American heart journal plus : cardiology research and practice最新文献

{"title":"Circulating fibrocyte levels correlate with left ventricular mass in middle-aged healthy adults without hypertension","authors":"Daniel S. Feuer ,&nbsp;Borna Mehrad ,&nbsp;Ellen C. Keeley","doi":"10.1016/j.ahjo.2024.100442","DOIUrl":"10.1016/j.ahjo.2024.100442","url":null,"abstract":"<div><h3>Background</h3><p>Fibrocytes, circulating bone-marrow derived cells that differentiate into fibroblasts and myofibroblasts, are a major source of hypertensive arterial fibrosis and correlate with left ventricular (LV) mass in subjects with hypertension. We tested whether circulating fibrocytes levels correlate with LV mass in middle-aged adults without hypertension.</p></div><div><h3>Methods</h3><p>We measured peripheral blood fibrocyte levels and their activated phenotypes in 13 middle-aged, non-hypertensive adults and performed cardiac magnetic resonance imaging to assess LV mass.</p></div><div><h3>Results</h3><p>There was a strong correlation between total fibrocyte levels (CD45 + Col1+) and LV mass index (<em>r</em> = 0.71, <em>p</em> = 0.006), as well as fibrocyte subsets expressing the chemokine markers CCR2 (<em>r</em> = 0.60, <em>p</em> = 0.032), CCR5 (<em>r</em> = 0.62, <em>p</em> = 0.029), CCR7 (<em>r</em> = 0.60, <em>p</em> = 0.034), co-expression of CXCR4 and CCR2 (<em>r</em> = 0.62, p = 0.029), α-SMA+ (<em>r</em> = 0.57, <em>p</em> = 0.044), CD133 (<em>r</em> = 0.59, <em>p</em> = 0.036), and pSTAT6 (<em>r</em> = 0.64, <em>p</em> = 0.032).</p></div><div><h3>Conclusions</h3><p>Circulating fibrocytes are associated with LV mass index in middle-aged, non-hypertensive adults and may be a harbinger for the development of hypertension.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"45 ","pages":"Article 100442"},"PeriodicalIF":1.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000855/pdfft?md5=2dd7c26ff9c185edc2245da1dfb10ae9&pid=1-s2.0-S2666602224000855-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141990863","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":"The association of exhaled carbon monoxide with atrial fibrillation and left atrial size in the Framingham Heart Study","authors":"Oseiwe B. Eromosele ,&nbsp;Ayelet Shapira-Daniels ,&nbsp;Amy Yuan ,&nbsp;Abdulkareem Lukan ,&nbsp;Olumuyiwa Akinrimisi ,&nbsp;Marius Chukwurah ,&nbsp;Matthew Nayor ,&nbsp;Emelia J. Benjamin ,&nbsp;Honghuang Lin","doi":"10.1016/j.ahjo.2024.100439","DOIUrl":"10.1016/j.ahjo.2024.100439","url":null,"abstract":"<div><h3>Background</h3><p>Exhaled carbon monoxide (eCO) is associated with subclinical and overt cardiovascular disease and stroke. The association between eCO with left atrial size, prevalent, or incident atrial fibrillation (AF) are uncertain.</p></div><div><h3>Methods</h3><p>eCO was measured using an Ecolyzer instrument among Framingham Heart Study Offspring and Omni participants who attended an examination from 1994 to 1998. We analyzed multivariable-adjusted (current smoking, and other covariates including age, race, sex, height, weight, systolic blood pressure, diastolic blood pressure, diabetes, hypertension treatment, prevalent myocardial infarction [MI], and prevalent heart failure [HF]). Cox and logistic regression models assessed the relations between eCO and incident AF (primary model), and prevalent AF and left atrial (LA) size (pre-specified secondary analyses). We also conducted secondary analyses adjusting for biomarkers, and interim MI and interim HF.</p></div><div><h3>Results</h3><p>Our study sample included 3814 participants (mean age 58 ± 10 years; 54.4 % women, 88.4 % White). During an average of 18.8 ± 6.5 years follow-up, 683 participants were diagnosed with AF. eCO was associated with incident AF after adjusting for established AF risk factors (HR, 1.31 [95 % CI, 1.09–1.58]). In secondary analyses the association remained significant after additionally adjusting for C-reactive protein and B-type natriuretic peptide, and interim MI and CHF, and in analyses excluding individuals who currently smoked. eCO was not significantly associated with LA size and prevalent AF.</p></div><div><h3>Conclusion</h3><p>In our community-based sample of individuals without AF, higher mean eCO concentrations were associated with incident AF. Further investigation is needed to explore the biological mechanisms linking eCO with AF.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"45 ","pages":"Article 100439"},"PeriodicalIF":1.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266660222400082X/pdfft?md5=f1c3cddaa7e2e01fb4542c63e75c47c2&pid=1-s2.0-S266660222400082X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979332","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":"Protocol-driven approach to guideline-directed medical therapy optimization for heart failure: A real-world application to recovery","authors":"Crystal Lihong Yan ,&nbsp;David Snipelisky ,&nbsp;Mauricio Velez ,&nbsp;David Baran ,&nbsp;Jerry D. Estep ,&nbsp;E. Joseph Bauerlein ,&nbsp;Nina Thakkar Rivera","doi":"10.1016/j.ahjo.2024.100438","DOIUrl":"10.1016/j.ahjo.2024.100438","url":null,"abstract":"<div><p>The objective of our study was to evaluate the real-world effects of an aggressive, personalized protocol for guideline-directed medical therapy (GDMT) titration in patients with heart failure (HF) with reduced ejection fraction (HFrEF). We conducted a two-center retrospective cohort study. Patients with HFrEF who presented to a HF clinic from January 2020 to December 2022 were placed on a GDMT protocol. 180 patients were included in the study. Mean GDMT score significantly increased from 4.7 to 5.9 (<em>p</em> &lt; 0.001) between initial and final visits. Mean left ventricular ejection fraction (LVEF) significantly increased from 28 % to 33 % (+5 %, <em>p</em> &lt; 0.001). 27 (15.7 %) of the 172 patients with complete New York Heart Association (NYHA) classification data had improvement by at least 1 class, while 2 (1.2 %) patients had worsening NYHA classification. 140 (77.8 %) patients had no unplanned hospitalizations between visits. 21 (11.7 %) patients had an unplanned hospitalization for acute HF during the study period with a mean time from first clinic visit to hospitalization of 183 days (range: 13–821 days). 2 (1.1 %) patients were hospitalized due to GDMT-associated adverse drug events (i.e. hypotension, hyperkalemia). 7 (3.9 %) patients died during the study period, which was lower than the predicted 1-year death rate for our cohort (12.3 %) using the MAGGIC score. In conclusion, an aggressive, personalized protocol for GDMT titration in patients with HFrEF led to significant improvements in LVEF, NYHA classification, hospitalization, and mortality in a real-world setting. This protocol may help serve as a road map to lessen the gap between clinical knowledge and practice surrounding optimization of GDMT and move HFrEF patients toward a path to recovery.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"45 ","pages":"Article 100438"},"PeriodicalIF":1.3,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000818/pdfft?md5=80183d367d9c6b2407db692a56e41752&pid=1-s2.0-S2666602224000818-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141962718","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":"Guideline-directed medical therapy prescribing patterns and in-hospital outcomes among heart failure patients during COVID-19","authors":"Pratyaksh K. Srivastava ,&nbsp;Alexandra M. Klomhaus ,&nbsp;Asim Rafique ,&nbsp;Pooja S. Desai ,&nbsp;Lori B. Daniels ,&nbsp;Clyde W. Yancy ,&nbsp;Eric H. Yang ,&nbsp;Gregg C. Fonarow ,&nbsp;Rushi V. Parikh","doi":"10.1016/j.ahjo.2024.100440","DOIUrl":"10.1016/j.ahjo.2024.100440","url":null,"abstract":"<div><h3>Study objective</h3><p>The association of prior to admission guideline-directed medical therapy (GDMT) use in patients hospitalized with Heart Failure with Reduced Ejection Fraction (HFrEF, ejection fraction ≤40 %) and Coronavirus Disease 2019 (COVID-19) with in-hospital outcomes has not been well studied.</p></div><div><h3>Design/setting/participants/interventions/outcome measures</h3><p>Using the American Heart Association's Get With The Guidelines Heart Failure Registry, we identified HFrEF patients presenting with acute decompensated heart failure (ADHF) and compared rates of GDMT prescription between those presenting prior to and during the pandemic. In a subgroup of patients with a concomitant COVID-19 diagnosis, we evaluated the association of prior to admission GDMT use with in-hospital mortality and severe COVID-19.</p></div><div><h3>Results</h3><p>23,899 patients were admitted with HFrEF during the pandemic (2/16/20–3/24/21) and 26,459 patients were admitted in the year prior (2/16/19–2/15/20). In this overall cohort, prior to admission ACEI/ARB/ARNI (45.6 % vs 48.1 %, p &lt; 0.0001) and BB (56.9 % vs 62.4 %, p &lt; 0.0001) use was lower among admitted HFrEF patients during the pandemic when compared to the year prior. Rates of ACEI/ARB/ARNI, MRA, and triple therapy (ACE/ARB/ARNI + BB + MRA) prescription at discharge were higher during the pandemic compared to the year prior. Among a subgroup of those with HFrEF and COVID-19 (n = 333), prior to admission GDMT use was not associated with in-hospital mortality or severe COVID-19.</p></div><div><h3>Conclusion</h3><p>We found no association between prior to admission GDMT use and in-hospital mortality or severe COVID-19 among HFrEF patients admitted with ADHF and COVID-19. GDMT prescription at discharge for HFrEF patients overall has remained either similar or improved during the pandemic.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"45 ","pages":"Article 100440"},"PeriodicalIF":1.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000831/pdfft?md5=2d0fdd03708262cb9f50db6885edc5af&pid=1-s2.0-S2666602224000831-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963086","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":"National cost savings, operational and safety benefits from use of magnetocardiography in the assessment of emergency department chest pain patients","authors":"Christopher W. Baugh ,&nbsp;Margarita E. Pena ,&nbsp;Robert B. Takla ,&nbsp;Ahmad O. Hadri ,&nbsp;Sharon E. Mace","doi":"10.1016/j.ahjo.2024.100434","DOIUrl":"10.1016/j.ahjo.2024.100434","url":null,"abstract":"<div><h3>Study objectives</h3><p>Patients frequently present to the emergency department (ED) with chest pain requiring further risk stratification. Traditional cardiac diagnostics such as stress testing may expose patients to ionizing radiation, may not be readily available, may take significant time for testing and interpretation, and adds cost to the workup. Magnetocardiography (MCG) is an alternative approach to assess candidates more quickly and efficiently than routine downstream testing.</p></div><div><h3>Design</h3><p>We created and ran 1000 trials of a Monte Carlo simulation. Using this simulation, we modeled the national annual impact by averting further cardiac diagnostics.</p></div><div><h3>Setting</h3><p>All EDs in the United States.</p></div><div><h3>Participants</h3><p>All ED adult patients with chest pain.</p></div><div><h3>Interventions</h3><p>Simulated use of MCG to reduce avoidable downstream cardiac diagnostics.</p></div><div><h3>Main outcome measures</h3><p>Our primary outcome was to estimate the impact of an MCG-first strategy on the annual national cost savings among eligible patients in the ED. Our secondary outcomes were the estimated reduction in short-stay hospitalizations, cancer cases, and cancer deaths due to radiation exposure.</p></div><div><h3>Results</h3><p>An MCG-first strategy was estimated to save a mean (±SD) of $574 million (±$175 million) by avoiding 555,000 (±93,000) downstream cardiac diagnostic tests. This resulted in a national annual cumulative decrease of 500,000 (±84,000) hospitalizations, 7,600,000 (±1,500,000) bed hours, 409 (±110) new cancer diagnoses, and 210 (±56) new cancer deaths due to radiation exposure from avoidable cardiac diagnostics.</p></div><div><h3>Conclusions</h3><p>If adopted widely and used consistently, an MCG-first strategy among eligible patients could yield substantial benefits by averting avoidable cardiac diagnostic testing.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"45 ","pages":"Article 100434"},"PeriodicalIF":1.3,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000776/pdfft?md5=594a256ecb82a12c4d173fcd420f8465&pid=1-s2.0-S2666602224000776-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961663","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":"Combination diuretic therapies in heart failure: Insights from GUIDE-IT","authors":"Jeffery Budweg ,&nbsp;Mustafa M. Ahmed ,&nbsp;Juan R. Vilaro ,&nbsp;Mohammad A. Al-Ani ,&nbsp;Juan M. Aranda Jr ,&nbsp;Yi Guo ,&nbsp;Ang Li ,&nbsp;Sandip Patel ,&nbsp;Alex M. Parker","doi":"10.1016/j.ahjo.2024.100436","DOIUrl":"10.1016/j.ahjo.2024.100436","url":null,"abstract":"<div><h3>Introduction</h3><p>Diuretics are the mainstay of maintaining and restoring euvolemia in the management of heart failure. Loop diuretics are often preferred, however, combination diuretic therapy (CDT) with a thiazide diuretic is often used to overcome diuretic resistance and increase diuretic effect. We performed an analysis of the GUIDE-IT study to assess all-cause mortality and time to first hospitalizations in patients necessitating CDT.</p></div><div><h3>Methods</h3><p>Patients from the GUIDE-IT dataset were stratified by their requirement for CDT with a thiazide to achieve euvolemia. A total of 894 patients were analyzed, 733 of which were treated with loop diuretics alone vs 161 used either chlorothiazide or metolazone in addition to loop diuretics. Kaplan-Meir curves were derived with log-rank <em>p</em>-values to evaluate for differences between the groups.</p></div><div><h3>Results</h3><p>There was no significant difference in all-cause mortality regardless of CDT utilization status (mean survival of 612.704 days vs 603.326 days, <em>p</em> = 0.083). On subgroup analysis, there was no significant difference in all-cause mortality amongst those using loop diuretics compared to CDT in the BNP-guided therapy group, (mean survival time 576.385 days vs 620.585 days, <em>p</em> = 0.0523), nor the control group (614.1 days vs 588.9 days; <em>p</em> = 0.5728). Time to first hospitalization was reduced in all using CDT compared to loop diuretics alone (280.5 days vs 407.2 days, <em>p</em> &lt; 0.0001). On subgroup analysis, both the BNP-guided group as well as the control group had reduced time to first hospitalization in the CDT group compared to those who did not require CDT (BNP group: 287.503 days vs 402.475 days, <em>p</em> ≤0.0001; control group 248.698 days vs 399.035 days, <em>p</em> = 0.0009).</p></div><div><h3>Conclusion</h3><p>Use of CDT is associated with earlier time to hospitalization, though no association was identified with increased all-cause mortality. Further prospective studies are likely needed to determine the true risk and benefits of combination diuretic therapy.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"45 ","pages":"Article 100436"},"PeriodicalIF":1.3,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266660222400079X/pdfft?md5=286071745bf1d2e77b4c6dfd626c8222&pid=1-s2.0-S266660222400079X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141962719","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":"Public interest in America on cardiac arrest following cardiovascular events of Bronny and Damar: A Google trend study","authors":"Jasneel Kahlam ,&nbsp;Alexander Sacher ,&nbsp;John P. Reilly ,&nbsp;David F. Lo","doi":"10.1016/j.ahjo.2024.100433","DOIUrl":"10.1016/j.ahjo.2024.100433","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Heart disease is one of the leading causes of death in the United States. Increased education and utilization of BLS by first responders have had a significant impact, but certain populations remain high risk, such as African Americans. Raising awareness among at-risk populations may lead to more bystander CPR performed, improving mortality rates. The influence of celebrity deaths and illnesses is an important driver of public awareness. Therefore, the cardiac arrests of both Bronny James and Damar Hamlin may have influenced cardiac arrest awareness.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;Google Trends data was pulled for the following search terms from 8/21/2022–8/14/2023: Cardiac arrest (disease), Cardiopulmonary Resuscitation (topic), Basic Life Support (topic), Myocardial Infarction (disease), Defibrillation (topic) and Automatic External Defibrillator (topic). The average relative search volume (RSV) for each search term was taken for a three-week period encompassing the week of and two weeks following the cardiac arrests of Damar Hamlin and Lebron James Jr., respectively. We used one-way ANOVA and independent sample &lt;em&gt;t&lt;/em&gt;-tests to compare the average values of Damar Hamlin's and LeBron James Jr.'s incidents with their respective 12-month averages.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;RSV was significantly higher surrounding Hamlin's cardiac arrest compared to James Jr.'s for Cardiopulmonary Resuscitation and Automatic External Defibrillator. RSV for Basic Life Support was increased in LeBron James Jr.'s time compared to the 12-month average and Damar Hamlin's incident. Compared to the 12-month average, Cardiac arrest, Cardiopulmonary Resuscitation, Defibrillation, and Automatic External Defibrillator during Hamlin's incident. Myocardial infarction RSV was higher during James Jr.'s incident compared to baseline. Over the long term, the search terms showed a significant increase after Damar Hamlin's incident when compared to before.&lt;/p&gt;&lt;p&gt;RSV was significantly higher surrounding Hamlin's cardiac arrest compared to James Jr.'s for “Cardiopulmonary Resuscitation” (23.56 vs. 22.0, &lt;em&gt;p&lt;/em&gt; &lt; 0.00) and “Automatic External Defibrillator” (19.59 vs. 19.4, p &lt; 0.00). RSV for “Basic Life Support” was increased in LeBron James Jr.'s time compared to the 12-month average and Damar Hamlin's incident (80.9 vs. 66.88, &lt;em&gt;p&lt;/em&gt; = 0.04). Compared to the 12-month average, “Cardiac arrest,” “Cardiopulmonary Resuscitation,” “Defibrillation,” and “Automatic External Defibrillator” during Hamlin's incident showed significant increases. “Myocardial infarction” RSV was higher during James Jr.'s incident compared to baseline (55 vs. 46.6, &lt;em&gt;p&lt;/em&gt; = 0.026). Over the long term, the search terms showed a significant increase after Damar Hamlin's incident when compared to before (&lt;em&gt;p&lt;/em&gt; &lt; 0.05).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Increases in the search terms for Hamlin's cardiac arrest compared to James Jr.'s cardiac arrest ","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"45 ","pages":"Article 100433"},"PeriodicalIF":1.3,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000764/pdfft?md5=11392adf8e83bbee2d2d3a771bf44173&pid=1-s2.0-S2666602224000764-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044834","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":"Investigation of outcomes following transcatheter edge to edge repair of the mitral valve versus medical management alone in patients with cardiogenic shock and mitral regurgitation","authors":"Caleb J. Chiang ,&nbsp;Mina Kerolos ,&nbsp;Michael Sunnaa ,&nbsp;Sushant Koirala ,&nbsp;Joseph Eid ,&nbsp;Ethan M. Ritz ,&nbsp;Laith A. Derbas ,&nbsp;Fareed Moses Collado ,&nbsp;Tisha M. Suboc ,&nbsp;Clifford J. Kavinsky ,&nbsp;Hussam S. Suradi","doi":"10.1016/j.ahjo.2024.100430","DOIUrl":"10.1016/j.ahjo.2024.100430","url":null,"abstract":"<div><h3>Study objective</h3><p>Assessing if Transcatheter Edge to Edge Repair (TEER) with Mitraclip™ in patients with moderate to severe mitral regurgitation (MR) and cardiogenic shock (CS) improves outcomes compared to medical management alone.</p></div><div><h3>Design</h3><p>A single-center, retrospective study was performed in an urban tertiary referral center.</p></div><div><h3>Setting</h3><p>Rush University Medical Center, United States.</p></div><div><h3>Participants</h3><p>Adult patients presenting with CS and moderate to severe MR between 2012 and 2021 were included.</p></div><div><h3>Interventions</h3><p>Undergoing Mitral TEER with Mitraclip versus medical management alone.</p></div><div><h3>Main outcome measures</h3><p>Major adverse cardiovascular events (MACE) defined as cardiovascular death, heart failure admission, stroke, and myocardial infarction assessed at 30 days, 6 months, and 1 year. The secondary outcome was a change in New York Heart Association (NYHA) classification at 30 days and 6 months.</p></div><div><h3>Results</h3><p>There were 28 patients included in the medical management and 33 in the mitral valve TEER groups. There was a decreased MACE in the intervention group at 30 days (24.2 % vs. 46.4 %, <em>p</em> ≤0.001) and 6 months (27 % vs. 75 %, <em>p</em> = 0.002), though not at 1 year (29.4 % vs. 41.7 %, <em>p</em> = 0.42). At 30 days, more patients in the mitral valve TEER group improved to NYHA classes I/II compared to medical management alone (10 [35.7 %] vs. 16 [50 %], <em>p</em> = 0.043). There were no differences in NYHA classes I/II at 6 months (7 [43.7 %] vs. 13 [54.2 %], <em>p</em> = 0.63).</p></div><div><h3>Conclusion</h3><p>Mitral valve TEER using the Mitraclip™ system improves mid-term cardiovascular compared to medical management alone in patients with CS but does not improve mortality.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"45 ","pages":"Article 100430"},"PeriodicalIF":1.3,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000739/pdfft?md5=a56b6e79588302531ce2e6640c4d4cc6&pid=1-s2.0-S2666602224000739-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961593","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":"Climate change versus Mediterranean diet: A hazardous struggle for the women's heart","authors":"Valentina Bucciarelli ,&nbsp;Federica Moscucci ,&nbsp;Camilla Cocchi ,&nbsp;Savina Nodari ,&nbsp;Susanna Sciomer ,&nbsp;Sabina Gallina ,&nbsp;Anna Vittoria Mattioli","doi":"10.1016/j.ahjo.2024.100431","DOIUrl":"10.1016/j.ahjo.2024.100431","url":null,"abstract":"<div><p>Climate change impacts food systems, causing nutritional deficiencies and increasing cardiovascular diseases (CVD). Regulatory frameworks like the European Farm-to-Fork Strategy aim to mitigate these effects, but current EU food safety regulations inadequately address health risks from poor diet quality and contaminants.</p><p>Climate change adversely affects food quality, such as nutrient depletion in crops due to higher CO₂ levels, leading to diets that promote chronic diseases, including CVD. Women, because of their roles in food production and their unique physiological responses to nutrients, face distinct vulnerabilities. This review explores the interplay between climate change, diet, and cardiovascular health in women. The review highlights that sustainable diets, particularly the Mediterranean diet, offer health benefits and lower environmental impacts but are threatened by climate change-induced disruptions. Women's adherence to the Mediterranean diet is linked to significant reductions in CVD risk, though sex-specific responses need further research.</p><p>Resilient agricultural practices, efficient water management, and climate-smart farming are essential to mitigate climate change's negative impacts on food security. Socio-cultural factors influencing women's dietary habits, such as traditional roles and societal pressures, further complicate the picture.</p><p>Effective interventions must be tailored to women, emphasizing education, community support, policy changes, and media campaigns promoting healthy eating. Collaborative approaches involving policymakers, health professionals, and the agricultural sector are crucial for developing solutions that protect public health and promote sustainability.</p><p>Addressing the multifaceted challenges posed by climate change to food quality and cardiovascular health in women underscores the need for integrated strategies that ensure food security, enhance diet quality, and mitigate environmental impacts.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"45 ","pages":"Article 100431"},"PeriodicalIF":1.3,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000740/pdfft?md5=8d94bbfd669349b8698c4ae57349dd1a&pid=1-s2.0-S2666602224000740-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961664","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 intra-arterial catheterization and mortality of acute heart failure patients without shock in ICU: A retrospective study","authors":"Yide Li ,&nbsp;Yuan Zhu ,&nbsp;Le Fu ,&nbsp;Liang Luo ,&nbsp;Yingfang She","doi":"10.1016/j.ahjo.2024.100432","DOIUrl":"10.1016/j.ahjo.2024.100432","url":null,"abstract":"<div><h3>Background</h3><p>Acute heart failure necessitates intensive care, and arterial catheterization is a commonly performed invasive procedure in the intensive care unit (ICU). We aimed to investigate the association between arterial catheterization and outcomes in acute heart failure patients without shock.</p></div><div><h3>Methods</h3><p>We utilized MIMIC-IV database records for acute heart failure patients at Beth Israel Deaconess Medical Center from 2008 to 2019. Employing doubly robust estimation, we examined the relationship between arterial catheterization and outcomes, including 28-day, 90-day, in-hospital mortality, and ICU-free days within 28 days.</p></div><div><h3>Results</h3><p>Of 6936 patients identified, 2078 met inclusion criteria; 347 underwent arterial catheterization during their ICU stay. We observed no significant difference in 28-day mortality (odds ratio [OR]: 0.61, 95 % confidence interval [CI]: 0.31–1.21, <em>P</em> = 0.155), though catheterization was associated with reduced in-hospital mortality (OR: 0.41, 95 % CI: 0.14–0.65, <em>P</em> = 0.02). No significant effects were observed on 90-day mortality or ICU-free days within 28 days.</p></div><div><h3>Conclusion</h3><p>Our findings suggest that arterial catheterization is not associated with 28- and 90-day mortality rates in acute heart failure patients without shock but is linked to lower in-hospital mortality. Additional research and consensus are required to determine the appropriate utilization of arterial catheterization in patients.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"45 ","pages":"Article 100432"},"PeriodicalIF":1.3,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000752/pdfft?md5=172b21c029aad1e0d48de2764cb0c699&pid=1-s2.0-S2666602224000752-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961598","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}