Cardiology Research最新文献

{"title":"Evaluation of Physicians' Compliance With Secondary Prevention Among Ischemic Stroke Patients: A Retrospective Study.","authors":"Alaa Alhubaishi,&nbsp;Maha A Almutairi,&nbsp;Malak A Alasqah,&nbsp;Shihanah H Alharthi,&nbsp;Abdulhadi M Alqahtani,&nbsp;Lina I Alnajjar","doi":"10.14740/cr1500","DOIUrl":"https://doi.org/10.14740/cr1500","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of disability and death worldwide. Globally, stroke affects 13.7 million individuals every year. Several studies have shown an increase in the rehospitalization rate among stroke patients caused by non-adherence to secondary prevention as recommended by the American Heart Association/American Stroke Association (AHA/ASA) guideline. The aim of this study was to evaluate physicians' compliance with secondary prevention of stroke upon patients' discharge.</p><p><strong>Methods: </strong>A retrospective chart review study was conducted at King Fahad Medical City. The primary outcome of this study was the number of patients discharged with the recommended medications for the secondary prevention of ischemic stroke (IS). The data were collected from the patient's medical record files and analyzed using the Statistical Package for the Social Sciences (SPSS).</p><p><strong>Results: </strong>Of the 675 patients who were screened for eligibility, 507 were included and 168 were excluded. The mean age of the patients was 59.5 (± 15.6) years. Of the 507 patients, 181 (35.7%) had a history of previous stroke. Overall, 376 (74%) stroke patients were discharged with appropriate secondary prevention recommendation per AHA/ASA guideline.</p><p><strong>Conclusions: </strong>This study stresses the importance of compliance with the AHA/ASA guideline for secondary stroke prevention and highlights the role of pharmacists in the stroke unit in which it is necessary to ensure that all stroke patients are discharged with the recommended medications to reduce recurrent stroke.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 4","pages":"302-308"},"PeriodicalIF":1.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/e2/cr-14-302.PMC10409549.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963559","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":"Comparing Left Atrial Low Voltage Areas in Sinus Rhythm and Atrial Fibrillation Using Novel Automated Voltage Analysis: A Pilot Study.","authors":"James Mannion,&nbsp;Kathryn Hong,&nbsp;Sarah-Jane Lennon,&nbsp;Anthony Kenny,&nbsp;Joseph Galvin,&nbsp;Jim O'Brien,&nbsp;Gael Jauvert,&nbsp;Edward Keelan,&nbsp;Usama Boles","doi":"10.14740/cr1503","DOIUrl":"https://doi.org/10.14740/cr1503","url":null,"abstract":"<p><strong>Background: </strong>Low voltage areas (LVAs) have been proposed as surrogate markers for left atrial (LA) scar. Correlation between voltages in sinus rhythm (SR) and atrial fibrillation (AF) have previously been measured via point-by-point analysis. We sought to compare LA voltage composition measured in SR to AF, utilizing a high-density automated voltage histogram analysis (VHA) tool in those undergoing pulmonary vein isolation (PVI) for persistent AF (PeAF).</p><p><strong>Methods: </strong>We retrospectively analyzed patients with PeAF undergoing <i>de novo</i> PVI. Maps required ≥ 1,000 voltage points in each rhythm and had a standardized procedure (mapped in AF then remapped in SR post-PVI). We created six anatomical segments (AS) from each map: anterior, posterior, roof, floor, septal and lateral AS. These were analyzed by VHA, categorizing atrial LVAs into 10 voltage aliquots 0 - 0.5 mV. Data were analyzed using SPSS v.26.</p><p><strong>Results: </strong>We acquired 58,342 voltage points (n = 10 patients, mean age: 67 ± 13 years, three females). LVA burdens of ≤ 0.2 mV, designated as \"severe LVAs\", were comparable between most AS (except on the posterior wall) with good correlation. Mapped voltages between the ranges of 0.21 and 0.5 mV were labeled as \"diseased LA tissue\", and these were found significantly more in AF than SR. Significant differences were seen on the roof, anterior, posterior, and lateral AS.</p><p><strong>Conclusions: </strong>Diseased LA tissue (0.21 - 0.5 mV) burden is significantly higher in AF than SR, mainly in the anterior, roof, lateral, and posterior wall. LA \"severe LVA\" (≤ 0.2 mV) burden is comparable in both rhythms, except with respect to the posterior wall. Our findings suggest that mapping rhythm has less effect on the LA with voltages < 0.2 mV than 0.2 - 0.5 mV across all anatomical regions, excluding the posterior wall.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 4","pages":"268-278"},"PeriodicalIF":1.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/ab/cr-14-268.PMC10409550.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9970321","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":"Safety and Feasibility of Tele-Cardiac Rehabilitation Using Remote Biological Signal Monitoring System: A Pilot Study.","authors":"Miho Nishitani-Yokoyama, Kazunori Shimada, Kei Fujiwara, Abidan Abulimiti, Hiroki Kasuya, Mitsuhiro Kunimoto, Yurina Yamaguchi, Minoru Tabata, Masakazu Saitoh, Tetsuya Takahashi, Hiroyuki Daida, Shuko Nojiri, Tohru Minamino","doi":"10.14740/cr1530","DOIUrl":"10.14740/cr1530","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation (CR) is categorized as a class I recommendation in the guidelines for the management of patients with cardiovascular disease (CVD). However, the penetration rate of outpatient CR is low in Japan. We designed a pilot study to evaluate the safety and feasibility of tele-CR using a remote biological signal monitoring system.</p><p><strong>Methods: </strong>A total of nine patients (median aged 70.0 (66.0 - 76.0) years (male = 6) with CVD who participated in phase II CR for 1 month under the exercise prescription using the cardiopulmonary exercise test (CPET) were analyzed. They participated in the tele-CR program with a remote biological signal monitoring system (Nipro HeartLineTM, Osaka, Japan, and Duranta, Miyagi, Japan) in the CR room and were instructed by the CR staff from a separate room in the hospital. We evaluated the occurrence and degree of remote biological signal monitoring defects as safety evaluation items, i.e., whether the patients could set the remote biological signal monitoring equipment, as a feasibility evaluation item during a 3-month period. We also performed CPET at the baseline and follow-up. Following the 3-month tele-CR program, a total of 122 remote CR programs were performed using the remote biological signal monitoring system.</p><p><strong>Results: </strong>No patient experienced a lack of remote biological signal monitoring during exercise therapy. Significant improvement was noted in the exercise capacity, as assessed using the cardiopulmonary test (from 19.5 (16.7 - 20.2) mL/kg/min to 21.1 (17.3 - 22.8) mL/kg/min, P = 0.01, age ratio from 86% (75-96%) to 99% (78-104%), P = 0.01). One patient required support using the remote biological signal monitoring system, including information technology literacy.</p><p><strong>Conclusions: </strong>This study suggests the safety and feasibility of tele-CR using the remote biological signal monitoring system. However, further investigations are required to explore the suitability, effects, and cost-effectiveness of tele-CR as an alternative to center-based CR in the future.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 4","pages":"261-267"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9a/61/cr-14-261.PMC10409546.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9970315","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":"Symptomatic Bronchogenic Cyst in a Lipomatous Interatrial Septum.","authors":"Alexander T Phan,&nbsp;Janie Hu,&nbsp;Buzand Oganesian,&nbsp;Shammah O Williams","doi":"10.14740/cr1511","DOIUrl":"https://doi.org/10.14740/cr1511","url":null,"abstract":"<p><p>Intracardiac bronchogenic cysts are extremely rare congenital anomalies that arise during foregut development when the embryologic heart tube and ventral foregut are in close proximity to one another. We report a case of an interatrial septal bronchogenic cyst found on non-contrast enhanced computed tomography (CT) in a 66-year-old female who presented to the emergency department with chest pain. Further cardiac investigations, including contrast-enhanced CT angiogram of the heart, transthoracic echocardiogram, and transesophageal echocardiogram, revealed a cystic mass in the lipomatous interatrial septum. The patient was subsequently diagnosed with a bronchogenic cyst of the interatrial septum. No surgical intervention was pursued, as the mass remained stable, and the cardiothoracic surgeon did not recommend excision. This case highlights a rare case of a symptomatic bronchogenic cyst arising in the interatrial septum diagnosed by imaging modalities. Bronchogenic cysts should be included in the differential diagnosis of intracardiac tumors.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 4","pages":"315-318"},"PeriodicalIF":1.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/0c/cr-14-315.PMC10409548.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9970319","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":"A Randomized Controlled Trial Comparing BioMime Sirolimus-Eluting Stent With Everolimus-Eluting Stent: Two-Year Outcomes of the meriT-V Trial.","authors":"Alexandre Abizaid,&nbsp;Ricardo Costa,&nbsp;Sasko Kedev,&nbsp;Elvin Kedhi,&nbsp;Suneel Talwar,&nbsp;Andrejs Erglis,&nbsp;Ota Hlinomaz,&nbsp;Monica Masotti,&nbsp;Farzin Fath-Ordoubadi,&nbsp;Krzysztof Milewski,&nbsp;Pedro Lemos,&nbsp;Roberto Botelho,&nbsp;Alexander Ijsselmuiden,&nbsp;Jacques Koolen,&nbsp;Petr Kala,&nbsp;Luc Janssens,&nbsp;Udita Chandra","doi":"10.14740/cr1498","DOIUrl":"https://doi.org/10.14740/cr1498","url":null,"abstract":"<p><strong>Background: </strong>Drug-eluting stents (DESs) based on biodegradable polymers (BPs) have been introduced to reduce the risk for late and very late stent thrombosis (ST), which were frequently observed with earlier generations of DES designs based on durable polymers (DPs); however, randomized controlled trials on these DES designs are scarce. The meriT-V trial is a randomized, active-controlled, non-inferiority trial with a prospective, multicenter design that evaluated the 2-year efficacy of a novel third-generation, ultra-thin strut, BP-based BioMime sirolimus-eluting stent (SES) versus the DP-based XIENCE everolimus-eluting stent (EES) for the treatment of <i>de novo</i> lesions.</p><p><strong>Methods: </strong>The meriT-V is a randomized trial that enrolled 256 patients at 15 centers across Europe and Brazil. Here, we report the outcomes of the extended follow-up period of 2 years. The randomization of enrolled patients was in a 2:1 ratio; the enrolled patients received either the BioMime SES (n = 170) or the XIENCE EES (n = 86). The three-point major adverse cardiac event (MACE), defined as a composite of cardiac death, myocardial infarction (MI), or ischemia-driven target vessel revascularization (ID-TVR), was considered as the composite safety and efficacy endpoint. Ischemia-driven target lesion revascularization (ID-TLR) was evaluated as well as the frequency of definite/probable ST, based on the first Academic Research Consortium definitions.</p><p><strong>Results: </strong>The trial had a 2-year follow-up completion rate of 98.44% (n = 252/256 patients), and the clinical outcomes assessment showed a nonsignificant difference in the cumulative rate of three-point MACE between both arms (BioMime vs. XIENCE: 7.74% vs. 9.52%, P = 0.62). Even the MI incidences in the BioMime arm were insignificantly lower than those of the XIENCE arm (1.79% vs. 5.95%, P = 0.17). Late ST was observed in 1.19% cases of the XIENCE arm, while there were no such cases in the BioMime arm (P = 0.16).</p><p><strong>Conclusions: </strong>The objective comparisons between the novel BP-based BioMime SES and the well-established DP-based XIENCE EES in this randomized controlled trial show acceptable outcomes of both the devices in the cardiac deaths, MI, ID-TVR, and ST. Moreover, since there were no incidences of cardiac death in the entire study sample over the course of 2 years, we contend that the findings of the study are highly significant for both these DES designs. In this preliminary comparative trial, the device safety of BioMime SES can be affirmed to be acceptable, considering the lower three-point MACE rate and absence of late ST in the BioMime arm over the 2-year period.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 4","pages":"291-301"},"PeriodicalIF":1.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/d5/cr-14-291.PMC10409544.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963560","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 Impact of Glucagon-Like Peptide-1 Receptor Agonist on the Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis and Systematic Review.","authors":"Ali Rahman, Sura Alqaisi, Sunil E Saith, Rana Alzakhari, Ralph Levy","doi":"10.14740/cr1523","DOIUrl":"10.14740/cr1523","url":null,"abstract":"<p><strong>Background: </strong>Since 2005, the cardioprotective effects of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have garnered attention. The cardioprotective effect could be an added benefit to the use of GLP-1 RA. This systematic review and meta-analysis aimed at summarizing observational studies that recruited type 2 diabetes individuals with fewer cardiovascular (CV) events before enrolling in the research.</p><p><strong>Methods: </strong>Systematically, the databases were searched for observational studies reporting compound CV events and deaths in type 2 diabetics without having the risk of cardiovascular diseases (CVDs) compared to other glucose-lowering agents. A meta-analysis was carried out using random effects model to estimate the overall hazard ratio (HR) with a 95% confidence interval (CI). Five studies were found eligible for the systematic review including a total of 64,452 patients receiving either liraglutide (three studies) or exenatide (two studies).</p><p><strong>Results: </strong>The pooled HR for major adverse cardiac event (MACE) and extended MACE was 0.72 (95% CI: 0.65 - 0.93, I² = 68%) and 0.93 (95% CI: 0.89 - 0.98, I² = 29%), respectively. The pooled HR for hospitalization due to heart failure (HHF) and occurrence of HF was 0.84 (95% CI: 0.77 - 0.91, I² = 79%) and 0.83 (95% CI: 0.75 - 0.94, I² = 95%), respectively. For stroke, GLP-1 RA was associated with a significant risk reduction of 0.86 (95% CI: 0.75 - 0.98, I² = 81%). There was no significant myocardial infarction (MI) risk reduction with GLP-1 RA. As for all-cause mortality, the pooled HR for the occurrence of all-cause mortality was 0.82 (95% CI: 0.76 - 0.88, I² = 0%). The pooled HR for the occurrence of CV death was 0.75 (95% CI: 0.65 - 0.85, I² = 38%). GLP-1 RA therapy was associated with a significantly low risk of MACE, extended MACE, all-cause mortality, and CV mortality. Except for MACE, the heterogenicity among the studies was low.</p><p><strong>Conclusion: </strong>We conclude that GLP-1 RA is associated with a low risk of CV events composites and mortality. The findings support the cardioprotective effect of GLP-1 RA.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 4","pages":"250-260"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/40/cr-14-250.PMC10409547.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963557","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":"Retinal Vascular Density Change in Patients With Aortic Valve Regurgitation.","authors":"Caner Topaloglu,&nbsp;Sinan Bilgin","doi":"10.14740/cr1502","DOIUrl":"https://doi.org/10.14740/cr1502","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess retinal vessel density in the superficial capillary plexus layer, deep capillary plexus layer and choriocapillaris plexus layer in patients with aortic valve regurgitation (AR) using optical coherence tomography angiography (OCTA).</p><p><strong>Methods: </strong>Thirty-eight healthy participants (group 1) and 38 patients with AR (group 2) were assessed for this study. Diagnosis of AR is made by transthoracic echocardiography (TTE). Severity of AR was assessed according to values in the 2014 American Heart Association/American College of Cardiology (AHA/ACC) valve guideline. Superficial capillary plexus density (SCPD), deep capillary plexus density (DCPD) and choriocapillaris plexus density (CCPD) were analyzed between groups using OCTA.</p><p><strong>Results: </strong>SCPD measurements were found to be decreased in the nasal, inferior and central regions of patients with AR (P ≤ 0.05). DCPD measurements were found to be decreased in the nasal and inferior regions of patients with AR (P ≤ 0.05). CCPD measurements were found to be decreased in the inferior and central regions of patients with AR (P ≤ 0.05). In patients with AR, CCPD measurements were significantly decreased in the inferior region compared to the control group. Central macular thickness was found to be significantly decreased in the patients with AR.</p><p><strong>Conclusions: </strong>Patients with AR showed decreased flow density compared with healthy controls. Retinal perfusion measured using OCTA in patients with AR may give an idea about microperfusion.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 4","pages":"309-314"},"PeriodicalIF":1.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/b3/cr-14-309.PMC10409551.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9970318","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":"Hypertrophic Cardiomyopathy: A Cardiovascular Challenge Becoming a Contemporary Treatable Disease.","authors":"Stefanos G Sakellaropoulos,&nbsp;Benedict Schulte Steinberg","doi":"10.14740/cr1514","DOIUrl":"https://doi.org/10.14740/cr1514","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy is one of the most common genetic inherited diseases of myocardium, which is caused by mutation in genes encoding proteins for the cardiac sarcomere. It is the most frequent cause of sudden death in young people and trained athletes. All diagnostic methods, including heart catheterization, transthoracic and transesophageal echocardiography, magnetic resonance imaging, genetic counseling and tissue biopsy are required for risk and therapy stratification and should be individualized depending on phenotype and genotype. Current therapy has not been tested adequately. Beta-blockers and verapamil can cause hypotension which can make hypertrophic cardiomyopathy worse. Disopyramide has been inadequately studied, and mavacamten was only studied in small trials. More definitive trials are currently ongoing. Novel invasive and noninvasive diagnostics, medical therapies, interventional and surgical approaches tend to influence the natural history of the disease, favoring a better future for this patient population.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 4","pages":"243-249"},"PeriodicalIF":1.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/3c/cr-14-243.PMC10409543.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9970320","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":"Dosimetric Evaluation of Cardiac Structures on Left Breast Cancer Radiotherapy: Impact of Movement, Dose Calculation Algorithm and Treatment Technique.","authors":"Esteban Barnafi Wittwer,&nbsp;Carolin Rippker,&nbsp;Paola Caprile,&nbsp;Demetrio Elias Torres,&nbsp;Rodrigo El Far,&nbsp;Araceli Gago-Arias,&nbsp;Tomas Merino","doi":"10.14740/cr1486","DOIUrl":"https://doi.org/10.14740/cr1486","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most frequently diagnosed and leading cause of cancer-related deaths among females. The treatment of breast cancer with radiotherapy, albeit effective, has been shown to be toxic to the heart, resulting in an elevated risk of cardiovascular disease and associated fatalities.</p><p><strong>Methods: </strong>In this study, we evaluated the impact of respiratory movement, treatment plans and dose calculation algorithm on the dose delivered to the heart and its substructures during left breast radiotherapy over a cohort of 10 patients. We did this through three image sets, four different treatment plans and the employment of three algorithms on the same treatment plan. The dose parameters were then employed to estimate the impact on the 9-year excess cumulative risk for acute cardiac events by applying the model proposed by Darby.</p><p><strong>Results: </strong>The left ventricle was the structure most irradiated. Due to the lack of four-dimensional computed tomography (4DCT), we used a set of images called phase-average CT that correspond to the average of the images from the respiratory cycle (exhale, exhale 50%, inhale, inhale 50%). When considering these images, nearly 10% of the heart received more than 5 Gy and doses were on average 27% higher when compared to free breathing images. Deep inspiration breath-hold plans reduced cardiac dose for nine out of 10 patients and reduced mean heart dose in about 50% when compared to reference plans. We also found that the implementation of deep inspiration breath-hold would reduce the relative lifetime risk of ischemic heart disease to 10%, in comparison to 21% from the reference plan.</p><p><strong>Conclusion: </strong>Our findings illustrate the importance of a more accurate determination of the dose and its consideration in cardiologists' consultation, a factor often overlooked during clinical examination. They also motivate the evaluation of the dose to the heart substructures to derive new heart dose constraints, and a more mindful and individualized clinical practice depending on the treatment employed.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 4","pages":"279-290"},"PeriodicalIF":1.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/39/cr-14-279.PMC10409545.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975711","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":"A Prospective, Randomized Open-Label Study for Assessment of Antihypertensive Effect of Telmisartan Versus Cilnidipine Using Ambulatory Blood Pressure Monitoring (START ABPM Study).","authors":"Rahul Sawant,&nbsp;Sachin Suryawanshi,&nbsp;Mayur Jadhav,&nbsp;Hanmant Barkate,&nbsp;Sumit Bhushan,&nbsp;Tanmay Rane","doi":"10.14740/cr1476","DOIUrl":"https://doi.org/10.14740/cr1476","url":null,"abstract":"<p><strong>Background: </strong>The antihypertensive agent telmisartan is an angiotensin II receptor blocker with a terminal elimination half-life of 24 h and has a high lipophilicity, thereby enhancing its bioavailability. Another antihypertensive agent, cilnidipine is a calcium antagonist and has dual mode of action on the calcium channels. This study aimed at determining effect of these drugs on ambulatory blood pressure (BP) levels.</p><p><strong>Methods: </strong>A randomized, open-label, single-center study was conducted during 2021 - 2022 on newly diagnosed adult patients with stage-I hypertension, in a mega city of India. Forty eligible patients were randomized to telmisartan (40 mg) and cilnidipine (10 mg) groups, with once daily dose administered for 56 consecutive days. Ambulatory blood pressure monitoring (ABPM) (24 h) was performed pre- and post-treatment, and the ABPM-derived parameters were compared statistically.</p><p><strong>Results: </strong>Statistically significant mean reductions were observed in all BP endpoints in telmisartan group but only in 24-h systolic blood pressure (SBP), daytime and nighttime SBP, and manual SBP and diastolic blood pressure (DBP) in cilnidipine group. The mean change from baseline to day 56 between two treatment groups showed statistical significance in last 6-h SBP (P = 0.01) and DBP (P = 0.014), and morning SBP (P = 0.019) and DBP (P = 0.028). The percent nocturnal drop within and between groups was statistically nonsignificant. Also, the between group mean SBP and DBP smoothness index differed nonsignificantly.</p><p><strong>Conclusions: </strong>Telmisartan and cilnidipine once daily were effective and well tolerated in the treatment of newly diagnosed stage-I hypertension. Telmisartan provided sustained 24-h BP control and may offer advantages over cilnidipine in terms of BP reductions, particularly over the 18- to 24-h post-dose period or critical early morning hours.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"14 3","pages":"211-220"},"PeriodicalIF":1.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/be/cr-14-211.PMC10257498.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9621242","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}