained ventricular tachycardia or ventricular fibrillation.</p><p><strong>Results: </strong>A total of 322 patients, with a mean age of 49.7 ± 1 years, including 129 women (40%), were studied. Women were significantly older than men (53.1 ± 9.1 vs. 47.2 ± 8.9, <i>P</i> < 0.0001). The most prevalent symptom was dyspnea on exertion, affecting 158 patients (49%). Nonobstructive HCM was present in 180 patients (55.9%), and atrial fibrillation was observed in 82 patients (25.46%). Major Adverse Cardiovascular Events were more frequent in patients with obstructive forms of the disease. Beta-receptor-blocking agents were the most used medication (85%). In addition, 29 patients (9% overall and 20.4% of those with obstructive forms) were treated with disopyramide, and 19 patients (5.9%) underwent surgical myectomy. Late gadolinium enhancement (LGE) was detected in 56 out of 122 patients (45.9%) who underwent cardiac magnetic resonance imaging. MACE incidence was notably higher in patients with positive LGE. Overall, MACE occurred in 110 patients (34.16%). Malignant ventricular arrhythmias were reported in 64 patients (19.87%), HF in 36 patients (11.18%), and HCM-related death in 4 patients (1.24%).</p><p><strong>Conclusion: </strong>This study showed the general characteristics, clinical outcomes, and therapeutic approach of HCM patients in Iran. We found more MACE in obstructive versus nonobstructive forms and LGE ≥ 10%. Disopyramide and implantable cardioverter-defibrillator implantation are well-adapted therapeutic options, followed by surgical myectomy. However, genetic testing and alcohol septal ablation are uncommon procedures.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 2","pages":"88-95"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12571097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410166","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":"Evaluating the Role of Baseline Brain Natriuretic Peptide in Predicting Heart Failure Post-acute Coronary Syndrome: Systematic Review and Meta-analysis.","authors":"Alivia Retra Kusumowardani, Narendra Lintang Yudhisthira","doi":"10.4103/heartviews.heartviews_125_24","DOIUrl":"10.4103/heartviews.heartviews_125_24","url":null,"abstract":"<p><strong>Context: </strong>Heart failure (HF) is a frequent complication following acute coronary syndrome (ACS), leading to higher mortality and rehospitalization rates. Measurement of brain natriuretic peptide (BNP) is well established to diagnose HF, and its levels during ACS have been associated with poor outcomes.</p><p><strong>Aims: </strong>This review aims to assess the predictive value of baseline BNP in determining the risk of HF following ACS.</p><p><strong>Methods: </strong>The search for relevant studies was conducted through Medline database, focusing on studies that reported baseline BN<i>P</i> values in ACS patients, the incidence of HF after follow-up, and their possible association. Statistical analysis was performed using Review Manager.</p><p><strong>Results: </strong>Out of 647 studies, 10 met the inclusion criteria. Eight studies showed a positive association between baseline BNP and HF post-ACS. However, the meta-analysis revealed no significant difference in HF occurrence based on baseline BNP levels (odds ratio 1.83, 95% confidence interval [CI]: 0.11-29.07, <i>P</i> = 0.67). Although the development of HF was significantly correlated with higher baseline BNP (standard mean difference: 0.95, 95% CI: 0.54-1.37, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Elevated baseline BNP levels were associated with an increased likelihood of HF following ACS. However, BNP alone may not be a reliable predictor. Serial measurements and integration with other risk factors may improve its predictive accuracy.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 2","pages":"116-125"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12571093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410137","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":"Left-sided \"Scimitar-like\" Vein: Partial Anomalous Left Pulmonary Venous Drainage to Main Portal Vein.","authors":"Damandeep Singh, Niraj Nirmal Pandey, Sivasubramanian Ramakrishnan","doi":"10.4103/heartviews.heartviews_35_25","DOIUrl":"10.4103/heartviews.heartviews_35_25","url":null,"abstract":"","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 2","pages":"132-135"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12571098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410230","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 Intervention in Asymptomatic Patients with Severe Aortic Stenosis.","authors":"Rasha Kaddoura, Mohammed Al-Hijji","doi":"10.4103/heartviews.heartviews_7_25","DOIUrl":"10.4103/heartviews.heartviews_7_25","url":null,"abstract":"","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"69-70"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972047","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":"Ruptured Membranous Interventricular Septal Aneurysm Causing Left Ventricular Outflow Obstruction in Congenitally Corrected Transposition of Great Arteries.","authors":"Neeraj Kumar, Niraj Nirmal Pandey, Sivasubramanian Ramakrishnan, Priya Jagia","doi":"10.4103/heartviews.heartviews_3_25","DOIUrl":"10.4103/heartviews.heartviews_3_25","url":null,"abstract":"","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"67-68"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972083","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":"A Milestone in Cardiac Care in Iraq: One-year Follow-up after the Nation's First Continuous-flow Left Ventricular Assist Device Implantation, Paving the Way for Heart Transplantation.","authors":"Ali Saad Merzah, Jasmin Hanke, Günes Dogan, Salwan Qahtan, Saleh Mehdi Al-Hasnawi, Lukman Faily, Arjang Ruhparwar, Jan D Schmitto","doi":"10.4103/heartviews.heartviews_20_25","DOIUrl":"10.4103/heartviews.heartviews_20_25","url":null,"abstract":"<p><p>The first successful implantation of the HeartMate 3 LVAD in Iraq represents a transformative achievement in the nation's medical history. Conducted collaboratively by German and Iraqi teams in December 2023, the procedure addressed end-stage heart failure in a 60-year-old male. Despite significant healthcare challenges, the patient's functional status improved markedly, moving from New York Heart Association Class IV to Class I within a year. This groundbreaking case highlights the potential for Iraq to integrate advanced cardiac interventions into its healthcare system, paving the way for heart transplantation programs. Ongoing collaboration and investment in healthcare infrastructure will be pivotal for sustaining these innovations.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"58-61"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972131","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":"Arrhythmogenic Cardiomyopathy with Biventricular Involvement and Right Ventricular Thrombosis: A Multi-modality Imaging Approach.","authors":"Fawaz Bardooli, Dhuha Rashed Aljawder, Dileep Kumar, Sadananda Padavagodu Shivappa, Anna Baritussio","doi":"10.4103/heartviews.heartviews_145_24","DOIUrl":"10.4103/heartviews.heartviews_145_24","url":null,"abstract":"<p><p>Arrhythmogenic cardiomyopathy (AC) is an inherited heart disease characterized by fibro-fatty changes of either ventricles in isolation or in combination. AC may present with ventricular tachycardia (VT), usually with a left bundle branch block (LBBB) morphology (although VT with right bundle branch block morphology may also be encountered). Diagnosis is multi-parametric and cardiovascular magnetic resonance (CMR) holds a key role in showing the typical tissue abnormalities of the ventricles. We report the case of a patient presenting with LBBB VT with multi-modality imaging findings consistent with AC with biventricular involvement and right ventricular (RV) thrombosis. The patient was treated with antiarrhythmics, heart failure therapy, and implantable cardioverter-defibrillator implantation. RV thrombus was treated with new oral anticoagulants.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"48-53"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972090","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":"Simultaneous Kissing Balloon Inflation Technique for Coronary Protection during Transcatheter Aortic Valve Replacement.","authors":"Omar Aldalati, Mohammad Alkhalil, Mardi Hamra, Azfar Zaman, Richard Anderson","doi":"10.4103/heartviews.heartviews_141_23","DOIUrl":"10.4103/heartviews.heartviews_141_23","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) using the valve-in-valve (ViV) approach presents a substantial risk of coronary artery obstruction, which adversely impacts patient outcomes. In this report, we describe the utilization of the simultaneous kissing balloon inflation technique during ViV TAVR, which resulted in significant improvement in the patient's condition.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"54-57"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972117","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":"In-hospital Utilization and Dose Optimization of Guideline-Directed Medical Therapies among Acute Heart Failure Yemeni Patients.","authors":"Adnan Al-Radhi, Abdulkafi Shujaa, Nora Alsagheer, Taha Al-Maimoony, Ahmed Al-Motarreb","doi":"10.4103/heartviews.heartviews_152_24","DOIUrl":"10.4103/heartviews.heartviews_152_24","url":null,"abstract":"<p><strong>Background: </strong>Despite robust evidence and strong recommendations supporting the incremental and dose-related benefit of combined neurohormonal blockers (guideline-directed medical therapy [GDMT]) in heart failure with reduced ejection fraction (HFrEF), real-world data shows significant gaps in uses and/or dosing of these therapies.</p><p><strong>Rationale: </strong>As heart failure (HF) hospitalization is viewed as an opportunity for the initiation and optimization of HF life-saving medications and the paucity of data exploring this important issue in Yemen, the current study aims to fill this gap.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the use, number, and dose optimization of the GDMT in a cohort of hospitalized patients with HFrEF in Yemen.</p><p><strong>Materials and methods: </strong>We included 1408 Yemeni patients with available ejection fraction (EF) enrolled in the Gulf CARE registry from February to November 2012. In this analysis, we included only four classes of GDMT, renin-angiotensin system inhibitors (RASi), evidence-based beta-blockers, and mineralocorticoid receptor antagonist (MRA). Each drug dose was converted to the equivalent daily dose of a selected representative drug. We explored the prescription of these drugs either separately or in combination and the target dose (TD) achievement for each drug at admission and discharge.</p><p><strong>Results: </strong>Among the1408 patients recruited, 916 patients (65%) were males and mean age was 53.5 ± 15.4 years, 53% (n = 748) presented with HFrEF (EF < 40%), 21% (n = 299) with HFpEF (EF ≥ 50%), and 26% (n = 361) with HFmrEF (Heart failure with mildly reduced ejection fraction) (EF 40-49%). Beta-blockers, renin-angiotensin system inhibitors, and MRA were prescribed to 28% (<i>n</i> = 400), 51% (<i>n</i> = 716), and 10% (<i>n</i> = 143) at baseline and 69.5% (<i>n</i> = 978), 82% (<i>n</i> = 1157), and 59% (<i>n</i> = 831) on discharge, respectively. The rate of TD achievement was (0.0% vs. 3.6% (<i>n</i> = 35]) for beta-blockers and (0.279% [<i>n</i> = 2] vs. 1.5% [<i>n</i> = 17]) for renin-angiotensin system inhibitors on baseline and discharge, respectively. Among 748 patients with HFrEF, 36% (<i>n</i> = 270) were not receiving any GDMT at baseline, while triple therapy was prescribed to 10% (<i>n</i> = 74) at baseline and 61.5% (<i>n</i> = 460) on discharge.</p><p><strong>Conclusions: </strong>A substantial gap in GDMT implementations with both underutilization and low TD achievement in patients with HFrEF in Yemen.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"7-18"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972052","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":"Assessment of the Utilization of Lipoprotein (a) and its Relationship with Cardiovascular Outcomes: A Retrospective Cohort Study from a Public Hospital in New York City.","authors":"Maisha Maliha, Natalia Nazarenko, Sanjana Nagraj, Vikyath Satish, Amrin Kharawala, Pawel Borkowski, Vibhor Garg, Tinatin Saralidze, Dimitrios Karamanis, Leonidas Palaiodimos","doi":"10.4103/heartviews.heartviews_138_24","DOIUrl":"10.4103/heartviews.heartviews_138_24","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Lipoprotein (a) [Lp(a)] is an independent genetic risk factor for atherosclerotic cardiovascular disease (ASCVD) and is associated with an increased risk of heart failure (HF), multiple vascular and valvular abnormalities and is closely linked to various lipid components, particularly low-density lipoprotein (LDL) cholesterol. Despite its clinical significance, Lp(a) testing has not gained widespread use in healthcare practice. Our study aimed to assess the utilization of Lp(a) testing and its association with ASCVD risk factors, HF phenotypes, vascular and valvular pathologies, lipid profiles, and the use of lipid-lowering drugs at a safety-net hospital within the largest municipal healthcare system in the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective study at Jacobi Medical Center, a public hospital in the Bronx, New York. Using a cutoff value of 75 nmol/L, we compared a study group with elevated Lp(a) levels to a control group. The primary outcomes assessed were the association between Lp(a) levels and ASCVD risk factors, HF phenotypes (classified by left ventricular ejection fraction), and vascular and valvular pathologies. Secondary outcomes included the relationship between elevated Lp(a) levels and lipid profiles, as well as the use of lipid-lowering medications such as statins, proprotein convertase subtilisin/kexin type 9 inhibitors, and ezetimibe.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 78 patients (41.0% female, median age 52.0 years, interquartile range 44.0-66.0 years). Patients with elevated Lp(a) had a significantly higher incidence of HF with preserved ejection fraction (HFpEF) (18.8% vs. 0%, &lt;i&gt;P&lt;/i&gt; = 0.004), but there was no significant association with HF with reduced ejection fraction (15.6% vs. 36.3%, &lt;i&gt;P&lt;/i&gt; = 0.613) or HF with midrange ejection fraction (12.5% vs. 13.6%, &lt;i&gt;P&lt;/i&gt; = 0.061). No significant associations were found between elevated Lp(a) and ASCVD risk factors, or valvular and vascular pathologies. However, patients with high Lp(a) levels had significantly higher LDL levels (96.5 mg/dL vs. 73.0 mg/dL, &lt;i&gt;P&lt;/i&gt; = 0.04). There was no significant association between the use of lipid-lowering drugs and elevated Lp(a) levels. Notably, some patients exhibited unexpectedly high Lp(a) levels despite having a comparable demographic and comorbidity risk profile to those with normal Lp(a) levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients with elevated Lp(a) levels were more likely to present with HFpEF and elevated LDL levels, although no significant associations were found with ASCVD risk factors, vascular, or valvular pathologies. The unexpectedly high Lp(a) levels in some individuals with similar risk profiles suggest the need for further research to refine guidelines for Lp(a) testing. Our study also highlighted the underutilization of Lp(a) testing in clinical practice, underscoring the importance of increasing awareness and improving ASCV","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"26 1","pages":"19-27"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972095","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}