Pub Date : 2024-08-08DOI: 10.1016/j.ijcha.2024.101479
Anne Vorlat , Jeroen van Eijk , Sjoerd Wiersma , Leroy Smid , Sofie Depooter , Bernard Paelinck , Khadija Guerti , Bart Peeters , Nicole Sturkenboom , Emeline Van Craenenbroeck , Hein Heidbuchel , Caroline Van De Heyning
Background
Cardiac fibrosis is increasingly recognized as a marker of worse outcomes in long-term follow-up after heart transplantation (HTX). We investigated the clinical determinants and biomarkers of focal and interstitial cardiac fibrosis as assessed with cardiac magnetic resonance (CMR).
Methods
Consecutive HTX recipients underwent CMR with late gadolinium enhancement for focal myocardial fibrosis and T1 mapping for interstitial fibrosis. We calculated the correlations of these findings with clinical parameters, history, biomarkers of fibrosis (B-type natriuretic peptide (BNP), growth differentiation factor-15, galectin-3 and soluble ligand ST2) and echocardiography.
Results
Forty-eight HTX patients were included: median age 63 ± 13 years, 11 ± 6 years after heart transplantation. Only donor weight (p 0.044) and the rate of a > 30 % mismatch between donor and recipient weight (p 0.02) were significantly different in patients with vs. without late LGE. Extracellular volume (ECV) was correlated with the weight mismatch between donor and recipient (r = 0.32, p 0.04), resulting in a higher ECV for oversized donors. BNP was the only biomarker of the four studied that was correlated with interstitial fibrosis as assessed by ECV (r = 0.35, p 0.04). T1 relaxation time was correlated with treated acute cellular rejection grade ≥ 2 (ISHLT grading) (r = 0.34, p 0.02).
Conclusion
Both focal and interstitial fibrosis, as determined by CMR, after heart transplantation are correlated with donor and recipient weight mismatch. BNP was the only biomarker clinically relevant to interstitial cardiac fibrosis.
{"title":"Clinical determinants and biomarkers associated with cardiac fibrosis after heart transplantation as assessed by magnetic resonance: Size matters","authors":"Anne Vorlat , Jeroen van Eijk , Sjoerd Wiersma , Leroy Smid , Sofie Depooter , Bernard Paelinck , Khadija Guerti , Bart Peeters , Nicole Sturkenboom , Emeline Van Craenenbroeck , Hein Heidbuchel , Caroline Van De Heyning","doi":"10.1016/j.ijcha.2024.101479","DOIUrl":"10.1016/j.ijcha.2024.101479","url":null,"abstract":"<div><h3>Background</h3><p>Cardiac fibrosis is increasingly recognized as a marker of worse outcomes in long-term follow-up after heart transplantation (HTX). We investigated the clinical determinants and biomarkers of focal and interstitial cardiac fibrosis as assessed with cardiac magnetic resonance (CMR).</p></div><div><h3>Methods</h3><p>Consecutive HTX recipients underwent CMR with late gadolinium enhancement for focal myocardial fibrosis and T1 mapping for interstitial fibrosis. We calculated the correlations of these findings with clinical parameters, history, biomarkers of fibrosis (B-type natriuretic peptide (BNP), growth differentiation factor-15, galectin-3 and soluble ligand ST2) and echocardiography.</p></div><div><h3>Results</h3><p>Forty-eight HTX patients were included: median age 63 ± 13 years, 11 ± 6 years after heart transplantation. Only donor weight (p 0.044) and the rate of a > 30 % mismatch between donor and recipient weight (p 0.02) were significantly different in patients with vs. without late LGE. Extracellular volume (ECV) was correlated with the weight mismatch between donor and recipient (r = 0.32, p 0.04), resulting in a higher ECV for oversized donors. BNP was the only biomarker of the four studied that was correlated with interstitial fibrosis as assessed by ECV (r = 0.35, p 0.04). T1 relaxation time was correlated with treated acute cellular rejection grade ≥ 2 (ISHLT grading) (r = 0.34, p 0.02).</p></div><div><h3>Conclusion</h3><p>Both focal and interstitial fibrosis, as determined by CMR, after heart transplantation are correlated with donor and recipient weight mismatch. BNP was the only biomarker clinically relevant to interstitial cardiac fibrosis.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"54 ","pages":"Article 101479"},"PeriodicalIF":2.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001453/pdfft?md5=555dd87294ea8eff691b099c2bf42684&pid=1-s2.0-S2352906724001453-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monoclonal antibodies (mAbs) are currently under investigation as a potential therapeutic option for COVID-19. Clinical trials are examining their efficacy in lowering mortality rates and the requirement for mechanical ventilation (MV). It is necessary to conduct a thorough examination of current randomized controlled trials (RCTs) in order to provide more definitive evidence on their effectiveness for COVID-19 patients. This meta-analysis aims to analyze RCT results on the impact of three mAbs (Anakinra, Sarilumab, Tocilizumab) on COVID-19 patient outcomes.
Method
The meta-analysis was conducted in accordance with the PRISMA guidelines. Eligible RCTs were conducted to evaluate the effectiveness of three mAbs in treating patients with COVID-19. These trials were identified by searching various databases up to April 1, 2024. In total, this meta-analysis incorporated 19 trials with a total of 8097 patients. Pooled relative risk and studies' heterogeneity were assessed by statistical analysis, which involved the use of fixed effects models and subgroup analysis.
Result
The administration of mAbs (Tocilizumab, Sarilumab, and Anakinra) showed various results in the management of COVID-19 patients. While the overall pooled data did not reveal a significant reduction in the need for MV, the study found that the use of mAbs was associated with a decreased risk of clinical worsening (pooled relative risk: 0.75, 95 % CI [0.59, 0.94], p = 0.01) and an increased probability of discharging COVID-19 patients by day 28 or 29 (pooled relative risk: 1.17, 95 % CI [1.10, 1.26]). Notably, the subgroup analysis revealed that Tocilizumab had a significant effect in reducing the risk of clinical worsening compared to Sarilumab. Additionally, the analysis of mortality outcomes indicated that the administration of mAbs had the potential to decrease the overall risk of mortality over time (pooled RR: 0.90, 95 % CI [0.83, 0.97], p = 0.01).
Conclusion
In summary, our meta-analysis suggests that mAbs, particularly Tocilizumab, may play a valuable role in managing COVID-19 by reducing the risk of clinical worsening, improving hospital discharge rates, and decreasing mortality.
{"title":"Investigating the impact of Tocilizumab, Sarilumab, and Anakinra on clinical outcomes in COVID-19: A systematic review and meta-analysis","authors":"Yousef Jafari Abarghan , Mohammad Heiat , Abolfazl Jahangiri , Mohammad Hossein Peypar , Mahdi Abdorrashidi , Amirmohammad Tohidinia , Mahmood Salesi , Shahrzad Tajik , Farnaz Farzaneh Dehkordi , Hamid Sedighian","doi":"10.1016/j.ijcha.2024.101483","DOIUrl":"10.1016/j.ijcha.2024.101483","url":null,"abstract":"<div><h3>Background</h3><p>Monoclonal antibodies (mAbs) are currently under investigation as a potential therapeutic option for COVID-19. Clinical trials are examining their efficacy in lowering mortality rates and the requirement for mechanical ventilation (MV). It is necessary to conduct a thorough examination of current randomized controlled trials (RCTs) in order to provide more definitive evidence on their effectiveness for COVID-19 patients. This <em>meta</em>-analysis aims to analyze RCT results on the impact of three mAbs (Anakinra, Sarilumab, Tocilizumab) on COVID-19 patient outcomes.</p></div><div><h3>Method</h3><p>The <em>meta</em>-analysis was conducted in accordance with the PRISMA guidelines. Eligible RCTs were conducted to evaluate the effectiveness of three mAbs in treating patients with COVID-19. These trials were identified by searching various databases up to April 1, 2024. In total, this <em>meta</em>-analysis incorporated 19 trials with a total of 8097 patients. Pooled relative risk and studies' heterogeneity were assessed by statistical analysis, which involved the use of fixed effects models and subgroup analysis.</p></div><div><h3>Result</h3><p>The administration of mAbs (Tocilizumab, Sarilumab, and Anakinra) showed various results in the management of COVID-19 patients. While the overall pooled data did not reveal a significant reduction in the need for MV, the study found that the use of mAbs was associated with a decreased risk of clinical worsening (pooled relative risk: 0.75, 95 % CI [0.59, 0.94], p = 0.01) and an increased probability of discharging COVID-19 patients by day 28 or 29 (pooled relative risk: 1.17, 95 % CI [1.10, 1.26]). Notably, the subgroup analysis revealed that Tocilizumab had a significant effect in reducing the risk of clinical worsening compared to Sarilumab. Additionally, the analysis of mortality outcomes indicated that the administration of mAbs had the potential to decrease the overall risk of mortality over time (pooled RR: 0.90, 95 % CI [0.83, 0.97], p = 0.01).</p></div><div><h3>Conclusion</h3><p>In summary, our <em>meta</em>-analysis suggests that mAbs, particularly Tocilizumab, may play a valuable role in managing COVID-19 by reducing the risk of clinical worsening, improving hospital discharge rates, and decreasing mortality.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"54 ","pages":"Article 101483"},"PeriodicalIF":2.5,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001490/pdfft?md5=4441d8698bd8937f6f859a75beb8bcd0&pid=1-s2.0-S2352906724001490-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atrial fibrillation is the most prevalent cardiac arrhythmia, presenting symptomatic patients with diminished quality of life and worsening of heart failure. Dofetilide, a class 3 antiarrhythmic agent, is a proven and safe rhythm control medication. Initial risk of QT prolongation leading to torsade de pointes (TdP) necessitates a standard protocol mandating hospitalization for three days for initiation.
Objectives
To assess safety when adhering to initiation protocol and identify traits for susceptibility to TdP in elective dofetilide admissions.
Methods
We conducted a retrospective study involving patients admitted to Mayo Clinic sites across four states for elective inpatient initiation of dofetilide between 2003 and 2022. Patients’ charts underwent review, focusing on dofetilide-related TdP occurrences, baseline characteristics including QT intervals, laboratory values, comorbidities, and concomitant medications. Patients who experienced TdP were subjected to further evaluation to identify potential risk factors.
Results
Of 2036 patients identified, mean age 66.4 ± 11.4 years, and 67.2 % male, 16 experienced dofetilide-related TdP (incidence rate 0.79%). Notably, 81% (13/16) of TdP cases occurred in patients who deviated from the FDA/manufacturer algorithm protocol. The concomitant use of active intravenous diuretic therapy, digoxin, and QT-prolonging drugs emerged as identifiable risk factors. Additionally, females exhibited a higher incidence of TdP (1.5%) than males (0.44%) {odd ratio [OR] 3.46; P = 0.017}.
Conclusion
Overall incidence of TdP related to dofetilide initiation was low (0.79%). Adherence to protocol during elective hospital admissions appears extraordinarily safe. Patients who did not require concurrent use of intravenous diuretics, digoxin, or QT prolonging drugs exhibited lower risk of TdP.
{"title":"Safety of dofetilide in stable patients and investigating traits of susceptibility to torsade de pointes","authors":"Maria Cecilia Tagle-Cornell , Chadi Ayoub , Christen Bird , Milagros Pereyra , Courtney Kenyon , Moaz Kamel , Shruti Iyengar , Hema Vemulapalli , Francesca Galasso , Marlene Girardo , Klanderman Molly , Komandoor Srivathsan","doi":"10.1016/j.ijcha.2024.101475","DOIUrl":"10.1016/j.ijcha.2024.101475","url":null,"abstract":"<div><h3>Background</h3><p>Atrial fibrillation is the most prevalent cardiac arrhythmia, presenting symptomatic patients with diminished quality of life and worsening of heart failure. Dofetilide, a class 3 antiarrhythmic agent, is a proven and safe rhythm control medication. Initial risk of QT prolongation leading to torsade de pointes (TdP) necessitates a standard protocol mandating hospitalization for three days for initiation.</p></div><div><h3>Objectives</h3><p>To assess safety when adhering to initiation protocol and identify traits for susceptibility to TdP in elective dofetilide admissions.</p></div><div><h3>Methods</h3><p>We conducted a retrospective study involving patients admitted to Mayo Clinic sites across four states for elective inpatient initiation of dofetilide between 2003 and 2022. Patients’ charts underwent review, focusing on dofetilide-related TdP occurrences, baseline characteristics including QT intervals, laboratory values, comorbidities, and concomitant medications. Patients who experienced TdP were subjected to further evaluation to identify potential risk factors.</p></div><div><h3>Results</h3><p>Of 2036 patients identified, mean age 66.4 ± 11.4 years, and 67.2 % male, 16 experienced dofetilide-related TdP (incidence rate 0.79%). Notably, 81% (13/16) of TdP cases occurred in patients who deviated from the FDA/manufacturer algorithm protocol. The concomitant use of active intravenous diuretic therapy, digoxin, and QT-prolonging drugs emerged as identifiable risk factors. Additionally, females exhibited a higher incidence of TdP (1.5%) than males (0.44%) {odd ratio [OR] 3.46; P = 0.017}.</p></div><div><h3>Conclusion</h3><p>Overall incidence of TdP related to dofetilide initiation was low (0.79%). Adherence to protocol during elective hospital admissions appears extraordinarily safe. Patients who did not require concurrent use of intravenous diuretics, digoxin, or QT prolonging drugs exhibited lower risk of TdP.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"54 ","pages":"Article 101475"},"PeriodicalIF":2.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001416/pdfft?md5=c751a7e7e1fb8fa67a0d86821f4a8eec&pid=1-s2.0-S2352906724001416-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1016/j.ijcha.2024.101482
B.A. Krishna , M. Metaxaki , N. Sithole , P. Landín , P. Martín , A. Salinas-Botrán
Background
Cardiovascular complications of COVID-19 are numerous and aspects of this phenomenon are not well known. The main objective of this manuscript is a systematic review of the acute and chronic cardiovascular complications secondary to COVID-19.
Methods
A systematic review of the literature through Medline via PubMed was conducted (2020–2024).
Results
There is a plethora of effects of COVID-19 on the heart in the acute setting. Here we discuss pathophysiology, myocardial infarctions, heart failure, Takotsubo Cardiomyopathy, myocardial injury, myocarditis and arrhythmias that are caused by COVID-19. Additionally, these cardiovascular injuries can linger and may be an underlying cause of some Long COVID symptoms.
Conclusions
Cardiovascular complications of COVID-19 are numerous and life-threatening. Long COVID can affect cardiovascular health. Microclotting induced by SARS-CoV-2 infection could be a therapeutic target for some aspects of Long Covid.
{"title":"Cardiovascular disease and covid-19: A systematic review","authors":"B.A. Krishna , M. Metaxaki , N. Sithole , P. Landín , P. Martín , A. Salinas-Botrán","doi":"10.1016/j.ijcha.2024.101482","DOIUrl":"10.1016/j.ijcha.2024.101482","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular complications of COVID-19 are numerous and aspects of this phenomenon are not well known. The main objective of this manuscript is a systematic review of the acute and chronic cardiovascular complications secondary to COVID-19.</p></div><div><h3>Methods</h3><p>A systematic review of the literature through Medline via PubMed was conducted (2020–2024).</p></div><div><h3>Results</h3><p>There is a plethora of effects of COVID-19 on the heart in the acute setting. Here we discuss pathophysiology, myocardial infarctions, heart failure, Takotsubo Cardiomyopathy, myocardial injury, myocarditis and arrhythmias that are caused by COVID-19. Additionally, these cardiovascular injuries can linger and may be an underlying cause of some Long COVID symptoms.</p></div><div><h3>Conclusions</h3><p>Cardiovascular complications of COVID-19 are numerous and life-threatening. Long COVID can affect cardiovascular health. Microclotting induced by SARS-CoV-2 infection could be a therapeutic target for some aspects of Long Covid.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"54 ","pages":"Article 101482"},"PeriodicalIF":2.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001489/pdfft?md5=0c8069f7a31260735abcdf03ed6769e7&pid=1-s2.0-S2352906724001489-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141962001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.ijcha.2024.101464
Marco Savino , Luigi Savino , Pasquale Mone , Concetta Schiano , Antonio De Luca , Gaetano Santulli
{"title":"Predicting exercise intolerance in elderly individuals with heart failure using the 30-second chair stand test","authors":"Marco Savino , Luigi Savino , Pasquale Mone , Concetta Schiano , Antonio De Luca , Gaetano Santulli","doi":"10.1016/j.ijcha.2024.101464","DOIUrl":"10.1016/j.ijcha.2024.101464","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"53 ","pages":"Article 101464"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001301/pdfft?md5=6ced9db2ccb950a5ef01fa1adad88174&pid=1-s2.0-S2352906724001301-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.ijcha.2024.101474
Ana Moya , Elayne Kelen de Oliveira , Leen Delrue , Monika Beles , Dimitri Buytaert , Marc Goethals , Sofie Verstreken , Riet Dierckx , Jozef Bartunek , Ward Heggermont , Eric Wyffels , Marc Vanderheyden
Background
Transcatheter aortic valve replacement(TAVR) has shown clear survival benefits in severe aortic valve stenosis(AS). However, patients unable to recover left ventricle function remain at risk with poor long-term survival. This single-center prospective study aims to analyze the supplementary benefits of myocardial work(MW) assessment for baseline risk stratification in patients with severe AS referred for TAVR.
Methods
A total of 110 patients with severe AS referred for TAVR were included in the study. Baseline ECG data, transthoracic echocardiographic(TTE) images and blood samples were obtained. The TTE examination was repeated one day and one month after valve replacement. The primary outcome of the study was a composite endpoint consisting of all-cause mortality and HF hospitalization.
Results
During a mean follow-up period of 521 ± 343 days, 29patients(26.4 %) reached the composite endpoint. Baseline troponins, NT-proBNP, sST2, GWI and GCW showed statistically significant differences between groups. Patients with a baseline GWI<2323 mmHg% (sensitivity 0.63 and specificity 0.76)had significantly worse outcome following TAVR. A basic predictive model included QRS-length, TAPSE, LAVI and E/e’. The addition of biomarkers did not yield any further advantages whereas incorporating the GWI cut-off value of 2323 mmHg% significantly enhanced the predictive value. Although there were no significant changes in LVEF and GLS, all patients exhibited a significant reduction in GWI and GCW immediately after TAVR.
Conclusion
Our findings provide evidence for the enhanced usefulness of MW analysis in the initial risk stratification of patients with severe AS referred for TAVR. Specifically, a baseline GWI<2323 mmHg% demonstrates an independent predictor associated with increased incidence of all-cause mortality and HF hospitalization following TAVR.
{"title":"Myocardial work and risk stratification in patients with severe aortic valve stenosis referred for transcatheter aortic valve replacement","authors":"Ana Moya , Elayne Kelen de Oliveira , Leen Delrue , Monika Beles , Dimitri Buytaert , Marc Goethals , Sofie Verstreken , Riet Dierckx , Jozef Bartunek , Ward Heggermont , Eric Wyffels , Marc Vanderheyden","doi":"10.1016/j.ijcha.2024.101474","DOIUrl":"10.1016/j.ijcha.2024.101474","url":null,"abstract":"<div><h3>Background</h3><p>Transcatheter aortic valve replacement(TAVR) has shown clear survival benefits in severe aortic valve stenosis(AS). However, patients unable to recover left ventricle function remain at risk with poor long-term survival. This single-center prospective study aims to analyze the supplementary benefits of myocardial work(MW) assessment for baseline risk stratification in patients with severe AS referred for TAVR.</p></div><div><h3>Methods</h3><p>A total of 110 patients with severe AS referred for TAVR were included in the study. Baseline ECG data, transthoracic echocardiographic(TTE) images and blood samples were obtained. The TTE examination was repeated one day and one month after valve replacement. The primary outcome of the study was a composite endpoint consisting of all-cause mortality and HF hospitalization.</p></div><div><h3>Results</h3><p>During a mean follow-up period of 521 ± 343 days, 29patients(26.4 %) reached the composite endpoint. Baseline troponins, NT-proBNP, sST2, GWI and GCW showed statistically significant differences between groups. Patients with a baseline GWI<2323 mmHg% (sensitivity 0.63 and specificity 0.76)had significantly worse outcome following TAVR. A basic predictive model included QRS-length, TAPSE, LAVI and E/e’. The addition of biomarkers did not yield any further advantages whereas incorporating the GWI cut-off value of 2323 mmHg% significantly enhanced the predictive value. Although there were no significant changes in LVEF and GLS, all patients exhibited a significant reduction in GWI and GCW immediately after TAVR.</p></div><div><h3>Conclusion</h3><p>Our findings provide evidence for the enhanced usefulness of MW analysis in the initial risk stratification of patients with severe AS referred for TAVR. Specifically, a baseline GWI<2323 mmHg% demonstrates an independent predictor associated with increased incidence of all-cause mortality and HF hospitalization following TAVR.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"53 ","pages":"Article 101474"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001404/pdfft?md5=35cf45ef13370fb283fb82ed082c8de8&pid=1-s2.0-S2352906724001404-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.ijcha.2024.101469
Owais Mohmad Bhat , Rakeeb Ahmad Mir , Iqra Bashir Nehvi , Nissar Ahmad Wani , Abid Hamid Dar , M Afzal Zargar
Sphingolipids are eighteen carbon alcohol lipids synthesized from non-sphingolipid precursors in the endoplasmic reticulum (ER). The sphingolipids serve as precursors for a vast range of moieties found in our cells that play a critical role in various cellular processes, including cell division, senescence, migration, differentiation, apoptosis, pyroptosis, autophagy, nutrition intake, metabolism, and protein synthesis. In CVDs, different subclasses of sphingolipids and other derived molecules such as sphingomyelin (SM), ceramides (CERs), and sphingosine-1-phosphate (S1P) are directly related to diabetic cardiomyopathy, dilated cardiomyopathy, myocarditis, ischemic heart disease (IHD), hypertension, and atherogenesis. Several genome-wide association studies showed an association between genetic variations in sphingolipid pathway genes and the risk of CVDs. The sphingolipid pathway plays an important role in the biogenesis and secretion of exosomes. Small extracellular vesicles (sEVs)/ exosomes have recently been found as possible indicators for the onset of CVDs, linking various cellular signaling pathways that contribute to the disease progression. Important features of EVs like biocompatibility, and crossing of biological barriers can improve the pharmacokinetics of drugs and will be exploited to develop next-generation drug delivery systems. In this review, we have comprehensively discussed the role of sphingolipids, and sphingolipid metabolites in the development of CVDs. In addition, concise deliberations were laid to discuss the role of sEVs/exosomes in regulating the pathophysiological processes of CVDs and the exosomes as therapeutic targets.
{"title":"Emerging role of sphingolipids and extracellular vesicles in development and therapeutics of cardiovascular diseases","authors":"Owais Mohmad Bhat , Rakeeb Ahmad Mir , Iqra Bashir Nehvi , Nissar Ahmad Wani , Abid Hamid Dar , M Afzal Zargar","doi":"10.1016/j.ijcha.2024.101469","DOIUrl":"10.1016/j.ijcha.2024.101469","url":null,"abstract":"<div><p>Sphingolipids are eighteen carbon alcohol lipids synthesized from non-sphingolipid precursors in the endoplasmic reticulum (ER). The sphingolipids serve as precursors for a vast range of moieties found in our cells that play a critical role in various cellular processes, including cell division, senescence, migration, differentiation, apoptosis, pyroptosis, autophagy, nutrition intake, metabolism, and protein synthesis. In CVDs, different subclasses of sphingolipids and other derived molecules such as sphingomyelin (SM), ceramides (CERs), and sphingosine-1-phosphate (S1P) are directly related to diabetic cardiomyopathy, dilated cardiomyopathy, myocarditis, ischemic heart disease (IHD), hypertension, and atherogenesis. Several genome-wide association studies showed an association between genetic variations in sphingolipid pathway genes and the risk of CVDs. The sphingolipid pathway plays an important role in the biogenesis and secretion of exosomes. Small extracellular vesicles (sEVs)/ exosomes have recently been found as possible indicators for the onset of CVDs, linking various cellular signaling pathways that contribute to the disease progression. Important features of EVs like biocompatibility, and crossing of biological barriers can improve the pharmacokinetics of drugs and will be exploited to develop next-generation drug delivery systems. In this review, we have comprehensively discussed the role of sphingolipids, and sphingolipid metabolites in the development of CVDs. In addition, concise deliberations were laid to discuss the role of sEVs/exosomes in regulating the pathophysiological processes of CVDs and the exosomes as therapeutic targets.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"53 ","pages":"Article 101469"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001350/pdfft?md5=ad7fcd071f4641227de1a1c90ba432fc&pid=1-s2.0-S2352906724001350-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141959484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.ijcha.2024.101398
Background
Idiopathic acute pericarditis is often presumed to have a viral cause. We hypothesized that if acute viral infection was the cause, the incidence of acute ‘idiopathic’ pericarditis would decrease during a public health lockdown introduced to prevent the spread of SARS-COVID-19 in New Zealand when acute viral infections decreased by 75% to 99%.
Methods
Hospitalization for acute ‘idiopathic’ pericarditis during 5 months of the national public health lockdown were compared to 54 months before the COVID-19 pandemic from administrative data.
Results
The hospitalization rate for acute pericarditis was similar before (n = 1364, 24.8 cases/30 days) compared to during the public health lockdown (n = 132, 25.8 cases/30 days), +4% 95 % confidence interval −25 % to +30 % (P = 0.67).
Conclusion
These observations do not support the hypothesis that acute viral infection is the cause for most cases of acute idiopathic pericarditis.
{"title":"Acute idiopathic pericarditis during a national lockdown to prevent transmission of SARS-COVID-19","authors":"","doi":"10.1016/j.ijcha.2024.101398","DOIUrl":"10.1016/j.ijcha.2024.101398","url":null,"abstract":"<div><h3>Background</h3><p>Idiopathic acute pericarditis is often presumed to have a viral cause. We hypothesized that if acute viral infection was the cause, the incidence of acute ‘idiopathic’ pericarditis would decrease during a public health lockdown introduced to prevent the spread of SARS-COVID-19 in New Zealand when acute viral infections decreased by 75% to 99%.</p></div><div><h3>Methods</h3><p>Hospitalization for acute ‘idiopathic’ pericarditis during 5 months of the national public health lockdown were compared to 54 months before the COVID-19 pandemic from administrative data.</p></div><div><h3>Results</h3><p>The hospitalization rate for acute pericarditis was similar before (n = 1364, 24.8 cases/30 days) compared to during the public health lockdown (n = 132, 25.8 cases/30 days), +4% 95 % confidence interval −25 % to +30 % (P = 0.67).</p></div><div><h3>Conclusion</h3><p>These observations do not support the hypothesis that acute viral infection is the cause for most cases of acute idiopathic pericarditis.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"53 ","pages":"Article 101398"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724000642/pdfft?md5=f43462c583923d95699e752bc6124e7a&pid=1-s2.0-S2352906724000642-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140769140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evidence regarding the duration of anticoagulation (AC) therapy for left ventricular thrombus (LVT) is lacking. This study aims to evaluate the rate and risk factors for LVT recurrence in patients with Anterior ST-Segment elevation Myocardial Infarction (STEMI) complicated by LVT.
Methods
This was a retrospective analysis of patients with Anterior STEMI complicated by LVT and reduced ejection fraction (<35 %) from 2010 to 2020. Patients with atrial fibrillation and hypercoagulable state were excluded. Recurrence of LVT was defined as a new LVT on transthoracic echocardiography (TTE) after interval resolution and AC discontinuation. Demographics, comorbidities, guideline directed medical therapy, TTE, and angiographic characteristics were assessed and compared in patients with and without LVT recurrence.
Results
87 patients met the inclusion criteria. Nine (10.3 %) had LVT recurrence of which three (33.3 %) had cardioembolic events. More patients with recurrence had ventricular aneurysm/scarring (33 % vs 10.3 %) and multi-vessel disease (22.2 % vs 9 %).
Conclusion
This study reveals that a portion of patients with Anterior STEMI complicated by LVT are at a higher risk of recurrence after initial resolution and AC discontinuation. Larger prospective trials are needed to re-address the appropriate duration of anticoagulation.
背景有关左心室血栓(LVT)抗凝治疗(AC)持续时间的证据尚缺。本研究旨在评估前ST段抬高型心肌梗死(STEMI)并发左心室血栓患者的左心室血栓复发率和风险因素。方法这是对2010年至2020年间前STEMI并发左心室血栓和射血分数降低(<35 %)患者的回顾性分析。排除了心房颤动和高凝状态患者。经胸超声心动图(TTE)显示,间歇期缓解和停用 AC 后出现新的 LVT,即为 LVT 复发。对 LVT 复发和未复发患者的人口统计学、合并症、指南指导的药物治疗、TTE 和血管造影特征进行了评估和比较。9例(10.3%)左心室支架复发,其中3例(33.3%)发生了心肌栓塞事件。更多复发患者患有心室动脉瘤/瘢痕(33 % vs 10.3 %)和多血管疾病(22.2 % vs 9 %)。需要进行更大规模的前瞻性试验,以重新确定适当的抗凝时间。
{"title":"Left ventricular thrombus recurrence after anticoagulation discontinuation","authors":"Kamran Namjouyan , Aastha Mittal , Seth Krueger , Devon Chosky , Enrique Soltero , Idorenyin Udoeyo","doi":"10.1016/j.ijcha.2024.101480","DOIUrl":"10.1016/j.ijcha.2024.101480","url":null,"abstract":"<div><h3>Background</h3><p>Evidence regarding the duration of anticoagulation (AC) therapy for left ventricular thrombus (LVT) is lacking. This study aims to evaluate the rate and risk factors for LVT recurrence in patients with Anterior ST-Segment elevation Myocardial Infarction (STEMI) complicated by LVT.</p></div><div><h3>Methods</h3><p>This was a retrospective analysis of patients with Anterior STEMI complicated by LVT and reduced ejection fraction (<35 %) from 2010 to 2020. Patients with atrial fibrillation and hypercoagulable state were excluded. Recurrence of LVT was defined as a new LVT on transthoracic echocardiography (TTE) after interval resolution and AC discontinuation. Demographics, comorbidities, guideline directed medical therapy, TTE, and angiographic characteristics were assessed and compared in patients with and without LVT recurrence.</p></div><div><h3>Results</h3><p>87 patients met the inclusion criteria. Nine (10.3 %) had LVT recurrence of which three (33.3 %) had cardioembolic events. More patients with recurrence had ventricular aneurysm/scarring (33 % vs 10.3 %) and multi-vessel disease (22.2 % vs 9 %).</p></div><div><h3>Conclusion</h3><p>This study reveals that a portion of patients with Anterior STEMI complicated by LVT are at a higher risk of recurrence after initial resolution and AC discontinuation. Larger prospective trials are needed to re-address the appropriate duration of anticoagulation.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"54 ","pages":"Article 101480"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724001465/pdfft?md5=adf79e10ff1f3bffd0527c4cd87e5e3b&pid=1-s2.0-S2352906724001465-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.ijcha.2024.101430
Background
Limited data exist on the prognostic value of changes in pulse pressure (PP, the difference between systolic and diastolic blood pressure) during hospitalization for patients with coronary artery disease who have undergone percutaneous coronary intervention (PCI).
Methods
In the Clinical Deep Data Accumulation System (CLIDAS), we studied 8,708 patients who underwent PCI. We aimed to examine the association between discharge PP and cardiovascular outcomes. PP was measured before PCI and at discharge. Patients were divided into five groups (quintiles) based on the change in PPQ1 (−18.0 ± 9.9 mmHg), Q2 (−3.8 ± 2.6), Q3 (reference; 3.7 ± 2.0), Q4 (11.3 ± 2.6), and Q5 (27.5 ± 11.2). We then analyzed the relationship between PP change and outcomes.
Results
The mean patient age was 70 ± 11 years, with 6,851 (78 %) men and 3,786 (43 %) having acute coronary syndrome. U-shaped relationships were observed for the incidence rates of major adverse cardiac or cerebrovascular events (MACCE, a composite endpoint of cardiovascular death, myocardial infarction, and stroke), revascularization, and hospitalization for heart failure (HF). After adjusting for confounding factors, higher PP at discharge was associated with an increased risk of MACCE (adjusted hazard ratio 1.41; 95 %CI, 1.06–1.87 in Q5 [73.9 ± 9.3 mmHg]). Evaluating PP change revealed a U-shaped association with MACCE (1.50; 1.11–2.02 in Q1 and 1.47; 0.98–2.20 in Q5). Additionally, Q5 had a higher risk for hospitalization for HF (1.37; 1.00–1.88).
Conclusions
Our findings demonstrate a U-shaped association between changes in PP and cardiovascular outcomes. This data suggests the significance of blood pressure control during hospitalization for patients who have undergone PCI.
{"title":"Change in pulse pressure and cardiovascular outcomes after percutaneous coronary intervention: The CLIDAS study","authors":"","doi":"10.1016/j.ijcha.2024.101430","DOIUrl":"10.1016/j.ijcha.2024.101430","url":null,"abstract":"<div><h3>Background</h3><p>Limited data exist on the prognostic value of changes in pulse pressure (PP, the difference between systolic and diastolic blood pressure) during hospitalization for patients with coronary artery disease who have undergone percutaneous coronary intervention (PCI).</p></div><div><h3>Methods</h3><p>In the Clinical Deep Data Accumulation System (CLIDAS), we studied 8,708 patients who underwent PCI. We aimed to examine the association between discharge PP and cardiovascular outcomes. PP was measured before PCI and at discharge. Patients were divided into five groups (quintiles) based on the change in PPQ1 (−18.0 ± 9.9 mmHg), Q2 (−3.8 ± 2.6), Q3 (reference; 3.7 ± 2.0), Q4 (11.3 ± 2.6), and Q5 (27.5 ± 11.2). We then analyzed the relationship between PP change and outcomes.</p></div><div><h3>Results</h3><p>The mean patient age was 70 ± 11 years, with 6,851 (78 %) men and 3,786 (43 %) having acute coronary syndrome. U-shaped relationships were observed for the incidence rates of major adverse cardiac or cerebrovascular events (MACCE, a composite endpoint of cardiovascular death, myocardial infarction, and stroke), revascularization, and hospitalization for heart failure (HF). After adjusting for confounding factors, higher PP at discharge was associated with an increased risk of MACCE (adjusted hazard ratio 1.41; 95 %CI, 1.06–1.87 in Q5 [73.9 ± 9.3 mmHg]). Evaluating PP change revealed a U-shaped association with MACCE (1.50; 1.11–2.02 in Q1 and 1.47; 0.98–2.20 in Q5). Additionally, Q5 had a higher risk for hospitalization for HF (1.37; 1.00–1.88).</p></div><div><h3>Conclusions</h3><p>Our findings demonstrate a U-shaped association between changes in PP and cardiovascular outcomes. This data suggests the significance of blood pressure control during hospitalization for patients who have undergone PCI.</p></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"53 ","pages":"Article 101430"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352906724000964/pdfft?md5=1667682f580d9fdcd253ae5c8312fe85&pid=1-s2.0-S2352906724000964-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141136571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}