Canadian Journal of Cardiology最新文献

{"title":"Sex Differences and Correlates of the Utility of the Cardiopulmonary Exercise Test for Prescribing Exercise at Entry to Cardiac Rehabilitation.","authors":"Susan Marzolini, Paul Oh, James E Peterman, Phillip Wallace, Azadeh Yadollahi, Fernando Rivera-Theurel, Carolina Carvalho, Leonard A Kaminsky","doi":"10.1016/j.cjca.2024.11.022","DOIUrl":"10.1016/j.cjca.2024.11.022","url":null,"abstract":"<p><strong>Background: </strong>Despite the importance of objective measures for prescribing aerobic exercise for mitigating cardiovascular risk in people with coronary artery disease (CAD), no study has examined sex differences in the utility of the cardiopulmonary exercise test (CPET) for developing the exercise prescription.</p><p><strong>Methods: </strong>CPET results from 1352 females and 5875 males with CAD were analysed to determine if there was a sex difference in achieving maximal oxygen uptake (V˙O_2max) or an identifiable first ventilatory threshold (VT₁). Secondary outcomes were to determine correlates of not achieving V˙O_2max or VT₁ in all patients and in males and females separately.</p><p><strong>Results: </strong>A greater proportion of males than females achieved V˙O_2max or VT₁ (89.7% vs 71.3%; P < 0.001) as well as specifically achieving V˙O_2max (40.2% vs 26.7%; P < 0.001) and VT₁ (88.0% vs 69.2%; P < 0.001). The most influential correlates of not achieving V˙O_2max or VT₁ were female sex (odds ratio 3.1, 95% confidence interval 2.6-3.7), age > 60 years, tested on treadmill vs cycle, depressive symptoms, and a secondary heart failure diagnosis. At entry to cardiac rehabilitation, these correlates were more prevalent in females than in males. Correlates differed by sex. The threshold for when age affected achieving V˙O_2max or VT₁ on the cycle CPET was earlier for females (> 50 years of age) than for males (> 70 years of age) with no difference on treadmill (> 80 years of age for both).</p><p><strong>Conclusions: </strong>Although most patients achieved V˙O_2max or VT₁ on the CPET, females were 3 times less likely than males to achieve V˙O_2max or VT₁. Strategies to improve utility of CPETs for females, such as alternative exercise test protocols and investigation into underlying mechanisms for effects of depressive symptoms, should be conducted.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738499","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":"Vascular Dysfunction Across the Lifespan-Why Cardiovascular Risk Reduction Is Important in Congenital Heart Disease.","authors":"Anita T Cote, Kevin C Harris","doi":"10.1016/j.cjca.2024.11.021","DOIUrl":"10.1016/j.cjca.2024.11.021","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715496","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":"Selecting an Aortic Valve Prosthesis in Patients Younger Than 65 Years of Age-Operative Risk vs Long-Term Survival.","authors":"Harold L Lazar","doi":"10.1016/j.cjca.2024.11.019","DOIUrl":"10.1016/j.cjca.2024.11.019","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695320","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":"Macrophages in Cardiovascular Fibrosis: Novel Subpopulations, Molecular Mechanisms, and Therapeutic Targets.","authors":"Ran Li, Xiaohan Li, Xi Zhang, Jizhang Yu, Yuan Li, Shuan Ran, Song Wang, Zilong Luo, Jiulu Zhao, Yanglin Hao, Junjie Zong, Kexiao Zheng, Longyong Lai, Han Zhang, Pinyan Huang, Cheng Zhou, Jie Wu, Weicong Ye, Jiahong Xia","doi":"10.1016/j.cjca.2024.11.018","DOIUrl":"10.1016/j.cjca.2024.11.018","url":null,"abstract":"<p><p>Cardiovascular fibrosis is a common pathological process that contributes to the development and progression of various cardiovascular diseases. Despite being widely believed to be an irreversible and relentless process, preclinical models and clinical trials have shown that cardiovascular fibrosis is an extremely dynamic process. Additionally, as part of the innate immune system, macrophages are heterogeneous cells that are pivotal in tissue regeneration and fibrosis. They participate in fibroblast activation, extracellular matrix remodelling, and the regression of fibrosis. Although we have made some advances in understanding macrophages in cardiovascular fibrosis, a gap still remains between their identification and conversion into effective treatments. Moreover, the traditional M1-M2 paradigm faces many challenges because it does not sufficiently clarify macrophage diversity and their functions. Exploring novel macrophage-based therapies is urgent for cardiovascular fibrosis treatment. Single-cell techniques have shed light on identifying novel subpopulations that differ in function and molecular signature under steady-state and pathological conditions. In this review, we outline the developmental origins of macrophages, which underlie their functions; and recent technology development in the single-cell era. In addition, we describe the markers and mediators of the newly defined macrophage subpopulations and the molecular mechanisms involved to elucidate potential approaches for targeting macrophages in cardiovascular fibrosis.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695331","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":"Bureaucratic Dissonance and Inertia: Barriers to the Effective and Equitable Implementation of Cardiovascular Guideline-Directed Medical Therapy in Canada.","authors":"Jafna L Cox","doi":"10.1016/j.cjca.2024.10.019","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.10.019","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811985","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":"Are the Cardiovascular Benefits and Potential Risks of Physical Activity and Exercise Dependent on Race, Ethnicity, or Sex?","authors":"Daniel T Tardo, Michael Papadakis","doi":"10.1016/j.cjca.2024.11.013","DOIUrl":"10.1016/j.cjca.2024.11.013","url":null,"abstract":"<p><p>Physical activity (PA) is established as a cornerstone of cardiovascular health, however, disparities in participation exist across sociocultural groups, which in turn affect cardiovascular outcomes. Evidence suggests that although the positive cardiovascular effects of exercise are consistent across populations, notable differences in the magnitude of these benefits exist for racial and ethnic minorities and the female sex. Women derive greater protection from PA compared with men, with reduced rates of sudden cardiac death. In this review we examine the complex interplay of race and/or ethnicity and sex on the cardiovascular benefits associated with PA and exercise, cardiovascular adaptations to exercise, risks of sudden cardiac death, and \"excessive\" volume of exercise. Understanding these factors is crucial for developing targeted interventions to promote cardiovascular health and offset disparities.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638443","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":"Absolute and Relative Risk of Exercise: When in Doubt, Let Them Play.","authors":"Paul Dorian, Noah D H Lewis, Paul Angaran, Kim A Connelly","doi":"10.1016/j.cjca.2024.10.006","DOIUrl":"10.1016/j.cjca.2024.10.006","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646874","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":"Dofetilide and Flecainide Combination: The Serendipity of Successful Treatment of Atrial Fibrillation After Failed Ablation.","authors":"Daniel A N Mascarenhas, Bharat K Kantharia","doi":"10.1016/j.cjca.2024.11.015","DOIUrl":"10.1016/j.cjca.2024.11.015","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643510","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":"Comprehensive Prevention of Exercise-Related Sudden Cardiac Arrest or Death.","authors":"Nathaniel Moulson, Julien Wiese, Bradley J Petek, Reid Mitchell, Saul Isserow, James McKinney","doi":"10.1016/j.cjca.2024.11.014","DOIUrl":"10.1016/j.cjca.2024.11.014","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643505","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":"Diagnostic Value of Combined Light and Electron Microscopic Examination in Endomyocardial Biopsy in Patients With Cardiac Amyloidosis.","authors":"Masayoshi Yamamoto, Yu Yamada, Taketaro Sadahiro, Kimi Sato, Tomoko Machino-Ohtsuka, Nobuyuki Murakoshi, Masaki Ieda, Tomoko Ishizu","doi":"10.1016/j.cjca.2024.11.007","DOIUrl":"10.1016/j.cjca.2024.11.007","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in imaging techniques, endomyocardial biopsy remains the gold standard for confirming cardiac amyloidosis (CA) and defining the amyloid type. Electron microscopy may detect amyloid deposits with greater sensitivity than light microscopy; however, its capabilities have not been thoroughly investigated.</p><p><strong>Methods: </strong>Patients with pathologically diagnosed CA were prospectively enrolled. Myocardial specimens were collected from the right ventricular septum, and light and electron microscopy were performed on the samples to compare their efficacy in detecting amyloid deposits.</p><p><strong>Results: </strong>Sixty-five patients were pathologically diagnosed with CA, including 13 with light-chain amyloidosis, 51 with transthyretin amyloidosis, and 1 with unclassified amyloidosis. Amyloid deposits were detected through both examinations in 60 (92.3%) of the 65 patients. However, they were detected through only light microscopy in 2 cases (3.1%) and only electron microscopy in 3 cases (4.6%). Patients with amyloid deposits detected through a single method had reduced thickness of the intraventricular septal wall (9.5 vs 15.1 mm, P = 0.001), lower left ventricular (LV) mass index (94 vs 147 g/m², P = 0.013), greater LV diastolic dimension (45 vs 41 mm, P = 0.044), lower left ventricular ejection fraction (49% vs 57%, P = 0.004), lower mean pulmonary capillary wedge pressure (9 vs 19 mm Hg, P = 0.021), and lower right atrial pressure (4 vs 8 mm Hg, P = 0.043) than did those in whom they were detected using both methods.</p><p><strong>Conclusions: </strong>Concomitant use of electron microscopy may improve the detection rate of amyloid deposits and prevent CA misdiagnosis, especially in patients with atypical features such as mild hypertrophy or eccentric hypertrophy with LV systolic dysfunction.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615266","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}