Current Problems in Cardiology最新文献

Cardiovascular diseases (CVDs) remain the leading cause of global mortality, yet disparities exist in cardiovascular research, particularly in low- and middle-income countries. This study presents a bibliometric analysis of cardiology research across OIC member countries from 2001 to 2025, examining productivity, impact, journal quality, and collaboration. OIC countries produced 64,299 publications, accruing 888,087 citations and 1,008,023 views. Annual publications rose from 516 in 2001 to 5,813 in 2025, an eleven-fold increase. Citation peaks occurred between 2013 and 2016, reaching 71,096 in 2016, while views peaked at 70,670 in 2020, reflecting temporal recognition trends. Journal analysis showed that mid-tier journals (Q2-Q3) hosted most publications: Q3 (35%), Q2 (28%), Q1 (20%), and Q4 (17%). Notably, Q1 and Q2 publications increased after 2015, indicating improved quality and visibility. Collaboration analysis revealed institutional (38%) dominated, followed by national (29%), international (28%), and single-authored papers (6%). International collaborations had the highest impact (29.7 citations per paper, FWCI 1.62), compared to national (8.5 citations, FWCI 0.44), institutional (7.7 citations, FWCI 0.36), and single-authored papers (4.2 citations, FWCI 0.36), highlighting the importance of cross-border partnerships. Country-level analysis showed Turkey, Iran, Egypt, Pakistan, and Saudi Arabia contributed most publications, while lower-output countries such as Algeria, Libya, Kyrgyzstan, and Azerbaijan achieved high citations per paper and FWCI. Overall, OIC cardiology research expanded substantially in quantity and visibility, yet disparities in productivity, quality, and impact persist, emphasizing the need to strengthen research capacity, promote high-quality studies, and foster international collaboration across all member countries.

Background: Rheumatic Heart Disease (RHD) remains a major cause of valvular morbidity in endemic regions despite declining incidence in high-income countries. While early disease manifests as acute rheumatic fever, contemporary presentations increasingly reflect advanced structural sequelae. Congestive hepatopathy and cardiac cirrhosis secondary to chronic right-sided failure remain under-recognized manifestations of advanced rheumatic valvular disease.

Objectives: To describe three cases of advanced rheumatic multivalvular disease presenting predominantly with ascites and hepatic congestion and to integrate these observations with current literature on pulmonary hypertension, right ventricular remodeling, and cardiac cirrhosis.

Methods: We conducted a retrospective case series at a tertiary referral center in North-India. Inclusion criteria comprised adult patients with echocardiographically confirmed rheumatic valvular disease, preserved left ventricular ejection fraction (≥50%), right-sided heart failure manifestations, and evidence of congestive hepatopathy. Comprehensive clinical, echocardiographic, laboratory, and hepatic Doppler assessments were performed. A structured literature review contextualized the findings.

Results: Three middle-aged women (46-52 years) presented with progressive dyspnea and tense ascites. All demonstrated severe left-sided rheumatic lesions (mitral stenosis or regurgitation), severe functional tricuspid regurgitation, pulmonary hypertension (PASP 55-64 mmHg), and preserved left ventricular systolic function (LVEF 58-62%). Marked left atrial enlargement (indexed volume 68-82 mL/m²) and varying degrees of right ventricular dysfunction (TAPSE 13-16 mm) were observed. High serum-ascites albumin gradients and hepatic Doppler abnormalities confirmed post-sinusoidal portal hypertension consistent with stage II-III congestive hepatopathy. All patients responded to diuretic therapy but were unsuitable for percutaneous intervention due to advanced rheumatic morphology and were referred for surgical valve replacement and tricuspid repair.

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Introduction: Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide, necessitating advanced diagnostic tools for risk stratification. Coronary computed tomography angiography (CCTA) combined with radiomics-a computational method extracting quantitative features from medical images-has emerged as a promising approach to predict major adverse cardiac events (MACEs) in patients who underwent CCTA for suspected coronary lesions.

Objectives: This systematic review and meta-analysis aimed to evaluate the diagnostic performance of radiomics-based models derived from CCTA for predicting MACEs.

Methodology: We conducted a comprehensive literature search across PubMed, Embase, and Cochrane Central. The main outcome was pooled MACEs predictability estimates, measured by pooled area under the curve (AUC), hazard ratios (HRs) and C-statistics. Subgroup analyses explored performance by radiomic features (e.g., pericoronary adipose tissue [PCAT]) and patient populations. Methodological quality was assessed by using the METRICS tool.

Results: Eleven studies meeting inclusion criteria were analyzed. The pooled AUC for radiomics models was 0.800 (95% CI: 0.732-0.868; I² = 75.1%). PCAT-based models showed lower consistency (AUC: 0.777, I² = 80.7%) compared to non-PCAT models (AUC: 0.859, I² = 0%). Subgroup analyses revealed AUCs of 0.754 for coronary artery disease (CAD), 0.901 for suspected/confirmed CAD. Univariate HR was 2.54 (95% CI: 2.00-3.24), while multivariate HR was 1.34 (95% CI: 1.04-1.72). Overall, the average METRICS total score was 70.32% ± 14.20%.

Conclusions: Radiomics-based CCTA models demonstrate robust performance for MACE prediction, with variability tied to feature selection and patient populations. These findings highlight radiomics' potential to enhance risk stratification and guide personalized interventions.

Sex-based differences in cardiovascular disease are well recognized; however, their implications in valvular heart disease (VHD), particularly mitral and tricuspid valve disorders, remain incompletely understood. As transcatheter therapies for structural heart disease rapidly expand, understanding how biological sex influences disease presentation, diagnostic evaluation, and procedural outcomes has become increasingly important. This review summarizes current evidence on sex-related differences in the epidemiology, pathophysiology, imaging assessment, and management of mitral and tricuspid valve disease in the era of transcatheter interventions. Women have a higher prevalence of mitral and tricuspid valve disease and often present with smaller cardiac chamber dimensions, distinct valvular morphology, and different patterns of ventricular remodeling compared with men. These differences may influence disease severity assessment, timing of intervention, and procedural outcomes. Multimodality imaging-including echocardiography, cardiac magnetic resonance, and cardiac computed tomography-plays a key role in identifying anatomical and functional variations that may contribute to these disparities. Despite increasing use of transcatheter mitral and tricuspid interventions, women remain underrepresented in clinical trials and registries, limiting the development of sex-specific treatment strategies. Available data suggest comparable procedural success across sexes, although disparities in complications, symptom burden, and referral patterns persist. Addressing these gaps through equitable trial enrollment, sex-specific imaging thresholds, and mechanistic research will be essential to advancing personalized and equitable care for patients with valvular heart disease.