Current Problems in Cardiology最新文献

{"title":"Editor’s Message","authors":"","doi":"10.1016/S0146-2806(24)00535-8","DOIUrl":"10.1016/S0146-2806(24)00535-8","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 12","pages":"Article 102900"},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142540059","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(24)00539-5","DOIUrl":"10.1016/S0146-2806(24)00539-5","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 12","pages":"Article 102904"},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142540137","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":"Can the Charlson comorbidity index help to guide DOAC dosing in patients with atrial fibrillation and improve the efficacy and safety of treatment? A subanalysis of the MAS study","authors":"Gualtiero Palareti ,&nbsp;Cristina Legnani ,&nbsp;Sophie Testa ,&nbsp;Oriana Paoletti ,&nbsp;Michela Cini ,&nbsp;Emilia Antonucci ,&nbsp;Vittorio Pengo ,&nbsp;Daniela Poli ,&nbsp;Walter Ageno ,&nbsp;Paolo Prandoni ,&nbsp;Domenico Prisco ,&nbsp;Alberto Tosetto ,&nbsp;the MAS Working Group","doi":"10.1016/j.cpcardiol.2024.102913","DOIUrl":"10.1016/j.cpcardiol.2024.102913","url":null,"abstract":"<div><h3>Background</h3><div>Frailty influences the effectiveness and safety of anticoagulant therapy in patients with atrial fibrillation (AF). The age-weighted Charlson comorbidity index may offer a valuable tool to assess the risk of adverse events in AF patients treated with direct oral anticoagulants (DOACs). This sub-analysis of MAS trial data aimed to assess whether using the Charlson index, instead of the standard criteria, would have led to different dosing and improved adverse event occurrence during treatment.</div></div><div><h3>Methods</h3><div>The MAS study looked for a relationship between DOAC levels assessed at baseline and adverse events during follow-up. The study is described in detail elsewhere.</div></div><div><h3>Results</h3><div>Among the 1,657 patients studied, 832 (50.2 %) had a relatively low Charlson index (up to 6, general median class), of whom 132 (15.9 %) were treated with reduced doses. Conversely, among the 825 patients with a high Charlson index (≥7), 257 (31.1 %) received standard doses. A weak but statistically significant positive correlation (r = 0.1413, p &lt; 0.0001 by ANOVA) was observed between increasing Charlson classes and DOAC levels standardized to allow comparability among drug results. However, no significant differences were found in the incidence or number of adverse events during follow-up, or in other parameters, between patients with low and high Charlson's scores.</div></div><div><h3>Conclusions</h3><div>Utilizing the Charlson index would have led to notable differences in DOAC dosing compared to standard criteria. However, we found no evidence that its use would have improved the prediction of adverse events in AF patients enrolled in the MAS study.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102913"},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559350","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":"Determinants of cardiovascular health indices among physicians in a tertiary centre","authors":"Ruth Eshikotse Pius MB, BS ,&nbsp;Janet Ngozi Ajuluchukwu MB , BS, MMED, FNCS, FESC, FMCP ,&nbsp;Alero Ann Roberts BSc, MB, BS, MPH, FMCPH","doi":"10.1016/j.cpcardiol.2024.102914","DOIUrl":"10.1016/j.cpcardiol.2024.102914","url":null,"abstract":"<div><h3>Background</h3><div>Physicians spearhead the prevention and management of cardiovascular diseases, however, there is a paucity of studies that have assessed the cardiovascular risk profiles of physicians in Africa. We aimed to determine the cardiovascular health indices of a cross-section of physicians in Nigeria.</div></div><div><h3>Methodology</h3><div>A cross-sectional study was conducted among medical doctors in a tertiary hospital in Nigeria, with different specialties being proportionally represented. Sociodemographic, work-associated, and cardiovascular factors, together with anthropometry and Fuster-BEWAT score (FBS): <u>b</u>lood pressure, <u>e</u>xercise, <u>w</u>eight (BMI), <u>a</u>limentation and <u>t</u>obacco were used to assess cardiovascular health indices.</div></div><div><h3>Results</h3><div>The number of doctors enrolled in this study was 251 with a median age of 34; 51.4 % were males. While the mean FBS was 7.8 (±2.1), 1.6 % of physicians had ideal FBS, as 59.4 % and 39.0 % had intermediate and poor FBS respectively. A small proportion of doctors had adequate fruit or vegetable intake (1.2 %), or exercise (10.4 %). The percentages of doctors who had ideal blood pressure and BMI were 46.6 % and 27.9 % respectively. Almost all doctors were non-smokers (98.4 %). Medical officers and residents had better cardiovascular health compared to consultants. There was no statistically significant association between cardiovascular health score and other work-associated factors.</div></div><div><h3>Conclusion</h3><div>The composite cardiovascular health index of physicians was assessed as intermediate (7.8 on a maximum scale of 15). Positive metrics were normotensive blood pressure (46.6 %) and tobacco use (98.4 %). We recommend that Nigerian physicians need to improve weight, exercise, and alimentation cardiovascular health practices.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102914"},"PeriodicalIF":3.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559362","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":"Response to “Five-year risk of all-cause death and cardiovascular events in women with gestational diabetes and hypertensive disorders of pregnancy”","authors":"Rinad Akhtar,&nbsp;Aabish Aftab","doi":"10.1016/j.cpcardiol.2024.102915","DOIUrl":"10.1016/j.cpcardiol.2024.102915","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102915"},"PeriodicalIF":3.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548808","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":"Role of pulmonary ultrasonography in diagnosis of acute heart failure","authors":"Hela Bouzidi ,&nbsp;Selim hammami ,&nbsp;Ihsen zairi ,&nbsp;Sofien kammoun ,&nbsp;Sondos kraiem ,&nbsp;Mariem jabeur ,&nbsp;Rania gargouri ,&nbsp;Leila Abid","doi":"10.1016/j.cpcardiol.2024.102910","DOIUrl":"10.1016/j.cpcardiol.2024.102910","url":null,"abstract":"<div><h3>Background</h3><div>One of the most prevalent causes of emergency room visits is acute dyspnea. Several etiologies, including cardiac, pulmonary, metabolic, psychogenic etc… may be involved. Acute heart failure (AHF) is among the most common causes. This study aims to evaluate, in patients presenting with acute dyspnea to the emergency departement (ED), the accuracy of a diagnostic approach combining Lung ultrasonography (LUS) and clinical assessment as compared to the traditional AHF diagnostic work-up.</div></div><div><h3>Methods</h3><div>This is a bi-centric cross-sectional observational study, conducted at the Emergency and Cardiology Department of both the Hedi Chaker Hospital in Sfax and the Habib Thameur Hospital in Tunis for the period extending from 01/07/2022 to 30/09/2023. The diagnostic performance of pulmonary ultrasonography was studied and the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were compared with those of clinical examination, chest X-Ray, NT-pro -BNP and the Transthoracic echocardiography (TTE) which was the reference exam.</div></div><div><h3>Results</h3><div>The most common cause of acute dyspnea is acute heart failure (79.3 %). LUS had a sensitivity of 94,2 % in diagnosing AHF and a specificity of 77,5 %. Its PPV and NPV were respectively 92 % and 81 %. The area under curbe (AUC) of B-Lines required for the diagnosis of interstitial pulmonary syndrome was excellent (92 %). There was a moderate significant positive correlation between the number of B-Lines and NT-Pro-BNP levels <em>r</em> = 0.51, <em>P &lt;</em> 0.001. Also, there was a very strong significant positive relationship between the pulmonary congestion assessed by LUS and Left atrium - pressure <em>r</em> = 0.788, <em>P &lt;</em> 0.001</div></div><div><h3>Conclusion</h3><div>LUS is an excellent test both to confirm and exclude the diagnosis of AHF in patients consulting the emergency room for acute dyspnea and therefore deserves to be performed systematically.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102910"},"PeriodicalIF":3.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548809","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":"Role of biomarkers in early diagnosis and prognosis of cardiac amyloidosis: A systematic review and meta-analysis","authors":"Arif Albulushi ,&nbsp;Jehad Al Buraiki ,&nbsp;Gamal Aly ,&nbsp;Yahya Al-Wahshi ,&nbsp;Alireza Jahangirifard","doi":"10.1016/j.cpcardiol.2024.102883","DOIUrl":"10.1016/j.cpcardiol.2024.102883","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac amyloidosis is characterized by amyloid fibril deposition in the heart, leading to restrictive cardiomyopathy and heart failure. Early diagnosis and monitoring are crucial for effective management. This systematic review and meta-analysis evaluates the utility of various biomarkers in the early detection, disease progression, and prognosis of cardiac amyloidosis.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search of PubMed, Scopus, and Web of Science databases for studies published between 2000 and 2024 that assessed the diagnostic and prognostic value of biomarkers in cardiac amyloidosis. Data were extracted and analyzed to determine the sensitivity, specificity, and prognostic significance of each biomarker. The correlation between biomarker levels and imaging findings was also explored.</div></div><div><h3>Results</h3><div>A total of 45 studies were included in the meta-analysis. NT-proBNP and troponins had high sensitivity and specificity for early diagnosis of cardiac amyloidosis. Novel biomarkers, such as serum amyloid P component and light-chain assays, showed promise in distinguishing between amyloidosis subtypes and predicting disease progression. However, significant variability existed in the correlation between biomarkers and imaging findings.</div></div><div><h3>Conclusions</h3><div>Biomarkers are crucial for early diagnosis and prognosis of cardiac amyloidosis. NT-proBNP and troponins are well-established markers, while novel biomarkers offer additional insights into disease progression and subtype differentiation.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102883"},"PeriodicalIF":3.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569919","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":"Thalassemia and iron overload cardiomyopathy: Pathophysiological insights, clinical implications, and management strategies","authors":"Bagus Aditya Ansharullah MD ,&nbsp;Henry Sutanto MD, MSc, PhD ,&nbsp;Pradana Zaky Romadhon MD","doi":"10.1016/j.cpcardiol.2024.102911","DOIUrl":"10.1016/j.cpcardiol.2024.102911","url":null,"abstract":"<div><div>Thalassemia is a hereditary blood disorder characterized by reduced hemoglobin production, leading to chronic anemia. A major complication of thalassemia is iron overload, primarily due to regular blood transfusions and increased gastrointestinal iron absorption, which can lead to iron overload cardiomyopathy, a significant cause of morbidity and mortality in thalassemia patients. This review aims to provide an in-depth analysis of the pathophysiological mechanisms underlying iron overload cardiomyopathy in thalassemia, examining how excessive iron accumulation disrupts cardiac function through oxidative stress, cellular damage, and altered calcium homeostasis. Clinical manifestations, including fatigue, arrhythmias, and heart failure, are discussed alongside diagnostic strategies such as echocardiography and cardiac MRI for early detection and monitoring. Management approaches focusing on iron chelation therapy, lifestyle modifications, and advanced interventions like gene therapy are explored. The review also highlights the importance of early diagnosis, regular monitoring, and patient adherence to therapy to prevent the progression of cardiomyopathy. Recent advances in treatment and future research directions, including personalized medicine, and gene editing technologies, are presented. Addressing the challenges in managing iron overload in thalassemia patients is crucial for improving outcomes and enhancing quality of life.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102911"},"PeriodicalIF":3.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548810","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":"Prevalence and determinants of heart disease in Somaliland: An analysis of the 2020 Somaliland demographic and health survey (SLDHS)","authors":"Hodo Abdikarim ,&nbsp;Mustafe Abdillahi Ali ,&nbsp;Abdirizak Hassan Abokor ,&nbsp;Omer Adam Farih ,&nbsp;Asma Mahamoud Abdillahi ,&nbsp;Abdirashid M. Yousuf ,&nbsp;Abdisalam Hassan Muse","doi":"10.1016/j.cpcardiol.2024.102885","DOIUrl":"10.1016/j.cpcardiol.2024.102885","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular diseases (CVDs) are a leading cause of death globally, particularly in low- and middle-income countries. While data on heart disease prevalence in Somaliland is limited, the 2020 Somaliland Demographic and Health Survey (SLDHS) provides a valuable opportunity to assess this critical public health issue.</div></div><div><h3>Methods</h3><div>This study analyzed data from the 2020 SLDHS, a nationally representative cross-sectional survey. We included 18,930 individuals after data cleaning and variable selection. Heart disease was the outcome variable, while demographic and socioeconomic factors, including age, sex, region, residence, wealth, tobacco use, diabetes, and hypertension, were analyzed as predictors using STATA version 17.</div></div><div><h3>Results</h3><div>The prevalence of heart disease in Somaliland was 0.7 % (95 % CI [0.6 %, 0.9 %]). Significant associations were observed with: Sool region (AOR 1.86–6.821, <em>p =</em> 0.000), female sex (AOR 1.086–2.508, <em>p =</em> 0.019), older age groups (AOR 1.182–9.621, 1.073–11.247, 1.899–19.504 and 4.126–38.282, <em>p =</em> 0.023, 0.038, 0.002, 0.000 respectively), rural residence (AOR 1.025–2.198, <em>p =</em> 0.037), tobacco use, diabetes, and hypertension.</div></div><div><h3>Conclusion</h3><div>This study highlights the importance of regional disparities, gender differences, and the impact of modifiable risk factors like tobacco use, diabetes, and hypertension in influencing heart disease prevalence in Somaliland. These findings emphasize the need for targeted interventions and public health strategies to address these factors and improve cardiovascular health outcomes in the region.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102885"},"PeriodicalIF":3.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512414","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":"Ascertaining the prognostic role of cardiac resynchronisation therapy in cardiac sarcoidosis: A comparison with ischaemic cardiomyopathy","authors":"Mansimran Singh Dulay ,&nbsp;Raheel Ahmed ,&nbsp;Alexander Liu ,&nbsp;Rui Shi ,&nbsp;Joseph Okafor ,&nbsp;Alessia Azzu ,&nbsp;Iosif Karalis ,&nbsp;Kamleshun Ramphul ,&nbsp;John Arun Baksi ,&nbsp;Kshama Wechalekar ,&nbsp;Rajdeep Khattar ,&nbsp;Owais Dar ,&nbsp;Peter Collins ,&nbsp;Athol Umfrey Wells ,&nbsp;Vasilis Kouranos ,&nbsp;Rakesh Sharma","doi":"10.1016/j.cpcardiol.2024.102892","DOIUrl":"10.1016/j.cpcardiol.2024.102892","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac Resynchronisation Therapy (CRT) has demonstrated short and long-term benefit in heart failure with reduced ejection fraction (HFrEF), including ischaemic (ICM) and non-ischaemic cardiomyopathy. However, there is a paucity of evidence regarding its role in cardiac sarcoidosis (CS).</div></div><div><h3>Methods</h3><div>Consecutive CS patients with CRT and baseline left ventricle ejection fraction (LVEF)≤40 referred to one specialist hospital in London between November 2008-March 2023 were retrospectively reviewed. The baseline characteristics, short-term echocardiographic, clinical parameters and long-term primary and secondary outcomes were compared against a cohort of ICM patients with CRT and baseline LVEF≤40. Patients with incomplete follow-up were excluded. The primary endpoint was a composite of all-cause mortality, cardiac transplantation or heart failure hospitalisation. Secondary endpoint included ventricular arrhythmic events.</div></div><div><h3>Results</h3><div>63 CS and 93 ICM patients were analysed. A greater proportion of ICM patients male with older ages overall (both p &lt; 0.01), whereas a larger proportion of CS patients had atrioventricular block and heart failure hospitalisations (both p &lt; 0.01). Both cohorts demonstrated significant serial increase in left ventricular (LV) ejection fraction and reduction in LV end-systolic and end-diastolic volumes (p &lt; 0.01). After a mean follow up of 40.9 (±32.0) months, the primary and secondary endpoint was reached by significantly more CS patients (log-rank p = 0.008 and log-rank p = 0.004). Age (HR: 1.12 (95 %CI 1.06-1.17, p &lt; 0.001) and presence of CS (HR: 8.33 (95 %CI 3.03-22.93, p &lt; 0.001) were independent predictors of the primary endpoint on multivariable analysis.</div></div><div><h3>Conclusion</h3><div>CS patients with CRT demonstrated reverse remodelling, but had adverse long-term primary and secondary outcomes when compared to ICM patients.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102892"},"PeriodicalIF":3.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480086","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}