Cardiology Research最新文献

{"title":"Association Between the Presence of Coronary Artery Disease or Peripheral Artery Disease and Left Ventricular Mass in Patients Who Have Undergone Coronary Computed Tomography Angiography.","authors":"Tetsuro Tachibana, Yuhei Shiga, Tetsuo Hirata, Kohei Tashiro, Sara Higashi, Yuto Kawahira, Yuta Kato, Takashi Kuwano, Makoto Sugihara, Shin-Ichiro Miura","doi":"10.14740/cr1532","DOIUrl":"10.14740/cr1532","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular mass (LVM) is a critical marker of future cardiovascular risk. We determined the association between LVM measured by coronary computed tomography angiography (CCTA) and the presence of coronary artery disease (CAD) or peripheral artery disease (PAD) in patients who had undergone CCTA for screening of CAD.</p><p><strong>Methods: </strong>We enrolled 1,307 consecutive patients (66 ± 12 years old, 49% males) who underwent CCTA for screening of CAD at the Fukuoka University Hospital (FU-CCTA registry), and either were clinically suspected of having CAD or had at least one cardiovascular risk factor. Patients with coronary stenosis of ≥ 50% by CCTA were diagnosed as CAD. Patients with an ankle brachial pressure index < 0.9 or who had already been diagnosed with PAD were considered to have PAD. Left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) were measured. The patients were divided into CAD (-) and CAD (+) or PAD (-) and PAD (+) groups.</p><p><strong>Results: </strong>The prevalences of CAD and PAD in all patients were 50% and 4.8%, respectively. Age, %males, %hypertension (HTN), %dyslipidemia (DL), %diabetes mellitus (DM), %smoking and %chronic kidney disease in the CAD (+) group were significantly higher than those in the CAD (-) group. Age, %males, %HTN, %DM and %smoking in the PAD (+) group were significantly higher than those in the PAD (-) group. CAD was independently associated with LVMI (odds ratio (OR): 1.01, 95% confidence interval (CI): 1.01 - 1.02, P < 0.01) in addition to age, male, HTN, DL, DM, and smoking. PAD was also independently associated with LVMI (OR: 1.01, 95% CI: 1.0 - 1.02, P = 0.018) in addition to age, DM, and smoking.</p><p><strong>Conclusions: </strong>LVMI determined by CCTA may be useful for predicting atherosclerotic cardiovascular diseases including both CAD and PAD, although there were considerable differences between %CAD and %PAD in all patients.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"387-395"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Daily Aerobic Exercise Duration on Phase 2 Cardiac Rehabilitation at a Rehabilitation Hospital and Health-Related Quality of Life After Discharge.","authors":"Tomohiro Matsuo, Takuro Ohtsubo, Tomoki Yanase, Katsuhiro Ueno, Shuichi Kozawa, Takako Matsubara, Yosuke Morimoto","doi":"10.14740/cr1527","DOIUrl":"10.14740/cr1527","url":null,"abstract":"<p><strong>Background: </strong>Phase 2 in-patient cardiac rehabilitation (CR) at a rehabilitation hospital is now added the medical service fees in Japan and in light of the recent reimbursement for CR, a study needed to be performed to determine exertional exercise on its effectiveness and benefits to patients. We examined the effects of daily aerobic exercise duration on health-related quality of life (HR-QoL) at 6 months after discharge from phase 2 CR.</p><p><strong>Methods: </strong>Of the 54 consecutive cardiovascular disease patients admitted to a rehabilitation hospital after acute care, 43 were considered acceptable candidates for enrollment according to predetermined inclusion and exclusion criteria. Of these, 40 patients completed study requirements, including return of a questionnaire on HR-QoL survey 6 months after discharge. The primary outcome was HR-QoL as evaluated using the EuroQol five-dimension five-level (EQ-5D-5L). Two multiple regression models were constructed to assess the influences of daily aerobic exercise duration (content of rehabilitation) and other clinicodemographic variables assessed during acute care (model 1) or at transfer from acute care to a rehabilitation hospital (model 2).</p><p><strong>Results: </strong>Both model 1, which included age, Barthel index of daily function before hospitalization, and daily aerobic exercise duration in the rehabilitation hospital (R² = 0.553, P < 0.001), and model 2, which included New York Heart Association functional classification at transfer, Charlson comorbidity index at transfer, and daily aerobic exercise duration (R² = 0.336, P = 0.002) identified aerobic exercise duration as a significant independent factor influencing HR-QoL at 6 months post-discharge (model 1: P = 0.041; model 2: P = 0.010).</p><p><strong>Conclusions: </strong>Enhanced daily aerobic exercise content during phase 2 in-hospital CR can significantly improve longer-term HR-QoL among cardiovascular disease patients independently of other clinicodemographic factors, including age, activities of daily living before treatment, and baseline condition at rehabilitation onset. These findings, that in the small sample size, support the continued expansion of phase 2 CR at a rehabilitation hospital in Japan.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"351-359"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Assessment of Thin-Strut BioMime Coronary Stent System in Real-World Population at Single-Center: A Retrospective Observational Study.","authors":"Girish Meennahalli Palleda, Mohit Gupta, Ankit Bansal, Vishal Batra, Sanjay Tyagi, Shekhar Kunal","doi":"10.14740/cr1515","DOIUrl":"10.14740/cr1515","url":null,"abstract":"<p><strong>Background: </strong>The short-term clinical outcomes of first-generation thicker-strut durable polymer-based drug-eluting stents (DES) have been widely examined. However, there is a scarcity on qualitative research on the long-term usage of DES that evaluated the thinner strut biodegradable stents for coronary artery disease. Hence, we sought to investigate the long-term safety and performance of thinner strut biodegradable polymer-based BioMime sirolimus-eluting coronary stent system in real-world patients with symptomatic ischemic heart disease.</p><p><strong>Methods: </strong>This was a retrospective, observational, single-center, post-marketing clinical follow-up study. The primary endpoints were the incidence of major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction (MI) attributed to target vessel revascularization (TVR), and target lesion revascularization (TLR) at 1-, 2-, 3- and 4-year follow-ups. The secondary endpoints were cardiac death, MI, TLR, TVR, device and procedural success rates, and stent thrombosis (ST).</p><p><strong>Results: </strong>In all, 1,188 consecutive patients were enrolled, and 1,333 (1,257 <i>de novo</i> and 76 in-stent restenotic lesions) out of 1,565 lesions were treated with the study device. The mean age of patients was 53.26 ± 10.31 years and 86.2% were male. The quantitative coronary angiographic derived mean lesion length and diameter were 29.62 ± 9.62 mm and 3.01 ± 0.29 mm, respectively. The average length and diameter of the study device implanted were 30.89 ± 6.31 mm and 3.17 ± 0.25 mm, respectively. The cumulative incidence of MACE at 1-, 2-, 3-, and 4 years was 0.61%, 1.47%, 2.08%, and 3.40%, respectively, and cumulative deaths due to cardiac causes were 0.61%, 1.13%, 1.22%, and 1.83%, respectively. There were no cases of TLR or TVR at 1-year follow-up. The cumulative rate of TLR at 2-, 3-, and 4 years was 0.35%, 0.87%, and 1.57%, respectively, while that of TVR was 0.61%, 1.47%, and 2.35%, respectively. Three (0.3%) incidences of probable ST occurred during the 6-month follow-up; no new cases were reported further. In subgroup analysis, MACEs were comparable across the long- and short-length stent groups through 4-year follow-up.</p><p><strong>Conclusions: </strong>This long-term study demonstrates the safety and performance of the ultra-thin BioMime sirolimus-eluting stent with satisfactory clinical outcomes in patients with symptomatic ischemic heart disease in real-world scenario.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"360-369"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subvalvular Aortic Stenosis: Learning From Human and Canine Clinical Research.","authors":"Amanda E Crofton, Samantha L Kovacs, Joshua A Stern","doi":"10.14740/cr1547","DOIUrl":"10.14740/cr1547","url":null,"abstract":"<p><p>Subvalvular aortic stenosis (SAS) is the most common congenital heart disease (CHD) in dogs and is also prevalent in human children. A fibrous ridge below the aortic valve narrows the left ventricular outflow tract (LVOT) and increases blood flow velocity, leading to devastating side effects in diseased patients. Due to the similarities in presentation, anatomy, pathophysiology, cardiac development, genomics, and environment between humans and dogs, canine SAS patients represent a critical translational model of human SAS. Potential adverse outcomes of SAS include arrhythmias, left-sided congestive heart failure, endocarditis, exercise intolerance, syncope, and sudden cardiac death. The greatest divergence between canine and human SAS clinical research has been the standard of care regarding treatment of these outcomes, with pharmacological intervention dominating best practices in veterinary medicine and surgical intervention comprising the standard practice for human SAS patients. Regardless of the species, the field has yet to identify a treatment option to prevent disease progression or permanently remove the fibrous ridge, but historical leaps in SAS research support a continued translational approach as the most promising method for achieving this goal.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"319-333"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the Influence of Smoking and Uncontrolled Lipid Profile in the Development of ST-Elevation Myocardial Infarction.","authors":"Meutia Putri Aristya, Nada Putri Pranidya, Mery Natalia Hutapea, Afdhalun Anwar Hakim","doi":"10.14740/cr1564","DOIUrl":"10.14740/cr1564","url":null,"abstract":"<p><p>We report a case of a 25-year-old male with the traditional risk factor for coronary artery disease (CAD), such as frequent smoking, while the other risk factors such as familial history of CAD were denied and hypertension, obesity, diabetes mellitus, or coagulation factors were not found. Patient was admitted with anterior ST-elevation myocardial infarction. Coronary angiography showed high intracoronary thrombus burden and total occlusion of the proximal segment of left anterior descending artery. Percutaneous coronary intervention was then performed as the treatment of choice, and resulted with no residual stenosis after. The patient had a smooth and progressive recovery.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"416-420"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulation Use as an Independent Predictor of Mortality and Major Adverse Cardiovascular Events in Hospitalized COVID-19 Patients: A Multicenter Retrospective Analysis.","authors":"Nathan DeRon, Lawrence Hoang, Kristopher Aten, Sri Prathivada, Manavjot Sidhu","doi":"10.14740/cr1529","DOIUrl":"10.14740/cr1529","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) is associated with increased incidence of cardiac arrhythmias and thrombotic events. The adverse cardiovascular outcomes related to ambulatory anticoagulation (AC) therapy in COVID-19 patients are unknown. The goal of this study was to identify the effects of AC use in hospitalized COVID-19 patients.</p><p><strong>Methods: </strong>This is a multicenter, retrospective study that identified 2,801 hospitalized COVID-19 polymerase chain reaction (PCR)-positive patients admitted between March 2020 and July 2021. Of these, 375 (13.4%) were ambulatory AC users. Data were collected from the electronic health records of hospitalized patients. Mortality included in-hospital death and hospice referral. Major adverse cardiovascular events (MACEs) included acute heart failure (HF), myocardial infarction (MI), myocarditis, pulmonary embolism (PE), deep venous thrombosis (DVT), pericardial effusion, pericarditis, stroke, shock, and cardiac tamponade. A Chi-square test was used to analyze categorical variables, and multivariate logistic regression analysis was performed to account for comorbidities.</p><p><strong>Results: </strong>AC non-users exhibited a higher incidence of mortality than AC users (13.9% vs. 7.7%, P = 0.001). However, MACE incidence was higher in AC users than AC non-users (44.8% vs. 26.8%, P < 0.001). The higher MACE incidence was driven by higher rates of acute HF (8.3% vs. 2.5%, P < 0.001), MI (26.9% vs. 18.2%, P < 0.001), PE/DVT (16.3% vs. 2.7%, P < 0.001), pericardial effusion (1.6% vs. 0.5%, P = 0.025), and stroke (2.9% vs. 1.2%, P = 0.018). After multivariate logistic regression, MACE incidence remained higher (odds ratio (OR) = 1.61, 95% confidence interval (CI): 1.27 - 2.05, P < 0.001) and all-cause mortality rate lower (OR = 0.34, 95% CI: 0.23 - 0.52, P < 0.001) in AC users.</p><p><strong>Conclusions: </strong>Ambulatory AC use is associated with increased MACEs but decreased all-cause mortality in patients hospitalized with COVID-19. This study will help physicians identify patients at risk of cardiovascular mortality and direct management based on the identified risk.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"370-378"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of Left Internal Mammary Artery Flow Velocity in Predicting the Prognosis of Patients After Coronary Artery Bypass Grafting.","authors":"Feng Wei Guo, Hong Chen, Ya Ling Dong, Jia Nan Shang, Li Tao Ruan, Yang Yan, Yan Song","doi":"10.14740/cr1566","DOIUrl":"10.14740/cr1566","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to explore the value of the left internal mammary artery flow velocity (LIMAV) measured by ultrasound before coronary artery bypass grafting (CABG) in predicting the prognosis of patients after left internal mammary artery (LIMA) bypass grafting.</p><p><strong>Methods: </strong>One hundred and four patients who underwent CABG with LIMA as the bridge vessel in the cardiovascular surgery department of our hospital between May 2018 and June 2019 were selected. All patients underwent transthoracic Doppler ultrasonography to measure LIMAV preoperatively. Intraoperatively, mean graft flow (MGF) and pulsatility index (PI) of the LIMA bridge were measured using transit time flow measurement (TTFM). The primary endpoint event in this study was cardiac death within 18 months after surgery.</p><p><strong>Results: </strong>The Cox survival analysis showed that the MGF, the LIMAV and left ventricular ejection fraction (LVEF) were risk factors for death after CABG. The cut-offs of MGF, LIMAV and LVEF for the prediction of death after CABG were ≤ 14 mL/min (area under the curve (AUC): 0.830; sensitivity: 100%; specificity: 65.6%), ≤ 60 cm/s (AUC: 0.759; sensitivity: 65.5%; specificity: 85.3%), and ≤ 44% (AUC: 0.724; sensitivity: 50%; specificity: 88.5%), respectively. Compared with the use of MGF, MGF + LIMAV, combination of the MGF + LIMAV + LVEF (AUC: 0.929; sensitivity: 100%; specificity: 81.1%) resulted in a stronger predictive value (MGF vs. MGF + LIMAV + LVEF: P = 0.02).</p><p><strong>Conclusion: </strong>LIMAV measured by preoperative transthoracic ultrasound combined with intraoperative MGF and LVEF may have a greater value in predicting patients' risk of cardiac death after CABG.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"396-402"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of MYPN, TTN, SCN5A, MYO6 and ELN Mutations With Arrhythmias and Subsequent Sudden Cardiac Death: A Case Report of an Ecuadorian Individual.","authors":"Elius Paz-Cruz, Viviana A Ruiz-Pozo, Santiago Cadena-Ullauri, Patricia Guevara-Ramirez, Rafael Tamayo-Trujillo, Rita Ibarra-Castillo, Jose Luis Laso-Bayas, Paul Onofre-Ruiz, Nieves Domenech, Adriana Alexandra Ibarra-Rodriguez, Ana Karina Zambrano","doi":"10.14740/cr1552","DOIUrl":"10.14740/cr1552","url":null,"abstract":"<p><p>Cardiac pathologies are among the most frequent causes of death worldwide. Regarding cardiovascular deaths, it is estimated that 5 million cases are caused by sudden cardiac death (SCD) annually. The primary cause of SCD is ventricular arrhythmias. Genomic studies have provided pathogenic, likely pathogenic, and variants of uncertain significance that may predispose individuals to cardiac causes of sudden death. In this study, we describe the case of a 43-year-old individual who experienced an episode of aborted SCD. An implantable cardioverter defibrillator was placed to prevent further SCD episodes. The diagnosis was ventricular fibrillation. Genomic analysis revealed some variants in the <i>MYPN</i> (pathogenic), <i>GCKR</i> (likely pathogenic), <i>TTN</i> (variant of uncertain significance), <i>SCN5A</i> (variant of uncertain significance), <i>MYO6</i> (variant of uncertain significance), and <i>ELN</i> (variant of uncertain significance) genes, which could be associated with SCD episodes. In addition, a protein-protein interaction network was obtained, with proteins related to ventricular arrhythmia and the biological processes involved. Therefore, this study identified genetic variants that may be associated with and trigger SCD in the individual. Moreover, genetic variants of uncertain significance, which have not been reported, could contribute to the genetic basis of the disease.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"409-415"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Genetic Characteristics of Arrhythmogenic Right Ventricular Cardiomyopathy Patients: A Single-Center Experience.","authors":"Bandar Saeed Al-Ghamdi, Faten Alhadeq, Aisha Alqahtani, Nadiah Alruwaili, Monther Rababh, Sara Alghamdi, Waleed Almanea, Zuhair Alhassnan","doi":"10.14740/cr1531","DOIUrl":"10.14740/cr1531","url":null,"abstract":"<p><strong>Background: </strong>Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited progressive cardiomyopathy. We aimed to define the long-term clinical outcome and genetic characteristics of patients and family members with positive genetic tests for ARVC in a single tertiary care cardiac center in Saudi Arabia.</p><p><strong>Methods: </strong>We enrolled 46 subjects in the study, including 23 index-patients (probands) with ARVC based on the revised 2010 ARVC Task Force Criteria (TFC) and 23 family members who underwent a genetic test for the ARVC between 2016 and 2020.</p><p><strong>Results: </strong>Of the probands, 17 (73.9%) were males with a mean age at presentation of 24.95 ± 13.9 years (7 to 55 years). Predominant symptoms were palpitations in 14 patients (60.9%), and syncope in 10 patients (43.47%). Sustained ventricular tachycardia (VT) was documented in 12 patients (52.2%). The mean left ventricular ejection fraction (LVEF) by echocardiogram was 52.81±6.311% (30-55%), and the mean right ventricular ejection fraction (RVEF) by cardiac MRI was 41.3±11.37% (23-64%). Implantable cardioverter-defibrillator (ICD) implantation was performed in 17 patients (73.9%), and over a mean follow-up of 13.65 ± 6.83 years, appropriate ICD therapy was noted in 12 patients (52.2%). Genetic variants were identified in 33 subjects (71.7%), 16 patients and 17 family members, with the most common variant of plakophilin 2 (PKP2) in 27 subjects (81.8%).</p><p><strong>Conclusions: </strong>ARVC occurs during early adulthood in Saudi patients. It is associated with a significant arrhythmia burden in these patients. The <i>PKP2</i> gene is the most common gene defect in Saudi patients, consistent with what is observed in other nations. We reported in this study two novel variants in <i>PKP2</i> and desmocollin 2 (DSC2) genes. Genetic counseling is needed to include all first-degree family members for early diagnosis and management of the disease in our country.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"379-386"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Prevention of Cryptogenic Stroke and Outcomes Following Surgical Patent Foramen Ovale Closure Plus Medical Therapy vs. Medical Therapy Alone: An Umbrella Meta-Analysis of Eight Meta-Analyses Covering Seventeen Countries.","authors":"Urvish Patel, Chetna Dengri, David Pielykh, Aakash Baskar, Muhammad Imtiaz Tar, Greshaben Patel, Neel Patel, Nishel Kothari, Sri Abirami Selvam, Amit Munshi Sharma, Vikramaditya Samela Venkata, Shamik Shah, Syed Nazeer Mahmood, Appala Suman Peela","doi":"10.14740/cr1526","DOIUrl":"10.14740/cr1526","url":null,"abstract":"<p><strong>Background: </strong>Cryptogenic stroke (CS) is an exclusion diagnosis that accounts for 10-40% of all ischemic strokes. Patent foramen ovale (PFO) is found in 66% of patients with CS, while having a prevalence of 25-30% in the general population. The primary aim was to evaluate the risk of recurrent stroke following surgical PFO closure plus medical therapy vs. medical therapy alone amongst CS, an embolic stroke of undetermined source (ESUS), or transient ischemic attack (TIA). The secondary aim was to evaluate new-onset non-valvular atrial fibrillation, mortality, and major bleeding.</p><p><strong>Methods: </strong>We conducted an umbrella meta-analysis using PRISMA guidelines on English studies comparing surgical PFO closure plus medical therapy versus medical therapy alone for managing CS. We extracted data on interventions and outcomes and used random-effects models with generic inverse variance to calculate relative risks (RRs) with 95% confidence intervals for outcome calculations.</p><p><strong>Results: </strong>A comprehensive search yielded 54,729 articles on CS and 65,001 on surgical PFO closure, with 1,591 studies focusing on PFO closure and medical therapy for secondary CS, ESUS, or TIA prevention. After excluding non-meta-analyses, 52 eligible meta-analyses were identified, and eight studies were selected for outcome evaluation, excluding non-English, non-human, and studies before January 2019 as of August 31, 2021. Among a total of 41,880 patients, 14,942 received PFO closure + medical therapy, while 26,938 patients received medical therapy alone. Our umbrella meta-analysis showed that PFO closure plus medical therapy had a 64% lower risk of recurrent strokes than medical therapy alone (pooled RR: 0.36). PFO closure plus medical therapy was associated with 4.94 times higher risk of atrial fibrillation. There was no difference in the risk of death or bleeding between both groups.</p><p><strong>Conclusion: </strong>In patients with CS, PFO closure, in addition to medical therapy, reduces the risk of recurrence. More research is needed to assess the efficacy of early closure as well as specific risk profiles that would benefit from early intervention to reduce the burden of stroke.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 5","pages":"342-350"},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}