Current Cardiology Reviews最新文献

Introduction: Echocardiographic assessment of the aortic root structure is critical with regard to efforts to diagnose and manage aortic valve diseases. However, traditional teaching methods often fail to provide the necessary depth and practical experience for residents. This study addresses this knowledge gap by exploring the value of applying computed tomography 3-dimensional (CT-3D) printing in the context of teaching echocardiographic assessment of the aortic root structure.

Methods: Between January 1, 2022, and November 30, 2024, thirty residents in the Ultrasound Department of our hospital were recruited and randomly divided into a 3D printing group and a traditional teaching group. Participants in the 3D printing group used CT-3D printed aortic root models, whereas those in the traditional teaching group relied on standard methods. The theoretical knowledge and operational skills of participants in both groups were evaluated.

Results: Participants in the two groups did not differ significantly in terms of their theoretical knowledge. However, participants in the 3D printing group outperformed those in the traditional teaching group in terms of their operational skills; the 3D printing group also exhibited higher levels of teaching effectiveness satisfaction (all P<0.05).

Discussion: Our results revealed that the use of CT-3D printed models can result in improved operational skills and increased teaching satisfaction, echoing the findings reported by other studies that have revealed enhanced learning outcomes as a result of the integration of 3D printing into medical education Conclusion: The use of CT-3D printed models significantly improved operational skill training and teaching satisfaction in the context of education in the echocardiographic assessment of the aortic root structure.

Introduction: RIHD is a significant complication in cancer radiotherapy, caused by oxidative stress and tissue damage. This study aimed to evaluate the protective effect of PGZ pretreatment against RIHD by assessing oxidative stress markers, enzyme levels, biochemical parameters, and cardiac tissue changes in a mouse model.

Materials & methods: 72 BALB/c mice were randomly divided into eight groups: control, PGZ (10, 20, and 30 mg/kg), IR (8 Gy), and IR + PGZ (at three doses). PGZ was administered daily for 10 days before exposure to RT on Day 11. 24 hours post-irradiation, cardiac tissues were analyzed for MDA levels, GPX and GSH concentrations, and serum markers including LDH and CPK. Histopathological examination was performed at 1 week and 1 month after irradiation to evaluate early inflammatory changes and late fibrosis.

Results: Results showed GPX activity increased by 28.2% and 48.4%, and GSH levels rose by 37.6% and 52.9% at doses of 20 and 30 mg/kg PGZ. MDA levels decreased by 40.35% and 52.63% at doses of 20 and 30 mg/kg, respectively. Serum LDH was reduced by 36.2% at 30 mg/kg. Tissue damage was significantly mitigated, with reductions of 88.9% at one week and 91.2% at one month. Fibrosis reduction was 23.5%, 41.5%, and 53.3% for 10, 20, and 30 mg doses.

Discussion: The findings highlight PGZ's potential to protect against RIHD via antioxidant enhancement; however, further clinical validation and exploration of long-term safety are essential.

Conclusions: PGZ shows promise in reducing RIHD by enhancing antioxidants and decreasing tissue damage, warranting further clinical investigation.

β-thalassemia Major (β-TM) is a severe hereditary disorder characterized by insufficient synthesis of β-globin chains, resulting in chronic anemia and lifelong dependence on regular blood transfusions. Despite advancements in therapeutic modalities, cardiac complications, including atrial fibrillation, cardiomyopathy, and pulmonary hypertension, continue to be significant contributors to morbidity and mortality among β-TM patients. These persistent cardiovascular risks underscore the urgent need for early, accurate detection and the implementation of personalized assessment strategies to improve patient outcomes. The prevalence of cardiac complications is notably high, with studies reporting affected individuals in up to 71% of the β-TM population. This highlights cardiac pathology as a predominant clinical concern in this population. The primary underlying mechanism is iron overload, predominantly resulting from chronic transfusional therapy. Excess iron accumulates in the myocardium, leading to myocardial siderosis, the development of dilated cardiomyopathy, and an increased risk of life-threatening arrhythmias. Cardiac magnetic resonance imaging (cMR), particularly T2* imaging, remains the gold standard for quantifying myocardial iron deposition and guiding therapeutic interventions. Emerging biomarkers, such as Growth Differentiation Factor-15 (GDF-15) and galectin-3, have shown potential for early detection of cardiac involvement and risk stratification, with the prospect of improving clinical outcomes through timely and targeted interventions. This review aims to discuss the prevalence and pathophysiology of cardiac complications in β-thalassemia major (β-TM), delineate risk factors, including serum ferritin levels, iron chelation therapy, age, genetic predispositions, and splenectomy, and evaluate current diagnostic and monitoring strategies. Furthermore, the utility of novel biomarkers, including follistatin and other emerging candidates, for early detection and prognosis is discussed, highlighting their potential to facilitate personalized management approaches that may reduce cardiac morbidity and mortality. In conclusion, integrating advanced imaging modalities such as cMR, novel biomarker profiling, and individualized risk stratification, considering ferritin levels, genetic factors, and splenectomy status, may significantly enhance early detection and intervention strategies, ultimately mitigating the burden of cardiac complications in β-TM.

Background: Cardiac False tendons are anatomical variants of fibromuscular structures that generally should not exist in the heart. The left ventricular tendon, which crosses the left ventricular cavity, is typically seen in most cases of false cardiac tendons; however, our case differs from other cardiac false tendons. This case involves a fibrous tendon that spans the mitral valve, connecting the left atrium and ventricle. This unusual presentation has only been documented once. Based on our knowledge and research, this is the first documented occurrence in the United Arab Emirates and the second incident worldwide.

Case presentation: A 12-year-old girl presented to an outpatient clinic with palpitations as her main complaint. After transthoracic echocardiography, it was suggested that a false tendon was passing through the mitral valve to connect the left atrium and left ventricle. We performed a transesophageal echo to confirm the diagnosis, and the results were identical to those of the transthoracic echocardiography. Since the uncommon false tendon only caused mild symptoms, an extensive multidisciplinary meeting was held, and we opted to manage the patient conservatively and monitor them annually at the outpatient cardiology clinic.

Conclusion: In this uncommon case presentation, accurately diagnosing the condition and establishing a treatment and follow-up plan are crucial for understanding similar cases in the future. This variant of false tendons across the mitral valve appears to be a benign anatomical structural variant, comparable to other false tendons in the heart. Currently, there is insufficient evidence to link false tendons to increased cardiac morbidity and mortality.

Introduction: Acute myocardial infarction is a significant global health issue, with a high mortality rate. Early intervention, specifically coronary angiography, has been shown to improve patient outcomes significantly. Recent technological advances have introduced novel therapeutic interventions like Supersaturated Oxygen (SSO2) Therapy, which promises enhanced recovery post-ischemia. To evaluate the efficacy and potential benefits of SSO2 therapy in improving post-ischemic outcomes, including left ventricular function, myocardial scarring, and overall cardiac morphology.

Methods: This review synthesizes findings from early clinical trials and pre-clinical animal studies focusing on the application of SSO2. The therapy involves delivering oxygen at ten times the normal level directly to the infarcted artery to facilitate high oxygen diffusion before restoring downstream flow.

Results: Pre-clinical studies demonstrate that SSO2 therapy enhances Left ventricular ejection fraction (LVEF), increases mean arterial PaO2, reduces myocardial apoptosis, and decreases myocardial scarring and infarct sizes. Clinical trials, including the Acute Myocardial Infarction with Hyperoxemic Therapy (AMIHOT I and AMIHOT II), have shown improvements in echocardiographic regional wall motion and have helped in preventing myocardial dilatation and remodeling.

Conclusion: SSO2 therapy presents a promising advance in the treatment of myocardial infarction. While early results are favorable, indicating significant improvements in cardiac function and tissue preservation, long-term follow-up studies are necessary to determine the impact on mortality rates, recurrence of ischemic events, and healthcare resource utilization.

Introduction: Nonbacterial thrombotic endocarditis (NBTE) involves sterile vegetations on heart valves due to systemic hypercoagulability, often linked to malignancies. It is frequently underdiagnosed and presents significant clinical management challenges, often manifesting as thromboembolic events like ischemic stroke. We aim to report the first case of cancerassociated NBTE that showed a positive response to rivaroxaban as a maintenance anticoagulant, with 3D echocardiographic evidence of vegetation reduction, and to evaluate the performance of direct oral anticoagulants (DOACs) in treating cancer-associated NBTE through a systematic review of case reports.

Methods: A case study and a systematic review of case reports on the use of DOACs in the setting of cancer-associated non-valvular atrial fibrillation (NVAF) were presented. Electronic databases were searched, and relevant studies were selected based on predefined eligibility criteria. Data were extracted and analyzed qualitatively, focusing on demographics, clinical presentation, anticoagulation and anticancer therapies, and outcomes (surgery, NBTE resolution, thromboembolic events, and mortality).

Results: In addition to our case, thirty-three studies were included in the systematic review. Most patients were already on DOAC therapy before the NBTE diagnosis. Lung and pancreatic cancers were the most common primary neoplasms. The aortic and mitral valves were most frequently affected. Anticoagulation therapy often shifted from DOACs to heparin upon NBTE diagnosis, with low-molecular-weight heparin showing better outcomes in vegetation resolution and thromboembolic event prevention.

Discussion: This study reinforces the suggestion that heparins are more appropriate for treating cancer-associated NBTE. However, satisfactory DOAC outcomes warrant further research.

Conclusion: Effective NBTE management with DOACs appears to be strongly associated with the successful control of the underlying neoplasm.

Cardiovascular diseases, especially myocardial infarction, remain the prominent causes of death globally, necessitating the exploration of innovative therapeutic strategies. Medical and surgical available treatments mainly manage disease symptoms and prevent deterioration, but do not focus on the repair of lost cardiomyocytes. Mesenchymal stem cells (MSCs) have emerged as a promising tool for heart repair and regeneration after injury, as they possess unique properties, such as the potential for differentiation into cardiomyocytes and vascular endothelial cells, immunomodulation, the release of mediators, and paracrine effects. This review focuses on the latest understanding of MSC therapies for cardiac repair, specifically addressing their properties, mechanism of action, preclinical and clinical studies, problems and prospects, and future strategies. MSCs can be isolated from various tissues, including bone marrow and adipose tissue, each with its own advantages and disadvantages in cardiac repair. Many preclinical studies conducted concluded that MSCs could differentiate into cardiomyocytes. MSCs involve multiple factors that enhance angiogenesis, promote the survival of existing myocardium and cardiomyocytes, reduce fibrosis, modulate the immune response, activate existing cardiac stem cells, and facilitate tissue remodeling; all of these processes are crucial in myocardial repair after MI. Although preclinical studies have promising outcomes, the application of MSC therapy in clinical trials has faced many challenges. Clinical trials conducted so far have yielded variable outcomes, with some showing marked improvements and others producing no promising results, indicating less improvement in cardiac function and mortality. This variability may be due to multiple sources, including MSCs, delivery methods, culture conditions, the timing of administration after MI, and patient-dependent factors, such as disease severity, overall patient well-being, and other comorbid conditions. The review concluded that although MSCs have a significant role in cardiac repair, further research is essential for overcoming current challenges to unlocking the maximum regenerative potential of these cells.

Introduction: Peripheral arterial disease (PAD) is a significant contributor to global morbidity, with regional burdens exhibiting considerable heterogeneity. The PAD burden attributable to metabolic risks across regions with varying socioeconomic levels has yet to be adequately characterized.

Methods: This study analyzes PAD burden attributable to metabolic risks across different socioeconomic regions using data from the Global Burden of Disease (GBD) 2021 study. We analyzed data on PAD attributable to metabolic risks, including high systolic blood pressure (SBP), high fasting plasma glucose (FPG), kidney dysfunction (KD), and high body mass index (BMI), across four health systems, four world bank income levels, five Socio-demographic Index (SDI) levels, and 21 GBD regions, from 1990 to 2021. We presented age-standardized mortality rates (ASMR), age-standardized disability-adjusted life year rates (ASDR) and estimated annual percentage changes (EAPC) to assess burden and trends.

Results: In 2021, the burden of PAD due to metabolic risks remained high in regions with higher socioeconomic levels, though it showed a declining trend. Conversely, the burden in regions with lower socioeconomic levels was also high but exhibited an increasing trend. High FPG has become a significant factor in the burden of PAD, particularly in higher socioeconomic regions. Gender disparities in the burden of PAD attributable to metabolic risks were evident, with males exhibiting higher ASMR and ASDR, although females in middle-income regions had slightly elevated ASDRs. Finally, an inverted "U" relationship was observed between SDI and burden, with regions around an SDI of 0.75 exhibiting a higher burden of PAD attributable to metabolic risks.

Discussion: These findings underscore the urgent need to tailor region-specific public health strategies that account for socioeconomic disparities in metabolic risk exposures contributing to the PAD burden.

Conclusions: Effective public health interventions targeting these metabolic risks are urgently needed, especially in low-socioeconomic regions where the burden remains disproportionately high. Enhanced blood glucose control and early intervention strategies should be prioritized to mitigate the growing impact of PAD globally.

Introduction: COVID-19 can be associated with varying degrees of cardiac involvement in children, such that myocardial damage can be caused directly by the COVID-19 virus itself or systemic inflammation caused by the infection. The present study was conducted with the aim of evaluating ECG findings in children with COVID-19.

Methods: This is a prospective cross-sectional study that was conducted by census method on 764 children with COVID-19 in hospitals related to Mashhad University of Medical Sciences in 2022. The data were extracted using a checklist including clinical information and medical records of the patients and analyzed using descriptive and statistical tests.

Results: 764 children with COVID-19 were examined, of which 385 (51%) were male. The studied patients included MISC (25.9%), Kawasaki-like disease (0.3%), pulmonary (12.7%), and gastrointestinal (2%) involvements. More than half of the patients (58%, 444 patients) showed changes in echocardiography findings, including mitral valve insufficiency, dilation of one or more cardiac chambers, and pericardial effusion. 98.8% of patients had NAX. AVB grade I was found in 26 patients (3.4%). Abnormal ST-T segments were observed in 25 patients (3.3%). The prevalence rate of S wave fragmentation was 2.8% (21), and fragmented R waves were found in 13 patients (1.7%).

Discussion: Patients hospitalized in the intensive care unit (ICU) had a higher amount of disorder for each parameter change. Additionally, a significant association was found between the higher occurrence of AV node block and arrhythmia with clinical status (p<0.05), with the same higher rate in patients kept in the ICU.

Conclusion: ECG findings can be used to predict the presence or absence of myocardial involvement as well as its severity. Furthermore, patients with changes in ST-T fQRS and PR interval are more likely to experience cardiac involvement, which could result in a poorer prognosis.

Anthocyanins are natural polyphenols found in various fruits and vegetables, offering numerous health benefits. Clinical studies suggest that anthocyanin supplementation may regulate blood pressure, improve lipid profiles, reduce triglycerides (TG), thiobarbituric acid reactive substances (TBARS), cytokines, and platelet aggregation, while also reducing arterial stiffness. The multiple pathways, including the downregulation of proinflammatory markers and suppression of the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway, prevention of lipoprotein oxidation, enhancement of nitric oxide (NO) bioavailability, improvement of endothelial function, and modulation of the gut microbiota, collectively contribute to managing cardiac health. However, some clinical studies have found no significant positive impact of anthocyanins on cardiovascular disease, possibly due to the varied form, stability, dosage, and study duration. Therefore, future research should investigate anthocyanin stability, establish standardised therapeutic strategies, and conduct large-scale longitudinal studies to elucidate the impact of anthocyanin consumption on cardiovascular health and quality of life.