Current Problems in Cardiology最新文献

{"title":"The future of cardiology: Integrating single-cell transcriptomics with multi-omics for enhanced cardiac disease insights","authors":"Zhengchun Tang ,&nbsp;Faris Alrumaihi ,&nbsp;Wanian M. Alwanian ,&nbsp;Hajed Obaid Alharbi ,&nbsp;Khaled S. Allemailem ,&nbsp;Mohammed Alissa ,&nbsp;Omar Alasmari ,&nbsp;Saad Almousa ,&nbsp;Thomas Ainsworth ,&nbsp;Xiangmei Chen","doi":"10.1016/j.cpcardiol.2025.103005","DOIUrl":"10.1016/j.cpcardiol.2025.103005","url":null,"abstract":"<div><div>Recent advancements in single-cell transcriptome sequencing (scRNA-seq) have revolutionized our understanding of cellular heterogeneity in cardiovascular diseases, enabling the identification of novel therapeutic targets. This technology allows for high-resolution analysis of gene expression at the single-cell level, revealing the complex dynamics of human heart cell development and the diverse roles of cardiac cell types in health and disease. Despite its transformative potential, current applications of scRNA-seq face limitations, including challenges in data integration and the need for comprehensive multi-omic approaches to fully elucidate the mechanisms underlying cardiovascular pathologies. This review highlights the significant insights gained from scRNA-seq studies in the mammalian heart, emphasizing the importance of integrating spatial transcriptomics and other omics technologies to enhance our understanding of cardiac biology. Furthermore, it addresses the critical research gaps in the field, particularly in the context of personalized medicine and the need for improved methodologies to analyze rare cell populations. By exploring these challenges and opportunities, this review aims to pave the way for innovative diagnostic and therapeutic strategies that can ultimately improve outcomes for patients with cardiovascular diseases.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 103005"},"PeriodicalIF":3.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081331","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":"A review regarding the article ‘Cardiovascular outcomes of sodium-glucose co-transporter 2 inhibitors use after myocardial infarction: A systematic review and meta-analysis of randomized controlled trials’","authors":"Qiang Fan PhD,&nbsp;Yunfei Ling PhD","doi":"10.1016/j.cpcardiol.2025.103006","DOIUrl":"10.1016/j.cpcardiol.2025.103006","url":null,"abstract":"<div><div>Myocardial infarction (MI) without established heart failure (HF) represents a distinct high-risk condition that is not sufficiently represented in other trial populations. Early intervention with disease-modifying therapies, such as Sodium-Glucose Co-transporter 2 inhibitors (SGLT2i), could potentially prevent progression to chronic HF in these patients. Prior trials involving patients with type 2 diabetes mellitus (T2DM), HF, or nephropathy have predominantly focused on stable outpatients and have generally excluded patients with recent acute cardiovascular events. While there is a growing interest in the potential benefits of SGLT2 inhibitors in the acute MI setting, further research is essential to determine their efficacy and safety in this patient population. This will require well-designed, targeted clinical trials that specifically address the unique characteristics and needs of patients with acute MI, including those with new onset left ventricular dysfunction, transient HF, or concurrent T2DM. Furthermore, the safety profile of SGLT2 inhibitors in post-MI patients appears to be favorable, as they have been found to have a comparable incidence of serious adverse events to placebo. This is an important consideration, as safety is a paramount concern when introducing new therapies, especially in a vulnerable patient population like those recovering from an acute MI. It is important to conduct further research to determine whether the early introduction of SGLT2 inhibitors post-MI can lead to similar benefits as those observed in patients with T2DM and established cardiovascular disease.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 103006"},"PeriodicalIF":3.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081230","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":"Sleep: Its nature and mechanism in Avicenna's medicine and psychology","authors":"Zahra Sadat Pour Seyyed Aghaei ,&nbsp;Farah Ramin","doi":"10.1016/j.cpcardiol.2025.103001","DOIUrl":"10.1016/j.cpcardiol.2025.103001","url":null,"abstract":"<div><div>Sleep is a fundamental necessity for humans and other living beings. Throughout history, many thinkers have sought to understand its complexities. Avicenna, in his works, elucidates the nature and mechanism of sleep from two angles: \"sleeping,\" as an essential process for sentient beings, and \"dreams,\" which reflect the effects of sleep on human life and health. This article explores sleep through Avicenna's lens, examining its philosophical, psychological, and medical foundations. It begins with a definition of sleep, followed by an analysis of its causes, manifestations, and types, including natural, unnatural, and artificial. The findings indicate that Avicenna was a pioneer in studying altered states of perception within the imagination, showcasing his understanding of hypnotic sleep and its therapeutic applications for disorders like melancholy.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 103001"},"PeriodicalIF":3.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076101","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":"Cardiac transplantation in muscular dystrophies: A case series","authors":"Mariano G. Bergier ,&nbsp;Rocio Blanco ,&nbsp;Ezequiel Lillo ,&nbsp;Ricardo Posatini ,&nbsp;César A. Belziti","doi":"10.1016/j.cpcardiol.2025.102997","DOIUrl":"10.1016/j.cpcardiol.2025.102997","url":null,"abstract":"<div><div>Muscular dystrophies can involve cardiac complications, including dilated cardiomyopathy, arrhythmias, and conduction system disorders. In cases of terminal heart failure, cardiac transplantation may be considered a viable option; however, its feasibility in this population has been questioned for many years. This case series describes the preoperative characteristics and postoperative outcomes of five patients with muscular dystrophy and dilated cardiomyopathy who underwent cardiac transplantation at a tertiary care center in Latin America between 2018 and 2024. All patients were male, with a mean age of 38.4 ± 11.5 years at transplantation. Genetic variants were confirmed in all cases. Although two patients experienced postoperative respiratory and swallowing complications, survival was 100 %, with a median follow-up of 16 months and good functional capacity. Cardiac transplantation is a valid option for patients with muscular dystrophies and dilated cardiomyopathy, emphasizing the importance of functional evaluation and a multidisciplinary approach to optimize outcomes.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 102997"},"PeriodicalIF":3.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075679","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":"Practical guidance for management of atrial fibrillation in sports cardiology","authors":"Andrea Palermi ,&nbsp;Lorenzo Vilhelm Molinari ,&nbsp;Fabrizio Ricci ,&nbsp;Sabina Gallina ,&nbsp;Giulia Renda MD, Ph.D","doi":"10.1016/j.cpcardiol.2025.102995","DOIUrl":"10.1016/j.cpcardiol.2025.102995","url":null,"abstract":"<div><h3>Importance</h3><div>Atrial fibrillation (AF), the most prevalent sustained arrhythmia, portends higher risk of cardiovascular morbidity and mortality, and is associated with quantifiable impairment in quality of life. While physical activity is widely recognized for its cardiovascular benefits, recent evidence challenges its role in the development of AF.</div></div><div><h3>Observations</h3><div>Emerging data suggest a U-shaped relationship between physical activity and AF risk. Mild to moderate exercise appears protective, whereas prolonged, high-intensity activity is associated with an increased risk, possibly driven by cardiac remodeling, autonomic alterations, and atrial substrate changes typical of the so-called athlete's heart. This relationship is further modulated by other factors, including genetic predisposition, acquired cardiac conditions, and stimulant use. With the growing participation of aging populations in sports, the clinical management of AF in athletes presents unique challenges. Pharmacological strategies for rhythm and rate control may conflict with performance goals, and the use of anticoagulants must be carefully balanced against the risk of traumatic bleeding in contact sports. Recent evidence supports strategies such as short-term anticoagulant withdrawal to mitigate hemorrhagic risk while maintaining thromboembolic protection. A personalized approach, incorporating shared decision-making, is essential, particularly for elite athletes.</div></div><div><h3>Conclusions and relevance</h3><div>While regular physical activity generally confers cardiovascular benefits, prolonged intense exercise bouts may paradoxically increase the risk of AF. The evaluation and management of AF in athletes require a tailored, multidisciplinary approach that accounts for the distinct needs of this population.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 102995"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrioventricular block and conduction disorders induced by ICIs: Individual patient data systematic review","authors":"Luca Pascalis MD,&nbsp;Luca Fazzini MD,&nbsp;Christian Cadeddu Dessalvi MD PhD","doi":"10.1016/j.cpcardiol.2025.103003","DOIUrl":"10.1016/j.cpcardiol.2025.103003","url":null,"abstract":"<div><div>Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that enhance T cell-mediated anti-tumor responses but may induce cardiotoxicity, including conduction disorders and atrioventricular blocks (AVB). A systematic review of 30 case reports involving cancer patients treated with ICIs was conducted. The majority of affected patients were in advanced stages of lung and kidney/urothelial cancers, predominantly male, and typically developed AVB within three weeks of therapy, often accompanied by myocarditis. Complete AVB was the most frequently observed disorder, necessitating interruption of therapy and temporary pacing. Less than half of the cases were reversible, and in-hospital mortality was significant. Further research is needed.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 103003"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076483","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":"Real-world efficacy of tirzepatide in patients with heart failure without diabetes","authors":"Silvio Nunes Augusto Jr ,&nbsp;David Kaelber MD PhD MPH ,&nbsp;W.H. Wilson Tang MD","doi":"10.1016/j.cpcardiol.2025.102998","DOIUrl":"10.1016/j.cpcardiol.2025.102998","url":null,"abstract":"<div><h3>Background</h3><div>Tirzepatide, a dual agonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has shown significant cardiovascular benefits in clinical trials. This study investigates the real-world impact of tirzepatide on heart failure (HF) outcomes, leveraging data from the TriNetX platform.</div></div><div><h3>Methods</h3><div>Using data from January 1, 2013, to December 01, 2024, we conducted a propensity-matched analysis of two cohorts of patients with HF without diabetes, where the only difference was the use of tirzepatide. The primary outcome was the incidence of acute heart failure (acute HF), with secondary outcomes including major adverse cardiovascular events (MACE), chronic kidney disease (CKD), stroke, and coronary arterial disease (CAD).</div></div><div><h3>Results</h3><div>After propensity-matching, 897 patients were compared between the two cohorts in a 4-year follow-up, showing that untreated patients were at higher risk of incident acute HF (HR: 3.12, 95 %CI = 2.240–4.349, log-rank <em>p</em> &lt; 0.001) and MACE (HR: 3.57, 95 %CI = 2.32–5.48, log-rank <em>p</em> &lt; 0.001). Stroke (HR: 2.796, 95 %CI = 1.353–5.776, log-rank <em>p</em> &lt; 0.01), CKD (HR: 1.48, 95 %CI: 1.08–2.03, log-rank <em>p</em> = 0.015), and CAD (HR: 1.474, 95 %CI,1.169–1.859, log-rank <em>p</em> = 0.001) outcomes also favored the treatment cohort.</div></div><div><h3>Conclusion</h3><div>Tirzepatide presents a promising therapeutic option for managing heart failure, with significant metabolic and cardiovascular benefits. These real-world findings reinforce its potential role as a transformative treatment in improving clinical outcomes and quality of life for patients with HF without diabetes.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 102998"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Artificial Bachmann's Bundle”, employing carbon nanotube fibers in the prevention/management of atrial fibrillation","authors":"John E. Madias MD, FACC, FAHA","doi":"10.1016/j.cpcardiol.2025.102999","DOIUrl":"10.1016/j.cpcardiol.2025.102999","url":null,"abstract":"<div><div>The present communication constitutes a proposal of attempting to restore interatrial electrical conduction in patients with interatrial block and malfunctioning Bachman's bundle, or other interatrial conduction pathways, employing carbon nanotube fibers (i.e., an “artificial Bachman's bundle”), in order to prevent emergence of atrial fibrillation, and by extension even possibly ameliorate or effectively treat paroxysmal/persistent/permanent atrial fibrillation.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 102999"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076479","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":"Genotype-phenotype correlations in hypertrophic cardiomyopathy: Insights from an HCM Center of Excellence","authors":"Muddasir Ashraf MD ,&nbsp;M. Fuad Jan MBBS (Hons), MD ,&nbsp;Arshad Jahangir MD ,&nbsp;Stacie Kroboth BS ,&nbsp;Zaid Abood MD ,&nbsp;Sara Walczak BS ,&nbsp;Heather Sanders NP ,&nbsp;A. Jamil Tajik MD","doi":"10.1016/j.cpcardiol.2025.102996","DOIUrl":"10.1016/j.cpcardiol.2025.102996","url":null,"abstract":"<div><h3>Background</h3><div>Owing to the recognition of previously unknown pathogenic gene variants and reclassification of longer-known variants, gene distribution in patients with hypertrophic cardiomyopathy (HCM) is ever-changing. Conflicting data make the role of genotype in risk stratification unclear.</div></div><div><h3>Methods</h3><div>We evaluated genotype distribution and genotype-phenotype correlations in all adult patients with HCM seen at our HCM Center of Excellence from March 31, 2010, to April 30, 2023. We also evaluated a composite outcome, including all-cause mortality, stroke, implantable cardioverter-defibrillator placement, heart failure hospitalization, left ventricular assist device implantation, heart transplantation, septal myectomy, and alcohol septal ablation, based on genotype status. All-cause mortality was separately analyzed.</div></div><div><h3>Results</h3><div>Of 827 patients with HCM, genotyping was completed in 754 (91.2 %). We identified 202 (27 %) genotype-positive (Gen-P), 163 (22 %) variant of unknown significance (VUS), and 389 (51 %) genotype-negative (Gen-N) patients. Mean ages were 47, 57, and 58 years, respectively. The most common gene implicated was <em>MYBPC3</em> (63 %). More patients were on optimal medical treatment after following up with our HCM center. Electrocardiographic, Holter, echocardiographic, and cardiac magnetic resonance imaging characteristics differed based on genotype status. The composite outcome was worse in Gen-P than Gen-N (HR 1.84, <em>p</em>&lt;0.001). Although analysis of all-cause mortality showed survival was different for Gen-P and VUS patients than for Gen-N patients, this difference was not statistically significant.</div></div><div><h3>Conclusion</h3><div><em>MYBPC3</em> was the most common gene implicated. Outcomes were worse in Gen-P patients. Centers of Excellence play an important role in the optimal medical management of patients with HCM.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 102996"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076091","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":"Utility of lung ultrasound to identify patients at risk of rehospitalization for acute decompensated heart failure","authors":"Juan María Iroulart,&nbsp;Fernando Garagoli,&nbsp;Mariano G. Bergier,&nbsp;Santiago Decotto,&nbsp;Gonzalo Fernández Villar,&nbsp;César Belziti,&nbsp;Emiliano Rossi,&nbsp;Rodolfo Pizarro","doi":"10.1016/j.cpcardiol.2025.103002","DOIUrl":"10.1016/j.cpcardiol.2025.103002","url":null,"abstract":"<div><h3>Introduction</h3><div>Residual congestion at hospital discharge predicts adverse outcomes in acute decompensated heart failure (ADHF). Lung ultrasound (LUS) is a reliable tool for assessing pulmonary congestion. This study aims to evaluate a simplified 4-zone LUS method for identifying heart failure patients at risk after discharge.</div></div><div><h3>Methods</h3><div>This prospective study included adults hospitalized for ADHF without treatable secondary causes. We employed a 4-zone LUS method to quantify B-lines. The primary endpoint was a composite of mortality or rehospitalization within 180 days. We used univariate and multivariate Cox models to evaluate the prognostic value of B-lines. A receiver operating characteristic (ROC) curve identified the optimal B-lines threshold.</div></div><div><h3>Results</h3><div>We included 155 patients (median age: 81 years [IQR 75–85]; 52.9 % male). After the follow-up period, 53 (34.2 %) patients met the primary endpoint. The ROC curve for the number of B-lines at discharge showed an AUC of 0.8, with 7 B-lines identified as the optimal cutoff (sensitivity: 70 %, specificity: 82 %). In univariate analysis, the global B-line count at discharge (HR: 1.33, 95 % CI 1.22-1.45) was significantly associated with the primary endpoint. Using a cutoff of ≥7 B-lines, the association was stronger (HR: 6.92, 95 % CI 3.80-12.60). After multivariable adjustment, ≥7 B-lines at discharge remained significant (HR: 4.41, 95 % CI 1.98-9.81).</div></div><div><h3>Conclusion</h3><div>In our population, the detection of 7 or more B-lines at discharge serves as a reliable marker for identifying patients at risk of mortality or rehospitalization within 180 days.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 103002"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076040","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}