Acta Cardiologica Sinica最新文献

{"title":"The Unseen Tear: Early Recognition of Left Ventricular Myocardial Dissection by Contrast-Enhanced Transthoracic Echocardiography.","authors":"Yi Ling Tan, Shiun Woei Wong","doi":"10.6515/ACS.202603_42(2).20260112A","DOIUrl":"10.6515/ACS.202603_42(2).20260112A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 2","pages":"285-288"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-138-5p Promotes HF in Rats by Reducing Histone Methylation in the Myd88 Promoter Region through Inhibition of EZH2.","authors":"Ye Zhang, Weihui Lu","doi":"10.6515/ACS.202603_42(2).20250815A","DOIUrl":"10.6515/ACS.202603_42(2).20250815A","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate how microRNA-138-5p (miR-138-5p) promotes heart failure (HF) in rats by inhibiting enhancer of zeste homolog 2 (EZH2) and reducing histone methylation in the myeloid differentiation primary response gene 88 (MyD88) promoter region.</p><p><strong>Methods: </strong>An HF rat model and isoproterenol (ISO)-induced H9c2 cell injury model were established. Echocardiography was used to assess cardiac function in the rats, flow cytometry was used to detect cardiomyocyte apoptosis, and reverse transcription quantitative polymerase chain reaction or Western blotting was performed to detect the expressions of miR-138-5p, EZH2, and Myd88, as well as Bax, Bcl-2, and Caspase-3. The relationship between miR-138-5p and EZH2 was analyzed by luciferase reporter assay. The methylation level of histone H3 lysine 27 trimethylation (H3K27me3) at the Myd88 promoter region mediated by EZH2 was assessed by chromatin immunoprecipitation assay.</p><p><strong>Results: </strong>The expression of miR-138-5p was increased in myocardial tissue in the HF rats and ISO-induced H9c2 cells. Inhibition of miR-138-5p enhanced cardiac function in the HF rats. Inhibiting miR-138-5p decreased cardiomyocyte apoptosis, downregulated the expressions of Bax and Caspase-3 genes, and upregulated the expression of Bcl-2. miR-138-5p targeted and bound to the 3'-untranslated region of EZH2 mRNA, and promoted cardiomyocyte apoptosis by inhibiting EZH2 expression. EZH2 increased the H3K27me3 methylation level in the Myd88 promoter region, leading to decreased Myd88 expression. Overexpression of Myd88 and high EZH2 expression promoted cardiomyocyte apoptosis.</p><p><strong>Conclusions: </strong>miR-138-5p targets and inhibits the expression of the EZH2 gene, reducing H3K27me3 methylation in the Myd88 promoter region, thereby enhancing Myd88 expression, promoting cardiomyocyte apoptosis, and exacerbating HF.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 2","pages":"171-185"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Assessment of Ventricular Remodeling Following Mitral Valve Repair: A Focus on Volume, Mass, and Relative Wall Thickness.","authors":"Chih-Yao Chiang, Wei-Ting Lee, Shen-Che Lin, Jih-Hsin Huang, Jer-Shen Chen, Darrell Shih, Kuan-Ming Chiu","doi":"10.6515/ACS.202603_42(2).20250727A","DOIUrl":"10.6515/ACS.202603_42(2).20250727A","url":null,"abstract":"<p><strong>Background: </strong>Mitral valve repair facilitates ventricular reverse remodeling, inducing changes in geometry and mass. This study examined geometric normalization and mass regression following valve repair, and evaluated correlations between recurrent mitral regurgitation (MR) and long-term clinical outcomes.</p><p><strong>Methods: </strong>This study included 160 consecutive patients undergoing mitral valve repair, stratified according to the severity of recurrent MR. Serial Doppler echocardiographic parameters including ventricular geometry and hemodynamic indices were compared between baseline and post-repair assessments. Cox regression analysis was conducted to identify the predictors associated with recurrent MR and late adverse events.</p><p><strong>Results: </strong>During follow-up, MR < grade 3 was noted in 107 patients and MR ≥ grade 3 in 53 patients. The entire cohort experienced 43 major adverse cardiovascular and cerebral events (MACCEs). Paired comparisons demonstrated consistent reductions in dimension, intracavity volume, ventricular mass, stroke volume, and wall stress (WS), accompanied by increases in relative wall thickness (RWT) in both subgroups. However, the MR ≥ grade 3 subgroup demonstrated attenuated reverse remodeling. Both left ventricle (LV) WS and mass showed positive correlations with dimension and volume, but WS was inversely correlated with RWT. Suture annuloplasty was more prevalent in the MR ≥ grade 3 subgroup. The results of Cox regression analysis identified regurgitant volume, end-systolic volume, LV mass, and suture annuloplasty as independent predictors of MACCEs.</p><p><strong>Conclusions: </strong>The extent of reverse remodeling was correlated with the reduction in regurgitant volume. Suture annuloplasty was a predictor for recurrent MR. The persistence of volume overload and eccentric hypertrophy impacted late clinical outcomes.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 2","pages":"232-245"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Transthyretin Amyloidosis: Insights from Taiwan Illuminate a Global Challenge.","authors":"Yu-Wen Cheng, Chun-Li Wang","doi":"10.6515/ACS.202603_42(2).20251014A","DOIUrl":"10.6515/ACS.202603_42(2).20251014A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 2","pages":"228-231"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From ASCOT to Asia: A More Active and Successful Approach in Preventing Cardiovascular Disease.","authors":"Chia-Pin Lin, Pao-Hsien Chu","doi":"10.6515/ACS.202601_42(1).20250806A","DOIUrl":"https://doi.org/10.6515/ACS.202601_42(1).20250806A","url":null,"abstract":"<p><p>The prevalence of cardiovascular disease (CVD) is increasing globally. Hypertension and dyslipidemia are well-established risk factors, and their co-existence significantly increases the risk of CVD. Epidemiological studies consistently report a high prevalence of their co-existence, ranging from 15% to 31%. The combined impact of hypertension and dyslipidemia on the vascular endothelium is more detrimental than their individual effects, potentially accelerating atherosclerosis and increasing the overall risk of CVD. This review highlights the benefits of concurrently treating dyslipidemia and hypertension to prevent CVD, drawing insights from the Anglo-Scandinavian Cardiac Outcomes Trial study and recent clinical studies conducted in Asia. Notably, the single-pill combination of amlodipine and atorvastatin has been shown to enhance adherence while providing a synergistic effect in protecting the vascular endothelium and preventing CVD. By aggressively managing both conditions, healthcare providers can significantly reduce the risk of future cardiovascular events across diverse patient populations and ethnicities.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 1","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation of NYHA III and IV Heart Failure with Infrared Thermal Imaging.","authors":"Şahbender Koç, Zuhal Koç","doi":"10.6515/ACS.202601_42(1).20250706A","DOIUrl":"https://doi.org/10.6515/ACS.202601_42(1).20250706A","url":null,"abstract":"<p><strong>Background: </strong>In advanced heart failure patients, limited exercise capacity often prevents significant increases in core temperature. Due to reduced muscle mass and minimal blood flow in inactive muscles, their limb temperatures tend to be lower. This study investigates whether core-hand temperature difference can serve as a distinguishing criterion between New York Heart Association (NYHA) Class III and IV heart failure.</p><p><strong>Methods: </strong>This study included 80 patients with NYHA Class IV (median age: 68 years) and 82 with NYHA Class III (median age: 65 years) heart failure with reduced ejection fraction. Core body temperature was measured using an infrared thermometer, while hand temperature was recorded with a forward looking infrared C5 thermal camera after a 15-minute acclimatization at room temperature.</p><p><strong>Results: </strong>The core-mean hand temperature difference (Tc-Mht) was 8.7 °C ± 1.5 °C in the Class IV group and 7.1 °C ± 1.7 °C in the Class III group (p < 0.001). The difference in hand temperature (highest-lowest) was 3 °C (2-4 °C) in the Class IV group and 1 °C (0-2 °C) in the Class III group (p < 0.001).</p><p><strong>Conclusions: </strong>A Tc-Mht > 7.7 °C showed 76% sensitivity (95% confidence interval: 66-84%) for detecting NYHA Class IV in thermoneutral environments. Tc-Mht may serve as a prognostic marker in heart failure patients.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 1","pages":"111-118"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venlafaxine-Associated Takotsubo Cardiomyopathy Complicated by Cardiogenic Shock and Left Ventricular Outflow Tract Obstruction: A Case Report and Literature Review.","authors":"Yee-Jen Wu, Chih-Fan Yeh, Po-Chih Lin, Chi-Sheng Hung","doi":"10.6515/ACS.202601_42(1).20251105A","DOIUrl":"https://doi.org/10.6515/ACS.202601_42(1).20251105A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 1","pages":"139-142"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale, Objectives and Study Design of the Taiwan Registry of Hypertrophic Cardiomyopathy (THIC).","authors":"Yen-Wen Wu, Wen-Chung Yu, Chung-Lieh Hung, Chih-Hung Lai, Chao-Yung Wang, Chih-Chan Lin, Jyh-Ming Jimmy Juang, Chun-Yao Huang, Po-Sheng Chen, Tsung-Yu Ko, Wei-Ting Chang, Hsinyu Tseng, Zheng-Wei Chen, Chun-Yuan Chu, Wen-Jone Chen, Yi-Heng Li","doi":"10.6515/ACS.202601_42(1).20250718B","DOIUrl":"https://doi.org/10.6515/ACS.202601_42(1).20250718B","url":null,"abstract":"<p><strong>Background: </strong>The <b>T</b>aiwan Registry of <b>H</b>ypertroph<b>ic</b> <b>C</b>ardiomyopathy (THIC) is a multicenter national registry containing the clinical and imaging data of patients with hypertrophic cardiomyopathy (HCM) in Taiwan. The aim of the registry is to systematically evaluate the clinical, genetic and biochemical features, possible natural course, and outcomes of HCM and relevant rare diseases that mimic HCM such as Fabry disease (FD) and transthyretin amyloid cardiomyopathy in Taiwan, and to identify their specific \"red-flag\" signs, which are especially valuable from the perspective of unique genetic mutations or clinical manifestations in Taiwanese patients. Herein, we present the design and initial baseline data from the registry.</p><p><strong>Methods: </strong>The THIC is an observational program that aims to collect prospective and/or retrospective data of patients with HCM in Taiwan. The registry plans to recruit 800 individuals with unexplained left ventricular hypertrophy, including 200 with FD, with a follow-up period of at least 12 months, and the project is expected to run for 5 years. Data on baseline characteristics, laboratory and imaging results, deaths, major adverse cardiovascular, cerebrovascular and renal events are collected.</p><p><strong>Results: </strong>The THIC has been in the enrollment phase since December 2022, and has enrolled 534 patients (age 62.37 ± 13.41 years, male 65.6%) as of March 15, 2025 from 13 centers. At enrollment, 284 of these patients had HCM, 227 had FD, and 23 had ATTR-CM. Family history was found to be an important diagnostic clue; however, common echocardiographic and laboratory data including N-terminal pro-brain natriuretic peptide were not significantly different between the three groups.</p><p><strong>Conclusions: </strong>The THIC will contain comprehensive clinical and imaging data of patients with HCM, FD and ATTR-CM in Taiwan, and provide an opportunity to extend our knowledge on the clinical presentations and long-term consequences of these disease entities. It will aid in understanding patients with unexplained LVH in the context of the genetic background of Taiwanese patients, and in identifying predictors of LVH and important clinical events.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 1","pages":"74-86"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Implications of Left Ventricular Ejection Fraction Improvement in Patients with Heart Failure with Reduced and Mildly Reduced Ejection Fraction.","authors":"Yi-Sheng Chen, Chi-Cheng Huang, Chun-Chieh Wang, Hung-Yu Chang, Juey-Jen Hwang, Charles Jia-Yin Hou, Ting-Hsing Chao, Chung-Lieh Hung, Chih-Ping Hsia, Bing-Hsiean Tzeng, Yen-Wen Wu","doi":"10.6515/ACS.202601_42(1).20250714C","DOIUrl":"https://doi.org/10.6515/ACS.202601_42(1).20250714C","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the prognostic implications and optimal timing for assessing left ventricular ejection fraction (LVEF) trajectory in patients with heart failure (HF) and an LVEF < 50%.</p><p><strong>Methods: </strong>The Taiwan Society of Cardiology HF Registry 2020 is a prospective, multicenter registry of hospitalized HF patients in Taiwan. This study included patients with an LVEF < 50% during their index HF hospitalization, and at least one follow-up echocardiogram within 2 years. HF with improved EF (HFimpEF) was defined as an absolute increase in LVEF > 10% from baseline. The primary endpoints were all-cause mortality and HF hospitalization at 2 years. Predictors of an improvement in LVEF trajectory were also evaluated.</p><p><strong>Results: </strong>A total of 1478 patients were enrolled, with 873 in the HFimpEF group and 605 in the non-HFimpEF group. HFimpEF was associated with a lower risk of mortality (hazard ratio: 0.41 [0.27-0.62], p < 0.001) and reduced HF hospitalizations (8.6% vs. 24.4%, p < 0.001) at 2 years follow-up. Subgroup analysis showed that survival benefits diverged at an LVEF improvement > 10%, emerging as early as 6 months and persisting beyond 12 months. Lower baseline LVEF was paradoxically associated with better survival. Neither maximal guideline-directed medical therapy (GDMT) score nor revascularization correlated with LVEF trajectory. However, HFimpEF patients received higher doses of renin-angiotensin system inhibitors and beta-blockers in the first year.</p><p><strong>Conclusions: </strong>LVEF trajectory at 6 months appears to be a valuable prognostic tool, and higher-dose fundamental HF therapy was more important than achieving a higher overall GDMT score.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 1","pages":"62-73"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Myocardial Salvage in Anterior ST-Elevation Myocardial Infarction through Adjunctive Supersaturated Oxygen Therapy after Percutaneous Coronary Intervention: A Case Report and Literature Review.","authors":"Yi-Chung Huang, Chung-Ming Tu","doi":"10.6515/ACS.202601_42(1).20251124A","DOIUrl":"https://doi.org/10.6515/ACS.202601_42(1).20251124A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 1","pages":"128-131"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}