Cardiology最新文献

{"title":"Prognostic Impact of Coronary Calcifications in Patients with Recently Diagnosed Prostate Cancer.","authors":"Nina Stødkilde-Jørgensen, Andreas Bugge Tinggaard, Simon Winther, Andreas Sjoeholm-Christensen, June Anita Ejlersen, Jørgen Bjerggaard Jensen, Morten Böttcher","doi":"10.1159/000543735","DOIUrl":"10.1159/000543735","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with prostate cancer are at increased risk of cardiovascular events. A non-electrocardiogram gated CT scan of the thorax is part of the diagnostic workup, allowing for assessment of coronary calcifications. However, the prognostic impact of a coronary artery calcium score (CACS) obtained from such CT scans is uncertain. This study aimed to investigate the association between CACS and a combined endpoint of all-cause death, myocardial infarction, or stroke in patients with recently diagnosed prostate cancer.</p><p><strong>Methods: </strong>The primary analysis included patients (N = 571) with recently diagnosed prostate cancer and without known coronary artery disease undergoing prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT). Patients were stratified into four CACS groups. Cox proportional hazard models adjusted for risk factors were used to examine the association between CACS and the combined endpoint.</p><p><strong>Results: </strong>Patients were distributed in the four CACS groups as follows: CACS 0-10 (26%), 11-99 (21%), 100-399 (24%), and ≥400 (29%). An increased risk of the combined endpoint was found with increasing CACS. Compared with CACS 0-10, the hazard ratios for CACS 11-99, 100-399 and ≥400 were 0.95 (95% confidence interval [CI]: 0.37-2.42), 2.39 (95% CI: 1.13-5.09) and 3.14 (95% CI: 1.52-6.48), respectively. Only 53% of patients in the CACS ≥400 group received statins.</p><p><strong>Conclusion: </strong>In patients with prostate cancer, assessment of a CACS from the initial PET/CT scan allows for the identification of patients with a threefold higher risk of death, myocardial infarction, or stroke. Initiation of preventive statin treatment in these patients could reduce cardiovascular events.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499065","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":"Transvalvular Flow Rates in Patients with Moderate-To-Severe and Severe Aortic Stenosis: Clinical Usefulness and Risk Stratification.","authors":"Hyungseop Kim, In-Cheol Kim, Hee-Jeong Lee","doi":"10.1159/000544784","DOIUrl":"10.1159/000544784","url":null,"abstract":"<p><strong>Introduction: </strong>The definition of low-flow/low-gradient aortic stenosis (AS) using the stroke volume index (SVI) alone overlooks factors like vascular resistance and valve stiffness. Consequently, an SVI indicating a normal flow might indicate a low flow when used with the transvalvular flow rate (TFR), which incorporates ejection time. We compared the SVI (35 mL/m2) and TFR (250 mL/m2) and analyzed the outcomes for patients with and without aortic valve replacement (AVR).</p><p><strong>Methods: </strong>From 2013 to 2016, we retrospectively evaluated the clinical data of patients with moderate-to-severe and severe AS, defined as a maximum aortic valve velocity ≥3.5 m/s or a valve area ≤1.3 cm2. Patients were categorized into AVR and non-AVR groups. The non-AVR group was further classified by a TFR above or below 250 mL/m2. Moreover, we compared the SVIs with TFRs. We examined the rates of all-cause mortality and heart failure hospitalizations.</p><p><strong>Results: </strong>Among 135 patients, 42 (31%) had mismatched SVIs and TFRs; 41 had a high SVI and a low TFR, whereas one had a low SVI and a high TFR. Among the 59 non-AVR patients, 25 (71.4%) of the 35 patients with a low TFR died, whereas 4 (16.7%) of the 24 patients with a high TFR died. The TFR in the 76 AVR patients was similar to that in the non-AVR patients, 3 of whom died (3.9%). The Kaplan-Meier analysis revealed that non-AVR patients with a low TFR had worse outcomes and the AVR patients fared best. The SVI was significantly less suitable than the TFR for risk stratification.</p><p><strong>Conclusion: </strong>This study highlights that a high TFR, rather than a high SVI, is associated with a better prognosis, even among non-AVR patients, suggesting that the TFR is better for risk assessment and complements the SVI.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440244","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":"Long-Term Prognosis in Takotsubo Syndrome: A Comprehensive Approach.","authors":"Francesco Santoro, Natale Daniele Brunetti","doi":"10.1159/000544168","DOIUrl":"10.1159/000544168","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405729","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":"Additive Predictive Value of Left Ventricular End-Diastolic Volume Index to the Development of Persistent Atrial Fibrillation in Nonobstructive Hypertrophic Cardiomyopathy.","authors":"Yajie Tang, Pan Yang, Minghu Xiao, Lei Song, Minjie Lu, Zhe Zheng","doi":"10.1159/000544032","DOIUrl":"10.1159/000544032","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the association between left ventricular end-diastolic volume index (LVEDVi) and the risk of persistent or long-standing persistent atrial fibrillation (perAF) in nonobstructive hypertrophic cardiomyopathy (NOHCM) patients.</p><p><strong>Methods: </strong>Forty-nine NOHCM patients with perAF were selected as the case group (NOHCMAF group). A control group comprised 98 NOHCM patients without atrial fibrillation (AF) history.</p><p><strong>Results: </strong>Compared to the control group, patients in the NOHCMAF group were associated with higher CHA2DS2-VASc score (3.0 ± 1.7 vs. 2.2 ± 1.1, p = 0.003), higher grade of diastolic dysfunction (II/III) (43.3% vs. 19.4%, p < 0.001). Meanwhile, they were associated with a larger left atrial diameter (LAD) (46.8 ± 4.7 vs. 39.3 ± 4.5 mm, p < 0.001) and a smaller LVEDVi (63.88 ± 15.07 mL/m2 vs. 78.86 ± 12.26 mL/m2, p < 0.001). Multivariate logistic analysis indicated the independent predictive factor of LVEDVi (odds ratio: 0.908, confidence interval: 0.861-0.957, p < 0.001). The multivariable models revealed the additive discrimination for perAF by the LVEDVi with a higher C-statistic of 0.945 in combination with age at diagnosis and LAD. The LVEDVi cutoff for predicting perAF was 71 mL/m2.</p><p><strong>Conclusions: </strong>LVEDVi was independently associated with the occurrence of perAF in NOHCM patients, demonstrating an incremental value compared to conventional LA parameters. Increased cardiac rhythm monitoring is recommended for patients with LVEDVi ≤71 mL/m2.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390161","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":"Prognostic Value of Measuring Body Surface Area in Patients with Acute Coronary Syndrome.","authors":"Udaya S Tantry, Sahib Singh, Paul A Gurbel","doi":"10.1159/000543736","DOIUrl":"10.1159/000543736","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122255","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 Single-Center Experience with Continuous and Pulsatile Flow Veno-Arterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock.","authors":"Simon Lindner, Henning Johann Steffen, Ibrahim Akin, Claude Jabbour, Daniel Duerschmied, Thomas Helbing, Simone Britsch","doi":"10.1159/000543906","DOIUrl":"https://doi.org/10.1159/000543906","url":null,"abstract":"<p><strong>Introduction: </strong>Pulsatile flow in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for the treatment of cardiogenic shock may yield physiological benefits over continuous flow. The primary objective of this study was to evaluate whether there are detectable differences between these modes in a small single-center cohort.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients who underwent VA-ECMO support for cardiogenic shock at our institution between 2019 and 2023. Data collected included demographic information, disease severity scores, duration of ECMO support, and duration of pulsatile flow. Primary outcome variables were in-hospital mortality and Barthel score. Safety outcomes were stroke or systemic embolization, bleeding, and limb ischemia.</p><p><strong>Results: </strong>A total of 66 patients were included in the analysis. Seventeen (26%) had received continuous and 49 (74%) pulsatile VA-ECMO. In-hospital mortality was 71% vs. 80% (p = 0.445) and mean Barthel scores in survivors were 85 vs. 71 (p = 0.488). All safety outcomes were similar between the groups. In VA-ECMO devices capable of pulsatility, actual pulsatile flow was delivered during 64% of total runtime.</p><p><strong>Conclusion: </strong>We could not demonstrate clear differences in mortality or functional outcome between pulsatile and continuous flow in this single-center cohort. However, the small sample size, short time of actual pulsatile flow, and several between group differences clearly limit the robustness of this observation. The inconclusive nature of our results underscores the need for larger and randomized controlled trials.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966189","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":"Unravelling ATTR Cardiac Amyloidosis in Iceland: A Nationwide Epidemiological Study.","authors":"Hekla María Bergmann, Ævar Örn Úlfarsson, Hafsteinn Einarsson, Helena Xiang Jóhannsdóttir, Gunnar Thór Gunnarsson, Thórdís Jóna Hrafnkelsdóttir, Karl Andersen, Inga Jóna Ingimarsdóttir","doi":"10.1159/000543750","DOIUrl":"https://doi.org/10.1159/000543750","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac amyloidosis (CA) arises from the deposition of misfolded amyloid proteins in the heart's extracellular matrix, leading to significant cardiac disease. Recent data suggest that CA is under-recognised, and advances in treatment have increased focus on this condition with the intention of implementing treatment earlier to improve prognosis. There is limited knowledge regarding the prevalence of transthyretin CA (ATTR-CA) on a national level, particularly in Iceland. Therefore, this study represents the first nationwide effort to evaluate the baseline characteristics, diagnostics, and treatment of ATTR-CA in Iceland.</p><p><strong>Methods: </strong>A retrospective study of all patients diagnosed with ATTR-CA in Iceland from 6 May 2013 to 11 March 2024 was identified in the Icelandic Cardiac Amyloid Registry (ICE-CAR) created in 2023 by heart failure (HF) specialists at Landspitali University Hospital in Reykjavik, Iceland. Diagnosis was based on different combinations of transthoracic echocardiography, an elevated Perugini score on bone scintigraphy and heart biopsies, as well measurements of free light chains, M-component measurements in blood and urine. Patients were grouped according to the National Amyloidosis Centre (NAC) prognostic staging system for ATTR-CA.</p><p><strong>Results: </strong>In total, 65 patients with ATTR-CA were identified (males n = 60, females n = 5, median age 81.4 years [IQR 75.5-85.5 years]), all wild-type and no mutant variant. Diagnosis was made with myocardial biopsy in 7 cases. Upon diagnosis, 83% of the patients had an interventricular septum thickness of ≥15 mm and 92% showed a posterior wall thickness of ≥12 mm. Approximately 57% of patients belonged to New York Heart Association (NYHA) functional class I-II. The HF phenotypes according to left ventricular ejection fraction (LVEF) were distributed as follows: reduced (HFrEF) n = 24 (37%), mildly reduced (HFmrEF) n = 9 (14%), preserved (HFpEF) n = 29 (44.5%), and unknown LVEF n = 3 (4.5%). A total of 54 patients had reported NAC stage: stage I 23 (35.4%), stage II 20 (30.8%), stage III 11 (16.9%). Around 32% received disease-modifying treatment.</p><p><strong>Conclusion: </strong>Despite the low NYHA class observed in the study population, our findings in Iceland's nationwide assessment of ATTR-CA indicate more advanced age and lower LVEF at diagnosis compared to other studies. This highlights the critical need for early detection and appropriate therapeutic interventions in managing ATTR-CA.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975133","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: Short- and Long-Term Safety in Myocarditis Patients.","authors":"Ze-Ping Li, Guang-Ling Li, Ya-Nan Wang, Hong Yang, Lu-Yun Wang, Guang-Lin Cui, Kun Miao, Jian-Gang Jiang","doi":"10.1159/000543593","DOIUrl":"10.1159/000543593","url":null,"abstract":"<p><strong>Introduction: </strong>Aims of the study were to assess the short-term and long-term outcomes of percutaneous endomyocardial biopsy (EMB) in patients with myocarditis and to identify the risk factors for EMB-related complications in this patient population.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 294 hospitalized patients with clinically suspected myocarditis at Tongji Hospital from October 2019 to October 2023, with a median follow-up duration of 18 months. Patients were divided into an EMB group (n = 151) and a non-EMB group (n = 143) based on whether they underwent EMB procedure. The incidence of endpoints was compared between the two groups, and the Kaplan-Meier survival curve was used to assess the survival rate without endpoints. Endpoints included major adverse cardiovascular events (MACE), ventricular enlargement, and decline in cardiac function. Multivariate logistic regression analysis was employed to evaluate the risk factors for EMB-related complications.</p><p><strong>Results: </strong>The incidence of major short-term complications following EMB was 2.0% (3/151), while the incidence of minor complications was 9.3% (14/151). Multivariate risk regression analysis revealed that operative duration (OR: 1.101, 95% CI: 1.02-1.079, p < 0.05) and BNP levels (OR: 1.083, 95% CI: 0.931-1.26, p < 0.05) were associated with short-term complications following EMB. Compared to the non-EMB group, the EMB group had no significant increase in hospital stay (10 [8, 15] vs. 9 [7, 16], p = 0.27) and no significant decline in cardiac function. Long-term follow-up results showed that 8 patients (5.3%) in the EMB group experienced MACE, 14 patients (9.3%) had left ventricular enlargement, and 18 patients (11.9%) had a decline in left ventricular ejection fraction (LVEF) after discharge; in the non-EMB group, 12 patients (8.4%) experienced MACE, 30 patients (19.9%) had left ventricular enlargement, and 18 patients (11.9%) had a decline in LVEF after discharge. The Kaplan-Meier curve revealed a lower incidence of endpoint events in the EMB group (p < 0.05).</p><p><strong>Conclusion: </strong>In patients with myocarditis, EMB is associated with a risk of short-term complications, with higher levels of BNP and operative duration being independent risk factors for EMB-related complications. However, EMB does not adversely affect cardiac function or hospital stay during the inpatient period and may contribute to the improvement of long-term outcomes in patients with myocarditis.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022374","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":"High-Sensitivity Troponin I Measurement in a Large Contemporary Cohort: Implications for Clinical Care.","authors":"Daniel Esau, Peter Nord, Beth L Abramson","doi":"10.1159/000543403","DOIUrl":"10.1159/000543403","url":null,"abstract":"<p><strong>Introduction: </strong>Contemporary methods of cardiovascular (CV) risk stratification are frequently inaccurate. Biomarkers such as high-sensitivity troponin I (hsTnI) have the potential to improve risk stratification. However, uncertainties exist regarding factors that determine hsTnI concentration. Our aim was to investigate the prevalence of elevated hsTnI in a large contemporary Canadian cohort and describe the effect of comorbidities on hsTnI concentration.</p><p><strong>Methods: </strong>We report a large dataset of 41,602 visits in which hsTnI was measured routinely in ambulatory outpatients. hsTnI was remeasured in 28% of patients, with a mean time between measurements of 387 days (IQR 364-441). Low-, medium-, and high-risk categories were created based on hsTnI cutoffs for each sex. Laboratory data, blood pressure, and anthropomorphic measures were extracted from the electronic medical record.</p><p><strong>Results: </strong>Remeasurement of hsTnI did not change risk category in 92.7% of cases. Male sex, higher HDL-C, higher Hgb A1c, decreasing eGFR, and increasing systolic blood pressure were significant predictors of increased hsTnI. High non-HDL-C and the use of statins were associated with lower hsTnI. The inverse relationship between hsTnI and non-HDL-C was partially corrected when the confounding effect of statin therapy was considered. Model fit was poor (adjusted R-squared = 0.0091).</p><p><strong>Conclusion: </strong>Traditional CV risk factors were predictors of serum hsTnI levels; however, a significant amount of the variance in hsTnI cannot be explained by these factors alone. This suggests that hsTnI adds additional information that is not provided by traditional risk stratification methods and supports ongoing study of hsTnI as a biomarker for CV risk stratification.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000864","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":"Nourishment of Nerves and Innervation: A Novel Approach for the Treatment of Myocardial Infarction.","authors":"Xiaorui Yin, Dan Cai, Zhimin Song, Chunli Song","doi":"10.1159/000543513","DOIUrl":"10.1159/000543513","url":null,"abstract":"<p><strong>Background: </strong>Autonomic innervation of the heart plays a pivotal role not only in regulating the heart rate but also in modulating the cardiac cell microenvironment via cell-cell interactions and influencing the heart's repair capabilities. Currently, the primary clinical approach for treating myocardial infarction (MI) is percutaneous coronary intervention. However, the myocardial salvage rate remains low for patients with advanced disease. MI is recognized as an autonomic nervous system disorder, marked by sympathetic hyperactivity and the loss of parasympathetic nerves. Following MI, ventricular sympathetic nerve sprouting occurs, leading to an increase in ventricular sympathetic innervation and, consequently, an increased risk of ventricular arrhythmia, which is the primary cause of sudden cardiac death in patients with a history of MI. The vagus nerve positively regulates cardiomyocyte proliferation and regeneration, enhancing ventricular remodeling and cardiac function post-MI. This process is highly significant in the treatment and rehabilitation of MI. Cardiac autonomic nerves are influenced by factors such as inflammation, immunity, intercellular communication, metabolism, genetics, epigenetics, and cytokine secretion related to cardiac mesenchymal nerves. In recent years, significant advancements have been made regarding treatment for MI, specifically in the fields of autonomic nervous system therapies, stem cell and extracellular vesicle treatments, traditional Chinese medicine acupuncture and moxibustion, and peripheral electrophysiological stimulation and bioengineering materials.</p><p><strong>Summary: </strong>The balance of dominance between the sympathetic and parasympathetic nervous systems in the heart affects tissue regeneration and cardiac remodeling after MI. The secretion of neurons regulates the microenvironment of cardiac repair. The neural therapy of MI involves multiple fields such as traditional Chinese medicine, biomaterials, stem cell therapy, and drug research and development and has broad development prospects.</p><p><strong>Key messages: </strong>The regulation exerted by the cardiac autonomic nervous system on the heart significantly influences the prognosis of MI. This involves nervous system modulation of inflammation and heart rate and complex interactions between neurons and cardiomyocytes, immune cells, fibroblasts, adipocytes, stem cells, and other cellular components. Genetic and epigenetic modifications, as well as shifts in energy metabolism, also play crucial roles.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-23"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000865","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}