Current Problems in Cardiology最新文献

{"title":"The diagnosis and treatment of asymptomatic and symptomatic patients with carotid artery stenosis","authors":"Robert J. Henning MD, FACC, FAHA, Brian L. Hoh MD, MBA, FACS, FAHA","doi":"10.1016/j.cpcardiol.2025.102992","DOIUrl":"10.1016/j.cpcardiol.2025.102992","url":null,"abstract":"<div><div>Carotid artery atherosclerotic stenosis is an important annual cause of stroke in the United States. Moreover, the incidence of carotid artery stenosis is significantly increasing due to the widespread popularity of high fat and high salt diets, sedentary lifestyles, and the increasing age of the population. Of major importance to cardiovascular specialists is the fact that individuals with atherosclerotic carotid artery stenosis can have a prevalence of atherosclerotic coronary artery disease as high as 50 to 75%.</div><div>Vascular screening for carotid artery stenosis with Doppler ultrasound should be considered for all symptomatic patients with possible carotid stenosis and also considered for asymptomatic patients with (1) symptomatic peripheral arterial disease, coronary artery disease, or atherosclerotic aortic aneurysm or, (2) multiple atherosclerotic risk factors.</div><div>Carotid artery atherosclerotic plaques that are at high risk for rupture and thrombosis or cerebral embolization are characterized by large lipid cores, intraplaque hemorrhage, thin fibrous caps less than 165 μms that are infiltrated by macrophages and T cells or have surface ulcer(s) or fissures. Carotid artery plaque rupture with cerebral embolism can cause a stroke, transient ischemic attacks (TIA), or ipsilateral blindness (amaurosis fugax).</div><div>Medical treatment based on the recommendations of the American and European Societies for Vascular Surgery and the American Heart Association for symptomatic patients with carotid stenosis and also asymptomatic patients with high risk carotid stenosis plaques include antiplatelet drugs, antihypertensive drugs for hypertension control and lipid lowering drugs. Management strategies and decisions about carotid revascularization in asymptomatic patients with high risk carotid stenosis should involve a multidisciplinary team and shared decision-making is recommended.</div><div>The 30 day and five to 10 year outcomes in asymptomatic carotid stenosis patients who have undergone carotid endarterectomy, carotid stenting and/or optimal medical therapy are summarized from the Veterans Administration Cooperative Study, the Asymptomatic Carotid Atherosclerosis Study and the Asymptomatic Carotid Surgery Trials. The current Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial (CREST-2) should help to resolve the debate regarding carotid artery revascularization versus primary medical treatment in asymptomatic patients with >70% carotid artery stenosis.</div><div>Symptomatic patients who present within 4.5 hours of stroke onset require evaluation for acute intravenous pharmacologic thrombolysis and patients who present with large vessel occlusion within 24 hours of symptom onset should be considered for mechanical thrombectomy to reduce the neurologic deficit. Patients with carotid artery stenosis who present with a history of cerebral infarct in the preceding six months due to cereb","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 6","pages":"Article 102992"},"PeriodicalIF":3.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015793","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":"Comparative lipidomic profiling in adolescents with obesity and adolescents with type 1 diabetes","authors":"Antonio García-Hermoso ,&nbsp;Nidia Huerta-Uribe ,&nbsp;Mikel Izquierdo ,&nbsp;Katherine González-Ruíz ,&nbsp;Jorge Enrique Correa-Bautista ,&nbsp;Robinson Ramírez-Vélez","doi":"10.1016/j.cpcardiol.2025.102991","DOIUrl":"10.1016/j.cpcardiol.2025.102991","url":null,"abstract":"<div><h3>Objective</h3><div>Both adolescents with obesity and those with type 1 diabetes (T1D) exhibit alterations in lipid profiles, but direct comparisons are limited. Comparing lipidomic profiles between obese individuals and those with T1D is crucial for identifying specific metabolic markers, informing tailored interventions, and advancing precision medicine strategies for these distinct populations. The aim of the study was to compare lipidomic profiles between adolescents with obesity and those with T1D, and to analyze associations between metabolites and clinical parameters.</div></div><div><h3>Methods</h3><div>We included 156 adolescents aged 11–18 years (59.6% girls) from the HEPAFIT (<em>n</em>=114, obesity) and Diactive-1 Cohort (<em>n</em>=42, T1D) studies. Clinical measures included anthropometrics, body composition, lipids, liver enzymes, glucose, and HbA1c. Lipidomic analysis of 277 serum/plasma metabolites used UHPLC-MS.</div></div><div><h3>Results</h3><div>Distinct lipid profiles were seen, with higher diglycerides, triglycerides, and certain phosphatidylinositols in the obesity group, while phosphatidylcholines, phosphatidylethanolamines, cholesterol esters, sphingomyelins, and ceramides were elevated in T1D. Triglycerides acyl chain lengths and saturation levels also varied. Multivariate analysis identified seven metabolites –PC(O-18:1/18:1), PC(O-18:1/22:4), PE(O-16:0/18:1), PE(18:2e/22:6), PC(40:1), PC(O-22:1/20:4), and PE(P-18:0/18:1)– significantly associated with clinical parameters.</div></div><div><h3>Conclusions</h3><div>Distinct lipid profiles were observed among adolescents with obesity and T1D in the study, emphasizing the importance of understanding specific metabolite associations with clinical parameters for more precise health management.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102991"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015810","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":"National trends in heart failure admissions in Peru: Insights on regional and demographic disparities from 2018 to 2023","authors":"Carlos Diaz-Arocutipa MD ,&nbsp;Rafael Salguero-Bodes MD ,&nbsp;Víctor Juárez MD ,&nbsp;Roberto Martín-Asenjo MD ,&nbsp;German Valenzuela-Rodriguez MD, PhD ,&nbsp;Javier Torres-Valencia MD ,&nbsp;Patricia Ríos-Navarro MD ,&nbsp;Marcos Pariona MD ,&nbsp;Lourdes Vicent MD, PhD","doi":"10.1016/j.cpcardiol.2025.102985","DOIUrl":"10.1016/j.cpcardiol.2025.102985","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) represents a significant public health challenge, particularly in low- and middle-income countries, where demographic shifts and healthcare disparities influence disease patterns. This study aimed to analyze trends in HF admissions across Peru from 2018 to 2023.</div></div><div><h3>Methods</h3><div>We conducted a secondary data analysis of emergency department morbidity records of patients aged ≥20 years registered in the National Superintendence of Health (SUSALUD) database. HF admissions were identified using ICD-10 codes. Age-adjusted standardized HF admission rates per 100,000 persons were estimated using the direct method. Annual percentage changes with their 95% confidence intervals (CI) were estimated using Poisson regression models.</div></div><div><h3>Results</h3><div>In total, 38,931 HF admissions were recorded, with the majority occurring in patients aged ≥60 years (69.2%), and 51.2% of cases were men. HF admissions showed an overall annual growth rate of 2.78% (95% CI 0.95% - 4.65%), 2.92% (95% CI 1.13% - 4.74%) for men, and 2.57% (95% CI 0.45% - 4.73%) for women. Regional disparities were evident, with the highest rates observed in the Amazon region. HF admissions declined during 2020, followed by a rebound in subsequent years.</div></div><div><h3>Conclusion</h3><div>HF admissions in Peru increased from 2018 to 2023, with notable disparities by sex and region. These findings underscore the need for targeted interventions to address regional and demographic variations in HF burden.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102985"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015832","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":"In-hospital outcomes of percutaneous left ventricular assist device recipients in cardiogenic shock hospitalizations with chronic kidney disease: A nationwide analysis","authors":"Akhil Jain MD ,&nbsp;Karnav Modi MBBS ,&nbsp;Ankit Vyas MD ,&nbsp;Maharshi Raval MD ,&nbsp;Argishty Mirzakhanian ,&nbsp;Parth R Nayak MD ,&nbsp;Rupak Desai MBBS ,&nbsp;Venkat Subramaniam MD ,&nbsp;Kiran Garikapati MD ,&nbsp;Rajkumar Doshi MD ,&nbsp;Sourbha S. Dani MD ,&nbsp;William Bennett MD ,&nbsp;Carl J. Lavie MD ,&nbsp;Jose Tafur Soto MD","doi":"10.1016/j.cpcardiol.2025.102993","DOIUrl":"10.1016/j.cpcardiol.2025.102993","url":null,"abstract":"<div><h3>Background</h3><div>There is a lack of data on the role of chronic kidney disease (CKD) in patients who received percutaneous left ventricular assist devices (pLVAD) as mechanical circulatory support (MCS) as an adjunct treatment for cardiogenic shock (CS) management.</div></div><div><h3>Methods</h3><div>Using National Inpatient Sample (2016-19), we extracted CS patients receiving pLVAD and divided them into CKD and non-CKD cohorts. Multivariate regression analysis was used for adjusted odds ratios for outcomes before and after entropy balancing (EB) and predictive margins for the probability of all-cause in-hospital mortality (ACM). ACM was also compared between CS patients who did not receive MCS.</div></div><div><h3>Results</h3><div>In our study, 29,515 patients received pLVAD as the only MCS device in CS, and the prevalence of CKD amongst them was 9.7 %. After EB, ACM did not differ in CS with and without CKD (aOR 1.008, <em>p</em> = 0.953). Higher adjusted incidence rate ratios (IRR) were noted for length of stay (LOS) (aOR 1.68, <em>p</em> &lt; 0.001) and hospitalization cost (aOR 1.365, <em>p</em> = 0.001) in CS with CKD. Mean LOS and hospitalization cost was significantly higher in CKD cohort before and after EB (post-EB: 17.4 days vs. 10.3 days, <em>p</em> &lt; 0.001 and USD 652097 vs. 482359, <em>p</em> = 0.001, respectively). ACM was significantly higher in CS patients who did not receive any MCS if they had CKD (aOR 1.26, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>CKD patients receiving pLVAD for CS had no difference in ACM but had higher resource utilization than those without CKD. pLVAD use was associated with a lower ACM in CKD patients when compared to patients who did not receive any MCS.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102993"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015824","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":"Sacubitril-valsartan in Cancer therapy-induced heart failure: A systematic review and meta-analysis of functional and hemodynamic parameters","authors":"Ramon Hüntermann ,&nbsp;Caroline O. Fischer-Bacca MD ,&nbsp;Marcel F. Alves ,&nbsp;Vanio A. Livramento Junior ,&nbsp;Francisco B. Alexandrino MD ,&nbsp;Mariane Y. Sato ,&nbsp;Rodrigo França Gomes MD, MBA, Msc, PhD ,&nbsp;Franciani R. Rocha PhD ,&nbsp;Marcelo V. Gambetta MD ,&nbsp;Edielle S. Melo MD, MSc, PhD","doi":"10.1016/j.cpcardiol.2025.102987","DOIUrl":"10.1016/j.cpcardiol.2025.102987","url":null,"abstract":"<div><h3>Background</h3><div>Cancer therapy-induced cardiotoxicity (CTRCD), in the form of heart failure with reduced ejection fraction (HFrEF), is being increasingly recognized. However, the potential benefits of sacubitril/valsartan (S/V) in managing HFrEF secondary to CTRCD remain unclear.</div></div><div><h3>Objective</h3><div>We performed a systematic review and meta-analysis to assess the effectiveness of S/V in preventing cardiotoxicity.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and Cochrane databases for studies evaluating S/V in patients with HFrEF due to CTRCD and reporting the following outcomes: (1) NYHA class; (2) NT-ProBNP and (3) echocardiographic measurements, specifically left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) and E/e' ratio. Statistical analyses were performed using RStudio software. Heterogeneity was assessed using I² statistics.</div></div><div><h3>Results</h3><div>We included 257 patients from six studies. All patients received S/V. The mean patient age was 63 ± 8 years, and 85 % of patients had breast cancer. The mean LVEF was 34±7 % at baseline. S/V significantly improved NYHA class compared to baseline (MD -0.7; 95 % CI -1.2 to -0.3; <em>p</em> &lt; 0.01), NT-proBNP (MD -985.1 pg/mL; 95 % CI -1231.3 to -739.1; <em>p</em> &lt; 0.01), GLS (MD -2.5 %; 95 % CI -3.6 to -1.4; <em>p</em> &lt; 0.01;), and E/e’ (MD -1.99; 95 % CI 3.7 to -0.1; <em>p</em> = 0.03). LVEF (MD 7.3 %; 95 % CI 5.4 to 9.2; <em>p</em> &lt; 0.01) with S/V treatment relative to baseline.</div></div><div><h3>Conclusion</h3><div>In patients with HFrEF due to CTRCD, S/V significantly improved the clinical and echocardiographic parameters of left ventricular systolic and diastolic functions.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 5","pages":"Article 102987"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015837","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":"Guideline-directed medical therapy for heart failure: Real-world evidence in one Latin-American center","authors":"Julián Mauricio Jiménez ,&nbsp;Leslie Johana Restrepo ,&nbsp;Manuela Villa ,&nbsp;Sofia Gutiérrez ,&nbsp;Isabella Villarreal ,&nbsp;Johanna Marcela Vanegas ,&nbsp;James Samir Díaz-Betancur","doi":"10.1016/j.cpcardiol.2025.102990","DOIUrl":"10.1016/j.cpcardiol.2025.102990","url":null,"abstract":"<div><h3>Background</h3><div>Despite recommendations from clinical practice guidelines to initiate four drug classes in patients with heart failure (HF) with reduced ejection fraction, information on real-world implementation remains limited. This study evaluated the medications initiated and titrated, the time until the optimal treatment tolerated, pharmacological profiles, patient's adherence, and causes of non-use of guideline directed-medical therapy (GDMT) in a cohort of patients with HF.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on patients treated in a heart failure program in Colombia. Optimal treatment tolerated was defined as that achieved within 6 months of follow-up. Medication adherence was assessed using the 4-item Morisky-Green scale.</div></div><div><h3>Results</h3><div>A total of 471 patients were included, with a median age of 76 years, 56.9 % male, and a median left ventricular ejection fraction of 35 %. Overall, 43.9 % of patients were on GDMT quadruple therapy, with a median time to optimal tolerated treatment of 57 days (IQR: 1–133). More than 90 % reached target doses with mineralocorticoid receptor antagonists and SGLT2 inhibitors, while less than 50 % achieved it with beta-blockers and renin-angiotensin-aldosterone system inhibitors. Adherence, according to the Morisky-Green scale, was 89.9 % and main causes of non-adherence were lack of social-family support (46.8 %) and forgetting to take medication (44.7 %).</div></div><div><h3>Conclusions</h3><div>In this real-world study of patients with HF, GDMT use rates were higher than those previous national registries. However, the medication doses were lower than those recommended by clinical guidelines. Identifying and quantifying adherence barriers in low- or middle-income countries is essential for implementing recommendations in clinical practice.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102990"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015821","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":"Relationship between lifestyle factors and cardiovascular disease prevalence in Somaliland: A supervised machine learning approach using data from Hargeisa Group Hospital, 2024","authors":"Yahye Hassan Muse ,&nbsp;Mukhtar Abdi Hassan ,&nbsp;Hodo Abdikarim ,&nbsp;Nuh Botan ,&nbsp;Kaltun Hassan ,&nbsp;Idiris Dahir ,&nbsp;Ayanle Suleiman ,&nbsp;Abdisalam Hassan Muse","doi":"10.1016/j.cpcardiol.2025.102994","DOIUrl":"10.1016/j.cpcardiol.2025.102994","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular diseases (CVDs) are leading contributors to global morbidity and mortality, with low- and middle-income countries experiencing disproportionately high burdens. In Somaliland, urbanization and lifestyle transitions have increased the prevalence of CVDs, necessitating an in-depth exploration of associated risk factors.</div></div><div><h3>Objective</h3><div>This study investigated the relationship between lifestyle factors and CVD prevalence among adult patients in Somaliland using data from the Hargeisa Group Hospital in 2024.</div></div><div><h3>Methods</h3><div>A cross-sectional design was employed, enrolling 411 adults aged ≥ 18 years. Data were collected through structured questionnaires and analyzed using traditional statistical methods and seven supervised machine learning models: Logistic Regression, Random Forest, Support Vector Machine (SVM), Probit Regression, KNN and Decision Tree. The study assessed associations between sociodemographic variables, lifestyle factors, and CVD prevalence while evaluating the predictive model performance.</div></div><div><h3>Results</h3><div>Age and smoking were the most significant predictors of CVD prevalence across all models, with individuals aged ≥ 60 years exhibiting the highest risk. Urban residence was associated with lower CVD prevalence, while behaviors such as khat chewing and physical inactivity increased the risk. Machine learning models, notably SVM, demonstrated robust predictive performance, achieving an accuracy of 63.4 % and an AUC of 67.1 %.</div></div><div><h3>Conclusion</h3><div>Lifestyle factors, particularly smoking, khat chewing, and dietary habits, are critical drivers of the CVD prevalence in Somaliland. These findings underscore the need for targeted public health interventions focusing on smoking cessation, dietary improvements, and culturally sensitive awareness campaigns. Machine learning techniques offer valuable tools for enhancing the predictive accuracy and guiding tailored health strategies.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102994"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015836","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 Role OF 3D echocardiography in prediction of pulmonary vascular resistance and its reversibility in simple congenital heart disease with secondary pulmonary hypertension","authors":"Mohamed Rashad Awad ,&nbsp;Inas Ibrahim Eweda ,&nbsp;Eslam Mohammed Ismail ,&nbsp;Adham Ahmed Abdeltawab M.D.","doi":"10.1016/j.cpcardiol.2025.102983","DOIUrl":"10.1016/j.cpcardiol.2025.102983","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary hypertension is a progressive and often fatal disease that frequently presents with the non-specific symptom of dyspnea on exertion.</div></div><div><h3>Aim</h3><div>To determine non-Invasive Predictors of Pulmonary vascular resistance severity and reversibility in simple Congenital Heart Disease Patients Using 3D Echocardiography.</div></div><div><h3>Patients and methods</h3><div>This was a Prospective cohort study conducted on 40 patients selected from attendees of Cardiology clinics of Ain Shams University Hospitals over a period of 2 years.</div></div><div><h3>Results</h3><div>There was a statistically significant positive correlation between PVR and its reversibility and right ventricular parameters (EDV/ESV/SVI), tricuspid valvular parameters (Coaptation height/Tenting volume/Annulus perimeter/Major axis/Minor axis) measured by 3D echocardiography (<em>P</em> &lt; 0.05). On the other hand, no statistically significant correlation was found between PVR or its reversibility and ejection fraction, and annulus area (<em>P</em> &lt; 0.05). All echocardiographic parameters are either excellent or good predictors for reversibility of PVR except for EF, FAC, and S'.</div></div><div><h3>Conclusion</h3><div>We conclude that EDV, ESV, SVI, CoH, tenting volume, and annulus perimeter were the most important variables to predict the PVR and found that all echocardiographic parameters were either excellent or good predictors for reversibility of PVR except for EF, FAC, and S'.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102983"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015794","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 surgery outcomes: The efficacy of dexmedetomidine in reducing postoperative delirium - A bibliometric study","authors":"Wang Yabo PhD,&nbsp;Li Dongxu PhD,&nbsp;Li Xiao PhD,&nbsp;An Qi MD","doi":"10.1016/j.cpcardiol.2025.102984","DOIUrl":"10.1016/j.cpcardiol.2025.102984","url":null,"abstract":"<div><div>Postoperative delirium (POD) is a prevalent complication following cardiac surgery, characterized by acute brain dysfunction observed in critically ill patients. Despite the significant impact of POD, there is currently no established treatment. Recent research has suggested that modulation of cholinergic neurotransmission and α2-adrenergic receptors may offer a therapeutic strategy for managing delirium during critical illness. This study employs bibliometric analysis to examine the emerging evidence on the role of dexmedetomidine, an α2-receptor agonist drug, in the prevention and treatment of POD. A systematic bibliometric analysis was conducted to identify and evaluate the literature on the use of dexmedetomidine in relation to POD. The study period spanned from 2006 to 2022, and the search was conducted in the Web of Science (WOS) database, focusing on relevant references. The analysis included the examination of the most frequent keywords, research trends, and frontiers to provide a comprehensive overview of the field. The bibliometric analysis revealed 160 research papers on the topic, indicating a significant increase in research output over the past decades. The field distribution, knowledge structure, and research topic evolution were identified as key areas of exploration. The analysis also highlighted the emergence of new topics and trends in the study of POD and its management. This bibliometric analysis provides a robust framework for understanding the current state of research on dexmedetomidine's efficacy in managing POD. It highlights the need for continued investigation and underscores the potential of this pharmacological approach to improve patient outcomes following cardiac surgery.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102984"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015807","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":"Mitochondrial calcium homeostasis and atrial fibrillation: Mechanisms and therapeutic strategies review","authors":"Yixuan Chang ,&nbsp;Qi Zou","doi":"10.1016/j.cpcardiol.2025.102988","DOIUrl":"10.1016/j.cpcardiol.2025.102988","url":null,"abstract":"<div><div>Atrial fibrillation (AF) is tightly linked to mitochondrial dysfunction, calcium (Ca²⁺) imbalance, and oxidative stress. Mitochondrial Ca²⁺ is essential for regulating metabolic enzymes, maintaining the tricarboxylic acid (TCA) cycle, supporting the electron transport chain (ETC), and producing ATP. Additionally, Ca²⁺ modulates oxidative balance by regulating antioxidant enzymes and reactive oxygen species (ROS) clearance. However, Ca²⁺ homeostasis disruptions, particularly overload, result in excessive ROS production, mitochondrial permeability transition pore (mPTP) opening, and oxidative stress-induced damage. These changes lead to mitochondrial dysfunction, Ca²⁺ leakage, and cardiomyocyte apoptosis, driving AF progression and atrial remodeling. Therapeutically, targeting mitochondrial Ca²⁺ homeostasis shows promise in mitigating AF. Moderate Ca²⁺ regulation enhances energy metabolism, stabilizes mitochondrial membrane potential, and bolsters antioxidant defenses by upregulating enzymes like superoxide dismutase and glutathione peroxidase. This reduces ROS generation and facilitates clearance. Proper Ca²⁺ levels also prevent electron leakage and promote mitophagy, aiding in damaged mitochondria removal and reducing ROS accumulation. Future strategies include modulating Ryanodine receptor 2 (RyR2), mitochondrial calcium uniporter (MCU), and sodium-calcium exchanger (NCLX) to control Ca²⁺ overload and oxidative damage. Addressing mitochondrial Ca²⁺ dynamics offers a compelling approach to breaking the cycle of Ca²⁺ overload, oxidative stress, and AF progression. Further research is needed to clarify the mechanisms of mitochondrial Ca²⁺ regulation and its role in AF pathogenesis. This knowledge will guide the development of innovative treatments to improve outcomes and quality of life for AF patients.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102988"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015827","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}