Cardiology Plus最新文献

{"title":"Rats subject to extracorporeal membrane oxygenation have improved cardiac function following anticoagulation and reversal with factor IXa aptamer-antidote oligonucleotide pair.","authors":"Shahid M Nimjee, Fellery de Lange, George A Pitoc, Bruce A Sullenger","doi":"10.1097/CP9.0000000000000122","DOIUrl":"10.1097/CP9.0000000000000122","url":null,"abstract":"<p><strong>Background and purpose: </strong>Unfractionated heparin (UFH) is the most commonly utilized rapid-onset anticoagulant, valued for its potency and reversibility with protamine. However, UFH and protamine are associated with significant side effects, including increased morbidity and mortality, and concerns about sustainability due to the environmental impact of large-scale pig farming for heparin production. This study evaluates an alternative anticoagulant strategy using a factor IXa (FIXa) aptamer paired with a matched oligonucleotide antidote, comparing its efficacy and safety to heparin-protamine in a rat extracorporeal membrane oxygenation (ECMO) model.</p><p><strong>Methods: </strong>Twenty-four Sprague-Dawley rats were randomized into two groups: one receiving heparin (600 IU/kg) and protamine (1 mg/100 IU heparin), and the other receiving a cholesterol-modified FIXa aptamer (10 mg/kg) and its antidote (50 mg/kg). Coagulation parameters, platelet counts, inflammatory markers, cardiac function, and histopathology were assessed during and after 60 minutes of ECMO.</p><p><strong>Results: </strong>The FIXa aptamer effectively maintained circuit patency without clot formation, comparable to heparin. The antidote rapidly reversed the aptamer's anticoagulant activity, similar to protamine's reversal of heparin. Notably, the aptamer-antidote group demonstrated superior outcomes, including improved mean arterial pressure (58 ± 6 mmHg vs. 54 ± 3 mmHg at 30 minutes; 59 ± 8 mmHg vs. 51 ± 5 mmHg at 3 hours post-ECMO) and cardiac function (shortening fraction: 60 ± 16% vs. 42 ± 8%; P = 0.01). Additionally, the aptamer group exhibited better platelet preservation (platelet count decrease: -288,000 ± 121,000/μL vs. -404,000 ± 89,000/μL; P = 0.03). Inflammatory profiles were similar between groups, except for a transient increase in interleukins 10 (IL-10) in the aptamer group. Histopathological analysis revealed no significant differences in myocardial lesions.</p><p><strong>Conclusions: </strong>The antidote-controlled anti-FIXa aptamer represents an alternative anticoagulant strategy that may prove useful for managing patients with a history of heparin-induced thrombocytopenia (HIT) and myocardial dysfunction associated with protamine administration.</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"10 2","pages":"87-98"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546138","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":"RNA-ssisting immunity to heal the heart: a new frontier in therapeutics.","authors":"Joel Gregory Rurik, Christian Le Phu, Julian Mustroph, Marcus Buggert","doi":"10.1097/CP9.0000000000000116","DOIUrl":"10.1097/CP9.0000000000000116","url":null,"abstract":"<p><p>Cardiovascular diseases remain the leading cause of death worldwide. Despite significant progress and the development of numerous effective drugs, substantial morbidity and mortality persist. This review highlights one potentially fruitful avenue for discovering novel therapeutics: leveraging ribonucleic acid (RNA) to tip the immunological balance toward tissue repair. Decades of research have primed the three disciplines of cardiology, immunology, and RNA drug development, to bring potent intersectional therapies to the clinic. We discuss both coding and non-coding RNA interventions across multiple cell types, such as monocytes, macrophages, and T cells, throughout different cardiovascular diseases. Altogether, advanced RNA-based medicines targeting the immune system are primed to transform how cardiovascular diseases are treated.</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"10 2","pages":"129-144"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546139","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":"Harnessing mRNA technology for ischemic heart disease: a review of regenerative and protective therapies.","authors":"Matthew Adjmi, Isabelle Tse, Lior Zangi","doi":"10.1097/CP9.0000000000000118","DOIUrl":"10.1097/CP9.0000000000000118","url":null,"abstract":"<p><p>As ischemic heart disease (IHD) remains the leading cause of mortality worldwide, there is an urgent need for innovative therapies that go beyond symptom management. The irreversible damage to cardiac tissue following myocardial infarction (MI) and the limited regenerative and proliferative capacity of adult cardiomyocytes (CMs) present significant challenges to the development of treatments capable of restoring cardiac function. This review focuses on emerging modified and non-modified messenger ribonucleic acid (mRNA)-based therapies, which offer targeted and transient protein expression. The studies reviewed here address three major therapeutic strategies: cardiac regeneration, aimed at inducing CM proliferation to restore lost cardiac muscle; cardiac protection, centered on anti-apoptotic and anti-inflammatory methods to mitigate further tissue damage; and cardiovascular regeneration, focused on promoting angiogenesis and restoring vascular integrity after injury. By examining mRNA and modified mRNA (modRNA) therapies across these three approaches, this review showcases mRNA's promising role in advancing muscular and vascular regenerative and protective therapeutics for IHD.</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"10 2","pages":"117-128"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546137","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":"Retraction: Characteristics of patients undergoing percutaneous coronary intervention for chronically total occluded arteries: a single-center observational study in India.","authors":"","doi":"10.1097/CP9.0000000000000082","DOIUrl":"10.1097/CP9.0000000000000082","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1097/CP9.0000000000000061.].</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"9 2","pages":"156"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11213492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472536","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":"Association between cheese intake and risk of atherosclerosis: a two-sample Mendelian randomization phenome-wide study","authors":"Song Wen, Zehan Huang, Guodong He, Bin Zhang, Yuqing Huang","doi":"10.1097/cp9.0000000000000075","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000075","url":null,"abstract":"\u0000 \u0000 Previous observational studies have yielded conflicting results regarding the association between cheese intake and atherosclerosis. Also, relative contribution to each subtype (coronary atherosclerosis, peripheral atherosclerosis, cerebral atherosclerosis, and arterial stiffness) remains unclear. The primary objective of this investigation was to assess the causal association between cheese intake and atherosclerosis.\u0000 \u0000 \u0000 \u0000 A two-sample Mendelian randomization (MR) study was conducted based on summary statistics from published genome-wide associations of cheese intake (n = 451,486 individuals), coronary atherosclerosis (n = 14,334 cases, 346,860 controls), peripheral atherosclerosis (n = 6,631 cases, 162,201 controls), arterial stiffness (n = 151,053 individuals, no available cases/controls), cerebral atherosclerosis (n = 104 cases, 218,688 controls), and atherosclerosis (excluding cerebral, coronary, and peripheral arterial disease [PAD]) (n = 6,599 cases, 212,193 controls). Primary analysis was conducted using an inverse-variance weighted (IVW) method. Sensitivity analyses included weighted median, MR Egger, and weighted mode analyses. Results are shown as odds ratio (OR) and 95% confidence interval (CI).\u0000 \u0000 \u0000 \u0000 In the IVW analysis, genetically predicted cheese intake was inversely associated with coronary atherosclerosis (OR: 0.98, 95% CI: 0.97–0.99; P = 0.002), peripheral atherosclerosis (OR: 0.56, 95% CI: 0.37–0.84; P = 0.006), arterial stiffness (OR: 0.87, 95% CI: 0.81–0.94; P = 0.001), and atherosclerosis (excluding cerebral, coronary, and PAD) (OR: 0.65, 95% CI: 0.43–0.98; P = 0.037), but not with cerebral atherosclerosis (OR; 0.91, 95% CI: 0.07–11.28: P = 0.941). The sensitivity analyses supported an association of cheese intake with coronary atherosclerosis, peripheral atherosclerosis, arterial stiffness, and atherosclerosis (excluding cerebral, coronary, and PAD), but not cerebral atherosclerosis.\u0000 \u0000 \u0000 \u0000 This study suggested that cheese intake is inversely associated with coronary atherosclerosis, peripheral atherosclerosis, arterial stiffness, and atherosclerosis (excluding cerebral, coronary, and PAD), but not cerebral atherosclerosis. These findings support dietary interventions, especially increasing cheese intake, in subjects with high risk to cardiovascular diseases.\u0000","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":" 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140392933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical challenges in small animal models for mimicking human ischemic cardiovascular diseases","authors":"Kai Hu, G. Ertl","doi":"10.1097/cp9.0000000000000072","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000072","url":null,"abstract":"Animal models are essential for exploring pathophysiology and testing novel therapy options of human metabolic cardiovascular diseases. Several small animal models have been developed during the last decades to study effects on myocardial infarct size, healing or cardiac remodeling and thus outcome after ligation of a left coronary artery. The present review describes the value and limitations of small animal models mimicking human ischemic myocardial insult and offers technical tips for using them. A perspective on future improved small animal models mimicking human cardiovascular diseases is also given.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"29 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140396835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-of-art review: intravascular imaging in percutaneous coronary interventions","authors":"Tarek Nafee, Areeb Shah, Michael Forsberg, Jingsheng Zheng, Jiafu Ou","doi":"10.1097/cp9.0000000000000069","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000069","url":null,"abstract":"The history of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) reflects the relentless pursuit of innovation in interventional cardiology. These intravascular imaging technologies have played a pivotal role in our understanding of coronary atherosclerosis, vascular pathology, and the interaction of coronary stents with the vessel wall. Two decades of clinical investigations demonstrating the clinical efficacy and safety of intravascular imaging modalities have established these technologies as staples in the contemporary cardiac catheterization lab’s toolbox and earning their place in revascularization clinical practice guidelines. In this comprehensive review, we will delve into the historical evolution, mechanisms, and technical aspects of IVUS and OCT. We will discuss the expanding evidence supporting their use in complex percutaneous coronary interventions, emphasizing their crucial roles in optimizing patient outcomes and ensuring procedural success. Furthermore, we will explore the substantial advances that have propelled these imaging modalities to the forefront of contemporary interventional cardiology. Finally, we will survey the latest developments in the field and explore the promising future directions that have the potential to further revolutionize coronary interventions.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"66 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139450309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Frailty on Independent Living After Surgery: A Population-Based Retrospective Cohort Study.","authors":"A Garland, T Mutter, O Ekuma, C Papadimitropolous","doi":"10.14283/jfa.2023.27","DOIUrl":"10.14283/jfa.2023.27","url":null,"abstract":"<p><strong>Background: </strong>Most people value quality of life over mere duration. At least 50% of people are extremely averse to ever living in a nursing home (NH).</p><p><strong>Objectives: </strong>Assess whether pre-operative frailty is associated with new, post-operative NH placement.</p><p><strong>Design, setting: </strong>Retrospective, population-based cohort study in the Canadian province of Manitoba, 2000-2017.</p><p><strong>Participants: </strong>7408 persons ≥65 years undergoing any of 16 specific, elective, noncardiac surgeries of varying Operative Surgical Stress (OSS).</p><p><strong>Measurements: </strong>The primary outcome was new admission to a NH, or being placed on a waiting list for a NH, within 180 days of index hospital admission, among index hospital survivors. Frailty was assessed from administrative data by the Preoperative Frailty Index (pFI), which ranges 0-1. Other outcomes were 30-day and 90-180 day mortality, and post-hospital medical resource use to 180 days. Analyses used multivariable regression models, adjusted for age, sex, OSS, year of surgery, anesthetic technique, and socioeconomic status. P-values were adjusted for the six outcomes.</p><p><strong>Results: </strong>Subjects had mean age (±SD) of 74±7 yrs; 61% were male. pFI ranged 0-0.68, with a mean±SD of 0.21±0.09. All six outcomes were significantly associated with greater frailty. Each additional 0.1 unit increase in pFI was associated with a hazard ratio for new NH admission or wait-listing of 3.01 (p<0.0006).</p><p><strong>Conclusions: </strong>While our study agrees with prior work indicating that greater frailty is associated with higher probability of post-operative discharge to a NH, it overcomes a number of limitations of all prior work. Strong arguments follow that prospective surgical candidates be evaluated for their degree of frailty, and that their informed consent include discussion of the possibility of survival with loss of independence.</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"5 1","pages":"57-63"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82006288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute myocardial infarction in a patient with thrombotic thrombocytopenic purpura: a case report and literature review","authors":"Feng Hu, Mengjia Chen, Xun Yuan, Yunling Lin, Lianglong Chen","doi":"10.1097/cp9.0000000000000068","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000068","url":null,"abstract":"Acute myocardial infarction (AMI) induced by thrombotic thrombocytopenic purpura (TTP) has been previously reported, but comorbidity with autoimmune hemolytic anemia is rare. The index patient, a 55-year-old woman, presented with acute ST-elevation myocardial infarction (STEMI). A diagnosis of TTP was established on the presence of thrombocytopenia, microangiopathic hemolytic anemia, acute kidney injury, fever, and neurologic symptoms (ischemic stroke); autoimmune hemolytic anemia was established based on Comboost test. Percutaneous coronary intervention and dual antiplatelet therapy were not initiated due to elevated risk of bleeding. Instead, the patient was treated with glucocorticosteroid and plasmapheresis. Despite the treatment, the patient suffered a watershed acute cerebral infarction, and finally died of gastrointestinal bleeding. This case highlights the challenges in managing STEMI in TTP patients.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"12 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139006543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-alcoholic fatty liver disease and risk of cardiovascular diseases: clinical association, pathophysiological mechanisms, and management","authors":"Rong Yang, Jian-Gao Fan","doi":"10.1097/cp9.0000000000000067","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000067","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) is a fatty liver disease associated with metabolic dysfunction in genetically susceptible individuals due to over-nutrition and lack of exercise. With the prevalence of obesity, metabolic syndrome, and type 2 diabetes mellitus, NAFLD has become the most common cause of chronic liver disease worldwide. NAFLD shares many risk factors with cardiovascular diseases (CVDs). NAFLD is associated with increased risk of major cardiovascular events and other cardiac complications even after adjustment for traditional cardiovascular risk factors. The primary pathology of NAFLD is within the liver, but the most common cause of deaths in patients with NAFLD is CVDs. This review summarizes the epidemiological evidence for the association between NAFLD and CVD risk and the pathophysiological mechanisms underlying this association. Current treatment strategies for NAFLD and their potential impact on CVD risk are also discussed.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"79 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139011310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}