Acta Cardiologica Sinica最新文献

{"title":"A Multidisciplinary Consensus on Cardiovascular Assessment and Management of Kidney Transplant Recipients.","authors":"Shun-Neng Hsu, Kang-Ling Wang, Niang-Cheng Lin","doi":"10.6515/ACS.202607_42(4).20260618A","DOIUrl":"10.6515/ACS.202607_42(4).20260618A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 4","pages":"528-530"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617884","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":"Surgical Treatment of Hypertrophic Obstructive Cardiomyopathy: Results of Extended Septal Myectomy in 24 Patients.","authors":"Erturk Karaagac, Hasan Iner, Suat Ozdal, Hidayet Onur Selcuk, Seray Deniz Gurbuz, Yuksel Besir, Orhan Gokalp, Levent Yilik","doi":"10.6515/ACS.202607_42(4).20251124D","DOIUrl":"10.6515/ACS.202607_42(4).20251124D","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic obstructive cardiomyopathy generally responds well to medical therapy. However, about 5% of patients require invasive procedures. There is no clear consensus on the invasive treatment for these patients. Therefore, we aimed to analyze and present the results of our experience with surgical treatment between 2014 and 2024.</p><p><strong>Methods: </strong>A total of 24 patients who underwent extended septal myectomy were retrospectively analyzed. Preoperative demographic and comorbid factors were assessed. The patients underwent echocardiography 12 months after surgery. Preoperative and postoperative functional capacity in the first year and the results of the echocardiographic examinations were analyzed.</p><p><strong>Results: </strong>Nineteen (79.1%) patients were in New York Heart Association (NYHA) class III-IV before surgery, while none were in NYHA class III-IV after surgery (p < 0.001). The septal thickness (mm) was 19.7 ± 2.34 before surgery compared to 10.9 ± 1.38 after surgery; the left ventricular outflow tract gradient (mmHg) was 90.6 ± 15.4 before surgery compared to 21.3 ± 4.48 after surgery, and the decrease was statistically significant (p < 0.001). No statistically significant differences were found between left ventricular ejection fraction (%), left ventricular end-diastolic diameter (mm), left ventricular end-systolic diameter (mm) and mean pulmonary artery pressure (mmHg) values before and after surgery.</p><p><strong>Conclusions: </strong>Extended septal myectomy performed after evaluation by the heart team for the treatment of hypertrophic obstructive cardiomyopathy led to satisfactory results in suitable patients. A surgical treatment option could be considered in symptomatic patients despite optimal medical therapy.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 4","pages":"544-550"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617906","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":"Huge Circumferential Left Atrial Intramural Hematoma after Ablation for Atrial Fibrillation - An Unusual Complication.","authors":"Hung-Kai Huang, Wei-Chieh Chen, Ying-Chieh Liao, Shoei K Stephen Huang","doi":"10.6515/ACS.202607_42(4).20260330A","DOIUrl":"10.6515/ACS.202607_42(4).20260330A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 4","pages":"654-657"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617864","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":"TAMIS Consensus on Multidisciplinary Team Care in Post-Acute Stage of Acute Coronary Syndrome: Nutrition, Pharmacotherapy, and Cardiac Rehabilitation.","authors":"Ching-Ping Chao, Chun-Chih Chiu, Wei-Cheng Lin, Hsin-Chiao Chuang, Jia-Ying Hu, Li-Wei Liu, Chun-Yao Huang, Yu-Chen Wang, Wei-Chun Huang, Kolong Lin, Hsiu-Yueh Su, Yen-Wen Wu","doi":"10.6515/ACS.202607_42(4).20260309B","DOIUrl":"10.6515/ACS.202607_42(4).20260309B","url":null,"abstract":"<p><strong>Background: </strong>Post-acute care (PAC) following acute coronary syndrome (ACS) aims to reduce recurrent cardiovascular events, improve cardiac function, enhance quality of life, and lower mortality. Effective PAC requires a multidisciplinary team including cardiologists, nurses, dietitians, rehabilitation specialists, and psychologists to deliver individualized strategies.</p><p><strong>Objectives: </strong>To summarize current evidence and provide consensus recommendations across three key domains of PAC: nutritional management, pharmacotherapy, and cardiac rehabilitation.</p><p><strong>Methods: </strong>This consensus was developed from 2024-2025 through expert discussions hosted by the Taiwan Myocardial Infarction Society (TAMIS) Expert Committee, based on a review of current scientific and clinical evidence.</p><p><strong>Results: </strong>Nutritional management emphasizes Mediterranean and DASH dietary patterns, restriction of saturated and trans fats, and weight control; evidence for most nutraceuticals remains limited. Pharmacotherapy focuses on guideline-directed medical therapy and adherence management, with pharmacist-provided education and follow-up shown to improve clinical outcomes. For cardiac rehabilitation, center-based programs have been shown to reduce rehospitalization, recurrent events, and mortality. Home-based models improve quality of life and accessibility with comparable functional benefits and no significant difference in short-term mortality compared to center-based care. Telerehabilitation also enhances functional recovery, though its specific effects on mortality and rehospitalization remain inconclusive.</p><p><strong>Conclusions: </strong>Current evidence underscores that nutrition planning, pharmacist involvement, and structured rehabilitation are central to integrated PAC for ACS. Multidisciplinary collaboration is essential to optimize long-term outcomes and support patient recovery.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 4","pages":"534-543"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617899","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":"Cardiovascular Disease Management Consensus in Kidney Transplantation Recipients.","authors":"Cheng-Hsu Chen, Yen-Wen Wu, Chih-Yuan Lee, Hung-Tien Kuo, Tung-Min Yu, Kun-Hua Tu, Lee-Moay Lim, Jo-Nan Liao, Ting-Tse Lin, Ning-I Yang, Tzung-Dau Wang, Hsu-Han Wang, Sho-Mon Wang, Tsai-Hung Wu, Hsin-Hsu Wu, Mei-Yi Wu, Sheng-Wen Wu, Ming-Che Lee, Chien-Yi Hsu, Horng-Rong Chang, Shuo-Ming Ou, Yang-Jen Chiang, Wen-Jone Chen, Mai-Szu Wu","doi":"10.6515/ACS.202607_42(4).20260204A","DOIUrl":"10.6515/ACS.202607_42(4).20260204A","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation is the definitive treatment for end-stage kidney disease; however, organ availability in Taiwan remains limited, with only 4.9% of patients on the waiting list receiving transplants in 2019. More than 86,000 individuals require regular dialysis, highlighting the need for improved transplantation rates. Although the median survival time post-transplantation is 5.7 years, nearly half of Taiwanese transplant recipients died in 2019, emphasizing cardiovascular disease as a major concern. Notably, patients who survive for more than a decade post-transplantation are increasingly prone to cardiovascular disease, diabetes, and hypertension. The aim of this study was to develop a joint consensus with the Taiwan Society of Nephrology, Taiwan Society of Cardiology, and Transplantation Society of Taiwan, to outline the best practices for evaluating and managing cardiovascular disease in kidney transplant recipients.</p><p><strong>Methods: </strong>A consensus committee of 24 Taiwanese nephrologists, cardiologists, and surgeons synthesized recommendations from the literature and international guidelines, finalizing them via a formal voting process (70%/90% agreement).</p><p><strong>Results: </strong>Clinical recommendations emphasize pre-transplant cardiac assessment, including echocardiography and perfusion imaging; vigilant post-transplant surveillance of blood pressure, lipids, and glycemic control; and the judicious use of immunosuppressants to minimize metabolic complications. Multidisciplinary collaboration between nephrologists, cardiologists, and transplant experts is crucial for delivering patient-centered care.</p><p><strong>Conclusions: </strong>By adopting these guidelines, clinicians can promote long-term graft survival, reduce cardiovascular complications, and improve patient outcomes in the evolving transplantation landscape in Taiwan.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 4","pages":"513-527"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617871","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":"REVIVE after the Storm: The TAMIS Expert Consensus on Multidisciplinary Post-Acute Care Following Acute Coronary Syndrome.","authors":"Ching-Ping Chao, Yen-Wen Wu","doi":"10.6515/ACS.202607_42(4).20260630A","DOIUrl":"https://doi.org/10.6515/ACS.202607_42(4).20260630A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 4","pages":"531-533"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617938","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":"Single High Take-Off Coronary Ostium: Procedural Implications During Coronary Angiography in an Elderly Patient.","authors":"Yang-Chuan Chen, Shi-Chue Hsing, Chih-Hsueng Hsu","doi":"10.6515/ACS.202607_42(4).20260524A","DOIUrl":"10.6515/ACS.202607_42(4).20260524A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 4","pages":"649-653"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617901","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":"Improved Anticoagulation Guideline Adherence and Clinical Outcome Through Hospital-Wide Atrial Fibrillation Alarming System.","authors":"Tzu-Wei Liao, Wei-Ta Chen","doi":"10.6515/ACS.202607_42(4).20251105B","DOIUrl":"10.6515/ACS.202607_42(4).20251105B","url":null,"abstract":"<p><strong>Background: </strong>Direct oral anticoagulation (DOAC) therapy has been approved for stroke prevention in atrial fibrillation (AF) patients. However, about 30% of patients with AF are not on oral anticoagulants (OACs). About 30% of patients on OACs are on off-label dosages.</p><p><strong>Objective: </strong>We used a hospital-wide AF screening system to improve the OAC guideline adherence rate. We also assessed the impact on clinical outcomes.</p><p><strong>Methods: </strong>All electrocardiograms (ECGs) of each hospitalized patient were screened using an AF screening system, regardless of whether the ECGs were obtained during or before hospitalization. Patients with AF were enrolled. The CHA₂DS₂-VAS score was calculated and appropriate DOACs were suggested to the primary care team. The DOAC guideline adherence rate was calculated. The annual stroke and bleeding rates were also calculated.</p><p><strong>Results: </strong>At baseline, the DOAC guideline adherence rate was only 40.6%. After the intervention, the guideline adherence rate increased to 82.5%. After discharge, the adherence rate did not decrease. The annual stroke rates for patients on guideline-recommended DOACs with and without our intervention were 2.79% and 3.12%, respectively. The annual stroke rate for patients on DOACs not adhering to the guidelines was 9.91%. The minor bleeding rate was significantly higher in the groups that adhered to the guidelines, but the major bleeding rate was not significantly different.</p><p><strong>Conclusions: </strong>Implementation of a hospital-wide AF screening system improved the DOAC guideline adherence rate and reduced the annual stroke rate for patients with AF. The minor bleeding rate was increased.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 4","pages":"606-615"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617945","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":"Bortezomib Suppresses Abnormal Proliferation, Migration, and Phenotypic Switching of Aortic Smooth Muscle Cells.","authors":"Yu-Hsin Tseng, Lin-Yen Wang, Yu-Hsin Kuan, Shang-En Huang, Erna Sulistyowati, Siao-Ping Tsai, Jwu-Lai Yeh, Jong-Hau Hsu","doi":"10.6515/ACS.202607_42(4).20251121A","DOIUrl":"10.6515/ACS.202607_42(4).20251121A","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis is the leading cause of cardiovascular disease and mortality worldwide. The proliferation, migration, and phenotypic switching of vascular smooth muscle cells are central to its pathogenesis. Bortezomib, the first Food and Drug Administration-approved proteasome inhibitor for multiple myeloma, suppresses the proliferation and migration of pulmonary artery smooth muscle cells. However, its effects on aortic vascular smooth muscle cells (AoSMCs) remain unclear.</p><p><strong>Methods: </strong>Rat AoSMCs were treated with platelet-derived growth factor-BB (PDGF-BB) or angiotensin II (Ang II), with or without bortezomib. Cytotoxicity, proliferation, and migration were assessed by MTT, wound healing, and Boyden chamber assays. Intracellular and mitochondrial ROS were measured by DCFH-DA and MitoSOX. mRNA and protein levels of bone morphogenetic protein-2 (BMP-2), Runt-related transcription factor 2 (Runx2), α-smooth muscle actin (α-SMA), phosphorylated extracellular signal-regulated kinase (ERK), and phosphorylated protein kinase B (Akt) were assessed by RT-qPCR and Western blotting. Calcium deposition was assessed using Alizarin Red S staining.</p><p><strong>Results: </strong>Bortezomib attenuated PDGF-BB and Ang II-induced proliferation and migration of AoSMCs accompanied by reduced ROS production and decreased phosphorylation of ERK and Akt. Furthermore, bortezomib suppressed PDGF-BB- and Ang II-induced osteogenic markers (BMP-2 and Runx2) and calcium deposition, while restoring the contractile marker α-SMA, which was inhibited by PDGF-BB and Ang II.</p><p><strong>Conclusions: </strong>Bortezomib attenuated PDGF-BB- and Ang II-induced proliferation, migration, and phenotypic switching of AoSMCs, potentially through reduced ROS production. Mechanistically, bortezomib inhibited ERK and Akt phosphorylation and restored a contractile phenotype. These findings suggest that proteasome inhibition may offer a novel therapeutic approach to modulate vascular remodeling in atherosclerosis.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 4","pages":"583-595"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617878","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":"Impact of Preoperative Cardiac Evaluation and Recommendations on Morbidity and Mortality in Patients Undergoing Elective Non-Cardiac Interventions: A Retrospective Cohort Study.","authors":"Süha Asal, Şahhan Kılıç, Emrecan Uygun, Mert Babaoğlu, Mustafa İnceoğlu, Samet Yavuz, Yetkin Korkmaz, Tufan Çınar, Ahmet Lütfullah Orhan","doi":"10.6515/ACS.202607_42(4).20251206A","DOIUrl":"10.6515/ACS.202607_42(4).20251206A","url":null,"abstract":"<p><strong>Background: </strong>Preoperative cardiac evaluation aims to reduce cardiovascular risks in elective non-cardiac surgery, however its routine use is a subject of ongoing debate due to low event rates. This study examines patient characteristics, risk factors, diagnostic findings, recommendations, and outcomes to assess the value of these consultations and refine referral criteria.</p><p><strong>Methods: </strong>This retrospective cohort study included 482 patients who underwent elective non-cardiac surgery with preoperative cardiology consultations at a tertiary hospital (March-September 2021). Data on demographics, cardiovascular risks, echocardiographic/electrocardiographic findings, recommendations, and outcomes (in-hospital complications, mortality, one-year survival, hospital stay) were analyzed.</p><p><strong>Results: </strong>The median age of the patients was 69 years (interquartile range [IQR] 60-76), and 66.2% were male. Common surgeries included endoscopy/colonoscopy (31.7%) and genitourinary procedures (19.3%). Coronary artery disease (48.8%), hypertension (48.9%), and diabetes (37.8%) were prevalent. Most cases (96.5%) were asymptomatic, with ejection fractions > 50% (88.1%). Common recommendations included antiplatelet/anticoagulant modification (41.1%), although 54.8% of patients required no new recommendations. New diagnoses were rare (3.7%). In-hospital complications occurred in 2.9%, mortality in 0.6%, and one-year mortality in 1.7% of the patients, with a median hospital stay of 1 day (IQR 0-3).</p><p><strong>Conclusions: </strong>Despite the high burden of comorbidities in the study cohort, low adverse event rates suggest many consultations may be unnecessary, particularly in asymptomatic patients with preserved function, supporting more selective referral criteria to enhance efficiency.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"42 4","pages":"627-636"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617928","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}