American journal of cardiovascular disease最新文献

{"title":"Exploring the impact of metabolites function on heart failure and coronary heart disease: insights from a Mendelian randomization (MR) study.","authors":"Vicheth Virak, Pengkhun Nov, Deshu Chen, Xuwei Zhang, Junjie Guan, Dongdong Que, Jing Yan, Vanna Hen, Senglim Choeng, Chongbin Zhong, Pingzhen Yang","doi":"10.62347/OQXZ7740","DOIUrl":"10.62347/OQXZ7740","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) and coronary heart disease (CHD) are major causes of morbidity and mortality worldwide. While traditional risk factors such as hypertension, diabetes, and smoking have been extensively studied, the role of metabolite functions in the development of these cardiovascular conditions has been less explored. This study employed a Mendelian randomization (MR) approach to investigate the impact of metabolite functions on HF and CHD.</p><p><strong>Methods: </strong>To assess the causal impacts of specific metabolite risk factors on HF and CHD, this study utilized genetic variants associated with these factors as instrumental variables. Comprehensive genetic and phenotypic data from diverse cohorts, including genome-wide association studies (GWAS) and cardiovascular disease registries, were incorporated into the research.</p><p><strong>Results: </strong>Our results encompass 61 metabolic cell phenotypes, with ten providing strong evidence of the influence of metabolite functions on the occurrence of HF and CHD. We found that elevated levels of erucate (22:1n9), lower levels of α-tocopherol, an imbalanced citrulline-to-ornithine ratio, elevated γ-glutamyl glycine levels, and elevated 7-methylguanine levels independently increased the risk of these cardiovascular conditions. These findings were consistent across different populations and robust to sensitivity analyses.</p><p><strong>Conclusion: </strong>This MR study provides valuable insights into the influence of metabolite functions on HF and CHD. However, further investigation is needed to fully understand the precise mechanisms by which these metabolite factors contribute to the onset of these conditions. Such research could pave the way for the development of targeted therapeutic strategies.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"14 4","pages":"242-254"},"PeriodicalIF":1.3,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278923","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":"Investigating the effect of cancer medication in the development of Takotsubo cardiomyopathy.","authors":"On Chen, Azad Mojahedi","doi":"10.62347/STFL9135","DOIUrl":"10.62347/STFL9135","url":null,"abstract":"<p><p>Takotsubo cardiomyopathy (TCM) is a cardiac condition that is usually characterized by sudden heart failure (HF) or chest pain that resembles acute coronary syndrome (ACS). It is identified by severe systolic dysfunction of the left ventricle (LV) and can be caused by physical, medical, or emotional stress. The pathophysiological mechanisms leading to TCM have not yet been clearly determined. TCM is a complex condition to diagnose and may go undetected during cancer treatment due to the wide variety of cardiotoxic effects associated with antineoplastic therapies. Consequently, timely identification and effective treatment are critical to enhancing the prognosis. Nevertheless, TCM is a more prevalent condition in oncology than was previously believed; therefore, clinicians who treat cancer patients should consider it in their differential diagnosis. The purpose of this manuscript is to provide physicians with a summary of the available evidence regarding the ramifications of the association between TCM and cancer to aid in improving patient management.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"14 4","pages":"196-207"},"PeriodicalIF":1.3,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278925","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":"A normal and particularly small (<35 mm) left atrial size measured during echocardiography suggests low likelihood of moderate or severe left ventricular systolic dysfunction.","authors":"Mohammad Reza Movahed, Arman Soltani Moghadam","doi":"10.62347/YJTK3145","DOIUrl":"10.62347/YJTK3145","url":null,"abstract":"<p><strong>Introduction: </strong>The left atrium (LA) size can change due to cardiac pathologies like heart failure and aging. While the link between LA enlargement and left ventricular (LV) dysfunction is acknowledged, this study aims to assess the negative predictive value of normal LA size concerning the severity of LV systolic function in a large cohort undergoing diagnostic echocardiography.</p><p><strong>Methods: </strong>This retrospective cohort study, conducted at the University of California, Irvine Medical Center from 1984 to 1998, aimed to elucidate the negative predictive value of normal LA size measured by M-mode and two-dimensional echocardiography in a large cohort undergoing diagnostic assessment.</p><p><strong>Results: </strong>In the analysis of 22,390 echocardiograms, 55.1% exhibited normal LA size (<40 mm), while 44.9% showed abnormal LA size (≥40 mm). Within the normal LA size group, only 2.4% demonstrated abnormal LV systolic function, with 1.1% mildly depressed, 0.7% moderately depressed, and 0.6% severely depressed LV function. The negative predictive value of normal LA size for abnormal LV systolic function was calculated at 97.5%, rising to 99.3% and 99.4% for moderate or severely decreased LV systolic function, respectively. In patients with small LA size (<35 mm), moderate to severely depressed LV systolic function was observed in only 0.8%, with severe LV systolic dysfunction in 0.3%, yielding an overall prevalence of 1.5% for all systolic dysfunction in the small LA size group.</p><p><strong>Conclusion: </strong>Our findings underscore the clinical significance of normal LA size as a reliable indicator of preserved LV function.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"14 4","pages":"236-241"},"PeriodicalIF":1.3,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278922","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":"Evaluating antiarrhythmic drugs for managing infants with supraventricular tachycardia; a review.","authors":"Azad Mojahedi, Afsaneh Mirshekari","doi":"10.62347/ZTXC5809","DOIUrl":"10.62347/ZTXC5809","url":null,"abstract":"<p><p>Supraventricular tachycardia (SVT) is the most prevalent arrhythmia observed in infants, impacting individuals with or without congenital cardiac dysfunction. Infantile-onset SVT typically manifests within the initial one to two months of life. A variety of anti-arrhythmic medications are employed to treat SVT in infants during their first year of life. Nevertheless, a consensus has yet to be reached on the most efficacious drug, and treatment approaches continue to vary considerably As SVT remains a frequent problem around the world, with different management approaches and no obvious optimal option, we conducted a systematic review of the new update of antiarrhythmic drugs for managing SVT in infants under one year old.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"14 3","pages":"144-152"},"PeriodicalIF":1.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632398","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":"Disparities by sex, race, and region in acute myocardial infarction-related outcomes during the early COVID-19 pandemic: the national inpatient sample analysis.","authors":"Harshith Thyagaturu, Amro Taha, Shafaqat Ali, Nicholas Roma, Sanchit Duhan, Neel Patel, Yasar Sattar, Karthik Gonuguntla, Harigopal Sandhyavenu, Irisha Badu, Erin D Michos, Sudarshan Balla","doi":"10.62347/WKBJ1501","DOIUrl":"10.62347/WKBJ1501","url":null,"abstract":"<p><strong>Background: </strong>Disparities in acute myocardial infarction (AMI)-related outcomes have been reported before the COVID-19 pandemic. We studied in-hospital outcomes of AMI across demographic groups in the United States during the early COVID-19 pandemic.</p><p><strong>Methods: </strong>The National Inpatient Sample (NIS) database was queried for 2020 to identify AMI-related hospitalizations based on appropriate ICD-10-CM codes categorized by sex, race, and hospital region categories. The primary outcome was in-hospital mortality in females, racial and ethnic minority groups, and Northeast hospital region compared with males, White patients, and Midwest hospital region, respectively. Multivariable regression analysis was used to calculate the adjusted odds ratio and mean difference.</p><p><strong>Results: </strong>A total of 820,893 AMI-related hospitalizations were identified during the study period. On adjusted analysis, during the early COVID-19 pandemic, females had lower odds of in-hospital mortality [aOR 0.89 (0.85-0.92); P < 0.01] and revascularization [aOR 0.68 (0.66-0.69); P < 0.01] than males. Racial and ethnic based analysis showed that Asian/Pacific Islander patients had higher odds of in-hospital mortality [aOR 1.13 (1.03-1.25); P < 0.01] than White patients. During the early COVID-19 pandemic, Northeast and Western region hospitals had higher odds of in-hospital mortality, lower odds of revascularization, longer length of stay, and higher total hospitalization costs than Midwest region hospitals.</p><p><strong>Conclusions: </strong>Our study disclosed disparities in AMI-related mortality and revascularization by sex, race and ethnic, and region during the early COVID-19 pandemic. Special attention should be given to at-risk populations. Whether these disparities continue in the post-vaccination era warrants further study.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"14 3","pages":"153-171"},"PeriodicalIF":1.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632397","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":"Percutaneous coronary intervention involving coronary bifurcation is associated with higher mortality and complications.","authors":"Allistair Nathan, Mehrtash Hashemzadeh, Mohammad Reza Movahed","doi":"10.62347/XDDB4510","DOIUrl":"10.62347/XDDB4510","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) in patients with bifurcation lesions is associated with higher complexity and adverse outcomes. The goal of this study was to evaluate the inpatient outcomes of patients with PCI of bifurcation lesions.</p><p><strong>Methods: </strong>The National Inpatient Sample (NIS) database, years 2016-2020, was studied using ICD 10 codes. Patients undergoing PCI for bifurcation lesions were compared to those undergoing PCI for non-bifurcation lesions, excluding chronic total occlusion lesions. We evaluated post-procedural inpatient mortality and complications.</p><p><strong>Results: </strong>PCI in patients with bifurcation lesions was associated with higher mortality and post-procedural complications. A weighted total of 9,795,154 patients underwent PCI; of those, 43,480 had a bifurcation lesion. The bifurcation cohort had a 3.79% mortality rate, and the rate in those with non-bifurcation lesions was 2.56% (OR, 1.50; CI: 1.34-1.68; P<0.001). Upon conducting multivariate analysis, which adjusted for age, sex, race, and significant comorbidities, PCI for bifurcation lesions remained significantly associated with a higher mortality rate compared to non-bifurcation lesion PCI (OR, 1.68; 95% CI, 1.49-1.88; P<0.001). Furthermore, PCI for bifurcation lesions was associated with higher rates of myocardial infarction (OR, 2.26; 95% CI, 1.68-3.06; P<0.001), coronary perforation (OR, 7.97; 95% CI, 6.25-10.17; P<0.001), tamponade (OR, 3.46; 95% CI, 2.49-4.82; P<0.001), and procedural bleeding (OR, 5.71; 95% CI, 4.85-6.71; P<0.001). Overall, post-procedural complications were 4 times more in patients with bifurcation lesions than in those without (OR, 4.33; 95% CI, 3.83-4.88; P<0.001).</p><p><strong>Conclusion: </strong>Using a large, national inpatient database, we demonstrate that both mortality rates and post-procedural complication rates were significantly higher in patients undergoing PCI for bifurcation lesions than in those undergoing PCI for non-bifurcation lesions.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"14 3","pages":"180-187"},"PeriodicalIF":1.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632401","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":"Impact of frailty index on cardiovascular outcomes and readmissions of patent foramen ovale closure procedure: a propensity matched national analysis.","authors":"Saliha Erdem, Amro Taha, Neel Patel, Dhruvil Ashishkumar Patel, Anoop Titus, Khaled M Harmouch, Yasemin Bahar, Sanchit Duhan, Bijeta Keisham, Moinuddin Syed, Juan Carlo Avalon, Yasar Sattar, M Chadi Alraies","doi":"10.62347/PTMD5117","DOIUrl":"10.62347/PTMD5117","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter patent foramen ovale (PFO) occluder device is a procedure mostly performed to prevent secondary stroke as a result of paradoxical emboli traversing an intracardiac defect into the systemic circulation. The complications and outcomes following the procedure remain poorly studied. We aimed to investigate morbidity and mortality associated with occluder device procedures using hospital frailty index score stratification.</p><p><strong>Methods: </strong>The Nationwide Readmission Database was employed to identify patients admitted for PFO closure from 2016 to 2020. Two groups divided by index frailty score were compared to report adjusted odds ratio (aOR) for primary and secondary cardiovascular outcomes. Outcomes included in-hospital mortality, acute kidney injury, acute ischemic stroke, and post-procedure bleeding. Statistical analysis was performed using <i>STATA v.17</i>.</p><p><strong>Results: </strong>Of the 2,063 total patients who underwent the procedure, 45% possessed intermediate to high frailty scores while the other 55% had low frailty scores. The first cohort had higher odds of in-hospital mortality (aOR 6.3, 95% CI 2.05-19.5), acute kidney injury (aOR 17.6, 95% CI 9.5-32.5), and stroke (aOR 3.05, 95% CI 1.5-5.8) than the second cohort. There was no difference in the incidence of post-procedural bleeding and cardiac tamponade and 30/90/180-day readmission rates between the two cohorts. Hospitalizations in the first cohort were associated with a higher median length of stay and total cost.</p><p><strong>Conclusion: </strong>High to intermediate frailty scores may predict an increased risk of in-hospital mortality in patients undergoing PFO occluder device procedures.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"14 3","pages":"188-195"},"PeriodicalIF":1.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632400","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":"Gender-based disparities in outcomes of coronary bifurcation stenting in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis.","authors":"Resha Khanal, Mohammad Hamza, Maria Najam, Salman Abdul Basit, Zarghoona Wajid, Amna Rashdi, Neel Patel, Saman Razzaq, Rajendra Shah, Khaled M Harmouch, Bandar Alyami, Yasemin Bahar, Muhammad Aamir, Mohammed Abu-Mahfouz, Yasar Sattar, M Chadi Alraies","doi":"10.62347/YBJN2231","DOIUrl":"10.62347/YBJN2231","url":null,"abstract":"<p><strong>Introduction: </strong>Around 15-20% of lesions necessitating percutaneous coronary interventions (PCI) are attributed to coronary bifurcation lesions. We aim to study gender-based differences in PCI outcomes among bifurcation stents.</p><p><strong>Methods: </strong>3 studies were included after thorough systematic search using MEDLINE (EMBASE and PubMed). CRAN-R software using the Metabin module was used for statistical analysis. Pooled odds ratios (OR) were calculated using the random effect model and the Mantel-Haenszel method, with a 95% confidence interval (CI) used to determine statistical significance. Heterogeneity was assessed using Higgins I².</p><p><strong>Result: </strong>Women exhibited a higher risk of in-hospital mortality (OR 0.67, 95% CI 0.58-0.76, I² = 0%, P < 0.0001), post-procedural bleeding (OR 0.53, 95% CI 0.47-0.6, I² = 0%, P < 0.0001) and post-procedure stroke (OR 0.72, 95% CI 0.52-1.0, I² = 0%, P < 0.06) as compared to men. However, there were no significant differences in terms of myocardial infarction (OR 0.84, 95% CI 0.22-3.27, I² = 49.4%, P < 0.80) and cardiac tamponade (OR 0.63, 95% CI 0.06; 5.72, I² = 0%, P < 0.6821) in both groups.</p><p><strong>Conclusion: </strong>Our study reveals a noteworthy increase in in-hospital mortality in women, which could be attributed to a higher rate of major bleeding, advanced age, increased co-morbidities, and complex pathophysiology of the lesion in comparison to men. Further studies are required to gain a better understanding of the precise mechanisms thus enhancing procedural outcomes.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"14 3","pages":"136-143"},"PeriodicalIF":1.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632399","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 occurrence of ST elevation myocardial infarction (STEMI) and non-STEMI in patients with post traumatic stress disorder (PTSD) using the large nationwide inpatient sample (NIS).","authors":"Abdullah Mohamed Niyas, Fathima Haseefa, Mohammad Reza Movahed, Mehrtash Hashemzadeh, Mehrnoosh Hashemzadeh","doi":"10.62347/YTCI7645","DOIUrl":"10.62347/YTCI7645","url":null,"abstract":"<p><strong>Background: </strong>PTSD leads to increased levels of stress hormones and dysregulation of the autonomic nervous system which may trigger cardiac events. The goal of this study is to evaluate any association between PTSD and the occurrence of STEMI and NSTEMI using a large database.</p><p><strong>Method: </strong>Using the Nationwide Inpatient Sample (NIS) and ICD-9 codes from 2005 to 2014 (n=1,621,382), we performed a univariate chi-square analysis of in-hospital occurrence of STEMI and NSTEMI in patients greater than 40 years of age with and without PTSD. We also performed a multivariate analysis adjusting for baseline characteristics including age, gender, diabetes, race, hyperlipidemia, hypertension, and tobacco use.</p><p><strong>Results: </strong>The 2005-2014 dataset contained 401,485 STEMI patients (745, or 0.19%, with PTSD) and 1,219,897 NSTEMI patients (2,441, or 0.15%, with PTSD). In the 2005 dataset, 0.5% of PTSD patients had STEMI compared to 1.0% of non-PTSD patients (OR=0.46, 95% C.I., 0.36-0.59). Similarly, 0.6% of patients with PTSD and 2.2% of patients without PTSD had NSTEMI (OR=0.28, 95% C.I., 0.23-0.35). In the 2014 dataset, 0.3% of PTSD patients had STEMI compared to 0.7% of non-PTSD patients (OR=0.43, 95% C.I., 0.35-0.51). Similarly, 1.4% of patients with PTSD versus 2.9% of patients without PTSD had NSTEMI (OR=0.48, 95% C.I., 0.44-0.52). Similar trends were seen throughout the ten-year period. After adjusting for age, gender, diabetes, race, hyperlipidemia, hypertension, and tobacco use, PTSD was associated with a lower occurrence of STEMI (2005: OR=0.50, 95% C.I., 0.37-0.66; 2014: OR=0.35, 95% C.I., 0.29-0.43) and NSTEMI (2005: OR=0.44, 95% C.I., 0.34-0.57; 2014: OR=0.63, 95% C.I., 0.58-0.69).</p><p><strong>Conclusion: </strong>Using a large inpatient database, we did not find an increased occurrence of STEMI or NSTEMI in patients diagnosed with PTSD, suggesting that PTSD is not an independent risk factor for myocardial infarction.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"14 3","pages":"172-179"},"PeriodicalIF":1.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632402","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":"Cardiogenic pulmonary edema - is it lone cardiogenic? \"Missing link\" between hemodynamic and other existing mechanisms.","authors":"Hamayak S Sisakian, Ani R Tavaratsyan","doi":"10.62347/YGQQ8696","DOIUrl":"10.62347/YGQQ8696","url":null,"abstract":"<p><p>The current traditional pathophysiologic concept of pulmonary edema of cardiogenic origin explains its development by a hydrostatic effect due to increased pulmonary capillary pressure resulting in fluid flux to alveolar and interstitial areas from capillaries. However, several experimental studies and clinical data of poor response to hemodynamic and diuretic treatment in many scenarios provide further evidence of the involvement of several other contributing factors to the development of cardiogenic pulmonary edema. Several experimental and clinical studies have found that sympathetic overactivity with elevated plasma catecholamine concentrations may play an important role in the development of cardiovascular-associated pulmonary edema. Catecholamine-induced pulmonary injury may be one of the key mechanisms in acute cardiogenic pulmonary edema triggering proinflammatory cytokine overactivation, oxidative stress and myocardial injury. In the everyday treatment of acute heart failure, physicians should consider the possibility of other noncardiogenic mechanisms involved in the progression of acute pulmonary edema, particularly catecholamine overactivity, lymphatic drainage, inflammatory and oxidative stress, high surfactant protein. The classic, hemodynamic treatment approach in pulmonary edema with the coexistence of other contributing factors may not provide adequate clinical benefit during treatment.</p>","PeriodicalId":7427,"journal":{"name":"American journal of cardiovascular disease","volume":"14 2","pages":"81-89"},"PeriodicalIF":1.3,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11101961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141064889","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}