Cardiology journal最新文献

Background: Both cancer itself and cancer treatment [i.e., chemotherapy (CT) and radiotherapy (RT)] are associated with an increased risk of cardiovascular disease. The influence of cancer treatment on the coronary plaque profile was examined as assessed by integrated-backscatter intravascular ultrasound (IB-IVUS).

Methods: The patients analyzed were those who had undergone surgery, CT, or RT for cancer prior to undergoing percutaneous coronary intervention (PCI) using IVUS between 2010 and 2020. Grayscale and IB-IVUS analyses were performed for the culprit lesion of a coronary artery just before PCI. To determine the association of cancer treatment with outcomes [% plaque volume index (PVI) and % lipid plaque volume (LV)], we used regression models while adjusting for covariates.

Results: A total of 162 chronic coronary syndrome patients who underwent PCI using IVUS were included: 89 received either or both CT and RT ± surgery (CT/RT group), and 73 received surgery alone (surgery group). Compared to the surgery group, the CT/RT group had a high cancer stage, low creatinine and high % LV. By a univariate regression, % PVI was associated with cancer stage (β = -0.16, p = 0.02), RT (β = 0.4, p = 0.02) and HbA1c (β = 0.15, p = 0.01), and % LV was associated with CT/RT (β = 6.93, p = 0.01) and HbA1c (β = 3.65, p = 0.01). After adjustment for covariates, CT/RT was significantly associated with % LV (β = 6.77, p = 0.02), but not with % PVI (β = 0.25, p = 0.15).

Conclusions: Chemotherapy and RT were associated with the coronary plaque profile, but not with the coronary plaque volume. Chemotherapy and RT.

Mitral valve regurgitation is the second most common valve defect in Europe among adults. Primary mitral regurgitation (MR) results from structural abnormalities of the valve apparatus (e.g., leaflet prolapse, chordae rupture), often due to myxomatous degeneration or congenital defects. Secondary MR arises from left ventricular remodeling (e.g., after myocardial infarction or heart failure), leading to functional valve incompetence despite normal valve structure. The choice of treatment depends on the degree of valve regurgitation and the severity of the patient's clinical symptoms. The focus herein is on discussing the anatomy of the mitral valve, the pathophysiology of regurgitation, and diagnostic methods. The qualification process is then outlined for invasive treatment and various methods of mitral valve repair, including new minimally invasive techniques. Transcatheter mitral valve repair methods are discussed, among other methods, "edge-to-edge" repair and transcatheter mitral valve replacement. Publicly available data confirms that the latter is a widely available and safe treatment method, that represents a promising alternative to surgical treatment.

Background: There has been insufficient research on the assessment of exercise capacity in patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI) who exhibit inspiratory muscle weakness (IMW).

Methods: A retrospective cohort study involving CHD patients who underwent PCI at Peking University Third Hospital Heart Rehabilitation Center between January 2019 and December 2021 was conducted. Patients who had undergone inspiratory muscle testing and cardiopulmonary exercise testing (CPET) were included, and their clinical data were collected and analyzed.

Results: A total of 571 post-PCI CHD patients were included in the study. The average age was 60.8 ± 4.3 years, and 479 male patients (83.9%) were included. The average maximal inspiratory pressure (MIP) of the enrolled patients was 90.7 ± 26.1 cm H2O, with 56 patients (9.8%) presenting with IMW. The IMW group had lower peak oxygen uptake (VO2peak) (17.4 ± 4.2 vs. 19.3 ± 5.1 mL/ /min/kg, p < 0.001) and oxygen uptake efficiency slopes (OUES) (1464.7 ± 368.5 vs. 1619.2 ± 400.4, p = 0.004). MIP correlated with VO2peak (r = 0.719, p < 0.001) and OUES (r = 0.622, p < 0.001). Multivariate regression analysis revealed that VO2peak (OR = 0.917, 95% CI = 0.858 ~ 0.980) and history of chronic obstructive pulmonary disease (COPD) (OR = 1.705, 95% CI = 0.934~ 3.112) were independent risk factors for IMW.

Conclusions: After PCI, CHD patients exhibiting IMW, especially those with comorbid COPD, demonstrated reduced exercise tolerance and oxygen uptake efficiency.

Background: Lipoprotein(a) [Lp(a)] is a highly atherogenic particle that significantly increases overall cardiovascular risk. Evidence regarding concentrations of Lp(a) in the Polish general population remains limited, as well as the association between Lp(a) and various clinical characteristics. The aim in this study was to analyze Lp(a) concentration in a Polish population hospitalized in a tertiary referral hospital, compare clinical characteristics between patients with low and high Lp(a) and find the predictors of increased Lp(a) concentrations.

Methods: This was an observational, cross-sectional study. All patients hospitalized in the Clinical Department of Internal Medicine, Endocrinology, Diabetology, and Nephrology in the Czerniakowski Hospital between 01.03.2024 and 08.10.2024 and with measured Lp(a) concentration were consecutively included. Patients were divided into two groups: those with high Lp(a) (≥ 30 mg/dL) and those with low Lp(a) ( < 30 mg/dL). The groups were compared in terms of multiple clinical characteristics. Multiple logistic regression was used to determine independent predictors of high Lp(a). The p-value below 0.05 was considered statistically significant.

Results: Out of 562 patients, 117 had high Lp(a) concentration (20.8%). The groups did not differ in terms of age, sex, or clinical examination findings. In a multiple logistic regression, male sex was associated with a decreased odds ratio of high Lp(a) (OR = 0.2857, 95% CI: 0.1107 to 0.6468, p = 0.01).

Conclusions: High Lp(a) is prevalent in the Polish population, and thus it is important to measure it routinely in each individual at least once in a lifetime and control all other known cardiovascular risk factors to decrease the overall risk.

Background: Heart failure (HF) is a leading cause of hospitalization and mortality, regardless of left ventricular ejection fraction (LVEF). The prevalence of HF with preserved and mildly reduced ejection fraction (HFpEF and HFmrEF) is rising, along with increasing hospitalizations. Patients with HF exhibit varied clinical presentations and therapeutic needs, which depend on HF status rather than solely on LVEF. The study aimed to compare the general characteristics, clinical presentation, and diagnostic features of ambulatory and hospitalized (HOSPs) patients enrolled in the HF-POL study.

Methods: HF-POL was a multicenter observational study in 14 Polish clinical centers, enrolling adult patients with HF and LVEF > 40%, either hospitalized for HF decompensation or under ambulatory care. Data collected included demographics, comorbidities, medications, physical exams, echocardiography, and additional diagnostics.

Results: Among the 1497 patients, 52.5% were men, with a mean age of 75 years and an LVEF of 50%. HOSPs (63.4%) were older, more likely to be women, and more frequently had a new HF diagnosis compared to ambulatory (36.6%). HOSPs had fewer previous HF hospitalizations and lower rates of coronary artery disease and prior myocardial infarction. However, they had higher rates of chronic obstructive pulmonary disease, cancer, and depression. HOSPs were more often treated with beta blockers, mineralocorticoid receptor antagonists, calcium blockers, nitrates, amiodarone, and digoxin, but less often with sodium glucose cotransporter 2 inhibitors.

Conclusions: The HF-POL registry highlighted important differences between hospitalized and ambulatory HF patients, underscoring the need for individualized management, particularly during transitions from hospital to ambulatory care.