Canadian Journal of Cardiology最新文献

{"title":"The Present Status of the Intra-aortic Balloon Pump for Circulatory Support in Patients With Cardiogenic Shock and High-risk Percutaneous Coronary Intervention","authors":"Lance Ng MBChB, Vladimír Džavík MD","doi":"10.1016/j.cjca.2025.01.015","DOIUrl":"10.1016/j.cjca.2025.01.015","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 771-774"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001063","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":"Evaluating Volume and Resource Needs for Implementing an ST-Elevation Myocardial Infarction Shock Protocol","authors":"Rene Boudreau MD , Michel Le May MD , Nikita Malhotra MD , Cole Clifford MD , Quinton Barry MD , William Knoll MD , Morgane Laverdure MD , Taia Glover BSc , Wryan Helmeczi MD , Salar Farokhi Boroujeni BSc , Marino Labinaz MD , Alexander Dick MD , Christopher Glover MD , Michael Froeschl MD, MSc , Zeeshan Ahmed MD, MHPE , Omar Abdel-Razek MD, MSc , Pietro Di Santo MD , Sharon Chih MBBS, PhD , Rebecca Mathew MD , Munir Boodhwani MD , Derek Y.F. So MD, MSc","doi":"10.1016/j.cjca.2025.02.001","DOIUrl":"10.1016/j.cjca.2025.02.001","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 4","pages":"Pages 784-788"},"PeriodicalIF":5.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373849","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":"NOVEL THERAPIES FOR PATIENTS WITH SYSTEMIC RIGHT VENTRICLE.","authors":"Guillermo Agorrody, Danielle Massarella, Rafael Alonso-Gonzalez","doi":"10.1016/j.cjca.2025.03.028","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.03.028","url":null,"abstract":"<p><p>Systemic right ventricular dysfunction is a significant prognostic factor in congenital heart disease, particularly affecting patients with transposition of the great arteries post-atrial switch and congenitally corrected transposition of the great arteries. These patients often experience chronic pressure loading conditions, leading to structural, mechanical, and electrical adaptations that can result in heart failure. This paper reviews novel therapeutic approaches for managing systemic right ventricular failure in patients with adult congenital heart disease, focusing on pharmacologic, device-based, and advanced heart failure therapies. Traditional heart failure medications such as angiotensin converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARBs), beta-blockers, and mineralocorticoid receptor antagonists (MRAs) have shown mixed results in systemic right ventricular failure. However, newer agents like angiotensin receptor-neprilysin inhibitors (ARNI) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated promising outcomes in improving cardiac remodeling and function. Cardiac resynchronization therapy has shown benefits in selected patients, particularly those with prior ventricular pacing. Mechanical circulatory support and heart transplantation remain viable options for advanced heart failure, with recent studies indicating favorable long-term outcomes. The management of systemic right ventricular failure requires a personalized approach, considering the unique anatomical and physiological characteristics of each patient. While traditional therapies have limited efficacy, novel pharmacologic and device-based treatments might offer new hope for this patient population. Further research is needed to refine these strategies and identify new therapeutic targets.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771432","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":"Adult Height, Cardiovascular Disease, and the Underlying Mechanism: A Comprehensive Epidemiological and Genetic Analysis.","authors":"Jinyu Xiao, Jiayuan Li, Xueyao Wu, Yu Hao, Xunying Zhao, Wenqiang Zhang, Bin Xu, Tianpei Ma, Li Zhang, Rong Xiang, Huijie Cui, Chao Yang, Peijing Yan, Mingshuang Tang, Yutong Wang, Yang Qu, Lin Chen, Yunjie Liu, Yanqiu Zou, Ling Zhang, Zhenmi Liu, Yuqin Yao, Chunxia Yang, Ben Zhang, Xia Jiang","doi":"10.1016/j.cjca.2025.03.027","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.03.027","url":null,"abstract":"<p><strong>Background: </strong>Adult height measures the complete growth of an individual and influences the development of cardiovascular diseases (CVD). Despite recent within-sibling studies suggesting minimal impact from environmental confounders, biological mechanisms underlying the height-CVD relationship remain elusive.</p><p><strong>Methods: </strong>Leveraging the large-scale UK biobank dataset and summary statistics from the latest genome-wide association studies (GWAS), we re-evaluated the effect of height on 8 major CVD subtypes. Phenotypic associations were determined by Cox proportional hazard analysis. Putative causal relationships were assessed through univariable Mendelian randomization (MR). Mediation analysis and two-step MR were further performed to investigate the mediation effect of 15 common cardiometabolic or pulmonary risk factors.</p><p><strong>Results: </strong>Height was consistently associated with a decreased risk of coronary artery disease (CAD), confirmed by both epidemiological (HR = 0.90, 95%CI = 0.88-0.91) and genetic (OR = 0.89, 95%CI = 0.86-0.92) analysis. Forced vital capacity (FVC) was identified as the most significant mediator for height-CAD relationship by both epidemiological (proportion mediated (PM) = 65.6%, 95%CI = 53.1%-78.0%) and genetic (PM = 46.2%, 95%CI = 5.0%-87.5%) analysis. Notably, obesity, blood pressure, lipids, and C-reactive protein also exhibited significant mediatory effects. Despite a consistent risk effect of height on atrial fibrillation (AF) and venous thromboembolism (VTE), no promising mediator was identified.</p><p><strong>Conclusion: </strong>Our study confirms the health impact of height on CAD, AF and VTE and emphasizes FVC as the primary pathway linking height to CAD. Importantly, it indicates that the CAD risk associated with non-modifiable height could be mitigated through enhanced lung function and cardiometabolic conditions.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771421","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":"Who should be referred for tricuspid valve intervention?","authors":"Géraldine Ong, Thomas Attumalil, Alexandru Patrascu, Amr Gamal, Yazeed Almalki, Michael Ruiz, Sami Alnasser, Neil Fam","doi":"10.1016/j.cjca.2025.03.025","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.03.025","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) is a common condition that becomes more prevalent with age. Increasing severity of TR is linked to a poorer prognosis. Traditionally, surgery has been the primary treatment option, though outcomes have often been suboptimal. Recently, there has been growing interest in transcatheter interventions for TR, with a range of devices currently under development. These devices generally fall into three categories: valve repair, valve replacement and caval valve implantation. This article explores these various approaches and devices, offering insights into optimal patient selection to maximize therapeutic benefits.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751140","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":"Echocardiographic assessment of Right Ventricular Diastolic Function in Children and Adults: Present State and Future Directions.","authors":"Matthew Henry, Luc Mertens","doi":"10.1016/j.cjca.2025.03.024","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.03.024","url":null,"abstract":"<p><p>Diastolic function plays an important but often overlooked role in overall ventricular performance and is comprised of sequence of events which together result in adequate filling at low filling pressures. From a physiologic point of view there are two distinct, yet related periods that drive diastole: active relaxation and late filling. Much of the literature on diastolic function is based on the left ventricle however there are significant differences in morphology, physiology and adaptation between ventricles. Echocardiographic assessment of RV diastolic function is challenging due to our imperfect understanding in RV physiology, suboptimal imaging tools and the use of models that have been built using the left ventricle. Conventional assessment includes IVC size, RA volume and the use of Doppler to quantify tissue and blood velocity (TV E/A, e', a', E/e', IVRT, hepatic vein and pulmonary artery). In adults, TV E/A used in combination with e', IVC size, may be used to classify diastolic impairment however in children this is dependent to a greater degree on age and pathology. Right atrial and ventricular strain suffers from fewer limitations and may show incremental benefit however remains understudied, particularly in children. Novel methods made possible with ultrafast ultrasound provide a means to non-invasively assess intraventricular pressure differences as a measure of active relaxation, and shear wave velocity to directly assess myocardial stiffness, however these remain in pre-clinical stages. This review discusses right ventricular diastolic physiology, the current state and limitations of echocardiographic evaluation and explores promising new methods for its assessment.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751228","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":"Potent P2Y12 Inhibitors in Patients with Cancer Undergoing Percutaneous Coronary Intervention.","authors":"Francesco Costa, Jose Ignacio Larrubia Valle, Maria Victoria Garcia Ruiz","doi":"10.1016/j.cjca.2025.03.026","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.03.026","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751231","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":"Sex-Specific Associations of Cardiovascular Risk Factors with Subclinical Cardiac Remodeling: A Magnetic Resonance Imaging Study.","authors":"Maya S Verma, Kate Lindsay, Jiayi Ni, Matthias G Friedrich, Judy M Luu","doi":"10.1016/j.cjca.2025.03.023","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.03.023","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is the leading cause of death in women, yet sex-specific risk factor influences remain understudied. Cardiac magnetic resonance imaging (CMR) detects early remodeling via left ventricular mass-to-volume ratio (LVMV), a validated concentricity marker. This study examines sex differences in the association of CV risk factors, diet, and cardiac remodeling.</p><p><strong>Methods: </strong>We analyzed 622 age-matched adults (51% female, mean age 50.8 ± 9.5) from the Courtois Cardiovascular Signature Program. LVMV was defined as LV systolic mass divided by end-diastolic volume. Alcohol and sugar intake was self-rated on a Likert scale. Mann-Whitney U and regression analyses assessed sex-specific associations between CV risk factors and LVMV.</p><p><strong>Results: </strong>Hypertension was present in 20.6% of males and 17.4% of females; diabetes in 9.8% and 6.0%. Males had higher triglycerides, alcohol/sugar intake, and LVMV (0.92 ± 0.20 vs. 0.77 ± 0.18 g/ml). Hypertension correlated with higher LVMV in both sexes (males: ß=0.099, p<0.001; females: ß=0.078, p<0.05), while triglycerides (ß=0.032, p<0.05) and alcohol intake (H=19.41, p<0.0001) were male-specific predictors. In females, diabetes and sugar intake were significantly associated with LVMV (ß=0.102, ß=0.062, p<0.05).</p><p><strong>Conclusions: </strong>CV risk factors impact cardiac remodeling differently by sex. In males, LVMV was linked to triglycerides and alcohol intake, while in females, diabetes and sugar intake showed stronger associations. These results underscore the need for tailored cardiovascular prevention strategies that account for sex differences in metabolic and lifestyle risk factors.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751139","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":"Predictors of cardiovascular events in patients with Takayasu arteritis.","authors":"Shiping He, Zhan Rong, Yanhong Wang, Zhenbiao Wu, Hongbin Li, Lili Pan, Xinwang Duan, Lijun Wu, Hongfeng Zhang, Yunjiao Yang, Jing Li, Xiaofeng Zeng","doi":"10.1016/j.cjca.2025.03.022","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.03.022","url":null,"abstract":"<p><strong>Background: </strong>This study was aimed to analyze the factors associated with cardiovascular events and develop a prediction model to predict 10-year cardiovascular events probability in patients with Takayasu arteritis (TAK).</p><p><strong>Methods: </strong>Patients with TAK were prospectively enrolled from seven clinical centers between July 2013 and March 2021. The Cox proportional hazard regression was used to assess factors associated with cardiovascular events and develop a prediction model. The model performance was measured by Harrell's concordance index (C-index), Brier score and calibration plots. The nomogram was used to calculate the 10-year cardiovascular events probability.</p><p><strong>Results: </strong>A total of 702 patients (aged 29.2 ± 9.9 years; 623 [88.7%] women) were included. Cardiovascular events were observed in 94 patients (13.4%) after a median follow-up of 67 months (IQR 46-99). Elevated erythrocyte sedimentation rate (ESR) at disease onset (HR 2.30 [1.47-3.60]), pulmonary hypertension (HR 1.87 [0.93-3.77]), pulselessness (HR 1.73 [1.14-2.63]), diagnostic delay ≥ 3 years (HR 1.63 [1.01-2.65]), aortic regurgitation (HR 1.61 [1.01-2.56]), and age at diagnosis (HR 1.05 [1.02-1.07]) independently increased cardiovascular events and were included in the final model. The optimism-corrected C-index and Brier score of prediction model were 0.71 (0.66-0.76) and 0.072, respectively, and the calibration plots suggested good agreement between the observed and predicted probability of cardiovascular events.</p><p><strong>Conclusion: </strong>Patients with TAK were at high risk of cardiovascular events. Advanced age at diagnosis, diagnosis delayed over 3 years, pulselessness, pulmonary hypertension, aortic regurgitation, and elevated ESR at disease onset were risk factors for cardiovascular events.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742535","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":"Unveiling Estrogen's Protective Power in Women's Cardiovascular Health.","authors":"Amélie Paquin, Ana C Iribarren","doi":"10.1016/j.cjca.2025.03.020","DOIUrl":"https://doi.org/10.1016/j.cjca.2025.03.020","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742537","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}