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Efficacy of Tai Chi exercise in patients with hypertension: systematic review and meta-analysis 太极拳运动对高血压患者的疗效:系统回顾和荟萃分析
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-28 DOI: 10.1016/j.cpcardiol.2024.102798
Wenxuan Zhang, Hong Wang, Zheng Xiong, Chunmu Li

Background

An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries. Pharmachological approaches have side effect, prompting exploration of Non-pharmacological approaches, like Tai Chi. Although early evidence suggests a potential favourable benefit with Tai Chi, it remains unclear whether the method can significantly reduced SBP and DBP. We aimed to assess by a systematic review and meta-analysis the effectiveness of Tai Chi in alleviating SBP and DBP on hypertension patients.

Methods

Our study adhered to the PRISMA method and was registered in PROSPERO under the code CRD42024496192. The search was carried out in the PubMed, Web of Science, Embase, and the Cochrane Library databases in December 2023. Five randomized controlled trials were included (a total of 568 patients). Risk of bias was employed to assess the quality of individual studies, and a random-effects model was utilized to examine the overall effect.

Results

The results showed that Tai Chi, when compared to routine care, had a statistically significant impact on anxiety ((MD = 5.49, 95 % CI: 3.44 to 7.54, p = 0.001), with a heterogeneity I2 = 54%. Tai Chi did not show a significant difference in terms of DBP when compared to standard care (MD =3.18, 95 % CI: 1.89 to −4.48, p = 0.31). The included trials exhibited small sample sizes, substantial heterogeneity.

Conclusions

Tai Chi effectively lowers SBP levels in hypertension patients, however, did not show a statistically significant difference on DBP.

背景据估计,全球有 12.8 亿 30-79 岁的成年人患有高血压,其中大多数(三分之二)生活在中低收入国家。药物治疗方法有副作用,这促使人们探索非药物治疗方法,如太极拳。虽然早期证据表明太极拳可能带来好处,但该方法能否显著降低 SBP 和 DBP 仍不清楚。我们旨在通过系统综述和荟萃分析评估太极拳在缓解高血压患者 SBP 和 DBP 方面的有效性。方法我们的研究遵循 PRISMA 方法,并在 PROSPERO 中注册,代码为 CRD42024496192。研究于 2023 年 12 月在 PubMed、Web of Science、Embase 和 Cochrane Library 数据库中进行了检索。共纳入了 5 项随机对照试验(共 568 名患者)。结果表明,与常规护理相比,太极拳对焦虑有显著的统计学影响(MD = 5.49,95 % CI:3.44 至 7.54,p = 0.001),异质性 I2 = 54%。与标准护理相比,太极拳在DBP方面未显示出明显差异(MD = 3.18,95 % CI:1.89 至 -4.48,p = 0.31)。结论太极拳能有效降低高血压患者的 SBP 水平,但在 DBP 方面没有显示出具有统计学意义的差异。
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引用次数: 0
Racial disparities in trend, clinical characteristics and outcomes in Takotsubo syndrome Takotsubo 综合征的趋势、临床特征和结果中的种族差异。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-27 DOI: 10.1016/j.cpcardiol.2024.102826
Song Peng Ang MD , Jia Ee Chia MD , Chayakrit Krittanawong MD, FACC , Tharangini Vummadi DO , Abhishek Deshmukh MBBS , Muhammed Haris Usman MD, FACC , Carl J Lavie MD FACC , Debabrata Mukherjee MD, FACC, MSCAI

Introduction

Takotsubo syndrome (TTS) is an acute transient nonischemic cardiomyopathy often characterized by its hallmark feature of left ventricular apical ballooning. The correlation between racial backgrounds and the prognosis of individuals with TTS remains poorly defined. Our study aimed to explore the influence of race on the trends, clinical presentations, and outcomes in patients diagnosed with TTS.

Methods

We queried the National Inpatient Sample (NIS) database from 2016 to 2020 and identified hospitalizations with TTS. We compared the clinical features and outcomes across three different races - non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic population. The primary outcome was in-hospital mortality.

Results

76,505 weighted hospitalizations for TTS were identified, of which 65,495 (85.6%) were non-Hispanic White, 5,830 (7.6%) were non-Hispanic Black, and 5,180 (6.8%) were Hispanics. After propensity-score matching, NHB patients had higher odds of acute kidney injury (OR: 1.49, 95% CI: 1.21-1.84, p < 0.001) and mechanical ventilation (OR: 1.33, 95% CI: 1.04-1.68, p = 0.02). Hispanic patients had a higher incidence of acute kidney injury requiring dialysis when compared to NHW patients (OR: 2.53, 95% CI: 1.11-5.77, p = 0.027). There was no significant difference in terms of in-hospital mortality between NHB and Hispanic patients when compared to NHW patients. Notably, Hispanic populations experienced a higher mortality rate during the COVID-19 period.

Conclusion

Our study suggested significant differences in the outcomes of TTS across different racial groups. Hispanic populations experienced a higher mortality rate with TTS during the COVID-19 era. Further research should emphasize discovering the factors contributing to the observed disparities.

导言高骤变综合征(TTS)是一种急性短暂性非缺血性心肌病,通常以左心室心尖气囊扩张为特征。种族背景与 TTS 患者预后之间的相关性仍不十分明确。我们的研究旨在探讨种族对确诊为 TTS 患者的趋势、临床表现和预后的影响:我们查询了2016年至2020年的全国住院患者样本(NIS)数据库,并确定了TTS住院患者。我们比较了三种不同种族--非西班牙裔白人(NHW)、非西班牙裔黑人(NHB)和西班牙裔人群--的临床特征和预后。主要结果是院内死亡率:确定了 76,505 例 TTS 加权住院病例,其中 65,495 例(85.6%)为非西班牙裔白人,5,830 例(7.6%)为非西班牙裔黑人,5,180 例(6.8%)为西班牙裔。经过倾向分数匹配后,非西班牙裔白种人患者发生急性肾损伤的几率更高(OR:1.49,95% CI:1.21-1.84,p):我们的研究表明,不同种族群体的 TTS 结果存在显著差异。在 COVID-19 时代,西班牙裔人群的 TTS 死亡率较高。进一步的研究应强调发现导致观察到的差异的因素。
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引用次数: 0
Response to “Outcomes after septal myectomy in a cohort of patients with hypertrophic cardiomyopathy” 对 "一组肥厚型心肌病患者房间隔肌肉切除术后的疗效 "的回应
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-26 DOI: 10.1016/j.cpcardiol.2024.102822
Syeda Zuha Sami
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引用次数: 0
Letter to the Editor: Rising mortality related to cardiovascular disease and prostate cancer amongst older men across the United States 致编辑的信:美国老年男性心血管疾病和前列腺癌死亡率不断上升。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-25 DOI: 10.1016/j.cpcardiol.2024.102828
Umer Bin Shahzad MBBS, Ume Aiman MBBS
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引用次数: 0
Outcomes of definite vs probable/presumed cardiac sarcoidosis: a systematic review and meta-analysis 确诊与可能/推测的心脏肉样瘤病的结果:系统回顾和荟萃分析。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-25 DOI: 10.1016/j.cpcardiol.2024.102820
Raheel Ahmed , Areeba Ahsan , Mushood Ahmed , Margaux Dragon , Rigoberto Rafael Hernñandez Caballero , Shehroze Tabassum , Hritvik Jain , Mohsin Zia Sana Ullah , Debankur Dey , Kamleshun Ramphul , Peter Collins , Anwar Chahal , Vasilis Kouranos , Nitish Behary Paray , Rakesh Sharma

Background

Diagnosing cardiac sarcoidosis (CS), which can be associated with arrhythmias and heart failure, remains challenging despite multiple advances over time. The 2014 Heart Rhythm Society (HRS) consensus statement recommends an endomyocardial biopsy (EMB) to establish a definite diagnosis of CS. In the absence of a positive EMB, a diagnosis of probable or presumed CS is made on the basis of clinical and imaging criteria.

Objective

To investigate whether there is any difference in outcomes between definite vs probable/presumed CS.

Methods

PubMed/MEDLINE, Embase, and the Cochrane Library databases were searched for relevant studies published after 2014. Risk ratios (RR) with 95% confidence intervals (CI) were calculated using the random effects model and presented in forest plots.

Results

6 studies involving 2,204 patients were identified. The cohort had a mean age of 56.8 years (SD: ±13.6 years). The median duration of follow-up was 40.5 months. No statistically significant difference was observed between definite and probable/presumed CS for reduced risk of the composite endpoint (RR: 1.80, 95% CI: 0.93 to 3.49), and all-cause death (RR: 1.01, 95% CI: 0.48 to 2.10).

Conclusion

This meta-analysis demonstrated the equivalence of clinical course and prognosis between definite and probable/presumed CS. This highlights the importance of a multi-disciplinary approach to CS care and emphasizes that histological confirmation should not be a prerequisite to diagnose or manage this condition.
背景:心脏肉样瘤病(CS)可伴有心律失常和心力衰竭,尽管随着时间的推移取得了多项进展,但诊断CS仍具有挑战性。2014 年心律学会(HRS)共识声明建议通过心内膜活检(EMB)明确诊断 CS。如果心内膜活检未呈阳性,则根据临床和影像学标准诊断为可能或推测的 CS:调查确诊 CS 与可能/推测 CS 的结果是否存在差异:方法:检索 PubMed/MEDLINE、Embase 和 Cochrane Library 数据库中 2014 年之后发表的相关研究。采用随机效应模型计算风险比(RR)及95%置信区间(CI),并以森林图的形式展示:结果:共发现 6 项研究,涉及 2,103 名患者。研究队列的平均年龄为 56.8 岁(标准差:±13.6 岁)。随访时间的中位数为 40.5 个月。在降低复合终点风险(RR:1.06,95% CI:0.66 至 1.72)、全因死亡风险(RR:1.03,95% CI:0.73 至 1.46)、心脏性猝死(RR:1.59,95% CI:0.99 至 2.56)、心律失常(RR:0.80,95% CI:0.60 至 1.07)和 HF 相关住院(RR:0.91,95% CI:0.59 至 1.38):这项荟萃分析表明,确诊 CS 和可能/推测 CS 的临床病程和预后相当。这凸显了多学科方法对 CS 护理的重要性,并强调组织学确诊不应成为诊断或处理这种疾病的先决条件。
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引用次数: 0
Response to “Rising mortality related to cardiovascular disease and prostate cancer amongst older men across the United States” 回应 "美国老年男性心血管疾病和前列腺癌死亡率上升"。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-25 DOI: 10.1016/j.cpcardiol.2024.102824
Muzna Murtaza, Syeda Zuha Sami, FNU Venjhraj, Zainab Muhammad Hanif
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引用次数: 0
Aspirin use in patients with elevated lipoprotein(a): Impact on cardiovascular events and bleeding 脂蛋白(a)升高患者使用阿司匹林:对心血管事件和出血的影响。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-25 DOI: 10.1016/j.cpcardiol.2024.102827
Walter Masson , Leandro Barbagelata , Juan Patricio Nogueira

The role of aspirin in cardiovascular primary prevention remains controversial. There are physiological reasons to explore its potential benefits in patients with high levels of lipoprotein(a) [Lp(a)], mainly due to its antifibrinolytic properties and interactions with platelets. The primary objective of this systematic review was to evaluate the cardiovascular benefits and bleeding risks associated with aspirin use in patients who have elevated Lp(a) levels but no history of cardiovascular disease. This systematic review was conducted following PRISMA guidelines. We performed a literature search to identify studies assessing the cardiovascular benefits and bleeding risks of aspirin use in patients with elevated Lp(a) levels (or a related genetic variant) who have no history of cardiovascular disease. Five studies (49,871 individuals) were considered for this systematic review. Three studies assessed the impact of aspirin use in relation to genetic variants associated with elevated Lp(a) levels (SNP rs379822), while the remaining two studies directly measured plasma levels of Lp(a). The endpoints evaluated varied among the studies. Overall, the findings consistently show that carriers of the apolipoprotein(a) variant or patients with Lp(a) levels > 50 mg/dL experience a reduction in cardiovascular risk with aspirin use. No significant bleeding issues were observed, although such events were reported in only two studies. This systematic review suggests that aspirin use in patients with elevated Lp(a) levels and no prior cardiovascular history may reduce cardiovascular risk. The available data on bleeding risk is insufficient.

阿司匹林在心血管一级预防中的作用仍存在争议。探讨阿司匹林对脂蛋白(a)[Lp(a)]水平高的患者的潜在益处有其生理原因,主要是由于阿司匹林的抗纤维蛋白溶解特性以及与血小板的相互作用。本系统综述的主要目的是评估脂蛋白(a)水平升高但无心血管疾病史的患者服用阿司匹林对心血管的益处和出血风险。本系统综述遵循 PRISMA 指南进行。我们进行了文献检索,以确定评估无心血管疾病史的脂蛋白(a)水平升高(或相关基因变异)患者服用阿司匹林对心血管的益处和出血风险的研究。本系统综述考虑了五项研究(49,871 人)。其中三项研究评估了阿司匹林的使用对与脂蛋白(a)水平升高相关的基因变异(SNP rs379822)的影响,其余两项研究则直接测量了血浆中的脂蛋白(a)水平。各项研究评估的终点各不相同。总体而言,研究结果一致表明,载脂蛋白(a)变异体携带者或脂蛋白(a)水平大于 50 毫克/分升的患者服用阿司匹林可降低心血管风险。尽管只有两项研究报告了出血事件,但未观察到明显的出血问题。本系统综述表明,脂蛋白(a)水平升高且无心血管病史的患者服用阿司匹林可降低心血管风险。有关出血风险的现有数据尚不充分。
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引用次数: 0
Guidelines for Authors 作者指南
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-23 DOI: 10.1016/S0146-2806(24)00447-X
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引用次数: 0
Innovative pharmacological approaches to hypertrophic cardiomyopathy: The emerging role of Aficamten 治疗肥厚型心肌病的创新药理方法:Aficamten 的新作用。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-23 DOI: 10.1016/j.cpcardiol.2024.102802
Emmanuel Kokori , Ravi Patel , Gbolahan Olatunji , Abdulbasit Opeyemi Muili , Victor Oluwatomiwa Ajekiigbe , Abdulrahmon Moradeyo , Adetola Emmanuel Babalola , Julia Mimi Kwape , Oluwatobi Omoworare , Nicholas Aderinto

Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by left ventricular hypertrophy (LVH), which can lead to left ventricular outflow tract (LVOT) obstruction. Traditional treatments often provide limited symptom relief and may not adequately reduce the LVOT gradient. Myosin inhibitors, such as Aficamten , offer a new therapeutic approach by modulating myocardial contractility and improving symptoms. This paper evaluated the efficacy and safety of Aficamten in patients with symptomatic HCM. We conducted a comprehensive literature review of studies evaluating Aficamten for symptomatic HCM, including clinical trials and observational studies up to July 2024. Data on efficacy, safety, and patient outcomes were extracted and analyzed from a total of 10 studies involving 1,067 patients. Aficamten demonstrated substantial efficacy in reducing the LVOT gradient, with dose-dependent reductions ranging from 3.6 % to 48.6 %. It also improved symptoms, with 82.3 % of patients experiencing reduced left ventricular ejection fraction (LVEF) and notable improvements in New York Heart Association (NYHA) functional class. Exercise capacity was enhanced, as indicated by increased peak oxygen uptake. Safety profiles were generally favorable, though some serious adverse events, such as atrial fibrillation and cardiac dysfunction, were reported. Aficamten was well-tolerated overall, with manageable dose-dependent adverse effects. Aficamten represents a promising advance in the management of symptomatic HCM, offering significant reductions in LVOT gradient and improvement in symptoms and exercise capacity. Its safety profile is generally favorable, although ongoing monitoring is necessary to manage potential adverse effects. Future research should focus on long-term outcomes, comparative effectiveness, and real-world evidence.

肥厚型心肌病(HCM)是一种遗传性心脏疾病,以左心室肥厚(LVH)为特征,可导致左心室流出道(LVOT)阻塞。传统治疗方法通常只能缓解有限的症状,而且可能无法充分降低左心室流出道梯度。阿菲康坦等肌球蛋白抑制剂通过调节心肌收缩力和改善症状提供了一种新的治疗方法。本文评估了阿菲康坦对有症状的 HCM 患者的疗效和安全性。我们对评估阿菲康坦治疗症状性 HCM 的研究进行了全面的文献综述,包括截至 2024 年 7 月的临床试验和观察性研究。我们从涉及 1067 名患者的共 10 项研究中提取并分析了有关疗效、安全性和患者预后的数据。阿菲康坦对降低左心室出口梯度有显著疗效,剂量依赖性降低幅度从3.6%到48.6%不等。它还能改善症状,82.3%的患者左心室射血分数(LVEF)降低,纽约心脏协会(NYHA)功能分级明显改善。运动能力得到增强,峰值摄氧量有所提高。尽管报告了一些严重不良事件,如心房颤动和心功能不全,但安全性总体良好。Aficamten的总体耐受性良好,剂量依赖性不良反应可控。Aficamten 是治疗无症状 HCM 的一个有希望的进步,它能显著降低 LVOT 梯度,改善症状和运动能力。其安全性总体良好,但仍需持续监测以控制潜在的不良反应。未来的研究应侧重于长期结果、比较效果和真实世界的证据。
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引用次数: 0
Title Page 标题页
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-23 DOI: 10.1016/S0146-2806(24)00446-8
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引用次数: 0
期刊
Current Problems in Cardiology
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