Research in heart yield and translational medicine最新文献

{"title":"Comparing Left Atrial Strain and the HFA-PEFF Score in Diagnosing Heart Failure with Preserved Ejection Fraction: A Cross-Sectional Study.","authors":"Hai Nguyen Ngoc Dang, Thang Viet Luong, Bang Hai Ho, Tien Anh Hoang, Anh Xuan Mai, Hung Minh Nguyen","doi":"10.18502/jthc.v20i2.19706","DOIUrl":"https://doi.org/10.18502/jthc.v20i2.19706","url":null,"abstract":"<p><strong>Highlights: </strong>The LA strain demonstrates diagnostic efficacy comparable to the HFA-PEFF score in diagnosing HFpEF.Integrating LA strain indices into current guidelines could enhance future HFpEF diagnostics.</p><p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) has a high hospitalization rate. While recent guidelines recommend parameters like E/e' and e' velocity for diagnosis, their accuracy remains limited. Left atrial (LA) strain is a potential diagnostic parameter, yet its role in the Vietnamese population is unclear. This study aims to evaluate LA strain's diagnostic value in HFpEF among Vietnamese patients, exploring its relationship with established parameters of left ventricle diastolic function.</p><p><strong>Methods: </strong>A cross-sectional study (15/04/2022 - 01/12/2023) included 49 patients with HFpEF and 69 individuals without cardiac dysfunction. The study subjects were evaluated for LA strain and HFA-PEFF score. Diagnostic criteria for HFpEF were based on the 2021 European Society of Cardiology guidelines for diagnosing and treating acute and chronic heart failure.</p><p><strong>Results: </strong>LA strain including LA reservoir (LASr), conduit (LAScd), and contractile (LASct) functions, in the HFpEF group were 20.80% [13.30-26.50], 10.89±5.16%, and 9.08±6.18%, respectively. The control group had corresponding LASr, LAScd, and LASct values of 34.45% [31.14-38.07], 17.38±4.41%, and 17.33±5.72% (p<0.001). The area under the curve (AUC) for LASr, LAScd, LAScr, and HFA-PEFF score to diagnose HFpEF was 0.852, 0.770, 0.778, and 0.890, respectively. Comparing the AUCs for diagnosing HFpEF between LASr and HFAPEFF score, no difference was found with p=0.419.</p><p><strong>Conclusion: </strong>LASr has a diagnostic value equivalent to the HFA-PEFF score in diagnosing HFpEF and could be incorporated into the existing HFpEF diagnostic guidelines.</p>","PeriodicalId":524236,"journal":{"name":"Research in heart yield and translational medicine","volume":"20 2","pages":"105-115"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontal T-P Angle: A Novel ECG Parameter for Predicting SYNTAX-1 and SYNTAX-2 Scores in Acute Non-ST-Segment Elevation Myocardial Infarction.","authors":"Erdoğan Sökmen, Muhammet Salih Ateş","doi":"10.18502/jthc.v20i1.19219","DOIUrl":"https://doi.org/10.18502/jthc.v20i1.19219","url":null,"abstract":"<p><strong>Highlights: </strong>Novel ECG Parameter: The frontal T-P angle (fT-Pa), derived from the difference between T-wave and P-wave axes, is introduced as a new predictor for coronary artery disease (CAD) complexity in acute NSTEMI patients.Strong Correlation with SYNTAX-2: fT-Pa showed a significant correlation with SYNTAX-2 scores (r = 0.229, *P* = 0.005), outperforming its association with SYNTAX-1, suggesting its utility in risk stratification.Predictive Cutoff Values: ROC analysis identified fT-Pa cutoffs of 36.5° (for SYNTAX-2 > 26.2) and 39.5° (for SYNTAX-1 > 22), offering practical thresholds for clinical use.Clinical Implications: fT-Pa provides a simple, reproducible tool to assess CAD severity even in patients with normal T-wave and P-wave axes, aiding early risk assessment in acute NSTEMI.</p><p><strong>Background: </strong>Few studies have investigated P-wave and T-wave axes, most of which focus on mortality. The frontal T-P angle (fT-Pa) is a novel ECG-derived parameter of ventricular repolarization. We aimed to evaluate the association between fT-Pa and SYNTAX-1 (SS-1) and SYNTAX-2 (SS-2) scores in patients with acute non-ST-segment elevation myocardial infarction (ANSTEMI).</p><p><strong>Methods: </strong>This retrospective study included 158 ANSTEMI patients undergoing coronary angiography. The study population was stratified based on SS-1 (≤22 vs. >22) and SS-2 (≤26.2 vs. >26.2). The fT-Pa was calculated by subtracting the P-wave axis from the T-wave axis, both obtained from the ECG device's built-in software, and compared between groups.</p><p><strong>Results: </strong>fT-Pa showed significant correlations with age (r=0.242, P=0.003), SS-2 (r=0.229, P=0.005), and T-wave axis (r=-0.626, P<0.001). Both age and fT-Pa were significantly correlated with and predictive of SS-2 (β=0.679; OR, 0.700 [95% CI, 0.584 to 0.816]; P<0.001 for age) and (β=0.147; OR, 0.048 [95% CI, 0.012 to 0.085; P=0.010 for fT-Pa). ROC curve analysis identified an fT-Pa cutoff of 36.5 (64% sensitivity, 68% specificity; AUC, 0.674; P<0.001) for predicting SS-2 > 26.2, and a cutoff of 39.5 (70% sensitivity, 62% specificity; AUC, 0.692; P=0.010) for predicting SS-1>22.</p><p><strong>Conclusions: </strong>fT-Pa showed a stronger correlation and association with SS-2 than with SS-1. This parameter may serve as a simple, reproducible tool for predicting coronary artery disease complexity, even in patients with normal T-wave and P-wave axis ranges.</p>","PeriodicalId":524236,"journal":{"name":"Research in heart yield and translational medicine","volume":"20 1","pages":"29-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Familial Hypercholesterolemia on Major Adverse Cardiac and Cerebrovascular Events in Patients with Premature Coronary Artery Disease: A Retrospective Cohort Study.","authors":"Shayan Shahi, Nasrin Gholamizadeh, Shayan Dasdar, Kaveh Hosseini, Arash Jalali, Masoumeh Lotfi Tokaldani, Masih Tajdini","doi":"10.18502/jthc.v20i1.19221","DOIUrl":"https://doi.org/10.18502/jthc.v20i1.19221","url":null,"abstract":"<p><strong>Highlights: </strong>Probable FH (LDL-C ≥190 mg/dL) was identified in 20.2% of PCAD patients.Probable FH linked to higher all-cause mortality (p < 0.05) but not MACCE incidence.Early mortality in FH may mask MACCE risk, warranting aggressive lipid management.</p><p><strong>Background: </strong>Evaluating the impact of familial hypercholesterolemia (FH) on the occurrence of major adverse cardiac and cerebrovascular events (MACCE) in patients with premature coronary artery disease.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at Tehran Heart Center, between 2004 and 2011. 3907 patients with acute coronary syndrome (ACS) who underwent coronary angiography were collected from registry systems. The patients were divided into \"Unlikely FH\" and \"Probable FH\" using a modified and simplified version of the Dutch Lipid Clinic Network (DLCN) criteria. After a 10-year follow-up, different components of MACCE between the two groups were evaluated.</p><p><strong>Results: </strong>Data from 3206 premature coronary artery disease patients with baseline LDL values were extracted. 2558 (79.8%) patients were categorized into the Unlikely FH group, and 648 (20.2%) patients were in the probable FH group. In the unlikely FH group, 745 (29.1%) patients experienced at least one of the MACCE events. In the probable FH group, 193 (29.7%) experienced at least one MACCE event. The difference between groups did not reach the level of significance (p>0.05). The mortality rate in the unlikely FH group was 6.9% (n=179), while in the probable FH group, the mortality rate was 7.8% (n=51) (p<0.05).</p><p><strong>Conclusions: </strong>In the present study, patients with probable FH pose a higher risk regarding mortality than unlikely FH patients.</p>","PeriodicalId":524236,"journal":{"name":"Research in heart yield and translational medicine","volume":"20 1","pages":"47-54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Researching Long-Term Outcomes Following Coronary Artery Bypass Grafting: A Closer Look.","authors":"Rohan Magoon","doi":"10.18502/jthc.v20i2.19712","DOIUrl":"https://doi.org/10.18502/jthc.v20i2.19712","url":null,"abstract":"","PeriodicalId":524236,"journal":{"name":"Research in heart yield and translational medicine","volume":"20 2","pages":"165-166"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-Onset Type I Left Ventricular Rupture Following Double Valve Replacement: An Unexpected Cause of Cardiac Tamponade.","authors":"Aditya Doni Pradana, Real Kusumanjaya Marsam, Hendry Purnasidha Bagaswoto, Habibie Arifianto, Putrika Prastuti Ratna Gharini","doi":"10.18502/jthc.v20i2.19711","DOIUrl":"https://doi.org/10.18502/jthc.v20i2.19711","url":null,"abstract":"<p><strong>Highlights: </strong>Cardiac tamponade due to late-onset type I left ventricular wall rupture is a very rare condition that has been reported only infrequently.A multimodality cardiac imaging approach is essential to confirm and characterize the diagnosis of left ventricular wall rupture.</p><p><strong>Background: </strong>Cardiac tamponade is a life-threatening emergency caused by substantial pericardial accumulation of fluid, blood, or pus. This buildup compresses the cardiac chambers, resulting in hemodynamic compromise, shock, and possible death. Postoperative cardiac tamponade incidence ranges from 0.1% to 6%. We describe a case of late-onset type I left ventricular (LV) rupture after double-valve replacement (DVR), presenting as cardiac tamponade.</p><p><strong>Case presentation: </strong>A 58-year-old woman was referred to our hospital with a 1-month history of progressive breathlessness and orthopnea. She had undergone DVR surgery, specifically an aortic and mitral valve replacement, 3 months prior to admission. Echocardiography performed at the referring hospital revealed a large, loculated pericardial mass, suspected to be a hemopericardium, that was compressing the LV structure and causing cardiac tamponade. Further imaging with cardiac computed tomography (CT) demonstrated contrast extravasation at the atrioventricular groove adjacent to the prosthetic mitral valve, which confirmed a type I LV rupture.The patient was diagnosed with a late-onset type I LV wall rupture following DVR. Urgent pericardiocentesis was performed, followed by an open thoracotomy, the creation of a pericardial window, and the surgical repair of the rupture site.</p><p><strong>Conclusions: </strong>Multimodal cardiac imaging, such as echocardiography and cardiac computed tomography, is essential for comprehensive assessment and characterization of the underlying etiology of postoperative cardiac tamponade.</p>","PeriodicalId":524236,"journal":{"name":"Research in heart yield and translational medicine","volume":"20 2","pages":"159-164"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Heart Rate Variability by Smartphone App Using Pulse Photoplethysmography in Acute Myocardial Infarction.","authors":"Tien Anh Hoang, Nhat Long Tran","doi":"10.18502/jthc.v20i1.19220","DOIUrl":"https://doi.org/10.18502/jthc.v20i1.19220","url":null,"abstract":"<p><strong>Highlights: </strong>Smartphone-based PPG measurements of SDNN and rMSSD effectively differentiate AMI patients from healthy controls, with SDNN ≤21.35 ms showing high sensitivity (87.6%) for detection.Reduced HRV indices (SDNN and rMSSD) correlate with clinical severity markers, including lower LVEF, higher Killip class, and multivessel CAD.Short-term HRV assessment via smartphone PPG offers a noninvasive, accessible tool for early AMI screening and risk stratification.SDNN outperforms rMSSD in diagnostic accuracy (AUC 0.832 vs. 0.738), supporting its utility in digital health monitoring for cardiovascular disease.</p><p><strong>Background: </strong>Heart rate variability (HRV) correlates with localized myocardial ischemia and predicts adverse cardiovascular outcomes after acute myocardial infarction (AMI), including sudden cardiac death, non-sudden cardiac death, and noncardiac death. Photoplethysmography (PPG) measurements demonstrate good agreement with ECG for time-domain HRV indices. In this study, HRV was measured via smartphone PPG, focusing on standard deviation of all normal RR (NN) intervals (SDNN) and root mean square of successive differences (rMSSD)-parameters recognized for their low error and recommended for clinical use.</p><p><strong>Methods: </strong>This cross-sectional case-control study was conducted at a tertiary hospital in Vietnam. HRV indices (SDNN and rMSSD) were measured for 2 minutes using a camera-based PPG smartphone application. Clinical data were collected at admission. Linear and logistic regression analyses assessed associations between HRV, AMI status, and clinical severity. Receiver operating characteristic (ROC) curve analysis evaluated diagnostic performance.</p><p><strong>Results: </strong>A total of 101 patients with AMI and 121 age- and sex-matched healthy controls were included. The AMI group exhibited significantly lower HRV indices, with a mean SDNN of 20.63 ±10.16 ms and rMSSD of 23.67±12.38 ms, compared with 33.99±11.72 ms (SDNN) and 35.9 ±16.21 ms (rMSSD) in the control group (P <0.001 for both). An SDNN cutoff of ≤21.35 ms yielded an area under the curve of 0.832, with a sensitivity of 87.6% and specificity of 62.4% for identifying AMI. Lower HRV was also significantly associated with higher clinical severity indicators, including reduced left ventricular ejection fraction, Killip class II-IV, regional wall motion abnormalities, and multivessel coronary artery disease.</p><p><strong>Conclusions: </strong>The use of camera-based HRV smartphone applications to measure short-term SDNN and rMSSD may serve as a novel digital health tool to improve the detection of coronary artery disease, particularly AMI, given its simplicity and noninvasive nature.</p>","PeriodicalId":524236,"journal":{"name":"Research in heart yield and translational medicine","volume":"20 1","pages":"37-46"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic Diagnosis and Treatment of ALCAPA Syndrome in a Pregnant Woman: A Case Report.","authors":"Seyed Mohammad Hashem Montazeri, Somayyeh Norouzi","doi":"10.18502/jthc.v20i1.19223","DOIUrl":"https://doi.org/10.18502/jthc.v20i1.19223","url":null,"abstract":"<p><strong>Highlights: </strong>Echocardiography is a safe tool for diagnosis of ALCAPA syndrome in pregnant patients with diagnostic clues .</p><p><p>In this report, we present the case of a 21-year-old woman diagnosed with ALCAPA syndrome during pregnancy, based on echocardiographic findings. We also review the diagnostic process, pregnancy management, and treatment of the patient.</p>","PeriodicalId":524236,"journal":{"name":"Research in heart yield and translational medicine","volume":"20 1","pages":"69-73"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the Unforeseen: Left Ventricular Fibroma Recurrence or Rare Complication? A Multimodality Imaging Revelation.","authors":"Sahar Asl Fallah, Mohammad Sahebjam, Kyomars Abbasi, Narges Shahbazi, Shayan Shahi, Samira Shirzad","doi":"10.18502/jthc.v20i2.19710","DOIUrl":"https://doi.org/10.18502/jthc.v20i2.19710","url":null,"abstract":"<p><strong>Highlights: </strong>Postoperative intramyocardial abscess may present with echocardiographic features indistinguishable from tumor recurrence. Cardiac magnetic resonance (CMR) with late gadolinium enhancement is critical for accurate differentiation and diagnosis.The surgical technique of using two dissimilar xenopericardial patches can create a potential dead space, serving as a nidus for infection and subsequent abscess formation despite an initially uncomplicated postoperative course.CMR findings of a T2-hyperintense core without early enhancement, surrounded by an enhancing rim, are characteristic of a contained hematoma or abscess. This signature pattern effectively rules out true neoplastic recurrence.</p><p><p>Cardiac fibroma is a sporadic primary cardiac tumor that is more prevalent in children but accounts for approximately 1% of cardiac tumors in the adult population. It is a benign tumor consisting of fibroblasts and connective tissues, typically associated with a favorable prognosis. Nonetheless, large fibromas may have a poorer prognosis due to the increased risk of arrhythmias and sudden cardiac death.In this case report, we describe a 38-year-old woman who experienced chest discomfort and shortness of breath roughly 3 months following the total resection of a left ventricular fibroma. The initial suspicion was the recurrence of fibroma, but upon further investigation, an intriguing scenario unfolded: the formation of a hematoma and abscess at the previous surgical site. Ultimately, the patient underwent redo-cardiac surgery.</p>","PeriodicalId":524236,"journal":{"name":"Research in heart yield and translational medicine","volume":"20 2","pages":"154-158"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Dyssynchrony in Wolff-Parkinson-White Syndrome Patients before and after Radiofrequency Ablation.","authors":"Maryam Moradian, Mohammad Rafie Khorgami, Avisa Tabib, Mohammad Dalili, Fariba Rashidighader, Shabnam Boudagh, Mohammad Mahdavi, Reza Abbaszadeh, Yasaman Khalili, Soheila Hoseinzadeh Moghadam","doi":"10.18502/jthc.v20i2.19704","DOIUrl":"https://doi.org/10.18502/jthc.v20i2.19704","url":null,"abstract":"<p><strong>Highlights: </strong>Radiofrequency ablation significantly improved QRS duration, PR interval, fractional shortening, and LVEF in WPW patients.Intraventricular dyssynchrony (SPWMD) was markedly reduced after ablation, while interventricular delay (IVMD) showed no significant change.Two-dimensional strain analysis demonstrated significant improvement of dyssynchrony indices in all echocardiographic views after ablation.The location of accessory pathways was not significantly associated with dyssynchrony, yet ablation successfully eliminated dyssynchrony in all patients.</p><p><strong>Objective: </strong>To evaluate the impact of radiofrequency ablation (RFA) on dyssynchrony in children with Wolff-Parkinson-White (WPW) syndrome.</p><p><strong>Methods: </strong>This pre-post interventional study was conducted at Rajaie Cardiovascular Institute in Tehran, Iran, and included patients with WPW syndrome who had accessory pathways and were candidates for RFA. Demographic and baseline data, such as age and sex, were recorded. Patients underwent ECG studies and RFA of their accessory pathways. Twelve-lead ECG was performed before and one day after RFA. Standard echocardiographic views were obtained using a Vivid S60 system with appropriate transducers in 1D (M-mode) and 2D modes, along with Doppler evaluation. Intraventricular and interventricular dyssynchrony indices were assessed, and 2D strain analysis was performed. Data were analyzed using IBM SPSS Statistics for Windows, version 26.0.</p><p><strong>Results: </strong>This study included 54 patients with WPW syndrome, 17 of whom had ventricular dyssynchrony. Ablation significantly affected QRS duration, PR interval, fractional shortening, left ventricular ejection fraction, and septal-to-posterior wall motion delay but did not significantly alter interventricular mechanical delay. The most common accessory pathways were left lateral, right posteroseptal, and left posteroseptal. The location of the accessory pathway was not significantly associated with the occurrence of dyssynchrony.</p><p><strong>Conclusions: </strong>Based on the findings of this study, RF ablation eliminated dyssynchrony in all WPW patients and improved functional and strain parameters in this population. These improvements enhance cardiac function and reduce associated risks, particularly in pediatric patients.</p>","PeriodicalId":524236,"journal":{"name":"Research in heart yield and translational medicine","volume":"20 2","pages":"89-96"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Dysfunction in β-Thalassemia: A Narrative Review.","authors":"Jana Jaber, Tania Al Hakim, Hussein ALfakeer, Rafay Ansari, Nour El Houda Alameh, Kantash Kumar, Hiba Hamdar","doi":"10.18502/jthc.v20i2.19709","DOIUrl":"https://doi.org/10.18502/jthc.v20i2.19709","url":null,"abstract":"<p><strong>Highlights: </strong>Iron overload is the primary driver of heart problems. Patients with β-thalassemia major require lifelong blood transfusions to survive.Early detection is critical because symptoms appear late. Cardiac dysfunction often remains hidden (subclinical) until the disease is advanced.Management focuses on iron chelation and monitoring. Since the body cannot naturally remove excess iron, the primary treatment to prevent or reverse cardiac damage is iron chelation therapy.</p><p><strong>Introduction: </strong>β-thalassemia, particularly the major form, is associated with significant morbidity, as it requires lifelong maintenance transfusion therapy to manage the condition. This transforms thalassemia from a fatal childhood disease into a chronic disorder. Nonetheless, this therapeutic approach presents challenges due to its pathological adverse effects on cardiac health, including heart failure and arrhythmias.</p><p><strong>Discussion: </strong>Multiple lifelong transfusions, combined with the pathological effects of thalassemia-such as hemolysis and ineffective erythropoiesis-exacerbate excessive iron deposition, primarily in the liver but most critically in the heart. This creates a vicious cycle between iron overload and cardiac dysfunction. Due to their high dependence on blood transfusions, thalassemia major patients are predisposed to left-sided heart failure, resulting from both dilated and restrictive cardiomyopathy, as well as life-threatening arrhythmias and electrical disturbances. These complications arise from the heart's overwhelmed capacity to clear free radicals. Cardiac dysfunction represents a critical complication requiring early detection and prompt intervention, underscoring the limitations of conventional echocardiography in diagnosing subclinical and systolic dysfunction-the latter often appearing only in advanced disease. Earlier risk stratification is essential, with recent studies highlighting the role of genetic predisposition, biomarkers, and advanced noninvasive imaging (MRI) in facilitating timely treatment initiation, such as iron-chelating therapy, to improve survival outcomes.</p><p><strong>Conclusions: </strong>Iron overload is an inevitable consequence for thalassemia major patients requiring transfusions, as the human body lacks mechanisms to eliminate excess iron. These patients require careful observation, monitoring, and timely diagnosis according to standard guidelines to facilitate chelation therapy and prevent its harmful effects. This review examines the complex interplay between symptomatic management of thalassemia, subsequent iron overload, and cardiac dysfunction in treated patients, with the goal of promoting early detection of therapeutic complications and timely intervention.</p>","PeriodicalId":524236,"journal":{"name":"Research in heart yield and translational medicine","volume":"20 2","pages":"137-153"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}