Canadian Journal of Cardiology最新文献

{"title":"Persistent Hypoxemia Following Redo Tricuspid Valve Surgery: A Vicious Cycle of Shunting.","authors":"Nadhem Abdallah, Marcel Rivard, Robert Shapiro, Mengistu A Simegn, Andrew Shaffer, Gautam R Shroff","doi":"10.1016/j.cjca.2025.03.009","DOIUrl":"10.1016/j.cjca.2025.03.009","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633541","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":"Obesity and Public Health-Dare We Have Hope?","authors":"Yoni Freedhoff","doi":"10.1016/j.cjca.2025.02.037","DOIUrl":"10.1016/j.cjca.2025.02.037","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633539","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":"Atrial Functional Mitral Regurgitation: from Echo to the surgical view.","authors":"Michele Galeazzi, Marco Rolando, Paolo Berretta, Olimpia Bifulco, Marco Di Eusanio","doi":"10.1016/j.cjca.2025.03.006","DOIUrl":"10.1016/j.cjca.2025.03.006","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623440","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 Implantation vs Surgical Aortic Valve Replacement in Patients at Lower Surgical Risk: Meta-analysis of Randomized Trials.","authors":"Tsahi T Lerman, Noam Greenberg, Mark Kheifets, Yeela Talmor-Barkan, Pablo Codner, Leor Perl, Guy Witberg, Katia Orvin, Alon Eisen, Tzlil Grinberg, Keren Skalsky, Yaron Shapira, David Belkin, Troels Højsgaard Jørgensen, Hans Gustav Hørsted Thyregod, Ole De Backer, Boris Fishman, Ran Kornowski, Amos Levi","doi":"10.1016/j.cjca.2025.02.036","DOIUrl":"10.1016/j.cjca.2025.02.036","url":null,"abstract":"<p><strong>Background: </strong>The use of transcatheter aortic valve implantation (TAVI) for severe aortic stenosis is expanding to patients across the entire spectrum of surgical risk. We performed a meta-analysis and compared TAVI with surgical aortic valve replacement (SAVR) in trials that enrolled lower-risk patients.</p><p><strong>Methods: </strong>We conducted a meta-analysis of randomized controlled trials and compared safety and efficacy outcomes between TAVI and SAVR among lower-risk patients (mean and/or median Society of Thoracic Surgeons [STS] score < 4). Point-estimate meta-analysis and reconstructed individual patient data survival analysis were conducted. Primary outcomes included all-cause mortality, stroke, and a composite of all-cause mortality or disabling stroke (PROSPERO, CRD42024541837).</p><p><strong>Results: </strong>The analysis included 6 randomized controlled trials, totaling 2668 TAVI and 2573 SAVR patients, with a mean follow-up time of 3.02 years. TAVI was associated with lower risk of all-cause mortality (risk ratio, 0.68; 95% confidence interval, 0.52-0.88) and a composite of all-cause mortality or disabling stroke (risk ratio, 0.69; 95% confidence interval, 0.55-0.86) without a significant difference in stroke up to 2 years. Longer-term point-estimate analysis showed no difference. In reconstructed individual patient data, TAVI was associated with a lower risk of all-cause mortality, driven by an early advantage. Restricted mean survival time differences for primary outcomes were < 2.5 months and ≤ 1 month for all-cause mortality. TAVI was associated with a lower risk of bleeding, kidney injury, and atrial fibrillation, but a higher risk of pacemaker implantation and moderate to severe aortic regurgitation.</p><p><strong>Conclusions: </strong>In patients at lower surgical risk, TAVI was associated with improved short-term mortality. More data from long-term studies are needed.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613370","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":"Personalized Treatment of Severe Obstructive Hypertrophic Cardiomyopathy: Combining Septal Reduction Therapy and Myosin Inhibitors.","authors":"Josef Veselka, Ladislav Dusek, Klara Hulikova Tesarkova","doi":"10.1016/j.cjca.2025.03.003","DOIUrl":"10.1016/j.cjca.2025.03.003","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596230","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":"Understanding the Hemodynamic Basis of Angiotensin Receptor Neprilysin Inhibitor Intolerance: Reason for Frustration or New Motivation?","authors":"Micha T Maeder","doi":"10.1016/j.cjca.2025.03.005","DOIUrl":"10.1016/j.cjca.2025.03.005","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584181","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":"Frailty as a Potential Modifier in the Triad of Cardiovascular Disease, Physical Activity, and Sedentary Behaviour.","authors":"Kuo-Chin Hung, Chia-Ter Chao","doi":"10.1016/j.cjca.2025.03.004","DOIUrl":"10.1016/j.cjca.2025.03.004","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584815","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 vs Clopidogrel in Cancer Patients Undergoing Percutaneous Coronary Intervention.","authors":"Mauro Gitto, Samantha Sartori, Birgit Vogel, Pier Pasquale Leone, Kenneth Smith, Benjamin Bay, Prakash Krishnan, Joseph Sweeny, Angelo Oliva, Pedro Moreno, Sean Gilhooley, Francesca Maria Di Muro, Parasuram Melarcode Krishnamoorthy, Annapoorna Kini, George Dangas, Roxana Mehran, Samin Sharma","doi":"10.1016/j.cjca.2025.02.035","DOIUrl":"10.1016/j.cjca.2025.02.035","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer undergoing percutaneous coronary intervention (PCI) experience a higher risk of both ischemic and bleeding events. The aim of this study was to assess ischemic and bleeding risks after PCI in cancer patients treated with potent P2Y12 inhibitors (P2Y12i; prasugrel and ticagrelor) compared with clopidogrel.</p><p><strong>Methods: </strong>Consecutive patients with cancer undergoing PCI at a tertiary center between 2012 and 2022 and discharged on P2Y12i were included in this study. Propensity score covariate adjustment was used to account for baseline differences between patients treated with potent P2Y12i and clopidogrel. Key clinical endpoints included major adverse cardiac and cerebrovascular events (MACCEs---composite of death, myocardial infarction, or stroke) and major bleeding.</p><p><strong>Results: </strong>Of the 1702 included patients, 373 (21.9%) were treated with potent P2Y12i and 1329 (78.1%) with clopidogrel. Factors associated with potent P2Y12i use were acute coronary syndrome presentation and lesion length, whereas clopidogrel use was associated with active cancer status, thrombocytopenia, older age, and femoral access. MACCEs at 1 year occurred in 3.5% of patients treated with potent P2Y12i vs 6.8% of those receiving clopidogrel (log-rank test, P = 0.035; adjusted hazard ratio [adj HR] 0.53, 95% confidence interval [CI] 0.26-1.10), but no differences in bleeding risk were detected (5.5% vs 7.0%, adj HR 0.92, 95% CI 0.53-1.60). The reduction in MACCEs was significant in patients with remission but not active cancer (P_interaction = 0.011).</p><p><strong>Conclusions: </strong>Among cancer patients undergoing PCI, potent P2Y12i use was associated with similar bleeding risk and lower incidence of ischemic events compared with clopidogrel, but with no significant difference after propensity score adjustment.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584816","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":"Refining Prognostication and Therapeutic Guidance Through Advances in Right Heart Imaging Approaches.","authors":"Hoda Mombeini, Valentina Mercurio, Ryan Osgueritchian, Julia Grapsa, Jiwon Kim, Monica Mukherjee","doi":"10.1016/j.cjca.2025.03.002","DOIUrl":"10.1016/j.cjca.2025.03.002","url":null,"abstract":"<p><p>There is growing consensus on the importance of accurately assessing right heart size and function because of its critical relationship with cardiac outcomes across a wide range of cardiovascular diseases. The right heart plays a central role in maintaining cardiac performance, making its assessment essential for diagnosis, management, and prognostication. The need for precise and reliable assessment tools has led to substantial advancements in imaging technology, which have been used to successfully address many of the challenges posed by the unique and complex anatomy of the right heart chambers. In this review we underscore the evolving role of multimodality imaging in risk stratification, therapeutic guidance, and outcome prediction. Further advancements in technology and clinical integration are essential to optimizing care and improving outcomes for patients with cardiovascular disease. We will delve into the strengths and limitations of multimodality techniques and their applicability in different clinical scenarios to equip clinicians with insights into selecting the most appropriate modality for specific cardiac conditions. Additionally, we underscore the practical implications of these imaging modalities in guiding clinical decisions and improving patient outcomes.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583717","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":"Early Potentially Irreversible Cardiac Damage in Fabry Disease Precedes Gb3 Inclusion Body Formation.","authors":"Chung-Lin Lee, Pei-Sin Chen, Yu-Ying Lu, Yu-Ting Chiang, Ching-Tzu Yen, Chun-Ying Huang, Yen-Fu Cheng, Hsiang-Yu Lin, Yun-Ru Chen, Dau-Ming Niu","doi":"10.1016/j.cjca.2025.03.001","DOIUrl":"10.1016/j.cjca.2025.03.001","url":null,"abstract":"<p><strong>Background: </strong>Fabry disease (FD) is a lysosomal storage disorder impacting multiple organs, including the heart. In this study we investigated whether early-stage globotriaosylceramide (Gb3) accumulation, occurring before the formation of inclusion bodies, could cause significant stress and potentially irreversible damage of the cardiac tissue in patients with FD.</p><p><strong>Methods: </strong>Immunofluorescent staining and Western blotting were performed on fibroblasts from FD IVS4 patients and myocardial biopsies from G3Stg/GLAko mice as well as 3 IVS4 patients (aged 44, 37, and 41 years). Notably, all biopsies showed detectable Gb3 accumulation under immunoflourescence (IF) but lacked the typical pathology of FD (Gb3 inclusion bodies). Staining targeted nuclear factor-kappaB (NF-κB), interleukin-18 (IL-18), phospho-p42/44 mitogen-activated protein kinase (MAPK), and inducible nitric oxide synthase (iNOS) as markers of inflammation and oxidative stress. In addition, α-smooth muscle actin (α-SMA) IF staining was conducted to identify myofibroblasts.</p><p><strong>Results: </strong>Fibroblasts from FD patients, along with cardiac tissues from both G3Stg/GLAko mice and FD patients, exhibited significant accumulation of inflammatory markers such as NF-κB IL-18, and phospho-p42/44 MAPK, as well as the oxidative stress marker iNOS. Despite the absence of typical FD pathology, the presence of fibrogenesis was confirmed in myocardial biopsies from these patients through strong positive staining of α-SMA.</p><p><strong>Conclusions: </strong>Significant cellular stress and potential irreversible damage may occur before the onset of typical pathologic changes in the cardiac tissues of FD patients. Our findings raise an intriguing question: Should enzyme replacement therapy be initiated much earlier than currently recommended? To answer this, validation through rigorous randomized controlled trials is needed to draw definitive conclusions.</p>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584814","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}