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Obesity and Cardiovascular Risk among South Asian Americans. 南亚裔美国人的肥胖症和心血管风险。
IF 1.9 Q3 Medicine Pub Date : 2023-03-01 Epub Date: 2023-02-03 DOI: 10.1007/s12170-023-00714-5
Ashwini Deshpande, Nilay S Shah, Namratha R Kandula

Purpose of review: South Asian Americans experience higher cardiometabolic risk and disproportionately high rates of cardiovascular disease (CVD) compared to other racial and ethnic groups in the United States. The purpose of this review is to summarize recent evidence about the role of obesity in CVD risk in South Asian Americans and identify key evidence gaps and future directions for research and interventions for obesity in this group.

Recent findings: South Asian Americans are predisposed to abdominal obesity and have a higher distribution of visceral fat, intermuscular fat, and intrahepatic fat compared to adults of other race and ethnic groups. In this population, the risk for cardiometabolic disease appears to be elevated even at a normal body mass index. Social, cultural, religious, interpersonal, and environmental factors are related to obesity and obesity-related behaviors among South Asian Americans.

Summary: There is a relatively high prevalence of obesity in South Asian-origin populations in the United States, who have unique socio-cultural determinants of overweight and obesity. Future research should clarify why the risk for metabolic disease and CVD is elevated at normal BMI in the South Asian American population, and environmental and other structural factors that may influence obesity in this group. Interventions must be adapted to the social and cultural context of South Asian Americans to improve effectiveness and implementation.

综述目的:与美国其他种族和族裔群体相比,南亚裔美国人的心脏代谢风险更高,心血管疾病(CVD)发病率也高得不成比例。本综述旨在总结有关肥胖在南亚裔美国人心血管疾病风险中的作用的最新证据,并确定该群体肥胖研究和干预的主要证据差距和未来方向:与其他种族和族裔的成年人相比,南亚裔美国人容易腹部肥胖,内脏脂肪、肌间脂肪和肝内脂肪的分布较高。在这一人群中,即使体重指数正常,罹患心脏代谢疾病的风险似乎也会升高。社会、文化、宗教、人际关系和环境因素与南亚裔美国人的肥胖症和肥胖相关行为有关。未来的研究应阐明为什么南亚裔美国人在体重指数正常的情况下患代谢性疾病和心血管疾病的风险会升高,以及可能影响该群体肥胖的环境因素和其他结构性因素。干预措施必须适应南亚裔美国人的社会和文化背景,以提高有效性和实施效果。
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引用次数: 0
Genetics of Mitochondrial Cardiomyopathy 线粒体心肌病的遗传学
IF 1.9 Q3 Medicine Pub Date : 2023-02-10 DOI: 10.1007/s12170-023-00715-4
A. Towheed, A. Goldstein
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引用次数: 0
An Overview of the Risks of Contemporary Energy Drink Consumption and Their Active Ingredients on Cardiovascular Events 当代能量饮料及其活性成分对心血管事件的风险综述
IF 1.9 Q3 Medicine Pub Date : 2023-02-09 DOI: 10.1007/s12170-023-00716-3
Kaden T. Bunch, MAREN B. Peterson, Megan B. Smith, T. Bunch
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引用次数: 0
Application of Pharmacogenetics for the Use of Antiplatelet and Anticoagulant Drugs 药物遗传学在抗血小板和抗凝药物应用中的应用
IF 1.9 Q3 Medicine Pub Date : 2023-01-10 DOI: 10.1007/s12170-022-00713-y
S. Tuteja
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引用次数: 1
Remote Patient Monitoring: What Have We Learned and Where Are We Going? 远程患者监测:我们学到了什么?我们要去哪里?
IF 1.9 Q3 Medicine Pub Date : 2023-01-01 Epub Date: 2023-04-22 DOI: 10.1007/s12170-023-00720-7
Bert Vandenberk, Satish R Raj

Purpose of review: Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is an important part of patient follow-up. The increasing number of patients with CIEDs and the recent pandemic pose several challenges for already limited device clinic resources. This review focuses on recent evolutions in RM and identifies future needs to improve RM.

Recent findings: RM has been associated with multiple clinical benefits, including improved survival, early detection of actionable events, reduction in inappropriate shocks, longer battery lives, and more efficient healthcare utilization. The survival benefit was driven by studies using alert-based continuous RM with daily transmissions and fast reaction times. Patients report a high satisfaction rate without significant differences in quality of life between RM and in-office follow-up.The increasing workload, due to the increasing number of CIEDs implanted with daily remote transmissions, results in several challenges for the future of RM. RM requires appropriate reimbursement for RM device clinics to optimize patient/staff ratios, including sufficient non-clinical and administrative support. Universal alert programming and data processing may minimize inter-manufacturer differences, improve the signal-to-noise ratio, and allow the development of standard operating protocols and workflows. In the future, programming by remote control and true remote programming may further improve remote CIED management, patient quality of life, and device clinic workflows.

Summary: RM should be considered standard of care in management of patients with CIEDs. The clinical benefits of RM can be maximized by an alert-based continuous RM model. Adapted healthcare policies are required to keep RM manageable for the future.

综述目的:心脏植入式电子设备(CIED)的远程监测(RM)是患者随访的重要组成部分。CIED患者数量的增加和最近的疫情给本已有限的设备诊所资源带来了一些挑战。这篇综述的重点是RM的最新发展,并确定了改进RM的未来需求。最近的发现:RM具有多种临床益处,包括提高生存率、早期发现可操作事件、减少不适当电击、延长电池寿命和更有效的医疗利用率。使用基于警报的连续RM进行的研究推动了生存效益,该RM具有每日传播和快速反应时间。患者报告称,RM和办公室随访之间的生活质量没有显著差异,满意度很高。由于每天远程传输的CIED数量不断增加,工作量不断增加,这给RM的未来带来了一些挑战。RM需要对RM设备诊所进行适当的报销,以优化患者/员工比例,包括足够的非临床和行政支持。通用警报编程和数据处理可以最大限度地减少制造商之间的差异,提高信噪比,并允许开发标准操作协议和工作流程。未来,通过远程控制和真正的远程编程进行编程可能会进一步改善远程CIED管理、患者生活质量和设备诊所工作流程。总结:在CIEDs患者的管理中,RM应被视为护理标准。RM的临床效益可以通过基于警报的连续RM模型最大化。需要调整医疗保健政策,以保持RM在未来的可管理性。
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引用次数: 1
Leveraging Digital Health to Improve the Cardiovascular Health of Women. 利用数字健康改善妇女心血管健康。
IF 2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 Epub Date: 2023-09-30 DOI: 10.1007/s12170-023-00728-z
Zahra Azizi, Demilade Adedinsewo, Fatima Rodriguez, Jennifer Lewey, Raina M Merchant, LaPrincess C Brewer

Purpose of review: In this review, we present a comprehensive discussion on the population-level implications of digital health interventions (DHIs) to improve cardiovascular health (CVH) through sex- and gender-specific prevention strategies among women.

Recent findings: Over the past 30 years, there have been significant advancements in the diagnosis and treatment of cardiovascular diseases, a leading cause of morbidity and mortality among men and women worldwide. However, women are often underdiagnosed, undertreated, and underrepresented in cardiovascular clinical trials, which all contribute to disparities within this population. One approach to address this is through DHIs, particularly among racial and ethnic minoritized groups. Implementation of telemedicine has shown promise in increasing adherence to healthcare visits, improving BP monitoring, weight control, physical activity, and the adoption of healthy behaviors. Furthermore, the use of mobile health applications facilitated by smart devices, wearables, and other eHealth (defined as electronically delivered health services) modalities has also promoted CVH among women in general, as well as during pregnancy and the postpartum period. Overall, utilizing a digital health approach for healthcare delivery, decentralized clinical trials, and incorporation into daily lifestyle activities has the potential to improve CVH among women by mitigating geographical, structural, and financial barriers to care.

Summary: Leveraging digital technologies and strategies introduces novel methods to address sex- and gender-specific health and healthcare disparities and improve the quality of care provided to women. However, it is imperative to be mindful of the digital divide in specific populations, which may hinder accessibility to these novel technologies and inadvertently widen preexisting inequities.

综述目的:在这篇综述中,我们全面讨论了数字健康干预措施(DHI)在人群层面的影响,通过针对性别和性别的预防策略来改善女性的心血管健康(CVH)。最近的发现:在过去的30年里,心血管疾病的诊断和治疗取得了重大进展,心血管疾病是全球男性和女性发病率和死亡率的主要原因。然而,女性在心血管临床试验中往往诊断不足、治疗不足、代表性不足,这都导致了这一人群中的差异。解决这一问题的一种方法是通过DHI,特别是在种族和少数民族群体中。远程医疗的实施在增加医疗就诊的依从性、改善血压监测、体重控制、体育活动和采用健康行为方面显示出了希望。此外,智能设备、可穿戴设备和其他电子健康(定义为电子提供的健康服务)模式促进的移动健康应用程序的使用也促进了女性的CVH,以及在怀孕和产后。总的来说,利用数字健康方法提供医疗保健、分散临床试验并将其纳入日常生活方式活动,有可能通过减轻医疗保健的地理、结构和财务障碍来改善女性的CVH。摘要:利用数字技术和战略引入了新的方法来解决性别和性别特定的健康和医疗保健差距,并提高向妇女提供的护理质量。然而,必须注意特定人群中的数字鸿沟,这可能会阻碍这些新技术的普及,并无意中扩大先前存在的不平等。
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引用次数: 0
The Efficacy of Mobile Applications for Weight Loss. 手机减肥应用的功效。
IF 1.9 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.1007/s12170-023-00717-2
Kelsey Ufholz, James Werner

Purpose of review: A variety of mobile-based applications aimed at weight loss have become popular in recent years. This review describes the features and effectiveness of mobile weight loss apps.

Recent findings: Overall, mobile apps can help patients lose weight either as well as or better than traditional paper-and-pencil weight loss interventions and often better than minimal intervention control groups. Mobile apps promote multiple strategies, including self-monitoring of diet, exercise, and weight, as well as social support and educational content. Significant variation exists in app types, which makes it difficult to conclude which features drive program effectiveness. Intervention success varies based on patients' level of engagement with the app. There is a deficit of apps and app-based studies of older, less tech-savvy adults, ethnic/racial minorities, and low-income individuals, as well as longer-term studies.

Summary: Mobile apps can successfully help patients lose weight and represent a cost-effective, accessible alternative to intensive in-person weight loss programs. More research is needed into their long-term potential, especially for hard-to-reach populations.

综述目的:近年来,各种旨在减肥的基于移动的应用程序变得流行起来。这篇综述描述了移动减肥应用程序的功能和有效性。最近的研究发现:总体而言,移动应用程序可以帮助患者减肥,与传统的纸笔减肥干预措施一样好,甚至更好,通常比最小干预对照组更好。移动应用程序推广多种策略,包括自我监控饮食、运动和体重,以及社会支持和教育内容。应用类型存在显著差异,这使得很难断定哪些功能推动了程序的有效性。干预的成功取决于患者对应用程序的参与程度。针对老年人、不太懂技术的成年人、少数民族/种族和低收入人群的应用程序和基于应用程序的研究以及长期研究都很缺乏。总结:移动应用程序可以成功地帮助患者减肥,并且代表了一种成本效益高、可访问的替代密集的面对面减肥计划。需要对它们的长期潜力进行更多的研究,特别是对难以接触到的人群。
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引用次数: 2
Health Techequity: Opportunities for Digital Health Innovations to Improve Equity and Diversity in Cardiovascular Care. 健康技术公平:数字健康创新改善心血管护理公平性和多样性的机会。
IF 1.9 Q3 Medicine Pub Date : 2023-01-01 DOI: 10.1007/s12170-022-00711-0
Mario Funes Hernandez, Fatima Rodriguez

Purpose of review: In this review, we define health equity, disparities, and social determinants of health; the different components of digital health; the barriers to digital health equity; and cardiovascular digital health trials and possible solutions to improve health equity through digital health.

Recent findings: Digital health interventions show incredible potential to improve cardiovascular diseases by obtaining longitudinal, continuous, and actionable patient data; increasing access to care; and by decreasing delivery barriers and cost. However, certain populations have experienced decreased access to digital health innovations and decreased representation in cardiovascular digital health trials.

Summary: Special efforts will need to be made to expand access to the different elements of digital health, ensuring that the digital divide does not exacerbate health disparities. As the expansion of digital health technologies continues, it is vital to increase representation of minoritized groups in all stages of the process: product development (needs findings and screening, concept generation, product creation, and testing), clinical research (pilot studies, feasibility studies, and randomized control trials), and finally health services deployment.

综述目的:在本综述中,我们定义了健康公平、差异和健康的社会决定因素;数字医疗的不同组成部分;数字卫生公平的障碍;心血管数字健康试验以及通过数字健康改善健康公平的可能解决方案。最近的发现:通过获得纵向、连续和可操作的患者数据,数字健康干预显示出改善心血管疾病的巨大潜力;增加获得保健的机会;通过减少交付障碍和成本。然而,某些人群获得数字健康创新的机会减少,参与心血管数字健康试验的人数减少。摘要:需要作出特别努力,扩大获得数字卫生不同要素的机会,确保数字鸿沟不会加剧卫生差距。随着数字卫生技术的不断扩展,在这一过程的所有阶段增加少数群体的代表性至关重要:产品开发(需求发现和筛选、概念产生、产品创建和测试)、临床研究(试点研究、可行性研究和随机对照试验),以及最后的卫生服务部署。
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引用次数: 7
Virtual Cardiology: Past, Present, Future Directions, and Considerations. 虚拟心脏病学:过去、现在、未来的方向和注意事项。
IF 2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2023-01-01 Epub Date: 2023-05-29 DOI: 10.1007/s12170-023-00719-0
Gauranga Mahalwar, Ashish Kumar, Ankur Kalra

Purpose of review: Through this review, we attempt to explore the role of telemedicine and virtual visits in the field of cardiology pre-COVID-19 and during COVID-19 pandemic, their limitations and their future scope for delivery of care.

Recent findings: Telemedicine, which rose to prominence during COVID-19 pandemic, helped not only in reducing the burden on the healthcare system during a time of crisis but also in improving patient outcomes. Patients and physicians also favored virtual visits when feasible. Virtual visits were found to have the potential to be continued beyond the pandemic and play a significant role in patient care alongside conventional face-to-face visits.

Summary: Although tele-cardiology has proven beneficial in terms of patient care, convenience, and access, it comes with its fair share of limitations-both logistical and medical. Whilst there remains a great scope for improvement in the quality of patient care provided through telemedicine, it has shown the potential to become an integral part of medical practice in the future.

Supplementary information: The online version contains supplementary material available at 10.1007/s12170-023-00719-0.

综述目的:通过本综述,我们试图探讨远程医疗和虚拟就诊在新冠肺炎之前和新冠肺炎大流行期间在心脏病学领域的作用、它们的局限性及其未来的护理范围。最近的发现:远程医疗在新冠肺炎大流行期间变得突出,不仅有助于在危机时期减轻医疗系统的负担,而且有助于改善患者的预后。在可行的情况下,患者和医生也喜欢虚拟就诊。虚拟就诊被发现有可能在疫情之后继续下去,并与传统的面对面就诊一起在患者护理中发挥重要作用。摘要:尽管远程心脏病学已被证明在患者护理、方便和获取方面是有益的,但它在后勤和医疗方面都有相当大的局限性。虽然通过远程医疗提供的患者护理质量仍有很大的提高空间,但它已显示出在未来成为医疗实践不可或缺的一部分的潜力。补充信息:在线版本包含补充材料,可访问10.1007/s12170-023-00719-0。
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引用次数: 0
Risk Assessment and Management of Outflow Tract Arrhythmias Refractory to Prior Treatments 既往治疗难治流出道心律失常的风险评估和管理
IF 1.9 Q3 Medicine Pub Date : 2022-12-19 DOI: 10.1007/s12170-022-00712-z
P. Futyma, Łukasz Zarębski, Shaojie Chen, A. Enriquez, H. Pürerfellner, P. Santangeli
{"title":"Risk Assessment and Management of Outflow Tract Arrhythmias Refractory to Prior Treatments","authors":"P. Futyma, Łukasz Zarębski, Shaojie Chen, A. Enriquez, H. Pürerfellner, P. Santangeli","doi":"10.1007/s12170-022-00712-z","DOIUrl":"https://doi.org/10.1007/s12170-022-00712-z","url":null,"abstract":"","PeriodicalId":46144,"journal":{"name":"Current Cardiovascular Risk Reports","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49561185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
期刊
Current Cardiovascular Risk Reports
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