Current Problems in Cardiology最新文献

{"title":"Fulminant myocarditis secondary to dengue infection requiring veno-arterial extracorporeal membrane oxygenation","authors":"Ramiro M. Arias MD , Juan P. Fescina MD , Juan F. Furmento MD , Lucrecia M. Burgos MD , Pablo Fernandez Oses MD , Juan P. Costabel MD , Leonardo A. Seoane MD","doi":"10.1016/j.cpcardiol.2025.103108","DOIUrl":"10.1016/j.cpcardiol.2025.103108","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 8","pages":"Article 103108"},"PeriodicalIF":3.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310788","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 Dual Functionality of EZH2 in Cardiovascular Disease: Bridging Cancer Biology and Cardiac Pathophysiology through Epigenetic Regulation, Metabolic Reprogramming, and Novel Therapeutic Interventions.","authors":"Shengwei Fang, Faris Alrumaihi, Wanian M Alwanian, Hajed Obaid Alharbi, Nujud Ahmed Alnughymishi, Somayah Mohammad Alfifi, Elizabeth Bennett, Peipei Zhang","doi":"10.1016/j.cpcardiol.2025.103104","DOIUrl":"https://doi.org/10.1016/j.cpcardiol.2025.103104","url":null,"abstract":"<p><p>Enhancer of zeste homolog 2 (EZH2), canonically recognized as an oncogenic driver through its histone methyltransferase activity, has emerged as a critical epigenetic orchestrator in cardiovascular pathophysiology with unexpected functional complexity. While extensive oncological research has established EZH2's role in facilitating the Warburg effect and metabolic reprogramming in cancer cells, recent cardiovascular investigations reveal that EZH2 employs remarkably parallel mechanisms to coordinate the metabolic shift from oxidative phosphorylation to glycolysis during cardiac ischemia-a previously unrecognized molecular paradigm bridging cancer biology and cardiovascular pathophysiology. This review synthesizes emerging evidence demonstrating EZH2's unique context-dependent functionality in cardiac tissue, acting simultaneously as a transcriptional co-activator through non-canonical FOXM1 interaction and as an epigenetic repressor via its canonical PRC2-mediated H3K27 trimethylation activity. Most significantly, we highlight the novel discovery that EZH2 establishes a distinctive methylation landscape in ischemic cardiomyopathy through direct interaction with DNA methyltransferases, creating a molecular signature that suppresses cardioprotective factors like KLF15 while enhancing matrix metalloproteinase expression that drives adverse cardiac remodeling. Despite compelling preclinical evidence supporting EZH2 inhibition across multiple cardiovascular conditions, including atherosclerosis, cardiac hypertrophy, and myocardial fibrosis, a critical translational gap persists due to delivery limitations, potential off-target effects, and inadequate understanding of EZH2's temporal and tissue-specific functions. This review identifies crucial research opportunities, including developing cardiac-specific EZH2 modulators, exploring combination therapies targeting downstream pathways, and comprehensive interactome mapping to reveal cardiovascular-specific interactions. Decoding the complex regulatory networks governed by EZH2 across developmental stages and disease contexts represents a frontier for developing innovative epigenetic interventions addressing the global burden of cardiovascular disease.</p>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103104"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303478","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":"Circular RNAs as Regulatory Mediators and Therapeutic Targets in Doxorubicin-Induced Cardiotoxicity.","authors":"Shengwei Fang, Thomas Ainsworth, Peipei Zhang","doi":"10.1016/j.cpcardiol.2025.103106","DOIUrl":"https://doi.org/10.1016/j.cpcardiol.2025.103106","url":null,"abstract":"<p><p>Doxorubicin (DOX) remains a cornerstone chemotherapeutic agent despite its dose-dependent cardiotoxicity that can progress to irreversible dilated cardiomyopathy. At the same time, the mechanisms of DOX-induced cardiac injury are multifactorial, emerging evidence highlights circular RNAs (circRNAs) a unique class of covalently closed non-coding RNA molecules, as critical regulators of DOX cardiotoxicity. This review comprehensively examines the biogenesis and functional repertoire of circRNAs and their pivotal role in modulating DOX-induced cardiac damage. CircRNAs exert cardioprotective or cardiotoxic effects primarily through competitive endogenous RNA activity, RNA-binding protein interactions, translational products, and RNA N6-adenosine methylation-related mechanisms. Notably, the research gap lies in understanding how circRNAs orchestrate the complex interplay between five major regulated cell death pathways triggered by DOX: apoptosis, autophagy, necroptosis, ferroptosis, and pyroptosis. Additionally, circRNAs influence cellular processes underlying DOX-induced cardiomyocyte dysfunction, including oxidative stress, calcium handling defects, myocardial atrophy, thrombosis, and premature senescence. The novelty of this review lies in synthesizing evidence on circRNA-mediated regulatory networks across these diverse pathophysiological mechanisms, providing a theoretical foundation for developing circRNA-based diagnostic biomarkers and therapeutic interventions. Future research directions should focus on elucidating additional molecular mechanisms, validating circRNA-based biomarkers, and establishing translational frameworks for clinical applications to mitigate DOX cardiotoxicity while preserving its antitumor efficacy.</p>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103106"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303474","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":"Coronary Artery Disease and Human Immunodeficiency Virus.","authors":"Tushar Sharma, Bhavina Sharma, Rahul Chaudhary, Nauder Faraday, Andrew M Goldsweig","doi":"10.1016/j.cpcardiol.2025.103101","DOIUrl":"https://doi.org/10.1016/j.cpcardiol.2025.103101","url":null,"abstract":"<p><p>Cardiac complications in individuals infected with the human immunodeficiency virus (HIV) have been recognized since the 1980s. However, the type of cardiac conditions seen in this population has changed substantially since the introduction of antiretroviral therapy (ART). Coronary artery disease (CAD) has emerged as a leading cause of morbidity and mortality in HIV positive individuals. HIV and ART have both been linked to the development of CAD through multiple mechanisms. There is limited specific guidance for management of CAD and its risk factors in people with HIV. This literature review explores the pathophysiology and management of CAD in HIV-infected patients, identifying gaps in evidence and areas for future research to address the growing burden of CAD in this patient population.</p>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103101"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303475","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":"Medicaid Coverage in the Context of an Ecological Framework of Health in the United States-A Present-Day Power Dynamic with Negative Implications.","authors":"Ross Arena, Nicolaas P Pronk, Colin Woodard","doi":"10.1016/j.cpcardiol.2025.103105","DOIUrl":"https://doi.org/10.1016/j.cpcardiol.2025.103105","url":null,"abstract":"<p><p>Power dynamics may be defined as \"a way different people or different groups of people interact with each other and where one of these sides is more powerful than the other one.\" Pronk et al. recently proposed an ecological framework for United States (U.S.) population health, identifying culture, politics, policy, and socioeconomics as forcing factors that drive variations in health behaviors, health conditions and ultimately health outcomes. The current analysis examines the percentage of individuals currently covered by Medicaid alone in the context of the forcing factors and health outcomes of the ecologic framework. Counties identified as aggressively individualistic had a significantly higher percentage of the population covered by Medicaid alone compared to all other groups. The percentage of the population covered by Medicaid alone was significantly correlated with all measures and outcomes within the ecological framework. Apart from the prevalence of binge drinking and cancer, all other measures and outcomes trended toward a less favorable pattern as the percentage of the county-level population covered by Medicaid alone increased. The potential for reductions in Medicaid funding represents a current political power dynamic. The current study indicates this power dynamic may have significant adverse consequences to the proposed ecological framework for health-the percentage of the population covered by Medicaid alone is related to an unfavorable phenotype across all forcing factors of the framework as well as health outcomes. Loss of Medicaid coverage has significant implications for further worsening population health.</p>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103105"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303476","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":"Cardiovascular disease in patients with limited English proficiency: A narrative review","authors":"Zara Latif MD ,&nbsp;Maha Inam MBBS ,&nbsp;Aditya Tummala ,&nbsp;Beier Nelson ,&nbsp;Tracy T. Makuvire MD, MPH ,&nbsp;Haider J. Warraich MD","doi":"10.1016/j.cpcardiol.2025.103107","DOIUrl":"10.1016/j.cpcardiol.2025.103107","url":null,"abstract":"<div><div>Patients with Limited English Proficiency (LEP) form a large proportion of the population and experience significant differences in care. A multitude of studies have explored care differences in patients with LEP and cardiovascular disease (CVD). This review covers several key areas in CVD care including coronary artery disease, acute coronary syndrome, heart failure, and several CVD risk factors. While there are no significant differences seen in door to balloon time between LEP and English speakers, important differences exist in coronary artery disease awareness and symptom recognition among LEP patients. Additionally, LEP patients with heart failure experienced higher rates of hospital readmissions and emergency department visits. Mixed evidence exists regarding CVD risk factors control such as diabetes, hypertension, and hyperlipidemia based on language preference. Employing key interventions that target multiple domains in health care delivery can address some of the care disparities seen among LEP patients with CVD.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 8","pages":"Article 103107"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295327","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":"Number of beats of nonsustained supraventricular and ventricular tachycardias according to fibonacci sequence","authors":"John E. Madias","doi":"10.1016/j.cpcardiol.2025.103102","DOIUrl":"10.1016/j.cpcardiol.2025.103102","url":null,"abstract":"<div><div>Myriads of phenomena in inanimate and animate Nature conform to the Fibonacci sequence and Golden rule. Hundred patients, aged 60.39±13.96 SD (28-92) 53 female, who underwent AEM and had ≥1 bout(s) of NSVT and/or NVT, were analyzed, according to whether the number of beats in these arrhythmias, conformed to the Fibonacci sequence. There was no difference in age, gender, risk factors, and cardiovascular/cerebrovascular pathologies, of the ∼30 %, whose arrhythmias conformed to the Fibonacci sequence, and the remainder 70 %. There is a need to explore the reproducibility of this phenomenon, and its diagnostic and prognostic role in the management of patients.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 8","pages":"Article 103102"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291460","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":"Challenges in the clinical care of major cardiovascular conditions in primary care: a narrative review","authors":"Caesar Chan ,&nbsp;Dawnie Ho Hei Lau","doi":"10.1016/j.cpcardiol.2025.103099","DOIUrl":"10.1016/j.cpcardiol.2025.103099","url":null,"abstract":"<div><div>Cardiovascular conditions continue to be increasingly common. This narrative review addresses the barriers in managing cardiovascular diseases in primary care settings, including but not limited to disparities in healthcare access, asymptomatic or minimally symptomatic nature of many conditions, and nonadherence to treatment. Strategies for early detection, patient education and tailored interventions are discussed across five major cardiovascular diseases.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 8","pages":"Article 103099"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303440","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":"Meta-analysis of erector spinae plane block efficacy in managing postoperative pain following cardiac surgery","authors":"Bhushan Sandeep PhD ,&nbsp;Xin Huang MD ,&nbsp;Fenglin Jiang MD ,&nbsp;Han Cheng MD ,&nbsp;Yuan Li MD ,&nbsp;Zongwei Xiao PhD","doi":"10.1016/j.cpcardiol.2025.103098","DOIUrl":"10.1016/j.cpcardiol.2025.103098","url":null,"abstract":"<div><div>Cardiac surgery is associated with significant postoperative pain, necessitating effective multimodal analgesia to reduce opioid-related morbidity. This systematic review and meta-analysis evaluated the analgesic efficacy of erector spinae plane block (ESPB) in adult cardiac surgery. Twenty-three randomized controlled trials (1,612 patients) were included. Primary outcomes revealed no significant difference in 24-hour postoperative coughing pain scores between ESPB and control groups (MD 0.12; 95 % CI:0.26 to 0.50; <em>P</em> = 0.54). However, ESPB demonstrated significant reductions in coughing and resting pain scores at 48 h (MD -0.60; 95 % CI:0.81to-0.38; <em>P</em> &lt; 0.00001) and 72 h (MD -0.67; 95 % CI:1.02 to-0.33; <em>P</em> = 0.0001), alongside reduced 24-hour morphine consumption (MD -2.04; 95 % CI:2.46 to-1.61; <em>P</em> &lt; 0.00001) and shorter mechanical ventilation duration (MD -26.53 minutes; 95 % CI:41.78 to-11.27; <em>P</em> = 0.0007). No differences were observed in ICU/hospital stays or surgical/anesthesia durations. Subgroup analyses highlighted variability in continuous versus single-shot ESPB techniques. High heterogeneity (I² &gt;50 %) and moderate-to-low GRADE evidence underline the need for standardized protocols. ESPB shows promise in enhancing recovery by reducing opioid use and late-phase pain, though further high-quality trials are warranted.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 8","pages":"Article 103098"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303477","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":"Early prescription of SGLT2i for acute patient care: from current evidence to future directions","authors":"Fabrizio Ricci ,&nbsp;Silvio Saraullo ,&nbsp;Andrea Boccatonda ,&nbsp;Anna Sorella ,&nbsp;Alessia Cipollone ,&nbsp;Paola Simeone ,&nbsp;Sabina Gallina ,&nbsp;Francesca Santilli ,&nbsp;Francesco Cipollone ,&nbsp;Damiano D’Ardes","doi":"10.1016/j.cpcardiol.2025.103081","DOIUrl":"10.1016/j.cpcardiol.2025.103081","url":null,"abstract":"<div><div>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have emerged as transformative therapies in the management of chronic heart failure (HF), offering substantial reductions in mortality and hospitalizations. Beyond their initial classification as diuretics, SGLT2i exert a spectrum of cardioprotective effects that extend far beyond renal modulation. By activating autophagic pathways and mimicking a starvation-like state, SGLT2i enhance cellular bioenergetics and mitigate acute injury, potentially underpinning both their immediate and sustained cardiometabolic benefits when administered early in acute care settings. In acute decompensated HF, early initiation of SGLT2i enhances clinical decongestion by increasing diuresis, improving diuretic efficiency, and mitigating diuretic resistance, translating to shorter hospitalizations and reduced readmissions and mortality. In acute myocardial infarction, SGLT2i reduce the incidence of first and total HF hospitalizations, arrhythmic events, adverse cardiac remodelling, and contrast-induced acute kidney injury, while mitigating stent failure and atherosclerotic progression. Furthermore, they demonstrated efficacy in preventing new-onset and recurrent supraventricular and ventricular arrhythmias. However, the evidence remains inconclusive regarding their impact on sudden cardiac death or outcomes following cardiac arrest. In critically ill patients, SGLT2i use is associated with reduced rates of acute kidney injury and the need for renal replacement therapy, with promising implications for the management of sepsis and multi-organ dysfunction. Importantly, adverse effects such as renal impairment, electrolyte disturbances, acid-base imbalances, urinary tract infections, and dysglycemia appear infrequently in this population. This narrative review synthesizes the underlying pathophysiological mechanisms, current clinical evidence, and potential future applications of early SGLT2i therapy in acute care settings, providing insights into their expanding role in contemporary cardiovascular medicine.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 8","pages":"Article 103081"},"PeriodicalIF":3.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166507","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}