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Editorial commentary: Exercise recommendations in hypertrophic cardiomyopathy shouldn't end at the recommendation 肥厚性心肌病的运动建议不应止于此。
IF 7.3 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 DOI: 10.1016/j.tcm.2024.12.001
André La Gerche
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引用次数: 0
Artificial intelligence-driven electrocardiography: Innovations in hypertrophic cardiomyopathy management 人工智能驱动的心电图:肥厚型心肌病管理的创新。
IF 7.3 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 DOI: 10.1016/j.tcm.2024.08.002
Leopoldo Ordine , Grazia Canciello , Felice Borrelli , Raffaella Lombardi , Salvatore Di Napoli , Roberto Polizzi , Cristina Falcone , Brigida Napolitano , Lorenzo Moscano , Alessandra Spinelli , Elio Masciari , Giovanni Esposito , Maria-Angela Losi
Hypertrophic Cardiomyopathy (HCM) presents a complex diagnostic and prognostic challenge due to its heterogeneous phenotype and clinical course. Artificial Intelligence (AI) and Machine Learning (ML) techniques hold promise in transforming the role of Electrocardiography (ECG) in HCM diagnosis, prognosis, and management.
AI, including Deep Learning (DL), enables computers to learn patterns from data, allowing for the development of models capable of analyzing ECG signals. DL models, such as convolutional neural networks, have shown promise in accurately identifying HCM-related abnormalities in ECGs, surpassing traditional diagnostic methods.
In diagnosing HCM, ML models have demonstrated high accuracy in distinguishing between HCM and other cardiac conditions, even in cases with normal ECG findings. Additionally, AI models have enhanced risk assessment by predicting arrhythmic events leading to sudden cardiac death and identifying patients at risk for atrial fibrillation and heart failure. These models incorporate clinical and imaging data, offering a comprehensive evaluation of patient risk profiles. Challenges remain, including the need for larger and more diverse datasets to improve model generalizability and address imbalances inherent in rare event prediction. Nevertheless, AI-driven approaches have the potential to revolutionize HCM management by providing timely and accurate diagnoses, prognoses, and personalized treatment strategies based on individual patient risk profiles.
This review explores the current landscape of AI applications in ECG analysis for HCM, focusing on advancements in AI methodologies and their specific implementation in HCM care.
肥厚型心肌病(HCM)由于其表型和临床过程的异质性,给诊断和预后带来了复杂的挑战。人工智能(AI)和机器学习(ML)技术有望改变心电图(ECG)在 HCM 诊断、预后和管理中的作用。包括深度学习(DL)在内的人工智能使计算机能够从数据中学习模式,从而开发出能够分析心电信号的模型。卷积神经网络等深度学习模型在准确识别心电图中与 HCM 相关的异常方面已显示出良好的前景,超过了传统的诊断方法。在诊断 HCM 时,ML 模型在区分 HCM 和其他心脏疾病方面表现出很高的准确性,即使是在心电图结果正常的情况下也是如此。此外,人工智能模型还能预测导致心脏性猝死的心律失常事件,并识别有心房颤动和心力衰竭风险的患者,从而加强了风险评估。这些模型结合了临床和成像数据,可对患者的风险状况进行全面评估。挑战依然存在,包括需要更大、更多样化的数据集来提高模型的通用性,并解决罕见事件预测中固有的不平衡问题。尽管如此,人工智能驱动的方法仍有可能通过提供及时准确的诊断、预后和基于患者个体风险特征的个性化治疗策略,彻底改变 HCM 的管理。本综述探讨了当前人工智能在心电图分析中应用于 HCM 的情况,重点关注人工智能方法的进展及其在 HCM 治疗中的具体实施。
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引用次数: 0
Contemporary diagnostic approach to arrhythmogenic cardiomyopathy: The three-step work-up 心律失常性心肌病的现代诊断方法:三步工作法。
IF 7.3 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 DOI: 10.1016/j.tcm.2024.09.002
Francesca Graziano , Alessandro Zorzi , Alberto Cipriani , Barbara Bauce , Ilaria Rigato , Martina Perazzolo Marra , Hajnalka Vago , Bela Merkely , Kalliopi Pilichou , Cristina Basso , Domenico Corrado
Arrhythmogenic Cardiomyopathy (ACM) is a cardiac disorder characterized by non-ischemic myocardial scarring, which may lead to ventricular electrical instability and systolic dysfunction. Diagnosing ACM is challenging as there is no single gold-standard test and a combination of criteria is required. The first diagnostic criteria were established in 1994 and revised in 2010, focusing primarily on right ventricular involvement. However, in 2019, an international expert report identified limitations of previous diagnostic scoring and developed the 2020 Padua criteria with also included criteria for diagnosis of left ventricular variants and introduced cardiac magnetic resonance tissue characterization findings for detection of left ventricular myocardial scar. These criteria were further refined and published in 2023 as the European Task Force criteria, gaining international recognition. This review provides an overview of the 20 years of progresses on the disease diagnostic from the original 1994 criteria to the most recent 2023 European criteria, highlighting the evolution into our understanding of the pathobiology and morpho-functional features of the disease.
心律失常性心肌病(ACM)是一种以非缺血性心肌瘢痕为特征的心脏疾病,可导致心室电不稳定和收缩功能障碍。诊断 ACM 极具挑战性,因为没有单一的金标准检测方法,需要结合多种标准。第一个诊断标准于 1994 年制定,并于 2010 年进行了修订,主要侧重于右心室受累。然而,2019 年,一份国际专家报告指出了之前诊断评分的局限性,并制定了 2020 年帕多瓦标准,其中还包括左心室变异的诊断标准,并引入了用于检测左心室心肌瘢痕的 CMR 组织表征结果。这些标准得到进一步完善,并于 2023 年作为欧洲工作组标准发布,获得国际认可。本综述概述了从最初的 1994 年标准到最新的 2023 年欧洲标准这 20 年来在疾病诊断方面取得的进展,重点介绍了我们对该疾病的病理生物学和形态功能特征的认识的演变。
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引用次数: 0
Editorial commentary: Evolving use of quinidine in the treatment of ventricular arrhythmias 奎尼丁在治疗室性心律失常中的应用不断发展。
IF 7.3 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 DOI: 10.1016/j.tcm.2024.08.001
Jeremy Y. Feng, Sanjay Dixit
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引用次数: 0
Letter to the Editor: Is oral hydroquinidine a real alternative to intravenous quinidine for intubated patients in intensive care unit? 社论评论:对于重症监护室的插管患者而言,口服氢奎尼丁是静脉注射奎尼丁的真正替代品吗?
IF 7.3 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 DOI: 10.1016/j.tcm.2024.08.004
Alma Feka, Marianne Cumin, Farshid Sadeghipour
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引用次数: 0
The relationship between alcohol intake and cardiovascular health: Gaps in knowledge. 社论评论:酒精摄入量与心血管健康的关系:知识空白。
IF 7.3 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 DOI: 10.1016/j.tcm.2025.01.006
Zain S Ali, Adrian Baranchuk
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引用次数: 0
The current state and future of renal denervation: A review 肾脏去神经化的现状与未来:回顾。
IF 7.3 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-02-01 DOI: 10.1016/j.tcm.2024.08.005
Aneel S. Maini, Mansi Maini, Tayo Addo, Vivek Koshti, Thomas Koshy, James A. de Lemos, Angela Price, Dharam J. Kumbhani
Renal denervation as an option for difficult to treat hypertension has been a concept for several decades, with recent U.S. FDA approval of new, minimally invasive devices. However, while renal denervation has the potential to improve hypertension management, several challenges require consideration prior to widespread adoption. The effect relative to sham control is modest, and generally similar to addition of a single blood pressure lowering medication. It is possible that with additional technique refinement greater effects may be possible. Key factors to consider beyond the direction, strengths, and limitations of the renal denervation technologies themselves, are an understanding of patient groups that derive greatest benefit and phenotypes or biomarkers that predict greater response. This review provides an update on these challenges in addition to the current state and future of renal denervation within the context of hypertension management and treatment.
将肾脏去神经作为治疗高血压难治症的一种选择已经有几十年的历史,最近美国食品及药物管理局又批准了新的微创设备。然而,虽然肾脏去神经化有可能改善高血压的治疗,但在广泛采用之前还需要考虑一些挑战。与假性控制相比,其效果并不明显,一般与添加单一降压药的效果相似。随着技术的进一步完善,可能会产生更大的效果。除了肾脏去神经支配技术本身的方向、优势和局限性之外,需要考虑的关键因素还包括对获益最大的患者群体以及预测更大反应的表型或生物标志物的了解。本综述除了介绍高血压管理和治疗背景下肾脏去神经支配的现状和未来外,还对这些挑战提供了最新信息。
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引用次数: 0
Cardiovascular-liver-metabolic health: Time to integrate liver assessment into cardiology practice?
IF 7.3 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-27 DOI: 10.1016/j.tcm.2025.01.003
Luan C V Lima, Lubna Al-Sharif, Matheus Souza
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引用次数: 0
Enhancing cardiovascular prevention: Multimodal physical activity is powerful, but individualisation is the key to better outcomes.
IF 7.3 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-25 DOI: 10.1016/j.tcm.2025.01.004
Matthew Hollings, Chloe Trevor
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引用次数: 0
Atrial fibrillation versus atrial myopathy in thrombogenesis: Two sides of the same coin?
IF 7.3 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-24 DOI: 10.1016/j.tcm.2025.01.002
Panteleimon E Papakonstantinou, José Miguel Rivera-Caravaca, Mauro Chiarito, Hanne Ehrlinder, Panayiotis Iliakis, Aleksandra Gąsecka, Giulio Francesco Romiti, William A E Parker, Gregory Y H Lip

Atrial fibrillation (AF) and atrial myopathy are recognized contributors to cardiovascular morbidity, particularly ischemic stroke. AF poses an elevated risk of thrombogenesis due to irregular heart rhythm leading to blood stasis and clot formation. Atrial myopathy, marked by structural and functional alterations in the atria, is emerging as a crucial factor influencing thromboembolic events, independently of AF. This narrative review article provides an overview of the interwoven relationship between AF and atrial myopathy in thrombogenesis, focusing on the epidemiology, risk factors, and clinical implications of these two entities. The discussion encompasses the association between AF burden and stroke risk, evaluating current evidence and guidelines for anticoagulant therapy. Additionally, it explores the role of atrial myopathy in the pathogenesis of thromboembolic events, emphasizing the patient's clinical profile assessed by the CHA2DS2-VASc score. The manuscript provides insights into ongoing trials and future perspectives, discussing potential advancements in antithrombotic therapy, fibrin clot dynamics, and anti-inflammatory strategies. This comprehensive review challenges the conventional perception of AF as a sole cause of stroke, urging a holistic approach to risk assessment of thrombogenesis and management in the high-risk population that AF patients constitute.

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引用次数: 0
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Trends in Cardiovascular Medicine
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