Pub Date : 2024-10-18DOI: 10.1016/j.cpcardiol.2024.102884
Unicuspid aortic valve (UAV) is a rare congenital valvular anomaly, often misdiagnosed as the more prevalent bicuspid aortic valve (BAV). The aim of this study was to explore demographic, clinical characteristics, diagnosis, surgical options, short and long term outcomes of young adults with UAV.
A systematic review and meta-analysis of literature were conducted for studies (1971-2024) including patients (≥ 14 years old) with diagnosis of UAV. Among the 2953 studies retrieved, 67 case reports, 6 case series (n = 130) and 13 retrospective studies (n = 918), were included in the analysis. Data from retrospective studies were aggregated using a random effects model for estimating the pooled risk ratio and mean difference.
UAV is mostly unicommissural in adults (mean age 36 years old at diagnosis, 76–79 % males). The most common conditions associated in UAV patients were aortic coarctation (from 3.8 to 12 %), ventricular septal defect (3 %) and Turner syndrome (3 %). In general, the diagnosis was performed with TTE and confirmed with TEE (+/- 3D-TEE). The most common types of surgery were AVR. Dilated ascending aorta was described in 44 % and 35 % of retrospective studies and case reports, respectively. Concomitant ascending aorta replacement/repair was reported 38 % and 27 % of retrospective studies and case reports, respectively. Overall survival was reported in 3 studies, ranging from 95 to 98 % at 10 years.
UAV should be considered a separate entity from BAV. Further investigations with regards to the possibility of a familial incidence, associated histopathological changes in the aorta, and ideal follow up and intervention are needed.
{"title":"Current evidence of unicuspid aortic valve in young adults: A systematic review and metanalysis","authors":"","doi":"10.1016/j.cpcardiol.2024.102884","DOIUrl":"10.1016/j.cpcardiol.2024.102884","url":null,"abstract":"<div><div>Unicuspid aortic valve (UAV) is a rare congenital valvular anomaly, often misdiagnosed as the more prevalent bicuspid aortic valve (BAV). The aim of this study was to explore demographic, clinical characteristics, diagnosis, surgical options, short and long term outcomes of young adults with UAV.</div><div>A systematic review and meta-analysis of literature were conducted for studies (1971-2024) including patients (≥ 14 years old) with diagnosis of UAV. Among the 2953 studies retrieved, 67 case reports, 6 case series (<em>n</em> = 130) and 13 retrospective studies (<em>n</em> = 918), were included in the analysis. Data from retrospective studies were aggregated using a random effects model for estimating the pooled risk ratio and mean difference.</div><div>UAV is mostly unicommissural in adults (mean age 36 years old at diagnosis, 76–79 % males). The most common conditions associated in UAV patients were aortic coarctation (from 3.8 to 12 %), ventricular septal defect (3 %) and Turner syndrome (3 %). In general, the diagnosis was performed with TTE and confirmed with TEE (+/- 3D-TEE). The most common types of surgery were AVR. Dilated ascending aorta was described in 44 % and 35 % of retrospective studies and case reports, respectively. Concomitant ascending aorta replacement/repair was reported 38 % and 27 % of retrospective studies and case reports, respectively. Overall survival was reported in 3 studies, ranging from 95 to 98 % at 10 years.</div><div>UAV should be considered a separate entity from BAV. Further investigations with regards to the possibility of a familial incidence, associated histopathological changes in the aorta, and ideal follow up and intervention are needed.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 10.1016/j.cpcardiol.2024.102888
Background
This study was conducted with descriptive design to determine the level of knowledge and quality of life of individuals suffering from coronary artery disease.
Methods
The study was conducted with 236 patients who applied to the cardiology outpatient clinic of a training and research hospital between November 2021 and April 2022. The data of the study were collected by personal information form, coronary artery disease education questionnaire-II and cardiac health profile scale.
Results
The patients’ total mean score for the coronary artery disease education questionnaire-II was 25.71±12.49. According to the total score obtained from the coronary artery disease education questionnaire-II, it was determined that 49.2% of the patients had an "insufficient" knowledge level, 44.5% "Poor", and 5.9% "Acceptable". Knowledge level of only one patient was good. In the chest pain classification of the cardiac health profile scale, the chest pain level of 28.4% of the patients was the "class II". Total mean score of the patients for the cardiac health profile scale was 679.88±245.89.
Discussion
It was found that the level of knowledge of the participants about coronary artery disease was insufficient and their level of quality of life was moderate. It is recommended to organize education programs based on the education, culture, perception of health, spoken language in order to elevate their knowledge level and thus their level of quality of life.
{"title":"The level of knowledge related to the disease and quality of life among coronary artery patients","authors":"","doi":"10.1016/j.cpcardiol.2024.102888","DOIUrl":"10.1016/j.cpcardiol.2024.102888","url":null,"abstract":"<div><h3>Background</h3><div>This study was conducted with descriptive design to determine the level of knowledge and quality of life of individuals suffering from coronary artery disease.</div></div><div><h3>Methods</h3><div>The study was conducted with 236 patients who applied to the cardiology outpatient clinic of a training and research hospital between November 2021 and April 2022. The data of the study were collected by personal information form, coronary artery disease education questionnaire-II and cardiac health profile scale.</div></div><div><h3>Results</h3><div>The patients’ total mean score for the coronary artery disease education questionnaire-II was 25.71±12.49. According to the total score obtained from the coronary artery disease education questionnaire-II, it was determined that 49.2% of the patients had an \"insufficient\" knowledge level, 44.5% \"Poor\", and 5.9% \"Acceptable\". Knowledge level of only one patient was good. In the chest pain classification of the cardiac health profile scale, the chest pain level of 28.4% of the patients was the \"class II\". Total mean score of the patients for the cardiac health profile scale was 679.88±245.89.</div></div><div><h3>Discussion</h3><div>It was found that the level of knowledge of the participants about coronary artery disease was insufficient and their level of quality of life was moderate. It is recommended to organize education programs based on the education, culture, perception of health, spoken language in order to elevate their knowledge level and thus their level of quality of life.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480092","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}
Pub Date : 2024-10-18DOI: 10.1016/j.cpcardiol.2024.102890
Objectives
The aim of this study was to assess quality of life and associated factors among hypertensive patients attending in public hospital at Addis Ababa.
Methods and material
An institutional -based cross-sectional study was conduct among adults in Addis Ababa selected public hospitals. Systematic sampling technique was used to select 423 study participants after proportional allocation was made on each hospital. Data was collected by questionnaire adapted from WHO STEP wise approach to Surveillance on NCDs modified by the FMOH and EPHI. Data entry, cleaning by data exploration and analysis was done by using SPSS. Descriptive and logistic regression models were used for data analysis. The result was considered statistically significant at p < 0.05.
Result
The magnitude of high health-related quality of life in hypertensive patients was 53.6% (with 95% CI: 48.6-58.6). Having experienced any complications co morbidities HRQOL (AOR = 7.177; CI = 4.761–9.698), Starting treatment for hypertension below 3 years were (AOR= 3.029: CI=2.406-9.133, higher educational level (AOR=3.477: CI= 0.708-17.059), age 40 and above (AOR=3.216: CI= 1.073-9.643), having an income of <3000birr (AOR=1.75: CI= 1.14-2.68) were significantly associated with the dependent variable.
Conclusions and recommendation
This study showed the magnitude of low health-related quality of life in hypertensive patients is high. Having complications or co morbidities, starting treatment for hypertension below 3 years, being educated, older age, income of less than 3000 per month were factors associated to low health related quality of life in hypertensive patients.
{"title":"Health related quality of life and associated factors among hypertensive patients attending public hospitals in Addis Ababa, Ethiopia, 2024","authors":"","doi":"10.1016/j.cpcardiol.2024.102890","DOIUrl":"10.1016/j.cpcardiol.2024.102890","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to assess quality of life and associated factors among hypertensive patients attending in public hospital at Addis Ababa.</div></div><div><h3>Methods and material</h3><div>An institutional -based cross-sectional study was conduct among adults in Addis Ababa selected public hospitals. Systematic sampling technique was used to select 423 study participants after proportional allocation was made on each hospital. Data was collected by questionnaire adapted from WHO STEP wise approach to Surveillance on NCDs modified by the FMOH and EPHI. Data entry, cleaning by data exploration and analysis was done by using SPSS. Descriptive and logistic regression models were used for data analysis. The result was considered statistically significant at p < 0.05.</div></div><div><h3>Result</h3><div>The magnitude of high health-related quality of life in hypertensive patients was 53.6% (with 95% CI: 48.6-58.6). Having experienced any complications co morbidities HRQOL (AOR = 7.177; CI = 4.761–9.698), Starting treatment for hypertension below 3 years were (AOR= 3.029: CI=2.406-9.133, higher educational level (AOR=3.477: CI= 0.708-17.059), age 40 and above (AOR=3.216: CI= 1.073-9.643), having an income of <3000birr (AOR=1.75: CI= 1.14-2.68) were significantly associated with the dependent variable.</div></div><div><h3>Conclusions and recommendation</h3><div>This study showed the magnitude of low health-related quality of life in hypertensive patients is high. Having complications or co morbidities, starting treatment for hypertension below 3 years, being educated, older age, income of less than 3000 per month were factors associated to low health related quality of life in hypertensive patients.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480090","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}
Pub Date : 2024-10-10DOI: 10.1016/j.cpcardiol.2024.102867
Introduction
Amyloidosis is a group of diseases characterized by the deposition of misfolded protein fragments, forming insoluble fibrils in organs and tissues. Transthyretin (ATTR) amyloidosis, particularly cardiac amyloidosis (CA), leads to myocardial stiffness and heart failure. Right ventricular (RV) involvement is common in CA, but assessing RV stiffness noninvasively is challenging. This study aimed to evaluate RV stiffness using shear wave elastography (SWE) and correlate the findings with clinical, laboratory, and echocardiographic parameters.
Materials and Methods
In this prospective, single-center, cross-sectional study, 60 patients were divided into three groups: 20 with cardiac ATTR amyloidosis (ATTR-CM), 20 with non-cardiac ATTR amyloidosis (ATTR non-CM), and 20 healthy controls. Myocardial stiffness was measured using SWE in the free wall of the RV. Pearson's and Spearman's correlation coefficients were used for statistical analysis, with significance set at p < 0.05.
Results
RV SWE values showed a strong positive correlation with functional class and a moderate correlation with BNP and troponin I levels. A significant negative correlation was found between RV SWE values and the 6-minute walk test distance. SWE also correlated with echocardiographic variables like interventricular septum thickness and RV basal diameter. An SWE cutoff of ≥ 4.6. kPa was associated with cardiac involvement, showing 65 % sensitivity and 76 % specificity.
Conclusions
SWE is a valuable noninvasive technique for assessing RV stiffness in CA patients, correlating well with clinical and echocardiographic parameters. An RV SWE value of ≥ 4.6 kPa could aid in early detection of cardiac involvement in ATTR amyloidosis, improving diagnosis and management.
简介淀粉样变性是一组以错误折叠的蛋白质片段沉积在器官和组织中形成不溶性纤维为特征的疾病。转甲状腺素（ATTR）淀粉样变性，尤其是心脏淀粉样变性（CA），会导致心肌僵硬和心力衰竭。右心室（RV）受累在 CA 中很常见，但用无创方法评估右心室僵硬度具有挑战性。本研究旨在使用剪切波弹性成像（SWE）评估右心室僵硬度，并将评估结果与临床、实验室和超声心动图参数相关联：在这项前瞻性、单中心、横断面研究中，60 名患者被分为三组：20 名心源性 ATTR 淀粉样变性（ATTR-CM）患者、20 名非心源性 ATTR 淀粉样变性（ATTR 非 CM）患者和 20 名健康对照组。心肌僵硬度采用心室游离壁的 SWE 测量。采用皮尔逊和斯皮尔曼相关系数进行统计分析，显著性以 p < 0.05 为限：RV SWE 值与功能分级呈强正相关，与 BNP 和肌钙蛋白 I 水平呈中度相关。发现左心室 SWE 值与 6 分钟步行测试距离呈明显负相关。SWE 还与超声心动图变量（如室间隔厚度和 RV 基底直径）相关。SWE 临界值≥ 4.6 kPa 与心脏受累相关，显示出 65% 的敏感性和 76% 的特异性：SWE是评估CA患者RV僵硬度的一种有价值的无创技术，与临床和超声心动图参数有很好的相关性。RV SWE值≥4.6 kPa有助于早期发现ATTR淀粉样变性的心脏受累情况，从而改善诊断和治疗。
{"title":"Assessment of right ventricular myocardial stiffness by cardiac elastography in patients with transthyretin amyloidosis","authors":"","doi":"10.1016/j.cpcardiol.2024.102867","DOIUrl":"10.1016/j.cpcardiol.2024.102867","url":null,"abstract":"<div><h3>Introduction</h3><div>Amyloidosis is a group of diseases characterized by the deposition of misfolded protein fragments, forming insoluble fibrils in organs and tissues. Transthyretin (ATTR) amyloidosis, particularly cardiac amyloidosis (CA), leads to myocardial stiffness and heart failure. Right ventricular (RV) involvement is common in CA, but assessing RV stiffness noninvasively is challenging. This study aimed to evaluate RV stiffness using shear wave elastography (SWE) and correlate the findings with clinical, laboratory, and echocardiographic parameters.</div></div><div><h3>Materials and Methods</h3><div>In this prospective, single-center, cross-sectional study, 60 patients were divided into three groups: 20 with cardiac ATTR amyloidosis (ATTR-CM), 20 with non-cardiac ATTR amyloidosis (ATTR non-CM), and 20 healthy controls. Myocardial stiffness was measured using SWE in the free wall of the RV. Pearson's and Spearman's correlation coefficients were used for statistical analysis, with significance set at p < 0.05.</div></div><div><h3>Results</h3><div>RV SWE values showed a strong positive correlation with functional class and a moderate correlation with BNP and troponin I levels. A significant negative correlation was found between RV SWE values and the 6-minute walk test distance. SWE also correlated with echocardiographic variables like interventricular septum thickness and RV basal diameter. An SWE cutoff of ≥ 4.6. kPa was associated with cardiac involvement, showing 65 % sensitivity and 76 % specificity.</div></div><div><h3>Conclusions</h3><div>SWE is a valuable noninvasive technique for assessing RV stiffness in CA patients, correlating well with clinical and echocardiographic parameters. An RV SWE value of ≥ 4.6 kPa could aid in early detection of cardiac involvement in ATTR amyloidosis, improving diagnosis and management.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407189","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}
Pub Date : 2024-10-10DOI: 10.1016/j.cpcardiol.2024.102880
Background
Direct Oral Anticoagulants (DOACs) are the first line anticoagulation for patients with non-valvular atrial fibrillation (NVAF). Percutaneous Left Atrial Appendage Occlusion (LAAO) has emerged as a new therapy and its safety and effectiveness compared with DOACs are still controversial.
Methods
A systematic review of randomized controlled trials and observational studies was conducted, focusing on patients with NVAF. Outcomes analyzed included: (1) all-cause mortality; (2) cardiovascular (CV) mortality; (3) thromboembolic events; (4) stroke or transient ischemic attack (TIA); (5) bleeding events; and a (6) composite of death, hemorrhagic, and thromboembolic events. We performed a subgroup analysis of major bleeding according to different definitions: (1) Bleeding Academic Research Consortium (BARC); (2) International Society on Thrombosis and Haemostasis (ISTH); and (3) other definitions.
Results
Ten studies involving 18,507 patients were included, with 42.35 % undergoing LAAO. In pooled analysis, LAAO was associated with lower rates of all-cause mortality (HR 0.63; 95 % CI 0.50-0.80), cardiovascular mortality (HR 0.56; 95 % CI 0.45-0.70), and of the composite outcome (HR 0.73; 95 % CI 0.58-0.92). A trend towards lower stroke/TIA events was observed but not statistically significant. Overall bleeding events did not significantly differ between groups; using the ISTH definition, LAAO showed significantly lower incidence of bleeding events (HR 0.63; 95 % CI 0.43-0.91). No difference was found in thromboembolic events.
Conclusion
LAAO was associated with a significantly lower all-cause mortality and cardiovascular mortality, as well as the composite of death, hemorrhagic or thromboembolic events, as compared with DOACs.
背景：直接口服抗凝药（DOACs）是非瓣膜性心房颤动（NVAF）患者的一线抗凝药物。经皮左心房阑尾封堵术（LAAO）已成为一种新疗法，与 DOACs 相比，其安全性和有效性仍存在争议：方法：对随机对照试验和观察性研究进行了系统回顾，重点关注 NVAF 患者。分析的结果包括(1)全因死亡率；(2)心血管（CV）死亡率；(3)血栓栓塞事件；(4)中风或短暂性脑缺血发作（TIA）；(5)出血事件；(6)死亡、出血和血栓栓塞事件的复合。我们根据（1）出血学术研究联盟（BARC）；（2）国际血栓与止血学会（ISTH）；（3）其他定义的不同定义对大出血进行了亚组分析：共纳入 10 项研究，涉及 18,507 名患者，其中 42.35% 的患者接受了 LAAO。在汇总分析中，LAAO 与较低的全因死亡率（HR 0.63；95% CI 0.50-0.80）、心血管死亡率（HR 0.56；95% CI 0.45-0.70）和综合结果（HR 0.73；95% CI 0.58-0.92）相关。中风/TIA事件呈下降趋势，但无统计学意义。采用ISTH定义，LAAO组的出血事件发生率明显降低（HR 0.63；95% CI 0.43-0.91）。在血栓栓塞事件方面没有发现明显差异：与 DOACs 相比，LAAO 可显著降低全因死亡率和心血管死亡率，以及死亡、出血或血栓栓塞事件的复合死亡率。
{"title":"Left atrial appendage occlusion devices vs direct oral anticoagulants for atrial fibrillation: An updated systematic review and meta-analysis","authors":"","doi":"10.1016/j.cpcardiol.2024.102880","DOIUrl":"10.1016/j.cpcardiol.2024.102880","url":null,"abstract":"<div><h3>Background</h3><div>Direct Oral Anticoagulants (DOACs) are the first line anticoagulation for patients with non-valvular atrial fibrillation (NVAF). Percutaneous Left Atrial Appendage Occlusion (LAAO) has emerged as a new therapy and its safety and effectiveness compared with DOACs are still controversial.</div></div><div><h3>Methods</h3><div>A systematic review of randomized controlled trials and observational studies was conducted, focusing on patients with NVAF. Outcomes analyzed included: (1) all-cause mortality; (2) cardiovascular (CV) mortality; (3) thromboembolic events; (4) stroke or transient ischemic attack (TIA); (5) bleeding events; and a (6) composite of death, hemorrhagic, and thromboembolic events. We performed a subgroup analysis of major bleeding according to different definitions: (1) Bleeding Academic Research Consortium (BARC); (2) International Society on Thrombosis and Haemostasis (ISTH); and (3) other definitions.</div></div><div><h3>Results</h3><div>Ten studies involving 18,507 patients were included, with 42.35 % undergoing LAAO. In pooled analysis, LAAO was associated with lower rates of all-cause mortality (HR 0.63; 95 % CI 0.50-0.80), cardiovascular mortality (HR 0.56; 95 % CI 0.45-0.70), and of the composite outcome (HR 0.73; 95 % CI 0.58-0.92). A trend towards lower stroke/TIA events was observed but not statistically significant. Overall bleeding events did not significantly differ between groups; using the ISTH definition, LAAO showed significantly lower incidence of bleeding events (HR 0.63; 95 % CI 0.43-0.91). No difference was found in thromboembolic events.</div></div><div><h3>Conclusion</h3><div>LAAO was associated with a significantly lower all-cause mortality and cardiovascular mortality, as well as the composite of death, hemorrhagic or thromboembolic events, as compared with DOACs.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480091","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}
Pub Date : 2024-10-10DOI: 10.1016/j.cpcardiol.2024.102881
Objective
This study aims to compare the relative effects of different mind-body exercises on cardiorespiratory function and quality of life in Heart failure (HF) patients, providing valuable insights for their rehabilitation.
Methods
We conducted a search across seven Chinese and English databases, including China National Knowledge Infrastructure (CNKI) and Web of Science. A network meta-analysis was performed using STATA 14.0 within a frequentist framework.
Results
A total of 38 studies were included, encompassing eight types of mind-body exercises. Ten studies reported peak VO2, indicating that dancing outperformed Tai Chi (MD:3.52, 95 % CI:6.74, -0.30) and Baduanjin (MD:2.34, 95 % CI:4.32, -0.36). Additionally, Pilates demonstrated greater effectiveness than Yijinjing, aside from Tai Chi (MD:5.10, 95 % CI:8.71, -1.49) and Baduanjin (MD:3.92, 95 % CI:6.50, -1.34). Twenty-one studies reported the six-minute walk test (6MTW), with only Tai Chi significantly improving 6MTW scores compared to the control group (MD: 50.77, 95 % CI: 8.12, 93.42). Twenty-three studies assessed left ventricular ejection fraction (LVEF), finding that Tai Chi (MD: 3.83, 95 % CI: 2.07, 5.59), Baduanjin (MD: 2.90, 95 % CI: 1.04, 4.76), and yoga (MD: 3.32, 95 % CI: 0.37, 6.27) significantly increased LVEF in HF patients. Nineteen studies evaluated quality of life, with the Liuzijue possibly being the most effective intervention (SUCRA: 98.9).
Conclusion
Different mind-body exercises have their own advantages in improving the heart function and quality of life of HF patients. In the future, higher-quality studies with larger samples are needed to further verify the validity of the results.
{"title":"The impact of various mind-body exercises on cardiorespiratory function and quality of life in heart failure patients: A network meta-analysis","authors":"","doi":"10.1016/j.cpcardiol.2024.102881","DOIUrl":"10.1016/j.cpcardiol.2024.102881","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to compare the relative effects of different mind-body exercises on cardiorespiratory function and quality of life in Heart failure (HF) patients, providing valuable insights for their rehabilitation.</div></div><div><h3>Methods</h3><div>We conducted a search across seven Chinese and English databases, including China National Knowledge Infrastructure (CNKI) and Web of Science. A network meta-analysis was performed using STATA 14.0 within a frequentist framework.</div></div><div><h3>Results</h3><div>A total of 38 studies were included, encompassing eight types of mind-body exercises. Ten studies reported peak VO<sub>2</sub>, indicating that dancing outperformed Tai Chi (MD:3.52, 95 % CI:6.74, -0.30) and Baduanjin (MD:2.34, 95 % CI:4.32, -0.36). Additionally, Pilates demonstrated greater effectiveness than Yijinjing, aside from Tai Chi (MD:5.10, 95 % CI:8.71, -1.49) and Baduanjin (MD:3.92, 95 % CI:6.50, -1.34). Twenty-one studies reported the six-minute walk test (6MTW), with only Tai Chi significantly improving 6MTW scores compared to the control group (MD: 50.77, 95 % CI: 8.12, 93.42). Twenty-three studies assessed left ventricular ejection fraction (LVEF), finding that Tai Chi (MD: 3.83, 95 % CI: 2.07, 5.59), Baduanjin (MD: 2.90, 95 % CI: 1.04, 4.76), and yoga (MD: 3.32, 95 % CI: 0.37, 6.27) significantly increased LVEF in HF patients. Nineteen studies evaluated quality of life, with the Liuzijue possibly being the most effective intervention (SUCRA: 98.9).</div></div><div><h3>Conclusion</h3><div>Different mind-body exercises have their own advantages in improving the heart function and quality of life of HF patients. In the future, higher-quality studies with larger samples are needed to further verify the validity of the results.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407192","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}
Pub Date : 2024-10-10DOI: 10.1016/j.cpcardiol.2024.102877
{"title":"Artificial intelligence electrocardiography for the evaluation of cardiac involvement in Fabry disease","authors":"","doi":"10.1016/j.cpcardiol.2024.102877","DOIUrl":"10.1016/j.cpcardiol.2024.102877","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407179","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}
Pub Date : 2024-10-10DOI: 10.1016/j.cpcardiol.2024.102879
Given the rapid development of large language models (LLMs), such as ChatGPT, in its ability to understand and generate human-like texts, these technologies inspired efforts to explore their capabilities in natural language processing tasks, especially those in healthcare contexts. The performance of these tools have been evaluated thoroughly across medicine in diverse tasks, including standardized medical examinations, medical-decision making, and many others. In this journal, Anaya et al. published a study comparing the readability metrics of medical education resources formulated by ChatGPT with those of major U.S. institutions (AHA, ACC, HFSA) about heart failure. In this work, we provide a critical review of this article and further describe approaches to help mitigate challenges in reproducibility of studies evaluating LLMs in cardiology. Additionally, we provide suggestions to optimize sampling of responses provided by LLMs for future studies. Overall, while the study by Anaya et al. provides a meaningful contribution to literature of LLMs in cardiology, further comprehensive studies are necessary to address current limitations and further strengthen our understanding of these novel tools.
{"title":"ChatGPT as a medical education resource in cardiology: Mitigating replicability challenges and optimizing model performance","authors":"","doi":"10.1016/j.cpcardiol.2024.102879","DOIUrl":"10.1016/j.cpcardiol.2024.102879","url":null,"abstract":"<div><div>Given the rapid development of large language models (LLMs), such as ChatGPT, in its ability to understand and generate human-like texts, these technologies inspired efforts to explore their capabilities in natural language processing tasks, especially those in healthcare contexts. The performance of these tools have been evaluated thoroughly across medicine in diverse tasks, including standardized medical examinations, medical-decision making, and many others. In this journal, Anaya et al. published a study comparing the readability metrics of medical education resources formulated by ChatGPT with those of major U.S. institutions (AHA, ACC, HFSA) about heart failure. In this work, we provide a critical review of this article and further describe approaches to help mitigate challenges in reproducibility of studies evaluating LLMs in cardiology. Additionally, we provide suggestions to optimize sampling of responses provided by LLMs for future studies. Overall, while the study by Anaya et al. provides a meaningful contribution to literature of LLMs in cardiology, further comprehensive studies are necessary to address current limitations and further strengthen our understanding of these novel tools.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.1016/j.cpcardiol.2024.102875
Hypertension is a prevalent condition that significantly contributes to cardiovascular morbidity and mortality worldwide. Aldosterone, a key hormone in the regulation of blood pressure, has been implicated in the pathophysiology of hypertension, leading to increased interest in aldosterone synthase inhibitors (ASIs) as a therapeutic option. This meta-analysis aims to systematically evaluate the efficacy and safety of ASIs in reducing blood pressure and associated adverse events in older adults with hypertension, providing a comprehensive overview of current evidence to inform clinical practice.
A comprehensive electronic search was conducted using PubMed, Google Scholar, Cochrane Central, and Clinicaltrials.gov were extensively searched till 31 December,2023. Out of 729 articles identified through our search strategy, 6 randomized controlled trials met the eligibility criteria and were included in the meta-analysis. The studies varied in sample size, duration, and specific ASIs evaluated, focusing on older adults with hypertension. Baseline characteristics and outcomes were extracted using an online Excel sheet, summarising parameters such as age, sex, race, BMI, and duration of hypertension. The Cochrane risk of bias tool was utilised to assess the quality of included trials across five domains: selection, reporting, performance, detection, and attrition bias. Statistical analyses were performed using RevMan version 5.4, applying random effects models for forest plots with a significance level set at p<0.05.
The meta-analysis found that aldosterone synthase inhibitors (ASIs) significantly reduced systolic blood pressure (SBP) with ASIs compared to placebo, with a mean difference of Mean Difference (MD) -5.44, 95% Confidence Interval (CI) -7.02 to -3.86; p-value <0.00001, I^2 = 26%], indicating effective blood pressure management in older adults with hypertension. Additionally, the analysis showed a significant reduction in plasma aldosterone levels favouring the intervention group (MD=-1.89, 95% CI, P=0.00001, I²=0%). However, there was no statistically significant difference in the incidence of serious adverse events between ASIs and placebo (RR=0.98, 95% CI, P=0.86, I²=0%), suggesting that ASIs are generally safe for use in this population.
ASIs are generally well-tolerated among the studied population. Overall, the findings support the efficacy of ASIs in managing hypertension without a significant increase in adverse events. However, future large scale trials are required to confirm our results and determine the long term benefits and risks of ASI in treatment of hypertension.
高血压是一种普遍存在的疾病，在很大程度上导致了全球心血管疾病的发病率和死亡率。醛固酮是调节血压的一种关键激素，与高血压的病理生理学有关联，因此人们越来越关注醛固酮合成酶抑制剂（ASI）作为一种治疗选择。本荟萃分析旨在系统评估醛固酮合成酶抑制剂在降低老年高血压患者血压及相关不良事件方面的疗效和安全性，为临床实践提供全面的现有证据。截至 2023 年 12 月 31 日，我们使用 PubMed、Google Scholar、Cochrane Central 和 Clinicaltrials.gov 进行了全面的电子检索。在通过搜索策略确定的 729 篇文章中，有 6 项随机对照试验符合资格标准并被纳入荟萃分析。这些研究的样本量、持续时间和评估的具体 ASI 各不相同，主要针对患有高血压的老年人。使用在线 Excel 表提取基线特征和结果，总结年龄、性别、种族、体重指数和高血压持续时间等参数。科克伦偏倚风险工具用于评估纳入试验在五个方面的质量：选择偏倚、报告偏倚、绩效偏倚、检测偏倚和自然减员偏倚。统计分析使用 RevMan 5.4 版进行，采用随机效应模型绘制森林图，显著性水平设定为 p
{"title":"Efficacy and safety of aldosterone synthase inhibitors in hypertension: A systematic review and meta- analysis","authors":"","doi":"10.1016/j.cpcardiol.2024.102875","DOIUrl":"10.1016/j.cpcardiol.2024.102875","url":null,"abstract":"<div><div>Hypertension is a prevalent condition that significantly contributes to cardiovascular morbidity and mortality worldwide. Aldosterone, a key hormone in the regulation of blood pressure, has been implicated in the pathophysiology of hypertension, leading to increased interest in aldosterone synthase inhibitors (ASIs) as a therapeutic option. This meta-analysis aims to systematically evaluate the efficacy and safety of ASIs in reducing blood pressure and associated adverse events in older adults with hypertension, providing a comprehensive overview of current evidence to inform clinical practice.</div><div>A comprehensive electronic search was conducted using PubMed, Google Scholar, Cochrane Central, and Clinicaltrials.gov were extensively searched till 31 December,2023. Out of 729 articles identified through our search strategy, 6 randomized controlled trials met the eligibility criteria and were included in the meta-analysis. The studies varied in sample size, duration, and specific ASIs evaluated, focusing on older adults with hypertension. Baseline characteristics and outcomes were extracted using an online Excel sheet, summarising parameters such as age, sex, race, BMI, and duration of hypertension. The Cochrane risk of bias tool was utilised to assess the quality of included trials across five domains: selection, reporting, performance, detection, and attrition bias. Statistical analyses were performed using RevMan version 5.4, applying random effects models for forest plots with a significance level set at p<0.05.</div><div>The meta-analysis found that aldosterone synthase inhibitors (ASIs) significantly reduced systolic blood pressure (SBP) with ASIs compared to placebo, with a mean difference of Mean Difference (MD) -5.44, 95% Confidence Interval (CI) -7.02 to -3.86; p-value <0.00001, I^2 = 26%], indicating effective blood pressure management in older adults with hypertension. Additionally, the analysis showed a significant reduction in plasma aldosterone levels favouring the intervention group (MD=-1.89, 95% CI, P=0.00001, I²=0%). However, there was no statistically significant difference in the incidence of serious adverse events between ASIs and placebo (RR=0.98, 95% CI, P=0.86, I²=0%), suggesting that ASIs are generally safe for use in this population.</div><div>ASIs are generally well-tolerated among the studied population. Overall, the findings support the efficacy of ASIs in managing hypertension without a significant increase in adverse events. However, future large scale trials are required to confirm our results and determine the long term benefits and risks of ASI in treatment of hypertension.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394964","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}
Introduction: Myocardial infarction (MI) is associated with a significant post-event inflammatory response which also contributes to post-MI prognosis. Colchicine, an anti-inflammatory agent, has exhibits potential benefits in various cardiovascular conditions such as coronary artery disease, pericarditis and atrial fibrillation. This meta-analysis predominantly aimed to provide an up-to-date evaluation of the efficacy and safety of colchicine in reducing adverse cardiovascular events in patients following acute MI.
Methods: A Systematic and comprehensive search was conducted on PubMed, Cochrane Library, Scopus, Google Scholar and clinicaltrials.gov for randomized controlled trials (RCTs) investigating the effect of colchicine on patients with MI until May 2024. Our primary outcome was a composite of adverse cardiovascular events, while secondary outcomes included all-cause mortality, incidence of stroke, cardiac arrest, hospitalization urgency, adverse gastrointestinal events and levels of high-sensitivity C - reactive protein (Hs-CRP). Risk ratios (RR) and standardized mean differences (SMD) were pooled under the random-effects model.
Results: Eleven trials with 7161 patients were included in our analysis out of which 3546 (49.51%) were allocated to colchicine and 3591 (50.14%) received placebo. Colchicine demonstrated statistically significant reduction in the composite of adverse cardiovascular events (RR=0.75, 95% CI: 0.60-0.94, P=0.01, I2= 48%), hospitalization urgency (RR=0.46, 95% CI: 0.31-0.68, P=0.0001, I2=0%) and levels of Hs-CRP (SMD= -0.43, 95% CI:-0.83-0.03, P=0.03, I2=85%) but statistically significant increment in adverse gastrointestinal events (RR=1.86, 95% CI: 1.14-3.02, P=0.01, I2=79%). However, all-cause mortality (RR =1.00, 95% CI: 0.72-1.39, P=0.98, I2=0%), cardiac arrest (RR=0.81, 95% CI: 0.33-1.95, P=0.63, I2=0), incidence of stroke (RR=0.45, 95% CI: 0.17-1.19, P=0.11, I2=36%) and recurrent MI (RR=0.78, 95% CI: 0.57-1.06, P=0.11, I2=11%) remained comparable across the two groups.
Conclusion: The use of colchicine post-MI reduces the composite of adverse cardiovascular events, levels of Hs-CRP, hospitalization urgency but increases adverse gastrointestinal events. However, colchicine does not impact all-cause mortality, cardiac arrest, stroke incidence and incidence of recurrent MI. Large scale multicenter RCTs especially with longer follow-up duration are warranted to validate these findings.
{"title":"The Effect of Colchicine on Myocardial Infarction: An Updated Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Ayesha Younas, Zainab Awan, Tehreem Khan, Samay Mehta, Aqsa Munir, Hafsa Arshad Azam Raja, Hrtivik Jain, Ahmed Raza, Ayesha Sehar, Raheel Ahmed, Abdulqadir J Nashwan","doi":"10.1016/j.cpcardiol.2024.102878","DOIUrl":"https://doi.org/10.1016/j.cpcardiol.2024.102878","url":null,"abstract":"<p><strong>Introduction: </strong>Myocardial infarction (MI) is associated with a significant post-event inflammatory response which also contributes to post-MI prognosis. Colchicine, an anti-inflammatory agent, has exhibits potential benefits in various cardiovascular conditions such as coronary artery disease, pericarditis and atrial fibrillation. This meta-analysis predominantly aimed to provide an up-to-date evaluation of the efficacy and safety of colchicine in reducing adverse cardiovascular events in patients following acute MI.</p><p><strong>Methods: </strong>A Systematic and comprehensive search was conducted on PubMed, Cochrane Library, Scopus, Google Scholar and clinicaltrials.gov for randomized controlled trials (RCTs) investigating the effect of colchicine on patients with MI until May 2024. Our primary outcome was a composite of adverse cardiovascular events, while secondary outcomes included all-cause mortality, incidence of stroke, cardiac arrest, hospitalization urgency, adverse gastrointestinal events and levels of high-sensitivity C - reactive protein (Hs-CRP). Risk ratios (RR) and standardized mean differences (SMD) were pooled under the random-effects model.</p><p><strong>Results: </strong>Eleven trials with 7161 patients were included in our analysis out of which 3546 (49.51%) were allocated to colchicine and 3591 (50.14%) received placebo. Colchicine demonstrated statistically significant reduction in the composite of adverse cardiovascular events (RR=0.75, 95% CI: 0.60-0.94, P=0.01, I<sup>2</sup>= 48%), hospitalization urgency (RR=0.46, 95% CI: 0.31-0.68, P=0.0001, I<sup>2</sup>=0%) and levels of Hs-CRP (SMD= -0.43, 95% CI:-0.83-0.03, P=0.03, I<sup>2</sup>=85%) but statistically significant increment in adverse gastrointestinal events (RR=1.86, 95% CI: 1.14-3.02, P=0.01, I<sup>2</sup>=79%). However, all-cause mortality (RR =1.00, 95% CI: 0.72-1.39, P=0.98, I<sup>2</sup>=0%), cardiac arrest (RR=0.81, 95% CI: 0.33-1.95, P=0.63, I<sup>2</sup>=0), incidence of stroke (RR=0.45, 95% CI: 0.17-1.19, P=0.11, I<sup>2</sup>=36%) and recurrent MI (RR=0.78, 95% CI: 0.57-1.06, P=0.11, I<sup>2</sup>=11%) remained comparable across the two groups.</p><p><strong>Conclusion: </strong>The use of colchicine post-MI reduces the composite of adverse cardiovascular events, levels of Hs-CRP, hospitalization urgency but increases adverse gastrointestinal events. However, colchicine does not impact all-cause mortality, cardiac arrest, stroke incidence and incidence of recurrent MI. Large scale multicenter RCTs especially with longer follow-up duration are warranted to validate these findings.</p>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407191","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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