Current Problems in Cardiology最新文献

SGLT2 inhibitors and cardiac fibrosis: A comprehensive review. SGLT2抑制剂与心脏纤维化：全面回顾。

IF 3.3 3区医学

Current Problems in Cardiology Pub Date : 2025-10-01 Epub Date: 2025-08-05 DOI: 10.1016/j.cpcardiol.2025.103149

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

{"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":"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.","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}

引用次数: 0

Developing a tool to predict the likelihood of undergoing orthotopic cardiac transplant from the urgent waitlist - a single centre UK experience. 开发一种工具，以预测接受原位心脏移植的可能性从紧急候补名单-单一中心英国的经验。

IF 3.3 3区医学

Current Problems in Cardiology Pub Date : 2025-10-01 Epub Date: 2025-08-05 DOI: 10.1016/j.cpcardiol.2025.103147

Mansimran Singh Dulay, Rishi Patel, Winston Banya, Dharani Yogasivam, Ramey Assaf, Nahal Raza, Andrew Morley-Smith, Fernando Riesgo-Gil, Owais Dar

{"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":"Background: 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.Methods: 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.Results: 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.Conclusion: 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.","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}

引用次数: 0

Inflammation, abdominal aortic aneurysm enlargement and rupture. Lessons learned from the Covid19 pandemic. 炎症，腹主动脉瘤增大和破裂。从2019冠状病毒病大流行中吸取的教训。

IF 3.3 3区医学

Current Problems in Cardiology Pub Date : 2025-10-01 Epub Date: 2025-08-05 DOI: 10.1016/j.cpcardiol.2025.103151

Antonio V Sterpetti, Francesca Miceli, Alessia Di Girolamo, Antonio Bozzani, Vittorio Arici, Marta Ascione, Luca Di Marzo

{"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":"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.","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}

引用次数: 0

Interleukin-36: a novel therapeutic target for atherosclerosis. 白细胞介素-36：动脉粥样硬化的新治疗靶点。

IF 3.3 3区医学

Current Problems in Cardiology Pub Date : 2025-09-28 DOI: 10.1016/j.cpcardiol.2025.103187

Shuting Tan, Yongheng Li, Zhenshuai Yao, Xiao Xu, Jin Wang, Xiaofang Zhu, Pingping He

{"title":"Interleukin-36: a novel therapeutic target for atherosclerosis.","authors":"Shuting Tan, Yongheng Li, Zhenshuai Yao, Xiao Xu, Jin Wang, Xiaofang Zhu, Pingping He","doi":"10.1016/j.cpcardiol.2025.103187","DOIUrl":"10.1016/j.cpcardiol.2025.103187","url":null,"abstract":"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.","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"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}

引用次数: 0

Title Page 标题页

IF 3.3 3区医学

Current Problems in Cardiology Pub Date : 2025-09-25 DOI: 10.1016/S0146-2806(25)00196-3

引用次数: 0

Design and Methods of the AUTOMATED-WCT Trial: Evaluating Machine Learning-Based ECG Support for WCT Interpretation. 自动WCT试验的设计和方法：评估基于机器学习的心电图对WCT解释的支持。

IF 3.3 3区医学

Current Problems in Cardiology Pub Date : 2025-09-25 DOI: 10.1016/j.cpcardiol.2025.103186

Adam M May, Sarah LoCoco, Krasimira M Mikhova, Rugheed Ghadban, Phillip S Cuculich, Daniel H Cooper, Thomas M Maddox, Prashanth Thakkar, Elena Deych, Ian Rowlandson, Alexander Siotis, Nandan Anavaker, Peter A Noseworthy, Anthony Kashou

{"title":"Design and Methods of the AUTOMATED-WCT Trial: Evaluating Machine Learning-Based ECG Support for WCT Interpretation.","authors":"Adam M May, Sarah LoCoco, Krasimira M Mikhova, Rugheed Ghadban, Phillip S Cuculich, Daniel H Cooper, Thomas M Maddox, Prashanth Thakkar, Elena Deych, Ian Rowlandson, Alexander Siotis, Nandan Anavaker, Peter A Noseworthy, Anthony Kashou","doi":"10.1016/j.cpcardiol.2025.103186","DOIUrl":"https://doi.org/10.1016/j.cpcardiol.2025.103186","url":null,"abstract":"Background: Distinguishing wide complex tachycardia (WCT) as ventricular tachycardia (VT) or supraventricular WCT (SWCT) is critical yet challenging. Manual ECG algorithms require substantial expertise and are inconsistently applied, and contemporary computerized ECG interpretation (CEI) systems often return only a generic \"wide complex tachycardia\" label. Novel machine learning-based ECG models (Solo Model, Paired Model) can provide a VT probability or a direct VT/SWCT classification, but they have not yet been evaluated in a prospective, randomized, workflow-integrated trial.Design: We will conduct a prospective, multicenter, investigator-initiated, open-label, four-arm randomized reader trial. Physicians (attendings and fellows in cardiology, emergency medicine, critical care) will be randomized 1:1:1:1 to: (1) Control #1-WCT ECG only; (2) Control #2-WCT ECG + baseline ECG; (3) Solo Model-WCT ECG + model output (no baseline ECG); (4) Paired Model-WCT ECG + baseline ECG + model output. Each participant will interpret 20 adjudicated WCT ECGs on a secure virtual platform, classify rhythm, rate confidence and percieved usefulness, and indicate likely next steps in clinical management.Primary endpoint: WCT classification accuracy. Secondary endpoints: sensitivity, specificity, PPV, NPV, F1 score, time to diagnosis, interpreation confidence, perceived usefulness, and intended management after diagnosis.Conclusion: The AUTOMATED-WCT Trial will be the first randomized, multicenter evidence on machine learning-based ECG decision support for WCT differentiation.","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103186"},"PeriodicalIF":3.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182423","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}

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Guidelines for Authors 作者指南

IF 3.3 3区医学

Current Problems in Cardiology Pub Date : 2025-09-25 DOI: 10.1016/S0146-2806(25)00203-8

引用次数: 0

Nocturnal hypertension and cardiovascular events: risk analysis using propensity score matching. 夜间高血压和心血管事件：使用倾向评分匹配的风险分析。

IF 3.3 3区医学

Current Problems in Cardiology Pub Date : 2025-09-25 DOI: 10.1016/j.cpcardiol.2025.103185

Joaquin Perea, Daniel Martin, Marlon Ruiz Holguín, Diego Arluna, Oscar Gomez, Santiago Simone, Alvaro Sosa Liprandi, Maria Ines Sosa Liprandi

{"title":"Nocturnal hypertension and cardiovascular events: risk analysis using propensity score matching.","authors":"Joaquin Perea, Daniel Martin, Marlon Ruiz Holguín, Diego Arluna, Oscar Gomez, Santiago Simone, Alvaro Sosa Liprandi, Maria Ines Sosa Liprandi","doi":"10.1016/j.cpcardiol.2025.103185","DOIUrl":"10.1016/j.cpcardiol.2025.103185","url":null,"abstract":"Background: Nocturnal hypertension (NHT) is associated with major adverse cardiovascular events (MACE) and heart failure (HF), and remains an area of growing interest, with evidence suggesting a differential impact compared to daytime hypertension (DTH).Objectives: To evaluate the relationship between NHT and the risk of cardiovascular events, independently of daytime blood pressure.Methods: We conducted an observational study based on a continuous registry of patients who underwent ambulatory blood pressure monitoring at a tertiary care center. Propensity score matching (1:1) was applied using relevant clinical factors to ensure comparability between groups. The primary outcome was the composite of MACE and HF. Cox regression and cubic spline models were used to explore non-linear associations and identify critical thresholds.Results: After matching, 1,392 patients were analyzed (691 per group). In adjusted models, nocturnal systolic blood pressure was significantly associated with increased risk of MACE/HF (HR 1.04; 95 % CI: 1.01-1.07), whereas daytime systolic pressure showed no association (HR 0.98; 95 % CI: 0.95-1.01). In the multivariable model, NHT maintained its adverse effect (HR 1.03; 95 % CI: 1.01-1.04), together with other established clinical predictors. Risk curves demonstrated a non-linear association, with a significant increase in risk above 148 mmHg of nocturnal systolic blood pressure.Conclusions: NHT independently increases the risk of cardiovascular events and provides prognostic thresholds that may improve risk stratification.","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103185"},"PeriodicalIF":3.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182502","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}

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Editor’s Message 编辑器’的消息

IF 3.3 3区医学

Current Problems in Cardiology Pub Date : 2025-09-25 DOI: 10.1016/S0146-2806(25)00202-6

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Information for Readers 读者资讯

IF 3.3 3区医学

Current Problems in Cardiology Pub Date : 2025-09-25 DOI: 10.1016/S0146-2806(25)00197-5

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