Current Problems in Cardiology最新文献

{"title":"Title Page","authors":"","doi":"10.1016/S0146-2806(25)00196-3","DOIUrl":"10.1016/S0146-2806(25)00196-3","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 11","pages":"Article 103177"},"PeriodicalIF":3.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158558","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":"Design and methods of the AUTOMATED-WCT trial: evaluating machine learning–based ECG support for WCT interpretation","authors":"Adam M. May MD ,&nbsp;Sarah LoCoco MD ,&nbsp;Krasimira M. Mikhova MD ,&nbsp;Rugheed Ghadban MD ,&nbsp;Phillip S. Cuculich MD ,&nbsp;Daniel H. Cooper MD ,&nbsp;Thomas M. Maddox MD, MSc ,&nbsp;Prashanth Thakkar MD ,&nbsp;Elena Deych MS ,&nbsp;Ian Rowlandson MS ,&nbsp;Alexander Siotis MD ,&nbsp;Nandan Anavaker MD ,&nbsp;Peter A. Noseworthy MD ,&nbsp;Anthony Kashou MD","doi":"10.1016/j.cpcardiol.2025.103186","DOIUrl":"10.1016/j.cpcardiol.2025.103186","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Design</h3><div>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.</div></div><div><h3>Conclusion</h3><div>The AUTOMATED-WCT Trial will be the first randomized, multicenter evidence on machine learning–based ECG decision support for WCT differentiation.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 12","pages":"Article 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}

{"title":"Guidelines for Authors","authors":"","doi":"10.1016/S0146-2806(25)00203-8","DOIUrl":"10.1016/S0146-2806(25)00203-8","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 11","pages":"Article 103184"},"PeriodicalIF":3.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158560","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":"Nocturnal hypertension and cardiovascular events: risk analysis using propensity score matching","authors":"Joaquin Perea ,&nbsp;Daniel Martin ,&nbsp;Marlon Ruiz Holguín ,&nbsp;Diego Arluna ,&nbsp;Oscar Gomez ,&nbsp;Santiago Simone ,&nbsp;Alvaro Sosa Liprandi ,&nbsp;Maria Ines Sosa Liprandi","doi":"10.1016/j.cpcardiol.2025.103185","DOIUrl":"10.1016/j.cpcardiol.2025.103185","url":null,"abstract":"<div><h3>Background</h3><div>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).</div></div><div><h3>Objectives</h3><div>To evaluate the relationship between NHT and the risk of cardiovascular events, independently of daytime blood pressure.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>NHT independently increases the risk of cardiovascular events and provides prognostic thresholds that may improve risk stratification.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 12","pages":"Article 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}

{"title":"Editor’s Message","authors":"","doi":"10.1016/S0146-2806(25)00202-6","DOIUrl":"10.1016/S0146-2806(25)00202-6","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 11","pages":"Article 103183"},"PeriodicalIF":3.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158559","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)00197-5","DOIUrl":"10.1016/S0146-2806(25)00197-5","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 11","pages":"Article 103178"},"PeriodicalIF":3.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158563","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":"Value of extreme left axis deviation in patients with complete left bundle branch block","authors":"Guido Vannoni MD,&nbsp;Carlos D. Labadet MD,&nbsp;Giuliana Caminotti MD,&nbsp;Bárbara Zambudio MD,&nbsp;Juan M. Fiamengo Tch,&nbsp;Lucas N. Campana MD,&nbsp;María V. Vannoni MD,&nbsp;Gerardo M. Marambio MD,&nbsp;Jorge A. Lax MD,&nbsp;Juan A. Gagliardi MD, PhD","doi":"10.1016/j.cpcardiol.2025.103174","DOIUrl":"10.1016/j.cpcardiol.2025.103174","url":null,"abstract":"<div><h3>Introduction</h3><div>Complete left bundle branch block (LBBB) is associated with increased risk of cardiovascular events. The value of extreme deviation of the QRS axis to the left (LAD) in the context of LBBB is controversial.</div></div><div><h3>Objective</h3><div>To evaluate whether LAD (-45°) in patients with LBBB is a marker of systolic dysfunction and ventricular remodeling.</div></div><div><h3>Material and methods</h3><div>Cross-sectional cohort study including 102 patients with LBBB who underwent echocardiography to assess left ventricular (LV) diameters, wall thickness and ejection fraction (EF).</div></div><div><h3>Results</h3><div>Mean age was 67.9 ± 13 years. 48 % were women. 80.4 % met Strauss criteria for LBBB and 28.4 % had LAD. The LAD group showed lower EF (32.2 ± 12 % vs. 46.7 ± 17 %, p = 0.00009) and higher LV end-diastolic diameter index (34.8 ± 9 vs. 30.9 ± 6, p = 0.011). LAD had 45 % sensitivity, 88 % specificity, positive predictive value of 0.79 and negative predictive value of 0.62 for identifying reduced EF. Cardiomyopathy diagnosis was more frequent in the LAD group (93.1 % vs. 61.6 %; p = 0.0016). LV hypertrophy prevalence was similar between groups, but LAD patients had higher prevalence of eccentric LV hypertrophy.</div></div><div><h3>Conclusion</h3><div>In LBBB, LAD (-45°) identifies patients with worse systolic function, greater degree of LV dilatation, and more eccentric hypertrophy. Additionally, cardiomyopathy prevalence was higher in this population.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 11","pages":"Article 103174"},"PeriodicalIF":3.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056169","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":"Sex differences in in-hospital outcomes in hypertrophic cardiomyopathy: A nationwide analysis","authors":"Ahmed M. Saad MD ,&nbsp;Mohammed Abozenah MD ,&nbsp;Colby Salerno DO ,&nbsp;Andrew M. Goldsweig MD, MS","doi":"10.1016/j.cpcardiol.2025.103172","DOIUrl":"10.1016/j.cpcardiol.2025.103172","url":null,"abstract":"<div><h3>Background</h3><div>Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiomyopathy. HCM is associated with heart failure (HF), arrhythmia, and acute coronary syndrome (ACS). The influence of sex on in-hospital outcomes in HCM is unknown. We conducted a nationwide analysis to compare outcomes between women and men with HCM hospitalized for HF, arrhythmias, or ACS.</div></div><div><h3>Methods</h3><div>This retrospective cohort analysis of the 2022 National Inpatient Sample (NIS) identified adults hospitalized with acute HF, arrhythmia, or ACS plus a secondary diagnosis of HCM. The primary outcome was in-hospital mortality. Secondary outcomes included length of stay (LOS) and total hospital charges. Multivariable logistic and linear regression models were used to adjust for demographics and comorbidities.</div></div><div><h3>Results</h3><div>Among 5,089 HCM admissions (51.1 % female; mean age 65.9 years), women were older (68.9 vs. 62.1 years) and more often admitted for acute HF. Arrhythmia presentations were similarly common in both sexes, and men more frequently had ACS. In-hospital mortality was 1.7 % and did not differ by sex after adjustment (adjusted odds ratio 1.3, <em>p</em> = 0.63). Mean LOS was 4.3 days and was similar between sexes. Total hospitalization charges showed no significant sex difference for HF or ACS, but men incurred higher charges for arrhythmias.</div></div><div><h3>Conclusions</h3><div>In this nationwide analysis, sex was not an independent predictor of in-hospital mortality or LOS among admissions with HCM and acute cardiovascular events. Resource utilization was broadly comparable except for arrhythmia admissions, where charges were substantially higher in men. Differences in hospital charges suggest that differences in management may exist.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 11","pages":"Article 103172"},"PeriodicalIF":3.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056236","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":"Knowledge mapping of SGLT2-inhibitors and cardiovascular outcomes: A bibliometric analysis","authors":"Aysa Rezabakhsh ,&nbsp;Hadis Iraji ,&nbsp;Ashot Avagimyan ,&nbsp;Elena Aghajanova ,&nbsp;Zinaida Jndoyan ,&nbsp;Lilia Mirzoyan ,&nbsp;Waseem Hassan ,&nbsp;Solomon Habtemariam ,&nbsp;Anne Meddahi-Pellé ,&nbsp;Graciela Pavon-Djavid ,&nbsp;Abolfazl Barzegri","doi":"10.1016/j.cpcardiol.2025.103171","DOIUrl":"10.1016/j.cpcardiol.2025.103171","url":null,"abstract":"<div><h3>Introduction</h3><div>Initially developed for the treatment of type 2 diabetes mellitus (T2DM), SGLT2 inhibitors have increasingly been recognized for their substantial cardiovascular, renal, and metabolic benefits. This study undertakes a systematic bibliometric analysis to delineate research trends, quantify advancements, and identify influential studies on SGLT2 inhibitors and cardiovascular outcomes.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed using the Scopus database, resulting in 10,211 documents up to the search date. Both original research articles and reviews (narrative and systematic) were included. Quantitative metrics such as publication count, citation analysis, and authorship were employed. Network visualization tools (e.g., VOSviewer) and bibliometric software (R Studio with bibliometrix packages) were used to analyze collaboration networks, keyword co-occurrence, and thematic clustering.</div></div><div><h3>Results</h3><div>The analysis revealed a significant upward trend in publication volume, with a notable peak in recent years, indicating a heightened interest in the topic among scientists. The United States and selected European institutions emerged as major contributors, with prominent authors and funding sources influencing the research output. Thematic analysis highlighted a focus on cardiovascular diseases, heart failure, renal outcomes, and mechanistic studies of SGLT2 inhibitor action. Notably, landmark randomized controlled trials have reported significant reductions in cardiovascular mortality, heart failure hospitalizations, and progression of kidney disease.</div></div><div><h3>Conclusion</h3><div>This study underscores the transformative impact of SGLT2 inhibitors on cardiovascular therapy. The analytical framework highlights the expansion of the field, and the integration of translational research.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 12","pages":"Article 103171"},"PeriodicalIF":3.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056183","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 triadic relationship between nonalcoholic fatty liver disease, type 2 diabetes, and cardiovascular disease: From molecular mechanisms to clinical management","authors":"Yuxi Jin ,&nbsp;Mohammed Alissa ,&nbsp;Ahmed Ezzat Ahmed ,&nbsp;Amin A. Al-Doaiss ,&nbsp;Naif Asiri ,&nbsp;Yasser Assiri ,&nbsp;Shahid Ullah Khan Phd ,&nbsp;Munir Ullah Khan ,&nbsp;Samuel Joseph","doi":"10.1016/j.cpcardiol.2025.103170","DOIUrl":"10.1016/j.cpcardiol.2025.103170","url":null,"abstract":"<div><div>Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) represent interconnected metabolic disorders with multifaceted etiology, demonstrating bidirectional relationships and pronounced associations with cardiovascular diseases (CVDs). Despite extensive research, significant knowledge gaps persist regarding the temporal progression of these comorbidities, optimal screening strategies for high-risk populations, and personalized therapeutic approaches targeting the hepatic-cardiac-metabolic axis simultaneously. Current literature lacks a comprehensive analysis of phenotypic heterogeneity within NAFLD-T2DM-CVD clusters and fails to address sex-specific and ethnic variations in disease progression patterns adequately. A systematic literature search was conducted across PubMed, Medline, Embase, Web of Science, and Google Scholar databases from inception to June 2024, employing various combinations of terms including NAFLD, NASH, T2DM, and CVDs, with emphasis on identifying mechanistic pathways, epidemiological trends, and therapeutic innovations. This review identifies novel pathophysiological mechanisms linking hepatic steatosis, insulin resistance, and cardiovascular dysfunction, including previously underexplored roles of gut microbiome dysbiosis, advanced glycation end products, and epigenetic modifications. Emerging evidence suggests distinct molecular signatures that could facilitate precision medicine approaches. The intricate interplay between diabetes, hepatic dysfunction, and cardiovascular complications represents a global health challenge requiring integrated management strategies. Future research should prioritize developing biomarker-guided therapeutic algorithms, investigating sex-specific treatment responses, and establishing standardized protocols for concurrent NAFLD-T2DM-CVD management to optimize clinical outcomes and reduce healthcare burden.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 11","pages":"Article 103170"},"PeriodicalIF":3.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006870","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}