Hearts (Basel, Switzerland)最新文献

{"title":"PCSK9 Inhibitors and Anthracyclines: The Future of Cardioprotection in Cardio-Oncology.","authors":"Matthew L Repp, Mark D Edwards, Christopher S Burch, Amith Rao, Ikeotunye Royal Chinyere","doi":"10.3390/hearts5030027","DOIUrl":"https://doi.org/10.3390/hearts5030027","url":null,"abstract":"<p><p>The field of cardio-oncology is an expanding frontier within cardiovascular medicine, and the need for evidence-based guidelines is apparent. One of the emerging focuses within cardio-oncology is the concomitant use of medications for cardioprotection in the setting of chemotherapy regimens that have known cardiovascular toxicity. While clinical trials focusing on cardioprotection during chemotherapy are sparse, an inaugural trial exploring the prophylactic potential of Sodium-Glucose Cotransporter-2 inhibitors (SGLT2is) for anthracycline (ANT)-induced cardiotoxicity has recently commenced. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, though less studied in this oncology demographic, have exhibited promise in preclinical studies for conferring cardiac protection during non-ischemic toxic insults. While primarily used to reduce low-density lipoprotein, PCSK9 inhibitors exhibit pleiotropic effects, including the attenuation of inflammation, reactive oxygen species, and endothelial dysfunction. In ANT-induced cardiotoxicity, these same processes are accelerated, resulting in premature termination of treatment, chronic cardiovascular sequelae, heart failure, and/or death. This review serves a dual purpose: firstly, to provide a concise overview of the mechanisms implicated in ANT-induced cardiotoxicity, and, finally, to summarize the existing preclinical data supporting the theoretical possibility of the cardioprotective effects of PCSK9 inhibition in ANT-induced cardiotoxicity.</p>","PeriodicalId":93563,"journal":{"name":"Hearts (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering the Intricate Molecular Bases of Atrial Fibrillation","authors":"Diego Franco","doi":"10.3390/hearts4040010","DOIUrl":"https://doi.org/10.3390/hearts4040010","url":null,"abstract":"Atrial fibrillation (AF) is the most prevalent electrophysiological disorder in humans [...]","PeriodicalId":93563,"journal":{"name":"Hearts (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135186647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering the Involvement of the Epicardium in Cardiac Diseases","authors":"Rita Carmona, Carmen López-Sánchez, Virginio García-Martinez, Virginio García-López, Ramón Muñoz-Chápuli, Estefanía Lozano-Velasco, Diego Franco","doi":"10.3390/hearts4040011","DOIUrl":"https://doi.org/10.3390/hearts4040011","url":null,"abstract":"The epicardium is a very dynamic cardiac layer with pivotal contributions during cardiogenesis, acting in the postnatal period as an apparently dormant single-cell layer. In mammalian embryos, the epicardium, which originates form the proepicardium, translocates into the pericardial cavity and subsequently rests on the surface of the myocardium. Later, it gives rise to the epicardium-derived cells, which migrate into subepicardial space, invade the developing myocardium, promoting its growth, and contribute to different cell types. Anomalies in the process of epicardial development, the generation of epicardium-derived cells and their signaling mechanisms in different experimental models lead to defective cardiac development, reminiscent of human congenital heart diseases. Furthermore, recent studies have reported that epicardial derivates in adults, i.e., epicardial adipose tissue, are associated with electrophysiological cardiovascular anomalies. Herein, we provide a state-of-the-art review focusing on both congenital and adult heart diseases associated with epicardial development.","PeriodicalId":93563,"journal":{"name":"Hearts (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135186515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durable Continuous-Flow Mechanical Circulatory Support","authors":"John Pepper","doi":"10.3390/hearts4040009","DOIUrl":"https://doi.org/10.3390/hearts4040009","url":null,"abstract":"The prevalence of heart failure in the UK is 1 in 35 people aged from 65 to 74 and 1 in 15 people aged from 75 to 84 [...]","PeriodicalId":93563,"journal":{"name":"Hearts (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135216612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and Safety of Direct Oral Anticoagulants (DOACs) versus Vitamin K Antagonists (VKAs) amongst Patients with Valvular Heart Disease (VHD): A Systematic Review and Meta-Analysis","authors":"Ghanshyam Patel, Beshoy Iskandar, N. Chelikam, Siddhant Jain, Vandit Vyas, Tanvi Singla, Lavanya Dondapati, Ali Bombaywala, A. Peela, Milan Khealani, Sindhu Mukesh, Hariprasad Reddy Korsapati, A. R. Korsapati, H. Regassa, Nitesh Jain, Urvish Patel, V. S. Venkata","doi":"10.3390/hearts4030008","DOIUrl":"https://doi.org/10.3390/hearts4030008","url":null,"abstract":"Background: Both valvular heart disease (VHD) and atrial fibrillation (AF) frequently coexist. AF is an important cause of arrhythmias with a definitive cardiovascular morbidity. The use of either vitamin K antagonists (VKAs/warfarin) or direct oral anticoagulants (DOACs) (also known as new oral anticoagulants (NOACs)) has been the mainstay for preventing stroke and systemic embolism in patients with VHD and/or AF, and this has been broadly discussed. However, there are limited studies on anticoagulation therapy for patients with valvular atrial fibrillation (VAF). The main aim of this meta-analysis was to evaluate the outcomes (stroke–vascular events and intracranial bleeding) following DOAC and VKA treatment amongst patients with VAF. Methods: We identified clinical trials and observational studies published in the last 10 years. A systematic review and a meta-analysis were performed to evaluate the outcomes of patients with valvular atrial fibrillation following DOAC vs. VKA treatment. Data evaluation was performed using Review Manager 5.4; the endpoints were stroke–vascular events and intracranial bleeding following DOAC and VKA treatment amongst VAF patients. Risk ratios (RR) were evaluated with 95% confidence intervals. Using random effects models, forest plots were obtained. Heterogeneity was assessed by using the I2 statistic. Results: Eight studies were included in this metanalysis, and a total of fifteen thousand two hundred and fifteen patients (DOAC (8732) and VKA (6483)) were pooled. We found a significant risk reduction in stroke–vascular events when using DOACs in comparison with using VKAs (pooled RR: 0.76; 95% CI: 0.64–0.90, p = 0.002). A total of 14862 patients (DOAC (8561) and VKA (6301)) were pooled from a total of six studies for intracranial bleeding. We found a significant risk reduction in terms of intracranial bleeding when using DOACs in comparison with using VKAs (pooled RR: 0.43; 95% CI: 0.24–0.77, p ≤ 0.05). Conclusions: When compared to VKAs, DOAC agents were found to have less risk of stroke–vascular events and intracranial bleeding. Further prospective studies are essential to establish the efficacy and safety of DOAC agents in patients with various subtypes of VAF.","PeriodicalId":93563,"journal":{"name":"Hearts (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48150764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Advances in Peripheral Artery Disease","authors":"F. Biscetti","doi":"10.3390/hearts4030007","DOIUrl":"https://doi.org/10.3390/hearts4030007","url":null,"abstract":"Despite its significant impact on patients’ lives and the healthcare system, peripheral arterial disease (PAD) has long been overshadowed by other cardiovascular diseases [...]","PeriodicalId":93563,"journal":{"name":"Hearts (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48677757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring Water Balance to Predict Hospitalization in Patients with Chronic Heart Failure: A Retrospective Study","authors":"Kenichi Hirose, Keita Otsuka, Shinichiro Shiozawa, Go Hirose, M. Shino, Takeo Hokari, Satoru Kohno, Kohzo Nakayama","doi":"10.3390/hearts4030006","DOIUrl":"https://doi.org/10.3390/hearts4030006","url":null,"abstract":"Background: Patients with chronic heart failure often experience repeated acute exacerbations leading to high rates of rehospitalization. Therefore, the management of patients to prevent rehospitalization and retain their physical function is important. Brain natriuretic peptide (BNP) and N-terminal-pro BNP are used to estimate the conditions of patients with chronic heart failure, but some hospitals cannot measure these levels in real time. To overcome this, we used bioelectrical impedance analysis as an alternative. Methods and results: Between April 2017 and December 2019, we measured water balance in the outpatient department of Hirose Hospital in three groups: those who had been hospitalized for chronic heart failure (257 patients), those with chronic heart failure who had not been hospitalized (224 patients), and controls with other chronic diseases (275 patients). We found that water balance was significantly correlated to the history of hospitalization, and age was a confounding bias in this correlation, regardless of whether patients have been hospitalized with chronic heart failure. Moreover, patients who have high extracellular water content/total body water content ratios, even in a stable period, are at risk of becoming unstable and experiencing rehospitalization. Conclusion: Water balance monitoring could be a useful indicator to estimate patient condition in real time and predict improvement in chronic heart failure. This easy-to-use indicator may enable timely management of exacerbation of patient condition and reduce hospitalization events.","PeriodicalId":93563,"journal":{"name":"Hearts (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48862607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic Consequence of Interventional Cardiac Catheterization in the Early Postoperative Period after Congenital Heart Surgery","authors":"D. Eason, A. Rossi, Khalifah Aldawsari, B. Patel, Habiba Farooq, D. Khan","doi":"10.3390/hearts4030005","DOIUrl":"https://doi.org/10.3390/hearts4030005","url":null,"abstract":"While still considered a high-risk procedure, cardiac catheterization during the early postoperative period is being performed more frequently in the current era. Limited data are currently available concerning the acute hemodynamic consequences of these procedures. Therefore, the purpose of this study was to evaluate the safety/efficacy of cardiac catheterization performed within thirty days of congenital heart surgery. We completed a retrospective review of all catheterizations within 30 days of congenital heart surgery. Procedures were performed due to failure to progress or hemodynamic deterioration. There were 1873 congenital heart surgeries during the study period. One hundred and three (6.2%) patients with a median age of 124 days underwent catheterization. Sixty-three cases received interventions, and forty patients underwent diagnostic catheterization. Early cardiac catheterization did not show a significant immediate change in the hemodynamics or inotrope score. Survival for patients undergoing diagnostic Cath (81%) did not differ significantly from the intervention group (89%). Although cardiac catheterization was performed on patients at the highest risk for death in the postoperative period, catheter intervention did not increase the risk of death. Those patients undergoing catheter intervention did not seem to experience major adverse events but achieved mild improvement in tissue perfusion.","PeriodicalId":93563,"journal":{"name":"Hearts (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45699101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premature Cardiovascular Misdiagnosis of Senior Endurance-Trained Athletes","authors":"J. Jackson","doi":"10.3390/hearts4010004","DOIUrl":"https://doi.org/10.3390/hearts4010004","url":null,"abstract":"A mature Caucasian patient, an endurance-trained triathlete (age group), had a routine ECG. The patient was immediately referred to Emergency based on supposed ECG abnormalities indicating a heart attack. This diagnosis was quickly dismissed based on no symptoms, heart rate of 50 BPM, athletic status, excellent health, and no prior cardiovascular problems. The patient had a history of severe white coat hypertension and underwent a further stress test and echocardiogram. The stress test showed exaggerated systolic blood pressures (over 225 mmHg) and high in-clinic basal blood pressures (160/90 mmHg), and the patient was diagnosed as hypertensive with exercise blood pressure close to stroke territory. He was told to stop racing, reduce training, and was prescribed antihypertensive drugs (which he did not take). Subsequent at-home 24 h (values close to 120/80 mmHg) and stress blood pressure measurements reversed that decision when considered in combination with an excellent echocardiogram result. The literature clearly describes endurance-trained athletes with systolic pressures over 225 mmHg Hg as being conditioned with no pathological aspects. Endurance-trained athletes should be examined as special cases in the field of cardiovascular medicine as trained physiological responses often present as cardiac abnormalities, and misdiagnosis can inappropriately change the athlete’s life.","PeriodicalId":93563,"journal":{"name":"Hearts (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43389241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Sodium-Glucose Cotransporter 2 Inhibitors on Clinical and Laboratory Variables in Heart Failure Patients with Reduced Left Ventricular Ejection Fraction in a Latin American Hospital: A Retrospective Study","authors":"M. Speranza-Sánchez, J. P. Díaz‐Madriz, Esteban Zavaleta‐Monestel, J. M. Chaverri-Fernández, Sebastián Arguedas‐Chacón, Marleny Blanco-Jara, Abigail Fallas-Mora, Luis Daniel Velásquez-Alfaro","doi":"10.3390/hearts4010003","DOIUrl":"https://doi.org/10.3390/hearts4010003","url":null,"abstract":"Heart failure (HF) is a syndrome suffered by more than 26 million people worldwide. SGLT2 inhibitors are drugs that have been shown to positively affect the management of HF patients, regardless of their diabetes status. A retrospective observational study was conducted on heart failure patients with reduced ejection fraction (HFrEF) enrolled at the HF clinic, who were on SGLT2 inhibitors. For these patients, baseline and follow-up data were collected and analyzed over time. Changes over time were quantified and statistical analysis was conducted to validate whether the changes were significant. After the screening of all the HF program patients, 24 met the inclusion criteria, with an average age of 68 years. Through the study, it was possible to find a statistically significant difference in the values of NT-ProBNP before and after adding a SGLT2 inhibitor in 14 patients (p = 0.0214). In addition, there was an improvement in the NYHA functional scale of 71% and no significant change in renal function or other laboratory values. Based on the studied parameters and throughout the clinical changes during the follow-up period, it was possible to establish an improvement in HFrEF patients on SGLT2 inhibitors as part of their therapy.","PeriodicalId":93563,"journal":{"name":"Hearts (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47713380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}