Current Problems in Cardiology最新文献_第8页

The global magnitude and temporal trend of hypertensive heart disease burden attributable to high sodium intake from 1990 to 2021 1990 年至 2021 年高钠摄入导致的高血压心脏病负担的全球规模和时间趋势。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2024-11-18 DOI: 10.1016/j.cpcardiol.2024.102931

Yuanyuan Wang , Yanran Li , Zhaojia Lu , Zhengyan Li , Rui Wang , Zhengming Wang , Yong Gu , Liyun Chen

Background

The relationship between high sodium intake (HSI) and hypertensive heart disease (HHD) has been confirmed. However, notable regional disparities exist in implementing effective measures to control sodium intake. This study was carried out to estimate the spatiotemporal trends in the burden of HHD attributable to HSI.

Methods

Data obtained from the Global Burden of Disease Study 2021 were analyzed, considering factors such as age, gender, year, and region. Joinpoint regression analysis was applied to investigate the temporal trends in the HHD burden resulting from HSI over the past 32 years.

Results

From 1990 to 2021, the global cases of HHD increased significantly annually. The age-standardized prevalence rates showed a slow gradual increase. However, both the age-standardized death and disability-adjusted life-year (DALY) rates decreased. Specifically, HSI was responsible for 29.2% of total HHD deaths and 30.4% of total DALYs in 1990 but only 22.8% of total HHD deaths and 23.4% of total DALYs in 2021. A greater burden from HSI exposure was observed among men, older adults and people living in middle and low sociodemographic index (SDI) countries and regions. Moreover, over the 32-year period, Guam and Colombia demonstrated the highest reduction in age-standardized death and DALY rates, respectively.

Conclusion

Globally, the age-standardized burden of HHD due to HSI has demonstrated a decline. Although some areas have effectively managed this issue, it remains a challenge in specific areas. Hence, it is crucial to examine and implement the strategies adopted by successful nations to further mitigate this burden.

背景：高钠摄入（HSI）与高血压性心脏病（HHD）之间的关系已得到证实。然而，在采取有效措施控制钠摄入量方面存在明显的地区差异。本研究旨在估算高钠血症导致高血压心脏病负担的时空趋势：分析了 2021 年全球疾病负担研究（Global Burden of Disease Study 2021）中获得的数据，并考虑了年龄、性别、年份和地区等因素。结果：从1990年到2021年，全球人類豬型流感病例增加了20%：结果：从 1990 年到 2021 年，全球人類豬型流感病例逐年大幅增加。年龄标准化患病率呈现缓慢的逐步上升趋势。然而，年龄标准化死亡率和残疾调整生命年（DALY）率均有所下降。具体而言，1990 年，人类住区性流感导致的死亡人数和残疾调整寿命年数分别占住区性流感死亡总人数和残疾调整寿命年数的 29.2% 和 30.4%，而到 2021 年，人类住区性流感导致的死亡人数和残疾调整寿命年数分别仅占住区性流感死亡总人数和残疾调整寿命年数的 22.8% 和 23.4%。据观察，男性、老年人以及生活在中低社会人口指数（SDI）国家和地区的人因接触人的生命指数而承受的负担更大。此外，在 32 年期间，关岛和哥伦比亚的年龄标准化死亡率和残疾调整寿命年数减少率分别最高：在全球范围内，人類豬型流感造成的人類高密度脂蛋白血症的年齡標準化負擔已呈下降趨勢。尽管一些地区已有效控制了这一问题，但在一些特定地区，这一问题仍是一项挑战。因此，研究并实施成功国家所采取的战略以进一步减轻这一负担至关重要。

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引用次数: 0

High consumption of artificially sweetened beverages and associated risk of cardiovascular events: A systematic review and meta-analysis 大量饮用人工甜味饮料与心血管事件的相关风险：系统回顾和荟萃分析。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2024-11-17 DOI: 10.1016/j.cpcardiol.2024.102837

Ivo Queiroz , Maria L.R. Defante , Arthur Tavares , Vanio Antunes , Cynthia Florencio de Mesquita , Lucas M. Barbosa , Beatriz Ximenes Mendes , Angela S. Koh MBBS, MPH, PhD, FACC, FESC

Background

With the rising use of artificial sweeteners as sugar substitutes, concerns regarding their impact on cardiovascular health have emerged. Artificially sweetened beverages are the primary source of diet sweeteners, but despite approval by national food agencies, evidence of their association with cardiovascular events has not been conclusive. Our Meta-Analysis assessed the relationship between artificially sweetened beverage consumption and long-term outcomes of cardiovascular events in extended follow-up cohorts.

Methods

Medline, Embase, and Cochrane databases were systematically searched for cohort studies investigating the incidence of all-cause mortality, cardiovascular mortality, stroke, and coronary heart disease among individuals with high consumption of ASB compared to minimal or no consumption. Pooled event hazard ratios with 95% confidence intervals were calculated using a random-effects model in R software, with heterogeneity assessed via I² statistics.

Results

We included twelve prospective cohorts comprising 1,224,560 patients. Analyses were conducted on patient groups with data adjusted for co-founding, such as dietary factors and comorbidities. One or more daily dose of Artificially sweetened beverages was significantly associated with a higher risk of all-cause mortality (HR 1.14; 95% 1.03 to 1.26; p < 0.01;), Cardiovascular mortality (HR 1.29; 95% 1.1 to 1.53; p < 0.01), and stroke (HR 1.15; 95% 1.01 to 1.32; p = 0.04;).

Conclusion

In this meta-analysis, we found a significant association between high consumption of ASBs and increased incidence of ACM, CVD, and stroke, highlighting potential long-term cardiovascular implications.

背景：随着越来越多地使用人工甜味剂作为糖的替代品，人们开始关注它们对心血管健康的影响。人工甜味饮料是膳食甜味剂的主要来源，但尽管获得了国家食品机构的批准，有关其与心血管事件的关系的证据却并不确凿。我们的 "元分析 "评估了人工增甜饮料消费与长期随访队列中心血管事件的长期结果之间的关系：我们在 Medline、Embase 和 Cochrane 数据库中系统检索了队列研究，这些研究调查了大量饮用人工增甜饮料的人群与极少饮用或不饮用人工增甜饮料的人群之间的全因死亡率、心血管死亡率、中风和冠心病发病率。我们使用 R 软件中的随机效应模型计算了汇总事件危险比和 95% 的置信区间，并通过 I² 统计量评估了异质性：我们纳入了 12 个前瞻性队列，包括 1,224,560 名患者。对患者分组进行了分析，并根据饮食因素和合并症等共同因素对数据进行了调整。每日饮用一种或多种人工甜味饮料与较高的全因死亡风险（HR 1.14；95% 1.03 至 1.26；p < 0.01；）、心血管死亡风险（HR 1.29；95% 1.1 至 1.53；p < 0.01；）和中风风险（HR 1.15；95% 1.01 至 1.32；p = 0.04；）显著相关：在这项荟萃分析中，我们发现大量食用 ASB 与急性心肌梗死、心血管疾病和中风发病率增加之间存在显著关联，这凸显了对心血管疾病的潜在长期影响。

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引用次数: 0

Right ventricular strain as a predictor of trastuzumab-induced chemotherapy-related cardiac dysfunction: A meta-analysis 右心室应变作为曲妥珠单抗诱发化疗相关心功能障碍的预测指标：一项荟萃分析。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2024-11-09 DOI: 10.1016/j.cpcardiol.2024.102919

Hritvik Jain MBBS , Mushood Ahmed MBBS , Muhammad Daoud Tariq MBBS , Jyoti Jain MBBS , Aman Goyal MBBS , Ramez M. Odat MD , Mayank Jha MBBS , Suchit Shashikumar MBBS , Isobel Scott MBChB , Raheel Ahmed MBBS, MRCP

Introduction

The survival rates of breast cancer patients have improved drastically in the past few decades due to advancements in anti-neoplastic drugs. Trastuzumab (TZ) chemotherapy is associated with left ventricular dysfunction leading to cardiotoxicity. Two-dimensional speckle-tracking echocardiography has demonstrated efficacy in predicting TZ-induced cardiotoxicity; however, its role in using right ventricular (RV) strain parameters remains unclear.

Methods

A comprehensive literature search spanning major electronic databases was conducted to identify studies comparing pre- and post-TZ chemotherapy RV strain parameters. The outcomes of interest included RV global longitudinal strain (GLS) and RV free-wall longitudinal strain (FWLS). Mean differences (MD) with 95% confidence intervals (CI) were pooled using the inverse-variance random-effects model. Statistical significance was set at p<0.05.

Results

Four studies involving 275 cancer patients were included. The mean age of the patients was 53.35 ± 11.1 years. The pooled analysis demonstrated significantly reduced RV GLS [MD: -1.94; 95% CI: -2.83, -1.05; p<0.01] and RV FWLS [MD: -2.05; 95% CI: -3.61, -0.50; p<0.01] on follow-up post-TZ chemotherapy compared to pre-TZ baseline values.

Conclusion

Following TZ-based chemotherapy, RV subclinical damage ensues without overt clinical signs, leading to the deformation of RV mechanics. This meta-analysis demonstrated a reduction in RV GLS and RV FWLS after TZ-based chemotherapy.

导言：过去几十年来，由于抗肿瘤药物的进步，乳腺癌患者的生存率大幅提高。曲妥珠单抗（TZ）化疗与导致心脏毒性的左心室功能障碍有关。二维斑点追踪超声心动图在预测曲妥珠单抗诱发的心脏毒性方面具有疗效，但其在使用右心室（RV）应变参数方面的作用仍不明确：方法：对主要电子数据库进行了全面的文献检索，以确定比较 TZ 化疗前后 RV 应变参数的研究。相关结果包括RV整体纵向应变（GLS）和RV自由壁纵向应变（FWLS）。采用逆方差随机效应模型对平均差 (MD) 和 95% 置信区间 (CI) 进行了汇总。统计显著性以 pResults 为标准：共纳入四项研究，涉及 275 名癌症患者。患者的平均年龄为（53.35 ± 11.1）岁。汇总分析表明，RV GLS明显降低[MD：-1.94；95% CI：-2.83，-1.05；p结论：以 TZ 为基础的化疗后，RV 亚临床损伤随之而来，但无明显临床症状，导致 RV 力学变形。这项荟萃分析表明，TZ 化疗后 RV GLS 和 RV FWLS 均有所下降。

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引用次数: 0

Incidence and in-hospital mortality among women with acute myocardial infarction with or without SCAD 伴有或不伴有 SCAD 的急性心肌梗死女性患者的发病率和院内死亡率。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2024-11-09 DOI: 10.1016/j.cpcardiol.2024.102921

Chayakrit Krittanawong MD, FACC , Yusuf Kamran Qadeer MD , Song Peng Ang MD , Zhen Wang PhD , Mahboob Alam MD, FACC , Samin Sharma MD, FACC, MSCAI , Hani Jneid MD, FACC, FSCAI

Background

Spontaneous coronary artery dissection (SCAD) has been increasingly recognized in the past decades. SCAD patients can present with acute myocardial infarction (AMI), particularly in young healthy women without conventional risk factors. However, data on the outcomes of SCAD patients presenting with AMI or benefit of PCI for SCAD in the setting of AMI is inconclusive.

Methods

We evaluated the prevalence, recent trends, the incidence and in-hospital mortality among women with acute myocardial infarction (AMI) who presented with or without SCAD, and to evaluate the impact of PCI on in-hospital mortality from a population-based analysis, using the National Inpatient Sample (NIS) database between 2016 and 2019.

Results

From 2016-2019, there were 1,527,555 cases of females presenting with AMI. Of that number, there were 12,125 cases of SCAD. Mortality trends in the SCAD and non-SCAD group were comparable. There was a gradual increase in incidence each year for SCAD-STEMI.

Conclusion

Mortality did not differ from 2016-2019 in patients with MI found to have SCAD or not. However, it seems that the SCAD-MI cases are gradually increasing each year. More research needs to be performed to better elucidate treatment outcomes in these patients.

背景：在过去几十年中，自发性冠状动脉夹层（SCAD）已被越来越多的人所认识。自发性冠状动脉夹层（SCAD）患者会出现急性心肌梗死（AMI），尤其是没有传统危险因素的年轻健康女性。然而，有关 SCAD 患者发生急性心肌梗死后的预后或在发生急性心肌梗死的情况下对 SCAD 进行 PCI 治疗的益处的数据尚无定论：我们利用2016年至2019年期间的全国住院患者样本（NIS）数据库，评估了急性心肌梗死（AMI）女性患者中伴有或不伴有SCAD的患病率、近期趋势、发病率和院内死亡率，并通过基于人群的分析评估了PCI对院内死亡率的影响：2016年至2019年期间，共有1527555例女性出现AMI。其中，12125 例为 SCAD。SCAD 组和非 SCAD 组的死亡率趋势相当。SCAD-STEMI的发病率逐年上升：2016-2019年，被发现患有SCAD或未患有SCAD的心肌梗死患者的死亡率并无差异。然而，SCAD-MI病例似乎每年都在逐渐增加。需要开展更多研究，以更好地阐明这些患者的治疗效果。

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引用次数: 0

The future of hypertension pharmacotherapy: Ongoing and future clinical trials for hypertension 高血压药物治疗的未来：正在进行的和未来的高血压临床试验。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2024-11-08 DOI: 10.1016/j.cpcardiol.2024.102922

Taha Mansoor MD , Fatima Farrukh MD , Subaina N. Khalid MD , Dmitry Abramov MD , Erin D. Michos MD, MHS , Anurag Mehta MD , Timir K. Paul MD, PhD , Sourbha S. Dani MD, MSc , Mahmoud Al Rifai MD , Arunima Misra MD , Vijay Nambi MD, PhD , Salim S. Virani MD, PhD , Abdul Mannan Khan Minhas MD, MS

Hypertension is among the most prevalent diagnoses across the world and increases the risk of many serious health problems, such as stroke, heart disease, and kidney disease. Pharmacological approaches to treat hypertension are often required and reduce blood pressure through mechanisms such as vasodilation, inhibition of the renin-angiotensin-aldosterone pathway, and increased urine output to reduce blood volume, among other mechanisms. Further research is ongoing to find novel pathways and mechanisms to treat hypertension, which we summarize in this review. We used clinicaltrials.gov to gather information about ongoing clinical trials of pharmacological hypertension therapy as of March 2024 and found 103 clinical trials that met our criteria. The interventions of these 103 clinical trials include novel and previously approved pharmacological and dietary supplement therapies for hypertension. We aim to use these clinical trials to provide insight into the future therapies and practices of hypertension treatment.

高血压是全球最常见的疾病之一，会增加许多严重健康问题的风险，如中风、心脏病和肾病。高血压通常需要药物治疗，通过血管扩张、抑制肾素-血管紧张素-醛固酮途径、增加尿量以减少血容量等机制来降低血压。我们在本综述中总结了目前正在进行的进一步研究，以寻找治疗高血压的新途径和新机制。我们使用 clinicaltrials.gov 收集了截至 2024 年 3 月正在进行的高血压药物治疗临床试验信息，发现有 103 项临床试验符合我们的标准。这 103 项临床试验的干预措施包括治疗高血压的新型和以前批准的药物疗法和膳食补充疗法。我们希望通过这些临床试验来深入了解高血压治疗的未来疗法和实践。

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引用次数: 0

Genetic predisposition to acute lung injury in cardiac surgery ‘The VEGF Factor’: Review article and bibliometric analysis 心脏手术急性肺损伤的遗传易感性 "血管内皮生长因子因子"：评论文章和文献计量分析。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2024-11-06 DOI: 10.1016/j.cpcardiol.2024.102927

Wang Yabo PhD , Li Dongxu PhD , Li Xiao PhD , Bhushan Sandeep PhD , An Qi MD

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are among the most prevalent complications associated with cardiac surgery involving extracorporeal circulation (ECC), contributing to adverse outcomes and representing a significant impediment to successful cardiac surgical procedures. Vascular endothelial growth factor (VEGF) is implicated in the etiology of ALI/ARDS; however, its precise role remains a subject of debate due to the presence of somewhat contradictory findings in the literature, necessitating further investigation. To date, numerous studies have explored the role of VEGF in the pathophysiology of ALI/ARDS, with ongoing discussions regarding whether VEGF exerts a protective or detrimental effect. The genetic polymorphism of the VEGF gene is a significant factor in the development of ALI/ARDS. Research has indicated that the prevalence of the VEGF polymorphic gene is markedly higher in postoperative cardiac surgery patients who develop ALI/ARDS compared to the general population. Furthermore, the mortality rate among patients possessing the VEGF polymorphic gene is significantly elevated. Concurrently, it has been demonstrated that ARDS patients who are positive for the VEGF polymorphism exhibit a reduction in VEGF levels within alveolar lavage fluid, which correlates with an exacerbation of lung injury. The present paper provides a comprehensive review of the genetic polymorphisms of VEGF and their implications in the pathophysiological alterations observed in postoperative cardiac surgery patients with ALI/ARDS, thereby offering novel insights and evidence to further elucidate the mechanisms underlying ALI/ARDS.

急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS）是涉及体外循环（ECC）的心脏手术最常见的并发症之一，可导致不良预后并严重阻碍心脏手术的成功。血管内皮生长因子（VEGF）被认为与 ALI/ARDS 的病因有关；然而，由于文献中存在一些相互矛盾的研究结果，其确切作用仍是一个争论的话题，因此有必要进行进一步研究。迄今为止，已有许多研究探讨了血管内皮生长因子在 ALI/ARDS 病理生理学中的作用，关于血管内皮生长因子是起保护作用还是起有害作用的讨论仍在继续。血管内皮生长因子基因的遗传多态性是诱发 ALI/ARDS 的一个重要因素。研究表明，在发生 ALI/ARDS 的心脏手术后患者中，VEGF 多态基因的患病率明显高于普通人群。此外，拥有血管内皮生长因子多态基因的患者死亡率也明显升高。同时，有研究表明，血管内皮生长因子多态性呈阳性的 ARDS 患者肺泡灌洗液中的血管内皮生长因子水平会降低，这与肺损伤加重有关。本文全面综述了血管内皮生长因子的遗传多态性及其对心脏手术后 ALI/ARDS 患者病理生理改变的影响，从而为进一步阐明 ALI/ARDS 的内在机制提供了新的见解和证据。

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引用次数: 0

Transforming pediatric heart failure: Efficacy of low-dose sacubitril/valsartan 改变小儿心力衰竭：小剂量沙库比妥/缬沙坦的疗效。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2024-11-06 DOI: 10.1016/j.cpcardiol.2024.102926

Hui Zha , Xuejia Zhai , Lin Wang , Quancheng Yang , Qing Guo , Yanyu Chen , Jie Liu , Hua Peng

Aims

Pediatric heart failure is a significant cause of illness and death in children. We aimed to assess sacubitril/valsartan's effectiveness and find the proper dosage for pediatric patients.

Methods

Patients unresponsive to traditional medicines for at least 12 months prescribed sacubitril/valsartan from January 2020 to March 2023 were reviewed. The initial dose was 0.2 mg/kg bid, gradually increasing in 0.1 mg/kg increments. The target dose was determined based on blood pressure fluctuations at 70/50 mmHg. Clinical efficacy and quantity-effect relationship were evaluated using echocardiography, NT-proBNP, and the concentration of valsartan, sacubitril, sacubitrilat.

Results

A total of 23 pediatric patients with dilated cardiomyopathy and advanced heart failure were enrolled. Mean sacubitril/valsartan dose was 1.84 mg/kg/day. After 6 months, LVEF increased significantly (38.09% to 45% at 3 months, 52% at 6 months; p < 0.001). LV size reduced to 4.4 cm (IQR, 4.1–5.2) and 4.5 cm (IQR, 4–5.1) at 3 and 6 months, respectively, from 4.6 cm (IQR, 4.2–5.6) at baseline (both P < 0.05). NT-proBNP levels reduced by 5.7 at 3 months (p < 0.05) and 5.38 at 6 months (p < 0.001). Sacubitrilat is the active form of Sacubitril. The highest concentration of sacubitrilat was observed at approximately 1.6 mg/kg. The maintenance dose correlated positively with time (p < 0.001) and valsartan/sacubitril concentration (p < 0.05).

Conclusion

Low dose sacubitril/valsartan is effective in children with heart failure, with dosage adjustments to avoid hypotension. Adjusted dosing can increase EF and reduce heart size, offering new possibilities for pediatric heart failure treatment.

目的：小儿心力衰竭是导致儿童患病和死亡的重要原因。我们旨在评估沙库比特利/缬沙坦的疗效，并找到适合小儿患者的剂量：方法：我们对 2020 年 1 月至 2023 年 3 月期间至少 12 个月对传统药物无反应的患者处方沙库比妥/缬沙坦的情况进行了审查。初始剂量为 0.2 mg/kg bid，以 0.1 mg/kg 为增量逐渐增加。目标剂量根据 70/50 mmHg 的血压波动确定。使用超声心动图、NT-proBNP以及缬沙坦、沙库比特利、沙库比特利钠的浓度评估临床疗效和量效关系：共有23名患有扩张型心肌病和晚期心力衰竭的儿童患者入选。萨库比特利/缬沙坦的平均剂量为 1.84 毫克/千克/天。6个月后，LVEF显著增加（3个月时为38.09%，6个月时为45%，6个月时为52%；P < 0.001）。左心室大小从基线时的 4.6 厘米（IQR，4.2-5.6）分别缩小到 3 个月时的 4.4 厘米（IQR，4.1-5.2）和 6 个月时的 4.5 厘米（IQR，4-5.1）（P 均<0.05）。3 个月时，NT-proBNP 水平降低了 5.7（P < 0.05），6 个月时降低了 5.38（P < 0.001）。Sacubitrilat 是 Sacubitril 的活性形式。在约 1.6 毫克/千克的剂量下，sacubitrilat 的浓度最高。维持剂量与时间（p < 0.001）和缬沙坦/沙库比特利浓度（p < 0.05）呈正相关：结论：小剂量沙库比特利/缬沙坦对心力衰竭儿童有效，但需调整剂量以避免低血压。调整剂量可增加EF，缩小心脏体积，为小儿心衰治疗提供了新的可能性。

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引用次数: 0

The association between insulin resistance and cytokines in adolescents with excess of adiposity 肥胖青少年的胰岛素抵抗与细胞因子之间的关系

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2024-11-05 DOI: 10.1016/j.cpcardiol.2024.102925

Robinson Ramírez-Vélez , María Correa-Rodríguez , Juan Carlos Calderón-González , Albeiro Dávila-Grisales , Katherine González-Ruíz , Jorge Enrique Correa-Bautista , Mikel Izquierdo

Background and aims

Increased adiposity has been directly associated with insulin resistance (IR), and cytokines released by adipose tissue seem to link adiposity to IR in youth. We used an antibody-based array to investigate the differential levels of serum cytokines according to insulin status in a cohort of overweight/obese and inactive adolescents and evaluated their potential associations with clinical and metabolic characteristics.

Methods and results

We performed a cross-sectional data analysis from 122 adolescents (11–17 years of age). We assessed body composition, cardiometabolic risk factors, biochemical variables, and physical fitness. The concentration of 55 cytokines was quantified in blood samples. The homeostasis model assessment insulin resistance (HOMA‐IR) and AST/ALT and TG/HDL ratios were calculated. IR adolescents as defined as HOMA-IR >2.5. The number of adolescents with IR in the study was 91 (66 % girls). In the IS group, after controlling for confounders, higher IL-15 levels were significantly associated with higher alanine aminotransferase levels and lower AST/ALT ratio, respectively (Ps<0.05). In the same line, there were significantly higher alanine aminotransferase levels and lower AST/ALT ratio, respectively, with FGF-9 (Ps<0.05). Likewise, higher alanine aminotransferase levels were significantly associated positively with HGF (p=0.045). Additionally, leptin levels are associated with six adiposity indexes (i.e., fat mass/height index, body fat, body mass index, android fat mass and gynoid fat mass) in overweight/obese adolescents with IR (Ps<0.05).

Conclusions

These data may provide novel insights into the pathogenic mechanisms underlying IR in youth, offering new targets for prevention.

背景和目的：肥胖的增加与胰岛素抵抗（IR）直接相关，而脂肪组织释放的细胞因子似乎与青少年的肥胖和IR有关。我们使用基于抗体的阵列研究了一组超重/肥胖和不运动青少年血清细胞因子水平与胰岛素状态的差异，并评估了它们与临床和代谢特征的潜在关联：我们对 122 名青少年（11-17 岁）进行了横断面数据分析。我们对身体成分、心脏代谢风险因素、生化变量和体能进行了评估。对血清中 55 种细胞因子的浓度进行了量化。我们还计算了胰岛素抵抗稳态模型评估（HOMA-IR）以及 AST/ALT 和 TG/HDL 比率。HOMA-IR大于2.5的青少年即为IR青少年。研究中共有 91 名青少年患有 IR（66% 为女孩）。在IS组中，在控制了混杂因素后，较高的IL-15水平分别与较高的丙氨酸氨基转移酶水平和较低的谷草转氨酶/谷丙转氨酶比率显著相关（PsConclusions：这些数据为了解青少年红外热的发病机制提供了新的视角，为预防红外热提供了新的目标。

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引用次数: 0

Current status and challenges of cardiac transplantation in the MENA region: A narrative review 中东和北非地区心脏移植的现状与挑战：叙述性综述。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2024-11-05 DOI: 10.1016/j.cpcardiol.2024.102920

Mohammad Tanashat , Ahmed Zayed MD , Mohammed Ayyad MD , Mouath Abu Daoud , Mohammad Tabbalat , Obieda Altobaishat , Jana Nusier , F.N.U. Deepak , Yazan A. Al-Ajlouni MD, MPhil

Introduction

Cardiac transplantation has progressed markedly since 1967, with advances in immunosuppression, surgical techniques, and postoperative care that improve outcomes. However, challenges persist in the Middle East and North Africa (MENA) region due to unique cultural, economic, and infrastructural barriers. This review explores the status, innovations, and challenges of cardiac transplantation within MENA countries, comparing outcomes with global standards.

Methodology

A comprehensive literature search was conducted across PubMed, Web of Science, and Cochrane databases, including studies from inception to May 2024. Search terms targeted heart transplantation practices, challenges, and innovations in the MENA region. Articles not in English, non-human studies, and duplicates were excluded. Data extraction focused on patient demographics, transplantation outcomes, and barriers specific to the MENA context.

Results

Cardiac transplantation in MENA has made strides, with established programs in Saudi Arabia, the UAE, and Lebanon. Innovations like ex-vivo perfusion and Left Ventricular Assist Devices (LVAD) are improving transplant outcomes, yet organ shortages remain critical. Cultural and religious beliefs influence donation rates, and infrastructure varies widely, with disparities in healthcare resources across countries. Key barriers include low donor registration, inconsistent brain death definitions, and limited public awareness. Economic and infrastructure limitations further complicate access to advanced transplantation techniques.

Conclusion

While cardiac transplantation has evolved in MENA, significant barriers hinder widespread adoption. Enhancing public awareness, developing regional networks, and implementing standardized protocols can improve outcomes. Targeted immunosuppressive therapies and continued innovation in organ preservation are essential to advance cardiac transplantation in MENA.

导言：自 1967 年以来，心脏移植手术取得了显著进展，免疫抑制、手术技术和术后护理方面的进步改善了手术效果。然而，由于独特的文化、经济和基础设施障碍，中东和北非地区（MENA）仍然面临着挑战。本综述探讨了中东和北非国家心脏移植的现状、创新和挑战，并将结果与全球标准进行了比较：在 PubMed、Web of Science 和 Cochrane 数据库中进行了全面的文献检索，包括从开始到 2024 年 5 月的研究。检索词针对中东和北非地区的心脏移植实践、挑战和创新。排除了非英语文章、非人类研究和重复文章。数据提取侧重于患者人口统计学、移植结果以及中东和北非地区特有的障碍：结果：中东和北非地区的心脏移植手术取得了长足进步，沙特阿拉伯、阿联酋和黎巴嫩都建立了心脏移植项目。体外灌注和左心室辅助装置（LVAD）等创新技术正在改善移植效果，但器官短缺问题依然严峻。文化和宗教信仰影响着捐献率，基础设施也大相径庭，各国的医疗资源也不尽相同。主要障碍包括捐赠者登记率低、脑死亡定义不一致以及公众意识有限。经济和基础设施的限制使先进的移植技术更加复杂：结论：虽然心脏移植在中东和北非地区得到了发展，但广泛采用仍面临重大障碍。提高公众意识、发展地区网络和实施标准化方案可以改善治疗效果。有针对性的免疫抑制疗法和器官保存方面的持续创新对于推动中东和北非地区的心脏移植至关重要。

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引用次数: 0

Bibliometric analysis of ST elevation myocardial infarction research from 1933 to 2023: Focus on top 100 most-cited articles 对 1933 年至 2023 年 ST 波抬高型心肌梗死研究的文献计量分析：关注被引用次数最多的 100 篇文章。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology

Pub Date : 2024-11-05 DOI: 10.1016/j.cpcardiol.2024.102923

Siddig Ibrahim Abdelwahab , Manal Mohamed Elhassan Taha , Abdullah Farasani , Ahmed Ali Jerah , Saleh M Abdullah , Bassem Oraibi , Yasir Babiker , Hassan Ahmad Alfaifi , Amal Hamdan Alzahrani , Ahmed S. Alamer , Tawfeeq Altherwi , Ibrahim Abdel Aziz Ibrahim , Waseem Hassan

The primary objective of this study was to conduct a bibliometric analysis of the most influential papers on ST-Elevation Myocardial Infarction (STEMI). Using the Scopus database (October 2024), a targeted search was performed to identify relevant publications. Three retrieval options were considered based on the appearance of search terms. Precisely those documents were analyzed where the search terms appeared only in the title, allowing for a focused analysis of the most directly relevant studies. Next, from this search, the top 100 most cited papers, spanning from 1981 to 2018, were selected for detailed examination. Data analysis was conducted using VOSviewer and R Studio to provide insights into publication trends, author productivity, and the thematic focus of STEMI research. Author performance was evaluated through various bibliometric indicators, including total publications (TP), total citations (TC), h-index, g-index, m-index, HG composite, and Q2 index. Key metrics such as mean total citations per article (MeanTCperArt) and mean annual citation rate (MeanTCperYear) were also calculated. Thematic analysis of research topics was conducted using unigrams, bigrams, and trigrams, highlighting primary areas of focus across the most impactful STEMI studies. The results underscore significant trends in STEMI research, with highly cited papers shaping the field's evolution. This bibliometric approach provides valuable insights into research patterns, major contributors, and prevalent themes within STEMI literature.

本研究的主要目的是对ST段抬高型心肌梗死（STEMI）方面最有影响力的论文进行文献计量分析。我们使用 Scopus 数据库（2024 年 10 月）进行了有针对性的检索，以确定相关出版物。根据检索词的外观，考虑了三种检索方案。首先，对检索词仅出现在标题中的文献进行精确分析，以便对最直接相关的研究进行重点分析。接下来，从这一搜索中选出了引用次数最多的前 100 篇论文（时间跨度从 1981 年到 2018 年）进行详细研究。我们使用 VOSviewer 和 R Studio 进行了数据分析，以深入了解发表趋势、作者生产力和 STEMI 研究的主题重点。作者的表现通过各种文献计量指标进行评估，包括总发表量（TP）、总引用量（TC）、h指数、g指数、m指数、HG综合指数和Q2指数。此外，还计算了每篇文章的平均总被引次数（MeanTCperArt）和平均年被引率（MeanTCperYear）等关键指标。研究主题的专题分析使用了单词、双词和三词，突出了最具影响力的 STEMI 研究的主要关注领域。结果强调了 STEMI 研究的重要趋势，其中高被引论文影响着该领域的发展。这种文献计量学方法为了解 STEMI 文献中的研究模式、主要贡献者和流行主题提供了宝贵的见解。

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引用次数: 0