Current Problems in Cardiology最新文献_第3页

Analysis of the relationship between different intensities of physical activity and pulse wave velocity in adults: an epidemiological study 成人不同运动强度与脉搏波速度关系的流行病学研究

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2026-01-13 DOI: 10.1016/j.cpcardiol.2026.103259

Maria Eduarda M. Vigilato , Eduardo R. de Victo , William R. Tebar , Stefany C.B. Silva , Isabella I. Sampaio , Lucas A. Benetello , Gerson Ferrari , Luiz Carlos M. Vanderlei , Diego G.D. Christofaro

Background

Arterial stiffness, reflected by pulse wave velocity (PWV), is an important cardiovascular risk marker. Physical activity (PA) may reduce arterial stiffness, but the most beneficial intensity remains unclear. The objective this study was to analyze the relationship between different intensities of PA and arterial stiffness in adults and to verify whether these relationships are independent of sex, age, and socioeconomic status.

Methods

A total of 185 participants (104 women) were included in this study. Arterial stiffness was assessed using PWV, measured by a non-invasive oscillometric device (Arteriograph AOP). Three consecutive measurements were performed (with one-minute intervals), and the device provided the final PWV value. PA intensity (light, moderate, and vigorous) was objectively measured using an ActiGraph GT3X accelerometer. The associations between PWV and PA intensities were examined using Pearson’s correlation and linear regression models, with the crude model and subsequently adding sex, age, and socioeconomic status, to estimate the magnitude of these associations.

Results

An inverse relationship was found between PWV and vigorous-intensity PA in the unadjusted model (β = –0.007; 95 % CI: –0.011, –0.002; p = 0.006). This association remained significant after adjustment for sex (β = –0.006; 95 % CI: –0.010, –0.001; p = 0.010), but lost significance after additional adjustment for age (β = –0.001; 95 % CI: –0.004, 0.001; p = 0.323). No associations were observed between PWV and light or moderate PA.

Conclusion

PWV was inversely associated with vigorous-intensity PA; however, but age appears to exert a strong influence on this relationship.

脉波速度（PWV）反映的血管刚度是重要的心血管危险指标。体育活动（PA）可能降低动脉僵硬，但最有益的强度尚不清楚。本研究的目的是分析成人不同强度PA与动脉僵硬度之间的关系，并验证这些关系是否与性别、年龄和社会经济地位无关。方法共纳入185例受试者，其中女性104例。采用无创动脉示波仪（Arteriograph AOP）测量PWV，评估动脉硬度。连续进行三次测量（间隔一分钟），该装置提供最终的PWV值。使用ActiGraph GT3X加速度计客观测量PA强度（轻度、中度和剧烈）。使用Pearson相关和线性回归模型检验PWV和PA强度之间的关联，使用粗糙模型，随后添加性别、年龄和社会经济地位，以估计这些关联的程度。结果在未调整的模型中，PWV与剧烈PA呈负相关（β = -0.007; 95% CI: -0.011, -0.002; p = 0.006）。在调整性别后，这种相关性仍然显著（β = -0.006; 95% CI: -0.010, -0.001; p = 0.010），但在额外调整年龄后，这种相关性失去了显著性（β = -0.001; 95% CI: -0.004, 0.001; p = 0.323）。PWV与轻度或中度PA之间没有关联。结论pwv与高强度PA呈负相关；然而，年龄似乎对这种关系有很大的影响。

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引用次数: 0

Urinary chlorine at hospital admission as a predictor of diuretic resistance and clinical evolution in acute heart failure 住院时尿氯作为急性心力衰竭患者利尿剂抵抗和临床演变的预测因子

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2026-01-12 DOI: 10.1016/j.cpcardiol.2026.103262

Cristhian E. Scatularo MD, MTSAC , Gardenia L Chango Acurio MD , Luciano Battioni MD, MTSAC , Analía Guazzone MD , Hugo O. Grancelli MD, MTSAC

Introduction

The natriuresis measurement is useful to diagnose diuretic resistance (DR) and adjust furosemide doses in acute heart failure (AHF) hospitalized patients, but the utility of urinary chloride is unknown.

Objectives

To correlate the urine chloride at admission (UCLA) in AHF patients with the development of DR and cardiovascular (CV) events at the 180-day outpatient follow-up.

Methodology

A prospective study included patients hospitalized for AHF, without shock, creatinine >2.5 mg/dL or mechanical respiratory support at admission. They received 40 mg of intravenous furosemide at admission, UCLA was measured, and diuretic treatment was based on a protocol. DR was defined as the requirement for furosemide ≥240 mg/day, sequential nephron diuretic blocked (SNB), hypertonic saline serum, or renal replacement therapy.

Results

116 patients were included, 51% were men, UCLA was 105 meq/L, and DR was developed in 17% of patients. The UCLA was associated with the development of DR (p 0.0001; AUC ROC curve 0.81; cut-off point 96 meq/L). UCLA <96 meq/L was associated with persistent congestion (p 0.01), furosemide ≥240 mg/day use (p 0.004), worsening of AHF (p 0.002) and renal function (p 0.02), use of SNB (p 0.001) and inotropic drugs (p 0.007), a longer hospital stay (p 0.02) and a higher CV death (p 0.05). At 180-day follow-up, UCLA <96 meq/L was associated with AHF readmissions (p 0.002).

Conclusion

In AHF hospitalized patients, low UCLA was associated with DR, persistent congestion, need for more aggressive decongestion strategies, worse in-hospital clinical outcomes and more AHF hospitalizations at 6 months.

导读：钠尿测量有助于诊断急性心力衰竭（AHF）住院患者的利尿抵抗（DR）和调整速尿剂量，但尿氯的效用尚不清楚。目的：在180天的门诊随访中，AHF患者入院时尿氯化物（UCLA）与DR和心血管（CV）事件的发展之间的关系。方法：前瞻性研究纳入住院AHF患者，入院时无休克、肌酐bb0 2.5 mg/dL或机械呼吸支持。他们在入院时接受40毫克静脉滴注速尿，测量UCLA，并根据协议进行利尿剂治疗。DR定义为需用速尿≥240 mg/天、序贯肾元利尿阻断（SNB）、高渗生理盐水血清或肾脏替代治疗。结果：纳入116例患者，51%为男性，UCLA为105 meq/L， 17%的患者发生DR。UCLA与DR的发生相关（p 0.0001； AUC ROC曲线0.81；截止点96 meq/L）。结论：在AHF住院患者中，低UCLA与DR、持续充血、需要更积极的去充血策略、更差的住院临床结果和6个月AHF住院率相关。

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引用次数: 0

Invasive versus conservative management in infective endocarditis after transcatheter aortic valve implantation: A systematic review and meta-analysis. 经导管主动脉瓣植入术后感染性心内膜炎的侵袭性与保守性治疗：一项系统回顾和荟萃分析。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2026-01-11 DOI: 10.1016/j.cpcardiol.2026.103264

Panagiotis Theofilis, Kyriakos Dimitriadis, Nikolaos Pyrpyris, Paschalis Karakasis, Eirini Dri, Eirini Beneki, Aikaterini Vordoni, Panagiotis Tsioufis, Maria Chatzi, Evangelos Oikonomou, Konstantinos Aznaouridis, Konstantinos Tsioufis

Background: Infective endocarditis after transcatheter aortic valve implantation (TAVI-IE) is an uncommon but severe complication associated with substantial morbidity and mortality. Therapeutic strategies vary widely, since invasive management is often precluded by prohibitive risk and conservative medical therapy may be linked to poorer outcomes. Therefore, we aimed to compare outcomes between conservative and invasive management in patients with TAVI-IE.

Methods: A systematic search of PubMed, Scopus, and Web of Science identified comparative studies evaluating conservative versus invasive treatment in TAVI-IE. The primary endpoints were all-cause in-hospital and 1-year mortality. Pooled risk ratios (RRs) with 95 % confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was quantified with I², publication bias was assessed with Egger's test, and sensitivity analyses (leave-one-out, GOSH plots) were performed.

Results: The search yielded 2,551 records; 15 studies met inclusion criteria for data extraction and meta-analysis. No significant differences were observed between conservative and invasive strategies for in-hospital mortality (RR 0.99, 95 % CI 0.80-1.24, p = 0.96; I² = 0 % with p = 0.67) or 1-year mortality (RR 1.03, 95 % CI 0.84-1.26; p = 0.81; I² = 11.4 % with p = 0.33). There was no evidence of publication bias (Egger's test: in-hospital, p = 0.07; 1-year, p = 0.54). Results were robust in sensitivity analyses.

Conclusions: In patients with TAVI-IE, conservative and invasive treatments were associated with comparable in-hospital and 1-year mortality. These findings support individualized, multidisciplinary decision-making rather than presuming a uniform advantage of either approach.

背景：经导管主动脉瓣植入术后感染性心内膜炎（TAVI-IE）是一种罕见但严重的并发症，具有很高的发病率和死亡率。治疗策略差异很大，因为侵入性治疗往往被禁止性风险所排除，保守的药物治疗可能与较差的结果有关。因此，我们的目的是比较TAVI-IE患者的保守治疗和侵入性治疗的结果。方法：对PubMed、Scopus和Web of Science进行系统检索，确定了评估TAVI-IE中保守治疗与侵入性治疗的比较研究。主要终点是院内全因死亡率和1年死亡率。采用随机效应模型计算合并风险比（rr）和95%置信区间（ci）。异质性用I²量化，发表偏倚用Egger检验评估，并进行敏感性分析（留一图，GOSH图）。结果：搜索得到2551条记录；15项研究符合数据提取和荟萃分析的纳入标准。在院内死亡率（RR 0.99, 95% CI 0.80-1.24, p=0.96; I²=0%,p=0.67）或1年死亡率（RR 1.03, 95% CI 0.84-1.26; p=0.81; I²=11.4%,p=0.33）方面，保守策略与有创策略无显著差异。没有发表偏倚的证据（Egger检验：住院，p=0.07； 1年，p=0.54）。结果在敏感性分析中是稳健的。结论：在TAVI-IE患者中，保守和侵入性治疗与相当的住院死亡率和1年死亡率相关。这些发现支持个性化的、多学科的决策，而不是假设任何一种方法都有统一的优势。

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引用次数: 0

Social vulnerability and mortality attributable to non-optimal temperature in the United States: A county-level ecological analysis 美国非最适温度导致的社会脆弱性和死亡率：一个县级生态分析。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2026-01-11 DOI: 10.1016/j.cpcardiol.2026.103260

Pedro Rafael Vieira de Oliveira Salerno MD , Ricardo J. Estrada-Mendizabal MD , Zhuo Chen PhD , Jean-Eudes Dazard PhD , Khurram Nasir MD , Weeberb Requia PhD , Robert D. Brook MD , Sanjay Rajagopalan MD , Sadeer Al-Kindi MD , Salil V Deo MD

Objectives

To quantify county-level mortality attributable to non-optimal temperature in the United States and examine whether social vulnerability modifies this relationship.

Study design

Ecological time-series analysis from 2000–2020.

Methods

We analyzed 1,514 counties representing 91.2% of the 2010 U.S. adult population (ages 25–84), including 33,395,241 deaths (after imputation: 33,421,054) which were linked to monthly mean temperature. A two-stage modeling framework was used. First, quasi-Poisson models with natural cubic splines estimated county-specific non-linear temperature–mortality associations, with population offsets and spline-based control for seasonality. Second, coefficients and variances were pooled using random-effects multivariate meta-analysis to identify the minimum mortality temperature (MMT) and percentile (MMP). Effect modification was assessed by incorporating Social Vulnerability Index (SVI) quartiles into a multivariate meta-regression. Attributable deaths were estimated using 5,000 Monte Carlo draws and classified as heat-related (above MMT) or cold-related (below MMT); crude rates were expressed per 100,000 person-years.

Results

The pooled MMT was 22.7 °C (95% CI: 22.2–23.2), corresponding to the 78.4th percentile (95% CI: 76.1–80.8). Nationally, an estimated 72,361 (95% CI: 68,837–76,153) cold-attributable and 6,129 (95% CI: 5,309–7,227) heat-attributable deaths occurred annually, equivalent to 40.1 and 3.4 per 100,000 person-years. More socially vulnerable counties had higher MMTs [SVI Q4: 23.9 °C vs Q1: 21.0 °C] and higher heat- (2.0 vs 0.7) and cold-related mortality rates (40.9 vs 28.0).

Conclusions

Cold accounted for most temperature-related deaths in the U.S., and social vulnerability intensified both cold- and heat-related mortality. These findings support geographically targeted, vulnerability-responsive public health strategies.

目的：量化美国非最佳温度导致的县一级死亡率，并检查社会脆弱性是否改变了这种关系。研究设计：2000-2020年生态时间序列分析。方法：我们分析了1514个县，占2010年美国成年人口（25-84岁）的91.2%，包括33,395,241例与月平均温度相关的死亡（经估算后：33,421,054例）。采用两阶段建模框架。首先，采用自然三次样条拟泊松模型，利用种群偏移量和基于样条的季节性控制，估计了特定国家的非线性温度-死亡率关联。其次，采用随机效应多变量荟萃分析合并系数和方差，确定最低死亡温度（MMT）和百分位数（MMP）。通过将社会脆弱性指数（SVI）四分位数纳入多元元回归来评估效果修改。使用5000张蒙特卡罗图估计归因死亡，并将其分类为热相关（高于MMT）或冷相关（低于MMT）；粗率表示为每10万人年。结果：合并MMT为22.7°C (95% CI: 22.2-23.2)，对应于78.4百分位（95% CI: 76.1-80.8）。在全国范围内，每年估计有72,361例（95% CI: 68,837-76,153）例因冷导致的死亡和6129例（95% CI: 5,309-7,227）例因热导致的死亡，相当于每10万人年40.1例和3.4例。社会脆弱的县有更高的mmt [SVI Q4: 23.9°C vs Q1: 21.0°C]和更高的热（2.0 vs 0.7）和冷相关死亡率（40.9 vs 28.0）。结论：在美国，寒冷导致了大多数与温度相关的死亡，而社会脆弱性加剧了与寒冷和炎热相关的死亡率。这些研究结果支持有地理针对性、针对脆弱性的公共卫生战略。

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引用次数: 0

Coronary artery calcium clinical utilization: An update 冠状动脉钙的临床应用：最新进展

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2026-01-10 DOI: 10.1016/j.cpcardiol.2026.103258

Ibrahim Mortada MD, MS , Esosa Odigie-Okon MD, MSc , Afaq Motiwala MD , Joseph Allencherril MD , Abdul Qadeer MBBS , Diann Gaalema PhD , Amer Abdulla MD , Thomas Blackwell MD , Hani Jneid MD

Coronary artery disease (CAD) remains a leading cause of mortality and morbidity worldwide. Coronary artery calcification (CAC) is a well-established marker of atherosclerotic burden, and its quantification provides an objective measure of subclinical coronary atherosclerosis that can refine cardiovascular risk stratification and guide decisions regarding risk factor modification and lipid-lowering therapies. There is extensive data supporting the role of CAC scoring as an adjunct risk refinement tool, and it has been incorporated into multiple primary prevention guidelines. In addition to the Agatston method, CAC can also be quantified using non-gated computed tomography (CT) scans which are simple and widely available from non-cardiac screening strategies, including those obtained routinely for lung cancer screening. The integration of artificial intelligence and automated CAC assessment in non-gated studies is further expanding its application for risk stratification to a much larger population. This review summarizes the current tools, evidence and guidelines supporting the use of CAC to help risk stratify, optimize lipid lowering therapy, and potentially improve patient outcomes.

冠状动脉疾病（CAD）仍然是世界范围内死亡率和发病率的主要原因。冠状动脉钙化（CAC）是一种公认的动脉粥样硬化负担标志物，其量化提供了亚临床冠状动脉粥样硬化的客观测量，可以细化心血管危险分层，指导有关危险因素调整和降脂治疗的决策。有大量数据支持CAC评分作为辅助风险细化工具的作用，它已被纳入多个一级预防指南。除了Agatston方法，还可以使用非门控计算机断层扫描（CT）对CAC进行量化，这种方法简单且广泛应用于非心脏筛查策略，包括肺癌筛查常规方法。人工智能和自动化CAC评估在非门控研究中的整合进一步扩大了其在风险分层中的应用范围。这篇综述总结了目前支持使用CAC的工具、证据和指南，以帮助风险分层、优化降脂治疗，并可能改善患者的预后。

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引用次数: 0

Balancing hope and heart: An umbrella review of cardiotoxicity in immune checkpoint inhibitor cancer therapies 平衡希望和心脏：免疫检查点抑制剂癌症治疗中心脏毒性的综述。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-12-22 DOI: 10.1016/j.cpcardiol.2025.103257

Yashendra Sethi , Saurabh Singhal , Apoorv Pratap Singh , Akshat Banga , Pratik Agarwal , Oroshay Kaiwan , Inderbir Padda , Aakash Paruthi , Sneha Annie Sebastian , Arsalan Moinuddin , Gurpreet Johal , Nigel H. Greig

Background

Immune checkpoint inhibitors (ICIs) have significantly advanced cancer treatment, especially in improving survival rates for patients with various malignancies such as melanoma, non-small cell lung cancer (NSCLC), and renal cell carcinoma. Despite their therapeutic promise, ICIs carry the risk of immune-related adverse events, with cardiotoxicity emerging as a notable concern. This umbrella review aims to critically evaluate the diverse data from published systematic reviews and meta-analyses, to provide a cohesive overview of ICI-associated cardiotoxicity across different cancer types and treatment regimens.

Methods

This umbrella review analytically evaluates data from systematic reviews and meta-analyses on cardiotoxicity in cancer patients receiving ICI therapy. We conducted a comprehensive search across PubMed, Scopus, and Google Scholar, from inception till Jan 2025. The JBI checklist was employed to assess the quality of included studies.

Results

Our analysis reveals varying cardiotoxicity risks associated with ICIs. The incidence of cardiac immune-related adverse events ranges from 0.8 % to 1.3 %, with myocarditis being the most common (0.5-0.72 % of patients). Combination therapies significantly increase risks: dual ICIs elevate myocarditis risk 3.07-fold compared to monotherapies, whereas PD-1/PD-L1 inhibitors with chemotherapy increase all-grade and severe cardiotoxicity by 53 % and 63%, respectively. NSCLC patients face a 97 % higher risk of all-grade cardiotoxicity with combination treatments. ICI-induced myocarditis carries a high mortality rate of 37.7 %. Notably, some studies report no significant increase in cardiac events, highlighting the need for further investigation to reconcile these disparate findings.

Conclusions

The variability in cardiotoxicity reports highlights the complex risk landscape associated with ICI therapy. Although ICIs continue to enhance cancer care, they require careful cardiovascular monitoring and comprehensive risk management, particularly for combination therapies and patients with existing heart conditions.

背景：免疫检查点抑制剂（ICIs）具有显著的癌症治疗进展，特别是在提高各种恶性肿瘤（如黑色素瘤、非小细胞肺癌（NSCLC）和肾细胞癌）患者的生存率方面。尽管具有治疗前景，但ICIs存在免疫相关不良事件的风险，心脏毒性正在成为一个值得关注的问题。本综述旨在批判性地评估来自已发表的系统综述和荟萃分析的各种数据，以提供不同癌症类型和治疗方案中ici相关心脏毒性的综合概述。方法：本综述对接受ICI治疗的癌症患者心脏毒性的系统评价和荟萃分析数据进行了分析性评价。我们在PubMed， Scopus和b谷歌Scholar上进行了全面的搜索，从创建到2025年1月。采用JBI检查表评估纳入研究的质量。结果：我们的分析揭示了不同的心脏毒性风险与ICIs相关。心脏免疫相关不良事件的发生率从0.8%到1.3%不等，其中最常见的是心肌炎（0.5-0.72%）。联合治疗显著增加风险：与单一治疗相比，双重ICIs使心肌炎风险增加3.07倍，而PD-1/PD-L1抑制剂联合化疗使全级和严重心脏毒性分别增加53%和63%。联合治疗的非小细胞肺癌患者出现全级别心脏毒性的风险高出97%。ici引起的心肌炎死亡率高达37.7%。值得注意的是，一些研究报告心脏事件没有显著增加，强调需要进一步的调查来调和这些不同的发现。结论：心脏毒性报告的可变性突出了与ICI治疗相关的复杂风险景观。尽管ici继续加强癌症治疗，但它们需要仔细的心血管监测和全面的风险管理，特别是对于联合治疗和已有心脏病的患者。

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引用次数: 0

Epitranscriptomic regulation in cardiovascula disease: mechanistic roles and clinical implications of m6A RNA methylation in cardiac pathophysiology 心血管疾病的表转录组调控：m6A RNA甲基化在心脏病理生理中的机制作用和临床意义

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-12-19 DOI: 10.1016/j.cpcardiol.2025.103253

Shahid Ullah Khan , Mustafa H. Halawi , Mazen Almehmadi , Essam H. Ibrahim , Ramadan Taha , Ahmed Ezzat Ahmed , Esmael M. Alyami , Nuruliarizki Shinta Pandupuspitasari , Endang Widiastuti , Munir Ullah Khan , Jonathan P. Harrington , Tahir Ullah khan

N6-methyladenosine (m6A) RNA methylation has emerged as a pivotal epitranscriptomic regulator influencing cardiovascular development, homeostasis, and disease progression. As the most abundant internal modification in eukaryotic mRNA, m6A dynamically modulates RNA stability, translation, splicing, and degradation through the coordinated actions of “writers,” “readers,” and “erasers.” Recent advances demonstrate that dysregulated m6A modifications contribute to major cardiovascular disorders, including cardiac hypertrophy, heart failure, arrhythmias, atherosclerosis, ischemia reperfusion injury, and cardiomyopathy. METTL3-mediated hypermethylation promotes pathological hypertrophy, autophagy imbalance, and ischemic injury. In contrast, demethylases such as FTO and ALKBH5 exert cardioprotective effects by preserving contractile function, enhancing angiogenesis, and regulating key transcripts involved in Ca²⁺ cycling, autophagy, and metabolism. m6A-dependent control of noncoding RNAs further amplifies its impact on inflammatory signaling, endothelial dysfunction, and vascular remodeling. The involvement of m6A in glucose metabolism, hypoxia responses, and vascular smooth muscle phenotypic transitions highlights its broad relevance across cardiovascular risk factors. As detection technologies advance, m6A profiling shows promise as a diagnostic biomarker and therapeutic target. Understanding epitranscriptomic regulation may unlock innovative treatment strategies and reshape the future of cardiovascular medicine.

n6 -甲基腺苷（m6A） RNA甲基化已成为影响心血管发育、体内平衡和疾病进展的关键外转录组调控因子。作为真核生物mRNA中最丰富的内部修饰，m6A通过“写者”、“读者”和“擦除者”的协同作用，动态调节RNA的稳定性、翻译、剪接和降解。最近的研究表明，失调的m6A修饰可导致主要的心血管疾病，包括心脏肥厚、心力衰竭、心律失常、动脉粥样硬化、缺血再灌注损伤和心肌病。mettl3介导的高甲基化促进病理性肥大、自噬失衡和缺血性损伤。相比之下，去甲基化酶如FTO和ALKBH5通过保持收缩功能、增强血管生成和调节参与Ca 2 +循环、自噬和代谢的关键转录物来发挥心脏保护作用。m6a依赖性非编码rna的控制进一步放大了其对炎症信号、内皮功能障碍和血管重构的影响。m6A参与葡萄糖代谢、缺氧反应和血管平滑肌表型转变，突出了其在心血管危险因素中的广泛相关性。随着检测技术的进步，m6A谱分析有望成为诊断性生物标志物和治疗靶点。了解表观转录组学调控可能会开启创新的治疗策略，重塑心血管医学的未来。

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引用次数: 0

Challenges in the diagnosis and management of hypertrophic cardiomyopathy and the promise of artificial intelligence 肥厚性心肌病诊断和治疗的挑战以及人工智能的前景。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-12-18 DOI: 10.1016/j.cpcardiol.2025.103249

Isna H. Khaliq MD , Aum Solanki MD , Menhel Kinno MD, MPH , Annabelle Santos Volgman MD , Ahmet Afsin Oktay MD

Hypertrophic cardiomyopathy (HCM), the most prevalent inherited cardiomyopathy, is characterized by left ventricular hypertrophy that typically manifests with asymmetric wall thickening and is not caused by a pressure overload state or systemic disease. Despite its considerable prevalence—estimated to affect up to 1 in 200 individuals based on imaging data—it often goes undiagnosed or misdiagnosed, particularly in general clinical settings. Traditional tools, such as the electrocardiogram, although widely used, frequently yield nonspecific findings that complicate the early identification or screening of HCM. In recent years, artificial intelligence (AI) and machine learning have emerged as powerful tools with the potential to revolutionize HCM diagnosis and management. AI-driven algorithms trained on ECG and imaging data are being developed to improve early detection, risk stratification, and therapeutic monitoring in patients with or at risk for HCM. Additionally, AI has shown utility in biomarker-based prediction models, further enhancing diagnostic precision and clinical decision-making. Harnessing the power of AI may help close critical diagnostic gaps and optimize outcomes for individuals affected by HCM.

肥厚性心肌病（HCM）是最常见的遗传性心肌病，其特征是左心室肥厚，通常表现为不对称的心壁增厚，不是由压力过载状态或全身性疾病引起的。尽管它相当普遍——根据影像学数据估计，每200人中就有1人受到影响——但它经常未被诊断或误诊，特别是在一般临床环境中。传统的工具，如心电图，虽然广泛使用，但经常产生非特异性的结果，使HCM的早期识别或筛查复杂化。近年来，人工智能（AI）和机器学习已经成为强大的工具，有可能彻底改变HCM的诊断和管理。正在开发经心电图和成像数据训练的人工智能驱动算法，以改善HCM患者或有HCM风险患者的早期发现、风险分层和治疗监测。此外，人工智能在基于生物标志物的预测模型中显示出实用性，进一步提高了诊断精度和临床决策。利用人工智能的力量可能有助于缩小关键的诊断差距，并优化HCM患者的治疗结果。

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引用次数: 0

The scope of cardiology research: More than 300 topics covered through bibliometric evaluation 心脏病学研究范围：通过文献计量学评估涵盖的300多个主题。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-12-18 DOI: 10.1016/j.cpcardiol.2025.103256

Saeed Alshahrani , Siddig Ibrahim Abdelwahab , Manal Mohamed Elhassan Taha , Abdullah Farasani , Jobran M Moshi , Ahmad Assiri , Khaled A Sahli , Hussam M. Shubaily , Marwa Qadri , Amani Khardali , Waseem Hassan

This study provides a bibliometric overview of cardiovascular-related bibliometric research identified in the Scopus database using a title–abstract–keyword (TAK) search strategy. A total of 2,069 records were identified, with original articles (n = 1,130) and review papers (n = 596) representing the predominant document types. Restricting the analysis to these two categories yielded 1,726 documents, underscoring their central role in bibliometric reporting. A clear temporal growth was observed, increasing from a single publication in 1991 to 71 in 2025, with notable expansion after 2020. Authorship and institutional analyses revealed a strong concentration of contributions from China. Hu Y. was the most prolific author (13 publications), followed by Shou X. (7), while several others contributed five publications each. The China Academy of Chinese Medical Sciences (44 publications) and Beijing University of Chinese Medicine (41) were the leading institutions. China dominated global output with 229 publications, far exceeding the United States (25) and other contributing countries. Funding was primarily provided by the National Natural Science Foundation of China (84 publications). Frontiers in Cardiovascular Medicine was the leading journal (44 publications), followed by Medicine (United States) (28) and Heliyon (18). Thematically, over 300 cardiological subtopics were identified, spanning clinical areas such as heart failure, atrial fibrillation, and obesity-related cardiovascular disease, as well as emerging domains including artificial intelligence, autophagy, ferroptosis, non-coding RNAs, and digital health. Studies also addressed societal and environmental determinants such as gender disparities, air pollution, and psychosocial stress. Collectively, these findings demonstrate the accelerating adoption of bibliometric approaches in cardiovascular science and the field’s transition toward interdisciplinary, technology-integrated, and data-driven research directions.

本研究使用标题-摘要-关键词（TAK）搜索策略对Scopus数据库中心血管相关文献计量学研究进行了文献计量学综述。共确定了2,069条记录，其中主要的文件类型为原创文章（n = 1,130）和综述论文（n = 596）。将分析限制在这两个类别产生了1 726份文件，强调了它们在文献计量报告中的中心作用。观察到明显的时间增长，从1991年的一份出版物增加到2025年的71份，在2020年之后有显著的扩展。作者身份和机构分析显示，中国的贡献高度集中。胡颖是最多产的作者（13篇），其次是寿旭（7篇），其他几个人每人发表了5篇文章。中国中医科学院（44篇）和北京中医药大学（41篇）是领先的机构。中国以229篇论文占据全球主导地位，远远超过美国（25篇）和其他贡献国。主要由国家自然科学基金资助（84篇）。《心血管医学前沿》（Frontiers in Cardiovascular Medicine）是排名第一的杂志（44篇），其次是《医学》（美国）（28篇）和《Heliyon》（18篇）。在主题上，确定了300多个心脏病亚主题，涵盖心力衰竭、心房颤动和肥胖相关心血管疾病等临床领域，以及人工智能、自噬、铁死亡、非编码rna和数字健康等新兴领域。研究还涉及社会和环境决定因素，如性别差异、空气污染和社会心理压力。总的来说，这些发现表明了文献计量学方法在心血管科学中的加速应用，以及该领域向跨学科、技术集成和数据驱动的研究方向的转变。

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引用次数: 0

NRF2-mediated anti-ferroptotic pathways in diabetic cardiomyopathy: Mechanistic insights, therapeutic advances, and challenges in cardiovascular protection 糖尿病性心肌病中nrf2介导的抗紧铁途径：机制见解、治疗进展和心血管保护的挑战。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-12-18 DOI: 10.1016/j.cpcardiol.2025.103251

Shahid Ullah Khan Phd , Mustafa H. Halawi , Mazen Almehmadi , Essam H. Ibrahim , Ramadan Taha , Khalid M. Alsyaad , Ahmed Ezzat Ahmed , Amin A. Al-Doaiss , William Thornbury

Diabetic cardiomyopathy (DCM) remains a major contributor to cardiovascular morbidity and mortality, yet its underlying mechanisms extend beyond hyperglycemia-induced metabolic stress. Emerging evidence identifies ferroptosis, a regulated, iron-dependent lipid peroxidation process, as a central driver of diabetic myocardial injury. This review synthesizes molecular insights demonstrating how chronic hyperglycemia, oxidative stress, and mitochondrial dysfunction create a uniquely ferroptosis-prone cardiac environment. Particular emphasis is placed on the NRF2 signaling network, which orchestrates antioxidant defense through the HO-1 pathway and the SLC7A11-GSH-GPX4 axis. Diabetic impairment of AMPK/AKT-dependent NRF2 activation compromises these protective systems, accelerating lipid peroxidation, mitochondrial damage, inflammation, and cardiomyocyte death. We further evaluate emerging pharmacologic and natural NRF2 activators, including sulforaphane, curcumin, dexmedetomidine, canagliflozin, and 6-gingerol, demonstrating consistent cardioprotective, anti-ferroptotic benefits in preclinical models. Despite encouraging progress, concerns regarding long-term NRF2 overstimulation, metabolic reprogramming, and oncogenic risk underscore the need for carefully optimized therapeutic strategies. By integrating mechanistic advances with translational challenges, this review highlights NRF2-ferroptosis modulation as a promising frontier for targeted DCM therapy and future precision cardiology.

糖尿病性心肌病（DCM）仍然是心血管疾病发病率和死亡率的主要原因，但其潜在机制超出了高血糖诱导的代谢应激。新出现的证据表明，铁下垂是一种受调节的铁依赖性脂质过氧化过程，是糖尿病心肌损伤的主要驱动因素。这篇综述综合了慢性高血糖、氧化应激和线粒体功能障碍如何创造一个独特的易发生铁中毒的心脏环境的分子见解。特别强调的是NRF2信号网络，它通过HO-1途径和SLC7A11-GSH-GPX4轴协调抗氧化防御。糖尿病AMPK/ akt依赖性NRF2激活损害这些保护系统，加速脂质过氧化、线粒体损伤、炎症和心肌细胞死亡。我们进一步评估了新出现的药理学和天然NRF2激活剂，包括萝卜硫素、姜黄素、右美托咪定、卡格列净和6-姜酚，在临床前模型中显示出一致的心脏保护和抗铁沉益处。尽管取得了令人鼓舞的进展，但对NRF2长期过度刺激、代谢重编程和致癌风险的担忧强调了仔细优化治疗策略的必要性。通过整合机制进展和翻译挑战，本综述强调nrf2 -铁下垂调节是靶向DCM治疗和未来精确心脏病学的一个有前途的前沿。

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引用次数: 0