Canadian Journal of Cardiology最新文献

{"title":"Physical activity, sedentary behaviour, and cardiovascular disease risk factors in Canadians living with and without cardiovascular disease.","authors":"Jennifer L Reed, Danisha Zaman, Marisol T Betancourt, Cynthia Robitaille, Melissa Majoni, Christopher Blanchard, Carley D O'Neill, Stephanie A Prince","doi":"10.1016/j.cjca.2024.12.029","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.029","url":null,"abstract":"<p><strong>Background: </strong>To describe and compare the proportion of adult Canadians living with and without cardiovascular disease (CVD) meeting the physical activity (PA) and sedentary behaviour (SB) recommendations from the Canadian 24-Hour Movement Guidelines using accelerometer and self-reported measures.</p><p><strong>Methods: </strong>Using adult (aged 18-79 years) accelerometer data (Actical worn during waking hours for 7 consecutive days) as well as chronic condition, socio-demographic, recreational screen time, and PA questions from three combined cycles of the Canadian Health Measures Survey, the PA, SB, and CVD risk factors of adults living with and without CVD were compared.</p><p><strong>Results: </strong>A total of 7,035 Canadian adults who reported living with (n=363) and without (n=6,672) CVD were included. Few adults living with CVD were meeting the PA (29%) and SB (15%) recommendations. CVD status was not significantly associated with the likelihood of meeting the PA or screen time recommendations, but adults living with CVD had a lower likelihood of meeting the sedentary time recommendation when compared to adults without CVD (aOR=0.49, 95% CI: 0.30 - 0.82). Adults, primarily males, living with rather than without CVD engaged in less light and moderate intensity PA.</p><p><strong>Conclusion: </strong>The PA and SB of Canadian adults living with and without CVD are significantly different. Adults living with CVD had a lower likelihood of meeting the sedentary time recommendation, and adults living with CVD, primarily males, engaged in less light and moderate intensity PA. The identification of these movement behaviour targets may assist in allocating resources to sedentary individuals with the greatest need of PA.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Nitric oxide in the sweep gas for patients receiving Extracorporeal Membrane Oxygenation or Cardiopulmonary Bypass.","authors":"Roberto Chiletti, Sophie H Fincher, Stephen B Horton, Giles J Peek, Paul Checchia, Warwick Butt","doi":"10.1016/j.cjca.2024.12.027","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.027","url":null,"abstract":"<p><p>Nitric oxide (NO) was proclaimed the 1992 \"molecule of the year\" by Culotta in Science magazine because of its importance in neuroscience, physiology and immunology. Inhaled NO has been in clinical use for over 35 years to decrease pulmonary hypertension and improve oxygenation. Over the last 20 years there has been much research to understand the role of nitric oxide on cell surface receptors, mitochondria, and intracellular processes which involve calcium and superoxide radicals. This research has shown that, irrespective of the cause, NO has a major role in the systemic inflammatory response syndrome (SIRS) and ischaemia-reperfusion injury (IRI).¹ More recent clinical research has focused on NO use in patients undergoing cardiopulmonary bypass and receiving extracorporeal life support, with some centres incorporating nitric oxide into sweep gas as part of routine practice. This article reviews NO pathways in humans, the biological effects of NO, the interplay between nitric oxide and red blood cells, and animal and human studies on the effects of exogenously administered NO.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Problems using the cardiopulmonary exercise test in cardiac rehabilitation: it is time to retire outdated protocols and replace them with better ones.","authors":"Daniel A Keir","doi":"10.1016/j.cjca.2024.12.026","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.026","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter aortic valve replacement in aortic stenosis patients with New York Heart Association functional class III or IV.","authors":"Jorge Nuche, Jules Mesnier, Julien Ternacle, Effat Rezaei, Francisco Campelo-Parada, Marina Urena, Gabriela Veiga-Fernandez, Luis Nombela-Franco, Anna Franzone, Antonio J Munoz-Garcia, Victoria Vilalta, Ander Regueiro, David Del Val, Lluis Asmarats, Maria Del Trigo, Vicenc Serra, Guillaume Bonnet, Melchior Jonveaux, Ronan Canitrot, Dominique Himbert, Jose Maria de la Torre Hernandez, Gabriela Tirado-Conte, Eduard Fernandez-Nofrerias, Pedro Cepas, Fernando Alfonso, Lola Gutierrez-Alonso, Juan Francisco Oteo, Yassin Belahnech, Siamak Mohammadi, Thomas Modine, Marisa Avvedimento, Josep Rodés-Cabau, Asim N Cheema","doi":"10.1016/j.cjca.2024.12.025","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.025","url":null,"abstract":"<p><strong>Background: </strong>Patients with symptomatic aortic stenosis are a vulnerable population with associated cardiac damage and a significant comorbidity burden. This study aimed to determine the rate, factors associated with, and prognostic value of poor functional status (NYHA class III-IV) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).</p><p><strong>Methods: </strong>This multicenter study included 6,363 transarterial TAVR patients, classified according to baseline functional status (NYHA class I-II vs. III-IV).</p><p><strong>Results: </strong>A total of 3,800 (60%) patients presented an NYHA class III-IV before the TAVR procedure. Atrial fibrillation (OR:1.32,95%CI:1.11-1.58,p=0.002), chronic kidney disease (OR:1.73, 95%CI:1.45-2.05, p<0.001), COPD (OR:1.65,95%CI: 1.32-2.05), p<0.001), reduced LVEF (OR:2.28, 95%CI:1.70-3.05, p<0.001), and moderate and severe pulmonary hypertension were associated with a poor functional status. At 1-year follow-up, patients with NYHA class III-IV presented a higher rate of mortality (8.81 per 100 person-years, 95%CI: 7.57-10.15 vs. 13.12 per 100 person-year - 95%CI: 11.80-14.58, log-rank p<0.001) and heart failure hospitalization (8.25 per 100 person-years - 95%CI: 7.05-9.65 vs. 12.5 per 100 person-years - 95%CI: 11.24-14.00, log-rank p=0.005). Comorbidity factors (COPD, CKD) and signs of cardiac damage (atrial fibrillation, pulmonary hypertension) determined an increased risk of poorer clinical outcomes (p<0.01 for all).</p><p><strong>Conclusions: </strong>More than one-half of patients undergoing TAVR in the contemporary era presented an advanced functional class before the procedure, and this was associated with a greater comorbidity and cardiac damage burden. Patients with poorer baseline functional status exhibited worse clinical outcomes at 1-year follow-up. These findings highlight the importance of future studies on earlier interventions for aortic stenosis patients.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking Down Bias: A Methodological Primer on Identifying, Evaluating, and Mitigating Bias in Cardiovascular Research.","authors":"Nicholas Grubic, Amy Johnston, Varinder K Randhawa, Karin H Humphries, Laura C Rosella, Katerina Maximova","doi":"10.1016/j.cjca.2024.12.022","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.022","url":null,"abstract":"<p><p>Systematic error, often referred to as bias is an inherent challenge in observational cardiovascular research, and has the potential to profoundly influence the design, conduct, and interpretation of study results. If not carefully considered and managed, bias can lead to spurious results, which can misinform clinical practice or public health initiatives and compromise patient outcomes. This methodological primer offers a concise introduction to the identification, evaluation, and mitigation of bias in observational cardiovascular research studies assessing the causal association of an exposure (or treatment) on an outcome. Using high-profile examples from the cardiovascular literature, this review provides a theoretical overview of three main types of bias - selection bias, information bias, and confounding - and discusses the implications of specialized types of biases commonly encountered in longitudinal cardiovascular research studies, namely, competing risks, immortal time bias, and confounding by indication. Furthermore, strategies and tools that can be used to minimize and assess the influence of bias are highlighted, with a specific focus on using the target trial framework, directed acyclic graphs, quantitative bias analysis, and formal risk of bias assessments. This review aims to assist researchers and healthcare professionals in designing observational studies and selecting appropriate methodologies to reduce bias, ultimately enhancing the estimation of causal associations in cardiovascular research.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefit of systematic \"jailed wire\" technique for bifurcation provisional stenting. A CABRIOLET sub-study.","authors":"François Dérimay, Aurélien Mercier, Adel Aminian, Luc Maillard, Géraud Souteyrand, Pascal Motreff, Benoit Lattuca, Guillaume Cayla, Gilles Rioufol, Gérard Finet","doi":"10.1016/j.cjca.2024.12.021","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.021","url":null,"abstract":"<p><strong>Background: </strong>Jailed wire (JW) in the side branch (SB) is recommended during coronary bifurcation provisional stenting, but real benefit is unsure. Our objective was to evaluate benefit of a JW technique in the CABRIOLET registry.</p><p><strong>Methods: </strong>In CABRIOLET, including 500 patients, we compared the primary composite endpoint poor final SB angiographic result (TIMI flow<III, dissection grade>B, thrombosis, residual stenosis>70%, or additional SB stenting) whether JW was performed or not. Based on the usual operators practices, we also compared a systematic JW strategy: operators known to place JW frequently (>75% performed), to a conditional strategy: selective JW practices (<20% of JW).</p><p><strong>Results: </strong>JW was performed in 251 patients (50.2%), without significant baseline clinical and angiographic differences with no-JW. JW was associated with higher primary endpoint (15.1% vs 8.4%, p<0.05), increased fluoroscopy time and contrast volume (15.9±7.3 min and 181±62 ml vs. 13.3±6.5 min and 161±74 ml, p<0.05). JW was performed in 12.1% of patients (26/214) in conditional JW group and 78.7% (225/286) in systematic. The primary endpoint was similar in both strategies (11.2% and 12.2%, p=0.78), although with greater fluoroscopy time and contrast volume for systematic JW (180±57 ml and 15.3±7.5 min vs. 162±79 ml and 13.7±6.1 min, p<0.05). There was no difference in 1-year major adverse cardiovascular events depending on JW was performed or not and between conditional or systematic strategies.</p><p><strong>Conclusions: </strong>In a large registry, JW was associated with poorer final SB angiographic results than no-JW. Final SB angiographic result was similar between conditional or systematic JW strategies.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Acquisition of Cardiovascular Adaptation to Aerobic Exercise: When Does It Begin and How Does It Evolve Depending on Intrinsic and Extrinsic Factors?","authors":"Fabian Sanchis-Gomar, Marco V Perez, Carme Perez-Quilis, Giuseppe Lippi, Carl J Lavie, François Haddad, Jeffrey W Christle, Jonathan Myers","doi":"10.1016/j.cjca.2024.12.023","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.023","url":null,"abstract":"<p><p>The acquisition and evolution of cardiovascular (CV) adaptation to physical activity or exercise training are critical in enhancing cardiorespiratory fitness (CRF) and reducing CV disease (CVD) risk. CV adaptations to exercise occur through structural, functional, and molecular changes that enhance cardiac efficiency. These adaptations, such as increased stroke volume, improved blood pressure regulation, and enhanced endothelial function, collectively reduce CVD morbidity and mortality. This review explores how cardiovascular adaptations vary across different demographics, highlighting the importance of exercise timing, intensity, and recovery periods. It delves into the immediate physiological responses to physical activity, such as increased heart rate and cardiac output, and the longer-term adaptations, including cardiac hypertrophy and improved vascular function. The influence of age, sex, and pre-existing health conditions on cardiovascular responses to exercise is also discussed, emphasizing the need for tailored exercise interventions. Finally, the review highlights the significance of recovery periods in optimizing cardiovascular adaptations and how insufficient recovery may lead to adverse outcomes. Overall, understanding the timing and evolution of cardiovascular adaptations can inform exercise prescriptions to improve cardiovascular health across populations for the primary and secondary prevention of CVD.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the time right for preventive cardiology guidelines on sedentary behaviors and sitting time?","authors":"Julie Riopel-Meunier, Paul Poirier, Jean-Pierre Després, Marie-Eve Piché","doi":"10.1016/j.cjca.2024.12.024","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.024","url":null,"abstract":"<p><p>This review looks into sedentary behavior (SB) beyond its simplistic definition of \"sitting\" while also including sedentary activities. It explores the definition, physiological characteristics, prevalence, and guidelines of SB, contrasting it with physical activity (PA). The discussion encompasses: 1) the association between SB and mortality, with a specific focus on cardiovascular (CV) outcomes; 2) biological mechanisms linking SB to CV health, differentiating between the impacts of acute and chronic sitting additionally, 3) sex and gender differences in SB and, 4) SB as an independent CV risk factor are explored. The review concludes with an examination of the potential beneficial effects of PA on mitigating the detrimental impacts of SB and an analysis of evidence supporting the use of break-up strategies in preventive cardiology. This analysis sheds light on the significant CV health deleterious consequences of SB. It highlights the potential of incorporating strategies to reduce and interrupt prolonged sitting alongside existing guidelines promoting PA. These findings suggest considering SB as a major CV risk factor, emphasizing the importance of targeting SB reduction and interruption as a valuable approach for preventing and managing CV disease. However, further research is needed to determine the long-term effectiveness of SB interventions, informing the development of optimal guidelines for CV health management.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First in Canada use of novel heart preservation system.","authors":"Lebei Pi, Vivek Rao, Filio Billia, Diego Delgado, Michael McDonald, Yas Moayedi, Juglans Alvarez","doi":"10.1016/j.cjca.2024.12.019","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.019","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation of Left Ventricular Function and Myocardial Microstructure in Fetuses with Right Ventricular Hypoplasia.","authors":"Jing Ma, Yuman Li, Haiyan Cao, Yaping Yuan, Shizhen Chen, Liu Hong, Li Zhang, Xin Zhou, Mingxing Xie","doi":"10.1016/j.cjca.2024.12.020","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.020","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate changes in left ventricular (LV) function and myocardial microstructure in fetuses with right ventricular hypoplasia (RVH) using two-dimensional speckle tracking echocardiography (2D-STE), diffusion tensor cardiovascular magnetic resonance imaging (DT-CMR) and proteomics analysis.</p><p><strong>Methods: </strong>51 singleton fetuses diagnosed with RVH and 51 normal fetuses were retrospectively included. LV global longitudinal strain (GLS) and global circumferential strain (GCS) were acquired by 2D-STE. Fraction anisotropy (FA), mean diffusivity (MD) and helix angle were measured using DT-CMR in four fetal specimens with RVH and three normal fetal specimens. Bioinformatics analysis was performed for differentially expressed proteins between RVH and normal specimens.</p><p><strong>Results: </strong>In RVH fetuses, LVGLS and regional longitudinal strain were significantly lower than in controls (p<0.001), whereas LV sphericity index and LVGCS were increased. In RVH fetuses, FA was higher in middle and apical segments than in normal fetuses (p<0.001). LV MD was reduced in all the segments (p<0.001). Circumferentially oriented myocytes and left-handed oriented myocytes were increased, but right-handed orientated myocytes were decreased (p<0.001). Using proteomics, 95 myocardial proteins differed with upregulation of 66 and downregulation in RVH, hearts including myocardial contractile fibrillar proteins and cell membrane protein complexes.</p><p><strong>Conclusions: </strong>In fetal RVH, the left ventricle demonstrates altered function with reduced longitudinal but augmented circumferential strain which may support its need to augment its preload and consequent cardiac output. Decreased right-handed and increased circumferentially oriented myocytes may contribute to this adaptation. The left ventricle in fetal RVH also demonstrates a differential expression of various myocardial proteins.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}