Current Problems in Cardiology最新文献

英文中文

Innovations in Quantitative Rapid Testing: Early Prediction of Health Risks. 定量快速检测的创新：健康风险的早期预测。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-02-01 DOI: 10.1016/j.cpcardiol.2025.103000

Khaled S Alleilem, Saad Almousa, Mohammed Alissa, Faris Alrumaihi, Hajed Obaid Alharbi, Nahlah Makki Almansour, Leen A Aldaiji, Amr S Abouzied, Mahdi H Alsugoor, Omer Alasmari, Marwh Jamal Albakawi, Jens Stride

As health monitoring becomes increasingly intricate, the demand for innovative solutions to predict and assess health status is more pressing than ever. This review focuses on the transformative potential of multi-sensor technologies in health monitoring, emphasizing their role in early health status prediction. By integrating diverse sensor types ranging from wearable fitness trackers to implantable devices and environmental monitors healthcare professionals can gain a richer, more nuanced understanding of an individual's physiological state. We analyze various configurations of multi-sensor networks and their efficacy in identifying early indicators of health issues, such as cardiovascular diseases, diabetes, and respiratory ailments. For example, the combination of biometric sensors that track vital signs with environmental data on pollutants can yield invaluable insights into a patient's overall health. This integrated approach not only improves the accuracy of health assessments but also facilitates timely interventions. Furthermore, we address the challenges inherent in multi-sensor systems, including data integration, device interoperability, and the need for advanced algorithms capable of processing complex datasets. Recent advancements in machine learning and artificial intelligence are underscored as pivotal in enhancing the capabilities of these technologies for predictive health analytics. Ultimately, this review highlights how multi-sensor systems can redefine early health status prediction, paving the way for proactive healthcare strategies that significantly improve patient outcomes and optimize healthcare delivery.

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引用次数: 0

The Future of Cardiology: Integrating Single-Cell Transcriptomics with Multi-Omics for Enhanced Cardiac Disease Insights.

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-01-31 DOI: 10.1016/j.cpcardiol.2025.103005

Zhengchun Tang, Faris Alrumaihi, Wanian M Alwanian, Hajed Obaid Alharbi, Khaled S Allemailem, Mohammed Alissa, Omar Alasmari, Saad Almousa, Thomas Ainsworth, Xiangmei Chen

Recent advancements in single-cell transcriptome sequencing (scRNA-seq) have revolutionized our understanding of cellular heterogeneity in cardiovascular diseases, enabling the identification of novel therapeutic targets. This technology allows for high-resolution analysis of gene expression at the single-cell level, revealing the complex dynamics of human heart cell development and the diverse roles of cardiac cell types in health and disease. Despite its transformative potential, current applications of scRNA-seq face limitations, including challenges in data integration and the need for comprehensive multi-omic approaches to fully elucidate the mechanisms underlying cardiovascular pathologies. This review highlights the significant insights gained from scRNA-seq studies in the mammalian heart, emphasizing the importance of integrating spatial transcriptomics and other omics technologies to enhance our understanding of cardiac biology. Furthermore, it addresses the critical research gaps in the field, particularly in the context of personalized medicine and the need for improved methodologies to analyze rare cell populations. By exploring these challenges and opportunities, this review aims to pave the way for innovative diagnostic and therapeutic strategies that can ultimately improve outcomes for patients with cardiovascular diseases.

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引用次数: 0

A review regarding the article ‘Cardiovascular outcomes of sodium-glucose co-transporter 2 inhibitors use after myocardial infarction: A systematic review and meta-analysis of randomized controlled trials’

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-01-31 DOI: 10.1016/j.cpcardiol.2025.103006

Qiang Fan PhD, Yunfei Ling PhD

Myocardial infarction (MI) without established heart failure (HF) represents a distinct high-risk condition that is not sufficiently represented in other trial populations. Early intervention with disease-modifying therapies, such as Sodium-Glucose Co-transporter 2 inhibitors (SGLT2i), could potentially prevent progression to chronic HF in these patients. Prior trials involving patients with type 2 diabetes mellitus (T2DM), HF, or nephropathy have predominantly focused on stable outpatients and have generally excluded patients with recent acute cardiovascular events. While there is a growing interest in the potential benefits of SGLT2 inhibitors in the acute MI setting, further research is essential to determine their efficacy and safety in this patient population. This will require well-designed, targeted clinical trials that specifically address the unique characteristics and needs of patients with acute MI, including those with new onset left ventricular dysfunction, transient HF, or concurrent T2DM. Furthermore, the safety profile of SGLT2 inhibitors in post-MI patients appears to be favorable, as they have been found to have a comparable incidence of serious adverse events to placebo. This is an important consideration, as safety is a paramount concern when introducing new therapies, especially in a vulnerable patient population like those recovering from an acute MI. It is important to conduct further research to determine whether the early introduction of SGLT2 inhibitors post-MI can lead to similar benefits as those observed in patients with T2DM and established cardiovascular disease.

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引用次数: 0

Sleep: Its nature and mechanism in Avicenna's medicine and psychology

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-01-30 DOI: 10.1016/j.cpcardiol.2025.103001

Zahra Sadat Pour Seyyed Aghaei , Farah Ramin

Sleep is a fundamental necessity for humans and other living beings. Throughout history, many thinkers have sought to understand its complexities. Avicenna, in his works, elucidates the nature and mechanism of sleep from two angles: "sleeping," as an essential process for sentient beings, and "dreams," which reflect the effects of sleep on human life and health. This article explores sleep through Avicenna's lens, examining its philosophical, psychological, and medical foundations. It begins with a definition of sleep, followed by an analysis of its causes, manifestations, and types, including natural, unnatural, and artificial. The findings indicate that Avicenna was a pioneer in studying altered states of perception within the imagination, showcasing his understanding of hypnotic sleep and its therapeutic applications for disorders like melancholy.

引用次数: 0

Cardiac transplantation in muscular dystrophies: A case series

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-01-30 DOI: 10.1016/j.cpcardiol.2025.102997

Mariano G. Bergier , Rocio Blanco , Ezequiel Lillo , Ricardo Posatini , César A. Belziti

Muscular dystrophies can involve cardiac complications, including dilated cardiomyopathy, arrhythmias, and conduction system disorders. In cases of terminal heart failure, cardiac transplantation may be considered a viable option; however, its feasibility in this population has been questioned for many years. This case series describes the preoperative characteristics and postoperative outcomes of five patients with muscular dystrophy and dilated cardiomyopathy who underwent cardiac transplantation at a tertiary care center in Latin America between 2018 and 2024. All patients were male, with a mean age of 38.4 ± 11.5 years at transplantation. Genetic variants were confirmed in all cases. Although two patients experienced postoperative respiratory and swallowing complications, survival was 100 %, with a median follow-up of 16 months and good functional capacity. Cardiac transplantation is a valid option for patients with muscular dystrophies and dilated cardiomyopathy, emphasizing the importance of functional evaluation and a multidisciplinary approach to optimize outcomes.

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引用次数: 0

Practical guidance for management of atrial fibrillation in sports cardiology

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-01-29 DOI: 10.1016/j.cpcardiol.2025.102995

Andrea Palermi , Lorenzo Vilhelm Molinari , Fabrizio Ricci , Sabina Gallina , Giulia Renda MD, Ph.D

Importance

Atrial fibrillation (AF), the most prevalent sustained arrhythmia, portends higher risk of cardiovascular morbidity and mortality, and is associated with quantifiable impairment in quality of life. While physical activity is widely recognized for its cardiovascular benefits, recent evidence challenges its role in the development of AF.

Observations

Emerging data suggest a U-shaped relationship between physical activity and AF risk. Mild to moderate exercise appears protective, whereas prolonged, high-intensity activity is associated with an increased risk, possibly driven by cardiac remodeling, autonomic alterations, and atrial substrate changes typical of the so-called athlete's heart. This relationship is further modulated by other factors, including genetic predisposition, acquired cardiac conditions, and stimulant use. With the growing participation of aging populations in sports, the clinical management of AF in athletes presents unique challenges. Pharmacological strategies for rhythm and rate control may conflict with performance goals, and the use of anticoagulants must be carefully balanced against the risk of traumatic bleeding in contact sports. Recent evidence supports strategies such as short-term anticoagulant withdrawal to mitigate hemorrhagic risk while maintaining thromboembolic protection. A personalized approach, incorporating shared decision-making, is essential, particularly for elite athletes.

Conclusions and relevance

While regular physical activity generally confers cardiovascular benefits, prolonged intense exercise bouts may paradoxically increase the risk of AF. The evaluation and management of AF in athletes require a tailored, multidisciplinary approach that accounts for the distinct needs of this population.

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引用次数: 0

Atrioventricular block and conduction disorders induced by ICIs: Individual patient data systematic review

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-01-29 DOI: 10.1016/j.cpcardiol.2025.103003

Luca Pascalis MD, Luca Fazzini MD, Christian Cadeddu Dessalvi MD PhD

Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that enhance T cell-mediated anti-tumor responses but may induce cardiotoxicity, including conduction disorders and atrioventricular blocks (AVB). A systematic review of 30 case reports involving cancer patients treated with ICIs was conducted. The majority of affected patients were in advanced stages of lung and kidney/urothelial cancers, predominantly male, and typically developed AVB within three weeks of therapy, often accompanied by myocarditis. Complete AVB was the most frequently observed disorder, necessitating interruption of therapy and temporary pacing. Less than half of the cases were reversible, and in-hospital mortality was significant. Further research is needed.

引用次数: 0

Real-world efficacy of tirzepatide in patients with heart failure without diabetes 替扎帕肽对无糖尿病心衰患者的实际疗效

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-01-29 DOI: 10.1016/j.cpcardiol.2025.102998

Silvio Nunes Augusto Jr , David Kaelber MD PhD MPH , W.H. Wilson Tang MD

Background

Tirzepatide, a dual agonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has shown significant cardiovascular benefits in clinical trials. This study investigates the real-world impact of tirzepatide on heart failure (HF) outcomes, leveraging data from the TriNetX platform.

Methods

Using data from January 1, 2013, to December 01, 2024, we conducted a propensity-matched analysis of two cohorts of patients with HF without diabetes, where the only difference was the use of tirzepatide. The primary outcome was the incidence of acute heart failure (acute HF), with secondary outcomes including major adverse cardiovascular events (MACE), chronic kidney disease (CKD), stroke, and coronary arterial disease (CAD).

Results

After propensity-matching, 897 patients were compared between the two cohorts in a 4-year follow-up, showing that untreated patients were at higher risk of incident acute HF (HR: 3.12, 95 %CI = 2.240–4.349, log-rank p < 0.001) and MACE (HR: 3.57, 95 %CI = 2.32–5.48, log-rank p < 0.001). Stroke (HR: 2.796, 95 %CI = 1.353–5.776, log-rank p < 0.01), CKD (HR: 1.48, 95 %CI: 1.08–2.03, log-rank p = 0.015), and CAD (HR: 1.474, 95 %CI,1.169–1.859, log-rank p = 0.001) outcomes also favored the treatment cohort.

Conclusion

Tirzepatide presents a promising therapeutic option for managing heart failure, with significant metabolic and cardiovascular benefits. These real-world findings reinforce its potential role as a transformative treatment in improving clinical outcomes and quality of life for patients with HF without diabetes.

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引用次数: 0

“Artificial Bachmann's Bundle”, employing carbon nanotube fibers in the prevention/management of atrial fibrillation

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-01-29 DOI: 10.1016/j.cpcardiol.2025.102999

John E. Madias MD, FACC, FAHA

The present communication constitutes a proposal of attempting to restore interatrial electrical conduction in patients with interatrial block and malfunctioning Bachman's bundle, or other interatrial conduction pathways, employing carbon nanotube fibers (i.e., an “artificial Bachman's bundle”), in order to prevent emergence of atrial fibrillation, and by extension even possibly ameliorate or effectively treat paroxysmal/persistent/permanent atrial fibrillation.

引用次数: 0

Genotype-phenotype correlations in hypertrophic cardiomyopathy: Insights from an HCM Center of Excellence

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-01-29 DOI: 10.1016/j.cpcardiol.2025.102996

Muddasir Ashraf MD , M. Fuad Jan MBBS (Hons), MD , Arshad Jahangir MD , Stacie Kroboth BS , Zaid Abood MD , Sara Walczak BS , Heather Sanders NP , A. Jamil Tajik MD

Background

Owing to the recognition of previously unknown pathogenic gene variants and reclassification of longer-known variants, gene distribution in patients with hypertrophic cardiomyopathy (HCM) is ever-changing. Conflicting data make the role of genotype in risk stratification unclear.

Methods

We evaluated genotype distribution and genotype-phenotype correlations in all adult patients with HCM seen at our HCM Center of Excellence from March 31, 2010, to April 30, 2023. We also evaluated a composite outcome, including all-cause mortality, stroke, implantable cardioverter-defibrillator placement, heart failure hospitalization, left ventricular assist device implantation, heart transplantation, septal myectomy, and alcohol septal ablation, based on genotype status. All-cause mortality was separately analyzed.

Results

Of 827 patients with HCM, genotyping was completed in 754 (91.2 %). We identified 202 (27 %) genotype-positive (Gen-P), 163 (22 %) variant of unknown significance (VUS), and 389 (51 %) genotype-negative (Gen-N) patients. Mean ages were 47, 57, and 58 years, respectively. The most common gene implicated was MYBPC3 (63 %). More patients were on optimal medical treatment after following up with our HCM center. Electrocardiographic, Holter, echocardiographic, and cardiac magnetic resonance imaging characteristics differed based on genotype status. The composite outcome was worse in Gen-P than Gen-N (HR 1.84, p<0.001). Although analysis of all-cause mortality showed survival was different for Gen-P and VUS patients than for Gen-N patients, this difference was not statistically significant.

Conclusion

MYBPC3 was the most common gene implicated. Outcomes were worse in Gen-P patients. Centers of Excellence play an important role in the optimal medical management of patients with HCM.

{"title":"Genotype-phenotype correlations in hypertrophic cardiomyopathy: Insights from an HCM Center of Excellence","authors":"Muddasir Ashraf MD , M. Fuad Jan MBBS (Hons), MD , Arshad Jahangir MD , Stacie Kroboth BS , Zaid Abood MD , Sara Walczak BS , Heather Sanders NP , A. Jamil Tajik MD","doi":"10.1016/j.cpcardiol.2025.102996","DOIUrl":"10.1016/j.cpcardiol.2025.102996","url":null,"abstract":"<div><h3>Background</h3><div>Owing to the recognition of previously unknown pathogenic gene variants and reclassification of longer-known variants, gene distribution in patients with hypertrophic cardiomyopathy (HCM) is ever-changing. Conflicting data make the role of genotype in risk stratification unclear.</div></div><div><h3>Methods</h3><div>We evaluated genotype distribution and genotype-phenotype correlations in all adult patients with HCM seen at our HCM Center of Excellence from March 31, 2010, to April 30, 2023. We also evaluated a composite outcome, including all-cause mortality, stroke, implantable cardioverter-defibrillator placement, heart failure hospitalization, left ventricular assist device implantation, heart transplantation, septal myectomy, and alcohol septal ablation, based on genotype status. All-cause mortality was separately analyzed.</div></div><div><h3>Results</h3><div>Of 827 patients with HCM, genotyping was completed in 754 (91.2 %). We identified 202 (27 %) genotype-positive (Gen-P), 163 (22 %) variant of unknown significance (VUS), and 389 (51 %) genotype-negative (Gen-N) patients. Mean ages were 47, 57, and 58 years, respectively. The most common gene implicated was <em>MYBPC3</em> (63 %). More patients were on optimal medical treatment after following up with our HCM center. Electrocardiographic, Holter, echocardiographic, and cardiac magnetic resonance imaging characteristics differed based on genotype status. The composite outcome was worse in Gen-P than Gen-N (HR 1.84, <em>p</em><0.001). Although analysis of all-cause mortality showed survival was different for Gen-P and VUS patients than for Gen-N patients, this difference was not statistically significant.</div></div><div><h3>Conclusion</h3><div><em>MYBPC3</em> was the most common gene implicated. Outcomes were worse in Gen-P patients. Centers of Excellence play an important role in the optimal medical management of patients with HCM.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 4","pages":"Article 102996"},"PeriodicalIF":3.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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