Cardiology最新文献

{"title":"Estimated Pulse Wave Velocity to Global Longitudinal Strain Ratio: A Tool for Differentiating Heart Failure Subtypes?","authors":"Ying Wang, Min Lu","doi":"10.1159/000546345","DOIUrl":"https://doi.org/10.1159/000546345","url":null,"abstract":"<p><strong>Background: </strong>Ventricular-arterial coupling (VAC), which refers to harmonious interaction between the ventricles and arteries, is essential for maintenance of optimal cardiovascular function. The ratio of the pulse wave velocity (PWV) to left ventricular global longitudinal strain (GLS) has been established as a reliable noninvasive metric for assessing VAC.</p><p><strong>Aims: </strong>This study aimed to assess VAC noninvasively in heart failure (HF) using the estimated pulse wave velocity (ePWV) to GLS ratio, defined from speckle tracking imaging.</p><p><strong>Methods: </strong>According to the HF stages by the American Heart Association, 131 subjects were divided into four groups: group 1 (n = 36) at risk of developing HF and pre-HF (American College of Cardiology/American Heart Association stages A and B), group 2 (n = 35) having HF with preserved ejection fraction (HFpEF), group 3 (n = 35) having HF with reduced ejection fraction (HFrEF), and group 4 (n = 30) as controls. To determine the ePWV/GLS ratio, the ePWV was calculated based on the previously established formula using age and mean pressure, and the GLS was derived from speckle tracking echocardiography. The study evaluated the VAC in all groups and compared with the established metrics such as arterial elasticity (Ea) and ventricular end-systolic elasticity (Ees) ratios. The correlation between the ePWV/GLS ratio and other parameters obtained by echocardiography was also assessed.</p><p><strong>Results: </strong>Significant differences in the ePWV/GLS ratio were observed among the groups, and the severity of VAC impairment correlated with the HF stage. The lowest ePWV/GLS ratio was observed in the control and stage A-B group (0.530 ± 0.100 vs 0.640 ± 0.10), followed by the HFpEF group (0.992 ± 0.215), whereas the HFrEF group had the highest ratio (1.500 ± 0.369). The ePWV/GLS ratio showed a moderate correlation with the Ea/Ees ratio [r =0.753, (95% CI, 0.665-0.821), P <0.0001], but performed better in distinguishing HF subtypes. A threshold of 0.625 for the ePWV/GLS ratio was established by the ROC curve to detect the impaired VAC, with an AUROC of 0.923 and 95% CI of 0.876-0.969. In addition, the ePWV/GLS ratio was strongly associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and moderately correlated with left ventricular mass index (LVMI), end-diastolic volume (EDV), left ventricular ejection fraction (LVEF), age, and E/e'.</p><p><strong>Conclusion: </strong>The ePWV/GLS ratio is an easily accessible parameter for evaluating VAC. It is closely related to the HF stage and can effectively differentiate between HF subtypes. Although the ratio was higher in patients with HFpEF than in healthy individuals, it was lower than in patients with HFrEF.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-15"},"PeriodicalIF":1.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141510","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":"Authors' Response Letter - Expanding the Use of Point-of-Care hs-cTnI in Emergency Primary Care: Insights from the OUT-POC Pilot Study.","authors":"Tonje R Johannessen, Odd Martin Vallersnes, Anne Cecilie K Larstorp, Sigrun Halvorsen, Dan Atar","doi":"10.1159/000546344","DOIUrl":"10.1159/000546344","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149594","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":"Expanding the Use of Point-of-Care hs-cTnI in Emergency Primary Care: Insights from the OUT-POC Pilot Study.","authors":"Yusuf Hoşoğlu","doi":"10.1159/000546315","DOIUrl":"https://doi.org/10.1159/000546315","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149596","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":"Endomyocardial Biopsy: Evaluating the Impact of Updated Indications on Diagnostic Yield.","authors":"María Teresa Politi","doi":"10.1159/000545774","DOIUrl":"https://doi.org/10.1159/000545774","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076180","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":"Endomyocardial Biopsy in Myocarditis: Assessing Safety and Prognostic Implications.","authors":"Mitra Chitsazan","doi":"10.1159/000545035","DOIUrl":"https://doi.org/10.1159/000545035","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954636","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":"Mechanisms and intervention strategies of TMAO (Trimethylamine NOxide) in abdominal aortic aneurysm.","authors":"Dilixiati Abudureheman, Shuake Janaerbieke, Yuhang Song, Shuo Han, Wufuer Yimaer, Huguo Wang","doi":"10.1159/000546190","DOIUrl":"10.1159/000546190","url":null,"abstract":"<p><p>This review comprehensively discusses the role of trimethylamine oxide (TMAO) in abdominal aortic aneurysm (AAA). TMAO, a metabolite produced by gut microbiota acting on dietary precursors, is associated with various cardiovascular diseases. In AAA, TMAO is involved in multiple processes. It induces inflammation by promoting macrophage polarization and increasing inflammatory markers in vascular smooth muscle cells. It also participates in apoptosis and extracellular matrix remodeling. TMAO is closely associated with risk factors such as atherosclerosis, hypertension, and diabetes and affects their progression through multiple mechanisms, such as in atherosclerosis, where it promotes foam cell formation and endothelial cell damage. Intervention strategies for TMAO include dietary modification, gut microbiota regulation, and inhibition of key enzymes. Dietary modifications such as the Mediterranean diet can reduce TMAO levels, and probiotics and prebiotics have shown a potential to modulate gut microbiota to affect TMAO synthesis. However, these strategies have limitations and require further study. This review provides a comprehensive understanding of the role of TMAO in AAA and provides insights for future research and clinical applications.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-32"},"PeriodicalIF":1.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974908","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":"Prevalence and Characteristics of Heart Disease in Patients with Acromegaly in Colombia (RAPACO HEART Study).","authors":"Alin Abreu-Lomba, David Aristizábal-Colorado, Santiago Sierra-Castillo, Danilo Weir-Restrepo, Carlos Alberto Gómez-Mercado, David Alexander Vernaza Trujillo, Henry Mauricio Arenas-Quintero, Alejandro Castellanos-Pinedo, Clara I Saldarriaga-Giraldo, Alejandro Pinzón-Tovar","doi":"10.1159/000545875","DOIUrl":"10.1159/000545875","url":null,"abstract":"<p><strong>Introduction: </strong>Acromegaly is a chronic disorder characterized by excessive secretion of growth hormone (GH) and insulin-like growth factor type 1 (IGF-1), resulting in multisystem involvement. Cardiovascular complications affect up to 80% of cases and represent a major concern in advanced stages of the disease. This study aimed to determine the prevalence of acromegalic heart disease (AHD) and identify factors associated with its development in a Colombian population.</p><p><strong>Methods: </strong>A retrospective, multicenter case-control study was carried out using data from the national RAPACO registry. Patients aged 16 years or older with confirmed acromegaly and an available echocardiogram were included. AHD was defined by structural or functional cardiac abnormalities attributable to acromegaly.</p><p><strong>Results: </strong>A total of 193 patients with acromegaly were analyzed; 61 (31.6%) had AHD. Compared with the non-AHD group, these patients were older, had a 4.5 cm larger abdominal perimeter, and had a median time from disease onset to diagnosis of 8 years (vs. 6 years in those without AHD). Among the 61 AHD cases, the most frequent finding was isolated left ventricular hypertrophy (n = 32, 52.4%), followed by biventricular hypertrophy (n = 12, 19.7%), valvulopathy (n = 4, 6.6%), and combined LVH with valvulopathy (n = 4, 6.6%). GH and IGF-1 levels were modestly higher in AHD patients. In multivariate analysis, hypertension (HTN) showed an odds ratio (OR) of 1.75 (95% CI: 0.67-4.65) for AHD, while carpal tunnel syndrome significantly increased the odds of AHD (OR 3.81, p = 0.01, 95% CI: 1.36-11.14).</p><p><strong>Conclusions: </strong>Despite therapeutic advances, AHD remains common in Colombian patients with acromegaly. Notably, carpal tunnel syndrome was independently associated with AHD, alongside HTN, arrhythmias, and type 2 diabetes mellitus. These findings underscore the need for proactive cardiovascular screening and management strategies in this patient population.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966021","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":"D-Dimer as Biomarker for Prognosis of Coronary Artery Disease and Heart Failure: Reappraisal of Its Central Role.","authors":"Kainuo Wu, Jonathan Van Name, Lei Xi","doi":"10.1159/000546154","DOIUrl":"10.1159/000546154","url":null,"abstract":"<p><strong>Background: </strong>D-dimer is a fibrinogen degradation product formed by the breakdown of cross-linked fibrin in a series of enzyme-mediated steps. Since the D-dimer assay allows for detection of thrombin production and endogenous fibrinolysis, it has been increasingly used in clinics as a screening test to exclude venous thromboembolism and disseminated intravascular coagulation. Additionally, D-dimer has been evaluated for determining the initiation of anticoagulation therapy in patients with selected cardiovascular disease.</p><p><strong>Summary: </strong>This narrative review has evaluated the updated evidence from several recent clinical studies/trials and provides a reappraisal of the utility of D-dimer assay for disease prognosis and clinical management decisions in patients with stable coronary artery disease, acute coronary syndrome, and heart failure. We further discussed several confounding factors that may affect circulating levels of D-dimer, including those observed during the COVID-19 pandemic.</p><p><strong>Key messages: </strong>Better understanding of the pathophysiologic mechanisms underlying D-dimer formation would improve accuracy and specificity of D-dimer as biomarker for predicting long-term outcome of the severity of coronary artery disease and heart failure.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954586","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":"Physical Assessment of Congestion and Perfusion Status in Heart Failure.","authors":"Kenichi Kasai, Chisaki Kanehiro, Sakiko Honda, Chieko Sakai, Atsushi Shindo, Kuniyasu Harimoto, Tatsuya Kawasaki","doi":"10.1159/000546111","DOIUrl":"10.1159/000546111","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical profiles based on congestion and perfusion are fundamental to the management of patients with heart failure (HF), but the standard assessment has been underutilized in clinical practice, due in part to its complexity. This study investigated whether congestion and perfusion status by physical examination, such as high jugular venous pressure (JVP) and peripheral cold sensation, would be informative in this context.</p><p><strong>Methods: </strong>This prospective study consisted of 257 patients who were admitted for the treatment of HF. A body-to-peripheral temperature gradient and the presence or absence of peripheral cold sensation was assessed before discharge. JVP was considered high if visible pulsation of the internal jugular vein was observed in the seated position at rest or with inspiration, and categorized as wet. The primary outcome was a composite of all-cause death and hospitalization for worsening HF.</p><p><strong>Results: </strong>A total of 132 (51.3%) patients were classified as cold on the peripheral sensation, with a higher temperature gradient (9.0 ± 1.8°C) than patients without peripheral cold sensation (4.8 ± 1.7°C, p < 0.01). On JVP assessment, 54 (21.0%) patients were classified as wet. During a mean follow-up period of 446 ± 280 days, 109 patients experienced a primary outcome event. The presence of peripheral cold sensation and wet condition were associated with a higher incidence of the primary outcome (hazard ratio, 1.70 and 1.62; 95% confidence interval, 1.14-2.52 and 1.04-2.52; both p < 0.01, respectively). The status of congestion and perfusion based on the standard classification and our simple physical method using peripheral sensation and JVP assessment showed similar trends in the incidence of the primary outcome at 1 year.</p><p><strong>Conclusions: </strong>Physical assessment of congestion and perfusion status based on the presence or absence of peripheral cold sensation and wet condition by JVP assessment was practical and useful for the risk stratification of patients with HF.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954174","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":"Characterizing the Field of Mendelian Randomization Studies for Cardiovascular Disease.","authors":"Ben Omega Petrazzini","doi":"10.1159/000545278","DOIUrl":"https://doi.org/10.1159/000545278","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972558","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}