Canadian Journal of Cardiology最新文献

{"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}

{"title":"Extracorporeal membrane oxygenation for patients with electrical storm or refractory ventricular arrhythmias: Management and outcomes.","authors":"Reha Kumar, Jennifer M Amadio, Adriana C Luk, Abhishek Bhaskaran, Andrew C T Ha","doi":"10.1016/j.cjca.2024.12.018","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.018","url":null,"abstract":"<p><p>Patients on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are at high risk for ventricular arrhythmias due to derangements in myocardial perfusion, hemodynamics, and heightened catecholamine states. Existing data on the management and outcomes of patients with electrical storm or refractory ventricular tachycardia/fibrillation (VT/VF) treated with VA-ECMO are primarily derived from retrospective observational studies. Typical survival rates are in the range of 40-50%, with 15-20% of patients undergoing VT ablation and 30-40% of patients requiring advanced heart failure therapies (cardiac transplant or durable left ventricular assist device). Similarly, there is a paucity of published data on VT/VF management for patients whilst on VA-ECMO as it is largely extrapolated from patients with electrical storm. Although many of the treatment principles (identifying reversible causes, anti-arrhythmic drugs, VT ablation, and reduction of adrenergic tone) are translatable, several aspects require special consideration when managing VT/VF in the VA-ECMO patient population. Among carefully selected patients on VA-ECMO who underwent VT ablation, reported recurrence rates were ∼30% and a sizeable proportion of them (30-40%) required advanced heart failure therapy as an exit strategy. As well, there are specific issues which require consideration for patients on VA-ECMO who undergo VT ablation such as vascular access, ECMO access site complications, and bleeding due to systemic anticoagulation. Optimal management of VT/VF in this patient population requires ongoing reassessment and dialogue among electrophysiology, heart failure, and critical care specialists. Additional research is needed in order to better inform the care of this very high-risk patient population.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863436","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":"How does the dose and type of exercise impact acute cardiovascular function in healthy individuals?","authors":"Robert F Bentley, Nino Nikolovski, Jack M Goodman","doi":"10.1016/j.cjca.2024.12.016","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.016","url":null,"abstract":"<p><p>During aerobic exercise, the cardiovascular system is tasked with delivering oxygen to active skeletal muscle via muscle blood flow while regulating mean arterial blood pressure. The impact of aerobic exercise on acute cardiovascular function may be modulated by the dose and type of exercise. Acutely, dose is the product of exercise intensity and time, while the exercise type may refer to common aerobic modalities like cycling, running, swimming or rowing. Each modality is unique for their medium of completion as well as the implications on blood flow arising from the position of active muscle mass relative to heart level. The purpose of this review was to address how an acute exercise dose influences cardiovascular function between prominent aerobic exercise modalities in healthy individuals. Across all modalities, all doses may transiently reduce both left and right ventricular systolic and diastolic function as well as both macro and micro -vascular function. However, accurately quantifying and comparing exercise dose across the literature is challenging due to methodological differences in exercise prescription and the cardiovascular demands imposed by differing modalities of exercise. Further, potential confounding influence of cardiovascular drift alongside variation in age, the composition of cohorts with respect to biological sex and timing of cardiovascular measures further complicates interpretation. Future work should focus on exercise intensity prescription according to modality specific physiological thresholds in order to provide a comparable dose. This approach may serve to standardize the physiological stimulus and allow for objective assessments to be compared with confidence.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852929","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":"Genetics, Fitness and Left Ventricular Remodeling: The Current State of Play.","authors":"Stephanie J Rowe, Youri Bekhuis, Amy Mitchell, Kristel Janssens, Paolo D'Ambrosio, Luke W Spencer, Elizabeth D Paratz, Guido Claessen, Diane Fatkin, Andre La Gerche","doi":"10.1016/j.cjca.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.017","url":null,"abstract":"<p><p>Cardiorespiratory fitness (CRF) exists on a spectrum and is driven by a constellation of factors including genetic and environmental differences. This results in wide inter-individual variation in baseline CRF and the ability to improve CRF with regular endurance exercise training. As opposed to monogenic conditions, CRF is described as a complex genetic trait as it is believed to be influenced by multiple common genetic variants in addition to exogenous factors. Importantly, CRF is an independent predictor of morbidity and mortality and therefore understanding the impact of genetic variation on CRF may provide insights into both human athletic performance and also personalised risk assessment and prevention. Despite rapidly advancing technology, progress in this field has been restricted by small sample sizes and the limited number of genetic studies utilizing the gold-standard objective measure of peak oxygen consumption (VO₂peak) for CRF assessment. In recent years, there has been increasing interest in the heritability of numerous parameters of cardiac structure and function and how this might relate to both normal cardiac physiology and disease pathology. Regular endurance training can result in exercise-induced cardiac remodeling which manifests as balanced dilation of cardiac chambers and is associated with superior CRF. This results in a complex relationship between CRF, cardiac size and exercise, and whether shared genetic pathways may influence this remains unknown. This review will highlight recent and relevant studies in to the genomic predictors of CRF with a unique emphasis on how this may relate to cardiac remodeling and human adaption to endurance exercise.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833916","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":"Exertional Dyspnea with an Elevated Right Ventricular Systolic Pressure: Is it the Heart, the Lungs, or Both?","authors":"Stephen P Wright, Nathan W Brunner, John T Granton, Susanna Mak","doi":"10.1016/j.cjca.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.015","url":null,"abstract":"<p><p>Pulmonary hypertension (PH) is a highly prevalent hemodynamic condition that occurs as a complication of circulatory, pulmonary, and systemic disorders, increases right ventricular (RV) afterload, and confers adverse prognosis. For patients experiencing chronic dyspnea, echocardiographic screening may raise suspicion for PH. Untangling its cause(s) can then be challenging, as the circulatory and pulmonary systems are functionally interlinked and diseases in both often co-exist, but is essential to appropriately select therapies that may unload the RV. Here, we highlight advances in the hemodynamic assessment of PH, with a focus on using exercise to clarify the underlying pathophysiology to better individualize management.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833915","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":"Definition, Classification, and Management of Primary Non-Cardiac Causes of Cardiogenic Shock.","authors":"Tiffany Yuen, Janek M Senaratne","doi":"10.1016/j.cjca.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.014","url":null,"abstract":"<p><p>Cardiogenic shock is a complex syndrome presenting with a critical state of cardiac output insufficient to support end-organ perfusion requirements. Contemporary cardiogenic shock classification recognizes broad categories of primary cardiac etiologies of cardiogenic shock, such as acute myocardial infarction and heart failure. Primary non-cardiac etiologies of cardiogenic shock, however, are poorly described in literature and have not been captured by any contemporary classification, leading to challenges in diagnosing and managing these cases. In this review, we propose that primary non-cardiac causes of cardiogenic shock be recognized as its own category that builds on the original Shock Academic Research Consortium classification with its own additional modifiers. We present a detailed framework that groups each non-cardiac cause by its underlying disease mechanism (vascular, infectious, inflammatory, traumatic, toxic, cancer-related, endocrine, metabolic) and review available literature on their respective management strategies. We expect that the ability to classify primary non-cardiac causes of cardiogenic shock will help with early identification and targeted management of the primary non-cardiac insult, support patients through their shock state, and may lead to improvement of in-hospital cardiogenic shock mortality rates in clinical practice. Moreover, this new framework can further assist clinical trial classifications to properly phenotype cardiogenic shock for clinical research purposes.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827533","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 metabolically resistant apelin-17 analog LIT01-196 reduces cardiac dysfunction and remodeling in heart failure after myocardial infarction.","authors":"Pierre-Emmanuel Girault-Sotias, Robin Deloux, Nadia De Mota, Stephanie Riche, François Daubeuf, Xavier Iturrioz, A Parlakian, Alain Berdeaux, Onnik Agbulut, Dominique Bonnet, Solene Boitard, Catherine Llorens-Cortes","doi":"10.1016/j.cjca.2024.11.034","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.11.034","url":null,"abstract":"<p><strong>Background: </strong>To protect patients after myocardial infarction (MI) and preserve cardiac function, the development of new therapeutics remains an important issue. Apelin, a neuro-vasoactive peptide, increases aqueous diuresis and cardiac contractility while reducing vascular resistance. However, its in vivo half-life is very short. We therefore developed a metabolically resistant apelin-17 analog, LIT01-196 and investigated its effects on cardiac function and remodeling in a murine MI model.</p><p><strong>Methods: </strong>The selectivity of LIT01-196 towards ApelinR was checked in vitro. Its in vivo half-life was assessed in male Swiss mice by radioimmunoassay. After permanent coronary artery ligation to induce MI, mice received subcutaneous administration of LIT01-196 (MI+LIT01-196, 9 mg/kg/day) or saline (MI+Vehicle) for 4 weeks. LV function was assessed using echocardiography and Millar catheter, vascular density by immunofluorescence and cardiac fibrosis by Sirius red staining. Real-time quantitative PCR measured mRNA expression of HF and fibrosis biomarkers and SERCA2.</p><p><strong>Results: </strong>The in vivo half-life of LIT01-196, a specific and selective ApelinR agonist, was two and a half hours. MI+LIT01-196 mice showed significantly improved LV function, reduced HF biomarkers and enhanced cardiac contractility and SERCA2 expression compared with MI+Vehicle. LIT01-196 treatment almost doubled cardiac vascular density and maintained LV wall thickness post-MI. It also significantly reduced cardiac fibrosis and fibrosis biomarkers, without decreasing arterial blood pressure.</p><p><strong>Conclusions: </strong>Chronic LIT01-196 treatment post-MI improves LV function without decreasing blood pressure, increases cardiac vascular density and reduces cardiac remodeling. This suggests that Apelin-R activation by LIT01-196, may constitute an original pharmacological approach for HF treatment after MI.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823852","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":"From the Valve to the Basket: Facilitated Balloon Valvuloplasty for Palliative Treatment of Severe Calcified Mitral Valve Stenosis.","authors":"Gianluca Pillitteri, Gerardo V Lo Russo, Angelo Squeri, Roberto Nerla, Fausto Castriota","doi":"10.1016/j.cjca.2024.12.013","DOIUrl":"10.1016/j.cjca.2024.12.013","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823848","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":"Your heart can't see what sneakers you are wearing: Exercise training load in endurance athletes is inadequately quantified in sports cardiology - A systematic review.","authors":"Christophe Dausin, Rafael Machado Tironi, Véronique Cornelissen, Peter Hespel, Rik Willems, Mark Haykowsky, André La Gerche, Guido Claessen, Stephen Foulkes","doi":"10.1016/j.cjca.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.cjca.2024.12.009","url":null,"abstract":"<p><strong>Background: </strong>Training load may be an important factor underlying the (patho-)physiologic cardiovascular adaptations from endurance exercise. Yet quantifying training load remains challenging due to the complexity of its components (Frequency, Intensity, Time, and Type; F.I.T.T). This systematic review aims to evaluate how training load has been quantified in sports cardiology studies and to provide recommendations for how this can be improved.</p><p><strong>Methods: </strong>A comprehensive search was conducted across PubMed and EMBASE up to October 2024. Studies involving \"sports cardiology\", \"training load\", and \"endurance sport\" were included. Data extraction included study characteristics, training load assessment methods, cardiovascular outcomes, and athlete profiles.</p><p><strong>Results: </strong>A total of 62 studies with 1,060,700 participants were included. The majority of studies (59.7%) focused on exercise induced cardiac remodelling, while other topics included cardiac arrhythmias (12.9%), cardiac autonomic adaptation (3.2%), exercise dose-response (6.5%), and coronary heart disease (17.7%). Training load was primarily quantified by questionnaires (58.1%), while heart rate monitoring, a more objective measure, was used in only 1.6% of the studies. All studies reported exercise type, but only 19.4% measured all F.I.T.T components.</p><p><strong>Conclusion: </strong>There is a lack of uniformity in the assessment of key F.I.T.T variables to quantify training load within the field of sports cardiology, with many studies relying on subjective or incomplete methods. As cardiology moves into the precision medicine era, researchers and clinicians should seek to obtain objective training load information from their athletes according to the F.I.T.T framework, and data from objective wearable devices represent the optimal way to do this.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821942","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}