Cardiovascular diagnosis and therapy最新文献

{"title":"Pulmonary hypertension in adults with congenital heart defects (ACHDs)-in light of the 2022 ESC PAH guidelines-part I: definition, epidemiology, classification, diagnostics, genetics, risk stratification and follow-up, gender aspects.","authors":"Harald Kaemmerer, Gerhard Paul Diller, Ingo Dähnert, Stephan Achenbach, Christina A Eichstaedt, Andreas Eicken, Annika Freiberger, Sebastian Freilinger, Ralf Geiger, Matthias Gorenflo, Ekkehard Grünig, Alfred Hager, Michael Huntgeburth, Ann-Sophie Kaemmerer-Suleiman, Rainer Kozlik-Feldmann, Astrid E Lammers, Nicole Nagdyman, Sebastian Michel, Kai Helge Schmidt, Mathieu Suleiman, Anselm Uebing, Fabian von Scheidt, Ulrike Herberg, Christian Apitz","doi":"10.21037/cdt-24-148","DOIUrl":"https://doi.org/10.21037/cdt-24-148","url":null,"abstract":"<p><p>The number of adults with congenital heart defects (ACHDs) is steadily increasing and is about 360,000 in Germany. Congenital heart defect (CHD) is often associated with pulmonary hypertension (PH), which sometimes develops early in untreated CHD. Despite timely treatment of CHD, PH not infrequently persists, redevelops in older age, and is associated with significant morbidity and lethality. The revised European Society of Cardiology (ESC)/European Respiratory Society (ERS) 2022 guidelines for the diagnosis and treatment of PH represent a significant contribution to the optimized care of those affected. However, the topic of \"adults with congenital heart defects\" is treated only relatively superficially in this context. In the present article, part I, therefore, this topic is commented on in detail from the perspective of congenital cardiology with a special focus on definition, epidemiology, classification, diagnostics, genetics, risk stratification and follow-up and gender aspects of PH in ACHDs. This paper consists of two parts. Part II will provide comments on the topics of supportive therapy, special situations like pregnancy, contraception, and non-cardiac surgery, targeted pharmacotherapy, organ transplantation, special management like shunt lesion, left ventricular disease, and univentricular hearts, interventions, intensive care, ACHDs follow-up and future perspective on PH in ACHDs. By examining these aspects in detail, this article aims to fill the gaps in the existing guidelines and provide a more thorough understanding from the perspective of congenital cardiology.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 5","pages":"935-948"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603243","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":"Role of STK38L in atrial fibrillation-associated myocardial fibrosis: findings from RNA-seq analysis.","authors":"Yu Zhang, Ru Zhang, Xiaochen Wang, Sihua Fang, Bangning Wang","doi":"10.21037/cdt-24-164","DOIUrl":"https://doi.org/10.21037/cdt-24-164","url":null,"abstract":"<p><strong>Background: </strong>Myocardial fibrosis is a key pathological feature of many cardiovascular diseases, leading to cardiac dysfunction. Transforming growth factor β1 (TGF-β1) induces the proliferation and activation of cardiac fibroblasts (CFs), key contributors to myocardial fibrosis. To explore the mechanism underlying myocardial fibrosis, we aimed to determine whether serine/threonine kinase 38 like (STK38L) contributes to the development of myocardial fibrosis by regulating the proliferation and activation of CFs triggered by TGF-β1.</p><p><strong>Methods: </strong>In this study, atrial tissue samples from atrial fibrillation (AF) patients with features of myocardial fibrosis (a category of atrial cardiomyopathy) and sinus rhythm (SR) patients without myocardial fibrosis were collected for RNA sequencing (RNA-seq). The specific molecule STK38L was identified. Primary mouse CFs were activated with TGF-β1 and subsequently transfected with STK38L-small interfering RNA (siRNA). The effect of STK38L-siRNA on fibroblast activation and proliferation was assessed using scratch and Cell Counting Kit-8 (CCK-8) assays. Furthermore, a mouse model of myocardial fibrosis induced by continuous subcutaneous injection of isoprenaline (ISO) was established to assess <i>STK38L</i> expression levels. Molecular experiments confirmed the expression of STK38L in fibrotic atrial tissues, ventricular tissues of ISO mouse, and primary CFs of neonatal mice.</p><p><strong>Results: </strong>We identified 1,870 genes exhibiting differential expression in the RNA-seq data between the AF and SR groups. Masson's trichrome staining revealed increased fibrosis in the heart tissues of the AF group. Elevated levels of STK38L were observed in the atrial tissues of the AF group and in the TGF-β1-stimulated primary mouse CFs. <i>In vitro</i>, STK38L knockdown suppressed mouse CFs activation and proliferation. Additionally, <i>in vivo</i> experiments showed that elevated mRNA levels of <i>STK38L</i>, periostin (<i>POSTN</i>), and collagen type I alpha 1 chain (<i>COL1A1</i>) in ISO-treated mouse hearts correlated with greater myocardial fibrosis, suggesting that STK38L plays an important role in the development of fibrosis.</p><p><strong>Conclusions: </strong>This study revealed a significant correlation between increased STK38L expression and AF characterized by atrial fibrosis as well as between STK38L expression and the TGF-β1-related induction of myocardial fibrosis. Additionally, STK38L knockdown was shown to suppress CFs activation and proliferation under TGF-β1 stimulation. These findings suggest an important role of STK38L in the development of fibrosis, and help screen for new strategies to treat this complex disease.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 5","pages":"798-809"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603247","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 optical coherence tomography for guidance of percutaneous coronary intervention for coronary bifurcation disease: a review of current clinical applications.","authors":"Yang Li, Ryoji Nagoshi, Amane Kozuki, Yoichi Kijima, Yaling Han, Junya Shite","doi":"10.21037/cdt-24-163","DOIUrl":"https://doi.org/10.21037/cdt-24-163","url":null,"abstract":"<p><p>Percutaneous coronary intervention (PCI) for coronary bifurcation disease remains one of the most challenging situations in interventional cardiology in terms of procedural success rates and long-term cardiac events. Optical coherence tomography (OCT), with a higher signal-to-noise ratio and the ability to distinguish plaque components, can display the true condition of bifurcation lesions without overlapping or shortening and achieve detailed visualization of vascular structures, which is superior to those of other imaging modalities. Three-dimensional (3D) reconstruction of OCT images (3D-OCT) helps to gain a more informed understanding of the geometry and morphology of bifurcation lesions and provide additive information on plaque distribution. Following stent implantation, 3D-OCT can also guide the re-crossing of guide wires through stent struts jailing the side branch (SB) ostium and more clearly display the jailing strut configuration, as well as the ideal position of the guidewire recrossing point and stent struct link connection, to confirm the optimal guidewire position and understand interactions between stents and vessel walls, which may improve clinical results after PCI. The present review provides an up-to-date overview of the clinical use of 3D-OCT for accurate assessment of bifurcation anatomy, guiding the optimal guidewire rewiring into SB during bifurcation stenting, and evaluation of post-PCI results, offering novel information about atherosclerotic disease or stenting process.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 5","pages":"949-957"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603274","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":"The image of a disabled person in art through the ages.","authors":"Liudmila Alexeevna Zotova, Victoria Alexandrovna Kotova","doi":"10.21037/cdt-24-262","DOIUrl":"https://doi.org/10.21037/cdt-24-262","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 5","pages":"982-986"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603264","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":"Mediating effect of health literacy on social support and self-care ability in older patients undergoing percutaneous coronary stent implantation.","authors":"Li Yao, Fuhong Wu, Hua Mu, Xinli Wang, Juan Liu, Hongyan Lu","doi":"10.21037/cdt-24-50","DOIUrl":"https://doi.org/10.21037/cdt-24-50","url":null,"abstract":"<p><strong>Background: </strong>Health literacy refers to individual skills to access, process, understand, and use health information to stay healthy. Social support is a multi-faceted construct including of perceived, enacted, and structural support dimensions and negative social reactions. This study explored the mediating effect of health literacy on social support and self-care ability in older patients undergoing percutaneous coronary stent implantation (PCI).</p><p><strong>Methods: </strong>Between December 2021 and March 2022, a total of 249 older patients who underwent PCI in our hospital were included in this cross-sectional study using the convenience sampling method. The demographic and health history of patients was collected by questionnaire. Exercise of self-care agency scale (ESCA), chronic disease health literacy management scale (HeLMS) and social support rating scale (SSRS) were also analyzed and their correlations were evaluated.</p><p><strong>Results: </strong>This study indicated that the total scores of health literacy, self-care ability and social support after PCI were 85.96±20.03, 82.82±27.65 and 25.3±4.93, respectively. Correlation analysis showed that health literacy, social support and self-care ability were positively correlated. Both social support (P=0.003) and health literacy (P=0.03) could positively predict self-care ability. Health literacy played a partial mediating role between social support and self-care ability, and the mediating effect was 0.015, accounting for 7.32% of the total effect.</p><p><strong>Conclusions: </strong>The health literacy and social support are at the high levels, and the self-care ability of PCI patients is at a medium level. The health literacy of older patients after PCI is the ability of social support and self-care ability. Medical staff can enhance the health literacy of patients by improving their level of social support, and then promote their self-care ability.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 5","pages":"821-831"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603232","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":"The efficacy, safety, and related factors of bronchial artery embolization for hemoptysis: a systematic review and meta-analysis with subgroup analysis.","authors":"Yinghui Tao, Jiaying Li, Ruisi Su, Minhui Zhou, Haonan Zhu, Zhichao Sun","doi":"10.21037/cdt-24-157","DOIUrl":"https://doi.org/10.21037/cdt-24-157","url":null,"abstract":"<p><strong>Background: </strong>Bronchial artery embolization (BAE) is a common and important way to manage hemoptysis. This study's purpose was to summarize the efficacy, safety, and related factors of BAE in the treatment of hemoptysis.</p><p><strong>Methods: </strong>From January 2010 to August 2023, a systematic literature search was conducted in PubMed, EMBASE, Web of Science, and Cochrane Library databases. Original studies with BAE for hemoptysis were included, with no restrictions on language. The outcomes of interest were technical success rate, clinical success rate, recurrence rate, mortality rate, and major complication rate. Pooled proportions with 95% confidence intervals (CIs) were calculated using random-effects models. The Newcastle-Ottawa Scale (NOS) was employed for quality assessment. Factors such as publication year, region, sample size, amount of hemoptysis, etiology, and embolization materials were extracted for subgroup analyses. Additionally, sensitivity analyses and test for publication bias were conducted.</p><p><strong>Results: </strong>A total of 32 studies, including 6,032 patients, met our inclusion criteria. 27 studies were of high quality, while five of moderate quality. The results indicated the prevalence of technical success was 97.2% (95% CI: 95.1-98.8%) and 93.2% (95% CI: 90.3-95.7%) in clinical success. Hemoptysis recurrence and mortality rates after BAE were 24.8% (95% CI: 20.5-29.4%) and 2.3% (95% CI: 1.1-3.8%), respectively. Moreover, the pooled prevalence of major complication was 0.1% (95% CI: 0.0-0.4%). Subgroup analysis revealed that studies published after 2017 demonstrated a higher technical success rate and a lower recurrence rate. Massive hemoptysis showed a higher technical success rate but a lower clinical success rate. BAE also demonstrated superior efficacy in patients with bronchiectasis. The clinical success rate was significantly higher in patients with benign diseases than those with malignancies. Gelatin sponge (GS) showed poor embolization efficacy. N-butyl-2-cyanoacrylate (NBCA) and coils exhibited reduced recurrence rates, while NBCA displayed an even lower recurrence rate than non-absorbable particles. The study by Ishikawa <i>et al.</i> influenced the stability of the pooled major complication rate, and the sensitivity analysis confirmed the robustness of the remaining results.</p><p><strong>Conclusions: </strong>BAE is safe and effective in treating different degrees of hemoptysis caused by benign and malignant lesions. Promising clinical efficacy was observed with NBCA as an embolic material for the treatment of hemoptysis. However, further conclusions should be investigated using evidence-based medicine.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 5","pages":"859-877"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603260","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":"Efficacy and safety of leadless ventricular pacemaker: a single-center retrospective observational study.","authors":"Lin Yan, Lin Ling, Yumeng Song, Tingbo Jiang","doi":"10.21037/cdt-24-181","DOIUrl":"https://doi.org/10.21037/cdt-24-181","url":null,"abstract":"<p><strong>Background: </strong>The Micra leadless pacemaker (MLP) has been demonstrated to be safe and effective as a substitute for conventional transvenous ventricular pacemakers (TVP). However, its application in the general population is still restricted. The aim of this retrospective study was to assess the safety and efficacy of MLP.</p><p><strong>Methods: </strong>Clinical data and device parameters were gathered on every patient receiving MLP implantation between 1 January 2019 and 31 December 2023, in the First Affiliated Hospital of Soochow University. The efficacy of MLP on the primary composite endpoint, atrioventricular (AV) synchrony, hospitalization, and post-implantation quality of life was assessed. Safety outcomes included implantation procedural characteristics, acute and chronic complications, and stability of pacing parameters. Meanwhile, we compared pacing parameters, AV synchrony, and improvement of life quality between patients who had been implanted with the MicraTM VR (Medtronic Micra™ MC1VR01) and Micra™ AV (Medtronic Micra™ MC1AVR1). Multivariate linear regression models were used to unearth potential predictors of echocardiography or electrocardiogram (ECG) parameters on pacing parameters.</p><p><strong>Results: </strong>A total of 94 patients were included, and implantation was successful in all of the cases. A single patient experienced effusion hours after the implantation, indicating a low rate of both acute and chronic complications. In patients with complete AV block (AVB), Micra AV increased AV synchrony from 23.2%±6.3% to 80.8%±5.7%. After 28 days of implantation, the patients' Minnesota Living with Heart Failure Questionnaire (MLHFQ) score decreased from 27.1±18.6 to 20.0±17.6, and none of them required hospital readmission. Left ventricular end-diastolic diameter (LVEDD, 50.0±6.7 cm), left ventricular end-systolic diameter (LVESD, 32.6±3.9 cm), and ECG R wave in lead V5 (RV5, 1.3±0.6 mV) can be employed for the prediction of pacemaker threshold [0.50 (0.38-0.67) mV], sensing voltage (10.1±4.7 mV), and impedance (785.9±226.4 Ohm) correspondingly.</p><p><strong>Conclusions: </strong>Despite being a small, single-center, retrospective study, our study provided data for assessing the safety and efficacy of MLP. Clinicians and patients can make well-informed therapy decisions by being aware of its benefits and forecasting pacing parameters.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 5","pages":"878-889"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603224","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":"The transcription factor PPARA mediates SIRT1 regulation of NCOR1 to protect damaged heart cells.","authors":"Min Wang, Fang Zhou, Yuntao Luo, Xu Deng, Xinyu Chen, Qin Yi","doi":"10.21037/cdt-24-101","DOIUrl":"https://doi.org/10.21037/cdt-24-101","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a clinical syndrome with a high risk. Our previous research showed a regulatory relationship between Sirtuin 1 (SIRT1), peroxisome proliferator-activated receptor α (PPARA) and nuclear receptor co-repressor 1 (NCOR1). This study aimed to investigate the regulatory mechanism of SIRT1/PPARA/NCOR1 axis in HF.</p><p><strong>Methods: </strong>HF models <i>in vitro</i> were established by doxorubicin (DOX)-induced AC16 and human cardiac microvascular endothelial cell (HCMEC) lines. The contents of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), interleukin-1β (IL-1β), and IL-18 were detected using enzyme-linked immunosorbent assay. Then, we assessed the levels of reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD) and adenosine triphosphate (ATP). Moreover, the relationship between SIRT1 and PPARA was detected using the co-immunoprecipitation (Co-IP) analysis. The connection between PPARA and NCOR1 was analyzed using chromatin immunoprecipitation (ChIP).</p><p><strong>Results: </strong>Overexpression of SIRT1 or PPARA could reduce apoptosis in DOX-induced AC16 and HCMEC cells, the levels of IL-1β, IL-18, ANP, BNP, ROS and MDA, while increasing the levels of SOD and ATP. In addition, overexpression of PPARA could increase the viability of DOX-induced cells and the levels of myosin heavy chain 6 (Myh6) and Myh7. Co-IP showed that SIRT1 interacted with PPARA. Silencing PPARA could reverse the effect of SIRT1 overexpression on DOX-induced AC16 and HCMEC cells. ChIP assay demonstrated that PPARA could bind to the promoter region of <i>NCOR1</i>. Silencing NCOR1 could reverse the effect of PPARA overexpression on DOX-induced AC16 and HCMEC cells.</p><p><strong>Conclusions: </strong>This study revealed that PPARA could mediate SIRT1 to promote NCOR1 expression and thus protect damaged heart cells. The finding provided an important reference for the treatment of HF.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 5","pages":"832-847"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603267","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":"Impact of educational intervention and pedometer-based self-monitoring on physical activity levels in patients with pulmonary arterial hypertension.","authors":"Maria Wieteska-Miłek, Piotr Zieliński, Michał Florczyk, Sebastian Szmit, Bogna Rajewska, Marcin Kurzyna","doi":"10.21037/cdt-24-249","DOIUrl":"https://doi.org/10.21037/cdt-24-249","url":null,"abstract":"<p><strong>Background: </strong>Appropriate levels of physical activity (PhA) provide health benefits to patients with chronic diseases, including patients with pulmonary arterial hypertension (PAH). In this study, we examined the effect of physicians' PhA recommendations on PhA, and the benefits and effectiveness of PhA self-monitoring using a pedometer for PAH patients.</p><p><strong>Methods: </strong>A prospective clinical trial was performed from 22 April 2021, with consecutive PAH outpatients in stable condition at least three months prior to the study. Each patient was educated about the benefits of PhA in PAH during the initial visit. Patients wore pedometers (Omron HJ-321-E) for 2 weeks. After PhA assessment, the patients were contacted by a physician by phone. Patients who walked <5,000 steps per day (inactive group) were recommended to increase their PhA, and patients who walked ≥5,000 steps per day (active group) were recommended to maintain this level of PhA. Patients wore pedometers for 3 months. The primary endpoint was the number of steps taken after 12 weeks of the study. The secondary endpoints were the 6-minute walk distance (6MWD), quality of life (QoL) (36-Item Short-Form Health Survey), and anxiety and depression levels.</p><p><strong>Results: </strong>The study included 41 PAH patients aged 45.9±11.9 years, with 32 (78%) of them women. Initially, 18 (44%) patients were in the inactive group (2-week mean: 3,318±1,185 steps/day) while 23 (56%) patients were in the active group (2-week mean: 7,647±1,991 steps/day). The entire study group showed an insignificant decrease in their PhA from 5,203 [interquartile range (IQR), 3,787-7,387] to 4,672 (IQR, 3,821-7,201) steps per day (P=0.57). Patients in the inactive group showed an insignificant increase in their PhA after 12 weeks [increase in the average number of steps per day by 104 (IQR, -244 to 1,007), P=0.52], while patients in the active group showed an insignificant trend towards PhA reduction [change in average daily steps: -815 (IQR, -1,400 to 580), P=0.37]. There were no differences at week 12 in the 6MWD, N-terminal-pro-B-type natriuretic peptide (NT-proBNP) level, QoL, or levels of anxiety and depression, all P values >0.05.</p><p><strong>Conclusions: </strong>Education, a simple recommendation about PhA, and self-monitoring with a pedometer are insufficient to achieve intervention in PAH patients. Additional methods of motivating and supervising these patients are necessary.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 5","pages":"810-820"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603225","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":"Prevalence and predictors of right ventricular dysfunction among adults living with HIV in northwest Nigeria.","authors":"Shehu A Kana, Rukayya S Alkassim, Aishatu L Adamu, Ibrahim Y Ibrahim, Bryan E Shepherd, Mahmoud U Sani, C William Wester, Muktar H Aliyu","doi":"10.21037/cdt-24-165","DOIUrl":"10.21037/cdt-24-165","url":null,"abstract":"<p><strong>Background: </strong>People living with the human immunodeficiency virus (PLWH) are at increased risk of cardiovascular diseases. Right ventricular (RV) function has important prognostic value in cardiac pathology, and advances in imaging modalities, such as transthoracic echocardiography have enabled in-depth RV studies. There is, however, a scarcity of multiparameter RV function studies in PLWH in low- and middle-income settings, such as Nigeria. The aim of this study is to determine the prevalence and predictors of RV dysfunction among adult PLWH in northwest Nigeria.</p><p><strong>Methods: </strong>This is a retrospective cross-sectional study conducted between February 1, 2023 and August 31, 2023. We consecutively recruited 330 adults [median age 45 years, interquartile range (IQR), 38 to 52 years, 61% female] attending human immunodeficiency virus (HIV) and general outpatient clinics in a tertiary hospital in northwest Nigeria. They included 110 antiretroviral therapy (ART)-experienced PLWH, 110 ART-naïve PLWH, and 110 age- and sex-matched HIV-negative control subjects. All participants had conventional two-dimensional (2D), tissue Doppler (TDI), and speckle tracking (2D-STE) echocardiography to estimate left ventricular (LV) and RV systolic and diastolic function, peak systolic and diastolic myocardial velocities, RV and LV longitudinal strain, and chamber dimensions. All participants also underwent 12-lead electrocardiography. Multiple linear and Firth's logistic regression modeling were performed to assess for independent predictors of RV myocardial performance index (RVMPI) as a continuous and as a dichotomous variable, respectively.</p><p><strong>Results: </strong>The prevalence of RV dysfunction, as determined by the RVMPI among HIV-positive participants was 14.5% [95% confidence interval (CI): 10.5-19.8%] compared to 0% (95% CI: 0.0-3.4%) for those without HIV. Among participants with HIV, RVMPI was associated with participant age (P<0.001) and left ventricular ejection fraction (LVEF) (P<0.001). Results were similar when RVMPI was dichotomized. The association between RV dysfunction and LVEF was modified by ART status: a 10% decrease in LVEF was associated with an average decrease of 0.08 in RVMPI among participants who were ART-experienced (β=-0.08, P<0.001) but a lesser decrease among those who were ART- naïve (β=-0.03, P=0.14).</p><p><strong>Conclusions: </strong>This study highlights the complexity of RV dysfunction in PLWH and underscores the importance of LVEF and age as key factors influencing the risk of RV dysfunction in PLWH.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"14 5","pages":"753-770"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603233","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}