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Assorted topics III 2024 各种主题 III 2024.
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.pcad.2024.11.001
Carl J. Lavie
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引用次数: 0
A review of the interplay between Takotsubo cardiomyopathy and adrenal insufficiency: Catecholamine surge and glucocorticoid deficiency 回顾塔克苏波心肌病与肾上腺功能不全之间的相互作用:儿茶酚胺激增与糖皮质激素缺乏
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.pcad.2024.10.001
Afshin Heidari , Mohammad Ghorbani , Sara Hassanzadeh , Elham Rahmanipour

Background

Takotsubo Cardiomyopathy (TCM) is a transient heart condition often precipitated by stress and characterized by atypical ventricular ballooning. The interplay between TCM and Adrenal Insufficiency (AI), particularly the influence of catecholamine excess and glucocorticoid deficiency on TCM's pathogenesis in individuals with AI, warrants comprehensive exploration for a better understanding of TCM pathophysiology and establishment of potential therapeutic strategies.

Methods

We conducted an extensive literature search via PubMed and Google Scholar, targeting reports on AI, heart failure, and cardiomyopathy, supplemented by forward and backward citation tracing. We analyzed 46 cases from 45 reports, assessing the clinical presentation and outcomes in the context of AI categorization.

Results

In patients with AI, a glucocorticoid deficit appears to exacerbate the myocardial vulnerability to catecholamine toxicity, precipitating TCM. Most conditions were reversible; however, three pre-1990 cases resulted in irreversible outcomes.

Conclusions

The investigation into the AI and TCM intersection highlights the pathogenic significance of catecholamines in the absence of glucocorticoids. The data consolidates the hypothesis that glucocorticoid scarcity exacerbates the cardiac susceptibility to catecholaminergic toxicity, potentially triggering TCM. The study affirms glucocorticoids' cardioprotective roles and elucidates how catecholamine surges contribute to TCM pathogenesis, suggesting strategic clinical management adjustments for AI patients to reduce TCM incidence.
背景:塔克氏心肌病(Takotsubo Cardiomyopathy,TCM)是一种一过性心脏疾病,通常由应激诱发,以非典型心室气囊扩张为特征。中药与肾上腺功能不全(AI)之间的相互作用,尤其是儿茶酚胺过多和糖皮质激素缺乏对中药在 AI 患者中发病机制的影响,值得进行全面探讨,以更好地了解中药的病理生理学并制定潜在的治疗策略:我们通过 PubMed 和 Google Scholar 进行了广泛的文献检索,主要针对有关人工智能、心力衰竭和心肌病的报道,并辅以正向和反向引文追踪。我们分析了 45 篇报道中的 46 个病例,并根据 AI 分类评估了临床表现和预后:结果:在 AI 患者中,糖皮质激素的缺乏似乎加剧了心肌对儿茶酚胺毒性的脆弱性,从而诱发了中药。大多数情况是可逆的,但有三例 1990 年以前的病例导致了不可逆转的结果:对 AI 和中药交叉的调查强调了儿茶酚胺在糖皮质激素缺失时的致病意义。这些数据巩固了糖皮质激素缺乏会加剧心脏对儿茶酚胺能毒性的易感性,从而可能引发中医的假说。该研究肯定了糖皮质激素的心脏保护作用,并阐明了儿茶酚胺激增是如何导致中医发病的,建议对人工流产患者进行战略性临床管理调整,以降低中医发病率。
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引用次数: 0
The ventilatory efficiency parameters outperform peak oxygen consumption in monitoring the therapy effects in patients with hypertrophic cardiomyopathy 在监测肥厚型心肌病患者的治疗效果方面,通气效率参数优于峰值耗氧量。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.pcad.2024.10.005
Stefan Seman , Milorad Tesic , Marija Babic , Lidija Mikic , Lazar Velicki , Nduka C Okwose , Sarah J Charman , Maria Tafelmeier , Iacopo Olivotto , Nenad Filipovic , Arsen Ristic , Ross Arena , Marco Guazzi , Djordje Jakovljevic , Thomas G Allison , Dejana Popovic , on behalf of SILICOFCM study investigators

Aim

We sought the cardiopulmonary exercise testing (CPET) parameter that most accurately reflected therapeutic efficacy in patients with hypertrophic cardiomyopathy (HCM).

Methods

Well-being questionnaire, N-terminal brain natriuretic peptide measurements, echocardiography, and CPET were performed in patients with symptomatic non-obstructive HCM during phase II, randomized, open-label multicentre study, before and after 16 weeks of traditional or sacubitril/valsartan treatment. Patients were followed 36 months after the initial CPET. Primary endpoints were changes in: 1) peak oxygen consumption (VO2); 2) VO2 at anaerobic threshold (AT); 3) oxygen pulse; 4) minute ventilation (VE)/carbon-dioxide (CO2) production slope; 5) VE/VCO2 at AT (VE/VCO2_AT); 6) VE/VCO2 nadir; 7) VE/VCO2 intercept; and 8) partial end-tidal pressure of carbon-dioxide (PETCO2) change during CPET.

Results

Of 115 screened patients, 61 (52 ± 14 years, 43 % women) were included. Within subject therapy effects were detected only by the VE/VCO2 intercept and PETCO2 change, whereas the differences between medical regimens were detected by differences in VE/VCO2 nadir and VE/VCO2_AT changes after the treatment. The best predictors of the change in well-being were left ventricular outflow tract maximal gradient and VE/VCO2 intercept (B = 0.41,0.36; SE = 0.16,0.30; CI = 0.14–0.79, 0.15–1.14; p = 0.006,0.016, respectively). Adverse cardiac events were best predicted by the initial VE/VCO2 nadir.

Conclusion

Ventilatory efficiency parameters outperform peak VO2 in gauging therapy effects in patients with HCM.
目的:我们寻找能最准确反映肥厚型心肌病(HCM)患者疗效的心肺运动测试(CPET)参数:在 II 期随机、开放标签多中心研究中,对有症状的非梗阻性 HCM 患者在接受传统治疗或沙库比曲利/缬沙坦治疗 16 周前后进行了健康问卷调查、N 端脑钠肽测量、超声心动图和 CPET。在首次 CPET 治疗 36 个月后对患者进行随访。主要终点是以下指标的变化1)峰值耗氧量(VO2);2)无氧阈值(AT)时的 VO2;3)氧脉搏;4)分钟通气量(VE)/二氧化碳(CO2)产生斜率;5)AT 时的 VE/VCO2(VE/VCO2_AT);6)VE/VCO2 最低值;7)VE/VCO2 截距;8)CPET 期间二氧化碳部分潮气末压(PETCO2)的变化:结果:在 115 名接受筛查的患者中,61 人(52 ± 14 岁,43% 为女性)入选。仅通过 VE/VCO2 截距和 PETCO2 变化来检测受试者内部的治疗效果,而通过治疗后 VE/VCO2 nadir 和 VE/VCO2_AT 变化的差异来检测医疗方案之间的差异。左心室流出道最大阶差和 VE/VCO2 截距(B = 0.41,0.36;SE = 0.16,0.30;CI = 0.14-0.79,0.15-1.14;P = 0.006,0.016)是预测健康状况变化的最佳指标。初始 VE/VCO2 最低值对不良心脏事件的预测效果最佳:结论:在衡量 HCM 患者的治疗效果方面,通气效率参数优于峰值 VO2。
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引用次数: 0
List of recent issues
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/S0033-0620(24)00157-9
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引用次数: 0
Healthy and unhealthy plant-based diets and the risk of cardiovascular diseases: The Rotterdam study and updated meta-analysis 健康和不健康的植物性饮食与心血管疾病风险:鹿特丹研究和最新荟萃分析。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.pcad.2024.10.008
Xiang Jun Wang , Trudy Voortman , Tosca O.E. de Crom , Martijn Tilly , Maryam Kavousi , M. Kamran Ikram , Marinka Steur

Background

Consumption of more plant-based foods is gaining popularity, but the role of healthy versus unhealthy plant-based diets in cardiovascular disease (CVD) risk remains inconclusive.

Objectives

We investigated associations of plant-based diet indices (PDIs) with incident CVDs in a prospective cohort study and conducted an updated meta-analysis.

Methods

We included 3507 men and 5345 women of the population-based Rotterdam Study. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for CVD, coronary heart disease (CHD) and stroke per SD increment of an overall PDI, healthy PDI (hPDI) and unhealthy PDI (uPDI), among men and women separately. We combined our findings with previously published effect estimates in an updated meta-analysis.

Results

We documented 2015 CVD cases (1231 CHD and 952 stroke) during 107,290 person-years follow-up. Among men, the PDI and hPDI were associated with a 7 % (HR 0.93, 95 % CI 0.87–0.99) and 8 % (HR 0.92, 95 % CI 0.86–0.98) lower CVD risk. Among women, there was evidence suggesting a U-shaped association of the PDI with stroke (pnon-linearity < 0.01). In meta-analyses including up to 43,067 incident CVD cases among 359,740 participants from nine studies, the PDI and hPDI, were associated with a lower CVD riskand the uPDI with a higher CVD risk (pooled HRs [95 % CI], per SD, PDI: 0.94 [0.91–0.97], I2 = 50.4 %; hPDI: 0.94 [0.91–0.98], I2 = 74.7 %; uPDI: 1.03 [1.01–1.06], I2 = 49.0 %).

Conclusions

Our findings support recommendations to consume relatively more healthy plant-based foods for CVD prevention. Potential differences by sex and non-linear associations warrant further investigation.
背景:食用更多的植物性食品越来越受到人们的欢迎,但健康与不健康的植物性膳食在心血管疾病(CVD)风险中的作用仍无定论:我们在一项前瞻性队列研究中调查了植物性饮食指数(PDI)与心血管疾病发病率的关系,并进行了最新的荟萃分析:我们纳入了基于人群的鹿特丹研究中的 3507 名男性和 5345 名女性。我们使用多变量 Cox 比例危险模型分别估算了男性和女性在总体 PDI、健康 PDI(hPDI)和不健康 PDI(uPDI)每 SD 增量下心血管疾病、冠心病(CHD)和中风的危险比(HRs)和 95 % 置信区间(CIs)。我们在最新的荟萃分析中将我们的研究结果与之前发表的效果估计值相结合:在 107,290 人年的随访中,我们记录了 2015 例心血管疾病病例(1231 例冠心病和 952 例中风)。在男性中,PDI和hPDI分别与心血管疾病风险降低7%(HR 0.93,95% CI 0.87-0.99)和8%(HR 0.92,95% CI 0.86-0.98)相关。在女性中,有证据表明 PDI 与中风呈 U 型关系(非线性 2 = 50.4%;hPDI:0.94 [0.91-0.98],I2 = 74.7%;uPDI:1.03 [1.01-1.06],I2 = 49.0%):我们的研究结果支持为预防心血管疾病而摄入相对较多的健康植物性食品的建议。潜在的性别差异和非线性关联值得进一步研究。
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引用次数: 0
Optical coherence tomography angiography in cardiovascular disease 心血管疾病的光学相干断层血管造影。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.pcad.2024.10.011
Oluwapeyibomi I. Runsewe , Sunil K. Srivastava , Sumit Sharma , Pulkit Chaudhury , W.H. Wilson Tang
Endothelial dysfunction and microvascular remodeling underly the development and progression of a host of cardiovascular disease (CVD). However, current methods to assess coronary epicardial microvascular function are invasive, time-intensive, and costly. Optical coherence tomography angiography (OCTA) is an established technology within ophthalmology that provides a quick, noninvasive assessment of vascular structures within the retina. As a growing body of evidence reveals strong associations between the retinal changes on OCTA and the development and progression of CVD, OCTA may indeed be a surrogate test for end-organ dysfunction. OCTA has potential to enhance diagnostic performance, refine cardiovascular risk assessment, strengthen prognostication, and ultimately, improve patient care. We explore the current literature on OCTA in cardiovascular diseases to summarize the clinical utility of retinal OCTA imaging and discuss next-generation cardiovascular applications.
内皮功能障碍和微血管重塑是一系列心血管疾病(CVD)发生和发展的基础。然而,目前评估冠状动脉心外膜微血管功能的方法都是侵入性的、耗时耗力且成本高昂。光学相干断层血管造影(OCTA)是眼科领域一项成熟的技术,可对视网膜内的血管结构进行快速、无创的评估。越来越多的证据表明,OCTA 所显示的视网膜变化与心血管疾病的发生和发展密切相关,因此 OCTA 可能确实是内脏器官功能障碍的替代检测方法。OCTA 具有提高诊断性能、完善心血管风险评估、加强预后判断以及最终改善患者护理的潜力。我们探讨了当前有关心血管疾病中 OCTA 的文献,总结了视网膜 OCTA 成像的临床实用性,并讨论了下一代心血管应用。
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引用次数: 0
Cover 2 (Masthead) 封二(刊头)
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/S0033-0620(24)00131-2
{"title":"Cover 2 (Masthead)","authors":"","doi":"10.1016/S0033-0620(24)00131-2","DOIUrl":"10.1016/S0033-0620(24)00131-2","url":null,"abstract":"","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"86 ","pages":"Page IFC"},"PeriodicalIF":5.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Testosterone replacement therapy and cardiovascular risk: TRAVERSE with caution 睾酮替代疗法与心血管风险:慎用TRAVERSE。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.pcad.2024.07.003
Srikanth Krishnan , Jairo Aldana-Bitar , Ilana Golub , Sina Kianoush , Travis Benzing , Keishi Ichikawa , Matthew J. Budoff
{"title":"Testosterone replacement therapy and cardiovascular risk: TRAVERSE with caution","authors":"Srikanth Krishnan ,&nbsp;Jairo Aldana-Bitar ,&nbsp;Ilana Golub ,&nbsp;Sina Kianoush ,&nbsp;Travis Benzing ,&nbsp;Keishi Ichikawa ,&nbsp;Matthew J. Budoff","doi":"10.1016/j.pcad.2024.07.003","DOIUrl":"10.1016/j.pcad.2024.07.003","url":null,"abstract":"","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"86 ","pages":"Pages 73-74"},"PeriodicalIF":5.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Substances use and risk of hypertension before midlife in military young adults: CHIEF cohort study, 2014–2020 军队青壮年中年前的药物使用与高血压风险:首席队列研究,2014-2020 年。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.pcad.2024.08.005
Gen-Min Lin , Kun-Zhe Tsai , Yun-Chen Chang , Pang-Yen Liu , Xuemei Sui , Carl J. Lavie , Po-Shun Hsu

Background

The use of substances, e.g., tobacco and betel nut, are prevalent among military personnel in Taiwan, whereas some specific substances such as alcohol use are forbidden in military base. There were inconsistent findings for the incidence of hypertension with habitual substances use in diverse populations, while no studies were carried out in the military.

Methods

A total of 2419 Taiwanese military personnel, aged 18–39 years, who were not taking any antihypertensive agents and did not have a baseline systolic blood pressure (SBP) ≥130 mmHg and/or diastolic blood pressure (DBP) ≥80 mmHg were followed for incidence of hypertension from baseline (2014) through the end of 2020. Alcohol, tobacco and betel nut use status (active vs. former/never) were self-reported by each participant at baseline. New-onset hypertension of each participant was defined by an average of two resting BP measurements in the annual health examinations (2015–2020). Multivariable Cox regression analysis with adjustments for baseline BP and other potential covariates were performed to determine the risk of incident hypertension with each substance use. Five-year absolute changes in BP level with specific substance use were compared using analysis of covariance (ANCOVA).

Results

There were 867 active smokers (35.8 %), 237 active betel nut chewers (9.8 %) and 961 active alcohol consumers (39.7 %) at baseline. During a median follow-up of 5.8 years, 911 new-onset hypertension events (37.7 %) were observed. While compared to those without any substances use, merely active holiday alcohol users had a significantly lower risk of incident hypertension [hazard ratio (HR) and 95 % confidence interval: 0.72 (0.58–0.89)]. The 5-year diastolic BP increase (mmHg) was borderline significantly lower in active alcohol users on holidays as compared to former/never alcohol users (4.02 (standard deviation =9.01) and 4.76 (9.42), p = 0.07). The risk of incident hypertension was not significant in active smokers and active betel nut users, while the 5-year BP increase level was significantly greater in active smokers than former/never smokers (5.60 (9.96) vs. 4.42 (9.22), p = 0.03).

Conclusion

Our findings suggest that military young personnel consuming alcohol only allowed on holidays had a lower incidence of new-onset hypertension. On the contrary, the 5-year BP change may increase greater with habitual smoking, though the risk of new-onset hypertension was not affected.
背景:台湾军人普遍使用烟草和槟榔等物质,而一些特定物质如酒精在军事基地是禁止使用的。关于高血压发病率与习惯性使用药物的关系,在不同人群中的研究结果不一致,而在军队中则没有研究:方法:从基线(2014 年)到 2020 年底,对未服用任何降压药且基线收缩压 (SBP) ≥130 mmHg 和/或舒张压 (DBP) ≥80 mmHg 的 2419 名 18-39 岁台湾军人进行了高血压发病率跟踪调查。酒精、烟草和槟榔的使用状况(活跃与曾经/从未)由每位参与者在基线时自我报告。每位参与者新发高血压的定义是在年度健康检查(2015-2020 年)中两次静息血压测量的平均值。在对基线血压和其他潜在协变量进行调整后,进行了多变量 Cox 回归分析,以确定每种药物使用导致的高血压发病风险。使用协方差分析(ANCOVA)比较了使用特定药物五年后血压水平的绝对变化:结果:基线时有 867 名活跃的吸烟者(35.8%)、237 名活跃的槟榔咀嚼者(9.8%)和 961 名活跃的饮酒者(39.7%)。在 5.8 年的中位随访期间,共观察到 911 例新发高血压(37.7%)。与未使用任何药物的人群相比,仅在节假日积极饮酒的人群发生高血压的风险明显较低[危险比(HR)和 95% 置信区间:0.72 (0.58-0.89)]。与以前/从未饮酒者相比,节假日积极饮酒者的 5 年舒张压升幅(毫米汞柱)明显低于以前/从未饮酒者(4.02(标准差=9.01)和 4.76(9.42),P = 0.07)。积极吸烟者和积极槟榔使用者发生高血压的风险并不明显,而积极吸烟者的 5 年血压升高水平明显高于曾经/从不吸烟者(5.60 (9.96) vs. 4.42 (9.22),p = 0.03):我们的研究结果表明,只允许在节假日饮酒的青年军人新发高血压的发病率较低。结论:我们的研究结果表明,只允许在节假日饮酒的军队青年新发高血压的发病率较低,相反,习惯性吸烟者的 5 年血压变化可能会更大,但新发高血压的风险不受影响。
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引用次数: 0
Clonal hematopoiesis of indeterminate potential and cardiovascular disease: Pathogenesis, clinical presentation, and future directions 不确定潜能克隆造血与心血管疾病:发病机制、临床表现和未来方向。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.pcad.2024.09.001
Saivaroon Gajagowni , Steven Hopkins , Yusuf Qadeer , Salim S. Virani , Job A.J. Verdonschot , Catherine C. Coombs , Christopher I. Amos , Kevin T. Nead , Siddhartha Jaiswal , Chayakrit Krittanawong
Clonal hematopoiesis of indeterminate potential (CHIP) is a well-studied phenomenon in hematologic malignancies. With advancements in gene sampling and analysis and the use of large cohort studies, CHIP has recently been linked to cardiovascular disease (CVD). The relationship between CHIP and CVD appears to be bidirectional, with traditional risk factors for cardiovascular disease increasing the mutation burden in CHIP, and CHIP itself effecting the incidence or prognosis of a variety of CVD. The purpose of this review is to understand the epidemiology, risk factors, and pathogenesis of CHIP in the context of various CVD conditions.
具有不确定潜能的克隆性造血(CHIP)是血液系统恶性肿瘤中一种被广泛研究的现象。随着基因取样和分析技术的进步以及大型队列研究的应用,CHIP 最近被认为与心血管疾病(CVD)有关。CHIP 与心血管疾病之间的关系似乎是双向的,心血管疾病的传统风险因素会增加 CHIP 的突变负担,而 CHIP 本身则会影响各种心血管疾病的发病率或预后。本综述旨在从各种心血管疾病的角度了解 CHIP 的流行病学、风险因素和发病机制。
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引用次数: 0
期刊
Progress in cardiovascular diseases
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