CardiologyPub Date : 2024-09-17DOI: 10.1159/000541360
Jianhui Liu,Zhikui Chen,Dihui Cai
{"title":"Association of obstructive sleep apnea on heart failure and its risk factors: A two-step Mendelian randomization study.","authors":"Jianhui Liu,Zhikui Chen,Dihui Cai","doi":"10.1159/000541360","DOIUrl":"https://doi.org/10.1159/000541360","url":null,"abstract":"BACKGROUNDRecent studies have indicated that obstructive sleep apnea (OSA) is linked to a higher likelihood of heart failure (HF). However, the causal connection between the two conditions is uncertain. We aimed to investigate the causal association of OSA with HF and its risk factors.METHODSThe OSA summary statistics are derived from the FinnGen database, including 38,998 cases and 336,659 controls. and HF summary statistics come from HERMES, the UK biobank, and the FinnGen database. A two-sample Mendelian randomization (MR) analysis was conducted to examine the causality of OSA on HF risk. Furthermore, the mediator effect of potential risk factors was assessed by a two-step MR.RESULTSThe results of MR analysis demonstrated that genetically determined OSA is causal associated with the higher likelihood of HF (HERME: odds ratio [OR] = 1.222; 95% confidence interval [CI] [1.091, 1.369]; p = 5.19 × 10-4) (FinnGen: OR = 1.233; 95% CI [1.129, 1.346]; p = 3.32 × 10-6) (UK Biobank: OR = 1.002; 95% CI [1.000, 1.003]; p = 0.014). Two-step MR analysis indicated that obesity, blood glucose, depression, and other CVDs have significant mediating effects on the causal effect between OSA and HF.CONCLUSIONThis MR study emphasizes the causal effect of OSA on HF risk. Adiposity traits play a major role in the process of OSA leading to HF. Considering the detrimental impact of OSA on HF, it becomes imperative to prioritize the prevention and management of HF in individuals afflicted with OSA. The foremost intervention strategy should revolve around effective obesity management.","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":"55 1","pages":"1-17"},"PeriodicalIF":1.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258244","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":"Dose-Dependent Relationship between Iron Metabolism and Perioperative Myocardial Injury in Cardiac Surgery with Cardiopulmonary Bypass: A Retrospective Analysis.","authors":"Qian Li, Hong Lv, Yuye Chen, Jingjia Shen, Jia Shi, Chenghui Zhou","doi":"10.1159/000541213","DOIUrl":"10.1159/000541213","url":null,"abstract":"<p><strong>Introduction: </strong>We sought to comprehensively explore the potential linear and nonlinear relationship between preoperative iron metabolism and perioperative myocardial injury (PMI) following cardiac surgery with cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>Patients who underwent cardiac surgery with CPB between December 2018 and April 2021 were retrospectively collected. The measurements of iron metabolism included serum iron (SI), serum ferritin (SF), transferrin (TRF), transferrin saturation (TS), and total iron-binding capacity (TIBC). Logistic regression and restricted cubic spline (RCS) models were used for linear and nonlinear analysis. The primary outcome was PMI with a 100× upper reference limit.</p><p><strong>Results: </strong>Of 2,420 patients screened, 744 eligible patients were enrolled for the final analysis. The incidence of PMI was 25.7%. No significant linear relationship was observed. In the RCS models adjusted with age (median: 56), female, and history of diabetes, a statistically significant difference was detected between TRF (p for nonlinear 0.0152) or TIBC (p for nonlinear 0.0477) and PMI. The gentle U-shaped relationship observed between TRF, TIBC, and PMI suggests that when TRF and TIBC increase, the risk decreases, reaching its lowest point when TRF = 2.4 and TIBC = 54. Nevertheless, as TRF and TIBC continue to increase, the risk starts to rise again. Subgroup analyses yielded consistent findings, with a notable emphasis on older patients who were more susceptible to variations in iron metabolism.</p><p><strong>Conclusion: </strong>Iron metabolism, including TRF, and TIBC, exhibited a nonlinear relationship with PMI by the RCS model adjusted by age, gender, and history of diabetes.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280573","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}
CardiologyPub Date : 2024-09-06DOI: 10.1159/000541302
Takahiro Okumura, Toyoaki Murohara
{"title":"Gender Differences in Cardiovascular Disease: Perspectives on Disparities in Women's Treatment and Outcomes.","authors":"Takahiro Okumura, Toyoaki Murohara","doi":"10.1159/000541302","DOIUrl":"10.1159/000541302","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153169","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}
CardiologyPub Date : 2024-09-05DOI: 10.1159/000541178
Xue Zhang, Yue Yuan
{"title":"Meta-Analysis of the Efficacy and Safety of Radiofrequency Catheter Ablation for Pediatric Paroxysmal Supraventricular Tachycardia.","authors":"Xue Zhang, Yue Yuan","doi":"10.1159/000541178","DOIUrl":"10.1159/000541178","url":null,"abstract":"<p><strong>Introduction: </strong>This meta-analysis was to evaluate the efficacy and safety of radiofrequency catheter ablation (RFCA) in treating children with paroxysmal supraventricular tachycardia (PSVT).</p><p><strong>Methods: </strong>From inception to December 16, 2023, PubMed, Embase, Cochrane Library, Web of Science, CNKI (China National Knowledge Infrastructure), VIP (Chinese Science and Technology Periodical Database), and WanFang were searched for this meta-analysis. Children under the age of 18 diagnosed with atrioventricular reentrant tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) were enrolled. The outcomes included the success rate of RFCA, the recurrence rate of PSVT following RFCA treatment, and any complications associated with the procedure. Newcastle-Ottawa Scale (NOS) was used to assess the quality of studies. The outcome data were represented as rates (RATE) and corresponding 95% confidence intervals (CIs). Subgroup analyses were conducted based on regions and follow-ups.</p><p><strong>Results: </strong>Fourteen articles encompassing 6,032 children were included in the study. RFCA demonstrated remarkable efficacy in children patients, achieving success rates of 98% (RATE: 0.98, 95% CI: 0.96-0.99) for AVRT and 99% (RATE: 0.99, 95% CI: 0.98-1.00) for AVNRT. The analysis also reveals that post-RFCA, the recurrence rates for AVRT were 5% (RATE: 0.05, 95% CI: 0.03-0.07), while for AVNRT, they were slightly lower at 4% (RATE: 0.04, 95% CI: 0.02-0.08). In the subset of Asian children patients, these recurrence rates were observed to be 5% for AVRT and 3% for AVNRT. Monitoring for a duration of up to 12 months of post-RFCA indicated recurrence rates of 4% for AVRT and 3% for AVNRT. However, for follow-up periods extending beyond 1 year, there was a slight increase in these rates to 4% for AVRT and 6% for AVNRT. Additionally, the complication rates associated with RFCA in the children population were relatively minimal, recorded at 2% (RATE: 0.02, 95% CI: -0.01-0.06) for AVRT and 1% (RATE: 0.01, 95% CI: 0.00-0.02) for AVNRT.</p><p><strong>Conclusion: </strong>RFCA appears to be a highly effective and safe treatment option for AVRT and AVNRT in children, with high success rates and relatively low recurrence and complication rates. However, long-term follow-up may be necessary to monitor for potential recurrences. These findings are valuable for clinicians and patients in making informed decisions about the treatment of these cardiac arrhythmias in pediatric patients.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-19"},"PeriodicalIF":1.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139380","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}
CardiologyPub Date : 2024-09-03DOI: 10.1159/000541179
Konstantinos Dean Boudoulas, Antonios Pitsis, Cezar Iliescu, Konstantinos Marmagkiolis, Filippos Triposkiadis, Harisios Boudoulas
{"title":"Floppy Mitral Valve/Mitral Valve Prolapse and Manifestations Not Related to Mitral Regurgitation: Time to Search the Dark Side of the Moon.","authors":"Konstantinos Dean Boudoulas, Antonios Pitsis, Cezar Iliescu, Konstantinos Marmagkiolis, Filippos Triposkiadis, Harisios Boudoulas","doi":"10.1159/000541179","DOIUrl":"10.1159/000541179","url":null,"abstract":"<p><strong>Background: </strong>Floppy mitral valve/mitral valve prolapse (FMV/MVP) is a complex entity in which several clinical manifestations are not directly related to the severity of mitral regurgitation (MR).</p><p><strong>Summary: </strong>Patients with FMV/MVP and trivial to mild MR may have exercise intolerance, orthostatic phenomena, syncope/presyncope, chest pain, and ventricular arrhythmias, among others. Several anatomical and pathophysiologic consequences related to the abnormal mitral valve apparatus and to prolapse of the mitral leaflets into the left atrium provide some explanation for these symptoms. Further, it should be emphasized that MVP is a non-specific finding, while FMV (redundant mitral leaflets, elongated/rupture chordae tendineae, annular dilatation) is the central issue in the MVP story.</p><p><strong>Key message: </strong>The purpose of this review was to highlight the clinical manifestations of FMV/MVP not directly related to the severity of MR and to discuss the pathophysiologic mechanisms contributing to these manifestations.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124894","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}
CardiologyPub Date : 2024-08-27DOI: 10.1159/000541011
Fabiana Duarte, Inês Ricardo, Clarissa Faria, Pedro Alves da Silva, Nelson Cunha, Sandra Miguel, Rita Pinto, Fausto Pinto, Ana Abreu
{"title":"Impact of an Exercise-Based Cardiac Rehabilitation Program on Cardiopulmonary Test Parameters.","authors":"Fabiana Duarte, Inês Ricardo, Clarissa Faria, Pedro Alves da Silva, Nelson Cunha, Sandra Miguel, Rita Pinto, Fausto Pinto, Ana Abreu","doi":"10.1159/000541011","DOIUrl":"10.1159/000541011","url":null,"abstract":"<p><strong>Introduction: </strong>Exercise-based cardiac rehabilitation programs (CRPs) represent a multidisciplinary therapeutic approach tailored to improve cardiorespiratory fitness and overall health-related quality of life, while reducing cardiovascular hospitalizations and mortality. Our aim was to determine changes in exercise capacity and cardiac events according to the left ventricular ejection fraction (LVEF) following a CRP.</p><p><strong>Methods: </strong>This single-center cohort study included 131 patients who completed a center-based CRP from 2015 to 2022. Cardiopulmonary exercise testing (CPET), transthoracic echocardiography, and laboratory analysis were performed before and after program completion.</p><p><strong>Results: </strong>Of 232 enrolled patients, 131 were included in our cohort analysis, with 36.6% having a reduced LVEF. These patients exhibited higher rates of atrial fibrillation (p = 0.019) and NT-proBNP values (p < 0.001). Patients with reduced LVEF had lower peak VO2 (pVO2) (p = 0.046), percentage of predicted oxygen consumption (ppVO2) (p < 0.001), and VO2 at anaerobic threshold (p = 0.015) during baseline CPET. Completion of the CRP led to comparable improvements in exercise performance between groups, assessed through Δ pVO2 (p = 0.990), Δ ppVO2 (p = 0.610), and Δ VE/VCO2 slope (p = 0.200). In the study population, male gender and hypertension independently predicted variation in VE/VCO2 slope (p = 0.017) and oxygen uptake efficiency slope (p = 0.048), respectively, post-CRP. During follow-up, 9.2% of all patients had hospital admissions for cardiac events, and 3.8% died, with no significant differences between groups.</p><p><strong>Conclusion: </strong>Patients with reduced LVEF admitted to our CRP showed lower functional status based on specific CPET parameters. After CRP, both reduced and preserved LVEF groups experienced similar functional improvements. Therefore, strategies to increase participation of patients with reduced LVEF in such programs are warranted.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079220","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}
CardiologyPub Date : 2024-08-27DOI: 10.1159/000541106
Yoonsun Won, Kyung Eun Ha, Se-Eun Kim, Joonpyo Lee, Chan Joo Lee, Jeonggeun Moon
{"title":"Prevalence and Predictors of Thromboembolic Events in Patients with Left Ventricular Dysfunction and Left Ventricular Thrombus.","authors":"Yoonsun Won, Kyung Eun Ha, Se-Eun Kim, Joonpyo Lee, Chan Joo Lee, Jeonggeun Moon","doi":"10.1159/000541106","DOIUrl":"10.1159/000541106","url":null,"abstract":"<p><strong>Introduction: </strong>Thromboembolic events (TEs) associated with left ventricular (LV) thrombus (LVT) are of clinical concern; however, further investigation into their prevalence and risk predictors is warranted.</p><p><strong>Methods: </strong>We retrospectively identified 256 patients diagnosed with LVT by echocardiography between 2010 and 2021. The primary outcome was the occurrence of TE, including stroke and arterial thromboembolism. Patients were divided into TE (+) and TE (-) groups for clinical comparison, with a focus on factors related to TE.</p><p><strong>Results: </strong>The TE event rate was 9% over a median period of 4 ± 3 years. Notably, most TE occurred within 3 months and became scarce after 2 years of follow-up; based on this, LVT chronicity was defined as LVT persistency for ≥2 years. A prior TE history proved to be a positive predictor of TE (hazard ratio [HR]: 5.92, confidence interval [CI]: 1.45-24.18, p = 0.01), while LVT chronicity showed to be a negative predictor (HR: 0.04, CI: 0.01-0.15, p < 0.001). LVT chronicity accurately predicted TE (area under curve of 0.86 [95% CI: 0.80-0.93], cutoff value of 794 days [sensitivity: 69%, specificity: 91%]).</p><p><strong>Conclusion: </strong>TE associated with LVT occurs in the early period of recognition, and a history of TE is an independent predictor for future TE. Once LVT becomes chronic (≥2 years), TE is rare.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079221","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}
CardiologyPub Date : 2024-08-27DOI: 10.1159/000541108
Nicola Marziliano, Giuseppe Giuliani
{"title":"Telemedicine and Point-of-Care Devices: A Tale of Success for the Nurses' Management of Patients with Chronic Illness.","authors":"Nicola Marziliano, Giuseppe Giuliani","doi":"10.1159/000541108","DOIUrl":"10.1159/000541108","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079222","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}
CardiologyPub Date : 2024-08-23DOI: 10.1159/000541105
Takahiro Okumura, Toyoaki Murohara
{"title":"Heart Failure with Improved Ejection Fraction: A New Frontier in Heart Failure Management.","authors":"Takahiro Okumura, Toyoaki Murohara","doi":"10.1159/000541105","DOIUrl":"10.1159/000541105","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055041","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":"Prediction of 28-Day All-Cause Mortality in Heart Failure Patients with Clostridioides difficile Infection Using Machine Learning Models: Evidence from the MIMIC-IV Database.","authors":"Caiping Shi, Qiong Jie, Hongsong Zhang, Xinying Zhang, Weijuan Chu, Chen Chen, Qian Zhang, Zhen Hu","doi":"10.1159/000540994","DOIUrl":"10.1159/000540994","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) may induce bowel hypoperfusion, leading to hypoxia of the villa of the bowel wall and the occurrence of Clostridioides difficile infection (CDI). However, the risk factors for the development of CDI in HF patients have yet to be fully illustrated, especially because of a lack of evidence from real-world data.</p><p><strong>Methods: </strong>Clinical data and survival situations of HF patients with CDI admitted to ICU were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database. For developing a model that can predict 28-day all-cause mortality in HF patients with CDI, the Recursive Feature Elimination with Cross-Validation (RFE-CV) method was used for feature selection. And nine machine learning (ML) algorithms, including logistic regression (LR), decision tree, Bayesian, adaptive boosting, random forest (RF), gradient boosting decision tree, XGBoost, light gradient boosting machine, and categorical boosting, were applied for model construction. After training and hyperparameter optimization of the models through grid search 5-fold cross-validation, the performance of models was evaluated by the area under curve (AUC), accuracy, sensitivity, specificity, precision, negative predictive value, and F1 score. Furthermore, the SHapley Additive exPlanations (SHAP) method was used to interpret the optimal model.</p><p><strong>Results: </strong>A total of 526 HF patients with CDI were included in the study, of whom 99 cases (18.8%) experienced death within 28 days. Eighteen of the 57 variables were selected for the model construction algorithm for model construction. Among the ML models considered, the RF model emerged as the optimal model achieving the accuracy, F1-score, and AUC values of 0.821, 0.596, and 0.864, respectively. The net benefit of the model surpassed other models at 16%-22% threshold probabilities based on decision curve analysis. According to the importance of features in the RF model, red blood cell distribution width, blood urea nitrogen, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment, and white blood cell count were highlighted as the five most influential variables.</p><p><strong>Conclusions: </strong>We developed ML models to predict 28-day all-cause mortality in HF patients associated with CDI in the ICU, which are more effective than the conventional LR model. The RF model has the best performance among all the ML models employed. It may be useful to help clinicians identify high-risk HF patients with CDI.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1"},"PeriodicalIF":1.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999428","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}