Cardiovascular diagnosis and therapy最新文献

{"title":"Early and late outcomes after Cardioband procedure in patients with atrial and non-atrial functional tricuspid regurgitation.","authors":"Piera Ciaramella, Francesco Candido, Marco Russo, Antonio Giovanni Cammardella, Amedeo Pergolini, Federico Ranocchi","doi":"10.21037/cdt-24-407","DOIUrl":"10.21037/cdt-24-407","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 6","pages":"991-993"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of myocardial perfusion imaging techniques and artificial intelligence (AI) tools in coronary artery disease (CAD) diagnosis through multi-criteria decision-making method.","authors":"Hasan Erdagli, Dilber Uzun Ozsahin, Berna Uzun","doi":"10.21037/cdt-24-237","DOIUrl":"10.21037/cdt-24-237","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVDs) continue to be the world's greatest cause of death. To evaluate heart function and diagnose coronary artery disease (CAD), myocardial perfusion imaging (MPI) has become essential. Artificial intelligence (AI) methods have been incorporated into diagnostic methods such as MPI to improve patient outcomes in recent years. This study aims to employ a novel approach to examine how parameters/criteria and performance metrics affect the prioritization of selected MPI techniques and AI tools in CAD diagnosis. Identifying the most effective method in these two interconnected areas will increase the CAD diagnosis rate.</p><p><strong>Methods: </strong>The study includes an in-depth investigation of popular convolutional neural network (CNN) models, including InceptionV3, VGG16, ResNet50, and DenseNet121, in addition to widely used machine learning (ML) models, including random forests (RF), K-nearest neighbor (KNN), support vector machine (SVM), and Naïve Bayes (NB). In addition, it includes the evaluation of nuclear MPI techniques, including positron emission tomography (PET) and single photon emission computed tomography (SPECT), with the non-nuclear MPI technique of cardiovascular magnetic resonance imaging (CMR). Various performance metrics were used to evaluate AI tools. They are F1-score, recall, specificity, precision, accuracy, and area under the receiver operating characteristic curve (AUC-ROC). For MPI techniques, the evaluation criteria include specificity, sensitivity, radiation dose, cost of scan, and study duration. The analysis was evaluated and compared using the fuzzy-based preference ranking organization method for enrichment evaluation (PROMETHEE), the multi-criteria decision-making method (MDCM).</p><p><strong>Results: </strong>According to the study's findings, considering selected performance metrics or criteria, RF is the most efficient AI tool for SPECT MPI in the diagnosis of CAD with a net flow (<i>Φ^net</i> ) of 0.3778, and it's revealed that CMR is the most efficient MPI technique for CAD diagnosis with a net flow of 0.3666. By expanding this study, more comprehensive evaluations can be made in the diagnosis of CAD.</p><p><strong>Conclusions: </strong>It was concluded that CMR outperformed the nuclear MPI techniques. SPECT, as the least advantageous technique, remained below average on other criteria except for the cost of the scan. Integrating the RF algorithm, which stands out as the most effective AI tool in diagnosing CAD, with SPECT MPI may contribute to SPECT becoming a superior alternative.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 6","pages":"1134-1147"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Let us pay more attention to performing coronary function assessment for multivessels!","authors":"Hiroki Teragawa, Chikage Oshita, Yu Hashimoto","doi":"10.21037/cdt-24-454","DOIUrl":"10.21037/cdt-24-454","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 6","pages":"998-1002"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged pre-catheterization fasting: do the risks outweigh the benefits?","authors":"Anand Shah, George A Stouffer","doi":"10.21037/cdt-24-395","DOIUrl":"10.21037/cdt-24-395","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 6","pages":"1020-1024"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of sodium-glucose cotransporter 2 inhibitors on the triglyceride-glucose index in acute myocardial infarction patients with type 2 diabetes mellitus.","authors":"Kai Wang, Tingting Fan, Fei He, Haoliang Li, Yu Fang, Guangquan Hu, Xiaochen Wang","doi":"10.21037/cdt-24-287","DOIUrl":"10.21037/cdt-24-287","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As a novel oral anti-hyperglycemic agent, sodium-glucose cotransporter 2 inhibitors (SGLT2-i) have been demonstrated to improve cardiovascular outcomes in acute myocardial infarction (AMI) patients with type 2 diabetes mellitus (T2DM). However, the mechanism responsible for the beneficial effects remains unclear. Recently, extensive studies have demonstrated a close relationship between elevated fasting triglyceride-glucose (TyG) index and the risk of AMI. Additionally, research has identified that SGLT2-i can reduce the TyG index in T2DM patients. However, it remains ambiguous whether the benefit of SGLT2-i in patients with AMI and T2DM is due to an improvement in the TyG index. Consequently, we aimed to assess the impact of SGLT2-i on the TyG index in AMI patients with T2DM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective and cross-sectional study was conducted on 180 AMI patients with T2DM admitted to the chest pain center of the Second Affiliated Hospital of Anhui Medical University from January 2020 to January 2023. Based on the hypoglycemic regimens administered after admission, the patients were categorized into a control group (79 cases treated with sulfonylureas, α-glycosidase inhibitors, metformin, etc.) and a SGLT2-i group (101 cases administered with dapagliflozin or empagliflozin). Propensity score matching (PSM) was adopted to balance the baseline characteristics of patients and minimize selection bias to confirm the robustness of the results. After PSM, control group remained 32 patients, and SGLT2-i group remained 37 patients. All patients underwent regular follow-up after discharge, and comparisons were made between the two groups in terms of clinical indicators and major adverse cardiovascular events (MACEs) in 1 year. Univariate and Multivariate Cox regression analysis was performed to identify the predictors of MACE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant differences were observed between the two groups in terms of various parameters before PSM, included age, proportion of insulin use, Gensini score, serum creatinine (Cr), total cholesterol (TC), and cardiac troponin I (cTnI). After PSM, there were no statistically significant differences in baseline clinical indicators and laboratory tests. The median follow-up period was 11 months in both cohorts. The comparison of follow-up results between the two groups after matching confirmed statistically significant differences in triglyceride (TG) reduction index reduction, left ventricular end-diastolic diameter (LVDD) reduction, and white blood cell (WBC) reduction in the SGLT2-i group (all P&lt;0.05). Additionally, a higher incidence of MACEs was observed in the control group (P=0.01). Univariate analysis showed that usage of SGLT2-i, Cr, low-density lipoprotein cholesterol (LDL-C), TyG index at baseline, and changes of TyG index (TyG at follow-up minus TyG at baseline) were associated with the risk of MACE. However, multivariate analysis showed on","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 6","pages":"1096-1107"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning paving the way for successful antegrade crossing of total chronic coronary occlusions.","authors":"Philipp Breitbart, Dirk Westermann, Grigorios Korosoglou","doi":"10.21037/cdt-24-423","DOIUrl":"10.21037/cdt-24-423","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 6","pages":"1007-1010"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superiority of coronary paclitaxel DCBs to limus DCBs in the late angiographic outcomes: the first meta-analysis showing the differences of coronary DCBs.","authors":"Kota Yamada, Tetsuya Ishikawa, Yohei Tamura, Isao Taguchi","doi":"10.21037/cdt-24-391","DOIUrl":"10.21037/cdt-24-391","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 6","pages":"1025-1028"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated volumetry of core and peel intrapulmonary vasculature on computed tomography angiography for non-invasive estimation of hemodynamics in patients with pulmonary hypertension (2022 updated hemodynamic definition).","authors":"Claudius Melzig, Oliver Weinheimer, Benjamin Egenlauf, Thuy D Do, Mark O Wielpütz, Ekkehard Grünig, Hans-Ulrich Kauczor, Claus Peter Heussel, Fabian Rengier","doi":"10.21037/cdt-24-293","DOIUrl":"10.21037/cdt-24-293","url":null,"abstract":"<p><strong>Background: </strong>Computed tomography pulmonary angiography (CTPA) is frequently performed in patients with pulmonary hypertension (PH) and may aid non-invasive estimation of pulmonary hemodynamics. We, therefore, investigated automated volumetry of intrapulmonary vasculature on CTPA, separated into core and peel fractions of the lung volume and its potential to differentially reflect pulmonary hemodynamics in patients with pre- and postcapillary PH.</p><p><strong>Methods: </strong>A retrospective case-control study of 72 consecutive patients with PH according to the 2022 joint guidelines of the European Society of Cardiology and the European Respiratory Society who underwent right heart catheterization (RHC) and CTPA within 7 days between August 2013 and February 2016 at Thoraxklinik at Heidelberg University Hospital (Heidelberg, Germany) was conducted. Vessel segmentation was performed using the in-house software YACTA. Vascular volumes in different core and peel fractions of the lung were corrected for body surface area. Spearman correlation coefficients with mean pulmonary arterial pressure (mPAP), pulmonary arterial wedge pressure (PAWP) and pulmonary vascular resistance (PVR) were calculated, and a linear regression analysis was done to account for potential confounders.</p><p><strong>Results: </strong>Median age of the study sample was 71.5 years [interquartile range (IQR), 60.0-77.0 years], 48 (66.67%) were female. Median mPAP was 35.5 mmHg (IQR, 27.0-47.2 mmHg). Postcapillary PH was present in 24/72 (33.3%) patients and precapillary PH in 48/72 (66.7%) patients. Moderate to strong correlations between core intrapulmonary vessel volumes and mPAP were observed in postcapillary PH patients with a maximum at 50% core lung volume (r=0.71, P<0.001). No significant influence of age or sex on this relationship was identified. Correlation with RHC measurements was weak or negligible in patients with precapillary PH.</p><p><strong>Conclusions: </strong>Automated volumetry of vessels in the core lung strongly correlated with mPAP in patients with postcapillary PH and has potential for non-invasive assessment of postcapillary PH in patients undergoing CTPA.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 6","pages":"1083-1095"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional speckle-tracking echocardiography-derived deformation analysis of the morphologic left ventricle in adults with corrected dextro-transposition of the great arteries-insights from the CSONGRAD Registry and MAGYAR-Path Study.","authors":"Árpád Kormányos, Nándor Gyenes, Zoltán Ruzsa, Alexandru Achim, Nóra Ambrus, Kálmán Havasi, Máté Vámos, Tamás Szili-Török, Csaba Lengyel, Attila Nemes","doi":"10.21037/cdt-24-266","DOIUrl":"10.21037/cdt-24-266","url":null,"abstract":"<p><strong>Background: </strong>Dextro-transposition of the great arteries (dTGA) stands out as a prevalent cyanotic congenital heart defect (CHD), characterized by an intricate reversal in the arrangement of the major arteries. In the past, several surgical procedures have been used to treat dTGA, including the atrial switch. Although the method is no longer used, survivors of the procedure still living among us. Recent advancements in cardiovascular imaging have led to the emergence of several novel echocardiographic techniques, notably three-dimensional (3D) and/or speckle-tracking echocardiography (STE). The present study aimed to employ 3DSTE to determine morphologic left ventricle (mLV) strain parameters in adults with dTGA who underwent Senning or Mustard procedure at infancy. Furthermore, it was also aimed to assess whether the type of correction procedure had any impact on mLV deformation parameters.</p><p><strong>Methods: </strong>Eleven dTGA patients, with a mean age of 28.8±8.5 years (6 males, 6 Senning- and 5 Mustard-operated patients) were enrolled. They were compared to 34 healthy controls matched for age and gender (age: 35.7±12.8 years, 21 males). All subjects underwent complete two-dimensional (2D) Doppler echocardiography with 3DSTE data acquisition as per recent guidelines.</p><p><strong>Results: </strong>Comparing all dTGA patients to the control group no mean segmental or global mLV strains showed significant differences, however out of the regional strains, midventricular mLV longitudinal strain was significantly better (higher) in dTGA compared to the healthy group (-16.8%±7.4% <i>vs.</i> -13.3%±2.5%, P<0.05). The Mustard-operated patients showed significantly worse (lower) global mLV circumferential strain compared to that of controls (-22.1%±12.4% <i>vs.</i> -28.9%±4.7%, P=0.05). Out of the regional strains the Mustard procedure group had a significantly worse (lower) apical mLV circumferential strain (-24.8%±11.9% <i>vs.</i> -35.6%±9.0%, P=0.05), better (higher) midventricular mLV longitudinal strain (-20.1%±9.2% <i>vs.</i> -13.3%±2.5%, P=0.04) and a worse (lower) apical mLV area strain (-36.3%±17.0% <i>vs.</i> -48.8%±9.7%, P=0.03).</p><p><strong>Conclusions: </strong>Significant mLV strain abnormalities are present in dTGA late after atrial switch procedures. These differences are more pronounced in the Mustard-operated group.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 6","pages":"1038-1047"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive models of in-hospital deterioration of Society of Cardiovascular Angiography and Intervention shock stage in patients with acute myocardial infarction initially presenting with stable hemodynamic condition.","authors":"Takuto Mukaida, Yu Kataoka, Kota Murai, Kenichiro Sawada, Takamasa Iwai, Hideo Matama, Satoshi Honda, Masashi Fujino, Shuichi Yoneda, Kensuke Takagi, Kazuhiro Nakao, Fumiyuki Otsuka, Yoshio Tahara, Yasuhide Asaumi, Teruo Noguchi","doi":"10.21037/cdt-24-226","DOIUrl":"10.21037/cdt-24-226","url":null,"abstract":"<p><strong>Background: </strong>The Society of Cardiovascular Angiography and Intervention (SCAI) has defined 5 stages of cardiogenic shock (CS). In patients with acute myocardial infarction (AMI) who initially present in stable hemodynamic condition (SCAI CS stage: A or B), CS stages could deteriorate despite therapeutic management. However, deterioration of SCAI CS stages after AMI remains to be fully characterized. Therefore, the current study sought to investigate the frequency and clinical characteristics about deterioration of SCAI CS stages after AMI.</p><p><strong>Methods: </strong>We retrospectively analyzed 347 patients in a derivation cohort and 163 patients in a validation cohort who had AMI (SCAI shock stage upon arrival: A/B) and underwent percutaneous coronary intervention (PCI) at National Cerebral and Cardiovascular Center, Suita, Japan (enrolment period of study subjects: 2019.07.01-2022.09.30). Deterioration of CS (D-CS) was defined as SCAI shock stage C-E after PCI. Clinical characteristics and in-hospital mortality were compared according to D-CS status. Adjusted hazard ratios (HRs) for in-hospital mortality were calculated with multivariate Cox proportional hazards models that included variables with P<0.10 in univariate models. Uni- and multivariate logistic regression analyses were used to identify predictors of D-CS.</p><p><strong>Results: </strong>D-CS occurred in 17.3% (60/347) of the derivation cohort. Patients with D-CS had lower systolic blood pressure (BP) (P<0.001) and left ventricular ejection fraction (LVEF) (P<0.001) upon arrival with a higher proportion of initial Thrombolysis in Myocardial Infarction (TIMI) grade flow 0 or 1 (P=0.002). During hospitalization (13.9±9.4 days), D-CS was associated with higher in-hospital mortality [adjusted HR, 12.95; 95% confidence interval (CI): 1.46-114.97; P=0.02]. Initial systolic BP, LVEF, and TIMI grade flow 0 or 1 independently predicted D-CS. The D-CS risk score including these variables satisfactorily predicted D-CS [area under the curve (AUC), 0.749; 95% CI: 0.651-0.848] and in-hospital mortality (AUC, 0.961; 95% CI: 0.914-1.000) in the validation cohort.</p><p><strong>Conclusions: </strong>D-CS occurred in 17.3% of patients with AMI initially presenting in stable condition and increased the risk of in-hospital mortality. Our D-CS risk score (initial systolic BP, LVEF, and TIMI grade flow) could be helpful to predict D-CS.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 6","pages":"1148-1160"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}