Current Problems in Cardiology最新文献

{"title":"Long-term prognosis of elderly patients undergoing atrial septal defect closure: Are we acting too late?","authors":"Maria Rita Lima ,&nbsp;Mariana Sousa Paiva ,&nbsp;Sérgio Maltês ,&nbsp;Sérgio Madeira ,&nbsp;Inês Carmo Mendes ,&nbsp;José Pedro Neves ,&nbsp;Rui Anjos","doi":"10.1016/j.cpcardiol.2024.102930","DOIUrl":"10.1016/j.cpcardiol.2024.102930","url":null,"abstract":"<div><h3>Background</h3><div>Atrial septal defects (ASD) often go unrecognized until very late in life. The impact of ASD closure on life expectancy in elderly patients remains unclear. This study compares the survival of patients≥65-years who underwent ASD closure with their average life expectancy (ALE).</div></div><div><h3>Methods</h3><div>Single-centre retrospective study including all patients ≥65-years who underwent <em>ostium secundum</em> (OS) ASD closure (surgical/percutaneous) between 1998-2020. Baseline characteristics and the predicted peri-procedural ALE (as determined per pre-defined national ALE tables) for every given patient were assessed.</div></div><div><h3>Results</h3><div>706 patients underwent OS ASD closure, 37 (5%) had ≥65 years–mean age 69±5 years, 62% presented with heart failure. Mean ASD size=21±9mm, 22% patients had severe tricuspid regurgitation, mean systolic pulmonary artery pressure (SPAP)=50±11mmHg. Five patients were treated surgically. At a mean follow-up of 9±5 years, mortality rate was 46%, occurring 8.8±5.3 years after the procedure. 25 (68%) outlived their predicted ALE. Overall, the mean age of death did not differ from the predicted ALE (79±6 vs. 84±1 years, p=0.304), however there was a 10-year absolute difference between patients who died prematurely vs. those who surpassed ALE (77±4 vs. 87±3 years, p&lt;0.001). Patients who failed to reach ALE had higher SPAP (58±10 vs. 46±8mmHg, p=0.001) and a higher incidence of severe tricuspid regurgitation (42 vs. 12%, p=0.040).</div></div><div><h3>Conclusion</h3><div>Survival after late ASD closure was comparable to the expected ALE, though one-third of the patients died prematurely. Higher SPAP and severe tricuspid regurgitation were associated with premature death. ASD closure in elderly requires a thorough evaluation to ensure maximum benefit.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 2","pages":"Article 102930"},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682872","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":"The global magnitude and temporal trend of hypertensive heart disease burden attributable to high sodium intake from 1990 to 2021","authors":"Yuanyuan Wang ,&nbsp;Yanran Li ,&nbsp;Zhaojia Lu ,&nbsp;Zhengyan Li ,&nbsp;Rui Wang ,&nbsp;Zhengming Wang ,&nbsp;Yong Gu ,&nbsp;Liyun Chen","doi":"10.1016/j.cpcardiol.2024.102931","DOIUrl":"10.1016/j.cpcardiol.2024.102931","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between high sodium intake (HSI) and hypertensive heart disease (HHD) has been confirmed. However, notable regional disparities exist in implementing effective measures to control sodium intake. This study was carried out to estimate the spatiotemporal trends in the burden of HHD attributable to HSI.</div></div><div><h3>Methods</h3><div>Data obtained from the Global Burden of Disease Study 2021 were analyzed, considering factors such as age, gender, year, and region. Joinpoint regression analysis was applied to investigate the temporal trends in the HHD burden resulting from HSI over the past 32 years.</div></div><div><h3>Results</h3><div>From 1990 to 2021, the global cases of HHD increased significantly annually. The age-standardized prevalence rates showed a slow gradual increase. However, both the age-standardized death and disability-adjusted life-year (DALY) rates decreased. Specifically, HSI was responsible for 29.2% of total HHD deaths and 30.4% of total DALYs in 1990 but only 22.8% of total HHD deaths and 23.4% of total DALYs in 2021. A greater burden from HSI exposure was observed among men, older adults and people living in middle and low sociodemographic index (SDI) countries and regions. Moreover, over the 32-year period, Guam and Colombia demonstrated the highest reduction in age-standardized death and DALY rates, respectively.</div></div><div><h3>Conclusion</h3><div>Globally, the age-standardized burden of HHD due to HSI has demonstrated a decline. Although some areas have effectively managed this issue, it remains a challenge in specific areas. Hence, it is crucial to examine and implement the strategies adopted by successful nations to further mitigate this burden.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 2","pages":"Article 102931"},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683183","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":"High consumption of artificially sweetened beverages and associated risk of cardiovascular events: A systematic review and meta-analysis","authors":"Ivo Queiroz ,&nbsp;Maria L.R. Defante ,&nbsp;Arthur Tavares ,&nbsp;Vanio Antunes ,&nbsp;Cynthia Florencio de Mesquita ,&nbsp;Lucas M. Barbosa ,&nbsp;Beatriz Ximenes Mendes ,&nbsp;Angela S. Koh MBBS, MPH, PhD, FACC, FESC","doi":"10.1016/j.cpcardiol.2024.102837","DOIUrl":"10.1016/j.cpcardiol.2024.102837","url":null,"abstract":"<div><h3>Background</h3><div>With the rising use of artificial sweeteners as sugar substitutes, concerns regarding their impact on cardiovascular health have emerged. Artificially sweetened beverages are the primary source of diet sweeteners, but despite approval by national food agencies, evidence of their association with cardiovascular events has not been conclusive. Our Meta-Analysis assessed the relationship between artificially sweetened beverage consumption and long-term outcomes of cardiovascular events in extended follow-up cohorts.</div></div><div><h3>Methods</h3><div>Medline, Embase, and Cochrane databases were systematically searched for cohort studies investigating the incidence of all-cause mortality, cardiovascular mortality, stroke, and coronary heart disease among individuals with high consumption of ASB compared to minimal or no consumption. Pooled event hazard ratios with 95% confidence intervals were calculated using a random-effects model in R software, with heterogeneity assessed via I² statistics.</div></div><div><h3>Results</h3><div>We included twelve prospective cohorts comprising 1,224,560 patients. Analyses were conducted on patient groups with data adjusted for co-founding, such as dietary factors and comorbidities. One or more daily dose of Artificially sweetened beverages was significantly associated with a higher risk of all-cause mortality (HR 1.14; 95% 1.03 to 1.26; p &lt; 0.01;), Cardiovascular mortality (HR 1.29; 95% 1.1 to 1.53; p &lt; 0.01), and stroke (HR 1.15; 95% 1.01 to 1.32; p = 0.04;).</div></div><div><h3>Conclusion</h3><div>In this meta-analysis, we found a significant association between high consumption of ASBs and increased incidence of ACM, CVD, and stroke, highlighting potential long-term cardiovascular implications.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102837"},"PeriodicalIF":3.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669965","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":"Right ventricular strain as a predictor of trastuzumab-induced chemotherapy-related cardiac dysfunction: A meta-analysis","authors":"Hritvik Jain MBBS ,&nbsp;Mushood Ahmed MBBS ,&nbsp;Muhammad Daoud Tariq MBBS ,&nbsp;Jyoti Jain MBBS ,&nbsp;Aman Goyal MBBS ,&nbsp;Ramez M. Odat MD ,&nbsp;Mayank Jha MBBS ,&nbsp;Suchit Shashikumar MBBS ,&nbsp;Isobel Scott MBChB ,&nbsp;Raheel Ahmed MBBS, MRCP","doi":"10.1016/j.cpcardiol.2024.102919","DOIUrl":"10.1016/j.cpcardiol.2024.102919","url":null,"abstract":"<div><h3>Introduction</h3><div>The survival rates of breast cancer patients have improved drastically in the past few decades due to advancements in anti-neoplastic drugs. Trastuzumab (TZ) chemotherapy is associated with left ventricular dysfunction leading to cardiotoxicity. Two-dimensional speckle-tracking echocardiography has demonstrated efficacy in predicting TZ-induced cardiotoxicity; however, its role in using right ventricular (RV) strain parameters remains unclear.</div></div><div><h3>Methods</h3><div>A comprehensive literature search spanning major electronic databases was conducted to identify studies comparing pre- and post-TZ chemotherapy RV strain parameters. The outcomes of interest included RV global longitudinal strain (GLS) and RV free-wall longitudinal strain (FWLS). Mean differences (MD) with 95% confidence intervals (CI) were pooled using the inverse-variance random-effects model. Statistical significance was set at p&lt;0.05.</div></div><div><h3>Results</h3><div>Four studies involving 275 cancer patients were included. The mean age of the patients was 53.35 ± 11.1 years. The pooled analysis demonstrated significantly reduced RV GLS [MD: -1.94; 95% CI: -2.83, -1.05; p&lt;0.01] and RV FWLS [MD: -2.05; 95% CI: -3.61, -0.50; p&lt;0.01] on follow-up post-TZ chemotherapy compared to pre-TZ baseline values.</div></div><div><h3>Conclusion</h3><div>Following TZ-based chemotherapy, RV subclinical damage ensues without overt clinical signs, leading to the deformation of RV mechanics. This meta-analysis demonstrated a reduction in RV GLS and RV FWLS after TZ-based chemotherapy.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102919"},"PeriodicalIF":3.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632049","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":"Incidence and in-hospital mortality among women with acute myocardial infarction with or without SCAD","authors":"Chayakrit Krittanawong MD, FACC ,&nbsp;Yusuf Kamran Qadeer MD ,&nbsp;Song Peng Ang MD ,&nbsp;Zhen Wang PhD ,&nbsp;Mahboob Alam MD, FACC ,&nbsp;Samin Sharma MD, FACC, MSCAI ,&nbsp;Hani Jneid MD, FACC, FSCAI","doi":"10.1016/j.cpcardiol.2024.102921","DOIUrl":"10.1016/j.cpcardiol.2024.102921","url":null,"abstract":"<div><h3>Background</h3><div>Spontaneous coronary artery dissection (SCAD) has been increasingly recognized in the past decades. SCAD patients can present with acute myocardial infarction (AMI), particularly in young healthy women without conventional risk factors. However, data on the outcomes of SCAD patients presenting with AMI or benefit of PCI for SCAD in the setting of AMI is inconclusive.</div></div><div><h3>Methods</h3><div>We evaluated the prevalence, recent trends, the incidence and in-hospital mortality among women with acute myocardial infarction (AMI) who presented with or without SCAD, and to evaluate the impact of PCI on in-hospital mortality from a population-based analysis, using the National Inpatient Sample (NIS) database between 2016 and 2019.</div></div><div><h3>Results</h3><div>From 2016-2019, there were 1,527,555 cases of females presenting with AMI. Of that number, there were 12,125 cases of SCAD. Mortality trends in the SCAD and non-SCAD group were comparable. There was a gradual increase in incidence each year for SCAD-STEMI.</div></div><div><h3>Conclusion</h3><div>Mortality did not differ from 2016-2019 in patients with MI found to have SCAD or not. However, it seems that the SCAD-MI cases are gradually increasing each year. More research needs to be performed to better elucidate treatment outcomes in these patients.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102921"},"PeriodicalIF":3.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632047","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 future of hypertension pharmacotherapy: Ongoing and future clinical trials for hypertension","authors":"Taha Mansoor MD ,&nbsp;Fatima Farrukh MD ,&nbsp;Subaina N. Khalid MD ,&nbsp;Dmitry Abramov MD ,&nbsp;Erin D. Michos MD, MHS ,&nbsp;Anurag Mehta MD ,&nbsp;Timir K. Paul MD, PhD ,&nbsp;Sourbha S. Dani MD, MSc ,&nbsp;Mahmoud Al Rifai MD ,&nbsp;Arunima Misra MD ,&nbsp;Vijay Nambi MD, PhD ,&nbsp;Salim S. Virani MD, PhD ,&nbsp;Abdul Mannan Khan Minhas MD, MS","doi":"10.1016/j.cpcardiol.2024.102922","DOIUrl":"10.1016/j.cpcardiol.2024.102922","url":null,"abstract":"<div><div>Hypertension is among the most prevalent diagnoses across the world and increases the risk of many serious health problems, such as stroke, heart disease, and kidney disease. Pharmacological approaches to treat hypertension are often required and reduce blood pressure through mechanisms such as vasodilation, inhibition of the renin-angiotensin-aldosterone pathway, and increased urine output to reduce blood volume, among other mechanisms. Further research is ongoing to find novel pathways and mechanisms to treat hypertension, which we summarize in this review. We used clinicaltrials.gov to gather information about ongoing clinical trials of pharmacological hypertension therapy as of March 2024 and found 103 clinical trials that met our criteria. The interventions of these 103 clinical trials include novel and previously approved pharmacological and dietary supplement therapies for hypertension. We aim to use these clinical trials to provide insight into the future therapies and practices of hypertension treatment.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102922"},"PeriodicalIF":3.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632051","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":"Genetic predisposition to acute lung injury in cardiac surgery ‘The VEGF Factor’: Review article and bibliometric analysis","authors":"Wang Yabo PhD ,&nbsp;Li Dongxu PhD ,&nbsp;Li Xiao PhD ,&nbsp;Bhushan Sandeep PhD ,&nbsp;An Qi MD","doi":"10.1016/j.cpcardiol.2024.102927","DOIUrl":"10.1016/j.cpcardiol.2024.102927","url":null,"abstract":"<div><div>Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are among the most prevalent complications associated with cardiac surgery involving extracorporeal circulation (ECC), contributing to adverse outcomes and representing a significant impediment to successful cardiac surgical procedures. Vascular endothelial growth factor (VEGF) is implicated in the etiology of ALI/ARDS; however, its precise role remains a subject of debate due to the presence of somewhat contradictory findings in the literature, necessitating further investigation. To date, numerous studies have explored the role of VEGF in the pathophysiology of ALI/ARDS, with ongoing discussions regarding whether VEGF exerts a protective or detrimental effect. The genetic polymorphism of the VEGF gene is a significant factor in the development of ALI/ARDS. Research has indicated that the prevalence of the VEGF polymorphic gene is markedly higher in postoperative cardiac surgery patients who develop ALI/ARDS compared to the general population. Furthermore, the mortality rate among patients possessing the VEGF polymorphic gene is significantly elevated. Concurrently, it has been demonstrated that ARDS patients who are positive for the VEGF polymorphism exhibit a reduction in VEGF levels within alveolar lavage fluid, which correlates with an exacerbation of lung injury. The present paper provides a comprehensive review of the genetic polymorphisms of VEGF and their implications in the pathophysiological alterations observed in postoperative cardiac surgery patients with ALI/ARDS, thereby offering novel insights and evidence to further elucidate the mechanisms underlying ALI/ARDS.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102927"},"PeriodicalIF":3.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606968","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":"Transforming pediatric heart failure: Efficacy of low-dose sacubitril/valsartan","authors":"Hui Zha ,&nbsp;Xuejia Zhai ,&nbsp;Lin Wang ,&nbsp;Quancheng Yang ,&nbsp;Qing Guo ,&nbsp;Yanyu Chen ,&nbsp;Jie Liu ,&nbsp;Hua Peng","doi":"10.1016/j.cpcardiol.2024.102926","DOIUrl":"10.1016/j.cpcardiol.2024.102926","url":null,"abstract":"<div><h3>Aims</h3><div>Pediatric heart failure is a significant cause of illness and death in children. We aimed to assess sacubitril/valsartan's effectiveness and find the proper dosage for pediatric patients.</div></div><div><h3>Methods</h3><div>Patients unresponsive to traditional medicines for at least 12 months prescribed sacubitril/valsartan from January 2020 to March 2023 were reviewed. The initial dose was 0.2 mg/kg bid, gradually increasing in 0.1 mg/kg increments. The target dose was determined based on blood pressure fluctuations at 70/50 mmHg. Clinical efficacy and quantity-effect relationship were evaluated using echocardiography, NT-proBNP, and the concentration of valsartan, sacubitril, sacubitrilat.</div></div><div><h3>Results</h3><div>A total of 23 pediatric patients with dilated cardiomyopathy and advanced heart failure were enrolled. Mean sacubitril/valsartan dose was 1.84 mg/kg/day. After 6 months, LVEF increased significantly (38.09% to 45% at 3 months, 52% at 6 months; <em>p</em> &lt; 0.001). LV size reduced to 4.4 cm (IQR, 4.1–5.2) and 4.5 cm (IQR, 4–5.1) at 3 and 6 months, respectively, from 4.6 cm (IQR, 4.2–5.6) at baseline (both <em>P</em> &lt; 0.05). NT-proBNP levels reduced by 5.7 at 3 months (<em>p</em> &lt; 0.05) and 5.38 at 6 months (<em>p</em> &lt; 0.001). Sacubitrilat is the active form of Sacubitril. The highest concentration of sacubitrilat was observed at approximately 1.6 mg/kg. The maintenance dose correlated positively with time (<em>p</em> &lt; 0.001) and valsartan/sacubitril concentration (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Low dose sacubitril/valsartan is effective in children with heart failure, with dosage adjustments to avoid hypotension. Adjusted dosing can increase EF and reduce heart size, offering new possibilities for pediatric heart failure treatment.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102926"},"PeriodicalIF":3.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606973","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":"The association between insulin resistance and cytokines in adolescents with excess of adiposity","authors":"Robinson Ramírez-Vélez ,&nbsp;María Correa-Rodríguez ,&nbsp;Juan Carlos Calderón-González ,&nbsp;Albeiro Dávila-Grisales ,&nbsp;Katherine González-Ruíz ,&nbsp;Jorge Enrique Correa-Bautista ,&nbsp;Mikel Izquierdo","doi":"10.1016/j.cpcardiol.2024.102925","DOIUrl":"10.1016/j.cpcardiol.2024.102925","url":null,"abstract":"<div><h3>Background and aims</h3><div>Increased adiposity has been directly associated with insulin resistance (IR), and cytokines released by adipose tissue seem to link adiposity to IR in youth. We used an antibody-based array to investigate the differential levels of serum cytokines according to insulin status in a cohort of overweight/obese and inactive adolescents and evaluated their potential associations with clinical and metabolic characteristics.</div></div><div><h3>Methods and results</h3><div>We performed a cross-sectional data analysis from 122 adolescents (11–17 years of age). We assessed body composition, cardiometabolic risk factors, biochemical variables, and physical fitness. The concentration of 55 cytokines was quantified in blood samples. The homeostasis model assessment insulin resistance (HOMA‐IR) and AST/ALT and TG/HDL ratios were calculated. IR adolescents as defined as HOMA-IR &gt;2.5. The number of adolescents with IR in the study was 91 (66 % girls). In the IS group, after controlling for confounders, higher IL-15 levels were significantly associated with higher alanine aminotransferase levels and lower AST/ALT ratio, respectively (<em>Ps</em>&lt;0.05). In the same line, there were significantly higher alanine aminotransferase levels and lower AST/ALT ratio, respectively, with FGF-9 (<em>Ps</em>&lt;0.05). Likewise, higher alanine aminotransferase levels were significantly associated positively with HGF (<em>p</em>=0.045). Additionally, leptin levels are associated with six adiposity indexes (i.e., fat mass/height index, body fat, body mass index, android fat mass and gynoid fat mass) in overweight/obese adolescents with IR (<em>Ps</em>&lt;0.05).</div></div><div><h3>Conclusions</h3><div>These data may provide novel insights into the pathogenic mechanisms underlying IR in youth, offering new targets for prevention.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102925"},"PeriodicalIF":3.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606957","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":"Current status and challenges of cardiac transplantation in the MENA region: A narrative review","authors":"Mohammad Tanashat ,&nbsp;Ahmed Zayed MD ,&nbsp;Mohammed Ayyad MD ,&nbsp;Mouath Abu Daoud ,&nbsp;Mohammad Tabbalat ,&nbsp;Obieda Altobaishat ,&nbsp;Jana Nusier ,&nbsp;F.N.U. Deepak ,&nbsp;Yazan A. Al-Ajlouni MD, MPhil","doi":"10.1016/j.cpcardiol.2024.102920","DOIUrl":"10.1016/j.cpcardiol.2024.102920","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac transplantation has progressed markedly since 1967, with advances in immunosuppression, surgical techniques, and postoperative care that improve outcomes. However, challenges persist in the Middle East and North Africa (MENA) region due to unique cultural, economic, and infrastructural barriers. This review explores the status, innovations, and challenges of cardiac transplantation within MENA countries, comparing outcomes with global standards.</div></div><div><h3>Methodology</h3><div>A comprehensive literature search was conducted across PubMed, Web of Science, and Cochrane databases, including studies from inception to May 2024. Search terms targeted heart transplantation practices, challenges, and innovations in the MENA region. Articles not in English, non-human studies, and duplicates were excluded. Data extraction focused on patient demographics, transplantation outcomes, and barriers specific to the MENA context.</div></div><div><h3>Results</h3><div>Cardiac transplantation in MENA has made strides, with established programs in Saudi Arabia, the UAE, and Lebanon. Innovations like ex-vivo perfusion and Left Ventricular Assist Devices (LVAD) are improving transplant outcomes, yet organ shortages remain critical. Cultural and religious beliefs influence donation rates, and infrastructure varies widely, with disparities in healthcare resources across countries. Key barriers include low donor registration, inconsistent brain death definitions, and limited public awareness. Economic and infrastructure limitations further complicate access to advanced transplantation techniques.</div></div><div><h3>Conclusion</h3><div>While cardiac transplantation has evolved in MENA, significant barriers hinder widespread adoption. Enhancing public awareness, developing regional networks, and implementing standardized protocols can improve outcomes. Targeted immunosuppressive therapies and continued innovation in organ preservation are essential to advance cardiac transplantation in MENA.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102920"},"PeriodicalIF":3.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606965","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}