CJC Open最新文献

{"title":"Successful Heart Transplantation in a Patient with Sporadic Inclusion Body Myositis—A Case Report","authors":"Aarti Kumar MD , Ifunanyachukwu Okwuosa , Shaitalya Vellanki MD , Megan Kamath MD","doi":"10.1016/j.cjco.2025.10.021","DOIUrl":"10.1016/j.cjco.2025.10.021","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 4","pages":"Pages 466-468"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel De Novo DES Mutation Associated with Early-Onset Restrictive Cardiomyopathy and Complex Phenotype: A Case Report","authors":"Ziru Sun PhD , Yarui Zhao PhD , Yijie Luo PhD , Qian Wang PhD , Xinyu Zhang MD, PhD , Huixia Lu MD, PhD , Xiaoping Ji MD, PhD","doi":"10.1016/j.cjco.2025.12.003","DOIUrl":"10.1016/j.cjco.2025.12.003","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 4","pages":"Pages 392-395"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Nature and Impact of Chest Pain in Postural Orthostatic Tachycardia Syndrome","authors":"Kavithra Karalasingham BHSc ,&nbsp;Mishal Fayyaz ,&nbsp;Robert S. Sheldon MD PhD ,&nbsp;Kathryn King-Shier RN, PhD ,&nbsp;Satish R. Raj MD, MSCI","doi":"10.1016/j.cjco.2025.12.002","DOIUrl":"10.1016/j.cjco.2025.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Postural orthostatic tachycardia syndrome (POTS) is a chronic autonomic disorder that predominantly affects female patients of childbearing age. Chest pain is a common and debilitating symptom in POTS, but the nature of the chest pain and the patient experience surrounding it remain poorly understood.</div></div><div><h3>Methods</h3><div>A qualitative descriptive design was used. Sixteen patients diagnosed with POTS who were experiencing chest pain were recruited. Semistructured video interviews were conducted that explored the nature and impact of chest pain in daily life. Transcribed interviews were manually analyzed using conventional content analysis.</div></div><div><h3>Results</h3><div>Most patients described their chest pain as sharp and stabbing, often radiating from the left side of the chest to the jaw, back, or arms. Triggers for chest pain included physical exertion, such as walking and using stairs, and high temperatures; few described the pain as unpredictable. Frequency and duration of pain varied widely across patients, with episodes of pain ranging from fleeting to constant. Many shared that chest pain restricted physical activities that they once engaged in with their peers and that their social lives were directly affected, as shortness of breath from talking could trigger chest pain. Many patients also described feelings of isolation and frustration because of both their limited social and physical activities and recognition of a decrease in their overall capabilities. The most common coping strategies to mitigate chest pain were sitting or lying down and breathing strategies.</div></div><div><h3>Conclusions</h3><div>Chest pain in POTS affects multiple dimensions of patients’ lives and requires ongoing adaptation and coping.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 4","pages":"Pages 440-447"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening Transitions in Care for Patients with ST-Elevation Myocardial Infarction: A Theory-Based Qualitative Study","authors":"Jacob Crawshaw PhD ,&nbsp;Marija Corovic MSc ,&nbsp;Muhammad Ajlan MBBS, FRCPC, ABIM ,&nbsp;Karen D. Mosleh MSc ,&nbsp;Madhu Natarajan MD, FRCPC ,&nbsp;J.D. Schwalm MSc, MD, FRCPC","doi":"10.1016/j.cjco.2025.12.004","DOIUrl":"10.1016/j.cjco.2025.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Despite strong evidence for secondary prevention after ST-elevation myocardial infarction (STEMI), adherence to pharmacotherapy and participation in cardiac rehabilitation remain suboptimal. Fragmented transitions from hospital to outpatient care contribute to early discontinuation, inadequate self-management support, and delayed functional and psychological recovery, particularly in regional systems without standardized follow-up care. This study examined barriers and enablers to post-STEMI transitions in care using a theory-informed qualitative approach.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with STEMI patients (n = 14), healthcare providers (n = 8), and system leaders (n = 4) within a regional cardiac network in Ontario, Canada. Interview guides were informed by the Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR). Data were analyzed using directed content analysis.</div></div><div><h3>Results</h3><div>Patients reported barriers including knowledge gaps about symptoms and treatment (TDF domain: knowledge), difficulty sustaining behavioural routines (TDF: behavioural regulation domain), and logistical challenges in accessing services (TDF: environmental context and resources domain). Providers and leaders emphasized poor communication across settings (CFIR: networks and communication construct), limited follow-up planning (CFIR: planning construct), and lack of sustainable funding models (CFIR: available resources construct). Enablers included strong social support (TDF: social influences domain), expanded roles for nurse practitioners and pharmacists (TDF: social/professional role and identity domain), and openness to virtual follow-up models (CFIR: adaptability construct). Suggested solutions include structured discharge education, interdisciplinary collaboration, standardized follow-up systems, and fostering a culture supportive of implementation.</div></div><div><h3>Conclusions</h3><div>Applying behavioural and implementation frameworks identified multilevel barriers and enablers to post-STEMI follow-up. Actionable strategies, such as structured education, interdisciplinary care, and expanded nonphysician roles, could strengthen secondary prevention and improve outcomes.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 4","pages":"Pages 430-437"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid Transcatheter-Edge-to-Edge-Repair and Transcatheter Tricuspid Valve Replacement for Tricuspid Regurgitation: Patient Profiles and Outcomes","authors":"Julius Jelisejevas MD ,&nbsp;Brian Chiang MD ,&nbsp;Ali Husain MBBCh ,&nbsp;Gnalini Sathananthan MBCHB ,&nbsp;Robert Moss MD ,&nbsp;Philipp Blanke MD ,&nbsp;Jonathon A. Leipsic MD ,&nbsp;Janarthanan Sathananthan MD ,&nbsp;Giacomo M. Cioffi MD ,&nbsp;Mario Togni MD ,&nbsp;Stéphane Cook MD ,&nbsp;D. Scott Lim MD ,&nbsp;Anson Cheung MD ,&nbsp;John G. Webb MD ,&nbsp;David A. Wood MD ,&nbsp;Robert H. Boone MD","doi":"10.1016/j.cjco.2025.11.006","DOIUrl":"10.1016/j.cjco.2025.11.006","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter tricuspid valve replacement (TTVR) is typically reserved for patients in whom tricuspid valve transcatheter edge-to-edge repair (T-TEER) is deemed unsuitable or unlikely to provide effective treatment. Comparative data evaluating patient profiles, disease stage, and outcomes between T-TEER and TTVR are limited. We aimed to analyze and compare patient profiles, selection, and outcomes with either T-TEER or TTVR.</div></div><div><h3>Methods</h3><div>A total of 43 consecutive patients from May 2018 to April 2023 were retrospectively divided into 2 groups: Group-1 underwent T-TEER; and Group-2 underwent TTVR. Primary endpoints are as follows: inpatient mortality; and 30-day and 12-month mortality. Secondary endpoints are as follows: echocardiographic tricuspid regurgitationgrading; new pacemaker implantation; and heart failure-related readmissions at 30 days and 12 months.</div></div><div><h3>Results</h3><div>A total of 43 patients underwent intervention (T-TEER, n = 14; TTVR, n = 29;). The mean age was 77.6 ± 10.3 years, and 38 patients (88%) were diagnosed with functional tricuspid regurgitation. The in-hospital mortality rate was 7%; the 30-day mortality rate was 12% with heart failure readmission for 14%.The 12-month mortality rate was 33%, with heart failure readmission for 37%. No in-hospital or 30-day mortality occurred in the T-TEER group. The 12-month mortality rate was 29% in the T-TEER group vs 34% in the TTVR group. The TTVR cohort showed numerically younger patients (76.2 ± 10.6 vs 80.4 ± 9.6 years, <em>P</em> = 0.24) and numerically higher TRI-scores (for tricuspid; 6.0, interquartile range [IQR], 4.0-7.0 vs 4.5, 1.5-5.75, <em>P</em> = 0.09). The calculated GLIDE-score (<strong>g</strong>ap, <strong>l</strong>ocation, <strong>i</strong>mage quality, <strong>d</strong>ensity, <strong>e</strong>n-face TR morphology) was significantly lower in the T-TEER cohort (<em>P</em> &lt; 0.01). The length of hospitalization was significantly longer in the TTVR group (1, interquartile range, 1-4 vs 1, 1-1; <em>P</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that patients undergoing T-TEER vs TTVR may represent different disease stages. Further data are required to determine the best patient selection for T-TEER vs TTVR to optimize patient outcomes.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 4","pages":"Pages 411-419"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning–Based Model for Predicting Acute Kidney Injury in Patients Hospitalized with Heart Failure: Development and Validation Study","authors":"Yahui Li MD ,&nbsp;Xuhui Liu MS ,&nbsp;Xujie Wang MS ,&nbsp;Ling Zhou MD ,&nbsp;Chunxia Zhao MD","doi":"10.1016/j.cjco.2025.11.019","DOIUrl":"10.1016/j.cjco.2025.11.019","url":null,"abstract":"<div><h3>Background</h3><div>Acute kidney injury (AKI) substantially worsens outcomes in patients hospitalized with heart failure, yet effective early prediction tools remain limited. This study aimed to develop and validate a machine learning–based model for AKI prediction in heart failure patients.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 870 patients hospitalized for heart failure between October 2017 and June 2024. Missing values (&lt;30%) were imputed, and feature selection was performed using LASSO and backward stepwise logistic regression. Five machine learning models (XGBoost, LightGBM, Logistic Regression, Support Vector Machine, and Decision Tree) were developed and evaluated using ROC curves, precision–recall curves, calibration plots, and decision curve analysis.</div></div><div><h3>Results</h3><div>AKI occurred in 271 patients (31.2%). Baseline comparisons showed significant differences in renal function and electrolyte levels between AKI and non-AKI groups (all P&lt;0.05). Ten potential predictors were identified by LASSO, and seven remained significant after logistic regression. Among all models, XGBoost achieved the best discrimination with AUC of 0.927 (95% CI: 0.902–0.951) in the validation set. It showed excellent sensitivity (0.761), specificity (0.967), and positive predictive value (0.911). Calibration and decision curve analyses confirmed strong agreement and net clinical benefit. SHAP analysis indicated chronic kidney disease (OR=2.805, 95% CI: 1.461–5.383) and electrolyte disturbances as key predictors.</div></div><div><h3>Conclusions</h3><div>The proposed machine learning–based model accurately predicts AKI risk in heart failure patients, outperforming conventional methods. Its interpretability and robust performance suggest promising utility as a clinical decision support tool, warranting external validation.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 4","pages":"Pages 379-391"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise Volume and Coronary Artery Calcification: A Systematic Review","authors":"Chase J. Ellingson BKin ,&nbsp;Jyotpal Singh PhD ,&nbsp;M. Abdullah Shafiq BKin ,&nbsp;Neha Mehta PhD ,&nbsp;Sabiha Sultana MSc ,&nbsp;J. Patrick Neary PhD ,&nbsp;Yang Zhan MD ,&nbsp;Amir Ahmadi MD ,&nbsp;Matthew J. Budoff MD ,&nbsp;Payam Dehghani MD","doi":"10.1016/j.cjco.2025.12.009","DOIUrl":"10.1016/j.cjco.2025.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Exercise confers numerous health benefits, including a reduction in all-cause and cardiovascular (CV) mortality. However, conflicting evidence suggests that high-volume endurance exercise may increase coronary artery calcification, a robust predictor of CV events. This systematic review investigated the relationship between exercise volume and coronary artery calcium (CAC) scores.</div></div><div><h3>Methods</h3><div>A systematic search of Medline, Embase, PubMed, and the Cochrane Library (1990 to November 26, 2025) was conducted. Studies reporting exercise volume and CAC scores were included. The methodological index for nonrandomized studies (MINORS) scale was implemented to test study quality. Exercise volume (minutes per week) was stratified into 4 categories: low; moderate; moderate-high; and high.</div></div><div><h3>Results</h3><div>A total of 33 studies met the inclusion criteria: 15 reported higher CAC scores in their highest-volume groups; 8 showed no association or inverse associations; and 10 included single-cohort data. Nine of 12 comparative studies with participants exercising &gt; 450 min/wk showed higher CAC scores in high-volume exercisers. The majority of the 9 studies reporting clinical outcomes showed no relationship or an inverse association between exercise volume and mortality or CV events. Among 5 studies assessing plaque composition, 4 reported a more benign, calcified plaque composition among their high-volume exercisers, representing a potential mechanism for the lower risk of CV events and mortality reported in this population, compared to that of less-active individuals with similar CAC scores.</div></div><div><h3>Conclusions</h3><div>High-volume exercisers may have higher CAC scores compared to less-active cohorts. Despite elevated CAC scores, lower mortality and CV event rates observed in these groups challenge the clinical significance of this observation.</div></div><div><h3>Registration</h3><div>PROSPERO CRD42024607693.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 4","pages":"Pages 457-465"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brugada Phenocopy Induced by Kratom Overdose","authors":"Hamood Al-Harbi MD ,&nbsp;Sheldon M. Singh MD","doi":"10.1016/j.cjco.2025.11.005","DOIUrl":"10.1016/j.cjco.2025.11.005","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 3","pages":"Pages 325-326"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus Methodology for the Canadian Brain and Heart Clinical Practice Guidelines","authors":"Zhe Li PhD ,&nbsp;Sheldon Tobe MD ,&nbsp;Diana Sherifali RN, PhD ,&nbsp;Megan Racey PhD ,&nbsp;Diane Hua-Stewart MPH, MACP ,&nbsp;Christopher A. Gravel PhD ,&nbsp;Meghan Lewis MSc ,&nbsp;Sumali Mehta MSc ,&nbsp;Michael D. Hill MD ,&nbsp;Nazia Haider MHI ,&nbsp;Patrice Lindsay PhD ,&nbsp;Peter Liu MD ,&nbsp;Jodi D. Edwards PhD","doi":"10.1016/j.cjco.2025.11.018","DOIUrl":"10.1016/j.cjco.2025.11.018","url":null,"abstract":"<div><div>Brain and heart diseases are leading causes of morbidity and mortality globally. Emerging evidence suggests a close interplay between brain and heart conditions, due to overlapping risk factors, common mechanistic pathways, and genetic factors. Therefore, a call has been made for the use of more interdisciplinary approaches to the prevention and treatment of brain and heart conditions. In this paper, we report on the consensus methodology used for the development of the first Canadian brain and heart clinical practice guidelines. The consensus panel included 10 expert subgroups, to develop research questions and recommendations for specific brain-heart conditions, the McMaster Evidence Review and Synthesis Team, to support the literature search, review, and critical appraisal, and an evidence review team to ensure the rigor and consistent application of the methodology. The consensus process followed the Appraisal of Guidelines for Research and Evaluation II (AGREE II) framework, with the following 4 key stages: (i) the McMaster Evidence Review and Synthesis Team conducted systematic reviews and provided subgroups with data extraction and evaluation tools; (ii) A consensus conference was held, with evidence and recommendations evaluated and voted on by all subgroups; (iii) the evidence review team conducted a final review of evidence for each subgroup and determined the level and strength of each recommendation; and (iv) final recommendations and evidence levels were submitted to all subgroups for ratification and approval by the steering committee. This paper summarizes and describes the consensus methods used to evaluate and integrate evidence from both the cardiac and neurological medical literature for the development of the first Canadian brain and heart clinical practice guidelines.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 3","pages":"Pages 336-343"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Role of Endothelial Cells in the Pathophysiology, Diagnosis, and Management of Acute Kawasaki Disease","authors":"Antonino Calvaruso MD ,&nbsp;Laura Andreozzi MD, PhD ,&nbsp;Lucia Paolini MD ,&nbsp;Fiorentina Guida MD ,&nbsp;Arianna Catelli MD ,&nbsp;Eleonora Bellini MD ,&nbsp;Eleonora Battelli MSc ,&nbsp;Marcello Lanari MD, PhD ,&nbsp;Marianna Fabi MD, PhD","doi":"10.1016/j.cjco.2025.11.001","DOIUrl":"10.1016/j.cjco.2025.11.001","url":null,"abstract":"<div><div>The vital role of the endothelium in Kawasaki disease (KD) has been clear for over 20 years. Endothelial cells (ECs) play a critical role in the pathophysiology of the disease, being the target of several molecular pathways resulting in EC damage, dysfunction, and potential detachment or transition to another cell phenotype. The alteration of endothelium health is crucial for the development of coronary artery damage. In children with KD, molecular components or cells are released from injured endothelium and can be measured in peripheral blood samples, suggesting several potential diagnostic and therapeutic implications. Novel diagnostic and therapeutic strategies focusing on ECs and on the pathways that result in endothelial damage have been investigated, but to date, the evidence is not yet strong enough to change clinical practice. Nonetheless, results are promising and provide a reliable basis to guide the design of translational research, as seen with statins, which have confirmed their beneficial effects on vascular integrity in later stages of KD, including in clinical studies. The purpose of this narrative review is to provide a comprehensive overview of the current knowledge on the role of ECs in the pathophysiology, diagnosis, and management of KD, and to synthesize the available evidence to guide further research aimed at confirming the viability of these new strategies.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 3","pages":"Pages 356-369"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}