Acta cardiologica最新文献

Background: Previous studies have shown that valvular heart disease (VHD) is closely related to the development of heart-related disease (HRD). However, the current research for the relationship between VHD and HRD is complex and poorly targeted. Meanwhile, these studies lack the support of bibliometric analysis results.

Objective: Our study focused on a bibliometric analysis of published papers on the relationship between VHD and HRDs. The study also attempted to identify the primary authors, institutions and countries to analyse the status and trends of research on VHD and HRDs.

Methods: The PubMed database was searched for publications on VHD and HRD between 2000 and 2023. Python v3.10.8, R v4.2.2 and VOSviewer v1.6.18 software tools were utilised to perform this bibliometric analysis and visualisation.

Results: There were 4,235 qualified publications found in total, with the annual number of publications increasing. According to the analysis of the co-occurrence of keywords, we found that the main research directions are for age, gender, disease diagnosis and treatment. Newly emerging research mainly focuses on heart failure, which is relatively related to VHD.

Conclusion: These results provided a useful perspective on current research and future prospects for the research on the link between VHD and HRD, which could help researchers to select partners and facilitate their research to elucidate the underlying molecular mechanisms of VHD and HRD, including the causes, prevention, and treatment.

Background: In developing countries, rheumatic mitral valve stenosis (MS) is still a problem and its progression leads to left atrial (LA) damage. Due to the complexity of the LA geometry, currently used techniques like antero-posterior dimension (LAD) and 2D echo derived LA volume (LAV) have several limitations that are corrected by 3D derived LA volumes in addition to functional evaluation.

Purpose: To assess the LA functions using 2D speckle tracking echocardiography and 3D transthoracic echocardiography in patients with clinically significant MS in comparison to normal healthy subjects.

Results: Fifty patients and 50 healthy controls were studied. Patients' mean age was 40.2 ± 8.8 years, the majority were female 45(81.8%). 3D indexed LA maximum (LAVmaxI) and minimum (LAVminI) volumes were significantly higher in MS than in the control group, whereas 3D LA EF was significantly lower in MS than in the control group (p 0.001). LA strain reservoir, conduit, and contraction parameters were significantly lower in the MS group than in the control group (p = 0.001). However, only 3D LAEF, 2D LASr, 2D LAScd, and 2D LASct showed a correlation with the mitral valve area with a p < 0.05, but 3D LAVmaxI and 3D LAVminI did not. Additionally, in the comparison of severe and very severe mitral stenosis subgroups, 3D LAVmaxI and 3D LAVminI did not show any statistically significant differences between the two groups, although 3D LAEF, 2D LASr, 2D LAScd, and 3D LASct showed significant difference between the two groups (p < 0.05).

Conclusions: Left atrial functional and structural remodelling has been highlighted in patients with significant rheumatic MS. However, left atrial functional assessment by 3D echocardiography and 2D speckle tracking echocardiography correlate better with mitral valve area than conventional LA size measurements. Whether the functional assessment of the LA has an additive predictive value with regards to patient outcome needs to be interrogated.

Background: This study aims to evaluate the prognostic value of the inflammatory indices i.e. Platelet Lymphocyte Ratio (PLR), Neutrophil Lymphocyte Ratio (NLR), and Systemic Immune Inflammation Index (SII) as potential predictors of Major Adverse Cardiovascular Event (MACE) in patients undergoing Primary Percutaneous Coronary Intervention (PPCI) on Saphenous Vein Graft (SVG) with a history of Coronary Artery Bypass Graft (CABG).

Methods: This retrospective study evaluated 74 patients who underwent PPCI on SVG at a tertiary centre between 2015-2023. Patients were divided based on experiencing MACE within one year. Baseline characteristics and inflammatory markers were compared between groups. Logistic regression identified predictors of MACE.

Results: Of these 78, 74 completed the one-year follow-up and were included in the analysis. MACE occurred in 24 patients. We divided patients into two groups based on the occurrence of MACE. The MACE group had a significantly higher pre-procedural PLR compared to others (Mean difference [95%CI]: 22.24 [1.39, 42.23], p-value: 0.0346), while pre-procedural NLR, and SII, and post-procedural PLR, NLR, and SII were comparable between groups. Left Ventricular Ejection Fraction (LVEF) and pre-procedural PLR were predictors of one-year MACE; however, with low odds ratios (Odds Ratio [95%CI]: 0.91 [0.86, 0.96], 1.02 [1.00, 1.03], respectively). Only LVEF was an independent predictor of MACE. LVEF yielded a better discriminatory power than pre-procedural PLR. Pre-procedural PLR > 104.18 yielded a 70% sensitivity at 54% specificity for one-year MACE.

Conclusion: Pre-procedural PLR and LVEF might be a predictor of one-year MACE following PPCI on SVG in post-CABG patients.

Background: Nocturnal blood pressure dipping is crucial for cardiovascular health, but the effect of exercise on this phenomenon is not well understood. This study aims to investigate how a single session of aerobic exercise impacts nocturnal blood pressure dipping in individuals with hypertension who are on medication.

Methods: Twenty hypertensive adults (67 ± 16 years) participated in a randomised, parallel-group clinical trial. They were randomly assigned to either an exercise or control group. Resting blood pressure was measured after a 20-minute period of comfortable seating in a calm environment. The exercise group performed 40 min of treadmill running/walking at an intensity of 60-70% of their reserve heart rate. The control group remained seated for an equivalent period with reading allowed. Ambulatory blood pressure monitoring was used to measure blood pressure over 24 h. Nocturnal dip was calculated by comparing the mean wakefulness and sleep blood pressure values.

Results: No significant differences were observed between the exercise and control groups in systolic and diastolic blood pressure values at rest, during wakefulness, sleep, or over 24 h. The absolute nocturnal dip also showed no significant differences between the groups for systolic blood pressure (MD = 3.00 [95% CI: -4.77 to 10.77] p = 0.428) or diastolic blood pressure (MD = 4.60 [95% CI: -2.81 to 12.00] p = 0.208). Similarly, the relative nocturnal dip (percentage) did not differ significantly for systolic blood pressure (MD = 0.029 [95% CI: -0.039 to 0.837] p = 0.465) or diastolic blood pressure (MD = 0.047 [95% CI: -0.036 to 0.132] p = 0.250).

Conclusions: A single session of aerobic exercise does not impact the nocturnal dip in systolic and diastolic blood pressure in medication-controlled hypertensive individuals.