Cardiology in Review最新文献

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The Role of Uric Acid in the Pathogenesis of Heart Failure With Preserved Ejection Fraction. 尿酸在保留射血分数的心力衰竭发病机制中的作用。
IF 2.3 4区 医学
Cardiology in Review Pub Date : 2026-05-08 DOI: 10.1097/CRD.0000000000001299
Jie Tan, Jiahan Ke, Xiaohan Qiu, Jun Gu
{"title":"The Role of Uric Acid in the Pathogenesis of Heart Failure With Preserved Ejection Fraction.","authors":"Jie Tan, Jiahan Ke, Xiaohan Qiu, Jun Gu","doi":"10.1097/CRD.0000000000001299","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001299","url":null,"abstract":"<p><p>With advancing age and the development of risk factors such as hypertension, type 2 diabetes, obesity, and atrial fibrillation, the incidence of heart failure with preserved ejection fraction (HFpEF) has shown a year-on-year increase and is projected to become the most common form of heart failure in the near future. Uric acid (UA) is the end product of purine metabolism in the body and is closely associated with metabolic syndrome. Studies indicate that elevated serum uric acid levels constitute an independent risk factor for the onset, progression, and prognosis of HFpEF. UA can directly participate in the pathophysiological process of HFpEF by inducing oxidative stress, activating the inflammasome and pro-inflammatory signaling pathways, and impairing both cardiomyocyte function and microvascular endothelial integrity. This systematic review examines the epidemiological association between UA and HFpEF, the underlying mechanisms of UA involvement in HFpEF, and the potential benefits of urate-lowering therapy, including xanthine oxidase inhibitors and sodium-glucose cotransporter 2 inhibitors, for patients with HFpEF. It aims to enhance awareness of serum uric acid management in HFpEF patients and promote further exploration of pharmacological interventions in this field.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855978","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}
引用次数: 0
Cyanotic Congenital Heart Disease in Pregnancy: A Comprehensive Review of Pathophysiology, Maternal-Fetal Outcomes, and Contemporary Management. 妊娠期紫绀型先天性心脏病:病理生理学、母胎结局和当代管理的综合综述。
IF 2.3 4区 医学
Cardiology in Review Pub Date : 2026-05-08 DOI: 10.1097/CRD.0000000000001317
Kristjana Frangaj, Kateryna Strubchevska, Olena Strubchevska, Marko Kozyk, Rimsha Ahmad, William H Frishman, Wilbert S Aronow
{"title":"Cyanotic Congenital Heart Disease in Pregnancy: A Comprehensive Review of Pathophysiology, Maternal-Fetal Outcomes, and Contemporary Management.","authors":"Kristjana Frangaj, Kateryna Strubchevska, Olena Strubchevska, Marko Kozyk, Rimsha Ahmad, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001317","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001317","url":null,"abstract":"<p><p>Advances in pediatric cardiac surgery and medical management have enabled an increasing number of women with cyanotic congenital heart disease to reach reproductive age and contemplate pregnancy. Maternal complications occur in approximately 32% of pregnancies in women with uncorrected cyanotic heart disease, with heart failure, arrhythmias, and thromboembolism representing the primary adverse events. Fetal outcomes are critically dependent on maternal oxygen saturation, with live birth rates of 92% when saturation exceeds 90% but plummeting to 12% when saturation falls below 85%. This review synthesizes current evidence regarding the pathophysiology of major cyanotic lesions, maternal cardiovascular adaptations and risks, fetal and neonatal outcomes, risk stratification approaches, and contemporary management strategies from preconception through the postpartum period. Particular attention is given to lesion-specific considerations, guideline-based recommendations from the American Heart Association, American College of Cardiology, and the European Society of Cardiology, and the essential role of multidisciplinary cardio-obstetrics teams in optimizing outcomes for this high-risk population. The 2025 American College of Cardiology/American Heart Association/Heart Rhythm Society/International Society for Adult Congenital Heart Disease/Society for Cardiac angiography and Interventions Guideline for the Management of Adults with Congenital Heart Disease reinforces the importance of structured preconception counseling, individualized risk stratification, and coordinated multidisciplinary care in specialized ACHD centers.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855652","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}
引用次数: 0
From Lumen to Myocardium With Artificial Intelligence: A Clinician's Guide to Comprehensive Cardiac CT. 从管腔到人工智能心肌:临床医生对心脏综合CT的指导。
IF 2.3 4区 医学
Cardiology in Review Pub Date : 2026-05-08 DOI: 10.1097/CRD.0000000000001293
Abbas Mohammadi, Seyedhesamoddin Khatami, Sheida Ebrahimi, Sharnvir S Chattha, Ashkan Mohammadi, William H Frishman, Wilbert S Aronow
{"title":"From Lumen to Myocardium With Artificial Intelligence: A Clinician's Guide to Comprehensive Cardiac CT.","authors":"Abbas Mohammadi, Seyedhesamoddin Khatami, Sheida Ebrahimi, Sharnvir S Chattha, Ashkan Mohammadi, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001293","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001293","url":null,"abstract":"<p><p>Coronary artery disease assessment has long focused on stenosis severity, yet luminal narrowing alone fails to capture ischemic burden, plaque vulnerability, or myocardial health. This mismatch drives unnecessary invasive coronary angiography and delays preventive therapy. Cardiac computed tomography (CT) has evolved from a simple anatomical gatekeeper into a comprehensive, noninvasive platform that addresses this gap. This review synthesizes current evidence and provides practical guidance for clinicians, with an emphasis on artificial intelligence integration. High-quality coronary CT angiography now serves as a foundational anatomical roadmap, with trials demonstrating its feasibility for planning complex revascularization (SYNTAX III REVOLUTION) and safely reducing invasive procedures (DISCHARGE). CT-derived fractional flow reserve improves diagnostic specificity, reduces nonobstructive catheterization, and guides revascularization decisions, though prognostic evidence remains mixed and image-quality constraints apply. Quantitative plaque characterization, particularly low-attenuation and total plaque volumes, strongly predicts myocardial infarction and mortality, outperforming stenosis severity and supporting proactive preventive therapy even in nonobstructive disease. Emerging applications include CT-derived extracellular volume for detecting diffuse fibrosis and cardiac amyloidosis, with prognostic value across aortic stenosis and heart failure.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855676","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}
引用次数: 0
PCSK9 as a Biomarker and Therapeutic Target for Anthracycline Cardiotoxicity Prevention: Recent Advancements and Future Perspectives. PCSK9作为蒽环类药物心脏毒性预防的生物标志物和治疗靶点:最新进展和未来展望
IF 2.3 4区 医学
Cardiology in Review Pub Date : 2026-05-08 DOI: 10.1097/CRD.0000000000001296
Ahmed Farid Gadelmawla, Mohanad A Alkuwaiti, Amal A Alsubaiei, Najat Y AlSejari, Abdullah M Alharran, Hamza A Abdul-Hafez, Ahmed Elmorsy Mohamed, William H Frishman, Wilbert S Aronow
{"title":"PCSK9 as a Biomarker and Therapeutic Target for Anthracycline Cardiotoxicity Prevention: Recent Advancements and Future Perspectives.","authors":"Ahmed Farid Gadelmawla, Mohanad A Alkuwaiti, Amal A Alsubaiei, Najat Y AlSejari, Abdullah M Alharran, Hamza A Abdul-Hafez, Ahmed Elmorsy Mohamed, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001296","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001296","url":null,"abstract":"<p><p>Anthracycline-induced cardiotoxicity continues to be a significant clinical challenge in oncology, affecting up to 30% of patients who are subjected to sequential chemotherapy regimens and substantially restricting the therapeutic potential of these highly effective anticancer agents. Despite the fact that anthracycline-based chemotherapy has an overall 5-year survival rate of 80%, dose-dependent cardiotoxicity is a rising safety concern which manifests as cardiomyopathy or congestive heart failure. This highlights the need for novel cardioprotective strategies are required as the currently available regimens are insufficiently effective. Anthracycline exposure induces proprotein convertase subtilisin/kexin type 9 (PCSK9) upregulation in cardiomyocytes in a concentration- and time-dependent manner. The nuclear accumulation induces apoptosis through the degradation of karyopherin subunit beta-1 (KPNB1). Elevated PCSK9 levels are linked to pathological remodeling, increased myocardial fibrosis, and a reduced left ventricular ejection fraction. Cardioprotection against Anthracycline-induced cardiotoxicity is primarily achieved through lipid-independent mechanisms, including the suppression of inflammasome-mediated injury, modulation of innate immune signaling, attenuation of myocardial fibrosis, and restoration of mitochondrial homeostasis, which are regulated by PCSK9 inhibition. The inhibition of PCSK9 has been demonstrated in preclinical models to enhance anticancer efficacy by reducing chemoresistance and increasing cardiomyocyte viability by 35-88% during anthracycline/trastuzumab exposure.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855965","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}
引用次数: 0
Treatment and Outcomes for Acute Ischemic Stroke in Cardiomyopathy Patients With Heart Failure: A Retrospective Cross-Sectional Study. 心肌病合并心力衰竭患者急性缺血性卒中的治疗和预后:一项回顾性横断面研究。
IF 2.3 4区 医学
Cardiology in Review Pub Date : 2026-05-07 DOI: 10.1097/CRD.0000000000001222
Aarti Kishore Jain, Nimrod Gozum, Serena Wong, Bridget E Nolan, Kevin M Clare, Eric Feldstein, Sima Vazquez, Brittany Russo, Anish Thomas, Aiden Lui, Maya Pandit, Gurmeen Kaur, Chaitanya Medicherla, Chirag D Gandhi, Fawaz Al-Mufti
{"title":"Treatment and Outcomes for Acute Ischemic Stroke in Cardiomyopathy Patients With Heart Failure: A Retrospective Cross-Sectional Study.","authors":"Aarti Kishore Jain, Nimrod Gozum, Serena Wong, Bridget E Nolan, Kevin M Clare, Eric Feldstein, Sima Vazquez, Brittany Russo, Anish Thomas, Aiden Lui, Maya Pandit, Gurmeen Kaur, Chaitanya Medicherla, Chirag D Gandhi, Fawaz Al-Mufti","doi":"10.1097/CRD.0000000000001222","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001222","url":null,"abstract":"<p><p>Cardiomyopathy (CM) is a common cause of heart failure (HF), and those with HF have up to a 3-fold increased risk of stroke. This study aims to examine the incidence of intravascular thrombolysis and endovascular thrombectomy and the functional outcomes in acute ischemic stroke (AIS) patients with CM and HF. International Classification of Diseases-10 codes were used to query the National Inpatient Sample database for patients with AIS and concurrent CM and HF from 2016 to 2019. Incidence of reperfusion therapy, medical complications, discharge disposition, length of hospital stay, and mortality between patients with and without CM and HF were compared using propensity score matching and multivariable logistic regression analysis. Of 2,939,160 patients identified with AIS, 80,915 (2.8%) had concomitant diagnoses of CM and HF. Patients in this population had more severe strokes (25.9% vs 19.6%, P < 0.001) and received endovascular thrombectomy at higher rates (8.8% vs 5.6%, P < 0.001) but equivalent rates of intravascular thrombolysis (3.0% vs 2.9%, P = 0.107). Additionally, CM/HF patients were more likely to experience inpatient death (6.6% vs 5.4%, P < 0.001). Despite this, those who survived were statistically more likely to have a favorable discharge disposition (45.7% vs 43.9%, P < 0.001). Although CM and HF patients are more likely to experience complications, prolonged length of stay, and inpatient death, those who survive have higher rates of favorable discharge disposition. These results suggest that stroke intervention is safe and efficacious in patients with CM and HF.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834157","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}
引用次数: 0
Contemporary Management of Ascending Aortic and Arch Dissection: Integrating Open, Hybrid, and Endovascular Strategies. 升主动脉和动脉弓夹层的当代处理:综合开放、混合和血管内策略。
IF 2.3 4区 医学
Cardiology in Review Pub Date : 2026-05-07 DOI: 10.1097/CRD.0000000000001300
Antônio Agostinho Moura Filho, Adnaldo da Silveira Maia, Luciana Rascov, Hugo Farah Affonso Alves, Yuri Marinheiro Aragão, Fabio Antônio Serra de Lima Júnior, Aydan Rzazade, Gabriel Damasio Palma da Fonseca, Renato Rossi Ribeiro, Bruno Silva Ribeiro, Felipe Reale Cividanes, Ahmet Kilic, José Honório de Almeida Palma da Fonseca
{"title":"Contemporary Management of Ascending Aortic and Arch Dissection: Integrating Open, Hybrid, and Endovascular Strategies.","authors":"Antônio Agostinho Moura Filho, Adnaldo da Silveira Maia, Luciana Rascov, Hugo Farah Affonso Alves, Yuri Marinheiro Aragão, Fabio Antônio Serra de Lima Júnior, Aydan Rzazade, Gabriel Damasio Palma da Fonseca, Renato Rossi Ribeiro, Bruno Silva Ribeiro, Felipe Reale Cividanes, Ahmet Kilic, José Honório de Almeida Palma da Fonseca","doi":"10.1097/CRD.0000000000001300","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001300","url":null,"abstract":"<p><p>Acute aortic dissection is the most frequent presentation of acute aortic syndromes and remains a rapidly progressive and life-threatening condition requiring immediate diagnosis and treatment. Advances in surgical techniques, hybrid strategies, and endovascular technologies have expanded treatment options, particularly for high-risk and anatomically complex patients. This narrative review summarizes current evidence and guideline-based strategies for the management of aortic dissection, with emphasis on acute type A disease. The review integrates data from registries, contemporary clinical trials, meta-analyses, and recent international guidelines. Open surgical repair remains the standard of care for acute type A aortic dissection, providing reliable entry tear exclusion, restoration of true lumen perfusion, and prevention of rupture. Expanded surgical strategies such as frozen elephant trunk improve distal aortic remodeling and reduce late reinterventions in selected patients. Hybrid and adjunctive technologies, including modular dissection stents and branched stented anastomosis techniques, aim to improve distal perfusion and simplify arch reconstruction. Endovascular repair of the ascending aorta is emerging as a potential alternative for high-risk or inoperable patients, supported by early feasibility data and dedicated device development. Management of aortic dissection is rapidly evolving toward individualized, anatomy-driven strategies that integrate open, hybrid, and endovascular therapies. While open surgery remains the cornerstone for acute type A dissection, emerging endovascular technologies may expand treatment eligibility in selected patients. Future progress will depend on continued device innovation, multidisciplinary aortic team models, and prospective clinical trials to define optimal treatment algorithms.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834229","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}
引用次数: 0
Long-Term Exposure to PM2.5 and Risk of Incident Dementia: A Systematic Review and Meta-Analysis of Cohort Studies. 长期暴露于PM2.5与痴呆风险:队列研究的系统回顾和荟萃分析。
IF 2.3 4区 医学
Cardiology in Review Pub Date : 2026-05-06 DOI: 10.1097/CRD.0000000000001287
Jonah Rocheeld, Bracha Gluck, William H Frishman, Wilbert S Aronow
{"title":"Long-Term Exposure to PM2.5 and Risk of Incident Dementia: A Systematic Review and Meta-Analysis of Cohort Studies.","authors":"Jonah Rocheeld, Bracha Gluck, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001287","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001287","url":null,"abstract":"<p><p>Exposure to ambient fine particulate matter (PM2.5) is associated with cardiovascular and inflammatory pathways implicated in neurodegeneration. However, epidemiologic findings linking PM2.5 exposure to dementia incidence remain heterogeneous. We conducted a systematic review and meta-analysis of existing cohort studies evaluating the association between PM2.5 exposure and incident dementia. A literature search yielded 909 records, of which 15 cohort studies, including approximately 65 million participants in Europe, Asia, and North America, were included in the meta-analysis. Hazard ratios were standardized to a 1 μg/m3 increase in PM2.5 exposure using logarithmic transformation. Effect estimates were then pooled using a random-effects model. Long-term PM2.5 exposure was associated with an increased risk of incident dementia (pooled HR 1.04, 95% confidence interval 1.01-1.06). Substantial heterogeneity was observed across studies (I2 = 88.3%). These findings support growing evidence that chronic exposure to fine particulate air pollution may contribute to the development of dementia and highlight air pollution as a potentially modifiable environmental risk factor for neurodegenerative disease.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834206","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}
引用次数: 0
Catheter Ablation Versus Antiarrhythmic Drugs in the Management of Ventricular Tachycardia in Ischemic Cardiomyopathy: An Updated Systematic Review and Meta-analysis. 导管消融与抗心律失常药物治疗缺血性心肌病室性心动过速:最新的系统综述和荟萃分析。
IF 2.3 4区 医学
Cardiology in Review Pub Date : 2026-05-06 DOI: 10.1097/CRD.0000000000001294
Mohab Elnashar, Kerollos Abdelsayed, Ahmed Elmorsy Mohamed, Mustafa Abomohsen, Ahmed Farid Gadelmawla, Zeyad Kholeif, Abdul Hakim Almakadma, Imad Samman Tahhan, Rana Rashwan, Mohamed Elnady, Hritvik Jain, Siddharth P Agrawal, Salah H Alahwany, William H Frishman, Wilbert S Aronow
{"title":"Catheter Ablation Versus Antiarrhythmic Drugs in the Management of Ventricular Tachycardia in Ischemic Cardiomyopathy: An Updated Systematic Review and Meta-analysis.","authors":"Mohab Elnashar, Kerollos Abdelsayed, Ahmed Elmorsy Mohamed, Mustafa Abomohsen, Ahmed Farid Gadelmawla, Zeyad Kholeif, Abdul Hakim Almakadma, Imad Samman Tahhan, Rana Rashwan, Mohamed Elnady, Hritvik Jain, Siddharth P Agrawal, Salah H Alahwany, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001294","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001294","url":null,"abstract":"<p><p>Ventricular tachycardia (VT) is a major cause of morbidity and mortality in patients with ischemic cardiomyopathy. Prior randomized controlled trials comparing catheter ablation (CA) with antiarrhythmic drug (AAD) therapy have reported inconsistent findings. We conducted an updated meta-analysis to compare the efficacy and safety of CA versus AAD therapy in this population. Four randomized controlled trials involving 846 patients were included. The weighted mean age was 58.7 years, the weighted mean left ventricular ejection fraction was 33.5%, and 88% of participants were male. In the AAD group, amiodarone and sotalol were used in 60% and 40% of patients, respectively. CA significantly reduced the primary composite outcome compared with AAD therapy (risk ratio [RR] = 0.85, 95% confidence interval [CI]: 0.75-0.97, P = 0.01), mainly driven by a lower incidence of treated sustained VT below the implantable cardioverter-defibrillator detection limit (RR = 0.25, 95% CI: 0.15-0.43, P < 0.01). CA also significantly reduced treatment-related adverse events (RR = 0.49, 95% CI: 0.36-0.65, P < 0.01). No significant differences were observed in all-cause mortality, appropriate implantable cardioverter-defibrillator shocks, or VT storm. In patients with ischemic cardiomyopathy and VT, CA reduces arrhythmic events and treatment-related adverse events compared with AAD therapy, although a survival benefit remains unproven.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834165","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}
引用次数: 0
Anticoagulation in Patients With Gastrointestinal Disease. 胃肠道疾病患者的抗凝治疗
IF 2.3 4区 医学
Cardiology in Review Pub Date : 2026-05-06 DOI: 10.1097/CRD.0000000000001301
Omar Alkasabrah, Jaishkar Ramesh, Radhe Kinner Shah, Muhammad Qasim Chaudhry, Faiza Aman Jajja, William H Frishman, Wilbert S Aronow
{"title":"Anticoagulation in Patients With Gastrointestinal Disease.","authors":"Omar Alkasabrah, Jaishkar Ramesh, Radhe Kinner Shah, Muhammad Qasim Chaudhry, Faiza Aman Jajja, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001301","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001301","url":null,"abstract":"<p><p>Gastrointestinal (GI) disease complicates anticoagulation by simultaneously increasing bleeding risk and maintaining high thromboembolic vulnerability. Mucosal injury, portal hypertension, malignancy, inflammatory bowel disease, and vascular lesions predispose to hemorrhage, whereas interruption of therapy increases the risk of stroke, venous thromboembolism, and stent thrombosis. Contemporary management follows an indication-first, risk-balanced approach that integrates thrombotic urgency, GI disease phenotype, and patient-specific bleeding-risk factors. Direct oral anticoagulants demonstrate heterogeneous GI bleeding profiles, with higher risk observed with dabigatran and rivaroxaban, while apixaban is comparatively safer in high-risk populations. Periprocedural management is guided by procedural bleeding risk, renal function, and drug pharmacokinetics, with strategies emphasizing appropriate interruption and minimal use of bridging. In acute GI bleeding, management prioritizes hemodynamic stabilization, restrictive transfusion strategies, and early endoscopic or interventional radiology-guided source control, with selective use of reversal agents in severe cases. Adjunctive measures, including proton pump inhibitor therapy and Helicobacter pylori eradication, reduce recurrent bleeding risk. Resumption of anticoagulation is generally associated with improved survival and reduced thromboembolic events when timed appropriately. Key knowledge gaps remain regarding optimal reversal strategies, lesion-specific restart timing, and management in cirrhotic populations.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834049","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}
引用次数: 0
Global Longitudinal Strain as a Surveillance Tool in Hematologic Cancer-Related Cardiotoxicity. 整体纵向应变作为血液学癌症相关心脏毒性的监测工具。
IF 2.3 4区 医学
Cardiology in Review Pub Date : 2026-05-06 DOI: 10.1097/CRD.0000000000001292
Jatin Thukral, Pyush Moudgil, Ninaad Sindhwani, Sakshi Makkar, Jasmine Kaur, Abhay Mann, Riya Kaushal Shah, Harbir Kaur, Siddharth Pravin Agrawal, Nikhil Thukral, William H Frishman, Wilbert S Aronow
{"title":"Global Longitudinal Strain as a Surveillance Tool in Hematologic Cancer-Related Cardiotoxicity.","authors":"Jatin Thukral, Pyush Moudgil, Ninaad Sindhwani, Sakshi Makkar, Jasmine Kaur, Abhay Mann, Riya Kaushal Shah, Harbir Kaur, Siddharth Pravin Agrawal, Nikhil Thukral, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001292","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001292","url":null,"abstract":"<p><p>Advances in the treatment of hematologic malignancies have significantly improved survival, leading to an increasing burden of cancer therapy-related cardiac dysfunction (CTRCD). Early detection of cardiotoxicity is critical, as conventional measures such as left ventricular ejection fraction often identify myocardial injury only after irreversible damage has occurred. Global longitudinal strain (GLS), derived from speckle-tracking echocardiography, has emerged as a sensitive and reproducible tool for detecting subclinical myocardial dysfunction. This review summarizes the role of GLS in the surveillance of cardiotoxicity in patients with hematologic malignancies. We discuss the pathophysiological basis of chemotherapy-induced myocardial injury, including oxidative stress, mitochondrial dysfunction, and inflammatory mechanisms. Evidence supporting GLS as a predictive and monitoring tool is examined across baseline risk stratification, treatment-related changes, and long-term outcomes. GLS consistently demonstrates earlier detection of myocardial dysfunction compared with left ventricular ejection fraction and provides prognostic value in diverse therapeutic settings, including anthracycline-based chemotherapy, hematopoietic stem cell transplantation, and novel immune-based therapies. The integration of GLS into cardio-oncology practice, particularly in combination with cardiac biomarkers, enhances early detection and risk stratification. Despite limitations such as intervendor variability and lack of standardized thresholds, GLS is increasingly incorporated into guideline-recommended surveillance strategies.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834178","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}
引用次数: 0
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