Cardiology in Review最新文献_第10页

Osimertinib-Associated Cardiotoxicity in EGFR-Mutant Non-Small Cell Lung Cancer: Mechanisms, Phenotypes, and Surveillance. 奥西替尼相关的egfr突变非小细胞肺癌的心脏毒性：机制、表型和监测。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-08-24 DOI: 10.1097/CRD.0000000000001437

Sooraj Srirangadhamu Gopu, Abul Hasan Shadali Abdul Khader, Siddharth Pravin Agrawal, Salman Ayub Jajja, Anjali Pareshbhai Patel, William H Frishman, Wilbert S Aronow

{"title":"Osimertinib-Associated Cardiotoxicity in EGFR-Mutant Non-Small Cell Lung Cancer: Mechanisms, Phenotypes, and Surveillance.","authors":"Sooraj Srirangadhamu Gopu, Abul Hasan Shadali Abdul Khader, Siddharth Pravin Agrawal, Salman Ayub Jajja, Anjali Pareshbhai Patel, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001437","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001437","url":null,"abstract":"Osimertinib, a third-generation EGFR-TKI, is now the standard first-line treatment for EGFR-mutant non-small cell lung cancer and is increasingly given in the adjuvant setting for up to 3 years and in combination with chemotherapy. As exposure has lengthened and shifted toward curative-intent settings, its cardiac effects have acquired greater clinical weight, because patients may remain on therapy for years and survive long enough for cardiovascular outcomes to matter. This review argues that the dominant cardiac phenotype, a decline in left ventricular ejection fraction, with or without clinical heart failure, is best understood as an often reversible functional cardiomyopathy rather than structural myocardial injury. The neuregulin-1/ErbB signaling axis, which maintains adult cardiomyocyte function and whose disruption by trastuzumab causes a comparable reversible dysfunction, provides the lens for this interpretation, and off-target inhibition of ErbB2/ErbB4 has been proposed as a mechanism for osimertinib cardiotoxicity. That account is incomplete: the EGFR-TKIs that inhibit HER2 most potently do not carry the largest clinical signal, and a recently described GATA4-MYLK3-MYL2 contractile pathway offers an alternative, not clearly ErbB-dependent, mechanism. The proximal cause, therefore, remains unresolved, but across the available evidence, the dominant phenotype appears functional, contractile, and often reversible.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812000","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

Cardiovascular Effects of Kratom (Mitragyna speciosa). Kratom （Mitragyna speciosa）的心血管作用。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-08-24 DOI: 10.1097/CRD.0000000000001438

Christopher Wu, Sebastian Gastelum, Jonathan Al-Fakhoury, Nathaniel Bowes, Karam Khamashta, John Crupi, William H Frishman, Wilbert S Aronow

{"title":"Cardiovascular Effects of Kratom (Mitragyna speciosa).","authors":"Christopher Wu, Sebastian Gastelum, Jonathan Al-Fakhoury, Nathaniel Bowes, Karam Khamashta, John Crupi, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001438","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001438","url":null,"abstract":"Mitragyna speciosa (kratom) is an increasingly used product marketed for pain relief, mood enhancement, stimulation, and self-management of opioid withdrawal. Its principal alkaloids, mitragynine and 7-hydroxymitragynine, interact with μ-opioid, adrenergic, serotonergic, and dopaminergic receptors and may also influence cardiac ion channels and autonomic regulation. Experimental studies demonstrate inhibition of the human ether-à-go-go-related gene potassium channel, delayed ventricular repolarization, and potential effects on sodium and G-protein-coupled inwardly rectifying potassium channels. Clinically reported cardiovascular manifestations include tachycardia, hypertension, QTc prolongation, Brugada-pattern electrocardiographic abnormalities, ventricular arrhythmias, cardiac arrest, and possible myocardial or vascular injury. Kratom may also interact with cardiovascular medications through inhibition of cytochrome P450 enzymes and drug transporters, potentially altering exposure to β-blockers, antiarrhythmics, calcium-channel blockers, anticoagulants, and digoxin. Although preliminary studies have suggested possible anti-inflammatory, metabolic, antioxidant, and opioid-substitution benefits, these findings remain largely preclinical or observational. Interpretation of the available literature is limited by heterogeneous product composition, polysubstance exposure, inconsistent dosing, and reliance on case reports, toxicologic surveillance, and pharmacovigilance data. Greater clinical awareness and prospective research using standardized kratom preparations are needed to clarify its cardiovascular risks, potential benefits, and clinically relevant drug interactions.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811979","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

Pediatric Hyperlipidemia Guidelines: A Comprehensive Review of Screening, Diagnosis, and Management. 儿童高脂血症指南：筛查、诊断和治疗的综合综述。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-08-21 DOI: 10.1097/CRD.0000000000001433

Nhi D Nguyen, Tzvi Fishkin, Amgad N Makaryus, William H Frishman, Wilbert S Aronow

{"title":"Pediatric Hyperlipidemia Guidelines: A Comprehensive Review of Screening, Diagnosis, and Management.","authors":"Nhi D Nguyen, Tzvi Fishkin, Amgad N Makaryus, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001433","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001433","url":null,"abstract":"Atherosclerotic cardiovascular disease originates in childhood, and cumulative exposure to low-density lipoprotein cholesterol (LDL-C) is a major determinant of lifetime cardiovascular risk. Multiple professional societies have published guidelines for lipid screening, diagnosis, and management in pediatric populations; yet important differences exist among these recommendations. Our objective is to review and compare major pediatric dyslipidemia guidelines and identify areas of consensus, disagreement, and remaining evidence gaps. A narrative review was conducted to compare recommendations from major professional society guidelines on lipid screening, diagnostic criteria, lifestyle management, pharmacologic therapy, and management of hypertriglyceridemia. Across guidelines, there is broad agreement that lifestyle modification is first-line therapy and that statins are safe and effective for children with familial hypercholesterolemia. Key differences exist around universal screening, the age and LDL-C thresholds for statin initiation, LDL-C treatment targets, and the role of genetic testing. More recent guideline updates support earlier identification and treatment of pediatric dyslipidemia, particularly in children with familial hypercholesterolemia. Pediatric dyslipidemia guidelines are evolving toward earlier detection and more intensive management of lipid disorders in children. However, important evidence gaps remain, including limited long-term cardiovascular outcome data following childhood lipid-lowering therapy, insufficient pediatric evidence for newer lipid-lowering agents, and persistent disparities in access to screening.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788796","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

Informed Consent as Innovation: Redesigning Consent in the Age of AI and Immersive Medicine. 作为创新的知情同意：在人工智能和沉浸式医学时代重新设计同意。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-08-21 DOI: 10.1097/CRD.0000000000001440

Chase Goldberg, Tobias Whitford, Galal Elsayed, William Frishman, Mill Etienne

引用次数: 0

Updates on Imaging Modalities for the Diagnosis of Aortic Stenosis. 主动脉瓣狭窄影像学诊断的最新进展。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-08-20 DOI: 10.1097/CRD.0000000000001435

Hadi Itani, Mohamad B Moumneh, Ahmed Zayed, Arun Gajan Pradeep, Mohammad Ennab, Bahy Abofrekha, Omar Khaya, Jonathan Spagnola, William H Frishman, Wilbert S Aronow

{"title":"Updates on Imaging Modalities for the Diagnosis of Aortic Stenosis.","authors":"Hadi Itani, Mohamad B Moumneh, Ahmed Zayed, Arun Gajan Pradeep, Mohammad Ennab, Bahy Abofrekha, Omar Khaya, Jonathan Spagnola, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001435","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001435","url":null,"abstract":"Aortic stenosis (AS) is the most common degenerative valvular disease in elderly patients and is linked to high morbidity and mortality. Accurate diagnosis and risk stratification are critical for effective management. Transthoracic echocardiography is the standard diagnostic tool, but its reliance on flow-dependent parameters can lead to inconsistent grading, especially in low-flow, low-gradient, or normal-flow, low-gradient AS. Advanced echocardiographic methods, such as 3D imaging, stress echocardiography, and Doppler indices, such as the mean gradient-to-effective orifice area ratio, improve the evaluation of AS severity and assist in clinical decision-making. Computed tomography provides a flow-independent evaluation of AS. It uses noncontrast calcium scoring with sex-specific thresholds, along with contrast-enhanced angiography, for detailed anatomical assessment. These modalities are essential for procedural planning, particularly for transcatheter aortic valve replacement. Cardiac magnetic resonance (CMR) provides additional prognostic information. It quantifies myocardial remodeling and fibrosis, which are associated with outcomes and recovery potential. Emerging technologies are expanding diagnostic capabilities in AS. Examples include 18F-sodium fluoride positron emission tomography for detecting microcalcification, artificial intelligence-based ECG and echocardiography for early diagnosis, and 4D flow CMR. Integration of echocardiography, computed tomography, CMR, and emerging positron emission tomography and artificial intelligence-based approaches can help address diagnostic uncertainty. This integration helps refine AS subtype classification and inform individualized intervention strategies.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788823","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

Pacemakers in Pediatric Patients. 儿科患者的心脏起搏器。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-08-17 DOI: 10.1097/CRD.0000000000001429

Margot Richards, Lauren Tetelbaun, William H Frishman

引用次数: 0

Pompe Disease: From a Cardiovascular Lens. 庞贝病：从心血管透镜。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-08-14 DOI: 10.1097/CRD.0000000000001432

Abdullah Ali, Dinushan Thirumavalavan, John Nicholas Catanzaro, Tzvi Fishkin, Amgad N Makaryus, William H Frishman, Wilbert S Aronow

引用次数: 0

Complete Revascularization Versus Culprit-Only Percutaneous Coronary Intervention in Non-ST-Elevation Myocardial Infarction With Multivessel Disease: A Nationwide Propensity Score-Matched Analysis. 非st段抬高型心肌梗死合并多血管疾病患者的完全血运重建术与单纯经皮冠状动脉介入治疗：一项全国性倾向评分匹配分析

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-08-14 DOI: 10.1097/CRD.0000000000001431

Mohamed Hamouda Elkasaby, Alaa Ayyadhah Alanazi, William H Frishman, Wilbert S Aronow

{"title":"Complete Revascularization Versus Culprit-Only Percutaneous Coronary Intervention in Non-ST-Elevation Myocardial Infarction With Multivessel Disease: A Nationwide Propensity Score-Matched Analysis.","authors":"Mohamed Hamouda Elkasaby, Alaa Ayyadhah Alanazi, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001431","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001431","url":null,"abstract":"We used the National Inpatient Sample from 2016 to 2022 to compare complete revascularization with culprit-only percutaneous coronary intervention in adults hospitalized with non-ST-elevation myocardial infarction and multivessel disease. Hospitalizations complicated by cardiogenic shock, cardiac arrest, coronary artery bypass grafting, or mechanical circulatory support were excluded. Complete revascularization was defined as intervention on at least 2 native coronary territories during the index admission. We performed 1:1 propensity score matching on 52 covariates. The primary outcome was in-hospital major bleeding. Among 713,844 weighted hospitalizations (142,769 unweighted), 27.5% underwent complete revascularization. Matching yielded 37,048 well-balanced pairs (all standardized mean differences <0.01). Complete revascularization was associated with more major bleeding (12.22% vs 10.52%; odds ratio 1.18; 95% confidence interval, 1.13-1.24; P < 0.001), whereas in-hospital mortality was similar (1.01% vs 0.98%; P = 0.684). Major adverse cardiovascular events trended lower (14.61% vs 15.10%; P = 0.062), driven by less recurrent myocardial infarction (P = 0.034). Complete revascularization was also associated with a longer stay (3 vs 2 days) and higher cost ($127,536 vs $91,771; both P < 0.001). The excess bleeding was consistent across 17 subgroups and greatest in patients younger than 65 years (P for interaction < 0.001).","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758172","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

Ebstein's Anomaly: Contemporary Medical and Surgical Management Strategies. Ebstein的异常：当代医学和外科管理策略。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-08-13 DOI: 10.1097/CRD.0000000000001424

Cameron Levchuck, William H Frishman

引用次数: 0

Efficacy and Safety of Baxdrostat for Patients With Uncontrolled or Resistant Hypertension: A Systematic Review and Meta-Analysis. 巴司他对未控制或顽固性高血压患者的疗效和安全性：一项系统综述和荟萃分析。

IF 3.2 4区医学

Cardiology in Review Pub Date : 2026-08-13 DOI: 10.1097/CRD.0000000000001427

Ahmed Farid Gadelmawla, Ahmed W Hageen, Rahma Mogahed Rateb, Ahmed Diaa, Karim Atta, Amal A Alsubaiei, Najat Y AlSejari, Ali Saad Artam, Ameer Awashra, Haya Jebreen Mohammed Warasna, Elsayed S Moubarak, Abdullah M Alharran, William H Frishman, Wilbert S Aronow

{"title":"Efficacy and Safety of Baxdrostat for Patients With Uncontrolled or Resistant Hypertension: A Systematic Review and Meta-Analysis.","authors":"Ahmed Farid Gadelmawla, Ahmed W Hageen, Rahma Mogahed Rateb, Ahmed Diaa, Karim Atta, Amal A Alsubaiei, Najat Y AlSejari, Ali Saad Artam, Ameer Awashra, Haya Jebreen Mohammed Warasna, Elsayed S Moubarak, Abdullah M Alharran, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001427","DOIUrl":"10.1097/CRD.0000000000001427","url":null,"abstract":"We evaluated the efficacy and safety of baxdrostat in adults with uncontrolled or resistant hypertension. We searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL from inception to January 2026. We included randomized controlled trials that involved hypertension patients with resistance type and compared baxdrostat versus placebo. The primary outcomes were the changes in mean seated systolic blood pressure and diastolic blood pressure. Secondary outcomes included changes in estimated glomerular filtration rate (eGFR), serum potassium, and serum aldosterone. Three randomized controlled trials were finally included, comprising 1264 patients were followed for 12-24 weeks. Compared with placebo, baxdrostat reduced seated systolic blood pressure by 8.62 mm Hg [mean difference (MD) = -8.62, 95% confidence interval (CI), -10.55 to -6.70, P < 0.001] and seated diastolic blood pressure by 3.55 mm Hg (MD = -3.55, 95% CI, -4.81 to -2.28, P < 0.001). Baxdrostat lowered serum aldosterone by 4.03 ng/dL, reduced eGFR by 5.49 mL/min/1.73 m2, and increased serum potassium by 0.39 mmol/L. However, baxdrostat was associated with higher adverse events compared with the placebo. Baxdrostat lowers blood pressure and aldosterone levels in uncontrolled and resistant hypertension but increases potassium and modestly reduces eGFR, supporting careful laboratory monitoring and longer trials to evaluate long-term clinical outcomes.","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720493","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