Pubblicazioni recenti - cardiac disease
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Ninety-Day Stroke Recurrence in Minor Stroke: Systematic Review and Meta-Analysis of Trials and Observational Studies.
J Am Heart Assoc2024 Apr;():e032471. doi: 10.1161/JAHA.123.032471.
Lim Andy, Ma Henry, Johnston S Claiborne, Singhal Shaloo, Muthusamy Subramanian, Wang Yongjun, Pan Yuesong, Coutts Shelagh B, Hill Michael D, Ois Angel, Kapral Moira K, Knoflach Michael, Woodhouse Lisa J, Bath Philip M, Phan Thanh G,
Abstract
BACKGROUND:
Risk of recurrence after minor ischemic stroke is usually reported with transient ischemic attack. No previous meta-analysis has focused on minor ischemic stroke alone. The objective was to evaluate the pooled proportion of 90-day stroke recurrence for minor ischemic stroke, defined as a National Institutes of Health Stroke Scale severity score of ?5.
METHODS AND RESULTS:
Published papers found on PubMed from 2000 to January 12, 2021, reference lists of relevant articles, and experts in the field were involved in identifying relevant studies. Randomized controlled trials and observational studies describing minor stroke cohort with reported 90-day stroke recurrence were selected by 2 independent reviewers. Altogether 14 of 432 (3.2%) studies met inclusion criteria. Multilevel random-effects meta-analysis was performed. A total of 6 randomized controlled trials and 8 observational studies totaling 45?462 patients were included. The pooled 90-day stroke recurrence was 8.6% (95% CI, 6.5-10.7), reducing by 0.60% (95% CI, 0.09-1.1; =0.02) with each subsequent year of publication. Recurrence was lowest in dual antiplatelet trial arms (6.3%, 95% CI, 4.5-8.0) when compared with non-dual antiplatelet trial arms (7.2%, 95% CI, 4.7-9.6) and observational studies 10.6% (95% CI, 7.0-14.2). Age, hypertension, diabetes, ischemic heart disease, or known atrial fibrillation had no significant association with outcome. Defining minor stroke with a lower National Institutes of Health Stroke Scale threshold made no difference - score ?3: 8.6% (95% CI, 6.0-11.1), score ?4: 8.4% (95% CI, 6.1-10.6), as did excluding studies with n
CONCLUSIONS:
The risk of recurrence after minor ischemic stroke is declining over time but remains important.
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Investigating the impact of couple counseling based on the CHARMS model on sexual quality of life and marital satisfaction of wives of men suffering from myocardial infarction: a study protocol.
Reprod Health2024 Apr;21(1):55. doi: 10.1186/s12978-024-01776-3.
Rabeipoor Soheila, Khademvatani Kamal, Barjasteh Samira, Ghafuri Delniya,
Abstract
INTRODUCTION:
Cardiovascular diseases are a common chronic illness in adults, with implications for health and psychological well-being. These implications not only affect the patients themselves but also impact family members, especially the spouses of patients. One significant issue and consequence of this disease is its impact on marital relationships and sexual satisfaction, which can also influence other dimensions of quality of life. The aim of the current study is to determine the effect of couple counseling based on the CHARMS model on sexual quality of life and marital satisfaction of wives of men suffering from myocardial infarction.
METHOD:
This study is a clinical randomized controlled trial. Sampling will be done on a convenience basis. Participants will be randomly allocated into two groups: control (50 couples) and intervention (50 couples). Couples in 6 groups of 8 members each will attend counseling sessions based con the CHARMS model, with sessions held weekly and lasting for 60 min. Data collection tools will include Demographic information questionnaire, Women's Sexual Quality of Life Questionnaire, Enrich Marital Satisfaction Questionnaire, Sexual Compatibility Questionnaire and Perceived Quality of Relationship Dimensions Questionnaire, which will be completed by women in both groups before and after the intervention. Data will be analyzed using appropriate statistical tests and SPSS software.
DISCUSSION:
This trial will evaluate whether a counseling intervention based on the CHARMS model can enhance sexual quality of life and marital satisfaction of wives of men with myocardial infarction in Urmia city.
TRIAL REGISTRATION:
IRCT code: IRCT20240218061046N1.
© 2024. The Author(s).
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Interpretable machine learning-based clinical prediction model for predicting lymph node metastasis in patients with intrahepatic cholangiocarcinoma.
BMC Gastroenterol2024 Apr;24(1):137. doi: 10.1186/s12876-024-03223-w.
Xie Hui, Hong Tao, Liu Wencai, Jia Xiaodong, Wang Le, Zhang Huan, Xu Chan, Zhang Xiaoke, Li Wen-Le, Wang Quan, Yin Chengliang, Lv Xu,
Abstract
OBJECTIVE:
Prediction of lymph node metastasis (LNM) for intrahepatic cholangiocarcinoma (ICC) is critical for the treatment regimen and prognosis. We aim to develop and validate machine learning (ML)-based predictive models for LNM in patients with ICC.
METHODS:
A total of 345 patients with clinicopathological characteristics confirmed ICC from Jan 2007 to Jan 2019 were enrolled. The predictors of LNM were identified by the least absolute shrinkage and selection operator (LASSO) and logistic analysis. The selected variables were used for developing prediction models for LNM by six ML algorithms, including Logistic regression (LR), Gradient boosting machine (GBM), Extreme gradient boosting (XGB), Random Forest (RF), Decision tree (DT), Multilayer perceptron (MLP). We applied 10-fold cross validation as internal validation and calculated the average of the areas under the receiver operating characteristic (ROC) curve to measure the performance of all models. A feature selection approach was applied to identify importance of predictors in each model. The heat map was used to investigate the correlation of features. Finally, we established a web calculator using the best-performing model.
RESULTS:
In multivariate logistic regression analysis, factors including alcoholic liver disease (ALD), smoking, boundary, diameter, and white blood cell (WBC) were identified as independent predictors for LNM in patients with ICC. In internal validation, the average values of AUC of six models ranged from 0.820 to 0.908. The XGB model was identified as the best model, the average AUC was 0.908. Finally, we established a web calculator by XGB model, which was useful for clinicians to calculate the likelihood of LNM.
CONCLUSION:
The proposed ML-based predicted models had a good performance to predict LNM of patients with ICC. XGB performed best. A web calculator based on the ML algorithm showed promise in assisting clinicians to predict LNM and developed individualized medical plans.
© 2024. The Author(s).
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Extra-Skeletal Manifestations in Osteogenesis Imperfecta Mouse Models.
Calcif Tissue Int2024 Apr;():. doi: 10.1007/s00223-024-01213-4.
Crawford Tara K, Lafaver Brittany N, Phillips Charlotte L,
Abstract
Osteogenesis imperfecta (OI) is a rare heritable connective tissue disorder of skeletal fragility with an incidence of roughly 1:15,000. Approximately 85% of the pathogenic variants responsible for OI are in the type I collagen genes, COL1A1 and COL1A2, with the remaining pathogenic OI variants spanning at least 20 additional genetic loci that often involve type I collagen post-translational modification, folding, and intracellular transport as well as matrix incorporation and mineralization. In addition to being the most abundant collagen in the body, type I collagen is an important structural and extracellular matrix signaling molecule in multiple organ systems and tissues. Thus, OI disease-causing variants result not only in skeletal fragility, decreased bone mineral density (BMD), kyphoscoliosis, and short stature, but can also result in hearing loss, dentinogenesis imperfecta, blue gray sclera, cardiopulmonary abnormalities, and muscle weakness. The extensive genetic and clinical heterogeneity in OI has necessitated the generation of multiple mouse models, the growing awareness of non-skeletal organ and tissue involvement, and OI being more broadly recognized as a type I collagenopathy.This has driven the investigation of mutation-specific skeletal and extra-skeletal manifestations and broadened the search of potential mechanistic therapeutic strategies. The purpose of this review is to outline several of the extra-skeletal manifestations that have recently been characterized through the use of genetically and phenotypically heterogeneous mouse models of osteogenesis imperfecta, demonstrating the significant potential impact of OI disease-causing variants as a collagenopathy (affecting multiple organ systems and tissues), and its implications to overall health.
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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Author Correction: New genetic signals for lung function highlight pathways and chronic obstructive pulmonary disease associations across multiple ancestries.
Nat Genet2024 Apr;():. doi: 10.1038/s41588-024-01752-4.
Shrine Nick, Guyatt Anna L, Erzurumluoglu A Mesut, Jackson Victoria E, Hobbs Brian D, Melbourne Carl A, Batini Chiara, Fawcett Katherine A, Song Kijoung, Sakornsakolpat Phuwanat, Li Xingnan, Boxall Ruth, Reeve Nicola F, Obeidat Ma'en, Zhao Jing Hua, Wielscher Matthias, , Weiss Stefan, Kentistou Katherine A, Cook James P, Sun Benjamin B, Zhou Jian, Hui Jennie, Karrasch Stefan, Imboden Medea, Harris Sarah E, Marten Jonathan, Enroth Stefan, Kerr Shona M, Surakka Ida, Vitart Veronique, Lehtimäki Terho, Allen Richard J, Bakke Per S, Beaty Terri H, Bleecker Eugene R, Bossé Yohan, Brandsma Corry-Anke, Chen Zhengming, Crapo James D, Danesh John, DeMeo Dawn L, Dudbridge Frank, Ewert Ralf, Gieger Christian, Gulsvik Amund, Hansell Anna L, Hao Ke, Hoffman Joshua D, Hokanson John E, Homuth Georg, Joshi Peter K, Joubert Philippe, Langenberg Claudia, Li Xuan, Li Liming, Lin Kuang, Lind Lars, Locantore Nicholas, Luan Jian'an, Mahajan Anubha, Maranville Joseph C, Murray Alison, Nickle David C, Packer Richard, Parker Margaret M, Paynton Megan L, Porteous David J, Prokopenko Dmitry, Qiao Dandi, Rawal Rajesh, Runz Heiko, Sayers Ian, Sin Don D, Smith Blair H, Artigas María Soler, Sparrow David, Tal-Singer Ruth, Timmers Paul R H J, Van den Berge Maarten, Whittaker John C, Woodruff Prescott G, Yerges-Armstrong Laura M, Troyanskaya Olga G, Raitakari Olli T, Kähönen Mika, Pola?ek Ozren, Gyllensten Ulf, Rudan Igor, Deary Ian J, Probst-Hensch Nicole M, Schulz Holger, James Alan L, Wilson James F, Stubbe Beate, Zeggini Eleftheria, Jarvelin Marjo-Riitta, Wareham Nick, Silverman Edwin K, Hayward Caroline, Morris Andrew P, Butterworth Adam S, Scott Robert A, Walters Robin G, Meyers Deborah A, Cho Michael H, Strachan David P, Hall Ian P, Tobin Martin D, Wain Louise V,
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Cost-utility analysis of palivizumab for preventing respiratory syncytial virus in preterm neonates and infants in Colombia.
BMC Infect Dis2024 Apr;24(1):418. doi: 10.1186/s12879-024-09300-5.
Ordóñez Jaime E, Huertas Victor M,
Abstract
AIM:
Palivizumab has proven effective in reducing hospitalizations, preventing severe illness, improving health outcomes, and reducing healthcare costs for infants at risk of respiratory syncytial virus (RSV) infection. We aim to assess the value of palivizumab in preventing RSV infection in high-risk infants in Colombia, where RSV poses a significant threat, causing severe respiratory illness and hospitalizations.
METHODS:
We conducted a decision tree analysis to compare five doses of palivizumab with no palivizumab. The study considered three population groups: preterm neonates (??35 weeks gestational age), infants with bronchopulmonary dysplasia (BPD), and infants with hemodynamically significant congenital heart disease (CHD). We obtained clinical efficacy data from IMpact-RSV and Cardiac Synagis trials, while we derived neonatal hospitalization risks from the SENTINEL-1 study. We based hospitalization and recurrent wheezing management costs on Colombian analyses and validated them by experts. We estimated incremental cost-effectiveness ratios and performed 1,000 Monte Carlo simulations for probabilistic sensitivity analyses.
RESULTS:
Palivizumab is a dominant strategy for preventing RSV infection in preterm neonates and infants with BPD and CHD. Its high efficacy (78% in preventing RSV in preterm infants), the substantial risk of illness and hospitalization, and the high costs associated with hospitalization, particularly in neonatal intensive care settings, support this finding. The scatter plots and willingness-to-pay curves align with these results.
CONCLUSION:
Palivizumab is a cost-saving strategy in Colombia, effectively preventing RSV infection in preterm neonates and infants with BPD and CHD by reducing hospitalizations and lowering healthcare costs.
© 2024. The Author(s).
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Global characterization of myeloid cells in the human failing heart.
Sci Bull (Beijing)2024 Mar;():. doi: S2095-9273(24)00198-1.
Zhang Si, Tang Tingting, Zhu Yicheng, Zhang Xuzhe, Liu Jinping, Cai Jie, Zhang Lingxue, Xia Ni, Nie Shaofang, Zhang Min, Zhu Zhengfeng, Hu Desheng, Wang Weimin, Zhang Li, Liao Yuhua, Dong Nianguo, Cheng Xiang,
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Clinical and cardiac CT characteristics of congenital coronary abnormalities occasionally detected in a middle-aged population: A long-term follow-up study.
J Cardiovasc Comput Tomogr2024 Apr;():. doi: S1934-5925(24)00076-5.
Conte Edoardo, Marchetti Davide, Melotti Eleonora, Schillaci Matteo, Mushtaq Saima, Maffi Vanessa, Pontone Gianluca, Bartorelli Antonio, Andreini Daniele,
Abstract
INTRODUCTION:
Congenital coronary artery anomalies (CCAA) represent one of the most challenging conditions as their clinical presentation may range from sudden cardiac death to a complete subclinical form. The aim of the present study was to evaluate the diagnostic and prognostic role of cardiac CT (CCT) evaluation in patients with CCAA, focusing on anomalies of origin.
MATERIAL AND METHODS:
The present is a retrospective analysis of a prospective clinical registry including a consecutive cohort of patients who underwent clinically indicated CCT from January 2007 to October 2015 for suspected but unknown coronary artery disease (CAD) and were diagnosed for having a congenital coronary abnormality compared to a control group matched for age, sex and segment stenosis score (SSS). Dedicated analysis of all CCT was performed for the present study and only coronary anomalies of origin were considered and included in the study. Two different composite end-points were identified for the present analysis: major cardiovascular events (MACE) and all-cause of death.
RESULTS:
Among the 81 patients with CCAAs enrolled the most frequent anomaly was left main artery absence, which was identified in 41 individuals (50.6%). Forty-five subjects (55.5%) have an anomalous origin of the coronary artery from a different sinus of Valsalva and 45 subjects had also an anomalous course with the retro-aortic being the most common (32%). Eleven participants (13.6%) displayed also an intramural segment, while 10 (10.3%) had a slit-like ostial morphology. At multivariate analysis CT identification of ARCA, anomalous inter-arterial course and abnormal ostial morphology were significantly associated with MACE even when adjusted for age and SSS, without any differences in all-cause mortality between the two groups (6.2% vs 2.4% p ?= ?0.2478).
CONCLUSION:
The result of the present study is that CCT can be successfully used to define the anatomy and features of CAA. It suggested that in middle-aged patients, the identification of high risk characteristics at CT may have a prognostic value in term of cardiovascular events occurrence at follow-up even if the rate of events strictly linked to CCAA is low.
Copyright © 2024 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
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Temporal Analysis in Outcomes of Long-Term Mechanical Circulatory Support: Retrospective Study.
Thorac Cardiovasc Surg2024 Apr;():. doi: 10.1055/s-0044-1782600.
Ondrusek Matej, Artemiou Panagiotis, Bezak Branislav, Gasparovic Ivo, By Theo Mmh de, Durdik Stefan, Lesny Peter, Goncalvesova Eva, Hulman Michal,
Abstract
BACKGROUND:
?Mechanical assist device indications have changed in recent years. Reduced incidence of complications, better survival, and the third generation of mechanical support devices contributed to this change. In this single-center study, we focused on two time periods that are characterized by the use of different types of mechanical support devices, different patient characteristics, and change in the indications.
METHODS:
?The data were processed from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). We retrospectively defined two time intervals to reflect changes in ventricular assist device technology (period 1: 2007-2015; period 2: 2016-20222). A total of 181 patients underwent left ventricular assist device implantation. Device utilization was the following: HeartMate II?=?52 (76.4%) and HeartWare?=?16 (23.6%) in period 1 and HeartMate II?=?2 (1.8%), HeartMate 3?=?70 (61:9%), HeartWare?=?29 (25.7%), SynCardia TAH?=?10 (8.8%), and BerlinHeart EXCOR?=?2 (1.8%) in period 2. The outcomes of the time intervals were analyzed and evaluated.
RESULTS:
?Survival was significantly higher during the second time period. Multivariate analysis revealed that age and bypass pump time are independent predictors of mortality. Idiopathic cardiomyopathy, bypass time, and the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) score are independent predictors of adverse events. Furthermore, the first period was noted to be at an increased risk of the following adverse events: pump thrombosis, gastrointestinal bleeding, and bleeding events.
CONCLUSION:
?Despite the higher risk profile of the patients and persistent challenges, during the second period, there was a significant decrease in mortality and morbidity. The use of the HeartMate 3 device may have contributed to this result.
Thieme. All rights reserved.
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Premature Ventricular Complexes: Assessing Burden Density in a Large National Cohort to Better Define Optimal ECG Monitoring Duration.
Heart Rhythm2024 Apr;():. doi: S1547-5271(24)02393-2.
Krumerman Andrew, Di Biase Luigi, Gerstenfeld Edward, Dickfeld Timm, Verma Nishant, Liberman Leonardo, Amara Richard, Kacorri Ardit, Crosson Lori, Wilk Alan, Ferrick Kevin J,
Abstract
BACKGROUND:
Premature ventricular contractions (PVCs) burden is a risk factor for heart failure and cardiovascular death in patients with structural heart disease. Long-term ECG monitoring can have a significant impact on PVC burden evaluation by further defining PVC distribution patterns.
OBJECTIVE:
This study aimed to ascertain the optimal duration of ECG monitoring to characterize PVC burden and understand clinical characteristics associated with frequent PVCs and NSVT in a large US cohort.
METHODS:
Commercial data (iRhythm's Zio patch) from June 2011 to April 2022 were analyzed. Inclusion criteria were age >18 years, PVC burden ?5%, and wear period ?13 days. PVC burden cutoffs were determined based on AHA/ACC/HRS guidelines for very frequent PVCs (10,000-20,000 over 24 hours). Patients were categorized by PVC densities : Low (
RESULTS:
Analysis of 106,705 patch monitors revealed a study population with mean age of 70.6±14.6 years; 33.6% female. PVC burden was higher in males and those >65 years of age. PVC burden mean error decreased from 2.9% at 24 hours to 1.3% at 7 days, and 0.7% at 10 days. Number of VT episodes per patient increased with increasing PVC burden (p
CONCLUSION:
Extending ambulatory monitoring beyond 24 hours to 7 days or more, improves accuracy of assessing PVC burden. VT frequency and duration vary based on initial PVC density, highlighting the need for prolonged cardiac monitoring.
Copyright © 2024. Published by Elsevier Inc.
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Kidney and Cardiovascular Effectiveness of Empagliflozin Compared to Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes.
Am J Cardiol2024 Apr;():. doi: S0002-9149(24)00268-6.
Edmonston Daniel, Mulder Hillary, Lydon Elizabeth, Chiswell Karen, Lampron Zachary, Shay Christina, Marsolo Keith, Jones W Schuyler, Butler Javed, Shah Raj C, Chamberlain Alanna M, Ford Daniel E, Gordon Howard S, Hwang Wenke, Chang Alexander, Rao Ajaykumar, Bosworth Hayden B, Pagidipati Neha,
Abstract
Placebo-controlled trials of sodium-glucose cotransporter-2 inhibitors (SGLT2i) demonstrate kidney and cardiovascular benefits for people with type 2 diabetes (T2D) and chronic kidney disease (CKD). We used real-world data to compare the kidney and cardiovascular effectiveness of empagliflozin to dipeptidyl peptidase-4 inhibitors (DPP4i), a commonly prescribed antiglycemic medication, in a diverse population with and without CKD. Using electronic health record data from 20 large US health systems, we leveraged propensity overlap weighting to compare outcomes for empagliflozin and DPP4i initiators with T2D between 2016 and 2020. The primary composite kidney outcome included 40% estimated glomerular filtration rate (eGFR) decline, incident end-stage kidney disease (ESKD), or all-cause mortality through 2 years or censoring. We also assessed cardiovascular and safety outcomes. Among 62,197 new users, 20,279 initiated empagliflozin, and 41,918 initiated DPP4i. Over a median follow-up of 1.1 years, empagliflozin prescription was associated with a lower risk of the primary outcome (HR 0.75, 95% CI 0.65-0.87) compared with DPP4i. Risks for mortality (HR 0.76, 95% CI 0.62-0.92) and a cardiovascular composite of stroke, myocardial infarction, or all-cause mortality (HR 0.81, 95% CI 0.70-0.95) were also lower for empagliflozin initiators. No difference in heart failure hospitalization risk between groups was observed. Genital mycotic infections were more common in patients prescribed empagliflozin (HR 1.72, 95% CI 1.58 - 1.88). Empagliflozin was associated with a lower risk of the primary outcome in patients with CKD (HR 0.68, 95% CI 0.53-0.88) and those without CKD (HR 0.79, 95% CI 0.67 - 0.94). In conclusion, initiation of empagliflozin was associated with a significantly lower risk of kidney and cardiovascular outcomes compared with DPP4i over a median of just over 1 year. The association with a lower risk for clinical outcomes was apparent even for people without known CKD at baseline.
Copyright © 2024. Published by Elsevier Inc.
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Pregnancy in women with dilated cardiomyopathy genetic variants.
Rev Esp Cardiol (Engl Ed)2024 Apr;():. doi: S1885-5857(24)00128-2.
Restrepo-Córdoba María Alejandra, Chmielewski Przemyslaw, Truszkowska Gra?yna, Peña-Peña María Luisa, Kubánek Milo?, Krebsová Alice, Lopes Luis R, García-Ropero Álvaro, Merlo Marco, Paldino Alessia, Peters Stacey, Jurcut Ruxandra, Barriales-Villa Roberto, Zorio Esther, Hazebroek Mark, Mogensen Jens, García-Pavía Pablo,
Abstract
INTRODUCTION AND OBJECTIVES:
Limited information is available on the safety of pregnancy in patients with genetic dilated cardiomyopathy (DCM) and in carriers of DCM-causing genetic variants without the DCM phenotype. We assessed cardiac, obstetric, and fetal or neonatal outcomes in this group of patients.
METHODS:
We studied 48 women carrying pathogenic or likely pathogenic DCM-associated variants (30 with DCM and 18 without DCM) who had 83 pregnancies. Adverse cardiac events were defined as heart failure (HF), sustained ventricular tachycardia, ventricular assist device implantation, heart transplant, and/or maternal cardiac death during pregnancy, or labor and delivery, and up to the sixth postpartum month.
RESULTS:
A total of 15 patients, all with DCM (31% of the total cohort and 50% of women with DCM) experienced adverse cardiac events. Obstetric and fetal or neonatal complications were observed in 14% of pregnancies (10 in DCM patients and 2 in genetic carriers). We analyzed the 30 women who had been evaluated before their first pregnancy (12 with overt DCM and 18 without the phenotype). Five of the 12 (42%) women with DCM had adverse cardiac events despite showing NYHA class I or II before pregnancy. Most of these women had a history of cardiac events before pregnancy (80%). Among the 18 women without phenotype, 3 (17%) developed DCM toward the end of pregnancy.
CONCLUSIONS:
Cardiac complications during pregnancy and postpartum were common in patients with genetic DCM and were primarily related to HF. Despite apparently good tolerance of pregnancy in unaffected genetic carriers, pregnancy may act as a trigger for DCM onset in a subset of these women.
Copyright © 2024 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
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The role of beat-by-beat cardiac features in machine learning classification of ischemic heart disease (IHD) in magnetocardiogram (MCG).
Biomed Phys Eng Express2024 Apr;():. doi: 10.1088/2057-1976/ad40b1.
Senthilnathan Sengottuvel, Shenbaga Devi S, Sasikala M, Satheesh Santhosh, Selvaraj Raja J,
Abstract
Cardiac electrical changes associated with ischemic heart disease (IHD) are subtle and could be detected even in rest condition in magnetocardiography (MCG) which measures weak cardiac magnetic fields. Cardiac features that are derived from MCG recorded from multiple locations on the chest of subjects and some conventional time domain indices are widely used in Machine learning (ML) classifiers to objectively distinguish IHD and control subjects. Most of the earlier studies have employed features that are derived from signal-averaged cardiac beats and have ignored inter-beat information. The present study demonstrates the utility of beat-by-beat features to be useful in classifying IHD subjects (n=23) and healthy controls (n=75) in 37-channel MCG data taken under rest condition of subjects. The study reveals the importance of three features (out of eight measured features) namely, the field map angle (FMA) computed from magnetic field map, beat-by-beat variations of alpha angle in the ST-T region and T wave magnitude variations in yielding a better classification accuracy (92.7 %) against that achieved by conventional features (81 %). Further, beat-by-beat features are also found to augment the accuracy in classifying myocardial infarction (MI) Vs. control subjects in two public ECG databases (92 % from 88 % and 94 % from 77 %). These demonstrations summarily suggest the importance of beat-by-beat features in clinical diagnosis of ischemia.
© 2024 IOP Publishing Ltd.
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piRNAs as emerging biomarkers and physiological regulatory molecules in cardiovascular disease.
Biochem Biophys Res Commun2024 Apr;711():149906. doi: 10.1016/j.bbrc.2024.149906.
Liu Zhihua, Zhao Xi,
Abstract
Cardiovascular diseases (CVD) represent one of the most considerable global health threats, owing to their high incidence and mortality rates. Despite the ongoing advancements in detection, prevention, treatment, and prognosis of CVD, which have resulted in a decline in both incidence and mortality rates, CVD remains a major public health concern. Therefore, novel diagnostic biomarkers and therapeutic interventions are imperative to minimise the risk of CVD. Non-coding RNAs (ncRNAs) have recently gained increasing attention, with PIWI-interacting RNAs (piRNAs) emerging as a class of small ncRNAs traditionally recognised for their role in silencing transposons within cells. Although the functional roles of PIWI proteins and piRNAs in human cells remain unclear, growing evidence suggests that these molecules are gradually becoming valuable biomarkers for the diagnosis and treatment of CVD. This review provides a comprehensive summary of the latest studies on piRNAs in CVD. This review discusses the roles of piRNAs in various cardiovascular subtypes, including myocardial hypertrophy, heart failure, myocardial infarction, and cardiac regeneration. The perceived insights may contribute novel perspectives for the diagnosis and treatment of CVD.
Copyright © 2024 Elsevier Inc. All rights reserved.
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Prevalence and Risk Factors for Cerebral Palsy in Children With Congenital Heart Disease Based on Risk of Surgical Mortality.
Pediatr Neurol2024 Mar;155():133-140. doi: 10.1016/j.pediatrneurol.2024.02.011.
Ghosh Suman, Lien Ing Grace, Martinez Kerstin, Lin Tracy, Bleiweis Mark S, Philip Joseph, Jordan Lori C, Pavlakis Steven G,
Abstract
BACKGROUND:
Children with congenital heart disease (CHD) have a higher prevalence of motor impairment secondary to brain injury, resulting in cerebral palsy (CP). The purpose of this study is to determine the prevalence of CP in CHD in a single-center cohort, stratify risk based on surgical mortality using Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) categories and identify risk factors.
METHODS:
Retrospective cohort study of pediatric patients registered in the University of Florida (UF) Society of Thoracic Surgeons Congenital Heart Surgery database from 2006 to 2017 with a diagnosis of CHD who continued follow-up for more than two years at UF.
RESULTS:
A total of 701 children with CHD met inclusion criteria. Children identified to have CP were 54 (7.7%). Most common presentation was spastic hemiplegic CP with a Gross Motor Function Classification System of level 2. Analysis of surgical and intensive care factors between the two groups showed that children with CHD and CP had longer time from admission to surgery (P = 0.003), higher STAT categories 4 and 5 (P = 0.038), and higher frequency of brain injury and seizures (P
CONCLUSIONS:
In our cohort, 7.7% children with CHD develop CP; this is significantly higher than the 2010 US population estimate of 0.3%. Our study suggests higher STAT categories, brain injury, and seizures are associated with developing CP in children with CHD.
Copyright © 2024 Elsevier Inc. All rights reserved.
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Advanced cell and gene therapies in cardiology.
EBioMedicine2024 Apr;103():105125. doi: 10.1016/j.ebiom.2024.105125.
Carvalho Adriana Bastos, Kasai-Brunswick Tais Hanae, Campos de Carvalho Antonio Carlos,
Abstract
We review the evidence for the presence of stem/progenitor cells in the heart and the preclinical and clinical data using diverse cell types for the therapy of cardiac diseases. We highlight the failure of adult stem/progenitor cells to ameliorate heart function in most cardiac diseases, with the possible exception of refractory angina. The use of pluripotent stem cell-derived cardiomyocytes is analysed as a viable alternative therapeutic option but still needs further research at preclinical and clinical stages. We also discuss the use of direct reprogramming of cardiac fibroblasts into cardiomyocytes and the use of extracellular vesicles as therapeutic agents in ischemic and non-ischemic cardiac diseases. Finally, gene therapies and genome editing for the treatment of hereditary cardiac diseases, ablation of genes responsible for atherosclerotic disease, or modulation of gene expression in the heart are discussed.
Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.
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Modulation of lipid profile by secretory phospholipase A2 group IIA: Verification with a transgenic mouse model.
Biochem Biophys Res Commun2024 Apr;712-713():149955. doi: 10.1016/j.bbrc.2024.149955.
Liang Ling, Song Jing, Miao Shisheng, Xie Qiang, Li Weihua, Huang Honglang, Shen Dongyan, Zhang Wei,
Abstract
We previously demonstrated a positive relation of secretory phospholipase A2 group IIA (sPLA2-IIA) with circulating high-density lipoprotein cholesterol (HDL-C) in patients with coronary artery disease, and sPLA2-IIA increased cholesterol efflux in THP-1 cells through peroxisome proliferator-activated receptor-? (PPAR-?)/liver X receptor ?/ATP-binding cassette transporter A1 (ABCA1) signaling pathway. The aim of the present study was to examine the role of sPLA2-IIA over-expression on lipid profile in a transgenic mouse model. Fifteen apoE and C57BL/7 female mice received bone marrow transplantation from transgenic SPLA2-IIA mice, and treated with specific PPAR-? inhibitor GW9662. High fat diet was given after one week of bone marrow transplantation, and animals were sacrificed after twelve weeks. Immunohistochemical staining showed over-expression of sPLA2-IIA protein in the lung and spleen. The circulating level of HDL-C, but not that of low-density lipoprotein cholesterol (LDL-C), total cholesterol, or total triglyceride, was increased by sPLA2-IIA over-expression, and was subsequently reversed by GW9662 treatment. Over-expression of sPLA2-IIA resulted in augmented expression of cholesterol transporter ABCA1 at mRNA level in the aortas, and at protein level in macrophages, co-localized with macrophage specific antigen CD68. GW9662 exerted potent inhibitory effects on sPLA2-IIA-induced ABCA1 expression. Conclusively, we demonstrated the effects of sPLA2-IIA on circulating HDL-C level and the expression of ABCA1, possibly through regulation of PPAR-? signaling in transgenic mouse model, that is in concert with the conditions in patients with coronary artery disease.
Copyright © 2024 Elsevier Inc. All rights reserved.
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High expression of CASP1 induces atherosclerosis.
Medicine (Baltimore)2024 Apr;103(16):e37616. doi: 10.1097/MD.0000000000037616.
Li Yongchao, Du Lihong, Meng Lingbing, Lv Chao, Tian Xinping,
Abstract
Atherosclerosis is a chronic, progressive vascular disease. The relationship between CASP1 gene expression and atherosclerosis remains unclear. The atherosclerosis dataset GSE132651 and GSE202625 profiles were downloaded from gene expression omnibus. Differentially expressed genes (DEGs) were screened. The construction and analysis of protein-protein interaction network, functional enrichment analysis, gene set enrichment analysis, and Comparative Toxicogenomics Database analysis were performed. Gene expression heatmap was drawn. TargetScan was used to screen miRNAs that regulate central DEG. 47 DEGs were identified. According to gene ontology analysis, they were mainly enriched in the regulation of stimulus response, response to organic matter, extracellular region, extracellular region, and the same protein binding. Kyoto Encyclopedia of Gene and Genome analysis results showed that the target cells were mainly enriched in the PI3K-Akt signaling pathway, Ras signaling pathway, and PPAR signaling pathway. In the enrichment project of Metascape, vascular development, regulation of body fluid levels, and positive regulation of cell motility can be seen in the gene ontology enrichment project. Eleven core genes (CASP1, NLRP3, MRC1, IRS1, PPARG, APOE, IL13, FGF2, CCR2, ICAM1, HIF1A) were obtained. IRS1, PPARG, APOE, FGF2, CCR2, and HIF1A genes are identified as core genes. Gene expression heatmap showed that CASP1 was highly expressed in atherosclerosis samples and low expressed in normal samples. NLRP3, MRC1, IRS1, PPARG, APOE, IL13, FGF2, CCR2, ICAM1, HIF1A were low expressed in atherosclerosis samples. CTD analysis showed that 5 genes (CASP1, NLRP3, CCR2, ICAM1, HIF1A) were found to be associated with pneumonia, inflammation, cardiac enlargement, and tumor invasiveness. CASP1 gene is highly expressed in atherosclerosis. The higher the CASP1 gene, the worse the prognosis.
Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.
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A rare case of methemoglobinemia in a preterm newborn with unclear etiology.
J Neonatal Perinatal Med2024 Apr;():. doi: 10.3233/NPM-230163.
Abu Zahra M, Jaber Dunia Z, Badran Eman F,
Abstract
Cyanosis is a bluish discoloration of the tissues due to increased levels of deoxygenated hemoglobin in capillaries. It is a common finding in newborn infants that can be caused by different diseases, including pulmonary, cardiac, infectious, and hematological disorders. Methemoglobinemia is a rare cause of cyanosis, in which hemoglobin is oxidized, changing its heme iron configuration from the ferrous (Fe2 +) to the ferric (Fe3 +) state, creating methemoglobin (Met-Hb), a form that does not bind oxygen, leading to decreased oxygen delivery to the tissues and cyanosis. We report a rare case of a preterm newborn, who developed cyanosis and worsening hypoxemia on day ten of life, she was found to have elevated Met-Hb percentage in blood gas analysis that required treatment with intravenous methylene blue. Her symptoms resolved after a period of maintenance treatment with oral methylene blue and ascorbic acid, and the etiology of her disease remains unclear.
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Initiating a Fetal Cardiac Program from Scratch in Low- and Middle-Income Countries: Structure, Challenges, and Hopes for Solutions.
Pediatr Cardiol2024 Apr;():. doi: 10.1007/s00246-024-03479-9.
Rakha Shaimaa,
Abstract
Although fetal cardiac programs are well established in developed countries, establishing an efficient program in low- and middle-income countries (LMICs) is still considered a significant challenge. Substantial obstacles usually face the initiation of fetal cardiac service from scratch in LMICs. The primary structural frame of a successful fetal cardiac program is described in detail, emphasizing the required team members. The potential challenges for starting fetal cardiac services in LMICs include financial, awareness-related, prenatal obstetric screening, sociocultural, psychosocial, and social support factors. These challenges could be solved by addressing these barriers, such as collecting funds for financial support, raising awareness among families and health care providers, telemedicine, building international health partnerships, modifying training protocols for fetal cardiologists and sonographers, and initiating support groups and social services for families with confirmed fetal cardiac disease. Initiating a successful fetal cardiac program requires multi-aspect structural planning. The challenges for program initiation require diverse efforts, from modified training and promoting awareness of care providers and the community to governmental and nonprofit organizations' collaborations for proper building and utilization of program resources.
© 2024. The Author(s).
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