Current Cardiology Reviews最新文献

Background: Cardiovascular diseases represent a significant global health burden, necessitating diverse approaches for effective management. Herbal interventions have gained attention as potential adjuncts or alternatives to conventional therapies due to their perceived safety and therapeutic potential. This structured abstract provides a comprehensive review of herbal interventions for the management of CVDs, summarising key findings, mechanisms of action, and clinical implications.

Objective: This systematic review aims to evaluate the impact of various herbal interventions employed for managing cardiovascular diseases.

Method: We conducted an extensive literature search across electronic databases, including PubMed, Scopus, and Web of Science, from inception to 2022. Studies were included if they investigated the use of herbal remedies for preventing or treating CVDs. Data extraction and synthesis focused on botanical sources, active compounds, mechanisms of action, and clinical outcomes.

Result: Numerous herbal interventions have demonstrated promising cardiovascular benefits. A number of medicinal herbs well identified to treat CVD are Moringaoleifera, Ginseng, Ginkgo biloba, Celosia argentea, Gongronematrifolium, Gynostemmapentaphyllum, Bombaxceiba, Gentianalutea, Allium sativum, Crataegus spp, Curcuma longa, Camellia sinensis, and Zingiber officinale. Mechanistic insights reveal that herbal interventions often target multiple pathways involved in CVD pathogenesis. These mechanisms encompass anti-inflammatory, antioxidant, anti-thrombotic, anti-hypertensive, and lipid-lowering effects. Additionally, some herbs enhance endothelial function, promote nitric oxide production, and exert vasodilatory effects, contributing to improved cardiovascular health. Clinical studies have provided evidence of the efficacy of certain herbal interventions in reducing CVD risk factors and improving patient outcomes. However, more rigorous, large-scale clinical trials are needed to establish their long-term safety and effectiveness. It is crucial to consider potential herb-drug interactions and standardise dosages for reliable therapeutic outcomes.

Conclusion: This comprehensive review highlights the potential of herbal interventions as valuable adjuncts or alternatives for managing cardiovascular diseases. Herbal remedies offer diverse mechanisms of action, targeting key CVD risk factors and pathways. While promising, their clinical utility warrants further investigation through well-designed trials to establish their safety and efficacy, paving the way for integrated approaches to cardiovascular disease management. Healthcare providers and patients should engage in informed discussions about the use of herbal interventions alongside conventional therapies in the context of CVD prevention and treatment.

Cardiovascular and neurological diseases cause substantial morbidity and mortality globally. Moreover, cardiovascular diseases are the leading cause of death globally. About 17.9 million people are affected by cardiovascular diseases and 6.8 million people die every year due to neurological diseases. The common neurologic manifestations of cardiovascular illness include stroke syndrome which is responsible for unconsciousness and several other morbidities significantly diminished the quality of life of patients. Therefore, it is prudent need to explore the mechanistic and molecular connection between cardiovascular disorders and neurological disorders. The present review emphasizes the association between cardiovascular and neurological diseases specifically Parkinson's disease, Alzheimer's disease, and Huntington's disease.

As a major cause of various cardiovascular diseases, the prevalence of hypertension has been increasing in the past 30 years, leading to significant socioeconomic and health burdens. Obesity is one of the major risk factors for hypertension. Body mass index (BMI) is the most used anthropometric index to measure obesity in clinical practice and to assess the risk of obesity-related diseases. However, obesity is a heterogeneous disease, and the accumulation of fat in different body regions leads to differences in cardiovascular and metabolic risks. BMI only reflects the overall obesity but does not consider the distribution of fat and muscle mass. The limitation of BMI makes it insufficient to assess the risk of hypertension attributed to obesity. In addition, waist circumference is an easily obtainable anthropometric index to evaluate abdominal fat distribution. High waist circumference is an independent risk factor for various cardiovascular diseases and all-cause mortality regardless of BMI. Preliminary data indicate that waist circumference is significantly associated with the risk of hypertension at different BMI levels. However, routine measurement of waist circumference is currently not required in current clinical guidelines or is only recommended for obese populations, indicating an insufficient understanding of waist circumference. In this review, we summarize the measurement methods and diagnostic thresholds of waist circumference for abdominal obesity, the trend of central obesity prevalence, the superiority of waist circumference over other anthropometric indices, and recent cross-sectional and longitudinal studies on the association between obesity and hypertension.

Female carriers of Duchenne Muscular Dystrophy (DMD) carry a heterozygous pathogenic variant in the dystrophin gene and can transmit pathogenic variants to their offspring. DMD is an X-linked recessive disease that affects up to 19.8 in every 100,000 male births. Those carriers with symptoms can be referred to as women with dystrophinopathy. Even among asymptomatic carriers, cardiac involvement can be verified in between 2.5% and 75% through echocardiography. The most commonly affected wall of the left ventricle is the inferolateral, with myocardial fibrosis detected by cardiac nuclear resonance. Therefore, screening is recommended for these women carriers due to the risk of cardiomyopathy. There is a lack of longitudinal studies on the evolution of these carriers. In this article, data on clinical presentation, cardiac assessment for female patients with dystrophinopathy and DMD carriers, and approaches for these patients are discussed.

Volatile organic compounds (VOCs) can be subdivided into exogenous and endogenous categories based on their origin. Analyzing the endogenous VOCs can provide insights into maintaining the internal organs' homeostasis. Despite the ongoing development and the current understanding, studies have suggested a link between cardiovascular metabolic alterations in patients with ischemic heart disease and elevated levels of ethane and isoprene detectable through exhaled breath analysis. Conversely, patients with chronic heart failure exhibit elevated acetone and pentane in their exhaled air. These substances originate from disturbances in the heart tissue, including cellular and subcellular modulations. Hypothetically, ethane levels in the exhaled breath analysis can demonstrate the severity of ischemic heart disease and, consequently, the risk of death in the next 10 years due to cardiovascular disease (CVD). Real-time direct mass spectrometry is the preferred method for assessing VOCs in exhaled breath analysis. The accuracy of this analysis depends on several factors, including the selection of the relevant breath fraction, the type of breath collection container (if used), and the pre-concentration technique.

Over the past decades, there has been a notable increase in the risk of Cardiovascular Disease (CVD), even among younger individuals. Policymakers and the health community have revised CVD prevention programs to include younger people in order to take these new circumstances into account. A variety of CVD risk assessment tools have been developed in the past years with the aim of identifying potential CVD candidates at the population level; however, they can hardly discriminate against younger individuals at high risk of CVD.Therefore, in addition to the traditional 10-year CVD risk assessment, lifetime CVD risk assessment has recently been recommended by the American Heart Association/American College of Cardiology and the European Society of Cardiology prevention guidelines, particularly for young individuals. Methodologically, the benefits of these lifetime prediction models are the incorporation of left truncation observed in survival curves and the risk of competing events which are not considered equivalent in the common survival analysis. Thus, lifetime risk data are easily understandable and can be utilized as a risk communication tool for Public Health surveillance. However, given the peculiarities behind these estimates, structural harmonization should be conducted in order to create a sex-, race-specific tool that is sensitive to accurately identifying individuals who are at high risk of CVD. In this review manuscript, we present the most commonly used lifetime CVD risk tools, elucidate several methodological and critical points, their limitations, and the rationale behind their integration into everyday clinical practice.

The novel 2019 coronavirus disease (COVID-19) was first reported in the last days of December 2019 in Wuhan, China. The presence of certain co-morbidities, including cardiovascular diseases (CVDs), are the basis for worse outcomes in patients with COVID-19. Relevant English-language literature was searched and retrieved from the Google Scholar search engine and PubMed database up to 2023 using COVID-19, SARS-CoV-2, Heart failure, Myocardial infarction, and Arrhythmia and Cardiac complication as keywords. Increased hemodynamic load, ischemia-related dysfunction, ventricular remodeling, excessive neurohumoral stimulation, abnormal myocyte calcium cycling, and excessive or insufficient extracellular matrix proliferation are associated with heart failure (HF) in COVID-19 patients. Inflammatory reaction due to the excessive release of inflammatory cytokines, leads to myocardial infarction (MI) in these patients. The virus can induce heart arrhythmia through cardiac complications, hypoxia, decreased heart hemodynamics, and remarkable inflammatory markers. Moreover, studies have linked cardiac complications in COVID-19 with poor outcomes, extended hospitalization time, and increased mortality rate. Patients with COVID-19 and CVDs are at higher mortality risk and they should be given high priority when receiving the treatment and intensive care during hospitalization.

Objectives: The objective of this systematic review and meta-analysis is to evaluate the influence of caffeine (CAF) intake strategies, taking into account their form, timing, and dosage, on heart rate variability (HRV) indices in the post-exercise recovery period.

Methods: The meta-analysis adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and is registered in the PROSPERO database (CRD42023425885). A comprehensive literature search was carried out across MEDLINE, Web of Science, LILACS, and SCOPUS, concluding in May 2023. We concentrated on randomized clinical trials comparing CAF supplementation effects to placebo on HRV indices post-exercise in active adults aged 18 and above. The primary endpoint was the assessment of HRV indices, measured both prior to and following exercise.

Results: Of the 10 studies included, 7 were used for the meta-analysis, and all contributed to the systematic review. The research explored a variety of CAF strategies, spanning different forms (capsule, drink, gum), times (10, 45, 60 min) and doses (2.1 to 6.0 mg/kg). The outcomes revealed no substantial variations between the placebo and CAF conditions in terms of both the square root of the average of successive squared differences between adjacent RR intervals (RMSSD) (standardized mean difference (SMD) -0.03, 95% CI -0.265 to 0.197, p=0.77) and high frequency (HF) index (SMD -0.061, 95% CI -0.272 to 0.150, p=0.57). Furthermore, metaregression analysis, employing a fixed-effects model and accounting for the administered CAF doses, revealed no significant correlation between caffeine doses and HRV indices (p>0.05).

Conclusion: In conclusion, there is moderate-certainty evidence suggesting that different CAF intake strategies, encompassing aspects such as form, time, and dose, do not have a significant impact on HRV indices recovery post-exercise (i.e., vagal modulation).

Background: Adherence to Congestive Heart Failure with reduced Ejection Fraction (CHFrEF) guidelines is not easily attainable everywhere, particularly in countries with a high prevalence of low socioeconomic status, which includes many Middle Eastern countries. However, it is well-established that adherence to the guidelines is associated with lower mortality and morbidity rates.

Objective: Our objective is to investigate the adherence to the degree of treatment guideline in CHFrEF within a patient population in the Middle East and correlate the level of compliance both fully and partially with morbidity and mortality outcomes. Methods and Statistics: We conducted a retrospective study on patients with CHFrEF in the Middle East region who were maintained on Sacubitril/Valsartan for up to 4 years (190 patients). This study included follow-up assessments for morbidity and mortality rates and their correlation with the level of adherence to guidelines.

Results: Statistical analysis was performed using IBM SPSS® 27th version. In both the partial adherence group and the full adherence group, there was a statistically significant improvement in NYHA (pretreatment and post-treatment) and Ejection fraction (pretreatment and posttreatment). This means that regardless of the level of adherence to the use of Sacubitril/Valsartan in CHFrEF, there was an overall improvement in the morbidity and mortality rates over the four years of follow-up.

Conclusion: While we fully support the idea of achieving full CHFrEF guideline adherence, we recognize the difficulty of this task. Nevertheless, this study reinforces the notion that any degree of adherence to guideline is correlated with better morbidity and mortality rates over a long-term follow-up.