Current Problems in Cardiology最新文献

{"title":"Atrial Myopathy in Persistent Atrial Fibrillation: Three-Dimensional Quantification of Atrial Fibrosis by High-Density Electro-Anatomic Mapping and Its Association with Arrhythmia Duration.","authors":"Rogelio Robledo-Nolasco, Elias Noel Andrade-Cuellar, Juan Carlos Solis-Gómez, Saul Yair Guillot-Castillo, Jose Javier Ik Yahalcab Zamora-Diaz, Rocio Aceves-Millan, Andrea Paulina Maldonado-Tenesaca, Maria Alejandra Monroy-Jimenez, Ivan Alejandro Elizalde-Uribe, Daniel Torres Peynado, Rodrigo Bonilla-Figueroa, Kevin Josué Acevedo-Gómez","doi":"10.1016/j.cpcardiol.2025.103193","DOIUrl":"https://doi.org/10.1016/j.cpcardiol.2025.103193","url":null,"abstract":"<p><strong>Background: </strong>Progressive atrial myopathy marked by fibrotic remodelling drives the transition from paroxysmal to persistent atrial fibrillation (AF), yet the temporal dynamics of fibrosis within persistent AF remain poorly defined.</p><p><strong>Objective: </strong>To quantify dense scar and borderline fibrotic zones using high-density electro-anatomic mapping (HD-EAM) in patients with persistent AF, and to compare fibrotic burden between early persistent (>7 days-<3 months) and persistent (≥3 months-<1 year) AF.</p><p><strong>Methods: </strong>Retrospectively analysed 78 consecutive patients (59 ± 15 years, 59% men) undergoing first-time pulmonary vein isolation for persistent AF. Atrial voltage maps (CARTO 3 CONFIDENSE™) acquired in sinus rhythm classified tissue as healthy (>0.5 mV), borderline (0.3-0.5 mV), or dense scar (<0.2 mV). Echocardiographic left atrial diameter (LAD) and volume (LAV) were compared with mapping data. The primary endpoint was dense scar point count; secondary endpoints included AF/atrial tachycardia recurrence and correlation between imaging modalities.</p><p><strong>Results: </strong>Twenty-two patients had early persistent and 56 persistent AF. Mapping resolution was similar (5 193 ± 459 vs 5 399 ± 601 points, p = 0.83). Dense scar points were significantly higher in persistent AF (2 807 ± 336 vs 1 634 ± 236; p < 0.001). LAD and LAV from HD-EAM correlated moderately with echocardiography (r = 0.45 and 0.48; both p < 0.01) but did not differ between groups. After 7.2 ± 3.7 months, recurrence occurred in 16% of persistent versus 8% of early persistent AF (p = 0.11).</p><p><strong>Conclusions: </strong>Fibrotic burden increases markedly after three months of uninterrupted AF despite stable atrial size. HD-EAM enables intra-procedural quantification of atrial myopathy and may guide personalised ablation strategies.</p>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103193"},"PeriodicalIF":3.3,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An apparent paradox in visit-to-visit blood pressure variability and adverse outcomes in malignant hypertension patients: The West Birmingham malignant hypertension registry","authors":"Antonios A. Argyris ,&nbsp;Alena Shantsila ,&nbsp;D. Gareth Beevers ,&nbsp;Eduard Shantsila ,&nbsp;Gregory Υ.Η. Lip","doi":"10.1016/j.cpcardiol.2025.103192","DOIUrl":"10.1016/j.cpcardiol.2025.103192","url":null,"abstract":"<div><h3>Background</h3><div>Malignant phase hypertension (MHT) is a severe form of hypertension with high morbidity and mortality; data on the association of visit-to-visit blood pressure (BP) variability and outcomes are lacking. Given that such high BP variability has been associated with poorer outcomes in the general hypertensive population, our aim was to examine the prognostic role of visit-to-visit BP variability with cardiovascular disease and mortality in this high risk MHT population.</div></div><div><h3>Methods</h3><div>Data from the West Birmingham MHT Registry were analyzed. We calculated quartiles of visit-to-visit BP variability and used Kaplan-Meier curves and Cox proportional hazard models to examine the association of BP variability with incidence of outcomes.</div></div><div><h3>Results</h3><div>A total of 339 patients (age 48 ± 13 years, 65 % male) were included, with a median follow-up 11 years (IQR 3-18). On Kaplan-Meier analyses, subjects in the highest variability quartiles had significantly lower risk of cardiovascular disease, all-cause mortality and all-cause mortality/dialysis than patients in the lower quartiles (log rank <em>p</em> &lt; 0.001). In Cox proportional hazard models, higher systolic BP variability was associated with lower incidence of all outcomes [HR (95 % CI): 0.266 (0.128-0.552) for higher vs lower quartile for all-cause mortality]. Higher diastolic BP variability was associated with lower risk of mortality outcomes [HR (95 % CI): 0.236 (0.107-0.519)]. This effect was attenuated in the subgroup with better BP control at follow-up.</div></div><div><h3>Conclusions</h3><div>Higher visit-to-visit BP variability was associated with lower prevalence of cardiovascular disease and mortality in a MHT population. Given the extremely high initial BP of MHT patients, the high BP variability reflects likely better BP control in the follow up visits, re-emphasizing the crucial role of early and rapid control of BP in this high-risk population.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 12","pages":"Article 103192"},"PeriodicalIF":3.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of neuromodulation in heart failure with preserved ejection fraction","authors":"Jumana Algheffari ,&nbsp;Abdel Rahman Salameh ,&nbsp;Lina Adil ,&nbsp;Aamir Hameed ,&nbsp;Kurdo Araz","doi":"10.1016/j.cpcardiol.2025.103189","DOIUrl":"10.1016/j.cpcardiol.2025.103189","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome with limited treatment options to improve long-term outcomes such as quality of life, exercise capacity, and mortality. Neuromodulation-based therapies have emerged as potential interventions to address autonomic dysregulation in HFpEF. This review discusses the long-term efficacy and safety of four key neuromodulation therapies: Renal Denervation (RDN), Baroreceptor Activation Therapy (BAT), Vagus Nerve Stimulation (VNS), and Greater Splanchnic Nerve (GSN) Ablation. Each therapy shows promise, but variability exists in terms of patient outcomes, procedural risks, and long-term durability. This paper evaluates the pros and cons of each approach, focusing on their potential to improve clinical outcomes in diverse HFpEF phenotypes.</div></div><div><h3>Objective</h3><div>To summarise and critically assess the role of neuromodulation-based devices in managing HFpEF, including their mechanisms, efficacy, and impact on patient outcomes.</div></div><div><h3>Methods</h3><div>We reviewed clinical trials and studies involving neuromodulation therapies for HFpEF, focusing on VNS, RDN, BAT, and GSN. The review includes randomised controlled trials and feasibility studies assessing various endpoints such as functional status, QoL, exercise capacity, and adverse events.</div></div><div><h3>Results</h3><div>Neuromodulation therapies show potential in improving symptoms and QoL for HFpEF patients. The ANTHEM-HFpEF trial demonstrated VNS's efficacy in enhancing functional status and autonomic tone, although cardiac mechanical function showed minimal change. RSD trials, including RDT-PEF and UNLOAD-HFpEF, indicated mixed results with some improvements in symptoms and cardiac function, though limitations like sample size and device effectiveness persist. BAT, through the BAROSTIM NEO System, has shown promise in reducing sympathetic activity and improving heart failure symptoms. The GSN ablation trials indicated significant reductions in pulmonary capillary wedge pressure (PCWP) and improved exercise capacity, though further large-scale studies are needed to confirm these findings.</div></div><div><h3>Conclusions</h3><div>Neuromodulation-based device interventions represent a promising frontier in HFpEF management, offering potential improvements in symptoms, QoL, and functional status. However, the variability in trial outcomes and the need for further research underscore the necessity for continued investigation to fully establish the efficacy and safety of these therapies.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 12","pages":"Article 103189"},"PeriodicalIF":3.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted antihypertensive therapy after hypertensive pregnancy: Lactation-safe choices, treatment thresholds, and outcomes (2015–2025)","authors":"Abdulhakim M. Alhazmi ,&nbsp;Arif Albulushi","doi":"10.1016/j.cpcardiol.2025.103191","DOIUrl":"10.1016/j.cpcardiol.2025.103191","url":null,"abstract":"<div><h3>Background</h3><div>Postpartum hypertension is a leading driver of emergency visits and readmissions within 6 weeks of delivery, yet optimal therapy must balance BP control with lactation safety.</div></div><div><h3>Objective</h3><div>To synthesize contemporary evidence (Jan 2015–Aug 2025) on postpartum antihypertensives with emphasis on breastfeeding compatibility, treatment thresholds/targets, and maternal–infant outcomes. Data Sources: PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane, ClinicalTrials.gov/ICTRP, and guideline repositories (AHA/ACOG/NICE), plus LactMed and UK Specialist Pharmacy Service (SPS). Eligibility: RCTs, comparative cohorts/case–control studies, and ≥10-patient case series reporting postpartum outcomes or lactation data.</div></div><div><h3>Results</h3><div>First-line postpartum agents compatible with breastfeeding in term, healthy infants are dihydropyridine calcium-channel blockers (nifedipine, amlodipine), ACE inhibitors (enalapril), and labetalol. Multiple large cohorts associate nifedipine (at discharge) with lower hypertension-related readmissions than labetalol. Small RCTs show signals for enalapril-related cardiac reverse remodeling and physician-optimized self-monitoring improving 9-month BP and cardiac structure. Severe BP ≥160/110 mmHg warrants urgent treatment (IV labetalol or hydralazine; oral IR nifedipine if no IV), while persistent ≥150/100 mmHg merits/continues oral therapy titrated toward ≤140/90 mmHg in clinic (≈≤135/85 mmHg at home). Early review within 3–10 days (≤72 h after severe disease) and remote/home BP programs reduce unplanned care.</div></div><div><h3>Conclusions</h3><div>For lactating patients, nifedipine ER/amlodipine, enalapril, and labetalol are appropriate first-line choices; real-world data favor nifedipine for lowering readmissions. Scaling home BP monitoring with early follow-up improves outcomes. Large pragmatic RCTs comparing step-care strategies and tracking infant outcomes remain a priority.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 12","pages":"Article 103191"},"PeriodicalIF":3.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A race against time: The impact of timing of first post-implantation LVAD infection and patient outcomes","authors":"Andrew Takla MD ,&nbsp;Omofolarin Babayale MD ,&nbsp;Basil Verghese MD ,&nbsp;Soidjon Khodjaev MD ,&nbsp;Maryrose Laguio-Vila MD","doi":"10.1016/j.cpcardiol.2025.103188","DOIUrl":"10.1016/j.cpcardiol.2025.103188","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular assist devices (LVADs) serve as lifesaving support for patients with advanced heart failure but are prone to infectious complications. The timing of these infections may play a crucial role in determining clinical outcomes. This study examines the differences between early (≤18 months) and late (&gt;18 months) LVAD infections.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, 105 LVAD patient charts were reviewed, and 50 patients identified to have LVAD-related infections. These patients were categorized based on the timing of infection: early (≤18 months post-implantation) and late (&gt;18 months). Variables analyzed included patient demographics, infection type, microbial etiology, post-implantation complications, treatment course, relapse rates, and survival outcomes.</div></div><div><h3>Results</h3><div>Early infections were associated with more severe LVAD infections, including higher rates of bacteremia and candidemia. It was also linked to infection with more aggressive pathogens, higher prevalence of Staphylococcus aureus in early infections (45 % vs. 26 %), a higher relapse rate (80 % vs. 63 %) (<em>p</em> = 0.029), and a shorter time to relapse. Among those with relapses, bacteremia was predominantly associated with the recurrence. Furthermore, early infections resulted in higher mortality (25.8 % vs. 15.7 %) and a shorter mean survival time (2.3 vs. 4 years).</div></div><div><h3>Conclusions</h3><div>Early LVAD infections are associated with higher relapse rates and worse clinical outcomes compared to late infections. These findings suggest that closer monitoring, more aggressive early interventions, and tailored antimicrobial strategies may improve patient outcomes in the early post-implantation period. Prospective studies are needed to validate these observations and guide infection prevention strategies in LVAD patients.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 12","pages":"Article 103188"},"PeriodicalIF":3.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of cardio-obstetrics care on maternal outcomes in pregnant women with heart disease: A systematic review and meta-analysis","authors":"Sneha Annie Sebastian MD ,&nbsp;Harshan Atwal MD ,&nbsp;Tanesh Ayyalu MD ,&nbsp;Martha Gulati MD, MS","doi":"10.1016/j.cpcardiol.2025.103190","DOIUrl":"10.1016/j.cpcardiol.2025.103190","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Maternal mortality is at an all-time high in the U.S., with maternal cardiac disease being the leading cause of death. Cardio-obstetrics is a collaborative, multidisciplinary approach to maternal care, bringing together experts from maternal-fetal medicine, cardiology, and other specialties. This study investigates the impact of cardio-obstetrics team care on maternal outcomes, focusing on how this integrated model can improve the health and well-being of pregnant women with cardiovascular disease (CVD).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a systematic review by searching MEDLINE, Web of Science, Scopus, and Cochrane up to March 5, 2025. Statistical analysis was performed using RevMan 5.4, with an inverse variance random effects model to calculate risk ratios (RR) for dichotomous outcomes. Heterogeneity was assessed using the Higgins I² test. The study protocol is registered in PROSPERO (CRD420251010149).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We identified six observational studies evaluating cardio-obstetrics team care, including a total of 1,109 pregnant women with CVD, with a mean age of 30.8 years. Most participants had a CARPREG II score &gt; 2, indicating high risk for adverse maternal cardiovascular outcomes. The average gestational age at delivery was 38 weeks, with arrhythmias being the most common cardiovascular condition, followed by congenital and valvular heart disease. Pooled analysis revealed a statistically significant reduction in the 30-day postpartum readmission rate for pregnant women with CVD receiving cardio-obstetrics care compared to standard care (RR 0.29, 95 % CI: 0.13–0.64, &lt;em&gt;p&lt;/em&gt; = 0.002, I² = 0 %) with no observed heterogeneity. There was also a significant decrease in postpartum arrhythmias (RR 0.07, 95 % CI: 0.04–0.12, &lt;em&gt;p&lt;/em&gt; &lt; 0.001, I² = 0 %). However, no significant difference in maternal mortality was found between the two groups (RR 0.74, 95 % CI: 0.14–3.93, &lt;em&gt;p&lt;/em&gt; = 0.72, I² = 0 %).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Maternal outcomes with cardio-obstetrics team care in pregnant women with CVD were promising, indicating the potential of this integrated care model when compared with standard care. These results emphasize the need for further research to explore its long-term benefits. Standard care data were approximated using national averages due to the lack of direct comparison data, which should be considered when interpreting the results.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Lay Summary&lt;/h3&gt;&lt;div&gt;Heart disease is the leading cause of death during pregnancy in the U.S. This study looked at whether having a specialized cardio-obstetrics team made up of doctors from different specialties working together improves outcomes for pregnant women with heart disease. Six studies with &gt;1,100 women found that women cared for by these cardio-obstetrics teams had fewer hospital readmissions and fewer heart rhythm problems after delivery, though death rates were not differen","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 12","pages":"Article 103190"},"PeriodicalIF":3.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2 inhibitors and cardiac fibrosis: A comprehensive review.","authors":"Paschalis Karakasis, Panagiotis Theofilis, Panayotis K Vlachakis, Anastasios Apostolos, Nikias Milaras, Nikolaos Ktenopoulos, Konstantinos Grigoriou, Aleksandra Klisic, Efstratios Karagiannidis, Barbara Fyntanidou, Dimitrios Patoulias, Antonios P Antoniadis, Nikolaos Fragakis","doi":"10.1016/j.cpcardiol.2025.103149","DOIUrl":"10.1016/j.cpcardiol.2025.103149","url":null,"abstract":"<p><p>Cardiac fibrosis is a key pathological substrate that drives diastolic dysfunction, arrhythmogenesis, and heart failure progression across a spectrum of cardiometabolic disorders. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for glucose lowering, have demonstrated pleiotropic effects on myocardial structure, notably attenuating fibrotic remodeling. Experimental models of diabetes, hypertension, ischemia, and cardiotoxicity consistently show that SGLT2 inhibitors mitigate interstitial and perivascular fibrosis through modulation of oxidative stress, mitochondrial function, autophagy, and canonical profibrotic signaling cascades, including TGF-β/Smad, STAT3, and mTOR. These actions are largely preserved in non-diabetic settings and appear to extend beyond hemodynamic or glycemic benefits. Clinical data, including cardiac magnetic resonance-based assessments, support the notion of diffuse fibrosis regression, particularly in heart failure with preserved ejection fraction and diabetic cardiomyopathy. Moreover, reductions in serum collagen biomarkers and improvements in myocardial energetics further substantiate their antifibrotic capacity. Nonetheless, fibrosis-specific endpoints remain underrepresented in major cardiovascular outcome trials, and histological validation in human tissue is lacking. Integrating artificial intelligence-driven fibrosis quantification, spatial transcriptomics, and high-resolution imaging may refine phenotyping and enable precision antifibrotic therapy. Whether fibrosis regression translates into durable clinical benefit remains an open question. This review comprehensively synthesizes the mechanistic, translational, and clinical evidence supporting the role of SGLT2 inhibitors as modulators of cardiac fibrosis across diverse cardiovascular disease states.</p>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103149"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a tool to predict the likelihood of undergoing orthotopic cardiac transplant from the urgent waitlist - a single centre UK experience.","authors":"Mansimran Singh Dulay, Rishi Patel, Winston Banya, Dharani Yogasivam, Ramey Assaf, Nahal Raza, Andrew Morley-Smith, Fernando Riesgo-Gil, Owais Dar","doi":"10.1016/j.cpcardiol.2025.103147","DOIUrl":"10.1016/j.cpcardiol.2025.103147","url":null,"abstract":"<p><strong>Background: </strong>Orthotopic Cardiac Transplantation (OCTx) improves survival in advanced heart failure. Currently, a tool in United Kingdom from NHS Blood and Transplant (NHSBT) helps predict likelihood of OCTx from waitlist. However, it does not use predictive variables such as age, or Human Leukocyte Antibody (HLA%). We aimed to develop OCTx predictive models incorporating known prognostic variables at 3-, 6-, 9- and 12-months.</p><p><strong>Methods: </strong>All patients who were urgent-listed for OCTx at Harefield Hospital between 2014 and 2018 (n = 125) were analysed. Variables included age, gender, blood group (BG), midline sternotomy, ventricular assist device (VAD), body mass index (BMI) and HLA%. Multivariable logistic regression models were constructed following internal validation per timepoint. A separate validation dataset was collected using 52 patients transplanted between 2019 and 2023, to compare model effectiveness against the current NHSBT tool.</p><p><strong>Results: </strong>At 3-months, variables included were age, gender, sternotomy, BG O and HLA%=0, with model area under curve (AUC) of 0.74 (0.66-0.83 95 % confidence interval [CI]). 6-month model included variables age, gender, BG O, sternotomy, BMI and HLA%=0, model AUC of 0.80 (0.72-0.89 95 % CI). 9-month model used age, BG O, VAD, BMI and HLA%=0, giving an AUC of 0.80 (0.71-0.89 95 % CI). The final 12-month model included midline sternotomy, BMI and HLA%=0 and HLA%=1-24, with AUC 0.78 (0.68-0.88 95 % CI). Our predictive models recorded an 85 % win-ratio compared to the NHSBT tool.</p><p><strong>Conclusion: </strong>We were able to develop models to predict urgent OCTx, with greater accuracy than the currently available tool. Multicentre external validation would help enable its wider implementation.</p>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103147"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation, abdominal aortic aneurysm enlargement and rupture. Lessons learned from the Covid19 pandemic.","authors":"Antonio V Sterpetti, Francesca Miceli, Alessia Di Girolamo, Antonio Bozzani, Vittorio Arici, Marta Ascione, Luca Di Marzo","doi":"10.1016/j.cpcardiol.2025.103151","DOIUrl":"10.1016/j.cpcardiol.2025.103151","url":null,"abstract":"<p><p>Patients with moderate-severe COVID19 infection suffer from several cardiovascular diseases: heart failure (3 %-33 %), myocardial ischemia (0.9 %-11 %), ventricular dysfunction (10 %-47 %), arrhythmias (9 %-17 %), venous thrombo-embolism (25 %) and arterial thrombosis (1 %-3 %). Although intracranial and coronary arterial aneurysms have been described in adults and children with COVID19, few reports have correlated COVID19 infection and sudden degeneration of aortic aneurysms and dissections. We analyzed the risk factor for enlargement and rupture of aortic aneurysms in patrients with moderate-severe COVID19 infection. Several COVID19 related mechanisms may impact aortic aneurysm progression: increased elastin and collagen digestion by enzymes triggered by viral spike proteins in ACE2-negative myeloid cells and/or by inflammatory cytokines; hypoxemia related to thrombosis of micro vessels of the aneurismal wall; dysregulation of the immune system. Patients with known arterial aneurysm may be at risk for sudden increase of dimensions and rupture during moderate-severe COVID19 infection.</p>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103151"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-36: a novel therapeutic target for atherosclerosis","authors":"Shuting Tan ,&nbsp;Yongheng Li ,&nbsp;Zhenshuai Yao ,&nbsp;Xiao Xu ,&nbsp;Jin Wang ,&nbsp;Xiaofang Zhu ,&nbsp;Pingping He","doi":"10.1016/j.cpcardiol.2025.103187","DOIUrl":"10.1016/j.cpcardiol.2025.103187","url":null,"abstract":"<div><div>Cardiovascular diseases remain the foremost cause of global morbidity and mortality, with atherosclerosis serving as the pathological basis for most related disorders. Despite the clinical benefits of statin therapy, a substantial residual risk persists, underscoring the need to explore novel therapeutic targets. Interleukin-36 (IL-36), a member of the interleukin-1 family, has emerged as a key regulator of immune and inflammatory responses. Beyond its established roles in tissue repair, host defense, and inflammatory signaling, IL-36 has been increasingly implicated in cardiovascular pathology, including myocardial infarction, ischemic injury, and myocarditis. Recent evidence highlights its pro-atherogenic functions mediated through sustained vascular inflammation, abnormal angiogenesis, impaired cholesterol metabolism, excessive neutrophil extracellular trap formation, and disrupted autophagy. These findings collectively suggest that IL-36 not only contributes to the initiation and progression of atherosclerosis but also holds promise as a potential therapeutic target. This review summarizes recent progress on the regulatory roles and signaling mechanisms of IL-36, emphasizing its contribution to atherogenesis.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 12","pages":"Article 103187"},"PeriodicalIF":3.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}