Global Cardiology Science & Practice最新文献

Left ventricular aneurysms (LVAs) and pseudoaneurysms (LVPs) are common complications following acute myocardial infarction (AMI), predominantly involving the anterior wall due to complete occlusion of the left anterior descending (LAD) artery. Both conditions are associated with heart failure, arrhythmias, and thromboembolic events. However, differentiating between LVA and LVP is crucial, as LVPs carry a higher rupture risk and require surgical management. We present a case of LVP, diagnosed using cardiac magnetic resonance imaging (CMRI), in a patient with chronic total occlusion of the LAD, which was managed surgically. This case emphasizes the critical role of imaging in guiding appropriate treatment decisions.

Background: The increase in the number of patients with heart failure in recent years is multifactorial and is partly due to an aging population, improved survival from acute cardiovascular events (e.g., myocardial infarction), and advances in primary and secondary prevention strategies that have extended life expectancy of patients. Objective: The purpose of this study is to evaluate health-promoting behaviors in patients with heart failure. Methodology: Using a cross-sectional, observational research method, 143 patients diagnosed with heart failure at the Chapidze Emergency Cardiology Center (Tbilisi, Georgia) were interviewed. The average age of the patients was 64.8 ± 9.2 years, 63% of whom were men. Results and discussion: The results showed a negative association between age and healthy eating habits, as well as a positive mental attitude. Higher education levels were associated with better health behaviors. The more knowledge patients had about their disease, the more likely they were to engage in health-promoting behaviors. Patients with a disease duration of >15 years were more likely to engage in healthy eating habits and maintain a positive mental attitude. Subjects implanted with a pacemaker/cardioverter had a low-confidence mental attitude. Conclusions: Interventions that promote healthy behaviors in patients with heart failure should be expanded, particularly in those who are older, less educated, have a longer disease duration, have low disease knowledge, and/or are implanted with a cardioverter/pacemaker. Future interventions should include educational, psychological, and behavioral support strategies tailored to individual needs to encourage health-promoting behaviors and maintain a positive mental attitude among patients with HF.

Radial access for coronary interventions usually has fewer complications than the femoral route. An iatrogenic arteriovenous fistula (AVF) at the access site is a complication sometimes associated with coronary procedures, most often via the transfemoral route. However, it is rarely encountered with transradial access. We report a rare case of iatrogenic right radial arteriovenous fistula in a 52-year-old male following percutaneous transluminal coronary angioplasty (PTCA) via a right radial access. The increasing frequency of right radial access for coronary interventions necessitates awareness and recognition of this potential complication. Furthermore, necessary precautions should be taken to prevent its development.

Objective: Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide, including in Azerbaijan. This study investigates the association of ITGA2 (C807T) and ITGB3 (T1565C) gene polymorphisms with platelet characteristics in Azerbaijani patients with arterial hypertension (AH), focusing on potential thrombotic risk. Methods: A total of 100 participants were examined, including 76 hypertensive patients and 24 controls. The hypertensive group was further subdivided based on comorbidities: ischemic heart disease (IHD) and type 2 diabetes mellitus (T2DM). Genotyping was performed using the massARRAY method. Platelet indices, including mean platelet volume (MPV), plateletcrit (PCT), and platelet large cell ratio (P-LCR), platelet distribution width (PDWsd) were evaluated. Statistical analysis was conducted using IBM SPSS Statistics 26, with correlation tests, ANOVA, and Chi-square tests to examine genotype distribution and platelet characteristics. Results: Carriers of the homozygous C/C genotype of the ITGA2 gene and T/T genotype of the ITGB3 gene exhibited the highest platelet counts and elevated MPV, suggesting a tendency toward increased platelet aggregation. Although all platelet parameters remained within the normal range, significant correlations were found between the ITGA2 T allele and MPV, PDWsd, and LPCR in hypertensive patients (p < 0.05). The study indicates that patients with the T/T genotype of ITGA2 and ITGB3 may have an elevated risk of thromboembolism. Conclusion: Integrin gene polymorphisms, particularly in ITGA2 and ITGB3, are associated with altered platelet characteristics in Azerbaijani patients with arterial hypertension. These genetic markers could serve as predictors for thrombotic complications, providing insights into targeted prevention strategies in CVD management.

Background: Phrenic nerve injury (PNI) and esophageal injury are serious complications associated with atrial fibrillation (AF) ablation procedures. Pulsed field ablation (PFA), a non-thermal modality, has emerged as a promising alternative to conventional thermal ablation techniques, such as radiofrequency ablation (RFA) and cryoballoon ablation (CBA). Objective: To evaluate and compare the incidence of PNI and esophageal injury following PFA, RFA, and CBA in patients undergoing AF ablation. Methods: A systematic search of The Cochrane Library, MEDLINE, and EMBASE databases was conducted for studies published between 2014 and 2024. Cohort and case-control studies comparing PFA with RFA and/or CBA in relation to PNI and esophageal injury were included. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Results: Eleven studies involving 4,603 patients were included in the analysis. The incidence of PNI was 0.23% with PFA, 0.63% with RFA, and 2.68% with CBA, respectively. A meta-analysis of five studies comparing PFA and CBA showed a significantly lower risk of PNI with PFA (RR 0.13, 95% CI [0.04-0.35]; p < 0.0001). No esophageal injury was reported in the PFA group, compared to 2.79% in the RFA group and 1.45% in the CBA group. Pooled analysis demonstrated that PFA significantly reduced the risk of esophageal injury compared to RFA (RR 0.06, 95% CI [0.01-0.29]; p = 0.0005) and CBA (RR 0.07, 95% CI [0.01-0.39]; p = 0.002). Conclusion: PFA is associated with a significantly lower risk of phrenic nerve and esophageal injury than RFA and CBA.

Erectile dysfunction and cardiovascular disease share common underlying mechanisms, with the former being an early marker of cardiovascular risk. Phosphodiesterase-5 inhibitors, widely used as first-line therapy for erectile dysfunction, also exhibit systemic vasodilatory properties with potential cardiovascular implications. This systematic review evaluates their impact on cardiovascular outcomes in patients with coexisting erectile dysfunction and cardiovascular disease. A comprehensive analysis of 13 studies identified significant cardiovascular benefits, including reduced risks of myocardial infarction, heart failure, and overall mortality. The mechanisms underlying these effects include improved endothelial function, reduced systemic inflammation, and enhanced exercise capacity. Despite these benefits, neutral or adverse outcomes have been noted in specific conditions and populations, such as heart failure with preserved ejection fraction and post-stroke patients. These findings highlight the importance of patient-specific factors in determining the appropriateness of phosphodiesterase-5 inhibitors. These results underscore the potential of these therapies to provide cardioprotective effects while emphasizing the necessity for tailored treatment strategies to maximize benefits and mitigate risks in high-risk populations.

This study examines the impact of congenital syphilis incidence trends on congenital heart surgery outcomes in Brazil, with a focus on mortality rates, treatment costs, and length of hospital stay. Using an ecological study design, we analyzed nationwide data from 2007 to 2023 to identify regional and temporal patterns in these relationships. The results revealed significant increases in the incidence of syphilis across all regions, accompanied by marked disparities in healthcare resource allocation and surgical capacity. The Northeast and Southeast regions demonstrated expansion in approved surgeries, while the North and South regions exhibited comparatively slower growth, highlighting inequities in specialized care access. Correlation analyses identified a moderate negative association between syphilis incidence and mortality rate, and a strong negative correlation between cost per surgery and mortality. Our regression model explained 44.2% of the variance in mortality rates, with syphilis incidence, cost per surgery, and length of hospital stay emerging as significant predictors. Machine learning validation confirmed the predominance of linear relationships, with Linear Regression (R ² = 0.513) outperforming Random Forest (R ² = 0.321). These findings highlight the need for targeted interventions to address regional disparities and optimize resource allocation, offering evidence-based guidance to policymakers and healthcare providers to improve neonatal health outcomes in Brazil.

Introduction: Diagnosing heart failure with preserved ejection fraction (HFpEF) remains challenging. Several diagnostic criteria have been proposed, and current guidelines recommend using the HFA-PEFF score in the diagnostic algorithm for HFpEF. We sought to evaluate the clinical utility of left atrial strain (LAS) in the diagnosis of HFpEF as assessed by the HFA-PEFF score. Methods: This was a prospective, mono-centric, cross-sectional study conducted from October 2021 to June 2022 in the Cardiology Department of the Internal Security Forces Hospital of Marsa, Tunisia. Patients were classified into two groups (A and B) based on the HFpEF diagnosis assessed by the HFA-PEFF scoring system: Group A with a score of ≥5 and Group B with a score of <5. Results: A total of 110 patients were eligible for the study. The mean age was 61 ± 11 years. A female predominance was noted, with 57% of the patients being female. Hypertension and diabetes were the most common cardiovascular risk factors, found in 81.8% (n = 90) and 54.5% (n = 60) of patients, respectively. The median HFA-PEFF score was 4 [2-6]. Forty-six patients (41.6%) were given a clinical diagnosis of HFpEF. LAS analysis showed that PALS (p < 0.001) and PACS (p < 0.001) were significantly lower in Group A compared with Group B. PALS was strongly correlated with the HFA-PEFF score (r = -0.693, p < 0.001). PALS (AUC = 0.889; p < 0.001) was significantly the best predictor of HFpEF diagnosis. After multivariate analysis, PALS (HR = 0.782; 95% CI [0.629-0.973]; p = 0.027) was an independent predictor of HFpEF diagnosis, with a cut-off value of 24% (sensitivity of 86% and specificity of 89.5%). Conclusion: PALS is a simple and sensitive ultrasound parameter that can be used for the diagnosis of HFpEF.