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The Role OF 3D echocardiography in prediction of pulmonary vascular resistance and its reversibility in simple congenital heart disease with secondary pulmonary hypertension 三维超声心动图在单纯性先天性心脏病伴继发性肺动脉高压肺血管阻力及其可逆性预测中的作用
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-17 DOI: 10.1016/j.cpcardiol.2025.102983
Mohamed Rashad Awad , Inas Ibrahim Eweda , Eslam Mohammed Ismail , Adham Ahmed Abdeltawab M.D.

Background

Pulmonary hypertension is a progressive and often fatal disease that frequently presents with the non-specific symptom of dyspnea on exertion.

Aim

To determine non-Invasive Predictors of Pulmonary vascular resistance severity and reversibility in simple Congenital Heart Disease Patients Using 3D Echocardiography.

Patients and methods

This was a Prospective cohort study conducted on 40 patients selected from attendees of Cardiology clinics of Ain Shams University Hospitals over a period of 2 years.

Results

There was a statistically significant positive correlation between PVR and its reversibility and right ventricular parameters (EDV/ESV/SVI), tricuspid valvular parameters (Coaptation height/Tenting volume/Annulus perimeter/Major axis/Minor axis) measured by 3D echocardiography (P < 0.05). On the other hand, no statistically significant correlation was found between PVR or its reversibility and ejection fraction, and annulus area (P < 0.05). All echocardiographic parameters are either excellent or good predictors for reversibility of PVR except for EF, FAC, and S'.

Conclusion

We conclude that EDV, ESV, SVI, CoH, tenting volume, and annulus perimeter were the most important variables to predict the PVR and found that all echocardiographic parameters were either excellent or good predictors for reversibility of PVR except for EF, FAC, and S'.
背景:肺动脉高压是一种进行性且常致死性疾病,常表现为用力时呼吸困难等非特异性症状。目的:利用三维超声心动图确定单纯性先天性心脏病患者肺血管阻力严重程度和可逆性的无创预测因素。患者和方法:这是一项前瞻性队列研究,从艾因沙姆斯大学医院心脏病学诊所的参与者中选择40例患者,为期2年。结果:PVR及其可逆性与三维超声心动图测量的右心室参数(EDV/ESV/SVI)、三尖瓣参数(包合高度/支棚体积/环周长/长轴/短轴)呈正相关(P < 0.05)。另一方面,PVR及其可逆性与射血分数、环空面积无统计学意义(P < 0.05)。除了EF、FAC和S'外,所有超声心动图参数都是PVR可逆性的优秀或良好预测指标。结论:EDV、ESV、SVI、CoH、帐篷体积和环周是预测PVR最重要的变量,并发现除EF、FAC和S'外,所有超声心动图参数都是PVR可逆性的优秀或良好预测指标。
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引用次数: 0
Cardiac surgery outcomes: The efficacy of dexmedetomidine in reducing postoperative delirium - A bibliometric study 心脏手术结果:右美托咪定减少术后谵妄的疗效——文献计量学研究。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-17 DOI: 10.1016/j.cpcardiol.2025.102984
Wang Yabo PhD, Li Dongxu PhD, Li Xiao PhD, An Qi MD
Postoperative delirium (POD) is a prevalent complication following cardiac surgery, characterized by acute brain dysfunction observed in critically ill patients. Despite the significant impact of POD, there is currently no established treatment. Recent research has suggested that modulation of cholinergic neurotransmission and α2-adrenergic receptors may offer a therapeutic strategy for managing delirium during critical illness. This study employs bibliometric analysis to examine the emerging evidence on the role of dexmedetomidine, an α2-receptor agonist drug, in the prevention and treatment of POD. A systematic bibliometric analysis was conducted to identify and evaluate the literature on the use of dexmedetomidine in relation to POD. The study period spanned from 2006 to 2022, and the search was conducted in the Web of Science (WOS) database, focusing on relevant references. The analysis included the examination of the most frequent keywords, research trends, and frontiers to provide a comprehensive overview of the field. The bibliometric analysis revealed 160 research papers on the topic, indicating a significant increase in research output over the past decades. The field distribution, knowledge structure, and research topic evolution were identified as key areas of exploration. The analysis also highlighted the emergence of new topics and trends in the study of POD and its management. This bibliometric analysis provides a robust framework for understanding the current state of research on dexmedetomidine's efficacy in managing POD. It highlights the need for continued investigation and underscores the potential of this pharmacological approach to improve patient outcomes following cardiac surgery.
术后谵妄(POD)是心脏手术后常见的并发症,其特点是在危重患者中观察到急性脑功能障碍。尽管POD的影响很大,但目前还没有确定的治疗方法。最近的研究表明,调节胆碱能神经传递和α2-肾上腺素能受体可能为危重疾病期间谵妄的治疗提供了一种治疗策略。本研究采用文献计量学分析,对α2受体激动剂右美托咪定预防和治疗POD作用的新证据进行研究。我们进行了系统的文献计量学分析,以确定和评估有关右美托咪定与POD使用的文献。研究时间跨度为2006年至2022年,在Web of Science (WOS)数据库中进行检索,重点检索相关文献。分析包括检查最常见的关键词、研究趋势和前沿,以提供该领域的全面概述。文献计量分析揭示了160篇关于这一主题的研究论文,表明在过去几十年里,研究产出显著增加。领域分布、知识结构和研究课题演变是重点探索领域。分析还强调了POD及其管理研究中出现的新课题和新趋势。这项文献计量学分析为了解右美托咪定治疗POD疗效的研究现状提供了一个强有力的框架。它强调了继续研究的必要性,并强调了这种药理学方法改善心脏手术后患者预后的潜力。
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引用次数: 0
Mitochondrial calcium homeostasis and atrial fibrillation: Mechanisms and therapeutic strategies review 线粒体钙稳态与心房颤动:机制和治疗策略综述。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-17 DOI: 10.1016/j.cpcardiol.2025.102988
Yixuan Chang , Qi Zou
Atrial fibrillation (AF) is tightly linked to mitochondrial dysfunction, calcium (Ca²⁺) imbalance, and oxidative stress. Mitochondrial Ca²⁺ is essential for regulating metabolic enzymes, maintaining the tricarboxylic acid (TCA) cycle, supporting the electron transport chain (ETC), and producing ATP. Additionally, Ca²⁺ modulates oxidative balance by regulating antioxidant enzymes and reactive oxygen species (ROS) clearance. However, Ca²⁺ homeostasis disruptions, particularly overload, result in excessive ROS production, mitochondrial permeability transition pore (mPTP) opening, and oxidative stress-induced damage. These changes lead to mitochondrial dysfunction, Ca²⁺ leakage, and cardiomyocyte apoptosis, driving AF progression and atrial remodeling. Therapeutically, targeting mitochondrial Ca²⁺ homeostasis shows promise in mitigating AF. Moderate Ca²⁺ regulation enhances energy metabolism, stabilizes mitochondrial membrane potential, and bolsters antioxidant defenses by upregulating enzymes like superoxide dismutase and glutathione peroxidase. This reduces ROS generation and facilitates clearance. Proper Ca²⁺ levels also prevent electron leakage and promote mitophagy, aiding in damaged mitochondria removal and reducing ROS accumulation. Future strategies include modulating Ryanodine receptor 2 (RyR2), mitochondrial calcium uniporter (MCU), and sodium-calcium exchanger (NCLX) to control Ca²⁺ overload and oxidative damage. Addressing mitochondrial Ca²⁺ dynamics offers a compelling approach to breaking the cycle of Ca²⁺ overload, oxidative stress, and AF progression. Further research is needed to clarify the mechanisms of mitochondrial Ca²⁺ regulation and its role in AF pathogenesis. This knowledge will guide the development of innovative treatments to improve outcomes and quality of life for AF patients.
心房颤动(AF)与线粒体功能障碍、钙(Ca 2 +)失衡和氧化应激密切相关。线粒体ca2 +对于调节代谢酶、维持三羧酸(TCA)循环、支持电子传递链(ETC)和产生ATP至关重要。此外,Ca 2 +通过调节抗氧化酶和活性氧(ROS)清除来调节氧化平衡。然而,ca2 +的稳态破坏,特别是超载,会导致ROS产生过多,线粒体通透性过渡孔(mPTP)打开,以及氧化应激诱导的损伤。这些变化导致线粒体功能障碍、ca2 +渗漏和心肌细胞凋亡,驱动房颤进展和心房重构。在治疗上,针对线粒体Ca 2 +的稳态显示出减轻AF的希望。适度的Ca 2 +调节可以增强能量代谢,稳定线粒体膜电位,并通过上调超氧化物歧化酶和谷胱甘肽过氧化物酶等酶来增强抗氧化防御。这减少了ROS的产生并促进了清除。适当的Ca 2 +水平还可以防止电子泄漏,促进线粒体自噬,帮助受损线粒体的清除,减少ROS的积累。未来的策略包括调节Ryanodine受体2 (RyR2)、线粒体钙单转运体(MCU)和钠钙交换器(NCLX)来控制Ca 2 +过载和氧化损伤。解决线粒体ca2 +动力学问题为打破ca2 +过载、氧化应激和房颤进展的循环提供了一种令人信服的方法。需要进一步的研究来阐明线粒体ca2 +的调节机制及其在房颤发病中的作用。这些知识将指导创新治疗的发展,以改善房颤患者的预后和生活质量。
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引用次数: 0
Rural-urban disparity in survival and use of PCI in patients who develop STEMI while hospitalized for a non-cardiac condition 因非心脏疾病住院期间发生STEMI的患者的生存和PCI使用的城乡差异。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-10 DOI: 10.1016/j.cpcardiol.2025.102979
Ryan Searcy MD , Rajiv Patel MD MPH , Peter Drossopoulos BS, Sameer Arora MD MPH, George A. Stouffer MD

Background

The development of ST-segment elevation myocardial infarction (STEMI) in patients hospitalized for non-cardiac indications carries a high mortality rate.

Objectives

Determine the impact of rural vs. urban hospital location and hospital percutaneous coronary intervention (PCI) volumes on clinical outcomes.

Methods

The New York Statewide Planning and Research Cooperative System database was queried for STEMI claims from 2011 to 2018. The 2010 Rural-Urban Commuting Area classification scheme was used to stratify hospitals as urban or rural.

Results

64960 STEMI patients were identified from 231 hospitals with 2880 (4.4%) being classified as inpatient STEMI (IPS). IPS patients were older (73.5 ± 13.3 years vs 64.6 ± 14.2 years; p < .0001) and more frequently female (49.3% vs 33.1%; p < .0001), had more comorbidities, were less likely to receive PCI (13.1% vs 69.4%; p < .0001), and had higher 1-year mortality (59.6% vs 16.4%; p < .0001) than outpatient STEMI (OPS). IPS that occurred in rural hospitals were less often treated with PCI (3.8% vs 13.8%; p < 0.01) and had higher one-year mortality (68.6% vs 58.9%; p < 0.01) than those occurring in urban hospitals. Similar results were observed when hospitals were divided into rural vs suburban vs urban based on the 2013 National Center for Health Statistics Urban-Rural Classification Scheme for Counties. Patients with IPS admitted to low-volume PCI centers were significantly less likely to receive PCI and had higher one-year mortality, after adjustment for demographics and comorbidities, compared to those admitted to high-volume PCI centers.

Conclusions

IPS treated at rural hospitals and/or low-volume PCI centers were less likely to be treated with PCI and had higher one-year mortality rates.

Unstructured Abstract

The development of ST-Segment Elevation Myocardial Infarction (STEMI) in patients hospitalized for non-cardiac indications carries a high mortality rate. Using a large retrospective cohort study, we investigated the impact of hospital location and PCI volume on outcomes in inpatient STEMI (IPS). Patients with IPS were generally older, more frequently female, and had more comorbidities than those with outpatient STEMI. After adjustment for demographics and comorbidities, those with IPS admitted to rural and/or low-volume PCI centers were less likely to receive PCI and experienced higher one-year mortality rates.
背景:st段抬高型心肌梗死(STEMI)在非心脏指征住院患者中的发展具有很高的死亡率。目的:确定农村与城市医院位置和医院经皮冠状动脉介入治疗(PCI)容量对临床结果的影响。方法:查询2011年至2018年纽约州规划与研究合作系统数据库的STEMI索赔。采用2010年城乡通勤区分类方案将医院划分为城市医院和农村医院。结果:在231家医院共发现64960例STEMI患者,其中2880例(4.4%)被归类为住院STEMI。IPS患者年龄较大(73.5±13.3岁vs 64.6±14.2岁);P < 0.0001),女性更常见(49.3% vs 33.1%;p < 0.0001),有更多合并症,接受PCI的可能性较小(13.1% vs 69.4%;P < 0.0001),且1年死亡率较高(59.6% vs 16.4%;p < 0.0001)高于门诊STEMI (OPS)。发生在农村医院的IPS较少接受PCI治疗(3.8% vs 13.8%;P < 0.01), 1年死亡率较高(68.6% vs 58.9%;P < 0.01)。根据2013年国家卫生统计中心城乡分类方案,将医院分为农村、郊区和城市,也观察到类似的结果。与住在大容量PCI中心的患者相比,住在小容量PCI中心的IPS患者接受PCI的可能性显着降低,并且在调整人口统计学和合并症后,一年死亡率更高。结论:在农村医院和/或小容量PCI中心治疗的IPS患者接受PCI治疗的可能性较小,且一年死亡率较高。非结构化摘要:st段抬高型心肌梗死(STEMI)在非心脏指征住院患者中的发展具有很高的死亡率。通过一项大型回顾性队列研究,我们调查了医院位置和PCI容量对住院STEMI (IPS)患者预后的影响。IPS患者通常年龄较大,女性更常见,并且比门诊STEMI患者有更多的合并症。在调整了人口统计学和合并症后,那些住在农村和/或小容量PCI中心的IPS患者接受PCI的可能性更小,一年的死亡率更高。
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引用次数: 0
Changes in functional capacity of heart failure patients following a cardiac rehabilitation program 心脏康复计划后心力衰竭患者功能能力的变化。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-08 DOI: 10.1016/j.cpcardiol.2025.102978
Carolina Castro Gómez , Angelica Cardona Hernández , Helen Johana Ortiz Rojas , Andrea Valencia Orozco , Angela María Murillo Anzola

Purpose

To evaluate the effectiveness of a cardiac rehabilitation (CR) program on functional capacity in patients with heart failure at a high-complexity hospital in the city of Cali during the period from 2017 to 2023.

Methods

A retrospective descriptive study that included 127 patients over 18 years of age diagnosed with heart failure, who completed 36 rehabilitation sessions with complete records of the 6-minute walk test (6MWT), anthropometric and physiological measurements at the beginning and end of the program. Categorical variables were summarized as absolute frequencies and percentages. For dependent variables, the Wilcoxon signed-rank test for paired samples was applied. Statistical significance was set at 0.05.

Results

The median age was 65 years. Overall, a significant improvement was observed in the distance covered during the walk test and oxygen consumption with the CR program. In patients under 60 years of age, the distance increased from 479.0 to 598.5 meters, while in the group over 60 years, the distance improved from 419.0 to 523.0 meters.

Conclusion

The CR program proved to be effective in improving functional capacity and quality of life in patients. These findings highlight the importance of implementing structured rehabilitation programs for patients with cardiovascular diseases.
目的:评估2017年至2023年卡利市一家高复杂性医院心脏康复(CR)计划对心力衰竭患者功能能力的影响。方法:一项回顾性描述性研究,包括127名18岁以上诊断为心力衰竭的患者,他们完成了36个康复疗程,并在项目开始和结束时完成了6分钟步行测试(6MWT)、人体测量和生理测量的完整记录。分类变量被总结为绝对频率和百分比。因变量采用配对样本的Wilcoxon sign -rank检验。统计学意义为0.05。结果:中位年龄65岁。总的来说,在步行测试中的距离和CR计划的耗氧量方面观察到显著的改善。60岁以下患者距离由479.0米增加到598.5米,60岁以上患者距离由419.0米增加到523.0米。结论:CR方案可有效改善患者的功能能力和生活质量。这些发现强调了对心血管疾病患者实施结构化康复计划的重要性。
{"title":"Changes in functional capacity of heart failure patients following a cardiac rehabilitation program","authors":"Carolina Castro Gómez ,&nbsp;Angelica Cardona Hernández ,&nbsp;Helen Johana Ortiz Rojas ,&nbsp;Andrea Valencia Orozco ,&nbsp;Angela María Murillo Anzola","doi":"10.1016/j.cpcardiol.2025.102978","DOIUrl":"10.1016/j.cpcardiol.2025.102978","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effectiveness of a cardiac rehabilitation (CR) program on functional capacity in patients with heart failure at a high-complexity hospital in the city of Cali during the period from 2017 to 2023.</div></div><div><h3>Methods</h3><div>A retrospective descriptive study that included 127 patients over 18 years of age diagnosed with heart failure, who completed 36 rehabilitation sessions with complete records of the 6-minute walk test (6MWT), anthropometric and physiological measurements at the beginning and end of the program. Categorical variables were summarized as absolute frequencies and percentages. For dependent variables, the Wilcoxon signed-rank test for paired samples was applied. Statistical significance was set at 0.05.</div></div><div><h3>Results</h3><div>The median age was 65 years. Overall, a significant improvement was observed in the distance covered during the walk test and oxygen consumption with the CR program. In patients under 60 years of age, the distance increased from 479.0 to 598.5 meters, while in the group over 60 years, the distance improved from 419.0 to 523.0 meters.</div></div><div><h3>Conclusion</h3><div>The CR program proved to be effective in improving functional capacity and quality of life in patients. These findings highlight the importance of implementing structured rehabilitation programs for patients with cardiovascular diseases.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102978"},"PeriodicalIF":3.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967273","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}
引用次数: 0
Bibliometric analysis: A few suggestions (Part Two) 文献计量学分析:几点建议(第二部分)。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-07 DOI: 10.1016/j.cpcardiol.2025.102982
Siddig Ibrahim Abdelwahab , Manal Mohamed Elhassan Taha , Abdullah Farasani , Saleh M Abdullah , Jobran M Moshi , Abrar Fahad Alshahrani , Nizar A. Khamjan , Zenat A. Khired , Ahmad Assiri , Ali Mohammed Alqassmi , Amal Mayudh Alhusayni , Ibrahim Abdel Aziz Ibrahim , Saeed Alshahrani , Waseem Hassan
This manuscript serves as a follow-up to our previous work, "bibliometric analysis: a few suggestions," where we highlighted key aspects of bibliometric research and offered recommendations for improving its rigor. In this draft, we expand on those ideas and provide additional suggestions aimed at enhancing the depth and scope of bibliometric analysis. By analyzing a few randomly selected bibliometric studies, we identified common practices and gaps in the field, which informed the inclusion of new recommendations not covered in our earlier paper. These suggestions include refining search string definitions, strategies for search field selection, performance indicators for authors, methods for studying thematic evolution, and a few techniques like bibliographic coupling, co-citation analysis, and three-way plots. This manuscript aims to improve the comprehensiveness and effectiveness of bibliometric research practices and contribute to the development of more robust methodologies in this field.
这份手稿是我们之前工作的后续,“文献计量学分析:一些建议”,我们强调了文献计量学研究的关键方面,并提出了提高其严谨性的建议。在本草案中,我们对这些想法进行了扩展,并提供了旨在提高文献计量学分析的深度和范围的额外建议。通过分析36个随机选择的文献计量学研究,我们确定了该领域的常见做法和差距,这为我们早期论文中未涉及的新建议提供了信息。这些建议包括改进搜索字符串定义、搜索字段选择策略、作者绩效指标、研究主题演变的方法,以及书目耦合、共被引分析和三方图等高级技术。我们还为医学期刊的编辑和审稿人提供了一些建议。本文旨在提高文献计量学研究实践的全面性和有效性,并有助于在该领域开发更强大的方法。
{"title":"Bibliometric analysis: A few suggestions (Part Two)","authors":"Siddig Ibrahim Abdelwahab ,&nbsp;Manal Mohamed Elhassan Taha ,&nbsp;Abdullah Farasani ,&nbsp;Saleh M Abdullah ,&nbsp;Jobran M Moshi ,&nbsp;Abrar Fahad Alshahrani ,&nbsp;Nizar A. Khamjan ,&nbsp;Zenat A. Khired ,&nbsp;Ahmad Assiri ,&nbsp;Ali Mohammed Alqassmi ,&nbsp;Amal Mayudh Alhusayni ,&nbsp;Ibrahim Abdel Aziz Ibrahim ,&nbsp;Saeed Alshahrani ,&nbsp;Waseem Hassan","doi":"10.1016/j.cpcardiol.2025.102982","DOIUrl":"10.1016/j.cpcardiol.2025.102982","url":null,"abstract":"<div><div>This manuscript serves as a follow-up to our previous work, \"bibliometric analysis: a few suggestions,\" where we highlighted key aspects of bibliometric research and offered recommendations for improving its rigor. In this draft, we expand on those ideas and provide additional suggestions aimed at enhancing the depth and scope of bibliometric analysis. By analyzing a few randomly selected bibliometric studies, we identified common practices and gaps in the field, which informed the inclusion of new recommendations not covered in our earlier paper. These suggestions include refining search string definitions, strategies for search field selection, performance indicators for authors, methods for studying thematic evolution, and a few techniques like bibliographic coupling, co-citation analysis, and three-way plots. This manuscript aims to improve the comprehensiveness and effectiveness of bibliometric research practices and contribute to the development of more robust methodologies in this field.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 3","pages":"Article 102982"},"PeriodicalIF":3.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958268","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}
引用次数: 0
Role of MicroRNAs in regulating sarcoplasmic reticulum calcium handling and their implications for cardiomyocyte function and heart disease microrna在调节肌浆网钙处理中的作用及其对心肌细胞功能和心脏病的影响。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-07 DOI: 10.1016/j.cpcardiol.2025.102980
Benjamin Alexander Carter, Victoria Elizabeth Parker
The regulation of calcium signaling within cardiomyocytes is pivotal for maintaining cardiac function, with disruptions in sarcoplasmic reticulum (SR) calcium handling linked to various heart diseases. This review explores the emerging role of microRNAs (miRNAs) in modulating SR calcium dynamics, highlighting their influence on cardiomyocyte maturation, function, and disease progression. We present a comprehensive overview of the mechanisms by which specific miRNAs, such as miR-1, miR-24, and miR-22, regulate key components of calcium handling, including ryanodine receptors, SERCA, and NCX. Notably, we identify critical research gaps, particularly the inconsistent findings regarding miRNA expression in heart disease and the need for standardized experimental conditions. Furthermore, we emphasize the potential of miRNAs as therapeutic targets, given their ability to influence calcium handling pathways and cardiac remodeling. The review also discusses the challenges in translating miRNA research into clinical applications, including the need for safe and effective delivery methods. By synthesizing current knowledge and identifying areas for future investigation, this review aims to provide insights into the therapeutic potential of miRNAs in diagnosing and treating heart diseases, ultimately contributing to improved patient outcomes.
心肌细胞内钙信号的调节对于维持心脏功能至关重要,肌浆网(SR)钙处理的中断与各种心脏病有关。这篇综述探讨了microRNAs (miRNAs)在调节SR钙动力学中的新作用,强调了它们对心肌细胞成熟、功能和疾病进展的影响。我们全面概述了特定mirna的机制,如miR-1、miR-24和miR-22,调节钙处理的关键成分,包括ryanodine受体、SERCA和NCX。值得注意的是,我们确定了关键的研究空白,特别是关于心脏病中miRNA表达的不一致的发现和标准化实验条件的需求。此外,我们强调mirna作为治疗靶点的潜力,因为它们能够影响钙处理途径和心脏重塑。这篇综述还讨论了将miRNA研究转化为临床应用的挑战,包括对安全有效的递送方法的需求。通过综合目前的知识和确定未来研究的领域,本综述旨在深入了解mirna在诊断和治疗心脏病方面的治疗潜力,最终有助于改善患者的预后。
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引用次数: 0
Associations between central and brachial blood pressure in patients with hypertension and aortovascular disease: Implications for clinical practice: An analysis and review 高血压和主动脉血管疾病患者中枢性血压和肱动脉血压之间的关系:对临床实践的影响:分析和回顾:CBP和bBP之间的关系
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-07 DOI: 10.1016/j.cpcardiol.2025.102981
Liwei Wang MD , Gang Zhao MBBS , Bhushan Sandeep PhD
The importance of central hemodynamic metrics such as Central blood pressure (CBP), which directly measure the pressure exerted by the cardiac muscle on the major arteries, offering a more direct assessment of cardiovascular workload compared to brachial blood pressure (bBP), which measures pressure against the walls of peripheral arteries. This review consolidates findings that evaluate the correlation between CBP and key markers of aortovascular disease. The growth of thoracic aortic aneurysm (TAA) is a significant component of aortovascular assessment. CBP correlates more precisely with arterial stiffness (AS), TAA growth, and cardiovascular diseases, providing a more reliable forecast of aortovascular diseases, adverse cardiovascular events (CVE), and organ damage than bBP. Integrating CBP into routine clinical practice could enhance aortovascular assessments and therapeutic strategies compared to bBP, especially by gaining a deeper understanding of aortic wave dynamics, which could fundamentally change aortovascular diagnostics and treatment. It is recommended to incorporate CBP into aortovascular and cardiovascular risk management. Further research is needed to confirm these aspects and to explore the practical implications of CBP in clinical settings.
中心血流动力学指标的重要性,如中心血压(CBP),它直接测量心肌对大动脉施加的压力,与肱血压(bBP)相比,可以更直接地评估心血管负荷,肱血压(bBP)测量外周动脉壁上的压力。本综述整合了评估CBP与主动脉血管疾病关键标志物之间相关性的研究结果。胸主动脉瘤(TAA)的生长是主动脉血管评估的重要组成部分。与bBP相比,CBP与动脉僵硬度(AS)、TAA生长和心血管疾病的相关性更精确,可以更可靠地预测主动脉血管疾病、心血管不良事件(CVE)和器官损伤。与bBP相比,将CBP纳入常规临床实践可以增强主动脉血管评估和治疗策略,特别是通过对主动脉波动力学的更深入了解,这可以从根本上改变主动脉血管的诊断和治疗。建议将CBP纳入主动脉血管和心血管风险管理。需要进一步的研究来证实这些方面,并探索CBP在临床环境中的实际意义。
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引用次数: 0
Prognostic significance of diastolic wall strain as a predictor of remodeling and poor outcomes in heart failure and pulmonary embolism: A systematic review 舒张壁张力作为心力衰竭和肺栓塞的重塑和不良预后预测因子的预后意义:一项系统综述。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-03 DOI: 10.1016/j.cpcardiol.2024.102970
Yarub Alalousi MD , Chiranjeevee R Saravanan MBBS , Pugazhendi Inban MD , Shakir Muthana Shakir Al-Ezzi MD , Yogesh Tekuru MBBS

Background

Diastolic wall strain (DWS), also referred to as right ventricular (RV) dysfunction, is a significant predictor of pulmonary embolism (PE) and heart failure (HF). Rooted in linear elastic theory, DWS reflects decreased wall thinning during diastole, indicating reduced left ventricular (LV) compliance and increased diastolic stiffness. Elevated diastolic stiffness is associated with worse outcomes, particularly in PE and HF with preserved ejection fraction (HFpEF). This study systematically reviews the prognostic significance of DWS and its impact on PE and HF.

Methods

A systematic search of scientific literature published between 2014 and 2024 was conducted using PubMed and Cochrane Reviews. Keywords such as “diastolic wall strain,” “right ventricular dysfunction,” and “pulmonary embolism” were employed to identify relevant studies. Seven articles meeting the inclusion criteria were selected and analyzed to synthesize insights into DWS and its role in risk stratification and prognosis for PE and HF patients.

Results

The findings suggest that elevated DWS values are correlated with increased short- and long-term mortality in PE patients and a higher likelihood of early complications in both PE and HF. In cases where HF is present alongside elevated DWS, the risk of significant bleeding is heightened. DWS emerged as a reliable tool for PE risk stratification and predicting adverse outcomes in HF patients.

Conclusion

DWS is an essential prognostic marker for PE and HF, independently predicting major adverse cardiac events (MACE). Its straightforward assessment can improve risk stratification and guide clinical management in individuals at risk for cardiac failure.
背景:舒张壁应变(DWS),也称为右心室(RV)功能障碍,是肺栓塞(PE)和心力衰竭(HF)的重要预测因子。基于线性弹性理论,DWS反映了舒张期壁薄度降低,表明左室顺应性降低,舒张刚度增加。舒张刚度升高与较差的预后相关,特别是在PE和HF中保留射血分数(HFpEF)。本研究系统回顾了DWS的预后意义及其对PE和HF的影响。方法:使用PubMed和Cochrane Reviews系统检索2014 - 2024年间发表的科学文献。以“舒张壁劳损”、“右室功能障碍”、“肺栓塞”等关键词识别相关研究。选取符合纳入标准的7篇文章进行分析,以综合了解DWS及其在PE和HF患者的风险分层和预后中的作用。结果:研究结果表明,DWS值升高与PE患者的短期和长期死亡率增加以及PE和HF早期并发症的可能性增加有关。在HF与DWS升高同时存在的情况下,显著出血的风险增加。DWS成为心衰患者PE风险分层和预测不良结局的可靠工具。结论:DWS是PE和HF的重要预后指标,可独立预测主要心脏不良事件(MACE)。它的直接评估可以改善风险分层和指导有心力衰竭风险个体的临床管理。
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引用次数: 0
Trends in heart failure-related mortality among middle-aged adults in the United States from 1999-2022 1999-2022年美国中年人心力衰竭相关死亡率趋势
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-12-20 DOI: 10.1016/j.cpcardiol.2024.102973
Ali Bin Abdul Jabbar MD, Mark T May, McKayla Deisz, Abubakar Tauseef MD

Introduction

Heart failure (HF) represents a significant contributor to morbidity and mortality. Heart failure mortality trends among the middle aged have not been fully characterized into the years of the COVID-19 pandemic. Our objective was to analyze the trends in mortality related to heart failure across various demographic and geographic categories—including gender, race, and census region—spanning from 1999 to 2022, with particular attention paid to the effect of the COVID-19 pandemic on HF mortality.

Methods

Heart failure-related mortality data were extracted from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database and stratified into different demographic and geographic groups. Statistically significant trends in mortality over time were identified using Joinpoint regression.

Results

Heart failure mortality decreased among most studied demographic groups from 1999 to 2011-2013, then increased through 2022, often with a marked increase in mortality in the pandemic years of 2020-2022. Males, Black or African Americans, and the South generally had higher mortality rates than their demographic or geographic counterparts. Existing disparities between high-risk groups and others generally worsened during the pandemic.

Conclusion

The COVID-19 pandemic accelerated a decade of heart failure mortality increases, and in some categories worsened existing disparities. This is likely due to reduced access to healthcare during the pandemic, along with a direct increase in mortality from heart failure caused by COVID-19.
心衰(HF)是导致发病率和死亡率的重要因素。在COVID-19大流行期间,中年人心力衰竭死亡率的趋势尚未完全确定。我们的目标是分析1999年至2022年不同人口和地理类别(包括性别、种族和人口普查地区)与心力衰竭相关的死亡率趋势,特别关注COVID-19大流行对心力衰竭死亡率的影响。方法:从疾病控制和预防中心广泛在线流行病学研究数据(CDC WONDER)数据库中提取心力衰竭相关死亡率数据,并按不同的人口和地理分组进行分层。使用关节点回归确定死亡率随时间的统计学显著趋势。结果:从1999年到2011-2013年,大多数研究人群的心力衰竭死亡率下降,然后到2022年上升,通常在2020-2022年的大流行年死亡率显着增加。男性、黑人或非裔美国人以及南方的死亡率通常高于人口或地理上的同类。在大流行期间,高危群体和其他群体之间存在的差距普遍加剧。结论:新冠肺炎大流行加速了十年来心力衰竭死亡率的上升,并在某些类别上加剧了现有的差距。这可能是由于大流行期间获得医疗保健的机会减少,以及COVID-19引起的心力衰竭死亡率直接增加。
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Current Problems in Cardiology
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