Cardiology最新文献

{"title":"Striking Variations in Aortic Valve Replacement Rates and Use of Transcatheter Aortic Valve Implantation among European Nations.","authors":"Dominik Buckert, Marvin Krohn-Grimberghe, Wolfgang Rottbauer","doi":"10.1159/000534471","DOIUrl":"10.1159/000534471","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"275-276"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Post-Acute Coronary Syndrome Dyslipidemia Management: Insights from the North American Acute Coronary Syndrome Reflective III.","authors":"Meshal Alanezi, Andrew T Yan, Mary K Tan, Ronald Bourgeois, Peiman Malek-Marzban, Rani Beharry, Suhaib Alkurtass, Gabor T Gyenes, Pierre-Louis Nadeau, Nduka Nwadiaro, Sean Jedrzkiewicz, Dongsheng Gao, Harish Chandna, William B Nelson, Shaun G Goodman","doi":"10.1159/000536392","DOIUrl":"10.1159/000536392","url":null,"abstract":"<p><strong>Introduction: </strong>Despite contemporary practice guidelines, a substantial number of post-acute coronary syndrome (ACS) patients fail to achieve guideline-recommended LDL-C thresholds. Our study aimed to investigate this guideline recommendations-to-practice care gap. Specifically, we aimed to identify opportunities where additional lipid-lowering therapies are indicated and explore reasons for the non-prescription of guideline-recommended therapies.</p><p><strong>Methods: </strong>ACS patients with LDL-C ≥1.81 mmol/L (70 mg/dL) despite maximally tolerated statin ± ezetimibe therapy (including those intolerant of ≥2 statins) were enrolled 1-12 months post-event from 27 Canadian and US sites from September 2018 to October 2020 and followed up for three visits during the 12 months post-event. We determined the proportion of patients who did not achieve Canadian/US guideline-recommended LDL-C thresholds, the number of patients who would have been eligible for additional lipid-lowering therapies, and reasons behind lack of escalation in lipid-lowering therapies when indicated. Individual patient and aggregate practice feedback, including guideline-recommended intensification suggestions, were provided to each physician.</p><p><strong>Results: </strong>Of the 248 patients enrolled in the pilot study (median age 64 [57, 73] years, 31.5% female and STEMI 27.4%), 75.4% were on high-intensity statins on the first visit. A total of 18.5% of those who attended all 3 visits had an LDL-C measured only at the first visit which was above the threshold. After 1 year of follow-up, 51.9% of patients achieved LDL-C thresholds at either visit 2 or 3. In the context of feedback reminding physicians about guideline-directed LDL-C-modifying therapy in their individual participating patients, we observed an increase in the use of ezetimibe and PCSK9 inhibitor therapy at 3-12 months. This was associated with a significant lowering of the mean LDL-C (from 2.93 mmol/L [baseline] to 2.09 mmol/L [3-6 months] to 1.87 mmol/L [6-12 months]) and a significantly greater proportion of patients (from 0% [baseline] to 38.6% [3-6 months] to 53.4% [6-12 months]) achieving guideline-recommended LDL-C thresholds. The most prevalent reasons behind the non-intensification of LDL-C-lowering therapy with ezetimibe and/or PCSK9i were LDL-C levels being close to target, the pre-existing use of other lipid-lowering therapies, patient refusal, and cost.</p><p><strong>Conclusion: </strong>Although most patients post-ACS were on high-intensity statin therapy, almost 50% failed to achieve guideline-recommended LDL-C thresholds by 1-year follow-up. Furthermore, additional lipid-lowering therapies in this high-risk group were underprescribed, and this might be linked to several factors including potential gaps in physician knowledge, treatment inertia, patient refusal, and cost.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"266-274"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641643","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":"Bernard Lown (1921-2021).","authors":"Regis A DeSilva","doi":"10.1159/000536615","DOIUrl":"10.1159/000536615","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"189-192"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680710","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":"Frailty and Cardiovascular Disease: A Bidirectional Association.","authors":"Ina Volis, Barak Zafrir","doi":"10.1159/000535494","DOIUrl":"10.1159/000535494","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"205-207"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138797163","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":"Traditional Cardiovascular Risk Factors and Coronary Microvascular Dysfunction in Women and Men: A Single-Center Study.","authors":"Lior Zornitzki, Aviel Shetrit, Ophir Freund, Shir Frydman, Ariel Banai, Reut Amar Shamir, Jeremy Ben-Shoshan, Yaron Arbel, Shmuel Banai, Maayan Konigstein","doi":"10.1159/000539102","DOIUrl":"10.1159/000539102","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary microvascular dysfunction (CMD) is common in patients with and without obstructive epicardial coronary artery disease (CAD). Risk factors for the development of CMD have not been fully elucidated, and data regarding sex-associated differences in traditional cardiovascular risk factors for obstructive CAD in patients with CMD are lacking.</p><p><strong>Methods: </strong>In this single-center, prospective registry, we enrolled patients with nonobstructive CAD undergoing clinically indicated invasive assessment of coronary microvascular function between November 2019 and March 2023. Associations between coronary microvascular dysfunction, traditional cardiovascular risk factors, and sex were assessed using univariate and multivariate regression models.</p><p><strong>Results: </strong>Overall, 245 patients with nonobstructive CAD were included in the analysis (62.9% female; median age 68 (interquartile range: 59, 75). Microvascular dysfunction was diagnosed in 141 patients (57.5%). The prevalence of microvascular dysfunction was similar in women and men (59.0% vs. 57.0%; p = 0.77). No association was found between traditional risk factors for coronary atherosclerosis and CMD regardless of whether CMD was structural or functional. In women, but not in men, older age and the presence of previous ischemic heart disease were associated with lower coronary flow reserve (β = -0.29; p &lt; 0.01 and β = -0.15; p = 0.05, respectively) and lower resistive reserve ratio (β = -0.28; p &lt; 0.01 and β = -0.17; p = 0.04, respectively).</p><p><strong>Conclusion: </strong>For the entire population, no association was found between coronary microvascular dysfunction and traditional risk factors for coronary atherosclerosis. In women only, older age and previous ischemic heart disease were associated with coronary microvascular dysfunction. Larger studies are needed to elucidate risk factors for CMD.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"455-462"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857166","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":"Influence of Comprehensive Nursing Care on Heart Failure Patient Management: A Systematic Review and Meta-Analysis.","authors":"Wenying Zhang, Xuezhen Wang, Xuefeng Wu, Shaomei Tang","doi":"10.1159/000540387","DOIUrl":"10.1159/000540387","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure is a common chronic illness associated with high readmission rates and death. Comprehensive nursing care, management of symptoms, and psychological support are increasingly seen as critical components of successful heart failure therapy.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to determine the effect of comprehensive nursing care on clinical outcomes and quality of life in heart failure patients.</p><p><strong>Methods: </strong>We searched electronic databases (PubMed, PROSPERO, and Web of Science) for randomised controlled trials and observational studies on comprehensive nursing care treatments for heart failure patients. Data on readmission rates, mortality rates, and quality of life were obtained and examined.</p><p><strong>Results: </strong>A total of 693 studies satisfied the inclusion criteria. A meta-analysis found that comprehensive nursing care reduced heart failure-related readmissions considerably when compared to conventional therapy (odds ratio [OR]: 0.77; 95% CI: 0.66-0.88, p = 0.0002). There was a significant difference in all-cause mortality (OR: 0.76; 95% CI: 0.60-0.97, p = 0.03), but comprehensive treatment enhanced quality of life and functional status (standardised mean difference -0.05, 95% CI: -0.21 to 0.10, p = 0.49).</p><p><strong>Conclusion: </strong>Comprehensive nursing care improves clinical outcomes and quality of life for heart failure patients. This study stresses the need to add comprehensive nurse interventions in normal heart failure treatment programmes.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"535-548"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757211","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":"The Cockroach of Critical Care: Atrial Fibrillation and Predictors in the ICU Setting.","authors":"Dustin Staloch, Michael S Lloyd","doi":"10.1159/000534783","DOIUrl":"10.1159/000534783","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"174-175"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134648543","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":"Overcoming the Clinical Inertia behind Inadequate Adherence to Guideline-Directed Medical Therapy.","authors":"Takahiro Okumura, Toyoaki Murohara","doi":"10.1159/000536504","DOIUrl":"10.1159/000536504","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"225-227"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140157616","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":"Age-Stratified Clinical Outcome in Patients with Known Heart Failure Who Receive Pacemaker, Resynchronization Therapy, or Defibrillator Implants.","authors":"Cecilia Rorsman, Maiwand Farouq, Sofia Marinko, Pyotr G Platonov, Rasmus Borgquist","doi":"10.1159/000538529","DOIUrl":"10.1159/000538529","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with heart failure (HF) and bradycardia may be eligible for different types of cardiac implantable electronic devices (CIED), depending on the presence of atrioventricular conduction disease, age, and comorbidities. We aimed to assess the prognosis for these patients, after CIED implantation, stratified for the type of CIED device.</p><p><strong>Methods: </strong>All patients with preexisting HF diagnosis who received a CIED with a right ventricular lead during the period 2005-2018 in Sweden were identified via the pacemaker registry. Data were crossmatched with the population registry and national disease registries. The outcome was 5-year risk of HF hospitalization and mortality.</p><p><strong>Results: </strong>A total of 37,745 patients were included in the study. Comparing demographics for implantable cardioverter defibrillator versus pacemaker implants, median age was 66 years versus 83 years, 20% versus 41% were female, 64% versus 50% had ischemic heart disease, and 35% versus 67% had atrial fibrillation (all p &lt; 0.001). Five-year mortality was highest in single-chamber pacemaker recipients (61% compared to average 40%, p &lt; 0.001), but the proportion of cardiovascular mortality was highest for cardiac resynchronization therapy (CRT) recipients (68% vs. 63% p &lt; 0.001). Adjusted mortality was higher for pacemaker patients in all age decile groups (ranging from &lt;60 to &gt;90 years old, all p &lt; 0.001), HF hospitalization occurred in 28% (dual-chamber pacemaker) to 39% (CRT-P) of patients, and cause of death was HF in 15% (dual-chamber pacemaker) to 25% (CRT-D), all p &lt; 0.001.</p><p><strong>Conclusion: </strong>In this large real-world cohort of CIED-treated patients with prior HF, demography and mortality data indicate that clinicians chose devices according to the overall status of the patient. HF-related events occurred in all groups but were more common in CRT-treated patients.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"474-483"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331552","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":"Upregulated Genes in Atrial Fibrillation Blood and the Left Atrium.","authors":"Takahiro Kamihara, Tomoyasu Kinoshita, Reo Kawano, Seiya Tanaka, Ayano Toda, Fumiya Ohara, Akihiro Hirashiki, Manabu Kokubo, Atsuya Shimizu","doi":"10.1159/000537923","DOIUrl":"10.1159/000537923","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial fibrillation (AF) is a common arrhythmia associated with aging. Many known risk factors are associated with AF, but many senior individuals do not develop AF despite having multiple risk factors. This finding suggests that other factors may be involved in AF onset. This study aimed to identify upregulated genes in the peripheral blood and left atrium of patients with AF. These genes may serve as potential biomarkers to predict AF onset risk and its complications.</p><p><strong>Methods: </strong>Gene expression data were analyzed from blood (n = 3) and left atrial samples (n = 15) of patients with AF and sinus rhythm. We evaluated the significant genes identified using p value analysis of weighted average difference to confirm their rankings. We created figures for the genes using GeneMANIA and performed a functional analysis using Cytoscape3.10.1. Hub and bottleneck genes were identified based on degree and betweenness centrality. We used reference expression (RefEx) to confirm the organs in which the extracted genes were expressed. Heatmaps and Gene ontology term evaluation were performed to further elucidate the biological functions of the genes.</p><p><strong>Results: </strong>We identified 12 upregulated genes (CAST, ASAH1, MAFB, VCAN, DDIT4, FTL, HEXB, PROS1, BNIP3L, PABPC1, YBX3, and S100A6) in both the blood and left atrium of patients with AF. We analyzed the gene functions using GeneMANIA and Cytoscape. The identified genes were involved in a variety of pathways, including lysosomal function and lipid and sphingolipid catabolism. Next, we investigated whether the 12 identified genes identified were systemically expressed or had high organ specificity. Finally, RefEx was used to analyze the gene expression levels in various tissues. Four genes, FTL, ASAH1, S100A6, and PABPC1, were highly expressed in the normal heart tissue. Finally, we evaluated the expression levels of the 12 genes in the blood of patients with AF using a heatmap. Our findings suggest that the 12 genes identified in this study, especially the lysosome-related genes (FTL and ASAH1), may be involved in AF pathogenesis.</p><p><strong>Conclusion: </strong>Lysosome-related genes may be important to understand the AF pathophysiology and to develop AF-related future studies.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"357-368"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140058681","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}