World Journal of Cardiology最新文献

Metabolic dysfunction-associated steatotic liver disease (MASLD), particularly in patients with type 2 diabetes mellitus (T2DM), is increasingly recognized as a multi-system disease that affects both hepatic and cardiovascular health. This study explores the association between MASLD-related liver fibrosis and cardiac dysfunction, focusing on how liver fibrosis contributes to cardiac remodeling and dysfunction. Cernea et al's research highlights the strong correlation between liver fibrosis and changes in left ventricular mass, left atrial dimensions, and systolic and diastolic function in diabetic patients. Notably, the study suggests a protective role of sex-hormone binding protein against cardiac remodeling. These findings underline the importance of early detection of liver fibrosis using non-invasive markers like fibrosis-4 index and nonalcoholic fatty liver disease fibrosis scores, which may offer dual protection for both liver and heart health in T2DM patients. Moreover, this study calls for further research into the shared pathogenic mechanisms, including inflammation and fibrosis pathways, between the liver and heart. It advocates for the integration of liver fibrosis screening into cardiovascular risk management, urging clinicians to adopt a more holistic approach in treating patients with MASLD and T2DM. The research has broad implications for preventing cardiovascular complications and improving outcomes in this high-risk population.

Atrial fibrillation (AF)/atrial flutter (AFL) is the most common sustained cardiac arrhythmia. The known risk factors for developing AF/AFL include age, structural heart disease, hypertension, diabetes mellitus, or hyperthyroidism. This study aims to attribute the trends in AF/AFL-related mortalities over the past two decades 1999-2020 concerning race and sex and disparity among them. To the best of our knowledge, this is the first study that estimates the trends and mortality due to AF/AFL from 1999-2020 in older adults in the United States. In this 21-year analysis of mortality data, we found a constant increase in mortality rates due to AF/AFL in older adults. From 1999 to 2020, the overall mortality in older adults aged 65 and above, regardless of sex and race, is found to be almost doubled i.e. about a 50.2% increase in the number of deaths due to AF/AFL. Furthermore, other confounding risk factors such has obesity, prior myocardial infarction, inflammation, hypertension, birth weight, diabetes mellitus, hyperthyroidism, hormone replacement therapy in menopausal women increases the risk in the occurrence or recurrent occurrence of AF.

Sodium-glucose cotransporter-2 (SGLT-2) inhibitors represent a cutting-edge class of oral antidiabetic therapeutics that operate through selective inhibition of glucose reabsorption in proximal renal tubules, consequently augmenting urinary glucose excretion and attenuating blood glucose levels. Extensive clinical investigations have demonstrated their profound cardiovascular efficacy. Parallel basic science research has elucidated the mechanistic pathways through which diverse SGLT-2 inhibitors beneficially modulate pulmonary vascular cells and arterial remodeling. Specifically, these inhibitors exhibit promising potential in enhancing pulmonary vascular endothelial cell function, suppressing pulmonary smooth muscle cell proliferation and migration, reversing pulmonary arterial remodeling, and maintaining hemodynamic equilibrium. This comprehensive review synthesizes current literature to delineate the mechanisms by which SGLT-2 inhibitors enhance pulmonary vascular cell function and reverse pulmonary remodeling, thereby offering novel therapeutic perspectives for pulmonary vascular diseases.

Heart failure (HF) is a complex syndrome characterized by the reduced capacity of the heart to adequately fill or eject blood. Currently, HF remains a leading cause of morbidity and mortality worldwide, imposing a substantial burden on global healthcare systems. Recent advancements have highlighted the therapeutic potential of mesenchymal stromal cells (MSCs) in managing HF. Notably, umbilical cord-derived MSCs (UC-MSCs) have demonstrated superior clinical potential compared to traditional bone marrow-derived MSCs; this is evident in their non-invasive collection process, higher proliferation efficacy, and lower immunogenicity and tumorigenicity, as substantiated by preclinical studies. Although the feasibility and safety of UC-MSCs have been tested in animal models, the application of UC-MSCs in HF treatment remains challenged by issues such as inaccurate targeted migration and low survival rates of UC-MSCs. Therefore, further research and clinical trials are imperative to advance the clinical application of UC-MSCs.

Background: The increasing risk of cardiovascular disease (CVD) associated with worsening environmental exposure is a critical health concern garnering global research attention.

Aim: To systematically assess the scope and characteristics of research on the relationship between environmental exposure and CVD.

Methods: A thorough examination of publications on the relationship between environmental exposure and CVD from 1999 to 2022 was carried out by extensively screening the literature using the Web of Science Core Collection. The language of the selected publications was standardized to English. Afterward, different academic tools such as CiteSpace, VOSviewer, HistCite, Python, Matplotlib, and Bibliometrix were utilized to examine the research trends in this field.

Results: The study's findings indicated a steady increase in scientific publications among the 1640 analyzed documents, peaking in 2022 with 197 publications. The United States emerged as the leading nation regarding high-quality publications and international collaboration. Harvard University was identified as the most prolific institution. "Environmental research" was the most frequently contributing journal, and Muenzel T was recognized as the top contributor. Current research hotspots are primarily concentrated on themes such as "cardiovascular disease", "exposure", "risk", "mortality", and "air pollution".

Conclusion: This study highlights increasing research on the link between environmental exposure and CVD, identifying key exposures and diseases while emphasizing the need for further investigation into underlying mechanisms.

Hypertrophic cardiomyopathy (HCM) is an autosomal dominant inherited cardiomyopathy characterized by left ventricular hypertrophy. It is one of the chief causes of sudden cardiac death in younger people and athletes. Molecular-genetic studies have confirmed that the vast majority of HCM is caused by mutations in genes encoding sarcomere proteins. HCM has a relatively wide phenotypic heterogeneity, varying from asymptomatic to sudden cardiac death, because of the many different mutations and pathogenic genes underlying it. Many studies have explored the clinical symptoms and prognosis of HCM, emphasizing the importance of genotype in evaluating patient prognosis and guiding the clinical management of HCM. To elaborate the main pathogenic genes and phenotypic prognosis in HCM to promote a better understanding of this genetic disease. Retrospective analysis of literature to evaluate the association between underlying gene mutations and clinical phenotypes in HCM patients. As sequencing technology advances, the pathogenic gene mutation spectrum and phenotypic characteristics of HCM are gradually becoming clearer. HCM is a widespread inherited disease with a highly variable clinical phenotype. The precise mechanisms linking known pathogenic gene mutations and the clinical course of this heterogeneous condition remain elusive.

The estimated annual incidence of out-of-hospital cardiac arrest (OHCA) is approximately 120 cases per 100000 inhabitants in western countries. Although the rates of bystander cardiopulmonary resuscitation (CPR) and use of automated external defibrillator are increasing, the likelihood of survival to hospital discharge is no more than 8%. To date, various devices and methods have been utilized in the initial CPR approach targeting to improve survival and neurological outcomes in OHCA patients. The aim of this review is to discuss strategies that facilitate resuscitation, increase the chance to achieve return to spontaneous circulation and improve survival to hospital discharge and neurological outcomes in the pre-hospital setting.

This article discusses the study by Grubić Rotkvić et al on the mechanisms of action of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in patients with type 2 diabetes mellitus (T2DM) and heart failure (HF). T2DM and HF are highly comorbid, with a significantly increased prevalence of HF in patients with T2DM. SGLT2i exhibit potential in reducing hospitalization rates for HF and cardiovascular mortality through multiple mechanisms, including improving blood glucose control, promoting urinary sodium excretion, reducing sympathetic nervous system activity, lowering both preload and afterload on the heart, alleviating inflammation and oxidative stress, enhancing endothelial function, improving myocardial energy metabolism, and stabilizing cardiac ion homeostasis. Further research and clinical practice will help optimize the use of SGLT2i in HF patients.

Coronary microvascular disease (CMD) is one of the commonest causes of cardiac chest pain. The condition is more prevalent in women, and incidence is known to increase with age, hypertension, and diabetes. The pathophysiological pathways are heterogenous and related to intrinsic vascular and endothelial dysfunction. Furthermore, this entity is known to be associated with adverse cardiovascular outcomes. Despite this, there is inertia amongst cardiologists to further evaluate patients with non-critical coronary artery disease and suspected CMD. With refinement in technology, we have now better understanding of CMD and invasive testing in the catheterization laboratory is a viable option for confirming the diagnosis of CMD. However, despite advances in diagnosing and stratifying this entity, therapeutic options remain limited and poorly defined. In this editorial, we will briefly focus on the pathophysiology and invasive assessment and therapeutic options available for CMD.

Background: Listening to music has been shown to reduce pain and anxiety before, during, and after invasive coronary procedures.

Aim: To perform a systematic review and meta-analysis to explore the effect of therapeutic use of music on both, perioperative and postoperative outcomes of invasive coronary procedures.

Methods: An exhaustive literature search of 3 electronic databases (MEDLINE, Scopus, Cochrane CENTRAL) was conducted from inception until 10^th December 2023. The results of our analyses are presented as standard mean difference (SMD) or weighted mean difference, with 95%CI and pooled using a random effects model. A P value < 0.05 was considered significant in all cases.

Results: From 21 studies, 2141 participants were included in our analysis. The pooled analysis demonstrated that music listening significantly improves post-procedural pain (SMD = -0.78, 95%CI: -1.34 to -0.23; P = 0.006), anxiety (SMD = -0.86, 95%CI: -1.43 to -0.29; P = 0.003), heart rate [mean difference (MD) = -3.38, 95%CI: -5.51 to -1.25; P = 0.002], and systolic blood pressure (MD = -5.89, 95%CI: -9.75 to -2.02; P = 0.003). There was no significant improvement in diastolic blood pressure (MD = -3.22, 95%CI: -6.58 to 0.14; P = 0.06) or respiratory rate (MD = -0.97, 95%CI: -1.98 to 0.03; P = 0.06).

Conclusion: Music listening can be used in healthcare settings for patients undergoing invasive coronary procedures to reduce anxiety levels and improve their physiological parameters.