Future cardiology最新文献

Aim: We aimed to assess low to mid-range left ventricular ejection fraction (LVEF) predictors at one-month follow-up in STEMI patients using baseline electrocardiography (ECG) and standard laboratory tests.Methods: In this retrospective cross-sectional study, 130 STEMI patients (79% male, mean age: 57.2 ± 11.9 years) were enrolled. Multivariate linear regression analysis determined the relationship of baseline 12-lead ECG and clinical/laboratory parameters with LVEF at the 1st-month follow-up visit.Results: The mean LVEF of the patients at the 1st-month follow-up visit was 51.8 ± 8.7%. There was a significant negative correlation between age (r = -0.206)*, peak CK-MB level (-0.0411)**, QTc interval (r = -0.209)*, STE amount (mV) (r = -0.286)**, V_5-6 RWPT (r = -0.238)** and aVR RWPT (r = -0.466)** with LVEF (*p < 0.05; **p < 0.01). The aVR R wave peak time (RWPT) (OR: 0.88, p < 0.01) and peak CK-MB level (OR: 0.91, p < 0.01) were the two most important predictors of low-to-mid-range LVEF (<%50) during mean 38 ± 5 days follow-up after STEMI.Conclusion: Our study results suggested that the baseline aVR RWPT and peak CK-MB level were associated with low-to-mid-range LVEF at the 1st-month follow-up after STEMI. These parameters may be used in the risk stratification of STEMI patients to develop LV remodeling during follow-up.

Bicuspid aortic valve (BAV) is one of the most common congenital valvular heart diseases occurring in 0.5-2% of the general population, in 2-6% of patients with severe aortic stenosis (AS) and up to 20% of octo/nonagenarians undergoing surgery. In this regard, Transcatheter aortic valve replacement (TAVR) has emerged as a therapeutic alternative. At the present time, there is not enough evidence to determine which is the best therapeutic approach for AS in BAV. We report a severe acute recoil following TAVR with a self-expanding prosthesis in heavily calcified BAV. In addition, we provide an updated review of the clinical significance of prosthesis underexpansion in the medium-term.

Pulsed-field ablation (PFA) is a newer energy delivery method, an alternative to thermal lesion, allowing for safe and durable pulmonary vein isolation in the context of atrial fibrillation ablation. Graded tissue sensitivity allows for specifically targeting atrial cardiomyocytes, rendering collateral damage to nearby nerves and vessels unlikely. In the present rapid communication, we report on our center's initial experience with a novel PFA platform and describe the ways in which it can be used targeting sites beyond PV ostia and antra, in the context of atrial fibrillation/flutter/tachycardia ablation, alone or in conjunction with a mainstream 3-dimensional electroanatomical mapping system (3D-EAM). More specifically, the exploratory application of PFA in the vicinity of pacemaker/defibrillator leads may prove of particular significance for clinical practice, given the frequent need to isolate the superior vena cava in patients bearing a transvenous cardiac rhythm management device.

Dysfunctions in miRNA production have been recently investigated as predictors of neoplasms and their therapeutic strategies. In this review, we summarize the available knowledge on miRNAs and cardiac tumors (such as myxoma) and mediastinal tumors (such as thymoma) and propose new avenues for future research. MiRNAs are crucial for cardiac development through the expression of cardiac transcription factors (miR-335-5p), hinder the cell cycle by modulating the activity of transcription factors (miR-126-3p, miR-320a), modulate the production of inflammatory factors such as interleukins (miR-217), and interfere with cell proliferation or apoptosis (miR-218, miR-634 and miR-122). Current and future research on miRNAs is essential, as a deep understanding could lead to a revolution in the field of diagnostics and prevention of neoplastic diseases.

Proton pump inhibitors (PPI) are widely used medications for gastrointestinal disorders. Recent research suggests a potential association between long-term PPI use and increased cardiovascular (CV) risk, creating a complex clinical dilemma. This review critically evaluates the current evidence for this association, considering the limitations of observational studies and the lack of definitive confirmation from randomized controlled trials.This review delves into the reported association between PPIs and adverse CV events, examining proposed mechanisms such as drug interactions, electrolyte imbalances induced by PPIs and their potential impact on cardiac and vascular function. Evidence suggests these mechanisms converge, with varying influence depending on patient populations.Clinicians require a risk-benefit analysis for each patient considering their CV risk profile. Alternative gastrointestinal therapies should be explored for high-bleeding risk patients. Medications with lower cytochrome-P450 interaction potential may be preferable among essential PPI users. Elucidating the specific mechanisms by which PPIs might influence CV health, assessing long-term vascular effects and investigating interactions with newer anticoagulant medications are crucial for future research.

Functional coronary angiography (FCA) is a novel modality for assessing the physiology of coronary lesions, going beyond anatomical visualization by traditional coronary angiography. FCA incorporates indices like fractional flow reserve (FFR) and instantaneous wave-free ratio (IFR), which utilize pressure measurements across coronary stenoses to evaluate hemodynamic impacts and to guide revascularization strategies. In this review, we present traditional and evolving modalities and uses of FCA. We will also evaluate the existing evidence and discuss the applicability of FCA in various clinical scenarios. Finally, we provide insight into emerging evidence, current challenges, and future directions in FCA.