Current Problems in Cardiology最新文献

{"title":"RNA-targeting therapies for amyloid transthyretin cardiomyopathy: A systematic review and meta-analysis","authors":"João Victor de Oliveira Ramos ,&nbsp;João Vitor Andrade Fernandes ,&nbsp;Yan Gadelha de Abrantes Formiga ,&nbsp;Fabyan Esberard de Lima Beltrão ,&nbsp;Marcelo Dantas Tavares de Melo ,&nbsp;Fábio Fernandes","doi":"10.1016/j.cpcardiol.2025.103057","DOIUrl":"10.1016/j.cpcardiol.2025.103057","url":null,"abstract":"<div><h3>Introduction</h3><div>Amyloid transthyretin (TTR) cardiomyopathy is a progressive disease caused by TTR amyloid deposition, leading to heart failure and mortality. RNA interference (RNAi) therapies reduce amyloid formation by silencing hepatic TTR mRNA. This meta-analysis evaluates their efficacy and safety.</div></div><div><h3>Methods</h3><div>A systematic search conducted in February 2025 in Cochrane Central, PubMed, and Embase identified RCTs comparing RNAi therapies with placebo. Primary outcomes were all-cause mortality and cardiac adverse events. Safety outcomes included any adverse events and serious cardiac adverse events. A leave-one-out sensitivity analysis assessed robustness. Statistical analyses used inverse-variance common-effects and DerSimonian-Laird random-effects models. Heterogeneity was evaluated using REML and I² statistics, with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Three RCTs (1,199 patients) met inclusion criteria. RNAi therapy did not significantly reduce all-cause mortality (OR 0.97; 95 % CI 0.26–3.62; I² 72.4 %). However, excluding the ENDEAVOR trial, mortality reduction was significant (OR 0.65; 95 % CI 0.45–0.95; I² 0 %). RNAi therapy reduced cardiac adverse events in pooled (OR 0.72; 95 % CI 0.57–0.90; I² 38 %) and subgroup analyses (OR 0.66; 95 % CI 0.51–0.84; I² 0 %). No significant differences were found in serious cardiac adverse events (OR 0.98; 95 % CI 0.77–1.27; I² 0 %). Safety analyses showed no increase in overall adverse events (OR 0.78; 95 % CI 0.42–1.44; I² 49.8 %).</div></div><div><h3>Conclusion</h3><div>RNAi therapies reduce cardiac adverse events and may improve survival in selected patients. Further studies should refine patient selection and assess long-term outcomes.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 7","pages":"Article 103057"},"PeriodicalIF":3.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903975","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":"Post-implantation syndrome in patients undergoing thoracic and abdominal endovascular aortic repair: Comprehensive systematic review and meta-analysis","authors":"Andreina Carbone MD ,&nbsp;Davide Turchino MD ,&nbsp;Carlo Fanti MD ,&nbsp;Roberta Bottino MD ,&nbsp;Francesco Ferrara MD, PhD ,&nbsp;Carlo Mannina MD ,&nbsp;Stamatios Lerakis MD ,&nbsp;Giuseppe Comentale MD, PhD ,&nbsp;Salvatore Rega MD ,&nbsp;Antonio Cittadini MD, PhD ,&nbsp;Giovanni Esposito MD, PhD ,&nbsp;Emanuele Pilato MD, PhD ,&nbsp;Umberto Marcello Bracale MD, PhD ,&nbsp;Eduardo Bossone MD, PhD","doi":"10.1016/j.cpcardiol.2025.103055","DOIUrl":"10.1016/j.cpcardiol.2025.103055","url":null,"abstract":"<div><div>Post-implantation syndrome (PIS) can lead to prolonged hospitalization and major adverse cardiovascular events (MACE). This systematic review and meta-analysis investigated the clinical profile of PIS after abdominal (EVAR) and thoracic endovascular aortic repair (TEVAR).</div><div>A comprehensive literature search identified 1463 studies, of which 16 (14 retrospective and 2 prospective) met the inclusion criteria. Data from these studies were aggregated using a random effects model to calculate pooled risk ratios and mean differences. The analysis included 2890 patients (males 84.7%, mean age 63.3 years ± 18.8) with 882 experiencing PIS. No significant differences were found in demographics, anthropometric measurements, risk factors, medical history, or chronic medical treatments between the two groups. Fever (above 38°C) was the most frequent clinical manifestation, observed in 75-100% of PIS cases. As expected, higher levels of post-procedural white blood cells (WBC) and platelets (PLT) were shown in PIS patients compared to non-PIS patients. Interestingly, pre-procedural WBC and PLT counts were significantly higher in the PIS group (p&lt;0.001 and p&lt;0.002 respectively). Patients with PIS were more likely to receive polyester graft (p=0.003), while those with polytetrafluoroethylene prostheses were less likely to develop PIS (p=0.04). The PIS group exhibited longer hospital stays compared to the non-PIS group (p&lt;0.001). While most studies reported no evident PIS impact on outcomes, two studies reported higher rate of MACE. Larger prospective studies are needed to determine the optimal management strategies of patients at risk of PIS.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 6","pages":"Article 103055"},"PeriodicalIF":3.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847671","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":"Histone modifications as molecular drivers of cardiac aging: Metabolic alterations, epigenetic mechanisms, and emerging therapeutic strategies","authors":"Faris Alrumaihi ,&nbsp;Amin A. Al-Doaiss ,&nbsp;Faqir Ullah ,&nbsp;Wanian M. Alwanian ,&nbsp;Hajed Obaid Alharbi ,&nbsp;Fai Abdullah Alassaf ,&nbsp;Somayah Mohammad Alfifi ,&nbsp;Fahad M Alshabrmi ,&nbsp;Faris F. Aba Alkhay ,&nbsp;Eid A. Alatawi","doi":"10.1016/j.cpcardiol.2025.103056","DOIUrl":"10.1016/j.cpcardiol.2025.103056","url":null,"abstract":"<div><div>Cardiac aging represents a complex pathophysiological process characterized by progressive metabolic recombination and functional dedifferentiation of cardiac cellular components. Despite advancements in cardiovascular medicine, a critical research gap persists in understanding the precise epigenetic mechanisms that drive age-related cardiac dysfunction. This comprehensive review elucidates the pivotal role of histone modifications—including methylation, acetylation, and phosphorylation—in orchestrating the molecular landscape of cardiac aging. Significant gaps remain in our understanding of site-specific histone modification impacts on cardiac function, the intricate crosstalk between different histone marks, and their integration with metabolic alterations that characterize the aging myocardium. Current evidence reveals a dynamic epigenetic signature in aged cardiac tissue, typically featuring increased transcriptional activation markers alongside decreased repressive marks, though context-dependent variations exist. This review explores how histone modifications influence critical pathways governing mitochondrial dysfunction, DNA damage repair, inflammation, and fibrosis in aging hearts. Innovative therapeutic approaches targeting specific histone-modifying enzymes promise to mitigate age-related cardiac deterioration, potentially revolutionizing treatment paradigms for cardiovascular diseases in aging populations. Addressing these knowledge gaps requires multidimensional approaches that integrate epigenomics with functional assessment of cardiac performance.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 7","pages":"Article 103056"},"PeriodicalIF":3.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912269","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":"Editor’s Message","authors":"","doi":"10.1016/S0146-2806(25)00072-6","DOIUrl":"10.1016/S0146-2806(25)00072-6","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 5","pages":"Article 103050"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738789","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":"Title Page","authors":"","doi":"10.1016/S0146-2806(25)00067-2","DOIUrl":"10.1016/S0146-2806(25)00067-2","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 5","pages":"Article 103045"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738788","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":"Guidelines for Authors","authors":"","doi":"10.1016/S0146-2806(25)00073-8","DOIUrl":"10.1016/S0146-2806(25)00073-8","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 5","pages":"Article 103051"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738784","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":"Information for Readers","authors":"","doi":"10.1016/S0146-2806(25)00068-4","DOIUrl":"10.1016/S0146-2806(25)00068-4","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 5","pages":"Article 103046"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738786","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":"Retraction Notice to “Letter to the Editor: Long-Term Valve Durability in Patients Undergoing Transcatheter Aortic Valve Implantation – ScienceDirect” [Current Problems in Cardiology 48 (2023) 101836]","authors":"Bakht Muhammad Zurmati","doi":"10.1016/j.cpcardiol.2025.103037","DOIUrl":"10.1016/j.cpcardiol.2025.103037","url":null,"abstract":"<div><div>This article has been retracted: please see Elsevier Policy on Article Withdrawal (<span><span>https://www.elsevier.com/about/policies/article-withdrawal</span><svg><path></path></svg></span>).</div><div>&lt;This article has been retracted at the request of the Editor-in-Chief. Following concerns raised by a reader, it was found that the Letter to the Editor does not meet the quality standards of the journal.&gt;</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 6","pages":"Article 103037"},"PeriodicalIF":3.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755624","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":"Noninvasive assessment of myocardial stiffness using shear wave elastography in Amyloidosis and Fabry disease","authors":"Caio RF Cafezeiro PhD ,&nbsp;Aristóteles AC Neto PhD ,&nbsp;Cristhian E Romero MD ,&nbsp;Natália M Pereira MD ,&nbsp;Bruno VK Bueno MD ,&nbsp;João H Rissato MD ,&nbsp;Fernando L Pereira MD ,&nbsp;Maria C Chamas PhD ,&nbsp;Marcelo D Tavares PhD ,&nbsp;Felix JA Ramires PhD ,&nbsp;Wilson Mathias Jr PhD ,&nbsp;Carlos E Rochitte PhD ,&nbsp;Viviane T Hotta PhD ,&nbsp;Fábio Fernandes PhD","doi":"10.1016/j.cpcardiol.2025.103038","DOIUrl":"10.1016/j.cpcardiol.2025.103038","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>Diastolic function comprises MS and impaired relaxation, and is essential for the comprehensive analysis of heart failure. The goal of this study was to investigate the use of cardiac shear wave elastography for assessing shear wave propagation speed and myocardial stiffness (MS) in Fabry disease (FD), cardiac amyloidosis (CA) and healthy volunteers (HV).</div></div><div><h3>Methods</h3><div>We prospectively enrolled 60 participants, with 20 patients each in the CA, FD and HV groups. Echocardiogram, blood exams and walking test were achieved. MS evaluation was performed using an ultrasound scanner. <strong>Results</strong>: Shear wave propagation speed and MS were significantly higher in patients with CA than in HV in the basal anteroseptal segment (MS PLAX 6.6 ± 1.4 kPa vs. 5.38 ± 1.1 kPa, respectively, <em>p</em> = 0.01; PSAX 6.86 ± 1.4 kPa vs. 5.6 ± 1.2 kPa, respectively, <em>p</em> = 0.01) and in the right ventricle (5.9 ± 2.6 kPa vs. 4.0 ± 0.7 kPa, respectively, <em>p</em> = 0.003), with no difference in the mid anteroseptal segment and the apical septal. There was a difference in the MS of patients with CA in the right ventricle when compared to the FD group (5.9 ± 2.6 kPa vs. 4.4 ± 1.0 kPa, respectively, <em>p</em> = 0.01). There was no statistical difference between any myocardial segment in the FD group compared to the HV group. <strong>Conclusions</strong>: Shear wave propagation speed and MS were higher in patients with CA compared to FD and healthy volunteers. Evaluation of FD group did not reveal any difference from the control group</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 6","pages":"Article 103038"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739181","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":"Takotsubo syndrome complicated by ventricular arrhythmias vs. Ventricular arrhythmias triggering Takotsubo syndrome","authors":"John E. Madias MD, FACC, FAHA","doi":"10.1016/j.cpcardiol.2025.103041","DOIUrl":"10.1016/j.cpcardiol.2025.103041","url":null,"abstract":"<div><div>The present review focuses on the thesis that there is an amphidromic relationship between ventricular arrhythmias (VA) and takotsubo syndrome (TTS), with VA emerging as complications of TTS, and TTS being precipitated by VA with or without culmination in cardiac arrest (CA). The mechanism(s) of these phenomena is(are) being explored, and the emerging diagnostic possibilities are outlined. Emphasis is made on the need to upgrade our current approach in diagnosis TTS, and its occasional presence as a “TTS component”, in association with other cardiovascular and other comorbidities. The diagnosis and management of various emerging TTS subtypes, with preceding or following VA/CA is outlined, the various established or possible phenotypes are presented, and ways to confirm their pathophysiologic trajectories are offered.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 6","pages":"Article 103041"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739180","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}