Current Cardiology Reviews最新文献

Introduction: Chronic heart failure (CHF) represents a major global health burden. This review explores the potential of artificial intelligence (AI) in improving its diagnosis, treatment, and management.

Methods: This study conducted a comprehensive literature review to evaluate the current and emerging applications of AI in CHF. Databases, such as PubMed, Scopus, and IEEE Xplore, were searched for peer-reviewed articles published between 2015 and 2025, focusing on AIbased diagnostic tools, predictive modeling, treatment personalization, and remote monitoring systems.

Results: Significant advancements were identified in AI-enhanced diagnostics, predictive models for hospital readmissions, personalized treatment optimization, and AI-driven remote monitoring systems. These technologies have demonstrated improvements in diagnostic accuracy, risk stratification, and real-time patient management.

Discussion: AI offers substantial benefits for CHF management by enabling data-driven, individualized care. Nonetheless, challenges remain, including variability in data quality, lack of algorithm transparency, and ethical considerations regarding patient privacy and accountability.

Conclusion: AI holds transformative potential for CHF management. Its successful integration can enhance diagnostic precision, personalize treatment, and support proactive patient care- ultimately improving outcomes and reducing the global burden of CHF.

Background: Cardiovascular diseases (CVDs) are a major global health burden with increasing prevalence rates and high morbidity and mortality rates. CVD has a variety of clinical and lifestyle risk factors, including, but not limited to, diabetes, dyslipidaemia, chronic smoking, hypertension, and obesity. Predictors of CVD outcomes need to be identified to advance healthcare practices and decrease disease burden.

Methods: This retrospective study evaluated predictive factors for cardiovascular disease (CVD) outcomes in 697 patients, considering a range of clinical and behavioral variables. Data collected included demographics, lifestyle habits (e.g., smoking, alcohol use), clinical measurements (e.g., blood pressure, lipid profiles), and comorbidities (e.g., hypertension, diabetes). Statistical analyses were performed to identify associations between these factors and CVD outcomes.

Results: Data from 697 participants were analyzed (29.3% female, 70.7% male), with a mean age of 58.09 ± 13.14 years. The majority of participants resided in rural areas (66.1%). Smoking (52.8%) and elevated triglycerides were prevalent among participants. The most significant risk factors associated with CVD development were smoking, high triglycerides, hypertension, and diabetes. Smokers were 2.59 times more likely to develop CVD in the presence of these risk factors.

Discussion: In this high-burden rural population in Rajasthan, India, several key CVD risk factors were identified, including smoking, hypertension, diabetes, obesity, and high cholesterol. Notably, even smokers who reported relatively healthier lifestyles were still affected. CVD development was strongly associated with multiple modifiable risk factors, highlighting the cumulative impact of lifestyle and clinical determinants.

Conclusion: This study underscores the significant influence of lifestyle and clinical factors, such as smoking, hypertension, obesity, diabetes, and dyslipidemia, on cardiovascular disease risk. These findings highlight the urgent need for comprehensive strategies to mitigate these risks by promoting healthy habits, improving healthcare access, and strengthening public health policies. Implementing such measures can reduce CVD incidence and improve overall population health outcomes.

Introduction: Chronic heart failure (CHF) remains a leading cause of global morbidity and mortality, frequently resulting in hospitalizations and diminished quality of life. Sacubitril/ Valsartan, the first angiotensin receptor-neprilysin inhibitor (ARNI) approved by the FDA, has shown promising effects in reducing mortality and improving clinical outcomes. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Sacubitril/ Valsartan compared with conventional therapies in patients with CHF.

Methods: A systematic review was conducted following PRISMA 2020 guidelines. PubMed, Scopus, and Web of Science were searched up to April 18, 2024, using predefined terms. Eligible studies included randomized controlled trials comparing Sacubitril/Valsartan with standard therapies in adult CHF patients. Data extraction was performed independently by multiple reviewers, and study quality was assessed using the JBI checklist. Meta-analyses were conducted to estimate pooled outcomes.

Results: Ten randomized controlled trials, including 15,650 patients, were analyzed. The mean age across studies was 68.4 years, with males comprising 59.4% of the Sacubitril/Valsartan group and 63.3% of the control group. Sacubitril/Valsartan significantly reduced NT-proBNP levels (SMD = -0.30, 95% CI: -0.58 to -0.03; p = 0.03) and disease-related events (OR = 0.82, 95% CI: 0.76-0.89; p < 0.00001). Hypotension was the most frequently reported adverse event (OR = 1.57, 95% CI: 1.28-1.93; p < 0.0001), whereas hyperkalemia and renal dysfunction did not differ significantly from control groups.

Discussion: The findings indicate that Sacubitril/Valsartan improves outcomes in patients with CHF and exhibits an acceptable safety profile, although clinicians should monitor for hypotension.

Conclusion: Sacubitril/Valsartan represents an effective therapeutic option for CHF, providing significant benefits in reducing mortality and morbidity compared with standard therapy.

Introduction: Cardiovascular diseases (CVDs) remain the leading cause of global mortality, with congenital heart disease (CHD), acquired heart disease (AHD), valvular disorders, and cardiomyopathies contributing significantly to morbidity. Retinal fundus imaging has emerged as a non-invasive modality capable of capturing microvascular alterations that may serve as biomarkers for systemic cardiovascular dysfunction.

Methods: This review systematically examined literature published between 2015 and 2025 on the use of retinal fundus imaging for predicting structural heart diseases. Databases including PubMed, Scopus, and Web of Science were searched using predefined keywords. Studies were evaluated according to disease focus, imaging modality, analytical methods, and diagnostic performance.

Results: Findings highlight that deep learning and machine learning models applied to retinal fundus images have demonstrated promising accuracy in detecting and classifying CVDs. Convolutional neural networks achieved up to 91% AUC for CHD detection, while hybrid multimodal approaches improved sensitivity in AHD and valvular disease prediction. Cardiomyopathies were associated with vessel tortuosity and microhemorrhages, quantifiable through automated image analysis. Table 1 provides a statistical summary of performance across studies.

Discussion: Emerging approaches, such as transformer-based models and adaptations of the Segment Anything Model (SAM) for medical imaging, offer potential for improving generalizability and interpretability. Challenges remain, including dataset imbalance, limited longitudinal validation, and the black-box nature of AI models.

Conclusion: Retinal imaging holds strong potential as a scalable, non-invasive tool for cardiovascular disease prediction. Integrating advanced AI architectures may enhance diagnostic accuracy and accelerate translation into clinical practice.

Introduction: Transcatheter patent foramen ovale (PFO) closure is the treatment of choice in younger patients with cryptogenic stroke or high-risk PFO features. A common complication post-procedurally is atrial fibrillation or flutter (AF/Af). In this study, we evaluate the incidence of AF/Af following PFO closure compared to medical therapy, the time to occurrence, and the role of age in AF/Af occurrence.

Methods: A systematic literature search was conducted in MEDLINE (Pubmed) and Scopus databases for studies assessing the incidence of AF/Af post-PFO closure in contrast to medical therapy, the incidence within the 1st month post-procedurally or later, and the role of age in AF/Af occurrence.

Results: Twenty-nine studies (10 randomized, 18 observational, 1 case-control) were included in this systematic review, of which 10 (7 randomized, 3 observational) were meta-analyzed. Subjects undergoing PFO closure were at higher risk of developing AF/Af (RR: 2.27, 95% CI: 1.29, 4.01, p=0.009). There was a trend for higher AF/Af rates within the 1st month post-intervention. There was no statistical difference after the 1st month of follow-up (3 studies, RR: 0.60, 95% CI: 0.02-19.88, p=0.60). Mean age of participants did not affect the primary endpoint (β: -0.03, CI: - 1.13, 0.06, p=0.45, residual I 2 =44%, R2 =4%).

Discussion: AF/Af risk is elevated following PFO closure, particularly early post-procedure, likely due to procedural factors. However, the arrhythmias are often transient and not agedependent. Study heterogeneity and limited monitoring methods may affect the reported incidence.

Conclusion: PFO closure increases short-term AF/Af risk compared to medical therapy, but the events are typically mild and age-independent. This should be weighed against the long-term benefit of stroke prevention. Moreover, standardized monitoring is needed to better define this risk.

Introduction: Pulmonary veno-occlusive disease (PVOD) is a rare subtype of pulmonary arterial hypertension (PAH), often diagnosed only in cases resistant to PAH therapy or after lung histology is obtained through transplantation or autopsy. Early diagnosis of PVOD, however, is associated with improved outcomes. We present a case of PVOD initially diagnosed and confirmed by lung biopsy.

Case presentation: A 24-year-old male military pilot, a non-smoker, was admitted with progressive dyspnea. On examination, his heart rate was 110 beats per minute, respiratory rate 20 per minute, oxygen saturation 88% at rest and 95% with 3 L/min supplemental oxygen. He was classified as WHO functional class IV, with a six-minute walking distance of 60 m and NT-proBNP of 3315 pg/ml. Electrocardiogram and echocardiography revealed right heart enlargement. Right heart catheterization confirmed precapillary pulmonary hypertension with a low cardiac index (1.75 L/min/m²). High-resolution computed tomography (HRCT) of the lungs showed septal lines, centrilobular ground-glass opacities, and latero-aortic and subcarinal lymph node enlargement, suggestive of PVOD. Diagnosis was confirmed histologically via open lung biopsy and genetically by identification of biallelic EIF2AK4 variants. Eight months after diagnosis, lung transplantation was performed, resulting in dramatic improvement of the patient's condition. This case highlights key aspects of PVOD etiology, epidemiology, diagnosis, and management.

Conclusion: Patients with PAH should undergo careful evaluation for PVOD. Recognition of characteristic clinical, radiological, and genetic features enables suspicion of this rare PAH subtype and guides cautious titration of targeted therapies. Lung transplantation remains the preferred treatment option for PVOD patients.

Introduction: Lyme disease, primarily caused by Borrelia burgdorferi in North America, is a common spirochetal infection transmitted via tick bites. The dissemination of Lyme spirochetes can result in multisystem complications, including Lyme carditis.

Methods: This review incorporated data from observational studies, retrospective analyses, systematic reviews, and case reports involving patients with confirmed or presumed Lyme carditis. Key outcomes included prevalence, reversibility, and chronicity of cardiac involvement, as well as diagnostic and prognostic implications.

Results: Atrioventricular block represents the most prevalent conduction abnormality in Lyme carditis, occurring in up to 90% of cases, with high-degree of persistent blocks potentially necessitating temporary or permanent pacing. While the majority of conduction abnormalities resolve with appropriate antimicrobial therapy, a subset of patients experience persistent dysfunction. Structural complications, including myocarditis, pericarditis, and, less frequently, endocarditis and dilated cardiomyopathy, have been documented. Emerging evidence suggests that persistent myocardial inflammation and autoimmune mechanisms may contribute to the development of long-term cardiac remodeling and dysfunction. Reports of coronary artery involvement and aneurysmal changes, though rare, raise further concern regarding chronic cardiovascular risk.

Discussion: This review highlights several cardiovascular complications of Lyme carditis that can persist despite medical therapy. While permanent conduction abnormalities, fulminant myocarditis, and subsequent ventricular dysfunction have been reported, studies on chronic heart failure are limited, and coronary artery involvement remains underrecognized, necessitating further research.

Conclusion: While Lyme carditis is generally self-limited with timely therapy, accumulating evidence indicates the potential for lasting cardiac sequelae. Further longitudinal studies are warranted to delineate risk factors, pathophysiologic mechanisms, and optimal strategies for longterm surveillance and management.

Introduction: Cardiovascular disease is a leading cause of mortality in the Gulf region, with acute Myocardial Infarction (MI) being a critical contributor due to prevalent comorbidities, including diabetes, hypertension, and obesity. This systematic review and meta-analysis evaluate the prognostic factors impacting post-MI outcomes.

Method: This study conducted a systematic review and meta-analysis to identify risk factors influencing Myocardial Infarction (MI) outcomes in Saudi Arabia and Gulf countries. A comprehensive search of major databases between 2013 and 2024 included studies examining demographic and clinical predictors such as age, gender, and comorbidities. Eligible studies were screened following PRISMA guidelines. Adjusted odds ratios for mortality were pooled, and heterogeneity was assessed through Q and I² statistics. Bias and publication bias were evaluated using ROBINS-I and funnel plots, respectively. Analyses were performed to provide regionspecific insights into MI prognosis and outcome predictors.

Results: The findings reveal that gender, age, comorbidities, and biomarkers significantly influence mortality risks. Women presented higher mortality rates than men, attributed to older age and a heavier comorbidity burden. Ventricular arrhythmias and recurrent MI emerged as predictors of adverse in-hospital outcomes, including heart failure and cardiogenic shock. The pooled odds ratio for short-term mortality indicated over three times the mortality risk following MI, although long-term mortality findings lacked statistical significance.

Discussion: The findings highlight the combined impact of demographic and clinical factors on MI outcomes in the Gulf region. The gender disparity reflects both biological and systemic influences.

Conclusion: Tailored interventions, improved risk stratification, and targeted management strategies are needed to address the high-risk profiles and outcome disparities in Gulf MI patients.

Introduction: HFpEF accounts for 12-25% of heart failure cases in South Asia, primarily driven by hypertension, diabetes, and obesity. Late diagnosis and healthcare disparities worsen outcomes. This expert consensus aims to provide region-specific guidelines for the diagnosis, management, and prevention of HFpEF.

Method: A modified Delphi process with experts from five South Asian countries was conducted, informed by a literature review (2018-2024) and adapted international guidelines.

Results: Recommendations include the use of an adjusted H2FPEF score (BMI > 25 kg/m²), essential echocardiographic criteria (E/e' > 9, LAVi > 34 mL/m²) for diagnosis, and SGLT2 inhibitors as first-line pharmacotherapy, with finerenone for cardio-renal protection. Emphasis on lifestyle modification, patient education, and aggressive management of comorbidities is highlighted to reduce hospitalizations.

Discussion: HFpEF presents earlier and is associated with higher comorbidity in South Asia. Adaptations such as lower BMI thresholds and region-specific screening are critical. Cost and accessibility challenges persist in the use of SGLT2 inhibitors and finerenone. Public health measures and infrastructure strengthening are necessary to improve outcomes.

Conclusion: Early diagnosis, multidisciplinary management, and tailored treatment strategies can enhance outcomes in HFpEF in South Asia. This consensus serves as a call for regionally focused implementation to reduce the burden of HFpEF.