Current Problems in Cardiology最新文献

英文中文

Artificial Intelligence in detection of acute coronary occlusion in NSTEMI patients 人工智能在NSTEMI患者急性冠状动脉闭塞诊断中的应用。

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.2025.103254

Sara Tomovic , Robert Herman , Srdjan Dedic , Nikola Boskovic , Stefan Juricic , Srdjan Aleksandric , Marina Ostojic , Ivana Nedeljkovic , Vojislav Giga , Marko Banovic

The prognosis of patients with MI has improved significantly with the recognition that early reperfusion is critical, particularly since timely percutaneous coronary intervention (PCI) became widely adopted. The invasive reperfusion era also reshaped MI diagnostics, shifting the paradigm from Q-wave vs. Non-Q-wave MI to ST-Elevation Myocardial Infarction (STEMI) vs. Non-ST-Elevation Myocardial Infarction (NSTEMI).

The current ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) paradigm have long been the cornerstone of myocardial infarction (MI) care but fail to identify many patients with acute coronary occlusion (ACO), delaying treatment and worsening outcomes. This limitation is increasingly important, since NSTEMI now represents the majority of presentations accounting for roughly 70% of AMI worldwide and many of these occlusive events are managed with delays contributing to worse outcomes. Adding to this challenge, substantial inter-physician variability in ECG interpretation for ACO has been demonstrated.

In this review, we highlight recent advances using the artificial intelligence in the evaluation of patients presenting with ECG changes suggestive of NSTEMI and evaluate its role in the detection of NSTEMI patients with acute coronary occlusion.

由于认识到早期再灌注至关重要，特别是及时经皮冠状动脉介入治疗（PCI）被广泛采用，心肌梗死患者的预后已显著改善。有创再灌注时代也重塑了心肌梗死的诊断模式，从q波心肌梗死与非q波心肌梗死转变为st段抬高型心肌梗死（STEMI）与非st段抬高型心肌梗死（NSTEMI）。目前的st段抬高型心肌梗死（STEMI）和非st段抬高型心肌梗死（NSTEMI）模式长期以来一直是心肌梗死（MI）护理的基石，但未能识别许多急性冠状动脉闭塞（ACO）患者，导致治疗延迟和预后恶化。这一限制越来越重要，因为NSTEMI现在占AMI的大多数，约占全球AMI的70%，并且许多这些闭塞事件的处理延迟导致结果更差。增加这一挑战的是，已经证明了ACO的ECG解释在医生之间存在很大的差异。在这篇综述中，我们重点介绍了人工智能在评估具有非stemi心电图变化的患者中的最新进展，并评估了其在检测急性冠状动脉闭塞的非stemi患者中的作用。

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Innate lymphoid cells and trained innate immunity in cardiovascular disease: Mechanistic insights, immunopathology, and emerging translational opportunities 先天淋巴样细胞和先天免疫在心血管疾病中的作用：机制、免疫病理学和新兴的转化机会。

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.2025.103252

Mustafa H. Halawi , Mazen Almehmadi , Essam H. Ibrahim , Ramadan Taha , Ahmed Ezzat Ahmed , Esmael M. Alyami , Theodore Whitmore , Muhammad Sohail , Fazal Rehman , Shahid Ullah Khan

Cardiovascular diseases (CVDs) remain the leading global cause of morbidity and mortality, with growing evidence highlighting the immune system as a central regulator of disease initiation and progression. Recent advances have uncovered pivotal roles for innate lymphoid cells (ILCs) and trained innate immunity (TI) in shaping cardiovascular homeostasis and inflammation. This review synthesizes current knowledge on the development, tissue residency, and functional specialization of ILC subsets, including ILC1/NK cells, ILC2, and ILC3, as well as their divergent contributions to atherosclerosis, myocardial infarction, heart failure, myocarditis, and pericarditis. ILC1 and NK cells promote vascular inflammation and plaque progression, whereas cardiac-resident ILC2s exert reparative, anti-inflammatory, and atheroprotective effects. Parallel evidence shows that TI, driven by metabolic stressors such as hyperglycemia, oxidized LDL, smoking, and a Western diet, induces persistent myeloid reprogramming that amplifies vascular inflammation and accelerates CVD. We further highlight their potential as diagnostic biomarkers and therapeutic targets, including cytokine-directed interventions, modulation of the IL-33/ILC2 axis, and epigenetic therapies. Together, these insights position ILC biology and TI as transformative frameworks for advancing precision immunocardiology.

心血管疾病（cvd）仍然是全球发病率和死亡率的主要原因，越来越多的证据强调免疫系统是疾病发生和进展的主要调节因子。最近的研究进展揭示了先天淋巴样细胞（ILCs）和后天免疫（TI）在形成心血管稳态和炎症中的关键作用。这篇综述综合了目前关于ILC亚群的发育、组织居住和功能特化的知识，包括ILC1/NK细胞、ILC2和ILC3，以及它们在动脉粥样硬化、心肌梗死、心力衰竭、心肌炎和心包炎中的不同作用。ILC1和NK细胞促进血管炎症和斑块进展，而心脏驻留的ILC2s发挥修复、抗炎和动脉粥样硬化保护作用。平行的证据表明，由代谢应激源（如高血糖、氧化低密度脂蛋白、吸烟和西方饮食）驱动的TI诱导了持续的髓细胞重编程，从而放大了血管炎症并加速了心血管疾病。我们进一步强调了它们作为诊断生物标志物和治疗靶点的潜力，包括细胞因子定向干预、IL-33/ILC2轴的调节和表观遗传治疗。总之，这些见解使ILC生物学和TI成为推进精确免疫心脏病学的变革性框架。

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Burden of cardiovascular diseases attributable to diet high in sodium in China and the global from 1990 to 2021 1990 - 2021年中国及全球高钠饮食导致的心血管疾病负担

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.2025.103248

Wuyang Wei , Meiyuan Chen , Jiyong Wei , Xiaoyu Zheng

Background

Diet high in sodium is an established major risk factor for cardiovascular diseases (CVDs), yet a comprehensive and updated assessment of its attributable disease burden, particularly comparing China with global patterns over the last three decades, is lacking.

Methods

This study aims to quantify and compare the deaths and disability-adjusted life years (DALYs) of CVDs attributable to diet high in sodium in China and globally from 1990 to 2021. Using data from the Global Burden of Disease (GBD) Study 2021, we applied the comparative risk assessment framework to estimate the sodium-attributable CVD burden. Mortality and DALYs were analyzed as absolute numbers and age-standardized rates (ASRs). Temporal trends were assessed using estimated annual percentage changes (EAPCs), and future burden to 2046 was projected using an age-period-cohort (APC) model.

Results

In 2021, diet high in sodium was responsible for 1.71 million [95 % uncertainty intervals (UI): 0.36-3.81 million] global deaths and 37.77 million (95 % UI: 9.05-80.81 million) DALYs. The global age-standardized death rate (ASDR) and DALY rate (ASDAR) were 20.4 and 437.7 per 100,000, respectively. From 1990 to 2021, while absolute death counts increased by 52 %, the ASDR significantly declined (EAPC: -1.46 %). Pronounced sex and age disparities were observed, with males bearing a consistently higher burden and the elderly experiencing the highest rates but slowest improvements. In China, the 2021 ASDR (40.91/100,000) and ASDAR (837.94/100,000) were approximately double the global averages, despite substantial declines since 1990 (ASDR EAPC: -1.74 %; ASDAR EAPC: -1.85 %). Projections to 2046 indicate rising absolute numbers globally and in China, driven by demographic changes, despite continuing declines in age-standardized rates.

Conclusion

High sodium intake remains a major contributor to the global and Chinese CVD burden, with significant sex and age disparities. Although age-standardized rates have improved, the rising absolute burden underscores the imperative for more effective, targeted salt-reduction public health strategies.

背景：高钠饮食是心血管疾病（cvd）的主要危险因素，但缺乏对其归因疾病负担的全面和最新评估，特别是将中国与过去三十年的全球模式进行比较。方法：本研究旨在量化和比较1990年至2021年中国和全球高钠饮食导致的心血管疾病死亡和残疾调整生命年（DALYs）。使用来自2021年全球疾病负担（GBD）研究的数据，我们应用比较风险评估框架来估计钠导致的心血管疾病负担。死亡率和DALYs以绝对数字和年龄标准化率（ASRs）进行分析。使用估计年百分比变化（EAPCs）评估时间趋势，并使用年龄-时期-队列（APC）模型预测到2046年的未来负担。结果：2021年，高钠饮食导致全球171万例[95%不确定区间（UI）： 0.36- 381万]死亡和3777万例（95% UI: 905 - 8081万）伤残调整生命年。全球年龄标准化死亡率（ASDR）和DALY率（ASDAR）分别为20.4和437.7 / 10万。从1990年到2021年，虽然绝对死亡人数增加了52%，但平均死亡率显著下降（EAPC: -1.46%）。观察到明显的性别和年龄差异，男性承受的负担一直较高，老年人的发病率最高，但改善速度最慢。在中国，尽管自1990年以来大幅下降（ASDR EAPC: -1.74%; ASDAR EAPC: -1.85%），但2021年ASDR（40.91/100,000）和ASDAR（837.94/100,000）约为全球平均水平的两倍。到2046年的预测表明，尽管年龄标准化率持续下降，但受人口结构变化的推动，全球和中国的绝对数字仍将上升。结论：高钠摄入仍然是全球和中国心血管疾病负担的主要因素，存在显著的性别和年龄差异。虽然年龄标准化率有所改善，但不断上升的绝对负担凸显了制定更有效、更有针对性的减盐公共卫生战略的必要性。

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Information for Readers 读者资讯

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-12-06 DOI: 10.1016/S0146-2806(25)00262-2

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Editor’s Message 编辑器’的消息

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-12-06 DOI: 10.1016/S0146-2806(25)00260-9

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Title Page 标题页

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-12-06 DOI: 10.1016/S0146-2806(25)00259-2

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Editor’s Message 编辑器’的消息

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-11-28 DOI: 10.1016/S0146-2806(25)00248-8

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Title Page 标题页

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-11-28 DOI: 10.1016/S0146-2806(25)00242-7

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Progress on application of exosomes on cardiovascular disease: A ten-year retrospective analysis 外泌体在心血管疾病中的应用进展：十年回顾分析

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-11-28 DOI: 10.1016/j.cpcardiol.2025.103211

Zichun Tang MD , Shuang Feng MD , Zongwei Xiao

Background

Exosomes, nanoscale extracellular vesicles (30–150 nm) carrying bioactive molecules (e.g., miRNAs, proteins), have emerged as pivotal mediators in cardiovascular diseases (CVDs), offering potential as diagnostic biomarkers and therapeutic vectors. Despite growing interest, a comprehensive analysis of global research trends, hotspots, and translational gaps in exosome applications for CVDs remains limited.

Methods

We conducted a ten-year (2016–2025) bibliometric analysis of 2617 publications from the Web of Science Core Collection, employing integrative tools (LDGAS and KMVS) to map research distribution, collaborations, and citation trends. Data was analyzed for contributions by country, institution, journal, and author, with a focus on mechanistic insights, clinical applications, and technological innovations.

Results

Global publications surged post-2016, with China leading in output (50 % of top institutions) and the USA/Europe dominating citation impact (e.g., Harvard Medical School: 7.83 citations/paper). Three key themes emerged: exosomal regulation of oxidative stress, inflammation, and angiogenesis; engineered exosomes (e.g., inflammation-targeting macrophage exosomes and stem cell-derived exosomes; circulating miRNAs (e.g., miR-21-5p in heart failure). Challenges include heterogeneous exosome isolation methods (<5 % studies reach preclinical trials) and imbalanced collaborations (China-USA partnerships dominated, 83 %).

Conclusions

Exosome research in CVDs demonstrates transformative potential but requires standardized protocols, diversified clinical trials, and strengthened global partnerships. Prioritizing AI-driven biomarker discovery and interdisciplinary synergy will accelerate clinical translation.

体是携带生物活性分子（如mirna、蛋白质）的纳米级细胞外囊泡（30 - 150nm），已成为心血管疾病（cvd）的关键介质，具有作为诊断生物标志物和治疗载体的潜力。尽管人们对外显体在心血管疾病中的应用越来越感兴趣，但对其全球研究趋势、热点和翻译差距的综合分析仍然有限。方法采用综合工具（LDGAS和KMVS）对Web of Science核心馆藏的2617篇论文进行了为期10年（2016-2025）的文献计量学分析，绘制了研究分布、合作和被引趋势。数据按国家、机构、期刊和作者进行分析，重点关注机制见解、临床应用和技术创新。结果2016年后，全球出版物数量激增，其中中国的产量领先（占顶级机构的50%），美国/欧洲的引用影响占主导地位（例如哈佛医学院：7.83次引用/篇）。出现了三个关键主题：氧化应激、炎症和血管生成的外泌体调节；工程化外泌体（如炎症靶向巨噬细胞外泌体和干细胞衍生外泌体）；循环mirna（如心力衰竭中的miR-21-5p）。挑战包括异质外泌体分离方法（5%的研究进入临床前试验）和不平衡的合作（中美伙伴关系占主导地位，83%）。结论心血管疾病的染色体研究具有变革潜力，但需要标准化的方案、多样化的临床试验和加强全球伙伴关系。优先考虑人工智能驱动的生物标志物发现和跨学科协同将加速临床翻译。

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IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2025-11-28 DOI: 10.1016/S0146-2806(25)00243-9

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Current Problems in Cardiology

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