Cardiology最新文献

{"title":"Response to Letter to the Editor: Interpreting Longitudinal LV Size Reduction: The Role of Age, Comorbidity, and Loading Conditions.","authors":"Israel Gotsman, David Leibowitz","doi":"10.1159/000548694","DOIUrl":"https://doi.org/10.1159/000548694","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel double MYH7/MYBPC3 variants in a Chinese family of Hypertrophic Cardiomyopathy with Early-onset and Sudden Death.","authors":"Bo Wang, Jia Zhao, Yanmin Zhang, Ke Feng, Xueli Zhao, Jiao Liu, Chao Han, Lu Yao, Lanlan Zhang, Jing Li, Shengjun Ta, Wenxia Li, Jie Gao, Yue Wang, Yuze Qin, Jing Wang, Liwen Liu","doi":"10.1159/000548235","DOIUrl":"https://doi.org/10.1159/000548235","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic cardiomyopathy (HCM) is a common inherited heart condition. Traditional genetic testing is typically conducted on the proband only, with family members undergoing Sanger sequencing, which may overlook other pathogenic variants. This study explores the gene sequencing strategy in a three-generation family based on genetic carrier status and examines the relationship between phenotypic characteristics and genotype.</p><p><strong>Methods: </strong>High-throughput second-generation sequencing was performed on the proband to analyze HCM-related pathogenic genes. Subsequently, the identified pathogenic variants were validated by Sanger sequencing in the proband and family members. Clinical, electrocardiographic, and echocardiographic assessments were conducted for family members.</p><p><strong>Results: </strong>Second-generation sequencing of the proband (III7) revealed a pathogenic variant MYBPC3-P453Lfs. Initially, no HCM-related pathogenic variants were detected in another patient (III11), prompting additional sequencing of III11, which identified the MYH7-G823E pathogenic variant. Both patients had severe left ventricular outflow tract obstruction. Sanger sequencing showed that five family members carried both mutations. Among them, three died suddenly before age 40, one required an implantable cardioverter-defibrillator for arrhythmias, and one developed HCM before adulthood. Cardiac magnetic resonance imaging (MRI) of patients carrying both mutations showed myocardial fibrosis of 32.75%, significantly higher than the 6.98% observed in patients carrying only one mutation.</p><p><strong>Conclusion: </strong>In families with varying HCM phenotypes, second-generation sequencing should be considered for all members. In this family, carrying one variant led to outflow tract obstruction, while carrying both variants resulted in severe disease, including sudden death and early onset. Cardiac MRI is crucial for assessing the severity of the disease within the family.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-22"},"PeriodicalIF":1.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real world data: Survival outcomes and risk factors in extracorporeal membrane oxygenation use of cancer patient.","authors":"Jheng-Jie Li, Hui-Fen Chan, Ming-Hsien Lin, Hsiao-En Tsai, Fang-Hsin Chen","doi":"10.1159/000548439","DOIUrl":"https://doi.org/10.1159/000548439","url":null,"abstract":"<p><strong>Background/purpose: </strong>Extracorporeal membrane oxygenation (ECMO) is a vital therapy for cardiopulmonary failure, yet its use in patients with cancer remains controversial due to immunosuppression and coagulopathy. Advances in oncology necessitate re-evaluating ECMO's role in this population. This study investigates survival outcomes and prognostic factors in ECMO patients with and without cancer.</p><p><strong>Methods: </strong>We analyzed a retrospective cohort of 342 adult ECMO patients treated at National Taiwan University Hospital Hsin-chu Branch between January 2017 to December 2023. Patient demographics, medical history, and pre-ECMO laboratory parameters were assessed. Kaplan-Meier curves and Cox proportional hazards models were used to identify survival predictors.</p><p><strong>Results: </strong>Among the 342 patients, 40 had cancer, with solid tumors constituting 92.5% of cases. 90-day mortality were 56.8% for non-cancer patients and 70.0% for cancer patients, with no significant difference (p = 0.087). Hyperlactatemia (>10 mmol/L, HR: 2.74, p < 0.001) and hypoalbuminemia (< 2.4 g/dL, HR: 1.76, p = 0.018) were significantly associated with worse survival outcomes in the multivariable analysis. Cancer status was not statistically significant (HR: 1.41, p = 0.114). Subgroup analyses in cancer patients confirmed elevated lactate (>10 mmol/L, HR: 8.85, p < 0.001) and low albumin (< 3.4 g/dL, HR: 3.62, p = 0.018) as significant prognostic factors.</p><p><strong>Conclusions: </strong>ECMO may be an option in highly selected patients with solid tumors and without significant metabolic derangements. Elevated lactate and low albumin predict poor outcomes, highlighting the need for early metabolic optimization. ECMO is a potential bridge therapy for critically ill cancer patients, warranting further validation and assessment of the impact of modern oncologic therapies on outcomes. Only three patients in this study had hematologic malignancies. Therefore, the findings primarily reflect outcomes in patients with solid tumors and should not be generalized to those with hematologic cancers.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-29"},"PeriodicalIF":1.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factor analysis and prediction of acute postoperative lung injury after type A aortic dissection.","authors":"Mingming Yuan, Shansong Gao, Shuqin Zhong, Jianfeng Huang, Xiaoming Liu, Qicai Wu","doi":"10.1159/000548374","DOIUrl":"https://doi.org/10.1159/000548374","url":null,"abstract":"<p><p>Objective To investigate the risk factors of acute lung injury (ALI) after type A aortic dissection and establish a predictive model to evaluate the risk of ALI. Methods The clinical data of patients who underwent type A aortic dissection in the First Affiliated Hospital of Nanchang University from January 2022 to June 2024 were retrospectively analyzed. According to whether acute lung injury occurred after surgery, ALI group and non-ALI group were divided into two groups. Univariate and multivariate analysis were performed on the factors that may cause acute lung injury, and multivariate Logistic regression prediction model was constructed. Results A total of 187 patients were included in the study, including 94 patients in the non-ALI group and 93 patients in the ALI group. The incidence of ALI after type A aortic dissection was 49.7%. Multivariate analysis showed that BMI, smoking history, D-dimer, interleukin-6, and cardiopulmonary bypass time were independent risk factors for ALI after type A aortic dissection. The prediction model based on these risk factors has good prediction efficiency. Conclusion BMI, smoking history, D-dimer, interleukin-6 and cardiopulmonary bypass time are independent risk factors for ALI after type A aortic dissection. The predictive model established based on these risk factors has good predictive efficacy, which helps to identify high-risk patients early, take appropriate preventive measures, improve surgical safety and improve patient prognosis.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-24"},"PeriodicalIF":1.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of risk factors for frailty syndrome in elderly patients with acute coronary syndrome and establishment of a nomogram prediction model.","authors":"Guodong Ma, Guozhen Ma, Li Yu, Sibing Huang, Hanhua Gao","doi":"10.1159/000548077","DOIUrl":"https://doi.org/10.1159/000548077","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the risk factors of frailty syndrome in elderly patients with acute coronary syndrome (ACS) and establish a nomogram prediction model.</p><p><strong>Methods: </strong>Totally 256 elderly ACS patients admitted to our hospital from September 2022 to March 2025 were retrospectively selected and randomly assigned into a modeling group and a validation group in a 7:3 ratio. The modeling group was assigned into a frailty group and a non frailty group based on the presence or absence of frailty syndrome. Clinical data of patients were collected. The logistic method was performed to analyze the influencing factors of elderly ACS patients with frailty syndrome. R software was performed to construct nomogram prediction models. ROC and calibration curves were performed to evaluate the discrimination and consistency of nomogram prediction models. DCA was used to evaluate its clinical application value.</p><p><strong>Results: </strong>Out of 179 patients, 70 developed frailty syndrome, with an incidence rate of 39.11%. The logistic analysis results showed that age, CCI index, living alone, anxiety, history of falling, sarcopenia, and NT-proBNP were risk factors for frailty syndrome in elderly ACS patients (P<0.05). The AUC of the modeling group was 0.877, and the H-L test showed χ2=8.567 (P=0.785). The AUC of the validation group was 0.890, and the H-L test showed χ2=7.231 (P=0.705). DCA curve showed that when the threshold probability was between 0.06 and 0.95, the nomogram prediction model for evaluating elderly ACS with frailty syndrome had high clinical application value.</p><p><strong>Conclusion: </strong>Age, CCI index, living alone, anxiety, history of falling, sarcopenia, and NT-proBNP are the influencing factors of frailty syndrome in elderly ACS patients. The predictive model constructed based on these factors has good predictive performance.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-18"},"PeriodicalIF":1.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting Longitudinal LV Size Reduction: The Role of Age, Comorbidity, and Loading Conditions.","authors":"Mehmet Göl, Ayşe Hoşoğlu, Yusuf Hoşoğlu","doi":"10.1159/000548405","DOIUrl":"https://doi.org/10.1159/000548405","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-4"},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of two Vascular Closure Strategies in Transcatheter Aortic Valve Replacement: Suture and Plug versus Suture alone: A Systematic Review and Meta-Analysis.","authors":"Hamzah Pratama Megantara, Iwan Dakota, Taofan Taofan, Suci Indriani, Ruth Grace Aurora, Suko Adiarto","doi":"10.1159/000548359","DOIUrl":"https://doi.org/10.1159/000548359","url":null,"abstract":"<p><strong>Introduction: </strong>Vascular complications following transcatheter aortic valve replacement (TAVR) significantly contribute to morbidity and mortality. Conventional suture-based closure technique has been widely utilized for large-bore arterial access closure. Recent findings on hybrid strategy combining plug and suture-based devices has been on spotlight as it may improve the hemostatic efficacy and lower the access-site related complications and clinical outcomes.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of studies comparing a suture-based approach with a hybrid closure strategy (suture+plug) in aortic stenosis patients undergoing TAVR. Included studies were appraised following the Cochrane Risk of Bias and Newcastle-Ottawa Scale tools. Forest plots were extracted in Review Manager with a main outcome of pooled-risk ratio (RR). The primary endpoint was the composite of access-site related vascular complications as defined by Valve Academic Research Consortium criteria whilst secondary end-points were in-hospital bleeding, closure device failure, mortality and unplanned endovascular or surgical intervention Results: Six eligible studies encompassing 2,064 patients were analyzed. Compared with suture-based closure, hybrid closure exhibited a lower rate of vascular complications [pooled-RR 0.46; 95% CI, 0.38-0.57; p <0.001], closure device failure [pooled-RR 0.35; 95% CI, 0.13-0.96; p=0.04], in-hospital bleeding events [pooled-RR 0.38; 95% CI, 0.26-0.55; p <0.001] and mortality [pooled-RR 0.51; 95% CI, 0.26-0.99; p=0.049]. Unplanned endovascular or surgical intervention was no different among two groups [pooled-RR 0.42; 95% CI, 0.17-1.06; p=0.07].</p><p><strong>Conclusion: </strong>Hybrid vascular closure strategy offers better efficacy with lesser complications amongst patients undergoing TAVR, directing the clinical adoption of hybrid techniques, although further large-scale multicenter studies are warranted to confirm the benefit and optimize patient selection.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-25"},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro and ex-vivo flow models for arterial thrombosis: a systematic review.","authors":"Hande Eyisoylu, Rachele Cagnazzo, Gijsje H Koenderink, Moniek P M de Maat, Heleen M M van Beusekom","doi":"10.1159/000548375","DOIUrl":"https://doi.org/10.1159/000548375","url":null,"abstract":"<p><p>Arterial thrombosis is a multifaceted process characterized by platelet aggregation and fibrin deposition, leading to the occlusion of blood vessels. It plays a central role in cardiovascular conditions such as myocardial infarction and ischemic stroke. Gaining insight into the mechanisms underlying arterial thrombosis is essential for developing effective treatments aimed at preventing thrombotic events and reducing associated health burdens. In vitro and ex vivo models serve as critical tools for investigating the pathophysiology of arterial thrombosis by providing controlled environments to study thrombus formation and characteristics. This systematic review provides a comprehensive overview of in vitro and ex vivo flow-based models used to study arterial thrombosis, classifying them by scale (macro vs. micro) and evaluating their design principles, physiological relevance, and experimental utility. A systematic search of Medline, Embase, and Web of Science was conducted using broad and specific terms related to arterial thrombosis models incorporating flow or shear stress. Articles were screened by two independent reviewers. Studies were included if they described in vitro or ex vivo models with dynamic flow; models limited to static or venous conditions or in vivo studies were excluded. In total, 82 studies met the inclusion criteria. Macro-scale models can mimic complex flow patterns in larger arterial conditions and enable the formation of thrombi comparable in size to clinical specimens. Microfluidic models allow precise control over shear conditions and geometry with minimal blood volumes and are suitable for high-resolution imaging and customization, including endothelialization and patient-specific designs. While, both model types present limitations in replicating complex in vivo hemodynamics, standardization, and scalability, they offer valuable, controllable platforms for mechanistic studies and drug testing in arterial thrombosis. While no single model fully recapitulates the in vivo environment, ongoing innovations-particularly in microfabrication and model standardization-continue to improve physiological relevance and clinical translatability.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-37"},"PeriodicalIF":1.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MicroRNA Expression Pre-Trastuzumab Treatment in HER-2+ Early Breast Cancer Patients as a Predictor of Cancer Therapy-Related Cardiac Dysfunction: A Pilot Cohort Study.","authors":"Fernando Pivatto Júnior, Ângela Barreto Santiago Santos, Eduarda Foresti Englert, Géris Mazzutti, Guilherme Oliveira Magalhães Costa, Marco Aurélio Lumertz Saffi, Marina Siebert, Pedro Emanuel Rubini Liedke, Vinícius Henrique Fritsch, Andreia Biolo","doi":"10.1159/000548345","DOIUrl":"10.1159/000548345","url":null,"abstract":"<p><strong>Introduction: </strong>At present, existing risk scores together with traditional biomarkers such as troponin and brain natriuretic peptide are still unable to accurately predict cancer therapy-related cardiac dysfunction (CTRCD). MicroRNAs (miRNAs) have emerged as promising biomarkers for improved identification of high-risk patients; however, limited studies have been performed in patients with HER2-positive breast cancer. This study aimed to investigate the predictive potential of six serum-derived circulating miRNAs for CTRCD occurrence in patients with early-stage HER2-positive breast cancer receiving trastuzumab (TTZ).</p><p><strong>Methods: </strong>A prospective cohort study was conducted involving consecutive female patients aged 18 years or older with HER2-positive early breast cancer, who attended the breast oncology outpatient clinic of the institution between March 2019 and March 2022. Blood samples were obtained prior to the initiation of TTZ therapy. CTRCD was defined as a reduction in left ventricular ejection fraction >10 percentage points, resulting in a value <53%. Quantification of miRNAs - including let-7f-5p, miR-1-3p, miR-20a-5p, miR-126-3p, miR-130-3p, and miR-210a-3p - was performed using quantitative real-time polymerase chain reaction. The optimal miRNA cutoff points were determined using the Youden index. CTRCD-free survival was analyzed using Kaplan-Meier curves, with group comparisons conducted via the log-rank test.</p><p><strong>Results: </strong>A total of 47 patients (mean age 53.1 ± 13.2 years) were included and followed for a median of 14.2 months (IQR 10.9-24.5), corresponding to 71.5 patient-years of follow-up. Doxorubicin was administered as part of the treatment regimen in 22 patients (46.8%). Six patients (12.8%) developed CTRCD. Patients exhibiting high baseline expression levels of miR-20a-5p, miR-126-3p, miR-130-3p, and miR-210-3p prior to TTZ treatment demonstrated significantly reduced CTRCD-free survival (all p < 0.05). Elevated levels of miR-126-3p and miR-130-3p showed 100% sensitivity and specificities of 53.7% and 48.8%, respectively, for predicting the development of CTRCD.</p><p><strong>Conclusion: </strong>This pilot study suggests that elevated expression of some miRNA prior to TTZ treatment may be associated with lower CTRCD-free survival, but these findings require confirmation in larger, prospective studies. While high levels of miR-126-3p and miR-130a-3p were observed in all patients who developed CTRCD, their potential role as biomarkers of cardiotoxicity risk should be further explored in future research with broader patient cohorts.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Effects of Exposure to Microgravity: A Literature Review.","authors":"Alfredo Mendoza-Arzate, Alejandro Hernández-Chávez, Marco Antonio Robles-Rangel, Ricardo Jesús Martinez-Tapia","doi":"10.1159/000548170","DOIUrl":"https://doi.org/10.1159/000548170","url":null,"abstract":"<p><strong>Background: </strong>Space exploration has progressed significantly, with increased human presence in orbit, the development of space stations, and the planning of increasingly prolonged missions. However, the space environment poses substantial physiological challenges, particularly for the cardiovascular system. According to NASA's Human Research Program, the five primary risks associated with human spaceflight are: (1) microgravity, (2) ionizing cosmic radiation, (3) isolation and confinement, (4) closed environmental systems, and (5) the great distance from Earth.</p><p><strong>Summary: </strong>The cardiovascular system is among the most extensively studied in aerospace medicine due to the adaptive responses it undergoes in microgravity. Documented changes include altered blood flow dynamics, disturbances in electrical conduction, and structural effects on the myocardium. These may result in variations in heart rate, blood volume, and endothelial function, as well as a potential predisposition to long-term cardiovascular events.</p><p><strong>Key messages: </strong>Evidence from studies involving astronauts, animal models, and ground-based simulations has enhanced our understanding of these mechanisms, enabling the development of preventive strategies. These findings noy only contribute to the safety and success of future space missions but also provide valuable insights into cardiovascular diseases on Earth, potentially informing novel therapeutic approaches.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-27"},"PeriodicalIF":1.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}