Anatolian Journal of Cardiology最新文献

Patients with connective tissue diseases (CTDs) are at increased risk for the development of pulmonary hypertension (PH) and pulmonary arterial hypertension (PAH), which is a specific subtype of PH characterized by progressive remodeling of precapillary pulmonary arterioles. Evidence suggests that early detection of PH through screening in this patient group may be associated with better outcomes. Various methods, including cardiac and thoracic imaging, blood biomarkers, pulmonary function tests, and composite algorithms, have been employed for screening of PH. Here, a multidisciplinary consensus group composed of 10 rheumatologists, 4 cardiologists, and 3 pulmonologists was formed with the objective of developing recommendations and a screening algorithm for PH in patients with CTD. A systematic literature review in the PubMed database focusing on the studies evaluating the performance of different screening methods on detecting PH in CTDs was conducted. The literature review identified 33 relevant articles after title, abstract, and full-text evaluation. The included studies had considerable heterogeneity regarding hemodynamic definitions of PH and PAH, the diagnostic cutoff values of screening methods utilized, and the symptom status of the patients. With the exception of 2 studies, the populations in included studies consisted of only patients with systemic sclerosis (SSc). Consensus-based recommendations and an algorithm prioritizing echocardiography for screening and early detection of PH in patients with SSc and patients with CTD exhibiting overlap features of SSc were developed based on literature data and incorporating the perspectives of group members. No recommendations could be made for asymptomatic patients with CTDs without overlap features of SSc due to limited data.

Objective: Although opportunistic infections and malignancies have declined due to antiretroviral therapy, the prevalence of cardiovascular disease (CVD) among people with human immunodeficiency virus (PWH) has increased. This study examines early markers of CVD using transthoracic echocardiography (TTE) performed at rest and after a 6-minute walk test (6-MWT) in PWH. This prospective study was conducted in Türkiye between 2019 and 2022.

Methods: The PWH and healthy individuals were evaluated for demographic and laboratory analysis and examined using TTE at rest and after 6-MWT.

Results: The interventricular septum (IVS) and posterior wall (PW) were significantly thicker in the PWH group than in healthy controls. Pulmonary pulse transit time (pPTT) was markedly reduced in PWH (127.5 ms vs. 457 ms, P < .001). In the PWH group, the E/e' ratio increased after 6-MWT [6.26 (IQR: 5.1-7.3) vs. 5.9 (IQR: 4.9-6.9) at rest (P = .028)]. The PWH with CD4+ counts <350/mm3 exhibited a higher E/e' ratio [6.91 (IQR: 5.05-8.62)] than those with CD4+ counts >350/mm3 [5.41 (IQR: 4.87-6.17); P = .035]. A weak inverse correlation was observed between CD4+ count and E/e' ratio (P = .010, r = -0.348).

Conclusions: The IVS thickness, PW thickness, E/e' ratio, and pPTT may serve as valuable parameters for the early detection of CVD in PWH. Changes in diastolic indices may offer insights into disease progression. The pPTT may be a promising marker for evaluating the pulmonary vascular status and right ventricular function. These findings underscore the need for further research into the diagnostic and prognostic utility of diastolic parameters and pPTT in the clinical management of PWH.

Background: To explore the impacts of cardiac rehabilitation exercise plus sacubitril valsartan sodium on cardiac function, lung function, and quality of life in chronic heart failure (CHF) patients.

Methods: One hundred and forty-six CHF patients admitted to the hospital from January 2023 to December 2024 were chosen and divided into a control group (conventional treatment + sacubitril valsartan sodium) and a study group (conventional treatment + sacubitril valsartan sodium + cardiac rehabilitation exercise).

Results: The total effective rate of the study group was higher when comparing with the control group (P < .05). The study group had higher left ventricular ejection fraction level as well as lower left ventricular end-systolic diameter, left ventricular end-diastolic diameter, and N-terminal pro B-type natriuretic peptide levels when comparing with the control group after 3 months of intervention (P < .01). The study group had higher forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC levels when comparing with the control group following 3 months of intervention (P < .01). The study group had higher SpO2, PaO2, and PaO2/FiO2 levels after 3 months of intervention (P < .01). The study group had longer 6-minute walking test after 3 months of intervention (P < .01). The study group had lower MLHFQ score when comparing with the control group after 3 months of intervention (P < .01). The rate of rehospitalization and incidence of major adverse cardiovascular event (MACE) in the study group were lower than in the control group (P < .05).

Conclusion: Cardiac rehabilitation exercise combined with sacubitril valsartan sodium is effective in treating CHF patients, which improves cardiac function, lung function and blood gas levels, promotes exercise endurance and quality of life, and reduces the rehospitalization rate and MACE incidence in CHF patients.